Perimenopause, Menopause & Your Metabolic Health: A Conversation With Dr. Tanmeet Sethi, MD

We recently hosted an incredible live Q&A inside The Blood Sugar Method with Dr. Tanmeet Sethi, MD. Dr. Sethi is an integrative family physician, menopause expert, TEDx speaker, and author of Joy Is My Justice. Her work blends science, compassion, and decades of clinical experience supporting women through hormonal transitions and midlife metabolic changes.

This was one of our most engaged events to date. Women asked real questions about symptoms, hormones, weight changes, stress, sleep, and metabolic health. Dr. Sethi generously shared practical, science backed strategies that you can apply right away.

If you are new to our community, learn more about The Blood Sugar Method here.

Why Midlife Feels Different: Dr. Sethi’s Foundation

Dr. Sethi began by explaining something many women feel but rarely hear clearly from their doctors:

Midlife shifts in estrogen have a profound impact on:

• insulin levels

• muscle mass

• bone density

• abdominal fat storage

• inflammation

• cravings and appetite

• sleep and stress hormones

If you feel like your body is changing faster than you can keep up, it is not your imagination. These biological changes make metabolic health more vulnerable and make weight loss harder than it was in your twenties and thirties.

Her reminder: It is not your fault. You are working against real physiological forces.

Three Lifestyle Anchors That Matter Most

Dr. Sethi emphasized three powerful, foundational tools for better metabolic health in perimenopause and menopause.

1. Protein and Fiber at Every Meal

Not for dieting, but for stabilizing blood sugar, supporting muscle, and lowering insulin.

2. Prioritizing Sleep

One night of poor sleep raises cravings and blood sugar the next day. This becomes even more sensitive in perimenopause.

3. Honor Your Cellular Clocks

Every organ has a clock, not just your brain. Your pancreas is less insulin sensitive at night, which means nighttime snacking or late eating can have a bigger impact on glucose and weight gain.Aim for twelve hours between dinner and breakfast whenever possible.

The Role of Stress

Dr. Sethi shared personally that caregiving stress has deeply affected her own metabolic markers. Stress raises cortisol, which directs fat storage to the midsection and impacts blood sugar.

Her message was powerful: You cannot out exercise or out diet chronic stress. Care, boundaries, movement, meditation, and rest are all part of metabolic health.

Your Questions Answered

Our members asked about:

Preparing for perimenopause in your 40s

Build habits now: protein, fiber, movement, balanced plates, circadian eating, and sleep.

Distinguishing hormonal symptoms from thyroid issues

If thyroid labs are stable but symptoms persist, perimenopause may be the cause.

Abdominal fat that seems impossible to lose

This is extremely common and linked to declining estrogen and rising cortisol.Strength training, protein, circadian eating, and sometimes medication support can help.

Muscle and joint pain

Turmeric with black pepper, fish oil, movement, sleep, and hormone optimization can provide relief.

HRT timing

Dr. Sethi noted that the best time to start HRT is when symptoms are interfering with your quality of life and when it is safe based on your individual profile.Some women benefit from progesterone alone during perimenopause, while others may need full HRT.

Fasting insulin as an early marker

Fasting insulin often rises long before A1C. Dr. Sethi likes fasting insulin below 10, with 6 or lower being ideal.

The Blood Sugar Method x Dr. Sethi

We are deeply aligned with Dr. Sethi’s mission. Our members consistently improve A1C, stabilize energy, reduce abdominal fat, and make sense of their symptoms using simple, sustainable lifestyle practices.

Inside The Blood Sugar Method you get:

Live sessions like this one

Cooking classes

Monthly metabolic meal plans

Expert workshops

Direct support from our team

A private community of women going through the same transitions

Recordings of every event, including this full conversation with Dr. Sethi

Learn more & join us here to watch the recording of Dr. Sethi's event, plus all of our other events, too!

Bonus: Ask us questions in the community, and we will respond within a few hours with detailed, thoughtful, personal responses. All part of the membership.

Explore more of Dr. Sethi’s work and writings here.