Brain Fog, Weight Gain, Poor Sleep: Dr. Stacy Sims on Why Women Are Given SSRIs Instead of Answers

0:01This is a Be Well Moment, the most replayed moments from my latest conversation. It's a glimpse into the wider episode, which you can find linked in the show notes below. Because sometimes one small moment is enough to reconnect to living well and being well.

0:22I know it changes and it differs, but what age roughly does perimenopause start? anywhere from 32 to 35. See, that blows my mind. And people don't realize it, right? Yeah. People don't realize it. Okay. And one of the things that I say all the time is like one of the major, I guess, representatives is a woman who's between the ages of 35 and 40 goes to the doctors like, I'm having all these problems, like I'm putting weight on or not sleeping well. I'm losing muscle. I feel like I'm waking up squishy overnight. I can't relax. I'm tired but wired. And physicians who are not that well-versed in perimenopause will say, well, it's because you are a career driven woman.

1:06You might have kids. You might have older parents. You might have a partner who's also just as busy and it's stressed. So here's a serotonin reuptake inhibitor to help. Good old SSRI. Right, right. And this is not the answer. Because when we start looking at the actual symptomology of perimenopause, you might not start having overt symptoms until you're in your mid-40s, but it actually starts seven years before that. See, I didn't realize that I am obviously perimenopausal then. This is where - I'm in that bracket. Yeah. 32 to 35. And so when we're looking at anovulatory cycles, this is where we start to see more and more anovulatory cycles that are occurring.

1:49And this is what's driving the perimenopause. Wow. So I think when people hear that, they then, I naturally think about, I guess, kids. Yeah. Right? And, you know, your fertility start dropping. Yeah. And so that's quite aligned with perimenopause. Yeah. Okay. And it's not something for people to freak out. we see this again from textbook and medical text but that doesn't necessarily mean that you are perimenopausal okay right so it's the average age but i guess that maybe i'm not aware of it and that's why we're talking about it today maybe i'll leave this and think i am yeah maybe maybe not but i mean like i was i was um classified as a geriatric mom because i had my daughter when i was 38 why do they use these terminologies by the way um because i was older than 32 when i was pregnant.

2:35It's wild. I know. Geriatric. Yeah. It was a geriatric mom. But yeah, I didn't know IVF or anything. It was natural. Not that it was easy to get pregnant, but it was very doable. But then afterwards, it's like I had a really bad postpartum depression, but was it postpartum depression on its own or was it perimenopause that was coming into play? These are things that aren't talked about, right? So if we unpack it and look at what are all the symptomology of perimenopause with mood disorder, changes in body composition, poor sleep, you know, changes in blood glucose control, all of these things and the severe depression and anger and rage and all of those, it could be postpartum depression or it could be perimenopause or it could be both.

3:24So if we start to make women aware of what's happening, right, we know definitively that but in your mid 40s, you are perimenopausal. Okay. So some of the overt signs and symptoms, because we can't do blood tests, we don't know, right? There are no clinical tests. It's all subjective. So we look at mood, we look at body composition, we look at gut health, if significant changes in gut health, because we see - So more bowel transitions, more frequency going to the bathroom, or diarrhea, or constipation. All of those things. Okay, flatulence, bloating, all of these things. If you're having more issues with iron as well, so you're starting to have more low ferritin, maybe you're…

4:09Iron deficient. Yep, but not quite anemic. Not anemic. Yes. And we start seeing there's a decrease in the diversity of the gut microbiome, which predisposes women to putting on our visceral fat. because when we're looking at how our sex hormones are metabolized, we have that second pass where it goes through and is bound by sex hormone binding globulin, gets shot into the intestines through bile, and then are unpacked by the gut microbiome and then shot back out. We have more and more anovulatory cycles. We lose those little bugs that are unbinding from sex hormone binding globulin, reduces the diversity, So we start to see more overt symptoms of a low diversity of gut microbiome.

4:58Right. And that could be the only thing that you have is perimenopause. And you're like, why do I have such gut disbiome issues here? And it's perimenopause. So if we're looking at the symptomology of it, most people think, oh, it's just hot flashes. I'm just - That's the number one thing that's spoken about. But isn't it one of the least? it's the most overtly seen and felt but it is probably the least common we see most of the parasympathetic changes that happen where women are just walking around tired but wired and brain fog and they're like what is going on that's the thing yeah brain fog right it's so hard to explain yeah but sometimes i can't pronounce my words yeah yeah yeah it's like jet lag it's yeah which we're probably both experiencing right now where you're walking around and you feel like you're part of your life and you're part of everything but you're just a little bit removed it's i think it's the claritine ad or the claritine ad where they have the head that's separated from the body like allergies that's brain fog that's brain fog yeah yeah i experienced that yeah so that's part of the misstep in our estrogen progesterone receptors in the brain where I think it is Lisa Moscone showed images where there's a huge light up of all our estrogen receptors in perimenopause but it's not because we have all this estrogen that's being released and we're estrogen dominant but it's because the brain is trying to soak up as much estrogen as possible because there's less of it being produced so when we're having this overstimulation of estrogen receptors then we start to have a misstep and people like well that's part of brain fog.

6:45So it's a whole systems, like all of our systems are affected. Thank you for listening to this Be Well Moment. If it resonated, the full conversation is linked in the show notes. And I hope it gave you a small pause to take a moment for you and to reconnect to living well and being well. If you loved it, please do leave a review, follow the show or share this maybe with someone you love.

7:13Thank you.