Bree: I'm really excited about this episode of Pause to Go with Dominique Cocuzza. She's a new good friend of mind, and I know you're going to enjoy what she has to share. Dominique is a perimenopause fitness coach and the founder of Periwink the first ever fitness and lifestyle app designed specifically for women in perimenopause.

This was actually the first interview I recorded for the pause to go podcast and we had a few issues with audio, but the content and this conversation is so good that it's worth forgiving a few glitches here and there. We talk about the stigma of perimenopause and menopause and why it's important to address the side effects that many women experience in this phase.

One more time. In this episode, Dominique speaks about the dearth of healthcare providers who are adequately trained to provide the kind of experienced support that women in midlife deserve. When she speaks of credentialed providers, she is referring to NAMS certified menopause practitioners. And NAMS stands for the north American Menopause Society, which I will link in the show notes because it's an excellent resource.

 I love the wealth of information that Dominique and other guests bring to these conversations. But please keep in mind that the recommendations you hear on this podcast are no substitute for your own medical care. Listen to your body and get the support you need. And now enjoy the episode.

Well, Dominique, I have to tell you, when I first posted about this podcast on Instagram and Facebook, I had so many people reach out and say you were the person I needed to talk to.

You were the person and you were called a genius 

Dominique: guru. Oh my gosh. And a goddess. Oh my gosh. I love it. 

Bree: So whatever you're doing. Yes, absolutely. So Dominique is a perimenopause fitness coach. You're also a biohacker, right? 

Dominique: Yeah. 

Bree: And I am so happy to have you here today to talk to us about menopause because I need your help. I need your help in understanding what the hell is going on. 

Dominique: Yeah. So lots going on. That's what's going on 

Bree: There aren't a lot of people who are in the field of perimenopause. And so I'd just love to talk a little bit about you and your history, so how does a little girl growing up in New Jersey come to the place where you are now? Can you tell us a little bit about your trajectory? 

Dominique: Oh gosh. Yeah. Well, I feel like I have lived many, many lives at this point and the little girl growing up in New Jersey had a dream to be an artist and to be a dancer.

And, I still am those things. Actually, those threads have woven through my life since the beginning. This is my third career. I spent many years in New York city, after a fine arts degree and a museum studies degree, a master's degree as a museum professional. Working with marginalized cultural materials.

So, cultural material, art, artifacts, contemporary art from American Indian cultures, African, and Australian Aboriginal. So that was the bulk of my career life until I had children actually. And, I moved here to Charlottesville, Virginia, and I started working for the Kluge Rue Aboriginal art museum.

I had my two babies who are now 10 and 12, two boys. and I switched career paths to become a Waldorf teacher, which. Was very interesting enriching and extremely demanding, and too demanding on my family life actually. So I became certified Waldorf teacher. so I was able to carry my art into that, and that was fantastic.

and then in my forties I kind of hit some walls, in terms of my health. Actually, if we rewind back to my thirties, I had been in perfect health pretty much until a year after nine 11 happened and I experienced getting ill after that. And I think it had a lot to do with the stress I was in New York city.

and, just kind of living in a constant state of fight or flight, commuting and just worrying all the time. Also being exposed to a lot of, contaminants in the air and I came down with Hashimoto's thyroiditis. So, I have a long, long term history of, biohacking, but I didn't call it biohacking until I got into my forties.

[00:05:03] Dominique: So I had in my teens, I was macrobiotic. I was raised in a very non-medically intervention kind of household. When we were sick, we would go to the chiropractor. You know, we ate organic. My mother was, you know, particular about, we did dry brushing. I mean, we did all kinds of stuff.

So, then when I got to my thirties and I encountered this health problem, I immediately sought out an acupuncturist and made major lifestyle changes and immediately was able to get my Hashimoto's and my thyroid situation settled and stable. So that was like a big pivotal moment for me. So when I came to my forties and I was postpartum, I was also experiencing some other problems with adrenal fatigue and I had a long-term Lyme disease that went undetected.

And so I started biohacking in a much more systematic and comprehensive way and really experimenting with lots of modalities. so that's kind of like the health background I come from in terms of, you know, using non-intervention, well using natural remedies and lifestyle remedies to manage my health, using food as medicine, And then in my forties, I also started biohacking for sports performance.

I have this long-term history of researching and understanding how from many perspectives, you know, from the physical, from the psychological, from the spiritual, and when the pandemic hit, I was working full-time at a gym, an upscale gym at full tilt, six days a week, no time for lunch, like super booked, really successful -- but also on the glass ceiling, there, there was nowhere for me to go, in terms of making more income or growing the amount of people that I saw because I was totally tapped out there in terms of what I could do. So the pandemic came along and the gym closed and I transitioned to working outside and many of my clients followed me.

 This is my seventh season outdoors. And I guess really what happened was I had my perimenopause wake-up call during the pandemic. And it was like, you know, add perimenopause and the pandemic is like the perfect storm. and I didn't realize what was happening. I really felt like I was losing my mind.

Dominique: I didn't recognize that I had been in perimenopause, even though I started optimizing for menopause when I was postpartum at 40 years old and with Lyme disease and adrenal fatigue. And, I was looking at the work of Dr. Sara Gottfried, a wonderful gynecologist who specializes in women's hormones. And she's, she's just great. So I started using her protocols 10 years ago and had really great results with them. and, was on a great trajectory in terms of my experience of my perimenopause, which I did not recognize I was in by the way, until really the meltdown happened, my wake-up call during the pandemic.

And I kept going back to my gynecologist with questions about my period, because I had had a super, super regular period, my entire life. To the, almost to the minute I'm like, yes, it's 28 days. I know I'm going to wake up with it. And it started to change and I started to have more bleeding and was wondering if it had to do with a new copper IUD that I had just gotten.

It was the first time I'd ever been on birth control in my life. And, I didn't know if it was this breakthrough bleeding was, you know, related to menopause or if it was related to the IUD and she didn't really have any answers for me. She said everything looked normal and then I started to experience some really troubling symptoms that I didn't recognize as perimenopause, because what we hear about perimenopause is weight gain and hot flashes and really there's no other information that I got, you know, like even though I was well-educated, I just kind of thought I was gonna wake up one day and my period would just be gone. And that would be it. I didn't realize that this phase can take months to up to 14 years, 

Bree: 14 years. 

Dominique: So, my symptoms were cognitive symptoms. They were, extreme, forgetfulness, much worse than I'd ever experienced. I was getting lost when I was driving in the car, the places I knew where I was going, you know, like familiar places. and then I have this story that was kind of like this story encapsulates my perimenopause, like shit storm.

So it was summertime. And I think it was two summers ago. I was with my children. We were at the pool. We came home, we drove into the driveway and there on my grill stood this giant black vulture. Like this vulture was just standing there and looking at me and I was terrified. It was gigantic 

Bree: and not a common occurrence to see a vulture on your grill.

Dominique: Yeah. No, and it wouldn't leave. And you know, I'm Italian and there's like a bit of me. That's a little superstitious. And I was just like, someone in this house is going down. This thing is here and he knows that death is coming here and it is here. It is a harbinger. And I was like, oh my God, who is it going to be?

Is it me? I try to shoo the thing away. It would not leave. And then I started to realize. The one who was actually going to die was the vulture. The vulture came to my house to die. So I was so exacerbated when that happened, that I lost my keys and I went inside and I, I was cooking dinner. I was trying to shoo the vulture away.

And then I went outside and I was blowing that leaves. And I realized a couple hours later that I couldn't find my keys. Well, I couldn't find my keys for three days. I needed to work. And I was in a panic. I felt like lost and trapped in my house at the same time. And I was actually starting to think that maybe this vulture thing, wasn't even a real thing.

Like, I'm like, am I making this up in my mind? Like, I felt like I was tripping. I was just like this. I can't believe what's happening right now. And I felt tremendous anxiety. And I had my friend come over here, try to talk me down, help me look for the keys. I was on the phone with my mom. She's like trace all your steps.

Like I tore this house apart. So many times couldn't find the keys. I had to borrow a car from a client of mine and it gets even funnier. So the last time I'd seen the keys was right around where the vulture was on the fence. So I started to think maybe this vulture ate my freaking keys. So. I wasn't the only one who thought that, because many of my friends who I spoke to and my mom were like, do you think the vulture could have eaten the keys?

And I was like, I can't believe you're saying that it actually crossed my mind. So my client came over and he kind of saved the day. He let me borrow his car. And I said, let's take care of this thing. And I imagine that we were actually going to bury the thing. So I'm inside.

I come around the side of the house and he's an older, eccentric German man. And I see him with the gloves on kind of breaking the wings back on the vulture and then stomping on the thing. And I'm like, what the hell is he doing? He was trying to see if the keys were inside. Right. So then he takes this, just throws it over the side of the fence.

And I'm like, what are you doing? I thought we're going to bury this thing. And he's like, no, why would we do that? And I looked at him and I was like, well, why wouldn't we do that? Isn't that what we should do? He's like, well, this animal's going to be a wonderful feast for all the other animals. Then in that moment, I realized that I was confronting my fear of death.

And I didn't even know I had a fear of death and this man who had an older, wiser perspective, helped me to break through to something. And I was like, oh gosh, yeah, that's, what's going to happen to us too. We're gonna, we're gonna nourish the earth with our death, you know? And so that was a huge breakthrough. And then I found myself kind of back at the doctor's office with these symptoms. And I was like, something's, something's definitely going wrong here. I found my keys eventually. Thank God they were in my garden.

They fell in my garden, three days later. And, I was back to my normal life again, but still having a lot of forgetfulness realizing also that there was something new that came up. I could not drink alcohol at all. Like,

I would be wrecked after alcohol--  like it would take me two days to recover from a couple of glasses of wine.

And I was never a big drinker, but I was like, okay, this is a marked difference. Like, I can't even enjoy a single glass of wine now. So I went to the OB-GYN and she finally tested my hormones and I happened to be there at the right moment. because my test came back and she's like, your estrogen is so off the charts immediately go and get a pregnancy test.

 I was like, there's no way I have this IUD. I can't be pregnant. And she's like, well, it looks like you're like in your first trimester, based on your estrogen, it's so high. It's supposed to be under 50. It was over 1000. And two weeks later I went back and I got tested again and it was normal. So I discovered I have this thing called estrogen dominance, which is pretty common, but not very well-spoken of, in terms of educating women about perimenopause.

Bree: You happened to be there at the right moment --that you happen to be tested at the right moment. What do you mean by that? 

Dominique: As women in general, even if we're not perimenopausal . we are in a constant state of change, which is one of the wonderful things about us. but it also makes it difficult for us to pinpoint, our hormonal imbalances because they're changing. So anytime we have a test, it's really just a snapshot of what's happening at that very moment.

so I had two snapshots. One was during a time where I was feeling very symptomatic. and then another was during a time where I wasn't. Now during the time where I wasn't, everything looked completely normal. So I was lucky enough to go when I did feel symptomatic and, kind of at the height of my estrogen surge. If I hadn't gone at that time, I wouldn't, I wouldn't have caught it.

And I would have gone on not knowing what was happening. So, my advice to women who are seeking testing is to go or to have their tests done when they are feeling at the height of their symptoms because that's likely when an imbalance will be detected. Yeah. So I happened to catch it at the right time.

Bree: So then what happened? 

Dominique: So then, you know, I have this option to take some, bio identical progesterone because what happens in perimenopause, which a lot of women are unaware of. We hear we hear a lot about estrogen and the loss of estrogen. and that's, you know, what we typically think about in terms of menopause, but what happens in the perimenopause period for most women is that progesterone decreases first.

So that leaves relative estrogen levels high. And when our relative estrogen level is high, we experience symptoms associated with estrogen dominance. Most women are, we hear about hot flashes, but we don't hear about estrogen dominance. You don't have hot flashes when you're estrogen dominant --

Bree: progesterone, that causes hot flashes?

Dominique: Yeah. Well, the lack of estrogen when the, so first the progesterone decreases and we experienced the estrogen dominance and that eventually the estrogen decreases and that's when hot flashes come in, hot flashes, hot flashes, or a lack of estrogen. Yeah. 

Bree: Thank you for clarifying that.

Dominique: Yeah. So, you know, unless we're having hot flashes, which is what we hear about, we don't realize a lot of us that were in peri-menopause -- estrogen dominance has a whole nother set of characteristics and symptoms associated with it, including weight gain, mood, memory loss, Having too much estrogen, it's a growth factor.

And so, yeah, so there's a lot of things that we can do to mitigate that, in our lifestyle, including eliminating alcohol, which is also estrogenic, I did find myself declining, the hormonal replacement and trying to work with some, natural yam cream, which is a natural progesterone. I did that a little bit, only when I was feeling symptomatic and that seemed to help.

But I also tried to use natural supplements and I, my first stage of this, I found myself in the supplement aisle. I'm just going to be full disclosure here. My ex-husband works at a natural food store and we recently divorced, well, now it's been about two and a half years, but during this time period, when I was in perimenopause in the pandemic, I was also going through, you know, just post divorce, settling children.

[00:19:14] Dominique: It was really challenging time.

[00:19:16] Bree: I'm sure the stress really helped with all of this too. I'm sure it was, 

[00:19:20] Dominique: it was major, wake up, call shitstorm. So, I, my ex had, at that time started dating someone who is half his age. So I find myself in the natural food store, looking at menopause items and embarrassed that he's going to see me, somebody I've known and has been in my life for 35 years.

but at that moment I was like, what the hell is going on here? How did I end up embarrassed about womanhood and why am I ashamed of aging? And it was like, I saw myself from a higher perspective and I was ashamed that I was ashamed. 

Bree: Yes! 

Dominique: I said, you know, I'm an educated, progressive, I'm a feminist woman. Who's really in the know about a lot of things in terms of women's health. And I coach women, how dare me be embarrassed about aging. And, and then I got mad and I started to feel like, okay, this isn't all my responsibility. Some of it is, but look at what's happening in the larger culture here. And it's no wonder why I feel this. And if I feel this way, I'm sure many, many women feel this way. And many women are out there wondering what the hell is going on with themselves. And also not being supported or feeling like they have to remain secretive. And I just said to myself, this isn't acceptable once I saw it, I couldn't un- see it and I needed to do something about it.

So that's really when I shifted toward working specifically around menopause perimenopause and supporting this life stage for women 

 Bree: Eradicating shame around this issue is just, it's so crucial. It's real. I mean, when I posted about this podcast, the first time I hit "post", I was scared. I was scared. To post about menopause. It had been such, such a taboo sexuality in general, was taboo topic in my growing up experience and menopause even more, right, because we have age and sexuality and all of the things going on at once. So I, I hear that and I want to thank you for leaning into that and committing to this work it's, it's just crucial.

Dominique: It's my pleasure. It's my pleasure. And I'm so passionate about it. And I really do think it's our generation gen X women that will make a mark and change this forever. and it's happening. And I know that I know that what I'm doing is needed and important and. It's it's happening worldwide, that the world is waking up to honoring the stage of womanhood.

There are many cultures that already honor this stage of womanhood, but I'm talking about Western culture in particular. Yeah. 

Bree: And on that front, I'd really love to dive into menopause itself. Can you explain what is actually happening when we go into perimenopause and menopause?

Dominique: Yeah. I'm going to explain it though from not, not, not so much a biological point of view, more of a kind of understanding of womanhood and our stages. We have these milestones in womanhood and not all milestones are experienced by every woman. But menarche and menopause are experienced by every woman.

Bree: So menarche is the onset of menstruation, correct? 

Dominique: Yes. So menarche and menopause have something in common and that they are only one day. So menarche is the first day of our first period. And menopause is one year after our last period to the day. 

Bree: That sounds really hard to track. 

Dominique: Well, if you track your period, which I highly recommend,there are many apps that you can do.

So with, you can look back on your data and, you know, once you start missing your period, it's noticeable. I think so. Yeah, but unless you've not had your period for a year, you are not in menopause. You're in perimenopause and menopause is the period leading up to menopause that can last for a few months to over a decade.

And we don't just wake up one day and our period ends. Now, not all women have highly symptomatic perimenopause periods. And in fact, women in the Western world seem to be much more symptomatic than women who live in cultures, who revere aging, and who have, respect for women who are post-reproductive.

Bree: So respect, just having respect for women at that stage in their life has an effect on how women experience it physically. 

Dominique: Absolutely. Yes. 

Bree: Incredible. 

Dominique: So yeah, the cultural surround and the expectations of women in aging and the mindset that we have adopted absolutely affects our symptoms. And there are, there are studies that prove that, yeah, we'll talk more about how, you know, how to manage symptoms a little bit later, but I just want to say women, if you're in gen X and you're not menopausal, you are in perimenopause.

Okay. There are a lot of times that I try to approach this topic with gen X women. And, some women are really interested in hearing about it and, and eager, because they want support and they want to be able to talk about this in a safe space I have had quite a few experiences with broaching this topic with women who are very defensive and, stating that they're not in it and that that's not them and they're not there yet.

And they just want to shut the conversation down. Well, we're going to talk about that a little bit later about how we are part of the problem, but if you are in gen X, you're in peri-menopause. Okay.

Bree: Acouple of years ago, I am gen X. You and I are about the same age and I'm 48 and one of my dear friends. So I was about 46 at the time. I was really struggling emotionally. I was in a very high stress, position with work and was having, a lot of symptoms I had brain fog, I had irritability, I had insomnia. And she, and I met for coffee and she handed me a book on menopause.

And she said, I know that you may not think that you're here yet, but I'm definitely here. And I think you should read this book. And I said, oh, thank you. And then I promptly donated it. I mean, what was that about? That gets back to that shame. Right? So I also, I also just want to say to people who are listening, you're not alone. If you feel that way, but we can move beyond it. 

We can move --

Dominique: and I'll tell you something, it feels so much better when you move beyond that. I mean, there's tremendous power and potential in this life stage, which I'll get to later. and we'll talk about that. the intensity in the feeling life that we have around this period is similar to how we feel and we're, pre-adolescent in some ways.

so when I think about, and I've heard other women talk about this as well, and other doctors, how adolescence and menopause are bookends of our fertility, and they're literally the inverse of each other mirror reflections. And in those time periods, we have this intensity in the feeling of life, as I mentioned, and it's accentuated by the shifting changes in our biology.

and I think what you're, what you're speaking about in terms of the shame also can be accompanied by a feeling of loss of our former selves. I don't know if you remember when you were pre-adolescent, but there was a part of me that was. Struggling to let go of my girl, self 

[00:28:12] Bree: me too. 

[00:28:13] Dominique: And there was sadness around that.

There's also something like that for us now. it's, it's difficult for some of us to let go of our maiden or our mother's self or, our, our fertile self and that loss of fertility, along with the cultural baggage, which doesn't help, you know, we feel this sense of loss, that needs to be acknowledged.

Both adolescence and perimenopause are uncertain times in which our identity is shifting and fluid. So not having this steady stable thing, our period, you know, Not having that thing that also connects us to, you know, the universal moon energies, having a loss of that is also unstable for us.

And it's a time, you know, during adolescence where we define who we are and in perimenopause and menopause, we redefine who we are in this world. It's when we go from a child to a woman, our focus extends beyond ourselves. We start to define ourselves in relationship to others and individuals, and we cultivate ourselves as caretakers.

But once we cross from mother to crone, our focus turns inward and our energies concentrate within us. as we tend to, redefine, and we assert our new being. And our potent energies ripen, and they ray out into the world in a new way that instead of nourishing individuals can actually nourish humankind in a much larger cultural way.

 I do believe that our power can change the world. Once we're in this stage, we go from being a princess to a queen. 

Bree: You know, you, you mentioned moving into the crone state and I, I heard on another podcast. I'm going to look it up and put it in the show notes but so we've acknowledged that there are stages or we culturally see the stages of Maiden then matron and then crone.

But I've heard people adding in a third stage between matron and crone, which is Maven. 

Or queen. 

 Dominique: I love that. 

Bree: Yeah. I really love that too, because I don't feel like I'm quite at the crone state yet. I look forward to that. My grandmother is 96 and she, probably would not like the word crone, but she is like the most glorious wise woman that you could imagine. I'm not there yet, but I do feel like I'm in that Maven state.

So it's fun, it's a fun distinction there. I don't know if you've heard of that.

Dominique: Okay. I absolutely love it. I feel like I just recently put my queen crown on, and left my princess gown on the side of the road. My princess gown was, beautiful pleaser and my queen crown has leveled up her standard.

And is willing to say no, but I'm  now I feel like I'm going into a whole nother stage unexpectedly, which I call my goddess stage where I'm actually accessing something that I feel is my divine feminine. And I'm just on the threshold of experiencing this, but this has to do with not needing to act and just being a receptacle for goodness and actually receiving for the first time in my life.

Bree: I think about how poignant it is. To think of you moving into a receiving state when you're also moving into a state of. Not being a vessel for new life anymore. 

Dominique: Right. It's really moving to hear that. I've just been focusing on that topic for like this past week and I'm really feeling it and like how the vessel or that space or that pause in our time, it can be impregnated with inspiration that is so much more than personal interaction. It allows space for universal inspiration to come in and an intuition and, you know, I do believe that in this stage, our intuition deepens tremendously and it becomes our responsibility to not just listen to our intuition, but actually to act upon it.

Bree: I agree. I agree. 

Dominique: Well, I wanted to talk about the social stigma a little bit. I just wanted to start by reading something from the ancient Chinese book entitled The Yellow Emperor's Classic from 2,600 BC.

And this particular passage is how menopause was conceived during that time. And, and in the minds of these people. "At seven times seven, A woman's heavenly dew wanes. The pulse of her conception channel decreases, but she, that dwelt in the baby's palace moves upward into her heart. And her wisdom is deepened.

Chinese call menopause the new spring. So our culture shapes our experience of this timeframe. And as I mentioned, when aging women are valued by their culture, they are far less symptomatic in perimenopause. Growing old and aging are two different things. Our mindset around aging and our expectations shape our experience.

Dominique: And it's up to us to rewrite the story of aging and this culture, I believe that we actually increase in value to our families and our cultures as we age. And, you know, there's a whole -- I could get into this. I'm a real nerd, but you might not know this, but there are only two animals that experienced menopause.

And those are humans, human women, and certain species of tooth whales including killer whales. So there's only us who experience living beyond post reproduction. And what they have found is that killer whales and narwhals and, two other types of tooth whales, these grandmother whales are actually completely necessary and integral to the survival of the species of the whales.

In fact as the mother ages and she becomes post-reproductive, their survival is even more dependent on her because these post-reproductive whales are the ones who guard the entire herd, but also know where to find resources in times of scarcity. They're the ones who help in all the caretaking with, their grandchildren whales

So they actually gain value the longer they live, post reproductively. And there are a lot of similarities between those grandmother whales and our human grandmothers. Unfortunately, we don't live in the same kind of cultural closeness that we used to, which was close to how the whales live.

But I do believe that we, you know, we increase in value as we age. As I mentioned before women are part of this problem. I was watching this Ab Fab episode that I put into my app recently as inspiration. And it's a bunch of English women who get together for the support group with menopause and there's one American woman in there and they go around and they start to introduce each other.

Dominique: And, the American woman is like," oh, we, we don't do, we don't do menopause in the U S no, we don't have it." We are a part of the problem, the cultural silence and the shame. we are perpetuating it here because we don't want to admit it's happening there. We drank the Kool-Aid. Unfortunately our culture has not normalized the stage of life for women.

However, it has normalized symptoms. We've been conditioned to think that we just have to suck it up and experience these symptoms. And it's just part of it. It doesn't have to be part of it. There are things that we can do to manage our symptoms. There are things that we can do to balance our hormones, the way that we live, the way that we think play a huge role in that.

Bree: Can you share one specifically?

Dominique: That hot flashes are common. Long-term and persistent hot flashes are actually associated with heart disease. Many women don't know that. So I talked to many women. Who've had these really bad, hot flashes for years, and no one has said to them, this needs to be managed, you know, and if it goes unmanaged, the out the health outcomes for women who've experienced persistent hot flashes, the long-term health comms are, are scary.

how can hot flashes be helped? There are many things that we can do to help hot flashes, including stopping drinking alcohol. Red wine in particular is associated with hot flashes. But sugar, I mean, managing our stress levels and cultivating our parasympathetic nervous systems. I mean, there's, there's a lot of work that can be done, you know, in terms of biohacking in the natural realm.

And then there are also bio-identical hormones that can help with that. and synthetic hormones, there's a whole array of possibilities here. 

Bree: So people aren't just stuck with hot flashes. That's what you're saying. Right. Don't be just stuck. 

Dominique: Don't be just stuck with weight gain either. I mean, it doesn't have to go that way.

If you believe it's going to go that way and you've been conditioned and you drank the Kool-Aid here and you're either not willing to deal with it or in denial or just laying down. And saying, okay, I guess this is it. It doesn't have to go that way. Okay. You do actually have agency and control over your health choices that lead to how you feel long-term.

 There's misogyny in the medical world, the fact that there are only 1400 qualified doctors worldwide to deal with women who have menopause symptoms and are in perimenopause points to a larger problem of gender inequity in science and medicine. I just, 

Bree: I just want to repeat that because you and I talked about it before we started recording, but I think that number is extraordinarily haunting.

Only 1400 in the world. 

Dominique: Yes. So the menopause society has only 1400 qualified doctors who have been specifically trained to deal with women in this stage of life. Yeah. Thousands and thousands of women daily enter perimenopause. And, we have 1400 doctors. So yeah, if you look and you ask and you research, you'll find out that menopause, the topic, only receives like about a week, if that, of study in medical school.

So these doctors just don't know what to do. If you look at the studies on hormones and synthetic hormones, they're all over the place, really. Women are not just our pelvic and reproductive health.

Okay. So yes, there's been attention paid to reproduction. but like our long-term health outcomes have not been adequately studied because most scientific studies have been performed on men. So there's just simply a deep lack of understanding and data about how hormonal change affects our long-term health outcomes, affects treatment, all of it.

There are wonderful resources and information that, Dr. Lisa Marsconi has put together, Dr. Lisa Mosconi excuse me. she wrote the book XX Brain. Fantastic. But she talks about this gender inequity in science, and she's a scientist herself. One of the few women who was studying, long-term health outcomes, dealing with menopause, hormonal change and brain health.

Dominique: So we're not getting the care we need. It's kind of up to us to speak it out, unfortunately. And you know, given the cultural surround with menopause and aging, it's hard for a lot of women to ask for the help that they need. But I do think that Gen X women are coming to the table here and we are doing something about this and we will change this for generations to come.

And the M word is now becoming mainstream. This year, literally and getting a make-over. So it's about time that things shift and we actually demand that things shift, but that has to start with us individually accepting our aging experience and, and, you know, embracing it.

Bree: Absolutely. 

 I know how much you want, and I want the social stigma to go away, for more research to take place, for us to have a better cultural understanding of the possibilities around this phase of life and the value of women post-menopause right. The value of the queen, the value of the crone, ah, what a beautiful thing.

What do you wish for any woman who's going through the perimenopause process? 

Dominique: Well, I have a lot of wishes and, this can be a stormy time for us and it's okay. We can allow ourselves to go through this storm and the feelings that we're feeling, we can acknowledge them. We can be present with them.

Peri-menopause is the mother of all wake-up calls and you know, these things that are coming up for us, that we were having such intensity in our feeling life about our relevant. They are not to be dismissed. They're not to be brushed under the carpet. We may be experiencing an entire reshuffling of relationship dynamics.

We may be experiencing health problems. We may be experiencing a time in our life in which we are called to literally redefine everything. And it's an opportunity. It's not a time to put things under the carpet. And in fact, putting things under the carpet will lead to long-term consequences in our quality of life and in our relationships and in our health.

Bree: And in the generations to come too -- 

Dominique: This has a legacy. and you know, this, this wake up call is the upheaval of the old guard. This disruption of the status quo. Of, you know, a status quo that some of us have been keeping so steady. Some of us even medicate ourselves in order to keep the status quo.

So we're called to listen to ourselves and not just to listen, but to actually act upon our wisdom. And that wisdom is present in our bodies. Tuning into that wisdom in our bodies, including our symptoms is so important. Our bodies are not our enemies. Our bodies are not acting against us. They are telling us something.

Bree: And we need to honor that wisdom that our body has. It may be uncomfortable. We may not enjoy it, but we can't brush it under the carpet. We can't bury the vulture. 

Dominique: We can't bury the vulture. We got to leave that dead vulture in the freaking yard and deal with it. 

This is an amazing opportunity. Actually, we have other things to do now, aside from reproducing. What we need now is self-care. It's paramount for us this time period, it's a critical window to address things that need to change in our lives and our relationships and our health.

It's an opportunity to mitigate major health issues that will manifest if we brush things under the carpet, like heart disease, cancer, dementia, and Alzheimer's. The lifestyle choices that we make now, and the mindset that we adopt are going to have the potential to shape our entire future. And now is the time we can't wait. And you know what? It's never going to be the perfect time to take care of yourself. It's never going to look perfect. But a lot of the women that I talked to were like, I'm not ready to do this yet. And I'm like, if you're not ready to do this yet, I don't know when you're ever going to be ready. It's never going to look perfect. You have to start now though. Another thing that this is a great opportunity for is to resolve the past and revisit the things that need to be healed in us. And there are a lot of things-- all of us are carrying stories, habits, 

choices that are not serving our highest and best good. And we're doing that because we're still living out of past patterns. So revisiting those things that need to be healed is so, so important.

Also finding a community, finding a safe place to talk about this, be supported is so very important and integral to what we need. Our health outcomes are also affected by our community and our sense of support that we have surrounding us. Big deal for women, of all ages, but particularly in this stage, it's very important.

Dominique: And I guess my best hope is, for women to become the mother, the queen, or the bride of themselves, and to begin to define life on their own terms, because they're not done. There's still so much for us to do. There's still so much living for us to do. We are now living some of us, if we're lucky, more years, post reproductively than we were living in our fertile time.

Bree: Yes, 

Dominique: Our post-reproductive years are actually outnumbering our fertile years. So we've got a lot of living yet to do, and we have a lot to offer this world and we are needed.

Bree: Fitness for you clearly inhabits the whole being, the spiritual, being, the emotional being and the physical being. You are a strength training advocate. Can you talk to us a little bit about some of the choices that we can make to take care of our bodies and our physical wellbeing that involve strength training?

Dominique: Well, I think, you know, as I mentioned, you know, working with all the underlying mindset kind of has to really proceed and happen, parallel to what we do with our physiology, in order to, to maximize our results and feel and look the best that we can, in terms of strength training.

 I am and have been, a lifter for the past 10 years. And, you know, I did endurance sports my entire life. And then finally, when I got into my forties, I was like, oh my God, why didn't I start lifting in my twenties? Because it's actually the thing that I'm really good at. I'm competitive. I have two state records and a national record, in different strength sports, which I never thought I would do in my forties, by the way ever.

That's incredible. yeah, I love it. And actually, when I began strength training in my early forties, my entire perception of my body image changed and I stopped looking at myself for how I appear aesthetically and I really started to value what my body could do. Once I started tapping into my potential and my strength.

My strength is not just my physical strength. It's mental strength, it's spiritual strength. Its strength for me as a strength coach is all-encompassing because I don't believe that there is a difference between our mind and our body. We're not separate mind, separate body.

So in terms of strength, training, resistance training, you know, scientifically it's been proven, you know, stronger people are harder to kill. So the more muscle mass that you can retain into your age, the longer your lifespan is the stronger your grip is. The longer your life span is so maintaining, growing, and working in strength to keep our muscle mass up not only helps us to perform better in life but also usually gives women the desired results that they want aesthetically. So we have tremendous benefits coming out of strength, training, hormonally, you know, we have immune benefits. We have cardiovascular benefits. We have bone health benefits that support us in our aging process.

And so I've actually started not lifting quite so heavy cause I liked, you know, my happy place is going into the gym and lifting twice my body weight three times and then leaving. But that's what I like to do. but since I started Perry wink, I've now been on my own program for several months now.

And my body has changed quite a bit because I'm not lifting heavy. I'm lifting consistently and doing resistance training with my ladies three times a week, but it's only a half an hour a week. And I'm astounded how I am very pleased with my body composition results. And my muscle mass hasn't changed, like has not decreased, has to do with the diet too.

and, and how I eat. But yeah, you don't have to like kill yourself at the gym in order to be healthy and fit. it's just doing the right kinds of exercises and fueling your body and using food as self-care, using anti-inflammatory principles as well. will help maximize your, your results. 

 Bree: Can you tell us a little bit about Periwink?

 Yeah. So I am now I'm getting ready to launch Periwink on a larger scale. Periwink, you know, I have, I, I kind of say I'm a fitness coach, but it's a lot more than that. clearly

Dominique: it's, it's not working out. So although working as a big part of it and that's actually the joy place in a lot of fun for, for my clients and maybe the most favorite thing that they do is we work out together.

So Periwink is an all-encompassing program that is meant to help women look and feel their best as they age in perimenopause to come through this stage of life with the community, the support and the coaching that they need from me. it involves. really kind of adopting new ways of thinking about how we live and think about our bodies.

There are a lot of lifestyle practices that are meant to cultivate parasympathetic, nervous system activities, or nervous system response, that help us to kind of put money into our health bank account over the longterm. There's an anti-inflammation, custom food plan that everyone receives and that has a shopping list.

Dominique: And because it requires us to cultivate long-term habits, it's not a diet. We're trying to love our body into permanent changes here. So I have an app called Periwink. It has content every day, and three days a week, there are workouts programmed, and that are progressive and they can be done with resistance bands to heavy kettlebells and depends on what your equipment is, but there's coaching for any of those types of equipment in each of the movements.

The workouts are really not long. They're like half an hour and that's it, but they're challenging. they're definitely challenging. There is also a lot of content in the app around food, around lifestyle habits, around mindset. There's inspiration. There are funny, funny things from our past, from the eighties that are completely politically incorrect and hilarious.

There are ways to track your progress. There's a community feature in the app. you know, so it's pretty all-encompassing. And the ladies that I have that have stuck with me now through two betas, stay that it's been life-changing for them. There's no quick fixes here and I don't offer any magic bullets.

Dominique: You know, the food is cook it yourself. It's whole food. There's nothing processed. it's really learning how to, you know, Take care of ourselves, but in a way, that's going to fit into your life. So it has to be a gradual change. You can't just go in there and change everything all at once. We have to kind of ease into our change.

So we're, we're learning how to change with our change 

Bree: Learning how to change with our change. 

I will put a link to Periwink in the show notes so that people can find it. Also put a link to your website so people can be in contact with you. Thank you for being a true queen.

Dominique: Thank you. I really appreciate you, doing this and getting the word out for women and I love your direction. It's it's very valuable. 

Bree: Thank you. 

Bree: Here are my key takeaways from this conversation. 

Number 1.  perimenopause can have a number of different effects on your body, cognitively, emotionally, and physically. And your perimenopause may not look like someone else's. So if you are experiencing symptoms that are unusual for you, speak to your healthcare provider to see how fluctuating hormones might be involved.

Number 2. If you find yourself feeling ashamed of your perimenopause or menopausal experience, know that you are not alone. Together, we can create greater support and communication around this phase of life. We are all part of the shifting culture.

 Number 3. According to Dominique. If you are gen X, that's born between 1965 and 1980, and you have not already been through menopause, then you are perimenopausal. Welcome to the club, my friend.

Number 4.Tthere are actions we can take to find greater ease in what can be an uncomfortable or frightening transition. You don't need to suck it up and you shouldn't. Talk to your healthcare provider and consider lifestyle changes to help you through this time.