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)

Meet a Pelvic Floor Physical Therapist!

Meet a Pelvic Floor Physical Therapist!

Sit down with me and meet Amanda Nayfield PT, DPT, WCS, pelvic floor physical therapist, mom, wife, and outdoor adventurer! And check her out @connectNWPT What you will learn in this episode: How she got interested in pelvic health in her training as a physical therapist A personal success story in pelvic pain and intimacy What happens at the first physical therapy appointment What a pelvic floor assessment entails and why it is important How a physical therapist’s exam is different from a medical doctor’s pelvic exam How pelvic PT helps postpartum pelvic and sexual health How pelvic PT helps menopausal sexual dysfunction How pelvic PT helps males with pelvic pain --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

12 Apr 202030min

Pelvic Exams - I know I know, your favorite topic!

Pelvic Exams - I know I know, your favorite topic!

Okay, I get it. Who wants to listen to a podcast about pelvic exams?  You! Why? Because they are so important in the workup of pelvic pain and sexual health concerns!  You will learn how I think about pelvic exams and how my exams are different than your "average" pap smear exams. I did the best I could to keep this one short and sweet! I hope it brings you value and understanding! - Dr. C. Things you will learn: Reasons that you need a pelvic exam with sexual dysfunction How you can “see” estrogen status with a pelvic exam. Clitoral phimosis is a thing! This can decrease orgasms. The dry posterior vulva! Oh my! CT scans and MRI can’t usually “see” pain. Pelvic floor muscles - you can’t see them but you can feel them on exam and if you reproduce the pain we have found a reason for pain. Reasons for pain during sex (dyspareunia) can be found on a pelvic exam. --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

5 Apr 20207min

Question and Answer Round Two - A Urologist and Sex Therapist

Question and Answer Round Two - A Urologist and Sex Therapist

The second half has dropped!  Join Dr. Casperson and Tracy Rienstra, M.Ed., Health Educator, Peer Sexual Health Education (PSHE) coordinator. Topics discussed this time:  How do you bring up sexually transmitted infections in a new relationships? How do advocate when your medications cause sexual side effects? Sexual desire mismatch in a relationship. Female “ejaculation” or squirting - what is that about? How do I explore my sexual boundaries? I have been faking orgasms - HELP! - Where do I go from here? How to talk to your partner about faking orgasms Advice for someone who is scared to have sex for the first time. What to do with competing sex drives. --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

29 Mars 202037min

Question and Answer with a Sex Therapist and a Urologist - episode one of two

Question and Answer with a Sex Therapist and a Urologist - episode one of two

Dr. Casperson and Tracy Rienstra, M.Ed., Health Educator and Peer Sexual Health Education (PSHE) coordinator meet up to talk Q&A's that were asked of them as a part of a University lecture on sexual health.  In this episode topics discussed: Is my anatomy normal?  Basic Genital Care What does the vulva include? Why post menopause causes more UTI and infection The care and cleaning of foreskin The most common penis issues in our clinics Blood flow and erections Why smoking causes erectile dysfunction Premature ejaculation How to get curious when erectile dysfunction is a problem in a relationship Is erectile dysfunction the end of your sex life? Am I having unrealistic expectations for my body? Side effects of antidepressants. --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

25 Mars 202027min

Lichen Sclerosis

Lichen Sclerosis

We all want good skin.  But what happens when the skin condition is in the private area?  This is a skin condition 101 talk on lichen sclerosis.  It affects up to 3% of all women (and some men too).  Learn about it and how it is treated.   --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

1 Mars 202010min

Testosterone For Desire in Women

Testosterone For Desire in Women

Today we are learning about the role of testosterone in female desire disorders.  A brand new consensus guideline just came out dictating the role of testosterone in post menopausal women with low sexual desire. What a great time to learn more! You will learn: The myth that testosterone is a male hormone. How aromatase affects one’s active testosterone, in both men and women. How testosterone plays a role in sexual desire and overall health. How well does testosterone work for HSDD (hypoactive sexual desire disorder). The role of placebo in sexual health studies including the Viagra studies. Side effects of too  much testosterone. Who shouldn’t take testosterone. Myths of testosterone. Why is there no FDA approved testosterone product for women? --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

15 Feb 202028min

Sexual Dysfunction page 2 - the second half of the handout

Sexual Dysfunction page 2 - the second half of the handout

Today's podcast is a rundown of the back side of my sexual dysfunction handout.   Topics include: Hormones The proper application of Vaginal estrogen - in my opinion Estrogen creams verus tabs Lubrication recommendations and vulvar skin care Intravaginal DHEA AASECT certified sex therapists Pelvic Floor Physical Therapist recommendations Book Recommendations Desire in a long term relationships Apps and Websites for pleasure and orgasm Vaginal lasers - what they are good and not good for And of course, always remember that is is not individual medical advice.  Yes I am a doctor, but this is for general health information only.  --- 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 Feb 202021min

Female Sexual Dysfunction Handout Front Page

Female Sexual Dysfunction Handout Front Page

When you come see me for sexual dysfunction issues there is a double sided handout that you get in the office.  Well here I break down the information on the front page of the handout for you!  We talk about desire (spontaneous and responsive), arousal, orgasmic dysfunction and sexual pain concerns.   We talk about what is normal, what could be causing your lack of success in this arena, as well as different treatment options. Stay tuned next week for the back page!!! --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

28 Jan 202021min

Populärt inom Hälsa

somna-med-henrik
rss-bara-en-till-om-missbruk-medberoende-2
inga-beiga-morsor
alska-oss
sexnoveller-deluxe
johannes-hansen-podcast
angestpodden
not-fanny-anymore
sova-med-dan-horning
brottarbroder
dilemma-2
en-beroendepodd-av-the-house
tyngre-traningssnack
sa-in-i-sjalen
rss-viktmedicinpodden
rss-beroendepodden
rss-sjalsligt-avkladd
halsoveckan-by-tyngre
rss-activation-podcast
dodsdomar