Weight Loss in Menopause: Interview with Dr Malaika Woods

welcome back to another episode of Christian Natural Health today I'm very pleased to have Dr Malica woods with us

Dr Woods is duly board certified with the American Board of obesity medicine and the American Board of Obstetrics and

Gynecology she is the founder of Dr Woods wellness and the number one best-selling author of physician

unleashed the physician Freedom formula in addition to running her own Independent Practice Dr Woods also

coaches other Physicians and practitioners on starting and growing their own independent practices when not

working in the office Dr Woods enjoys singing especially gospel music she has been a choir director throughout the

years and a wedding singer for many of her family and friends spending time with her wonderfully supportive husband

daughter son and close friends are her most treasured moments her secret ambition is to one day write a fictional

book that gets turned into a Blockbuster movie and we should talk about that welcome Dr Woods thanks for joining us

thank you so much for having me Dr Laur yeah absolutely so let's start by talk

talking about weight gain in menopause so why is that such a common thing that

people seem to struggle with absolutely so first let's just Define menopause

menopause is technically one year without having a period now for women

who no longer have their uteruses from hysterectomy Etc they can't judge it by that so there are some symptoms that go

along with that there's hot flashes night sweats vaginal dryness those types of things and one of those common

symptoms is actually this uh belly fat around the middle and literally Dr Lauren I'll have women whether it's in

person or even virtually just kind of grab around the middle and go I don't know where this came from it wasn't you

know 18 months ago or something like yeah yeah what's happening during menopause is that your hormones are

declining so your ovaries produce uh the bulk of your main hormones that you would think of like estrogen

progesterone testosterone and all of those levels are declining what is typically happening uh

and I kind of look at it this way so you've got estrogen kind of higher always progesterone is lower but as they

are both declining often progesterone is declining faster so you in essence get a

gap or what we call estrogen dominance and estrogen is a fat storing hormone so that's one of the main drivers behind

seeing that extra weight during the menopausal years and then just of course

as women are aging the metabolism slows down a little bit maybe the thyroid Etc so there's often a combination of things

but definitely those hormonal shifts are one of the really important driving factors of that and how did the adrenals

play into this great question so your adrenal glands produce cortisol which is

your stress hormone that's one of the main things that the adrenal glands do and as far as stress is concerned like

you know I asked this question all of my patients Dr Lauren like how would you rate your stress well and they'll give

me a number like on a scale of 1 to 10 and then I point out this idea that there's different types of stress stress

so there is the perceived stress or the emotional stress when you go it's five it's seven and some people are just

naturally cool calm and Collective you know that that's just their personality so they're never quotequote stressed

according to them however there is dietary stress so sometimes you're

eating foods that are inflammatory to the body and causing stress and then there's pain and inflammation that come

from other sources that are also a cause of stress so I think that's important to note about stress also this idea that

whether the stressful event was yesterday or even five years ago

sometimes it can have a lingering impact on the body and the body's you know mechanisms and so cortisol

directly can inhibit the conversion of your thyroid hormone from inactive to

active and if anybody knows anything about the thyroid it's one of the most important hormones as it relates to

Energy and Metabolism so stress plays a role in that way and then cortisol is

another Fat storing hormone so that's another one that we don't want to be I'm going to use the term out of balance uh

Loosely because there's really kind of probably not such a thing as hormone balance it's really about optimization

but kind of the layman's term is balance and so you don't want your cortisol quote unquote out of balance nor your

other hormones yeah and one of the things that I thought was really that I found to be really interesting as far as

all of this is concerned is progesterone being the precursor to cortisol so like when you're going into menopause if your

adrenals are already lower then progesterone plummets faster is that true absolutely so we call it the

progesterone steel you may have heard of it or the prenolone steel so when you

look through those Cascade of hormones you got uh you start cholesterol is a parent body first of all of all of your

sex hormones and even cortisol so that's why I always tell people you know all fat is not bad you need some cholesterol

in your system obviously absolutely but from uh cholesterol going few steps down you get uh DHEA which

turns over to testosterone DHE going down a few more steps you get progesterone you get cortisol so there's

definitely a link between all those hormones and if you're pulling away basically because you're stressed you're

kind of pulling away from your body's ability to make some of those hormones Upstream from cortisol absolutely and

because of that I don't know what you found but certainly in my practice I've seen that a lot of women when they're going into menopause if their adrenals

are low or if there's toxicity they seem to have a harder time of it do you find the same abely absolutely and so on the

on the topic of toxicity one of the things that I talk a lot about is just sort of the impact of inflammation and

so obviously if you're toxic you're inflamed and if you're inflamed you know your body's not going to burn fat well

because if you think about it in another way whether it's toxin specifically or if it's inflammation the byproduct of

that right your body's always trying to protect you like you know uh one thing that I tell people all the time is that

your body is divinely designed has a great capacity to heal and in its effort to protect you those inflammatory

markers those toxins they're often stored in the fat cells kind of to keep away from you know just the normal

mechanisms of the body and as a result those toxic fat cells are not gonna want

to shrink which is what we really want them do yeah sure yeah absolutely that makes

sense so you mentioned that estrogen tends towards storing fat estrogen I've

always kind thought of also as helping with water retention are those two things happening simultaneously or does

one happen and then the other happen or how do those things relate to each other they definitely can be happening

simultaneously I guess for me when I see that transition I kind of look more at that um influence as far as being fat

storing um and what's interesting too and this is what I love about how these hormones kind of balance each other uh

kind of your your take on estrogen kind of helping with fluid because progesterone though it's very beneficial

it can cause especially if you're in the realm of like hormone replacement or if you're taking Progesterone which is a

lot of what I do in my practice what you'll find is that sometimes progesterone can cause a little fluid retention you know initially it usually

will kind of balance itself out but it's just another kind of great just to look

at how those hormones balance each other one might a little fluid one may lend toward removing fluid right and so one

extra piece to tease apart here so it's the estrogen to Progesterone ratio that makes the the most that that's most

important but at the same time there's also the testosterone how does testosterone play into weight oh that is

a great question and so let me just start off first of all by saying I think a lot of uh women especially have the

wrong idea about estrogen in my I'm sorry about testosterone in my opinion so I think first of all people sort of

mistakenly think that testosterone is only important for men which is not true and then a lot of people mistakenly

think that testosterone is only about sexual function and that's not true either so certainly testosterone can

help with lipido and can enhance orgasm that kind of thing uh but then the nonsexual benefits of testosterone are

related to increases in energy mental Clarity building muscle mass over time

and that's the key as it relates to your metabolism building muscle mass over time so that you can burn fat more

efficiently so obviously it's not like a weight loss fix but the way I describe it it's sort of like turning a dial in

your favor it's as far as your metabolism is concerned right that makes sense so one thing that's really

interesting about synthetic hormones versus bioidentical can be that if you

end up adding in like sometimes some women for example will gain weight with birth control certain birth controls of

course not that doesn't happen with everybody with bioidentical hormones do you always notice that if the estrogen

is high and you give progesterone that the weight falls off just with that or do you have to make sure that you've got

all of them in the mix that is a great question and so the way that I determine you know which

hormones are needed it really depends on the individual woman but I'll give you kind of a rule of thumb women who are

earlier in the stages let's say they're kind of per menopausal and that just basically means you're starting to get

symptoms but you haven't hit the clinical definition of menopause so they're already again the high flashes the ni sweats the weight gain Etc

usually the last thing they need in a lot of cases is estrogen so I often will

start with progesterone and testost because the thing with estrogen even when your periods are spacing out and

even when you've stopped having a period for a number of months or even a year

you're still potentially having some fluctuations in those hormone levels and so one of the things that you want to be

most cautious about is overshooting on the estrogen so you always want to kind

of start with that last so I love progesterone because uh and this is my secret weapon hormone by the way Dr Lord

and you know about this too but it helps with sleep and it helps with mood and so those are two amazing things about

progesterone it works at the Gaba receptors the neurotransmitters on the brain just to have a calming effect so

all of those women you know who are dealing with anxiety and irritability and these types of things as you're getting into their 40s and 50s and

Beyond progesterone can do wonders there the other thing about uh progesterone

and kind of speaking to the complement of these hormones what I find Also let's say if a woman is having hot flashes but

she's just in mid 40s and her Labs show that her estrogen levels still look present at least what I find is that

giving progesterone because it has a similar enough chemical structure it can actually help to alleviate some of those

classically known as estrogen deficient symptoms sure and then when we get to

testosterone um again I love to start with that uh for for most women also and

a little bit of testosterone does convert to estrogen kind of speaking of all those hormones are connected and so

again we can help the estrogen deficient symptoms without giving estrogen right off the bat and I think that's the best

way to avoid overshooting or giving excess estrogen yeah and one of my

favorite ways to get there is DHEA as well same concept so like that one's going to feed that whole pathway and

support the adrenals too yeah yeah very cool so um what would you say to a woman

who wants to balance her hormones but maybe doesn't want to jump to bioidenticals quite yet do you have like

some go-tos before that yeah absolutely so I think first of all we got to talk about basic lifestyle things first and

not Overlook that right so there are some things that are uh what I call

menopause Pretenders because sometimes you're having symptoms and you're thinking you're in menopause but it may

be you're struggling with a menopause Pretender and one of those is alcohol you know you're having you know a lot of

women want to have a glass of wine at night to relax and things like that but

but what's happening and what they need to understand is that that is often a menopause Pretender meaning that when

you get that blood sugar swing in the middle of the night that's gonna bring about sweats for a lot of women sure and

um and I know you know this Dr Lauren so I'm just kind of speaking to your audience you know sugar is gonna Spike

initially right from that glass of wine and then in the middle of the night your blood sugar's tanking you got to keepi

in cortisol your body's trying to get the blood sugar up and you're starting to sweat and so sometimes you gotta

again deal with the menopause Pretender of alcohol deal with other menopause Pretender of

sugar okay that is another big one same phenomenon that happens at night when you get in too much sugar even outside

of alcohol definitely getting your rest which is super important and a lot of people Overlook the importance of sleep

uh also getting in regular physical activity all of these things are going to help in that menopausal transition if

you're not ready uh to go into a biodental hormones and then if we get into supplements things such as DHEA which

you've already mentioned uh there are other things like Chase tree magnesium so there's several different herbs that

can help with that too yeah gotcha so uh what would you say to women who are

concerned about the potential risks associated with like synthetic hormones

and also versus bioidentical hormones can you can you give us kind of the arguments on both sides of that fence

yeah absolutely and it's um you know it's a story that has been developing

and very controversial really over the last 20 plus years kind of like my entire time in practice so I remember uh

Dr Lauren back when I was a resident that's when the big Women's Health Initiative study came out back in 2002

uh what that study was it was a randomized clinical trial women average age 62 they were giving half of them

primin which is synthetic estrogen primin as in pregnant mayor's urine

that's where they got it from and then the other arm of the group they got Prim Pro which was the synthetic estrogen

along with the synthetic uh progestin which is what we should techn technically call it other than

progesterone that mroy progesterone acetate so basically they stopped the study early because of a a concern for

the risk of breast cancer heart attack and stroke so back in 2002 the big

message was hormones cause cancer hormones cause you know uh heart attacks

and basically everyone should be off of their hormones and so I kind of imagined during that time you know all the

primary care docs were just ripping up all the prescriptions for hormones and the only docs that were still

prescribing hormones were the OB Jens such as myself yeah now the backstory

behind that too is that there had been Decades of data a lot of it was you know

observational so it wasn't the highest standard that we consider the randomized clinical trial but there was a a lot of

data showing the benefits of hormones and we thought before the Women's Health Initiative you put a woman on hormones

when they hit menopause and you keep them on it for the rest of their life and then this stud came out and you know

it was a huge 20 some years later and after kind of unpacking unpacking this data several

things have come out uh as a result and I think a lot of people agree that that initial statement was really an

overstatement of of the results and it didn't always apply to what was happening clinically so I mentioned at

the top that the average age of the woman in that study was 62 now we don't usually start a woman on hormones at the

age of 62 we're starting in their mid-40s you know maybe in their 50s

right so one of the theories was that maybe the increased risk of heart attack and stroke was because a lot of these

women maybe already had pre-existing disease pre-existing cardiovascular disease so I could go on and on about

that but 20 again 20 plus years later what we saw in that data now is that the

younger women really didn't have an increased risk of heart attack and stroke and by younger I mean really up through the age of 60 we also saw that

even on the synthetic uh estrogen there was a 30% reduction in osteoporosis a

30% reduction in colon cancer uh so those are some of the big things uh that came out of that and I think other data

that has come out uh since then we see say like the nurses uh health study which is a big observational study they

show a 30 to 50% reduction and heart disease for women who've been on hormone replacement what we don't have a lot of

actually uh Dr Lauren is uh big studies on bioidentical hormones we don't necessarily have as uh big of a study as

the women's health initiative but just to give you another example of let's just say the difference between

progesterone and the progestin I think one of the biggest links to in the Women's Health

Initiative study it was the progestin the synthetic progestin that really was the culprit as far as that risk of heart

attack stroke and breast cancer so the women in the synthetic estrogen arm did

not show an increased risk of breast cancer in fact it was showing lower incidence but it wasn't clinically

significant so it was actually less breast canc so it's again you could go on and on with that data but let's take

progesterone so bioidentical progesterone um again we talked about sleep we talked about mood but if you

take synthetic mroy progesterone acetate it actually can be associated with weight gain think about the Depo Pera

shot is a great I know I was gonna ask yeah and the Depo Pera shot also has uh

it had a blackbox warning at least when I prescribed it years ago if you had significant depression you shouldn't

take it so those are just one difference between bioidentical versus synthetic

and a lot of the traditional OB Jens now are prescribing more commercially

prepared bioidentical hormones so you can get that from your traditional gynecologist if you have that discussion

I think right yeah absolutely and overall I'm assuming your preference Is bioidentical is that true it is yes okay

and is there what's the main reason that you prefer that over the synthetic yeah so one of the main reasons why I prefer

bioidentical is because I feel like number one like with the progesterone there's really no question there the

other thing that's nice about the bioidentical is that we can really create preparations very unique to our patients and that is the reason why

we're able to get particularly compounded bioidentical and the reason why we're allowed to have compounded

medications is because we can create a dose that's very unique whereas if you get a commercially prepared there's just

you know dose one two three and there's in between or above so those are some of the reasons why I really like the

bioidentical gotcha so if you have a woman who is very frustrated about her

weight and she's tried the hormones and maybe that hasn't had as much of a benefit as she'd like what's your take

on all of the various things like everybody's asking for OIC and all that stuff right now all the other approaches

commercially for weight loss tell us your thoughts okay so you know obesity medicine is another one of my

certifications so one of the things that I found very interesting um about this and I remember back when I was kind of

doing my coursework they had a graph of all the different ways a person could lose weight this is prior to O

whether you had surgery whether you took medication whether you did diet or lifestyle if you looked at the graph

over time everybody lost a significant amount of weight and if you continue to follow them over time they started to gain weight back so you know one of my

big take-home points then is in some ways losing weight can be easy but keeping the weight off is really the

challenge and so that's what I really try to work with people on again of course addressing Life Style factors

first I do use you know old style traditional things like fenine which is just a big basic appetite suppressant um

and Dr Lauren I also use gp1s uh compounded as well but I have a little

bit of a different approach I call it the functional medicine approach to it so the first idea is that we're going to

use it as a tool it's not meant to be a forever type medication for someone who's trying to lose weight secondly

we're going to do the dosing differently so that we hopefully eliminate any of

the significant side effects and sort of the horror stories that people hear about like I was slow to start using

this with my patients because I had you know suspicion about it I had concern about it I should say so I remember

reading a story about some lady she said she threw up every day for a year I'm like well first of all why were you on it for a year I

know they too right maybe maybe take that as a clue yeah so these horror

stories you hear about like all this nausea vomiting we were able to micro do it using compounded versus the standard

preps you start at a pretty high dose um the the other thing too is that we really stress the importance of the

lifestyle strength training is important so one of the other things that people probably hear is that you lose a lot of

muscle mass potentially if you use this medication yeah in the reality is any

method that you use to lose weight if you're losing it rather rapidly you're going to risk losing a lot of muscle and

so you got to do your strength training and those types of things to counteract that so that's the way that we do it you

know we do it kind of cautiously as a tool and then a team approach so I have an integrative nutrition coach on my

team you know we see people regularly so we want to give them guidance along the way not just here's your medicine and

we'll see you in three months or whatever fantastic and so what's kind of the average length of time that you have

somebody on a glp1 for example yeah I would so of course it depends on how much weight they're trying to lose but I

would take probably six to nine months is pretty common for someone who's like 20 is 20 30 pounds if they're more than

30 pounds then they're going to be leaning for a longer gotcha yeah okay and I'm assuming like do you have do you

find that you have to monitor things like liver enzymes pancreas enzymes stuff like that or not really micro

doing yeah we do a certainly a set of Baseline Labs which will check uh liver

function and then we follow that you know I look at Labs about every six months at least anyway on all my PA so

we check it then too but I've had I've honestly had uh no Maj complications and

few I haven't had anybody who had to stop the medication because of side effects so people have done very well with it gotcha awesome and so um taking

kind of a step back and looking at your overall philosophy how do you integrate your holistic philosophy of Medicine

with your face how does how do you see those in interacting with each other yeah so you know let me just tell you a

little bit a story that really impacted me so back when I was in medical school

my husband um actually lost his vision and uh lost his vision we didn't know what was going

on he was having numbness and tingling in his body we claim to learn that he

had multiple sclerosis and so by the time we got there he was pretty blurry

in both eyes and so we went to see a neuro opthalmologist at the University

of Kansas I believe his name is Dr Whitaker the first thing he said when we sat down was is it okay if I pray with

you awesome like I was a medical student so there was a lot I didn't know right

at the time so we were just scared we didn't understand what was happening um at the time and so that had such a huge

impact on me to see a physician pray with their Pati and so that gave me

courage to offer that now I don't pray with every patient every time but there are certain situations like someone has

had a loss or there's something difficult happening I will say hey is it okay if we pray so and I will honestly

tell you too Dr Lauren it was probably after I started my own group my own practice that I felt more comfortable to

do that yeah practice now since 2012 so you know I've been doing it uh for a

while right thing I would say too is that um you know just kind of first of

all being in the field of Obstetrics and Gynecology where you're sort of helping

to usher in life like that's just a beautiful uh thing to witness it kind of

puts you in awe of this entire process and acknowledging you know that there

had to be a god behind it you know what I mean these things are just not happening

randomly it's the way that I see it as well and it was way back in the eth grade biology class when I learned about

reproduction that I thought you know it' be neat to deliver a baby yeah yeah that and ended up you know being an

obstetrician gynecologist so that's another thing and then taking it Beyond just traditional medicine and now doing

functional medicine where I'm just reawakened to this idea of how many ways

that your body is working for yourself can heal itself like you know my mind was blown when I you know learned about

functional medicine and I was a little bit upset because I'm like about this stuff you know what I

mean are so ready to just repair regenerate and do all these amazing

things and I'm just like this is not by halfen stance yeah oh absolutely and so

segue onto that how did you transition from a more traditional practice to

functional medicine why did how did you make like what made you decide to make that jump I guess so I was in a busy obj

group um I was a year out from having my second kid I was uh about 240 pounds so

I had gotten to my heaviest I was stressed at work and I knew I needed to do something different for myself so I

began by learning about uh obesity medicine and I started helping patients lose weight and so the first weight loss

program I learned about Dr Lauren was it was five shakes a day yeah did it myself

I lost 20 pounds but I had the worst constipation of my life gosh the first 20 pounds down and

then I'm gonna kind of share my weight loss Journey as I did this transition um

and in my group they were telling me I need to see more people I was like I can't do this like this hamster wheel I

just started to feel like this is not why I got into this I want to be able to

develop Rapport and spend time with my patients and I wasn't able to do that anymore um so I decided to leave my

group at that time and initially I was just going to do regular OBG and a little bit of weight loss that was kind of what I was going to do um and then I

learned about bioidentical hormones really from patients coming in telling me how amazing felt I was like let me

check this out and so when I did my training shout out to World link medical and Dr Neil ruser again mind blown again

I'm like I'm I'm a fully board certified OB gen and I don't think I know anything about hormones really wow also and I

started offering that and so I developed sort of a cash based practice alongside my traditional Obin practice and then

and that started 2012 and then 2015 I decided to stop taking Insurance because the other side of the practice was kind

of growing on yeah and as I was learning biodental good friend of mine who's a

physician who lives in California she mentioned functional medicine now this was back in like 2013 14 I was like what

is that I've never heard of it oh wow and told me about it and then she and I first we were like seminar sisters now

we're just like sisters but we did all the cour workk together so I got certified with the institute for

functional medicine so the way I look at it now is that functional medicine is the umbrella under which I do everything

else so that's really the umbrella and then also the foundation if you will and

in the process personally I lost another 20 pounds on fenine that my doctor prescribed for me and then the third 20

pounds I lost just littleit diet and exercise and kind of those regular things so I lost 60 pounds over the

course of two years from 2011 2013 so that was kind of my my personal

transformation and then also my uh career transformation as well right awesome very cool so what have I not

asked you that you want to make sure you leave with our audience this is one of the things that

I really want to stress with people because I know that sometimes it can be frustrating when you when you're dealing

with something going going on with your health you know whether you don't have a diagnosis or maybe you have a diagnosis

and now you don't know sort of what the path is going to be for you going forward I want to encourage uh your

listeners just with the idea that your diagnosis is not your destiny amen yes

and that goes back to your faith uh that goes back to the idea that just understanding that your body is divinely

designed and has a great capacity to heal and even in the midst of you know whatever it is you're walking through

because some things you know you're you're not going to get rid of perhaps but you know you can always give God

glory in the midst of whatever your journey is with your health uh but I really want to encourage people to just

be encouraged in the idea that that diagnosis is not their Destiny because sometimes I think people think well my

grandmother had diabetes so I'm probably gonna get it and they don't realize that that can be reversed like you can put

yourself on a totally different trajectory so that is really the mess message the diagnosis is not your

destiny yes absolutely where can people go to learn more about you okay so I

actually have a free Facebook group called the natural hormone fix so you

can look that up and you'll see my smiling face there and you can ask to join and we go live and we talk about

you know hormones from the functional medicine perspective and then I also have a free report called the three

secrets to hormone balance every woman should know and you can grab that online Dr woodw wellness.com

SLU GUI D perfect I will link to that in the show notes and thank you so much Dr

Woods this has been really educational I appreciate it thank you so much for having me

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