What menopause actually does to a woman
Estrogen comes down. If you are going into perimenopause or menopause, that is happening, and nothing stops it. What Dr. Martin spends episode 1756 on is the second thing that happens, the one that does not get measured, and the one he says decides how rough the years either side of it are.
Progesterone comes down too. If it ends up lower than estrogen, the balance between the two tips, and the symptoms follow the tipping rather than the drop.
He starts, though, by saying the part people never quote. Plenty of women go through it well balanced. Their body changes, obviously, but nothing severe. His eight are for the ones whose body was really changing and who could not work out why.
The eight changes he saw most in his office
Dr. Martin, listing what he saw in perimenopause:
Dr. Martin, The Doctor Is In, Episode 1756Anxiety, exhaustion, cycle changes, skin and hair changes because the thyroid's affected. Everything can slow down. Brain fog, hot flashes, night sweats, joint pain.
Eight things. Read the list again and notice how many of them a woman in her late fifties would put down to age, or to a busy year, or to nothing at all. Anxiety that was not there before. Being tired in a way sleep does not fix. Hair that changed. Fog.
Joint pain is the one he flags himself. That was a surprising one, he says. People get joint pain in perimenopause, and almost nobody connects the two.
The men's version has a name too. Women get perimenopause, men get andropause. He is careful that none of this has to be anyone's experience.
Why it is the balance, not the drop
Here is what he did about it when he had a practice.
Dr. Martin on what he measured:
Dr. Martin, The Doctor Is In, Episode 1756So again, what I did in my office in my practice days, we tested all these things. We tested estrogen and progesterone. And that's the key, guys.
Two numbers, not one. Because the thing he is looking at is the relationship between them.
He calls it a teeter totter. Estrogen on one end, progesterone on the other. Estrogen dominance, the phrase everyone has heard, does not mean a woman is swimming in estrogen. Estrogen is coming down. It means progesterone came down further and ended up underneath it.
Dr. Martin on the imbalance:
Dr. Martin, The Doctor Is In, Episode 1756If it comes down below estrogen, you got problems, Houston. You have an imbalance.
Progesterone, he points out, is named for what it was for. Pro gestation. Pro babies. You are not having a baby now, so it comes down. The trouble is what it takes with it on the way.
Where stress comes into it
This is the piece that explains why two women the same age, the same weight, the same everything, can have completely different decades.
Dr. Martin on stress and progesterone:
Dr. Martin, The Doctor Is In, Episode 1756Because when stress, cortisol, the stress hormone, it robs progesterone. So progesterone even goes down further if you have stress.
Follow the chain. Stress raises cortisol. Cortisol robs progesterone. Progesterone falls below estrogen. Estrogen is now dominant. And everything on his list of eight gets worse.
A hard year, a sick husband, a job that will not let go, a stretch of bad sleep. In his frame none of that is separate from your hormones. It is the thing tipping them.
Why the thyroid slows at the same time
Women tell him their metabolism is not slow, it is in a coma. They look at food sideways and gain weight. He repeats it because he heard it so many times, and because there is a reason for it.
When estrogen is dominant, he says, the thyroid slows down. That is why the skin and hair changes are on his list of eight, and it is why the weight and the energy tend to move together rather than one at a time. He puts it in one sentence in the same passage: everything can slow down.
It is also why he will not look at the thyroid on its own. More on that in the thyroid never acts on its own.
Why he did not reach for estrogen
Estrogen is falling, so the obvious move is to add estrogen back. He reports that as what medicine does, and then he says what he did instead.
Dr. Martin on his own clinical position:
Dr. Martin, The Doctor Is In, Episode 1756But at the Martin Clinic, I didn't like the use of estrogen, only because of the potential enormous side effects, especially in cancer, because cancer needs fuel.
His reasoning is about growth. He names insulin and estrogen as two growth hormones, and his concern is what a growth hormone does if there is something there you do not want growing.
That is his view of his own practice, and it is not a recommendation about anyone's prescription. If you are on hormone therapy, or deciding about it, that is a conversation with the practitioner who knows your history. What he did in his office does not make the decision for you.
What a woman can look at first
Working backwards through his chain gives you the order.
Stress first, because it is the lever he names by mechanism. Cortisol robs progesterone. Anything that genuinely lowers the stress load, including sleep, is working on the tipping and not just the symptoms.
Sleep next, and it is circular in the worst way. The imbalance wrecks sleep, and wrecked sleep raises cortisol, and cortisol takes more progesterone. Somewhere in that loop is the place to push.
Then the thyroid, because he will not treat it as a separate problem. If the weight and the energy went at the same time as the hot flashes, that is the estrogen dominance he is describing, not three unrelated things happening at once.
Common questions
What does menopause actually do to a woman's body?
Estrogen comes down. Dr. Martin's point is that the symptoms track the balance between estrogen and progesterone, not the estrogen number on its own. When progesterone falls below estrogen, the balance tips and things start showing up.
What are the signs of perimenopause?
The eight he says he saw most often in his office: anxiety, exhaustion, cycle changes, skin and hair changes, brain fog, hot flashes, night sweats and joint pain. Joint pain was the one that surprised him.
What is estrogen dominance?
Not an excess of estrogen. He describes a teeter totter. Estrogen is coming down, but if progesterone comes down further and ends up below it, estrogen is dominant by comparison.
Why does stress make menopause worse?
Because cortisol, the stress hormone, robs progesterone. A stressful stretch pulls progesterone down further, which tips the balance further.
Does menopause affect the thyroid?
He says yes. When estrogen is dominant the thyroid slows down, which is why the weight and the energy tend to change at the same time as everything else.
Read next: High Estrogen In A Woman Over 60: What Estrogen Dominance Means and Which Hormones Should A Woman Over 60 Get Tested?.
Hormones, from the clinic shop
Hormonal Support Formula is the hormone formula on the clinic shop, and it sits in the same group as the thyroid and cortisol formulas because of how tied together he says those three are.
60-day money-back guarantee. Talk to your own practitioner about anything you are prescribed. Nothing here is a reason to change a prescription.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
