Perimenopause Explained: Why Your Body Feels Off (And What Actually Helps) with Dr. Mary Grimberg

Mary Grimberg 

We’re not aware of our bodies. And I speak this as somebody that is going through it and it was thrown into it. And so I want to help people even before they get to perimenopause. So that transition isn’t as hard, so it’s not a disease like you’re saying. And I just want to remind people the power is with you. It starts with you. Cancer was a gift to you now, and it took me a long time to get there, but I’m so thankful that I’m awake at 39. I believe that perimenopause is this perfect opportunity for us to all have that collective awakening.

Lorne Brown 

By listening to the Coherence Code Podcast, you agree to not use this podcast as medical advice to treat any medical condition, either yourself or others. Consult your own physician or healthcare provider for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Welcome to the Coherence Code Podcast, where we explore how the mind and body work together so you can move from stress and inner conflict to clarity, calm, and alignment. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine and a clinical epitherapist. And through my work, I’ve seen that healing happens when you remove what gets in the way and allow the body and the nervous system to do what they’re designed to do to heal. Welcome to the Coherence Code Podcast.

Today I have Dr. Mary Grimberg. Now, she is a pelvic floor and orthopedic physical therapist and the owner of ResilienceRx, which is a multi-clinician physical therapy and wellness practice in Austin, Texas. I recently was interviewed on her podcast, TMI Talk with Dr. Mary, and we got a little bit into perimenopause and menopause, and I was like, “I got to have you on my podcast.” So she’s here today. I want to let you know that she does help people move through the whole perimenopause transition. That’s a big part of her passion these days. And from what I learned from her, she likes to do this beyond hormone replacement therapy alone. She does this by regulating the nervous system and really addressing the whole person from a mind, body, soul perspective. And what we’re going to learn today through movement and rehab lens, she teaches women to understand their bodies, recognize patterns, and basically regain control.

As I mentioned, she is also the host of the TMI Talk with Dr. Mary podcast. Her mission is to reshape the perimenopause conversation by bridging science with empowering tools that give both practitioners and clients more options, freedom and confidence through life’s transition. We were introduced through radiologists, Dr. Mitchell Abrams, and through my research Mary, I would say that I think your mission, Mary, and you’ll tell me if right or wrong, is basically to reshape the perimenopause conversation beyond hormone replacement therapy alone. And you do this by integrating movement, rehab, nervous system regulation, facial lymph function perspective, looking at these symptoms as a whole mind, body, soul dimension. So that’s kind of what I’m thinking. Do I get a good sense of you so far?

Mary Grimberg 

Yes. Yes, absolutely. And I want to add more to the conversation because all of those things can be helpful, hormone replacement therapy or menopause hormonal therapy. They can be helpful, but there’s still a whole person here that we’re working with. And I’ve worked with many people who are still maybe on those tools and they’re still struggling because it’s not just one tool in the toolbox. And I really like to reshape the conversation so we can really start feeling empowered in our bodies during this time versus just angry and upset about what’s going on. I mean, it’s normal to feel that way when your body’s adjusting, but if we can start reshaping the conversation, it can make this journey a bit more tolerable.

Lorne Brown 

That’s what I hope we’re going to get to do. And the way you said there’s multiple tools and hormone therapies, one of them, I often use this analogy that a colleague of mine shared. When you go on a journey and imagine you’re a carriage and you have this long journey, if you have one horse, there’s a chance that horse may not survive, so you never finish the journey or at least not on a timely manner. So sometimes you want to have multiple horses, many horses. And each horse here is a tool or modality. Hormone therapy is modality, physical therapy is a modality, acupuncture, herbs, all these things. So depending on where you’re at on an individual level, you may want to hook up many horses to your carriage. And so we’re going to talk about all the horses that you can do. I thought your background is important to share because I understand you were diagnosed with Hodgkin’s lymphoma in your early 30s, and I was wondering if you can share how that chapter changed your relationship with your body and health and why it brought you into this desire to help women going through perimenopause and in the menopause stage of their life.

Mary Grimberg 

Yeah. Well, I mean, getting cancer at 33 is never anything you expect, especially on your birthday. That’s a fun treat

Lorne Brown 

To- Oh, really? It was on your birthday? Yeah. Okay.

Mary Grimberg 

But before that, I was eating healthy. I was exercising. I had cleaned out all the chemicals in my house. I was getting massages regularly. I was doing everything on paper right. So technically, why did I still get sick? I was a good weight. My blood pressure was great. My blood work was perfect. There were no issues. And that’s when I sat with it because you’re face-to-face with death at 33 and you have to think, how did I get here? Not blaming myself, but more like, if I did what all healthy people are doing, there must be something more that I’m unaware of. And that’s when I started looking more into Eastern medicine and realizing, oh, the throat area, that’s my inability to speak my truth. My cancer was in my right collarbone. I had a history of chronic throat infections, sinus infections most of my life.

And I look and so much of my life was people pleasing, not wanting to be a bother, holding back my truth. And then I just realized how much that was affecting my nervous system, how much not knowing my body’s signals and suppressing those because I didn’t want to bother anybody and how much unprocessed trauma and grief and all these things that affect us day to day. And that’s really what opened my eyes . Oh my gosh, we can do all of these things to help ourselves in perimenopause, but if we don’t have a connection to ourselves and we don’t know what that means, we’re missing a huge point of it. And I was thrown at … I didn’t know this until last year, but for the last six years, my health was just after chemo, I had gut issues, I had gained 30 pounds, I had crippling anxiety, cystic acne, and was not able to sleep.

All of the typical things that you hear about in perimenopause, but it wasn’t brought up to me until I really had to do my own research and see, wow, I’m at higher risk for this. It starts as early as 35, but I was 33. I had a history of endometriosis already. Now add-on chemotherapy. I didn’t have my period for three months. There’s a lot to add on here. And that’s when I said, okay, this is it. I’ve done so much work to … And we’re never going to find all of the answers. It’s a constant evolving process. But now the tools that I’ve learned, I want to just share those with women that they’re free. You can use them immediately. These are things that just check in with ourselves and understand what our bodies are saying. And so that’s really what took it to this next level of, okay, it’s been six years of this.

I had my big life change back in 2020 was really when it hit. So at the end of 2019 was when I got diagnosed right when I was done with treatment a few months after COVID hit and went through divorce at that same time and lost a father figure all that year. And it was my dark night of the soul. And that was the beginning of my awakening.

Lorne Brown 

So yeah, definitely a very loud wake-up call. COVID, also cancer relationship change. And so when you started experiencing weight gain, fatigue, you talked about cystic acne, blood pressure changes, and you stopped cycling because of everything that was going on, including the cancer treatment. So your cycles stopped as well. The doctors say it’s related to you not having your cycle because of chemo, some treatments can put you into artificial menopause, right? And so how was it received when you were going to see your healthcare providers when you were experiencing this?

Mary Grimberg 

Not well. Perimenopause wasn’t even brought up on the radar. I went to my OB-GYN after. I was having two periods a month of crippling pain after the periods returned. And I was just told like, “Okay, this is just kind of waiting out. You can go on some birth control.” And that just didn’t feel good for me. I didn’t like that. I felt very dismissed, but at the same time, I’m also recognizing those are the tools that Western medicine was given. And so it was up to me to figure out, okay, well, what else could be going on with my body? And I had another doctor who was more aware of non-traditional forms of medicine and started realizing, “Oh, you might be experiencing insulin resistance.” And so then that really helped me to know, oh, okay, that’s why I gained just 30 pounds because I’ve always been an athlete.

I’ve eaten healthy. I’ve exercised. I never really understood. I was like, I didn’t have the body type that would just gain weight and lose it fast. And then that’s when I had to look, okay, well, what else could be going on? My cholesterol skyrocketed. These are all early signs. I’m sure you see it with your clients, especially cholesterol. Now they’re seeing a spike in cholesterol can be a sign of perimenopause, but I had all the signs. Oh, and just severe difficulty sleeping.

Lorne Brown 

And you talked about even the anxiety and poor sleep. So I’m curious, did your cycle eventually, do you cycle now or did it

Mary Grimberg

Yeah, it’s pretty regular now

Lorne Brown

So I want to define for our listeners, there’s perimenopause, which is basically the period of time before menopause and pause, menopause, pause is when your menstruation stops. So real quick, because people who are listening to this probably, yeah, I’ve heard this a hundred times, but maybe somebody hearing it for the first time. Menopause, the Western definition is, it’s a retrospective definition. You haven’t had a period for a year. And sometimes it’s just through transitional life. Sometimes it’s artificially imposed like cancer treatments, chemo, radiation. Perimenopause in general is like the five to 10 years leading up to menopause. So in your case, the treatment puts you into menopause or lack of cycles for a while, but they have returned. And while you’re in that of no progesterone or low estrogen, you developed all these symptoms, your blood pressure, your sleep, and oftentimes they won’t want to use hormone therapy, somebody who has a history of cancer.

It’s not necessarily they don’t, by the way. If somebody’s had a history of cancer, you’re definitely going to talk to your physician. Where I’m really curious for our listeners is from your own experience, how did this shape the way you now work with women in midlife transition? Not just those that have gone through cancer treatment that go into menopause, but for those that are in their 40s or 50s that are in that perimenopause phase, meaning they’re still cycling, but I can’t sleep, I’m gaining weight, my blood pressure’s up, I have anxiety, the urogenital issues of urgency or burning, itching, all the weird things that people are like, “What’s going on? ” Where their doctor’s saying, “Hey, you just need antidepressant, or you just need some painkillers for your aches and pains, or you need a sleeping aid. You have more of a holistic way to go under the cause.

How did it shape the way you now work with women in perimenopause and menopause?”

Mary Grimberg 

Oh, well, first it’s validating their experiences. I mean, these women just want to be heard and they’re frustrated and they get upset and then it’s going and saying, “Okay, well, now let’s focus on what we can do about it. ” And I really focus on educating them, “Hey, when progesterone declines, this is what potentially this is what can happen. Our sleep declines.” Sometimes during our phase of cycle, when estrogen and progesterone are lower, our fascia can be more restricted. And then in that, maybe we have more joint pain. So I get them to start connecting the dots so they start feeling more empowered in their body versus feeling like a victim to it because during this time we can feel that way. And you’ll see that a lot in mainstream media too. It’s just a lot of fear mongering. And I want to bring it back to, “Hey, this is your body.

Let’s start listening. Let’s start noticing patterns.” So first, if they are cycling, get them to notice, “Hey, what are your symptoms associated with a certain time in your cycle?” And is it day three when your hormones are at their lowest? Is it then or is it when you’re ovulating? What or not ovulating? So then they can start to understand what is potentially going on. And then now the other pieces are just starting to get them to simply just notice their body. What are the sensations? After you say yes to something you wanted to say no to, do you feel lighter or do you feel heavier? Do you feel energized or do you feel depleted? Do you feel tight or do you feel relaxed? Those are your body signals giving you, because we’ve focused so much, we’re from neck up most of our lives and if we can get into the body and get them to notice, “Ooh, yeah, that’s what that is.

Oh, I just thought my body was, that’s just what my body would do. And it’s no, it’s a signal. It’s communication. Let’s create a partnership here.” Because I was so angry with my body for so long, I thought it had failed me. I didn’t know it was waking me up to go on this journey because this is an incredible journey to be on in empowering women in this way. But obviously that took some time to get to that point, but those are some of the things that I’ll start with and then educate them on how the whole body’s connected. So sometimes they’ll come in, for instance, somebody having low back pain for years and then realizing I worked on one of their scars along their left shoulder and getting them just doing that, freeing up their low back pain and their minds being blown because when the fascia is restricted, it’s this 3D connective tissue that can pull and twist our body in different ways.

And when it gets restricted, it can cause pain in so many different areas of our body. And then finally too, getting them to understand sleep hygiene. So many of us are on our computers before bed or on our screens or scrolling on social media and then educating them on how important melatonin is. So if we can naturally improve our melatonin production, this helps to reduce cortisol and melatonin helps regulate our blood sugar. So there’s all of these things that are going on. And then finally validating them and realizing, hey, maybe we weren’t thriving in chaos before. Maybe we had more buffers with our hormones, but now those are declining. So we have to really narrow in what our body is wanting.

Lorne Brown 

Yeah. Through the lens, you often see this through the lens as a physiotherapist, right? And we’re going to go into that a little bit more. And I often see it through the lens of Chinese medicine and hypnosis. And the way you just described that, all the stuff we were doing, burnout happens, but we’re pushing, pushing. When these hormones start to fluctuate in perimenopause, the estrogen’s fluctuating, progesterone is declining. And then in menopause, both have declined. If there is resilience in the system, it won’t even notice the change in hormones. And you’ll pretty much sail through perimenopause, menopause. But just like when there’s change outside of us, it stresses the system. And if we have resilience, we have the capacity to adapt. And that’s happening inside. As the hormones are changing, which is not a disease, it is a natural transition. It’s supposed to happen.

It’s a stress to the body though because they’re shifting. And if we do not have the resilience, therefore the capacity to adapt, we discover these symptoms of high blood pressure, insomnia, anxiety. So in your work as a … So I’m aligned to how you address this holistically. You use the word fascia a bit. And I was curious, doing my prep to have our interview today and from when we talked on my podcast on your podcast, I’m curious about the fascia lymph and nervous system dysregulation. If you can kind of share, what do you mean by fascia and also how does this show up? When you start to see things, symptoms, you’re like, oh, this is fascia … And it’s all connected. You talked about that scar on somebody that was affected to the backbone, scar on the shoulder affected the back pain. How is fascia issues showing up, lymph issues showing up, nervous system dysregulation showing up?

And so people can start to be aware rather than getting a prescription drug for each of those symptoms, they may realize there’s an underlying cause that they could address.

Mary Grimberg 

Yeah. Well, I love this because I love talking about fascia. There’s just so much in this that is … It’s been newly researched over the last few decades. It hasn’t been a big focus in Western medicine. And it’s a 3D connective, resilient tissue that moves and adapts to everything that we do. It connects everything in our body. It surrounds our internal organs, it surrounds our muscles, it surrounds our joints, all of these different areas. But for some reason, it hasn’t really been addressed more in the modern rehab world, especially in physical therapy. People are starting to come around to it a bit more. But why does this matter in perimenopause? Well, some of the research that has come out has shown … Well, first, let me kind of back up a little bit. There’s to overgeneralize what this is, is there’s two main layers in the superficial layer is the top layer.

So basically you’ve got your skin, and then you’ve got skin ligaments that are like little lines that look like gel bars, and then you’ve got superficial fat in there, and then you’ve got superficial fascia, and then you’ve got deep fat and deep fascia, and then below that you have your muscles. So even just the way our skin moves can tell us how that layer of fascia underneath is moving. And so we know a lot about metabolic health, we’re starting to understand the extracellular matrix of the area surrounding the fascia, that helps make it up. If that’s restricted, there’s some research coming out showing that it can impair, it can affect insulin’s ability to be more responsive, and that’s huge. And how our skin moves can potentially affect our blood sugar. This is pretty mind-blowing stuff. So this is early evidence coming out. And then you can potentially lead that to say, okay, well, it didn’t say specifically fascia, but it’s all in that same area.

It’s all what makes all of it up. And so now we’ve got deep fascia. And so the point of all of this is that it connects everything from head to toe. And so if you go into perimenopause already, maybe with a history of an ankle sprain like 20 years ago or something, and that fascia isn’t moving as freely. So fascia needs to move like a sheath and it can move. It needs to glide over other fascia. And the way it glides is it glides over through hyaluronic acid. And now if that hyaluronic acid becomes densified, we can’t move it as freely, so it gets a little bit more sticky. So now think of it as like a garden hose. The garden hose can’t extend its full length if it’s bound up at one end. So the same thing. So if our fascial restriction in our ankle doesn’t get improved, now this can affect maybe the opposite hip or the opposite shoulder because it can’t move as freely like the garden hose.

And so why is this important in perimenopause? Well, the research that’s been coming out is showing that the deeper layer of fascia has estrogen receptors. And now when estrogen declines, that fascia becomes more rigid. So it might make us more susceptible to pain, which we think it’s joint pain, but it actually could be fascial pain. So it changes the whole picture of musculoskeletal pain in perimenopause. And now fascia is basically a highway for our lymphatic system. So our lymphatic system helps assist our immune system. It helps assist our detox system, and we need to keep that fluid flowing to help our body, its immune system work appropriately. Now, if we know that fascia is becoming restricted, we can potentially assume that the lymph will likely be too. And those lymph vessels are supported by estrogen. So when those start declining, you can start feeling swelling and things like that in our hands and feet.

The point of all of this is to say that if we can start moving our fascia and we understand how to support our lymphatic system, this can really help some of the symptoms that we might be experiencing during this time. If the lymph is moving freely, that also will help clear out some of that histamine buildup because we know that mast cells are in that superficial fat layer that I was just mentioning about. And when hormones become dysregulated, the mast cells can become dysregulated and secrete histamine, and we need the lymph to help assist to clear that as well. So it’s looking at a different light. Maybe somebody’s taking hormone replacement therapy, but they’re still not feeling better. Well, maybe we need to assist the lymph system and the fascial system. Are those moving appropriately? And overall, from that standpoint, the basis of all of this is the nervous system.

So we know now that the fascia … So when we’re in fight or flight, the fascia becomes more rigid and restricted. And there’s now research coming out saying that it’s a two-way street. So when our fascia is restricted, it actually tells the nervous system that we’re in fight or flight. So we need to address it in both ways. So the point of all of this is to say that you can work on your fascia and lymph, but if we don’t look at the nervous system that’s keeping us in chronic fight or flight, you can do all these things on top of it. It may not stick as freely or easily.

Lorne Brown 

No pun intended. It won’t stay. And this reminds me of a conversation I had with Dr. Neil Theise. He’s a liver pathologist. He was episode 86, where it’s all about fascia. And he kind of connected how Chinese medicine and acupuncture helps because there’s more and more research that’s working on the fascia. I know today you just came from your acupuncture session for today. Yes. And Chinese medicine has this saying that when there is cheap flow, like you talked about this free flow, there’s health and no pain. And when there’s chief stagnation, we develop pain in the disease. And so this is interesting. Now I want to know then, how do you practically help people? How would you approach this with the women that you’re seeing to regulate the nervous system, to reconnect to their bodies through their movement or breath? What are you doing practically?

And also, do you have one of those aha stories where somebody came in and they’re like, “I got this, this, this. ” And it’s one of those things like you worked on the scar idea and all of a sudden the back pain went away. I find those fun, but if you could share that in there as well, that would be great.

Mary Grimberg 

Yeah, I have quite a few of those because we’re known for the people sending us or other practitioners or people finding us by sending us the mystery cases. I love being known for that because we get to look at it from this whole perspective. So a few different things. Well, first just getting them to understand, well, let’s go, how do I help them drop into their bodies? Well, first I educate them too on how the nervous system knows two things. It knows, are we running from bare or are we safe? And it doesn’t communicate the way you and I communicate. It sends messages, little whispers, maybe symptoms or sensations and starts to get them to check into their bodies just maybe once a day. This is a long-term thing. It’s hard to start checking in initially because you’re not used to it or it may be more, maybe not hard is the right word, but it just can be an adjustment to start paying attention.

So first is getting them to pay attention, maybe set an alarm every few hours

And just notice, take a few deep breaths. Where are you holding tension in your body? Is there something that’s coming up for you? What does that feel like? Getting them to slow down, chewing their food to applesauce consistency. I’ll fully admit. I don’t do that every time I eat, but when I notice that I’m dysregulated, I have to show my body that it’s safe, and we do that through slower, more intentional movements. So I get them to start understanding the body’s communication. Also, getting them to recognize emotional stress with physical pain. One person in particular I’ll think about, she was having chronic … I see a lot of issual buttock pain and perimenopause, but it’s also, people think it’s like the top of their hamstring, but your pelvic floor muscles are right, they’re right there. You’ve got your obturators right there, obturator internist. And every time we clinch, the pelvic floor’s going to clench when we’re in that fight or flight.

And so I just started to get her to notice, “Hey, what does it feel like when you’re having different conversations with people? ” And she noticed, she started connecting the dots that every time she talked to her boss and her boss yelled at her, her pain increased and that blew her mind that she did not associate the two. And my goal is to get people to quit their jobs when they’re talking. I mean, yes, but there’s also the reality that you still have to pay your bills and things like that. But once people start connecting the two, you can’t really unsee it. And then you get to make better life choices based on those, right? Because if you know your pain is getting so bad and your health is getting affected, you almost really don’t have a choice because the body is showing you.

So I like to start planting seeds for them to get to that point.

Lorne Brown 

That’s what I call in my … I think we talked a bit about it in your interview of me, my notice, accept, choose again, process. Notice the first key, right? Getting notice. And in a sense, you’re making the unconscious conscious. I think it was Freud who said, “The mind forgets, but the body remembers.” And so I’m really aligned with this idea of just getting really practiced at listening to our body and seeing those connections. So then you can create awareness around that. And then usually from that awareness, you start to make new choices or decisions. My scent changes because the body’s talking to you and it’s whispering, like you said, but sometimes if you don’t listen, it yells like your Hodgkin’s diagnosis, right?

Mary Grimberg 

Yeah, exactly.

Lorne Brown

You said you give some of these cases, so do you have anything that you can share? It may not have shown up, but somebody’s got insomnia and hot flashes, they’re in perimenopause, and then you’re palpating and stretching something and it changes. I don’t know. Does that happen in your practice? I don’t know how much the fascia connects that directly.

Mary Grimberg 

I would say getting them to notice … So I’ll notice this just with a few different clients, one particular chronic hip pain and noticing that their diaphragm was actually more restricted. So the diaphragm itself connects to the psoas that goes along the spine. And that’s something that people are unaware of. And then we know the diaphragm fascially is connected to the tongue and then all the way down to the feet. So a lot of the symptom changes that I’ll see in my clinic are going to be helping them with their nervous system. And so one in particular, I just noticed her inguinal area, so the groin area, you can see on the side affected, so we’ll say it was the left side, you could see more veins. On the right hip, you couldn’t, and the body speaks to us. So noticing the fascia … So the deep fascia and superficial come together around the groin area.

That’s why when people are in larger bodies, you still always see the groin area because they come together there. But that’s also an area where lymph can get more restricted because we’re sitting and a lot of the time, or maybe we never move that area. So you could see that there was likely a buildup of pressure, even if it was subtle, because why would it be on the left and not on the right, and the left is where they’re having all of their symptoms, and just freeing up the inguinal area from a fascial standpoint. And notice when bringing that up, they had more pain in the right side. They didn’t. So you can start noticing, oh, interesting. And then freeing up the diaphragm there helps with reducing that pain as well. So it was diaphragm, inguinal area, we’ve got the adductor, so the inner thigh muscles, all of those because that can affect everything down to the feet and then all the way up to the diaphragm.

And when you free up someone’s diaphragm, and when I say that, I mean it’s the area at the base of your ribs, it’s an upside down bowl and it works with your pelvic floor. Your pelvic floor is an upside, like a regular size bowl. They work together. So if your diaphragm’s restricted, it can’t get that inferior movement, that descending movement to then help relax the pelvic floor. And then the diaphragm relaxes and the pelvic floor contracts. And so they work inversely together. So if our diaphragm is restricted, this is one of the major ways we can show our body that it’s safe. It works with the vagus nerve to calm the nervous system. So I will see people feel significantly relaxed after leaving the office because we’re starting to get their bodies to feel like it’s safe. And sometimes it’s the first time they’ve ever felt that way.

I had one person in particular who was just chronic pain, just chronic anxiety. And I said, and chronic hip pain and the hip pain wasn’t improving with more traditional physical therapy type stuff. And I had said to her, “Can you give me a minute? Can we practice regulating your nervous system?” And I explained why it’s important. Had her lay down on the bed, walked her through mindfulness exercise, focusing on her diaphragm breathing. So breathing through the belly and allowing those ribs to expand and come back. And I also have something on my ceiling that it’s a little kinetic piece of art. It’s like a little mobile that you … And usually people use them for babies, but my clients love them because they move slowly and are controlled. And so when one moves, the other moves. So it’s all kinetic art, so it just moves freely.

And I tell them, I say, “I want you to slowly track that. ” When you slowly track with your eyes, your body doesn’t think you’re being chased by a bear. If it’s going fast, that’s when it’s thinking, “Oh gosh, danger, danger.” And you slow that down, so their vision slows down. And then I get them to notice what this feels like in your body? Dropping them into their senses, sensation. What does the pressure feel like on the bed, under your heels? How about the bolster, under your knees? What are some of the sounds that you’re hearing? Do you notice any colors on the mobile that you notice? Any smells? And when they can start getting into their senses, their five senses, I don’t really add taste. So the four senses, they can really drop in because that’s all they’re focusing on.

Lorne Brown 

I love what you just shared about the fascia and the diaphragm, because that was one of my things, that stuck diaphragm for sure. I sometimes even get that spasm even, right? And I bet if you have that … And then the vagus nerve … I love this. I’m going to have to listen to us again so I can hear more of what you just said because there was so much there that is important. For the listeners, I’ll say, “Just lie on Mary’s table.” And she’ll do it. You don’t have to understand. You just have to tell her where it hurts, tell her your symptoms, and then she’ll go and palpate and release.

Mary Grimberg 

Well, I wanted to add on to what you’re saying is we want to support our natural hormone production as much as possible during this time. And our body’s going to prioritize survival. Reproduction is not survival. It’s a luxury for our body.

It’s going to prioritize cortisol to keep us alive. It’s going to shoot up our blood sugar. It’s going to keep us running from that bear because that’s what it thinks is happening. Estrogen and progesterone, hey, you can wait. We got to stay alive. And when you can start looking at it that way, you can really start to understand. And I think a lot of people have a real hard time in perimenopause, and it was a hard adjustment for me because I was thrown into it fast. We’re not aware of our bodies. And I speak this as somebody that is going through it and it was thrown into it.

And so I want to help people even before they get to perimenopause so that transition isn’t as hard because there are some people that go through it swimmingly with minimal issues. So it’s not a disease like you’re saying. And I just want to remind people the power is with you. It starts with you because there’s so much fear mongering around menopause right now. You go on social media and it’s fear, fear, buy this, this, this, this, this. And it really starts with you. And you can add on all of the greatest and latest things, but it won’t, in my professional opinion, it won’t stick until you understand your body’s nervous system because it just won’t hold.

Lorne Brown 

When you interviewed me on your TMI podcast and today and our discussions we’ve had, the message here, first of all, is this is a normal phase in a woman’s life and you do not need to suffer. So if somebody’s dismissing you, find another practitioner or listen to Mary’s podcast. I have a ton of episodes on perimenopause, menopause from OB/GYN, so you can get the information to go to somebody to help you. And there are many horses, tools that you can add to support you in this transition. So it can be swimmingly, it can be easier, if that’s if I’m understanding correctly from our discussion.

Mary Grimberg 

Yeah. I mean, it’s still … Hey, I’m still in it. So even just the last few weeks, I’ve been having more histamine issues. I’m like, oh, okay. It’s frustrating. All right, what is my body saying? Okay, well, I need to be adding … I’m working with a functional medicine doctor, an acupuncturist, and realizing, oh, okay, I need to start rebalancing my gut. There’s different foods I need to be eating. I was eating the same things over and over and they were all healthy, but it wasn’t working for my body and I needed to cut out caffeine. And when those things start happening, it’s like, okay, so it’s refined, refining, refining. And it’s easy to get frustrated, but I don’t want to stay in the anger because then your nervous system gets set off. So it’s like feeling a frustration, moving through it, finding a solution and then working and having this different point of view of what is my body trying to tell me versus how can I fix my body?

You don’t need to be fixed. You just need to learn how to listen.

Lorne Brown 

At the time of our recording here, I was just on retreat and the majority of them are women and the majority of them are perimenopause, menopause. And they were sharing and the discussion was how this brought them to the work to do deeper work because what the hell’s going on? And not a lot of things were working. So they finally had to go in and check on their house inside, and they’re so glad they did. And to be a great mothers, you don’t have to have a child to be a great mother talking about that maternal instinct or what your role is in the community. Because in Chinese medicine, before you go into perimenopause, menopause, the energy is going down to your uterus every month to support a pregnancy. And then perimenopause and menopause is a redirection of these resources, this energy rather than your uterus that’s going to the shin like a heart center because you’re wiser now and now you have a chance to be the matriarch for your community.

And it’s also a survival mechanism because it takes a lot of energy to bear a child. And once you get to this stage of your life in your mid to 40s and beyond, it wants to keep you alive. So it’s conserving the energy for longevity. And so there’s wisdom there. And so we go along with it and you can’t, although you may want to look and do things you did at 19 at 49, currently you’re not meant to live that way. Things have to change. You got to work smarter versus harder, I guess, is the expression. So again, you can fight what’s happening, which I think would aggravate the symptoms. Or from what I understand, Mary, your approach was you used this as an opportunity to listen to your body, to listen to yourself. And it sounds like you reconnected or connected to an aspect that you were kind of ignoring before you got cancer and all the burnout, and it’s changed how you are now and how you address the women you see in your practice.

Mary Grimberg 

Oh yeah. I mean, everything goes through this lens of my … Would I be proud of this on my deathbed? I know it’s really deep, but it’s true. Every decision I make, I’m like, is this a fear-based decision or is this out of love? Even with business stuff, it’s hard because even in business, it’s been difficult for me to find mentors that align with this type of vision. “Hey, I still like to build a business, but I want it to be heart centered.” And adding on the spiritual aspect is that as your estrogen progesterone is declining, so is your tolerance for things that don’t align with you. So your soul’s asking you to be redirected and you get veer off course and then you’re pushed back. Veer of course, it pushed back. And the more we veer off and come back, okay, well, maybe we need to learn a few times.

I’m one of those people. I knew I needed to make these changes, but I was delaying. I was like, “Not yet, not yet, not yet.” And I know this work and I’m doing it. It is what it is. And then I had to surrender because I was like, okay, I am trusting that there is more. I am supposed to learn something from this. I don’t know what it is yet. And as each day passes, it’s evolving and it shifts my energy from anger to, okay, there’s a bigger plan. I don’t know yet. Look at where cancer led you. Cancer was a gift to you now. And it took me a long time to get there, but I’m so thankful that I’m awake at 39 when so many people my age are still running around with their heads cut off and just disconnected from the beauty in life.

And I really want to try to reel it in. And I believe that perimenopause is this perfect opportunity for us to all have that collective awakening because you’re almost worse off. And

Lorne Brown 

The conscious circles, the way you just described this, rather than you had a perception shift. Rather than, why is this happening to me? You went to, why is this happening for me? And that perception shift also impacts your nervous system, right?

Mary Grimberg

Yeah, it’s lighter. You don’t feel like, “Oh, I got to control because you don’t have control. That’s an illusion.”

Lorne Brown 

Yeah. How do our listeners connect to you and learn more from you? So your website, your podcast, we’ll put them in the show notes, but can you just let us know where to find you?

Mary Grimberg 

Yeah. So I’m on Instagram, YouTube, and TikTok @drmarypt. You could also find me on drmarygrimberg.com. You can learn about our physical therapy practice in Austin, Texas. It’s resilient-rx.com. And then my team, I talk with Dr. Mary podcast as well. And then also I do have a, if you’d like to jump on my email list for future updates, I’m working on building some retreats and more offerings in the pipeline for 2026. And I also have a free heart rate HRV tracker. So I gave that to your team, I believe. And so in that, so much of heart rate variability is focused on the physical and sleep, but I have a tracker with a guide that helps us understand stress so we can see it in real time on our Apple Watches or on a HRV tracker. And it’s a nice way to start understanding. Maybe we don’t feel things in our body yet, but maybe we can start seeing them through data and realize, oh, if my heart rate variability dropped, what was I stressed about?

And then I also have emotional prompts too. Did I say yes to something I wanted to say no to? Did I take on too much when I didn’t need to? Because that can really help you hone it in too, because that’s something for me. I didn’t understand that connection with my body, but when I saw the data, it helped me start understanding it a bit more.

Lorne Brown 

Well, that I like. So say that again. Where do they find that? Because I love finding data to give you prompts so you make the unconscious conscious so you can start to make choices. You said you give some emotional prompts. So can you share where they find that part?

Mary Grimberg 

Yes. I will send you the link so you could put it in the show notes.

Lorne Brown 

It’ll be in the show notes. But what are they looking for? What will it be called?

Mary Grimberg 

Oh, HRV tracker.

Lorne Brown 

HRV tracker. Perfect. Yeah. We’ll be in the show notes. Perfect. 

Mary Grimberg 

Yeah.

Lorne Brown 

All right. Mary, I’m so glad we got a second chance to chat. I invite everybody to go listen to our conversation on TMI with Dr. Mary. Also check out the episode, I really enjoyed it with Dr. Mitchell Abrams on her podcast and listening to the one on my podcast with Dr. Mitchell Abrams. So we’re on both. Coherence Code Podcast has Mary and Mitchell Abrams and TMI with Dr. Mary has Mitch and me with Mary as well. So hopefully you check those out. Mary, I really enjoyed this. Thanks again for taking some time with me to talk again.

Mary Grimberg

Thank you for having me.

Lorne Brown

Just a follow-up to our conversation with Mary. I just want to share a few episodes I mentioned and other few that you may be interested in if you’re in your 40s or beyond, or you’re experiencing perimenopausal symptoms and symptoms in the menopause phase of your life. First of all, I gave a shout out to Japp Van Der Wal. He’s at episode 84 on basically spirituality. He’s an embryologist that became spiritual from understanding the embryo and he talks a little bit about fascia there as well. Neil Theise, a doctor, liver pathologist, 86. Hebridges science and spirituality. Super interesting. Then I’m just looking at some of my list here. We got episode 89 with Jerilyn Prior. So she talks a lot about hormone therapy in particular, progesterone hormone. We got Nicky Keat. She’s in there twice. So look her up, episode 91, and there’s one somewhere in the hundreds.

We got Lara Briden there as well as Kali, MacIsaac and Ashley Damm. There’s quite a few I have on perimenopause and menopause people going through that transition. But those are the names. I think if you check those out right away, they may give you some good information that you can then go to your healthcare provider to get that support because we don’t want you to be dismissed. And two is we want you to get the support so this can be a smooth transition because the transition is happening whether you want it or not, you’re going to go, if you live to your 50s and beyond, you’re going to go from regularly cycling, menstruating to no longer cycling, and it does not have to be a time where you’re suffering. So that’s why I want you to get this information. Also, if you go to my blog, either on acubalance.ca or Lornebrown.com, there’s a section on menopause under the blogs.

So if you go there, that’s where I put all the episodes that relate to menopause and perimenopause for my podcast. And I have just specific blogs that we’ve written about perimenopause, menopause to give you information to support you during this transition. Wishing you all the best. Thank you. Thank you for spending this time with us on the Coherence Code Podcast. I’m Dr. Lorne Brown, and I will see you next week for another conversation on coherence and healing. If this conversation resonated with you, please like, subscribe or follow the show, and also share it with someone who might benefit from it as well. Remember to take a moment to breathe, reflect, and stay connected. Welcome to the Coherence Code Podcast.