Episode 53: How to Optimize Hormone Health Through Menopause with Pauline Cox






Brief summary of show:


Have you hit that health slump, you know, the one where your metabolism seems to be changing, and diet and exercise isn’t helping?


Our bodies are complex and ever-changing, and my guest this week, Pauline Cox, explains how hormone health and blood sugar levels are part of the root causes of many imbalances.


Pauline is a nutritionist and has a deep passion for health and nutrition. Her day-to-day work involves translating complex science into simple, easy to follow steps to make health information increasingly accessible.


She is the author of the award-winning book, Primal Living in a Modern World, co-founder of high street and online low-carb and keto specialists Sow & Arrow and co-founder of online women's health membership, My Health Mastery. Her own health journey inspired her to focus on optimizing health and hormonal balance in women of all ages.


Listen in as we talk about:

  • [7:55] Tips to balance estrogen and progesterone

  • [9:20] What kinds of sugars to avoid in order to support proper blood sugar

  • [18:00] Signs to look out for to know if you’re entering perimenopause or menopause

  • [20:40] Tips to get your family onboard with eating healthier


Resources mentioned in this episode:


Notes from Natalie:


Connect with Pauline

Connect with Me





View Transcript for this Episode

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[00:00:43] I share my designs with my team at school and at home where we collaborate on designs. And I'm going to give you 45 days free of Canva pro. If you go to my website, Natalie tisdel.com/. Favorites, just click on Canva. Once you get there, I may get a small commission if you purchase through this link, but that's just to keep my website and my podcast going.

[00:01:08] So thank you once again, Natalie tisdel.com/favorites and click on Canva.

[00:01:16] Hi everyone. It's Natalie. In the last few years, I've realized that we don't have to conform to society when it comes to how we feel specifically what we put into our bodies. Although we're surrounded by messaging, that's not always healthy.

[00:01:31] We can control our health. And we have the ability to control our attitudes about our health. You don't have to think of limiting what you eat, but instead think of the beautiful foods and supplements you can nourish your body with every single day. My guest is an inspiration and I can't wait for you to hear what she has to offer.

[00:01:51] Pauline Cox is a passionate advocate. Anti-inflammatory lifestyles using food as medicine. She has two bachelor's of science and a master's in nutrition from the university of Bristol. We talked about hormone balance, ideal foods for immunity, bloating, and so much more. Be sure to join me on my website and if you've not done so already, I would love to deliver tips.

[00:02:16] Like you will be learning today. Right to your inbox, you can join my newsletter by going to Natalie tisdel.com or clicking the link in the show notes onto the interview. Now with Pauline Cox.


[00:02:32] Natalie: Pauline. I want to jump right into this topic of hormones. And I think most people think it's going to matter when I hit menopause, which for most women, probably just around 50 midlife, but what I'm hearing from you, and what I know about you is that's not always the case. It's the, before

[00:02:52] Pauline: menopause.

[00:02:53] Absolutely. It's that really crucial period, the perimenopause Natalie, and, and that really is it's about a 10 year period where our hormones really start to change anywhere from the age of 35, particularly over the age of 40, we get this shift in our hormones and that shift can really be impacted by lifestyle and nutritional habits.

[00:03:19] And so we, we can really make that transition. From the sort of peri-menopause to the menopause, to post-menopause a much more enjoyable experience and a much better experience if we have that knowledge and understanding of what we can do to make that transition better. I

[00:03:36] Natalie: remember when I was young, I'm thinking, oh, that's so far off.

[00:03:40] That's old people menopause. That's all the people, but I'm listening to you talk about perimenopause and you know, a lot of women are having babies still in their forties, especially with the delay of, of having families. But how does one know that this is the cycle they're entering? And you know, some people have regular blood work, but how can we become more aware of this?


[00:04:03] Pauline: That's such a great question because really every woman is slightly different. However, our hormonal kind of life spectrum, if you like is really interesting. So as a teenager, we have quite a retic, hormones, you know, when we start first start having our periods. Periods can be heavy, long, short, very random until they start to settle in their twenties.

[00:04:26] And then again, things stay relatively stable depending on what our lifestyle and our diets like through the thirties. And then as we enter a mid to later thirties, particularly at early forties, the hormonal changes start to kick in, and this is where. Again, depending on lifestyle and diet, things can start to change.

[00:04:45] So a progesterone tends to decline at a fairly steady rate, but estrogen can be quite erratic again, just like back in our teenagers. And so women can start to find from. The forties onwards that their periods start getting heavy again, or they might get longer or shorter or stop missing periods. And so really those telltale signs start to come in with our menstrual cycle and the changes that we might start experiencing from about the age of 40.

[00:05:15] Natalie: Okay. So let's, let's focus on that for a moment and then let's move into our fifties. So in our forties, maybe we're in perimenopause. Maybe we know it. Maybe we don't. do you recommend, let's start with that. Do you recommend, validating that with blood work or what do you recommend for women in their forties?

[00:05:33] Pauline: I think really from women in their forties, it's just an understanding that this is a normal transition hormones change, how quickly they change and how radically they change is very much dependent on our lifestyle and diet. For example. Stress stress has a big impact on our sex hormones because it impacts something called progesterone.

[00:05:56] So Eastern Julian progesterone worked together. They had this really beautiful dance where progesterone helps keep estrogen in check. However, progesterone has the same precursors. As cortisol our stress hormone. And so if we're stressed a lot of the time when we're making lots of cortisol, then progesterone levels start to lower.

[00:06:16] And that can cause estrogen to start to go higher. Hence us having maybe heavier periods or some of these issues and dominant type symptoms like PMs or breast tenderness. Now, as we enter that period of our forties, if progesterone has already started. Gradually decline. And we're stressed on top of that.

[00:06:37] You can see how that would increase the decline of progesterone and start to cause that mismatch between estrogen and progesterone. And so the symptoms of early perimenopause leading into the later stages of perimenopause can be much more significant. If we go have those supporting lifestyle habits and dietary.

[00:06:58] Habits too, to help with balancing out the hormone.

[00:07:02] Natalie: Okay. So, uh, I've heard you say it so many times. I want to go deeper into these lifestyle habits. What are the things we can and should be doing to help balance that I love the way you say estrogen, because we say estrogen. So I want to, I want to say Eastern gym because it's more fun today.

[00:07:18] Um, what are the things that we can do to balance those?


[00:07:22] Pauline: I love that such an important question. So dietary wise, it's so key that we ensure our blood sugars are really nice and stable. So blood sugars play an incredibly important role throughout our female lives. But particularly when we get to this stage of peri-menopause, if we have high blood sugars, Going to drive something called insulin resistance.

[00:07:46] And this is where our insulin levels just start to creep up, creep up, creep up. And that has a really big impact on inflammatory levels has an impact on weight. So it can really start to change our body composition and encourages visceral fat to be laid down to that belly fat. And it, it really has an impact on our cognitive function.

[00:08:07] So memory, brain fog, recall mental wellbeing, all of the areas of the body that become insulin resistant, including the brain, including the muscles and the other, the other cells and tissues of the body are affected when insulin starts to go up and they can't get the fuel in anymore. So we start to experience fatigue.

[00:08:29] And a lack of focus and concentration, but also this weight gain. And that creates this kind of perfect metabolic storm, which has a big impact on thyroid hormones, as well as our sex hormones, estrogen and progesterone. So blood sugars would be the first thing I would say from a nutritional perspective.


[00:08:46]Pauline: So all sugars. So any refined sugar, or what about fruits and things for sure. Refined sugars. So the thing to really recognize here, Natalie, is that it's not just about the white stuff that we add to our cups of tea. It's really about looking at the impact food. Or now blood sugar. So for example, we might be eating whole wheat bread and pastor, and, um, we might be having porridge, but known as maple syrup, all these foods that we traditionally would think of as being healthy, but actually having a really big impact on our blood sugars.

[00:09:23] And it may be in our twenties. You know, even early thirties when we're very active and we're using lots of glucose, our insulin sensitivity is really high that our body can handle that level of blood sugar when we're eating those types of foods. But actually as we start to get into our late thirties, early forties, maybe we're not as physically active.

[00:09:43] Maybe we don't have the same muscle mass. Maybe our insulin says sensitivities, not so. Our growth hormone definitely starts to decline. That impacts our metabolism and our muscle building. Then our blood sugar becomes more sensitive. I, we, we can't handle those foods that have the really high glycemic index.

[00:10:04] And so we want to be looking at more. Vegetable-based like lots of cruciferous and green leafy vegetables, colorful vegetables, you know, half of our plate could be full of these wonderful vegetables and then a quarter of a plate. With our lovely quality protein, eggs fish. Chicken, but really nice quality meats of, quality protein, like fish and eggs.

[00:10:27] And then the other quarter of our plate healthy fats, which are the backbone of our hormones, low fat diet is another precursor to hormonal imbalance and disrupting. So we want those healthy fats, avocados, olives, olive oil, avocado oil, eggs. So the really beautiful, healthy fats that are going to have.

[00:10:49] Sustain us keep us nice and satiated, but also aren't going to have an impact on him, inflammatory levels as well, which some fats can.

[00:10:59] Natalie: So I'm hearing this thinking Quito. That's what, that's the term that I'm in the last couple of years, people have been doing keto diet, but, but that's really hard for people who are especially used to breads and pastas and especially in America, um, we, we love our car.

[00:11:19] Pauline: You know, you're absolutely right. And I think really it's about finding those empowering alternatives so that we can, we don't have to give up and do without, we can actually just look at really lovely alternative forms of a very familiar food. So I love and bread rolls and, Bagels, but I have them made out of seed flowers and psyllium husk and almond flour and coconut flour.

[00:11:44] So these flowers are very high in fiber, which is very good for our Aboul health. Again, incredibly important for our hormone balance. The bowel movements are very, very important to stop, hormones that we want to get excreted from being reabsorbed into the body. Very important for our gut microbiome also.

[00:12:04] So these fiber rich flowers that don't have the same blood spiking impact are very, they're just ideal for making these lovely bread alternatives. Now they are more expensive because the product is more expensive. Wheat flour is very, very cheap and. Very cheaply produced also. So it, makes sense that wheat flour is, is, um, breads made from wheat are less expensive.

[00:12:32] However, when you buy these really. Quality alternative breads. They're very low in sugar, low in carbs, and packed with fiber and healthy fats and nutrients. You know, seeds and nuts are very high in vitamin E. So you're getting all these wonderful ingredients you don't actually need as much of the product either.

[00:12:53] I tend to find. Yeah, maybe three bread rolls will do me for the whole week, but it's there. If you want to, you know, if you want some scrambled eggs or if you fancy some smoked salmon and cream cheese with a bagel, it's there. You're not thinking, oh, I just wish I could

[00:13:07] Natalie: tell there's something about when you tell yourself I can't have it.

[00:13:12] You want it more so finding that alternative is, and one thing I noticed often is the popularity of. carb free or even gluten-free that there are so many products out there now that really aren't that good for you, but they say gluten-free or keto, but they're loaded with other things that we don't want.

[00:13:33] Do you find that as.

[00:13:35] Pauline: Absolutely Natalie. And I think you've made such a great point that it's so important to look at labels and just look for those simple ingredients, coconut flour, almond flour, psyllium husk, which is a really nice rich source of fiber, maybe coconut oil. it could be that there's some seed flowers like Sesame and nettle chia seed.

[00:13:55] If you start looking at these gluten-free products and you, you don't recognize the name of the ingredient. You know, don't find him

[00:14:03] Natalie: wrong words, no idea what that is. It's probably

[00:14:06] Pauline: not the good and the, the really beautiful thing about this way of eating. Is a, it does encourage us to burn our own fat for fuel.

[00:14:15] So it really helps with hunger. It stops that blood sugar rollercoaster, which really drives eating, eating, eating. And as we get over about the age of 40, because of the hormonal shift, we do find that our metabolic rate start slowing and our hunger levels start increasing. So things like growth, hormone and testosterone, lower.

[00:14:36] Then things like leptin and ghrelin, our hunger hormones increase insulin increases. So we find the shift in hormones tends to drive, increase appetite, but slower metabolism. So we do want to start being more focused and cautious about the foods that we kind of got away with eating in our twenties. You know, the fast food, the processed food, the sugars, drinking maybe every other night or partying a lot.

[00:15:03] There's a transition. And part of having this great menopausal period leading into menopause is about accepting that, you know, I can't eat and drink and live. Like I used to now is the time that I really want to start focusing on looking after my brain health and my liver health and my gut health, and really making this transition through and, and thinking about where do I want to be in my eighties and nineties and how I want to protect my brain function.

[00:15:33] You know, over the age of 50 Natalie, the biggest killer of women is heart disease. But over the age of 75, the biggest killer in women is outsiders. So we, we really want to be thinking about how diet and lifestyle impact those statistics and how we can protect ourselves from being one of those statistics.

[00:15:53] Natalie: So you talked about that stage of perimenopause. How does a woman know I've hit menopause? Is it strictly that I've stopped having periods? Um, how do you know when that's what it is and what should you be doing differently there or all the things you just spoke about? Do they apply to menopause?

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[00:17:25] Pauline: Yes. They really apply to this leader. So menopause is defined as one year. Of no periods. So we've stopped having the bleeding for exactly 12 months and then technically that's your menopause. So it's this period leading up to menopause. And actually we really there's. No, there's no time. That's too early to be preparing our bodies for balancing female health because you know, in our twenties where.

[00:17:55] Maybe looking at having children in our later twenties or early thirties. So we really want to be focused on stabilizing hormones and optimizing fertility. After we've had children. If we do want children, then at that point again, we want to be looking at stabilizing hormones because many women in their thirties now aren't just juggling motherhood, their job juggling work and the stress of family life and taxiing children everywhere.

[00:18:21] You know, women don't have that same lifestyle as maybe 30, 40 years ago, women would have this much more emotional and physical. Yeah on women. So even in our thirties, we really want to be thinking, how do I support my liver? How do I support my gut health? How do I eat to really balance my hormones and optimize my energy levels, my sleep.

[00:18:45] And then from forties onwards, again, really important to be thinking. am I self-medicating with sugar and caffeine and alcohol. And what's that actually doing to me? I might feel better in that moment, but actually what's it doing to my hormones and my sleep and my blood sugars and my body composition.

[00:19:03] And how's it impacting my mental wellbeing of my energy and my relationship with myself. Yeah. It's about maybe just examining those habits that we have going on in our life and thinking, what could I be doing as an alternative to give myself that stress relief and that, that vice that's that's going to be impacting my health in a really positive way, rather than something that short term feels good, but actually it's really negative impact on my own.

[00:19:31] Long-term health. Yeah. How

[00:19:33] Natalie: does this apply to families? Like I, I have three children and I am always trying. I mean, I feel like, I'm not successful at it, but I keep trying of telling them eat from the earth. Like the color in your food should come from the ground, like so many additives and colors.

[00:19:52] And so I feel like what you're saying is good for. Anyone. I mean, we're, we're speaking about women and hormones, but how do you balance this with a family and a husband and you know, the 12 year old picky son who doesn't want to eat what I eat?


[00:20:08] Pauline: Yes. Oh, that's such a great question. And I have a twelve-year-old son also.

[00:20:14] I hear what you're saying. Really what children tend to do is model those around them. So I don't force the children to eat certain foods, but what I do is encourage them to select. So by putting things on the table, everyone's sitting down together to eat and, and seeing, you know, mum and dad eating blueberries and strawberries, or having some lovely steamed broccoli with.

[00:20:39] Nice. Great. Um, cracked pepper and salt on there, or having, carrots with some homeless. So finding those, like, make your bottles easy and choose your battles. So if they'll eat carrots and peppers, but they're not eating their broccoli, Hey, that's a win, you know, it's really about encouraging the behaviors that they're already shown a little bit of as opposed to berating the ones that they're not getting quite right yet.

[00:21:07] So. I've always found, offering a selection and finding a compromise, you know, if they want pizza, fantastic. Let's make one ourselves and let's add on some, you know, some peppers on there and let's have it with some greens and let's. Pair up and team it up with other things that are going to be really helpful for them, but they still get some of the foods that they love as well.

[00:21:31] Yeah.

[00:21:32] Natalie: And the alternative type crest and imagining to what do you make pizza?

[00:21:36] Pauline: Quirky and

[00:21:37] Natalie: ingredients, but

[00:21:40] Pauline: again, it comes back to the seed flowers. So things like almonds, flour, and egg and coconut oil, you know that my children are fortunate in that they've grown up in the environment that I'm in. The biggest challenge I find is when they're outside of the environment, You know, going to school and parties and friends houses, and you know that, well, I want the m&ms and I want the, foods that other kids might have more readily and foods that I'm less encouraging of, um, actually just don't even buy in the house so that when they're hungry, they'll grab a banana or if they want something.

[00:22:18] And it'll sweeter then we're like, okay, let's make, let's make some nice muffins, but making them out of almond flour and eggs and bananas, and maybe some CHOC chips in there too. it's having that kind of armory of things in the fridge and in the cupboard that when they want something and when they're hungry enough, they'll stop picking up the grapes and they'll start, um, you know, just helping themselves to the slices of coutry meats or cheese.

[00:22:43] I find cheese boards are great for meal time, just putting up some nice raw cheeses. Some grapes and some chopped up fruit salad, making things look really appealing for the eyes works very, very well with children as well. Yeah. I'm

[00:22:58] Natalie: from the earth. Like, you know, I just say that and I'm sure they're tired of me saying it.

[00:23:03] okay. So I want people to access more of your information because I know you put a lot of it out there and I just love the way you describe it and the way you, present it. So how can women who are interested in. Changing all of these things or getting on a better routine, get more information.

[00:23:22] Pauline: Well, I run a free Facebook group called healthy keto and low carb living. And so that's a nice place to just dip your toe into and have a look at what people are sharing in terms of ingredients and recipes and food ideas. If you're looking for more structured support in a slightly more formal setting, then I also run a women's health membership, which every month I do two lives on various subjects.

[00:23:48] So at the moment. I'm running a hormone series for the next five months, which sounds like a really long time, but actually there's so much to get to grips with, with hormones. And I feel like it's not just a one topic, um, recording. It's something that I love women to really get to grips with understanding, you know, the impact of eating for our brain protection.

[00:24:11] When we get to this perimenopausal age, the impact of. exercise on pelvic floor health. So there's a whole series of subjects we covering in that membership. And it's a membership it's really appropriate for women of all ages from, teenage twenties, right through to eighties and nineties, because your body is incredibly responsive and it will change at any age.

[00:24:35] And I've had little. Gosh, she was 76 when she joined and had incredible changes to an autoimmune condition. She'd been suffering for many, many, many years. So, it's something that our body is very forgiving and con. Find room for improvement.

[00:24:52] Natalie: I think that's really important and I'm struggling with lack of energy in the afternoon.

[00:24:56] And I blame it on other things say, oh, I'm just busier. I have a heavy load or I've been traveling. And, and yet taking that step back and saying, well, wait a minute, what have I been eating? Have I been exercising as much instead of blaming it on other things?

[00:25:11] Pauline: Absolutely. And we do tend to normalize Natalie.

[00:25:14] We normalize. Period issues like heavy periods or skip periods. We normalize tiredness. We normalize lack of sleep. We normalize feeling anxious, but actually when we start looking at the different components that build great mental health and great physical energy and great sleep and hormonal balance, there is so much we can do.

[00:25:38] To empower ourselves with our hormone journey and our health journey and our health outcomes. And in stage. Can

[00:25:47] Natalie: I ask you about following up on that when a woman hits menopause, and this is one of those things, when you're young, you think I'll never have to deal with that. And when they're doing everything you're talking about or hormone supplements, something that you can avoid, if you're doing all of these things, as I know so many people go to their doctor and say, I just have to take the hormones.

[00:26:08] Pauline: The answer to that is yes, absolutely. You can have this very natural transition from perimenopause to menopause without having, you know, hot flashes and masses of anxiety and insomnia, because those things really start to happen. For example, estrogen plays an enormous role in helping glucose to be taken up by the neurons in the brain.

[00:26:34] And so as our estrogen starts to decline that lack of intake of glucose into the brain causes this memory, brain fog, inability to face. It's the same with the mitochondria, which are the batteries of ourselves. We have receptors for estrogen on those. And so when our Eastern levels go down, we get this real state of fatigue.

[00:26:56] Now how rapidly estrogen declines. Again, hugely depends upon lifestyle, stress, dietary, And so you can have a very great transition. Our lifestyle and dietary choices are cumulative over the decades. And so this is why I was saying it's never too early to start really thinking about. You know, nutritional density, gut health, liver function, healthy fats, balancing hormones, insulin sensitivity, and blood sugars.

[00:27:28] All of these things that build a really strong foundation at any stage in our life. But particularly as we go from our thirties to forties and from forties into that menopausal stage,

[00:27:39] Natalie: and I want to. Women to not feel overwhelmed by it, because for some, all of this sounds like so much. I mean, some of us have heard these terms and being a health reporter for many years, I have, but for other people to think, oh my goodness, you're talking about 10 different things.

[00:27:54] I don't know what half of these words mean that it's doable. And it's really not that hard. These are just foods. And most of them are just natural foods versus a lot of processed

[00:28:04] Pauline: foods. Absolutely nicely. And yes, I totally reiterate what you're saying. That it's a step-by-step process and you don't want to add more stress to yourself by thinking I can't have this and I must do that.

[00:28:17] It's about. Pretty intuitive with your eating and understanding what are the foods that support your health and how you overcome those cravings. Maybe why you're getting those cravings. And maybe the foods that you're eating at the moment are working against you. And so it's this gentle transition over into different.

[00:28:37] And, you know, I've had women say to me, but I don't like vegetables and oh, I really, oh, I can't eat this and I, don't not that. And that's okay. It's about finding the foods you do, like working with those and Hey, you know what, so many women turn around a month or two down the line and say, my taste buds have changed so much and now I really love some nice steamed broccoli with salt, and I love my scrambled eggs and.

[00:29:04] A very, very interesting journey that women take when they start falling in love with taking care of themselves and seeing food as a very powerful form of medicine to support their health journey.

[00:29:18] Natalie: I love that falling in love with taking care of yourself. What a beautiful. Yeah. Yeah. Well, I am just so thrilled that we have this conversation.

[00:29:27] You've inspired me to do things a little bit differently. Um, and to find that energy again, that I feel like I've been losing. And I know there are people out there. They tell me all the time they are too. So thank you. Where can people get the information you spoke of just a moment ago on your membership and on your Facebook

[00:29:44] Pauline: group?

[00:29:45] So the Facebook group is called. Healthy keto and low carb living. Um, the membership, we have a website which is fat burning females. So it's really about helping women to access that fat-burning power again and get away from being sugar burners. And so with your listeners, Natalie, if they're used to.

[00:30:05] Happy hormones, they will get a 20% discount on the annual membership. So that's saving over a hundred dollars. Um, dollar-wise it's $520 for the year, which gives you access to what you got a one-to-one with myself and my other colleague. You also get access to all the library videos that bimonthly lives, private Facebook group.

[00:30:27] It's an incredibly supportive environment and we've kept it as cost effective as we can for the females joining so that they really get this opportunity to get this kind of quality and traction without paying for that. One-to-one that a lot of people, maybe it's not with them means. And

[00:30:45] Natalie: having that supportive community in your friends online, all of that boy that makes all the

[00:30:50] Pauline: difference to it really does from an accountability perspective, but also a support perspective.

[00:30:55] Just asking the question, is this normal, or I'm struggling with this is anyone else. And having that community of women in that group. it really makes a difference. It's like . Having your hand held through this journey. So, yeah.

[00:31:08] Natalie: Well, thank you. It's great to talk to you and I look forward to catching up again soon, getting more tips on how we can eat healthy and just feel better as

[00:31:17] Pauline: women.

[00:31:18] Thank you, Natalie. It's been so lovely speaking to you today, and I look forward to catching up with you again to

[00:31:24] Natalie: also, okay. We'll do that. Thank you.






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