Chapter 5 - The Biochemistry Of Chaos

Perimenopause can feel like your mind and body are speaking different languages, and the scariest part is how quickly it can change. We slow it all down and translate the “chaos” into clear physiology, so you can stop treating every symptom like a personal failure and start seeing patterns you can act on.

We talk about why perimenopause is not “mini menopause”, but a distinct neurological and endocrine transition where progesterone tends to fade and oestrogen can swing unpredictably. Those swings can disrupt neurotransmitters, which helps explain mood shifts, anxiety, low mood, and that maddening brain fog where you walk into a room and forget why you’re there. From there we widen the lens to the full-body cascade: metabolic and blood sugar instability, rising insulin resistance, stubborn weight gain around the middle, cravings, and the energy crashes that make you feel like you’re running on fumes.

We also unpack the wired-but-tired state and allostatic load, plus gut microbiome changes including the estrobilome and how dysbiosis can influence oestrogen metabolism. Inflammation and immune flares come into the picture too, and we acknowledge how past trauma can raise inflammatory markers and make the transition feel even rougher. Finally, we share a practical framework for moving forward: “restump the house” by rebuilding foundational health first, using comprehensive blood tests and, when appropriate, functional medicine testing such as advanced hormone testing (DUTCH) and cortisol assessment, while remembering testing is only one snapshot and needs skilled interpretation.

If this resonates, follow the podcast, share the episode with a friend who’s navigating perimenopause, and leave a review so more women can find clear, evidence-informed support.

Transcript

Chaos As A Biochemical Reset

SPEAKER_00 0:00

Chapter 5 The Biochemistry of Chaos Change is hard, messy in the middle, and gorgeous at the end. Robin Sharma, the 5 a.m. Club. Own your morning to elevate your life. What if the chaos you feel in your body right now isn't a sign that something is wrong, but proof that your body is brilliantly and beautifully resetting. The female body is made up of complex systems and phases that we as women get to gradually explore and in time learn to cherish. Deep in perimenopause, the cherishing part can feel far out of reach, but trust me it does come. It may feel messy during the process, even chaotic and unpredictable. But your body isn't broken. Your biochemistry is working hard to come back online. For now, focus on the peace that awaits you on the other side. Be gentle with yourself as you begin to understand what is often described as a second puberty, a natural occurrence, a biochemical reset happening in your body. It may feel disorientating, but it is guiding you into the power of a new life phase. The biochemistry of chaos, not mini menopause. This chapter's focus is to help you understand your basic biochemistry so you can begin to find some peace within the turbulence of perimenopause. As you know by now, perimenopause is not menopause. This chapter continues to explain why. There is a bit of a caveat to what we're about to cover. There is nothing basic about female biochemistry. This beautifully complicated design comes from the delicate interplay between your hormones, your genetics, and every other system in your body. It is a dance that is always shifting, always changing. Perimenopause is not minimenopause, it's a distinct neurological and endocrine transition. This transition involves altered brain energetics and heightened sensitivity to hormonal change, making it a unique life phase requiring specialized understanding and care. This is why an empowerment approach matters so much, one that sees you as an active participant in your own healthcare, not just a passive recipient. You deserve comprehensive information and a voice in every decision about your body. At the hormonal level, perimenopause only heightens this complexity.

Why Hormone Swings Hit Hard

SPEAKER_00 2:45

Progesterone quietly leaves the scene while estrogen begins her wild, unpredictable swings. This hormonal chaos or unpredictability sets off biochemical shifts throughout your body, shifts you may already be feeling. Hormonal chaos and biochemical shifts the cascade of biochemical shifts brain chemistry shifts. You might be experiencing mood swings, anxiety, depression, or that maddening brain fog, where you walk into a room and forget why you're there. Here's what's important to understand. It's not about whether your estrogen is high or low at any given moment. It's your wild swings, the unpredictable ups and downs that wreak havoc on your brain chemistry. These fluctuations directly impact the neurotransmitters that regulate your mood and cognitive function, which is why you can feel fine one day and utterly unraveled the next.

The Body Systems That Change

SPEAKER_00 3:47

Metabolic and blood sugar instability. Your metabolism can start to shift, and not in your favor. You might notice you're gaining weight, especially around your middle, even though you're eating the same way you always have. Your body becomes less efficient at using insulin, which means sugar isn't getting into your cells properly for energy. This insulin resistance can also slow down your metabolic rate, making it harder to maintain your weight and easier to feel exhausted. You might experience energy crashes, intense sugar cravings, or that hangry feeling more frequently. Fight or flight state without a trigger. Your stress response system can get stuck in overdrive. Even when nothing particularly stressful is happening, your body acts like there's a tiger chasing you. This creates what researchers call allostatic load, which is essentially your body wearing itself out from chronic stress. This state accelerates aging at a cellular level and can amplify all your other perimenopausal symptoms. You might feel anxious for no reason, struggle to sleep even when exhausted, or feel simultaneously wired and tired. Gut microbiome changes. There's a whole ecosystem of bacteria in your gut called the estrobilome that specifically helps metabolize estrogen. When this bacterial community gets out of balance, dysbiosis, it can actually increase the amount of free estrogen circulating in your system, making your estrogen dominance even worse. This imbalance triggers bloating, digestive upset, constipation, diarrhea, or unpredictable bowel movements. You might notice your digestion has become unreliable or that foods you used to tolerate fine now cause problems. Autoimmune and inflammatory responses. It's possible that your immune system can shift into overdrive, triggering inflammatory responses throughout your body. You might experience joint pain that wasn't there before, mysterious hives or skin reactions, migraines or flare-ups of autoimmune conditions. As noted earlier, research has shown that if you've experienced trauma or adverse childhood experiences, your inflammatory markers can be significantly higher, which means these symptoms can be even more pronounced. Past trauma literally changes how your body responds to the hormonal chaos of perimenopause. This hormonal unpredictability is why perimenopause feels so different for every woman, because every woman's biochemistry is uniquely her own. The indisputable complexity is why my approach, both in my clinic and in this book, begins with taking it back to the basics. The basics of restoring your foundational health, repairing your gastrointestinal tract, rebalancing your hormones, and reclaiming your metabolic flexibility. Restumping

Restumping Foundational Health First

SPEAKER_00 6:55

the house. To understand what I mean by foundational health, I want to paint a picture in your mind. Say you've just purchased a home. Not just any home. This is your dream property with the high ceilings, dark wooden beams, light in every room, and a view to die for. However, it is going to require major renovation to unlock and bring life to the potential you see. Where do you start this endeavor? Naturally you start by restumping the house. You make sure the foundation is solid and the bones of the home are strong. If these structures aren't sturdy, then it makes no sense to begin discussing the interior design plans that are dancing in your head. That's the exciting part, right? The paint colours, the furniture layout, the lighting fixtures, the hardwood floors, but none of this decor, not a single cushion will matter until the foundation is sorted first. Your body is no different. Until your foundational health is in order, no other protocol will be effective when it comes to healing your body sustainably. In order to restump your foundational health, we begin with data gathering through foundational blood testing to identify where the deficiencies in your body might be. This way we avoid focusing on the interior design before we restump the house. The key to unlocking your unique body chemistry. How do we gather this data? We order a comprehensive panel of blood tests to assess your hormonal imbalances, metabolic health, inflammation, and nutrient levels, identifying potential deficiencies. Before we blame everything on hormones, it's crucial to rule out other health issues that can mimic perimenopausal symptoms. Your thyroid might be sluggish, your blood sugar could be unstable, you might have inflammation brewing, or you could simply be deficient in key nutrients. Current medical guidelines recommend considering your symptoms while also checking for these common health issues before confirming a perimenopause diagnosis. A comprehensive approach means making certain conditions like thyroid disorders, metabolic problems, and nutrient deficiencies are properly investigated and ruled out first. A comprehensive panel of blood tests will provide the foundational data to help me or your practitioner identify the underlying root causes of your symptoms and why you don't feel good, even if your GP says, no, you're fine. Beyond these comprehensive blood panels, there is additional testing, including the Dutch test, dried urine test for comprehensive hormones, which is an advanced hormone test that shows a more three-dimensional portal into what's really going on. We will talk about this test in depth in chapter 10 and why it's critical to evaluate your gut health too. Typically, the blood tests your GP orders will be less comprehensive and more focused on diagnosing disease or indicating a serious condition. Functional medicines testing, the testing I order in my clinic, is designed to identify hormonal, metabolic, or nutrient deficiencies, all of which can be the underlying causes of your symptoms. This way we can look deeper into what is really going on in your body. To effectively gather the comprehensive data needed in order to give you the proper treatment, there's a first line of testing and a second line to call in. Since I want to serve every one of my patients with the biggest healing toolbox possible, offering every tool I can, I will call in the second line of testing when necessary. It could mean a deeper line of foundational blood work, more functional testing, or the Dutch test. I don't want to leave a stone unturned, nor should you. Testing

Testing Limits And Reading Signals

SPEAKER_00 10:55

is important but limited. For proper treatment and to avoid inadequate care, first you need a practitioner who has an understanding of both the nuances of this life phase and the limitations of testing. For example, testing might catch your estrogen when she's at her low of lows, but the right practitioner will know that periomanopause is, overall, an estrogen-dominant state and treat you accordingly. Reading between the lines. The second nuance your practitioner must be able to see is when the testing indicates your thyroid is sluggish. A well-informed practitioner will recognize this as a hint to investigate further, often toward adrenal health. In this case, it may be appropriate to order a second line of testing, such as measuring cortisol levels in urine or saliva, to get a fuller picture. A third nuance is to recognize when signs of insulin resistance appear. This is a red flag because it means you can't properly access energy from your food. Left unaddressed, this can overwork the liver, sometimes leading to metabolic dysfunction associated steatotic liver disease or MASLD, previously called non-alcoholic fatty liver disease, which is driven by fat buildup in the liver. Without resolving the insulin resistance, prediabetes or type 2 diabetes may follow. In many cases, dietary and lifestyle modifications can help manage this. For you, beautiful, the one listening to my words, it is essential to have a practitioner who understands the intricacies of female biochemistry over the age of 35, one who can see the sensitivities and the needs of your unique body, and who knows when to question or look beyond the data, understanding that most testing only captures a single moment in time. Without a practitioner who understands both the intricacy of perimenopause's chaos and the importance of gathering foundational data through functional testing, neither you nor your practitioner will ever hold the keys to unlock and heal your unique biochemistry. The

Be The Practitioner You Needed

SPEAKER_00 13:14

Practitioner I Needed. I want to revisit the words of the incredible Eastern Medicine professor who changed my life that day in the student health clinic. She told me in no uncertain terms, be the practitioner you needed. The practitioner I needed to resolve my health challenges as that young 24-year-old who no doctor had answers for. Those words have become my mission. I want to practice in a way that when a woman comes to me and says she doesn't feel well, that something isn't quite right in her body, I don't tell her you're fine. I want to be her health detective. I want to listen and validate every one of her symptoms and call in every line of testing I have access to, to discover what is happening just beneath the surface of her symptoms, and then treat those deeper issues. My hope for every woman is that she sees a doctor who believes what she is saying is the truth, who believes her when she says she's not fine, something is awry. Then, her doctor would order full testing to gather the foundational data needed about her unique body and biochemistry, and for that doctor to then use their toolbox to restore her foundational health, so she can feel better and can heal her body and reclaim her vitality, her energy, and live the life she so longs for. This chaos of perimenopause is not permanent. With the right approach, you can navigate your way through, even the messy middle, to reclaim the vitality and vibrance you deserve.