54: Barbara Birke: What No One Tells You About Muscle Loss, Hormones & Strength Training After 40

Hormone therapy advice can sound strangely absolute, with one "safe" route, one "right" dose, and a list of options you have been told to avoid entirely. But research changes, medicine changes, and after 21 years as a hormone doctor (and now living in perimenopause myself), I do not see things the same way I did when I started. In this solo episode of Hello Hormones, I am sharing three things I have changed my mind about: oral estrogen, hormone pellets, and how much say women should have in adjusting their own hormone dose. I also talk about what shifted my thinking, why monitoring matters so much, and the one opinion I would happily change if better research came out. If you have ever been told there is only one acceptable way to do hormone therapy, or felt like you were not allowed to trust what your body was telling you, this episode will give you a more realistic picture of your options. The best hormone plan is the one built around you, with the right monitoring in place.

Perimenopause can bring a lot of questions about what to try, what to test, and whether hormone therapy is the only option. With herbs, supplements, labs, and HRT all in the conversation, figuring out what actually fits your body can get confusing fast. In this episode of Hello Hormones with Dr. Suzanne Gilberg. We talk about where botanicals may fit during perimenopause, which labs and health markers can give you a clearer picture of what is going on, and why hormone therapy should be individualized rather than approached with a one-size-fits-all protocol. Dr. Suzanne Gilberg is an OB-GYN with more than 25 years of experience combining conventional women's healthcare with botanical and integrative medicine. If you've wondered how hormones, herbs, and personalized care can work together, this episode will give you a much clearer place to start. What's Discussed: (16:31) Botanicals vs. hormone therapy in perimenopause. (18:21) Chasteberry for PMS, mood, and progesterone support. (19:27) Black cohosh, phytoestrogens, and hot flashes. (23:12) Why supplement quality and sourcing matter. (26:28) What herbs can and cannot do for long-term health. (31:16) Using herbs alongside hormones for sleep and mood. (36:35) The labs Dr. Suzanne checks in perimenopause. (38:25) Why hormone testing does not tell the whole story. (421:2) Why body composition matters more than scale weight. (47:10) How she individualizes estrogen, progesterone, and testosterone therapy. ✍️ FREE GUIDES: Top 7 Perimenopause Myths You Need to Stop Believing ASAP: drcarriejones.com/myths Hormones 101 Cheat Sheet: drcarriejones.com/hormones101 The Perimenopause & Menopause Labs Test Checklist: drcarriejones.com/labs The 101 on Stress, Cortisol And Your Nervous System Ebook: drcarriejones.com/stressfreebie Which Stage of Perimenopause Am I In? Ebook: drcarriejones.com/stages

Shoulder pain, frozen shoulder, hip pain, and plantar fasciitis can all show up during perimenopause, even when there was no obvious injury. And because these symptoms are rarely connected back to hormones, many women assume they are simply getting older or doing something wrong. We dive deeper into this in Hello Hormones with Dr. Carrie Jones with Dr. Fiona Lovely. We also chat about brain fog, memory changes, sleep apnea, blood sugar, HRT, and why "I don't feel like myself anymore" can be part of the perimenopause transition. Dr. Fiona Lovely is a chiropractor, menopause educator, and host of Not Your Mother's Menopause. She has more than 20 years of clinical experience and is the creator of a menopause doula certification program. What's Discussed: (05:43) Why more women are recognizing perimenopause symptoms earlier and how younger women are starting to prepare before symptoms become disruptive. (08:46) What the musculoskeletal syndrome of menopause is and why joint, tendon, and muscle problems may become more common as estrogen declines. (12:29) Why frozen shoulder can be an early sign of perimenopause, especially when shoulder pain appears without an obvious injury or trauma. (14:31) How plantar fasciitis, unexplained hip pain, and glute pain may be connected to hormonal changes rather than simply aging or overuse. (25:05) Why the conversation around HRT extends beyond hot flashes and includes brain, bone, and cardiovascular health. (27:54) Why you can still be experiencing perimenopause even if you rarely or never have hot flashes or night sweats. (40:31) What happens to the brain as estrogen changes, including shifts in blood flow, connectivity, metabolism, and areas involved in memory. (45:51) Why brain fog, forgetting names, and losing your train of thought do not automatically mean you are developing dementia or Alzheimer's disease. (48:14) Why "I don't feel like myself anymore," emotional flatness, and losing interest in things you once enjoyed can show up during the menopause transition. (53:07) How blood sugar changes and sleep apnea may affect brain health in perimenopause, and why sleep apnea in women can be easier to miss than expected.

There are a lot of health numbers you could track, but more data does not automatically mean more clarity. In perimenopause especially, the useful part is figuring out which patterns actually help you understand why your sleep, hormones, energy, or blood sugar may suddenly feel different. In this solo episode of Hello Hormones, I am sharing the health metrics I personally pay attention to and what they have taught me about my own body. I talk about sleep and early-morning waking, hormone patterns throughout the month, glucose and insulin, and a lot more about how I use tracking without letting the numbers take over my life. I also break down how I use tools like sleep data, hormone testing, glucose monitoring, and a very low-tech workout calendar to spot patterns and make small adjustments. If you have ever wondered which health numbers are actually worth paying attention to, this episode will help you simplify the noise and focus on what gives you useful feedback. What's Discussed: (01:05) Sleep tracking and staying asleep during perimenopause. (03:28) Alcohol, late meals, travel, and their impact on sleep. (05:25) Tracking hormone patterns throughout the month. (07:34) Why one hormone test may miss the bigger picture. (08:17) Glucose and insulin changes across the menstrual cycle. (09:00) Fasting glucose and insulin levels worth watching. (11:02) Tracking water and daily movement for accountability. (13:25) A simple way to track workouts consistently.

You can spend years holding everything together with anxiety, urgency, perfectionism, or sheer willpower, then hit perimenopause and suddenly feel like your brain stopped cooperating. Trouble focusing, emotional overwhelm, forgetfulness, procrastination, and feeling like you have completely lost your ability to multitask can all overlap with ADHD, which is exactly why so many women start asking questions in midlife. In this episode of Hello Hormones, Dr. Jolene Brighten and I break down the connection between ADHD and perimenopause, including how shifting estrogen can affect dopamine, memory, motivation, and cognitive flexibility. We also talk about testosterone, blood sugar, sleep, exercise, thyroid and iron testing, and why symptoms that look like ADHD still deserve a full evaluation. Dr. Jolene Brighten is a women's health expert, author, and clinician who specializes in helping women better understand the connection between their hormones and their brains. If you have ever wondered why the strategies that used to keep you organized, productive, and on top of everything suddenly are not working the same way, this episode will help you understand what may be changing and what is worth looking at next. What's Discussed: (1:56) Why getting good grades does not rule out ADHD in women. (3:13) Why ADHD may suddenly feel harder to manage during perimenopause. (6:38) How masking can make ADHD look very different in women and girls. (10:50) Why perimenopause and ADHD symptoms can be so difficult to tell apart. (13:15) Why late-night scrolling and shopping may be your brain trying to reclaim dopamine and personal time. (16:14) How changing estrogen can affect focus, memory, motivation, and cognitive flexibility. (23:53) Why low testosterone can feel like losing your motivation or "spark." (29:35) How blood sugar swings can make ADHD and perimenopause symptoms feel worse. (44:00) What to rule out before assuming brain fog and forgetfulness are ADHD. (46:58) Why 20 minutes of exercise may support focus and attention for hours afterward. ✍️ FREE GUIDES: Top 7 Perimenopause Myths You Need to Stop Believing ASAP: drcarriejones.com/myths Hormones 101 Cheat Sheet: drcarriejones.com/hormones101 The Perimenopause & Menopause Labs Test Checklist: drcarriejones.com/labs The 101 on Stress, Cortisol And Your Nervous System Ebook: drcarriejones.com/stressfreebie Which Stage of Perimenopause Am I In? Ebook: drcarriejones.com/stages