075: [FEMALE HEALTH] Menopause, Hormonal Health, & Fertility according to Chinese Medicine

Hi everyone! Welcome back to The Other Way. I'm thrilled to be here after taking a short break to recover from Spirit Weavers and my Reiki training in Ojai. I'll be sharing an episode about those experiences soon.

Today, I'm excited to welcome back an amazing guest, Dr. Gabby Pavelko, a Doctor of Traditional Chinese Medicine based in Sausalito, CA. Dr. Gabby is a primary care doctor with a special focus on hormonal and women's health, which will be our topic today. In addition to her practice, Dr. Gabby serves as Chief of Staff at Rootless, a supplement containing seaweed and iodine, a crucial trace mineral for women's health, which we will discuss in detail.

In this episode, we will explore the intersection of Traditional Chinese Medicine (TCM) and perimenopause and menopause, covering topics such as:

- The lifecycles of a woman according to Chinese Medicine
- Perimenopause and menopause: perspectives from Western Medicine and TCM
- Understanding chronic symptoms through TCM and what to do about them
- The role of cortisol in balanced hormones
- The importance of the thyroid in navigating perimenopause and menopause
- Reframing menopause: insights from Asian traditions and celebrating the "Second Spring"

And much more!

Tune in for a deep dive into women's health and the wisdom of TCM with Dr. Gabby Pavelko.

 About Dr. Gabby:

Gabby earned her Doctorate in Acupuncture and Chinese Medicine at the American College of Traditional Chinese Medicine in San Francisco, specializing in women's health and fertility. She is a California Licensed Acupuncturist.
As Chief of Staff at Rootless, Gabby uses seaweed to promote health for people and the planet. She is passionate about sharing her knowledge of TCM to advance the narrative of food as medicine. Her career intersects food innovation, plant-based medicine, community building, and women's health.
Gabby understands the difficulty of balancing hormones, having struggled with painful cramps and mood swings due to early hormonal birth control. Through lifestyle changes, TCM, and daily seaweed consumption, she has achieved hormonal harmony and aims to help other women do the same.

To connect with Dr. Gabby:
 
IG: gabbypavelko &  get.rootless
Email: drgabbytcm@gmail.com
Booking site for appointments with Dr. Gabby
Getrootless.com

Wanna get free Rootless? Keep reading!

Rootless Labs is seeking women aged 35+ for a 4-week trial of The Daily Bites. Participants receive 3 free pouches and a 20% subscription discount after the trial. To join, complete a 5-minute survey. Read more here.

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Transcript

Kasia: 0:01

Hello and welcome to the Other Way, a lifestyle podcast exploring uncommon, unconventional or otherwise alternative approaches to life, business and health. I'm your host, kasia. I'm the founder of InFlow, a women's wellness brand that designs intentional products to help women reconnect to their unique cyclical rhythm and find a balance between being and doing. This podcast is an extension of my mission within Flow. Here we provide intentional interviews with inspiring humans, trailblazers, researchers, spiritual teachers and more on the journey of doing things the other way. Now, today's guest is no exception. Hello everyone, welcome back to the Other Way. I am so excited to be back.

Kasia: 0:58

I took a break last week, recovering from Spirit Week of Weavers and my Reiki training. I'm going to share an episode all about my adventures coming up soon, but for now, I am integrating and I'm so excited to be back and welcoming another incredible guest, dr Gabby Pavelko, who is a doctor of traditional Chinese medicine based in Marin County here in Sausalito of traditional Chinese medicine based in Marin County here in Sausalito and she covers many conditions in her practice as a primary care doctor here in California, but her specialty is really hormonal health and women's health, which is our focus on the podcast today. So we are really doing a perimenopause and menopause focus episode, but I would say that this conversation is relevant for everyone, even if you are in your you know, in the height of your fertile years. This is such a relevant conversation because we're really viewing women's health and the cycles that women go through through this tcm lens, and I learned so much on today's episode. We covered what are the life cycles that a woman goes through according to traditional Chinese medicine. How does that compare to Western medicine?

Kasia: 2:13

We define perimenopause and menopause. What is it according to Western medicine and TCM, as well as when does it begin? What are some of the signs and symptoms to look out for? We talk about how menopause and perimenopause symptoms are not your fate, how these chronic symptoms are actually signs according to tcm and what can be done about them. We dive into the importance of cortisol for balanced hormones, the importance of your thyroid for navigating perimenopause and menopause, and we talk about reframing this life stage that we get into and the wisdom of ancient traditions on how to celebrate what they call the second spring, and so much more. This episode is for all you ladies out there that are really looking to understand your body better, to understand what's happening within your body a bit better and to really view your health from a holistic point of view. So, without further ado, let's jump on in and welcome Dr Gabby to the podcast. Dr Gabby, welcome to the podcast.

Dr. Gabby Pavelko: 3:22

Thank you so much for having me. I'm really excited to be here.

Kasia: 3:25

I am so excited. We have been waiting for some time to get this on the books and we have so much to cover. But before we do, I would love for you to share. Actually, when we were talking about intros and how would you like me to refer to you on this podcast, you mentioned that a lot of people call you not just Dr Gabby Pavelko, but the last resort doctor. Can you talk a bit about that?

Dr. Gabby Pavelko: 3:51

Yeah, I think what's really interesting is that I'm in the field of traditional Chinese medicine.

Dr. Gabby Pavelko: 3:57

A lot of people call it alternative medicine, complementary medicine, and I don't think a lot of people in the western world think of it as the first approach to go to when something isn't working, and so they usually say, oh, I already went to 10 different types of doctors, I already spent so much time and money on trying to figure this out, and now I'm coming to you, can you?

Dr. Gabby Pavelko: 4:22

And I think that it's a really interesting place to be because you feel like they still have hope, but they've already been through this really intense journey along the way. But it also makes me feel like I wish she would have reached out to me a little bit sooner, because, yes, I can help now. It's never too late, but I think that I could have done a lot along the journey, if anything, to reduce your frustration with the medical system or whatever you've been through. So, whether it's fertility and these days like more menopause type things, it's really frustrating because people go to many rounds of IVF, many different types of specialists, all different types of doctors, and aren't getting any answers or the answers that they're looking for. And then they usually come and say I've already tried all these other things, you're my last resort, can you help?

Kasia: 5:14

And the answer is yes usually I love that and it is wild. For the folks who have been listening to this podcast for a while, they will know that I did. Actually, when I left my corporate job, I went to study Chinese medicine for two years. I didn't finish the program, but one of my projects did involve speaking with practitioners in China and their medical system is just set up so differently and TCM is so incorporated as a standalone medicine that's available to the people but also it's available within hospitals. It's like part of the treatment protocol and I think that it's obviously exciting that here in the West, Chinese medicine is now covered by insurance for a lot of the conditions. But I just I love you naming the fact that treatment can begin so much sooner. It doesn't have to be after you've expired all of your other options.

Dr. Gabby Pavelko: 6:10

Yeah, and I really don't think that people realize like the depth and breadth of what you can see someone for TCM for.

Dr. Gabby Pavelko: 6:13

I think a lot of people recognize you can go for pain, and I think that's something that's been really almost over communicated potentially, and I don't think people realize you can come for like sleep digestion, fertility, menopause, hormones, all of that sort of stuff. So I think that it's starting to grow in other areas and not just necessarily be known for chronic pain. I would say typically people are like, oh, I've had this back ache for five years and I've tried all these different things and I have a really interesting story about that. But because I think usually people assume if something is chronic they have to live with it and that's not necessarily the case, right, and it doesn't necessarily mean that you have to do a lot of different treatments to fix it. So I think that there's a lot of misconceptions around TCM and traditional Chinese medicine and we're hoping that we can spread the word and get more people to come sooner, because I think a lot of times they can help. Other types of medicine or modalities can't.

Kasia: 7:12

A hundred percent. I personally always feel like, okay, acute situations like broken ankle, I'm going to be going to a surgeon. But when it comes to something chronic, something autoimmune, like situations for which a lot of the conventional Western treatments especially just have bandaid options, which is to reduce the symptoms but not really treat the root cause TCM is just so powerful for that. But before I go down that entire path, I would love for you to introduce yourself to our audience, but in a kind of different way. I love to do three words that you would use to describe yourself.

Dr. Gabby Pavelko: 7:48

I love that. I am Dr Gabby Pavelko and I actually have my doctorate in traditional Chinese medicine, which in California means I am a primary care doctor. I would say the three words that I would use to describe myself are charismatic, adventurous and intuitive.

Kasia: 8:07

Okay, I definitely honed in on the first two. The intuitive is surprising. I love it. This is why I love this question, because you get to see somebody's other side. But, yes, you are probably the most charismatic person I know, to be frank, so I love that. Very warm for treatment too, I'm certain.

Kasia: 8:26

So I want to start to shift gears into some of the more Chinese medicine-focused questions and since you mentioned that there's so many conditions that Chinese medicine can help with, what I would love to focus on in this episode is really focusing on women's health, which is the theme for this season, and looking at women's cycles and life stages. So I feel like in the West we really focus on, really it feels like the start of you've gotten your period and then you go through menopause and it's like beginning and then end. It's like really dreadful, I feel, the way that it's just positioned. I'm curious. First of all, did I miss anything in that positioning? But how does TCM view women's cycles and life stages? And if you look over the course of a female's life like, what are some of the main milestones that TCM focuses on?

Dr. Gabby Pavelko: 9:17

So in TCM, women actually go through seven-year cycles and men go through eight-year cycles, and this is one of the first things you learn in TCM school and I just thought this was so interesting because it explains so much. So women mature actually a little bit faster because they're going through these like seven-year cycles Proof proof right here. Yes, but I think what's interesting and what a lot of people have been focusing on lately is in the traditional Chinese medicine doctrine the women's cycles actually end at 49 in terms of the traditional teachings, because women used to only live until they were like 49. And in a lot of the ancient world menopause wasn't even really a thing. Because women are living longer now and so with just innovation in health and medicine, it's like we're staying alive longer, but we were never really prepared as people, I think, for all of the things that come with living longer potentially. So I think that's really interesting and actually in the original teachings, men, theirs was 64, was like where theirs kind of ended. So it's interesting because at first, when thinking about this, you might think does that mean like women's lives like end at 49? There's like nothing to look forward to after that. And I think in Western medicine that's been like.

Dr. Gabby Pavelko: 10:41

The traditional view of menopause is you're drying up, you're aging, you're going to become irrelevant to like not only your job, but also your husband, your family, your children, all of that sort of stuff, and I think that we're redefining that now, not only from a Western medicine perspective. I think aging and going through menopause is actually the most powerful time in a woman's life. You hear all these amazing examples about how women actually are finding their way after they've done that, but I think traditional Chinese medicine always had a view like that, where actually, you know, even though they're saying 49 was the last cycle of a woman's life, 49 was the last cycle of a woman's life. It's because you have given up this role as just being a mother to children and to having menstruation, to becoming a mother of wisdom, and it really like in Asian cultures, like they're the most revered, right Like people, they're the wisest and if you think about even teachings of like women in all cultures in ancient medicine, they were really the people that everyone would go to get information from, and I think that there is so much truth to that.

Dr. Gabby Pavelko: 11:54

Every year that goes by, I feel so much wiser, I learned so much and specifically women have this intuition. I think I said intuitive when I described myself, but all women are intuitive. I think we all need to tap into it a little bit more and I think what it means to each woman is slightly different, but there is this healing wise woman that happens after 49. And I think that's the part that wasn't really included in the ancient teachings so much but is being unearthed now and also parallel pathing that in Western medicine too.

Kasia: 12:30

I have so many questions to loop off of this, but I'm curious actually If you have any insight into when you talk about the wise woman being revered. Can you talk a bit about that, because I feel obviously I just shared that I came back from Spirit Weavers. We were celebrating women of all ages. They have so many beautiful kind of traditions at this gathering of supporting women who are transitioning into puberty through to honoring and revering the sages of the group which are elders. Curious, what does it look like in Asian cultures? Because maybe we can paint a different narrative.

Dr. Gabby Pavelko: 13:06

Yeah, I think that you think about like the grandmother figure in a family and it's this wise woman that a lot of times actually cares for the young children, give you an herbal formula off the top of her head, like, oh you're sick, take this kind of thing. Your mother always told you these things when you were a kid and I feel like there's always this kind of rub between a mother and her daughter. But when you go to the next generation, if your wise grandmother tells you to do it, you just do it. I think it's interesting because that has been lost a little bit in Western society A lot of women after they go through menopause. It's interesting because I recently heard a stat that the divorce rate is a lot higher as women are going through perimenopause.

Dr. Gabby Pavelko: 13:53

I was actually curious about that as I started to dig deeper and talk to a lot of women who are getting divorced during this stage of their life. It's initiated by them. They have woken up to the fact that the kids have left the house. They have never really been able to focus on themselves, they've never really been able to focus on their bodies, and they want to go on an adventure. They want to travel around the world. They want to start a whole new career at this stage of life, because post-menopause can actually be a third or a fourth of your life. Now women are living until their 80s and sometimes even longer, and I think it's just really amazing and inspiring to hear these stories, because at first I was a little worried that it was like because they're aging, they're not feeling that. But as you have seen, even in today's world, women in their 70s breaking Guinness records right. It's very different from the way that it used to be and I'm very excited about that.

Kasia: 14:51

Same here. We, a bunch of girlfriends and I we actually organized a kind of wise women ceremony for one of our friends and she's in the stages of really perimenopause. But she was grieving that quite a bit and so we really wanted to make her feel special and reframe this, because there are so many beautiful gifts that come with this stage of life and I just love that you are naming that. That is just so powerful.

Dr. Gabby Pavelko: 15:18

Yeah, and I think just to give the audience some definitions about what these things are. I think what really blows my mind is we've been leading a lot of panels lately and we always ask people a question do you know what menopause is? And a lot of people are just like wait what? And menopause is the 12 year anniversary of not having had your cycle.

Kasia: 15:38

Wait 12 year or 12 months? 12 months, okay, yeah.

Dr. Gabby Pavelko: 15:46

Yeah. So what I mean by that is if you don't get a cycle for four months and then you get it again, you actually have to start over from day one. And I think it's interesting to a lot of women because they'll actually say, oh, I hit really early menopause. But sometimes, based on whether you have breast cancer or depending on your own hormones, a lot of women may or may not cycle or not have a regular cycle. So they're like this is a really hard thing to just define what menopause is off of, and I think that it's changing a lot. Define what menopause is off of, and I think that it's changing a lot.

Dr. Gabby Pavelko: 16:24

Perimenopause is the three to 10 to sometimes even longer years that lead up to that 12 month anniversary. And I think that what a lot of people don't realize is that perimenopause can start for women in their 30s. It can also maybe start in their late 20s, depending on different things family history, stress, diet, exercise, right and just because you don't have a regular cycle for 12 months doesn't necessarily mean you're in menopause. But I think that you should go to a doctor and start to have these conversations with them. I think it's also really helpful for women to get a baseline in their 20s and 30s to know, like when I'm feeling healthy, what does everything look like, and then, when I'm starting to notice differences, I can compare them against these baselines. I think that's the biggest kind of learning that I've had in this space of root cause and holistic health is really understanding what is normal for you and I think normal for every woman is slightly different, which is very nuanced, hi everyone.

Kasia: 17:32

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Kasia: 17:38

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Kasia: 17:44

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Dr. Gabby Pavelko: 19:01

happening in the body and what is happening in the body during perimenopause as well. Yeah, so hormones, just like we were talking about during puberty, is when you are really starting to ramp up a lot of your hormones and starting to produce them. You're starting to get your first menstrual cycle. All of that.

Dr. Gabby Pavelko: 19:15

Perimenopause is really when certain hormones are actually starting to decline and and they're going to go into decline for pretty much the rest of your life and estrogen, progesterone, dhea, testosterone even I don't think a lot of women realize that they have testosterone and that it can be really important. So there's different symptoms and signs to look out for, I would say, and I think Western medicine really focuses on the signs and symptoms, but for TCM, we think of signs and symptoms as your body communicating to you that something is wrong, and so I like to tell people that you don't have to experience a single symptom, but you will experience menopause because you're eventually going to stop having a monthly cycle, but you don't have to have hot flashes, you don't have to have night sweats, you don't have to have brain fog and all the things that come along with perimenopause or menopause, and I think that women, like I said, especially the younger generations are really trying to understand their bodies, and a lot of this is totally new information.

Kasia: 20:23

So essentially just to recap for people, puberty is when your hormones are like. I guess all of your kind of sex hormones are starting to be produced, right? Perimenopause is when they start to decline. And then what happens during menopause?

Dr. Gabby Pavelko: 20:37

The way that menopause is actually defined actually has nothing to do with your hormones.

Dr. Gabby Pavelko: 20:43

It's that 12-month anniversary, and so I think what is interesting is that for each woman, your hormones might actually be doing something differently, and I think a lot of people focus on estrogen, progesterone, testosterone right, but there's also cortisol. There's other hormones that people aren't necessarily paying as much attention to, and cortisol is actually like a predecessor for your sex hormones. So in today's society, you know, something that I think women are tired of hearing about is like's so much more stress, but cortisol is your stress hormone and the reality is like there is just a lot more stress in today's society, but if your body is like producing more cortisol, it's not producing as much estrogen or progesterone, and I think what is interesting is that you can stop having your cycle but you can still be like naturally producing estrogen. You can also eat foods, that kind of mimic estrogen in your body. So there's not necessarily for every woman.

Dr. Gabby Pavelko: 21:51

Menopause means estrogen is no more. It's different for every woman. So truly like, the definition of menopause is 12 consecutive months of not having a cycle. So I just want people to understand that.

Kasia: 22:04

I love that you actually mentioned that it's not necessarily the lack of the hormones, it's more so just physiologically, the kind of anniversary that you're describing there. I think that's so powerful. I'm curious does Chinese medicine how does Chinese medicine define menopause? Does that even exist in Chinese medicine, or is it viewed completely differently?

Dr. Gabby Pavelko: 22:24

Yeah, I'll always remember there was like a flyer in the waiting room of the clinic where I did my clinical practice during my studies that said menopause is the second spring and I think I love this definition.

Dr. Gabby Pavelko: 22:40

I loved it because to me, like spring, if you think about the feeling of spring, it's like awakening, everything is growing, all of that, and I had never really thought about it that way, but it really is truly a new time, I think, in a woman's life that she is not thinking so much about. Think about how much your cycle actually consumes of your life, whether you get really bad PMS symptoms or a lot of women actually have to miss work or things like that, and then it's to not have. That is actually really freeing for a lot of women. And it's interesting, like you said, to celebrate a woman entering this time of life, because for a lot of women, it's actually really a sensitive time because whether they had kids or didn't, whether they wanted to have kids or didn't, it's really a redefining moment of now. You're not defined by your ability to have children. You're now defined by you and your ability to do anything you want to do and that is like a really empowering place to be, which is amazing, so I love that definition.

Kasia: 23:51

I love that. Oh my gosh, what a beautiful perspective. I've never actually considered it that way, and I love that the texts actually speak to a second spring, because that is just such a beautiful perspective shift. It is like a whole new awakening of something else blooming. And so you spoke to this. In Western medicine we kind of mark menopause as that 12 month, 12 month anniversary of not having a period. Does it look the same for TCM? Is it also just that one day or is it? Is there a transition period? Like, how does TCM actually view that second spring?

Dr. Gabby Pavelko: 24:27

I think that the average age for menopause in Western medicine is 51. So I think that in traditional Chinese medicine that 49 is actually really close to that average age. But I think that's when they view menopause happening around is around that age of 50, which traditionally women didn't even think or like worry about menopause until they were 50. Right, so that's the age that I think is in everyone's mind.

Dr. Gabby Pavelko: 24:57

From a pattern perspective, I think that as anyone ages, women or men, we definitely see trends that you start to hear about, like hair thinning, hair falling out. A lot of that is actually related to kidney. There's things that are happening like eyes drying out, things like that's related to liver as you age liver, spleen, kidney those are ones that we focus on a lot. But I think that there is also just this specific nuance in Chinese medicine as it comes to women aging and ultimately, what it comes back down to is like in Western medicine we call it hormones, right, but in Eastern medicine it's your energy and even from a perspective of like fatigue, right, like feeling that feeling of just like being tired, and that's deficiency in Chinese medicine. So as you're starting to get older, you're really treating more of a deficient pattern in a lot of women, and that is, I think, really the indication that things are changing in their body.

Kasia: 26:06

It's not necessarily like a specific day, like in Western medicine, but there's definitely changes that we're looking out for, as we're talking to our patients and we are trained in Western medicine as well, so we understand those definitions as well too I think it's quite beautiful that actually, in chinese medicine, rather than it being like a very specific day that has some sort of a name to it or is defined as a marker, it's just a gentle shift in the patterns that show up in a woman's body.

Kasia: 26:39

I think that also lends itself very well to actually what happens physiologically, as we just talked about, which is that it's not just like a complete cessation of hormone production. It actually your hormones may actually still continue to be slightly produced. You don't get your period, but there is that subtle shift in your body. I think that, rather than it being such a binary kind of event, that is, 12 months after you don't have your period, you're now in this new phase of life. I view the TCM approach to this transition to being very gentle and more aligned with the way that nature, I think, experiences shifts like the shifts from fall into winter and winter into spring, right, like they're subtle, they don't just come on over. It's a very gentle switch. I love that.

Dr. Gabby Pavelko: 27:24

I think one of my favorite things that I used to make TCM understandable for people is, like one of the very earliest things that you learn about in TCM is yin and yang, and I think one of the best ways to actually paint this picture for people is men start their lives. Little boys have a ton of energy, they're loud, right, they're like running all over the place and as men age they actually become yin. So when you think about like older men, they actually are like Ola's blanket bundled up as they get older. And women start their lives very yin. We're quiet, we're cold when we're younger and then we actually transition into this yang phase and that is really like TCM's explanation of hot flashes right Of all, of that natural kind of warming of a woman's body, and I just I think that is like another just of those transitions and cycles that is so beautiful and well illustrated in TCM that like we're missing, I think, a little bit from Western medicine and it's so simple to understand.

Kasia: 28:29

I think that's such a beautiful concept and just seen throughout nature.

Kasia: 28:32

I love that you mentioned that.

Kasia: 28:34

Speaking to some of the symptoms that we talked about hot flashes, sleep disturbance, night sweats, mood changes I'm just reading off the list of thank you Google for symptoms of menopause or the symptoms we associate with menopause. Would TCM view these as imbalances or is it just because I think one of the things that blew my mind about Chinese medicine in a way and you can correct me if this is wrong, but the notion I think? For a while I was like, oh my gosh, I don't want to have any patterns show up in my body because a pattern implies that something is off, which again is like such binary thinking, and I remember speaking with an acupuncturist who had explained that at any given time, someone may have four or five patterns present within their bodies. In Western medicine we are fixated on treating the symptoms of the mood changes, the sleep disturbances, the hot flashes, et cetera. How does Chinese medicine view it? Would those symptoms indicate specific patterns that are out of balance, or is it kind of something that is viewed from a different perspective?

Dr. Gabby Pavelko: 29:37

Yeah, I think that I would take all the symptoms that someone is experiencing and, again, I would listen to them and I would validate it. But symptoms are not as significant, I would say, in TCM as they are in Western medicine Because, like you said, in Western medicine they're treating these like acute symptoms that are just coming up and they're never a lot of times actually addressing the root cause. So what we're doing is we're taking their pulse, we're looking at their tongue, we are asking them the 10 questions we're really starting to understand. Do they generally run hot and all of a sudden they're running cold, right, like noticing changes in that?

Dr. Gabby Pavelko: 30:17

Because to your point, it sounds scary if you're like you have an imbalance, but the reality is like most of us, especially in today's world, have a lot of influence in our bodies and we're not performing at our peak because of that. And so what we're doing with Chinese medicine is like very nuanced and making these like little adjustments, like within the energy and you know of your own body, so that it can heal itself. And I think that's really the powerful part, which is why TCM works so well with Western medicine, is, yes, symptoms are terrible and you want to get some acute treatments to help those, for example, like vaginal dryness not something that a lot of people even think about, but you can put a topical hormone to address that very acutely. It will help. But at the same time you can go to TCM and vaginal dryness is likely a yin deficiency, right. So again, as you're getting older, you're experiencing these kinds of deficiencies, so you can actually be tonifying or adding to that whatever organ is deficient, and so you're actually treating it from both sides.

Dr. Gabby Pavelko: 31:28

Because I think that what a lot of people assume is that if you're doing the root cause solution, that you are not acutely treating the symptoms as well. But you should. You don't want your patient to go home and be uncomfortable, but you want them to also have relief from their acute symptoms At the same time. We call it treating the root and treating the branch. So you are getting at what is causing it from the first place, but also addressing what they're showing up, as today.

Kasia: 31:57

I love that. I think that just makes a lot of sense to look at, both treating the acute symptoms but the root cause, which I feel like is just so important for a lot of these chronic conditions For women who are transitioning. They're in that phase of perhaps I'm entering perimenopause, I'm not sure if I am. It's funny because we're having kids later in life where, if you look at that, in 12, 5 to 10 to 12 year mark, some women that might still be in the conception journey might also be experiencing some of the indicators of perimenopause. What can we do to start to prepare ourselves and keep ourselves healthy? I'm sure that the list can be very long, so if you could prioritize like three things that should be top of mind for women that are transitioning into perimenopause, preparing for that next life stage.

Dr. Gabby Pavelko: 32:47

Yeah, oh, my gosh, that's such a great question. I think number one is to get a baseline so you know to your point you can still get pregnant while you're going through perimenopause. I think a lot of women forget about that, but also a lot of women actually go into perimenopause right after they have a child, because your hormones are all over the place already and then having a child is actually really depleting of all hormones and everything in your body, right? A lot of my friends who have recently just had babies in their early 40s are also experiencing perimenopause and a lot of them actually assume it's just postpartum, but it's transitions of hormones. All of them are transitions of hormones. So I would say, definitely get a baseline.

Dr. Gabby Pavelko: 33:34

Functional medicine doctors will tell you to do things like get a DEXA scan. It's going to tell you about your bone density, it's going to tell you about your visceral fat. Like, I'm not a functional medicine doctor, but I've gotten a DEXA scan. I'm in millennia pause, right, no-transcript. Just have an understanding of, like, where you were, where you are, where you're going. So there's an understanding of what is happening in your body and really just listen and check in with yourself If you're noticing changes in your cycle, if you're noticing changes in your body and really just listen and check in with yourself.

Dr. Gabby Pavelko: 34:31

If you're noticing changes in your cycle, if you're noticing changes in your sleep, if you're noticing changes and a lot of people actually say if you're 40, you're in perimenopause, right. So it's like really just putting down this, because a lot of women will deny it and I think have been trained to deny it. It's not scary, it doesn't have to be scary, but talk to a friend, talk to a doctor. If your doctor doesn't want to talk about it, find a new doctor, ask your mom. They may or may not talk to you about it, but I think that it's just really important to just talk to people, because that's how we're going to educate each other and ourselves.

Kasia: 35:10

A hundred percent and, ladies, we're reframing this. This is the second spring, so I don't think we need to be terrified of that. In that vein, making sure that we get familiar with our baseline, you started to talk about the importance of both cortisol, and you also talked about the role that our thyroids play in terms of hormonal health. Could you explain why is it important? Amongst some of the other tests that you mentioned, we should be looking at why specifically cortisol and checking your thyroid levels is so important.

Dr. Gabby Pavelko: 35:44

Yeah, so cortisol is produced by your adrenal glands and, from a TCM perspective, adrenal is actually part of your kidney and your kidney is like your life force in Chinese medicine, right. When you think about, like when you're tired, a lot of it can actually be related to cortisol and adrenal production. So I think that just getting an understanding of where you're at your cortisol, just like your other hormones, fluctuate throughout the day, throughout the month, all of that but producing cortisol and producing sex hormones are related. So if you're just constantly under stress, you're going to have excess cortisol and deficient sex hormone. So I think that is a really good way to think about it. So it's so important to understand that that's like burnout, right there.

Kasia: 36:32

Exactly, totally. See, that actually blew my mind hearing that for the first time, because when you talk about the TCM connection of life force, just that is like a powerful reframe. I think that in our society we're like burning a candle of both ends. Right, like you do the hard workouts, you work super hard, you're going out filling up all your calendar with all the things and you feel depleted at the end of that. Keep doing that. You're not just going to fall into like burnout, but I love that connection of life force, energy and that's a really important, I think, distinction of like how to view overdoing it as well. Now let's talk about thyroid and like the role that the thyroid plays in terms of, kind of female hormonal health.

Dr. Gabby Pavelko: 37:19

Yeah, the thyroid is really like the master of all hormones. Really, I think it's interesting because from a TCM perspective, we don't necessarily specifically learn about thyroid as like an organ or really even talk about thyroid as an organ, but it's so interesting because if you think about it as the battery of your body, so hypothyroid a lot of people hear about hyperthyroid, right? Hypo meaning low, hyper meaning high. As a society in America we are tending towards hypo and as you age you actually likely become more hypo, meaning your metabolism flows down, your energy is low, you have brain fog, things like that. That's more tending towards hypo and this is obviously a really oversimplification. Hyper is you have crazy amounts of energy, can't keep weight on. Do you know a lot of people like that? Not really, it's like more the other way. Yeah, there's also autoimmune versions of both of those. Right, you hear people talk about Hashimoto's and autoimmune Graves disease is like a hyper.

Dr. Gabby Pavelko: 38:23

I think that there's just a lot that hasn't really been studied. Research brought into the standard of care about thyroid and it's just it's so important in everything that you do, from your sleep to going to the bathroom regularly, and really the way to get your thyroid to perform more is actually to eat iodine, and that's not even something that, like a lot of people understand. But whether it's iodized salt or vegetables or seaweed or seafood, eggs, dairy, you have to eat it to get it into your body. And it's actually really important during times of women's health, hormonal changes, when you're trying to get pregnant, when you are pregnant, when you're postpartum and when you're going through menopause, you actually need two to three times as much iodine as you would any other time of your life. It's really important in brain development in children and all of that sort of stuff. And this is like the type of thing where this has been lost in, I think, the history of medicine and it's time to bring some of this stuff back because, you know, a lot of times people might think, oh, I'm going through menopause, I'm feeling all the things like brain fog or whatever, and then they'll go get their thyroid tested and their doctor will tell them it's normal.

Dr. Gabby Pavelko: 39:41

What that can be is called subclinical hypothyroid, where your doctor is saying to you everything is normal and people get so frustrated when they hear that because they're hoping that some test will reveal something that they can work on. I think the important takeaway from that is that normal? Everyone has their own normal. Feeling healthy for you, I think, is more what you need to focus on, right? So even if a doctor is telling you your health scores are normal, I think that's really a great time to actually go to a TCM doctor and say everything's showing up normal in Western medicine. Now can I get a little bit more nuanced on helping my body heal itself. And that full circle, I think, comes back to the last resort doctor, because it's okay, everything is normal. Why do I not feel well? Now we can help you.

Kasia: 40:28

So powerful, and also just reflecting. Going back to what you had shared earlier, if you have a baseline, you can see over time how those things are changing, and so you just might be more sensitive to recognizing those shifts in your body. Everybody's body reacts differently, and so, even though it might be, as you mentioned, clinically normal, you might be experiencing a decline in certain hormones or changes in your body that those are things that we don't look for necessarily in western medicine. Dr gaby, I could speak with you for hours, but we are actually on time, so I would love to have you share with our audience. Where can people find you? What are you up to, and if you want to throw in a shameless plug of an easy way to get some iodine from Rootless, we can definitely do that, as, well?

Dr. Gabby Pavelko: 41:16

Yeah, I think thank you so much for having this conversation. I could talk about this all day. Obviously, the time just flew by, but you can find me I am at @ Gabby Pavelko on social media. I see patients. I would love to talk to you, understand what you're going through and really help you. That's the whole point of this. So if you have any questions or want to dig deeper about any of this, please definitely reach out. I'm drgabbytcm@ gmailcom. And yeah, I work with rootless and it's been really transformative to see how eating a little bit of seaweed every day through whole food nutrition, along with dates, almonds, seeds, which are giving you things that you need as you go through menopause to really help mimic estrogen production almost, and help with that estrogen metabolism. What we're seeing is it's like a snackable supplement. You eat one a day and it actually does help regulate your body during these times. Yeah, definitely check it out. It's getrootless. com at @ get. rootless on social media.

Kasia: 42:25

Dr Gabby, it was such a pleasure to have you on. Thank you so much for joining me today and to everyone listening. See you next time. Thank you so much for tuning into the Other Way. If you enjoyed this episode, please leave a five-star review. It really helps the podcast grow and I'm ever so grateful. If you want to stay connected, you can find information on how in our show notes. And finally, if you're curious about inflow and want free resources around cyclical living or moon cycles, check out inflowplannercom. And, of course, for all my listeners, you can use the code podcast10, and that's all lowercase podcast10 for 10% off any purchase. All right, that's all for today. See you next time.