Dr. Mindy Pelz joins SheMD for a wide-ranging conversation about fasting, hormones and metabolic health throughout a woman’s life.

Mindy explains how her approach to fasting changed after she began seeing women experience symptoms including hair loss, thyroid issues and stalled weight loss when they fasted continuously without taking their menstrual cycle into account.

She breaks down how she approaches fasting during different phases of the cycle, why she recommends easing up on fasting before a period, and how those recommendations may change during perimenopause and after menopause.

Dr. Thaïs Aliabadi and Mindy also discuss insulin resistance, PCOS, metabolic health, ketones, protein, carbohydrates and the relationship between blood sugar and hormonal symptoms.

Mindy explains what she means by “metabolic switching,” how she structures an eating window, why she discourages constant snacking and what she likes women to eat when breaking a fast.

Plus, she shares why she sees menopause not as a decline but as an opportunity for women to rethink their health, their brains and the next chapter of their lives.

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What You’ll Learn

• How Dr. Mindy Pelz's experience with chronic fatigue influenced her interest in nutrition, lifestyle changes, and women's health.
• Why she developed a cycle-based approach to fasting and what she observed when women adjusted their fasting routines around their menstrual cycles.
• How estrogen and progesterone differ in their metabolic roles, including why progesterone is associated with an increased need for glucose.
• Why the week before menstruation may call for changes to fasting and carbohydrate intake.
• How fasting strategies may differ for women who are menstruating, perimenopausal, or postmenopausal.
• What metabolic switching means, how the body uses glucose and ketones for energy, and how fasting relates to this process.
• How insulin resistance may contribute to metabolic changes associated with PCOS, including weight gain, acne, hair loss, and irregular periods.
• Why Dr. Mindy emphasizes metabolic health when discussing hormonal symptoms, brain fog, and changes in weight.
• What autophagy is and how Dr. Mindy describes its role in cellular maintenance and repair.
• Why food quality, adequate protein, healthy fats, fiber, and less frequent snacking are central to her approach to metabolic health.
• How to think about fasting duration and timing in relation to menstrual cycles and symptoms such as spotting, anxiety, and insomnia.
• Why Dr. Mindy describes menopause as an opportunity for reinvention, personal growth, and a new stage of leadership.
• How changes in estrogen may affect neurotransmitters involved in mood, motivation, memory, and emotional well-being.
• How novelty, storytelling, and exposure to natural daylight can support habits associated with cognitive health.
• What Dr. Mindy recommends considering when breaking a fast, including broth, fiber, protein, and olive oil.
• Why she believes lifestyle education should be a more central part of conversations about women's hormonal health.

Key Timestamps

00:00 Why fasting differently may change women's experiences

03:13 How lifestyle changes inspired her work in women's health

04:40 Why fasting needs to account for women's hormonal cycles

05:05 Autophagy and the origins of Dr. Mindy's fasting approach

06:30 How the menstrual cycle influenced her approach to fasting

08:24 Why fasting strategies may change during perimenopause and menopause

10:10 Fasting, cortisol, and changing needs during perimenopause

12:58 Insulin resistance, PCOS, and hormonal symptoms

14:53 Why weight changes in midlife aren't simply a matter of willpower

21:22 Why some women feel better fasting than others

23:40 The connection between metabolic health, mood, and PCOS symptoms

25:24 How long should women fast?

28:42 Why the week before your period may require a different approach

30:26 Fasting strategies after menopause

31:18 What metabolic switching means

31:44 Minerals and supplements during fasting

32:36 Dr. Mindy's fasting cycle explained

40:23 Hemoglobin A1C, food quality, and hormone-supportive foods

42:35 Why constant snacking may affect metabolic health

45:04 Why Dr. Mindy describes menopause as an upgrade

48:49 How menopause may influence the brain, people-pleasing, and leadership

51:17 Metabolic switching and brain health in midlife

52:40 Supporting mood and cognition as estrogen declines

54:29 Storytelling, memory, and cognitive health

56:04 The best foods to break a fast

58:08 Foods Dr. Mindy avoids and her perspective on hormonal freedom

59:14 The one thing Dr. Mindy wants every doctor to understand about women's health

59:41 Where to find Dr. Mindy's work

Key Takeaways

• Fasting should not be approached as a one-size-fits-all practice. Dr. Mindy emphasizes that women's metabolic and hormonal needs can change throughout the menstrual cycle and during perimenopause and postmenopause. She advocates adjusting fasting routines rather than assuming longer fasts are always better.
• The week before your period may require a different approach. Dr. Mindy explains that progesterone rises during the luteal phase and that she believes this phase calls for greater attention to glucose availability. She recommends a less restrictive approach to fasting during this time.
• Metabolic health is an important part of the hormonal health conversation. The discussion explores how insulin resistance may be associated with PCOS, changes in weight, and symptoms such as acne, hair loss, and brain fog. The guests emphasize looking beyond individual symptoms to consider broader health factors.
• Perimenopause calls for flexibility and symptom awareness. Because cycles can become irregular during the transition to menopause, Dr. Mindy suggests paying attention to changes such as spotting, anxiety, and insomnia when considering fasting. Individual needs and medical guidance are important.
• Food quality comes before extending a fasting window. Dr. Mindy recommends prioritizing minimally processed foods, protein, healthy fats, fiber, and nutrient-rich carbohydrate sources as part of her approach to metabolic health.
• Metabolic switching describes the body's use of different energy sources. Dr. Mindy discusses the shift between using glucose from food and producing ketones when food intake is reduced. She connects this process to her broader approach to fasting and metabolic health, while acknowledging that individual responses vary.
• Menopause can be a new beginning, not simply a decline. Drawing on the grandmother hypothesis and research discussed in the episode, Dr. Mindy presents postmenopause as a potential opportunity to embrace new priorities, personal growth, and leadership rather than viewing aging solely through a lens of loss.
• Brain health deserves attention during the menopausal transition. The conversation explores how estrogen changes may affect brain function and neurotransmitters involved in mood, motivation, and memory. Dr. Mindy highlights novelty, storytelling, and daylight exposure as lifestyle practices worth considering.
• Breaking a fast is an opportunity to prioritize nourishment. Dr. Mindy discusses broth, fiber-rich foods, protein, and olive oil as options she favors when returning to eating, emphasizing nutrient-dense meals rather than restrictive food rules.
• Lifestyle education should be central to women's healthcare. Dr. Mindy closes by emphasizing the importance of helping women understand their bodies, make informed lifestyle choices, and seek care that considers the broader context of their hormonal and metabolic health.