134. Dr. Jessica Shepherd: Stop the Decline: Perimenopause Strategies

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Jan 29, 2026

Dr. Jessica Shepherd, board-certified OB/GYN and midlife health expert, focuses on perimenopause and longevity. She discusses why conversations should start in the late 30s. She highlights resistance training as key, the role of hormone therapy for brain, bone, and metabolic health, the importance of early bone assessment, and simple functional tests and movements to preserve strength.

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INSIGHT

Misapplied Science Derailed Menopause Care

The WHI study warped menopause care for decades by misapplying cardiology findings to women's hormonal health.
Jessica Shepherd says that misinformation created fear and delayed effective hormone use for millions of women.

ADVICE

Recognize And Evaluate Early Perimenopause

Notice early perimenopause signals like brain fog, sleep disruption, libido change, or emotional shifts and start the conversation.
Rule out thyroid, mental health, stress, and nutrition before deciding on hormone therapy.

ANECDOTE

A Doctor's Personal Menopause Wake-Up

Jessica Shepherd shared her own months-long experience of brain fog and memory lapses before realizing it was menopause.
She immediately started hormone therapy and highlights how long symptoms can go undiagnosed.

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Most people assume losing strength, energy, and bone health is inevitable as we age. But what if maintaining muscle, optimizing hormones, and protecting bone density were about targeting the right systems early rather than treating symptoms later?

In this episode of Extend, we sit down with Dr. Jessica Shepherd, a board-certified OB/GYN and expert in midlife health and longevity. With years of experience merging clinical medicine with functional approaches, Dr. Shepherd shares how resistance training, hormone therapy, nutrition, and modern therapies like GLP-1 medications can work together to help women thrive through midlife and beyond.

We talk about why muscle is the "organ of longevity," how bone quality and hormonal balance impact strength and metabolism, and why small, consistent lifestyle changes such as squats, grip exercises, and functional movement can have massive long-term effects. Dr. Shepherd also explores strategies to boost energy, preserve functionality, and support overall health so you can age stronger, healthier, and more resilient.

What We Discuss:

(04:00) Why many physicians leave traditional medicine for longevity-focused care
(07:50) Menopause, the WHI study, and how hormone therapy was misunderstood for decades
(11:45) Perimenopause explained: early symptoms like brain fog, sleep disruption, and emotional changes
(18:45) When women should start thinking about perimenopause and why conversations should begin in the late 30s
(23:30) Patient autonomy: ruling out thyroid, mental health, stress, and nutrition before starting hormones
(27:40) Hormones as optimization fuel for brain, bone, muscle, and metabolic health
(30:15) Why muscle is the organ of longevity and how resistance training protects metabolism and strength
(33:00) Bone health beyond density: early DEXA scans, bone quality, and osteoporosis prevention
(36:30) Functional longevity tests: sit-to-stand, grip strength, farmer's carry, and real-world strength
(39:50) Motivation and quick wins: how HRT and GLP-1 therapies can accelerate lifestyle change
(41:15) The synergy between hormone therapy and GLP-1 medications in perimenopause
(44:40) The future of hormone therapy: individualized delivery and integrated longevity care models
(46:45) Creating a well space for proactive health instead of reactive disease treatment

Thank You to Our Sponsors:

Function Health: Learn more and join using my link. Visit www.functionhealth.com/drshah and use gift code DRSHAH25 for a $25 credit toward your membership.

Learn more about Dr. Shah:

Website: https://www.drshah.com/

Clinic: https://www.next-health.com/

Instagram:@darshanshahmd

Learn more about Dr. Jessica Shepherd:

Instagram: jessicashepherdmd

Website: https://www.jessicashepherdmd.com/

Linkedin: Jessica Shepherd, MD, MBA, FACOG