Perimenopause as a Recalibration

Most women are taught to accept fatigue, weight gain, brain fog, and mood changes as a normal part of aging. What if the real issue has been overlooked gut health, muscle loss, and a medical system that failed to prioritize women's hormones.

In this episode of Extend, we sit down with Dr. Amy Shah, MD, double board certified physician in internal medicine and immunology, to unpack the powerful connection between the gut microbiome, hormone balance, and long term health. We break down the estrobolome, why fiber and fermented foods regulate estrogen metabolism, how 30 grams of morning protein stabilizes insulin and cravings, and when hormone therapy truly becomes indicated.

We also explore strength training for midlife, sprint intervals for cardiovascular resilience, early DEXA scanning, ferritin testing, and how small daily inputs build the physiological reserve that protects bone, brain, and metabolic health through perimenopause and beyond.

Dr. Amy Shah is a physician, nutrition specialist, bestselling author of I'm So Effing Hungry and I'm So Effing Tired, and founder of a global wellness education platform focused on evidence based lifestyle medicine. Through clinical practice, research translation, and her new book Hormone Havoc, she empowers women to take control of their health using nutrition, movement, and targeted medical intervention when necessary.

What We Discuss:

• (02:15) Why perimenopause is underserved in medicine

• (06:40) The estrobolome and estrogen metabolism

• (11:20) Pre, pro, and postbiotics explained

• (18:05) 30 grams of fiber and morning protein

• (24:30) Protein timing and insulin sensitivity

• (30:10) Strength, sprints, and midlife training

• (36:45) Cortisol, recovery, and overtraining

• (42:20) Ferritin and vitamin D testing

• (47:55) Early DEXA scans and body composition

• (52:10) Clear indications for hormone therapy

• (57:30) Women's heart disease differences

• (01:02:15) Redefining midlife performance

Thank You to Our Sponsors:

Function Health: Learn more and join using my link. Visit www.functionhealth.com/drshah and use gift code DRSHAH25 for a $25 credit toward your membership.

Timeline: Go to timeline.com/drshah to get 20% off your order.

Learn more about Dr. Shah:

Website: https://www.drshah.com/

Clinic: https://www.next-health.com/

Instagram:@darshanshahmd

Learn more about Dr. Amy Shah:

Website: https://amymdwellness.com/

IG: @dramyshah

TikTok: @dramyshah

Youtube: https://www.youtube.com/@dramyshah

LinkedIn: https://www.linkedin.com/in/amyshahmd/

Podcast: https://amymdwellness.com/pages/podcast