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Summary
On episode 490 of 40+ Fitness, Coach Allan sits down with Dr. Aviva Romm, a Yale trained, board certified family physician and midwife specializing in integrative women's health and obstetrics, to discuss her book Hormone Intelligence: The Complete Guide to Calming Hormone Chaos and Restoring Your Body's Natural Blueprint for Well-Being.
Dr. Romm argues that hormones are messengers, not the problem itself, and that too many women get handed a pill or a surgery before anyone looks at what's actually driving symptoms like heavy periods, fibroids, or PMS.
The conversation covers how to advocate for yourself in a medical appointment, what's really behind conditions like fibroids, and how to reframe perimenopause and menopause as a normal, even empowering, life transition rather than something to dread.
Links
- https://avivaromm.com
- https://avivaromm.com/book
Key Takeaways
- Hormones are messengers, not the enemy. Symptoms like PMS or painful periods are signals of an underlying imbalance, not something to just medicate into silence without asking what's causing them.
- Common doesn't mean normal. Miserable periods, constant PMS, or symptoms doctors wave off as “just being a woman” are widespread, but that doesn't mean you have to just live with them.
- Better medical care starts with preparation. Keep your clothes on for the conversation part of the visit (before the exam gown), bring a written list of concerns since doctors interrupt patients after about 60 seconds on average, and bring an advocate who can speak up for you.
- Partners should support, not side with the doctor. Dr. Romm warns against the “bro thing,” where a male partner and a male physician subtly team up against the patient instead of the partner staying focused on making sure she's heard.
- Fibroids are usually driven by high estrogen. That's often compounded by insulin resistance, stress hormones like cortisol and catecholamines, and environmental estrogen disruptors from plastics and chemicals in food packaging and cosmetics.
- Many women go straight to hysterectomy without hearing about alternatives. Studies show most patients are never told that medications can shrink a fibroid first, partly because of financial incentives built into the healthcare system that favor surgery.
- Perimenopause can run up to eight years, and it's personal. Every woman's hormone profile differs, so the right comparison isn't to a friend or running partner, it's to your own baseline over time, which is why Dr. Romm recommends keeping a symptom journal.
- Reframing menopause as empowering can reduce physical symptoms. Research shows women who approach the transition with a more positive attitude report fewer hot flashes, since chronic stress itself worsens symptoms.
- Dr. Aviva's three strategies to get and stay well: remind yourself you are not defined by your symptoms; figure out what you love and do more of it, and what you don't love and do less of it; and add in one core wellness habit, whether that's better sleep, time in nature, or movement you actually enjoy.
“There's a saying that if all you have is a hammer, you see everything as a nail. We are basically never taught to do anything but give pharmaceuticals and do surgeries when it comes to pretty much everything in women's health.”
Dr. Aviva Romm
Another Episode You May Enjoy
Episode 533 – How to use food to manage your menopause symptoms with Dr. Anna Cabeca