Surprising Menopause Symptoms and How to Overcome Them with Dr. Mariza Snyder

Dr. Jessica Drummond 00:00:03 Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis, or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Hi, and welcome back to the Integrative Women’s Health Podcast. I’m your host, doctor Jessica Drummond, founder and CEO of the Integrative Women’s Health Institute. I am thrilled to bring you today eight times bestselling author, naturopathic physician, and founder of Doctor Mariza, Doctor Mariza Snyder. She and I are going to have a very, I think, behind the scenes conversation, as you well know, because our Perimenopause and menopause certificate program is absolutely our number one best selling product right now, because the reality is, only 6% of women in perimenopause transitioning to menopause are getting any kind of treatment.
Dr. Jessica Drummond 00:01:57 never mind good, comprehensive, integrative treatment that takes care of all of the pre-existing challenges that she comes into perimenopause and menopause with. And as Doctor Morris says, very few of us in our 40s come in with a completely clean slate. So listen up to this interview, because you were going to see why it’s so important when we’re addressing perimenopause and menopause care, that we have to go so far beyond just a hormone common with underlying cardiovascular risk factors. Women come in with preexisting migraines, women come in with preexisting injury or musculoskeletal or sports injuries. Most women do not enter their 40s with a completely clean slate of health. So how do we support them when the research is not done? Looking at the complexity of underlying pre-existing vulnerabilities and the comorbidities that are so common in the perimenopause and menopause transition. Enjoy this conversation and I’ll see you on the other side. Hi and welcome back, everyone to the Integrative Women’s Health Podcast. I’m here with Doctor Mariza Snyder, and we’re going to talk about some of the lesser known symptoms, I would say, of perimenopause and menopause and the fact that by the time you hit your late 30s to early to mid 40s, when you’re starting the menopause transition, most people don’t come in in absolutely optimal health.
Dr. Jessica Drummond 00:03:52 So in your work, in your practice. Mariza, what are you seeing? Is the first thing that people feel when they’re transitioning into perimenopause that they may not even recognize as such.
Dr. Mariza Snyder 00:04:08 I would say the most common across the board is a lack of stress resilience. All of a sudden, things that felt like they could just roll off their shoulder. You know, the list that most of us are handling every single day. It just starts to feel heavier and you feel more triggered. You feel more irritated, and you’re just like, gosh, that used to not irritate me. I wouldn’t be irritated by 5 p.m., you know, I didn’t feel like I needed to chop my partner’s head off at 7:00 in the evening. And so that’s one of the first things I think a lot of women will notice. And they think it has a lot to do with that slow, precipitous decline of progesterone that starts to affect our brain and our stress response system.
Dr. Jessica Drummond 00:04:52 So for many years now, you’ve worked with women in perimenopause, using a holistic approach and centering.
Dr. Jessica Drummond 00:05:00 And sometimes, like the real value of essential oils. Can you talk a little bit about that when it comes to that stress resilience? Because I do think that the first symptoms I’m also seeing as well are cognitive and brain based and nervous system based. And I was having a happy hour with some friends the other day.
Dr. Mariza Snyder 00:05:22 And what are they, mocktails?
Dr. Jessica Drummond 00:05:24 I certainly do not drink anymore. Absolutely. Although again, that’s another thing that people don’t realize. It’s like, why can I not suddenly tolerate alcohol very well and why? And so one of the big complaints is like, I’m feeling all rage against my whole family. So it’s this brain, nervous system, mental health, stress, resilience. I think that, you know, essential oils and other tools like that that can help modulate our vagus nerve or some of our best initial tool. So what’s kind of your perspective on how do we start with addressing those things?
Dr. Mariza Snyder 00:06:02 Yeah, let’s go in. So let’s just talk about the stress response system.
Dr. Mariza Snyder 00:06:06 That kind of irritation, the rage, the mood swings. We know that a big part of that is these hormones are declining. And there’s a lot of tools. One of the ways that I like to think about it is sending our brain safety signals. And also, I mean, I love hormones too. Like a little progesterone goes a long way. So one of my favorite tools for sending a safety signal is going to be an essential oil. I always say that people can choose their mood, and I even say this to my three year old that he gets to choose his mood, right? It’s about regulating our system and nourishing and nurturing our system, and sometimes we just need a little reset. For my son, it’s a mama hug like as a reset. And I think that an oxytocin boost for any of us, whether it is your kids, or your partner, or your dog, or your kitten, or whatever. It may be your best friend. Like that’s a great way of helping to reset.
Dr. Mariza Snyder 00:06:57 But if none of those are available at the moment and you know you’re in your car and you’re you’re late to a meeting or whatever that thing is, or you just got off the phone with your boss and you just want to scream in a pillow. I also say, hey, go scream in a pillow. Like when I’m especially feeling Reiji in. That definitely happens. It doesn’t happen all the time in what I call late luteal phase, but it does happen. Sometimes I just scream in a pillow or I scream in my car. Like that is absolutely appropriate. But in moments where maybe families around and I don’t really have the luxury of doing something like that. I do love grabbing oils. And so one of my go to for me, one of my absolute favorite kind of calming, I always think of florals. Florals is very calming. And the cool thing about essential oils, they’re kind of similar. They work in the similar way as adaptogens work. By the way, I love adaptogens as well.
Dr. Mariza Snyder 00:07:43 I love Holy Basil tea, I love rhodiola, I love ashwagandha, so bringing in adaptogens I think can be great neuromodulators and stress response system neuromodulators as well. And so definitely supplementing those are great. But this is instantaneous, right? We kind of have to take adaptogens for a while for them to really start doing their thing. And sometimes I need something to work in 10s like that’s how quick. And so breathing in rose oil or lavender or jasmine or clary sage, all of these oils have been researched to go into the limbic system and really, really kind of reset that stress response system from a sympathetic nervous system mode. So that fight or flight, I’m about to chop heads to a much more calming, parasympathetic state. And so I’m a big fan of all the tools in the toolbox. I do breathwork, big time breathwork. Every month I have a eMDR therapist, I have a sauna, I walk, I send voice memos, I scream into pillows, and then I also use oils. And so, I mean, I’m a big fan of, again, safety signals, wherever they come from, to help support and modulate that stress response system.
Dr. Mariza Snyder 00:08:52 But I find that if we can keep our nervous system regulated, that that’s such a big part of this journey in creating more ease and grace for us and just feeling not only more at home in our bodies, but also feeling okay in our home and in our families and all the things that are going on.
Dr. Jessica Drummond 00:09:10 Yes, I think that’s so valuable. So, you know, you mentioned and I completely agree that in many cases, using supplemental hormones directly is a great tool. But I think it’s important to note that that’s often either not enough or you need some support to help metabolize those additional hormones, supplemental hormones, even if they are bioidentical and delivered in the right way. And all of that, and the fact that we know the research shows us that as estrogen declines, we have certain menopausal symptoms, but people with low estrogen with regulated nervous systems measured by heart rate variability or HRV, do not have the same symptoms as people with low estrogen, plus dysregulated heart rate variability or nervous system regulation. So I think that checklist is really important.
Dr. Jessica Drummond 00:10:10 It’s almost like every woman at 35 should be handed a like a workbook, a checklist that says like, are you walking in nature? Are you putting your dog? Do you have a floral scented oil that you can smell? Do you have a best friend that you can voice, memo or go to mocktail happy hour with? Like these nervous system regulating tools are actually really important medicine that I think get kind of pushed under the rug. It’s like you just need the right hormone prescription.
Dr. Mariza Snyder 00:10:41 I wish it was just that. I mean, I’m doing all the things, you know, for me just to be, you know, very transparent, not only in my own journey, but a lot of the women that I work with. I’ve never met a woman with a regulated nervous system. And I just kind of share that. And I myself did not come into I have a very deregulated nervous system. I was chronically abused as a child my entire childhood. And so I have what are they.
Dr. Jessica Drummond 00:11:06 Called, like a.
Dr. Mariza Snyder 00:11:07 Score, a type of PTSD? Yes, I have a score of an eight. And so I came into this world, you know, with a deregulated nervous system of never feeling safe. In a lot of ways, it’s shown up in a really I’ve kind of in the way of high performance. It’s a lot of accolades, like I’ve checked a lot of those boxes, but because I’ve always been very vigilant and besties and friends of mine are like, oh, Mariza, your follow up is amazing. You always get back to us. You’re our best resource. And I’m like, oh, that’s just trauma. But coming into my 30s, especially wanting to get pregnant, you know, with my son, I had my son at 41, even in my late 30s, my progesterone levels. Let’s just be honest, my progesterone levels have never looked great on paper, but my system has always been deregulated. So especially as I started to feel some of those subtle changes in my late 30s. For me, regulating my nervous system has always needed to be.
Dr. Mariza Snyder 00:12:03 It gets to be intentional. There’s a lot of things that I build into my day, every day that ensures that I’m sending beautiful safety signals to a little brain that wants to find emergency and everything in life. And so that’s what I’m always offering my women is, again, I find that most women are coming into the menopausal transition not only with a bit of a dysregulated nervous system, but also with so many big demands. I just pulled in Instagram a couple of weeks ago. How many women in perimenopause were moms? And it was 1000 women responded and 85% of women who were in perimenopause, had children that were in school still like they were still tending to them. I think I want to say 10% children were out of the household and 4% or so had kids in perimenopause, so they were postpartum in their 40s like me, because that’s its own little journey. And so I’m always just very curious, like, what are the stacks of demands for this particular group of women? You know, for the millions of us out there? And then how are we tending to that when we’re kind of designed to tend to our children first, you know, and tend to all the things that come with it.
Dr. Mariza Snyder 00:13:17 And so what does it look like for us to tend to our nervous system so that we show up in a way not only for our own bodies, but also for our family? Because I know that us as all as moms, we really do want to show up as the best moms. We want to show up as the best friends and the best partners. And you know, how do we bring our best? By loving ourselves and giving our best to ourselves too.
Dr. Jessica Drummond 00:13:37 Yeah, I think that’s such important data. So you mentioned a few key things. One is that I think it’s really valuable for people to know what their ace score is. You can Google this online. There’s a very simple screening tool and that is your adverse childhood experiences. And there’s a lot of research showing that if you have adverse childhood experiences, especially quite young, but also this flares, if they happened around puberty and or around pregnancy, those adverse childhood experiences or young adult or adult experiences change kind of decreased the set point of your nervous system resilience.
Dr. Jessica Drummond 00:14:23 And so if you’re starting a little bit behind the starting line, if you will, and then you tend to have some kind of trauma response. And in my community and it sounds like yours as Well, a lot of that is high achievement. Hypervigilance, peak performance, have challenges with really resting and recovering and going with the flow.
Dr. Mariza Snyder 00:14:51 Have high.
Dr. Jessica Drummond 00:14:52 Standards. Yeah. And I mean there’s some positive rewards of that. But there’s also a yeah with society loves society loves it. And it’s daily and chronically over a long term by the time you’re in your 40s stress. Yeah.
Dr. Mariza Snyder 00:15:07 Yeah. And you feel it. It’s exhausting. These for me and my own personal experience. It feels like something’s just chipping away at you over time. And yeah, there’s nothing like coming into the perimenopause transition. I call it the Reckoning. Yeah. With that level of deregulation in your nervous system. Right. Because if we haven’t had an opportunity to really tend to ourselves and again, create these beautiful Safety, brain signals via self-care, or all these strategies that you and I have been talking about.
Dr. Mariza Snyder 00:15:41 It can feel like someone just pulled the rug from under you.
Dr. Jessica Drummond 00:15:45 Yes. And in a recent episode, I spoke with Doctor Alisa Song, who works with children. And it would be awesome if absolutely every child got to work with her, because there’s this idea of training, those regulatory responses, whether it’s with essential oil or breathwork or acupuncture acupressure tools. We talked about this a lot, like in middle school and late elementary school, our children were always trying to kind of buffer their stress for them, but we actually have to teach them the tools of buffering stress. But if you grew up as a woman in your 30s and 40s, 50s now without an environment where you were kind of taught to regulate your nervous system in an effective and adaptive way, You know, a lot of people were taught to eat sugar or, you know, they were kind of like, go in your room and figure it out for yourself. You know, it was rare that you had like a parent or a caregiver sit and do breathing with you or sit with you while you navigated that pain and went through it or gave you some of these tools like nature exposure, or cuddle with your dog or whatever.
Dr. Jessica Drummond 00:17:03 And I think that we now have to teach ourselves in perimenopause and menopause because, as you said, it’s the reckoning where the support that we had for our metabolic system, our immune system, our nervous system of our estrogen and progesterone levels gets wiped out and it doesn’t get wiped out like, neatly, it gets wiped out really messy, you know, erratically.
Dr. Mariza Snyder 00:17:29 I always say there is nothing predictable about the perimenopause menopause Pause transition. It’s a time of unpredictability and yeah, you know, creating scaffolding around that to support us in that level of unpredictability. I also say it’s a time for review. Like everything is up for review, like there’s no sacred cows here. So true. Except your children.
Dr. Jessica Drummond 00:17:51 Yeah. I mean, of course you’re going to keep taking care of children, but you may even rethink because how you’re doing them regulated and all of that. Yeah, but I do think you’re absolutely right. I mean, I think there’s some benefit to sort of feeling yourself without those crutches, if you will, of estrogen and progesterone even temporarily, like noticing what in your life is irritating you.
Dr. Jessica Drummond 00:18:15 Should that actually change? So in your own assessment, has there been anything like I really need to do this differently, or I need to let go of this, or, you know, something that you see commonly with your clients or community?
Dr. Mariza Snyder 00:18:30 Yeah, I think a big part is I think we’ve been particularly women have been conditioned to really bully ourselves, you know, to just do it, just grit it out. And there’s a lot of negative self-talk. I can’t tell you how many women come to work with me, and they just really want me to know that they’re not lazy. They really want me to know that they’ve been really trying, that they’re not just dropping the ball. And that breaks my heart because I’ve never met a woman who hasn’t been trying. And so one of the things that I recommend is really, you know, that come through because it’s a hard time, no problem. And I’m in week four. I’m in late luteal right now.
Dr. Jessica Drummond 00:19:06 Of the menstrual phase for those who don’t speak most lately.
Dr. Jessica Drummond 00:19:09 Right. Right before your period. Yeah.
Dr. Mariza Snyder 00:19:11 And in Perry, all of it gets lit up is how I describe it. And I was so funny. I was looking at Doctor Stephanie Estima, had a little post, and, you know, she was doing a workout and she, you know, late luteal phase. You’re not pushing as hard. And so she was saying, you’re in week four without telling me and you’re in week four. And she alluded to like, you know, these little subtle things. And I was like, oh, everybody knows when I’m in week four, let me tell you. Like, it’s not subtle, okay, I’m coming in swinging. And so I think, you know, for so many of us, let’s say even in week four or maybe post ovulation, if you have an ovulatory month in the perimenopause transition or a day that you have a migraine or a day where you feel your cortisol awakening response just isn’t there, you wake up and you just can’t get out of bed.
Dr. Mariza Snyder 00:19:56 I think what’s important is that we set the table with self-trust, self-love, and coming from a place of surrender. So let’s say yesterday I had a really bad migraine, and the day before I knew that yesterday I was going to work out. I was going to do a big weight training workout because I’m not trying to lose my muscle mass. I’m trying to maintain my metabolic flexibility, and I really want to be strong and powerful and resilient for as many possible years as I can. And so training with heavy weights is very much on, you know, it’s a part of my weekly routine, but I woke up with a migraine yesterday. I might come through with that. That wasn’t going to happen. That just wasn’t happening yesterday and ten years ago, I would have beaten myself up and I probably would have done it anyway, would have been really subpar, and it would have been super hard and I would have felt awful on the other side, but I would have done it. And today, coming in with a deep knowing, like knowing my body, trusting my body, my body’s telling me, girl, don’t even think about that weight room.
Dr. Mariza Snyder 00:20:56 You know, today’s a walk, today’s a gentle walk. Today is gentle breath. Today is being gentle on yourself and on your brain. So I always want to start my day setting the table with how am I going to show up with compassion? And how am I going to pivot today based on how I’m feeling? And so that’s one of the things I always love to bring to my patients and my clients is like, let’s set the table. Coming from a place of compassion and love versus bullying ourselves into something that ultimately is not going to serve us over time. Yeah.
Dr. Jessica Drummond 00:21:26 And I think that, you know, when we develop that practice of self-compassion, because you have to unlearn what you were doing before for 40 years. You know, sometimes you’re going to get it right, sometimes you’re going to get it wrong, but the recovery is that much faster. So we were talking a bit about the most common early symptoms of perimenopause the rage, the mood swings, the brain fog. Talk a little bit more about some of those more cognitive and brain based symptoms that you see.
Dr. Mariza Snyder 00:21:59 I mean, all of it. But yeah, let’s break it down. So if it isn’t a lack of stress resilience that you notice, the other thing I see a lot is lack of word recall. So long term memory all of a sudden they’re just not able to pluck out whatever it is that you want to say. This is very much been an experience for me, especially with the brain injury last summer. And that rocked my world. You know, as a woman, when we’re firing off, I call it firing on all cylinders where you’re just like, you know, you’re just like, our brains just worked so fast. Everyone I’ve ever met, they’re just slaying dragons left and right. And then one day, all of a sudden, you’re not just laying dragons, and your brain is just not firing the way that you are used to it firing. And that word recall, you’re not remembering where something is, or you’re not remembering the word that you want or the sentence that you want.
Dr. Mariza Snyder 00:22:50 So brain fog is a big one that I’ll see of just either alertness or a lack of concentration. But most importantly, the thing that I think really rocks women’s worlds is that lack of word recall or that long term memory. And then the other thing is just overall, I think a lot of us, when we check in with our energy levels, I think what we’re really measuring is our mental energy, because I think that’s really where our capacity is of just being able to do so many things. And that’s what begins to feel very draining. It’s like they’re just not able to pull that mental energy that we used to be able to pull.
Dr. Jessica Drummond 00:23:24 Well, I was just going to say that I think women are at this age, often carrying many things. They have big jobs, they have multiple children. They all need different things. They’re caregivers for aging parents. They’re managing financially. They’re making dinner every night. Like there’s a lot you’re always sort of carrying in your head. And of course, this is where the reckoning comes in, right? You’re sort of reassessing where and when you want to be doing all of these things.
Dr. Jessica Drummond 00:23:53 But at some level, that’s just a part of this phase of life. And I think that’s what feels really slippery with this is like, oh, how come I can’t do that anymore?
Dr. Mariza Snyder 00:24:04 And it’s a lot of just speaking into what society has wanted from us is the mental bandwidth that requires. Yesterday I was making a decision for Kingston Gymnastics on scheduling, but I was also ordering his shoes. I was planning dinner, I was preparing for today’s interviews. I was checking in. Alex needed me to pay for something. Da da da da da, you know? And it’s all over. It’s not like I’m just centrally focused on one thing. I’m juggling multiple things and then also tending to my preschooler at the same time. And so, yeah, it’s a layer of so many things. And so when you feel like that foundation that you had isn’t fully there, it’s very scary. You know, at least for me, it was very scary. You know, I was like, oh my gosh.
Dr. Mariza Snyder 00:24:49 Oh, you get to recalibrate in a way. I mean, some things are still non-negotiable. I’m a big fan of delegating, asking my husband Alex, my partner, can you carry this for me? Like, can you hold this for me? Giving him ownership and even that is a level of mental delegation. Yeah.
Dr. Jessica Drummond 00:25:05 You have to trust that they’re going to do it, which I think a lot of women have trouble with. Yeah.
Dr. Mariza Snyder 00:25:10 And you have to be thinking about the thing that you want to hand over to your partner.
Dr. Jessica Drummond 00:25:13 You have to sort of manage it, if you will. You have to package it and hand it over. Yeah.
Dr. Mariza Snyder 00:25:19 So even that requires mental bandwidth. And so yeah, I think that in the time when we are the busiest, our life is very, very full. Navigating a lot of big life experiences, including the things that light us up, that it can be disarming to feel like our mental capacity isn’t where it was. The other thing I think is really disarming.
Dr. Mariza Snyder 00:25:40 You know, I’ll never forget watching my mom go through perimenopause. I always say that it was like a nightmare unfolding, and it was more the emotional, tumultuous ness that she was going through. And they were years where for like that, four days prior to her period, she wouldn’t even leave the house because she was afraid she was going to hurt somebody. Like she’s really severe. And she eventually went to a doctor and asked, like, is it normal for someone to want to kill everybody for like 4 to 5 days? Like the rage was so bad and her doctor, you know, luckily enough, validated it. But this is at a time where we really didn’t have solutions for that, you know? So she was validated but just was sent home to continue to live like that. And so a lot of women experience rage. Again, we talked about the irritability, the higher levels of anxiety. We even see ADHD increase, depression increase. I want to say it’s like over 60% of women start to experience depression and perimenopause.
Dr. Mariza Snyder 00:26:37 And so a lot of mood shifts and changes that can feel kind of unexpected, or at least just much more severe than it’s ever been before.
Dr. Jessica Drummond 00:26:46 Yeah. And this is where I am more of a proponent. I know you are as well of adding hormone therapies because, you know, our parents generation, our mothers generation didn’t really have that because of the floor of Women’s Health Initiative study. And as much as it’s very important to also regulate the nervous system and not just, you know, I’m not really a fan of kind of medication mill, you know, like everybody gets hormones without really thinking about it and talking about it and discussing everything we’re talking about here. Like, what do you want to reassess in your life? How healthy is your digestion and your liver and your brain? And, you know, really getting to your gut, like getting healthier. But on top of that, we now know that these tools are intensely valuable. So talk a little bit about some of the things that you’ve seen improve, adding whether it’s topical estradiol or progesterone that are readily available now but are vastly under prescribed in addition to the mental health improvements.
Dr. Mariza Snyder 00:27:58 Well, I mean, you think about in the last 20 years, since the Women’s Health Initiative in 2002, that kind of shut it all down, right? Over 75% of women came off of hormone replacement therapy at that time. And that was very much my mom was in that 20 year. She was literally right after that is when she was going through perimenopause and would have benefited what we saw an uptick in or what we’ve seen an uptick in is medications for depression and anxiety. So that’s what we’ve seen. The replacement of of hormones have been anti-anxiety medications. And what I’ve seen over the last couple of years. And again, just note that even a couple of years ago, only 4% of women in the US were on hormone replacement therapy, and now it’s 6%. So we are seeing an uptick, but it’s still even 6%.
Dr. Jessica Drummond 00:28:42 It’s still very.
Dr. Mariza Snyder 00:28:42 Low. 6% of the millions of women. Just full disclosure, you know, I just want to share a little bit about my I’m 44. I’ll be 45 in a couple of months.
Dr. Mariza Snyder 00:28:52 I was I, I again I had my son when I was 41. So up until last year I was breastfeeding very much in postpartum and then just kind of got like shoved into perimenopause and progesterone. She was gone. She disappeared. So progesterone was one of the first things I was able to get on to kind of manage the rage and the mood swings and just to support my stress resilience with all the other things that we were talking about. Those have always been practices of mine. So I believe it’s a yes and it just gets to be a yes. And and then something I haven’t shared that I find happens to a lot of women in perimenopause is an uptick in migraines and just inflammation, neuroinflammation. That’s why we see an increase in autoimmune conditions in perimenopause. When we’re talking about erratic hormones, we see an increase in inflammation across the board, particularly in the brain. So for me, I was averaging 15 to 20 migraines a month, predominantly in the luteal phase, almost every day in the luteal phase of my cycle.
Dr. Mariza Snyder 00:29:58 And then around ovulation or sometimes an ovulation, no ovulation. I wasn’t interested in a lot of medications. I’ve had them since I was seven, but obviously in perimenopause they have really taken a big step up. So, you know, I was following a dear friend of mine, Doctor Phyllis Gersh, who recommends estradiol for menstrual migraines or, you know, perimenopausal migraines and started literally two months ago. I started on estradiol as a solution for migraines and have gone from 15 to 20 a month down to two.
Dr. Jessica Drummond 00:30:28 Oh that’s great. That’s really good.
Dr. Mariza Snyder 00:30:30 So just trying to figure that out. But what I’ve seen, so I’ve seen migraines get significantly better. Brain fog. My brain is working so much better. I feel like that’s a side benefit. I’m like I’ll take it. Mood stability. So just more stable mood across the board, especially in that what would consider to be kind of that luteal phase where I find that mood just gets to be a little bit more unstable, especially if you’re still cycling in your kind of early perimenopause heading into late perimenopause.
Dr. Mariza Snyder 00:30:58 Although I like to break it up early, middle and late, the jump from early to late perimenopause feels like a really big jump, like there’s a lot of gray middle there. So I’ve seen more muscle definition. So women are maintaining more of their muscle mass. Less body composition changes as well more insulin sensitivity. So I’m always looking at those markers as well. Less inflammation across the board. Again, as long as we’re supporting the liver we’re supporting the gut. We’ve got these other lifestyle strategies connected in with hormones. I believe that hormones are vast optimizers. They’re not going to be the only fix all. But I do believe that if it’s because of hormones that we’re losing some of that emotional resilience, that mental resilience, then why wouldn’t we try to bring those in along with some lifestyle strategies before turning to SSRIs or some type of, you know, antidepressant or anti-anxiety medication?
Dr. Jessica Drummond 00:31:53 Yes. And that’s so important because as you mentioned, up until very recently, it was something like 25% of all women in their 40s were on an antidepressant medication.
Dr. Jessica Drummond 00:32:05 And the problem with that is it doesn’t work that well. We were still having increases in mid-life suicides. We were still having increases in depression and anxiety. And so I think it’s really powerful to see how few women, even now, because of the long tail of the Women’s Health Initiative, the concerns that women have about using hormonal therapies, that there’s still only a use of 6% when they can starting in perimenopause or the safest. And if you’re taught to. And I’m hoping that this conversation is really going to amplify this, start looking in your 30s, 40s, because a lot of times women also don’t see menopause until they’re like, oh, menopause. That’s like when you’re 50 or 60, right? You know, they think it’s much later than it is, but you were still postpartum and early 40s and feeling these brain symptoms of menopause. And sometimes it’s, as you said, sort of slow and messy and long. Ten, 15 years of perimenopause. But we also have some women who it happens to more abruptly.
Dr. Jessica Drummond 00:33:24 And that was more of my story. I was, you know, in kind of like a mild perimenopause. I had some changes in my cycles, not a lot of symptoms. And then I got Covid and it was a very rapid. I had 1 or 2 kind of mini cycles after that. And that was it was just like menopause. So that was also uncomfortable.
Dr. Mariza Snyder 00:33:50 Yeah, very I mean, talk about getting supercharged over into menopause. You know, with all the profound changes that happen, I think it’s really important that women understand that whether you have symptoms or not in perimenopause, your body systemically has changed that reproductive system of ours is a fifth vital sign. And when we start to lose, you know, our ovarian capacity, our ovarian function, and it has a profound impact on every system of the body, every organ system of the body. And so I always want to let women know that whether you breezed through it or it was so tumultuous, you were like, when do I get to get off this roller coaster ride of your body on the other side of menopause or post menopause is a very different body because it’s not binding to those critical hormones anymore.
Dr. Mariza Snyder 00:34:41 I hope that’s the biggest message we walk away from this is that it’s a reconfiguration. It’s a recalibration of every single organ system in the body. I think most importantly, the brain.
Dr. Jessica Drummond 00:34:54 Yes, and even the cardiovascular system. This is why because we talked about it helping the more immediate symptoms, the current migraines, the current mental health symptoms. The current brain fog. Sleep, sleep. Sleep issues. We could. Gosh, we could do a whole episode on sleep all day. And, And I think the more important thing is for people who feel like they didn’t really have symptoms at this time. They breezed through it, if you will. They still, because of that, estrogen decline and progesterone decline, have higher risk of dementia, which is much more common in women. They have higher risk of cardiovascular disease, high blood pressure, bone fractures. Yeah, metabolic issues like diabetes and prediabetes. And especially if you had either PCOS and or gestational diabetes or even preterm labor or pre-eclampsia.
Dr. Mariza Snyder 00:35:53 And these are all we are.
Dr. Jessica Drummond 00:35:56 And we don’t think about pregnancy as being predictive of what could happen post-menopausal. So I think that what you and I are both saying is that every woman, no matter what her symptoms are, should take stock in perimenopause and menopause and consider talk to their clinicians. Talk to one of us. Talk to someone on their health team about considering using hormone therapies because the data is so strong about their benefit and predict and prevention long term with, as you said, kind of the added bonus of, oh, by the way, you can find your words again.
Dr. Mariza Snyder 00:36:35 Yeah. I mean, I think a lot of women are heading to use hormone replacement therapy for symptom management, and that is the way it’s being prescribed as standard of care within the medical system. Right now. We’re not really looking at it as a preventative. We’re looking at as symptom management. And honestly, I’ll take the we can get like I want us to be thinking about it. I want you as you’re listening to this, to be thinking I should be thinking about hormone replacement therapy as a preventative, to neurodegeneration, as a preventative, to bone loss as a preventative to cardiovascular, you know, inflammation or risk factors as a preventative to metabolic syndrome.
Dr. Mariza Snyder 00:37:11 Along with lifestyle, making sure that we keep inflammation checked. And as a side benefit, yes, let’s manage those symptoms as well. But those symptoms, those symptoms are to me, a lot of these symptoms are a subtle calling card for metabolic issues. At the end of the day, if everything runs through our cellular energy, our mitochondrial energy, and we start to see that shift and change, potentially in an unfavorable direction in the Perimenopausal transition to me, even as early as our 30s, it’s something that we get to look at. So if I could wave a magic wand across the, you know, world for all the women, it would be that we are looking at labs. We are really looking at these biomarkers even as early as our 30s, so that we can have a timeline about what is going on with your body that, you know, we’re bringing in the optimizers, we’re bringing in the lifestyle strategies so that not only is that perimenopausal transition a little bit more ease and grace, not this crazy tumultuous roller coaster.
Dr. Mariza Snyder 00:38:17 It’s more like the kiddie coaster that my son goes on. You know, absolutely that the crazy roller coaster and Magic Mountain and that then we head into menopause, you know, with good biomarkers, with optimal biomarkers. And as much as, you know, for a woman who’s I’m dealing with perimenopausal symptoms. And let me tell you, my metabolic labs are a chef’s kiss. So it’s a yes. And, you know, do I get to bring on hormone replacement therapy and make sure that I’m optimizing my metabolic health? Yes. And because I know that we see once women get into their early to mid 60s, it can really be a downhill slope. From there we start to see Osteoporosis. We begin to see, you know, C-reactive protein much higher than it needs to be. We start to see an increase in prediabetes. And again, you know, we start to see scary numbers around their arterial walls. We start to see, you know, carotid artery scores not looking super great. And so I really want to know, like what in this transition can we do to be preventive preventative for when we hit our early to mid 60s? One of my best friends has a little boy who’s just a little bit younger than my son.
Dr. Mariza Snyder 00:39:29 And her mom and my mom are the same age, and I’ve been taking care of my mama since what I call the Zone of chaos. Since her perimenopause journey. I took over that situation and my mom had a crazy 180, gorgeous 180 like she’d weight train. She’s got great metabolic levels. She runs marathons. You know, she just robust. She’s the epitome of vitality. And she could throw my child in the air. You know her grandson race with my grandson do all her grandson. You know my best friend’s little boy. Her mother is the same age. She cannot pick up her grandson, who’s £28, and she doesn’t feel comfortable watching him unless there’s another adult present, because she’s afraid that if something happens to her grandson, she may not be able to do what she needs to do to take care of him.
Dr. Jessica Drummond 00:40:18 Yeah, you’re exactly right. And these things start earlier than we think. I think this is a message that’s really important, because women who are not metabolically optimized in their 40s by the time they’re 60 can have early stage dementia.
Dr. Jessica Drummond 00:40:35 You know, women’s cardiac arrhythmias are on the rise. Women’s colon cancer is on the rise. Even in midlife. Women’s strokes are on the rise because of exactly what you’re saying. We have so many things contributing to metabolic dysregulation, everything from our toxin exposures to the foods that we eat to the lack of stress management and nervous system regulation that preparing all of that in our 30s and 40s is like so key. And as you said, then, you know, you and I both have these like perfect metabolic labs and yet still symptomatic. I had plenty of hot flashes, I had some sleep disturbance. And it took that next level of optimizing with hormones, but so much more effectively lower doses needed. It helped more quickly when you have that baseline of resilience. And I think even if you’re in your 70s or 80s, you know, I’ve seen this with my mom and she had a hip fracture because she has pretty significant osteoporosis at this point. But she had been exercising for years, like during the pandemic.
Dr. Jessica Drummond 00:41:52 She was walking ten miles a day on beach and surfaces Forces. And, you know, you don’t even have to be an Olympic athlete. You know, just everyday walking, everyday functional activity, functional mobility and functional strength training. And she was able to fully recover from that. Where, you know, about 50% of women in their 70s who have a hip fracture will die from it. Yeah.
Dr. Mariza Snyder 00:42:17 Within five years.
Dr. Jessica Drummond 00:42:18 So that recovery, even if you know your mom is such a perfect example, my mom too, in that the more resilience you have, even though they didn’t get the benefit of hormones, they’re still able to recover and be functionally active. And, you know, travel. I mean, we’ve been all over, you know, she’s lived all over the world. We walk on cobblestone streets without like, fear. Yeah.
Dr. Mariza Snyder 00:42:44 And, you know, we get to be honest that not everyone’s going to be a candidate for hormone replacement therapy. And you know, I know those women are wondering, well, what about me? And it’s very much what we’re talking about.
Dr. Mariza Snyder 00:42:55 Again, hormone replacement therapy. I mean, if you’re a candidate, I want you to be looking at those options, having those conversations as early as perimenopause. You don’t know when none of us deserve to suffer needlessly, none of us. And if you have symptoms, it’s a worthy conversation. And we need to support that gut microbiome that’s shifting and changing because of Perry. We need to create an anti-inflammatory protocol that’s really supportive movement, stress regulation. You know, I tell people, protect your sleep like it’s $1 million meeting. Nobody, nobody, except for my son, gets to mess with my sleep routine. Nobody. And like, once the door shut, it’s over. Like, don’t come to me with you. Hold it till the morning. It’s not important enough. And, you know, having deep connections like those are the things. And so it’s a yes. And so if you’re not able, for whatever reason, to be on hormone replacement, I just want you to know, I hope you take from this conversation as well, that there is a lot that you can do to stack the deck in your favor to reduce that inflammation, to protect your brain and heart, to protect your bones, and to feel like you’re alive and strong and resilient.
Dr. Mariza Snyder 00:44:02 So it’s a one. Or there’s a lot that we get to do to take care of our bodies.
Dr. Jessica Drummond 00:44:07 Absolutely. Thank you so much for this encouragement, for sharing your story, for giving women in their early to mid 40s who were like, I’ve lost my brain so much hope that they can fully get it back because you have been fully sharp in this entire interview. And so yeah. So what resources do you have to share? Where can people find you and learn more about your work?
Dr. Mariza Snyder 00:44:34 Again, I think one of the things I hope the through line that came through today was our metabolic health. And one of the best ways to understand that besides the subtle symptoms and signs, you know, you feeling exhausted or you’re feeling sluggish is to really be looking at those biomarkers because metabolic syndrome and cardiovascular disease, if they’re their silent, even insulin resistance. It’s silent, you know. And so I think it’s important to know the type of biomarkers and lab ranges that are, you know, really dialed for your body, like optimal lab ranges.
Dr. Mariza Snyder 00:45:04 So often doctors will just be like, oh, everything’s normal, norm, and it’s not normal. You have a blood sugar or your hemoglobin A1. C is touching prediabetes and your doctor continues to keep telling you everything is normal. It’s not normal. I even think prediabetes and diabetes, as far as I’m concerned. Why are we even calling it prediabetes? And so, so many women walk out of their doctor’s offices and are just like, I don’t feel good. And yet I’m being told things are just fine. So I have a metabolic lab assessment that gives you optimal ranges. It gives you everything you need to kind of figure out for yourself. Is this something I’m dealing with right now, and then what can I do next? So I have that little lab guide, but you can find me on Insta at Doctor Mariza. Dr. Mariza and I have a podcast that Jessica’s about to be on called energized with Doctor Mariza as well. And it’s literally, this is who I’m serving. I’m serving you.
Dr. Mariza Snyder 00:45:53 This is what I’m talking about all day long.
Dr. Jessica Drummond 00:45:54 That’s fantastic. And I’ll put in the show notes, the links for everything, for people to easily find you and that metabolic lab checklist. That is fantastic. I mean, if you were 30 years old, actually any age, but you if you’re a 30 year old woman or above, like this is the time to start knowing your numbers and your baseline and then check it every year, every other year and keep on pace of that, because then you’re going to see when perimenopause is starting to impact your metabolic function at those very early stages, like just a slight uptick in that hemoglobin agency or that fasting.
Dr. Mariza Snyder 00:46:30 Glucose, triglycerides or, yeah, fasting glucose or fasting insulin, like, you know, and if you can’t get a fasting insulin, you can always I always tell people, just divide your triglycerides by your HDL. You know, getting that ratio ideally would love it under a two. And I share that in the guide as well. And so there’s ways again, if your doctors won’t run certain things.
Dr. Mariza Snyder 00:46:52 I really take all that into account inside of this guide, because I know sometimes it can be really hard, even when you’re advocating for yourself to get what you need. And so there’s workarounds. And then I make sure to include all of that.
Dr. Jessica Drummond 00:47:03 Oh fantastic. This is gold. So definitely go to the show notes, download that guide, follow Doctor Marissa on Instagram. And thank you so much for being here today.
Dr. Mariza Snyder 00:47:15 Thanks for having me.
Dr. Jessica Drummond 00:47:20 What a great conversation with my dear friend and colleague, Doctor Mariza Snyder. I hope you got some insight in this field. Have the normal stressors of midlife. We have kids. We are perimenopausal in the same time. We have businesses. We have health challenges. Doctor Snyder talked about how she had a head injury and she had post-concussion syndrome. She actually had two head injuries in a row. Stuff happens, life happens. So I always give you something to do. This week is get Doctor Mariza Schneider’s book, the Essential Oils Menopause Solution. Now, it’s kind of an internet joke, right? It’s like essential oils can’t solve everything.
Dr. Jessica Drummond 00:48:05 And this is true. But yes, and essential oils have their place in order to optimize the resilience of your nervous system. So if you’ve been shaken up by a virus, by a vaccine, by a head injury, by a car accident, by an emotional stressor, a divorce, a job change, a move, or if you’re just working too hard, all of these tools of safety for the nervous system actually help your body to heal. They’re not the whole solution. It’s not essential oils or on therapy. There is a lot in this book of day to day tools that you can use for nervous system regulation, and this is probably the biggest theme of this entire podcast, right? Our number one on our Integrative Women’s Health Institute seven step system is nervous system regulation. There are tools in this book. Explore and choose one. Practice it. It’s better for us to have practice of nervous system regulation. Use the aromatherapy foam roller on your wrist. Use the diffuser. Take deep, slow breaths.
Dr. Jessica Drummond 00:49:27 I can’t emphasize enough the benefit of nervous system regulation when you’re recovering from an injury or major emotional stressor, so get all of the support you can. It’s a yes. And thank you so much for being here with us this week. I hope you learn every week one new tool to take back to your practice. Women really need your help. As I said, it’s still only 6% of women are getting the menopausal care that they need. You are a part of the solution. Thank you for the work that you’re doing. I’ll see you back here next week. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast. Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.