182: Perimenopause & Menopause Beyond Estrogen: FSH, Brain Fog & Maca with Dr. Deanna Minich

Still having periods, but dealing with brain fog, disrupted sleep, or changes in how you feel? The perimenopause conversation needs to go beyond estrogen.

In this episode of Confessions of a Male Gynecologist, I welcome back Dr. Deanna Minich, nutrition scientist and Chief Science Officer at Symphony Natural Health, to explore an overlooked part of the hormone conversation: follicle-stimulating hormone, or FSH.

Most of us were taught to think of FSH as a reproductive hormone. But emerging research is exploring its connections to bone, fat tissue, and the brain—and what those connections might mean during the menopause transition.

We discuss why symptoms can appear while estradiol remains within the reference range, what "endocrine recalibration" means, and why menopause deserves a broader conversation than estrogen deficiency alone.

Then we dive into maca and Femmenessence, a supplement I've used in my practice for years. Deanna explains how maca varieties and formulations differ, what the published trials have examined, and why a product that contains no hormones can still affect hormone levels.

We also address important safety questions, including hormone-sensitive breast cancer, and separate emerging research from established clinical guidance.

In This Episode, You Will Learn:

• Why FSH may change before periods stop and why a single result has limitations
• How the endocrine system adapts during perimenopause and menopause
• Emerging research on FSH, bone loss, and brain health
• What associations with amyloid and cognitive changes can, and cannot, tell us
• Why cardiovascular findings remain mixed
• How maca varieties, sourcing, and formulations differ
• The research behind Femmenessence and its life-stage-specific products
• Using supplements alongside menopausal hormone therapy in individualized care
• Why "hormone-free" does not necessarily mean "no effect on hormones"
• Safety considerations for women with a history of hormone-sensitive breast cancer

About Dr. Deanna Minich

Deanna Minich, PhD, MS, CNS, FMCP, is a nutrition scientist, educator, author, and functional medicine practitioner with more than 25 years of experience at the intersection of nutrition, endocrine health, and systems biology. She serves as Chief Science Officer at Symphony Natural Health, where she leads scientific strategy, research, education, and clinical translation focused on women's endocrine health across the lifespan. At Symphony Natural Health, Dr. Minich's work centers on advancing a whole-systems understanding of hormonal health—one that extends beyond individual hormones to consider the interconnected roles of the endocrine, metabolic, neurological, and skeletal systems. Her current research and education focus extensively on the menopausal transition, endocrine resilience, and the emerging systemic biology of follicle-stimulating hormone (FSH). In 2026, Dr. Minich and colleagues published a comprehensive review in the Journal of Clinical Medicine, "Is Follicle-Stimulating Hormone (FSH) Misnamed? Rethinking Its Role in Menopause as a Systemic Regulator of Bone, Brain, Metabolism, and Aging," examining emerging evidence that FSH biology may extend beyond its traditional reproductive role. Dr. Minich has authored more than 50 peer-reviewed scientific publications, four book chapters, and seven consumer books, including The Rainbow Diet and Whole Detox. She has been a faculty member with the Institute for Functional Medicine since 2013 and received the 2025 Linus & Ava Helen Pauling Award in Functional Medicine. Across her research, teaching, and work at Symphony Natural Health, Dr. Minich is helping expand the conversation around women's hormonal health from a focus on individual hormones and symptoms toward a more integrated understanding of endocrine resilience, nutrition, lifestyle, and healthy aging.

Connect with Dr. Deanna Minich:

www.deannaminich.com

Episode Resources:

Symphony Natural Health: https://symphonynaturalhealth.com
Femmenessence: https://femmenessence.com

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Medical Disclaimer
This podcast and website represent the opinions of Dr. Shawn Tassone and his guests. The content here should not be taken as medical advice and is for informational purposes only. Because each person is so unique, please consult your health care professional for any medical questions.

IMPORTANT CONTEXT

FSH research discussed here includes observational and preclinical findings; it does not establish that lowering FSH prevents dementia or other diseases. Femmenessence may affect hormone levels and is not appropriate for everyone. Anyone with hormone-sensitive cancer or taking cancer treatment should consult their oncology team before use. Monitoring estrogen levels alone does not establish cancer safety.

This episode is educational and does not replace individualized medical care. Dr. Minich works for the company that produces Femmenessence; Dr. Tassone discusses his clinical experience and work with its team.