November 14, 2025 • 18 mins
Integrative medicine specialist Dr. Karen Koffler joins Kim Azzarelli to discuss major life transitions that are often misunderstood: perimenopause and menopause. Dr. Koffler explains the hormonal changes behind common symptoms like brain fog, fatigue, and disrupted sleep, and shares practical ways to find relief through lifestyle changes, nutrition, and self-care. She also reframes this stage as a natural re-set—an opportunity to reclaim energy and focus on yourself.
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Episode Transcript
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Speaker 1 (00:02):
Welcome to hear something good on women's health and longevity.
We are so grateful to our partner, Always Discreet, that
can be found at Walgreens, the Women's well Being destination,
supporting every stage together, we're bringing you something good each
week on women's health, and it wouldn't be possible without
their support. Each week, we aspire to bring you the
good news on women's health by talking to renowned scientists
(00:24):
and medical experts, and by sharing health advice that can
help you live healthier and happier. Today, we're talking with
doctor Karen Kaffler, an integrative medicine specialist, about the transitions
nearly every woman experiences but are often misunderstood perimenopause and menopause.
This can be a time of tremendous change, both physically
(00:45):
and emotionally, and doctor Karen Kaffler shares insightful practical ways
to not only cope, but to thrive. Doctor Kaefler is
an Assistant Professor of Medicine at the University of Miami
School of Medicine and physician at Lifespan Medical with it
emphasis on longevity medicine. She also has her own private
practice focused on women's health and longevity. Welcome back, doctor Koffler.
Speaker 2 (01:08):
It's great to be back with you, Kim.
Speaker 1 (01:10):
So many women have heard the term perimenopause, but maybe
don't really know what it means. How would you define
that in simple terms?
Speaker 3 (01:18):
Yeah, so perimenopause is that period of time that leads
up to menopause and menopause of course, it means having
gone one year without a period, so it's sort of
a retrospective definition. But the perimenopausal period can actually last
(01:39):
years until a woman ceases having her mensies. And in
that period of time there can be some very subtle
changes that amplify over time depending on the woman. So
it literally can start in a woman's thirties later thirties,
and be manifesting throughout her forties.
Speaker 1 (02:01):
And how would you know if you're moving into perimenopause?
What are the symptoms? What might be evident?
Speaker 3 (02:06):
So there's sort of earlier symptoms and then later symptoms,
and the later symptoms. Of course, as you get closer
to the ending of your period, the symptoms tend to
be a little bit more dramatic. Again, this is extremely
person dependent. There are many women who have virtually no symptoms,
but there's about twenty five percent of women who have
(02:27):
fairly dramatic symptoms so early on. They can be quite subtle.
They can be mood changes, They can be a little
brain fog, more fatigue. Women can say things like it
just don't feel like myself. There can be loss of
enthusiasm for things. There can be subtle changes in their
period maybe lighter flow, maybe heavier flow, maybe shorter in duration,
(02:52):
maybe longer in duration.
Speaker 2 (02:54):
So it can be extremely.
Speaker 3 (02:56):
Varied and they may not necessarily think there's any real
change happening, but indeed there's some changes happening within the
body at the level of the hormones and the receptors
and the cells and their responsiveness.
Speaker 1 (03:09):
So what is actually happening hormonally? Why are we going
to perimenopause and then menopause.
Speaker 3 (03:16):
So there's a change in ovarian responsiveness to a hormone
released by the brain called fsh as our follicle supply,
as our eggs are dwindling and our ovaries are going
through life, there's just less of a responsiveness, and so
(03:38):
that's what's happening at the level of the ovaries. Without
this same amount of estrogen being produced. Therefore, there's going
to be an impact on a variety of tissues because
we have receptors for those hormones throughout the body in
the brain, in bone, in heart, and blood vessels in
the gut, in the vaginal tissue, in the bladder. So
(04:00):
as those levels become more often wildly fluctuating, especially as
you move into later perimenopause, you can have extreme excursions
in estrogen levels from very high to very low. That
can most definitely impact a woman's mood, her ability to think,
(04:23):
her ability to sleep, which is often more a function
of progesterone. Vasomotor symptoms hot flashes, night sweats, joint pain
is often a very common complaint. Palpitations can happen, and
then there can be metabolic changes. We can see the
development of insulin resistance. We can see elevated cholesterol levels
(04:46):
for the first time. That's a really common thing that
women notice. You know, they never had cholesterol issues and
now suddenly they have elevated cholesterol. So you can see
that it's really the changes in estrogen and progesterone levels
can have very manifest symptoms in a woman.
Speaker 1 (05:03):
What's so interesting and so important because all of those
symptoms that you mentioned, whether it's brain fog or the
inability to sleep, or high cholesterol or metabolic syndrome, or
particularly brain fog and not feeling like yourself is kind
of scary. And so if you don't realize that it's
tied to hormonal fluctuations, you probably start looking for all
different other reasons or factors. And so I think it's
(05:25):
really important for women to understand what is actually happening,
and on some level to expect some level of symptoms.
But as you said, not everybody experiences the same symptoms,
so that's what makes it kind of interesting.
Speaker 2 (05:36):
Agreed.
Speaker 3 (05:36):
And also it can often be happening at demanding times
of a woman's life anyway, if they happen to be
raising children, or taking care of elderly parents, or have
job constraints or financial worries, it's so understandable that they
would assume those external.
Speaker 2 (05:54):
Factors were really at the root of it.
Speaker 3 (05:56):
And in fact, those external factors can most definitely influence
the hormones, so it's it's sort of a catch twenty
two for many women.
Speaker 1 (06:06):
It's so amazing, But what are some of the ways
that you can get relief from these symptoms.
Speaker 3 (06:11):
I think it's first recognizing that you're not crazy, you know,
and recognizing that your body.
Speaker 2 (06:17):
Is going through a very remarkable change.
Speaker 3 (06:19):
You know, many of us can recall in elementary school,
we sat down our girls to say, okay, here's what's coming,
and we explain to them what your period is and
what it's going to feel like and so forth. And
we actually need the same kind of course for women
in their forties. Yeah, and to also recognize, just like
(06:42):
you know, there were girls who missed school because they
had super heavy periods and other girls who missed their
periods for months at a time and didn't think a
thing about it. The menopause and perimenopauseal periods are very
unique to each woman.
Speaker 2 (06:56):
So what can we do?
Speaker 3 (06:57):
Number one, Like I said, recognize that you're under going
a pretty significant biochemical change and give yourself a break.
This is a time to really take stock in your
lifestyle and of course massive changes all at once, but recognize,
because your biochemistry is changing, you're going to need to
(07:18):
give yourself more time and attention. You're going to need
to pay attention to your lifestyle more. You're going to
need to secure your sleep, which can be very affected,
particularly by dropping progesterone.
Speaker 2 (07:32):
Levels.
Speaker 3 (07:32):
You're going to need to pay attention to how you eat,
because boy, how often do I hear about weight gain,
particularly in the midsection. As a woman goes through perimenopause
and menopause, super super common for a variety of reasons.
So you can't continue business as usual as you go
(07:52):
through the perimenopausal and menopausal period, exercise becomes a critical factor.
Speaker 2 (07:57):
Self care has to move to a higher priority.
Speaker 3 (08:02):
And then there are many things that we can do now.
There is hormones that we can use. There are supplements
that we can use to help women for things.
Speaker 2 (08:11):
Like hot flashes.
Speaker 3 (08:13):
Actually, acupuncture and Chinese medicine have helped women a lot
with vasomotor symptoms like hot flashes. Cognitive behavioral therapy actually
works incredibly well for hot flashes, and there are medications
that are being used to help women who can't take,
for instance, hormones. Exercise goes a very long way ameliorating
(08:34):
some of the symptoms like brain fog and so forth.
So there's a ton of things that we can offer
women as they go through this period.
Speaker 1 (08:45):
Perimenopause and menopause are natural transitions nearly every woman will experience,
but they're often misunderstood. That's why Always Discrete and Walgreens
have partnered to bring you this episode of Here's Something
Good on women's health and longevity. Together, we're empower ering
women on their well being journey by normalizing conversations around
women's health, providing education, and ensuring access to essential resources.
(09:09):
Today's podcast deals with the sometimes mystifying changes that happen
during perimenopause and menopause. The good news is that there
are effective ways to manage symptoms and even to turn
the transition into an opportunity to reset your life and health.
With this and other episodes, we aim to drive meaningful
conversations that help women at every stage of their health journey.
(09:30):
Continue listening to today's conversation to get answers to some
of your most important questions about perimenopause and menopause. Brought
to you in partnership with Always Discreet, offering products that
can support you in your daily life and providing the
comfort and protection you need to feel secure. Found at Walgreens,
the Women's wellbeing destination, supporting every stage, and I think
(09:55):
it's so important to as you said, the first thing
first is to recognize that this is actually happening and
you're not going crazy. I think a lot of people
feel like it's just them. So obviously there's lots of
symptoms that we've discussed, and you know, things maybe that
we haven't mentioned, like hair loss, hair thinning, which happens
to a lot of us, incontinence, which happens to many people,
(10:16):
although it's something we don't typically talk about. But I
think again, part of normalizing these conversations is understanding that
incontinence happens to many people and that there are things
we can do in terms of product and kind of
really understanding the products that are right for incontinence versus
your period is all really important. So, Doctor Coffler, how
common is this?
Speaker 3 (10:35):
Actually, it's quite common, so it's not age specific, but
certainly you know, as estrogen drops off, there's a change
in the lining of the urethra and the bladder, and
there's a tendency to have pelvic floor laxity and therefore incontinence.
So very, very common, and you know, there's many products. First,
(10:57):
you know, it's a reason why many women our prescribed
vaginal estrogen, so that is a very effective way of
treating that whole region and strengthening the tissue. But just
in terms of incontinence today, there are pads that are
that women can almost tailor to the degree of incontinence
that they're experiencing.
Speaker 2 (11:18):
So that's incredibly helpful.
Speaker 3 (11:20):
And by the way, you know, these are odor reducing,
they are super absorbent, they're different from the typical pads
that we would use with our men sees. And then
there's pelvic floor physical therapy that's extremely effective for women
in strengthening the pelvic floor.
Speaker 1 (11:36):
So I think what's so interesting about being able to
have these conversations with you and doctors like you is
making us realize that everybody goes through this. I love
what you said about elementary school and preparing young women
for their first period. We should be preparing ourselves. I
wish I had been more prepared, knowing what the symptoms
were and what to expect. So you talk about lifestyle,
(11:57):
and lifestyles are kind of a catch all. What are
the three things that you would do or you would
tell people to do as a're entering this transition stage
around lifestyle, So from.
Speaker 3 (12:06):
A nutrition standpoint, because that is sort of the lowest
hanging fruit, although it can also be very challenging because
of the relationship many of us have developed with food.
Number One, make sure you are getting adequate protein. That's
super important. And the number that we're using these days
not to get overly scientific, but the number we're thinking
(12:28):
women need for sure is at least a gram or
one point two grams per kilogram, So that does require
a conversion.
Speaker 2 (12:36):
But for someone like.
Speaker 3 (12:38):
Me, I need about sixty eight grams of protein a day,
so ensuring adequate protein is really important. The other thing
is reevaluate your relationship with sugar, because the perimenopausal and
menopausal period is defined in part by an increase in
insulin resistance. Cortisol remains high, which tends to cause weight
(13:01):
gain around the mid section and raises blood sugar levels,
and now you're losing estrogen, which has been protective against that.
So insulin resistance at this time is really common and
that's synonymous with weight gain. So having sugar regularly and
your diet worsens that and causes weight gain. That's the
(13:21):
nutrition piece. On the exercise piece, I cannot stress enough
how important it is to make exercise a part of
your lifestyle. Find something you love and do it and
two days a week's strength train.
Speaker 2 (13:36):
You've heard me harp on that before.
Speaker 3 (13:38):
So two days a week strength train because we're losing
muscle mass. One hundred percent of us as we age
are losing muscle mass, and muscle mass is one of
the most important biomarkers of healthy aging. And as you
build muscle, you raise testosterone levels, you lower cortisol levels.
You actually feed your brain, so you help you help
(14:01):
nurture baby brain cells that can help you in the
thinking process. You offset dementia, You're protecting your heart, You're
protecting your blood vessels from hypertension. The list goes on
and on and on. So exercise is key. And then sleep,
you know, developing great sleep habits are absolutely essential. We
(14:23):
see sleep as an important vital sign these days, and
getting adequate deep stage sleep really can offset some of
the issues that we see in menopause. Even as deep
sleep is challenged by things like hot flashes and night sweats,
and just the lower progesterone lowers the quality of our sleep,
but there are many ways to overcome that, including the
(14:45):
use of progesterone and hormones in order to ensure better sleep.
Speaker 1 (14:50):
Well, that's amazing. So those are three very practical tips
So last words, as we go from perimenopause to menopause,
I've heard you talk about kind of a reset. How
should be women be thinking about this phase of life.
Speaker 3 (15:05):
Yeah, you know, there's a quality of freedom actually that
can come when you are not you know, when you
get through menopause, and even as you're going through the transition.
Speaker 2 (15:18):
First of all, it is a natural process.
Speaker 3 (15:22):
And we are among the only species that outlive our
reproductive potential. So it's pretty remarkable that we get another
whole half of life practically as we go through the
perimenopause and menopause period. And my feeling is, you know,
it's an opportunity for us to use the energies that
(15:43):
the body was using in order to go through cycles,
which is very energy demanding. That energy can now be
used in other directions. And so if women see it
as a time to recognize, you know, I've put a
lot of energy outward into a whole variety of people
(16:03):
and things, and now this is a time for me
to reclaim that and ensure that I'm giving my self attention, love,
giving myself the best nutrition, fortifying my body, ensuring adequate sleep,
nurturing my relationships, finding the things that I love. I
really think that we can use this period of time
(16:25):
to choose how we're going to live the next half
of our lives instead of sort of just going through
responding to all the demands. I think it's a really
great time for us to make that choice from a
deeper place.
Speaker 1 (16:39):
Thank you, Karen. I really always enjoy talking to you,
and it's always inspiring and it is so exciting to
look at it from this perspective versus like a sort
of a chore. Thinking about how we're living our lives
for the next half, as you say, is a really
important moment. So again, thank you for the advice and
the conversation.
Speaker 2 (16:57):
Thank you so much, Kim.
Speaker 1 (17:02):
Here are the top takeaways. First, recognize what's happening. Fluctuating
hormones that lead to mood changes, lack of energy, sleep disruption,
weight gain, and even hair loss are perfectly normal. It's
not just to you. You're not going crazy, and there
are ways to deal with these conditions. Talk to your
medical provider to get advice on what makes sense for you. Second,
(17:27):
take a lifestyle inventory. This is a time to focus
on you and to take care of yourself. To deal
with symptoms, make sure you're eating well, including cutting back
on sugar and getting plenty of protein. Doctor Kofler recommends
one point two grams of protein per kilogram of body weight.
Exercise is a must. She recommends adding twice weekly strength
(17:48):
training to your routine and prioritize getting a good night's
sleep every night. Lastly, seek out products to help manage
some symptoms. As estrogen drops during perimenopause, there are physiological changes.
One result occasional bladder leaks. Know the difference between products
designed for incontinence versus menstrual flow. They serve very different purposes.
(18:12):
Thank you for listening, and please share today's episode with
others in your life. Have a great day. For more
podcasts from iHeartRadio, check out the iHeartRadio app, Apple Podcasts,
or wherever you listen to your favorite shows. Today's episode
of Here's Something Good on women's health and longevity was
brought to you by our partner Always Discreet that can
(18:32):
be found at Walgreens, the women's well being destination supporting
every stage
Welcome to hear something good on women's health and longevity.
We are so grateful to our partner, Always Discreet, that
can be found at Walgreens, the Women's well Being destination,
supporting every stage together, we're bringing you something good each
week on women's health, and it wouldn't be possible without
their support. Each week, we aspire to bring you the
good news on women's health by talking to renowned scientists
(00:24):
and medical experts, and by sharing health advice that can
help you live healthier and happier. Today, we're talking with
doctor Karen Kaffler, an integrative medicine specialist, about the transitions
nearly every woman experiences but are often misunderstood perimenopause and menopause.
This can be a time of tremendous change, both physically
(00:45):
and emotionally, and doctor Karen Kaffler shares insightful practical ways
to not only cope, but to thrive. Doctor Kaefler is
an Assistant Professor of Medicine at the University of Miami
School of Medicine and physician at Lifespan Medical with it
emphasis on longevity medicine. She also has her own private
practice focused on women's health and longevity. Welcome back, doctor Koffler.
Speaker 2 (01:08):
It's great to be back with you, Kim.
Speaker 1 (01:10):
So many women have heard the term perimenopause, but maybe
don't really know what it means. How would you define
that in simple terms?
Speaker 3 (01:18):
Yeah, so perimenopause is that period of time that leads
up to menopause and menopause of course, it means having
gone one year without a period, so it's sort of
a retrospective definition. But the perimenopausal period can actually last
(01:39):
years until a woman ceases having her mensies. And in
that period of time there can be some very subtle
changes that amplify over time depending on the woman. So
it literally can start in a woman's thirties later thirties,
and be manifesting throughout her forties.
Speaker 1 (02:01):
And how would you know if you're moving into perimenopause?
What are the symptoms? What might be evident?
Speaker 3 (02:06):
So there's sort of earlier symptoms and then later symptoms,
and the later symptoms. Of course, as you get closer
to the ending of your period, the symptoms tend to
be a little bit more dramatic. Again, this is extremely
person dependent. There are many women who have virtually no symptoms,
but there's about twenty five percent of women who have
(02:27):
fairly dramatic symptoms so early on. They can be quite subtle.
They can be mood changes, They can be a little
brain fog, more fatigue. Women can say things like it
just don't feel like myself. There can be loss of
enthusiasm for things. There can be subtle changes in their
period maybe lighter flow, maybe heavier flow, maybe shorter in duration,
(02:52):
maybe longer in duration.
Speaker 2 (02:54):
So it can be extremely.
Speaker 3 (02:56):
Varied and they may not necessarily think there's any real
change happening, but indeed there's some changes happening within the
body at the level of the hormones and the receptors
and the cells and their responsiveness.
Speaker 1 (03:09):
So what is actually happening hormonally? Why are we going
to perimenopause and then menopause.
Speaker 3 (03:16):
So there's a change in ovarian responsiveness to a hormone
released by the brain called fsh as our follicle supply,
as our eggs are dwindling and our ovaries are going
through life, there's just less of a responsiveness, and so
(03:38):
that's what's happening at the level of the ovaries. Without
this same amount of estrogen being produced. Therefore, there's going
to be an impact on a variety of tissues because
we have receptors for those hormones throughout the body in
the brain, in bone, in heart, and blood vessels in
the gut, in the vaginal tissue, in the bladder. So
(04:00):
as those levels become more often wildly fluctuating, especially as
you move into later perimenopause, you can have extreme excursions
in estrogen levels from very high to very low. That
can most definitely impact a woman's mood, her ability to think,
(04:23):
her ability to sleep, which is often more a function
of progesterone. Vasomotor symptoms hot flashes, night sweats, joint pain
is often a very common complaint. Palpitations can happen, and
then there can be metabolic changes. We can see the
development of insulin resistance. We can see elevated cholesterol levels
(04:46):
for the first time. That's a really common thing that
women notice. You know, they never had cholesterol issues and
now suddenly they have elevated cholesterol. So you can see
that it's really the changes in estrogen and progesterone levels
can have very manifest symptoms in a woman.
Speaker 1 (05:03):
What's so interesting and so important because all of those
symptoms that you mentioned, whether it's brain fog or the
inability to sleep, or high cholesterol or metabolic syndrome, or
particularly brain fog and not feeling like yourself is kind
of scary. And so if you don't realize that it's
tied to hormonal fluctuations, you probably start looking for all
different other reasons or factors. And so I think it's
(05:25):
really important for women to understand what is actually happening,
and on some level to expect some level of symptoms.
But as you said, not everybody experiences the same symptoms,
so that's what makes it kind of interesting.
Speaker 2 (05:36):
Agreed.
Speaker 3 (05:36):
And also it can often be happening at demanding times
of a woman's life anyway, if they happen to be
raising children, or taking care of elderly parents, or have
job constraints or financial worries, it's so understandable that they
would assume those external.
Speaker 2 (05:54):
Factors were really at the root of it.
Speaker 3 (05:56):
And in fact, those external factors can most definitely influence
the hormones, so it's it's sort of a catch twenty
two for many women.
Speaker 1 (06:06):
It's so amazing, But what are some of the ways
that you can get relief from these symptoms.
Speaker 3 (06:11):
I think it's first recognizing that you're not crazy, you know,
and recognizing that your body.
Speaker 2 (06:17):
Is going through a very remarkable change.
Speaker 3 (06:19):
You know, many of us can recall in elementary school,
we sat down our girls to say, okay, here's what's coming,
and we explain to them what your period is and
what it's going to feel like and so forth. And
we actually need the same kind of course for women
in their forties. Yeah, and to also recognize, just like
(06:42):
you know, there were girls who missed school because they
had super heavy periods and other girls who missed their
periods for months at a time and didn't think a
thing about it. The menopause and perimenopauseal periods are very
unique to each woman.
Speaker 2 (06:56):
So what can we do?
Speaker 3 (06:57):
Number one, Like I said, recognize that you're under going
a pretty significant biochemical change and give yourself a break.
This is a time to really take stock in your
lifestyle and of course massive changes all at once, but recognize,
because your biochemistry is changing, you're going to need to
(07:18):
give yourself more time and attention. You're going to need
to pay attention to your lifestyle more. You're going to
need to secure your sleep, which can be very affected,
particularly by dropping progesterone.
Speaker 2 (07:32):
Levels.
Speaker 3 (07:32):
You're going to need to pay attention to how you eat,
because boy, how often do I hear about weight gain,
particularly in the midsection. As a woman goes through perimenopause
and menopause, super super common for a variety of reasons.
So you can't continue business as usual as you go
(07:52):
through the perimenopausal and menopausal period, exercise becomes a critical factor.
Speaker 2 (07:57):
Self care has to move to a higher priority.
Speaker 3 (08:02):
And then there are many things that we can do now.
There is hormones that we can use. There are supplements
that we can use to help women for things.
Speaker 2 (08:11):
Like hot flashes.
Speaker 3 (08:13):
Actually, acupuncture and Chinese medicine have helped women a lot
with vasomotor symptoms like hot flashes. Cognitive behavioral therapy actually
works incredibly well for hot flashes, and there are medications
that are being used to help women who can't take,
for instance, hormones. Exercise goes a very long way ameliorating
(08:34):
some of the symptoms like brain fog and so forth.
So there's a ton of things that we can offer
women as they go through this period.
Speaker 1 (08:45):
Perimenopause and menopause are natural transitions nearly every woman will experience,
but they're often misunderstood. That's why Always Discrete and Walgreens
have partnered to bring you this episode of Here's Something
Good on women's health and longevity. Together, we're empower ering
women on their well being journey by normalizing conversations around
women's health, providing education, and ensuring access to essential resources.
(09:09):
Today's podcast deals with the sometimes mystifying changes that happen
during perimenopause and menopause. The good news is that there
are effective ways to manage symptoms and even to turn
the transition into an opportunity to reset your life and health.
With this and other episodes, we aim to drive meaningful
conversations that help women at every stage of their health journey.
(09:30):
Continue listening to today's conversation to get answers to some
of your most important questions about perimenopause and menopause. Brought
to you in partnership with Always Discreet, offering products that
can support you in your daily life and providing the
comfort and protection you need to feel secure. Found at Walgreens,
the Women's wellbeing destination, supporting every stage, and I think
(09:55):
it's so important to as you said, the first thing
first is to recognize that this is actually happening and
you're not going crazy. I think a lot of people
feel like it's just them. So obviously there's lots of
symptoms that we've discussed, and you know, things maybe that
we haven't mentioned, like hair loss, hair thinning, which happens
to a lot of us, incontinence, which happens to many people,
(10:16):
although it's something we don't typically talk about. But I
think again, part of normalizing these conversations is understanding that
incontinence happens to many people and that there are things
we can do in terms of product and kind of
really understanding the products that are right for incontinence versus
your period is all really important. So, Doctor Coffler, how
common is this?
Speaker 3 (10:35):
Actually, it's quite common, so it's not age specific, but
certainly you know, as estrogen drops off, there's a change
in the lining of the urethra and the bladder, and
there's a tendency to have pelvic floor laxity and therefore incontinence.
So very, very common, and you know, there's many products. First,
(10:57):
you know, it's a reason why many women our prescribed
vaginal estrogen, so that is a very effective way of
treating that whole region and strengthening the tissue. But just
in terms of incontinence today, there are pads that are
that women can almost tailor to the degree of incontinence
that they're experiencing.
Speaker 2 (11:18):
So that's incredibly helpful.
Speaker 3 (11:20):
And by the way, you know, these are odor reducing,
they are super absorbent, they're different from the typical pads
that we would use with our men sees. And then
there's pelvic floor physical therapy that's extremely effective for women
in strengthening the pelvic floor.
Speaker 1 (11:36):
So I think what's so interesting about being able to
have these conversations with you and doctors like you is
making us realize that everybody goes through this. I love
what you said about elementary school and preparing young women
for their first period. We should be preparing ourselves. I
wish I had been more prepared, knowing what the symptoms
were and what to expect. So you talk about lifestyle,
(11:57):
and lifestyles are kind of a catch all. What are
the three things that you would do or you would
tell people to do as a're entering this transition stage
around lifestyle, So from.
Speaker 3 (12:06):
A nutrition standpoint, because that is sort of the lowest
hanging fruit, although it can also be very challenging because
of the relationship many of us have developed with food.
Number One, make sure you are getting adequate protein. That's
super important. And the number that we're using these days
not to get overly scientific, but the number we're thinking
(12:28):
women need for sure is at least a gram or
one point two grams per kilogram, So that does require
a conversion.
Speaker 2 (12:36):
But for someone like.
Speaker 3 (12:38):
Me, I need about sixty eight grams of protein a day,
so ensuring adequate protein is really important. The other thing
is reevaluate your relationship with sugar, because the perimenopausal and
menopausal period is defined in part by an increase in
insulin resistance. Cortisol remains high, which tends to cause weight
(13:01):
gain around the mid section and raises blood sugar levels,
and now you're losing estrogen, which has been protective against that.
So insulin resistance at this time is really common and
that's synonymous with weight gain. So having sugar regularly and
your diet worsens that and causes weight gain. That's the
(13:21):
nutrition piece. On the exercise piece, I cannot stress enough
how important it is to make exercise a part of
your lifestyle. Find something you love and do it and
two days a week's strength train.
Speaker 2 (13:36):
You've heard me harp on that before.
Speaker 3 (13:38):
So two days a week strength train because we're losing
muscle mass. One hundred percent of us as we age
are losing muscle mass, and muscle mass is one of
the most important biomarkers of healthy aging. And as you
build muscle, you raise testosterone levels, you lower cortisol levels.
You actually feed your brain, so you help you help
(14:01):
nurture baby brain cells that can help you in the
thinking process. You offset dementia, You're protecting your heart, You're
protecting your blood vessels from hypertension. The list goes on
and on and on. So exercise is key. And then sleep,
you know, developing great sleep habits are absolutely essential. We
(14:23):
see sleep as an important vital sign these days, and
getting adequate deep stage sleep really can offset some of
the issues that we see in menopause. Even as deep
sleep is challenged by things like hot flashes and night sweats,
and just the lower progesterone lowers the quality of our sleep,
but there are many ways to overcome that, including the
(14:45):
use of progesterone and hormones in order to ensure better sleep.
Speaker 1 (14:50):
Well, that's amazing. So those are three very practical tips
So last words, as we go from perimenopause to menopause,
I've heard you talk about kind of a reset. How
should be women be thinking about this phase of life.
Speaker 3 (15:05):
Yeah, you know, there's a quality of freedom actually that
can come when you are not you know, when you
get through menopause, and even as you're going through the transition.
Speaker 2 (15:18):
First of all, it is a natural process.
Speaker 3 (15:22):
And we are among the only species that outlive our
reproductive potential. So it's pretty remarkable that we get another
whole half of life practically as we go through the
perimenopause and menopause period. And my feeling is, you know,
it's an opportunity for us to use the energies that
(15:43):
the body was using in order to go through cycles,
which is very energy demanding. That energy can now be
used in other directions. And so if women see it
as a time to recognize, you know, I've put a
lot of energy outward into a whole variety of people
(16:03):
and things, and now this is a time for me
to reclaim that and ensure that I'm giving my self attention, love,
giving myself the best nutrition, fortifying my body, ensuring adequate sleep,
nurturing my relationships, finding the things that I love. I
really think that we can use this period of time
(16:25):
to choose how we're going to live the next half
of our lives instead of sort of just going through
responding to all the demands. I think it's a really
great time for us to make that choice from a
deeper place.
Speaker 1 (16:39):
Thank you, Karen. I really always enjoy talking to you,
and it's always inspiring and it is so exciting to
look at it from this perspective versus like a sort
of a chore. Thinking about how we're living our lives
for the next half, as you say, is a really
important moment. So again, thank you for the advice and
the conversation.
Speaker 2 (16:57):
Thank you so much, Kim.
Speaker 1 (17:02):
Here are the top takeaways. First, recognize what's happening. Fluctuating
hormones that lead to mood changes, lack of energy, sleep disruption,
weight gain, and even hair loss are perfectly normal. It's
not just to you. You're not going crazy, and there
are ways to deal with these conditions. Talk to your
medical provider to get advice on what makes sense for you. Second,
(17:27):
take a lifestyle inventory. This is a time to focus
on you and to take care of yourself. To deal
with symptoms, make sure you're eating well, including cutting back
on sugar and getting plenty of protein. Doctor Kofler recommends
one point two grams of protein per kilogram of body weight.
Exercise is a must. She recommends adding twice weekly strength
(17:48):
training to your routine and prioritize getting a good night's
sleep every night. Lastly, seek out products to help manage
some symptoms. As estrogen drops during perimenopause, there are physiological changes.
One result occasional bladder leaks. Know the difference between products
designed for incontinence versus menstrual flow. They serve very different purposes.
(18:12):
Thank you for listening, and please share today's episode with
others in your life. Have a great day. For more
podcasts from iHeartRadio, check out the iHeartRadio app, Apple Podcasts,
or wherever you listen to your favorite shows. Today's episode
of Here's Something Good on women's health and longevity was
brought to you by our partner Always Discreet that can
(18:32):
be found at Walgreens, the women's well being destination supporting
every stage
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