Diet and Hormones During Perimenopause (Episode 419)

Full Transcript: Episode 419

Lisa Hendrickson-Jack: Welcome to the Fertility Friday podcast, your source for information about the fertility awareness method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of the fifth vital sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices and I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with me today.

Today’s episode is all about managing many of those symptoms that women start to experience as we get into our late 30s, early 40s, and start approaching menopause. Today I’m sharing a brand new interview with Dr. Anna Cabeca and we’re focusing on how diet can have an impact on the menstrual cycle. And we get into some really interesting topics and even talk about a number of different dietary strategies. And I think what I really like about this episode is that we challenge some of the diet dogma ideas that are out there. The idea that there’s only one diet, this random person knows what it is, and this one diet is the right diet for everybody at all points in their life. So if you’ve been listening to the podcast for some time, you’ll know that I just don’t think that that is a possibility. I think that as we go through our lives, we go through different phases from being a baby and a toddler and a growing child to a teenager and an adult. And then there’s different phases of our life where we are in the reproductive phase wanting to have children. And so I do feel that if we think about our life through the different phases that we go through, there are different strategies that would be more effective at different times. And so from that perspective, it doesn’t necessarily make sense that there’s one magical diet that is going to serve all of those purposes throughout our entire lives.

So before we jump into today’s episode, I’ll tell you a little bit about Dr. Anna Cabeca. Dr. Cabeca is triple board certified and a fellow of gynecology and obstetrics, integrative medicine, and anti-aging and regenerative medicine. She has special certifications in functional medicine, sexual health, and bioidentical hormone replacement therapy. When her own health took a troubling turn during menopause, she sought out the wisdom of healers around the world. She learned that modern medicine and time-tested natural remedies are not at odds. Working together, they create indisputable results and true well-being. Using delicious healing foods and simple lifestyle changes, Dr. Anna reclaimed her health and her life. Fueled by her belief that every woman deserves to be empowered and in control of their health and life, she developed the Keto-Green lifestyle, which has helped thousands of women opt out of menopause misery and experience a joyful transition to the next stage of their lives. With her methods, you too can breeze through menopause into your second spring feeling the best you ever have. And if you didn’t have a chance to listen to my first episode with Dr. Anna, I’d suggest going back and having a listen at fertilityfriday.com/280. And in our first episode together, Dr. Anna shared her personal experience with losing her cycle after an incredibly stressful period of time and what she personally did to have it come back in the face of what appeared to be a premature menopause scenario. So again, that’s episode 280. So without further ado, let’s go ahead and jump into today’s episode with Dr. Anna.

And I’m excited to be here once again with Dr. Anna Cabeca. Welcome to the show and congratulations on your newest book, MenuPause, which I love the title by the way.

Dr. Anna Cabeca: Thank you, I know it’s a great title. It just makes me laugh every time I say it.

Lisa Hendrickson-Jack: Oh yeah, super catchy. And I feel like that leads us right into our discussion today. For all of the listeners, I mean, typically my work and body of work is focused on that kind of reproductive age. So kind of like that 18 to — I mean, I do take my work up until that age, you know, 45 typically, but because I’m teaching charting, I think a lot of my clients are falling into that general reproductive life stage. And many of my clients are falling into that pre-menopause stage, although I don’t necessarily work with clients who are past menopause. I have a few in different capacities, but your work is focused, I think, a lot more on that pre-menopause/menopause stage. And I would love to start off just by asking what inspired you to kind of focus on that demographic and also what are some of the major challenges specific to women during that age group.

Dr. Anna Cabeca: Oh my gosh, it’s the most underserved population there is. It really is. It is the most underserved and misunderstood population, really, Lisa. And I knew this because my mess became my message. Like I struggled with early menopause, diagnosed at 39 with infertility and early menopause, reversed that, then full-blown perimenopause symptoms just chaos at 48. And I really worked to re-establish hormone balance. And when I did, the whole world became a brighter, more beautiful place. And I was like, oh my gosh, I need everyone else to do this too.

Lisa Hendrickson-Jack: Yeah, no, that is — it’s so true what you said. I feel like that stage of life is underserved. But I also feel like it’s portrayed in a very negative light so that young women have very mixed feelings going towards this stage. It’s almost like we don’t think it’s a natural stage of life. And I think it’s been so highly spotlighted in a really negative way that I think many women expect it to be this horrific time with all these symptoms. And I think we don’t necessarily realize that that would be a sign of an issue if it’s really, really bad. So maybe talk a little bit about your experience with some of those ideas and expectations around that particular time of life.

Dr. Anna Cabeca: Yeah, you know, I mean, the whole thing is that we look at it in a negative light. We look at menopause as aging and aging rapidly. And from there, what happens — incontinence, dementia, Alzheimer’s, no sex, and it’s just terrible. And I think in other cultures, and through my journey, and I talk about this in MenuPause — I talk about menopause around the world because I’ve experienced other cultures. And one of the things that I learned from the Japanese culture is that they — the word they use for menopause, I mean post-menopause, is konenki, which means second spring, a time of renewal. And isn’t that beautiful? A second spring. Then in America, you say the winter of your life or you’re rowing north. I mean, that cold, icy terrain — what is going on? And so I think it’s really important to look back and say, okay, what is important for hormonal balance? What do we need to do and what are the problems? And when I look at that in menopause and perimenopause, the symptoms of the brain fog, the mood swings, the weight gain without doing anything different — that’s critical. I experienced all of that and I was a mess. And I was a single mom with three kids at home, one in elementary, one in middle school, and one in high school. And it was a true time of chaos. And through that discovery and finding my Keto-Green way, that pulled me out of the depths of hell to be able to write three books and have hundreds of thousands of people online doing my work. And I wasn’t able to do this when I was 48. I’m 55 years old now with a 14-year-old — that miracle baby I had at 41.

Lisa Hendrickson-Jack: So I think one of the questions that comes to mind is if you want to talk a little bit about what changes hormonally. I think one of the things you mentioned was that you could literally be doing the same things, but when you reach a certain age you start to gain weight without doing anything different. And this is certainly something I see in the menstrual cycle. Obviously in the work that I do, the menstrual cycle is front and center. We’re looking at all the different aspects of the cycle. Many women who were completely fine — air quotes — when they reach this age point, like when they reach that kind of pre-menopause stage, all of a sudden they start having a lot more difficulty with progesterone production, a lot more signs of low progesterone, sometimes an increase in PMS symptoms, and they’re really not doing a lot of things differently than they were in their 20s and 30s. So maybe share a little bit about what’s happening in the background.

Dr. Anna Cabeca: Yeah, so what is really important to understand is that our reproductive hormones start to decline in our mid to late 20s. Doesn’t that suck? I mean, that’s just not fair. And it’s true. So we’ll start to see a decline in DHEA from our mid to late 20s — both men and women. And so by the time we’re in our 60s and 70s, we have 75 percent less. And then in our mid to late 30s, progesterone starts to decline. Well, progesterone and DHEA are both precursors to estrogen and testosterone, and progesterone is a direct precursor to cortisol, our stress hormone. And so in our mid 30s to 40s, we start to see the steep decline in progesterone. And add in a good dose of stress — maybe you’re going through perimenopause and your daughter’s going through puberty — and that’s like chemistry for an atomic bomb. And so there’s a lot of stress, and work stress, and relationship stress, of course, and that further worsens the decline in our hormones. So these are the reproductive hormones that have a really big role. And then beyond that, the hormones that are increasing are insulin and cortisol — those hormones directly age us. So we start to see a decline in the reproductive hormones of longevity and an increase in the hormones of aging, insulin and cortisol. But now it’s a transition that we can decrease the progression of versus increase. There are certain ways the standard American diet increases rapid aging. Stress increases rapid aging. And the opposite is true. Love, good relationships, how we nourish our body — food is so critically important. We have to really understand that it matters what we eat. And we used to just count calories and say fat was bad. And we had so much misinformation. And it’s important to understand what works for us because the same thing doesn’t work for everyone.

Lisa Hendrickson-Jack: I mean, I really appreciate how you described it. I feel like from my perspective this is a natural stage of life, winding down one stage of our lives. And the way I look at it and describe it to clients isn’t that there’s something wrong with you, but it’s just that as we get older, it seems like we have a little bit less resilience in certain areas. I think one great example of that is your focus on balancing blood sugar — the sensitivity we might have to some things that we didn’t before. So maybe that would be an interesting topic to delve into a little bit — the topic of insulin resistance and how, just by nature of this different stage of life that we’re entering into, how we respond differently to literally the same foods that we were consuming before.

Dr. Anna Cabeca: Yeah, and so this is where there are actually 13 weight control hormones that I write about in my second book called Keto Green 16, and how important the lifestyle hacks and nutrition hacks that we incorporate can really help regulate these hormones, including leptin, the hormone of feeling satisfied, ghrelin, the hormone of hunger. And of course insulin and cortisol. And these make a really big difference. So we will be doing the same thing. This is what my patients will come in and say: “Dr. Anna, I’m not doing anything different and I’m gaining 20 pounds.” And when that happened to me, boy, I was humbled. And so I recognized that there’s a metabolic shift, and it happens with or without a uterus. So if we’ve had a hysterectomy and our ovaries removed, that’s only a piece of the puzzle.

Lisa Hendrickson-Jack: And I know in our first interview together, we talked about your book The Hormone Fix. And it’s interesting because whenever you talk about a specific type of diet, whether it be keto or paleo or what have you, there’s always a lot of noise around that in terms of whether this is the way we should be eating or not. But what I really appreciated about our conversation was, again, you’re addressing this population of women who can’t necessarily tolerate the high glycemic foods in the same kind of way. And so for many women, not necessarily going full keto, but certainly adjusting their macro ratio is a huge part of going through pre-menopause more smoothly. And you touched on stress again. I feel like at this stage of life we’re just not as resilient. The things that we often did — not getting good sleep, maybe exercising a little bit too much — in our 20s we might have been able to handle these things a lot more. I know for myself, when I was in my 20s I could have a really bad night and be pretty much okay the next day. But now that I’m edging towards my 40s, it’s a lot different.

Dr. Anna Cabeca: For sure. And especially when we’re not sleeping well, we have an increase in cortisol and we’re depleted. We can have more of an acidic physiology. And that is when our body’s in survival mode and we’re robbing Peter to pay Paul. I talked about progesterone declining in our mid to late 30s. And one of the things that’s really important, that I’ve recognized through my research and my own experiences, is that progesterone is like the lid to a pressure cooker. And as the pressure’s increasing in our 35 to 60 age range and our progesterone is depleting, it’s like taking the lid off a pressure cooker. And all the things that you used to tolerate and handle, you just can’t anymore. And so improving our progesterone is key. Our progesterone is produced by our ovaries in women predominantly, and then our adrenal glands as well will produce progesterone. So if we’re under stress, we’re going to be depleting that progesterone even more. Progesterone is a hormone for mood and memory and metabolism. It’s really one of those regulating hormones. It’s a mother hormone to most all of our other steroid hormones. Progesterone’s been used to treat traumatic brain injury. It’s been used for memory. And definitely when I used it in women who’d had a hysterectomy and were told they didn’t need progesterone — I used it to help them balance their hormones because I believe you need progesterone with or without a uterus. Other parts of our body need bioidentical progesterone. And so I would prescribe it and patients would come back time and time again saying, “Dr. Anna, I feel like a cloud has lifted. I’ve lost 10 pounds. I feel so much better. I’m sleeping better.” So all of those factors played into improving their metabolism. But the depletion of progesterone is a really big issue. And what we know from current research is that our brain will use glucose for fuel. And one of the things that I recognized when I was going through that second spiral of deep perimenopause at 48 — I was really struggling. I had the brain fog, the mood swings, the memory loss. And I used to have a really perfect memory. So it was disruptive. But the worst thing was when I gained 20 pounds without doing anything different. That triggered action. So I started using ketones for fuel, shifting from glucose to ketosis. And as I got better at it, I got into a healthy way. And what I recognized is that my memory was sharp, I was clear, I was focused. I called it energized enlightenment. I think there’s a spiritual, energetic combination of getting into ketosis and alkaline at the same time. And then research showed up a couple of years later that looked at this time period between 35 and 55. I call it neuroendocrine vulnerability. And we see all those symptoms I just mentioned. The reason is that gluconeogenesis in the brain is estrogen-dependent — well, I believe more it’s progesterone-dependent, as progesterone is a precursor to estrogen. But the use of ketones in the brain is not hormone-dependent. And that’s the shift. Menopause is natural and mandatory for all of us, just like puberty, but suffering is optional. So as we go into this stage of life, we have to shift our fuel source. There’s a hormonal problem, but there’s also a fuel problem — how we’re fueling our body. There’s a healthy way to get into ketosis and there’s an unhealthy way, and the healthy way is the Keto-Green way.

Lisa Hendrickson-Jack: Maybe share a little bit more about that. I mean, this conversation around food and what we should eat is very complex. And being that I work with clients day in and day out, it’s clear that there are so many mixed and conflicting messages around what we should eat. I think one of the issues is that there’s often this idea that there’s this one way for everyone to eat at all the different times of your life. There are certain diets where it’s kind of like, this is how to eat for your whole life. But then, like you said, when you turn a certain age or go through a certain phase, your body’s responding differently to the same things. I mean, that in and of itself is clear evidence that there are more optimal ways to eat at different points of your life. For example, I think a lot of women who would find themselves experiencing these symptoms just want the fix — okay, so I gained this weight, then I’m just going to exercise it off or I’m just going to diet. We often think that there’s a simple fix.

Dr. Anna Cabeca: Yeah, and there’s a couple of reasons why. And actually, I was on the phone with a reproductive endocrinologist I knew very well the other day and we were talking about things that trigger early menopause. Like endometriosis is associated with earlier menopause. And I was questioning whether IVF treatments and infertility injectable meds were associated with early menopause. The research is conflicted in this. And I certainly know that stress can affect early menopause. Absolutely without a doubt. And if someone tells you that’s not true, they are wrong. And this reproductive endocrinologist said, “Yeah, I love your work. I’ve been telling my patients to do a low carbohydrate, more ketogenic diet, and when they do that, their IVF cycles are better.” I’m working in the Keto-Green world now since 2015, and I’ve run into things where people have some trouble. Sometimes they’re doing Keto-Green and they’re on this plan for a while and they’re like, “Dr. Anna, I’m stuck. I’m at this plateau.” And there’s something we have to pause. So in my new book, MenuPause, I came up with five different pauses to help us break through plateau, to help with symptoms, to further figure out what’s going on.

Lisa Hendrickson-Jack: Yeah, sure. And I’m really curious to know how that ties into your title and what it pauses. So yeah.

Dr. Anna Cabeca: Yeah, so MenuPause is such a great title. So for the first one, it’s Keto-Green Extreme. My programs are designed to optimize your hormones. The nutrients I put in my foods help with detoxifying our hormones in a very healthy way, help supporting gut bacteria — so all the menus are designed this way. The first one is Keto-Green Extreme and it’s really an autoimmune protocol adaptation. So there are no nightshades in it. We pause nightshades and peppers, which can be very inflammatory for some people — especially if you have MS or Hashimoto’s. And each pause is six days. Why six days? Because our gut mucosal lining regenerates every 72 hours. So there’s two 72-hour cycles in here, and you get a sense of whether you’re feeling better with this approach. And then the second pause is a plant-based pause. So we pause everything but plant foods. We do use good quality proteins and fats in this menu plan, but the goal is to get into ketosis. And in the plant-based plan, you’ve got a lot of varietals of plant foods, micronutrients, sprouts, and really good stuff to help support the gut microbiome and help you keep from being constipated — that is the number one problem with getting on a ketogenic diet. Plant-based foods can really help with that and support hormone detoxification. Then I do a complete swing and pause all plants into more of a carnivorous plan, because some people find their bodies just not able to digest the plant foods like they need to. So we go to a nose-to-tail carnivorous plan. And then the fourth plan — you’re in high ketosis at the end of your carnivore plan — so we go right into a cleanse. It’s a liver and gallbladder cleanse. I start with a liver gallbladder flush in the morning with some olive oil and lemon juice combination. And then you have smoothies during that week. It’s really gut healing. We’re healing the body from inflammatory fluids, healing the gut mucosal lining, healing the cell membrane integrity. That’s powerful. And then we go into a carb-up plan that has good sweet potatoes and root vegetables. So it’s heavier carbs, and it may pull us out of ketosis, but it can be very beneficial. I’ve had patients lose weight on this plan, which makes me crazy because that doesn’t work that way for me. But for some people, two carbs will send them on a downward cycle. So I’m very conscious about making sure we’re still maintaining blood sugar stability to the best of our ability. But we do need that flexibility. We need to cross-train our diet, just like we need to cross-train our exercise routine. It creates more resilience. When we optimize our insulin sensitivity, when we optimize oxytocin — the powerful hormone of love, bonding, and connection — and moderate our stress hormone cortisol, that is the key to longevity. And getting there is the Keto-Green way. The lifestyle is 90 percent of it.

Lisa Hendrickson-Jack: What’s really interesting about how you broke down the different pauses is that in many ways it highlights the different things that different diets do. And you do it in an interesting way because, for example, there are many people who might want to live a lifestyle where they’re only eating one way. Whereas your work is bringing them together and showcasing the different kinds of things that they do. I feel like with the time that we’re in right now, there’s certainly these ideas that this is the way everyone should eat and this is how they should eat forever. And there’s always this kind of idea that this is the diet now — okay so carnivore, okay so vegan, okay so paleo. And there’s always kind of this idea that it’s like, this is gonna work for everybody. So maybe share a little bit about that.

Dr. Anna Cabeca: Yeah, it’s different depending on your desired outcome and we have to change it up. And now working with tens of thousands of women and seeing what they’re posting and eating — I still hear about really wealthy individuals that are being treated by a nutritionist and they’re on three meals and three snacks. I’m like, early dementia, heart disease, and metabolic syndrome over 50. That does not work. Women: two or three meals a day but no snacks. And I’m pretty much a two-meal-a-day person now. And the same thing — when I was carnivore too long, that worked against me. I actually gained weight. And it’s very interesting. Again, these things tell you something, but short-term pauses can be that breakthrough. And in working with women online, especially in menopause — the most underrepresented group — you go to a doctor and they’re going to give you a sedative, an anti-anxiety medicine, and something just so you don’t call them for another six months. But when we reverse that and get you feeling better and feeling energetic, you’re empowered. And when we’re doing this type of practice between food, adaptogens, and some bioidenticals, we’re so empowered. And if one more person tells me to eat chicken salad for lunch, I’m just going to scream. Chicken is also high in alpha-linoleic acid, which can actually decrease metabolism. So maybe there’s a point we don’t need to be doing so much chicken. And if you eat the same thing every day, you’re going to have a food sensitivity to it. You’ve got to watch that. For me, coffee can interrupt things. When I drink black coffee in the morning — especially when I’m worn out — my blood sugar will go up from that coffee. Coffee increasing cortisol, increasing glucose. So in essence, I’m breaking my own fast by drinking black coffee, zero calories. It blew my mind when I was wearing my continuous glucose monitor and I put this together. We want to look and see — could that potentially be interrupting things? Maybe there’s a reishi mushroom coffee substitute or the dandelion root coffee substitute we can use instead, especially if we’re working on fertility or having trouble with weight loss. The same thing every day can cause a food sensitivity and we have to change things up. It’s just like changing up your workout routine — you would never do the same thing every day. I look at this with animal training because my daughter’s in the rodeo and she can’t run her horse around the barrels every day. She only races the course in training once a week, because otherwise he’s going to get aggravated and worn out. He’s got to go on long hikes, trail rides. They have to change things up. And I was watching that thinking, oh my gosh, it’s just like us for high peak performance. In order to do that, you’ve got to change it up. And in the concept of creating my six-day MenuPause plans, I also give the seventh day as maybe a feast day, maybe a fasting day, maybe a day you’re going to experiment with something you’re really craving. It’s an opportunity to learn. And you can get restriction fatigue in anything we do. Like cheese — I love cheese, but that will put three pounds on me if I eat a little piece of cheese because it inflames me. And it took me two food sensitivity tests confirming that I couldn’t do cow’s milk, sheep’s milk, or goat milk. When your body is inflamed, it’s in storage mode. It’s not in peak performance mode.

Lisa Hendrickson-Jack: I feel like that brings me to one of the questions I was thinking about. If someone goes through this plan and tries all these different ways of eating for periods of time and then tunes into their body to see how they feel at different stages, I think that is very educational. My experience has been that a lot of us are not used to really tuning into our body and finding out what it needs. And sometimes we can get into these habits — when you’ve literally been eating the same way for two, three, five years or whatever, even if something isn’t necessarily right for you, you haven’t experienced something different. So you might just think, okay, this is just how it is. Even what you mentioned about the cheese — everyone is different. And the only way to figure out what’s going to work for you is to try different things and really tune into your body. But even that, I feel like there could be limitations because then you could get into a habit where you’re doing certain things that worked really well for you at one point in your life, and then you move into a different stage and those same things that used to make you feel so good potentially don’t. I feel like what it comes down to in many ways is there are certain tenets for human beings — certain things that we require — but then there’s way more diversity between people.

Dr. Anna Cabeca: Absolutely. And we have to try things and have fun trying it too. Often we don’t know what’s better for us and we get stuck in our ways. And this is one of the things in MenuPause — I brought in some healing practices from around the world that have helped women for generations get through menopause in a healthy way. I think it’s really powerful to open our minds. I can get stuck in a rut and continue to do things that used to work for me but don’t work anymore. And oftentimes we just need to make a change. And those things will start to work again. So I have found our bodies to be amazing and fascinating, but the perimenopause journey, 35 to 55, this period of neuroendocrine vulnerability — it is a powerful time of change, a physiologic empowerment if we allow it to be, otherwise it’s misery. And I’ve lived it both ways, and I’ve helped patients get out of that misery. It enables us to walk into the second spring of our lives with this sense of purpose. Both my parents died from complications of diabetes. If I knew then what I know now, it really makes a difference. When I started implementing these therapies, I had to operate less, I had to medicate less, and patients did better. It’s different when you empower that patient to lower their blood pressure naturally and they feel better than they have in a decade. That’s what makes a difference.

Lisa Hendrickson-Jack: It’s really refreshing to speak to a medical professional who uses food as medicine. A lot of us kind of unsuccessfully go to doctors and hope that we’re going to get some information about how we can make ourselves healthier, and often we’re just left with a prescription and a lot more questions than we had coming in. And one of the things I was thinking about — the word for menopause in Japanese: konenki. And how “second spring.” What is spring? It’s a time of new life. And essentially, when you’re moving from one transition to another, that’s basically what it is. And so one of the questions I just wanted to ask you about — our culture has a really conflicted relationship with pre-menopause and menopause. We look at it in a very negative way. And many women for one reason or another do end up having a hysterectomy at an earlier age. And kind of there’s this idea that once you’re done having kids, or if you never want kids, you kind of don’t even need a uterus — it’s kind of de-emphasized. So maybe share a little bit about why it would be a good thing to maintain our health overall — like through a lot of things we’ve talked about today, I’m thinking potentially if we were to optimize our diet, what’s best for our body, what works to balance our blood sugar and to optimize our hormone production, then we would potentially cycle longer than we would otherwise. And this would be a good thing.

Dr. Anna Cabeca: That’s a good thing. That’s longevity. The longer — and this is the area of research of some of the longevity institutions — looking at how do you preserve ovarian function for longer and reproductive potential for longer in a healthy way. And that is a key marker of longevity. So if I was menopausal at 39 and wasn’t able to reverse it, what would I be like right now at 55 years old? I imagine I would have followed the course of my mom and had my first heart surgery at 52 and died at 65 undergoing a second heart surgery. That was the course I saw my mom struggling through — the last 15 years of her life struggling for oxygen. I mean, it’s inflammation, hormone imbalance, and adrenal fatigue. I always say the triad of the devil’s pitchfork is inflammation, hormone imbalance, and adrenal dysfunction. But when my ovaries were shut down — shriveled up on ultrasound — it completely revived for a whole other decade. That’s powerful medicine. That is something through lifestyle that no prescription could do. And be careful when we’re on our prescriptions too. We can suppress our own natural ovarian function on prescriptions like birth control pills do. That is not enhancing longevity. We have to be very cognizant of that. And I think there’s some organizations that are trying to research this. It goes hand in hand with what Lisa always talks about on the show and the title of her book — the vital sign. Because if we think about the menstrual cycle as a vital sign being about more than just reproduction, then it would make sense that in the healthiest situation, when we take good care of ourselves, we would have that reproductive function until it stops naturally. And the average age falls somewhere between 45 and 55. And imagine — obviously at 55, if you’re still having ovulatory function, it’s not that you’re going to be conceiving. The egg quality isn’t there. But in terms of the hormone production you’re getting from your ovaries, even though it’s less than in your 20s or 30s, there’s so much value in that. And some of the questions that we don’t necessarily have the answers for — what is the effect of IVF multiple times, the infusion of synthetic hormones? What is the effect of 20 or 30 years of birth control? There’s a huge gap in that research. A lot of the money for studies comes out of IVF research. So when there’s money involved, they’ll study it. But who’s studying menopause? Where’s the money in that? And again, menopausal women — when we’ve invested in studies like the Women’s Health Initiative and the HERS trial, those led to catastrophic results for the insurance companies. And with so many confounding variables, it’s really hard. And I think this is where you mentioned right at the beginning of our conversation — being able to trust our intuition, being able to get in touch with ourselves and what we’re really feeling, what makes us feel better. And I know from working with women, sometimes we say “how are you feeling?” And oftentimes they don’t know. They’ve shoved down that level of awareness so deep that there’s no awareness left. So reconnecting with that. And honestly, in the second spring of our lives, this is essential. It is so beautiful to have this intuition, to have this wisdom, to be able to trust it and explore what works for you at this moment. It may not work for you in another moment, but what’s working for you at this moment — making you feel alive and vital and a contributor and passionate and sexy and all of those good things. And the earlier we start the better. And that way we can breeze through menopause into our second spring.

Lisa Hendrickson-Jack: Well, I was actually going to end it and not ask another question, but then you said something that made me think. You mentioned feeling sexier, feeling more vibrant. And I think that’s a maybe nice place to end on — where if we’re focusing on health, we’re focusing on hormone balance, and we’re focusing on reducing some of those symptoms. And it’s incredible to think that you could have such great success by shifting the way we eat from more of a traditional American standard diet to a diet that more effectively supports and enhances our hormone production. So maybe you could share a little bit about how that not only helps our health, but how that might improve our sexual function and enjoyment at that age. Because of course, we’re all pretty familiar with just the idea — okay, when you get older, vaginal dryness, low hormones, not a good sex life.

Dr. Anna Cabeca: It doesn’t have to be that way. Honestly, the Keto-Green way again heals the gut, and the vagina is an extension of the gut. Healthy fats are critical. And also the combinations of food that I put together really make a difference. I’m a gynecologist first and foremost. And I always say vaginal health can tell me a lot about the health of a woman’s body. And this is game-changing. I also created products to help with that — Julva, my product for the vulva, clitoris to anus, to keep that tissue healthy. It’s for urinary leaks and vaginal dryness; it has DHEA and plant stem cells in it. And things like stress, birth control pills — those affect the health of the vagina. But just healing the energy — when we are more carb-heavy, we have less sex drive. When we’re in ketosis, we have higher sex drive. It’s a different energy level. Carbs: heavy, grounding. Ketosis: heavy energetic enlightenment. It’s like going from gasoline to jet fuel.

Lisa Hendrickson-Jack: Amazing. Well, so as we bring everything to a close, I just want to thank you so much for being here. Maybe just share a little bit about where you are on social so everyone can go find you, a little bit about your books.

Dr. Anna Cabeca: Yeah, thank you. So my book is MenuPause and you can buy it anywhere books are sold. I highly recommend it. Five six-day menu plans. And then find me on social at the girlfriend doctor — Instagram, I’m there a lot. And on Facebook. And I have a great Keto-Green community that will be running through my MenuPause plans once the book is released, April 12th. So please join me. Thanks for having me, Lisa. And my website, DrAnna.com. Definitely come check out tons of free resources there.

Lisa Hendrickson-Jack: Awesome. Well, I will make sure to link all of those wonderful places in the show notes. Thank you so much. Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/419.

I hope that you enjoyed today’s episode with Dr. Anna. I really appreciate her approach to menopause and really looking at some of those underlying factors based on how women’s bodies change during that time. And of course, one of the things that I’ve noticed by paying attention to the menstrual cycle charts is that it does become more difficult to make progesterone. Not that you can’t make progesterone in that pre-menopause phase, but it does seem that that would be the phase of life where we have less resilience. And so some of the habits that we have accumulated over our teens, 20s, and 30s that didn’t really cause a significant issue start to become really problematic at that time. And it’s around that time when many women do start to struggle with their cycles for the first time, potentially after having not really had any issues with their cycles. And I would say the biggest thing that changes is our resilience. And of course, a big part of that is our tolerance to sugars and sugary foods and the increased likelihood of developing insulin resistance.

So one of the things I appreciate about Dr. Anna’s approach is that it does look at dietary strategies to really minimize some of those symptoms and to give our body what it really needs during that time. Of course, there are different ways to do it. And the conversation we had about the menopause strategies was really fascinating — to look at the different kinds of pros and cons of different ways of eating for periods of time to really kind of get the body back into its groove. So I thought it was a really fascinating discussion, and I hope that you enjoyed it as well. So with that said, I hope you have a wonderful weekend whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.