Recently, I had the pleasure of talking to Aviva Romm, a Yale-trained, board certified family physician, midwife, herbalist, and award-winning author. She’s an international authority on botanical and functional medicine for women and children.
Here’s an excerpt of our conversation here.
In this second installment, Dr. Romm and I talk about what you can do to feel more like yourself. And shake that brain fog …
We talked at length about perimenopause and menopause and how women can feel pretty crappy during that time. What can women do to feel better?
I take a meta-approach, and use really good functional medicine, putting mind/body at the center of our awareness. What’s happening, how we think about things, our emotional responses to things has an impact, both on our biochemistry and on the choices that we make.
One of the first things I want to get clear with women early on is, how do you feel about being perimenopausal? What’s going on in your life? How’s your marriage, how’s it going with your kids? How are your parents? Are you in a caretaker role for anybody right now, and are you getting time for yourself? That’s something that I really want to get out on the table right away.
The other thing that’s really important is that if she’s not getting time for herself, she’s not going to be able to implement the other things that she needs to do. Making better food choices, doing time for better food preparation, exercise, or taking supplements. That’s all very important.
I want her to get clear with where she’s at, then start to reframe how she looks at menopause. It can be a really powerful time in her life, where she’s free from some of the restrictions she’s had before, and can start to really develop herself, let herself be free , and explore her creativity.
You’re setting a mental framework, and giving people some liberty to live within it.
Yes. It’s where we are, so fighting against it’s not going to change it.
What about sleep? You mentioned that women in perimenopause and menopause have trouble sleeping. What can they do about it?
When progesterone goes down, it has a huge impact on sleep. Working on sleep for a woman who’s having sleep disruption is probably one of the most important things I do around the menopausal time. One of the few times that I actually will use hormone replacement therapy, or bio-identical hormones, is for women who are having a miserable time sleeping.
Great. Let’s get into a little more detail on how you approach it.
When sleep’s out the window, everything else is not going to happen I work with women on a few aspects of that. One, what’s keeping her up at night? Are there actually things that she’s worrying about? I created this little exercise that I have my patients do, and I call it a “worry journal.” I literally have them get a cheap notebook, and sit somewhere other than the bedroom.
About a half hour before you get ready for bed, write down everything that you’re worrying about. Just a mental download; it doesn’t have to be articulate, it doesn’t have to be publishable, just do a mental brain dump. Then on the back of that page, write down your to-do list for the next day, the kind of thing that you’d be laying there in bed thinking … Getting ready to go to sleep, and you’re like, “Oh, shoot, I have to take the dogs tomorrow. I have to pick up the dry cleaning.” All those kind of things.
After you do that, go take a shower, go do five minutes of meditation, and just leave that behind energetically, so then when you do go to bed, you can remind yourself, “Okay, I’ve already done the work of worrying.”
That’s terrific. Anything else?
Botanicals and supplements can have a huge impact on sleep. Some of the ones that have the best data behind them, the best scientific research for sleep, are Valerian, passionflower, hops, and lemon balm. Any of those can be used by themselves, or in combination. I usually recommend a liquid extract or capsules. Lots of companies out there on the market have wonderful combinations of a variety of those, and they’re all completely, perfectly safe, even if someone is taking a sleep medication or an anxiety medication.
The only caution for any of those is, hops is a little bit estrogenic. So if a woman has a history of estrogen-related breast or other cancer, then I say skip the hops for her; but otherwise, perfectly safe.
I hope you enjoyed my talk with Dr. Romm. Post a comment below and let us know if you have any questions or comments. We’re here to help.
P.S. … Over the years, we’ve heard from many of you suffering from the effects of perimenopause and menopause. So we got our research team on it.
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Steve Sisskind, M.D.
Hi, I'm Dr. Steve Sisskind, Chief Medical Officer & Founder at RealDose Nutrition.
As a young physician, I struggled because my patients came to me with serious health issues, but I didn't have the right tools to help them. Medical school taught me how to put "band aids" on their symptoms with drugs and surgery, but not how to address the root causes of their problems.
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