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In the first installment of The Endocrine Series, we explored insulin resistance, a condition where your body struggles to use insulin effectively, often worsened by hormonal shifts during perimenopause. Now, we turn our attention to prediabetes—a stage where blood sugar levels are elevated but not yet high enough for a type 2 diabetes diagnosis. While prediabetes increases the risk of developing type 2 diabetes and cardiovascular disease, it doesn’t have to be inevitable. Early intervention is key.

In this episode, we’ll discuss how simple lifestyle changes—like adjusting your diet and exercise—can reverse prediabetes, regulate blood sugar, and lower health risks. We'll also cover medical treatments, including anti-obesity medications and hormone replacement therapy, to further support metabolic health. Listen in for practical tips on managing prediabetes and preventing the progression to type 2 diabetes.

References
“I Love Lucy” chocolate factory clip

Ep. 11: Understanding Insulin Resistance During Perimenopause

Audio Stamps
00:40 - Dr. Patil-Sisodia reminds us about insulin resistance and how rising blood sugar levels indicate whether someone is in the prediabetes range, as they begin to exceed normal thresholds.

01:56 - Another indicator of prediabetes is the hemoglobin A1C test, which measures average blood sugar over three months and signals prediabetes when levels are between 5.7% and 6.4%.

03:05 - Excessive carbohydrate intake and reliance on packaged meals high in refined sugars stress the pancreas and contribute to insulin resistance.

04:35 - Lack of physical activity contributes to pancreatic stress and insulin resistance, as sedentary lifestyles lead to muscle atrophy, weight gain, and changes in body composition.

05:55 - Dr. Patil-Sisodia uses an analogy from “I Love Lucy” to demonstrate how the pancreas operates in hyperdrive in prediabetes, producing excessive insulin to manage blood sugar levels.

07:15 - We hear practical ways to slow down the pancreas's assembly line by adapting diet and fitness habits.

10:58 - Dr. Patil-Sisodia emphasizes the importance of discussing metabolic medications and hormone replacement therapy with your primary care provider to address prediabetes.

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Struggling with stubborn pounds around your midsection, despite sticking to a healthy diet and regular exercise, is a frustrating reality for many women as they enter perimenopause and menopause. Hormonal shifts—particularly a decline in estrogen—can trigger insulin resistance, making it harder to lose weight, control blood sugar levels, and maintain muscle mass.

In this episode, the first of my Endocrine Series, we dive into what insulin resistance is, how decreasing estrogen during perimenopause worsens it, and the key steps you can take to monitor and manage it effectively. Tune in for practical tips to help you work with your healthcare providers and take charge of managing insulin resistance, weight changes, and overall metabolic health during perimenopause and beyond.

Audio Stamps
00:49 - Dr. Patil-Sisodia explains insulin resistance, detailing the pancreas's role and the two primary ways it can malfunction.

02:26 - We learn about autoimmune attacks, where malfunctioning white blood cells target beta cells in the pancreas, reducing insulin production and causing type 1 diabetes.

03:30 - We discover how changes in body composition and increased visceral fat can impair beta cell function, raising insulin demand and contributing to insulin resistance.

06:48 - Dr. Patil-Sisodia highlights how decreasing estrogen during perimenopause worsens insulin resistance, making blood sugar control more difficult for women with type 1 or type 2 diabetes.

08:07 - We hear key steps to monitor insulin resistance, including tracking body changes, screening for diabetes risk, and discussing treatment options with healthcare providers.

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Menopause is often a misunderstood and misrepresented phase of life, leaving many women to navigate it in silence and confusion. Each year, over one million women in the U.S. enter menopause, yet many feel unsure about when and how to seek support. Am I too young to ask for help? Are my symptoms “severe enough” to warrant a conversation with my doctor?

In this episode, we welcome Dr. Naomi Busch, the visionary founder of Seattle Menopause Medicine—a groundbreaking practice born from a conversation among friends at a book club! Join us as Dr. Busch and I passionately debunk some of the most pervasive myths surrounding menopause, providing clarity and confidence for women facing this transition.

You’ll discover:

• Why age should not be a barrier to seeking menopause care
• The misconception that significant suffering is required before seeking help
• Effective alternative strategies to manage menopausal symptoms without hormone therapy
• Essential insights into osteoporosis awareness and maintaining bone health post-menopause
• Key information about testosterone pellet therapy and its implications for women

Tune in now to explore how Dr. Busch’s compassionate, evidence-based approach is reshaping care for women, empowering them to embrace this pivotal stage of life with knowledge and confidence!

Audio Stamps

01:08 - Dr. Patil-Sisodia introduces today’s guest, Dr. Naomi Busch, who opened Seattle Menopause Medicine in 2023 to guide women through perimenopause and into the menopause transition.

04:47 - Dr. Busch addresses how many women are dismissed for being too young for menopause treatment and shares her comprehensive approach to working with women experiencing menopausal symptoms.

09:42 - Dr. Busch busts the myth that women must be "suffering enough" to warrant menopause treatment.

14:45 - Dr. Busch addresses the misconception that life will be ruined without hormone therapy, highlighting that while it's beneficial for some, many women can effectively manage symptoms with alternative treatments.

19:53 - Dr. Busch highlights the importance of osteoporosis awareness, stressing that many women remain uninformed about their bone health, especially post-menopause.

24:38 - Dr. Busch clarifies the misconception that obtaining hormone therapy from a compounding pharmacy is superior to receiving it from standard pharmacies.

28:30 - Dr. Busch and Dr. Patil-Sisodia discuss concerns about testosterone pellets for women, regulatory challenges for female testosterone therapies in the U.S., and dosing complexities.

References

Visit the Seattle Menopause Medicine website

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