Healing Migraines Naturally
Dr. Leslie Cisar
Recording 0164 | Edited transcript | 48:29
[00:00]
Hi there, welcome to the Healing Migraines Naturally podcast. I'm your host Dr. Leslie Cisar 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 want to 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.
[00:31]
The hot flashes, the mood swings, the sleep disturbances, the whole picture and she said, "I think if my migraines were better, I'd probably handle this menopause better." Her underlying assumption behind that statement was menopause is hell and you can get through hell a lot better if you're not suffering 25 days out of the month with horrible migraines. And I told her, "You're experiencing this very hard perimenopause for the exact same reasons you are experiencing your migraines."
[01:08]
And she went quiet and then she said, "What do you mean?" She had been treating these as two completely separate problems. 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 because the HRT conversation is not accounting for what is actually happening in your body and this is a serious problem.
[01:52]
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 many HRT 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 women of this certain age are being bombarded by these advertisements on social media.
[02:47]
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. 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 to HRT products and a black box warning is the most serious warning category that any prescription medication can receive.
[03:39]
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 percent 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 overcorrection in one direction followed by overcorrection in the other and the truth as usual is more complicated than either headline.
[04:28]
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 began 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 progestin, that's like a synthetic progesterone, that has a different profile than the bioidentical hormones that are prescribed today via all those telehealth apps.
[05:15]
So the breast cancer signal in the Women's Health Initiative study was associated with that synthetic progestin and not with bioidentical progesterone. 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.
[06:02]
So let's ask some of those harder questions. 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 advise the 2025 warning removal were members of an advocacy group funded by Pfizer and Bayer, a group that had been specifically calling for that removal.
[07:05]
So we deserve more than a one sided message. So the studies behind 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 measuring everything else that the woman is already carrying as far as a hormonal metabolite load. 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 that length of the study.
[07:55]
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.
[08:47]
Any woman with migraines already has a toxin overload problem. In my nine 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.
[09:34]
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. The HRT is safe messaging was not designed with you in mind. The most important thing missing from the mainstream HRT conversation starts with one fact. Your body does not care where the estrogen came from.
[10:12]
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 makeup, our own personal care products. Most of us are exposed to them every single day.
[10:56]
They're not identical to human estrogen, but they bind to estrogen receptors and create estrogen-like effects in the body. Oh, 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 type of plastic that's soft. 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 you want your baby chewing on something soft, the little teething ring, the little toy.
[11:31]
Babies like it. If it's soft and they can chew on that. 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 that it advertises itself as BPA free.
[12:07]
This is because this is one of many, many xenoestrogen compounds that when they enter our body, they're close enough in molecular shape to estrogen that they're going to stimulate our estrogen sensitive cells. And these xenoestrogens accumulate over a lifetime. So when you have a woman, so she's already been making her naturally occurring estrogen in her ovaries, and then she's been accumulating xenoestrogens for decades. And then you add on what is called exogenous estrogen.
[12:44]
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.
[13:25]
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.
[14:07]
In fact, our medical system doesn't handle system level problems very well. So this isn't theoretical. 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 today compared to 2001. 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, that argument doesn't hold up for this age group.
[14:54]
Routine mammography is not recommended for most women under 45, and that guideline has barely changed since 2001. 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 United States compared to 2001.
[15:39]
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 going to be 54 in a couple weeks, and I've been alive long enough, where it used to be unheard of for a young woman to be diagnosed with breast cancer.
[16:24]
And ask yourself, do you have friends, family, co-workers, where they're 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.
[17:00]
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. Girls are hitting puberty younger and younger, which researchers link directly to environmental or this xenoestrogen exposure. 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.
[17:48]
But 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.
[18:31]
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.
[19:13]
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.
[19:56]
It would implicate enormously powerful industries, 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.
[20:36]
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. 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.
[21:23]
That molecule does not disappear when it becomes a metabolite. Your liver runs it through detoxification pathways phase one and phase two 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 xenoestrogens. The xenoestrogens have to go through the same process. If you do absorb, say, a little BPA molecule that is very similar in structure to estrogen and it's going to bind to those estrogen receptors and it's going to stimulate that estrogen sensitive cell, just like estrogen would, your liver has to detoxify that BPA molecule as well and it has to be eliminated from the body.
[22:16]
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 from the body, they're still going to stimulate those estrogen sensitive cells.
[22:53]
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 one detoxification. So we're going to get a little technical here. There's the 2-OH pathway, the 4-OH pathway, and the 16-OH pathway. So you can kind of think of these as three conveyor belts 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 processed so that they can be eliminated from the body.
[23:56]
But these conveyor belts, they are not all equal. The 2-OH pathway is the conveyor belt you want these molecules to go through. If the molecules go through that 2-OH conveyor belt, the metabolites that are produced bind weakly to estrogen receptors, and they're considered to be protective. The 16-OH conveyor belt, 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 similarly to the full estradiol molecule that hasn't been processed.
[24:46]
Now the 4-OH 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. 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.
[25:33]
So your liver needs specific nutrients to run these conveyor belts, and without those adequate nutrients, the liver cannot complete the process. So the 2-OH 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, Brussels 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 2-OH conveyor belt.
[26:22]
So if you're deficient in those nutrients, if your digestive tract struggles to break down the food that contains the nutrients, so a lot of people, they eat broccoli, they eat cauliflower, they eat Brussels sprouts, oh I can't eat those, I'm going to get a lot of gas. Well guess what? If you get gas after eating Brussels sprouts, your digestive tract is not breaking the Brussels sprouts down properly. It's not that Brussels sprouts cause gas, these cruciferous vegetables, they're very nutrient dense, and so it's harder for your digestive tract to break them down.
[26:54]
If your digestive tract is robust, it can break down Brussels 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 Brussels 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 Brussels sprouts. And that 2-OH conveyor belt really needs those types of nutrients that are found heavily in those cruciferous vegetables.
[27:30]
So that's the 2-OH conveyor belt. Let's take a look at the 4-OH 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, if anything's going to get on this conveyor belt, it's like let's just run this thing as fast as we can.
[28:03]
So guess what nutrient you need to run that conveyor belt quickly? It's magnesium. Now amongst migraine sufferers, everybody's looking for the miracle magnesium, but nobody's asking the question why are people so deficient in magnesium? 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 going to absorb the minerals that are in the food that you're eating.
[28:26]
You're not going to absorb the other nutrients that are in the food that you're eating. So instead of pushing supplements on everyone, we really need to be looking at okay are the factors for good digestion in place? So 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.
[29:12]
So there are also some genetic factors that influence where those molecules go, which conveyor belt 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.
[29:56]
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 episodes of the podcast, I hope this gives you another example to help you understand this principle. And 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 puts them into the bile and the bile is squirted into our small intestine when we eat.
[30:45]
So when we have a healthy microbiome, when we've got the good bacteria, the beneficial bacteria in our digestive tract, those estrogen metabolites, they're going to 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.
[31:21]
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 tract is designed to absorb stuff. 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. So it's not about, oh, okay, now let me take some probiotics. The bacteria that is living in your digestive tract is there because of the conditions in the digestive tract.
[32:15]
So different types of bacteria live in different types of environments. Bacteria that requires oxygen, it's not going to live inside of your digestive tract. It's not a lot of oxygen inside of there. So what we call beneficial bacteria flourish inside of a digestive tract that is functioning optimally where there's good motility throughout the digestive tract, 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.
[32:50]
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 vegetarian or near vegetarian diet. So the food that we eat and the conditions of proper functioning within the digestive tract, that's what's dictating the bacteria in there.
[33:22]
You can take capsules and capsules of so-called beneficial bacteria. They're not going to survive if it's not a hospitable environment for that bacteria. So this is a situation that's plaguing many, many American women. If you're struggling with migraines, you're probably also struggling with this. So 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.
[33:56]
We should have a good appetite where we feel like eating a wide variety of food. 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 pass the remnants out. So if you're experiencing anything in there, your digestion is not functioning properly. So we have a woman with migraines, digestive symptoms, and all of these hormonal symptoms who is now being told to consider hormone replacement therapy.
[34:31]
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. It'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?
[35:08]
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 xenoestrogen exposure compromised detoxification pathways.
[36:05]
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.
[36:48]
We may be working directly against that protection. I'm not saying HRT 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 five-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. The hot flashes, the night sweats, the mood swings, the insomnia, the weight gain.
[37:33]
Women are told this is just what menopause is. Brace for it, survive it, or take HRT. 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.
[38:13]
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.
[38:44]
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 xenoestrogen 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.
[39:20]
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.
[39:56]
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. you do not have to go through those menopause symptoms. I have covered these three principles across more than 100 podcast episodes.
[40:30]
I have three free training webinars. I don't want to re-explain them from scratch, but I want to show exactly where 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.
[41:04]
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 got to absorb the nutrients, we've got to bring the nutrients into the blood stream, and we've got to circulate and deliver those nutrients to the cells.
[41:40]
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.
[42:24]
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 resiliency and vitality. We have to have enough resiliency and vitality to weather all of the stressors that we're bombarded by every day. Whether they're physical stressors like weather changes, sunlight, physical activity, or things that we call stress like mental and emotional stress. And mental and emotional stress stimulates the production of cortisol, a stress hormone.
[43:10]
And I want to talk a little bit about cortisol. 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.
[43:49]
So 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. 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.
[44:33]
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.
[45:21]
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.
[46:00]
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?
[46:29]
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 covered 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.
[47:13]
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 full results review where we go through everything together and connect it to your complete symptom picture.
[47:54]
The investment is $1,500. 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 Cisar N.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.
[48:22]
I hope this was informative and I'll talk to you next time.
