The Diary Of A CEO with Steven Bartlett
Menopause Expert: Belly Fat Grows During Menopause! Your Estrogen Levels Are Controlling You & This Hormone Is Quietly Killing Your Sex Life!
Thu, 27 Mar 2025
Is your belly fat, stress, or burnout actually a hormone issue? Dr. Sara Szal reveals the hidden hormone connection and how to fix it for good Dr. Sara Szal (previously Gottfried) is a Harvard-trained medical doctor and researcher, with 30 years of experience. She is the author of 4 bestselling books such as, ‘The Autoimmune Cure: Healing the Trauma and Other Triggers That Have Turned Your Body Against You’. 00:00 Intro 02:43 What Sara Does for People 04:16 Background and Training 05:56 Helping 40,000 People 08:44 What Is Precision Medicine? 10:19 What’s Wrong with Conventional Medicine? 13:04 Why Sara Chose This Career 15:10 Importance of Healing from Past Trauma 16:44 How Trauma Manifests into Health Conditions 20:43 Lack of Nutrition and Lifestyle Education in Medical Training 22:12 Cortisol and Stress 25:23 Is There a Link Between Cortisol and Trauma? 26:02 Daily Habits That Disrupt Hormones 29:15 How to Optimise Your Health 30:35 Is Sugar the Enemy? 31:56 Supplements for Hormonal Balance 32:52 Common Nutritional Deficiencies 36:54 How to Regulate Cortisol Levels 41:04 Is It Easy to Get Someone to Change? 42:20 Can Encouraging Change Cause Harm? 44:25 How to Support Someone Breaking Bad Habits 46:34 When Should Men Start Monitoring Testosterone? 47:58 Testosterone in Women 48:32 Signs of Low Testosterone in Men 49:02 Symptoms of Low Testosterone in Women 49:52 Symptoms of High Testosterone in Women 50:54 How to Regulate Testosterone Levels 53:08 Why Estrogen Is Important for Both Men and Women 58:40 Importance of Fibre in the Diet 59:30 Role of the Microbiome in Hormone Regulation 01:00:51 Fibre-Rich Foods 01:01:04 Sara’s Preferred Diet 01:02:53 The Ketogenic Diet 01:05:01 Side Effects of the Keto Diet 01:05:36 Can You Stay on Keto Long-Term? 01:07:00 Strategies for Effective Weight Loss 01:08:05 Fasting 01:12:05 What Is Perimenopause and When Does It Begin? 01:16:12 Can Menopause Symptoms Be Avoided? 01:16:47 Birth Control 01:17:37 Who Is Birth Control For? 01:18:28 How Is Sara Doing Today? 01:19:36 Whole Body Yes 01:20:39 How to Know If a Marriage No Longer Works 01:24:54 Sara’s Divorce: Could It Have Been Saved? 01:26:40 Are Women in Menopause More Likely to Divorce? 01:28:01 Do Happiness Levels Increase in Your 50s? 01:29:10 How to Better Support Women 01:32:38 How Gender Roles Can Be Harmful to Women 01:33:59 Why Women Are Generally More Stressed Than Men 01:35:11 Are Women More Sensitive Than Men? 01:35:46 Why Women Are More Prone to Autoimmune Diseases 01:38:13 Does Late Motherhood Increase Cancer Risk? 01:39:31 Are Gender Roles Misaligned with Human Biology? 01:40:44 What Is Polarity in Heterosexual Relationships? 01:44:52 How to Keep Sexual Attraction Alive 01:48:35 Building Emotional Connection with Conversation Cards 01:50:36 How Sleep Affects Hormonal Balance 01:52:18 Heart Rate Variability (HRV) 01:52:57 How to Improve HRV Follow Dr. Sara: Instagram - https://g2ul0.app.link/eJThWwn62Rb Website - https://g2ul0.app.link/6kAPJDr62Rb Podcast - https://g2ul0.app.link/NRL9His1cSb Free 'ACE' quiz - https://g2ul0.app.link/tzyN1dj1cSb You can purchase Dr Sara’s book, ‘The Autoimmune Cure: Healing the Trauma and Other Triggers That Have Turned Your Body Against You’, here: https://g2ul0.app.link/Mt0ZFgF62Rb Get your hands on the Diary Of A CEO Conversation Cards here: https://bit.ly/conversationcards-mp Watch the episodes on Youtube - https://g2ul0.app.link/DOACEpisodes Sign up to receive email updates about Diary Of A CEO here: https://bit.ly/diary-of-a-ceo-yt Ready to think like a CEO? Gain access to the 100 CEOs newsletter here: https://bit.ly/100-ceos-newsletter Follow me: https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Vivobarefoot - https://vivobarefoot.com/DOAC with code DOAC20 for 20% off ZOE - http://joinzoe.com with code BARTLETT10 for 10% off Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: Why is menopause affecting my belly fat and stress levels?
3 to 75% of women do not get the treatment for perimenopause and menopause that they deserve. And women are asking, why is it that I can't manage stress the way I once did? Why do I have this belly fat that appeared out of nowhere? And my usual techniques for how to deal with that aren't working. Why would I rather mop the floor than have sex with my husband?
But there's more than 100 plus symptoms that women aren't aware of.
But you believe many of the symptoms of menopause are avoidable? Yes.
And let's get into that.
Dr. Sara Sal is the Harvard-trained physician and hormone expert who's unlocking the science and simple tricks behind feeling your best, no matter your age.
Most people have imbalanced hormones. Think of them as text messages that your body sends to keep everything functioning optimally. But for example, out of the 40,000 people I've tested and treated, around 90% of them have a problem with their cortisol hormones.
And if my body's making too much cortisol, what is the harm?
It's associated with more belly fat. We know that it shrinks the brain in women, but not men. It's associated with depression. But also, if you're someone who's making a lot of cortisol, you're going to make less testosterone. And that leads to a whole host of serious problems.
And what about trauma? Does that impact your hormones?
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Chapter 2: How does Dr. Sara Szal's background influence her medical approach?
I'm a physician, so I work in academic medicine. I do research for people, I teach, and I take care of patients. So that's the official BBC answer, and the unofficial answer is I'm a healer.
And what does that mean, a healer? Because that's a broad term, so that could mean many things.
It means that my task is to connect to your innate healing capacity and to work with you to activate it.
And who do you do that for?
So I do it for professional athletes, executives, and everyday people.
And when you say healing, if someone came to you and they said, how do you heal people? What would your answer be?
My answer is I don't heal people. To me, that's a patriarchal way of thinking about it. What I do is I work with someone who's got the capacity to heal, and we work to be in the service of that. So it's not me providing something that they don't have already.
It's more understanding what some of the obstacles might be to their own healing, understanding what would allow them to be the best version of themselves, to feel fully alive.
And what was your training? So can you talk me through your sort of academic journey?
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Chapter 3: What is the difference between precision medicine and conventional medicine?
I think I've got it here.
Oh, do you? It's a questionnaire. So my score is six out of 10. So childhood divorce, my parents got divorced when I was about a year old. That's one out of the six. Other things are abuse, neglect, emotional abuse, physical abuse, having a parent with a substance use disorder.
So things that, you know, it's not a complete list, but it's a validated questionnaire that was used in the 1990s and found among people who are middle-aged. You're not quite yet middle-aged. But for people who are middle-aged, 40 to 65. They found that people who had higher ACE scores, one or higher, they then had a greater risk of 45 different chronic diseases.
How important is it for us to understand our early upbringing and our trauma if we are to heal as adults? Because you said there that if you score high on this ACE score, this trauma score, this childhood trauma system sort of questionnaire, then as an adult, you're more likely to get a variety of different diseases.
So do we need to heal our bodies in some way to avoid getting some of those diseases?
Yes. And that's the critical question. Yeah. So if you know that you have an elevated ACE score, and there's a lot of people who have a score of zero, about 40% of men, about 30% of women. And what we know is that if you've got this greater risk for 45 different chronic conditions, there's a way that those ACEs are living on in your body now. Unless you're addressing them.
And it's the living on in your body that we want to pay attention to. So for some people, it's their immune system. And it leads to more allergies, more histamine overload, more food intolerances, maybe autoimmunity. where their immune system is attacking their own tissues, maybe autoimmune disease. There are other people who have more nervous system dysregulation.
Maybe they've got anxiety or depression or post-traumatic stress disorder, mental health issues. And for other people, it could be more endocrine. They've got chronic cortisol problems.
Which is hormones.
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Chapter 4: How can trauma impact your health and hormones?
We know that it shrinks the brain in women, but not men. Starting in midlife, starting in your 40s, it's not an old age thing. And this has been shown a couple of different ways. There was a study from the University of Texas in San Antonio showing that women in their 40s with high cortisol have a shrinkage of total brain volume.
And then Lisa Moscone at Cornell also just showed in a study looking at men and women that women with high cortisol also have shrinkage of their total brain volume. And they start to have a difficult time using glucose as fuel in their brain.
Which is going to result in what kind of behaviors?
Well, it makes you tired. It gives you slow brain energy. And I can tell for the most part you don't have that. But if you do have it, there's a way that you kind of, your brain slows down, you feel foggy, you're not able to multitask and kind of keep up with everything.
Is there a link between cortisol and trauma?
Oh, yes.
What is that link?
So for people who experience toxic stress or trauma, what typically happens is cortisol goes up. That's part of the alarm, the body's stress response. What we know is that for people who've got more serious exposure to trauma and they have post-traumatic stress disorder, those people have probably gone through a period of high cortisol and now they can't keep up anymore.
And they are in a low cortisol state.
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Chapter 5: What lifestyle changes can optimize hormone balance?
And he said, you know, listen, it's been the Christmas holidays. I had a lot of pound cake. I had some cocktails. You know, maybe that's part of the problem. But we had measured his hemoglobin A1c, which is a three-month summary of what's happening with your glucoses. Thanks for watching.
Thank you.
Thank you. Thank you.
Thank you.
Thank you. Thank you. Thank you. Thank you.
Thank you. Thank you.
Thank you. Thank you. Thank you.
Thank you.
Thank you. Thank you. Thank you. Thank you. Thank you.
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Chapter 6: How does estrogen affect both men and women?
When you say polarity, if we're talking about heterosexual relationships, what is the polarity that you think we've lost?
I would say right now in my 50s, I'm having the best sex of my life, the best orgasms of my life. And there's a lot of polarity in my relationship. And I've learned that This is pretty controversial and edgy, so I'm just going to say it anyway. I feel like for women who are professionals, who work really hard, there are some ways that polarity can be really helpful in the bedroom.
And here I'm talking about gender roles and understanding sort of what is satisfying for you sexually and asking for it in your relationship. A lot of the professional women that I know, they enjoy vanilla sex, but they also like a weave of domination.
To be dominated or to dominate?
Both. I mean, it's a personal preference, but I think there's a way that it's a way of playing with power that I think can be sexually very satisfying. What do you think? Do you think it's important in sexual relationships? to have polarity, to have like the feminine and masculine attributes? Or do you think you both just come to a sexual connection equals and that's how it should always be?
I think probably the answer is that everybody has their own favorite flavor of ice cream. And I can only speak to my favorite flavor of ice cream, which is I like... I don't like vanilla ice cream. It's not my favorite flavor. And I think I do like to be more dominant. That turns me on. And I like to vary it because I'll get bored.
Especially if you're in a long relationship, you've got to fucking find some way to spice it up. Yes, you do. I'm buying all kinds of stuff off the internet to try and, you know, keep it novel and new.
Okay, now things are getting interesting.
Are we? Yes. Well, I honestly, I landed here in LA and before I even landed, I ordered loads of stuff just to be at the house when I got here. Fantastic. It's funny because my team are listening. No, but I do because I'm like, I have, I have, I like try and plan sex to be interesting.
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Chapter 7: What are common nutritional deficiencies impacting health?
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