Beyond Hot Flashes: Understanding the Change and Thriving Through Menopause

Menopause represents a profound biological transition that affects millions of women, yet most enter this phase with more questions than answers. In this comprehensive two-part exploration, we break down what's actually happening in your body during perimenopause and menopause—and why symptoms like hot flashes, brain fog, mood swings, and weight gain aren't just things you need to "tough out."

The hormonal rollercoaster of menopause affects nearly every system in your body, from temperature regulation to mood, bone density, and cardiovascular health. As estrogen and progesterone production declines, the hypothalamus (your brain's thermostat) struggles to regulate body temperature, leading to those notorious hot flashes and night sweats. Sleep becomes disrupted as melatonin and serotonin levels fluctuate, creating a vicious cycle where poor sleep increases stress hormones that further worsen symptoms.

Beyond the immediate discomfort, menopause brings significant long-term health considerations. Post-menopausal women face increased risks of cardiovascular disease, accelerated bone loss, metabolic dysfunction, and even cognitive decline. But these changes aren't inevitable sentences—they're biological processes we can influence through both medical approaches and lifestyle modifications.

Modern hormone replacement therapy is much safer than many believe, especially when started before age 60. The six pillars of lifestyle medicine—nutrition, physical activity, sleep hygiene, stress management, avoiding risky substances, and social connection—provide powerful tools for managing symptoms and protecting long-term health. A plant-predominant diet rich in phytoestrogens, combined with regular resistance training and stress reduction techniques, creates a foundation for thriving through this transition.

Menopause isn't the end of vitality—it's the beginning of a potentially powerful new chapter that deserves science, support, and solidarity. With knowledge as your compass and practical strategies as your toolkit, you can navigate this transition with confidence rather than confusion. Your best years aren't behind you—they're unfolding right now.

Go check out my website for tons of free resources on how to transition towards a healthier diet and lifestyle.

You can download my free plant-based recipes eBook and a ton of other free resources by visiting the Digital Downloads tab of my website at https://www.plantbaseddrjules.com/shop

Don't forget to check out my blog at https://www.plantbaseddrjules.com/blog

You can also watch my educational videos on YouTube at https://www.youtube.com/channel/UCMpkQRXb7G-StAotV0dmahQ

Check out my upcoming live events and free eCourse, where you'll learn more about how to create delicious plant-based recipes: https://www.plantbaseddrjules.com/

Go follow me on social media by visiting my Facebook page and Instagram accounts
https://www.facebook.com/plantbaseddrjules
https://www.instagram.com/plantbased_dr_jules/

Last but not least, the best way to show your support and to help me spread my message is to subscribe to my podcast and to leave a 5 star review on Apple and Spotify!
Thanks so much!

Peace, love, plants!
Dr. Jules

Episode Transcript

Speaker 1 (00:11):
Hey everyone, welcome to Season 2 of the Dr Jules
Plant-Based Podcast, where wediscuss everything from
plant-based nutrition to themain pillars of lifestyle
medicine style medicine.
Yo, plant-based buddies,welcome back to another episode
of the podcast.
Today we're going to be talkingabout menopause.

(00:34):
We're going to break down thisvery misunderstood,
misrepresented andunder-researched condition in
two parts.
Part one understanding thechange.
So if you've ever experiencedhot flashes, brain fog, mood

(00:55):
swings or weight gain, thisepisode is for you, and if you
live with someone who'sexperiencing these symptoms, you
may want to tune in as well.
So for millions of women, thesesymptoms aren't just getting
older.
They're signs of biologicaltransition that deserves more

(01:17):
respect, more clarity and moresupport.
Now here's the reality.
Most women enter menopause withmore questions than answers.
Medical appointments are rushed, treatment plans are
inconsistent and our culturalnarrative paints menopause as
the end of vitality instead ofwhat it actually is A new phase

(01:41):
of strength, self-knowledge andliberation.
But only if we understandwhat's going on inside of the
body.
Today, we'll talk about thehormonal rollercoaster that is
menopause and we'll explainwhat's happening biochemically
and, I'll hope, to give you theknowledge you need to take

(02:02):
control of this transitioninstead of just surviving it.
If we start by defining ourterms.
Menopause is defined as 12consecutive months without a
menstrual period.
Typically, it occurs betweenthe ages of 45 and 55, but the

(02:23):
average age is 51 to 52.
Perimenopause represents theyears leading up to menopause,
when hormones begin to fluctuate.
Very often, this is when thesymptoms start In terms of the
hormonal shift.

(02:43):
As women age, the ovariesgradually produce less estrogen
and less progesterone, and thisdecline affects nearly every
system of the body, fromtemperature regulation to mood,
to bone density, tocardiovascular health and risk
factors.
But menopause is not a disease.

(03:04):
It's a natural biologicaltransition.
But that doesn't make thesymptoms any easier to deal with
.
Now, in terms of these symptomsand why they happen hot flashes
occur because estrogeninfluenced the hypothalamus and
that's your brain's thermostat,and as estrogen declines, heat

(03:27):
regulation gets chaotic.
Now, in terms of night sweats,it's the same mechanism, it just
happens at night.
And in terms of sleepdisturbance, well, melatonin and
serotonin can also drop withestrogen and this worsens sleep.
And very often these causes orthese symptoms, they cause

(03:49):
stress, which can, in return,increase stress.
Hormones like cortisol, andhaving high levels of cortisol
before going to bed is going tolead to less sleep in terms of
quantity and in terms of quality, and the vicious circle begins

(04:10):
Now in terms of mood swings andanxiety.
Even on top of the poor sleep,estrogen impacts dopamine and
serotonin pathways directly andindirectly.
In terms of brain fog,cognitive processing can also
dip temporarily during thistransition.
For all of the hormonal shiftsthat I've already mentioned.

(04:36):
In terms of weight gain, lowestrogen will shift fat storage
patterns towards storing morevisceral fat than subcutaneous
fat.
It can lead to insulinresistance and increased
metabolic dysfunction diabetes.
We know that visceral fat ismore inflammatory and this

(04:58):
increases the risk of prettymuch all types of chronic
diseases of pretty much alltypes of chronic diseases.
Now, if we consider vaginalsymptoms or urinary symptoms,
often combined under the name ofgenitourinary syndrome, we have
loss of libido, we have vaginaldryness, we have urinary

(05:19):
incontinence, all caused by thedrops in estrogen.
It leads to less lubricationand thinning of vaginal tissues.
Now these symptoms are real,they're not in your head and you
don't just have to tough it out.
We actually have possiblealternatives or solutions that

(05:41):
may improve your quality of life.
Now, on top of the acutesymptoms that menopause can
cause, it's important to knowthat it can also increase
long-term risks of chronicdiseases.
Now, estrogen protects bloodvessels and after menopause,
cardiovascular risk risessharply.

(06:03):
And estrogen also plays a veryimportant role in maintaining
your bone density.
Post-menopause women can loseup to 20% of bone mass within
5-7 years.
Estrogen helps regulate glucosemetabolism, can lead to weight
gain, insulin resistance,pre-diabetes and then type 2

(06:26):
diabetes, which severely impactsthe risk of other chronic
diseases.
And estrogen also plays a rolein protecting your brain.
So Alzheimer's disease is muchmore common in postmenopausal
women and we can see cognitivedecline being accelerated once
women reach the postmenopausalstate.

(06:51):
What about practical strategies?
What can be done to alleviatethese symptoms?
Now here's what we know worksand what you can maybe start
exploring today.
Start by tracking your symptoms.
Using an app or a journal tonote patterns is very useful for

(07:11):
you and for your doctor.
Knowledge is power, and Iencourage my patients to
download either a period trackeror a menopause symptom tracker.
Knowing how your symptomsevolve means knowing how your
hormones fluctuate, so it's veryimportant to have that baseline

(07:32):
because after three to fourmonths of patterns, we're able
to predict how certain symptomswill either evolve and get
better or get worse, and if weshould be treating them or not.
Now I really want you to askabout hormone therapy or HRT,
now.
Modern HRT is much safer thanmany people think, especially

(07:57):
when started before age 60.
It can help with symptoms andlong-term health.
But unfortunately, the Y studycreated some phobias of
replacing hormones and for years, women were left to suffer and
to tolerate symptoms that do notneed to be toughed out.
Now, nowadays, we've reviewedthese studies, we've conducted

(08:20):
new ones and we know that modernhormone replacement therapy can
be used safely in the vastmajority of women who have no
contraindications, and thisimproves health and improves
chronic disease risk andlong-term health outcomes.

(08:40):
Now, if you think you'reentering your post-menopausal
era, consider getting blood workdone not just hormone levels,
but also cholesterol, fasting,glucose, thyroid levels, maybe
even vitamin D.
And if you really want toimprove your symptoms, it's time
to double down on prioritizingsleep Now, even if it's

(09:01):
disrupted, set a schedule.
And if you're really seriousabout improving your sleep,
consider going back andlistening to my episode on sleep
.
We'll talk about how sleepstages evolve into sleep cycles
and how different stages havedifferent roles in body repair
and in emotional repair, and howwe can go about having a better

(09:26):
night's sleep.
And also, if you're enteringyour peri or post-menopausal era
, consider building a teamaround you, find a provider who
knows about menopause and HRT,read up online, write down a set
of questions that you want tomake sure to have answered.
Knowledge is power, and havingknowledge about what's happening

(09:50):
inside your body will empoweryou to make better decisions and
more personalized decisionsabout your health.
Now, if you're going throughmenopause, or even just
approaching it, I want you toknow you're not broken and
you're not past your prime.
You're stepping into a possiblya powerful phase of life and,

(10:12):
with knowledge and support andthe right tools, you can feel
vibrant, clear and in control.
Menopause is not just somethingyou need to tough out.
It actually can help, and thereare a lot of lifestyle changes
that we'll discuss in part twothat can help as well.
We have a lot of differenttools that can help with

(10:42):
menopausal symptoms.
We have hormone replacementtherapy, medications like
venlafaxine, gabapentin a lot ofdifferent things can help.
A lot of different things canhelp.
But what if I told you thatmenopause relief wasn't just
found in a pill, but in yourplate, in your sleep, your
sneakers and even in your sociallife?
So in this part two, we aregoing to explore the six

(11:06):
evidence-based pillars oflifestyle medicine that can help
you thrive during menopause andnot just survive.
Now here's the thing Menopauseisn't just about estrogen.
It's about the bodyrecalibrating itself after
decades of hormonal balance.
And while hormone therapymedications can help, they won't

(11:28):
address the root causes ofinflammation, poor sleep,
insulin resistance or moodswings.
And that's where lifestylemedicine comes in, as an adjunct
to therapy, something you usewith modern medicines and not
just instead.
Now, these aren't band-aids.

(11:49):
Instead, these aren't band-aids, these are tools, real,
practical, powerful strategiesbacked by science and rooted in
your daily habits.
Your lifestyle can absolutelyimprove or worsen menopausal
symptoms.
Now, what about nutrition?
Now, what about nutrition?

(12:10):
Remember that food isinformation, and menopause is
the perfect time to re-evaluateyour diet, because food directly
influences hormones,inflammation, gut health and
mood.
Fiber from whole plants notonly helps regulate estrogen
metabolites and supports healthyweight, it actually gets

(12:33):
fermented by the good gut bugsin our microbiome, and then they
reward us by producingshort-chain fatty acids that get
reabsorbed into our circulation, cross the blood-brain barrier
and impact pretty much everymetabolic process we have, from
weight to hunger, to metabolism,to mood.

(12:55):
And let's not forget aboutphytoestrogens that are found in
soy, flax and lentils.
They bind to estrogen receptors, act like CIRMs or selective
estrogen receptor modulators,and may even reduce hot flashes.
And let's not forget that awhole food, plant-based diet is

(13:17):
an anti-inflammatory diet andhas been shown to reduce joint
pain, improve mood and stabilizeeverything from inflammation to
blood sugar.
And two nutrients crucial forthe postmenopausal female are
calcium and vitamin D, bothcrucial for bone health, and we

(13:37):
could probably include vitaminK2, although it's less studied,
still crucial for bone health.
Now, a plant-predominant dietisn't just safe for menopause,
it's ideal.
Other than nutrition, physicalactivity plays a major role in

(14:01):
managing postmenopausal symptomsand I tell my patients to move
to balance their hormones, andexercise is one of the most
powerful hormone balancers wehave.
Exercising reduces hot flashesand night sweats, it boosts mood
and cognition via serotonin anddopamine, and it helps build

(14:23):
lean muscle, which tend todecline after menopause.
It protects againstosteoporosis by stressing the
bones and it reduces the ratesof heart disease, which tend to
go up in post-menopause.
My tip would be to combineresistance training, at least

(14:44):
2-3 times a week, with aerobicactivities like low, steady
state cardio, for example, atabout 150 minutes per week.
Muscles aren't just meant tomake you move.
When you contract them and youstress them, they produce
myokines, anti-inflammatorycompounds that impact a ton of

(15:06):
metabolic processes, from moodto anxiety, to concentration and
to metabolic health.
Another very important tool inthe postmenopausal toolbox is
sleep, and sleep disruption isone of the top complaints during
menopause and one of the mostunder addressed Now.

(15:29):
The estrogen and progesteronedecline that you see in the
postmenopausal state directlyinfluence melatonin and GABA,
and these are both key sleepregulators.
This worsens insulin resistance, inflammation, mood swings,
increases cardiovascular risk,cancer risk.
If you're not sleeping well,inflammation gets worse and then

(15:51):
sleep gets worse and you enterinto this vicious circle.
If you're trying to improveyour sleep, remember to avoid
caffeine and alcohol in theafternoon.
Cool your bedroom and considerrelaxation tools like breath
work or yoga, meditation,reading a book, limiting blue

(16:13):
light exposure and maybeincreasing the amount of
magnesium-rich foods in yourdiet.
The goal is to slow down yoursympathetic nervous system and
increase parasympathetic tone ortraffic through the vagus nerve
, which puts you in this restand relax state.

(16:34):
Now, people that have a lot ofstress tend to be in the
sympathetic fight or flightstate.
Stress increases stresshormones and this can be your
worst enemy during menopause.
Chronic stress amplifieseverything from hot flashes to

(16:56):
fatigue to emotional reactivity,and it hijacks your sleep and
actually worsens belly fat.
High cortisol levels willshuttle fat storage away from
subcutaneous stores intovisceral fat the fat that you
accumulate inside of organsaround them in your belly.

(17:17):
Visceral fat is much moreharmful to increase inflammation
and the risk of chronicdiseases.
So try to find stressmanagement tools like breath
work, the box, breathing,mindfulness, journaling or
walking in nature, and make sureto set boundaries and give
yourself permission to slow down.

(17:38):
Now, if you don't manage stress, your hormones will manage you.
Also watch out for riskysubstances.
Now this is not just aboutavoiding cigarettes.
It's also about minimizing thesubstances known to disrupt
hormones or to worsen symptoms.

(17:59):
Alcohol increases night sweats,sleep disturbance.
Ultra-processed foods willdisrupt gut health and blood
sugar.
Caffeine can worsen anxiety andalso interfere with sleep.
So if these substances areplaying a role in your diet,
maybe consider reducing orlimiting them before going to

(18:20):
medication.
Now let's not forget theunderrated hormone regulator,
social connection and one of themost protective factors for
women.
Health in menopause isconnecting with other people.
It reduces cortisol, itincreases oxytocin, the
anti-stress and pro-love hormone, and it decreases the rates of

(18:41):
depression and cognitive decline.
So to connect with more people,consider volunteering, consider
a walking group, maybe start amenopause circle for mutual
support and spend intentionaltime with friends and try to
laugh more often.
Now let's be clear there's nomagic fix, but there is a

(19:05):
formula and it's in your habits.
These six pillars won't justhelp you manage menopause.
Hopefully they'll help rewritewhat it means to be in this
phase of life Better energy,better sleep, better mood,
better bones, less brain fog and, most of all, clarity that your

(19:26):
best years are not behind you.
But you need to change.
You need to see the power oflifestyle habits Now.
Menopause deserves science,support, solidarity, more
research and remember thatyou're strong, you're smart,

(19:47):
you're still evolving.
This is not the end.
It's the beginning of the nextbeautiful chapter.
There's a reason that women arethe ones making babies and
bringing them to life and goingthrough menopause.
The men in your life won'tadmit it, but you are so, so
strong and so much stronger thanwe are.

(20:09):
I've seen women deliver babies,go through menopause, go
through cancer and come back theother side stronger than ever.
So make sure to advocate foryourself.
Track your symptoms, track yourmenstrual periods, get to know

(20:29):
your body so that you canrecognize when it starts to
change.
Ask questions, seek answers andmake sure that menopausal
symptoms are not taken lightly.
You deserve to live a highquality of life, but managing

(20:52):
menopausal symptoms starts withyou.
It starts with eating betterand exercising more, managing
stress and sleep and connection,and avoiding substances that
are known to worsen symptoms.
And after that or with that,consider hormone replacement

(21:12):
therapy.
Modern therapies are much saferthan you think and, for a lot
of women, are much safer thanyou think, and for a lot of
women, they give them their lifeback Right on.
Thanks so much for listening.
I hope you've learned somethingthat will help you manage the
menopausal transition better.
Take care, we'll see you at thenext episode.

(21:35):
Peace, hey, everyone, go checkout my website, peace.