Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

Welcome to the latest Midlife Minute.

In this episode, I answer questions related to disordered relationships with food, relative energy deficiency, bone health, and intermittent fasting.

Stay tuned to find out what can happen to your body when you’re undernourished, and how to approach intermittent fasting in a way that supports your health rather than adding more stress.

IN THIS EPISODE, YOU WILL LEARN:

How fasting culture can sometimes intersect with undernourishing the body

The link between a lifetime of anorexia, fasting, and restrictive eating and lower bone mineral density in midlife

The importance of restoring energy availability

The endocrine and metabolic changes that can accompany loss of the menstrual cycle

When transdermal estradiol and progesterone may be appropriate if menstrual recovery does not occur

The importance of getting enough protein, fiber, healthy fats, and overall nourishment when fasting intermittently

What to consider when using electrolytes during a fast

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Research:

1. Relative Energy Deficiency in Sport (REDs): Endocrine Manifestations, Pathophysiology and Treatments.

Endocrine Reviews. 2024. Angelidi AM, Stefanakis K, Chou SH, et al. Review

2. The IOC Consensus Statement: Beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S).

British Journal of Sports Medicine. 2014. Mountjoy M, Sundgot-Borgen J, Burke L, et al.

3. Eating Disorders.

Lancet. 2020. Treasure J, Duarte TA, Schmidt U. Review

4. Eating Disorders.

The Journal of the American Medical Association. 2025. Attia E, Walsh BT. Review

5. All-Cause and Cause-Specific Mortality Risk in Individuals With Eating Disorders: Systematic Review and Meta-Analysis of Relative Risk and Aggravating or Attenuating Factors.

World Psychiatry: Official Journal of the World Psychiatric Association. 2026. Semchishen SN, Højlund M, Lemaire D, et al. Recent

6. ACOG Committee Opinion No. 740: Gynecologic Care for Adolescents and Young Women With Eating Disorders.

Obstetrics and Gynecology. 2018. Committee on Adolescent Health Care Guideline

7. Fractures in women with eating disorders—Incidence, predictive factors, and the impact of disease remission: Cohort study with background population controls.

The International Journal of Eating Disorders. 2020. Frølich J, Winkler LA, Abrahamsen B, et al.

8. A Systematic Review and Meta-Analysis of the Association Between Eating Disorders and Bone Density.

Osteoporosis International: A Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2016. Robinson L, Aldridge V, Clark EM, Misra M, Micali N. SR

9. Bone Health in Adult Women With ED: A Longitudinal Community-Based Study.

Journal of Psychosomatic Research. 2019. Robinson L, Aldridge VK, Clark EM, Misra M, Micali N.

10. Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-Analysis.

Sports Medicine. 2025. Gallant TL, Ong LF, Wong L, et al. SR

11. Impact of Relative Energy Deficiency in Sport (REDs) on Bone Health in Elite Athletes: A Retrospective Analysis.

Journal of Cachexia, Sarcopenia and Muscle. 2025. von Brackel FN, Munzinger R, Bartosik M, et al. Recent

12. Medical Complications of Anorexia Nervosa.

Pediatrics. 2025. Trapani S, Rubino C.

13. Screening for Eating Disorders in Adolescents and Adults.

The Journal of the American Medical Association. 2022. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Review

Today, I’m delighted to connect with registered dietitian and certified diabetes care and education specialist, Kara Siedman. Her broad clinical experience spans inpatient oncology, diabetes, and gastroenterology. She is currently the Vice President of Science and Partnerships at Resbiotic.

In today’s conversation, we focus on the value of nutrition at the intersection of the microbiome and overall health. We discuss nutritional dogma, the impact of gastroparesis, IBS, IBD, SIBO, and other similar diagnoses. We explore midlife risk factors and medications that impact the microbiome, the influence of low FODMAP diets and irritable bowel syndrome management, food fears, and disordered food relationships. We also examine the influence of probiotics and prebiotics, clarify why constipation is multifactorial, discuss the hallmarks of aging related to the microbiome and midlife changes, and review evolving research on the microbiome and responses to GLP-1 drugs.

This conversation with Kara Siedman is truly invaluable, so stay tuned!

IN THIS EPISODE, YOU WILL LEARN:

How nutrition has shifted away from hard science toward influencer opinions and social media dogma

Why nutrition should be personalized rather than treated as one-size-fits-all

Why carbohydrates should not be demonized, and the important role each macronutrient plays

Why Kara views nutrition as a bridge between conventional and functional medicine

Why supporting the microbiome is about building stability and resilience through multiple foundational factors rather than one isolated intervention

Medications that can disrupt the microbiome

Why a low FODMAP diet should be viewed as a bridge for symptom management, and not as a treatment for IBS or something that should necessarily be followed indefinitely

How the microbiome changes with aging and menopause

Multiple factors that can contribute to constipation

What research has revealed about the gut microbiome as a potential factor in GLP-1 responses

Bio:

Kara Siedman is a registered dietitian and certified diabetes care and education specialist with over 15 years of clinical experience in inpatient care, outpatient program development, and integrative/functional nutrition.

Kara’s work in a leading gastroenterology practice sparked her transition into functional nutrition, where she integrated root-cause approaches into GI care and became a mentor and key opinion leader in the field. Her passion for the gut microbiome evolved into a professional specialty, leading her to collaborate with top biotech and microbiome-focused companies.

As Senior Director of Science & Partnerships at resbiotic, Kara educates healthcare providers on microbiome science and the clinical application of targeted microbiome therapies. Known for her ability to simplify complex research, she brings clarity, credibility, and passion to gut health education.

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Kara Siedman, RD, CDCES

Resbiotic

On Instagram

Resbiotic on LinkedIn

I am thrilled to have Gary Taubes back on the show today. (He was with me before on episode 137. Gary is an investigative science and health journalist whose work has been pivotal in catalyzing the low-carb keto movement. He has written many books, including his most recent, Rethinking Diabetes, and his articles are in many of the best anthologies. He has also received many science awards.

Today's discussion is particularly significant, given the recent report from the American Diabetes Association revealing that the annual cost of diabetes in the United States reached a staggering $412.9 billion in 2022, with individuals diagnosed with diabetes now representing one in every four dollars spent on healthcare.

In our discussion today, we dive into the history of diabetes, pertinent statistics, the prevailing standard of care, and the transformative influence of insulin on diabetes management and reactive hypoglycemia. Gary provides insights into his reactions to GLP-1s, the integration of medical and nutritional science into medicine, and the influence of organizations such as the American Diabetes Association, AHA, USDA, and NIH. Our discussion also extends to the effects of pharmaceuticals, the shortcomings of our approach to diabetes management and of existing models, and the challenges the low-carb community faces.

Stay tuned for today's eye-opening conversation, where we shed light on the complexities of diabetes care and explain how simple lifestyle changes can tremendously improve quality of life.

IN THIS EPISODE YOU WILL LEARN:

Rethinking Diabetes is a groundbreaking exploration of diabetes diagnosis, management, and treatment

Gary discusses the evolution of evidence-based medicine

Why the traditional medical approach to treating diabetes is inadequate

How the guidelines of the American Diabetes Association were based on outdated assumptions

How medical treatments compare with lifestyle changes for managing diabetes

Controversies surrounding how the pharmaceutical industry has influenced the way medical associations have shaped their diabetes management policies

How medical guidelines and dietary advice have evolved

What constitutes a healthy diet?

How patients often have trouble following diet recommendations, despite their best intentions

Is obesity a hormonal disorder or caused by overeating?

Connect with Cynthia Thurlow

Check out Cynthia’s website.

Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

Follow on X, Instagram & LinkedIn

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Gary Taubes

On his ⁠website⁠

⁠Twitter⁠

⁠Facebook⁠

Previous Episode Mentioned

⁠Ep. 137 – High Blood Sugar Levels and Long-Term Damage with Gary Taubes⁠

Book Mentioned:

Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments is available from most bookstores or on ⁠Amazon⁠.

Today, I’m honored to reconnect with Dr. Jolene Brighten. She’s an award-winning, board-certified naturopathic endocrinologist, nutrition scientist, and leading voice in women’s health. She’s the author of Beyond the Pill, Healing Your Body Naturally After Childbirth, and her latest book, ADHD and Women: A Guide to Optimizing Your Hormones and Thriving with ADHD, which represents an expansion of her core thesis that women’s symptoms get chronically misattributed when the hormone piece is left out of the picture, which she now applies to ADHD. She also hosts The Dr. Brighten Show.

In today’s conversation, we look at why ADHD symptoms surface or worsen at hormonal transitions, the mental health effects of oral contraceptives and synthetic hormones, and the gut-brain connection to ADHD. We explore how gut dysbiosis dysregulates vagal nerve signaling; how butyrate and other short-chain fatty acids influence it; what endobelly is and how it affects histamine and mast cell degranulation; and emerging research on GLP-1s and endometriosis. We also discuss rejection sensitivity disorder and masking, nutritional and o lifestyle recommendations for improving symptomatology, and how key supplements like cytochrome and saffron can improve memory and mitochondrial health.

Stay tuned for a truly insightful conversation with Dr. Jolene Brighten and a deeper look at ADHD and Women.

IN THIS EPISODE, YOU WILL LEARN:

How perimenopause can amplify ADHD symptoms

Why ADHD in some women remains unidentified until midlife

How gut dysbiosis can influence vagal nerve signaling in the ADHD brain

Why butyrate and resistant starches may be important for the ADHD brain

The connection between endometriosis, ADHD, and the gut

How Dr. Brighten guides neurodivergent women through HRT conversations

How rejection sensitivity dysphoria can affect women with ADHD

Dr. Brighten shares lifestyle recommendations for women with ADHD

Bio:

Dr. Jolene Brighten is a hormone expert, nutrition scientist, and founder of Dr. Brighten Essentials. Board-certified in naturopathic endocrinology, a certified menopause specialist, and sex counselor, she is the bestselling author of Beyond the Pill, Is This Normal?, and the forthcoming ADHD and Women. She is dedicated to helping women optimize their hormone, brain, and sexual health through evidence-based education.

Connect with Cynthia Thurlow

Check out Cynthia’s website.

Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

Follow on X, Instagram & LinkedIn

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Dr. Jolene Brighten

Website

Pre-order bonuses for ADHD and Women (Meal plans to help optimize hormones and a PMDD workshop)

On Social Media: @DrJoleneBrighten

The Dr. Brighten Show

Welcome to this week’s Midlife Minute!

Today, I examine partial and full hysterectomies and what we know about their potential long-term effects, clarifying what the research tells us about bone, brain, and cardiovascular health, and what women should discuss with their healthcare providers before and after surgery.

IN THIS EPISODE, YOU WILL LEARN:

How a partial hysterectomy differs from a full hysterectomy, and the abrupt estrogen changes ovarian removal can produce

Why having a hysterectomy before ages 40-45 can have a greater impact than having surgery closer to natural menopausal age.

How a hysterectomy can impact women’s bone health

What the research reveals about the connection between surgical menopause at a younger age, cognitive decline, and Alzheimer’s pathology

How a hysterectomy can affect women’s cardiovascular health

Why starting HRT early after an early-age hysterectomy could be important for your long-term health

Why younger women who experience surgical menopause may require higher estradiol doses than the standard menopausal regimens

The importance of advocating for yourself, understanding your personal risk, and talking with your clinician about estrogen and other hormone therapy before undergoing surgery

Quotes:

“Start those conversations early- before you ever have surgery.”

“If you are having these surgeries done before 45, before 40, you need HRT!”

“We have to manage our stress.”

“We have to get enough sleep.”

“We should be strength training.”

“We should be physically active.”

“We should be eating an anti-inflammatory diet.”

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Research:

Increased Risk of Osteoporosis With Hysterectomy: A Longitudinal Follow-Up Study Using a National Sample Cohort. American Journal of Obstetrics and Gynecology. 2019. Choi HG, Jung YJ, Lee SW.

Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.

Cardiovascular Disease After Hysterectomy in the Nurses' Health Study and Nurses' Health Study II. Obstetrics and Gynecology. 2025. Thao V, Borah B, Stewart EA, et al.

Treatment of Women After Bilateral Salpingo-oophorectomy Performed Prior to Natural Menopause. The Journal of the American Medical Association. 2021. Kaunitz AM, Kapoor E, Faubion S.

Hysterectomy, Oophorectomy, and Bone Health: A Systematic Review and Meta-Analysis. European Journal of Endocrinology. 2025. Shariful Islam M, Tuesley KM, Wilson LF, et al.

Risk of Osteoporosis and Fracture After Hysterectomies Without Oophorectomies: A Systematic Review and Pooled Analysis. Osteoporosis International. 2022. Xu W, Wu W, Yang S, et al.

Hysterectomies Are Associated With an Increased Risk of Osteoporosis and Bone Fracture: A Population-Based Cohort Study. PloS One. 2020. Yeh YT, Li PC, Wu KC, et al.

Age at Surgical Menopause Influences Cognitive Decline and Alzheimer Pathology in Older Women. Neurology. 2014. Bove R, Secor E, Chibnik LB, et al.

Reproductive Period and Risk of Dementia in a Diverse Cohort of Health Care Members. Neurology. 2019. Gilsanz P, Lee C, Corrada MM, et al.

Examining the Association of Hysterectomy With and Without Oophorectomy on Cardiovascular Disease and All-Cause, Cardiovascular or Cancer Mortality: A Systematic Review and Meta-Analysis. BJOG: An International Journal of Obstetrics and Gynecology. 2024. Chen Y, Li F, Liang L, et al.

Association of Premature Natural and Surgical Menopause With Incident Cardiovascular Disease. The Journal of the American Medical Association. 2019. Honigberg MC, Zekavat SM, Aragam K, et al

Optimizing Health After Early Menopause. Lancet. 2024. Mishra GD, Davies MC, Hillman S, et al.

Hormone Replacement Therapy for Women Previously Treated for Endometrial Cancer. The Cochrane Database of Systematic Reviews. 2018. Edey KA, Rundle S, Hickey M.