Perimenopause, ovulatory dysfunction spectrum

I’m thrilled to connect with Dr. Natalie Crawford today. She’s a double-board-certified fertility doctor and the author of The Fertility Formula. Unlike most other physicians, she blends lifestyle and functional medicine with science-based facts, aiming to help women conceive and understand their bodies. While this conversation may not feel fully aligned with the perimenopause and menopause transition, I encourage you to listen with an open mind to what Natalie shares about hormones.

In our discussion, we explore fertility as a vital sign, the impact of infertility, and why one in six women experiences infertility. We break down ovarian reserve and the realities of aging. We also cover specific labs that can help assess ovarian reserve and overall health. We explain DOR and POI, the overlap between fertility and perimenopause, and why the ovaries can behave like a “cranky toddler” in perimenopause. Finally, we dive into the role of the gut microbiome in estrogen metabolism and inflammation, and discuss IVF, egg freezing, modern reproductive options, lifestyle influences, and a series of rapid-fire questions.

Dr. Crawford’s book, The Fertility Formula, is a must-read for women of all ages. It contains many valuable insights, and I love the way she blends an integrative approach with an allopathic approach for her patients.

IN THIS EPISODE, YOU WILL LEARN:

• How fertility serves as a health marker that reflects a woman’s hormonal, cellular, and metabolic health

• The role of inflammation in infertility

• Dr. Crawford clarifies ovarian reserve, highlighting the importance of understanding egg quality and quantity.

• Why AMH testing is the most informative first step for women concerned about their fertility

• Dr. Crawford outlines three factors that can cause missed or irregular periods.

• The importance of tracking ovulation and understanding the body's signals during perimenopause

• Inflammation and aging can disrupt chromosome alignment and impair embryo development.

• How poor estrogen clearance and gut microbiome imbalances disrupt brain-ovary signaling and ovulation timing

• The link between sleep deprivation and low sperm counts, and how stress and lack of muscle mass can drive insulin resistance and inflammation

• Why sleep, muscle mass, and stress reduction are all essential for fertility

• It’s essential to approach fertility proactively, and to know how to do that.

Bio: Natalie Crawford

Natalie Crawford, MD, is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and is co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas. Dr. Crawford is CEO and co-founder of Pinnacle, a professional network for women in medicine. She completed her undergraduate degree at Auburn University, obtaining a degree in Nutrition Science, Medical School at UTMB, OBGYN Residency at UTSW, and REI Fellowship at UNC, concurrently obtaining a Master of Science in Clinical Research. Dr. Crawford is a digital health educator on social media, YouTube, and hosts the podcast  “As a Woman” with over 6 million downloads. Her debut book, “The Fertility Formula”, will be released by Penguin Random House. 

Connect with Cynthia Thurlow  

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Connect with Dr. Natalie Crawford

• On her website

• On social media: @NatalieCrawfordMD

• Dr. Crawford’s book, The Fertility Formula, is available here.