54: Thriving Through the Perimenopause Hormone Rollercoaster with Dr. Jen Pfleghaar

In this episode of Thyroid Pharmacist Healing Conversations, Dr. Izabella Wentz interviews Dr. Jenny Pfleghaar, double board-certified physician and author of the upcoming book, The Perimenopause Reset, about how to thrive through the hormone rollercoaster of perimenopause. (She has Hashimoto’s too!)

Perimenopause symptoms can feel overwhelming and confusing, and we’re finally lifting the curtain. We share practical insights and cutting-edge solutions, including how progesterone, cycle syncing, and peptides can help you rebalance hormones, support detox pathways, and navigate this life stage with more ease and joy.

Tune in to learn:

• Why perimenopause feels unpredictable and what’s actually happening hormonally. It’s not just a slow decline in estrogen. Dr. Jen explains that during perimenopause, estrogen can spike and crash wildly, while progesterone steadily drops. This hormonal mismatch is why symptoms like mood swings, anxiety, and irregular cycles can appear seemingly out of nowhere and why the traditional “wait and see” approach doesn’t work.

• The overlooked role of cortisol, and why stress hits harder now. As progesterone levels drop, its natural calming effect on the nervous system fades. Dr. Jen highlights how women in perimenopause become more sensitive to stress, and how cortisol spikes can drive insomnia, anxiety, and fatigue. She emphasizes daily tools like HRV monitoring, breathwork, and parasympathetic support to calm the system and rebalance hormones.

• Blood sugar swings aren’t just about food; they’re a hormone issue. Perimenopause shifts metabolic function, increasing insulin resistance even in healthy women. Dr. Jen connects the dots between blood sugar instability and symptoms like belly weight, brain fog, and energy crashes, and shares why protein-forward meals and strength training are non-negotiable for midlife women.

• Sleep isn’t just rest, it’s hormonal therapy. Poor sleep amplifies cortisol, disrupts blood sugar, and worsens estrogen/progesterone balance. Dr. Jen underscores how addressing the cause of poor sleep, like stress, late-night eating, or alcohol, can unlock profound hormonal improvements without starting with medications.

• Progesterone might be the missing piece for mood, sleep, and calm. As levels drop in perimenopause, many women experience anxiety, restlessness, and disrupted sleep. Dr. Jen explains why bioidentical progesterone, particularly in oral form, can be a safe, effective way to restore balance and help women feel like themselves again.

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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/