If you’ve ever found yourself blaming fatigue, brain fog, or sudden hot flashes on just getting older, this episode is a must listen. My guest today shares her raw and real journey through perimenopause and advocating for hormone replacement therapy. And more importantly, how it has changed her life for the better.
Sara shares the beginning stages of her perimenopause journey, what led to her decision to implement HRT, and the almost immediate as well as long-term effects.
So, grab your coffee (or maybe even a fan) and let’s chat about what every woman needs to know about hormone replacement therapy.
Hit play now. Your future self will thank you!
Welcome back!
Welcome back to another episode of Small Daily Habits.
Today we’re diving into a topic that every woman will experience at some point in her life, perimenopause. It sneaks up on you like a ninja in the night if you aren’t paying attention, or perhaps because we’ve been conditioned to believe that these symptoms are just a part of getting older. But before you know it, you begin questioning everything from your mood swings to why you’re suddenly sweating in the weirdest places.
Joining me today is my friend, fellow personal trainer and FSU dance department grad, Sara Dimmick. Sara co-owns a very successful personal training studio in New York City called Physical Equilibrium. And she is here today because she graciously agreed to share her journey through perimenopause with us. I’m so excited to have you here. Welcome to the show, Sarah.
Sara Dimmick (01:40)
Thank you, Christine. It’s so great to be here and to see you. It’s been a long time since we were in college together.
Christine (01:46)
Yes, it has been! So let’s start at the beginning. when did you first realize were experiencing perimenopause?
The First Signs of Perimenopause
Sara Dimmick (01:56)
It actually took me several years to figure this out. It was actually in the middle of the pandemic. My business was tanking because I own a personal training studio in New York City. I had a five-year-old at home who was doing homeschooling on zoom kindergarten. So, there was a lot going on and the world was a little bit crazy.
I was waking up in the middle of the night, anxious, not being able to sleep. I was gaining weight. I was having fatigue, and my hair was falling out a little bit. My skin was kind of getting itchy too. So I was having these symptoms, but they weren’t all the time. They were kind of around for a couple of months and then they would go away and then they would come back.
And so, I was just thinking I’m stressed. Maybe I’m not exercising the way I used to because my gym was closed, so I’m doing different things. I’m still exercising, but my exercise routine has changed a little bit. And also, was having my knee issues came back, so I wasn’t running.
Definitely when you’re stressed, I was probably drinking a little bit more than I should have been at night, because I was sitting at home not as busy, and so I was bored. So, there was a lot of things contributing to it, and it was kind of off and on. Then I decided, I’m going to get my act together and my gym started coming back and things started normalizing and my son was back in school.
Then when my routine got better for exercise, I was still experiencing all of those things. And actually, the symptoms got worse. So, as I was doing better, quote unquote, better with all of the things that I should have been doing, eating good, sleeping, getting to bed earlier, not drinking as much, exercising in a good routine, taking supplements and vitamins. I was even going to acupuncture to try to alleviate some of these symptoms. I think it’s different for everybody. I also want to say that my symptoms are very different from friends that I talk to or clients that I talk to. If you look up the perimenopause symptoms, there are about 50.
And you could have one or you could have 30 of them. So really, there’s so many things that happen when your estrogen and your other hormones start going out of whack. And I had never really thought about hormone replacement therapy at first. I was more thinking of the holistic route as far as, because I come from personal training and my partners are registered dietitians, so you look at your diet, you look at your exercise, you look at your sleep habits.
Maybe you take some supplements like fish oil and B12, vitamin D, all the things that people recommend. And not anything, I don’t like fad diets and I don’t want quick fixes. I’m willing to put the work in. So once I did all of those things and my symptoms didn’t alleviate and it actually got worse, I was having night sweats almost every night, waking up like drenched, I’d have to sleep with the air conditioner on. Even in the winter, I sleep with the air conditioner on.
Christine (05:17):
I’m laughing because I know what you mean!
Sara Dimmick:
I would be sweating in the subway. I would just get up in the morning, walk to the subway. I’d be standing in the subway and I’m just drenched. I get to work and I’m sweating. So, I had those symptoms. I had other symptoms. My vagina was dry and itchy and I’m like, what is going on? All my skin was itchy. My head was itchy.
It didn’t help that my son also had lice at school. So, then I’m thinking, do I have lice or is this just an itchy scalp? I’m using that little comb that you use for the lice and now all my hair’s coming out and I’m like this is horrible.
Christine (05:52)
You start to question everything.
Sara Dimmick
I don’t need to be pulling out more hair. My hair is thinning and I’m pulling it out with that stupid lice comb. I just was like, okay, I’m over this. And at the same time, I was thinking there has to be some connection to hormones and going through this change of life here in your mid to late forties for most people.
Christine (06:08)
Right!
Sara Dimmick
There’s been a lot of media coverage. And if you’re a woman in your 40s, if you’re on social media, I’m sure you are getting hammered with ad after ad after ad of all of these symptoms and how you could take either supplements or hormone replacement therapy or follow this doctor or follow this podcaster who talks about it. So, I started doing research and looking things up. And thankfully,
There’s this group in New York called The Swell, and they produce events specifically for women in this age group around things that they’re experiencing. And so I went to one event in the Hamptons that had a panel of well-renowned doctors, urologists, OBGYNs, brain doctor, cancer doctors, and they were all talking about how the drop of estrogen really affects lots of things. Your bones, your brain health, your heart health, your mood, all of these things. Then they talked about the study in 2002, the Women’s Health Initiative that had said estrogen and hormone replacement increased your risk of cancer.
And so, at that time, if you think back to maybe our mother’s age, they didn’t take HRT, before them, hormone replacement was very popular. And then after that study, a lot of people got very worried and stopped taking hormone replacement and a lot of doctors stopped prescribing them. But read the research and look, it has been debunked.
And there’s a lot now coming out talking about how actually effective hormone replacement therapy is for certain people, it’s not for everybody again, but I think that you can, like anything, like any kind of medication or drug or therapy, you have to think about the positives versus the negatives.
Christine (08:14):
Mm-hmm
The Role of Hormone Replacement Therapy
Sara Dimmick
Everybody’s highly individual. So, I’m not saying that everybody should be on HRT, but I’m also saying it’s out there and it’s safe. And I started it because I did the research, and I also went to my doctor and discussed it with them and did it in a safe manner and I’m being monitored by physicians.
Christine (08:46):
Yeah, and I think that’s the way to go. It’s empowering, I think, to take a look at yourself and just kind of tune into what is actually happening and then to do the research and figure out for yourself what’s going to work for you, right? It is very individual. We’re all very different people. You said it yourself about the symptoms, your friends and your clients, same thing with me, my friends and my clients don’t necessarily have the symptoms as I have.
But it’s nice to be able to talk about it. And when you do finally figure it out for yourself, sharing your experience so other people know, okay, well, this could work for me. I think that it’s great to share the different perspectives and how things are working out for you.
First Signs HRT was Working
Christine:
So once you started the HRT, could you tell our listeners a little bit about the changes that you felt?
Sara Dimmick (09:40):
At first I was like, is this more mental because I’m pulling at a solution and I’m really hoping this is going to be the thing that works. So, I ended up on an estrogen patch. I already have a Mirena IUD, so I was getting progesterone.
When my doctor tested my hormones, she actually said, you’re fine. You’re in the normal range. I will say my estrogen was 35 on a scale of 30 to 400. So, to me that was low. My doctor said it was in the normal range, 30 and below is menopause. So I was like, I’m pretty close and I have 10 symptoms of menopause. So, I said, I would really like to try some estrogen therapy and see if this helps me.
This has happened to literally every one of my friends and most doctors are saying your hormone panel doesn’t make a difference. You have to go on symptoms.
Christine (10:24)
Yeah, exactly.
Sara Dimmick (10:45)
So, she reluctantly gave me the patch. She also recommended I go on birth control. But again, I looked at the research and I think that the patch for me was better because it’s kind of a constant delivery system, whereas the pill is something you have to take every day. It might spike for a little while and then it declines. You have to remember to take it every day where the patches you stick it on, and you change it once or twice a week. So, it’s a little bit different.
It depends again on each individual person. I swear immediately, I mean, not immediately, but within a few days, I started sleeping better. And maybe that was just because of my anxiety around the whole situation. Somebody finally listened to me, I finally got help and I could calm down a little bit. I have to say I also got a vaccine that week and had other weird symptoms going on so I was questioning if it was the estrogen.
So, for a week or two, there was a lot of influx going on, but I was starting to sleep better. I also had a little bit more energy all of a sudden and I didn’t ever think that I had that traditional brain fog or memory loss or not being able to pay attention at work, but I suddenly had almost like a big jolt of energy where I could get a lot of things done and focus.
Then I thought, well, maybe I did have a little bit of this brain fog. It could have been from sleeping better also. I was still waking up and having hot episodes, but I wasn’t drenched in sweat. And over time, now that I’ve been on for about four months, going on five months, I can see a big difference.
Again, I still once in a while, and I think it’s like as my hormones are still fluctuating, I have weeks where I’m waking up hot and other weeks where I’m sleeping totally fine. So, I’m not waking up totally drenched. I’m just kind of uncomfortable. And same thing with during the day, during the week, walking around in New York and on the subway or exercising, I’m not getting these intense hot flashes. It’s more definitely more muted.
Some of the other symptoms went away. The vaginal problems, she also gave me vaginal estrogen, which you know, I would say if anybody were concerned about cancer or something like that, the vaginal estrogen is not as restricted as the patch is for some people. And long term, if you have a lot of UTIs or urinary problems, the vaginal estrogen has been really proven to help with a lot of those things. And even 80- and 90-year-olds can use it. The urologist that I’ve been following really pushes that. If these are symptoms you currently have you should definitely check in out too.
Christine (13:46):
Yes, exactly. I like what you’re saying about things being interconnected. you don’t know exactly how bad things are or how much things are connected until you start to see some of that relief and then you’re like, okay, well, maybe I was under more stress or like you said, maybe now because I’m sleeping better, I’m realizing these things.
For me, through ,y move to FL, I was just starting to get help in January of last year that was pushing me forward through this menopause journey. But then we found out we were moving in March. I was in the middle of one injury and then I got a second injury in the summer before we moved. So all of that stress amplified everything so much.
So right at the point where I felt like I was getting better and getting the help, then other things changed. And I feel like that happens to a lot of women because life happens, you go through life and there’s ups and there’s downs. Unfortunately, when you’re in the midst of this with all the hormone changes, sometimes you don’t know which way is up what is actually a symptom and what is stress related and maybe you just need to find ways to destress.
But it’s really hard to navigate during those times and things are so connected. So, you never really know until you start to feel some of that relief. Once that happened for me I was able to manage a little bit better and start to really connect the dots.
Sara Dimmick (15:11):
Absolutely, and I think you have to give yourself a little grace and let things play out over time. I talk about how, as we’re getting older, we’re lucky to be at this age that we’re able to go through these changes. I’ve had friends pass away from cancer or, other situations that they didn’t get to this point. So, I think don’t beat yourself up if you’re not perfect. You probably have kids, you might have aging parents, you might have other job stresses in your life. So, there’s a lot of things going on you have to give yourself grace.
Christine (15:39):
Absolutely!
So what has been your biggest takeaway from your experience with HRT that you can share with women listening today?
Sara Dimmick (15:52):
It’s not the be all end all. I would also say you have to think about your other lifestyle changes or the things that you’re doing. We know over time you lose muscle as we age, both men and women, but especially women going through peri/post menopause. When menopause actually hits bone density goes down. So, between bone density, and muscle loss, those are the things that you have to really combat.
Lifting weights, exercise, eating a proper diet, trying to get better sleep habits, those are all things that you should be focusing on in general. And then I would say the HRT is more like icing on the cake.
Christine (16:39):
Mm-hmm.
Sara Dimmick:
Or if you feel like that can help you start your journey so that then you can sleep better, have more energy to work out, or you have more focus to focus on work or your family situation or whatever. You have to do it all in tandem and together. It’s not just one thing is going to fix you. So, I would say that would be where I’m coming from on this.
Christine (17:03):
Yes, absolutely. I think the same thing. I think that it’s about putting all the pieces together, but sometimes you’re so stuck in that moment that it’s hard to do that. It goes back to taking a little bit of time and grace.
Advocating For Yourself: Finding the Right Care:
Christine:
After you made the appointment and you started doing the HRT, you mentioned to me that you realized the first doctor that you saw wasn’t super helpful and you had to kind of advocate for yourself. So, at that point, did you seek a different doctor and how did that go?
Sara Dimmick (17:35):
Yes, so the first doctor that I said tested my hormones and told me I was totally fine and I ended up bullying into giving me the hormone patch. I just realized after having a conversation or two with her, she was still more in the OB situation. She wasn’t an expert in menopause. She’s delivering babies and focused on her younger women clientele.
I just felt like at this point I needed somebody who was more focused on the new research that’s coming out or the research that’s been out, but now people are actually talking about. So, I ended up switching practices. I’m now seeing people at NYU here in New York and they have a new women’s practice.
Christine (18:12):
Right.
Sara Dimmick:
I’m feeling a little more confident and comfortable over there. They checked the prescription that I was on, gave me a little tweak. I’m going to check in with them in a few more months. And if I need anything else tweaked, they’re going to help me with that. I think that’s really important. You don’t have to settle for the first doctor’s opinion. That’s why you get a second opinion or a third opinion.
And even some of these lectures that I’ve been to, some of these companies are sponsoring them. I want to be clear that these are, for-profit companies. But if you can’t find the help that you’re looking for in your local doctors, there are now doctors doing consults via virtual health consultations.
You can go to a local lab and get your hormones tested, or you can see doctors in person for your yearly checkups and your mammograms and all of those things. But if those doctors aren’t giving you the help that you need, there’s resources out there to consider. I think maybe we’ll put them in the resource list as well.
Christine (19:29):
Yes, I will drop them in the show notes at the end. I love that. I love that you stood your ground, and I love that you advocated for yourself and found the right doctor for you. I think it’s important as your body is changing that you find a doctor who is experienced in how your body is changing. A lot of the primary care doctors or just general doctors they don’t go through the training for this.
So, they’re not prepared with the studies and the newer things that we’re talking about now to have those discussions. A lot of times they just tell you to go on birth control and not really getting to your personal symptoms and exact situation.
They just kind of giving you the one size fits all kind of option and that’s not what this is. So, it’s great to advocate for yourself and to get that second or third opinion if you’re not feeling comfortable with how things are going. I think that’s really important.
One Habit That Changed it All:
Christine: Because this show is called Small Daily Habits, I like to ask all my guests what is one small daily habit that you can share with the audience that has helped you along this journey? So, if there was one thing that you could narrow it down to, what is one thing that really changed it for you?
Sara Dimmick (20:47):
I would say sleep health, getting to bed a little earlier. I was never somebody who stayed up super late to begin with. But through this journey, I found myself trying to go to bed earlier and earlier, especially when I was waking up in the middle of the night because I was thinking, well, if I’m going to be up from one to three, I better go to bed at nine.
Christine:
Yes!
Sara Dimmick:
So I started going to bed earlier and earlier because I was thinking if I wake up in the middle of the night at least I’ll maybe get the full hours by the end of the night when I actually have to wake up in the morning. Then over time this is now just really changed my habit of winding down at night and getting into bed a little earlier. I have to say it’s definitely been a gamechanger!
Christine: (21:43):
I absolutely agree. I think the same was true for me. You feel exhausted by all the things that are happening to you and all of the decisions that you’re trying to make and the research that you’re trying to do that I think trying to do something like harder workouts or just trying to change any of those habits, your nutrition, it’s all mental and it’s hard to get into. I think sleep feels so much better anyway and you are more likely to actually do it.
There are less barriers to sleep than other habits and it will get you what you need to then be able to make those other changes. So, I think sleep is where it’s at ladies! Okay, before we wrap up and start talking about the resources you mentioned, I know that you wanted to briefly discuss GLP-1s.
GLP 1’s and The Rising Popularity:
Christine: GLP 1’s are becoming increasingly popular as weight loss drugs, but are still relatively new, which means we don’t have a lot of information about long-term use. So, as a personal trainer, how do you approach this topic with your clients? And what is your professional opinion on long-term use?
Sara Dimmick (22:45):
Well, I’ll say that being a personal trainer in New York I have a lot of clients that are on them. And is the new hot thing to use. Everybody is on their own journey. And a lot of our clients have been trying to lose weight for a long time and they have a lot of barriers.
These new drugs are amazing. I mean, you see the weight loss in people dramatically and very fast. Sometimes I’m a little worried because they’re losing weight too fast, I believe. What we don’t want to see is muscle wasting. We don’t want to see people lose weight and lose all of their muscle. So, we do tests on our in-body machine. We’ll do body scans every couple months with clients to make sure that they’re not losing muscle.
You can lose a little bit of muscle as you’re losing weight, especially if you’re a bigger person. However, we’re looking at the body composition, the percentage of body fat to the muscle as well. And then we’re also looking at visceral fat, the fat around your stomach, because that is the dangerous fat that increases heart disease, diabetes, high blood pressure, cholesterol, That is the fat we don’t want.
These drugs are amazing. You’ve seen people lose weight. But like I said, we want to talk about bone density. And the only way to keep bone density is to increase muscle mass. And so you have to lift weights. That’s the only way that you’re going to increase muscle mass is lifting weights. So we really advocate for weightlifting two to three times a week. Sometimes even four times a week.
As far as cardio goes, you want to do cardio too maybe you don’t need to do as much. You want to really focus on the weight training. With GLP 1’s, we don’t know long term if people stop using them, if they can maintain their body composition over time.
Will they be able to stop using them or will they have to be on them long term? I know people now that have peaked and are trying to taper down a little bit. When you make the choice to use these drugs you might want to think about just gradually going on them and not doing such a huge weight loss right away. So, maybe start off with a smaller dose.
People don’t eat on these drugs, you have no appetite. I’ve had clients come in, their appointment is at four o’clock and they haven’t eaten or drank anything all day. These drugs make you not want to eat. They make food repulsive. You forget to eat, you don’t want to eat. They can make you nauseous, and throw up. That’s not good.
Christine (25:06):
Yeah, right.
Sara Dimmick:
You need food to sustain your body and your brain function.
Christine:
Yeah, and to build that muscle that you’re talking about.
Sara Dimmick:
Exactly. Exactly. You have to eat protein. You have to be on a lower dose that you can eat. You want to enjoy food and enjoy life. I would just caution people that are on those drugs to think about what they’re doing to their body long term.
Christine:
Right, it’s fine to maybe get that kickstart that you need, at that beginning stage when you’re just kind of feeling like you’ve been trying to do these things and it’s not working, but to realize that you still need to do the work in order to get the maximum results. So at some point, these lifestyle habits are still going to come into play.
You still want to be able to eat, to fuel your body, to be able to increase that muscle mass. So, I do think that is an important caution. It’s okay to want and need some help, but there is no easy button here. We still have to put in the work and we still have to listen to our bodies and figure out our needs as individual. Again, very individual journeys.
Sara Dimmick (26:31):
Exactly, everybody is on their own path and there’s not a one-stop shop for everybody. But the information is out there and there’s a lot of different tools and you can mix and match all the things to get you where you need to be.
Christine (26:43):
Exactly! Okay, well it’s time to wrap up the episode with these wonderful resources that you wanted to share with our listeners. So, Sara, can you go ahead and tell us a little bit about what you want to share?
Sara Dimmick (26:55):
Yeas, so we have a few books that I highly recommend. Estrogen Matters, The Menopause Brain, and The New Menopause are all great books. You can find them on Amazon or your local book store. Also, there’s a documentary on PBS, The M Factor, Shredding the Silence on Menopause is a great documentary to watch.
I don’t think there’s many documentaries on menopause, but there is one.
Christine (27:22):
No. I did try to watch that one, but I am not a member of PBS and so there is a process to become a member. It’s on my list of things to do. I just haven’t gotten there yet.
Sara Dimmick (27:29)
And then I discussed, Alloy, A-L-L-O-Y. I believe it’s My Alloy is one of the online doctors that spoke at The Swell and they have virtual doctors that can help you if you are having trouble finding hormone replacement therapy in your rural district or if you don’t have doctors that are helping you.
I would then also just think about caution with the things that you’re getting targeted for on Instagram and Facebook, do your research.
You don’t need to have a big list of supplements that you’re taking. Think that less is more and make sure that it’s studied, and FDA approved and talk to your doctor about it. I don’t want people wasting a lot of money on things that are heavily targeted to you on Instagram or Facebook.
Christine (28:39):
Right, right. Well, thank you so much for sharing all of that and thank you for being here today. It was so nice to have this discussion and reunite after all of these years.
Sara Dimmick:
Awesome, well it was great catching up Christine and I look forward to maybe visiting you in Florida soon.
Christine:
Yes that would be awesome we’ve got a pool waiting here for you.
Thanks for being here and sharing your story. I know so many women will find this relatable and helpful. And for those of you in the New York City area, check Sara and her team out at Physical Equilibrium.
Join us Next Week!
That’s a wrap ladies. Thanks again to our amazing guest, Sara Dimmick, and thanks to all of you for tuning in. I hope this episode hits close to home and gives you the courage you need to advocate for yourself and stop suffering in silence. There is support out there and you can start with the resources Sara mentioned.
Don’t forget to share this episode with a friend. Let’s keep the conversation going and support each other through this journey. Then meet me back here next week as we tackle the role of strength training in terms of weight management and hormonal balance. We’ll do a deep dive on how muscle mass impacts metabolism and overall health, as well as common mistakes when you are just getting started or kickstarting your routine again. See you there.
Remember, BIG changes begin with small daily habits. Until next time….
Wishing you much love, health, and happiness,
Christine
Missed last weeks episode titled The Midlife Metabolism Reset: Break Free from Your Plateau. Tune in here. Read the show notes here.
