Ep #376: Navigating Grief, Perimenopause, and Menopause: An Interview with Jill Crotty

Welcome to The Widowed Mom Podcast, Episode 376: Navigating Grief, Perimenopause, and Menopause: An Interview with Jill Crotty.

Welcome to The Widowed Mom Podcast, the only podcast that offers a proven process to help you work through your grief, to grow, evolve, and create a future you can truly look forward to. Here’s your host, Master Certified life coach, grief expert, widow, and mom, Krista St-Germain.

Hey there. Welcome to another episode of the podcast. I’ve got a good interview for you today. You will like this episode. If you are at all curious about how perimenopause and menopause can overlap with grief, why symptoms like anxiety and brain fog and poor sleep are so often misunderstood, and what you can do if you feel like your body and your emotions have changed in ways that you don’t recognize.

If you think hormonal changes might be making widowhood even harder than it already is, I think you’re gonna find this conversation incredibly validating and empowering. And today, I’m joined by my dear friend, Jill. Jill is a women’s health nurse practitioner who earned her doctor of nursing practice degree and has more than 25 years of experience caring for women. She specializes in women’s health, functional medicine, and bioidentical hormone therapy. And she’s passionate, as you will soon find out, about helping women navigate perimenopause and menopause with compassionate evidence based care.

I am so excited for you to hear our conversation. Before we dive in though, a quick reminder that this episode is for educational and informational purposes only. Although Jill is a licensed health care provider, nothing we discuss today should be considered personal medical advice or a substitute for care from your own health care team. And with that, let’s get into my interview with Jill Crotty.

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Krista: Welcome, Jill. I’m happy that you are here. Welcome to the podcast.

Jill: Thank you for having me. I’m super excited.

Krista: Yeah. We’ve been trying to figure this out for a while. So a little background for the people before I have Jill introduce herself. I don’t know why it took me so long to realize, oh, as it relates to perimenopause and menopause, I could call Jill. Because Jill is someone I’ve known since college, and I know what she does.

And it’s so wild how, like, sometimes what you need is right in front of you, and it doesn’t occur to you to reach out. And it finally occurred to me, and you have helped me so much. And now I’m learning about perimenopause, and so many listeners are struggling with it. So I’m so glad that you’re willing to come on the conversation and help some people who are highly confused. For people who have no idea who you are or what you do, tell them a little bit.

Jill: Okay. So I’m Jill Crotty. I own Glow 365. It’s a med spa here in Wichita, Kansas. But prior to me owning a med spa for 5 years, I’ve been a women’s health nurse practitioner. I do have a doctoral degree in that as well. I’ve been doing this since 2010. So long time but I work with perimenopause and menopausal women. We treat a lot of bioidentical hormone replacement therapy but we also help women struggling with fertility hormone imbalance and perimenopause really just to give women the quality of life they deserve.

Krista: So it probably goes without saying, but Jill is someone I trust deeply and respect tremendously. So again, glad to have you. Okay. So let’s start with, like, basics. If you could describe the difference between perimenopause and menopause, how would you do that?

Jill: Yes. So these are statistics most women don’t love to hear, but perimenopause is kind of the roller coaster of hormones. This can actually start in your thirties and it can last more than 10 years. Your hormones are still being made, but they’re unpredictable and they can lead to like fluctuating symptoms from month to month. Menopause is kind of the destination.

Your ovaries have largely stopped producing estrogen and progesterone and this kind of results in a lower hormonal baseline. So symptoms can continue, but treatment then focuses on supporting long term health, including like bone health, heart health, and vaginal health. Also brain health. These are all affected when your hormones dip a little bit low. So honestly, used to think that we could not help women with hormones until you got into that menopausal state.

Now we know that that is not the case anymore. Really, this is the time to focus about helping symptoms, but also preventing other disease states that low hormones can affect like osteoporosis, dementia, cardiac health. So I mean, perimenopause, the 1st thing to decline is typically testosterone and then comes progesterone because you know, we’re all born with a certain amount of eggs and quality of eggs and as we age that decreases. So you tend to hear women say, my sleep is poor, I’m getting anxiety, my sex drive is low. These are all things that we can start to support in perimenopause, even though your ovaries are producing, those ovaries will produce estradiol until they fully want to shut down. But those other 2 hormones are the ones that start to lack. And that’s when women start to feel that perimenopausal shift.

Krista: And so then how do we know firmly that we are in menopause?

Jill: Well, true menopause is going one full year without cycles. But we at our office, we really sit you down for an hour. We get a whole lifestyle case going as far as like sleep and stress and medications in your background and have you had a hysterectomy? Are you still having cycles? But then we draw a really extensive lab panel. So we’re really able to kind of narrow down. Do you have ovarian function? What’s your hormone data look like? There’s also outliers that affect your sex hormones. So like cortisol, thyroid, looking at mineral deficiencies.

So we do a lot of out of the box thinking lab work just because what’s typically drawn in an office when a woman goes in is a CBC. I’m checking their kidney and their liver, maybe getting a cholesterol panel and then them saying, oh, you’re fine. And they’re just not really drawing the appropriate lab work at that point.

Krista: Yeah. That’s exactly what happened to me. So I went to my primary care doctor a couple of years ago and I said, hey, what are we doing about this whole perimenopause menopause thing? And they’re like, well, we can do some blood work. And I kind of had to insist on it. They didn’t even really wanna do it in the first place. And then when they did it, that’s exactly what they did. And it was absolutely not valuable at all. And the poor person helping me was 25, like and had no specialty. And I just didn’t know what she didn’t know. So she was trying to be helpful.

Jill: And I will say that I used to think it was the younger providers, oh, well, they just haven’t been through menopause yet. But I will say like, there are some providers out there, you know, OBGYNs. And we weren’t really taught that in school, like functional medicine, we were really taught like hysterectomy birth control, urine ablation for balancing hormones, or taking care of heavy periods. So really, had to go off and learn functional medicine to know that there is something additional that we can do. So I just think it’s honestly for me, they are going to have to want to learn the education to be able to then have those conversations and sometimes they just get used to what they know and that’s okay But I just would then say refer them to people that want to help and want to do a more holistic approach and want to draw the lab work and help them like send them somewhere else if you don’t wanna do it.

Krista: Yeah. Knowing the difference of seeing now having had lab work. So let’s see. I’ve been working with you for a year and a half or more. So I’ve seen way more numbers than I’ve ever seen before, and you’ve helped me make sense of them and helped me adjust them. And what I have learned in that time is that it’s not sometimes enough to go to either your primary care provider. It’s not sometimes enough, as you said, because, you know, my next stop was go to the OB GYN. And as you know, because I told you, the response was, well and I’m not kidding you guys. “Let me know when your family says that you’re a bitch, and then I’ll write you a prescription.”

Jill: For an antidepressant. Not for hormones.

Krista: I don’t even know. I was so aghast. And then that’s when I realized, oh, wait, I know Jill. I think this is what Jill does. I should probably call her and get in.

Jill: There’s definitely a bit of gaslighting situation that happens with for women. It’s really sad.

Krista: Yeah. I don’t think actually interestingly, because this is long history with this particular provider. I don’t think his heart is in a bad place. I just literally think he doesn’t know what he doesn’t know. And so what that tells me is that I’m not the only one. There are lots of women out there like me, and we have to go looking for this information and looking for this level of care proactively because it’s unlikely that we’re gonna get it offered to us at a standard checkup or well woman exam.

Jill: And really, I feel like I treat so many women, and we’re just scratching the surface. Like, it’s just coming out in social media and making women aware, and we’re finally in an estradiol patch shortage. I hate it, but it does make me a little bit happy because people are striving to get hormone therapy. But I’m also like, why can’t we keep up 4 percent of the population are on a patch? Why are we in a shortage?

But I’m also like, well, means prescribers are starting to listen to women, prescribe the medication. So we’re getting there but there’s still so many women to educate that just don’t know that functional medicine or holistic care or just someone that is dedicated to hormone, really doing a deep dive and knowing there are people out there that will help you, that is the message we are trying to get across.

Krista: Yeah. And by the end of this podcast, if you are listening, you will know so much more than you knew before you started. So we’re headed in the right direction. Plus for my listeners, a lot of them find themselves in a place where it gets extra confusing because now we’ve got grief introduced.

Right? So grief is such a full body experience. We might have been doing things that help address what’s going on for our ourselves hormonally pre loss. We might not. It might all be like the magic storm that’s happening all at the same time, but I just feel like it’s especially important for my people because it’s just it’s such a chaotic, you know, wild experience.

So let’s go back to symptoms of perimenopause. And I’m also really glad you said that part of what you do is not just to alleviate symptoms because I think that’s kind of how I have been thinking about it, but it’s to, like, look at the things long term. So I do wanna talk a little bit more about, like, what that means exactly and what good care here can create later. But if we go back to thinking about perimenopause, what are some of the things that people typically associate with perimenopause symptom wise and what are the things that they don’t even realize that are related to perimenopause?

Jill: Okay. So I think one of the biggest misconceptions is that perimenopause is hot flashes and irregular periods. In reality, I often see women who have no idea that their symptoms are related to changing hormones. So I would say anxiety is one of the biggest maybe that comes out of nowhere or maybe you have a low level of anxiety, but all of a sudden it has dramatically increased irritability, disrupted sleep, brain fog, low concentration, low motivation, fatigue, joint pain, heart palpitations, weight gain, low sex drive, vaginal dryness, urinary changes. We start to see more increase in UTIs, maybe leakage of urine and it’s like people just don’t recognize themselves anymore.

Going back to women are told their labs are normal or that they’re simply stressed. So I will say stress can play a role in fluctuating estrogen and progesterone during perimenopause because estradiol actually affects our brain neurotransmitters like serotonin, dopamine, GABA. So it makes us more susceptible to mood changes. The fact that many providers don’t draw the necessary labs that give you the answers as to whether there are issues going on with your hormones or that there’s outside influencers that impact hormone regulation. I mean, it’s a huge disservice and that’s when women get to us.

It’s like, they’re so fed up. They’re being told they’re normal. They’re being prescribed medications that are kind of masking things instead of looking for root cause if they come to us like, please help me. I am like at my wit’s end, nobody’s helping me. This is how I feel.

And so that’s when we go, okay, let’s take a deeper dive into the labs that actually address the symptoms that you’re having or the potential prevention that we can make by putting you on hormone therapy. And I know that you kind of want me to scratch the surface on that, but I have women that come in and they’ll be menopausal and they’ll say, well, my hot flashes are gone. Like I really kind of breeze through menopause but I’m here because my friends are all on hormones and should I be on hormones? You know, they’re telling me how great they feel and I’m like, well, you don’t really realize how you feel until you get on hormone therapy. And I’m not saying hormone therapy is right for everyone, but I will say even if you are symptom free in menopause, there are multiple studies showing that dementia risk increases when you are not on estradiol.

Osteoporosis, your bones are affected when you’re not on estradiol. Your cardiac risk actually goes up if you’re not on estradiol because estradiol keeps our vessels pliable. So as we get into menopause and we’re not on HRT, it kind of harden and thicken and that increases our risk for cardiovascular disease. So I mean, there’s so many things, brain, heart, bones that are super important even with estradiol alone. Now if someone chooses, you know, I want to support those things but we have a strong family history of breast cancer in our family or you know I’m really nervous about being on hormone therapy because women still remember that when it’s a health initiative study that was over 20 years ago stating that if you took hormone therapy, you’re going to have a stroke.

You’re gonna have a blood clot. They were actually prescribing a progestin instead of progesterone, which is a synthetic form of progesterone. They were also giving oral estrogen which oral estrogen does increase your risk over things that don’t have to be processed and metabolized to the liver. So things like the patch creams, troches, injections. Those are things that are going to be safer for you to do hormone therapy wise than oral estrogen.

You will never see me prescribe oral estrogen in our practice, but if someone is like really super nervous, we might do a Dutch test which is a urinary metabolite test that can tell me how you metabolize your hormones and if you are processing hormones down a bad pathway, potentially DNA damaging pathway or a healthy pathway. If it’s more DNA damaging, we can definitely put you on things that will help kind of shift that to healthy metabolism pathway and sometimes that’s magnesium or B12. It’s very independent and people’s results will influence my decision whether I put you on a patch or whether I put you on a trochee. I mean, there’s different ratios of estrogen and kind of that’s where my expertise comes into play as far as you know, what they should be getting. But there’s things that we can do, you know, if people are all in, obviously like I’m always going to choose bio identical and that really just means that they’re very chemically structured to what your ovaries produce but they still carry a 1 percent risk.

In my heart of hearts, I really feel like cancer comes from you not having a good terrain so if you’re a very stressed out person or you lack sleep or you’re not eating very healthy or you know there’s just things that are not great internally with yourself. I think that you’re gonna be more likely to get a cancer diagnosis than somebody on HRT that is doing all the right things but there’s also genetic influences.

So I can’t tell you that I’m gonna put you on HRT and you’re not gonna get cancer. There is a very small risk of 1 percent cause I can’t go home with you and tell you how to live your life and make sure you’re making all the right choices and some people unfortunately do all the right things and they get cancer. So my job is to make sure that you’re getting your screenings, making sure we’re doing everything as healthy as possible because at the end of the day, it’s your body, your decision. I’m there to support you and kind of what path you want to take. But I know we kind of got way off topic, but I’m so passionate about it that it’s, you know, I can just talk and talk and talk.

Krista: Some of the main things I’m hearing are, yes, we can alleviate symptoms, and there are a ton of them, many which we are unaware of or don’t associate with perimenopause. But also we don’t wanna stop with just thinking about it as symptom alleviation. We wanna think about it as long term health, reducing risk of dementia, reducing risk of cardiac disease, and keeping our bones healthy, aging well. And then also, there are lots of different options for hormones, including those that have a history of breast cancer or unique things that are special to them that with the right testing can be managed. Obviously, this is what you do all day, so you need to understand all the details, and I love that you do. But none of us, we don’t we just need to have a Jill in our corner. You know?

Okay. And so many of the symptoms that you were talking about are so they’re just so similar to what we experience in grief. So if we think about the grief aspects, so all of these, like, hormonal shifts that are happening and that can cause the brain fog and the sleep disruption and the anxiety and all of that, how do we know, or maybe does it matter? How do we know if it’s grief? What’s grief? What’s hormones?

Jill: Well, that’s where lab testing comes into play, but I will say grief is already one of the most profound stressors a person can experience. So when you add hormone fluctuations on top of that, it only magnifies your symptoms. Like I said before, as far as estrogen supporting kind of those brain chemicals, progesterone also has calming effects. So as these hormones kind of fluctuate or decline, women often have less physiologic reserve to cope with that stress. So I do care for women that say, you know, I’m grieving, but this feels different or their emotions may feel more overwhelming, their sleep is deteriorating, anxiety is escalating, you know, they may lose confidence because they no longer feel like themselves. It’s rarely just one thing. I feel like it’s kind of grief and hormones that are interacting together. So you might feel those symptoms even more if you’re experiencing grief.

Krista: Yeah. As I’m thinking about the question too, sometimes I get a question from moms that will be like, is this normal teenage behavior? Is this grief? And my answer is always like, it’s not the most useful question. I get why we ask that question, but it’s not the most useful question because it’s very difficult to separate the two, and there really isn’t much that grief doesn’t impact.

So really what’s a more useful question is like, how do I support this child given that they are a normal teenager and in grief? So that’s what I’m thinking now as I even, you know, read over my own question is maybe the more helpful question is not where it’s coming from, but just what is useful now. What do you need? What takes you in the direction of a better quality of life independent of how we got here?

Jill: Well and I think that they don’t always have to be separated. I think they coexist quite frequently, actually. But as a provider, I can tell you doing the detailed history, when did symptoms begin? Are they cyclical? Are there hot flashes, night sweats, vaginal? You know, I’m asking all those symptomatic questions. Have there been major life events that have occurred around the same time? But then we really evaluate the bigger picture. So we’re drawing labs, we’re looking at mineral deficiencies, iron status, thyroid function, insulin resistance, inflammation, cortisol and thyroid both influence sex hormone regulation and cortisol is a big one because that is the hormone released in a stress response. So let’s say somebody is just perimenopausal, they have zero stress.

They live on an island in Costa Rica, everything’s great. We know it’s probably perimenopause. Let’s say we’ve got grief on top of that or let’s say you’re approaching 45 to 50, cortisol is actually on its way up anyway, even in the most unstressed person. You’re going to start seeing things like belly fat because cortisol likes to deposit as belly fat. That’s one of the biggest complaints I have women come in for is like, what is happening? I haven’t changed the way I eat. I am exercising, but I’m carrying this weight.

So we take a look at cortisol, but cortisol, you pair that with grief, you know, we’ve got to then sit you down and come up with a plan to do daily stress reduction activities every day. And like, what does that look like? If it’s super high, I’m probably gonna put you on like a cortisol adaptogen or some type of supplement to help bring that down because as long as your cortisol is way, way high and I’m trying to regulate your sex hormones, it is extremely difficult to get to a balanced state if your cortisol is so off the rails.

So that’s when it comes back to lifestyle and how are we gonna take those steps every day to help women navigate stress and bring a sense of calm. So, I mean, it’s not easy. Will say functional medicine, it is not a quick fix. I mean, yes, I give you hormones but I don’t give you prescriptions and say you’re going to be great in 4 weeks. Like you have to be ready for the journey.

It is a journey and a lot of times it’s lifestyle hormone management, but everyone is different. It is not a cookie cutter by any chance. Like we just don’t give a script and say, you’re gonna be great in 6 weeks. Like everybody’s very individualized. So that’s why we spend an hour at that first visit, like really understanding where you’re coming from so that I know what labs to draw. So that way when we meet back up, you get that individualized plan of care. You’re not gonna match Susie over here or Jane. Like, you’re gonna have your own path. So, you know, that’s why I love it.

Krista: Like got a provider who is just like prescribing and then letting them go, maybe that ought to be like a red flag of, hey. Why am I not doing regular blood work? Why are we not looking at the numbers on a regular basis to see what’s working, how I’m changing, all that?

Jill: Mhmm. Red flags are being prescribed an antidepressant. Just eat less and exercise more. This is just the way you’re supposed to feel. These are all the things I hear my patients…

Krista: Just have a glass of wine.

Jill: Just, it’s fine. Take some time, but this is how women your age are supposed to feel. No. Red flag. Find someone different. I cannot stress that enough.

Krista: Going back to the symptoms. Have you noticed in your perimenopausal clients? Do you call I guess you call them patients probably. Have you noticed that if you’re already working with someone and you’re helping them with through perimenopause and they go through something that’s like a major loss or a trauma, have you noticed that their symptoms change or worsen or?

Jill: Yes. We do see that clinically. Trauma doesn’t cause menopause, but significant stress can absolutely unmask or intensify those symptoms that we were discussing. The body’s stress response influences cortisol, sleep, blood sugar regulation, inflammation, and immune function. So if someone is navigating profound loss, they’re often sleeping less, eating differently, exercising less, carrying enormous emotional stress, all of which can make that hormonal symptom feel much more severe. But like I said, cortisol, it’s one way that triggers how our sex hormones regulate.

So even if stress is high, perimenopausal symptoms can be worsened, belly fat increases, anxiety increases. And this is why it’s important to care for the whole person and not just their, you know, numbers on paper. Like, numbers could say one thing, but your symptoms and what you’re telling me can be completely different and that’s why we take a whole person approach or a more holistic approach.

Krista: So if somebody’s like, I don’t know if my provider is taking a whole person approach, how would they know?

Jill: They should be asking you about your stress and your sleep and your nutrition and your gut health and your exercise and just getting a bigger picture of your daily, they should be drawing hormone labs. They should be drawing full thyroid, cortisol, vitamins, really getting a very large panel and that usually doesn’t happen. It’s usually CBC, CMP, cholesterol, A1C. That tells us nothing about where we’re at hormonally. So it’s frustrating. It’s frustrating for me when my people come in so frustrated. It’s like, they’re made to feel crazy. I mean, they’re like, I feel crazy because they’re telling me I’m normal. Well, your labs are normal. They’re just not drawing the right labs. You know? They’re not getting the full picture. You don’t have anemia. You don’t have an infection. Your liver and your kidney are working great, but that’s all that’s telling you. You’re just not seeing the big picture.

Krista: Okay. So let’s say someone’s listening to this and now I think I feel like was gonna say forties and fifties, but now I really need to say, like, thirties, forties, fifties. And they’re suspecting that they’re in perimenopause, but they don’t have any support around that. What should they do if they’re like, they don’t feel like their doctor is listening? Are there particular questions to ask? What do we do?

Jill: Okay. So I would be very specific about your symptoms. Be an advocate for yourself. So instead of saying like, I don’t feel well, say things like my sleep has dramatically changed. I’m having anxiety that I’ve never experienced before. I’m forgetting words. My periods have changed. I’ve lost my sex drive. Tell me if you’re having hot flashes or night sweats. Say my moods feel different than my normal grief.

And then I would just plain ask, could perimenopause be contributing to this and what are my available treatment options? Again, if you feel dismissed, don’t assume that it’s all in your head. If the provider wants to place you on an antidepressant or an anti anxiety, ask for hormone labs. If they won’t draw hormone labs, that’s when I would say seek another provider that will. Look for a functional provider wherever you live. Find one that’s experienced in treating premenopausal menopause comprehensively because really you need someone that’s going to take your symptoms seriously.

Krista: Are there letters behind a person’s name that can give a hint that they understand this? Or Not is it necessarily.

Jill: Not necessarily. I would say look for, like, integrative, functional. I will tell you, I went to school, got my nurse practitioner as a women’s health nurse practitioner. And I think my schooling was 2 weeks in menopause. 2 weeks.

Krista: Woah.

Jill: Yeah. So that was me going, oh, hysterectomy is an option. Let’s put you on birth control to get you through menopause. Oh, you’re having heavy periods. Let’s get you an ablation. I feel so bad treating those women before I learned functional medicine. Like I want to go back to all those women and be like I’m so sorry like there were so many other things I could have done for you but it took me going out and learning functional medicine which is really like I mean there’s obviously like 2 year coursework, seminars, conferences. Like, honestly, you never stop learning. There are podcasts that are great that you can kind of go down some rabbit holes for learning about functional and women’s health and hormones. And I mean, I can even provide you with a list if you wanna give those to your listeners.

Krista: Sure. We can put it in the show notes.

Jill: Yeah. But honestly, I would look for integrative, holistic, functional in their name somewhere or just that they are used to seeing that kind of whole picture because that’s the kind of person that’s gonna really kind of do a deeper dive.

Krista: Okay. That that’d be good to have for sure. Okay. So we talked about a lot of the hormonal types of things. What are some of the non hormonal or the lifestyle interventions that can help with the symptoms like sleep, mood swings, those kinds of things?

Jill:Okay. So I tell women consistent sleep routines, you know, putting your phone away, not watching TV, trying to get 7 to 8 hours of uninterrupted sleep, strength training several times per week for bone health. I like low impact exercise. I don’t wanna take someone’s joy. So if they like going to a high intensity place to work out, it’s okay. But then you have to be really good 20 minutes a day of doing some type of stress reducing activity because HIIT training in your forties and fifties actually increases cortisol.

Krista: I hate hearing that too. That’s a hard one for me because I really love It’s hard Peloton ride. Yeah.

Jill: I know. But I’m just like, okay. Go do that and then go sit in an infrared sauna, or I’m gonna need you to then go meditate or do some yoga or go for a walk or just something that brings you joy. I really don’t care what it is. As long as you’re doing it 20 minutes a day.

There’s a beautiful account on Instagram called Pocket Breath Coach that actually teaches women how to breathe and like bring down their cortisol. I’m big on fiber. I need every woman hitting 25 grams of fiber a day. This is like blood sugar stabilization helps you with your cholesterol, help you metabolize your hormones. Limiting alcohol in this phase of life is pretty important because you will find that you drink after dinner, you’re going to have a harder time sleeping, you’re going to get hot flashes at this stage of life.

And then I will say, I don’t like to overwhelm women with supplements, but I will say there are some lifers for me in my opinion, fish oil, cardiac health and dementia risk decreases. Magnesium helps you metabolize hormones the proper way. B12. And when I’m saying B12, I need everyone to be on methylcobalamin. It is already methylated vitamins.

So someone that has MTHFR, this is a biggie. I need you taking this type of B12. B12 is how you work at the cellular level, how you metabolize hormones, and then D3K2, not just D3. I need you to pair it with K2 because K2 pulls calcium out of your bloodstream and takes it to your bone. So it’s very bone supportive.

So I’m big on those select few, like take them until you die. Like you need to be on these supplements every single day And just because you’re going to optimize your vitamin D levels, your B12 levels, and really lowering inflammation, helping your heart, helping your brain. These are all things that are not non negotiables, but they’re pretty important. And I would say obviously exercise. I’m a really big advocate for creatine as well, like 5 grams a day. It is more and more studies are coming out saying it is really excellent for dementia and brain health for women in menopause. Yeah.

Krista: Put it in my yogurt and in my water.

Jill: Perfect. I put it in my coffee.

Krista: Fantastic. Yeah. Okay. So I wanted to ask follow-up questions on that. So fiber, as someone actually trying to get more fiber, do have suggestions on, like, good ways to do this? I’m also noticing I somehow ended up on BeanTok.

Jill: Oh. Which is the side of TikTok that I’m sending people.

Krista: People are talking about bean consumption for perimenopause.

Jill: Because that’s your highest source of fiber nutritionally beans are. Beans, avocados, berries. I can even give you a list so it’s my favorite snapshot. It gives you kind of your higher fiber food counts and it works its way down to its lower fiber food counts. What the serving size is, how many grams you’re getting.

A good mix of soluble and insoluble fiber is great. I think an avocado is 10 grams. I try to actually do a protein shake in the morning and I’ll throw in like half an avocado, some chia, some flax, some berries. I mean, by the time I’m done, I’ll even maybe do a little bit of Greek yogurt, but you have to be careful because dairy can be inflammatory for some people. But if you don’t have a gut reaction after eating it, I would say you’re good.

But honestly, my protein shake alone in the morning is about 17 grams of fiber. I will say that I do cheat a little bit. I carry a really good fiber supplement. It’s 11 grams per scoop. So I do that before dinner every single day in like 6 ounces of water. So I’m actually overshooting my goal. I’m at like 28 to 30 grams a day but I’m just like let’s get it in there and I will say as far as blood sugar stability, fiber is probably my top thing, but go move after you eat for, like, 10 minutes, take a walk because that will really stabilize your blood sugar too.

Krista: That’s also helpful. So you had talked about vitamin B problems, and I had a client that was asking a question about that. And so the question was about, what is it, MTHFR deficiency and how that’s related? Is there more to say about that?

Jill: It’s just a genetic snip to where someone has MTHFR, they can’t metabolize B vitamins well. So if you’re going to somewhere like Walgreens, you know, any kind of supermarket to get your B vitamins, it’s cyanocobalamin. Someone that has MTHFR cannot break that down and metabolize it and use that. So that’s what I’m saying. Go out and find methylcobalamin or methyl B12.

You can usually find those at places like Whole Foods, natural grocers, but they’re already broken down in a form that everyone can absorb. So someone that says I take Benadryl but it hypes me up, that is a red flag for me that they may have MTHFR. B vitamins honestly are pretty important because it’s how you function cellularly but also how you metabolize hormones down that healthy pathway or potentially DNA damaging pathway. So instead of doing a lot of MTH of our testing, I really just put a lot of women on methylated vitamins.

So they’re already broken down. I know they’re going to get that benefit. It’s going to increase their B12 numbers and I can tell you if you’re looking at your B12 numbers, our reference range on a lab is way too low. Functionally, we want you between 801,000 when we’re looking at B12. So if you’re drawing a lab and your levels in the 300, I need you on methylated vitamins and I would say like a 5000 mcg every single day. Take it in the morning. It will keep you up at night. It turns your urine super bright yellow like neon, but it’s really good for you. And that is one that I really love women to take in the morning.

Krista: And menopause or perimenopause makes this harder? Is that like a sign of…

Jill: Not that it makes it harder, but if you’re on hormones, we wanna make sure that you’re metabolizing them effectively and that you’re not gonna increase your risk for any kind of DNA damage with your hormone therapy.

Krista: Is that in a standard lab that somebody would be drawing, or is that something? No, okay.

Jill: I will say some providers are getting better at vitamin D, but B12 is a rarity that they draw that. Unless someone has, like, a blood disorder known in their family that they’re drawing B12, it’s typically not drawn. So they can ask for it to be drawn.

Krista: Oh, so much. Again, we got – I think half the battle is finding the right provider that you trust and then just letting them bring their expertise to you as opposed to you trying to know everything there is to know because there’s just so much to know, and I’m sure it’s a full time job. And I’m also just based on what little podcast listening I have done, it seems like there has been such a lack of money invested in studying women’s health for so long that I imagine that the more the consumer drives and pushes for the information, hopefully, more money gets put into it, which means the science will change, and it will just be evolving and evolving and evolving and kind of maybe hard for the layperson like me to keep up with, and we need to depend on providers that this is their bread and butter passion.

Jill: And I will say we’re already seeing that this last year with the whole vaginal estrogen and then removing the black box warning saying, vaginal estrogen cream does not cause cancer. That stays local. And so that was a really big win for menopause, menopause society. Like, that all came down probably 6 to 8 months ago. They’ve removed the black box. So now more doctors are prescribing it.

Krista: Can you – since we didn’t talk about that, can you talk about why someone would take vaginal estrogen and what that helps with?

Jill: Yes. Yes. So as we age, we lose estrogen. Estrogen is one of the hormones that keeps everything well lubricated vaginally. So if someone is complaining of painful intercourse, vaginal dryness, UTIs, leakage of urine, it’s because it’s called vaginal atrophy where they’re just not getting that estrogen to that tissue. So some women will be on systemic hormones and still it won’t reach vaginally. So sometimes I’ll have to put them on vaginal estradiol cream as well but that is something that you can get it commercially, you can get it compounded. I do the compounded just because there’s parabens in the prescription and I am not about that. But it’s usually like a daily, you do it every day for a week as a loading dose and then twice a week after that, but it’s going you’re gonna have more moisture support when that replaces the estrogen, like, gets in there. It’s going to strengthen those muscles.

You can insert it vaginally. You can rub it around the urethra. So if you do that, you’re gonna have less leakage. You’re gonna get less UTIs. So it’s something that easily a prescription can be given for that. It’s going to stay localized. It’s not going to affect your lab values, but it’s just gonna give you that support that you need vaginally. But I think every woman can have that.

Krista: Okay. And so you really don’t have to wait until you’re experiencing dryness or any sort of discomfort or atrophy?

Jill: Oh, I mean, I probably wouldn’t do it. If you’re well lubricated during sex and you’re not having issues, there’s no need to start it. But once you start getting into having those symptoms, ask for it because that’s just an easy, easy thing to do and so much relief for women.

Krista: Okay. You’re gonna have to ask because nobody’s probably You’re going to have to ask.

Jill: Yes. Check. Yes.

Krista: Alright. Okay. Let’s switch gears a little bit because part of what you do is or a big part of what you know about is aesthetics at Glow 365. So given your background in aesthetics, how do you see hormonal changes affecting how women feel about their bodies? What are they telling you and how does that intersect maybe with grief and confidence?

Jill: Well, I think they no longer recognize the woman in the mirror, but also if they’re grieving, that disconnect can become even more painful because they’re mourning both a loved one and then the version of themselves they feel they’ve lost. I will say with hormones and fluctuations like estradiol, DHEA, they affect far more than reproductive health, they actually influence skin quality, collagen production, muscle mass, body composition, hair. I mean so many things. I can tell you my philosophy and at glow I teach my providers like aesthetics isn’t about chasing perfection. It’s about helping women feel healthy, vibrant, confident.

Sometimes it’s rebuilding confidence. It starts with sleeping through the night, restoring energy, balancing hormones. If they want to have a glowiness to their skin, know some people automatically go to aesthetics as a very vain treatment. Honestly, it’s the people that come in that I can boost their confidence. That is the most rewarding outcome for us. Like they walk out of their crying like I’m so happy I feel like myself. Know, that is like a game changer. And so I’d never want someone to think that going in and treating yourself, like you have to take care of yourself. It’s very important for your mental health too. So it’s not just about outer beauty. It’s about your mental health.

Krista: Yeah. What do you say to the people who won’t do it because they feel guilty?

Jill: Remind her that caring for herself isn’t selfish. It’s one of the greatest gifts she can give her family. If they have children, they don’t need a perfect mother, but they need a healthy mother who has the physical and emotional capacity to keep showing up. And honestly, addressing things like sleep, nutrition, mental health, or doing something that helps them feel confident again, it isn’t vanity, it’s actually healing. I feel like when women care for themselves, they’re better equipped to care for everyone else. Give yourself permission to heal doesn’t diminish the love you have for the person you’ve lost. Like, you have to take care of yourself and give yourself.

Krista: You sound like me, Jill. I feel like I’m preaching it from the high heavens sometimes. And, also, I think it in at the same time, one of the things that I found helpful when it comes to guilt or just thoughts of selfishness is that there’s kind of this I like to think about it as, like, healthy guilt, healthy selfishness. Like, yeah, of course, if we’re used to putting ourselves low on the list, of course, we’re gonna feel guilty about it. And we don’t even have to make ourselves not feel guilty about it as much as we have to acknowledge that, oh, of course, it’s my conditioning, that’s why I feel guilty, and I’m still gonna do the thing that is self care or what makes me feel better or more like myself. I don’t have to let guilt get in the way. Yeah. Last question. What do you wish that every one of my listeners in perimenopause or menopause knew, but nobody’s telling her?

Jill: Okay. So I would say there are real biological changes happening and for those that are mourning, it happens alongside an incredibly difficult life experience. I think that grief and hormonal changes can amplify one another. That doesn’t mean you have to suffer whether it’s lifestyle changes, addressing hormone imbalance, blah, blah, blah. There are effective ways that we can help women feel better. You don’t have to choose between surviving and thriving. I feel like with the right support and a personalized approach, it’s possible to honor that grief while also with bringing your health and your sense of self.

Krista: Amazing. I appreciate that. I know people hear a variety or a spin off that from me, but hearing it from someone else is really helpful. Okay. So besides how people can work with you, which I want you to tell them in a minute, was there anything you wish I had asked you that I didn’t ask you or anything that you really wanted people to know that we didn’t talk about?

Jill: No. I just can’t stress enough, like, advocate for yourself. Nobody’s gonna do it but you. And if you’re not happy, move on to someone else. There are so many providers out there willing to help you, that’s probably my biggest thing. Like make time for yourself, give yourself some joy every day even if you have to wake up 15 minutes early or go to bed 15 minutes late like give yourself some time to yourself, super important.

You know what I went through last year, I had a breast cancer diagnosis last year and I can tell you like it made me reflect back and go, okay, I need to stress less, I need to take care of my body. I need to do what I’m telling my patients to do you know because there’s times I’m working till really late or not taking the time to decompress and so for me that’s probably one of the biggest things that I’ve learned like I feel like that happened for a reason and you know, while I was sad initially that I can’t be the girl I was last year, she actually needed to work on some things and so I feel like everything is a life lesson and it’s hard to understand at the time sometimes when you’re going through something difficult but I always think for me it changed me into a better person because then I started doing things to protect my health and making sure that I was actually taking the time for me. And you should never feel guilty about doing those things. Like, don’t feel guilty. Just do it.

Krista: Okay. So if people want to work with you, what are their options?

Jill: So if you live in Kansas, we can prescribe. I’m licensed in the state of Kansas. We can do virtual appointments, in office appointments. You can go to myglow365.com, which lists all the services that we offer and it does really go in-depth about what we offer in women’s health. If you are outside of Kansas, I can definitely work with you but I can’t prescribe.

So if you’re looking at how do I just make my life a little healthier? What are some things you’re going to recommend for sleep and stress and gut health? And we can do gut health testing and there’s lots of things we can do without writing a prescription for hormones. So I would say if you’re outside of Kansas and you want to work with me and I can give you recommendations on what I would prescribe you, but then you’re gonna have to go find someone in your state that is willing to write that prescription. But I’m always happy to help with just the everyday lifestyle things too.

Krista: Okay. Amazing. Definitely. So you could help someone get the right lab work, understand their results, understand what they need, and you could tell them, hey. If you lived in Kansas, this is what I would prescribe.

But since I can’t, you can take my suggestion and talk to your provider who can prescribe. So myglow365.com. Amazing. Thank you so much for being willing to come and share your wisdom with my audience. I think it will be really helpful, and I have a feeling I’m gonna hear a lot of – I’m gonna get a lot of emails saying thank you. I really needed that.

Jill: It’s my pleasure.

Krista: Alright. We’ll talk soon. Thank you, friends. Okay.

Jill: Alright. Bye.

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If you like what you’ve been hearing on this podcast and want to create a future you can truly get excited about even after the loss of your spouse, I invite you to join my Mom Goes On coaching program. It’s small group coaching just for widowed moms like you where I’ll help you figure out what’s holding you back and give you the tools and support you need so you can move forward with confidence.

Please don’t settle for a new normal that’s less than what you deserve. Go to coachingwithkrista.com and click Work With Me for details and next steps. I can’t wait to meet you.