The Mel Robbins PodcastHow to Hack Your Hormones and Use Science to Lose Weight and Sleep Better | The Mel Robbins Podcast
EVERY SPOKEN WORD
125 min read · 25,444 words- 0:00 – 2:27
Intro
- MRMel Robbins
(ticking sound) Today is a conversation for all of us. We are talking about the big M and the big H, menopause and hormones. Hormone changes in women affects half of the population, and there is so much misinformation flying around the internet, I thought, "I have to have a conversation about this." And I wanna have a conversation with you and a medical doctor. That's what we're doing today. (upbeat music) Hey, it's your friend Mel, and welcome to The Mel Robbins Podcast. All right, I have been wanting to do this episode for such a long time. What are we talking about today? Well, we are talking about the big M and the big H. What is that? We're talking about menopause and hormones. And no, do not touch that off button, everybody needs to hear this, hormone changes in women affects half of the population. And so, I don't care if you are in the stage and the age where you feel bitchy and itchy and dry and hot and your hormones are all out of whack, or if you're living with somebody who is going through that, today is a conversation for all of us. The first time I saw a woman have a hot flash was about 30 years ago. My parents were throwing Chris and I a, um, like, an engagement party at their house in Western Michigan, and I'll never forget this. My mom and I were standing there talking to one of my mom's best friends. I love this woman, I'm not gonna say her name because she would be mortified if I said her name, and so I'm gonna respect her privacy, but I'm sure you're listening and you know who you are and know that I love you. But we were standing there and we each had, like, one of those fancy paper plates, you know, the stiff kind, and we had helped ourselves to the buffet, and we're talking. All of a sudden, out of nowhere, this friend of my mom's flushed bright red and water started dripping down her face. And this particular friend of my mom's is the kind of friend that was always impeccably dressed, like she just looked like a Chanel ad every time she walked into a room, and so I could tell she was mortified. Her makeup foundation was starting to run, and she took her plate and started fanning her face. And I said, "Are you okay?" I mean, I
- 2:27 – 5:15
Why the hell is going on with my body?
- MRMel Robbins
thought she was having a heart attack, but she said, "No, no, no, I'm just..." (blowing) and she blew her... (blowing) "I'm just having a hot fla- hot flash. It's just so awful." And my mom kinda looked at me and said, "Oh ho ho ho, just you wait. Just you wait, Mel." Well, I have been in the hormonal change for probably six years, and I'm embarrassed to tell you, I know about as much about menopause and hormone fluctuation in women and in girls as I did 30 years ago, which means I know jack shit. And there is so much misinformation flying around the internet, I thought, "I have to have a conversation about this." And I wanna have a conversation with you and a medical doctor, somebody who understands this. We're not gonna be getting our menopause tips on TikTok, people, we're talking to a doctor about what is going on in our bodies. We are gonna cover everything from PMS to hormones in women to what to expect when menopause hits, and the thing that everybody that I know is bitching about my age, which is the bread basket that develops in the middle. That's what we're doing today. And who have I asked to guide us through the land of menopause and hormones in women? None other than Dr. Amy Shah. That's right, Dr. Amy Shah is a double board certified doctor. She did her training in nutrition from Cornell, she did her residency at Harvard, she got a fellowship in Columbia. She is an expert on hormones. In fact, her runaway bestseller, I'm So Effing Tired: Yes I Am, Sister!: A Proven Plan to Beat Burnout, Boost Your Energy, and Reclaim Your Life. Dr. Amy Shah is back by popular demand, and by my begging, because I wanna understand what is going on with my hormones. Dr. Amy, welcome back.
- ASDr. Amy Shah
What an honor.
- MRMel Robbins
(laughs)
- ASDr. Amy Shah
Thanks, Mel.
- MRMel Robbins
You're welcome. So, I loved your book, I'm So Effing Tired. Title's fantastic, by the way.
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
Because I do feel effing tired, and it's a proven plan to beat burnout, boost your energy, and reclaim your life. And what I really wanted to talk about, because when I hear the word tired, I think about two things. First of all, I think about how everybody I know feels burnt out, and I wanna talk about adrenal fatigue, but I also wanna talk about menopause, the big M.
- ASDr. Amy Shah
The big M.
- MRMel Robbins
The big M. I am gonna be double nickels 55 this year. I am in the thick of it, and I would love to talk to you about what the fuck is going on with our hormones and our bodies, and why isn't there more information? I mean, it affects
- 5:15 – 13:38
What happens in our bodies during PMS and menopause?
- MRMel Robbins
half of the population, for crying out loud. So where do you wanna start, Dr. Amy?
- ASDr. Amy Shah
Uh, I think the menopause conversation needs to be had, and much more commonly and much more openly. Most women go through this time of life and they have no idea why their anxiety level has increased, why their energy has decreased, why they feel like there's a brain fog. People will present with, um, ear itching, body itching. People will s-
- MRMel Robbins
Wait, that is something that's...
- ASDr. Amy Shah
That's part of menopause.
- MRMel Robbins
It is?
- ASDr. Amy Shah
Yes.
- MRMel Robbins
That explain... Body itch-
- ASDr. Amy Shah
Yes.
- MRMel Robbins
Did you just see me as we were walking up?
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
I was itching my back as if, like, I'd just been bitten by a mosquito. Why does your body... I- I- I'm gonna hijack this conversation so fast.
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
So keep going with the weird ass symptoms.
- ASDr. Amy Shah
Yeah, it, uh, the biggest, I think the biggest symptoms that people feel is the brain fog.
- MRMel Robbins
Yes.
- ASDr. Amy Shah
That happens-
- MRMel Robbins
Yes.
- ASDr. Amy Shah
...with menopause, and the mood changes. Um, the, the feeling of, um, hot-And then- (laughs)
- MRMel Robbins
(laughs)
- ASDr. Amy Shah
... colds. You know, the hot flashes and then the sudden change in temperature. Like, what is happening? Why are we feeling like this? And we don't have the conversation enough and so everybody's kind of feeling like they're going crazy.
- MRMel Robbins
Yes.
- ASDr. Amy Shah
And one of the biggest complaints, and I know that we'll pr- touch on this, is the increase of fat around the middle.
- MRMel Robbins
Yes.
- ASDr. Amy Shah
So brain fog, fatigue, the increase in fat, especially around the middle, and all of these weird symptoms all have to do with your changing hormones.
- MRMel Robbins
Okay. You're gonna have to break this down for us-
- ASDr. Amy Shah
Yes.
- MRMel Robbins
... because the conversations that I'm having with my girlfriends, it's all about the fact that we're going through this metamorphous. I feel totally out of control. The last time I felt like this in my own body was when I was going through puberty and I started to get b- you know, first you get those, like, knots or whatever they're called-
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
... bumps or whatever they are.
- ASDr. Amy Shah
Yeah.
- 13:38 – 15:29
Best metaphor to help you understand what’s going on in your body.
- ASDr. Amy Shah
- MRMel Robbins
Okay.
- ASDr. Amy Shah
Okay? Estrogen is your social, um, and she's super smart, she's super social, um, she is outgoing. Uh, she can be a little bit risk-taker.
- MRMel Robbins
Uh-huh.
- ASDr. Amy Shah
Um, she can be a little bit out of control.
- MRMel Robbins
Got it.
- ASDr. Amy Shah
Then you have the sister, the progesterone sister.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
She's very calm, level-headed. She knows when the other one's, like, kinda going off the rails.
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
She's the one that kinda keeps you at home-
- MRMel Robbins
Uh-huh.
- ASDr. Amy Shah
... says, "No study toni- you know, stay at home."
- MRMel Robbins
Yep.
- ASDr. Amy Shah
"Let's just chill." Um, she's the one that, um, keeps you calm.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
Okay? So when we're going through menopause, we are getting less estrogen and less progesterone so you're starting to feel like you're not as sharp, you're not as, you're not taking as many risks, you're, you're not as social.
- MRMel Robbins
Yep.
- ASDr. Amy Shah
Um, your level of estrogen is going down.
- MRMel Robbins
Gotcha.
- ASDr. Amy Shah
You might not have the energy levels.
- MRMel Robbins
Yep.
- ASDr. Amy Shah
You might not feel like doing the things you used to do. Your activity level might go down just without even realizing it.
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
You're just sitting more.
- MRMel Robbins
Uh-huh.
- ASDr. Amy Shah
As progesterone goes down, you start to get more anxious. You start to feel like you can't sleep. And you start to feel like your life is out of control.
- MRMel Robbins
Wow.
- ASDr. Amy Shah
And so what you're noticing-
- MRMel Robbins
Is this also why I'm waking up in the middle of the night?
- 15:29 – 18:15
How to optimize your health in every phase of hormone change.
- MRMel Robbins
stages that women go through from puberty to menopause?
- ASDr. Amy Shah
Yeah, that's a great question. So women start their hormonal cycles, uh, at puberty. And so you basically see a big surge of hormones and all the aftermath that happens with it, um, from, you know, periods to breast development to, um, uh, body fat distribution changes. There's all kinds of, um, brain changes that happen, um, during puberty and, um, it's, the hallmark is, is the period.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
And when you start that period, from then till menopause, every month you have a cycle. And I think what people, what I (sighs) , it's a pet peeve of mine, is that women often aren't even taught what their cycle is and what to expect and how to manage it because you just go through life thinking it's just an annoying period, but you don't really learn anything more about it. So the first day of your period is a very momentous day. It's the start of your 28-day cycle. And the reason why I think it's important for us to understand is that you're starting basically when you shed the lining of your, um, uterus, that's your period, you're starting over. So now from day one of your period all the way till day 14 you get a rise in your hormones, and if you don't get pregnant, then you're gonna get a fall in the hormones.
- MRMel Robbins
Get a fall in what hormones?
- ASDr. Amy Shah
Estrogen, um, rises, um, throughout the first part of the cycle and progesterone actually rises too. They have, they're kind of different peaks and, um, but they do and testosterone has a little spike closer to ovulation, so day 14. But what's really, um, the interesting part is that at the latter half of your cycle, if you don't, if you're not going to be pregnant, so most months you're going to be experiencing a little, a fall in your hormones. And I think it's really important for women to realize that you can train and eat and fast and live differently throughout those different changes of your hormones to match what's happening. So from day one through day 14 when your estrogen and progesterone levels are getting higher and climbing especially towards that day 14, you're gonna feel more energetic, you're gonna be more stress resilient, you're gonna be able to do more workouts, you're gonna
- 18:15 – 22:32
When in your cycle you should train and eat like an athlete.
- ASDr. Amy Shah
be... So I always talk about that a- time as like train like an athlete, eat like an athlete. Eat more, train more, energy levels are good, stress levels are good. This is the time to try out intermittent fasting or just kinda like that, um, time-restricted eating that I was saying, like, no, no food two to three hours before bed and, um, try things out.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
... a- at the ladder half of your cycle, especially that one week before the period, so day 21 through 28, so it's called the late luteal phase. So the latter part of the luteal phase, when your hormones are really dipping down there, the kinda mini menopause column.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
That's when you pull back on the very stressful activities, you pull back on, um, eating lots e- uh, like maybe you're eating a lot more treats or sugar, carbohydrates, um, in the first half of the cycle. That's when you wanna pull back a little bit.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
You want to, um, realize that your body is less stress-resilient, so maybe this is not the time to take on all the projects and to be skimping on sleep and to be working out excessively and to be adding the intermittent fasting for the first time. Like, you don't want to be, um, testing your stress resiliency at this time if possible, 'cause according to your own cycle, this is the time that you're going to be least stress resilient, also gonna be more insulin resistance, uh, resistant, which is why I said to maybe come down f- um, on the sugar and the carbohydrate level-
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
... start to eat more fiber and protein, um, to keep yourself fuller. And so, when you understand that, you're like, "Oh, well, that makes sense. I naturally don't feel like doing my high-intensity workouts the, you know, the final week of my period." Or, you know, you wanna, um, get more sunlight or more massages or more walks, and like that's a way to manage the last, um, f- like week of your cycle.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
So from the time you hit puberty to the time you go into menopause, you have these monthly cycles, so I think it- it's imperative for us to learn them and to learn how to optimize them. So when we know that there's a testosterone burst in the middle of the cycle, like around day 14, if you're trying to build muscle, if you're trying to do something that requires a little more confidence and bravado, maybe it's asking for a raise, maybe it's doing that thing that you're really scared to and you can- you have some ability to schedule that, the mid-cycle time is the time to do it.
- MRMel Robbins
Wow. This is so interesting. You know, if we were all clued into this, in terms of how to optimize your energy or your focus during certain stages of your cycle, and if we knew what really worked for our bodies from a younger age, by the time we get to menopause, we wouldn't have to have the discussions that we're having today. I mean, it's kind of lame that as a 54-year-old woman, I'm still going, "What the fuck is going on with my body?"
- ASDr. Amy Shah
Exactly. The problem is, is that the more- the- the world is a man's world, at least the medical research world, because that's what we've researched. And so because we don't have enough research on this topic-
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
... it's almost like, well, where's the research that says that there is a, you know, a d- this happens in women? We don't have 10,000 women studies where we look at their cycles and we look at menopa- I mean, we need that. We need that data, so we can say, "Hey, if you are trying to optimize your muscle mass, um, you should be training hard in the middle of your cycle." Like w- where are those studies? Where is the data, so we have a toolbox? So instead of speaking in a hypothetical sense, in the physiological sense, we have hard data like we have for other things.
- MRMel Robbins
That makes a lot of sense. So a woman goes through puberty, she gets her menstrual cycle, and then what happens when somebody gets pregnant? What happens to the hormones then?
- ASDr. Amy Shah
So basically what happens is if at ovulation, the egg gets fertilized, the hormones stay high. They don't drop to let the lining shed.
- 22:32 – 27:42
What is really happening with your hormones during pregnancy?
- ASDr. Amy Shah
So as the hormones, they stay high, you get uh, obviously hCG, people know this because this is the one hormone that actually rises during early pregnancy, you get h- um, and that's what you check when you pee on a stick is the hCG levels are in the blood, you can check the hCC- that's the hallmark that says, "Oh, the body knows that you're pregnant and has released hCG, um, because y- uh, it's- there's been an implantation." And so you don't get the whole last part of your cycle that you usually do. There's no late luteal phase, and there's no PMS. Your hormone levels stay high, you know, at- at those levels, um, for the duration of the pregnancy. And then when you have the baby, um, it can take a few months actually to normalize. There's some fluctuations, but then you'll go back to having kind of that, uh, approximately 28 day to 32 day cycle, um, with the rise and fall of hormones.
- MRMel Robbins
And then there's perimenopause. I guess this is like the warmup for menopause. I mean, what happens there?
- ASDr. Amy Shah
Perimenopause is your estrogen and progesterone are at the bottom, uh, are getting low. So if you've ever had toothpaste, like a tube of toothpaste, when you kind of get to the end of the toothpaste, sometimes you press on it and you just get a splatter, and sometimes you just press on it and you get a full squeeze of toothpaste, and sometimes you press on it and you get nothing. And so that's what's happening during perimenopause. Some months you're getting a good dose of estrogen and progesterone and you're almost feeling like you're normal, and other months you have a low level and you're getting all these symptoms, and some months are- you're feeling absolutely terrible because your hormone levels are super low. And so you can have a lot of fluctuations during this time where it's- that's perimenopause. Basically, you're getting to the end. Menopause is there's nothing left. Your levels are very low. Um, you're not ovulating anymore.
- MRMel Robbins
Mm.
- ASDr. Amy Shah
And so...The years of perimenopause can be long, confusing, and variable-
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
... based on what's happening. So one of the things that people talk about is hot flashes, and the reason why hot flashes happen is one of the roles of your hormones is to tell your brain center, your hypothalamus, your temperature center, um, what to do, like how to, uh, regulate our temperature. So that month, if you just get a splatter of estrogen or you get none, um, you get dysregulation of that central thermostat. And so now you're hot, you're sweating, and you get these, um, peaks and valleys of temperature. And so that's how I would describe perimenopause, and that can happen for multiple years, and that's why there's treatment now. Like, there's things you can do. Um, hormone replacement therapy is really good for, um, that kinda hot flash temperature dysregulation, um, that seems to help. And so you have all that, and then you hit menopause, and menopause, the definition is no menstrual periods, uh, so no ovulations for 12 months. And f- so full year goes by, you don't have fluctuations anymore, you're just at low levels. And so for women, um, often the at five to 10 years after menopause, they are able to now kind of get acclimated to the no hormone state.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
So it seems like the fluctuations of the hormones are c- wreaking havoc on our brain and our body, but then once you kind of normalize at a lower level, about five to 10 years, you seem to have a reprieve of the symptoms, so you're no longer getting the hot flashes, you're no longer having, um, some of the menopausal symptoms. No menstrual period for 12 months.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
Okay? But the drop in estrogen and progesterone that we're talking about here happens up to 10 years before menopause.
- MRMel Robbins
Wow. So you know what's interesting is that I started to see a big spike in sort of fogginess and feeling like something wrong, probably like in my, I'd say early to mid-40s.
- ASDr. Amy Shah
Yes. That's very typical. So it can be as early as 35 for people who are going through menopause a little bit early, but-
- MRMel Robbins
Uh-huh.
- ASDr. Amy Shah
... usually in your 40s, especially your mid-40s, is when people really start to see, "Oh, you know, that exercise that I was doing is not working f- to control my weight anymore."
- MRMel Robbins
Well, everybody that I know that is in this range and is talking about the fact that their body shape has changed.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
That there is this thickening in the middle. My sister-in-law, who I love, keeps referring to her body as a Twinkie.
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
Just like a Twinkie with legs. I'm like, "Will you shut up? Stop."
- ASDr. Amy Shah
That's hilarious.
- MRMel Robbins
And, you know, I
- 27:42 – 34:04
Where the heck did this muffin top come from?
- MRMel Robbins
know that I'll get flak for saying this because I'm a lean, athletic build kind of person.
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
But all my pants fit very differently now.
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
The... It's as if I have a, uh, you know like those inner tubes that you sit in in a pool?
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
It's like I've put one from the belly button to the crotch, and around the back too. It's like all of a sudden it's filled out, so my pants don't fit anymore.
- ASDr. Amy Shah
Mm-hmm.
- MRMel Robbins
Even though it doesn't seem like my body's changed. I mean, it looks like it has.
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
Why the f- why are we all... I could not do more crunches, I couldn't eat healthier if I tried, I am already getting eight or nine hours of sleep. For God's sakes, I've cut back on the alcohol, I smoke a little weed here and there, that's not putting on this shit in the middle, I don't even get the munchies when I-
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
... when I smoke weed. Why is this happening?
- ASDr. Amy Shah
This is happening-
- MRMel Robbins
It doesn't seem fair.
- ASDr. Amy Shah
I know. It's because our estrogen levels, as they start to drop, our body is looking for more hormonally active, um, cells. So what I mean to say is the fat that you accumulate-
- MRMel Robbins
Yes.
- ASDr. Amy Shah
... in your middle-
- MRMel Robbins
Yes.
- ASDr. Amy Shah
... it produces estrogen.
- MRMel Robbins
Okay, wait a minute.
- ASDr. Amy Shah
Fat produces estrogen.
- MRMel Robbins
What do you mean fat produces estrogen?
- ASDr. Amy Shah
Fat cells, uh-
- MRMel Robbins
You didn't say that the estrogen sister was a fat sister.
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
You just said that she was the one that was the party girl.
- ASDr. Amy Shah
Yes. She-
- MRMel Robbins
Okay, so fat cells?
- ASDr. Amy Shah
In our ov- I was talking about that estrogen, progesterone, that are primarily coming from our ovaries when we are, uh, prior to menopause.
- 34:04 – 37:04
The top 5 health questions for Dr. Shah and her answers.
- MRMel Robbins
complain to you about-
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
... when they come see you, uh, for help with nutrition and hormones?
- ASDr. Amy Shah
Yes.
- MRMel Robbins
And how do, how do you attack fixing them?
- ASDr. Amy Shah
The number, I would, I would say, uh, number one, two, and three. Okay, so number one is definitely the weight gain.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
The weight gain is very frustrating because if you're an active person, we're already living in a world that's working against us, right? We already talked about that. This world, the default is that we are going to be in the categories of medically overweight or obese. 73% of Americans are there now.
- MRMel Robbins
Wow.
- ASDr. Amy Shah
It's gonna be at 85% before we know it, right? So, we're already working against the s- uh, so most of us are already metabolically challenged. We're already fighting against this battle. Then, we gotta deal with the estrogen going down-
- MRMel Robbins
Yes.
- ASDr. Amy Shah
... which makes you less active, less energetic, and losing your muscle mass, so now you have more fat, and it's making your mood a little bit lower, right?
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
So, we can... The therapies that I recommend, uh, a lot of them have to do with things to counteract the changes in the lowering of estrogen.
- MRMel Robbins
Okay, like what?
- ASDr. Amy Shah
So, walking more.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
So what I tell women is, like, our cortisol levels can be really high when we're doing tons and tons of, um, l- high-intensity exercise, so it's better to have a baseline of walking, and you can do bouts of HIIT if you want, but really, having more activity. It's called NEAT, non-exercise activity thermogenesis. NEAT activity is actually a bigger driver of our weight.
- MRMel Robbins
What is that last word? Thermogenesis?
- ASDr. Amy Shah
Yes.
- MRMel Robbins
Non-activity, non-electric.
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
What I, I can't keep up with, what n- what is thermogenesis? (laughs) That's a big word.
- ASDr. Amy Shah
Non-exercise-
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
... activity thermogenesis. Thermogenesis is metabolism.
- MRMel Robbins
Okay, so what is a non-exercise... Is walking is non-ex-
- ASDr. Amy Shah
Walking. So-
- MRMel Robbins
Okay.
- ASDr. Amy Shah
... if you're not walking for exercise, um, so the, the, the thought is you wear a watch or you wear a pedometer.
- 37:04 – 40:50
Did you know that PMS is a mini-menopause?
- ASDr. Amy Shah
mini PMS is happening for a few years now.
- MRMel Robbins
So is PMS-
- ASDr. Amy Shah
A mini menopause.
- MRMel Robbins
I- it's a drop in your estrogen and progesterone in the middle of your normal cycle?
- ASDr. Amy Shah
Yes.
- MRMel Robbins
No shit.
- ASDr. Amy Shah
That's what's happening.
- MRMel Robbins
I didn't know that.
- ASDr. Amy Shah
That's when your body's like, "Oh, she didn't get pregnant. There's, you know, the egg didn't get fertilized. We gotta shed this lining." They drop the hormones, so you get to be basically the lowest level of estrogen and progesterone-
- MRMel Robbins
Yep.
- ASDr. Amy Shah
... and then you shed your lining, which is your period, and then you start all over again.
- MRMel Robbins
Wow, so will the things that you're saying that help for somebody in perior or menopause itself also help with PMS symptoms?
- ASDr. Amy Shah
Yes.
- MRMel Robbins
That is a revelation.
- ASDr. Amy Shah
It is for me, too. I thought to myself, "Wow, the same things that we are doing to improve our nutrition during our cycle-"
- MRMel Robbins
Yes.
- ASDr. Amy Shah
"... we just expand on that." The late luteal phase, which is that PMS phase of the cycle-
- MRMel Robbins
Okay.
- ASDr. Amy Shah
... is what's happening. Now-
- MRMel Robbins
I kinda like that, um, oh, that's not another name for menopause. I was gonna say I think it's sexier to say, "I'm in my late-"
- ASDr. Amy Shah
Luteal. (laughs)
- MRMel Robbins
"... luteal phase." Not menopause.
- ASDr. Amy Shah
The late luteal phase.
- MRMel Robbins
Luteal phase.
- ASDr. Amy Shah
That-
- MRMel Robbins
But you're talking, that's a period, okay, sorry. (laughs)
- ASDr. Amy Shah
Yeah, that's a per- that's, that's the, that's the week before your period, that's PMS.
- MRMel Robbins
Gotcha.
- ASDr. Amy Shah
Um, so the, uh, one surprising thing that people have to understand is that hormone replacement therapy does not help with the weight gain part. The weight gain part is not an indication to go get hormones.
- MRMel Robbins
Okay.
- 40:50 – 43:39
Why sleeping in a cold, dark room will help you lose weight.
- ASDr. Amy Shah
your appetite, um, as we said, you know, your hormones, your hunger hormones are really dysregulated when you don't sleep.
- MRMel Robbins
Yes.
- ASDr. Amy Shah
And so you wanna have a good night's sleep, but often you can't sleep because your hormones are disrupted, so it's this, like, the cycle. So one of the things I o- tell people is really, really try your best to improve your sleep hygiene. If you haven't started a routine to improve your sleep hygiene, start it now in perimenopause or postmenopause.
- MRMel Robbins
Okay, now tell us your top three things-
- ASDr. Amy Shah
Ho-
- MRMel Robbins
... for a better night's sleep.
- ASDr. Amy Shah
Top three things for a better night's sleep, cold room.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
Your body temperature has to drop by one degree to fall asleep.
- MRMel Robbins
Oh.
- ASDr. Amy Shah
So how do you get that done fastest? You could take a shower. You can cool down the room.
- MRMel Robbins
Yep.
- ASDr. Amy Shah
You can get into pajamas that cool your bo- you know, you want to cool your core body temperature.
- MRMel Robbins
Okay.
- ASDr. Amy Shah
That's how you'll fall asleep.
- MRMel Robbins
Love that.
- ASDr. Amy Shah
Pitch black.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
If you can't control the curtains and the light, then wear a face mask-
- MRMel Robbins
Yep.
- ASDr. Amy Shah
... or a eye mask. Uh, there are good studies on, w- the few studies that we have, one is on menopausal women, um, even if you have a ambient light in the room, like a light coming through the window, um, it will stop weight loss if you're on a weight loss plan.
- MRMel Robbins
Really?
- ASDr. Amy Shah
Circadian rhythm disruption, especially during that time, seems to really mess up, um, the hormones in that sense. So you wanna have a pitch black room. Um, and then, uh, the third thing is you want a nightly routine. So you wanna prepare your brain and your body for sleep because body, your body loves routines. You know, our bodies are built on rhythms and cycles.
- MRMel Robbins
Yes, yes.
- ASDr. Amy Shah
And if every night you go to sleep at 8:00 PM or 9:00 PM-
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
... and then so at 8:45, you start to turn off all the lights, you put away your phone, you start to brush your teeth, you're cluing in your body that it's time for sleep. So keeping that same-Time and routine is essential for good sleep, so people will sleep one day at nine o'clock and the next day at 11:00 and the next day. They're massively disrupting their sleep cycles, and there's some data now that shows that it's maybe more important to stay on the same bedtime-
- MRMel Robbins
Huh.
- ASDr. Amy Shah
... than even the total number of hours slept.
- MRMel Robbins
Wow. Um, are there certain foods that we should be eating more of or less of to help with the menopause symptoms and hormone regulation and, you know, for everybody's benefit, I just wanna remind everybody, this is your second appearance.
- 43:39 – 48:22
Top 3 tricks that regulate your cravings.
- MRMel Robbins
it, and so that will be linked in the show notes along with both of your books. But, you know, if you had to bottom line it for people that are, you know, really wanting to use food to regulate hormone, like, what are the top recommendations?
- ASDr. Amy Shah
Remember that, um, I likened it to PMS in the sense that you're less stress-resilient, so you're, what I mean is that the things that spike your cortisol, um, are just now more and at a lower threshold.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
Caffeine, alcohol, uh, sugar.
- MRMel Robbins
Shit, are we not gonna have fun now too?
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
I mean... (laughs)
- ASDr. Amy Shah
It's like all the, people say to me, "I- I always drank this much caffeine and I always eat- ate this much sugar."
- MRMel Robbins
Yes.
- ASDr. Amy Shah
And-
- MRMel Robbins
Or had a glass of wine.
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
Or did whatever. What the hell is going on?
- ASDr. Amy Shah
Yeah, and that's because now your hormones have changed and your metabolism changed. You're also less insulin sensitive. So, um, you know you've heard the term insulin resistance?
- MRMel Robbins
Yes. What does that mean?
- ASDr. Amy Shah
So that happens during, uh, menopause.
- MRMel Robbins
What is insulin resistance?
- ASDr. Amy Shah
In- ins- insulin resistance means that when the sugar is trying to get into your cells-
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
... the insulin has to open the door-
- MRMel Robbins
Oh.
- ASDr. Amy Shah
... um, to let the sugar in. That's insulin.
- MRMel Robbins
Oh.
- ASDr. Amy Shah
Yeah. So it usually matches, meaning the- when you have a lot of-
- MRMel Robbins
So what does it mean when you're insulin resistant? The doors shut, the doors open?
- ASDr. Amy Shah
It's the doors shut and you don't hear it as- as easily, like you're knocking louder and louder to try to get in.
- MRMel Robbins
Oh.
- ASDr. Amy Shah
And the insulin's like, "Dude, we just let m- sugar in. We're not gonna let more sugar in." And the body's like, "No, but I need to get it out of the bloodstream. I need to put it..." And- and the insulin's like, "No, but the cell is packed. It can't take any more sugar." And so while they're having these fights and discussion, that's called insulin resistance.
- MRMel Robbins
Oh.
- ASDr. Amy Shah
And so when insulin, um, resistance happens, the body gets signals to store fat, to say let's get this sugar out of here because it's not going into the cell, so we gotta put it somewhere. So we end up hav- when insulin resistance happen, not only do you have a higher risk of getting type 2 diabetes-
- 48:22 – 50:55
Why anxiety increases during PMS.
- ASDr. Amy Shah
I can't believe X, Y, and Z happened," and it starts a whole anxiety spiral, and a lot of women during menopause have crippling anxiety.
- MRMel Robbins
Does hormone replacement therapy tend to help with anxiety?
- ASDr. Amy Shah
Yes, if progesterone replacement.
- MRMel Robbins
Gotcha. Can you explain what a hormone is?
- ASDr. Amy Shah
Yeah.
- MRMel Robbins
Like I- I don't even, I'm not sure I would know how to explain what a hormone is and what it does.
- ASDr. Amy Shah
Yeah. I- i- that's a great question. I always, uh-... feel like there's so much confusion-
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
... about hormones. Hormones is a chemical messenger, so in my analogy of the highway-
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
... it's the car. It's the car.
- MRMel Robbins
Oh.
- ASDr. Amy Shah
It travels from your brain or from your ovaries to wherever it needs to go. It can go to the muscle, it can go to the heart, it can go... So, it's a traveling message and we need it. Our bodies cannot function without hormones. Like, people get so annoyed with hormones, but you cannot function without your hormones, even cortisol. Cortisol is a good hormone. It can... Just doesn't... It has to be balanced.
- MRMel Robbins
So, what is the estrogen, the estro... Oh, I'm getting this now. So, the fun party sister-
- ASDr. Amy Shah
The social one.
- MRMel Robbins
... the social one is driving one car.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
And when she arrives, it's time to party.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
When the progesterone sister is driving another car, when she arrives, party's over.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
Then-
- ASDr. Amy Shah
And she calms everybody down, like-
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
... "Let's just chillax now, guys. Let's just, you know, tone it down. Let's relax."
- MRMel Robbins
Is insulin a hormone?
- ASDr. Amy Shah
Insulin is a hormone.
- MRMel Robbins
Really? So, when insulin gets in the car, what is insulin telling you to do?
- ASDr. Amy Shah
So, insulin is telling you to let... Open the door to let the glucose in. It's signaling to store, um, store, it's a storage signal.
- MRMel Robbins
Uh-huh.
- 50:55 – 1:05:23
What you need to know about hormone replacement therapy.
- ASDr. Amy Shah
high, high doses of thyroid hormone and I say to people that more is not always better, right? Like, it's not just doing one thing. It's doing five different things, and one of the things it's doing is it's going to the heart. And if you send too much thyroid hormone to the heart, you're going to have all kinds of problems, including arrhythmias, heart palpitations. People that are taking too high doses of thyroid hormone will have heart problems often. So, it's not... It's- it's like playing with fire.
- MRMel Robbins
Wow. So, they're just kind of driving in the wrong directions, or they're not arriving where they used to arrive, and that's what's making the changes. So, the hormones are the root cause of PMS and menopause.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
Wow. And for some of the symptoms, hormone replacement therapy will alleviate symptoms.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
But for other things like the fat dis- redistribution or the losing muscle tone or the... That you're gonna have to make lifestyle changes.
- ASDr. Amy Shah
Yeah. So, the other hormone that we didn't talk about but that's really important even in women is testosterone.
- MRMel Robbins
Really?
- ASDr. Amy Shah
Testosterone is actually in higher levels, like four times the level of estrogen or progesterone. Like, it's high.
- MRMel Robbins
In women?
- ASDr. Amy Shah
Yes. In women.
- MRMel Robbins
Really?
- ASDr. Amy Shah
And we always think about, uh, testosterone as like a male hormone, right? Of course males have much higher levels-
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
... of testosterone than women, but our testosterone is also high compared to our other hormones. And so, having testosterone there... So, testosterone is the sister that doesn't live as close to the other sisters, but testosterone is the leader. It's the one... It's the muscular, it's the aggressive, it's the leader sister. So, testosterone is something that we get a spike of testosterone-
- MRMel Robbins
Yep.
- ASDr. Amy Shah
... at ovulation. So, if you know your cycle, roughly a week after your period, um, is when your testosterone levels are peaking. And so, that's when you wanna build the most muscle, that's when your libido will be the highest.
- MRMel Robbins
Yeah.
- ASDr. Amy Shah
Your confidence levels will be similar to the other gender. Like, uh, your people that take too much testosterone, for example, when they're taking replacement and they go overboard, they'll be angry, aggressive, and maybe even a risk-taking behavior.
- MRMel Robbins
Huh.
- ASDr. Amy Shah
And so, we know that testosterone can be good in small amounts, especially for women during peri- perimenopause and during the cycle if you're lower than you need to be, but of course, you don't want to overdo it. People overdo it all the time.
- MRMel Robbins
How do you figure out what to take?
- ASDr. Amy Shah
Yeah, I know (laughs) . I know. It's... They're so much misinformation out there. For example-
- MRMel Robbins
What are the big ones? Yeah.
- ASDr. Amy Shah
They-
- MRMel Robbins
Give me some of the big myths.
- ASDr. Amy Shah
Big example. The one thing that all doctors can agree about that no hormones, is that those pellets that people get are no good.
- MRMel Robbins
I don't know what the hell a pellet is. I've just heard about this.
- ASDr. Amy Shah
Yes.
- MRMel Robbins
What the hell are pellets?
- 1:05:23 – 1:09:12
Power nap or meditate at THIS time for best results.
- ASDr. Amy Shah
between about 3:00, like, 1:00 to 4:00 PM. When your cortisol dips, um, it's a great time to either do a power nap 20 minutes, do a meditation, do something calming, because remember, when your progesterone's dropping, you're likely more anxious, you're overwhelmed.
- MRMel Robbins
Yep.
- ASDr. Amy Shah
It's a nice break from the day, um, when you can do it. Do something that's very centering, prayer, whatever it is.
- MRMel Robbins
Let me ask you a question about that. These menopausal symptoms that you're talking about, I've heard what I think is probably a myth, that if you just ride it out, just, like, three years, Mel, ride out the hot flashes, the dryness, the bitchiness, all this stuff, the brain fog, and in three years, you'll just snap right back. Is that true?
- ASDr. Amy Shah
Well, what happens is that your body just starts to get used to it. And so you're l- operating at a level that's just stable. There's no squeezing of the toothpaste, there's nothing there. Your body starts to accommodate. Um, and so it's not that it's snapping back, but that the symptoms seem to go away, a lot of the symptoms, um, that were really troublesome during perimenopause. And so, um, it's often the time where, uh, people feel a little reprieve. But remember that disease risk goes way up after menopause. Our hormones protect us from heart disease and all of the, uh, disease of aging, and so once you hit menopause, you start to have an increased risk of all of those inflammatory diseases.
- MRMel Robbins
Okay. Wow, yet another thing to look forward to. Is there anything more that we should know about the increased risk of inflammatory diseases?
- ASDr. Amy Shah
So, one of, um, the big criticisms of hormone replacement therapy was that it would cause cancer, um, but now we know that it's the opposite, that actually, hormones actually protect us, uh, from a lot of these diseases, especially heart disease.
- MRMel Robbins
Mm-hmm.
- ASDr. Amy Shah
And for women, it can actually be protective. Um, and then in the right population of women, um, like, very close to the start of menopause or perimenopause, the, the earlier you start it, the better risk protection you get from-
- MRMel Robbins
Wow.
- ASDr. Amy Shah
... uh, hormone replacement therapy.
- MRMel Robbins
So, what is the biggest myth around menopause?
- ASDr. Amy Shah
I think the biggest... Honestly, my biggest pet peeve about menopause is the fact that women feel shame around it, and they can't have conversations with their doctors. They often feel like they're, um, marginalized and, um, and they're not listened to from their provider when they say, "Oh, I have this correlation... th- the symptoms. I don't feel right. Feel tired, but I feel anxious. My sleep is off." And they often get a prescription and no explanation about what's happening. And I know countless women who've just come home with anti-anxiety medications, and no one explained to them that there's a lot going on in your body that could explain why you're feeling this anxiety at this time, and there are things that you can do. Not to say there's anything wrong with medications. There's a great need for medications, but there's also a big need for education around menopause.
- MRMel Robbins
I agree. There is a huge need for education, not only around menopause, but also around women's hormonal health and cycles in general. And I consider myself to be a very well-educated person. I'm intellectually curious, I read all the time, and I have flunked this topic.
- 1:09:12 – 1:15:46
Why it’s way past time we start talking about women’s health.
- MRMel Robbins
And when I've gone to my doctor or to my OB-GYN, it feels like people are like, "Yeah, well, it's gonna last till you're 60," and, "You know, you can do hormones," or, you know, whatever. "You're gonna have to tolerate the weight gain. It'll disappear, uh, by the time you're 60."
- ASDr. Amy Shah
I hate that. I think that term is like gaslighting, like, you know, medical gaslighting where women just feel like they're not listened to, um, and their, their complaints are just dismissed. And I think that's something we really need to work on as a society because, like I said, 40, age 40, age 50, age 60 is now very different than it was even just 20 years ago. Women are doing things in their 40s, 50s, and 60s that women did not do. And so, we're changing the... Uh, we gotta change the conversation. So, it's not that, "Oh, you're just, th- you know, you're just worried, you're just stressed, you're just getting old," and dismissing their concerns. These people are running companies. They're leading countries. They're... I mean, they... We need to have conversations about what they could be doing to optimize themselves at that level, not just saying, "Oh, well, you're just getting old."
- MRMel Robbins
So, what would you advise any of us who feel like we are just not getting the answers from the doctors, like, that we're seeing? Do you just change your doctor? I mean, what do you do?
- ASDr. Amy Shah
I think in this day and age, we have enough physicians that are interested, educated, um, and can be an advocate for you, that you should go seek that out. Uh, because I think that we're changing the conversation, not only within ourselves, but in the medical community of saying like, "Hey, listen, um, if a woman comes with you, to you with these complaints, don't just write it off as separate things. Think about, like, where is she in her cycles? Like, where is she with her hormones? Could it be, um, this?" And one big myth that I wanna bust is that you must check your hormone levels to diagnose a hormone problem or menopause. So, there is this big myth that in order to be considered in menopause or perimenopause, you must get your hormone levels checked, because that's what you hear on the internet. Menopause is not a diagnosis of hormone levels. It is a diagnosis of symptomatology, um, and the definition has nothing to do with the level of hormones. And so, um, a lot of people spend thousands and thousands of dollars trying to get testing to figure out what their hormone levels are, um, but that's not necessarily the first place you need to go.
- MRMel Robbins
Well, when should you get your hormone levels tested?
- ASDr. Amy Shah
If you're getting replacement therapy and you're trying to troubleshoot something. But the diagnosis of menopause is not made through a lab test.
- MRMel Robbins
Well, that's one thing that we learned today, that the diagnosis of menopause is made after you have gone an entire year without menstruating.
- ASDr. Amy Shah
And the problem is, is that, um, like I said, there's a lot of, um, misinformation, there's a lack of research, and there's a lack of interest, to be honest. And so, uh, I think that all of those things make menopause an area that is mismanaged, that is, um, an area... Like, if you look on the internet and you look for supplements around PMS or menopause or hormones, it's a wild, wild west. I mean, clearly people are looking to alternative practitioners and online therapies for their hormonal concerns. But when you see what's out there, it is like, very scary. And so, that's a clear sign that women are looking for answers, and so we need to have more information. Even the basic things like we talked about here, this should be basic education for all women.
- MRMel Robbins
Dr. Amy Shah, I'm having you back to talk about circadian rhythm-
- ASDr. Amy Shah
Yes.
- MRMel Robbins
... and I'm having you back to talk about the rhythm of the day. You are a freaking rockstar. The book is I'm So Effing Tired, But We Ain't So Effing Tired No More-
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
... because Dr. Amy has given us simple things backed by profound science that you learned today, that will help you take control of your hormone health so that you can...... live a much better life. Thank you, thank you, thank you. You are going to, I- I cannot wait to have you back.
- ASDr. Amy Shah
Ah, I'm so honored to be here and I would love to.
- MRMel Robbins
(beep) What is that last one? Thermogenesis?
- ASDr. Amy Shah
Yes.
- MRMel Robbins
Non-activity, non-electric, what-
- ASDr. Amy Shah
(laughs)
- MRMel Robbins
... I can't keep up with. What, what is thermogenesis? (beep) You're, you're in fucking menopause, so your mind is going.
- NANarrator
(laughs)
- MRMel Robbins
(laughs) There we go, yeah, we'll talk about that later.
- NANarrator
We'll do that later.
- MRMel Robbins
(beep) Do you want me to say which hormones?
- NANarrator
No, it's ...
- MRMel Robbins
It is? Okay, well then I would say what hormones. (laughs)
- NANarrator
(laughs)
- MRMel Robbins
(laughs) Yeah, no, we'll definitely keep it in what hormones then. (beep) I think that, uh, Diet Coke-
- NANarrator
Oh, yeah.
- MRMel Robbins
... and the outside put a little life in, uh, sinus-infected Mel Robbins here. Oh, and one more thing. I know this is not a blooper. (laughs) This is the legal language. You know, what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend, I am not a licensed therapist, and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist or other qualified professional. Got it? Good. I'll see you in the next episode. (instrumental music) Hey, it's Mel. Thank you so much for being here. If you enjoyed that video, by God, please subscribe, 'cause I don't want you to miss a thing. Thank you so much for being here. We've got so much amazing stuff coming. Thank you so much for sending this stuff to your friends and your family. I love you. We create these videos for you, so make sure you subscribe. Mwah.
Episode duration: 1:15:46
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