By Peter A. McCullough, MD, MPH
Does every woman have to go on prescription/compounded hormones (estrogens, progestins, testosterone) as menopause approaches? If your are looking for a non-pharmaceutical approach, then this show is for you featuring Melissa Schreibfeder, leader of the Functional Nurse Academy.
🌿 Focal Points: Naturopathic Approaches to Perimenopause
Dr. Peter McCullough interviews Melissa Schreibfeder, RN — leader of the Functional Nurse Academy. As a practicing doctor, McCullough questions the widespread use of prescriptions to manage a the “natural process” of menopause—he believes there must be a more natural way.
🔍 The Big Picture: Why Perimenopause Is So Hard
Schreibfeder opens with the reality that women in the U.S. are struggling through this transition because they enter it already depleted. She cites:
1 in 8 women will be diagnosed with hypothyroidism in their lifetime
Autoimmune conditions are “exploding”
Only 7% of Americans are considered metabolically healthy (per NHANES/CDC data she references)
Over 40% of Americans are obese
75% of chronic disease is tied to diet and lifestyle
The core physiological story: perimenopause is the body’s handoff of sex-hormone production from the ovaries to the adrenal glands. For many women, that handoff is anything but smooth — especially when compounded by stress, nutrient depletion, gut dysfunction, and environmental toxic burden.
🧬 The Hormonal Landscape
Key points from the discussion on physiology:
Early perimenopause → erratic surges, often estrogen dominance (heavy/longer periods, breast tenderness, weight gain)
Late perimenopause → low estrogen symptoms
Adipose tissue is endocrine tissue — it secretes estrogen, so weight gain can worsen estrogen excess
The HPA axis (hypothalamus–pituitary–adrenal) is central; chronic stress causes the pituitary to down-regulate signaling to the adrenals as a protective mechanism, producing a functional adrenal-reserve problem
Thyroid is deeply interconnected — McCullough notes lifetime risk of hypothyroidism is 8% in men vs. 15% in women, so annual full thyroid panels matter
Progesterone drop is the hormone most strongly linked to sleep disturbance
💊 The Three Core Botanicals
1. 🥦 DIM (Diindolylmethane)
When to use: Symptoms of estrogen excess (estrogen dominance) — heavy periods, weight gain, breast tenderness, insomnia, fatigue.
Mechanism of action:
Rich in sulfur
Inhibits aromatase, reducing conversion of testosterone → estrogen
Promotes favorable estrogen metabolites via Phase 1 liver metabolism (reducing DNA damage and cancer risk)
Does not directly lower estrogen — it improves metabolism and clearance of it
“It doesn’t directly lower the estrogen levels. It helps with the metabolism.”
2. 🌱 Maca (Lepidium meyenii)
When to use: Broad support across perimenopause, menopause, and post-menopause.
Mechanism of action:
Adaptogenic — supports the HPA axis (adrenals) and the HPO axis (ovaries)
Phytoestrogenic modulator — it modulates estrogen rather than simply raising or lowering it, so it’s not contraindicated in high-estrogen states
Extremely nutrient-dense (antioxidants, minerals, amino acids) that fuel hormonal signaling
McCullough’s read: likely acts on the hypothalamus/pituitary to blunt intense FSH/LH (gonadotropin) surges
Key dosing note: The therapeutic dose studied was high at 1,000 mg twice daily (2,000 mg/day total). Schreibfeder flags a common pattern — “failed” herb studies often under-dose or shorten duration yielding a null result.
“There was an 84% success rate in symptom relief.”
3. 🌿 Vitex (Chasteberry / Chaste Tree Berry)
When to use: Rebalancing estrogen–progesterone, and indirectly helping sleep (given progesterone’s link to sleep).
Mechanism of action:
Acts on the HPA axis to support hormonal regulation
Encourages dopamine production → lowers prolactin
Enhances luteinizing hormone (LH) output → indirectly supports progesterone production
Helps rebalance the estrogen-to-progesterone ratio
Schreibfeder’s framing: estrogen is beneficial (bone health, etc.), but without enough progesterone to balance it, “it’s like estrogen gone wild.”
⚙️ The Foundations First (Non-Negotiable)
Both agree botanicals come after the basics:
Stress & sleep — deep restorative sleep is when estrogen metabolism happens; blue-light exposure suppresses melatonin
Morning sunlight, dimming lights after sundown, circadian signaling
Exercise — McCullough calls aerobic + strength training the single biggest stress reliever in the literature
Breath work, gratitude, prayer/spiritual practice — Schreibfeder notes this is actually evidence-based
“Drainage pathways” open — daily bowel movements before any detox protocol (water, fiber, magnesium)
Foundational nutrients — magnesium glycinate (minimum~450 mg/day, not oxide), vitamin D3 + K2 (McCullough’s go-to: ~10,000 IU D3 + 200 mcg K2; he notes K2 works on the RANKL ligand, the same target as Prolia), and a broad women’s daily multivitamin—McCullough likes GNC Womens Active
🎁 Venus from The Wellness Company
For women who don’t want to juggle separate compounded prescriptions, Venus (from The Wellness Company) combines all three of these botanicals — DIM, Maca, and Vitex — plus additional supportive ingredients into a single formulation, targeting perimenopausal symptom relief through the natural mechanisms described above rather than jumping into hormone replacement therapy with no end in sight for these prescription drugs.
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Peter A. McCullough, MD, MPH
Chief Scientific Officer, The Wellness Company
