Ep. 472 What Women Aren’t Told About Menopause & HRT with Jaclyn "Jackie" Piasta | Menopause and HRT

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Previously titled “Ep. 472 What Women Aren’t Told About Menopause & HRT with Jaclyn "Jackie" Piasta” — renamed by the publisher on Aug 3, 2026

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Recorded07 Jun 2025

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Today, I am thrilled to reconnect with my friend and colleague, Jackie Piasta. Jackie is a Vanderbilt-trained nurse practitioner. She is board-certified in women's and gender health, and has been practicing since 2010. She serves on medical advisory committees for several foundations and co-hosts the justASK Podcast. In our discussion today, we dive into the challenges menopausal women face with hormone replacement therapy due to the lack of provider education on the effects of oral estrogen, the importance of bio-individuality, and how nuanced messaging can make all the difference for women. Jackie unpacks the latest guidelines from the American Urological Society, which address vulvovaginal, urinary, and sexual health symptoms, and explains the importance of addressing those issues proactively. We also explore fertility tracking in perimenopause, especially for women using long-acting reversible contraception (LARCs), and the latest trends in hormone testing. You will not want to miss this insightful conversation where Jackie sheds light and offers practical guidance on the often-missed details of women’s health. IN THIS EPISODE, YOU WILL LEARN: Why bio-individuality is essential in menopause treatments The challenges OB-GYNs and other clinicians face in staying updated on menopause treatments. Why healthcare providers must become more educated about hormone therapy Jackie explains the historical context surrounding the vilification of oral estrogen. How the new American Urological Society guidelines are now addressing symptoms of perimenopause and menopause Why vaginal laser therapy might be harmful for some individuals Why diagnosing menopause in women using long-acting reversible contraceptives (LARCs) is so challenging Why hormone level labs are needed to guide clinical decision-making on menopause treatments Jackie highlights the need for more research to understand the hormone levels that protect bone health. Connect with Cynthia Thurlow Follow on Twitter Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Jaclyn Piasta Monarch Health Jackie on all social media: Jackiep_gynnp The justASK Podcast

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