947: It’s Important to Pause in Meno(pause) With Dr. Sharon Stills

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Katie: Hello and welcome to the Wellness Mama Podcast. I’m Katie from wellness mama.com. And this episode is with Dr. Sharon Stills and it goes into the topic of why the pause part is important in menopause. And she highlights both the biological changes, but also more importantly, what she calls the Sacred Second Act.

And the emotional and spiritual shifts that happen as well, and how reframing our mindset around them can actually make a drastic difference even in how our body feels and why. And I love her explanation of the hormone side. I learned some things I did not know about hormones and hormone replacement, as well as how the adrenals come into play.

And a big one is why cortisol, which I know we’re hearing a lot about on the media and on social media right now, might not actually be the problem, and dropping your cortisol might not be the solution. So she makes some really important points in this podcast, gives some great action steps. And I included some links in the show notes if you wanna learn more about any of these topics.

But for now, let’s join Dr. Sharon. Dr. Sharon, welcome. Thank you so much for being here today.

Sharon: Oh, my gosh. Thank you for having me. I’m super excited.

Katie: I’m very excited to learn from you and we’re going to get to cover a couple of what I feel like are very important topics in the span of two episodes. So if you guys listening, stay tuned for another episode with Dr. Sharon. In this episode in particular, when researching for this podcast, you sent so many great topics and this one really stood out to me, which is, the importance of the pause part of menopause.

I feel like there are so many kind of societal conceptions around menopause and it being framed in a negative light often, or as a problem to solve. And it seems like you have an amazing viewpoint on this that might feel a lot more empowering for women and also help women navigate that phase of life with a lot more grace, ease, and joy.

So to jump in, I would love if you could just kind of share broadly the basis of what you mean by the importance of the pause in menopause.

Sharon: Yeah, thank you. Well, the word menopause has the word pause in it. So it’s like staring right at us in the face. And what it’s referring to, obviously, is the cessation of our menstrual cycle. But to me, I take it to a much broader meaning that it’s really this opportunity to pause. For many of us, we’ve been raising kids, we’ve had careers. We’re taking care of neighbors and the community and parents and all the things. And we don’t really pause. We just keep going, going, going, going, going. And when we get to this point in our life, it’s really this beautiful time where we can exhale, where we can pause. Because pausing just in general, just allowing yourself to exhale, allowing yourself to have some blank spots on your calendar, to have a moment in the morning to greet the day, or a moment in the evening to watch the sunset is healing.

It’s settling for our nervous system and it’s healing for our immune system, our adrenals, for our endocrine system, for our hormones, for everything. And so when we get to menopause often we’re pausing because the hammer’s coming over our head and we have hot flashes and we’re gaining weight and we don’t feel good. But what if we just paused, not only to address our physical body, but also to address our emotional body, our spiritual body, our mental body to really take inventory of what did we want this life to be about? And are we living into our dreams? Are we living what our childhood aspirations were? Are we making time to do the things that are really important to us? And so I often have patients do what may seem like a little morbid of an exercise, but I have them write their eulogy. Because how do you want to be remembered? And if you want to be remembered as someone who is always dancing, but you’re not taking time to go take a dance class or even to have a dance party naked in your living room, are you doing the things that are important to you?

If you want to be remembered as someone who was a pillar of her community and volunteered… this was one for me. I was like, I want to really be remembered as someone who’s volunteering and giving back, that’s an important quality to me. And then I realized, Ooh, I’m not really doing that. So if I want to be remembered for that, I better start doing it.

And so to reverse engineer the life we want to have, I think is a really important piece of menopause, of aging, of stepping into what I call our sacred second act.

Katie: Oh, I love that. That language a sacred second act. And the little bit I’ve read, it seems like perhaps other cultures have a more accepting and loving understanding of the space of life than perhaps we do in America. It seems like we often can easily oversimplify things as like a medical symptom or problem or something to be solved or just throw hormones at it. And not saying hormones might not be really helpful, but like to your point, it’s kind of like a both and seemingly of like, yes, the physical part and understanding that is important. And I feel like this part you just explained, I haven’t heard talked about in the mainstream conversation, but have read things. I don’t know if this is true, but like, for instance, in Japan, they view that as like a second spring and a beautiful thing.

And there’s like a reference around it. And ironically, they seem to suffer from fewer symptoms and medical issues related to menopause than we do in America. So I wonder how much of it, since our perception is so heavily influenced and vice versa with our reality, how much our negative perception around this might actually be contributing to the discomfort we might experience or the just changes and how pronounced they feel.

But I love, I love the sacred second act and the reframing of the conversation around it. You said also, of course, there is this physical piece. So I’m sure from your work, there’s a lot of things women can know and be aware of on the physical side: definitely want to make sure we speak even more about the emotional and spiritual side. But what are some of the maybe reframes related to the physical side of menopause that can be really helpful and empowering for women?

Sharon: Yes. And I just, before I answer that, I just want to say absolutely, I love the second spring and I love the native cultures where when a woman goes through menopause, it’s thought now that she’s not losing her blood to the earth, she’s retaining it. And so in that retaining wisdom, and she gets called a crone, a wise woman.

And I think, yes, we have this… It is societal, and it seeps into us from whether we’re standing in line at the grocery store, or it’s our auntie, or it’s our teacher, or it’s a meme on Instagram that, oh, aging is not a good thing. It’s going to really stink, this is not something to look forward to. And I have a totally different perspective on that.

I think aging first of all is a privilege. Not everyone gets to age and it is really this time where we can step into who we are and what we’re meant to be. We can shed a lot of the drama, like I think of what a drama queen I was in my 20s and 30s and how now I’m not interested in drama.

I’m interested in peace. I’m interested in sisterhood. And so there’s a lot that comes with really reframing and stepping into your wisecrown. So, I just wanted to add that. But as far as physical, yes. And so to me, the mind body complex, it’s inseparable. And I think a lot of us, we tend to kind of go, we lean to one camp or the other.

We’re like, I’m gonna affirmate my way into amazing health. Or I’m gonna organic broccoli my way to feeling the best I can. When really, the truth lies within marrying the two because we are this emotional, energetic, spiritual being living in a vessel, which is our physical body. And so, when it comes to hormonal transitions, perimenopause, menopause, I am a huge proponent of bioidentical hormone replacement done wisely and properly. And as a naturopathic medical doctor, it doesn’t get more root cause than me. I’m very about the root cause, not covering up symptoms, all the things. And so if you came to me and you had migraines and 10 other women are in my practice who have migraines, you’re all going to have a different root cause.

Could be emotional, could be stress, could be a subluxation, could be food sensitivities, could be a leaky gut, could be toxicity, et cetera, could be hormones. But when we get to menopause, which is not a disease, it’s a natural transition that’s coming for you at some point. Every woman, it’s happening, you can’t stop it, nor should you want to. The root cause is that your ovaries are like, peace out, I’m going to the Bahamas, I’m getting on a hammock, I’ve done my job, and I’m done. I’m not giving you any more hormones, I’m tired, I’ve done my job. And so the root cause is the cessation of hormones. And there’s a nice little story that your adrenal glands are going to pick up the slack and produce hormones for you. But newsflash, by the time you get to be 50, your adrenal glands have probably been through the ringer and they’re like, yeah, we’re not that interested in promoting your hormone production. And even if they were, it wouldn’t be to the same level of your ovaries. And so most of us also need some TLC for our adrenals at that point as well. But so the root cause is that your hormones are low. And so it’s the one time in life, in a transition, in a medical situation, in a physical situation where I’m like, the answer is the same for every woman. You can’t eat your way back to hormone balance. You can’t exercise your way. You can’t think your way. You can’t sleep your way. And all those things are super important. So there are a lot of people who just think, Oh, I can get some hormones and go living detached from nature, detached from my purpose, detached from a healthy diet. And that’s not the case either.

But when you get balanced hormones, when you replace the hormones… And I’m not talking about to super physiological doses where you’re getting a period again, or you have the levels of an 18 year old, because I don’t want to be 18 again. And that’s not necessary. And that could actually be dangerous. I’m talking about subphysiological levels that one, get rid of your symptoms so you don’t have to suffer. Because if you want to do what we were talking about initially, if you want to get in touch with your purpose, and be happy, and be contributing, and living the life of your dreams, you need to feel good.

If you don’t feel good, it’s really hard to care about how you’re going to give back to your community or how you’re going to show up in a deeper, more profound way in your relationships. But when you feel good, when your hormones are balanced, then you can do the other work. And that includes taking care of your movement, and your sleep, and your diet, and your hydration, and your toxicity, and all the things that we talk about in this line of work.

Katie: I love that. It seems like this reframe, it really helps you to take a positive mindset at this versus a negative one versus it being a medical problem. I love that you brought that up. Which I haven’t experienced menopause yet, but I found that even in healing my thyroid, that was so much more empowering to come from a place of the positive versus the negative.

And even after healing my thyroid and releasing the excess weight from that, when I came at it from a place of how do I maximally nourish my body? How do I give it all to things it’s asking for? How do all of my food choices reflect this reverence and nourishment of my body? Not a restriction of calories, even doing the same things, it was a so much more pleasant experience. And I felt like I became much more in tune with my body versus trying to sort of like force my body to do what I want and will it into submission. I also love that you brought up the idea of aging, not being something that we need to try to avoid or stop, but that it’s something to be embraced.

I feel like that is sadly counter cultural in today’s world, but like you said, it’s a privilege that not everyone gets. And it seems like we do view aging itself as a medical problem to solve. And so I think, like you said, the supplementing in physiologic doses in a way that’s in harmony with your body, is such an important piece that maybe often gets overlooked when we just can start throwing hormones at something at the expense of understanding those other pieces.

And I also love that you mentioned, you know, we can’t just out hormone and out supplement the things that our body was meant to have, like that harmony with nature. It seems like there’s a beautiful metaphor here with the seasonality and the harmony with nature and the seasons our body goes through. And just getting to learn how to relate to our body in a different way through that season, as well as seemingly, I would guess, actual connection and being more in harmony with nature is probably an actual important piece of that as well. Like I know there’s talk of essentially nature deficit disorder in the modern world, because we have the ability to divorce ourselves from natural light patterns and from time outside and from natural movement and how that really does change us.

And how, just like we can shape our environment, our environment also really does shape us and how that piece is so often overlooked, but also very often free that we can re-implement. And so I’d be curious to just touch a little bit more on some of those things we can do as women, especially before menopause and through menopause, to really get more in tune with our bodies, to get more in tune with nature and to make that transition and process as pleasant and joyful as possible.

Sharon: Mm. I love that. And I changed my my bio a couple of years back because I used to say I was an anti-aging doctor. And then I realized, wait a second, why am I anti something that is a natural process? That’s like, you can’t fight against aging, it’s happening. So I changed it to now I’m a pro-aging doctor. I support the aging process because we’re all going to go through it. And so as far as yes, nature is so important and getting your feet on the ground in the morning and watching the sunrise and taking nature breaks and hugging trees and all the things are so important to connect. But I want to go back to like the physiological hormone piece. Because when we talk about aging, I think what we have done is we have watched our mothers and our grandmothers age, and most of them did not have bioidentical hormone replacement.

And so they were old, right? They, didn’t age well. By the time they were 60, they were not able to run around and play with the grandkids and they had heart disease and diabetes and Alzheimer’s and all of these things are preventable with proper hormone replacement. And so it’s not just about getting symptoms, which of course I don’t want anyone to suffer, but it’s also about saying:  I’m going to do something that is this big far ranging gift to myself that’s going to give me the best chance to ward off osteoporosis, breast cancer, cardiovascular disease, Alzheimer’s, dementia, genitourinary problems, immune dysfunction, autoimmune disease. And so there’s some real tactical, practical things. And I think there’s so much confusion about how do you replace your hormones? And so I just want to give a few quick things that the listeners can kind of look at and think about when they’re finding someone to help them. Because I’ve been doing this for 23 years now. And I see women from all over the globe at this point. Because this is not just a United States problem, this is a global problem of a misunderstanding of how to provide hormone replacement for women. And it breaks my heart. I see women who have been suffering for 10 years, 15 years, 20 years, because they’ve been told you can’t have hormone replacement because there’s a family history of cancer or you have a clotting disorder. And we have to remember that bioidentical hormones are very different than synthetic hormones.

Bioidentical mean that they’re biologically the same as the hormone structure, the chemical structure of what your body has been producing. And so when they get to the receptor site, the cell is like, hello, old friend. I’m so glad you’re here. Come on in, let’s have tea. Let’s make some good things happen. And so a couple of really important things and misconceptions are that you can monitor hormones in blood work. And that’s not true. You can monitor thyroid hormones in blood work. Great way. But to monitor your sex hormones, you really need to do 24 hour wet urine testing. And I say wet, not dry, because there’s a lot of people doing dried urine testing, which is just four samples, and it’s very inaccurate. Hormones are very cyclical creatures, just like we are as females. I mean, as humans in general, we’re cyclical.

And so we need to capture a whole day of urine to see the ebbs and flows of what is going on in hormone production. On top of that, we need to look at the metabolites of what these hormones are doing. So estrogen, which should never be taken orally, should only be taken transmucosally. And I don’t say transdermal because there’s a lot of women who take their hormones transdermally, which means to the skin. I say transmucosal and mucosal tissue would be the external labia. So it’s moist tissue because when you apply hormones to the skin, you end up getting a down regulation and then the hormones stop working and you have to use more and more and more.

So by applying transmucosally, we can use less and get even better effects. So we need to look at estrogen metabolites, we need to look at testosterone metabolites, because these metabolites have a whole personality of their own. And so when someone says estrogen causes cancer, it’s super lazy medicine.

There’s not even a molecule called estrogen. Estrogen is just the umbrella, there’s different kinds of estrogens. And estriol, which is known as E3, is very anti-cancer. I actually use it in active cancer treatments. So it is preventative. So is 2 methoxyestradiol, another estrogen metabolite. I use those two to treat active cancer.

And so, yes, is estrone, which is E1, a very inflammatory estrogen? Yes. And can it be a risk factor in developing a cancer because it’s hitting the alpha receptor sites and saying grow rather than estriol, which hits the inhibitory beta receptor sites? Yes. And so it’s a lot to talk about. I could teach about this for… but just to give you like to walk away with, Oh, there’s a lot more to estrogen and its metabolites and different receptor sites and different properties of what estrogen does than just this blanket statement estrogen causes cancer.

So if your doctor wants to monitor you in the blood. If they want to give you oral estrogen or they’ve told you, oh and this one drives me insane, you’re too old. You missed the window so you can’t have hormones anymore. You’re just going to suffer for the next 30 years of your life. That is such a false statement. So it’s never… I think of when I do hot yoga and Bikram would say like, it’s never too late. It’s never too late to repair your body, to get out of pain. And I think the same thing for hormones. It’s never too late. Yes, of course, is it better to start earlier and start getting that protection and not losing bone mass and not having your arteries get clogged? Of course, but it’s never too late to start hormones. I have patients in my practice who are 75.

I’ve been getting this whole rash of, I love it, these like 75, 80 year old women who have been told no. And I tell them yes. And I get to watch their lives change. Their memory comes back, their sleep returns, their energy returns. They stop, they’ve been having hot flashes for 15 years. I mean, it’s just heartbreaking that they’ve been allowed to suffer.

And so you don’t have to suffer. And if you’re not 70 or 80 listening, you know, just tuck this away because at some point this will become applicable to you.

Katie: Well, that’s so much hope that like really it can be helpful at any age. And it makes me curious also in an ideal world, maybe it’s different for each woman, but when is the best time in an ideal situation to start testing that, to be aware of it and to start doing hormone replacement if necessary?

Cause I don’t even think I’m perimenopause yet, but I am 38. So this is a topic that I’m like now aware of and researching actively. When is kind of the ideal window that you would say in a perfect scenario for a woman to start paying attention to this?

Sharon: I love that question. So first of all, if you are a woman and you have had fibroids, ovarian cysts, acne, migraines, endometriosis, problems getting fertile, any of these hormonal issues, the time is now. Because you want to be preventative, you want to pregame, and you want to balance your hormones if they’re out of balance. Now, if that is not the case for you, and you’ve had no hormonal problems, which is like amazing. I know there are some unicorns out there. Then, yes, you can wait and get like a baseline at 40. It’s good to get a baseline. You’re feeling good. You have regular cycles. You don’t have premenstrual symptoms. Then get a baseline at 40. And if everything looks good and you feel good, then get another baseline at like 43, 44, just to see. Because there are some women out there that their hormones will drop, but they won’t notice it, they won’t feel it. But if they’re dropping, then it’s already affecting the brain and the bones and we want to start being preventative.

If you’re someone who’s been struggling, then getting a baseline immediately is important. So me personally, I had like the worst hormones. I had the worst PMS. I mean, I literally suffered like two and a half weeks out of every month. It was, it was not pretty. And when I started working, so I was in my early thirties, got out of medical school, opened a practice, started working with menopausal women, because Suzanne Summers had just written her book. And I started seeing, oh my God, like these women in their fifties, they’re doing better than I am. So I started applying what I was doing with them to myself in a different way because I was still cycling. And so, I got rid of my PMS, I balanced my hormones, and so much so that when I went through menopause, I never even had a hot flash. And so there is a lot of value to pre-gaming, what I call it, because I pre gamed. And so knowledge and information is always empowering. And so it’s good to get a baseline and just see. Because my experience is some women will lose their testosterone way before they lose their progesterone and estrogen.

And then there’s like the flip side where some women do the exact opposite. And so sometimes you know and sometimes you don’t. So the data is important to have. The other thing is your metabolites. So when we’re checking metabolites, there’s a metabolite called 4-hydroxyestrone, and it’s considered to be carcinogenic. So it is a risk factor for breast cancer. Doesn’t mean if yours is high, you’re going to have breast cancer. It’s a risk factor. It also is known to cause DNA damage. And so because cancer is never just one thing. But if we have a risk factor that we can measure and we can mitigate through the use of supplements like sulforaphane and glutathione and magnesium and optimizing detox, then this is a good thing.

And we cannot feel, we cannot feel Oh, my metabolites are off. It’s not something that really shows up necessarily as symptoms. So that also is a good reason to get a baseline just to see how you’re metabolizing. Some women metabolize beautifully and they don’t need any support. And other women don’t metabolize so well and they need some support.

Katie: That was really helpful. And I feel like I have a much clearer picture of the things to ask for and be aware of as I start to go through those different check marks of 40 and 43 and beyond. And it make sense to me what you’re saying of like, if the earlier we can notice if things are shifting and support the body in what’s actually shifting versus just guessing, that it can make that whole journey a lot smoother and also probably prevent, even though you said it’s wonderful, like for 75 and 80 year old women, it’s still helpful, but I would guess the earlier we can get there, the less of the ups and downs we’ll have in that getting it all kind of worked out. And you also mentioned that people kind of assume that the adrenals are going to take over when the ovaries take a back seat.

And that this isn’t the whole story either because the adrenals also are going through changes and have been doing a lot of work for a long time. Especially in, case in point, I was overstressed for a lot of years and I know my adrenals kind of pulled some extra hours during that time. So what are some ways we can all, cause I feel like this applies to people of every age honestly, but how can we support and even be aware of and understand our adrenals in a way that’s helpful?

Katie: Yeah, I burnt my adrenals out in my late 20s, and now I’m almost 57 and I still have to TLC them all the time. They’re very sensitive, adrenal glands. So, one of the most important things is to find out what your adrenals are doing. Because we hear a lot that high cortisol is the root evil in all of our lives.

And the truth is, when I test cortisol levels, and we do that by a four point salivary cortisol test. So, every hormone, every everything has its optimal way of being measured. So, sex hormones, 24 hour wet urine. Thyroid, great in the blood. Adrenals, diurnal salivary, four points, so you can see what the adrenals are doing.

And I can tell you, I’ve been doing this like I said for 23 years. Most women, perimenopausal, menopausal, do not have high cortisol anymore. That ship has sailed. The high cortisol was when they were younger, because at some point the high cortisol, the adrenals, just like the ovaries peaced out, the adrenal glands are like, you know what?

I can’t, you’re way too stressed. You’re not supporting me. I can’t do this anymore. I’m done. And they stopped producing cortisol and you go from being really high to really low. And so a lot of times more often, a lot more often, I’m actually giving bioidentical cortisol to repair and re-nurture and regenerate the adrenal glands. I’m giving glandular therapies, I’m giving herbal tinctures, I’m giving B vitamins, specifically pantothenic acid is very good for the adrenals. Vitamin C is very good for the adrenals. And so I’m building up the adrenal glands.

But the value in looking at the cortisol rhythm is that what if you’re not putting out cortisol in the morning when you should be? That’s when cortisol, you should have your cortisol awakening response, it should be the highest. What if you’re not putting it out in the morning, but then in the afternoon it goes sky high and now it’s high at night and you’re having a hard time falling asleep? So when we look at the individual samples at 8am, at noon, in the afternoon, and then at midnight, we can personalize. Maybe you need some bioidentical cortisol in the morning to raise your levels, and then maybe in the evening when you get home and stress kicks in, maybe we need to use some phosphatidylserine, say, or theanine, or whatever we’re using, to blunt that response and bring the high cortisol down. But I can tell you, I see flat lines of like no cortisol production a lot more often than I see super high elevated levels. And these symptoms can be confusing. You can be burnt out. You can be wired and tired. It’s hard to really know without getting the data and seeing exactly what you’re putting out.

And then of course, you’re not going to just heal your adrenal glands from all my herbs and all my bottles of bioidentical hormones. You have got to, got to, this is so important, do the lifestyle piece. You’ve got to figure out, how am I going to dance with stress? Because if you’re alive, it’s like newsflash, you’re going to have stress.

It’s part of the human condition. And so it’s not about getting rid of the stress, it’s about learning how to dance with it. It’s about learning your sacred no, your sacred yes. It’s learning how to be at peace in the midst of the storm.

Katie: Oh, I love that language too. The sacred yes and the sacred no. And I’m very much still in the learning process on those for myself. This has been a recent lesson for me. And that was really surprising to know about cortisol because we hear that on social media seemingly right now so much: cortisol is a problem, do all these things to get rid of your cortisol. But to know that from actual years of clinical testing, that might not actually be the problem and in fact, the reverse might be true. I feel like that’s a really groundbreaking thing for women to understand. And I feel like I could keep learning from you on this topic for hours and hours, but I know we’re getting to the end of our time for this episode.

I personally want to keep learning from you. Where can we find you online and keep learning about this topic and learning from you?

Sharon: My website is just Dr. Stills, drstills.com, and you can find me under Dr. Sharon Stills. And my most exciting news is that I’m opening a 7, 000 square foot clinic in Scottsdale in the fall of 2025. So, I’m going to bring all this under one roof where people can come and heal and do all the things we’re talking about: de-stress, balance their nervous system, support their adrenals, their hormones, and so much more. So I’m not going anywhere. I’m, you know, a lot of people my age are retiring. And I’m like, nope, there’s more to do. I practice what I preach and there’s a lot of life left to live and there’s a lot of knowledge and support left to give because people are suffering and they really need help.

Katie: I love that. And I will make sure that is linked in the show notes. That’s so exciting about your clinic. And for this episode, thank you so much for your time. I learned so much.

Sharon: Ah, thank you.

Katie: Thank you as always for listening. Stay tuned for round two with Dr. Sharon, and I hope that you will join me on the next episode of the Wellness Mama Podcast.