Hormone Cafe

Perimenopause Explained: Hormone Roller Coasters, Testing & How to Feel Like Yourself Again | Episode 26

In this episode of The Hormone Café, Dr. Sarah Pederson breaks down perimenopause—what it is, how to know if you’re in it, and what you can do to feel better during this major hormonal transition. She explains why symptoms can feel extreme and unpredictable, how hormone testing actually works in perimenopause, and why a whole-body, root-cause approach is essential for long-term relief.
Rather than accepting “this is just part of aging,” Dr. Sarah outlines how targeted nutrition, lifestyle support, lab testing, supplements, and — when appropriate — low-dose bioidentical hormone therapy can dramatically improve quality of life.
In This Episode, You’ll Learn:
🌿 What Perimenopause Actually IsPerimenopause is the transition between regular, ovulatory hormone production and menopause.Instead of a smooth decline in estrogen and progesterone, hormone production becomes sporadic and erratic, leading to dramatic highs and lows.This hormonal “roller coaster” is what drives many of the frustrating symptoms women experience.
🔥 Common Symptoms of PerimenopauseDr. Sarah explains that symptoms can vary widely and may include:
Anxiety and mood swings
Depression or irritability
Brain fog and poor concentration
Hot flashes, night sweats, and temperature intolerance
Fatigue and poor sleep
Weight gain despite eating well and exercising
Changes in metabolismPerimenopause is natural — but suffering is not inevitable.
🧪 How to Test for Perimenopause (and Why One Lab Isn’t Enough)Hormone levels fluctuate dramatically in perimenopause. One “normal” lab does not rule it out.Dr. Sarah explains:
Why FSH and LH are key markers
What values typically look like in reproductive years vs. perimenopause vs. menopause
Why testing multiple times, at least two weeks apart, is critical to identify trendsTrending labs over time gives a much clearer picture than a single snapshot.
🩸 When Irregular Bleeding Is a Red FlagNot all irregular cycles require treatment — but certain symptoms do:
Extremely heavy bleeding
Bleeding lasting weeks at a time
Bleeding through clothes or experiencing “waterfall” bleedingThese situations warrant intervention to protect health and improve quality of life.
🥗 Why Nutrition Is Always the FoundationBefore jumping to medication, Dr. Sarah emphasizes:
Eating enough calories to support hormone production
Stabilizing blood sugar to reduce hormone swings
Ensuring adequate protein, healthy fats, and micronutrientsNutrition is the base that allows any other therapy to work effectively.
🧠 Supporting the Entire Endocrine SystemPerimenopause is not just about estrogen and progesterone.Dr. Sarah walks through why it’s essential to assess:
Thyroid function (full thyroid panel, not just TSH)
Adrenal health (DHEA/DHEA-S)
Nutrient status (magnesium, zinc, B vitamins, omega-3s)
Mitochondrial and metabolic health
📈 Why Blood Sugar Matters More Than You ThinkUsing continuous glucose monitoring, Dr. Sarah explains how blood sugar instability can worsen:
Insomnia
Anxiety
Inflammation
Hormone irregularityBalanced glucose = more stable hormones.
🌱 Gut Health, Absorption & Hormone BalanceEven a perfect diet won’t help if nutrients aren’t absorbed.Daily bowel movements, minimal bloating, and proper digestion are essential to hormone production and detoxification.
💊 Supplements: When to Support vs. When to Avoid
High estrogen → support detox pathways (DIM, calcium D-glucarate)
Low hormones → avoid estrogen-lowering supplements
Strategic use of nutrients like DHEA when appropriateSupplement choice must match hormone status.
🧠 Mental Health & Nervous System SupportMood changes during perimenopause are influenced by:
Hormone fluctuations
Life stressors (career changes, aging parents, family transitions)Sarah highlights the importance of therapy, nervous system regulation, and targeted neurotransmitter support when needed.
🌸 Hormone Therapy: When It’s HelpfulHormone replacement therapy can be life-changing for severe symptoms such as:
Debilitating insomnia
Drenching night sweats
Severe brain fogSarah explains:
Why low-dose, bioidentical hormones are used
How therapy is personalized
The importance of monitoring labs and symptoms
Why hormones should support — not override — natural physiology
📊 Discovery, Stabilization & Weaning PhasesHormone therapy is never “one and done.”Treatment includes:
Discovery phase (finding the right dose)
Stabilization phase (feeling great consistently)
Planned weaning into menopauseThe goal is support, not dependence.
Key Takeaways:
Perimenopause can last 5–10 years and looks different for everyone
Hormone swings — not aging — drive many symptoms
One lab test is not enough to diagnose perimenopause
Whole-body evaluation is essential for lasting results
Hormone therapy can be powerful when used thoughtfully
You are not doomed to feel bad — feeling better is possible
Resources & Next Steps:
If you think you may be in perimenopause or you’re experiencing symptoms that are affecting your quality of life, you don’t have to navigate it alone.
📍 Westminster, Colorado🌐 Learn more or schedule: verafertility.com📧 Follow along: @verafertility

Bypassing the Gut: How IV Therapy Supports Egg, Sperm & Implantation Health | Episode 25

In this episode of The Hormone Café, Dr. Sarah Pederson explains how IV nutrient therapy can support fertility when diet and supplements aren’t enough. She breaks down why nutrient deficiencies persist despite “doing everything right,” how IVs bypass absorption barriers, and how targeted IV formulations can improve egg quality, sperm quality, implantation, and surgical recovery.
In This Episode, You’ll Learn:
💉 Why IV Therapy Matters in Fertility CareDr. Sarah explains why many fertility patients remain deficient in key nutrients despite optimal diet and supplementation:
Poor gut absorption
Digestive inflammation or dysfunction
Liver metabolism limiting nutrient availabilityIV therapy allows nutrients, antioxidants, and hydration to be delivered directly into the bloodstream—bypassing the gut and liver for faster, more effective results.
🧪 Key Nutrients Commonly Low in Fertility PatientsFrequently identified deficiencies include:
Folic acid & B vitamins
Vitamin C and other antioxidants
GlutathioneThese nutrients are essential for:
Cellular energy and metabolism
Egg and sperm quality
Detoxification and inflammation reduction
🥚 Egg Quality IVDesigned to support ovarian health and cellular protection:
High-dose antioxidants to reduce oxidative stress
Supports mitochondrial function and egg integrity
Can be used weekly or monthly depending on fertility goalsSarah explains that while we’re born with all our eggs, egg quality can be supported through targeted antioxidant pathways.
🌱 Implantation & Uterine Blood Flow IVCreated for patients with:
Thin uterine lining
Recurrent miscarriage
Chronic inflammation or endometritisThis IV focuses on:
Improving blood flow to the uterus
Supporting implantation before and after ovulation
Working alongside diet, supplements, and medication—not replacing them
🩺 Pre- & Post-Surgical Recovery IVsDr. Sarah discusses why surgery should be restorative—not depleting:
Surgery places stress on the body and increases dehydration
Nutrients and electrolytes support healing and circulation
IVs help reduce recovery time and support fertility-preserving outcomesThese IVs are now integrated into Vera’s fertility-sparing surgical protocols.
👨 Sperm Quality IVMen benefit from IV therapy too. This IV supports:
Sperm morphology (normal head and tail structure)
Motility and progressive motility
Hydration and reduced sperm agglutination
Blood flow to the testesIdeal for men who have optimized diet and supplements but still have suboptimal semen parameters.
🧠 IV Therapy as an Adjunct—Not a ReplacementDr. Sarah emphasizes:
IVs do not replace good nutrition or supplements
They enhance and accelerate results when absorption is limited
Best used as part of a comprehensive fertility plan
Key Takeaways:
Persistent nutrient deficiencies often stem from absorption issues—not effort
IV therapy delivers targeted nutrients directly into circulation
Antioxidants play a critical role in egg and sperm quality
Blood flow and hydration are essential for implantation and recovery
IV therapy can support fertility at multiple stages for both men and women
Resources & Next Steps:
If you feel like you’re doing “all the right things” but still struggling with egg quality, implantation, recovery, or sperm parameters, IV therapy may be a supportive next step.
📍 Westminster, Colorado🌐 Learn more or schedule: verafertility.com📧 Follow along: @verafertility

Low, Dominant, or Imbalanced? Understanding Estrogen & Progesterone Profiles | Episode 24

In this episode, Dr. Sarah Pederson breaks down the three most common female hormone profiles—low estrogen & progesterone, estrogen dominant, and progesterone dominant/low estrogen—and explains how each one affects mood, energy, cycles, fertility, and overall health. This episode empowers women to understand their symptoms, test hormones properly, and align nutrition, exercise, supplements, and treatment with their unique hormone profile.
In This Episode, You’ll Learn:
🧪 The Three Core Hormone ProfilesDr. Sarah explains how estrogen and progesterone work together—and what happens when they fall out of balance:
Low Estrogen + Low Progesterone (“Low–Low”)
Estrogen Dominant (Relative Low Progesterone)
Progesterone Dominant / Low Estrogen
Each profile presents differently and requires a different approach to treatment, lifestyle, and supplementation.
🩺 Why Proper Hormone Testing Matters
Best timing for hormone labs:
Cycle day 3: Estrogen, progesterone, FSH, LH, testosterone
5–7 days after ovulation (depending on luteal phase length)
Why checking progesterone at the wrong time leads to misdiagnosis
How incorrect supplementation can worsen symptoms instead of helping
🌱 Low Estrogen & Low Progesterone (Low–Low Profile)Common symptoms include:
Depression, brain fog, low stress tolerance, fatigue
Light or skipped periods, long cycles, short luteal phase
Recurrent miscarriage, poor cervical mucus, thin uterine lining
Low libido, vaginal dryness, UTIs, hair thinning, brittle nails
Hot flashes, cold intolerance, poor circulation
Root causes may include:
Chronic stress
Under-eating or poor nutrient absorption
Excessive exercise
Postpartum or breastfeeding states
Perimenopause or ovarian insufficiency
Support strategies:
Adequate calories and protein
Gentle exercise (yoga, Pilates, barre)
Stress reduction and sleep prioritization
Targeted supplements (omega-3s, magnesium, vitex)
⚖️ Estrogen DominanceCommon symptoms include:
Anxiety, irritability, mood swings
Heavy or painful periods, clots, PMS
Breast tenderness, fibroids, endometriosis
Migraines, acne, bloating, weight gain
Poor sleep, constipation, joint inflammation
Key contributors:
High sugar or refined carbohydrate intake
Low protein consumption
Poor liver or gut estrogen metabolism
Support strategies:
Higher protein intake (≈80g/day)
Strength training, HIIT, frequent movement
Fiber-rich diet for estrogen detoxification
Supporting liver and gut health
Reducing alcohol and excess sugar
🌡️ Progesterone Dominant / Low EstrogenCommon symptoms include:
Sedation, brain fog, low motivation
Excessive sleepiness, low blood pressure, dizziness
Weight gain, insulin resistance, cravings
Heat intolerance, nausea, constipation
Vaginal dryness, low libido, breast fullness
Key focus areas:
Supporting ovulation and estrogen production
Balanced, moderate exercise
Stress reduction and adequate sleep
Avoiding progesterone-only supplementation when estrogen is low
🧠 Why Hormone Ratios MatterDr. Sarah emphasizes:
Hormones must be balanced—not treated in isolation
DIM, progesterone, or bioidentical hormones can be harmful if mismatched
Nutrition, exercise, and supplements should support—not fight—your hormone profile
Ongoing lab monitoring ensures treatment is helping, not harming
Key Takeaways:
Most symptoms are clues to your hormone profile—not random
Estrogen and progesterone must be evaluated together
Timing of hormone testing is critical
One-size-fits-all hormone advice often backfires
Aligning lifestyle and treatment with your hormone profile leads to better mood, energy, cycles, and fertility
Resources & Next Steps:
If you suspect hormone imbalance or feel stuck with persistent symptoms, proper hormone testing and individualized care are essential.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility

Mental Health & Your Cycle: Understanding Mood Changes, Communication, and Self-Care | Episode 23

In this episode of The Hormone Café, Dr. Sarah Pederson is joined again by Kelly Sinning, licensed professional counselor and perinatal mental health specialist, to explore how women’s mental health fluctuates across the menstrual cycle. From hormonal highs and lows to how to communicate needs with partners and friends, this episode provides actionable insights for thriving mentally and emotionally throughout your cycle.
In This Episode, You’ll Learn:
💬 Talking About Your Cycle with Friends and Partners
With friends: opening up often encourages mutual sharing, creating understanding and support.
With partners: conversations require context, clear explanation, and understanding of differences in perception.
Men and women experience emotional rhythms differently — women operate on a 28-day cycle, men on a 24-hour clock.
Key strategies:
Explain what different phases of your cycle feel like
Give concrete guidance for your needs (e.g., “I just want to rest tonight”)
Use humor and timing strategically
Help partners anticipate moods rather than reacting to them
❤️ Aligning Needs with Hormonal Phases
Understanding the cycle allows better mental health and relationship dynamics:
Ovulation: Higher energy, more romantic and social
Luteal phase (pre-period): Irritability, fatigue, introspection
Period: Need for rest, downtime, lower energy
By planning and communicating your needs during each phase:
Relationships feel smoother
Self-care is easier
Partners can participate constructively without feeling “in the dark”
🧠 Hormonal Fluctuations and Mental Health
Mood, energy, and motivation naturally vary across the cycle.
Weeks of low motivation or fatigue are normal, not personal failure.
High energy phases can be leveraged for productivity and social connection.
Low energy phases offer rest, reflection, and introspection — which have value.
Planning for each phase reduces guilt, pressure, and stress.
🌿 Thriving Through the Cycle
Identify the purpose and opportunity in each phase.
Use introspective, quiet phases for planning, learning, and rest.
Use high-energy phases for action, productivity, and social engagement.
Embrace natural rhythms instead of fighting them.
Kelly emphasizes that leaning into these biological patterns improves mental health and overall alignment with your body.
Key Takeaways:
Mood changes across the menstrual cycle are normal and biologically driven.
Open, clear communication with friends and partners is critical.
Recognize the value of low-energy phases — they are productive in different ways.
Planning around your hormonal rhythm helps reduce stress and improve relationships.
Embrace your cycle rather than trying to power through it.
Resources & Next Steps:
If you find certain phases of your cycle mentally or emotionally challenging, a mental health professional specializing in perinatal and hormonal health can provide guidance.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility

Mental Health During Fertility: Relationships, the Two-Week Wait, and Coping with the Emotional Rollercoaster | Episode 22

In this episode of The Hormone Café, Dr. Sarah Pederson is joined by Kelly Sinning, licensed professional counselor and certified perinatal mental health specialist, to discuss the emotional and relational challenges that often arise during the fertility journey. From shifting friendships to strain within marriage, the two-week wait, and repeated disappointment, this episode offers practical, compassionate tools to protect your mental health during a season that is often filled with highs, lows, and invisible grief.
At Vera, mental health is considered just as essential as physical and hormonal health when navigating fertility.
In This Episode, You’ll Learn:
🤍 How Fertility Changes Friendships
Kelly explains that fertility struggles often shift relationships in unexpected ways.
Common experiences include:
Difficulty feeling happy for pregnant friends
Avoiding baby showers or pregnancy announcements
Feelings of anger, jealousy, sadness, or resentment
Guilt for not being the “friend you used to be”
These changes are normal and often temporary. Fertility is a season that comes with different emotional needs.
Key takeaway:
It is okay to scale back
You can love people from afar
Protecting your mental health now helps preserve relationships long-term
You do not need to show up the same way in every season of life.
💬 Letting Go of Guilt in Relationships
Many people push themselves to attend events or overextend emotionally, which often leads to:
Resentment
Emotional exhaustion
Awkward or painful interactions
Instead:
Honor where you are
Communicate honestly when possible
Trust that strong friendships can withstand temporary distance
Most friends respond with understanding when given context.
❤️ How Fertility Impacts Your Relationship with Your Spouse
Trying to conceive often changes intimacy and connection.
Common challenges include:
Sex becoming scheduled and pressure-filled
Loss of spontaneity and desire
Emotional disconnect
Feeling misunderstood by your partner
This does not mean the relationship is failing — it means the season has changed.
🔑 Redefining Connection During Fertility
If sex no longer feels like the primary form of connection, alternatives may include:
Holding hands
Cuddling
Going on dates without fertility talk
Shared activities that feel nurturing and light
Emotional check-ins without problem-solving
Connection can evolve without disappearing.
🗣️ How to Have Hard Conversations with Your Partner
One of the most important tools discussed is having conversations about how to have the conversation.
Consider:
Timing (not right after work or during stress)
Tone (humor vs. seriousness)
Setting (walks, dates, neutral spaces)
Avoiding trigger words
Setting expectations beforehand
This reduces defensiveness and emotional shutdown.
🧠 Understanding Different Coping Styles
Men and women often cope differently during fertility challenges.
Common patterns:
Women often seek connection and conversation
Men often retreat when they feel helpless or out of control
Neither response is wrong — they are different coping mechanisms.
Awareness of these differences reduces resentment and miscommunication.
⏳ Surviving the Two-Week Wait
The two-week wait is one of the most emotionally taxing parts of fertility.
Helpful strategies include:
Scheduling something enjoyable during that time
Planning events unrelated to fertility
Giving your mind something else to focus on
You will still think about pregnancy — but shared mental space helps.
🧪 Be Honest About How You Test
Kelly emphasizes being realistic about pregnancy testing habits.
If you:
Test early — plan for it
Wait until your period — plan for that too
There is no “right” way — only what is honest for you.
Planning ahead helps reduce emotional spirals after negative tests.
🛠️ Plan for Disappointment (Without Losing Hope)
Planning for how you’ll care for yourself after a negative test is not pessimistic — it is protective.
Ask yourself:
How do I cope when I’m disappointed?
Do I need alone time or connection?
Do I need quiet or distraction?
Who feels safe to talk to?
Self-care is one of the few things you can control during fertility.
🌊 The Emotional Rollercoaster of Fertility
Fertility is marked by:
High highs
Low lows
Emotional whiplash
Exhaustion — even from hope
This is normal.
Trying to force stability during an inherently unstable season often increases distress.
Instead:
Acknowledge the waves
Ride them rather than fight them
Adjust expectations for productivity, energy, and social engagement
💔 Fertility as Invisible, Prolonged Grief
Every cycle without pregnancy can feel like a loss.
This grief is:
Real
Cumulative
Often misunderstood
Rarely acknowledged by others
Support is essential — not optional.
Seek out:
People who understand loss
Others navigating fertility challenges
Mental health professionals
Supportive communities
You do not have to carry this alone.
Key Takeaways:
Fertility changes relationships — and that’s okay.
Protecting your mental health is not selfish.
Connection with your partner may look different during this season.
Planning for hard moments reduces emotional overwhelm.
Support and community are critical during fertility challenges.
Resources & Next Steps:
If fertility feels emotionally overwhelming, working with a mental health professional trained in perinatal and fertility-related care can be life-changing.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility

Gut Health & Fertility: Why Your Digestion Matters for Hormone Balance | Episode 21

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN at Vera Health and Fertility, breaks down why gut health is foundational to hormone balance, fertility, and overall well-being. From how often you should be pooping to advanced gut testing and treatment options, this episode explains how digestion, absorption, inflammation, and the gut microbiome directly impact your hormones and reproductive health.
At Vera, gut health is never overlooked. If your body cannot properly digest and absorb nutrients, it cannot make hormones correctly — no matter how healthy your diet may be.
In This Episode, You’ll Learn:
💩 What a “Healthy Gut” Actually Looks LikeDr. Pederson explains what normal digestion should feel like — and what is not normal.
A healthy gut means:
Bowel movements 1–2 times per day
Soft, well-formed stool
No straining
No diarrhea
No undigested food visible
Consistent color and texture
No blood (black, brown, or bright red)
You should never:
Go a full day without pooping
Be bloated or gassy
Have abdominal pain related to digestion
If these symptoms are present, your gut needs to be tested.
🧠 Why Gut Health Is Critical for Hormones & Fertility
Your gut breaks food down into:
Amino acids
Fats
Short-chain fatty acids from fiber
These nutrients are the building blocks of hormones
Poor digestion or absorption = poor hormone production
Gut inflammation is closely linked to:
PCOS
Hashimoto’s
Endometriosis
Infertility
Failed IVF cycles
🧪 How to Test Your Gut
The most comprehensive tool is a stool (poop) test, which is done at home and mailed to a lab.
Gut testing evaluates:
How well you digest food
How well you absorb nutrients
Gut inflammation levels
Your gut microbiome profile
Bacterial overgrowth
Parasites and infections
Additional testing may include:
Blood work for inflammatory markers
SIBO breath testing (for severe bloating and gas)
Food sensitivity testing (basic or advanced)
🥗 Why Elimination Diets Often Fail
Dr. Pederson explains that diets like Whole30 or randomly cutting gluten or dairy are often too broad and not actionable long-term.
Food sensitivity testing allows:
A personalized food protocol
Structured reintroduction phases
Clear identification of trigger foods
Long-term clarity around what your body tolerates
This creates empowerment — not restriction.
⚙️ Common Gut Issues Seen in Fertility Patients
🔹 Poor Digestion
Inadequate pancreatic enzyme function
Leads to poor hormone production
Treated with:
Over-the-counter digestive enzymes
Prescription digestive enzymes (when needed)
🔹 Leaky Gut & Inflammation
Can cause bloating, food sensitivities, hormone imbalance
Often treated with targeted supplements such as:
IgG
Gut-healing protocols
Personalized food plans
🔹 Parasites & Infections
Extremely common and often undiagnosed
Can persist for years
May require:
Antibiotics
Herbal antimicrobials
Multiple treatment rounds
🔹 Bacterial Overgrowth
Examples include Enterobacter and other pathogenic bacteria
Treatment is guided by sensitivity testing
May include:
Antibiotics
Herbal options (berberine, oregano, uva-ursi)
🦠 Why Probiotics Are Not One-Size-Fits-All
Many probiotics contain lactobacillus
Some patients already have an overgrowth
Taking the wrong probiotic can worsen symptoms
Gut testing determines:
Which bacteria are low
Which are overgrown
Whether you need:
A probiotic
A prebiotic
Dietary fiber instead
Key beneficial bacteria discussed:
Lactobacillus
Bifidobacteria
Akkermansia
🌾 The Role of Fiber & Short-Chain Fatty Acids
Fiber feeds healthy gut bacteria
Fiber is converted into short-chain fatty acids
Low fiber intake leads to:
Low gut bacteria
Increased bloating and gas
Poor nutrient absorption
Prebiotic, fiber-rich foods include:
Vegetables
Beans
Seeds
Whole grains
📖 Patient Case Study: Healing the Gut to Restore Fertility
Dr. Pederson shares a powerful case of a patient who:
Pooped only every 7–10 days
Experienced vomiting from constipation
Had:
Severe metabolic imbalance
Elevated beta-glucuronidase
Low short-chain fatty acids
A gut infection (Enterobacter)
Treatment included:
Targeted antibiotics
Gut-healing foods
Fiber supplementation
Calcium D-glucarate
Probiotics
Temporary dietary changes
After 3 months:
Daily bowel movements
Improved hormone balance
Successful pregnancy after failed IVF
Long-term gut health maintained postpartum
🍽️ Daily Habits That Support Gut Health
Eat enough fiber daily
Support digestion with:
Apple cider vinegar
Fermented foods (kimchi, sauerkraut, pickles)
Use probiotics only when appropriate
Focus on whole, anti-inflammatory foods
Avoid feeding bad bacteria with:
Excess sugar
Alcohol
Highly processed foods
Key Takeaways:
Gut health is essential for hormone balance and fertility.Daily bowel movements are a non-negotiable sign of health.Bloating, gas, and constipation are not normal.Personalized testing leads to targeted, effective treatment.Healing the gut can dramatically improve fertility outcomes.
Resources & Next Steps:
If you struggle with bloating, constipation, hormone imbalances, or unexplained infertility, comprehensive gut testing may be the missing piece.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility

PMS & PMDD Explained: Root Causes, Hormones, and Holistic Treatment Options | Episode 20

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN at Vera Health and Fertility, dives deep into PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder). She explains why PMS is not normal, explores the root causes behind luteal-phase mood and physical symptoms, and outlines a comprehensive, holistic framework for treatment — from nutrition and lifestyle to supplements, hormone testing, and medical therapies.
In This Episode, You’ll Learn:
💡 What PMS and PMDD Actually Are
PMS occurs during the luteal phase (after ovulation, before your period)
Common symptoms: irritability, rage, mood swings, headaches, cramps, breast tenderness
PMDD is a more severe form with debilitating mood symptoms that impair daily functioning
PMS should not be normalized — symptoms almost always indicate an underlying imbalance
🩺 Root Causes of PMS & PMDD
Blood sugar instability (increased insulin resistance during the luteal phase)
Inflammation
Hormonal imbalances (estrogen, progesterone, LH, FSH)
Poor-quality or absent ovulation
Gut and detox pathway dysfunction
Chronic stress and elevated cortisol
🍽️ How to Eat During the Luteal Phase
Your body needs more calories, rest, and nutrients after ovulation
Aim for a 1:1 ratio of protein to carbohydrates
Increase carbohydrates, but choose high-quality sources:
Seed breads
Protein pastas
Brown rice and wild rice
Always pair carbohydrates with protein
Avoid large amounts of sugar, which fuel inflammation and worsen mood symptoms
🥑 Anti-Inflammatory Foods That Reduce PMS Symptoms
Omega-3–rich foods:
Fish (2–3x/week)
Chia seeds
Flax seeds
Leafy greens for antioxidants:
Kale
Arugula
Spinach
Turmeric for inflammation reduction (cook with it or add to drinks)
🧠 Why Blood Sugar Matters for Mood
Blood sugar spikes increase inflammation
Inflammation disrupts neurotransmitters in the brain
This directly worsens irritability, rage, anxiety, and depression in the luteal phase
Continuous glucose monitoring can be helpful during this phase
🧪 Hormone Testing for PMS & PMDD
Test hormones during the luteal phase (typically ~7 days after ovulation)
Check:
Estrogen
Progesterone
LH and FSH
Consider testing on your worst symptom day if symptoms spike just before your period
Mapping hormone patterns helps identify crashes, imbalances, and estrogen dominance
⚖️ Common Hormone Imbalances Linked to PMS
Low progesterone
High estrogen (estrogen dominance)
Rapid estrogen drops before menstruation
Anovulation (periods without ovulation)
🌿 Supplements Used for PMS & PMDD (Based on Labs)
Vitex (chasteberry) to support hormone production
Omega-3s (~1,000 mg daily if not eating enough fish)
Magnesium for mood and muscle relaxation
L-theanine and GABA for mood and anxiety support (taken at night)
Adaptogens for stress-related PMS:
Ashwagandha
Rhodiola
DIM or calcium d-glucarate for estrogen metabolism (only if estrogen is high)
⚠️ Important Note on Supplements Supplements should always be chosen based on your specific hormone profile. Do not take estrogen-lowering supplements if estrogen is already low.
💊 Medical Treatment Options (When Needed)
Bioidentical progesterone during the luteal phase for low progesterone
Bioidentical estradiol for estrogen crashes or severe luteal symptoms
“Bridge dosing” to prevent sudden hormone drops before your period
SSRIs/SNRIs (e.g., sertraline/Zoloft):
Can be used as needed or only during the luteal phase
Do not require daily, long-term use in many cases
🏃 Lifestyle Factors That Matter in the Luteal Phase
Adequate calories and protein to support hormone production
Exercise to help metabolize hormones (can tolerate higher intensity if well-fueled)
Daily bowel movements to support estrogen detoxification
Stress reduction to lower cortisol and improve mood regulation
🧬 Real Patient Case Highlight A patient with severe rage and PMS symptoms was found to be:
Not ovulating
Estrogen dominant
Insulin resistant
After blood sugar regulation, cyclic progesterone, and nutrition changes, she resumed ovulation, normalized her luteal phase, and felt like herself again.
Key Takeaways:PMS and PMDD are not normal and should not be dismissed.
Luteal-phase symptoms are signals of deeper hormonal, metabolic, or inflammatory issues.
Targeted nutrition, hormone testing, supplements, and — when needed — medical therapy can dramatically improve symptoms.
Feeling amazing every day is possible with the right support.
Resources & Next Steps:If you experience PMS, PMDD, migraines, mood swings, or luteal-phase discomfort, schedule a consultation with Dr. Sarah and her team. They take a root-cause, personalized approach to hormone health.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility on Instagram & TikTok

Nutrition for Painful Periods: What to Eat (and Avoid) to Reduce Cramps | Episode 19

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN at Vera Health and Fertility, is joined again by registered dietitian Callie to discuss how nutrition and lifestyle choices can significantly reduce period pain. They cover anti-inflammatory foods, key nutrients for cramp relief, what to limit during your cycle, and how to support your body throughout the entire menstrual cycle so your period doesn’t disrupt your life.
In This Episode, You’ll Learn:
💡 Foods That Help Reduce Period PainFocusing on anti-inflammatory and nutrient-dense foods can lower cramping and discomfort:
Anti-inflammatory foods: turmeric, nuts, seeds, olive oil, avocado oil
Magnesium-rich foods to relax muscles and reduce cramps:
Pumpkin seeds (2 tablespoons daily)
Spinach, almonds, dark chocolate
Iron-rich foods, especially for heavier bleeding:
Spinach
Grass-fed beef and other quality meats
Hydrating and “cooling” foods:
Berries
Cucumbers
Watermelon
Starting these foods before your period begins can help prevent pain rather than just reacting to it.
🩺 Foods to Limit During Your PeriodCertain foods can increase inflammation and worsen cramps:
Excess caffeine, especially in the first few days of your cycle
Highly processed and fried foods
Alcohol, particularly leading up to your period
Excess added sugars without protein
🍓 How to Handle Period Cravings Without Worsening Pain
Choose real carbohydrate sources like fruit instead of refined sugar
Pair carbohydrates with protein to stabilize blood sugar
Water-based fruits (berries, watermelon) are ideal
If having chocolate or sweets, always eat protein alongside it to prevent blood sugar spikes and increased cravings
🌿 What to Eat Throughout Your Entire Cycle to Prevent Pain
Balanced meals with protein, healthy fats, and high-fiber carbohydrates
Emphasis on variety for optimal micronutrient intake
Iron-rich foods throughout the cycle to prepare for menstrual blood loss
Warming foods leading up to and during your period:
Bone broth
Warm herbal teas
Prioritize diverse vegetables, seeds, and whole foods to support B vitamins and anti-inflammatory pathways
🚶 Lifestyle Tips to Reduce Period Pain
Hydration is critical during menstruation:
Aim for at least 64 oz daily
Enhance water with cucumber, berries, herbal teas, or bone broth
Gentle movement to improve uterine blood flow:
Walking
Light stretching
Easy daily activity
Stress reduction and rest:
Allow extra rest during the first days of your cycle
Gentle self-care and reduced demands support hormone balance
🍵 Helpful Teas for Menstrual Support
Red raspberry leaf tea for uterine support
Herbal teas to encourage warmth, hydration, and relaxation
Key Takeaways:Painful periods are not normal and should not disrupt daily life.Anti-inflammatory foods, magnesium, iron, hydration, and gentle movement can significantly reduce cramping.Nutrition throughout the entire cycle plays a major role in how your period feels.Small, consistent lifestyle and nutrition shifts can dramatically improve menstrual comfort.
Resources & Next Steps:If you experience painful periods or want personalized nutrition support for cycle health, schedule a consultation with Callie. She works one-on-one with patients to build practical, sustainable nutrition plans tailored to their cycles and symptoms.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility on Instagram & TikTok

Eating for Fertility: What to Eat, What to Avoid, and How to Build a Fertility-Friendly Plate | Episode 18

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN at Vera Health and Fertility, sits down with registered dietitian Callie to discuss how nutrition directly impacts fertility, hormone balance, and preparation for conception. Whether you are actively trying to conceive or simply want to optimize hormone health for future fertility, this episode breaks down exactly how to eat to support your body.
At Vera, nutrition is always the foundation. Food comes first, and everything else builds on top of a strong nutritional base.
In This Episode, You’ll Learn:
🍳 Go-To Foods to Optimize Fertility Callie explains that fertility nutrition starts with balance, quality, and consistency.
Protein first:
Eggs
Poultry
Grass-fed beef
Greek yogurt (low or no added sugar, if tolerated)
Wild-caught salmon
Healthy fats for hormone production:
Avocados
Olive oil and avocado oil
Nuts and seeds
Olives
Slow-digesting carbohydrates (to support blood sugar balance):
Quinoa
Wild rice
Brown rice
Fertility-supportive, anti-inflammatory foods:
Berries
Cruciferous vegetables (broccoli, Brussels sprouts)
🧠 Key Nutrients for Hormone Balance & Conception
Choline (eggs) – supports egg quality
Omega-3 fatty acids (wild-caught salmon) – supports implantation and blood flow
Iron (beef, spinach, lentils, beans) – supports ovulation and menstrual health
⚖️ What If You Don’t Like Fish?
Plant-based omega-3 sources:
Chia seeds
Flax seeds
Walnuts
For optimal levels, supplementation may be needed and should be discussed with a practitioner
🥩 Does Food Quality Matter? (Short Answer: Yes)
Look for:
Grass-fed beef
Pasture-raised poultry and eggs
Wild-caught fish
These labels indicate animals raised in more natural environments with higher nutrient density
Local farms can be an excellent option when available
🍽️ What a Fertility-Friendly Plate Should Look Like
½ plate: vegetables
¼ plate: protein
¼ plate: slow-digesting carbohydrates
1–2 servings of healthy fats per meal
Healthy fats are critical because fat is the precursor to hormone production and helps reduce cravings and blood sugar swings.
⏰ Daily Habits That Support Fertility
Eat every 3–4 hours to stabilize blood sugar and hormones
Never skip meals regularly
Protein at breakfast is non-negotiable:
Aim for 20–30 grams within the first hour of waking
Always pair carbohydrates with protein:
Never eat “bare carbs”
Example: pair fruit with nuts, yogurt, cheese, or a protein source
Stay hydrated:
Minimum of 64 oz daily
Gentle movement:
Walking
Yoga
Pilates
Prioritize quality sleep:
Focus on sleep quality, not just hours
🍳 What If You’re “Not a Breakfast Person”?
Start small:
One egg and a piece of fruit
Over time, your metabolism and hunger cues will adjust
Eating protein in the morning helps regulate cortisol, blood sugar, and hormones throughout the day
🛒 Grocery Store Tips for Fertility Nutrition
Shop the outer perimeter of the store:
Produce
Meat
Fish
Dairy
Choose foods with:
Simple ingredient lists
Fewer than 6–8 ingredients
Read labels carefully:
“Whole grain” labels can be misleading
Watch for seed oils and added sugars
Be a “nutrition detective”:
Look at fiber content
Check oils used
Assess sugar sources
🚫 Foods to Limit When Trying to Conceive
Highly processed foods and fast food
Seed oils (soybean oil, canola oil, etc.) when consumed regularly
Artificial sweeteners (especially sugar alcohols like erythritol)
Excess added sugars, especially from processed foods
Better options include:
Natural sweeteners like maple syrup, honey, or coconut sugar (in moderation)
Brands that use healthier oils (example: avocado oil instead of seed oils)
🐟 Fish & Mercury Awareness
Avoid high-mercury fish:
Swordfish
Choose lower-mercury options:
Wild-caught salmonCanned tuna (in moderation)
Fish choices can be personalized based on preference and tolerance
Key Takeaways:Nutrition is foundational to fertility and hormone balance.
Protein, healthy fats, and blood sugar stability are critical.
Food quality matters just as much as food quantity.
Small, consistent habits create big hormonal shifts over time.
There is no “all or nothing” approach — balance is key.
Resources & Next Steps:If you are trying to conceive or want personalized nutrition guidance for hormone balance, fertility, or cycle optimization, Callie works one-on-one with patients to create realistic, sustainable nutrition plans.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility

PCOS Nutrition & Blood Sugar Balance: What to Eat for Hormones & Weight Loss | Episode 17

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN at Vera Health and Fertility, is joined by registered dietitian Callie, who specializes in women’s health and blood sugar management. Together, they break down how to eat with PCOS, support insulin resistance, understand what “low carb and low sugar” actually means, and use nutrition, movement, and lifestyle strategies to support hormone balance and sustainable weight loss.
In This Episode, You’ll Learn:
💡 PCOS Nutrition Essentials A balanced plate is the foundation for hormone health:
Half your plate: colorful vegetables
One-quarter: protein (critical for blood sugar stability)
One-quarter: high-fiber carbohydrates (oats, quinoa, brown rice, beans, lentils)
Healthy fats: olive oil, avocado, nuts, seeds
Protein helps slow carbohydrate digestion and prevent blood sugar spikes.
🍳 How to Build a PCOS-Friendly Breakfast
Never skip breakfast — consistency matters for blood sugar and hormones
Add vegetables to eggs (spinach, peppers, onions)
Blend veggies like spinach or zucchini into protein pancakes, muffins, or smoothies
Veggies can be mixed into almost anything without affecting taste
🩺 Eating for Insulin Resistance
Eat vegetables and protein first, then carbohydrates
Always pair carbs with protein and fiber
Avoid long gaps between meals to prevent blood sugar crashes
Aim for consistent meals and protein-containing snacks
Target ~5–7 grams of fiber per meal
🚶 The Power of Movement for Blood Sugar Control
Just 5–10 minutes of movement after meals can significantly lower glucose spikes
Walking, light chores, marching in place, or gentle activity all count
Movement helps muscles absorb glucose and improves insulin sensitivity
Data from continuous glucose monitors (CGMs) shows how impactful movement can be
🥦 What “Low Carb” and “Low Sugar” Really Means for PCOS
PCOS does not require a ketogenic or no-carb diet
Focus on carbohydrate quality, not elimination
Prioritize high-fiber carbs and ancient grains
Avoid quick sugars (honey, sweeteners, refined carbs) without protein
Look for foods with at least 2–3 grams of fiber per serving
⚖️ Weight Loss Tips for PCOS
Protein at every meal improves satiety and hormone balance
Strength training 2–3 times per week supports insulin sensitivity and metabolism
Frequent, small bouts of movement throughout the day matter
Stress management is critical — high cortisol can block weight loss
Hydration supports blood sugar regulation and overall metabolic health
💧 Hydration Guidelines
Absolute minimum: 64 oz per day
Ideal target for most people: 64–80 oz daily
Increase intake gradually to avoid discomfort
Proper hydration improves blood sugar control and insulin sensitivity
Key Takeaways:
PCOS nutrition is about balance, consistency, and quality — not restriction.
Protein, fiber, movement, stress management, and hydration all work together to regulate blood sugar and hormones.
Small, practical changes can have a powerful impact on insulin resistance and weight loss.
Tracking fiber intake and pairing carbs correctly can dramatically improve glucose stability.
Resources & Next Steps:
If you’re struggling with PCOS, insulin resistance, or hormone imbalance and want personalized nutrition guidance, schedule a consultation with Callie. She helps patients build realistic, sustainable meal plans tailored to their unique needs.
📍 Westminster, Colorado🌐 Schedule a consultation: verafertility.com📧 Follow along: @verafertility on Instagram & TikTok