123. The Menopause Gut with Cynthia Thurlow: Why Fixing Your Hormones Without Fixing Your Gut Will Never Be Enough

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[SPEAKER_01]: Hello and welcome to The Wild Drop with me, Amber Berger, a podcast for Wellness Meet Simplicity, empowering you to own your wellness, starting at home.
[SPEAKER_01]: Each episode we dive into things we wish we were warned about and explore practical street forward strategies designed for busy days like you.
[SPEAKER_01]: Whether you're juggling meetings, running errands, or managing family life, I'm here to help sift through the noise and show you how integrating wellness into your daily routine can be simple and stress-free.
[SPEAKER_01]: Find out how by tuning in to today's well-drop.
[SPEAKER_01]: Midlife is an opportunity to finally tune in, but no one warns you until now that when your body starts changing, your energy drops, your mind feels foggy, and suddenly what worked for you for decades just doesn't anymore.
[SPEAKER_01]: In today's episode of The Well Drop, I'm sitting down with Cynthia Thurlow, a nurse practitioner, functional nutrition expert, and leading voice in women's metabolic health, who has helped thousands of women better understand
[SPEAKER_01]: We're diving into the powerful insights from her new book, The Menopause Gut, which explores the critical connection between your hormones, your microbiome, and how you actually feel day-to-day.
[SPEAKER_01]: This is not your typical hormone conversation.
[SPEAKER_01]: This we're going to get into why midlife can feel like an identity shift, not just a physical one, but actually driving sub-urnway gain, brain fog and burnout.
[SPEAKER_01]: and the deeper layer most people avoid from generational patterns to store stress that often starts the surface during the phase.
[SPEAKER_01]: So if you've been feeling often can't quite explain why this episode will help you connect the dots and start to understand what your body is asking for.
[SPEAKER_01]: So let's dive in.
[SPEAKER_01]: Thank you for being with us on the wildjobs in the air.
[SPEAKER_02]: So I've been looking forward to this conversation, Amber.
[SPEAKER_02]: Thanks for having me.
[SPEAKER_01]: Likewise, and I'm so excited for your new book.
[SPEAKER_01]: I think that I love to always talk about the things you weren't born about.
[SPEAKER_01]: And I don't think most people realize that your guts starts to change as your hormones change.
[SPEAKER_01]: Like, there is definitely not this like gut hormone connection that we are aware of, especially in our 30s.
[SPEAKER_01]: Would you like to open that?
[SPEAKER_02]: No, I think it's interesting because really it's maybe been the last five ten years that more and more research has come out about the importance of the gut microbiome.
[SPEAKER_02]: And let's at least define what that is because for a lot of people they're like, I know where my brain is, I know where my heart is, I know where my stomach is, and where is the gut microbiome, somewhere in the digestive tract.
[SPEAKER_02]: So it's 40 trillion bacteria viruses fungi and protozoa.
[SPEAKER_02]: that are part of this little ecosystem in our large intestine or colon, and it interfaces with every single organ in the body.
[SPEAKER_02]: Like, there's a gut bone access, there's a gut brain access, there's a gut ovarian access, and it heavily influences not just the trajectory of us aging, but our entire health.
[SPEAKER_02]: And I think as more research comes out, we'll probably start taking it more seriously.
[SPEAKER_02]: But it was something that I felt like was really
[SPEAKER_02]: If you think Perry Metapaus and Metapaus is just slapping on an estrogen patch, you're missing a much more nuanced conversation, and so I think on a lot of different levels, just building awareness around gut health and how it's changing, I think for a lot of women just that awareness.
[SPEAKER_02]: allows them to understand like things at a much deeper level without getting super science.
[SPEAKER_02]: It's just making the information accessible.
[SPEAKER_02]: And certainly like my generation, we didn't even talk about Perry Metapolls.
[SPEAKER_02]: We all just hit it like a wall and slow down the whole day.
[SPEAKER_01]: It's like growing up, there is no phase of life that you knew about, even called Perry Metapolls.
[SPEAKER_01]: had babies and you knew at some point in your 50s, there was menopause.
[SPEAKER_01]: I mean, even being in the wellness space, I didn't even know about parry menopause until I guess the terms probably start to really come to the forefront five years ago, like I'm 45.
[SPEAKER_01]: So I was only just turning 40 and I wasn't even thinking, oh, there's like this phase and think I knew things would start to change like around 42, 43, but I didn't know that there
[SPEAKER_01]: six to 10 year window of chaos.
[SPEAKER_02]: Well, and I can tell you in 2018, I decided to do a TED Talk and I was both embarrassed.
[SPEAKER_02]: to talk about Perry Metapolls, but at that time, this will blow your mind in 2018, there were four TED talks on Metapolls, which is why they agreed to let me talk about where you were and I remember when I stood on stage, I was like, this should be like, no different than me talking about any other phase in a woman's life and yet I was so embarrassed because
[SPEAKER_02]: Like, women in my generation kind of grew up feeling uncomfortable talking about the aging process.
[SPEAKER_02]: And yet, I think Perry menopause is this incredible opportunity to show up so much differently or lives and feel much more authentic.
[SPEAKER_02]: And so, you know, 2018 was eight years ago.
[SPEAKER_02]: So, it's not a surprise that you weren't even aware of Perry Menopause until five years ago, because I didn't know about Perry.
[SPEAKER_02]: And I'm the licensed medical provider.
[SPEAKER_02]: No one taught me about it until I remember I walked into my July uns Office.
[SPEAKER_02]: And I was remarking that my periods were really heavy.
[SPEAKER_02]: And so, you know, she did an internal exam.
[SPEAKER_02]: I happen to have my periods start that day.
[SPEAKER_02]: She was like, oh, my gosh, your cycle so heavy.
[SPEAKER_02]: And she offered me the pill, an IUD, an ablation.
[SPEAKER_02]: Or, you know, if you're done having kids, let's just pull your uterus out.
[SPEAKER_01]: This, I hear all the time.
[SPEAKER_02]: Those were the four options I was given.
[SPEAKER_02]: And I remember I knew enough.
[SPEAKER_02]: to exit the exam room, check out and leave.
[SPEAKER_02]: And I effectively fired her and found a midwife because I was like, I don't want to do any of those things.
[SPEAKER_02]: There has to be a better way.
[SPEAKER_02]: And so I think for a lot of women in the conventional system, those are the tools that the gynecologists have.
[SPEAKER_02]: And so I'm not being critical.
[SPEAKER_02]: I'm just talking about like, there's traditional alipathetic medicine.
[SPEAKER_02]: And they're only given so many tools in the toolbox.
[SPEAKER_02]: And all those things would have fixed my heavy nostril cycles but didn't actually address the underlying issue for why my cycles were so heavy.
[SPEAKER_01]: And I think that that's like a perfect.
[SPEAKER_01]: thing to just pause on for someone who's listening to really understand how this is just how this system, these doctors were taught.
[SPEAKER_01]: They didn't actually know that there can be other solutions, it was only for people like yourself and like me who are like, wait, there has to be another way and like,
[SPEAKER_01]: are advocating for themselves to say let me just like wait a minute and I think in the doctor's office because even still today all these years later birth control is usually the first thing I have many people that I know that that's what they're given and then the second thing is about like the removal or ID and or removal.
[SPEAKER_01]: And so I just would love to, like, tell people that, like, you are an NP, you were in this industry and you didn't even know that there could be other solutions out there.
[SPEAKER_01]: So just let somebody say, like, just don't take the first suggestion as, like, that's all the rest of you.
[SPEAKER_02]: Well, and it's interesting because I arguably trained it if not the leading medical university in the United States, one of them, and not in my undergraduate curriculum at Johns Hopkins, not in graduate school where there are any other options provided to us.
[SPEAKER_02]: And so it's the system that is designed to address symptoms.
[SPEAKER_02]: and let me be clear, like, traditional allopathic medicine, if you are really sick or you urgently or emergently need surgery, there is no way better, when it comes to prevention and chronic disease management, we don't do such a stellar job.
[SPEAKER_02]: So, for me, I was so frustrated with not only being told, it's normally game weight, it's normal to have cycles this heavy, it's normal to just give oral contraceptives to fix this issue,
[SPEAKER_02]: really forced me to look very introspectively at the traditional model and decide for myself that I wanted more than that.
[SPEAKER_02]: And 10 years ago, there weren't as many options, and yet I was able to navigate in a system and find the right people for me, which included getting started on thyroid replacements, getting really aggressive about lifestyle modifications and nutrition
[SPEAKER_02]: to help balance out these incredibly heavy cycles.
[SPEAKER_02]: And yet, you know, I always want to be respectful of my fears.
[SPEAKER_02]: But I think for a lot of women, especially our generations of women, they want more than just conventional options.
[SPEAKER_02]: And so I think that, you know, certainly like your platform and just bringing awareness to the fact that women have options, because we're kind of conditioned to just shut up.
[SPEAKER_02]: We're kind of conditioned to just accept that.
[SPEAKER_01]: Not even ask questions, right?
[SPEAKER_01]: Right.
[SPEAKER_01]: You have awareness as fully the first step, and that once you have the awareness and to know that there is more than one choice, like starting with lifestyle habits for me is like the starting point that if you start and do a few changes there, it might actually just fix everything.
[SPEAKER_01]: Imagine if then everything is fine, and then if not, so then you know that there are some other things and tools in the toolbox, you don't have to just go straight to like, you know, a pharmaceutical,
[SPEAKER_01]: potential side effects.
[SPEAKER_01]: Yeah, not like the end all be all.
[SPEAKER_01]: And I do love that you said that when people, I think HRT think God is now having a moment and it's back on the table.
[SPEAKER_01]: But for people who think like I'm just going to take hormones and everything's fine, they're totally forgetting that there's a huge lifestyle piece in this midlife time of our life that is not to be in afterthought.
[SPEAKER_01]: Like when you're writing this book, what did you feel is like women's
[SPEAKER_01]: something that women haven't been told about in my life for my life.
[SPEAKER_02]: Oh God, I've been so much about how, uh, because I started the book off talking about this romantic location.
[SPEAKER_02]: I took with my husband and I got me based the same food in Morocco and I got violently ill and he didn't and I didn't at the time understand why that had happened.
[SPEAKER_02]: I was like, I'm just unlucky.
[SPEAKER_02]: No, it's our physiology is changing with a decline in hormones.
[SPEAKER_02]: So I think the things that I was thinking about that were really relevant to women was do most women know that our immune system changes with this decline in hormones.
[SPEAKER_02]: Do most women know that their bone health is highly dependent
[SPEAKER_02]: on gut health.
[SPEAKER_02]: Do most women know that early childhood trauma and trauma as a young adult impacts when we go into menopause, it actually ages our ovaries.
[SPEAKER_02]: And so I think on a fundamental level, there's so much wonderful information coming out about period menopause and menopause and hormone replacement therapy and the value of GLP ones, if that's appropriate in lifestyle, but yet
[SPEAKER_02]: has not been one that people are focusing on and when I stumble upon all this because I have a podcast in my own and I would interview experts and I would take I always take a little bit away from every single guest like something that they've taught me it's like a nugget of gold.
[SPEAKER_02]: And when my publisher reached out to me in 2024 and said do you think you have a second book in you?
[SPEAKER_02]: I said yes I think in my idea and I literally wrote a one page I kind of like the
[SPEAKER_02]: Now, normally when you write a book proposal, it's like a hundred pages long.
[SPEAKER_02]: Yeah, this was one.
[SPEAKER_02]: And so she literally got one page of my idea and green light of the project and said run with it because this is so unique and so different.
[SPEAKER_02]: And yet, I feel really fortunate, blessed.
[SPEAKER_02]: that I was able to synthesize all this information in a way that's really accessible because it is incredibly unique.
[SPEAKER_02]: It's also very complimentary to other works that other experts have put out there already.
[SPEAKER_02]: And I think it's helpful because now we're going to have so many resources that are going to be able to help women.
[SPEAKER_02]: And I always say not everyone can work with me as a patient, but they can definitely work with me because
[SPEAKER_02]: I've put all of this like I would say this is like a love letter to women.
[SPEAKER_02]: It's all the things I wish I had known and I'm like, I would say if I didn't know isn't in P, how would I expect the late person to know or most clinicians like as I go on podcasts, these physicians and nurse practitioners are like, oh my god, no one ever taught me this.
[SPEAKER_02]: No, I don't.
[SPEAKER_02]: It becomes this domino effect of, like if you think about the impact of our work, I think this is where books can be particularly powerful because you can capture all this wisdom and someone can either listen to it or read it and be able to take tangible things away.
[SPEAKER_02]: Like one of the things that I really made a huge effort in writing them at a post gut was, I don't want it to all just be about bright shiny objects because let's be clear in the health and wellness space we
[SPEAKER_01]: Yeah, there's lots of things like we're trying to like sift through the noise here like what are like a core thing because like when someone's thinking the gut they're me leading the thing probiotics like is that like what somebody's like first thing should be that they're thinking about no I mean when I think about the very first things that I talked to patients about it, so what is.
[SPEAKER_02]: sleep quality because sleep and your gut are intricately interconnected.
[SPEAKER_02]: You have a vagus nerve.
[SPEAKER_02]: You have a super high way of information.
[SPEAKER_02]: It goes back and forth between the brain and the gut.
[SPEAKER_02]: Number two is stress management.
[SPEAKER_02]: And how many women in middle ages?
[SPEAKER_02]: This book, I was like, tell me a woman who doesn't sleep and tell me a woman who doesn't manage your stress.
[SPEAKER_02]: Mm-hmm.
[SPEAKER_02]: That's management.
[SPEAKER_02]: And we know that stress can be both good, like, automatic stress, like you and I are talking, if you measured our cortisol, it's probably up a little bit, because we're engaged.
[SPEAKER_02]: We're excited.
[SPEAKER_02]: We're having this conversation.
[SPEAKER_02]: But like chronic stress is what I'm talking about.
[SPEAKER_02]: It's the stuff that breaks down our muscles and, you know, reduces our ability to fight infections.
[SPEAKER_02]: It can lead to leak gut.
[SPEAKER_02]: Chronic stress is what becomes really debilitating so like managing your stress and nutrition like oh my gosh I tell people all the time 70% of Americans eat just solely ultra-process foods and we know the additives The chemicals they mostifiers the artificial sugars can be particularly damaged damaging to the gut microbiome And so I think about things on a very foundational level that before we go to probiotics before we go to like medications And there's a time and a place for that.
[SPEAKER_02]: We'd be clear.
[SPEAKER_02]: It's the foundational elements
[SPEAKER_02]: That have to be addressed because if you're not sleeping and are not managing your stress and you're eating garbage diet, I can guarantee you your gut health is going to suffer and so, you know, unfortunately, I think because of our traditional alipathic model, we think that supplements will fix lifestyle related issues, yes, we want to fight the magic thing and I think that's a problem is that like,
[SPEAKER_01]: the lifestyle piece like the sleep and the stress and what you're eating.
[SPEAKER_01]: It's not sexy, so it's not going to go viral on TikTok or Instagram.
[SPEAKER_01]: It's not like I was like we have to figure out a way to make it cool because this is stuff that really moves the needle.
[SPEAKER_01]: I have a whole thing like set your bedroom up to sleep like a baby and that to some people it might just seem stupid, but it's actually not.
[SPEAKER_01]: It's like a core thing that we need to kind of upgrade in midlife and take
[SPEAKER_01]: What is the light like in my room?
[SPEAKER_01]: How is the sound where am I charging my fall?
[SPEAKER_01]: Like some of these basic things that we don't realize is actually like interrupting us from getting this good quality sleep and the same thing with like the food that we become this package society especially as busy moms it's a grab and go.
[SPEAKER_01]: And I just try to tell people, let's just go back to eating meal food again, not so sexy, but like not such a novel idea like we always eat real food like things that didn't come from a machine or in a bag like let's that's all you need to do.
[SPEAKER_01]: It's not that complicated, but it's just not that marketable at the same time.
[SPEAKER_02]: I know you're absolutely correct, and I will tell patient major in the majors, meaning if you are not moving your body, you're not eating high-quality food, you're not managing your stress and you're not sleeping, all the things that I talk about, like you have to focus on those things first because one thing that Perry Metapost forces us to do, I look at it as a litmus test.
[SPEAKER_02]: How well are you taking care of yourself?
[SPEAKER_02]: Maybe you didn't do such a stellar job in your 20s and 30s and we weather that a whole lot better.
[SPEAKER_02]: But with those alterations and hormones and neurotransmitters, the wheels will fall off the bus.
[SPEAKER_02]: I mean, it certainly did for me and I love to be transparent because people assume I've got it all together all the time.
[SPEAKER_02]: It's only because I had to make some drastic changes.
[SPEAKER_02]: And I think for a lot of women, it doesn't necessarily have to be drastic, but we do have to go to bed earlier.
[SPEAKER_02]: We do have to, you know, do more than five minutes in meditation once a week.
[SPEAKER_02]: We do have to determine, are we in a toxic relationship?
[SPEAKER_02]: Are we in a toxic job situation?
[SPEAKER_02]: Are we in an unhealthy situation overall?
[SPEAKER_02]: I think for a lot of women, it forces them to really get honest.
[SPEAKER_02]: clear about is there a lifestyle working for them or against them.
[SPEAKER_02]: Yeah.
[SPEAKER_02]: And with that awareness week and then make better choices because I think in my grandmother said something to me really invaluable at 18.
[SPEAKER_02]: said one of the most important decisions you will ever make is who you marry which I thought was hilarious because I was like whatever.
[SPEAKER_02]: I'm never getting married.
[SPEAKER_02]: I didn't get married in my 30s, but here's the thing that I can tell you without question.
[SPEAKER_02]: How many of my girlfriends got divorced in their 40s because they realized maybe they didn't realize that their 20s or 30s but they're like, they woke up one day and were like, well, wait a minute, this person is not the
[SPEAKER_02]: But I think a lot of our stress in life or the benefit of being with the right partner and new and certainly have to be coupled.
[SPEAKER_02]: But I think for a lot of people, they don't realize that a lot of choices we've made when we were younger can make our life harder or easier in pairing that a pause.
[SPEAKER_02]: Like I jokingly say, if a man or your partner can make it through pairing that a pause with you, then you're good.
[SPEAKER_02]: You've got a good person.
[SPEAKER_01]: Yeah, that's right because I think for a lot of partners, it becomes very confusing to try to figure out like why someone's upset one day and happy the next or why someone, you know, you know, I mean, it's hard on the guys as hard as it can be on us as women, I also would love to learn like what were your like little signs and shifts that you had to make, but like it is easily just as easily because I've had friends who've had to, you know, have surgeries and put themselves into, you know,
[SPEAKER_01]: menopause in their late 30s and so that obviously changes all your hormones.
[SPEAKER_01]: And there's an adjustment for the husband that they're also not warned about what happens to the women because their mother did and talk about it.
[SPEAKER_01]: Hopefully that'll change for like the next generation.
[SPEAKER_01]: Like my son knows so much about very many of them.
[SPEAKER_01]: Well we don't be like a semblance of some sympathy or at least the expectation to know like this is a phase and a chapter of life right like if you just don't know that that's even a thing like we didn't even know was a thing for ourselves how can our partner even have a clue as to what's going on because I think I feel bad for the guys that they usually probably think it's themselves when it's nothing to do with them at all.
[SPEAKER_02]: Well, I think, I mean, I think a guess to my podcast recently stated that 70% of the divorces are initiated by women, and I wonder how many of those divorces could have been prevented.
[SPEAKER_02]: Yeah.
[SPEAKER_02]: If there was more understanding up front because I think in a lot of ways, the the poor sleep, not being able to manage your stress quite as effectively, just being irritable.
[SPEAKER_02]: Like I remember saying to my husband, I've ever just been so irritable.
[SPEAKER_02]: I didn't understand why
[SPEAKER_02]: I think that if men understood what was coming, they could probably be more empathetic and more supportive.
[SPEAKER_02]: And by the same token, I think if women knew it was coming, it's like reverse tuberty.
[SPEAKER_02]: Like the irony being when I was in Perry, Metapollas, my kids were in tuberty.
[SPEAKER_02]: And I was like, isn't this ironic?
[SPEAKER_02]: And all the time it, exactly.
[SPEAKER_02]: He taught it properly.
[SPEAKER_02]: I had two kids in puberty, and then I'm going through parry menopause.
[SPEAKER_02]: And I think for a lot of people, we do a whole lot better if we know what to anticipate as opposed to the abyss.
[SPEAKER_02]: That's how I felt.
[SPEAKER_02]: Like it was the abyss of trying to figure it all out.
[SPEAKER_02]: And then,
[SPEAKER_02]: trying to figure out like where are you fall in time and space when all of a sudden nothing it's almost like the upside down world like you're like suddenly everything that used to work all my habits that got me to be a very successful person suddenly are maladaptive and parry medical is what is that like that is what I hear all the time what used to work to stop working and I think that's like what shocks women and then they just feel lost and confused and overwhelmed and then like the Instagram algorithm gets them and then they're just like
[SPEAKER_01]: out of their minds.
[SPEAKER_01]: Like well, we're like some early signs for you because all of these symptoms, I think I used to probably blame like mommy brain.
[SPEAKER_01]: Yeah, brain fog stuff.
[SPEAKER_01]: I've been missing my keys or worse, my phone.
[SPEAKER_01]: But I never thought, oh my God, it's probably my hormone shift in.
[SPEAKER_01]: I never came to my minds until there.
[SPEAKER_02]: So I had my first pregnancy at 34 in my second at 36.
[SPEAKER_02]: So just to give everyone context.
[SPEAKER_02]: So when I was in my late 30s, I attributed a lot of like the fatigue, the anxiety around my cycle.
[SPEAKER_02]: Like I'd never had mood issues, but I just felt like I had kind of a flat, like I just didn't feel like I was, we used to term Anne Hadonia, which is a fancy way of saying like we just thought kind of blah.
[SPEAKER_02]: like I've a call just having trouble sleeping and I was like what and I figured I've got a at the point when I was 40 I had a I had a four-year-old in the six-year-old I was like oh it's because I'm exhausted I work as an team I has been travels a ton and really a lot of doing a lot of solar parenting we had a puppy it's a lot yeah it's a lot and two very active little boys so like you know anyone that's listening that has little kids you know it's just it's it's a wonderful
[SPEAKER_02]: exhausting time in your life.
[SPEAKER_02]: And so I think, for me, it was trouble sleeping, anxiety, and then just feeling blah.
[SPEAKER_02]: And then just the other thing was that degree of irritability that I had never had.
[SPEAKER_02]: Like, I was never someone who had bad PMS.
[SPEAKER_02]: And so for me, it was like middle of my cycle, so grumpy.
[SPEAKER_02]: And
[SPEAKER_02]: I just chalked it up to I'm just sleep deprived and I have too much of my plate and so those were kind of mind beginning but I think the big thing that woke me up to something was up was that I had never had problems after pregnancy is losing weight and I suddenly became incredibly weight loss resistant and I was like what?
[SPEAKER_02]: in the hell is going on with my body.
[SPEAKER_02]: Interesting.
[SPEAKER_02]: And you're young.
[SPEAKER_01]: I mean, in your early forties.
[SPEAKER_02]: Yep.
[SPEAKER_02]: And yeah, you know, my, my internists said to me, Cynthia, you're 42, 43.
[SPEAKER_02]: This is just the way things are.
[SPEAKER_02]: You're middle age, no.
[SPEAKER_02]: And I was like, wow.
[UNKNOWN]: Yeah.
[SPEAKER_02]: Um, do you think maybe there's a reason why I can't lose weight?
[SPEAKER_02]: Like, is my thyroid off?
[SPEAKER_02]: Is it, you know, at that time I didn't even think it was, you know, a macros thing or two intense exercise or whatever it was I was doing.
[SPEAKER_02]: And so I again, I go back to like fired my provider and found someone else that like actually dug a little deeper and we're like, yeah, you're, you're, you need, you like are desperately need some thyroid replacement.
[SPEAKER_02]: And so I think for a lot of individuals, they're kind of gas lit.
[SPEAKER_02]: Like they're told that it's normal to be tired.
[SPEAKER_02]: It's normal to not sleep well.
[SPEAKER_02]: It's normal again weight.
[SPEAKER_01]: And when you're five foot three, it really does make a difference on a showdowns makes a big difference.
[SPEAKER_01]: And I love I always say, you know, it's okay to switch doctors.
[SPEAKER_01]: I think we're not kind of told that it's okay, but your doctor may not serve you in this chapter.
[SPEAKER_01]: And it's okay to go somewhere else.
[SPEAKER_01]: I think you're naturally loyal as women, right?
[SPEAKER_01]: You find someone they be with us.
[SPEAKER_01]: They really know us, but they just may not be equipped for this chapter and it's not their fault.
[SPEAKER_01]: It's just because they weren't taught it.
[SPEAKER_01]: And unless you seek,
[SPEAKER_01]: You know, more education outside the system, maybe they're not the best connecting the dots.
[SPEAKER_01]: And it's a complicated time, we're complicated beings, which is why we weren't probably in clinical studies for so long, but I do think the weight is probably where the people that's where like it feels like the rails are coming off.
[SPEAKER_01]: Why is it always the midsection?
[SPEAKER_01]: I call it like the estrogen pooch.
[SPEAKER_02]: You know, I mean, we, here's the sad thing.
[SPEAKER_02]: The only worm in the goes up in middle ages cortisol.
[SPEAKER_02]: So we have 40 times more cortisol receptors than our abstinence.
[SPEAKER_02]: So there's two reasons why we may see shifts and but well, there's multiple reasons.
[SPEAKER_02]: But like the two big ones that I think about is with like unyielding stress and cortisol being high, we're gonna have more fat-less deposition in your abdominal area.
[SPEAKER_02]: But there's also more likely to accumulate visceral fat, which is the pathologic,
[SPEAKER_02]: bad fat that's around visceral organs that's deep.
[SPEAKER_02]: It's not the pesky kind of subcutaneous fat that we all get irritated with.
[SPEAKER_02]: That we might have on our butts or our thighs.
[SPEAKER_02]: It's the deeper visceral fat that becomes problematic.
[SPEAKER_02]: And so I think for a lot of women, that's their tell.
[SPEAKER_02]: It's like, oh, I've been managing my stress pretty well.
[SPEAKER_02]: And then all of a sudden you're like, no, I'm not managing my stress pretty well.
[SPEAKER_02]: Because I'm realizing my body composition is changing.
[SPEAKER_02]: There's other things that contribute to those body compositions shifts, but I think for a lot of women, it's really frustrating, because what they're told is, oh, we've had a couple babies.
[SPEAKER_02]: Yeah, you're middle age.
[SPEAKER_02]: You're not moving as much.
[SPEAKER_02]: Maybe you eat too much.
[SPEAKER_01]: And then I think- I think- I had a doctor tell me eat less and exercise more.
[SPEAKER_02]: Yeah, I think I can honestly tell you that I probably told my patients that in my 20s as an MP, I was a young MP, and that's what we were taught.
[SPEAKER_02]: Oh, that is what you're taught.
[SPEAKER_02]: They actually teach exercise more or less, and yeah, we know exercises that terrible way to lose weight.
[SPEAKER_02]: Full stop.
[SPEAKER_01]: And I think in midlife, I mean, from what I've seen, because I'd love to, I don't know how you feel about the Dutch test, but I love the Dutch test because it can show you
[SPEAKER_01]: And I do see, when your cortisol is higher and people can settle down at nights, that will show on the test because you're doing it over 24 hours.
[SPEAKER_01]: But people aren't connecting that cortisol, gut, estrogen, combination.
[SPEAKER_01]: So related that now back to the gut.
[SPEAKER_01]: Is there something that we could do to help balance that out if we already kind of lock in some of those lifestyle things that you mentioned before?
[SPEAKER_02]: Yeah, I mean, I think, you know, there's, there's a lot that goes on with the gut.
[SPEAKER_02]: I mean, obviously, like chronic stress is going to lead to leaky gut.
[SPEAKER_02]: Women are four to five times more likely to develop leaky gut, and leaky gut is what leads to not only underlying food sensitivity is because you provoke an immune response when you have leaky gut, but it's also like we see a rise in lupus rheumatoid, Hashimoto, celiac, et cetera.
[SPEAKER_02]: There's
[SPEAKER_02]: Yeah, and long haul COVID and so I think for a lot of people like they don't realize to like get that diagnosis like I was diagnosed with Hashimoto's and I was like wait a minute, this doesn't make any sense.
[SPEAKER_02]: I don't know, he got in there like, yeah, you do get you do and so what was like what precipitated that is like chronic stress anti biotic use even if it's appropriate.
[SPEAKER_02]: toxin exposure.
[SPEAKER_02]: I go back to the chronic stress because so many women are like, oh, I'm, I'm like the, you know, we see a duck gliding across upon.
[SPEAKER_02]: They look very calm on the top underneath their paddling furiously.
[SPEAKER_02]: And so I said that it was to my patients are doing they look calm on the outside and rest on the inside.
[SPEAKER_02]: And I think for a lot of us were just wired a certain way.
[SPEAKER_02]: And so whether that's, you know, childhood experiences young adult experiences just being super type A.
[SPEAKER_02]: We have to learn how to kind of decompress and learn how to manage our stress, you know, working on that vagal nerve training is really important.
[SPEAKER_02]: So can you do things to improve gut health?
[SPEAKER_02]: Absolutely.
[SPEAKER_02]: But it is going to start with those basics of understanding if you don't get a good night's sleep, that impacts your gut bacteria.
[SPEAKER_02]: If you don't manage your stress and impact your gut bacteria and impacts your susceptibility leaky gut, same thing with nutrition, same thing with exercise.
[SPEAKER_02]: It's this gold eloxic effect of the right amount of exercise.
[SPEAKER_02]: So women get really mad when I say this, but I'm going to say it.
[SPEAKER_02]: If you're doing orange theory fitness six days a week with no recovery,
[SPEAKER_02]: or a crossfit or you're doing marathon after marathon guess what you will get a transient leaky gut because of the intensity but your body needs to like needs more of the restorative stuff like napa gen yoga zone to cardio which is like at a comfortable pace.
[SPEAKER_02]: Often times the less is more in Italy.
[SPEAKER_01]: Yes, I say that all the time, nobody wants to hear it, but I often, it's funny because when these shifts start to happen and because as a women or like fight to the death, people then start to go an overdrive on the workouts, right?
[SPEAKER_01]: Like I'll hear from people, I'm working out harder than ever.
[SPEAKER_01]: I'm doing these hot pilates classes and I'm doing some string training.
[SPEAKER_01]: Usually it's not enough string training, but I'm fatter than ever.
[SPEAKER_01]: and I'll be like drop the hot classes or spike in your cortisol.
[SPEAKER_01]: When are you doing these classes?
[SPEAKER_01]: Because most of us in order to fit in, I also think your cortisol rises in the morning.
[SPEAKER_01]: You're having a copy, you're rising it even more.
[SPEAKER_01]: You put a workout on top of that, it's rising even more.
[SPEAKER_01]: So then your body's going to just start holding.
[SPEAKER_01]: So I like to suggest people to like push your workouts a little bit later or skip, if you can, caffeine in the morning,
[SPEAKER_01]: And really, we have to sort of parent ourselves that we do our children.
[SPEAKER_01]: We have to be a little bit more gentle.
[SPEAKER_01]: And I love that you are validating that because I see it time and time again.
[SPEAKER_01]: We always think harder, better, more is better, less is more here.
[SPEAKER_02]: Yeah, and I think that's hard.
[SPEAKER_02]: It's hard.
[SPEAKER_02]: My type is to understand and like listen, if I were to tell you what I do now for workouts, first is what I did 10 years ago.
[SPEAKER_02]: I'm like, listen, I sleep in.
[SPEAKER_02]: I don't get, I mean, let's I have to get on the early flight.
[SPEAKER_02]: I do not get up early.
[SPEAKER_02]: I used to get up at four o'clock in the morning, go to the gym and then go to the hospital.
[SPEAKER_02]: No, no, no, no patience.
[SPEAKER_02]: And I did that for years.
[SPEAKER_02]: And I think about it now, and I'm like, I'd rather get the sleep, like, you know, you start realizing that
[SPEAKER_02]: to value it actually.
[SPEAKER_02]: They have to value it and it's also like just boundaries in general about your personal life.
[SPEAKER_02]: Like, I, there was someone I, I forget which kind of mindset expert on Instagram had this incredible post that was talking about like, as you could older you have less real friends.
[UNKNOWN]: Yeah.
[SPEAKER_02]: And I was like, oh my gosh, this is so much my life.
[SPEAKER_02]: I have a sibling who I loved early, who always has a ton of people at his house every weekend.
[SPEAKER_02]: He is wife love entertaining and I love their friends.
[SPEAKER_02]: But I'm like my husband and I like a smaller group of friends.
[SPEAKER_02]: We like less people at our house.
[SPEAKER_02]: And so I was saying, well, finally it's been validated as an introvert.
[SPEAKER_02]: That's actually better for me.
[SPEAKER_02]: Like I don't have to know the sense of pressure that I have to be part of this big, huge friend group.
[SPEAKER_02]: And so I think it really impacts us on every level.
[SPEAKER_02]: Like we have more boundaries or in our personal life.
[SPEAKER_02]: We have more boundaries or in our business.
[SPEAKER_02]: We have more boundaries around everything we're doing because we're realizing time is precious being really conscientious about an intentional about where our energy goes as how we protect ourselves.
[SPEAKER_02]: Oh yeah, it's the beginning.
[SPEAKER_02]: Even when I go to events, I've now gotten very specific about what I speak at events.
[SPEAKER_02]: How long I stay at the event?
[SPEAKER_02]: What are the expectations of the person's organizing it?
[SPEAKER_02]: Because as an introvert, I can get on stage and do my talk and connect with people afterwards and before.
[SPEAKER_02]: But then I'm like, I need to recharge my batteries.
[SPEAKER_02]: And so I think for everyone listening, it's identifying that we actually do better in middle-age doing less.
[SPEAKER_02]: And that is hard to wrap our heads around because we've been conditioned to believe that we should multitask, that we should be doing 50 things at once.
[SPEAKER_02]: That, you know, the tubeless should be managed.
[SPEAKER_02]: Like, you know, there's a whole lot of trouble done.
[SPEAKER_01]: And I loved that.
[SPEAKER_01]: Like, I am super type A. I mean, my schedule is packed, not for the better.
[SPEAKER_01]: But I always say, like, your 40s is an amazing chapter.
[SPEAKER_01]: I call it, you kind of like, don't give a fuck kind of energy.
[SPEAKER_01]: You sort of like, sort of, like, that's like how the beginning starts.
[SPEAKER_01]: And then you start the boundary setting.
[SPEAKER_01]: But you need to take a moment to like, understand, like, kind of what serves you and what does in.
[SPEAKER_01]: and going back actually to our partners, you just made me think like my husband, it was probably like two years ago that I was like, I can't handle going out more than like at the most twice a week, my preference is once a week.
[SPEAKER_01]: And so anything that was beyond that, I'd just be like, no, even if it was with our best friends and our best friends would be like, is Amber and say, social, I am super social, but it was literally I was like starting boundary setting.
[SPEAKER_01]: And my husband at first was like, what's wrong with you?
[SPEAKER_01]: I'm always a yes girl and I was like I can physically handle it like my energy is everything like I want to feel good and energize so I can like
[SPEAKER_01]: do all the things I want to during the day.
[SPEAKER_01]: I'm a morning person, I'm a day person.
[SPEAKER_01]: And by the end of the day, I'm done.
[SPEAKER_01]: And I don't want to have to push myself.
[SPEAKER_01]: Of course, I could do it.
[SPEAKER_01]: But it wasn't worth the energy suck that would happen at the end.
[SPEAKER_01]: And so I was like, we'll just have to push off those plans.
[SPEAKER_01]: And we just can't pile it all in at once.
[SPEAKER_01]: It just doesn't work anymore.
[SPEAKER_01]: Unfortunately.
[SPEAKER_01]: Like I wish it could, but it doesn't.
[SPEAKER_02]: Now, and it's interesting because, you know, my husband's even larger introvert than I am.
[SPEAKER_02]: So it's easy out of Friday night when I say, I don't want to do anything because I've been talking all day.
[SPEAKER_02]: He's like, that's fine.
[SPEAKER_02]: And we have wonderful neighbors.
[SPEAKER_02]: And we crack up that all of us are introverts.
[SPEAKER_02]: And so we'll say like all the time, like you live across the street, we should be getting together more often.
[SPEAKER_02]: And then everyone's also in the same life stage.
[SPEAKER_02]: Like we're almost at that open door slash empty nest time frame.
[SPEAKER_02]: And so we're like, but sometimes it's just so nice
[SPEAKER_01]: yeah I agree right and especially when you're like doing this kind of work it's like we're putting so much out there so something that we have to protect like a little bit of those I have to like force myself to find those quite moments but I think you do have an easier time doing it once you are aware of like where you want to put your
[SPEAKER_01]: time and energy, like I think that's back to that whole awareness piece, like becoming aware.
[SPEAKER_01]: And I think connecting the gut to so much, I didn't realize about like the gut bone connection.
[SPEAKER_01]: To me, that is fascinating, because most women never think about that.
[SPEAKER_01]: They just know calcium.
[SPEAKER_02]: No, and it's fascinating to me, like when I started stumbling upon the research, I was like, oh my god, leaky bone, leaky gut.
[SPEAKER_02]: and how appropriately we've identified estrogen as this primary prevention tool for osteoporosis.
[SPEAKER_02]: But yet, no one's talking about the fact that if your gut is unhealthy, it doesn't matter who much estrogen you're taking, you are going to get more bone breakdown than more bone build up.
[SPEAKER_02]: And so, you know, for my perspective, and certainly working with tens of thousands of women over the past 10 years, it's just really reaffirmed for me why it's so important to think comprehensively
[SPEAKER_02]: one strategy is going to fix everybody.
[SPEAKER_02]: It's important.
[SPEAKER_02]: Let me be very clear.
[SPEAKER_02]: I'm so happy that hormone replacement therapy is getting the attention.
[SPEAKER_02]: It deserves.
[SPEAKER_02]: However, it's not just about replenishing hormones, although that's a very important component because it won't fix.
[SPEAKER_02]: You know, if you don't sleep and you don't manage your stress and you're, you know, the standard American diet and you don't exercise,
[SPEAKER_02]: Yes, hormone replacement therapy will be helpful, but not as much as the lifestyle piece.
[SPEAKER_02]: And I think for a lot of individuals, because we've conditioned patients to believe a pill will take away their lifestyle hills.
[SPEAKER_02]: I mean, I worked in clinical cardiology for 16 years.
[SPEAKER_02]: It may be very clear.
[SPEAKER_02]: I did a lot of prescription management.
[SPEAKER_02]: I did a lot of lifestyle management.
[SPEAKER_02]: And 95% of the time my patients would say, I'm not going to stop smoking.
[SPEAKER_02]: I'm not going to die it.
[SPEAKER_02]: I'm not going to become more physically active.
[SPEAKER_02]: Just write the script for the higher discipline pressure medicine or for the lipid piece or my diabetes medication just increase it.
[SPEAKER_02]: And I would always say to them, wouldn't you like to be on less medicine?
[SPEAKER_02]: Like, how about that as a thought?
[SPEAKER_02]: Like, let's not shame people in a feeling that there's anything wrong with taking medications.
[SPEAKER_01]: Nothing.
[SPEAKER_02]: Just a minimum viable necessary.
[SPEAKER_02]: Um, and I don't count where my replacement therapy is medicine.
[SPEAKER_02]: And I count on that as like, that is what makes the difference between thriving versus surviving middle age.
[SPEAKER_02]: But I think for a lot of individuals, I hear people in the integrated medicine space who will shame people like.
[SPEAKER_02]: Well, I'm not any men if I'm not on any medicine, so I'm like good for you, but some people maybe they've done everything they can to manage their lipids, which are disaster and they do need a medication.
[SPEAKER_02]: I mean, I actually take a medicine called ZDF for my crappy genetic tool that I have that, you know, even with optimized lifestyle stuff.
[SPEAKER_02]: And so I share that so that no one feels any sense of shame if they do indeed have to be on a medication because it's like, you do the lifestyle piece first and then if you need a medication.
[SPEAKER_01]: I think a lot of people do, I say, they do good things, but sometimes in the wrong order.
[SPEAKER_01]: So it's like start with the lifestyle, if it's not fixed, then you can add whatever is necessary on top of that.
[SPEAKER_01]: A lot of times they're just adding the thing, not doing the lifestyle.
[SPEAKER_01]: So I say, they're not even optimizing to get what they want if it's a medicine for it to do for them, because it could even be so much more if they locked in the lifestyle piece along with it.
[SPEAKER_01]: It's like a two-part system.
[SPEAKER_01]: It's not just like a one-part.
[SPEAKER_01]: So I love that you are reiterating that because I say that all the time that lifestyle is number one, if we can just remember to start there and who knows it just might make things so much easier.
[SPEAKER_01]: And then if you feel better, like it's like the domino effect of like so many good things start to like happen from then on out.
[SPEAKER_01]: One last thing I want to circle and touch upon because I think it's so fascinating because I've been seeing this is like what is the element of generational stress and why does that start to surface in this chapter because I feel like that was never talked about or learned about but I'm seeing it a lot.
[SPEAKER_02]: Yeah, you know, it's interesting when I started writing the book.
[SPEAKER_02]: There were a couple things that shocked me.
[SPEAKER_02]: One was about this gut-bone access.
[SPEAKER_02]: The other one was the impact of adverse childhood events.
[SPEAKER_02]: And let's even back up further and talk about epigenetic changes that are related to previous generations.
[SPEAKER_02]: Because, you know, I think that the more I understand about my family lineage, the more my life makes sense.
[SPEAKER_02]: Now that I'm a grown adult, but I think it's helpful
[SPEAKER_02]: stress over time changes as epigenetically so down at a cellular level.
[SPEAKER_02]: And that can be expressed in different ways.
[SPEAKER_02]: Like I fervently believe that the stress, the migrant mothers and grandparents experienced imprinted my parents, which imprinted me, and it means that I can either carry on maladaptive patterns and issues or they can stop with me.
[SPEAKER_02]: So when I talk about adverse childhood
[SPEAKER_02]: Anyone that's listening can go online.
[SPEAKER_02]: It was a joint venture between Kaiser Permanente and the CDC.
[SPEAKER_02]: And it's a very quick quiz.
[SPEAKER_02]: But we know when we talk about big T-Tromb, I think everyone would recognize that rape, murder, suicide, or big T-Tromba.
[SPEAKER_02]: When I trained in inner city Baltimore, that's all I thought Toronto was.
[SPEAKER_02]: Now we understand there's this other insidious little T-Tromba.
[SPEAKER_02]: That's abuse, neglect, whether it's verbal, physical, emotional, etc.
[SPEAKER_02]: And that can be equally toxic.
[SPEAKER_02]: And so I think what's interesting is when you look at the body
[SPEAKER_02]: how this rewires us, these early experiences rewire our autonomic nervous system, which is our nervous system, and can make us ensure that our cortisol levels remain elevated.
[SPEAKER_02]: So we're in this kind of for lack of a better way to explain it, a sympathetic dominant state, which a lot of people, frankly, in our modern day lifestyle are naturally.
[SPEAKER_02]: So you see that the gasoline of if you have a lot of adverse childhood events, that can rewire you in unique ways.
[SPEAKER_02]: It can make you more susceptible to poor metabolic health, disorder relationships with food, et cetera, et cetera.
[SPEAKER_02]: And what's interesting is,
[SPEAKER_02]: That impacts the gut microbiome because, remember, I talked about chronic stress as caustic and can lead to impacting our immune system, coming some more likely to get optimistic infections, more likely to have autoimmune conditions.
[SPEAKER_02]: Once you have one autoimmune condition in your prone to more, I had my first to my 20s after getting treated for Lyme, appropriately within antibiotics.
[SPEAKER_02]: But what's interesting is that chronic exposure to cortisol activation can age the ovaries.
[SPEAKER_02]: Our ovaries are the most might-acondrial dense organ in our bodies, not surprisingly, because they're responsible for creating life.
[SPEAKER_02]: They're also incredibly susceptible to cortisol.
[SPEAKER_02]: Cortisol can be at a high level, can age the ovaries.
[SPEAKER_02]: So there's solid research suggesting that people that have high adverse childhood events scores may go into the response earlier.
[SPEAKER_02]: That has been my clinical experience.
[SPEAKER_02]: and there was a bit of research that another physician mentioned on my podcast where it's talked about if a woman is sexually abused as a child because on to have children that are sexually abused she will go into menopause eight years earlier than her peers average age here in the United States is 51 I want everyone to think about that it doesn't have to be as horrific as as the experience of sexual abuse as a child and then having children that go on to be sexually abused.
[SPEAKER_02]: But it just goes to showing the imprinting of that cortisol response of your body doesn't feel safe.
[SPEAKER_02]: And so I think for a lot of women, maybe women who have never admitted what they went through as children to anyone else, it imprints your body in really unique and profound ways.
[SPEAKER_02]: I think one of the things that I felt like was a big takeaway from the book was a whole chapter on like stress and before we were talking about like fluffy stress like you know intensely exercising or you know your stress because your cat got sick or whatever it is.
[SPEAKER_02]: But like the really insidious nature of high adverse childhood events scores,
[SPEAKER_02]: And how that ages us and impacts the way that our health goes to me was a whoa, like I literally remember my editor saying holy cow, you're blowing my mind right now because I almost died at one years old.
[SPEAKER_01]: I had J. R. A.
[SPEAKER_01]: 11 Crohn's disease at 14.
[SPEAKER_01]: So I guess I would be categorized as adverse sort of health child, hooded bed.
[SPEAKER_01]: But then I've been dealing with my son the last six years on his autoimmune journey which has been this huge mystery of like trying to put the pieces together and the one thing in my biological age I've done a handful is my metabolic system is aging like a 51 year old when the rest of me is 34
[SPEAKER_01]: But I never connected the dots on that that is all stress related.
[SPEAKER_01]: I really think my son is a big piece because I don't really have any trauma from my childhood stuff for some reason if anything, it's like, I feel like a gift because it led me into living this wellness lifestyle since 94 and set me free in a way, but definitely the last six years,
[SPEAKER_02]: I mean, I'm sure that must because I was just having conversation before this conversation of like I don't understand like why my metabolic system is so old like what is a problem, but it has to be stressed because there's no healthy otherwise and I mean we're my cousins had to be years ago my kids were younger she said you're only as happy as you're most unhappy child and so that left me with us like really heavy feeling of realizing like as mothers.
[SPEAKER_02]: We carry everything with us.
[SPEAKER_02]: And so even if, you know, this is the way things were imprinted and this is the way your son was gonna grow up or, you know, my, my younger son is kind of like, my child that I'm always looking at, like, it's okay, I think for each one of us, like, as moms, we're just so connected to our children that
[SPEAKER_02]: I'm sure the stress of watching the issues with this health kind of evolve are very, like, way heavily on you.
[SPEAKER_02]: Is that a technology?
[SPEAKER_01]: On your person, like, it has to.
[SPEAKER_01]: Well, this was so insightful.
[SPEAKER_01]: I'm so excited for your book.
[SPEAKER_01]: Where can we find you?
[SPEAKER_02]: Probably easiest to go to my website, so www.synthetharlo.com.
[SPEAKER_02]: If you look at the top of the website, there's a banner where you can pre-purchase the menopause gut.
[SPEAKER_02]: The retailer of your choice, I always say if you have a brick and mortar bookstore try to give them your business because I think the online stores are really
[SPEAKER_02]: making it hard for brick and mortar businesses.
[SPEAKER_02]: But I'm active across social media.
[SPEAKER_02]: I would say right now I'm really concentrated on growing sub stack.
[SPEAKER_02]: That's kind of been my passion project.
[SPEAKER_02]: I have a podcast called Everyday Wellness, which is absolutely one of my favorite things I do in my business.
[SPEAKER_02]: I love interviewing people.
[SPEAKER_02]: I'm an introvert.
[SPEAKER_02]: So I love to.
[SPEAKER_02]: be the person asking all the questions and being able to kind of absorb all of the incredible gifts that my guests have, but I'm active all across social media.
[SPEAKER_02]: I've got a free Facebook group called The Midlife Pause Backslash My Name, which was originally the title of the book and I keep for my
[SPEAKER_02]: my team and my family, maybe we should change the title of the free Facebook group.
[SPEAKER_02]: But there are men and women in there, it's a no-drama place, but it's a good place where my team and I answer questions a couple days a week.
[SPEAKER_02]: But I'm also the person, I'm the kind of person that if you message me on social media, I might actually be the person that responds, because I still like to be actively involved in what people are interested in learning more about.
[SPEAKER_02]: As much as I love my team, I tell them all the time.
[SPEAKER_02]: They may not answer it the way that
[SPEAKER_01]: I still like how you get all in the show notes for sure.
[SPEAKER_01]: And I always love to close out our conversation by asking, and it could be related to anything.
[SPEAKER_01]: Like, what is one drop of one's wisdom you like to leave with us today?
[SPEAKER_02]: Oh, I would say learn how to stay.
[SPEAKER_02]: learn how to say no and not have to explain yourself like women as they're learning how to say no feel like they have to explain themselves and one of the beautiful aspects of middle age and as your estrogen declines you care a lot less about what they say.
[SPEAKER_02]: is that boundaries become really important.
[SPEAKER_02]: And the value of saying, no.
[SPEAKER_02]: So in my world, unless it's a hell, yes, it is a hell, no, with a couple of postrophies.
[SPEAKER_02]: And so I think for a lot of women, part of navigating middle age with grace, it's just learning to discern between what works for you and what doesn't.
[SPEAKER_02]: And there, you can be incredibly gracious and say, no, thank you.
[SPEAKER_01]: Yeah, not sorry.
[SPEAKER_01]: I feel like we like to say sorry too much.
[SPEAKER_02]: That went in addition.
[SPEAKER_02]: I just say former people please are that still like, I always feel that like, I don't want to disappoint people.
[SPEAKER_02]: It's like, no, I'm actually protecting my boundaries and that's the way that we have to find that reframe to understand.
[SPEAKER_02]: But I would say that is a nugget of wisdom I wish I learned earlier.
[SPEAKER_01]: I love that.
[SPEAKER_01]: Well, thank you so much for being with us on the well job today and we will link everything in the show notes so you can go and check out Cynthia's new book and the menopause gut.
[SPEAKER_02]: Thanks for having me.
[SPEAKER_00]: But the well-drop podcast and content posted by Amber Berger and Deena Wismar is presented solely for general informational, educational, and entertainment purposes.
[SPEAKER_00]: The use of information on this podcast or materials linked from this podcast or website is at the user's own risk.
[SPEAKER_00]: It is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional, diagnosis, or treatment.
[SPEAKER_00]: Users should not disregard or delay in obtaining medical advice for any medical or mental health condition they may have and should seek the assistance of their health care professionals for any such conditions.
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