Why You're So Tired in Perimenopause and Menopause with Dr. Sarah Vadeboncoeur, ND

If you’re trying to solve the mystery of why fatigue is calling all the shots right now, you’re in good company. Why am I tired after getting a decent night's sleep? Why does my doctor say all my bloodwork is “normal”? Is it too much to ask for enough energy to get through a typical day?

My guest today, Dr. Sarah Vadeboncoeur ND would say you can enjoy midlife with more energy than you had in your 20s (without eliminating the coffee or carbs).  It’s because she applies a thorough systematic approach to helping her clients get to the bottom of what's zapping all their energy.

It may come as no surprise that Dr. Sarah always starts by considering the possibility of nutritional deficiencies. When these are detected, supplements can often offer quick results. She emphasizes the role of the most common nutrient deficiencies in midlife and how to address them. Dr. V also exposes what we need to know about the flawed existing diagnostic reference ranges for iron levels, and reminds us that you don’t have to wait for an anemic diagnosis to seek support. 

We couldn’t skip over the obvious impact of heavy menstrual cycles on our energy levels either. I share some of my biggest challenges and discoveries when it came to managing endometriosis in perimenopause. This is also where we highlighted how dieting trends like intermittent fasting can be dangerous when your body is already struggling to function with low iron levels.

After listening, you might be surprised to realize how helpful it is to be faced with a newfound anger, agency, or the all-time low of tolerance for B.S. these days. While you may feel like these intense emotions just wreak havoc on your life, Dr. Sarah helps us reframe them as incredible tools for helping you reassess your boundaries and priorities

If you feel like a slave to the societal expectations of what it means to be a good wife, mom, daughter, or employee, Dr. V will challenge you to name these expectations and find ways to rebel against them. When we do this work, we make room for joy and pleasure in the messy middle. In doing so, we leave a legacy that inspires our kids to let go of unrealistic societal expectations too.

To learn more about Sarah and her work, connect with her on her website at www.drsarahv.ca, follow her on Instagram @sarahvadeboncoeur and listen to her podcast The Fatigue Fixer. 

Links Mentioned: 

Episode #26 Understanding Cultural Menorage with Mona Eltahawy

Episode #44: What Women in Perimenopause Need to Know About Iron Deficiency with MaryAnn Jacobsen

TRANSCRIPT

Jenn Salib Huber: 0:00
Hi and welcome to the Midlife Feast, the podcast for women who are hungry for more in this season of life. I'm Dr. Jenn Salib Huber your host. I'm an intuitive eating dietitian and naturopathic doctor, and I help women manage menopause with oat dieting and food rules. Come to my table, listen and learn from me trusted guest experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. And if you're looking for more information about menopause, nutrition and intuitive eating, check out the Midlife Feast community, my monthly membership that combines my no-nonsense approach that you all love to nutrition with community, so that you can learn from me and others who can relate to the cheers and challenges of midlife.

Hey there. Have you ever found yourself wondering why am I so freaking tired? Why do I just want to lay down and go to sleep? Why don't I have the get up and go that I used to have? This is a question I get a lot, and so so many women in midlife will say I'm just so exhausted, I'm just so tired, I don't know what to do. No one can find anything wrong. Is this just how it's going to be? And so I wanted to invite to my friend and colleague, dr Sarah Vatabag-Kow, who isa naturopathic doctor in Canada and she also has her own podcast, the Fatigue Fixer podcast.

So Fatigue is her thing and we have a really great conversation talking about some of the things you might expect, like iron and some of the nutrition stuff, but we have a really great discussion about some of the cultural reasons why women are tired. So I look forward to bringing this one to you. It was a great conversation and, as always, let me know what you think. Hello, hello, welcome, sarah, to the Midlife Feast.

Sarah Vadeboncoeur: 2:01
Thank you, I'm so excited for this conversation.

Starting with Nutrient Deficiency

Jenn Salib Huber: 2:04
I am too, and so you are new to podcasting world. So Sarah has the Fatigue Fixer podcast and that came out just this fall right yeah, in November and I was honored to be a guest and it was a great conversation. I've had lots of great feedback on that. So, on that note, we're here to talk about fatigue, which I know is going to be super popular because so many people ask me about it. It comes up in almost every conversation I have with everyone, but it often comes up because no one has had a solution yet. They're still tired. They may feel better, they might feel a little less tired, but they're like why am I still so tired? So what do we need to know about fatigue?

Sarah Vadeboncoeur: 2:52
Sarah Go Let me distill 12 years of my brain in the next few minutes. So the first thing I want women to understand is how common this is, and I think that's no surprise, right, when we look at our own lives, when we speak to the women or we look at the women in our lives like we're all tired. And part of what drives me so much specifically around fatigue is that I refuse to accept that half of the population has fatigue as our baseline level of being.

I just that is not okay to me and I know it's probably not okay to a lot of the women listening to this podcast right now. So why are we so tired? Part of what I love about what I get to do is I'm helping women see the different pieces of the puzzle. We were just talking about puzzling before we hit record, and I kind of do see my job as like looking at the different puzzle pieces. So the first puzzle piece I always look at is the physical piece, and that's because when we talk about some of the other pieces in a few moments, it's really hard to do some of the deeper work when you are physically drained all the time. So within the physical piece, there's three main categories that I'm looking for. The first one are nutrient deficiencies, which are by far the most common.

I literally just finished putting together a training I'm doing on iron deficiency and it's estimated that up to 30% of women worldwide in their reproductive years at some point are going to be anemic, and the number one reason that that's happening is iron deficiency. It adds up to like half a billion women, which is crazy. It is crazy. So the reason I love the physical stuff and, like my patients, kind of think it's funny, but I get excited when I find iron deficiency because I am Because number one women finally feel like there's a reason and an explanation and it helps them feel like they're not crazy, because so many times they have been feeling so tired and no one's taken it seriously or they've been dismissed and they start to question their own knowing, because they know that something is wrong but no one seems to have any answers.

So I get excited when I find nutrient deficiencies whether it's iron, vitamin B12 or vitamin D Because I'm like here's a very simple reason why you're tired and this is one of the fastest, easiest things to fix with like some good diet changes and good supplementation, like you're going to feel different in three months and maybe even sooner.

Jenn Salib Huber: 5:40
So can we talk about the iron for a sec? Sure, so, and I, well, I'm just going to ask you, let's talk about iron with and without deficiency. So if somebody is told that their iron is a bit low, but they're not anemic, so they don't have to do anything about it, what do you say to that? I said bullshit.

Why You Don't Need to Wait for an Anemic Disagnosis

Sarah Vadeboncoeur: 6:04
I knew you were going to say that, so I know I didn't know my language, so it's really important to understand. There's a couple of things that I think are really important to know. The first is that the reference ranges that are being used to diagnose iron deficiency are deeply problematic. And I don't know what it's like in Europe, but here in Canada the standard test we're using is a test called ferritin, and the normal range in most labs starts at a ferritin of 12.

This is deeply problematic because if your ferritin is under 30, you are at significantly increased risk of fatigue, hair loss, depression, anxiety. You're more likely to be diagnosed with a psychiatric disorder, a sleep disorder. So we have all these women with technically normal iron stores walking around exhausted, depressed, with their hair falling out, but when they go to the doctor the doctor runs blood work but they're told well, technically it's normal. So that's the first problem is the reference ranges are terrible. The second problem is that there is this miss, this like idea that if you're not anemic, that your iron is magically okay, when in fact anemia is the very last step of iron deficiency. So if you're waiting for anemia to treat, you're going to be unwell for a long time, and the other thing that came up in my prepping for this course that I'm doing is that women are waiting an average of seven months to seek help when they're tired.

So seven months, seven months. If you're listening to this, please don't wait seven months because, again, if it is a physical cause of fatigue, there are very simple, inexpensive things you could do that would get you feeling better, like within a month or two. The other thing that was shocking is how often iron deficiency is misdiagnosed. So I can't remember the exact number. I want to say it was about 30% of women with iron deficiency are told they have depression and then they spend the next one to two years being treated for depression. So they are losing a year or two because they're actually being treated for the wrong condition.

Jenn Salib Huber: 8:19
That's just awful, isn't it? So, if we let's try and like zoom in a little bit on midlife, yes, and so let's talk about what some of the things that are happening that might contribute to this. So we're in perimenopause, we're starting to have some crime scene periods, right? Yes? So we're like setting alarms to wake up in the middle of the night so that we don't completely ruin our bedding. We're afraid to leave the house for more than an hour at a time.

These are usually heavy periods that are often happening more frequently. So now, instead of these 28 day cycles, there may be now 23, 24 days, and we're at this stage of life where we're also prone to mood changes. Right, it's this window of vulnerability around mood changes, and so many women are dismissed for perimenopause. They're dismissed for mood changes, they're dismissed for fatigue. So I won't really wonder is like seven months even a realistic estimate of how long women are waiting?

Defining a Heavy Period

Sarah Vadeboncoeur: 9:32
I'm sure some women are waiting longer for sure. So midlife is such an important time to be aware specifically about iron deficiency, for a couple of reasons. Number one you talked about the heavier periods, and I think again, this is one of the things that we normalize is how heavy our periods can be, and we just kind of assume it's something that we have to deal with and learn to live with. I think a lot of women assume that, unless you're bleeding through your pants or bleeding through onto your sheets, that you don't have a heavy period, when in fact a heavy period really isn't that uncommon, and so the way that you can know if you have a heavy period is if, over the course of your entire period so the entire time that you're bleeding,

if you soak through more than eight super pads or tampons or 16 regular pads or tampons, or if you're using a cup, if you fill that cup more than three times all of those, so not all of those, just one either the eight tampons or the 16 regular or the three times the cup, that is equivalent to a heavy period. If you're not sure to like, if measuring is difficult, if you're using period underwear, if you have to change your protection more than every three hours or, like Jen said, if you cannot make it through the night without changing like those are all red flags that you have a heavy period, and this is one of the main reasons why women are more prone to iron deficiency compared to men is that we do have this monthly blood loss.

So, and we have great treatments for heavy periods, some that are very gentle and easy and uninvasive, up to like an IUD or a hysterectomy, which isn't for everyone. But one thing that I'm so passionate about in my practice is that I want women to know what their options are, because then you can make an informed decision, and a lot of times women are not presented with any of these options. So again, they're literally wearing a pad and a tampon and wearing three pairs of underwears and hoping to God that they make it through the meeting without bleeding onto their chair.

Jenn Salib Huber: 11:40
Yeah, it's crazy. I mean just to share a little bit of my experience and why I'm so passionate about talking about iron deficiency especially. I had endometriosis for most of my life and developed fibroids and heavy periods in perimenopause and let me tell you, it was no joke trying to make it through the first 24 to 48 hours. It was like herculean efforts really just to manage it and thankfully I got to menopause early, which was great. And for the first time ever, sarah, my ferritin, is 65.

Sarah Vadeboncoeur: 12:21
I saw you post and I was so happy for you.

Jenn Salib Huber: 12:25
I've never had it over 50. And it's like it hit 65 and I swear it was like light bulbs started going off in my head. It is no joke about the fatigue, so anyway, it is no joke. But, yeah, I think we're just really trying to drive home that it is common and it is somewhat normal, but it doesn't mean that you have to suffer Absolutely. Just because it's expected, just because it's not pathological doesn't mean that it is something that is not worthy of being managed or treated. And, like you said, with whatever options you have presented to you, I would have taken like anything.

Sarah Vadeboncoeur: 13:02
Yeah, if it was going to work, I would have done anything. So many of my patients, when they see the IUD option, like at first they're kind of reluctant and then we chat through the pros and cons and they are like so happy once they get that IUD in and they either stop bleeding or have very minimal bleeding and they're like I can actually function, Like I'm not worried about going to work on the days I have my period.

Jenn Salib Huber: 13:27
And just for people know, there are other options too. I wasn't a candidate for IUD because of some scar tissue, so it wasn't an option for me, but there were some medication options that were really, really helpful at getting me through, because we knew that I was probably going to be in menopause in the next year. It was really just about managing me until that time and it was life changing truly.

Making the Connection Between Fatigue and Dieting

Sarah Vadeboncoeur: 13:50
Yeah, we have great options. The other thing I want to point out, because I think this is so important, especially for your audience, is that midlife is also a time where women start following all these stupid diets, and even one of the things. I mean. There's many reasons I hate intermittent fasting and I know you don't like it either and one of the reasons is that most women are already not consuming enough dietary iron.

We know on average, women need about 18 milligrams of iron, like bare minimum, to keep enough iron in their body, and most women are eating around 13 milligrams a day. What happens to your iron intake when you all of a sudden stop eating breakfast? Your iron intake probably just dropped by a third. So now you're trying to meet all your iron requirements in two meals a day, and good luck doing that. Even if you eat meat and I think this is another common misconception about iron deficiency is that people think, well, if you eat meat you're not at risk.

I would say the vast majority of my patients are meat eaters and they are still very iron deficient for many reasons. Number one it might not be enough just from what you're getting in your diet. And again, especially if you are menstruating and you're in midlife or you're having heavy, more frequent periods, you're losing more iron than what's coming in and it puts you in this deficient state.

Jenn Salib Huber: 15:15
Yeah, absolutely. And the thing about dietary iron is that it is. I'm not going to say it's hard, but it does require regular deposits of iron and that means having at least two iron-rich meals per day on top of the little bits. And so one of the things, too, that people often are surprised and this is a little bit less common now that the gluten-free fad has somewhat reduced but in Canada and the US a lot of grains, wheat-containing grains are fortified with iron and for a lot of people who were going wheat-free and gluten-free when they didn't need to and you know, or were tried it out and but maybe thought, oh, it's still the better choice, but it wasn't necessary for them, those are people who I was seeing their iron levels drop quickly, you know, because they weren't getting just that little bit.

You don't think of it, but if you were having cereal every morning, for example, and all of a sudden you stopped or you went to a gluten-free cereal, that is going to drop your iron intake by you know, three or four milligrams, which is, you know, a lot when you're trying to get 18. It is.

Sarah Vadeboncoeur: 16:30
Anyway, we're getting way after. That's such a good point.

Jenn Salib Huber: 16:33
Yeah, let's focus because I could. I could go off on all the tangents. Okay, so we've got iron and hopefully everyone has heard as loud and clear. We'll also put in a show, a link in the show notes, to the episode with Mary Ann which is talking about iron deficiency without anemia, because I love talking about it. Why else are we tired?

Looking at Thyroid Disorders and Metabolic Function

Sarah Vadeboncoeur: 16:52
So if we go back to the physical reason so we've talked about the nutrient deficiencies the second thing I'm always screening for are thyroid disorders. We know that about one in eight women is going to experience some kind of thyroid issue at some point in her life and we know that about it's estimated about half of those are undiagnosed, meaning we have a lot of women walking around with a thyroid condition that hasn't been diagnosed and this is also a major reason why women can be tired.

So making sure that you're getting regular screening on your thyroid, especially in midlife, because we know that any big hormonal changes whether it's puberty, pregnancy, postpartum, perimenopause, anytime there's those big hormonal shifts, there is more risk for a woman to develop a thyroid issue. And then the third category is looking more around metabolic function.

So looking at cholesterol, looking at blood sugar balance, and a lot of times again we have this idea that if we're not diabetic we're doing great, and a lot of times there are subtle changes that we can see in a woman's blood sugar and cholesterol panel, even if she's not technically again in a diabetic category or someone who would benefit from medication. It's just showing us that there are things happening metabolically that could absolutely be impacting her energy levels. So those are the big three kind of like physical categories that I'm looking for.

Jenn Salib Huber: 18:20
Yeah, I would totally agree. Those are always on my list too, so always good to you know. Look for the obvious first and, like you say, it's not sometimes easier. And patients and clinicians I think we get excited when we find something that at least has a clear plan of action.

The Unspoken Cause of Fatigue: The Mental and Emotional Load of Women

Sarah Vadeboncoeur: 18:38
Yeah, and it's going to make it easier to do the stuff we're going to talk about now. The second reason why I think so many women are tired is a lot of the like, mental, emotional load that we carry, and I literally think about this every time I leave my house to go to the office and I'm literally carrying multiple bags and every time I do this and you've like, you've probably all seen the memes of like women getting into the car versus men where they're holding like a wallet and we're carrying like our whole life- yeah, and it like dawned on me and like, not only are we physically carrying the bags, like what emotional baggage are we literally carrying? are we putting on the second?

We wake up and literally carrying around all day long until we get back into bed, because that shit is heavy and it is exhausting. And just yesterday alone I had such great conversations with women who are in and around the 40s and they're starting to realize how much they have been over functioning in their family and in their relationship. And by over functioning I mean taking on tasks that you do not have to do, that other people in your family are fully capable of, but that, for multiple reasons, you have decided to take on and either not let them do or that they have stopped doing.

And I get so excited when I see a woman start to get a little bit angry. Because, to me. When she gets angry, it means she's finally waking up and realizing that the load that she has been carrying is unsustainable. Yeah, and she's ready to start doing something about it.

Jenn Salib Huber: 20:29
Yep, that comes out as men are rage for many of us in midlife.

Why PMS and Meno-Rage Can Be a Helpful Tool

Sarah Vadeboncoeur: 20:34
It does it does. And that's why I think anger is an emotion that we really need to pay attention to more, because I really do think it can be a really good guide at helping to shine a spotlight on what is not working, and, especially when women do start to experience like more PMS or overt rage, there's often a clue or multiple clues in there. What is setting you off? What are you getting so enraged about? Because a lot of times, what I see anyways is that we tend to assume something is wrong with us. Why like something's wrong.

I'm getting so angry, like what can we do to make the anger go away? And I actually like to open up the conversation to see what is that anger, trying to tell you there's nothing wrong with you? It's actually that your body has gone to the point where it's like I cannot maintain, I refuse to maintain this level of over functioning, whether it's at work, whether it's with your kids in your family, in your relationship. Yeah, it's exhausting.

Jenn Salib Huber: 21:49
And I really think that the gift of midlife for so many people is that it becomes physically, mentally, emotionally uncomfortable to continue doing the things that you don't want to do anymore. And that often shows up in my work around food. Women just say I can't spend the rest of my life hating my body and feeling like we're at war. I can't, I don't want to and I can't. I'm terrified but I can't. And I think that with the fatigue, the over functioning, the unpaid work of women just carrying the mental load of what we do, especially if you are managing children or aging parents or whatever, we're the default household managers Right, and not always by intention.

You know, when I've had these conversations with my husband, usually it used to come out in a moment of mental rage. I'd pull out this list. Do you see, all the things that I do? And he knew, but he didn't know. But he'd always say like I never asked you to do that. I know you didn't, I know that. Yet here I am doing it all and now I'm really fucking pissed about it and it's making me tired. And you know like this conversation plays out your office, my office all the time of women just saying like I'm tired of doing it all. I'm tired of doing it all, but they feel trapped. They feel like what else am I going to do? Who's going to do it? Right?

Sarah Vadeboncoeur: 23:25
And that's where we zoom out even further and we start to look at the societal expectations. And the reason that we feel this internal pressure is that from a very young age we have learned what a good mom and a good wife and a good worker and a good daughter. Society presents those roles in a very specific way that doesn't benefit most women, because the expectations that are put upon us are literally unattainable. But yet, because those are the expectations, when we are not able to meet them again we think that it's a problem with us.

Why am I not able to do all these things? Like there's something wrong with me. I need to be more productive. I need to like do it's not you, it's that the rules are rigged? Like there's no way anyone can do all the things long term all at the same time and not pay a price, whether that's your physical health, your mental health, your marriage. Like it's just untenable. And I'm starting to feel so. I'm 41. So I'm definitely starting to see these things changing in me and I'm so excited for more of it. And it excites me that you say that like women just get to this point where they're like I can't and I'm like good, like I know it feels scary as heck to think about changing the dynamics in your relationship and changing the like, maybe the setup that you have with your kids, but what I always come back to, especially for me as a mom, is that I'm very conscious about what I am modeling for my child, and what I don't want for my son is for him to grow up thinking that mom is the one who does all the stuff for everybody.

Jenn Salib Huber: 25:29
I don't want that for him.

Sarah Vadeboncoeur: 25:31
I don't want that for any potential future partner of his. I just I refuse to live that life for me. I that's not the version of motherhood that I signed up for. And also, like when we look at most women, if you ask most moms would you want this life for your daughter? We would probably have a very emotional, absolutely not reaction.

Yeah, and yet we feel trapped in this system, and so we just keep doing it, and what we're doing is we're modeling it, which means the next generation is going to be stuck in this same system that we're stuck in. Yeah, so I almost feel like part of what's happening for me and it sounds like this is I'm not alone is I feel like I'm actively starting to rebel, where I'm like? I know this is the expectation, but I am consciously choosing to not participate in that system.

Jenn Salib Huber: 26:30
Yeah, and if you and you and anyone else who hasn't listened to the episode with Mona Altahawi on cultural men or rage, this is what this is all about. You know, it is that inability to continue to participate in the system that we are not benefiting from, but yet we were holding up.

Sarah Vadeboncoeur: 26:55
Yeah, her book is one of the most triggering books I've ever read and I appreciate that because I knew there was something in there hitting hard against my conditioning when I read her book. I actually want to have her on my podcast and I saw that you had her. She's amazing.

Jenn Salib Huber: 27:12
She is amazing.

Challenging Societal Expectations and Redistributing the Load

Sarah Vadeboncoeur: 27:13
It is like it feels so scary because what happens is that when you take a step back, when you decide I am not going to do all the things anymore, there's going to be a gap, which I kind of think of as the messy middle, where other people aren't going to pick up the slack, and our inclination is going to be to go right back to what we were doing, because it's going to feel deeply uncomfortable if there's dishes that are unclean or laundry or whatever.

The thing is that you decide to stop overdoing. But if you don't stop doing it and give people in your life the opportunity to pick up the slack, they will never magically volunteer to do it, and that is the real truth. We have to be the leaders and we have to consciously take a step back and allow people to step up and pick up the slack and start doing more stuff. And you'll also maybe realize that some people don't want to pick up the slack, and that's where the really hard decisions start to happen about what kind of relationship do I want to be in, what kind of mom do I want to be to my child.

And it's not easy by any stretch, but neither is living in a family, and a system and a society where you are burning yourself out in order to meet expectations that someone else put out for you. These are not our expectations. We weren't born thinking that these are the things we need to do. We learned all of this, and if we learned it, it means it can also be unlearned.

Jenn Salib Huber: 29:01
Oh, my goodness, I feel like we have two podcasts happening here, so we might have to have a part two at some point, but I think everyone will be able to appreciate that we're tired because we're doing too much, and we're doing too much because of what has been expected of us and we need to work on our boundaries is how I would summarize that conversation. Would you agree?

Sarah Vadeboncoeur: 29:23
I would. I think boundaries and also what I always go back to and part of what I teach in kind of the group that I lead is if you're hearing this and you're resonating and you're like, okay, but where do I start? I always encourage women to go back to your priority, and I use that word singularly on purpose, because part of our problem is we have this idea that we have priorities. So maybe if I were to ask your priorities, you'd be like, oh, my health, my family and my work Okay, great. Except what happens when family and health get put side by side and now you have to pick one. You're going to pick one, meaning that one is actually more of a priority than the other one.

So if we aren't actually clear on what our actual priority is, it's very hard to set boundaries because we don't actually know what we want to absolutely say yes to and what boundaries are going to help protect us from in terms of saying no. I will not tolerate that. So getting clear on like, yeah, what is actually most important and then what are the actions that I need to take so that my actions match that priority, because so much of the time and I think health is a great example. If you ask a lot of women if health is their priority oh yeah, absolutely very, very important. But then look at how we spend our time.

We prioritize everything else, and again, this is not to blame you. That is the impossible expectations that we've tried to manage. So it's not our fault, but it is our responsibility to choose to do something different, and I think the sooner you figure out what is actually most important, you can start to drop some of the stuff that actually isn't really that important for you.

Jenn Salib Huber: 31:25
So go lower the bar, lower the bar Totally.

Sarah Vadeboncoeur: 31:27
Drop the balls that bounce man just drop them.

Jenn Salib Huber: 31:31
And also, on that note about health, when you ask someone well, are you healthy? Is health a priority? They have the bar set so high. It's like oh, I really want to go to the gym six days a week and cook and make all my own food. I just don't have time. Who does? Unless you're Oprah, who does? Lower the bar, redefine what health means to you, make it accessible, make it something that is tied to how you're feeling today, not just in 20 years, and don't think of everything as an all or nothing, make or break decision, because health, that isn't health, right?

No, health is the long game, and I really really feel so strongly that we have set the bar, not you and I, but culturally. We've set the bar too high so that even women who have a really strong interest, desire motivation to improve their health, feel like they're so far below where they think they need to be that they don't know where to start. They just feel stuck in quicksand and they just say screw it, okay, let's keep going. Okay, so we've got the physical, we have the cultural bullshit, and then one comes next.

Taking Cues From Emotions For What Your Body Needs Most

Sarah Vadeboncoeur: 32:53
So we had the physical, we had the kind of like mental, emotional, and then we have the cultural. So those are kind of the big three things that I see. I'm sure there are a million other reasons why we're tired too, but those are kind of the three big categories that I encourage women to kind of like, look at and focus on. So first one is your physical, that's your nutrition, your exercise, it's the deficiencies we talked about. Second one is your mental, emotional, like.

What is in your backpack, literally, what are you carrying around every day? Is it guilt, is it shame, is it sadness, is it anger, like whatever it is? Can we start to acknowledge that all feelings are good because they are simply trying to guide us either towards something that our body likes. When we feel joy and calm and awe and love, that's our body's way of trying to say do more of whatever the heck is happening right now. This feels good, I like this, do more of this. When we feel enraged and angry and anxious and unmotivated and depressed, that's our body's way of trying to say something right now is not working for me. Can we redirect, can we pivot, and so emotions are such great signposts that are happening to us all the time and the sooner we can pay attention and acknowledge them and get to know them and try to understand what they're telling us, the better.

Like you can start to create a life that feels better by noticing those emotional reactions. And another reason we're so tired is we try to suppress things that don't feel good. So a lot of women are suppressing their anger, we're suppressing our sadness, we're suppressing our guilt and our rage and all these different things, and that has a huge cost. And I think part of why so many women get such crazy PMS is that during the rest of the month there are things that bother us but hormonally we're able to not like react to them.

We're able to kind of deal with them or put them away and not worry about it. And when we get into that hormonal drop, I kind of joke like PMS is a time of like zero bullshit tolerance, like our tolerance is gone and all the stuff that annoyed the crap out of you all month it comes shooting out because it didn't magically disappear when you didn't say anything. It all got stuck in your body and now it comes shooting out and then again then we feel bad that we've had this like big explosion, but our body needs to release those emotions.

So if we can do that on a more consistent basis, it's going to reduce the likelihood of things coming out in this like explosive way, which rarely gets the results or outcomes that we want. So that's a big one. Is this like emotional suppression? It's another. And again, it's culturally learned that women need to be kind and nice and helpful and all the things and anger doesn't look good on us and we can all name women who are like angry, that have had the audacity to show up angry in public and we tear them apart.

Making More Time in the Day to Meet Your Own Needs

Jenn Salib Huber: 36:23
Yeah, oh, how true is that? Yeah, and you know, the thing about to kind of bring it back around to some of the intuitive eating skills that lots of listeners will know we'll be hearing about, is that when we experience emotional hunger and we reach for food, we are experiencing that really strong emotion and food has been an accessible way that we've dealt with it and there's not, in the moment itself, care like we need to normalize that eating feels good and can help to take us out of that stressful response when we're feeling a strong emotion.

So one of the things that I teach and I think we can use this for any emotion is just being able to ask yourself what do I need right now? You know, am I tired? Do I need to rest? Do I need to say no? Do I need to cancel? You know this thing that I'm going to do Do I need to take a day off? Like what do we need? Needs to become the default question. Not what should I do, not even what can I do. It's what do I need, because that's where the attunement comes in and that's when we're able to actually connect to our own needs and not what others have put on us.

Sarah Vadeboncoeur: 37:35
And I love that you brought that up, because that is another reason we are so tired is that if you look at the average day that you're spending, how much of that day is designed to meet your needs? For most women, it's zero to very little. So how can you start to number one, ask yourself like what do I need? And then what do we need to do to get to a place where we believe that we are worthy of having the things that we need as a minimum? I love to talk about needs and wants. These are the basic things that I need to get through my day. For example, I need eight hours of sleep. I don't do well on seven and I sure don't do well. I need eight. That is a need. So your needs are like what is the bare minimum stuff that needs to be happening for you to be able to get through your day, ideally with some energy left in the tank.

I talk about energy management a lot. Most women wake up and are already working with an energy deficit, either because we haven't fully recovered from the day before, we haven't slept well, especially if you're in midlife and you're flashing and you're waking up and staring at the ceiling. So we wake up, our tank is already empty and then we spend our whole day doing things for other people and over functioning. And then we wonder why, over time, we're exhausted and we're not recovering simply just from getting enough sleep. Well, you have to make up that deficit, just like if you spent for 10 years more money than you had in your bank account. You're not going to pay that off with one paycheck. It's going to take some time to rebuild that.

So we need to manage our energy. So the needs are like the bare bones. What do I need? The wants are what is going to make life more pleasurable and enjoyable, because, again, this is your one life. As far as we know, we don't get another chance. So do we want to run it like run through this life, ragged and exhausted and pissed off and miserable, or can we spend a little bit less time doing laundry and dishes and carve out some time for puzzles or dance or music or whatever it is that makes your life worth living.

I don't want to wait till retirement to start doing the things I love. I want them to happen now because, number one, there is no guarantee that you're making it to retirement age and, number two, I don't want to start living my life when I'm in my 60s, I want to live it now.

Jenn Salib Huber: 40:18
Yeah, so so true, so so true.

Sarah Vadeboncoeur: 40:22
So it's so important to like. And again, it's not easy, because if you fill your day with all the things that we're supposed to do, there is no time, so you do have to. Again it's like an active, conscious rebellion or rejection of these expectations, which are impossible to meet, no matter how smart and energized and great you are. It's not you, it's the system.

So can we start to let go of that and put things back in the day that are filling your tank, what puts energy back in your tank and how can we prioritize putting some of that back into our daily routines? That's where you're going to wake up with some energy in your tank and also have some left at the end of the day because you didn't over give all of your energy and keep nothing for yourself.

Jenn Salib Huber: 41:14
I love that and I often talk about, like you know, see opportunities for eating as opportunities for moments of pleasure. Not just nourishment, right. Not just nutrition, like, make the time to eat a lunch that you enjoy, make the time to sit down and eat your meals. That little shift in participation in the experience of eating can help to fill your battery, can help to recharge your battery, right, yeah. And no mention, and it can't be that simple and obviously must include carbs, Must have carbs.

Sarah Vadeboncoeur: 41:54
Must have carbs. I just had a bagel for lunch so I got my carb check. But honestly, this is a change I made in my own schedule. It took me 10 years of practice to figure out that a 30 minute lunch break is not enough when you're seeing people back to back for seven, six, seven hours in a row. So I don't know, maybe a year to go I expanded to a 45 minute lunch break so I can actually like, not be rushed. I'm telling you, every time I have my lunch it feels like a gift. I'm like I have 45 minutes, I can cook, I can sit, I can relax, like it literally is these small things, but done consistently, they add up and they make a huge difference. It doesn't have to be that you're overhauling your whole life. It could literally be that, starting January 1st, you block off a lunch break. Yeah, that's a great place to start.

Jenn Salib Huber: 42:50
I love it. We've covered so much here and I know that this is going to be a well-loved episode. I'm pretty sure I say that every time because I really do love every episode. But I know that fatigue is such a common question that I hear and comes up and it's been a frequently requested topic, and so I thank you so, so much. So, before we get to the end, and when you share where everyone can find you, what would you say is the missing ingredient in midlife? Sarah?

The Missing Ingredient in Midlife According to Sarah

Sarah Vadeboncoeur: 43:20
So this might be a bit controversial, but this is a word I'm also trying to reclaim, and it's the word selfish. Oh, I think we would all benefit from being a little bit more selfish, and I know that's a loaded word that you might be cringing at, but I want to remind you that the opposite of selfish is selfless, and that is a word that we actually reward people for. I don't want to be selfless. I am here in this life to be myself and to live a life and to have a great life, and that means I need to center myself in my life, which, again, can feel really selfish and uncomfortable. But if you are not at the center of your life, who the heck is? And that might be the problem that we have de-centered ourselves.

Jenn Salib Huber: 44:14
People will recognize what I'm about to say, because I say this all the time. But you have to put your own oxygen mask on first and it's why they tell you in the plane, even if you're with your children, they will tell the parents put your oxygen mask on first. It is not being selfish to meet your own needs so that you are taking care of yourself and others. And this is I've been saying this for years, but I talk about it so much in this space because I think so many women in midlife and I'm going to generalize and say especially those with kids, but obviously not exclusively we get to this place and we have not been meeting our needs at all and then all of a sudden, it's like how did I get to this place where I don't have a minute to myself anymore? So putting your own oxygen mask on first is not selfish. It is selfish, I guess, but it's okay, is what I'm saying?

Sarah Vadeboncoeur: 45:17
Yeah, love it.

Jenn Salib Huber: 45:19
Let's be a little bit more selfish so where can people learn about all the awesome things that you do?

Sarah Vadeboncoeur: 45:23
So the best place to find me is on Instagram at Sarah Vadvankar, and then, if you want to learn more about my programs and my services, you can check out my website at drsarahvca.

Jenn Salib Huber: 45:37
Thank you so much for bringing your passion for not just women's health, but health in general and fatigue to the midlife feast, Sarah.

Sarah Vadeboncoeur: 45:47
My pleasure. This was so much fun. Thank you.

Jenn Salib Huber: 45:51
Thanks for tuning in to this week's episode of the Midlife Feast. For more non-diet, health, hormone and general midlife support, click the link in the show notes to learn how you can work and learn from me. And if you enjoyed this episode and found it helpful, please consider leaving a review or subscribing, because it helps other women just like you find us and feel supported in midlife.