Episode 218
Jennifer Pfleghaar:Why Your Menstrual Cycle Holds the Secret to Better Workouts and Weight Loss
Jennifer Pfleghaar:
Why Your Menstrual Cycle Holds the Secret to Better Workouts and Weight Loss
Dr. Jen Pfleghaar, emergency medicine physician turned integrative doctor, shares how women can optimize workouts and nutrition by syncing with their menstrual cycle.
We discuss timing exercise intensity and nutrition to work with your hormones rather than against them, the importance of protecting progesterone, and why muscle building is critical for aging women.
We discuss timing exercise intensity and nutrition to work with your hormones rather than against them, the importance of protecting progesterone, and why muscle building is critical for aging women.
First Aired on: Nov 17, 2025
Episode 218
Jennifer Pfleghaar:Why Your Menstrual Cycle Holds the Secret to Better Workouts and Weight Loss
Jennifer Pfleghaar:
Why Your Menstrual Cycle Holds the Secret to Better Workouts and Weight Loss
Dr. Jen Pfleghaar, emergency medicine physician turned integrative doctor, shares how women can optimize workouts and nutrition by syncing with their menstrual cycle.
We discuss timing exercise intensity and nutrition to work with your hormones rather than against them, the importance of protecting progesterone, and why muscle building is critical for aging women.
We discuss timing exercise intensity and nutrition to work with your hormones rather than against them, the importance of protecting progesterone, and why muscle building is critical for aging women.
First Aired on: Nov 17, 2025
Table of Contents:
Table of Contents:
In this episode:
In this episode:
Introduction
Dr. Jen Pfleghaar is a double board-certified physician in Emergency and Integrative Medicine who earned her medical degree from Lake Erie College of Osteopathic Medicine. After dealing with her own Hashimoto's diagnosis and reversing her autoimmune condition through root-cause medicine, she now helps women optimize their health through her virtual practice. In this episode she joins me to talk about cycle syncing and how women can work with their natural hormonal rhythms instead of against them.
Episode Highlights
Understanding Your Menstrual Cycle Phases
Dr. Jen explains the fundamental difference between men's 24-hour hormone cycles and women's 28-day cycles with changing hormone levels every single day.
- Follicular phase (days 1-14): estradiol is more dominant and you're more stress-resistant
- Luteal phase (days 15-28): progesterone should be more predominant but often declines in perimenopause
- Women experience different hormone levels every day, unlike men who stay consistent
- Knowing where you are in your cycle helps you plan activities accordingly
Exercise Timing Based on Your Cycle
The key to optimizing workouts is matching your exercise intensity to your hormonal state and stress resistance.
- Follicular phase: do HIIT workouts, lift heavy weights, run sprints, and push harder
- You're less likely to get injured during the follicular phase
- Luteal phase: lighter weights with more reps, shorter sessions, mobility work, walking with incline
- Start new workout programs during your follicular phase when you can handle more stress
- Don't do sprints or intense training during luteal phase to avoid injury
Nutrition and Fasting Strategy
Dr. Jen reveals why intermittent fasting every day can backfire for women and how to time it properly.
- Follicular phase: more insulin sensitive and can handle longer fasts better
- This is when to do 24-36 hour fasts for hormesis and autophagy benefits
- Luteal phase: body demands more calories and you're more insulin resistant
- Daily intermittent fasting can create cortisol spikes and weight gain in some women
- Listen to your body's need for more calories during luteal phase
Stress Management and Protecting Progesterone
Understanding how cortisol impacts your hormones is crucial for perimenopausal women who are already under significant stress.
- Stress converts progesterone into cortisol, creating hormone imbalances
- Perimenopausal women (mid-30s to mid-50s) are typically extremely stressed
- Cold plunging and other hormetic stressors should be timed carefully
- Avoid adding stress during high-stress life periods or luteal phase
- Focus on parasympathetic activation through breath work, prayer, and nature
The Critical Role of Muscle Mass
Dr. Jen emphasizes that every woman should be lifting weights to combat aging and metabolic decline.
- We lose 1-2% of muscle mass after age 40, leading to sarcopenia
- Muscle acts as a metabolic buffer, helping process glucose and calories
- Weight lifting is essential for women with PCOS and insulin resistance
- GLP-1 users need to prioritize muscle building to avoid metabolic rebound
- Building muscle helps create flexibility in your eating patterns
Tracking Your Cycle Without a Uterus
Women who have had hysterectomies can still benefit from cycle syncing since they still have hormonal fluctuations.
- Track mood and energy patterns to identify your luteal phase irritability
- Use LH ovulation strips to track hormone surges
- Monitor temperature with wearables
- Consider saliva testing to map your hormone patterns
- Sync with teenage daughters' cycles as they often align
Notable Quotes from this Episode
We are different every single day of the 28 day cycle. From the start of bleeding to the start of bleeding, the next cycle is about 28 days is what it should be. And we have different hormone levels of the main hormones every single day.
Dr. Jen Pfleghaar
We're not gonna be doing the same thing every day because our hormones aren't the same every day.
Dr. Jen Pfleghaar
I have more energy now than I did in my twenties. We should shine in perimenopause. We know more. We're wise.
Dr. Jen Pfleghaar
Other Resources:
Other Resources:
Connect with Jennifer Pfleghaar
Connect with Jennifer Pfleghaar
Watch this interview:
Watch this interview:
Episode Transcript
Jennifer Pfleghaar: When our estradiol is, is more predominant in this follicular phase for working out, let's say we can go harder. This is where you wanna do HIIT workouts. This is when you can also do like sprints.
Julie Howton: Welcome back to The Inspired Living with Autoimmunity podcast. I'm your host, Julie Houghton, and today we're joined by Dr. Jennifer Flager, a double board certified physician in emergency and integrative medicine who completed her fellowship at an the Andrew Weill Center for Integrative Medicine. Dr.
Jen believes that true wellness thrives when body, mind, and spirit are aligned with God's design. Diagnosed with Hashimoto's, she became passionate about autoimmune healing, hormone balance, and root cause medicine. Dr. Jen co-authored Eat, sleep, move, breathe, and is the author of the Perimenopause Reset. In today's conversation, we are talking about cycle sinking and the importance for women to live in harmony with their hormone cycles, as well as proactive steps that we can take to optimize longevity.
Dr. Jen, welcome to the podcast. Hi.
Jennifer Pfleghaar: Thank you, Julie for having me.
Julie Howton: I'm so excited for our conversation, um, and, and can't wait to, to dive in to cycle syncing. But first, for listeners who aren't familiar with you, you have a, an amazing autoimmune journey of, of your own. Um, I'd love for you to share your story.
How do you go from ER doc to this integrative amazing resource for all of us?
Jennifer Pfleghaar: Yeah, well, it, it kind of took a while, so, and you never know, like the seeds that are planted. So I started having some cycle issues actually in high school, and my mom was reading in one of those women's world magazines. You know, you get at checkout and she's like.
Jenny, I want to ask your doctor to test your thyroid. So it ended up, I had a thyroid nodule. I had all these thyroid problems. I was gaining weight, all of these things. And I had to have, um, a biopsy, which was fine. But when I, when you're a senior in high school, that was very traumatic. Yeah. And yeah, and all these things.
So everything was kind of fine. And during college, um, then I got into medical school and my nodule had grown. Well, imagine that. 'cause. The root cause wasn't addressed. Right. While my mom was so good, like being an advocate for me. I mean, she wasn't a doctor or no one was in the medical field. Even in my home.
Yeah. And it was funny because I, I knew I wanted to be a doctor, but you're in pre-med, it has nothing to do with medicine. And even your first two years of medical school, you're not doing a lot of clinical work. It's memorization, weeding them out and some grooming by the pharmaceutical companies in there.
Another day, another story, but. I, the nodule was bigger. We were in anatomy and I was feeling, I'm like, oh, that's bigger. And um, I was becoming a do, which we do osteopathic manipulative therapy. So we were using our hands, getting really good at feeling things. So went back, they did an ultrasound and they're like, this could be cancerous.
You need to have surgery like right away. And I'm like, oh my goodness. What? Like, my neck's gonna have a scar. And like, I was just a first year in medical school and I was like, what is going on? So I took my final exams and went to surgery that morning. Um, I remember people in my class, they're like, what happened to her?
She's not taking the finals. Did she drop out? You know? And I'm like, we have surgery, so. Um, praise God. It was not cancer. And I remember still the, the ENT came out and he's like, it's not cancer, but it's, it was Hashimoto's thyroiditis. 'cause they do a frozen biopsy while you're in surgery. He's like, oh, it's just this autoimmune disease named after this guy.
It's so silly, silly name, and you can't do anything about it. Eventually your thyroid will just die and you'll be on chronic medication, but no problem. Yeah, well, but imagine I'm a first year medical student. Oh, this is a doctor telling me this. I am all in. I believe it until I didn't feel good. And I started reading the studies about using T three instead of monotherapy.
I remember. I went into the office and I was like crying because they were not listening to me. I'm like, I can't study. I'm like, I feel horrible. Like I'm depressed even a little bit, because of course they had me on birth control to regulate my cycle too. So this is like common stuff that happens. Yeah.
Right. So then finally, um, you know, I probably suffered way more than I should have. Then I start becoming, I, I'm, I'm still just like eating gluten, doing whatever, not thinking about my gut health stress because I am in the run of it, you know, medical school residency. So finally after residency, it's like the least healthy.
Thing you
Julie Howton: can do is go to medical school.
Jennifer Pfleghaar: Yes. Stay up all night. Yeah. And we would even have, like, there's a lot of depression and suicide in, in residency and, and you know, that actually happened to, to a colleague of mine right when she got out of residency and they, they think that they're doing stuff, you know, you're doing these fun events and stuff, but like, you don't have peace, you don't have sleep.
Right. It's not, we're, we're all drinking to, to like. Like, like quelch, our, like trauma we're having, you know, like I, if I was reading my Bible, that would've helped if I was right. You know, eating well and eating well. Yeah. Getting some sleep and, yeah, it's, yeah. So I mean, I, I can see why it happened, how it happened.
Um, so then I. Out of medical school residency, and I'm actually working in the emergency room. I'm starting my family, and I start reading about how to optimize my body for fertility and starting a family off birth control, all this stuff. And then I start reading about gut health and how gut health is connected to autoimmunity.
And Im, you know, and this was. Um, 20 years ago. So I, I cut out gluten, I start doing all this stuff, then I start looking into Lyme disease and just more and more root cause stuff. And I tell my husband, Hey, like, I think I wanna go into integrative medicine and do a fellowship. And I had at that point reversed my Hashimoto's and my antibodies with zero.
Yeah. So, and, and I became disillusioned with the ER and conventional medicine and woke up, um, let's say, um, which, you know. A lot of conventional medicine doctors are still waking up. But you've gotta, you gotta plant these seeds, um, and know that these protocols that your doctor is following for your rheumatoid arthritis or celiac or these autoimmune diseases they're dated, you know, and for them to break through, it's, I mean, they have to be brave and they have to realize that they might lose their job at a conventional medicine place if they're not pushing drugs.
They might. So, um. Yeah, it's just, it's been so great practicing the last decade, integrative medicine, seeing people actually heal. Seeing them not need me anymore, but then maybe needing me just for longevity or hormone care. Yeah. Well, been great.
Julie Howton: Yeah. And I know you must see it all the time. 'cause we see it all the time as first, you know, you get them well and they learn and they, and then it's the up level, right?
And then it's like, oh wow. You know?
Jennifer Pfleghaar: Yes.
Julie Howton: Um, people, yeah. It's op,
Jennifer Pfleghaar: it's the optimizing is the fun
Julie Howton: part, I say. Right. It is. It's so exciting and it, but I, I find it. Even extra exciting when people are starting behind the eight ball in their journey when they too have been told you can't heal, you know, oh, this isn't fixable.
Yes. Um, and, and so I, that's my, my huge goal is for nobody to ever be told that again. You know, I know how I felt when I was told my RA would only get worse. Um, and it, it just, I look forward to the day. If I'm alive to see it when, you know, people are no longer told that. Um. Right. But, you know, there's a, a lot of work to do, but in the meantime, we have you, so this is great.
Jennifer Pfleghaar: Yeah. It might not happen. It might not happen. You know, you might not go to a conventional doctor and say that your body can heal.
Julie Howton: Right.
Jennifer Pfleghaar: Because. Because they don't want that getting out. But it's good. And, and you know, we're all called names, of course. Like I've had people call me horrible names about how I practice medicine and I'm like, what I'm doing is evidence-based and right.
You know, you can't, there's studies that show the connection between autoimmunity and gut health and stress and hormone regulation and toxins and, yeah. All the, yeah, but my favorite is when I have a doctor, I still have patients. See conventional medicine doctors, I am not perfect. Um, sure. You know, I want Oh, we do too.
Get test. We're not primary
Julie Howton: care. Get test.
Jennifer Pfleghaar: Yeah. Yeah. Just, just use it. Use them for what it's good for to rule out stuff. You know, even E up as even though we know Yeah,
Julie Howton: yeah. I mean it got, if I need emergency surgery, I'm going to a Western trained hospital base. You know, I'm not gonna go get acupuncture.
Yeah. You know, but I
Jennifer Pfleghaar: will, I I do think it's funny, you probably get this a lot too. So I'll, like, I have a patient with lupus, which is very hard to control. Right. Um, but she's doing so well. Her kidney function is doing amazing. 'cause when she came to me, it was kind of. Struggling a little bit, and her labs look amazing.
She feels amazing because one of her root causes was mold, mold, mold, toxicity. But her rheumatologist, who actually I, when we lived in Ohio, I had seen him at like a social event. So he knows like who I am and you think he'd be calling me and be like, what's the secret sauce? Like right. And I told her, I'm like, I think he has my cell phone number.
Like, have him reach out and let's get all his patients healthy. Oh, my phone does not ring. Yep. It rings.
Julie Howton: No, so
Jennifer Pfleghaar: they're just, it, it's a whole system, broken system. So
Julie Howton: it is, it is. I think when it totally breaks, we'll turn the corner, but in, in the meantime, there are options. I wish, you know, 20 years ago. The, the integrative functional medicine would, or at least that even I was aware of it.
Um, I, you know, it, it would've been, but then I wouldn't be doing what I'm doing now, so, 'cause I, I needed my journey. Mm-hmm. I know. Um, and so you're, you're latest book the Perimenopause Reset. Yeah. Um, I'm, I wanna dig in a little bit to some of the gold that you have in the book and, and, and share with listeners.
And, you know, we have listeners of, of many in perimenopause that too can trigger autoimmunity hormone. Yeah. Hormone health is, is, uh, really impactful. Um, but you. Are such an amazing resource because I think it is so important, especially when we talk about the autoimmune people. And I, I went through this too, like I held so tightly to the things that worked at first in my healing journey.
Um, and especially as women, I really think as humans, I don't think we're supposed to do the same thing every day. For an extended period of time anyway. Right. But when we're talking about women who, especially women who are cycling, and I am no listeners now, I'm no longer cycling. Um, but it, it is so important to, to support that cycle and not certain things may be good for certain parts of your cycle and not for others.
And, and a lot of women. With, you know, have that perfectionism mindset and it's like, no, I need to, whether it's fill in the blank, like, you know, I'm working out hard every day. I'm intermittent fasting every day. Um, fill in the blank. Yeah. So take us through a little bit that, that approach of, or I guess first start with like, what, what is cycle thinking?
Mm-hmm. Um, and, and how do we support cycle and. I guess tune in right to,
Jennifer Pfleghaar: yeah. Oh, I love that. Tune in is great way. Yeah. To talk about, well, men have a 24 hour. Hormone cycle. They're the same every day. They're the same. And women, we are different every single day of the, the 28 day cycle. Okay. From the start of bleeding to the start of bleeding, the next cycle is about 28 days is what it should be.
And we have different hormone levels of the main hormones every single day. So progesterone after sometimes. Sometimes it feels like minute by minute, but yes. Yeah. Well, and I think that we need to really just. Like you said, tune into this. We need to make sure that this is part of our daily routine. Like we know where we're at in our cycle so we can plan accordingly.
It's just kind of like when you look at the weather app to see what the weather's gonna be for the week. Like that's what we need to do with our cycle. So for the first half of this, some people don't even do that.
Julie Howton: They
Jennifer Pfleghaar: don't, but you live on a farm, you
Julie Howton: know, some people don't even like. Plan for that.
Right. I you, you live on a farm, you have animals. You know, people are always amazed that I know what weather's expecting, we're expecting here in Colorado. Um, and it's like, well, yeah, I have to,
Jennifer Pfleghaar: yeah, exactly. You have to prepare. Well, I mean, and we should know where we're on our cycles so we can let our spouses know and our kids, they can get like a.
You know, a better idea. So why, why does it matter? Well, the first and second half of the cycle, we're just gonna put in those two categories to keep it simple. So the follicular phase, day one is the first day of bleeding. Two, about day 15, which is ovulation. And then the luteal phase, which is ovulation two up until when you bleed again.
So basically days one through 14 is follicular. End days, 14 or 15 through 28 is luteal phase and the follicular phase, that first half, we're gonna hone in on that. That is when your estradiol is more dominant. So estradiol is what basically is pretty erratic during perimenopause, up and down. It can be, but basically it is declining with like these random.
Spikes that we get based on, um, the response to the follicles that are getting lesser and lesser and less robust and less healthy. Um, and then when you hit menopause, your estradiol is flatlined. Okay. With sometimes the caveat is, um, you can get some estrogen from aromatization of fat, so sometimes you will still have that estradiol, but for the main part, your ovaries are not making anymore.
Right. And then progesterone is more predominant in the luteal phase, and that one just goes down. It's like a. Sled hill that goes down as opposed to estradiol, which is more of a roller coaster. Um, progesterone is just going down. So a lot of the things we see is that there's more of this estrogen dominance kind of picture that is going on.
So more cramps, heavier cycles, those kind of things happen. More PMS symptoms. So what we wanna do is we want to control our stress through diet, exercise, and how we live from day to day. And keep that progesterone robust as we can and keep it equal and as even as we can in the perimenopause phase. So this is where cycle sinking.
We're gonna be working with our hormones instead of against them. And kind of like what you said, Julie, we're not gonna be doing the same thing every day because our hormones aren't the same every day. And you, you can even look at some of the big names, um, in the keto world that were like strict ketogenesis 24 7, 365 days a year.
They're now going back and saying, oh no, we need refeeding. Yeah, we need this other thing. And it kind of goes back with like. How food was available and stuff, right. When we didn't, when we didn't have refrigerators, which I had to just get a new refrigerator day. And Julie was so gracious with her time because they came right when the podcast was supposed to start.
So thank you for that called life. Yeah. Well, and that's the thing. I try, I'm entering my luteal phase, so I'm like, I'm not gonna get stressed about this. It's gonna work. And if we have to reschedule, I'm not gonna get right. Mad about that. Right. So, um, so follicular phase. Okay. Estrogen estradiol is predominant.
We are more resistant to stress. So stress, um, is anything that impacts our, our cortisol. So this could be big fluctuations in blood glucose. This could be doing a sauna or an ice bath or different hormetic or ESIS effects. Um, this could be our workout. So we are more resistant to stress, so that means that.
When our estradiol is, is more predominant in this follicular phase for working out, let's say we can go harder. This is where you wanna do HIIT workouts. High intestinal intensity interval training. This is where you'd wanna lift really heavy, like really increase your max weights. You know, when you're doing your weight lifting.
This is when you can also do like sprints. This is when I run my sprints. You can always tell, my kids can always tell when I'm in my follicular face, they hear me on that treadmill. Uhhuh running my sprint intervals. Yes, yes. We're actually less likely to get. Hurt in the follicular phase, they did a study on football players in England, so soccer players, professional soccer players, and they had more injury during that second half of that luteal phase of their cycle.
And, and I've seen this in my practice too. I had a younger woman tear their ACL plane soccer and I'm like, Hey, by chance, were you in the luteal phase? And they're like, yes. And I'm like, makes sense. Um, so that follicular phase that is when. Train hard, lift weights, push it in the gym. Do your sprints to get your VO two max up.
All the things okay, so you can really push yourself 'cause you're more stress resistant. This also goes with fasting. So you brought up, you know, some people are just very, you know, I'm only going to eat this. I'm only gonna do this. Well, I've seen this time and time again with women. You, well, you know what happens?
Like we go on in the Instagram, the TikTok, the, yeah, we go on the social media. And everyone's like, I'm fasting and intermittent fasting. I lost 50 pounds, whatever. And they probably didn't, they were probably doing other stuff, but, right. Um, yeah, because, you know, it's all fake. Instagram's all fake. Um, so for most of it, but we want to realize that this doesn't work for everyone, and this could stress out your body.
So if you are doing fasting, we want to do it in the follicular phase because we don't wanna stress the body out and your body can handle. More fasting in that phase. Okay. Now it's interesting though 'cause we're actually more insulin. Sensitive during that follicular phase. Okay. So we actually process carbs and stuff better, but I treating perimenopausal women know that we care more about stress because this class of women, we are so stressed out.
Like ages? Yeah. Mid thirties to mid fifties. You know, anywhere in between that. Yeah. Depending on your genetics can. Can be perimenopause. I mean, these women are just super stressed. Like, even if, you know, and I think the crazy thing was when I was in northwest Ohio, I was treating people in my community versus now, and I'm, I'm virtual, I can see whoever, wherever.
Yeah. But it was, I, these women would come to me and I'm like, I thought they had it. All together, like everything was perfect on their social media and they're so stressed out, like, so stressed out. I have so much going on and I'm like, wow. Like they are stressed and they're hiding it. Not hiding it, but you know, putting on a good front.
Yeah. Which is stressful too. So I just know from seeing hundreds and hundreds of women that they are stressed out even if they say they're not or don't look like it. Right. So we don't want to intermittent fast. Every single day through our cycle, we want to do long fast for hormesis, for the autophagy, for gut health, you know, to mix things up, but just keep it in that follicular phase.
And I've seen it with continuous glucose monitors. Um, I had a patient who was actually in menopause. And she was intermittent fascinating every day 'cause she wanted to lose weight and she felt fine doing it, but she gained weight and she came to me, I'm like, let's put on a continuous glucose monitor and see what's going on.
So she was getting a big. Glucose, which is insulin spike, stress spike in the morning, every single morning. So her body thinks she's stressed every morning when she's intermittent fasting. 'cause she's doing it every
Julie Howton: day.
Jennifer Pfleghaar: She's starving. Yeah. Yeah. She's doing it every day and then she's gaining weight.
'cause her body's like, Nope, I'm gonna gotta keep it. Yeah, yeah, yeah. So she just from eating a healthy breakfast and being more consistent, lost weight, you know, like increasing your calories. I love that you said that.
Julie Howton: I see that all the time. Yes. Starving yourself. She at least felt well. Or I have women that are like, you know, I know I need to be doing this, and I, and it, you know, I, I'm gonna do it and, but I don't feel well, and I'm like, whoa.
Pushing through it. Yes.
Jennifer Pfleghaar: Yes. If it, well,
Julie Howton: I see this with training and what worked a few years ago may not work now. Like, right. Yes, yes. We're always evolving and changing and, and, yes. Um, yeah. Well, and
Jennifer Pfleghaar: that's a great point. In perimenopause, I'll have women come and they're like. I did the things I always did.
You know, when I would gain weight, I would do some HIIT workouts. I would go extremely low calorie, low carb, you know, they would do all these things. They're like, and it's not budging. And I'm like, well, cortisol. So if you're already more stressed because the season of life you're in, you're stressed because you're hormones are changing, then you are going to hold onto that weight more.
And no, we have to lean into our cycle. So another like. Cushion that women in perimenopause and menopause can kind of put as a buffer for eating and whatnot is weightlifting and gaining muscle mass. And I, I started, so Emory just turned six. So when, like six years ago is when I, like, I weight lifted before, but I, like now I go where the boys go, where the men go, you know?
And I, I really lift heavy now and it is such a nice buffer because you can really just. Eat a bunch of calories for a couple days and like your, your muscle eats up that glucose, right? So it's, it's a good buffer. If you're like listening, you're like, well, I have tried everything. Have you tried lifting really heavy and also giving the body the protein and amino acids to build muscle.
And lift heavy. But don't start, don't start it in your luteal phase. If you're still cycling, start a new workout in your follicular phase. Start a new, you know, lifestyle eating. I don't wanna call it a diet, but if you wanna add more protein or, or try carnivore, you know, that's really trendy, carnivore. Do it during the follicular phase, you know, so they'll do carnivore during the first two weeks and then maybe the next two weeks, you know, add in more fat, add in more like healthier carbs.
So there's a way to work with your body and also not have shame and guilt is a big thing, I feel like. Yeah. You know, like, oh, I messed up. And it's like, no, your body's okay. Um, so then the, the luteal phase I've been kind of alluding to this, is when our body shifts. So we have, progesterone is more predominant here.
Now remember, sometimes during the perimenopause we feel more estrogen dominant here 'cause we had that. Slow, like declining progesterone, right? And then if we have problems with our estradiol, how we're metabolizing it in our gut or in our liver, or we're doing things like drinking a lot of alcohol, so we're not metabolizing our, our estrogen, while like a lot of things can foggy, make this more foggy plus stress can deplete our progesterone.
So we, it just feels more exaggerated. Women start having shorter cycles. They start having anxiety palpitations. So it's all these symptoms that they, they've never had PMS before. They have it now. They have heavy periods. This is all because of those hormone changes. Yeah. So what we can do is protect the progesterone from keeping, you know, our, keeping progesterone progesterone instead of going down that hormone cascade to cortisol, calm, calm down our body.
So we're not giving it stress. It doesn't need during that luteal phase. 'cause keep in mind, so. From a reproductive standpoint, our luteal phase is when you know the egg was released. The sperm is hooking up with egg and the body's preparing for a baby. So this is not when we would That's gentle. Yes. Time.
We're not going to orange theory and like working, like running. We're not running from a bear. If we're running from a bear or stressing out our body, like our body is gonna be like. I am not reproducing, like I'm not Right and not important right now.
Julie Howton: Yeah, yeah,
Jennifer Pfleghaar: yeah. So, so that luteal phase, this is not, you know, I tell patients if they're starting, you know, if we're doing something for gut health, like, hey, like let's do a week of carnivore and see how you do with that, or, or like, Hey, you wanna burn a little more fat?
Let's do a 36 hour fast. We're saving that for that first half of the cycle. Yeah. So the luteal phase. Just like be gentle with yourself here. Yeah. Like this is the phase. It's so funny because once you start really leaning into the cycle and the rhythm and listening to your body, you will eat more calories in your luteal phase because your body will want it.
Yeah. And, and I'm not talking about binging on crumble cookies or something, which no one should be eating. Is that even food?
Julie Howton: No. It's funny you said I, I, it, my brain went to like Twinkies, which I think we can all agree. Isn't food crumble cookies just as bad as they're just prettier.
Jennifer Pfleghaar: I feel like crumble cookies are the new Twinkies from the one.
They are.
Julie Howton: They, they come every once in a while. There's, there's one that's not far from the clinic and their, you know, sales rep. Like they, what cookie company has a sale? Like they'll come and bring. A box of cookies and I'm like, do you, we're a functional medicine clinic. We don't want, they probably
Jennifer Pfleghaar: work
Julie Howton: for
Jennifer Pfleghaar: like a
Julie Howton: diabetes
Jennifer Pfleghaar: company or something.
Like a medication probably. They probably do. That's awesome. They're probably like, Hey, like if we can't get the patients, let's get the workers there anyways. That's awful. But, but yeah, we're not talking about like eating that kind of stuff. 'cause if you're craving No. Sweet
Julie Howton: potatoes and butternut squash.
Jennifer Pfleghaar: Yeah. Good real food. Yes. Yes. But maybe some,
Julie Howton: a little more carby or like some
Jennifer Pfleghaar: tallow fried something, you know, like Yeah, like we can, but, but this is the thing like, oh, you know, actually what I really like, so. Um, my kids always know, 'cause I'm like, let's make popcorn, you know, after dinner. And because I've tested popcorn with a continuous glucose monitor, I do really good with it.
Okay. Um, so we put like extra grass fed butter Redmond, salt pluck seasoning, which is like organ meat. Meat, yeah. Oh yeah. Yeah, yeah. Yeah. It's so, it's
Julie Howton: so
Jennifer Pfleghaar: good. I that and I trusted it.
Julie Howton: Do that with pop sorghum 'cause I can't do the corn.
Jennifer Pfleghaar: Oh. Oh yeah. Sometimes I do well with corn, which is surprising. Yeah, yeah.
Well, which is great. Good for you. Yeah. Well you'll have to send me that other recipe though. That's interesting. Pop
Julie Howton: sorghum. It's stuff. But it's cute that 'cause your family is keyed in onto Yeah, well
Jennifer Pfleghaar: it was even so funny. And, and even just more calories, even more protein. I was visiting my parents like when they were down in Key West and I'm just like, I need more protein.
My dad's like, you're eating a lot. And I'm like, yes. I'm in luteal phase. And it's not like we're gaining 20 pounds from eating a more, for me it's like a couple days. It's actually I'm coming up on it now, which is great. 'cause like my husband and I are going, um, to the Hack Your Health conference for a couple days, so I'm like, I'm going to eat all the meat.
All the things.
Julie Howton: Yeah. Yeah.
Jennifer Pfleghaar: And it's like my, it's. Sometimes it can get outta control. Sometimes I'm like, oh, it's a birthday and sometimes it will get, you have to reign it in. You do have to be conscious, but I love that
Julie Howton: you said, I wanna highlight that though, because people think. Because of what we do for a living that like, oh, perfect.
Yeah. You know, it's, even though all I do is work with them on, like dumping that perfectionism. Yes. Right. Um, but it, it's like we still, the, I remember like the first time, instead of making like. Keto Paleo Thanksgiving. You know, I just shifted to a Paleo Thanksgiving and it was such a great experience for me because just from having some of the, well, it was delicious, but just from having some of the, the, I made them, I know they were clean, you know, desserts.
It was enough to like, it woke up my sugar dragon. And like, you know, so we, we still have to course correct sometimes and just catch Oh yeah. The like, okay. You know? Yeah. Um, it was, it was funny. Still human.
Jennifer Pfleghaar: Yeah. We are, it was funny, we were at like a, I was at a church retreat and someone to the fire they brought, have you ever had, it's like peanuts plus candy, corn, and it tastes like, like a payday.
Oh, it's like, no, but it's just peanuts and candy. Now if it was dye-free candy, corn, no fructose corn, that would be better. But this was probably bad. Well, and not made with
Julie Howton: corn syrup. And yeah,
Jennifer Pfleghaar: I mean it was bad. We knew it was bad, but I wasn't drinking alcohol. 'cause alcohol is bad on the liver too. But I, we were just at the campfire.
Yeah. And my friend who, who I've only known since February, since we met there, but she looks at me, she's like, Jenny, are you okay? You're eating like a lot of that, like are you going down the rails? They were like, worried about me. Do we need an intervention? Wish she was, she was like, and I'm like, no. I'm like, I, I'm just like, I'm luteal.
Like, I think it was on my period, so it was like the right end of it, and I'm just like, I just like want this right now. Yeah. But, and tomorrow's is a new day? Yes. Like. We, you can, and like even my daughter sometimes I'm like, oh, I'm a little off track. Like we can all get there and we, we have to have friends or family that's like, hey, like get back on track.
And what that might mean is when you go to your next follicular phase, if you're cycling still, then you do a 24 hour fast or you do like right now. Right. I'm just on, um, ketones. 'cause I like to just be on ketones. And, um, me too, I acid when I'm doing podcasts. Yeah. I just wanna be sharp. Yeah. I feel, exactly.
Yeah. It's just like that clear ketone brain. And I do that when I see patients all day. I'm usually in ketosis just for my brain. Right. So I can be very focused with them, but, but that's the thing. We, we can't be like, like so bent on the rules that like, it's stressing us out. Right. So back to the luteal phase, like.
You're going to eat calories. Your body is actually demands more calories during this part. You are more like insulin resistant. You, which, you know, you're like, you're adding carbs when you're insulin resistant. Yeah. That's just how your, your cycle is. But we wanna balance that with the stress aspect. So if, if it was different, if we had a 24 hour, you know, hormones, that would be different.
But like the cortisol is just such a big problem with women. I'm constantly telling them to activate their parasympathetic system. You know, like, you're gonna have stress, but how are you managing it? You know, are you praying? Do you have peace? Like it's, it's like I don't want them to be stressed out by food.
During their luteal phase. So this is where it's like, you know, you're gonna reign it back in, in follicular phase because you're gonna be more able to do that. You are gonna, it's your body, it's just gonna gel with it as opposed to fighting it during the, the luteal phase. And, and this is what we see with continuous glucose monitors.
This is what we see in the data even. And, and we know that, you know, insulin does go up in the luteal phase. I mean, they're starting to. Actually study, um, you know, cycles and hormones and all of that. More in the data, but, but really it just makes sense intuitively too. Right. So, um, oh, to working out now.
So what do you do in the luteal phase? Yeah. What do
Julie Howton: you recommend? Obviously we know not hit right? Not necessarily lifting your heaviest, right. So what's that balance look like? Still
Jennifer Pfleghaar: weight lifting? Still the same amount. I knew you were gonna say it. Yes. Still weightlifting, but I mean, you are not gonna be as into it.
Like you're gonna be like, oh, I have to weightlift. So do a shorter session, do lighter weights with more reps. I, you could even do the same weights like I did, um, you know, shoulder presses and I still used 20 on each side, but I wasn't gonna say, oh, I'm gonna go to, I'm gonna burn out at 25. I'm gonna increase my, no.
'cause I don't, I have this right shoulder that tweaks every once in a while because I overdo it in my luteal face. So, right. You need to just. Be aware, you know, still do squats, but don't do as much weight. You know, you're not gonna earn a medal. Okay? So just chill out a little. And then mobility exercises.
This is when you can walk at an incline, walk with a weight vest, you know, just listen to your body. Do not do your sprints. Like there's, we don't wanna get hurt, we're not gonna mess around here. Especially as we're aging. We just don't want that. So, um, yeah. So just make sure you're lifting your body but still lifting weights.
'cause remember, lifting weights and muscle, we need to preserve the muscle. We have, we lose one to 2% of our muscle mass after age 40. And this is really where sarcopenia and aging happens. Yeah. Is, is losing that muscle. And this is where. Also, you know, the use of the GLP ones used incorrectly, right? You know, the semi glut tirzepatide, so many women are losing muscle right now.
Yeah. I am terrified in five to 10 years because they're all gonna be breaking their bones like well,
Julie Howton: and add to it. You know, the other beautiful thing about putting on muscle is supporting metabolism and blood sugar regulation, right? Mm-hmm. So the, the people that are using the GLP ones incorrectly and not.
Watching muscle and, and intentionally building muscle. Right. That rebound. I mean, most women are familiar with yo-yo dieting. Like the rebound after something like that is gonna be way worse than Yeah. 'cause now your metabolism's even slower. You've lost muscle. It's, it's gonna be bad. It, it's, yeah. It is, and I know you're a Peptide fan.
I'm a peptide fan. Like they're love that they're, it's just that it needs to be done intentionally and and carefully and people need the education and, and the monitoring. It's not, yeah, I just had that conversation with somebody yesterday. It's like, yeah, you know, some people are using, you know, they're going to like.
The, the, uh, whatever, a med spa, uh, 'cause they can get their GLP one there and, but, and they're still eating crap and they're still not exercising. They're just eating only a little bit. Um, yeah.
Jennifer Pfleghaar: I think a good word for hormones and peptides right now is just sketchy. It's very sketchy. It's very sketchy out there.
Yeah. And my mentor, Pam Smith was just, she's like the goat of Dr. Smith's like the goat of hormones, but she's not on like social media and stuff. Yeah. Like, and I'm like, I'm like, I feel like I need to just do this so people don't. Right.
Julie Howton: That's my husband. He is been doing it for 20 years, but. He's in the clinic.
He's not on social media either.
Jennifer Pfleghaar: Yes. Okay. And that's, yes, that's the thing. Like I might only see like patients two days a week, like since I had my last kid. 'cause I put it down to that. But like I am s. Still, like, we need time. You need time to see patients, to study, to read the studies, to still, yeah.
Learn, go to conferences. Mm-hmm. And be with colleagues. Now, a lot of the people that are the big faces or all the time, you know, they're, you see 'em on all the podcasts, they're writing books and you see 'em on all, they're not seeing, they're not practicing. Yeah. Mm-hmm. Mm-hmm. It's, it's, thank you for that.
That's, yes. Well, even like our surgeon in general is not. Seeing patients. Yeah. And like, and, and, and here's the other thing. If you see someone come out of nowhere, like nowhere, there's money behind that. Right. And I'm seeing that with the hormone stuff right now. I'm just sitting back and I'm like, Hmm, okay.
Yeah. Okay. Yeah, there's a lot of, so. You have to, you have to use discernment. I'm, I just joke, I'm from
Julie Howton: New Jersey. I'm skeptical always. Like I think it's okay to be good. It's, it's that versus naive, right? Like it's, it's good to, but it, it's back to what you do is empower people to take charge of their health and that's what we do.
And, and with that also is responsibility. Like we all need to be doing. Research and like you can't just trust somebody because they have a DO or an MD after their name. Mm-hmm. Yeah. You can't. Yeah, sadly. But I mean you, why? You know? Yeah. And I, again, I say this with love. I'm married to a do my God. Yeah.
You know? Well, but that
Jennifer Pfleghaar: I also, to, to your point, I also have a test. Okay. If you can't find someone's credential, so, so everyone likes to call themselves doctor expert. That's the new thank you. If you can't find their credentials within three seconds of looking at their website profile, whatever. Then they are probably not a real medical doctor.
And that's fine too, right? We, I love my physical therapist, I love my chiropractors, I love my PhDs, but they're hiding it and they're not being honest. So that's my three second rule. I like that. If you can't find it within three seconds of looking at a profile or website, they are not being honest with what kind of professional they are.
That would be like a lawyer or, I don't know. A mechanic like Sure. Because a Juris doctorate
Julie Howton: is still a doctorate.
Jennifer Pfleghaar: Oh, my dad would pull that one. Yeah. My dad's like, right, like my dad's like, you know, I'm a doctor. Right, right. Of jurisdiction because you know, if he was trying to get me to eat my vegetables or something, sure.
He would say that, and I'm like. Stop. Stop. Which by the fact, my family does not listen to any of my medical advice. They're not supposed
Julie Howton: to really, really, you know, our household is like, you know, it's a physician and a health coach. Yeah. So we're,
Jennifer Pfleghaar: that's probably, you know, that's probably fine. Yeah. Yeah.
What, what
Julie Howton: piece do you wanna ignore from whom? At what point, you know?
Jennifer Pfleghaar: Yeah. And that's, well, and that's the thing. That's why raising kids is so stressful, these perimenopausal women. I mean, I'm just like. Whew. Like, I'm not even stressed about the fridge or anything. I'm like, my teenage boy is like, whew. He is hard on, hard on us with like, you know, he's is, is is his job right now.
Like, that's, then we're trying to just pray, give him grace. Um, he's around. He's at an amazing. Um, homeschool hybrid. I mean, I'm, that's fantastic. I feel so blessed for that. But, but yeah, it is, um, it is the time where there is stress, so yeah. But that's, that's why I really do like the cycle sinking. And then for perimenopausal women.
You're not supposed to, like what we've been talking about. You're not supposed to do the same thing every day. You know, maybe you could do it with like the moon. You could pick, you know, every moon cycle. You know, you do a 24 hour fast or something like that. So you need to mix it up too and play around with your eating windows.
Make sure you are having times where you are just. Eating carbs and you know, it's this fast and famine and this or the feast or famine. And that's what they, yeah. Used to do. They used to have these big feasts but then not eat for a a couple days or Right. Not eat a lot. So we need to kind of go back to that and applying like a little bit of stress or hormesis like, like fasting and if you're perimenopausal, that is good at times.
I'll use this as an example. So I was a big fan of cold plunging. Mm-hmm. Big, big fan. Got me through some really like, like I was a little bit stressed, like minor stress, like really good for me. Um, when we moved, when we knew we were moving and it was very stressful. I, I just, I stopped. I stopped. I haven't cold plunged enough Stress.
Yeah. Yes. So it's like you can push it a little bit too much. So, um, just like if you're sick or have a fever, you're not gonna run a marathon. So. So you need to, to realize that hormesis is great and we need that for, to, to push our bodies at time. But if you're under a lot of stress, that could make things worse.
And then that could, you know, that can lead to autoimmune disease if we are pushing too hard. So I wanna actually get back into cold plunge and I need to get it set up. So, yeah,
Julie Howton: it's, but I love that, that you point that out because even that. We're talking about women and, and sinking, and that's important, but, but timing.
It, it's even for men. Like if they're lifting and trying to put on muscle, they need to time their cold plunge. Like, oh yeah, we need to understand the physiology of, of, yes. What we're doing. Yeah. We
Jennifer Pfleghaar: actually, yeah, we can talk about the data behind that. So cold plunging, um, when you don't wanna cold plunge right after like a big leg day or you're working out because that can actually affect putting on muscle.
So if you're gonna, if you're gonna have a muscle building day, then you're gonna have to cold plunge a couple hours apart from that. Right? So I think, I think that's also interesting because you know, you don't wanna be doing all that work. Um, response and then blunt the response response that you're going for
Julie Howton: response.
Yeah. Yeah. So I wanna underscore, and you said it and you said it, and I've heard you say, I know the answer to this, but I have to tee it up anyway. Mm-hmm. Who should be lifting weights?
Jennifer Pfleghaar: Oh, everyone. Every woman? Yes. Per, even younger. Because we're seeing so much PCOS and polycystic ovarian syndrome, which is a problem of, uh, it's a metabolic problem.
Okay. Yeah. Insulin resistance. So we're seeing so much insulin resistance and really aging. We just, every day, every day as we sit here, every minute we're getting more insulin resistance. It's part of aging and it, and it's that balance. And this is why Metformin used to be the original biohacking, the anti-aging drug.
Yeah. Yeah. 'cause it helps with the insulin resistance. And, I mean, we could go into mTOR and stuff like that 'cause it, it is a process of, you know, you need to build muscle plus. But that stimulates mTOR, which increases aging versus, you know, fasting, which decreases mTOR. But this is why you work with, you know, someone like us and you come up with a plan, and this is why we don't eat all day or workout all day to stimulate mTOR all day.
And this is why we can incorporate fasting during certain times of our cycle to reduce stress, but get the benefit. So it's, it's pretty beautiful and amazing how our bodies are made. So it is, and we work with it. And
Julie Howton: like if you take the step back and you listen to this conversation, it, it all, it comes back to how we were designed.
Mm-hmm. Right. And, and, and. Modern day times we live so differently than we did when we were feasting and then fasting. Right? Yeah. Unless we're being intentional. Um, and, and so it's the same thing working with the cycle. And yes, now we need to compensate. You know, when I was taking care of the horses on the farm and doing all the physical things like I did, I was lifting heavy things.
I was stacking hay bales. I was doing. The stuff right now that I'm at the clinic, I have to actually intentionally create different workouts because my days look different and it's the same. Yeah. It's like we need, we're living longer, we're living in a different kind of environment. We need to be intentional.
Jennifer Pfleghaar: Yeah. We
Julie Howton: really do. To protect through aging. Um. So do you have tips for, this has come up at some, you know, things like come up in patterns mm-hmm. Um, for women that are listening that are perimenopausal or, you know, just still cycling, but I've had a hysterectomy because those women tend to forget that they're still cycling.
Right. Because they mm-hmm. 'cause they're not bleeding. Yeah. Um, do you have any tips for how they can like. Track, tune in, pay attention, any any tricks for that?
Jennifer Pfleghaar: Yeah. So it, it'd probably be easier the later you get and, and perimenopause maybe. So with some of the like changes of, you know, maybe the pelvic floor feeling heavier, stuff like that, possibly.
But, um, you can still, because you're still cycling, you can still kind of feel it. Mm-hmm. So I'll have women kind of, um. Kind of like work around that. Like if they're like, oh yeah, like I'm really irritable right there. I'm like, okay, that's probably your luteal phase, so let's track.
Julie Howton: Yeah,
Jennifer Pfleghaar: track that and see.
You could also, um, you could do testing, you could do like saliva testing where you check it like within 30 days, you, you check it like every four days and stuff. There's lab companies out there that do that. You could also, um, even though we don't ovulate. Every time when we're in perimenopause, sometimes we skip and then, or sometimes we ovulate twice.
You could track your lh. Surge and then get a better idea and then just keep tracking it. Um, where your LH would be, like that's the trigger. Um, ovulation. So that's the, the strips that women wear when they're trying to get pregnant. So you could buy, you know, a hundred of those off Amazon and just track it that way.
But, but same thing. You would want to still cycle sink because it's
Julie Howton: important. That's why I, you know, 'cause the, and they might need to progesterone,
Jennifer Pfleghaar: yeah. Yeah. They might need progesterone support. So, I mean, that's happening. A lot of women that I see, I've seen, um, you know, a handful of women that they've come to me because they were told they needed a hysterectomy and then we got their estrogen and nap metabolism figured out and they, they were able to keep their uterus.
And, and that's another thing, it's, it's like a big pet peeve of mine that.
Julie Howton: Pull it out.
Jennifer Pfleghaar: I just don't under, yeah. I just don't understand why doctors think taking out organs fix the problem it doesn't. Gall bladder
Julie Howton: uterus. Yes. Yes. You don't need them. It's like the hormones
Jennifer Pfleghaar: I try to explain to women. I'm like, look like you had to have a hysterectomy.
That should be a red flag that we have to work on your estrogen metabolism because you still have breasts and like, we don't want an estrogen related cancer. You know, you right. Have an estrogen excess. You don't wanna
Julie Howton: take away parts as the problems. Surprise. Yeah. Deal with it. Well,
Jennifer Pfleghaar: and that's the same with if we look at all the fertility treatments and IVF, it's like, no, like you're not fixing, how about why?
That is there. Yeah. Yes. So yeah. Yeah. Oh yeah. And taking out gallbladders. I'm seeing that a lot with the GLP ones, with people losing Sure. So fast, so high dose, and then they need gallbladder surgery and I'm like, we are not doing this is, we're not doing it. Right.
Julie Howton: Yeah, no, definitely. I'll, I'll throw in one more little non-scientific tip for, for women, but I just, I just.
Women without a uterus to really realize that they're, this is still for them, this conversation. You don't need to have to buy feminine hygiene products to, to yeah. Tune into this conversation. Um, and I like the where you started, it would be where I would start too is the track it, like pay attention to patterns.
Mm-hmm. Because there's probably a pattern, even if, like you said, sometimes it's not totally consistent, um, but. For the women who have a teenage daughter living in the house. Mm-hmm. Those cycles tend to sink too. So where is she in her cycle? Does that line up with what you kind of think you're experiencing symptom wise?
It can be an easy cheat and there's so many different trackers you can use, um, yeah. That are free. Yeah. Or you could track
Jennifer Pfleghaar: your temperature if you have a wearable. Yeah. So that would be another thing, like an easy way I forgot to mention. So, yeah. Yeah, definitely. Make sure, 'cause you, you still have the hormones going on.
Your hormones are still being expressed in other tissues in your body. It's not just about the uterus. So, and have no shame that. You got your uterus out. It happened. It's done. So now, right. Let's move on and learn and, and get things better because yeah, it's very hard when women. You know, when they get that, the, uh, partial hysterectomy and they're just like, oh, everything's better.
But then they're still having all the bad symptoms and minus the bleeding and Yeah. And then sometimes they'll take out, do a total, and then I've seen this more times than not, they'll put women on estradiol but not progesterone. And I'm like. Oh my goodness. Unopposed, estrogen that, yeah. Well it's still, if you read the new FDA report, it's fine.
It's fine in there. As long as they don't have a uterus. And I'm like, oh yeah. 'cause we just don't need progesterone anymore for us or for any of our other in our brain. So it's, like I said, it's sketchy out there. It's the best word. It is. That might be, that might be my word of 2026. Sketchy. I'm just kidding.
That, that's, that's a negative word. Maybe it'll be shrewd. We need to be
Julie Howton: shrewd. Ooh. Well, and again, it comes down to youre, as a snake, the responsibility, and again, most a, a gearing at the physicians right now. Um, you know. I don't know of anybody who got into medicine for any other reason, but to help people.
Right, right. And so we have to understand the training. Like, and I, I just had this this week. Well, my God, you know, and my gynecologist. Said this and, and I'm like, oh, your gynecologist probably doesn't know a lot about hormones. Sorry. Like it's rare. Um, so we need to take the time to do our homework and find the right people to support us.
Right. Um, and get, get Jen's book, read it So that, but that's the thing. I think the, the difference there it is. It's so beautiful. The PerMon Menopause Reset. I love the colors and the, um, but that's. It all comes down to us. Right? So we need to read, we need to learn, we need to research. Yeah. And then when we need support, find the the right person.
Um, yeah, absolutely. Yeah. So we're at the point where listeners are leaning in 'cause you've already given us so much amazing gold. But what is one step that listeners can take starting today to support their health?
Jennifer Pfleghaar: Yeah, I would say make sure you're spending time in the parasympathetic state, so breath work, meditation, prayer, so that, that is throughout the cycle, so really not just
Julie Howton: for half.
Yeah.
Jennifer Pfleghaar: Yeah. And, and like we were talking about earlier, like. You know, I go out and I take care of the animals and give them feed and get that early morning sunlight and just ground basically, and be in nature. So just make sure that you're spending that time and not making excuses for, to not do it because it just, it will, it will catch up with you for sure.
Amazing.
Julie Howton: Ah, Jen, thank you so very much. Where can people find you if they're like, oh my gosh, she is amazing. I know because. If they're just looking for your name, they may not find you on in all the places. So what's the best place?
Jennifer Pfleghaar: Yeah, it's hard to spell. It's hard to spell. So you can go to Dr. Jen book, D-R-J-E-N book, or Healthy by Dr.
Jen. Those are my two websites. And then if you wanna hang out, I'm on Instagram. Integrative, doctor, mom, integrative, Dr. Mom. And I also have a YouTube that I'm trying to put longer videos in there and, and I'm just putting up videos of the farm too 'cause it's kind ridiculous that we're trying to do this.
Lots of funny stories with that, but, but yeah. Um, I am, I'm here. I do see patients virtually and the book is really just something that, um, I, I pray everybody needs women. Yeah. My goal is to help like. 500,000 women because there, there's like 7 million women in perimenopause. So we gotta help that. Just think of, because they're struggling.
Think
Julie Howton: the world would be a better place too. Like it, yeah. We could, we'd
Jennifer Pfleghaar: be more balanced if
Julie Howton: we could get the perimenopausal women out of that constant stress state.
Jennifer Pfleghaar: Yeah.
Julie Howton: Just think of that trickle down. It would be amazing. Yes.
Jennifer Pfleghaar: Yes. Yeah. I mean, and really we should shine in perimenopause. Yes. It, it should be, I have more energy now than I did in my twenties.
Like yeah, we should, we know more. We're wise, so yeah, get wisdom and, and feel good. So
Julie Howton: I love it. Jen, thank you so much. I so appreciate the time. I'm glad that we were able to, to make it all work. Yes, thank you. And, and I look forward to hopefully having you back in the future.
Jennifer Pfleghaar: Sounds great. Thank you so much, Julie.
Have a good day.
Julie Howton: You
Jennifer Pfleghaar: as
well.
Julie Howton: For everyone listening, remember, you can get the transcripts and show notes by Visiting Inspired Living Show. I hope you had a great time and enjoyed this episode as much as I did. I'll see you next week.
Julie Howton: Welcome back to The Inspired Living with Autoimmunity podcast. I'm your host, Julie Houghton, and today we're joined by Dr. Jennifer Flager, a double board certified physician in emergency and integrative medicine who completed her fellowship at an the Andrew Weill Center for Integrative Medicine. Dr.
Jen believes that true wellness thrives when body, mind, and spirit are aligned with God's design. Diagnosed with Hashimoto's, she became passionate about autoimmune healing, hormone balance, and root cause medicine. Dr. Jen co-authored Eat, sleep, move, breathe, and is the author of the Perimenopause Reset. In today's conversation, we are talking about cycle sinking and the importance for women to live in harmony with their hormone cycles, as well as proactive steps that we can take to optimize longevity.
Dr. Jen, welcome to the podcast. Hi.
Jennifer Pfleghaar: Thank you, Julie for having me.
Julie Howton: I'm so excited for our conversation, um, and, and can't wait to, to dive in to cycle syncing. But first, for listeners who aren't familiar with you, you have a, an amazing autoimmune journey of, of your own. Um, I'd love for you to share your story.
How do you go from ER doc to this integrative amazing resource for all of us?
Jennifer Pfleghaar: Yeah, well, it, it kind of took a while, so, and you never know, like the seeds that are planted. So I started having some cycle issues actually in high school, and my mom was reading in one of those women's world magazines. You know, you get at checkout and she's like.
Jenny, I want to ask your doctor to test your thyroid. So it ended up, I had a thyroid nodule. I had all these thyroid problems. I was gaining weight, all of these things. And I had to have, um, a biopsy, which was fine. But when I, when you're a senior in high school, that was very traumatic. Yeah. And yeah, and all these things.
So everything was kind of fine. And during college, um, then I got into medical school and my nodule had grown. Well, imagine that. 'cause. The root cause wasn't addressed. Right. While my mom was so good, like being an advocate for me. I mean, she wasn't a doctor or no one was in the medical field. Even in my home.
Yeah. And it was funny because I, I knew I wanted to be a doctor, but you're in pre-med, it has nothing to do with medicine. And even your first two years of medical school, you're not doing a lot of clinical work. It's memorization, weeding them out and some grooming by the pharmaceutical companies in there.
Another day, another story, but. I, the nodule was bigger. We were in anatomy and I was feeling, I'm like, oh, that's bigger. And um, I was becoming a do, which we do osteopathic manipulative therapy. So we were using our hands, getting really good at feeling things. So went back, they did an ultrasound and they're like, this could be cancerous.
You need to have surgery like right away. And I'm like, oh my goodness. What? Like, my neck's gonna have a scar. And like, I was just a first year in medical school and I was like, what is going on? So I took my final exams and went to surgery that morning. Um, I remember people in my class, they're like, what happened to her?
She's not taking the finals. Did she drop out? You know? And I'm like, we have surgery, so. Um, praise God. It was not cancer. And I remember still the, the ENT came out and he's like, it's not cancer, but it's, it was Hashimoto's thyroiditis. 'cause they do a frozen biopsy while you're in surgery. He's like, oh, it's just this autoimmune disease named after this guy.
It's so silly, silly name, and you can't do anything about it. Eventually your thyroid will just die and you'll be on chronic medication, but no problem. Yeah, well, but imagine I'm a first year medical student. Oh, this is a doctor telling me this. I am all in. I believe it until I didn't feel good. And I started reading the studies about using T three instead of monotherapy.
I remember. I went into the office and I was like crying because they were not listening to me. I'm like, I can't study. I'm like, I feel horrible. Like I'm depressed even a little bit, because of course they had me on birth control to regulate my cycle too. So this is like common stuff that happens. Yeah.
Right. So then finally, um, you know, I probably suffered way more than I should have. Then I start becoming, I, I'm, I'm still just like eating gluten, doing whatever, not thinking about my gut health stress because I am in the run of it, you know, medical school residency. So finally after residency, it's like the least healthy.
Thing you
Julie Howton: can do is go to medical school.
Jennifer Pfleghaar: Yes. Stay up all night. Yeah. And we would even have, like, there's a lot of depression and suicide in, in residency and, and you know, that actually happened to, to a colleague of mine right when she got out of residency and they, they think that they're doing stuff, you know, you're doing these fun events and stuff, but like, you don't have peace, you don't have sleep.
Right. It's not, we're, we're all drinking to, to like. Like, like quelch, our, like trauma we're having, you know, like I, if I was reading my Bible, that would've helped if I was right. You know, eating well and eating well. Yeah. Getting some sleep and, yeah, it's, yeah. So I mean, I, I can see why it happened, how it happened.
Um, so then I. Out of medical school residency, and I'm actually working in the emergency room. I'm starting my family, and I start reading about how to optimize my body for fertility and starting a family off birth control, all this stuff. And then I start reading about gut health and how gut health is connected to autoimmunity.
And Im, you know, and this was. Um, 20 years ago. So I, I cut out gluten, I start doing all this stuff, then I start looking into Lyme disease and just more and more root cause stuff. And I tell my husband, Hey, like, I think I wanna go into integrative medicine and do a fellowship. And I had at that point reversed my Hashimoto's and my antibodies with zero.
Yeah. So, and, and I became disillusioned with the ER and conventional medicine and woke up, um, let's say, um, which, you know. A lot of conventional medicine doctors are still waking up. But you've gotta, you gotta plant these seeds, um, and know that these protocols that your doctor is following for your rheumatoid arthritis or celiac or these autoimmune diseases they're dated, you know, and for them to break through, it's, I mean, they have to be brave and they have to realize that they might lose their job at a conventional medicine place if they're not pushing drugs.
They might. So, um. Yeah, it's just, it's been so great practicing the last decade, integrative medicine, seeing people actually heal. Seeing them not need me anymore, but then maybe needing me just for longevity or hormone care. Yeah. Well, been great.
Julie Howton: Yeah. And I know you must see it all the time. 'cause we see it all the time as first, you know, you get them well and they learn and they, and then it's the up level, right?
And then it's like, oh wow. You know?
Jennifer Pfleghaar: Yes.
Julie Howton: Um, people, yeah. It's op,
Jennifer Pfleghaar: it's the optimizing is the fun
Julie Howton: part, I say. Right. It is. It's so exciting and it, but I, I find it. Even extra exciting when people are starting behind the eight ball in their journey when they too have been told you can't heal, you know, oh, this isn't fixable.
Yes. Um, and, and so I, that's my, my huge goal is for nobody to ever be told that again. You know, I know how I felt when I was told my RA would only get worse. Um, and it, it just, I look forward to the day. If I'm alive to see it when, you know, people are no longer told that. Um. Right. But, you know, there's a, a lot of work to do, but in the meantime, we have you, so this is great.
Jennifer Pfleghaar: Yeah. It might not happen. It might not happen. You know, you might not go to a conventional doctor and say that your body can heal.
Julie Howton: Right.
Jennifer Pfleghaar: Because. Because they don't want that getting out. But it's good. And, and you know, we're all called names, of course. Like I've had people call me horrible names about how I practice medicine and I'm like, what I'm doing is evidence-based and right.
You know, you can't, there's studies that show the connection between autoimmunity and gut health and stress and hormone regulation and toxins and, yeah. All the, yeah, but my favorite is when I have a doctor, I still have patients. See conventional medicine doctors, I am not perfect. Um, sure. You know, I want Oh, we do too.
Get test. We're not primary
Julie Howton: care. Get test.
Jennifer Pfleghaar: Yeah. Yeah. Just, just use it. Use them for what it's good for to rule out stuff. You know, even E up as even though we know Yeah,
Julie Howton: yeah. I mean it got, if I need emergency surgery, I'm going to a Western trained hospital base. You know, I'm not gonna go get acupuncture.
Yeah. You know, but I
Jennifer Pfleghaar: will, I I do think it's funny, you probably get this a lot too. So I'll, like, I have a patient with lupus, which is very hard to control. Right. Um, but she's doing so well. Her kidney function is doing amazing. 'cause when she came to me, it was kind of. Struggling a little bit, and her labs look amazing.
She feels amazing because one of her root causes was mold, mold, mold, toxicity. But her rheumatologist, who actually I, when we lived in Ohio, I had seen him at like a social event. So he knows like who I am and you think he'd be calling me and be like, what's the secret sauce? Like right. And I told her, I'm like, I think he has my cell phone number.
Like, have him reach out and let's get all his patients healthy. Oh, my phone does not ring. Yep. It rings.
Julie Howton: No, so
Jennifer Pfleghaar: they're just, it, it's a whole system, broken system. So
Julie Howton: it is, it is. I think when it totally breaks, we'll turn the corner, but in, in the meantime, there are options. I wish, you know, 20 years ago. The, the integrative functional medicine would, or at least that even I was aware of it.
Um, I, you know, it, it would've been, but then I wouldn't be doing what I'm doing now, so, 'cause I, I needed my journey. Mm-hmm. I know. Um, and so you're, you're latest book the Perimenopause Reset. Yeah. Um, I'm, I wanna dig in a little bit to some of the gold that you have in the book and, and, and share with listeners.
And, you know, we have listeners of, of many in perimenopause that too can trigger autoimmunity hormone. Yeah. Hormone health is, is, uh, really impactful. Um, but you. Are such an amazing resource because I think it is so important, especially when we talk about the autoimmune people. And I, I went through this too, like I held so tightly to the things that worked at first in my healing journey.
Um, and especially as women, I really think as humans, I don't think we're supposed to do the same thing every day. For an extended period of time anyway. Right. But when we're talking about women who, especially women who are cycling, and I am no listeners now, I'm no longer cycling. Um, but it, it is so important to, to support that cycle and not certain things may be good for certain parts of your cycle and not for others.
And, and a lot of women. With, you know, have that perfectionism mindset and it's like, no, I need to, whether it's fill in the blank, like, you know, I'm working out hard every day. I'm intermittent fasting every day. Um, fill in the blank. Yeah. So take us through a little bit that, that approach of, or I guess first start with like, what, what is cycle thinking?
Mm-hmm. Um, and, and how do we support cycle and. I guess tune in right to,
Jennifer Pfleghaar: yeah. Oh, I love that. Tune in is great way. Yeah. To talk about, well, men have a 24 hour. Hormone cycle. They're the same every day. They're the same. And women, we are different every single day of the, the 28 day cycle. Okay. From the start of bleeding to the start of bleeding, the next cycle is about 28 days is what it should be.
And we have different hormone levels of the main hormones every single day. So progesterone after sometimes. Sometimes it feels like minute by minute, but yes. Yeah. Well, and I think that we need to really just. Like you said, tune into this. We need to make sure that this is part of our daily routine. Like we know where we're at in our cycle so we can plan accordingly.
It's just kind of like when you look at the weather app to see what the weather's gonna be for the week. Like that's what we need to do with our cycle. So for the first half of this, some people don't even do that.
Julie Howton: They
Jennifer Pfleghaar: don't, but you live on a farm, you
Julie Howton: know, some people don't even like. Plan for that.
Right. I you, you live on a farm, you have animals. You know, people are always amazed that I know what weather's expecting, we're expecting here in Colorado. Um, and it's like, well, yeah, I have to,
Jennifer Pfleghaar: yeah, exactly. You have to prepare. Well, I mean, and we should know where we're on our cycles so we can let our spouses know and our kids, they can get like a.
You know, a better idea. So why, why does it matter? Well, the first and second half of the cycle, we're just gonna put in those two categories to keep it simple. So the follicular phase, day one is the first day of bleeding. Two, about day 15, which is ovulation. And then the luteal phase, which is ovulation two up until when you bleed again.
So basically days one through 14 is follicular. End days, 14 or 15 through 28 is luteal phase and the follicular phase, that first half, we're gonna hone in on that. That is when your estradiol is more dominant. So estradiol is what basically is pretty erratic during perimenopause, up and down. It can be, but basically it is declining with like these random.
Spikes that we get based on, um, the response to the follicles that are getting lesser and lesser and less robust and less healthy. Um, and then when you hit menopause, your estradiol is flatlined. Okay. With sometimes the caveat is, um, you can get some estrogen from aromatization of fat, so sometimes you will still have that estradiol, but for the main part, your ovaries are not making anymore.
Right. And then progesterone is more predominant in the luteal phase, and that one just goes down. It's like a. Sled hill that goes down as opposed to estradiol, which is more of a roller coaster. Um, progesterone is just going down. So a lot of the things we see is that there's more of this estrogen dominance kind of picture that is going on.
So more cramps, heavier cycles, those kind of things happen. More PMS symptoms. So what we wanna do is we want to control our stress through diet, exercise, and how we live from day to day. And keep that progesterone robust as we can and keep it equal and as even as we can in the perimenopause phase. So this is where cycle sinking.
We're gonna be working with our hormones instead of against them. And kind of like what you said, Julie, we're not gonna be doing the same thing every day because our hormones aren't the same every day. And you, you can even look at some of the big names, um, in the keto world that were like strict ketogenesis 24 7, 365 days a year.
They're now going back and saying, oh no, we need refeeding. Yeah, we need this other thing. And it kind of goes back with like. How food was available and stuff, right. When we didn't, when we didn't have refrigerators, which I had to just get a new refrigerator day. And Julie was so gracious with her time because they came right when the podcast was supposed to start.
So thank you for that called life. Yeah. Well, and that's the thing. I try, I'm entering my luteal phase, so I'm like, I'm not gonna get stressed about this. It's gonna work. And if we have to reschedule, I'm not gonna get right. Mad about that. Right. So, um, so follicular phase. Okay. Estrogen estradiol is predominant.
We are more resistant to stress. So stress, um, is anything that impacts our, our cortisol. So this could be big fluctuations in blood glucose. This could be doing a sauna or an ice bath or different hormetic or ESIS effects. Um, this could be our workout. So we are more resistant to stress, so that means that.
When our estradiol is, is more predominant in this follicular phase for working out, let's say we can go harder. This is where you wanna do HIIT workouts. High intestinal intensity interval training. This is where you'd wanna lift really heavy, like really increase your max weights. You know, when you're doing your weight lifting.
This is when you can also do like sprints. This is when I run my sprints. You can always tell, my kids can always tell when I'm in my follicular face, they hear me on that treadmill. Uhhuh running my sprint intervals. Yes, yes. We're actually less likely to get. Hurt in the follicular phase, they did a study on football players in England, so soccer players, professional soccer players, and they had more injury during that second half of that luteal phase of their cycle.
And, and I've seen this in my practice too. I had a younger woman tear their ACL plane soccer and I'm like, Hey, by chance, were you in the luteal phase? And they're like, yes. And I'm like, makes sense. Um, so that follicular phase that is when. Train hard, lift weights, push it in the gym. Do your sprints to get your VO two max up.
All the things okay, so you can really push yourself 'cause you're more stress resistant. This also goes with fasting. So you brought up, you know, some people are just very, you know, I'm only going to eat this. I'm only gonna do this. Well, I've seen this time and time again with women. You, well, you know what happens?
Like we go on in the Instagram, the TikTok, the, yeah, we go on the social media. And everyone's like, I'm fasting and intermittent fasting. I lost 50 pounds, whatever. And they probably didn't, they were probably doing other stuff, but, right. Um, yeah, because, you know, it's all fake. Instagram's all fake. Um, so for most of it, but we want to realize that this doesn't work for everyone, and this could stress out your body.
So if you are doing fasting, we want to do it in the follicular phase because we don't wanna stress the body out and your body can handle. More fasting in that phase. Okay. Now it's interesting though 'cause we're actually more insulin. Sensitive during that follicular phase. Okay. So we actually process carbs and stuff better, but I treating perimenopausal women know that we care more about stress because this class of women, we are so stressed out.
Like ages? Yeah. Mid thirties to mid fifties. You know, anywhere in between that. Yeah. Depending on your genetics can. Can be perimenopause. I mean, these women are just super stressed. Like, even if, you know, and I think the crazy thing was when I was in northwest Ohio, I was treating people in my community versus now, and I'm, I'm virtual, I can see whoever, wherever.
Yeah. But it was, I, these women would come to me and I'm like, I thought they had it. All together, like everything was perfect on their social media and they're so stressed out, like, so stressed out. I have so much going on and I'm like, wow. Like they are stressed and they're hiding it. Not hiding it, but you know, putting on a good front.
Yeah. Which is stressful too. So I just know from seeing hundreds and hundreds of women that they are stressed out even if they say they're not or don't look like it. Right. So we don't want to intermittent fast. Every single day through our cycle, we want to do long fast for hormesis, for the autophagy, for gut health, you know, to mix things up, but just keep it in that follicular phase.
And I've seen it with continuous glucose monitors. Um, I had a patient who was actually in menopause. And she was intermittent fascinating every day 'cause she wanted to lose weight and she felt fine doing it, but she gained weight and she came to me, I'm like, let's put on a continuous glucose monitor and see what's going on.
So she was getting a big. Glucose, which is insulin spike, stress spike in the morning, every single morning. So her body thinks she's stressed every morning when she's intermittent fasting. 'cause she's doing it every
Julie Howton: day.
Jennifer Pfleghaar: She's starving. Yeah. Yeah. She's doing it every day and then she's gaining weight.
'cause her body's like, Nope, I'm gonna gotta keep it. Yeah, yeah, yeah. So she just from eating a healthy breakfast and being more consistent, lost weight, you know, like increasing your calories. I love that you said that.
Julie Howton: I see that all the time. Yes. Starving yourself. She at least felt well. Or I have women that are like, you know, I know I need to be doing this, and I, and it, you know, I, I'm gonna do it and, but I don't feel well, and I'm like, whoa.
Pushing through it. Yes.
Jennifer Pfleghaar: Yes. If it, well,
Julie Howton: I see this with training and what worked a few years ago may not work now. Like, right. Yes, yes. We're always evolving and changing and, and, yes. Um, yeah. Well, and
Jennifer Pfleghaar: that's a great point. In perimenopause, I'll have women come and they're like. I did the things I always did.
You know, when I would gain weight, I would do some HIIT workouts. I would go extremely low calorie, low carb, you know, they would do all these things. They're like, and it's not budging. And I'm like, well, cortisol. So if you're already more stressed because the season of life you're in, you're stressed because you're hormones are changing, then you are going to hold onto that weight more.
And no, we have to lean into our cycle. So another like. Cushion that women in perimenopause and menopause can kind of put as a buffer for eating and whatnot is weightlifting and gaining muscle mass. And I, I started, so Emory just turned six. So when, like six years ago is when I, like, I weight lifted before, but I, like now I go where the boys go, where the men go, you know?
And I, I really lift heavy now and it is such a nice buffer because you can really just. Eat a bunch of calories for a couple days and like your, your muscle eats up that glucose, right? So it's, it's a good buffer. If you're like listening, you're like, well, I have tried everything. Have you tried lifting really heavy and also giving the body the protein and amino acids to build muscle.
And lift heavy. But don't start, don't start it in your luteal phase. If you're still cycling, start a new workout in your follicular phase. Start a new, you know, lifestyle eating. I don't wanna call it a diet, but if you wanna add more protein or, or try carnivore, you know, that's really trendy, carnivore. Do it during the follicular phase, you know, so they'll do carnivore during the first two weeks and then maybe the next two weeks, you know, add in more fat, add in more like healthier carbs.
So there's a way to work with your body and also not have shame and guilt is a big thing, I feel like. Yeah. You know, like, oh, I messed up. And it's like, no, your body's okay. Um, so then the, the luteal phase I've been kind of alluding to this, is when our body shifts. So we have, progesterone is more predominant here.
Now remember, sometimes during the perimenopause we feel more estrogen dominant here 'cause we had that. Slow, like declining progesterone, right? And then if we have problems with our estradiol, how we're metabolizing it in our gut or in our liver, or we're doing things like drinking a lot of alcohol, so we're not metabolizing our, our estrogen, while like a lot of things can foggy, make this more foggy plus stress can deplete our progesterone.
So we, it just feels more exaggerated. Women start having shorter cycles. They start having anxiety palpitations. So it's all these symptoms that they, they've never had PMS before. They have it now. They have heavy periods. This is all because of those hormone changes. Yeah. So what we can do is protect the progesterone from keeping, you know, our, keeping progesterone progesterone instead of going down that hormone cascade to cortisol, calm, calm down our body.
So we're not giving it stress. It doesn't need during that luteal phase. 'cause keep in mind, so. From a reproductive standpoint, our luteal phase is when you know the egg was released. The sperm is hooking up with egg and the body's preparing for a baby. So this is not when we would That's gentle. Yes. Time.
We're not going to orange theory and like working, like running. We're not running from a bear. If we're running from a bear or stressing out our body, like our body is gonna be like. I am not reproducing, like I'm not Right and not important right now.
Julie Howton: Yeah, yeah,
Jennifer Pfleghaar: yeah. So, so that luteal phase, this is not, you know, I tell patients if they're starting, you know, if we're doing something for gut health, like, hey, like let's do a week of carnivore and see how you do with that, or, or like, Hey, you wanna burn a little more fat?
Let's do a 36 hour fast. We're saving that for that first half of the cycle. Yeah. So the luteal phase. Just like be gentle with yourself here. Yeah. Like this is the phase. It's so funny because once you start really leaning into the cycle and the rhythm and listening to your body, you will eat more calories in your luteal phase because your body will want it.
Yeah. And, and I'm not talking about binging on crumble cookies or something, which no one should be eating. Is that even food?
Julie Howton: No. It's funny you said I, I, it, my brain went to like Twinkies, which I think we can all agree. Isn't food crumble cookies just as bad as they're just prettier.
Jennifer Pfleghaar: I feel like crumble cookies are the new Twinkies from the one.
They are.
Julie Howton: They, they come every once in a while. There's, there's one that's not far from the clinic and their, you know, sales rep. Like they, what cookie company has a sale? Like they'll come and bring. A box of cookies and I'm like, do you, we're a functional medicine clinic. We don't want, they probably
Jennifer Pfleghaar: work
Julie Howton: for
Jennifer Pfleghaar: like a
Julie Howton: diabetes
Jennifer Pfleghaar: company or something.
Like a medication probably. They probably do. That's awesome. They're probably like, Hey, like if we can't get the patients, let's get the workers there anyways. That's awful. But, but yeah, we're not talking about like eating that kind of stuff. 'cause if you're craving No. Sweet
Julie Howton: potatoes and butternut squash.
Jennifer Pfleghaar: Yeah. Good real food. Yes. Yes. But maybe some,
Julie Howton: a little more carby or like some
Jennifer Pfleghaar: tallow fried something, you know, like Yeah, like we can, but, but this is the thing like, oh, you know, actually what I really like, so. Um, my kids always know, 'cause I'm like, let's make popcorn, you know, after dinner. And because I've tested popcorn with a continuous glucose monitor, I do really good with it.
Okay. Um, so we put like extra grass fed butter Redmond, salt pluck seasoning, which is like organ meat. Meat, yeah. Oh yeah. Yeah, yeah. Yeah. It's so, it's
Julie Howton: so
Jennifer Pfleghaar: good. I that and I trusted it.
Julie Howton: Do that with pop sorghum 'cause I can't do the corn.
Jennifer Pfleghaar: Oh. Oh yeah. Sometimes I do well with corn, which is surprising. Yeah, yeah.
Well, which is great. Good for you. Yeah. Well you'll have to send me that other recipe though. That's interesting. Pop
Julie Howton: sorghum. It's stuff. But it's cute that 'cause your family is keyed in onto Yeah, well
Jennifer Pfleghaar: it was even so funny. And, and even just more calories, even more protein. I was visiting my parents like when they were down in Key West and I'm just like, I need more protein.
My dad's like, you're eating a lot. And I'm like, yes. I'm in luteal phase. And it's not like we're gaining 20 pounds from eating a more, for me it's like a couple days. It's actually I'm coming up on it now, which is great. 'cause like my husband and I are going, um, to the Hack Your Health conference for a couple days, so I'm like, I'm going to eat all the meat.
All the things.
Julie Howton: Yeah. Yeah.
Jennifer Pfleghaar: And it's like my, it's. Sometimes it can get outta control. Sometimes I'm like, oh, it's a birthday and sometimes it will get, you have to reign it in. You do have to be conscious, but I love that
Julie Howton: you said, I wanna highlight that though, because people think. Because of what we do for a living that like, oh, perfect.
Yeah. You know, it's, even though all I do is work with them on, like dumping that perfectionism. Yes. Right. Um, but it, it's like we still, the, I remember like the first time, instead of making like. Keto Paleo Thanksgiving. You know, I just shifted to a Paleo Thanksgiving and it was such a great experience for me because just from having some of the, well, it was delicious, but just from having some of the, the, I made them, I know they were clean, you know, desserts.
It was enough to like, it woke up my sugar dragon. And like, you know, so we, we still have to course correct sometimes and just catch Oh yeah. The like, okay. You know? Yeah. Um, it was, it was funny. Still human.
Jennifer Pfleghaar: Yeah. We are, it was funny, we were at like a, I was at a church retreat and someone to the fire they brought, have you ever had, it's like peanuts plus candy, corn, and it tastes like, like a payday.
Oh, it's like, no, but it's just peanuts and candy. Now if it was dye-free candy, corn, no fructose corn, that would be better. But this was probably bad. Well, and not made with
Julie Howton: corn syrup. And yeah,
Jennifer Pfleghaar: I mean it was bad. We knew it was bad, but I wasn't drinking alcohol. 'cause alcohol is bad on the liver too. But I, we were just at the campfire.
Yeah. And my friend who, who I've only known since February, since we met there, but she looks at me, she's like, Jenny, are you okay? You're eating like a lot of that, like are you going down the rails? They were like, worried about me. Do we need an intervention? Wish she was, she was like, and I'm like, no. I'm like, I, I'm just like, I'm luteal.
Like, I think it was on my period, so it was like the right end of it, and I'm just like, I just like want this right now. Yeah. But, and tomorrow's is a new day? Yes. Like. We, you can, and like even my daughter sometimes I'm like, oh, I'm a little off track. Like we can all get there and we, we have to have friends or family that's like, hey, like get back on track.
And what that might mean is when you go to your next follicular phase, if you're cycling still, then you do a 24 hour fast or you do like right now. Right. I'm just on, um, ketones. 'cause I like to just be on ketones. And, um, me too, I acid when I'm doing podcasts. Yeah. I just wanna be sharp. Yeah. I feel, exactly.
Yeah. It's just like that clear ketone brain. And I do that when I see patients all day. I'm usually in ketosis just for my brain. Right. So I can be very focused with them, but, but that's the thing. We, we can't be like, like so bent on the rules that like, it's stressing us out. Right. So back to the luteal phase, like.
You're going to eat calories. Your body is actually demands more calories during this part. You are more like insulin resistant. You, which, you know, you're like, you're adding carbs when you're insulin resistant. Yeah. That's just how your, your cycle is. But we wanna balance that with the stress aspect. So if, if it was different, if we had a 24 hour, you know, hormones, that would be different.
But like the cortisol is just such a big problem with women. I'm constantly telling them to activate their parasympathetic system. You know, like, you're gonna have stress, but how are you managing it? You know, are you praying? Do you have peace? Like it's, it's like I don't want them to be stressed out by food.
During their luteal phase. So this is where it's like, you know, you're gonna reign it back in, in follicular phase because you're gonna be more able to do that. You are gonna, it's your body, it's just gonna gel with it as opposed to fighting it during the, the luteal phase. And, and this is what we see with continuous glucose monitors.
This is what we see in the data even. And, and we know that, you know, insulin does go up in the luteal phase. I mean, they're starting to. Actually study, um, you know, cycles and hormones and all of that. More in the data, but, but really it just makes sense intuitively too. Right. So, um, oh, to working out now.
So what do you do in the luteal phase? Yeah. What do
Julie Howton: you recommend? Obviously we know not hit right? Not necessarily lifting your heaviest, right. So what's that balance look like? Still
Jennifer Pfleghaar: weight lifting? Still the same amount. I knew you were gonna say it. Yes. Still weightlifting, but I mean, you are not gonna be as into it.
Like you're gonna be like, oh, I have to weightlift. So do a shorter session, do lighter weights with more reps. I, you could even do the same weights like I did, um, you know, shoulder presses and I still used 20 on each side, but I wasn't gonna say, oh, I'm gonna go to, I'm gonna burn out at 25. I'm gonna increase my, no.
'cause I don't, I have this right shoulder that tweaks every once in a while because I overdo it in my luteal face. So, right. You need to just. Be aware, you know, still do squats, but don't do as much weight. You know, you're not gonna earn a medal. Okay? So just chill out a little. And then mobility exercises.
This is when you can walk at an incline, walk with a weight vest, you know, just listen to your body. Do not do your sprints. Like there's, we don't wanna get hurt, we're not gonna mess around here. Especially as we're aging. We just don't want that. So, um, yeah. So just make sure you're lifting your body but still lifting weights.
'cause remember, lifting weights and muscle, we need to preserve the muscle. We have, we lose one to 2% of our muscle mass after age 40. And this is really where sarcopenia and aging happens. Yeah. Is, is losing that muscle. And this is where. Also, you know, the use of the GLP ones used incorrectly, right? You know, the semi glut tirzepatide, so many women are losing muscle right now.
Yeah. I am terrified in five to 10 years because they're all gonna be breaking their bones like well,
Julie Howton: and add to it. You know, the other beautiful thing about putting on muscle is supporting metabolism and blood sugar regulation, right? Mm-hmm. So the, the people that are using the GLP ones incorrectly and not.
Watching muscle and, and intentionally building muscle. Right. That rebound. I mean, most women are familiar with yo-yo dieting. Like the rebound after something like that is gonna be way worse than Yeah. 'cause now your metabolism's even slower. You've lost muscle. It's, it's gonna be bad. It, it's, yeah. It is, and I know you're a Peptide fan.
I'm a peptide fan. Like they're love that they're, it's just that it needs to be done intentionally and and carefully and people need the education and, and the monitoring. It's not, yeah, I just had that conversation with somebody yesterday. It's like, yeah, you know, some people are using, you know, they're going to like.
The, the, uh, whatever, a med spa, uh, 'cause they can get their GLP one there and, but, and they're still eating crap and they're still not exercising. They're just eating only a little bit. Um, yeah.
Jennifer Pfleghaar: I think a good word for hormones and peptides right now is just sketchy. It's very sketchy. It's very sketchy out there.
Yeah. And my mentor, Pam Smith was just, she's like the goat of Dr. Smith's like the goat of hormones, but she's not on like social media and stuff. Yeah. Like, and I'm like, I'm like, I feel like I need to just do this so people don't. Right.
Julie Howton: That's my husband. He is been doing it for 20 years, but. He's in the clinic.
He's not on social media either.
Jennifer Pfleghaar: Yes. Okay. And that's, yes, that's the thing. Like I might only see like patients two days a week, like since I had my last kid. 'cause I put it down to that. But like I am s. Still, like, we need time. You need time to see patients, to study, to read the studies, to still, yeah.
Learn, go to conferences. Mm-hmm. And be with colleagues. Now, a lot of the people that are the big faces or all the time, you know, they're, you see 'em on all the podcasts, they're writing books and you see 'em on all, they're not seeing, they're not practicing. Yeah. Mm-hmm. Mm-hmm. It's, it's, thank you for that.
That's, yes. Well, even like our surgeon in general is not. Seeing patients. Yeah. And like, and, and, and here's the other thing. If you see someone come out of nowhere, like nowhere, there's money behind that. Right. And I'm seeing that with the hormone stuff right now. I'm just sitting back and I'm like, Hmm, okay.
Yeah. Okay. Yeah, there's a lot of, so. You have to, you have to use discernment. I'm, I just joke, I'm from
Julie Howton: New Jersey. I'm skeptical always. Like I think it's okay to be good. It's, it's that versus naive, right? Like it's, it's good to, but it, it's back to what you do is empower people to take charge of their health and that's what we do.
And, and with that also is responsibility. Like we all need to be doing. Research and like you can't just trust somebody because they have a DO or an MD after their name. Mm-hmm. Yeah. You can't. Yeah, sadly. But I mean you, why? You know? Yeah. And I, again, I say this with love. I'm married to a do my God. Yeah.
You know? Well, but that
Jennifer Pfleghaar: I also, to, to your point, I also have a test. Okay. If you can't find someone's credential, so, so everyone likes to call themselves doctor expert. That's the new thank you. If you can't find their credentials within three seconds of looking at their website profile, whatever. Then they are probably not a real medical doctor.
And that's fine too, right? We, I love my physical therapist, I love my chiropractors, I love my PhDs, but they're hiding it and they're not being honest. So that's my three second rule. I like that. If you can't find it within three seconds of looking at a profile or website, they are not being honest with what kind of professional they are.
That would be like a lawyer or, I don't know. A mechanic like Sure. Because a Juris doctorate
Julie Howton: is still a doctorate.
Jennifer Pfleghaar: Oh, my dad would pull that one. Yeah. My dad's like, right, like my dad's like, you know, I'm a doctor. Right, right. Of jurisdiction because you know, if he was trying to get me to eat my vegetables or something, sure.
He would say that, and I'm like. Stop. Stop. Which by the fact, my family does not listen to any of my medical advice. They're not supposed
Julie Howton: to really, really, you know, our household is like, you know, it's a physician and a health coach. Yeah. So we're,
Jennifer Pfleghaar: that's probably, you know, that's probably fine. Yeah. Yeah.
What, what
Julie Howton: piece do you wanna ignore from whom? At what point, you know?
Jennifer Pfleghaar: Yeah. And that's, well, and that's the thing. That's why raising kids is so stressful, these perimenopausal women. I mean, I'm just like. Whew. Like, I'm not even stressed about the fridge or anything. I'm like, my teenage boy is like, whew. He is hard on, hard on us with like, you know, he's is, is is his job right now.
Like, that's, then we're trying to just pray, give him grace. Um, he's around. He's at an amazing. Um, homeschool hybrid. I mean, I'm, that's fantastic. I feel so blessed for that. But, but yeah, it is, um, it is the time where there is stress, so yeah. But that's, that's why I really do like the cycle sinking. And then for perimenopausal women.
You're not supposed to, like what we've been talking about. You're not supposed to do the same thing every day. You know, maybe you could do it with like the moon. You could pick, you know, every moon cycle. You know, you do a 24 hour fast or something like that. So you need to mix it up too and play around with your eating windows.
Make sure you are having times where you are just. Eating carbs and you know, it's this fast and famine and this or the feast or famine. And that's what they, yeah. Used to do. They used to have these big feasts but then not eat for a a couple days or Right. Not eat a lot. So we need to kind of go back to that and applying like a little bit of stress or hormesis like, like fasting and if you're perimenopausal, that is good at times.
I'll use this as an example. So I was a big fan of cold plunging. Mm-hmm. Big, big fan. Got me through some really like, like I was a little bit stressed, like minor stress, like really good for me. Um, when we moved, when we knew we were moving and it was very stressful. I, I just, I stopped. I stopped. I haven't cold plunged enough Stress.
Yeah. Yes. So it's like you can push it a little bit too much. So, um, just like if you're sick or have a fever, you're not gonna run a marathon. So. So you need to, to realize that hormesis is great and we need that for, to, to push our bodies at time. But if you're under a lot of stress, that could make things worse.
And then that could, you know, that can lead to autoimmune disease if we are pushing too hard. So I wanna actually get back into cold plunge and I need to get it set up. So, yeah,
Julie Howton: it's, but I love that, that you point that out because even that. We're talking about women and, and sinking, and that's important, but, but timing.
It, it's even for men. Like if they're lifting and trying to put on muscle, they need to time their cold plunge. Like, oh yeah, we need to understand the physiology of, of, yes. What we're doing. Yeah. We
Jennifer Pfleghaar: actually, yeah, we can talk about the data behind that. So cold plunging, um, when you don't wanna cold plunge right after like a big leg day or you're working out because that can actually affect putting on muscle.
So if you're gonna, if you're gonna have a muscle building day, then you're gonna have to cold plunge a couple hours apart from that. Right? So I think, I think that's also interesting because you know, you don't wanna be doing all that work. Um, response and then blunt the response response that you're going for
Julie Howton: response.
Yeah. Yeah. So I wanna underscore, and you said it and you said it, and I've heard you say, I know the answer to this, but I have to tee it up anyway. Mm-hmm. Who should be lifting weights?
Jennifer Pfleghaar: Oh, everyone. Every woman? Yes. Per, even younger. Because we're seeing so much PCOS and polycystic ovarian syndrome, which is a problem of, uh, it's a metabolic problem.
Okay. Yeah. Insulin resistance. So we're seeing so much insulin resistance and really aging. We just, every day, every day as we sit here, every minute we're getting more insulin resistance. It's part of aging and it, and it's that balance. And this is why Metformin used to be the original biohacking, the anti-aging drug.
Yeah. Yeah. 'cause it helps with the insulin resistance. And, I mean, we could go into mTOR and stuff like that 'cause it, it is a process of, you know, you need to build muscle plus. But that stimulates mTOR, which increases aging versus, you know, fasting, which decreases mTOR. But this is why you work with, you know, someone like us and you come up with a plan, and this is why we don't eat all day or workout all day to stimulate mTOR all day.
And this is why we can incorporate fasting during certain times of our cycle to reduce stress, but get the benefit. So it's, it's pretty beautiful and amazing how our bodies are made. So it is, and we work with it. And
Julie Howton: like if you take the step back and you listen to this conversation, it, it all, it comes back to how we were designed.
Mm-hmm. Right. And, and, and. Modern day times we live so differently than we did when we were feasting and then fasting. Right? Yeah. Unless we're being intentional. Um, and, and so it's the same thing working with the cycle. And yes, now we need to compensate. You know, when I was taking care of the horses on the farm and doing all the physical things like I did, I was lifting heavy things.
I was stacking hay bales. I was doing. The stuff right now that I'm at the clinic, I have to actually intentionally create different workouts because my days look different and it's the same. Yeah. It's like we need, we're living longer, we're living in a different kind of environment. We need to be intentional.
Jennifer Pfleghaar: Yeah. We
Julie Howton: really do. To protect through aging. Um. So do you have tips for, this has come up at some, you know, things like come up in patterns mm-hmm. Um, for women that are listening that are perimenopausal or, you know, just still cycling, but I've had a hysterectomy because those women tend to forget that they're still cycling.
Right. Because they mm-hmm. 'cause they're not bleeding. Yeah. Um, do you have any tips for how they can like. Track, tune in, pay attention, any any tricks for that?
Jennifer Pfleghaar: Yeah. So it, it'd probably be easier the later you get and, and perimenopause maybe. So with some of the like changes of, you know, maybe the pelvic floor feeling heavier, stuff like that, possibly.
But, um, you can still, because you're still cycling, you can still kind of feel it. Mm-hmm. So I'll have women kind of, um. Kind of like work around that. Like if they're like, oh yeah, like I'm really irritable right there. I'm like, okay, that's probably your luteal phase, so let's track.
Julie Howton: Yeah,
Jennifer Pfleghaar: track that and see.
You could also, um, you could do testing, you could do like saliva testing where you check it like within 30 days, you, you check it like every four days and stuff. There's lab companies out there that do that. You could also, um, even though we don't ovulate. Every time when we're in perimenopause, sometimes we skip and then, or sometimes we ovulate twice.
You could track your lh. Surge and then get a better idea and then just keep tracking it. Um, where your LH would be, like that's the trigger. Um, ovulation. So that's the, the strips that women wear when they're trying to get pregnant. So you could buy, you know, a hundred of those off Amazon and just track it that way.
But, but same thing. You would want to still cycle sink because it's
Julie Howton: important. That's why I, you know, 'cause the, and they might need to progesterone,
Jennifer Pfleghaar: yeah. Yeah. They might need progesterone support. So, I mean, that's happening. A lot of women that I see, I've seen, um, you know, a handful of women that they've come to me because they were told they needed a hysterectomy and then we got their estrogen and nap metabolism figured out and they, they were able to keep their uterus.
And, and that's another thing, it's, it's like a big pet peeve of mine that.
Julie Howton: Pull it out.
Jennifer Pfleghaar: I just don't under, yeah. I just don't understand why doctors think taking out organs fix the problem it doesn't. Gall bladder
Julie Howton: uterus. Yes. Yes. You don't need them. It's like the hormones
Jennifer Pfleghaar: I try to explain to women. I'm like, look like you had to have a hysterectomy.
That should be a red flag that we have to work on your estrogen metabolism because you still have breasts and like, we don't want an estrogen related cancer. You know, you right. Have an estrogen excess. You don't wanna
Julie Howton: take away parts as the problems. Surprise. Yeah. Deal with it. Well,
Jennifer Pfleghaar: and that's the same with if we look at all the fertility treatments and IVF, it's like, no, like you're not fixing, how about why?
That is there. Yeah. Yes. So yeah. Yeah. Oh yeah. And taking out gallbladders. I'm seeing that a lot with the GLP ones, with people losing Sure. So fast, so high dose, and then they need gallbladder surgery and I'm like, we are not doing this is, we're not doing it. Right.
Julie Howton: Yeah, no, definitely. I'll, I'll throw in one more little non-scientific tip for, for women, but I just, I just.
Women without a uterus to really realize that they're, this is still for them, this conversation. You don't need to have to buy feminine hygiene products to, to yeah. Tune into this conversation. Um, and I like the where you started, it would be where I would start too is the track it, like pay attention to patterns.
Mm-hmm. Because there's probably a pattern, even if, like you said, sometimes it's not totally consistent, um, but. For the women who have a teenage daughter living in the house. Mm-hmm. Those cycles tend to sink too. So where is she in her cycle? Does that line up with what you kind of think you're experiencing symptom wise?
It can be an easy cheat and there's so many different trackers you can use, um, yeah. That are free. Yeah. Or you could track
Jennifer Pfleghaar: your temperature if you have a wearable. Yeah. So that would be another thing, like an easy way I forgot to mention. So, yeah. Yeah, definitely. Make sure, 'cause you, you still have the hormones going on.
Your hormones are still being expressed in other tissues in your body. It's not just about the uterus. So, and have no shame that. You got your uterus out. It happened. It's done. So now, right. Let's move on and learn and, and get things better because yeah, it's very hard when women. You know, when they get that, the, uh, partial hysterectomy and they're just like, oh, everything's better.
But then they're still having all the bad symptoms and minus the bleeding and Yeah. And then sometimes they'll take out, do a total, and then I've seen this more times than not, they'll put women on estradiol but not progesterone. And I'm like. Oh my goodness. Unopposed, estrogen that, yeah. Well it's still, if you read the new FDA report, it's fine.
It's fine in there. As long as they don't have a uterus. And I'm like, oh yeah. 'cause we just don't need progesterone anymore for us or for any of our other in our brain. So it's, like I said, it's sketchy out there. It's the best word. It is. That might be, that might be my word of 2026. Sketchy. I'm just kidding.
That, that's, that's a negative word. Maybe it'll be shrewd. We need to be
Julie Howton: shrewd. Ooh. Well, and again, it comes down to youre, as a snake, the responsibility, and again, most a, a gearing at the physicians right now. Um, you know. I don't know of anybody who got into medicine for any other reason, but to help people.
Right, right. And so we have to understand the training. Like, and I, I just had this this week. Well, my God, you know, and my gynecologist. Said this and, and I'm like, oh, your gynecologist probably doesn't know a lot about hormones. Sorry. Like it's rare. Um, so we need to take the time to do our homework and find the right people to support us.
Right. Um, and get, get Jen's book, read it So that, but that's the thing. I think the, the difference there it is. It's so beautiful. The PerMon Menopause Reset. I love the colors and the, um, but that's. It all comes down to us. Right? So we need to read, we need to learn, we need to research. Yeah. And then when we need support, find the the right person.
Um, yeah, absolutely. Yeah. So we're at the point where listeners are leaning in 'cause you've already given us so much amazing gold. But what is one step that listeners can take starting today to support their health?
Jennifer Pfleghaar: Yeah, I would say make sure you're spending time in the parasympathetic state, so breath work, meditation, prayer, so that, that is throughout the cycle, so really not just
Julie Howton: for half.
Yeah.
Jennifer Pfleghaar: Yeah. And, and like we were talking about earlier, like. You know, I go out and I take care of the animals and give them feed and get that early morning sunlight and just ground basically, and be in nature. So just make sure that you're spending that time and not making excuses for, to not do it because it just, it will, it will catch up with you for sure.
Amazing.
Julie Howton: Ah, Jen, thank you so very much. Where can people find you if they're like, oh my gosh, she is amazing. I know because. If they're just looking for your name, they may not find you on in all the places. So what's the best place?
Jennifer Pfleghaar: Yeah, it's hard to spell. It's hard to spell. So you can go to Dr. Jen book, D-R-J-E-N book, or Healthy by Dr.
Jen. Those are my two websites. And then if you wanna hang out, I'm on Instagram. Integrative, doctor, mom, integrative, Dr. Mom. And I also have a YouTube that I'm trying to put longer videos in there and, and I'm just putting up videos of the farm too 'cause it's kind ridiculous that we're trying to do this.
Lots of funny stories with that, but, but yeah. Um, I am, I'm here. I do see patients virtually and the book is really just something that, um, I, I pray everybody needs women. Yeah. My goal is to help like. 500,000 women because there, there's like 7 million women in perimenopause. So we gotta help that. Just think of, because they're struggling.
Think
Julie Howton: the world would be a better place too. Like it, yeah. We could, we'd
Jennifer Pfleghaar: be more balanced if
Julie Howton: we could get the perimenopausal women out of that constant stress state.
Jennifer Pfleghaar: Yeah.
Julie Howton: Just think of that trickle down. It would be amazing. Yes.
Jennifer Pfleghaar: Yes. Yeah. I mean, and really we should shine in perimenopause. Yes. It, it should be, I have more energy now than I did in my twenties.
Like yeah, we should, we know more. We're wise, so yeah, get wisdom and, and feel good. So
Julie Howton: I love it. Jen, thank you so much. I so appreciate the time. I'm glad that we were able to, to make it all work. Yes, thank you. And, and I look forward to hopefully having you back in the future.
Jennifer Pfleghaar: Sounds great. Thank you so much, Julie.
Have a good day.
Julie Howton: You
Jennifer Pfleghaar: as
well.
Julie Howton: For everyone listening, remember, you can get the transcripts and show notes by Visiting Inspired Living Show. I hope you had a great time and enjoyed this episode as much as I did. I'll see you next week.
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Jennifer Pfleghaar
Dr. Jen Pfleghaar is a double board-certified physician in Emergency and Integrative Medicine. She earned her medical degree from Lake Erie College of Osteopathic Medicine, completed residency at St. Vincent’s Mercy Hospital, and fellowship at the Andrew Weil Center for Integrative Medicine. She believes true wellness thrives when body, mind, and spirit are aligned with God’s design.
Diagnosed with Hashimoto’s, she became passionate about autoimmune healing, hormone balance, and root-cause medicine. Dr. Jen co-authored Eat. Sleep. Move. Breathe., serves on the boards of the Invisible Disabilities Association and American Board of Integrative Medicine.
Through her practice, Healthy by Dr. Jen, she provides virtual care and shares education as @integrativedrmom. She lives on a mini farm in Tennessee with her husband and four children. She loves cheering at her kids’ games, lifting weights, reading Scripture, and tending to her chickens.
Her newest book, The Perimenopause Reset, was writt
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