Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+
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Ep. 665 Metabolic Health in Perimenopause and Menopause | Menopause, Perimenopause, Metabolic Health
Welcome to this week's Midlife Minute episode! Have you ever been told your fasting glucose and A1c are normal, yet you still feel that something is off with your metabolic health? Today, we begin a new series exploring metabolic health during perimenopause and menopause. We take a closer look at the metabolic changes that can occur as estrogen declines, why traditional screening may miss early signs of insulin resistance, and which additional lab tests may offer a more complete picture of your health. Drawing on research and clinical experience, I explain how hormonal changes can affect insulin sensitivity, body composition, and cardiovascular risk. We also explore why it's important to look beyond the number on the scale, understand the differences between standard and advanced metabolic testing, and advocate for more comprehensive conversations with your healthcare practitioner. Stay tuned to learn which metabolic markers deserve your attention and how a proactive approach to testing can help you better understand your health during midlife. IN THIS EPISODE, YOU WILL LEARN: Why normal fasting glucose and A1c levels may not reveal early insulin resistance How declining estrogen affects insulin sensitivity, body composition, and cardiovascular health Why visceral fat and changes in muscle mass matter, even when your weight stays the same Which foundational metabolic markers to discuss with your healthcare practitioner, including ApoB, fasting glucose, A1c, blood pressure, and waist circumference How fasting insulin, HOMA-IR, and the triglyceride-glucose (TyG) index can provide additional insight into insulin resistance Why a two-hour oral glucose tolerance test may identify changes missed by fasting measurements What NMR lipoprotein profiling and C-peptide testing can reveal, and why they are considered additional tools rather than first-line screening How to approach metabolic testing in a practical, step-by-step way Why understanding your metabolic health during midlife requires looking beyond standard laboratory results Connect with Cynthia Thurlow Cynthia's website: https://cynthiathurlow.com/ Everyday Wellness Podcast on Instagram: https://www.instagram.com/everydaywellnesspodcast/ Follow Cynthia on Instagram: https://www.instagram.com/cynthia_thurlow_/ Submit your questions: support@cynthiathurlow.com Join The Midlife Pause community: https://www.facebook.com/groups/themidlifepause Cynthia's book, The Menopause Gut: https://www.penguinrandomhouse.com/books/777129/the-menopause-gut-by-cynthia-thurlow-np/ Intermittent Fasting Transformation: https://www.penguinrandomhouse.com/books/678861/intermittent-fasting-transformation-by-cynthia-thurlow-np/ The Midlife Pause Supplement Line: https://themidlifepause.com/ ** For more information about Cynthia's upcoming retreat, visit https://www.cynthiathurlow.com/ and click the Events tab. References: El Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention. AHA Scientific Statement. Circulation. 2020. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T. Menopause: A Cardiometabolic Transition. Lancet Diabetes Endocrinol. 2022. D'Costa Z, Spertus E, Hingorany S, et al. Cardiovascular Risk Associated with Menopause and Menopause Hormone Therapy. Curr Atheroscler Rep. 2025. Cybulska AM, Schneider-Matyka D, Wieder-Huszla S, et al. Diagnostic Markers of Insulin Resistance to Discriminate Between Prediabetes and Diabetes in Menopausal Women. Eur Rev Med Pharmacol Sci. 2023. Song Y, Manson JE, Tinker L, et al. Insulin Sensitivity and Insulin Secretion by HOMA and Risk of Diabetes in a Multiethnic Cohort of Women: WHI. Diabetes Care. 2007. Tsai SF, Yang CT, Liu WJ, Lee CL. Development and Validation of an Insulin Resistance Model for a Population Without Diabetes Mellitus. EClinicalMedicine. 2023. Doi SA, Ward GM. Examination of the fasting and 2-h plasma glucose in light of impaired beta-cell function. Endocrine. 2015. Abbasi F, Silvers A, Viren J, Reaven GM. Relationship Between Several Surrogate Estimates of Insulin Resistance and a Direct Measure of Insulin-Mediated Glucose Disposal. Diabetes Res Clin Pract. 2018. Piché ME, Lemieux S, Corneau L, et al. Measuring Insulin Sensitivity in Postmenopausal Women Covering a Range of Glucose Tolerance. Metabolism. 2007. Bhasin G, Dafale RS, Kamath SU, et al. Comparative performance of invasive, semi-invasive, and non-invasive insulin resistance-related indices. PLoS One. 2025. Wang Q, Ferreira DLS, Nelson SM, et al. Metabolic characterization of menopause: cross-sectional and longitudinal evidence. BMC Med. 2018.
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