Episodi

  • Supplements for Women’s Health: Fertility, Hormones & Vaginal Health — What Actually Helps | Episode 31

    Supplements for Women’s Health: Fertility, Hormones & Vaginal Health — What Actually Helps | Episode 31
    Feb 19 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson breaks down supplements for women’s health—how to use them strategically for hormone balance, fertility, vaginal health, and metabolism, and why more supplements is almost never better. She walks through her testing-first, nutrition-forward philosophy, explains why random supplement stacking can backfire, and outlines how to create a personalized supplement plan that actually works—and eventually allows you to come off supplements altogether. In This Episode, You’ll Learn: 🌱 Dr. Sarah’s Core Supplement Philosophy Supplements should: Support nutrition, not replace itBe measured and intentional, not randomBe used in the lowest effective doseAlways have a goal and an exit plan Taking 20–30 supplements because of TikTok, Instagram, or generic advice often overwhelms digestion, metabolism, and absorption—and can worsen symptoms. 🧪 Why Testing Comes First Before recommending supplements, Dr. Sarah emphasizes testing: Nutrient status (antioxidants, vitamins, omegas)Egg qualityHormone production (estrogen, progesterone, testosterone)Metabolism and absorption You should never take supplements that work against your hormone profile. ⚠️ When Supplements Can Make Things Worse Dr. Sarah shares examples of supplements that can backfire: DIM lowering estrogen in someone already estrogen-deficientProbiotics worsening symptoms when taken blindlyEgg quality supplements used unnecessarily when egg quality is already strong Without testing, supplements can actively harm progress. 💊 Targeted Supplementation: Less Is More Examples of precision-based supplementation: Low B12 → supplement only B12, not a full B-complexLow omega-3s → supplement omega-3, then recheckHigh omega-6s → adjust diet + omega-3 dose If levels don’t improve, the issue may be absorption or gut health, not dosage. 🧠 Fat-Soluble vs. Water-Soluble Vitamins Water-soluble (B vitamins, vitamin C): Excess is usually excreted in urine Fat-soluble (A, D, E, K): Stored in the bodyCan accumulate to harmful levelsMust be monitored regularly Taking fat-soluble vitamins long-term without testing can impair metabolism and organ function. 🦠 Absorption, Gut Health & Fillers Matter If supplements aren’t raising blood levels: Gut inflammation may be blocking absorptionMicrobiome imbalances may interfereFillers or capsule materials may cause reactions Some patients react to: Microcrystalline celluloseSilicaCapsule binders The issue is often the form, not the supplement itself. 🌿 Why One Supplement at a Time Is Important Starting multiple supplements simultaneously makes it impossible to identify: GI reactionsSensitivitiesWhat’s actually helping Dr. Sarah recommends introducing supplements one at a time—especially for sensitive patients. 🚫 Never Power Through a Bad Reaction If a supplement causes: Stomach painNauseaFatigueFeeling “off” Stop it. Your body should feel better, not worse. A reaction signals: Incorrect dosePoor toleranceWrong formInappropriate supplement for your physiology 🧬 Egg Quality Supplements: Keep It Simple For low egg quality, Dr. Sarah typically recommends: ~3 targeted supplements, not 10 Common options include: CoQ10 / UbiquinolNAC (N-acetylcysteine)GlutathioneResveratrolAlpha-lipoic acid These work best alongside nutrition and gut optimization—not in isolation. 🌸 Using Supplements to Support Hormone Production Supplements should address why hormones are low, not just push levels: Omega-3s for hormone building blocksProtein and B vitaminsDHEA for adrenal support (when appropriate)Vitex or maca in select cases If a supplement doesn’t change lab values or symptoms, it’s discontinued. 🦠 Probiotics Are Not One-Size-Fits-All Different guts need different species: LactobacillusBifidobacteriaSaccharomyces boulardiiAkkermansia Taking the wrong probiotic can worsen overgrowth and symptoms. 🌿 Estrogen Metabolism & Gut Support For estrogen dominance: Address beta-glucuronidaseIncrease fiber intakeUse targeted supplements (e.g., calcium D-glucarate when indicated) Dietary changes are often more powerful than pills. 🔄 Supplements Should Be Temporary Whenever Possible The long-term goal: Restore natural productionOptimize gut healthImprove nutrient absorptionTransition back to food-based support Supplements are a bridge, not a permanent crutch. 🩺 Short-Term Supplement Use After Surgery Example: Post-endometriosis surgery: Omega-3NACCurcumin Used for ~3 months to reduce inflammation and recurrence—then discontinued. ☕ Alternative Ways to Get Antioxidants To reduce pill burden: Food (greens, berries, protein)Teas (green tea)Spices (turmeric)Powders and tincturesIV nutrients (vitamin C, glutathione, ALA) A 360° approach minimizes daily capsule overload. 📊 Measuring Effectiveness Matters Supplements should produce measurable change: Improved labsBetter symptomsObjective data (e.g., CGM for blood sugar) If it’s not working, ...
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    22 min
  • Primary Ovarian Insufficiency (POI): Early Menopause, Hormones, Fertility & What to Do | Episode 30

    Primary Ovarian Insufficiency (POI): Early Menopause, Hormones, Fertility & What to Do | Episode 30
    Feb 16 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson explains Primary Ovarian Insufficiency (POI)—also known as premature menopause—what it is, how it’s diagnosed, why it happens, and how to support your body hormonally, metabolically, and emotionally if your ovaries stop functioning earlier than expected. Dr. Sarah walks through real patient examples, the long-term health implications of early estrogen loss, and why hormone support is often essential—not optional—in these cases. In This Episode, You’ll Learn: 🌱 What Primary Ovarian Insufficiency Is Primary Ovarian Insufficiency (POI) occurs when: Ovarian function declines before age 40Estrogen, progesterone, and testosterone levels are very lowBrain hormones (FSH, LH) are very highPeriods become irregular or stop completely It may also be called: Premature menopausePremature ovarian failure 🔥 How POI Is Diagnosed Diagnosis includes: Multiple hormone tests over timeVery low estrogen, progesterone, testosteroneVery high FSH and LH (brain signaling distress)Poor egg quality Hormones must be tested more than once to identify patterns, not just a single snapshot. 🧠 Why Brain Hormones Are So High When ovaries stop responding, the brain: Increases FSH and LH dramaticallyWorks overtime trying to stimulate estrogen productionContributes to fatigue, brain fog, and exhaustion Replacing estrogen helps calm this feedback loop. 🩺 Why POI Is Different From Natural Menopause Unlike menopause in the 50s: Some ovarian function may remainOvulation can occasionally returnFertility may still be possible with support This creates opportunities—but also unique medical needs. 🦴 Why Estrogen Replacement Is Critical Estrogen is not just about cycles—it: Protects bone densityProtects cardiovascular healthReduces inflammationSupports blood vessel growthNourishes every cell in the body Without estrogen, women with POI: Age more rapidlyLose bone density earlierHave increased heart disease risk 💊 Hormone Therapy: Not Optional in POI Dr. Sarah explains that in POI: Estrogen replacement is medically necessaryGoal is to replace ~2 mg/day (what the body would normally make)Hormones are continued until natural menopause age (~50–51) This is long-term physiologic replacement, not short-term symptom control. 🌸 How Hormones Are Replaced Treatment typically includes: Estrogen (patch or oral)Progesterone (always required with estrogen)Testosterone (if low energy, muscle loss, or libido issues) Doses are: PersonalizedTitrated carefullyAdjusted over time 📊 Ongoing Monitoring Is Key Follow-up includes: Hormone levels every 3–6 monthsSymptom trackingDose adjustments as life demands change Some days may require more hormone support (stress, workouts, illness). 🔄 Hormone Needs Are Dynamic Patients learn to: Adjust doses during high-stress or high-activity daysUnderstand how lifestyle affects hormone demandBecome empowered in their own care 🧬 What Causes POI? Potential causes include: Autoimmune disease (most common)Autoimmune thyroid disease (Hashimoto’s, Graves)Celiac disease, lupus, rheumatoid arthritisGenetic conditions (X chromosome abnormalities)Childhood infections (e.g., mumps)Poor ovarian blood flowAnatomical or vascular differences Sometimes, no clear cause is found. 🧪 What Else Needs to Be Evaluated A full POI workup should include: Autoimmune screeningThyroid functionBlood sugar and insulinLipids and omegasBone density (DEXA scan)Vaginal health and microbiome 🌸 Vaginal Health & Estrogen Low estrogen can cause: Vaginal drynessPain with intercourseMicrobiome imbalances Support includes: Daily vaginal estrogen for 1 monthOngoing use as neededPeriodic “reset” months (e.g., twice yearly) 👶 Fertility With POI: Is Pregnancy Possible? Yes—for some patients: ~5–10% may ovulate spontaneouslyHormone support improves chancesOvulation medications often requiredEstrogen priming may help rejuvenate ovarian function Each cycle must be closely monitored and adjusted. ❤️ Supporting Blood Flow & Inflammation Fertility support often includes: Treating anemiaImproving pelvic blood flowPelvic floor physical therapyVitamin E for circulationReducing inflammation and immune overactivity 🧠 The Emotional Side of POI POI can feel: UnfairIsolatingOverwhelming Dr. Sarah emphasizes: Do not compare your journey to othersFocus on learning what your body needsThis diagnosis is not a life sentence With the right plan, patients can feel excellent, energized, and empowered. Key Takeaways: POI is menopause before age 40Estrogen replacement is essential for long-term healthHormone therapy is individualized and monitoredFertility is sometimes still possibleBone, heart, and vaginal health must be protectedYou can feel amazing—even with this diagnosis Resources & Next Steps: If you’ve gone long stretches without a period, are experiencing menopausal symptoms in your 30s–40s, or have been diagnosed with POI, comprehensive hormone evaluation is ...
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    21 min
  • Menopause Explained: Symptoms, Hormones, Sleep, Weight & What to Do About It | Episode 29

    Menopause Explained: Symptoms, Hormones, Sleep, Weight & What to Do About It | Episode 29
    Feb 12 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson breaks down menopause from start to finish—what it is, when it happens, common symptoms, and how to support your body so you can feel strong, clear-headed, and energized during this transition. Dr. Sarah explains the difference between perimenopause and menopause, why symptoms happen, and why menopause is a natural life stage—not something to fear or “power through.” Most importantly, she emphasizes that just because menopause is natural does not mean you have to feel miserable. In This Episode, You’ll Learn: 🌸 What Menopause Actually Is Menopause is defined as: No menstrual cycle for 12 consecutive monthsOvaries producing very small amounts of estrogenNo ovulation or regular cycling Perimenopause is the transition phase, where communication between the brain and ovaries becomes erratic before cycles stop completely. 📅 When Menopause Happens Average age in the U.S.: 51Normal range: mid-40s to late 50s Every woman’s timeline is different—and that’s normal. 🔄 Why Symptoms Occur Menopausal symptoms stem largely from: Rapid drops and fluctuations in estrogenLoss of hormonal stabilityIncreased sensitivity to blood sugar, stress, and inflammation The body is shifting from cyclical hormone production to very low baseline hormone levels. 🔥 Common Menopause Symptoms Symptoms vary widely and may include: Hot flashes and night sweatsInsomnia and poor sleep qualityHair thinning, brittle nails, thin skinBrain fog and memory issuesMood changes, irritability, anxietyFatigue and low energyMetabolic slowdown and weight gain Some women have many symptoms; others have very few. ✨ Menopause Is Natural — Suffering Is Not Required Dr. Sarah emphasizes: Menopause does not need to be “fixed”Debilitating symptoms should be addressedYou deserve to feel great at every stage of life Do not dismiss symptoms as “just menopause.” 😴 Insomnia & Night Sweats: The Big Drivers Poor sleep is one of the most disruptive menopausal symptoms and is often driven by: Blood sugar instabilityHigh cortisol (stress hormone)Hormonal fluctuationsThyroid dysfunction Good sleep should happen 5–6 nights per week. Anything less needs support. 🩸 Blood Sugar & Metabolism Matter More Than Ever Hormonal transitions amplify blood sugar swings. Key goals: Avoid lows (50s) and highs (>140)Aim for a stable glucose curveAverage glucose under ~100 Dr. Sarah often uses continuous glucose monitoring (CGM) to personalize nutrition. 🥩 Protein First in Menopause Many women in menopause need: More proteinFewer carbohydratesCareful timing of meals Carbohydrate spikes can worsen: AnxietyMood swingsInsomnia ⚡ Cortisol, Anxiety & the “Tired but Wired” Feeling High nighttime cortisol can: Prevent melatonin productionSuppress estrogenCause middle-of-the-night awakenings Support includes: Strict bedtime routinesNo blue light 90 minutes before bedJournaling, calming rituals, nervous system regulation 🌡️ Thyroid & Thermoregulation Thyroid dysfunction can worsen: Hot flashesCold intoleranceTemperature swings Optimizing thyroid function is essential for symptom control. 💊 Bioidentical Hormones — Used Correctly Hormone therapy can be: Life-changingRestorativeProtective But must be: PersonalizedProperly dosedMonitored carefully Hormones alone are not enough without addressing nutrition, gut, thyroid, and metabolism. 🥦 Nutrition Still Comes First Key principles: Stable blood sugarAdequate proteinHigh-quality fatsNo artificial sweeteners (stevia, monk fruit, erythritol, etc.) Dr. Sarah recommends a primal-style diet during menopause. ⏰ Intermittent Fasting — Use Carefully Unlike cycling women, menopause may benefit from fasting—but timing matters: Do not skip breakfastCortisol is highest in the morningBetter to shorten or skip dinner instead Fasting windows should support metabolism, not stress it. 🏋️ Exercise for Hormone Support & Bone Health Essential components: Weight-bearing exercise (especially with low estrogen)Resistance training for muscle massModerate cardio for heart health Overtraining can worsen: Weight gainFatigueHormonal imbalance 🧠 Brain Fog & Estrogen Metabolism Brain fog can result from: Poor estrogen clearanceImbalanced estrogen ratios (E1, E2, E3)Gut, liver, or kidney dysfunction Daily bowel movements, hydration, and detox pathways matter. 💧 Hydration & Hormone Clearance Adequate water intake supports: Kidney functionEstrogen metabolismReduced brain fog 📊 A Whole-Body Approach True menopausal support evaluates: HormonesBlood sugarSleepCortisolThyroidGut healthNutritionExercise Everything must work together. 🔁 Lifestyle Changes Are Required — And Worth It What worked in your 20s–40s may no longer work. Menopause requires: New strategiesGreater precisionMore intentional self-care With the right plan, many women feel better in their 50s and 60s than ever before. Key Takeaways: Menopause is a natural transition, not a...
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    22 min
  • Nutrition Testing Explained: Antioxidants, Omegas, Mitochondria & Hormone Health | Episode 28

    Nutrition Testing Explained: Antioxidants, Omegas, Mitochondria & Hormone Health | Episode 28
    Feb 9 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson dives into nutritional status and nutrition testing—why it’s foundational for hormone production, fertility, and overall health, what nutrients are most important to test, and how to turn results into a personalized action plan. Dr. Sarah explains why even “healthy eaters” can be nutrient deficient, how deficiencies impact ovulation, egg quality, energy, and metabolism, and why targeted testing allows for precise nutrition and supplement support instead of guesswork. In This Episode, You’ll Learn: 🥗 Why Nutrition Is the Foundation of Hormone Health Hormone production depends entirely on having the right nutritional building blocks. Dr. Sarah explains how proper nutrition supports: Estrogen, progesterone, and testosterone productionRegular ovulation and healthy cyclesEnergy, metabolism, and gut functionMitochondrial and cellular health Feeling good, ovulating regularly, and having stable energy all start with nutrition. 🧪 Why We Test Nutrients Instead of Guessing Even with a “clean” diet, it’s hard to know: If you’re absorbing nutrientsIf ratios are correctIf what you’re doing is actually working Testing provides clarity, direction, and measurable progress. 🧬 The NutrEval: A Comprehensive Nutrition Panel One of Dr. Sarah’s favorite tests evaluates: Antioxidant statusOxidative stressMitochondrial functionOmega fatty acid ratiosToxin exposureMethylation needs This gives a full picture of cellular health and hormone-building capacity. ✨ Antioxidants & Egg Quality High antioxidant levels are essential for: Reducing oxidative stressProtecting egg qualityPreventing chromosomal abnormalities Key antioxidants evaluated include: Vitamin AVitamin CVitamin EAlpha-lipoic acidCoQ10 Low antioxidants = increased cellular stress and reduced fertility potential. ⚡ Mitochondrial Health = Energy & Hormones Mitochondria are the energy factories of your cells. Poor mitochondrial function can lead to: FatiguePoor hormone productionBrain fogMetabolic dysfunction Nutrition testing helps identify where mitochondrial support is needed. 🔥 Omega-3, Omega-6 & Inflammation Balance Dr. Sarah explains why omega balance matters: Omega-3s are anti-inflammatory and hormone-supportiveOmega-6s are abundant in seed oils and easy to overconsume Even “healthy” diets can have excess omega-6 due to salad dressings and packaged foods. Testing ensures proper ratios, not just good intentions. 🐟 Why Omega-3s Are Hard to Get from Diet Alone Top omega-3 sources are almost exclusively fish. If fish isn’t eaten 2–3x per week, supplementation is often necessary—and must be measured to ensure it’s working. ☣️ Toxins & Heavy Metals That Impact Hormones Nutrition testing also screens for: LeadMercuryArsenicCadmium These toxins can interfere with estrogen production and overall endocrine function, sometimes requiring detox support or increased antioxidant intake. 🧠 Methylation Support: Are You Using the Right Vitamins? Some bodies require methylated forms of nutrients like: Folate (methylfolate)Vitamin B12 (methylcobalamin) Without proper methylation, vitamins can build up without being utilized—testing identifies what form your body needs. 🥦 Food First, Supplements Second Dr. Sarah emphasizes: Nutrition should always come firstSupplements should be targeted, not randomHigh levels don’t need more supplementation Brightly colored fruits and vegetables provide plant-based antioxidants, while supplements fill only true gaps. 💊 Why Supplements Sometimes “Don’t Work” Low blood levels despite supplementation may indicate: Poor absorptionCapsule fillers (like microcrystalline cellulose)Gut or stomach issues Switching forms (liquid, powder, different capsule) can dramatically improve absorption. 🧂 Minerals Matter More Than You Think Key minerals tested include: Magnesium (sleep, metabolism, hormone balance)Zinc (ovulation, immunity) Deficiencies may reflect absorption issues, mineral imbalances, or endocrine dysfunction. 📊 Personalized Plans, Not Supplement Overload Dr. Sarah explains why random supplement stacks: Overwhelm the gutDon’t address root causesWaste time and money Targeted plans focus only on deficiencies—and are re-tested to ensure improvement. 💉 When IV Nutrition Is Helpful In cases of severe deficiency or malabsorption, IV nutrients can: Rapidly replenish vitaminsSupport healing while gut protocols are underwayFast-track hormone recovery IVs may include vitamin C, B vitamins, glutathione, and alpha-lipoic acid. Key Takeaways: Nutrition is the foundation of hormone production“Eating healthy” doesn’t guarantee nutrient sufficiencyAntioxidants are critical for egg quality and cellular healthOmega balance directly affects inflammation and estrogenSupplements should be personalized and measuredIf nutrients aren’t absorbing, gut health must be addressed Resources & Next Steps: If you’re struggling with ...
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    14 min
  • Bioidentical Hormones Explained: Testosterone, Progesterone, Estrogen & How to Use Them Safely | Episode 27

    Bioidentical Hormones Explained: Testosterone, Progesterone, Estrogen & How to Use Them Safely | Episode 27
    Feb 3 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson breaks down bioidentical hormones—what they actually are, how they differ from synthetic hormones, and how they’re used safely and effectively in clinical practice. She walks through testosterone, progesterone, estrogen, and DHEA, explaining how each hormone functions in the body, the best delivery methods, and why dosing, timing, and personalization matter so much. Rather than using hormones as a “band-aid,” Dr. Sarah emphasizes a root-cause, physiology-first approach—supporting the body while working toward long-term balance and eventual weaning when appropriate. In This Episode, You’ll Learn: 🌱 What “Bioidentical” Really Means Bioidentical hormones have the same molecular structure as the hormones your body naturally produces. Dr. Sarah explains the key hormones used in practice: TestosteroneProgesteroneEstrogen (estradiol, estrone, estriol)DHEA (adrenal hormone and precursor) These hormones are used to support—not override—natural physiology. 🔥 Testosterone in Women: Why It Matters Testosterone isn’t just for men. Women need it for: LibidoEnergy and motivationMuscle mass and recoveryHealing and metabolismEgg quality and follicle stability Dr. Sarah explains why daily, low-dose testosterone is preferred over pellets or injections, how it supports fertility, and why the goal is always eventual weaning—not lifelong use. 💊 Best Absorption Methods for Testosterone Troches (dissolved between cheek and gum)Topical creams Oral testosterone is avoided to protect gut and liver health and ensure steady absorption. 🌸 Progesterone: Timing Is Everything Progesterone is only made after ovulation. Dr. Sarah explains: Why checking progesterone at the wrong time leads to misdiagnosisWhy progesterone taken too early can inhibit ovulationThe danger of “cycle day 21” testing for everyone Progesterone should always support the natural cycle—not disrupt it. 🩸 When Progesterone Is Helpful Progesterone may be used when: You’re not ovulating at allYou have irregular or absent cyclesYou have a luteal phase defectProgesterone is low after ovulationSupporting early pregnancy Dr. Sarah outlines how cyclic progesterone can help retrain the body to ovulate and cycle regularly. 🌙 How Progesterone Is Given Oral (most common; taken at night due to drowsiness)Vaginal (more uterine-focused, less blood absorption)Patch or cream (typically for peri/postmenopause)Injections (sometimes necessary in pregnancy) If progesterone makes you feel worse, the dose or delivery method needs adjusting—there’s no “powering through.” 🧠 Estrogen: Not Too High, Not Too Low Estrogen is produced daily and plays a critical role in: OvulationCycle lengthEnergy and cognitionUterine lining healthPregnancy support Dr. Sarah explains why estrogen must be tested before and after ovulation and how low estrogen is often misdiagnosed as PCOS. 📈 When & How Bioidentical Estrogen Is Used Estrogen may be used when levels are truly low and root causes are addressed simultaneously. Delivery options include: Oral estradiol (micro-dosed and carefully titrated)Vaginal estrogen (for dryness, UTIs, cervical mucus, microbiome support)Patches (helpful in perimenopause or when oral estrogen isn’t tolerated) The goal is always physiologic balance—never excess. 🌊 Perimenopause, Menopause & Hormone Smoothing During perimenopause, estrogen can swing dramatically. Low-dose daily estrogen (often via patch) can: Smooth hormone fluctuationsReduce brain fog, mood swings, headachesImprove sleep and energy Dr. Sarah emphasizes that hormone therapy should always have a plan—support, stabilize, then wean. 🧬 DHEA: The Precursor Hormone DHEA supports: Estrogen and testosterone productionAdrenal health and stress resilienceFertility and pregnancy support It can be used orally or vaginally depending on goals and symptoms. 📊 Root Cause Always Comes First Hormones are never used in isolation. Dr. Sarah reviews: Nutrition and adequate calorie intakeStress and cortisol balanceThyroid and adrenal healthGut absorption and metabolism Hormones support healing—they don’t replace it. Key Takeaways: Bioidentical hormones match your body’s natural hormonesDose, timing, and delivery method matterHormones should make you feel better, never worseTesting must match physiology and cycle timingRoot causes must always be addressedEvery hormone plan needs an end game Resources & Next Steps: If you’re struggling with hormone symptoms, fertility challenges, or perimenopause and want a personalized, physiology-based approach, support is available. 📍 Westminster, Colorado 🌐 Learn more or schedule: verafertility.com 📧 Follow along: @verafertility
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    30 min
  • Perimenopause Explained: Hormone Roller Coasters, Testing & How to Feel Like Yourself Again | Episode 26

    Perimenopause Explained: Hormone Roller Coasters, Testing & How to Feel Like Yourself Again | Episode 26
    Jan 26 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson breaks down perimenopause—what it is, how to know if you’re in it, and what you can do to feel better during this major hormonal transition. She explains why symptoms can feel extreme and unpredictable, how hormone testing actually works in perimenopause, and why a whole-body, root-cause approach is essential for long-term relief. Rather than accepting “this is just part of aging,” Dr. Sarah outlines how targeted nutrition, lifestyle support, lab testing, supplements, and — when appropriate — low-dose bioidentical hormone therapy can dramatically improve quality of life. In This Episode, You’ll Learn: 🌿 What Perimenopause Actually Is Perimenopause is the transition between regular, ovulatory hormone production and menopause. Instead of a smooth decline in estrogen and progesterone, hormone production becomes sporadic and erratic, leading to dramatic highs and lows. This hormonal “roller coaster” is what drives many of the frustrating symptoms women experience. 🔥 Common Symptoms of Perimenopause Dr. Sarah explains that symptoms can vary widely and may include: Anxiety and mood swingsDepression or irritabilityBrain fog and poor concentrationHot flashes, night sweats, and temperature intoleranceFatigue and poor sleepWeight gain despite eating well and exercisingChanges in metabolism Perimenopause is natural — but suffering is not inevitable. 🧪 How to Test for Perimenopause (and Why One Lab Isn’t Enough) Hormone levels fluctuate dramatically in perimenopause. One “normal” lab does not rule it out. Dr. Sarah explains: Why FSH and LH are key markersWhat values typically look like in reproductive years vs. perimenopause vs. menopauseWhy testing multiple times, at least two weeks apart, is critical to identify trends Trending labs over time gives a much clearer picture than a single snapshot. 🩸 When Irregular Bleeding Is a Red Flag Not all irregular cycles require treatment — but certain symptoms do: Extremely heavy bleedingBleeding lasting weeks at a timeBleeding through clothes or experiencing “waterfall” bleeding These situations warrant intervention to protect health and improve quality of life. 🥗 Why Nutrition Is Always the Foundation Before jumping to medication, Dr. Sarah emphasizes: Eating enough calories to support hormone productionStabilizing blood sugar to reduce hormone swingsEnsuring adequate protein, healthy fats, and micronutrients Nutrition is the base that allows any other therapy to work effectively. 🧠 Supporting the Entire Endocrine System Perimenopause is not just about estrogen and progesterone. Dr. Sarah walks through why it’s essential to assess: Thyroid function (full thyroid panel, not just TSH)Adrenal health (DHEA/DHEA-S)Nutrient status (magnesium, zinc, B vitamins, omega-3s)Mitochondrial and metabolic health 📈 Why Blood Sugar Matters More Than You Think Using continuous glucose monitoring, Dr. Sarah explains how blood sugar instability can worsen: InsomniaAnxietyInflammationHormone irregularity Balanced glucose = more stable hormones. 🌱 Gut Health, Absorption & Hormone Balance Even a perfect diet won’t help if nutrients aren’t absorbed. Daily bowel movements, minimal bloating, and proper digestion are essential to hormone production and detoxification. 💊 Supplements: When to Support vs. When to Avoid High estrogen → support detox pathways (DIM, calcium D-glucarate)Low hormones → avoid estrogen-lowering supplementsStrategic use of nutrients like DHEA when appropriate Supplement choice must match hormone status. 🧠 Mental Health & Nervous System Support Mood changes during perimenopause are influenced by: Hormone fluctuationsLife stressors (career changes, aging parents, family transitions) Sarah highlights the importance of therapy, nervous system regulation, and targeted neurotransmitter support when needed. 🌸 Hormone Therapy: When It’s Helpful Hormone replacement therapy can be life-changing for severe symptoms such as: Debilitating insomniaDrenching night sweatsSevere brain fog Sarah explains:Why low-dose, bioidentical hormones are usedHow therapy is personalizedThe importance of monitoring labs and symptomsWhy hormones should support — not override — natural physiology 📊 Discovery, Stabilization & Weaning Phases Hormone therapy is never “one and done.” Treatment includes: Discovery phase (finding the right dose)Stabilization phase (feeling great consistently)Planned weaning into menopause The goal is support, not dependence. Key Takeaways: Perimenopause can last 5–10 years and looks different for everyoneHormone swings — not aging — drive many symptomsOne lab test is not enough to diagnose perimenopauseWhole-body evaluation is essential for lasting resultsHormone therapy can be powerful when used thoughtfullyYou are not doomed to feel bad — feeling better is possible Resources & Next Steps: If you think you may be in perimenopause...
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    26 min
  • Bypassing the Gut: How IV Therapy Supports Egg, Sperm & Implantation Health | Episode 25

    Bypassing the Gut: How IV Therapy Supports Egg, Sperm & Implantation Health | Episode 25
    Jan 19 2026

    In this episode of The Hormone Café, Dr. Sarah Pederson explains how IV nutrient therapy can support fertility when diet and supplements aren’t enough. She breaks down why nutrient deficiencies persist despite “doing everything right,” how IVs bypass absorption barriers, and how targeted IV formulations can improve egg quality, sperm quality, implantation, and surgical recovery.

    In This Episode, You’ll Learn:

    💉 Why IV Therapy Matters in Fertility Care Dr. Sarah explains why many fertility patients remain deficient in key nutrients despite optimal diet and supplementation:

    • Poor gut absorption
    • Digestive inflammation or dysfunction
    • Liver metabolism limiting nutrient availability IV therapy allows nutrients, antioxidants, and hydration to be delivered directly into the bloodstream—bypassing the gut and liver for faster, more effective results.

    🧪 Key Nutrients Commonly Low in Fertility Patients Frequently identified deficiencies include:

    • Folic acid & B vitamins
    • Vitamin C and other antioxidants
    • Glutathione These nutrients are essential for:
    • Cellular energy and metabolism
    • Egg and sperm quality
    • Detoxification and inflammation reduction

    🥚 Egg Quality IV Designed to support ovarian health and cellular protection:

    • High-dose antioxidants to reduce oxidative stress
    • Supports mitochondrial function and egg integrity
    • Can be used weekly or monthly depending on fertility goals Sarah explains that while we’re born with all our eggs, egg quality can be supported through targeted antioxidant pathways.

    🌱 Implantation & Uterine Blood Flow IV Created for patients with:

    • Thin uterine lining
    • Recurrent miscarriage
    • Chronic inflammation or endometritis This IV focuses on:
    • Improving blood flow to the uterus
    • Supporting implantation before and after ovulation
    • Working alongside diet, supplements, and medication—not replacing them

    🩺 Pre- & Post-Surgical Recovery IVs Dr. Sarah discusses why surgery should be restorative—not depleting:

    • Surgery places stress on the body and increases dehydration
    • Nutrients and electrolytes support healing and circulation
    • IVs help reduce recovery time and support fertility-preserving outcomes These IVs are now integrated into Vera’s fertility-sparing surgical protocols.

    👨 Sperm Quality IV Men benefit from IV therapy too. This IV supports:

    • Sperm morphology (normal head and tail structure)
    • Motility and progressive motility
    • Hydration and reduced sperm agglutination
    • Blood flow to the testes Ideal for men who have optimized diet and supplements but still have suboptimal semen parameters.

    🧠 IV Therapy as an Adjunct—Not a Replacement Dr. Sarah emphasizes:

    • IVs do not replace good nutrition or supplements
    • They enhance and accelerate results when absorption is limited
    • Best used as part of a comprehensive fertility plan
    Key Takeaways:
    • Persistent nutrient deficiencies often stem from absorption issues—not effort
    • IV therapy delivers targeted nutrients directly into circulation
    • Antioxidants play a critical role in egg and sperm quality
    • Blood flow and hydration are essential for implantation and recovery
    • IV therapy can support fertility at multiple stages for both men and women
    Resources & Next Steps:

    If you feel like you’re doing “all the right things” but still struggling with egg quality, implantation, recovery, or sperm parameters, IV therapy may be a supportive next step.

    📍 Westminster, Colorado 🌐 Learn more or schedule: verafertility.com 📧 Follow along: @verafertility
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    9 min
  • Low, Dominant, or Imbalanced? Understanding Estrogen & Progesterone Profiles | Episode 24

    Low, Dominant, or Imbalanced? Understanding Estrogen & Progesterone Profiles | Episode 24
    Jan 15 2026

    In this episode, Dr. Sarah Pederson breaks down the three most common female hormone profiles—low estrogen & progesterone, estrogen dominant, and progesterone dominant/low estrogen—and explains how each one affects mood, energy, cycles, fertility, and overall health. This episode empowers women to understand their symptoms, test hormones properly, and align nutrition, exercise, supplements, and treatment with their unique hormone profile.

    In This Episode, You’ll Learn:

    🧪 The Three Core Hormone Profiles Dr. Sarah explains how estrogen and progesterone work together—and what happens when they fall out of balance:

    • Low Estrogen + Low Progesterone (“Low–Low”)
    • Estrogen Dominant (Relative Low Progesterone)
    • Progesterone Dominant / Low Estrogen

    Each profile presents differently and requires a different approach to treatment, lifestyle, and supplementation.

    🩺 Why Proper Hormone Testing Matters

    • Best timing for hormone labs:
      • Cycle day 3: Estrogen, progesterone, FSH, LH, testosterone
      • 5–7 days after ovulation (depending on luteal phase length)
    • Why checking progesterone at the wrong time leads to misdiagnosis
    • How incorrect supplementation can worsen symptoms instead of helping

    🌱 Low Estrogen & Low Progesterone (Low–Low Profile) Common symptoms include:

    • Depression, brain fog, low stress tolerance, fatigue
    • Light or skipped periods, long cycles, short luteal phase
    • Recurrent miscarriage, poor cervical mucus, thin uterine lining
    • Low libido, vaginal dryness, UTIs, hair thinning, brittle nails
    • Hot flashes, cold intolerance, poor circulation

    Root causes may include:

    • Chronic stress
    • Under-eating or poor nutrient absorption
    • Excessive exercise
    • Postpartum or breastfeeding states
    • Perimenopause or ovarian insufficiency

    Support strategies:

    • Adequate calories and protein
    • Gentle exercise (yoga, Pilates, barre)
    • Stress reduction and sleep prioritization
    • Targeted supplements (omega-3s, magnesium, vitex)

    ⚖️ Estrogen Dominance Common symptoms include:

    • Anxiety, irritability, mood swings
    • Heavy or painful periods, clots, PMS
    • Breast tenderness, fibroids, endometriosis
    • Migraines, acne, bloating, weight gain
    • Poor sleep, constipation, joint inflammation

    Key contributors:

    • High sugar or refined carbohydrate intake
    • Low protein consumption
    • Poor liver or gut estrogen metabolism

    Support strategies:

    • Higher protein intake (≈80g/day)
    • Strength training, HIIT, frequent movement
    • Fiber-rich diet for estrogen detoxification
    • Supporting liver and gut health
    • Reducing alcohol and excess sugar

    🌡️ Progesterone Dominant / Low Estrogen Common symptoms include:

    • Sedation, brain fog, low motivation
    • Excessive sleepiness, low blood pressure, dizziness
    • Weight gain, insulin resistance, cravings
    • Heat intolerance, nausea, constipation
    • Vaginal dryness, low libido, breast fullness

    Key focus areas:

    • Supporting ovulation and estrogen production
    • Balanced, moderate exercise
    • Stress reduction and adequate sleep
    • Avoiding progesterone-only supplementation when estrogen is low

    🧠 Why Hormone Ratios Matter Dr. Sarah emphasizes:

    • Hormones must be balanced—not treated in isolation
    • DIM, progesterone, or bioidentical hormones can be harmful if mismatched
    • Nutrition, exercise, and supplements should support—not fight—your hormone profile
    • Ongoing lab monitoring ensures treatment is helping, not harming
    Key Takeaways:
    • Most symptoms are clues to your hormone profile—not random
    • Estrogen and progesterone must be evaluated together
    • Timing of hormone testing is critical
    • One-size-fits-all hormone advice often backfires
    • Aligning lifestyle and treatment with your hormone profile leads to better mood, energy, cycles, and fertility
    Resources & Next Steps:

    If you suspect hormone imbalance or feel stuck with persistent symptoms, proper hormone testing and individualized care are essential.

    📍 Westminster, Colorado 🌐 Schedule a consultation: verafertility.com 📧 Follow along: @verafertility
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