Hormones, Rage & Brain Fog: The Truth About Perimenopause with Dr. Carrie Jones

Carrie Jones 

So one day she loves you and the next day she’s going to stick the fork in your eye because it’s a rollercoaster she can’t control. It’s a very common universal … I mean, I’ve probably read tens of thousands of comments at this point of women who completely can identify with this. And then what happens is they blame themselves. They’re like, “Well, I must be wrong. If something’s wrong with me, hysteria, hysterical. What do these things come from?” It’s about women who were put into insane asylums when honestly what they probably needed was some love, some patience, some grace, and some hormones.

Lorne Brown 

In better men.

Carrie Jones 

Well, in some cases.

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 in 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.

So most women don’t come in saying, “Hey, I think I’m in perimenopause.” They come in saying, “You know what? I don’t feel like myself.” And today we’re going to be talking about what’s really going on in that phase and why it often gets missed. To help us unpack it, I’m joined today by Dr. Carrie Jones. Dr. Jones is a naturopathic physician who specializes in women’s hormones and perimenopause. She’s widely known for her expertise in hormone testing. Having served as a medical director of Precision Analytical, that’s the lab behind the Dutch test. She’s also completed advanced training and residency focused on women’s health and endocrinology, holds a master of public health and has taught and lectured internationally, including at the conference, the Integrated Fertility Symposium that I get to host. What I really appreciate about Carrie is how she actually takes what can feel like a black box such as hormones or perimenopause and makes it actually understandable and actionable.

Carrie, welcome to the Coherence Code Podcast.

Carrie Jones 

Oh my gosh. I’m so excited to see you and of course thrilled to be here.

Lorne Brown 

It’s good to have you back. For our listeners, Carrie has spoken at the Integrated Fertility Symposium on Healthy Seminars. She’s done a few things, so I know what a wealth of information she is. And she’s a woman who I think is probably perimenopause herself. She is. So she’s going to talk not only clinically, not only trained as knowledge, but she’s going to talk from experience, I’m guessing.

Carrie Jones 

Yes, most definitely.

Lorne Brown 

So lots of fun to hear. To start off, what is happening in the perimenopause? People think we have to differentiate menopause versus perimenopause. And then most people think, oh, I don’t feel like myself, but it can’t be related to menopause because I’m not having hot flashes and night sweats. So can you just introduce perimenopause? Because that’s where I see the majority of my patients actually.

Carrie Jones 

It’s funny that you said that a lot of women don’t come in and go, “I think I’m perimenopause.” I was making the joke the other day that women will hear midlife like, “Oh, you’re in the midlife.” And I was like, “No, that’s my mom. My mom is midlife.” Oh, wait. Wait, no, I am midlife. Dang it. That is us. So perimenopause is the transitional period. It’s about a six to 10 year transitional period that can hit late 30s depending on the woman into the 40s and early 50s. And when I say transitional, I mean it’s like a reverse puberty. So we all remember puberty. We had to go through all these changes for years until for women they get their period, then eventually hopefully it’ll get regular. And that’s like when all the reproductive stuff and the growth stuff and the development stuff turns on.

In perimenopause, we’re backing out of that. So it’s not an overnight sensation. It is truly a year’s process where the brain unwinds the fertility aspect, our hormones start to shift, our ovaries in a sense start to close down. And because of that, we get a lot of symptoms, just like we can have a lot of symptoms through puberty. Now up until the point a woman has her last period for the last time when she has gone 12 consecutive months with no period, that’s the doorway of menopause. So it’s definitely a different definition. Perimenopause is the transition leading up. She absolutely usually still has her period regularly for a while. Then it gets irregular. Then she starts skipping long periods of time. Eventually that 12 months hits and then she’s like, “Congratulations, you get a crown, a certificate, the next phase, you are considered menopausal.” And in a lot of cases we call them postmenopausal, no longer reproductive, no longer having periods.

Ovaries aren’t doing what they used to do.

Lorne Brown

Right. Thanks for that definition. And remind me of this, it’s not a medical condition. It is a natural transition phase. Chinese medicine says it perfectly. In the way you talked about reverse puberty, I think it is how you used it.

Carrie Jones 

Yeah.

Lorne Brown 

They say that puberty is the first spring and menopause is the second spring in women. And so the energy or resources that went to gestate to reproduce is now redirected to the heart center. So you can be the matriarch for your community. And also it’s a survival mechanism in the body. As we age, we need our resources to help us stay healthy in old age so we don’t want to use resources for reproducing. So it’s also just wisdom in the body. It’s kind of cruel because I was just thinking, as you said, the reverse puberty, often in that family, if they have a daughter, often they are in that stage of going through puberty, they’re teenagers when their mother is going through perimenopause. So in a heterosexual couple or any couple, that must be a crazy household sometimes.

Carrie Jones

And I hear it all the time. I have a lot of women that I consult with or in apprenticeships or former patients who are like, “Oh my gosh, my daughter’s 13,” or, “Oh my gosh, my daughter is 15.” And she’s definitely going through it. And as pheromones do, I have had perimenopausal women say, “Yeah, I was skipping my period for a while, but then my 13-year-old got her period and now my periods came back.” And I’m like, “Yeah, that can happen. It’s not going to be forever, but you are going through your own springs for sure.”

Lorne Brown 

Well, I want to talk about the symptoms that can show up because we often see women come into our practice where they’ll be put on antidepressants, maybe in the birth control pill, they’ll be put on NSAIDs, anti-inflammatories, allergy medications. There’s lots of things going on. And when we sit with them, we realize, oh, this is part of the perimenopausal phase and we don’t need to treat it necessarily that way. Can you share the most common, most popular signs and symptoms that … So the women can start thinking, “Oh, this is what’s going on. ” And I would love for you to tie in the biology, what’s happening in the hormones behind these signs and symptoms that you’re seeing and noticing.

Carrie Jones 

In research, we divide it into the stages of perimenopause. So we have an early stage and a late stage. The early stage is when cycles may change by, they call it, they say seven days. I would argue most women notice their cycles change by three or four days to start. So they might have been a 28-day girl, another a 25-day girl. And eventually they may get to a 21-day girl or a 35-day girl, but that’s how they define early. In early the hormone that changes first is progesterone. And progesterone is calming and she’s soothing, she’s relaxing, she makes really easy periods. But if it starts to decline, then women start to say things like, “Ah, I don’t sleep anymore.” All of a sudden I wake up at 3:00 AM or, “Geez, I thought I had my anxiety under control, but I’m feeling really quite anxious.” Or they’ll go more extreme.

They’ll go, “The rage. The rage is getting me. If my partner clanks his spoon one more time, I’m going to just punch him in the face and fly off the handle or the opposite. They’ll get depressed. So they’re like, I don’t know what’s wrong with me. I have a great life. I have a great job. I have great kids. Everything’s great. The world may not be great, but everything in their immediate area is doing pretty well. And they’re like, I’m just so sad. I’m so depressed. There’s a lot of fatigue that can happen, that the hormone changes can really affect menstrual cycles. So some women will say it’s really heavy. I’m in a lot of clots out of nowhere. All of a sudden I have cramps. I’ll get women that say true puberty. They’re like, I’m getting acne. What is this? Why am I getting acne?

So progesterone changes first. Then estrogen starts to change and it will swing up and it will swing down because it’s a little bit chaotic for a while and eventually everything drops low. And when that estrogen starts swinging, this is when women start to say, now not only am I not sleeping, but I’m also getting hot flashes at night, or I’m waking up hot, or I’m having full-blown night sweats, or I’m having them in the day, or my joint pain is getting bad. I have this right hip pain that I just can’t get comfortable with. I stretch, I foam roll, I don’t understand. Or they’re like shoulder pain, frozen shoulder, big toe pain. These random pains that they’re thinking, “What did I do? I must have injured myself. I must have done it while running. Must be age.” And it turns out hormones are very involved. Dryness.

A lot of women notice dry ears, so they’ll get itchy, scratchy ears. They’ll get dry eyes, dry skin, dry hair, dry vaginal symptoms. So painful, we call it genitourinary syndrome of menopause. So pain with sex, pain in general, changes in the skin, the atrophy or thinning of the skin, urinary tract infections. And there’s over a hundred documented signs and symptoms. So I could definitely go on. There’s some weird ones like phantom smells that can happen and worsening tinnitus or ringing in the ears. I’ll hear nervous system changes. So like zapping, they’ll have all of a sudden they’re like, I get these weird zap sensations on my legs or in my arms out of nowhere, but it’s a progression. So what I hear is that women will start out with symptoms maybe in their early 40s and by mid or late forties, if they’re still sort of trying to cycle, they’re like, “Oh yes, I’ve progressed.

I’ve graduated into these new symptoms.” Or somebody may listen and go, “I don’t have any joint pain.” Whereas somebody else will be like, “I have a ton of joint pain.” These changes in estrogen and progesterone impact all 12 systems of the body. So one of the big keynotes I like to hit home is that your experience may not be the experience of your best friend or your sister or your neighbor. They may have a bunch of cardiovascular symptoms like heart palpitations, heart irregularity. Their blood pressure might go up and you don’t have any of that, but you have all the gastro symptoms like all of a sudden you’re bloated all the time and all of a sudden now you have heartburn out of nowhere and constipation and some hot flashes. And the answer is we want to make sure it’s nothing else, but as I said, it impacts all 12 systems of the body.

Lorne Brown 

Joy oh joy.

Carrie Jones 

Yeah. I know. The people go, “Is there any upside?” I’m like, “Yes, there’s a ton outside.”

Lorne Brown 

But I want to kind of repeat some of these because the increase in histamine, the itchy ears and the runny nose is a common thing and often they’ll start to treat symptoms. So they got an antidepressant because you said they’re waking up at 3:00 AM. So they’re feeling anxious or depressed or they go on an antidepressant. They go on a sleep aid because they’re waking up at 3:00 AM. They’re on some anti-inflammatories because they’re having joint pain and achiness. And at the end of the day, we’re chasing symptoms, but we’re not going after the underlying cause. And so we’re going to get into the testing and the underlying cause, which is related to the hormones. But I think of my wife, and I can talk about my wife on my podcast because she doesn’t listen to it.

Carrie Jones 

That’s awesome. 

Lorne Brown 

Yeah, she was like for ages, we need a new mattress, flip the mattress because of that hip, right? Yes. The hip is comfortable. Women come in, just the descriptions, I don’t feel like myself. And I saw the documentary M factor two before the pause. And one of the doctors used the acronym NFLMS, not feeling like myself. Yeah, that is most common. I got to share a story with you. I was out for dinner with the boys. We do this once a month and this one was about 10 of us and we’re eating and having a good time. Actually, an interesting stat. All 10 of us have been in with our partners for over at least over two decades. None of us are divorced.That’s a cool stat. That’s a very cool stat.

Carrie Jones 

Yeah.

Lorne Brown 

So one of the guys said, “I’m having trouble in my relationship. I can’t do anything right.” She is constantly mad at me when I chew. Whenever I do, the kids are like late teenagers, right? Some of them are in their 20s, even though they are scared to be in the house with her. I think I got out of this relationship. She’s not the person I married. And I didn’t say anything yet, but I was like right away, I was like, this is what I see in my practice. But another guy goes with his mouth fool chewing. And you got to understand, the group is scientists, entrepreneurs, doctors, so doctors. None of them knew except for the one guy who was a dentist, but it was because his wife had already gone through perimenopause and was already two or three years into menopause with his mouth chewing.

He goes, “It’s menopause.” He goes, “Yeah, I thought I had to leave my relationship too. I had three and a half bad years. It was bad. And now that she’s in menopause, all those hormones have calmed down and our relationship is perfect.” He goes, “Don’t divorce her. You just got to wait it out. Tickle.” And then I tuned in a bit about, there’s actually things that she can do right now so she doesn’t have to experience all these signs and symptoms and rage. So anyways, I thought

Carrie Jones 

For the guys. As a woman, I’m almost 50 and still perimenopausal and I have to explain these things to my husband all the time and not only explain to him, but re-remind myself, okay, his chewing is not that bad. He’s not that annoying. I don’t need to rage against the machine for whatever he’s doing. But I hear this all the time. There’s a hilarious social media. He’s like a comedian on social media and he was explaining how when women go through menopause, it’s not the words out of your mouth, it’s the tone and breathing and chewing and using your spoon and fork are considered tone. So if you’re breathing too loud or chewing too loud or you’re clanking your spoon, you’ve hit the tone wrong and she’s going to fly off the handle and correct you. And it was just hysterical because there were thousands of comments of women who were like, “I can completely relate.

I’m sending this to my partner.” Absolutely. I do find in this time, women have been caretakers historically. They’re always the caretakers. They juggle all the balls. They make all the things happen, especially if they have a male partner, that’s what I’m referring to. It’s not that maybe men aren’t great husbands or fathers or what have you, but when women view the world differently and take things on differently historically than men do. When these hormones shift, when we get into puberty, let me back up. When we’re young and getting into puberty, I had a neuroscientist say to me, “We wire up to be a mother. Not everybody gets the best wiring. I realize that. But we wire up to do things like if you get pregnant to try to do what’s best for the baby. When the baby’s born, like when the baby cries, what does that mean?

Attend to the needs of the baby, pull the family together, be the matriarch of the family. When you go through perimenopause, you don’t need that wiring in the brain anymore because biologically the point of perimenopause is to back you out of your reproductive years. You’re no longer going to be able to get pregnant at a certain point here. So why would we need the wiring for all that maternalness? Why would we need the wiring for listening to a baby cry or things like that?

It doesn’t mean we still don’t have part of it in menopause, but the backing out of it’s very wild. And so it impacts all of our brain hormones. It impacts even our hormones like oxytocin, which is our love and our bonding hormone. So women don’t have that like, oh, that’s cute when he chooses like that. That’s cute when he’s constantly clearing his throat. It’s fine. It’s not a big deal. We lose that buffer temporarily for a couple years and because the buffer’s gone, it’s usually irritation and rage and contempt that comes through because we’ve always had this great buffer through our various brain hormones and this stability of our other hormones, estrogen, progesterone for years to come. Now, just as your dentist friend said, once she’s on the other side and even if these hormones are low, they’re in a steady state. So I’m not saying that being low is great either, being at a very menopausal low level, but the steady state is important.

She doesn’t feel like she’s on an out of control roller coaster. So one day she loves you and the next day she’s going to stick the fork in your eye because it’s a rollercoaster she can’t control. It’s a very common universal … When I read the Reddit boards, when I read the Facebook groups, when I read social media comments, I mean, I’ve probably read tens of thousands of comments at this point of women who completely can identify with this. And then what happens is they blame themselves. They’re like, “Well, I must be wrong. Something’s wrong with me. ” And it’s hysteria, hysterical is where these things came from. It’s about women who were put into insane asylums when honestly what they probably needed was some love, some patience, some grace and some hormones.

Lorne Brown 

And better men.

Carrie Jones 

Well, in some cases, that’s the other thing I wanted to say about the divorce statistics. In some cases, just as your dentist friend said, maybe wait a couple years, it’ll be better and also step up and be a good man. But on the other hand, I do have a lot of women that go, “I’m tired of holding it all together and he’s not the partner I want or need or deserve, and I’m going to stand up for myself and be more authentic and I am going to get divorced for myself.” And so we do see divorce rates go up for both reasons. She’s tired of putting up with him as a child or him and not as the partner she’s hoping for and vice versa, but also her hormones are all over the place.

Lorne Brown 

The filter’s gone. So I think men can do better. I can do better, men can do better. And what’s happening in perimenopause is that the filter of patience and kindness is gone and now the guys are, they’re noticing how we’re not stepping up to the game in our culture. It’s our culture, right? Yes. And so I guess if we put everybody into perimenopause, maybe men will learn to step up, right?

Carrie Jones 

Right, exactly. That and

Lorne Brown 

Just- Maybe we shouldn’t be treating this.

Carrie Jones 

Right.

Lorne Brown 

But

Carrie Jones 

Also why aren’t they stepping up from the beginning? So then it becomes about boundaries and truths and-

Lorne Brown 

Carrie, I got a new treatment plan. We’re going to talk about all the treatment that the women can do, but now we got to talk. We also have to add another module where the guys send some men to how to be a good man in the house.

Carrie Jones 

Starting from a young age.

Lorne Brown 

Absolutely.That’s also, like you said, it’s not all in the women. Maybe men need to step up a bit more. Agreed. We talked about the symptoms. We’re going to talk about how to look into this. So there’s kind of two camps and I’m curious where you’re at. And because of your background with testing, the Dutch test, I’m curious how you do this. And I just want to share the two camps. There’s one camp that will do testing, like try and test your sex hormones. So they’ll look at the progesterone and estrogen, a serum blood test or even maybe a Dutch test. That’s not how my clinic does it. Because of what you said, these hormones are going up and down so much in perimenopause, particularly estrogen’s really erratic and progesterone can be, but mostly on a decline. We go by where are you age-wise and what are your symptoms?

We will test other things because we’re looking at cardiovascular health, metabolic health, vitamin D, other thyroid. We’ll look at other things. So I’m curious about the big picture, but we tend not to run a DUTCH test if we think of somebody’s perimenopause nor a serum blood test. Again, in general, there’s always a specific case for somebody individually. And we’ve just started to change and I want to chat with you about this, the at-home test. So for example, in our clinic, a lot of our patients use MIRA. We recommend MIRA. It’s an at-home test where it’s a urine test where we get a daily progesterone, estrogen, LH and FSH. And I want to know because a one snapshot to me is really not that useful, but we’re just getting really good at it and I want to learn more from you about using these at home tests because I think that can give me some information.

That’s my thinking. I’m curious what you teach and how do you see this? And then we’ll unpack more about all these tests.

Carrie Jones 

Oh, for sure. So the menopause guidelines, as you said earlier, like perimenopause, it’s not a disease state, it’s a natural state. And so there’s no test for the diagnosis. Do you have perimenopause? Again, it’s age and symptoms just as you said. So the menopause society said, why test? Don’t test estrogen and progesterone. It’s all over the place. So what I tell when I teach, what I say is if she’s in early enough perimenopause and she still has regular cycles and you want to know what her estrogen and progesterone are doing and specifically maybe more advanced, you want to do a Dutch and get the metabolites like where does estrogen going? Where’s testosterone going? Cortisol, then absolutely go ahead and do it. When she’s on the throes of perimenopause and it is a wild rollercoaster we have no control over, I agree with your clinic, you and your clinic, I don’t test the estrogen and progesterone.

I absolutely test everything else, thyroid and glucose and insulin and cardiometabolic and vitamin D and cortisol things because those can also go haywire and get worse in perimenopause, but they’re not necessarily cycle day specific. So I don’t look at estrogen progesterone. Once she is postmenopausal, or let’s say once she’s like, “Well, I haven’t had a period in like eight months.” So she’s not at the 12-month mark, but she is eight months in and let’s say she’s considering hormones or wants to see what’s going on. I’m like, “Yeah, you haven’t had a period in eight months. If you would like to do estrogen and progesterone in a Dutch test or a blood test, I’m totally fine with that. If you want to see it, I know what it’s going to be. It’s going to be low, but here we go. ” I like you, I have been using the MIRA test myself.

I got into it a year ago. I saw the ads online and they were promoting fertility and I was like, “Hold on, I would love to know what my hormones are doing day to day because I am in the throes of perimenopause.” So I bought a test, started testing it and I was like, lo and behold, some months I ovulate, some months not so great. I could see this up and down. I could see things related to migraines I would get or symptoms I would get. And so I reached out to the company and I was like, “Why aren’t you talking about perimenopause?” And they were like, “That’s a brilliant idea. We should really get into that more.” And so I’m really glad because a lot of my colleagues, a lot of my friends who are still cycling but kind of perimenopausal, you get to see day to day.

So I jokingly say you see the entire forest instead of one tree. When you get your blood drawn, that’s one tree. Your estrogen on Wednesday at 80 AM is this number. Is it the same at 8:15? Is it the same on Thursday? I have no idea. We don’t know. All I know is one day. So I really am loving the broader scope that I can see of somebody’s whole cycle. I just consulted on a case, a perimenopausal woman, 48 years old. She was getting headaches and what felt like yeast infections through her cycle, but her cycles were really weird and irregular. She actually did a mira. So her doctor sent me the mirror and was like, “What do you see?” I was like, “Look at her estrogen. It’s up, it’s down, it’s left, it’s right.” I said, “Nope, these massive swings play a big role in the vaginal microbiome and it plays a big role in serotonin in the brain and a nerve we have called the trigeminal nerve and migraines that can be associated with it.

” So no wonder she’s so symptomatic. Look at this wild ride she’s on. And it was really validating for the patient to go, “I’m not crazy. I knew it was hormones.”

Lorne Brown 

It does help with that validation and lets you know if you’re ovulating and it has that AI part. So all the women that are putting into this and it learns about you over two to three cycles. And like you said, I love that tree analogy. So you’re seeing the forest because you’re getting to look at it daily versus one day in the month.

Carrie Jones 

Yes. Because what can happen is, you probably saw this all the time. You send a woman to get blood work done. Let’s say she’s in the second half of her cycle, the luteal phase and she gets her blood work and her progesterone looks great. It’s like the number you want it to be in the blood work on that one day. But she says to you, “Lorne, I’m having horribly heavy periods. I don’t sleep. I’m anxious. I feel terrible. Are you sure my progesterone is good? I know that one day is good.” Then you do something like Mira and you’re like, “Nope, you literally are good one day.” One day it spikes up and then it crashes back down. And of course, I see that all the time in perimenopause. It’s like they get enough oomph to make progesterone for a day or two and then it just crashes right back down.

So it’s misleading. The lab’s not wrong. They were at a good level that one day, but it didn’t mean it lasted. And that’s why she says, “I felt terrible.” What do you mean it looks good in the lab work?

Lorne Brown

Yeah. And like you, we’ve had it for a little over a year, year and a half, maybe two years now and we started with fertility using the Mira and we don’t test the serum, the sex hormones usually for our perimenopausal patients. But because of the mira, we’re like, oh, maybe we need to think about this again because this is different. It’s looking at it daily versus once. So now we can get some information. And as you shared, patients can look at this because they have it and they share their dashboard with us. They can start to say, “It’s just nice to know that there’s not something seriously wrong.” We keep talking about the brain. One of the common symptoms we also hear is the brain fog. Brain fog. That’s another common. They just feel not sharp and that fatigue in the brain, all this stuff related to hormonal changes.

So to unpack the testing a bit more, I just want to hear what you’re doing. So we’re looking for overall health. And so we often will look at a thyroid panel,

See what their B vitamins are doing, vitamin D levels. Because of the cardiovascular risk for women in this stage with the hormones, we’ll look at their cholesterol, the triglycerides. Is that something you’d look at? And then cortisol can be all over the place and that can impact weight gain and sleep cycles and blood sugars can change as well. So often do the blood glucose, we’ll look at cortisol. Are you doing that? Because that’s our holistic approach. Our goal is not just to test the bare minimum to see, oh, you’re not going to die. Our women want vitality. They’re like, okay, what systems are out of balance? How can we help these systems? So did I do any testing or-

Carrie Jones 

I do add insulin. I see a lot of women at this age become more insulin resistant. So metabolic syndrome, they’re getting the weight around the center, one could be cortisol, two might be thyroid glucose, estrogen related, but that insulin. And then because I’m starting to see a lot of women, cardiovascular, they can’t feel. They don’t feel their blood pressure go up, they don’t feel their cholesterol go up, their triglycerides go up. They often don’t feel their blood sugar start creeping into the hundreds, at least in the US above a hundred is not good. And so I have been looking even deeper sometimes at these lipids. If somebody’s cholesterol’s starting to look not great, especially if it’s somebody I’ve seen for a while and I’m like, “Man, you’ve had good cholesterol, good cholesterol, good cholesterol. Oh no.” Then I will do a deeper, more advanced cholesterol panel and look at apolipoprotein B and LP little A and the particle size.

And I’ll do CRP, which is an inflammatory marker. A lot of women are like, “I feel puffy. I’m suddenly inflamed. Things hurt.” I’m like, “Well, let’s see what’s going on. ” And the reason is not to just create a bunch of labs for nothing or spend a bunch of money. They’re all trackable and they tell me something so that as we work on a plan for you, I want to make sure these are going down. We often talk about men’s and women’s health, we call them the four horsemen or the four horse women of the apocalypse. It’s the four things we want to avoid or minimize as best as possible. The first one is cancer. The second is the cardiometabolic because heart disease is the number one killer of people. Then we have the third neurodegenerative. So think dementia and Alzheimer’s and then the fourth is fragility.

So osteoporosis, osteopenia, you fracture and break a hip, God forbid a femur. Something happens to the bones, you’re unstable. And so these are the four things for a longevity purpose and we can track them in blood.

Lorne Brown 

DEXA scan. We also do that then. You mentioned the dust purplesis. We do that too in our clinic.

Carrie Jones

Which I think is great because in the US the DEXA scan isn’t until like 60 or 65 and everybody’s already awesome. It’s too late then. I wish we could do it at 40. Yeah.

Lorne Brown

And if we do it at 40, then we can monitor and see because not all 60-year-olds are equal. So how are they changing over that decade or two? Yes.

Carrie Jones 

Yes.

Lorne Brown 

So right now it seems like we’re going to talk about hormones then. So the hormones are fluctuating. And so the Chinese medicine idea of this and my idea is hormones are not the reasons. They’re not the cause. If they were the problem, then every single woman would have symptoms and every single woman could have the same symptoms. But what we know is that not all women have symptoms when you’re in perimenopause and those that do don’t have the same symptoms. So the hormones are fluctuating, but in Chinese medicine, how we look at this is that the window of tolerance has changed and your resilience has diminished and your ability to adapt to change has diminished. So now when the hormones are changing, that’s a stress, internal stress on the body and those that have resilience and still the ability to adapt don’t notice anything because the body’s doing it underground.

But those that have had a lot, either they came in their genetics, how they came in intergenerationally or how it’s Next drugs and rock and roll, how they lift their life.

Carrie Jones

Yes.

Lorne Brown 

It’s a message to the body about resilience and adaptability in Chinese medicine, kind of the kidney system and the liver system, not talking about the Western here. Now hormones have made a comeback. So we really got to unpack this part. A, hormones, 2001 World Health Initiative, don’t take it. Then I know you’re trained and as my naturopaths and our clinic are part of that menopause society, they’ve re-looked at the research, they criticized the research, they looked at the types of hormones, whether they’re bioidentical or not, synthetic, and it’s made a comeback. We love to do extremes though. Now it’s like everybody should be on estrogen. In front of the water.

So I’d like to hear your thoughts because in our clinic we do hormones. In British Columbia, progesterone estrogen is now covered by the province for women. And so in our clinic, we are holistic. So we’re looking at the diet, the lifestyle. We’ll use supplements and other things, acupuncture and herbs. We’ll do all that and we’ll also use hormone therapy. We don’t want anybody to suffer. We don’t deny anybody hormones, but we’re not like, oh, you’re 43, you got to take estrogen. However, some docs in some movies out there say everybody should do it. And they’re quoting data that it’ll help prevent Alzheimer’s, it’ll help prevent cancers or cardiovascular disease. So can I, because I don’t think you’re paid by a drug company. I am not

Carrie Jones 

Paid by a single drug company.

Lorne Brown 

No. We’re still learning because it’s kind of fairly new that the black box has been removed and now it’s awesome that this treatment modality is back to being available to women because there’s been a couple of decades where women have suffered unnecessarily. So I just want to hear more about what we call HRT now MHT, menopause hormone therapy. And can you go into, I think dosage matters and I think the type of hormone matters and where you are matters.

Carrie Jones

And I still call it HRT. I understand why they call it menopause hormone therapy, but I’m not menopausal yet. For me, it doesn’t resonate to say like, oh, if I take MHT, I’m like, well, I’m not there yet. I still cycle regularly.

Lorne Brown 

I think it was a rebrand. I think it’s a rebrand. They’re trying to rebrand. It has a bad name, right? There’s fear

Carrie Jones 

Around that. That connotation. When I was first going into second year medical school when the WHI came out and I was very lucky, my attending, my mentor said, I mean, we’ll be careful, but I’m not going to stop prescribing hormones. So I feel that I have had, I mean, I graduated in 2005. I’ve been licensed for 21 years. So with her oversight in those early years, I have a lot of hormone experience in prescribing that I think a lot of other doctors just stopped completely. Other than the birth control pill and the IUD, they just stopped completely and didn’t until very recently. So having two decades of experience prescribing for women using progesterone and estradiol and even testosterone and everything, I always thought hormones are quite helpful. In my observation, probably in yours as well, I treated my patients the same way you did.

I found that the women who came into perimenopause were balanced, healthy, doing really well, taking care of themselves, and stress isn’t too bad. All the things did better with their perimenopausal symptoms. They weren’t necessarily immune because something like 87% of women are going to get at least one symptom, but they may only have a handful of symptoms. I was talking to a doctor the other day who’s 47, she just got her, she hit her 12 months. She was like, “Woo-hoo, I’m menopausal. I’m 47 years old.” And I said, “What did you feel?” And she goes, “Nothing.” I had to look at my app and realize like, oh my gosh, I’m now … But she lives her life, is very healthy, manages stress, all the things. And I realized not everybody has that luxury, but I did notice that. So then I noticed if you didn’t have that coming into it, if you could get that help, like if you could go see a clinic like yours and you could do all the well rounded, the foundations of medicine and if you chose to add in hormones, they worked better because what I’m seeing now is, and I’m a comment reader.

I love to read the comment section of everything. And what I see now is I’m really grateful women have the opportunity to use hormones, which they didn’t have before. Before it was like the devil and caused cancer. So there’s all these pop-up telehealth companies. There’s all sorts of clinics now that are getting trained, but then women are like, “Okay, some things are better, but some things aren’t, or it didn’t work at all for me. Or I’m still having all these side effects. I thought hormones were the holy grail. Why isn’t it working for me? ” And I’m like, “Is hormones the only thing you’re doing? Are you doing anything for your foundations of health, exercise and diet and stress and sleep and movement, et cetera, et cetera, et cetera. Are you getting any other support?” “No, I just put my patch on and I take my progesterone and I don’t feel like a rockstar.

“I’m like, ” I know. I wish we could teach more broadly that it truly is a systems approach. Estrogen and progesterone play in the entire system. So if the system is inflamed, if the system has high blood sugar, if the system is mad, if the system is in pain, if the system is in fight or flight and stressed out, hormones might actually make it worse. So I wanted to start there because I would imagine you and your team have the same observations for women. Some women do great,

Knock it out of the park with hormones, but I just keep seeing women that are like-

Lorne Brown 

Some do not.

Carrie Jones

“Ah, I thought this was a magic pill.” I’m like No, no, we’re not. No

Lorne Brown 

You still have to participate in your health. And the way you share this, it’s actually an important thing to highlight. Some women go on it and they feel worse. So it’s not like everybody’s going to feel better. So that’s just the case. And just some people do not deal well with hormones and some of those women know they didn’t feel well on the birth control pill or medicated IUD and they don’t feel well on MHT, HRT, whatever you want to call it.

The part I want to add, and then we’ll talk a little bit more about the hormones is when I was sharing about resilience and adaptability, it’s because of the fluctuating hormones. That’s a stress on the body. It’s changed. When you give somebody hormone therapy, you’re kind of balancing it out. So it’s not so up and down and a big decline like in progesterone and estrogen. However, the reason we want to do it, like you’re sharing the diet and the lifestyle and stress reduction and movement and we want to take care of if there’s metabolic inflammation or other things are off, it’s because we’re thinking long term. So yes, if we give you hormone therapy, there’s a great chance you’re going to have awesome symptom management.

However, the underlying cause of you being depleted, the resilience, these other systems out of balance and not being able to pivot and adapt will likely show up again in your 60s or 70s when you’re that much older and now you don’t have the capacity or the adaptability to deal with this. And now we see disease in older age. Our goal is that you die healthy, you die of old age. Who wants to live from 65 to 85 sick? So the idea is healthy. So when we recommend we’re going to do hormone therapy and we want to do these other things is because we know the hormone therapy is going to do symptom management, but it’s not going to address the underlying cause.

Carrie Jones

And women will say that too. 

Lorne Brown 

And that’s how we think about it

Carrie Jones 

Women will say that. They’ll say these things got better. I was listening to a woman tell her story. She had 5,000 comments where she was like, ” I don’t feel like myself. I’m super depressed. I’m angry. I’m angry. “It’s all very mental, emotional for her. And she said,” And I’m on estrogen and progesterone. 5,000 comments later, lots of women are like, same girl, same girl, same girl. “But a lot of women in the comments, a lot of women were like, ” I think it’s a feedback to you to make changes in your life. It doesn’t mean you’re not perimenopause. It doesn’t mean the change in hormones isn’t affecting you. Glad you’re on hormones, but also are you living the life that you really want? How is your stress? Are you happy? “Just checking in with your authentic self. Sometimes we just push and push and push and then we get into the 40s and perimenopause is like, ” I don’t really care about that.

I’m going to change with these hormones and I’m going to shift you to this new stage. And so if you don’t make changes, it’s going to feel worse. “I’m not saying this to blame women, but more of a mirror of like we mentioned in the beginning, is there any good part about perimenopause? And I’m like, ” Yes, I think as you call it the second spring, I think as women are coming through the second spring and this next phase of them, who do you want to be? What are you going to accept? What boundaries are you going to put into place? What things, hobbies and habits are going to bring you joy and are you going to start doing? “Because I think as women start identifying that, then some of these, especially mental emotional type symptoms also improve. It’s still part of the foundations.

Lorne Brown 

Absolutely. It’s like that wake up call and the second spring in Chinese medicine. There’s the physical, this is what’s happening, but remember Chinese medicine’s mind, body, and spirit. The spiritual is exactly what you said. It is a transformation. You are transforming caterpillars to butterflies. There’s a new woman emerging and every hot flash is like this burning off of old karma.

Carrie Jones 

There you go

Lorne Brown 

And it is a signal to shift because if you’re having symptoms, like you said, I’m glad you said it because if I mansplain it, I’m a dead man. Carrie said that this is that opportunity to look in at your life, your hobbies. Do I want to stay married to this guy? Am I going to allow him to treat me this way? Yes. So lots of changes. So there’s physical changes and spiritual changes.

Carrie Jones 

Yes, I love that. Yes. Absolutely. Now, as you said though, the dose and the route also count. So sometimes in the United States anyway, and especially in this menopause society, they’re really pushing the patch for estrogen and then the capsule for progesterone, the oral micronized progesterone as if that’s the only way.That’s what we start with. There are tons of other options, but sometimes we forget. So sometimes I’ve had a lot of women say to me, ” I tried hormones that didn’t work for me. ” And I’m like, ” Well, what’d you try? “And they’re like, ” Well, I tried the patch and I swallowed the progesterone and I hated it. “And I’m like, ” Could be the dose. There are different doses, could be the route doing a patch maybe not the right route for you. You may react to the adhesive, your skin tissue may be of a skin type that you don’t absorb very well that route when you use the patch.

The oral progesterone route, maybe it’s the wrong dose, maybe you’re sensitive to peanut oil, not in Canada, but in the United States we still put peanut oil in ours unless you get it compounded. So I tell women, you have lots of options, right? “And they had no idea. I’m like, ” You realize there’s gels, there’s creams, there’s vaginal, there’s injections, there’s sublingual. Sky’s the limit. What do you want? “We could definitely rotate this. And I think that’s really helpful for women to understand that it’s not fixed. It’s not like this patch and this pill and that’s all you get.

Lorne Brown 

And at our team meetings with my naturopaths who are also part of that menopause society like you, they shared that the dosage, like birth control pill dosage, is a much higher dose than menopause hormone therapy, lower dose. And yeah, it depends if there’s a lot of issues vaginally, then often they’ll be using vaginal applications. Some women have asked,”Can I put it on my face? “Funny enough, ” I said,” I’m going to talk to my natural mast scope. “And they go, ” dosage matters. So talk to your health provider, everybody. “But she goes,” Yeah, just like it will puff up parts of the body, some of the wrinkles and stuff will shift as well. Now we’re going to see women all putting estrogen off.

Carrie Jones 

Right. Yeah. I heard on a podcast.

Lorne Brown 

I heard a podcast. So talk to your health. So the hormones now, the study got it wrong is my understanding then.

Carrie Jones 

So the study looked at, just so everyone knows, the Women’s Health Initiative, the study we’re saying looked at synthetic estrogen and synthetic progesterone, which is called a progestin. They’re not the same, but what they did is they looked at the … When those two were combined, that’s what stopped the presses. Hormones cause cancer. There’s an increased risk and it was that progestin that actually only slightly increased the risk of breast cancer. It wasn’t massive … It wasn’t like thousands and thousands of women develop breast cancer. It was a very small increase. There was a second part of the study that was synthetic estrogen only. So women had had a hysterectomy.

Lorne Brown 

I want to just say one thing. When you say small increase in cancer, just for the listeners, because people are like, ” I don’t want cancer. “From the medical perspective, it was insignificant. 

Carrie Jones 

So all studies- They actually put that in the study

Lorne Brown 

Yeah. So there’s always things that change, but meaning that it’s not necessarily caused by this and insignificant. I just want to clarify that.

Carrie Jones 

And actually there’s a wonderful graphic out of the UK. It’s their NICE, their nice, I don’t know what you call it, department or whatever, but they show if you’re on a progestin, it’ll bump up your risk a tiny bit. If you’re on just estrogen, your wrist bumps down. If you’re on the birth control pill, it bumps up a little bit. And if you drink alcohol, of course, it bumps up even more. And if you are obese or overweight, it bumps up the most. So I know women are like, ” Oh my gosh, can’t you have hormones that cause cancer? “I’m like, ” Actually, hormones are probably the least of your concerns. If you are overweight or obese, that inflammatory visceral adipose increases the all cause cancer, but breast cancer in particular more so than going on hormones. And it’s a nice visual pun intended because they’re called nice for women to go, oh crap.

Okay. Here I was thinking that going on any kind of hormone would just blow up my risk factor and in fact it doesn’t. The media went wild with it when it shouldn’t have.

Lorne Brown 

And then as we share on the hormones, and I want to go into natural approaches here, but the hormones, they were using synthetic and it was the actual, the progesterone synthetic that they think may have been causing the issues, not the estrogen. Yes. Now we’re using bioidentical estrogen and bioidentical progesterone and these have been determined to be safe.

Carrie Jones 

Safer. Is that that they’re risk free because we do know that every … I mean, women have hormonal symptoms in their body from their own hormones, but definitely much, much, much safer in that what I was saying is there was a second part of the study that was the synthetic estrogen only. So the women had had a hysterectomy, they didn’t need the progestin. They just did the estrogen part and they had a reduced incidence of breast cancer. But that didn’t make publication until a lot later. That didn’t make the news until very recently actually that if you didn’t do the progestin, you actually had a decreased risk of breast cancer. And like I said, it’s so unfortunate how that whole study was played out. If you know the behind the scenes of the study and the pressure and the … It’s just awful. It’s just awful what it did to women.

Because immediately in 2001, 2002, women halted their hormones and then what did it do for their other risks, their heart risk, their bone risk, brain risk, like mood, just vaginal health. Other things I think about, I’m like, how women have gone without this support if they wanted it for decades at this point.

Lorne Brown 

Going into the natural approaches. So we’ve discussed so far that there’s a variety of symptoms related to changes in hormones and that you’re not crazy, but there’s a change going on and there’s some testing we can do. We talked about at-home testing like the MIRA system and we talked about other testing because we’re looking at it holistically because all these systems can be off. We want to make these systems well, even if you’re using hormone therapy, not only do you have symptom management, but you start to have better health so you can live well longer into your life. And now I want to talk about approaches. How do we bring that resilience, that adaptability? How do we work on the system? So I’ll share a quick case just because she’s in my mind because I just saw her this week. She came to me.

I saw her a couple years ago, perimenopause. She’s in her fifties now. She was having crazy heavy bleeding, so we were able to acupuncture herbal again, a couple years ago. So we weren’t doing hormone therapy yet. We were still scared of it. She came back recently and her last period was maybe three or four months ago. Her cycles have stayed well as if they’re not heavy and eight, 10, 14 days of bleeding, but she was having four per hour, hot flashes, night sweats, four per hour. I suggested she get in to see our naturopathic doctors because she may be a candidate for hormone therapy. They have a wait list. I said, “I will start with acupuncture and herbs.” I always like to do this because I’m working on that. Remember the kidney liver system? I’m basically working on the autonomic nervous system a lot, right?

Because if the autonomic nervous system gets into a nice place, it affects the hormonal, the endocrine, the immune system, obviously the nervous system. And so we did acupuncture two, sometimes three times a week over two weeks and I put on a Chinese herbal formula. At the end of the second week, she was having four a day, not for an hour. Amazing. And she’ll stay on their herbs for three to six months and I encourage her to still see the naturopaths because this may be another part of the program giving her the hormone therapy because she’s not in menopause yet, but she’s pretty close. She’s having three periods a year maybe. And so that’s kind of our approach here. I wanted to hear from you about the supplements that women would be taking or what’s most common. And let’s think about it, we got brain fog, we got sore muscles, we got in a bad mood.

I want to think of those kinds of symptoms, hot flashes, nightspots obviously, but kind of want to know your favorites or most common ones that you think generally you would be recommending. And Carrie’s not your doctor. I was

Carrie Jones 

Just going to say that.

Lorne Brown 

So we’re going to talk in general and I’m not your doctor. Even if we are your doctor, we don’t realize you’re listening to this right now. So you do need to speak to your healthcare provider, please. We’re giving you general information.

Carrie Jones 

And we’re also probably going to banter and list off a lot of our favorites. It doesn’t mean you need to write them all down and take all of them because there’s a lot of really cool things out there. We like personalized medicine. I do use a lot of adaptogenic herbs. You mentioned nervous system, stress response. I find using things like ashwagandha, rhodiola, western herbs, eleuthercoccus, holy basil, which is more Indian, Shatavari. Those are some of my favorites when people say, “I can’t handle stress or I’m tired.” I sort of pick and choose depending. I do a lot of sleeping herbs, skullcap, passion flour, even like chamomile or lavender. I’ll use cortisol calming support, phosphatidylserine, which is a part of our cell wall, but also very helpful for Zol. I use brain support like L-thanine. I will use 5-HDP. If somebody’s not on an antidepressant type medication, I’ll use the spice saffron.

There’s some cool research on saffron and mood and things like ADHD and depression I see quite a bit. I will use mushrooms. So I’ll use the lion’s main cordyceps, especially for the brain fog and brain support. I use creatine when people are working out. I like carnitine. Carnitine is a shuttler of fatty acids. So it helps your body burn fatty acids better. Unfortunately, when we break down and make fatty acids, estrogen helps funnel that into the factory that breaks it down, you don’t have a lot of estrogen. You can have issues with that and then it’ll just store right back as fat tissue and carnitine, which we naturally have in our body, and we get from food, but sometimes not enough. So we might add that. I like gut health support. So I will do digestive enzymes. I’ll do prebiotics and probiotics and short chain fatty acids like butyrate and pasteurized Arkansia.

And what else do I use for the mitopure? There’s a number of things that we can do. So you can see as I’m going through blood sugar support we can use, like berberine and alpha lipoic acid. We have inflammation support we can use like resveratrol and curcumin or turmeric. So you can see we have a wide variety and a lot of this has been studied. Sometimes I’ll get pushback from people who go, “That’s not in the literature.” I’m like, “Actually, a lot of it is now. A lot of companies have jumped on some of these herbs because they’re so potent and we do have some literature on it. “

Lorne Brown 

And you’re supporting the systems, like you mentioned, the blood sugar. So again, the berberine, if there’s inflammation, if there’s mitochondria health. So don’t take all of them. And so you see your healthcare provider. Some of those herbs like the skullcap, passion flour, safflower, there are Chinese herbs also. And so the herbal tea I like is because we can have 10, 15, 20 herbs, but it’s in a tea. So you’re not popping 20 different pills by formula. But that’s where you want individualized medicine where there’s some testing. That’s why we look at the thyroid, the vitamin D. We look at all inflammatory markers. We look at things and then we see which system is really needing the support and we go there versus giving you everything. We’re like, let’s just correct what’s out of balance and then everything else will usually fall into place.

Carrie Jones 

Yeah. I mean, even there’s support for the heart, right? There’s support for the liver, for the bile that has antioxidant status. Even melatonin, and we mentioned sleep, but melatonin is a very potent antioxidant in the body. And it’s like I said way earlier, it’s heavily concentrated in the ovaries. And so even something like that, which is most of these herbs and nutrients are very multidisciplinary in nature. They’re not a one trick pony. They do a lot in the body.

Lorne Brown 

Okay. Nice. Kerry, we’re going to wrap up here because you’re a busy person and I want to say first of all, thanks for joining me today. It’s so good to reconnect with you. I want to let people find out how they can find you. And also with the Mira Healthy Seminars, my other company, Mira sponsors a lot of our community lectures, which is great. So if you’re a practitioner, you go there, they can get you a device and stuff through the Healthy Seminars group because they’re a sponsor for health providers to test it out. And also Miras provides me in the clinic where we can give coupons out. So I have a coupon for our listeners if you’re interested. We’ll put it in the show notes, but it’s number two, Lorne Brown for 20% off that gets you 20% off your Mira supplies and your system.

So check that out. Again, I’ll put it in the show notes. So big thank you to Mira. Again, letting you guys know I used it in my practice for a while and I got introduced to it and then they started sponsoring healthy seminars and I reached out to them because I know I was interviewing you and they said I can extend that coupon to everybody. So check that out in the show notes. And Carrie, where can we find more about you? Because I know you have a podcast and you’re really doing a lot of educational outreach and you got so much more information to share than what we were able to do just in this hour, though I thought we covered a lot. We

Carrie Jones 

Covered a lot. I’m very impressed with everything we did talk about. So absolutely. You can find everything that I do on my website, which is drcaryjones.com. And even there, I have my free ebooks. For example, if you go to dryjones.com/labs, all the labs that we talked about, thyroid, cardiovascular, nutrients, if you’re like, “Whoa, this is so much.” I was taking notes but not that fast. I have it for you, of course, in an ebook. You can find me on social media on Instagram @dr.carijones. My podcast is Hello Hormones with Dr. Carrie Jones. I have a YouTube channel, which of course is @drcarijones. And basically my whole goal is free education as much as possible. So through social media, my newsletter, my ebooks, YouTube and my podcast, I am just trying whatever way you consume media. I want to help you. I even have a Substack because I want to make sure women have … We didn’t get this education growing up.

We didn’t get it young. We didn’t get it in the last 10 years. We haven’t really had it in the last five years at large. And so now that it’s become much more accessible, I just really want to help women understand their body and understand their hormones.

Lorne Brown 

Perfect. So that’s carriejones.com, right?

Carrie Jones 

Dr. DRcarijones.com.

Lorne Brown 

DrCaryjones.com and there you’ll find, you’ll have links to a Substack for YouTube, for podcasts, all information. Check that out. And then the mirror, check out the show notes if you’re interested in the mirror for testing. And on IFQ Balance, we have the longevity diet, which is an anti-inflammatory low glycemic index diet, which you can download for free because diet and lifestyle movement are a big part of it so you can get the diet part through there as well. Dr. Carrie Jones, it was great to be with you again and thank you for sharing all this information.

Carrie Jones 

Oh my gosh. Thank you for having me on.

Lorne Brown 

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.