Ep. 508 Perimenopause Uncovered: From Heavy Periods to Stubborn Weight Gain – A Talk with Dr. Heather Hirsch | Menopause & Perimenopause

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Previously titled “Ep. 508 Perimenopause Uncovered: From Heavy Periods to Stubborn Weight Gain – A Talk with Dr. Heather Hirsch” — renamed by the publisher on Aug 3, 2026

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Recorded11 Oct 2025

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Show notes

I am delighted to connect with a physician friend and colleague, Dr. Heather Hirsch, today. Dr. Hirsch is an entrepreneur and a board-certified internist by the American Board of Internal Medicine. She is also the Founder and CEO of Health by Heather Hirsch, and has a telemedicine practice offering best-in-class individualized care for perimenopause and menopause. In our discussion, we explore heavy menstrual cycles and the benefits of journaling and shared decision-making. We discuss common and frustrating causes of weight loss resistance in middle age, the power of strength training and adequate protein intake, and estrogen as a metabolic regulator that is intricately linked to many physical systems, including digestion. We also examine how educating clinicians on shifts in estrogen, progesterone, and testosterone during perimenopause could prevent countless ER visits, and we tackle concerns surrounding contraception and pregnancy prevention in perimenopause, a biopsychosocial approach to low libido, and the often-overlooked silent symptoms Dr. Hirsch often sees in perimenopause and beyond. Today’s conversation with Dr. Hirsch is truly invaluable. I highly recommend her Perimenopause Survival Guide, written by an internal medicine doctor extremely well-versed in perimenopause and menopause. IN THIS EPISODE, YOU WILL LEARN: How hormonal fluctuations disrupt the body and create confusion in perimenopause The benefits of journaling How hormonal and lifestyle shifts disrupt metabolism, weight, and insulin sensitivity during perimenopause Why body composition changes matter more than your weight How declining estrogen affects insulin resistance, metabolism, and diabetes risk The value of shared decision-making How hormones, medications, sleep, relationships, and past trauma can cause changes in libido How siloed healthcare often leaves perimenopause symptoms misunderstood How irregular ovulation increases pregnancy risk and why hormone therapy is not a contraceptive Connect with Cynthia Thurlow Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Heather Hirsch On her website YouTube Social media: @Heather Hirsch MD

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