
243: Perimenopause Masterclass: What Your Doctor Isn't Telling You
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Janell Yule's masterclass offers a comprehensive look at perimenopause, emphasizing holistic health through understanding hormones, digestion, and lifestyle. She encourages women to actively support their bodies rather than resist changes occurring during this natural transition.
Key Phases of Perimenopause:
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Pre-Transition (35-41 years)
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Occasional body temperature irregularities
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Mood fluctuations and irregular cycles
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Early Transition (41-45 years)
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Estradiol decline and shorter cycles
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Sleep disruptions and intermittent hot flashes
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Mid-Transition (45-48 years)
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Increased sleep issues, hot flashes, and night sweats
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Disrupted adrenal regulation
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Late Transition (49-55 years)
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Longer gaps between periods
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Cognitive changes; focus on brain health
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Core Symptoms:
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Irregular menstrual cycles
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Hot flashes, night sweats
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Anxiety, depression
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Digestive issues
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Weight gain, fatigue
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Thyroid/adrenal dysfunction
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Low libido, vaginal dryness
Hormonal Insights:
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Estrogen Metabolism: Critical to managing breast and overall health.
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Progesterone: Essential for mood, anxiety control, and sleep.
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Testosterone: Supports muscle mass, energy, libido.
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Cortisol/Adrenals: Vital to managing stress response; cortisol impacts hormone balance significantly.
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Thyroid Health: Must be assessed comprehensively, beyond just TSH.
Gut Health Importance:
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Gut microbiome directly impacts hormonal balance, detoxification, and overall health.
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Constipation and digestive issues significantly exacerbate perimenopausal symptoms.
Nutrition and Lifestyle Recommendations:
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Avoid inflammatory foods (gluten, refined sugars, dairy, alcohol).
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Increase protein intake (90-100g daily), healthy fats, and fiber.
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Balance blood sugar by including protein, fat, and fiber at every meal.
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Strength training is essential (2-3x weekly).
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Sleep hygiene, rest, and stress management are critical for hormone health.
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Regular supplementation: Multivitamins, Omega-3s, Magnesium, Vitamin D (as needed).
Mindset Shifts:
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Develop a supportive, positive relationship with your body.
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Embrace perimenopause as an opportunity for personal growth and self-awareness.
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Create empowering beliefs around health and aging rather than resistance or dread.
Action Steps:
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Track menstrual cycles diligently.
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Focus on gut and liver health (castor oil packs, digestive enzymes, cruciferous veggies).
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Test hormones comprehensively using tools like the DUTCH test to "test, not guess."
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Foster community support and seek guidance from knowledgeable health practitioners.
Final Message: Perimenopause is a natural transition, not a dysfunction. By understanding your body's signals, supporting hormonal balance, prioritizing gut and overall health, and adopting a positive mindset, women can navigate this phase with greater ease and confidence.