Counseling Patients Who Decline HRT

What if everything you’ve been told about menopause is wrong?

In this episode, I sit down with Dr. Mary Claire Haver — board-certified OB/GYN and leading menopause expert — to unpack the science reshaping women’s health. We break down the FDA’s recent removal of the 22-year black box warning on hormone therapy, why only 4% of women use HRT today, and how fear and misinformation have shaped decades of care.

Dr. Haver also dives into the rise of menopause “biohacks,” from NAD and PRP to the fundamentals that truly move the needle: sleep, strength training, and metabolic health. Her message is simple: Menopause isn’t a disease — it’s a transition, and you deserve informed, evidence-based support.

If you’ve ever felt dismissed or confused during midlife changes, this conversation will give you clarity, confidence, and the science to advocate for yourself.

Follow Dr. Haver:
Instagram: @drmaryclaire
TikTok: @drmaryclaire
Website: The Pause Life
Pre-order The New Perimenopause, set to release on April 7, 2026: https://thepauselife.com/pages/the-new-perimenopause-book
Listen to Dr. Haver's podcast, unPAUSED, here: https://thepauselife.com/pages/the-unpaused-podcast

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I’m Louisa Nicola — clinical neurophysiologist — Alzheimer’s prevention specialist — founder of Neuro Athletics.

My mission is to translate cutting-edge neuroscience into actionable strategies for cognitive longevity, peak performance, and brain disease prevention.

If you're committed to optimizing your brain — reducing Alzheimer’s risk — and staying mentally sharp for life, you’re in the right place.

Stay sharp. Stay informed. Join thousands who subscribe to the Neuro Athletics Newsletter → https://bit.ly/3ewI5P0

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Topics discussed:

00:00 – Intro

01:55 – The FDA removed the “black box” warning for HRT

05:16 – The Social Media Effect on Menopause Education

07:54 – How Doctors Historically Dismiss Women’s Symptoms

11:12 – Why So Many Women Get Antidepressants Instead of HRT

14:07 – Life Stress vs Hormone-Driven Symptoms

16:48 – The Timing Hypothesis / Critical Window Explained

19:06 – Why Modern RCTs Aren’t Happening

20:10 – Proven Benefits: Bone Health & Osteoporosis Prevention

21:35 – HRT, Dementia, and Brain Health: What the Data Actually Shows

23:16 – Environmental Toxins, Brain Health & Midlife Risk Factors

25:24 – How the Internet Distorts Menopause Education

27:10 – The “Brain Eating Itself” Debate: The Real Science

30:09 – What Brain Fog Really Is During Perimenopause

32:24 – Why High-Functioning Women Struggle the Most

34:03 – Breast Cancer Risk: What the WHI Actually Found

35:00 – Why Sleep Is the First Line of Treatment

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