Finally Answered

In this podcast episode Stasha-Gae Roberts, DNP, founder of Compassion Primary Care discusses whether weight gain in midlife may be related to hormonal changes. It notes that hormones can fluctuate or decline, but nutrition and calorie intake remain relevant. Hormones also affect systems throughout the body, potentially influencing thinking, sleep, energy, mood, stress responses, food cravings, sexual health, and fat storage.

Stasha identifies accompanying symptoms as one clue that hormones may be contributing to weight gain. These may include fatigue, disrupted sleep, cravings, brain fog, changes in libido, vaginal dryness, and thinning or loss of hair. Timing is another consideration, including perimenopause, menopause, the period after childbirth, or starting medications such as birth control pills.

The pattern of weight distribution may also offer clues. This episode discusses weight concentrated around the abdomen, buttocks, or thighs, and describes insulin resistance and changes in cortisol as possible factors associated with abdominal weight gain. It emphasizes that weight changes can involve physiological processes, even when someone is attentive to eating, exercise, and stress management.

Stasha explains that estrogen can fluctuate rapidly during perimenopause, alongside changes in mood, fatigue, and menstrual cycles. Progesterone declines more gradually, while testosterone may be suboptimal; these hormonal changes may affect weight, muscle gain, and weight loss. Common approaches that once worked may need adjustment, such as adding resistance or strength training.

Stasha concludes that symptoms, weight distribution, and life stage should be considered together when assessing possible hormone-related weight gain. The next episode will discuss which specific factors are checked when evaluating these concerns.

This episode discusses testosterone as one possible factor in fatigue and other concerns among midlife women, particularly when routine lab results are described as normal. It explains that testosterone is produced by the ovaries and other parts of the body, gradually declines, and has receptors throughout the body. The speaker emphasizes that treatment aims for physiological levels rather than male-range levels.

Stasha-Gae Roberts, DNP and Founder of Compassion Primary Care, describes her approach to assessment: reviewing symptoms and prior lab results, taking a thorough history, and considering factors beyond hormone levels, including ferritin, vitamin D, thyroid function, and sex hormone-binding globulin (SHBG). She notes that lab reference ranges are population averages and says results should be considered alongside a patient’s symptoms and history.

Testosterone formulations, including oral medication, pellets, injections, topical creams, and vaginal applications are reviewed. Stasha does not prescribe oral testosterone or pellets, and typically uses creams or compounded injections. She explains that formulation and dosing are selected individually, and discusses vaginal application as an option when symptoms include dryness or painful intercourse.

Treatment considerations for women with a cancer history or concerns about estrogen, noting that hormone use should be discussed in light of individual circumstances and may involve consultation with an oncologist. She also describes compounded medications as a way to tailor formulations and doses, and discusses the limited research on testosterone for women, including challenges with measuring low levels.

Monitoring is presented as part of treatment. Stasha describes follow-up around six weeks after starting therapy and repeat blood work around three months later. Possible signs of excessive testosterone include acne, facial hair, oily skin, voice changes, hair loss, aggression, and mood changes.

The podcast concludes by placing hormone treatment within a broader review of health, including thyroid function, gut health, nutrition, sleep, stress, and medication needs. The speaker emphasizes that testosterone is not appropriate for everyone and that care should be based on an individual’s symptoms and overall health.

This podcast episode explains that Compassion Primary Care does not bill insurance and operates as a direct primary care practice. Patients pay a monthly membership fee directly to the practice, with Stasha-Gae Roberts, DNP and Founder of Compassion Primary Care describing the model as having no additional or hidden fees. Patients may also keep commercial insurance, Medicare, or a health-sharing plan, but the practice does not accept Medicare Advantage or HMO patients.

Stasha contrasts direct primary care with insurance-based care, saying that insurance requirements can affect which diagnoses, tests, and treatments are covered. The membership model is presented as allowing more time with patients, including longer appointments and a more integrative approach focused on investigating possible root causes of health concerns.

Using car and homeowner’s insurance as comparisons, the lecture distinguishes routine care from coverage for major or unexpected expenses. Stasha encourages patients to retain insurance or another form of coverage for hospitalization, surgery, specialist care, and other high-cost situations, while using direct primary care for ongoing primary care and chronic health concerns.

This episode describes early investigation and preventive care as a way to identify health issues before they progress. Stasha gives insulin resistance as an example, noting that it can precede diabetes, and discusses looking for early signs related to chronic conditions such as diabetes and high blood pressure.

Stasha discusses lab and imaging costs, including functional tests that insurance may not cover. Patients are told the cost of testing in advance and may choose to pay out of pocket; the lecture notes that cash prices can sometimes be lower than insurance-billed costs.

The practice offers monthly access through calls, texts, virtual appointments, and in-person visits, which may take place in patients’ homes or at The Wellness Center of Ellenton. Stasha discusses how patients can combine membership with insurance, or pay out of pocket, and emphasizes transparent pricing.

We discuss the role of testosterone in women, noting that women naturally produce it in smaller amounts than men and that its use in women is not new. We also cover the FDA’s September 17, 2026 meeting on finding an approved treatment for postmenopausal women, and the speakers’ repeated point that more research is needed.

You woke up tired again. Nothing has changed in your life, and you have been diligent about your health. You eat well. You move your body. And something still does not feel right. You went to your doctor, the labs were done, and you were told everything was normal.You are not imagining this. You are not losing your mind. And you do not have to prove you are struggling to be taken seriously here.I'm Stasha-Gae Roberts, DNP, ARNP, AGPCNP-BC, BHRT-certified. Nurse practitioner, U.S. Army Veteran, and founder of Compassion Primary Care in Tampa, Florida. I built this practice for the woman who has been to the appointments, had the labs drawn, and left every single time knowing something was still wrong.This is the episode to start with. It is not about one symptom. It is about who I am, why this practice exists, and how I work.If you want to go further, I offer a free discovery call. It is not a medical visit, just a conversation to see whether this practice is right for you:https://link.compassionprimarycare.com/widget/bookings/new-call/discovery-call-stashaNot your twenties. Not your new normal. Finally, answers.

In this episode, Stasha-Gae Roberts, DNP and founder of Compassion Primary Care discusses whether bioidentical hormone replacement therapy (BHRT) may help with anxiety and mood changes during perimenopause and menopause. Shifts in estrogen and progesterone, along with symptoms such as night sweats, joint discomfort, and disrupted sleep, may contribute to anxiety, irritability, and changes in mood. BHRT may be one part of care for some women, but it is not a cure for anxiety or depression, and a medical evaluation is needed to identify possible causes.

Stasha explains how she assess new or worsening anxiety in midlife, beginning with a detailed history of symptoms, related changes, prior treatment, and their effect on daily life. Depending on the patient, evaluation may include hormone, cortisol, thyroid, and metabolic testing, as well as nutrient levels and gut testing. She also consider referrals, including mental health counseling or a sleep study, when appropriate.

She describes an individualized care plan that may address hormones, thyroid function, nutrient deficiencies, blood pressure, diabetes, sleep, stress, diet, hydration, caffeine, and exercise. The role of strength training and the possibility that over-exercising may contribute to health concerns for some women are also discussed. Follow-up, lab monitoring, and honest communication help us adjust the plan over time.

Lastly, Stasha explains how her Christian faith informs her approach to stress management for patients who share that belief, including prayer, scripture, church, and Christian counseling. She emphasizes that spiritual support can accompany, rather than replace, appropriate medical evaluation and care.