Protecting Your Heart, Bones, and Brain Through the Stages of Menopause

Menopause changes your life… and your health. It can be a tough transition, but we need to shift our perspective on this important time. Menopause is not a disease; it’s a normal stage of life—and it’s a privilege to still be alive.

In this episode, I talk with Dr. Suzanne Gilberg-Lenz, a conventional board-certified OB-GYN who also practices integrative, holistic, and Ayurvedic medicine. We discuss the ways that the stages of menopause change your life for the better, and what you can do to protect your health throughout the transition.

As you start to enter perimenopause and menopause, you can make adjustments and build healthy habits to mitigate long-term health issues, including heart disease, which is not discussed enough. The place to start is with hormones, according to Dr. Gilberg-Lenz, and also incorporating botanicals, herbs, and supplements as well.

Another big factor that needs to be addressed is lifestyle. You’ll learn about adjustments you should make and why you must make yourself a priority during this time. Because with the right approach, your fifties can be a truly magical decade.

Freebies From Today’s Episode
Get the FREE introduction to Suzanne’s book Menopause Bootcamp to optimize your health, empower yourself, and flourish as you age


00:06:15 – Inspiring safe and effective space for women as they age
00:09:29 – Addressing misogyny and ageism, seeking change
00:12:18 – Ayurveda validates holistic life view, benefits patients
00:15:26 – Validating, prioritizing, prevention: women's health matters
00:21:45 – Menopause isn't a disease; problematic screening
00:24:11 – Hormones safe and effective for most, alternatives are available
00:28:07 – Aging habits need adjustments, shift mindsets and prioritize self-care
00:31:19 – Questions about hormones and managing stress
00:34:45 – HRT benefits early on, genes can affect appearance
00:40:18 – Checking hormones constantly is not necessary, genetic specialization
00:42:32 – Hormone therapy is an ongoing conversation

Mentioned in this episode:

Learn more about Dr. Suzanne Gilberg-Lenz

I recommend reading Dr. Suzanne Gilberg-Lenz’s book Menopause Bootcamp

Listen to my podcast episode about bioidentical hormone replacement therapy during menopause

I recommend Joe Dispenza’s retreats

Read more about Dr. Prudence Hall

Read Uzzi Reiss’s book The Natural Superwoman

Click Here To Read Transcript

ATHE_Transcript_Ep 529_Dr. Suzanne Gilberg-Lenz
JJ Virgin: [00:00:00] Hey, this is JJ Virgin. Welcome and thanks so much for joining me. This is Ask the Health Expert here. I put the Power of Health in your hands and give you access to the top people in health and wellness. In each episode, I share safe ways to get healthy, lose weight, heal your gut detox and lots more. So if you wanna get healthy and get off the dieting for life merry-go-round, I'll give you strategies that will help you look and feel better fast.
All right. I. This all the time. So I am just going to share with you what I do since I always get asked and it's so in line with what we're gonna be talking about today. So I have my new pal, Dr. Suzanne Gilberg with me. She literally, I was like, how have I never met you? This is so weird. We have so many [00:01:00] of the new of the same friends and she is, we, we are.
Soul sisters in the way we think she's a little lot bit smarter than me, and that's how I was like my friends, smarter than me. So let me tell you a little bit about Dr. Suzanne and then I'm gonna pull back the kimono since you asked. You didn't ask, but I know you will so I'm gonna tell you anyway. So Dr.
Suzanne Gilberg. Is a diplomat of the American College of obstetrics and gynecology. She got her medical degree from the USC School of Medicine. We will not hold that against you, Dr. Suzanne, since I graduated from ucla, cause I did do my grad work at usc, so I forgive you. Anyway, she also did her residency in obstetrics and gynecology at Cedar Sinai.
So like really? Credentialed background and she has done a load of media. Everything from Steve Harvey, Dr. Oz at the Today Show, cnn, and she is really out there [00:02:00] now redefining menopause. So she's got this super cool background where she had, you know, This really credentialed huge medical school residency, all that.
Then she did integrative medicine, studied that. Then she went and studied Ayurveda. So I mean, a really cool background that has all come together to change the way that she looks at and treats menopause. And so I think that is really exciting that she's got a book out now. It's called Menopause Bootcamp.
You're gonna want to get this for sure. And we have such a great conversation about everything from ageism. You know how amazing it is once you go through menopause, like how it changes your life and for the better and what you can do to really protect yourself from the most scary things that happen as we age, that really are what take women down.
What happens with your heart, your bones, your brain. So [00:03:00] I'm gonna share with you when I went through menopause and it really hit me hard when my son got hit and nearly died and I spent four and a half months in the ICU and it was right when I was 49. So like boof, I get hit and I start going through this and one of the first things that happened is I went on.
And they saved me. I do have Hashimoto's. It is completely controlled and I use, I use thyroid medication through my buddy Dr. Alan Christensen, and I also do estrogen, progesterone, and testosterone. And I will tell you that I still remember, you know, the first thing that I did was thyroid notice a huge difference.
And I could tell I needed thyroid because, I started to lose the outer third of my eyebrows. I was cold and I'm usually running hot. I was cold and I started to get a little tingy yellow on my hands and I got constipated, man, who wants that? So I knew something was up. That was when I first started on thyroid.
Then the next thing that happened is my hormones started to go down. One of the things that I noticed as I was doing [00:04:00] hormone replacement therapy that helped me kind of go, you know, I need to dose this differently, was I couldn't recover well from. And that's when I knew I needed a little bit more estrogen and then I, my gum started to bleed a little bit.
Same thing. So I now do estradiol patches, and then I do testosterone injections, and then I cycle. Oral progesterone. So that's what I do. I get asked all the time. So if you were wondering, that's what I do along with a special WPthroid that I get from Dr. Alan Christensen. There it is. I pulled back the kimono, but again, you're gonna hear in this we talk about.
Exercise, how you need to shift that what you need to do for mindfulness, all sorts of good stuff. So you are going to wanna get your pen and paper out, take notes on this, and also grab her Dr. Suzanne's Menopause Bootcamp. Now I'm gonna also have a really cool surprise for you as well at
So make sure [00:05:00] you go there, grab that, and I will be right. With Dr. Suzanne, stay with me.
All right, Dr. Suzanne, we have to start this interview because we've been having so much fun offline. I know. We're gonna let everybody into the conversation. Exactly, and I don't, first of all, I don't understand how, I've never met you before today. I don't know how that happened, but we're, you know, the
Dr. Suzanne Gilberg-Lenz: universe wasn't ready for us to know each other yet.
JJ apparently, Now that you
JJ Virgin: have your book out and it's a topic that my audience is always starving for. Yeah. We're gonna be digging into menopause. You have menopause bootcamp out. You know, let's start with the obvious question cause I'd really love to understand why you got into this. I have a friend who does a lot of menopause and she's like, she's like, I don't know if I wanna stay here.
Everyone's so angry, , you know,
Dr. Suzanne Gilberg-Lenz: hormonal. You know, . [00:06:00]
JJ Virgin: I know. So, you know what the obvious first, like how did you decide you were gonna tackle menopause? You know, it's,
Dr. Suzanne Gilberg-Lenz: it's like a lot of things in life. It wasn't something like I decided that I was gonna tackle. It's just sort of evolved over time. And I think some of it was that I, as my patients were aging with me, I've been very privileged to, I'm in a private practice that I've been in for 22 years, so, I saw someone yesterday who I am now caring for, cuz I'm that age who I delivered.
You know, it's like one of those practices Wow. Where I really, wow. Yeah, yeah. Put an i u d in a 16 year old that I delivered , I was like, wow. Full circle. So, so I, I think as I evolved and my patients evolved and their needs evolved, I was seeing more and more people entering into that phase of their life.
And really being flummoxed, having no preparation, no idea what to do. And to be perfectly honest, I had to learn too, because I came out of a prestigious [00:07:00] medical school and residency program, Cedar Sinai Medical Center, you know, I don't think there's anybody on the planet that does not know that name. And really didn't have hardly any education on, you know, women's health and aging.
And it's not to disparage the medical education system, which has plenty of things that we could improve on, but there's only so many things you can squeeze into a four year residency. And it just, it just was missing completely. And so I had to start going and looking for the information myself. And the more I dug in, the more interesting I found it.
And what your, your audience may not know about me is that I have a background not only in conventional ob gyn I'm board certified, but I'm also board certified in integrative and holistic medicine and had been a student and practitioner of Ayurveda of Indian Medicine. So I, I really felt like I had a different perspective on the aging process, the, the importance of destigmatizing and normalizing.
[00:08:00] and I had this toolkit that was a lot wider and deeper. And I think that is when I did decide like, okay, I really, this is what I wanna do. I want to create a space that is safe and effective for people to experience a normal life transition, but also to have the support and the validated legitimate you know, ways to handle this that I was able to offer.
I just, you know, It's a big, it's a big, big, big topic, and it's, yet, it's very simple.
JJ Virgin: It's kind of interesting though. You know, you're an ob, G Y N. . They didn't really go deep in women's health.
Dr. Suzanne Gilberg-Lenz: Well, we did go deep in women's health, but when you're learning how to do pelvic surgery and manage high-risk pregnancies, you know?
Right. But there's a lot of focus on procedures. You're right. And not on Yeah. Normal, normal events of of life. And I do think that, you know, look, there's a lot of issues that we are trying to address and need to be addressed in healthcare and in [00:09:00] medicine specifically. But when you look at. Inequity and bias.
You know, there's misogyny and ageism. I'm not even gonna talk about like white supremacy and racism and medicine. We're gonna leave that for another conversation. Yeah, that's a
JJ Virgin: heartbreaking situation.
Dr. Suzanne Gilberg-Lenz: It's a huge thing. It's a huge thing, and I don't think people are doing it on purpose, but it's baked into the system and misogyny and ageism are just.
Part of our culture. So a lot of what happened as I started, as I mentioned, like, well, look, my patients needed this stuff and weren't getting the answers they needed. So I dug in and I started learning and educating myself. But also I started seeing the big picture here, which was, as an individual living in this culture, in this body, I really wanted to see change on a, a larger structural cultural level in terms of how women treat ourselves, what we expect, and what narrative we're willing to participate in.
And that has been one of the most wonderful and gratifying aspects of [00:10:00] the work that I'm doing because there's something about midlife, you know? Sure. It's really, really discombobulating. That transition is rough. But once you get through, You have got you. You have resilience, you have wisdom, and you understand what your own value is, and you have a lot to offer.
And we really, we, and I'm talking about me and you and the people listening to this podcast, we can continue to choose to accept this narrative that as we age, we're not viable, we're not legitimate, we're invisible, we don't matter, blah, blah, blah, blah. Or we can say, that is not my story. That's your story.
Go have fun with your story. My story is X, Y, z
JJ Virgin: I gotta tell you. So a couple, I mean, you're bringing up so much stuff. I love this so much. It, it is interesting. I'm, I'm 59, which still is amazing to me, and if someone had told me that whatever happens at 50, that flip switch gets flipped. I was like, why couldn't I, I wish I could have been 50 at 30, you know?
[00:11:00] Right. , it's like I keep trying to explain this to my friends who are in their twenties, thirties, forties. I'm like, oh no, this is so. Fantastic. Yeah. You're like, this is the greatest. Yeah. And you know, I was with a group of friends. We got to go to the Grammys and we were at the Grammys and we were watching, and it was the year that Dolly Parton was heading the whole thing up, and Diana Ross had her 70th birthday there and all these amazing, powerful women were there.
Yeah, yeah. But you know, they. , if they had J Lo, they had some other younger gal, but it was really about like, you know, Dolly who was belting it out at what Yeah, she's 70 something. Yeah. And Diana Ross. And I'm like, holy smokes. You know, . Yeah. So, yeah, you know, I, I, I wonder like, did it help you? Why did you go do Ayurvedic practice, learn Ayurvedic, and was some of that help with this ageism stuff?
Like, it seems like some of these other cultures, like you look at the blue zones and this longevity, and I always. Because people are [00:12:00] celebrated as elders, and we realize their importance.
Dr. Suzanne Gilberg-Lenz: That's a huge thing in pretty much every indigenous culture. Ayurveda, I didn't necessarily get that, but what I did get was a toolkit that validated my personal life view, which is more mind, body, spirit oriented, obvi.
Look, I'm a surgeon. I believe in western medicine. I prescribe medications, and I have participated in western medicine, which is a miracle, but it does not address everything. And we look at normal developmental processes of which menopause is. I think sometimes the indigenous cultures and the more holistic traditional medicines have, have something to offer.
Let's put it this way, my interest in Ayurveda grew partly cuz I'm just a seeker. And when I, I had a lot of experiences during my medical training where I realized that the encounter between the patient and. It was not just what it looked like on the face [00:13:00] of it. Like, you have a problem, I have a solution and I'm going to help you and you're gonna go on your merry way.
I mean, sure that happens sometimes, but there was something else going on that wasn't being addressed, whether it was, you wanna call it energy, healing, love, whatever that was. Mm-hmm. and I actually had a patient who had a big influence on me, and it's, the story is in the. And she introduced me. I was doing yoga and meditation really to just sort of like take care of myself, right?
I was a busy resident and a young mother. I had both my pregnancies during my ob gyn residency, so it was kind of crazy. And I was coming out into practice and trying to just take care of myself, found yoga and meditation, and from there found Ayurveda. Ayurveda is like Chinese medicine. Grew up around the same time, five, 6,000 years ago.
Yoga is actually a branch of Ayurveda, and I really started looking at it for my own. I was curious and I started seeing the benefits very quickly for my patients because I had specific. Spiritual practices that were [00:14:00] not invasive, you know, or I had, I started really getting interested in herbalism and in botanical medicine, which is super powerful.
And of course, you know, maybe 30% of pharmaceuticals are actually plant derived. And I just had an interest in other ways to do things. And I'm here in Los Angeles where, you know, people tend to be pretty open-minded. And it rapidly, I developed a reputation in the community for being open-minded, for being like, look, she can attend your birth and, you know, keep you safe and she can do surgery, but she's also not afraid to talk about herbs or meditation.
And it just kind of grew from there and I got more and more interested and just started incorporating those things.
JJ Virgin: So let's look at, at how you approach menopause then. Like, someone's coming in to the office, cuz now, now they have the opportunity with the Menopause Bootcamp book. And I think you do retreats too, don't you?
Yeah. Yeah. So you. Like someone walking in. So how would you help someone who's maybe just, just kind of starting to have like irregular [00:15:00] periods, mood swings, et cetera, you know, what's the process you take them through so that this isn't such a chaotic time of life? Yeah, I mean,
Dr. Suzanne Gilberg-Lenz: a lot of what I do, honestly is just allow them some time and space to talk about what's going on, because what's frequently, unfortunately happened by the time they get to.
is that they've been dismissed. Either they had labs done, which are really not meaningful largely in this context, and oh, they're normal. Sorry, nothing to do. Or Oh yeah, that's a normal part of aging. Bye. Good luck. I mean, a lot. So a lot of times I really have to unwind that because people feel really invalidated, which is why your, your friend was saying like, people can be angry when they, when they finally get to someone.
Cuz their gut instinct is like, I. I don't feel right that that can't be right. So part of it is just hearing the story and validating, yeah, you're right, it is really uncomfortable. And then helping them prioritize what is it that they wanna get out of this, because I, I remind them you don't have a disease, but also I [00:16:00] don't want you to get diseases because it's gonna lead to something that I think is very, you know, we.
How do we prevent those long-term health issues? I mean, obviously what you do before you get to menopause is incredibly important, but even if you start doing things at menopause or around perimenopause, the time leading up to menopause, you can have a big impact. So I'm talking about heart disease.
Brain health and bone health. These are the big three that women face as we age. So as we get to perimenopause and menopause, I wanna help you live through that experience so you don't hurt anybody you know, and let you know that there are things you can do. So is it the hot flashes, is it the sleep? Is it your sex life?
What, where, what's the main issue for you today? Over time, what are the issues evolving for you? How can we address. Via pharmaceuticals, botanicals, lifestyle support and community, which is a huge part of what the bootcamp really provides. Honestly, people talking to each other and then [00:17:00] moving forward, I'm there to sort of guide you through the process while building those healthy habits to decrease those long-term health consequences over time.
I think the message is not, it's not getting out there. That we can mitigate these long-term health issues and that women have heart disease, that the number one killer of women is heart disease. This makes me crazy.
JJ Virgin: I'm so with you on like, I love that you said bones, brain and heart. And I'm like, why is there so much emphasis on breast cancer and we don't talk about heart disease?
Totally because it's
Dr. Suzanne Gilberg-Lenz: scary. So let me just say this. I feel like I'm, look, I'm a breast cancer survivor. I had breast cancer in my forties, so I feel like I can say what I want. All right. So I'm gonna say I feel the same way, and I do feel like it's a little bit of a third wheel topic. Like you can't say anything about breast cancer.
I mean, breast cancer's a thing. I don't want anybody to get breast cancer. It sucked. Although in some ways it changed my life for the better. That's more of my. But the reality is that most women who are [00:18:00] diagnosed with breast cancer are going to be diagnosed in early stages, and it's a big wake up call.
But guess what the number one killer of those women is? Well, I mean, I know you know it's heart disease. I'm more likely as a breast cancer survivor to die of heart disease than breast cancer. And I think it's the kind of the fear mongering that's out there. I want people to get their breast screening and colon, you know, screening and all that, but like, let's be real.
Let's be real about what the, the things are that are really facing us. And of course these are things that we can do something about. I mean, you know, we can have an impact on our genetics by what we're thinking, doing, eating, how we're sleeping, what we're filling our time with, what, what our senses are coming into contact with.
Not just what you know, eating is obviously so important, but how we, when we, why we. Who we're, who we're evolving ourselves, what energy is near us, blah, blah,
JJ Virgin: blah. Well, let's [00:19:00] dig into that. You know, I just did a summit. The what to eat, when to eat, and why Summit . Oh my God. Because I was like, no one talks about food.
Come on. It's the place we start. We start with what's at the end of your fork. And I wanna dig into all of these things. I will tell you, I used to work at a clinic. In Palm Springs where I would see clients and I, it was incredible to see people's lab work when their estrogen dropped and to see the difference between someone who was doing a bioidentical and someone who wasn't and what was going on with all their cardiovascular factors.
Cause like zoom, you know? Yeah. Like, no,
Dr. Suzanne Gilberg-Lenz: it's wild. I mean, cholesterol goes up. Listen, I personally had that experience in the last 18. Where I was a person whose cholesterol was super low. Genetically, probably, and estrogen wise, I'm not actually through with menopause, which is insane. I don't Hmm.
Understand it. But my, I think part of it was the stress and the change in lifestyle with the pandemic, especially as a physician. But my cholesterol [00:20:00] went up like 80 points. Mm. I was, and I, you know, listen, I'm just being honest here. Like, I know everything you're supposed to do. Yeah. So it was, and a lot of it's hormonal.
A lot
JJ Virgin: of it's hormonal. It's, well, here's the thing, and you know, the, the thing I love to say is your body's not a bank account. It's a chemistry lab. I know there's a huge argument between the bank account model and the hormone model for weight. And they both matter, of course, but you're individuals. It was really interesting during the pandemic,
I stepped on the scale and my weight had gone up five pounds. And I'm like, okay, huh, what's up? And I thought, okay, well this is just stress. Started going up a pound a day. , I had a stress triggering autoimmune thing happen. So it is, wow. These are like, so critical for us to look at, like, yes, you know, what can stress do?
What can stress do to an autoimmune disease? To , you know, to cholesterol, to how sticky your blood is. It's, yeah. Crazy. Yeah. But it was really interesting. It's when I first started to really become aware of this was, [00:21:00] first of all, one of my biggest frustrations is we start, like, I don't know when they actually ever prescribe bone density tests.
I actually did. 30, like, I don't know why this is. Well, the US
Dr. Suzanne Gilberg-Lenz: Preventative Services task force and all its glory does not recommend bone density until well past 60, which is
JJ Virgin: what are you supposed to do at that point? Like right , I know
Dr. Suzanne Gilberg-Lenz: so well, but the bone density is also like, not the greatest test, it's just that we have, it's the test we have.
So yeah, there, there's so many, but this is another reason why. You know, algorithm and cookbook medicine is problematic when you're looking at something that is not a disease. I don't know how many times I say this a day, this is not a disease. This is a stage of life. It's a normal stage of life, and it's an honor and a pleasure and a privilege to get to this stage of life because if you don't, that means you're not here anymore.
The other thing to remember is that the average age of menopause is 51 to 50. [00:22:00] The average lifespan of a North American woman is 80 ish, so we are spending at least a third of our lives in this time. So you're right when you start looking and questioning the screening tests that are involved. And when we try to like put a normal life phase into the disease model, I think this is part of the problem we're having here because, you know, again, with all due respect to Western medicine, I'm very, very careful to.
Disparage the privilege that I've had to be a physician, but we have a lot of problems in our perspective there. It's a disease model. It is not a prevention or a wellness model. And so I think that's part of the failure to address menopause cuz menopause is not a disease.
JJ Virgin: And I think this is so important, like, hey, I had a son who was hit by a car when he was 16, literally left for dead in the street. Western medicine saved him. Right. And then all of the [00:23:00] alternative stuff brought him back. Right, exactly. We needed all of it. I think you used all the tools in your toolbox.
Exactly. But I think the, the kind of through line here is this is how do we feel the best for that last third of life? Yeah. What do you do? What do you do during that time? And especially for women, you know, we have, it's very different during childbearing years and how you treat yourself versus now. So looking at someone now who's, you know, Perry or in menopause post, like what, what are the shifts that they need to make to now feel their best and to lower that risk of, of heart disease, to be able to not, you know, start to have dementia and to keep their bones healthy and strong?
What do they need to do?
Dr. Suzanne Gilberg-Lenz: I mean, I, I wanna start with with hormones because the, I think that hormones have become so fraught, and by hormones I mean using menopausal hormone therapy. So I am trained [00:24:00] conventionally. I am a member of the North American Menopause Society. I believe in science. I believe in evidence.
I. They are a little too conservative. . I will say that I think the use of what we call bioidentical hormones, which your audience should know, is not a medical term. Yeah, sure. It's a marketing term. I don't care. I'm trying to speak the same language here. If I'm trying to communicate and educate, I'm not here to shame you about the words you're using.
I'm here to talk to you. So yeah, I use the term bioidentical. I really don't. I have colleagues that don't wanna use that term cuz they're mad at it, but that's silly. It means that these hormones are biologically identical to what your body was making in larger quantities prior to menopause. All right.
The, the thing people should know is that pharma makes these, there are FDA-approved bioidentical hormones and they are safe, effective, and, and vetted if those particular formats or dosages don't work for you. . I think [00:25:00] if you're working with a trusted professional and a trusted compounding pharmacy to find a way to get those hormones into your body safely and effectively, I don't have a problem with that.
I, I disagree that compounding overall is bad. I think that's really throwing the baby out with the bathwater. But I do think that people get very nervous. There's two, I feel like there's two cancers. Hormones for everything. Everything is hormones. Everybody should be on every hormone, they should be on every precursor hormone.
There's, by the way, no data to support any of that. And then there's people who are like, my great-grandmother had breast cancer, or My mom had breast cancer. I can't use hormones. Okay, so. I'm the middle path . I'm the pretty much the middle path about most things. Neither of those is true. Hormones are not for everybody.
Hormones are safe for almost everybody, not, not everybody. And I will say vaginal hormones are safe for everybody. Cancer survivors, stroke survivors, any of that. So looking at hormones to help optimize your health, to decrease your risk of osteoporosis. [00:26:00] That data is very clear to probably decrease your risk of dementia on Alzheimer's because women face two to three times the risk of Alzheimer's and dementia as their male cohorts.
Super important to understand that. And heart disease, the data is there from the nineties. You know, it's, there's large studies that indicate that heart health is definitely improved by using hormones. Let's say you can't or don't wanna use hormones. I have all sorts of information in the book on botanicals, herbs, supplements that I think have robust data to support their use.
Are you gonna do, are you gonna put a head-to-head study of. An herbal preparation and a pharma, of course not you. The the, they're not the same. And I think apples and oranges, and again, colleagues of mine who wanna disparage that I disagree with, I think we have to have a wider and a deeper toolkit and be realistic with what people are using and need and want to use.
And then the obvious one, lifestyle. So I have a whole thing I call the six S's of [00:27:00] self-care, sex, sleep, sustenance spirituality and social connection. What we're eating, like you talked about, what we're eating, when we're eating, how we're eating, we have to change that. I mean, I've seen it in my own body.
So you know, I'm not a nutritionist, I'm not a nutrition expert, but we understand that insulin resistance changes our, the estrogen influences where our fat is deposited. So even though that large study came out last year, that freaked everybody out, that was like, no, metabolism doesn't change and you don't gain weight.
Like, oh my God, what planet are you living on? The reality like, dude, for reals, come on now. Yeah. The reality is that the weight distribution absolutely does change. We get thicker in the waist and we don't like it, and it's uncomfortable. And it also is, has health consequences, right? Visceral fat increases your risk for heart disease in cardiometabolic disease, diabetes, inflammatory process.
So, Keeping that in mind, you have to really think about how you're eating when you're eating portion control. People don't wanna talk about that. I'm very [00:28:00] anti-diet culture, but the reality is like, I'm a small woman. I am five three on a good day. Like I don't need, my boyfriend is, you know, nearly six feet.
I don't need to eat the same amount as him. Like, I just don't, you know, I mean, I could, but I'm, you know, gonna be his size and without the height. I think we have to talk about some things that are uncomfortable. How we exercise when we exercise really needs to change. So I was always like, go to the gym directly after work since my twenties.
Oh, first of all, hell, I mean, I'm not going to the gym at night. That is not happening. Is not working. I also can't go hard the way I used to because I don't ha I need recovery time. And I actually, if you are working out too hard and too much, you're gonna increase stress, you're gonna increase cortisol.
Mm-hmm. , you're gonna hold onto
JJ Virgin: You're breakdown muscle . That's
Dr. Suzanne Gilberg-Lenz: right. Yeah. So you're not gonna, you're so, so we have to shift our mindset about how we balance our care of our body, but we have to [00:29:00] continue to move and get that blood flowing. And we have to continue to evolve in our eating and eating for nutrition, but also for joy and for fun.
Alcohol is a big problem in general. I'm not, I'm not a teetotaler, but like, look, if you are using wine to unwind at night, you know it's not good for you. Sorry. It's just not like if you're a wine connoisseur and you wanna enjoy your wine, I think you should do that in moderation. But if you have wine every single.
It's not, you're not gonna get away with it the way you did when you were 40 even or 45. So, and then the sleep thing, which is just like so, so, so, so, so hard. But we have gotta get on restoring our sleep and really, we know what sleep hygiene is. We're not doing it. How many people really are putting their phone and their devices down an hour before they go to bed?
I, a lot of people are not. So I could go on and on as you could hear. But I think these are some of the adjustments. And then the other thing I sort of [00:30:00] touched on, which. You know what we're bringing into our world via our senses and relationship and boundaries. And you sort of alluded to that there is this magic thing that happens in your fifties, the no F's to give fifties, and I wonder if it's hormonal in some ways.
Maybe because we are not cycling anymore. We're not so interested in like, what's your issue? Like we care. But like we need to center ourselves. We need to have boundaries. We need to say no. We need to say yes to ourselves. You know, you can only. Pour out from that cup for so many decades without getting burnt out, resentful and sick.
And if you don't put yourself as a priority, nobody else is gonna do it. So that has to change. Just it has to.
JJ Virgin: So I, I wanna ask a couple questions. We get asked so many questions about hormones, and it's always been my thought process that. , you wanna do all of the things that you possibly can, you know, put in those [00:31:00] stress.
I, I, I hate the word stress management, but do the things that help bring you joy. It's probably a better way to do it. Yes. Yeah. I will tell you, Suzanne, it took me until during the pandemic, I found Dr. Joe Dispenza and starting to retreats. It's great to go to breathwork retreats during the pandemic , you know, I was like, but I was like, here we are going to these, you know, retreats and no one is getting sick because their vibration's so high.
And you know, and then I also started yoga, and like the me in my forties, that was burning out everything, you know, in my fifties. I'm like, no, we cannot do this anymore. , this is no longer working right at all. Yeah. . So I, I think it's so key to look at like, what needs to shift in terms of our exercise, how we eat.
Like, I can't eat the way I ate in my forties. Right. Like, you know, I just, I'm, I'm not a, not that hungry, you know? Right. It's really interesting. Yeah. Yeah. And I have to really be [00:32:00] careful with my sleep hygiene in my fifties, and I also cannot have the extra glass of. cannot have. It cannot. Yeah. Well, completely.
I'm up at three and I'm like, I can't believe I did this to myself again. Mm-hmm. , you know? Mm-hmm. . So there's clear things that I think we just have to say. This is, this is now, but the trade-offs are so worth it, of being, of the, of the zero Fs given. Philosophy someone actually, that's really true. You feel like that T-shirt, I'm like
So I actually do have the t-shirt, but, but one question that I've seen come up over and over and over again is this question about bioidenticals because it's always been, been my feeling and maybe it's cuz I have the lifestyle hammer, right? That's what I have as my toolbox is like, let's get you, let's get your exercise done correctly.
Let's get you, you know, and again, like over exercising and. , creating crazy stress is not gonna be helpful here. So let's get your stress hormones dialed. Let's get you exercising correctly, eating correctly, good sleep, good relationships. And then let's see what you need in terms of [00:33:00] hormones. I take bioidenticals Like, and, and when this, when I told you about my son getting hit, my son actually got hit and pushed me straight into menopause, as you can imagine.
Oh yeah. Cuz I was 49 at the time. I was like, it was like foomp. And luckily I, I've heard that before
Dr. Suzanne Gilberg-Lenz: by the way. When people have a major trauma, And they're in sort of the transition that it's like
JJ Virgin: a light switch. It was like soup. Yeah. It mm-hmm. , it was pretty brutal. I, I don't know. Do you, you must know Dr.
Prudence Hall. Yeah, of course. So, prudence, prudence came to the hospital with hormones. I'm like, thank you. You know, I was just like, it was just really rough. But I've heard that you really have to start hormone replacement therapy while you're going through it, that if you wait till afterwards, it doesn't.
what's the lowdown on this? That's
Dr. Suzanne Gilberg-Lenz: an amazing question. I'm so glad you asked it. I, I think it, I'm not sure what that even means. And this is, it's excellent to,
JJ Virgin: it's like your receptor door is closed and I'm like, the receptor doors closed. Like, really? Cuz [00:34:00] you can regain your insulin sensitivity and those are really important receptors.
I don't,
Dr. Suzanne Gilberg-Lenz: I don't know. I don't know. I, I feel like there's a little bit of a fear tactic involved in some of what goes on, and some of it is marketing to be honest with you, I don't know that we have that question really resolved. I can tell you this. Here's where the large robust data does exist. If you initiate hormone therapy within 10 years of your menopause and before the age of 60, you will accrue those lifelong health benefits that we discussed.
So the heart disease, the osteoporosis, the brain. So that that's actually what the data indicates. Now, I will say this for people who want to preserve the elastin and the collagen in their skin, or diminish that, that slow that, or that that loss or slow that loss starting earlier is better. And I think the other thing that people need to understand is that the other [00:35:00] side of that is that you do not need to wait for menopause to start hormone therapy.
You can start whenever you are having symptoms. So if you're suffering, and I, a lot of people in their forties are starting to, their periods are perfect, but they're having crazy PMS. They're having joint pain, they're having hot flashes, they're having sexual complaints. There's no reason in an otherwise healthy person who doesn't have a medical reason, they can't use hormones.
There's no reason they cannot use hormones unless there's a reason they cannot use hormones. So it's just, it's just not true that you have to wait to start. But also, I don't want people to feel like, okay, I'm 53 and I've been in menopause for four years. There's no reason for me to start now. That is not, that is not.
That is not true. And listen, there's also genes, you know, like we do have genes. Yes, we all know about epigenetics and the ability to sort of turn on and off genes, but there's gene expression. If you look at people in your family older than you, you know, chances are , [00:36:00] that's probably what you're gonna look like.
Really? That's the truth. If you look at like even body shape and things like that. So some of it is, or gray hair, you know, some of that. Out of your, out of your control. And here's the other thing this idea of control, which I have come up against over and over and over in my life and in my career.
So it's very interesting. The longer I talk about this, the more I do it. There are so many parallels between pregnancy and childbirth and menopause. They're both life transitions. They're both transformations. You know, you're birthed as a mother, you're birthed as a, an adult woman later in life again.
But one of the biggest struggles I think we face during both of those periods is loss of control and having to surrender to some of the stuff that's going on in our bodies. That doesn't mean you give up, but you fighting it isn't really gonna be helpful.
JJ Virgin: It's gonna be hurtful, if anything. Yes, it is.
Just gotta roll with it. Yeah. You couldn't imagine going, you know what, I'm gonna be pregnant. I'm not gonna gain any, , you know, I mean that would just be like , [00:37:00] that
Dr. Suzanne Gilberg-Lenz: that would be unhealthy, most
JJ Virgin: likely. Yeah. Yeah. And I'm glad you brought up that other thing about testing your hormones cuz it's always seemed like to me as you're going through it, that it's such a moving target.
Yeah, exactly. Shouldn't it be based more on symptoms? Yes. Well it is and
Dr. Suzanne Gilberg-Lenz: it is officially, officially that is how we treat, we treat clinically based on symptoms. There are time and place for, for testing. If I have you on testosterone for instance, I'm gonna. Keep an eye on your testosterone levels or you know, if I'm ruling out that you have a thyroid problem or something else, but I use thyroid a lot for people to understand the differences between hormone testing for menopause and hormone testing for thyroid.
Okay, well, is it step right? And it's a disease. I mean, we're looking for disease process. We're look, we're looking for dysfunction. This is not dysfunction. The other thing is you nailed it. You know, our hormones are altering all day, every day. We have circadian rhythms. We have obviously monthly, monthly rhythms, and those start getting unpredictable.
It's not helpful to look at those numbers, [00:38:00] excuse me. And when people start chasing those numbers, , they get very, very stressed. And I do think that there are some people out there that use that to keep you coming in and constantly tweaking and changing. And it's like, it's not like if your estrogen is here and your progesterone's there, you're gonna be in a bad mood.
But if it's the other way around, you're gonna have a hot flash. That's not how it works. So, you know, and the other thing that irks me a little bit is this whole. People will sell this idea of like, well, we're individualizing your care except for that we're trying to get you into this perfect reference range.
That is literally the opposite of individualizing care. Yeah. So
JJ Virgin: buyer beware. Yeah, that makes so much sense. It always struck me, I was like, you know, I, I was one of those people. I was very athletic, did not have any curves. Totally did not look like one of those curvy estrogenic, you know, I was like, so why would I go hit the same curve, like same stats as everybody else?
I could tell, and I just worked. I, I'd read Uzi Reese's book years ago, and I thought, this makes so much sense how you do it based on your [00:39:00] symptoms. And I still remember like being in the gym and not being able to recover. and I go, this is so interesting, like this is, and then just using estrogen to the point where I needed to so I could recover.
And then, then the next one that showed up was like bleeding gums. And I'm like, oh, you know? So it's like kind of learning those symptoms. And really, this is one where you've gotta be able to work with your. Physician and how Yeah. And, and you know, understand what's going on because Yeah. You know, ultimately it's how you're feeling, right.
Exactly. Exactly. That's the, exactly. And then looking at, I would think the labs to just see what's going on with your cardiovascular risk factors.
Dr. Suzanne Gilberg-Lenz: Oh, for sure. I'm not saying no labs at all, but just like checking hormones constantly doesn't make sense. Makes sense. I mean,
JJ Virgin: there are some other like sense.
Dr. Suzanne Gilberg-Lenz: some other specific things that again, are not super conventional, but like for instance, as a breast cancer survivor, I wanted to look at whether or not there are, there are metabolic pathways. I mean, I feel like I should bring this with me, but that like huge, you know algorithm that shows you all of the hormone [00:40:00] pathways, right?
But there are estrogen. I think people don't understand that estrogen is not one thing. There are multiple forms of estrogens and we have metabolic pathways that. Help to clear certain kinds of estrogens via your liver and your gut or accumulate. And I was curious for my own benefit to know like what pathway was my genetics favoring and was I accumulating estrogens that might be detrimental to my breast cancer prognosis?
I mean, this is like a deep dive academicy thing. It's definitely not conventional, and I think that is a very specialized thing. I'm not selling it, that everybody should be doing this. That's a very specific targeted ask, right? I, I was taught by old school surgeons at LA County, you know, USC General Hospital, and I'll tell you, I never forgot this.
If you are doing a test and you have no idea what you're gonna do with that result, you have no business doing that test. [00:41:00] What are you doing with the results of that? If you don't know or your doctor can't answer, you really need to rethink if you're gonna do
JJ Virgin: that test, right? , I had my telomeres tested six years ago, and I go, and what do I do with this?
We don't know. I'm like, great. I'm glad I tested that. Thanks so much. That was a really fun test. Thank you one for the team . Yeah. I was like, okay. One final question and it's also back around hormones cuz I know all the questions we had asked. Oh for sure. And so it was great to hear that one because it's always been kind of a head scratcher for me on this.
Well, wait a minute. So you can't start hormones, you know, it's like it doesn't make a lot of sense. No. What. Length of time on hormones, so I love your
Dr. Suzanne Gilberg-Lenz: question so much. Yeah. That's another one that I think has, you know, I think at some point there was a position statement out there either by North American menopause or by one of the organ, maybe American College of O B G Y N that.
That got misinterpreted. Everybody kind of held onto it. Oh, [00:42:00] three years and you should have a conversation or five years and you should revisit. And somehow that morphed into you have to come off at four years. And I don't know where that came from. It's not really a thing. And in fact, the position has been very clearly stated in the last, I think, 18 months by North American Menopause Society, which is the authority in this region.
And that is that it, it should be an ongoing conversation, but there is not a reason why you have to come off your hormones. I mean, sure, if you develop a problem, if you develop a blood clot or you develop a cancer that is estrogen dependent or you have a stroke, God forbid you're gonna have to come off of some of your hormones.
but otherwise you can stay on them. And usually what I tell people is like, we'll just talk about it, you know, every, every year, every, however often you're coming in and look at it. I do have people that at a certain point in their life say like, you know, it's just one more thing. I'm not really sure what I wanna do about this.
I wanna wean and see if I'm having symptoms. I understand that the benefit, you know, of these things is there, but I'm doing X, Y, Z. It's an individualized [00:43:00] conversation, but you do not have to come off your hormones if you don't want.
JJ Virgin: Yay. Well, and I also think of, you know, again, thinking of the blue zones, some of the research that came out of there where you hear about these Okinawan women and you wonder if how much of our modern day, crappy, stressful, toxic lifestyle is really depleting our hormones and making us Oh yeah.
Have, you know, have way lower estrogen and progesterone. Testosterone through menopause and after menopause. And we would have normally, yeah. And so potentially, are we just replacing to where we would've been had we not been in this crappy , you know, toxic depleting lifestyle maybe. Yeah. Yeah. So, Yeah. Yes.
Awesome. This has been amazing information. I super appreciate your time and I am excited to dig into your Menopause Bootcamp book. Now, I know we were talking offline that you're gonna have something super special for everyone listening. Yes. But [00:44:00] we also are not sure what the super special thing is. Yes.
It's gonna be a surprise. It's
Dr. Suzanne Gilberg-Lenz: a surprise.
JJ Virgin: So I always like to, to have some great cool things. So that is even more exciting because when you go to Awesome. When you go there, there's gonna be something amazing that you're going to get as a gift from Dr. Suzanne. So now you gotta go over there to see what the gift.
Dr. Suzanne Gilberg-Lenz: There you go. I love it. I love it. I personally love a surprise
JJ Virgin: though, , who doesn't love surprises. I do too. So again, and thank you, Dr. Suzanne. I don't know where you've been all my life, but now you're in my life and I'm keeping you. Oh,
Dr. Suzanne Gilberg-Lenz: I'm so happy about that. I feel the same way.
Jj, thank you for having me.
JJ Virgin: You are welcome.
For more info on this and other health topics I cover or to rate and review, find me on Instagram, Facebook, and my website [00:45:00] And don't forget to subscribe to my show so you won't miss a single episode. Go to Thanks again for being with me this week.


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