Postpartum at older ages versus perimenopause

Millions of women in their 30s–50s are being told they’re “depressed” when their brains and hormones are simply changing.

In this episode, I sit down with Dr. Suzanne Gilberg-Lenz to unpack the truth about midlife mood shifts, rage, and the hormonal fluctuations that mimic depression but aren’t the same. We break down the science of perimenopause, why women are so often misdiagnosed, and how decades of excluding women from research left major gaps in understanding how estrogen, progesterone, and testosterone shape the brain. Dr. Gilberg-Lenz reveals how hormonal changes—starting up to ten years before menopause—can transform mood, cognition, and stress, and how modern science is finally catching up to just how powerfully hormones influence the mind.

About the guest:

Dr. Suzanne Gilberg-Lenz is a board-certified OB/GYN and integrative women’s health expert who blends conventional medicine with Ayurvedic training. A USC-trained physician with a residency at Cedars-Sinai, she supports women from adolescence through menopause and is the author of Menopause Bootcamp (Harper Wave, 2022). Her work focuses on demystifying midlife, challenging ageism in healthcare, and empowering women with science-based guidance.

Follow Dr. Gilber-Lenz:

• Instagram: @askdrsuzanne 
  
  

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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.

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Topics discussed:

00:00 – Intro

02:07 – Early Signs of Perimenopause

03:15 – How Hormones Shift in Your 30s–50s

04:32 – Why Anxiety Spikes in Midlife

07:02 – Antidepressants vs. Hormones

09:27 – How Estrogen Shapes Mood & Neurochemistry

11:23 – PMS, PMDD, Postpartum & Perimenopause Overlap

12:25 – Perimenopause Amplifies Existing Issues

18:00 – Estrogen, Progesterone & Testosterone in the Brain

20:45 – AMH, Egg Quality & Fertility After 40

23:17 – Postpartum vs. Perimenopause at 40+

26:55 – Getting Pregnant on Hormone Therapy

31:19 – Reinventing the Menopause Narrative

34:25 – Gut Health, Microbiome & Hormones

35:30 – Ayurveda’s Role in Midlife Health

37:10 – The Patient Who Transformed Dr. Gilberg-Lenz’s Path

43:08 – Negative Thoughts, Cortisol & Brain Aging

44:23 – Hormone Chaos, Inflammation & Cognitive Decline

48:23 – When Labs Are “Normal” but Symptoms Aren’t

49:53 – How Perimenopause Should Be Treated

51:55 – The Future of Midlife Women’s Healthcare

56:28 – Why the System Fails Women (and How to Navigate It)

58:02 – GLP-1s, Hormones & Longevity

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