This Is Perimenopause: Menopause, Perimenopause and Women's Health in Midlife

Sex used to be fun. Now it's either painful, non-existent, or something you do because you feel like you should. Your body doesn't feel like yours anymore, and you're honestly starting to wonder if this is just what happens when you hit midlife.

Dr. Arielle Buch-Frohlich hears this exact story all the time in her Toronto practice. She's a clinical psychologist who specializes in sex and couples therapy, and women show up to her office feeling broken, ashamed, and pretty convinced that their sexual life is basically over. But after years of working with women going through perimenopause and menopause, she's got a totally different take on things.

Each episode will share life stories and expert insight into women's health and your perimenopause and menopause journey.

In This Episode 

• Why most women experience decreased libido during menopause (and why that's totally normal)
• How hormones, stress, and body changes create the perfect storm for sexual challenges
• The psychosocial approach to understanding your sexual health - it's not just physical!
• Why "good enough sex" might be exactly what you need right now
• The biggest sexual myths that are sabotaging your intimacy 
• Treatment options beyond just "use more lube" - from pelvic floor therapy to hormone therapy
• How to navigate mismatched libidos without destroying your relationship

Plus, Dr. Arielle gives us the inside scoop on:

• Anna & Solomon - Toronto's first comprehensive sexual health clinic 
• Why multidisciplinary care is the future of sexual wellness

The changes you're experiencing? They're real, but they don't have to be permanent. And the solutions are way more comprehensive than most people realize.

This podcast is brought to you by IRIS. Daily care products made with clean ingredients for hydrated vulvas and vaginas. Use code TIP20 for 20% off at lovemyIRIS.com. 

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
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Dr. Arielle Buch-Frohlich is a Clinical Psychologist licensed with the College of Psychologists of Ontario and Quebec. She studied psychology in Montreal, where she completed a doctorate in Clinical Psychology (Psy.D) from the Université du Québec à Montréal (UQAM). Additionally, she completed clinical training at the Sex and Couple Therapy Service at the Allen Memorial Institute.

She is the Founder Clinical Director of Anna & Salomon: Sex and Couples Health, a comprehensive care clinic for individuals and couples navigating the complexities of sexual and relational health.

In her practice, she provides inclusive Sex and Couples Therapy using a combination of Emotionally Focused Therapy (EFT), Cognitive Behavioural Therapy and Acceptance and Commitment Therapy (ACT). She offers specialized services to address communication challenges, infidelity, and transitions into parenthood, from fertility to perinatal and postpartum care. Additionally, she offers dedicated support for those experiencing intimacy-related challenges during or after oncology treatments. She strives to foster connection, healing, and resilience for every stage of life.

Her virtual practice services clients located across Ontario and Quebec, including Toronto (GTA), Montreal and Ottawa. Therapy can be provided in English and in French. 



 Links for this episode

• Dr. Arielle Buch-Frohlich
• Anna & Salomon: Sex and Couples Health
• Dr. Arielle on Instagram

Hosted on Acast. See acast.com/privacy for more information.

Today’s question for Dr. Sarah Shaw is:

Are there other reasons to take hormone therapy besides the approved list?

In this episode, you'll discover:

• Hormone therapy is not a panacea and requires a nuanced approach
• The appropriate off-label uses for hormone therapy
• What is the Musculoskeletal Syndrome of Menopause
• The importance of HT when menopause happens before the age of 40

Lume Women + Health is now open! They understand the unique challenges women face during perimenopause and beyond. Be sure to check out their dedicated menopause program that provides personalized support, medical guidance, and lifestyle optimization education to help you manage symptoms, improve your well-being, and thrive during this life stage.

Every week, the team at Lume Women + Health will be dropping into our podcast to answer one of your questions. Be sure to follow our podcast so that you never miss these Lume Minutes. Find ‘This Is Perimenopause, the podcast’ wherever you listen to your favorites.

Episode Links

• Dr. Sarah Shaw Bio
• Lume Women + Health

Connect with Mikelle & Michelle at This is Perimenopause

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Hosted on Acast. See acast.com/privacy for more information.

Each episode will share life stories and expert insight into women's health and your perimenopause and menopause journey.

**Correction**  Dr. Jen mentions a breast cancer risk of 8/1,000 in this episode; she meant 8/10,000.

"Vaginal estrogen should just be over the counter at this point," says Dr. Jennifer Zelovitzky. This is just one of the many facts she shares that'll change how you think about menopause care. As the clinical director of women's health at MedCan Toronto, Dr. Jen isn't just pushing back against outdated medical beliefs—she's showing us how women are suffering needlessly because doctors are treating menopause based on fear instead of facts.

With incredible clarity and genuine compassion, Dr. Jen connects the dots between your hot flashes, middle-of-the-night wake-ups, and anxiety attacks, giving you the evidence-based insights to get better care from a medical system that has let women down. "Hormone therapy is held to a higher standard than literally any other treatment out there," she points out, and her breakdown of the double standards will leave you nodding along and ready to take action.

In This Episode 

• Why most doctors miss perimenopause symptoms and how to get them to listen
• The truth about hormone therapy safety that wasn't covered in your doctor's half-day of menopause training
• How micronized progesterone is different from the progestins used in the WHI study
• Why guidelines are called "guidelines" not "rules," and why this matters for your care
• The truth about vaginal estrogen safety and why warning labels are misleading
• The connection between estrogen and serotonin that explains your shifting mental health
• How to stand your ground when your family doctor tries to take you off hormone therapy that's working
• What makes the MedCan six-month program different from standard menopause care
• A preview of Dr. Jen's new educational course that puts expert knowledge within everyone's reach

Whether you're just starting to notice changes or you've achieved menopause, Dr. Jen's holistic approach and straight-talk will help you advocate for the care you deserve. Because as she puts it, "Menopause is inevitable, but suffering is completely optional."

This podcast is brought to you by IRIS. Daily care products made with clean ingredients for hydrated vulva and vaginas. Use code TIP20 for 20% off at lovemyIRIS.com. 

• Email us and let us know what you think of the podcast and what topic you want us to cover next
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
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Dr. Jennifer Zelovitzky

Dr. Jennifer Zelovitzky is a certified Menopause Specialist and the Clinical Director of Women’s Health at Medcan Toronto. She is helping women better understand their bodies and advocate for their needs in the Canadian Healthcare system.  She is also the mom of 2 amazing daughters and 3 fur babies. 

Links for this episode

• Jennifer Zelovitzky Instagram
• Medcan Women’s Health
• Professor Susan Davis  Instagram
• Sinai Health Menopause Clinic
• Better with Bria

Hosted on Acast. See acast.com/privacy for more information.

Today’s question for Dr. Amy Louis Bayliss is: I have heard about testosterone replacement for women. What is it for?

In this Lume Minute, you'll discover:

• The truth about testosterone research
• Testosterone's role in libido
• Why female desire is complex
• Current prescription options
• Key safety considerations
• The need for more research 

Lume Women + Health is now open! They understand the unique challenges women face during perimenopause and beyond. Be sure to check out their dedicated menopause program that provides personalized support, medical guidance, and lifestyle optimization education to help you manage symptoms, improve your well-being, and thrive during this life stage.

Every other week, the team at Lume Women + Health will be dropping into our podcast to answer one of your questions. Be sure to follow our podcast so that you never miss these Lume Minutes. Find ‘This Is Perimenopause, the podcast’ wherever you listen to your favorites.

Episode Links

• Dr. Amy Louis-Bayliss
• Lume Women + Health

Connect with Mikelle & Michelle at This is Perimenopause

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Hosted on Acast. See acast.com/privacy for more information.

Each episode will share life stories and expert insight into women's health and your perimenopause and menopause journey.

Today we’re talking about something we all do but rarely discuss: pooping. In this episode, pelvic floor physiotherapist Aliya Dhalla helps us unclench and get real about bowel health.

From constipation confessions to hemorrhoid horror stories, we're flushing away the taboos and getting down to business. Got insufferable hemorrhoids? Are you a twice-a-day pooper, or someone who struggles to go more than once a week? Or are you just wondering if your pooping habits are normal. This episode has all the bowel health insights you need. 

In this episode:

• The ideal pooping frequency 
• How to establish a morning poop routine that works
• Why your poop should resemble a "ripe banana" in consistency
• What a squatty potty is and why everyone needs one
• The truth about hemorrhoids, and how to manage flare-ups and reduce discomfort
• The connection between constipation and bladder leaks
• Why you should pay attention to your pelvic floor health
• Even a breathing technique to help you poop

So, stop holding it in and join us for a conversation about bathroom anxiety, hemorrhoids, squatty potties, and optimizing your output. Because everybody poops. And with Aliya's practical advice, you'll learn how to work with your body's natural rhythms for smoother, more satisfying bathroom visits.

This podcast is brought to you by IRIS. Daily care products made with clean ingredients for hydrated vulva and vaginas. Use code TIP20 for 20% off at lovemyIRIS.com. 

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

 Links for this episode

• Aliya on Instagram
• Not Your Mother’s Pelvic Floor Podcast
• Box Wellness Co
• Box Wellness Online Courses

Hosted on Acast. See acast.com/privacy for more information.

Today’s question for Dr. Woganee Filate from one of our listeners is, why can't I sleep anymore? Why don't I sleep through the night? Why am I waking at 3 a.m. all the time?

In this Lume Minute, you'll discover:

• The variety of symptoms
• Tracking and rating symptoms
• MQ6 Tool
• Menopause Foundation of Canada symptom tracker
• Have a goal for your appointment with your medical provider

Lume Women + Health is now open! They understand the unique challenges women face during perimenopause and beyond. Be sure to check out their dedicated menopause program that provides personalized support, medical guidance, and lifestyle optimization education to help you manage symptoms, improve your well-being, and thrive during this life stage.

Every other week, the team at Lume Women + Health will be dropping into our podcast to answer one of your questions. Be sure to follow our podcast so that you never miss these Lume Minutes. Find ‘This Is Perimenopause, the podcast’ wherever you listen to your favorites.

Episode Links

• Dr Woganee Filate Bio
• Lume Women + Health

Connect with Mikelle & Michelle at This is Perimenopause

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Hosted on Acast. See acast.com/privacy for more information.

Each episode will share life stories and expert insight into women's health and your perimenopause and menopause journey.

"It's not just about HRT or not...it's about realizing that the landscape has changed, and the playbook has changed. Full stop." 

Powerful words from Dr. Kirsten Smith set the stage for an enlightening conversation about what women really need during the menopause transition. Drawing on her extensive 15+ years of experience as a naturopathic doctor specializing in women's hormonal health, Dr. Smith challenges the simplistic narratives around hormone therapy and offers insights you likely won't hear in a standard medical appointment.

In This Episode: 

• The true role of hormone therapy—valuable but just one tool in your health toolkit 
• The shocking connection between hormonal changes and mental health, including increased suicide risk in women aged 45-55 
• Why conventional antidepressants might fail during perimenopause 
• The art and science of hormone dosing, and why your perfect dose might be completely different from your friend's 
• Red flags that your hormone dose might need adjustment 
• The critical gaps in medical training around women's health 
• How to find healthcare providers who understand the complexities of menopause 
• Practical strategies for building a complete approach to lasting health during menopause and beyond

Dr. Smith expands the conversation beyond hormones to address the complete picture of women's health during this transition, acknowledging that midlife health "does require more work.” But she also offers the reassurance that perfection isn't required—just consistent attention to the foundations of health. Whether you're currently on hormone therapy, considering it, or seeking alternatives, this conversation provides important information to help you advocate for yourself and make informed decisions about your health.

This podcast is brought to you by IRIS. Daily care products made with clean ingredients for hydrated vulva and vaginas. Use code TIP20 for 20% off at lovemyIRIS.com. 

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Dr. Kirsten Smith, ND | MSCP (cand.) | Visionary Women’s Health Expert | Integrative Hormone Specialist

For over 16 years, Dr. Kirsten Smith has redefined care for women navigating perimenopause and menopause, blending cutting-edge evidence-informed science with the wisdom of naturopathic medicine. Her pioneering work bridges the gap between conventional diagnostics and holistic healing, offering women a third path - one where bioidentical hormones (HRT), targeted nutrition, and evidence-backed botanicals work in harmony to restore vitality.

Based between Ontario’s forests and Costa Rica’s Pacific coast, Dr. Smith aims for the balance she teaches: mornings analyzing menopause research and doing patient consults, afternoons surfing with her son. This synergy of science and nature fuels her mission to reclaim midlife as a launchpad for women - not an expiration date. Dr. Smith's mission goes beyond treating patients; her legacy is cultivating a movement where women approach menopause with knowledge and agency, not fear. By mentoring practitioners and advocating for systemic change, she hopes future generations will inherit a healthcare model that honours hormonal transitions as important times in a woman's life that deserve, research, training and care. ️

Links for this episode

Work with Dr. Kirsten Smith

Dr. Kirsten Smith on Instagram

Hosted on Acast. See acast.com/privacy for more information.

Today’s question for Dr. Sarah Shaw is:

What are the Health Canada approved indications for hormone therapy?

In this episode, you'll discover:

• The approved indications for hormone therapy in Canada are limited to three main areas
• Off-label prescribing allows for hormone therapy use beyond approved indications
• Yellow light indications where hormone therapy may be beneficial
• The timing of hormone therapy initiation is crucial for maximizing benefits

Lume Women + Health is now open! They understand the unique challenges women face during perimenopause and beyond. Be sure to check out their dedicated menopause program that provides personalized support, medical guidance, and lifestyle optimization education to help you manage symptoms, improve your well-being, and thrive during this life stage.

Every week, the team at Lume Women + Health will be dropping into our podcast to answer one of your questions. Be sure to follow our podcast so that you never miss these Lume Minutes. Find ‘This Is Perimenopause, the podcast’ wherever you listen to your favorites.

Have a question? Send us a message at [email protected] and we’ll get you an answer.

Episode Links

• Dr. Sarah Shaw Bio
• Lume Women + Health
• MQ6 Tool
• Menopause Foundation of Canada symptom tracker

Connect with Mikelle & Michelle at This is Perimenopause

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Hosted on Acast. See acast.com/privacy for more information.

Each episode will share life stories and expert insight into women's health and your perimenopause and menopause journey.

Imagine a menopause practitioner who says hormone change can actually be fun. Meet Dr. Kara Dionisio, a naturopathic doctor who describes her work as "helping hormone change not suck."

In this candid and refreshing conversation, Dr. Kara unpacks what she calls "the art of clinical practice" – where medical guidelines meet real women's lives. With humor and depth, Dr. Kara explains why your perimenopause experience deserves personalized care rather than one-size-fits-all solutions, and offers practical strategies you can implement right away.

In This Episode: 

• Why most healthcare providers receive little to no training in menopause care
• The importance of finding a Menopause Society certified practitioner (MSCP)
• How to build your own "menopause support team" beyond just your doctor
• The art of clinical practice: merging evidence, clinical judgment, and patient values
• The truth about hormone therapy for mood and cardiovascular health
• Why consistency beats perfection when it comes to perimenopause health habits
• How to take agency over your health while navigating this transition

Whether you're just noticing the first signs of change or deep in the hormone hurricane, this episode reminds us that while perimenopause can be challenging, it's also an opportunity to reclaim your health and reimagine your future.

Because as Dr. Kara emphasizes, "Suffering is not an option."

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Dr. Kara Dionisio, ND, MSCP, is a Naturopathic Doctor and menopause nerd who brings evidence-based care, strategic education, and fierce advocacy to midlife health. Menopause is her magic—and she believes midlife is a time to rise.

As founder of Dr. Kara & Associates in Owen Sound, Ontario, Kara has supported thousands through the menopause transition with personalized, evidence-informed care—continually redefining the art of comprehensive support (no one-trick ponies here), where each woman gains the agency to be the author of her own menopause story.

A trailblazer in her field, Kara holds a BSc and MSc in Nutrition & Metabolism, and was among the first Naturopathic Doctors in North America to earn the Menopause Society Certified Practitioner designation, inspiring many to follow. She teaches clinical menopause education in academic and professional settings and leads the Confident Clinician Menopause Fellowship, now in its third year.

She lives in Owen Sound with her two feisty kids, a red-bearded Irish dude, and a beagle with main-character energy. Kara believes thriving midlife women can (and should) rule the world—and she’s here for it.

 Links for this episode

• Dr Kara Dionisio Practice
• Dr Kara’s Geeky Bio
• Follow Dr Kara on Instagram
• The Menopause Society - Find a Healthcare Practitioner 

Hosted on Acast. See acast.com/privacy for more information.

Today’s question for Dr. Amy Louis Bayliss is:

Which supplements are best for me to prioritize and for what?

In this Lume Minute, you'll discover:

• Supplement safety considerations
• Dr Amy Louis-Bayliss’ recommended supplements:
• Vitamin D 
• Iron 
• Calcium 
• Creatine
• Magnesium 
• B12

Lume Women + Health is now open! They understand the unique challenges women face during perimenopause and beyond. Be sure to check out their dedicated menopause program that provides personalized support, medical guidance, and lifestyle optimization education to help you manage symptoms, improve your well-being, and thrive during this life stage.

Every other week, the team at Lume Women + Health will be dropping into our podcast to answer one of your questions. Be sure to follow our podcast so that you never miss these Lume Minutes. Find ‘This Is Perimenopause, the podcast’ wherever you listen to your favorites.

Episode Links

• Dr. Amy Louis-Bayliss
• Lume Women + Health
• MQ6 Tool
• Menopause Foundation of Canada symptom tracker

Connect with Mikelle & Michelle at This is Perimenopause

• Email us and let us know what you think of the podcast and what topic you want us to cover next.
• Sign up for our weekly newsletter
• Follow This Is Perimenopause on Instagram
• Follow This Is Perimenopause on Facebook

Hosted on Acast. See acast.com/privacy for more information.