209: Make Perimenopause Feel Easy: What Every Woman Needs to Know - with Dr. Mariza Snyder - ReversABLE

Episode Transcript
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(00:00):
Mariza (00:00.846)I'm okay. Yeah, I'm gonna lie. well, I'm lying to you. That's why. That's okay. I have a migraine. I know. I know, but I just, I have them. They're chronic and so, I, you know.

(00:01):
Josh Dech (00:02.284)Yeah? That's like a very medium way to start the day.
god. Why, what's up?
ew. This is not a good time to be doing any kind of anything.
Josh Dech (00:23.62)Okay, well that sounds awful. I'm better than you are. Why are we doing this if you have a migraine?
Mariza (00:23.758)How are you, Josh?
Mariza (00:29.138)I, you know, well, I don't wanna reschedule. That's why. I just, don't know. I always wake up and I'm just like, it's like Russian roulette, you know, any given day of the week. I'm like, we'll see what happens. Yeah. Yeah.
Josh Dech (00:34.04)Yeah, but you got a migraine. That's an awful sensation.
Hmm, really? Like, are we talking like, like one of those nauseating, shoot me in the head kind of migraines that you have to medicate for because you just can't get through your life?
Mariza (00:48.492)Hmm. Yeah, well, I started with excedrin migraine this morning because I thought maybe that'll handle it. And if that doesn't handle it, then I have to take a tryptan, which is a bigger, heavier, Socketumi kind of drug. But usually when I'm on interviews, I do pretty good.
Josh Dech (01:06.338)Yeah, okay. I know obviously we're...
with your migraines.
Mariza (01:15.116)Yeah. How are you? Is that how are you?
Josh Dech (01:17.164)I you're a big girl. I won't make you do anything, but if you need to reschedule, that's okay. Migraines are a nasty business. Okay. I appreciate that. Yeah. So I imagine of course in this space you've done some investigating, nobody's found anything.
Mariza (01:26.26)no, no, I'm good, I'm good. But I just wanted to be honest. They are, they are nasty business. I don't wish them on my worst enemy.
Mariza (01:42.208)No, have had them, so if you want a little bit of a background, I've had them since I was seven. I had them because of child abuse. I was abused as a child a lot. I had them into college and finally took a very integrative approach after being on drugs forever. And then they went away, or they were very infrequent.
until I was pregnant at 40 years old and they came back with a vengeance and they've just been here ever since. Worse than ever before. And then I had a back to back concussions when my son was two, two years ago and that definitely didn't help them. So yeah, just a lot of brain, it's really, it's brain trauma and trauma trauma. And perimenopause, god damn you.
Josh Dech (02:30.53)Yeah. Yeah, fuck you, hey? So really quick, the trauma, was there physical abuse where like you were hit and it damaged the tissue in your neck and skull?
Mariza (02:35.309)Yeah. Yeah.
Mariza (02:42.987)Yeah, no, yeah, physical abuse. Yeah, like thrown downstairs, thrown off beds kind of vibe.
Josh Dech (02:45.668)Okay.
Mm-hmm. Fuck. So one of the major...

(00:22):
Mariza (02:52.533)Yeah, well, migraines are actually why I am here.
Josh Dech (02:57.732)Well, I love that. I'd also like you to get free of those. There is really, really quick. I just want to test something with you. I got a very limited field of knowledge, but I tend to apply it. OK, there's something in the back of your skull called the joint capsule. It's that little like pocket kind of at the base of your skull where it gets soft. And if I turn around here, it's right. it's these guys here. If you follow from the from the top of the ear down.
Mariza (02:59.447)That's why I do the wor- yeah. Me too!
Josh Dech (03:25.42)It's kind of at the base of the skull right where you like ram into your skull and it gets soft. Not right at the spine, just over the muscle hump in these guys. When you press in there, do you have any pain or discomfort?
Mariza (03:31.243)Yeah, yeah, yeah.
Mariza (03:37.518)So these are, like those occipital muscles. I always think of those as kind of the occipital. No, it's not, today isn't a, today, get cervicogenic migraines because of the, but today's not one of those. No, no painness, no pain. I have a lot of neck stuff. But not today. yeah, constant, chronic neck problems.
Josh Dech (03:41.282)Not the muscles. So you got the muscles, the erectors on the spine.
Josh Dech (03:58.775)Okay, so there is lot of next step. So one of the things to consider, yeah, okay. There is a really interesting course, chiropractor that I've been working with for myself and I've shadowed on it for many, years actually works on the C1, C2 and the top two vertebrae, right? And how to properly mobilize those. Yeah, right? And then maybe whether you're doing NUKA or something else.
Mariza (04:14.721)Yeah, yeah, yeah, upper cervical. Yeah, yeah, no, that's what cured my migraines initially.
Josh Dech (04:24.396)But it didn't hold though, right?
Mariza (04:27.276)Over time, I, you know, it was a couple decades that I was, I'm still under upper cervical care. It was a couple decades where that was the thing. That was it. And so kind of a little back story, I was a biochemist at the Lawrence Livermore National Lab, which is our biggest nuclear arms lab. It's connected to, Sandy, did you ever watch Oppenheimer?
Josh Dech (04:54.755)No.
Mariza (04:56.169)Okay, yeah. So that's the sister lab. And so I worked there.
Josh Dech (05:00.244)Mmm. I mean, I know about Oppenheimer, but I've not seen it, but that's super cool.
Mariza (05:05.165)Yeah, yeah, yeah, so that is the Los Alamos lab. That was the first original nuclear arms lab we had who he built it, right? And then the second lab is the Lawrence Livermore National Laboratory, which is in Livermore, California. I heavily secure, heavy security. I worked there as a bio engineer, biochemist, and I worked on basically weaponized biological.
viruses and things like that, or I was testing for those things. Yeah, yeah. Do you remember the anthrax envelopes? Do you remember all that? My lab was the lab that was trying to figure out through mRNA who it was. Anyway, so.
Josh Dech (05:35.236)Oh, yeah, that went really poorly for the world in 2020. I know that.
Josh Dech (05:44.726)I do.
Josh Dech (05:50.658)I've done like talks about your lab. That's super fucking cool.
Mariza (05:53.678)Yeah, it was, anyway, I just wanted to give context. So I was working at that lab and my migraines were pretty intense. This was right after college. And there was a, I would travel, it was a 45 minute commute to get there from where I lived. And there was a woman in somewhere in another one of them, was a, she was a physicist and she had had chronic migraines her whole life and had gone to this integrative practice, which this is 2002. This is a long ass time ago. I'm gonna date myself.
Right now I was 24 years old or something like that. it was an integrative, they had an upper cervical chiropractor, there was no functional medicine at the time. We didn't have a word for it. But she was like, my migraines are cured. And I was like, liar. I had done all the things, I had been every neurologist and all the things, but it was on my way home.

(00:43):
And I went. It was literally off the freeway. So I was like, eh, I mean, I drive past it all the time. And, you know, over the course of 90 days, I was migraine free for almost 20 years. And then I got pregnant and perimenopause. I don't know. don't, usually pregnancy gets rid of women's migraines. But mine, I think I had 100 migraines during my pregnancy. And they've been with me ever since.
Josh Dech (06:52.42)Hmm.
Josh Dech (07:20.618)I think from the sounds of it, a very simple solution would be someone who can do the similar same upper cervical care that can be solidified with ozone and prolotherapy.
Mariza (07:23.189)Yeah.
Mariza (07:31.213)ozone and prolo therapy. Yeah, yeah, yeah, yeah.
Josh Dech (07:33.702)You ever heard of prolotherapy? Yeah, pretty simple, dextrose, bing bang boom. That's what I used for mine. I was kicked in the top of the head like a stump, like broke a whole bunch of connective tissue and stuff and I just chronic headaches and neurological issues and focus concentration, sleep. My CNS is all jacked up, but that's what it came down to. And prolotherapy and ozone solidified that for me over time. And that's what made my adjustment start to hold.
Mariza (07:59.104)Hmm, interesting. okay, yeah, it's ozone therapy I haven't done. I've done a lot of hyperbaric oxygen, but not ozone therapy. Yeah.
Josh Dech (08:06.724)Mm-hmm.
Well, the reason they combine ozone and prolo, prolo is the ticket because prolo is what stiffens the ligaments in the connective tissue to make them hold that adjustment. Because repetitive trauma over time breaks down those collagenous structures, right, in that connective tissue so it becomes more lax. Prolo tightens that back up.
Mariza (08:21.483)Yeah, yeah.
Nice. Yeah, I always talk about there being a limitation of matter. We're so delicate, really. We are, it's easy to break us. you know.
Josh Dech (08:30.361)Mmm. So delicate. It's terrible.
It is.
Mariza (08:37.581)know, neuromuscular skeletal issues, know, pain management, all of that. It's, I mean, it's bigger than people, I think people realize. You know, because it's not something we're always talking about. It's something I live with, but I actually don't ever talk about it. I do talk about migraines, because I know so many women suffer from them. Not often. But I live with them. But I talk about perimenopause and cardio metabolic and blood sugar issues, you know, some of the more silent killers versus this one.
Josh Dech (08:48.012)No.
Josh Dech (08:56.687)Sure.
Mariza (09:07.535)No, it's not so silent Not so silent Yeah
Josh Dech (09:08.663)Yeah, not so silent. Well, that brings me to my question. First of all, what's your hard stop today? I know I'm just kind of yammering on.
Mariza (09:17.353)Yeah, yeah,
sorry, I would say like an hour. Does an hour work, Josh?

(01:04):
Josh Dech (09:27.535)yeah, I book these for up to an hour. I actually have a gap. I put a one hour gap between you and my next interview. I figured we might chat a little bit, but I want to make sure you the time. then, so obviously Perry menopause and all that stuff. What's like the big burning passion around this right now that you'd to make sure we cover today or like a topic you want the episode to surround?
Mariza (09:48.717)Yeah, I'm curious if it is in alignment with you. You know, the big, the big curious topic that I really want to impart.
is one, helping women to understand if they're in it or not and really validate their experience. know, it's often, particularly in this transition, there's a lot of brush off. So how we can advocate for ourselves, how we can gain agency and how, and understanding that this is a window of vulnerability for many of us, but also a beautiful big window of opportunity. So things are shifting and the symptoms are clear. Like it's interesting to me that in this transition,
women have so many symptoms and we're just like, you know, like, and it's kind of the vibe.
Josh Dech (10:36.489)That's fair. I know we get brushed off. Welcome to medicine. Well, I think that's a great place to start. We'll kick off with a what is it? How do know if you're in it? We'll go into like what's too early? What are your symptoms? Let's just rip it apart. I think this is super cool. Okay. Do you have any questions for me before we get rolling?
Mariza (10:45.163)man.
Mariza (10:53.388)If that feels in alignment, think, yeah, I don't have particularly any questions more so I want to feel, I want to make sure that that feels good to you. Oh, that's amazing, yay. I'm not surprised.
Josh Dech (11:00.451)I love it. It's a topic we've not yet covered. Yeah.
Yeah, not at all my wheelhouse even a little bit. So I just want to have it correct. It's a soft Z like Marisa
Mariza (11:14.188)Actually, no Z at all. Isn't that crazy? It's Marisa, like Teresa. Yeah. Yeah. There we go.
Josh Dech (11:18.681)Maurice, Maurice with a soft s, Maurice. Okay. Well, there we go. All right. Well, I'll kick things off with a quick little welcome and we'll get rolling.
Mariza (11:28.288)Thanks, Josh.
Josh Dech (11:30.137)Marisa Snyder, thanks so much for being here.
Mariza (11:33.014)Thank you!
Josh Dech (11:34.617)I'm glad to have you here. It's been a little bit since we've actually connected. I saw you at Ben's book launch party. Was that May?
Mariza (11:41.64)It was, yes, it was May. I know. In a lot of ways, it kind of is a while ago. It's interesting how that was before the summer, now we're deep in the summer.
Josh Dech (11:44.259)I feel like it's so long ago. It's like literally July and that was in May. Shoot me.
Josh Dech (11:57.082)You know what? Time eludes me. I have ADHD anyway. Time doesn't exist in my brain. I'm like a puppy. But we're not here to talk about Ben. We both love him. But we're here to talk about you. Marisa, you are the peri-menopause girl. My wife's actually been following you for a number of years. And we saw you when we were at the party there with Ben. And she's like, I think that's Marisa. I think I follow her. And she's scrolling through her phone. like, it is her. So we had to go over and introduce. And here we are. And now we're friends. But you specialize.
Mariza (11:58.472)You
Mmm, I love it.

(01:25):
Josh Dech (12:26.349)and perimenopause. So I want to start with two quick questions. First of all, what is it? And two, how do know if you're in it or not?
Mariza (12:36.108)That's such a great question. And so many women want to know what is going on. Perimenopause is the transition. It's your second puberty. You know, we all have gone through, any woman who's here at this point, we all went through puberty, right? You Josh, you went through, you went, you're your own version of it. And...
Josh Dech (12:55.705)Yes, I started menstruating when I was 13, yeah.
Mariza (12:58.956)But you went through adolescence, right, where things were changing. And what I think a lot of us don't realize, even in puberty for women, or for young girls, it is about an eight year process. The brain is reorganizing, that's very much a neuroendocrine transition, the body is obviously reorganizing, and hormones are coming online. Right now we are kicking off these rhythmic cycles for the next 35 to 40 years.
Josh Dech (13:01.285)Of course.
Mariza (13:28.91)Well, similar to the ascension into our reproductive years, now in perimenopause, it's the wind down. So at the start of puberty, we have anywhere between 500,000 to 300,000 eggs. And every single month, we are cranking those eggs and prepping them up for that one to get released, right? I always want to always emphasize that ovulation, not your period, is the main event of the menstrual cycle. Without that, we don't even have a period, right? You got to have ovulation.
to make it all work. And so when we get to around, I would say late 30s, kind of 40 years old, let's just say it started midlife, we only have about 10,000 or less eggs. And so the ovaries are like, okay, we are winding this down. And it is that transition of the wind down where we are getting down to, you know, maybe like less than a thousand eggs by menopause or even, you know, maybe hundreds of eggs. It's that wind down, it's that transition. Now that transition,
You know, we could, I always call it the reckoning, where everything is shifting, hormones are shifting, and it's not just our reproductive hormones, estradiol and progesterone, although those are very much erratically declining without permission. But also cortisol can get involved, insulin can get involved, melatonin is declining, testosterone is declining, and this cacophony of this orchestra, so to speak, of all these hormones shifting profoundly during this transition as we are getting to menopause. And I will say that
There's no kind of definitive real end date. I know we talk about menopause as being this end date moment, but really it's a continuum. It's all a continuum. know, whatever's happening in this perimenopause transition is going to continue on even when your hormones are in a very low hormone state, particularly those reproductive hormones. this transition that what I consider to be a very defining moment for a woman given the amount of changes and symptoms and physiology that they're just experiencing.
can feel a lot like a reckoning and is an area of focus that we've really have ignored up until I would say the last few years.
Josh Dech (15:39.365)So I want to back it up a little bit. You mentioned all these hormones, estrogen, testosterone, progesterone, cortisol. It's going to be a lot of names to remember, but for those who are coming into this for the first time, can you just give us a very simple bullet point overview of what these hormones each, what they are and what they do for us?
Mariza (15:47.519)I know, yeah.
Mariza (15:56.181)Yeah, absolutely. Well, let's start with estrogen. She's the queen bee. if they're Beyonce. Okay, let's just let's just tag estrogen as Beyonce.
Josh Dech (16:04.304)Totally.
Mariza (16:06.172)She is a master regulator of many systems of the body, particularly the reproductive system. But estrogen is helping to regulate muscle protein synthesis, bone remodeling. It is the master regulator. She is NASA control for the brain. Estrogen is also driving mood and also supporting the gut. mean, when we have really healthy estrogen, we've got good microbiome diversity.
assisting in, obviously you need to do a lot of other things for good microbiome diversity, estrogen is a key player there as well. so estrogen is a major regulator for our body, but also it's one of the prime hormones that primes up ovulation every single month. So I just want you to think of estrogen as kind of a whole body hormone.
Josh Dech (16:41.507)Of course.
Mariza (16:58.826)Progesterone, it stands for progestation. So the only way that we actually make progesterone is we have to ovulate. So after we release that egg, we have this temporary endocrine structure called the corpus luteum. And that's what releases progesterone in the second half of your cycle. And that's like that calming hormone. It helps to upregulate GABA, which is really calming for our mood, calming for sleep. And so when we are not ovulating, which begins to happen in perimenopause, all of a sudden our sleep is disrupted.
PMS symptoms get worse. We start to have more mood symptoms. I mean the most common symptom of perimenopause is irritability. Okay, followed up by mood swings and rage.
Josh Dech (17:39.46)The best. Perfect.

(01:46):
Mariza (17:42.926)And so that's progesterone, but progesterone is also phenomenal for helping for sleep, helping for mood regulation. It is also involved in muscle regulation and in metabolic health. It helps to modulate the immune system along with estrogen and even modulate water retention. So something to think about there. And again, there's a lot of things about these hormones that unfortunately we are still not fully clear on because the clinical research wasn't
required on women, on females, until 1993. And so just note that we're still catching up on the clinical research for women. There was a mandate by the FDA in 1977 that did not allow for any reproductive age woman to be studied in any clinical research. And that went on until 1993.
Mind you, there was a lot of clinical research that defined our medicine, our diagnostics, our drugs, mean everything in the 80s. I remember being in college and being in my psychology classes and my biology classes and as we were reviewing all of the clinical research, it was all men. It was all men from the 80s. And so it was really fascinating. So just note that there's a lot of things about these hormones that we're still not fully clear on. Testosterone.
I think when we think about testosterone for women, we think libido.
But it's so much more than that. Again, the research, we don't know a lot about testosterone in women, but we are beginning to learn more. We know that testosterone boosts motivation, confidence, libido. It boosts being self-assured in yourself. It also boosts cognitive function, and it kind of helps you to fire on all cylinders. One of the big reasons why women love testosterone is that it helps with muscle recovery and obviously building muscle. So those are some of the benefits of testosterone and something a lot of people don't know, testosterone is the
Mariza (19:35.392)most biologically active hormone in a woman's body, not estrogen. So I'm just gonna leave that there for a second. Big one.
Josh Dech (19:42.63)That's a big one, because think a lot of women are afraid of testosterone.
Mariza (19:47.886)Yes, and they shouldn't be because we so testosterone very similar to men for men and women. peak in our late 20s, give or take, would say 25 to 27 years old. And then it's a gradual decline. And for some people, it's a bigger decline than others. really depends on your metabolic status, your stress levels, your lifestyle, you know, whether you're living a sedentary life or not. But by the time women are in menopause, they will have 50 percent less testosterone than when they had in their 20s.
in their early 30s. And for some women, it's even sooner than that. So it just really depends. That's why it's important to be looking at your hormones. Next, I mentioned melatonin. Well, I cannot tell you how much I love this hormone as a precursor to mitochondrial function, as a beautiful sleep aid. It's a signal hormone in your circadian rhythm. mean, melatonin is doing a lot of great things for our body, and it is also declining very similarly to how progesterone declines.
study that just came out looking at midlife women in sleep and the results were that 67 % of women in midlife have sleep issues and one of it is lifestyle like caregiver burden, stress, a lot of things that are happening. I always say that there's nothing about this modern day world that lends to happy optimized hormones. But melatonin declines around the same time that the progesterone declines pretty similarly.
Mariza (21:17.739)Progesterone isn't as erratic in its declining impairment of pods as estrogen is.
but it's still very profound. And when those two hormones are declining at the same time, we do see a lot of sleep issues that lends to a lot more issues. And then the other hormone I mentioned was insulin. And that's a hormone I talk about a lot. Insulin is our, I would consider, well, it's a fat storage hormone, it's our metabolic hormone, it's our energy processing hormone. And what we see a lot in midlife is that as hormones, these other whole body hormones, estrogen and progesterone,
testosterone as they begin to decline, we do see an increase in insulin resistance. And I would say, I would argue, and I think Benazati would argue with me as well, we would be on the same page, that insulin resistance alone is the number one risk factor for cardiometabolic disease. And other, obviously other diseases as well. And so I'm very interested in, okay, what's happening in this kind of transition, this interim, where we are losing these, what I consider to be our health shield.
You know, I think about these hormones as being a health shield and as they start to falter, what begins to happen with some of these other hormones that are really what I consider to be kind of the big body signalers. And then the last hormone I didn't mention, but I think it's all the rage right now. I felt like I used to talk about it so much, it's gonna be cortisol. And that, I call that the survival hormone. It's such a powerful, profound hormone, but very much kind of similar to...
Josh Dech (22:41.957)Mm.
Mariza (22:51.103)insulin in terms of it has receptor sites on almost every single cell in the body and for good reason like You know if your body had to choose between survival and procreation It's gonna choose for survival first and so and cortisol is gonna be a part of that that that signal or that conversation and so we do see as women move into Midlife and even before midlife. I know for me I had deregulated cortisol levels at a very young age due to trauma and due to just burning myself into the ground but
Mariza (23:21.007)But we do see that there's, you know, a kind of what I consider to be like that zone of chaos where hormones are declining, life is happening, lifestyle isn't maintained, and we start to see a deregulation of cortisol as well, which can lead to some unpleasant symptoms.
Josh Dech (23:38.44)Well, I want to ask you, Marisa, because you talk about how, you know, 60, I think you said 63 or 67 % of women are showing decreases of melatonin and all these hormones are all screwed up. I mean, obviously melatonin, know is the one that helps you go to sleep. It's super powerful antioxidant, all dose 30 to 40 milligrams before bed. And I really quite like it. I actually was, there was a point where I was playing with it. I was up to 60, 70, 80 milligrams before bed, because there's really no lethal dose on it. But I wanted to see because the more I took,

(02:07):
Mariza (23:52.193)Yes.
Mariza (24:03.661)Wow.
Josh Dech (24:07.303)the more wild my dreams got. And so I was kind of just experimenting to see what would happen inside of my brain. And let me tell you, it was a wild ride. But my question for you, we know statistically that up to 92 % of the population is metabolically unhealthy. So we have these really basic hormones like melatonin, testosterone, estrogen, progesterone, cortisol, insulin, all these different things. All these screw ups and this dysregulation, these deficiencies, these declines that we're seeing, do you believe
Mariza (24:22.123)Yes.
Josh Dech (24:36.561)that this is a natural order of things? Or do you believe it's accelerated or made much worse due to the fact that we're so unhealthy as a nation?
Mariza (24:44.845)I would say that it's the latter. I would say that a lot of women are coming into midlife.
coming into perimenopause, already experiencing a level of insulin resistance. You can't feel insulin resistance per se. Yes, there are subtle symptoms like cravings and mood swings and energy crashes and feeling hangry, but overall, it's kind of hard to feel insulin resistance, just like it's hard to feel bone loss or it's hard to feel streaking, plaque streaks in your vascular walls, or even hypertension, very rarely.
do we feel hypertension? If you're feeling hypertension, that is a massive red flag. And so yes, we get into this time in our lives where maybe as these hormones were cyclically stable, we're kind of managing, we're doing okay. We somehow...
maybe not really have it under control, but it feels enough under control. And then we lose the cyclical hormones that our body has been reliant on for decades. They run very consistently, very cyclically. They do the same thing that they every single month, right? We know that estrogen is going to peak around day 10, day 12. We know that progesterone is going to peak around day 19, 21. We can track this very, very easily. And when these hormones
begin to what my dear friend calls unconsciously uncouple. I say erratically decline, okay? an example of this, let's say the brain has been reliant on estradiol for decades.
Josh Dech (26:16.64)Mm-hmm. I like that term. Sure.
Mariza (26:26.558)Let's say Estradial is the CEO. The CEO comes to work at 9 o'clock a.m. Every single day. Leaves work at let's say 8 p.m. Every single day. Let's be honest, estrogen is working 24-7. But let's just say she's got a timeline. And you know, and the brain's reliant on that. CEO shows up every day, same time, every single day for years. And then all of a sudden, the CEO doesn't show up to work until 2 p.m.
but stays until 2 a.m. and then doesn't come to work the next day and then comes back to work at nine and then doesn't show up again until, you so this is the inconsistency. So there's a lot of massive remodeling that's happening because of faltered communication and basically hormones not binding to receptor sites in the way that they used to. And what ultimately exacerbates that is also the lifestyle that's playing out, the increased amount of stress,
decreased sleep issues, decreased sleep to sleep issues, the already pending insulin resistance, the sedentary lifestyle, the not being outside during the day when it's sunlight, and then not having dim lights at night. All of this is adding up, and ultimately potentially not eating a very nutrient-dense diet. And so you've got these hormones that begin to falter, and it feels like the rug is pulled out from under you.
Josh Dech (27:48.86)So those are really your big risk factors in perimenopause is actually getting into perimenopause safely with the most optimized health profile possible. And then your body will kind of do what it does. But the 92 % of the population who's getting into perimenopause right now, who is not metabolically healthy, will be experiencing some of those symptoms or at least either worse. So I want to talk about how you know if you're in perimenopause or not. So.
Mariza (28:15.019)Absolutely. Yeah.
Josh Dech (28:16.537)What are the symptoms you can look to experience? What are some of the telltale signs? Is there blood work for this? Like how would you know almost without a doubt say I'm in perimenopause?
Mariza (28:27.246)Yeah, I love this question because so many, this is literally the number one question I get from my community and my patients. Like, am I, this it? Is this perimenopause? You know, that's always the question. And so I even myself, I was like, is this, am I finally here? Is this it? And there is no definitive blood test. So the way that we clinically diagnose perimenopause is through symptoms, through age, and through cycles, menstrual cycles. That's kind of how we look at it. So what are some of the most subtle symptoms? Again, perimenopause is a, it's a continuum.
We know that natural menopause can happen anywhere between the ages of 45 and 55 years old. And so if perimenopause is a four to 10 year transition leading into menopause, then that means that women as early as their mid to late 40s, or sorry, mid to late 30s can be in perimenopause. So there are three major stages in perimenopause. The first one is the late reproductive stage. I know, I'm sure you've heard that by the time a woman is 35 years old, she's having a geriatric
pregnancy, right? That is considered late reproductive stage. The reason why we say that is we know that there's only so many eggs left, probably close to like maybe 50,000 give or take, and that... the ovaries know that. The body knows that.
Josh Dech (29:28.966)Yes.

(02:28):
Josh Dech (29:42.897)Sure, it's keeping track, it's got an inventory.
Mariza (29:44.431)Yeah. And so egg quality is going to be, it's just going to shift. And so is our egg supply that we've got. And at that point, we may start to experience a few anovulatory cycles where we're not ovulating. And that has an impact on progesterone and the communication between the brain. The brain's like, we need to ovulate because that's all the brain is thinking about. Ovulate, ovulate is what we do. It's what we do. It's how we continue the species. And the ovaries are like, sorry, we didn't do it. So there's this miscommunication, this fault
communication between the brain and the ovaries. so initially, with progesterone beginning to subtly, or maybe not so subtly decline, we will notice more brain-related symptoms. So sleep may shift. You may notice that your PMS symptoms, that used to be two or three days, is now four or five days. You may notice more irritability, low stress tolerance. So what women will tell me is that, man, I used to feel stable. I used to feel like I had my edge. I used to feel like I could fire on all cylinders, and now I feel like I'm efforting more.
I'm really having to try harder. So it's the brain related symptoms that women come to me first. And then I would say early perimenopause. This is where both progesterone and estrogen are definitely shifting. And I'll start to see again, more kind of more PMS type symptoms. maybe although she's still cycling consistently, instead of a maybe 28 day, 26 day, 27 day cycle, is now a 24 day cycle or 25 day cycle.
and they'll start to feel that difference all throughout the cycle. And that's why I always tell women to always track your menstrual cycle because it is your monthly report card, especially in perimenopause. Other symptoms that women will begin to experience in early perimenopause are going to be brain fog, lack of word recall, more mood symptoms, but also then things like frozen shoulder, workout recovery, body composition changes, again, more heightened sleep issues, feeling more fatigued.
Just not, I would say that usually at 42, 43 women are coming to me and they're like, I feel like I'm falling off a cliff. Like I do not feel like myself anymore. What is going on? And I always joke that it's kind of in that moment, you know, where we ask the universe, send me a sign, make it impossible for me to miss. It's usually around 42, 43 where women are like, I feel like this is the sign that it's impossible for me to miss. And then we get into late perimenopause where this is now.
Josh Dech (32:08.316)Wow.
Mariza (32:12.876)Periods and menstrual cycles are very erratic. You are skipping periods up to 60 days. At this point, when this begins to happen, you're about one year to four years away from menopause, that defining moment where you haven't had a period for 12 consecutive months. This is where we start to see the hot flashes, the night sweats, the vaginal dryness, a painful intercourse, maybe UTIs are coming up, more physical symptoms, things like even weird symptoms like palpitations, burning mouth syndrome,
tinnitus in the ears, just more inflammation. know, brain is really feeling it. Sleep is becoming a major issue for some women. Body composition changes have been happening. They're just, things are really feeling. This is kind of what I consider to be like the eye of the storm, a little bit of the unraveling. This is where women, their mental health is the most vulnerable. It's also where we see the highest increase in divorce rates and loss in relationships, also in loss productivity.
As a nation, the United States loses $26 billion a year in lost productivity and health costs in women in this particular transition, this part of perimenopause and into early menopause.
Josh Dech (33:26.632)26 billion dollars a year plus higher divorce rates is why is it is it is it moods is it emotions is it Like that's that's shocking Wow
Mariza (33:29.302)Yeah, in-laws
Mariza (33:35.223)It's everything.
Mariza (33:39.696)It's a, it is an economic crisis. It's like, cause you think about, I always say that I serve everybody by serving women because I do believe that women are at the epicenter of every family.
Josh Dech (33:44.582)No kidding.
Mariza (33:52.664)They're at the epicenter of every community. are some of the most important parts of workforce. And I think when we are able to optimize women's health in this particular transition, we don't just change communities and change families, we change the world.
Josh Dech (33:53.277)Yes.
Josh Dech (34:10.706)Wow, and that's extremely powerful because I think sometimes we don't really see it beyond ourselves or our relationships and what's happening right now in the here in front of us, but it really is. You multiply that by tens, if not hundreds of millions of people and it really has a big impact. Again, not just economically, but socially, societally, like everything starts to shift and fall into line with or without that, which is staggering. That is a shocking, shocking number. Now you mentioned here that
A lot of women are coming to you feeling like they're falling off a cliff. They got even frozen shoulder, which I thought was just more of an injury or lack of use thing. But your body starts to fall apart. Your connective tissue starts to fall apart. Your brain function, cognitive, productive relationships, all these things fall apart. Would it be fair to say, because we did reference this 92 % who are metabolically unhealthy. So our data points, largest point of data for all this happening is in the 92%. That means only 8 % of them, these women coming into perimenopause menopause are going to be
healthy getting there. So would it be then fair to say that relationships would be better, productivity would be better, moods, emotions, everything would be better if you got to paramentopause safely and in a healthy way.

(02:49):
Mariza (35:23.695)Yes, and if you were able to navigate perimenopause with great cellular energy. I always say that every thought that we have, everything that we do, all of it is dependent on our cellular energy, on our mitochondrial energy. And yeah, that's a great question. The first question I always ask any of my patients is, you metabolically healthy? Are you a part of the 7 %? Let's find out.
Josh Dech (35:42.703)How do we do that?
Mariza (35:53.476)because that's the first step.
And so I want to talk a little bit about those biomarkers. You've probably had other people talk about them as well, but really quickly, you know, I it's it's interesting, you know, we live in a time where we really have to have agency over our health. I say this and I don't say it lightly, but that nobody's coming to save you. No one's coming to save me. Like I'm the one everyone's calling, you know, and so I better I better know my numbers. And so if you don't if you walk away, if there's anything you walk away with this conversation, I hope it's this that you at least know these five biomarkers.
your five biomarkers. So the way that we diagnose that 93 % is that when you have one or more of these biomarkers out of range. And how we diagnose metabolic syndrome, which is the massive precursor to cardiovascular disease and dementia and all of the major chronic conditions, is when three or more of these are out of range. So the first one is fasting glucose. And if it's 100 milligrams per deciliter or more, that would be considered metabolically unhealthy.
Here's the thing, if you are at 100 milligrams per deciliter or more, you are pre-diabetic. And I argue that we shouldn't have pre-diabetes. They should just all be diabetes. I don't understand why we are like, you're just kinda diabetic.
Josh Dech (37:10.984)That's such a stupid process. So many times the medical system is just full of just hiccups, hitches and failures. A great example, I had a client of mine many, many years ago. I talk about this one all the time. Such a shocking example to look at where she went to her doctor and her doctor said, okay, well, your thyroid is low. Like your TSH is high. And just for you listening for clarity, TSH is called thyroid stimulating hormone. And this is when your brain, it's actually a pituitary hormone from the brain that will say, hey,
We're detecting all the circulating active thyroid in my body and I'm not having enough of it. So I'm gonna increase, my brain is gonna tell my thyroid through this thyroid stimulating hormone, make more. So she went to her doctor and she got her TSH measured, this hormone, and her doctor said, okay, well your results, it comes out at 4.3. Now in Alberta at the time, the reference range that was acceptable was between two and four. So 2.0 to 4.0. She said, well, you're 4.3.
Let's come back in three months time. And if it goes higher and out of range a little bit more, then we'll intervene. Well, obviously it's going to, right? It shouldn't be that high to begin with. So it's going to get worse. So she comes back three months later. It's 5.7. Her doctor goes, well, it's still within range. So come back if it gets worse. Well, here's what happened. That reference range over that three month span, the first blood work was in December. The next was in March. So it was about three months time between over that new year. They changed the reference range.
And they said it's now from 2.0 instead of two to four, it's two to 6.5. They added 67 % onto the reference range because what they're doing in blood work is they're opening this up and saying, okay, we're taking samples from the population as a whole at hand, and we're gonna say this is what's standard or normal. But because 92 % of us are sick or metabolically unhealthy, our reference range of quote normal is actually sick by definition.
And so you get all these people coming in, you're talking about these biomarkers. For you listening right now, I just really wanted to hammer that home. That what's normal is far from optimal. And so as Maurice is talking about this, just know, get a second opinion on your blood work from somebody who understands functional. Because your doctor is looking for red or green. Is it in or out of range? They're not looking at the numbers and doing the
I want to speak into that too. Two things about that fasting glucose number one, it's a reactive number, number one. So it's after the fact. I'll talk, and number two, particularly when we're also when we're looking at these numbers too, reference ranges are still really based on men. And so we don't diagnose diabetes until 126 milligrams per deciliter. But what we know is that when women get to around 107, 108 milligrams per deciliter, that that alone is a significant
risk for cardiovascular disease. You do not need to be at 126 milligrams per deciliter for it to be a cardiovascular risk, particularly for women. Now again, I don't want anyone above 90. And ideally I would love you, kind of ideally I wanted under 85 milligrams per deciliter. That's what I'm looking for. That's what I'm aiming for. But again, this is a reactive number. And so why aren't we looking at fasting insulin? When we know fasting insulin can kind of dictate or
show that you're in the direction of pre-diabetes and diabetes 10 plus years in advance. And when I'm looking at a fasting insulin lab, I don't want it above five.
Josh Dech (40:36.329)So, you show you... Yeah, so, okay. And I know we took a of a segue there. And so, we're looking at blood sugar and fasting insulin. That's your first of five biomarkers, which are going to get us into the cellular metabolic health. I just wanted to re-anchor that conversation because I know I derailed us. So, cellular health, metabolic health, getting into perimenopause safely, or even if you're in it for correcting your body so you can transition to menopause better.
Mariza (40:37.966)So that's the first biomarker.
Yeah, we did.
Mm-hmm. Yes.
Mariza (40:50.574)Yeah. Yes.

(03:10):
Mariza (41:01.242)Yes, this is technically to decide if you're part of the 7 % of metabolically healthy. But here's the thing, like if you would fall into that category if you were 99 milligrams per deciliter, which is just maybe on a good day, we caught you at 99.
Josh Dech (41:17.927)your doctor would see nothing because he didn't flag in the machine.
Mariza (41:20.228)Yeah, and what we almost wouldn't say anything if you were to pre-diabetic 84 % of people who are pre-diabetic have no idea that they are Yeah, and almost close to just I just really want to hammer this because I'm a mom of a little boy and right now Currently we are at around 38 % of our children between the ages of 12 and 18 that are pre-diabetic
Josh Dech (41:29.737)Gross.
Josh Dech (41:46.506)And you know what it is though, it is really the food, it's our lifestyles and the number one leading cause of liver transplants. Now this is years ago, I had a doctor at a conference she told me, well, sorry, this doctor was a client of mine who was at a medical conference on fatty liver disease. And they said by 2025, the number one leading cause of liver transplant, including in children will be from non-alcoholic fatty liver, primarily due to things like high fructose corn syrup and inflammatory oils and preservatives.
So we are doing it to ourselves, but like you said, a lot of us don't know it, not only because we're not measuring the markers, but this is what's normal. You come in at 99 on your blood work, your doctor goes, yeah, well, you're within normal range. Excuse me? That's crazy. Yeah, and you don't know to advocate for yourself or to check your own blood work. You're not trained on this stuff.
Mariza (42:29.188)Yeah, well, if you don't know, you don't know.
Well, that's why I'm, that's why I've at the very least know these numbers. So, okay, so that was, that was fasting glucose. Next one is high density lipoprotein. So HDL, you're known as your good cholesterol. So for women, if it's under 40, men, if it's under 50, fit 40 and under 50 under. Here's the thing, if again, if you're 40 or under, I'm very concerned.
Very concerned. So I want it to be in the 60s, the 70s. This is where I want it to be. So that's, HDL is the next one that we're looking at. Next is going to be your triglycerides. So if it's at or above 150 milligrams per deciliter, again, this is a indicator of metabolic dysfunction. I ideally, optimally want it around, I want it at 80 or less. The American Heart Association will say 100.
like they've updated, even still, would, again, 80 should be the benchmark. Next is blood pressure. I was actually just interviewing a cardiologist who's a functional cardiologist, and he was basically, what we're looking at is anything at...
at 130 systolic over 85 diastolic is considered metabolically unhealthy. However, when I was in that interview, because again, we're updating and updating in terms of optimal, he's saying 116 over 70. 116, not 120.
Josh Dech (44:05.197)That's a really interesting number to pick, right? Because like 120 over 80 is like the textbook what they taught back in school when I was in paramedics. That was like kind of the rounded number. Why 116? Why 116?
Mariza (44:16.976)Here's the thing about cardiometabolic disease or cardiovascular disease, stroke, heart attack, is that it is, I I just interviewed Dr. Gundry not too long ago, a couple months ago, and it was the stat he said was so alarming, I was like, are we taking this to the bank? He was like 100 % of cardiovascular disease is preventable. 100%.
Josh Dech (44:42.161)I believe that though. mean, most of-
Mariza (44:43.472)I know, I do believe it too, it's, no one's making, very few people feel comfortable making a claim like that. But you know, he's a cardiologist, he's a cardiothoracic surgeon. And he's like, this is the truth. And so when I was interviewing this other cardiologist, he's like, we just, we didn't know what we didn't know. We're becoming more sophisticated in what we know and what is a driver. And blood pressure even at 120 over 80 is still driving.
inflammation, it's still driving plaque, it's still driving plaque streaks and so the goal is 116 over 70.
Josh Dech (45:18.793)Wow, what an odd number, but I get that. So we'll call it 116 over 70. So you got.
Mariza (45:22.896)I think our imaging's getting better. Yeah.
Josh Dech (45:25.705)That's fair, okay, we're getting more precision. But what about those who say, like my wife, she says, well, my blood pressure's normally 90, 95 over 60. Like she's just been low her entire life. Is that a sign of metabolic dysfunction? Is that a genetic thing?
Mariza (45:38.146)No, again, it's blood pressure that we're most concerned about, increased pressure on the vascular wall. So if your wife is below the 116 over 70, then yes, I'm usually 104 over 65.
Josh Dech (45:54.967)Okay, so under is not necessarily a bad thing, obviously until you die. Right, okay.

(03:31):
Mariza (45:57.297)No. It's the hypertension that we're worried about. But again, 130 over 85, we're talking about red zone. And again, all of these markers, you're like, okay, well, I have this medically managed. These markers need to be in range without medication. This is without medical management.
Josh Dech (46:14.825)Yeah, it's really, I've seen some pretty high blood pressures. Now, I mean, obviously when I was a paramedic, those having a stroke and those in trauma, like it's going to happen. But I remember years back, I had a client of mine and I was working at a gym as a personal trainer. was probably 11 years ago now, something like that. Anyway, point being part of our intake was taking blood pressure, just this little battery powered machine. It was just, you know, for liability reasons, he was like 190 over 130.
Mariza (46:20.588)Yes, absolutely. Yeah.
Mariza (46:39.568)Sure, yeah.
Josh Dech (46:44.713)I'm like, this can't be right. Sat him down, took it again and again and again. And I was like, Matt, I gotta send you home. It's like, I can't do a session with you today. You need to see your doctor immediately. If I had you go and lift a dumbbell and put any strain on yourself, you'll probably have a stroke. Like this is not okay. And he ended up going in, got some medication. And then that allowed him to take care of the immediate emergent blood pressure that could cause a stroke and kill him.
until we got it down over the coming three, four months, we worked on metabolic health and exercise and diet and his blood pressure normalized, came off his drugs, he was fine. So I don't think we really equate to say like, at least in the gen pop, he didn't realize what his blood pressure meant. And I think for anybody listening to you right now, well, my blood sugar being 100, what's the big deal? Insulin, HDL, triglycerides, blood pressure, what's the big deal? If we're metabolically unhealthy because we want these metabolic markers to be healthy,
to get into perimenopause and menopause safely. Even if you're in one or the other, you can still correct your symptoms and aid yourself and overall health by correcting these. That's where this conversation started, but for the sake of not dying and for wellness, what are the importance of having blood sugar, insulin, HDL, triglycerides, and blood pressure in normal levels besides just not having a heart attack or a stroke?
Mariza (48:02.608)I mean, think part of it is not having a heart attack or stroke, or basically... I mean, I don't know if you know this, Josh, but more women than men die of heart attacks and stroke.
Josh Dech (48:06.004)Fair. That's a ticket there then.
Mariza (48:15.184)More women than men have chronic migraines, autoimmunity, dementia, cognitive decline, Alzheimer's. And I think the statistic that is the most alarming to me besides the 26 billion that I shared, but that women will spend 25 % more of their lives than men riddled in chronic issues, debilitating health.
Josh Dech (48:41.268)Well, let me ask you this.
Mariza (48:41.552)And so if it's all in relation to good cellular energy or good mitochondrial function, how do we future proof our health or how do we shove back that 25 %? We're not talking about that 25 % happening in our 80s. We're talking in our 50s and our 60s.
Josh Dech (49:03.988)Wow. Wow.
Mariza (49:05.326)So this isn't, know, you know, when I share things like one in two of us, one in two women will have an osteoporotic fracture. Probably 70s, 80s. Again, it's not, yeah, one in two. Again, it's not, is it motivating enough? I don't know. You know, one in four of us will end up in a home, you know, in a facility. Again, is that motivating enough? No.
Josh Dech (49:14.897)One and two?
Mariza (49:34.403)What I think is motivating enough right now is that you are most likely experiencing subtle symptoms or not so subtle symptoms that is having an impact on your quality of life and how you show up for the people that matter the most to you. And so when I think about the things that we can do right now to mitigate our symptoms and to feel more alive in our body and to really just have the freedom, you're not negotiating with yourself about what you can and can't do. That I believe that we should
get to double dip. One, that we're doing the things that are helping us to feel more alive right now so that we can show up for the people and things that matter most to us because for women we are hardwired for that. But number two is that these same things, these same lifestyle strategies, these same habits, these same rituals are not just having an impact on you now, but they are future-proofing your health 30, 40 years down the road. So for example, my mom is
Mariza (50:30.992)64 years old. She just played competitive tennis last night. She played pickleball the day before. She ran a marathon last month and a half marathon last weekend. This woman is crushing life. She can throw my son in the air. She can sprint with him, run with him. This woman is a beast. Okay. And mind you, her perimenopause journey was a nightmare unfolding. And she decided she knew that she was in a reckoning. She knew that she was at a crossroads. And she decided that she
wasn't gonna let it happen to her. She was gonna be proactive. And man, the transformation is phenomenal. Now, my best friend, I actually just celebrated her birthday just yesterday. She has a mom. She has a mom too, obviously we all have moms. And she has a, her little boy is almost the same age as mine. But her mom is one year younger than my mother. She's already had a heart attack. She has significant serious inflammation. She can't get off the floor. She's in chronic pain. She's already, it's already happening. She's already living a life
where her life, her quality of life is suffering and she is struggling. Let me tell you, the experience that my mom is having with my son is a very different experience than my best friend's mom is having with her grandson. Very different. Their quality of lives are so polarizing. They're so different. And I want what my mom's got. I want that life.

(03:52):
I want the life where I can decide I'm gonna go hike a mountain with my friends this weekend at 60, almost 65 years old. I want the life where I am getting on a plane and I am literally shot putting my luggage in the overhead compartment at five foot two. And that I am snatching it off the overhead compartment without any help. People always ask to help me, tall men, because I'm short, I am. And I snatch that sucker, like I snatch my 50 pound dumbbell and I put it on the ground steady and easy.
Josh Dech (51:54.538)Yeah.
Mariza (52:24.038)at 30 years down the road. And so the things that I'm educating on is one, have agency, know your numbers. But then number two, what are the things that you are committing to today that are your non-negotiables that allow you to not have to negotiate with yourself 20, 30 plus years down the road?
Josh Dech (52:42.25)That right there is such a great descriptor to really explain why over here, North America, have elderly who are in nursing homes. They're sick. They're burdened on the medical system. They are declining at age 50, 60. By the time they get to 80, they're completely dependent on somebody else. They're barely surviving, but they're still economically viable to the system. That's the issue. That's the elderly.
But other countries who do not have these same issues, they have elders who are in their 80s and 90s and cooking, cleaning, walking, hunting, working with children like they are contributing because they're aging well and aging gracefully. So for anybody listening right now, any woman who's listening to this thing, okay, I want to get to to perimenopause in a healthy way, in a safe way. I'm in it right now, for example, or I'm toward the end of it going into menopause, wherever it is they are. What are the top three or top five things?
that you would tell them right now to do that would pivot and change their life entirely.
Mariza (53:41.381)Yep, number one, it's about what substrates you're putting in your body. I always ask myself, is this gonna fuel my future brain?
So it's about eating to balance your blood glucose. It's about eating to preserve your cellular energy. To me, that is lots of micronutrient and antioxidant rich foods, of foods in polyphenols, gut loving foods, if you can tolerate things like fermented foods, yogurt, kimchi, those types of foods, like things that are gonna help support your gut microbiome. Protein, making sure that you're getting sufficient protein so that you're actually building the building block
of the body, Essential amino acids are what builds everything in the body. That's what builds our proteins. And good omega fats. And then getting very clear about where the added sugar is, where the processed foods are, and figuring out a way to swap them out, cut them out. So that's gonna be number one. That's gonna be how am I feeding my future brain? That's what I ask myself when I prepare anything for myself and my family. Number two, it's gonna be sleep.
I always tell my women, you need to protect your sleep like it's a million dollar meeting. That Netflix show is not a million dollar meeting. That email that you need to send, is not a million dollar meeting. The dishwasher that needs to be, again, know, unloaded is not a million dollar meeting. Like, your sleep consistency is everything. And it's not like it used to be. I remember when I was in my 20s, even in my 30s, I could run, race into bed and fall asleep. Now you have got to, you got to work yourself up to that situation.
So, you know whether it's an out, know, it's 40 minute routine 30 minute routine Whatever that looks like have good sleep hygiene But more importantly go to bed at the same time every single night and get up in the morning the same time every single night sleep consistency is everything and So and if you're having a hard time going to sleep, obviously there's a lot of things that you can do including progesterone and magnesium Melatonin, I mean, there's a lot of strategies that we can implement having a good routine but even if you're struggling to go to
Mariza (55:48.322)by the night, the one thing that you can do every morning is get up at the same time and get light on your eyes. Signal your eyes, reset your circadian rhythm. That's gonna be number, that's number two. Number three is move like your life depends on it. So I believe that we should build our life around movement.
We live a very sedentary life and I used to, there was a myth that I used to, I used to believe I was a personal trainer too. And I thought that as long as I got the one big workout in in the morning or any time of the day, that pretty much I was good for the day. And yeah, I could, I could slide on that in my 20s. Probably shouldn't have, but like I could, you know, I remember being in college, being in a seat for six hours a day, but I would get the one workout in and I was golden, right? But man, as you move into your 30s and your 40s and honestly, at any point even,
Mariza (56:35.835)our children, we need to build our life around movement. And I know you're all wondering, well, how the heck do I do that when I have got endless obligations? And the answer is exercise snacks. It's exercise snacks. It is one to five minutes of mini bursts of movement throughout your day. It adds up. It is extra movement, but I love the little burst movements, jump squats, jack squats, mountain climbers, pushups, walking up and down your stairs with weights, jumping jacks, anything that's going to get your heart rate
that's going to stimulate that muscle. So again, building your life around movement. Reorganize your life around movement. I think about the research for the Blue Zones and how every single one of these centenarians are so physically active. They're not going to the gym. They're not going to a Pilates class. They are just moving their butt all day long. That is what they're doing. So that would be number three. And number four, yes.
Josh Dech (57:33.099)I love that Marisa. I just want to put a plug in there for the listeners often an idea that there's misinformation around blue zones that they're all like vegans they eat a shit ton of meat they do suckling pigs and roasts like they eat meat they move they sleep and they're social those are those are well shit okay well I guess it's my show now it's all right
Mariza (57:48.184)Yes, that's the next one. That's... Yes! No, Judge, absolutely!
The next thing is to build your community, spend time with the people that you love, doing the things that you love, have your girl besties, your book besties, your perimenopause and menopause besties. I will say that this particular transition can be very lonely because there's a lot of blame and shame put on women for what they're going through. Women are often blamed for their symptoms. They're often blamed for their stress, their issues, their sleep issues, all of it. And there's a lot of shame, you know.
when we're dealing with hot flashes and night sweats, it's something to be embarrassed about. And so we often tend to go inward. We tend to get smaller. that's societal expectations and pressure. And there's a lot. It's a whole different conversation for a different day. But this is not the time to go inward unless you're reflecting on who you want to become in the next part of your life, the second half of your life. By all means, do that. But this is the time to double down on safe friendships. This is the time to double down on community to connect.

(04:13):
I the ultimate longevity hack is grabbing a matcha, unsweetened, unsweetened matcha with your bestie, going for a walk in nature and just catching up and processing whatever you're going through. So I happen to live in the most funky, cute little beach town called Lucadia in Northern San Diego and we have the most incredible, Celiac friendly seed oil friendly, like all organic, they make their own nut milks and they milk,
They make the most incredible matcha lattes. And we grab one and we're right next to one of the coolest surfer beaches. So we head down the beach, we walk the beach, and we just catch up. We catch up on our books, we catch up on our life, we catch up on everything. And it is my most favorite thing to do.
Josh Dech (59:43.66)That sounds awesome. As I'm looking outside right now, it's like thunder and rain and cold. I don't know why live in Alberta. know, Marisa, when I moved here, the first year it was 2013-14, I got out of my car, it was minus 47 or 48 degrees. Just the surface of the moon gets to minus 45, just for a contrast. And it's been as low as think minus 56, 57 with wind chill here. So I don't know why live where the air hurts my face. But then I look at like Australia, where
what, nine of the 14 most deadly spiders in the world live, they got snakes and these giant monsters in their house, and I'm like, this is why I live where the air hurts my face. So it sounds nice though.
Mariza (01:00:20.427)Or you could live here where it's like the, I would say we swing from 50 degrees to 75 all year long without deadly spiders or snakes. I know it's true, it's so hard.
Josh Dech (01:00:29.023)That sounds really tough. I don't know how you do it. Yeah, you sound oppressed. I'm not sure how you guys get through all of this. So we got here's what we got Marisa. We've got food, sleep, movement, community. And what was our last bit here to longevity and wellness?
Mariza (01:00:48.623)I would say the last bit if I had to, like, I would say number one on the agency side.
And I just, just speaking to all the women, all the mamas, all the women who are in the sandwich generation, who are taking care of elderly parents and also raising children at the same time, and are really holding it all together. This is your permission slip to prioritize you in a world that tells you to prioritize everyone and everything else. I will tell you the cost of self-sacrificing is your health. And I will tell you, there is a moment, there's a fork in the road in midlife where your body tells you, your body screams at you to say, know what, it's time.
to prioritize you. And you're not going to get through the second half of your life without prioritizing you first. And that is probably my biggest message to any woman listening to this is that if your body is signaling to you that something is wrong, it is time to focus on yourself. Because I promise you that when you are thriving, when you've got the energy and the capacity, you are always going to give to everybody else.
Josh Dech (01:01:51.692)That's really powerful because so much, especially women tend to give, give, give, give, give, give, give till they have nothing left to give and then their body has nothing left to give them. And that's a recurring theme I've seen a lot in my lifetime. And it's so, so important at some point to say, no, I got to do this for me. can't, you know, the saying, right? Put your mask on first. I think that's incredibly important. So let me, let me throw the ball back to, don't have any leading questions or anything that I want to ask right now, Marisa, but I'd like to ask you.
Is there anything that we've missed? Is there anything we haven't talked about, any gold nuggets or words of wisdom that you'd like to leave, leave us with today?
Mariza (01:02:29.773)Yeah, absolutely. I would say that just from my own personal perimenopausal journey, I shared with you before we got started that I came in to adulthood with a lot of trauma. And there were years where I was performing, I felt like productivity was the only thing that mattered in terms of my worthiness and worthwhileness. And I think that a lot of us, a lot of women come in with beliefs, a lot of people in general, but it's the women come in with beliefs that
if they're not productive, that they're not worthwhile. Or if they're not putting their family first, they're not worthwhile. And so that may be coming up for review for you in terms of your boundaries and your relationships and your beliefs. And you may find yourself kind of finding yourself back where you were over and over again like I have in the past. And I will say that what has been the ultimate reckoning for me is doing the deeper work. So I have somatic therapists, I have internal family systems therapists, because I want to heal the
and I want to heal some of my biggest patterning, not only as a mother, but also as a woman who I'm becoming. You know, I always think, who am I going to be in the second half of my life? I've lived, most likely I've lived half my life at 45, almost 46 years old. You know, that puts me at 90, 91, give or take. And I don't want to live longer per se. I don't want to live to 120. I want it to be quality. So I want to be clear on my full body yeses and my full body nos. And one of the best ways that I can do that is really do the work on myself.
And so if you find yourself in a crossroads in this particular transition where you're grappling with your identity, you're grappling with who you've become, you're grappling with wondering if you're living somebody else's life. Has it ever been your path?
You know, this is the time to really get to do that inner work. And I go through a lot of that in the book as well because I know that this is a reckoning. I know that everything is up for review. I know because I'm in it. And I know that I get to...
Mariza (01:04:30.037)ask these questions of myself. I get to do this work to feel more aligned, more peaceful, more calm, more regulated as I step into the second half of my life. I think that this becomes the kind of existential question of like, is this it? Is this what it's all been for? And is this what I really want moving into the next phase? And I just want...
My ask of you is to explore those questions. In the book, I lay out so many beautiful questions around the mindset and who you're becoming because I get that cellular energy is the epicenter of everything. You've got to feel healthy before you can do the bigger work, but once you get to that place where you are feeling healthier and you're feeling better and you're still finding yourself wondering, is this really it? I want you to know that you can ask those questions of yourself and get really clear about what is it that you
truly love.
Josh Dech (01:05:26.86)I love that that's really really powerful because it it puts the ball back into your court when I think so much of the time it feels like we're kind of a Slave to our genetics. There's nothing we can do It's a byproduct of life and we've got to ride the wave and hope for the best or you know women who gain a lot of weight during perimenopause menopause Which is a big concern even men going through andropause, right? Well, I'm just gonna fall apart. It's aging or I hurt because I'm old. That's not the case You're not just a slave to time and genetics
Mariza (01:05:48.238)Yes.

(04:34):
Josh Dech (01:05:56.087)but you are a byproduct of your cellular metabolic health. And I just had actually a little laugh here. I looked down on the ground, I got my wiener dog, Bruce, and he just, he sleeps like 16 hours a day. Like it's a very different life. He's on his back, his little legs are kicking right now. He's twitching cause he's dreaming, probably chasing a squirrel. And he just has it so easy. But here we are as humans and it's our job to really pick up all the pieces of an environment and a lifestyle and a world that is not designed.
to be biologically compatible with humans. this is why, no, that's why it feels so complicated. It's like, how do I eat this? How do I do that? So hard. You're juggling 48 different balls. You gotta jump from piece to piece. You gotta know all these things just to try to keep yourself from falling apart. But at the end of the day, if we went back, I'm not saying hunter gatherer, they do have very hard lives, but they don't have all the metabolic diseases we do because they sit, we sit, move.
Mariza (01:06:27.812)No, not anymore.
Yeah, and it feels so hard.
Josh Dech (01:06:52.192)We eat processed food, they find their food, they hunt it and they gather it. Even our environments, our indoor air is recirculated, recycled, they have open air concepts. A lot of these hospitals don't use HEPA filters over there. actually have, the architecture is built in such a way to circulate fresh air and they have better outcomes than we do here in North America with trillions of dollars sunk in. So everything about what we do has been built to compensate for and lean into a system in a world not compatible with our biology.
But if we can step back and step out for just a moment to whatever, mean, we have to live in the modern world now unless we move somewhere else. But if we can just step out in some way, or form, then everything begins to change slowly, but surely, which I think is very powerful.
Mariza (01:07:35.396)Yeah, no, I agree with everything you said. Like even just the way that our, you know, I was talking to my son yesterday, we were outside grounding in the early morning and we were getting sunlight and we were looking at all the flowers and the butterflies and the hummingbirds that were flying around and the birds were chirping everywhere. This really tropical, really pretty garden in our backyard. And he goes to farm camp, you know, during summer. He learns, he's learning how to farm. He's outside all the time. But one of our goals is Kingston clocks about a thousand hours outside in nature.
every year, which averages about three to four hours a day, give or take. And he and I were outside and I was explaining to him, you know, because there's a lot of repetition in my in our life when it comes to a four and a half year old. And I was just like, we're we're light beans. And what that means is we are signaled by the light.
Josh Dech (01:08:17.964)sure.
Mariza (01:08:23.881)And that means we want to be outside as much as possible. We want the sun rays on our eyes when we get up and nice and then at night, you know, he's got blackout curtains. Everything's dark. We dim everything. Everything's kind of red light. Because I'm like our we're signaled like butterflies, you know, like a lot of animals that were diurnal, you know, we need it. We need to make sure we're going, you know, we're going to bed at the same time. And so it's these concepts that I'm teaching my son at such an early age that he understands this is just how he was brought up. Even still, we're still mitigating them.
Josh Dech (01:08:35.308)Hmm.
Mariza (01:08:53.745)modern world, you right now we bought, I used to make real homemade popsicles. And I caved and I'm buying Good Pops, which are five grams of sugar and the cleanest we can get, but his whole world's been like.
He's like, what is this? What are these popsicles? I don't even know what's going on here. And he wants to eat popsicles all day every day. And I'm like, my gosh, we've created a monster, a popsicle monster. And so, you know, lot of conversations around sugar intake and what's feeding our tummy friends and, you know, what sugar is doing to our bodies and how we really fuel our bodies and really having them understand, not like sugar is a villain type of thing. So I don't want to do that either, but just being mindful about how our body processes
Josh Dech (01:09:22.688)That's so good.
Mariza (01:09:39.355)the substrates that we put into our system. And if we gunk up those systems with too much of the added sugars, and mind you, these don't have any added sugar, but still sugar is sugar, you know what saying? Like, it is what it is. And just having them understand the way that our bodies process energy and how our bodies feel most alive. And how can we do that as much as possible, including limiting the amount of sugar we're consuming as much as possible and eating foods that are gonna really fuel our tummy.
friends and so even you know even the discussion last night we're talking about cherries and he's like cherries why did the why does the red on the cherry stain my face and my fingers and I'm like it's actually that is the pigment that is the polyphenol that makes cherries so good for your body so it just always in those conversations about how are we more attuned to nature how are we more deeply connected to nature and how can we live and cultivate more of that life that that's
Josh Dech (01:10:26.572)Hmm.
Mariza (01:10:39.158)the conversation as a mom that I'm having with my son.
Josh Dech (01:10:42.636)It's an important one to have with kids, but also with yourself because if you're not brought up that way, right? Like as grown ass adults, it's not a conversation we often have with ourselves. Say, wait a minute, the amount of times I had a fellow recently, he's in his twenties, came in with his mom, they wanted help with his gut. And they say, no, we really want to get involved. He's got colitis or Crohn's, whatever it was. And he says, do I have to give up drinking? I'm like, yeah, 100%. Like it's destroying your liver, your gut, your immune system, everything. He's like, okay, well.
Mariza (01:10:46.19)with us, with ourselves.
Mariza (01:11:07.46)Yeah, yeah. Everything.

(04:55):
Josh Dech (01:11:11.404)Yeah, I'm not ready to commit to the program right now because he didn't want to give up drinking. He's happy to bleed from the bowel and take his medications as long as he can get drunk. And that is the conversation that had that been had earlier. Like what you're doing is just not at four years old. Like this guy would be getting healthy by now. I see it all the time.
Mariza (01:11:24.374)Yeah. Or even women. mean, anyone. You know, we didn't talk about alcohol and how... No. It's just a full stop. You know, we're gonna talk about a non-negotiable no alcohol. Like, there's nothing about it that is fueling your future brain. It's poisoning your future brain.
Josh Dech (01:11:33.629)Yup.
Josh Dech (01:11:40.768)Those antioxidants, they mean jack shit. can get, the pros don't outweigh the, go have a glass of wine for the antioxidants. No, get them from a handful of berries, right? Yeah, just the benefits don't outweigh the cost of alcohol, which is pure poison. So I'm glad you mentioned that. Yeah.
Mariza (01:11:48.285)Resveratrol, my gosh. Yes, yes, please.
Mariza (01:11:57.199)Yeah, I'm glad you mentioned it. I'm glad it's one of those things that I and it can be very controversial telling midlife women to give up their wine down and I'm like, but it's how's your sleep? Have you measured it? I mean, have you worn a woobstrap? Like you want the evidence. I'm a big fan of bio observability as well and measuring biometrics and man, there's you know, the numbers don't lie. A CGM isn't going to lie to you. You know, your woobstrap is going to tell you that you tanked your your HRV is in the gutter.
Josh Dech (01:12:10.423)Mm-hmm.
Josh Dech (01:12:27.153)Absolutely. that measurements are everything. I'm so glad you bring that up because I mean, you my wife's got an aura ring. I'm a big fan of like a whoop strap or something, something, anything. Yeah, because it brings awareness to what's going on, which I think is powerful. Now, Marisa, if somebody wants to learn about you, read about you, read your book, find you on social, wherever it is, where do you want to point them? Because this conversation is not finished.
Mariza (01:12:36.868)Something, something.
Mariza (01:12:41.124)Yeah.
Mariza (01:12:52.336)Yes, no, it's not. And there's so much more to unpack in the book, The Peri-Mentapause Revolution, which is one of the first books on the topic ever written. So I'm super excited. I know, I know. Is it 20, 25? Let me just double check. That's the gear we're living in right now. So yes, it's the first Peri-Mentapause book. mean, obviously Peri-Mentapause and menopause are having a moment, mainly because 75 million women in the US right now are in it. And there will be over 1.5 billion women
Josh Dech (01:13:01.9)What?
Josh Dech (01:13:07.625)Yeah, right.
Mariza (01:13:22.35)in by 2030, which is a big part of the population in the world. so it's you can find the book anywhere books are sold called the perimenopause revolution. It's a rallying cry. It's a movement. mean, we are ready to not be ignored anymore. And then number two, I have a beautiful podcast called Energized with Dr. Marisa. It is all about this beautiful journey, but mostly rooted in your metabolic health and how to feel more energized. And then on Insta, I love Instagram. I'm on social at Dr. Marisa. So D.
And with the book, there's lots and lots of bonuses that will start to help you move the needle in terms of how you feel immediately. So the bonuses are over $500 worth in bonuses so that while you're waiting for the book, you can get started now.
Josh Dech (01:14:10.433)That's so good. Well, thank you so much. I'm to make sure everything's down below. You guys want to check out those resources. Scroll down to the show notes. If you're not sure how clicking on the episode, little bottom left of the little picture, you click show more. I hear that all the time. I don't know what the show notes are. It's all the text. You need to drop it down. That's right below the image on your podcast player and you can get all these links are down there below to access. Marisa, thank you so much. Your time experience expertise has just been brilliant. Thank you for being here.
Mariza (01:14:38.522)Thanks, Josh.

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209: Make Perimenopause Feel Easy: What Every Woman Needs to Know - with Dr. Mariza Snyder

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}209: Make Perimenopause Feel Easy: What Every Woman Needs to Know - with Dr. Mariza Snyder