PERIMENOPAUSE

THE GUTSY GYNECOLOGIST’S GUIDE

BALANCING
YOUR
HORMONES

DR. TABATHA
THE GUTSY GYNECOLOGIST

MAY 2022
CONTENTS
Foreword. A
Welcome From Dr.
Tabatha

Introduction. The
Wonderful World Of
Hormones.

System One. Our GI

Tract and Gut
Bacteria AKA Gut
Microbiome.

System Two. Lets

Talk Adrenals.

System Three. Our

Liver Wears Many
Hats.

System Four. How

The Brain Plays A
Role.

System Five. The

Importance Of Our
Spirituality.

Final Notes. Let Me

Help You On Your
Journey.

DR. TABATHA
THE GUTSY GYNECOLOGIST
 FOREWORD
Welcome! I am so glad you decided to pick up a copy of my book:
Balancing Your Hormones, Especially During Perimenopause - The
Gynecologists Guide. I hope this finds you well. The information
I’m about to share with you applies to all women, no matter
their age. The steps in this book will show you how to get and
feel balanced no matter what stage of life you are in.
Live in love,

Dr. T ab ath a
 INTRODUCTION
THE WONDERFUL WORLD OF HORMONES
Does this sound like you? Hot flashes,
night sweats, mood swings, weight
gain, brain fog? No one wants to
experience these things but
unfortunately, many women do. For
so long we’ve been told we just need
more estrogen to feel better. “Oh,
she’s going through the change. She
just needs some estrogen and she’ll
feel better.” As a functional
gynecologist, I’m here to tell you -
the answer isn’t that simple.
Over the years, I’ve had many women
taking synthetic estrogen and
progestins (as conventional medicine
trained me to do) only to complain that
they are still suffering from the
annoying symptoms. Do we just
increase the dose?
The conclusion that came out of the
Womens Health Initiative (WHI) study
that was published in 2003, told us
that if women are on estrogen
replacement therapy, they should be
on the lowest dose for the shortest
duration of time because of the risk of
blot clot and stroke. This report caused
wide-spread panic and knee-jerk
reactions from many authority figures.
Consequently, many women were
taken off their estrogen by the very
physicians that prescribed them in the
first place.
These women were left feeling
miserable and asking, “What are we
supposed to do to gain good quality of
life through this transition?”
 “What are we supposed to do to gain good
quality of life through this transition?”
This is where functional medicine
shines! We figure out the real root
cause of those symptoms and tackle
them head on. I’m here to tell you that
it isn’t usually low estrogen, it’s more
complex than that. It’s the delicate
balance of multiple hormones in our
body during a major transition in our
life.
The symptoms happen when there is
an abrupt change in hormone levels,
and a major imbalance that isn’t
managed actively with lifestyle
choices. We aren’t supposed to need
high levels of estrogen our entire
lives. Besides, no pill can mask those
symptoms completely for the rest of
your life, and who wants to worry
about developing a blood clot or
stroke?
As a functional gynecologist, I’m here
to tell you that we need to make
lifestyle changes to address the root
cause of those symptoms, so they
disappear for good!
Let me just tell you, balancing our
hormones requires addressing
multiple systems in our body, not just
our reproductive system.
Yes, our ovaries make our female
hormones, but other systems like our
gut, liver, and brain are key players
determining when hormones are
produced, and how they are utilized,
metabolized, and excreted.
If these systems are not working in
harmony, then our hormones will not
be balanced, and we will feel like
we’re riding a roller coaster that we
didn’t want to get on!
Yes, menopause is a transition. Things
will change, but it doesn’t have to be
miserable.
Menopause shouldn’t cause your
children to disown you or your
husband to divorce you (as people
joke). We women were created to be
cyclical beings. Our hormones
fluctuate every day of every month
(that’s another talk). We were created
to sustain major life changes- like
puberty, menses, pregnancy, child-
birth, peri-menopause, and post-
menopause.
If we tend to our inner gardens, so to
speak, we can navigate these changes
with ease and joy!
 SYSTEM ONE
OUR GI TRACT AND GUT BACTERIA AKA OUR MICROBIOME
First things first-our guts. We need
to nourish our bodies with clean,
healthy, whole foods that give us the
healthy fats, protein, fiber, energy,
vitamins, minerals, micro-nutrients,
and phytonutrients that our bodies
need to make and utilize our
hormones every day. Even with the
best diet, many of us still need to
supplement with a high-quality
multivitamin because our food
sources are so depleted and many of
our processed foods and medications
actually deplete the nutrient stores
we do have.
In addition to nourishing ourselves,
we need to make sure we are
eliminating (pooping!) regularly.
It’s super important to have regular,
soft, formed bowel movements every
day to rid your body of metabolized
hormones and ensure that we are
eliminating toxins from our body that
accumulate from our environment.
I see women every day in my office
who suffer from constipation and let
me tell you, they are usually the ones
on the biggest, scariest roller
coasters. How do they get off that
ride? Get more fiber! Eat more
vegetables. That will ensure that you
are pooping every day.
If that doesn’t regulate your bowels,
then you have more issues to address.
 BRISTOL STOOL SCALE

type SEPERATE HARD LUMPS,

LIKE NUTS (HARD TO PASS)

type SAUSAGE-SHAPED BUT

LUMPY

LIKE A SAUSAGE BUT WITH

type CRACKS ON IT’S SURFACE

type LIKE A SAUSAGE OR SNAKE,

SMOOTH AND SOFT

type SOFT BLOBS WITH CLEAR-

CUT EDGES (PASSED
EASILY)

type FLUFFY PIECES WITH

RAGGED EDGES, A MUSHY
STOOL

type WATERY, NO SOLID PIECES,

ENTIRELY LIQUID
In addition to eating right, we need
to have beneficial bacteria living in
our GI tract. There is an entire GU
Y!
D
BA
ecosystem living within us called I’M
A

our gut microbiome, and they are

running the show. It may be
necessary to work on ridding our
body of unhealthy bacteria if we are
currently on a highly processed, YEAH
, ME
sugar laden diet. It can be life
TOO!

changing to go from gut dysbiosis to

gut harmony.

In addition to dietary changes, this

may require prebiotics, probiotics,
digestive enzymes, or more
aggressive treatments of harmful
bacteria or biofilms.

lets check in
RID YOURSELF OF PROCESSED FOOD, FAST FOOD,
ARTIFICIAL SWEETENERS, AND ALCOHOL.

EMBRACE REAL FOOD. TRY TO EAT NON-GMO, ORGANIC

PRODUCE, GRASS-FED BEEF, AND FREE-RANGE POULTRY.

EAT MOSTLY PLANTS. YOU SHOULD EAT VEGETABLES

WITH EVERY MEAL, AIMING FOR 6-8 SERVINGS/DAY.
CRUCIFEROUS VEGETABLES LIKE BROCCOLI,
CAULIFLOWER, BRUSSELS SPROUTS, KALE, AND
CABBAGE HELP METABOLIZE OUR ESTROGEN
SO IT DOESN’T BUILD UP AND CAUSE ROLLER
COASTER FLUCTUATIONS, WHICH PRODUCE
THOSE AWFUL SYMPTOMS.

DRINK MORE WATER! YOU SHOULD DRINK HALF YOUR

BODY WEIGHT IN OUNCES EVERY DAY, AND MORE WHEN
YOU ARE PHYSICALLY ACTIVE.
E.G. IF YOU WEIGH 160 LBS, THEN YOU SHOULD DRINK
AT LEAST 80 OZ. OF WATER/DAY.
 SYSTEM TWO
LETS TALK ADRENALS

The adrenal glands make the stress
hormones cortisol, adrenaline, and
noradrenaline. They also make
aldosterone, which affects our blood
pressure. This is one reason living a
stressful life can lead to hypertension
and heart disease. “When I say
stressful life, what do I mean?”
If you wake up in the morning and are
rushing around (without ever taking a
deep breath), getting ready for work,
getting the kids ready, eating while
driving, continuing all day long
running from one responsibility to the
next without ever stopping to process
and reflect on the days events, then
your cortisol level has been elevated
nonstop.
Our bodies were not designed to work
like that. Our grandmothers and
ancestors did not go, go, go 24-7.
Sure, they worked hard and endured a
lot, but they had down time mentally,
emotionally and physically.
In this day and age, our brains and
bodies are stimulated and on the go
every minute of the day. Just because
everyone around you is living this way
doesn’t make it normal or right or
healthy.
TIME OUT!
 t r es s f u l l i f e ,
“When I say s ? ”
wha t d o I m ea n

Every day in my office I see women

who live that crazy busy life for years
lets c he c k i n
on end until one day when they break.
“I was fine. I have always been able to
IT’S VITALLY IMPORTANT TO FIND
handle my work, my kids, my
TIME EVERY DAY TO STOP…
husband, and work out at boot camp,
but now, I can barely get out of bed.”
TO LISTEN TO WHAT YOUR BODY IS
TRYING TO TELL YOU (THOSE
I explain to them that, “Yes, you were
SYMPTOMS ARE MESSAGES FROM
able to juggle it all, but you depleted
YOUR BODY TRYING TO TELL YOU
yourself so completely that your body
SOMETHING).
and mind are done. They want to rest
now. You didn’t replenish them with
TO BREATHE DEEPLY TO ACTIVATE
what they needed as they worked all
YOUR PARASYMPATHETIC SYSTEM,
day, every day, so now they are on
WHICH BRINGS DOWN YOUR
strike. It’s time to listen to what your
CORTISOL LEVELS.
body and mind need, and then make
some compromises if you want them
TO PROCESS YOUR THOUGHTS AND
to function again. And, if you want
FEELINGS, SO YOU CAN CULTIVATE
them to function well (so you actually
HEALTHY RELATIONSHIPS.
feel good), then you need to make
major changes, not just little
compromises.” It’s vitally important WE WANT TO RESPOND,
to find time every day to stop… NOT JUST REACT, TO
PEOPLE AND SITUATIONS.

TO RESTORE ALL THE ENERGY THAT

YOU JUST EXPENDED, SO YOU
DON’T FIND YOURSELF RUNNING
ON “E”.
 SYSTEM THREE
OUR LIVER WEARS MANY HATS

Our liver has many important jobs, including metabolizing fats, proteins, and
carbohydrates, making cholesterol, (which is the backbone to hormone
production), metabolizing hormones, detoxifying chemicals (like alcohol),
metabolizing medications, storing glycogen (fat), vitamins, and minerals, and
making clotting factors. Our liver performs more than 500 functions for our
bodies. If our liver is overworked (from things like daily alcohol intake,
medications, birth control pills or hormone replacement pills, or storing excess
fat from obesity), then it’s going to have a hard time processing our hormones
appropriately, in a cyclical fashion, like our body was designed to do.

So you see,
we disrupt our hormone balance
with our choices every single
day.
 le t s c h e c k i n
DO NOT DRINK ALCOHOL EVERY DAY.
WHEN YOU DO DRINK, IT SHOULD BE 1-2 GLASSES MAX.
DRINKING RED WINE HAS THE BENEFIT OF RESVERATROL.

TAKE ONLY MEDICATIONS THAT YOU TRULY NEED.

FREE YOUR BODY FROM THAT EXCESS FAT YOU’RE CARRYING.

AVOID DEEP FRIED FOODS THAT ARE DIFFICULT TO DIGEST.

IF YOU EAT RED MEAT, EAT ONLY GRASS-FED BEEF 1-2

TIMES/WEEK TO AVOID INGESTING TOO MUCH SATURATED
FAT AND EXOGENOUS HORMONES.

DON’T HEAT YOUR FOOD IN PLASTIC CONTAINERS AND

DON’T DRINK FROM PLASTIC WATER BOTTLES THAT HAVE
BEEN SITTING IN THE SUN (HORMONE DISRUPTORS LEECH
OUT FROM THE PLASTIC INTO YOUR WATER AND FOOD).
USE GLASS AND STAINLESS STEEL INSTEAD.

EAT GARLIC, TUMERIC, WALNUTS, VEGETABLES LIKE BEETS

AND CARROTS, AVOCADOS, AND GREEN TEA ON A REGULAR
BASIS TO SUPPORT PROPER LIVER FUNCTION.
 SYSTEM FOUR
HOW THE BRAIN PLAYS A ROLE
For so long, western medicine tried
to say that the brain wasn’t directly
affected by the other systems in our
bodies, but the science has proven
otherwise. We now know that the
bacteria that live in our gut (GI tract)
communicate through chemical
messengers to our brains, and in
return our brain communicates with
our other systems.
Serotonin is a major player when it
comes to how we feel. The most
common class of anti-depressants are
called SSRIs (Selective Serotonin
Reuptake Inhibitors). They work by
blocking the reabsorption of
serotonin in the brain, so more
chemical is available. “So why doesn’t
it always work?”
Because it doesn’t fix the root cause
of the problem(s). Functional
medicine seeks to determine why
your serotonin level is too low in the
first place or why your receptors are
not responding to the serotonin you
do have. Ninety percent of the
serotonin in our body comes from the
enterochromaffin cells in the GI
tract. Not only does serotonin keep
us mentally healthy, but it directly
affects our intestinal motility. (That
is part of the reason why we get a
“tummy ache” when we are worried).
So, if your gut microbiome is not in
harmony, or you are ingesting things
that damage your intestinal lining,
you will not have healthy levels of
functioning serotonin to distribute.
 Another huge contributor to our
brain health is sleep! We need sleep
to allow our brains time to process
and organize events, thoughts, and
feelings that we experienced
throughout the day. When we don’t
make time for adequate, scheduled
sleep, then our brains cannot
function properly. It ends up sending
mixed messages to our endocrine
system, and our circadian rhythms
are disrupted leading to hormone
imbalance.
The adrenal glands become confused
(in addition to never having down
time during the day) and produce
cortisol when it’s not supposed to, so
then we fall into a pattern of not
being able to stay asleep. It sends
signals to the liver telling it to store
more fat and tells our bowels to slow
down and stop digesting because it
thinks we are in a time of crisise are
stuck in sympathetic, chronic stress
mode.
All of these interactions lead to a
downward spiral causing
dysfunctional sleep. Every day I see
women in my office who either
cannot fall asleep or stay asleep. It
goes on night after night, falling
asleep at midnight, only to wake up at
2:30, and stare at the clock until their
alarm goes off. Or worse yet, they get
up and scroll their phone or watch tv.
It’s imperative that we cultivate good
sleep hygiene if we want our
hormones to become balanced and
free ourselves of those awful
symptoms.
-HINT-
You want to be in
parasympathetic,
rest and digest mode
more often!
 lets check in
BE PHYSICALLY ACTIVE DURING THE DAY, TO EXPEND PHYSICAL
ENERGY AND RELEASE TOXINS THROUGH SWEATING .

DO NOT EAT AFTER 7PM TO STABILIZE YOUR BLOOD SUGAR

AND GIVE YOUR PANCREAS AND LIVER A REST.

DO NOT DRINK MORE THAN ONE 4 OZ GLASS OF ALCOHOL

(FOR SOME WOMEN, EVEN THAT IS TOO MUCH) WITH DINNER.

DO NOT WATCH DISTRESSING NEWS OR SOCIAL MEDIA IN

THE EVENINGS.
CUT OFF SCREEN TIME AN HOUR BEFORE BED AND KEEP
THE TV OUT OF THE BEDROOM.

GO TO BED AROUND THE SAME TIME EVERY NIGHT.

JOURNAL YOUR THOUGHTS, MEDITATING, PRAYING,

READING, SOAKING IN THE TUB WITH EPSOM SALTS, OR
MAKING LOVE AS A WAY TO UNWIND YOUR BRAIN.

REMOVE ANY BLUE LIGHT OR ELECTRONIC ENERGY FROM

YOUR BEDROOM.
KEEP IT DARK AND QUIET, USING EAR PLUGS IF YOUR
HUSBAND/PARTNER SNORES.

WAKING UP AROUND THE SAME TIME EVERY DAY.

 SYSTEM FIVE
THE IMPORTANCE OF OUR SPIRITUALITY
What makes you feel alive and
connected? If you are living day-to-
day, just going through the motions,
and the only feelings you have are the
symptoms of your unbalanced life,
then you aren’t nourishing your
spirit. You deserve to feel alive and
well! You should be excited to wake
up in the morning and enjoy your
family and the people you interact
with, and the work that you do. You
have a purpose on this earth, and you
should be cultivating that.
Sometimes life gets so busy and
congested that we forget to nourish
our spirit, and that can leave us
feeling empty and disconnected from
the people we love.
That disconnect can lead us to
focusing on our symptoms, which can
exacerbate (or magnify) them. We can
get lost in our problems and forget
that there is a solution; a way out. We
can forget how to feel alive and
joyful, just as a human being.
We may end up identifying ourselves
as someone’s mom or wife, as the
boss of a company, or maybe we have
completely lost our identity. When
we always put others first and don’t
practice self-care, our spirit suffers.
We need to remember that there is
more to life than keeping a clean
house, having our kids excel at every
event, getting that raise, owning that
boat, or having that new handbag.
 Life is about connecting with your higher
power, knowing that there is more to life than
meets the eye, that you are part of a greater
plan, and that you are enough simply by being
YOU!

lets check in
ENGAGE IN YOUR COMMUNITY WITH ACTS OF KINDNESS .
VOLUNTEER FOR THINGS THAT YOU ARE PASSIONATE
ABOUT.
SHARE YOUR TIME, TALENTS, AND TREASURES EXPECTING
NOTHING IN RETURN.

GET IN TOUCH WITH NATURE.

FEEL THE EARTH BENEATH YOUR FEET; RUN OUTSIDE; PLAY
AT THE BEACH.
APPRECIATE THE BEAUTY OF THE FLOWERS IN YOUR
GARDEN; FEEL THE DIRT ON YOUR HANDS AS YOU GARDEN.
ENJOY WATCHING THE SQUIRRELS CHASE EACH OTHER AS
YOU WALK YOUR NEIGHBORHOOD.

JOIN A CHURCH.
BECOME PART OF A LARGER, FAITH-BASED FAMILY;
SOMETHING BIGGER THAN YOURSELF.

MEDITATE OR PRAY.
GET TO KNOW THE INNER WORKINGS OF YOUR MIND.

JOURNAL YOUR THOUGHTS AND FEELINGS.

SET GOALS FOR YOURSELF; FUEL YOUR DREAMS.

SIMPLY DO SOMETHING FOR YOURSELF, ON A REGULAR BASIS,

THAT BRINGS YOU JOY.
 FINAL NOTE
Sometimes, our patterns have become so dysfunctional that it requires
major interventions to re-align our systems. What I want you to
understand is that it is multi-factorial and requires a multi-system, root
cause approach. I have no doubt that it’s possible to have balanced
hormones and eventually sail through menopause like it’s a lovely
breeze. I’ve seen it time and time again with my patients. When you are
committed to working on balancing and supporting all of your body’s
systems, in a holistic, root cause approach, you can absolutely restore
balance, and free yourself from those annoying symptoms/messages
your body is yelling at you!

If you would like to work with me one-on-one to tackle your issues, then
please schedule a free call with my assistant:

I would love to help you feel like yourself again and regain your joy!
Live in Love,

Dr. T ab ath a

LETS CONNECT!