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There's a moment many women reach in midlife where things don't feel wrong but they don't feel right either. Digestion changes. Bloating appears out of nowhere. Sleep feels lighter. Inflammation lingers. And no one ever told us these systems might all be connected.
I sat down with Cynthia Thurlow, a nurse practitioner and intermittent fasting expert, to talk about a topic that is still vastly underexplored in women's health: the gut microbiome during perimenopause and menopause.
So many women are told their digestive symptoms, inflammation, mood changes, or recurrent infections are just "part of aging." What Cynthia makes clear is that these experiences are deeply rooted in physiology and that when we understand what's happening, we're no longer powerless. This conversation matters because it replaces dismissal with clarity and fear with context.
We examine how this topic shows up in daily life:
- Why declining estrogen affects gut barrier integrity, immune response, and inflammation
- How "leaky gut" can contribute to bone loss, autoimmune risk, and metabolic changes
- The connection between gut health, mood, anxiety, and neurotransmitter signaling
- Why fiber and short-chain fatty acids become more important in perimenopause and menopause
- How fermented foods can support microbiome diversity and recovery after stress, illness, or antibiotics
- The gut–vaginal microbiome connection and why improving one can support the other
- How chronic stress and unprocessed trauma can accelerate hormonal aging and menopause timing
About Cynthia Thurlow:
Cynthia Thurlow, NP is a nurse practitioner, intermittent fasting expert, and educator specializing in women's health, hormones, and longevity. Her work bridges functional and conventional medicine, with a focus on helping women understand the physiological changes of perimenopause and menopause through a science-based, compassionate lens.
📘 Book - The Menopause Gut
Balance Your Microbiome to Reclaim Your Health in Midlife and Beyond
https://www.penguinrandomhouse.com/books/777129/the-menopause-gut-by-cynthia-thurlow-np/
Connect with Cynthia Thurlow:
Website: https://www.cynthiathurlow.com/
Instagram: https://www.instagram.com/cynthia_thurlow_/
Twitter: https://x.com/_cynthiathurlow
YouTube: https://www.youtube.com/@CynthiaThurlow
Timestamps
00:00 Intro
01:30 What the Gut Microbiome Really Is (and Why It Matters for Whole-Body Health)
05:52 How Perimenopause Triggers Early Changes in the Gut Microbiome
15:23 Practical Gut Health Tips: Diet, Sugar, Sleep, and Inflammation
20:19 Alcohol, Emotional Awareness, and Its Impact on the Microbiome
26:03 Food as Comfort: Emotional Eating, Reflection, and Gut Health
27:52 Vaginal Microbiome Explained: Its Connection to Gut Health
30:26 Stress, Cortisol, Bone Health, and the Gut-Brain Connection
33:11 How Trauma Creates Long-Term Effects on the Body and Microbiome
40:28 Processing Trauma in Healthcare Workers and Physical Health Outcomes
45:02 Healing the Gut Through Awareness and Lifestyle Changes
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📖 Unbreakable: A Woman's Guide to Aging with Power
Dr. Vonda Wright's newest book, Unbreakable, is a bold guide for women ready to redefine what aging looks and feels like. Blending cutting‑edge science with real‑world strategies, it helps you build strength, resilience, and momentum through every decade of life. Discover how to turn aging into your greatest advantage and live with power, purpose, and vitality.
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About Dr. Vonda Wright:
I'm Vonda Wright, an orthopedic sports surgeon and women's healthy‑aging expert. For 20 years I've helped athletes and everyday women protect their joints, build muscle, and extend their health span. Here you'll get science-backed strategies to age with power, so you can keep doing what you love for decades to come.
Connect with Dr. Vonda Wright:
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