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

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

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Today, we have another episode in a series of conversations with experts and highly vetted companies.

In this episode, we feature CocoaVia, a brand of cocoa flavanol supplements made from a proprietary cocoa extract that aims to support cognition and heart health. I am delighted to welcome Dr. Amy Shah, who trained at Cornell, Harvard, and Columbia. Dr. Shah is a well-known expert on metabolic health and intermittent fasting. With a background in internal medicine, allergies, and immunology, she has helped many patients transform their health with cutting-edge nutritional and medical science. 

In our conversation, we explore cocoa flavanols, explaining what they are, their benefits, and how they work mechanistically. We discuss how perimenopause and menopause can lead to endothelial dysfunction due to low sex hormones, and the effects of lifestyle factors like circadian rhythm alignment. Dr. Shah shares foods she finds particularly helpful for middle-aged women and reviews the research on cocoa flavanols. We also cover the impact of cocoa flavanols on health span, longevity, and brain health, including improvements in memory, word recall, and spatial reasoning, and Dr. Shah offers guidance on supporting the maturation and health of teens and young adults.

Today’s conversation with Dr. Shah is practical and evidence-based. I also share how cocoa flavanols have helped my younger son’s focus and attention, and how my husband and I use these products in our daily lives.

IN THIS EPISODE, YOU WILL LEARN:

How cocoa flavanols support heart health, brain health, and longevity

Why nitric oxide production matters for vascular flexibility, especially in perimenopause

How circadian rhythm optimization improves energy, mood, and metabolic health

Why introducing fiber and probiotic foods slowly may be necessary for gut adaptation

How cocoa flavanols and other bioactives can enhance health span and lifespan

The importance of selecting the right supplement quality and dose to prevent ineffectiveness or excess

How cocoa flavanols can improve cognition, memory, and brain function over 8–12 weeks

Why natural drinks (coffee, cocoa flavanols) are far better than energy drinks or caffeine for teens

How combining core lifestyle habits with targeted bioactive compounds supports long-term health and longevity

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Connect with Dr. Amy Shah

On her website

CocoaVia

I am thrilled to have Gary Taubes back on the show today. (He was with me before on episode 137. Gary is an investigative science and health journalist whose work has been pivotal in catalyzing the low-carb keto movement. He has written many books, including his most recent, Rethinking Diabetes, and his articles are in many of the best anthologies. He has also received many science awards.

Today's discussion is particularly significant, given the recent report from the American Diabetes Association revealing that the annual cost of diabetes in the United States reached a staggering $412.9 billion in 2022, with individuals diagnosed with diabetes now representing one in every four dollars spent on healthcare. 

In our discussion today, we dive into the history of diabetes, pertinent statistics, the prevailing standard of care, and the transformative influence of insulin on diabetes management and reactive hypoglycemia. Gary provides insights into his reactions to GLP ones, the integration of medical and nutrition science into the medical field, and the influence of organizations such as the American Diabetes Association, AHA, USDA, and NIH. Our discussion also extends to the effects of pharmaceuticals, the shortcomings in our approach to diabetes management and existing models, and the challenge the low-carb community faces.

Stay tuned for today's eye-opening conversation, where we shed light on the complexities surrounding diabetes care, explaining how simple lifestyle changes can tremendously improve quality of life.

IN THIS EPISODE YOU WILL LEARN:

Rethinking Diabetes is a groundbreaking exploration of diabetes diagnosis, management, and treatment

Gary discusses the evolution of evidence-based medicine

Why the traditional medical approach to treating diabetes is inadequate

How the guidelines of the American Diabetes Association were based on outdated assumptions 

How medical treatments compare with lifestyle changes for managing diabetes

Controversies surrounding how the pharmaceutical industry has influenced the way medical associations have shaped their diabetes management policies

How medical guidelines and dietary advice have evolved

What constitutes a healthy diet?

How patients often have trouble following diet recommendations, despite their best intentions

Is obesity a hormonal disorder or caused by overeating?

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Previous Episode Mentioned

⁠Ep. 137 – High Blood Sugar Levels And Its Long-Term Damage with Gary Taubes⁠

Book Mentioned:

Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments is available from most bookstores or on ⁠Amazon⁠.

As a nurse practitioner, I feel a deep responsibility to my listeners and community to ensure that every guest I bring on shares accurate, evidence-based information. A few months ago, I decided to remove two podcasts from earlier this year to make way for an expert who could speak specifically and authoritatively on breast cancer health. So, I am honored to welcome Dr. Robin Roth today, better known as The Boobie Docs, on her popular breast health social media platform, where she shares information about breast cancer in a fun and educational way. 

Dr. Roth is an associate professor of radiology, specializing in breast and abdominal imaging. She is also the host of The Girlfriend's Guide to Breast Cancer podcast, created to support those navigating a breast cancer diagnosis or caring for a loved one.

In our discussion today, we dive into misinformation about breast health and breast imaging. We explore the importance of acknowledging disinformation on social media, risk factors for early breast cancer screening, significant and modifiable risk factors, and the effects of dense breast tissue. We examine breast imaging, exploring ultrasound and mammography, the differences between 2D and 3D mammograms (the gold standard), and when to use MRIs. We clarify why thermography and QT imaging are not the gold standard, and why we need to request different types of imaging modalities. We discuss the importance of screenings, challenges, including diagnoses like DCIS, personalized approaches to breast cancer screening, breast cancer staging, and issues with imaging after mastectomies and with implant placement. Dr. Roth also explains how 80% of breast biopsies end up being benign, how to manage anxiety and callbacks for mammograms, how to understand lab reports in plain language terms, and the benefits of supportive resources like cancerbesties.com.

With her expertise and approachable style, Dr. Roth reminds us that proper information can make all the difference when it comes to breast health. You will not want to miss this conversation, especially during Breast Cancer Awareness Month.

IN THIS EPISODE, YOU WILL LEARN:

How online platforms fuel confusion around breast health and imaging

Disinformation may influence breast cancer screening decisions

Modifiable factors that can reduce or increase your risk of breast cancer

Why dense breast tissue matters for imaging accuracy

Ultrasounds, 2D and 3D mammograms, and MRIs 

Thermography and QT imaging are not gold standards

Why every individual DCIS diagnosis needs a personalized approach

Breast cancer staging and how it guides treatment

80% of biopsies are benign, but still essential

How to manage anxiety around callbacks and make sense of lab reports

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Connect with Dr. Robyn Roth

On her website

Social Media: @the boobie docs

Preorder a copy of Everyone Has Boobies

Today, I am thrilled to reconnect with a friend and colleague, Dr. Mariza Snyder, to discuss her new book, The Perimenopause Revolution. 

In our conversation, we explore some of the most pressing challenges around aging, including shame in a youth-obsessed culture, the lack of research on women’s health, and the physical toll of the aging process. We explain why the menstrual cycle should be considered a fifth vital sign, and what happens when metabolic health begins to decline in midlife, highlighting the value of apps and technology in empowering women to track their cycles. Dr. Mariza clarifies why biometrics, VO₂ Max, DEXA scans, and grip strength matter. She also shares her core pillars of metabolic health and the non-negotiables she believes make the most difference for women navigating the perimenopause-to-menopause transition.

I truly enjoyed Dr. Mariza’s book, and I know it will be a powerful resource for women who want to take charge of their metabolic health during perimenopause and beyond.

IN THIS EPISODE, YOU WILL LEARN:

How hormonal shifts in midlife can alter energy, mood, and metabolism in unexpected ways

Changes that ripple through sleep, stress, and cognition during perimenopause

Why, in perimenopause, old diet and exercise strategies often stop working the way they used to 

How cultural messages around aging fuel shame and confusion for women

How DEXA scans reveal much more about your body composition than weighing yourself does

What lab work can reveal about hidden risks 

Why you should consider doing bone and muscle scans early in life

The benefits of daily strength training for maintaining vitality and independence

How regular movement stabilizes energy and glucose levels

Why food choices become a critical foundation during midlife transitions

Bio: 

Dr. Mariza Snyder is a powerhouse advocate for midlife women, leveraging 17+ years as a practitioner, author, and speaker to spark a massive movement for women in perimenopause and beyond. With her top-rated Energized with Dr. Mariza podcast (13 million downloads) and a passionate social media audience with over 400K and 8 million monthly views, she’s a trusted guide—offering science-backed solutions for perimenopause and metabolic health.

Her upcoming book, The Perimenopause Revolution (Hay House, October 2025), is the ultimate resource for women ready to take charge of their health and embrace perimenopause with resilience and confidence.

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Energized with Dr. Mariza Podcast

The Perimenopause Revolution

I’m honored to reconnect with Dr. Felice Gersh today! She is a multi-award-winning physician with dual board certification in OB-GYN and Integrative Medicine. We connected once before in Episode 221, where we spoke about PCOS and metabolic health.

Today, Dr. Gersh joins me to dive into perimenopause and menopause. We discuss various issues surrounding the Women’s Health Initiative and talk about estrogen as a family of hormones, estrogen-mimicking chemicals, synthetic hormones, and oral contraceptives. We get into the importance of thyroid function, the pro-inflammatory state of a loss of estrogen in perimenopause and menopause, and the importance of nutrition and exercise for metabolism. We also speak about the lesser-known changes that occur in menopause, including changes in body odor, constipation, sarcopenia, osteoporosis, and vocal changes. 

I intend to invite Dr. Gersh back again to discuss women and mitochondrial health, and then once again to talk about her latest book, Menopause: The Fifty Things You Need to Know. 

Stay tuned to find out what menopause really is, and what it does to a woman’s metabolic system.

IN THIS EPISODE YOU WILL LEARN:

The Women’s Health Initiative study and its devastating effects

Differences between synthetic and bioidentical hormones

How chronic diseases of aging can be delayed when hormones are incorporated along with other lifestyle refinements

What do hormones do?

Why every immune cell in the body has receptors for vital hormones

Menopause is not defined by a specific moment in time.

Changes that occur physiologically during the perimenopause years

How hormones can change the perimenopause paradigm 

Why perimenopause translates into many sleep issues

Phytoestrogens: nature’s gift to women

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Connect with Dr. Felice Gersh

On her website: ⁠Integrative Medical Group of Irvine⁠

Instagram⁠

All of Dr. Gersh’s books are available on ⁠Amazon⁠

⁠Episode 221 on PCOS with Dr. Felice Gersh⁠

I am delighted to connect with a physician friend and colleague, Dr. Heather Hirsch, today. Dr. Hirsch is an entrepreneur and a board-certified internist by the American Board of Internal Medicine. She is also the Founder and CEO of Health by Heather Hirsch, and has a telemedicine practice offering best-in-class individualized care for perimenopause and menopause.

In our discussion, we explore heavy menstrual cycles and the benefits of journaling and shared decision-making. We discuss common and frustrating causes of weight loss resistance in middle age, the power of strength training and adequate protein intake, and estrogen as a metabolic regulator that is intricately linked to many physical systems, including digestion. We also examine how educating clinicians on shifts in estrogen, progesterone, and testosterone during perimenopause could prevent countless ER visits, and we tackle concerns surrounding contraception and pregnancy prevention in perimenopause, a biopsychosocial approach to low libido, and the often-overlooked silent symptoms Dr. Hirsch often sees in perimenopause and beyond.

Today’s conversation with Dr. Hirsch is truly invaluable. I highly recommend her Perimenopause Survival Guide, written by an internal medicine doctor extremely well-versed in perimenopause and menopause.

IN THIS EPISODE, YOU WILL LEARN:

How hormonal fluctuations disrupt the body and create confusion in perimenopause

The benefits of journaling 

How hormonal and lifestyle shifts disrupt metabolism, weight, and insulin sensitivity during perimenopause

Why body composition changes matter more than your weight

How declining estrogen affects insulin resistance, metabolism, and diabetes risk

The value of shared decision-making 

How hormones, medications, sleep, relationships, and past trauma can cause changes in libido 

How siloed healthcare often leaves perimenopause symptoms misunderstood 

How irregular ovulation increases pregnancy risk and why hormone therapy is not a contraceptive

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Connect with Dr. Heather Hirsch

On her website

YouTube 

Social media: @Heather Hirsch MD

I am thrilled to connect with Anna Runkle today. Anna is known to more than a million subscribers across many platforms as the Crappy Childhood Fairy. For the last 30 years, she has shown people how to heal the symptoms of childhood trauma to live happier, freer, and more fulfilling lives. 

In her work, Anna almost always noticed a haunting sense of disconnection from others as an adult symptom of childhood trauma. Today, she shares her story, and we dive into complex PTSD and shame, exploring the adverse childhood event study, dysregulation, and how neglect affects the brain and impacts emotional regulation, memory, and learning. We discuss disconnection as a trauma response, obstacles to isolation, and finding your voice in complex PTSD and menopause. Anna also shares her daily practice and explains how writing helps to regulate the nervous system. 

You will love this invaluable conversation with Anna, also known as The Crappy Childhood Fairy, who is a fantastic resource for thousands, if not millions.

IN THIS EPISODE, YOU WILL LEARN:

How Crappy Childhood Fairy originated

The differences between Complex PTSD and PTSD

What does dysregulation look like?

Unseen aspects of emotional dysregulation affect daily life

Ways that childhood traumas can impact the brain

How early trauma often leads to a chronic sense of disconnection

Ways those with CPTSD can learn to cope with the stress of dealing with others and start connecting

Anna shares her daily practice technique for emotional regulation

Why the transition to menopause can be particularly hard for trauma survivors

The importance of addressing trauma in healthcare and the need for better education and support for trauma survivors

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Connect with Anna Runkle

On YouTube

Anna’s book, Re-Regulated, is available on most online bookstores 

Pre-order Anna’s new book, Connectability, and insert your receipt number to gain access to exclusive free bonuses.

Today, I am thrilled to reconnect with a previous guest, Dr. Mary Claire Haver. 

Dr. Haver is a board-certified OBGYN, a certified menopause provider, and the founder of Mary Claire Wellness, a private medical practice focusing on women in midlife. Her best-selling book, the Galveston Diet, and her latest New York Times best-seller, The New Menopause, are fabulous resources for middle-aged women.

In our discussion today, we dive into various aspects of perimenopause, looking at the associated challenges. We discuss factors accelerating ovarian aging, the role of contraception, mental health shifts, and the often delayed diagnosis of premature ovarian insufficiency. We examine the differences between hormone replacement therapy and oral contraceptives, discussing the importance of advocacy for women's health and the benefits of vaginal estrogen. We explore the disparity in federal funding for women's health research, the impact of the Women's Health Initiative, body composition changes, the estrabolome, the 30 Plant Challenge, and the advantages of HRT. Dr. Haver also talks about her preferred supplements. 

I'm sure you will find this conversation a valuable resource that you will likely revisit several times.

IN THIS EPISODE YOU WILL LEARN:

Bio: Dr Mary Claire Haver

Dr. Mary Claire Haver is a board-certified OB-GYN who has devoted her adult life to women's health. When she began to experience the changes of menopause and mid-life weight gain, she created her online program, The Galveston Diet, which currently has over 80,000 students. The Galveston Diet is the first and only nutrition program in the world created by a female OB-GYN, designed for women in menopause.

As part of her ongoing research, she became certified in Culinary Medicine in 2019, specializing in medical nutrition. In 2021, Dr. Haver opened Mary Claire Wellness; the clinic was born out of repeated requests from the Galveston Diet students and Dr. Haver's social media followers for personal guidance. 

Dr. Haver lives with her husband and two daughters in Galveston, Texas. She is the author of The Galveston Diet (Rodale; January 10th, 2023).

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Books Mentioned

Dr. Haver’s books, ⁠The Galveston Diet⁠ and ⁠The New Menopause ⁠

⁠The Menopause Brain⁠ and the⁠ XX Brain⁠ by Lisa Mosconi

Previous Episode Mentioned

⁠Ep. 308 Dr. Mary Claire Haver: Weight Gain in Middle Age, Perimenopause and Inflammation

Today, I am thrilled to connect with Dr. Elizabeth Yurth. Dr. Yurth is double board-certified, as a physician in physical medicine and rehabilitation in addition to anti-aging and regenerative medicine. With over 30 years of clinical experience, Dr. Yurth continues to lead the way in orthopedics, cellular and regenerative medicine, and the future of aging.

In our conversation, we explore immunosenescence and its implications for longevity. We discuss the off-label utilization of medications, including low-dose naltrexone, rapamycin, and GLP-1s, and examine other types of peptides, growth hormone secretagogues, and thymic peptides. We speak about hormones and anabolics, highlighting the benefits of anabolics for the bone health of those with osteopenia and osteoporosis. Dr. Yurth also shares her favorite supplements and outlines the key elements for optimal brain health.

This episode is the first of a series of conversations with Dr. Yurth. She will join us again to dive into cardiovascular disease and explore powerful ways to support healthy aging at the cellular level.

IN THIS EPISODE, YOU WILL LEARN:

Why the thymus gland shrinks with age and what that means for immunity

How thymic peptides support immune health, healing, and recovery

The role thymosin alpha-1 plays in modulating the immune system

Why thymosin beta-4 must be cycled for safe healing support

How IGF (Insulin-like Growth Factor) decline impacts muscles, joints, and the brain with aging

How growth hormone secretagogues can safely raise IGF

How BPC-157 (a gastric peptide) aids gut repair, musculoskeletal healing, and brain protection

Why mitochondrial peptides matter for energy, recovery, and repair

How anabolics support bone strength and recovery

How creatine and choline support the brain and muscles

Bio:

Elizabeth Yurth, MD, ABPMR, ABAARM, FAARM, FAARFM, FSSRP, is Co-Founder and Chief Medical Officer of Boulder Longevity Institute, where she has been providing Tomorrow’s Medicine Today to her clients since 2006. 

Dr. Yurth obtained her Medical Degree from the University of Southern California Keck School of Medicine, completed her residency at the University of California – Irvine, and her Fellowship in Sports and Spine Medicine from Stanford-affiliated Sports Orthopedics and Rehabilitation (SOAR) in Palo Alto, CA., along with her 30 years as a practicing orthopedist specializing in sports and spine medicine. 

Dr. Yurth has made it her mission to learn and share the latest scientific research on how to truly heal the body at the cellular level. She is Fellowship trained in Anti-Aging, Regenerative, and Cellular Medicine. She has completed +500 hours of CME training focused on Longevity, Nutrition, Epigenetics, Bioidentical Hormone Replacement Therapy, Regenerative Peptide Treatments, and Regenerative Orthopedic Procedures. 

Dr. Yurth continues to serve as a thought leader in Cellular Medicine, speaking at longevity events across the world and teaching others through her position as a founding faculty member for Seeds Scientific Research and Performance Institute (SSRP), which leads the way in connecting the latest research to clinical practice.

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