unPAUSED with Dr. Mary Claire Haver

In this episode of unPAUSED, pulled from the archive because it’s one worth hearing again, Dr. Mary Claire Haver sits down with Dr. Rachel Rubin, board-certified urologist, nationally recognized expert in sexual medicine, assistant clinical professor of urology at Georgetown University, and a lead advocate behind the 2025 American Urological Association guidelines on genitourinary syndrome of menopause. The conversation starts with the number that explains everything: three training programs in the last three years even acknowledge women’s sexual health — men have more than 27. The reason your doctor doesn’t know how to talk to you about libido, arousal, orgasm, or pain is that no one ever taught them.

Dr. Rubin delivers the anatomy lesson medicine skipped — why the clitoris and penis are the same tissue, why the cervix is triply innervated despite being taught as nerve-free, and why “my orgasm changed after my hysterectomy” is biology, not psychology. They cover why sex should never hurt and pain always deserves a diagnosis, the vulvar vestibule tissue most doctors were never taught to examine, the hormone changes that start in your 30s — not at menopause — and the case Dr. Rubin has built her career on: vaginal estrogen and DHEA prevent more than half of UTIs and could save Medicare an estimated $6–22 billion a year. Plus the medications that quietly affect sexual function, the two FDA-approved drugs for low libido most women have never heard of, and the five hormone options every woman deserves to know are on her menu.

Guest links:
Dr. Rachel Rubin (Website) https://www.rachelrubinmd.com/
Dr. Rachel Rubin (Instagram) https://www.instagram.com/drrachelrubin/
Dr. Rachel Rubin (X) https://x.com/drrachelrubin

Books:
“The New Perimenopause,” by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
“The New Menopause,” by Dr. Mary Claire Haver https://www.amazon.com/dp/B0CKBZ4K1Z

Never miss an episode—sign up for The ‘Pause Life Newsletter: https://thepauselife.com/pages/newsletter

Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The ‘Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with entrepreneur Mark Cuban, cofounder of the Mark Cuban Cost Plus Drug Company, to unpack the estrogen patch shortage and why so many women in perimenopause and menopause struggle to find and afford hormone therapy. Holding up her own patch, Dr. Haver asks the question her patients keep asking: why is this so hard to get? Mark explains why the shortage hit so hard — patches require specialized manufacturing that pills don't, demand surged after the black box warning was removed, and supply couldn't keep up — plus how Cost Plus Drugs has worked to buy every patch manufacturers can produce, and who gets served first when a generic drug runs short.

Then they take apart how drug prices are really set: how pharmacy benefit managers (PBMs) decide what your insurance covers, how rebates drive list prices higher, and why a handful of conglomerates now own the insurer, the pharmacy, the PBM, and the physician practice all at once. They compare what a generic estradiol patch costs to make against what many women pay at retail, cover Dr. Haver's case for vaginal estrogen as one of the most affordable treatments in menopause care, why there's still no FDA-approved testosterone for women, how untreated symptoms push women out of the workforce, and the playbook for lowering your prescription costs — from 90-day supplies to comparing cash prices with your copay.

Guest links:
Mark Cuban Companies https://markcubancompanies.com/
Cost Plus Drug Company https://www.costplusdrugs.com/
Mark Cuban (Instagram) https://www.instagram.com/mcuban/
Mark Cuban (X) https://x.com/mcuban

Books:
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/dp/B0CKBZ4K1Z

Articles:
Menopausal Hormone Therapy Use Among Postmenopausal Women (JAMA) https://jamanetwork.com/journals/jama-health-forum/fullarticle/2823976

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Pamela Brown, CNN anchor and chief investigative correspondent, and host of the network's new women's health streaming series Body Language by CNN — born from an experience Pamela nearly kept hidden. In the same year she lost her mother, while covering the White House, she was blindsided by postpartum OCD: intrusive thoughts that grew louder and scarier, hidden from everyone — including her husband — while she reported live on air. Dismissed when she flagged the highest score on a postpartum screening form, she finally found her own diagnosis through an article online, and turned the experience into an eight-part series covering perimenopause, GLP-1s, egg freezing, PCOS, thyroid disease, the fourth trimester, and Alzheimer's.

Pamela and Dr. Haver dig into what the series uncovered: why intrusive thoughts are not psychosis — and why that distinction matters so much for new mothers — with Dr. Haver sharing her own postpartum intrusive thoughts as a young resident, and what the Andrea Yates case changed for her generation of OB-GYNs. They cover the "GLP-1 babies" boom and why fertility rises on these medications, the GPS protocol (GLP-1, protein, strength training), the telemedicine revolution in menopause care and its limits, the FDA hearing on testosterone for women — including both women's own experience using it — the estrogen patch shortage and the letter-writing campaign that forced the FDA to respond, and why Dr. Haver believes vaginal estrogen could prevent half of UTIs in older women, along with the falls and fractures that follow. The episode closes with why the postpartum system fails mothers — one six-week appointment — and what needs to change.

Guest links:
Pamela Brown (Instagram) https://www.instagram.com/pamelabrowncnn/
Pamela Brown (X) https://x.com/PamelaBrownCNN
Pamela Brown at CNN https://www.cnn.com/profiles/pamela-brown-profile
Body Language by CNN https://www.cnn.com/videos/title-2600886

Books:
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/dp/B0CKBZ4K1Z

In this episode of unPAUSED, recorded on location at the Aspen Ideas Festival, Dr. Mary Claire Haver sits down with Dr. Trisha Pasricha, neurogastroenterologist at Beth Israel Deaconess Medical Center, assistant professor of medicine at Harvard Medical School, and author of the new book You've Been Pooping All Wrong. Women in perimenopause and menopause who describe bloating, new constipation, or digestion that suddenly feels unfamiliar are often told it's stress or age — Dr. Pasricha explains the real biology, starting with the estrogen receptors inside the gut's own nervous system, and makes the case for treating the gut as a second brain rather than plumbing. She breaks down why IBS affects women about twice as often as men, and why women with gut pain are so often told it's all in their heads — in her words, it's not the stress causing the symptoms, it's the symptoms causing the stress.

They cover the less obvious causes of bloating — including pelvic floor dysfunction — accidental bowel leakage after menopause and how it's treated, the link between smartphones in the bathroom and hemorrhoids, what to expect from GLP-1s, and why women treating iron deficiency can often take oral iron every other day to ease constipation. Then it's the serious part: the four colorectal cancer red flags women should stop normalizing, which stool colors need attention, why colonoscopy is the only screening option that prevents colorectal cancer, and why new bloating after menopause should always be evaluated. The practical takeaways include daily fiber targets, the case for psyllium and fermented foods, why ramping up fiber slowly prevents gas and bloating, a realistic approach to cutting ultra-processed foods — and the habit Dr. Pasricha asks of her own patients: look at your stool every day, because knowing what's normal for you is how you notice when something changes.

Guest links:
Dr. Trisha Pasricha (Website) https://www.trishapasricha.com/
Dr. Trisha Pasricha (BIDMC Gut-Brain Institute) https://research.bidmc.org/gut-brain/people/team-member-1
Dr. Trisha Pasricha (Instagram) https://www.instagram.com/trishapasrichamd/
Dr. Trisha Pasricha (TikTok) https://www.tiktok.com/@drtrishapasricha
Gut Checker (Substack) https://gutchecker.substack.com/
Ask a Doctor (Washington Post) https://www.washingtonpost.com/people/trisha-pasricha/

Books:
"You've Been Pooping All Wrong: How to Make Your Bowel Movements a Joy," by Dr. Trisha Pasricha https://www.penguinrandomhouse.com/books/776380/youve-been-pooping-all-wrong-by-trisha-pasricha-md-mph/
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Erica Kelly, board-certified dermatologist, Clinical Professor at the University of Texas Medical Branch, and founder and director of UTMB's Cosmetic Dermatology Division and this time it's the practical half: sunscreen, routines, treatments, and hair. Dr. Kelly settles the questions filling everyone's feed — chemical vs. mineral sunscreen, whether the endocrine-disruption fears are backed by evidence, why some filters are banned in the US but not Europe — and explains why the best sunscreen is simply the one you'll actually wear, every day, including the spots everyone forgets: scalp, ears, and lower lip. Mary Claire also shares her own recent diagnosis: a squamous cell carcinoma on her nose — which Dr. Kelly removed.

Guest links:

- Dr. Erica Kelly at UTMB Health Aesthetics https://utmbhealth.com/aesthetics/about/erica-kelly

- Dr. Erica Kelly (UTMB Health) https://doctors.utmbhealth.com/profile/005428

Recommended Books:

- "The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book

- "The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z

00:00:00 – Mineral vs chemical sunscreen

00:02:16 – Are sunscreens endocrine disrupting?

00:04:56 – Do you need sunscreen every day?

00:06:28 – The ideal morning and evening skincare routine

00:07:19 – What a dermatologist actually uses on her skin

00:10:17 – Supplements and the evidence for collagen

00:12:43 – When professional skin treatments make sense

00:13:22 – The four approaches to cosmetic treatment

00:15:02 – How menopause changes lasers and Botox

00:17:01 – How to choose a safe cosmetic provider

00:19:18 – When to start Botox

00:22:22 – Menopause changes across the whole body

00:24:49 – Diet, sleep and skin aging

00:27:02 – Does red light therapy work?

00:28:25 – What actually helps menopausal hair loss

00:32:16 – The number one thing to do for your skin

00:32:46 – Drugstore skincare Dr. Kelly recommends

Never miss an episode—sign up for The 'Pause Life Newsletter:

https://thepauselife.com/pages/newsletter Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The 'Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Erica Kelly, board-certified dermatologist, Clinical Professor at the University of Texas Medical Branch, and founder and director of UTMB's Cosmetic Dermatology Division — and the first physician who ever connected the dots for Mary Claire between estrogen, collagen, and what happens to women's skin in midlife. Dr. Kelly explains why so many women feel their skin change almost overnight in their 40s and 50s — the sudden dryness, sensitivity, sagging, easy bruising, and acne all at once — and the mechanism behind it: women lose around 30% of their skin's collagen in the first five years after menopause, while estrogen receptors throughout the skin lose the hormone that kept the barrier, moisture, and elasticity working.

Dr. Kelly walks through what's really happening layer by layer — why skin gets rough and pores dilate, why moisturisers you've used for years suddenly cause reactions, why acne and wrinkles show up together, the truth behind itchy ears, hyperpigmentation, and rosacea — and the "your face has gotten too small for your skin" anatomy of midlife sagging. Then it's the evidence: what the research actually shows about systemic hormone therapy and skin aging, her deep dive into topical estrogen creams (including why she uses estriol on the face and how long results take), and the skincare ingredients worth your money — why retinoids and sunscreen are "light years ahead of everything else," plus the honest verdict on hyaluronic acid, ceramides, niacinamide, vitamin C, exfoliating acids, peptides, and growth factors. This is Part 1 of a two-part conversation.

Guest links:

Dr. Erica Kelly at UTMB Health Aesthetics https://utmbhealth.com/aesthetics/about/erica-kelly

Dr. Erica Kelly (UTMB Health) https://doctors.utmbhealth.com/profile/005428

Books:

"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book

"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z

Never miss an episode—sign up for The 'Pause Life Newsletter: https://thepauselife.com/pages/newsletter Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The 'Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Gabrielle Lyon, board-certified family physician, founder of the Institute for Muscle-Centric Medicine, and bestselling author of Forever Strong — this time with the practical roadmap for building muscle in your 40s, 50s, 60s and beyond. Dr. Lyon explains why your first meal of the day matters most and why 30–50 grams of protein at that meal can change your body composition on its own. She breaks down anabolic resistance — why the diet and training that worked at 20 stops working at 58 — and the research showing it's reversible: women over 60 got no muscle response from 15 grams of protein, but at 30 grams responded just like 20-year-olds.

They get specific: what a 50-gram breakfast looks like, why two eggs won't stimulate aging muscle, how essential amino acids and creatine fill the gap, why the protein RDA is a floor rather than a target, the truth about red meat and saturated fat, the honest state of the evidence on hormones and muscle, and Dr. Lyon's warning about GLP-1 medications and accelerated sarcopenia. Plus: why progressive overload should really be progressive stimulus, where a woman who has never lifted should start, and why getting bulky isn't the risk — becoming frail is.

Guest links:
Dr. Gabrielle Lyon (Website) https://drgabriellelyon.com/
Dr. Gabrielle Lyon (Instagram) https://www.instagram.com/drgabriellelyon/
Dr. Gabrielle Lyon (YouTube) https://www.youtube.com/drgabriellelyon

Books:
"Forever Strong," by Dr. Gabrielle Lyon https://www.amazon.com/dp/B0C4VSDWQ2
"The Forever Strong PLAYBOOK," by Dr. Gabrielle Lyon https://www.amazon.com/dp/B0FL32CJ81
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/dp/B0CKBZ4K1Z

For full show notes, please visit: [BIT.LY LINK]
Never miss an episode—sign up for The 'Pause Life Newsletter: https://thepauselife.com/pages/newsletter

Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The 'Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Gabrielle Lyon, board-certified family physician, founder of the Institute for Muscle-Centric Medicine, and bestselling author of Forever Strong, to explain why skeletal muscle — not body fat — determines how well women age. Dr. Lyon shares the case that changed her career: a patient in her mid-fifties who had done everything she was told — dieting, cardio, the food pyramid — yet showed signs of accelerated brain aging. The problem wasn't her fat. It was her muscle.

Dr. Lyon explains why muscle is the body's largest site for glucose disposal — meaning low muscle mass can cause insulin resistance and prediabetes even in lean women — and why muscle quality, not just quantity, drives the metabolic dysfunction usually blamed on obesity, yet still isn't measured in routine care. She and Dr. Haver dig into why 60–70 grams of protein a day isn't enough to protect muscle through perimenopause and menopause and why women should aim for closer to 100 grams alongside resistance training, how sedentary muscle lowers your carbohydrate tolerance before blood sugar and insulin become dysregulated, and the myokines — including BDNF — released when muscle contracts that support brain health, metabolism, and long-term independence. Dr. Lyon's takeaway: resistance training and adequate protein are the two things women actually control as they age, and no hormone therapy can make up for them if they're missing.

Guest links:
Dr. Gabrielle Lyon (Website) https://drgabriellelyon.com/
Dr. Gabrielle Lyon (Instagram) https://www.instagram.com/drgabriellelyon/
Dr. Gabrielle Lyon (Facebook) https://www.facebook.com/doctorgabriellelyon/
Dr. Gabrielle Lyon (LinkedIn) https://www.linkedin.com/in/dr-gabrielle-lyon-00175a1a8/
Dr. Gabrielle Lyon (YouTube) https://www.youtube.com/drgabriellelyon
The Dr. Gabrielle Lyon Show (Apple Podcasts) https://podcasts.apple.com/us/podcast/the-dr-gabrielle-lyon-show/id1622316426

Books:
"Forever Strong: A New, Science-Based Strategy for Aging Well," by Dr. Gabrielle Lyon https://www.amazon.com/Forever-Strong-Science-Based-Strategy-Aging/dp/B0C4VSDWQ2
"The Forever Strong PLAYBOOK: A Six-Week, Science-Based Plan to Sharpen Your Mind, Strengthen Your Body, and Get Healthy at Any Age," by Dr. Gabrielle Lyon https://www.amazon.com/Forever-StrongTM-PLAYBOOK-Science-Based-Strengthen/dp/B0FL32CJ81
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z

In this solo episode of unPAUSED, Dr. Mary Claire Haver tells the truth about hair loss in women over 40 — a medical condition with real, identifiable causes, not a vanity complaint to be dismissed as stress or aging. She breaks down the biology of the hair growth cycle and the hormonal mechanism driving midlife thinning: as estrogen declines, androgens like DHT take over at the follicle, shrinking it with every cycle. She walks through the five most common causes of hair loss in midlife women — female pattern hair loss, telogen effluvium (including the dramatic shedding triggered by illness, surgery, stress, and rapid weight loss on GLP-1 medications), iron deficiency, thyroid dysfunction, and nutrient deficiencies and medications — plus the red flags, like bald patches, a receding hairline, or scalp scarring, that need a dermatologist immediately.

Dr. Haver then details exactly how to advocate for yourself: the full lab workup to request (and why ferritin must be checked even when standard blood counts look normal), what to bring to your appointment, and the treatment options that actually work — from correcting deficiencies first, to topical and oral minoxidil, finasteride, spironolactone, PRP, microneedling, and laser therapy. She gives the honest answer on whether hormone therapy treats hair loss, which supplements have real evidence behind them, why biotin is unlikely to help without a true deficiency, and shares her own experience with both female pattern hair loss and a post-illness shed. The episode closes with a practical five-step action plan for documenting your hair loss, requesting the right tests, and getting the workup you deserve — because your hair is a vital sign.

Resources:
Download the FREE Midlife Hair Loss Guide https://thepauselife.com/pages/the-midlife-hair-loss-guide
Dr. Mary Claire Haver (Substack) https://drmaryclairehaver.substack.com/

Books:
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Melinda French Gates, philanthropist and founder of Pivotal, to talk about her call for a "menopause revolution" — including the $215 million in new funding for women's health she announced in her New York Times essay, bringing her total investment in women's health to more than $600 million in two years. Melinda opens with the numbers driving her urgency: nearly one in three women over forty has menopause symptoms severe enough to disrupt her life, only about one in four gets treated, fewer than a third of OB-GYN training programs teach menopause at all, and just five cents of every dollar spent on medical research goes to women's health.

Melinda shares her own story — how, despite what she calls unbelievable privilege and access to the best health care in the world, it took three doctors to get the right care for her symptoms, and how chronic insomnia and brain fog left her doubting herself walking into meetings with world leaders and CEOs. She and Dr. Haver trace how the Women's Health Initiative halted research, education, and hormone therapy almost overnight, why the health care system was built for men's bodies by default, the racial disparities leaving women of color to suffer most with the least treatment, and the new research she's funding through Wellcome Leap into women-specific heart disease and microvascular diagnostics. The episode closes with Melinda's concrete advice for every woman who wants change: advocate for yourself at the doctor's office, educate your friends with credible information, contact your representatives, and vote — because midlife shouldn't be an off-ramp, but one of the most vibrant chapters of a woman's life.

Guest links:
Melinda French Gates (YouTube) https://www.youtube.com/@melindagates
Melinda French Gates (Instagram) https://www.instagram.com/melindafrenchgates/
Melinda French Gates (Facebook) https://www.facebook.com/melindagates/
Melinda French Gates (LinkedIn) https://www.linkedin.com/in/melindagates/
Melinda French Gates (X) https://x.com/melindagates
Pivotal https://www.pivotal.com/founder
Moment of Lift Books https://www.momentoflift.com/
Melinda French Gates at the Gates Foundation https://www.gatesfoundation.org/about/leadership/melinda-french-gates

Books:
"The Next Day," by Melinda French Gates https://www.melindafrenchgates.com/
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z