Lifting, Under-Eating and Perimenopause: Truths After 40

Nikkiey: What's up, everybody? Hey, you guys. Welcome to the 300th episode of The WarriorBabe Show. Man, I can hardly believe that I am saying that out loud. 300 episodes. And get this, we're also approaching 1.2 million downloads. What even is life right now? Whether you've been here from the start or this is your very first episode, I just want to say thank you.

Thank you for showing up, for pressing play, for trusting me, this brand, this mission with your time, with your attention, with your energy, and with your journey. This platform has been one of the greatest gifts of my life. And while I may be the one behind the mic, I know without a doubt that this platform was given to me by God. To speak boldly, to serve powerfully, and to help you listeners step into the strongest, most confident version of yourself.

So today, we're celebrating not just me, but you, us, this entire community. And what better way to celebrate that than by pulling the highlights from episodes 200 to 300 of our favorite guests, the ones that blew up the downloads and sparked some of the deepest breakthroughs and most thought-provoking conversations. One being Dr. Stacy Sims. The episode was This Is Why Your 1200 Calorie Diet Isn't Working. That is still one of the top episodes being downloaded.

We had Alicia Erickson on too, and she talked about how to get ripped at 51. And Dr. Jolene Brighten, The Truth About Hormones They Never Taught You. So we're going to compile all of this into one episode. These women brought fire. They brought truth, they brought science. And I can't wait for you guys to hear the best moments all over again in one episode. So whether you're out walking, whether you're lifting, whether you're cleaning, whether you're driving, just lean into this episode.

It's going to be packed with so much knowledge and so much truth. I hope you guys enjoy, and let's celebrate this milestone together. I love you all.

Today, we're diving into how women can build muscle, lose fat, feel strong, and actually understand their bodies. And I just can't wait to get into Stacy's brain and have her drop all of this knowledge here. Dr. Sims, welcome to The WarriorBabe Show.

Stacy: Thanks for having me. I've been looking forward to this.

Nikkiey: Let's go. So first, I want to kick it off with training, because I feel like this is where most women feel totally lost. The things that worked in their 20s, their 30s, even sometimes in the early 40s. A lot of women all do cardio. They do HIIT. They do light weights. It's just not cutting it anymore. And the WarriorBabe community is super hungry to build muscle, to feel strong, and to stop spinning their wheels in the gym. But they just don't know where to start, what actually is best for their body now. So what actually changes in how women should train once they hit this stage of life, like perimenopause and menopause?

Stacy: Yeah. So I like to bring people back to that conversation around puberty, right? Because we've all been through it. We know that your body changes, and you have all these things that happen, and then you get your menstrual cycle. So we're on the other side of things, where our body is unwinding our ovarian function. So what does that mean, really? We're having more and more anovulatory cycles, so we're not dropping an egg. If we don't drop an egg, then we don't produce progesterone. We're having more flux of estrogen, and our body has been affected by a continuous cycle of estrogen and progesterone for decades.

Now every system of the body is starting to be affected. We see it from brain changes, cardiovascular changes. We see it when you go get a blood test, and all of a sudden you have high cholesterol, and you're like, I've never had that before. I don't have a family history. It's primarily because of estrogen and progesterone and how they have an interplay in every system of the body. We also have the other side of things, where our body, by aging, is becoming less and less responsive to protein intake and to resistance training. So all these women who up to this point have been like, oh yeah, I get 20 grams of protein after training.

I've done my HIIT. I've done my CrossFit Metcon. I've done my 3x10s or 3x15s. I've gone into fatigue. None of that works now, because our body's like, oh, wait a second. We need more protein to stimulate anabolism, or building muscle. We also need to find a different stressor that's going to create an adaptive response, because our bodies are really kind of used to not being threatened. So if we are able to create a stress that's going to cause a threat, the body's then like, oh, I've got to build more muscle.

I've got to have a powerful contraction. If we're able to do a strong contraction, then it's going to respond in kind. So when we take that into translation, it's like, okay, what are we doing here? We want to look at that power-based range of lifting, where we want people to learn how to lift heavy properly. We want to do compound movements. We want to have adequate rest between our sets, because we want a central nervous system response. If we're having a central nervous system response, it's the nerve saying, hey, wait a second. I need to be able to stimulate all of these muscle fibers for a really strong contraction.

How am I going to do that? Okay, I need some more of this neurotransmitter around so I can actually jump and contract these muscle fibers. In these muscle fibers, I also need my myosin and actin to be really on point. So let's stimulate the myosin a bit more so the myosin and actin contract strongly and bond together. And then, by the nature of having to have more lean mass, if we are having continuous stress from the central nervous system and also the peripheral nervous system, the body's like, okay, I need to be able to build more mass to keep up with what's happening from the brain.

So when we're looking at the training scope, it's no wonder that people who are used to doing the HIIT and the higher reps and lower weights aren't finding a change. Because it's not the right kind of stress we need when we're starting to have these changes in our hormones.

Nikkiey: So what you're basically saying is lifting is essential. It's not optional, really. Right?

Stacy: Exactly. Yeah.

Nikkiey: Amen to that.

Stacy: Even young kids, right? We have that fear of lifting and development, but it's about functional movement and getting them used to pushing and pulling and stuff, because we don't do that in a natural environment anymore.

Nikkiey: Yeah, totally. Why is building muscle so important? Why is resistance training so important?

Stacy: Because cardio has had this vibe for 100 years, right? We have to do all this stuff for our heart. And trust me, I know, I'm a retired endurance athlete. But when we start looking at being able to age well and not get old, we want brain health, we want cognitive function, we want to be able to carry our groceries into our kitchen, we want to be able to be active with our grandkids, or not grow old but age well with our partner.

It's become muscle-centric, right? When we're seeing the push-pull load and what muscle does for us, and the building of the muscle and how metabolically active it is: the more metabolically active tissue we have, the better blood glucose control we have, the better our blood lipids are, the less we're looking to store that visceral fat. So we have less of a threat of cardiovascular risk factors. We also want to build muscle so that we're pulling torque on the bone, so we have strong bones and we don't have that risk of having chalk for bones and stepping off the curb and breaking a hip.

So as we talk about it, we're in that bubble, right? Where we're like, yes, strength training for the win. But we also want to remember it's not just for the now. It's protecting us to age well and not get old.

Nikkiey: Ladies, are you feeling frustrated with body changes you're experiencing during menopause? It's time to take control. If you're between 45 and 65 years old and tired of struggling with body fat and muscle loss, WarriorBabe is here for you. At WarriorBabe, we've helped over 18,000 women just like you lose body fat, build toned muscle, and understand their bodies better with personalized plans based on hormone and thyroid testing and more. Imagine knowing exactly what your body needs to see real results, and results that last. Look, don't wait anymore. Take charge of your health and join our community of strong, empowered women. Visit warriorbabe.com/apply today to start your transformation. That's warriorbabe.com/apply. All right, let's get back to the show.

Yes, I got full body chills there. So much alignment. And I love the knowledge you have, how you dive into the science-based things and what you stand for. This message just needs to continue to get louder and louder and louder. What would you say is the ideal weekly training split for someone who's 50 years old and wants to build muscle?

Stacy: A minimum is two times a week, minimum. And this is total body movements. If you are looking to actually build on top of the strength. So if we're doing total body compound movements, we're really focusing on the strength, and that's great. If we want to start accumulating more lean mass, and that's bone and muscle, then we're looking at three times. That's the minimum. You don't really want to eke it out to going every day, which some people do, like, oh, more is better. Because we also really need to focus on recovery.

You can't build without recovery. So people are always like, oh, I can't spend that much time in the gym. If you have an hour a week divided into 20-minute segments three times a week, you can get a lot done in 20 minutes in the gym when you're looking at strength training.

Nikkiey: Heck yeah. And so many women think it's more about moving the body more. They've come from the age of I need to eat less and I need to train more. And now the narrative is less is more. But let's shift gears to nutrition, because that's where I feel like a lot of women are stuck.

Every conversation I have with someone on the nutrition topic, it's like a deer looking at headlights. Women are eating 1,100 calories, 1,200 calories, thinking that it's going to help them drop fat, it's going to help them drop weight. But they're not seeing the progress that they want to see. In fact, they're gaining weight, they're losing muscle, or they're feeling just constantly exhausted. So with all that being said, many women, like I said, are eating 1,100, 1,200 calories and wondering why they aren't seeing the progress they want or losing fat. Can you speak to the danger of that? Especially for women who are in the phase of menopause and going through that journey, but more so the danger of just eating 1,100, 1,200 calories.

Stacy: Yeah, it's not enough. We've been caught in this narrative, probably from the 100 years of cardio stuff, where it's calories in, calories out, eat less, burn more. And we have to remember that inherently we are biological beings that require food. If we are not eating enough to support just general health, the body perceives it as a threat.

And the body is like, wait, I want to stay alive. So I'm going to start conserving every possible high metabolic cost that I can. If you're only eating 1,100 to 1,200 calories a day, that's not really even enough to touch a resting metabolic rate. We see on average a resting metabolic rate is around that 1,100 to 1,200 calorie point. So that's lying in bed and not even blinking, right? This is just the basic amount that your body needs to survive, from all its breathing and heart rate and blood circulating and brain and everything.

But as soon as you get up to pee, you need more calories. Your body needs food to do all of these energetics. And if you're not eating, your body's like, I'm bringing it all down. I'm only going to allow the essentials to work well. So I need to preserve the brain, and I'm going to keep trying to fuel the brain. I don't have enough blood sugar, so I'm going to start using some free fatty acids or ketones and amino acids. Where does that come from? It comes from your lean mass.

Your lean mass is very metabolically active. And that's one of the first things the body is going to go after and say, hey, you're too metabolically active. I can't conserve you. So I'm going to break you down and use you for the sum of the parts. So when we see women who aren't eating enough, we see this, right? They put on belly fat. They put on a lot of extra subcutaneous fat. They look a little bit puffy. They're losing lean mass. They're not responding to training. And then they can't sleep well, right? Because they're in this sympathetic drive, where their body's in this really highly stressed state of, there's no nutrition coming in.

How am I going to cope? I'm getting ready to fight or flight, and that's the continuous feeling. When we get into the menopause transition, unfortunately, we see a big shift in body composition with this change in the hormones, because the body is under a sympathetic drive. That's why we're always feeling tired but wired. We're having these shifts, and the body's under a little bit of normal stress from these shifts because it's starting to find a new biological set point. So we start seeing conversations between the liver and free fatty acids floating in the blood, where now the liver is like, I need to store you around the organs in case I need to be able to access you, which is why we get visceral fat.

We also see that we have less ability for insulin to pull sugar into the muscle. We have more insulin resistance. And it's because the body's like, I need to conserve blood sugar, I need it for the brain. So there are all these things going on because we're under a bit of stress. So if we're like, let's feed the body and let's train appropriately, we start to see better conversations across the organs, which allow us to not store visceral fat, but to take fatty acids and put them into the skeletal muscle to be used at rest.

And to increase our body's ability to pull glucose into the skeletal muscle and the liver without insulin. So we start to see better metabolic health. If we're not feeding it, we don't even start to have an impetus on that.

Nikkiey: I feel like everybody needs to rewind that whole last bit and just listen to it over and over and over again. I'm over here with chills, screaming yes in my head because of all that you just said. I'm so glad you said that. And the way you broke it down makes it so understandable what is actually going on.

Because a lot of women don't know, hey, this is what's happening around my liver, visceral fat equals this. The brain doesn't compute like that for women who don't have the knowledge that you have or aren't in the bubble that we're in, where we eat, sleep, breathe this kind of stuff. So I just thank you. That's the exact message I want to continue hammering home, so women can understand how important it is to eat food and eat the right amount of food.

Ladies, are you feeling frustrated with body changes you're experiencing during menopause? It's time to take control. If you're between 45 and 65 years old and tired of struggling with body fat and muscle loss, WarriorBabe is here for you. At WarriorBabe, we've helped over 18,000 women just like you lose body fat, build toned muscle, and understand their bodies better with personalized plans based on hormone and thyroid testing and more. Imagine knowing exactly what your body needs to see real results, and results that last. Look, don't wait anymore. Take charge of your health and join our community of strong, empowered women. Visit warriorbabe.com/apply today to start your transformation. That's warriorbabe.com/apply. All right, let's get back to the show.

Today, guys, I have Alicia here with me. She's also known as the Midlife Maven. At 51, Alicia completely transformed her entire health and fitness journey, proving that midlife is just the beginning. So let's kick it off. What initially sparked your decision to take this path? And what did those early steps look like as you began such an incredible transformation?

Alicia: So I've always been about my fitness and health, from a very young age. My dad was very active. My mom, she did kind of the Jane Fonda thing. They were both good models for me. But my dad was an Ironman triathlete, so he was super inspirational to me. He took me to my first ever fun run. And I remember that feeling when I was done with that fun run. I was like, whoa, I got a little boost of something. This feels good. I like that endorphin kick. So that carried through my life. That was just the theme: I knew that I needed to be moving my body on a regular basis for my mental health. Not just my physical health, but my mental health.

Fast forward to having kids, being a new mom, a stay-at-home mom. I was like, I need to do this or I'm going to lose my ever-loving mind. I need to sweat.

Nikkiey: Yeah.

Alicia: Seriously, I was like, I am going to go deep down that hole if I do not keep moving my body, somehow break a sweat. Daily, I need to do something or I'm going to lose my mind. So it's just been a theme throughout the course of my life.

Probably in my early 30s was when I joined a gym, and then I really started to learn more about lifting weights. But I think what a lot of us women tend to do is what I tended to do. Do you remember Jamie Eason? Do you know Jamie Eason?

Nikkiey: I've heard of that name.

Alicia: She was on bodybuilding.com, and I did her programs, and I was like, this is amazing. But I kind of tended to go back to the boot camp classes, you know, that a lot of women do. They want to be in community, which I understand. So I kind of went back and forth.

And then into my 40s, I really started getting into CrossFit. I did CrossFit for about eight years and really loved that. And I loved everything it taught me, because I felt like it taught me a lot about pushing myself, about trying new things that I didn't think I could do, learning new skills, how to move my body. And I know that can be kind of a controversial thing with CrossFit and proper movement and stuff. Our gym was really good about moving well, I will say that. But as I was entering that perimenopause phase, I just kind of felt like my body wasn't responding as well anymore.

And there was also just a lot going on with life, running businesses. My husband is also a small business owner, so we're all about the entrepreneurial spirit, but it takes a lot of effort. And then raising teenage girls. So when my girls finally had left, I was like, oh, okay, what are we doing now? It's so all-consuming. You're going, going, going. Then I was like, okay, I want to really see what I'm made of.

I want to see what I can do with this. This has always been a passion. It's always been a priority for me, but let's take this to the next level. I'm going to figure out how I'm going to do this. And I was like, I need to go back to the weight room and just start regular strength training. I need to get my protein in check. I need to up my protein. I knew my macronutrients were not where they needed to be. So I was like, I need to figure out what my macronutrients need to be, get back in the gym. I need to stop doing all this cardio, because I was always a runner, and just all this high-intensity, long cardio.

I'm like, we're going to lift weights. We're going to prioritize our protein. I had cut out alcohol, and then it kind of turned into sugar, so then I decided I was cutting sugar, just refined, processed sugars. So walking, nutrition and weightlifting. And I was laser freaking focused. I was like, we're freaking doing this. I was on a mission, and the results started to come. And I was like, dang, okay, this is really working. Once I got super focused and honed in on what I wanted to do and stuck with it, it was amazing.

Nikkiey: You mentioned the basics there. You mentioned back to the weight room, you mentioned protein intake, and you mentioned macros.

Alicia: Yeah.

Nikkiey: And something I see you do on social media, which has inspired me, because I'm only at 2,000 steps today, don't yell at me, is getting out there and getting your 10K steps in, walking too.

Alicia: Yes. Huge. Walking is my new absolute favorite thing to do. I do not run anymore. I walk and I hike. I live in Washington state, so we have like a million hikes here, and we hike all summer long. We're snowshoeing this winter. It's just my favorite. It feels so good, and my body loves it.

Nikkiey: Yeah. Okay. With strength training, when you got back into it, a lot of people experience some intimidation. They don't know where to start. They're afraid to walk into the gym. We're coming up on a new year. How did you feel when you got back into it? And what would be some pieces of advice you could give somebody that's maybe just starting?

Alicia: I completely understand how that can be intimidating, because I had been at CrossFit for years, so I hadn't been back to a regular gym. But I was scouting out gyms in my area, and I knew I wanted to go to a hardcore kind of gym. I knew I wanted to go to a gym that has people who are in there to win it.

Nikkiey: I just met you, but yeah, that makes so much sense.

Alicia: Right. I was like, I don't want to go to a dinky gym. It matters. If you're working out at home, which a lot of people can do successfully, you have your TV in the room, you have your kitchen, you have your computer that you can sit down and work at. Your environment matters, where you're at.

Nikkiey: I completely agree.

Alicia: It just gets you in a different mindset. It gets you locked in. And so I'd been scoping out gyms, and I found this one. It's a bodybuilding gym and it's kind of gritty. It's called Dig Iron. And I was like, okay, I want to go there, but I'm super intimidated. So I made friends with a gal at the front desk. I'm like, I just don't want to look like an idiot the first time I'm in here. Can you just make sure I know where everything is? And she said, oh yeah, of course, of course. So there's a back room, and I kind of started working out more in the back room, with the barbells and the dumbbells. And as I was getting more familiar and more comfortable being there, I expanded out more into the cables and the machines.

Nikkiey: And then you just take over the whole gym.

Alicia: Pretty soon I'm like, what's up? Mama's here. I'm here to F it up. But you know what I mean? It's so funny how we get in our own heads and we get so nervous about it, and we think people are watching us. If somebody is watching you and judging you, that's on them. That's not on you. At the end of the day, nobody cares.

People are more consumed with what they're doing. Nobody's really watching you. So take a deep breath, go to the back corner if you need to, and just kind of scope things out while you're in the back corner, check things out, do something small to get started. And then, as you get more comfortable, you can branch out to new machines and new things as you're getting better and feel more comfortable. And pretty soon, everybody's going to know your name. Everybody's going to know who you are. You're going to feel like a badass, and you're going to walk around and own the place.

Nikkiey: Amen. That's how it goes. Anything that you start at the beginning is going to be hard and going to be a change. Anything. You just got to push yourself over the edge. Even just how you walked into the gym and had the confidence to go ask somebody, hey, can you just show me around? Then you're not by yourself walking into the gym. You have somebody else around.

Alicia: And people want to help, you know. At the end of the day, if it's a good gym, the people are going to be helpful and friendly and want to connect with you.

Nikkiey: To piggyback off of that, building physical strength often has a ripple effect. So for you, how has the physical strength that you've built influenced other areas of your life, like your relationships, your career, what you're doing with your people, and your own mindset?

Alicia: I can tell you, it's so interesting. I saw something the other day, a before and after physique comparison, and it was talking about how it's not just the physical that changes. There's a whole entire mental transformation that happens when you are doing a physical transformation. They have to go hand in hand. Right. And honestly, this whole last couple of years, I have felt just unstoppable.

Whereas I used to talk to myself in a certain way, and I used to feel limited, and I used to compare. I feel like actually owning my own business before this helped with my mind space, but just the confidence that I have built and that mental side, I feel like I can do freaking anything. I feel like the sky is the limit. I am 51, and I feel like I have the whole world ahead of me. I have my whole life ahead of me. I have so much that I'm going to do, and I am so excited.

Every once in a while I might have a moment where I'm like, oh gosh, can I do this? And I'm like, heck yes, we can. We're doing this. We can do this. It's giving me that confidence that I can do freaking anything I want. Because you're going to blow your mind with what happens when you put a layer of muscle on your body.

Nikkiey: Say it louder.

Alicia: It's going to be crazy. It's going to be crazy. If I could just encourage that one thing. And I see it with the women I'm talking to every day. They're like, oh, I'm seeing this muscle coming. It feels so good, and I feel so amazing, and I feel so powerful. They just didn't realize that they had it in them.

Nikkiey: Yeah. What's one piece of advice you'd like to leave the women who are listening to this with, as they're navigating the stage of life they're going through?

Alicia: That it is not too late. You are still magnificent and powerful, and you are actually just getting started. You have been pouring into everything else up until this point in your life. You've been pouring into your career, your spouse, your kids, everything, everyone else. Now it's your time. You're going to make you a priority. It's your time. And you are literally just going into that second half of your life. You need to make it the best. You want to be your best for the second half. This is the time when you get to be you and do your thing.

You want to feel good. You want to look good. You want to do all the things. You've got to have that high energy. And it's not too late. You can start now and completely change your life.

Nikkiey: One hundred percent. No doubt. Amen. Thank you for all your insight and your energy and your words.

Alicia: Thanks for having me.

Nikkiey: Hey, while you're listening, if you're getting value from this episode, take a moment to tap that review button or share this podcast with a friend. It's a small gesture that goes a long way in helping more women find their way to feeling stronger and more confident in their skin. I appreciate you so much for taking the time to support this show.

Dr. Brighten is here today, everyone. She is on a mission to help women uncover the root causes of hormonal imbalances and reclaim their vitality through informed, science-backed choices. Today we're diving into all of the things: perimenopause, hormonal shifts, mood, libido, energy, and what it truly means to take control of your health through every phase of womanhood. I'm really excited for this conversation. Dr. Brighten, welcome.

Jolene: Yeah. Thanks so much for having me. I'm very excited to jump in and talk.

Nikkiey: Everybody, she sent over some of the best questions.

Jolene: So I'm going to tell you right now that you're going to want to share this with your friends, because we are going to bust so many myths, and I'm going to give you everything that your doctor should have given you in every single visit you've ever had, but hasn't yet.

Nikkiey: Amen to that, lady. I'm super stoked. So for many women, let's first start off in the bucket of hormonal imbalance. Perimenopause feels like it just sneaks up on them. I've learned that it can start as early as your mid-thirties, right? So what are the earliest signs of hormonal changes that women experience? What should we be paying attention to?

Jolene: Yes. What every woman needs to know about perimenopause is that hot flashes are not the first sign. Irregular periods are not the first sign. The very first hormone to decline in perimenopause is progesterone. Progesterone is only made after ovulation.

The onset of perimenopause is when our savings account of eggs is running out. When you're out of eggs, you enter into menopause, which is 12 consecutive months of no period. The next day you're postmenopausal. So you've got a birthday of no periods. Yay, menopause. Next day, postmenopause. But before that, what we see is that progesterone begins its decline.

What do those symptoms look like? Worsening PMS. So you're more irritable. Your partner chews their food loudly. You're like, I'm getting a divorce. I'm out of here. I can't be with this person anymore. I'm so irritable. Because what progesterone does is stimulate the GABA receptor in your brain. You make progesterone, or you take oral micronized progesterone, and your body converts that into allopregnanolone. That hits the brain. GABA lights up. GABA says, chill. You love this person. They're not that annoying. And we're going to get really good sleep. We're going to go to sleep and we're going to stay asleep throughout the night.

So if you're someone 35 or older and two, three, maybe even five days before your period you're having night waking, or you're waking up much earlier, so instead of waking up at six like you usually do, now you're waking up at four or five, that can be pointing towards a progesterone issue. The good news is that in the early perimenopause phase, there's still a lot we can do naturally to get the ovaries to work for you and help mitigate these symptoms.

Nikkiey: How? What can we do?

Jolene: Yes. Okay. We'll go right into it.

Nikkiey: Give it to us now.

Jolene: Okay. So if you are experiencing increased PMS, you are having breast tenderness before your period, you're irritable, you're having insomnia or sleep issues, there are several things that can help. Number one is we increase our vitamin C, whether that's coming dietarily or through supplements, and vitamin B6. With vitamin B6, we're going to be looking at 20, 25 milligrams coming in a day. Those are going to support the corpus luteum, the temporary endocrine structure that's left behind post-ovulation to produce progesterone. There's an herb known as chaste tree berry, or vitex.

We typically use that at 200 milligrams. That can also help with supporting ovarian production of hormones, and it can help during that luteal phase. Now, the other thing we've got to look at is stress. Stress is absolutely the number one thing that will rob you of a really easy period. The reason is that when the brain perceives stress, your body, wanting to survive no matter what, says: make stress hormones, survival hormones. Don't make reproductive hormones, expensive hormones that potentially get us pregnant in a scary environment. We need to survive.

So your body, being really wise, is going to shift in that way. The problem is the modern woman is living under chronic stress day by day by day. And evolutionarily speaking, the way you developed your entire hormonal system does not match what is happening in your environment. So what can we do with that? We have to look at where we can mitigate stress and where we can cut out stress. You cannot control all stress, but you can control your response.

I have several articles on drbrighten.com, and one I would recommend people check out is on vagus nerve stimulation. I also have a podcast episode going through ways that you can stimulate your vagus nerve. There are certain breathing exercises. There are massage exercises. The vagus nerve runs from your brain. It innervates your heart, and it innervates your gut. And this is a way that we can access the rest and digest aspect of our nervous system. We can hum. We can sing out loud. We can do deep breathing.

That will shift us to more resilience against stress. And then I ask people in my practice to basically do a stress inventory. I just want you to brain dump all of the things that are causing you stress. And then I want you to look at what you're unnecessarily putting on your plate. Because we do that. We think, oh, I'm the only one who can do this best. Does it really have to be you? Do you really have to sign up for that PTA thing again? Do you really have to volunteer for this extra thing? Where can you offload stuff?

And then I want you to look at what is perceived stress and what's actual stress. Because sometimes, when we write something down as a source of stress and look at it, we're like, actually, I'm making that up in my head. That's not real stress. I need to let that go. And then there's my favorite one. Everybody talks about a detox diet. I'm like, detox the people in your life who are toxic. So take a look at that. If there are people in your life that, when you spend time with them, you feel more exhausted, drained, you go home, you think about the interactions, you hate on yourself about things, those people have got to go, especially if you're in a healing phase of life. And that doesn't make them bad people. It makes them not the right people for you and your hormones.

Nikkiey: Yeah. Wow. Such good advice already this far into the episode. I'm sure many people are going to rewind and listen to that back, and you should, because that was a great, powerful answer. I want to ask you, what are the most common myths and misconceptions you often hear from your patients about perimenopause and hormone health?

Jolene: Actually, I hear this one from other providers: that perimenopause and menopause are just natural, so if you're having symptoms, you just need to ride it out. And you know what I find really funny, as somebody who has been prescribing hormone replacement therapy, or menopause hormone therapy, for over a dozen years, and this is part of my core training and my background in medicine, is how many of these doctors, primarily gynecologists, are out here telling women to just raw dog their way through menopause. Suck it up, get through it. It's natural. Don't use these hormones, they'll cause cancer. Some of them send me nasty messages, like, what are you trying to do, kill this patient, giving them HRT? I'm like, no, I'm trying to give them back their life, let them not lose their mind and actually enjoy a fully lived life.

And now these people are like, oh my God, sign me up. I want this HRT, and I'm also going to be an expert in it. And I'm like, could you just for a minute recognize the fact... I mean, there are a few gynecologists out there who I think are in the menopause space doing a great job, and they do talk about how they had no background, no training, and they did a disservice to their patients. We have to have that dialogue to build trust with patients, because the people out there that you denied hormones to absolutely remember you.

So I think that is one big myth in that space: it's natural, so you should just deal with it. You don't have to just deal with it. And you don't have to use hormones if you don't want to. That's one option. There are a lot of natural therapies that we can use. Nutrition and lifestyle go so far. And I will be the one to tell you, HRT is not enough. I don't care about these people singing it like it's the gospel that's going to save your life. It is not enough. You have to be looking at nutrition and lifestyle as well. The way you show up every day to live your life has such a tremendous impact on your outcomes. And I think anytime we put basically this paywall between people, like, if you want optimal health, you have to see a provider, you have to get a prescription, it's very disempowering, because there's a lot that you can do now, with or without hormones.

And there are also other medication options we can use, if you're like, I don't want to go the hormonal route, I'd rather try something else. So you shouldn't just suffer through it. There are lots of options, lots of things that we can do. The other myth is that perimenopause is a new phenomenon, that it wasn't even a thing until this generation of millennial women started talking about it. When really, it's been documented for hundreds of years. Perimenopause has always existed. And so there's the concept that our ancestors didn't have this, therefore you don't need hormones.

I hate to tell you this, but our ancestors died in childbirth a lot. A lot. And they also didn't make it past their fifties. Our life expectancy has been extended. And so with that, we have to pivot and look at how to support women much better. The other myth I'll mention is that if you take hormones, you're going to get cancer. That's a big one. There was a study called the Women's Health Initiative.

They used much older women than we initiate HRT with these days, and they already had the onset of certain disease processes. So we weren't going to reverse those. Hormones aren't going to reverse those. But the concept that these hormones cause cancer, we have to really peel it back. As the new research is coming out, what we're seeing is that progestin, which you find in hormonal birth control, tends to be the one that is more associated with cancer than the bioidenticals that we use today. Premarin, which comes from a pregnant horse whose urine we took and extracted estrogen from, also not great. But using your own biological hormones doesn't show the same risk as we see with the synthetic hormones that we were using.

I just released a podcast episode. I have several where we talk about estrogen and breast cancer. And the latest one with Dr. Felice Gersh is great, because she talks in so much detail about how estradiol, the form that we use in hormone replacement therapy, actually helps glue the cells together so that you don't get metastasis, which is what kills us in breast cancer. I know there are going to be people commenting, yes, it does cause cancer and you're going to kill people, because this myth has been so perpetuated by the media. But medicine got it wrong and science got it wrong to make that blanket statement.

And I want women to understand that smoking, drinking alcohol and binge eating ultra-processed food are higher risk factors for breast cancer than using a very small dose of estrogen hormone replacement therapy with progesterone HRT as well. They've got to be balanced out. And when it's done right, we're using the lowest dose to support your body. We are not trying to get your period back or get your levels back to what they were when you were still menstruating.

Nikkiey: Oh gosh, thank you. That information right there, I think a lot of people overlook it, or believe the media, believe what people have to say about this, especially if people have status and they're sharing it as well. So I just love that breakdown. Let's jump into the mood, energy and libido conversation during hormonal shifts. Mood swings, fatigue and libido changes are common complaints during perimenopause. What's happening behind the scenes that drives these symptoms?

Jolene: Yes. Okay. So actually, my book Is This Normal? has the whole first half about your sexual health and hormones, and the second half is just about hormones. And so here is what is going on in perimenopause. It is very multifactorial. Firstly, cyclically speaking, it is normal for your libido to decline post-ovulation. That is because estrogen drives a lot of our sexual desire, our sexual fantasies, vaginal lubrication, our arousal, all of it.

Testosterone is also coming into play, and it's always the one everyone knows about, but estrogen is important too. Once progesterone comes online, things shift. This is where I joke that you'd rather get into sweatpants than get into his pants, because it's just comfy time. It's just, let's cuddle. And that's what I always tell women: you need to tell your partner that they need to decrease your stress during this time, and they need to up the type of love that you need.

Whether that is physical touch, whether that is praise, whether that is just doing the dishes because it takes a load off your plate. That's going to help you be more receptive to any sexual advances that are made. Otherwise, if your nervous system is dysregulated, you're not going to receive those signals. It's basically like someone cut the phone line. They're trying to talk to you and it's not going anywhere. So that is something that's really important to know. Now, in perimenopause, I told you that we start with a decline of progesterone.

Now we're much more irritable. Our nervous system is much more primed to being sensitive, and maybe we're not getting good sleep. The other thing that happens in perimenopause is that our estrogen is starting to go up and down. I like to joke it rocks harder than an AC/DC concert, because it is up and it's down and it's unpredictable. Studies have shown that with the right amount of estrogen, you have sexual fantasies, you are all about your partner. With too much estrogen, you're actually more critical of your partner. You're much more critical of them and you're much more irritable.

Some women have the extra added benefit, and that's a joke, it's not actually a benefit, of histamine issues too. As estrogen goes up, histamine goes up. As histamine goes up, estrogen goes up. We think about histamine for allergies, but histamine in the brain can also make us feel aggravated. We can feel more irritable. And if you feel like you have the period flu, where you have hormonally driven flu-like symptoms, you're not going to be interested in sex.

So there are those two hormonal pieces in early perimenopause. Once we get into late-phase perimenopause, estrogen is down. Sexual fantasies down. Pain with sex comes on. We're not able to self-lubricate, which, by the way, in the luteal phase you don't self-lubricate either. That's also normal. So now we need lube. We probably need vaginal estradiol as well, which doesn't go systemic, so we don't worry about that. If you have a history of breast cancer, we don't worry about it. It's not going systemic. And it's going to help keep your vaginal microbiome healthy as well, which is so, so important so that you don't end up with yeast vaginitis, bacterial vaginosis and UTIs.

Because if you get that, you're also not going to have sex. If every time you have sex you get an infection, you're not interested in that. So we see that decline. But there's also the effect on the brain. We feel less happy, honestly. We know that in women in perimenopause and menopause, with the hormone decline that happens, we're seeing 40% of that population with new-onset anxiety and depression.

So we're not happy in our brain. Our brain doesn't feel good. Our body doesn't feel good. As estrogen is going down, insulin resistance is rising. Visceral adiposity is accumulating. We're getting belly fat. Our body's changing. Now we have body image issues. Maybe not yet true for you, but this can happen. Body image issues and the threat of unintended pregnancy are two big reasons why women will get out of the mood, not be able to get in the mood, or have an inability to orgasm. They have a major impact on our mental health. Now, with that said, for some women, with vaginal estrogen, lube, and no chance of getting pregnant, they are in the mood all the time.

And we also understand that testosterone, about 50% is made from the ovaries. But you've got your adrenal glands. They make DHEA. DHEA gets converted into testosterone. So you may still have testosterone going. But if you don't, we need to look at that piece as well, because testosterone plays a very important role in our sexual health. Now, the thing that doesn't get talked about enough, and I talk about this a lot in Is This Normal?, is that insulin resistance and inflammation are very bad for your libido and your orgasms. We don't talk about this enough. When we have insulin resistance, damage can be done to the clitoris. When glucose is elevated, the nerves in the clitoris can become damaged. Now we have an inability to orgasm. If sex is painful and not fun and you don't even get an orgasm out of it, you're going to be less inclined to want it.

Now, the last thing I will say on this topic is that women are also going through a significant life change that causes them to reflect on their life and recognize that in most cases they have been a caretaker to their children, their parents, their partner. There's a lot of stress going on during this period of time. Stress, for some people, makes them want to have more sex, but for most people it makes them want to have less. So again, it's robbing you of anything that is reproductively driven.

But the other thing is that relationships can become challenging and strained, because women are tired after 40-something years of showing up for everyone else, and maybe being in a marriage for 20 years where you have constantly let him borrow your brain. You've been his secretary. You've been his house cleaner. You've been his babysitter. You have been all of these roles that, as women, we have to pay people to help us do. But men get to use women and their unpaid labor, and it is exploitive. It really is. And I do want to say that there are lots of partnerships where this works beautifully.

It works absolutely beautifully. But there are ones where it doesn't, and it does feel absolutely exploitive, and it feels like, I have been used as a means to an end and not valued for the person that I am. And that can create strife in a relationship. So when it comes to libido, it's never just your hormones. Sometimes hormones lead to a desire not to have sex, or to pain with sex, and that leads to relationship issues. And even if we correct the hormone issues, the relationship issues have persisted.

And so those also have to be addressed as well. What I want women to hear is: it's not that you're broken, and it's not just a you issue. There are so many factors, including societal stressors and inputs and expectations that we didn't even talk about, that can be contributing to low sexual desire.

Nikkiey: Yeah. Wow. Such a great answer. You've spoken about the importance of the brain-hormone connection, too. How can women support their mental and emotional well-being through this time, when they're experiencing this?

Jolene: Oh gosh. You know, okay. So I'm going to say, I did Lupron. I have endometriosis and adenomyosis. I did an injection of Lupron for two months. Do not recommend. Zero out of 10. Worst thing ever. Because Lupron is a medication that is chemical castration. You essentially just go into menopause within a couple of weeks. There's no perimenopause. It is just boom: here are your hot flashes, here's your depression, here is your brain fog, here is your inability to do anything you used to do to the capacity you would expect of yourself.

Nikkiey: Wait, can I pause you for a second there? I'm super interested. I used Lupron when I froze my eggs. Is that the same type of drug? When you go through the process of IVF using Lupron, I had to do it for the whole cycle. Is that the same type of drug you're talking about here?

Jolene: With Lupron, Lupron is given so that you stop making hormones. You stop ovulating. You stop producing estrogen. You stop making all hormones. When you're doing an IVF cycle, they're usually injecting you with FSH and LH, follicle stimulating hormone and luteinizing hormone, to cause lots of eggs to proliferate. Using Lupron long term in that situation would stop you from producing eggs, so I doubt that's what they used. There are definitely different protocols. But the standard for IVF is follicle stimulating hormone and luteinizing hormone to get you to make lots of eggs, then doing the trigger shot in some instances.

There are actually several medications that they can use to free up your eggs, and then they're going to harvest them.

Nikkiey: Gotcha. Okay. Makes sense. Got it.

Jolene: Yeah. You would know if you were on Lupron, because you're going to have hot flashes. You're going to have all the menopausal symptoms. You're going to have vaginal dryness. Everything hits you all at once. So to the mental health component, I'm actually developing a supplement that I've named Radiant Mind, because when I went through this, I was like, I have to have something.

I was just in a spiral. So I leveraged saffron. Most of the companies I found didn't have enough saffron, so I was doubling up on it. Then I was using things like bacopa, and leveraging acetylcholine, which is a certain form of choline, and you can get choline from eating eggs. We know this is really important for the neuronal development of infants. It's really important for your neuronal health. So I'm actually coming out with this supplement soon.

It's been in lots and lots of research and development. But because I went through that, I very much am like, when it is my time for menopause, I'm going to have this. This is for me. I've had several friends ask, who did you make this with in mind? I'm like, me. Me. Because I don't want to end up on an SSRI with the side effects, which can be low libido, inability to orgasm, having withdrawals when I come off.

Certainly SSRIs have a time and a place. But if I can do it without needing that... I already have to take a thyroid medication every day, so I'm like, that's enough. And you're talking about IVF. I've been through IVF. I've been through my organized calendar of taking this and taking that, so many things, that I'm like, you need to keep it simple. So anyhow, those are some of the supplements that I have utilized. Omega-3 fatty acids are another one, super important for brain health.

Make sure that you're getting one that is third-party tested and that is actually distilled in a way to try to remove some of the environmental pollutants that are inherently in fish and in fish oil. We have ways in our company that we can remove some of those so that we're not upping our exposure to those things. Also make sure that you're optimizing your blood sugar. If you have insulin dysregulation alone, you don't even have diabetes yet.

You don't even have prediabetes, but we're seeing fasting insulin levels going up. That can be affecting your brain energy and how your brain is actually able to function. Anything that supports mitochondrial health is going to support your brain health. It will support your ovaries as long as they're working, and your heart as well. So we're looking at CoQ10, ubiquinol is a really important one, L-carnitine, alpha-lipoic acid. And then making sure you're eating a really nutrient-dense diet, lots of polyphenols.

Polyphenols, it's so funny, because I'm writing my next book and I was reading all this research about polyphenols and rosemary. I have a ton of rosemary growing at my house. And last night I was making tomato soup with onions and garlic, great for liver detoxification, and I had bell peppers in there. But I was like, rosemary. And then rosemary garlic bread. I was putting rosemary on everything. My husband's like, whoa, this is rosemary night. I'm like, you don't even know the research I just read today.

It's so important. It's so important. So rosemary, blueberries, pomegranates, green tea. Polyphenols are great for your gut health, great for your brain health, great on the cellular level. Dr. Kara Fitzgerald has done really groundbreaking research showing that a high-polyphenol diet for eight weeks reversed people's biological age by over four years. In just two months of loading up on polyphenols, they aged backwards cellularly.

So this is why I'm like, your diet matters. And any doctor who tells you it doesn't matter what you eat, just walk away from them, knowing it's not their level of expertise.

Nikkiey: Yeah. Wow. Amazing. Dr. Brighten, thank you for sharing your expertise, and for helping so many women feel seen, heard and, most importantly, empowered in their health journeys. Thank you for your time today. I appreciate you.

Jolene: Yeah. Thank you so much.

Nikkiey: Hey, really quick before you go, I have one small favor to ask. If this episode brought you value or sparked something in you, take just a moment to hit that review button. Your rating and review make all the difference, helping more women discover the tools they need to transform their fitness and their confidence. It takes less than a minute, but it can change the path of someone else's journey. Thank you so much for leaving that review. I appreciate you so much. Thank you.