Don't Wait for the Stop | Optimize Hormones Before Perimenopause | GenX Hits Menopause E29
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Heather Reilly Hiemstra sits down with Dr. Cathleen Gerenger — chiropractic physician, acupuncturist, functional health practitioner, and the Tampa Bay area’s go-to healthy living expert — to map the hormone timeline nobody handed us in our 20s. The conversation opens a truth most women have never heard spelled out: perimenopause isn’t a switch that flips at 50. It’s a slow, decade-by-decade depletion of thyroid, progesterone, testosterone, and estrogen that begins before you’ve even had your first child — and every symptom you were told to “power through” was actually your body asking for help.
If your moods, sleep, libido, or confidence have quietly shifted and your doctor keeps telling you your labs are “normal,” this episode is your permission slip to ask louder, dig deeper, and stop waiting for the crisis to start the conversation.
Conversations include:
- Your Hormones Started Leaving in Your 20s Dr. Kathleen traces the decade-by-decade hormone depletion most women never learn about — thyroid dropping first, then progesterone crashing postpartum, testosterone taking confidence with it in your 40s, and estrogen reshaping your skin and body in menopause. The timeline is earlier, and the stakes are higher, than almost anyone tells us.
- “Normal” Lab Results Are Not the Same as Optimal Health A result that falls within the broad reference range can still leave you exhausted, foggy, and running on cortisol. Dr. Kathleen explains why optimal levels — where your body feels its best — matter more than the low end of normal, and why thyroid, insulin, inflammation, and metabolic markers all belong in a comprehensive panel.
- Insulin Is a Hormone, Too One of the episode’s most revelatory moments: insulin dysregulation is a hormonal problem, not just a sugar problem. Dr. Kathleen shares cases where balancing estrogen and thyroid brought hemoglobin A1c back to normal without ever directly treating glucose — the body healing itself when given the right support.
- The Cortisol Hamster Wheel Stress hormone cortisol is protective in short bursts, but women running on it chronically hit a wall that compounds every other hormonal deficit. Dr. Kathleen connects the dots between cortisol overload, mental fog, poor food decisions, and the guilt spiral that makes midlife health feel impossible — and explains why “put in before you take out” is a more sustainable path than restriction.
- Become Your Own Health Advocate — With a Checklist Three concrete takeaways close the episode: don’t wait for your period to stop before paying attention; normal bloodwork does not equal optimum health; and you are the smartest doctor in that room, because you live in your body. Dr. Kathleen offers a free lab checklist on her Instagram to help women walk into any appointment armed with the right questions.
Tune in to map your own hormone timeline, reframe what “normal” actually means, and walk away with the vocabulary to advocate for the comprehensive labs your body deserves — because the only person who knows something is off is you.
About Dr. Cathleen Gerenger
Dr. Cathleen Gerenger is a Chiropractic Physician, Acupuncturist, and Functional Health Practitioner known as “The Healthy Living Expert.” Based in Tampa, Florida, she helps patients uncover the root causes of their symptoms through a whole-body approach that integrates Chiropractic care, Acupuncture, Hormone Optimization, Nutrition, Regenerative Health, Peptide Therapy, and Genetic Testing.
Born in Vietnam and raised in the United States, Dr. Cathleen’s personal journey of resilience shaped her passion for healing, wellness, and helping others live with greater vitality. She earned her doctorate from Life University at the age of 24, becoming the youngest graduate in her class.
Dr. Cathleen has appeared on NBC WFLA News Channel 8, CBS News 10 Tampa Bay, WESH 2 News Central Florida, NBC 4 New York, international docuseries, and infomercials aired in more than 60 countries. She is also the 2024 Mrs. Vietnam Florida and is passionate about inspiring women to reclaim their health, confidence, and purpose. Outside of her work, Dr. Cathleen enjoys golf, Pilates, yoga, cooking, and living an active, wellness-centered lifestyle.
Episode Highlights
Perimenopause Starts Earlier Than You Think
“When we talk about perimenopause, it happens about 10 to 15 years before the menopause symptoms. And when we talk about menopause, all we talk about is that period — oh my god, your period stopped, you’re in menopause. You will always be in menopause. The symptoms go away, but you’re still in menopause. And it’s sad because our hormones start to deplete in every single decade of our lives.”
Normal Labs Are Not the Same as Optimal Health
“Normal blood work does not always mean optimum health. So many women come in and by the time they find me, they’ve seen about five different specialists. Many women are told that everything is fine because their labs fall within that broad reference range — but optimum health requires looking more closely at your hormones, your thyroid, your insulin, your inflammation, your nutrients, and your metabolic markers. Our body functions as a whole entire unit. We separate every single organ and we have a specialist for every organ in our body and none of the specialists communicate with each other.”
Testosterone — Your Confident Hormone
“Testosterone — your confident hormone — starts to drop in your 40s. So not only is the weight gain there, you’re tired, you don’t sleep, you’re cranky, and then your confidence just totally tanks. And then we get to our 50s — menopause is not just about hot flashes or night sweats. It’s way beyond that.”
Before You Take Out, You Put In
“Before you take out, you put in. Instead of punishing yourself and feeling guilty — because there’s a lot of guilt, we women carry plenty of guilt — instead of saying you cannot have this, I say: well, maybe today, put some cucumbers in your salad, or just eat a cucumber. And then the more your body becomes healthier, the more your body’s like — when you eat a bad meal, you’re like, ugh.”
You’re the Smartest Doctor in That Room
“Do not wait until your period stops to pay attention to your symptoms. You live in your body. You’re the smartest doctor in that room. He doesn’t know what a hot flash feels like or night sweats — you’re the one that’s sweating in that bed and waking up multiple times and your sleep is off.”
FAQs
What is perimenopause and when does it actually start?
Perimenopause begins 10 to 15 years before menopause symptoms appear — meaning hormonal shifts can start in your 30s or even late 20s, not at 50. Dr. Cathleen explains that the depletion happens decade by decade: thyroid drops first in your 20s, progesterone crashes after childbirth in your 30s, testosterone (your “confidence hormone”) declines in your 40s, and estrogen falls in menopause. If you’re experiencing anxiety, poor sleep, mental fog, or unexplained weight gain right now, those symptoms may already be your body’s signal — don’t wait for your period to stop before paying attention.
Why do my hormone labs come back "normal" but I still feel exhausted and foggy?
Standard lab reference ranges are deliberately broad, so you can sit at the low end of normal and feel terrible while your doctor sees no red flag. Dr. Cathleen says she starts paying attention when hemoglobin A1c climbs above 5.0 — well before the 5.7 prediabetes threshold — because "optimal levels" mean where your body feels its best, not just where it clears a cutoff. Ask your provider specifically for thyroid, progesterone, estrogen, testosterone, insulin, inflammation markers, and metabolic markers — not just a basic panel.
Can balancing hormones actually improve blood sugar and reverse pre-diabetes?
Yes. Dr. Cathleen describes patients whose hemoglobin A1c was at 6.0 and normalized within roughly three months simply by balancing estrogen and thyroid, without directly treating glucose at all. The key insight is that insulin is a hormone, not just a blood-sugar marker, and when interconnected hormonal deficits (like low thyroid causing fatigue and poor food choices) are corrected, the metabolic picture often corrects with them. If you've been told you're prediabetic, ask your functional health provider to look at the full hormonal picture before defaulting to glucose-specific treatment.
