Navigating Perimenopause: Testing, Symptoms, and Actionable Strategies for Women’s Health

Natalie Tysdal (01:22)

Bria, thank you so much for joining me today.

Bria Gadd (01:24)

Thanks for having me, Natalie. I'm so grateful to be here.

Natalie Tysdal (01:27)

So I know you call perimenopause a gift. I think most women going through it would disagree with you. So you have to defend yourself.

Bria Gadd (01:35)

Ha

I'm gonna defend myself and it is a gift for two reasons, I think. Number one, the first, and it is the gift we did not ask for, but it is a gift you need. Maybe I'll just clarify that around it, that it's, yeah, you weren't expecting it, didn't ask for it, probably didn't want it, but I promise you it is a gift. So I think gift number one, which is really the deeper one of it, is that perimenopause is really just a big transition.

Natalie Tysdal (01:46)

and

Bria Gadd (02:05)

And like all transitions in our body, in our life, like moving or changing jobs or getting married or getting divorced, we understand it comes with a greater energy demand in our life. And so perimenopause comes along, we're out here, we're juggling all the balls and it comes along in midlife and all of a sudden someone throws another ball in. And so we start dropping balls. That's kind of what happens. So, but what I really think it does and the gift that we didn't...

really asked for is it starts to demand our attention to prioritize our balls that we're juggling and to really more deeply understand what's going on in our own body and our mind and our souls, I think even where if this energy demand that has kind of come into play has now made this energy supply and demand deficit in our body, which I think is really where the problems start to come in.

what is keeping us in this deficit? And that's what I think perimenopause does. It comes in with like a great big pink highlighter and highlighting the things that are no longer serving us, both like emotionally, but also like physically within our body so that we address them now. Because at 45, 55, we still have decades left to live, to go after our dreams, to live however we want with.

way fewer expectations on ourselves. So that's why I think it is a gift. is our life cycle's way of demanding we pay attention and make the changes so we can have this beautiful second chapter.

Natalie Tysdal (03:46)

Otherwise we would just ignore them and go about our bad habits without really putting the microscope on our lives and saying, what should I be eating? Should I be, what are my hormones looking like? Exercise, all that stuff. I had never framed it that way and I agree with you because it's a wake up.

Bria Gadd (03:48)

Yep.

Yeah.

It is, yeah, it's a wake up call and women are exceptional at ignoring the messages of our body in the name of helping other people ⁓ or in the name of doing other things or in the name of I'll do it later when there's time to prioritize myself. And I think that's really the second little gift that I think about with perimenopause is like from puberty to perimenopause, we're hormonally hijacked every month.

in the name of like procreation, in the name of keeping these humans alive, like in the circle of life and for all good reasons. But when that starts to change, when we actually achieve menopause, you get your full thoughts and feelings all month long. And you can accomplish a lot more when you are not being hormonally hijacked in the name of helping other people half the month.

Natalie Tysdal (04:58)

Okay, I'm laughing because I love the way you frame this and I love that when you have achieved menopause, we have trophies lined up behind us when we achieve this. But in the meantime, the battle, the race, however we want to make it of menopause, the end, so we're spending all these years with the hormones. And then those last few years before you actually achieve it,

Bria Gadd (05:06)

what I've achieved in that club.

Absolutely.

Natalie Tysdal (05:27)

can be a really hard race that some people wanna drop out of.

Bria Gadd (05:30)

Yeah, that's true. You are climbing your Everest, but you want to get to the top. You want to summit. You really do. I promise we're going to lose people along the way.

Natalie Tysdal (05:33)

you

So let's talk

about achieving that. Let's talk about how to reach that summit ⁓ and getting the right tests, seeing the right practitioner, ⁓ doing all the things. Can you touch on some of those things? Because I think for a lot of women, they don't realize they're in paramedic, which we know can go on for years. And they might not even realize they've hit menopause.

Bria Gadd (06:07)

I mean, I think if you don't notice, that's probably a really good thing. It probably means you're doing well, you know? Or you're blaming, it's a really good choice. It is a time for you to like get comfortable with like eye to eye looking at yourself in a mirror, I think, and really like have your own like dark night of the soul moments to know like, what do I want in my life? And is this lining up to help me, you know, reach that even? But I think...

Natalie Tysdal (06:11)

Hmm. Are you blaming it on other things?

or people.

Bria Gadd (06:35)

It's funny, it can be a very emotional time, of course, with all of the things changing. So one, I always like to give women such an important perspective on what our body actually is doing for us. Because I think we've spent a lot of our lives as women outside of our bodies or belittling, like looking at our body from the outside in and not recognizing what a damn survivor she is. Like I think we...

thinking, you we blame her, we poke at her, you know, we've done a lot of this in our life. And I think this is another time where we start to recognize that any symptom from your body is a message of something going on that we should pay attention to. And when we reach this, really this energy supply and demand deficit, which is really where the problems are coming. If it was only simply, you don't have enough hormones, we would have hormones and everyone would be fine. But that's not the case. You know, I think we are getting

much more availability to hormones. So I think first and foremost, it's really important for women to honor that her body is literally trying to survive. And when we understand that, we almost like picture yourself as a survivor on a deserted island in the Hunger Games, like wherever you are, you can start to look at your habits and your choices in accordance to that. Like if you...

If Natalie, you were on a deserted island and you have no idea when rescue or food or water is coming, because this is how your body is thinking in terms of I gotta keep you alive, would you go for a run on the beach and skip breakfast?

Natalie Tysdal (08:13)

Yeah, no.

Bria Gadd (08:15)

You wouldn't do it. So I think one, when we start to understand that, I think that can be really, really helpful is just like, okay, my body is telling me something. She's here to help me survive and thrive. But then moving into actual, what do we do? I really like to take some of the chaos out of it and try to compare it to like money, even this whole debt example. So if all of these symptoms we're experiencing in perimenopause into menopause are really a form of health debt, of energy debt in the body,

How do we get out of debt? First, we look at our finances and we reduce demand, like anything that is unnecessary that we can avoid. We increase energy supply to the body, which for us is like quality nutrition, good quality sleep if we can, as best as we can, figuring out why we might not be sleeping well. Pleasure and joy, which I think is such an important one. ⁓

And then we look at the supply chain pipelines, right? Which is really where I think functional lab work and testing kind of comes into play. If you have now looked at your life and been like, okay, well I am, I'm functionally moving every day, like I'm actually getting fresh air and outside, I'm actually going to bed at an appropriate hour and trying to be in bed for a certain amount of hours. I am eating quality nutrition and having fun. If we're doing these things and we're still suffering, then I think that's when it's time to get help.

And that's what functional lab work does. I think it comes in and helps us with testing to see ⁓ are these energy supply chain pipelines, are they kinked, are they holy, know, is there leaks coming out the side? So that's kind of the simple steps, I think, to trying to get where we're trying to go.

Natalie Tysdal (09:57)

Where do you advise people to go? I know that you work with people and I don't know if you do so ⁓ remotely, but where does a woman start? If she's at her general practitioners and she's like, okay, so yes, this is what's happening, but not all practitioners are saying, and I'm gonna do this lab work and I'm gonna offer you help. It's some, you know, the old fashioned way is like, it's just a normal part of life. You don't really need hormones or anything.

Bria Gadd (10:23)

Yeah.

Natalie Tysdal (10:25)

⁓ Where does a woman start?

Bria Gadd (10:26)

Yeah, lots of clients.

I mean, I do think, first and foremost, I do think going to your health care practitioner, and I think we can actually ask for some more deeper blood work. I mean, obviously, depending on insurance and stuff, but there's a lot of blood work that we can really ask for more deeply that we're not getting, you know, besides our hormones that I think contribute more to this health debt, to this problem in perimenopause of symptoms.

So asking for like a full blood sugar panel, which is well within the doctor's ability, a full iron panel, full thyroid panel, and let's see what see with differentials. These alone will give us more information. And if your doctor can't read it, then that is when I think it's time to reach out to, you know, a functional practitioner like myself. And there are many of us all over the world. But yes, most of us work remotely to...

to better understand what that blood work means. And then I would say, like, if I could do anything for any woman, it would be to run a Dutch, which is a dried urine test of comprehensive hormones, ⁓ and a GI map, which is a stool sample to check your gut microbiome. Because most of our hormonal issues, most of what's keeping us from feeling great when we're taking hormone replacement therapy, is found in those two labs.

Natalie Tysdal (11:46)

Wow, okay, so I have not done those two. Surprising, mean, I've done a lot of other things, but tell me about, I think I've done it all, my husband would go, you've done it all, but tell me about the Dutch test because I hear it often and what it shows.

Bria Gadd (11:51)

Ow.

Yeah.

So as I said, it's called a Dutch because it stands for dried urine test of comprehensive hormones. it's literally, comes to your house. It has, you know, absorbent pieces of paper that you urinate on at very specific times over one night at a certain time in your cycle if you are still cycling. ⁓ And yes, it tells us what our sex hormones are doing on that day. But I think more, most importantly,

It tells us what our adrenal hormones are doing, so our cortisol in our DHEA. So not just the levels, but the pattern that they're taking, which speaks a lot to blood sugar regulation and our ability to sleep. Our DHEA, which is really more of a recovery hormone, and it's the parent hormone to our sex hormones in our adrenals. How is it looking? And how they're clearing.

which I think is really one of the most valuable aspects of the Dutch, is that we get to look at all of these hormones, our sex hormones, our adrenal hormones, the pathways that they are taking and are they getting out of our body or are they getting stuck? ⁓ And then there's some other beautiful markers on their melatonin, RB vitamins, things like that that are really, really valuable. But those are the pieces that I think can answer so many of our questions as to why am I not sleeping?

Natalie Tysdal (13:22)

So tell me a recent client that found something and how you adjusted it and how they started feeling based on that test.

Bria Gadd (13:29)

Oh, for

sure. Yeah, absolutely. So, gosh, I had, I have had a client recently. She's a really busy mom of four human beings, which is a lot if you have any human beings in your life. And her, she was having like acne every single month and couldn't quite figure out why mean, at 48, like, why is this happening? And she, you know, like many of us, we start to

get annoyed at everybody for half of our month sometimes, right? And then it leaks into it. It's just half of a month that I'm annoyed at everyone, it's all month long. And ⁓ what we really discovered there is that her hormones, like her hormone production was quite fine. Her sex hormone production was quite fine. But what was happening is she wasn't metabolizing her estrogen down a very safe pathway and she wasn't methylated it out of her body. So we're getting this estrogen recirculation.

Natalie Tysdal (13:58)

Yeah.

you

Bria Gadd (14:24)

in blood and also in urine, it looked like her hormones were perfectly fine and balanced. So if she'd gone to her doctor and they tested, they would have said, no, your hormones are fine. But what we were able to learn is that no, her estrogen was recycling, which gives us like an estrogen dominant experience in our body, which can mean things like acne. It can mean tender breasts. It can mean a lot of frustration and anxiety for people.

So we were able to work on addressing just her detoxification of what was going on, how to support the liver, how to clear the gut and make sure we're pooping every single day to get that estrogen out of the body.

Natalie Tysdal (15:03)

That's fascinating. is it ⁓ women in midlife who primarily would benefit from the Dutch test or even when you said acne, of course, I'm thinking young women.

Bria Gadd (15:14)

Yeah.

Yeah. No, think honestly, I think anyone can benefit. You know, I work primarily with women in midlife, but I have had the opportunity to work with many of their daughters now and it's ⁓ it's the exact same. We get to really see, you know, what's backlogging the body like a slow drain. I mean, if you get in your shower and then all of sudden the showers filling up and not going down, that's what happens in our body. If the liver is congested or if the gut is having some issues, then it just kind of backlogs up and that

downstream effect of impact on our body really becomes problematic in perimenopause when things are already a bit erratic and we're not operating with like brand new engine bodies at that point.

Natalie Tysdal (15:57)

Yeah.

So what for that client, what was the fix?

Bria Gadd (16:01)

Yeah, we had some other work to do was when we needed to get her pooping every single day. So that was a really big one. So looking at nutrition, eating, you know, real food and not just a lot of quick fixes like protein shakes and things like that, that we can fall into like real fiber, lots more hydration and electrolytes. I always think minerals are an underutilized tool for most people. So increasing magnesium and then

Natalie Tysdal (16:25)

Yeah.

Bria Gadd (16:28)

We focused on a lot of good liver support, so glutathione and milk thistle and things like that to help, and just overall detox. So hot yoga can be really helpful or castor oil packs. And for her, as we dug in, I always like to run a GI map as well, which is the other lab we did discover a parasite. So we were kind of seeing why the gut, like I'm always trying to answer the question why, and we were able to see like, part of the reason the liver is congested.

Natalie Tysdal (16:53)

Hmm.

Bria Gadd (16:57)

and the gut is not methylated because we have this parasite. So it was a bit of a lengthier protocol.

Natalie Tysdal (17:04)

I'm big on gut health and I did just do an episode ⁓ with ⁓ the worm queen, if you're familiar with her, parasites. Fascinating. That's a big one. So if you don't have that information, you could be running in circles trying to solve problems that you don't know what they are.

Bria Gadd (17:08)

I did too.

Yes.

Yeah, I think that is one of the biggest things. if this, like I said, this, feel like a Dutch and a GI map should be something that is almost like our annual, you you go for your annual thing because it tells you, I mean, arguably before you go on any hormones, we should absolutely be checking these two things. Cause otherwise you might be either gonna cause more problems for yourself or not getting any results from your hormones. And then as women, we start to feel like it's our fault, like, something's wrong with me. But it's not.

Natalie Tysdal (17:51)

Yeah, yeah.

One of the things that I'm finding really fascinating in today's healthcare world, especially for midlife women, is taking it into your own hands, getting the tests. And there are a lot of companies that do this now, where yes, you can order it and you can go in and you can do tests through your general care practitioner. But are these tests that you can order online and do for yourself and then take them to someone or plug it into AI and

Bria Gadd (18:19)

Yeah.

Natalie Tysdal (18:21)

Read it.

Bria Gadd (18:21)

Yeah, I mean, you can. You definitely can. And there's even for a lot of these labs, you can use like HSA and FSA to help cover with insurance, which can be really helpful for a lot of people. ⁓ And yes, you can.

Natalie Tysdal (18:33)

Are they covered often

by insurance though? If they're ordered by a doctor, they're not.

Bria Gadd (18:36)

No, no, yeah, and

a conventional doctor wouldn't typically order ⁓ that kind of a lab, a functional doctor would for sure. ⁓ So normally they are going to be an out of pocket, which is why I do think though, as you said, we're getting this ability as women to, you know, be more empowered and taking things on. And I think kind of like we're good at getting massages and facials and things like that. I think this is going to be something that we start to recognize as self-care. But ⁓

Natalie Tysdal (18:42)

Mm-hmm.

Yeah. Yeah.

Bria Gadd (19:06)

I feel what is most important is that I think that there needs to be context, which is where we run into trouble with it. Just, yes, AI might be able to give you some good understanding of some of the markers, but it's not considering the context of the woman's life, of all of the symptoms she's having and the lifestyle going forward. So I do think for me, I like to have that minimum, you know.

Natalie Tysdal (19:22)

Yeah, absolutely. Yeah.

Bria Gadd (19:30)

two or three calls when I do a lab with someone because I need to understand their background. I need to understand their goals and everything that goes into their internal story. ⁓ And then I like to spend an hour going over a lab because I think it only matters if the woman understands it and can be compliant following through. Yeah.

Natalie Tysdal (19:49)

Absolutely, I agree.

So let's get to some other tips then. Some of the things you would recommend for someone who's going through or achieving their menopause, tips you would have for achieving it and feeling good in the process.

Bria Gadd (20:00)

Yes, I'm doing the math.

Yeah,

yeah, I think ⁓ I think I always want to come down to like anchoring yourself in foundations of health. You know, we really have forgotten we're very good as women at like keeping our our dogs and our kids on schedules. And yet we don't always do the same things for ourselves. So I think, you know, holding as I said, holding space for sleep, having a really good wind down time, so much of sleep issues come from just a central nervous system that's upside down and sideways. So just

Doing whatever you need at night so your body feels safe going to sleep makes a huge difference in us getting that rest. I also feel really strongly about functional movement before fitness. know, even as a trainer in my background and I love fitness and I think it's so valuable.

I think if you are sitting in front of a computer all day like I am, and you're not actually getting out and walking and moving and expanding, I don't think that investing that energy in fitness is the smartest thing to do. I think we need to start with functional movement first. So get out for that walk in the morning. Yeah. Yeah. So walk, walk every day, walk after your meals. It can be so good for blood sugar.

Natalie Tysdal (21:09)

just a walk, stretching, some of those things.

Mm-mm. So good.

Bria Gadd (21:17)

And then yeah, stretch, mobility work, that kind of thing. So if all you have is time to walk in a day and maybe a couple tight days a week to do some mobility or yoga or stretching, that's enough. That's enough to keep the body feeling calm during a very tumultuous time hormonally.

Natalie Tysdal (21:34)

Yeah.

What about a couple of the things we need to not do? What are the biggest culprits in getting in the way of successfully transitioning with your hormones?

Bria Gadd (21:48)

Mm, yeah, I think we need to not skip pleasure for ourselves in different ways. I think that I sit across from a lot of women who I'm like, when was the last time you laughed so hard that you cried? You don't have that answer. So I think if you haven't, if you haven't,

laugh so hard that you've cried in the last little bit, it's time to figure out what will do that for you and start doing it because it is grossly underestimated as a form of, I think, hormone balancing for us as humans. ⁓ What else not to do? Don't skip meals. Just don't do it.

Natalie Tysdal (22:26)

And that's such,

mean, the fads that we hear about and some people swear by them of intermittent fasting, ⁓ those, you the diets that work for a while, but is that an example?

Bria Gadd (22:40)

Yeah, I think that's a great example. do think, remember that in perimenopause and into menopause, you're again, you're in a body that's went from walking on solid concrete to now like walking on a swinging bridge. You know, the ground beneath you is not solid. So we need to anchor ourselves in the most solid habits, which blood sugar regulation requires consistent nutrition ⁓ in a day. But

there's a lot of value in like the fasts in between your meals. So I think, you know, when it's what to do and what not to do, I would wake up and I would eat within two hours of waking and I would eat enough to be full and satisfied for four to five hours. So I'm not eating in between there because that break gives your body time to do what it needs to do.

Natalie Tysdal (23:26)

Yeah. What is the normal ⁓ amount of time from paramedopause to menopause? Or is there a normal? You hear of two years, five years, some people in paramedopause for a long time. What can we consider normal?

Bria Gadd (23:38)

Yeah.

I mean, the hormonal shift, just like puberty, right, has a range. the hormones begin to shift in our mid 30s. So it can be 15 plus years for this whole reverse puberty to actually complete. Most women are really noticing the significant drop of ovarian reserve of hormones, probably for two to five years.

Natalie Tysdal (24:08)

Okay, can, someone asked me this recently and I think it's an important question because we also go through major life changes, not just hormonally, but with families, with aging parents, with kids going off to college, with other things. Can that transition happen faster under stress?

Bria Gadd (24:27)

Yes, absolutely, absolutely. And I think that's where, ⁓ well, I think sometimes it's like we think it's happening, but this is where I think this whole like let's lump it under perimenopause gets a bit problematic because I had a massive issue with my hormones at 37, but when I realized it, like your sex hormones are an unnecessary part of your body's survival.

Like we don't have to have our sex hormones in order for us to survive. We have to have our adrenal hormones. So when the body is freaking out a little bit about where survival, it's gonna cut out non-essential personnel. So you might seem like you're losing or you're heading faster into this time in your life when really your body's just in a scared, conserving survival state. So I think that's where if we can come back to these like, okay, how do I?

bring back this energy supply and demand so my body can feel safe. Often our hormones can restore until we're much closer to 50, which is really when we see the drop more organically.

Natalie Tysdal (25:30)

Yeah, well great information today and some super takeaways. I'll be sure to put links in the show notes ⁓ to you and to some of the things that you have mentioned. And I just appreciate your time today and your podcast as well. If you want to tell everyone about that, I'll put a link in for that. What is it called?

Bria Gadd (25:37)

Thanks, Matt.

yeah, thank you so much. It's called the Period Whisperer podcast. And yes, it's all about the hormones and all about perimenopause into menopause and beyond.

Natalie Tysdal (25:56)

All right, go even deeper into the things we talked about today. Brea, thank you so much. It's great to talk to you.

Bria Gadd (25:59)

now.

Thanks, Natalie.