Extend Podcast with Darshan Shah, MD 89. Sara Szal, MD: Why 80% of Women Experience Brain Fog in Perimenopause (And How to Fix It)
Aug 26, 2025
Dr. Sara Szal, a Harvard-trained gynecologist and bestselling author, unveils why 80% of women face brain fog during perimenopause. She critiques traditional treatments like birth control and antidepressants, advocating for her 'hormone therapy plus' approach. The conversation touches on overlooked perimenopause symptoms, the importance of proper hormone testing, and the differences between bioidentical and synthetic hormones. Dr. Szal emphasizes the need for personalized care to empower women navigating this transition, ultimately redefining aging and health.
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How Contemplative Practice Sustained Her
- Dr. Sara Szal described losing presence during training and returning to daily yoga and contemplative practices.
- She used those practices to stay grounded while treating many patients and later when rebuilding her own health.
Doctorhood Moment That Sparked Her Shift
- At 35 Dr. Sara Szal sat in her PCP's office and was offered a birth control pill and an antidepressant.
- She went to the lab, found severe hormone and metabolic dysfunction, and changed her treatment path.
Test Hormones And Metabolism Early
- Get hormone and metabolic labs rather than accepting dismissal; test FSH, estradiol, progesterone, cortisol, thyroid, fasting insulin and glucose.
- Use results to guide personalized treatment instead of blanket antidepressants or birth control.
