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Hormone Cafe

Hormone Cafe

Written by: Sarah Pederson
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The Hormone Café is your cozy corner for honest conversations about women’s health, fertility, and hormones. Hosted by Dr. Sarah Pederson, holistic OB-GYN and founder of Vera Health and Fertility, each episode helps you understand your body so you can feel amazing, balance your hormones, and have the family you desire as naturally as possible.

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Episodes
  • Perimenopause Explained: Hormone Roller Coasters, Testing & How to Feel Like Yourself Again | Episode 26

    Perimenopause Explained: Hormone Roller Coasters, Testing & How to Feel Like Yourself Again | Episode 26
    Jan 26 2026
    In this episode of The Hormone Café, Dr. Sarah Pederson breaks down perimenopause—what it is, how to know if you’re in it, and what you can do to feel better during this major hormonal transition. She explains why symptoms can feel extreme and unpredictable, how hormone testing actually works in perimenopause, and why a whole-body, root-cause approach is essential for long-term relief. Rather than accepting “this is just part of aging,” Dr. Sarah outlines how targeted nutrition, lifestyle support, lab testing, supplements, and — when appropriate — low-dose bioidentical hormone therapy can dramatically improve quality of life. In This Episode, You’ll Learn: 🌿 What Perimenopause Actually Is Perimenopause is the transition between regular, ovulatory hormone production and menopause. Instead of a smooth decline in estrogen and progesterone, hormone production becomes sporadic and erratic, leading to dramatic highs and lows. This hormonal “roller coaster” is what drives many of the frustrating symptoms women experience. 🔥 Common Symptoms of Perimenopause Dr. Sarah explains that symptoms can vary widely and may include: Anxiety and mood swingsDepression or irritabilityBrain fog and poor concentrationHot flashes, night sweats, and temperature intoleranceFatigue and poor sleepWeight gain despite eating well and exercisingChanges in metabolism Perimenopause is natural — but suffering is not inevitable. 🧪 How to Test for Perimenopause (and Why One Lab Isn’t Enough) Hormone levels fluctuate dramatically in perimenopause. One “normal” lab does not rule it out. Dr. Sarah explains: Why FSH and LH are key markersWhat values typically look like in reproductive years vs. perimenopause vs. menopauseWhy testing multiple times, at least two weeks apart, is critical to identify trends Trending labs over time gives a much clearer picture than a single snapshot. 🩸 When Irregular Bleeding Is a Red Flag Not all irregular cycles require treatment — but certain symptoms do: Extremely heavy bleedingBleeding lasting weeks at a timeBleeding through clothes or experiencing “waterfall” bleeding These situations warrant intervention to protect health and improve quality of life. 🥗 Why Nutrition Is Always the Foundation Before jumping to medication, Dr. Sarah emphasizes: Eating enough calories to support hormone productionStabilizing blood sugar to reduce hormone swingsEnsuring adequate protein, healthy fats, and micronutrients Nutrition is the base that allows any other therapy to work effectively. 🧠 Supporting the Entire Endocrine System Perimenopause is not just about estrogen and progesterone. Dr. Sarah walks through why it’s essential to assess: Thyroid function (full thyroid panel, not just TSH)Adrenal health (DHEA/DHEA-S)Nutrient status (magnesium, zinc, B vitamins, omega-3s)Mitochondrial and metabolic health 📈 Why Blood Sugar Matters More Than You Think Using continuous glucose monitoring, Dr. Sarah explains how blood sugar instability can worsen: InsomniaAnxietyInflammationHormone irregularity Balanced glucose = more stable hormones. 🌱 Gut Health, Absorption & Hormone Balance Even a perfect diet won’t help if nutrients aren’t absorbed. Daily bowel movements, minimal bloating, and proper digestion are essential to hormone production and detoxification. 💊 Supplements: When to Support vs. When to Avoid High estrogen → support detox pathways (DIM, calcium D-glucarate)Low hormones → avoid estrogen-lowering supplementsStrategic use of nutrients like DHEA when appropriate Supplement choice must match hormone status. 🧠 Mental Health & Nervous System Support Mood changes during perimenopause are influenced by: Hormone fluctuationsLife stressors (career changes, aging parents, family transitions) Sarah highlights the importance of therapy, nervous system regulation, and targeted neurotransmitter support when needed. 🌸 Hormone Therapy: When It’s Helpful Hormone replacement therapy can be life-changing for severe symptoms such as: Debilitating insomniaDrenching night sweatsSevere brain fog Sarah explains:Why low-dose, bioidentical hormones are usedHow therapy is personalizedThe importance of monitoring labs and symptomsWhy hormones should support — not override — natural physiology 📊 Discovery, Stabilization & Weaning Phases Hormone therapy is never “one and done.” Treatment includes: Discovery phase (finding the right dose)Stabilization phase (feeling great consistently)Planned weaning into menopause The goal is support, not dependence. Key Takeaways: Perimenopause can last 5–10 years and looks different for everyoneHormone swings — not aging — drive many symptomsOne lab test is not enough to diagnose perimenopauseWhole-body evaluation is essential for lasting resultsHormone therapy can be powerful when used thoughtfullyYou are not doomed to feel bad — feeling better is possible Resources & Next Steps: If you think you may be in perimenopause...
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    26 mins
  • Bypassing the Gut: How IV Therapy Supports Egg, Sperm & Implantation Health | Episode 25

    Bypassing the Gut: How IV Therapy Supports Egg, Sperm & Implantation Health | Episode 25
    Jan 19 2026

    In this episode of The Hormone Café, Dr. Sarah Pederson explains how IV nutrient therapy can support fertility when diet and supplements aren’t enough. She breaks down why nutrient deficiencies persist despite “doing everything right,” how IVs bypass absorption barriers, and how targeted IV formulations can improve egg quality, sperm quality, implantation, and surgical recovery.

    In This Episode, You’ll Learn:

    💉 Why IV Therapy Matters in Fertility Care Dr. Sarah explains why many fertility patients remain deficient in key nutrients despite optimal diet and supplementation:

    • Poor gut absorption
    • Digestive inflammation or dysfunction
    • Liver metabolism limiting nutrient availability IV therapy allows nutrients, antioxidants, and hydration to be delivered directly into the bloodstream—bypassing the gut and liver for faster, more effective results.

    🧪 Key Nutrients Commonly Low in Fertility Patients Frequently identified deficiencies include:

    • Folic acid & B vitamins
    • Vitamin C and other antioxidants
    • Glutathione These nutrients are essential for:
    • Cellular energy and metabolism
    • Egg and sperm quality
    • Detoxification and inflammation reduction

    🥚 Egg Quality IV Designed to support ovarian health and cellular protection:

    • High-dose antioxidants to reduce oxidative stress
    • Supports mitochondrial function and egg integrity
    • Can be used weekly or monthly depending on fertility goals Sarah explains that while we’re born with all our eggs, egg quality can be supported through targeted antioxidant pathways.

    🌱 Implantation & Uterine Blood Flow IV Created for patients with:

    • Thin uterine lining
    • Recurrent miscarriage
    • Chronic inflammation or endometritis This IV focuses on:
    • Improving blood flow to the uterus
    • Supporting implantation before and after ovulation
    • Working alongside diet, supplements, and medication—not replacing them

    🩺 Pre- & Post-Surgical Recovery IVs Dr. Sarah discusses why surgery should be restorative—not depleting:

    • Surgery places stress on the body and increases dehydration
    • Nutrients and electrolytes support healing and circulation
    • IVs help reduce recovery time and support fertility-preserving outcomes These IVs are now integrated into Vera’s fertility-sparing surgical protocols.

    👨 Sperm Quality IV Men benefit from IV therapy too. This IV supports:

    • Sperm morphology (normal head and tail structure)
    • Motility and progressive motility
    • Hydration and reduced sperm agglutination
    • Blood flow to the testes Ideal for men who have optimized diet and supplements but still have suboptimal semen parameters.

    🧠 IV Therapy as an Adjunct—Not a Replacement Dr. Sarah emphasizes:

    • IVs do not replace good nutrition or supplements
    • They enhance and accelerate results when absorption is limited
    • Best used as part of a comprehensive fertility plan
    Key Takeaways:
    • Persistent nutrient deficiencies often stem from absorption issues—not effort
    • IV therapy delivers targeted nutrients directly into circulation
    • Antioxidants play a critical role in egg and sperm quality
    • Blood flow and hydration are essential for implantation and recovery
    • IV therapy can support fertility at multiple stages for both men and women
    Resources & Next Steps:

    If you feel like you’re doing “all the right things” but still struggling with egg quality, implantation, recovery, or sperm parameters, IV therapy may be a supportive next step.

    📍 Westminster, Colorado 🌐 Learn more or schedule: verafertility.com 📧 Follow along: @verafertility
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    9 mins
  • Low, Dominant, or Imbalanced? Understanding Estrogen & Progesterone Profiles | Episode 24

    Low, Dominant, or Imbalanced? Understanding Estrogen & Progesterone Profiles | Episode 24
    Jan 15 2026

    In this episode, Dr. Sarah Pederson breaks down the three most common female hormone profiles—low estrogen & progesterone, estrogen dominant, and progesterone dominant/low estrogen—and explains how each one affects mood, energy, cycles, fertility, and overall health. This episode empowers women to understand their symptoms, test hormones properly, and align nutrition, exercise, supplements, and treatment with their unique hormone profile.

    In This Episode, You’ll Learn:

    🧪 The Three Core Hormone Profiles Dr. Sarah explains how estrogen and progesterone work together—and what happens when they fall out of balance:

    • Low Estrogen + Low Progesterone (“Low–Low”)
    • Estrogen Dominant (Relative Low Progesterone)
    • Progesterone Dominant / Low Estrogen

    Each profile presents differently and requires a different approach to treatment, lifestyle, and supplementation.

    🩺 Why Proper Hormone Testing Matters

    • Best timing for hormone labs:
      • Cycle day 3: Estrogen, progesterone, FSH, LH, testosterone
      • 5–7 days after ovulation (depending on luteal phase length)
    • Why checking progesterone at the wrong time leads to misdiagnosis
    • How incorrect supplementation can worsen symptoms instead of helping

    🌱 Low Estrogen & Low Progesterone (Low–Low Profile) Common symptoms include:

    • Depression, brain fog, low stress tolerance, fatigue
    • Light or skipped periods, long cycles, short luteal phase
    • Recurrent miscarriage, poor cervical mucus, thin uterine lining
    • Low libido, vaginal dryness, UTIs, hair thinning, brittle nails
    • Hot flashes, cold intolerance, poor circulation

    Root causes may include:

    • Chronic stress
    • Under-eating or poor nutrient absorption
    • Excessive exercise
    • Postpartum or breastfeeding states
    • Perimenopause or ovarian insufficiency

    Support strategies:

    • Adequate calories and protein
    • Gentle exercise (yoga, Pilates, barre)
    • Stress reduction and sleep prioritization
    • Targeted supplements (omega-3s, magnesium, vitex)

    ⚖️ Estrogen Dominance Common symptoms include:

    • Anxiety, irritability, mood swings
    • Heavy or painful periods, clots, PMS
    • Breast tenderness, fibroids, endometriosis
    • Migraines, acne, bloating, weight gain
    • Poor sleep, constipation, joint inflammation

    Key contributors:

    • High sugar or refined carbohydrate intake
    • Low protein consumption
    • Poor liver or gut estrogen metabolism

    Support strategies:

    • Higher protein intake (≈80g/day)
    • Strength training, HIIT, frequent movement
    • Fiber-rich diet for estrogen detoxification
    • Supporting liver and gut health
    • Reducing alcohol and excess sugar

    🌡️ Progesterone Dominant / Low Estrogen Common symptoms include:

    • Sedation, brain fog, low motivation
    • Excessive sleepiness, low blood pressure, dizziness
    • Weight gain, insulin resistance, cravings
    • Heat intolerance, nausea, constipation
    • Vaginal dryness, low libido, breast fullness

    Key focus areas:

    • Supporting ovulation and estrogen production
    • Balanced, moderate exercise
    • Stress reduction and adequate sleep
    • Avoiding progesterone-only supplementation when estrogen is low

    🧠 Why Hormone Ratios Matter Dr. Sarah emphasizes:

    • Hormones must be balanced—not treated in isolation
    • DIM, progesterone, or bioidentical hormones can be harmful if mismatched
    • Nutrition, exercise, and supplements should support—not fight—your hormone profile
    • Ongoing lab monitoring ensures treatment is helping, not harming
    Key Takeaways:
    • Most symptoms are clues to your hormone profile—not random
    • Estrogen and progesterone must be evaluated together
    • Timing of hormone testing is critical
    • One-size-fits-all hormone advice often backfires
    • Aligning lifestyle and treatment with your hormone profile leads to better mood, energy, cycles, and fertility
    Resources & Next Steps:

    If you suspect hormone imbalance or feel stuck with persistent symptoms, proper hormone testing and individualized care are essential.

    📍 Westminster, Colorado 🌐 Schedule a consultation: verafertility.com 📧 Follow along: @verafertility
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    23 mins
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