Ep. 579: Normal Isn’t Optimal – The Shocking Truth About Progesterone, Brain Health & Hormone Timing with Dr. Felice Gersh | Menopause & HRT

I am delighted to welcome Dr. Felice Gersh for part two of our conversation on progesterone, brain health, and cognition. Dr. Gersh is a valued colleague, friend, and mentor. She is a board-certified OBGYN in integrative medicine. She taught at the USC Keck School of Medicine for 12 years and is the founder and director of the Integrative Medical Group of Irvine.

Today, we continue our conversation by exploring the liver's role in detoxification, dosing, and alternative routes of administration for progesterone. We cover the effects of allopregnanolone, the timing hypothesis, how to optimize hormones during perimenopause and menopause, the impact of cycling hormones in menopause, optimal estradiol levels, progesterone intolerance, and paradoxical effects. We also discuss growth factors in estrogen cycling, mitochondrial health and inflammation, how shift work disrupts circadian rhythms, and immune system changes in menopause.

This is a conversation you will definitely want to revisit. Dr. Gersh truly challenged my thinking about hormone therapy with her simple but powerful message about the importance of considering the bigger picture when it comes to hormone replacement therapy.

IN THIS EPISODE, YOU WILL LEARN:

• How reproductive hormones influence cognition, mood, and focus

• The cognitive changes, brain fog, and memory lapses that occur during menopause

• How allopregnanolone, progesterone’s metabolite, can either support calm and sleep or potentially accelerate cognitive decline over time

• How different routes of progesterone administration (oral, vaginal, rectal) produce very different outcomes

• Dr. Gersh challenges the assumption that static hormone dosing aligns with the evolution of female physiology. 

• How localized symptoms act as indicators of what could be happening in the brain, bones, and cardiovascular system

• The benefits of using progesterone in cycles rather than continuously

• How estradiol and progesterone decline in menopause can lead to low-grade inflammation, shifts in immune function, and reduced mitochondrial efficiency

• How shift work disrupts circadian rhythms

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Connect with Dr. Felice Gersh

• On YouTube and Instagram

• The Integrative Medical Group of Irvine