Glucagon

The Key to the Exit Doors

“Doc, if insulin is the key that opens the entrance doors to our cells, what hormone owns the keys to the exit doors?”

That would be glucagon. And once you understand it, fat loss in midlife stops feeling mysterious and starts feeling predictable.

The Gatekeepers of Langerhans

A village once built the most magnificent food storage system in the world.

Every home had a pantry.
Every barn had a cellar.

Every family had barrels of grain, smoked meat, and jars of preserved fruit lining their walls.

At each end of the village stood gatekeepers.

The first gatekeeper was named Beta of Langerhans.

His job was simple: whenever food arrived at the village gates, he unlocked the entrance so the workers could carry it inside safely. This was critical because food left sitting in the streets would rot, poison the water supply, attract rats, and destroy the village.

So when food arrived, Gatekeeper Beta opened the entrance doors to the village, gestured with his arms, and said:

“Freely enter!”

The workers obeyed and freely carried food into the villagers’ homes for immediate use.

But sometimes there was too much, the excess had to go somewhere. So the workers carried the overflow into giant storage pantries beneath the village:

They first filled the B pantry.
Then the H pantry.
Then the C pantry.

At first, this system worked beautifully, until there was just too much food arriving and the pantries became full.

The workers stopped listening to Beta because there was nowhere left to store the food. They left most of the food at the village’s entrance.

Beta of Langerhans did all he could do, and that was to hold the gates open with all his might until he was exhausted.

And the villagers could barely walk through town because the road was full of food, and the storage rooms had become so swollen there were bulges everywhere.

Then, one really bad winter, something unexpected happened.

The food carts stopped arriving.

For the first time in years, Beta of Langerhans rested.

And when he rested, the second gatekeeper finally had to do its job. His name was Alpha of Langerhans.

When no food arrived through the entrance gate, his job was to open the pantry doors. You see…

Beta opened the entrance doors.
Alpha opened the exit doors.

He carried a ring of old iron keys that unlocked the storage pantries beneath the village. And as he walked through town…

He opened the Belly pantry.
Then the Hip pantry.
Then the Chest pantry.

Stored food finally began leaving the dark cellars to feed the village.

The people grew…

Leaner.
Stronger.
Clearer in mind.

And the villagers realized something they had forgotten long ago:

“Their village was never designed to constantly store food. It was designed to alternate between using new fuel and using stored fuel.”

The Lesson

Insulin is produced by the Beta Cells within the Islets of Langerhans in the pancreas. Insulin opens the entrance doors to our cells, letting the fuel in as glucose.

Insulin is the gatekeeper that unlocks the entrance doors to our cells, allowing blood sugar to leave the bloodstream and enter the cells safely.

Without insulin, blood sugar becomes dangerously elevated, which is toxic to the body.

But when we constantly overeat, especially processed carbohydrates and sugar, insulin never gets to rest. The excess fuel is continuously stored in the fat pantries throughout the body: belly, hips, and chest.

Glucagon is Alpha, the other gatekeeper. It unlocks the exit doors to our storage pantry cells. It releases stored fat back into circulation so the body can burn it for energy.

But glucagon has one non-negotiable requirement:

“Glucagon only rises when insulin falls.”

This is the most important sentence in this chapter. Perhaps in this entire book.

That is why the goal of the Meso-Menu is not simply to eat less. It is to bring insulin levels down long enough and consistently enough for glucagon to finally open the storage rooms. When it does, your body begins releasing the fuel it has been hoarding, possibly for years.

How to Activate Glucagon Safely

To release glucagon, you do not need to suffer.
It does not require deprivation.

It requires space, consistent, intentional gaps between meals where insulin is allowed to fall.

1. Create Gaps Between Meals

Fat burning happens between meals, not during them. Every time you eat, insulin rises. To raise glucagon, insulin must fall. This means fewer meals, no snacking, and intentional gaps of four to five hours between eating. The pause between meals is not wasted time. It is where the work happens.

2. Eat Protein

Animal protein is the only food that raises glucagon, and it minimally raises insulin, if at all, provided it is not consumed in excessive quantities at once.

This is why protein-first meals are so effective at unlocking fat release. The protein signals glucagon while moderating insulin’s rise. The result is a hormonal environment that favors fat burning over fat storage.

3. Eliminate Liquid Calories

Liquid calories spike insulin rapidly and completely. Smoothies, fruit juices, sweetened coffee drinks, sodas, even the ones marketed as healthy, shut the door on glucagon immediately. They are not food in the hormonal sense. They are insulin triggers.

4. Walk Between Meals

Gentle movement while insulin is low amplifies glucagon’s effect. Walking is not about burning calories. It is about hormonal signaling that tells your body that it needs to access stored fuel for movement. A 10 to 15-minute walk between meals, when insulin is falling, meaningfully enhances fat release.

5. Protect Your Sleep

Poor sleep raises insulin resistance by the following morning. Better sleep lowers insulin the next day, which gives glucagon room to rise throughout the day. Sleep is not passive. It is metabolic leverage, and its effects on glucagon are direct and measurable.

6. Relax

Stress causes cortisol levels to rise, helping you fight or flee. For you to throw punches or run fast, you’ll need fuel. The body automatically releases insulin when cortisol spikes. Cortisol spikes occur whether you are mentally or physically stressed. That’s why strenuous exercise is not a weight loss tool.

You now know about the insulin-glucagon seesaw. If insulin is up, you are in a fat-storing state. If insulin levels are low, glucagon is released. Glucagon places you into a fat-burning state.

So what is our favorite way to bottom out insulin, top out glucagon, and switch from fat-storing to fat-burning?

INVITATION

Hi, this is Vicky Mac. I’d like you to become a member of Doc Mac’s Substack. To learn my favorite glucagon-releasing tool, and Doc’s, too, upgrade to a paid subscription. I think mine is better, but he has had a lot of success with his. And I’d love for you to learn more about his system.

You can do so at www.HopeForMenopause.com

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The Fat-Storing Hormone

“Doc, I barely eat. I eat clean. I have tried every diet known to women. So why, now that I am in menopause, won’t this excess weight budge?”

Once you enter menopause, your ovaries stop producing many of the hormones that once made fat burning easier.

And here is the difficult truth:

“You cannot burn fat without fat-burning hormones.”

To lose menopausal weight, you must learn to play a different game.

I call it the Insulin-Glucagon Seesaw Game, and it is the most consistent fat-burning strategy I have found during menopause.

And remember:

Menopause begins the moment estrogen misses its mark and ovulation no longer occurs.

OPEN UP!

It was Halloween in the late 1960s.

I had already made it home before curfew. My pillowcase, my candy bucket of choice, was heavy, but not full. There was still room.

There is always room when you are a boy chasing Almond Joys.

Children were still trick-or-treating in the neighborhood, so I asked Mom if I could make one more quick pass through the streets behind our house.

To my surprise, she said yes.

I slipped through the backyard, down the alley, and along the dirt path leading to Phoenix Avenue.

Most porch lights were already off.

No light meant no candy.

Simple rules.

But one house still glowed in the middle of the block.

I walked onto the porch and knocked.

Suddenly, a group of teenagers appeared behind me.

They dumped a pile of garbage into the front yard.

I froze.

One of them splashed lighter fluid onto the pile.

Another lit it.

I started pounding on the front door.

OPEN UP!

I could hear movement inside.

Voices.

I pounded harder and yelled louder.

OPEN UP!

But no one opened the door.

When I turned around, the fire had exploded into towering flames.

The teenagers disappeared as quickly as they had arrived.

Only their laughter remained.

I ran home as fast as I could.

The Moral of the Story

Insulin is the key to your cellular entrance doors.

When blood sugar rises after a meal, your pancreas releases insulin.

Insulin unlocks your cells’ entrance doors so glucose can move from the bloodstream into the cell, where it can be used for energy.

Without insulin, blood sugar would rise to toxic levels.

But as we age and gain weight, insulin often has a harder time unlocking those cellular entrance doors.

This is called insulin resistance.

When insulin struggles to open the doors, blood sugar remains elevated.

The higher the blood sugar rises, the more damaging it becomes.

“Chronically elevated blood sugar slowly caramelizes the body from the inside out.”

In response, the pancreas releases even more insulin.

The knocking becomes louder.

Harder.

More desperate.

Eventually, the cells stop listening.

A QUICK NOTE FROM DOC

Next week, I am writing about something every woman in her Third Act needs to understand. Your fat cells have exit doors.

Most women never find them, not because they lack willpower, but because nobody ever showed them where to look.

Next Monday, I will show you exactly how to open those doors and teach your body to burn fat as its primary fuel — so that slenderness in your Third Act is not a struggle. It is simply what happens.

That article is free. But only if you are subscribed.

Subscribe below, it takes 30 seconds, and it will be waiting in your inbox Monday morning.

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And if this article resonated with you today, tell me in the comments. I read every one of them. Your words let me know I am writing the right things for the right people.

The Train Whistle

22 Years ago, I built a home near a lake.

What I did not realize when I purchased the property was that an Amtrak station sat nearby.

Every night, trains passed through the station, blowing their whistles.

Some engineers apparently believed they were auditioning for a Peter, Paul, and Mary song.

At first, the whistles were annoying.

But over time, Vicky and I stopped hearing them.

Our brains adapted.

That is insulin resistance in metaphor form.

But when guests stay overnight, they almost always mention the whistles the next morning.

“You can hear those train whistles blow from 100 miles!”

That is insulin sensitivity.

Sensitive cells hear insulin.

Resistant cells no longer do.

What Happens During Insulin Resistance

Your Fat Cells Become Inflamed

High insulin levels cause fat cells to enlarge.

As fat cells expand, immune cells called macrophages move in and release inflammatory proteins called cytokines.

What was once simple fat storage becomes a chronic inflammatory event.

A Silent Battle Begins

Elevated insulin activates inflammatory messengers such as TNF-alpha, IL-6, and IL-1 beta.

This creates low-grade chronic inflammation.

You may not feel it directly.

But it quietly accelerates:

• Heart disease

• Diabetes

• Stroke

• Alzheimer’s disease

• Certain cancers

You Store More Fat

Insulin strongly promotes the storage of visceral fat.

This is the dangerous fat surrounding the liver, heart, kidneys, and abdominal organs.

Visceral fat is far more metabolically harmful than the softer fat found beneath the skin.

Healing Slows Down

Chronically elevated insulin interferes with the body’s repair systems.

Circulation worsens.

Cellular healing slows.

In advanced diabetes, this impaired healing can become so severe that wounds refuse to close.

Inflammation and Insulin

Inflammation drives insulin resistance.

Insulin resistance raises insulin.

Elevated insulin increases fat storage.

More fat storage increases inflammation.

And the cycle continues.

This is why I believe one of the most powerful actions any middle-aged person can take is this:

Eat in a way that consistently keeps insulin low.

Not occasionally low.

Consistently low.

Insulin’s Three Plans

When insulin opens your cellular doors, and glucose enters the cell, your body has three possible plans for that glucose.

Plan A

Burn glucose immediately for energy.

Plan B

Store glucose as glycogen in the muscles and liver for future use.

Plan C

Convert excess glucose into triglycerides and store it as body fat.

This final process is called de novo lipogenesis — the creation of new fat from sugar.

Most menopausal women unknowingly spend much of their day trapped in Plan C.

Insulin and Estrogen

Before menopause, estrogen helped maintain insulin sensitivity.

It helped insulin open the cellular doors more efficiently.

As estrogen declines, you become more resistant to insulin, but several other problems occur that also make you more resistant to insulin.

And they all happen simultaneously:

Muscle Mass Decreases

Muscle is the primary location where glucose is absorbed and utilized.

Less muscle means less blood sugar clearance.

Cortisol Rises

The stress hormone raises blood sugar and insulin levels.

Sleep Becomes Lighter

Even a few nights of poor sleep can worsen insulin resistance.

Together, decreased muscle mass, elevated cortisol, and poor sleep dramatically increase insulin resistance.

And elevated insulin makes menopause significantly messier.

Dieting Is Not The Answer

This is one of the greatest misunderstandings in menopause.

When insulin levels are elevated, aggressively cutting back on food intake backfires.

Here is why:

• Severe caloric restriction raises cortisol

• Elevated cortisol raises insulin

• Elevated insulin blocks fat release

So women diet harder.

And the body responds by locking fat down even tighter.

The scale refuses to move.

Willpower gets blamed.

The woman blames herself.

But this is usually not a willpower problem.

It is a hormonal misunderstanding.

The rules changed.

The strategy must change with them.

After 46 years of practice, I have learned one truth that rises above almost all others:

“To lose weight after becoming hormonally challenged in menopause, you must bottom out insulin and keep it bottomed out.”

Read that again.

Slowly.

Let it settle in.

“To lose weight after menopause, you must bottom out insulin and keep it bottomed out.”

How to Bottom Out Insulin

1. Stop Spiking It

Insulin rises most aggressively from:

• Sugar

• Refined low-fiber carbohydrates

• Constant snacking

• Liquid calories

If you want to lose menopausal weight, these four habits must go.

2. Eat Protein First

Protein creates a stable hormonal foundation for the meal.

Protein-rich foods have a very low glycemic load.

When protein is eaten first, the blood sugar impact of the rest of the meal is reduced.

Protein also:

• Preserves muscle mass

• Improves satiety

• Stabilizes blood sugar

The order matters.

Protein first.

High-fiber vegetables second.

God made fats alongside them.

3. Stop Raising Insulin Between Meals

Every time you eat, insulin rises.

If you snack constantly, insulin rarely has time to fully bottom out.

This is especially common in men.

Men graze.

If you graze, stop.

“Spacing meals gives insulin time to fall.”

This is not deprivation.

This is physiology.

When true hunger arrives:

Eat a Meso-Meal.

Do not snack.

Eat when hungry.

Stop when satisfied.

A Meso-Meal consists of:

• Clean animal protein

• High-fiber vegetables

• God-made fats

4. Lower Stress Before Lowering Calories

Cortisol raises insulin.

If stress remains elevated, fat release becomes difficult regardless of caloric intake.

Before meals, try:

• Prayer

• Breathwork

• Quiet reflection

• Pause and Breathe

These calm the nervous system and improve digestion and insulin regulation.

5. Sleep

Stanford research has shown that sleep deprivation:

• Reduces insulin sensitivity

• Raises cortisol

• Increases ghrelin (the hunger hormone)

• Lowers leptin (the satiety hormone)

The result?

More hunger.

Higher blood sugar.

More fat storage.

“Sleep is metabolic medicine.”

And unlike most medicines, it costs nothing.

Vicky — In Her Own Words

“After I stopped ovulating, I gained weight so fast it hurt.

I dieted harder.

Exercised harder.

And got nowhere.

When my husband explained that deprivation dieting and excessive exercise were actually raising cortisol — which was raising insulin — which was locking fat down even tighter, I nearly cried with relief.

Not because it was easy to hear.

Because it finally made physiological sense.

The biggest shift for me was not eating less.

It was eating differently.

Protein first.

High-fiber vegetables.

No snacking.

And finally prioritizing real sleep.

Within days, the scale began moving downward for the first time since menopause.

Consistently.

Dramatically.

All the way back to my happy weight.”

— Vicky Mac

Doc’s Favorite Insulin Remedy

When true hunger arrives, build a Meso-Meal:

• A palm-sized serving of clean animal protein

• A handful of high-fiber vegetables

• A dollop of God-made fat (extra virgin olive oil is my favorite)

Then follow these simple rules:

• Eat real food

• Eat in the right order

• Eat only when genuinely hungry

• Stop snacking

When insulin finally bottoms out, the body can once again access stored fat.

That is when fat burning begins.

Final Thought

Middle age did not remove your ability to lose weight.

It changed the hormonal rules.

In younger years, caloric restriction and exercise alone could move the scale.

But during the Third Act of life, insulin becomes one of the primary levers.

When insulin stays elevated, the body stores fat.

When insulin falls, the body can finally release it.

Learning how to manage insulin may be one of the most important skills for optimizing:

• Hormones

• Weight

• Longevity

• Discipline

And here is the beautiful part:

Insulin has a hormonal partner.

When insulin falls, glucagon rises.

When glucagon rises, fat can finally leave storage.

In the next chapter, we will explore glucagon — insulin’s forgotten twin.

In a Nutshell

“Middle age did not take away your ability to lose weight. Your hormones changed the rules. The old game of dieting harder and exercising harder no longer works the same way. You must now learn to play the Insulin-Glucagon Seesaw Game.”

This Week’s Usie

This week, our youngest son graduated with his MBA.

As Vicky and I stood beside him beneath the stone archway, I could not help but notice the words carved above the doorway:

“Today Decides Tomorrow.”

That may be one of the greatest descriptions of hormones, weight, discipline, and longevity I have ever seen.

Your future metabolism is being built by what you repeatedly do today.

Every meal.

Every walk.

Every night of sleep.

In every stressful moment, you learn to be quiet instead of feeding.

Today decides tomorrow.

Not someday.

Today.

And watching our son graduate reminded me of something else.

Meaningful transformations rarely happen quickly.

Degrees are earned one assignment at a time.

Healthy bodies are rebuilt one meal at a time.

Disciplined lives are built one repeated action at a time.

The future quietly grows inside the small choices nobody applauds.

Until one day, everyone notices.

Subscribe To My Substack

If this chapter from my new book resonated with you, I think you would deeply enjoy my Substack community.

Every week, I teach what 46 years of hormone and weight optimization practice taught me while helping thousands of women and men navigate menopause, andropause, weight resistance, aging, longevity, food, discipline, and hormones.

Subscribers receive:

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To subscribe, click the button below:

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And yes — I write every article myself with, of course, a little help from Vicky.

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If You Want To Talk To Me

If you have:

• Gained weight despite eating well

• Weight loss resistance

• Loss of sleep

• Hormone-induced anxiety

• Low moods

• Loss of interest in intimacy

• Loss of motivation to socialize

• Fatigue

• Hormonal confusion

You do not have to figure this out alone.

I always make time for people who genuinely want help.

If you would like to talk with me personally, click the scheduling link and choose a time that works for you.

We will discuss:

• Your hormones

• Your metabolism

• Your food preferences

• Your schedule

• Your symptoms

• And what I would personally do if I were you

No pressure.

No hard sell.

Just a real conversation and a real plan.

And this week, the first two Substack subscribers who schedule a conversation will receive a very special gift:

Free access to our 7-Day Challenge beginning next week. It includes:

• Daily accountability.

• Daily guidance.

• Daily customization.

Sometimes, one week changes everything.

And sometimes the life you miss is still waiting for you on the other side of balanced hormones.

SCHEDULE YOUR CONVERSATION BY CLICKING HERE

— Doc Mac

46 years of experience in hormone and weight optimization

Oh, and don’t forget to comment.

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DISCLAIMER: The information in this article is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It is not a substitute for professional medical advice. Always consult your physician before beginning or modifying any health program.

If this Monday feels a little different, it’s because it is. After years of showing up in your inbox through Kit, I’ve moved my newsletter home to Substack.

Same Doc Mac. Same 5 AM. Same commitment to giving you the clearest, most honest answers about your hormones and your health.

Just a better home to do it from.

Now — let’s get to work.

Estrogen Lost Its Dancing Partner

Why your sleep, your calm, and your sense of yourself left all at the same time

“Doc, since I went into menopause, I just don’t look or feel like myself anymore. Why?

I define menopause differently. It begins when ovulation ceases.

Because when that happens, estrogen loses its dancing partner.

The 28 Day Dance

Elias was a dazzling, powerful, passionate, and a little chaotic dancer. The audience held its breath when he took the stage.

Maren wasn’t flashy. But the moment she walked onto the stage, everything settled. Her movements were grounded and unshakable. When she danced, the world exhaled.

When Elias and Maren danced together, the performance was extraordinary. His wild energy, refined by her calm. Her steady grace, elevated by his brilliance. Together they were something neither could be alone.

They danced for 28 days; every night, the theater was sold out, and then Maren disappeared.

And Elias began to spiral.

This is menopause.

Estradiol is Elias: beautiful, energizing, and essential, but unbridled without a counterbalance.

Progesterone is Maren: the calming dancer, the neurological exhale, the hormone that was quietly making everything work.

When ovulation stops, your ovaries stop producing progesterone. Not gradually. Suddenly. And estrogen, which is still present, is still dancing, has nothing to balance it.

Science calls it estrogen dominance. I call it what it actually is:

Progesterone deficiency.

“The problem is not the dancer who stayed. It is the dancer who left.”

Progesterone

Before menopause, progesterone was doing far more than you realized:

• Soothing your brain’s GABA receptors — the neurological system responsible for calm, safety, and rest

• Supporting deep, restorative sleep — the kind where you wake feeling recovered

• Neutralizing estrogen’s fat-storing drive — particularly around the middle

• Acting as a natural diuretic — keeping fluid retention in check

• Providing the emotional buffer that kept the sharp edges smooth

When progesterone disappears, which happens once ovulation ceases, every single one of those functions goes with it, and this happens:

• 3 a.m. wake-up calls.

• Irrational anxiety that greets you before you’ve had coffee.

• Belly bloat that feels permanent.

• Annoyances are everywhere.

That is not you getting older.

It is progesterone deficiency.

Dance Again

Two of the most powerful natural tools for protecting what little progesterone your body still produces are:

1. Reduce belly fat.

Belly fat contains an enzyme called aromatase that converts progesterone directly into additional estrogen, worsening the very imbalance that makes menopause miserable. The less belly fat, the less aromatase. The less aromatase, the more progesterone survives.

2. Increase Magnesium.

Support magnesium daily. It is essential for hormone production and nervous system calming, and most women in midlife are deficient. Think of it as the background music that makes Maren’s return possible.

Those are two of the best ways to get estrogen and progesterone dancing together again.

But before I explain the third and perhaps most powerful way to get progesterone back on the dance floor and for estradiol and progesterone to balance each other out, let me explain something important…

Hormone optimization rarely comes from a magic pill, supplement, or article. It happens by learning how the body actually works.

Week after week.
Tool after tool.
Decision after decision.

That is exactly why I write here.

For 46 years, I have studied hormones, weight, metabolism, aging, discipline, and vitality with thousands upon thousands of patients.

And what I discovered is this:

The body is always listening.

Listening to:

How you sleep
How you eat
How you move
How you think
How you handle stress
How consistently you care for yourself

Hormones are not isolated chemicals floating randomly through the bloodstream.

They are messengers responding to the environment you create every single day.

That is why true hormone optimization is not about chasing symptoms.

It is about building a body that allows hormones to function the way they were originally designed.

And that takes education.
Not overwhelm.
Not perfection.

Just learning, applying, adjusting, and continuing to show up.

That is what we do here together.

Every week, I’ll continue sharing the greatest lessons my 46 years in health optimization practice have taught me about how to feel like yourself again once your hormones have paused.

Because once you understand the rules your hormones live by… everything begins to make more sense, because…

“You are nothing more than a reflection of how well balanced your hormones are.”

Now there are two paths you can go by.

You Can Balance Hormones Slowly — Or You Can Balance Them Quickly

You can stay here and subscribe to the Third Act Newsletter, and each week I will share my favorite tool for optimizing hormones, weight, longevity, and discipline one step at a time.

Or you can go fast.

This week I kept two spots open for a free conversation — no agenda, no pitch. Just your hormones, your symptoms, and honest answers from someone who has spent 46 years figuring this out.

One conversation. Fully customized to where you are right now.

You can climb to the mountain slowly, one article at a time.

Or you can hop in my helicopter.

→ IM Me By Clicking Here ←

Or take the slow road — both paths go to the top.

Subscribe, and I’ll see you next Monday.

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Why Balance Estrogen and Progesterone?

Because when these two hormones fall back into rhythm, something remarkable often happens.

Sleep improves.
Mood stabilizes.
The cravings quiet down.
The anxiety softens.
The body begins feeling safer again.

And slowly… the woman who thought she was disappearing often begins to return to herself.

The theater starts filling again.
The musicians return to their seats.
The lights warm.
And the dance between progesterone and estradiol begins once more.

The theater will sell out again.

The 20mg Reset: What Vicky Actually Used

If you have been reading my articles, you know that my first patient to ask me to help with menopause was my wife. Let me explain to you what we eventually came up with to get Elias and Maren to start dancing again.

We found that the best way to balance progesterone and estradiol is to microdose bioidentical progesterone, which we believe is the single most transformative step to relieve her of the plethora of menopausal symptoms, which are actually the symptoms of progesterone deficiency.

It improved her sleep within days. And when sleep changes, everything else becomes more workable.

The tool Vicky uses is a USP Progesterone Cream, specifically Emerita Pro-Gest Cream. Vicky has used maybe half a dozen different progesterone creams, and this is her favorite. She and my clients prefer a tube to a pump for dosage control.

Important: It must say USP Progesterone, not Wild Yam Extract. Wild yam is the source, but your body cannot convert it without laboratory processing.

The dose she uses: one-quarter teaspoon, approximately 20mg, applied to a thin-skinned area before bed. Most place it on their:

Inner wrist
Upper chest,
Ankle.

And they rotate sites each night to prevent reduced absorption, because progesterone increases the thickness of their skin, which reduces absorption.

Vicky likes to apply it to different parts of her ankle, switching between them every night. Old habit from the early days when we weren’t sure about transference to a partner. The sock goes on to protect me. Sleep follows.

I woke like a cuddly bear, so I used to think she made sure to apply some to me while I slept.

Always consult your healthcare provider before beginning any hormone-modulating supplement.

How Do You Know You Are Progesterone Deficient?

Know Your P/E Ratio

The progesterone-to-estradiol ratio is the single most revealing hormonal marker for menopausal women. Salivary hormone assay kits are available online without a prescription: you purchase, collect, mail, and receive results within a week.

An ideal ratio is approximately 200:1. Most symptomatic women that I talk to are well below 100:1. Here is what the numbers tend to mean clinically:

• Around 100:1 — rapid weight gain, significant weight-loss resistance

• Around 75:1 — sleep disturbances, continued weight gain

• Around 50:1 — heightened anxiety, low mood

• Around 25:1 — loss of interest in intimacy, social withdrawal, marked drop in motivation

These are clinical correlations, not rigid cutoffs. But knowing your number gives us something to work from and something to improve toward.

At home, salivary assays to discover your P/E Ratio can be purchased from the vendors below.

Verisana (P/E Ratio)

Everlywell (10 Biomarkers)

Once you get your results, I will gladly go over them in a phone call at no charge.

IM Me When You Receive Your Test Results.

Vicky’s Account

I was in the 3 a.m. club for years. Every night like clockwork: heart racing, mind spinning, no reason I could name. Just a nervous system that had lost its off switch.

I tried everything that was supposed to help. None of it addressed what was actually wrong, which was that my progesterone had disappeared and my brain was running without its natural calming agent.

The night I began using 20mg of progesterone cream, I slept five unbroken hours. That doesn’t sound like much. But after years of waking at three, it felt like a miracle. Within two weeks, I was sleeping through. Within a month, the morning anxiety had quieted to something manageable. Within three months, I recognized myself again.

Maren came back. Not all at once. But she slowly stepped back onto the stage. — Vicky Mac

Next week: The hormone most women don’t realize they need. Chapter Three: Testosterone — The Drive Hormone.

If this article described your mornings, I want to hear from you.

Not to sell you anything. Just to listen.

Every week, I keep two spots open for a free conversation — no agenda, no pitch. Just Doc Mac, your symptoms, and 45 minutes of honest answers. Women who’ve had this call tell me it’s the first time they finally understood what was happening in their bodies.

If that sounds like something you need, send me a message directly on Facebook. I read every one personally.

→ Send Doc Mac a Message: m.me/thehopeprotocol ←

And if you’re not ready for that yet — that’s completely fine. Stay here. Read all about hormones and menopause every Monday. The answers will come one article at a time.

— Doc Mac

DISCLAIMER: The information in this article is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It is not a substitute for professional medical advice. Always consult your physician before beginning or modifying any health program.

Yes. Absolutely yes.

And that question is exactly why I’m writing this article today, because DIM may be the single most important supplement for anyone in their Third Act of life, whether you are a woman navigating menopause or a man quietly wondering why you don’t feel like yourself anymore.

Let me explain why with a story.

The Keeper of the River

The valley had one river that fed everything: the fields, the orchards, and the town below.

Every autumn, when the cold came and the leaves fell, the river swelled.

At the great fork where the river split into two channels, an old keeper stood watch.

One channel ran dark. It fed stagnant pools where nothing grew, where the water turned heavy, poisonous, and still.

The other ran clear and bright, carrying good water all the way to the sea.

The keeper’s job was not to dam the river. Not to drain it. Only to direct it.

For forty years, he stood at the fork, faithfully guiding the current toward the clear channel. The valley thrived. The orchards bore fruit. The town stayed well.

Then one autumn, the keeper grew ill. He set his tools down and went home to rest.

The river went where it wanted.

The dark channel ran full. The bright channel thinned to a trickle.

The valley began to change. Slowly. Then noticeably. Then undeniably.

It wasn’t that there was too little water. It was that the water was going to the wrong places.

This is precisely what happens when estrogen goes unguided in our bodies.

It’s not that we have too much.
Or too little.
It’s just misdirected.

DIM is the keeper at the fork of the Estrogen River.

Estrogen Dominance Doesn’t Discriminate

It affects both women and men, but the journey looks very different for each.

For women, it happens nearly overnight. The moment a woman stops ovulating, two critical hormones disappear: progesterone and testosterone. Estrogen takes over without opposition. One day, you feel like yourself. The next, you don’t.

For men, it’s a slow walk into the abyss.

Estrogen Dominance in a man is like the frog in the pot; the temperature rises so gradually that by the time it feels wrong, it’s too late.

Most men spend a decade wondering why their energy disappeared, why their belly keeps growing, and why their drive has faded. They never once connected it to their hormones, especially estrogen, the Feminine Hormone.

When a woman arrives in her Third Act, estrogen dominance announces itself through a familiar cluster of symptoms:

• Sudden, unexplained weight gain

• Weight loss resistance despite dieting

• Sleep that is broken or gone

• Anxiety that appears out of nowhere

• Moodiness and emotional days

• Loss of interest in intimacy

• Fading motivation to be social

If you are nodding at this list, you don’t have a motivation problem. You most likely have a hormone problem. And the river is flowing in the wrong direction.

When a man discovers he is estrogen-dominant, he also gains weight, especially around the belly, grows “man boobs,” and loses his drive, his drive for sex, success, and to beat you to the next red light.

What Is DIM?

DIM stands for diindolylmethane, pronounced dye-in-doll-methane. Don’t worry about the name. Worry about what it does.

DIM is not a hormone. It does not add estrogen or remove it.

DIM is an estrogen router.

Like food, your hormones are digested.

Your liver metabolizes estradiol into various metabolites.

One group is harmful: carcinogenic and fat-storing.
The other is beneficial: protective, anti-inflammatory, and metabolically helpful.

DIM directs estradiol down the beneficial pathway instead of the harmful one.

Your body already makes tiny amounts of DIM when gut bacteria break down cruciferous vegetables like broccoli, Brussels sprouts, and cabbage.

But to produce enough to matter, you would need to eat approximately two pounds of cruciferous vegetables every single day. Supplementation bypasses that problem entirely.

One critical detail: DIM must be micro-encapsulated to be properly absorbed. If the label doesn’t specify micro-encapsulated, your body will not absorb it effectively.

You Can Go Slow — Or You Can Go Fast

You can stay here, subscribe to my Substack, and each week I’ll give you one powerful tool to help bring your hormones back into balance one step at a time.

Or you can go fast.

Enroll in my free week of coaching, and I’ll walk you through exactly what I would do if I were in your shoes based on your hormones, your weight, and where you are right now. No guesswork. No overwhelm. Just a clear, personalized plan.

You can climb the mountain one step at a time.
Or you can hop in my helicopter.

Both are free.
Your choice.
Your speed.

Only two spots available each week.

Click Here 👉 FREE HORMONE BALANCING TRAINING

As always, please consult your healthcare practitioner before beginning any new supplement. Although the science consistently shows DIM to be well tolerated with few adverse effects, I have occasionally seen exceptions in my own patients over 46 years of practice. Your individual health history matters.

Subscribe to continue reading — and to get the exact DIM protocol Vicky and I follow every night.

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