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Child: Welcome to my Mommy’s podcast.
Katie: Hello and welcome to The Wellness Mama podcast. I’m Katie from wellnessmama.com. And today I am back with Dr. Mariza Snyder to talk about the five pervasive myths about perimenopause that we can all stop believing right now. And some of them might surprise you.
Dr. Mariza is well-qualified to speak on this topic as a functional doctor and a perimenopause and menopause expert. She has literally written the book on a couple of these topics, including her most recent, The Essential Oils Menopause Solution, and her number one national bestseller, The Essential Oils Hormone Solution, which focuses on optimizing women’s health through essential oils. She has done this work for the past 15 years, lecturing at conferences, being featured on all major mainstream media for her work with this, and most importantly, working with many women to reclaim their health and find empowerment, even through perimenopause and menopause. So without further ado, let’s join and learn from Dr. Snyder. Dr. Mariza, welcome back. Thanks for being here again.
Dr. Mariza: Thank you, honey, for having me.
Katie: Well, we had an amazing first conversation about a lot to do with perimenopause, especially hormone levels, symptomology, what to look for, body composition changes. I feel like you built such a strong foundation, and I’ll make sure that episode is linked in the show notes of this one.
In today’s episode, I would really love to tackle and debunk some myths around perimenopause because I know there are voices like yours that are really helping to educate in a wonderful way around this, but it seems like there’s still a lot of pervasive myths floating around that might be doing a disservice to women. So to start off broad, can you walk us through why are there even so many myths? Why does it seem like perimenopause and menopause are so misunderstood? And there’s just so much conflicting information even floating around out there.
Dr. Mariza: Yeah, that’s such a great question, Katie. One of the reasons why we really struggle with this is that there’s a big knowledge gap in the healthcare system. The typical doctor will get about 20 minutes of menopause care or menopause education in medical school. And once they move into residency and specialty, even OBGYNs, I mean, it’s a surgical residency more than anything. And thank goodness that they’re so great at delivering babies.
But there’s really not a lot of menopausal education. I think it’s tied to the type of education that we get as doctors. It’s tied to a lot of beliefs around women as they get older, that there’s a lack of worthiness or that they’re losing their youthfulness or their aliveness. And that there’s, you know, now that they can’t have babies anymore, that maybe their worthiness went away along with that.
But also, you know, thinking about deep into the history of understanding what menopause was, it was as if kind of what we wrote off is that women were just kind of going crazy. They had a wandering womb that left their, you know, it was just, it’s just weird, pervasive myths that kind of have just come through.
And we really didn’t start majorly researching it until we had a drug, basically Premarin, which is horse urine, estrogen, that was marketed to women. And so it’s been marketing, it’s been a lack of education, and most definitely a lack of research.
And in the lexicon, perimenopause wasn’t even a word that we knew until the 1960s. And if we even fast forward, into the 1990s, that particular transition, the perimenopausal transition, wasn’t investigated, wasn’t researched, until 30 years ago. And so even I believe up until five years ago, if you were to type perimenopause in Microsoft Word, it would be it would look like it was a misspelled word, like that’s how far.
You know, and so I would say that not until recently in the last five years where we really identifying and recognizing what perimenopause is. And the reason I feel like it’s having such a major renaissance right now is that women, you know, it’s like nothing they’re having are struggling. They’re on this rollercoaster ride leading into menopause, but there was really no way of identifying what was going on with them. The way that we thought about menopause was that it’s hot flashes and night sweats and maybe vaginal dryness. And if you didn’t have any of, you didn’t have those three top symptoms, then you were dealing with something else. It wasn’t the menopausal transition and menopause.
And so we just weren’t really tying the symptoms together to what the perimenopausal journey was. And so women were just getting dismissed. Even today, a woman needs to see an average of five doctors before, and not that perimenopause is a diagnosis by any means, but to be validated that that’s the experience that they’re in.
So my, I remember when my mom was going through perimenopause, it was really me helping her to identify that that’s what was going on. She was just dealing with all these symptoms. And I think a lot of women are like, is this menopause? Like, what is this? And back then, even 10 years ago, it kind of was just this menopause thing transition. And we didn’t realize that, okay, there’s this perimenopause transitory time. And then menopause is this defining moment, one day at a time where we haven’t had a period for 12 months, and then we move into postmenopause. And so, yeah, I would say, I think it’s 70% of medical students currently wouldn’t be able to identify a perimenopausal woman even today. So we got a ways to go.
Katie: Wow. Well, I’m glad there are voices like yours that are hopefully going to help shorten that gap and increase the knowledge base. But I would love to jump in then because you made such a strong case for why there are so many misconceptions to begin with. But what are the biggest perimenopause myths and what do we need to know to debunk them once and for all?
Dr. Mariza: I think one of the big myths is that once you get through perimenopause and you hit menopause, whatever, all that stuff you were dealing with is gone. That it’s a point in time and ta-da, you’re through it and it’s over. And that is so far from the truth. What I had said early in our last interview was that perimenopause does set off an acceleration of events that really changes our body and creates more risk for chronic conditions down the road.
The loss of these hormones is definitely profound, and it needs to be recognized as such. And really, when I think about menopause, I think of menopause as a late signal, meaning that like osteoporosis or even insulin resistance, like you’re kind of late to the game by the time you get there, things are already been set in motion.
And so it isn’t even menopause that should be garnering our attention. It’s really the transition leading to menopause. We don’t want to wait until our hormones are practically ground zero. These life-giving whole-body hormones. We really want to be paying attention when those symptoms are presenting themselves. You know, all symptoms, subtle or very acute and big need to be tended to. And if these subtle symptoms are an indicator of things coming down the road later, it’s so important for us to listen. And so perimenopause is that opportunity for us to shore up and prioritize our health and the types of pivots that are going to help us to thrive in the second half of our life. So that’s a big myth that I hope we get to debunk.
Katie: Yeah, that makes sense. And we got to touch on like the hormone replacement aspect and like, not just to avoid symptoms, but actually to get into optimal range in our first episode together. But I think it’s such an important point you just made of across the board, not just in perimenopause, but in general, symptoms are messengers. And it’s easy in the Western world to think of them as a bad thing and to try to just get rid of the symptom. But when we reframe that as they’re messengers and they’re giving us valuable information about our body, it puts us in a state of like curiosity and listening and being able to work with our body to hopefully figure out better results and ways to support our body as well. I know we touched in the first episode on body composition changes and weight gain during perimenopause. Are there any myths around that that women can understand?
Dr. Mariza: Yeah, I think the big myth, the big pervasive myth is that it’s inevitable. Like you’re just going to gain weight. You’re just going to get belly fat. And I mean, the stats demonstrate that, yes, there is a change in body composition and in biomarkers that are going out of range. I’ve looked at so much research where we’ve looked at women at the start of perimenopause and biomarkers, blood glucose, triglycerides, HDL, measuring our hip to waist ratio, even blood pressure looks great. They’re ideal. They’re within normal range.
But as they move through perimenopause into menopause and being tested right after menopause, many of those biomarkers are beginning to move out of range. So things are shifting. And as you mentioned, listening to our bodies, looking at these biomarkers over time and listening to those symptoms, you know, if we’re starting to notice a little bit more, a little bit more shift in fat from our booty and our thighs over to our belly, it’s worthwhile to be paying attention and also looking at those biomarkers at the same time.
But even though we’re losing these hormones and they could be shifting or at least not lending as much protection to our metabolic health, we get to pivot. It doesn’t have to be our fate by any means. I think that first step is to really be test, don’t guess, really looking at those numbers to make sure that your biomarkers are within range or within optimal range.
And then the other thing is to be, again, what we talked about earlier is focusing on our metabolic health. And so when I think about our metabolic health, I think about the food that we put into our bodies, food being medicine. And there’s a way to eat metabolically healthy that I think allows our bodies to thrive, not only for our blood glucose regulation, our cellular energy, but also our microbiome.
And so when I talk about metabolically healthy foods, it’s getting enough clean, healthy protein. So we eat a lot of salmon, a lot of fish in our house. It’s a lot of probiotic and prebiotic foods that help to feed our gut. It’s a lot of green leafy vegetables and cruciferous vegetables and the color of the rainbow. Like I’m always thinking about what is this food going to make for amazing future brain cells? It’s always what I’m thinking about for myself and my family. So building meals around honoring and loving ourselves and our cellular metabolism, I think is really important.
Also, again, keeping an eye on that blood glucose stability and regulation. I find that insulin resistance can drive a lot of fat storage. And so just keeping our eye on those things. And again, the one beautiful habit that I talked about in the last episode was really moving our body throughout the day. So one, making sure that we’re eating metabolically healthy foods that are feeding and nourishing our gut and cells.
And then two, that we are really in the activity of moving our body throughout the day, I think are going to make huge gains and then building that muscle, like maintaining that good muscle. I think those are the type of pivots that when we double down on those, we really start to see some really great metabolic shifts and body composition shifts that feel good to our bodies. But at the end of the day, it’s really honoring ourselves as well and making sure that we’re creating good health span and lifespan. That’s always my intention and my mindset around that.
I also believe that perimenopause is an opportunity for us to really, again, as I talked about, prioritized what really matters to us in our health. I think for maybe in our 20’s and our 30’s, we could get away with a couple of things. Maybe we could have a couple of glasses of wine and then the next day we could be back at work, high functioning. And as we move in through perimenopause, that may not be true anymore. And so you may begin to realize that, oh, the things that I could get away with or like the little cheats that I could make, or it just, maybe we don’t have bandwidth for that anymore. And so I think perimenopause is a beautiful opportunity to really get clarity around your health goals, reset your mindset around your health goals and really be honest with yourself about what kind of boundaries you want to set for your own health and well-being.
Katie: That’s a good point. And I don’t think I’m actually technically in the perimenopause phase yet, but I’ve noticed already some of the things you’re talking about of like, I just prefer not to have alcohol in my life anymore because it’s not worth the recovery time and making more time for a sleep routine. Like we talked about in the first episode, like little changes like that, that have such a big payoff when we really integrate them regularly.
I would guess there’s also some myths around hormone replacement therapy, especially because it seems like there was a whole wave at one point where it was considered dangerous, and women were told definitely don’t do hormone replacement therapy. And now there seems to be still a lot of myths and misconceptions floating around when it comes to hormone replacement therapy. So can you debunk any of the ones that are still floating around?
Dr. Mariza: Yeah, absolutely. Yeah. The Women’s Health Initiative didn’t do us any favors. If anything, it set us back about two decades and a lot of women have suffered in the process. You have to know that with the Women’s Health Initiative, we were using synthetic hormones, right? MPA and CEE is the equine estrogens, and they were oral. So there’s a lot of things that we learned about within the Women’s Health Initiative and a lot of the big alarming headline news articles, like that estrogen causes breast cancer or that it causes cardiovascular disease and stroke, that a lot of that has been debunked.
A couple of things that we know, one, maybe we don’t use synthetic oral hormones. Maybe use the real stuff. That would be a great idea. So you’ll see that a lot of hormone replacement today is bioidentical hormone replacement therapy, meaning identical to the hormones in your body, still made in a lab, but at least they are recognized by the receptor sites on your cells. So that’s a really nice lock and key.
Next, what we learned is that there is a window. And it’s not fully defined, but I would say the sooner you bring hormone replacement in so that your receptor sites remember, oh, this is estrogen. Oh, this is progesterone, that would be best. And so right now only 6% of women are on hormone replacement therapy and menopause. Only 2% of women are on it on peri. I think we’re going to start to see as we start to have more education and really begin to realize, oh, it would be a good idea for us to be on these hormones before we get to ground zero. I think we’re going to start seeing more and more women in perimenopause on them as well.
I always liken it to, you know, I’m on armor thyroid. It’s like it’s T4 and a desiccated T4 and T3. And we never would have waited until my TSH was five. Or my T3 and T4, my free T3 and free T4, were down to a zero. Like we would never have waited until I was all the way down to zero before we were like, okay, now we can actually give you some thyroid hormone.
The same thing though I believe with estradiol and progesterone. We’re beginning to realize that having women wait until they’re all the way down to almost nothing on both of those hormones may not be the best move. But there is technically what we call like this kind of healthy cell hypothesis window, which is the, within 10 years of a woman going into menopause. And I would even argue that we would start earlier.
The other myth is that after that 10 years that hormones aren’t really playing a role in helping women in terms of their health span and the more research is coming out, that that is simply not true that, that once women stop hormone replacement therapy at 60 or 65 or 70, that a lot of the symptoms or the shifts and changes due to the lack of those hormones begin to uptick, for instance, more cardiovascular issues, more general urinary symptoms, bone rebuilding stops. And so we’re now realizing that women can, for the most part, be on hormone replacement therapy basically, until the wheels fall off. But that it should always be looked at and consistent with what is going on with their lifestyle.
Another thing that I, that is being debunked right now, is dosage and in timing, rhythmic versus static. And so if you go to your allopathic doctor, they’re going to recommend, you know, they’re going to put a patch on you, maybe give you some Permetrium, tell you to take it every single day and send you on your way. And really the lowest dose possible for the least amount of time.
And a lot of that’s beginning to shift. I kind of address the time issue where we really can be on them consistently as long as we would love, but also dosage that we want to make sure that we are not just taking enough to mitigate symptom, but we’re taking enough to actually prevent disease. And that’s how these really play out.
I will say what the caveat is that, if there was a silver bullet, Katie hormones are it, I mean, there’s nothing like a light bulb moment when you don’t have progesterone and your sleep is off and your mood is off. You’re having rage issues and someone gives you some oral micronized progesterone. And it’s like, I cannot tell you how many voice memos and emails and DMs I get from women who get on progesterone and they’re just like, oh my, I hadn’t, no, I just didn’t know. Like my whole life has shifted. And same with estradiol or even testosterone. They’re just like, this version of me is still there. Like I’m coming back. Like it’s mind blowing.
So I will say if there was a magic bullet, it’s definitely hormone replacement therapy for women that are struggling due to hormone deficiency. And if you have poor metabolic health or poor lifestyle strategies in place, hormones are only going to do so much. So I think of them as optimizers. So they’re very much a yes/and. Ideally have a lot of those lifestyle strategies and habits in place. And you’ll find that your hormones, those hormone replacement molecules are going to work so much better for you in your body. So I wouldn’t say it’s a yes/and when it comes to, it’s not, they’re not an end all be all, fix all the things, without a little bit of support from healthy lifestyle.
And then the other thing that I wanted to say about them, is going to be dosage in terms of just figuring out the right dosage. So just note that it’s going to take a minute to figure out the right type, the right dose, what’s working. I had a woman just a couple of weeks ago who moved from a progesterone cream over to an oral micronized progesterone. And it just ended up bringing it, for some women, it can actually end up increasing some symptoms. And so she, after about a month of trying that out, she ended up moving back to the cream because it just, it, it did what it did its job without the symptoms. And so you’re going to have to always figure out what works best.
And then the other thing I wanted to just debunk as well, is there’s a lot of misunderstanding around hormone replacement therapy. Some doctors think that birth control is hormone replacement therapy, that a hormonal IUD is hormone replacement therapy. And so just be on the lookout. The standard of care for women in perimenopause is birth control, like a mini pill, or it is the Mirena IUD, because they’re under the impression, that it regulates your hormones and it regulates your cycle, which it doesn’t do either.
Again, can it mitigate symptoms? Yes, absolutely. But is it mitigating symptoms by regulating your cycle and regulating your hormone? That would be a full body no. They are hormone disruptors. They’re endocrine disruptors. And so, just note that you may be sold the pill or the IUD for perimenopause, when really what you may need is a little bit of oral-micronized progesterone. And so I think it’s important to really advocate for what you want based on your symptoms versus kind of just getting kind of this, what I call like a Band-Aid. And I will say that the Mirena IUD isn’t going to address, the progestin in that is not going to address a lot of the brain changes that are occurring due to a lack of actual progesterone in the body.
Katie: Oh, so many, I just took so many notes on that because I haven’t.
Dr. Mariza: I know that’s so much. It’s such a big topic.
Katie: But I love what you said, too. And this goes back to something I say on here a lot, which is like, yes, there’s a time and a place for all of these things. And I think hormone replacement therapy, thankfully, we’re talking about it. Women understand that it’s valuable. And do all of the lifestyle things that are free and within your control as well, like the morning sunlight, the getting enough nature time and movement and nutritious food and sleep. And then anything you add is going to be able to work better because you’re supporting your body in all those other ways as well. So I love that you brought that up.
I also realized in our other episode, we didn’t even get to touch on, but you literally wrote the book about this. You have a whole book dedicated to perimenopause and essential oils specifically, which I feel like also nobody else is talking about. So can you just kind of give us a primer on that?
Dr. Mariza: Absolutely. I love essential oils. I’ve got them all over my right here. I have them all over my desk. I’ve got a peppermint. I always put peppermint on before an interview to kind of just kind of fire off, you know, just brings oxygen to the lungs. It kind of oxygenates the brain and just wakes you up. So I love peppermint.
But the reason why I wanted to write a book about essential oils and perimenopause and menopause is that it is a profound transition and it could feel like your world is just kind of shaky and falling apart in a lot of ways. And so one of the things I’m always looking for is how do we get these wins? I believe that women deserve so many wins. And yes, hormone replacement therapy can be a beautiful win. And yes, bringing in these beautiful lifestyle habits and strategies are amazing wins.
But sometimes we need like a very, very fast one. And so I use like peppermint. Like I said, it can be great for hot flashes, it can be great for working out, it can be great for awakening the brain and also just energizing you. But the way that I think about essential oils most is anchoring to your rituals, kind of how I talked about with my sleep routine is I’ve got these physical anchors. One I’ve got my supplements, and then I’ve got my oils.
Same thing with my son’s routine, we have a little routine that we anchor to and part of it is using like lavender essential oil for his bedtime routine. And just again, it’s a way of letting the brain know like, oh, we’re gearing up for this thing. I’m gearing up for a walk, I’m gearing up for a meditation, I’m gearing up to go to sleep at night, I’m gearing up for a very productive day, it just kind of lets the brain know.
The other thing I love about aromatherapy is that you really get to choose your mood, particularly in perimenopause and menopause is that our moods can be so inconsistent, and maybe, you know, at times, a little inconvenient, I would say, and mind you, I do believe that we should feel all the feels. But I will say that in peri, sometimes you could just be angry and not know why. Or you could feel doom and gloom one day and feel fine the next, it can be so inconsistent, it has a lot to do with our hormones, but also the deeper work that we get to do.
And I love that you can really anchor to oils like lavender and other florals like rose, and clary sage to really calm the sympathetic nervous system, to calm the hypothalamic pituitary adrenal access, and really create ease. One of the reasons why I love oils is that my body loves when I send it safety signals, my little hyper vigilant little version of me really loves to be kind of told everything’s going to be okay. I think at the epicenter of everything, it’s safety, even hormones really provide a lot of that just that kind of safety and coming home to.
But one of the things I’ve always loved about essential oils is that they’ve always really helped me to feel grounded and to feel safe. And so that is how I’ve kind of built them into a lot of different rituals is just feeling good, feeling safe, supporting mood, supporting stress. And I feel like that really can help us move through our day with more ease and grace and feeling better in our body.
So I have all these beautiful rituals, sleep rituals, self-care rituals that are, that are accentuated with essential oils that just make them a lot more magical and really amp up the benefit.
Katie: Amazing. Well, you are such a wealth of knowledge. I will make sure I link to your books. You’ve actually written a lot of books, your books, your website, and your perimenopause survival guide, all in the show notes for you guys listening on the go. That will all be at wellnessmama.com. But you are an absolute wealth of knowledge. I love our conversations. I learned so much today and I’m so grateful for your time. Thank you so much for being here.
Dr. Mariza: Absolutely.
Katie: And thank you as always for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did. And I hope that you will join me again on the next episode of the Wellness Mama podcast.
If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.
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