58. Progesterone: What Every Woman Over 35 Needs to Know

59. Truth: Your OBGYN Probably Can’t Help You in Perimenopause

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In this week’s episode, Claudia addresses one of the BIGGEST frustrations women face–going to their OB/GYN for perimenopause help, only to realize they’re not as knowledgeable about hormones as we expect. Too often, doctors miss the full picture, leaving women dismissed and without real solutions.

We’re covering:

Why your OB/GYN is great for pregnancy–but often clueless about perimenopause
Why perimenopause isn’t just about estrogen and progesterone
The common treatments doctors prescribe that don’t actually fix the root cause
What you really need to do to start feeling better

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Today, we’re having a real talk about something I see way too often: women going to their OB/GYN for perimenopause symptoms… and leaving frustrated, dismissed, or with a one-size-fits-all prescription that doesn’t actually help them feel better.

You’re Not “Too Young” and You’re Not Imagining It

If you’ve been told your labs are “normal” (if they ran any labs), were told “you’re too young for perimenopause” or my favorite “I don’t believe in hormone replacement therapy” as if it’s Santa Claus…meanwhile you’re struggling with exhaustion, mood swings, crappy sleep, anxiety, weight gain, hot flashes, inflammation or any of the other crazy symptoms of perimenopause —this episode is for you.
And if you’ve been given birth control, an antidepressant, or told to “just wait it out”—you’re not crazy for NOT accepting that as a solution.

Why Your OB/GYN May Not Be Your Go-To for Perimenopause Support

So, let’s break down why your OB/GYN may not be the expert you think they are when it comes to perimenopause… and what you need to do instead to actually take back control of your health – and more importantly, feel better. Life is too damn short to feel like crap, ladies. So I hope I light a little fire under your beautiful butt.

I’m Not Anti-Doctor—But They’re Not Trained for This

First, let’s get one thing clear—I am NOT anti-doctor. We need them, especially for serious medical issues. It’s important to rule things out and get an exam or imaging if need be. But when it comes to perimenopause, most OB/GYNs are simply not trained to help you navigate this transition holistically, meaning with a whole body approach. Heck, they’re barely trained in MENOPAUSE.

Most Docs Aren’t Getting the Education They Need

According to a survey from The Menopause Society, more menopause education is needed in residency programs. As medicine advances, we women are expected to live longer, with 90 million women in the US expected to be menopausal by 2060. So we will spend about 1/3 of our life in menopause aka: in a low hormone state, which really is a recipe for increased risk of chronic diseases.
Despite the rising need for menopausal care, residency programs often lack menopause education, leaving OBGYNS unable to provide proper care for women.

What You’re Likely to Hear (That’s Not Actually Helping)

They often just address symptoms with birth control. And if you’ve been paying attention, you know that is not addressing root causes, which is what I help you better understand as a functional & integrative health coach. Is it sometimes needed? Sure. It’s a tool but way over prescribed IMO, especially to treat peri symptoms.

They’re Focused on Fertility & Menopause, Not the 10-15 Years Before

Their focus is primarily on pregnancy and menopause (if you’re lucky)—not the 10-15 years leading up to it (which is perimenopause), when your metabolism, thyroid, and stress hormones are shifting drastically. Yes, us perimenopausal ladies are super lucky. We’re getting hit from all angles.

Most Miss the Bigger Picture of What’s Really Going On

And most doctors ONLY think of estrogen and progesterone and completely miss what’s happening with your adrenal health (hello cortisol), blood sugar, thyroid, detox pathways, nutrient imbalances—all of which are MAJOR players in how you feel in perimenopause.

Common “Solutions” That Miss the Mark

And if your doctor does acknowledge perimenopause, the typical options are:

Birth control (which can mask symptoms and doesn’t address the root cause – which is hormone decline); also the hormones in birth control are synthetic; they are not bioidentical hormones, which mimic what your body makes naturally

An antidepressant (which may help mood, as well as hot flashes, but won’t fix all the other symptoms you may be dealing with, not to mention your metabolism, your energy output, your thyroid function, or inflammation)

Or they may just say “Your labs are fine” – if they run any labs – or “you’re just getting older” (which is obviously not helpful). You do NOT need to suffer for years to come. Not on my watch.

What They’re Missing: The WHOLE BODY

What are they missing? The bigger picture of how all your systems work together. Perimenopause isn’t just about sex hormones—although they play a huge role, holy moly – that sharp decline in progesterone and that fluctuating estrogen greatly impacts how you feel day to day.
But it’s also about how your entire body is adapting to the stress of those hormone fluctuations, the stress of being in midlife, nutritional deficiencies, blood sugar dysregulation which is typical in this phase of life, and lifestyle factors that, quite frankly, have been building up for decades. I’m sorry to say but under eating, over exercising, or living a sedentary lifestyle, drinking too much alcohol, staying up late – yeah, it tends to bite us in the ass in our 40s and above.

HRT Can Help—But It’s Not the Only Thing You Need

If you’re struggling with fatigue, mood swings, anxiety, middle of the night wakes, stubborn weight, and other bothersome symptoms, the answer isn’t just slapping on HRT and hoping for the best—you know I’m a fan of HRT, but it’s about fixing the multiple underlying imbalances that are making your symptoms worse.

Source:

https://www.contemporaryobgyn.net/view/survey-shows-menopause-curriculums-lacking-in-residency-programs

Claudia Petrilli is a Functional Health Coach, Integrative Nutrition Coach, Women’s Health Educator, and creator of The Perimenopause Method. Having experienced debilitating periods, digestive issues, a sluggish thyroid, a pituitary tumor, and perimenopause symptoms in her late 30s, she knows exactly what it’s like to get dismissed by doctors and spend years searching for answers.

After making the decision to advocate for her health years ago and investing in her education, she changed her life. Now, she’s changing the lives of countless women by teaching them to advocate for themselves and improve their hormone health, so they can feel and look their best — in their 40s and beyond!

When she’s not digging into client cases and learning about women’s health, you’ll find Claudia with her life partner of 15 years, Mike, and their rescue pup, Dawson, the love of their life.