Over 40?  You’re in a generation where talking about hormones, peri-menopause and menopause is just becoming mainstream.  It’s also the first generation that is learning the effects of hormone shifts on fitness enthusiasts, older athletes and fitness competitors. Dr. Brianne Showman is a doctor of physical therapy, a runner, CrossFit athlete and competes in various CrossFit and hybrid athlete competitions in the US. She’s on a mission to help her clients live pain free and well informed when it comes to hormone shifts with age. In this episode of The Health Fix Podcast, Dr. Jannine Krause and Dr. Bri Showman talk about how the peri-menopause journey impacts training, fitness and competitions.

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What You’ll Learn In This Episode:

  • Discovering what works best for your body when it comes to fitness and hormones
  • What excessive bleeding in peri-menopause looks like
  • Possible best times for PRP during certain times of the cycle
  • How increased electrolyte needs show up over 40
  • Differentiating overtraining from declining hormones

Resources From The Show: 

Instagram: @bri.showman 

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Podcast Transcript

4:31 – Crying during a workout

5:31 – Working out around your period

7:41 – Heavy periods

10:43 – Cramps

12:06 – Sleep patterns and sleeplessness

13:07 – How Dr. Bri got her sleep back on track with supplementation

14:51 – The importance of sleep and how it helps recharge  and balance the body

17:35 – Losing definition in the body

24:20 – Other symptoms

29:32 – Getting back into competition

33:01 – Questioning yourself when workouts become more difficult and you aren’t feeling yourself – Overtraining or hormones?

34:52 – Adjusting diet knowing your sweet spot

36:48 – Heat sensitivities and hot flashes

42:05 – Tracking cycles

43:49 – Symptoms of low estrogen


JANNINE: [Intro] Welcome to the Health Fix Podcast, where health junkies get their weekly

fix of tips, tools and techniques to have limitless energy, sharp minds and fit

physiques for life.

Hey health junkies, on this episode of the Health Fix Podcast, I’m interviewing

Dr. Brianne Showman. She’s a good friend of mine. She’s a physical therapist and in fact

a doctor of physical therapy. She’s been doing it for over 16 years.

So when Bri talked to me about hormone changes, she was experiencing and wanting to know more

info, especially as a CrossFit athlete, I was like, yes, let’s talk about this.

Because I don’t get a chance to share a lot of what I experience openly on the podcast

because I’m interviewing other people.

But Dr. Bri and I are getting older, we’re over 40 and we’re trying to stay fit and we’re

We’re experiencing hormone changes that a lot of women are talking about, but I think

we’re the first generation, like Bri says in the podcast, to really openly talk about

perimenopause, but also be women who are athletes and higher level athletes and doing a lot

of really cool things.

And I want people to do that.

I want people to dream.

I want you to be thinking about like, what are all the things I want to do in life and

who cares how old I am. And really hormones can get in the way of that and be one of the

things that holds women back and I don’t want that to be the case. Neither does Dr. Bri.

And so we are going to have a podcast today where we are just talking about hormones,

what we’re experiencing, what we’re doing to counter it and just share our experiences.

So this one’s a fun one. Can’t wait for you guys to check it out. Let’s get on with

the podcast. Hey, health junkies, I have Dr. Bri

Showman on it. We’re going to be talking about hormones. And one

of the things that she just brought up that I really want to

talk about is like, we could quite possibly be the first

generation of women who are really working out harder and

trying to figure out how do we work out with this hormone

thing? And how do we deal with it? So welcome back to The Health

Fix Podcast.

DR. BRI: Thank you. I’m excited to be here and talking to you again.

JANNINE: Yeah. And one of the big things that you and I have kind of been working with and me too,

we’re both in our 40s, we’re both trying to figure out this perimenopausal business is like,

how does it fit into workouts and how can we still work out hard? Because there’s so many

people and you probably heard this, like so many people saying like, weightlifting is great,

but don’t push it too hard. And then you’re like, don’t do too much cardio. And you’re like,

well, what the f to it? How much can I do? Have you had that question to yourself like,

like, what’s too much and what’s not enough?

Like– 

DR. BRI: Yes and no, and I think it comes up more

when I just have those days, like, it’s better now,

but still have those days of like, just feeling sluggish

or just not having the strength and like,

wanting to be able to push harder,

but I just feel like my body isn’t on some days.

And so it’s not really a, no one’s really necessarily

asked me the question, but it’s more of me

just kind of thinking as far as during my own workouts.

Like, what– like going through this perimenopause,

going through these hormone changes,

what is the body still capable of doing?

JANNINE: Right, ’cause like, there’s all these women online

and you’ve probably seen it too.

Like all these mobility challenges of women

in their like 60s and then there’s this one lady

who hangs on bars and like takes her clothes off

and puts them back on, have you seen her?

I’m like, wow, you know, and that I can do,

but the mobility challenges,

I get really confused as to what I’m supposed to do

and I have to keep watching it.

And I’m like, I’m just gonna do my own mobility challenge

at this point.

But the point is, is like, yeah, you’re looking at this

and you’re like, what’s normal for this age?

Like what can I push my limits and be okay and what’s not?

And you know, it’s one of those things that I too

in the back of my mind, you know,

I don’t know if this has ever happened to you,

but like in the middle of like a deadlift workout,

all of a sudden started crying.

And I’m like, I wasn’t sad.

Like nothing was going on.

I’ve got tears coming down my eyes and I’m like,

What in the world?

Has that ever happened to you?

Have you ever cried during a workout?

Like kind of nowhere, like, I mean, there’s reason.

(laughing)

Well, that’s a whole ‘nother podcast.

(laughing)

DR. BRI: Um, only on workouts where I’m just like,

so well, I shouldn’t say that.

Usually it’s more when I’m so like mentally frustrated

’cause there’s either something I’m just like,

a movement I’m struggling with and I just am like,

beyond struggling.

Or typically it’s more if I’ve had a really rough week

and I’m just so like mentally and mushy overwhelmed already

and then it’s a hard workout and that’s usually,

it was gonna happen, that’s what it happens.

JANNINE: Oh my goodness, it’s one of, I don’t know,

it’s just bizarre and it’s one of the things I asked women

about ’cause like a couple women have like when I posted

on it before them and like, yes, that happens to me.

But more than anything, I think one of the biggest things

is trying to figure out with like cycles and like period,

like when’s a good time to go, when’s not a lot of people will say like ovulation and I do talk

about it too is like a great time to do the hardest workouts but then when you have your

period sometimes it’s better to adjust. Have you found that that’s kind of been the way for you to

kind of look at things? 

DR. BRI: It’s you know it’s interesting because I have I haven’t noticed

too much of a difference? Well, I shouldn’t say I haven’t been able to track any like during this

time of the month, I’m always stronger or this time of the month, I’m always a more sluggish or

anything. But it’s interesting. I would when I had my podcast, I had a guy at one point that said

during like the first couple of days of the cycle is actually when we’re at our strongest,

so we should be able to hit some good PRs then. But then as I’ve been reading some stuff since

then it’s it contradicts that so I’m like I’m kind of at this point to them like I’m not sure what

to believe because I’ve heard multiple aspects of different times of the cycle so I’m kind of

I’m to the point with my training you know as you get older you get wiser um that’s just like you

know if I’m just not feeling it that day like just don’t push this hard you know or I can’t get

get a weight up that I would normally be able to get up.

Like, okay, it is what it is.

I’m just kind of listening to my body now

rather than trying to force something to happen.

That’s just not a good day.

JANNINE: Makes sense.

I mean, makes sense.

And I do think everyone’s individual.

I think there’s like parameters that we can kind of look at

in terms of the cycle.

And one of the things that, you know, you experience in

and I myself have experienced as well

is really heavy bleeding and it not stopping

and being like, you know, for me, it’s like,

I don’t even want it to go to the gym

when I don’t know if I’m gonna bleed through my tights,

right?

You’re like, oh my God, like, this isn’t embarrassing.

It’s deadlift or squat day.

And like, you know, your coach is watching you.

And then what if I start bleeding everywhere?

Like, I don’t know if you ever had like these things

in your head where your head goes down these like crazy

rabbit holes of like, what if, what if the blood’s like

running down my leg and on the floor?

Like, what do I do?

So tell us your story in terms of, you know,

let’s go through your story in terms of the heavy bleeding

and kind of some of the experience that you had

where you and I were kind of talking

over the last couple of months

is to what’s kind of played out for you.

DR. BRI: Yeah, absolutely.

And it wasn’t even something I was thinking

was hormone changes, it was just more of like,

okay, something’s like, this is really weird.

I was going through like the super tampons

within like three or four hours,

which was like totally abnormal for me.

I would like just crazily like go through so many in a day,

which, yeah, it was definitely not normal.

And that would happen like month after month after month.

And I was like, what the heck?

And it was kind of all those things.

It’s like, yeah, I got to like make sure I change

before I go to the gym, take one with me as a Justin case.

Like I’m going to be there for two hours.

You never know what might happen.

And I got to the point too is because I did,

When I first started noticing it heavier,

I bled through a tampon, bled through a pad

and was like dripping down my leg in the morning

when I got out of bed.

And I was like, what is going on?

So ever since then, it’s like my paranoia now.

It’s like, when I have my period

when I know it’s those heavier days,

I’m like, if I wake up to the nine, go to the bathroom,

like I’ll change it.

Like I’ll have it on the counter.

It’ll be like, won’t turn the light on,

but I’m like, I don’t even care

’cause I’m not risking this anymore.

JANNINE: You get traumatized to a point, I mean, I felt like it, like, to the point where I was like,

okay, black jeans only, you know, these days, like, you just, I don’t know if this started,

like, when I was younger, and I don’t know if you had this experience, but when you’re a teenager

and you’re trying to figure out your period, like, you have some accidents, right? And you

need to get a couple of things on the jeans and like, you remember that and you’re like,

Like I literally was like, I’m never wearing white pants again.

That’s it. Everything’s black from here on out, you know?

But I did get scared because you get to bleeding and you go,

what if I don’t stop?

Like, what if this keeps going?

Because the most I’ve bled was 62 days in a row.

I counted every day and I’ve had to counsel a lot of

patients through the different days and going like, look,

you know what, we can do this.

There are herbs, things of that nature.

So, give us a little scoop like when you were bleeding and it wasn’t seeming to stop and

it’s pretty heavy.

In your head, what was going down?

Were you panicking a little bit?

It’s like, “What if I never stopped bleeding?”

Like, “What?”

DR. BRI: It wasn’t that bad, just because it didn’t last as long as what yours or you’re saying

yours did.

It was probably my heavy days, probably at the worst, was maybe three, maybe four, but

It was just kind of those things.

I’m like, okay, we need to increase my iron intake.

We need to do like, do these things

’cause I don’t need to get any of it right now

as I’m, as this is happening.

So it wasn’t, yeah, it wasn’t ever like non-stop necessarily

but it was just definitely different

than what I was used to.

JANNINE: It’s crazy.

I mean, you think to yourself like, whoa, what’s happening?

Now, did you have any cramps or like major plots

or anything that kind of came along with yours?

DR. BRI: Every once in a while, the clots, not real often, but they will happen every once in a while.

Cramping, I usually always, right around the first day of my cycle, maybe into the second day, a lot of times I’ll get cramps.

They have been, it’s always hit or miss. Some months are really bad, and I need to take some a leave, and other days, or other months are really not as bad.

So that’s kind of hit or miss. But I have had bigger clots the past, probably year.

You know, a lot of docs will talk about fibroids and high estrogen levels, and of course that’s

something that I instantly, because when we’re in this perimenopausal realm we’re like

high estrogen, then it drops and high, and then it drops.

And the clots are linked to that, and it’s linked to uterine lining thickening, and so

did you have any imaging done?

I can’t remember.

Did you get a transvaginal ultrasound or anything for them to look and see what was going on

with your uterus at all?

DR. BRI: I have not.

JANNINE: Yeah.

me either. I chose not to do it just because I was like me, I kind of know what’s up. You know,

I’m going to ride it out if it got heavier and I couldn’t get it to stop maybe, but you know,

working that angle. So let’s let’s talk about getting getting the different symptoms that you

had. So we had the heavy period mood insomnia. Let’s talk about sleep. Let’s talk about that.

Tell us a little bit more about what else you were experiencing when when the period went off the

the rails? 

DR. BRI: Um, definitely difficulties. It was more of, especially like during that

first week of my cycle, difficulty falling asleep. Um, we kind of got that under control.

And then it was more of I would wake up. Um, well, for my middle of the night, which is

like 11 to 12, somewhere in there, because I get up crazy early. Um, go to better really

get up crazy early. But I would wake up and I would just like be wide awake and need to

take something to fall back asleep. And so I was getting this sleeplessness that just

wasn’t normal for me because normally I’m a really good sleeper. And so I really had

to work on figuring out with your help on like what to take before going to bed to make

sure I can fall asleep and stay asleep.” 

JANNINE: What ended up being the magical formula for sleep

for you? One ended up being the good combo. 

DR. BRI: So before bed I do 400 milligrams of magnesium,

700 milligrams of ashwaganga and 800 milligrams of altheanine.

JANNINE: Gotcha. And have you had any nights where you like maybe you’re traveling and you forgot to take it

and what happened if you didn’t take it.

Are you able to kind of flux?

Are you like, I’m not just in it out yet?

DR. BRI: I can do, I found, like if I travel,

I’ll usually always take the pills with me.

I may go without the magnesium.

And I found, I still do pretty well without the magnesium

as long as I have the others.

But I have not tried, since I’ve started on,

I haven’t tried to go without.

JANNINE: Gotcha, gotcha, let me see.

DR. BRI: I like my sleep.

JANNINE: That’s the thing,

and that’s the thing that I find with a lot of women.

When we find something that works, we just go with it, right?

Don’t keep trying to mess up the apple cart

or disrupt the apple cart,

as I call it, just go with it.

Until you’ve been a couple of solid months

and then maybe you can flex a little bit,

but sleep is so important.

Now, from not having your workout

or not having your sleep and then getting sleep,

I’m guessing that changed your workouts

and how it felt in the body.

I would love for you to kind of describe

to folks who are listening,

what it feels like in the body

when you’re like trying to slog through getting some sleep

and not getting it to when you fully get sleep.

What is it felt like for you?

What is it kind of, you know, give us a scoop?

DR. BRI: Yeah.

– Are you talking workouts or just life in general?

JANNINE: Both.

DR. BRI: Both, but workout thing is it’s hard to judge

because we also, as I got my sleep better,

I also, we got the hormones figured out

and we’re as able to get that.

As far as I know level that I have blood working in

in two weeks, but I think it’s leveled out.

So that was kind of going hand in hand,

but my workouts essentially in July,

like my strength was gone, my motor was gone.

I was thinking I was in this overtraining, which tried to help perfectly because I was

going on vacation.

So I was like, awesome week off, we’ll be good.

I’ll come back.

I’ll be awesome.

And I came back and it was not awesome.

Still had no motor.

I could barely stand up, which for me should have been a lightweight.

I couldn’t even stand up to 100 pound squat when normally I could do like a 200 like rep

out five easily.

So that was all shot.

And then over, that was also one of my sleep wasn’t great.

Yeah, I hadn’t worked on that.

And then over the span of like from July

to probably November timeframe,

my motor graduate came back,

my strength gradually came back.

I’d still not back to where it was.

I did lose some strength,

but yeah, just everything feels more normal now,

like at least like a dip before I should say.

JANNINE: Gotcha, gotcha.

Well, and that’s important to hear that,

that it’s back to normal.

It feels, you know, like where things were,

because I think a lot of women feel like,

uh-oh, once things start to change,

it’s never gonna be able, like you can’t go back.

And I know that there’s individual changes, of course,

but it is good to hear that you were able

to get back in and start building strength again.

And I think for a lot of women too,

we think, oh no, is there a point at which we won’t gain

any more muscle?

Give us this, ’cause I’ve seen you do muscle ups

in the last couple like weeks on social media.

And so, do you feel like you’re still actively

building muscle right now?

Do you feel like it’s still happening?

DR. BRI: I do, but I also digos through those,

probably the like August, September, October timeframe,

I kind of was going through that like,

do I have to stop competing?

Like, is this my new normal?

Um, I was kind of just trying to like reevaluate and like, what, what does 2024 look like for

me with competitions, like, is this going to be a thing?

Um, but I do feel like my definition is coming back again as far as in my shoulders and my

legs.

So I’m definitely getting the strength back that and the muscle back that I had, had

lost before. 

JANNINE: Definition.

That’s important to hear because I know a lot of women will tell me, and this happened

to me, I think pretty much from probably between 2000, 2022 and 2023, I lost a lot of my definition

and kind of felt like it had more of a fat suit developing over my body. And I’m like,

Oh my God, this isn’t my body. And I saw a picture of myself and my cousin’s wedding

in my arms. I’ve always been big, but I didn’t have any definition. They look like inflated,

Like, I looked puffy and I was like, “Oh, God, what, you know, what the heck?”

So seeing your body change like that is hard, isn’t it?

DR. BRI: Oh, absolutely.

Especially when you’re used to having that, having the muscle, you see it in your stomach.

Did you get down some nasty rabbit holes in the head about, “Oh my God, what if I never

get my definition back?”

Did you think anything in that department or you’re like, “I got this, it’s fine.”

DR. BRI: Um, yeah, I haven’t gone there yet.

I think it was, I was still dealing with just the frustration

of like, why am I so freaking weak right now?

JANNINE: I hate, no, like I got to a point, no joke.

In 2022, I got to a point where I couldn’t even do one pull up.

I don’t know, like all of a sudden it was over the course

of time, like I just would get so tanked

and I’d go to do a pull up and I couldn’t even do it.

I’m like, oh my gosh, some things, well, this is not me.

you know. 

DR. BRI: Yeah. 

JANNINE: Where did you see the most strength loss? Was it squats? I think because you had

mentioned like you were having trouble getting like standing up on a 200 pound squat. But like

what what else did you see that? 

DR. BRI: Um, everything and something else too. And I don’t know if it was

related or not. Or if it was just a coincidence, I kind of think they’re related. Um, the other

reason I kind of had to take a step back with everything is I had in May, I had PRP on my shoulder.

Um, just from my own ultrasound training, we found a small or a partial tear in the one

of my rotary cuff muscles.

So we’re like, let’s just do some maintenance on it.

Let’s take care of it.

It was kind of a, it was perfect timing for what should have been like after the open after

quarter finals before my next qualifier.

And so I did a PRP and it completely shut my shoulder down.

Like my shoulder blade, like it all forgot how to work.

Like there was no like, scap retraction, there was no stability, like it was gone.

It probably took until it was the other September, October timeframe that finally I was like,

Oh, I can do a hanging scap retruck again, or a scap pull up.

Like, so the shoulder stuff like went completely gone to, which is the other thing that like,

and I don’t know if it was because all of the hormone changes were going on, or if it

It was just something, the way my body reacted to that PRP,

even though I’ve had PRP before, I’m not sure.

But that was the other issue that kind of happened

at the same time of everything is my shoulder

just forgot how to work.

JANNINE: Oh my gosh.

You know, I see, and this one I see my practice all the time

is like women will have shoulder, like frozen shoulder.

And I’m sure you’ve seen this being a physical therapist,

you know, frozen shoulder and women over 40 frozen shoulder,

especially in women over 50.

and having shoulder stuff.

But interesting that you just kind of lost

the strength with the PRP, I wonder.

So here’s where my mind went on that.

My mind went to like, I wonder

if there’s an estrogen component to the PRP working

for women in particular and an estradiol,

the most useful estrogen.

If at that point you attained and had higher

of inflammatory estrogen and lower of the useful estrogen.

I don’t know, it just dawned on me like.

DR. BRI: It’s, yeah, highly possible.

JANNINE: Okay, here’s a wild question.

Do you remember, and it’s okay if you don’t.

Do you remember if you were near your period

or right after your period when you had the PRP done?

Do you know anything that you’d cycle?

DR. BRI: Let me grab my phone.

I can check my calendar.

JANNINE: Mm.

Let’s look, ’cause that would be interesting

to see if there was like a low,

like ’cause we’re gonna be low

in estrogen right as we get into the period.

And that’s why Chinese medicine tells women

not to push as hard during when they’re on their period,

which is interesting because Western medicine

in a lot of folks research, they’re like,

yeah, from day one in your period to mid cycle, push it.

And mid cycle at ovulation,

that’s the time where you can PR and sprint.

But I’m like, hmm, interesting.

I wonder if there was something there.

DR. BRI: 22 days. 

JANNINE: Okay. So it would have been after ovulation heading into period. Hmm. A lot of women will

sprain or strain their ankles or like roller ankles and stuff either mid cycle or right before

the period. Wonder, wonder if there was like low estrogen component. It’s just me being a geek,

but something to think about because I have, you know, and maybe it’s something that we think about

because, you know, you recommending folks for PRP, me, you know, recommending folks to, like,

maybe we need to find, think about when would be a good time for folks to have the PRP,

DR. BRI: Yeah. 

JANNINE: Cycles. I don’t know, it could be a research study we’re thinking about right here.

DR. BRI: Yeah, it’s interesting to think about because, you know, I didn’t know,

It’s good to have your input on as far as like that perspective of it because it’s just something

I’ve been thinking about the past couple months as far as like with the hormone changes,

could have that impacted what happened with the shoulder?

JANNINE: Maybe. Like if I think about like, okay, estrogen is lower when we first start the period and then

as we get up towards ovulation, it’s coming up higher and then it comes back down a bit. So like

ideally in a perfect world, having PRP around ovulation might be like the sweet spot,

like just before ovulation because it does dip down after. Yeah.

So I’m like, hmm, ladies out there, this might be a tip.

You’re going to get a baby still have a cycle before ovulation, maybe, maybe the secret.

I don’t know. It’s something to think about, something to think about.

Now, in all of this, did you have any headaches or migraines or anything in that department or

or visual changes, faintness, dizziness.

DR. BRI: I definitely haven’t,

I haven’t had any headaches or migraines.

I have been more, when you talk about

the dizziness, faintness,

I have been more electrolyte sensitive.

I’ve always been able to tell us,

well, let’s see, ever since,

I don’t know, 15 years ago now,

I was training for a marathon.

I was exhausted, almost all asleep driving home,

took a three hour nap, was exhausted when I woke up,

got electrolytes in me.

I was like, wide awake in 15 minutes.

I was like, all right, so ever

and then I’d been to a Con Ed course.

Two years later, had nausea, dry heaves.

I was like, what the heck?

I was at the airport, got some seven up.

That didn’t help, got some, since in the airports,

there’s not a whole lot of options.

got some Gatorade for electrolytes and like went away.

So I’ve started realizing kind of my symptoms

with electrolytes.

And I’ve been noticing I’m more like I have to use

the element packets a little bit more frequently.

And there was one day at work,

I was kind of dizzy and lightheaded.

And so I just got some electrolytes in me

and it kind of, it went away.

So I have noticed that aspect of it,

my body is just a lot more electrolyte sensitive than it, than it used to be.

JANNINE: It’s a great point. And I think I’ve seen that quite a bit too with myself, but also

with patients. It seems like, of course, I’m going to run it on labs and see what the sodium

potassium chloride show up as. And if it’s borderline low, my recommendation is quite often

to get the electrolytes. So yeah, I mean, I think for myself, I’m going to be honest. I don’t,

I haven’t pushed myself much in the last year with workouts where I would be able to like

accurately say something. I only had one experience, which is so funny. And this is why I run regularly

when friends decide that they might want to spring a 5k on me and tell me they signed up me up for one

after I worked at the fair all day in like a hot like trailer making fried cheese curds.

I think I was like, I think I was hella dehydrated. The next day when we ran that 5k because I was

having a hard time keeping up and then I got nauseous and I was like, please don’t let me

throw up all of these nice people that don’t know me in this small town while I’m doing this random

5k. And so I was like wondering to myself like could it have that have been that I just needed

more electrolytes because it was hot as in the middle of August, you know, and the whole night

before we had been frying cheese curds up at the fair. So– 

DR. BRI: Highly possible. 

JANNINE: Highly possible. So I

mean, it’s thinking about these things, you know, where when you’re younger, you can bounce back so

fast and you just don’t think about it. No, we were talking about competitions and competing

and you’ve got some stuff coming up and I’m guessing you competed while you were working

on trying to get your hormones imbalanced. Did you compete? Did you learn? 

DR. BRI: I actually did

because of two competitions. So in late August, early September was when the qualifier for the

competition in December would have been. I did four out of the six workouts just to kind of see

or just to do them. I didn’t register for the qualifier. Two of them I didn’t do just because

they were heavy in my shoulder I knew wasn’t ready for it. I was, so I looked at like compared my

scores to the leaderboard on the qualifier afterwards. I was like close to last place on all of them.

Like, and it’s a competition I’ve qualified for in the past. Like, I was usually kind of last person

in type thing with the qualifiers to to the competition, but I’ve qualified. So and like,

knowing it’s like, you know, I know people on the leaderboard. And so like, knowing people on

there, I’m like, I knew where I used to be. And so, and then there was another big competition here.

It’s a local competent Scott National Exposure. And just at the level I was at, I’m like, I’m,

I’m not doing it. So I’ve judged them at them instead since I couldn’t compete.

But I finally feel like I’m to the point that I’m like, let’s see where I, where I add up with people so I, I did register for a qualifier coming up now.

JANNINE: Okay. Okay.

You know, I mean, and, and most folks here listening is probably right now aren’t competing, but I like to like, just see kind of anything you’ve noticed and, and the fact that you’re going back into it I think is really key because I think a lot of folks feel like,

feel like, Oh no, I’m done. Like I’m not coming back from this. This is it. Have you had to work

through some mindset stuff around coming back and, and not just judging and moving forward there?

DR. BRI: Absolutely. And even, um, so I do want to back up a second. So at the competition, I was talking

to a girl I know who I’m friends with now and we were just talking kind of like why I wasn’t

competing that and everything and she’s like you know she’s like I’m kind of feeling that sluggishness

she’s like maybe I should get my hormones checked and then I was talking to someone else I know

out who is involved in high rocks races as well that’s how I know her and we were just kind of

messaging back and forth recently, as we’re since I wasn’t going out to the race in December,

she’s like, “Why aren’t you coming?” And I was like, “Well, this is why.” She’s like, “Oh,

like maybe I should get that looked into.” So it’s really really interesting like having these

conversations. But along with that, so I’m registered for High Rocks in May. And that same friend,

she keeps trying to get me to both times I’ve raced in the past, she’s like, “Why aren’t you

racing at the higher level? Like, you’re strong. You should be racing at the higher level.” And

And one of them, like, I just,

there was a couple of different rate life reasons I hadn’t,

but so I messaged her after I registered,

I’m like, I’ll see you in Anaheim.

And she’s like, and I was like, she messaged me back.

And I was like, but I’m not racing pro.

She’s like, why are you not racing pro?

‘Cause, and I was like, well, I said,

I haven’t competed since all my hormone issues.

I said, I have a qualifier here in February and the open.

I said, I’ll see, let me see how my body feels with that.

I can always change division.

So I am kind of at this point where I’m like,

I’m mentally ready to compete, but at the same time,

I don’t fully know what my body’s ready for.

So I like at the same time, like not fully ready

to like jump into the higher level.

JANNINE: Well, I mean, I think it’s good to keep realistic, right?

In the head about what you’re ready for.

And, you know, obviously things change,

But I think it’s also realistic, right?

We have to be realistic and thinking,

what can I do and how can I keep coming back, right?

Or moving forward.

But what’s so interesting is that you would talk to

other folks and they’re like,

oh, I’m experiencing this too.

And it’s funny ’cause we just don’t,

we don’t seem to talk about hormones

and what we’re experiencing as much as one would think, you know?

DR. BRI: And that’s what I wanna get on here and talk with you

’cause I was like, this, there’s just,

it’s starting to get more talked about,

but it still really isn’t talked about at time,

and it needs to be, especially in the athletic population

as things are like, we’re getting sluggish,

or we’re feeling weak one day, or multiple days,

or just things aren’t feeling quite normal.

JANNINE: It’s, you know, it’s one of those things

that I’d be curious, you know,

if there’s a little bit of ego going,

like, I don’t wanna tell anyone that I feel like, you know,

I’m not feeling my best or I think the other side of it,

which maybe even more real,

at least what I experienced in my head was,

am I not eating right?

You know, what am I doing wrong?

What am I doing wrong?

Is what kind of kept happening in my head?

Like, what am I doing wrong?

Why do I, you know, I’m trying all these things.

Why do I feel like crap?

Why can’t I do a pull up?

Why is, you know, my, my deadlift in squat?

Why are my numbers going down?

And, and did you feel that way at first?

Like, what am I doing wrong?

Did you wonder? 

DR. BRI: Oh, absolutely. That’s why back in July,

initially I was like, Oh, I must be over trained. And like, I

haven’t taken a break in four months, like, which is normally

my timeframe of like, okay, I need to like five days off. So

that’s why I was just more like, okay, I’m hitting you over

training points. It’s just take some time off. It’s fine. Um,

like I had no clue at that point that I was just like, Oh,

maybe it’s a hormone thing. It was just like, this is just how I

feel when I get over trained. It’s time to take break.

And, and you know what, I mean, ultimately overtraining, you know, what, what is overtraining mean

for the body? A lot of times I do think that overtraining does take our hormones. I mean,

I’ve seen in labs of women who who we could say overtraining, we could say hormone imbalance,

we could say probably both of them together, their DHEA, which is brain to ovaries and brain

to adrenal signaling for hormone production, it was low. It was really low. And I’m like,

my gosh, you’re like menopausal level, you know, and some women, of course, will stop their periods,

you know, it’ll stop out of nowhere. And they’ll be like, “Oh, I’m in menopause. Cool.” But really,

it was over-trained because I’ve done that to myself multiple times where I stopped for like

months and months and months because I’m under eating and also over training.

Let’s talk about that for a second because a lot of women will talk about body composition

changing. Like you were saying, you lost some definition, some people will talk about gaining

weight and gaining weight in particular in the belly and they’re like, I never had belly fat,

now I have a little belly fat. Then first thought is to cut calories and jack with that side of

things. Did you did you start playing with diet at all in terms of thinking like I need more protein

or I need you know less carbs or any of that stuff? 

DR. BRI: I didn’t. I mainly because I knew the level I’m

still training at and I knew and maybe it should be adjusted as hormones change. But I knew kind of

of where my sweet spot was for protein fats and carbs

and it’s kind of where I’ve stuck.

With that said, I also like,

so normally, ’cause I’m training two hours a day,

like I usually have to get 3,000 calories

just to make sure I don’t like,

I can still get muscle, don’t lose weight.

But I’m like, if I’m at my 3,000

and like I’m hungry, I’m like, I’m gonna eat.

I’m not gonna be like, oh, just let’s just go to bed

and try to sleep through this hunger, whatever.

So I do, I know where my sweet spot is

for what I need to take in,

but I also have learned just to really listen,

like if I’m hungry, eat more.

But there are some days, I’m like, you know what?

I know I’m still short on my 3000,

but I’m also not hungry anymore.

So I’m just gonna, so I’m kind of giving myself

grace to knowing as the phases of the cycle change, as my hormones are changing that those

intakes are going to may need to change a little bit.

JANNINE: For sure. I know like calories, I mean, it’s interesting for a lot of people who are training,

we kind of figure out how, what we need, right? And we know so well, like what works and what doesn’t.

but it really, it’s crazy how, how it can flux depending on where, where the body is. Now,

one of the other things that you experience with some heat sensitivity, and I think for a lot of

people, we think hot flashes, but heat sensitivity can be a little bit different than that. Give

us a little explanation of how, how it presented for you. 

DR. BRI: Yeah, like, yeah, I wouldn’t put it in

the hot flash standpoint, but it’s just like, I mean, obviously, I live in Phoenix, our summers are

warm but I’ve lived here for 20 years like I’m kind of used to it um but this past summer like

my air conditioner temperature one I’ve changed it’s the same pretty much the same thing it’s always

been um but all of a sudden in the middle of the day if I was at home I’d be like I’m just kind of

like really warm right now like I feel like I just need to like go my sports bra and um

And I was kind of like, “Okay, it’s weird, but whatever.”

And like same thing, like at the gym at times I would notice like I was just a little bit warmer

than what I normally am or at work. I would just notice I’m a little bit warmer and

it wasn’t necessarily like said hot flash. I just noticed like just kind of a little bit warmer.

And then the same thing kind of going to bed at night. I never got like the night sweats, but

same thing just like laying in bed. I could just be like, “I need…” I always

I was with my fan on in the summer, but normally I’ll do like a sheet on top of me in the fan.

I’m like, I wanted nothing to do with a sheet for a period of time, like just falling asleep.

Once I like gotten to bed, my like metabolism dropped and whatever, it would go away.

But I definitely noticed just a difference there that that I haven’t since.

JANNINE: Wow.

Wow.

Yeah.

Well, because like, we, we describe hot flashes, like feeling flush and warm, you know, but,

but when you’re like, I don’t want extra things touching me, you know, including, including

my partner.

Stay away.

Um, I, I’ve experienced that myself too.

I haven’t had like a full on like, I’ll get warm, but I’ve never had like a full on kind

of hot flash, but I have had that heat sensitivity and I’ve also felt it with workouts.

I got overheated, realy fast, and I would be like,

open the doors, open the doors, let me get outside.

Did that ever happen to you where, like, in a workout,

you just were like, tired.

DR. BRI: And it was more of, if I would go for a run,

like normally in the summer, I can, I mean, okay,

it’s not the smartest thing to do,

but it can be like 100 degrees and I’ll go for a run.

And like, it wouldn’t even faze me necessarily.

But yeah, this past summer,

it’s like I would go for a run and be like half mile in and be like I got a walk like

I just don’t like I’m not feeling it. So during the like workout I remember when I was at

the gym. Yeah a little bit at the gym but I think I noticed it more and maybe it’s more

of the like cardio based workouts rather than like the lifting based workouts but um but

yeah I definitely noticed that. 

JANNINE: Well you know I think when you you’re used to a hundred

degree temperature and being in Arizona. I mean, I think it’s all like what you’re used to, right?

Well, 100 degrees, I’d die. But I go running when it’s negative 10, you know? So you can take

the, you know, and look at that way. And like negative 10 actually feels nicer now than it used

to. And I think maybe I am running a little bit, bit warmer in that department. So, you know, it’s,

It’s just it’s fascinating all the different things and all the different experiences we have.

I was really excited that you wanted to talk about it with me and share your experience with

folks, because I really think it’s valuable to talk with your friends and talk with people about

what you’re experiencing and what’s going on. And just sharing, because I think in your case,

you’re being so open to share with me and what is going on. I could identify and be like,

this is what’s happening and so now you know you can share with friends of course seeing

seeing patients as a physical therapist you probably see folks having symptoms have you seen

have you had anybody on on your table have a hot flash yet 

DR. BRI: Um I definitely have I mean even

prior to this I definitely have but it’s been interesting because um like I don’t mind talking

about this stuff and so like in the past I have had patients in there like mid 40s to young 50s who

are kind of going through it too. Like it’s been like just has some really good conversations

with them about all the things. 

JANNINE: Yeah, no, it’s, it’s fun stuff. It’s fun stuff. So now, of course,

fast forward, you’re, you’re doing better. Things are balanced. Periods not, not crazy heavy. It’s

back, back and regular from what I heard. 

DR. BRI: Sometimes they still are, but most of them are good now.

JANNINE: And here’s the thing, you know, like as we’ve talked about like will flux the body’s constantly

in flux and right now it’s definitely going to have ups and downs and one of the big things that I

always love to kind of, you know, highlight for folks is that hormone balancing is not just a like

you get it balanced and you’re done. There’s maintenance. There’s things to be paying attention

to. There’s things to be watching. So now that you’re feeling better and you’re dialing things in a

little bit more with it with coming up training and things of that nature, have you implemented

certain things to track and watch to keep yourself on top of some of the

hormone shifts that are coming up as you move forward. 

DR. BRI: Yeah, as far as tracking, I

not a ton, like I do track my cycle. I’ve done that for quite a few years,

partially because every time you go for your annual appointment, they’re like,

what was your last cycle? So I’m like, probably need this on the calendar. I

JANNINE: I wish to be able to tell you that.

DR. BRI: Right?

Also, so there’s no surprises.

So like, I can keep driving like,

okay, probably in three days,

I should probably have to carry stuff with me.

But for me, I think the biggest thing is just list,

like paying attention to how everybody’s feeling.

Like if I start not sleeping well again,

if I start having the heat sensitivity again,

or just any of those like symptoms I was experiencing before,

or even initially when we started adjusting

my hormones, I started having symptoms of low estrogen.

And so we had to do some things too,

or just like took away, took out how many days a week

I was taking my DIM complex to cause it got too low.

And so I think just knowing now what those symptoms

of low estrogen is as well, I can just really pay attention

to like what my symptoms are and if I’m starting to see

or notice anything, that’s different again.

so I can figure out what we need to adjust again.

JANNINE: Huge, huge.

Let’s talk about what your symptoms of low estrogen were

so that folks can kind of have a sense

because I still find that one of my biggest

educating points is, you know, heavy periods,

having periods that won’t stop,

that’s high estrogen, low estrogen looks different.

So give us a scoop in terms of what symptoms

you were experiencing.

DR. BRI: The main, the main thing slash things I noticed

like dryness like everywhere like lips overly trapped skin extra dry my like I was waking up

with my eyes dry like crazy dry eyes um vaginal dryness like pretty much everything was just super dry

JANNINE: Yeah it’s it’s a it’s a real deal it’s a real deal and I think one of the biggest things like

dry eyes dry vaginal tissue so many women are like taking one for the team because they’re like I

I guess this is what it’s going to be like when I get older and like ladies,

this is low estrogen and like getting UTIs and things like that.

Like this is low estrogen.

We want to counter that.

And especially for drying out, like that’s our lubrication, even our skin.

And yeah, these are your lips.

Nobody wants chapped lips.

Like that doesn’t feel good and cracky nails.

I don’t know if you ended up with any nails cracking or anything like that.

DR. BRI: I don’t think I didn’t let it go long enough.

’cause it was like pretty,

I’m like, when it wasn’t comfortable getting a tampon in,

I’m like, we got a problem.

(laughs)

JANNINE: Yeah, no, that means things are dropping.

And of course, folks, she had mentioned DIMM,

which is known as dien dolmethane.

And it’s a natural, this is an herb formula

that’s coming from cabbage cauliflower broccoli.

And we were using it to help to clear hormones naturally,

but it’s natural, but we can still overdo it in that case.

And this is where it’s really important

to be working on that balance.

And so now you know to kind of watch that

and see kind of what it feels like on that end of things.

Huge, huge stuff.

So of course, since we wanted to chat

and kind of put out the message

about what it’s like with Perimenopause

and some of the different things,

I would love for you to kind of tell us

if there’s anything I forgot about,

anything else you wanted to mention,

anything we should tell folks before we sign off today.

DR. BRI: Oh, let’s see, anything you missed.

As far as symptom-wise and stuff I went through, I don’t think we missed anything.

But I think the biggest thing, especially if, especially for athletes, training hard, is

just noticing or paying attention to that sluggishness, that weakness.

Like, yes, it happens if nutrition’s not on point.

happens just different times just for different reasons. But if

it becomes like this downward spiral trend, like there’s

probably something going on and it’s definitely worthwhile to

get the hormones looked at.

JANNINE: So huge, so huge. I mean, I think, you know, it goes a long

way once we get older to start tracking things and to pay

attention and knowing like what’s normal for you and what’s a

shift, because then we can head off some of the issues and one

of the big things that, of course, I’d like to make sure we

can help women head off is all the grief that goes with really heavy periods. The grief that

goes with dry, vaginal tissue, all that stuff too. But then the other big one is the body composition

change. So many women will notice it happening and they don’t know what to do and then it compounds

and now we’ve got 20, 30, 40, 50 pounds on top of the body that is a physically fit body. But

But unfortunately, we didn’t get the hormones in check

to keep the body comp in relative balance.

Let’s put it that way.

DR. BRI: Yeah  

JANNINE: Crazy stuff.

Wow, my goodness, good stuff today.

I really appreciate you chatting with me

and just helping women to kind of have a little bit of idea

of what it’s like to be an athletic woman

and going through perimenopause

and some of the symptoms that you may have.

So we’ll definitely make sure that you guys have more details.

sure that a lot of you weren’t taking notes while you’re listening. We’ll put them in

the podcast notes at doctorjkrausend.com. But also I mentioned Dr. Bri is a physical therapist

and she is in where where are you exactly in in the Phoenix area? Where are you?

DR. BRI: I’m in Mesa specifically. 

JANNINE: Mesa specifically gotcha. So folks can find you there and any

what can we tell them about finding you should they want to have someone that’s been through

some of the changes and understand training and things of that nature.

Yeah. I’m not up to social media anymore. You can find me on Instagram @bri.showman.

That’s probably the easiest at this point. 

JANNINE: Okay. Sounds good. Well, there you heard it guys.

And of course, you’ll see some of these little clips on Instagram as well,

just because we want to keep the word out there, but also help support women who are athletic,

who are training and really wanting to understand what is going on with the body.

and let’s keep you in tip-top shape because we want people strong for life.

That’s our jam. 

DR. BRI: Absolutely. 

JANNINE: Well, thanks so much, Bri, for coming on. I appreciate it.

DR. BRI: You’re welcome Jannine. This is fun.

JANNINE: [Outro] Hey, fellow health junkie. Thanks for listening to the Health Fix Podcast.

If you enjoy tuning in, please help support me to get the word out about the podcast.

Subscribe, rate, and review, and just get that word out. Thanks again for listening.

Jannine Krause

Get back to your wild, active, vibrant self

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