Fasting, Hormones & Menopause: Why Women Need A Different Approach To Men with Dr Mindy Pelz #342
Dr. Mindy Pelz, a nutrition expert, discusses how women's health, hormones, and fasting differ from men's due to their 28-day menstrual cycle. She explains tailoring fasting, diet, and exercise to each cycle phase and life stage (reproductive, perimenopausal, post-menopausal) for optimal health.
Deep Dive Analysis
21 Topic Outline
Why Women Need a Different Approach to Health
Hormonal Differences Between Men and Women
Why Women Should Consider Fasting
Fasting Contraindications and Cautions
Understanding Insulin Sensitivity and Resistance
The Menstrual Cycle: Power Phase (Days 1-10)
The Menstrual Cycle: Manifestation Phase (Days 10-15)
Societal Implications of Women's Hormonal Cycles
The Role of Testosterone in Women's Health
The Menstrual Cycle: Second Power Phase (Days 16-19)
The Menstrual Cycle: Nurture Phase (Days 20-28)
Six Lengths of Fasting and Their Benefits
Fasting for Autophagy and Cellular Repair
Fasting for Gut Health and Microbiome Reset
Fasting for Fat Burning and Dopamine Reset
Applying Fasting to the Menstrual Cycle Phases
Hormone Metabolism: Liver and Gut's Role
Fasting for Perimenopausal Women (Over 40)
Fasting for Postmenopausal Women
Fasting for Irregular Cycles and Infertility
Misconceptions and Psychological Benefits of Fasting
7 Key Concepts
Insulin Resistance
This occurs when cells have been exposed to high glucose and insulin levels for too long, causing them to become less responsive to insulin's signal. Consequently, glucose struggles to enter cells for energy, leading to elevated blood sugar.
Insulin Sensitive
This is the opposite of insulin resistance, where cells are highly responsive and open to insulin. This allows glucose to efficiently enter cells to be used for energy, maintaining balanced blood sugar levels.
Autophagy
A cellular repair process that begins around 17 hours of fasting, acting like a dimmer switch. The body identifies and removes damaged cell components, bacteria, and viruses, and strengthens the working parts within the cell, making it stronger for survival.
Apoptosis
This is a process of programmed cell death where the body intelligently decides to kill off severely damaged, rogue, or aging (senescent) cells. This happens during longer fasts to prevent these cells from hindering the survival of the human.
Estrobilome
A specific group of bacteria residing in the gut that plays a crucial role in breaking down and metabolizing estrogen. Supporting these microbes through a diet rich in green leafy vegetables and polyphenols is essential for proper estrogen clearance.
Hormetic Stress
Small, controlled doses of difficult situations or stressors, such as fasting or temperature extremes. These challenges, rather than causing harm, actually stimulate the body to become stronger, more resilient, and promote overall health and longevity.
Dopamine Resistance
Similar to insulin resistance, this refers to a state where the brain's dopamine receptors become less responsive. This means an individual requires more stimulation, such as larger quantities of food, to achieve the same level of pleasure or reward they once experienced.
11 Questions Answered
Women's hormonal profiles are complex, involving estrogen, progesterone, and testosterone, which fluctuate throughout the menstrual cycle, unlike men's testosterone which is released regularly. Progesterone, for example, needs higher glucose levels and is incompatible with fasting during certain cycle phases.
Fasting can help women become more insulin sensitive, which is beneficial for conditions like PCOS and infertility, and can help maintain age-appropriate estrogen levels, especially for women over 40 experiencing hormonal decline.
Individuals with eating disorders (should involve a doctor), pregnant women (fasting is not recommended), and nursing women (should keep fasts under 15 hours to avoid toxin transfer to breast milk) should avoid or be cautious with fasting.
Day one is the day a woman starts her period and needs to use feminine care products, not the days of spotting before the full flow begins.
Women are generally more insulin sensitive in the first half of their cycle (Power Phase, days 1-10) when estrogen is building, but become more insulin resistant in the week before their period (Nurture Phase) when progesterone is high, as progesterone requires higher glucose.
Testosterone, though often seen as a male hormone, is crucial for women's libido, motivation, and drive, peaking during the ovulation (Manifestation) phase (days 10-15) and aiding in muscle building.
Around 17 hours, the body enters a state of autophagy, where cells begin to repair themselves by removing damaged components, bacteria, and viruses, and strengthening mitochondria.
A 24-hour fast can reboot intestinal stem cells, repair the mucosal lining (beneficial for leaky gut), eliminate bad bacteria (helpful for SIBO), and promote a more even distribution of microbes for better nutrient absorption.
As women enter perimenopause around 40, their ovaries decline, leading to a drop in estrogen, which makes them more insulin resistant. This hormonal shift means old strategies for weight management and health may no longer work, leading to frustration and new health challenges.
By consistently following the 'fasting cycle' protocol (tailoring fasting and food to the phases of a theoretical 30-day cycle), many women can bring their cycles back into sync and improve fertility within 30 to 90 days.
Difficulty going without food, experiencing 'hangry' feelings or hypoglycemia, can be a warning sign of early mitochondrial dysfunction or insulin resistance, indicating a need to improve metabolic health.
32 Actionable Insights
1. Honor Women’s Biological Differences
Stop trying to do everything (eating, working out, medications) the same way as men, as women are massively different biologically and hormonally and need tailored approaches to thrive.
2. Cycle-Sync Your Lifestyle
Tailor everything from working habits, workouts, social life, and diet to better match your hormonal profile at each stage of your menstrual cycle to feel more in control and improve conditions like PCOS, infertility, and irregular cycles.
3. Learn Cycle Hormonal Fluctuations
Understand the four phases of the menstrual cycle (Power, Manifestation, Second Power, Nurture) and how hormones (estrogen, progesterone, testosterone) vary, as this foundational knowledge empowers women to work with their bodies.
4. View Fasting: Therapeutic Healing State
Stop viewing fasting as a fad diet and instead see it as a therapeutic healing state that builds health and prevents disease, as the human body was designed to have periods without food.
5. Heal Metabolic Dysfunction
If you struggle to go without food for even 8 hours, recognize this as a warning sign of mitochondrial dysfunction or early diabetes. Use a ‘pre-reset’ (e.g., two weeks of cleaning up food) to slowly train your body to fast, as it gets easier with practice.
6. Fasting for Perimenopause
Women over 40 (perimenopausal) should use fasting as an imperative tool to keep age-appropriate estrogen levels high and become more insulin sensitive, as estrogen decline makes them more insulin resistant and can lead to weight gain and cognitive issues.
7. Post-Menopausal 5-1-1 Fasting Protocol
Post-menopausal women should follow a weekly fasting pattern like the 5-1-1 protocol: five days of a favorite fast (e.g., 15-16 hours) with a low-carb/ketobiotic diet, one day of a longer fast (e.g., 24 hours for gut repair), and one day of no fasting with hormone-feasting foods to support progesterone and improve sleep/anxiety.
8. Fasting for Fertility and PCOS
Women in their fertility years (e.g., with PCOS or struggling to get pregnant) should use fasting to become insulin sensitive and allow estrogen to function properly, potentially restoring regular cycles and improving fertility.
9. Power Phase Longer Fasts
During the first 10 days of the menstrual cycle (Power Phase, starting with the first day of the period), when hormones are low and women are insulin sensitive, they can tolerate longer fasts (e.g., 24-hour, 36-hour, 48-hour, 72-hour fasts) and a low-carb diet.
10. Power Phase Intense Workouts
During the first 10 days of the menstrual cycle (Power Phase), women can push hard with workouts, including HIIT training and plyometrics, as their hormones can handle it.
11. Manifestation Phase Shorter Fasts
During the ovulation phase (Manifestation Phase, roughly day 10-15), when estrogen and testosterone are at their peak, women should keep fasts under 15-16 hours to avoid excessive detox reactions due to hormone metabolism.
12. Manifestation Phase Liver Support
During the ovulation phase, focus on metabolizing hormones by supporting the liver and gut with bitter foods (radicchio, lemons, ginger, arugula) and avoiding alcohol. Increase polyphenol, probiotic, and prebiotic foods (fermented foods, nuts, seeds, green leafy vegetables) to support the estrobilome in breaking down estrogen.
13. Manifestation Phase Lift Weights
During the ovulation phase, leverage high testosterone levels to build muscle by doing heavier weightlifting workouts.
14. Second Power Phase Longer Fasts
After ovulation (roughly day 16-19), when hormones are low again, women can reintroduce longer fasts (e.g., 24-hour, 48-hour) and a low-carb style of eating.
15. Second Power Phase Push Activities
During the second power phase, women can push their workouts and ramp up their social calendar and workload due to low hormone levels.
16. Nurture Phase Minimize Fasting
The week before a woman’s period (Nurture Phase, roughly day 20-28), when progesterone needs glucose to be higher and the body is more insulin resistant, women should minimize or avoid fasting (keep under 13 hours if metabolically flexible) to prevent raising cortisol, which can hinder progesterone production.
17. Nurture Phase Feast Carbs
During the week before a woman’s period, lean into ‘hormone feasting foods’ like smart carbs (potatoes, sweet potatoes, squashes, quinoa, citrus/tropical fruits) and clean chocolate (for magnesium) to support progesterone production and manage cravings.
18. Nurture Phase Reduce Stress
During the week before a woman’s period, women should slow down, reduce stress, say no to more things, and focus on self-care. Exercise should be softer (e.g., yoga, Pilates, walking, hiking) to allow the female body to recover.
19. Reset Irregular Cycles
If you have an irregular or absent cycle, follow a 30-day fasting reset protocol (day 1-30, repeated for 30-90 days) to help balance hormones and bring your cycle back into sync, potentially improving fertility.
20. Plan Life by Cycle
Women with regular cycles can plan their work, social, and exercise calendars according to their menstrual phases, leveraging power phases for high-stress activities and nurture phases for recovery.
21. Mindful Communication with Women
Men (partners, fathers, sons, friends) should understand women’s hormonal flux and adapt communication, such as avoiding tough conversations the week before a woman’s period and choosing times when hormones make them more verbally outward.
22. Intermittent Fasting (12-16 Hours)
Aim for 12-16 hour fasts to switch into the fat-burning system, produce ketones (which calm and reduce hunger), lower inflammation, and boost growth hormone.
23. Autophagy Fast (17+ Hours)
Engage in 17+ hour fasts to trigger autophagy, where the body repairs cells, removes damaged components (bacteria, viruses, senescent cells), and initiates apoptosis to eliminate rogue cells.
24. Gut Health Fast (24 Hours)
Perform 24-hour fasts to reboot intestinal stem cells, repair the gut lining (beneficial for leaky gut, SIBO), eliminate bad bacteria, and redistribute microbes for better nutrient absorption.
25. Fat Burner Reset (36 Hours)
Utilize 36-hour fasts (e.g., alternating with 12-hour eating windows) to lose more weight, particularly visceral belly fat, and convert white fat into more easily burnable brown fat.
26. Dopamine Reset Fast (48 Hours)
Engage in 48-hour fasts to reset the entire dopamine system, increase dopamine receptor sites, and enhance enjoyment of simple life pleasures, which can help overcome food addiction.
27. Immune Reset Fast (72 Hours)
Implement 72-hour fasts to reboot the entire white blood cell and immune system.
28. Embrace Micro Discomfort
Actively seek small doses of discomfort, like extending fasts, as these hormetic stressors strengthen the body and mind, revealing new coping mechanisms and dopamine-stimulating activities.
29. Gradually Train for Fasting
Approach fasting as a training process, starting with shorter fasts and gradually increasing duration. Be playful and curious, understanding that initial difficulty is part of adaptation, and it gets easier over time.
30. Fasting Caution: Eating Disorders
If you have an eating disorder or are recovering, involve your therapist and doctor in any fasting experience, or avoid fasting, to prevent triggering harmful patterns.
31. Fasting Caution: Pregnancy
Pregnant women should not use fasting as a tool; instead, focus on other health aspects like the microbiome.
32. Fasting Caution: Nursing
Nursing women should keep fasts under 15 hours to avoid stimulating autophagy and potentially pushing toxins into breast milk.
8 Key Quotes
We have to stop trying to do everything from how we eat to how we work out to the medications we take at the same as men, because we are massively different.
Dr. Mindy Pelz
Men, you are almost 100% run by testosterone. You, in a 24-hour period, you're getting testosterone every 15 minutes. Women, we are not just running off of one hormone.
Dr. Mindy Pelz
If you are eating all day long, we're literally going against our genetic design. We're working against our genes, not with our genes.
Dr. Mindy Pelz
If you have to eat all day and you don't and you struggle to go eight hours without food, that is your body saying, warning, warning, we are in a mitochondrial mess and we need to clean things up.
Dr. Mindy Pelz
45 to 55 is the most common decade for women to commit suicide. Now, why is that? There is a hormonal decline that is changing our brains and our bodies. And we are not understanding ourselves.
Dr. Mindy Pelz
When we shed blood, it is a version of a detox. So we need that menstrual cycle. It is how your body is removing toxins from your system. It is a beautiful mechanism that has been born into us that we should cherish.
Dr. Mindy Pelz
Fasting is not a fad diet. It is a healing state you put your body into. Your body was designed to fast.
Dr. Mindy Pelz
You don't know how good a sip of water can taste until you fasted.
Sally (quoted by Dr. Rangan Chatterjee)
2 Protocols
Fasting Cycle for Women (General Principle)
Dr. Mindy Pelz- **Power Phase (Day 1-10, start of period)**: Hormones are low. Can tolerate longer fasts (e.g., 24-hour, 36-hour, 72-hour fasts) and push workouts (HIIT, plyometrics).
- **Manifestation Phase (Day 10-15, ovulation)**: Estrogen and testosterone peak. Keep fasts under 15-16 hours to avoid detox reactions. Focus on metabolizing hormones by supporting liver and gut with bitter foods (radicchio, lemon, ginger, arugula), polyphenols, probiotics, and prebiotics. Use testosterone for heavier weight lifting and starting projects.
- **Second Power Phase (Day 15/16-19)**: Hormones are low again. Can return to longer fasts (e.g., 24-hour, 48-hour dopamine fast) and low-carb eating. Push workouts and social calendar.
- **Nurture Phase (Day 20-28/start of period)**: Progesterone rises, body becomes more insulin resistant. Minimal to no fasting (under 13 hours if metabolically flexible, otherwise no fasting). Focus on 'hormone feasting foods' (smart carbs like potatoes, sweet potatoes, squashes, quinoa, citrus, tropical fruits, and magnesium-rich chocolate). Reduce stress, prioritize self-care, and engage in softer activities like yoga or walking.
5-1-1 Fasting Protocol for Postmenopausal Women
Dr. Mindy Pelz- **Five days a week**: Engage in a preferred shorter fast (e.g., 15-16 hours) combined with a low-carb, 'ketobiotic' style of eating, emphasizing nature's carbs like leafy greens.
- **One day a week**: Extend the fast to 24 hours to promote gut repair and estrogen breakdown for brain health.
- **One day a week**: Step out of fasting entirely, consume 'hormone-feasting foods' to support progesterone, reduce anxiety, and improve sleep.