🌿 Key Takeaways
- Perimenopause and menopause affect far more than hot flashes — mood shifts, sleep disruption, joint discomfort, brain fog, and weight changes are all part of the picture.
- Declining progesterone is often the first hormone to drop, directly reducing the body’s ability to manage stress and sleep — making lifestyle support essential alongside any hormone therapy.
- CBD and the endocannabinoid system share a close relationship with estrogen receptors throughout the body, and early research in estrogen-deprived subjects shows promising symptom relief.
- Vaginal moisturizers and lubricants are not the same thing — every woman in the menopause transition can benefit from a daily vaginal moisturizer, regardless of sexual activity.
- Stress management may matter even more than sleep hygiene during midlife — because unmanaged stress is what prevents sleep in the first place.
If you’ve ever felt like you were going a little crazy in your late thirties or forties — waking up at 3 AM drenched in sweat, feeling inexplicably irritable, watching the scale creep up despite doing everything right — you are not alone, and you are definitely not going crazy. You might just be in perimenopause.
In Episode 6 of Pelvic Pain Unpacked, host Tamar Hill of MedRoots — a company specializing in CBD products for pelvic discomfort relief, menopause support, muscle discomfort, wellness, and increasing pleasure — sat down with Victoria Byrd, a pharmacist, integrative women’s health coach, and certified menopause educator with over two decades of healthcare experience. Victoria is the founder of Women Mastering Midlife and the host of the Women Mastering Midlife podcast.
What followed was one of the most wide-ranging, honest conversations about what actually happens to the body during the menopause transition — and what women can do about it, including the emerging role of CBD.
How a Pharmacist Ended Up Specializing in Menopause
Victoria Byrd: When we went to pharmacy school, there was no disease state of menopause that we learned. An occasional hormone prescription would show up on a patient’s med list and we were told to discontinue it. We didn’t talk about hormones. We didn’t talk about menopause.
That started to change for Victoria around 2019, when she began looking for a way to practice healthcare more holistically — focused on prevention and lifestyle rather than simply managing symptoms with medications. Then, at 40, the symptoms hit her personally: 3 AM episodes of intense worry, hot flashes, night sweats, and irregular periods.
Victoria Byrd: The doctor I went to said, “We’ll put you on a birth control pill until you’re 50, then take you off. If you haven’t had a period in a year, congrats — you’ve gone through menopause. And here’s something for your sleep.” I felt so defeated. No one was helping me navigate what I was feeling. There had to be more and better answers.
That frustration sparked her deep dive into all things menopause — and eventually into building a practice, a podcast, and a coaching program dedicated entirely to helping midlife women thrive.
What Menopause and Perimenopause Actually Look Like
Tamar Hill: For women just stepping their toes in the waters — what are the most common symptoms you see?
Victoria Byrd: I work with a lot of women who are still in the perimenopause stage — they haven’t gone 12 months without a period yet. Some have extremely heavy bleeding. Some feel like teenagers again: losing hair, dealing with acne, mood swings, and rage. They’re seeing weight gain in ways they’ve never experienced — and in places that make them uncomfortable. And many just don’t feel joy with things anymore. They’ll say, “I just don’t get excited about life and I don’t know why.”
Beyond the more visible symptoms, Victoria highlighted several that fly under the radar:
Cholesterol and insulin resistance: Estrogen loss can trigger changes in how the body processes sugar and fat, raising the risk of pre-diabetes and type 2 diabetes.
Bone density loss (osteoporosis): Estrogen is essential for bone maintenance. Sarcopenia — muscle loss — compounds this, since less muscle means less protection and a lower calorie burn at rest.
Cardiovascular changes: Estrogen is a natural anti-inflammatory. Without it, arterial walls begin to lose elasticity. Establishing estrogen therapy within the first 10 years of menopause may help preserve cardiovascular health.
Genital urinary syndrome: Vaginal dryness, tissue thinning, and increased UTI risk affect quality of life significantly — but many women don’t bring it up unless directly asked.
Victoria Byrd: Once women get comfortable talking about it, they’ll say things like, “It hurts to use toilet paper — it feels like everything’s tearing.” These are real symptoms that deserve real solutions. The more we normalize these conversations, the easier it gets.
The Mood, Sleep, and Brain Fog Connection
One of the most misunderstood aspects of perimenopause is how profoundly it affects mood and mental clarity — and how often those symptoms get misdiagnosed.
Victoria Byrd: Mood symptoms often come first. And because doctors who aren’t versed in menopause care don’t connect it to hormones, they’ll often jump straight to an antidepressant. But the real issue may be that progesterone — your “chill hormone” — is the first to drop off in perimenopause. When progesterone stops showing up to the party, your ability to stay calm and grounded goes with it.
Sleep disruption is equally complex. Tamar shared that she sometimes lies awake processing everything she’d pushed aside during the day — that classic 2 AM download. Victoria explained what’s driving that physiologically:
Victoria Byrd: It’s multifactorial. There’s the brain that won’t stop, yes. But there’s also cortisol — our natural wake-up signal — which rises earlier as progesterone declines. And then there’s the pineal gland, which actually shrinks as estrogen diminishes. That gland produces melatonin, so you’re losing the natural signal to fall and stay asleep. Sleep is under attack and we’re being flanked on all sides.
Her practical tip for middle-of-the-night racing thoughts: keep a notepad on the nightstand. Write it all down, get it out of your head, and go back to sleep. Avoid reaching for your phone’s blue light if you can help it.
As for brain fog and memory, Victoria noted that word-finding difficulty and walking-into-a-room-and-forgetting-why moments are hallmarks of estrogen fluctuation in perimenopause. She also raised a sobering observation: women make up roughly three-quarters of memory care center residents. Whether that’s connected to decades of undertreated hormone decline — particularly in the generation after the WHI study scared doctors away from hormone therapy — is a question researchers are actively exploring.
Weight Gain, Muscle Loss, and the Metabolism Trap
If there’s one topic that unites midlife women across all backgrounds, it’s the frustration of doing everything right and still gaining weight.
Victoria Byrd: The things that worked before simply don’t work anymore. Women are undereating and still gaining weight. Part of it may even be evolutionary — the body may be storing fat as protective padding against falls and fractures when you don’t have estrogen keeping your bones dense. But the bigger issue is that our bodies aren’t processing sugar and insulin the way they used to.
The muscle loss problem compounds this further. As estrogen drops, the body loses muscle — and muscle is the body’s most metabolically active tissue.
Victoria Byrd: When you’re undereating, your body burns muscle for energy first, because muscle costs more to maintain than fat. Your body, running in survival mode, saves the fat and burns the muscle. You lose muscle at an even higher rate, which means fewer calories burned at rest. It’s a vicious cycle.
Tamar Hill: So we need to build the muscle, eat our protein, and burn the fat.
Victoria Byrd: Exactly. Eat your protein, get your fiber, drink your water, do your resistance training. And still be a human.
Understanding Hormone Therapy — Without the Fear
The 2001–2002 WHI study cast a long shadow over hormone replacement therapy, and many women today are still working through confusion and fear around it. Victoria offered some much-needed clarity:
Victoria Byrd: The population studied in the WHI was older and largely unhealthy, and the types of estrogen and progesterone used are not what’s commonly prescribed today. Women deserve good education about the safety and efficacy of modern hormone therapy before making any decision about it.
She broke down the key terms:
Bioidentical simply means the chemical structure of the hormone is identical to what your body naturally produces. FDA-approved estradiol and micronized progesterone both qualify.
Forms of estradiol include gel, patch, ring, and tablet — each with different pros and cons depending on lifestyle, cost, and personal preference.
Vaginal estrogen vs. systemic estrogen address different needs. Up to half of women on an estrogen patch still need vaginal estrogen on top of it.
Victoria Byrd: Even if you have estrogen on board, if you haven’t optimized the environment you’re putting it into — if you’re not sleeping, not managing stress, not moving your body — you won’t see the results you’re hoping for.
Pelvic Health, Vaginal Dryness, and Products That Actually Help
Victoria Byrd: A lubricant and a vaginal moisturizer are not the same thing. Even if you’re not sexually active, a vaginal moisturizer helps with everyday discomfort. That’s a recommendation I give to most women regardless of their relationship status.
One of Tamar’s nurse practitioners shared a patient story that captures this well: a woman who had never experienced discomfort during intimacy began using MedRoots’ vaginal moisturizer and pleasure product as menopause brought new dryness. Her practitioner reported back that not only was the discomfort gone — intimacy was better than ever.
Tamar Hill: Why should you shrivel up and stop enjoying your life? There’s no reason for that. With the right support — including CBD products designed for pelvic health — women don’t have to.
Victoria also touched on vaginal atrophy — tissue thinning caused by estrogen loss — and its role in increasing UTI risk and everyday discomfort. She recommended pelvic floor physical therapy as a key addition to any midlife wellness team.
CBD and Menopause: What the Research Is Starting to Show
As a pharmacist, Victoria was taught virtually nothing about CBD — and what little she was taught was negative. Her encounter with MedRoots at the Menopause Society conference opened a new door.
Tamar Hill: There’s a study on estrogen-deprived mice that I found fascinating. When given CBD, their menopause-related symptoms improved significantly. I’m not saying CBD is a cure or a replacement for estrogen — but for women who can’t or don’t want to use estrogen, it may be a meaningful complementary option.
The connection isn’t arbitrary. Estrogen receptors exist throughout the body — in the brain, the cardiovascular system, the bones, and beyond. So do cannabinoid receptors, part of the endocannabinoid system. Emerging research points to an interplay between these two systems that science is only beginning to map.
Practically speaking, CBD may support several menopause-related challenges: reducing the discomfort of inflamed joints (including the frozen shoulder that often appears with estrogen loss), improving sleep quality, supporting mood regulation, and easing pelvic and muscle discomfort. Victoria tried MedRoots’ CBD products at the conference herself.
Victoria Byrd: I gave it a whirl. It just felt nice. I didn’t have back discomfort that night.
Stress: The Real Foundation of Menopause Management
If there’s one theme running underneath every symptom in this episode, it’s stress. Victoria made a point that reorients the entire conversation:
Victoria Byrd: A lot of people say sleep is the foundation, and I agree — sleep is vital. But if you’re not managing your stress, you won’t sleep. So I almost want to put stress mitigation before sleep in the hierarchy of what matters most for midlife women.
The women Victoria works with are often senior leaders, business owners, and sandwich generation caregivers managing aging parents and teenagers simultaneously. Telling them to slow down isn’t simple — but she tries to make it accessible:
Victoria Byrd: Do a breathing exercise at a red light if you can’t add it anywhere else. Close the laptop at 8 PM. Take a 10-minute walk. We are a hustle society and we don’t know how to rest. But if we don’t learn, it’s going to catch up with us.
Navigating Menopause With Mindset and Self-Advocacy
Victoria Byrd: Mindset is a big part of it. If you walk in thinking this is the worst time of your life, it probably will be. But if you see it as an opportunity to really focus on what matters to you — your creativity, your career, your relationships, travel, whatever brings you joy — that shift has a real effect on how the transition feels.
Victoria Byrd: You’ve been in your body for decades. You know yourself better than anyone. Trust your intuition, ask questions, don’t be afraid to get a second opinion, and do the research. We are still in a stage in medicine where women have to do the legwork for their own healthcare. We’re paving the road for the next generation. Our children will thank us.
Tamar Hill: We’ve got to talk about it more. The more we normalize menopause — including pelvic health, sexual wellness, mood, and all of it — the more women can find the help they need.
Ready to Feel Like Yourself Again?
If you’re navigating menopause and looking for natural, science-informed CBD solutions for hot flashes, sleep, mood, pelvic discomfort, and more, MedRoots is here to help. Our products are designed specifically with midlife women in mind — from vaginal moisturizers and suppositories to CBD muscle creams, pleasure products, and wellness supplements.
📞 Call us: 833-797-7576 🌐 Visit us online: medroots.com/pages/contact
Don’t wait to feel better. Your next chapter deserves support.
This article is based on Episode 6 of Pelvic Pain Unpacked featuring Victoria Byrd, PharmD, integrative women’s health coach and certified menopause educator. It is for informational purposes only and does not constitute medical advice. Please consult your healthcare provider before making any changes to your health regimen.