125 - Tolerance & Truth: The Threshold of Perimenopause
What if losing tolerance isn’t a problem, but an invitation to be more sensitive to our truths? And, if we do take active measures (through hormone support or nervous system work) to improve our range of tolerance, can we use that to stay steady in our selves while standing up for what really matters?
In this mini-musing, Sarah explores the deeper meaning of “tolerance” through the lenses of perimenopause, nervous system regulation, relationships, hormones, breathwork, and emotional truth. As many women move through midlife and begin noticing less patience for what once felt manageable, Sarah asks an important question: are these shifts something to support so they don’t feel so hard, or a threshold to really to listen to? Or, perhaps is there a sacred third where we can find support and keep our sensitivity to truth.
This conversation weaves together the science of estrogen, CO2 tolerance, nervous system capacity, relational dynamics, and emotional authenticity; all pointing toward a deeper inquiry about truth, integrity, and what happens when our bodies stop helping us override ourselves.
Rather than framing increased sensitivity as dysfunction, Sarah invites us to consider how support, regulation, and greater capacity might help us attune more honestly to our lives instead of bypassing what’s real.
In this episode, Sarah explores:
Perimenopause and changing emotional tolerance
The relationship between estrogen, mood, and relational appeasement
Why many women begin reassessing relationships and patterns in midlife
The difference between bypassing discomfort and building capacity
Window of tolerance, nervous system regulation, and resonance
CO2 tolerance and how breath affects clarity, stress, and emotional regulation
How hormones influence perception and emotional intensity
Why increased support should help us access truth — not suppress it
The connection between authenticity, boundaries, and integrity
Learning to respond to whispers before life requires a “Mack truck” moment
Episode Transcript:
[00:00:00] Hello and welcome to Threshold Moments. Today, we have a mini-musing. So Threshold Moments is all about the times in life where the things that once worked no longer worked. They're about those times where something in our identity starts to crack open, and accompaniment and possibly tools and recognition and orientation can be super helpful.
So the mini-musings fall more in alignment with orientation and tools and things that can be helpful as we move through thresholds, but in this case, even day-to-day life. So today, I wanted to talk about tolerance. Whoo. I am forty-three years old, and I am at the beginning of [00:01:00] perimenopause. And many women that I work with who are going through perimenopause are noticing waves of rage or for me, at the end of my cycle, closer to the end of my cycle, the period is much longer at the end of my cycle in which I feel less tolerant.
And some people might say that we're a little less tolerant of the BS that we used to put up with. And what I have found interesting as I am in circles where people are trying on bioidentical human... Excuse me, bioidentical hormone therapy is this inquiry of, do I still get the medicine out of this period of life?
Meaning, do I still get the lessons that come from a time in life where you [00:02:00] start to have less tolerance for the things that aren't actually good for you? So when our estrogen drops, our... What should I say first, actually, is that estrogen is a hormone that is really useful in supporting serotonin, dopamine, and mood regulation.
It's what we might call a relational tolerance hormone. One could say it might even mask how you really feel in order for you to feel like you belong, to pair up with somebody, even if it means quieting parts of yourself that are like, "Actually, that's not cool with me. Actually, I don't like that." So if you think on an evolutionary perspective, when you hit puberty and when you enter your fertile years and when your estrogen [00:03:00] rises, this is a time if it were for, you know, your species living and continuing on, that reproduction would be a priority.
Maybe not for anyone in- individual, but for, uh, how our systems have survived over time. So as estrogen increases, and it's this relational hormone of often pleasing and appeasing, we might find as we get older that we could look back and go like, "Why did I say yes to that?" Or, "Man, I used to really push over for these other things, and I'm not here for it anymore."
I heard one doctor who was on a very, very popular podcast of another doctor, and she apparently is the leading doctor in, in hormone replacement therapy, especially for women. And she said the reason why it hasn't been tested as much [00:04:00] as therapies for men is because it's predominantly men who are funding the testing and who are doing the testing, and that men's systems are more predictable and easier to test if they are relatively the same day to day versus a woman, a woman who is cyclical.
The, the thing she wanted men to listen to at the end was to say, "Hey, listen, the majority of divorces happen during the time that a woman is in perimenopause, and there's so much research to show that marriage is actually more beneficial for men. Men live longer when they're married. Men make more money when they're married.
So hey, men, if you wanna stay healthier, live longer, and make more money, start taking women's health seriously, and let's really look at the studies of [00:05:00] how we can support them." So this woman was a huge advocate of women using progesterone and estrogen as they, you know, as they go forward in age. And she could tell you all of the benefits way beyond mood that it can help with.
I am not a specialist in this. I cannot do that right here and now. Here's what I thought was interesting. I listened, and I was like, "This is so interesting," because if you were to listen to Elizabeth... What is her name? She, she wrote Eat Pray Love.
All right, we'll do a little edit right here. If you were to listen to some women speak, hmm Okay, here's the edit. I have heard multiple people, Professor Galloway is one in particular, who has studied ... who has cited many [00:06:00] studies in which it shows that it benefits men more to be married to women. So obviously these are studies that are looking at relationships between men and women, and I'm actually very curious how that would change if it was between a woman and a woman, or a man and a woman, or someone who is non-binary.
But for right now, this, this is the research and the studies that they have. And Liz Gilbert also bringing forth saying it does not benefit a woman to be married, and here's why, and here are the studies, and here's what it shows. A woman's gonna be happier, she's gonna be healthier, she's gonna make more money if she's not married.
The reason why Professor Galloway was saying this, he's like, "I think men should buy the meals when they, when they go out with their dates and when they get married, because it benefits them more than it benefits the woman for them to be together." This is [00:07:00] slightly a side step, but only to say that when I listen to this woman say that we should take female health more seriously because it would benefit men because then they would be married longer and live longer and make more money, I was like, "Oh, so interesting."
Because what this shows is that a woman is giving up her life force energy often in order to support a man in a heterosexual relationship. And if most divorces are happening during perimenopause, I could see there being a few reasons for this. I could see that our ancestors generally only lived into their 40s, so there's one theory that marriage, when you say, "Till death do us part," would only really last 15 years and that humans tend to really change every 10 to 15 years, so that it is a unique thing for [00:08:00] both partners to live so long and to kind of have to regenerate who they are every 10 to 15 years and say, like, "Are we still a match?"
The other one being when our tolerance lower- lowers for BS, and when we start to notice, like, that really pisses me off, and that really pisses me off, and that pisses me off, do we ask our partners to step up? And do they step up? And often when we start to notice all of the things that we said yes to before, there can be some grief and some sadness.
And when we finally feel the anger, the anger can be so high and so hot. This episode on tolerance is not just about perimenopause and whether or not somebody should be taking, you know, additional supplements or h- doing hormone therapy. I'm interested because I'm like, "Oh, can we have both? Is there a sacred third [00:09:00] where you could have support so the ups and downs don't feel so massive, but we can still attune to who we are, what's true for us, and use the extra support to step into that truth, not to mask our truth again?"
When the nervous system was being studied more on the Western way, right? We could say our ancestors, without using the phrase nervous system, knew how to discharge anger, how to be with grief, how to move joy. But when it was studied more in the form of like, "Ooh, this isn't just a mind thing. There are patterns happening in the body," Peter Levine and Dan Siegel
I believe it's Dan Siegel's term, the window of tolerance. Peter Levine then used it on his maps, and said that the window of tolerance is where you can really [00:10:00] tolerate all the stresses and joys in your life. So for some people, that window of tolerance is gonna be quite small, right? Their demands are so much higher than their resources, and they might yell quicker, they might flip out more easily because of their past and how they're wired or their current scenarios.
So the goal often in nervous system work is can we widen that window of tolerance? That same thing is often, more often now called the range of regulation, and updated again, b- called the range of resonance. I first heard that from Tel Darden because she said the word regulation is often overcoupled with control, and like, oh, you know, I don't wanna do this work to feel controlled, like, more in control of my body, more controlled by others.
Another field where the word tolerance is used is with breath. [00:11:00] In the science of oxygen and CO2 of our body, we have this idea of CO2 tolerance. So most of us, when we think of CO2, we think of it as a toxin that we wanna get out of our body, and we take these big breaths hoping that more oxygen will come in.
But the funny thing is, and the interesting thing is, that actually the hemoglobin that carries the oxygen through our body is about 97% saturated with oxygen. And so for the most part, it's not that we need to take a bigger breath so that We have more oxygen. We are already actually have what we need.
That's a thought in and of itself. It's more how do we get that oxygen to go into our brain and our muscles and our organs? [00:12:00] How do we get it to be useful?
So CO2 tolerance, what happens, I'll just break this down a little bit, is that, um, when we're stressed, we'll actually over-breathe. So when we're stressed, our bodies will do more output, almost like they're running away from something or fighting something. So the other side of ATP is that CO2 output, and that is acidic, and our body can't handle that much of it.
Our body really wants to stay as close to neutral as possible. I believe it's as close to 7.4 as possible. I'd have to actually look this up, where I think it's like if you go to 7.37 or 7.42, like that little bit of a change would be too much for the body, and the breath is the number way to... number one way to bring it back.[00:13:00]
So when you're stressed, you're gonna be more likely to be creating more CO2 in your body, but then you'll start to over-breathe. So when you think about that like, uh, like a panic attack or even just a chronic over-breather, which is breathing through the mouth where a lot of CO2 goes out. So we'll do a whole episode on why we breathe through the nose, but right now, we breathe through the mouth.
We try to get like more and more CO2 out, and we actually get rid of too much CO2. It can lead to headaches. It can lead to a sense of tingling in the hands. It can lead to brain fog. It can lead to tightness. It can lead to a hard time sleeping. So the irony being that actually we often need to breathe less.
When we breathe less, we begin to build our tolerance for CO2. When we can keep the right amount of CO2 in our body, and perhaps even [00:14:00] like a tiny, tiny bit more, then the oxygen loses its affinity for the hemoglobin and will drop down into the muscles. So again, in our bloodstream, we have enough oxygen, but when the CO2 is high, if we cannot immediately get rid of what's uncomfortable...
Think about how the truth this is in life, right? If we don't immediately get rid of what's uncomfortable, but we can have the tolerance to be with it a little bit, then we get more of the wisdom. We get more of the oxygen. I went from metaphor to science, right? More of the oxygen drops in. And we get clear thinking.
So the... There's CO2 tolerance. There you could think of, like, tolerance to what is slightly toxic. This is just really interesting to me, and I am unsure if this is [00:15:00] coming through clearly to you, too. The inquiry and the thing that I'm coming around and getting to is like, oh, do we want tolerance? Do we wanna tolerate things that are toxic?
And/or do we have a big enough capacity? Can we grow our capacity and nurture our capacity to be with what is hard? And let's not call it toxic. To be with something that is just a little bit beyond neutral so that it brings more clarity, so that we get more fueled for, like, what is the next right action.
And so I wonder this, too, with perimenopause. I don't think that there's a right or wrong way to do it. I do think the way to look at it is w- if I were to take hormone replacement, can I use that to bolster myself[00:16:00]
so that I can really be with myself, so that I can really attune to my own existence, to this state in life, to this stage in life? And wouldn't it be so great if I'm not bothered by the tiny things, but that I can be sensitive enough to notice where the friction is and to make changes when I hear the whisper and not have to wait for a Mack truck, not have to wait to be overthrown by it?
Many years ago, I was going for a walk with Kate Northrup, and it was... I was newly postpartum, and I was very aware of hormones in the body, and not in the way that we're talking now, but more in the way of how cells all throughout our body have receptor sites, and depending on the ligands that go through and what the receptor sites take in change our emotions, [00:17:00] and whatever our emotions are tend to change how we perceive life and how we filter out what is true and what's not true.
And so I was like, are emotions even real anyway? Like, our hormones are changing and going up and down, and can I even trust my emotions? And she said the most magnificent thing to me. She said that Deb Kearns, now a mutual friend of ours, uh, who has been a friend and mentor of Kate's for a long time, I think she said since she was young, said to her, "You can trust your emotions.
You just can't always trust the volume." And so since I am still a cyclical being right now, I can kind of track when my emotions get big, and I can track the things that I'm like, "Ugh, I don't like that" at certain times that I might not notice at other times. And when I have more tolerance would be a time that I could go forth and have the conversation.
I'm gonna weave in one more thing. [00:18:00] In the world of psychedelics, MDMA, which is not necessarily psychoactive in that way, it is more that it changes your hormones so that you feel a different way, is often used for PTSD, and it is often used with couples. And the reason why, to my understanding, that it is so effective is that you are able to visit these challenging conversations or these very hard times in life, but now your system is being bolstered by serotonin and dopamine and oxytocin.
And oxytocin is the love hormone, and it is the relational hormone that, uh, makes you feel like you're bonding. Uh, on the other side of this, on the other side of these journeys, these things do tend to plummet quite a bit 'cause your body has released all the stores. So in a professional setting, MDMA, which is also known as Molly or [00:19:00] ecstasy in a professional setting, you will have proper supplementation before, during, and after to again help you with this big up and down.
But now again, think, like this gives you more tolerance to be in a really hard conversation or to th- think something through. So say we're like my husband and I, and we have this really hard thing to talk about, but both of us have low tolerance. We haven't slept enough, we're overworking, and we go at this thing, and we're both feeling heated.
Both of us have what we could call like hot amygdalas, and our prefrontal cortex is not online. Now, if we came from a place of high tolerance, say we've done our breathwork, and we have high CO2 tolerance, and, uh, I'm at a place in my cycle where maybe I have more tolerance, and he has had a day off of work, and he's worked out, and then we go to have the same conversation, we're gonna have a different outcome.[00:20:00]
So what I would say with tolerance is as our tolerance, as we grow our capacity to have greater tolerance, to not use that as a way to now start bypassing the way that we often did when we were young, when our survival depended on belonging and people liking us and wanting and needing to feel worthy and loved.
We still will have those inherent desires But what might be at the forefront even more would be truth, authenticity, and integrity.
So here we are. We've covered perimenopause and hormones. We have covered CO2 tolerance. We have covered MDMA. And again, just this theme of tolerance, and I actually feel so much clearer now that I've walked through this with you, that it's not an either/or. Tolerance is not an [00:21:00] either/or. As we grow our tolerance, whether it is through support of hormones or for those who are struggling with depression or anxiety and it's medication, or maybe it's through breathwork or working out, may we use that increase in tolerance to stand for what matters to us, not to bypass what is true.
Thank you so much for listening.