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.
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What You’ll Learn
- What perimenopause actually is and how it differs from menopause
- Why perimenopause can begin in your late 30s or 40s
- Why brain fog, sleep disruption, anxiety and mood changes can be early symptoms
- When hormone therapy may be considered during perimenopause
- The difference between HRT/MHT, birth control and vaginal estrogen
- What we know, and still don't know, about HRT and cardiovascular and bone health
- How GLP-1 medications can affect muscle and bone health
- The role of protein, resistance training, vitamin D, omega-3s, fiber and creatine
- What declining estrogen can mean for vaginal and urinary health
- What women should know about HRT and breast cancer risk
- Why listening to your symptoms and advocating for yourself matters
Key Timestamps
00:00 Why Every Vagina Needs Estrogen
01:32 Welcome Back Dr. Mary Claire Haver
05:44 What Perimenopause Actually Is
08:44 The "Zone Of Chaos" And Brain Glitching
18:08 How To Evaluate A Perimenopausal Patient
20:01 All Vaginas Need Estrogen
24:50 Why Perimenopause Is The Best Time To Start HRT
32:13 GLP-1s, Muscle Loss, And Bone Health
36:41 Patches, P