Episode 63: A Whole-Body Approach to Perimenopause with Dr. Julie Sarton and Dr. Alexa Charbonneau

Dr. Mary interviews pelvic floor physical therapists Dr. Julie Sarton and Dr. Alexa Charbonneau from Sarton Pelvic Healing about common perimenopause/menopause issues they treat, including urinary leakage (stress and urge), dyspareunia (pain with sex), nocturia (peeing at night), constipation, and broader musculoskeletal problems like SI joint pain and frozen shoulder. We discuss how symptoms can reappear or become “unmasked” in midlife and emphasize that while hormones matter, one-size-fits-all HRT messaging misses crucial factors such as nervous system regulation, lymphatic and gut function, fascia changes (including estrogen receptors in fascia), old injuries, breathing mechanics, and visceral/organ mobility. The conversation highlights nuanced decision-making for cancer survivors and people with conditions like endometriosis, genetic detox differences, and mast cell activation (MCAS), stressing quality of life and individualized, team-based care.What you will learn in this episode: Perimenopause can start as early as 35 and last a decadeMany symptoms they've normalized (leakage, joint pain, painful sex, brain fog, peeing at night) are treatable, not inevitableHRT is not one-size-fits-all — especially for those with endometriosis, cancer history, or genetic variants like MTHFR or APOE4How the pelvic floor is connected to the feet, jaw, neck, diaphragm, tailbone, and even cranial bonesHow there are estrogen receptors exist in fascia which may be why old injuries resurface in perimenopauseConstipation can recirculate estrogen, making hormonal symptoms worseThe lymphatic system is deeply underaddressed and may have real implications for breast healthNervous system regulation is foundational for lasting healing00:00 Episode Overview02:00 Meet the Guests05:36 Common Menopause Symptoms08:12 Dr. Julie’s Personal Journey12:43 Beyond One Size Fits All15:56 Nuanced Hormone Decisions17:48 Detox Constipation MTHFR19:08 Cancer Care and Quality20:30 Mast Cell and Gut Clues23:06 Lymph Histamine Overlap24:01 Estrogen Swings Explained24:37 Pelvic PT Full Body Care25:53 How Fascia Line Connect the Head to Feet27:48 Estrogen Receptors In Fascia29:35 Detective Work Success Stories30:33 Diaphragm And Visceral Work32:25 Constipation And Tailbone Keys34:28 Glymphatics Lymph And Drainage37:09 Nervous System Lifestyle Reset39:13 Menopause Recalibration Closing42:13 Where To Find Pelvic Healing43:25 Podcast Outro And SupportYou can learn more about Dr. Julie and Dr. Alexa’s practice: Sarton Pelvic Healing in Irvine and Southern California here:https://www.pelvichealing.comYou can follow their instagram below:https://www.instagram.com/pelvichealing/Want support for perimenopause that goes beyond hormones?Whether you (or your clients) are taking HRT but still having symptoms, not ready for it, or can’t tolerate it...there’s more we can do.I’ll be sharing practical tools from a movement and rehab perspective, focusing on the nervous system, fascia, lymph, viscera, and musculoskeletal system.If you want updates on workshops, resources, and strategies to support this phase of life more fully, would love you to join my email list.Subscribe to my email list hereI’ll see you in 2 weeks!PS:If you are interested in being a guest on the show, please fill out the form here.