Clearly Hormonal

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

The number-one cause of death in women is still heart disease — and perimenopause is where your cardiovascular risk starts to quietly climb. This week, Dr. Komal sits down with Dr. Harpreet Tsui, an internist, obesity medicine specialist, and founder of Coronado Health (a direct primary care practice in Nevada), to break down the 2026 ACC/AHA Dyslipidemia Guidelines — the biggest update to cholesterol guidelines in years.

This is a personal episode. Both physicians are Southeast Asian women with significant family histories of heart disease. Both are managing their own cardiometabolic health in real time. And neither of them is willing to accept "your numbers look fine" as the end of the conversation.

They cover what's changed in the guidelines, which genetic cholesterol markers your doctor may not be ordering, why perimenopause can flip your lipid panel overnight, and the exact language to use at your next appointment to get the full picture.

Guest

Dr. Harpreet Tsui, MD Internist | Obesity Medicine Specialist | Founder, Coronado Health (Direct Primary Care, Henderson, NV)

📍 coronadohealthdpc.com 📱 Instagram & TikTok: @drharpreet.tsui

Timestamps

[0:00] — Podcast intro and medical disclaimer

[1:03] — Meet Dr. Harpreet Tsui: internist, obesity medicine specialist, founder of Coronado Health in Nevada — and why both she and Dr. Komal wanted to have this conversation as Southeast Asian women with significant family histories of heart disease

[2:48] — Why direct primary care: Dr. Tsui on leaving the 15-minute appointment model to build a practice centered on women's health, obesity medicine, and actually having enough time to talk

[4:42] — Guidelines confusion and statins: from the clear LDL targets of residency training to the ambiguous "lower it if you feel like it" era — and why statins have gotten an unfair reputation despite data showing they reduce heart disease, stroke risk, and even drive plaque regression

[7:01] — Mistrust and culture around medications: immigrant family attitudes toward asking for help, the "I can do it on my own" mentality, and how even physicians absorb enough noise to hesitate — including Dr. Tsui, who prescribed herself a statin and left it on her nightstand for two weeks before she could take it

[12:14] — Key update: risk-based treatment replaces number-chasing. The new PREVENT ASCVD calculator factors in HDL, triglycerides, family history, ethnicity, and even zip code — and gives you both a 10-year and 30-year cardiovascular risk estimate, not just a snapshot of today

[16:11] — Perimenopause and lipid shifts: why cholesterol can change dramatically when estrogen drops, even when lifestyle hasn't. Dr. Tsui's LDL went from 77 to 177 in perimenopause. Dr. Komal's Lp(a) was normal before — and then it wasn't. Neither of them did anything differently.

[20:59] — ApoB and Lp(a) explained: the two genetic cholesterol markers now in the 2026 guidelines as independent cardiac risk factors. Your standard lipid panel can look stone-cold normal while these are quietly elevated — and why both physicians now check them routinely on midlife women

[23:28] — Female-specific risk factors are finally in the guidelines: menopause, PCOS, gestational diabetes, and preeclampsia are now formally recognized as independent cardiovascular risk factors. The gestational diabetes gap — including the postpartum glucose tolerance test that routinely gets missed — and why preeclampsia has lifelong cardiovascular implications

[29:32] — Lower LDL targets and the case for being more aggressive: below 70 for high-risk patients, below 55 for very high-risk — and why vascular specialists have been pushing for LDL at or below 50 for years ahead of these guidelines

[31:33] — Beyond statins: PCSK9 inhibitors, ezetimibe, omega-3s, and emerging Lp(a)-targeted therapies in the pipeline — what your options are if you genuinely can't tolerate statins

[32:06] — Why guidelines change — and why that's not the same as being lied to: the science evolves, the tools get better, and the recommendations follow

[33:13] — Pandemic messaging lessons: Dr. Komal on "flatten the curve," what it actually meant, and how the gap between what medicine knows and what gets communicated to the public continues to fuel mistrust

[34:31] — Rebuilding trust in science: Dr. Komal's experience at her Washington hospital during the first COVID deaths in the country, the CDC arriving to learn rather than lead, and why uncertainty in medicine is not the same as deception

[38:33] — Midlife women and heart risk: why cardiometabolic risk isn't discussed nearly enough in the context of menopause, and what Dr. Komal is doing in her own practice to screen every midlife woman proactively — before anything on the standard panel looks alarming

[40:04] — Estrogen loss and metabolic shift: the mechanism behind why visceral fat increases, muscle mass drops, insulin resistance develops, and cholesterol climbs when estrogen declines — and why this is biology, not a lifestyle failure

[41:09] — Inflammation markers and hsCRP: why both physicians check high-sensitivity CRP routinely, what Dr. Komal found when hers came back elevated despite well-controlled autoimmune disease, and the vicious cycle of visceral fat and cardiovascular inflammation

[43:26] — Personal plans, statins, and GLP-1s: Dr. Tsui shares her own treatment journey — transdermal estrogen, a statin, and adding back a GLP-1/GIP combination — and how her LDL dropped back below 70 and her hsCRP normalized. The reminder that everyone's genetics are different, and so is the plan.

[45:22] — Lifestyle first, medication timing: how Dr. Tsui structures the first conversation with patients — a deep dive on diet, body composition, schedule, and food access — and her three-month reassessment framework before deciding on pharmacologic intervention

[47:47] — Calcium scores and hidden disease: the coronary artery calcium (CAC) score as a window into subclinical atherosclerosis — including Dr. Tsui's own score of 214 at age 43, discovered while trying to prove her heart was healthier than her husband's

[50:12] — Statin side effects and PCSK9 inhibitors: managing myopathy, dosing strategies for women (who metabolize statins differently), and how Dr. Tsui gets about 75% of patients who need a PCSK9 inhibitor to actually commit to it

[51:37] — Insurance barriers to care: prior authorization requirements for PCSK9 inhibitors, the specialist referral runaround, and what happens to patients when the system gets in the way of evidence-based treatment

[52:31] — What to ask your doctor: specific language and specific tests — family history, the PREVENT ASCVD calculator, Lp(a), ApoB, fasting insulin, ferritin, GLP-1 conversations, and the "skinny fat" discussion that Southeast Asian patients in particular deserve to have

[55:19] — Family history, kids, and screening: when to start checking cholesterol in children (as early as age two with significant family history), why puberty brings new risk considerations, and a message to primary care physicians and their own patients — including the data on female physician mortality that should make all of us pause

[57:24] — Closing thanks and where to find Dr. Harpreet Tsui: Coronado Health in Henderson, NV | coronadohealthdpc.com | @drharpreet.tsui on Instagram and TikTok

Resources Mentioned

• 2026 ACC/AHA Dyslipidemia Guidelines
• PREVENT ASCVD Risk Calculator (American Heart Association)
• MASALA Trial (South Asian cardiovascular health research)
• Coronado Health: coronadohealthdpc.com
• Clearly Hormonal Episode with Dr. Ambreen Mohamed (CT coronary angiogram and women's heart disease — coming soon)

Connect

Dr. Komal Patil-Sisodia Endocrinologist | Internist | Obesity Medicine | Menopause Society Certified Practitioner 📍 Eastside Menopause & Metabolism — Kirkland, WA | eastsidemm.com 📱 Instagram & TikTok: @drpatilsisodia

Dr. Harpreet Tsui Internist | Obesity Medicine Specialist | Founder, Coronado Health 📍 Henderson, NV | coronadohealthdpc.com 📱 Instagram & TikTok: @drharpreet.tsui

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

Heart disease has long been framed as a “man’s disease” – but women are being missed, misdiagnosed, and overlooked in ways that can be life-threatening, especially within South Asian communities where cardiovascular risk often develops earlier and more aggressively.

In this episode, Dr. Komal Patil-Sisodia sits down with advanced imaging and preventative cardiologist, Dr. Ambreen Mohamed, to unpack the evolving science of women’s cardiovascular health, the hormonal shifts that impact risk throughout midlife, and why prevention needs to start far earlier than most people realize.
Together, they explore the subtle symptoms women experience that are too often dismissed, the intersection of menopause, PCOS, pregnancy complications, insulin resistance, and heart disease, and why traditional risk calculators frequently fail to capture the realities of South Asian patients. Most importantly, this conversation reframes prevention not as fear-based medicine, but as empowerment: understanding your risk factors early enough to change the trajectory of your health before disease develops.

Connect with Dr. Mohamed: 

LinkedIn
TikTok
Instagram
Website

Connect with me: 

LinkedIn
TikTok 

Instagram

Eastside Menopause & Metabolism 

Audio Stamps :
00:00 – Dr. Komal introduces Dr. Ambreen Mohamed and sets up the conversation around women’s cardiovascular health, prevention, and South Asian risk

00:00 Podcast Mission Setup

01:05 Meet Dr Ambreen Mohamed

04:38 Why Women Get Missed

07:10 Women’s Heart Attack Symptoms

11:18 Hormones Menopause PCOS Risk

15:06 Pregnancy As Stress Test

18:36 Menopause Hormone Therapy Debate

25:59 South Asian Heart Risk Factors

28:02 Advanced Lipids Lp(a) ApoB

33:07 MASALA Study And Risk Tools

36:27 Perimenopause Lp(a) Spike

37:18 Estrogen and Lp(a) Research

38:11 Who Counts as High Risk

39:55 Doctors Still Learning

42:12 Labs to Ask For

43:31 Insulin Resistance Markers

46:15 Beyond Labs and Blood Pressure

47:52 Sleep Apnea and Heart Risk

48:41 CAC Score When It Helps

50:12 CT Angiogram and AI

54:32 Lifestyle Changes to Start Now

58:48 Advocating at the Doctor

01:02:31 Wrap Up and Where to Find Her

01:04:25 Final Takeaways and Call to Action

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

Between trackers, lab tests, supplements, hormone experts, social media, and podcasts, women have more access to health information than ever before. However, despite (and sometimes because) of these resources, many women end up feeling confused and distrustful of their own bodies. 

In this episode, Dr. Komal Patil-Sisodia explores various factors contributing to the ambiguity, including long-standing systemic gaps in women’s healthcare. From “normal” lab results that don’t align with very real symptoms to a healthcare system built around specialties instead of whole-body care, women have been conditioned to push through pain and discomfort in order to adjust to everyone’s convenience but their own.

If you’ve struggled to find clear, conclusive answers about your health, this episode highlights why self-advocacy is essential in securing the individual care and comprehensive treatment you deserve.

Connect with me: 

TikTok 

Instagram

Eastside Menopause & Metabolism

Audio Stamps :

01:06 – Why “normal” labs can often feel more devastating than reassuring 

03:35 – Why better access to women’s health information hasn’t created more clarity 

05:51 – Problem #1: How fragmented medical specialties leave women trying to piece together their own health story

09:23 – Problem #2: What “normal” lab results actually mean and why population-based reference ranges can miss meaningful hormonal and metabolic shifts

14:21 – Problem #3: How the “push through” culture discourages women from trusting themselves and engaging in self-advocacy

17:07 – Problem #4: Why the lack of understanding around the whole-body impact of hormones contributes to the general confusion  

20:40 – Problem #5: How the missing roadmap for midlife women’s health adversely impacts access to individualized care and effective treatment options

27:32 – How the ambiguity in women’s health is due to systemic weaknesses rather than personal ones

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

When it comes to hormonal health, women just aren’t set up for success. Unexpected physical symptoms and psychological side effects – combined with a lack of medical clarity and resources – can lead to overwhelming confusion and self-doubt. 

In this episode, Dr. Komal Patil-Sisodia breaks down the hormonal “eras” of a woman’s life -using Taylor Swift’s albums as a powerful and relatable framework. From childhood to postmenopause, she explains what’s happening in your body, why each phase feels so different, and why none of it is a flaw. She delves into the biology behind emotional shifts, burnout, midlife transitions, and the clarity that comes with age – and why your body, rather than working against you, is actually guiding you.

Because every era deserves to be understood. 

Connect with me: 

TikTok 

Instagram

Eastside Menopause & Metabolism

Audio Stamps :

01:53 – Dr. Patil-Sisodia introduces the idea that women transition between multiple hormonal eras throughout their lives. 

04:13 – The Foundation Era takes place during childhood and is largely influenced by environmental and interpersonal patterns that shape lifelong stress response patterns.  

07:10 – Emotional intensity during puberty, AKA the Amplification Era, is completely normal and a function of basic neurobiology. 

10:18 – The Reproductive/Productivity Era is often marked by fatigue and burnout due to constant over-exertion, both personally and professionally.

13:41 – During the fourth Era, Performance Peak, women gain a heightened awareness around their ongoing burnout, all while experiencing the initial stages of perimenopause.

19:55 – The main hallmark of the Midlife Transition Era is stronger self-esteem, which encourages better boundary-setting and self-advocacy.

27:40 – During the Postmenopause Era, many women acquire a profound sense of liberation, stemming from the acknowledgment that some of their best (and most carefree!) years are still ahead of them. 

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

Do you ever feel like you’re not getting straight answers about your hormones, your cycle, or your health? You’re not alone. Women’s health has historically been under researched, undervalued, and under resourced, leaving many women stuck navigating symptoms without real clarity or support.

In this episode, Dr. Komal Patil-Sisodia (endocrinologist, internist, obesity medicine specialist, and Menopause Society certified practitioner introduces her newly rebranded podcast, Clearly Hormonal, and shares why she made the decision to move away from Reset Recharge. Through a variety of personal and professional experiences in women’s healthcare, she has gained a deep understanding of how the gaps in research and education impact both patients and providers – and why so many women end up feeling dismissed, misdiagnosed, or misunderstood.

Dr. Patil-Sisodia breaks down the systemic issues that have shaped women’s healthcare, why confusion around reproductive and hormonal health is so common, and what needs to change. Her mission with Clearly Hormonal is simple but powerful: to cut through the noise, identify the right questions, and empower women by providing them the clarity and knowledge they deserve.

Connect with me: 

TikTok 

Instagram

Eastside Menopause & Metabolism 

Audio Stamps 

01:17 – Dr. Patil-Sisodia posits that women are advocating for themselves to the best of their ability in a healthcare system that has yet to give them a clear framework to understand and address their conditions.

03:40 – Dr. Patil-Sisodia discusses her early experiences withgaps in women’s healthcare when, as a young adult, shewitnessed her mother’s two-year struggle to receive a diagnosis and treatment for a cardiovascular condition.  

05:05 – How the tables turned on Dr. Patil-Sisodia when she became a patient, an experience that heightened her insight into the emotional and psychological struggles faced by women dealing with reproductive health issues. 

10:00 – The medical field has failed to provide physicians with clearly defined processes and protocol for addressing women’s hormonal health.

15:50 – Rebranding the podcast was an intentional and strategic shift stemming from Dr. Patil-Sisodia’s growing clarity around her core audience and evolving goals. 

17:50 – It’s time to reclaim the narrative around the word “hormonal” – it’s not drama, it’s physiology.

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

In this episode of Reset Recharge, host Dr. Komal Patil-Sisodia delves into the complexities of women's reproductive health with guest Dr. Emmie Strassberg, a maternal fetal medicine specialist. They discuss the challenges women face during pregnancy and preconception, especially for those over 40 or with chronic health issues. Dr. Strassberg shares insights on how mental health, physical health, and coaching play pivotal roles in managing difficult pregnancies and optimizing outcomes. They also explore the impacts of pregnancy complications on long-term health and provide practical tools for women navigating postpartum and perimenopausal transitions. Tune in for an informative and empowering conversation aimed at helping women take control of their reproductive health.

Connect with me:

TikTok

Instagram

Eastside Menopause & Metabolism

Audio Stamps:

00:00 Introduction to Reset Recharge
00:59 Focus on Pregnancy Challenges
02:00 Meet Dr. Emmie Strassberg
03:21 Personal Stories and Coaching
04:13 Medical Models and Coaching
06:42 Understanding Reproductive Health
09:02 Emotional Support and Therapy
14:08 Practical Tools for Difficult Pregnancies
16:19 Long-term Health Implications
19:24 Managing Chronic Reproductive Conditions
20:09 Women Taking Charge of Their Health
20:42 Managing PCOS and Pregnancy
21:10 Gestational Diabetes Concerns
22:47 Challenges with Glucose Testing
24:08 Continuous Glucose Monitors in Pregnancy
25:35 Mental Health and Pregnancy Outcomes
26:20 Perimenopause and Postpartum Overlap
28:23 IVF, IUI, and Hormonal Impacts
29:16 Importance of Treating Mental Health
34:18 Preconception Consults and Planning
35:55 Where to Find Dr. Emmie Strassberg

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

In this episode of 'Reset Recharge,' host Dr. Komal Patil-Sisodia, a triple board certified endocrinologist, interviews Dr. Jessica Yearwood, a Menopause Society certified practitioner, about the deep impacts of perimenopause and menopause on women's health. The conversation covers a range of topics including cardiovascular health, urinary tract infections, osteoporosis, vasomotor symptoms, and abnormal bleeding. Dr. Yearwood shares her insights and experiences as an emergency medical physician and provides valuable advice on managing these conditions. The episode emphasizes the importance of self-advocacy and informed discussions with healthcare providers, aiming to empower women to take control of their health during the menopause transition. Dr. Yearwood also introduces her new menopause clinic in Gig Harbor, Washington, which offers consultative and direct care for women.

Connect with me:

TikTok

Instagram

Eastside Menopause & Metabolism

Audio Stamps:

00:00 Introduction to Reset Recharge

00:55 Meet Dr. Jessica Yearwood

02:07 Understanding Menopause Symptoms

05:12 Cardiovascular Health and Menopause

16:30 Genitourinary Health and UTIs

25:21 Musculoskeletal Health and Osteoporosis

32:39 Vasomotor and Neuropsychiatric Symptoms

37:28 Abnormal Bleeding and Menopause

43:56 Dr. Yearwood's New Menopause Clinic

46:39 Conclusion and Contact Information

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

In this episode of Reset Recharge, host Dr. Komal Patil-Sisodia discusses her personal experiences and insights into managing medical crises for loved ones while emphasizing the importance of self-care. She shares practical strategies for organizing care and maintaining emotional and physical well-being during stressful times, particularly for midlife women caught in the 'sandwich era'—balancing responsibilities between children and aging parents. This episode highlights the importance of delegation, setting boundaries, emotional rest, and modeling self-care for future generations.

Connect with me:

TikTok

Instagram

Eastside Menopause & Metabolism

Audio Stamps:

00:00 Introduction to Reset Recharge

00:53 A Personal Story: Navigating a Medical Crisis

01:42 The Power of Journaling

02:40 The Sandwich Era: Balancing Multiple Roles

04:29 Organizing During a Medical Crisis

07:02 Self-Care Strategies for Caregivers

09:23 Conclusion and Final Thoughts

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

In this episode of 'Reset Recharge,' host Dr. Komal Patil-Sisodia, a triple board-certified endocrinologist and women's health expert, discusses the transformative journey of women's lives through various stages like puberty, reproductive years, and menopause. Revisiting the perspectives from a previous episode titled 'Mother Nature is Not a Feminist,' she now emphasizes resilience, adaptability, and the unique strengths women accumulate over time. The episode explores the positive cultural attitudes toward aging women in different societies, challenges the modern pace of life that contradicts natural biological processes, and promotes rest as a form of strategic health maintenance rather than laziness. Dr. Patil-Sisodia advocates for a cultural shift to honor the full arc of women's lives, recognizing midlife changes as moments for intentional self-care rather than decline.

Connect with me:

TikTok

Instagram

Eastside Menopause & Metabolism

Audio Stamps:

00:00 Welcome to Season Two

00:58 Revisiting Mother Nature

01:46 The Arc of a Woman's Life

02:53 Cultural Perspectives on Aging

04:08 The Modern Pace of Life

04:59 Reframing Midlife

05:59 The Importance of Rest

06:49 Mother Nature's Assignment

07:25 Redefining Success and Aging

08:26 Closing Thoughts and Future Episodes

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question.

In this episode of Reset Recharge, Dr. Komal Patil-Sisodia highlights the transformative year of 2025 in women's health, focusing on menopause care. Key topics include the FDA's rewording of black box warnings on hormone therapy, breakthrough non-hormonal treatments, and the American Heart Association's new cardiovascular guidelines. The podcast also covers advances in weight management, bone health, and preventive screenings, along with the elevation of lifestyle medicine and the growing field of fem tech.

Connect with me:

TikTok

Instagram

Eastside Menopause & Metabolism

Audio Stamps:

00:00 Introduction to Reset Recharge

00:50 Reflecting on 2025: A Year of Change in Women's Health

01:36 Breaking the Black Box Barrier

03:00 Non-Hormonal Breakthroughs in Menopause Care

04:16 Cardiovascular Milestones in Menopause

05:44 Weight Management and Bone Health Updates

07:44 Prevention and Early Detection Strategies

08:22 Lifestyle Medicine Takes Center Stage

09:12 Advancements in Sexual and Public Health

10:05 The Rise of Menopause-Specific Fem Tech

10:39 Multidisciplinary Approaches to Menopause Care

11:10 Conclusion: Embracing the New Chapter

Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.