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By Peter A. McCullough, MD, MPHDoes 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 theFunctional Nurse Academy.🌿 Focal Points: Naturopathic Approaches to PerimenopauseDr. Peter McCullough interviews Melissa Schreibfeder, RN — leader of theFunctional 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 HardSchreibfeder 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 womenwill be diagnosed with hypothyroidism in their lifetimeAutoimmune conditions are “exploding”Only7% of Americansare considered metabolically healthy (per NHANES/CDC data she references)Over 40%of Americans are obese75%of chronic disease is tied to diet and lifestyleThe core physiological story: perimenopause is the body’s handoff ofsex-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 LandscapeKey points from the discussion on physiology:Early perimenopause→ erratic surges, oftenestrogen dominance(heavy/longer periods, breast tenderness, weight gain)Late perimenopause→low estrogensymptomsAdipose tissue is endocrine tissue— it secretes estrogen, so weight gain canworsenestrogen excessTheHPA axis(hypothalamus–pituitary–adrenal) is central; chronic stress causes the pituitary todown-regulatesignaling to the adrenals as a protective mechanism, producing a functional adrenal-reserve problemThyroidis deeply interconnected — McCullough notes lifetime risk of hypothyroidism is8% in men vs. 15% in women, so annual full thyroid panels matterProgesterone dropis the hormone most strongly linked to sleep disturbance💊 The Three Core Botanicals1. 🥦 DIM (Diindolylmethane)When to use:Symptoms of estrogen excess (estrogen dominance) — heavy periods, weight gain, breast tenderness, insomnia, fatigue.Mechanism of action:Rich insulfurInhibits aromatase, reducing conversion of testosterone → estrogenPromotesfavorable estrogen metabolitesvia Phase 1 liver metabolism (reducing DNA damage and cancer risk)Doesnot directly lowerestrogen — it improvesmetabolism and clearanceof 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 theHPA axis(adrenals)andtheHPO axis(ovaries)Phytoestrogenic modulator— itmodulatesestrogen rather than simply raising or lowering it, so it’s not contraindicated in high-estrogen statesExtremelynutrient-dense(antioxidants, minerals, amino acids) that fuel hormonal signalingMcCullough’s read: likely acts on thehypothalamus/pituitaryto blunt intenseFSH/LH (gonadotropin) surgesKey dosing note:The therapeutic dose studied was high at1,000 mg twice daily(2,000 mg/day total). Schreibfeder flags a common pattern — “failed” herb studies oftenunder-doseor shorten duration yielding a null result.“There was an 84% success rate in symptom relief.”3. 🌿 Vitex (Chasteberry / Chaste Tree Berry)When to use:Rebalancingestrogen–progesterone, and indirectly helping sleep (given progesterone’s link to sleep).Mechanism of action:Acts on theHPA axisto support hormonal regulationEncourages dopamine production→ lowersprolactinEnhances luteinizing hormone (LH) output→ indirectly supportsprogesterone productionHelpsrebalance the estrogen-to-progesterone ratioSchreibfeder’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 comeafterthe basics:Stress & sleep— deep restorative sleep is when estrogen metabolism happens; blue-light exposure suppresses melatoninMorning sunlight, dimming lights after sundown, circadian signalingExercise— McCullough calls aerobic + strength training the single biggest stress reliever in the literatureBreath 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 CompanyFor women who don’t want to juggle separate compounded prescriptions,Venus(fromThe Wellness Company)combinesall 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.📝Please subscribe toFOCAL POINTSas a paying ($5 monthly) or founder member so we can continue to bring you the truth.AlterAImay be used to assist in searches, synthesis, and review.Peter A. McCullough, MD, MPHChief Scientific Officer,The Wellness Company