Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

It’s Nurse Practitioners Week, and today, we have a special episode to highlight a historic moment in time.

On November 11, the FDA changed the labeling on hormone replacement therapy. 

Join me for a short, focused episode where I read a recently published JAMA article detailing those changes, to keep you up to date on this significant development.

IN THIS EPISODE, YOU WILL LEARN:

How recent FDA updates are changing menopausal hormone therapy

The history of estrogen’s role in heart and bone health

How past research sparked fear around hormone therapy

What the new labeling means for patients and prescribers

How individualized treatment is reshaping dosage and timing decisions.

Updated FDA labeling now distinguishes between systemic and topical therapies

Key considerations for menopause-related urinary and genital health

How these updates will potentially impact women’s long-term health

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I’m excited to share a new AMA episode with you today, dedicated to risk factors specific to women.

In this AMA session, I dive into the lifestyle factors that influence lipids, exploring the latest research and discussing Lp(a) and ApoB. Rather than answering your individual questions, I have woven them into the overall outline to create a cohesive and informative conversation.

IN THIS EPISODE, YOU WILL LEARN:

How women’s lifestyle choices directly affect their lipid profiles

How knowing if you’re a hyper absorber or hyper producer of cholesterol will change your treatment strategy

What the Boston Heart Cholesterol Balance test will reveal about your body’s ability to handle cholesterol

The best treatments for hyper absorbers, and the best treatments for hyper producers

How hard plaque differs from soft plaque, and why that matters for women’s heart health

How the new AI-assisted Clearly scan provides a more complete cardiovascular risk picture than a standard calcium score

How chronic stress and elevated cortisol fuel insulin resistance and inflammation, and damage blood vessel linings

The benefits of Mediterranean-style eating for improving lipid balance, vasomotor symptoms, and overall metabolic health

The importance of managing trauma, stress, and emotional health in midlife

How my “n=1” experiment with Zetia and micro-dosed GLP-1s significantly improved my ApoB and inflammation markers

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Resources: 

Dietary natural products as emerging lipoprotein(a)-lowering agents

The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis

An Update on Lipoprotein(a): The Latest on Testing, Treatment, and Guideline Recommendations

I am thrilled to have Dr. Olivera Bogunovic and Holly Hardman with me on the show today. Dr. Bogunovic is an assistant professor of psychiatry at Harvard Medical School and the medical director of the alcohol, drug, and addiction outpatient program at McLean Hospital. and Holly directed the documentary As Prescribed.

In today’s discussion, we dive into the ongoing benzodiazepine crisis in the United States, with over 92 million prescriptions written each year for medications like Ativan, Valium, Xanax, and Klonopin. We discuss the origin of those drugs in the 1970s as treatments for anxiety and how they lead to tremendous physical dependency. Holly shares her experience with the neurological effects she suffered after long-term use of Klonopin, and we examine challenges in psychiatric care, the need for informed consent, and the impact of social media. We also cover the role of lifestyle, the need for psychotherapy and psychosocial support, and the significance of hope.

This conversation is truly invaluable! Given how frequently benzodiazepines get prescribed, everyone must understand their associated risks and considerations.

IN THIS EPISODE YOU WILL LEARN:

How prescribing practices have evolved over the last two decades

The significant consequences older adults face when they suddenly stop using benzodiazepines 

Holly shares how doctors misinformed her when she began taking Klonopin. 

Holly describes the benzodiazepine-induced symptoms and cognitive issues she experienced

Why people must get informed about the long-term effects of benzodiazepines when consenting to take them

How benzodiazepines work in the body and impact the brain

Why benzodiazepines are ineffective when used long-term for insomnia

The challenges certain people face when accessing psychiatric care

What is BIND, and what are its symptoms?

The significance of diet and holistic approaches for managing mental health, and why community support is essential in the recovery process

Why As Prescribed is an educational documentary for everyone

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Connect with Dr. Olivera Bogunovic

⁠The McLean Hospital⁠ 

The documentary, As Prescribed, is available in the United States and Canada on Prime Video, Apple, Kanopy, Tubi, and Google.

I am honored to connect with board-certified plastic surgeon, Dr. Berry Fairchild, today. Dr. Fairchild blends surgical precision with artistry to create natural, lasting results. Known for her expertise in facial aesthetics and complex breast surgery, she is also deeply committed to philanthropy and ongoing international surgical missions.

In our discussion, we explore how societal expectations shape how women perceive themselves, the complex process of facial aging, and the benefits of a healthy lifestyle in supporting these changes. Dr. Fairchild highlights the essential elements of effective skin care, including hydration and sunscreen, and the use of retinoids, lasers, microneedling, neuromodulators, hyaluronic acid, fillers, and fat transfers, diving into the role of surgery and the value of conversations around various facial and body procedures. She also shares strategies for optimizing post-surgical recovery and how philanthropy has shaped both her personal and professional journeys.

Stay tuned for a truly enlightening conversation with Dr. Berry Fairchild, who is caring and open-minded about listeners’ questions regarding the aging process and ways to address an aging face and body.

IN THIS EPISODE, YOU WILL LEARN:

Facial aging actually starts deep below the skin

How losing even a small amount of weight can alter your facial appearance

Why surgical decisions must always  be individualized

The positioning of the eyebrows and the upper eyelid skin can help determine facial expression.

Why you could still consider surgical improvements even after you have had previous eyelid surgery

Deep-plane vs. SMAS-based facelifts

Importance of choosing a plastic surgeon with proven expertise and proper credentials 

Some surgeries, like breast reductions, go beyond cosmetic value to relieve pain.

Preparing yourself before having surgery for a faster and smoother recovery

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Connect with Dr. Berry Fairchild

On Instagram

TikTok

I am delighted to reconnect with my friend and colleague Robb Wolf today. Robb is a former research biochemist and a two-time New York Times and Wall Street Journal best-selling Author of The Paleo Solution and Wired to Eat. 

In our conversation today, we examine the pitfalls of diet dogmatism, the lure of oversimplified health narratives, and the effects of Giardia. We unpack the seed oil debate, exploring how the longevity craze might actually be making us sicker, and we highlight the benefits of sun exposure and targeted lab testing. We also touch on the neuroscience of obesity and how food exposure shapes overeating and palate fatigue.

As always, my conversation with Robb is insightful, practical, and packed with knowledge, so I know you will find it both inspiring and invaluable.

IN THIS EPISODE, YOU WILL LEARN:

The problem with dogmatic diets

How Giardia impacts gut health

How aggressive screening often creates risks, stress, and costs without improving outcomes

The health benefits of adequate sun exposure

Why consuming seed oils occasionally is not a huge concern

The overwhelming impact of our modern food environment

Why palate fatigue could cause overeating

How our culture has normalized constant indulgence

Some simple lifestyle actions that can yield massive health benefits

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Connect with Robb Wolf

 Robb’s Substack

Today, I am honored to be in conversation with Dr. Brooke Scheller. She is a doctor of Clinical Nutrition, a nationally recognized health expert, and the founder of Functional Sobriety, a nutrition-based program for alcohol reduction. She also wrote How to Eat to Change How You Drink. 

In our conversation today, we discussed the stigmatization of alcohol use and explored the nuances of curiosity and sobriety. We dispel common misconceptions, examine the research on alcohol consumption, tackle the definition of moderation, scrutinize the influence of industry ties, and unravel the issues linked to excessive alcohol consumption. Dr. Scheller also sheds light on how poor absorption affects the gut microbiome and contributes to a leaky gut, providing insightful nutritional strategies to address these concerns. Our conversation also extends to fertility, blood sugar, and the challenges posed by initiatives like Dry January and sober challenges.  

Stay tuned for today’s comprehensive exploration of the relationship between nutrition and alcohol use.

IN THIS EPISODE YOU WILL LEARN:

How the stigma surrounding alcohol use is changing

How does alcohol affect the brain and body?

How alcohol impacts the gut microbiome, intestinal permeability, and nutrient absorption

Dr. Scheller shares her personal experience with alcohol 

How alcohol consumption in middle-aged women could increase inflammation and oxidative stress

How alcohol impacts blood sugar

The link between alcohol consumption and male infertility 

Some suggestions for navigating a Dry January

How alcohol use impacts mental health

Overcoming alcohol addiction through self-awareness and wellness

Bio: Dr. Brooke Scheller DCN, CNS

Dr. Brooke Scheller is a Doctor of Clinical Nutrition, the founder of Functional Sobriety, and the author of How to Eat to Change How You Drink.

After finding freedom from alcohol in 2021, Dr. Brooke took her experience in sobriety and applied her expertise in nutrition and functional medicine to help others change their relationship with alcohol. Her approach results in improved brain health, mood, energy, focus, gut health, and hormone balance. 

Her launch of Functional Sobriety led to the development of her online community, the Functional Sobriety Network, and several online programs with members across the globe. Functional Sobriety offers the first-ever custom supplement program for the sober and sober-curious. As a motivational speaker, Dr. Brooke helps to spread the word about functional nutrition, alcohol-free wellness, and the power of sobriety. 

Connect with Cynthia Thurlow

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Check out Cynthia’s ⁠website⁠

Submit your questions to [email protected]

Connect with Dr. Brooke Scheller

On her ⁠website⁠

⁠Instagram⁠ (@drbrookescheller)

⁠Functional Sobriety⁠

How to Eat to Change How You Drink

I am delighted to connect with Dr. Andrea Matsumura today. Dr. Matsumura, affectionately known as the Sleep Goddess, is a board-certified sleep medicine physician, menopause expert, speaker, and the founder of the Dream Sleep Method. 

In our conversation today, we explore how different life stages impact our sleep quality. We discuss the effects of wearable technology, orthosomnia, and sleep stages, and explain why sleep quality is more important than its quantity. Dr. Matsumura highlights the red flags for sleep, breaks down how sleep deprivation affects our health, and examines specific sleep issues, including sleep-disordered breathing, Upper Airway Resistance Syndrome, chronic insomnia, and the challenges of shift work. She explains why sleep apnea is seen more commonly in menopause, and how it occurs in 67% of menopausal women, yet most fail to realize that they have it. We also tackle the risks of untreated sleep apnea and the sleep syndrome of menopause, sharing ways to address sleep issues with appliances, technology, medications, cognitive behavioral therapy, and ACT therapy, and pointing out those that have proven to be ineffective. 

This conversation with Dr. Matsumura is truly invaluable, and I look forward to reconnecting once her new book is published.

IN THIS EPISODE, YOU WILL LEARN:

How hormone changes in menopause impact airway function and sleep quality.

Why sleep apnea in women often goes undiagnosed 

How fragmented sleep affects brain function and mood

Why even mild sleep apnea can have significant health consequences

How different hormones influence specific stages of sleep.

How hormone therapy can improve sleep quality without curing sleep apnea

The value of oral devices and positional strategies for supporting breathing at night

How CPAP therapy can transform sleep and improve cardiovascular health

The benefits of cognitive behavioral therapy for addressing insomnia 

Why prescription medications and supplements seldom solve long-term sleep problems

Connect with Cynthia Thurlow  

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Connect with Dr. Andrea Matsumura

On her website

Instagram

Pre-order Dr. Andrea’s book, The New Perimenopause.

I am thrilled to reconnect with my dear friend, Dr. Stephanie Estima, today.

In this episode, we dive into questions from listeners once more, exploring topics that range from navigating the challenges of perimenopause and parenting to shifting perspectives on fasting, nutrition, and changes in hunger and thirst cues, especially during perimenopause and menopause. We also examine how dairy may become an inflammatory food item in midlife, the benefits of hormesis, hormone therapy, and so much more.

Our conversation today is honest and warm, so it is like sitting down with two close friends. Both Stephanie and I look forward to sharing many more of these Q&A sessions with you in the future.

IN THIS EPISODE, YOU WILL LEARN:

Some advice for mothers navigating perimenopause 

How to adjust your fasting in midlife

What perimenopause and menopause mean for satiety and hydration signals, and how to adapt

Why some women find dairy problematic in midlife, and how to experiment with reducing it

How hormesis builds resilience, and how stressors, like exercise, fasting, and cold/heat exposure, can improve metabolic and overall health

What you need to consider with hormones like DHEA and pregnenolone

How women with MTHFR can support methylation and detox pathways

The benefits of combining strength training, Zone 2 cardio, and occasional HIIT for fitness in midlife

Why you should embrace your callouses as badges of honor instead of trying to remove them

The value of micro-dosing with peptides and GLP-1s

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Connect with Dr. Stephanie Estima

On Instagram

On her weekly podcast, Better! With Dr. Stephanie

I am honored to connect with Esther Blum today! She is the bestselling author of "Cavewomen Don’t Get Fat," "Eat, Drink, and Be Gorgeous," and most recently, "See Ya Later, Ovulator!". Esther currently maintains a busy virtual practice where she helps women balance hormones, lose stubborn body fat, and treat the root cause of health struggles. 

Today we speak about medical gaslighting, how weight gain does not have to be a part of aging, andropause and menopause, and the Women’s Health Initiative. We dive into physical changes and significant symptoms during perimenopause and menopause, the role of the pelvic floor, deciphering what the dreaded “menopot” is, what does not work, and advocacy in terms of testing and hormones. We also address constipation, weight loss resistance, and how our tolerance for alcohol changes as we age, especially when using bioidenticals or hormone replacement therapy. 

IN THIS EPISODE YOU WILL LEARN:

Connect with Cynthia Thurlow

Follow on ⁠Twitter⁠, ⁠Instagram⁠ & ⁠LinkedIn⁠

Check out Cynthia’s ⁠website⁠

Connect with Esther Blum

On her ⁠website⁠

On ⁠Facebook⁠, ⁠Instagram⁠, ⁠LinkedIn⁠

Get your ⁠free copy of Esther’s Happy Hormone Cocktail⁠

Esther’s Books

⁠Esther’s book, See Ya Later, Ovulator!⁠, by Esther Blum

⁠Cavewomen Don’t Get Fat⁠, by Esther Blum

⁠Eat, Drink, and Be Happy⁠, by Esther Blum

I have received many requests for a masterclass on the gut microbiome, so I am excited to share one with you today.

In our masterclass today, I discuss the microgenderome, explaining how the gut microbiome changes throughout our lives, during puberty, pregnancy, and perimenopause. I cover the key shifts in the microbiome that occur, especially as estrogen and progesterone fluctuate. I unpack the symptoms women experience that indicate their microbiome may be non-optimized, offering practical solutions, including lifestyle strategies, hormones, peptides, and targeted supplements.

My goal is to do a solo episode every month. Please let me know which aspect you enjoyed the most, and what you would like to hear more about in my future monthly solo episodes.

IN THIS EPISODE, YOU WILL LEARN:

Why protein is critical in midlife, and how much of it you need to consume

An easy way to incorporate the many different plant varieties you need to consume every week into your meals 

Why fermented foods and prebiotics are essential for your gut health

The benefits of giving your digestive system a 12-hour break each day

How chronic stress affects your weight, hormones, and gut function

The connection between sleep quality, gut health, and hormonal changes in midlife

How to balance exercise intensity in midlife to support muscle maintenance and recovery

Specific supplements to support gut integrity and energy production

How hormone replacement therapy impacts the metabolism and microbial diversity 

The value of improving your gut health to reduce menopausal symptoms

Connect with Cynthia Thurlow  

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⁠LinkedIn⁠

Check out Cynthia’s ⁠website⁠

Submit your questions to ⁠[email protected]⁠