In this episode of the Thyroid Pharmacist Healing Conversations podcast, Dr. Izabella Wentz interviews Dr. Elena Zinkov about the critical yet often misunderstood transition of perimenopause.

Dr. Zinkov is a naturopathic doctor who has dedicated her career to empowering women through innovative hormone and peptide therapies. Having faced her own struggles with perimenopause symptoms in her 30s, Dr. Zinkov refused to accept what the medical establishment deemed "normal." Frustrated by a system that often overlooks the unique challenges women face such as brain fog, fatigue, weight gain, and metabolic dysfunction — she embarked on a mission to change the narrative.

Dr. Zinkov is leading the charge in redefining women’s health through innovative hormone and peptide therapies — specifically designed to empower women over 35 to reprogram their metabolism, build muscle, and confidently defy the aging process.

The conversation addresses common misconceptions about hormone replacement therapy, and offers insight into the role that hormones like progesterone, estrogen, and testosterone play in the body.

Listeners will learn about:

Perimenopause starts earlier than most women realize — often in their 30s. Dr. Zinkov explains that hormone decline begins as early as our mid-twenties, and symptoms like insomnia, anxiety, mood swings, weight gain, and irregular cycles can start showing up long before periods stop. Tracking hormone fluctuations through regular testing is key to catching these changes early.
Progesterone is the first hormone to decline — and it's essential for sleep, mood, and calm. Bioidentical progesterone metabolizes into allopregnanolone, which activates GABA receptors in the brain. This calming effect is why declining progesterone often shows up as insomnia, anxiety, and irritability. And no — progestin is not the same thing. In fact, it can worsen mood and increase health risks.
Growth hormone peptides (like sermorelin, CJC, Ipamorelin) paired with GLP-1s (like semaglutide) may help reverse metabolic decline in perimenopause. Dr. Zinkov shares that this combination not only supports weight loss but also builds lean muscle, regulates blood sugar, and boosts energy. These peptides work best when hormones are balanced, and they may even reduce autoimmune markers and inflammation.
Testosterone is critical for motivation, libido, muscle mass, and mood in women — but needs to be carefully dosed. Despite fears of "bulking up," women naturally produce testosterone and often need small amounts in midlife. Starting with a microdose (like 0.5–1 mg) in topical form can support energy and mental drive without unwanted side effects like acne or hair growth.
Weight loss isn’t just about willpower or calories in/calories out — it’s about metabolic function, hormones, and muscle. Crash dieting and over-exercising can backfire, especially in perimenopause. Dr. Zinkov emphasizes prioritizing protein, resistance training, and supporting thyroid, adrenal, and sex hormones to rebuild metabolism from the inside out.

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For the full list of resources and products mentioned in this episode, and to get the full episode transcript, see complete show notes here: https://thyroidpharmacist.com/articles/podcast/

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