Episode 148 - Thriving Through Perimenopause: A Deep Dive With Karen Martel (Full Transcript)
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SPEAKER_01:
Welcome to Nirvana Sisters podcast, where we take the intimidation out of well-being and beauty to help you achieve your highest state, your nirvana. We are sisters-in-law and your hosts.
SPEAKER_02:
I'm Amy Sherman. And I'm Katie Chandler. So let's get into some real conversation. Welcome to the show, Nirvana Sisters family. Today, I am so excited. We are sitting down with someone that I'm a huge fan of. I'm fanning out a little bit. I feel like I know her. Fan girling. I've been listening to her for two years, I want to say. So with no further ado, this is Karen Martell. Karen is the CEO of Hormone Solutions, heads a clinic and product line offering bio-identical hormone therapy and a holistic approach to addressing hormonal dysfunction in women during peri- and postmenopause. As a certified hormone specialist and transformational nutrition coach, Karen is a distinguished authority in women's weight loss and hormonal health, with a wealth of expertise, and that is a fact. In perimenopause and menopause, Karen is recognized as a leading expert in navigating the unique challenges and transitions women face during these phases of life. As the esteemed host of the highly acclaimed women's health podcast, The Hormone Solution with Karen Martell, she delves deeply into the intricacies of female fat loss, hormone optimization, and the complex interplay between hormones and overall health. Karen's mission is to empower women with the knowledge they require to seize control of their well-being and thrive throughout every stage of life. And she is wildly successful at that. And I can't wait to talk about it. So welcome to the show, Karen.
SPEAKER_00:
Well, thank you for having me, ladies. I'm so happy. That was really sweet. Thank you. I do it myself when I meet other people and I'm like, Oh my god, I've been listening to you because you're feeling you have this intimate relationship with the person because they've been in your head talking for years on end. When you actually meet them, even if it is just on video, it's like, oh my gosh, this is like meeting a star.
SPEAKER_02:
It's very exciting. I love it. All right. Well, before we get started, we like to kick off with a little nirvana of the week and I'm going to let Amy get the ball rolling so you can, so we can just get into the groove of it.
SPEAKER_01:
That reminds me, I posted this weekend on Instagram, this, it was like a quote that I had seen before and it reminded me of our nirvana that we do called Glimmer. I recently learned about a term called glimmer, which is essentially the opposite of trigger. Glimmers are those micro moments in your day that make you feel joy, happiness, peace, or gratitude. Once you train your brain to be on the lookout for glimmers, the more these tiny moments will begin to appear. And I was like, Oh, I love that.
SPEAKER_02:
Yes, I do love that.
SPEAKER_01:
So very similar to our nirvanas. So I would say my nirvana this week or weekend was I got some one-on-one time with my younger son. So my husband and older son went away for the weekend. They went on a trip. And so I was just here with my younger son, which like we're never here, just me and him. So it's cute. We just like got to hang out a lot and do fun things like, I don't know, just go like shopping around and have little dance parties. He was teaching me a TikTok dance and like all just fun stuff. It was just cute to have some one-on-one time with him. So, yeah. What about you, Katie?
SPEAKER_02:
Mine, without a doubt, is this moment right now because I'm so excited to talk to Karen. And shortly, I'm going to give my little personal Karen Martell anecdote on how she changed my life. So, this is my nirvana. Wow. Really, honestly. So, Karen, what was yours?
SPEAKER_00:
My nirvana, I would have to say, was this moment where one of my girlfriends from the States left me a voice note. We leave each other these 10-minute-long voice notes all the time. It's hilarious, right? Just get on the phone and talk. But we do. We just go back and forth with these silly voice notes all the time. She's off to Costa Rica today. She left me this really sweet little message where she just said something like, I'm off to Costa Rica early in the morning. How was your weekend? He's like, okay, love so much and I'll talk to you soon. And I was like, and my son was listening to it and he said, why does she say I love you? I said, you know what? Because we do. We love each other. We're really good friends and we love each other. And for some reason, it just stuck with me. And it was this moment of realizing what great friends I've made in the last few years in this industry. And for those listening, when you're in this industry, it's very lonely. Even though it seems like we're so out there talking to so many people, day-to-day, you're by yourself in your house, in your office with nobody around. And if you live in an environment like I live, which is in the middle of nowhere in this little town, there's nobody here that understands what I do, that nobody's in this industry. So all of my close friends now all live in another country. So it just made me reflect on the importance of having friendship and love from other women that understand you and where you're at in your life. Because prior to that, I didn't really have a lot because of where I was. So I was just super grateful and I had this like such touching moment about it. So that was my Nirvana.
SPEAKER_02:
All right. Well, before we get into all of this, I just want to, I'm going to try to be really concise, but I also don't want to be too short-sighted because I want you to understand the impact that finding your podcast really did have on my life. I, as a lot of our listeners now, I have two autoimmune conditions, one hypothyroidism and one is Addison's, which is pretty rare. I don't know if you're familiar, but I don't make stress hormones, cortisol or all testosterone. So I've spent the last decade pretty sick, like in and out of moments. I have good months, I have bad months, I have bad years. And towards the end of my 30s, I had a partial hysterectomy, kept my ovaries. But over the course of the last few years, my health was really deteriorating and I didn't know what was going on. Because as you know, perimenopause symptoms are a laundry list. It's not just hot flashes. I wasn't having hot flashes. So it didn't occur to me. This is what's happening to me. It was like a big learning curve figuring it out. And I figured it out by listening to you. I stumbled across your podcast. And I think I was like, you know, I had like stubborn 10 pounds I was trying to lose and your podcast used to be called the other side of weight loss. So I thought, Oh, this is great. And I was listening to you. And I can't tell you how many times I'd be driving around in the car, listening to your podcast, and I'd be screaming at the speakers, if you could hear me, like, yes, Karen, that's me. Yes, I experience that all the time. I feel like that all the time. So I finally, last April, decided to take the plunge and try HRT, even though my labs were coming back like fairly regular, but because I had that partial hysterectomy, I wasn't having a normal period. So I could never gauge where I was in my cycle. So it's hard to tell where your hormones are supposed to be when you don't know where you are in your cycle. But I thought, well, let me just give it a try. And I started an estrogen patch and a progesterone bioidentical cream. Within weeks, I started feeling really good. I started having great energy. I started, sex drive came back, looked like myself, felt like myself. Within months, my autoimmune conditions were practically in remission. I went from having like multiple bedridden days a week, sometimes horrible months at a time without a good streak for longer than a couple of days, to now I commute into New York City three days a week and work, come home, cook dinner for my family, play with my kids, go travel and feel great. Like I used to not even be able to travel without it really wrecking me. It completely I feel at 42 years old, I feel like I did when I was 25, healthier, better than I did for an entire decade of my 30s. And 100% it is because I stumbled across your podcast, without a shadow of a doubt, and just how incredibly informative you are. And you're really, really great at helping the listener understand all the complexities of it and how it can affect people in all these different ways. And you bring so much science and so much fact and so much of the studies and everything behind it. It's really what you're doing is we're Jewish, and we would call it a mitzvah. I mean, it's really, it's amazing, and I'm so grateful. So essentially, thank you, because you really, like, I went from thinking I'm going to be sick and tired for the rest of my life, this is just what my conditions are, to like, hey, I'm alive, like life is back.
SPEAKER_00:
Why did you have the hysterectomy? I think that's important for your audience here.
SPEAKER_02:
I had a lot of complications from like post-pregnancy, like prolapse and things like painful intercourse, like things like that, and horrible, horrible periods, like really painfully horrible periods. So that was, and that was just the first, the doctor said, this is what we do. We're not gonna, like that's just the only option I was given. And I took it, and like ultimately, It was a good move. I was happy I did it. But then it just sped up the menopause, you know, so yeah, and you're on thyroid medication. I am. Yeah, I'm on thyroid medication. I was I've been on thyroid medication and medication for my Addison's disease since I was like 30. Yeah. I do. And fludrocortisone. Yeah.
SPEAKER_00:
Okay. Yeah. So yeah, that all makes sense to me because the same, I didn't have a hysterectomy, but at 42, I hit menopause, but all my numbers looked good. And it was the thyroid medication had raised my sex hormone bonding globular, which is a protein that binds up primarily testosterone and estrogen. And so if it goes up, you can look like you have fine labs and blood work, but your free levels of hormones are really low because they're getting bound up by this protein. And so I couldn't figure it out. I was like, what is happening? And it took me years to ever even hear somebody talk about that, to talk about the fact that thyroid hormones could do this. But I just did the same as you, where I was like, I know I'm going through menopause, I'm having hot flashes, low sex drive, I can't sleep, suddenly I'm gaining weight, my periods become irregular. So I found a doctor who was willing to prescribe to me and I was like, I have to start this. And then since then, I've just been this huge advocate for women can take hormones early and that's okay. A lot of doctors are like, we can't give you estrogen until you're in menopause. Well, hello, perimenopause can be over 10 years long. So you want women to suffer for over a decade because they have these irregular estrogen cycles where sometimes it'll be high, sometimes it's low. and suffer and gain all this weight and be uncomfortable and have low sex drive and dry vagina and all of these things. When we just given her a little estrogen, she would have probably been a lot better. And then the other thing is doctors don't tell women that, oh, if you have a hysterectomy, yes, we can leave your ovaries, which helps, but your ovaries atrophy faster once her uterus is gone. So you will start to go into that perimenopause menopause state quicker. And typically when there's not the prolapsed uterus and things, but the heavy bleeding, the poor periods, the postpartum depression. A lot of that is due to low progesterone levels. So once again, women aren't being told, oh, you're 38 and you're suddenly bleeding out every month and you can't sleep and you've got horrible PMS. Well, let's put you on birth control pills. Let's give you an ablation or let's give you a hysterectomy. And those are your three top choices when that woman could just use a little bit of progesterone cream and probably be totally fine.
SPEAKER_01:
It's unbelievable. This. I, years ago, as the audience knows, I have vestibular migraines and they first started coming on, I don't know, maybe six, seven years ago, whatever it was. And a lot of it revolved around when I was getting my period, et cetera, et cetera. But at that time, I didn't know anything about hormones. It wasn't even a thought in my mind. And then one of my doctors was like, oh, you're probably peri-menopausal. I'm like, what are you talking about? Because it didn't even occur to me. And she's like, no, that can be 10 years. I'm like, oh, I didn't realize that. That being said, I didn't do anything about it until a year ago when I started taking hormone replacement stuff, and it's massive. The vestibular migraines got better from a lot of different things I did, but just in terms of general energy and just weight gain and all that stuff got so much better once I started taking hormones. And I feel like I speak to all of my friends, and everybody has something with their tire. They're this or that. And I was just with my girlfriends a couple of weekends ago, and I said to two of them that I was with, I was like, you've got to get your hormones checked. I'm telling you something is going on with you. If you're feeling tired, if you're feeling like Non-motivated or like get them checked and they both like we're like, okay I'm making an appointment on Monday because I just think there's not a lot of awareness. No one knows who to go to Regular doctors like my OB like literally has never had a conversation with me about it I mentioned at one time and she was like, oh, yeah, you can take and it was like synthetic prescription She wanted to prescribe me like there's just such little I mean, there's a lot of education now because of obviously your podcast and all these wonderful people putting out information, but like the more science-based, you know, MDs that are obese do not talk about this. They're not even, even if they don't know about it, they should refer and be like, you should go see, you know, an integrated or whatever. It's just, it drives me crazy because to your point, things can be mitigated perhaps easier by just doing an estrogen cream or something.
SPEAKER_00:
I read zero to seven percent of medical doctors are taught anything about menopause and they're taught zero about perimenopause. They also aren't taught about bioidentical hormone therapy in med school. They have to actually go and take an extra course and pay out of pocket for that, which who's going to, what family doctor is going to go do that? None of them. And so they have no education in this. And then, so we're telling, you know, you're telling your friends and I'm telling you like, oh, go, just go to your doctor and get your hormones checked. You obviously are having hormone problems. Go have them checked. And then they come back and they're like, my doctor said everything's fine. Every time. Because they'll look at the ranges, say, oh, you fall between 100 and 1000. So you're fine because you're at 101. or something like that. The ranges are ridiculous. They don't tell women to take that test on a certain day of their cycle, which is really important. So if they test it on day three of their cycle, it's going to look like they have no estrogen or progesterone. If they test on day 12 of their cycle, they're going to look like they have this massive amount of estrogen and no progesterone and think, oh my gosh, you're estrogen dominant. Like, oh, Panic, panic. So it's, unfortunately we can't rely on doctors. I always say try because that's typically the cheapest route for most people, but please don't expect them to have an answer for you or to come back and say, oh yeah, you've definitely, you're going into perimenopause, let's help you with this. They don't know how to do that.
SPEAKER_01:
So for our listeners, um, sorry, Katie, did you want to go?
SPEAKER_02:
No, I was just going to say, no, you go ahead. Cause we're probably going in the same direction.
SPEAKER_01:
Yeah. I let's break down just kind of like a one-on-one here. So anyone like, what are some of these like surprising symptoms or just symptoms in general of perimenopause? Because I think, you know, it would be helpful for our listeners to understand what that could entail. I'm sure it's a laundry list, but.
SPEAKER_00:
Yes, yeah, there's a lot of, there's a massive list of what perimenopause, it's usually perimenopause too. I think everybody has it in their head. I know I did. It was like if someone had asked me in my 20s or even 30s, what do you think menopause is? And I would have been like, oh, you know, when I'm in my 50s, my period's just going to disappear. I might have a few hot flashes, maybe gain a little weight and then it's over. and you're an old woman, or not an old woman, but you're getting to the second half of your life and you have no more period, and that's what it entails. And that's the furthest thing from the truth. Hairy menopause, we're seeing starting actually earlier and earlier because of the toxic environment that we're in, because of the stress that we're now under. We're now seeing it starting anywhere typically at mid-30s to late-30s for women. That is the typical age that we start to see perimenopause kick in. It can happen earlier, it can happen later, but typical, the majority of women, that's where we're going to see things starting to go amiss. And so first things that women will notice is period changes, heavier cycles, more emotional, maybe can't sleep around their cycle, maybe get some night sweats around their cycle. and they'll put on a few pounds of weight, typically no more than five pounds, but it kind of comes out of nowhere. You'll be like 38 and suddenly you wake up and you're five pounds heavier. You're like, I didn't change anything. Like what's going on here? That is the shift that starts to happen is that we don't ovulate as often. So as we get older, we don't ovulate as often because we come into this world with X amount of eggs. And so once those eggs are done, you no longer are going to be ovulating. And so we start to get months where there's no ovulation. And when there's no ovulation, we don't produce the bulk of our progesterone in the second half of the cycle. And if anybody here has ever tracked their cycle to get pregnant, we all track for to see what you check your basal body temperature every day. And you look for a spike in temperature on day 14, which is when you should be ovulating around that time. Temperature goes up and stays up for the second half of the cycle means you've ovulated and then it drops and then your period comes and the cycle starts again. So think of basal body temperature as a reflection of your metabolism. And so if you're no longer ovulating all the time, your basal body temperature isn't going up in the second half of that cycle. And there's not a lot of progesterone being produced. We produce a little bit of the adrenal system, the brain and the spinal cord, but very minimal compared to the ovaries. So now you've got the second half of the cycle, the temperature doesn't come up, which means metabolic rate's not coming up. Progesterone's really, really important for thyroid function. It also buffers the cortisol. There's no such thing as a progesterone steal, cortisol steal. I think there's a lot of misinformation around that, but they do have this relationship with each other where progesterone, because it's so calming and so anti-anxiety, it can really help tamper down cortisol levels and just stress in general. It's very calming. So now we are getting more anxiety, basal body temperature goes down, and progesterone acts on what's called the GABA receptors of your brain. And without it, we can have trouble sleeping because GABA, you've seen it in supplements, is very calming, it's anti-anxiety, and it induces sleep. So now we've got some insomnia, metabolic rates going down, we've got anxiety. Now we're probably eating worse, right? Because of all of that put together, we're more insulin resistant. The weight can continue to creep up at this point because of this like perfect storm of what's happening as we're starting to lose that progesterone. Some women will begin to lose testosterone as well. Testosterone we make in the ovaries as well as the adrenal system. It's almost about a 50-50 ratio. and so some women will start to lose it through the ovarian function and a hundred percent of our estradiol or estrogen in the ovaries is made from that testosterone. So if testosterone starts to go down, estrogen then can follow And then also if you're stressed out and the adrenal system's tapped, your testosterone can start going down as well through there. And testosterone is a woman's most abundant hormone when we're fertile, which most women don't know. So signs and symptoms of that coming down are, of course, the typical sex drive can start to go down. Women will notice that they can't put muscle on very well when they're working out. Muscle recovery. So after a workout, they just seem like they can't bounce back. Energy. Women will say all the time, like, oh, I'm just suddenly so tired. Women will be diagnosed with like chronic fatigue syndrome because the testosterone can influence energy that much. And you can think of testosterone as your lady balls. And it really does. It gives you that masculine kind of like get out there, get things done, be a little bit more aggressive with stuff. And so when we start to lose that, women find that they become more timid, like they can't get stuff done, they're tired, they don't want to work out, they don't want to have sex. And so that can start to kick in on top of the progesterone kicking in. As you start to get farther into your 40s, now estradiol starts to drop, and this is the primary hormone for women. Estradiol has a lot of bad press about it, but I tell you what, when that starts to go, that is when we see these horrible perimenopausal symptoms really kick in. And prior to that, you will see an estrogen dominance profile because you're losing that progesterone. We need progesterone to counterbalance estrogen. So that's why the heavy bleeding can start, the tender fibrocystic breasts before your period. because that's estrogen, which is proliferative growth. And so things can get out of control growth if we don't have enough progesterone. So you can start to get all of these symptoms because you're estrogen dominant, not so much that you have too much estrogen. but because in comparison to progesterone, and there isn't much, then you can start to get these symptoms of the estrogen dominance. So that's when, as I was saying before, that's when you typically would go to your doctor, because some women will start to bleed so heavily that they get anemic, they're bleeding, like they're going through a tampon every 20 minutes, and they're just like, oh my gosh, take it out. Like take the uterus out, get rid of it, I can't deal with this anymore. when it's they could have just used a little bit of progesterone. So anyways, as we start going in and losing the estrogen. then things really kick into gear. That's when we start to see the hot flashes, the night sweats for a lot of women, vagina dryness, and atrophy. So atrophy is like it actually dries and the walls of your vagina start to thin and they get really... Women will actually say to me, it's close because it dries so much and it atrophies so much, you can't actually get anything in there. You can't have sex with your partner. I've had women come to me in tears saying, oh, I haven't had sex with my partner for years because I tore last time. You know, you get these micro tears because it's so painful. And yeah, sure, you can try lubrication, but lubrication is different than vagina moisturizing than actual like your own vagina lubrication. It's much different than like going and getting yourself an over-the-counter sex lubrication. Very, very different. We want our own body to create the moisture down there so that we don't atrophy. And so that can start to happen. Depression, we need estradiol to help make serotonin. So a lot of women will now start to get depressed on top of the anxiety, thanks to the low progesterone. It has something to do with our sleep. So a lot of women will start to have even worse sleep. It's text drive. Estrogen is just as important as testosterone is for sex drive, sometimes more important. So it helps with sex drive. It helps with our skin. It helps to build collagen. So it helps with the wrinkles. So suddenly women will start to notice like, oh, my skin is suddenly aging really, really quickly. This is typically because they start to lose the estrogen. They can start to lose hair on their head, get a foggy brain because our brain is rich with receptors for estradiol. And so that's where the foggy brain comes in. You can't think straight. Women quit their jobs. This is a growing epidemic where women that are in these high up jobs that they need to be working, their brain needs to be working really, really well for it that they have to quit. We just had somebody a few weeks ago like that, and she said, I had to quit my corporate job because I couldn't think straight anymore because of the loss of hormones, Alzheimer's. And then we started to get susceptible to all of these diseases. So even if you're somebody that's super lucky, about 80 to 85% of women will have some degree of symptoms. 20 to 25% of those symptoms will be severe, We see the highest amount of suicide in women that are between the ages of 45 and 55. So if you're somebody though that you missed out on, you didn't have any of that happen to you, what's going on in the inside is also really important to take note of because you could not have hot flashes, still have a sex drive, all those good things. But what's going on on the inside, like we need estradiol for proper heart function, for bone protection, to ward off Alzheimer's and dementia, for our bowels to work appropriately, for our immune system to work appropriately, which is probably why you felt so great when you started hormones because it does really help with the immune system. It helps with thyroid function. So Then, of course, on top of all of this, the number one thing that we hear about and complain about is the weight gain. Everybody thinks estrogen is going to make them gain weight, but the loss of estradiol will cause more weight gain than any other loss of hormones because it's so important for blood glucose. for insulin sensitivity and blood glucose control, it has a huge impact on that. And then as we start to lose it, we become more insulin resistant. We start to put on that midsection weight gain, which is the worst place to carry fat. We see type two diabetes go through the roof in menopausal women. So there's just a little list, actually. Yeah, right. We could keep going.
SPEAKER_01:
I mean, we just have, like, the... We're the ones who have the babies. We're the ones who have to go through this. Like, I mean... Oh, it's terrible.
SPEAKER_00:
Yeah, I hate sounding so doomsday. No, but this is the truth. Right. There's so much we can do about it, and we'll talk about that.
SPEAKER_02:
Yeah, yeah. And there's so many things to like, you know, as you were naming each phase, I was thinking, Oh, I remember that. And then that's when like, my hip pain started. And I remember that happening. And that's what you know, it's like, right, and like all the inflammation and And when my progesterone, I look back and I think, I kind of think I know when my progesterone started to tank because I was like angry and like I was so stress intolerant. And if my kids were screaming, I would scream at them instead of being able to just coolly handle it. You know what I mean? So it's really, amazing how much it can impact every aspect of your life and how it can, every woman can experience similar things with different things at the same time. So let's get into what can we do about it? And how can we get all of our great mojo back and feel good again? Tune in next week for our part two with Karen Martell, where we get into how we can survive through perimenopause, not only survive, but thrive. She goes deep into bioidentical hormone replacement therapy and more. If you don't want to miss it.
SPEAKER_01:
Thanks for listening to Nirvana Sisters. For more information on this episode, check out the show notes, please subscribe, and leave us a review. Also, find us on Instagram at Nirvana Sisters. If you loved what you just listened to or know someone that would, please share it and tag us. Tune in next week for a fresh new episode of Nirvana Sisters. We'll continue to watch out for all things wellness so you don't have to. Bye.