Weight Gain in Perimenopause Over 35: Why Your Body Is Changing and What Actually Works

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Dr. Brighten: Sudden weight gain that feels completely outta control. Yeah. Today we are gonna talk about this most frustrating and most misunderstood issue that faces women, that women face after age 35. Let me know something.

Okay. Waking gain that's coming outta nowhere and sleep. That seems like you're never gonna get enough of it. No. Ugh.

Weight gain that seems to come out of nowhere and an inability to sleep. Welcome back to the Dr. Brighten show. Today we are gonna get into one of the most frustrating and most misunderstood issues women face after 35, and that is sudden weight changes that can feel completely out of your control and the sleep problems that always seem to come along with them.

If you feel like your body has [00:01:00] changed overnight. If you're gaining weight in places you never used to, or if your sleep is getting worse, you're in the right place. And listen. If you're also feeling more anxious, more inflamed, more tired, there is a reason for it all, and it has nothing to do with willpower and everything to do with your hormones.

So after age 35, there's a series of hormonal shifts that begin to fundamentally change our metabolism and our weight distribution. So progesterone is gonna quietly drop first. Progesterone is made after ovulation, and as the corpus luteum, the little structure that's left behind after ovulation. Isn't as strong as it used to be, and then we slowly over time, ovulate less regularly we see progesterone drops.

By the way, in this episode, I'm gonna talk about labs that you should have tested and what [00:02:00] the lab values are. So definitely stick around for that. Now the other thing that happens is that estrogen can become more chaotic. Often when you see the diagrams of what happens in perimenopause, it's always like an estrogen slowly declines.

No, it doesn't. Estrogen's doing this before, it is like going down. Um, and it does decline, but not before it rocks and rolls all over the place. Now we also see that cortisol can rise or it can fly out. It's really like dealer's choice is what it feels like, but for almost all women. As estrogen goes down, insulin resistance creeps in.

We're gonna talk about why. And after age 35, it is more common to see hypothyroidism develop. And so thyroid conversion can slow on its own, or we can develop Hashimoto's and autoimmune thyroid condition that's gonna affect our thyroid, that's gonna affect our metabolism.

And just to be clear, none of this means your body is broken. [00:03:00] Your body is adapting. It's adapting to a new era of of life, and so it's a lot of changes that your body's going through. We're gonna walk through today, why this is happening, what labs to run, and the exact steps that I recommend that you would implement today so you can get your metabolism, your mood, your sleep, back on track.

Now listen, before we get into it, if you can take 30 seconds, leave me a review. I'd really appreciate it. Wherever you're listening to this right now, your reviews help this podcast thrive. It also helps center women's voices in women's medicine. Podcasting is primarily male, so I'm against, I'm up against like a lot of beasts out there, so to speak.

So your support means everything to me and I really, really appreciate it. Okay, so let's start with what's actually happening biologically, because once you understand the why, everything else makes sense.[00:04:00] 

As I mentioned, progesterone's gonna drop first. Most women don't even realize this, but that progesterone decline is why sleep starts to get so bad, and that decline is helping and that decline is happening way before even we're detecting estrogen changes in our body. So when we have low progesterone, it means lower allop alone, which is a metabolite that stimulates the GABA receptor in your brain.

When that's down, you feel more stressed. The stress feels more intense. The HPA axis, that's how your adrenal glands are communicating with your brain. That pops off wild late. Now we got cortisol problems. Your sleep. It's not just hard to fall asleep, but it is the staying asleep and it's the early morning waking becomes a problem.

Blood sugar can also become, um, unstable during this time With progesterone changes, though it seems less pronounced than with estrogen, but it [00:05:00] can start early on

when estrogen. When progesterone is low, it is very common to feel more anxious and more easily overwhelmed, and to have worsening PMS symptoms, worsening PMDD symptoms like your PMS is super disruptive, and I swear to God, if your partner or your, you know, boyfriend or anyone choose wrong or breathes out loud, like you may just fly off the handle.

And this early change of progesterone can also signal the body to become more prone in storing fat. Again, we always talk about estrogen, but progesterone is involved in this as well.[00:06:00] 

And like I said, when progesterone goes down, GABA doesn't get the stimulation that it needs, and that calming neurotransmitter just doesn't keep us calm. Now, the other thing that happens is that with estrogen becoming inconsistent, unreliable, it's erratic. Some weeks it's high, some weeks it's low. Some months it's normal.

Some months it's not. That's a whole rollercoaster. And that rollercoaster is affecting your appetite. So estrogen actually weekly suppresses appetite. Doesn't like squash it, but it helps with appetite regulation. When estrogen goes down, we find our cravings come up. When estrogen goes down, we have blood sugar instability.

Cravings will also come up will, because your body will panic and say, grab that donut. It's the nearest thing, and we need fuel. We need energy now.[00:07:00] 

Estrogen also helps our muscles function better and it really governs where we store fat. So it's a big player in fat distribution when we are in our younger years and estrogen's riding high hips, butt, thighs, that's where we're gonna put our fat. When we get older and estrogen declines, we start putting the fat around our organs, deep, visceral fat that contributes to a lack of insulin sensitivity, and so estrogen insulin, they're all involved along with that fat distribution, and this is happening in our late phase perimenopause and on top of gaining fat.

We don't build muscle as easily. So everyone always thinks testosterone for muscle. Yes, and estrogen's super important for that as well. It's also super important for our joint lubrication and our ability to actually like go to the gym, move our body and not get hurt. So I want you to keep in mind estrogen's, not just a reproductive hormone, it is a metabolic [00:08:00] hormone as well.

Now progesterone's dropping estrogen's fluctuating.

Now progesterone's dropping estrogen's fluctuating, and now here comes cortisol. The body is shifting into survival mode. Cortisol steps in to compensate, but the problem is. Cortisol can contribute to you storing fat in your abdomen. Thanks, body. It can feel like a lot, but I just want you to understand what is going on with hormones because this whole like eat less, move more.

You just lack willpower is not doing anyone any favors and it's not profound like advice for women. We have to talk about the nuance of what women actually need to know about their body and how to support their body at the stage that they're at. Like I said, estrogen regulates your appetite. If estrogen goes down, tell you, you just eat less.

You are gonna feel like a failure. [00:09:00] So with cortisol, when that gets dysregulated, you might be waking like two, 4:00 AM You might have more cravings for like carbohydrates and salt. Cortisol also blunts thyroid conversion. When you have chronic stress, you're not gonna take your thyroid hormone into the active form.

I will link to our episode all about thyroid health and i I give you the reference ranges of the labs you should be looking for. You'll find that in the show [email protected], D-R-B-R-I-G-H-T-E n.com. But with cortisol being dysregulated, this is why you feel like you're eating normally and you still feel like your metabolism has suddenly changed and your body's betraying you.

So. We've got progesterone, we've got estrogen, we've got cortisol, and then we've got that insulin resistance I talked about. So I have an entire episode about the labs and the reference ranges on that. What you wanna get tested, what you should look for. I will also link to that in the show notes, but I want you to understand.

Estrogen is really like [00:10:00] the pivotal little straw who breaks the camel's back here is it becomes erratic, is insulin resistance, is is increasing, and so that's gonna lead to that midsection weight gain. Um, this is why we wanna do a waist hip ratio. You wanna measure your waist circumference during the, around the smallest part.

You wanna measure your hip circumference around the largest part, and you want to divide the waist by the hip. And that number should be less than 0.85. If it is more, then we're looking at visceral adiposity and metabolic health is definitely declining. So with the insulin changes. We'll also see carb cravings coa.

We will see there's blood sugar instability. So you're having afternoon crashes and sometimes even when you're eating well and you're like, I'm, I'm eating pretty good. We can still see belly fat distribution with insulin resistance, and then more belly [00:11:00] fat means more insulin resistance.

Now before we go further into solutions, I do wanna give you some of the lab testing. Like what to test, when to test what the numbers mean when it comes to these hormones.

And I think it's important that we do lab testing whenever it is feasible, economical, possible, you know, altogether. Because without labs we're guessing, and after age 35, like guessing, just like it doesn't work well for us. I mean, it doesn't work well anytime, but I also understand that some people just don't have access.

So I will give you resources to help support your health and your metabolism today. Even though I'm gonna talk to you about the labs right now, so I want you to understand hormones a rhythmics, so the timing matters if you are still [00:12:00] cycling and the interpretation matters. Normal. Normal ranges are not like what we're going for.

We're going for optimal here. So if you're still cycling, we wanna test progesterone and we wanna test this mid luteal phase. So that's gonna be seven days after ovulation, we do five to seven days after ovulation. What we wanna do, we're gonna look for a temperature spike. If you're doing fertility awareness method, or maybe we're gonna use LH test strips, you're gonna pee on a little test strip.

And when you have that spike seven days later, we're gonna go ahead and test. And if you're not tracking and you're not doing any of that, then it's seven days before you expect your next period.

But in late stage perimenopause, we have to use symptoms a little bit more. Sometimes you use, you have to use cycle, estimate, [00:13:00] estimate. Sometimes we have to use cycle estimation because anovulation is common. That means you're not ovulating. But if you're not ovulating. Your periods are really irregular.

I'm not really interested in testing progesterone. Okay? I just want you to understand that, that, that if you've got all the symptoms of low progesterone, you're over 45, your periods are like going away. I'm not really interested in running that test because it's not gonna tell us a whole lot. Now for progesterone, we wanna see that above 10, usually like 10 to 20, but we wanna see at least above 10 so that we know that we ovulated.

If you are seeing numbers that are below five. Strongly suggests that you are not ovulating. Uh, it could, if you measure it on your period, that's normal to see, but if you measured it at the right time of your cycle, you're not ovulating. And if you're below 10, the corpus lium isn't really doing its job as well to make ample progesterone.

And low progesterone is a top driver of forced sleep, [00:14:00] anxiety, irritability, terrible PMS, and feeling like. You are at the mercy of stress cyclically once a month just feeling like stress is kicking your booty.

Now when it comes to estradiol or E two, we wanna test that days 2, 3, 4 of your cycle. Day three is the best, but two to four of the cycle is typically in the range in which we will test it. So you're on your period. Day one is the first day of your period in perimenopause. If you're having no cycle, we can just test this anytime.

But we have to interpret in the context of fluctuations that if you haven't had a cycle in 60 days, that doesn't mean your cycle won't come back. But if you haven't had a cycle in like six months, your your cycle is probably not coming back. But you may be an outlier and it might. But for those women who are [00:15:00] still cycling optimal is day two or three of your cycle.

We're looking for, like, the number we're looking for is 30 to 50 picograms per milliliter. Um, you know, even getting closer to 80 can be normal if we're going above 80 and we've got symptoms of estrogen access. That can definitely be problematic and we, we wanna address that. But often when you are having sleep and weight gain problems, we're seeing under 25, which is indicating the ovaries have aged into menopause, they're graduating into their menopause era, and we will correlate that with an FSH.

And if that FSH is hitting double digits going above 25, yes we are in perimenopause. And so this is all really helpful if you've had a hysterectomy, but you kept your ovaries to know where things are at. Now, estrogen instability. It's a major contributor to the midsection weight gain and blood sugar swing.

So [00:16:00] that is why this information can be helpful, and we always wanna correlate it to your symptoms. Now, when it comes to cortisol, we wanna be looking at a curve. I don't do this by the blood because I, it's four points that I wanna see in the day, and I don't want you getting stuck four times in the day.

Blood, cortisol. Is nearly useless unless it's extreme. And that's like Addison's and, and, uh, Cushing's. And I'm running an A CTH at the same time. But anyhow, what the average person's gonna do is a four point salivary cortisol test. Um, there's several companies like ZRT Labs, Dutch has a cortisol test with metabolites.

They do a cortisol awakening response, which tells us about your morning cortisol, which is when cortisol should be spiking. And the optimal pattern for cortisol is we wanna see it's high in the morning, and then it's gradually decreasing through the day. You might get a second wind in the afternoon, and then by evening it's nice and low because cortisol and melatonin are gonna oppose each other.

And melatonin should be [00:17:00] rising at night and cortisol should be coming down. We also wanna look for a gradual slope. We don't wanna see, and I, I've seen this many times, spikes high in the morning, drops by 10:00 AM. That's a problem. You're gonna be crashing in the afternoon for sure.

My God.

So if your cord, if your cortisol is flat, it's too low, it's elevated at night, it's spiking in the morning and dropping low, that's gonna make it harder to sleep. That's gonna mess with your daytime energy. Um, sometimes you're gonna have craving skyrocket. You may have weight loss issues. Like, look, if you can't even get the energy to go to the gym, you're definitely gonna have some weight loss [00:18:00] late.

You're definitely gonna have some weight loss issues. Now with a thyroid panel because they did a whole episode breaking down. What all of these numbers mean, exactly what to look for, um, the full test, why we do it. I'm not gonna spend a lot of time in this episode. Again, dr Brighten.com, it's gonna be linked there.

If you're a newsletter subscriber, I send this all direct to you when these episodes come out. But briefly, TSH free, T four, free T three thyroid peroxidase and thyroid globulin antibodies. And we may also consider a reverse T three.

It is weird because I will space this, so it's double space, but then it gets into the teleprompter and then it's just like this huge space. Oh my God. It's still going.[00:19:00] 

Hypothyroidism or low thyroid hormone is a very big contributor, an overlooked driver of weight Changes that are happening after age 35, age 35 is the magic number we're most commonly gonna see hypothyroidism develop. So we definitely wanna be checking that. And then again. I said I did a whole episode on insulin.

I'm gonna direct you to [email protected]. You'll find it in the show notes for wet levels of fasting insulin, hemoglobin A1C, everything we're looking for in testing insulin.

I.

And keep, and keep in mind when we have insulin [00:20:00] resistance, even if the numbers are just slightly off, weight loss can become an uphill battle. So now that you know what's changing and how to test it, I wanna talk about the part that like everyone really wants to know, which is like, how do we fix it? What do we do about it?

Now if you go to dr Brighten.com/plan, you can grab a free meal plan, recipe guide, guide to sleep. I mean, it's got tons in it for helping you navigate perimenopause and what I'm gonna cover in here. Is a lot of what we need to do. That plan will give you exactly how to do it and guide you through it. So dr Brighten.com/plan.

First thing we wanna do, we wanna get that blood sugar stabilized as soon as possible. This is a foundation you cannot out exercise out supplement or out willpower, unstable glucose. However, all of those things will help you stabilize glucose. So here's.[00:21:00] 

So yes, we need to exercise. Yes, we need to sleep. And yes, there are supplements that can help, but there are people out there that are promising weight loss supplements like take green tea extract or take like things that speed you up or like just shake on a machine and you'll lose weight. And none of that is gonna be very effective if we are not addressing the foundation, which is blood sugar dysregulation.

Now. If that's linked to estrogen and you are a candidate, we wanna consider doing estrogen hormone therapy. I have a whole episode talking about that. I have several, actually, I will link to those so you can have all the resources to make an informed decision. But when it comes to regulating insulin, this is what we wanna do.

We want a protein forward first. Breakfast, 30 grams of protein [00:22:00] at breakfast. This alone can change your entire day, and then we wanna get like five to seven grams of fiber. Maybe you are someone who eats a lot of fiber, you hit 10 grams of fiber, you're hitting 10 grams of fiber every meal three times a day.

That's great, but at least five grams

when you're eating carbohydrates. Protein and fat and fiber, we wanna partner that with them. We don't want just a bagel that's gonna just be metabolic mayhem for our poor metabolic system and our insulin regulation.

And the cool thing about fiber is that it blunts glucose spikes and it's gonna support your microbiome in a healthy microbiome. People who eat more fiber have more microbial diversity. That has been associated with a lower risk of developing visceral adiposity, so having that deep belly fat. So don't overlook your microbiome.[00:23:00] 

And also don't overlook your evening meals. We wanna make sure that the evening meals are preventing nighttime blood sugar crashes. That can be a major reason why you wake up at two to 4:00 AM So we wanna make sure that we're eating protein fiber and getting fat at our evening meal. We're not just eating a bowl of pasta.

If you're gonna have a bowl of pasta. I throw some veggies in there. You can mix flax seeds in there sometimes into your pasta, like ground flaxseed. You can add in ground beef, like things to support stable blood sugar. I. Now I did mention supplements and some people are gonna need supplements to help manage their blood sugar, especially those that have a history of PCOS.

So my acetol is the top one. I, I look to my acetol all the time. It improves insulin sensitivity, ovulation cravings. Um, it is been shown time and again in the research to be just a real ally for [00:24:00] metabolic health. And so doing this strategy of like protein, fat fiber for breakfast, making sure you get that at every meal and definitely looking at your evening meal and then considering adding something like Myo ACETOL plus in can really help support you in reducing the belly fat, fat in reducing the belly fat, helping get better sleep, improving your blood sugar, and really setting the hormonal foundation.

You know, my book is this normal. I talked about how. Cortisol and insulin are the hormonal foundation. And if those are not set right, everything else just gets off balance. And so while you might chase sex hormones or even thyroid health, and you may need to address those, if you do not address that foundation, then you'll constantly just be chasing symptoms.

So let's talk about that second part of the foundation, which is the cortisol curve. Cortisol is not our enemy, [00:25:00] despite what? Well-meaning influencers. Well, not sometimes, not well-meaning influencers, but you know, people on the internet will tell you like, cortisol is the devil. No, it's not. It's absolutely necessary.

Regulates your inflammation, but dysregulated cortisol, that's what the problem is. So. We need a spike in the morning. We need it to go low at night. So here's how to get that back first thing in the morning. Open up those curtains if you can do 30 minutes outside, barefoot on the grass walking around.

Fantastic. In in nature. Oh, we love that. But if nothing else, just morning sunlight. Drink your coffee in front of the window. That will help anchor your morning cortisol. Now if you're somebody who's really struggling with your cortisol curve, sometimes I will say like you have to eat breakfast and have a full stomach before you have your coffee.

However, if you are like, no, I'm not doing that. Okay. 'cause definitely have those patients that are like, no. [00:26:00] First thing in the morning I'm having coffee, nothing else. Okay. Not a lot. Like you're gonna be surprised that you know weight, like talking about weight loss. Cream. Can we use a little bit of full fat cream?

It doesn't have to be a whole lot, but a little bit. And then a couple scoops of collagen in your coffee. That's gonna help give you a little protein and fat to help stabilize your blood sugar. And then you can have your coffee in front of you know the window and then go make your breakfast. But what we don't wanna do is drink black coffee on an empty stomach and then wait three to six hours to eat.

Wow, that's horrible. For our cortisol and our blood sugar.

Do you like high intensity workouts? I like high intensity workouts. I think they're great for women, but they're not great for women who have cortisol [00:27:00] dysregulation when we do them at night. So if you like high intensity workouts, hit it in the morning, try to get it in before noon because they can raise cortisol and that's great.

Uh, not when, not at night when we needed to come down. I'd also recommend. As often as you can in your day, but definitely before bed. Nervous system regulation, deep breathing, box breathing, uh, humming, 92nd somatic discharge count, uh, vagus nerve stimulation. I'll put an episode link to that. And then we wanna look at supporting our adrenal rhythm.

So I have like a couple of products that I recommend. It's called the Optimal Adrenal Kit. And explain what's in them. It's never pressure to buy my products. I do have a code for you if you wanna try them for 15% off pod 15, dr Brighten essentials.com. You're always welcome to try 'em. But if you're like, no, I wanna go a different route, I like to just explain what's in them so you know what to be looking for.

So [00:28:00] here is how I personally formulated these ingredients to make them work for my patients and for me and my family. My husband takes them. Um, okay, so first thing in the morning. Is adrenal support. Have that with breakfast. Two caps, rhodiola, occus, um, asparagus or osmosis. Holy basil. Really important adaptogenic herbs along with nutrients that feed your adrenal glands.

That helps you have energy in the morning signals. Get your cortisol out and keep it through the day, and it's not gonna leave you wired and tired at night. 'cause you're taking it in the morning. I also recommend taking B Active plus in the morning methylated activated B vitamins because when we've been under chronic stress, we often need more B vitamins and more magnesium, especially when we are struggling with sleep and perimenopause and HPA dysregulation.

So that's morning. You can take one, be active, that's gonna help you have energy throughout the day [00:29:00] in the evening. You can do this right at bed. You can do it with dinner Anytime in between. Adrenal calm, that is going to have phosphatidyl seine in it. Very key nutrient for bringing down your cortisol.

It's also going to have L-theanine and passion flower. Very key. When your progesterone leaves the building for stimulating gaba and helping you chill out, calm, not hate everybody, not have ruminating thoughts, not replay your day on repeat, and think about all the ways you hate yourself. Just go to sleep.

That's it. That's it. That's adrenal calm. Just go to sleep. Five. So that's what I recommend for resetting that cortisol curve.

Now the next bit of sad reality, the want I'm gonna drop on you is that after 35 muscle becomes your [00:30:00] metabolic engine, except you're deleting your muscle cells, what? We lose muscle, we lose metabolic flexibility, but we gain muscle and we gain metabolic flexibility. So this is why muscle is non-negotiable.

It improves insulin sensitivity and what happens, which, which is just like the worst. I, I had to give a presentation to, it was a, it was a bunch of practitioners, and I give a presentation on why eat less and move more is not life changing for perimenopausal women. One of the things I explained in the research is that, oh man, take a breath, everybody.

Two years and two years, two years before and two years after menopause, we are gaining fat at a higher rate. Two years before and two years after menopause. We are losing muscle at a higher rate. What is your weapon against this? Because that's not inevitable. That's what's happening to people who didn't get prepped by their doctors for what's coming and what the whole freaking reason I have this podcast is that I want you to survive and [00:31:00] live the best quality life possible.

Build muscle that is your metabolic weapon against that muscle's also gonna help reduce inflammation. It will help improve your sleep. If you are working out daily, it increases BDNF alpha. That is basically fertilizer for brain growth and brain health. There is nothing that beats medications like exercise does when it comes to mood and it comes to sleep, and it can help counter some of the estrogen fluctuations.

People who work out more consistently, they don't experience hot flashes in the same way that people do who are sedentary. So super, super important. Now on top of working out regularly. Building that muscle resistance training two, three times a week, depending on how you're doing it. I do it most days of the week because I target specific muscle groups, but maybe you have a full hour workout.

Three days a week. Great. Now let's feed that [00:32:00] muscle. We're looking at like a hundred to 120 grams of protein a day. For most people, that's gonna be like 30 to 40 grams of protein per meal. Not gonna lie, sometimes it feels like all I'm doing is like thinking about like, how did I get my protein in today and did I get enough, enough protein?

But I want that because I don't wanna lose muscle. My master's in nutrition research was in sarcopenic obesity. It is the saddest thing and it is preventable, and that's what I wanna help as many humans as possible Do. Now, easy ways to get protein, cottage cheese, Greek yogurt, protein powders, eggs. I've been doing this thing lately, and at first I hated it, but I suck with it now.

I embrace it yogurt, Greek yogurt with like 10 grams of protein, and then a scoop of protein powder that has 20 grams of protein and five grams of fiber, and I mix it up and I eat that and I mix berries in it so I get more fiber. And you know what? I actually like it now. I didn't like it at first because, um, I just find most protein powders like two sweets.

I'm not a sweet foods kind of person, [00:33:00] but it gives me 30 grams of protein, like super easy. And sometimes I'm like, let's mix a little chocolate in it, and now it tastes like dessert. Uh, so I can eat it at the end of the day, or I'll have it early in the day. By the way, I like legit dessert too. I'm not one of those.

Um. People who's like, yeah, let's like never eat dessert and just make these like gamified desserts all the time. No, I like a good dessert and I like, I like people to enjoy a good dessert, but I also have like a difficult eating toddler. He's very difficult. Um, and so I have figured out all these desserts where I increase the protein in the fiber in them because of him, uh, mom life.

Okay, so Danielle, lemme go back to like, I wanna say this. Women who add strength training, they often say. I'm eating more and I'm still losing weight. And like, how is that possible? It's because muscle is metabolically active. And so, um, if you are someone who likes to eat, like I like to eat, that is all the reason in the world to like work out more.

And I look at people as they age [00:34:00] and they're just like eating less and less and they're like, I don't require that much food. And I'm like, work out more. Please, please work out more now. Let's get into like improving sleep. I think I should like hit on that a little bit more, um, because this is like a piece that honestly, doctors, women, they often overlook.

Um, it, I, you know, it's something that like, we have this hustle culture of like, sleep when you're dead. But let me like de influence you on that. Insulin resistance increases within 24 hours of bad sleep. When you're sleeping poorly, you're skipping sleep. Look, we all gotta have a night out sometimes I ain't judging you for that, but when it's consistently, you're sleeping poorly.

Cortisol dysregulation is gonna happen. We're gonna see cortisol issues. When you're sleep deprived, you are stressed and your progesterone isn't gonna be manufactured in the same way, and it's gonna work less effectively. You also know that cravings increase if you've ever gone night after [00:35:00] night with poor sleep.

Um, so the research has shown that people have more cravings, the satiety, the hunger signals that say like, listen, you've had enough food. They don't signal as well. When we don't sleep as well, so the appetite regulating hormones are getting disrupted,

and when we have long term poor quality sleep. The belly fat storage is going to increase that deep visceral adiposity. And that's like so not fair, right? Because your hormones are like exiting the building and then they're like, oh yeah, we're not here to help you sleep anymore and we're gonna contribute to your weight gain.

Oh, and that sleep you're not getting, that's gonna contribute to your weight gain. The other thing for my hypothyroid ladies know that poor quality sleep hinders your thyroid hormone conversion. You will not make as much active thyroid hormone. Your body is gonna force you to slow down. I always say it to my [00:36:00] patients and I have to say it to myself as well.

If you don't choose to slow down when you're hustling so hard, your body will make you slow down. And just like you don't like to get punished by your parents, you do not want the body to make you slow down. So if you don't fix sleep, everything else is literally gonna become harder. So let's give you some sleep strategies that are gonna work.

First thing I wanna anchor that blood sugar in the evening with that protein, fiber, fat at dinner, definitely want to stabilize our glucose. We're gonna have fewer, uh, wake-ups, everything I told you about cortisol, um, and helping with that curve. Again, that's gonna help you, that's gonna help you get your cortisol set right.

But you may wanna add something like magnesium glycinate. One to two hours before bed, about 300 milligrams. That can also help with nighttime cortisol. That can improve deep sleep. Our brains work better. They're healthier. They even appear younger in some studies when we have higher levels of magnesium coming in.

Now, if you're not sleeping because you are [00:37:00] having hot flashes. Something you may wanna try is taking a warm shower. No, do this first. Okay, cool. Your room, drop your room temperature, get in, take a warm shower. You are gonna come out and you dry off. Do your whole thing. Come into your bed and it's gonna be cold and that's gonna help you get into that.

Nice deep sleep. You've heard me say it a million times, but it bears repeating. You gotta limit your bright screens 9:00 PM and on that blue light that's gonna suppress melatonin, it's gonna like rock your world, like in terms of cortisol and melatonin dysregulation. So look, wears some amber glasses if you really gotta watch your favorite TV show.

But definitely take note at the nights where you are watching TV or watching something stimulating. How do you sleep that night? Be your own n of one experience. Be your own N of one experiment. Now if your progesterone's low work with a provider because you might need progesterone therapy. It can be life-changing for your sleep, one to 200 [00:38:00] milligrams of micronized progesterone, oral micronized, progesterone.

Did a whole episode on it. How do we dose it, including sleep intolerance, including side effects. I will link that in the show notes so that you can get access to that and know what to talk to your provider about.

Okay, so let's wrap this up and like pull it all together. I'm gonna do a little summary for you because I know I just shared like a ton of information. So first things first, when it comes to weight loss, when it comes to sleep, we wanna stabilize our blood sugar. We wanna make sure that our evening blood sugar is supported with a nice dinner that is gonna be full of fiber, fat and protein, maybe not full of fat, but it has some fat, like you know, about a thumbs worth of fat on that plate when we lower cortisol.

That's gonna help improve sleep when we get exposed to sunlight. In the morning that's gonna actually pull your cortisol to the morning. It's gonna help shift it so it goes down at night. Remember that better [00:39:00] sleep is gonna improve that insulin sensitivity. So we have to be doing things. I just said everything about sleep, so I'm not gonna repeat all of that, but.

Better. Sleep is better insulin sensitivity, better insulin sensitivity is gonna improve your estrogen, and whereas your estrogen declines, it's also going to help that estrogen doesn't like have such a major impact on your metabolic health. Remember, strength training makes your metabolism feel responsive again.

Uh, it is super, super important that we retain as much muscle mass as possible and that's gonna also help us with our body composition and working out regularly, early enough in the day. We can still work out in the evening. Just don't make it like, you know, what do the kids say? Balls to the walls. Um, super, super intense 'cause that could keep you up at night.

And then when you need it, consider leveraging supplements. Supplements that can support with a cortisol rhythm. Maybe my udol supports your blood sugar. Um, making sure that [00:40:00] you're evaluating all your tools. 'cause maybe it's hormone therapy, but the biggest thing I want. You to take away from, is that what is going on in perimenopause?

It's not that like you don't know how to restrict yourself, um, enough. It's not about like, oh, you, you just don't know how to force your body into submission. It's about your hormones changing them, affecting your metabolism, them affecting your insulin regulation, them affecting your sleep. And once you fix the system, then the weights.

Starts to change the sleep, change the mood, change the energy change, like all of the benefits, start to try to come and you, and you can change that and you can feel like yourself again, please leverage the show [email protected] because I have built a library for you on how to lose weight and perimenopause and how to get better sleep.

Keep in mind, like perimenopause doesn't mean your body's broken or your hormones are broken. It means that you are adapting and you are [00:41:00] changing to a new stage of life, and you have to support yourself differently when that happens. And if you understand what's happening with your thyroid and your progesterone and your estrogen, how this all fits in.

Then you can make sure that you adapt to those changes, so you're set up for this next phase of life. It's ridiculous to tell women that what happened in their twenties and what helped them, you know, maintain their physique and get good sleep in their twenties is gonna be absolutely the golden ticket in the thing that's most effective in their fifties.

That makes no sense. We're in a completely different season of our life.

As always, thank you for being here. Thank you for caring about your health, and thank you for supporting the show and certainly leave me your comments. Let me know what was helpful. If you can take like 30 seconds, leave a review, I would appreciate it. And until next time, take care of your hormones and they'll take care of you.

[00:42:00] Okay.