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If you are a woman of a “certain age,” you know the signs – hot flashes, problems sleeping, mood changes, and unexplainable weight gain that doesn’t budge no matter what you do. That’s right; I’m talking about menopause.

And joining me for that conversation is my good friend and fellow registered dietitian, Esther Blum. Esther is a menopause expert, and her new book, See ya later, Ovulator, is a must-read guide for every woman, whether you are in menopause, about to start the journey, or know you one day will.

Esther’s straightforward message will help you thrive during this time of life, and she’s on the show today to share some of her advice. You’ll learn about:

• Hormone Replacement Therapy
• Correcting misconceptions about hormones
• Esther’s 3 Meno-Laws for fat loss
• The importance of taking care of yourself
• Getting good tests
• Addressing concerns regarding HRT
• Strategies beyond HRT
• Self-advocacy and finding the right practitioner

 

Resources:

• Chaste Tree
• Dutch Test
• Found My Fitness
• Promethease
• Institute for Functional Medicine
• The North American Menopause Society
• Dr. Deborah Gordon | Northwest Wellness & Memory Center
• The Seven 7 Habits for Highly Effective Families by Stephen R. Covey
• We Should All Be Millionaires by Rachel Rodgers
• Courage by Brene Brown (film)
• Daring Greatly by Brene Brown

 

Connect with Esther:

Website: Esther Blum

Instagram: @gorgeousesther 

 

Episode Credits:

Thank you to all who’ve made this show possible. Our hosts are Diana Rodgers and James Connelly. Our producer is Emily Soape. And, of course, we are grateful for our sponsors, Global Food Justice Alliance members, and listeners.

If you believe in making sure that people all over the world should have access to nutritious food, please join my mission through my non-profit, the Global Food Justice Alliance. All sustaining members get early access to ad-free podcasts plus free downloads, and you’ll be helping get healthy protein like meat, fish, and eggs to food-insecure kids. That’s sustainabledish.com/join.

A big thanks to the sponsor of today’s show, LMNT. Do you often suffer from headaches, muscle cramps, fatigue, or sleeplessness? It could be from an electrolyte deficiency, and drinking plain water may not be enough to replenish lost electrolytes. LMNT is a drink mix that has everything you need and nothing you don’t –  no artificial ingredients, food coloring, gluten, fillers, or sugar! 

LMNT comes in lots of great flavors, and when you go to sustainabledish.com/LMNT, you’ll get a free sample pack with your purchase. Plus, they have a convenient subscription program that makes it easy for you to keep your favorite flavors fully supplied. Head over to sustainabledish.com/LMNT to give it a try. 

For the month of February, running a free community blood sugar challenge. You’ll learn how to use a continuous glucose monitor (CGM) to guide your food choices, plus a free ebook and access to live Zoom calls.

I’m also partnering with Levels to offer two free months when you sign up as a member to get the CGM without a prescription. Just visit sustainabledish.com/bloodsugar to sign up.

And if you are listening to this after our challenge has ended, you can still get access to my blood sugar challenge ebook and the recorded Zoom calls, plus the special offer from Levels. 

 

Transcript:

Diana Rodgers, RD  

Welcome to the Sustainable Dish Podcast. I’m Diana Rodgers, a real food registered dietitian, author, and sustainability advocate. I co-host this podcast with James Connolly, who was a producer on my film Sacred Cow. I also founded the Global Food Justice Alliance, an initiative advocating for the inclusion of animal-source foods like meat, dairy, and eggs for a more nutritious, sustainable, and equitable worldwide food system. You can check it out and join me at global food justice.org. Thanks again for listening. And now, on to our show. 

(Blood Sugar Challenge Ad) Diana Rodgers, RD

Hey Everyone. I’m really excited to let you know about the free community blood sugar challenge that I am running for the month of February for my followers. You’ll learn how to use a continuous glucose monitor (CGM) to find out how food impacts your individual body so that you can make the best choices when it comes to your diet. It was a complete game changer for me, and I recommend CGMs to all of my nutrition clients. I’m partnering with Levels to offer two free months when you sign up as a member to get the CGM without a prescription. You just need to visit sustainabledish.com/bloodsugar – all one word – and enter your email to get the free ebook, access to the live Zoom calls, and this special offer from Levels. And if you are listening to this after our challenge has ended, you can still get access to my blood sugar challenge ebook and the recorded Zoom calls, plus the special offer from Levels. Learning about how food impacts your blood sugar is valuable information we all should know. Visit sustainabledish.com/bloodsugar to sign up.

Diana Rodgers, RD  

Welcome back to the podcast, everyone. I am so psyched to have yet again Esther Blum, registered dietitian, awesome friend to me, and new author on the podcast, and we are going to be talking about menopause. So and I think this is even helpful for men to listen to, to understand what their partners might be going through. And, you know, I’d say first Esther, I remember being… I used to work for Whole Foods Market. And when I was in my, like, late 20s, early 30s. I remember having like an older woman come in who was like, 60 or so. And I was like, you know, do you want to talk about menopause? And she’s like, Oh, no, we’ve already gone through that, like that was an eye… So I didn’t even realize like when it happens. I didn’t know anything about it. Nobody talks about it. It’s sort of this taboo thing. And we need to unveil the taboo.

Esther Blum, RD  

Absolutely. And we need to help women understand how to navigate through, which is why I wrote See You Later, Ovulator because I was like, this is not taught in medical school, even in residency. It’s like really not focused on and there’s 6000 women, on average, who go through menopause daily, to be 1.2 billion women in menopause by 2030. And the only solutions typically in a doctor’s office for a woman are to either go on the pill, to go on an IUD, to have a hysterectomy, or to just go home and wait it out and suck it up. None of which are really great solutions. You know, it’s a lot, I mean, yes. Okay, if you’re physically suffering with this direct with, you know, hemorrhagic bleeding and fibroids, and you endo and you’re past the point of no return, you may choose to get a hysterectomy and have some relief. But I want to give people the support pieces they need to have in place if they do choose that option and how to go down that road.

Diana Rodgers, RD  

Yeah, and this is something that you know, is near and dear to my heart, I, you know, went through a very stressful last few years, kind of went into early perimenopause and went on hormone replacement and actually was able to work with a functional medicine doctor that like guided me through everything that you recommend in the book, not only taking estrogen and progesterone but also testosterone. And that is like wild 

Esther Blum, RD  

Madness.

Diana Rodgers, RD  

 Craziness, right. And that is the dominant hormone, even for women. And we need to be talking about testosterone replacement, too, especially when we think about sarcopenia and just maintaining strength. And so many women that I’m in fact, all of my girlfriends pretty much who are close to me who are of my age, none of them are on hormone replacement at all. And so let’s talk about some of the you know, when we can start because it doesn’t have to be like official menopause, even though that’s what the doctors are saying. And then also let’s talk about like optimal things to do. Lifestyle, everything. Like go go. Yeah, let’s get folks a rundown.

Esther Blum, RD  

All right. So first of all, hormones are not a panacea for everything. They are a piece of the pie, but I do address them first. Because it’s such a quality of life issue. I mean, estrogen progesterone and testosterone support, neuroplasticity and cognitive function in the brain. They support really strong healthy bones. They support maintaining muscle which women lose the most amount of muscle really during perimenopause and menopause. And they offset the risk of heart disease and the fact that just that basic information is withheld from women and often ignored or swept under the rug is just that’s what inspired me to write the book because I was so eager, I was like, Are you kidding me? This is so egregious. So these are not your mama’s hormones. Okay. Back in the day, there was the Women’s Health Initiative study which did a huge disservice for decades of women, which is a… It was a study design that was so flawed to begin with, that took women who were 10 years postmenopausal and put them on Premarin, which is derived from the urine of pregnant horses. So it’s this weird Oh, synthetic estrogen with no opposing progesterone or testosterone, which – hello, that is not how hormones work in nature, you don’t just give high dose, or even low dose estrogen without, you know, compatible hormones. And it was synthetically derived. So after and the data was not interpreted correctly, which is a huge problem. So the conclusions from that study were that, oh, hormone replacement therapy is going to give you a heart attack, it’s going to cause blood clots, it’s going to increase your risk of stroke, and basically, you’re going to die. Hallelujah. Thank God, the North American menopause society revisited that study and revamp their position papers in 2018 and 2022. And said, Oh, gee whiz, you know what, bioidentical hormones which are given in microdoses, by the way, like a fifth of what is given in a birth control pill. So those can actually offset the diseases we spoke about can give a woman better quality of life, better libido, offset the risk of chronic illness, and they’re safe for a minimum of 10 years. And by the way, like, I have women in their 70s in my practice, who are like, I am never going off these hormones, and when I do I start hot flashing and not sleeping. So you know, it’s the research is going to come out more and more to say hormones are safe. The type and delivery system matters, and work with a practitioner. But as long as you’re tested and monitored, and you should be tested, monitored three to four times a year after starting and work with a good functional medicine, either a doctor or a nurse practitioner, somebody who can prescribe and check your levels. That is imperative. Okay, so that’s step one. But beyond the hormones, we really want to look at diet and lifestyle and the role that stress plays in our lives. Okay, so let’s just talk about my three meno-laws laws for fat loss. One is, of course going to be to optimize protein. And ideally, you do want animal protein, because it just, it’s a much more efficient way to get your protein. If you are plant-based, you’re gonna have to two cups of quinoa to get the same amount of protein in a four ounce chicken breast. So animal proteins are great, especially when they are regeneratively farmed and raised. And you want to get… the average woman needs about four to six ounces, three times a day. Or if you intermittent fast, you can have you know, seven, eight ounces of protein twice a day. My athletic mamas who are lifting weights can really go way above that as well. So there’s, you know, the myths on protein are not supported, there’s they’re not going to cause your kidneys to shut down, you’re not going to have bone loss, if you optimize your protein, your body does adjust, okay, especially when you’re eating a lot of plants with it, that makes a big difference. Number two is you want your protein intake to be higher than your carbs. So let’s say… let’s say you track your food on my fitness pal or any app, and you’re eating 120 grams of protein per day, which is a really great amount. Your carbs figure like around 100 grams to start, if you’re very athletic, you’re lifting weights, you’re doing CrossFit, you’re working out hard, then it’s more like a one-to-one ratio of protein to carbs. But generally, you want you always want your protein higher than your carbs, because that manages your blood sugar beautifully and enables you to lose fat. But it’s enough carbs where your cortisol and your thyroid are supported as well.

Diana Rodgers, RD  

Yeah, and let’s talk about just really briefly, like, you know, I have been really tinkering with my diet over the last year or so. And what worked for me in my 20s and 30s is not the same as what is working for me now. And I actually do better with some carbs because it’s managing my cortisol and I’ve just found that whatever I can do to keep my cortisol low is overall the best thing for me like by far and I used to be able to go super low carb like almost no carb cannot do that now and there’s a lot of women I see like in these I follow these like carnivore forums just to see what people are chatting about. And you know, the people who are not able to make a super low carb or zero carb diet work are women, middle-aged women. 

Esther Blum, RD  

That’s right. And so and listen keto works great for about three months or the carnivore diet works great for about three months for women in midlife when they’re going through hot flashes because you can really support that. But what happens is your adrenals and your thyroid start to conk out and you become metabolic resistant metabolically resistant, you can be more sluggish, more irritable, not sleeping as well. So this brings me to my third meno-law, which is to have carbs at dinner, which people are like Ha. And some women, I even have having carbs before bed like honey and salt on a rice cracker and people think I’m nuts. But I’m telling you, when you’re not sleeping, right, your cortisol tends to often be very high in the middle of the night. And insulin is antagonistic to cortisol. So if you get a slight bump in insulin, let’s say you’re having a piece of fish, a big potato and some asparagus, right, that white potato will raise your sugars a small amount. And that is enough to tamp down cortisol. So you can have a great night’s slumber plus, it raises your dopamine and serotonin. And so the cost of not sleeping metabolically is far greater than the cost of having just some carbs. So quality carbs with dinner, but sleeping, it actually corrects your insulin resistance, which is pretty amazing.

Diana Rodgers, RD  

Yeah, and I think also, priorities shift a little bit from like, you know, I gotta look great in a bathing suit to I want to feel happy. And I want to feel rested, and I want to have energy, right. And that is sort of like the main goal. And, when you do, what I noticed is when I do add a little bit more carbs in, I have much more energy to move about my day. I don’t want to just like take a nap all the time, which is generally how I feel when I’m too low on carbs.

 

Esther Blum, RD  

Yeah, absolutely. Yeah, I have no energy without some carbs and saying like, I’m not Oh, dealing on carbs at all. But, you know, I’m very mindful of my timing, and we tend to be more insulin sensitive at night anyway than first thing in the morning. So that’s all really helpful. And then, you know, lifestyle and stress management is also really key. I mean, we’re and Diana, like you and I’ve talked about this a lot. We are at the age where we’ve got teenagers, or we’re launching them to college. And we have aging parents, or ailing parents or parents who are dying. So you’re and your career if you’ve been working on your career plugging away for years and years, this is often a time when it’s like really taking off because you paid your dues, and your total expert in your field. And so you have all these plates spinning in the air. And this is a time like more than ever to delete those social media apps from your phone, to get actual paper books from the library or buy them online. And to really have like a solid calm, that time, routine, and to unwind and really be mindful of like who’s in your life, whose energy you are taking on and like what you truly want, you know, if you’re aligned with your values, like getting all those pieces in place, really also is essential for supporting your adrenals, supporting your cortisol. If you’re just running around, taking care of everybody else, you’re not putting that oxygen mask on first. And you can’t always put it on first, right there’s time, there’s crises, and there’s ebbs and flows. But for the most part, if you develop a spiritual practice, if you can breathe for 10 minutes at night before bed, right, everyone says, I don’t have time during the day, okay, great. But you have time at night, you have 10 minutes, you can meditate with your kids or your spouse, you can breathe, it doesn’t matter if you fall asleep to it. But just get your body in a place of routine and structure where you’re breathing. And you’re just being mindful of that and not the 1000 other to do list things that you have, because most of our chronic illness and struggles with menopause start up in the brain start up here – up top, that is what drives our progesterone into the toilet is, you know, in our adrenals because the other thing people don’t realize about menopause is that your ovarian production of hormones shuts down and your body all of a sudden the switch flips and your adrenals are responsible for just eking out very small amounts of hormones after that. And so if you go in with a really low cortisol curve, or like an excessively high cortisol curve, you know, you’re gonna really struggle in menopause and just the lifestyle pieces and the breathing is free. You don’t have to buy any supplements you have to like, you know, it’s just free.

Diana Rodgers, RD  

Yeah, so let’s talk about like some of the symptoms. I can share some of the ones I had, you know, I actually have never experienced a hot flash, but I had other stuff going on with my body. And I wonder if the hot flashes were just because I did have my blood sugar relatively under control. But the cortisol was still super high. But I was like getting MRIs because of massive joint pain and nobody could understand why my joints were like swelling up my knees was so bad at points where I couldn’t walk. I was having some really bad like brain fog, memory issues, huge memory issues. So a lot of this stuff just doesn’t need to happen. And you know, the more I read about menopause, especially the joint stuff, you know, it doesn’t need to be that way. And my symptoms were dramatically reversed once I started supplementing with hormones,

Esther Blum, RD  

Yes, so and women get all sorts of hormones, right? They get all sorts of symptoms that are hormone related. Pardon me. So anything from vaginal dryness, low libido, night sweats, irritability, depression, and anxiety is a huge one that I want to address as well. Some women get itchy nose and ears as well. UTIs, breast tenderness, so bloating, weight gain. So all of a sudden, you’re like inhabiting this body and you’re like, What the hell just happened? I haven’t changed my diet, I’ve gained all this weight, what seems like overnight, I have like two sips of alcohol and I’m hot flashing, what’s the deal? So the best way to offset these symptoms, right? You do want to do some good testing. I do, in my practice, we look at blood tests. But I also look at the Dutch and the GI map to determine your hormone production and how you detox your hormones and the state of your microbiome as well. If you have an inflamed microbiome, and you’re constantly recycling estrogen, that’s going to be a problem. Because if you or if you’re not detoxing it well in your liver, that will be a problem. Why? Because if you bring hormones into the picture and your detox pathways are off, you’re going to feel worse if your estrogen can surge 30% on any given day. And then if your is estrogen surging and you start using hormones too early, like then you can feel worse. So you want to make sure, usually most perimenopausal women I work with go on progesterone first. So progesterone is a natural steroid, which is why it quells that joint inflammation and pain, but it’s also nature’s chill pill, right? It helps us feel calm and relaxed, helps me not throw my teenage son out of the house. But it also really helps with sleep. And it’s a precursor to GABA, which is a really calming neurotransmitter. So a lot of doctors will say, Oh, no problem, just take progestogen. Just take a progesterone only pill that will help your menopause. Sadly, it does not. Synthetic progesterone does not work on the neural pathways that bioidentical progesterone does. And so, you know, women are being put onto antidepressants left and right. And they actually just have a progesterone deficiency and or an estrogen deficiency. So you really want to make sure that you’re like getting this checked out. If you’ve been to doctors and they’ve put you on the pill and you’re feeling like garbage or you know, you’ve been written off and just told to go home and wait, get your hormones tested because that can give you a real window into what you need. Then once women and again, if you’re cycling, if you are very early in perimenopause, right you can start with Chaste treat Chaste tree naturally raises progesterone, but if that if you’re doing that and that’s not making a dent or you’re kind of late stage perimenopause, then you can bring in progesterone either the last two weeks of your cycle or you can, depending on your levels, plenty of women like I started progesterone, you know, years ago and I just take it all month long because my levels were just so rock bottom and I wasn’t sleeping. And so and I still cycle even though I’m totally in perimenopause, it’s like not always regular but you know, I joke it’s like Voldemort at the minute I’m like, Oh, I haven’t had period No, I swear it shows

Diana Rodgers, RD  

No, I’m the same way. You and I are at the same exact stage.

Esther Blum, RD  

Like come on. And then so progesterone so delivery systems, okay. You can get it orally. You can get it filled at the pharmacy for like three or $4 a prescription. It’s called prometrium. It is in a base of peanut oil. So you need to be aware of your peanut allergies and it does go through your liver and gut so if you’re a poor metabolizer you may want to think about a troche which is like a waxy to – it’s like a lozenge that dissolves in your mouth under the tongue. And that goes right across the blood brain barrier. So it’s great for sleep, and it bypasses your liver and gut. Next is estrogens. People use them in the form of patches, people use them as creams or and if you’re having vaginal dryness and or UTIs you can use it vaginally to because estrogen is responsible for collagen production. That’s why a lot of us like wrinkle up really quick when we’re all of a sudden, we have massive skin changes when we go through menopause. And we’re like holy cow, like who’s that witch staring back at me in the mirror. And you know, it rebuilds college and vaginally to and restores elasticity to the vaginal walls and hydration as well. So those are great delivery systems. And then there’s testosterone which can be given in a cream, a topical cream is a great way to do it. The one form of delivery that I do not recommend are pellets. For those of you don’t know inserting hormone pellets is a surgical procedure, you have to have an incision made and your skin and there have a little tunnel dugout, usually in your tush. And then they’re dropped in and you’re sealed up. And I’ve seen far more side effects. Some women on my Instagram page swear by their pellets. But most people, the ones in my practice, like went to a doctor that put pellets in and just had horrible side effects, tremendous weight gain, raging irritability, some of them have like such a high libido that their partners were totally afraid of running and we’re like, oh my god, this is way too much. But pellets, you really can’t regulate the dose at all. Whereas like, you know, anything topical or oral, you can totally change the dose very quickly and easily. So and it’s flat. It’s such a small gentle dose, like no one needs to get pregnant at this age, you don’t need to ovulate you don’t need the hormones of a 22 year old. But you do need a micro dose which is going to offset you know, the bone loss the heart disease risk and the dementia risk as well.

Diana Rodgers, RD  

Now when I went to my OB GYN and I told her what I was taking, and I mentioned that testosterone, her eyes kind of bugged out of her head and she’s a pretty young open-minded OB or a gynecologist and so why, why? Why aren’t they like, why is it kind of okay, for estrogen progesterone, but like nobody… it’s, I was considered off-label use?

Esther Blum, RD  

Yes, you are. And the FDA does not approve the use of testosterone for women unless it is medically approved or prescribed by your practitioner. It’s only approved for men, which is the biggest crock of BS because as you mentioned, like testosterone is the most dominant hormone in a woman’s body and it converts to estrogen. So you know, it’s so ridiculous. And testosterone, women are so afraid and like, do you understand, you are not going to look like Arnold Schwarzenegger or Sly Stallone. You’re eating like… the average woman who comes to me is eating 1100 calories and like, do you think you even have the caloric intake to build muscle. You could not build muscle if you try it and they’re eating like 60 grams of protein, which is what I would put my dialysis patients on. You know, it’s ridiculous. So there’s just so much misinformation out there I to use testosterone and let me tell you, I was so sick. You know, a year and a half ago, so sick with Lyme and mold. I had like no cortisol curve, like I was dead. I couldn’t, I couldn’t lift weights without completely crashing for two days after. And when I went on hormones, my cortisol curve came back and I have played with adrenal supplements, I really can’t take a lot they really mess with my sleep. For years. I’ve tried every adrenal hormone, every adrenal supplement on the market. When I went on that testosterone I had been on progesterone a long time, slowly added in like really tiny amounts of estrogen. I really don’t need a lot but that testosterone – what a game changer that has been for my life so and like my libido too. Oh my gosh, I use it both vaginally and topically and it’s great ladies, like don’t – you’re a fool if you miss this, you really are.

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Diana Rodgers, RD  

Yeah. And so let’s talk about some of the concerns that women have, like maybe if they have genetic, you know, histories in their family of breast cancer and, you know, some of the concerns that are legitimate that these making women nervous to go on HRT.

Esther Blum, RD  

Yes, and clotting disorders too. Yes. So that is why I do the Dutch test in particular because it looks at your methylation patterns. You can also do like 23andme or, you know, look at your genetic SNPs, your MTFHR gene, as well and just see how you’re methylating. As long as you’re supporting those pathways, and you check out and you look at how your hormones are metabolizing through your liver and your gut, that significantly decreases your risk of cancer, but obviously, it’s always your body your choice, right? Oh, I always say this to all my clients, your body, your choice, but here’s the wild thing I treat, I would say about 10% of my practice is oncological patients like women who are you know, they’re coming to me because they’re having a horrible brain fog and depression and vaginal dryness and low libido on either letrozole or tamoxifen. And they’re like, no freakin way. I’m scared to go on hormones. I’ve had many oncologists tell them, you know what your quality, your risk of cancer is low like we’ve done a mastectomy and or a hysterectomy. Like there’s nothing to grow on here. And your quality of life at this point outweighs your risk of cancer. Because do you want to have severe osteoporosis when you’re 60 and have crumbling bones? That’s a real quality of life issue because the largest cause of death in people over the age of 65 is due to fractures and falls. So it’s a real mortality risk. So you have to outweigh you know, risk versus benefit.

Diana Rodgers, RD  

Yeah. One thing I did was I did my 23andme. And then we pulled it into found my fitness.com, which is Rhonda Patrick’s website, and she has an awesome tool that will give you a whole bunch more information than 23andme. Well, and I know there’s other websites of Prometheus and other ones as well. I think I’ve done them all, but I really found Found My Fitness to be the easiest one to like, read the benefits.

Esther Blum, RD  

And for those of you who are listening and are like I have no idea what the heck you guys are talking about. I can say this, there’s like really great lifestyle things that you can do to also optimize your hormone detox, right. Eating cruciferous vegetables, eating those beautiful brassicas, those cauliflower, broccoli, artichokes, radishes, kale, brussel sprouts, you know, those are all incredible ways to actually help your liver process your estrogen down the less inflammatory pathways, down the right pathways. Eating fiber from flax and chia seeds also binds excess estrogens and help pull them out. And pooping every day is also key. You know, I see a lot of women with estrogen dominance, coupled with severe constipation. So if you’re not pooping every day, your hormones are just sitting inside building up they’re not being detox properly. So that’s really great. And also I want to mention if you are not going to move forth with taking hormones, you know, the diet and the weightlifting as we mentioned, and there’s great supplements I list in my book as well. One of them is maca, which is a root which really supports your adrenal health and 87… there was a great study I saw, it said 87% of women on maca decrease their hot flashes. So you can also there’s all sorts of… you could also do vaginal laser therapy to rebuild your collagen to if you don’t want to use it vaginally. So there’s absolutely other options for you.

Diana Rodgers, RD  

Well, your book, I have it right here it is. It’s so unintimidating, which, you know, just from the length of it. It’s written in a very, like conversational kind of girlfriend way, which is how you speak. And so it’s easy to understand. You have tips in here. So you know about types of tests that do the diet stuff, the lifestyle stuff. And you’re right about… I see so many constipated women out of nowhere. And for me, it was the opposite. As soon as this all happened to me, I had like a horrible, like diarrhea issues, and I just couldn’t stop. And once the progesterone came into the picture, that’s what I needed. So I can it can be different for everybody. And I just, I know it’s scary. And it’s scary to self advocate. I have always been somebody who’s like the doctors worst nightmare, right? Like, like I have like a PCP who’s just like a traditional doctor who’s open minded. But I go to her with like a list of labs, I want a list of questions I have questioning everything. And if you aren’t like that, you need to get a little bit more like that if you want to have optimal health and really thrive at this stage in your life.

Esther Blum, RD  

Yeah, and you know, think about it this way, right? If you really struggle… I talk a lot about self advocacy. If you really struggle, number one, we all have that extra loudmouth friend or cousin or sister who’s like, happy to just release their, you know, crack the whip on the doctor, you know, and in a polite way. We don’t want to be abusive here. But you know, there’s always someone who can help. Number two, you can write down your list of questions. Number three, definitely, I mean, my book has like 20 pages of studies in the back. And you can go in and say, hey, you know what? I’ve done the research, I really think I’m a candidate for hormone replenishment, like, can you help me. A couple of things are gonna happen, right? Number one, there are some doctors that literally hold up their hands and are like, Don’t even talk to me about hormones, and they’ll throw you out of their office, because it’s an ego trip. That’s not your person. Number two. Number two, you’re gonna get doctors who are like, Sure, I can prescribe it and then they prescribe it but never follow up. So you want to know like, what are you going to do once you prescribe? Are you going to follow up? Are you going to test my levels again? If your practitioners looking at you, and like just sort of not really, not really feeling like they are very sure or familiar with the process, choose option three, which is work with a functional medicine practitioner, a nurse practitioner, prescribing physician, a naturopathic physician who can prescribe, you know, any of those folks who do this day in and day out, they’re going to be the ones you want to go to. And yes, it’s usually an investment. And it’s the best investment that you will make, because the quality of life that you will experience, the improvement is dramatic, and know it may not be perfect out of the gate, okay. There’s a couple of people on my Instagram page I’m thinking of in particular, who are always like, I am on hormones, and I’m not feeling great. And I’m like, it takes time, it takes three to six months for your tissues to fully saturate. It took me many months of like breast enlargement and tenderness to figure out like my unique cocktail. I’m no different than you, but be patient with the process. Understand, this is a big picture thing. And hormones. I mean, to me, hormones are like the control panel of an airplane, right? It’s complicated. And every woman has her own unique patterns and pathways and tolerances. So just give your practitioner time and partner with him or her to say, I feel good on this, I don’t feel good on this. Can we retest my levels? And it’s really worth the investment. Because once you get on a good cocktail, or you know, your baseline that will need to ramp up as you go through menopause. Like, it’s just that much easier when you’re with the right practitioner.

Diana Rodgers, RD  

So Esther, how do people find a practitioner to work with? I know, you know, I know, Dr. Deborah Gordon, for those of you who live in Oregon, she is amazing. She’s an MD, she’s a functional medicine doctor, she has a practice called Northwest Memory Center, where she is just really dedicated to longevity, hormone replacement. And, you know, making sure your mind is working great. Through the end of this, and I think there’s just so many angles you can take, right? There’s strength, there’s bone health, there’s brain health, I mean, there’s so many different levels of functionality that we need to really pay attention to as we get older. And you know, the values of everyone are going to be a little bit different. For me, it’s it’s all that stuff, you know, but how do people how do people connect with a functional medicine doctor? Do you have a resource for them?

Esther Blum, RD  

I do. I have them oftentimes go to ifm.org. That’s the Institute for Functional Medicine. I also like there’s menopause.org, which is the North American Menopause Society. They also have like really good practitioners. And then there’s also the search engine, you may have heard of it called Google. And you can google functional GYN with your zip code and like, see who comes up are functional MD, and see who comes up there.

Diana Rodgers, RD  

Yeah, um, and as far as like, things to look out for if you’re just doing a Google search, and you know, maybe there’s a few different options. You know, I’m always nervous about people who overly prescribe supplements and make money off the supplements and like, really have a gigantic list of cocktail that you need to take. So, you know, look at their Google ratings. Make sure there’s somebody who has some, like legitimate recommendations.

Esther Blum, RD  

Yes. And read the testimonials and call the office and say what kind of hormones do you prescribe? You know, do you prescribe pellets? Do you prescribe bioidenticals What’s your follow-up process? You know what results can I expect? I’m really… just don’t be afraid to interview. That medicine’s a business like you wouldn’t hire an interior designer or contractor without really grilling them about their process. Why would your medical care be any different?

Diana Rodgers, RD  

Yeah, anything else Esther?

Esther Blum, RD  

Just know that like this is as crazy as this right can be like, there’s so much power and wisdom that comes out of it, there really is like, to me, I feel like as I age, I lose my filter more, I say what’s on my mind. And I really get clear on what I will and won’t tolerate in my life anymore. And feeling crummy with menopause or having hot flashes or having meno-rage, it’s just a really great time to use your voice and use it in your favor and be like, You know what, guys, you know, either to your friends or your family, be like, You know what, things need to change around here. Like, I’ve been putting myself last for so long. And like, I can’t do this anymore. I’m really suffering. Often as women we are relied upon to be the glue for the family. And it’s a huge strain. So start to bring in help ask for help delegate as much as you can. If you can afford to hire some help here and there, even a college student, like do what you can to get support and delegate and you know, sometimes a really great book to read is the Seven Highly Effective Habits for Families. It’s by Stephen Covey. And that really helped me get clear on like having family meetings on like, Sunday nights, you know, where like, who’s got what going on this week? Who can take the dog, pickup medicine for the dog at the vet? Who’s gonna do the grocery shopping? Who’s gonna, you know, and who’s gonna do laundry? Just like starting to really delegate, especially as your family and kids get older, like, taking things off your plate, I feel like is so key. And it’s a great time in life. It really is.

Diana Rodgers, RD  

Yeah, and I see so many of my women friends who are moms doing way too much stuff for the rest of the family. I mean, I send my daughter to the grocery store, she can drive, she can… she eats, you know, I tell my kids, if they’re, you know, idle, and there’s groceries to be put away or dishes to be done, they should be up and doing that. And I think there’s a tendency to feel like, you know, especially as a mom of teenagers, like most of my mom friends are that we should still like have a function as a mother and do stuff and no way. Kids need to see their mother practicing self care. They need to see their mother having a life having girlfriends, taking classes in the evenings, if she wants to, you know, just you know, taking care of herself, because that’s the kind of model you want for them, not somebody who just, you know, says yes, all the time to every single task and never put yourself first.

Esther Blum, RD  

Well, and by the way, like your kids should know how to do laundry before they go to college. They should know how to cook a meal. It doesn’t have to be complicated. It could be beans, and it can but get, you know, give them the tools they need, like set them up for success. I mean, I said to my son the other day, I was like, how do you think you’re gonna handle the responsibility of driving a car when you can’t even put your laundry away, like ridiculous but he’ll do his laundry it to his credit, he’ll do it. God bless those pods because that is like the best invention on the planet. But you know, it’s um, you really do you need to delegate and like, we have enabled our kids, you know, and we all are guilty, right? We’re like, Oh, but I just love them and I want to help them and but guess what, like school of hard knocks wins every time like, get them to have some basic responsibilities, walking the dog, feeding the dog, you know, things that are life skills, so that when they go out in the real world, they’re like, oh, right, I got this. It’s not even a question. And it will serve you to like, I really learned this year to delegate, to hire help in my business, and also just yeah, keep my boys like, there’s nights where I’m like, dinner’s on your own everybody. Good luck. And like, make myself an omelet and go read a book. You know, I just, and I don’t worry that their meals are not perfect. I rather prioritize myself care at this point.

Diana Rodgers, RD  

Yeah, I’m going to recommend a couple other things to on top of the book you recommended and one is We Should All Be Millionaires. Oh, the best. Yes. But I recommended to you… 

Esther Blum, RD  

No, I recommended it to you – like Diana, read this book. It was so good.

Diana Rodgers, RD  

So good, so good. So that’s great, even if you’re not an entrepreneur, but I just think women tend to not be financially educated. You know, especially from the generation you and I grew up in a lot of my friends just feel really insecure when it comes to money, investing, knowing about money, right? So yeah, so even if you’re not running your own business, I highly recommend that and then I just the other night I watched a show called Courage by Brene Brown, which is a documentary that’s basically just a talk that she did on vulnerability and putting yourself out there and why vulnerability is courage. And she’s fantastic. And it really resonated with me. And I’m sure it’s gonna resonate with a lot of listeners here.

Esther Blum, RD  

Yes. Daring Greatly is like one of my all-time favorites also by Brene Brown.

Diana Rodgers, RD  

Yes. Great, Esther, how can people find you find the book and, you know, get on your newsletter list, which is really fun too.

Esther Blum, RD  

Oh, thank you. So please find my work. Come join my mailing list a because I have a really amazing live event that I’m doing in the end of February. It’s a virtual live events, you can literally be at home in your pajamas, it’s encouraged, so that you go to Esther blum.com estherblum.com. And then come hang with me on Instagram @gorgeousesther. And there you can find between those two sites. You will get so many resources tools, you get supplement recommendations, diet, lifestyle recommendations, hormone discussions, and it’s like, it’s a really great community of very engaged women. So I’m so grateful to like, you know, really crack open these conversations. And really, you know, it’s my goal to change the lives of 1 million women. So I got a long way to go, but I’m gonna get there.

Diana Rodgers, RD  

Well, I support you 100%. It’s always fun to have you on the podcast. And I look forward to having you back again in the future. And I don’t know, talk more about protein or more about misconceptions around food and women and meat and muscle and you know, all those great things that you and I both are so passionate about when it comes to women’s health.

Esther Blum, RD  

Let’s go babe, I’m so, so thankful to be here today. Thank you so much.

Diana Rodgers, RD  

Thank you. Have a great day. 

Esther Blum, RD  

You too. 

Diana Rodgers, RD 

Thanks so much for listening today and for following my work. If you believe in making sure that people all over the world should have access to nutritious food, please join my mission through my non-profit, the Global Food Justice Alliance. Visit sustainabledish.com/join and become a sustaining member today. All sustaining members get early access to ad-free podcasts plus free downloads, and you’ll be helping get healthy protein like meat, fish, and eggs to food-insecure kids. That’s sustainabledish.com/join. And thank you.