On ‘Treated with Dr. Sara,’ Cynthia Thurlow Shares Why Perimenopause Is the Perfect Time to Pause

If you’ve ever brushed off your burnout as “just stress” or blamed your brain fog on too many tabs open, welcome to life in the 21st century. But what if those signals were actually your hormones waving the white flag? 

That’s precisely what Treated with Dr. Sara, hosted by Dr. Sara Szal, explores in an episode featuring nurse practitioner and nutritionist Cynthia Thurlow. Understanding these signs is not a cause for alarm but a source of empowerment, putting you in control of your health and well-being.

This conversation is about realizing that the midlife shift—perimenopause and beyond—can be a turning point rather than a collapse. Szal and Thurlow unpack how women can better listen to their bodies, track the right biomarkers, and start making decisions that align with their actual lives.

It’s not all in your head

Discovering that burnout isn’t just in your head can be a profound relief. It’s a validation of your experiences and a reassurance that you’re not alone in this journey.

For Thurlow, burnout wasn’t theoretical. “Ten years ago, [I was] completely and utterly burned out. Like, couldn’t do more than walking for exercise for an entire year,” she remembers. The combination of career pressure, young kids, intense exercise, and lack of sleep took a toll on her body.

The concerning part? On paper, everything looked fine. Standard lab work didn’t flag the hormonal imbalances—progesterone running low, cortisol spiking high—that were fueling her exhaustion. “Because we coexist in this space of silence, the aging process is this silent process,” she explains. That silence often leaves women feeling isolated and confused.

The power of pausing

Instead of powering through, Thurlow eventually took the cues her body was giving her. “This healthcare hiccup, these symptoms that my body was demonstrating to me were showing me that that word ‘pause’ that we don’t reflect enough on was something that I needed to start focusing on,” she says. This ”pause” isn’t a setback. It’s a powerful tool for self-reflection and growth, inspiring you to make positive changes in your life.

The break turned into a career pivot for Thurlow. She left traditional medicine, built a new practice grounded in functional and integrative care, and began teaching women how to catch burnout before it spirals.

The concept of pause isn’t just about health—it’s about alignment. As Szal puts it, “alignment, purpose, and meaning become incredibly important” in midlife. If something in your life feels like trying to fit “a square block into a round hole,” it may no longer belong.

Biomarkers that matter

Burnout can feel emotional, but it often shows up in measurable ways. Thurlow says she wishes she had tracked more biomarkers early on, especially fasting insulin. “Because we can predict way ahead of time,” she notes, adding that many women dealing with things like PCOS or gestational diabetes are already carrying risk factors that don’t appear on standard checklists.

She also points to heart rate variability, or HRV, as an underused indicator. “Over the course of a week, what’s your average heart rate variability?” she asks hypothetically. “That may seem trite, but I find for myself, even looking at what the impact of travel is, what the impact of stress is.” When these numbers dip, it’s a sign the body isn’t bouncing back.

Choosing alignment in midlife

Thurlow admits she used to thrive on chaos, calling herself a “reformed adrenaline junkie” who deliberately chose the most complex, most stressful paths. But those patterns no longer serve her.

Now, she frames midlife as an initiation. “Perimenopause, menopause, period, like the word pause is so important for us as women to process,” she muses. “It is a time in our lives to reevaluate everything in our lives, as painful as that can be.”

Her new approach involves only saying yes to opportunities, people, and commitments that feel like a “whole body yes.” This means that when you’re faced with a decision, you should consider how your mind, body, and spirit respond. As she puts it, “When you get to a certain stage in life, it’s either a hell yes or it’s a hell no.”

Moving beyond survival mode

Burnout doesn’t have to define midlife. Instead, it can be the wake-up call that shifts women into alignment—with their health, their families, their work, and themselves. That’s the takeaway from this episode of Treated with Dr. Sara—burnout is not a failure, it’s a signal. With the proper awareness, the right biomarkers, and the courage to pause, women can turn this chapter into their strongest yet.

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