I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this Ask the Heart Doctor-style episode, Dr. Alvarez reframes perimenopause as more than irregular periods, hot flashes, or poor sleep. What if perimenopause is not the beginning of the end of your hormones, but the beginning of your cardiovascular risk? And what if the symptoms women often dismiss — waking up at 3 a.m., feeling more anxious or irritable, fatigue, palpitations, blood pressure changes, or cholesterol shifts — are actually the body’s early warning signs?

Dr. Alvarez explains that perimenopause can begin in the late 30s or early 40s, sometimes even earlier, and that estrogen does not simply decline — it fluctuates. These fluctuations affect the brain, nervous system, blood vessels, inflammation, sleep, metabolism, and cardiovascular health.

With clarity and urgency, she breaks down:

• Why perimenopause is not the same as menopause
 • How fluctuating estrogen affects sleep, cortisol timing, heart rate, and the autonomic nervous system
 • Why waking up around 3 a.m. may be more than stress or poor sleep hygiene
 • How hormonal instability can affect blood vessels, nitric oxide, inflammation, and vascular tone
 • Why blood pressure, cholesterol, insulin resistance, and body composition can begin changing before menopause
 • Why women should not wait until something is “wrong” to evaluate their cardiovascular risk
 • What a proper cardiometabolic profile should include, such as fasting glucose, hemoglobin A1c, fasting insulin, advanced lipid testing, blood pressure patterns, visceral fat, muscle mass, and hormone patterns

This episode is a direct call-to-action: perimenopause is not something to ignore or simply push through. It is a critical window for prevention. If your body feels different, listen to it. Becoming the CEO of your own health starts with recognizing the signals early, asking better questions, and taking your cardiovascular future seriously.

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 Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this episode, Dr. Alvarez addresses a common experience for women entering perimenopause: feeling tired, anxious, disconnected, forgetful, or simply “not like yourself” — only to be told that it is stress, aging, or all in your head.

These symptoms are not random, and women are not overreacting. During perimenopause, estrogen does not simply decline. It fluctuates unpredictably, affecting the brain, blood vessels, metabolism, inflammation, and cardiovascular system. This can contribute to brain fog, fatigue, mood changes, anxiety, and heart palpitations.

Dr. Alvarez explains why women need to understand the connection between hormonal changes and heart health — and why waiting until something appears on a standard test may mean missing an important opportunity for prevention.

With clarity and urgency, she breaks down:
 • Why perimenopause can begin in a woman’s late 30s or early 40s — sometimes even earlier
 • Why estrogen fluctuations can affect the brain, heart, blood vessels, and immune system
 • Why symptoms such as fatigue, anxiety, brain fog, and palpitations are not simply signs of stress or aging
 • Why up to 42% of perimenopausal women may experience palpitations
 • How hormonal changes can increase inflammation and contribute to cardiovascular risk
 • Why standard lab results may not capture what is happening during this transition
 • Which cardiometabolic markers women should discuss with their doctors, including glucose, insulin, hemoglobin A1c, blood pressure, lipid profiles, ApoB, and lipoprotein(a)
 • Why body composition matters beyond weight and BMI — including waist circumference, visceral fat, body fat percentage, and lean muscle mass
 • Why hormonal and thyroid markers should also be considered as part of a more comprehensive evaluation

This episode is a reminder that prevention begins before a heart attack, before permanent damage, and before something abnormal appears on a test. It begins when your body starts signaling that something has changed.

You do not need to wait for something to go wrong to take your health seriously. Listen to your body, ask the right questions, and step into your role as the CEO of your own health.

Visit NitzaMD.com
Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this episode, Dr. Alvarez explains why repeatedly waking up around 3:00 AM may not be random — and why it should not automatically be dismissed as stress, anxiety, or normal aging. For many women, especially during perimenopause, disrupted sleep can be an early signal that hormonal changes are affecting the nervous system, circadian rhythm, and cardiovascular health.

Dr. Alvarez shares the example of a 48-year-old woman who falls asleep without difficulty but wakes up at the same time each night with a racing mind and a noticeably stronger heartbeat. Although she had been advised to try meditation, magnesium, and better sleep hygiene, the deeper issue was a change in her physiology.

With clarity and urgency, Dr. Alvarez breaks down:

• Why fluctuating estrogen levels can disrupt sleep cycles, temperature regulation, and the body’s nighttime stress response
• How changes in cortisol, norepinephrine, and the autonomic nervous system can trigger early-morning awakenings
• Why waking up feeling warm, restless, or unusually aware of your heartbeat is not necessarily random
• How declining estrogen levels can increase inflammation and make the blood vessels and nervous system more reactive
• Why poor sleep recovery can contribute over time to higher blood pressure, insulin resistance, and blood vessel dysfunction
• Why sleep disruption during perimenopause should be evaluated alongside hormones, sleep patterns, and cardiovascular risk markers

Dr. Alvarez also addresses several common myths: waking up at night is not always “just stress,” it should not automatically be accepted as normal aging, and women do not have to wait until a serious problem appears on a test before taking action.

This episode is a call to listen closely when your body starts whispering. If you consistently wake up at the same time each night, do not dismiss the pattern. Becoming the CEO of your own health starts with recognizing the signal, asking the right questions, and taking prevention seriously before symptoms become larger problems.

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 Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this Ask the Heart Doctor-style episode, Dr. Alvarez tackles one of the most overlooked symptoms women experience during perimenopause and menopause: feeling exhausted even after a full night of sleep.

If you go to bed early, sleep through the night, and still wake up tired, this episode reframes fatigue as more than stress, aging, or “just being busy.” Dr. Alvarez explains that persistent fatigue can be a signal of deeper changes happening in the body — especially involving hormones, inflammation, oxygen delivery, sleep quality, and cardiovascular stress.  

With clarity and urgency, she breaks down:

• Why sleep time and sleep quality are not the same
• How declining estrogen can disrupt deep, restorative sleep
• Why inflammation increases during perimenopause and menopause
• How sleep apnea can show up differently in women
• Why snoring, brain fog, morning headaches, insomnia, and fatigue may be signs of sleep-disordered breathing
• How poor sleep can affect blood pressure, insulin resistance, weight gain, palpitations, stroke risk, and heart disease
• Why wearable devices like Oura Ring, Whoop, or Apple Watch may help women gather useful sleep data
• When a formal sleep study may be needed
• What labs and evaluations to ask about, including hormone status, thyroid panel, cortisol, and sleep quality testing

Dr. Alvarez also challenges common myths, including the belief that sleep apnea only affects overweight men, or that fatigue is simply part of getting older. Instead, she explains that fatigue may be a physiology signal — your body’s way of showing that something is changing before disease develops.

This episode is a direct call-to-action for women who feel tired but dismissed: don’t stop at “I’m just tired.” Ask why your body is not restoring. Becoming the CEO of your own health starts with listening to your body, asking better questions, and getting the right evaluation before symptoms become disease.

Visit NitzaMD.com
 Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this episode, Dr. Alvarez addresses one of the most common and frustrating experiences women face during perimenopause: feeling “off” even when their labs come back normal. If you’ve ever been told “everything looks fine,” “it’s just stress,” or “this is just aging” — while still feeling tired, anxious, foggy, wired, or not like yourself — this episode reframes those symptoms as signals worth taking seriously.

Dr. Alvarez explains why normal lab results do not always tell the full story, especially during perimenopause, when estrogen levels can fluctuate dramatically from one day to the next. These hormonal shifts can affect the brain, blood vessels, metabolism, nervous system, inflammation, cholesterol, sleep, and cardiovascular risk.

With clarity and urgency, she breaks down:

• Why estrogen is more than a reproductive hormone — and how it affects the brain, blood vessels, metabolism, and heart
• Why perimenopause can make women feel anxious, foggy, tired, wired, and unlike themselves
• Why “normal labs” may miss hormonal fluctuation and early physiologic changes
• Why perimenopause can begin in the late 30s and 40s
• What women should consider evaluating beyond basic labs, including:
  • Hormonal patterns, including estradiol, progesterone, testosterone, free testosterone, thyroid markers, and cortisol
  • Cardiometabolic markers such as fasting glucose, hemoglobin A1c, fasting insulin, and insulin resistance
  • Advanced lipid markers including LDL, HDL, triglycerides, non-HDL cholesterol, ApoB, and lipoprotein(a)
  • Blood pressure and vascular health, including ambulatory blood pressure monitoring when appropriate
  • Body composition, including waist circumference, visceral fat, body fat percentage, and lean muscle mass
  • Inflammation markers such as high-sensitivity C-reactive protein, homocysteine, and ferritin

Dr. Alvarez also shares why these symptoms matter from a prevention standpoint. Perimenopause is not just about symptoms — it can be a critical window to detect early cardiovascular risk before it becomes disease.

This episode is a direct call-to-action for women who have been dismissed, minimized, or told to ignore what their body is signaling. Becoming the CEO of your own health starts with asking better questions, understanding what should be evaluated, and taking symptoms seriously before they become something more.

Visit NitzaMD.com
 Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this episode, Dr. Alvarez addresses a topic many women experience but rarely talk about openly: urinary changes after 40. If you’ve found yourself planning your day around the nearest bathroom, waking up multiple times at night to urinate, or avoiding exercise because you’re afraid of leaking, this episode explains why these symptoms are common — but not something women should simply accept as “normal.”  

Dr. Alvarez explains how bladder function is connected to hormones, pelvic floor strength, tissue health, metabolism, and the body’s support systems. During perimenopause and menopause, fluctuating and declining estrogen levels can affect the tissues of the bladder and urethra, contributing to urgency, frequency, nighttime urination, and leakage.  

With clarity and compassion, she breaks down:

• Why urinary symptoms can increase during perimenopause and menopause
• How estrogen supports urinary tract tissue, elasticity, blood flow, and pelvic strength
• Why pelvic floor weakness can contribute to stress incontinence during coughing, laughing, or exercise
• Why urinary symptoms are treatable — and not just an unavoidable part of aging
• Why women who have never had children can still experience bladder changes
• What minimum testing may include:
  • Urinalysis to check for infection, blood, or inflammation
  • Post-void residual measurement to evaluate how well the bladder is emptying
  • Hormonal evaluation, including estradiol
  • Metabolic testing, including blood sugar/glucose levels
• Practical prevention steps:
  • Strengthening the pelvic floor
  • Maintaining a healthy weight
  • Staying hydrated while limiting bladder irritants like caffeine
  • Addressing hormonal health
  • Seeking pelvic floor therapy when needed

This episode is a reminder that urinary symptoms are not a source of shame. They are often the body asking for attention. If you are planning your day around the bathroom, avoiding movement because of leakage, or feeling like your body has changed and no one has explained why, it may be time to seek a real evaluation.

Because common does not always mean normal — and becoming the CEO of your own health starts with listening to your body and asking for answers.

Visit NitzaMD.com
 Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this Ask the Heart Doctor-style episode, Dr. Alvarez tackles a symptom many women quietly struggle with: hair thinning after 35. If you’ve noticed more hair in your brush, a wider part, or a thinner ponytail and wondered, “Is this stress? My shampoo? Or is something wrong with me?” — this episode reframes hair loss as more than a cosmetic issue. It can be a signal from the body.  

Dr. Alvarez explains why hair changes are common during perimenopause and menopause, when shifting estrogen levels, relative androgen changes, sleep disruption, stress, insulin resistance, and metabolic changes can all affect the hair growth cycle. She also explains why, from a cardiologist’s perspective, symptoms like hair thinning, fatigue, weight changes, and sleep problems should not be looked at in isolation — because this stage of life is also a metabolic and cardiovascular transition.  

With clarity and compassion, she breaks down:

• Why hair loss can feel so emotional for women
• How estrogen helps support the hair growth cycle
• Why perimenopause can shift the balance between growth and shedding
• Why hair follicles are sensitive to hormones, blood flow, nutrition, sleep, and stress
• Common myths about hair loss, including the belief that “nothing can be done”
• Minimum tests to discuss with your doctor, including iron levels, thyroid function, lipid panel, and metabolic markers
• Five practical steps to support hair and overall health: sleep, protein and nutrient-dense foods, strength training, stress management, and working with clinicians who understand women’s midlife physiology

This episode is a reminder that hair loss is not vanity, and it is not something women should be told to simply accept. Hair can be information — biology growing in plain sight. If your body is changing, listen early, ask better questions, and work with a clinician who understands the connection between hormones, metabolism, and women’s heart health.

Because becoming the CEO of your own health starts with taking your symptoms seriously.

Visit NitzaMD.com
 Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this Ask the Heart Doctor-style episode, Dr. Alvarez tackles one of the most misunderstood symptoms many women experience in their late 30s and 40s: sudden anxiety. If your heart starts racing, your chest feels tight, your mind starts spinning, or you wake up at night with nervous energy, you may have been told it is “just stress” or “just anxiety.” But what if your body is actually sending a hormone signal?

Dr. Alvarez explains why anxiety-like symptoms can appear during perimenopause, even when nothing major has changed in your life. As estrogen and other hormones begin to fluctuate, they can affect the brain, nervous system, blood vessels, sleep, and even the heart. What feels emotional may actually be physiological.  

With clarity and compassion, she breaks down:

• Why hormones are not just about reproduction — they are communication signals throughout the body
• How estrogen interacts with serotonin, dopamine, the nervous system, blood vessels, and the heart
• Why women can become more sensitive to stress, caffeine, poor sleep, and heart palpitations during hormonal shifts
• Why perimenopause can begin earlier than many women realize, sometimes in the late 30s
• Why palpitations are often benign, but should still be evaluated when they are new or disruptive
• The minimum tests women should know about, including thyroid testing, complete blood count, ferritin/iron levels, blood sugar markers, hemoglobin A1c, and lipid panel
• Five practical steps women can take: tracking symptoms and cycles, prioritizing sleep, strength training, reducing caffeine, and advocating for themselves during medical visits

This episode is a powerful reminder that anxiety is not always weakness, and it is not always “all in your head.” Sometimes it is information. Sometimes it is your nervous system responding to real changes happening inside your body. And when women understand those signals early, they can stop blaming themselves and start asking better questions.

Because becoming the CEO of your own health starts with listening to your body — and taking your symptoms seriously.

Visit NitzaMD.com
Follow @NitzaMD on Instagram and Facebook.

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this episode, Dr. Alvarez takes on one of the most common yet misunderstood symptoms women experience during perimenopause and menopause: hot flashes and night sweats. What many dismiss as just a frustrating sleep disruption may actually be an important physiologic signal that the body is going through a major hormonal and cardiovascular transition.  

Dr. Alvarez explains how fluctuating estrogen levels can disrupt the brain’s temperature regulation system, triggering sudden night sweats and hot flashes — and why those symptoms matter beyond comfort. She connects the dots between hormonal shifts, sleep disruption, rising stress hormones, blood pressure changes, cholesterol patterns, and long-term heart health.  

With clarity and urgency, she breaks down:

• Why hot flashes and night sweats are not “just part of getting older”

• How estrogen changes affect the nervous system, vascular system, and cardiovascular risk

• Why poor sleep during this transition can have a ripple effect on metabolism, energy, weight, and heart health

• The myths women are often told about vasomotor symptoms — and what is actually true

• Why hormone replacement therapy may be an important treatment option for many women, when guided by the right clinician

• What minimum testing women should discuss with their doctor, including a lipid panel, blood pressure monitoring, and thyroid testing  

This episode is a reminder that your body is not failing — it is communicating. Hot flashes may be more than an inconvenience. They may be one of the early warning signs that it is time to pay attention, ask questions, and take action. Because protecting your heart starts with listening to your body — and becoming the CEO of your own health.  

Visit NitzaMD.com

Follow @NitzaMD on Instagram and Facebook

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health.

In this episode, Dr. Alvarez breaks down one of the biggest myths keeping women confused and dismissed: the belief that you are “too young” for hormonal changes before 40. If your period has changed, your sleep feels off, your mood is different, your weight is harder to manage, or you simply do not feel like yourself, this episode explains why those shifts may be early signs of perimenopause — and why they should not be ignored.

Through both clinical insight and real-life perspective, Dr. Alvarez walks listeners through the 12 signs most women miss, including changes in cycle length and bleeding patterns, sleep disruption, anxiety, irritability, brain fog, hot flashes, palpitations, weight changes, joint pain, libido shifts, and bladder or vaginal symptoms. She explains how hormonal fluctuations can begin years before menopause, how these changes affect not only quality of life but also long-term cardiometabolic health, and why women deserve more than being told it is “just stress.”

With clarity and urgency, she also covers:

• Why perimenopause can begin earlier than many women expect

• How hormonal shifts can affect the brain, heart, metabolism, and overall well-being

• The myths that keep women dismissed or misdiagnosed

• The minimum tests to discuss with your doctor, including thyroid, iron, cholesterol, blood sugar, vitamin levels, and when hormone testing may be appropriate

• How to advocate for yourself clearly and effectively during medical appointments

• When to seek a second opinion without guilt

• Five practical steps you can start this week to better understand and support your body

This episode is a direct reminder that your body is communicating long before it starts screaming. You do not need to have every symptom for your experience to be real. Becoming the CEO of your own health starts with paying attention early, asking better questions, and refusing to dismiss what your body is trying to tell you.

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Follow @NitzaMD on Instagram and Facebook