Vaginal health and topical options

Cynthia reviews vaginal estrogen, DHEA, hyaluronic acid, lubricant cautions and clean OTC options like Jolva.

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Perimenopause is not just about hormones, it’s a metabolic transition that affects insulin sensitivity, gut health, stress tolerance, and long-term disease risk.

In this episode, Cynthia Thurlow, board-certified nurse practitioner and functional medicine expert, explains how women’s metabolism changes in midlife and why insulin resistance, poor stress resilience, and gut dysfunction often appear years before menopause.

She breaks down how perimenopause can begin earlier than most women expect, why symptoms vary so widely, and how lifestyle factors like fasting, exercise intensity, sleep, alcohol, and chronic stress interact with hormones during this transition.

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