My next guest is Dr. Michelle Leary. In this episode, Dr. Leary and I will talk all things hormones and the way they impact your metabolism, mental health, sexual health, physical health and aging, as well as some tips for how to help balance your hormones naturally.

Dr. Leary is a force to be reckoned with. She is a compassionate, intellectual, and dedicated provider to her patients. She began her early career in cardiac rehab prior to her training as a naturopathic physician. Following her 4 years of medical training, she began a research role at the Institute for Functional Medicine (IFM) and clinical residency program in adult primary care in Bellevue, WA at Eastside Integrated Primary Care.

In 2016 she was chosen as the first naturopathic physician ever to join a fellowship in multiple sclerosis management through the National MS Society. She has guest lectured for IFM, the Washington Association for Naturopathic Physicians, the University of Washington MS center, and Bastyr University. She became the Director of Functional Medicine at VIDA Integrated Health in 2019 where she leads a team of residents, doctors, nurses, and nutritionists.

Dr. Leary is passionate about Functional Medicine and specializes in sexual health and metabolic medicine for men and women. In addition to her clinical role, she is the owner and creator of PowerSexBeauty.com - a lifestyle brand/blog created for female bodily empowerment, embracing sensuality, clean beauty, and cellular health. 

Where you can find Dr. Leary:

Vida Integrated Health

Power Sex Beauty Blog

If you missed last week’s episode “Myofunctional Therapy: How It Can Improve Your Breathing, Sleep, Relieve Migraines, and More with Dana Tasche,” you can find it here: https://the-nutrition-edit.captivate.fm/episode/myofunctional-therapy-how-it-can-improve-your-breathing-sleep-relieve-migraines-and-more-with-dana-tasche

Books mentioned:

The Disease Delusion by Dr. Jeffrey S. Bland

Why Good Sex Matters by dr. Nan Wise

Attached by Amir Levine, M.D. and Rachel S. F. Heller, M.A. 

Interested in working with Jeannie one on one? Schedule a 30-minute Coffee Talk here.

Check out the Jeannie Oliver Wellness website or connect on social: @joliverwellness

Questions about this episode or the podcast? DM me on Instagram

Music credit: Funk’d Up by Reaktor Productions

A Podcast Launch Bestie production

Hello, hello, and welcome to the Nutrition Edit Podcast.

My guest today is Dr.

Michelle Leary.

Dr.

Leary is a functional medicine physician specializing in primary care, sexual

and hormonal health, fertility and anti-aging medicine for men and women,

and she's the Director of Functional Medicine at Vita Integrated Health.

Dr.

Larry began her early career in cardiac rehab prior to receiving

her doctorate from BA University.

Then in 2016, she was the first naturopathic physician ever to

be selected for a fellowship in multiple sclerosis management

through the National MS Society.

She has also completed training at the Institute of Women's Health, American

Academy of Anti-Aging Medicine, and the Prestigious Institute for

Functional Medicine in areas of sexology, hormone management, anti-aging

medicine, and metabolic weight loss.

In addition to her clinical role, Dr.

Larry is the owner and creator of Power sex beauty.com, a lifestyle brand blog

dedicated to women who want to empower themselves through optimization of health,

invigorate their sexual energy, and live beautifully from the inside and out.

Today we're talking about hormones and what you should and shouldn't be doing to

optimize your hormone health so you can feel more vibrant in every stage of life.

I love Dr.

Leary's approach and she shares so much great info with us today, and

I think you're gonna love it too.

And with that, let's jump into my interview with Dr.

Michelle Leary.

Hey everyone.

Welcome back to the Nutrition Edit podcast.

I'm your host, Jeannie Oliver, and today I have a very special guest with me, Dr.

Michelle Leary, who is the Director of Functional Medicine for Vita Integrated

Health.

Welcome, Michelle.

Thank you so much.

Thank you for having me.

This is so fun.

Yeah, I'm so glad you could join me.

Thank you for taking the

time.

Absolutely.

So let's just jump right in.

Why don't you tell us a little bit about yourself and your background and

how you got into practicing functional

medicine?

Yeah.

So, functional medicine is really near and dear to my heart and

has been for quite some time.

I am the current director of functional medicine, but it took many years to

kind of get to this spot and be able to do some of the magical things that

I think our colleagues are able to.

To do in this current practice.

So I, um, started off actually back in Switzerland when I was in my

early twenties teaching Pilates.

I was actually on a study abroad year in southern Switzerland

in an area called Luo.

And yeah, it's beautiful there.

Have you been there?

I've not been to Laguna,

I've

been lason in that, that area.

It's kind of like a magical place that everyone,

if they have the opportunity to go, it's right north of Como.

So here I was 20 years old living in this.

Uh, flat that was in Logano was, it was a very special time and

I was at the time, very deeply involved in the fashion industry.

I thought that I wanted to do international business and had actually

done an internship for Valentino and learned very, very quickly that I did

not, love the fashion industry for a variety of reasons, namely some of the.

Kind of cutthroat behaviors that go on behind the scenes is one might imagine

if you've seen Devil's Worst Prada, yes.

I ended up started teaching Pilates, and Pilates was such a savior

for me in terms of stress relief.

I had clients who were coming up to me asking about their bodies, what

to do for their health nutrition, and I loved being a resource.

However, I didn't have beyond my Pilates training.

I didn't have any other education in that realm, in the health realm.

I had taken lots of science, courses in end of high school at a community

college, but beyond that was really not immersed in, in the science world.

So I changed my major.

Uh, I decided that I was gonna switch to kinesiology, which is kind of

study of human movement, uh, exercise science, and ended up, taking another

extra year of my undergrad to do that.

And really fell in love with, uh, anatomy and physiology

and particularly biochemistry.

Biochemistry was really where I, uh, found that I could dive into

what was going on inside the body.

And so upon graduation with my exercise science degree, I went into cardiac rehab.

I was doing a lot of cardiac rehab, um, which is basically using exercise

as a modality of helping someone who's had a heart attack or another

cardiovascular event to get well, and that exercise component was

obviously so critical as part of their.

Path to healing, but I knew that I wanted more.

I wanted to be the one who was helping people prevent the heart attack

from the first place and not just from the lens of, after treatment.

And so I started, looking very closely at different, Doctoral programs,

naturopathic, osteopathic, and, uh, conventional allopathic medical schools.

I did another internship at the National Institute of Health

as well as, in New York City.

I had the opportunity to shadow a lot of physicians in different

specialties and that, uh, it may actually be more the, um, interest of

mind to go into naturopathic medicine.

And so I ended up doing that, um, circa around 2012.

I started my program, at BA year.

I trained for four years in naturopathic medicine.

And upon, actually my third year of school, I was introduced to an amazing

book that if, uh, your audience hasn't heard of before, called The

Disease Delusion by Jeff Bland.

Dr.

Jeff Bland, who is the founder of the Institute for Functional

Medicine, along with his wife Susan.

And he, was this just profound influence on my, end of school career and my, my

early years, in practice and, and still to this day, actually saw him last week

because I was introduced to him after reading his book from a colleague.

He then really, Got me involved in the Institute for Functional Medicine,

which was the organization that trains physicians, nutritionists, uh, dieticians,

chiropractors a whole lot, uh, in how to practice functional medicine.

So this is a long-winded way of saying that.

Jeff was, was this influence and mentor that has propelled,

my practice, and experience.

Because I then ended up working for the Institute for Functional

Medicine concurrent during my residency years in primary care.

Okay, good.

So congratulations doing that.

So it's been a road, it's been an interesting, road, but I, it's

been a really special experience that I'm fortunate to have.

That's amazing.

What a really cool story and journey.

I love that.

We'll talk more about my interesting.

Brief fashion background too, but I absolutely can relate

to what you're talking about.

It's a different, um, a different crowd.

Yeah,

yeah, for sure.

I think about when I showed up in that first day, like what I was

wearing in that first day and was like, oh gosh, like high fashion.

So it was, it was just a different time I guess.

Yes, absolutely.

So give us a little of a brief overview if you would.

I talk a lot about functional medicine, functional nutrition

on this show and in my practice.

Yeah.

But tell the listeners briefly what functional medicine is and how it

differs from conventional western

medicine.

So, Yeah, so functional medicine, it's a great question.

I think there's dozens of correct answers, but functional medicine is

really looking at the interweavings between genes, biochemistry, the

environment, lifestyle, and how all of those things influence how we express.

Outwardly a exhibition of health, or potentially an exhibition of dysfunction.

And I'm careful to use the term disease because disease is really just a

compilation of, of dysfunction that happens again and again and again

over time and is not able to self.

Correct.

And so functional medicine really uses the foundations of basic science.

So the understanding of immunology, biochemistry, making sure we're go, even

going back to genetics, basic genetics, uh, and then applying more modern

utilizations of genomics and how we can interpret and understand how someone.

Is, functioning as a human and if they are experiencing symptoms of

dysfunction, which is often why people come to you or I, what we

need to do to get them back on track.

Uh, using lifestyle as a foundation and then adding things on as a higher

level interventions thereafter.

I love that.

I think a, you know, a common phrase that we hear in our world is jeans load

the gun and lifestyle pulls the trigger.

Yeah.

Mm-hmm.

So I think that you explain that beautifully.

I, I love the way that you explain that.

Cause I've heard it described as addressing root causes

versus just the symptoms.

But I think even that's sort of a limited way of describing it.

So,

I would argue that there's a lot of, you know,

intentionality behind even Western medicine and treating the root cause.

And I have a lot of conventional colleagues that, you know, trained

more strictly western medicine and they would say they're still

treating the root cause, you know?

Um, and I think that we have to be careful to say that.

Doctors aren't all intending to treat the root cause.

We just sometimes have different tools in our toolbox.

Yes.

And that is, I think out of, We all go into, I think patient care

because we wanna help people.

It's just what are our tools in order to do that, what is our education?

In order to do that, and fortunately for you and I, we are taught

in our educational programs the importance of sleep and exercise

and nutrition and stress management.

And unfortunately those are just not prioritized in.

The conventional medical system right now, but it doesn't necessarily

mean they can't be applied, um, once someone is in practice.

So I think that's important to note.

Absolutely.

Absolutely.

So let's talk a little bit or tell us a little bit about hormones, because

I know this is a big focus for you.

Yeah.

And so talked about the role that hormones play when it comes specifically to.

Metabolism and how that changes or maybe doesn't change.

Yeah, as we age, um, specifically for us women, because yeah, so

many people come to me, you know, after the age of 40 typically,

and say everything that I used to.

Do, and he used to work for me, no longer works for me.

Mm-hmm.

My energy's in the tank.

I think my hormones are all out of whack.

what's going on?

And

obviously that's a very complex question

to unpack.

Yeah.

But I'd love to just focus in today on, you know, metabolic health specifically

and the role of, of hormones there.

So what do you see in your practice and what's your approach?

Yeah, it's such a, a good and broad question.

So I wanna just start with, um, when we think about women in their early

forties, cuz I see the same thing, right?

It's usually women who have children that may be school age

or even entering adolescents.

There's a lot of transitional, things happening just from a life perspective

at that time, and that alone can put a stress on our adrenal glands, which

adrenal glands produce cortisol, D h e a, several other very important hormones.

That then can influence how the thyroid functions, can influence how our

ovaries, function to some extent and can also influence our weight in a lot

of different ways in in metabolism.

I should use the term metabolism better than just weight.

So I wanna just say that there's this, you know, painting broad.

Brush strokes, that time of life is also a factor, but hormonally

things do shift, especially if metabolism is changing simultaneously.

And I would argue that metabolism influences hormones more so than

hormones, influence metabolism.

And I think that's a really important distinction for people to

understand that if we're gonna look at root cause of dysfunction, we

have to look at what is somebody's metabolic health and how is that.

Influencing how their hormones are being produced, or excreted

through the body process, metabolize whatever word you wanna use, right?

So if we have this, let's just use a made up case here.

If we have this, mid forties, individual who is working full-time,

has children maybe in middle school.

So running them around with all these different activities, she doesn't

have a lot of time for her herself.

Self-care is kind of being put on the back burner.

She's eating snacks on the go because she's starving and just trying to get

food, where she can, It's very likely just from a statistical standpoint,

still the person who's doing majority of the household chores, and may or

may not have a really vibrant, healthy sex life and or relationship with

her spouse if she is still partnered or has a partner to begin with.

All of those things can play a role in then how metabolism's, namely something

called insulin resistance, which I know you talk a lot about in, in your

world and your podcast, I'm sure.

Can influence how estrogen is then, um, not only, not only metabolized,

but also produced to some extent.

Right, and so we can see what I call the canary in the coal mine

when it comes to insulin resistance start to happen long before we

start to notice it on blood sugar.

So somebody might have a normal.

Blood sugar marker called a hemoglobin a1c, which is an average.

Mm-hmm.

Or they may also, um, not notice anything in terms of blood sugar

markers if they get something called a comprehensive metabolic panel.

Right.

So it's really important to note that there are other ways of, from a laboratory

perspective, seeing things change.

And of course weight gain is usually one of those pieces.

And loss of lean muscle tissue.

Yeah.

Loss of lean muscle tissue drives.

Part of this dysfunction.

So, so we get into this place where this person, this, uh, let's call

her Jane, is, is just overwhelmed, exhausted, doesn't have any time

for herself, starting to notice some changes in terms of how her clothes

fit, how her body feels, and she may have less lean tissue than she once did.

That is a key for us to then intervene and make sure that we are rebalancing

things, whether it be from a nutritional perspective, an adequate protein intake,

making sure that we are changing the type of exercise that she once did.

Maybe running is not the best form of exercise for her body.

And looking at ways that we can shift, again, insulin balance.

And there's a variety of ways that we can do that, again,

through natural interventions and.

And prescription if warranted.

I love that you take this approach because I so

often see it, people attacking this from the opposite way around.

Right.

And it's really exciting and empowering and I think a huge relief

to understand, wait, there are so many steps that we can take just

with our nutrition and our lifestyle and the type of movement or exercise

that we're doing, that can really.

Just to help us feel better and have smoother transitions or happier

hormones at any point in life.

Yes.

Really.

Exactly.

And, and estrogen and progesterone balance, uh, is really critical.

So as, again, if we use this mid forties example as estrogen is

starting to rise, and typically that's not necessarily the production of

estrogen, which comes from our ovaries.

Mm-hmm.

So our ovaries are the predominant place where estrogen is produced.

We may not be ovulating as consistently as we once did, and that creates an imbalance

between estrogen and progesterone where we have higher levels of estrogen cuz

our ovaries are still pumping that out.

But our progesterone is not as, vibrant or significant.

And that creates sometimes these shifts.

If you then add in some digestive uh, concerns that may also

be influencing how somebody.

Is able to get rid of, excrete their hormones, namely through

poor bowel elimination.

They're not sweating enough.

Uh, certainly chronically dehydrated or, or if there's any kidney

dysfunction, which can be mild.

Mm-hmm.

We can see then a slowing of just the whole process.

And I talked to my patients about we get these recycled estrogens on board, which

estrogen, one of its main jobs is to kind of help us prepare for a pregnancy.

That's one of the, just evolutionary.

Historical context.

Insulin drives up metabolism of estrogen, meaning we can take a little

bit of testosterone that our bodies are producing, namely from our adrenal

glands, from women and aromatize it.

That's an enzyme that can change from testosterone to estrogen.

So now we have dropping levels of testosterone, which are important

for women as well to maintain lean muscle tissue libido.

Energy.

Yeah.

All the things that start to fall apart a bit.

Right.

Again, around that, I'm gonna call it five years premenopausal time.

Right?

So, okay.

Before menopause starts to hit, That shift then can be accelerated when the

ovaries are really starting to get tired.

And that's the definition of perimenopause when we start to see these shifts

of whether it be high spurts of estrogen production from the ovaries,

and then low amounts of production of testosterone often coincide.

Yeah.

As someone who is entering that phase, this all makes perfect sense

and it's really, You explain it very elegantly and, and simply thank you.

Because obviously it's a complex process for sure.

Yeah.

But I think understanding the basics of this is really helpful.

Yeah.

The science is so critical for women to understand their own bodies.

No kidding.

No kidding.

And I feel so many of us, I think it's better for the younger generation.

Yeah.

But so many of us my age or or beyond, We knew so little.

Mm-hmm.

It was sort of taboo to talk about.

Mm-hmm.

Our parents didn't necessarily even talk about it with us.

Mm-hmm.

Mm-hmm.

And it's exciting to see that there's so much more good science out there now.

Mm-hmm.

Mm-hmm.

that.

We're shining a light on the fact that there is this sort of disparity

of information about women's health

massive.

And, I mentioned this to you before we started recording, but, kind of my

passion project, if you will, is through a blog that I've started called Power

sex beauty.com, and it's really focused on empowering women to learn more about

their sexual health, their bodies, and, and really how that interrelates

even with their own partnerships, spouses, et cetera, relationships.

Because I think there has been this subject of a little bit of a taboo,

hey, you know, you don't talk about sex, maybe within your girlfriends, but

if your girlfriends aren't being kind of fully, Aware of their own bodies.

Sometimes you can get some misinformation, uh, not intentionally of course, but then

everybody's kind of thinking, well, why am I not normal and why is this happening?

And so much of what women experience is normal.

And part of that is drop in libido.

Yeah.

Is there's a normal amount of drop in libido.

There are ways that we can support it, but the expectation that we are

going to, no matter what amount of stress, no matter what little sleep.

No matter what type of responsibilities are on our plate, that we're just

gonna be this overly sexual, ravenous human forever is very unlikely.

Albeit, there are ways to mitigate that, if that is a way of, increasing,

The person's satisfaction and, and what some of their goals are.

There are ways to that.

We can look at that.

But yeah,

absolutely.

I love that.

well, I'm already fascinated by your blog, so I'm excited to see more of it.

and we'll provide all that information in the show notes for you guys

too, so you can go check it out.

I think too, people suffer so much unnecessarily because they think, oh,

well this is just the way it has to be, especially when we're talking about.

Perimenopause symptoms.

Yeah.

Um, going through menopause, we have this idea that it's gonna be

this nightmarish, hellish thing.

Mm-hmm.

And you know, you just have to suffer through it and soldier on and.

Continue living up to all of the expectations of being

the superwoman and Yeah.

Quote unquote, you know, having it all.

Yeah.

Which really just means we have to do it all.

yeah.

So yeah, thank you for championing that, And really shedding

light on this because Yeah.

We have enough expectations of ourselves exactly as it is.

And then you add in societal Yeah.

Expectations, and all of these things.

And if we think, well, what, what's wrong with me?

I should be X, y, or Z constantly, and I should have, this ravenous sex drive all

the time, but we're completely depleted.

It's, yeah, it's completely unrealistic to expect that of ourselves.

I just think it gives us permission a little bit to step

back and go, wait a minute, like.

I'm a human, complex person, my body will change.

Yes.

What is normal?

What is reasonable?

Yes.

To expect of myself and

for others to expect of me.

Exactly.

And, and really there is a little bit of a misunderstanding around how hormones

can influence sex drive in the sense that.

Perimenopause can definitely influence sex drive in a variety of ways.

Hormonally is, is definitely one of them.

But dopamine, which is a neurotransmitter, is the predominant hormone that

initiates sexual desire in the brain.

So when we think about what drives sex drive, redundant there, but what

you know really increases sex drive, it is a brain neurotransmitter.

Peace and.

Dopamine is a pleasure seeking neurotransmitter.

It is designed to tell us to go seek, for time with friends, to have

sex, to spend time in nature, to do whatever it is that we wanna do.

And if dopamine is, again, not being produced in adequate amounts because of

depletion in other areas, which of course, the brain is an extremely complex organ.

It is not going to function as well.

Testosterone, what's important to just kind of maybe bring, bring the

other hormones full circle here.

Testosterone stimulates more dopamine binding in the brain.

And so you can see this indirect relationship with testosterone, which

is why testosterone, a lot of women will come and want their testosterone tested

cuz they'll think, well, that's the issue that's low and it might be, mm.

But where the literature is going and really where the

understanding of sex drive.

It's more of if somebody is, experiencing Anne Hedonia, which is really loss in

interest of pleasure seeking activities.

By definition, there's a fantastic book for women who are, and men

who are interested in this topic.

It's called Why Good Sex Matters by Dr.

Nan Weiss.

She's a neurobiologist and also a sex therapist.

It's a really cool combination.

And she really talks about this loss of, interest in pleasure seeking activities

as the driver of, loss of libido.

And we see this commonly in women who are postpartum.

Mm-hmm.

Yeah.

Where you get somebody who is exhausted, they are giving

everything they have to these little beings to try to keep them alive.

And their libido also because of evolutionary pressures has dropped.

Yeah.

And then women are still expected by their own expectations.

Maybe not always, right?

Maybe not what their husbands or partners are expecting, but their own expectations.

Why am I broken, right?

Why?

What's wrong with me is something that I hear a lot, and I said

this to a patient this morning.

I said, You evolutionarily were supposed to just be taking care of your

children so you could keep them alive.

Exactly.

And And nature has not prioritized sex.

Doesn't mean we can't influence it using our knowledge of biochemistry and

physiology, if that's what you want.

Yeah.

But let's talk about like what is it that you want versus what you

actually are expecting of yourself,

right?

Yeah, exactly.

And I think because people are so depleted and so run down

and they're doing too much.

Mm-hmm.

Or they're just stuck in the daily grind and they haven't prioritized pleasure

and fun and true rest, connection.

All of these things that feed our soul in life.

Yeah.

They're not getting that.

Dopamine that would be produced by those things.

So I think it kind of goes both ways.

Exactly.

Right.

You're not doing the things that stimulate this.

Yeah.

And then you're getting less of it, and then you want less of it

because you've got no dopamine.

Sort of this vicious cycle.

Is that

exactly accurate?

Yeah, that's accurate.

That's beautifully said.

Mm-hmm.

and probably even, taking it a step further is we also wanna think about

the inhibitory mechanisms that block some of that dopamine secretion.

And also, you know, how, those can be influenced things like antidepressants

even, which can absolutely be indicated for particularly anxiety disorders.

less favorable.

SSRIs specifically for specifically depression these days per some data

that came out a couple years ago, but it's a different conversation.

SSRIs can inhibit sex drive because they're intended to raise serotonin, which

serotonin's an important neurotransmitter as well and it's own right.

But it is actually going to inhibit someone's ability

to, be as interested in sex.

Yeah.

And particularly that dopamine connection.

So, Hence why there are agents out there that are in the antidepressant

realm that, increase dopamine, that tend to also not inhibit sex drive.

So, somebody, you know, is listening and is wondering, you

know, well, am I on one of those?

The name of that agent is Wellbutrin, which is a very common antidepressant.

not to say that everybody should run out and get a Wellbutrin, but I, I do like

that one better often, than some of the other categories that raise serotonin.

Depending on the situation.

Yeah.

And I can't tell you how often I have heard from clients that

when they first come see me, they are on one of those mm-hmm.

Medications.

Mm-hmm.

And they will say, I have absolutely zero sex drive.

Mm-hmm.

Since I've been taking this.

Mm-hmm.

I don't wanna kill myself anymore.

Mm-hmm.

Mm-hmm.

Mm-hmm.

But I also don't wanna have sex with my partner.

It's hurting my marriage.

Mm-hmm.

And.

Thank God there are better options now.

Mm-hmm.

Because that's an important part of

life too.

It absolutely is.

Yeah.

Yeah.

We don't want anyone to be depressed.

I mean, thank God for some of these things.

If it's gonna save your life.

Mm-hmm.

A hundred percent.

Yeah.

There's, go for it.

A place, I think.

Absolutely.

There's a time and a place, but I think we could both agree that

there's, you know, an overprescription.

Epidemic, in this country particularly, and doubt, it goes

back to the toolbox conversation.

If you're trained to only have a set of tools and that toolbox includes

writing prescriptions, and you only have seven minutes with your patient,

and they are saying that they're.

Feeling really, really down how much counseling you're gonna

get to do in seven minutes.

Exactly.

And then you add that to the mental health provider crisis.

Right now, how many people can find a therapist post covid, especially

a therapist that takes insurance?

Good luck.

Yeah.

If you find one and they're good, please send me a message so I can

refer people to them because it is near impossible right now to find.

And so we're in a situation where, Providers are doing the best they can.

And part of that is over-prescribing because what

else are you gonna do to help your

patients?

Exactly.

Yeah.

Yeah.

They do what they can.

Yeah, absolutely.

Exactly.

So, uh, that said, what are some of the most common ways that you see

that we women hijack our hormones?

maybe we're in a place where we don't necessarily have access to, the type of

medical care that we'd like to get, or maybe the mental health care, et cetera.

So we want, well, or we do, whether we do or we don't.

Mm-hmm.

If we want to stop doing things mm-hmm.

That are detrimental to, mm-hmm.

Hormone health.

Mm-hmm.

Neurotransmitter health.

Yeah.

What would be the most common things that you see as far as either

habits with nutrition or lifestyle?

You mentioned kind of that constant stress.

we know that that's a problem, but what are the other most common problematic

things that people are doing that can really throw the system off and

create that negative downward cascade?

Yeah, I love that question.

The first thing that comes to mind is sleep.

And that again, seems so obvious and so basic, and, and people sometimes are

like, oh, I know I should get more sleep.

But you really have to understand that if you're not prioritizing sleep, that

the expectations that things are going to get better without adequate sleep.

Yeah.

You can't just medicate or push your way through it.

so.

Burning the midnight oil to use an antiquated phrase

and trying to get up early.

And again, I think about so many of my patients that are getting up trying to

get their teenagers ready for school.

You know, 6:00 AM out the door.

They're staying up till 11, trying to just get some work done, answering

emails that are constantly giving us notifications on our phones.

waking up multiple times through the night because they're having to urinate

or that they're just tossing and turning cuz they're thinking about work.

Yeah.

Sleep has to be addressed.

Yeah.

And if you're not prioritizing your sleep, there's not a whole lot that I, I feel

like the other areas of health are going to be able to significantly influence.

Could not agree more with that.

The second would, definitely be the

lack of intentional movement.

One of my nutritionists, at Vita, her name is Carolina, she uses the term

intentional movement a lot, which I like.

People will not prioritize movement because of time often.

Mm-hmm.

I am a single mom of a five-year-old.

I get it, I work full-time.

Um, but it has to be prioritized in order to be able to achieve

again, the goals that you wanna do.

Intentional movement doesn't have to be high intensity.

Uh, I think that it's important that it also doesn't have to be long in duration.

You don't have to go to the gym for an hour, five minutes of going up

and down the stairs, or walking, you know, getting a step in the home.

It's just something that you can get your heart rate up, especially after

a meal, can make a huge difference.

Yeah, and again, going back to that insulin resistance piece.

I'm a big fan of, people getting a weighted vest.

You know, you can get these from any online, large retailer.

And they're so, effective at just increasing a little bit of

that strength training aspect.

Even in things like walking around the neighborhood, can make a huge

difference for those with young children.

Making sure that you're like strapping them on and then adding whatever you can.

And terms of a backpack.

Yeah.

cuz that can make a big difference.

so intentional movement, I would say.

Is really critical, but not just saying, you know.

Yeah, yeah, yeah, yeah, yeah.

Making a plan for yourself and strength training.

Just going back to that metabolism piece.

If we don't address metabolism, our hormones are not going, yes.

We're not gonna get where we want with our hormones.

And so prioritizing that is really critical.

so that's what I would say about movement you know, nutrition is obvious.

This is, you know, your realm.

You talk about this with your clients every single day.

But I really don't see women get enough protein.

Mm-hmm.

And yeah, with, uh, Ozempic or Semaglutide, um, the generic form of,

of Ozempic being extremely popular these days, which is a medication that I use

in my practice a lot with patients.

Mm-hmm.

that is causing an even bigger concern around, again, loss of lean muscle tissue.

Yes.

I actually have a doctor talking about that exact subject in a few weeks,

so we're gonna dive deep on that.

But absolutely, That's a major

concern.

It's a major concern.

And you get somebody who may only be in a category of lean tissue

that's borderline to start.

You give them an agent that can accelerate loss of lean tissue.

Yeah.

And then they go off this, they may lose weight, but they then

end up in a situation that is.

Potentially more metabolically compromised in the end.

With that being said, I do prescribe this, I do find that there is a,

a time and a place, I use it in, you know, for weight less often.

I.

But I require them to work with a nutritionist who has understanding Right.

Of ensuring they're getting adequate amount of, of protein.

Yeah.

And protein in the diet is, is just underrated right now.

you know, people go through trends.

Nutrition is certainly no stranger to, I'm kidding.

Fats and trends.

and you know, fats, you know, we're all the rage five years ago and I think they

still are really, really important to emphasize healthy fats, particularly

for metabolic balance as well.

But I think the key to the kingdom, frankly, is eat mostly

plants, some, meats, lots of fish, and ensure that you're getting.

At least a minimum amount of protein or your body weight

and type based on your goals.

And usually it, you know, nutritionist is the best person to kind of help

you work through that or using some of these really great apps.

Chronometers is one that um, I know my nutrition team loves.

It's one I use too.

Yeah, it's a good one.

So those are just some, just the basic suggestions.

And then also things like sleep apnea can go undiagnosed.

if somebody is even having some mild snoring, that can influence how their

body is able to not only get oxygen to their brain and cause that restorative

sleep, but also influencing their hormones, weight gain, increases

the risk for sleep apnea, right?

And so we have this unfortunate cascade of.

Somebody gets really busy, their metabolism is changing, which

influences their hormones, which then they develop sleep apnea,

which exacerbates their metabolic dysfunction, that's and their hormones.

And then there's a depletion of some of those feel good neurotransmitters.

So we have to look at if there's any kind of snoring that asking their doctor for a

sleep study referral, cuz that's, that's a fix, that's a non-pharmacologic fix.

That can be extremely beneficial.

Yeah.

And everyone check out my episode.

the week before this with, Dana Tasha.

She is a myofunctional therapist and we talk a lot about sleep and, um,

sleep apnea and all those things.

So we do a deep dive on that, which is a really great, great episode.

If you're, you know, dealing with any of those challenges or your partner

snores, Before we shift gears, cuz I definitely wanna make sure we get

everything in, in the interest of time touch, and I know this is a big,

subject, but touch a little on alcohol.

Yeah.

Oh gosh.

The mom wine club.

Yeah.

Yeah.

bluntly alcohol is a toxicant.

there is not a, large amount of benefit, if any.

Um, you could make a caveat that if somebody socially is engaging more, that

there are benefits in, in that piece.

because social community is very important, but there really

is no significant benefit to alcohol, and alcohol is processed.

Has more calories per gram than carbohydrates.

Seven calories per gram versus carbohydrates are four.

it has zero nutritional value to it and is, absolutely

something that can disrupt sleep.

It will, increase the demand for the liver, obviously, to be processed at night

and depletes something called glycine, which is a, uh, important amino acid

that is, responsible for keeping the.

Brain calm and cool and relaxed.

Uh, if you get a depletion of glycine, you often will experience frequent

wakings at night, which is a whole other conversation we could talk about.

but I, personally, um, I understand why people still, uh, engage

regularly in alcohol consumption.

I personally enjoy a glass of wine with my partner, but.

I know that I'm not gonna feel as clear even after one glass of wine the next day.

I, it's a known thing and as long as you are making a choice, just like

if you go and you eat some gummy bears, you probably know intuitively

gummy bears are not good for you.

But if you really want the gummy bears, okay, but alcohol can

influence the whole sorts of things.

There is a disruption in hormone processing with alcohol.

And so if somebody's already struggling with how their hormones are processed

through the liver, it is only going to add a little bit more work.

You can think of it as just it's pushing people to the back

of the line and hormones are tend to be, um, in that realm.

Alcohol is prioritized because it is a toxin.

Right.

Yeah.

Would that scare your audience to know?

Well, I think they've

probably heard me make points about that

before, and I'm the same as you.

You know, I love a beautiful craft cocktail or glass of wine

now and then, but I definitely notice its effects, especially

now that I'm more in touch with.

My body.

Yeah.

Um, when I was more dissociated from my body, it was a little different,

but now I kind of know what's going on and I can really tell just by looking

at my aura ring data, like, Ooh.

Yeah.

Okay.

And it's just no longer worth

it to me.

Yeah.

to do it, more often than, than once in a while because mm-hmm.

My health is a priority.

Mm-hmm.

Mm-hmm.

and I, I just feel like we are exposed to, so.

Many toxins in our world that we have absolutely no control over that, you

know, we can't be insane about it.

Right?

But the ones that we do have control over and can avoid,

Hey, let's just do our best.

Yeah.

And I think, again, looking at that social balance and just like anything, you know,

moderation's critical, but alcohol, it does slow everything down and makes it so

the body has to work a little bit harder.

And if that's an accepted.

Risk.

Mm-hmm.

when it comes to, Pathologies that can emerge.

Non-alcoholic and alcoholic fatty liver disease is one of the biggest, epidemics

in this country that coincides with high blood sugar, diabetes, elevated

triglycerides, the whole gamut.

And when you have fat deposits into your liver, again, like what's

the organ that's responsible for processing hormones and a variety

of other really important functions.

So, you know, you can't have this expectation that you're gonna

feel hormonally well, right?

If you are not treating your body with the respect that it's demanding.

When it starts to let you know, Hey, this isn't, I don't

like this, I don't feel good.

And I love the way that you phrased that, treating your body

with the respect that it's demanding.

When it's sending you these messages.

Mm-hmm.

That's a very, very different mindset and way of approaching this than saying,

well, I'm depriving myself of something.

Mm-hmm.

And I think that that's a very cultural thing.

Mm-hmm.

Mm-hmm.

Here that, oh, well you don't have to deprive, you shouldn't

have to deprive yourself.

Mm-hmm.

It's not depriving yourself, it's really treating your body with respect and giving

it what it needs and each stage of life.

Right.

and that's a much more empowered place to come from.

Yes.

And it just feels better.

It feels better when you make those choices because then your energy's better.

Your sleep is better.

You enjoy your life more.

So what are you actually depriving yourself of?

Yeah.

And Jenny, have you seen those, wine alternatives that are full

of adaptogenic herbs and Yes.

Things that are actually beneficial?

Yeah.

I also

give them

as client gifts.

I love them.

Yes.

I love, like, there's a couple of them that I absolutely love and

think that they taste super good and they're not high in sugar.

And I, you know, you can put 'em in a wine glass even, and then you feel like you're.

You know, and it's not to, and try to fool anybody, but really, like

you are prioritizing your health.

Yes.

When you make those choices and if your goal is to become intoxicated, well

it's not gonna work, but meaning, right.

Bringing those, but it, it's certainly will make you feel

a lot better the next day.

Absolutely.

And I think sometimes the ritual of having that.

Lovely.

You know, special drink and a pretty glass is important.

I think that that's a healthy thing.

I don't have any issue with that.

I encourage people often to create those rituals for themselves.

Yeah.

Because that's usually what they want.

That's the partition between maybe work and and personal

time, or now I'm on vacation.

All of those things that I think are significant and even healthy, and we can

do them in ways that serve us better.

Yep.

Agree.

Yeah.

So Couple things that I'd love to ask you.

we've touched on this a little bit, but when you're working with patients, how

do you sort of guide them out of that sort of mentality of being disempowered

and thinking, well, it's all downhill from here after a certain age, and

what are the most important ways.

know, we talked about sleep, intentional movement, getting enough

protein, maybe adjusting your alcohol, possibly maybe caffeine intake, right?

Mm-hmm.

To, feel better.

but, what do you think are the top few ways?

Yes.

Or what are the biggest tips that you would leave listeners with to

help them have healthier hormones and maintain healthier metabolism and body

composition in perimenopause and beyond?

Yeah, so this might seem like a slight departure

from what we've already talked about, but the mental, emotional, spiritual

piece, which is when anyone is familiar with, functional medicine, the center

of what's called the matrix, which is really the operating system in

which functional medicine, is taught is mental, emotional, spiritual.

And if that piece is not being addressed, um, which can obviously

be influenced by things like sleep and nutrition and exercise.

We're not gonna get where we wanna be.

And the empowerment piece really comes from, within, it comes from

our perceptions of ourselves.

It comes from how we, engage in the world with putting ourselves as a priority and.

I look at something called attachment theory, which has a lot to do with how

we relate to our intimate partners, but also how we relate to others,

friendships, family members, and can have some behaviors of self abandonment,

both in all the different types of attachment in, in the time we have,

we don't have, the opportunity to dive into all of that, but very briefly,

There's four different attachment types.

There's an anxious type, there's a dismissive avoidant type,

there's a fearful avoidant type, and then there's a secure, and

we would all aspire to be secure.

And again, bringing it back to how somebody can look within and say, okay.

How does this attachment type influence my mental emotional wellness?

Well, if you are constantly prioritizing, let's say, your partner, your kids, your

work over yourself, you may be someone who leans towards the anxious attachment

type because you feel your worth is only going to be achieved by giving.

Yourself to others, right?

And until you start to prioritize how to give yourself back to you,

and that can be small things.

You don't have to quit your job and abandon your children and

get divorced in order to do this.

But it may be saying no to, uh, project request or asking your partner to

drive your kids to this soccer practice or spending a weekend where you are

just able to write in your journal.

There are ways that we can get back to ourselves, and that is such a

common thing for women to be giving more than we have the capacity to do.

Yeah.

And we run on an empty tank.

The reason that attachment theory can be so useful.

Is because it gives you the understanding of why you developed the way that you did.

Usually due to very early childhood programming, which when your therapist

says, you know, it's all your parents' fault, it kind of is I love them, right?

As, as a parent myself, I'm like, oh, how do I not screw him up?

Like, how do I not, how do I not do this, but could be.

So many little microtraumas that can happen that are just daily life.

You know, that you as a very young child perceived, and now you have

spent the rest of your adult life trying to earn other people's worth.

Or at the same token for the dismissive avoidant types.

Maybe you've kept people a distance away because having people get to

know who you really are doesn't feel safe, and vulnerability is

a really uncomfortable thing.

So therefore, so having pointing at myself Yeah, and giving yourself the

opportunity to be more vulnerable with others is part of that work to do.

And it's actually the opposite of the anxious type, so.

I think that, the foundations of health, we already talked about

sleep, exercise, nutrition, stress management, you know, reduction of

toxicants like alcohol and caffeine.

Absolutely.

But if we don't talk about how our mental emotional space influences

how these other facets are working, we're not gonna prioritize exercise.

We're not gonna welcome in healthy conversations with friends and

family members and intimate partners.

We're not going to be able to achieve what we wanna do if

the mental piece isn't there.

And I personally have really fallen in love with attachment theory because

of, The way that it contextualizes the framework of how our brains develop.

Mm-hmm.

And how we relate to fascinating others.

Fascinating and ourselves.

So, strongly encourage anyone who's interested.

the book attached, by Levine is, is an excellent resource as is,

personal development school.com.

is another online resource that I refer people to a lot.

Cool.

We'll put

those in the show notes for you as well.

And Dr.

Leary, will you come back one day and do an episode with

me just on attachment theory?

My God.

Any day.

Okay, awesome.

I think people would be really curious to hear that.

I think that would be a really

valuable, yeah.

I just did this training for the Functional Medicine Coaching Academy.

for them I did a three-part series on attachment theory in relation

to, sexual desire and general, applications of functional medicine.

And attachment theory is just so central in my opinion, so I would love to.

Awesome.

Okay.

That sounds great.

Well, this has been such a great conversation.

I really enjoyed it and this is such great information.

Tell everyone where they can find you and um, again, we'll put this all in the show

notes, but yeah, give us the four 11.

Yeah.

so I have a clinical practice at Vita Integrated Health.

so that is in the Seattle area.

We have five clinics, three of which have functional medicine.

I'm the residency director, so I do have residents that, I oversee as well as a

fantastic colleague over in Bellevue.

So, we are currently in the midst of some transitions, but would love if anyone is

interested in doing clinical consults.

That is where to find me.

And I also have a blog, power sex beauty.com, which is,

again, my passion project.

Lots of articles on attachment theory, hypoactive sexual desire

disorder, and some hormonal pieces both for men and women on there.

So, um, that is where you can find me.

Awesome.

Yeah, it's a really great resource.

So Wonderful.

Well, thank you so much for taking the time to talk with us today.

We'll look forward to future episodes.

Pleasure and thanks for joining us, everybody, and we'll see you next time.