Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

Welcome to this week’s Midlife Minute!

Today, I examine partial and full hysterectomies and what we know about their potential long-term effects, clarifying what the research tells us about bone, brain, and cardiovascular health, and what women should discuss with their healthcare providers before and after surgery.

IN THIS EPISODE, YOU WILL LEARN:

How a partial hysterectomy differs from a full hysterectomy, and the abrupt estrogen changes ovarian removal can produce

Why having a hysterectomy before ages 40-45 can have a greater impact than having surgery closer to natural menopausal age.

How a hysterectomy can impact women’s bone health

What the research reveals about the connection between surgical menopause at a younger age, cognitive decline, and Alzheimer’s pathology

How a hysterectomy can affect women’s cardiovascular health

Why starting HRT early after an early-age hysterectomy could be important for your long-term health

Why younger women who experience surgical menopause may require higher estradiol doses than the standard menopausal regimens

The importance of advocating for yourself, understanding your personal risk, and talking with your clinician about estrogen and other hormone therapy before undergoing surgery

Quotes:

“Start those conversations early- before you ever have surgery.”

“If you are having these surgeries done before 45, before 40, you need HRT!”

“We have to manage our stress.”

“We have to get enough sleep.”

“We should be strength training.”

“We should be physically active.”

“We should be eating an anti-inflammatory diet.”

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Research:

Increased Risk of Osteoporosis With Hysterectomy: A Longitudinal Follow-Up Study Using a National Sample Cohort. American Journal of Obstetrics and Gynecology. 2019. Choi HG, Jung YJ, Lee SW.

Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.

Cardiovascular Disease After Hysterectomy in the Nurses' Health Study and Nurses' Health Study II. Obstetrics and Gynecology. 2025. Thao V, Borah B, Stewart EA, et al.

Treatment of Women After Bilateral Salpingo-oophorectomy Performed Prior to Natural Menopause. The Journal of the American Medical Association. 2021. Kaunitz AM, Kapoor E, Faubion S.

Hysterectomy, Oophorectomy, and Bone Health: A Systematic Review and Meta-Analysis. European Journal of Endocrinology. 2025. Shariful Islam M, Tuesley KM, Wilson LF, et al.

Risk of Osteoporosis and Fracture After Hysterectomies Without Oophorectomies: A Systematic Review and Pooled Analysis. Osteoporosis International. 2022. Xu W, Wu W, Yang S, et al.

Hysterectomies Are Associated With an Increased Risk of Osteoporosis and Bone Fracture: A Population-Based Cohort Study. PloS One. 2020. Yeh YT, Li PC, Wu KC, et al.

Age at Surgical Menopause Influences Cognitive Decline and Alzheimer Pathology in Older Women. Neurology. 2014. Bove R, Secor E, Chibnik LB, et al.

Reproductive Period and Risk of Dementia in a Diverse Cohort of Health Care Members. Neurology. 2019. Gilsanz P, Lee C, Corrada MM, et al.

Examining the Association of Hysterectomy With and Without Oophorectomy on Cardiovascular Disease and All-Cause, Cardiovascular or Cancer Mortality: A Systematic Review and Meta-Analysis. BJOG: An International Journal of Obstetrics and Gynecology. 2024. Chen Y, Li F, Liang L, et al.

Association of Premature Natural and Surgical Menopause With Incident Cardiovascular Disease. The Journal of the American Medical Association. 2019. Honigberg MC, Zekavat SM, Aragam K, et al

Optimizing Health After Early Menopause. Lancet. 2024. Mishra GD, Davies MC, Hillman S, et al.

Hormone Replacement Therapy for Women Previously Treated for Endometrial Cancer. The Cochrane Database of Systematic Reviews. 2018. Edey KA, Rundle S, Hickey M.

Today, I’m delighted to connect with Dr. Erin Kinney. She’s a naturopathic medicine doctor and the founder of the Kinney Clinic, which focuses on hormone replacement therapy, nutrition, adrenal health, thyroid, and lymphatic system issues. Dr. Kinney is also the stress reset expert and author of The Cortisol Cure.

In our conversation, we explore cortisol debt, how to recognize it through self-assessment, and why Dr. Kinney believes we need to change the narrative around stress. We discuss ways to modulate the autonomic nervous system, specifically the parasympathetic, the true drivers of low cortisol, including sleep and circadian rhythm disruption, overtraining without adequate recovery, nutrient depletion, chronic or stealth infections, and unresolved trauma. Dr. Kinney explains how Lyme disease, Epstein-Barr virus, and mold and mycotoxin exposure can contribute to more pronounced stress responses, and we examine the influence of caffeine, alcohol, and stimulants; calming supplements for stress and sleep; the gut-brain axis and gut immune dysfunction. Dr. Kinney also shares her preferred strategies to regulate cortisol easily and effectively.

Stay tuned for a truly enjoyable conversation with the delightful Dr. Kinney. Her book, The Cortisol Cure, is a great resource for anyone suffering from multiple stress-related issues.

IN THIS EPISODE, YOU WILL LEARN:

What “cortisol debt” means

The value of short, intentional periods of rest for training the “relaxed muscle”

How low cortisol can involve both external and internal stressors

How early trauma can train the nervous system to stay activated

Why alcohol may lead to disrupted sleep and anxiety

How caffeine and stimulants can increase your energy debt

Why supplements cannot replace foundational practices that support stress-response regulation

Dr. Kinney’s preferred supplements for calming the autonomic nervous system

How a poorly functioning gut can impact immune cells, thyroid-hormone conversion, and the body’s immune response

Dr. Kinney shares three repeatable practices to begin regulating cortisol

Bio:

Dr. Erin Kinney is a naturopathic doctor, author, and speaker specializing in hormonal health and the effects of chronic stress. She is the creator of the “Cortisol Bank Account” framework, the foundation of her book The Cortisol Cure, which breaks down complex stress and hormone science into a simple, accessible approach that helps readers understand what’s happening in their bodies and how to start feeling better. She founded The Kinney Clinic in Annapolis, Maryland, where she helps high-functioning men and women get to the root of fatigue, hormone imbalance, and chronic health issues so they can reset their stress response, boost their energy, and feel better than ever.

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Dr. Erin Kinney

The Kinney Clinic

On Instagram

The Dr. Kinney Show

This episode is sponsored by Life Extension.

I am delighted to have Dr. Crystal Gossard, the Manager of Education at Life Extension, joining me today. Dr. Gossard is a Doctor of Clinical Nutrition with over 15 years of experience in nutrition, fitness, dietary supplements, and integrative functional medicine.

In our conversation today, Dr. Gossard and I discuss uncommon heart health testing, including gaps in care for women in perimenopause and menopause, and clarify the critical importance of a bioindividual personalized approach. We dive into specifics on labs, including ApoB as a direct measurement, the influence of glycation, insulin resistance and insulin sensitivity, LP(a), and high-sensitivity CRP as both a marker of systemic inflammation and a targeted inflammatory profile marker. We also cover oxidized LDL, inflammation and oxidative stress, the importance of CoQ10, and screening modalities like coronary artery calcium scoring, CCTA, CT angio, and Cleerly, and minerals, including magnesium and its role in over 600 enzymatic reactions in the body.

***Try Life Extension https://www.lifeextension.com/Cynthia10labs @LifeExtensionWelleness and save $10 on orders of $50 or more, plus free shipping, with code: Cynthia10

IN THIS EPISODE, YOU WILL LEARN:

The importance of advanced lab testing for cardiovascular and metabolic health in women, particularly during perimenopause and menopause

What ApoB reveals about cardiovascular risk

Why Dr. Gossard considers LP(a) a one-and-done test

How elevated high-sensitivity CRP can indicate inflammation “simmering” in the background

How to manage inflammation through nutrition

How Dr. Gossard explains oxidized LDL

The value of CoQ10 for oxidized LDL

When should someone move beyond lab work to cardiovascular screening?

What magnesium testing can reveal

How magnesium supports the body

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Dr. Crystal Gossard

Life Extension

Instagram

LinkedIn

Live Foreverish Podcast

Try Life Extension and save $10 on orders of $50 or more, plus free shipping, with code: CYNTHIA10.

I’m thrilled to reconnect with microbiome expert Kiran Krishnan today. Kiran co-founded Just Thrive and previously served as Chief Scientific Officer at Microbiome Labs. He has more than 16 years of experience in the dietary supplement and nutrition industry, with postgraduate research experience in molecular biology and virology.

In today’s conversation, we take a deep dive into the science of spore-based probiotics, their ecological impact, how they interact with the existing gut microbiome, their potential to address dysbiosis, and why standard probiotics fail to survive stomach acid in meaningful numbers. We explore research on osteoarthritis, catabolism, and the gut-hormone connection, discussing how declining bacterial diversity may influence the metabolic and hormonal changes associated with perimenopause and menopause. Kiran explains the role of the pathobiome and endotoxemia, how the gut-brain axis can influence inflammation, and the importance of gut-barrier integrity, neurotransmitter production, and vagal nerve signaling in regulating the immune system. We also discuss the differences between fiber, resistant starch, polyphenols, fermented foods, prebiotics, and postbiotics, and Kiran shares his perspective on the carnivore diet, its potential impact on the microbiome, and key insights into SIBO.

Stay tuned for today’s fascinating and informative conversation with Kiran Krishnan.

IN THIS EPISODE, YOU WILL LEARN:

Kiran explains the science behind spore-based probiotics

Why spore-based probiotics can survive stomach acid better than many standard probiotics

How inflammation can inhibit the growth of beneficial gut bacteria

How bacterial diversity in the gut decreases during perimenopause and menopause

Why awareness of endotoxemia remains limited within the broader medical community

Kiran explains how the gut-brain axis helps the body respond to its environment

What prebiotics and postbiotics actually do

Why an inability to tolerate fiber may point to a problem with the underlying biology rather than the food itself

How SIBO and SIFO can be symptoms of a more complex underlying problem

Bio: Kiran Krishman, Ph.D.

Kiran is a research microbiologist and a health and wellness expert who aims to make complex information understandable to all. He has founded several successful health and supplement companies over the last 15 years, including co-founding and leading Microbiome Labs, a preeminent microbiome therapeutics-focused brand among healthcare professionals. He is currently a co-founder and partner in 3 other companies that aim to revolutionize wellness care. He has conducted and published several research studies in scientific journals, published chapters in scientific textbooks/references books, holds global patents, and is a sought-after speaker on human health and the microbiome.

Connect with Cynthia Thurlow

Check out Cynthia’s website.

Check out the Everyday Wellness Podcast on Instagram! www.instagram.com/everydaywellnesspodcast

Follow on X, Instagram & LinkedIn

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line

Connect with Kiran Krishnan

The Biome Learning Center: Join Kiran’s circle community to download his free leaky gut guide and 5 pillars for building a resilient gut.

Welcome to the latest Midlife Minute.

Today, I answer some listener questions about bone health, osteoporosis, HRT, and the menopause transition.

Stay tuned to learn more about bone loss, bone health, and proactive ways to protect your bone mass.

IN THIS EPISODE, YOU WILL LEARN:

Bone density loss during perimenopause

Value of HRT for protecting bone mass during the menopause transition

If you’re using an estrogen patch and your estrogen levels are still low, what should you consider?

How women with osteoporosis can continue strength training with guidance from a licensed medical provider

What highly-active women who consistently under-fuel their bodies may experience

Conditions and medications that could contribute to low bone density

The value of DEXA scans and bone health markers

Bone loss may accelerate during menopause

How HRT for osteoporosis prevention differs from HRT for established osteoporosis

The benefit of AMH and FSH labs for identifying women who may benefit from earlier intervention

Connect with Cynthia Thurlow

Follow on X, Instagram & LinkedIn

Check out Cynthia’s website.

Submit your questions to support@cynthiathurlow.com

Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.

Purchase Cynthia’s book, The Menopause Gut.

Cynthia’s Intermittent Fasting Transformation Book

The Midlife Pause Supplement Line