Peri-Menopause and Female Hormone Balance Solutions | Podcast #213


Peri-menopause can be hard on some women. It brings fatigue, mood swings and sleep troubles, a stressful transition that can last for months or years before menopause.

In today’s podcast, Dr. Justin Marchegiani explains the process of peri-menopausal stage and its effect to the body. Learn how the lowering levels of progesterone make one’s system more estrogen-dominant, the different issues brought by peri-menopause especially stress, mood issues, hot flashes, depression. Also, learn how to minimize its effect. Continue for more and don’t forget to share. Sharing is caring!

Dr. Justin Marchegiani

In this episode, we cover:

02:26    Adrenal Gland

04:31    Female Hormone Cycle

07:31    Hormone Physiology 101

26:27    Stress Response Buffering

12:35    Effects of Estrogen Exposure to Men


Dr. Justin Marchegiani: Hey guys! It’s Dr. Justin Marchegiani, welcome to today’s podcast. Uh, congratulations to Tom Brady and the New England Patriots, great go- not really a great game on the offensive side, great defensive game. Uh, 6 superbowl victory for Tom. And I did a podcast on Tom’s performance secrets 2 weeks ago which become even more pertinent today based off of his victory. He is officially the go- greatest of all time. So, really good uhm- to go back and revisit that podcast, lots of good insights in regards to sleep, in regard to hydration, in regards to nutrition, reducing inflammation, uh various training techniques, all these things I think are, a conglomerate of tools that uh- Tom uses to improve his performance, heal fast and keep his uh, pliability and performance up the uh- at the, you know, at the highest age possible. Really, to be a successful quarterback in the NFL, it’s pretty amazing.

So, today, we’re gonna open it up here for uhm… here, I kinda like- maybe a little live podcast here. Anyone wants to chime-in in these specific topics they want me to go into today, we can just choose a topic and just go off the cup and go live. I’m on Facebook as well so, feel free and check in with me on any of these mediums here so far. I’m gonna dive in one topic here today. We’ll go in on peri-menopause. So peri-menopause is really interesting. This is the kind of the phenomenon where you’re in this transition time of going into full menopause or- typically peri-menopause is just starting to miss some periods, you’re maybe in your mid- ty- typically upper 40s. Usually menopause starts between 48 to 51 and it can take 10 years, meaning the symptoms that you deal with during menopause, that can take up to 10 years sometimes. The hot flashes, the mood issues, the depression, uh anxiety, uhm those type of sleep issues, scrappy skin, all those things can kind of con- you know, consolidate and happen over a long period of time. Typically, peri-menopause is that- one year. Once you get in the menopause- menopause typically is like, once you’re been no cycle for 12 months. So, peri-menopause is this in-between time  where skipping cycles, maybe you have a period every 4 months, or 6 months, or you’re kinda lost your cycle regularity, you know, fertility may not quite be there, you may not be ovulating as much- uhm- you start to see your cycles just getting more and more irregular, typically in you’d mid- typically upper 40s when that starts to happen.

Now, what do we do about that? So, first thing is, make sure you’re not getting exposed to toxic hormones in your foods or in the environment. That’s number 1. Uh, number 2, the biggest hijacker of your hormones is gonna be your stress hormones, A.K.A. cortisol and adrenaline. So it’s really important that you get your adrenals looked at if you’re worried about peri-menopause because, DHEA Sulfate, this is the major sex hormone precursor that’s made by your adrenal glands. This is actually coming from your adrenals and it’s a precursor to make more estriol in women. It can go more testosterone in men. But estriol is that predominant estrogen that you’re gonna have when you start becoming more menopausal. Typically when you’re cycling and fertile, it’s more estradiol, E-2, the “di” is kinda- right, 2. And then estriol, or the TRI, that prefix for 3. So you start to make more estriol, and that’s gonna be more anticancer. It’s gonna be- it’s have some really good anti-aging benefits. Estriol’s really important for hydration, that’s why low estriol- low estriol can- can create vaginal dryness. It’s also a really good anti-inflammatory, it really helps with brain inflammation. This is why a lot of mood issues and brain fog and cognitive issues start as you become more and more uhm- peri-menopausal into menopause.

So we have to look at the adrenal glands, that’s number 1. Because these adrenals make DHEA, also cortisol hijacks your hormones. Cortisol increases blood sugar, and also decreases protein synthesis, meaning, you have less protein going to build up your brain chemicals and build up your muscle tissue, and that protein is primarily running through gluconeogenesis where it’s shredding up that protein and making more glucose out of it. That’s what stressed us. People get more flabby, they get more cellulite because of cortisol. Breaks down connected tissue, and it breaks down amino acids. So, your- getting your adrenals looked at is really important.

Uh, number 2 is looking at your female hormones as many women as they go more into peri-menopause, they become more estrogen-dominant. And the reason why is, because we talked cortisol hijacking, your hormones- it does so, ’cause it pulls progesterone downstream to make your stress hormone. So this is important. The more stressed you get, the more you deplete progesterone, that puts you more into an estrogen-dominant state. Typically, we have more progesterone than estrogen. It’s about a 20 to 25 to 1 ratio progesterone to estrogen, and when you start going estrogen-dominant, people think, “Oh, that means estrogen goes higher”. No, it just means there’s ratio, it starts to drop. So you still may have more progesterone, there’s that ratio drops down a little bit, and you start to see estrogen creep up, but you may not see estrogen ever go above progesterone. Just keep that in the back of your mind. That’s gets commonly confused.

So we have the progesterone there. And typically, when cortisol’s prolonged, this also affects the HPA, H-P-A-T, H-P-A-T-G-G: hypothalamus, pituitary, thyroid, adrenal, gonadal, gut access. So it affects that feedback loop from the brain, and the hypothalamus and the pituitary ups- upstairs to that feedback loop of the glands secreting hormones downstairs. And this is important, so we start to see cortisol rhythm operations. The cortisol rhythm starts fluctuating. We start to see it in women with their cycle operations. A lot of times we just see a lot of PMS or the extreme PMS is PMDD, which is that week or so, before you actually menstruate or bleed. And then we also see a lot of- a lot of times, sometimes shorter cycles, going from 28 to 26 to 24 to 22. So we start to have a shorter luteal phase, just really important ’cause your luteal phase is that primary phase where you’re making more progesterone. So we do test while we actually look at progesterone every other day for a full cycle. And one of the things we’ll start to see is, your overall progesterone that you make throughout the whole month, typically should be above that 3000 marker so, it starts to drop. You start to see it drop. And that’s big, ’cause that’s kind of like looking at your overall progesterone sum, we start to see it drop, and a lot of times that can happen when you compress that luteal phase when you shorten it, ’cause you just have less days where you’re even making progesterone. Uhm, that’s a big one. So we start to see cycle aberrations there, we could see a shorter luteal phase, we could see a longer follicular phase, we may be out of sync, or we’re not ovulating at that right time and your ovulation could be totally off, or maybe you’re not even ovulating. ‘Cause, you know, to have that good ovulation to signal, we need a- [clears throat] a rise in estrogen followed by rise in progesterone and then estrogen kinda pitters out while progesterone stays high and drops. This is kind of our typical rhythm, and how women’s cycle work. So, just kinda first thing that happens, those gotta- kind of hormone physiology 101.

So, we start off by menstruating. That menstruation is typically signaled by a drop in progesterone and estrogen. First thing, progesterone and estrogen drop. That’s step 1. 2, menstruation happens after that, that’s the shedding of the uterine lining. We want brighter blood that’s more oxygenated, more fresh, for starting to see browner, thicker kind of clottier stuff, it just could be- uhm- the uterine lining from previous cycles that didn’t flush out. So, 1, drop in progesterone and estrogen, 2, menstruation, that’s gonna happen for a few days, anywhere between 3 to 7 days, okay? We don’t wanna go more than 3 to 4 tampons per day on average. For our average high, is if not we lose too much blood, we go hemorrhagic, we go anemic because of that. Step 2 is FSH starts to increase. FSH is our brain hormone, follicle stimulating hormone. That FSH start to make the follicle grow a little bit. That follicle starts to produce estrogen. Estrogen starts to rise, right? As estrogen starts to rise, that starts to signal luteinizing hormone, which is our other brain hormone that talks to our ovaries. And then progesterone starts to rise typically around day 12 to 13 after that. So here we are at day 12 or 13, estrogen’s kinda topped out, that signals LH, then we have progesterone going up like this. So progesterone’s going up, and then at some point, estrogen starts to fall again, progesterone stays up, and then around day 28, they crash together and that signals the whole entire step again.

So, drop in estrogen progesterone, signals bleeding, FSH, increases, FSH creates more estrogen, more estrogen creates more LH, more LH creates progesterone, estrogen starts to drop, progesterone stays high, estrogen and progesterone drop and then signal bleeding at the end. So that’s kind of a general uhm, cycle physiology 101, Most people are clueless about that. When I talk to a woman, I say, “Hey how long is your cycle?”, the biggest kind of common misconception, “Oh, it’s 3 days or it’s 7 days”, like no, not your menstruation, your full cycle. Your cycle is from day 1, first day of bleeding to next day 1, typically 28 days later. Uhm- most people get that confused your cycles, your full hormonal rhythm, day 1 to day 1, how much you menstruate is gonna be your- your bleeding, your period time so to speak. Hope that helps. That’s a common misconception.

Alright, so we talked about adrenals, we talked about our female hormone cycle, we talked about hormones in the environment toxins. These things are really important because they disrupt, they put more stress on our metabolism to be our- to be our detoxification system to be able to metabolize hormones. Gut functions’ so important because this is where we absorb a lot of the nutrients from our food to make our hormones, right? Hormones are made from good cholesterol, right, it goes cholesterol pregnant alone and then 27 different hormones that spit out on the stress side, on the mineralocorticoid side and on- then on the anabolic estrogen progesterone, testosterone side. So we- we need to be able to absorb these nutrients so we can make our hormones. We need to be able to absorb nutrients to help buffer the stress response. Magnesium, L-Theanine, GABA, they help us buffer that stress response so we could- think of it as like, imagine buying a car where you can only shift it from first gear to second to third or fourth, fourth to fifth. So, all you can do is bring that car up from low to high but you can’t downshift. And a lot of people are in this place where they cannot downshift their metabolic car, so they constantly feel stressed, they cannot ever bring it down from fifth gear back to first gear. And this is one of the biggest issue- biggest issues we see, and if we can’t absorb our good amino acids, and- and- and make our good inhibitory nerves, transmitters like GABA, through L-Theanine, through magnesium, through dopamine through serotonin, we’re gonna have problems. And typically, this starts to mess up sleep. Starts to mess up our melatonin cortisol rhythm which is the next step. And that’s gonna be basically- melatonin goes up at night, cortisol goes down at night. We have this inverse relationship – melatonin up, cortisol down, right? We get this big “X”. And when cortisol stays high at night time, it disrupts sleep, it prevents melatonin from coming up. Melatonin is a powerful antioxidant, it’s powerful anti-cancer, it’s very anabolic, it helps you heal, recover, turn-over your neurotransmitter successfully and heal your body, ’cause you really tap into ’em, make a lot of your growth hormone in that first half of the night, 10:00PM to 2:00AM. So we wanna be asleep so we can plug in and access that growth hormone.

Okay, so we got our rhythm, cortisol, adrenals, digestion, absorption, and then also, the amino acids that we absorb through our digestive system, also help run our detoxification system. So, we wanna stop the toxins on one side, not drink out of plastics, not consume pesticides, consume organic, right, get, you know, higher quality step-4, step-5, if we’re using the whole food, step-method works, more grass-fed, pasture-fed, organic, the whole nine yards that’s gonna help us make more of the nutrients, absorb more of the nutrients where we can actually detoxify as well.

And then we talked about those hormones helping with sleep, helping to buffer stress. Uh, very-very important components to female hormone health, as well as make hormone health. Uhm- males really get the sure end of the stick, because there’s a lot of estrogens in the environment, you don’t have a lot of synthetic androgens in the environment, so men really get clavier because when men get a whole bunch of estrogen exposure, it starts to inhibit LH. LH is that upstream hormone in the brain that talks to the gonads, right? With the uh- the cells lay dig in the testicles to make more estrogen… I’m sorry, to make more testosterone so that estrogen disrupts that signal. Now we don’t talk to our testicles to make more testosterones, it starts to inhibit that. And it’s a- it’s a really a vicious cycle. With women, they just become more estrogen dominant, which is a good, that starts to mug their cycle. With men, it starts to decrease testosterone. And you start to see things like gynecomastia – man boobs. Uhm, maybe guys even being overly emotional because they’re- it starts throwing off testosterone-estrogen balance as well. So that’s gonna affect their mood and- and focus on- on the male side as well. And of course for the woman, it- it causes same things, ’cause they can create more PMS which can create irritability, breast ___[13:48], back pain, moodiness, irritability, sleep issue, all those things that you know, women do not like. And men don’t like them either, of course. It’s a two-way cycle in that for sure.

So we think we hit all the major things. I’m gonna open it up to questions, primarily on the peri-menopause, female hormone side of the fence. And again, this is total live podcast here. Uhm- again, I just- I interject a lot of clinical information ’cause I work with patients in the trenches. So if you have any of these issues and you wanna dive in, click below to make sure you subscribe, hit the bell, and schedule a consult with me and my staff. Let’s see what kind of questions we have here off the bat. Try to keep it pertinent on the topic if you can.

Alright, let’s see here. Uh, “How bad- how can a bad gut affect hormone?”. So it’s going to affect the two-wa- oh, couple of ways. We absorb all of our nutrients to create our hormones to our gut. Number 2, we absorb the nutrients to our gut to help us detoxify – number 2. And then number 3, dysbiotic bacteria increases an enzyme called beta-glucuronidase. And beta-glucuronidase, uhm deconjugates estrogen. So we have an estrogen molecule right? It is floating in our bloodstream, we conjugate it, we bind it to a protein, to escort it out of the body. It’s kinda like, hey guys in the night club, whatever rock and rowdy, security guard comes up, like puts the guys hands behind his back and like escorts him, out of the club, right? That’s kind of, when you conjugate, think about as putting- err- handcuffs on that rowdy hormone. And de-conjugation is just someone coming around with a handcuff key, and uncuffing each person, right? Think- that’s what’s happening with dysbiotic bacteria… dysbiotic bacteria, bad bacterial overgrowth, increases beta-glucuronidase, then we have the- the handcuffs, are taken off the hormone, and they can be rowdy again. So those are the big 3 ways that can affect that.

Okay, excellent. Any other questions, feel free- uhm, feel free and chime in. I’m- I’m more than like- I’m more than willing to answer any more questions. Okay. I think we hit all the major things here. Try to think of anything else we can do. Pa-pa-pa-pa-pa, awesome… Tssssss… ‘Kay. “What’s a good mindset to have when you are feeling hard bowel, and of crohn’s flare up right now?” So, ob- obviously, gut issues can affect hormone health too, right? So question is, how did it happen? I want to feel like I’m in control of the vicious cycle. I wanna know what the heck happened. So, I wanna look back and at least gain control over how I gotten into this flare up. Maybe the first thing I wanna know. And the second thing is what actions are you gonna take to get out of that flare up? So, feel free and check video 2 to 3 weeks ago on how to, you know, reverse an autoimmune condition flare. Take a look at that video. I go over a lot of good steps that are needed to- to be addressed.

Uhm, “Is fatty liver curable? What supplements would you recommend to help?”. So, yeah, it is, I mean, it’s typically gonna be a combination of insulin resistance. And insulin resistance has a major effect on female hormones. How? Because high amounts of insulin, are going to up-regulate specific enzymes that can increase androgens in women. So that can really throw off androgens, and then of course high amounts of androgens can- can mess up proactive, and prolactin can screw up uhm, estrogen and progesterone, right? So, this is a really, you know, concerning thing. So, high fructose, corn syrup, insulin-resistance are gonna be the big things that are going to cause that.

Uhm, “Thoughts on IF in regaining cycles, avoiding IF until cycle returns”. So, uhm- typically, what I would recommend, is that you do not engage in any intermittent fasting until you get your hormones back and under control. Not eating food for a long periods of time can actually be a stressor on your hormones. ‘Cause we need nutrition to run our metabolic systems. But if you are more stressed, it- it may be too much stress on your body avoiding these foods, these nutrients. ‘Cause then, longer periods of time may cause your adrenals to make more cortisol, and adrenaline and gluconeogenesis to regulate your blood sugar. The more stressed you’re at, uhm- the more stressed you’re at, the better you’re going to absor- the more stressed you are, the more gluconeogenesis, the more you’re gonna rely in other hormones to pick up your blood sugar. If those hormonal systems are weaker, you’re essentially gonna need more of those other systems to pick it up. Now, by eating and stabilizing your blood sugar, that’s gonna take stress off those hormonal systems that are weaker, and give them the chance to get stronger. It’s kinda equivalent if you break your ankle. You walk around on crutches for a bit, the goal of walking around on crutches is going to be to take weight off your ankle so it can heal.

Alright, excellent. Very good. Uhm, “Can low progesterone in ladies cause low libido?” It definitely can. Low progesterone can definitely cause, uhm, low libido in ladies. Uh- lot of times it’s just the estrogen dominants that starts to pick up, that can be the big issue.

Uh, Samuel writes in “Hey doc, been drinking a little more alcohol recently due to football games and hunting season, seems to have messed up my circadian rhythm a bit. Uh- what would you recommend for a reset?”. Uhm, more than likely, I would just stop with the uhm- stop with the alcohol kind of down a bit. You could do more vitamin-C and more sulfur amino acids, uhm, to help your body heal.

Excellent. Uh, let’s see here. Any other questions? Barbara Scott writes in, “Could chronic muscle pain impart of the menopause phase of life?”. Well, yeah, I mean, it definitely could. I mean, it’s very possible that, uhm, your adrenals are weaker, and then that’s gonna help- that’s gonna impair your body’s ability to manage inflammation well. It’s very possible. Uh, a lot your hormones have really good anti-inflammatory fats-progesterone estrogen, it just depends on what the root cause is. Did it happen from food? Did it happen from… uhm- stress? Did it happen from poor sleep? So, I wanna get a- a window in what the heck is happening there as well.

Okay, excellent. Let me keep on rolling here. Uh, “Can a hair analysis tell you a lot of accurate info?” Uh, I think a hair analysis can potentially give you some good info, the problem is, it’s all downstream information because all those nutrients that get into your hair, the half that come in through the gut. So if you have impaired gut issues, that’s going to affect what’s in the hair. So if people are looking at the hair, they’re looking at all these different mineral ratios in the hair, but if we have a gut issue, I consider that to be a lot more upstream.

Uh, “What’s the best way to balance out estrogen and progesterone in ladies?”. So, off the bat, uhm- you gotta at what the underlying reason is. Is there toxicity issues, number 1? Is there uh, absorption issues in the gut, number 2? What’s your adrenal strength at, number 3? How is your hormonal rhythm, number 4? And then I also wanna look at just uhm, you know, exposure to conventional, uhm hormones in the food. Those are all gonna be big ones, they’re off the bat.

Ugh, let me just see if I can continue to do that. “Tom Brady’s a beast last night”, not in- actually, all I had during the game was one kombucha, during the game, I got some keto-cups which are like one gram of sugar, uh- coconut, like peanut butter cups but that uses coconut oil instead. And then I had a pizza which is a cauliflower crusted, and then I use the dial almond cheese. So that was the big one that I had there.

Uh, “What would you recommend to naturally treats- treat sinus-headaches brought on by cold?” So, if you go to my site, and look at recommended products,, and then you look at recommended products. I have a couple of links to amazon products that I like for that. I like either a combination of the nasaline or a sinus- just injector, and essentially uhm, the Xlear Sinus Rinse. I think that works really good. The NeilMeds, good but the Xlear has a lot of the xylitol in there, which is great at killing different kinds of bacteria and also flushing things out, and it’s really helpful with that post-nasal drip as well.

Uhm, I think we hit a lot of good things here. JACK ATTACK writes in, “How do you feel about citrus pectin?”. Well on the context of hormones and peri-menopause, it’s really good at binding up a lot of these metabolized hormones that may have a problem getting escorted out, and it kinda puts the handcuff back on these hormones to help it escort outside the- of the body. So I think it really helps with detoxification of hormones. Thanks Jack, appreciate it.

“I’m an active 30-year-old male on a paleo diet suffering from bloating, loose stools every morning, find myself wanting to eat more starchy vegetables for energy.” Yeah, so I mean, that’s kind of a broad statement, but in general, I would look at the gut and figure out what- uh, the next step is there because the gut needs to be addressed.

Okay, try to keep all questions related to the topic of peri-menopause. Uhm, that’d be super helpful for me so I know what’s going on. ‘Kay, very good… Anything else guys? What else is going on? “What cauliflower crust pizza did you do?”. It’s a local place by my house that- that does an organic cauliflower crusted pizza, I’m not sure the actual brand. Uhm, and I did the diet cheese. So it’s kinda  lower carb too which is nice, so, I don’t get all bunch of a carbs either, feel pretty good afterwards too which is nice.

Alright guys, hope everything’s going well. Make sure you guys subscribe over to my thyroid reset summit,, we’re going live in a month. We got a whole bunch of free stuff I’m giving out as well. I’m giving out the first like, 25% of my thyroid book. So, really excited for that get out. Hopefully it’ll provide a lot of great information. Everything I try to put out there s- I wanted to be action-oriented, so you guys can use it to actually start getting better. I help more people through my content than I actually do in person. Obviously, you know, having a personal relation, if you can’t substitute that, but this is a great way to get good information out to people here. So, make sure you sign up.

“Best lab to discern HA versus early menopause?”. Uhm, can you define what HA is? Uhm, much or- I mean, it’s probably something very common. I just- give me what that meaning is there…

Uhm, “What’s the difference between ox bile and bile used by conventional docs…”, uh- I think you mean “urso… “, uh- I’m not sure how you pronounce that – ursodeoxycholic acid. So typically, a lot of bile- ox-bile’s typically used as a bile salt supplementation when they take it from oxes or- I think bovine sources it sounds like, and they’re using that supplement as wise. Now, my line and Liver Supreme, we will use bile salts, we will use beet roots, we will use… uhm- french tree, or ___[24:47], things that are really supportive for the liver, supportive for the gallbladder, thinning out the bile, and then we’ll also help provide uhm- extra bile as well because if we can’t break down our fats, typically we’re gonna have a hard time breaking down our cholesterol, right? And if we can’t break down our cholesterol, that’s gonna really hurt our hormones. This is a really important question ’cause if you’re dealing with peri-menopause, this may significantly affect your hormones not being able to break down good quality fats.

Uhm, so- “Hypoth- hypothalamic- hypothalamic amenorrhea versus early menopause?”. Okay, so amenorrhea. So amenorrhea is like you’re still in that cycling age, it’s premature, you’re not having your period, okay? I have a woman who is 40 years old, uhm, this last couple months, started to get her period back. I see that happen many times, she wants to have a second child. Her period’s back for the first time in two years. Why does that happen? It’s a combination of typically poor gut issues, you’re typically under- you’re getting underneath nutrition, and it can be a combination that you’re not eating enough, or you’re not breaking down and absorbing enough. And then of course, all of the hormonal stress that compound for math, ’cause of course that creates adrenal issues, and that creates female hormone issues, and that detoxification issues ’cause if you don’t absorb, then you can’t run- put the nutrients in and run detoxification systems as well. Uh, so best labs to discern that, I mean, you wanna run a high-quality month-long test, and then also want to run some blood work and also some uhm- some adrenal testing as well. So you’d wanna dig in, find a good functional medicine doc to get that set up for ‘ya.

Oh, great to hear Irma, glad you’re registered, awesome. Uh, another great question just came in here. Try to keep it to the female hormones today guys… Uhm, “If I see anything remotely sad or happy tears, is that an estrogen issue? Will that affect gut health?” So, it’s hard to say, is this a- a guy you asking this question or female? Uhm, but, yeah, definitely, hormonal imbalances can affect the emotions. And you know, it’s gonna be- you’re gonna be looking for that change in emotions, maybe more emotional’s typically what you’re gonna see, but yeah, that can definitely have major effects on your emotions as well.

Nora writes in. Hey Nora, “Got acne around my jaw since June 2018. Last consult you asked if I had started doing anything different around that time but I didn’t recall. Later I found I re-introduced some thyroid support for hypothyroidism around that time. Since tests show no more hypothyroidism now, is it okay to stop the ‘Thyro balance’?”. Uhm, so in general Nora, we’d wanna make sure that we’re testing your hormones on the thyroid side, and as you’re dropping that down, we’d wanna make sure that your hormo- your TSH stays within a good functional range, as well as your hormones stand a functional range. So, it’s not something you’d wanna just drop out by itself, you’d- you’d wanna test you, and make sure as we drop it out, there could be, you know, that you’re doing good there. And then regarding any jaw acne that happens, I mean, we’d want to make sure number 1, insulin is okay, right? Insulin’s good. Uhm, ’cause if you’re doing too much insulin that’s gonna drive more androgens and then that’s gonna activate the sebaceous glands to make more oil, and that can cause the acnes. So we wanna make sure insulin’s good, wanna make sure detoxification’s really good. So- and for me to add in more sulfur amino acids and detoxifying support to run those systems, that’s good. Number 3, potentially various fibers to help bind up some of these junks so it gets or- escorted out your gut better, and then I would say number 3, if we’re still having issues you may wanna add in some prostate glanding support like black currant seed oil, and email my office if we- if we-  I don’t have your protocol up in here in front of me yet, so when patients ask me about questions here, I- I may be having some incomplete info to go off of, so if we haven’t added any black currant seed oil, we may wanna do that to help with the prosta gland and then some help with the jaw issue. And the next thing will be to- to retest your hormones with the DUTCH test to look at also how you’re metabolizing your estrogens to make sure that’s getting better. But don’t adjust anything until we chat.

Yeah, vitex is gonna be a great hormone- a great herbal support, A.K.A chastry, that’s gonna be really good at helping progesterone balancing for sure, really good.

Uh, “After getting through menopause does one need to stay on additional hormone help continually through life?”. It really depends. So what I recommend is get all your hormones symptoms under controlled, number 1. Test your hormones, make sure your adrenals and your female hormones are relatively good, uhm, from lab-testing standpoint based on your age. And then I recommend gently tapering down your hormones and see how well you do. See if you can keep your symptoms, your menopausal, se- was under control, sleeping good, your mood’s good, vaginal dryness is okay, brain fog’s good, and if you can maintain that benefit while dropping that bioidentical hormone support, that may be an option but Barbara, you’d have to deal with that at a consult, and continue to monitor that and keep that dial on going, but that’s a great question.

Okay, great. Uhm… just kinda kind of- come in here guys if I skip your question, don’t take it personal, tryna go to the questions that are most pertinent to this conversation. Zoe-Holistic writes in, “Would you be worried about a 54-year-old woman, still cycling and ovulating? Would you recommend supplementation as a- oestrogen is very high”. It just depends if you’re 54 and you’re still cycling and- and- the cy- cycle’s relatively stable and lengthen, PMS-wise, I wouldn’t too wor- I wouldn’t be too worried, I wanna know more about your parents and this is something that your sisters or- aunts- aunts, and/or mom or, you know, mom went through as well, our grandparents went through? I wanna know a little more about the history. And doing some testing, right- I think would also be good just to see where your levels are at, I think that’s a really good thing. I’ve- I typically more concerned Zoe with people, uhm, prematurely going into menopause, that’s my bigger concern, that’s the thing I’m seeing these days. But I think it’s always good to get tested.

“Is there a connection between hypoglycemia and adrenal fatigue?”, yes! Great- great question Olga. I see a lot of low-blood sugar symptoms’ really being a big stressor on the adrenals, and then that can create a lot of lower progesterone issues, creates a lot of stress. I definitely see that being a concern.

“What is the average acceptable age for menopause?”, typically 48 to 51-ish.

Ik O, “Best test for progesterone levels?”. I mean, you can run a typical progesterone blood test, you know, we like to be at least 10 to 15 on that, around day 20 of your cycle, right? Considering your cycle being like 26 to 30 days, and/or like a- a good high-quality DUTCH complete panel that we’ll run around day 19 to 22.

Nora, you’re totally welcome. So, email my office if you need that black currant seed oil, I’ll put you on 2 capsules of that twice a day if your skin is still having some issues. Two caps, twice a day and I have a couple recommended brands.

Jessica Lynn writes in, “Does liquid vitamin-C raise estrogen? I read studies say that there’s a connection”. I’m not sure that it would raise it. I will typically give vitamin-C in fiber to actually help with estrogen detoxification, so I don’t think it would raise it, maybe there’s some modulate- maybe there’s some modulation effects, or may help modulate it but I couldn’t imagine it actually raising it, like taking maybe uh, hormone would.

“My kidney pain by eating a honey, age 27, serious problem?”. Uhm, yeah that’s a good question, kinda little off-topic, but in general, I would be careful with the too much fructose.

“Will chaste tree help with progesterone?”. It will, it’s gonna help with LH, luteinizing hormone which is gonna help talk to your- your ovaries, and that kind of female hormone area to make more progesterone?

DesignLover writes in, “Took birth control pills for 1 year for adult acne, it worked. Now I’m 37 and it’s creeping back around the jaw line. Connection to sugar or more estrogen related? Or more cortisol? Also, hard time sleeping.” Now again, like birth control pills can help, even though you’re actually giving more estrogen with the birth control pill, it does kinda level out your hormones, so you’re not getting swings. So, I think a lot of the hormone swings can really be a big effect there so we can kind of level stuff off. But I also see, you know, birth control pills cause more issues. You can see melasma as well, which is the estrogen, kind of stimulates the melanocytes and more pigmentation, you can kind of get that pregnancy mask, while on the birth control pill, and someone that can actually make their acne worse. I’ve seen it on both sides. Is there connection to sugar and more estrogen-related, yeah, there’s definitely a big connection with sugar because sugar will actually increase more insulin. And insulin will create more ___[33:23], which will cause the bacteria to feed off of your skin and create more acne.

“My natural doctor put me on liquid vitamin-C and I’m having short cycle, 26-27 days with very light bleeding and prolonged bleeding”. Yeah, I would need more info, I’d wanna test your hormones, see where you’re at. A lot of my younger female patients will use herbs to help the signaling upstream from the brain to your ovaries and then we’ll also- a lot of times give a little bit of bio-organical progesterone, but we’ll give it in a specific cyclical augmentation fashion while we’ll taper it up and down. But we really wanna be specific in how we do that.

Amelia V writes in, ” If taking T3 you mentioned in past, needing it uh- multi-x-day due to half life. Why am I only- why am I only RX dosage for the AM?” Uhm, so, yeah, if you’re just taking T3, I don’t recommend only taking it in the AM, and like if you’re doing a Cytomel or liothyronine, you’re gonna be dropping off on your- uhm- on your T3 within 4 to 5 hours, so you definitely want to uh, not do it that way. In the thyroid re- reset summit, we had ___[34:26] on the uhm- summit talking about these exact things. So make sure you subscribe, make sure you subscribe.

Olga writes in, “Can longtime use of Mirena iud cause energy problems?”. Yeah, Mirena can cause a lot of side effects. Merina is a synthetic progesterone, and there’s an iud to secretes that. So, yeah, it can definitely- I mean, my biggest issue with that is it just kind of seeps in your bloodstream throughout the whole month at least with like, birth control pills, you kinda take a reminder session, you know a 6 to 7 day reminder where you kinda- drop out your hormones and then- and then that can cause bleeding where you kinda have this steady state of hormones with the Merina, which I think’s a little bit unnatural because you don’t have any drop at all. That’s concerning, so- I always recommend my female patients if they want- uhm- an iud to try the ParaGard which is a copper-iud that’s non-hormonal.

Uhm, “‘Can’t miss’ interview from the thyroid summit? What was your favorite interview?”. It’s a great one, I’d had a lot of a really good interview. It’s hard to say which one was the best. It really depends on the topic. ‘Cause we’re really connected the thyroid to the gut, thyroid to the emotions, thyroid to the adrenals, thyroid to fertility, thyroid to female hormones, thyroid to- even male hormones or gut inflammation, or gluten, or autoimmunidase. So those, you know, it- it was so many different areas, it’s really hard to say.

Paul writes in, “In menopause, how to stop hot flashes?”. Well, a lot of times, the hot flashes can be from a lot of these upstream hormones in the brain like FSH going really high. ‘Cause think of the ovaries, right? Your brain makes hormones that talks to the ovaries to make more hormone, more female hormone. So, as the brain- as the ovaries aren’t, you know, don’t have the follicles coming in, and we’re not making as much hormone, the brain is trying to rev up the volume that talk to the uhm, downstream glands. And that FSH as it goes higher can really increase vasodilation so, giving certain herbs can really help with the signaling and help kind of decrease the volume a little bit, modulate the volume, and then giving some bioidentical hormones can also help modulate the volume as well. ‘Cause the brain says, “Hey, I’m getting a little bit more hormone in there naturally, we can lower the volume as well”, and then we deal with the herbs to help with the receptor sites too. So there’s a couple different ways that we can do it. But that’s kinda one of the major philosophies regarding FSH, and regarding a lot of the hot flashes.

Uhm, ” Is Chaste Tree something you can take to see how you feel…?”, I mean, you really want to be working with the functional med doc on this. A lot of variables when it comes to that.

DesignLover , “Is there a connection to an imbalance of hormones in women who haven’t bore any children?”. Potentially, I mean, women that haven’t born- birthed children, they don’t have that progesterone increase that happens, uhm- throughout pregnancy, so that- you that- 8 or 9 months where progesterone goes up because of HCG, that goes up significantly higher. So that may- let’s just say, you have a greater chance just kind of being more an estrogen dominance, over your- your cycling fertility time-frame so to speak, where hormone, who is uhm- pregnant one, they’re not gonna be using up the follicles as much ’cause you’re not cycling when you’re pregnant and a lot of time during the breastfeeding process. So, you’re not going to cycle through your eggs as fast. And then number 2, you’re more overall an average having a higher input of progesterone, so that has some effects as well.

Uhm, Zoe writes in, “Do you find the people with more severe menopause symptoms always have more adrenal issues when testing, is that your finding?”. I wouldn’t say always but I- ’cause it’s- it’s-  I don’t- I’m not a big fan of absolutes but I would say yes. I would say on average, that is a significant correlation, more menopausal issues have more adrenal issues. And also, peri-menopausal issues, more adrenal issues, and I’ll even go one step further, cycling female issues, right? Definitely adrenal issues.

Uh, Amelia writes in, ” I’ve heard it takes one month to re-balance cycle for every year you haven’t had one?”. Yeah, that pro- that makes sense, I definitely agree with that, I mean, I typically see a major rebalancing in a- in a woman’s cycle within 6 to 12 months. And a major rebalancing is- I thi- I would s- call that, is about a 50% improvement. Alright, and then from there, we continue to compound that improvement month after month.

“Can someone with copper toxicity use a copper iud?”. Yeah, I mean, you can just make sure you’re doing extra zinc, put some extra zinc in your supplementation regime to help balance out the copper toxicity. That would be a good helpful approach ’cause you have the paragard or- is a copper iud and of course that can increase your copper levels. So you gotta be careful with that. You gotta weigh that out with your doc and see if you are really are copper sensitive. I have some patients that cannot do a paragard copper iud, they just can’t do it. Uhm, some can do it great and they have no problems. So you really gotta weigh those options out.

Uhm, “Can peri-menopause cause weight gain in the stomach? I’m 49 years old, no period for 7 months, gained 20 lbs. in the stomach in the last year and I can’t seem to lose it, is it just from unbalanced hormones?” So, remember, a lot of uhm, adrenal issues connect to peri-meno- menopausal issues. And a lot of adrenal issues are coming from cortisol imbalances. And cortisol has a direct effect on your tummy through just cortisol itself, the stress hormones can aff- affect the gut, and also through more sugar being released which can have an effect in insulin which can also affect your tummy. So, adrenal issues, have a major effect with cortisol, and also plug in and connect to insulin as well. So, great questions there.

“Do you think women with polymorphisms in COMT and MTHFR should not take the contraceptive pill? Controversial topic”, I know. Well, I know, in general like COMT like uh- catechol-O-methyltransferase. So when you see, uhm these types of issues, you may have issues with various adrenaline and just being able to deal with stress because these catecholamines are- like, you know, basically your stress hormones, your stress neurotransmitters. And MTHFR typically is gonna have a major effect on folate and then also affect B-12 and can affect methylations. So, uh- birth control pills deplete a lot of those nutrients. So yeah, I think what you’re saying is a very valid topic ’cause those issues can really have an effect on those nutrients. So if you are taking the pill, uhm- you really wanna make sure you’re supplementing with extra methylating nutrients, magnesium. In my line we’d recommend like B-vitamins synergy which has like the extra-activated folate, activated B-12, activated B-vitamins, and also a good multi on top of that, with magnesium and calcium, other important minerals that tend to get depleted.

Uh, “What would cause early spotting and irregular monthly cycle?”. That’s gonna because by typically lower progesterone or progesterone dropping out too soon in your cycle.

“Are there other conditions that cause hot flashes after menopause?”. Uhm, hard to say. I mean, you could- you may notice issues with blood sugar. Blood sugar ___[41:27] may get problem. A low thyroid, you may see some issues with that like if you have autoimmune flares on the hashimoto’s side. So yeah, there’s some potential connections there.

“Thoughts on carb cycling/keto for women with hormone imbalances? Ideal balancing diet?”. So, a lot of women do go with keto initially because they have insulin-resistance, and keto is very helpful with insulin resistance. But if you’re insulin-resistance is dialed in and you’re doing good with your blood sugar, some women starts to do better as they add in a little bit of safer carbohydrates, starches, squash, sweet potatoes, and they may even be better doing it cyclically. What does that mean? You’re kind of lower-carb keto for 2 or 3 days and maybe you have a sweet potato for dinner with your veggies and your meat. So, that I think is- is a very valid point, and I see that clinically.

Uhm, let me see here. Any other questions on hormones? I think we hit everything guys. Give me a thumbs up, give me a share, I appreciate it, make sure you hit that bell. People magically just go off my subscribe list if the bell is not hit. So make sure that bell’s hit, so you get all my notifications. Appreciate, uh today’s chat. Hopefully en- you enjoyed it, if you enjoyed it, give me a comment below. Let me know what you think. Any questions related to the topic, I’ll be back in and address them in future podcast or- we’ll respond here and I’ll look forward to connecting with you guys tomorrow, for a live Q&A.

You guys have an awesome day, and uh, go Patriots! Take care. Bye.


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The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.