The Hormone Cafe

In this episode of The Hormone Café, Dr. Sarah Pederson breaks down menopause from start to finish—what it is, when it happens, common symptoms, and how to support your body so you can feel strong, clear-headed, and energized during this transition.

Dr. Sarah explains the difference between perimenopause and menopause, why symptoms happen, and why menopause is a natural life stage—not something to fear or “power through.” Most importantly, she emphasizes that just because menopause is natural does not mean you have to feel miserable.

In This Episode, You’ll Learn:

🌸 What Menopause Actually Is
Menopause is defined as:

• No menstrual cycle for 12 consecutive months
• Ovaries producing very small amounts of estrogen
• No ovulation or regular cycling

Perimenopause is the transition phase, where communication between the brain and ovaries becomes erratic before cycles stop completely.

📅 When Menopause Happens

• Average age in the U.S.: 51
• Normal range: mid-40s to late 50s

Every woman’s timeline is different—and that’s normal.

🔄 Why Symptoms Occur
Menopausal symptoms stem largely from:

• Rapid drops and fluctuations in estrogen
• Loss of hormonal stability
• Increased sensitivity to blood sugar, stress, and inflammation

The body is shifting from cyclical hormone production to very low baseline hormone levels.

🔥 Common Menopause Symptoms
Symptoms vary widely and may include:

• Hot flashes and night sweats
• Insomnia and poor sleep quality
• Hair thinning, brittle nails, thin skin
• Brain fog and memory issues
• Mood changes, irritability, anxiety
• Fatigue and low energy
• Metabolic slowdown and weight gain

Some women have many symptoms; others have very few.

✨ Menopause Is Natural — Suffering Is Not Required
Dr. Sarah emphasizes:

• Menopause does not need to be “fixed”
• Debilitating symptoms should be addressed
• You deserve to feel great at every stage of life

Do not dismiss symptoms as “just menopause.”

😴 Insomnia & Night Sweats: The Big Drivers
Poor sleep is one of the most disruptive menopausal symptoms and is often driven by:

• Blood sugar instability
• High cortisol (stress hormone)
• Hormonal fluctuations
• Thyroid dysfunction

Good sleep should happen 5–6 nights per week. Anything less needs support.

🩸 Blood Sugar & Metabolism Matter More Than Ever
Hormonal transitions amplify blood sugar swings.
Key goals:

• Avoid lows (50s) and highs (>140)
• Aim for a stable glucose curve
• Average glucose under ~100

Dr. Sarah often uses continuous glucose monitoring (CGM) to personalize nutrition.

🥩 Protein First in Menopause
Many women in menopause need:

• More protein
• Fewer carbohydrates
• Careful timing of meals

Carbohydrate spikes can worsen:

• Anxiety
• Mood swings
• Insomnia

⚡ Cortisol, Anxiety & the “Tired but Wired” Feeling
High nighttime cortisol can:

• Prevent melatonin production
• Suppress estrogen
• Cause middle-of-the-night awakenings

Support includes:

• Strict bedtime routines
• No blue light 90 minutes before bed
• Journaling, calming rituals, nervous system regulation

🌡️ Thyroid & Thermoregulation
Thyroid dysfunction can worsen:

• Hot flashes
• Cold intolerance
• Temperature swings

Optimizing thyroid function is essential for symptom control.

💊 Bioidentical Hormones — Used Correctly
Hormone therapy can be:

• Life-changing
• Restorative
• Protective

But must be:

• Personalized
• Properly dosed
• Monitored carefully

Hormones alone are not enough without addressing nutrition, gut, thyroid, and metabolism.

🥦 Nutrition Still Comes First
Key principles:

• Stable blood sugar
• Adequate protein
• High-quality fats
• No artificial sweeteners (stevia, monk fruit, erythritol, etc.)

Dr. Sarah recommends a primal-style diet during menopause.

⏰ Intermittent Fasting — Use Carefully
Unlike cycling women, menopause may benefit from fasting—but timing matters:

• Do not skip breakfast
• Cortisol is highest in the morning
• Better to shorten or skip dinner instead

Fasting windows should support metabolism, not stress it.

🏋️ Exercise for Hormone Support & Bone Health
Essential components:

• Weight-bearing exercise (especially with low estrogen)
• Resistance training for muscle mass
• Moderate cardio for heart health

Overtraining can worsen:

• Weight gain
• Fatigue
• Hormonal imbalance

🧠 Brain Fog & Estrogen Metabolism
Brain fog can result from:

• Poor estrogen clearance
• Imbalanced estrogen ratios (E1, E2, E3)
• Gut, liver, or kidney dysfunction

Daily bowel movements, hydration, and detox pathways matter.

💧 Hydration & Hormone Clearance
Adequate water intake supports:

• Kidney function
• Estrogen metabolism
• Reduced brain fog

📊 A Whole-Body Approach
True menopausal support evaluates:

• Hormones
• Blood sugar
• Sleep
• Cortisol
• Thyroid
• Gut health
• Nutrition
• Exercise

Everything must work together.

🔁 Lifestyle Changes Are Required — And Worth It
What worked in your 20s–40s may no longer work.
Menopause requires:

• New strategies
• Greater precision
• More intentional self-care

With the right plan, many women feel better in their 50s and 60s than ever before.

Key Takeaways:

• Menopause is a natural transition, not a disease
• Symptoms vary widely and are highly individualized
• Poor sleep, weight gain, and brain fog are treatable
• Blood sugar stability is critical
• Hormones work best when paired with nutrition and lifestyle support
• You can feel amazing in menopause with the right plan