[00:00:00] Leah: My guest today is Dr. Qua Miller, a board certified ob gyn and National Certified Menopause practitioner. She is absolutely amazing and she has reached the absolute ideal of what we think as a society success should look like. Realized it wasn’t making her happy. She was brave enough to let it go. That is everything we talked about in part one of this episode.

[00:00:25] And now, I mean, come on. I have an ob gyn who specializes in menopause. I wanna ask her how we go through this midlife section, how we enter perimenopause, what is perimenopause? How do we just go through all of this with more grace, more gumption, and just. Feeling good. So let’s jump into part two of this episode.

[00:00:49] But if you didn’t get a chance to listen to part one first, I would definitely suggest go back, listen to part one, cuz you are gonna wanna hang on to every word. This incredible woman says. All right, let’s jump in.

[00:01:07] So I wanna make a huge shift because I mean, you are expert and. Specialty as a physician is in perimenopause, menopause, like helping women in, I do we say the mid part of their lives. I don’t even know what we say, but yeah. 

[00:01:52] When 

[00:01:52] Dr. Miller: you start thinking of midlife health and then going into that menopausal transition, menopause average age is about 51, but there’s that transition that can be as long as 10 years before then.

[00:02:04] Okay, so 

[00:02:04] Leah: can we start, can you just tell me what perimenopause means? Can we just 

[00:02:09] Dr. Miller: start there? Yeah, absolutely. So if you live long enough and you have uterus and ovaries, you will go through menopause. I think Oprah just said on one of her specials is that you can outrun the Big O, the big am. Right. And so at some point we will go through menopause, which is the sation of, um, menstrual cycles.

[00:02:28] Average age is about 51, but you don’t just abruptly go through menopause. You don’t just abruptly just stop cycles. There’s a whole constellation of symptoms that we think of in the menopausal transition or perimenopause that kind of leads you up to that. So one of the common things that we find are menstrual cycle alterations and changes.

[00:02:51] Sometimes your cycle gets closer together, it gets farther apart. Um, you might have a change in the amount of bleeding that you’re experiencing. Sometimes it’s really, really heavy. Sometimes it’s really, really light. You might start experiencing what we call vasomotor symptoms of estrogen deficiency. So the hot flashes, the night fl, the night sweats, those sorts of things.

[00:03:14] You can have muscle joint aches, you can have skin changes, hair changes, mood changes, heart changes like heart palpitations. I see a lot of like increase of both of those symptoms when you think of increased anxiety and depressive symptoms around this time. There’s sexual dysfunction because you might have sex like vaginal dryness or just a loss of libido.

[00:03:37] Um, and so there’s so many different things that are happening, and unfortunately we don’t have a menopause class. You know how we have the puberty class. And they used to separate out, you know, the genders and they used to say, you go to this class and you go to this class. Yeah. We don’t have that for menopause.

[00:03:55] And even when you think of pregnancy, like you have 12 to 14 visits of your pregnancy and there’s so much recognition of like, so much time and education needed. And then here we get to menopause, which is a huge transition from a hormonal standpoint for your body and, and what’s happening and not a. Yes.

[00:04:14] Nothing That’s so 

[00:04:14] Leah: true. I honestly, like, I don’t even wanna admit this, but I feel like my education about perimenopause and menopause has come from sitcoms, so I’m not thinking that’s solid. 

[00:04:25] Dr. Miller: Right. Comedic relief, 

[00:04:27] Leah: like, yeah, like I, I don’t actually know. Okay, so perimenopause, so sh we can kind of assume it’s maybe starting about 40, 41.

[00:04:35] It’s just kinda, and then it’s about 10 years. 

[00:04:38] Dr. Miller: So on average it’s about four years is the transition, but it can be as long as 10 years. And remember, 51 is just the average. And so there are some who will experience menopause at like 40, 41. It’s considered early menopause, but it’s still menopause. But that means that their symptoms may start in their mid to late thirties.

[00:05:00] And so a lot of these women are not even counseled by their. Providers that this potentially could be what’s going on, 

[00:05:08] Leah: right? They’re like, what has happened to me? Yes. Okay, so, so what we’re seeing is the symptoms are, could be mood swings, could be hair change, hair loss, um, could be insomnia, changes, insomnia, sleep, 

[00:05:23] Dr. Miller: acne, brain fog.

[00:05:25] Acne, all, all of it. 

[00:05:27] Leah: And then of course, the ones we know from, from sitcoms, which is hot flashes and like night sweats, right? Like those, those are the, the big ones. Oh, and weight gain, right? That can be, and feeling low. It’s huge. 

[00:05:37] Dr. Miller: Huge weight gain, low energy. And a lot of this is physiologic. So this is one of the things that I’m really passionate about because.

[00:05:45] Weight and like youthfulness in general is, is so scrutinized in our society. And so if you can imagine, you don’t know what’s actually happening physiologically in your body and you might notice weight. And for women in the menopausal transition, they actually see it a lot in their midsection. And all of a sudden now we’re dealing and now we’re dealing with, um, self-esteem issues.

[00:06:09] As it relates to youthfulness, this is kind of the sun setting of reproductive potential. And then you’re also seeing your body shift almost like in a male pattern form where you’re getting more fat deposition here and you’re losing a little bit of that waistline. There’s physiology behind that and why that’s happening, and that’s why I think education for women to understand what’s happening is so important, but we don’t 

[00:06:36] Leah: really get that.

[00:06:37] Yeah, I agree. So, okay, how can we, can we help ourselves through this? Do we have to experience all these symptoms? Like is it a requirement? Are there things that we can do for ourselves to minimize them or negate them all together? Like what can tell me what Absolutely. 

[00:06:54] Dr. Miller: Absolutely. So couple of things that we can’t change is aging.

[00:06:59] Right. And there are certain things that happen in the body related to aging, namely our ability to hold onto muscle, um, our way that our diets are even, right? Like as we age, our metabolic, uh, rate actually decreases. And so if you did the same exact thing that you did in your thirties that you do in your sixties, you will gain weight.

[00:07:20] And so a big thing that I teach is what I call like my precisely model, my precisely model, cuz you’re precisely made. Where the P in the R stands for understanding what’s happening from a physiologic and a reproduction, a reproductive sense, sometimes that education, and this has been born out in research, that when you provide individuals with education about what to expect along the menopausal journey, their experience, the, excuse me, the severity of their symptoms completely down.

[00:07:55] Right? And so, Providing education and empowering education to know this is what’s happening in your body, and then these are the options, including hormones. Hormones are great if you are. If you are a candidate for hormones, I say, go for it. And then there are some who would like to stay away from hormones and there are other options too.

[00:08:15] And so really educating yourself about it and then finding. A clinician who knows what they’re talking about when it comes to menopause. I am a national certified menopause practitioner through the North American Menopause Society. We have to take exams, we have to do maintenance of certification. We go to conferences every year.

[00:08:34] This is what we live, and so find those people. Find those platforms where you can actually get really good evidence-based education and care for your symptoms. The other thing too is like when we look at like the menopausal transition in your forties, this is a really critical time for a lot of different reasons.

[00:08:53] Psychosocially, we call this the sandwich generation. You’re taking care of aging parents and maybe taking care of children, so you’re really getting pulled in multiple directions. You also may have new expectations and responsibilities in career or even in your family relationship, changes with your partners and your friends.

[00:09:13] Midlife crisis exists for a reason, and while I don’t think it’s necessarily a crisis for many, there are shifts in terms of what’s happening. And so understanding how to protect your energy is really, really important. And so I talk to people about boundaries. And, and having to protect that energy in that, you know?

[00:09:36] And then the e precisely also talks about energy and movement. One of the things that we can do to feel good in our bodies, how our bodies are, is just moving our bodies. And I’m not saying I. Movement for weight loss. I’m saying movement to feel good in our bodies. We know that that helps for bone health, that that helps for maintenance of muscle, for flexibility, all of the things that are gonna help us later on in life.

[00:10:00] We know that when we get up a good sweat that that triggers. That those like mood stabilizing hormones like serotonin and endorphins that make us feel good. And so encourage a way to move that feels good, that fits within your lifestyle and feel empowered in doing so and shifting the reason why you’re doing it.

[00:10:20] We’re not doing it because we wanna fit some sort of like aesthetic or ideal. We’re doing it because it feels good in our body. I also encourage community. C is community, community, community, community. There are, there are studies that actually show when you come together in community and discuss your menopausal symptoms, the severity again of your symptoms goes down because you have community to kind of work through.

[00:10:45] Now you’ll be so, you’ll be excited that. What worked for your friend for hot flushes that actually may work for you, and you could share information and you can feel not so isolated. You can feel like you, that you’re not alone. Another piece is, like I said, I is understanding your new identity. This is a cha.

[00:11:07] This is like a whole different aspect of your life. It’s a reproductive transition, but for so many because of the age, think of your forties, your, your milestone birthday, 50. There’s so many changes that come to your identity, and I encourage people to explore that a little bit. And then also, sexual health is really big.

[00:11:31] And so we talk about how can you. Maintain a fully fulfilling sexual life, if that is what you desire, and if you have a sense that something is off and you’re not happy, knowing that you’re, it’s not in your head that this is really a phenomenon and that we can treat, that I think could be really empowering.

[00:11:53] Leah: Oh, yes. I think so much of it, knowing that there are options is so empowering that it’s just. We’re not just stuck like this, which I think for so many of us, that’s our attitude towards everything. Like especially. We are the caregiver.

[00:12:06] We’re the one who takes care of everyone else. And so it, it can feel hard to take the time to take care of ourselves. But what I’m hearing is that is absolutely critical and imperative to how we are going to go through perimenopause and then menopause. The more we take care of ourselves, the better this is going to be as an experience and a process.

[00:12:28] Mm-hmm. And, , so one of my questions is around, The right kind of exercise. I’m gonna be honest, my Instagram algorithm knows me right now and it knows what I am wondering and I’m getting all kinds of things that are like, at your age is this kinda 

[00:12:44] Dr. Miller: cardios not even gonna work for you anymore.

[00:12:46] You 

[00:12:46] Leah: shouldn’t even be wasting your time. And I’m like, What should I, so, so so will you help me? Like, what do you believe for a, a perimenopausal and a menopausal woman, what is the best form of exercise for 

[00:13:01] Dr. Miller: us?

[00:13:02] Okay, this is gonna sound really simple, the American Heart Association. Recommends five days, at least 30 minutes of moderate intensity exercise. So that’s kind of like going on a nice wrist walk with the dog and two days a week of strength training. And that is what I recommend. 

[00:13:18] We also know that aerobic exercise is also very important for brain health when we think of stroke and the like, and so getting in that moderate exercise, that brisk walk with the dog, , that is really what you need in addition to two days at least of strength training working on those big muscle groups.

[00:13:38] Because as, as we age, our muscles will, will decline. Now with that being said, we can’t do exercise in a vacuum. We can work our muscles as much as possible, but we also need to feed our body proteins in order to be able to grow those muscles and maintain those muscles. 

[00:13:59] Leah: Yes. That’s, oh, that’s so true. So I too have been like working with a health coach, been being taught like, okay, more and more protein, right? Okay. I feel like when we’re talking about our, our exercise, what we’re eating, I don’t think we can, we can skip over the fact of every single woman who’s like, please touch on our bellies, and how the heck we get those 

[00:14:19] Dr. Miller: To something 

[00:14:19] Leah: we’re a little happier with. And I am gonna say, I am eager and on the edge of my seat for this answer.

[00:14:25] Dr. Miller: I will tell you. So as we age and as our hormonal. Balance shifts to a lower estrogen state, our bodies become more insulin resistant. What that means is that when we are more insulin resistant, we tend to hold weight in the belly. As you hold weight in the belly, it makes you more insulin resistant. So also the lower, also the lower levels of estrogen.

[00:14:59] Kind of changes the physiology such that you almost make this, I think it’s called the endomorphic body shape, which again encourages fat deposition in the belly. I also had an evolutionary biologist tell me that fat cells in fat can make estrogen. And so it’s kind of your body’s evolutionary way of replacing the estrogen that you used to make in your ovaries by putting it in your belly.

[00:15:29] So how do we get rid of it? Whew. A lot of it is diet. So when we understand that our bodies are becoming more insulin resistant and we just can’t process carbohydrates in the same way when we’re in the perimenopausal transition, and then we know that that weight is gonna go to our bellies because of all of these other changes that are happening.

[00:15:55] Modifying the type of carbohydrates that we’re having, how much we’re having helps with the weight loss in the belly. It’s not easy. It’s because in our diets we have very carbohydrate rich diets, and so I usually, I start out by. Telling my patients, swap out some of those simple, refined sugars, easy fixes.

[00:16:20] Like if you’re someone that likes to have a soft drink every day, or you like to drink juice every day, maybe cut that out before you start making dietary changes. And make small changes in small changes, small changes so that they become more sustainable. 

[00:16:34] Leah: Yeah. And we’re talking about refined carbs.

[00:16:38] Mm-hmm. More so the carbs that come from flour, sugar, those kind of things. Right. Because right, like anyone who’s doing macro counting or anything like that, your cauliflower, your broccoli, your fruits and vegetables, those all fit in the carbs category too. And we want those things. Right. You want that fiber.

[00:16:55] What’s your take on macronutrients? With helping us with perimenopause and, and menopause. Brain fog. Mm-hmm. Mental health, all those 

[00:17:06] Dr. Miller: things. So I will tell you, there have been so many studies that have been done studying what’s the best diet or the best, what have you, and the best one is the one that you can sustain.

[00:17:21] I would rather, yeah. I would rather someone who plans. Their day getting really good proteins, whether that’s through animal sources or being very intentional about non-animal sources. I will also tell you limiting intake of some of the, uh, plant-based sausages and things like that because they only have a lot of, uh, sodium and things like that, which can cause a lot of water retention and some other risk factors.

[00:17:52] I would rather someone come up with a plan for their day. Around good fruits and vegetables, a little, you know, some whole grains here and there. Right. Because that’s life. And be consistent with it, rather than doing so much work that they can’t really sustain it. 

[00:18:12] Leah: Yeah. The yo-yos are not helping us. The yo-yos, 

[00:18:14] Dr. Miller: the yo-yos actually make you gain weight, right?

[00:18:17] Every time you’re trying to stay. Set a new set point, your body goes back into that survival. And again, this is beyond the scope of what I know, but just in as it relates to menopause, slow and steady inconsistency along with some of that aerobic exercise and strain training, that’s gonna help with that weight maintenance.

[00:18:39] Leah: Mm. Okay. All right. My last question for you on this subject is, How prevalent is depression during perimenopause and menopause? Hmm, that’s 

[00:18:52] Dr. Miller: such a good question. If you’ve had an experience of a depressive episode or anxiety in the past, or you’ve experienced it with postpartum depression or postpartum uh, anxiety, you’re gonna have a higher risk of developing that in the menopausal transition.

[00:19:08] And so when I see patients that come in and they’re having a really hard time, and I’m like, yeah, this is, this is really happening to you. It’s not because of some failure on your part. This is literally a hormonal change that’s happening and making you susceptible to more of these mood changes. So those are patients that I love to support either holistically.

[00:19:31] With doing exercise and things like that, other ways to kind of elevate some of those other neuro transitions or starting on medication to help support them so that they can get through their day so that they’re not raging, so that they are showing up the best version of themselves. And there’s no shame in that.

[00:19:48] Leah: Hmm. Uh, that is so helpful just to recognize if you have experienced these, then you can, you can know that there is a chance, a good chance that you’re going to experience. Those mood swings in perimenopause and that’s just giving you some great clues so that you’re empowered. Exactly. And you’re ready to like, okay, I’m ready for this.

[00:20:08] Instead of thinking, huh, what’s wrong with me? I’ve broken. I, that’s so helpful. I love that. Okay. If you could tell all of the women listening like, I don’t know, like three, you know, just a few things of like, here are the best things that you can do for yourself to help yourself through perimenopause.

[00:20:26] What are they? 

[00:20:29] Dr. Miller: So the first thing that I would do is get a squad and talk about what’s happening with your body. Sometimes we think we are the end of one, that we are the only ones in the world going through it. And even just today, I reached out to my friend group and I said, is anybody else going through this?

[00:20:49] And it felt so good knowing that. People in my community were also experiencing what I was experiencing, and I didn’t feel so alone. I didn’t feel so kind of like foreign to myself, and I realized that that was really important. Sometimes we stay cloaked and shamed because our bodies are changing. We’re hot, we’re snappy, and we’re ashamed.

[00:21:12] But I would challenge you through that shame. Tap into your community and if you don’t have a community, there’s a lots of online communities that you can learn a lot about your changing body. So I would, that would be one of the first things. You have 

[00:21:26] Leah: one, including, I mean, you have your, your coaching and so I’m gonna shout you out, right, and be 

[00:21:31] Dr. Miller: like, don’t worry, I’ll have her links on the show notes.

[00:21:33] So if 

[00:21:35] Leah: you’re like, I’ve got no one, I mean, it’s funny because in, in one of my friend groups, I’m the oldest and so what they’re experiencing is so different. Like they have little ones. They’re, you know, early, mid thirties. I’m about to have my first child go to college. My, I am literally understanding that like I could, I could be entering grandma stages and like, you know, the 

[00:22:02] Dr. Miller: next five to 

[00:22:03] Leah: something years, right?

[00:22:05] Like I am in such a different world. It’s just different. Different, yeah. And so, so you know, if someone kind of feels like the way I do, like I have these two groups of friends. One group is all older than me and one group is all younger than me, right? And I’m like, need the best of both world. I do, but like, I’m like my solo.

[00:22:23] So anyone who’s like, I don’t have that, Dr. Taniqua can help you, and I’ll have links to her website. So I love that. Got you there. Um, okay. All right. So, so, so number two, we’re creating our 

[00:22:33] Dr. Miller: squad. Yep. We’re creating our squad. Number two, be unapologetic in getting what you want with your care. Here’s what I mean.

[00:22:41] I get so frustrated when I’m seeing clients or patients that come to me and said that my doc told me to tough it out. And there’s no other aspect of medicine where we tell people really to tough it out. You go to the dentist, you get a filling, you get lidocaine right now, will getting your tooth filled?

[00:23:06] Kill you? No. Is it her? Does it hurt? Yes. And so we treat that discomfort so it makes no sense to me. When you have a person sitting in front of you, her whole world is upended cuz she’s not sleeping, she’s going through hot flashes, night sweats that are literally causing these physiologic symptoms. And you tell her tough it out makes no sense.

[00:23:29] And so I just wanna empower women go to the North American menopause website, it’s menopause.org and find someone who’s a national certified menopause practitioner. They love all things menopause, perimenopause, and we’ll be able to hear you and listen to you if you don’t find that person.

[00:23:50] Keep looking. There are lots of platforms online, especially if you don’t have someone in your community that are now offering this direct to consumer care to get the help that you need. And I say, be dogged about it. It’s your life, it’s your body. So get the care that you deserve. 

[00:24:12] Leah: Mm, yes. Yes, please. Are there questions that we should be asking?

[00:24:18] Or tests that we should be asking for that can be helpful for us through this journey. 

[00:24:25] Dr. Miller: So I always recommend when you’re seeing just your primary care physician outside of the perimenopausal transition is making sure that your blood counts are okay, making sure that your thyroid dysfunctioning, and then also making sure that your vitamin D levels are healthy.

[00:24:39] We know that low vitamin D levels can be linked to low energy, and as we think about, um, calcium and vitamin D importance for bone health, those are just some tests that I would recommend just for all comers. But I will tell you when you’re in perimenopause, sometimes your labs are normal because everything is fluctuating.

[00:25:00] And personally, I don’t care if you have normal labs. If you come in to see me and you are miserable with hot fleshes and night sweats, I’m gonna treat you. 

[00:25:09] Leah: I love that. Okay. . So we got through one and two. Get your squad. Get your squad. Get your 

[00:25:13] Dr. Miller: squad. Advocate for yourself.

[00:25:14] Dog it. Advocate for yourself. I love that. Okay. In three, your sexual life does not need to end with menopause. I can say more about that. I’m Say it. You’d be surprised. Yes. You’ll be so surprised that there are so many people that they’re having vaginal dryness and they’re just kind of like suffering through penetrative intercourse, for example.

[00:25:40] And I’m like, no, we got things to fix that, you know, to make it enjoyable to get them back to a place. Where it’s part of being a human being and having that intimacy if desired with a partner. And so again, you can find someone who’s NAM certified, but there are also some providers that are sexual health experts, and I encourage people to not seek shame in it.

[00:26:06] Some people are a little bit coy about the idea of being in their fifties or their sixties and having vaginal dryness that’s making intercourse painful. If they’re having penetrative intercourse, and I empower them to say, no, this should not be painful. This should be enjoyable. It might feel different.

[00:26:24] It might be different than it what it was in your twenties, but each encounter should hopefully be one that satisfies you and, and, and pleases you. And so I encourage people to talk about it and it’s shameful my colleagues. Um, we don’t necessarily talk or ask the question about sex, even at the gynecologist’s office.

[00:26:46] And so I encourage patients to bring it up themselves. 

[00:26:51] Leah: I love that. Okay. Okay. And then, um, I’m guessing that you would also be like, Hey, mama’s rest is really critical in all this, and water, and obviously, you know, we already covered this, but like, moving our bodies, especially for our mental health, right?

[00:27:08] Mm-hmm. Like, I mean, not just for the sake of, um,

[00:27:12] Dr. Miller: Fitting an aesthetic. Exactly. There we go. There 

[00:27:15] Leah: we go. Jess, that was so well said. Um, right, so like water, rest, what we’re putting into our bodies, moving our bodies, 

[00:27:24] Dr. Miller:  and doing things that bring you joy. Like, you know, during my leave I had to ask myself, what do you enjoy? What are your hobbies?

[00:27:36] Do 

[00:27:36] Leah: you 

[00:27:36] Dr. Miller: even have hobbies? You even have any? And there were things that I realized that I did enjoy. My coach worked with me and we talked about anchors related to your senses. I love, I. Citrus grapefruit candles. So I just started looking for grapefruit candles all over the place. I love looking at flowers.

[00:27:55] I literally have a flower subscription delivery once a month. I get flowers delivered to my house. I love it. 

[00:28:03] Leah: I’m the same. So, so when I turned 40, I decided to make, uh, uh, 40 till 40. And, and so I had 40 days till I was turning 40, and I was like, I’m gonna write out 40 things I wanna do in, in these 40 days.

[00:28:17] Um, and, and honestly, I was struggling to come up with what the 40 things were like. I actually went to my audience. I’m like, what do you guys think I should put on the list? Right? Um, but some of the things that came out of that, that were so powerful was looking at what do I enjoy? And one of mine was, I love fresh flowers.

[00:28:35] I love like smells. I’m such an, like, I, I love those senses, right? Like, when the laundry smells fresh, when the detergent smells good, when the hand smells good, it just makes a lot happy. And so, you know, like looking for these things that, that bring us joy and indulging, and I’m, for those listening, I’m totally using finger quotes right now, but indulging in those things and giving ourselves permission to bring more joy into the mundane, right?

[00:29:03] Like, yes, make, make, doing the dishes or going on the walk or, or doing the things that made me feel a little bit more like drudgery. Mm-hmm. Figure out how to make them fun and each of our fun is gonna be different. 

[00:29:17] Dr. Miller: Mm-hmm. And figure and, but take the time to figure it out. Yes. Because that’s what’s gonna sustain you, you 

[00:29:24] Leah: know?

[00:29:24] Oh, yes. Yes. And we think about who do we wanna be as we h Right. Like I, that was really powerful for me. I sat down and I was like, who do I wanna be? In, in a decade, in two decades, in three decades. Mm-hmm. And as I thought about that, I was like, I was like, I wanna be vibrant. I have this vision. It’s very, very clear.

[00:29:46] I mean, I’ve got it down to the detail of me taking my grandkids to Disneyland. We, we love Disneyland. My husband, it’s, it’s his fault. Anyways. We do. And, um, And I just envision them having to keep up with me, not me trying to keep up with them. Okay. Right. So, like, I have, and so I’m like, okay, well then I’ve gotta be active, I’ve gotta have strong muscles.

[00:30:09] I’ve, I’ve gotta be able to move. Right? So I, I have that vision, I have this vision of, of energy. I’ve, you know, I’ve always been that person that, you know, everyone’s like, woo. She’s like a, you know, the Energizer bunny, I don’t wanna lose that. You know, like, I’m like, I want my energy and then I want to feel at peace.

[00:30:28] I wanna feel joyful. I don’t wanna turn into an old crotchety woman. I don’t wanna be the curmudgeon. I wanna be joy filled and happy. So that’s really been focusing on like, then I need to live in gratitude. Mm-hmm. I need to like spend every day trying to, trying to center myself in gratitude. And I need to make life fun because make 

[00:30:47] Dr. Miller: it fun and put in boundaries.

[00:30:50] Yes. 

[00:30:50] Leah: Oh, oh, yes. Because we can look at boundaries as fences that are holding us back, or we can see boundaries as the, the, oh, I’m blanking on the word. You know, those, it’s, it’s protecting the barricade. Yes. Like, like there’s like, right, like, like there’s times where we’re being protective, that boundary.

[00:31:11] Protects us. It’s not stifling us. Mm-hmm. It’s not holding us back. It’s holding us in. So we’re safe. And like when we can embrace boundaries as like safety, as, as protecting us and the people we love and the relationships that matter most to us, then, then we stop looking at boundaries as you’re trying to stop me or start looking at them as you’re protecting me.

[00:31:35] Right. And that, that is so powerful. 

[00:31:38] Dr. Miller: I love that so much. I could talk 

[00:31:41] Leah: to you all day. Hi girl. All day. I love this. Thank you so much for being on the podcast with me today, sharing your knowledge and your wisdom. It. I’m so excited for everyone to hear this episode. 

[00:31:56] Dr. Miller: Thank you. Thank you for having me.

[00:32:00] Leah: How amazing was this episode with Dr. Qua? She is incredible. , and it was so exciting to have her on the Balancing Busy podcast.

[00:32:09] So I know you’ve got your own takeaways. I wanna tell you a couple of the things I’m the most excited for. . I believe in this so much too, so I wanna reiterate it is small changes will create. Consistent habits that you can sustain trying to go all in, do something crazy, it’s not sustainable.

[00:32:28] You’re not gonna be able to maintain it. And that’s actually worse for our health. So when we’re thinking about making changes to our health, Dr. Taniqua made the comment of, you know, just starting by maybe replacing the sodas or juice, look for small changes and then stack ’em. And that’s what I talk about all the time with system stacking.

[00:32:46] We make little changes, we make little adjustments, little refinements, and then we stack on top of ’em until we’re seeing really, really big differences and amazing results. Then my last thing that was really helpful for me that I had never thought of it this way and I thought this was so good, was.

[00:33:05] Understanding that perimenopause and menopause it can come with mood changes. I didn’t even realize that there was a higher chance of depression and some of these things until I was doing my research before this episode.

[00:33:20] So being able to ask about that and having her ex. Explain. Hey, look, if you’ve had a history of mental illness or feeling like you don’t have the mental stamina that you want, maybe you know, we had the baby blues or maybe we had ha have had and dealt with some depression or some anxiety at other times in our life, then that just helps us know, okay, then there might be a better chance for you that, that you’re going to deal with some of those.

[00:33:51] Mood symptoms during perimenopause and menopause, but just being armed with that, we don’t have to blame ourselves. We don’t have to get upset with ourselves. We don’t have to think, oh my gosh, what’s wrong with me? We can just recognize that our hormones are going wacky, and that’s okay, and then we can start doing all those things that are gonna help us.

[00:34:08] So making sure we’re getting sleep, making sure we’re moving our bodies, making sure we’re. Fueling it with the right foods that we’re getting, the water intake we need, and then of course, getting outside help if that is your additional step. That was so helpful to me and just really powerful. I feel like I learned so much.

[00:34:28] I hope you did too. If you’re not already, please make sure that you are subscribed and downloading these episodes and share this episode with a friend. Someone where you’re like, you know what Dr. Qua told us we need to have community. We need to have our squad where we can talk about these things together.

[00:34:46] It’s gonna actually lower our symptoms. So round up your squad, ladies, send out this episode to them and then talk about it together. . All right. I’ll see you on the next episode of the Balancing Busy Podcast.

[00:34:57] I am Leah Rela helping you do less but better so that you can live your bliss. See you next week.

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