277. Everything Women Need to Know About Perimenopause, Menopause & Hormone Therapy - Compilation

I've brought together some of my best conversations on menopause and perimenopause with Dr. Jessica Shepard, Dr. Vonda Wright, and my wife Sage. Covering why your "normal" labs miss it, how a frozen shoulder can signal hormone changes, and the truth about hormone therapy. If you're navigating midlife, this video is for you. CLICK HERE TO BECOME GARY’S VIP!: https://bit.ly/4ai0Xwg Connect with Dr. Jessica Shepherd Website: https://bit.ly/3Pf6ZHG YouTube: https://bit.ly/47La74k Instagram: https://bit.ly/3NG17Xu TikTok: https://bit.ly/416VYLb Facebook: https://bit.ly/4ryjyeE X.com: https://bit.ly/4192QaQ LinkedIn: https://bit.ly/3Nhrm6x Connect with Dr. Vonda Wright Website: https://bit.ly/439JGmN YouTube: https://bit.ly/43EDGTe Instagram: https://bit.ly/47UjwHl TikTok: https://bit.ly/3X7Mcq2 Facebook: https://bit.ly/3JGqEhi X.com: https://bit.ly/4oiKJt1 LinkedIn: https://bit.ly/3Lj4T7K Connect with Sage Workinger-Brecka Instagram: https://bit.ly/44sN390 Thank you to our partners A-GAME: “ULTIMATE15” FOR 15% OFF: http://bit.ly/4kek1ij AION: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4h6KHAD AIRES: "ULTIMATE20 " FOR 20% OFF: https://bit.ly/4a3Duze BAJA GOLD: "ULTIMATE10" FOR 10% OFF: https://bit.ly/3WSBqUa BODYHEALTH: “ULTIMATE20” FOR 20% OFF: http://bit.ly/4e5IjsV COLD LIFE: THE ULTIMATE HUMAN PLUNGE: https://bit.ly/4eULUKp CYMBIOTIKA: "ULTIMATE10" FOR 10% OFF: https://bit.ly/4tjyluP GENETIC METHYLATION TEST (UK ONLY): https://bit.ly/48QJJrk GENETIC TEST (USA ONLY): ⁠https://bit.ly/3Yg1Uk9 GOPUFF: GET YOUR FAVORITE SNACK!: https://bit.ly/4obIFDC H2TAB: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4hMNdgg HEALF: 10% OFF YOUR ORDER: https://bit.ly/41HJg6S PEPTUAL: “TUH10” FOR 10% OFF: https://bit.ly/4mKxgcn SNOOZE: LET’S GET TO SLEEP!: https://bit.ly/4pt1T6V WHOOP: JOIN & GET 1 FREE MONTH!: https://bit.ly/3VQ0nzW Watch the “Ultimate Human Podcast” every Tuesday & Thursday at 9AM EST: YouTube: https://bit.ly/3RPQYX8 Podcasts: https://bit.ly/3RQftU0 Connect with Gary Brecka Instagram: https://bit.ly/3RPpnFs TikTok: https://bit.ly/4coJ8foX: https://bit.ly/3Opc8tf Facebook: https://bit.ly/464VA1H LinkedIn: https://bit.ly/4hH7Ri2 Website: https://bit.ly/4eLDbdU Merch: https://bit.ly/4aBpOM1 Newsletter: https://bit.ly/47ejrws Ask Gary: https://bit.ly/3PEAJuG Timestamps 00:00 - Intro of Show 04:23 - Perimenopause begins in your late 30s 05:16 - Why hormone symptoms don't show on labs 06:55 - The earliest warning signs to watch for 11:38 - Why the whole picture matters more than one number 13:33 - Frozen shoulder reversing after hormone therapy 13:46 - The misquoted study and the FDA reversal 15:37 - Good, better, best: when to start 20:11 - Frozen shoulder as a midlife inflammation sign 23:35 - Dispelling the estrogen and breast cancer myth 24:14 - Why estrogen affects every tissue in the body 29:44 - What "natural" hormone therapy really means 32:37 - Vaginal and facial estrogen, and collagen loss 35:31 - New data in 120 million women 37:59 - Sage's story: brain fog and frozen shoulder 43:31 - Reading the Dutch test results 46:36 - When mold and toxins muddy the picture 48:27 - Three weeks later: everything changed 52:37 - Don't let anyone say it's in your head Disclaimer: This podcast is for informational purposes only and does not provide medical advice. It is not intended for diagnosing or treating any health condition. Always consult a licensed healthcare professional before making health or wellness decisions. Gary Brecka is the owner of Ultimate Human, LLC which operates The Ultimate Human podcast and promotes certain third-party products used by Gary Brecka in his personal health and wellness protocols and daily life and for which Ultimate Human LLC and/or Gary Brecka directly or indirectly holds an economic interest or receives compensation. Accordingly, statements made by Gary Brecka and others (including on The Ultimate Human podcast) may be considered promotional in nature. Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:12Gary Brecka?

  Hey guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist Gary Brecka. Today, we're doing something a little different, and I'm fired up about this one. What you're about to watch is a compilation, three conversations that I've been wanting to put together for a long, long time. Because if there's one area where women have been let down by medicine, by media, by the system, it's menopause. Fifty million women have unnecessarily suffered for decades because of one misquoted study. That's not a headline. That's a quote from the chairman of the FDA. Let that land. So today, I'm bringing you three of the most important voices in this entire space. First, Dr. Jessica Shepherd, a board-certified OB-GYN, menopause expert, and someone who completely has rewritten the playbook on

• 0:57Gary Brecka?

  women's hormonal health. Then, Dr. Vonda Wright, a board-certified orthopedic surgeon, will tell you why a frozen shoulder is not just a joint problem, it's your body screaming that your hormones are in crisis. And finally, my wife Sage, who lived this, tested this, and came out the other side. By the end of this episode, you will know what perimenopause actually is, when it starts, what to test, why standard blood work misses it, and what to do when you find the answers. If you're a woman, or you love a woman, stay in your seat. This one matters. My first guest changed the way that I understand women's hormonal health, and honestly, the way I show up as a husband. Dr. Jessica Shepherd is a board-certified OB-GYN and menopause specialist who didn't stay in the system when the system was getting it wrong. She blew the whistle.

• 1:42Gary Brecka?

  She founded Modern Meno. She wrote the book Generation M, and she's made it her mission to capture women before they fall off the hormonal cliff and give them the building blocks to thrive at 60, 70, and 80. Here's Dr. Jessica Shepherd. I know that you're a classically trained physician. Yeah. But at some point, there was a shift in your career and your career choices. And I'm always fascinated by that because... Comfort would dictate that you just stay in the system.

• 2:12Speaker 01

  Yeah.

• 2:13Gary Brecka?

  Do what the system tells you. You make a good living. Kind of keep your mouth shut.

• 2:19Gary Brecka?

  Don't, don't, don't raise your hand.

• 2:22Gary Brecka?

  But I wonder if there was, what, what preempted that shift?

• 2:26Speaker 01

  You know, there are really pivotal moments in your life where you, everyone gets choice. And to decide what they want to do with that moment. And my background, a little behind the scenes about me is I got my undergraduate degree in kinesiology, exercise physiology. So I really understood what the body could do, what it could adapt to when it's optimized. So I feel that the beginning of my medical career was in the best of, the best of what the body can do. And so going into medicine, obviously, we know how to fix train wrecks. We deal in illness and disease, which is great. We do need that side to society.

• 3:09Speaker 01

  So now practicing 15 years of seeing the worst and fixing disease and operating. I did a fellowship in minimally invasive gynecology. So I was a high-volume surgeon. But what I really started to understand is the story. The story behind the scenes of all these women that I would see in the exam room. And I knew deep down, I was like, there's something else going on. And that something else is all the behind the scenes thing that allow people to show up with disease. Whether that's with nutrition, exercise, stress, emotional issues that are going on, actually feed into how we present in chronic disease as well. And so I think that that was the pivotal moment that I said to myself, I have to do something different.

• 3:52Speaker 01

  And that's when I ventured more into looking at root cause, looking at lifestyle, being able to actually educate while empowering women about their life, especially in midlife.

• 4:04Gary Brecka?

  I think most say, I still have a period I can't be in that phase.

• 4:08Speaker 01

  Yeah, I think we affix a period or a menstrual cycle to functionality in the sense of nothing's wrong. Right? Or nothing is changing. And that's really not even biologically how we're Body's work. Nothing shifts overnight. It all is a process. And so when we think of perimenopause, starting in our latter 30s, all the way through our 40s, I think it's very astounding. Even when I tell my patients that that is really the duration of what happens. They sit and think about it's like you see the light bulb go off because one either they're going through it and have been for years. Or two, really sitting to say, oh, my body is going through a transition that took years. That's how the cells work. That's how we see changes in the body.

• 4:49Speaker 01

  And especially with hormones, when we see the flux between estrogen and progesterone, whether they're, you know, counteracting each other in the way they didn't before or on a decline, that takes years.

• 5:00Gary Brecka?

  And you know, I, I think if there was just one way to torture a woman, it would be like the estrogen lever, right?

• 5:06Speaker 01

  Oh, yeah.

• 5:07Gary Brecka?

  Oh, saggy skin, mood disorders, libido leave in the building, poor sleep, brain fog, you know, crushing fatigue, all with one little lever.

• 5:14Speaker 01

  Yeah.

• 5:14Gary Brecka?

  And, and, and, you know, testing for it, I think is also something that's really poorly understood. I think most people will do blood tests that are snapshot in time. And I can't tell you how many women came through our functional clinics. And their blood work was quote unquote, fine.

• 5:32Gary Brecka?

  You know, within normal limits.

• 5:33Speaker 01

  And that's what you'll typically find is that you're just fine. I, you know, classically trained as a physician, that's what we were taught is we're really looking for abnormalities. And I said that before is we live in the world of illness and disease. So we're always looking for something that is really wrong. When really what we should be looking at as the human body is it transitions for both men and women. But you know, for now, women is even in the moment of it looks within normal range. How are you feeling? So we have not kind of brought the experiential part of perimenopause onto the actual fundamental science behind it. And that's where we are now is being willing to hear women when they say, I feel A, B, C, D. May not show up in a lab.

• 6:17Gary Brecka?

  Yeah.

• 6:17Speaker 01

  As a hormone malfunction or dysfunction, it actually is experientially what the receptors to the hormones are experiencing, which gives them the symptom. So we just have to listen more.

• 6:27Gary Brecka?

  Yeah.

• 6:28Speaker 01

  Imagine that. Listening more.

• 6:31Gary Brecka?

  Men are classically trained to not do that.

• 6:33Speaker 01

  Yeah.

• 6:34Gary Brecka?

  Halfway through your sentence, we're getting out the toolbox and we're going like, let me tell you how to fix that.

• 6:39Speaker 01

  Right. So imagine that laundry list that you were talking about of sleep, of anxiety, of periods changing, of hot flashes at night. So that list is pretty hefty. So imagine going through that list when you're in a doctor's office, but there's nothing on a lab to say, yeah, I understand what you're saying.

• 6:54Gary Brecka?

  Yeah. I wonder if we could just back up and for, especially for the women and for the men that are listening. Where do they start? Like, what are some of the early warning signs? Is it mood changes? Is it weight gain? What are retention? Is it all of the above?

• 7:08Speaker 01

  It is. It's really all of the above. I say that, you know, every woman who enters this midlife phase is really a moment for them to be more self-aware. Self-aware in the sense that I'm actually going to pay attention to me. Imagine that, right? So pay attention to what's going on in my body because guess what? The story is going to be different for the next one beside you and thereafter. And so that can come in the brain fog. I would say even for me, my journey, it was brain fog. So imagine this, I'm a board certified OB-GYN, menopause expert, wrote a book, and my first symptom was that brain fog, that executive functioning, clarity, memory. And it took me roughly about six months to put the pieces together.

• 7:52Speaker 01

  Right? Because there's also denial that goes with this, right?

• 7:54Gary Brecka?

  Yeah, yeah, yeah.

• 7:55Speaker 01

  Oh, that's not really happening.

• 7:55Gary Brecka?

  The plumber always has a leaky faucet, right?

• 7:57Speaker 01

  You know, there's nothing really going on, or you attribute it to something else. I'm stressed, this, that, this. And finally, I was like, holy hell, Jessica. You know, you are perimenopausal age and you are having symptoms. The good thing is that I had the kind of the self-awareness to kind of put the pieces together, but I also had the tools and the resources. So immediately I was like, well, hormone therapy is what I'm going to choose. But for women who maybe don't have that luxury of knowing everything, and I'm sure we'll dive into that, is the symptoms that start are very subtle. But in that is the consistency behind it, right? Symptomatology usually is based on not a one-off or something that happens and you never experience

• 8:38Speaker 01

  it again is now it's coming, maybe not as frequent, but I noticed that it's there.

• 8:44Gary Brecka?

  Yeah.

• 8:45Speaker 01

  And so not to dismiss those feelings of what you're feeling and then finding someone to discuss that with you, someone who again is going to put the experiential part of hormone changes in midlife onto you are actually going through it. So that can start anywhere from latter 30s, 38. I'm not even going to put an age out there, but latter 30s.

• 9:04Gary Brecka?

  Mm-hmm.

• 9:04Speaker 01

  And going all the way up until you actually hit, like you said before, that wall of menopause, which is where your estrogen now is like flatlined. It's like, we're not here anymore, but all before that is the fluctuation. It's high, it's low. It's like, I'm going to stay steady here and I'm going to go lower.

• 9:19Gary Brecka?

  Mm-hmm.

• 9:20Speaker 01

  So all that time is when you're going to start to feel these symptoms either start, become more frequent, more intense, or more severe. So testing is a little tricky because again, the estrogen and progesterone are still there if you have a cycle.

• 9:35Gary Brecka?

  Hmm.

• 9:36Speaker 01

  Right? So we know in menopause, you do not have a cycle anymore, which states that the ovaries are not eliciting enough estrogen release to give you a cycle.

• 9:45Gary Brecka?

  Hmm.

• 9:45Speaker 01

  So while you're still having a cycle, whether it's infrequent, if it's irregular or regular in the perimenopausal phase, we know that estrogen and progesterone are giving off enough to give you a cycle, just not enough where the rest of your target organs, your brain, your muscle, how your fat is distributed, are now actually responding to that flux.

• 10:05Gary Brecka?

  Hmm.

• 10:05Speaker 01

  So the goal is in testing is not necessarily to tell you, am I perimenopausal? It's a good starting ground for a conversation because what at the end of the day is the most important? The experience of what you're doing. So I can come on the back end and saying, I still think you're worthy of hormone therapy. If that's what you choose, this is where we're going to start. Now, the Dutch test, I think is good for looking at metabolites or variations of your estradiol and your progesterone and what they're actually doing, right? It's a good follow-through to see exactly where the peaks are, where it's maybe going down a little bit. That is more extensive. But if someone's just basically trying to see where am I?

• 10:46Speaker 01

  I always say, yes, your estrogen and progesterone, your FSH is good to look at, but also things like cortisol. Thyroid, also your vitamin D, because now you're going to start to see deficiencies in other parts of your body because you're going through this transition. In medicine, what we typically do, like I said, we are good at disease. I am really trying to capture women before they hit menopause to give them the best building blocks so that at 60, 70, and 80, they are optimized instead of waiting for it to be a catastrophic fall off the cliff. That's really what we're trying to do when we think of longevity, looking at hormone therapy in mid-age, is really that opportunity, that chapter to say, my next chapter is coming.

• 11:30Speaker 01

  Forty percent of our lives are spent in the post-menopausal phase. What do I want this chapter to look like? Let's start mixing up the recipe a little bit.

• 11:38Gary Brecka?

  Yeah, you know, and I think it's important to note that these are not things that jump out of the labs, right?

• 11:42Speaker 01

  Do not.

• 11:43Gary Brecka?

  And I think we always want it to be so black and white. Okay, hemoglobin A1C 6.4.

• 11:46Speaker 01

  That's what we've told women.

• 11:47Gary Brecka?

  Biotic, yeah. This is independent. It's not that clear. It's the, it's the whole picture. And I love how you are talking about the symptomology, the subjective part of the health history that says, this is how I feel, this is how I wake up, this is how I think, this is my mood, my emotions, my libido, my energy levels. I mean, those are all classic signs. And I think just as adults, I mean, men and women, we intentionally try to sometimes ignore these.

• 12:15Speaker 01

  Oh, we are classically trained as men and women, as humans, to

• 12:19Gary Brecka?

  Humans, yeah.

• 12:20Speaker 01

  Ignore what your body is telling you until it tells you something where it's catastrophic. And that's when we say, I may need to take care of that. So it's trying to kind of front end that with being like, let's pay attention to our bodies so much that the moment something is changing, we can start the conversation and not wait till it's a train wreck.

• 12:41Gary Brecka?

  Yeah. And I think, so the, the blood panel testing, I will say that three weeks, almost to the day, after my wife started hormone therapy. Complete game changer.

• 12:54Speaker 01

  Isn't it? And you were seeing this like firsthand.

• 12:58Gary Brecka?

  Yeah, I mean libido came back.

• 13:00Speaker 01

  Yeah.

• 13:02Gary Brecka?

  And and I think sadly, in a lot of a lot of marriages and relationships, you know, when libido leaves the building, you know, they're, you know, they think that love and attraction has left the building and it starts to create a lot of unnecessary friction in a relationship. So libido came back. Her sleep almost immediately in that period deepened. The frozen shoulder went away and after the three week period, probably 10 days after that.

• 13:27Speaker 01

  That's amazing.

• 13:27Gary Brecka?

  I mean, she went from here to just being able to put her hand straight up in no pain. And these were adhesions.

• 13:32Speaker 01

  Wow.

• 13:33Gary Brecka?

  So and I've been down the rabbit hole of, you know, what, what, what is the mechanism of that? Because I just thought I never made, you know, drew drew that correlation. And and then I think, like we talked about, when the FDA.

• 13:46Speaker 01

  Yes.

• 13:46Gary Brecka?

  You know, removed the black box warning from female hormone therapy and the chairman of the FDA came out and said, hey, 50 million women have unnecessarily suffered because this study was misquoted. And the mainstream media loves, loves controversy.

• 14:02Speaker 01

  They love sensationalizing.

• 14:03Gary Brecka?

  This is gonna kill you and they're gonna die. And and I think so many women, millions and millions of them, just completely hormone therapy was off the table because of.

• 14:14Speaker 01

  I think we look for, you know, in general, direction, especially when it comes to your health. That's what we've always idealized medicine as, direction in order to give someone what they need to do in order to be their best health. So when the WHO, you know, kind of came out with this kind of catastrophic message, it really did, one, misalign what providers thought, you know, we do no harm. And if we're thinking, oh, my goodness, I gave something that may be of substantial harm to a patient, the first thing we'll do is saying, I'm not doing that anymore. So now you have kind of the director of this relationship between physician and patients being like, I can't give that to you.

• 14:56Gary Brecka?

  Yeah.

• 14:57Speaker 01

  And then patients also seeing it on their level because it was brought in the media way that it was brought. Was to everybody, right? So now the public is like, oh my God, now I've done something to harm myself. And so that really annihilated the benefits, which we now know and have known for years of what hormones can really offer you, not only for symptoms. And that's, you know, something that we can discuss is hormone therapy. Yes, there are symptoms that we've discussed over and over again now, but also longevity. What does it do for preventing chronic disease? What does it do for brain health or bone health later on in life? Those are the conversations that we really should have focused on when looking at the benefit of hormone therapy.

• 15:37Gary Brecka?

  Think a lot of women, you know, they're, they're, they're getting into this too late. And I've heard you talk about target timeframes.

• 15:44Speaker 01

  Yeah.

• 15:45Gary Brecka?

  Where like, there's a good, better, best, right? There's never a time where there's no hope, but there's a, there's a time where it's good, a time where it's better and a time where it's best. And relative to hormone therapy, what does that look like for, for women?

• 15:59Speaker 01

  That was one of the things that the WHI did get wrong in the study because the ideal fundamental of the study was cardiovascular risk. And what can we do to decrease cardiovascular risk? Cause heart disease is the number one killer of women. So that, you know, when we're looking at a study, we're like, this is, this is good. We're going to look at something that has great outcome. Unfortunately, who they used hormone therapy in, in the study were not the best. And we're talking about good, better, best of who we should have been using. These were women who were on the average older than menopausal age. So they were way in their elder 50s into 60s, smokers, people who had history of heart disease. So again, that's not ideally who you want to start hormone therapy in. Who you do want to, for anyone

• 16:43Speaker 01

  who's listening, is in that late peri-menopause into early menopause transition, which could mean if you wanted to put a tag on it on age, maybe 45 through 55. And that is when we start to see the flux in hormones and peri-menopause, you're still having your cycle into that early timeframe, probably within the first five to 10 years of not having a cycle is the ideal time. Do you want to know why? I think you want to know why.

• 17:08Gary Brecka?

  I always want to know. And my audience wants to know why.

• 17:11Speaker 01

  But we're dealing with symptoms, so we're minimizing and resolving some of those symptoms, which can make a woman's life very frustrating. But the other part and benefit of estrogen and progesterone and testosterone is that it has such stark relationships that are beneficial when we think of glucose metabolism, brain health, decreasing inflammation. Estrogen really is one of those robust hormones that is an anti-inflammatory, right? We know that inflammation is one of the main causes of disease.

• 17:41Gary Brecka?

  Root of all evil, yeah.

• 17:42Speaker 01

  But it is. And then we talk about glucose, right? So sugar, like, how is it manifesting in a way where it's going to control your glucose better? And then the last thing is, your organs need estrogen. There are estrogen receptors all over, so we're losing muscle mass. So when estrogen is lost, we're not able to kind of get our lean muscle mass like we like. Our gut health, gut health is imperative for future and disease prevention, but also heart muscle and brain, so bones even. So I could go on and on about the receptors that are needing estrogen. So when you lose it, your body is like, what do I do now?

• 18:17Gary Brecka?

  Yeah.

• 18:17Speaker 01

  So I really think that timing is important, that 45 through 55. And that's loose numbers. That's not saying if you start after the age of 55 that you're not going to get the benefit. But we want to get you before the body starts to have the inflammatory response. Now you've been exposed to your heart muscle not being optimal, so you're increasing atherosclerosis and things that are going to cause heart disease.

• 18:39Gary Brecka?

  Now, here's what's fascinating. Dr. Shepherd just gave us the why behind hormones, but you might be sitting there thinking, I'm not having hot flashes. I don't have all those symptoms. I'm probably fine. But what if your body was already sending you distress signals that no one was connecting them back to your hormones? My wife Sage had frozen shoulder for almost nine months. An orthopedic surgeon wanted to put her under anesthesia and break the adhesions. Never once, not a single doctor, connected that back to menopause, until Dr. Vonda Wright. Dr. Wright is a board-certified orthopedic surgeon who has taken care of nearly 100,000 people in her career. And she will tell you, your bones, your joints, your muscles, they're all talking to you about your hormones. Dr. Vonda Wright is one of the rare orthopedic surgeons who treats the whole person, not

• 19:24Gary Brecka?

  just the body part. When a 46-year-old woman walks into her clinic with frozen shoulder, she doesn't just ask about the shoulder. She asks, how are you sleeping? What else are you feeling? Because she already knows what's going on. Please welcome Dr. Vonda Wright.

• 19:37Speaker 02

  In my own practice, whether honestly, it's, I have separated out my time, whether it's my orthopedic practice, and I'll give you an example, or whether it's my midlife menopause, or my precision longevity practice, we always assess where you are now. So I'll give you an orthopedic example of taking care of the whole person. And we can go into why many doctors can't do the whole person approach if you want to. And it doesn't have to be do with our desire, it frankly has to do with time.

• 20:09Gary Brecka?

  Time and compensation.

• 20:10Speaker 02

  Time and compensation, if we're honest about it. So if a woman comes to me, and she has the dreaded frozen shoulder, which means

• 20:19Gary Brecka?

  Oh my gosh, my wife had that. So I want to go down this rabbit hole. Awful.

• 20:23Speaker 02

  So what happens in frozen shoulder? It's an inflammatory response to midlife, or inflammation, obviously, because it also happens in people with diabetes. But how it presents is, out of nowhere, Gary, nothing happened. You did not bang your shoulder into the door. You did not work out hard. You have quick onset of excruciating pain.

• 20:46Gary Brecka?

  Unbelievable.

• 20:47Speaker 02

  Unrelenting, and you cannot sleep. And then, with very short amount of time, you can't move your arm, right? It's this motion people come in with.

• 20:56Gary Brecka?

  That's exactly what happened to my wife. I mean, exactly what happened to Sage.

• 21:00Speaker 02

  In a quick amount of time. So when a person comes into my orthopedic clinic, and I know, I read, oh, 46-year-old woman, shoulder pain, almost without pause. I know what's going on. So I'll go in the room, and I'll say, how can I help you today? But I do not focus on the shoulder first. We talk about the fact that she's 47, or 46, and how are you sleeping? And what else are you feeling? And because I am interested in helping her identify that she's in this critical time period of her life, when her ovaries are stopping their production of estrogen, and things are changing. If I were to do the typical thing,

• 21:45Speaker 02

  which is just say, oh, your shoulder's not moving. You've obviously got a frozen shoulder. Let me give you an injection, send you to therapy, blah, blah, blah. I miss the whole picture, and I'm not taking care of the whole person. And so for me, my style of orthopedic surgery is taking care of the whole person. So we're talking about how the fact they're not sleeping. They're anxious. They've never been anxious.

• 22:08Gary Brecka?

  Right.

• 22:08Speaker 02

  But all of a sudden, they feel different. And within five minutes, Gary, of starting a whole person approach to the frozen shoulder, these women are crying in my office. And it's not because I'm the meanest doctor they've ever seen. It's because finally, finally, they feel heard and seen. And it's so hard. And almost without, almost to a woman, Gary. And men say this to me too, because I take care of both men and women. But people will say to me, but you know what? I have a very high pain tolerance. Because there seems to be some badge of honor that is handed out on the.

• 22:52Gary Brecka?

  Yeah.

• 22:52Speaker 02

  The, oh, I've got a, they say, I have a very high pain tolerance. And I thought I could do this. I didn't want to come. But the reality is people wait and wait and wait and suffer.

• 23:03Gary Brecka?

  Yeah.

• 23:03Speaker 02

  When we could have intervened really early. And so I think that's why coming in with a frozen shoulder, treating someone like a whole person and not a body part. They are quickly telling me about how they really feel. And crying sometimes.

• 23:20Gary Brecka?

  Yeah, no, that was my wife.

• 23:22Speaker 02

  I feel like that is the way people deserve to be treated. As not a sum of body parts, whether it's your liver, your pancreas, or your heart, or your shoulder. I want people to understand the biology of what's going on. Yeah.

• 23:35Gary Brecka?

  And also, maybe we can talk a little bit about dispelling some of the myths of the link between estrogen and breast cancer.

• 23:41Speaker 02

  Oh, let's do that.

• 23:42Gary Brecka?

  There's a lot of fear around that. And one of the things that we discussed before the cameras started rolling was, I found those studies too, and actually followed the very same study that linked estrogen at the time to breast cancer, decoupled it, and fell in the polar opposite camp that there was actually a reduction. And I think there's a lot of women listening to this, and a lot of husbands that are curious about this too, for their wives. You know, is the hormone therapy a viable option?

• 24:14Speaker 02

  Well, let's, do you mind if we start back at? No, let's go back to square one. Why does this even happen? So, I think the fascinating, almost legendary thing that happens when you birth a female baby, a baby with XX chromosomes, Mm-hmm. is housed within her eggs. Her ovary, her ovaries are all the eggs she will ever have. More than 2 million, isn't that fascinating? That is still fascinating. So, the legacy of your entire family exists within the ovaries of these baby girls that we have, right? So, it's the natural history of ovarian life that, you know, and to contrast it,

• 24:55Speaker 02

  the analogous structure in an XY person, a male, is testicles, but you build 1,500 sperm a day or minute. It's rapid, right? Right. A female child is born with all the eggs. The natural history is that by puberty, we've lost a large percent of those. And then what we are designed to do, which we don't always do, is every month cyclically, as hormones predictably rise and fall, we use and exhaust a percentage. But here is why midlife is so profound for women and so different between men and women, because it is wrong to say that the physiology of men or women are the same.

• 25:39Speaker 02

  My own data show, down to the stem cell level, that they're different. So, by the time a woman reaches 35 to 40, you start to not feel like you've always felt because we have less than 1% of our eggs left. Estrogen, by and large, a very tiny percent is made in the adrenals, but most of a woman's estrogen is made in the follicle or the eggshell of an egg. So, when you have so few, you're just not producing the same level, healthy levels you've always produced. And the reason that's important, and I, and if there's one of several things I want your audience to walk away with,

• 26:21Speaker 02

  is estrogen, progesterone, and testosterone are not sex hormones. They are hormones, just like thyroid hormone or, or any hormones our body makes. They're not specifically sex hormones. There are estrogen receptors, alpha and beta, on every tissue of the body. So, imagine. Every tissue in the body becomes rapidly starved of one of its key ligands, of one of its key signaling pathways for all the good things, such that we know from the work of Lisa Moscone and Robbie Brenton, that without estrogen, your brain not only stars, but changes its chemistry. The heart, without the influence of estrogen,

• 27:06Speaker 02

  has thirty to forty percent more microvascular disease. And let's, I'm an orthopedic surgeon, let's talk about bone. We will lose twenty percent of our bone density in the time between peri-menopause and menopause. Wow. These are profound, profound biologic changes. So we started this conversation talking about frozen shoulder. Why do people walk in so inflamed? Why are women so inflamed in midlife? It's because estrogen is a profound anti-inflammatory. So when women walk into my office, bringing it back, and we take the time to listen, how are you sleeping? What's your brain doing? How, how do you feel in general?

• 27:51Speaker 02

  And they say, I don't feel like myself anymore. From a human biology standpoint, it makes so much sense. If every tissue in your body is affected, it makes sense that we should be having longer conversations about the restoration of the most natural way of living, which is with estrogen. It's not a byproduct. It's not something we should suffer through. If we're truly interested, Gary, in preventive health for women, we must talk about estrogen and we must talk about it earlier because my generation of women, I'm a generation Xer.

• 28:33Speaker 02

  You know, baby boomers have lost out because of this study. Xers are not sitting down, we are going to change the future so that millennials and my seventeen-year-old daughter, my eighteen-year-old daughter, will never

• 28:48Speaker 02

  Starve our brains. We'll never have 60% more microvascular disease in our hearts. We'll not lose our bone density so that we end up frail. It's almost, listen to me, Gary, how passionate I get. It is a war cry, a mantra to me, that I am going to save the health of this, the women coming after me.

• 29:08Gary Brecka?

  I definitely want to close the loop on, on female hormone therapy though, because having had such an intimate experience with it and how it revolutionized my wife in such a short period of time. And knowing the number of friends that she has that are her age that are either still suffering or just haven't, haven't figured it out. And, and my female audience.

• 29:33Gary Brecka?

  You're a fan of hormone replacement therapy.

• 29:34Speaker 02

  Yes.

• 29:36Gary Brecka?

  And testing for the hormones. And how soon can a woman reasonably start hormone therapy? Estrogen, progesterone supplementation?

• 29:44Speaker 02

  I want to premise this entire conversation with the thought that

• 29:50Speaker 02

  women are sentient beings with agency to choose. So I demand not that every woman go on hormones. Although if I were the queen of the world, every woman would go on hormones and go on them early. But every woman is sentient and has agency to choose, but you must choose out of facts, not fear. You can't glom onto some cultural mantra and go with that. You must be more curious and must be wiser in the decisions because it's your body. So that's my disclaimer. Number one, some women come to me and say, well, I want to do it naturally. I don't want to put artificial things in my body, to which I say,

• 30:37Speaker 02

  what? Let's, let's unpack that statement because I hear it dozens of times a day.

• 30:43Gary Brecka?

  I'd rather be miserable and natural, you know?

• 30:44Speaker 02

  Miserable, well, what's more natural? Than giving your body the building blocks it's always has had. You have always had estrogen, progesterone and testosterone. That is the natural state. What's not natural is not having them. So then the next thing people say to me is, yeah, but you know, I'm not a pill person. I don't want to take pills. I'm going to eat some soybeans and some yams.

• 31:10Gary Brecka?

  There you go.

• 31:10Speaker 02

  Okay, we'll do that. But do you know where body identical estradiol comes from? It is a plant-based

• 31:18Gary Brecka?

  Yeah.

• 31:19Speaker 02

  Harvesting of the hormone your body makes. You cannot, so what's more natural than taking the hormone your body makes? That's natural. Not eating yams and soybeans to try to get at what your body makes anyway. Oh, and by the way, we harvest estradiol, the molecule, which is the body identical hormone. It's the same molecule. There's only, you know, body, bio-identical is a marketing term. But when we say body identical, estradiol is a chemical structure. We're not making this stuff up.

• 31:54Gary Brecka?

  Right.

• 31:54Speaker 02

  Nature made this stuff, right? Right? Creation made this stuff up.

• 31:58Gary Brecka?

  I was fascinated when I found out it came from yams, too.

• 32:00Speaker 02

  Yeah. Right. So, okay, estradiol, your bodies, there are, there are three or four kinds of estrogen, but this is the main one to restore to your body. If you have a uterus, you must protect the endometrium with micronized progesterone, not, not artificial progesterone, micronized progesterone. And then testosterone is a female hormone.

• 32:28Gary Brecka?

  Yeah.

• 32:28Speaker 02

  It's a, it's a hormone. Men and women have it.

• 32:30Gary Brecka?

  And let me tell you something. Everything came back with her.

• 32:34Speaker 02

  This regiment.

• 32:35Gary Brecka?

  Not to get too personal, but things got a lot better.

• 32:37Speaker 02

  No, and I'm, I always talk about my own hormone journey. These three systemic hormones is where we start. But that's not where we end. To prevent the genitourinary syndrome of menopause, which is vaginal atrophy, the loss of sensation in our perineum, the loss of tissue, our labia will absorb.

• 33:02Gary Brecka?

  Yeah.

• 33:02Speaker 02

  And, yes, I'm so glad you said that. Eighty percent of all women suffer from incontinence. Nobody talks about it.

• 33:08Gary Brecka?

  Nobody talks about it.

• 33:09Speaker 02

  Vaginal estrogen, which is safe for every person, including people who have breast cancer, that's the fourth component. That is the fourth component. And then, you know, frankly, I'm as vain as they come. We lose thirty percent of the collagen in our face as estrogen walks out the door.

• 33:28Gary Brecka?

  Yes.

• 33:29Speaker 02

  Micro doses of estrogen on the face can restore the collagen build to an extent.

• 33:37Gary Brecka?

  Yeah.

• 33:37Speaker 02

  So, much better than superficial things we pat on, you know? So, facial estrogen, vaginal estrogen, estradiol, progesterone, testosterone is the complement that gives our body back the building blocks that it needs. And how early can we start? You can start in perimenopause, which can, and some women can start at thirty-five. The average age of perimenopause is forty-five, but we do not have to start, we do not have to wait until menopause at fifty-one or fifty-two. We can start much earlier. And the opposition to that, that I hear all the time is, why are you going to start a young woman on hormones?

• 34:22Speaker 02

  Blah, blah, blah.

• 34:23Gary Brecka?

  She needs to, yeah.

• 34:24Speaker 02

  But let's think about that. There are generations of women who have been put on birth control pills, which I'm not opposed to. However, it's synthetic. It is not natural. Those are, those are artificial types of estrogen at ten times the dose of menopause hormone therapy.

• 34:45Gary Brecka?

  Hmm.

• 34:46Speaker 02

  So, in menopause hormone therapy, we're giving you-

• 34:48Gary Brecka?

  At fourteen years old, too.

• 34:50Speaker 02

  Oh, right. For decades, right? Right. So, we're taking body identical hormones in very low doses.

• 35:01Speaker 02

  It is not an argument when people bring up to me, "Yeah, but why are you giving hormones to young women?" Well, you're giving birth control to young women, which is 10 times the dose. We do it for decades and decades, starting at teenagers.

• 35:14Gary Brecka?

  Muchy, lower ages.

• 35:15Speaker 02

  Right, so, and I don't want people to think from this conversation, I'm opposed to birth control. I am not, but I want people to be more curious and just don't slam on a mantra they hear somewhere that, "Oh, hormones, well, you're taking them anyway."

• 35:28Gary Brecka?

  Yeah.

• 35:29Speaker 02

  So, let's think this through a little bit.

• 35:31Gary Brecka?

  Yeah.

• 35:31Speaker 02

  Because if I can, Gary, there's new data that I'm going to present at this conference that is, was presented.

• 35:36Gary Brecka?

  At Xenos here?

• 35:37Speaker 02

  At Xenos. That was.

• 35:38Gary Brecka?

  Saudi Arabia.

• 35:39Speaker 02

  In Saudi Arabia. Well, it's been currently, as we speak, presented at the menopause meeting in Orlando that's going on this week. New data in 120 million women. It's a retrospective analysis of a vast database.

• 35:56Gary Brecka?

  Hundred and twenty million?

• 35:57Speaker 02

  Hundred and twenty million. This is a vast study that shows that you can decrease the odds by 60% of the following diseases by starting hormones earlier in perimenopause. Stroke, cardiovascular disease, heart attack, brain death, and osteoporosis. Going back to the astonishing ability of early hormone decision-making and truly being preventive disease modalities. And I want women to be literate themselves. I think gone are the days, long gone are the days.

• 36:41Speaker 02

  Maybe when I started practicing medicine, we were still in it. But gone are the days when a person can just blindly take advice. I encourage all people, men and women, to become experts in their own health, to become literate.

• 36:54Gary Brecka?

  Citizen scientists, yeah.

• 36:55Speaker 02

  That's right, to understand, so that they can make the best choices for themselves and to do it early, right? To your point, we think perimenopause can, which is the time when we're, when we have so few eggs, can, can start in their 35. Who would suspect while we're still having children? But many women, we understand now, including myself, I had my last child when I was 40, go right from postpartum. To perimenopause.

• 37:26Gary Brecka?

  Wow.

• 37:27Speaker 02

  But I don't, I'm gonna say this now because we're gonna unpack it, but I want women listening to understand that it's, you can feel better again. I mean, I, in a silly way, say, I went from menopause misery to midlife mastery. I have mastered this.

• 37:45Gary Brecka?

  Yeah.

• 37:45Speaker 02

  I am back in a way that-

• 37:47Gary Brecka?

  Mastery, I like that.

• 37:48Speaker 02

  Yeah, I am back in a way that I always was.

• 37:50Gary Brecka?

  I get 15% of it because you said it on my podcast, but.

• 37:54Speaker 02

  That's, listen to you.

• 37:55Gary Brecka?

  Menopause misery to midlife mastery, I love it.

• 37:58Speaker 02

  Yeah.

• 37:59Gary Brecka?

  You've now heard from two of the most qualified voices in women's hormonal health. You know what perimenopause is, why it starts earlier than anyone else tells you, what your bones and joints are going through, and why hormone therapy isn't something to fear, it's something just to understand. But sometimes the most powerful thing you can hear is not from an expert, it's from someone who lived it. My wife Sage is one of the most organized, energetic, and driven people I've ever known in my entire lifetime, and then menopause happened. And I watched her become a different person, not just because she was broken, but because her hormones were. She couldn't get out of bed, she had frozen shoulder for nine months, she couldn't even raise her shoulder above level, she had mood swings that neither of us could understand. And then we did the testing, and everything became clear.

• 38:44Gary Brecka?

  This is her story, and I think it might be yours too. The issue with menopause is that lots of things can crash at the same time. One of the things we noticed was rapid shift in mood, exhaustion in the morning, brain fog, libido left the building, and you were just not the same person.

• 39:00Speaker 03

  And I think it was just like a feeling of being overwhelmed constantly, and I kept thinking it was because of something else. And I think the main thing that forced us to really look at it was my frozen shoulder. My arm was stuck right here for almost nine months.

• 39:14Gary Brecka?

  And just so you know, we were doing all the things. Red light therapy, sauna, cold plunging, we have a hyperbaric chamber, she eats extremely clean.

• 39:23Speaker 03

  When I went to doctors, so we tried acupuncture, cupping, physical therapy, I mean, we tried so much stuff.

• 39:29Gary Brecka?

  When we did this Dutch test, getting that test was a game changer. When it came back. It explained everything.

• 39:35Speaker 03

  And I remember like crying with you when we got all these results back because you saw it finally. It wasn't just me saying, I don't feel good. You were, holy cow, I can see it in the science. I feel bad for guys because.

• 39:49Gary Brecka?

  You didn't feel really bad for me.

• 39:51Speaker 03

  No, because we didn't know what was going on with me and you can attribute so many things to other things. So if I was really upset about something or really sad about something, you know, maybe we go, oh, well, you're, you know, PMSing. Or because you didn't sleep well that night, or, you know, you can always just find another excuse as to why it's happening.

• 40:13Gary Brecka?

  Yeah.

• 40:13Speaker 03

  But it got really intense over the last year. And I think the main thing that forced us to really look at it and, and start reading about it was my frozen shoulder.

• 40:24Gary Brecka?

  Yep.

• 40:25Speaker 03

  So the only book that I read that linked frozen shoulder to perimenopause was Dr. Marie Claire Haver's book, which I think is brilliant. And it's called The New, The New Menopause. And I think she's coming out with a new one called The New Perimenopause. Don't quote me on that one. Anyway, new menopause has a list of like a long, long, long list of symptoms that I started reading through going, oh my God, I have that, I have that, I have that. And, and all these things I could check, mark off. And I'm like, am I in it? Cause I kept thinking, I'm not old enough to be in it. Turns out you can be in perimenopause in your 30s. Like this shit probably, sorry, language, but this stuff probably started happening a long time ago.

• 41:10Gary Brecka?

  Yeah. So, you know, one of the things we noticed was rapid shift in mood. You know, Sage is totally on her game. We built a business together. We ran a massive clinic together. We've traveled the world together and she literally couldn't remember one thing.

• 41:28Speaker 03

  Not a thing, not a single thing.

• 41:30Gary Brecka?

  Not from one minute to the next.

• 41:32Speaker 03

  Words.

• 41:32Gary Brecka?

  And. She had trouble with words. Sometimes I would walk in the bathroom and she would go, I just want you to know that I am furious with you. And I have no reason to be furious with you. But I'm just gonna be honest. And I would go, thank you for the warning.

• 41:46Speaker 03

  We sat in the kitchen one night.

• 41:48Gary Brecka?

  I will be on the other side of the house.

• 41:49Speaker 03

  And you had not done a single thing wrong. And I just looked at you and for whatever reason, I just, my blood started to boil. You had done absolutely nothing wrong. Usually you do something wrong, but this time you had not. And I was like, I don't know why I'm mad at you, but I am, but it's kind of scaring me. So I'm gonna leave the room. I'm gonna walk away and I'm going to go to the bedroom and just, you know, get my book or get in the bath or whatever it was that I did that night. And I've never had that happen before. And thankfully, it has not happened recently.

• 42:20Gary Brecka?

  So, so being the best biohacker in the world, I said, we need to really take a deep dive here. Let's get a full picture of the hormones. Let's look at everything and not just take a snapshot. So not just take a blood test. So we did this Dutch test. She did this blood test, Dutch test.

• 42:38Speaker 03

  And I had to pee on a stick five different times throughout the day.

• 42:43Gary Brecka?

  Which frustrated her and made her mad.

• 42:47Speaker 03

  Because I'm such a perfectionist.

• 42:49Gary Brecka?

  Maybe now would be a good time to apologize for that.

• 42:52Speaker 03

  Because it was hard. There's so many instructions with it. I'm gonna just tell you this right now. If you're like, particularly like I am, it's, you know, I like it all laid out. I like it at the right time. You have to set alarms. Yes, I'm a perfectionist. So that was a lot. But then I also had my blood work done within like a month of each other. Gene test we already knew about and the mold test was last year. So a lot of testing to figure this all out.

• 43:17Gary Brecka?

  So we, I'm trying to shortcut this for a lot of women that are on here.

• 43:21Speaker 03

  Exactly. Cause not everybody can afford all of these things.

• 43:23Gary Brecka?

  Yeah, but, but getting that test was a game changer. When it came back, it explained everything. So let's head back to the whiteboard and let's take a look at what we learned from this test. So this is Sage's Dutch test. And this is a 24 hour urine test. I think this is the gold standard for women's hormones, especially if you are perimenopause, pre-menopause. Or postmenopausal and you want to get an accurate picture of your hormones. The reason why is this doesn't just take a snapshot in time. It looks at the ratio of hormones. And listen up, women. The ratio of hormones is as important as your levels. Because at some times during the day, they can be at different levels. So when you just take a blood test and you just get a quick snapshot, you don't really get the true picture.

• 44:07Gary Brecka?

  And then it's hard to prescribe hormone therapy because you don't have the full profile. Hormones are not just manufactured. Hormones need precursors. There's raw materials in a woman's body that are used to make hormones. One of them is called pregnenolone. And we make cortisol, we make aldosterone, we make other hormones from pregnenolone. But it's this DHEA, it's this precursor in the body that acts like a construction material. And I don't care how good your contractor is. If you don't, you know, deliver materials to the job site, they're not accomplishing anything. And it's the same in a woman's hormonal system. If you don't have the precursors, the raw material, the construction product that you need to build other hormones, they become deficient.

• 44:49Gary Brecka?

  And what was shocking about this test was we discovered that she had virtually no cortisol. And so in the morning, cortisol is our waking hormone. It's responsive to light. One of the reasons why I love to get first light in the morning, you love to get first light in the morning. I generally encourage people, when you wake up, within 30 minutes, get outside, get natural sunlight in your eyes, is because that sunlight actually helps your cortisol rise and helps your melatonin get lower. What we realized was she had so little cortisol. When you look at it on a chart of a normal cortisol pattern climbing in the morning, you see that yours was flatlined. She had no waking hormone.

• 45:31Gary Brecka?

  And at the same time, you couldn't even register any more melatonin in your system. Your melatonin was off the charts. She wasn't even taking melatonin. But her melatonin was off the charts. So imagine that it's like taking an Adderall to go to bed and then taking a sleep medication to wake up.

• 45:48Speaker 03

  That is like feels exactly what life was like.

• 45:52Gary Brecka?

  Yeah, and you were, you were a lot more energetic at night than you were during the daytime. Sometimes the labs don't tell the full story. I talk about this a lot with heavy metal mold toxicity, viral pathogens, bacterial infections, and, and other kinds of.

• 46:09Gary Brecka?

  Toxins that we put into our body that don't necessarily show up on the labs, but they have other manifestations, brain fog, weight gain, water retention, fatigue, sometimes crushing fatigue. You go and get your labs done, the labs are normal, the doctor tells you everything's normal, you're actually very healthy, your liver and your kidneys are fine, your CBC, your complete blood count is normal, your comprehensive metabolic panel looks normal. Nothing is jumping off of this page. So we really don't have a reason for why you feel that way.

• 46:36Speaker 03

  Well, and that's what got so confusing is because we also did a vibrant wellness test, which was the mold, my toxins, parasites, whatever.

• 46:44Gary Brecka?

  We did get rid of all those.

• 46:45Speaker 03

  And, but that, you know, when, when that hit, my mold was like where a nine was high. I was a 49. I mean, I was off the charts for mold. So that was probably contributing to the brain fog too. So we didn't think so much about it being hormones because we're like, it must just be mold. But then when I started to clear that out and the symptoms weren't going away, it just was confusing. So to have the full picture and have as many, you know, not everybody can get all the tests done. But I think the blood test says a lot. I think the urine test says something different. And I think the, you know, the other mold and my toxins says, has a whole other picture. If you can do all three, that's what saved me at least.

• 47:28Speaker 03

  And then also the gene test just helps like account for a lot of it too, because so much of your genetics, your methylation is tied to hormone balance.

• 47:39Gary Brecka?

  You're a lot more energetic and super back on your game.

• 47:41Speaker 03

  Yeah.

• 47:42Gary Brecka?

  And your frozen shoulder is gone.

• 47:43Speaker 03

  Yeah, that is game changer. That was, that was brutal.

• 47:46Gary Brecka?

  Yeah.

• 47:47Speaker 03

  Frozen shoulder. I, but when I went to doctors, so we tried acupuncture, cupping, physical therapy, I mean, we tried so much stuff. And then I went to a doctor that said, well, we'll just put you under anesthesia or a light, twilight, whatever, and we'll just rip it out.

• 48:05Gary Brecka?

  Yeah.

• 48:06Speaker 03

  Rip it.

• 48:06Gary Brecka?

  It's called manipulation under anesthesia.

• 48:07Speaker 03

  Out, don't do that.

• 48:10Gary Brecka?

  If you see a video of manipulation under anesthesia, it is gruesome.

• 48:13Speaker 03

  Yeah, I saw a video and I was like, I'm not doing that. That's insane.

• 48:16Gary Brecka?

  It looks like they're breaking your shoulder.

• 48:17Speaker 03

  It looks like they're breaking your arm. So the fact that I got on hormones and three weeks later, I already was able to move up without pain is wild.

• 48:27Gary Brecka?

  Here's the wild thing, the night that we started the hormone therapy. Yeah. She was like, okay, we're in a log cabin at 10,500 feet without another soul around. Me, of course, to receive the brunt of it if it didn't work. There I was, just call me the catcher's mitt. And so I'm like, let's do it. And she took the hormones, passed out, I mean, passed out.

• 48:49Speaker 03

  Like at seven o'clock or something crazy?

• 48:51Gary Brecka?

  Yeah, seven o'clock at night and slept all through the night. And I was like, hallelujah, we got it.

• 48:56Speaker 03

  We're on something.

• 48:57Gary Brecka?

  And truthfully, it was all uphill from there. I mean, in a good way. It was all positive from there. You know, as they started to regulate, his pregnenolone started to provide the raw material for cortisol. Her sleep cycle started to normalize. As her melatonin started rising at night and falling in the morning, she was less exhausted in the morning. I noticed that almost right away. She was more on her game. You know, we have a huge project going on in Colorado and she was managing all the contractors. And that took a nosedive for a little while. And she was just, I, I, I think even the G C was like, who's this? Who's this chick showing up today with the long laundry list of things to check up on? And she was just all of a sudden back on her game.

• 49:39Gary Brecka?

  And then the greatest thing was over the next three weeks, the frozen shoulder thawed.

• 49:44Speaker 03

  Yeah. Yeah, so there's a freezing, frozen thawing stage is what I've learned about it.

• 49:49Gary Brecka?

  And it can take a year and a half for frozen shoulder to thaw.

• 49:52Speaker 03

  Some women up to three years if they just don't see anything, you know, change with it. So I, in my head, I was like, oh my God, I can't do three years of this. It's already been nine months, but.

• 50:01Gary Brecka?

  So ladies, it's okay to do hormone therapy.

• 50:04Speaker 03

  Yeah, I agree.

• 50:05Gary Brecka?

  And I think.

• 50:06Speaker 03

  Don't make yourself suffer unnecessarily. Oh, hot flashes, of course. That's just like something that all women I think go through. But that was the only thing that was ever like really pinpointed. It was like menopause, hot flashes, but that's the only symptom anybody would ever talk about. So growing up, I just thought that that was, you just get hot flashes. And I always thought, well, I'm always very chilly, so maybe I'll enjoy that. Don't just jump straight to hormones. Don't just, I think that it is important to get your methylation imbalance. Figure out what raw materials, simple raw materials might be missing. What kind of B12 is good for you? What kind of, you know, do you need five month of folate? Those are such important pieces to the methylation balance that leads to the hormones getting out of control.

• 50:50Speaker 03

  But also recognize like if, when you're in your thirties and you're like probably in baby making phase.

• 50:59Speaker 03

  You're not thinking about menopause. Menopause is like years away. That's like, that's like grandma stage, except I'm 47 and I don't feel like I'm grandma.

• 51:08Gary Brecka?

  No.

• 51:09Speaker 03

  Which is so weird. But back when I was in my 30s.

• 51:11Gary Brecka?

  You're a spoken hot grandma.

• 51:11Speaker 03

  Thank you, thank you. But back in my 30s, 50 felt so far away. Now it's three years away. But I think this stuff started back when I was probably 37. When we met, I think it was starting to hit, which is wild to think that.

• 51:27Gary Brecka?

  Yeah.

• 51:27Speaker 03

  But things were different in my late 30s.

• 51:30Gary Brecka?

  So women just don't need to suffer unnecessarily? Husbands don't need to suffer unnecessarily?

• 51:35Speaker 03

  No. Learn about it together. I think, I send you a lot of memes. Oh, my gosh. Actually, I have a funny one on here. I send you a lot of things from, Instagram is shockingly helpful. I'm not a TikToker, but I send, sometimes just to make him laugh. We do have a group chat with Josh and Victoria, and it's just so that Josh and Gary can, you know, suffer together and know that.

• 51:59Gary Brecka?

  We, we, we formed a male support group.

• 52:02Speaker 03

  It's a support group, yes. But I do believe that men need to educate themselves as well, and then just help your, your person through it. You know, there's.

• 52:13Gary Brecka?

  Lots of hugs, lots of back rubs, in all honesty.

• 52:16Speaker 03

  A lot of hugs. I mean, honestly, anything, you can get through anything with a good hug.

• 52:21Gary Brecka?

  You can.

• 52:21Speaker 03

  Yeah, it's true. What is it, 20 seconds of hugging?

• 52:24Gary Brecka?

  Yeah, oxytocin.

• 52:26Speaker 03

  Raises your oxytocin levels.

• 52:27Gary Brecka?

  That's what they say is in Cupid's arrow.

• 52:28Speaker 03

  Yes.

• 52:29Gary Brecka?

  That's the psychosomatic response. Oxytocin, dogs have 100 times the oxytocin that human beings do. That's why they're so loyal.

• 52:36Speaker 03

  Yeah.

• 52:36Gary Brecka?

  We can learn a lot from our dogs.

• 52:37Speaker 03

  Yeah, as a female, go get information. Do not let someone tell you you're fine. Don't let someone tell you nothing's wrong with you.

• 52:49Gary Brecka?

  Or it's all in your head.

• 52:50Speaker 03

  Or it's all in your head. Or you need these prescriptions that. Antidepressants, anti-anxiety, sleep medications, heavy, heavy, heavy stuff because it might be just simple things that you can get back in balance. And I think by getting all of those things in balance and replacing the raw materials and the hormones that you really do need, you can become the ultimate human.

• 53:14Gary Brecka?

  That was a great answer.

• 53:15Speaker 03

  Okay, good.

• 53:16Gary Brecka?

  Okay, if you made it this far, you know more about menopause than most physicians. Let me recap what you learned today. One, from Dr. Jessica Shepherd, perimenopause can start in your late 30s. Standard blood tests miss it. The Dutch test doesn't. Hormone therapy is a critical window and the women who benefit the most start it early, not late. Muscle is your metabolic currency. Build it, lift heavy, and don't skip the self-care. And secondly, we heard from Dr. Vonda Wright. Your bones, your joints, your muscles, they're all estrogen-dependent. The frozen shoulder, it's not just a shoulder problem. Bone loss triples in menopause. The critical decade to act is 35 to 45 years old. Bio-identical hormones are plant-derived, safe and potentially disease-preventing.

• 53:59Gary Brecka?

  New data from 120 million women backs that up. And last, we heard from my wife Sage. Even if your labs look normal, your body may be in crisis. The Dutch test shows what blood work hides. Hormone therapy can change your life in three weeks and no one, not one doctor, not your partner, not your own denial, should be allowed to tell you that you're fine when you know that you're not. If you want to go deeper with all three of these experts, check out the individual episodes in the link below. Follow Dr. Shepherd at ModernMeno and on Instagram at JessicaShepherdMD. Find Dr. Wright and her book Unbreakable on Instagram, everywhere books are sold. And join our VIP community at theultimatehuman.com/vip where you can submit your questions directly to future guests and get access to my personal protocols.

• 54:45Gary Brecka?

  Women, you don't have to suffer to be natural. You deserve to thrive at 40, 50, 60, 70, and beyond. And that's just science.