The New Science of Perimenopause: HRT, Brain Changes & What Actually Works | Dr. Mary Claire Haver | #178

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I sat down with Dr. Mary Claire Haver, board-certified OBGYN, certified menopause specialist, and author of The New Menopause and The New Perimenopause. Together we pull back what is actually happening inside a woman's body during the perimenopause transition, and what we can do about it.
What we explore:
- Why perimenopause starts in the brain, triggering fog, mood shifts, and sleep disruption years before your last period.
- The staggering research gap that has left perimenopause understudied and millions of women dismissed.
- How 20% of women absorb transdermal estrogen poorly without knowing it, and why testing matters.
- What metabolic syndrome of menopause is and why visceral fat doubles during the transition without diet changes.
- How to use GLP-1s safely in midlife while protecting muscle mass and bone density.
- Progesterone intolerance, how common it is, and what hormone therapy alternatives actually work.
About Dr. Mary Claire Haver: Dr. Mary Claire Haver is a board-certified OBGYN, certified menopause specialist, and New York Times bestselling author of The New Menopause and The New Perimenopause. She is one of the world's leading voices on midlife women's health and the founder of The Pause Life clinic.
Connect with Dr. Mary Claire Haver: Website: https://thepauselife.com
Instagram: https://www.instagram.com/drmaryclaire/ Linkedin: https://www.linkedin.com/company/the-pause-life
Youtube: https://www.youtube.com/@drmaryclaire
Get Dr. Mary Claire Haver's books here: The New Menopause; The New Perimenopause
👉 https://thepauselife.com/pages/the-new-perimenopause-book
Timestamps
00:00 Intro
03:20 Perimenopause research gap 05:58 Brain fog, mood changes, and hormones 10:00 Perimenopause mental health symptoms and HRT 11:17 Postpartum depression as a menopause warning sign 13:00 Outdated HRT guidelines and undertreated women 15:12 Estradiol dosing, absorption, and bone density protection 19:51 GLP-1s, muscle loss, and body composition in menopause 22:00 Visceral fat, subcutaneous fat, and menopause weight gain 25:00 Metabolic syndrome of menopause: causes and solutions 27:29 Oral vs. transdermal estrogen for cholesterol and heart health 30:38 Progesterone intolerance: symptoms and alternative options 33:47 Duavee, progestin IUDs, and hormone therapy alternatives 37:07 Testosterone for women: libido, bone health, and brain fog 40:04 Future of menopause medicine and women's health advocacy
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