Menopause: Symptoms, Hormones, Tests & Solutions with Sage Workinger-Brecka & Gary Brecka | TUH #227

Summary

Gary Brecka and Sage Workinger-Brecka discuss Sage’s experience with perimenopause and menopause, including symptoms that began in her late 30s. These included mood changes, fatigue, brain fog, reduced libido, irregular periods, feeling overwhelmed, and a frozen shoulder. Sage says she initially attributed the symptoms to other causes. Testing helped her and Gary connect them to hormonal changes.

They compare standard blood work with a 24-hour urine DUTCH test, which they say gave them a fuller picture of Sage’s hormone patterns. Gary interprets her results as showing low levels of several hormones and precursors, along with an abnormal cortisol and melatonin rhythm. Sage reports improvements in sleep, energy, mood, brain fog, and shoulder mobility after starting clinician-prescribed hormone therapy.

Strategies and Advice Discussed

• Take persistent symptoms seriously. Seek evaluation for substantial changes in mood, energy, memory, sleep, libido, menstrual cycles, or physical comfort—even if menopause seems unlikely because of age.
• Track symptoms and menstrual cycles. Sage describes using a period-tracking app and noticing that her cycle became unpredictable.
• Discuss appropriate testing with a clinician. The couple discusses blood tests, a 24-hour urine DUTCH test, and, in Sage’s case, testing related to mold exposure and genetics. They suggest that one standard blood test may not explain every symptom.
• Work with a qualified clinician on treatment. Sage says a clinician reviewed her results before prescribing her hormone plan. The couple discusses delivery methods, individualized treatment, and consistent timing.
• Ask informed questions at medical appointments. Sage recommends learning about possible explanations and preparing to discuss symptoms and test results with a doctor.
• Support daily routines. Gary recommends getting natural morning light soon after waking. The couple also mentions eating mostly whole, minimally processed foods, exercising, and maintaining sleep and wellness routines.
• Offer practical support as a partner. They recommend patience, listening, affection, and learning about menopause together. Gary jokes that partners should be considerate about household chores and morning routines.
• Don’t assume symptoms are “all in your head.” Their central message is to seek help when something feels wrong rather than dismissing persistent symptoms.

Medical context: The episode includes personal experiences and strong claims about hormone tests, hormone therapy, breast-cancer risk, and specific hormone patterns. These claims should not be treated as a diagnosis or universal guidance. Menopause care, including the potential benefits and risks of hormone therapy, depends on the individual. Discuss testing and treatment options with a qualified healthcare professional.

Presenters and Sources Mentioned

• Presenters: Gary Brecka and Sage Workinger-Brecka
• Other sources mentioned: Dr. Sarda, an OB-GYN who reviewed Sage’s tests, as described in the episode; Dr. Mary Claire Haver and her book The New Menopause; the DUTCH test; 10X Health