Episode Transcript
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(00:02):
Ever find yourself at 2amlike, what the actual fuck is happening
to me?
Spoiler.
It's not just your hormones.
It's your life cracking wide open.
And no one warned you.
I'm Jenna, clinic CEO,menopause whisperer and recovering
people pleaser turned truth slayer.
And I am Dr. Liana, menopauseexpert and medical rebel who's done
(00:25):
playing nice.
Welcome to Smoke, Mirrors and Perimenopause.
We're not here to gracefully age.
We're here to blow shit upwith truth, science and zero filters.
So follow the show and stepinto your I don't give a fuck era.
No shame, all flame.
Let's fucking do this.
We're back.
(00:46):
Episode number three.
Here we go.
Here we go.
Today we're going to talkabout something I think so many women
suffer with.
I know for me, it was thefirst sign that I was heading into
the toilet.
Pause with no alcohol.
Yeah, exactly.
And it's sleep.
(01:07):
Yeah.
Sleep is huge.
Which, Yeah.
I hope I don't have a problemwith that tonight, being that I'm
having a cold brew at like 4pmas a slow metabolizer.
That's okay.
One night won't be so bad.
Yeah.
Yeah.
But I know that it'sdefinitely something that I hear
(01:28):
from women all the time isjust how hard it becomes to sleep
when you enter your 40s and 50s.
And even beyond that, I know,like, postmenopausal women really
still struggle with sleep.
So tell us a little bit aboutwhy that happens.
Well, there's a normal.
As we age, it's normal toactually sleep less.
Yeah, so.
(01:49):
So there is a little bit ofthat happening.
Right.
So that's because we need less sleep.
We know that.
I wouldn't say it's because weneed less sleep.
I would say it's just thebrain just is naturally evolving
for some reason.
Something I haven't, to behonest, I haven't totally looked
into.
But I just know that instudies they show that, yeah.
(02:12):
You do get less deep sleep,you do get less REM sleep.
On average.
I think it's your averagesleep drops from like eight to almost.
Nearly six hours.
Wow.
As people are aging.
And I Sure.
I know it has a lot to do with hormones.
Oh, for sure.
Right.
So I think if we redo those studies.
Yeah.
And we see people on hormonereplacement therapy, that they are
(02:34):
going to be sleeping longer.
And I bet you that that'swhat's going to be the thing that
increases longevity.
Right.
That was going to be.
My question is, is it like anormal biological process that we
sleep less because we maybeneed less sleep to function?
Or is it just because we haveall these other things that are happening
in our body and we're notdoing the right things to replenish?
(02:54):
Right, right.
And we know sleep is like suchan important aspect of longevity.
Right.
So I think as we see peopleimprove their blood sugar.
Right.
I believe we're coming out ofthat epidemic.
Like people are becoming moreand more attuned to the fact that
they need to control theirblood sugar for better longevity,
better quality of life, weightmanagement, metabolic management,
(03:19):
all that.
So as that happens, as we domore hormone replacement therapy,
we'll definitely be sleeping longer.
Yeah, because we'll have moreneurosteroids on board.
So progesterone is aneurosteroid, which means it goes
and hits the brain and helpsyou sleep better.
Hits those brain receptors inthe neural cells.
So I think that we'll seebetter health later on in life because
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people will be sleeping more.
But that's obviously going torequire like long term studies.
Like that's going to remain tobe seen in the future.
Yeah, but I think thatdefinite, I think definitely, I mean,
people there, there is acorrelation, like if you get less
sleep on average throughoutlife, your lifespan is shortened.
(04:02):
Oh, for sure.
Yeah, we know that.
Numerous studies on that.
I also think an aspect is likestress mitigation and nervous system
regulation too.
Like from a longevity perspective.
Right.
Like, are people doing theright things in their life to ensure
that they're cutting back onstress and anxiety and all those
things that keep that mindracing in the middle of the night?
(04:23):
Can you talk a little bitabout like, what actually happens
for women during that time?
Like, why is that the numberone thing that like women in their
mid-40s are all of a suddenlike, fuck, I can't sleep, or I wake
up at 2 or 3 in the morning oryou know.
Yeah, it's gonna be becausethere's a drop in progesterone.
It's the progesterone.
Yeah, yeah, it's the drop.
And progesterone is one of thefirst things to start dropping.
(04:44):
Probably the first or thesecond hormone for most women, it's
not estrogen.
And we think that it is.
And estrogen obviously doesparticipate and contribute to that,
but it's really the progest,the drop in progesterone.
And so because that startshappening around mid to late 30s.
Right.
And then you couple that withthe fact that a lot of people, a
(05:05):
lot of women are having kidslater on in life.
So, you know, the sleepdisturbances with, with small kids
up until the, the time thatthey're like, finally.
Yeah.
Wiping their own ass, gettingdressed on their own, getting up
and feeding themselves.
Like, there's you, you're, you're.
You probably have like, howmany years?
I mean, decades?
A decade, honestly, like, whenyou think about it, you have at least
(05:27):
a decade of sleep disturbancewith the drop.
And then you're inperimenopause and you're like.
Right.
So I think it's a lot of things.
And then also too, there'stechnology now with blue light.
So that's really.
Other than helping the situation.
Yeah.
So I think, I think the, thefact that we're learning so much
more about perimenopause andmenopause now, women are going to
(05:50):
be seeing that.
Oh, I'm.
It's not only about estrogen,it's also about dhea.
Yeah.
Which is also made in the adrenals.
Right.
Testosterone and progesterone.
It's a concert of hormones.
And so that's why we're seeing.
That's why sleep is like oneof the first things to go.
Yeah.
(06:10):
And the lifestyle stuff toocomes into play so significantly.
Like, there's so much thatI've personally had to shift just
to prioritize sleep andgetting a good night's sleep.
And of course, there's stillnights that I don't get the best
night's sleep.
But, you know, cutting wayback on alcohol.
Like, I used to be able todrink, you know, a glass or two of
wine and be totally fine.
And now it just totallydisrupts my circadian rhythms, eating
(06:33):
too late at night.
Like, I understand early birdspecials now because literally, like,
my best sleep comes if I stop eating.
Right.
You know, five, six o'.
Clock.
Exactly.
Yeah, exactly.
And then if you have gut issues.
Yeah, Right.
So if your microbiome iscompletely out of whack, imbalanced,
and you're eating later,you're going to create worse problems
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for yourself or you're just, you're.
It's going to wreck your sleepfor sure because you're going to
have.
You're gonna put your bodythrough more work physiologically
and your liver is going to goto work when you sleep, which it
does.
There's a.
There's a circadian rhythm toyour organs and then that's just
gonna not let you sleep asdeeply as you can.
Right.
Yeah.
And I also can't work out atnight anymore.
(07:16):
Oh, no.
God, no.
Not at this age.
There's Nope, not happening.
Right.
I thought that was just.
Not only do I not want to do.
Right.
Yeah, no, it's like physicallyjust not going to happen.
Exactly.
Yeah.
Yeah.
So I think, I mean, gosh,sleep is like one of those things
that you absolutely.
(07:39):
HRT absolutely saved me.
Plus the lifestylemodification because I was actually
doing all the right things andstill I had trouble sleeping.
But when I introduced likeoral progesterone, like long acting
progesterone, and I slept likea baby, I was a whole new person.
It was totally different.
Yeah.
(07:59):
I think it's so interestingbecause like, so many women just
don't know about, about progesterone.
And as you said, like theother thing that people don't know
is literally your hormonesstart to go haywire.
Like, I mean, it could startas early as even like 25, 30, but
like 35 is that point.
Yeah.
Where if you look at like, youknow, the curves and what actually
happens with your hormonalprofile, it literally goes wackadoo.
(08:23):
It does.
It's crazy.
Yeah, it really does.
And testosterone too will dropso fast.
So that's.
Yeah, I, I mean, I, I think,you know, testosterone therapy is
also gaining a lot of tractionright now for women and that's still
not approved for women in theUnited States.
Isn't that wild?
(08:43):
Like, as if we don't need testosterone.
I am the most abundant hormonein our bodies, isn't it?
Testosterone, the heart, like the.
I think the most testosteronereceptors are like in the heart.
And so we just have them allover the place, honestly, in our
whole body.
But a lot of them are lie inthe heart.
And so, oh my gosh, I am likea whole another animal when I'm like,
(09:05):
without my testosterone, I.
You don't want to be around me.
I'm like a slog.
I'm like a slog, seriously.
But on it, like, I love it.
I mean, I'm just, I'm so productive.
Yeah.
I'm wild in the bedroom.
Like, wild.
Okay.
Hear that, fellas?
(09:26):
If you're listening, the oneman, the one that.
Right.
It is pride month.
Yeah.
So.
Oh my gosh, it's.
Yeah.
So testosterone is just solife giving.
Yeah.
The amount of productivity andit's just amazing.
So you know what I foundbefore I went on testosterone?
(09:47):
Because I was like, you know,dabbling with progesterone, got a
little estrogen on board, butthen like, definitely my body composition
was shifting.
So I felt like if I got sometea back in there, I'd feel better.
But like, what I noticed wasjust my personal level of confidence
without any physical shifts happening.
It's like when you lose yourtestosterone, you lose your mojo.
Exactly, exactly.
(10:08):
Yeah.
Like a slog.
I'm a slog.
I don't even know what a slog is.
Okay.
Like, okay.
You know that sloth from Zootopia?
Yeah.
I love that sloth.
Okay.
Yeah.
I feel like.
I feel like a sloth sitting onmy couch, having potato chips.
Like just slogging away, doing nothing.
This is a new verb we've justmade up, slogging.
(10:31):
But you're right.
You're absolutely right.
The personal confidence islike a thousand percent.
Yeah.
And you're just like, holyshit, I can take on the fucking world.
But I think like so many womenjust don't even realize they lose
it.
Right, Right.
That's like, oh, I just feel like.
No, I just feel like shit.
And this is normal, right?
Oh, no, that's normal.
Yeah.
And that's why the doctors are like.
(10:52):
And let me tell you, when Iwas in medical school, I didn't know.
Like, I didn't know.
They didn't teach me about this.
They didn't teach me how totest hormones.
And honestly, right now thereis no technical test to test for
perimenopause.
Right.
Because it's all a sliding scale.
It's all the lab values are aslope, so they slowly change.
So a one time snapshot ofblood work isn't going to tell you
(11:13):
exactly where you're at.
Right.
You have to do it over timeand take into account like what your
symptoms are over time.
So it's not just like, oh, letme give you this one test and tell
you you're in perimenopause.
Right?
Right.
It's a, it's a, it's a spectrum.
Yeah.
It all happens on the spectrum.
Well, and the interestingthing is there's no real standard
of care around it.
Right, Right.
So like, I feel like it's thewild, wild west out there.
(11:36):
Well, oh, down there.
Yeah, yeah, yeah, yeah.
Down, down there and out there.
Down there and out there.
It is the wild west whenyou're on H1.
But I think for.
So the standard of care inconventional medicine though is to
be on birth control untilyou're around your early 50s or prescribe
an antidepressant.
Right.
And being on even an IUD ororal birth control has its own side
(12:01):
effects.
That needs to be a whole newepisode, honestly, to talk about
how the standard of care rightnow is really failing women in regular
gynecology clinics,conventional gynecology clinics.
Because there's so manydifferent ramifications when you're
on, like, contraceptive, like,pseudo hormones.
I call them pseudo hormones,xenohormones, because they're not
(12:23):
bioidentical.
Like, and that's just doingwomen so wrong.
Yeah, it really is.
Can be really detrimental and harmful.
Right?
Yeah.
Yeah.
So, well, next episode we'll.
We'll talk about that.
Stay tuned for episode four.
It's going to be a good one.
All right, my friends.
(12:43):
No shame.
All flame.
Catch you on the next one.
We hope you love the show asmuch as we love doing it.
To learn more and join themodern menopause movement, visit
modernmennow.com that'smodernmennow.com because this conversation
doesn't end here.
And until next time, keepquestioning the smoke and mirrors.
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And remember, you're notlosing your mind.
You're finding your truth.
And a quick but boringdisclaimer just necessary to say
anything discussed in thispodcast is for educational and informational
purposes only and solely as aself help tool for your own use.
We are not providing medical,psychological or nutrition therapy
advice.
You should not use thisinformation to diagnose or treat
any health problems orillnesses without consulting your
(13:26):
own medical practitioner.
Always seek the advice of yourown medical practitioner and or medical
mental health provider aboutyour specific health situation.
Even though I am a doctor andphysician, I am not your physician
and this podcast does notcreate a doctor patient relationship.