117. The Hidden Link Between Migraines and Perimenopause

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https://www.drlesliecisar.com/apply

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I had a consultation call yesterday with a new client whose words really stayed with me. She was struggling with both migraines and a brutal perimenopause, the hot flashes, the mood swings, the sleep disturbances, and she said, “I think if my migraines were better, I’d probably handle menopause better.”

I had to gently stop her right there. Because what so many women don’t realize is that severe perimenopause and chronic migraines are not two separate problems happening at the same time. They’re the same underlying story showing up in different ways.

In this episode, I walk you through why your body reacts so strongly during this season of life, what hormones actually do (and don’t do) in this picture, why HRT is being marketed so aggressively right now, and what I think every woman should understand about estrogen, clearance, and toxic load before reaching for another patch, pill, or pellet.

If you’ve felt like your body is falling apart in your 40s and 50s, this episode will give you a completely new way to understand what’s happening, and a much more empowering path forward.

Connect with us:

Website: https://www.drlesliecisar.com/

Free Facebook Group: Healing Migraines Naturally, with Leslie Cisar, ND

Ready to try something radically different that actually works? Read more about my approach here: https://www.drlesliecisar.com/map

In health,
Dr. Leslie Cisar

Episode Transcript

hi there
welcome to the Healing Migraines Naturally podcast
I'm your host Doctor Leslie Caesar
and I'm a licensed naturopathic doctor
former chronic migraine sufferer
and I've dedicated my life to helping other women
rediscover a migraine free life
so I wanna start the podcast off
with something that happened yesterday
I was on a consultation call with a new client
and her main concern was her migraines
but she was also dealing with a really difficult
perimenopause the hot flashes
the mood swings the sleep disturbances
you know the whole picture
and she said I think if my migraines were better
I'd probably handle this menopause better
you know
her underlying Assumption behind that statement was
you know menopause is hell
and you can get through hell a lot better
if you're not suffering you know
25 days out of the month with horrible migraines right
and I told her
you are experiencing this very hard perimenopause
for the exact same reasons
you are experiencing your migraines
and she went quiet and then she said
what do you mean she had been treating these as two
completely separate problems right
she had her neurologist and her gynecologist
and both of those specialists
are going to focus on two very different things
and then one sentence changed the entire picture
if you have migraines
and you are in perimenopause or menopause
you are hearing a lot
right now about hormone replacement therapy
and I'm making this episode for you
okay because
thehrt conversation is not accounting
for what is actually happening in your body
and this is a serious problem
so you've probably noticed
the cultural moment that we're in
right now HRT ads are everywhere
Oprah is talking about it
we've got these telehealth platforms
prescribing hormone replacement
after a short intake form
in late 2025 the FDA removed the black box warnings
from manyhrt products calling them misleading
so I'm recording this in may of 2026
right so
this is why
those advertisements suddenly came out of the blue
and we you know
we women of this certain age
are being bombarded by these advertisements
on social media
so it's being presented as the obvious
long overdue answer for women
who are suffering through perimenopause
and menopause
and certainly American women have been struggling
um so I understand the momentum
but context matters here HRT was demonized for years
and the black box warning was put on these products
largely based on a flawed study
called the Women's Health Initiative
when that study was published in 2002
the FDA responded immediately
by adding a black box warning
tohrt products
and a black box warning is the most serious warning
category that any prescription medication can receive
so this black box warning was applied
to flag increased risks of breast cancer
heart disease stroke and blood clots
HRT prescriptions dropped by roughly 50%
almost overnight
new research has since challenged
the Women's Health Initiative methodology
and in late 2025 the FDA removed those warnings
so that is the arc
that brought us to this cultural moment
it's a story of over correction in one direction
followed by over correction in the other
and the truth as usual
is more complicated than either headline
hi there
I wanna jump in real quick and tell you about my client
Beth she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of her migraine
medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so if you're serious about changing your migraine story
go to Doctor Leslie Caesar dot com slash apply
or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done feeling helpless
and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
so the criticisms
of the original Women's Health Initiative
study are valid
the women who were enrolled in this study
were mostly over age 60
that's past the age when HRT is typically started
so more recent research suggests that women who begin
hormone replacement therapy earlier
within 10 years of their last period
may not carry the same risks
the original study also used synthetic hormones
specifically a synthetic progesterone
that's like a synthetic progesterone
that
has a different profile than the bioidentical hormones
that are prescribed today
via all those telehealth apps
so the breast cancer signal
in the Women's Health Initiative study
was associated with that synthetic progesterone
and not with bioidentical progesterone
the women who in the the women in the study
who actually took estrogen
only showed a decreased rate of breast cancer
so these are legitimate points
and they deserve to be acknowledged
but
the pendulum has now swung hard in the other direction
and when something becomes this aggressively marketed
when telehealth platforms prescribe it
after a short intake form
when celebrity endorsements reach millions of women
we have a responsibility to ask harder questions
let's let's ask some of those harder questions
okay so HRT is a significant market
nearly 24 billion globally in 2024
that's before they removed the black box warning
it's projected to reach 40 billion by 2033
Bayer Pfizer and Novartis are among the major players
so that doesn't mean that the research is corrupt
but it does mean the framing of findings
matters to people with a very large
financial stake in the outcome
and it's worth knowing
that four of the panelists on the FDA
expert panel that advised the 2025 warning removal
we're members of an advocacy group
funded by Pfizer and Bayer
a group that had been specifically
calling for that removal
so we deserve more than a one sided message
so the studies behind you know
this HRT is safe messaging
are controlled clinical trials
I'm not saying they aren't valuable
but they study hormone replacement therapy in isolation
one variable at a time and they're not
they're not measuring everything
else that the woman is already carrying
as far as a hormonal metabolite load
when a
when a clinician says HRT doesn't increase cancer risk
they mean HRT alone in a controlled population
didn't show a significant increase
during the length of the study
this is a much narrower statement than it sounds
and most women never hear that distinction
those studies
did not account for a woman's environmental exposure
history they didn't
account for her individual capacity to metabolize
estrogen they didn't account for decades of estrogen
mimicking chemical exposure
and they didn't account for the nutritional
and gut health factors
that determine how well her body can clear estrogen
here is what is critically important
for every woman listening
any woman with migraines
already has a toxin overload problem
in my 9 years of working
exclusively with women with migraines
I have never had a client
whose body was only generating migraines
not once migraines are one expression of a body
that is overburdened
and any woman with hormonal symptoms
PMS irregular cycles
heavy periods mood changes around her cycle
difficult perimenopause or menopause
has a problem with how her body metabolizes
and clears estrogen
these are not separate issues
they are the same underlying problem
showing up in different ways
if you have migraines and hormonal symptoms
you are not the average woman in a clinical trial
you are in a very different position
thehrt is
safe messaging was not designed with you in mind
the most important
thing missing from the mainstreamhrt conversation
starts with one fact
your body does not care where the estrogen came from
it doesn't know whether the estrogen came from a patch
a hormone patch
a plastic water bottle or your own ovaries
receptor binding doesn't care about the source at all
it all goes into the same pool
so
there is a category of chemicals called xenoestrogens
these are estrogen mimicking chemicals
found in plastics food packaging
pesticides even our
you know makeup
our own you know
personal care products
most of us are exposed to them every single day
they're not identical to human estrogen
but they bind to estrogen receptors
and create estrogen like effects in the body
so
you know
you can't buy baby toys with BPA in them anymore
can you that's because BPA
bisphenol a it's a plastic molecule
it's a it's a
it's a it's a type of plastic that's soft
so they put BPA they used to put it in a lot of things
they're putting it in less and less now
but they used to put it in baby toys because right
you want your baby chewing on something soft
the little teething ring the little toy
babies like it if they can kind of give that a nice
if it's soft and they can chew on them
so they would put BPA in baby toys
and babies were absorbing that BPA
xenoestrogen compound or molecule
and little babies were developing breast buds
their breast tissue was being stimulated
by that xenoestrogen molecule
so this is a very real very well documented phenomenon
and this is why they took BPA out of baby toys
and why now when you buy water bottles and things
it it advertises itself as BPA free
this is because this is one of you know
many many xenoestrogen compounds
that when they enter our body
they're close enough in molecular shape to estrogen
that they're gonna
stimulate our estrogen sensitive cells
and these xenoestrogens accumulate over a lifetime
so when you have a woman okay
so she's already been making her
naturally occurring estrogen
in her ovaries and then she's been accumulating
xenohormones for decades
and then you add on what is called exogenous estrogen
so
that's the estrogen that you're going to be applying
whether it's bioidentical or synthetic
via a cream or a patch
you're adding that exogenous estrogen
or extra estrogen into a pool that's already full
into a bucket that's already overflowing
if you have migraines to boot
so that woman
with all of that accumulation
is in a fundamentally different position
than the average clinical trial participant
where
none of that accumulated exposure was measured or
controlled for so
some women metabolize and clear estrogen efficiently
and some don't the reason why
is the piece most women have never heard of
and I'm going to cover it in detail in this podcast
but this is what the HRT is
safe conversation is missing
not because researchers are being dishonest
but because the research infrastructure
studies one thing at a time
total estrogen load is a systems level question
conventional research doesn't handle
systems level questions well
in fact our medical system
doesn't handle system level problems very well
this isn't theoretical okay
the trend is visible right now
so approximately
3,000 more women under the age of 45
are being diagnosed with breast cancer
every single year
compared to 2,001 so
3,000 additional women every year
who would not have received that diagnosis
20 years ago
the obvious objection well
you know screening's better well
it that argument doesn't hold up for this age group
routine
mammography is not recommended for most women under 45
and that guideline has barely changed since 2,001
so these women are not being screened more
they're finding these cancers themselves
they're finding a lump this is a real increase
it's not a detection artifact
the under 45 group is the sharpest signal
now across all ages 45 55
65 and older
breast cancer diagnoses have been rising adding up
we're looking at tens of thousands
more women diagnosed with breast cancer
every year in the
in the United States compared to 2,001
now for older women
we do have some advances in mammography technology
and you could argue that
that advancement in mammography technology
accounts for more early detection
and accounts for some of that increase
but even accounting for better detection
the trend is real and it's moving in one direction
the under 45 data is the cleanest signal
and I think I'm gonna be 54 in a couple weeks
and in my lifetime right
like I've been I've been alive long enough
where it used to be unheard of
for a young woman to be diagnosed with breast cancer
and ask yourself
do you do you have friends
family coworkers where they're
you know young women under 40
under 45 with a breast cancer diagnosis
this was not happening when I was young
it definitely
was not happening when my mother was young
so the under 45 data is the clearest signal
there's no detection argument that explains
those numbers and this is not a phenomenon
that's only happening in the United States
there's data coming out of France that confirms that
early onset breast cancer has been increasing
steadily from 1990 we've got data coming in from the UK
this is a global phenomenon
so the most important detail
the cancers increasing
most are estrogen receptor positive
they're being driven by estrogen
these are not random cancers
they're specifically the cancers that estrogen fuels
there is also a clear trend toward earlier puberty
right girls are hitting puberty younger and younger
which researchers link directly to environmental
or this xenoestrogen exposure
right
when we hear the word estrogen
we're thinking about
the estrogen that our ovary is making
or that we're applying in a HRT cream
but when you hear the word estrogen
when you hear the word estrogen sensitive cancer
when you hear early puberty
you have to think about the xenoestrogens
the estrogen like molecules
in the environment that we're exposed to
and we're absorbing into our bloodstream
and then
you also have to think about estrogen metabolism
which we're going to talk about
so girls today
are accumulating more lifetime estrogen exposure
before they ever reach menopause
the total load is already higher
before hormone replacement therapy enters the picture
estrogen driven cancers are rising
girls are getting more estrogen exposure earlier
and we are in the middle of the biggest push in decades
to add more estrogen to women's bodies
that combination deserves serious scrutiny
now some of you are probably asking
isn't this obvious
if women are getting more overloaded with estrogen
and cancer rates are rising
wouldn't adding more estrogen make things worse
biologically yes
the logic is sound
environmental estrogen exposure is increasing
girls are hitting puberty earlier
breast cancer rates in young women are rising
the cancers that are increasing are estrogen driven
total estrogen load is not accounted for
in HRT safety studies
adding exogenous estrogen
on top of an already burdened system
increases this load further
the conclusion is hard to dismiss
so why doesn't the medical establishment say this
directly
well the research infrastructure studies
individual variables not cumulative systems
acknowledging
total estrogen load as a meaningful risk factor
would complicate HRT prescribing significantly
it would implicate enormously powerful industries
plastics agricultural
plastics agriculture
personal care and it would require admitting
that conventional medicine
has been looking at this problem
too narrowly the absence of a
definitive study does not make the reasoning wrong
sometimes the dots are visible
long before anyone officially connects them
with a double blind placebo controlled study
this is the most important part of the episode
this is the piece almost completely missing
from the mainstream conversation
when most people hear metabolized
they think it means gone neutralized
done the estrogen did its job
got processed and left the body
that is not what happens okay
here is how it actually works
your ovaries produce estrogen
that estrogen travels through the bloodstream
to an estrogen sensitive cell
breast tissue uterus
brain wherever
it binds to the receptor and it does its job
then that estrogen molecule becomes a metabolic waste
material that your liver has to handle
that molecule does not disappear
when it becomes a metabolite
your liver runs it through detoxification pathways
phase 1 and phase 2
and it has to go through multiple steps
before it's fully processed
and it can leave the body
and until that process is complete
those estrogen metabolites are still circulating
still stimulating estrogen sensitive cells
they're still active just like the xenohormones
the xenohormones have to go through the same process
so if you do absorb say
a little BPA molecule
that is very similar in structure to estrogen
and it's gonna bind to those estrogen receptors
and it's gonna stimulate that estrogen sensitive cell
just like estrogen would your liver has to
has to detoxify that BPA molecule as well
and it has to be eliminated from the body
so it doesn't matter if it's estrogen that we've made
if they are xenoestrogens coming from outside
into the body
if it's a bioidentical estrogen from a patch or a cream
all of those molecules are going to act like estrogen
on estrogen sensitive cells
and your liver has to metabolize them
it has to break them down
so that they can be eliminated from the body
and until they are eliminated eliminated from the body
they're still going to stimulate those estrogen
sensitive cells
hi there
I wanna jump in real quick and tell you about my client
Beth she was getting 15 to 20 migraines
and headaches per month and as you can imagine
this was impacting her work performance
and her confidence she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I
help women uncover the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off all of her migraine
medication but most importantly
she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so
if you are serious about changing your migraine story
go to Doctor Leslie Caesar dot com slash apply
or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done feeling helpless
and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
so the metabolites
whether they're xenoestrogen metabolites
bioidentical hormone metabolites
or the actual estrogen your ovaries make
those metabolites are still active
this is one of the most critical pieces to understand
so there are three main pathways
the liver uses to process estrogen
in phase 1 detoxification okay
so we're going to get a little technical here
there's three pathways
there's the 2 o h pathway the 4 o
h pathway and the 16 o h pathway okay
so you can kind of think of these as you know
three three conveyor belts okay
and the estrogen molecules the xenoestrogen molecules
the bioidentical estrogen molecules
they've got to go through these three conveyor belts
to be metabolized and
and processed
so that they can be eliminated from the body
but these conveyor belts they are not all equal
the 20 pathway is the conveyor belt
you want these molecules to go through okay
if the molecules go through that 20 conveyor belt
the metabolites that are produced
bind weekly to estrogen receptors
and they're considered to be protective
the SIXTEEN OHA conveyor belt okay
that one is more concerning
that conveyor belt produces metabolites that lock
onto the estrogen receptor and don't let go
so that stimulates
it drives the cell to continue to proliferate
now the 4 o h pathway or conveyor belt
is the most problematic
those metabolites are what is called estrogenic
and they can directly damage DNA
in addition to stimulating the estrogen sensitive cell
so which conveyor belt your liver uses
comes down to nutrient status
this is the piece that nobody is talking about
this is if you've been listening to the podcast
this ties into what I call the first principle
the first thing your body needs
in order to function properly
and that's nutrients so
your liver needs specific nutrients
to run these conveyor belts
and without those adequate nutrients
the liver cannot complete the process
the 2 o h conveyor belt
that's the conveyor belt that we
want things to go down the most
there are nutrients
that are particularly dense in cruciferous vegetables
like broccoli or cauliflower or brussel sprouts
these nutrients are in other foods that we eat too
but these plants are particularly dense
in those nutrients
that are really specific to run that two
oh conveyor belt
so if you're deficient in those nutrients
if your digestive tract struggles to break down
the food that contains those nutrients right
so a lot of people they eat broccoli
they eat cauliflower they eat brussel sprouts oh
I can't eat those I'm gonna get a lot of gas right
well guess what
if you get gas after eating brussel sprouts
your digestive track is not breaking the brussel
sprouts down properly okay
it's not that brussel sprouts cause gas
these cruciferous vegetables
they're very nutrient dense
and so it's harder for your digestive tract
to break them down if your digestive tract is robust
it can break down Brussel sprouts
and you're not going to have a whole bunch of gas
but if it's struggling
if it's only partially breaking things down
and those brussel sprouts start to
kind of rot in your digestive tract yeah
you're going to have a lot of gas
and you're not going to be getting those beneficial
nutrients out of the Brussel sprouts
and that 2 o h
conveyor belt
really needs those types of nutrients that are
found heavily in those cruciferous vegetables
the 20 conveyor belt
let's take a look at the 40 conveyor belt
this is the conveyor belt where
if the estrogen gets on this conveyor belt
we want it to move through this conveyor belt
as fast as possible
if the conveyor belt starts to go real real slow
that's where those metabolites build up
that can cause DNA damage
so we want this conveyor belt right
if anything's gonna get on this conveyor belt
it's like let's just run this thing as fast as we can
so
guess what nutrient you need to run that conveyor belt
quickly
it's magnesium now amongst migraine suffers right
everybody's looking for the you know
the miracle magnesium but nobody's asking the question
why are people so deficient in magnesium
okay it's in a lot of foods so again
if you don't have adequate stomach acid
if your digestion in general
is struggling to break your food down
you're not gonna absorb the minerals
that are in the food that you're eating
you're not gonna absorb the other nutrients
that are in the food that you're eating so
you know instead of pushing supplements on everyone
we really need to be looking at okay
are the the factors for good digestion in place
um there are other nutrients that are necessary
for these pathways or for these conveyor belts
I'm just giving you sort of a high level overview
the main thing to take away here
is that a nutrient depleted woman
may push estrogen through more harmful pathways
or conveyor belts simply because her liver
doesn't have the raw materials
that it needs so
there are also some genetic factors
that influence where those molecules go
which convey about those molecules go
but it's not just about genetics
this is something that I've talked a lot about
on this podcast yes
genetics obviously
plays a role in our health
and the symptoms that we're predisposed to
but even women with the genetics
that predisposes them to put more estrogen
metabolites down that 4 oh conveyor belt
or the 16 oh conveyor belt
even if you have those genetics
if you have the nutrients that your body needs
to run that conveyor belt quickly
you're still not going to have a problem
it's more about whether your body has what it needs
than your genetics
so nutrient deficiencies
and digestive issues are extremely common
in women with migraines
so if you've heard me talk about this on other
other episodes of the podcast I hope this gives you
you know
another example to help you understand this principle
and you know there's another layer to this
and that is
what's going on inside your digestive tract
so
after the liver packages up these estrogen metabolites
for elimination from the body
it sends them it it puts them into the bile
and the bile is squirted into our small intestine
when we eat so when we have a healthy microbiome
when we've got the good bacteria
the beneficial bacteria in our digestive tract
those estrogen metabolites
are gonna move through the body
and exit
they're gonna move through the digestive tract
and they're going to leave the body in the stool
and we're going to eliminate the estrogen that way
but if we don't have the beneficial
bacteria in our digestive tract
if our microbiome is out of balance
it many times
will contain a bacteria
that produce an enzyme called beta glucuronidase
and that enzyme
sort of unpackages the estrogen metabolites
it literally undoes the liver's work
those reactivated metabolites
get reabsorbed back into the bloodstream
because our digestive track
is designed to absorb stuff right
and so those metabolites will circulate again
stimulate estrogen sensitive cells again
and have to go through the entire liver detox process
again
this is actually called enterohepatic recirculation
it's not about um oh okay
now let me take some probiotics
the bacteria that is living in your digestive track
is there because of the conditions
in the digestive track so
different types of bacteria
live in different types of environments
what we call beneficial bacteria
flourish inside of a digestive track
that is functioning optimally okay
where there's good motility
throughout the digestive track
where there's adequate
hydrochloric acid being produced in the stomach
where we've got
the pancreas producing adequate digestive enzymes
so that the food is further broken down
you know the types of food that we eat
foster the growth of different types of bacteria
people that live in the Arctic and eat
seal meat have a totally different
blend of bacteria in their digestive tract
than people who live near the equator and have a
a vegetarian or near vegetarian diet
so the food that we eat is
is part of and the conditions
of proper functioning within the digestive tract
that's what's dictating the bacteria in there okay
so you can take all the probiotics you want
they're not gonna survive
you can take capsules and capsules
of so called beneficial bacteria
they're not gonna survive
if it's not a hospitable environment for that bacteria
so this is this is a situation that's plaguing many
many American women
if you're struggling with migraines
you know
you're you're probably uh also struggling with this
so you know
if you're having any sort of digestive issues
I've talked about this on other podcast episodes
if you're having any symptoms in your digestive tract
things are not working properly okay
we should have a good appetite
where we feel like eating a wide variety of food
you know we're excited to eat
enthusiastic to eat the food tastes good
and we can chew the food and swallow the food
and then
we don't really feel anything going on in there
until we you know
pass pass the remnants out
but so if you're experiencing anything in there
your digestion is not functioning properly
so um
we have you know
a a woman with migraines um
digestive symptoms and all of these hormonal symptoms
who is now being told to consider
hormone replacement therapy
her body may already be failing to clear the estrogen
it naturally produces you add on exogenous estrogen
on top of a system that cannot complete the clearance
that's a very different proposition than a quick
telehealth intake form is going to identify
so I think we need to start thinking about menopause
differently and this is my own clinical perspective
my theory based on years of working with women
what if menopause isn't something that happens to us
what if it happens for us
my theory is that women go through menopause
because if we didn't
more of us would die from estrogen sensitive cancers
the body in its profound intelligence
winds down estrogen production
as a protective mechanism
to prevent the
accumulation of too much estrogen over a lifetime
and to allow women to live longer
women today
are carrying a higher lifetime estrogen burden
than any previous generation
earlier puberty decades of xenohormone exposure
compromised detoxification pathways
the body's protective mechanism
menopause
may be more necessary now than it has ever been
and yet the current message is to override it
add the estrogen back don't let your levels drop
menopause through my lens
is not a deficiency state to be corrected
it's a biological safeguard
our bodies are doing something intentional
adding exogenous estrogen back into a system
that has been accumulating
environmental estrogen for decades
that cannot fully clear the estrogen it already has
and whose liver and gut
are not equipped to handle more
we may be working directly against that Protection
I'm not saying AHRT is never appropriate
I'm saying the question
of whether it is right for any individual woman
cannot be answered by a population study
a celebrity endorsement
or a telehealth 5 minute intake form
it requires looking at the whole picture
and menopause isn't supposed to be this hard
menopause has become synonymous with suffering
in western culture hot
the hot flashes the night sweats
the mood swings the insomnia
the weight gain
women are told this is just what menopause is
brace for it survive it or takehrt
this is not true and we have the data that proves it
look at Japan Japanese women going through menopause
report hot flashes at a fraction
of the rate of American and European women
in some studies
less than 15% of Japanese women report hot flashes
in the United States that number is around 80%
same biological event wildly different experience
the difference is not genetic
Japanese women who move to western countries
and adopt western diets and lifestyles
lose that Protection their menopause experience
shifts towards the western pattern
this is not their DNA their genetics did not change
when they took the flight over
the variable is how their body has been supported
or not supported in the years leading up to menopause
Japanese women are not just eating differently
their bodies are clearing estrogen more efficiently
over a lifetime and when they reach menopause
when the body naturally winds down estrogen production
there's not a massive estrogen burden
left behind to cause chaos
the transition is smoother
because the system was not already overwhelmed
compare that to a western woman
who has spent decades
accumulating xenohormone exposure
whose liver is nutrient depleted
whose gut is disordered
and recycling estrogen back into circulation
and who then hits menopause
her estrogen clearance system was already failing
before menopause started
the drop in estrogen production
doesn't just change her hormone levels
it disrupts an already overburdened system
the severity of her symptoms is not menopause
it's the accumulation of years of impaired clearance
hitting all at once
severe
menopause symptoms are not a natural part of aging
they are a signal they are your
body
telling you that the estrogen burden has been too high
for too long
and the system does not have what it needs to manage
that transition
this is not something
that hormone replacement therapy solves
more HRT
adds more estrogen
to a system that was already struggling to clear it
so regular listeners to the podcast
know what I call the three principles
the three things
the body needs to maintain its state of health
and not generate symptoms
migraines are symptoms
menopause symptoms are symptoms okay
you do not have to go through those menopause symptoms
I have covered these three principles
across more than 100 podcast episodes
I have three free training webinars
I don't want to reexplain them from scratch
but I want to show exactly where they commit
they connect to everything we have just covered
so the first principle is about nutrients
if your body doesn't have the nutrients that it needs
if your cells don't have the nutrients
that they need to function properly
you're not going to feel well
so these nutrients they provide
the raw materials
that these three conveyor belts run on
nutrient deficiencies in migraine sufferers
isn't just about diet
it's about whether you are breaking the food down
that you're eating
are you eating a wide variety of food
many migraine sufferers are on elimination diets
and they're not eating a wide variety of food
the wider variety of food
we're able to eat the wider variety of nutrients
we're going to get into our body
but after we eat the food
break it down we've gotta absorb the nutrients
we've gotta bring the nutrients into the bloodstream
and we've gotta circulate and deliver those nutrients
to the cells
so when we have compromised appetite
and digestion and circulation of the nutrients
that's going to slow down our estrogen clearance
so these two things are highly connected
the second principle or the second thing
our body needs to maintain its state of health
or restore itself to health
is clearing metabolic waste materials and toxins
your liver is your primary organ of detoxification
for metabolic waste materials
like your hormones for toxins in the environment
whether they're naturally occurring or man made
and when it's overburdened everything backs up
any woman with migraines
already has a clearance problem
adding exogenous estrogen
increases the burden on a system that was already
struggling
and the third principle is about our own resilience
and vitality we have to have enough resilience
and vitality to weather all of the stressors
that we're bombarded by every day
whether they're physical stressors like weather changes
sunlight um
physical activity or things that we call stress
like mental and emotional stress
mental and emotional stress
stimulates the production of cortisol
a stress hormone
and I want to talk a little bit about cortisol
um your liver again
has to detoxify cortisol everything that the body makes
everything that our cells make
all of our hormones little peptides that our cells make
all of these signaling molecules
everything has to be detoxified
but here's the thing your liver detoxifies cortisol
before it detoxifies estrogen
and when cortisol is chronically elevated
it goes to the front of the line
the liver processes it first
so when a
when you have a woman who is under chronic stress
it's more likely that the estrogen
is going to accumulate because the liver
preferentially detoxifies the cortisol first
hi there
I wanna jump in real quick and tell you about my client
Beth she was getting 15 to 20 migraines and headaches
per month and as you can imagine
this was impacting her work
performance and her confidence
she also has two small children
and she was
starting to feel like she was a horrible mom
because she had nothing left for them
at the end of the day but she reached out
and she booked a free consult call with me
and after I asked her about her migraines
and her health history
I felt confident that I could help her
I help women uncover
the root drivers of their migraines
and follow a step by step plan to dramatically reduce
the frequency by up to 90%
without adding more medication
or taking a bunch of supplements
so we built her personal migraine map
followed the plan
and now she will get one to two migraines per year
which she uses ibuprofen to treat if she needs to
verses up to 15 to 20 per month
when we first started working together
that weren't responding well to any medication
she just reached out to tell me that
she got a promotion at work
she's on top of her career again
and has been able to come off
all of her migraine medication
but most importantly she's a confident mom again
and she's attending birthday parties at Jump Zone
with her kids and saying yes
instead of saying maybe later
I've worked with women like Beth
from all over the United States
who were told this is the best we can do
but they were still willing to dig deeper
so
if you are serious about changing your migraine story
go to Doctor Leslie Caesar dot com slash apply
or tap the link in the show notes
and on our free consult
we'll map out why your migraines keep coming back
and the first three steps you can take
over the next 30 days
I do cap new client spots each month
so if the calendar is full
the doors are closed for now
but if you're done feeling helpless
and ready to do the work to heal
pause this episode for 30 seconds
and book that console call now
so estrogen can build up because of
excessive cortisol production
and the need for the liver to metabolize
or eliminate the cortisol
so this is why
women who have a chronic stress picture
very frequently also have hormonal migraines
and significant
or severe menopause and perimenopause symptoms
so these three principles
they're not three separate symptoms
they're all connected the woman I spoke with yesterday
who was struggling with both
migraines and perimenopause
was experiencing both as expressions of the same
underlying problem her migraines and her perimenopause
were not two different problems
they were two symptoms of one body that needed support
in the same places
so what does this mean for you
a population level statistical study
cannot tell you what is safe for your body
your history your exposures
your nutrient status your gut health
your liver load your current symptom picture
all of that determines what safe actually means for you
the symptoms your body is generating
the migraines the hormonal symptoms
the fatigue the digestive issues
these are not separate problems
they're clues
they all point to the same underlying picture
nobody has been asking you the right questions
about what that picture looks like
not your gynecologist not a telehealth intake form
not a YouTube ad this is the work that I do
I ask the right questions
so before making any decision
about hormone replacement therapy
whether you are considering it for the first time
you're already on it
or someone is sort of pushing you towards it
you need answers to some basic questions first
what is my total estrogen picture
what has my environmental exposure
looked like over my lifetime
how is my digestion
am I actually absorbing the nutrients that I need
how well is my liver clearing estrogen
which detox pathways
or which conveyor belts is my body using
has anyone ever asked you these questions
these are not questions
a telehealth intake form can ask
but these are the questions that really matter
everything that we cover today
is something that you can actually test
so I run a complete hormone and metabolite panel
that shows
which pathway your body is running estrogen through
right now your full sex hormone picture estrogen
progesterone testosterone
your cortisol pattern
if you have excess cortisol
that's going to fill up that conveyor belt
before the estrogen so not one piece in isolation
the whole picture needs to be looked at together
so I'm opening up a limited number of spots
for the estrogen metabolism and migraine assessment
it includes a comprehensive intake session
the complete hormone and metabolite panel
and a few and a
and a full results review
where we go through everything together
and connect it to your complete symptom picture
the investment is 15 dollars
the link is in the show notes
spots are limited
if the assessment isn't the right next step for you
right now come join my free Facebook group
Healing Migraines Naturally with Leslie
Caesar and d or book a free consultation call
we'll look at your picture together
and figure out what makes sense
if I can help you I'll tell you that
if I can't I'll tell you that too
so thanks for being here I hope this was informative
and I'll talk to you next time