If you carry a BRCA mutation, chances are you’ve been told two terrifying things:

Your cancer risk is higher.

And hormones are dangerous.

But here’s the question women are almost never given a straight answer to:

If you remove your ovaries early to reduce cancer risk…

are hormones truly off the table — or are we harming women by withholding them?

Today on Hump Day Hormones, we’re breaking down BRCA mutations, breast cancer risk, and hormone therapy — with data, nuance, and clarity instead of fear and headlines.

This episode is a natural follow-up to our conversation on surgical menopause, because for many BRCA carriers, risk-reducing surgery means abrupt, early menopause.

We break down:

🔥 Why BRCA1 and BRCA2 carriers are often advised to remove ovaries in their 30s–40s

🔥 Why surgical menopause is not the same as natural menopause

🔥 How sudden estrogen loss increases risk for heart disease, bone loss, cognitive changes, sexual dysfunction, and overall mortality

🔥 The real fear driving hormone avoidance — and where it came from

🔥 Why older hormone studies don’t apply to young women thrown into menopause overnight

🔥 Why BRCA carriers are biologically different from average-risk populations

Then we get into what the science actually shows.

We walk through:

🔬 Landmark studies showing hormone therapy does not undo the breast cancer risk reduction from ovary removal

🔬 Why estrogen-only therapy appears most reassuring when possible

🔬 Why progesterone type matters — and why “not all progesterone is created equal”

🔬 What large cohort and meta-analysis data really say about breast cancer risk

🔬 Why context matters: age, timing, dose, route, and duration

We also cover:

✔ What ACOG and international menopause societies actually recommend

✔ Why short-term hormone therapy after early or surgical menopause may be appropriate — and protective

✔ How symptom control, bone, heart, and brain health factor into the decision

✔ What we still don’t know — and why individualized counseling is essential

Hormone therapy in BRCA carriers is not:

❌ An automatic “no”

❌ One-size-fits-all

❌ A decision driven by fear alone

It is:

✅ Nuanced

✅ Evidence-based

✅ About balancing risk, quality of life, and long-term health

For women with BRCA mutations, the real danger isn’t hormones —

it’s oversimplified advice.

If this episode helps bring clarity where there’s been fear, share it with the woman who’s been told “you just can’t” — without ever being told why.

If you’ve ever been told,

“Once you have a hysterectomy, you’ll go straight into menopause,”

this episode is for you — because that statement is not always true.

Today we’re breaking down one of the most misunderstood topics in women’s health: hysterectomy, surgical menopause, and what actually happens to your hormones — without fear, confusion, or outdated advice.

This episode was inspired by a powerful listener story and tackles the questions women are rarely given clear answers to:

• Does removing the uterus automatically cause menopause?

• Do ovaries still make hormones after hysterectomy?

• What’s the difference between surgical menopause and natural menopause?

• Why do symptoms after ovary removal feel so intense — and why are they often undertreated?

We explain why hysterectomy is not one single surgery, and why lumping all procedures together causes unnecessary fear and misinformation.

We break down:

• What menopause actually is (hint: it’s about ovaries, not periods)

• Why losing your period does NOT automatically mean menopause

• The difference between hysterectomy with ovaries left in place vs ovaries removed

• Why surgical menopause feels more abrupt and severe than natural menopause

• How sudden estrogen loss affects the brain, joints, sleep, mood, sex, and metabolism

• Why many women in surgical menopause are excellent candidates for hormone therapy

• What “replacement-level” estrogen really means for younger women

• Why “lowest dose for the shortest time” doesn’t make sense for everyone

• How labs, symptoms, and history should guide care — not fear

We also talk honestly about:

• Why hormone needs after surgical menopause are different

• Why underdosing is so common — and so harmful

• What major medical societies actually recommend

• How to know if you’re truly in menopause when you no longer have periods

If you’ve had a hysterectomy…

If you’re facing ovary removal…

Or if you’ve been told “this is just how it is now” after surgery…

This episode is here to remind you:

Your uterus is not the hormone factory — your ovaries are.

Surgical menopause is real.

And your symptoms deserve real treatment.

Fear should never replace facts — and menopause care should never stop at dismissal.

If this episode helps you, share it with a woman who’s been given more warnings than answers.

If your joints ache when you get out of bed…

If your hands hurt opening jars that never used to be a problem…

If your muscles feel weaker, softer, or harder to maintain — even though you’re trying…

You’re not imagining it.

You’re not broken.

And no — this is not “just aging.”

Today on Hump Day Hormones, we’re talking about joint pain and sarcopenia — two of the most common (and dismissed) complaints in perimenopause and menopause.

This episode is part of our Head-to-Toe Menopause Series, and it tackles what’s now being recognized as the musculoskeletal syndrome of menopause.

We break down:

🔥 Why up to 70% of midlife women experience new or worsening joint and muscle pain

🔥 Why perimenopause is a uniquely vulnerable time for musculoskeletal symptoms

🔥 How fluctuating and declining estrogen affects bones, joints, cartilage, tendons, and muscle

🔥 Why inflammation increases — and recovery slows

🔥 Why muscle loss accelerates in menopause (and why that matters for metabolism and insulin resistance)

🔥 Why symptoms often worsen with poor sleep, stress, or under-fueling

🔥 How to tell hormone-related pain from red flags that need further workup

If your knees, hips, hands, shoulders, or feet suddenly hurt — this is a real, recognizable pattern.

And then we get practical about what actually helps.

We talk about:

✔ Why resistance training is non-negotiable in menopause

✔ How much protein women actually need to preserve muscle

✔ Why even distribution of protein matters more than total grams

✔ Creatine and collagen — what the evidence actually shows

✔ How estrogen therapy can reduce joint pain for some women

✔ The role of testosterone in preserving lean mass (and why it’s not magic on its own)

✔ Why thyroid, vitamin D, iron, and inflammation labs matter

✔ When pain is not hormonal — and should not be ignored

Joint pain and muscle loss in menopause are not:

A personal failure

A lack of motivation

Something you should “just get used to”

They are:

A physiologic transition

Influenced by hormones, inflammation, sleep, nutrition, and stress

Highly responsive to the right, layered strategy

If you’ve been told, “This is just aging,” that’s outdated medicine.

Your body isn’t betraying you.

It’s asking for a different approach.

And the good news?

This is a season where small, consistent changes make a big difference — in strength, function, and how you feel in your body.

This episode is part of our Head-to-Toe Menopause Series, and it tackles one of the most underdiagnosed and undertreated menopause conditions out there — GSM. This is a menopause symptom that’s incredibly common, highly treatable, and somehow still whispered about like it’s a secret.

If you’ve ever thought:

“Why does sex suddenly feel like sandpaper?”

“Why am I peeing all the time?”

“Why do I feel irritated down there for no reason?”

You’re not broken.

You’re not “just getting older.”

You may have Genitourinary Syndrome of Menopause (GSM) — and today, we’re talking all about it.

We break down:

• What GSM actually is (and why it replaced the outdated term “vaginal atrophy”)

• Why symptoms often persist and worsen without treatment

• How low estrogen changes vaginal, vulvar, and urinary tissue at a structural level

• Why this is about collagen, blood flow, pH, and microbiome — not “just dryness”

• Why GSM can affect sex, bladder control, UTIs, irritation, and pelvic floor health

• Why common doesn’t mean normal — and why we should be talking about this more

And then we get very clear about what actually helps.

We talk about:

• The difference between lubricants and vaginal moisturizers

• Why vaginal estrogen is not a lubricant — and why that matters

• Why low-dose vaginal estrogen is the gold standard for GSM

• What the research really says about systemic absorption and safety

• Vaginal estrogen vs DHEA — and why “not estrogen” doesn’t mean safer

• What ACOG, AUA, and menopause societies actually recommend

• When pelvic floor physical therapy can be a game changer

• Why lasers and energy-based devices deserve a cautious conversation

GSM is not:

• Rare

• A personal failure

• Something you just have to live with

It is:

• Common

• Progressive without treatment

• One of the most treatable menopause conditions we see

If you’re dealing with dryness, irritation, pain with sex, urinary urgency, or recurrent UTIs — bring it up.

If your clinician doesn’t ask, you can.

And if your symptoms are dismissed, it’s okay to get a second opinion.

Menopause symptoms don’t need to be miserable — and this one is especially fixable.

New Episode of Hump Day Hormones is LIVE!

You didn’t suddenly lose discipline.

You didn’t forget how to eat or move.

And no — this is not a willpower problem.

If you’ve hit midlife and thought:

“I eat the same. I move the same. Why is everything going to my stomach?”

This episode is for you. 👖➡️😩

Today on Hump Day Hormones, we’re talking about menopause metabolism — and why fat suddenly packs up and moves straight to your belly.

This episode is a deeper, science-backed follow-up to our fan-favorite Menopause and Muffin Tops, because this topic deserves more than “eat less and move more.”

We break down:

🔥 Why perimenopause is the phase when women gain the most weight (yes, it’s proven)

🔥 Why estrogen loss alone is an independent risk factor for weight gain

🔥 Why menopause shifts fat toward the belly (visceral fat) — and why that matters

🔥 Why this fat is metabolically active and inflammatory (not the pinchable kind)

🔥 How cortisol, insulin resistance, and sleep disruption fuel the belly-fat loop

🔥 Why muscle loss quietly slows your metabolism behind the scenes

🔥 The evolutionary reason your body is choosing hormone survival over a flat stomach

And then we get real about solutions — not punishment.

We talk about:

✔ Why strength training is non-negotiable in menopause

✔ How protein becomes a hormonal tool, not a diet trend

✔ Why chronic calorie restriction backfires (hard)

✔ How sleep and stress directly influence belly fat storage

✔ How estrogen, testosterone, and properly dosed HRT can support metabolic health

✔ Why transdermal estrogen matters more than most people realize

And yes — we go there.

Belly fat in menopause is not:

❌ A personal failure

❌ Proof you’re “doing it wrong”

❌ Something you fix by eating less

It is:

✅ A hormonal adaptation

✅ A metabolic signal

✅ A clue about insulin, cortisol, muscle, and estrogen

Menopause doesn’t break your metabolism.

It changes the game.

And when the rules change, the strategy has to change too.

If this episode hit home, share it with the woman who keeps asking:

“Why is it all going to my stomach?”

Because now — you know. 💥

It may be freezing outside — but if you’re in midlife, it might feel like your body is on fire. 🔥

In this episode of Hump Day Hormones, we continue our Head-to-Toe Menopause Series by turning up the heat and tackling one of the most misunderstood (and dismissed) menopause symptoms: hot flashes.

If you’ve ever gone from “I’m fine” to “why am I radiating like a space heater?” in under 30 seconds — this episode is for you.

We break down:

• Why hot flashes start in the brain, not just the ovaries

• How estrogen stabilizes your internal thermostat — and what happens when it drops

• Why hot flashes are neurologic and vascular events, not just “being warm”

• The role of KNDy neurons and why they’re the real stars of the show

• Why you can swing from sweating to shivering within minutes

• The difference between hot flashes and histamine flushing

• Why night sweats are especially disruptive to sleep, cortisol, and metabolism

And here’s where it gets really important:

Hot flashes may be an early signal of vascular stress.

They don’t cause heart disease — but growing evidence shows they may act like a check-engine light for cardiovascular health during menopause.

We also cover:

• The connection between hot flashes, cortisol, insulin resistance, and inflammation

• Why more severe or frequent hot flashes deserve attention — not dismissal

• FDA-approved hormonal treatments and why they work so well

• Non-hormonal treatment options (SSRIs, gabapentin, and newer neurokinin-3 receptor antagonists)

• What lifestyle strategies help — and what won’t fix the root cause

Bottom line:

Hot flashes are real, biologically meaningful, and treatable.

They are not “just in your head,” not something you have to live with, and not a rite of passage you’re meant to suffer through.

Your body is communicating with you — and it deserves to be listened to.

We’re smack dab in the middle of Menopause Awareness Month (and yes, it’s also Breast Cancer Awareness Month) — so today, we’re taking things back to the basics. No studies, no medical jargon, just an honest, relatable conversation about something every woman eventually faces: how to actually talk to your provider about perimenopause, menopause, and hormone health.

If you’ve ever left your appointment thinking, “That was… not helpful,” or felt brushed off when you brought up hot flashes, brain fog, low libido, or the sudden mood swings that seem to appear out of nowhere — you are not alone. Women everywhere are having the same frustrating experience, and it’s time to change that.

This week, we’re unpacking what makes these conversations so difficult — from the lack of provider training in menopause management to the old-school medical biases that still label women as “emotional” or “overreacting.” Spoiler alert: it’s not you. The system has a lot of catching up to do.

We’re giving you a clear, actionable framework to help you walk into your next appointment confident and prepared. We’ll cover:

*How to schedule the right kind of appointment (and why an annual exam isn’t always the time for hormone talk)

*What to ask when choosing your provider — and how to find one who truly understands perimenopause and menopause

*How to track and articulate your symptoms like a mini hormone detective (because vague complaints get vague answers)

*How to set clear goals and expectations before you even step into the room

Happy Menopause Month! This week on Hump Day Hormones, we’re wrapping up our deep-dive into the perimenopause–estrogen–liver–gut connection with one seriously underrated superstar: your estrobolome — the gut bacteria squad that manages how estrogen moves through your body.

Think of it as your hormone recycling center — deciding whether estrogen gets shipped out for good or sneaks back in for a second round. When it’s balanced, life feels smooth: your mood is stable, your sleep makes sense, and your jeans fit the same two days in a row. But when it’s off? Cue bloating, irritability, and that lovely estrogen dominance storm we all know too well.

In this episode, we unpack how your gut influences everything from estrogen balance and thyroid health to inflammation, metabolism, and mood. You’ll learn why gut bacteria shifts during menopause can increase stubborn belly fat, trigger hot flashes, and even alter your mental clarity — and what you can do to fix it.

We’re talking probiotics, fiber, liver detox support, and the science-backed foods and supplements that actually help your body work with your hormones, not against them.

It’s the perfect mix of nerdy, necessary, and just a little bit sassy — because who said hormone education had to be boring?

Tune in, take notes, and let’s keep breaking down the stigma around women’s health one Wednesday at a time.

Your liver does more than help you survive margarita night—it’s the ultimate hormone traffic controller. From clearing out extra estrogen to converting thyroid hormones and even sweeping away excess cortisol, your liver keeps hormone chaos from piling up.

But when it gets sluggish? That’s when the real drama begins. Think heavy, painful periods, stubborn belly fat, 2 a.m. wakeups, PMS meltdowns, and even that one glass of wine hitting you like a freight train. Yep—your liver might be whispering “help me out here!”

In this week’s episode of Hump Day Hormones, we’re diving into:

✨ Why estrogen metabolism matters more than you think

✨ How a “congested” liver backs up hormones and fuels perimenopause mayhem

✨ The clinical signs your liver is waving a white flag (hello bloating, fatigue, and mood swings)

✨ What slows down liver detox—like stress, sugar, alcohol, and everyday toxins

✨ The two-step process of hormone detox (Phase 1 & Phase 2) and how food + lifestyle make all the difference

✨ Practical, science-backed ways to support your liver so your hormones stay balanced and your body feels like yours again

Think of it as a crash course in why your liver is the unsung hero of hormone balance—and why kale, beets, fiber, and maybe skipping that extra glass of rosé might just change your life.

Ever feel like your hormones are on a rollercoaster with no seatbelt? Welcome to perimenopause – or as some have called it, “puberty in reverse.” In honor of Perimenopause Awareness Month, we’re back with part two of our special series, and this week it’s all about estrogen: the multitasking, drama-filled hormone that keeps your brain, bones, heart, and skin in balance... until it doesn’t.

Last week, Jackie Piasta helped us unpack why perimenopause is finally getting the attention it deserves as millennials begin “hitting the pause.” Today, we dive into why estrogen is so unpredictable during this transition and why progesterone seems to skip the invite altogether. From heavy periods one month to hot flashes and night sweats the next, estrogen’s highs and lows can leave women feeling like they’re living in hormonal whiplash.

We’ll break down the stages of perimenopause, talk through what estrogen dominance really means (and why mainstream medicine side-eyes the term), and explore the real-life symptoms women face daily—brain fog, anxiety, sleep struggles, mood swings, libido changes, and more. Think of it as decoding the chaos so you can finally understand what’s happening inside your body.

This episode is fun, raw, and empowering, with practical takeaways that will leave you feeling less alone and more equipped to handle this transition. Because perimenopause isn’t just about periods—it’s a full-body journey. And understanding estrogen’s drama is the first step in taking back control.