Unravel the Complexities of Women’s Hormone Health with guest Dr. Mariza Snyder

On this episode of The Brainy Moms podcast, functional practitioner and women’s hormone expert Dr. Mariza Snyder joins Dr. Amy and Sandy to share a wealth of information on everything from perimenopause and metabolic health to delivery systems for bioidentical hormones. If you're trying to better understand why you’re gaining weight, tired, getting migraines, or having changes to your period, you won’t want to miss this incredibly informative episode! In fact, we learned so much from Dr. Mariza that we’re already planning to have her back!

ABOUT MARIZA SNYDER:
Dr. Mariza Snyder is a functional practitioner, women’s hormone expert and the author of eight books. The newest book, “The Essential Oils Menopause Solution,” focuses on solutions for women in perimenopause and menopause and the #1 National Bestselling book, “The Essential Oils Hormone Solution,” focuses on balancing women’s hormones naturally. For the past fifteen years, she has lectured at wellness centers, conferences, and corporations on hormone health, metabolic health, nutrition, and detoxification. She has been featured on Dr. Oz, Oprah Magazine, Fox News Health, MindBodyGreen and many publications. Dr. Mariza is also the host of the top-rated “Energized with Dr. Mariza Podcast,” (with over 9 million downloads) designed to empower women to become the CEO of their health. 

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Transcript

DR. AMY: Hi, smart moms and dads. Welcome to another episode of the Brainy Moms podcast brought to you today by LearningRx brain training centers. I'm your host, Dr. Amy Moore joined today by my co-host, Sandy Zamalis, and we are super excited to have a conversation today with our guest, Dr. Mariza Snyder. 

Dr. Mariza is a functional practitioner. woman's hormone expert and the author of eight books. Her newest book, “The Essential Oils Menopause Solution” focuses on solutions for women in perimenopause and menopause, and the number one national bestselling book, “The Essential Oils Hormone Solution” focuses on balancing women's hormones naturally. For the past 15 years, she has lectured at wellness centers, conferences, and corporations on hormone health, metabolic health, nutrition, and detoxification. She's been featured on Dr. Oz, Oprah Magazine, Fox News Health, Mind Body Green, and many publications. Dr. Mariza is also the host of the top rated “Energized with Dr. Mariza” podcast with over 9 million downloads designed to empower women to become the CEO of their own health. Welcome Dr. Mariza.

MARIZA: Thank you so much for having me. 

DR. AMY: So we like to start each episode with just getting a little bit of background on our guests. And so we'd like to know, you know, who you are, what your background is, and what got you so passionate about women's hormone health? Like, what was the defining moment that made you focus your career on that? 

MARIZA: Yeah. Well, my biggest defining moment was really at the age of 30 years old, about 14 years ago, and I had been dealing with hormone issues since I can remember. Since my teenage years. But again, I think like a lot of young women, I was just gaslit. I was told, you know, “Cramps are just the way that they are. Your periods are going to be awful.” Like it's just kind of how it works for us as women. And so it really didn't kind of culminate for me until I was in practice. And at the same time dealing with some pretty intense symptoms. And the symptoms that really knocked me on my booty was chronic fatigue. I had been kind of a rushing woman from high school too. Like, you know, when we had that like 10-minute period to get to classes, I was in meetings with like the principal and, you know, in different classes, I was running everywhere that I went. And I basically ran myself directly into the ground by the time I was in practice at 30 years old. And I'll, I'll never forget when I woke up one of my mornings getting ready to go to work, I had a caseload of patients to go and see and I literally felt like I could not get out of bed. And I knew at that point that something was very wrong. Like, you know, there was one thing to have exhaustion by 3 p.m., but it was another thing to not even be able to wake up in the morning and to get myself, like I had to will myself out of bed that day. And I remember looking in the mirror as I finally like got myself out of bed, willed myself there. And I just, when I looked at myself, I didn't even recognize the person anymore. And I thought to myself like, “Oh my gosh, you're in trouble. You've got to do something different because you've got a lot more years to do life.” Because you know, I was only 30 and I remember, you know, going and like, there was this deep knowing it was my hormones. I wasn't exactly sure what was going on. And I remember going to another practitioner—cause you know, I learned to not ever treat myself personally—and the only thing that she recommended was more birth control and Xanax. And I remember coming out of that office with two scripts, not having any more information outside of the fact that my hormones were all over the place. And I knew in that moment when I was sitting in the car that I had to figure it out myself. I had to figure this out. And although it was a, probably a three-year process of getting myself back to better metabolic health, better optimized mitochondria and having my hormones working really in lockstep with me again, I also knew that I was one of millions of women who, whether it was 35 or 42 or whatever age that was, that we're feeling the shifts and changes of, you know, dysregulated hormones. Poor metabolic function and mitochondria that were beyond, you know, 50 percent capacity. And I decided that I wanted to be the change that so many women needed. And since I had been in that lived experience, I knew what it felt like to not function at all. I wanted to be able to help women in every capacity so that they're able to thrive because I knew that we were the epicenter of almost everything, definitely of families, definitely of community. We made the world go round. We brought life into this world. Like, if I was going to double down on somebody, it was going to be women. And so, and that has been the work I've been doing ever since. 

DR. AMY: I love that. I love that you can empathize and completely understand with your target population, right? That you're not saying, “Oh, I feel bad for you so I want to fix you.” You're saying, “I've been there. I've been in the trenches. I've been in that struggle. And so I want to focus on that because I get it.” And I think that that probably builds trust between you and all of your patients and readers and listeners as well. 

MARIZA: And I feel like I'm in the lived experience right now of perimenopause of what I consider to be the biggest transition that women face. There's so much at stake in this transition that I we get to get into hopefully today a little bit. But I'm very much in it. I'm 44. I'm heading into the eye of the storm. And so, you know, I, everything, everything that I do every single day kind of is around the landscape of, “What's happening? What is shifting? How can I really set myself up and the women around me so that we thrive or at least, at least navigate this with as much grace as possible, and then come on the other side with as much strength, endurance, and aliveness. So that we can carry forth the second half of our life. I think a lot of women don't realize is that half of our life is spent in either just transition of perimenopause and beyond. And so, you know, what does that get to look like? Who do we get to become and how do our bodies get to function in what I consider to be some of the most important years ahead of us? 

SANDY: So I love, thank you for sharing your story. Because I think the takeaway I took from that is that even with your education, it's not necessarily obvious that hormones are causing, kind of a train or, you know, a systemic reaction, right, that gets you to a place where you're at ground zero and have to rebuild all that again. So, would you tell our listeners, what are some common issues that you see among women regarding hormone health? Like, are there three things that almost every woman experiences when they approach perimenopause? Or is it just sort of this wide array of symptoms and so there's just no information out there to help us navigate this?

MARIZA: Well, it's a “Yes and.” So I can absolutely share what are the most distinguishable symptoms and changes. Well, I can talk about symptoms and I can also talk about physiological changes, what's happening on a physiological level when it comes to perimenopause. But then I can also share what are some of the most common things that you're going to recognize. Because a lot of times women are going to recognize the symptoms before they recognize the physiological changes that are happening. And then other women, they kind of breeze through those symptoms and then notice, “Oh, there's some changes to my cycle happening that are pretty glaringly obvious.” And so, uh, do you have a preference on where you would love for me to start? 

SANDY: No, jump in. 

DR. AMY: Let's start with the symptoms and then what's happening in the body that's creating or causing those symptoms. 

MARIZA: Absolutely. So I, and this is coming from experience. I have surveyed over 200,000 women in this particular transition, usually between the ages of late thirties into mid-fifties. So that's kind of where I'm pulling this research, but then also there is a lot of research to substantiate what I have seen in my own polls. And so the number one symptom that women report the most disruptive, he thing that they want to address the most, is the stubborn weight gain. And it's not often, it's not necessarily the reproductive hormones that are fully, driving the stubborn weight gain, especially the stubborn belly fat. I would say that it's more of the metabolic shifts and changes that are happening. And so we start to see a level of insulin resistance. And yes, does that tie into our reproductive hormones? Absolutely. As we start to see a decline in estrogen, especially in our mid- to late forties, we know that estrogen drives insulin sensitivity and the less estrogen that we are producing as we get closer to menopause, —which would say the average age of menopause is 51 years old, give or take, right—that as we see that decline, especially in our mid-forties, that we will start to notice an uptick in a redistribution of fat around the midsection. So all of a sudden, you know, where we're estrogenic, we were carrying it in our thighs and our booty and now it starts to redistribute it to over our belly. The other thing that begins to happen here is we start to see, you know, if cortisol has been any kind of an issue, we start to see a bigger deregulation of cortisol over time as well. That also lends to insulin resistance and more systemic inflammation that can lend to that stubborn weight gain as well. And so that those kinds of distributions begin to happen. And there's actually a stat right now that I consider to be very alarming, but that 88 percent of women by the age of 45 will have at least one or more biomarkers of metabolic disease and are more likely to be overweight or obese than men. So at a time where even 45 years old, we're not even to the menopausal mark, we're starting to see about almost 90 percent of us are struggling with some level of metabolic dysfunction. And what I really, what I kind of attribute that to, again, as I mentioned earlier, is that mitochondrial capacity. I believe that once we are under 50 percent mitochondrial capacity, right—the energy powerhouses of every single cell in the body—that we start to see our metabolic biomarkers creep up. So when I talk about metabolic biomarkers, I'm talking about fasting blood sugar. I'm talking about hip-to-waist ratio. I'm talking about blood pressure, triglycerides, cholesterol. When we start to see those coming out of normal range, that's when we know that there's a level of metabolic dysfunction due to the fact that our mitochondria are less effective than they used to be. And that all can tie into also the decline of those reproductive hormones, especially estrogen and testosterone, which I consider more build-you-up metabolically driven hormones. Progesterone, not so much. She's playing a role in cortisol, which can also again, lend to that inflammatory component. But if anything, when we have an increased amount of progesterone, in that luteal phase of our cycle, that second phase towards our period, you know, when everything kind of hits the fan, she actually drives a little bit of insulin resistance. Hence why we have those crazy cravings and we want to eat all the ice cream and the carbs before our period. It's because we've got that progesterone rise where we start to feel a little bit of insulin resistance heading towards our period. So it's a little bit different when we, when progesterone is dropping. She contributes more to less stress-resilience, more stress when she begins to decline, versus contributing to metabolic issues. So that's the first symptom that we, that women will really want to address. The second one is sleep. Or a lack thereof. You know, I was in a session with another metabolic doctor the other day. And he's like, “Women just don't sleep. They don't, they don't sleep because they have kids. They don't sleep because of perimenopause. They don't sleep because of menopause.” And although he was kind of being a little bit, I don't know, sarcastic, or I don't know, I wasn't really loving the flavor or the tone of how he was saying it, but he was right. He was dead on the money. And then if you've got women like myself, who had children at 41 years old, not only am I in the stage of my son co-sleeps with me, but also my hormones are shifting. Yeah. There's definitely a component of a lack of sleep. But we do know that women do struggle with sleep and it's probably one of the biggest complaints that I see from my community is that they are struggling to get to sleep or they are struggling to go back to bed when they wake up around three or four o'clock in the morning. So that's the second symptom that I see a lot of. And again, it has a lot to do with declining hormones. It also has a lot to do with our circadian rhythm and our cortisol and melatonin, you know, rhythms. And you know, how are we treating ourselves throughout the day? How are we setting ourselves up for sleep at night? And then what are, what are the components of the decline in estrogen and progesterone and what are the role that they're playing on our neurotransmitters and melatonin for bedtime as well? So that's another kind of another play. And then the other two biggest symptoms that I see from women in this phase is going to be fatigue and brain fog. And we could say that those are attributed to sleep or lack thereof. Or again, that metabolic component to of heightened insulin resistance, more metabolic dysfunction, and the decline of those reproductive hormones, progesterone, estrogen, and testosterone. So it can be hard to pinpoint exactly who it is that is playing a role in some of these symptoms. But I do know that the shift in the, basically the connection between our metabolic health and the decline of our reproductive hormones, they're very much all playing a role in the symptomology that women are experiencing in perimenopause heading into menopause.

SANDY: This is really random. I saw a video recently that was talking about some symptoms and things for perimenopause. Because I'm right there. I'm gonna be 50 in the spring. Yay me. And I have had itchy ears. I can't tell you for how long. And I, this is one of those things where I, you know, I'm thankful for social media because we're airing all the stuff that nobody ever knows about.

MARIZA: Oh my gosh. Especially today, more than ever. 

SANDY: But then they were talking about itching ears being a sign of perimenopause and I was like, what? 

MARIZA: Yes. Absolutely. 

DR. AMY: So what's the mechanism of that? Like, why? 

MARIZA: I think it as potentially a histamine response is what's going on or maybe, you know, a histamine response with kind of a, you know, the ebbs and flows, especially in our forties, we see more levels of estrogen dominance then we actually see a decline in estrogen. Kind of like estrogens on that roller coaster. And I think it has a lot, a little bit to do with, and unfortunately, I don't know as much about exactly what's happening with that histamine response. I just know that they're interconnected. And that when we see kind of surges of estrogen that may be driving some of those other estrogen-dominant symptoms, things like migraines before your period, heavy, painful periods, fibrocystic breasts, bloating with maybe that itchiness and that kind of like, the more allergy-type of symptoms as well, are often interrelated to maybe a histamine response that women seem to activate more in perimenopause.

SANDY: Mind blown.

MARIZA: That's, that's kind of the, and yes, that is definitely also UTIs kick up a little bit more. And hair loss, obviously, because of one of the things that we miss a lot with women is thyroid issues. And hypothyroidism that begin to take place, you know, I have one of my one of my best friends is like one of the thyroid experts and she always says that it's not a matter of if it's a matter of when your thyroid is going to start to slowly not work as well as it used to. And so you get it kind of, you know, it kind of collides with perimenopause and perimenopause and menopause symptoms. And we sometimes miss the boat. And so one of the things that I recommend to women, well before we even get to perimenopause or menopause, is know your numbers. And I can speak to the types of labs that I recommend or that I ask my women in my community to demand, as they're heading into this 10 -to 14 -eyar transition, you know, where we get onto the other side of, of menopause and post menopause. And so that's always the first step is like how, what we can change what we can measure, right? We can optimize what we can measure. And the more that we can know about what's happening with our hormones, our metabolic system, you know, our vitamins and minerals, you know, it really sets us up for understanding what is happening with our bodies as we move through these transitions and also to be tracking our cycle every single month so that you can know. You know, now my —like the first part of our cycle, that's going to change. It's going to be that luteal phase because we're going to start having anovulatory cycles, right? Cycles where we're not ovulating and ovulation is the main event. It's the main event. I don't know why periods, menstruation became the main event. It never was. It's all about ovulation. I mean, if you think about it, this entire body, our hormones, our metabolic system, our immune system, our brain, our bones, our organs, our cardiovascular system is built to prepare our uterus and our menstrual cycle every single month for 40 years to have a baby just in case. Just in case we want to be ready for it. And then we start the whole thing over again. And you're, I mean, the, the level of energy, metabolic energy that is required to run our 28-day menstrual cycle, where we are literally a different person every single day of that cycle, depending on where our hormones are at, like, it is all designed for that. And so. And if we, it's critical, mission critical, that we know what's happening with our cycle, whether you want to have a baby or not. I'm not, you know, I'm not, do you. But you’ve got to understand that this body, it is literally the prime, like mode of operation here is having a baby is preparing for creating life is the biggest marathon of all.

Right? And so it's, we have to, we have to at least honor that or recognize it, you know, and, and understand it because this is what's happening every single month, you know, for 40 years, until we start that second puberty, right? Where we start to step out. And so that's what I always recommend. Women, one, know your labs, know your numbers, and I can go over what those labs should be. And the number two is know your cycle because who you are on day 13 is not who you are on day 27. And I'd even argue who you are on day 24. Or day five, like I'm coming up on day five right now. Hallelujah. I'm about to I'm that that early testosterone and follicular estrogen is about to come into play. I'm about to step into my superwoman energy. I am desiring her. Okay, I'm ready for her to come back online. Right. And so I know what I feel like I know what day five feels like. I know what day 10 feels like I know who day 10 Mariza is. Let me tell you, she is not day 22. You know, and so, and you know what? You better look out when I'm day 27, Mariza. You know what I'm saying? Like everybody needs to know that I'm towards the end. I'm like day, the last day of my luteal phase, right? I'm stepping in. So it's important that we know our cycle so that we really can understand the hormone shifts that are happening and, and what to expect from our bodies on a metabolic level, on an emotional and mental level, and even on an energy level. And so that's what I always recommend to women, especially as we start to navigate this very interesting middle zone where your body is changing without permission. The more that you can understand what is actually happening, the better off you're gonna feel more prepared as your body is shifting.

SANDY: I think we need to know those labs. What do you think? Yes. 

DR. AMY: Yeah. Well, so let me, let me set that up for just a second. So, I also live in the functional medicine world, right? That is just a place where I am passionate about and, you know, have seen functional medicine physicians for a couple of decades. I actually had a hysterectomy, complete hysterectomy at age 37 and woke up with an estrogen patch on my butt. I had not been asked if I wanted a estrogen patch on my butt when I woke up from a radical hysterectomy. We were talking earlier before we even started recording about how all of this happens against our will, right? Like, we're not asked for permission for our bodies to go into menopause or perimenopause. And so I kind of felt like, “Oh my goodness. That was against my will. Like let's have a conversation about whether I want an HRT.” 

MARIZA: Well, and how we fail women a hundred percent when they have early hysterectomy, surgical menopause, you know, we, I mean that. Yeah, whether someone just slaps an estrogen patch on you or someone never mentions that this is a time where your hormones are supposed to be there, and yet they're not being produced anymore. Right. Yeah, that's oh. That's another way big conversation. 

DR. AMY: It is. So, okay. So, the reason that I mentioned that is because, of course, now it's been a struggle. I'm 53, so we're going on, you know, 15 years of, “Okay, what are my hormone levels? How do we know what type of HRT I need?” And so, you know, I've had physicians who actually test, other physicians who say, “Hey, we just treat symptoms because testing isn't always accurate.” And so, talk a little bit about how do we find out what our hormone levels are or need to be and how those are treated and then follow up then with the functional levels that you're looking for in terms of thyroid labs. Because we know that a traditional physician is gonna look at TSH and wait until it's six before they say, “Okay, maybe you need some help.” Whereas maybe a functional level is a lot lower than that. Anyway, so hit us with all that. 

MARIZA: Yes. Well, and I do want to premise one that testing isn't cheap. So I'm going to give you, I'm going to give you the quick and dirty of what I want you to ask for your primary. So ideally, I try to get all of my patients to go and run labs with a lot of us have insurance, you know, and insurance should work for us. To some degree, you know. So there are labs that I'm going to recommend here that you should be able to get from your practitioner, as a physical exam annually. And then I'm going to talk about functional labs that again, can get a bit more pricey. And you're absolutely right, you know, depending on the functional doctor that you're working with, they not only measure hormones at different times, they also may, some may do blood, versus Dutch, versus, you know, like urine metabolites. And so I will do my best to kind of like really clean that up as much as possible. And you know, and when to test. When did, when do you even test these suckers? Like, right? You know, the magic number is always 21 days. Yeah. If you have a 28-day cycle, you know? What if you don't? A lot of us do not.

And so I'll talk a little bit about that. But first of all, I want to run through is the … Because again, if a lot of this underpinning too is metabolic health as well. And I am convinced that it is. Because I know we love, we do, hormones are shifting and they're playing a major role. The one thing I will say is hormones are controlling metabolic health, if us making babies is what's driving the show every single month, best believe your, your reproductive hormones have a lot to say to your metabolism about how that's going to go down. But I also want to share, you know, again, especially women, so I just want to share some stats as well, 70 percent of dementia and Alzheimer's patients are women. We lead the charge on cardiac arrest and stroke, not men. We have more heart disease than men do. We have higher amounts of depression. We are 70 percent of all autoimmune conditions are women. We have 70 percent of all migraines. Patients are women, migraine sufferers. And that's would be me. I also have an autoimmune condition. I have Hashimoto's thyroiditis. And so I fall into that category too. And so if you look at it, there's something there too, that again, that interception between our hormones and our metabolic health that we're missing on a physiological level. And we're not realizing that, you know, although women are living longer than men, we are often living longer with a chronic condition. So I just wanted to just note that. And that's why the other reason why I think labs are so critical is the sooner that we can know some of these, especially if we know the tide turns, it's not in menopause, it's in peri. Then the better equipped we will be to know what's going on with our lab. Like as there, as we, every year we can see what's our triglyceride level? You know, where's our cholesterol? Where's our fasting insulin, our fasting glucose or hemoglobin A1 C? So Yeah. Those are labs that I think are super critical and important. So let's go overall lab. So I want, I want a full lipid panel, obviously. I want a full metabolic panel. I want vitamin D. I want to C-reactive protein. I want you to beg for a fasting insulin because we know that a hemoglobin A1C, which is kind of three months, kind of a three-month snapshot of your of your glucose, blood glucose levels, is still not going to give us the kind of information that a fasting insulin is going to give us, in which it can like basically dictate prediabetes or diabetes, you know, 10 years in advance. So get a fasting insulin. Beg for it. In the U S we have a really difficult time wanting to give people that. But if you don't, what you can actually do is you can take your triglycerides and divide them by your HDLs. And if that, and I'd love to see that number one or under one. But if you are around a two, when you divide triglycerides versus your HDLs, which they, you that's on a typical lipid panel, no problem there. If it's a two or close to a two, then we really got to start working on reversing some of that metabolic damage. Triglycerides, I know it says 150 milligrams per deciliter. I want it under a hundred. Especially for women. A lot of the average standard deviations of labs that are at your standard doctor's office do not really take on women's physiology as much as I believe that they should. So I want a hemoglobin, A1C of a 5.5 or lower. Ideally, optimally, I want fasting insulin around an 85 milligrams per deciliter or under. Again, these are optimal ranges and a fasting insulin under five. So those are the kind of things I'm looking for. Again, vitamin D, magnesium, B, like B12, B9. I want on that test against C-reactive protein as well. So I want to see if there's any level of inflammation. And then on the thyroid panel … And then obviously a CBC, get the full CBC, look at ferritin, look at iron. I want to see where that is, especially when we're in perimenopause and we may be dealing with some level of estrogen dominance. We may see more bleeding and maybe more a lean towards anemia. So I would love to see that as well, especially if energy levels are low. And then thyroid labs. Again, a TSH under two optimal. I want a T3. I want a T4. I want a free T3. I want a free T4. I also want to look at your TPOs and thyroglobulins. I just want to make sure you don't have an autoimmune condition like me. You know, especially when, you know, when I was, I probably misdiagnosed, we got misdiagnosed my thyroid issue probably three years. And it's because my labs looked great. But we didn't run a TPO and there was glaringly, I had, you know, an autoimmune component there. And so, and then I would love to see if indeed there's an issue of reverse T3 as well. But yeah, and note that thyroid-stimulating hormone is not a thyroid hormone lab. It is a pituitary hormone. And so we don't get a good sense of what's going on with your with T3 and T4. And so those are the things I would love to look at a full thyroid panel. And I'm trying to think if there's anything else. I also love to look at growth hormone. Then that's what I would ask for from blood labs. So that would be my pretty much from the top of my mind right now, without looking at my list in front of me, those would be the non-negotiables that I would love. If you could get an APOB, get it. If you, if you see something going on with your lipid panel that you don't love, that kind of kind of like flags you, you can order, you can ask for an advanced lipid panel or an advanced cardiovascular panel. They are out there to kind of see what's going on with any inflammatory markers. Then, hormones. Okay. So I usually, I personally run Dutch tests. So I run dried urine, your metabolite test, and I run it in the luteal phase of a woman's cycle. I recommend, I always say, you know, again, usually I told women to track their period, track their cycle for two to three months. So that they know, you know, that week prior to their period, like what is that week, as good as we can get it right. And then when I'm running those labs, I'm looking at, I'm looking at cortisol, I'm looking at organic acids, I'm looking at progesterone and estrogen and testosterone, and I'm looking at all of those estrogen metabolites, how they're being processed in the liver through those detoxification pathways. But I'm particularly looking and seeing like, is the ratio of progesterone and estrogen looking pretty good? It's usually a 300-to-1 ratio that I'm looking for, but also making sure that estrogen is going down the right pathways and that you've got enough progesterone to get you through. And the majority of time when I'm running these labs, you know, most women are lower in progesterone than they would love to be and estrogen isn't always clearing in the proper channels. And so I'm just kind of looking at all of this, um, as a kind of a conglomerate of information. And then if you're also working with a functional doctor, you know, I always would love a GI map test to just give me a better sense of what's going on with the microbiome. And that would be kind of a full composite. But at the very, very, very least, if you can't afford the hormone test and you can't afford the GI map, get the, get the blood labs from your primary care physician so that we get a better sense of what's going on metabolically. Because at the end of the day, if we can optimize your cellular metabolic health, everything benefits from that. Your feelings, your brain, your energy, everything! Everything that we do is reliant on our cellular metabolism, our cellular energy. And if at the very least we can make shifts and changes to your metabolic health, it's going to also have a profound impact on your hormone health, especially as you're transitioning.

DR. AMY: Yeah, I think I, I can't remember. I might misspeak here, but I feel like I've heard that insulin and estrogen push and pull on each other that insulin is a strong hormone as well. And most people don't give it enough.

MARIZA:  It's the hormone. It's the hormone, like it's, it's running the show. I would say if there were three universal hormones that I would put my focus on the most, it would be cortisol. It would be insulin and it would be thyroid. Those would be the first three I would look at first before I look at anything else, because I just know that they're … If you want to look at in terms of receptor sites on every single cell in the body, it’s definitely insulin, thyroid and cortisol. Those are what I consider to be survival hormones and metabolically driven hormones. And I think we always kind of shove those in a different category. It's like hormones are over here and then you've got these. But those are the stress and metabolic hormones. I mean, if your body is constantly in a state of you're being chased by a tiger, whether it's trauma or perceived stress, or you're just a mom juggling children and trying to get them to school every day, you know, cortisol is running the show too, and it runs tandem with insulin and thyroid. So I always want to see what's going on with those kind of first and foremost. You know, if nine out of 10 causes of death for women is higher than normal blood sugar levels, and I'm talking about early prediabetes, then I want to know what's going on with insulin. Because that's insulin resistance.

DR. AMY: So why do traditional physicians not address it at this level? Like, what is different about your training and functional medicine physicians’ training and interests that is driving this new information and new approach? 

MARIZA: I think that, you know, the way that, you know, traditional medicine practice, like medical doctors are being trained is that they're chasing symptoms. It's a very symptom-management system. It's not preventative and, you know, and where we've really missed the boat, you know, especially for women, is that I think we, we didn't take into account kind of the, what I had mentioned earlier is that our entire body systems are built around this cycle. And we just kind of pretended like that wasn't true, you know? And so it's not, it's not been into the, I would say even only in the last couple of decades, how we've really defined perimenopause, you know? We didn't even acknowledge menopause until the forties and fifties where we had Premarin. You know, once we had a medication for, you know, a synthetic estrogen and we were like, “Well, let's, everything's menopause.” And so, you know, it was like, oh, you're, you know, you've got this, you got that. That's menopause. And here we have this drug. And so I think we just, we've not done a great job of really understanding women's physiology and what we're, what's coming to the surface right now is again, not even, you know, we start to treat. I can't tell you how many times I've gotten labs where someone's got prediabetes. They don't know it. No one said anything because it's just not on the radar until we're close to diabetes. But what, what they don't, what doctors don't realize in what our medical system hasn't been updated on, is that by the time we have diabetes, type two diabetes, men and women, but particularly my area, my area of focus is women, it's too late. We are on the path towards metabolic destruction. And we're on the path towards, you already, you flagged cardiovascular disease, like, you know, yeah. Now maybe we're going to start treating diabetes, but what about the direction our bodies took towards cardiovascular disease and dementia? And so that's, that's where we're not telling women like, “Oh my gosh, your fasting blood sugar is 90 milligrams per deciliter. You're heading towards prediabetes. This means that your chance of heart disease and of dementia are going to be increasing significantly. But we don't really flag women until they're closer to 126 milligrams per deciliter.

And that's way, way past the point of no return. And so it's a lack of understanding that the mechanism of our metabolic disease state, is what I feel. And then I also not take into it, not taking into account that as our hormones decline, they're protectors. And for good reason. Again, they're protecting the most vital part of our biological system, which is bringing life into this world. Like that is so critical. That is, that is the most critical. We want to extend this, the species, women have got to have babies, you think is the way it is got to be. And so these hormones are really protecting us. Now we see that men start to see earlier signs of metabolic disease that women, because there's not as much happening. You know, they run a 24-hour testosterone cycle. It's a very different situation than we are, in terms of our infradian cycle, our menstrual cycle. But as we lose that hormone protection, we lose the build-you-up hormones like testosterone, estrogen, and then our stress-resilient progesterone. Then we start to see that whatever hormone scaffolding was holding up our metabolic health, begins to drop, begins to decline. And if we don't have a good solid metabolic foundation, it's kind of like we are thrusted into these chronic conditions as early as our kind of our mid mid-fifties. 

DR. AMY: All right. So we've talked about weight gain. We've talked about sleep. We've talked about chronic fatigue. What about low libido? So we know that this is something that nobody ever wants to talk about or admit, but it's happening to women. 

MARIZA: Yeah, let's talk about it. I mean, and also I, you know, beg the question of like women are like, “And does it matter?” I mean, some are feeling that way. Like some are just like, “I just survived teenagers. You know, my kids are finally going to college or off into the world.” I'm just being real, you know. And women are like, “The last thing on my mind.” But let's talk about it. There's a couple of things that are happening. You know, one, having a, having thriving mitochondria in a thriving metabolic system is going to help with our libido in general. To have the energy to want to be intimate, opposed to vegging out in front of the TV, watching. whatever show you're loving, right? Or scrolling on Instagram or Facebook or whatever that may be. You know, there's something to be said about like that level of like deregulation or like disassociation that kind of, we just can disconnect because intimacy and sex require energy. They require it. Let's just be honest. They do. And if you ain't got it, you know, it, you know, it's not going to happen. And so I think it's a couple of things. One, our metabolic health is struggling a little bit, especially as we move into this area, we do see an uptick again, 88 to 92 percent of us are dealing with some level of insulin resistance. So that mitochondrial capacity is definitely lacking. Estrogen is waning. And so is testosterone. A lot of women don't know that testosterone is the most biologically active hormone in the body and it peaks at 25 and then it slowly declines. So when you were feeling frisky at 25, there was a reason, you know. And you know, your testosterone levels at the age of 45 are 50 percent less than it was at 25. And so when you think about the two hormones of the three reproductive hormones that are slowly declining, testosterone and progesterone, that's happening in our thirties. And no one's telling us this. You know, we start to feel these shifts and changes. There's a reason our hormones are declining as early as, you know, 34, 35 years old. And so testosterone being one of those. So we see a lot of women with a lower level of testosterone by the time they're in their forties. They have--their estrogen is slightly dropping. Vaginal atrophy can be happening as well, so things are more painful. So like a topical estrogen is very safe, especially, especially for maintaining that the integrity of our vaginal walls. But then also the biggest elephant in the room, the most gigantuan taking up the biggest amount of space in the room is deregulated cortisol. It’s that cortisol response that we're in this rushing women …  I mean, I think about as a mom, a toddler mom, I'm 44. I mean, I got my son out the door today. It's a whole thing, right? I started prepping for drop off last night. You know, I get up an extra hour early, you know, to, just to get everything ready. My husband's sleeping with my son, you know, as to be honest, like it is what it is. And then, and then I go to work and then I become, then I do mom stuff. Like my day is 7 a.m. to 11, like 11. I'm in mom energy or I'm in practitioner energy, or I'm in partnership energy. Um, also as sure a chauffeur and a cook and a laundry …  You know what I'm saying? And then and my hormones are changing at the same time. How dare you, you know? Like, you know. So I think, you know, the reason why women are struggling with libido is that they're stressed. They're stressed to the nine, they've got a million things, you know? Here's a checklist for today, you know? It's gonna bleed over till tomorrow. Let me tell you, and, and so I think that that's it. So what do we do about it? That's the million-dollar question. So one, hormones can help, right? Little extra testosterone is long—you know, if you're noticing that you need it, there's lots of ways to build testosterone naturally. We don't actually have an FDA-approved dosage for women, by the way. So you can work with a functional doctor to compound that, or you can boost testosterone naturally. And I can talk about that in a second. You know, estrogen. Look at that. Make sure she's, I mean, I'll be honest with you. I believe in bioidentical hormones in perimenopause. If the unraveling is happening in our forties, why are we waiting until our fifties? If you don't have progesterone at 42, don't wait until you're 52. Get it now. You know what I'm saying? And so I'm a big proponent of use every tool in the toolbox. If  it were, if it's for you. If you're a candidate for it, which the majority of us are, use it all. Like use every— I'm not going to pretend I'm 40. I'm on progesterone and testosterone right now. Okay. That's what's happening with me. And I'm on thyroid hormone too. So I'm taking three hormones right now just to maintain a level of hormone integrity because I want to keep them for as long as possible. But also I would say everything that you can do to downregulate that stress response system. So until our bodies feel safe, until we feel safe, we're not going to feel the need for, we're not going to want intimacy. So the one hormone that can trump cortisol is oxytocin, the queen bee. And so whether it's hugging your children or hugging your dog or obviously hugging your partner, that can help bring back some of those, that intimacy, that libido. But I would have to say that it, we've got to get our stress under control. We've got to feel safe in our environment. We've got to feel nurtured. We've got to be supported. If we want libido to come back, a big part of that is feeling supported that we're not carrying everything. And a little bit of hormone support, a little bit of mitochondrial support, like adaptogens to help with our mitochondrial function in our, in our stress-response system. Those will all help to kind of regain that libido. But I would say that just like our metabolic health, it is really a multifaceted approach with stress being the epicenter of why we are not feeling the sexy time anymore. 

DR. AMY: All right, so we need to let Sandy read a word from our sponsor. When we come back, because we actually are running low on time, I do want you to speak a little bit to your recommendation for delivery method of bioidentical hormones, and then we'll wrap up with final thoughts when we come back. 

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DR. AMY: And we're back talking to Dr. Mariza Snyder about hormone health for women who are in perimenopause or menopause, or just thinking about what that's going to look like when they hit that time of their life. So, you mentioned talking to your doctor about having testosterone compounded, for example. What do you recommend is the best delivery method for bioidentical hormones? I like, I wear a transdermal patch for my bioidentical. 

MARIZA: I love transdermal patches, especially for estrogen. I take … I think oral Prometrium for progesterone is beautiful. And I do recommend, you know, when, especially when it comes to progesterone, cycling it. I think it, even in menopause, can be really beneficial. So kind of every two weeks coming off. I do progesterone during the luteal phase when we are—cause remember without ovulation, we don't make progesterone. We got to ovulate in order for that corpus luteum to release that gorgeous hormone that so many of us take for granted. So I recommend cycling, but usually Prometrium is done orally. Although, if indeed, you know, you're just getting started in perimenopause and you're just noticing sleep issues, more anxiousness, more, you're feeling more triggered, you're feeling less resilient. You could even start with a topical. Like a serum, a progesterone serum. It's less, you know, usually when it comes to Prometrium or an oral, it starts at a hundred milligrams, but like a lot of the serums and creams are around 20 to 40. So if you just need to like take the edge off or help with sleep, a little bit of a topical progesterone can be beneficial. You can give that a go first before you move over to an oral.

And with progesterone, it's not, although we should be measuring all of our hormones when it comes to leveraging bioidentical hormones. If there was a hormone, you could kind of fudge and not necessarily a hundred percent, you know, be laser-focused on labs, it would probably be progesterone. But with estrogen and testosterone, because they’re growth hormones, they’re build-you-up hormones, you really do want to be measuring your labs when you're kind of perfecting. We don't want to move you too far into too much estrogen or too much testosterone, obviously. And then with compounded, it really depends on who you're working with when it comes to testosterone. A lot of the compounded testosterone I see on the market is definitely in his injections. Usually like a 0.1 milligram. Like, mine's an injection. But you know, I find that as long as you are measuring, you've got someone who is looking at your labs four to six weeks after you start something like an estrogen patch or testosterone, I feel pretty confident with that. But you know, do demand that they're looking at your labs if you are incorporating bioidentical testosterone and estrogen. Again, progesterone, I still think it's important to do so, but you can like, especially if you're using a serum, it's probably not going to be enough to skew anything. But definitely try to, you know, use it cyclically. And then with thyroid 100%, you need to be looking at those labs every eight to 12 weeks as well. And thyroid hormone is, is obviously, an oral as well. 

DR. AMY: Well, I feel like we could talk to you for another couple of hours. Would you be willing to come back and continue this conversation? There were so many other topics that we didn't get to even address. 

SANDY: Agreed. I have like five of my own. I was like, “Oh, shoot. We're out of time!”

DR. AMY: Is that something you'd be willing to do? Y

es. Yes. And I feel like today was kind of more like a foundational, you know, piece of the big puzzle. You know, and I hope that the labs really opened the door or just, you know, like where, what are those first steps, right? Knowing your body, tracking your cycle, having your labs. And if you're thinking to yourself, “Oh my God, I'm 48 now. I'm 50. And I've never really known my labs.” Today's the day. Like, even though I may have said 30 was a good time today, now is the best time. So I want you to know that if you're thinking to yourself, like, “I don't know my labs and I I've, I've never tracked my cycle.”  Today is a great day to start. I didn't start tracking my cycle until I was in my thirties. I didn't know. So I just wanted to just speak into that and if you're thinking to yourself that perimenopause was the time to really start dialing this in, and now you're 52 or 53, again, today is always the best day to get started.

DR. AMY: I love that. How can our listeners find out more from you? 

MARIZA: Absolutely. So my podcast is Energized. It embodies what so many of us want. At least it's what I want. So in that really goes, it's a podcast fully devoted to understanding women's health, women's hormone health, especially in midlife. And then my website is drmariza.com. I think on my website, I have a beautiful hormone quiz that you can take if you want to get super clear on which hormone may be the one that you would love or need to prioritize. I will say that they don't work in a silo, they work together, you know. And so, but sometimes opening the door to what may be going on can kind of lead you down that right path. So there's a hormone quiz on that homepage in case you want to check it out. 

DR. AMY: Fantastic. Thank you. Um, so this has been a phenomenal conversation. I'm excited to have you come back, maybe do a whole series with you, Dr. Mariza, so that our listeners can learn as much as possible about something that is impacting all of them.

MARIZA: 50 million of us right now.

DR. AMY: Right? And we do have some dads that listen to us as well, and this is impacting their partners. So it's not just an issue for women. Like I'm happy to share this kind of information with partners too, so that they can help support the rest of us, right?

MARIZA: Yeah. Dads always want to know. Dads whose wives are in perimenopause and menopause. They're like, “What's happening?” 

DR. AMY: Yeah. Okay. So listeners, um, like Dr. Mariza said, her website is drmariza.com. That is M A R I Z A. If you want to get your hormone report card, you can go to drmariza.com/hormonereportcard, but we will put all of those links—we'll put her social media handles in the show notes for you. Thank you so much for listening today. If you liked our show, we would love it if you would leave us a five-star rating and review on Apple Podcasts. You can follow us on social media on every channel at the Brainy Moms. Go do it now before you forget. If you wanna find out more about what it is that we do all day, every day, you can follow Sandy on TikTok at The Brain Trainer Lady. So look, until next time, we know that you're busy moms and we're busy moms. That's all the smart stuff we have for you today. Catch you next time.