Audio (00:00.098)
Their hormones can drop significantly and they don’t feel it, they don’t get any symptoms, and so they don’t do anything. Other women, their estrogen can drop a tiny amount, and their FSH goes up a little bit, like just past ten, and they’ve got every symptom under the sun. And but yet if a doctor looked at her levels and they’d be in range. And so they’d go, Well, you’re fine, you’re in range. But the range for estrodiol is ridiculous.

Audio (00:35.032)
Welcome to the Nutrient Dense Podcast. I’m your host, Hannah Aylward, holistic health coach, functional gut health practitioner, and the founder of Han. So many people are continuously failed by conventional and alternative health care. We are here to do it differently. Alongside my team of functional registered dietitians, I’ve helped hundreds of women around the world overcome their chronic digestive issues when nothing else worked.

I’ve learned a thing or two about what it really takes to transform your health from the inside out, and I’m here to share it all with you. Please keep in mind that this podcast is for educational purposes only and should never be used as medical advice. Now, let’s dive in. Your transformation is waiting.

Audio (01:22.542)
Hello, hello, my dears, and welcome back to another episode of the Nutrient Dense Podcast. Today I have Karen Martell on the podcast, and we were going to be discussing all things perimenopause and menopause, hormone shifts, digestive issues, and how it all kind of connects. Karen Martell is the CEO of Midlife Solutions, a woman’s health clinic and product line specializing in bioidentical hormone therapy and holistic solutions for midlife wellness.

As a certified hormone specialist and transformational nutrition coach, Karen is a leading authority in women’s weight loss, hormone optimization, and metabolic health. Welcome to the podcast, Karen. We’re excited to have you. Well, thank you for having me, Hannah. I’m excited to be here. Yes, amazing. So, as I think many of us do, we kind of get into this work because we needed a solution for ourselves. Would you say that that kind of rings true to you and your story of how you got into this like hormone balancing?

Bioidentical hormone solutions kind of side of everything? Yes, a hundred and fifty percent. Like so much where it was like, you’ve got no choice, but you’re gonna go into this because now you’ve got to help other people. And I keep I always think, did I really need to suffer that much and have all the things happen to me? But that’s what happens. It’s what brings me here to what I’m doing today, which is fantastic, and I love it. So I have to be grateful for the hard times that I went through.

And it started after I had my first baby, which I think is it starts for a lot of women. Their hormonal problems start after having children. Like I just don’t think we’re built anymore to be optimized post pregnancy. Like we’re so nutrient deficient and there’s so many toxins and endocrine disruptors in our environment that then we throw a getting pregnant on top of that.

And it just depletes us even more of all these nutrients that we need for proper hormone function. And so after I had my first baby, I just had this years of all of these hormonal problems and hormonal weight loss resistance. And it’s why I eventually went into what I I’m doing now, which is I wanted to help other women who were experiencing hormonal weight loss resistance.

Audio (03:41.566)
And I became a nutritionist and I was working with women privately. And but that time I had eaten a perfect paleo-based diet for 10 years. I had lost the weight and my digestive issues were fixed. And all of these problems that I had had post-pregnancy, I had gotten rid of and I had apparently cured myself of all these problems. And had somebody asked me then, which was in my 30s, like, what do you think your perimenopause is gonna be like?

Or menopause, I would have been like, well, perimenopause, like pff, and what it yeah, no problem at all. And then, you know, I’m gonna hit 49, 50, I’m gonna lose my period, maybe have a couple of hot flashes, and you know, voila, I’m gonna be in menopause. And I really thought that that was gonna be the case, even though I was dealing with women with hormonal imbalances and problems, and I was doing that every day in my practice.

And so I just was like, well, I’ve got this. Like I eat perfectly, I’m working out, I lift heavy, I prioritize protein, I intermittent fast and do all the things. And then in my early 40s, I hit early menopause. And it hit me like a freight train. And I had every symptom that you could think of, like go down the list. It was like hot flashes, night sweats, dry skin.

Rapid, rapid weight gain, digestive problems, rashes, hair loss, libido loss, suddenly my skin was changing. I it was horrible. And I mean, that’s early for hitting menopause. And it was because I was put on this wrong medication, and it’s a big long story. But basically, I was like, my gosh, if this can happen to me, you know, the nutritionist, it can happen to anybody.

Yeah. And then I started digging in and going, my gosh, women are not being told the right information about the what’s gonna happen with their hormones, what the symptoms are to be looking for, how long like perimenopauses average eight to ten years. It’s like 80% of us are gonna have symptoms of perimenopause. 100% are gonna have

Audio (06:04.244)
inward symptoms, like so you may not feel it outward like hot flashes are nice, so it’s but a hundred percent of us are gonna have detrimental effects on the inside of our body from the loss of these hormones. And we’re not being told when’s a good time to start HRT and what to start and you know what supplements to take and what biohacks that actually work for perimenopause and menopause. So anyways, I reversed

My menopause. I had a normal natural cycle then till a couple years ago. And now I’m 50, I’m in full-blown menopause now. But I was determined after that to get out this information and help women to navigate these years to the best of their ability. Yeah. It’s so needed because women really go through it. I feel like I’m constantly talking to clients and I’m constantly talking to my team and I’m just like,

We really go through it, you know, it’s like birth and being pregnant, like trying to get pr first trying to get pregnant. Well, first trying to not get pregnant. It’s like trying to not get pregnant. And then trying to get pregnant. And then all of the hormone fluctuations that impact everything, our energy and like our metabolic function and our digestive health, and then it’s pregnancy and then it’s postpartum and it’s it’s like so much and then it’s perimetopause and metopause and it’s like, my gosh. Seriously. Yeah.

And you know, not not to have like a victim mindset, but it’s like wow, women really deal with things that are kind of like out of their control, things that are like just happening to them. And we can have these really supportive, healthy habits. And of course there’s always things that we can do to optimize and support ourselves. But it’s like, dang, we really we really go through it on a level that men just No, I always think like, imagine if men went through what we went through, like stopped from.

Freaking presses if the guy went through it. Yeah, I know. If a guy went into the doctor’s office at 45 and was like, hey, doc, my penis is shriveling and I can’t get hard anymore. And I’m depressed and I’m getting gaining weight and I’m emotional, they it would be like, my god, well, here’s your Viagra, here’s this, here’s here’s your testosterone therapy. Like, no hesitation. And yet women are like,

Audio (08:21.106)
we go to our doctor and we’re, do you want birth control pills to control the bleeding? Do you want a hysterectomy? Do you want an antidepressant? It’s like, well, how about some hormones? Yeah. It’s so true. my gosh. So for those that aren’t like 100% clear on what this means, can you break down the difference between perimenopause and menopause and then also what’s happening to the body? Like what does that look like? What are things that women are looking out for or should be looking out for during this time?

Yeah, I think it’s a really good thing to know, especially if you’re younger like yourself, Hannah, where you can then be looking for the signs that you need to be looking out for. And typically we’re seeing perimenopause starting kind of earlier and earlier right now, but it usually late thirties, early forties is when the first symptoms start to show up. But we are seeing it start even sometimes mid-thirties for some women. I think I for sure started perimenopause in my mid-thirties.

Hundred percent. I had kids late, but I was I had very little progesterone. I did get tested. And so I think I was going through early peri like a perimenopause. So looking out for signs that are happening in your 30s, especially late 30s, and then going into early 40s, we stop ovulating as often because we come into this world with a certain amount of eggs. And then once those eggs are starting to go down, the basket’s getting lower and lower, then

Basically, you will stop making the bulk of your progesterone. Because if you don’t ovulate, you’re not going to make the bulk of that progesterone. So when you hit your lathers, I mean, this is why they tell us like have children before you’re 40 because your eggs are going to be dwindling. And especially once you get into your 40s, you’re not left with very viable eggs and or very many viable eggs. So

What women will notice then is heavier periods, insomnia, especially in the second half of your cycle, more extreme PMS symptoms. Women will say, like, geez, I just feel like I get two weeks out of the month where I feel good. And then I go through two weeks of hardcore PMS. And then, you know, they start bleeding out. They’ll say, my gosh, I’m going through like a tampon every five minutes. Like, what’s happening? That’s when you go to the doctor and they’ll say, here’s your.

Audio (10:48.32)
birth control or your hyster or you get a hysterectomy or something. But those are the first little few signs that you can pick up on. And then we’ll see like a five pound weight gain. That’s very, very common. So it’s not a big jump in weight like when your estrogen drops, but you’ll get a couple pounds, five pounds of unexplained weight gain. Just kind of like, I haven’t changed anything. Why am I suddenly gaining weight?

You can have an increase in anxiety because progesterone acts on the GABA receptors of your brain. So without progesterone, sleep gets disrupted. We can have increased anxiety, more PMS, and we become estrogen dominant. Not that we have too much estrogen, but in comparison to that progesterone.

We start getting the estrogen dominant symptoms, which is the weight gain in the stomach and the hips and the butt. You get inflamed breasts or enlarged breasts, and of course, more like I said, more anxiety and sleep problems. And so those are like the most common things that we see in those early years. It can also start to affect thyroids. So some women will actually develop hypothyroidism in perimenopause or menopause because all the hormones work synergistically together.

And so we can start seeing digestive problems in some women, hair loss, low libido. Some for some women, testosterone will start to go down during those early perimenopause years. Testosterone is kind of one of these hormones that because we only make, you know, about half, just less than half of our testosterone in our ovaries, we actually make a lot of it through different conversions from other hormones and then through the adrenal system.

Some women will actually hold on to their testosterone, but we’re seeing kind of more and more that women’s testosterone is dropping. And it’s a very important hormone. It’s actually one of our most abundant hormones when we’re fertile women. And all of your estrogen comes from testosterone in the ovaries. So it converts to the estrogen. So if testosterone starts to go down, then your estrogen is gonna follow that. And then we hit.

Audio (13:03.688)
Mid-40s, usually mid-40s to late 40s, we start to see the estrogen dropping. And this is kind of when all hell breaks loose, basically. Estradiol specifically is the most important and vital hormone for women’s health. And we’ve been taught to fear estrogen because of the old WHI study and and

Breast cancer scares, but now we know from all of the research that actually it’s breast protective. And so we we don’t want to fear estradiol because it is the most important hormone, especially for our metabolic health and bone health and brain health. And so you really want to start watching for the signs of estradiol going down at that point. So we’ve got our early 40s, first four or five years, you’ve gonna you’re gonna see that.

Progesterone, possibly testosterone and thyroid starting to drop. Second half of your 40s, early 50s is when estrogen starts dropping and we start to see metabolic health change. So we’ll see an increase in insulin resistance, definitely an increase in digestive problems. Esterdow actually helps with microbial diversity in the gut, like microbium diversity. It’s really important for the immune system, for our mitochondrial health.

for stress, it helps with depression, can help with sleep, helps with libido, helps with our skin, it helps build collagen in the skin. And so all you can start to see all of these changes happening amongst those things. So you’re gonna see your face changing, thinning, thin skin, vaginal tissue starts to get dry, you can start getting urogenital issues like increased urinary incontinence. You can get yeast infections easier.

Vaginal bacteria, vaginosis. So all of these things can start stacking up. And as I said before, 80% of women, 85% of women will have symptoms of perimenopause, in perimenopause. And this is eight to ten years. So this is the the window in which we should be starting to treat women with.

Audio (15:19.806)
If if you’re a good candidate, bioidentical hormone therapy and lifestyle changes. This is critical window. It’s not like wait till you’re in menopause and then we’ll help you, which is what we get when we go to the doctor’s office. Is like, well, that you’re on target. We’re looking at your labs. Everything looks good for where you’re at and how old you are, and see ya, and they don’t test on any specific day. And so it’s awful.

Absolutely awful. But doctors are not trained in menopause therapy. So what are you gonna do? You gotta figure it out for yourself. Yeah. So lots and lots to look out for. And what’s kind of coming through for me is you mentioned we’ll see that drop in progesterone typically start to happen first. And I think we’re seeing women with low progesterone in their twenties due to like chronic stress and under eating and overtraining and lack of sleep and all of this stuff. And then

birth control, use hormonal birth control that’s shutting down ovulation. That’s then essentially preventing, I don’t know if that’s the best word to use, but lowering the body’s progesterone, I guess we could say, to be more kind of accurate there. But as you mentioned, when we ovulate, we produce that kind of robust amount of progesterone. So we’re shutting that down for years. So it’s like we’re on a hormonal birth control. We’re shutting down ovulation for 10 years, 15 years, 20 years. We’re totally stressed.

We’re not eating a good, healthy diet, or if we have deeper gut issues, like in our clients, we’re not absorbing the nutrients from our food efficiently. So it’s like we’re just deficient, deficient, deficient. And then you add in diet culture and you add in overtraining. And it’s like women are low progesterone. I mean, when we see them in their 20s, you know. So it’s so important to address that like early and really try to do what you can there because the body will respond, especially when.

you’re not quite to that perimetapausal state yet. It’s like, let’s get, let’s get a head start on some of this stuff first, kind of before the hormones start to shift without us even being able to like control it, you know? Yeah. And I think that, you know, it’s there’s so many amazing things that we can utilize in those years. If you’re in your twenties, in your thirties, there’s a lot that you can do when it comes to lifestyle changes, lots of herbals.

Audio (17:37.142)
Yep. Stress management, gut health is absolutely critical. Yeah. And all if you put all those things together, depending on what that individual is suffering with, you have a great chance of getting those hormones to come back online, getting your body to metabolize them properly and detox. But once you get to the perimenopause where you are now losing ovarian function.

I think it’s important for women to know that at that point there is no amount of herbs, biohacking, fasting, dieting, gut supplement, anything that’s gonna bring back ovarian function or bring back those hormones. And so if you’re in your early years and you’re experiencing hormonal imbalance, you don’t need to jump to HRT.

Some women can benefit from a little, like a short stint of progesterone therapy. Like if they were on birth control for 10 years and then they come off of it and they’re wanting to regulate that cycle. You can use it in the second half of your cycle to help bring back a normal cycle. But you don’t want to stay, you want you want to encourage your own body to ovulate and encourage it to make that progesterone and be able to metabolize the estrogen that’s in the environment.

Mm-hmm. Yeah, absolutely. I just feel like it’s such a I say like we’re in like a low progesterone epidemic. Like there’s just women that are just, you know, they’re they’re exhausted, they’re stressed, they’re trying to raise children and work and do XYZ. They’re like lucky if they eat three meals a day. And it’s like that is going to have a huge impact on your hormones, especially progesterone production, just due to like basically running on running on cortisol and those other stress hormones. So it’s like

before we get to this perimenopausal state, like please support yourself. Do it now. Do it now. Get a hold on it now. And then and then, you know, we’ll we’ll hit that next stage when it comes. Yeah. We’re we’re being taught by social media, I think, and influencers to be really hard on ourselves. And we think that it’s gonna be healthy for us. You know, like the the fasting you know era that we just went through. I was

Audio (19:58.004)
On that train, absolutely. In the beginning, it was like, Yeah, keto, uh-huh, and let’s intermittent fast and eat one meal a day and eat carnivore. And it was like, woohoo! Then I started seeing clinically all of these women coming in that lost their cycle. Yes, exactly. Because then what are you telling your body? You’re telling your body there’s no nutrients around, there’s no food around, there’s not enough nutrients. So, what’s the first thing that your body’s gonna do? It’s gonna shut down fertility.

Because it thinks that your body can’t handle a pregnancy.

Audio (20:34.606)
We are big fans of eating enough protein over here on Team Han. Protein is essential for muscle repair, a strong gut lining, balanced blood sugar levels, and so much more. For most of our clients, we like recommending around 100 grams of protein per day to start, and adding in a good quality protein powder can be super helpful for hitting those numbers. It’s an easy add-in, you can throw it into a smoothie or even add it to oatmeal. Choosing the right protein powder can feel so overwhelming.

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Audio (22:49.772)
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Audio (24:53.728)
Are you running labs on women and seeing what’s going on with their hormones? Do you ever see estrogen drop before progesterone? Or is it is it more commonly progesterone and then estrogen? No, I see estrogen dropping sometimes first. Yeah. Not very often though. Yeah. Not very often. I definitely see women dropping in estrogen that have PCOS. It’s not called PCOS anymore, but polycystic ovarian syndrome. But those women tend to have

a low level of an enzyme that converts the testosterone to estradiol in the ovaries. And so we will see it in their profile. But yeah, it’s not something that happens often, but we do see it happening where you can see that they ovulated. Yeah. But then and their estrogen was okay in the beginning of their cycle and then suddenly it just plummets in the second half of the cycle. So then it’s like, okay, we’re let’s let’s look into this farther. Yeah. Yeah.

We got a lab back like that recently and I’m like, wow, this is the opposite of what I was expecting. Yeah. Yeah. Yeah. So we’ll see we’ll see it kind of go both ways too. For anyone that’s interested, are you testing at multiple points during the cycle? Like say someone is a woman is like late 30s, early 40s, and she’s like, Okay, some of these things are really starting to that you’re saying they’re resonating with me. I’m like, I’m like waking up in the middle of the night sweating a little bit, like a couple of times.

A month, I’m starting to feel more anxious. My luteal phase has gotten a lot worse. It feels like it’s like longer. That like dreaded, you know, post like ha second half of the cycle luteal phase is getting where it the to the point where you’re like, my gosh, I just have to like I can’t wait for this to be over. And it’s not like three days anymore. It’s like 10 days now. What kind of testing should these women be looking for? What does that look like? So ideally, if if money wasn’t a factor, I would have all women do.

Blood work and and I mean extensive not extensive, but a good amount of blood work where we’re not just looking at the hormones, because as I said before, hormones aren’t working in a silo by themselves. They’re working on and they’re impacting the entire system. So you can see liver enzymes going up, cholesterol going up, blood sugar going up, like

Audio (27:05.208)
There’s so many factors that can be impacted. And so just, you know, basic blood work, you know, CBC panel with differentials. We want to see what the immune system’s doing, you know, your inflammatory markers, your CRP, your fasting insulin, hemoglobin A1C, your lipid panel, like just they’re basic panels, but we wanna see all of that. We wanna see what is your ferritin and your iron stores doing? You know, what’s your B twelve?

Doing because women tend to be very deficient in bees. So getting that done with the hormones is a very good idea. Now, hormones, as we know, they change day to day, hour to hour. And so we want to test on a certain day of the cycle, which is day 21 of a 28-day cycle or seven days prior to the start of your period. And you want to test on that day.

Every time you test hormones, because there is supposed to be a peak of estrogen and progesterone around day 19 to 21. We want to see that what the levels are compared to where they should be in that time frame. And so testing blood, you’re gonna get a total amount of those hormones. You’re gonna see what the estradiol is, what the progesterone levels are, but total levels. There’s free.

And there’s bound. And so that’s gonna give you a collective look at all of the hormone levels. Okay. At the same time, it’s very beneficial if you’re cycling or you’re in, you know, even if you’re regular cycling to do a urine metabolite test because we wanna see.

That gives us a reflection of the free levels of hormones. And free hormone levels is what’s available for your body to use. They’re not bound to a protein. And so that’s gonna give you a better look at what your body’s able to utilize from those hormones. As well, you’re gonna get a cortisol pattern. So we wanna see like what’s the adrenal system doing because that has such an impact on your hormones. And we’re gonna be able to see.

Audio (29:22.36)
How does your body metabolize these hormones? Now, if you’re in menopause, starting with a urine metabolite test doesn’t make any sense because you probably don’t have any very little hormones to metabolize. So we don’t get to see that full picture of are you methylating? How is your sulfation pathways? You know, how is your glutathione pathways? So we want to get this big full picture.

And that has to happen if you are still producing those hormones or you’re on enough HRT that we can see how you’re metabolizing that HRT. A gut test at that time is also ideal because your gut has so much to do with how you break down your hormones, if you’re recycling your estrogen too much or not enough. It’s gonna give you if you’ve got the leaky gut, all of these things that.

are really crucial for hormone health, especially in your perimenopausal years. Like we really want to see how all of these systems are working together. So if money wasn’t a problem, that’s what I would start women with is the blood, the urine, and the gut test. Okay. So you want to test the hormones in the blood and the hormone metabolites in the urine. Yes. Yes. Yeah. And just kind of two different pictures. By two different pictures. Yep.

Okay, interesting. And yeah, if I had to just pick one though, I’m always gonna pick blood work. It is gold standard for testing hormones. And you can test a marker called six hormone binding globulin. And that’s gonna tell us how much of that protein you have in your body that’s binding up testosterone and estrogen. And so that can give us an idea of free hormone levels.

And then you can also test things like L8 luteinizing hormone, follicular stimulating hormone. And that can tell you a lot about kind of where you’re at with your journey into perimenopause. Like, how much are your ovaries struggling right now to ovulate? And when we see FSH going up, it’s like, okay, it’s time maybe first a little bit of HRT because your ovaries are struggling and it gets that level gets higher and higher and higher, the less estrogen you have. Hmm.

Audio (31:38.126)
So it’s a marker of how far into the perimenopause menopause journey are you. Okay. And how frequently would you recommend testing? Like if a woman’s in her late 30s, is it ideal to do this once a year, kind of to see how things are evolving? I yes. Right at that at the late 30s, early 40s, once a year I think is a very good idea because and even start when you’re

feeling great in your 30s so you can have a baseline yeah for later because some women their hormones can drop significantly and they don’t feel it they don’t get any symptoms and so they don’t do anything. Other women they get their estrogen can drop a tiny amount and their FSH goes up a little bit like just past 10 and they’ve got every symptom under the sun.

And but yet if a doctor looked at her levels, and there they’d be in range. And so they’d go, Well, you’re fine, you’re in range. But the range for estrodiol is ridiculous. It’s like if you’re between 50 and 500, you’re good. Like yeah. And so we want to know what’s good for you. I’m really estrogenic. So if my when my estrogen started dropping, it was still well within range, but I was having hot flashes and night sweats and dry skin and dry hair and you know.

I had all these symptoms of really low estrogen, even though it looked quite normal on my labs. So we always want to test, but we also want to go with how do you feel and what symptoms are you having? And then we kind of put it all the puzzle pieces together. Mm-hmm. And would you say that someone should be going with how they feel over the labs? Like maybe they’re in range and they’re like still feeling off. They should listen to that.

Hundred percent. Like really listen to it. And we can feel so dismissed if we go to a physician and they’re like, Yeah, you’re you’re totally fine. Like your estrogen’s fine, your progesterone’s fine. But yet here you are, you know, you know your body the best and you know that things have started changing, that your periods are heavier, that your PMS is horrible, that you can’t tolerate people anymore or whatever it might be.

Audio (33:58.636)
And if you’re having some of those symptoms, especially the mental health stuff, I think it’s so critical that you listen to that and you don’t go by your labs then. If your labs aren’t showing anything abnormal, then okay, something’s going on for you that you’re and your body’s not happy about it. So that could be the drop of estradiol. Estradiol helps us make serotonin, so it does help. And dopamine helps dopamine to stick around longer.

So women can start feeling really depressed, you know, or if the progesterone’s dropping and your body likes to have higher levels of progesterone. So you’re still ovulating, but you’re kind of throwing out these shitty eggs and you’re not actually like having great ovulation. So the progesterone’s subpar, you could be riddled with anxiety. You could be gaining weight, you could have heavy periods just from that small drop of progesterone. Mm-hmm.

Yeah. So really important to listen to your body. Yeah. And it’s so easy for women to be dismissed with this. I mean, if you send lab work to your OBGYN or whatever for an example, as an example, I mean, if they’re they’ll very quickly be like, it’s in range, you’re fine. Even if you’re increasingly anxious or waking up in the middle of the night, you can’t sleep more than five hours a night, you know, like that it’s so common for those things to be happening and them just to say, Everything looks fine.

Yeah. And then here’s your sleeping pill or here’s your antidepressant. When you never had depression before that. When I hit the early menopause, I couldn’t get off my couch. I had never suffered with depression ever. And I was floored and I was so depressed. And I was trying to I remember going like, what’s happening in my life that’s making me this depressed? Like I was trying to put it on something. Yeah. But it was just that my hormones were dropping.

And so like so important that you listen to yourself. And it’s not always the hormones. I’m not saying that it is, but if it’s happening during this your perimenopausal years, and it’s never happened before that, then there’s a good chance that it has to do something with the hormones. A lot of women will develop hypothyroidism because of the loss of these hormones. They never had a thyroid problem ever. We see this all the time in our clinic.

Audio (36:24.044)
Women come in and they’ve got you know, they’re gaining weight, they’re tired, they’re depressed, they think it’s estrogen or progesterone, and it could very well be both of those, but then we look at their thyroid and the their thyroid has tanked. And so we have to optimize that too. Yeah. And are you seeing this as a response? Like, what is that in response to the other hormone shifting, getting older, more wear and tear in the body? Like, why are so many women developing slow thyroid function as as they get a bit older?

It’s a bit of a vicious cycle where progesterone helps to the thyroid to function better. Estrogen helps thyroid receptors to be more sensitive. Testosterone has actually been shown to actually help lower thyroid antibodies. So for Hashimoto’s. So as these hormones are dropping, it’s gonna directly affect the thyroid function. At the same time, we become more insulin resistant when we have issues.

Processing our glucose because estradiol is so important for glucose metabolism and it even if we have estrogen receptors in the hunger centers of our brain. So we get dysregulated eating patterns and hunger signals and and then that can then affect like the insulin resistance can then affect thyroid function.

And then on top of all of this, estrogen and progesterone both affect gut integrity. And we convert a lot of our T4 to T3, the active thyroid hormone, in the gut. Yeah. And so now we’ve got gut problems, which then causes a conversion problem, which then causes hypothyroidism. Immune system, we have estrogen receptors on the immune cell. So as estrogen drops, we can develop autoimmune conditions. And the one of the most popular of the autoimmune for women.

Hashimoto’s. Yeah, there’s a lot there. And so why do you see symptoms varying so much woman to woman? You know, it seems like some women can have an okay experience and some women can kind of cruise through until they hit 50. And then some women are kind of feeling this at like 36, you know. So what do you see contributing to the this like difference in in different women? I mean, I think for sure the status of your health does impact.

Audio (38:42.69)
But it can also make no difference. So I just want one to be really clear about that, right? So as I said before, I was like the healthiest version of myself and I had every symptom under the sun. Now, who’s to say it could have been even worse had I not been as healthy as I was, right? So you know, but you of course, yeah, you want to be healthier. You want insulin sensitivity because your insulin can impact all of your hormones as well. Your stress. Right now, women.

are more stressed than I think they’ve ever been. You know, we’re doing it all now. We’re ra having children, raising children, working full-time jobs, expected to bring in the same income as our partners. And we still overdo it everywhere because that’s that’s w how we’re wired. We’re, you know, we we’re the primary caregivers. We’re the ones that do a lot of the cooking, the cleaning, the caretaking of children. And I’m not this is no bash on men. I’ve got a phenomenal husband who does all those things. But

We are just I think far more stressed than we’ve ever been, which I think is impacting our fertility hormones. Yeah, a hundred percent. Yeah, I agree. Cause we have these different axes in the body, right? So like the hypothalamus pituitary ovary axis and all these different

Essentially what’s just showing us everything in functional medicine is just called an axis. Just showing them showing the connections between the different organ systems and how they kind of impact one another, you know? So yeah, I agree. And I do feel like we see I I think it’s like after women have children, it’s such an energy intensive thing for the body to go through. I mean, quite literally creating a life and then breastfeeding and then the like

Post all of the things that come after that, like no sleep for a year or five, and like barely being able to eat and you know, taking a bite of your kids’ food when you’re that’s like all you’re eating for the day, like that kind of thing that is way more common than not. And then like all of the stressors go up and hopefully like the love goes up too, which is awesome. But it’s a hugely energy intensive process. And I think that

Audio (40:48.662)
a lot of women just kind of to no fault of their own just get like caught like trying to survive after, you know? And so the like the repletion aspect of things, like I’m like, you need two years to like fully recover from from having a a child, you know. And I know easier said than done, but it’s like when the body gives all of these resources and the body’s miraculous, but it’s not left with much after that, you know, and then it’s like the hormones and it’s like this crash, you know? Yeah. I think, you know, when you look back at how we used to do it for

millions of years. We would have community and we’d raise children together. And the women would stay at home and you would go with your girlfriends and everybody had their kids and it was way different. And the toxic load was way different. And so now we’ve got these as environment that is loaded with xenoestrogens and chemicals. Our bodies have so much crap in them now.

Like they say babies are being born with over five hundred different chemicals in them. Like that’s insane. And so we wonder, well, why are we having all these endocrine issues? because this is not the environment that we had a hundred years ago, even. And so everything has changed and so and it’s really impacting our hormones and fertility as well. I think both.

And so when you look at all of these things collectively, with the stress, only emotional stress and our lifestyle stress, but the environmental stress, we’re just some women are getting it worse than others. And I think that that’s why. And and then genetics have something to do with it. You know, my mom had a terrible menopause, just like I did. And you will hear that. You will hear women saying that, yeah, my menopause was exactly what my mom said her menopause was like, and her mom said hers was like. So there is a genetic piece.

in there but I do think that even if you don’t have outward symptoms like I said before we’re still all of us are impacted by the inward that happens when we lose these hormones bone health you don’t feel your bones until they break basically but they will all be going down your bones get more and more fragile without these hormones your cardiovascular health your brain health these are things that you can’t feel

Audio (43:12.12)
Happening until it’s quite far down the road, until you break the bone or have the heart attack or you develop dementia. And we know that these hormones can really help to ward off all of the number one killers of humans. Yeah, because as we see estrogen lower, we’ll see cholesterol typically go up, right? So it’s like these women will end up having high cholesterol, they’ll go for their

you know, annual physical or whatever and get a basic blood work panel. And then it’s like all of a sudden they have high cholesterol when they’re eating super healthy diets and they are not, you know, they’re taking care of themselves and all of that. And this hormone component can be like really impacting this. And it can be so confusing for women and and kind of scary too, because it’s like, my gosh, what’s going on? My cholesterol’s going up. I’m eating, you know, like fruits and veggies and beans and nuts and seeds and healthy proteins and

you know, what’s going on here and then we’ll see the thyroid piece overlap with that too, like the slow thyroid function. Blood sugar. Yeah. And in the most healthy women. Like mine went up went up so I was almost insulin resistant and I had had perfect blood sugar my whole life. And I didn’t just suddenly start eating all this sugar. I was a really perfect, like great eater. Yeah. Still I am. But we’ve done thousands of labs in our clinic now. And

You will see it almost in a hundred percent of women. Their LDL and their fasting blood sugar and fasting insulin go up from the drop of these hormones, especially estradiol. And so when a woman gets on HRT, are you seeing these labs renormalize? Sometimes, yes. Sometimes. For sure. Yep. Yeah. Not every time.

But we do see it correcting and slowly over time that starts to lower. It all just depends on the person, like how long have they been in menopause for? You know, is it just are they in perimenopause? How well do they eat? Are they doing the life? Are they have they changed the way they’re working out? Because so many things change with our physiology. Being the cardio bunny in perimenopause, menopause is the worst thing that you can do. And it’s actually gonna drive blood sugar up if you’re not doing it, you know.

Audio (45:19.712)
appropriately for your age. Yep. Yeah. my goodness. So much to get into. So for for women, I’m I’m assuming you, you know, you’re a big fan of HRT, it sounds like. And it would you were heavy heavily impacted by it by taking it, you know? And what would you say to women that are maybe on the fence about it or are feeling like I’ve heard some scary things about it, or is it really for me? How would you kind of navigate that conversation?

So number one, I would say that for the majority of women, it is safe to use HRT. Now there’s gonna be a small subset of women who have had certain types of cancers that will not be a good candidate for HRT. But for the most part, most women can safely use bioidentical hormone replacement therapy. If you’re like, I just don’t want to, I don’t feel like this is

Natural. So I get that a lot. Like, well, we’re supposed to lose these hormones. We’re supposed to go into menopause. I want you to think about the fact that we’re supposed to age. We’re supposed to develop cardiovascular disease in most cases. It’s the number one killer. So

If you turn 65, you turn 70, you go into your doctor’s office, and your doctor says, Hannah, you know, your heart is not doing well. We’re gonna have to give you this medication to help lower your cholesterol and help with your limpids and blah, blah, blah. Would you say to that doctor, you know what? No. This is natural. It’s part of aging. It’s supposed to happen. I’m not gonna take the medication.

I’m not gonna have the heart surgery. You know, I’m not going to take the bone medication because my bones are so fragile that if I break a hip, I have a 50% chance of dying within the year. You know, you wouldn’t, you just wouldn’t say that. Nor would you say that if you developed severe depression and the doctor says, Well, here’s your antidepressant, would you say, Well, it’s natural, like my body’s doing this for a reason.

Audio (47:30.05)
So, no, I’m not going to take that medication. Or you have hypothyroidism, I you have no thyroid, you had you have diabetes, you got no insulin. Are you gonna say, no, I don’t need those hormones because this is what my body’s naturally doing? So when you put it into that time that like that, then it changes it. It changes how it feels. Because if by taking bioidentical hormones can help prevent, and we know this from

really good sound research, it can help prevent all of these things. It helps lower your risk of cancers, like all cancers. It lowers your risk of all causes of mortality. You know, the WHI study, which was done on premrin, like oral estrogen. We have way better estrogen now, but it was done on oral estrogen showed that the women that were on at that estrogen had a 30% reduction in all cause mortality. We know that it

Helps prevent Alzheimer’s and dementia. Well, there’s no cure for Alzheimer’s and dementia. There’s no good drugs for it. And yet, you know, we see there was a great study done in the University of Arizona on 400,000 women. It showed that women that were on HRT estradiol for six years or longer had an up to a seventy percent reduction in developing Alzheimer’s and dementia. Wow. That’s crazy. Yeah.

And so it’s like, well, I would much rather to take bioidentical, which is exactly what my body’s producing, hormones for the rest of my life to help preserve my bones, my heart and my brain and my skin and all of the other things that it in my vaginal tissue, my libido, my mental health. Yes, I would much rather take that than take a whole slew of medications one day to help me ward off all of those things. Yeah. And be able to like sleep through the night.

Yeah. You know. Just that alone, right? Just that alone. Just that alone’s worth it, in my opinion. Cause like nothing is as torturous as that. Seriously. And that’s like number the one of the number one complaints we get. Yeah. The top three is probably weight gain, sleep, and libido. Yeah. And when you see women starting to use biodentical progesterone and estrogen, are you seeing them be able to sleep through the night? my gosh, yes. Absolutely. Yes.

Audio (49:54.496)
And most women it it will fix their sleep problems that developed in perimenopause. If it doesn’t, I mean I just did a whole like three part episode about this on my own podcast, but then there’s other things that we need to look at. And it’s usually the cortisol system because cortisol can come up and then blood sugar gets dysregulated, which then impacts the sleep. Yeah, wakes them up in the middle of the night, right? Okay, amazing. So everyone keep HRT in mind.

If you’re not on it already. But if you are if you don’t want to, I will say this. We don’t turn anybody away in our clinic. Like if nobody wants HRT, well, we’re gonna support you a hundred percent. Like it’s gonna be like, okay, then let’s figure out what else we can do that’s gonna help you help support your system as you go through this time. Yeah, beautiful. And that kind of directly leads into my next question, which is

What are some of these things that women can be focusing on? What are some proactive steps that women can be taking to kind of better support themselves? And or if they’re they don’t feel ready for HRT yet, or maybe they’re just not they’re not that age yet or whatever. Like what things should we be focusing on now to kind of better our experience and support our hormone balance overall? Reduce your stress load everywhere you can. And so that also includes, you know.

Chronic dieting and starvation and fasting and that kind of thing. Like you gotta be really careful, the c chronic cardio. So you we wanna reduce stress wherever we can. And that’s also like get rid of all the chemicals in your environment. You know, no synthetic smells, you know, perfumes, plastics, like clear out everything you can in your immediate environment. Help with, you know, stress reduction. Everybody’s like,

Strength redaction. I do it myself. I’m like, I’ll I’ll relax tomorrow. Like I’m a go, go, go person. But we really need to start being careful because that can impact the hormone so much. Digestion. Like you’re so big on digestion, Hannah. Like this is one of the best things that you can do for hormonal health, especially in your early years, is have good digestion, good microbiome, good, you know, like fix the leaky gut kind of thing. But we big focus on that a hundred percent.

Audio (52:14.69)
We want community. I think as we get older and we start going into perimenopause and menopause, community becomes so vital. And I see this happening to all of the women around me where we need each other more than ever during this time. Yeah. And so find your crew and make sure that you put time in with that community. Make it a point.

Because you know, in our twenties and thirties when we’ve got kids and we gotta we’re most of us are now having careers and going back to school and we’re doing whatever, it’s busy and and you do get kind of closed off in your in your own little home environment. And then as you know, your kids are growing up, you’ve you’ve you’re staying in the relationship at this, like you’ve either gotten rid of the husband or partner or you’re keeping them at that point.

But these years, and it’s about you, it’s about yourself. And it’s like, okay, now I want community. I need to build up my system as much as I can. I need to feed it nutrient dense foods. You want to be lifting heavy, cutting back on that crazy cardio. You want to prioritize your protein because we start to lose our muscle. We start becoming more insulin resistant. And so building muscle is like one of the

Absolute best things you can do for longevity and for insulin sensitivity and for bone health. taking things to support, like get the right supplements. Like, I’m a huge proponent of a good supplement stack because I don’t think we can get it all from our diet and lifestyle anymore. So find the things that your body needs, you know, do genetic testing, find out what your body has problems with. So you’re not having the big, you know.

supplement graveyard in in the kitchen that we all have. Like get specific about what does your body need. Get really individual and build those systems up in the body so that you can have a better chance of kind of getting through these years as best as possible. And when you do this, Hannah, I’ll just like little shed some light on this because I know there’s been a lot of like, here’s what’s coming. Yep.

Audio (54:26.336)
Honestly, if you can optimize your hormones or optimize and all these things that we’re talking about, like lifestyle factors and community and sleep, and you got that dialed in. These honestly are some of the best years of my life. And it’s just it seems like it’s just getting better and better. Like I turned 50 and I’m just like, woohoo! Like I love being 50. You know, early 40s, late 30s were not very fun.

But this, it’s just like it’s just getting better and better and you just become more who you really are and you start asking yourself, like, what do I want? Like, we don’t get to do that, it seems like, in our twenties and thirties. It’s all about like, what do the kids want? The partner, we need the career, we need you know, it’s this outward focus. Now it’s about going inward and going, What do I want in my life? And it’s awesome. It’s great. It’s it’s honestly some of the best years of my life.

I love that so much. Thank you for sharing. Yeah. Sometimes it can feel a little like doom and doom and gloom, you know. so it’s so nice to hear that. And I do hear I feel like your twenties are very much you’re trying to figure out who the heck you are. And it’s like, prove myself, what do I want? Who am I? And then thirties, you’re like, I’m I know a bit more, but you’re kind of just like running and hustling. It’s like, Are you having kids? The business, the this, the that, the career. And then forties, things start to shift, you know, but it feels like forties, fifties women

tend to they just like don’t have the capacity for the people pleasing anymore. They just don’t have Exactly. They don’t have the capacity for like putting everyone before themselves to the same extent or tiptoeing around everything, walking on eggshells is kind of what I see. And it’s like here’s what it is and that’s that. And here are my boundaries and love you so much, but I gotta go kind of kind of stuff. 100%. And that sounds good to me. It my God, it’s so like, it’s like this big weight off your shoulders. And er I remember

Women telling me that when you get to fifty in your late forties, fifties, you really you go into the don’t give an F club. That’s what they call it. And I was just like, yeah, yeah, you know. And then it happened and I’m like, my god, that’s like this is a real thing. Like I really feel that on the inside, where, you know, if somebody’s not, you know

Audio (56:45.964)
Whatever, if they’re d I don’t agree with somebody. Yeah. Rather than being the people pleaser that I used to be and never wanting to rock the boat, now I’m like, you know what? I do not have time for you. See you later. And that’s really refreshing. Yeah. That sounds good to me. That sounds good to me. Well, beautiful. I think that’s like a a fabulous way to kind of wrap things up. Any last minute thoughts or notes for the women listening that are kind of in this perimetapausal or metopausal chapter of their lives?

Yes. Don’t suffer. Like women are absolutely horrible at going and asking for help. And we were martyrs. We’re just like, I’m gonna tough you know, make my way through this, tough it out. Well, you’re not gonna get a badge for toughing it out. And your whole life can be turned upside down. Like there’s women that have to leave their jobs, their spouses, like really terrible, terrible things. And

Well, you could be living the best life possible. And that’s so super true when it comes to this age. And so if you are feeling off, you know, for sure, go to the doctor first. Likely they’re not gonna be able to help you. Yeah. And if that’s the case, then go get help elsewhere. Don’t stop. Advocate for yourself and your hormones and get the help that you need so that you can feel your

Best. Yeah, beautiful. And where can women learn more from you and about you if they’re interested? So Karen Martell.com, we’ve got a line of product for midlife women where we have like an over-the-counter estrogen face cream because it’s all the hottest rage right now. And we’ve got vaginal moisturizers and progesterone and

Sleep supplements, things like that. And then we have an HRT, a functional HRT clinic, and we can prescribe in every state testosterone, thyroid, progesterone, estrogen, as well as British Columbia, Canada. And then the podcast. I have a top iTunes podcast with over 500 and something episodes called The Hormone Solution. And there’s, of course, just a ton of information on.

Audio (59:03.17)
Yes, amazing, beautiful, thank you. We’ll have all of that linked in the show notes for everyone below. And thank you so much for your time today, Karen. I really appreciate this conversation. Well, thank you for having me.

Thanks for joining me for this episode of the Nutrient Dense podcast. If you found this episode valuable, don’t forget to subscribe, leave a review, share with a friend, and come back next week for a new episode. See you then.