Show notes
The frozen shoulder. The 3 a.m. anxiety. The brain fog and the rage that come out of nowhere. For decades, women were told it was "just stress" and sent home with an antidepressant. This week, Dr. A and Mary Alice welcome back the woman changing that — Dr. Mary Claire Haver, the OB-GYN The New York Times calls the "Menopause Queen" — for a full masterclass on perimenopause.It can start in your late 30s, it lasts 7 to 10 years, and almost no one warned us. Dr. Haver explains what's really happening in your body and brain, why so many women are dismissed, and what you can actually do about it — HRT, progesterone, vaginal estrogen, sleep, mood, and the myth that you have to wait until it's "bad enough" to get help. Because suffering isn't the price of admission.Subscribe to SHE MD Podcast for expert tips on PMOS, endometriosis, fertility, hormonal balance, mental health, and more. Share with friends and visit SHE MD website and Ovii for research-backed resources, holistic health strategies, and expert guidance on women’s health and well-being.SponsorsTalkiatry: Head to talkiatry.com/shemd to complete the short assessment and get matched with an in-network psychiatrist in just a few minutes. Babbel: Right now, Babbel is offering listeners up to 60% off. Go to Babbel.com/SheMD Egglife: Find Egglife chillin' in the fridge at Aldi, Whole Foods, Kroger, Target, Walmart & more. Visit egglifefoods.com to find a retailer near you. Acely: Visit Acely.com and use code SHE MD for 20% off. Ladder: If you have an iPhone, head to ladder.fit/SHEMD and take a quick quiz to find your perfect Ladder plan. Use our link and get a free 7-day trial with NO credit card, and $10 off your first month if you join. Skylight Frames: Right now, Skylight is offering our listeners $30 off their 15-inch calendars by going to myskylight.com/shemd. What You’ll LearnWhat perimenopause actually is and how it differs from menopauseWhy perimenopause can begin in your late 30s or 40sWhy brain fog, sleep disruption, anxiety and mood changes can be early symptomsWhen hormone therapy may be considered during perimenopauseThe difference between HRT/MHT, birth control and vaginal estrogenWhat we know, and still don't know, about HRT and cardiovascular and bone healthHow GLP-1 medications can affect muscle and bone healthThe role of protein, resistance training, vitamin D, omega-3s, fiber and creatineWhat declining estrogen can mean for vaginal and urinary healthWhat women should know about HRT and breast cancer riskWhy listening to your symptoms and advocating for yourself mattersKey Timestamps00:00 Why Every Vagina Needs Estrogen01:32 Welcome Back Dr. Mary Claire Haver05:44 What Perimenopause Actually Is08:44 The "Zone Of Chaos" And Brain Glitching18:08 How To Evaluate A Perimenopausal Patient20:01 All Vaginas Need Estrogen24:50 Why Perimenopause Is The Best Time To Start HRT32:13 GLP-1s, Muscle Loss, And Bone Health36:41 Patches, Pellets, Creams: What Actually Works40:23 Debunking The HRT-Breast Cancer Myth50:33 Creatine, Vitamin D, And Key Supplements54:56 The Histamine-Hormone Connection58:12 Vulvar Changes Nobody Warns You About1:04:37 Lightning Round: Hormone Myths Busted1:07:19 Three Takeaways For Every WomanKey TakeawaysPerimenopause is a years-long biological transition, not simply the period immediately before menopause.Symptoms can appear before periods become irregular or hot flashes begin.Brain fog, sleep disruption and mental health changes can be among the earliest signs of fluctuating hormones.Hormone therapy does not necessarily have to wait until a woman is fully menopausal; treatment should be individualized based on symptoms, risks and benefits.Bone health, cardiovascular health, muscle mass and metabolic health all deserve attention during the menopause transition.If using GLP-1 medications, Dr. Haver emphasizes adequate protein, resistance training and monitoring body composition rather than focusing solely on the number on the scale.Vaginal and urinary symptoms can be related to declining estrogen and may be treated with local estrogen therapy.The goal of understanding perimenopause is not simply to get through it, but to enter the next stage of life informed, healthy and empowered.Guest Bio: Dr. Mary Claire HaverDr. Mary Claire Haver is a board-certified OB-GYN and a leading voice in menopause and women's health. She has dedicated her career to helping women better understand the biological changes that happen during midlife and has been called the “Menopause Queen” by The New York Times. She is the author of the bestselling The New Menopause and her newest book, The New Perimenopause, which focuses on the years leading up to menopause. She also hosts the podcast Unpaused and shares women's health education across social media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.