Our bodies, explained

There are plenty of downsides to social media. We don’t have to tell you that. Anyone who’s ever gasped at their daily screen-time report knows how distracting it can be. But one very real upside is peer-to-peer conversation, particularly around systemic issues that have long gone ignored. “Perimonpause” may as well have been Latin to us only a decade ago. Now, even knowing that the word exists feels like a Very Big Deal. 

In this case, we’re talking about how women’s bodies change over a lifetime—and how little we’re actually taught about navigating those changes in ways that protect and improve our quality of life. From our reproductive years to perimenopause to menopause, the information gap is staggering. As you’ll find out in the below Q&A (hint: it’s very good), a study in 2023 uncovered that only 31.3% of OB/GYN program directors reported having a formal menopause curriculum. 

We’ve been talking about this topic pretty incessantly behind the scenes at Spread the Jelly. Together with our friends at Biologica, we started jotting down the questions we frankly should already know the answers to. Many of them should be basic knowledge, but unfortunately, they’re not. Below, answers to our most pressing questions about our own bodies. But first, meet the incredibly impressive team of experts who took us by the hand and helped us make sense of it all.

Why do women’s hormonal needs change so dramatically across different life stages? Are there any broad clinical patterns or statistics you see consistently across age groups? 

Dr. Radhika Kakarla: Women’s hormones change because the fundamental needs of our bodies change. It isn’t random. It is a biological response to exactly where we are in our life cycle. It all starts with the initiation phase of puberty. During this time, the connection between the brain and the ovaries known clinically as the HPA axis is still maturing. Because this communication network is essentially still under construction, periods can be erratic and painful. At this stage our bodies desperately need the right building blocks to help regulate these new systems and create a strong foundation for the future. 

By the time we reach our early 20s cycles tend to stabilize. Biologically our bodies are preparing for procreation which leads to a state of relative consistency. However this is also the era where our hormones are most affected by external factors like stress and our busy lifestyles. The clinical goal here shifts to maintenance. We need to continue supporting that strong foundation we built in our teens while prioritizing self-care to withstand the daily grind.

The next major physiological shift happens in our late 30s when estrogen and progesterone levels start to become erratic again. You might notice PMS symptoms worsening or cycles getting closer together as the body attempts to find a new sense of homeostasis. At this stage the body needs a little extra help, specifically support for regulation and relaxation to manage these fluctuations. 

Estrogen vs. progesterone: can you break down the difference between the two, and why the balance between them matters so much? 

Dr. Radhika Kakarla: I always think of estrogen as the "yang" because it is the builder and the energizer of the system. It builds the lining of the uterus to prepare for implantation and works hard to maintain our bone mass. It is also the architect behind our secondary sex characteristics giving us hips, breasts, and pubic hair. While it is the specific hormone that triggers ovulation, we mostly associate it with energy, vitality, and alertness. You can tell when estrogen goes missing because that spark fades. We start seeing fatigue and hot flashes along with vaginal dryness and bone loss. 

Progesterone is the "yin" to estrogen’s yang. It peaks during the luteal phase or the second half of your cycle and brings a much more grounding energy. Its main job is to maintain a pregnancy once implantation has occurred. In fact, in obstetrics, we often use it specifically to "calm" the uterus. That calming effect translates to how we feel mentally, too, since progesterone generally helps us sleep and relax. When we don't have enough of it to go around, we see the opposite effect. We end up with irregular periods, terrible sleep, and a whole lot of irritability.

We’ve seen this question come up more than a few times on our internet forum of choice (Reddit, ha). Should women be taking prenatals even when they’re not actively pregnant or trying to be? 

Dr. Radhika Kakarla: If you are having unprotected sex, the answer is definitely yes. You want to be covered just in case life decides to surprise you. Even if pregnancy isn't on the immediate horizon there is no harm in taking a prenatal because it can serve as a really great multivitamin for general wellness. That is exactly how we designed Biologica Primary Essentials. It covers your bases whether you are actively trying to conceive or just focusing on your own health, so you don't necessarily need to juggle multiple bottles. 

The main nutrient everyone talks about for pregnancy is folic acid, but we actually take a slightly different approach. We use folate in our formulations instead of the synthetic folic acid you see in most drugstore options. Folate is the natural form that your body can essentially grab and use immediately without having to do extra work to convert it. It’s a small detail that makes a big difference in how well your body absorbs what it needs.

Are there common nutrient deficiencies in women of reproductive age? How do they affect hormones? 

Dr. Maggie Luther: Iron is perhaps the most common deficiency due to monthly blood loss. Iron is required for the synthesis and metabolism of estrogen and progesterone. The enzyme (thyroid peroxidase) that produces thyroid hormones is iron-dependent, and low iron can cause hormonal imbalances that result in heavier periods, which then further depletes iron stores. Vitamin D acts more like a prohormone than a vitamin. It modulates the Hypothalamic-Pituitary-Ovarian (HPO) axis, which controls the entire menstrual cycle. 

Magnesium is involved in over 300 biochemical reactions, many of which regulate stress and sex hormones. When magnesium is low, the body stays in a "fight or flight" state, which can steal resources away from producing progesterone. B-Vitamins (B6, B12, and Folate): Vitamin B6 is crucial for the production of the corpus luteum, the structure that produces progesterone after ovulation. Deficiency is a leading cause of PMS and mood-related symptoms. B12 & Folate are necessary for methylation, a process that helps the body process and remove used hormones.

What actually shifts hormonally between the reproductive years, perimenopause, and postmenopause, and how do those changes impact what the body needs day to day? 

Dr. Maggie Luther: In the reproductive years, your body is governed by the predictable rise and fall of estrogen and progesterone. You have a high demand for nutrients that support blood loss and ovulation. Iron is essential due to monthly blood loss, and Folate & B12 help with cellular repair and potential pregnancy support. You’ll also want to prioritise healthy fats. This is crucial for manufacturing sex hormones; low-fat diets can often disrupt the menstrual cycle here. 

Perimenopause typically starts in your 40s, the ovaries begin to "sputter." Estrogen doesn't swings wildly, sometimes spiking 3x higher than normal before crashing. Progesterone usually drops first and more steadily, which leads to "estrogen dominance." This causes the classic symptoms of heavy periods, breast tenderness, and irritability. You’ll want to prioritize magnesium, which acts as a "calm-down" mineral for the nervous system during estrogen spikes and helps the liver clear out excess estrogen. Fiber is also essential for binding to metabolized estrogen in the gut and moving it out of the body to prevent "re-absorption." Your body also becomes more sensitive to insulin as estrogen fluctuates. You may find you can no longer "handle" sugar or refined carbs as well as you used to. 

Once you have gone 12 months without a period, you are postmenopausal. Estrogen and progesterone stay at a permanent low. Because estrogen is "bone-protective" and "heart-protective,” your risk for osteoporosis and cardiovascular issues increases sharply. Your metabolism also slows by about 200–300 calories per day. You need significantly more protein than before. Without estrogen, your body is less efficient at building and keeping muscle (sarcopenia). You’ll want to aim for roughly 1.2g of protein per kg of body weight. The calcium and Vitamin D requirement increases (from 1,000mg to 1,200mg of calcium) because the "shield" of estrogen provided for your bones is gone. Omega-3s are also important for heart health.

At Spread the Jelly, we talk a lot about how often women feel unheard in healthcare, during pregnancy and well beyond it. Why do you think so many hormonal symptoms are still minimized or undertreated? 

Dr. Minna Lee: Much of medicine tends to be data driven and concrete. Many of the very real symptoms of hormonal shifts in women can be vague and take time and effort to unpack. It is easier to dismiss what we cannot necessarily name or put a lab value on. As many breast cancers are driven by estrogen, we are often treating women with medication that blocks estrogen. In younger women (and older women), this can result in early menopausal symptoms or worsen their existing symptoms. 

We do our best to mitigate these effects, but I see across the age spectrum the toll it can take, physically and mentally. I tell all my patients that they need to always speak up. They are their own best advocates. We want women to live a full life (not the same life they had before necessarily, but full), and we have many strategies and countermeasures. For example, we have an excellent sexual medicine department that goes way beyond anything I could recommend. Be proactive, make a list, go in with your doctor prepared and concise. Find someone you trust and who will listen to you.

Many of our readers fall into the “reproductive years” category (18–45), which is a huge span. Since perimenopause isn’t talked about nearly enough, what early signs should women be paying attention to? 

Dr. Radhika Kakarla: The single most important tool you have is your menstrual cycle. It really is a window into your overall well-being and a fantastic way to gauge your stress levels and hormonal health. If you want to spot perimenopause early, you need to know what your baseline looks like so you can spot the deviations. 

Start paying attention to the specific rhythm of how you feel and exactly when you feel it. Notice if changes are consistently happening right before your cycle starts or how your energy shifts

immediately after it ends. The more you tune into those patterns the easier it is to catch the subtle shifts before they become big symptoms. 

Our bodies are meant to transition and change throughout our lifetime. While some things will inevitably become a "new normal" as we age, I firmly believe that every woman has the right to feel good and to know exactly what to expect. The new normal for everyone is different. For me, it has been focusing on sleep hygiene, strength training, and centering protein at meals. In my 20’s and 30’s, I could work/stay out all night and still function well the next day. That does not work anymore. Figuring out what you need (sleep, supplements, physical activity, stress reduction, boundaries) looks different for everyone. You don't have to just accept feeling off as the price of admission for getting older.

In a crowded wellness landscape, what actually separates an effective, stage-specific hormone supplement from one that’s mostly marketing? 

Dr. Maggie Luther: When it comes to clinical studies and making effective formulas specific to women’s changing needs, for a long time, women were left out of the conversation. That’s exactly why we exist. We specifically source ingredients backed by female-focused clinical trials that account for our unique hormonal fluctuations and metabolic rates. We don't just 'shrink and pink' a standard formula; we formulate to female Daily Values (DVs) for critical vitamins and minerals to support biochemistry that is distinctly different from a male baseline. 

When supplementation is truly aligned with a woman’s current hormonal stage, what changes do you see first (physically or otherwise)? 

Dr. Maggie Luther: When you switch from a generic "male-baseline" supplement to one formulated for the female physiology represented by the Daily Value (DV) and your specific hormonal stage, the results can feel much more significant. Here is what you’ll likely notice with a formulation created for female hormonal life stages: 

1. Cognitive & Emotional - Some of the first changes are often for the brain and nervous system. Whether it’s the brain fog of perimenopause or the PMS-related irritability of the reproductive years, the brain is the first to respond to corrected DVs. You’ll potentially notice a "longer fuse." When you bridge gaps in magnesium, B6, active folate and B12, the nervous system moves out of reactive mode. You may feel a sense of cognitive calm before you see any physical changes in the mirror. 
2. Metabolic Energy - Standard supplements often rely on caffeine or high-dose B12 for a "jolt." We focus on metabolic support. By meeting the specific micronutrient needs for your stage, your mitochondria (your cell's power plants) can produce energy efficiently. It’s not a "buzz"; it’s the feeling of finally having a full tank of gas. 
3. For women in their reproductive years, the first sign of alignment is often the absence of a symptom. For those in perimenopause or postmenopause, it’s the stabilization of temperature and mood, or the feeling like your brain can better maintain focus. 
4. Shift in Sleep Quality - Hormonal fluctuations are notorious for disrupting sleep, whether it's the progesterone drop before a period or the night sweats of later stages. Because our formulas account for these metabolic shifts, one of the many wins is deeper, more restorative sleep. When your hormones aren't struggling to find the building blocks they need, your cortisol levels stabilize, allowing for a natural transition into rest.
   

Are there any women’s health statistics you’ve come across that still surprise you? 

Dr. Minna Lee: One in eight women in the United States gets breast cancer. I say this almost every day, and still, the statistic jars me a bit. We don’t know exactly why, and it’s probably a multitude of interactions that we can’t quite explain right now. So many women will come in and say, "but why, what did I do?" It’s nothing that anyone did or didn’t do! That statistic is real, and it’s a numbers game. But, what can we do? Women can get screened! Put your health first. Screening saves lives. We can eat healthy, exercise, drink in moderation. These are things that are proven to decrease risk (and are good for our heart and lungs!).

Dr. Maggie Luther: Similarly to how women couldn’t get a loan at a bank until 1974, and were required to have a male co-signer, there are many things that either took way too long to change, or are still a problem today when it comes to supporting female health outcomes. 

It wasn’t until the NIH Revitalization Act of 1993 that women were legally required to be included in clinical research. Before that, most drug and supplement dosages were calculated based on the 70kg male baseline. Female hormonal cycles are seen as too complex or a confounding variable, which has been debunked, but made exclusion seen as an allowable necessity. 

Despite the fact that 100% of women will transition through menopause, the medical community often lacks the specific nutritional training to support it. This knowledge gap is why women are often told their perimenopausal symptoms are just part of aging. The Mayo Clinic published a study in Mayo Clinic Proceedings (2019), led by Dr. Juliana Kling, reporting that 25% of internal medicine residency programs did not include menopause in their core curriculum, with 4 out of 5 graduating residents not feeling competent to discuss or treat menopause. A more recent study in 2023 uncovered that really only 31.3% of OB/GYN program directors reported having a formal menopause curriculum.

Dr. Radhika Kakarla: The trend that worries me the most right now is the rise in colon cancer among younger women. We used to think of this as an "older person's problem," but the age of diagnosis is getting lower. It’s a wake-up call that we can't ignore gut health just because we’re in our 30s. The age for screening colonoscopy had changed from 50 to 45. I see 1-2 patients a year with no health problems who have significant findings on their colonoscopy. The second spike for inflammatory bowel disease is 50 in women - the 1st spike is age 15-30. 

I also see so many women caught off guard by their labs as they get older. You can eat the same and exercise the same, but suddenly see a spike in cholesterol or insulin resistance. It feels unfair, but it’s a direct result of losing that protective estrogen. 

And oddly enough, the orthopedic doctors have known about this one for years, but we are just catching up: women are much more prone to ligament and joint injuries than men because our hormones affect the laxity of our ligaments. A close friend tore her ACL in a jumping pit playing with her son. She happened to be an avid researcher and she pointed out to me that the incident was right before her period. She had found a few articles discussing an increased incidence of ligament injuries during the luteal phase (right before your menses when estrogen levels are at their lowest). When I asked an orthopedic surgeon, he replied “yeah we all know that happens in perimenopausal women.” And I thought to myself, we all know? Really? 

Look, I know listing all that out can feel a little heavy. But I promise you, the last thing I want to do is create unnecessary health anxiety, we have enough of that already! I tell you this not to alarm you, but to arm you. The beauty of knowing these patterns is that we can actually do something about them. We can screen earlier, adjust our nutrition, and move our bodies in a smarter way.