Introduction
Hi, good morning, and welcome back to Mornings with Megan. I’m Megan Pfiffner, a certified nutrition specialist helping to make perimenopause a little easier: explaining the science, skipping the fad diets, and knowing exactly where you’re coming from because this is my life right now too.
Before we get into it, I want to ask you something, and I want you to actually answer it in your head. Do you feel like yourself? Not the “I’m fine” version of yourself. I mean the version of you that has energy to spare, that sleeps well, that moves through the day without running on fumes and willpower and a third cup of coffee. If the answer is something between “not really” and “absolutely not,” then this episode is for you, because we’re going to talk about where to start, and I promise you it’s more doable than you think.
The World vs. The West
So basically everywhere else in the world, outside of the West, menopause is actually a good thing. In Japan, it’s culturally thought of as a renewal phase, when you find purpose and growth so you can live your truest life. In China, menopause is considered a second spring, a time to focus on yourself and your next phase of life. In India, it’s considered a social liberation, and the social boundaries that were in place before are supposed to be lifted. In many indigenous cultures, it’s considered a social status to step into a wiser phase of life where you are respected as an elder in the community.
Here in the West, menopause is very much associated with loss: loss of fertility, loss of youth, loss of estrogen. Let’s be honest, Western men are also worried about the loss of these things. Insert your favorite midlife crisis joke about little red convertibles here.
A systematic review of 13 studies found that 10 showed women with negative attitudes towards menopause experienced more symptoms during the menopause transition, also known as perimenopause. Worth noting: research on Japanese American women has found that they report fewer vasomotor symptoms like hot flashes compared to women of European descent. Is that entirely about diet and genetics? Probably some of both. But the cultural story you live inside matters too, and that is something we actually have some power over. That is not what I want for you or me, my peri friend.
Rewriting the Script
So I think we need to rewrite the script and frame perimenopause as a time to focus on ourselves, our health, and how we want to feel and experience the next 40 to 50 years. How do you want to feel and move through life? I want energy, a pain-free body, to be able to move and play and wake up not feeling like I got hit by a truck. I would also like some good sleep and a little less anxiety, which goes along with caring less about what other people think and caring more about what you actually think. Not what you think you should think, but what you truly think deep in your core.
The When-I-Have-Time List
This is about you and your body and your life. Do you have a “when I have time” list? I have met so many women who have things they want to do but don’t think they have time or deserve to do them because they have other obligations. Mine has had things on it for years: take dance lessons, start playing the piano again, pick up pencils and start drawing again.
The thing is, spending one hour a week doing something that lights you up, that fills your soul, that brings you true joy will pay dividends in your life. You will be happier, more fulfilled, less stressed, a better partner, a better parent, a better boss or employee. Maybe your list has something bigger than learning to dance or carve wood. Maybe you want to climb Mount Kilimanjaro or hike the Inca Trail. All possible, my peri friend.
If your issue is time, I want to share something from Episode 18 that stops people every single time they hear it. Laura Vanderkam, a New York Times bestselling author and time management expert, breaks the week down like this: 168 hours in a week. Minus 40 for work. Minus 56 for sleeping 8 hours a night. That leaves 72 hours. Seventy-two hours. Even if you work 50 hours a week, you still have 62 hours left. The question is not whether you have time; it’s where it’s actually going. If this is your blocker, go listen to Episode 18 after this. The full framework is there and it will change how you look at your entire week.
Before I go any further: if someone in your life is in the thick of perimenopause, feeling like it’s all downhill from here, send them this episode. The narrative we’ve been handed, we can rewrite it together. Send this to one woman who needs to hear a different story today.
What’s Actually in the Way
What is holding you back from being the person who kayaks, or paints in her garage, or finally books that trip? Two things are usually in the way. The first is the mental gymnastics of convincing yourself that you deserve to and can make time for yourself. The second is your body not cooperating: the exhaustion, the achy joints, the energy that crashes before noon. Most women in perimenopause are fighting both at the same time. That is where we are. But the good news is that both are addressable, and they are more connected than you think.
The Perimenopause Matrix
That is exactly what my Perimenopause Matrix is built around. Six pillars: Fuel, Move, Recharge, Regulate, Connect, and Clean. Fuel is how your body manages blood sugar and energy. Move is exercise and how you’re using your body. Recharge is sleep and recovery. Regulate is your nervous system and stress response. Connect is relationships and community. And Clean is your toxic load and what you put in and on your body. All six pillars talk to each other constantly. Pull one up and the others start to move. Let them all slide and everything gets harder all at once.
Today we are going to focus on the two that I find most foundational, the ones that make every other pillar easier or nearly impossible: the Recharge and Fuel pillars. Get those two working for you and the rest of the Matrix starts to fall into place.
Pillar One: Recharge
So let’s start with Recharge.
The first place I start with every single one of my clients is sleep. I know, I’m a nutritionist. But if you aren’t sleeping well, you’re more insulin resistant. You’re cranky. You have limited willpower. If you are more insulin resistant, you are more prone to cravings and blood sugar crashes. That is going to zap your energy and your bandwidth, feed into more poor sleep, and put your body in a metabolically compromised position where you are more likely to store fat around your organs, called visceral fat, rather than the less inflammatory subcutaneous fat.
You are also more likely to experience depression and anxiety on too little or poor sleep, as well as worse pain. Research has actually shown that poor sleep directly amplifies your pain response. So those achy joints you’re already dealing with will feel even more achy when you’re running on empty. This is also when your stress levels go up, which means poor digestion, gas, bloating, and issues with bowel movements. Sleep is where the Recharge pillar lives, and it is the most foundational piece connecting every other pillar in the Matrix. Regulate, Fuel, Move, Connect, Clean: all of them are harder when you are not sleeping. It really is the place to start.
So how do we start? My first question is: do you have a bedtime? Bedtime, you ask. Am I a child, you ask. No. You are a grown-ass woman and you deserve, no, you need a bedtime. It is the ultimate act of self-love and self-care. A bedtime means the day has an ending. You are not folding laundry until your body passes out. A bedtime is something to look forward to, a time to know that your body will rest, recharge, repair, and heal. It’s when your brain processes everything that happened that day. It’s when you store memories and file away things you learned. It’s when your brain and other organs take out the trash.
Can you imagine if the trash trucks in New York City were trying to make their rounds during rush hour? It would be a hot, stinking mess. Let’s not force your body to do its cleanup routine while you’re also trying to be an awake and functioning human.
How does one set a bedtime? Know when you need to get up and count back 8 hours. Do you have to sleep all 8 hours? No. But you do need the sleep opportunity. If it takes you 15 minutes to fall asleep and you wake up once to use the bathroom, and you give yourself 8 hours of sleep opportunity, you will probably land around 7.5 hours of actual sleep. If you know you need a full 8 hours, then give yourself 8.5 hours of sleep opportunity.
Once you have established your bedtime, set yourself up for success. Set an alarm 30 minutes before bedtime to remind you that it’s time to start winding down. Wrap up whatever you’re doing. Turn off your screens. Eventually it’s helpful to work up to an hour or so of no screens before bed, but baby steps.
If sleep is your biggest issue right now, go back and listen to Episode 7, where we go deep on everything from sleep hygiene to the stress-sleep connection. The link is in the show notes.
Pillar Two: Fuel
Now let’s talk Fuel.
This is the second pillar I always address, and it works in tandem with Recharge in a way that can almost feel unfair when it’s going wrong. Poor sleep worsens your insulin response. Blood sugar crashes disrupt your sleep. They keep each other stuck. But when you start moving both in the right direction, even a little, the whole system starts to feel different.
If you are interested in the lab side of this, go back and listen to Episode 16 on metabolic labs. But let’s focus today on how your body feels right now. Does your breakfast keep you full, your brain working, and your body feeling good for at least 4 hours? Do you have sugar and carb cravings an hour or two after breakfast? Do you hit the 2pm wall and would trade your left arm for an espresso and a croissant? Are you a hangry monster when you walk in the door after work and want to murder everyone until you have dinner? Do you get headaches, sweaty palms, anxiety, or feel jittery if you wait too long to eat? Then, my sweet peri friend, blood sugar needs some attention.
Here is the perimenopause layer on top of it all. Estrogen directly supports insulin sensitivity. When your estrogen is stable, your cells respond well to insulin and your blood sugar is regulated fairly smoothly. But in perimenopause, estrogen starts to fluctuate, sometimes quite wildly, and those fluctuations affect how your cells respond. The oatmeal that was totally fine at 38 might tank you at 44. The glass of wine that never bothered you might now wreck your sleep and spike your blood sugar at 2am. That is not weakness. That is not something you did wrong. That is physiology. And once you know what’s going on, you can actually work with it.
When addressing any food changes, I always like to start with adding rather than subtracting. If blood sugar is an issue, start by adding a protein and fiber-fueled breakfast. Even if blood sugar is not your main issue right now, a protein and fiber-packed breakfast is never the wrong call. It is the single most common change I make with clients and the one that ripples furthest across the rest of their day. You can make scrambled eggs with spinach and black beans in the microwave in under 7 minutes and throw some salsa or avocado on top for extra flavor and gut-loving diversity. You can make a smoothie with your favorite protein powder, frozen cauliflower, frozen spinach, and some low glycemic berries. You can have leftovers from the night before with your protein and veggies. You can also have a chia pudding bowl with all of your favorite toppings.
If you aren’t sure where to start, take my Breakfast Personality Quiz linked in the show notes. You get your personality type and a set of breakfast recipes that you can try until you find your Goldilocks fit.
Closing
So this week, two questions: do you have a bedtime, and what did you eat for breakfast this morning? This is not a small place to start. This is the foundation that every pillar in the Perimenopause Matrix sits on top of. You’re not behind. You are just beginning.
Can you do me a favor? If this episode gave you something to think about, share it with one woman in your life who needs a different story about perimenopause. Our bodies didn’t come with a user manual, and this perimenopause thing can feel confusing and lonely. But you are not alone. You are not crazy, and you are definitely not broken. Maybe someone in your life needs that reminder today. Let’s spread the word and be kind to each other and ourselves.
Now the legal bit: I’m a nutritionist, but I’m not your nutritionist. This podcast is for information and education only. No client relationship was formed. Always seek medical advice when necessary. I’ll see you next Wednesday morning.
