201 The Hormone Revolution We Should’ve Had Decades Ago with Dr. Lara Briden

In this episode, Sally sits down with Dr. Lara Briden, naturopathic doctor and bestselling author of Period Repair Manual, Hormone Repair Manual, and Metabolism Repair for Women. She’s been called the period revolutionary—and after this conversation, you’ll understand exactly why.

We talk about the massive paradox in women’s health:
Society suddenly worships estrogen and progesterone when women hit their mid-40s…
…yet spent the last 60 years casually switching those same hormones off in teenage girls.

Yep. We’re going there.

What We Get Into

• Why regular ovulation is not just “nice to have” — it’s literally how young women make hormones
• How we got stuck in a 60-year loop of shutting down women’s ovarian function (hint: the pill’s “regulate your period” pitch started as a cover story)
• The weird disconnect between medical guidelines that say periods are a vital sign… and the normalization of medicating them away
• What a healthy period actually looks like (spoiler: it shouldn’t hurt and it shouldn’t require you to white-knuckle your way through PMS)
• Why so many modern symptoms aren’t “women being women”—they’re the result of environment, lifestyle, and a system that never prioritized female physiology
• And the big one: Did menopause evolve? Or is it some biological glitch because women are living longer?

The Mic-Drop Moments

• Lara breaks down why menopause absolutely evolved on purpose—and why humans are more like killer whales than we think
• The “grandmother effect” and why older women have always been essential for the survival of the tribe
• The wild fact that among the Hadza, and other traditional-living communities, menopause brings zero symptoms
• The reality that our cycles are meant to be signals, not punishments

If You’ve Ever Thought…

“I guess this is just how my period is.”
“This is normal for my age.”
“Maybe my hormones just hate me.”

…this episode might flip your worldview upside down (in a good way).

About Dr. Lara Briden

Lara practices in Christchurch, New Zealand, helping women navigate PCOS, PMS, endometriosis, perimenopause, and other hormone-health challenges. Her work bridges biology, history, anthropology, and real-world clinical wisdom.

📲 Connect with Lara:  

Website: https://www.larabriden.com/ 

Instagram: https://www.instagram.com/larabriden/

Sally's Links:

Email: info@sallygarozzo.com 

[Free Guide] Healing The Trauma Underlying Your Menopause Symptom Severity: https://www.sallygarozzo.com/healingtraumatheguide

[On-Demand Masterclass] How To Heal The Trauma Underlying Your Menopause Symptom Severity [£17]: https://www.sallygarozzo.com/healingtrauma

[On-Demand Workshop] Redefine Your Values at Menopause and Live Life in Alignment With Them [£27]: https://www.sallygarozzo.com/redefine 

[Online Practitioners Diploma - Self Paced] Menopause Wellbeing Practitioner [£127]: https://www.sallygarozzo.com/meno

[One to One] Bespoke Transformational Hypnotherapy & Coaching:

Transcript

Sally (00:01.24)
So my guest today is Lara Brydon. Lara is a naturopathic doctor and the bestselling author of the period repair manual.

hormone repair manual and metabolism repair for women. She currently has consulting rooms in Christchurch, New Zealand, where she treats women with PCOS, PMS, endometriosis, perimenopause, and many other hormone and period related problems. So Lara, welcome to the podcast today. How are you?

Lara Briden (00:50.247)
Yeah, good Sally, thanks for having me. You and I are on opposite sides of the world, opposite seasons, opposite times of day.

Sally (00:55.854)
Yeah, yeah, we definitely are. So you're in New Zealand, I'm in Brighton in the UK, and we're so, so lucky to have you on the podcast today because you have such a wealth of knowledge. You've been called the period revolutionary. So thinking about those revolutionary terms, if you could rewrite how society thinks about women's hormones from the ground up, where would you start?

Lara Briden (01:26.025)
It's very simple. And some of my key messages, I would start with a society that would value women's hormones in the sense that would value regular ovulation in young women, because that's how young women make hormones. As young women, there's really only two ways to make hormones, either regular ovulation or pregnancy. And some women have both, some women don't have pregnancies, and that's fine. But fortunately, we've got this monthly cycle that's another good way to make hormones. And as you know, I this is a topic for maybe another

day, but we've come through what I call the era of contraceptive medication where we basically had about 60, feels like forever, but it's really about 60 years, three generations of routinely switching off the hormones of young women. And one thing I'll just say is it leads into the perimenopause discussion. As you know, there's lots of excitement about our hormones, estradiol and progesterone and how beneficial they are for bones and brain and all these things.

But it just leaves me scratching my head because I'm like, why are these hormones suddenly important at age 45 when for all of, you know, girls, teen years and twenties and thirties, they can just be routinely switched off as if they don't matter at all. So that's the weird, it's actually quite a paradox. It's quite a strange phenomenon. Yeah.

Sally (02:35.598)
you

Sally (02:41.078)
It is a strange paradox, yeah, and you pointing it out has actually made me think very differently. So why do you think that is? Why don't we as a society value women's hormones? Why do we think they're problematic?

Lara Briden (02:51.463)
Well, of course, I mean, so much, I'm a bit of a history buff. mean, I love my, my recreation is the history podcast. I was just talking to someone who was asking me like, which health podcast do you listen to? was like, I mainly listen to history podcast, but I do like to think about, the history of medicine. So many things in medicine that we just take as truths started somewhere, right? Like there was sort of a

Sally (03:04.663)
That's fascinating.

Lara Briden (03:17.449)
something that led to that. I mean, when it comes to women's health, obviously, the pill was invented for avoiding pregnancy. because that was not legal at the time in the 50s and 60s, they had to be like, wink, wink, air quotes. It's, you know, it's to regulate your period. it's not to it's not for pregnancy is to regulate your period to normalize your period. And then somehow that cover story

which nobody believed at the time. I mean, it was just a cover story, but it just kind of became this narrative that got deeply embedded and entrenched. And there's been a lot of wishful thinking for about 60 or 70 years that it's going to be fine. You know, we can switch off women's ovarian function. We can replace back these medications that are kind of like estradiol and progesterone, but actually not really at all.

And we're just gonna hope for the best and hope that's gonna be good enough for them. And that's kind of where we're at. And it's, the spell is breaking now, I think. We're, yeah, a lot of young women are just kind of suddenly going, I'm not doing that. I'm not doing that anymore. So yeah.

Sally (04:20.525)
Yeah.

Sally (04:27.278)
No, no thanks to people like you who have a very clear and strong voice in the world. yeah, that's really great actually. That's really highlighted a few things. So thank you for sharing that. So you've often said that periods are a vital sign, like blood pressure, for example. So can you unpack that a little bit more?

Lara Briden (04:41.575)
Mm-hmm.

Lara Briden (04:50.877)
Yeah. So it's interesting because it's not some, that's not mine actually. I mean, I agree. In my book, in period of perimmonial alcohol periods, our monthly report card, that was kind of my terminology. Periods as a vital sign actually came from medicine. So it came from, I'm not sure who originally maybe first said it, but in 2016, there was a pretty radical, I think it was 2016.

Sally (05:01.153)
Okay.

Lara Briden (05:15.463)
was a pretty radical statement released by the ACOG, the American College of Gynecologists and Obstetricians saying, yeah, menstruation is a vital sign in the sense that it's an indicator of health. And it's a pretty radical statement. they say doctors should ask young women, specifically girls, about their periods and advise them to chart their periods to learn about their health. And of course, by, I mean, just to spell it out,

Sally (05:25.217)
Okay.

Lara Briden (05:43.102)
By periods, that means natural menstrual cycles. Like there is no zero point in tracking or charting a pill induced bleed. So, I mean, they are talking about natural menstrual cycles. So again, it's a bit of a disconnect. So on the one hand, the official gynecologist association is saying menstrual cycles are a vital sign of health. You know, track them. On other side, it's like, just, but also you can just shut it all down. Hormonal birth control. don't want to keep coming back to that, but.

A very close colleague of mine, Professor Jerelyn Pryor, also has a great way of phrasing it. She says, a menstrual cycle, an ovulatory menstrual cycle, like a natural menstrual cycle, is both an indicator and a creator of good health. So indicator as in it's a barometer of health, you can only ovulate regularly if you're healthy in every way, and creator of health because it's how we make hormones.

Sally (06:36.01)
Okay, yeah, so it's both and. So what should we be looking for then for a healthy period?

Lara Briden (06:37.415)
Yep. Yep.

Lara Briden (06:45.013)
yeah, so, okay. So first of all, it doesn't have to be every 28 days. mean, that's a, that's actually not helpful to, for women to have this sort of rigid sense that it has to be that tight in a healthy menstrual cycle does vary, a reasonable amount, from one to one and across, across ages too. typically, teenagers will have longer cycles just cause that's, it takes longer for the brain to communicate with the ovaries. That's just a slower process.

in perimenopause, which is I know is our topic, the cycle will shorten classically. And that's because the FSH, the pituitary is screaming at the ovaries. And they pump it out like this, we're going to talk about this later. in that shortened cycle, they pump out a lot of estrogen. So that's so but back to your question of what should a normal during our reproductive years, should be, an advanced cycle should arrive.

approximately every 21 to 35 days for an adult and up to 45 days for a teenager. That's normal. And that defines what is likely to be an ovulatory cycle. But I'll just say, it's actually really helpful in something called body literacy to know, to track with temperatures and know if and when you ovulate. Because you can't assume, just because there's been a 28 day cycle, you can't assume that was an ovulatory cycle. You can't assume ovulation happened. So then the other parameters of a healthy menstrual cycle would be

no more than seven days of bleeding with the period and not more than, don't lose more than 18 milliliters of menstrual fluid, which is about five tablespoons. It's kind of in a maximum acceptable amount over all this, like spread over all the days, which is actually, if you think about it, not that much. And then other parameter, another parameter would be my other parameter, cause my, I have set the bar quite high for menstrual health, but it shouldn't be painful.

And it shouldn't have significant distressing premenstrual symptoms. There's nothing about menstruation or the menstrual cycle, that homoerotic cycle that should be inherently symptomatic. That's true for perimenopause as well. there's no, neither of those things are, should be inherently symptomatic. I know they often are, and that's not women's fault. That's not what I'm saying at all, like contributing factors to that. But our biology is such that those should be symptomless.

Sally (09:07.926)
Mmm. Yeah, there's a huge disparity, there, between what women actually experience and what could be the norm for them if they understood things differently.

Lara Briden (09:08.105)
processes.

Lara Briden (09:14.386)
Yes.

Lara Briden (09:21.019)
Well, and again, it's not just them. Again, it's not just women not understanding or making mistakes. A lot of it's our the environment we're in, our food environment, our environment with toxins, various factors in our modern lifestyle. think that turn what should be a symptomless transition into symptoms. But we know it's not just speculation, right? Like we know from people around the world, especially people, women, modern day, the few women we have in the world who are still living a kind of a

Sally (09:38.145)
Yeah.

Lara Briden (09:49.962)
forager type existence would be that like the hadza in Tanzania would be an example. I was just in Tanzania actually. I didn't see any hadza when I was there, I saw the Maasai. But they, yeah, that's one example. There's a few places in the world where women live still quite a traditional lifestyle. And just to point out, in terms of that, they have menopause. make periods stop around 45, 50. They know that's gonna happen.

generally happy about it. They don't report any symptoms and then they keep living, you know, so we can talk about that when we get to like, you know, did menopause evolve? We can talk about that a bit more.

Sally (10:29.826)
Yeah, that was my, that's actually my next question actually. Is menopause just an accident of living too long? Okay, which is what some of the medical profession talk about. Or is it something nature actually designed for us?

Lara Briden (10:43.923)
Yeah.

Lara Briden (10:49.001)
Okay, so I can speak to this very clearly. because my former career prior to becoming a naturopathic doctor, I was an evolutionary biologist interested in sex differences. So I my interest in female physiology as the normal version of physiology goes way back and I can say, not just from like trading as a biologist, but like looking at more recent literature about scientific papers and an amazing book called The Slow Moon Climes, we can put that in the show notes.

Sally (10:56.558)
Wow, okay.

Sally (11:15.234)
Yeah.

Lara Briden (11:17.469)
I can pretty much say categorically that menopause evolved. is not an accident of living too long. It's not actually the way evolutionary biologists talk about it. It's not that we evolved to stop making babies at a certain age. It's possible that's hard-capped, that our ovaries can only keep going for so long. But what evolved and what was selected for in evolutionary terms was a post-reproductive lifespan.

two to three decades at least in our modern world, probably four decades. That's almost half your life, like a third anyway, post reproductive. And for a long time scientists were scratching their heads, like how is that a thing? That doesn't make any sense, because obviously evolution is about making babies. so what they do, the way they do it is they crunch the numbers on everything, right? Like they do the maths on different aspects of it. And it's pretty clear.

and from several lines of evidence including several lines of evidence but including I'll get observation of modern day forager people that we evolved to do this that is beneficial it's highly beneficial for to have older women in the in the human group in the family group like older in the hadza for example women in their 50s and 60s and even into their 70s gather more food

Sally (12:32.876)
Yeah, the tribe.

Lara Briden (12:41.349)
than any other demographic. Like they're just holding it all together basically. Like one of the quotes from one of the anthropologists is like what would the, what would the had to do without their old ladies? Like how would they even you know survive? So and this, you just know this intuitively. Like women, older women get a lot done and have a lot of wisdom and so the, in the Slum and Climb she basically, in that book I just referred to Susan Maturin, this, the

Sally (13:01.208)
That's true.

Lara Briden (13:10.697)
academic makes builds the case that I'll split this way, a longer human lifespan evolved or was selected for in both men and women, because of post reproductive women, basically, it's positive. So the long lived genes were selected for because women who live that long are so beneficial, which I just love. And it is a version of the grandmother hypothesis. But it doesn't matter if you're a grandmother or not, like I'm not personally a grandmother.

and won't be, and that's fine. Like you don't have to, it's not about that. We come from a long lineage of people for whom, you know, having women live into their seventies was, whenever possible, was actually very beneficial. And so we've inherited that. And if you want a little bit more quirky detail on that, because we can compare it to with orcas or killer whales, there's only a few species of whale who have this. And their life history is quite similar to ours. They live like the female.

the whales lived to about 80 and they stopped having babies at 50. Sounds quite similar. And in their family groups, and there's reason to suspect, to think this is probably true for early hominids or our ancestors as well, that it's quite detailed, it's interesting detail. In orcas anyway, the males, the adult males, the sons, stay with their mothers. And well, actually in...

Sally (14:16.792)
Yeah.

Lara Briden (14:37.745)
think in Orcas both the sons and the daughters stay with their mothers and the males go off and mate with you know other pods but and come back and I think in there's evidence to suggest like it I think in some apes and maybe you know speculate that in hominids the young females would leave and the males stay with their mothers and so what so I did read one paper where they said menopause evolves in like when you crunch the numbers menopause will evolve in a structure in a family structure where adult males stay with their mothers

Because at that point, she becomes any wisdom, the more babies her adult male son can father, you know, the better her genes are. So she kind of becomes vicariously male at that point, she kind of switches into like, I'm going to, you know, pass on my genes through him. And in Orcas, they, one of the things that matriarchs do, which I just, when I read this, it just made me laugh so much. They reduce, they stop their adult sons from fighting, basically. They try to think.

They reduce chance of injury and violence from, yeah, so they just, that's one of the things they do. also, yeah, they're good influence and they also show the way to food sources and things like that. So it's quite a powerful message when you think about that. that's, again, that's true for even those of us who don't have adult sons. It doesn't matter. It's still part of our lineage. yeah, we're meant to be wise old women and that's what we do best.

Sally (15:40.75)
So they're a good influence.

Sally (15:47.138)
Yeah.

Sally (16:01.422)
Yeah, yeah, we've, I definitely feel that and I see that in my mom as well how she's evolved and sort of really finding herself at the moment and I feel like, oh yeah, this is, this feels like a really strong part of my, my lifespan I'm going into. It feels liberated. It feels free. It's like, I'm actually really looking forward to these post-product, post-reproductive years, you know, I feel more grounded and stable. So I'm glad you verified that as a thing.

Lara Briden (16:07.613)
Yeah.

Lara Briden (16:14.003)
Yeah.

Sally (16:31.138)
So let's talk about the difference between perimenopause and menopause. Why does that matter? And how does it affect women's health choices?

Lara Briden (16:43.687)
Right. So there's a big, it's a big mess right now, which I'm sure you can, I mean, I'm sure if anyone on social media might feel like things have gone a little bit off the rails is, a lot of like debate to put it mildly, to put it mildly, it's a mess and it's a mess and part of the problem, and I don't know how to remedy this cause everyone's got their own version of what menopause means.

Sally (16:47.394)
Okay.

Sally (16:59.138)
There is a lot of debate. It's a mess. Yeah.

Lara Briden (17:12.777)
I don't just mean what it means spiritually or anything like that. I mean literally what the word is describing. in a lot of, and again, you're in the UK, so it's a bit different between UK and other parts, but it's kind of all a mishmash everywhere. so would you, what do you, I'm actually asking you, the word menopause to you, what is that describing? Which part of the process is that describing?

Sally (17:18.776)
Yeah.

Sally (17:41.551)
Well, to me, it's describing, I suppose I've got two definitions of menopause. I use it as a throwaway comment, like, just the fury of menopause. But I also think of it quite literally as in that moment where that year where you haven't had a period and that's it, you're in menopause, but then you're post-menopause. So really for me, it's actually, when I think about it, there's perimenopause and then there's post-menopause.

Lara Briden (17:46.29)
Yeah.

Lara Briden (17:58.217)
Sure.

Lara Briden (18:04.39)
Right.

Lara Briden (18:08.745)
Yeah, I know. So, it's nothing. Okay, so I'll explain. Right, so everyone's using the words differently, which is why, for anyone listening, if you've been confused, that's one of the reasons, one of several reasons. The terminology I use in my book, and came from Professor Jarlene Pryor, who I mentioned earlier, is reproductive endocrinologist. She's a hormone specialist. She's a scientist, she's a clinician, she's retired now, but still active, but semi-retired.

Sally (18:11.414)
Menopause is just like that.

Lara Briden (18:39.367)
And also, by the way, she's still publishing scientific research in her 80s and never took estrogen therapy. that's just something just a little, I'll just drop that there. Yeah. she, well, right. So she, her, she defines in her terminology, which is scientifically grounded, perimenopause is the transition phase. So perimenopause is

Sally (18:48.622)
You

mic drop moment.

Lara Briden (19:07.687)
all the years of transition, including up to the one year after the final period. And then she defines menopause as the life phase that begins one year after the final period. Now that's actually how epidemiologists define it as well. So if you hear people take on how many, know, hundreds of million of menopausal women there are in the world, they mean post-menopausal. Like they mean women who are in their 60s, 70s and 80s. mean, epidemiologists will call that menopause.

And so does Jerrolyn, and so do I. I mean, that's, but I know a lot of people would call that post-menopause. So already you can see where the confusion comes in. And then perimenopause, which is all the transition, a synonym for that, like literally means exactly the same thing is the menopause transition, which gets shortened to the menopause. So I've noticed in the UK, depending on who you're talking to, very strong in the UK, the menopause means perimenopause. Would you agree?

Sally (19:43.607)
I see.

Sally (20:05.558)
Yes, I see. see. Yeah, I would agree. Yeah.

Lara Briden (20:07.369)
100%. Like that. And so the reason this is so important, like is why I it's a big mess because I don't know we want words to use now. People are probably just sitting there like going, what? What do we even call it? The years of transition, whatever you're going to call that, is if you're going to have symptoms, that's when they happen for one thing. That's, that can be the neurologically symptomatic time early in those years.

Sally (20:22.349)
Yeah.

Lara Briden (20:37.287)
that's a time of estrogen that's higher than normal. We can talk more about that.

Sally (20:43.405)
Yeah.

Lara Briden (20:45.523)
higher than normal, like higher than the reproductive years, then after the, you know, in that one year, basically you're only making hormones when you're having periods. So, I mean, just to put it in perspective, right? I just, what I said at the beginning. So once you are having long gaps between periods, there's not much hormone around anymore. Like now you're, and to be fair, estrogen does not drop to zero. Let's point out, like it drops, it drops significantly, but we can adapt to that. We are as,

the kind of mammals we are, we're adapted to be healthy with that lower level of estrogen. But clearly post-menopause, or if you want to call it menopause, as Jerolyn does, all the decades that come after, estrogen is lower than in the reproductive year, substantially lower. So you've got high estrogen versus low estrogen. Like if you think about it, what are we even talking about here? Like we're comparing two

totally different things. We're conflating them with the same word a lot of the time. It's a mess. It's like a total mess.

Sally (21:47.031)
Yeah and also the same and also the same kind of treatment we're asking for the same treatment but it's not it's a completely different treatment isn't it if you're in perimenopause or early perimenopause to menopause or postmenopause yeah

Lara Briden (21:52.595)
Totally.

Lara Briden (21:57.29)
Yes.

Yes, yes, it's, it's, couldn't be more different. It's like you're actually treating the opposite things you're trying. So, mean, Jerilyn's very passionate about this. mean, she's books and I I talked about this in my book as well. She's published a number of clinical trials and scientific papers on this demonstrating the early years of ferrimenopause is a time of higher than normal estrogen. To be fair, during that time, you can get symptoms of

Sally (22:06.819)
meaning.

Lara Briden (22:29.177)
It's not just, it's not that you're just going to have symptoms only of high estrogen during those years, because it's going up and down with every single menstrual cycle. And the higher it goes, the farther it falls. And night sweats and hot flushes are triggered by the fall in estrogen, the drop, which can, if it's gone higher, it's going to come all the way down and it's a rough ride. So she feels, and I would agree actually that, especially in those early years, probably the best hormonal treatment is body identical progesterone or uterogestin.

Sally (22:35.342)
Mm-hmm.

Sally (22:59.16)
Yeah.

Lara Briden (23:00.017)
There can be a more nuanced role for oestrogen I think during the troughs and we can drill down into the details, but like I'll just say categorically as well that at least according to Jerelyn, oestrogen therapy cannot blunt or stabilize or stop oestrogen from spiking up as high as it does. It can't flatten it. It can kind of shelter women in the drops. So there's potentially a role for oestrogen therapy in those years, but

Sally (23:17.134)
Hmm.

Lara Briden (23:27.197)
I'll just give you a hint. I've had so many patients, because obviously hormone therapy has just become so popular. Like even just a few years ago, it would go in the other direction. I'd be the one to suggest saying to a patient, do you want, you considered maybe some hormone therapy might be helpful at this point? And kind of going in that direction. Now I get people coming to me, suddenly they're on it because they got panicked. They saw that we're all shriveling up and dying without it. And they're taking their panic, you know, taking more estrogen when they've already got it.

higher than normal levels. so I've experienced, I've had lots of stories lately from my patients. And I'll just say this, as soon as someone tells me, as soon as you say, or I've experienced the very first day that I took hormone therapy, or HRT, or whatever you want to call it, I slept like a teenager, if that's been the experience, that's progesterone. That's from the uterine. Oestrogen doesn't do that. I mean, I think oestrogen can over time,

help to regulate circadian rhythm and the nervous system. And I think, promote sleep in different ways, but the sedative tranquilizing effect from hormone therapy, that's progesterone. So if that's what you got out of hormone therapy and really wanted, you could have just taken the progesterone part. You didn't need the estrogen part. And I'm talking about body identical progesterone, not a progestin, not the pill. Yeah.

Sally (24:33.503)
Yeah.

Sally (24:39.764)
Yeah, yeah.

No, no, it's very sedative, isn't it? Can you have too much progesterone? Yeah. Yeah, yeah, that's what I mean. And what would the side effects of too much progesterone be for someone?

Lara Briden (24:50.875)
yeah. you can, you can take too much.

Lara Briden (24:59.256)
Yeah, well, I hope just because you have listeners right now, I guarantee people listening to us going like who had a bad experience with natural progesterone. So I'll just acknowledge I'll give a nod to them. So it's a nuanced progesterone of all the hormones actually, it's sort of the most like, enigmatic and nuanced. It's like once you get into progesterone, like all these little labyrinths and like different rooms, and it's quite a I mean, it's lots of different experiences with progesterone, but in general.

Sally (25:10.113)
Yeah.

Sally (25:26.487)
Yeah.

Lara Briden (25:27.727)
in general, it's quite tranquilizing, or especially orally, which is why women should take it at bedtime. If they try to take it during the day, they'll feel groggy and weird. And some women even properly taking it at bedtime can get like quite groggy and weird from it, even the next morning, maybe feeling even depressed from it the next morning, from its sedating effects. It's that sometimes for what it's worth, that that sometimes won't last. That might just be like the first night or two and then

Sally (25:32.442)
Mm-hmm.

Lara Briden (25:57.172)
body sort of adjust to it. Different reasons for that. had a recent social media post about progesterone. I was trying to explain some of the complexities and responses and nuances and someone left the best comment. I almost feel like grabbing it from my phone, but it was something like, who knew that being in perimenopause, you basically have to become a biochemist and a psychologist and like know all about GABA receptors and you know.

metabolism of hormones and there's a neuro-stering called allopregnanolone and like most of them don't want to know, don't want to know all that but we kind of have to. Sure, yes.

Sally (26:24.718)
Thank

Sally (26:32.812)
we have to, we have to learn about it. And actually it's quite empowering to be honest. And the more you learn, the more you digest, the more you're like, wow, this is what's happening. I mean, we've just had to because there hasn't been the mainstream help for us. So progesterone intolerance, this is something that I want to get into because progesterone is useful, right? But especially for the sedative effects and the calming effects, but we get...

Lara Briden (26:40.861)
Yeah. Yeah.

Lara Briden (26:46.129)
Yeah. Yeah.

Lara Briden (26:52.092)
Right.

Sally (26:59.298)
But some people are intolerant to natural progesterone. How so and what can we do about it?

Lara Briden (27:04.745)
This is the post, this is where I, so this is actually I do this social media post called, progesterone is both good and bad for mood. And this is the post where someone said, who knew you had to become a biochemist? Okay, so I don't want to spend too much time, like I'll just give a brief like bullet points on this topic and people can check out, we'll put my article in the show notes and they can explore that. But I mean, clearly we're not talking about the progestins in conventional HRT or.

Sally (27:06.796)
This is The Post.

Sally (27:21.356)
That's great.

in the show notes.

Lara Briden (27:33.202)
progestins and hormonal birth control because none of them, they're sometimes called progesterone, which is incorrect because progesterone is a specific medical term. It's not a generic term like estrogen. It's very specific. It describes a specific molecule. So any use of the word progesterone to describe a progesterone or progestin is just incorrect, actually. It would help a lot. You can tell, obviously, I care quite a bit about using the right words for things. It would help a lot if people use the word

Sally (27:46.829)
Yeah.

Sally (27:53.219)
Yeah.

Lara Briden (28:00.967)
So I don't, by people, mean scientists and doctors and journalists and everyone would use the word progesterone properly. And it would also help us if had some agreement on her menopause versus menopause. I think we're have to have like a summit, like an international summit where we're like, okay, we actually just need to decide on the terms that we're using because this, can go on, it cannot go on like this. But anyway, you can sort of make your guess about it and maybe do a.

publish a poll, it's like, should menopause, what should the word menopause actually describe? But I'll share it. If you want to make that poll, I'll share it. But so a lot of women react badly to progestins, like have a negative mood reaction or something to progestin. So that's separate issue. That's just completely different issue. So that doesn't come, it shouldn't come into this conversation at all. Then

Sally (28:30.966)
Yeah, I'm gonna do that.

Sally (28:45.272)
Yeah. Yeah.

Lara Briden (28:53.341)
You get the majority of women who just feel good on progesterone, especially orally, as said, it's quite tranquilizing. It actually helps to regulate the adrenal cortisol access, like a sort of system. So they'll find it better, easier to cope with stress and which also gives you, starts to give you a clue of why this, like why losing progesterone with perimenopause, because it's the first hormone we lose, why it causes neurological symptoms. But restoring, I mean, taking progesterone can help.

relieve those symptoms. And then yeah, you get some women who get a negative like paradoxical. So you get someone who gets kind of groggy and depressed from it, so sedating. So that's one kind of sensitivity you get. that just might be, it's just so much depends on their nervous system, right? So it depends on lots of different things. But I mean, you know a lot about the nervous system. So it's going to depend on because progesterone is what we're talking about here.

Progesterone, it interacts with various receptors in the body. So it interacts with progesterone receptors, like in the uterine lining, for example, in the breasts and all over the, every cell in the body has progesterone receptors. Also though, what I'm talking about now, this is what I mean about the biochemistry, progesterone also metabolizes in the body to a neuro steroid called allopregnanolone, people, there's no test at the end of this. It's like a neurotransmitter, but it's a hormone. It interacts with

GABA receptors. So GABA is the, as you know, calming neurotransmitter, Valium Axon, alcohol Axon it, and GABA receptors are...

they're dynamic, they're very dynamic. And I think they're dynamic from in a lot of senses, just from, know, as probably the history of trauma, like things like that can affect. also don't just, they're not just dynamic from history, but like personal history, but they change literally like day to day, almost hour to hour, like they're reshuffling their shape and they're very adaptive. And they're also what's called biphasic. So they will...

Sally (30:41.486)
Hmm.

Lara Briden (30:58.469)
have a different, totally different response to the same substance, depending on how much of that substance there is. So some people get at the same thing. apparently, so alcohol, some people, a little bit of alcohol will cause anxiety, but a little more will like reduce anxiety. So this is similar with progesterone actually. So there is potentially a sweet spot. So there's a bunch of people online giving this advice. And I would say it's lined up with what I've seen with patients, although it can be hard. So that's for people who've had a negative react, a mood reaction to progesterone.

rather than going down with the dose, you need to go up, which is hard to do. It's kind of hard to do when you've had a negative reaction to something, but that can kind of override the negative reaction and put you into that sweet spot. I mean, there's other things too, some women would rather than taking progesterone orally, they'd take it vaginally or progesterone cream or like this, it's a lot.

Sally (31:30.688)
I've heard this, yeah. It's weird.

Sally (31:50.883)
Yeah, wow, there's so much to progesterone, but I love what you've, you've really described it well. And I didn't know about that biphasic element. And I love how you described the GAVA receptor as really dynamic and fluid and it can change from one minute to the next. So it's in a way, it's like having a wavy C, trying to balance on a wavy C, you know, it's quite a lot going on.

Lara Briden (31:58.313)
Yes.

Lara Briden (32:02.983)
Yeah. Yeah.

Yeah, it is. And that's one of the reasons the GABA receptors like that. mean, it would be very old evolutionarily, but if you think about it, like the GABA receptors reacting to progesterone and essentially, and progesterone goes, it goes up like 20 times and down again every month. Like if our GABA receptors were fixed and couldn't adapt,

women would literally go crazy every month. you could not deal with that kind of changing level of essentially neurotransmitter that dramatically every month. And also during pregnancy, mean, we make like, it goes up by like, don't how it goes up a lot. Progesterone just is astronomical, it reaches astronomical levels during pregnancy and the nervous system adapts to that. But then it could be hard. mean, women and then postpartum, the nervous system adapts to the loss of that and

Sally (32:46.275)
Yeah.

Sally (32:52.387)
Yeah.

Lara Briden (33:03.675)
This is where actually you start to get the sense that it's true that women who you can predict who's going to have potentially stronger neurological symptoms with perimenopause based on if they had neurological symptoms, postpartum, premenstrual.

Sally (33:17.366)
Yeah, yeah, they kind of overlap, don't they? So how does your treatment then in terms of HRT, in terms of like what you do for people, how does it differ from the medical world?

Lara Briden (33:35.816)
Right. Well, again, I'll give you a history. I said something I'm going back in history. So I started practicing in 97. And so back then, my main job, the reason I even got, I mean, I was, think the reason I got into women's health is well, A, I was already a biologist studying female physiology. So that was, that was a very strong drive. And that's mainly who's coming to me. But that's what those in the nineties, that was pre women's health initiative study. So women were on

Sally (33:37.304)
you

Lara Briden (34:05.865)
Premarin and Provera, which people don't even remember those anymore. mean, occasionally I get a woman who's still been prescribed it, but these are old school. These are like the horse, oestrogens and a progestin. The progestin that was probably responsible for the breast cancer risk and the Women's Health Initiative study. Women were on that. And so this is, this is not that long ago. And actually this attitude continued until probably less than 10 years ago. Like from most doctors, was like, they would just point, just stare at me and be like,

Sally (34:08.323)
Yeah.

Sally (34:22.19)
Yeah.

Lara Briden (34:35.773)
there's no difference between progestin and progesterone. I like, they just felt like there's no difference. Like there clearly is a difference. mean, there was science even back then to say there's clearly a difference. But also you can see they're different. So my main job in the late 90s, it was taking women off premon and provera and putting them on what was then called bioidentical estrogen and progesterone.

which became mainstream in about, I don't know when it became mainstream in the UK, Prometrium, which is the same as U2 Justin, oral micronized progesterone, came to Australia where I was practicing in 2016. I remember almost the date. I was just like, oh my God, it took so long. Like I was prescribing it in 1997 and I thought, oh surely. All the time back in the 90s I was like.

Sally (35:14.594)
Mm-hmm.

Lara Briden (35:25.095)
just around the corner, like just next year, they're gonna catch on to the fact that progesterone is safer for breast health than progestins, but nope, took 20 years. But now the consensus is, thank goodness, it's safer for breasts, progesterone compared to progestin. So that's your question, like how is what I recommend different? Well, what I guess what I'm trying to say is finally the mainstream prescribing has caught up, which I'm really happy about.

Sally (35:32.896)
No, wow.

Sally (35:40.163)
Yeah.

Sally (35:52.43)
Hmm.

Lara Briden (35:54.94)
And I don't want to have to be like that. No natural therapists don't want to be the only ones having to say like progesterone is better. So everyone kind of knows that now. I guess the other the difference where I might the where place where I might differ now, although this is changing too, is as per what we were just talking about earlier in the early years of perimenopause when periods or menopause, whatever you want to call it, when periods are coming close together, heavier than normal, estrogen is higher than normal.

Sally (36:01.762)
Yeah.

Lara Briden (36:23.709)
progesterone has gone away. My recommendation at that point would in many cases would be progesterone only and not estrogen yet. And then stay on progesterone and negotiate if and when you introduce estrogen. So that's different. mean, as you know, most doctors, depending on the doctor, they're like, well, you have to give them together. But like you don't, you can't give, well, in a postmenopausal woman, you can't give estrogen without progesterone. It goes in that direction.

Sally (36:30.07)
Yeah. Yeah.

Lara Briden (36:52.841)
you 100 % can get progesterone without estrogen, depending on this, like they're not a equal. I mean, if you think about it, it sort of just makes me sort of scratch my head. like, well, you can't, like I still hear doctors saying, well, you can't give progesterone without estrogen. I'm like, really? Well, you get progestins all the time on their own, like a progestin only pill by itself all the time. And it increases the risk of breast cancer and progesterone doesn't. like, so where's the like,

Sally (36:58.605)
Hmm.

Sally (37:19.628)
Yeah, the logic. Where's the logic? Yeah, did you say that you can or can't give estrogen only postmenopause?

Lara Briden (37:23.025)
Yeah. Yeah.

Lara Briden (37:30.953)
I mean, know, so I mean, so obviously on that side of things. So the problem is

Sally (37:34.862)
Sorry, estrogen only. Did I say progesterone? I thought I... Okay, yeah. Okay.

Lara Briden (37:37.93)
Yeah, you just say estrogen only. No, so you wouldn't, right? So I mean, if a woman has, right, so if a woman has a uterus, you're just going to take systemic estrogen and then she would need to take progesterone or progestin along with that to protect the uterine lining. Although she could take vaginal estrogen on its own. But I was just more using that as an example of, because that's true, then there seems to be sort of this mirror image, people think, oh, well.

They're like, well, if you can't take estrogen on its own, then you must not get to take progesterone on its own. It's like, no, it doesn't work that way. You can take progesterone on its own. It doesn't need estrogen to counterbalance it. Like, estrogen needs progesterone to counterbalance it. Does that, I hope I said it right at the beginning, but it's good if I said it wrong, then it's good that we've corrected it.

Sally (38:11.913)
I see.

Gotcha. Yeah, you did.

Sally (38:20.8)
Yeah, I just couldn't quite hear whether you said can or can't. That's all. Yeah. Yeah. Great, great, great. Okay. And so what are some of the symptoms of high estrogen then at the beginning of perimenopause?

Lara Briden (38:25.833)
Oh, oh yeah, you can't. No, you can't. Good to clarify.

Lara Briden (38:40.713)
Yeah, well, heavy periods. I just did a, I don't know when this is coming out, but I just did an Instagram post about that yesterday. Yeah, got a little bit of debate happening, which was interesting. So, um, breast pain, breast fullness. So, Jerrolyn, Professor Pratt talks about, and I think it's a really handy marker actually, if you want to know if your estrogen's high or low, put your palm flat in front of you, press in on your breasts, like straight in.

Sally (38:43.392)
Okay.

I saw that, I shared it yesterday, yeah, it was fascinating, yeah.

Sally (38:58.126)
Mm-hmm.

Lara Briden (39:08.399)
And that's, that invokes tenderness, then your estrogen is high compared to progesterone or straight up high. So that's kind of a handy marker. I mean, I think there are things that are going to modify that. Like in my books, I talk about how correcting iodine deficiency can often help with breast pain. so, I mean, breast, I'll just say breast shouldn't be painful, but like that's sort of a good marker. That sort of tenderness is a marker of that, there's a lot of estrogen around.

Sally (39:33.518)
It's so funny because I went to the doctor and I said, oh, my boobs are so sore. Can I, can I, can I reduce my estrogen a little bit? And she, and she said, oh, it's got nothing to do with estrogen. It's high. It's the progesterone that makes your boobs sore. And I thought to myself, no, even I know that I'm not a doctor. Oh God, honestly, I'm just like, what is going on?

Lara Briden (39:37.843)
Yeah. Yeah.

Lara Briden (39:46.342)
No!

Lara Briden (39:54.43)
Although to be fair, progesterone can sort of play a role too, but yes, in general, estrogen is the one that does that. A lot of women take progesterone to relieve breast pain, but again, it's going to dose dependent. yeah, other symptoms would be, and this is worth mentioning, so estrogen will always potentially cause a bit of an immune reaction in most women, but in women who are sensitive,

Sally (40:00.579)
Yeah, especially early perimenopause.

Yeah.

Lara Briden (40:21.193)
Big spikes in estrogen can cause a mass cell or histamine release. And then that can be like headaches, fluid retention that contributes to breast tenderness as well, anxiety because histamine is a stimulating neurotransmitter, even like rashes, even like nasal congestive, like the whole kind of histamine picture, that would be a sign, in some women that would be a sign of estrogen spiking high. And then the other symptom of high estrogen is sort of a after the fact, but like I said at the beginning, the higher it goes,

Sally (40:42.862)
See you.

Lara Briden (40:51.273)
in a cycle anyway, like it's different if you're taking it. If it's high estrogen from taking too much, then you can taper it down. But if it's high estrogen from your own cycle, it's going to peak and then it's going to crash, come all the way down over a few days leading up to the period. And that downward slope, like I mentioned earlier, like that's definitely, Professor Pryor has demonstrated, that's what will trigger night sweats, hot flushes during perimenopause is that downward.

Sally (41:20.686)
you

Lara Briden (41:20.859)
nose diving, estrogen. And also that can, be cut back from mood that can trigger binge eating. It can fix, sort of appetite regulation. Obviously it can be very unpleasant, especially if dopamine comes down with it. Especially, mean, you probably know, I don't, I don't know a lot about ADHD. I know it's, discussed right now and there's like a big link, but broadly, would say women who maybe have that.

Sally (41:23.618)
Yeah.

Sally (41:41.74)
linked to

Lara Briden (41:48.915)
tendency or have something going on with that side of things dopamine will potentially feel these estrogen ups and downs more than average. Yeah.

Sally (41:55.854)
Mmm.

It's so fascinating, honestly, when I think back to what I went through in my late thirties, mid thirties to late thirties with this estrogen dominant stuff, I really wish I knew what was going on. I feel so sorry for the younger version of me actually. And I just, yeah, I really do because, you know, I would, I'd go out and I'd be like, you know, in the evening, have a glass of wine and a curry. And I just feel awful. Everything would just feel like huge. And I get my really bad tummy and

Lara Briden (42:11.433)
Aww. Yeah.

Lara Briden (42:24.541)
Yeah.

Sally (42:27.886)
you know migraines and it was just such an awful experience and you you try and Google it and you don't know whether you've got like a tumor or a thyroid problem you know because nothing's making sense and it's it's just so great that people have access to like it social media has got its pros and cons but to be able to have access to people like yourself who've got this knowledge that's been hidden

Lara Briden (42:41.202)
Yeah.

Sally (42:54.37)
for so many years, because it's not been able to reach the masses. And now we have access to all this information to help us really make sense of what's going on. And when you start connecting the dots, especially with the histamine and the mast cell activation, you're like, my God, everything is linked. It's all linked. Suddenly you're not treating yourself and every symptom separately. You can treat the person as a whole. And I guess that's what you do in your practice. You probably have the time.

Lara Briden (43:22.153)
Yeah, I mean, that would be a very natu... a very naturopathic approach would be let's try to get upstream. Yeah, consider it like a lot of the other symptoms is downstream from some central...

issues, obviously with naturopaths, a lot of the times it comes back to the gut, yeah, mast cells and all comes back to the gut. Not always. The nervous system. I mean, I think there's a lot to be gained from just general nervous system regulation and just not even not trying to micromanage the hormones, just realizing the hormones are going up and down, maybe putting in some progesterone support or something like that, but also treat the nervous system. So that's a that's a big section in my perimenopause book, hormone repair manual. I have a

Sally (43:39.758)
Yeah.

Lara Briden (44:04.163)
chapter on like rewiring the brain. Most of the most distressing paramanopausal symptoms are neurological and there's also heavy periods and weight gain and other things but the neurological ones are usually the ones that give the most grief and yeah like I have a section called I thought I called I've just forgotten the phrase now but yeah yeah basically it's the basic principle or the you know basic principles for mind recalibrate you know mind rewiring or mind

Sally (44:07.459)
Yeah.

Lara Briden (44:32.317)
calibration, the basic action plan or something like that. think I called it. So, yeah, it's, it's, it's going to be things like get outside, take some magnesium, stop alcohol. I know you've talked to a lot of women about menopause. What's a paramenopause? What's your, cause my consensus would be I've almost without exception. I'd say amongst my patients, fellow practitioners, friends, everyone in their forties found a time when they just had to stop alcohol.

Sally (44:33.302)
Yeah.

Yeah.

Sally (44:42.946)
Yeah.

Lara Briden (45:00.979)
completely for a while. Yeah.

Sally (45:01.166)
Oh yeah, yeah, definitely. I remember it was like two days before Christmas and I'd had a gin and tonic. I was like, I can't do this anymore. I can't metabolize it. You know, it's just hanging around, puffing me up. yeah, but absolutely what you said about the nervous system. I mean, that's my approach is nervous system first. And then that, that links back to patterns and behaviors that you learned in childhood, what you learned about yourself growing up. Am I lovable?

Lara Briden (45:08.646)
No.

Yeah.

Lara Briden (45:19.772)
Yeah.

Sally (45:27.622)
How do I over function? How do I under function? What can I do to now support myself? What does my body actually need right now in order for me to get through this time? So I kind of work on the behaviors and the attitudes because that instead of micromanaging the hormones, as you say, which I feel is what most people who are hearing about menopause for the first time or perimenopause, I should say, for the first time are thinking, I've got to sort my hormones out.

Lara Briden (45:44.328)
Yeah.

Lara Briden (45:51.644)
Yeah.

Sally (45:58.243)
But yeah, progesterone, probably that'd be really good for you, but the estrogen side of things, maybe we need to work on, you know, the nervous system regulation first.

Lara Briden (46:01.596)
Yeah.

Lara Briden (46:08.581)
Yeah, I mean, the decision if and when to come in with some estrogen therapy is again, also equally nuanced to the progesterone conversation. I will also say some of them find it incredibly helpful. And you're going to have people listening right now who can put their hand up and say, know, was, you know, life saving and really stabilize their mood. And so, I mean, that can happen too. So there definitely can be...

a place for it. But you can sort of come at it from both angles. again, like not just the replay, I will certainly reject the word replacing hormones, because we're actually meant just to go back to the evolution of menopause, like we are, our biology is such that we've, our body's expecting and evolved to go like to go to a low hormone state basically, and spend decades there. And we are at least

traditionally or biologically, we should have been very well equipped for that. The fact that that's maybe harder to do in our modern world is the fault of, you know, ultra processed food and environmental toxins and all the things that maybe make that challenging or not possible for some women. But it's a recalibration. just so I talked about my basic action plan for brain rewiring. It's a recalibration. It's like it's in the book, I call it second puberty. So first, so when when you go through a major hormonal transition, the whole nervous system,

rewires basically we know it with first puberty so from children to adults you know they have a different brain and also during that that recalibration process under the influence of hormones we don't look at teenagers and think that's how they're always going to be now you know that's that's their permanent state now like we recognize this is if they're more emotional than normal or like behaving differently that's like that's part of the recalibrations of the other analogy I sometimes give.

Sally (48:00.887)
That's true.

Lara Briden (48:01.293)
is it's like updating your software on your computer. It's like while it's updating, gives you the little things like, do not turn off your computer. I'm doing my thing right now. But you know, once it reboots or updates, you pop out the other side, you've got new software. You've potentially got better software. I it could be argued that the post-reproductive brain is better in some ways. I mean, it's definitely got its own superpowers.

going on. I have a quote from my husband in the book where he's like, where's my menopausal upgrade? Where do I get? know, men don't really get that sort of complete new software installation. So I mean, they do too. mean, men are, the brain's plastic. So we are changing with lots of things, as you know, like just events and yeah.

Sally (48:48.013)
Yeah.

Yeah, it's perhaps just not as dramatic in the male body. Yeah, okay. So listen, thank you so much, Lara. This has been an incredible, beautiful conversation. I've really, really enjoyed getting some different perspectives from you, actually. You have a wealth of knowledge. I'm sure we could have carried on this conversation for another hour, but you have another podcast to do now. So this is how popular you are.

Lara Briden (48:53.085)
Yeah.

Lara Briden (48:58.887)
Yeah.

Lara Briden (49:06.002)
Mm-hmm.

Thank

Thank

Sally (49:18.38)
and in demand you are. Listen, where can people find you? Where are you most active on social media? If someone wants to work with you, where can they find you?

Lara Briden (49:25.871)
Yeah, no, it's great. Actually, what happened, so I have someone in demand. But what it actually is, Sally, is that I tend to, I like to book things together so I don't have to concentrate things so then I can have the rest of the day. well, today I was busy all day. But I like having, don't you love that having like some unstructured time, like some part of the day where you don't have something on your calendar and you can just, I found, I've always been like that. But when with my own personal perimenopause, menopause transition, I was just like, yeah.

Sally (49:43.767)
yeah.

Sally (49:47.766)
Yeah.

Lara Briden (49:55.138)
I need to have some unstructured time.

Sally (49:56.623)
Oh, definitely. I just spent 12 days on my own in Spain, dog sitting, and I had a few things in the diary, but for the most part, it was just unstructured time and it was absolute bliss. And it was a real milestone moment for me because I was like, wow, I can do this now. Before, when I was in my early, I was like 33, I went to Italy for two weeks on my own for, it was a language course, but it didn't.

Lara Briden (50:03.056)
Nice.

Sally (50:23.008)
really materialized that I was actually with other people. I was kind of on my own and I freaked out for the whole two weeks. I just wanted to come home. I couldn't be with myself. But now post-menopause, I don't know, something's changed. I can waft around very happily and just go from thing to thing. So yeah, yeah, unstructured time. Beautiful.

Lara Briden (50:45.797)
It's good for, I mean, it's really good for the nervous system. Yeah. So that's why I've got another podcast coming up right away. Um, because it's evening for me too. And I, as a rule, do not work in the evening. But when you, think when I was messaging with you, I was like, well, I've got another evening thing. So I could just put the two together and then I, you know, the rest of my evenings are free. But,

Back to the question, I'm very easy to find, because I don't know if there are any other Laura Bryden's in the world, which is very lucky. How often does that happen? So I'm larabryden.com and all my social media is at larabryden. my most followers is Instagram. So that's probably where I put my primary content, but it'll spill over into other platforms as well.

Sally (51:13.163)
you

Sally (51:27.948)
Yeah, perfect. Okay, well your Instagram is very juicy. There's lots of information on there. So if anyone's been intrigued by Lara and want to go and look at her posts, definitely go and head over to her Instagram because it's really good. It's like a whole encyclopedia over there.

Lara Briden (51:45.082)
thank you. That's great. And I'm about now that I'm just sitting here thinking I'm gonna, well, we can both do one, but I think I'm gonna do a poll, you know, calling all paraminopause, menopause, anyone to do with it. Okay, we need to have a discussion about terminology and take a vote on what these words mean. Yeah, totally. Yeah. Great. All right. Thanks to me. Great. Great to me.

Sally (52:00.95)
Yeah, there's got to be a symposium hasn't there I think.

All right, Laura, thank you so much.