I am thrilled to have nutritionist and menopause expert Andrea Donsky joining me today.
Andrea delivers a very positive message within the perimenopause and menopause space. In today’s discussion, we dive into her ongoing research on the 103 reported symptoms of menopause, exploring the impact of medical gaslighting and the need for advocacy and education. We discuss the significance of taking personal inventory and look at metabolic health, sarcopenia, and insulin resistance. Andrea also shares the singular challenges she has experienced as a nutritionist regarding women in perimenopause and menopause, and we cover concerns surrounding alcohol, ultra-processed foods, weight loss resistance, and the effects of wearables.
I am confident you will enjoy this informative conversation with Andrea Donsky and find it as engaging as I did.
IN THIS EPISODE YOU WILL LEARN:
Andrea shares the 20 most commonly reported symptoms of menopause
The challenges many women face in getting their symptoms recognized and treated by doctors
Why women need to be informed and empowered to make decisions about their health
How lifestyle and nutrition are crucial factors in managing menopause symptoms
Why women in menopause should avoid processed foods and alcohol
Why it is essential to make informed choices about what you consume
Tips for making vegetables taste great
Andrea discusses the benefits of intermittent fasting
Some tools and techniques for improving your health
The challenges surrounding weight loss resistance and factors that contribute to it
“The number one most common symptom across the board, whether you are in perimenopause or menopause, is fatigue, exhaustion.”
-Amdrea Donsky
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Submit your questions to support@cynthiathurlow.com
Connect with Andrea Donsky
Transcript:
Cynthia Thurlow: Welcome to Everyday Wellness podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
[00:00:29] Today, I had the honor of connecting with nutritionist and menopause expert Andrea Donsky. Today, we spoke about the research that she has been doing on symptoms surrounding menopause, of which there are 103 reported. The impact of medical gaslighting, advocacy and education, the role of taking inventory of self, the impact of metabolic health, sarcopenia, and insulin resistance, unique challenges that she sees as a nutritionist with regard to women in perimenopause and menopause including concerns around alcohol and ultra-processed foods, the impact of wearables, and lastly weight loss resistance. I know you will enjoy this conversation as much as I did recording it.
[00:01:15] Andrea, I have been so looking forward to this conversation. Your voice within the perimenopause and menopause space is one that amplifies a really positive message, and so I know my community will enjoy our conversation, our discussion, and in particular, I want to hear more about this new book that's coming out in probably 2026.
Andrea Donsky: [00:01:37] Yes, it is. Well, thank you. I'm very excited to be here, and I know that I had interviewed you years ago for our summit, so I'm excited to have this conversation.
Cynthia Thurlow: [00:01:49] Yeah. When I think about the scope of women going into menopause or in menopause is such a massive number, I think the most recent statistic was 1.2 billion women worldwide and I feel like our generation is finding their voices. And in many instances, I feel like I have older family members coming to me and saying, “Please be the voice so that younger women don't have to suffer the way that we do it.” It is something I take to heart and I take so personally because I feel like our mother's generation, in many instances, has really suffered needlessly. And I say this with great love and reverence, because I know that when the Women's Health Initiative was published in 2002, I think well-meaning providers kind of went along with the flow about fear mongering around hormones, hormone replacement therapy. And there were many women, including my mom and many of her sisters, that had started HRT, and taking them off of HRT really sent them into a spiral with chronic pain symptom, genitourinary symptoms.
[00:03:02] And I love the work that you're doing because you bring a unique focus to this space, really focusing in on lifestyle, which is incredibly important before we even start having a conversation around hormonal replacement therapy. So, talk to us about the work that you are doing because you mentioned in our intro that you were mentioning that you have some research that's going to be published. And for many people, whether they realize this or not, there's not enough research being done on women at this stage of life. So, thank you for the efforts that you do.
[00:03:34] And let's start with some of the findings of your symptoms, you've done a lot of surveying of your communities across social media. What are the most common symptoms that women are reporting? I'm sure we could probably both guess, but you have quite a few swath of symptoms that women are experiencing.
Andrea Donsky: [00:03:52] Yeah. So, I have been very passionate about doing research on symptomatology when it comes to perimenopause and menopause. And I'll take you back to a quick story from years ago. I met an old friend at a party and I asked her what she was doing and she told me she was creating an app for perimenopause and menopause symptoms. And I thought, an app? Don't you need like a lot of symptoms to have an actual app? And she was like, “Yeah, yeah, there's so many. There's like 35 to 40 symptoms.” And I was like, “Wow, that is a lot.”
[00:04:21] And the way that my brain works, I'm very analytical and I love data. So, I went back and I created this Google Doc and I put all these symptoms in and I started tracking it for years. And then I soonly, learned that there were way more than 35 to 40 symptoms. And I found there were 85 symptoms. And then I was like, “Wait a second, why don't we go to our community and ask the women what they're experiencing so we can actually get the data on how many symptoms there are.” And we quickly learned that there are over 103 symptoms, and that came. So, we now have 10 surveys on our website and the one that was our groundbreaking research, call it our foundation research, which is our signs and symptoms research. We now have almost 5000 responses and we know that there's 103.
[00:05:02] So, to answer your question, what are the top symptoms? Actually, I'd love you to guess and you tell me what you think the number one most common symptom is in perimenopause and menopause if you had to guess.
Cynthia Thurlow: [00:05:14] Clinically, I would say some alteration in sleep, so insomnia or I would say bloating, because it seems like insomnia, bloating, and weight-loss resistance are like the triad of the things that make people pretty miserable.
Andrea Donsky: [00:05:32] Oh yeah.
Cynthia Thurlow: [00:05:33] They can deal with other things, but those are the ones that seem to have the most expressed concerns. Frustration, disappointment, anger, any constellation of emotional response to the symptoms themselves. So, I'm curious where those fall.
Andrea Donsky: [00:05:50] So, I will tell you. So, the number one most common symptom across the board, whether you're in perimenopause or menopause, is fatigue, exhaustion. Over 70% of women reported feeling really tired, can't get out of bed. Number two is brain fog, with over 66% of women. Number three are sleep issues. So, it is absolutely in the top three. Then we have memory loss, anxiety, loss or low libido, joint pain, lack of concentration, lack of focus. Then hot flashes, number 10, which that really surprised me that it's actually number 10, because when we think of menopause and when I ask a room full of people when I'm speaking, I'm like, “What is the number one symptom” and they’re like, “hot flashes.”
Cynthia Thurlow: [00:07:00] That's quite a constellation of symptoms. And it's been my kind of clinical experience that depending on the person, if they're feeling tired, I feel like a lot of type A women, they just push through it. They're like, “I'm not tired. not tired.” Not to mention the fact, the word finding issues that people will experience, which is oftentimes a reflection of estrogen changes. And I know my listeners know that we have some of the most wild fluctuations of estradiol throughout perimenopause and even higher when we're in our peak cycling years. So, it's those alterations that can kind of create that.
[00:07:38] But what I find most interesting is that if I were to poll my listeners, those are my top three, but I think that it really speaks a lot, 5000 is a quite a significant number. So, listeners, we talk about statistical significance and I think about you have to have an N or a quantity of at least 100 to feel like you've got a good representative population of data. So, 5000 is incredible. And so, when we're talking about these symptoms, how many women listening have expressed that they're tired to their healthcare team and they've been told it's all in their head?
Andrea Donsky: [00:08:19] A lot, actually. We have another survey, so it's called Doctor's Visits. Actually, four of our surveys out of our ten right now, and we'll be submitting more, the abstracts are going to be published in the journal Menopause in December. So, this is very exciting that I'm going to be a published researcher in this symptomatology. So, one of them is our Doctor's Visit survey. So, to answer your question, this was based on 1050 women and all of these surveys are ongoing. I'd love you to put a link below so everyone, your listeners, can go and fill them out because the more that we know, the more that we can help women, and then we can also help to educate the doctors and healthcare providers.
[00:08:59] So we know, according to our doctors visit survey, that 90% of women, so 89% of women go to their doctor complaining about their symptoms. And how many times did they have to visit their doctors before the connection was made between their symptoms and it being perimenopause and menopause? 40% of women had to visit their doctor between two and three times, which is a lot. Only 25% of the women said they went once, 18% went four to five times, and 17% of the women went five or more times. And in many cases, still don't have their answers.
[00:09:33] I mean, these are massive statistics. 75% of the women out of the 1050 had to go between 2 and 5+ times to actually make the connections. So, yes, we need to educate doctors and healthcare providers. So, what are these symptoms and that's what we're doing. We're providing the list of the 103 symptoms. We went to the Menopause Society Conference where I showed four posters of our research, and what was interesting is a lot of the comments from the doctors and the healthcare providers were like, “Wow, that is so many symptoms.” Because if you google, like Cynthia, what's so interesting to me--
[00:10:07] So, like you, I'm in the midst of writing a book right now and I was trying to find who came up with the 34 recognized symptoms. It was really hard to find. We found it in a paper. One person who had mentioned in a paper in 2013, it is not anywhere in the literature, so that really surprised me. And I even asked the Menopause Society, “Where can I find the source?” They're like, “We don't know.” And I was like, “Wait, we're all quoting these 34 recognized symptoms, yet we don't know where it came from.” So, now we know it will be in journal Menopause 103 plus symptoms. So, no more of the 34, we know that there's that many.
[00:10:47] But what's also really interesting from our survey is that 40% of the women said that when they brought up menopause or perimenopause as a possibility for how they were feeling, said that they were dismissed by their doctors or healthcare providers, and only 10% brought it up with their patients. So, we have so much work to do to help educate.
[00:11:08] Now, someone like yourself, who understands, focuses on menopause, we need so many more professionals like yourself that can-- Because it'll make a huge difference for women. We won't feel gaslit. We won't feel dismissed. Also, the amount of time and energy and anxiety around our health. There's money that is being spent. There's so much that we can do to improve how we can treat women, how we can support women, how we can validate women in perimenopause and menopause.
Cynthia Thurlow: [00:11:36] Yeah, it's interesting for me because up until eight years ago, I worked in Clinical Cardiology, both inpatient, outpatient. And I remember what it was like post WHI, because there were a lot of female patients crying in the office to me, or crying in the hospital, talking about how they felt so much better on estrogen, they felt so much better on progesterone. And at that time, as a young woman, I was a young nurse practitioner, I was like, 30, I recall that I didn't fully appreciate because I actually went back and looked in my physiology text from my nurse practitioner program, and huge anatomy and physiology text, and honest to God, there was all this discussion about women's menstrual cycles, and there were probably two sentences on menopause. It's like “A woman goes into menopause at the age of 50 and falls off a cliff.” That was the amount of exposure that I had. And I recall over years and years and years of working in Cardiology I was like, “What is going on with women in their 40s?” Because I believed what they were experiencing, that was not my area of expertise.
[00:12:38] I mean, I had a constellation of functional integrative physicians, nurse practitioners, even GYN’s and midwives that I refer out to. I was like, “I think you need to go see someone and talk about what's going on.” But it was so apparent to me that there was this lack education for healthcare providers. I think even if I were to speak to my GYN and my nurse midwife friends and nurse practitioner friends, with very few exceptions, they would also agree, even as dedicated women's health experts, even they didn't have the scope of information.
[00:13:11] It's interesting. My current GYN is young. She just finished her residency. She loves middle-aged women. Do you know why she loves middle-aged women? Because there's not the complication of dealing with deliveries. She said, “I love serving this population because most of these women are done having babies. They're really focused on themselves.” She's like, “I love being their advocate.” And I said, “This is great. I'm so glad to know they are young providers that are interested in focusing in on women of this age,” because I think for so many of us, we felt like we have lost our voice.
[00:13:44] In fact, I'll give you the example. I was probably, oh, this is probably 10 years ago, so early 40s. And I just recall I was talking to my then GYN that was in Northern Virginia, who I liked fairly. I mean, you didn't get a lot of time with her, but you could go in and have a conversation. And I remember saying to her, “I have very heavy menstrual cycles. In fact, today my period started.” And so, she did an internal exam and she looked at me and she goes, “Oh my God,” and I said, “What?” And she said, “You weren't kidding. It was heavy.” And then she said, “That's okay. Here are options. We can put you on the pill. We can give you an IUD. We can do an ablation, or you're done having kids. You've told me that you're done. You and your husband, we can just do a hysterectomy.” And I was like, “No, no, no, and no.”
[00:14:30] We're so quick to fix the problem, to remedy the problem. But there were never any discussions about what's your sleep like, how do you manage your stress now? anti-inflammatory, nutrition. I mean, I know these are topics you like to talk about, but I reflect back on that, and I recognize, and this is not pejorative. The traditional allopathic model is not designed to talk about lifestyle. It is an unusual provider that will think to say to their patient, “Oh, by the way, let's make sure we're having these conversations.” But the way to help women navigate perimenopause into menopause is we have to start earlier. We need to start women are in their 30s having those conversations so that they're prepared. And anyone that's listening, and I know I have listeners under the age of 40, perimenopause can start that young. It really can, I suspect-- I had my second pregnancy at 36. I'm sure by the time I was 37, 38, I was starting to see some of those inklings and glimmers. I just attributed all of it to having young kids and a husband who traveled.
Andrea Donsky: [00:15:31] Well, we know it could start as early as 35. And I look back on my journey, and I believe I started around 35, 36. My first symptom was phantom smells. And that's when you smell things that other people don't. We have a survey on that too, because I was fascinated by phantom smells. And I remember I would work in an office with 20-year-olds, and I'd be like, “Do you smell smoke? Do you smoke gasoline?” And they're like, “We have no idea what you're talking about.” And I'm like, I smelt it for months. And then I had several MRIs and went to my doctor, went to an ENT, and they're like, “It's in your head or we don't know what the cause is,” but now we know it's a symptom of perimenopause and menopause.
[00:16:08] And also, I tried to get pregnant in my mid 30s, so I got pregnant during perimenopause and I lost baby, and then I got pregnant again. And then I ended up having-- It's called when you're bleeding? a hematoma? I forget what it's called anyways, I forget what the actual term is, the medical term, but I ended up being on bed rest for 10 weeks with my third, and this was my third, and I was 40 at the time in perimenopause and didn't know it. And that's where I feel like we're doing women such a disservice.
[00:16:37] And to your point, what you were saying earlier is we have to educate a lot of different people, so we have to educate the women themselves. So, I would love to see education in elementary school or high school. So, our daughters are learning. And I looked at my daughter's grade five curriculum. Now she's in grade eight. But I looked at this back when I was doing the work, and I was trying to figure out, how do we help integrate this education so that we understand it better? And they teach about-- obviously when kids are going through puberty, but they don't teach anything about perimenopause and menopause, and neither in the high school. So, I'm like, “We need to change it at the curriculum level so that girls when they don't come into this stage and they enter into their mid-30s or 40s and their 50s, it's not like, ‘whoa, what's happening to my body?’” Like, it happened to me and probably yourself and so many other women, it came by surprise.
[00:17:26] I mean, I didn't even think about perimenopause. So, I was in perimenopause for a total of 14 years, 11 of which I had no idea, no idea. So, from 35, 36 to 47, I was like, “What's happening to me? Why am I gaining weight and losing weight?” I had insane weight fluctuations. “Why am I raging? Why am I so awful to be around myself?” I was so angry and the moodiness and the sleep issues. I mean, I could go on and on and on and the phantom smells with no explanation.
[00:18:02] Now, if women know earlier, “Okay, these are possible symptoms. Speak to your doctor, healthcare provider. Here's what we can do to help. Maybe you need to start hormones earlier if you want to go on hormones or maybe some supplements, maybe lifestyle and nutrition.” For me, that's number one and number two, but if women know what they're entering into, they can make informed decisions and they don't have to question themselves, and they don't have to-- Self-esteem for so many of us goes down the drain because we're like, “Wait, is this happening? Is there an alien taking over my body? What is happening? Who am I?” And I feel like we would be able to really do ourselves such a service by being able to be treated earlier, feeling supported, feeling validated so that there aren't so many questions that are circulating in our minds and then thinking that we're like, “Is it me?”
[00:18:56] And I remember asking my friends who are the similar age to me, and I'm like, “Are you experiencing any of this?” And they're like, “No, we don't know what you're talking about.” So, I was like, “Oh, it must just be me.”
Cynthia Thurlow: [00:19:04] No, no, no. There's this shame around aging. Let's just be clear.
Andrea Donsky: [00:19:09] Absolutely.
Cynthia Thurlow: [00:19:10] My mother never talked to me about perimenopause, and certainly I don't think to this day would actually admit to what year or age she went into menopause. There's so much shamer on aging. In fact, my mom, for many years, would just tell people she was 30 until I became 30. And then I was like, “Okay, mom, I think it's time to kind of rewrite that narrative.” But I think for so many women, so many of my friends are so disconnected from their bodies, they are in many ways unwilling to acknowledge the change that's ongoing. Whereas I think there are those of us, like you mentioned the phantom smells, which I find fascinating. I've had a super sniffer my entire life. It was an asset as an ER nurse. I am still that way. I've never had a phantom smell. But I think when we talk about different symptoms, we're really speaking to bio individuality, so much of that is important.
[00:20:02] But this age and shame around the aging process is something that I think is so important for us to be talking about. When I think about the word perimenopause or menopause, that word pause really stands out to me as opportunities to kind of reevaluate things in our lives to say, “Am I happy with my relationships? Am I happy in my job? Am I happy in my marriage?” Or insert whatever item it is.
Andrea Donsky: [00:20:27] Yeah, that’s true.
Cynthia Thurlow: [00:20:29] You know, eight years ago, I left clinical medicine with no business plan. I don't recommend this. I tell everyone, “Don't do what I did,” but so much happier being able to serve my community and being able to serve women, solely focused on this stage of life, because I'm like, “Listen, if I wasn't prepared for it, how do I expect my patients, my clients, my community to be prepared?” And I think so much of your platform and my own is really about education and empowerment, not just for women going through the change, but also women that are not there yet or even, like, I think about my mom’s age group or even women in their 60s. We've referred quite a few women out to providers in their area that will, as an example, start HRT for individuals that are appropriately evaluated for cardiovascular risk, etc. Many of these women were successfully started and have had no untoward side effects starting on hormone replacement therapy, 5 years,10 years into menopause. And so, I look at it as these opportunities to show up differently in our lives, to care less about things that don't really matter.
[00:21:37] There are things, I used to care a whole heck of a lot more about 15 years ago that now I'm like, “Whatever, I don't care.” That's probably one of the blessings that I think about navigating this middle-aged lifetime is, I care a whole lot less than I used to about things that weren't important, like stupid stuff. I think everyone listening probably thinks of things that maybe before you had kids, maybe just socially, or your kids are in elementary school or preschool, and there just seems to be a lot of cattiness going on within the parental groups. I'm like, “No, I don't care.” It's so much better for my sanity and mental health.
Andrea Donsky: [00:22:13] It's like the book that was written, Don't Sweat the Small Stuff. You know what I call-- What you're saying, I actually have a term for it, I call it taking inventory of self. And as we get to be in our 40s and 50s. I'm in my 50s, I absolutely love where I am. I love menopause. I feel like once you go through the weeds, because it's very hard to see the light at the end of that tunnel when you're in the thick of things. So, when you're in the weeds and you are suffering, and I was there, and I completely understand, there were days I couldn't get out of bed. There were days where my hot flashes and my night sweats were so bad that I thought, “How am I going to go on like this?” It was really bad. My anxiety, my depression, literally, from all the symptoms that are on that list, they were bad. So, when you're going through it, I get it, I understand, but once you get through it, whatever it is you choose to do to help you with the tools in the toolbox that you have, your nutrition, your lifestyle, your supplements and/or your hormones, which is what you talk about, there is that light at the end of the tunnel and it does get amazing. It does get better for so many different reasons.
[00:23:25] And one of those reasons being what you're saying is either we find ourselves again or we find a new version of ourselves. And this is where I feel like we are shining. I wasn't great at putting down boundaries, I'm getting better at it now. And, before I was like, “Oh, am I really good at that?” Now I'm like, “I know what my superpowers are and what I'm really good at. I also know what I'm not really good at. So, I'm going to stick in my lane and I'm going to talk about things that I am really good at doing.” And I feel like I've come into my own. I feel like I have so much more confidence now. So there really is so much good once we go into menopause, it's just getting through the perimenopause stage if it is a stage where you are suffering with a lot of the symptoms, but there is hope and there is help. Listening to yourself, listening to what I talk about, so I feel like there's a lot to look forward to even though it may not feel like it right now for a lot of you.
Cynthia Thurlow: [00:24:24] I think that's such an honest kind of discussion to let people know, like, “I was in the thick of it and now I'm in a better place.” And I would be the first person to say, the very first time I had a hot flash, I think I was doing laundry, and I was like, “What was that?”
Andrea Donsky: [00:24:38] [laughs] I know, you're like, what?
Cynthia Thurlow: [00:24:39] I mean, it stopped me in my tracks, so I was like, “What was that?” I remember I texted my cousin, who's a GYN, and I said, “Did I just have a hot flash?” And she's like, “Welcome to the club.”
[laughter]
[00:24:49] So, I think for many of us, we start trying to figure out what exacerbates our symptoms. And I think a great deal about the metabolic changes that are happening in our bodies, how we start becoming sarcopenic. And so, this muscle loss with aging can drive so many of the unpleasant side effects that we experience, it can magnify them. Let's talk a little bit about the interplay between some of the changes with muscle as we're getting older and how that impacts insulin resistance because for anyone who's listening, and if you are listeners to this podcast, you know, I talk about this a lot, that loss of insulin resistance goes along with that loss of muscle. And so, it's not just about aesthetics, why it's so important to focus in on lifestyle. And that's why I love your work, because you really speak to this, helping women understand how to feed our bodies, how to focus on sleep, how to manage our stress, how to lift weights. Yes, lifting weights, ladies, it's very important. How we kind of navigate these lifestyle issues and how they improve or they can negatively impact metabolic health?
Andrea Donsky: [00:25:58] Oh, as we go into perimenopause and menopause, we are more prone to becoming insulin resistance. It's interesting when it comes to-- So, to answer your question about muscle and muscle is what helps to take in the glucose, it helps, that's why it's so. It helps us to get the glucose into the cells. So, as we go into perimenopause and menopause, and we are losing muscle quicker than we're building muscle, I mean, it's important for so many different things. Obviously, insulin resistance being a big part of it. And I do a lot of N of 1 research. And you're nodding, You're like, “Yep.”
[00:26:31] So, N of 1 research to me is crucial, because in order for me to help educate my community, I need to understand how it's affecting my body in particular. Now we're all different, everything. We're all affected differently. Our blood glucose is affected differently. I can eat something and be affected. You can eat something, you won't be as affected. But in general, I try to really drive the point home to our community that nutrition is at the basis for so many things. And it is really the number one thing that I want you to focus on when it comes to you entering into this phase of life. And I have women a lot will say to me, “Oh, Andrea, what do you do?” And I'm like, “Oh, I help women in perimenopause and menopause.” They're like, “Oh, I'm so past that.” And I'm like, “What do you mean? I'm so past that.” “Oh, I'm in menopause already. I've been in menopause for a few years now or 10 years or whatever it is.” And, I’m like, “No, ah-ah.” I'm like, “First of all, once you're in menopause you’re in menopause for the rest of your life. And it is so important that now more than ever, that you are focusing on nutrition. What are you eating? How is it affecting your blood sugar? Are you exercising? How are you managing your stress?” We know that we can't cope with stress as well, and we're more stressed now. 66% of us are more stressed now than were before. How are you handling those two? And are you taking supplements to help? You can't out-supplement good nutrition, but what are you doing to help yourself?” And obviously, I don't get into the hormones, but if the hormones are something that you're taking, what are you doing now to help yourself? And now it's really important that you focus on that.
[00:28:03] So, when it comes to nutrition and really managing your blood sugar. It's very interesting too, because I do a lot of N of 1 testing. I've been wearing a CGM, which is a continuous glucose monitor for a couple of months now because I was having some blood sugar issues. And I'm like, “Okay, let me look at it from a food standpoint.” So, it wasn't a food standpoint. What are the reasons that are causing it? Is it that my muscles are breaking down a lot quicker and I'm not taking in my glucose? Is it my hormones? What is it? So, I'm trying to figure out what is causing it, because my fasting glucose was always in a specific range, and now I'm like, “Oh, that's a lot higher than my regular range. What's going on?” So, I'm always trying to figure out.
[00:28:45] So, starting though and this is why I'm so passionate about looking at what we're eating. Food really does make a massive difference for how our blood sugar is going to remain level, or is it going to spike and it's normal for it to spike and then go down, but how long does it take for it to go down after it spikes? So, all of these questions come into play. And that's why I'm like, “Okay, when it's really important, you're the captain of your own ship, and you can make your own decisions. You have the power to decide what you're putting into and onto your body.”
[00:29:16] And, Cynthia, for years before I really started focusing on perimenopause and menopause, my focus was on what we are eating. What are the food additives? What are we putting in our body? I wrote a book called Unjunk Your Junk Food, back in 2011. So, this is what I've been focusing on for so many years. So, what you're putting in your body can make such a difference to triggering your symptoms, to how are you feeling, to whether it's spiking your glucose or not. So, what are you eating? So, I really say focus on eating a good amount of protein and I know you talk about this too. We talked about it in our interview back in 2021. Make sure you're getting a good amount of protein, make sure that you are focusing on fiber, those 25 to 35 g of fiber, eating a rainbow of vegetables, we want to get the different phytochemicals from the different color in your vegetables, low-glycemic fruits. If you're going to have your fruits, berries, sour apples. Try to avoid the ones that are going to spike your blood sugar too high.
[00:30:15] Looking at good quality fats, what type of fats are you eating? Are you ingesting seed oils now? Seed oils are canola, corn, cotton seed, soy, sunflower, safflower. This is from the work of doctor Cate Shanahan. She really put seed oils on the map, and I've interviewed her several times, and I'm sure you have too. She's amazing. So really looking at the type of oils that you're eating, which can cause inflammation in the body, again, something we're more prone to as we get into this phase of life. So, focusing on olive oil and a little bit of coconut oil and avocado oil, like those are-- Grass-fed butter, ghee, all the animal fats, that's what you want to focus on in terms of eating and avoiding those seed oils.
[00:30:58] And then we want to look at, for some people more in moderation, like maybe complex carbohydrates are good for you. I know for me, they'll spike my blood sugar. And so, for me, I have to follow a more keto/paleo diet, maybe legumes. Again, everybody's different. How does it affect your body and nuts and seeds? So, I really come from the point of view and I'm a big fan of intermittent fasting, by the way. I've been doing it for years. And I actually just mentioned you on a podcast I did this week. I talked about you.
Cynthia Thurlow: [00:31:25] Oh thank you.
Andrea Donsky: [00:31:26] Yeah, I talked about you being an expert in that. So, I just feel like there's these-- I try not to say, you have to do this or you have to do that. I try to come from a place of more balance because I do try to have a balanced perspective. But there is a formula that does work for us when we go into this phase of life, especially when it comes to balancing our blood sugar.
Cynthia Thurlow: [00:31:49] I think you bring up so many good points, and I think for many people, we may be one chronologic age, but in our brains we still think we're 20 or 30. And I jokingly say, “If you are still eating the way you did at 20 and 30, it's probably no longer serving you well.” And to your point, you know, the protein, fiber, those are the things that really help fill you up. Getting lots of brightly pigmented fruits and vegetables. I echo what you're saying. The irony for me about complex carbohydrates, I can eat a sweet potato or spaghetti squash, but plantains will spike my blood sugar. That is how bio individual this can be.
Andrea Donsky: [00:32:22] Uh, so different, right?
Cynthia Thurlow: [00:32:23] Yep. And that's why I think having a CGM is so invaluable. What do you find in your work to be what women struggle with most around nutrition? Is it the processed foods? Is it alcohol?
Andrea Donsky: [00:32:37] Oh, so, I mean, I think it's all of it. I do. I think, and I'm going to say this because I spent a lot of time on social media, and I feel like there's so much information, like a plethora of information, and a lot of misinformation. And it's a lot for someone trying to find the right information to grasp. And even for me, and I'm a nutrition expert, I've been doing this for 20 years, and I'm like, “Okay, this is all--” Like, there's so much out there, sometimes I'm just like, “Yeah, no.” I'm just going to do what works for me. So, I would say definitely alcohol is a big thing because of the whole alcohol culture. So, alcohol is a big one. And I have a lot of women will say that they do want to have their glass of wine before bed, but they can't. And we know I can't even have a sip of alcohol anymore because it'll trigger a hot flash immediately, that's it. And I don't want to have that hot flash, no. I'll decide depending on what I want to eat, like chocolate will also sometimes give hot flash for me, but I'll be like, I'm making the decision to have a piece of chocolate, even though I might have the hot flash. Or caffeine, a lot of women will say coffee.
[00:33:46] So, I would say, if you can avoid the alcohol. Even though I know that most of us love it to relax, especially at night, it will disrupt your sleep, it will have an effect on your brain, and it may cause hot flashes and night sweats. So, I would say alcohol is a big one, processed food, for sure, ultra-processed foods is a hard one too, because we're all busy. And that's what my book Unjunk Your Junk Food back in 2011 was because we're all busy, including myself. I was raising small kids at the time. So, I understand that you're trying to do the best you can do and get the nutrition that you want to get. So just be mindful of what you're getting. So, absolutely, if you're going to get processed foods, I get it. We can't all cook from scratch because we're busy. But when you're putting foods into your cart, just be mindful that it doesn't have high fructose corn syrup or trans fats or monosodium glutamate or artificial sweeteners, which I'm not a fan of, or artificial colors, artificial flavors, or certain preservatives.
[00:34:44] And what's interesting is now I'm tying all of those ingredients which I talked about in 2011 to it triggering or exacerbating perimenopause and menopause symptoms. So, for example, we know that MSG for some women can cause heart palpitations or excessive sweating, sound familiar? These are symptoms of perimenopause and menopause. We know that high fructose corn syrup can cause insulin resistance, which is the step before type 2 diabetes, which we talked about before. So, these are the things that I want you to be mindful of that you're putting into your body, especially when we have so many amazing alternatives nowadays that we don't have to choose those products.
[00:35:24] Again, it all comes down to choice and budget, which I totally understand. But, if you go to the bulk store, there are ways to get those alternatives and not have to have the high fructose corn syrup and the trans fats and all those ingredients that I just mentioned. So, I feel like ultra-processed foods is definitely a big one, the alcohol and just getting enough protein, that's a big one too. I find women find it really hard because for a lot of us, our appetites change. They decrease for a lot of us and a lot of women, which I'm sure your clients will say to you is, “But I don't even eat a lot, but yet I've gained so much weight.” So, a lot of us aren't eating enough and especially getting that protein that is a massive one.
[00:36:05] And even hydration, getting enough hydration, because hydration is tied to so many different things as well. Brain health, fatigue, so we want to make sure that we're getting enough hydration, like half your weight in ounces. I would say if you can kind of measure half your weight in ounces. That's really kind of just a goal to go towards, to be able to get enough of. And what about you? What are you finding that's difficult for women?
Cynthia Thurlow: [00:36:33] Yeah, I would say, number one is alcohol, largely because of this drinking culture that we're all a part of. It is a legal thing that we can consume. And I think coming out of the pandemic, I found that most women either felt like it served them well or it didn't. And so, I think that the pandemic for many of us was kind of showing us whether this was serving us ultimately in our best way. What I find interesting is, I think the alcohol piece, I feel like the amplification of the lack of research supporting the consumption of alcohol has started to kind of magnify. I think about Huberman Lab as being a really great example of this. Going into the research and really saying, in fact, I said to my husband when that came out, I think in 2022, I had said to him, “You should really listen to this,” because if you listen to the research for a lot of people, not that my husband, he probably has one or two drinks a week, but I think very much there's been this acceptable people consuming a bottle of wine at a sitting or binge drinking on the weekends. I think that's just been very normalized. And to me, there's no judgment either way, it's just helping people understand.
[00:37:43] As someone whose parent was a lifelong alcoholic, and I say this nonpejoratively because my father was a very intelligent individual who had underlying anxiety and depression, and that's how he kind of managed it. And at the end of his life, and I just share this with the community, it's the first time I've talked about it publicly. When we were making end-of-care decisions for my dad, he had fallen, had two head bleeds, and we were in the trauma ICU, and we were trying to make a decision based on his expressed wishes, what we were going to do. I said to the trauma surgeon and then neurosurgeon, I was like, “Well, my dad's been a lifelong drinker.” And they said, “We knew that before you even said it,” because our brain atrophies with age, gets smaller, but your dad's is significantly smaller than what we would expect to see in an 80-year-old male. And so, it was very sobering to have my dad's brain up on a scan and talking to them about that. And so, I just share that for anyone who's listening. If you think you might have an issue with drinking, you probably do. It's something you should investigate. But the same token, if someone chooses to drink, like you mentioned about the chocolate, I choose to have a piece here and there because I enjoy it and I recognize I might have some repercussions. I think having some alcohol here and there is probably okay for some people. It's not okay for me because it's the only thing gives me hot flashes, and I don't want hot flashes. And my sleep's too important though. Yes, alcohol is number one.
[00:39:13] Especially in the intermittent fasting community, I find that I have a lot of women who overfast, undernourish their bodies, then they get stuck, then they have to whittle themselves out of this OMAD, you know, chronic OMAD, eating one meal a day, chronically under eating protein, overexercising because they're desperate to lose weight. And trust me, I've been there, I've been with the weight loss resistance, and we so desperately want intermittent fasting to be the thing that fixes that. And it's usually way more complicated. So, I think for a lot of people, it's people under nourishing their bodies, whether they fast or not.
[00:39:46] And then just the chronic cravings that people will have because their body's desperate to get that protein. And we have this protein leverage hypothesis. We don't need enough protein in the setting of low estrogen and high FSH, follicular stimulating hormones. So, kind of the tail end of perimenopause into menopause, you're going to crave crap. You're not going to crave good food. If I'm craving something later in the evening before I go to bed, it is not to sit down and have a steak. I am generally like, “Ooh, where's the chip? Where's the chocolate?”
Andrea Donsky: [00:40:16] [giggles] Popcorn.
Cynthia Thurlow: [00:40:17] That's my clue to say, “Okay, how much did you eat today? Did you eat enough food?” So, I think that chronically under nourishing our bodies, again toxic diet culture doesn't help that, because we've been conditioned to not eat a whole lot, to stay tiny. There's that conditioning that we've gotten in the media and I think certainly our generations, that diet culture, Jenny Craig,-
Andrea Donsky: [00:40:38] Gen X [crosstalk].
Cynthia Thurlow: [00:40:39] -Weight Watchers, count your points. If it fits your macros, I could go on a rant-
Andrea Donsky: [00:40:43] Weight Watchers.
Cynthia Thurlow: [00:40:45] But I think it's important. Yeah, I think it's important to have a conversation with yourself. I actually do less intermittent fasting now and do more of a 12-hour window because I'm trying to build muscle. And I was really struggling to make sure I got three good boluses of protein during my day. So, we can always course correct. We can always go back and change things. If anyone's listening, Cronometer, I have no affiliation with them. They have a great app tracking. You can track your macros. Track your macros for a week or two and see if you're really getting enough protein. That I think is very important.
Andrea Donsky: [00:41:15] Yeah,
Cynthia Thurlow: [00:41:16] I would say the last thing that I find is we don't eat enough vegetables. I find that a lot of people, it's very easy to eat fruit because it's sweet and we like sweet things. But I encourage people do three vegetables to one piece of fruit. If you do kind of keep it in that realm of thinking like you're having a serving of vegetables with each meal, and then maybe you have berries, we're heading into fall, like tart apples, pears, eat things seasonally. I feel like people tend to do, they get enough fiber and they tend to feel better than if it's the reverse, which is three pieces of fruit. And then maybe you're lucky if you have a stalk of broccoli.
Andrea Donsky: [00:41:53] And there's so many amazing ways to make vegetables now to make it taste good. So, I'm a big fan of air fryers. And, you can take brussels sprouts and put on little bit of garlic and olive oil or avocado oil and a little bit of Himalayan salt and pepper, and then put it in the air fryer and they can come out nice and crispy. So, it tastes so good, or broccoli. My daughter, who's 19, she loves to cook and she makes the most delicious broccoli and cauliflower. She'll put on avocado oil and it's super simple, and she'll put it in the oven and we're like, “Hmm, this is so yummy.”
[00:42:26] I do believe that make your vegetables taste good. Like, you don't have to just steam them and eat steamed broccoli, because that's not so exciting for many of us. Find recipes, go on social media. It's so easy, they're at our fingertips now where you can get these delicious recipes that will make you want to eat more of your vegetables.
Cynthia Thurlow: [00:42:49] Yeah, it's such an easy way to think about it. Let’s MacGyver, like, let's find what we need to do to make this interesting. I love cruciferous vegetables, so it's easy for me to eat broccoli-
Andrea Donsky: [00:43:02] I love it too.
Cynthia Thurlow: [00:43:03] -But at a minimum I like things crispy. I like my vegetables crispy. And when they're crispy, if you put them in the air fryer, put them in the oven, it's more appealing than if they're soggy. I think about college food where you would have mushy broccoli or mushy green beans, like, no one wants that, they're probably devoid of nutrients as well.
[00:43:23] When I think about kind of prevailing themes around the stage of life, you mentioned a continuous glucose monitor. Are there any other tools that you're using or you like using and recommend with your clients?
Andrea Donsky: [00:43:34] So, I actually don't practice one-on-one, so, I don't have clients. So, I'm a big fan of wearables. I love wearables. I'm kind of a geek of the N of 1 research. So, I love my rings for tracking my sleep. I'm a big fan of that. And I like to know how much sleep I'm getting, especially deep restorative sleep, because that's the sleep that we need that deep sleep in order for the glymphatic system to kick in for our brain health, for our repair. So, for me, I'm always trying to hack deep sleep. So, I would say my rings are a big one, and that's probably what I use.
[00:44:14] But there are other wearables that can help with hacking your HRV, you can wear it around your wrist. So HRV is great, heart rate variability. So how well are we recovering from our day. So, I would say most of the wearables that I love are definitely around sleep, because sleep, for me, and you mentioned it before-- And you said from your clients that you were hearing, it’s one of the main things that they complain about. So, sleep and digestion, I always say, I kind of look at it like a Christmas tree. Like, you have this star at the top, which is literally kind of like in two, you've got your sleep and digestion, and then everything else flows from there. So, we really want to make sure that we're getting a good night's sleep and that our digestion is working optimally so that we can minimize a lot of the symptoms that we're experiencing, but also thrive and feel amazing. So, I would say those are two. What are some that you wear that you love?
Cynthia Thurlow: [00:45:08] Yeah, I have the Apollo Neuro, which is not as much like you can-- There's different settings, I can use it during the day, and I'll usually put it on my ankle.
Andrea Donsky: [00:45:19] Yeah.
Cynthia Thurlow: [00:45:20] In the midst of writing a book, I do find book writing to be stressful, admittedly. Whereas podcasting, to me, I'm in a flow state, I'm relaxed, it's great. Apollo Neuro obviously and Oura Ring is very helpful. There's a company that sent me. looks like a bean that you hug while you're sleeping, it's called Somnox.
Andrea Donsky: [00:45:37] Oh, interesting.
Cynthia Thurlow: [00:45:38] I'll be the first person to say it's not an inexpensive tool, but it was gifted to me. I kind of regulates your breathing, gets you into a parasympathetic state. I think about PMF therapy, so when I'm talking about tools, I have a PMF mat in my bedroom. I do like to do that after a workout, because again, it's all about maintaining this parasympathetic flow state, feeling good, feeling relaxed. And then I think if we really want to uncomplicate things, it's breath work. I was just at an event, and for the first time, thank you, Sachin Patel, we did a guided breath work therapy, but it was holotropic breathing, and so very powerful. It's amazing to experience it as an individual, but it was a whole room of people doing holotropic breathing. So, it is designed to get you into a parasympathetic state.
[00:46:22] But for many people, it can be very emotional. There are people that were crying not out of pain, out of just happiness. They were transported back to a time in their life when they were very happy. I was transported back to when my first child was born, just like a very happy time. And so, I think there's always things that we can do, like obviously, breath work is not expensive, that's free. I think there's a continuum of what works best. Grounding, I think about getting your feet in the earth, very, very beneficial. Light yoga, you don't necessarily have to be in a class, but all these things are in many ways doing the same thing. They're supporting good sleep. They're supporting that HRV, which is that balance between the parasympathetic and sympathetic, getting us out of our heads because we have a tendency as Americans, where it's like “Go, go, go, go” all the time. And I think most, if not all women benefit from some decompression as opposed to this constant desire to finish off the to-do list, which we know it's actually not healthy to multitask all the time.
[00:47:26] My next guest is actually brain health researcher, MD, PhD. And so, a lot of the things we're going to talk about are kind of on that trajectory. What are the things we can do to promote healthy brains as we're getting older, ties into the lifestyle that we've already talked about. Now, before we kind of wrap up today, the biggest issue that is expressed as an overall theme with my community is weight loss resistance. When you see women talking about being weight loss resistant, and by that, I mean it's not that they haven't attempted to lose weight, it's just they're finding it more challenging. What are some of the less common reasons that you think contribute to this? Maybe that women aren't thinking about, it's probably the lower lying fruit that's contributing.
Andrea Donsky: [00:48:11] So in writing my book, I have a whole chapter on this, and there are about 15 or 16 different reasons that contribute to waking. And so obviously, some of the common ones would be, what are you eating? Hormones, like, hormones are massive and the top of the list, really, so and they kind of probably go hand in hand with nutrition and hydration. Muscle, like, are you lifting heavy so your muscle, sarcopenia plays a role? And then there's also environmental pollutants, toxicants that are out there, things that are called obesogens. These are ingredients, like when you hear the terms that are mimicking estrogen. So xenoestrogens mimicking estrogen in the body, these are chemicals that we're exposed to that get stuck in our cells and cause us to gain weight. So, that's why I'm always being mindful of what those chemicals are that you're putting in your body through your food, like the additives we talked about, but also in your personnel care products, please be mindful. Are there parabens? Are there phthalates? What are things that you're putting on your body? Because we absorb 60% of what we put on our body, so that can make a big difference. And exercise too, weights, obviously, muscle strength is important, but movement as well, are you moving? And a lot of women can't move and I totally understand, but even if you can go for a walk around the block can make a big difference. Cortisol, of course, stress, we're more stressed now, as I mentioned before, and stress, cortisol in particular, will make you gain weight or will dock around the belly and increase your belly fat. So, there's so many different reasons as to why we're gaining weight in addition to the hormones in our food.
[00:49:54] So, it's a matter of just speaking to a qualified practitioner who can help you kind of pinpoint what it is for you that's causing it. And by the way, I didn't even mention it could be physiological. Maybe your thyroid is off, which is very common for women in this phase of life, maybe your thyroid is hypo, now so please ask your doctor for-- There are six thyroid tests that you can ask for, which is in addition to your TSH, which is your thyroid stimulating hormone that most doctors will give you a test for. But you also want to ask for free T3, free T4, reverse T3, as well as your thyroid antibodies. So that plays a role as well. And then stress and so there's so many different things. But to go back to the blood test, also ask for vitamin D, B12, and ferritin because all of those can play a role as well.
[00:50:43] So, as you could see, it's so multifaceted, and it's not just one thing that could be contributing to the weight loss. So, work with somebody that understands it, understands metabolic health, metabolic flexibility, that can help you kind of pinpoint and help you lose that weight, because everybody's different. And like you said before, and this is something I stress all the time, Cynthia, what works for me may not work for you, what works for you may not work for me, we are all individuals. So, something that may be contributing to my weight gain may not be contributing to yours. So, it's really important that you do what is best for your body. And when you're listening to people speaking and you're getting your information, and I encourage you get your information from several sources, but sources that you trust that don't overwhelm you and that also that you're like, “Okay, this makes sense to me.” And it's also experimenting in different ways. I'm a big believer in trial and error. And also, if something works for you now, it doesn't mean it'll work for you always. So, it's always changing things, being open to trying different things, because as our bodies are changing and we are going into menopause, and even once you're in menopause, things will change as well. Just be open to constantly trying new things and changing things up and not getting stuck in always doing or thinking that, “Okay, so I'm doing this now. It's going to be for the rest of my life,” because I don't believe that's the case. I believe that our bodies are constantly evolving.
Cynthia Thurlow: [00:52:05] No, I love the message, and I think that helping people understand that we don't want to be rigidly dogmatic. How important it is to give yourself grace to experiment. If it works for your best friend or your mom, doesn't necessarily mean it will or will not work for you. I think in many ways, the traditional allopathic medicine model has conditioned patients to believe that it's a one size fits all. And I'm here to say-
Andrea Donsky: [00:52:28] It’s not
Cynthia Thurlow: [00:52:29] -that could not be farther from the truth. Well, please let listeners know how to connect with you on social media. Let us know when your book is coming out, is it a 2026 book as well?
Andrea Donsky: [00:52:38] It is. It'll be spring 2026.
Cynthia Thurlow: [00:52:42] Exciting. Super exciting. But let us know how to connect with you outside of this podcast.
Andrea Donsky: [00:52:46] Yeah, absolutely. So, my website is wearemorphus.com. So, we called our company Morphus because it's metamorphosis. So, morph us because we have a really amazing community of women. So, it's wearemorphus.com. We have a whole line of supplements that help to support you in your journey. I'm all about solutions. So, we want to help you feel better from the symptoms that you're experiencing. And then I live on TikTok, so I'm at @andreadonsky on TikTok. And then we're also on Instagram @andreadonsky and @wearemorphus and pretty much any social media.
Cynthia Thurlow: [00:53:20] Awesome. So good to connect with you again.
Andrea Donsky: [00:53:21] You too, Cynthia. Thank you for having me on the.
Cynthia Thurlow: [00:53:24] If you love this podcast episode, please leave a rating in review, subscribe, and tell a friend.
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