đď¸ Episode 324: Perimenopause is RealâWhat You Need to Know with Jackie Piasta, WHNP-BC
Perimenopause is realâand often misunderstood. In this episode, I sit down with womenâs health nurse practitioner Jackie Piasta to unpack the truth about this critical (and neglected) phase of midlife. If youâve been told âyouâre too youngâ or âjust tough it out,â this conversation will feel like the validation youâve been missing.
Jackie and I dive into what perimenopause really looks likeâfrom migraines and mood swings to weight gain and disrupted sleepâand why these symptoms deserve real answers, not dismissal.
We talk through whatâs happening hormonally, why lab tests arenât the gold standard, and how to shift from a âbirth controlâ mindset to a hormone-optimization mindset in your 30s, 40s, and beyond.
In this episode:
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Why perimenopause can start in your 30sâeven with regular periods
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Common myths that keep women suffering in silence
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How to track symptoms and cycles instead of chasing lab results
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The role of hormonal birth controlâand when it helps vs. masks symptoms
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How estradiol, progesterone, and vaginal hormones can support brain, sleep, and libido
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Supplements and newer options: magnesium, L-theanine, flibanserin, even topical CBD
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Real-world patient cases that show how individualized care changes lives
Top takeaways:
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Perimenopause is a clinical diagnosisâthereâs no perfect test.
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Hormonal fluctuations can cause real physical, emotional, and cognitive changes.
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Bone loss, lipid changes, and heart risks start before menopause.
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Progesterone is often underused but powerful for night sweats, anxiety, and sleep.
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SSRIs are not first-line for new-onset mood changes in perimenopause.
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Early intervention mattersâdonât wait until menopause to get help.
We also talk about newer birth control formulations, managing migraines, and what the research is showing us about how menopause impacts heart health and brain function. Spoiler: itâs not just about hot flashes.
This episode is your permission slip to stop toughing it out and start asking for care that actually helps.
đ Referenced Studies & Resources:
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Brinton RD et al. Perimenopause as a neurological transition state. Nat Rev Endocrinol. 2015;11(7):393-405.
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Wu B et al. Trajectories of Blood Lipids Profile in Midlife Women. J Am Heart Assoc. 2023;12(22):e030388.
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SWAN Study: Lipid trajectory insights through the menopausal transition
https://www.instagram.com/jackiep_gynnp
https://www.mymonarchhealthco.com/
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