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In this episode, Dr. Theresa Pugh and I talk about what’s actually happening in perimenopause, especially the information that isn’t explained clearly. If you're in your 30s or 40s or you work with women in this age range, this podcast episode is for you.

Dr. Theresa Pugh is a board-certified family practitioner with over 20 years of experience in family medicine. She received her MD degree from the Medical College of Virginia at Virginia Commonwealth University and completed residency at Carilion Health Systems where she was able to train with the sports medicine department at Virginia Tech.

A lifelong horsewoman, she continues to ride and compete in hunter/jumpers and became trained in equine assisted learning in the Epona method. She is a facilitator for an Austin-based non-profit called Horselink who provides sanctuary for retired competition horses while providing equine programs for people who have experienced trauma. Dr. Pugh became interested in integrative medicine after being diagnosed with Sjogren's Syndrome.

Through her own healing journey, she gained valuable insight and experience into utilizing different healing modalities to balance mind, body and spirit. She is currently in private practice at Resilient Health in Austin and enjoys helping others with autoimmune conditions as well as practicing precision, personalized healthcare using advanced testing and medical genomics.

We cover:

• Why perimenopause starts earlier than most people realize
• The difference between estrogen dominance and low progesterone in perimenopause and how they can show up together
• What’s really happening when you wake up at 3am or feel ragey
• How symptoms like constipation, hip pain, frozen shoulder, and anxiety can all be hormone-related
• Why labs don't always tell the full story
• What to know about DIM, methylated B vitamins, and hormone detox
• How fascia, nervous system dysregulation, and stress play into it
• Why some people don’t tolerate progesterone and what to do about it
• We also talk about why so many women are told they’re “too young” to be in perimenopause and how to track symptoms so you can advocate for yourself or your patients. This is the conversation I wish more providers were having. It’s time we stop writing off women’s symptoms and start looking at the full picture.

Timestamps:

00:00 Introduction and Welcome

00:26 Understanding Perimenopause Symptoms

02:18 Hormonal Changes and Their Effects

03:37 Estrogen Dominance vs. Perimenopause

05:58 Progesterone and Its Impact

08:04 Detox and Lifestyle Adjustments

13:41 Emotional and Physical Changes

16:50 Hormone Replacement Therapy

29:25 Stress and Hormonal Balance

34:45 The Importance of Connection and Laughter

37:18 Small Changes for Big Impact

37:58 The Importance of Sleep

38:37 Infertility and IVF Stress

42:07 Understanding Menopause and Perimenopause

45:02 Managing Hormonal Fluctuations

50:32 Tracking Symptoms and Seeking Help

57:25 The Role of Vitamins and Supplements

01:07:54 Validating Perimenopause Experiences

01:12:06 Conclusion and Final Thoughts

You can learn more about her and the practice she works at, Resilient Health below:

https://resilienthealthaustin.com/

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