324. Perimenopause is Real

324. Perimenopause is Real

🎙️ Episode 324: Perimenopause is Real—What You Need to Know with Jackie Piasta, WHNP-BC Perimenopause is real—and often misunderstood. In this episode, I sit down with women’s health nurse practitioner Jackie Piasta to unpack the truth about this critical (and neglected) phase of midlife. If you’ve been told “you’re too young” or “just tough it out,” this conversation will feel like the validation you’ve been missing. Jackie and I dive into what perimenopause really looks like—from migraines and mood swings to weight gain and disrupted sleep—and why these symptoms deserve real answers, not dismissal. We talk through what’s happening hormonally, why lab tests aren’t the gold standard, and how to shift from a “birth control” mindset to a hormone-optimization mindset in your 30s, 40s, and beyond. In this episode: Why perimenopause can start in your 30s—even with regular periods Common myths that keep women suffering in silence How to track symptoms and cycles instead of chasing lab results The role of hormonal birth control—and when it helps vs. masks symptoms How estradiol, progesterone, and vaginal hormones can support brain, sleep, and libido Supplements and newer options: magnesium, L-theanine, flibanserin, even topical CBD Real-world patient cases that show how individualized care changes lives Top takeaways: Perimenopause is a clinical diagnosis—there’s no perfect test. Hormonal fluctuations can cause real physical, emotional, and cognitive changes. Bone loss, lipid changes, and heart risks start before menopause. Progesterone is often underused but powerful for night sweats, anxiety, and sleep. SSRIs are not first-line for new-onset mood changes in perimenopause. Early intervention matters—don’t 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: it’s not just about hot flashes. This episode is your permission slip to stop toughing it out and start asking for care that actually helps. 🔗 Referenced Studies & Resources: Brinton RD et al. Perimenopause as a neurological transition state. Nat Rev Endocrinol. 2015;11(7):393-405. Wu B et al. Trajectories of Blood Lipids Profile in Midlife Women. J Am Heart Assoc. 2023;12(22):e030388. SWAN Study: Lipid trajectory insights through the menopausal transition https://www.instagram.com/jackiep_gynnp https://www.mymonarchhealthco.com/ Want more honest, empowering conversations like this one?⁠Preorder my Next Book⁠ share this episode, and leave a review to help others find this important work. Let's stop leaving women out of the conversation—especially when it comes to sex, health, and healing. Listen to my Tedx Talk: ⁠⁠⁠⁠⁠⁠⁠Why we need adult sex ed⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠Take my Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠ To learn more about GennaMD by Solv Wellness, visit ⁠⁠⁠⁠⁠⁠⁠gennaMD.com ⁠⁠⁠⁠⁠⁠⁠for 20% off your first order. For an additional $5 off, use coupon code DRKELLY5. Providers can request patient education materials or samples at ⁠⁠⁠⁠⁠⁠⁠gennaMDHCP.com⁠⁠⁠⁠⁠⁠⁠. Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

Avsnitt(334)

3 Easy Wins

3 Easy Wins

Sometimes the assumption is that pelvic pain and sexual dysfunction is so very complicated.  Don't get me wrong, sometimes it is.  Doctors don't always have the "magic wand" that we all want.  BUT, sometimes the "win" or solution is just so easy I had to share them here (bonus 4th easy win included because it was just so fun I did't want to stop).  Win #1 - lube Win #2 - estrogen cream Win #3 - Responsive Desire Bonus Win #4 - listen and learn!  --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

7 Juni 20209min

Pelvic Organ Prolapse Master Class

Pelvic Organ Prolapse Master Class

Required listening for anyone who has been told they have prolapse.  1) what it is  2) why women get it  3) non-surgical options  4) surgical options  5) post op expectations  6) risks of surgery --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

31 Maj 202039min

Episode 20! - 237 Reasons Why People Have Sex

Episode 20! - 237 Reasons Why People Have Sex

In a now groundbreaking and often referenced paper "Why Humans Have Sex," Cindy Meston and David Buss asked over 700 individuals to list the reason why they last had sex.  Well, get ready for some spoken word poetry as Dr. Casperson reads all 237 reasons out loud.  Pay attention to your thoughts and judgements as your brain will tell you what you think the right and wrong reasons are!  Our biases are strong, but as they learned, there is not just one reason!  --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

24 Maj 202014min

For The Men! Intimacy Options After Prostate Cancer Treatment

For The Men! Intimacy Options After Prostate Cancer Treatment

This is our first episode geared towards the guys!  Join me and guest Dr. Pohlman as we discuss his podcast - The Prostate Health Podcast and his area of expertise, men's prostate and sexual health.  What we will learn: Changes after prostate cancer treatment Sex after prostate cancer Why men have more erectile dysfunction as they age. Options for intimacy after prostate cancer treatment. The role of testosterone after prostate cancer. www.prostatehealthpodcast.com --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

17 Maj 202020min

Steamy Sex Ed - second half

Steamy Sex Ed - second half

The second half of the steamy sex ed talk is here!  Ride along and you will learn:  Mindfulness for COVID and sex Faking orgasm Porn is fake Resources to help women achieve pleasure Why Penis in Vagina sex is bad for female orgasms Clitoral anatomy Medication for hypoactive sexual desire disorder Sexual pain Top tips for sex! Book recommendations --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

10 Maj 202026min

Steamy sex ed - part one

Steamy sex ed - part one

I did a lecture on female sexual dysfunction 101 and I broke it into two episodes for you! In this first half, learn about: How a urologist got into female sexual health Orgasmic inequality in heterosexual relationships Low desire versus bad sex Why women have sex Mindfulness for better sex Alcohol and sex - the good and bad Spontaneous versus responsive desire Sexual desire mismatch Tips for creating desire in a long term relationship --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

3 Maj 202021min

Uberlube Unboxing and Vaginal Estrogen

Uberlube Unboxing and Vaginal Estrogen

Uberlube.com sent me a box of goodies to share!  In this episode we talk about the importance of lubrication! I also answer a listeners question about vaginal estrogen, its purpose, expectations and limitations. Enjoy! --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

26 Apr 202019min

The Menopause Symptom No One Talks About!

The Menopause Symptom No One Talks About!

When estrogen goes away, the vulva and vagina loose their blood flow, elasticity and resistance to injury and infection. You are more prone to dryness, infections of the bladder and vagina and pain with intercourse. In this podcast we will learn about: Options for treatment, over the counter and prescription. Why lube is important. Lasers. In addition we will touch briefly on the specific population of breast cancer survivors. And in the general population, why estrogen isn’t always scary. Enjoy! --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

19 Apr 202020min

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