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You wake up at 3 a.m. with your heart racing, and you cannot figure out why. The anxiety out of nowhere, the PMS that got worse. It may trace back to one hormone that started leaving your body years before your first hot flash.
This episode is part of Tamsen Fadal’s series breaking down the topics from her New York Times bestselling book How to Menopause, one conversation at a time.
This week it's progesterone. Tamsen starts with a confession: her doctor prescribed it, and it sat in her medicine cabinet so long the pills congealed into a brick. She never took one, because nobody ever told her what progesterone was or why she needed it. So she spent a year struggling with the exact symptoms it would have helped.
She's not a doctor. She's a journalist who has lived this, breaking down what the leading menopause doctors she's interviewed have taught her, so you can take it to your own doctor.
Inside the episode:
- Why progesterone is one of the first hormones to drop, often years before anything else feels off
- The brain receptor that explains your 3 a.m. wake-ups
- Why it's non-negotiable if you still have your uterus and you're taking estrogen
- The straight answer on progesterone and breast cancer, and why the study that scared everyone doesn't tell the whole story
- Body identical vs. synthetic, plus the exact words to use with your doctor
- The one side effect that means you call your doctor instead of quitting
And, if you liked this conversation, check out the rest of the How To Menopause series:
Estrogen Down There 101: Here's Everything You Need to Know
Testosterone 101: Everything You Need to Know in 20 Minutes
Relationships 101: Is It Him or Is It Menopause? Here's How to Tell
Perimenopause 101: The Symptoms, Tests & Fixes No One Tells You About
Alcohol 101: Belly Fat, Bad Sleep and the Long-Term Cost of Drinking
Anxiety 101: What I Wish I Knew Before I Hit Perimenopause + How I Got My Life Back
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
The sleep doctor is in! If you're in perimenopause or menopause, sleep has probably become something you think about all the time. Falling asleep, staying asleep, waking up at 3am, feeling exhausted, waking up anxious even when you did fall asleep. Perimenopause sleep disruption and menopause insomnia are real, they are hormonal, and they are not your fault. The nights can feel endless.
That's why Tamsen Fadal invited Dr. Andrea Matsumura on The Tamsen Show. A board-certified sleep medicine physician, menopause expert, and creator of the D.R.E.A.M. Sleep Method, Dr. Matsumura breaks down exactly what is happening in the body when sleep falls apart in midlife and gives you the tools to get better sleep in perimenopause starting tonight.
- Why waking up at 3am is a cortisol event, not an anxiety problem, and what to do when it happens
- The sleep apnea statistic that will stop you cold: up to 90% of women in midlife who have it don't know, because they don't look like the textbook patient
- What melatonin actually is, why taking it at bedtime is usually the wrong move, and what happens to production by age 50
- How alcohol is disrupting your REM sleep, and why one glass hits completely differently now
- The D.R.E.A.M. Method: the five-part framework Dr. Matsumura built because treating one thing at a time only ever gets women halfway there
- The ferritin level behind restless legs that most providers aren't checking
- Why getting out of bed at 3am is the right call, even though it feels like the worst one
- How every additional 15 minutes of sleep compounds into something significant over time
This episode will help you get your sleep back on track because it’s the foundation of everything. When your sleep goes, it starts to unravel the rest of your life.
Check out Andrea’s essentials
If you liked this conversation, check this out: How to Finally Get to Sleep in Menopause
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
Sponsors:
Sign up for your $1 per month trial today at https://www.shopify.com/tamsen!
Get 15% off OneSkin with the code TAMSEN at https://www.oneskin.co/TAMSEN #oneskinpod #ad
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Have you ever stood in front of a full closet, said “I have nothing to wear,” and reached for the same safe outfit one more time? You are not alone, and it is not really about the clothes.
Tamsen’s viral closet clean out started as a simple declutter and spiraled into one of the most transformative things she has done in midlife, pulling in everything she had been avoiding about who she is now and the body she is in today.
In this deeply personal solo episode, Tamsen shares why she really did it and what she learned once she stopped negotiating with herself in front of the mirror.
You’ll learn:
- How to make a fast yes-or-no call on every piece without talking yourself back into it
- Why you get stuck doing this alone, and exactly who to bring into the room with you
- How to spot the clothes you are keeping out of grief instead of love
- Why holding onto clothes in multiple sizes quietly works against you every morning
- How to tell the difference between what is weighing you down and what is holding you up
This is the episode that will make you finally open the door you have been avoiding. The woman on the other side of that closet is already there, waiting for you to make room for her.
Download the Your Free Closet Glow Up Guide here
For all the tools Tamsen uses in her closet organization, click here
If you liked this conversation, check this out: Stacy London: Reinvent Yourself (and Your Style) in Midlife
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Managing menopause and perimenopause symptoms is hard enough without a supplement market flooded with products promising to fix hair loss, trouble sleeping, hot flashes, mood fluctuations, skin changes, and so much more. It can feel impossible to know what actually helps and what is just a waste of money.
Today's guest on The Tamsen Show, Phil Cowley, has spent 22+ years behind a pharmacy counter watching people walk in confused, overwhelmed, and chronically under-informed. He has seen firsthand which treatments work, which are a waste of money, and what the medical system has been getting wrong about hormones since 2002. Now he is joining Tamsen Fadal to tell the truth that women deserved to hear decades ago.
In this episode, Tamsen and Phil cover:
- The three supplements worth actually spending money on in midlife and why they will not break the bank
- Why anxiety is a depletion of something, not an excess, and what that means for how you treat it
- What the 2002 Women's Health Initiative got wrong and why women who came off hormone therapy die younger than those who stayed on it
- The real reason your body odor changes in menopause, what is happening at a bacterial level, and exactly how to fix it
- Why hair loss in menopause is never one problem and why treating only one cause never works
- Why losing lean muscle mass is the single strongest predictor of early death and what to do about it
- The $7 estrogen alternative your pharmacist already knows about
- Why caffeine does not give you energy, it just hides that you are out of it
- The one question to ask your pharmacist that most people never think to ask
- Generic versus name brand medications and the manufacturer variance that could be affecting your results
This episode is full of answers to questions most women have never thought to ask, but absolutely need to know.
You can find everything Phil mentioned in this podcast here!
Follow Phil on Instagram
Follow Phil on TikTok
If you liked this, check this out: The #1 Hair Loss Doctor: The Truth About Minoxidil, Supplements + Hormones
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Menopause anxiety and mood changes can creep up so slowly you don't even notice. You're avoiding things you used to do, snapping at people you love, waking at 3 a.m. with your heart racing. It's not in your head, and it often starts years before a single hot flash.
This episode is part of Tamsen's series breaking down the topics from her New York Times bestselling book How to Menopause, one conversation at a time.
This week it's anxiety and mood. Tamsen starts with the moment she caught herself avoiding driving in LA, a city she used to drive without a second thought. When she posted about it, the floodgates opened. She breaks down what the top doctors she's interviewed have taught her about why this happens and what actually helps, including the hormonal piece almost every doctor skips.
She's not a doctor. She's a journalist who has lived this, including a panic attack on a live news set that started her down this whole path.
Inside the episode:
- The two hormones behind your mood, and why the calming one disappears first
- Why anxiety here so often shows up as avoidance or rage instead of obvious panic
- The reason so many women get handed an antidepressant before anyone checks their hormones
- What actually helps, from body identical progesterone to the therapy approaches with real evidence behind them
- How Tamsen got back behind the wheel, and why facing the fear gradually breaks the loop
- The single shift that helped her more than any pill
The first step is recognizing this has a name and you're not making it up.
If you like this episode, then you will love: The 4 Tools That Rebuild Your Confidence Fast
If you liked this conversation, check out the rest of the How To Menopause series:
Estrogen Down There 101: Here's Everything You Need to Know
Testosterone 101: Everything You Need to Know in 20 Minutes
Relationships 101: Is It Him or Is It Menopause? Here's How to Tell
Perimenopause 101: The Symptoms, Tests & Fixes No One Tells You About
Alcohol 101: Belly Fat, Bad Sleep and the Long-Term Cost of Drinking
Coming up: Anxiety, Mental Health, Estrogen 101 and more!
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
If you’re struggling, you don’t have to do it alone. In the US, call or text 988 anytime to reach the Crisis Lifeline.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
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This is a conversation we should have had decades ago, because we're talking about a part of women's health that's been overlooked for too long: heart health.
Heart disease is the leading cause of death in women, but most don't even know it. In this episode, Tamsen Fadal sits down with cardiologist and Chief Medical Correspondent for ABC News, Dr. Tara Narula to break down how cardiovascular disease develops in women, why heart attack symptoms look different than they do in men, and the cardiac risk screening tools (including the calcium score and the Lp(a) test) that could save your life.
Tamsen and Dr. Narula discuss:
- Why heart disease risk builds earlier than most women think, and the life stages where it quietly accelerates
- The calcium score test that tells you exactly how much plaque is in your arteries
- The Lp(a) blood test that 1 in 5 women have elevated, is not controlled by diet or exercise, and almost nobody knows to ask for
- Why women are regularly sent home from emergency rooms with chest pain and told it is anxiety
- How pregnancy complications like preeclampsia and gestational diabetes predict future cardiac risk
- What GLP-1 medications are actually doing for the heart beyond weight loss
- The PREVENT calculator you can run online today to see your 10 and 30 year cardiovascular risk
- What the research actually says about hormone replacement therapy and heart health
- Why resilience after a cardiac diagnosis is not about going back to who you were
Plus, Tamsen explains why heart disease was never on her radar, and what Dr. Narula told her in this conversation that she wishes someone had said years ago.
Resources mentioned in this episode:
Centrum Silver: here and here
Follow Dr. Narula on Instagram
Follow Dr. Narula on Facebook
If you liked this conversation, check this out: The Menopause Heart Doctor Reveals the 3 Warning Signs Doctors Dismiss with Dr. Jayne Morgan
Find all The Tamsen Show expert picks here
Stop putting off those doctor's appointments! Go to https://www.zocdoc.com/TAMSEN to find and instantly book a doctor you love today!
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
One glass of wine at dinner. That's all it takes now to wreck your sleep, spike your anxiety, and leave you feeling like garbage for two days. It's not in your head, and it's not about willpower. Your body processes alcohol completely differently now, and almost nobody has explained that to you.
This episode is part of Tamsen's series breaking down the topics from her New York Times bestselling book How to Menopause, one conversation at a time.
This week it's alcohol, and Tamsen gets honest about her own relationship with it. She was never a big drinker, but a habit crept in over the years, and after the pandemic she realized one glass she didn't even really want was quietly costing her sleep, workouts, mood, and how she felt in her own skin.
She has not quit drinking, and she's not telling you to. She's breaking down what the leading doctors she's interviewed have taught her about what alcohol actually does to your body in midlife, so you can decide for yourself.
Inside the episode:
- The real reason one glass at 48 hits like five did at 32, and why you're essentially still drinking it the next morning
- What's happening in your body at 3 a.m. when your eyes pop open with your heart racing
- The hidden connection between alcohol and hot flashes, belly fat, and that next-day anxiety you haven't been linking to your Friday night wine
- What every doctor in the studio has told Tamsen about alcohol and breast cancer risk, and why this one is actually within your control
- The single question that changed Tamsen's drinking: what are you actually reaching for?
-Word-for-word scripts for the social pressure, the pushy friend, and the partner conversation
- Why tracking your drinks for one month with zero judgment might change everything
You don't have to quit. You don't have to call yourself anything. But if your body has been trying to tell you something, this episode will help you finally hear it.
If you liked this conversation, check this out: How to Eat to Curb Alcohol Cravings
If you liked this conversation, check out the rest of the How To Menopause series:
Estrogen Down There 101: Here's Everything You Need to Know
Testosterone 101: Everything You Need to Know in 20 Minutes
Relationships 101: Is It Him or Is It Menopause? Here's How to Tell
Perimenopause 101: The Symptoms, Tests & Fixes No One Tells You About
Coming up: Anxiety, Mental Health, Estrogen 101 and more!
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Melinda French Gates joins Tamsen with a major announcement, a huge new donation toward women’s midlife and menopause care, and she’s making it right here on The Tamsen Show.
Melinda has pledged $2 billion to women and families in her lifetime, and this new commitment expands her women’s health work into menopause for the first time. In this episode she breaks down what the funding means for perimenopause and menopause care, why so many women get dismissed by their doctors, and how she plans to fix it, starting with the people we turn to first: our doctors.
Right now only about a third of OBGYNs are trained in menopause. Less than one percent of aging research even looks at it. Melinda is putting real money and her name behind changing that, and this conversation is about what that shift will mean for you, your friends, your daughters, and the generations coming up behind us.
We also cover:
- Why the funding goes toward training doctors instead of going straight to women
- Why it took Melinda three doctors to get the right care, even with every resource available to her
- The bone health and cardiovascular risks no one warns you about
- How menopause could have its own Susan G. Komen moment
- What she learned about navigating big transitions and building your next chapter
- The daily non-negotiables and decades-long friendships that keep her grounded
Melinda’s latest book, The Next Day, is a must-read on navigating life’s biggest transitions. You can find it here
If you like this episode, then you will love: Perimenopause 101: The Symptoms, Tests & Fixes No One Tells You About
Follow Melinda on Facebook
Follow Melinda on Instagram
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
This show is sponsored by Midi Health. Visit https://joinmidi.com/tamsen today to book your personalized, insurance-covered virtual visit. Midi. The Care Women Deserve.
Go to https://www.leesa.com/ for 25% off select mattresses PLUS get an extra $50 off with promo code TAMSEN. Support our show and let them know we sent you after checkout!
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Most of what you've heard about hormone balance, perimenopause symptoms, and hormone therapy online is wrong. That misunderstanding is costing women years of unnecessary suffering through puberty, pregnancy, and menopause stages when effective solutions like testosterone for women already exist and can make a real difference.
Endocrinologist Dr. Gillian Goddard is joining Tamsen Fadal on The Tamsen Show to cut through the noise and explain how your hormonal system actually works and what to do when it feels like it isn't.
She breaks down the feedback loop mechanism that keeps your hormones self-regulating, why that process is far more dynamic than any "hormone optimization" trend on social media, and what happens when those loops are disrupted at key life transitions.
In this episode, Tamsen and Dr. Goddard cover:
- What a hormone actually is, and why the feedback loop model changes everything
- The thyroid-immune system connection and why puberty, pregnancy, and perimenopause are your highest-risk windows for thyroid disease
- The late reproductive stage: the perimenopause phase most doctors miss, and why it matters
- HRT vs. birth control for perimenopausal symptoms, and why the right answer depends on where you are in your reproductive stage
- Testosterone for women: what the science actually shows (and what it doesn't yet)
- How to talk to your doctor about perimenopause, hormone therapy, and getting your symptoms taken seriously
If you've ever left a doctor's office dismissed because your periods were still regular but you knew something was off, this episode is for you. The late reproductive stage affects roughly 50% of women between ages 37 and 45, and most women have never heard of it.
Dr. Goddard's message is clear: you don't need to suffer. Whether you're navigating your first period or your last, your symptoms are valid and they can be addressed.
If you liked this conversation, check out the rest of the How To Menopause series:
Estrogen Down There 101: Here's Everything You Need to Know
Testosterone 101: Everything You Need to Know in 20 Minutes
Relationships 101: Is It Him or Is It Menopause? Here's How to Tell
Perimenopause 101: The Symptoms, Tests & Fixes No One Tells You About
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Shannon Elizabeth was the it girl of the early 2000s... American Pie, Scary Movie, Love Actually, That 70s Show. What we didn't know was how much Shannon was carrying underneath all of it.
In this personal and unfiltered episode, Tamsen sits down with her cousin Shannon Elizabeth, for the first time with a microphone between them. They grew up together at their grandmother's house. They went through their divorces around the same time. They have been each other's people through all of it. And this conversation goes places neither of them planned.
Shannon gets honest about what it was actually like being swept up in the entertainment machine at 25 and moving so fast through the biggest moments of her career that she barely lived any of them. Now in her 50s, she talks about the announcement that got everyone talking, joining OnlyFans, and the real reason she is doing it now after years of watching creator culture build around her and staying on the sidelines. She wasn't in a good place for a long time and she didn't want to fake it. Now she is and she is ready to be seen.
You'll hear:
- What it was actually like being Nadia from American Pie and the parts of that chapter Shannon almost doesn't remember
- Why she built walls so high that even the people who loved her couldn't get through them and what finally made her put them down
- How going through divorce at the same time brought Tamsen and Shannon closer than they had ever been
- Why she is finally ready to share her real life publicly after years of saying no to creator culture
- What her 50s feel like compared to every decade that came before
- Why losing her dad changed how she understands community and family
This one feels like sitting on a couch with two old friends finally saying the things they have been meaning to say. Because that is exactly what it is.
Shop the products Shannon mentioned here
Learn more about Shannon’s foundation
Check out Shannon’s charity poker event
If you liked this conversation, check this out: Jamie Lynn Sigler: How to Forgive Yourself and Rewrite Your Story
Stay connected with Tamsen:
Get Tamsen's newsletter filled with free tools to living better, feeling stronger, and knowing you’re never alone
Get Tamsen’s NYT instant bestselling book, How To Menopause
Free Resources from Tamsen
Watch all the episodes on YouTube
Follow Tamsen on Instagram
The Tamsen Show on Instagram
Follow Tamsen on TikTok
Learn more about your ad choices. Visit podcastchoices.com/adchoices
Kachava: Code TAMSEN for 15% off your order https://www.kachava.com
Currentbody: Code TAMSENCB for 10% off https://go.shopmy.us/p-54389490
Medical Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
Learn more about your ad choices. Visit podcastchoices.com/adchoices
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