Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

Today, I’m honored to speak with Dr. Eleonora Teplinsky, a board-certified medical oncologist specializing in breast and gynecologic cancer, with over a decade of practice. She is Head of Breast and Gynecologic Medical Oncology at Valley Mount Sinai Comprehensive Cancer Center in Paramus, New Jersey, and a clinical assistant professor of medicine at Icahn School of Medicine at Mount Sinai. She also hosts the Interlude podcast, where she shares stories from people affected by cancer, and is the author of Beyond the Pink: Navigating Life, Health, and Breast Cancer. In our conversation, we discuss breast cancer risk, genetic testing, cancer incidence in older and younger women, and treatment options following a new diagnosis, including surgery, chemo, and medication therapies. Dr. Teplinsky shares her approach to fertility preservation, menopause after cancer, body image, and the emotional aspects of diagnoses and care. We also explore lifestyle factors, survivorship, long-term cardiovascular risk after cancer treatment, DEXA scans, lipids, coronary artery calcification scoring, and the importance of advocacy, quality of life, and long-term goals. Stay tuned for a thoughtful conversation about breast cancer and breast cancer survivorship, informed by Dr. Teplinsky’s expansive approach to care. Her book, Beyond the Pink, is one of the most thoughtful books I’ve read on breast cancer and survivorship, and a beautiful testament to the quality of care she provides. IN THIS EPISODE, YOU WILL LEARN: Common misconceptions about breast cancer risk The future of personalized breast cancer screening How genetic testing can help clarify breast cancer risk and inform screening decisions What may be contributing to the increase in breast cancer among younger women How Dr. Teplinsky approaches a new breast cancer diagnosis and treatment planning How Dr. Teplinsky helps patients navigate body image, grief, and surgery How Dr. Teplinsky approaches fertility preservation and treatment for younger women Which options are available, and which remain debated, when navigating menopause after breast cancer How cancer treatment side effects can make it difficult to start or maintain an exercise program How patients can advocate for themselves and how loved ones can provide support Bio: Dr. Eleonora Teplinsky is a board-certified medical oncologist specializing in breast and gynecologic cancers. Through her clinical work, media presence, and digital platforms, she has built a reputation for translating complex medical information into clear, compassionate, and actionable insights—empowering women to navigate cancer, survivorship, and long-term health with confidence. Her forthcoming book, Beyond the Pink, represents a critical shift in how breast cancer is understood, discussed, and lived through—moving beyond diagnosis and treatment to address the full scope of survivorship and long-term health. The book fills a significant gap in patient education by focusing on what happens after cancer care ends. Blending clinical expertise with patient-centered guidance, Beyond the Pink offers a comprehensive, actionable roadmap for navigating menopause, fertility, cardiovascular health, sexual health, mental well-being, and life after cancer. ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Cynthia Thurlow  Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Eleonora Teplinsky On all social media: @drteplinsky Beyond the Pink: Navigating Life, Health, and Breast Cancer is HERE.

Today, I’m delighted to reconnect with Dr. Bill Rawls, a physician with over 30 years of medical experience. His personal battle with chronic Lyme disease led him to explore holistic and herbal therapies. After restoring his health, he became a leading voice in cellular wellness and modern herbology. He founded Vital Plan, where he developed the RESTORE180 Herbal Protocol to help others reclaim their health, and he is the best-selling author of Unlocking Lyme and The Cellular Wellness Solution. In our conversation, Dr. Rawls and I discuss midlife vulnerability, including the loss of stress resilience, the impact of peak fertile years, perimenopause, and menopause, and how these directly impact cellular and lifestyle stressors. We explore chronic illness as a cellular problem, how we live in a state of managed illness, and five stress factors that add to cumulative cellular stress. We discuss tick-borne illnesses, adaptations and dormancy, how autophagy may impact cellular stress, detoxification, inflammation, sympathetic tone, and key herbs to support detoxification. Dr. Rawls also shares his love for adaptogens, especially ashwagandha, and their impact on stress resilience, along with his recommendations for nutrition, intermittent fasting, and books. Stay tuned for a truly invaluable conversation about why many women in midlife, despite being on optimal hormone therapies, still don’t feel any better—and how it all goes back to cellular stress and mitochondrial health. IN THIS EPISODE, YOU WILL LEARN: How mitochondrial dysfunction and cellular aging contribute to symptoms midlife women and men may experience Why perimenopause may cause cellular stress and dysfunctional cellular messaging What happens to our cells and mitochondria as we begin to age? Dr. Rawls explains why he describes chronic illness as a cellular problem The five major stress factors that impact cellular health How certain microbes, including tick-borne microbes and herpes viruses, can remain dormant in the body and reactivate with stress, menopause, or aging Why Dr. Rawls describes autophagy as an essential cellular housekeeping process  Why detoxification requires far more than a periodic cleanse or detox Dr. Rawls describes his process for integrating adaptogens into the lifestyles or protocols of midlife women and men Dr. Rawls shares some critical strategies for healthy aging Bio:  Dr. Bill Rawls is a physician with over 30 years in medicine whose own battle with chronic Lyme disease led him to explore holistic and herbal therapies. After restoring his health, he became a leading voice in cellular wellness and modern herbology. He is the bestselling author of Unlocking Lyme and The Cellular Wellness Solution, and the founder of Vital Plan, where he developed the RESTORE180 herbal protocol to help others reclaim vibrant health. ** For more information about Cynthia's upcoming retreat, visit ⁠https://www.cynthiathurlow.com/⁠ and click the Events tab. Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.   Purchase Cynthia’s book, The Menopause Gut.  Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Bill Rawls On his website Vital Plan Dr. Rawls’s most recent book, The Cellular Wellness Solution Recommended Books:  Adaptogens: Herbs for Strength, Stamina, and Stress Relief by David Winston Adaptogens in Medical Herbalism: Elite Herbs and Natural Compounds for Mastering Stress, Aging, and Chronic Disease by Donald Yance  Books by Rosemary Gladstar

Today, I’m excited to connect with Dr. Tanya Beaubrun, a family medicine physician specializing in functional integrative medicine, and a certified wellness and transformational coach. Dr. Beaubrun is also a motivational speaker and the author of Held and Healed. In our conversation, we discuss burnout and hormones, exploring how many women treat being busy as a badge of honor, and why it's important to reframe midlife and beyond. We unpack how the HPA axis regulates the body’s stress response, and look at metabolic health, the importance of advocacy, and the markers Dr. Beaubrun uses to manage her patients’ metabolic health. We also cover nutrition, Doctor TikTok, reframing menopause as power, and how this empowering time in women’s lives can help them come to terms with aging and longevity, and allow the younger generations to see what is possible. Stay tuned for today’s delightfully personal and highly informative conversation with Dr. Tanya Beaubrun. IN THIS EPISODE, YOU WILL LEARN: Why burnout can often go unrecognized in high-functioning women Dr. Beaubrun explains how she assesses metabolic health and the testing she uses How hormonal decline in midlife can affect the way women experience stress What the HPA axis is designed to do in the body How women need to be listened to by their clinicians without judgment  The metabolic and cardiovascular changes that women experience in midlife How Dr. Beaubrun helps women to focus on protein and nutrient density when they are busy Why healthy eating does not mean you have to avoid all the foods you love How healthcare providers can move from a paternalistic approach to a collaborative relationship with patients Reframing menopause as a powerful stage of life Bio: Dr. Tanya Beaubrun is a Functional and Integrative Medicine physician, wellness educator, speaker and author of Held and Healed. After more than 30 years in medicine—and following her own journey through burnout and recovery—she now helps women reconnect with their health by addressing the root causes of stress, hormonal imbalance and metabolic dysfunction.  Through her signature More Joy Method®, Dr. Tanya combines evidence-based medicine with compassionate whole-person care, empowering women to realize they are not broken—they simply need the right support to heal, thrive and rediscover joy. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Tanya Beaubrun On her website Instagram Dr. Beaubrun’s new book, Held and Healed

I am thrilled to welcome board-certified neurologist and six-time New York Times best-selling author Dr. David Perlmutter back to the Everyday Wellness Podcast for the third time. He is a fellow of the American Nutrition Association and serves on the board of directors. His most recent book is Brain Defenders. In this conversation, we discuss microglia, the brain’s immune cells, and explore their role in immune regulation, metabolism, and immunometabolism. We also examine why brain health prevention needs to start decades earlier, environmental threats, emerging therapies, lifestyle influences, especially alcohol consumption, and current brain-health research. Stay tuned for another invaluable conversation with Dr. David Perlmutter. I loved his latest book, which clarifies the role of immunometabolism — especially in midlife. IN THIS EPISODE, YOU WILL LEARN: How microglia support the neurons and nurture synaptic connections Why microglia can shift from being supportive to becoming destructive Dr. Perlmutter explains what immunometabolism means How metabolic issues can affect brain health decades before any cognitive symptoms appear Why Dr. Perlmutter considers exercise “brain medicine” The value of aerobics and resistance training for supporting brain health How chronic stress and environmental threats can affect brain health Dr. Perlmutter shares practical ways to reduce environmental threats to brain health The link between alcohol consumption and Alzheimer’s risk What emerging research shows about GLP-1s and neurodegenerative diseases Bio: About Dr. Perlmutter: Dr. David Perlmutter is a Board-Certified Neurologist and seven-time New York Times bestselling author whose work focuses on the intersection of neurology, nutrition, and brain health. A Fellow of the American College of Nutrition, he serves on its Board of Directors and on the Editorial Board of the Journal of Alzheimer’s Disease. His books, including the #1 bestseller Grain Brain, have been published in 32 languages and sold over a million copies. Dr. Perlmutter lectures globally at leading institutions and has been featured on major media outlets including 20/20, CNN, The Today Show, and Oprah. His contributions have earned him numerous national and international awards for clinical innovation and leadership. His upcoming book,⁠ Brain Defenders⁠, focuses on the pivotal role of microglia, the brain’s immune cells, in protecting, repairing, and reprogramming the brain for lifelong resilience, and is available now. ABOUT THE BOOK: Brain Defenders New York Times bestseller⁠ Brain Defenders⁠ reveals the powerful story of your brain's immune guardians (microglia) and how lifestyle choices can turn them into either fierce protectors or hidden saboteurs. The book directly challenges the notion that we now have meaningful treatments for diseases like Parkinson’s and Alzheimer’s. Despite FDA approval for drugs that reduce beta-amyloid, the book reveals that these drugs are not impactful and are actually profoundly dangerous. Packed with cutting-edge science and practical steps, Brain Defenders helps readers take charge of their long-term brain health and unlock lasting cognitive vitality. Connect with Cynthia Thurlow   Cynthia’s⁠ website⁠. Check out the Everyday Podcast on Instagram!⁠ www.instagram.com/everydaywellnesspodcast⁠ Follow on⁠ X⁠,⁠ Instagram⁠ &⁠ LinkedIn⁠ Submit your questions to ⁠[email protected]⁠  Join other like-minded women in a supportive, nurturing community:⁠ The Midlife Pause/Cynthia Thurlow⁠.  Purchase Cynthia’s book,⁠ The Menopause Gut⁠. Cynthia’s⁠ Intermittent Fasting Transformation⁠ Book ⁠The Midlife Pause Supplement Line⁠ Connect with Dr. David Perlmutter ⁠Brain Defenders⁠ Book On his⁠ website⁠

Today, I’m delighted to continue my conversation with Dr. Shivani Gupta about curcumin's science and its impact on mitochondrial and brain health. Dr. Gupta is the founder and CEO of Fusionary Formulas and the author of The Inflammation Code. She holds a master's degree and a PhD in Vedic sciences, and her dissertation focused on turmeric's role in inflammation, joint health, and cardiovascular health. In this conversation, we explore Ayurvedic medicine and daily rituals, body types and the five elements, and how they shape how we navigate our lives. We also spend significant time discussing how to find balance in midlife and the rituals Dr. Gupta has found particularly impactful for midlife women. This is another truly invaluable conversation with Dr. Shivani Gupta — one you will most likely want to revisit more than once. IN THIS EPISODE, YOU WILL LEARN: How much turmeric or curcumin you need to take daily to buffer inflammation  How curcumin supports the creation of new mitochondria as we age Dr. Gupta explains how Ayurveda uses the Vata, Pitta, and Kapha body types to understand individual differences How trauma or a major change can shift your Ayurvedic constitution The shift toward Vata many women tend to experience during the perimenopause to menopause transition, and how that may show up How to strengthen weak digestive fire  Dr. Gupta describes an Ayurvedic morning routine The value of using dry brushing as a simple daily ritual to support circulation and lymphatic flow The benefits of using abhyang massage as an Ayurvedic self-care ritual during menopause How stress and dysregulation affect the vagus nerve Bio: Dr. Shivani Gupta is an Ayurvedic practitioner, turmeric researcher, and founder of Fusionary Formulas. She holds a Master's degree in Ayurvedic Sciences and completed her PhD dissertation on turmeric, making her one of the world's foremost experts on its pharmacology and clinical application. She is the author of The Inflammation Code, published by Hay House, bridging ancient Ayurvedic wisdom with modern inflammation science. Dr. Gupta is known for making complex science accessible without dumbing it down — her work speaks equally to the everyday health-conscious woman and to clinicians who want to go deeper. ***Use the code CYNTHIA for 15% off at FusionaryFormulas.com. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Shivani Gupta On her website Use the code CYNTHIA for 15% off at FusionaryFormulas.com Instagram YouTube Facebook Pinterest Fusionary Formulas  The Inflammation Code (Book Website) The Inflammation Code Podcast

Today, I’m honored to speak with Dr. Kumkum Patel, a double board-certified gastroenterologist and neurogastroenterologist who specializes in the gut-brain-pelvic floor connection. In our conversation, we talk about IBS and stress in midlife, exploring the impact of the enteric nervous system, key risk factors for colorectal cancer, and how stress affects women differently in perimenopause and menopause. We discuss the influence of proton pump inhibitors, bile acid diarrhea after gallbladder removal, how women’s microbiome changes through the menopausal transition, and clues that indicate the estrobulome is optimized. Dr. Patel explains visceral hypersensitivity, the influence of motility, pelvic floor dysfunction, constipation, and why constipation should not be normalized. She also explains how she addresses tears, hemorrhoids, and fissures; what to do when standard approaches stop working; nutritional interventions; and how she uses microbiome testing. Stay tuned for today’s insightful conversation with Dr. Kumkum Patel about IBS, the gut-brain axis, and the menopausal transition. IN THIS EPISODE, YOU WILL LEARN: How stress affects the gut-brain axis The red flags that help Dr. Patel distinguish IBS from colorectal cancer or other conditions, and why midlife bowel changes should be evaluated How long-term PPI use can create additional problems, and how automatic refills contribute to prolonged use How bile acid diarrhea can occur after gallbladder removal, and other causes that may explain persistent diarrhea Symptoms that could indicate that a woman’s gut microbiome and estrobolome may not be functioning optimally How gastrointestinal and pelvic symptoms change during the menstrual cycle as women approach menopause How pelvic-floor dysfunction contributes to constipation Lifestyle changes that can help manage hemorrhoids and fissures and reduce further irritation How people who can eat most foods can improve their diet before adding supplements Where microbiome testing fits into Dr. Patel’s practice and why she uses it cautiously Bio: Dr. Kumkum Sarkar Patel is a double-board-certified gastroenterologist practicing in Orange County, California. She specializes in irritable bowel syndrome, swallowing disorders, pelvic floor disorders, and women's GI health. She graduated Magna Cum Laude with honors, with a Bachelor of Science degree in Biomedical Engineering from Virginia Commonwealth University. She earned a Master's degree in Public Health from Dartmouth Medical School at the Dartmouth Institute for Health Policy and Clinical Practice, and her medical degree from St. George’s University School of Medicine. She completed her internal medicine residency at NYU Winthrop Hospital and then did a Gastroenterology fellowship at the University of Illinois in Chicago. Dr. Patel completed specialized training in GI motility disorders at Washington University in St. Louis through the American Neurogastroenterology and Motility Society.  Dr. Patel moved to Southern California with her husband and two young sons in July 2020. Dr. Patel currently serves as a healthcare consultant and speaker for medical device and pharmaceutical companies. She also serves on the American College of Gastroenterology's Women in GI Committee to promote advancement for women in GI. Additionally, she is a passionate motivational speaker who has spoken nationally about women's health, work-life balance, postpartum depression, and gut health related to stress and mental health. In September 2022, Dr. Patel hosted the Equity and Levity Summit in Orange County, California, the first-of-its-kind women's empowerment conference. She was named the 2023 Healthcare Innovator of the Year by the Irvine Chamber of Commerce and named a 40 Under 40 Top Leader in Irvine in 2024. She has been featured on KTLA5 News, CBS8, NBC California Live, as well as in print in Good Housekeeping, Popsugar Wellness, Authority magazine, and VoyageLA magazine for her expertise in gut health, IBS, and lifestyle tips. In 2024, Dr. Patel opened her own concierge solo private gastroenterology and wellness practice with 3 offices in Orange County and telehealth available nationwide. She aims to help each patient take charge of their gut and overall health through an integrative mind-body approach. She works closely with pelvic floor physical therapists, dietitians, surgeons, and other practitioners to provide comprehensive GI care. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Kumkum Patel On her website Instagram

Welcome to the latest Midlife Minute. In this episode, I answer questions related to disordered relationships with food, relative energy deficiency, bone health, and intermittent fasting.  Stay tuned to find out what can happen to your body when you’re undernourished, and how to approach intermittent fasting in a way that supports your health rather than adding more stress. IN THIS EPISODE, YOU WILL LEARN: How fasting culture can sometimes intersect with undernourishing the body The link between a lifetime of anorexia, fasting, and restrictive eating and lower bone mineral density in midlife The importance of restoring energy availability The endocrine and metabolic changes that can accompany loss of the menstrual cycle When transdermal estradiol and progesterone may be appropriate if menstrual recovery does not occur The importance of getting enough protein, fiber, healthy fats, and overall nourishment when fasting intermittently What to consider when using electrolytes during a fast Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research: 1. Relative Energy Deficiency in Sport (REDs): Endocrine Manifestations, Pathophysiology and Treatments. Endocrine Reviews. 2024. Angelidi AM, Stefanakis K, Chou SH, et al. Review 2. The IOC Consensus Statement: Beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine. 2014. Mountjoy M, Sundgot-Borgen J, Burke L, et al. 3. Eating Disorders. Lancet. 2020. Treasure J, Duarte TA, Schmidt U. Review 4. Eating Disorders. The Journal of the American Medical Association. 2025. Attia E, Walsh BT. Review 5. All-Cause and Cause-Specific Mortality Risk in Individuals With Eating Disorders: Systematic Review and Meta-Analysis of Relative Risk and Aggravating or Attenuating Factors. World Psychiatry: Official Journal of the World Psychiatric Association. 2026. Semchishen SN, Højlund M, Lemaire D, et al. Recent 6. ACOG Committee Opinion No. 740: Gynecologic Care for Adolescents and Young Women With Eating Disorders. Obstetrics and Gynecology. 2018. Committee on Adolescent Health Care Guideline 7. Fractures in women with eating disorders—Incidence, predictive factors, and the impact of disease remission: Cohort study with background population controls. The International Journal of Eating Disorders. 2020. Frølich J, Winkler LA, Abrahamsen B, et al. 8. A Systematic Review and Meta-Analysis of the Association Between Eating Disorders and Bone Density. Osteoporosis International: A Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2016. Robinson L, Aldridge V, Clark EM, Misra M, Micali N. SR 9. Bone Health in Adult Women With ED: A Longitudinal Community-Based Study. Journal of Psychosomatic Research. 2019. Robinson L, Aldridge VK, Clark EM, Misra M, Micali N. 10. Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-Analysis. Sports Medicine. 2025. Gallant TL, Ong LF, Wong L, et al. SR 11. Impact of Relative Energy Deficiency in Sport (REDs) on Bone Health in Elite Athletes: A Retrospective Analysis. Journal of Cachexia, Sarcopenia and Muscle. 2025. von Brackel FN, Munzinger R, Bartosik M, et al. Recent 12. Medical Complications of Anorexia Nervosa. Pediatrics. 2025. Trapani S, Rubino C. 13. Screening for Eating Disorders in Adolescents and Adults. The Journal of the American Medical Association. 2022. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Review

I am thrilled to have Gary Taubes back on the show today. (He was with me before on episode 137. Gary is an investigative science and health journalist whose work has been pivotal in catalyzing the low-carb keto movement. He has written many books, including his most recent, Rethinking Diabetes, and his articles are in many of the best anthologies. He has also received many science awards. Today's discussion is particularly significant, given the recent report from the American Diabetes Association revealing that the annual cost of diabetes in the United States reached a staggering $412.9 billion in 2022, with individuals diagnosed with diabetes now representing one in every four dollars spent on healthcare.  In our discussion today, we dive into the history of diabetes, pertinent statistics, the prevailing standard of care, and the transformative influence of insulin on diabetes management and reactive hypoglycemia. Gary provides insights into his reactions to GLP-1s, the integration of medical and nutritional science into medicine, and the influence of organizations such as the American Diabetes Association, AHA, USDA, and NIH. Our discussion also extends to the effects of pharmaceuticals, the shortcomings of our approach to diabetes management and of existing models, and the challenges the low-carb community faces. Stay tuned for today's eye-opening conversation, where we shed light on the complexities of diabetes care and explain how simple lifestyle changes can tremendously improve quality of life. IN THIS EPISODE YOU WILL LEARN: Rethinking Diabetes is a groundbreaking exploration of diabetes diagnosis, management, and treatment Gary discusses the evolution of evidence-based medicine Why the traditional medical approach to treating diabetes is inadequate How the guidelines of the American Diabetes Association were based on outdated assumptions  How medical treatments compare with lifestyle changes for managing diabetes Controversies surrounding how the pharmaceutical industry has influenced the way medical associations have shaped their diabetes management policies How medical guidelines and dietary advice have evolved What constitutes a healthy diet? How patients often have trouble following diet recommendations, despite their best intentions Is obesity a hormonal disorder or caused by overeating?  Connect with Cynthia Thurlow   Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Gary Taubes On his ⁠website⁠ ⁠Twitter⁠ ⁠Facebook⁠ Previous Episode Mentioned ⁠Ep. 137 – High Blood Sugar Levels and Long-Term Damage with Gary Taubes⁠ Book Mentioned: Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments is available from most bookstores or on ⁠Amazon⁠.

Welcome to this week’s Midlife Minute! Today, I examine partial and full hysterectomies and what we know about their potential long-term effects, clarifying what the research tells us about bone, brain, and cardiovascular health, and what women should discuss with their healthcare providers before and after surgery. IN THIS EPISODE, YOU WILL LEARN: How a partial hysterectomy differs from a full hysterectomy, and the abrupt estrogen changes ovarian removal can produce  Why having a hysterectomy before ages 40-45 can have a greater impact than having surgery closer to natural menopausal age. How a hysterectomy can impact women’s bone health What the research reveals about the connection between surgical menopause at a younger age, cognitive decline, and Alzheimer’s pathology How a hysterectomy can affect women’s cardiovascular health Why starting HRT early after an early-age hysterectomy could be important for your long-term health Why younger women who experience surgical menopause may require higher estradiol doses than the standard menopausal regimens The importance of advocating for yourself, understanding your personal risk, and talking with your clinician about estrogen and other hormone therapy before undergoing surgery Quotes: “Start those conversations early- before you ever have surgery.” “If you are having these surgeries done before 45, before 40, you need HRT!” “We have to manage our stress.” “We have to get enough sleep.” “We should be strength training.” “We should be physically active.” “We should be eating an anti-inflammatory diet.” Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research: Increased Risk of Osteoporosis With Hysterectomy: A Longitudinal Follow-Up Study Using a National Sample Cohort. American Journal of Obstetrics and Gynecology. 2019. Choi HG, Jung YJ, Lee SW.  Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al. Cardiovascular Disease After Hysterectomy in the Nurses' Health Study and Nurses' Health Study II. Obstetrics and Gynecology. 2025. Thao V, Borah B, Stewart EA, et al. Treatment of Women After Bilateral Salpingo-oophorectomy Performed Prior to Natural Menopause. The Journal of the American Medical Association. 2021. Kaunitz AM, Kapoor E, Faubion S. Hysterectomy, Oophorectomy, and Bone Health: A Systematic Review and Meta-Analysis. European Journal of Endocrinology. 2025. Shariful Islam M, Tuesley KM, Wilson LF, et al. Risk of Osteoporosis and Fracture After Hysterectomies Without Oophorectomies: A Systematic Review and Pooled Analysis. Osteoporosis International. 2022. Xu W, Wu W, Yang S, et al. Hysterectomies Are Associated With an Increased Risk of Osteoporosis and Bone Fracture: A Population-Based Cohort Study. PloS One. 2020. Yeh YT, Li PC, Wu KC, et al. Age at Surgical Menopause Influences Cognitive Decline and Alzheimer Pathology in Older Women. Neurology. 2014. Bove R, Secor E, Chibnik LB, et al. Reproductive Period and Risk of Dementia in a Diverse Cohort of Health Care Members. Neurology. 2019. Gilsanz P, Lee C, Corrada MM, et al.  Examining the Association of Hysterectomy With and Without Oophorectomy on Cardiovascular Disease and All-Cause, Cardiovascular or Cancer Mortality: A Systematic Review and Meta-Analysis. BJOG: An International Journal of Obstetrics and Gynecology. 2024. Chen Y, Li F, Liang L, et al. Association of Premature Natural and Surgical Menopause With Incident Cardiovascular Disease. The Journal of the American Medical Association. 2019. Honigberg MC, Zekavat SM, Aragam K, et al Optimizing Health After Early Menopause. Lancet. 2024. Mishra GD, Davies MC, Hillman S, et al. Hormone Replacement Therapy for Women Previously Treated for Endometrial Cancer. The Cochrane Database of Systematic Reviews. 2018. Edey KA, Rundle S, Hickey M.

This episode is sponsored by Life Extension. I am delighted to have Dr. Crystal Gossard, the Manager of Education at Life Extension, joining me today. Dr. Gossard is a Doctor of Clinical Nutrition with over 15 years of experience in nutrition, fitness, dietary supplements, and integrative functional medicine. In our conversation today, Dr. Gossard and I discuss uncommon heart health testing, including gaps in care for women in perimenopause and menopause, and clarify the critical importance of a bioindividual personalized approach. We dive into specifics on labs, including ApoB as a direct measurement, the influence of glycation, insulin resistance and insulin sensitivity, LP(a), and high-sensitivity CRP as both a marker of systemic inflammation and a targeted inflammatory profile marker. We also cover oxidized LDL, inflammation and oxidative stress, the importance of CoQ10, and screening modalities like coronary artery calcium scoring, CCTA, CT angio, and Cleerly, and minerals, including magnesium and its role in over 600 enzymatic reactions in the body. ***Try Life Extension https://www.lifeextension.com/Cynthia10labs @LifeExtensionWelleness and save $10 on orders of $50 or more, plus free shipping, with code: Cynthia10 IN THIS EPISODE, YOU WILL LEARN: The importance of advanced lab testing for cardiovascular and metabolic health in women, particularly during perimenopause and menopause What ApoB reveals about cardiovascular risk Why Dr. Gossard considers LP(a) a one-and-done test How elevated high-sensitivity CRP can indicate inflammation “simmering” in the background How to manage inflammation through nutrition How Dr. Gossard explains oxidized LDL The value of CoQ10 for oxidized LDL When should someone move beyond lab work to cardiovascular screening? What magnesium testing can reveal How magnesium supports the body  Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Crystal Gossard Life Extension Instagram  LinkedIn Live Foreverish Podcast Try Life Extension and save $10 on orders of $50 or more, plus free shipping, with code: CYNTHIA10.

Welcome to the latest Midlife Minute. Today, I answer some listener questions about bone health, osteoporosis, HRT, and the menopause transition. Stay tuned to learn more about bone loss, bone health, and proactive ways to protect your bone mass. IN THIS EPISODE, YOU WILL LEARN: Bone density loss during perimenopause Value of HRT for protecting bone mass during the menopause transition  If you’re using an estrogen patch and your estrogen levels are still low, what should you consider? How women with osteoporosis can continue strength training with guidance from a licensed medical provider What highly-active women who consistently under-fuel their bodies may experience Conditions and medications that could contribute to low bone density The value of DEXA scans and bone health markers Bone loss may accelerate during menopause  How HRT for osteoporosis prevention differs from HRT for established osteoporosis The benefit of AMH and FSH labs for identifying women who may benefit from earlier intervention Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

I’m honored to reconnect with Dr. Felice Gersh today! She is a multi-award-winning physician with dual board certification in OB-GYN and Integrative Medicine. We connected once before in Episode 221, where we spoke about PCOS and metabolic health. Today, Dr. Gersh joins me to dive into perimenopause and menopause. We discuss various issues surrounding the Women’s Health Initiative and talk about estrogen as a family of hormones, estrogen-mimicking chemicals, synthetic hormones, and oral contraceptives. We cover the importance of thyroid function, the pro-inflammatory state associated with estrogen loss in perimenopause and menopause, and the role of nutrition and exercise in metabolism. We also discuss lesser-known changes that occur in menopause, including changes in body odor, constipation, sarcopenia, osteoporosis, and vocal changes.  I plan to invite Dr. Gersh back to discuss women and mitochondrial health, and then again to talk about her latest book, Menopause: The Fifty Things You Need to Know.  Stay tuned to find out what menopause really is, and what it does to a woman’s metabolic system. IN THIS EPISODE YOU WILL LEARN: Dr. Gersh discusses the Women’s Health Initiative study and its devastating effects. The difference between synthetic and bioidentical hormones. How chronic diseases of aging can be delayed when hormones are incorporated along with other lifestyle refinements. What do hormones do? Why every immune cell in the body has receptors for vital hormones. Menopause may not be defined by a specific moment in time. Physiological changes that occur during the perimenopause years How hormones can change the perimenopause paradigm entirely. Perimenopause and sleep issues Phytoestrogens - nature’s gift to women Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Felice Gersh Website:⁠ Integrative Medical Group of Irvine⁠ Instagram⁠ Dr. Gersh’s books are available on ⁠Amazon⁠ Previous Episode Mentioned ⁠Episode 221 on PCOS with Dr. Felice Gersh⁠

Welcome to the latest Midlife Minute. This episode unpacks ongoing research on Lp(a), explores how women’s lipids change during the perimenopause-to-menopause transition, and clarifies what we can do about it. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How total cholesterol, LDL, and ApoB tend to rise most steeply around the final menstrual period, rather than increasing gradually with chronological aging Why women should have their Lp(a) checked both before and after menopause How oral and transdermal estradiol can affect LDL, HDL, triglycerides, and Lp(a) differently Why I recommend including ApoB when checking your lipids during the perimenopause window How your lifestyle can reduce your cardiovascular risk, even when your Lp(a) is elevated Why omega-3 fatty acids and commonly used lipid medications do not lower Lp(a) Why supplements are not replacements for statins in genuinely high-risk patients  I review the various PCSK9 inhibitors currently available, how they are administered, and their effects  How a CAC, a CT angiogram, and an AI-assisted CT angiogram can help women and their providers determine how aggressive their approach should be when Lp(a) is elevated Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to [email protected]  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association.Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline 2. Menopause: A Cardiometabolic Transition. The Lancet. Diabetes & Endocrinology. 2022. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T.Review 3. Dyslipidemia Across the Menopause Transition: Mechanisms, Trajectories, and Opportunities for Cardiovascular Prevention. Maturitas. 2026. Castaneda R, Tatit CP, Hurtado Andrade MD, Faubion SS, Shufelt CL.RecentReview 4. Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. 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Effect of Lipid-Lowering Therapies on Lipoprotein(a) Levels: A Comprehensive Meta-Analysis of Randomized Controlled Trials. Atherosclerosis. 2025. Xie S, Galimberti F, Olmastroni E, et al.Recent 22. Effect of Omega-3 Fatty Acid Supplementation on the Postprandial Metabolism of Apolipoprotein(a) in Familial Hypercholesterolemia. Journal of Atherosclerosis and Thrombosis. 2023. Ying Q, Croyal M, Chan DC, et al.RCT 23.Lipoprotein(a) and Cardiovascular Disease. Lancet. 2024. Nordestgaard BG, Langsted A.Review 24. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022. Reyes-Soffer G, Ginsberg HN, Berglund L, et al.Guideline 25.Clinical Trial Design for Lipoprotein(a)-Lowering Therapies: JACC Focus Seminar 2/3.Journal of the American College of Cardiology. 2023. 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Cardiovascular Imaging. 2022. Osborne-Grinter M, Kwiecinski J, Doris M, et al.Clinical Trial 30. AI-Guided Quantitative Plaque Staging Predicts Long-Term Cardiovascular Outcomes in Patients at Risk for Atherosclerotic CVD. JACC. Cardiovascular Imaging. 2024. Nurmohamed NS, Bom MJ, Jukema RA, et al.Observational 31. The Lancet Commission on Rethinking Coronary Artery Disease: Moving From Ischemia to Atheroma. Lancet. 2025. Zaman S, Wasfy JH, Kapil V, et al.Review 32. Efficacy and safety of novel lipoprotein(a)‐targeted therapies: A systematic review and meta‐analysis of randomized controlled trials. Diabetes, Obesity & Metabolism. 2026. Santana AUL, Yusufzai MO, Freitas APS, et al. Recent Opinion