Perimenopause is not just about hormones, it’s a metabolic transition that affects insulin sensitivity, gut health, stress tolerance, and long-term disease risk.

In this episode, Cynthia Thurlow, board-certified nurse practitioner and functional medicine expert, explains how women’s metabolism changes in midlife and why insulin resistance, poor stress resilience, and gut dysfunction often appear years before menopause.

She breaks down how perimenopause can begin earlier than most women expect, why symptoms vary so widely, and how lifestyle factors like fasting, exercise intensity, sleep, alcohol, and chronic stress interact with hormones during this transition.

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This conversation explores:

Why insulin resistance often emerges in perimenopause
How stress and trauma shape metabolic and hormonal health
The role of gut health in PMS, mood, and estrogen balance
When fasting helps women and when it makes things worse
Why “doing everything right” can still lead to symptoms
How to individualize nutrition, training, and recovery in midlife

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Learn more about Cynthia Thurlow

Instagram: https://www.instagram.com/cynthia_thurlow_/

YouTube: https://www.youtube.com/cynthiathurlow

Website: https://www.cynthiathurlow.com/

Pre-order her upcoming book: The Menopause Gut (28th of April 2026):https://www.penguinrandomhouse.com/books/777129/the-menopause-gut-by-cynthia-thurlow-np/?mcp…

ACE (Adverse Childhood Experiences) questionnaire:https://www.acesaware.org/wp-content/uploads/2022/07/ACE-Questionnaire-for-Adults-Identified-English-rev.7.26.22.pdf

Cynthia Thurlow, NP: Perimenopause, Insulin Resistance and Midlife Metabolism

Longevity Optimization with Kayla Barnes-Lentz