The goop Podcast

Host: Gwyneth Paltrow
Episode: A Guide to Perimenopause & Menopause
Date: August 26, 2025
Guest: Dr. Taz Bhatia, Board-Certified Integrative and Functional Medicine Physician

Overview

This episode of The goop Podcast dives deep into the under-discussed realities of perimenopause and menopause. Gwyneth Paltrow and Dr. Taz Bhatia explore the subtle (and not-so-subtle) hormonal shifts women experience as early as their mid-30s, discuss why menopause deserves a rebranding, and share holistic, integrative approaches for navigating the physical and emotional changes of this life phase. Filled with actionable insights, validation, and hope, this conversation aims to empower women to understand, track, and manage their hormonal health with compassion and confidence.

Key Discussion Points & Insights

Why We Need to Talk About Perimenopause (02:20 – 03:49)

• Social Stigma & Silence: Gwyneth laments the taboo around discussing hormonal changes and perimenopause.
• Menopause Rebranding: She argues that menopause is a natural, powerful phase deserving a cultural reset.
  • Quote (Gwyneth, 02:31):
    “There’s nothing wrong with going through menopause. It’s an absolutely natural part of being a beautiful, wise woman.”

What is Perimenopause? Early Signs and Onset (03:49 – 06:24)

• Dr. Taz:
  • Perimenopause is the gradual shift in hormones, typically starting as early as age 35.
  • It’s a subtle process that can be masked by life’s other stresses and changes.
  • Early signs include changes in menstrual cycles, sleep issues, and altered stress tolerance.
  • Quote (Dr. Taz, 03:49):
    "Perimenopause is where the hormones start to shift... for some women, it might be earlier. For some, it might be later. But that shift in hormones is very subtle."

Hormonal Chain Reactions: Cortisol, Progesterone, Estrogen (06:24 – 09:37)

• Cortisol shifts often precede obvious hormonal changes (sleep disturbance, anxiety).
• Progesterone decline leads to classic symptoms:
  • 2 AM wakefulness
  • Increased anxiety and “foggy” days
• Estrogen dominance results from low progesterone:
  • Heavy, irregular periods
  • Weight gain (hips, thighs, abdomen)
• Quote (Dr. Taz, 07:30):
  “Progesterone actually acts as something that balances cortisol... when the progesterone drops, it doesn’t have that check and balance system anymore... all of a sudden you’re up at 2 o’clock in the morning.”

The Gut–Liver–Hormone Connection (10:40 – 12:59)

• Gut health (“ground zero”) affects hormone clearance.
• Constipation, diet, and liver burden (toxins, medications, unprocessed emotions) impact hormonal regulation.
• Eastern medicine view: Liver is the “laundromat” and holds repressed emotions, which can manifest physically.
  • Quote (Dr. Taz, 11:59):
    “Our feelings burden the liver... one of the things that has been like, haunting to me is the patients where they’ve gone through a divorce or they’ve gone through a loss... surely eight, 18 months later, we’re dealing with something and something with the breast, because the breast is on the liver meridian.”

Perimenopause Severity as a Predictor for Menopause (13:05 – 15:51)

• If untreated, severe perimenopausal symptoms often foreshadow difficult menopause.
• Making health changes—gut, liver, stress, toxin load—even small tweaks, can transform the experience.
• Optimal body fat (“not too thin!”): Crucial for hormone resilience.
  • Quote (Dr. Taz, 13:45):
    “If you’ve had a really rough perimenopausal transition… you may have a really rough menopausal transition as well. But tweaks here and there really, really make a difference.”

Integrative Approach: Ayurveda & Chinese Medicine (17:06 – 19:20)

• Dosha awareness (Ayurvedic typing): informs hormonal susceptibilities.
  • Vata: Prone to adrenal fatigue, low progesterone, low cortisol.
  • Pitta: Prone to thyroid and insulin issues, estrogen dominance.
• Multi-layer diagnostics: Eastern diagnostics + Western labs = most precise formula.
  • Quote (Dr. Taz, 18:13):
    “The beauty of marrying this stuff is that we know that vata is prone to certain hormone imbalances... Pittas are prone to certain hormone imbalances.”

Where to Start: Diet, Gut, and Hormones (19:35 – 21:47)

• Diet changes often make the most transformational difference.
• Dr. Taz shares her own health turnaround from simply going gluten-free (not celiac by strict definition).
• Gut support: Simplifying diet, using enzymes and probiotics, can sometimes resolve major hormone symptoms.

Hormone Replacement: Myths, Fears & Best Practices (21:47 – 26:07)

• History of fear: Women’s Health Initiative study caused widespread concern about cancer risk with hormone therapy.
• Current research: Hormones are vital for brain, bone, skin, and cognitive health.
• Personalized approach: Dosage must be tailored; monitoring levels crucial.
• Dr. Taz favors low-dose, bioidentical hormones when needed—customized forms (creams, troches, suppositories, oral).
• Quote (Dr. Taz, 22:17):
  “It’s not so much the hormone is bad, but it’s what your body is going to do with the hormone. If you have a really weak gut, or you have a toxic liver... then yes, that stuff is going to get stored.”

Tracking Hormones & Proactive Health (27:48 – 30:27)

• Frequency: When on hormone therapy, check levels at least twice a year, ideally quarterly.
• Early tracking: Start testing hormone baselines in teens/early 20s for better lifelong management.
• Example: Dr. Taz shares how early testing revealed and treated her teenage daughter's PCOS, improving both acne and mood.

Detoxing & Liver Health (30:27 – 33:22)

• Structured detox programs (3, 7, 10-day cleanses) can help—preferably with medical guidance, especially for more complex protocols.
• Simple detox = green juices, plant-based diet, herbs like milk thistle.
• Over-detoxing or going too hard can backfire if the body is weak: watch for severe symptoms.

Chronic Fatigue, Fibromyalgia, Autoimmunity & Hormones (33:22 – 37:19)

• Hormonal shifts often underlie chronic pain, inflammation, and fatigue; progesterone acts as a natural anti-inflammatory.
• Addressing root causes (hormones, stress, triggers) is more effective than just managing symptoms with medications.

Going Deeper: Hidden Infections, Toxins, and Diagnostic Tools (37:19 – 41:49)

• If diet and hormones aren’t the answer, Dr. Taz digs deeper:
  • Chronic viruses: Epstein-Barr/mono, Lyme, mycoplasma
  • Toxins: Mold, environmental exposures
• Diagnostic strategy:
  • Start with standard labs (LabCorp, Quest).
  • Add specialty/vibrational diagnostics (e.g., Zytoscan).
  • Emphasize intuition and subtle Eastern diagnostics for early detection.

COVID Long-haulers and Hormonal Disruption (41:49 – 45:33)

• Covid can profoundly disrupt hormones, cognition, and immune systems; Dr. Taz is seeing notable cases, especially in women.
• Recovery protocol:
  • Anti-inflammatory diet (low gluten/dairy/sugar)
  • Supplements: magnesium, methylated B vitamins, antioxidants
  • Medications: LDN (low-dose naltrexone), glutathione
  • IV therapy if needed: glutathione, vitamin C (targeted, not scattershot)

Common Concerns & Rapid-Fire Q&A

Hair Loss (45:41 – 46:54)

• Check thyroid, estrogen, progesterone, iron.
• Patterns of loss indicate which hormone is responsible (e.g., crown = thyroid, temples = estrogen/progesterone).

Night Sweats (46:54 – 48:21)

• Caused by estrogen fluctuations, often in late 40s.
• Interventions: Maca, evening primrose oil, CBD, low-dose hormone therapy if needed.
• Avoid caffeine, sugar, alcohol, spicy foods to minimize symptoms.

Libido (48:29 – 49:43)

• Usually linked to low testosterone but can arise post-partum or in perimenopause.
• Suggestions: Zinc, L-arginine, vaginal testosterone, or Addyi (medication) as a last resort.

Vaginal Dryness (50:11 – 51:52)

• Low estrogen causes post-menstrual dryness.
• Vaginal estriol (more protective than estradiol) or Estrace (prescription) rebuilds tissues and restores lubrication; laser treatments may help with tissue tightening but not dryness.

Quality of Life & Sex in Later Years (52:09 – 54:31)

• Reframing menopause as a time of “rising into your power.”
• Many women thrive—sexually, creatively, and professionally—in their 50s and beyond if supported and proactive.
  • Quote (Dr. Taz, 53:19):
    “I think the women that arrive at that and own that and embrace that... really live the next 30 or so years in their power.”

Notable Quotes & Memorable Moments

• On menopause needing a “rebrand”:
  • Gwyneth (02:31): “There’s nothing wrong with going through menopause. It’s an absolutely natural part of being a beautiful, wise woman…”
• On subtle hormonal changes:
  • Dr. Taz (03:49): “Perimenopause is where the hormones start to shift... that shift in hormones is very subtle.”
• On listening to the body:
  • Dr. Taz (41:49): “Our intuition, our ability to really listen to what’s happening to our body is so critical and so important.”
• On thriving post-menopause:
  • Dr. Taz (53:19): “They really live the next 30 or so years in their power…to assume that we’re done is something I’m not going to accept.”

Practical Takeaways

• Track your hormones early—don’t wait for symptoms.
• Don’t white-knuckle through menopausal symptoms: Safe, personalized hormone therapy, especially bioidenticals, can dramatically improve quality of life when carefully monitored.
• Gut and liver health are foundational—clean up diet, reduce toxin load, mind emotional health.
• Keep body fat in a healthy range—being super lean is not always better for hormonal transition.
• Consider integrative healthcare: Combining Eastern and Western approaches yields the most nuanced, effective strategies.
• Don’t be embarrassed! Sharing and discussing symptoms with friends and providers is powerful, healing, and normalizes the experience for all.

For further resources:

• Dr. Taz Bhatia: drtaz.com
• Podcast recommendation: Superwoman Wellness

[End of summary]