Tag Archives for " menopause "
On episode 602 of the 40+ Fitness Podcast, Dr. Heather Hirsch and I discuss her book, Unlock Your Menopause Type: Personalized Treatments, the Last Word on Hormones, and Remedies That Work.
[00:02:51.430] – Allan
Hey, Ras. How are you?
[00:02:53.400] – Rachel
Good, Allan. How are you today?
[00:02:55.320] – Allan
I'm good. I'm back in Bocas where I like to be. It was great to visit family. Don't get me wrong, that was a great catch up and I'm glad I did it, but I'm just happy to be home.
[00:03:08.170] – Rachel
Yeah, I hear you. It's hard to be away from your own home, your own habits, your own kitchen, your own bed for so long.
[00:03:14.940] – Allan
And my dogs. Those little things.
[00:03:20.750] – Rachel
[00:03:22.110] – Allan
How are thing up there?
[00:03:23.570] – Rachel
Good about the same. I'm doing the same thing you are. I'm squeezing every moment I can with family. When I get it, we're trying to get some vacations planned and just being as busy as we can. Summertime just feels like it goes by so fast because we aim to spend a lot of time together. Because I'll tell you right now, in the winter time, I shut down. I do not want to drive in the snow. I don't want to be outside except to run where I can at least generate some steam, some literal steam. Yeah, but, no, I'd like to spend as much time with my family as can.
[00:03:59.600] – Allan
So, yeah, Tammy and I are planning our September holidays because we're going to close Lula's down for the month and just go explore. So we're going to take some time off and just travel around this country. And Mexico. We're going to go up to Mexico for a little while, but that's kind of the plan for September. So we're putting that all together right now. But this trip will be the two of us together. To be better.
[00:04:25.330] – Rachel
Yes. Oh, that's wonderful. I'm glad you get the time to do that. That's great.
[00:04:30.330] – Allan
All right. And I mean, guys, guys, because I don't normally say this kind of thing, but look, the topic we're going to talk about today is menopause. And if you've listened this far, you need to keep listening. The health of the women around us is important to the quality of our lives, too. And so just recognizing that, no, she's not crazy, she is going through something, maybe seeing these buckets and that we're going to talk about in this interview and just saying, hey, that's her, that's her. And maybe this book will give her some options that will help her, I think that'd be a very valuable thing for both of you. So don't tune out just because this is a menopause issue. There's a lot of education in here that can help you, help the people around you and your relationships. So please do listen on.
[00:06:06.310] – Allan
Dr. Hirsch, welcome to 40+ Fitness.
[00:06:09.590] – Dr. Hirsch
Well, thank you so much for having me. This is so exciting.
[00:06:13.510] – Allan
So your book is called Unlock Your Menopause Type: Personalized Treatments, the Last Word on Hormones, and Remedies That Work. Now, my wife has just recently gone through menopause and so I've experienced this side of that relationship thing. I haven't experienced it, obviously. I've had a lot of conversations with experts in the field and in talking to them, particularly women that have experienced it, there's this concept that every woman experiences perimenopause and menopause differently. But your book took them and kind of said, look, we can group these into buckets, if you will, and within that, basically now you can be a lot more specific about how you address your health and wellness and mental everything by knowing kind of what your type is. I really like that idea because I think so many times people think, well, what's the answer? The answer? And it's a lot more complex than that.
[00:07:16.170] – Dr. Hirsch
Right, exactly. Wouldn't that be so easy? I'm glad you liked the types because certainly it was meant in many ways to really help women really help better target their symptoms by thinking through what are the predominant symptoms or what is the predominant health history I have leading up to menopause. So did I have surgery or cancer or did I never have a hot flash at all? Because if you never had a hot flash or an outward symptom, it may not even be on your radar. And therefore, actually your health could be really deterred by not knowing what that means. And so I also love The Buckets because I think truly there's not one size fits all. But I couldn't write a book that was like the million types of menopause that could add into limited at some point.
[00:08:14.770] – Allan
Yeah, your editor probably would have had a problem with a million types
[00:08:19.020] – Dr. Hirsch
she would have. Yeah. Actually, my agent actually, before I got to my editor, I said, I really want to write a book on why nobody cares about menopause. And she said, Well, I think that might make a better blog post. And actually we spent a lot of time thinking about the menopause books that were already on the market and what would make mine different, because there are good books, but I really also felt that there weren't inclusive enough. So I talk a lot about depression and anxiety. Younger women, women with cancer, seemingly kind of get left out of the equation because they just don't fall into the cookie cutter, 51 year old with hot flashes.
[00:09:01.150] – Allan
Yeah. Now, while we're on it, let's just briefly go over the six types and what kind of makes each of them unique.
[00:09:11.020] – Dr. Hirsch
Yes. So the first type is the premature type. And actually this is one that is a medical diagnosis. There is something called premature menopause, and that is when you have menopause before age 40 and early menopause is menopause between ages 40 and 45. Meaning really simply whether it's surgery and your ovaries were taken out or your period stopped and you had lab levels that showed menopause about one to 5% of the population has early menopause. And I had a patient last Friday she was sitting with me in my New York City office, and she said, how rare is this? And I said, Well, I think I did the math. And I said like 1%. I'm going to get this wrong, but 1% of 5 million is 50 million is 1% of 50 million. I don't know what the number it was either. How much is it?
[00:10:12.360] – Allan
I think it's 50,000.
[00:10:13.640] – Dr. Hirsch
50,000, right? Yeah, 50,000 women a year, and that's just 1%. But we could go up to 5%, right? So I said 50,000 women each year is not nothing either. And I also think that that number is dependent on getting lost in the weeds here. But I'm really passionate about this. I think that number is also getting lost in the weeds because she said also I haven't seen a doctor in a really long time, and I don't even know if my doctor really even considers the fact that I haven't had periods anymore. So that number 1 – 5% is probably an underestimate. Okay.
[00:10:45.070] – Dr. Hirsch
The second type is the sudden menopause type, often due to either something suddenly happening. I think of chemotherapy for cancer treatments. I think of surgery for maybe endometriosis or cysts or cancer, again, thinking of lupron or certain medications, even high dose steroids. I had a lady who went into menopause after a traumatic car accident. She had a traumatic car accident. Boom. Never got her periods again. And so for most women, the sudden menopause type is potentially where hormone therapy is not indicated because there are patients here who are suddenly waking up and taking chemotherapy for cancer.
[00:11:29.040] – Dr. Hirsch
And so this type really talks a lot about, in my book, non hormonal therapies, but also different ways of exercising, different ways of treating your body with a sudden type of menopause.
[00:11:40.930] – Dr. Hirsch
A full throttle menopause is exactly what it sounds like. Symptoms from head to toe, hair loss and night sweats and waking and fatigue and lack of motivation. And every single symptom you could think of is really your full throttle menopause.
[00:11:57.750] – Dr. Hirsch
The mind altering menopause, which is type four, is really near and dear to me as well because I think there are many women for whom their symptoms are really more mental health hearing, whatever that means. So there still could be a big shift in hormones, and they may get either misdiagnosed with depression, anxiety, bipolar, and there certainly could be multiple factors, but the shift in hormone there is huge. And this is actually one where I say movement really is medicine. There's the lingering menopause type, which is symptoms that just sort of never seem to go away, never as terrible as full throttle or as obvious as sudden menopause. But too many women let menopause symptoms go on for many, many years without feeling as though they are worth treatment or they're worthy of treatment, or they're just taking care of too many other people.
[00:12:55.530] – Dr. Hirsch
And then silent menopause type is really what I touched upon is that even if you never had a symptom, your body still changes. So what are the exercises you need to do? What are the health tests you still need to do? Because women with silent menopause type may seem lucky on the outside, but if that doesn't remind them that their body is still changing, they may be left at a disadvantage.
[00:13:18.030] – Allan
And I think it's important for them to kind of go through that process of deciding, okay, what's the best approach for me? Because there is no one size fits all. So here's an opportunity for you to do a lot of different things. And one of the things that's going to come up unfortunately or unfortunately, I guess it's unfortunate, is there's kind of this confusion about hormone therapy, because there was the nurse's study, and so we have information from a nurse's study. And that's what most, I think probably most general practitioners and maybe even a lot of gynecologists were taught was okay, this was the science. But we've learned a lot since that study. So pros and cons, should a woman consider hormone therapy or not?
[00:14:04.510] – Dr. Hirsch
So absolutely a woman should consider hormone replacement therapy. And I always like to preface all of my either talks or podcasts with again, I still don't think one size fits all. So it's not h or T or bust. But there are so many indications and there is so much now we know about the safety and efficacy. So I kind of think about it like this. If a person was diagnosed with hypothyroidism and they were feeling sluggish and slow and their hair was falling out, we wouldn't say to them, oh, well, just set your alarm earlier and meditate like you'll be okay. We would give them thyroid hormone. We would replace their medication because they're missing a hormone that is crucial to their entire body. And truly, estrogen is very similar. Now, biologically, women were meant to go through menopause. I don't know how long women lived postmenopausally, probably not as long as we do now. Maybe five years, ten years, I don't really know. And I actually think there is an evolutionary basis to being in menopause. You could help your children and then they could help their grandchildren. So I actually think there is an interesting evolutionary basis for menopause.
[00:15:26.880] – Dr. Hirsch
But now we live very, very long and our symptoms can be really quite severe. And now midlife is the peak of a woman's functionality in terms of intellectual capability, financial capability. And so not that all women need hormones or hormone replacement therapy, but for so many women it's just like that hypothyroidism, they lose their estrogen, progesterone, testosterone, and yes, things like meditation and gratitude and journaling, they can certainly help. But just like that example I gave you, oftentimes when I give them estrogen back, boo, it's like night and day, they're back to functioning and feeling so well. And we should not demonize an endocrine dysfunction or disorder. Now people get all up in arms. You ask the simple question about is it safe? But truly it is. And the thing about the safety of HRT back to your original question, is, it is so peppered with cultural and societal norms about menopause and whether we should take hormones or not. But anyways, it's not necessarily that menopause is a disease, and yes, it is a natural part of life. But when you are a doctor, when you see what I've seen, that the majority of women really feel so much better almost instantaneously, not all of them.
[00:16:46.850] – Dr. Hirsch
It really does. You really just see at the basics of this, you lose a hormone, I replace it, you function well again. So we know from the Women's Health Study, as well as some of those longer studies, right, the Nurses Health Study, lots of studies about HRT, that there is an immense amount of safety data, particularly for women who start within ten years of menopause. That's the one thing that the Whi scared people about. And the idea that hormone therapy increases the risk of breast cancer has also been demystified. And that if we use certain formulations, estradiol and prometrium, which are FDA approved, which you should absolutely get FDA approved, we don't see statistical increases in breast cancer. And we do know that women who do take FDA approved hormone replacement therapy live longer, die less from all causes, have less diabetes, gain less weight, have improvements in quality of life, better bone health. Oh, stops your symptoms, I forgot to say work longer, retire later. So many benefits from hormone replacement therapy. So before I get off my soapbox, my last thing is you're not doomed if you don't take hormone therapy. It's just that the last statistics showed that probably about seven to 10% of the US population is taking hormone replacement therapy. And if we can even get that numbers to 20%, at the peak before the WHI, it was 45% to 55% of women. I just want women to be able to have better conversations with their clinicians, with themselves, and to think about HRT as a valid option.
[00:18:27.730] – Allan
Yeah. And I think that's what's really important here is that you educate yourself. You're your own coach. I mean, you're your own CEO, and you have to make the best health and life decisions for yourself. And if you just go at it like a knee jerk, oh, no, that's bad, without really looking at your particular situation and what it would mean, and talking, of course, to your medical advisor, your practitioner, your gynecologist, and having those conversations, then at that point you can make an educated judgment of what's best for you.
[00:19:03.630] – Dr. Hirsch
[00:19:05.950] – Allan
Now, this is not all about getting a shot or pellets or whatever else, creams and everything else. There are things you can do every day to help symptoms help yourself feel better, to get through this easier and come out stronger. And we call those diet, exercise and self care. Can you talk a little bit about how those play into this?
[00:19:30.150] – Dr. Hirsch
Yeah, I think they're really crucial. And even to come off the backbone of talking about medication, sort of right off the bat, I do think that diet, lifestyle, mental health and sleep really lay the foundation for adding a medication on top of this. Because whether you take that medication off or on or you change the dose, these are the things that set up good habits for the rest of our lives. And once we're postmenopausal, we're always post menopausal. So to keep it brief, I will say one more plug for my book is which is incredible that I was even able to do this, but for each of those different types, I talk about the best types of diet, lifestyle, mindsets and foods for each one, which is really crucial. So let me give you a little window. The sudden menopause type, we talk a lot about anti inflammatory foods because I'm thinking if something suddenly brought you into menopause, perhaps you have cancer or you're taking chemotherapy. And when we talk about exercise, I'm talking more about like graded exercise, stretching, mobility, flexibility. When we talk about the mind altering menopause type, I feel as though because of that loss of dopamine, there are certain foods that can include those feel good that could increase not include increase those feel good hormones in the mind type of menopause.
[00:21:02.730] – Dr. Hirsch
I think that exercise is really medicine here. And getting your body moving, getting your cardiovascular system moving is so, so crucial to also help you release dopamine, serotonin and those happy neurotransmitters. And for the silent menopause type, I talk a lot about weight bearing exercise. And actually, of course, I should say across the board, weight bearing exercise for women as we get into our 40s is absolutely crucial.
[00:21:33.070] – Allan
Thank you for thank you for saying that.
[00:21:37.330] – Dr. Hirsch
Yes, it does not have to be going to CrossFit, does not have to be. But really, if you're new to it, starting with weight bearing exercises, squats and then picking up your milk and doing deadlifts with that, and upper body, your shoulders, your back. In my book, I talk about a lady who had silent menopause. She had a BMI of 20, played tennis two, three times a week, and as she was getting the turkey out of her Thanksgiving, out of the oven for Thanksgiving, she stood up, fractured her spine, and she hadn't been weight bearing, hadn't been told about osteoporosis at all. And so the weight bearing is so crucial, not just for the silent, but for all women post menopausally.
[00:22:21.780] – Dr. Hirsch
It really has to be incorporated in some way, shape or form. When we think know, I am not a bona fide nutritionist. I actually had Elizabeth Ward as a dietitian who wrote a wonderful book, a great companion book called The Menopause Diet Plan. And there are really certain foods that are so important that we should be getting for vitamins like zinc and iron and magnesium. Now, iron is not as important postmenopausally because you're not bleeding anymore. But perimenopause in your 40s, it's really crucial because it can lead to a lot of fatigue. And me, I always recommend a diet with at least 80 to 100 grams of protein a day. I have tracked macros once in my life. I personally hated it just because it just made me feel so crazy about it. But increasing protein in midlife is so important. So weight bearing, exercise, increasing your protein intake. And then we can talk a little bit more about some of the other lifestyle tips like sleep. But these are really such foundational backbones to thriving and feeling well because how you treat your body between ages 40 to 60 really sets up how you're going to spend the rest of your time on this planet.
[00:23:46.630] – Allan
Now, one of the topics that's come up, it's like why is a guy interviewing and reading all these books on menopause? Because I try to do at least one per year.
[00:23:57.290] – Dr. Hirsch
We love this. We love this.
[00:24:00.760] – Allan
Well, to me it's important to understand what's going on in my wife's life. And I know there's a lot of women out there that need this information. Me being a guy, that's not a valid reason for me to say I don't need to know this. But I've read some statistics. I couldn't quote them right now. But there's a lot of divorces that happen during perimenopause and during menopause and a lot of it can probably be traced back to just changes in behavior, changes in what's going on in your life. And as a result, there's a disconnect in your relationship. And there's a lot of other things that probably play into that like kids moving out of the house and other things. But I think it's just really important and I wanted to bring this up is that you have a conversation with your significant other, with your kids. I'm not screaming at you because I hate you. Maybe I'm just going through something here and helping them understand it. Could you talk a little bit about how someone can start that conversation? Particularly once they know they're tight?
[00:25:03.570] – Dr. Hirsch
Oh my gosh, 1000%. And really I got so excited and clapped. Is because it's so fundamental that men really understand this. And I think that it's easy to look at this now. We're in 2023, right? In terms of your partner being pregnant, certainly there are some nowadays I'm going to make some assumptions and a heteronormative relationship. So an assumption there, and that's not always the case. But in this assumption, or this scenario, men now are expected to go to some doctor's business, not all because that would be bizarre and touch the belly and help build the crib and take maternity pictures and help if their wife is and learn about and learn about breastfeeding and all of those things, right? There is no difference here. There is no difference here. There's not a big belly and there's no crib that needs to get built. But the process is so uniquely similar. We're going through a complete hormonal shift that we do so that we can reproduce for the species, right? And for men to be inquisitive, to want to learn, for their partners, to want to educate too, and educate other men or women, who knows?
[00:26:25.210] – Dr. Hirsch
And I actually think that men find this very interesting because as much as women have been shut out, they certainly feel shut out and also feel like same thing in the hospital when the baby's being born. Like, what can I do? What can I do?
[00:26:41.730] – Dr. Hirsch
I think you asked me what are tips for women to start the conversation. But gosh, I think that if men also were there for the conversation or almost even said actually men should say nothing. Women should take the lead maybe, right?
[00:26:59.370] – Allan
Well, that's what I'm thinking. You know, one of the things is at this point of this show, my guess is that our listenership is all women. Most of the guys tuned out the first minute when I said we're going to talk about menopause unless their wife was going through it or they thought they were going through it, most men are going to tune out. If you didn't message me, let me know. I'd be very interested to hear otherwise. But I think it's incumbent on the woman to recognize that as she changes, as hard as it is having conversations, because I've heard of women unable to complete their jobs. They have to quit their jobs because of the symptoms they're experiencing. And that's so unfortunate because it's a medical condition. And so they need to have a conversation with their employer and say, okay, I'm going through a medical situation. I'm treating it. I'm working with a doctor, and then you have certain protections that you wouldn't have otherwise. But I think it's just that point of saying, okay, I need to start these conversations because this is not just a thing I'm going to just breeze through and accept this could change me.
[00:28:03.340] – Allan
It is going to change me at some level, but it could change me drastically. And I need my partner to know that. I need my children to know that. I need my work to know that so that I can live a whole full life and not let these symptoms take me down.
[00:28:17.870] – Dr. Hirsch
I couldn't agree more. And I think that there may even be shows like this, for example, that they could sit down with their significant other to say, I think I could be entering perimenopause. There's probably some cute, humorous things that can light heartedly bring up the conversation. I have a small section on this, on my book, too, and telling not even just your partner, but also if there's children still at home, which sounds kind of silly, but it can help your children better understand that there's just…
[00:28:53.610] – Allan
Mommy's not crazy.
[00:28:54.190] – Dr. Hirsch
That there's a transition here that's not them. But women can have shorter fuses, feel more irritable because they're having trouble sleeping, because they don't feel good, and they're so used to more often taking care of the whole family. So there's also guilt and there's worry and anxiety there. But even just sitting down at the dinner table one day and talking a little bit about it and the physiology books are always great, unlock Your Menopause type is a great one. Podcasts like this show can be great for partners to listen to because it's so nice sometimes to hear a guy's voice. I did another interview on a Boston radio show with two male hosts, and it was just great because I love having men as hosts. These can serve as bridges, and it's so crucial.
[00:29:46.090] – Allan
Thank you. So, Dr. Hirsch, I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?
[00:29:56.030] – Dr. Hirsch
Oh, what a good question. Okay, I'm just going to go with what I've been doing. So, you know, not that I'm perfect, but I am certainly just a mere mortal myself. I try to be pretty introspective when I can. So I actually just started going back to therapy. I've been in therapy on and off for many years, and certainly I have no problem saying that out loud. And it really helps me to take off the mental load of I listen to a lot of patients talk about their lives and their histories. And for me to be the best doctor, for me to be the best mom or parent, I need a place where I can digest all of that information so that I could be a better continue to be a better doctor, continue to be a better wife and mother and friend. So for me, that's kind of what I call my mental health. That's my mental health, right? So for me, that's cognitive behavioral therapy, and I'm lucky that I have resources. But another way of doing that is other things that you can do, like journaling or journaling especially. It's basically free cognitive behavioral therapy.
[00:31:06.140] – Dr. Hirsch
For me, it's 20 minutes of exercise most days that keeps me also really feeling my best. I used to be a long distance runner. I used to run marathons. And in this time in my life, actually, I think that would be more stressful on my body if I didn't absolutely love it and have all the resources to refuel my body. And so I like to do 20 minutes of exercise a day, if I can, in the mornings, and it really sets me up for just a wonderful day. And oftentimes I'm either doing my Peloton or some cardio sorry, or some weights because the weight bearing activity is so important. The third thing that I do to be my best self. I would say gosh, I could say so many things, probably I could say sleep. But let's not lie. I love scrolling it. But I like being present, so I like to be in the present moment. So whether my kids are snuggling with me on the couch or I'm reading a book to them, my husband's telling me about his day. I'm looking out, beautiful scenery outside. I'm taking my first breath of air.
[00:32:07.180] – Dr. Hirsch
I'm just trying to live in the present moment that actually keeps me very sane and happy.
[00:32:12.970] – Allan
Awesome. If someone wanted to learn more about you and learn more about your book, Unlock Your Menopause Type, where would you like for me to send them?
[00:32:21.090] – Dr. Hirsch
I would love for you to send them to my website, heatherhirschmd.com. It's got all the resources you could ever need or my social media. I'm @heatherhirschmd across all the platforms.
[00:32:33.930] – Allan
Great. Well, thank you so much. And thank you for being a part of 40+ Fitness.
[00:32:38.450] – Dr. Hirsch
Thank you. It was a complete joy and pleasure to chat with you today. Thank you so much for talking about this topic.
[00:32:46.160] – Allan
[00:32:47.160] – Allan
Welcome back, Ras.
[00:32:48.650] – Rachel
Hey, Allan. Menopause is the topic of the day for me right now. As I mentioned to you and our viewers, way back in the spring, I hit menopause. So I'm postmenopausal now and I'm trying to deal with all these weird symptoms. But I also appreciate what you just mentioned in our intro that for the guys to listen in. And I happen to be married to my husband Mike, and I've been cluing him in on my strange behavior and my questions that I have and all the things that I've got going on. We do have an open discussion and for any of the ladies out there whomever your partner or spouse is, be open and start talking about it because it can be very helpful to get that conversation started.
[00:33:32.320] – Allan
Yeah. Me doing what I do, I talk to a lot of people in the field that are doctors. I try to have at least one menopause issue per year because I think it is an important age related topic for us to get into. But guys, we're going to live with this for potentially a decade or more. They're living with it and we're not experiencing what they're experiencing, but sometimes they're not going to articulate why they are all emotional and going off on you because you didn't mow the yard right or didn't pick out the trash right. Or like, okay, it went out and it's not in here. Sorry, I forgot to put the bag in there, that kind of thing. It's not worth trying to choke me to death, you know, just realize that that could be a symptom. And so it's worth having that discussion. And one of the things that I liked about Dr. Hirsch's book was the concept of the buckets.
[00:34:27.870] – Rachel
[00:34:28.620] – Allan
Because it shows you just how different the different symptoms for different women can be. And here's something we didn't really get into in the conversation, but the woman can be a combination of a couple of these. Actually, when you start reading through the descriptions and getting into a little bit more detail, you can be, well, I'm sort of a little bit that one, and sort of a little bit that one. And you may not be having all of the symptoms. You might only really have one or two, or you might have every single one of them that anyone's ever listed in any kind of thing. It's like, do you have yes, I got every one of them. Check them all off. But again, the book gives you some practical guidance and talks about different solutions and things that you can consider and if it's adversely affecting your life, again, you have to have the conversations and you have to find the relief that you can so that you can live as normal a life. Now, it's not a new normal. And I think that's one of the big takeaways from most of the interviews that I've done is that a lot of doctors in the past have just told women this is just how it is.
[00:35:41.710] – Rachel
[00:35:43.710] – Allan
Okay. And it's not. You do have some treatment options and you should really pay attention to those.
[00:35:50.590] – Rachel
Yeah. I think that's one of the biggest mysteries of menopause is that we all think this is natural. We went through puberty, now we did our childbearing years, now we're going through menopause. It's all very natural. But when things do interrupt your life, when things aren't quite right, there is a solution. And the second part to that, the second tricky part is that we're used to when you get a cold, you take antibiotics. When you break a bone, you get a cast. When you get menopause, there's a big blank after that and that's the hardest thing. So when you're young and in your thirty s and forty s, it's really important to start paying attention to what your body is doing, what's normal for your body. And then as you're shifting into perimenopause, which is when your hormones are all crazy and fluctuating, then you really got to dial it down. Because I think that's where I went wrong is that I'm a very athletic person. So when I'm getting achy and emotional and tired, it's probably because I ran too many miles and didn't eat enough. But that's not necessarily the case. So trying to piecemeal these different symptoms, it can be really difficult.
[00:37:01.830] – Rachel
And before you know it, like in my case, I'm in menopause and now I am really dealing with the carnage of my hormones being all out of whack. So I think that it is important to find a doctor who knows you to pay attention to your symptoms, start tracking some things and then doing some blood work when necessary to see if there's anything that can alleviate the symptoms, but that's part of it is chasing the symptoms. And that can be hard sometimes.
[00:37:28.620] – Allan
Yeah, well, I mean, when most of us went through puberty, a lot of folks really suffer with acne as an example. So what do you do? You look for treatment for acne because, again, it's somewhat debilitating as a 15 year old, 16 year old who's just completely breaking out with acne and feeling self conscious, and that's affecting everything in your life. This is actually maybe even a little bit more severe than that. And so just knowing, okay, I'm going through this. I do not want this to affect my career. I do not want this to affect my relationship. I do not want this to affect my kids. And so, depending on where you are in life, you're juggling a lot of different things, and now, boom, here's
[00:38:13.470] – Rachel
another thing to deal with. Yes.
[00:38:16.080] – Rachel
That highlights everything. It overshadows everything. And like you had mentioned, too, because emotions are often tied with menopause. Like, we are emotional people. I'm an emotional person just to begin with. But anxiety and depression is another side effect of these changing hormones. And if your husband or your partner notices those things and can talk to you about that, that could be another signal to go to your doctor. And we have talked about, or you guys talked about hormone therapy. A lot of people call it hormone replacement therapy, but that is another way to treat some of these symptoms, especially if you're getting super emotional with anxiety, depression, and even anger. Like you had mentioned, sometimes we are quick to get angry. And I noticed that in my own personality, I'm usually a very happy, very patient, very calm person. But since I've hit menopause, my emotions are pretty quick to change, and I've noticed that. So if your spouse or partner notices that, that could be a helpful symptom to chase with a doctor.
[00:39:26.540] – Allan
Yeah, because you're half aware of what you're doing most of the time.
[00:39:32.230] – Rachel
Yes. Half aware,
[00:39:34.480] – Allan
or you feel it afterwards, it's like, why did I go off on him? Why did I run into the bedroom and start crying? Those kind of things. And granted, I can't say I've experienced that we go through andropause so there is a lowering of our hormones, and we recognize that as we get older, we get a little softer, usually. But it's not that you have to or must do, but it's that you can. And so it's the thinking through, how do I properly treat myself so that I can live the best life possible? Because I say wellness is healthiest, fittest and happiest. And if this is adversely affecting your happiness and your lifestyle, it's a health problem. It's something that you should spend some time addressing. Now, it's not always hormone therapy or hormone replacement therapy, right? HRT, however you want to define it, but that's an option that's out there, and it's worth you having a conversation with your doctor. Now, if you're well out of menopause, you've been in menopause for several years, you're probably not a candidate for hormone replacement therapy, particularly estrogen and progesterone, if you still have a uterus.
[00:40:54.060] – Allan
But just recognize that it's available to most women that are perimenopause or just going through menopause. So while you're going through the heat or hot or everything else of the symptoms, the worst of the symptoms, that's the point where you have an opportunity to lessen the blow and live probably maybe even a better normal life, maybe even a better life than you had before. Because you know yourself and your body so much better when you give yourself the energy and stuff that you had when you were in your 30s. By this hormone replacement therapy, you're capable of moving more, you're capable of thinking clearer, you're capable of better, making better decisions and all that put together, it's kind of like a trifecta of health because you're moving more, you're eating better, and you're feeling better and you're happier. So just look at these solutions and decide what works best for you and your lifestyle. But don't just think you're a victim of your body. You do have a team and some people you can talk to that can help you work through this.
[00:41:59.050] – Rachel
So true. I think this book would be a really great place to start. I really like how she did put the six types, or the buckets of symptoms of menopause. I think that would be a fantastic place to start. And then also, I'm personally working with the women's health department of my hospital network, so I actually have a menopause specialist helping me get through all this. So start with your symptom management. Start taking notes, start journaling with how you're feeling. Get a book like this to maybe kind of put some of those thoughts into a framework and then maybe speak with your doctor and see how it's going. But please don't wait. If you're even thinking something's off, you're in perimenopause. Your periods are kind of wacky. Start now and go see a doctor and figure this out before it's too late. Or not that it's too late in a bad way. But the better you can get started now, the better you'll be later.
[00:42:55.110] – Allan
Yeah, well, the cool thing about the buckets is that then she gives you some ideas of protocols, like how you should be moving, how you should be eating. Hint, it's whole food. Yeah, for just about every bucket. Well, for every bucket. But it's just that concept of you're going to have some tools, some things you can try that she's worked with thousands of patients and helped them through menopause. So she's in a really good position to teach you how you can treat your body to make the symptoms less where you feel better, more like yourself. And yeah, after reading what she has to say about it, if you believe hormone therapy or hormone replacement therapy or HRT, however you want to say it is the right thing for you, then you can have that conversation with your doctor from a point of self education that now you can understand the answers to the question. Your doctor is just poo pooing it and saying no. You'll know, that that's not entirely the case. And you can just ask them if they've read anything since medical school, but just talk to them and you have a team and just make it work for you.
[00:44:04.350] – Rachel
On that note, Alan, I have a general practitioner. Like everybody, you have your main doctor and they know a lot. But when you have something important going on, you find an expert, whether that's a menopause specialist, a cardiologist, anybody out there you see a PT for muscular or other imbalances know, start with your general practitioner. But then when you need to see an, just go right to the expert.
[00:44:30.390] – Allan
Excellent. All right, well, I will talk to you next week.
[00:44:33.910] – Rachel
Great. Take care, Allan.
[00:44:35.440] – Allan
[00:44:36.030] – Rachel
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As we age, our hormones make some drastic changes that can lead to some difficult symptoms. We all experience this, although women suffer the most with weight gain, sleep issues, and hot flashes. In her book, MenuPause, Dr. Anna Cabeca provides 5 unique eating plans to help you address these symptoms.
[00:03:27.790] – Allan
[00:03:29.230] – Rachel
Hey, Allan, how are you today?
[00:03:31.110] – Allan
I'm doing all right. How are things with you?
[00:03:33.360] – Rachel
Good. As we recorded this, we're leading up to my race day, which is this weekend. This is my final week of taper, so I'm just going to enjoy myself this week.
[00:03:43.580] – Allan
Good, good. And unlike a lot of people that would be in your position, you're not carving up. You're not really changing anything about your nutrition. And that's a different take than what you'll read elsewhere of what you do for a long race like this. But you know, your nutrition, you're set, you've done the training, so you're set. And you have a plan. You have an actual plan for approaching this race, which I think is outstanding.
[00:04:15.850] – Rachel
Yeah. My trainer only suggested that I not changed my eating habits this week, that I eat, get in enough calories. I may not be as hungry as I would be as I'm running tons of miles and doing tons of drills, but just to maintain my standard way of eating. And in the past, I would do something very similar, and I just prefer to play it safe this week. So no restaurant eating, no crazy spicy dinners, nothing that I think could even possibly upset my digestive system. I just want to keep it status quo as I lead into race day.
[00:04:56.590] – Allan
Yeah, it's funny. There was this article they were talking about how they opened up a Popeye's restaurant in UK, and nobody was complaining that the mild was too spicy.
[00:05:09.430] – Rachel
[00:05:10.500] – Allan
Good. Don't get me wrong. I love the spicy stuff. I love it, love it, love it. In fact, I had been to Lou this weekend, and I have the sauce in there so I can put it on my eggs. So I love spicy foods. But it was just they were complaining that Popeye's chicken was too spicy in the UK.
[00:05:31.270] – Rachel
[00:05:32.250] – Allan
Well, they might not make it over there, which is probably just the better because it's not the best food for you to be eating so good. You've got control. Yeah, well, things here are going pretty good. We're winding down to our big season for Bocas, so Lula's will start to probably wind down. We've been fully occupied pretty much for the whole time since we opened in November, which has been good. But it's just that point we're like, okay, go. Hopefully we're going to get a little bit more of an opportunity here to settle down. Tammy is planning a trip to Ireland, and then we're going to have our anniversary break, which will just be a kind of a staycation for us. So we're planning those things. Nothing huge. And then just being I am looking at launching my six week program again. I'm kind of going back and forth of whether I do it as a group thing, like where we literally have everybody come through together or whether I do it at their own pace over a six week period of time. So that's kind of where I am planning it. But I am planning on going live again.
[00:06:45.970] – Allan
I only take clients during certain periods of time, and that's really just to fit my lifestyle the way I want to. So if you are wanting to work with me, this is a good time to send me an email, allan@40PlusFitness, I'm sorry, coach@40PlusFitness. It's coach@40PlusFitness. And let's get you on the list. Let's make sure you're aware of what I'm going to be doing as I figured it out. But it is a six week program. The intention is to teach you what you need to know to lose weight, to get fit, to figure out where you need to be. And so it's an educational thing in addition to the direct coaching. So it's a very direct, intensive coaching for you about what you need, where you are with what you have to do, what you want and be who you need to be. So if you're interested in that, coach@40Plusfitness.com and we can start that conversation.
[00:07:41.830] – Rachel
[00:07:42.980] – Allan
All right. So are we ready to have another conversation with Dr. Cabeca?
[00:07:47.680] – Rachel
[00:08:23.660] – Allan
Dr. Anna, welcome back to 40+ Fitness.
[00:08:26.950] – Dr. Cabeca
It is great to be here with you, Allan. Thanks for having me.
[00:08:30.910] – Allan
Initially, you brought up the concept for me anyway. I mean, I talked to some other people, but in general, how there's pulls and pushes and there's a keto community and there's a plant-based community. And never, ever should we go between the two. You got to pick your tribe and you got to get on one side or the other. And then you come out with Keto-Green, which is basically saying, yes, you can have your meat and your vegetables, too, and you can do it in a way that promotes health. Your new book, MenuPause: Five Unique Eating Plans to Break Through Your Weight Loss Plateau and Improve Your Mood, Sleep and Hot Flashes. Love the title.
[00:09:12.710] – Dr. Cabeca
[00:09:13.820] – Allan
But it takes a lot of the concepts from your previous two books, and it kind of lays it out in a way to say, okay, food is medicine, so let's use it that way.
[00:09:25.310] – Dr. Cabeca
Absolutely. And bringing in these different pauses in our life. And I say there's magic in the pause. Right, Allan? We really have to look at it that way, and especially when it comes to a hormonal shift, whether we're talking about menopause or andropause or whatever. But there is magic in the pause. There's a rewiring or reshifting. And where I was, I certainly had fun with the title Menu Pause. So I thought that was great. My editor came up with that title as we were looking for a new title, and I just love it. So I laugh every time I say it. And the five different eating plans to each pause, something different. And that came out of women in my online communities doing keto green and me now keto green since 2014, 2015, and how that's changed my life, especially with hormone balance and seeing the changes. But sometimes we had a roadblock. Why isn't it working for this person or why did it stop working? And so that had me really looking at, okay, well, what are some of the pauses that we have to make that we've had to make or adjust to break through some of the plateaus that we can hit?
[00:10:37.560] – Dr. Cabeca
Because when what we're doing stops working or we stop seeing those improved benefits, we start seeing continued improvements or some of the problem, we need to look a little bit deeper, change things up, bring some variety as a spice of life, right?
[00:10:54.840] – Allan
[00:10:56.150] – Allan
And there's a lot of good reasons for this book. But I want to say before the men tune out and I always say this in the preamble and I'll say it again to them is that this is first and foremost a weight loss book and a hormone shifting book, but not just for females. If a man uses these five eating plans as a way to structure their eating, they will lose weight too. So if you're in a relationship, not in a relationship, it doesn't matter. These eating plans will help you. And what you were saying about the pause is I think that's right. In Dr. Fung's book, The Obesity Code, one of the things he says is all diets work and all diets fail, and it's because our body will adjust to the way we're eating. So you start eating a certain way, a keto diet, and then something happens and your body just stops responding to it. You go vegan and your body's doing great, you're losing weight, and all of a sudden your body stops responding to it. So this ability to have these different eating plans, that structure pauses for various different things for various different reasons gives you a structure to say, okay, I'm going to go in, check this out, see if it serves me.
[00:12:05.420] – Allan
If it does, then I'll stick with it till it stops serving me. And if it doesn't serve me, I move on.
[00:12:11.690] – Dr. Cabeca
Absolutely. And we give it enough time to figure out every plan is designed to be safe. And we give enough time, the six days to just be the shortest, essentially amount of time to really get a benefit. And then also to see to be able to check in with yourself. How are you feeling now with this lifestyle, with this diet plan, it's always more than what we eat too. And I really established with my whole Keto Green approach, it's the keto green way, it's the lifestyle, it's the hormone oxytocin becoming more oxytocin rich in our lives. And that joy connection, that important physiologic effect of joy connection. Right. Pleasure and becoming more insulin sensitive. So when it comes to guys too, we'll see an improvement in their adrenal hormones, their testosterone, a decrease in blood pressure and sugar management and blood sugar as well in the short amount of times. And I expect it pretty much with every plan because again, there's a shift, there's a change up, except for maybe the carbohydrate up plan that I put in as plan number five.
[00:13:26.630] – Allan
Yeah. Now, I think a lot of women and maybe even men when they're going through some of these changes, obviously a woman's change is drastically different. So I'm going to try to compare what we guys go through, through what women go through. Not even close. So don't think it does, guys. I guess it feels bad, but not even close.
[00:13:46.820] – Dr. Cabeca
He's a wise man, right, ladies? He's a wise man.
[00:13:50.200] – Allan
But as they go through this, I think the knee jerk reaction today is what supplement do I need to take? What pill can I take? What surgery do I have to fix this problem? Why is food the better answer?
[00:14:10.910] – Dr. Cabeca
Definitely. Because how we nourish, our body is a whole framework for how we nourish other aspects of our lives. Right. And we have to give our body the fuel. We are designed to work with our environment, to interact and to respond to the energies of the food we eat. So beyond the micronutrient and macronutrient breakdown of what we're eating, there's a lot more to it than that. And I think when we set up, as we set up our eating plans, the key aspect is diversity. And I always tell clients, I interview a lot of people and selling when someone says, yeah, I eat a chicken salad every day for lunch, I just want that hand emoji to the top of your head. Like, I want that hand emoji because it is like, okay, we're eating the same thing every day, and that's just not good for you. I don't care how good of a health food you're eating. If you're eating the same thing every day, you can create a food sensitivity to it. So the importance of how we nourish our bodies, how we're going to do everything, and that sets the tone for hormonal balance.
[00:15:25.730] – Dr. Cabeca
Our behavior is affected by our physiology. So a balanced nourishing eating plan is key for willpower, brain power, love power, whatever it may be that we're working towards. So for physical and mental, wellbeing, how we nourish our body is key. And so having that as food, as medicine, it's absolutely true.
[00:15:53.510] – Allan
Yeah. Now the other aspect of this that I thought was really interesting and you brought science to bear. So this wasn't just you saying this is how you solve this problem or this is why this problem might be worse for you than someone else. I think we know is if you have a knee problem, you go to your doctor. Your doctor is going to say if you need to, you might want to lose some weight because the excess weight is causing knee pain. That's why part of the reason why you have the pain. So he encourages or she encourages you to go lose some weight. Why is weight loss part of a solution to the menopause symptoms that many women suffer with?
[00:16:30.390] – Dr. Cabeca
Yeah, because our fat is inflammatory and two of the things that cause worsening symptoms in menopause is inflammation and hormone imbalance, those two things. And fat is a contributor to both of those things. We naturally become more insulin resistant as we age, and that's why we can develop diabetes or prediabetes in menopause. And we've been doing really well up until then. And post menopause, that's because we're becoming more insulin resistant. And so type two diabetes becomes very prevalent in our age group, and that's got to stop. And that's why that's, again, why keto green eating is so critical for this. But fat holds inflammation and it creates basically cytokines storms within our body and inflammation creates increased hormonal imbalance. So what we see as people clear this up decrease inflammation through how we're nourishing the body, providing appropriate nutrients and not feeding it junk and sugar and inflammatory foods. We also see an improvement in hot flashes tremendous. Within two weeks, we can see 80% reduction in hot flashes through these lifestyle and nutritional changes. The other big thing I want to mention is, like, women will say, oh, I can't fast 13 hours. I'm hungry when I go to bed.
[00:17:58.480] – Dr. Cabeca
I'm hungry when I wake up. That's just how you've trained your body. Your body is not designed to be like that. And so let's retrain it into a healthier way that's actually going to serve you. And we know this really important factor. So built into the plan, I do at least 13 hours of intermittent fasting between dinner and breakfast, but you start where you're at. But the reason I do that is because research has shown in women with breast cancer that if you have at least twelve and a half hours between dinner and breakfast, you have a significantly reduced risk of recurrent breast cancer. So that should be number one health guideline, all the initials that you want, but really should be promoting that intermittent fasting is a key component of our lifestyle. And that improves insulin sensitivity and then improves really all of our symptoms and age related diseases that can occur. So the hot flashes, the mood swings, the night sweats, difficulty sleeping will improve with these shifts and how we're nourishing our body.
[00:19:02.530] – Allan
Yeah. And the same is true for men. If a man is obese, it's affecting their insulin sensitivity and therefore, it's affecting their hormones. And so it's creating a similar effect to us, we call it Andropause but it's basically a very similar approach, similar thing happening in our body. If we can reduce our fat stores, we're going to improve all of that and improve our health. And weight loss is often a side effect of better health. But basically what we're showing is the main symptom we see is when we step on that scale.
[00:19:38.540] – Dr. Cabeca
Yeah. And we want the weight loss, but we want in a way that we don't gain Yoyo dieted from my teens through my 20s and into my 30s. And I think that especially others, I went to high school and College in the 80s. So that's when the low carbohydrate craze was in place and we would do all these crazy things like Apple juice fasting and just nut stuff, like you're fasting on sugar. What the heck? If you're going to fast anyway, now we fast on bone broth a little bit better or just fast on water. But the key thing is and what we know is that calorie restriction decreases your metabolism more than fasting does. And that's a really important concept for people to understand. So you're not going to Yoyo diet back. And being of the, I would say of the warrior body type because there's an epigenetic component. We know this just from observing friends, family, colleagues, et cetera. Some of us are designed to be empowered to be very conservative with our nutrient use. I would say I could survive in the Sahara for six months without food or water, and I'd still be fine.
[00:20:47.780] – Dr. Cabeca
I'm thriving. And I see that among many of my clients, I say they have Pocahontas or Warrior, Viking heritage or Amazonian. Right. Because you're designed to be metabolically conservative, so you're at higher risk. However, you're designed to live through a famine, right? Live through deprivation cycle. But in America, we don't have that right. And so then we think, oh, I just have fat genes. I have obesity and diabetes on both sides of my family. And I want that mind shift to switch to say, no, you've got Warrior genes, you've got Survivor genes. You're amazing. You've got leadership genes. Let's use them. Part of what I really want to empower people to understand this epigenetic component. So it's kind of built in into my plans and into my program. And that's where that whole individual bio individuality comes in, like, what's right for you right now based on what you've been doing up till now and the state of life you're in, how your hormones are, are you burned out? Is your DHA estrogen, testosterone progesterone? Are you tanked in your hormone levels? Are you pretty resilient? And I think with this, with changing up and my goal with this, with cross training in the gym, cross training in your diet is to improve your resilience.
[00:22:11.080] – Dr. Cabeca
So you improve the diversity of your gut microbiome, and with that, you improve your immune system and you improve your overall longevity and quality of life.
[00:22:22.590] – Allan
Yeah. Now you have in the book five plans, and each of them starts out with kind of a six day approach. And I like the six day approach because it gives you that opportunity to check in with yourself to see how it's going. And I think anyone can agree you can do anything for six days if you put your mind to it. So it kind of gives them that finish line, even though it's not intended to truly be a finish line. But it's just give it six days, see if it works. And I like all of that. Obviously, if we've gotten ourselves obese, it's not going to fix itself in six days. So don't think that these are magic pills that are going to make everything great in six days. But each of them gives you a kind of a phase. A pause is the way you like to put it, gives you a pause on something so you can start to see the results and move forward. I want to go through each one of them because I think each of the one of them is really important, but I think it's important for them to know why would they use this plan and what is the plan entail?
[00:23:21.590] – Allan
So the first one and it has extreme in the title because it is kind of an extreme one, is the Keto Green Extreme. Can you talk about that one? Why we would want to use it?
[00:23:33.320] – Dr. Cabeca
Yeah, definitely. First want to say why six days? And six days if we consider that the gut gastrointestinal mucosal lininging of the intestines of our intestinal tract, GI tract regenerates in 72 hours. So that's three days. So incorporating two, three day cycle should be very healing and restorative to our GI tract, certainly in the cleanse. But even as we remove some of these inflammatory triggers or these pauses, as we take these pauses, it gives our body those two full 72 hours cycles to regenerate, respond, react. I think that's where some of this checking in, checking in with yourself can really be powerful. So with Ketogenic Extreme, because I definitely have clients who have had autoimmune diseases and have reactions to night shades. I mean, I was sitting at dinner with Dave Ashbury the other day and he sent his plate back twice because one time it had peppers and one time they had mushrooms in it. So anyway, some people are super sensitive to nitrates. Right. And so I removed that. It's really an autoimmune, kind of following some of the autoimmune protocol dietary changes with restriction of nightshades and peppers and some of those other inflammatory foods, if we're sensitive to that.
[00:25:02.410] – Dr. Cabeca
So checking in on that one is the number one reason to do that, especially if you have an autoimmune issue.
[00:25:08.970] – Allan
Okay. The next one is and you're using a word, well, there are two words that you use in two different ones, and I'm talking about each of those, but it's not exactly what it would mean to somebody else. Is the keto green plant based detox. Now, a lot of us will look at detoxes and thinking, oh, this is one of those where I'm going to take this supplement thing, and I'm going to be going to the bathroom for three days really bad and then not feel good. But this is a detox, but it's not a normal detox. Can you talk about this one and why we would want to use it?
[00:25:40.410] – Dr. Cabeca
Yeah. This is a grain free plant based plan. So it's more of a keto green plant based plan. So again, low in carbohydrates also. And I wanted to address my plant based eaters because my keto green 16th book, I did a 16 day omnipresent, a 16 day plant based plan. So I got a lot of feedback. Right. And then people who are omnivores did the 16 day plant based. And they loved it, too. So being able to again, do that periodically, and this is why I put it in for all of us to just detox from meat. And that's where that comes in. Detox from meat. And plus, one of the biggest problems that keto eaters and diet and diabetics and et cetera have is constipation. And the number one thing I want to clear from your system without, ideally, additional drug support vitamins, et cetera, is having regular bowel movements. So I put it after ketogenic stream. You can do them in any order. Certainly. But I did have a method to my madness, as usual. So putting it there because right now we've just reduced a lot of inflammation. But it's been pretty ketogenic. And I want to make sure your bowels are resuscitated to 72 hours of a low inflammatory diet.
[00:27:04.020] – Dr. Cabeca
But let's work on this to add in fiber support the gut microbiome. To add gut microbial diversity. We know the more plant diverse foods you have, the higher diversity in the gut, the better your immune system, the lower your risk of all inflammatory diseases, including diabetes, cardiovascular disease. And that goes again for men and women and all the menopausal symptoms. So that's why I incorporated a six day plant based diet, because we all need to do it periodically.
[00:27:31.290] – Allan
Okay. And now we're going to go to the other extreme because you have this carbohydrate pause. Can you talk about that? Because this is going to get some attention. It's like, wait, are we plant based or are we meat eaters? So where are we here? Can you talk about that?
[00:27:45.620] – Dr. Cabeca
Like I said, variety is the spice of life. And this is one of the things that I definitely had tried carnivore being keto green for a while and wanting to switch thing up, tried carnivore. And again, same thing felt good for a little bit, but then started gaining weight. I was like, wait, what's going on? Actually connected with another perimenopausal woman in the carnivore community. And she had run across this issue, too, again with women. Again, we talked about this before we started recording. It's really awesome to have diversity. There are certain plants that work for a short time and not for the long time. And that's why disruption. We want to disrupt what we're doing. And it's so good for us. But the carnivore knows to tail. And I wanted to show people how a healthy way to eat carnivore number one. Also, again, after I've just increased the microbial diversity of the gut that was powering you up. You're taking a break from all plant foods pretty much in the carnivore plan in just a healthy way, very carbohydrate restrictive. And again, we're pausing plants in this cycle.
[00:28:59.670] – Allan
And I can say this, if you go through the carbohydrate pause, when you finish it, you're going to be in the deep cut ketosis, which is going to help with your sensitivity. Whichever direction you go after this is going to make that next plan that much better for you.
[00:29:18.870] – Dr. Cabeca
Yeah, exactly. Right.
[00:29:22.720] – Allan
Okay, now the fourth one. And again, this is using one of the words that I typically don't like to see in any kind of eating plan is the cleanse, because it usually involves buying some very expensive juices and spending a lot of money and not getting many calories and rebounding after. But yours isn't going to do that. It's called the keto green cleanse. Can you talk about that?
[00:29:45.580] – Dr. Cabeca
Yeah, absolutely. And actually ran my pre release permission from my publisher to run my selected group, my girlfriend doctor club, through the six day cleanse. And the reason for the cleanse, too, right, we're in high ketosis number one from our carnivore for going in this order. And then so we're not hungry. We are not hungry. We're chewing. We've had good protein. The other part of carbohydrate pause the carnivorous plan is to give us more protein. Women, we don't get enough protein. And protein is so important for our muscle. And muscle is magic and menopause. So then going into cleanse number one, you're not hungry. And now we really want to detox the liver and detox your gallbladder and really work to support your body so the cleanse, we did this six days. I start you with an oil, lemon juice, olive oil, lemon juice, shot in the morning. And believe me, I had objections. They're very intelligent group of women, but they're like, okay, you're recommending it. So by day three, they're like, I can't wait. Can I stay on this forever? Can I do this? I'm like, no, just six days. We have to change things up.
[00:30:56.630] – Dr. Cabeca
So this liver, gallbladder flesh and very much it is a cleanse. So it is smooth, smoothies. It is teas, it is alkaline broth or bone broth. And making sure ideally you're getting enough protein and healthy fats during this. But it is a cleanse. So you are continuing to give your GI tract rest. You will see glowing skin, glowing complexion. You will feel higher energy. You'll start checking things off on your to do list that have been on your to do list. And so it's cleansing off the things that are weighing you down, as well as really working on an internal system. So, yeah, I'm excited for that. And honestly, you're not hungry. You're doing great. You're very supportive advice from my girlfriend doctor club because some of them were used to extended intermittent fasting. They're like, just follow the plan, as Dr. Anna says it, and you're not going to get hungry. And that's really key.
[00:31:57.210] – Allan
And then the final one is and I think this is really kind of a critical piece of all of this is at some point you're going to fit a level of health and maybe a level of weight loss where you're like, okay, this is a weight I feel comfortable. And maybe it was a weight that you were when you were 29. Maybe it was a weight you were when you graduated high school. And now you could wear the same size jeans, you were wearing then. But you get to a point. And now it's like, okay, I don't want to Yoyo, I don't want to go back to where I was because it worked so hard to get to where I am. So the last plan you have is the carbohydrate modification plan. Can you talk about that and how that works?
[00:32:36.810] – Dr. Cabeca
Yeah, and I love it. And I just opened my book to one of the recipes in the Carb modif. My Texas Rodeo Skillet. Skillets are big in Texas and everything's bigger in Texas. That's where I'm living now in Dallas. And so this is a modification for some of the beautiful skillet breakfast. So this has sunny side up eggs, Sriracha sauce, avocados and sweet potatoes and bacon mixed in. I mean, it's just so yummy. I'm getting hungry thinking about this plan. But the reason is because being in the keto green community for so long, sometimes we've been so restricted that we need the additional carbs. And when some of my clients have added in a sweet potato in the evening, they're sleeping better. Right. And I think it's really important to understand that. And some of them will lose weight once they do that because they have been really conservative and adding in a carb, at least it's a beautiful thing to do. And I think once you get through the plans, it's the principles of the plant and how balancing the fats, but also for flavor, the salts and the citrus that just makes things so much better, addressing your full taste palate so that you're really looking forward to your meals and even better.
[00:33:58.990] – Dr. Cabeca
So these concepts that have been built into the recipes that are all outlined in the book have really been designed to balance and nourish and set. You enjoy them, too. So I think that a lot of times we'll do a carb up, we'll do a carb up day periodically. That's absolutely okay. And it can be very good for you unless it triggers eating disorder. Unless it triggers an eating disorder.
[00:34:30.650] – Allan
Yeah. And just as you mentioned, you mentioned the recipe. So I'll kind of jump into that. You believe in variety. You talked about that several times today. And so this cookbook is really built on a massive variety of different foods. And each plan has some foods that fit. And some of the foods some of the recipes you have actually fit multiple plans. And you put that in there. In fact, last night for dinner, my wife and I had your egg roll soup because I love egg rolls. And I walked by the Chinese we have one Chinese restaurant here on the island, and I walk by there all the time. And I'm like, I just love to go in there and order their egg rolls. And I was just like, no, I won't do it. That's not what I'm doing right now. But I was able to make your soup and it was delicious. And I actually had a second serving of it because it was that good. So these are really good recipes. They fit each plan. So it's not just that. Here's a plan and go figure it out. It's like, here's how this works.
[00:35:30.100] – Allan
Here's a plan. Here's some tips. Here are some recipes. And so you build out recipes to pretty much fill the six days. And you give guidelines if you want to do it yourself. So it's really kind of a cool way that you're not going to get bored because it's not like a lot of plans. You're eating the same foods every day. In this case, I think the most I saw you like, you Cook something one day, and then maybe the third day you have it again as a leftover for lunch or something like that. But it's not eat the same food every day all the way through. You work through these plans, and maybe other than the cleanse, you're doing fairly similar things through the cleanse. But for the others, there's great recipes that are going to keep you interested. And you even give them a shopping list, which I think is also pretty cool.
[00:36:18.670] – Dr. Cabeca
Thank you. You know, my mom raising kids, was making things early. Sometimes having leftovers is just a one less meal I have to Cook. Right. So that's always definitely an option in the plan, too. And maybe if there's adding something a little bit more interesting, too, but to create as much simplicity and shopping as possible. But it's six days. So I want this diversity. I want this experience. I want it to be an experience.
[00:36:48.970] – Allan
Yeah. It is. That's what I'm saying.
[00:36:51.980] – Allan
Mine, it's something I would order at a Chinese restaurant. I'm like, I want egg rolls. So it's like cabbage. And I did it with pork and went through the whole process of making it. And I think it took me less than an hour to make the soup. And that included prep. And I'm a slow prepper. So I didn't even get to watch a whole TV series. I was watching a TV show. I didn't get to watch the whole thing because I had the meal ready before I finished. So really good recipes. You should check that out.
[00:37:22.400] – Allan
Dr. Anna, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well?
[00:37:31.510] – Dr. Cabeca
Thank you. Well, definitely get keto green. So incorporate the lifestyle, the nutrition into your lifestyle. That concept, that is by design, a number one way, certainly for me and for women going through menopause, and I think for so many, my kids are doing it. The second thing is make oxytocin the most powerful hormone in your body and so not stress. Really think, where do I see love today? Where am I loving, giving, grateful? What am I grateful for? Really focusing on that. How am I showing love to those I love? How am I receiving love? Sometimes that's even harder. So make oxytocin the most powerful hormone. And the third is just smile. Really smile, really genuinely feel good about yourself. And for women, oftentimes we have this, like I would say the negative, that nasty bitch on your shoulder talking down to you. So like, knock that nasty bitch off your shoulder and enjoy yourself. And that concept of truly, genuinely being happy in your own skin with whatever is in your life at this moment, it's a really powerful concept.
[00:38:43.750] – Allan
Well, thank you, Dr. Anna. If someone wanted to get in touch with you, learn more about MenuPause or your Girlfriend's Doctor club, where would you like for me to send them?
[00:38:54.220] – Dr. Cabeca
Definitely, just come to my website dranna.com. We have a MenuPause book page and some great bonuses to go along with the MenuPause book. So some trackers, some additional handouts and recipes and good things to support you in the videos, cooking videos, all this good stuff is there for you. So, dranna.com, and then join me on social media at the Girlfriend Doctor.
[00:39:19.120] – Allan
Awesome. You can go to fortyplusfitnesspodcast.com/533 and I'll be sure to have the link there. Dr. Anna, thank you so much for being a part of 40 Plus Fitness.
[00:39:29.970] – Dr. Cabeca
Thank you for having me, Allan. I love what you're doing. Thank you.
[00:39:40.850] – Allan
Welcome back, Ras.
[00:39:42.380] – Rachel
Hey, Allan. That was a fun interview with Doctor Anna Cabeca. Anytime I hear anything having to do with menopause, my ears peek up. So her book, MenuPause sounds like a really good book.
[00:39:55.130] – Allan
It is good. Obviously, I will not experience menopause, can't and won't. And so for me, it's really just about understanding what my wife, with my clients, with my friends, with my family, what they may experience as they're going. And I think there are periods of time when we really have to ratchet in our nutrition. For the most part, most of us can go through life and not really think about what we're eating. But there are particular periods in a woman's life where I think it becomes really important. Obviously, when you're trying to get pregnant and you are having a baby, there are times when your nutrition is tantamount to having a healthy baby, dealing with any kind of major illness or recovery. So cancer surgery, something like that. Nutrition is going to be really important to make sure that you're addressing your body's nutritional needs so that it can heal properly so that you have a good, strong immune system, really important. And then, of course, during menopause, when you're going through significant, significant hormone changes, and those changes, the perimenopause process, if you will, can take minutes where they're actually pulling out your ovaries and uterus, or it can take decades as you're going through those.
[00:41:24.750] – Allan
This is month to month, day to day, week to week. All of it changes in your hormones. And if you are just eating about doing your thing, you don't have information. What you have is a symptom. And you don't know if it was directly affected by what you're eating, what you're feeling, the movement or, yeah, you're just going through a huge hormone shift that you really couldn't deal with otherwise. Those are important. And within approach, you literally can sit down and look at a swath of time, the six day plans and say, okay, I'm going to do this thing over six days and see if my symptoms abate. And if they do now you have data, now you have information to say, hey, if I cut out this food, yes, my body screaming at me, eat more chocolate, but I don't eat more chocolate. Instead, I eat more vegetables, I eat more meat. I make sure that I'm eating whole food, and you feel better. You didn't need the chocolate. And I know that's hard to hear. Sometimes you need the chocolate. I understand. But sometimes your body is telling you something, and the answer is actually the exact opposite.
[00:42:54.060] – Rachel
That's so true. And what's interesting, how Anna put it, is that instead of turning to supplements or surgery or something, that a lot of doctors will suggest a pill for this or for that, it's turning to food. And food can actually really be true medicine for you. And I appreciate how she created these five different eating patterns or these five different types of eating for a six day window of time. Six days isn't that long. You can get through some sort of change, and you never know how you might feel afterwards. If it works for you, then it's a tool in your toolbox for all these different times in our lives when our hormones will fluctuate. Like I mentioned earlier, all of us have different symptoms as we approach menopause. Perimenopause is kind of tricky. That way our hormones can fluctuate day to day, week to week, month to month symptoms could be different from another. But by trying food as medicine, at least you have another tool in the toolbox that you can pick out later on.
[00:43:55.880] – Allan
Yeah. The only caution I put out there is if you're making a fairly drastic change. So let's just say you're eating the standard American diet today or something close to it, and you immediately say, okay, well, I'm going to go to the hardcore, intense low carb thing. Six days might not be enough time for you to fully adapt to that change. And so just recognizing that if you find that this food is affecting you and maybe even in a negative way, you may need to lean in instead of pulling back and saying it's not working. The six days is a great trial. And for a lot of people that don't have, say, insulin resistance or some other health issues going on, they're going to start seeing some potential positive change, weight loss and some other things will be happening during that period of time. But you might not feel really good. And there's a couple of reasons for it. One, yes, could be that you're going through the change into keto, and they call it keto flu. I prefer to call it carb withdrawals because your body used carbohydrates for fuel and now it doesn't have as many it's got to shift fuel systems.
[00:45:12.710] – Allan
That can be a little disruptive for most of us it is. But there's also other things. Our body stores toxins in our fat. So if you're starting to lose body fat, your body now has to deal with those toxins that it shuttled away earlier and didn't deal with. And if you're under a toxic load at home or at work or whatever, now you're adding more toxins to the mix. You might feel worse before you feel better. So just recognize six days is a good rule of thumb because as you said, you can do just about anything for six days.
[00:45:46.600] – Rachel
[00:45:47.630] – Allan
People can go without eating for six days and be fine. But that said, if you're feeling bad, you're making a change. If it's hard, just consider whether this is something you need to lean into or whether it is okay. You did your six days and it just didn't work. And let's say you tried that and it didn't work. That doesn't mean that tool is useless. If you needed to screw in a screw and the first thing you grabbed was a hammer, the hammer didn't work, but you get a screwdriver and it works. Later on, you got a nail. The hammer is going to be just fine. So just recognize that time and space and where you are now is different than where you will be later. So a tool today that's not useful can be a useful tool later. But there's really good eating plans in there. Really sound advice from Dr. Cabeca. And if hormones are an issue for you as you go through these changes, food will affect your hormone levels. What you think will affect your hormone levels, what you physically do will affect your hormone levels. All of that input, all of that information and it will affect how your body expresses hormones.
[00:47:06.550] – Allan
So while you can't fix this change because it is what it is, it's coming, you can reduce the impact of it with the right foods.
[00:47:16.740] – Rachel
Yeah, well, you both were discussing bio individuality and what is right for you right now is going to be different from what is right for you later. And that's just the way our hormones fluctuate. I think every woman understands and agrees with me that like I said, week to week, month to month, our hormones, our symptoms, the way we feel just changes so greatly. So what works for you today may not work tomorrow, but the point is that you get to try something new and it sounds like Dr. Cabeca offers several different meals that you get ways to try to eat in order to satisfy those changes. It's a great idea.
[00:47:56.510] – Allan
And if you're listening to this and the guys have tuned out, they can eat this way too.
[00:48:02.710] – Rachel
Oh, for sure.
[00:48:04.670] – Allan
These are healthy, good ways to eat. This is not like, oh, well, here's an estrogen pill. I'm going to give it to my husband too. No, it's not like that. This is food. This is really good. These are really good meal plans. They're very easy. She gives you the shopping list, the whole set. So it's really simple for you to kind of go in and say, okay, this is my meal plan for the week. It's the meal plan for my family for the week.
[00:48:25.090] – Rachel
I love that.
[00:48:26.110] – Allan
And so they're getting what they need to be healthy. You're getting what you need to heal and be healthy. Just recognize this is not a woman's eating plan this is an eating plan that anyone can do and be more healthy for doing it.
[00:48:42.500] – Rachel
That sounds great. Sounds like a great book.
[00:48:45.040] – Allan
Yeah, it is. All right, well, Rachel, we'll talk next week.
[00:48:48.120] – Rachel
The following listeners have sponsored this show by pledging on our Patreon Page:
|– Anne Lynch||– Eric More||– Leigh Tanner|
|– Deb Scarlett||– Ken McQuade||– Margaret Bakalian|
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On this episode, Dr. Aviva Romm and I discuss her new book, Hormone Intelligence.
This episode of the 40+ Fitness Podcast is sponsored by Reel Paper.
A little over two years ago, my wife and I moved to Bocas del Toro, Panama. It has opened our eyes to many things that you don't get exposed to in the United States. One is how much waste we humans create, and another is how impoverished people often live in unsanitary conditions. Reel Paper is a company that's working on both of these issues. Reel Paper sells toilet paper and paper towels made from 100% bamboo, which grows faster, requires less water, creates more oxygen, a.k.a. less greenhouse gases, and doesn't require replanting after harvesting.
Yes, sustainable toilet paper is available for you now, conveniently shipped for free to your home. Not only is the toilet paper sustainable, all of the packaging is as well. Living on an island, we're in a constant battle with plastic. It's everywhere and it takes decades to decompose. Reel Paper is also working to tackle the sanitation problem by providing composting toilets to impoverished communities. That's another thing I was introduced to here in Bocas. You can take something that would otherwise be unsanitary and spread disease, but when you treat it properly, you can take it and make something useful, fertilizer. Reel paper is partnering with a company to do just that.
I often joke that my health and fitness vision is for me to be able to wipe my own butt at 105. If I have any say about it, it'll be Reel Paper on the toilet roll. Go to 40plusfitnesspodcast.com/reel and use the discount code, 40plus to get 25% off your first order.
We must begin treating the planet better and you can do it by going to 40plusfitnesspodcast.com/reel and get 25% off with the discount code, 40plus. Thank you for supporting the show by checking out this wonderful company.[00:22:49.550] – Allan
The following listeners have sponsored this show by pledging on our Patreon Page:
|– Anne Lynch||– Eric More||– Leigh Tanner|
|– Deb Scarlett||– John Dachauer||– Margaret Bakalian|
|– Debbie Ralston||– John Somsky||– Melissa Ball|
|– Eliza Lamb||– Judy Murphy||– Tim Alexander|
Perimenopause is a time when a woman's hormones are going amuck and it can literally ruin her life. Amanda Thebe's book, Menopocalypse, takes you through her journey and the journeys of 1000s of other women so you can know what to expect and thrive during menopause.
Also, Amanda wants to send you a signed copy of the book. Go to 40plusfitnesspodcast.com/menopocalypse for more details.
This episode of the 40+ Fitness podcast is sponsored by Vault Health, guys, we need to discuss the elephant in the room. Most of us really struggle to manage certain health issues, especially when it affects things we don't want to talk about, like our libido and vitality. Yes, I'm talking about LowT. Did you know that 40 percent of men over 40 suffer from lowT? LowT can cause weight gain, loss of muscle mass, ED, fatigue and poor sleep, low energy and depression?
These completely dismantle any efforts you're making to be healthy and fit. If you're dealing with one or more of these. It's worth booking a free online consultation with a Vault physician at 40plusfitnesspodcast.com/vaul. Vault is all about discretion. After your free consultation and you agree you want treatment, they'll send a phlebotomist to your home to do a blood drawl. You'll get a personalized doctor review treatment plan. This can be with pills, cream or injections.
The medications are mailed to your home. There's nothing macho about neglecting your health. If you live in the United States and you're struggling, it's worth learning more. At Vault Health, 40plusfitnesspodcast.com/vault today. That's 40plusfitnesspodcast.com/vault.[00:23:25.590] – Allan
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In this episode, we meet Dr. Tara Allmen to get menopause advice and solutions presented in her book Menopause Confidential: A Doctor Reveals the Secrets to Thriving Through Midlife.
An accountant and a gynecologist have in common when meeting a man at a party, the question ‘what do you do for a living' is a conversation stopper. It shouldn't be that way. At least not when you meet a gynecologist. There is a lot to learn what the women in your life are (or will) experience. Menopause advice works for both women and men.
The symptoms of perimenopause and menopause can cause sleep disruption. It is important for women to focus on getting the best quality sleep. A few sleep tips provided by Dr. Allmen include:
Dr. Allmen decided to design her own colon cleansing approach and has been successful in coming up with a way that is a lot easier. She's shared this approach with her patients and they've had great results in colon screening prep. While not menopause advice, it is something we face in mid-life and you may find Dr. Allman's recipe for colon cleansing easy and effective.
It is very important that women work to maintain muscle mass and bone density by lifting weights.
Dr. Stephanie Faubion is the Director of the Women’s Health Clinic in the Department of Internal Medicine at the Mayo Clinic. She is one of the country’s leading experts on menopause and is knowledgeable about bone and joint health. She is also the author of The Menopause Solution.
The Menopause Solution, is meant as a guide for women during menopause to help them be healthier for the rest of their lives. Women are living longer than ever before. In 1900, women did not live past age 50 and rarely dealt with menopause. Now, the average lifespan of a woman is approaching age 90, so menopause is something that most women will go through and live many years beyond.
In order to get a head start on menopause, Dr. Faubion explains that women need to be informed about what’s happening to their bodies and what they can do about it. By focusing on fitness, their overall quality of life will be better. Other areas of concern include sleep and stress management. Successfully managing both areas is key in the prevention of long-term diseases such as heart disease and diabetes.
Joint health is another important topic for post-menopausal women. Around the midpoint in their lives, women will experience more joint pain. Many women will start to develop arthritis after menopause. Dr. Faubion recommends that women recognize when they have pain, examine what triggered it, and stay tuned into their bodies.
Bone health is another area of concern. Many women are seeing bone loss around the age of menopause. This correlates with a loss of estrogen. In fact, women will experience the most bone loss of their lives within the first five years of menopause. To prevent bone loss, women should adopt a proper diet complete while maintaining a sufficient calcium intake. Resistance training and getting enough Vitamin D are also helpful in minimizing bone loss.
Be sure to check out The Menopause Solution to learn more about bone and joint health post-menopause. To connect with Dr. Stephanie Faubion, visit http://www.mayoclinic.org/.
Dr. Mache Seibel is a leading expert on women’s wellness, estrogen, and menopause. He is also the editor of My Menopause Magazine, creator of mymenopause.com, and the author of The Estrogen Window.
Dr. Seibel explains that many once thought that having too much estrogen could lead to breast cancer. This was actually the result of a misguided study from 2002 called the Women’s Health Initiative. Though this was supposed to be an age-matched, controlled study, that was not the case, which led to inaccurate information being produced and disseminated.
Since then, other studies have refuted these findings by showing a 23% lower risk of breast cancer and heart disease, and a 25% lower risk of dementia in those who take estrogen. For those who enter menopause early and don’t take estrogen, they have shown to have a 70% increased risk of dementia. Lowering the risk of osteoporosis is another benefit.
Dr. Seibel explains that the benefits of taking estrogen are evident when estrogen is taken at the proper time or during the estrogen window. This is a window of opportunity where women can optimize their treatment, which begins with the onset of menopause. After all, the timing of menopause among women is quite varied. Five to 10% of women go into menopause before age 45, though the mean age is 51. However, symptoms can start up to a decade before menopause begins.
When women begin taking estrogen at the time of menopause, they can lower the risk of chronic illnesses and see the potential for the greatest benefit. To see where you are in menopause, take a quiz at www.menopausequiz.com. You can also get great feedback and tips at this site. To connect with Dr. Mache Seibel, visit his website at www.drmache.com or learn more about The Estrogen Window at http://www.estrogenwindowbook.com/.