Podcasts about ob gyn

I'm honored to reconnect with Dr. Felice Gersh today! She is a multi-award-winning physician with dual board certification in OB-GYN and Integrative Medicine. We connected once before in Episode 221, where we spoke about PCOS and metabolic health. Today, Dr. Gersh joins me to dive into perimenopause and menopause. We discuss various issues surrounding the Women's Health Initiative and talk about estrogen as a family of hormones, estrogen-mimicking chemicals, synthetic hormones, and oral contraceptives. We cover the importance of thyroid function, the pro-inflammatory state associated with estrogen loss in perimenopause and menopause, and the role of nutrition and exercise in metabolism. We also discuss lesser-known changes that occur in menopause, including changes in body odor, constipation, sarcopenia, osteoporosis, and vocal changes.  I plan to invite Dr. Gersh back to discuss women and mitochondrial health, and then again to talk about her latest book, Menopause: The Fifty Things You Need to Know.  Stay tuned to find out what menopause really is, and what it does to a woman's metabolic system. IN THIS EPISODE YOU WILL LEARN: Dr. Gersh discusses the Women's Health Initiative study and its devastating effects. The difference between synthetic and bioidentical hormones. How chronic diseases of aging can be delayed when hormones are incorporated along with other lifestyle refinements. What do hormones do? Why every immune cell in the body has receptors for vital hormones. Menopause may not be defined by a specific moment in time. Physiological changes that occur during the perimenopause years How hormones can change the perimenopause paradigm entirely. Perimenopause and sleep issues Phytoestrogens - nature's gift to women Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Felice Gersh Website:⁠ Integrative Medical Group of Irvine⁠ Instagram⁠ Dr. Gersh's books are available on ⁠Amazon⁠ Previous Episode Mentioned ⁠Episode 221 on PCOS with Dr. Felice Gersh⁠

After Mother Jones senior reporter Julia Lurie had her IUD removed, she was surprised to find that she felt happier and calmer than she had in years. Her experience made her wonder: What does the science say about how hormonal birth control affects mood? And in a moment when contraceptives are so politicized and misinformation is rampant, is it possible to talk about the side effects of birth control without giving ammunition to those who want to get rid of it altogether?In talking with scientists, doctors, and public health experts, Lurie learns that for years, research has found that people on hormonal contraceptives are much more likely to experience depression, suicidality, anxiety, insomnia, and other effects rarely discussed by the doctors who prescribe them. “For some women, it can be an almost overnight change,” says OB-GYN and contraceptive researcher Dr. Ojvind Lidegaard.This week on Reveal, we explore the gaps in women's reproductive health, from contraceptives to menopause. Support Reveal's journalism at Revealnews.org/donatenow Subscribe to our weekly newsletter to get the scoop on new episodes at Revealnews.org/weekly Connect with us on Bluesky, Facebook and Instagram Learn about your ad choices: dovetail.prx.org/ad-choices

Perimenopause affects more than 4 billion people, but has historically been neglected by medicine. It's the time before menopause when hormones start fluctuating wildly, leaving women with brain fog, hot flashes, dropping bone density, and mood changes. Thanks in part to social media, it's more prominent in public discourse than it used to be.But it's not just awareness that's blown up: It's also the promise that you don't have to suffer like those before you, thanks to hormone therapy. After decades of controversy over prescribing estradiol and progesterone due to concerns of increased breast cancer and heart disease risk, new research has many providers reconsidering their approach.Joining Flora to sort out the science are reproductive endocrinologists Nanette Santoro and Genevieve Neal-Perry, who are both running some of the biggest long-term studies on perimenopause and the effects of hormone therapy. Guests:Dr. Nanette Santoro is a reproductive endocrinologist at the University of Colorado Anschutz and is the president of the Endocrine Society.Dr. Genevieve Neal-Perry is a reproductive endocrinologist and the OB-GYN department chair at the University of North Carolina at Chapel Hill.Transcripts for each episode are available within 1-3 days at sciencefriday.com. Subscribe to this podcast. Follow our show on Instagram, TikTok, Facebook, and Bluesky @scifri and sign up for our newsletters. Got a science question that's keeping you up at night? Call us: 877-472-4374 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this special episode of The Egg Whisperer Show, I invited Dr. Nabil Arrach from Progenesis Academy to peel back the curtain on my work—and share what's ahead for The Egg Whisperer brand. We talk about the origin of the nickname, what my work with patients actually looks like (including home visits!), and exciting upcoming projects like The Egg Whisperer App. You'll get a true behind‑the‑scenes look at how I combine medical expertise, compassion, and personal connection in fertility care. In this episode, we cover: How the nickname "Egg Whisperer" came about and what it really means Why I often treat patients differently—even giving injections at home How growing up in an OB‑GYN family shapes my approach to fertility care The importance of personalized, love‑driven treatment for every patient What's coming next: The Egg Whisperer App and other new resources Read the full show notes on Dr. Aimee's websiteYou can find Progenesis Academy here. Do you have questions about IVF? Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, October 19, at 4 pm PST, where I'll explain IVF and Egg Freezing and answer your questions live on Zoom. Other ways to connect with me: Visit my YouTube channel for more fertility tipsSubscribe to the newsletter to get updatesJoin Egg Whisperer SchoolRequest a Consultation with Dr. Aimee Dr. Aimee Eyvazzadeh is one of America's most well‑known fertility doctors. Her success rate at baby‑making gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

Tara Chettiar joins as we talk through what the Lindsay Clancy case surfaces about postpartum mood disorders and why the public often misunderstands psychiatric illness when it gets filtered through legal arguments and internet certainty. We focus on practical clinical signals, especially sleep disruption, and what real safety planning and system reform should look like for postpartum families. • why we avoid diagnosing a public case and instead look for system lessons • how legal “insanity” clashes with the clinical spectrum of impairment • why med lists get misread and what SSRI activation can signal • baby blues versus postpartum depression and postpartum anxiety over time • postpartum OCD intrusive thoughts versus psychosis and delusions • sleep deprivation as the clearest danger sign and how it presents • what families can do in an acute postpartum mental health crisis • first line outpatient medication basics for OB GYN care • why postpartum psychosis needs emergency level triage • mother baby units and why the US has so few • what a postpartum mental health safety plan includes, including guns and pills • better screening in pregnancy, EPDS versus PHQ-9, and why anxiety matters • workforce gaps and why OBs, family medicine, pediatrics, and ER teams need training • Resources: Postpartum Support International at 1-800-944-4773 and text help, the National Maternal Mental Health Hotline at 833-TLC-Mama (852-6262), and 988 Be sure to check out thinking about obgyn.com for more information. And be sure to follow us on Instagram. 0:00 Welcome And Trigger Warning1:30 Meet Tara And Her Work7:10 Why The Clancy Case Matters11:55 Legal Binary Versus Clinical Reality12:50 Med Lists And Public Misreads14:50 SSRI Insomnia And Bipolar Red Flags18:15 Baby Blues Through Psychosis Spectrum24:00 Intrusive Thoughts Versus Psychosis28:13 Sleep Loss And Family Warning Signs30:45 First Line Meds And Titration34:55 ER Triage And Postpartum Advocacy39:05 Mother Baby Units And Step Down Care42:30 Safety Plans Means And Support45:35 Screening Tools EPDS Over PHQ948:05 Workforce Gaps And Training Fixes49:55 Policy Social Support And Paid Leave52:40 Hotlines Resources And Closing ThoughtsFollow us on Instagram @thinkingaboutobgyn.

Menopause isn't an ending—it's an evolution. Beverly Hills OBGYN and The Drew Barrymore Show resident expert Dr. Suzanne Gilberg joins us to break down the "Menopause Bootcamp" philosophy. In this episode, we move beyond the "suffering" narrative and explore a holistic integration of Ayurveda, modern medicine, and community support to help you navigate perimenopause and beyond with absolute authority. Welcome to MENO™ with Jacqueline Buckingham, the definitive destination for perimenopause, menopause, and everything on The Pause Spectrum™. IN THIS EPISODE, WE COVER: ➡️ The Bootcamp Mindset: Why we need to "train" for this life transition. ➡️ East Meets West: Integrating Ayurveda and lifestyle modifications with clinical OBGYN care. ➡️ Community as Medicine: Why you cannot navigate the "change" in isolation. ➡️ Reframing the Narrative: Moving from "loss of youth" to "gain of power." ➡️ Heart & Bone Health: The medical non-negotiables for women over 40. RESOURCES: Dr. Suzanne's Website: https://thedrsuzanne.com/ The Menopause Bootcamp: https://themenopausebootcamp.com/ Follow Dr. Suzanne: @askdrsuzanne ABOUT MENO MENO is the definitive platform for menopause and perimenopause care — connecting women to trusted experts, solutions, and support. https://joinmeno.com/ https://www.instagram.com/join.meno https://www.tiktok.com/@join.meno Follow our Founder/CEO on Instagram @jacquelinebuckingham Disclaimer: MENO is for general information and entertainment purposes only and does not constitute the practice of medicine in any way. MENO does not constitute professional health care services or medical advice. No doctor/patient relationship is formed as a result of this podcast. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of MENO is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard getting medical advice for any such medical condition they may have and should seek the assistance of their healthcare professionals for any conditions.

When Holly and Nathan Miller learned their baby was breech late in pregnancy, the unmedicated vaginal birth they had been preparing for suddenly felt out of reach. Living in rural South Georgia, they explored their options, including finding a provider experienced in vaginal breech birth, but ultimately faced limited choices close to home.   In this episode, EBB Childbirth Class graduates Holly and Nathan share how they shifted their focus from the birth they had originally envisioned to creating a family-centered Cesarean experience. They talk about advocating for a clear drape and immediate skin-to-skin, navigating conflicting information from providers, and finding ways to remain active participants in their baby's birth. They also reflect on Cesarean recovery, the importance of partner support, and what they learned about speaking up for their preferences even when circumstances were outside their control.   (01:27) Finding Evidence Based Birth® and Preparing for an Unmedicated Birth (03:33) When Birth Plans Began to Change (05:03) Navigating Birth Options in Rural South Georgia (07:51) Exploring ECV, Vaginal Breech Birth, and Cesarean (10:24) Shifting Toward a Family-Centered Cesarean (12:50) Advocating for a Clear Drape and Immediate Skin-to-Skin (15:10) Holly and Nathan's Cesarean Birth Story (17:43) What a Cesarean Felt Like Physically and Emotionally (22:03) Meeting Eliana and Beginning Skin-to-Skin (25:31) Breastfeeding and Recovering from a Cesarean (28:53) Partner Support During Postpartum Recovery (30:09) Advice for Navigating Breech Birth and Unexpected Changes (31:53) Looking Ahead to a Future VBAC   Resources EBB 256 – Top 3 Recommendations for Preventing Pelvic Floor Dysfunction after Birth with Dr. Sarah Duvall, Founder of Core Exercise Solutions All About Breach EBB 299 – A Breech Vaginal Birth Story with EBB Parents Naoma Kleisner, RN, MSN and Mohamed Koraichi EBB 298 – Overcoming Barriers to Breech Vaginal Birth with Dr. Emiliano Chavira, OB/GYN and Maternal Fetal Medicine Specialist EBB 297 – Frequently Asked Questions about Breech with Dr. Rebecca Dekker and Sara Ailshire, MA EBB 296 – Evidence on Breech Birth with Dr. Rebecca Dekker and Sara Ailshire, MA EBB 173 - Evidence on External Cephalic Version for Breech Positioned Babies EBB 172 – Breech Vaginal Birth with Dr. Rixa Freeze and Dr. David Hayes EBB 171 – The Experience of a Unique Vaginal Breech Birth with Janae and Andrew Rick EBB 111 – Positioning Breech Babies with Dr. Elliot Berlin

Today's menopause conversation is dominated by hormone therapy, which leaves many women who can't use it feeling left out and worried about their current and future health and well-being. This week's guests, Drs. Rebecca Dunsmoor-Su and Amy Voedisch — co-authors of Estrogen, Interrupted and hosts of the OvaryActive podcast — are here to bring some evidence-backed hope. Because no HT doesn't mean "sorry, you'll just have to suffer." Together we map out who actually shouldn't use hormone therapy versus outdated "rules" that no longer apply. The doctors break down the new NK3/NK1 "candy neuron" blockers Veozah and Lynkuet, the underrated combo drug Duavee, why vaginal estrogen is nearly contraindication-free, and how CBT, clinical hypnosis, and old-school options like gabapentin fit into the non-hormonal toolbox. Plus: bone health, DEXA scan timing, and why perimenopause — not menopause — is often the hardest stretch. Check out their book Estrogen, Interrupted and their podcast OvaryActive to learn more.Dr. Rebecca Dunsmoor-Su is a board-certified OB-GYN and Menopause Society-certified practitioner. She is the chief medical officer at Gennev, a telemedicine platform specializing in perimenopause and menopause, medical director at Seattle Clinical Research Center, and an associate clinical professor of obstetrics and gynecology at Washington State University. She holds a Masters of Clinical Epidemiology from the University of Pennsylvania.Dr. Amy Voedisch is a board certified OB-GYN and certified menopause practitioner through The Menopause Society. She is an associate clinical professor of obstetrics and gynecology at Stanford University and board-certified in Complex Family Planning. She holds a Masters of Epidemiology and Clinical Research from Stanford University.Courses and Coaching: https://livefeisty.com/courses/Sign up for our FREE Feisty 40+ newsletter: https://livefeisty.com/newsletters/feisty-40/Follow Us on Instagram:Feisty Menopause: @feistymenopauseHit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099Support our Partners:Hettas: Shop Hettas at https://alnk.to/h6KsEBr Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Previnex: Get 15% off your order with code HITPLAY at https://www.previnex.com/ Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr

What happens when a physician who spent years becoming highly skilled in IVF begins to ask a bigger question: Are we treating infertility, or simply trying to achieve a positive pregnancy test? In this powerful episode of The Hormone Genius Podcast, Teresa and Jamie sit down with Dr. Joseph Davis, an OB-GYN and fertility specialist with more than 15 years of experience, founder of Palm Integrative Fertility, and a member of FACTS About Fertility. Dr. Davis shares the very personal journey that led him from practicing IVF to embracing a more comprehensive, restorative approach to fertility care. His story is not about abandoning science, it is about recognizing that there is more science to fertility than many physicians are ever taught. Dr. Davis explains why conditions such as insulin resistance, thyroid dysfunction, endometriosis, diminished ovarian reserve, hormonal dysfunction, and recurrent miscarriage deserve deeper investigation, and why “unexplained infertility” may sometimes mean that we simply haven't found the explanation yet. One of the most fascinating parts of the conversation is Dr. Davis's discussion of the menstrual cycle itself. Rather than viewing ovulation as the finish line, restorative care looks closely at what happens after ovulation, including estrogen and progesterone patterns throughout the luteal phase and early pregnancy. Cervical mucus and other cycle biomarkers can provide valuable information about what is happening inside a woman's body. As Dr. Davis puts it, the patient is the best collector of her own personal health data. The conversation also tackles a difficult and important topic: the ethics of IVF and the dignity of the human embryo. Dr. Davis openly shares how his own ethical questions changed the way he viewed his work and ultimately led him to reconsider the role IVF played in his practice. Teresa also emphasizes an important message of compassion: this conversation is not about judging parents or children conceived through IVF. Rather, it is an invitation to think deeply about human dignity, informed consent, and the ethical questions surrounding fertility treatment. Finally, Dr. Davis talks about the exciting work being done through FACTS About Fertility, including the development of a new fellowship designed to train physicians in the science behind fertility awareness, restorative reproductive medicine, and cycle-based care. Your fertility matters. Your cycle matters. Your health history matters. And you deserve a practitioner who is willing to listen, investigate, collaborate, and help you understand the why behind what is happening in your body. If you've experienced infertility, recurrent miscarriage, diminished ovarian reserve, “unexplained” infertility, or simply want to understand your fertility more deeply, this is an episode you won't want to miss. Learn more about Dr. Davis and Palm Integrative Fertility: PalmFertility.com Learn about FACTS fellowship program, and electives at factsaboutfertility.org. Thanks so our sponsor We Heart Nutrition Supplements. Go to weheartnutrition.org and get 20% your first order with the CODE GENIUS! Medical Disclaimer: This podcast is for educational and informational purposes only and is not intended to diagnose, treat, cure, or prevent any disease or medical condition. Information discussed by guests and hosts represents their individual perspectives and should not be considered a substitute for personalized medical advice. Always consult your own qualified healthcare professional regarding your individual health and treatment options.

Aging is a privilege — but perimenopause and menopause can still blindside you. Kate Bowler sits down with Dr. Mary Claire Haver, board-certified OB-GYN and bestselling author of The New Menopause and The New Perimenopause, to explain what's actually happening in the body during perimenopause and menopause, why symptoms like brain fog, frozen shoulder, and anxiety get dismissed or misdiagnosed, and what the evidence really says about hormone replacement therapy after the 2002 Women's Health Initiative study derailed women's care for two decades. They also cover practical, low-cost tools for this stage of life — bone density screening, strength training, protein and fiber, cardio guidelines — and why replacing shame with information changes everything. This conversation was recorded on location at the Aspen Ideas Festival: Health.

Trying to conceive and wondering whether it is too late to get pregnant after 35? Being labeled “advanced maternal age” can make one birthday feel like a fertility cliff. But trying to get pregnant at 35 and 40 are not the same conversation, so should you keep trying on your own, get tested now, or discuss treatment before more time passes? In this episode of the As a Woman podcast, double board-certified OB/GYN and reproductive endocrinologist Dr. Natalie Crawford explains what actually changes as you move through your late 30s and into your 40s. She breaks down your chances of pregnancy, egg quality and miscarriage risk, when to request a fertility evaluation, which tests to ask for, how to track ovulation, and where egg freezing, IUI, IVF, and PGT may fit, helping you understand your options and use your time intentionally without letting fear make the decision for you. IN THIS EPISODE: 00:00 What Happens to Fertility After 35? 01:24 Is 35 Too Late to Get Pregnant? 03:19 What Are Your Chances of Getting Pregnant Each Month? 04:17 Egg Quantity vs. Egg Quality After 35 05:26 What Are Your Chances of Getting Pregnant at 38? 06:29 What Are Your Chances of Getting Pregnant After 40? 07:35 How Does Age Affect Chromosomal Abnormalities? 11:04 Does Paternal Age Affect Fertility? 13:01 Can You Carry a Healthy Pregnancy in Your 40s? 14:33 What Does Advanced Maternal Age Mean? 16:00 When Should You Get Fertility Testing After 35? 18:13 What Does an AMH Test Tell You About Fertility? 20:33 Is Egg Freezing Worth It After 35? 22:20 How Can You Get Pregnant After 40? 23:17 How to Track Ovulation When Trying to Conceive 24:50 What Fertility Treatment Is Best After 35? 26:08 Should You Do PGT With IVF After 35? AS A WOMAN WITH DR. NATALIE CRAWFORD: YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l  Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339  Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk  HOST RESOURCES: Order The Fertility Formula: https://www.nataliecrawfordmd.com/book  Newsletter: https://www.nataliecrawfordmd.com/newsletter  Instagram: https://www.instagram.com/nataliecrawfordmd  YouTube: https://www.youtube.com/@NatalieCrawfordMD  Become a patient: https://www.forafertility.com  Earn FREE CE/CME: https://learnatpinnacle.com/education  This episode is brought to you by The Pinnacle Podcast Network. ABOUT DR. NATALIE CRAWFORD: Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies. Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices

SEND US A TEXT MESSAGE!!! Let Drs. Nii & Renee know what you think about the show!A first year general surgery resident slid into my DMs after our previous episode on how GHANA MADE ME BETTER. She'd been following the show for almost 10 years, and she had one question:“How can I best start preparing for global surgery, especially in places like Ghana?”That question deserved more than a simple reply. It deserved an entire episode.So I'm sharing what I've learned from 14 years of humanitarian surgical work at KNUST University Hospital in Kumasi, Ghana, alongside International Healthcare Volunteers.You'll hear:→ Why global surgery is the truest test of your surgical foundation→ The #1 mistake residents make when they arrive (and why it destroys everything)→ How to start preparing RIGHT NOW. Not in fellowship, not as an attending, NOW→ What to look for in a global surgery program (and the red flags to avoid)→ What your first trip will actually look like. The OR, the clinical experience, and the emotional reality→ What 14 years of showing up consistently has taught me about this work For general surgery residents, all surgical specialty residents, medical students, and any physician who has ever thought about doing meaningful work beyond their hospital walls. "Global surgery is not a break from your training. It IS your training in its purest form."Find us on YouTube: www.youtube.com/@docsoutsidetheboxpodcastFREE DOWNLOAD: First-Gen Doctor Blueprint — Everything we wish someone had told us about finances, career planning, and building a life in medicine. Visit: https://darkos.lpages.co/first-gen-physicians/Have a question for us?Send us a Voice Message: https://www.speakpipe.com/docsoutsidetheboxText us: 833-230-2860DM us on Instagram: @docsoutsidetheboxEmail: team@drniidarko.comABOUT DOCS OUTSIDE THE BOX:Dr. Nii is a General Surgeon. Dr. Renee is an OB/GYN. We are first-generation Ghanaian and Haitian physicians who paid off $662,000 in student loan debt in 3 years, built a locum tenens agency, and navigated every major medical career decision without a family blueprint.We created this podcast for first-generation doctors — physicians who are the first in their families and lack the inherited knowledge about money, contracts, career strategy, and the unwritten rules of medicine that many of their colleagues learned growing up.Real conversations for first-gen doctors.Website: https://drniidarko.com/DISCLAIMER: Dr. Nii and Dr. Renee are physicians, not financial advisors or attorneys. Content shared in this podcast reflects personal experience and should not be considered financial, legal, or medical advice. Please consult qualified professionals before making financial or career decisions.© 2026 Docs Outside the Box. All rights reserved.

How does a practicing OB-GYN go from $8 million to over $20 million in net worth in just four years? In this Milestones to Millionaire episode, Allen returns four years after his first appearance on the podcast to share how a combination of disciplined investing and a major practice buyout transformed his financial picture. He walks through his full portfolio breakdown, which is nearly all invested in equities. The biggest driver of growth, though, was a hospital system's buyout of his group's stake in a jointly owned single specialty hospital, which resulted in a payout north of $4 million pretax per partner. Allen also discusses why he continues working full time despite having far more than enough money, citing both income and a genuine sense of identity and purpose tied to his career. He and his wife are now navigating more complex estate planning decisions, working with an attorney to structure trusts for their six children and future grandchildren, while trying to strike a balance between generosity and enabling dependency. His advice for younger physicians pursuing a similar path: pay yourself first, live within your means, and marry well, since a long, stable career combined with consistent saving can produce outcomes far beyond what most people expect. This podcast is sponsored by Bob Bhayani at Protuity. He is an independent provider of disability insurance planning solutions to the medical community in every state and a long-time white coat investor sponsor. He specializes in working with residents and fellows early in their careers to set up sound financial and insurance strategies. If you need to review your disability insurance coverage or to get this critical insurance in place, contact Bob at https://whitecoatinvestor.com/protuity today by email info@protuity.com or by calling (973) 771-9100. Celebrating your stories of success along the journey to financial freedom! Tune in every Monday to the Milestones to Millionaire Podcast, where we celebrate the financial achievements of our listeners and share practical tips for reaching your own milestones. We want to celebrate your milestones—no matter how big or small—and help inspire others to follow your lead. Every week, these episodes feature one listener who has recently achieved a milestone they are proud of and want to celebrate, and they give any advice they have for those who want to follow their example. Make sure to listen every Monday to be inspired by your fellow white coat investors. Celebrate YOUR Milestone on the Milestones to Millionaire Podcast: https://whitecoatinvestor.com/milestones  Website: https://www.whitecoatinvestor.com  YouTube: https://www.whitecoatinvestor.com/youtube  Student Loan Advice: https://studentloanadvice.com  TikTok: https://www.tiktok.com/@thewhitecoatinvestor  Facebook: https://www.facebook.com/thewhitecoatinvestor  Twitter: https://twitter.com/WCInvestor  Instagram: https://www.instagram.com/thewhitecoatinvestor  Subreddit: https://www.reddit.com/r/whitecoatinvestor  Online Courses: https://whitecoatinvestor.teachable.com  Newsletter: https://www.whitecoatinvestor.com/free-monthly-newsletter 

You've heard of an OB-GYN. You've probably heard of a psychiatrist. But have you ever heard of a reproductive psychiatrist?If the answer is no, you're not alone.In this episode, Sarah sits down with reproductive psychiatrist Dr. Claire Smith to explain why one of the most important specialties in maternal mental health remains one of the least known. Together, they discuss what reproductive psychiatry is, why so few specialists exist, how this training differs from general psychiatry, and why so many women never learn this specialty is available until they're already struggling.Follow Previa Alliance!Previa Alliance (@previa.alliance) • Instagram photos and videosPrevia Alliance Podcast (@previapodcast) • Instagram photos and videosKeep the questions coming by sending them to info@previaalliance.com or DM us on Instagram!

Send us Fan MailWhat if the thing standing between you and the business you really want isn't your circumstances?What if it's the conclusion you've drawn from them?In this episode of the EntreMD Podcast, I'm joined for the third time by Dr. Cheruba Prabakar, board-certified OB/GYN, fellowship-trained minimally invasive gynecologic surgeon, private practice owner, author, and “The Fibroid Doc.”And this conversation is not theory.Dr. Prabakar shares the story behind her work with women suffering from fibroids, including the deeply personal connection she discovered between the patients she serves today and watching her own mother suffer from fibroids decades ago.But we also talk about something every physician entrepreneur needs to hear:The moment when the dream feels impossible.In this conversation, we talk about fear, entrepreneurship, building a profitable business around meaningful work, creating impact through medicine, and refusing to put a lid on what you can build simply because you haven't seen it done before.You don't need to eliminate fear before you move.You need to stop allowing fear to make your decisions.Listen to this episode, identify the dream you may have talked yourself out of, and ask yourself one powerful question:What if I could?Then take the next step.Additional Resources:Learn more about my 12-month program. Interested in 1-on-1 coaching? Apply here.Grab a copy of the "The 7-Figure Physician CEO" book. When you are ready to work with us, here are three ways: The Profitable Private Practice Movement - If you want to build a thriving private practice that serves a lot of patients, while creating time and financial freedom for you, come join us here. EntreMD Business School Grow - This is our year-long program with a track record of producing physician entrepreneurs who are building 6, 7 and 7+ figure businesses. They do this while building their dream lives!EntreMD Business School Scale - This is our high-level mastermind for physicians who have crossed the seven figure milestone and want to build their businesses to be well oiled machines that can run without them.To get on a call with my team to determine your next best step, go here ...

Dr. Tiffanie Tate has many talents, among them as an author. Her newest book, "Perfectly Perfect," is written for kids twelve and under, a relatable story of friendship and compassion. In addition to her children's books, she is also the author of "FloweTry: A Collection of 108 Poetic Flows on Life, Love, and Liturgical Issues." Dr. Tiffanie is a Christian, mother, servant, listener and retired OB/GYN. She served as a medical officer in the US Navy during the global war on terror.https://drtiffanietate.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Send us Fan Mail2027 is not one reimbursement change. It's multiple changes moving at different speeds, some proposed, some confirmed, and the most expensive mistake is treating all of them like the same fee-schedule cut. Change 1, Medicare rates: CMS has proposed two 2027 conversion factors. The headline percentage is never your practice's percentage. Model your own top codes. Change 2, global procedures: Same-day E/M billed with a global procedure is getting more scrutiny. Documentation, not billing habit, decides whether it survives an audit. Change 3, specialty codes: New 2027 OB/GYN coding replaces the bundled global obstetric payment. The pattern applies to every specialty as codes get more specific. Change 4, digital care: Remote monitoring reimbursement is becoming more conditional on established-patient status, a documented initiating visit, and employed clinical staff. Change 5, rate transparency: Federal transparency files make commercial negotiated rates newly accessible, setting up next episode's data methodology. Three actions this week: Pull your top 20 Medicare CPT codes by allowed dollars Check whether your practice bills E/M on the same day as global procedures, and audit the documentation If you run remote monitoring, confirm employed clinical staff and a documented initiating visit Episode breakdown 00:00 Hook 00:40 The 2027 reframe 03:00 Change 1: Medicare rate nuance 07:00 Change 2: Global procedure scrutiny 11:00 Change 3: OB/GYN as the specialty example 15:00 Change 4: Digital care conditions 18:00 Change 5: Rate transparency 20:00 The three-question diagnostic 23:00 Close and next episode Resources 2027 Revenue Impact Brief: eligibility.natrevmd.com/know-where-2027-will-impact-your-practices-revenue-free-brief-natrevmd Metrics Audit Review (free, physician-led): eligibility.natrevmd.com/metrics-audit-natrevmd Website: natrevmd.com Referenced: EP210, the Modifier 25 framework Coming next: EP214, the one number to know before you negotiate with a payer 

Dr. Elissa Hellman is an experienced board-certified OBGYN.  She received her medical degree from NYU School of Medicine and completed her residency at Northshore University Hospital in Long Island in OBGYN.  Dr. Hellman has been in clinical practice for 15 years with a recent move from Milwaukee, WI to Israel.  She is also the physician at her self-named telemedicine gynecology practice focused on the health needs of Jewish women (www.drelissahellmanmd).  Through this platform, she offers one on one consultations to address gaps in knowledge and education many Jewish women face as they go through their reproductive years.  She also developed two educational courses Girls Growing Up, a puberty course for Jewish girls and The Kallah Curriculum, for Jewish brides who want to feel as prepared as possible in all aspects of women's health and reproduction as they can.  Instagram (@drelissahellmanmd) is where she hangs out and tries to have a little fun spreading evidence-based information about all the stages of womanhood- with a Jewish twist! CONNECT WITH DVORA ENTIN: Website: https://www.dvoraentin.com/ Instagram: https://www.instagram.com/dvoraentin YouTube: https://www.youtube.com/@misconceptionspodcast

I was sitting in my studio in Dallas with four women who had just spent five months inside my Magic Menopause Certification, and every one of them got emotional before we even started recording. That tells you something about what this season of life actually does to a woman who thought she had it handled. As a triple board-certified OB/GYN and the creator of the Keto-Green method and the Magic Menopause Coach Certification, I sat down with graduating coaches Chelsea, Song, Tara, and Jamie for a live, unscripted panel on everything nobody warns you about before perimenopause hits.  In this episode, you'll hear: - Why declining progesterone and DHEA between ages 35 and 55 quietly drive insulin resistance and weight gain that shows up out of nowhere - Why fibroids don't have to mean an automatic hysterectomy, and what a natural starting point can look like instead - Why perimenopause symptoms get dismissed as "normal" in a standard OB/GYN visit, and why that isn't good enough - Why this conversation belongs in mother-daughter relationships, starting as early as a daughter's first period  - How to reclaim vaginal and sexual health without shame - What it actually means to become the CEO of your own health This is the conversation I wish someone had handed me twenty years ago. Peace is possible on the other side of this transition. So is feeling like yourself again. Learn more about the Magic Menopause program at magicmenopause.com, subscribe if you're watching on YouTube, and comment your one word for this season of your life. I read every one.  Key Timestamps 00:00 — Why I brought four coaches into one room 04:00 — Fibroids, hysterectomy, and the missing third option 05:25 — The 30-day cycle nobody could explain 18:30 — Why the weight shows up even when nothing else changed 22:00 — The conversation that needs to start with our daughters  47:35 — Peeling back the shame around vaginal and sexual health 52:30 — Becoming the CEO of your own health Memorable Quotes "I didn't realize that until I crossed the line into menopause. And I was devastated." "You go to that doctor's appointment and you're the doctor. If your doctor won't partner with you, that's not your doctor."  -CONNECT WITH DR. ANNA- Website: http://drannacabeca.com/ Facebook: https://www.facebook.com/thegirlfrienddoctor Instagram: https://www.instagram.com/thegirlfrienddoctor/ TikTok: https://www.tiktok.com/@thegirlfrienddoctor Pinterest: https://www.pinterest.com/thegirlfrienddoctor/ * Always seek the advice of your own physician or qualified health professional before starting any treatment or plans. Information found here and results are provided for informational purposes only and are not intended to replace a one-on-one relationship with a qualified healthcare professional and are not intended as medical advice. *

In this episode, Jacqueline is joined by tech leader turned innovator Anastasia Sartan, the Founder & CEO of The Cycle.   After spending a decade building companies and working as a product director at Snapchat, Anastasia quietly battled severe PMDD. When traditional medicine left her without quick answers, she applied her data science background to medical research, leading to the creation of the first functional beverage formulated for female hormonal health. Together, Jacqueline and Anastasia discuss how the body absorbs liquid nutrients faster than powders, the hidden power of sea buckthorn, and how a surprise order from Sprouts changed Anastasia's career trajectory forever.   They dive into a live taste-test of the formulations and envision a world where women's biology is celebrated, from menstruating Barbies to cycle-accommodating lifestyle hotels. Welcome to MENO with Jacqueline Buckingham, the authority on menopause, perimenopause, and wherever you are on the pause spectrum.   IN THIS EPISODE WE COVER: ➡️ From Snapchat to Fem-Tech: Anastasia's experience navigating a high-stress corporate tech environment as a female leader, and how severe PMDD symptoms sparked her entrepreneurial mission. ➡️ The Problem with Powder Supplements: Why traditional pill supplements often require three to five months to show results due to low absorption rates and low functional dosages, and how liquid extracts offer immediate data points for your body. ➡️ The Magic of Sea Buckthorn Juice: The science behind this underappreciated ingredient—the only natural source of Omega-7—and how it acts as an anti-inflammatory that targets midlife dryness. ➡️ The Retail Breakthrough: How a hobby project consisting of an initial 8,000 cans secured a massive nationwide launch in all 500 Sprouts stores within three months of production. ➡️ The Pause Spectrum Demographics: Analyzing early nationwide sales data that reveals how period and perimenopause support lines are driving modern consumer demand. ➡️ Functional Herbs for Hormonal Health: A breakdown of phase-specific liquid organic herbs, including black cohosh for cooling comfort, sage for brain function, hops flower for anxiety reduction, and nettle leaf as a natural source of iron. ➡️ Rewriting the Instruction Manual on Biology: A critique of the lack of menopause and lifestyle education in traditional OB/GYN medical schooling. ➡️ Wild Dreams for Corporate Normalization: Anastasia shares her ultimate vision board goals, including a history-making collaboration for a menstruating Barbie, period wellness hotels, and the public debut of an upcoming sea buckthorn iron lemonade. RESOURCES https://onthecycle.com/ https://www.instagram.com/epysartan/ ABOUT MENO MENO is the definitive platform for menopause and perimenopause care — connecting women to trusted experts, solutions, and support. https://joinmeno.com/ https://www.instagram.com/join.meno https://www.tiktok.com/@join.meno Follow our Founder/CEO on Instagram @jacquelinebuckingham Disclaimer: MENO is for general information and entertainment purposes only and does not constitute the practice of medicine in any way. MENO does not constitute professional health care services or medical advice. No doctor/patient relationship is formed as a result of this podcast. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of MENO is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard getting medical advice for any such medical condition they may have and should seek the assistance of their healthcare professionals for any conditions.

In today's podcast episode, Dr. Kemi Doll, a 43-year-old double board-certified gynecologic oncologist and OBGYN, uterine cancer scientist at the University of Washington, coach for women of color in academic medicine, nonprofit founder supporting Black women with womb cancers, and author of A Terrible Strength, discusses Black womb health and the "terrible strength" that leads Black women to normalize heavy bleeding and pain, endure gynecologic disease, and delay care. She shares her personal history of lifelong painful, heavy periods, infertility labeled "unexplained," and a first endometriosis diagnosis during a C-section despite being a board-certified OBGYN, linking endurance to cognitive load and worsened outcomes. She addresses gynecology's history of experimentation on enslaved Black women and ongoing pain dismissal, and offers steps for healing and advocacy: making space for grief, learning family "womb stories," clarifying medical and physical goals, and bringing a "womb sister" to appointments, plus defining medically and spiritually safe support.    Steps for Healing & Medical Advocacy Dr. Doll outlines actionable strategies for Black women to navigate the healthcare system safely and advocate for their reproductive well-being: Strategy Actionable Step Make Space for Grief Allow yourself to grieve the time, fertility, or bodily peace lost to undiagnosed or dismissed pain. Learn "Womb Stories" Talk to maternal relatives to uncover family histories of fibroids, heavy bleeding, infertility, or gynecologic cancers. Clarify Your Goals Determine both your medical goals (e.g., pain management, fertility preservation) and your physical goals (e.g., daily energy, comfort). Bring a "Womb Sister" Never go to critical appointments alone. Bring a trusted friend, family member, or doula to act as your advocate and take notes. Define Safe Support Actively seek out healthcare providers who offer both medically safe clinical care and spiritually safe emotional support.  

Endometriosis affects an estimated 1 in 10 women, yet diagnosis can still take years. Some women experience debilitating period pain or GI symptoms, while others have little obvious pain and first encounter endometriosis during an infertility evaluation. How do you know when endometriosis could be the cause, and what should happen next? In this episode of the As a Woman podcast, Dr. Natalie Crawford talks with Dr. Mallory Stuparich, a board-certified OB/GYN and fellowship-trained minimally invasive gynecologic surgeon specializing in endometriosis and complex pelvic pain. They explain why endometriosis can be missed even after an ultrasound, how birth control and excision surgery serve different goals, what to consider about fertility before surgery, and how to choose care based on your symptoms and priorities. IN THIS EPISODE: 00:00 Endometriosis Symptoms, Treatment, and Fertility 01:21 Meet Dr. Mallory Stuparich 04:32 What Is Endometriosis? 06:09 What Do the Stages of Endometriosis Mean? 07:33 Why Does Endometriosis Take So Long to Diagnose? 09:03 What Are the Symptoms of Endometriosis? 10:35 Does Endometriosis Run in Families? 11:52 When Is Period Pain Abnormal in Teenagers? 13:01 Can Endometriosis Cause GI Symptoms? 13:58 What Are the Treatment Options for Endometriosis? 16:20 Does Birth Control Treat Endometriosis? 18:45 Can Birth Control Prevent Endometriomas? 21:15 Ablation vs. Excision Surgery for Endometriosis 25:04 When Is Lupron Used for Endometriosis and IVF? 28:00 How Does Endometriosis Affect Fertility? 29:22 Should You See a Fertility Specialist Before Endometriosis Surgery? 32:27 Can Repeat Endometriosis Surgery Improve Fertility? 34:25 How Do You Choose an Endometriosis Surgeon? 36:01 When Is Surgery Used to Diagnose Endometriosis? 37:47 Can Ultrasound Diagnose Endometriosis? 39:26 When Do You Need an MRI for Endometriosis? 41:32 Where Can Endometriosis Grow? 42:31 Endometriosis vs. Adenomyosis: What's the Difference? 43:50 How Is Adenomyosis Treated Before IVF? 45:21 Can Lifestyle Changes Help Endometriosis? 48:49 Can GLP-1 Medications Help Endometriosis? 50:24 What New Endometriosis Tests Are Being Studied? 51:14 How to Advocate for Endometriosis Care GUEST RESOURCES: Instagram: https://www.instagram.com/mallorystuparichmd/ Website: https://internationalendo.com/drmallorystuparich/ AS A WOMAN WITH DR. NATALIE CRAWFORD: YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l  Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339  Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk  HOST RESOURCES: Order The Fertility Formula: https://www.nataliecrawfordmd.com/book  Newsletter: https://www.nataliecrawfordmd.com/newsletter  Instagram: https://www.instagram.com/nataliecrawfordmd  YouTube: https://www.youtube.com/@NatalieCrawfordMD  Become a patient: https://www.forafertility.com  Earn FREE CE/CME: https://learnatpinnacle.com/education  This episode is brought to you by The Pinnacle Podcast Network. ABOUT DR. NATALIE CRAWFORD: Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies. Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices

You have probably been told that testosterone is a male hormone. Women produce more of it than estrogen, and for many of us it is the first hormone to go, sometimes reading zero five years before menopause while periods are still regular. Dr. Susan Hardwick-Smith and I get into what that costs you in muscle and bone, why there are thirty-one approved testosterone products for men and none for women, and what the number on your own lab report is measuring.Want ad-free episodes? Subscribe to Forever Strong Insider: https://bit.ly/4u5VSReCreate Her: Aging into the Healthiest Version of Yourself by Susan Hardwick-Smith MD https://www.amazon.com/Create-Her-Healthiest-Version-Yourself/dp/1637636644/ref=sr_1_3?s=books&sr=1-3 Dr. Gabrielle Lyon with Amy Pearlman Podcasthttps://bit.ly/3TcVgvBConnect with Dr. Susan Hardwick-SmithWebsite: drsusan.comYouTube: https://www.youtube.com/@drsusanInstagram: https://www.instagram.com/drsusanofficialTikTok: https://www.tiktok.com/@drsusanofficialFacebook: https://www.facebook.com/drsusanofficial/LinkedIn: https://www.linkedin.com/in/drsusanhardwicksmith/Thank you to our sponsors:Timeline - up to 20% off when you subscribe and save at https://bit.ly/4x18cm5BodyHealth - Use the code LYON20 to get 20% off your first order https://bit.ly/4wZgg6NBranch Basics - Get 15% off the Premium Starter Kit at https://bit.ly/4i6iOfK with the code DRLYON.Explore More from Dr. Gabrielle LyonPremium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.comWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon's clinical team https://drgabriellelyon.com/new-patient-inquiry/Connect with Dr. Gabrielle Lyon:Instagram: https://www.instagram.com/drgabriellelyon/TikTok: https://www.tiktok.com/@drgabriellelyonX (Twitter): https://x.com/drgabriellelyonFacebook: https://www.facebook.com/doctorgabriellelyonTimestamps:00:00 - Introduction: testosterone in women03:00 - Eighteen years in OB-GYN and the practice she left04:57 - Thirty years in medicine, zero training on testosterone06:40 - 31 FDA-approved products for men, zero for women07:35 - Why women produce more testosterone than estrogen09:20 - What the ovaries stop making at menopause10:18 - Testosterone reading zero five years early11:41 - Low testosterone symptoms in women13:22 - Intrinsa, the 2004 patch the FDA turned down19:04 - Off-label prescribing and what FDA approval means21:35 - Cognition, breast cancer, muscle and bone25:33 - Osteoarthritis and the anti-inflammatory theory26:31 - Dosing fears: hair loss, acne, voice changes28:16 - Why gels are dosed ten times higher32:14 - The 2019 international consensus34:00 - Dividing a 50 mg tube by ten38:18 - The Baylor study: pellet versus gel at six weeks40:13 - Safety data from fifty years of transgender care45:03 - Eight years of high dosing and what it cost46:16 - Lab reference ranges versus optimal ranges48:28 - ELISA versus LC-MS, and what the study found51:07 - Why free testosterone is calculated, not measured57:58 - Tachyphylaxis and chasing the number1:01:39 - Pellets, BioTE and where the reputation came from1:06:33 - Delivery methods, cypionate and enanthate1:11:47 - Whether anything raises testosterone naturally1:13:03 - DHEA at 100 mg and what it moved1:17:07 - Drugs that lower testosterone in women1:20:55 - Closing thoughts on dosing and accessIf you found this episode valuable, share it with someone who would benefit from it.Disclaimers: This episode includes paid sponsorships.The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Send us Fan MailResources RECOVER Diagnostic: https://eligibility.natrevmd.com/recover-quiz-lp natrevmd.com Payment Posting Audit Checklist: https://eligibility.natrevmd.com/payment-posting-checklist Show notes A provider sees a patient for a scheduled procedure. A separate problem comes up mid-visit, gets evaluated, and the practice bills both services with Modifier 25 attached. The claim pays, and everyone moves on, until that same claim gets swept into a targeted payer audit because the documentation never actually supported a separate, significant E/M service. The three failure patterns Routine pre-procedure work billed as a separate visit:  Baseline assessment before a procedure, confirming the patient is appropriate, reviewing labs, checking vitals, is part of the procedure. It is not a separate E/M, and Modifier 25 does not apply just because something happened before the procedure. Cloned or thin documentation:  An assessment and plan identical to the note from two visits ago, or a problem mentioned in one line with no distinct plan, will not survive a payer review. The documentation has to show medical decision-making distinct from, and above and beyond, the procedure. Modifier 25 used to override a denial:  A claim gets bundled and denied, someone appends Modifier 25 and resubmits, and it pays. If the documentation never supported a separate E/M, that resubmission was not a correction. It was a workaround, and it is exactly the pattern payer audits look for.The global period trap Global periods run 10 days for minor procedures and 90 days for major surgeries. During that window, routine E/M care for the same procedure is bundled and not separately billable, even with Modifier 25 attached. A genuinely unrelated new problem may have a path to separate billing, but it needs documentation of the unrelatedness and compliance with payer-specific global period rules. Procedural specialties, surgical groups, orthopedics, gastroenterology, dermatology, OB/GYN, carry the most risk here. The five-question audit test 1.  Was a significant E/M service actually performed, beyond the usual work of the procedure? 2.  Is the separate problem, assessment, and management clearly visible in the documentation? 3.  Would the E/M have been separately reportable if the procedure had not occurred that day? 4.  Do current NCCI, global-period, and payer-specific rules allow Modifier 25 here? 5.  Could the practice defend this claim on the medical record alone, not just the modifier? Three actions this week Pull 20 to 30 Modifier 25 claims from the last 90 days across your most frequent providers and run each one through the five-question test. Where claims fail, start with provider education, one conversation with examples from their own documentation, not a policy memo. If more than 20 percent of the sample fails, add a pre-release review for high-frequency or high-risk providers for 60 to 90 days while the pattern corrects. Episode breakdown The setup: what Modifier 25 is actually supposed to communicate The three failure patterns Three cases: yes, no, or verify The global period trap The five-question audit test Running your own Modifier 25 practice audit 

On this episode, Dr. Sadaf begins a three part series on sexual health during and after pregnancy! This first installment is everything you need to know about the safety, physical changes, and physiological hurdles of maintaining intimacy while expecting. Learn research based best practices as Dr. Sadaf dives into the key clinical studies showing that intercourse is safe for uncomplicated pregnancies, while also learning about the curveballs we can get from contraindications such as placenta previa and vasa previa. It is also time to turn the volume up on some of those whispered questions regarding oral sex, anal sex, and masturbation, and just get to the facts. In addition to all of that, Dr. Sadaf also explains trimester-specific positioning tips to protect placental blood flow, the science of how nipple stimulation can ripen the cervix, and when to seek guidance from an OB/GYN to ensure a healthy, comfortable, and satisfying sex life!Disclaimer: Anything discussed on the show should not be taken as official medical advice. If you have any concerns about your health, please speak to your medical provider. If you have any questions about your religion, please ask your friendly neighborhood religious leader. It's the Muslim Sex Podcast because I just happen to be a Muslim woman who talks about sex.To learn more about Dr. Sadaf's practice and to become a patient visit DrSadaf.comLike and subscribe to our YouTube channel where you can watch all episodes of the podcast!Feel free to leave a review on Apple Podcasts and share the show!Follow us on Social Media...Instagram: DrSadafobgynTikTok: DrSadafobgyn

For millions of young women and girls, often the first place they turn with questions about their bodies isn't a doctor's office, it's social media which can lead to encountering many misconceptions and outright misinformation. Or, if the right voices show up, it can mean something else entirely. Our guest today, Dr. Charis Chambers, is one of those voices. She's a board-certified OB/GYN with specialty certification in Pediatric & Adolescent Gynecology, and Chief Medical Officer at Clue, a leading period and cycle-tracking app. She's also the founder of The Period Doctor, a platform she launched in 2019 to provide medically accurate reproductive health information and to place more minority physicians in the spaces where patients are already looking for answers. As she tells Raise the Line from Elsevier host Lindsey Smith, Dr. Chambers embraces the role of being a bridge between generations: "I can serve as a medical mediator where I advocate for the child and then educate the parent so that the child's concerns are met." Stay tuned to this important conversation to also learn about: Her new book, The Period and Puberty Parenting Revolution, which tackles many of the same myths she encounters every day in her clinic; Why stubborn myths around periods rarely hold up once you ask where they come from; How she thinks about the responsibility, and limits, of being a trusted medical voice on social media. Mentioned in this episode: Clue The Period Doctor The Period and Puberty Parenting Revolution If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

I'm joined by board-certified OB-GYN and mom of three, Dr. Franziska Haydanek. We chat about balancing clinical practice with social media, fighting online medical misinformation, and navigating the unique pressures on physician creators. We also dive deep into the gaps of U.S. pregnancy and postpartum care. Dr. Fran shares essential advice on self-advocacy in the hospital, the warning signs every new parent should watch for postpartum, and why recovery extends far past the standard six-week mark. We discuss: How doctors balance social media algorithms with nuanced medical advice. Actionable phrases patients can use to advocate for themselves when feeling dismissed. The systemic flaws of insurance-driven U.S. postpartum care. Key postpartum red flags: preeclampsia, mastitis, wound infections, and intrusive thoughts. Why body recovery extends far beyond the arbitrary 6-week checkup. The game-changing benefits of pelvic floor physical therapy. How to safely bring social media health trends to your own doctor. Connect with Dr. Franziska Haydanek on Instagram @pagingdrfran and check out all her resources at https://www.pagingdrfran.com  Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and ⁠subscribe to PedsDocTalk⁠. Get trusted pediatric advice, relatable parenting insights, and evidence-based tips delivered straight to your inbox—join thousands of parents who rely on the PDT newsletter to stay informed, supported, and confident. ⁠⁠⁠⁠Join the newsletter⁠⁠⁠⁠! Shop Dr. Mona's favorite products: https://shopmy.us/shop/pedsdoctalk (paid link) And don't forget to follow ⁠⁠⁠⁠@pedsdoctalkpodcast⁠⁠⁠⁠ on Instagram—our new space just for parents looking for real talk and real support. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the ⁠PedsDocTalk Podcast Sponsorships⁠ page of the website.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Did you know that raising your love hormone, also known as oxytocin, is a key way to improve your health, hormones, and longevity? The Girlfriend Doctor, Dr. Anna Cabeca, joins me to talk about happy hormones, sexual health, and her Keto-Green way of living. How to Increase Your Oxytocin Practice Gratitude Journaling Make Time for Laughter and Play Have Great Sex Enjoy Time with Your Friends Do Any Activity that Brings you Joy  About Dr. Anna Cabeca: ⁠Dr. Anna Cabecca⁠ is The Girlfriend Doctor. She is a triple-board certified, Emory University trained, OB/GYN.  She speaks from experience. She has risen from her own ashes of personal tragedy that spiraled into depression from not one but two rounds of menopause, weight gain, hair loss, and many other debilitating symptoms.  Her journey led her around the world to learn about true health and natural healing.  Dr. Anna came away empowered with the knowledge that modern medical training and research, combined with time-tested wisdom and remedies, will yield indisputable results. Dr. Anna is the author of two best-selling books: The Hormone Fix, a groundbreaking holistic lifestyle program for menopausal women, and Keto-Green 16, a comprehensive nutritional plan to staying healthy and slim, at any age. She has also spent years developing and perfecting a complete suite of life-changing products and programs.  Everything Dr. Anna develops is part of her own daily routine, based on her exhaustive research, and her never-ending quest to find solutions that help women reclaim their vibrancy, sexuality, health, and happiness. In This Episode The impact of stress on our hormones [8:45] How to increase your oxytocin [13:30] How gut health impacts our hormones [17:45] What Julva is for and who should use it [24:30] How the KetoGreen diet plan helps balance hormones [29:00] The importance of practicing gratitude [33:00] Links & Resources Support the launch by purchasing your copy on September 29th! Available at ⁠⁠YourLongevityBlueprint.com⁠⁠, with local copies coming to the Integrative Health and Hormone Clinic in Eastern Iowa this October. ⁠⁠Use Code Immune Support to get 10% off Immune Support Use code TURMERIC to get 10% off ⁠⁠⁠⁠⁠⁠TURMERIC ⁠Use Code StephanieG10 for 10% Off Dr. Anna Cabeca's Products & Courses⁠ ⁠Find Dr. Anna Cabeca Online⁠ Follow Dr. Anna Cabeca on ⁠Instagram⁠ | ⁠Facebook⁠ | ⁠Twitter⁠ | ⁠YouTube⁠ | ⁠LinkedIn⁠ ⁠Find Your Longevity Blueprint Online⁠ Follow Your Longevity Blueprint on ⁠Instagram⁠ | ⁠Facebook⁠ | ⁠Twitter⁠ | ⁠YouTube⁠ | ⁠LinkedIn⁠ ⁠Get your copy of the Your Longevity Blueprint book and claim your bonuses here⁠ ⁠Find Dr. Stephanie Gray and Your Longevity Blueprint online⁠   Follow Dr. Stephanie Gray on ⁠Facebook⁠ | ⁠Instagram⁠ | ⁠Youtube⁠ | ⁠Twitter⁠ | ⁠LinkedIn⁠ ⁠Integrative Health and Hormone Clinic⁠

Your period has disappeared, but pregnancy and menopause are not the reason. Could stress, underfueling, or exercise be disrupting your brain-ovary connection, and what does your body need before your cycle can recover? In this episode of the As a Woman podcast, Dr. Natalie Crawford explains hypothalamic amenorrhea and the subtler hypothalamic dysfunction that can begin while your period is still arriving. Learn how chronic stress and low energy availability affect ovulation, which symptoms may signal low estrogen, what testing can help rule out other causes, and why recovery requires more than simply eating more. IN THIS EPISODE: 00:00 Why Did My Period Stop? 01:47 What Is Hypothalamic Amenorrhea? 03:30 What Causes Functional Hypothalamic Amenorrhea? 04:00 How Does the Brain Control Ovulation? 06:04 Can Stress Stop You From Ovulating? 07:33 Can Low Body Fat Stop Your Period? 08:42 Hypothalamic Amenorrhea vs. Hypothalamic Dysfunction 10:28 Can You Lose Your Period Without an Eating Disorder? 11:53 What Are the Health Risks of Hypothalamic Amenorrhea? 13:26 What Are the Symptoms of Low Estrogen? 15:35 How Can You Track Ovulation and Cycle Changes? 16:48 How Is Hypothalamic Amenorrhea Diagnosed? 18:52 What Hormone Tests Are Needed for a Missing Period? 21:44 Do You Need a Bone Density Scan for Hypothalamic Amenorrhea? 22:34 How Do You Recover From Hypothalamic Amenorrhea? 23:38 What Should You Eat to Get Your Period Back? 24:41 Does Hormone Replacement Therapy Help Hypothalamic Amenorrhea? 25:58 Can Reducing Stress Help You Get Your Period Back? 26:26 How Long Does It Take to Get Your Period Back? AS A WOMAN WITH DR. NATALIE CRAWFORD: YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l  Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339  Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk  HOST RESOURCES: Order The Fertility Formula: https://www.nataliecrawfordmd.com/book  Newsletter: https://www.nataliecrawfordmd.com/newsletter  Instagram: https://www.instagram.com/nataliecrawfordmd  YouTube: https://www.youtube.com/@NatalieCrawfordMD  Become a patient: https://www.forafertility.com  Earn FREE CE/CME: https://learnatpinnacle.com/education  This episode is brought to you by The Pinnacle Podcast Network. ABOUT DR. NATALIE CRAWFORD: Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies. Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices

SEND US A TEXT MESSAGE!!! Let Drs. Nii & Renee know what you think about the show!In just a few days, we leave for Ghana, and this year, our boys are coming with us.This is our 14th year doing humanitarian work at KNUST University Hospital in Kumasi with International Healthcare Volunteers. Before we board that plane, we're talking about what humanitarian medicine actually looks like. Not the Instagram version. The real version.You'll hear:What International Healthcare Volunteers actually does and why the focus is sustainability and education, not fly-in-fly-out surgeryThe white savior complex in humanitarian medicine and why that mindset can destroy more than it buildsWhy Nii comes back a better surgeon every year from complex tissue repairs to the CO₂ tank story and the GIST tumor patientThe OB/GYN cases Renee encounters, including patients arriving with hemoglobin levels of 4 and 5What medical students and residents can learn in Ghana that they simply can't learn in the U.S.How we make two weeks in Ghana work with two boys, an apartment in Accra, alternating weeks, and homeschooling this yearAnd the mindset behind why we keep going back: “I'm not going to save Ghana. Ghana doesn't need saving. I'm going because Ghana made me.”If you're the first doctor in your family and you've ever felt behind, confused, or alone in navigating medicine, this is your community.And if you've ever done humanitarian medical work, or wondered what it really looks like beyond the highlight reel, this episode is for you. Find us on YouTube: www.youtube.com/@docsoutsidetheboxpodcastRESOURCES MENTIONED IN THIS EPISODE:Locumstory.com - a free resource with unbiased information about locum tenens opportunities, real physician stories, and practical guidance to help you make informed decisions about your career. Check them out at https://dotb.s.gy/Pod International Healthcare Volunteers - https://www.ihcv.org/FREE DOWNLOAD: First-Gen Doctor Blueprint — Everything we wish someone had told us about finances, career planning, and building a life in medicine. Visit: https://darkos.lpages.co/first-gen-physicians/Have a question for us?Send us a Voice Message: https://www.speakpipe.com/docsoutsidetheboxText us: 833-230-2860DM us on Instagram: @docsoutsidetheboxEmail: team@drniidarko.comABOUT DOCS OUTSIDE THE BOX:Dr. Nii is a General Surgeon. Dr. Renee is an OB/GYN. We are first-generation Ghanaian and Haitian physicians who paid off $662,000 in student loan debt in 3 years, built a locum tenens agency, and navigated every major medical career decision without a family blueprint.We created this podcast for first-generation doctors — physicians who are the first in their families and lack the inherited knowledge about money, contracts, career strategy, and the unwritten rules of medicine that many of their colleagues learned growing up.Real conversations for first-gen doctors.Website: https://drniidarko.com/DISCLAIMER: Dr. Nii and Dr. Renee are physicians, not financial advisors or attorneys. Content shared in this podcast reflects personal experience and should not be considered financial, legal, or medical advice. Please consult qualified professionals before making financial or career decisions.© 2026 Docs Outside the Box. All rights reserved.

"I wanted someone who was helping with proactive strategies. So if I'm sick one to two days a year, I want a doctor, but the 363 other days a year, I want someone helping me with strategies to not get sick. Unfortunately, our doctors aren't trained for that; the medical system doesn't have that." —Keith Bozeman Proactive healthcare shouldn't wait until you're sick — that's the entire premise behind Medgevity, the concierge, physician-led practice built by this week's guest, Keith Bozeman. After losing access to the kind of doctor who actually had time for him, Keith set out to rebuild what he'd lost: a coordinated team of a physician, dietitian, and exercise scientist working together year-round, not just during an annual physical. In this conversation, Keith and host Justine Reichman dig into what it actually looks like to have a health team instead of a single doctor squeezing you into a 15-minute slot. They talk about DEXA scans that reveal what the bathroom scale hides, why cholesterol numbers alone don't tell the full story, and why perimenopause and andropause so rarely get discussed before they hit. This episode is for anyone in midlife who's frustrated with reactive medicine and wondering what a proactive, team-based approach could actually change. By the end, you'll understand why Keith insists the doctor has to be the quarterback of your care — and why he thinks gyms, not hospitals, might be the next healthcare hub in your community. Key takeaways: A patient who lost only five pounds on the scale actually lost nine pounds of fat and gained four pounds of muscle — proof that body composition data tells a truer story than weight alone. High cholesterol doesn't automatically mean a statin is the right call; additional data like calcium and soft plaque scores can change the decision entirely. Most people get zero guidance before perimenopause or andropause hits, even during annual OB/GYN visits, leaving couples blindsided by symptoms no one warned them about. Medgevity doesn't mark up any test or supplement it recommends, removing the financial incentive that often muddies medical advice. It took Keith at least 18 months and one trusted dietitian saying yes before Medgevity had a functioning team — proactive healthcare had to be built relationship by relationship. Partnering with gyms instead of building brick-and-mortar clinics let Medgevity reach people nationwide without the geographic limits of an in-person practice. Listen to the full conversation to hear Keith's complete story, and subscribe to Essential Ingredients so you never miss an episode: https://tinyurl.com/Essential-Ingredients-Podcast  Meet Keith:  Keith Bozeman is a healthcare entrepreneur, business leader, and Founder & CEO of MEDgevity, a physician-led healthcare company focused on longevity, preventive medicine, and personalized wellness. With a mission to transform traditional healthcare into a proactive model centered on helping individuals live healthier, longer lives, Keith is driving innovation at the intersection of medicine, nutrition, fitness, and technology. Before founding MEDgevity, Keith built an accomplished executive career in the technology and business services sectors, serving as President of TEKsystems and holding multiple senior leadership positions throughout his tenure. He also contributed to the startup ecosystem as a Principal at Blu Venture Investors, supporting emerging technology companies and growth-focused ventures. Under Keith's leadership, MEDgevity has expanded its network of physicians, nutrition experts, and health professionals while embracing artificial intelligence and modern healthcare solutions to improve patient outcomes. He is passionate about redefining healthcare through evidence-based longevity strategies, integrated wellness programs, and innovative care delivery models. Keith is recognized for his expertise in healthcare innovation, business leadership, longevity medicine, preventive health, digital health transformation, and organizational growth. Website LinkedIn Instagram Connect with NextGen Purpose: Website Facebook Instagram LinkedIn YouTube Podcast Chapters: 01:16 Meet Keith Bozeman: The Visit That Started Medgevity 02:16 The Real Cost of Skipping Proactive Care 03:42 Why the Doctor Has to Be Your Health Quarterback 10:12 DEXA Scans: What the Scale Doesn't Tell You 17:31 From Supercenter Dream to Virtual Care Model 19:17 Building a Trusted Team From Scratch in 18 Months 22:13 What Your First Month at Medgevity Looks Like 24:03 Bringing Proactive Healthcare Into Gyms Nationwide 27:46 Keith's Advice: Don't Give Up on Healthcare  THE PRIMES  ✨ You're more capable than you have ever been, and somehow more invisible than ever. You keep handing out advice you do not take yourself. You keep saying 'after this next thing' to your own life, and the people around you have no idea because, from the outside, everything looks fine— that is exactly what The Primes was built for.

Ladies, if you have ever been told your labs look normal while your body says otherwise, this one is for you. Dr. Amy Loden is a physician who nearly died from preeclampsia and now builds her practice around what medicine misses in women. She breaks down why pregnancy complications are a warning sign, what perimenopause is really doing to you, and why heart disease deserves your attention more than you think. You will walk away knowing what to ask for and why it matters.If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast https://lesleylogan.co/podcast/. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co mailto:beit@lesleylogan.co. And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe https://lesleylogan.co/podcast/#follow-subscribe-free.In this episode you will learn about:How pregnancy complications reveal health risks that were already there.Why perimenopause symptoms get dismissed as normal aging.The heart disease signs that look nothing like the classic ones.Why good quality sleep matters more than hours in bed.How to eat and move to protect your metabolic health.Episode References/Links:Vitality Medical and Wellness - https://www.vitalitymwc.orgDr. Amy's TEDx talk on pregnancy - https://beitpod.com/amytedxDr. Amy Tiffany on Instagram - https://www.instagram.com/dramytiffanyDr. Amy Loden on LinkedIn - https://www.linkedin.com/in/amy-lodenThe Postpartum Pivot by Dr. Amy Loden - https://vitalitymwc.org/read-the-bookSubmit your wins or questions - https://beitpod.com/questionsGuest Bio:Dr. Amy Loden Tiffany is a St. Louis-based physician entrepreneur, author, and TEDx speaker dedicated to women's metabolic, hormonal, and cardiovascular health. After surviving severe preeclampsia and experiencing burnout in traditional, high-volume medicine, she pivoted her career toward a personalized, root-cause approach to patient care. As the founder of Vitality, she guides women through major life transitions—from postpartum to perimenopause—to help them recognize subtle warning signs and prevent long-term illness. Through her clinical work and her book, The Postpartum Pivot, Dr. Loden empowers high-achieving women to listen to their bodies, optimize performance, and take control of their long-term health.  If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. https://lovethepodcast.com/BITYSIDEALS! DEALS! DEALS! DEALS! https://onlinepilatesclasses.com/memberships/perks/#equipmentCheck out all our Preferred Vendors & Special Deals from Clair Sparrow, Sensate, Lyfefuel BeeKeeper's Naturals, Sauna Space, HigherDose, AG1 and ToeSox https://onlinepilatesclasses.com/memberships/perks/#equipmentBe in the know with all the workshops at OPC https://workshops.onlinepilatesclasses.com/lp-workshop-waitlistBe It Till You See It Podcast Survey https://pod.lesleylogan.co/be-it-podcasts-surveyBe a part of Lesley's Pilates Mentorship https://lesleylogan.co/elevate/FREE Ditching Busy Webinar https://ditchingbusy.com/Resources:Watch the Be It Till You See It podcast on YouTube! https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-gLesley Logan website https://lesleylogan.co/Be It Till You See It Podcast https://lesleylogan.co/podcast/Online Pilates Classes by Lesley Logan https://onlinepilatesclasses.com/Online Pilates Classes by Lesley Logan on YouTube https://www.youtube.com/channel/UCjogqXLnfyhS5VlU4rdzlnQProfitable Pilates https://profitablepilates.com/about/Follow Us on Social Media:Instagram https://www.instagram.com/lesley.logan/The Be It Till You See It Podcast YouTube channel https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-gFacebook https://www.facebook.com/llogan.pilatesLinkedIn https://www.linkedin.com/in/lesley-logan/The OPC YouTube Channel https://www.youtube.com/@OnlinePilatesClasses Episode Transcript:Amy Loden Tiffany, MD, MBA 0:00  If we're going to call pregnancy a stress test, which is becoming an increasingly common term, is pregnancy a stress test of a woman's metabolism and her cardiovascular system? Then we have to ask, what are we stressing it for? And the way I'm looking at this is a little bit different than how I was trained, which again was if you got the problem, the solution is in the pregnancy. So what if we started looking at pregnancy from the perspective of this is an unveiling, an unveiling of what was already there, and that nothing's actually gone wrong. Lesley Logan 0:29  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started. Lesley Logan 1:11  Oh my God, Be It babe. Get ready. Get your notepad out. Get ready. If you're driving, listen. You're gonna re-listen. You're gonna share this episode with everybody. I am so freaking stoked about the guest that we have. I fell in love with her with every single answer, and we need women like this in the medical world. So Dr. Amy Loden is our guest today. We're going to talk everything from postpartum to perimenopause and heart health, because ladies, you can't be it till you see it if you get sick, cannot. And I know it's confusing. There's so much information out there in the world, and it's like, who do we trust? What do we do? And I'm just so grateful I found her, and you're gonna love it. So make sure you get ready to hit share on this episode for women in your life and the men who need to know about what women are going through. My mind is blown on the episode. Here's Dr. Amy Loden.Lesley Logan 1:54  All right, Be It babe, I'm excited. I'm super stoked. We're gonna talk about all things women, health-related, with an amazing professional person who actually studies this stuff, not what I've read, and then I'm asserting to you because I don't want to be that influencer. I think those people need to take a little step back and let the professionals do it. We have Dr. Amy Loden here on the show, who's going to tell us everything we need to know. But Dr. Amy, we tell everyone who you are and what you rock at, kind of how you got here.Amy Loden Tiffany, MD, MBA 2:20  Sure, thanks for inviting me. I'm happy to be here, Dr. Amy Loden. I am in St. Louis, Missouri. I help primarily women over 40, but certainly anyone who's like, "How are my hormones working for my life or not? How is my weight in the mirror matching the weight in my head or not?" And all the things that come with life transitions from postpartum to perimenopause, beyond, my goal is that women who've interacted with our team will have a better care experience because it's the care experience we want each of us to have had ourselves, and because each of us are not only professionals within the medical nursing communities, we're patients too, or daughters and sisters and mothers and neighbors and all the things. We know how much it sucks to be patient, right? And so we've tried to redesign what is the best thing for our ladies. Now, in full transparency, we do have a few dudes, but most of them have had their arms twisted by our rock-star ladies, and they are the ones that are coming because they're forced to. And eventually, they decide they like us, but we're pretty cool too. So that's who we serve, and that's what we do. And happy to go into any detail or rabbit hole you want to chase?Lesley Logan 3:21  Oh my God, Amy! I love that. When people ask about the people who listen to this podcast, we have mostly women and a few good men because there are some men out there, including my husband. They want to be interested. They want to. They want their partners, the women, their lives. They want to get what's going on. They don't want them to feel like an alien or like they're alone in this journey. So I think that's really, really cool. I also just want to highlight. I love that you brought up your patients too, because as someone who I feel very lucky to go through my perimenopause journey in today's time when people actually are talking about it, versus even 10 years ago, generations were not talking about this stuff, and I just feel it's really nice because then there's information I would never have known about HRT unless my girlfriend had told me about it. Oh, that could be going on, and then I could talk to someone. Can we go back though? Yeah, I feel like to be a doctor like yourself, who has empathy and understands, like you must have gone through a journey as well. You don't just want to do this Amy Loden Tiffany, MD, MBA 4:13  Because you wanted to do this. That's true. Lesley Logan 4:16  Maybe there are a few. There might be a few, but typically, like there there has there's a story there that got you to be like I want to care about this. So can you tell us a little bit more about that?Amy Loden Tiffany, MD, MBA 4:24  Absolutely, yeah. So definitely with the traditional college to medical school road, really didn't understand that there's a and I say this with all the love in my heart, but there is a bit of brainwashing to be a good doctor, right? And what is a good doctor was who you've been told it is. It's not necessarily an external criteria. It's who does academic medical center say, and that was very different. I learned through transferring all of my non-medical student fears into the actual application of those fears, and then being a patient and living those fears. That I realized there's a whole lot we're not talking about. There's a whole lot that we're not being told, both as doctors and as women, as patients, and it's hard to realize you don't know what you don't know if you've been told you're the expert and you know everything, right? And most doctors don't go around saying they know everything, but there's enough patients who feel like that's what's communicated, that that's the language I'm using.Lesley Logan 5:18  Yeah.Amy Loden Tiffany, MD, MBA 5:19  And that's really frustrating as a patient, so I didn't realize how frustrating though it was until I was a patient, and I'm a mom of five kids, my third and fourth are twins, and really I am so grateful to live in the United States in a time in history where complicated pregnancies does not mean that mom dies, because I developed severe preeclampsia with heart failure, and my twins came 31 weeks instead of at least 37, and I nearly died the night they were born. They nearly died the night they were born, and I just am grateful that God let me be in this situation that I had the help I needed. Historically, these are not good situations. We see this on TV and in movies frequently. And something like 70,000 women a year across the globe die of the same disease I had, preeclampsia. So it's not nothing, even in our day and age, in certain countries, and even in countries where you have advanced medical care and they do everything right. It can still happen. So, that for me was the pinnacle of this isn't working. What we're telling people to do isn't working because I had done all the things.Lesley Logan 6:30  Right, you were a doctor. You did all the things. I did all the things. You enjoyed all the appointments. You were probably doing, and this is your third and fourth. So you knew what it should feel like. You knew what you should be eating. You knew all the vitamins to take.Amy Loden Tiffany, MD, MBA 6:41  Correct, and it didn't work, right? It didn't work, and so I think that is the fundamental kind of if you place a pivot on why did I change how I think about healthcare as a doctor, it was because of my experience as a patient for myself. My husband had cancer twice, so being the advocate for him in those types of things, guiding my children and now my parents through healthcare, you start to carry a lot of stories, and you start to see, wow, they're not doing what I think is just the bare minimum. And if they're not doing that for me or for my family, I know they're not doing it for everybody else.Lesley Logan 7:11  Yeah.Amy Loden Tiffany, MD, MBA 7:12  And then at the same time, holding a ton of grace in my heart because that's—they're doing what they were taught.Lesley Logan 7:17  Right?Amy Loden Tiffany, MD, MBA 7:17  Right. And they can't do differently if they don't know differently. You can't be better if you don't know to be better.Lesley Logan 7:23  Yeah.Amy Loden Tiffany, MD, MBA 7:23  So that is a really tight tension. But I thought I would just keep plodding through and just be a better doctor in that context of me being a patient until a little—I guess it was two years later. My daughter at that time, my oldest, was seven, and I had about 3000 patients. I was working somewhere between 65 and 80 hours a week, and had four kids at that time. And my daughter came up to me one night, and I'm opening the computer. I'm doing work like I do every night, and she says, "You're gonna make my birthday gifts. Like, can I help?" Right, totally innocent seven-year-old looking forward to her birthday knows that her mom shops online, right? And so she's like, "I want to pick my birthday presents," and I kind of stared at her. I was like, "No, no, I'm going to work. We'll do that later," and go watch whatever show. It's probably Paw Patrol for all I know, right? That's in the background. Go watch it. It's gonna be bedtime soon. And she just stands there, and I haven't even looked at her at this point. My eyes are on my computer. I'm just telling her this as I'm going. I'm totally not in the moment, right?Lesley Logan 8:19  Of course, because like you have so many, you have 3000 patients and four kids.Amy Loden Tiffany, MD, MBA 8:23   I can't keep up. I can't keep up. Right? I'm barely getting enough sleep. I'm not exercising, and I'm just trying to survive. And she doesn't move. And so I remember not totally slow motion, but I remember turning to her and feeling like I was going to be like, "What?" Right? What do you need? And she's just got out of the shower, so her hair's wet. She's got her pink pajamas on, bright big blue eyes, and they're full of tears. And there are just silent tears tracking down her face, and I'm horrified. Oh my gosh, what's wrong? Right now, I'm in fix-it mode.Lesley Logan 8:55  Yeah.Amy Loden Tiffany, MD, MBA 8:55  And she still doesn't really budge, and she just says in a very sad voice, "Mommy. Why do you love your job more than me?"Lesley Logan 9:05  Oh.Amy Loden Tiffany, MD, MBA 9:07  Yes. So the twins tried to kill me. She did kill me, right? Like, that was a knife in my heart because nothing ever had I wanted to be better than a so-called good doctor than to be a good mom.Lesley Logan 9:17  Yeah.Amy Loden Tiffany, MD, MBA 9:18  And that was for me the moment that I realized I'm not doing either of these well, and I'm not showing up how I want to be personally or professionally. I'm certainly not taking care of my health. I'm not doing the things I'm telling my patients to do. Like, it was a moment where I really felt the failures. I felt all the feelings, and I told my husband that night, "This is not working anymore." And he actually thought I thought was talking about our marriage, and so he was like, "Oh my gosh, what's wrong with our marriage?" Right? No, but I need to, like, redo. We have to redo this. I either have to retire, or I have to do something different.Lesley Logan 9:51  Yeah.Amy Loden Tiffany, MD, MBA 9:51  And he was like, "You're not retiring. You will drive me crazy. Go find something different to do, and I will make sure our family is okay." And so I did. And this June will be five years of having Vitality here in St. Louis and serving women and trying to lean into all the pain and the things and the feelings they're dealing with from all the things and the feelings I dealt with having walked that path.Lesley Logan 10:13  Yeah. Oh, Dr. Amy, I love that you shared that whole story because I think there's so many women who are listening here and, like, they don't have, they may have one kid or they have no kids, but, like, I think we can all relate to, like, having just too much on the plate because.Amy Loden Tiffany, MD, MBA 10:27  Right.Lesley Logan 10:28  Hello, my high-achieving woman. I see you, everyone here listening. We call recovering perfectionists and overachievers. There's nothing wrong with being a high achiever, but what happens is we tend to just keep saying yes to things, and we're like, yeah, we can fit that one more thing in, that one more thing. All of a sudden, it just comes to, like, a volcano breaking point. Yes, and because we don't, we don't see the signs early that we are at the breaking point. We don't, you know, we, it's almost, it's actually proven to be not true. But everyone uses the frog in the boiling water, right? Like, we just kind of, like, you don't realize how hot it's getting until it's until your daughter is crying in front of you. Oh, exactly.Amy Loden Tiffany, MD, MBA 11:05  Yes, it was awful. I never want to relive that moment.Lesley Logan 11:08  Yeah, but also, like, thank goodness for her because that she felt brave enough to say that. Like, what a badass she is. I mean, she's just going to be, like, she's just going to be a girl who speaks her mind. She does.Amy Loden Tiffany, MD, MBA 11:18  She's 13 now, and she heard me tell that story once, and now she's like, "Well, you have to credit me for opening your business because I hadn't said what I did." I was like, "Won't you just tone it down a notch, please?"Lesley Logan 11:27  It's called balance, babe. It's called balance. Yes. Okay. So, can we, like, let's get to some of the health stuff that I think our listeners want to—I want to definitely get into perimenopause, but I do want to, because we started with a pregnancy, and I have had family members who, you know, have had preeclampsia in their, and it's scary. So, how are pregnancy complications connected to long-term heart risk? I don't think anyone's thought about that. I just thought, like, if it's because I don't have kids, like it's going to screw up your pelvic floor, and you might have to rebuild your abs and these other things. But I didn't know it can affect your heart long term.Amy Loden Tiffany, MD, MBA 12:01  I had no idea. I'm so glad you brought that up. So I actually did a TEDx talk on this very topic, where the idea is pregnancy is so much more than just the birth of a kid. That's how we think about pregnancy in our culture. That's even how we think of it medically, right? Like if you have preeclampsia, you have gestational diabetes, you have high blood pressure, whatever in pregnancy, the answer is end the pregnancy, deliver the kid if they're old enough, right? Like, get, move it along and it's gone. But that I strongly believe is not true. We can't test this in a lab, so you have to do a little bit of extrapolation here. But if we're going to call pregnancy a stress test, which is becoming an increasingly common term, is pregnancy a stress test of a woman's metabolism and her cardiovascular system? Then we have to ask, what are we stressing it for? And the way I'm looking at this is a little bit different than how I was trained, which again was, if you got the problem, the solution is in the pregnancy. So, what if we started looking at pregnancy from the perspective of this is an unveiling, an unveiling of what was already there, and that nothing's actually gone wrong. It's scary. It's horrifying. And yes, absolutely, people die. So how can I say nothing's gone wrong? What I mean is nothing has gone wrong in the context of the situation we put your body in. It's exactly responding the way it should for the context it's in. So if I have underlying insulin resistance, and then I put a pregnancy on top of that or perimenopause, and I'm starting to have more insulin resistance. Well, of course I'm going to develop gestational diabetes. If I'm having a lot more fluid retention and I'm putting up a low weight, of course my blood pressure is going to go up, right? If I've got underlying inflammation, of course preeclampsia is going to develop. So I think we need to stop and think about it as it's not done; it is unmasked.Lesley Logan 13:42  Got it. Amy Loden Tiffany, MD, MBA 13:42  And then once you know it's unmasked, you treat it.Lesley Logan 13:45  I see. I see. Because again, we think of pregnancy as just the baby, so you have the baby, but it's well, but there's a problem, an underlying problem that the pregnancy revealed is what you're saying. And so great if having the baby is the safest thing for both people, we do that. But also, you still have this underlying issue.Amy Loden Tiffany, MD, MBA 14:01  Yes, it's still there. Correct.Lesley Logan 14:03  Yes, and I don't think anyone does that. I think they're just, "Okay. Now you don't have gestational diabetes anymore." But I have had clients who had it, and then afterwards, so what do we got? Oh, I'm fine. Are you correct? I don't think so. I'm not a doctor, but they're not fine. Don't just be diabetes. Yeah, for a moment. Yes.Amy Loden Tiffany, MD, MBA 14:19  So I actually experienced this as a patient too. I went in after my first pregnancy with gestational diabetes. At the time, I was living in New York City. I walked everywhere. I was a normal weight. I ate pretty clean, and despite being in residency, I'd got decent sleep. I didn't have any other kids. It's my first kid, so I got decent sleep. Right, but I had the baby after having had gestational diabetes. I go see my OB, and she's, "Oh, just follow up with your primary doctor." I go see my primary doctor, and he's, "Your weight's normal, your labs are normal. We're done," and that is how I was trained too. So again, lots of love in my heart. They're not; they're just not told. But for more than 10 years, we've known that women who have these high-risk pregnancies are at high risk not just for diabetes, but heart disease, stroke, kidney failure, dementia. Listen, I can't treat dementia well in the clinic, right? So why wouldn't I want all hands on deck trying to prevent it?Lesley Logan 15:07  Yeah.Amy Loden Tiffany, MD, MBA 15:07  But that's not how our medical professionals are trained—nurses, advanced practice providers, any of them. And so we're asking people and expecting people to fill in a gap they don't know exists, and so all these reproductive-age women are falling into it. And then where it gets really interesting is some of the same things you have immediately postpartum in all your different types of hormone fluctuations are matched intermittently for 10 to 15 years before menopause when you're in the perimenopausal years.Lesley Logan 15:32  What?Amy Loden Tiffany, MD, MBA 15:33  Correct, but that's why these women are feeling, "I'm going to my doctor, I'm putting on weight, I'm doing all the things, it's not working," and they're being gaslit, partly because their doctors don't know what they don't know, and partly because we're not acknowledging this is the same physiologic status of hormones that are different than baseline. So we're not in a country, and we don't have the testing that would promote or facilitate checking what is your normal hormone level at 18, so that we know what 18 should look like, and then by 45, you know, we're not. So we're trying to patchwork together a whole bunch of tests, and different labs have different testing, and different people say different things about testing. It's very confusing.Lesley Logan 16:10  Yeah.Amy Loden Tiffany, MD, MBA 16:11  And you end up with women suffering. And at the end of the day, that's the problem I'm trying to solve: is how do we stop these women from suffering? Because they are called to live big lives, to be ambitious for a purpose, for a calling. They have a lot to do, and their health is one of their biggest assets. It should not be a liability.Lesley Logan 16:27  Yeah.Amy Loden Tiffany, MD, MBA 16:27  And that's what's happening, especially for women who are trying to not work just in the home but outside the home. Right? There's a lot they're carrying. Yeah. So that's, I don't remember. Sorry, I'm having a total perimenopause moment. I don't remember where we started with that question here. I'll stop there. Lesley Logan 16:42  Don't worry, babe. I got my focus meds on the ADHD today, so I'm tracking. So we're good. But we were talking about the postpartum, and then we got into those hormones that switch as, and they can repeat into perimenopause. And I think this is fascinating. I love that you brought up. It doesn't matter if you're in the home or out of the home. We have big lives. Correct. We can't have our health be a liability, and I think for a lot of us, it feels like, like my girlfriend's a weight-loss coach for women over 40 who feel like their body gave a middle finger. That's what her coaching is, and it's all about not going to yo-yo diet. That's not going to work. We have to figure out what is the underlying issues, and it can only go so far because you said we don't test our hormones at 18. We don't do that, so we don't know what is normal for us, and I remember I was having a lot of health issues, digestive issues in my 30s, and no doctor could help me. In fact, one doctor sending me to, I was in this weird part where they study HIV and Ebola in the hospital, and she's like, "Do you know why you're here?" I don't know why I'm here. I don't. This scares the hell out of me. This feels like a department I should not be in. I'm not in any pain. I feel like I'm taking someone's spot, and so because he could, he just couldn't figure out what's going on my stomach. So I found someone who did an actual test of everything. He's so range normal. We don't know what normal is for you. We just know what the average person of this population of people that who knows who they were that were tested. So what is normal for you might not be the average. And I was, "Oh well, that's the first time anyone said anything that makes sense. That's the first time." So you can be in range, but for your hormones, but it wasn't in range for you because maybe you were used to higher testosterone, you're used to higher things. And so I love that people like you exist. I'm sorry for the frustration of your own journey, but also without people like you, women like me wouldn't have someone going, "Hey, actually, maybe you should be on testosterone right now," even though the, this is what it is. Mine was actually zero, but people, you know, we can actually get you help because I feel so much better because someone finally was listening to me and thought, "Yes, we're not going to compare you to a random person. We got to compare you to how you're used to feeling."Amy Loden Tiffany, MD, MBA 18:42  Correct. And for most people, that can't happen in the traditional system.Lesley Logan 18:47  Yeah.Amy Loden Tiffany, MD, MBA 18:47  You can't do that in a 10-minute visit.Lesley Logan 18:49  Right.Amy Loden Tiffany, MD, MBA 18:50  You can't do it when your doctor has 3000 patients, 10-minute visits, and they really don't actually know who you are.Lesley Logan 18:55  Yeah.Amy Loden Tiffany, MD, MBA 18:56  You just can't. So we've got a little bit of unrealistic expectations as a society, and then you know any women's magazine or journal article you read says, "Talk to your doctor about this." So then you go in, I'm all prepared. I have my list. I've done it too, folks. Right? This is not a criticism, but they, they can't. They don't have the ability to process it, and the way they're paid is based on the questions they ask you for insurance. So every incentive is misaligned, and at the end of the day, women, people are being screwed.Lesley Logan 19:22  Yeah, yeah. No, it's so true. So I'm glad we talked about the postpartum. I want to get into now. We're in the perimenopause, and yep, this is hard because you mentioned the hormone shift of people after postpartum is its own crazy world. I keep checking on my sister-in-law every day. How are you feeling? Are you feeling okay? Right. You feel okay? She's, "I'm fine." Are you fine? Let me just, I just want you to know. It's okay if you feel different, right? I think I'm crazy, but I know that that people don't realize how they're feeling, and it's hard to get to the doctor until it's too late. So I'm just, I'm on her. But for people like me, we didn't have children, so we have never experienced a crazy shift. We just start to experience, "I don't feel like my, anymore," and all the symptoms are so different for every single person. I'm not having hot flashes, but I'm, I got to keep my hair still here. But my inflammation was insane. I was putting on weight and working out and eating the same. And I don't understand what's going on. You know, so can we talk a little bit about what, I don't know where you want to start with that. So you tell me where you want to start with my post, my perimenopausal people who are not necessarily attributing these changes to that.Amy Loden Tiffany, MD, MBA 20:27  So I think the biggest confusion I see in the exam room conversations is that there's just question of, am I in perimenopause or not? And it's more of a less of a yes-no and more of, are you on the spectrum, and where on the spectrum are you? And so if you think of it as a sliding scale, because some months those ovaries are working really great, and you feel all the feels, and you're 18 again, but a lot of months maybe you're more like 20 or 25, right? And then maybe out of the blue, I feel like I got run over by shock. Nothing's working for two or three months, and then we're back to 25, right? And so it's ups and downs. You're like, what is happening? It is a roller coaster, and it runs anywhere from 10 to 15 years before you actually go through menopause. So I think of it as reverse adolescence, and I think it's completely ironic that God lets us have teenage girls when moms are going through perimenopause because that is just double-adolescence whammy, right?Lesley Logan 21:19  And no wonder, no wonder marriages don't survive certain things. Right, you have a daughter going through puberty and a wife with a pair of menopause. Good luck to the husband. Correct, becauseAmy Loden Tiffany, MD, MBA 21:28  I want to have sex. I don't want to have sex. I have pimples all over my face. I don't want to go to the house. I do. My belly's bloated. It's not like my mood's up. All the things, and it's all in reverse. So it's a it's a period of a woman's life that I think needs to be acknowledged, and then within the healthcare system, there's more noise about it over the last five years. You're seeing more and more people talk about this, but there's not a lot of standardization, and so you're getting chiropractic, functional medicine, traditional medicine. You're getting all sorts of different recommendations. So my hope is that over the next decade, we start to see some standardization, and we start to say this is what is normal for this population. You still have to apply it to the person. You cannot take population data and apply it to individuals and say that you're going to have good luck, bye. We'll see you in a year. That doesn't work. What I do think is that women need to know what's normal for that time, and then they need to decide, do they want to do something about it beyond what their body is experiencing? And here's some really interesting data that I hope your listeners suddenly stop and listen. If they don't hear anything I've said yet, this will be really important for women who have hot flashes and night sweats. Either one, they're actually the same thing. We call them vasomotor symptoms. When you have those at a certain degree, so that they're happening most days of the week, more than 10 times a day would be an easy target to kind of pay attention to. You have that, and you choose not to take hormones. You actually have an increased risk for cardiovascular disease and stroke. That does not mean every woman in that category can or should take it. There may be reasons they can't, but the hormones we use today are different than what in the Women's Health Initiative that came out in the early 2000s. So you're getting a lot of confusion because women are reading about data from that, not realizing that it has changed, and that study is not going to be redone. It was a huge study. We're not going to see data like that, so we have to make really informed decisions. But cardiovascular disease, hear me, ladies. Cardiovascular disease, which includes stroke and heart failure, kills more women every year than all your cancers combined. Yeah, I get the women and they come in religiously for their mammograms or their Pap tests, right? But they don't know that the bigger risk is that they're going to die of heart disease, cardiovascular stroke, and we know that one in eight women, roughly, have breast cancer risk, and those women get it. One in two women are getting heart disease. So there's one inLesley Logan 23:50  Two.Amy Loden Tiffany, MD, MBA 23:51  One in two. So that means there's two of us on this call, right? We already know I'm going to get it because I had preeclampsia. So I'm the one. Lesley Logan 23:56  I was going to say. I hope it's not maybe. I hope it's not you. But, like, thank God you know that because I think it's one and two, especially if you don't know. Because if you know that you're at risk, you do. Then you can you do something. I am. I'm double the risk for breast cancer, so I have to do an MRI and a mammogram every six months, and I have some decisions I might have to make in my life. But because I know.Amy Loden Tiffany, MD, MBA 24:18  Right, I can take.Lesley Logan 24:20  I can take action. Yeah, correct.Amy Loden Tiffany, MD, MBA 24:22  And you know, using that same kind of history, if someone comes in my office and says that I don't want to take hormones because I was a breast cancer, I'm like, that's fine. But let's look at all the facts. Let's lay it out like your financial advisor does, and then you can make an informed decision. Because just acting out of fear or reacting is not wise either.Lesley Logan 24:38  I actually really appreciate you mentioning that because it's true. If I'm, I'm very lucky in that I still get to do the HRT that I'm on, even with my risk. But also they're checking me every six months, and I'm checking me. So if anything's going to happen, we're going to catch it so much more quicker. Whereas the hard stuff, there's only so much you can do with that. And so if you're, especially if you're not aware. Say there's all conversations, but I liked the way you laid it out with the wealth manager. I just met with mine. He laid out here's where we're being aggressive. Here's where we're doing this. Here's what's going on here. We're going to move this over here because we're going to risk-manage these risks. And I think that's that's a better way to look at it because we're not going to, every single one of us is unfortunately going to experience something because it's a body. We're not a machine. Amy Loden Tiffany, MD, MBA 25:21  It wears out.Lesley Logan 25:22  I did not know it was one in two, girl.Amy Loden Tiffany, MD, MBA 25:26  Yeah, and what's even more disturbing, you may have heard a lot of women have by now that women's heart disease presents differently than men.Lesley Logan 25:32  Yeah, can you tell us just in case my people haven't heard because I didn't know it was one in two? So let's go over the signs.Amy Loden Tiffany, MD, MBA 25:38  A lot of times people think of what's the so-called traditional? It's the jaw pain, the radiation of pain from your chest up to your jaw, to your back, down your left arm. Very classic symptoms. Classic because it was studied in men, and then we have these so-called atypical for women because they're not typical compared to men, but they're classic for women. And so, got a little bit of lingo here that it doesn't make total sense. But for women, sometimes it's they just feel a lot more anxious than they've been for unclear reasons. They have this sense that something bad is on the horizon. They can't really place why their sleep is different. Maybe they're having some shortness of breath they didn't used to have. Maybe they go up the stairs in their house, with a laundry basket, and they're huffing and puffing when six months ago they weren't. So it can be very subtle differences. It could be a new fatigue. Check labs are normal, but the fatigue's still there. That worries me when I hear women say this. Unfortunately, the number one sign that you have heart disease is sudden death.Lesley Logan 26:33  Oh.Amy Loden Tiffany, MD, MBA 26:34  So let that sink in for a second. So we can't always wait on what the signs are.Lesley Logan 26:39  Yeah, we can't fix that. Right. Correct. Okay, so that's hard because our signs are also. I feel like high-achieving women would so easily brush away that anxiety.Amy Loden Tiffany, MD, MBA 26:51  All the stuff. Correct. Because I have a lot of tabs open.Lesley Logan 26:54  Yeah, I got this going on, or I haven't been working out, so of course I'm out of breath going up the stairs. They would just so easily.Amy Loden Tiffany, MD, MBA 26:58  It's May, it's graduation season. It's wedding season, right? This is just aging, and that's not the story at all. The problem is 10-minute visit with your doctor who has 3000 patients. They don't know who you are. They're not going to notice that this is different for you.Lesley Logan 27:13  Yeah.Amy Loden Tiffany, MD, MBA 27:13  Decreased exercise tolerance is a big one. And so, if you could walk three miles every day in your neighborhood, now you're like, "Wow, I'm really struggling to get through one." I'm worried about that. I want to know what's going on and why.Lesley Logan 27:25  Yeah. So I guess since one getting a 10-minute visit is hard. I, where I live in, I live in Las Vegas. Last I heard, we are short general practitioners by 1400. I don't have one. I go to a women's clinic, and I'm really grateful. It's a, it's also a student-teacher thing. So I actually, they've caught things because the students are asking the questions because they'reAmy Loden Tiffany, MD, MBA 27:44  Yes, yes.Lesley Logan 27:46  I love them. I'm so grateful for them, but are there things that women can do to check their heart, or is it just being, is it just noticing the one mile versus a three mile? What can we, what are the signs we need to be checking on?Amy Loden Tiffany, MD, MBA 27:57  Certainly be aware of what your body is telling you. Again, if you have to remember nothing else, this is another one: is that your body is smart; it will talk to you, but you have to listen.Lesley Logan 28:05  Yeah.Amy Loden Tiffany, MD, MBA 28:06  So that's really essential. If something's different, say something. You're right. There's a big collapse, if you will, of how much support we have in healthcare, whether it's nurse practitioners or chiropractor or whatever. And the issue is not all of them are trained the same way. So when I worked in the OB/GYN clinic, it became apparent to both of us, on both sides of it, that OBs know stuff about women's health. I don't know, but I know stuff about metabolic and heart health that the OBs aren't taught, and most women use their OBs as their primary care, at least to a certain age.Lesley Logan 28:32  Right.Amy Loden Tiffany, MD, MBA 28:33  And again, you don't know what you don't know, so you don't realize what you're not looking for that you should be. And our system's not set up for good collaboration. So if I could tell women, here's a checklist of things I want to make sure you get, your doctor is going to give you some resistance, most likely because they don't realize that lipoprotein with a little a, it's like in parentheses at the end of it, not the big A. Lipoprotein little a. If you have that mutation, and 10 to 20% of our population does, you have a different rate of plaque development, at least risk for that than the average risk will miss. If you have high insulin levels, you have a higher risk that you're going to be on a pathway toward diabetes. Those are not things that are standard checks. So knowing that there's other tests you can ask for, and even if your insurance doesn't cover it, they're not expensive tests. Just get it once, right? Have an idea of what's going on in your body once gives you a ton of information. I offer a lot of our patients to wear different glucose monitors, even if they're not on diabetes. And all my physicians who are listening to this are probably like, "You do what?" But the reason is, if you can figure out that your glucose and insulin are high before you develop diabetes or pre-diabetes, if you figured out that insulin-resistant stage, that's a lot easier to fix, and our doctors aren't even taught about what is insulin resistance, what is the criteria for it, and how do we reverse it?Lesley Logan 29:47  Right, because there's some prevention we can do if we have information.Amy Loden Tiffany, MD, MBA 29:50  There's a ton, and it's things women can do in their homes or their businesses. It's not stuff I'm doing in the exam room.Lesley Logan 29:56  Yeah, and that's also, you know, you're listening to this podcast, you're kind of a go. Anyway, so you're gonna, you'll take the action. Our health insurance is very bizarre. I thought it was crap because, but it has a lot of preventative stuff that goes on with it. Hey, we want to put this thing in your house and check your heart and some other levels every, I don't know, two or three times a week. They keep calling them. I have two adults. We have two ADHD adults in this household. The box is here. One of us will open it when it becomes the pressure. I just have to hang tight. We'll get there. But I'm really impressed by that because we don't have access to a regular doctor. So what information can we gather so we could be watching it and monitoring it? So we can advocate for ourselves if something comes up. So having that prevention is really amazing. Okay, so we talked a little bit about the perimenopause and the different things. What are some simple shifts that women can make now to protect their future? I mean, obviously we have a wide range of women, so the now is different. But what are some things that they could be doing? Because I do think that they are getting information from the magazines and the Instagrams, and we should get it from the person who's experienced it and has seen it. You know, so you.Amy Loden Tiffany, MD, MBA 31:00  Some easy things, and I say easy relative because they're easy to do, which means they're easy not to do. So acknowledging that, right? It's real. Number one, understanding that just because you get eight hours of sleep, if they're not high-quality hours, you've got a metabolic risk from your sleep not being normal. That's important to understand because you spend a third of your life asleep, right?Lesley Logan 31:19  What's a metabolic risk? Just in case my people. So.Amy Loden Tiffany, MD, MBA 31:22  If you don't get good-quality sleep, your cortisol goes up. It's one of your stress hormones, and when cortisol goes up, glucose goes up. When glucose goes up, insulin goes up. Insulin's your fat-storing hormone. So even without your sex hormones being involved, or the ghrelin and leptin you're hearing about with weight and GLPs and all that, just those, you're not getting good sleep. It's going to be a problem. Insulin resistance is going to go up. Insulin resistance means your cells are not listening to the insulin your body is giving it, so your body works harder to get more insulin, and the cells work harder to ignore it, and it just keeps going in a vicious cycle. So if we consider that that's the root cause of a lot of these problems we've been talking about, we fix that. Number one is get good sleep, get good-quality sleep, and it's not, not just enough time in bed.Lesley Logan 32:02  Yeah, so.Amy Loden Tiffany, MD, MBA 32:03  That's important. Number two is most people don't realize that they're doing it backwards. They're, if they're, if they're even able to get exercise in their life right now, right? So we're going to make the assumption that you figured out some exercise regimen you like. We're, we're at that level, but they're doing it at the wrong time, and they're doing it in a way that they're sabotaging their end result. So rather than going to the gym and then going and eating dinner, or going to the gym first thing in the morning and skipping breakfast and all these things, you need to eat protein and fat, and then you need to move your thighs. I don't care if that's jumping jacks, going for a walk, running up the stairs, something where your thighs are moving regularly for 10 minutes. So make it whatever you like doing. This can be the mom at home who's doing all sorts of fun class activity with her kid, right? Like moving the baby around or the teenager can be equally fun to move around for what it's worth. And then it could be the CEO who's getting ready for a meeting and has 10 minutes after eating whatever lunch she had in the five-minute break she did, right? So looking at what makes sense in your life, but 10 minutes of physical activity, ideally after every meal, that's not realistic, but that's ideal. And then you start with the one meal a day you can do, and you do it most days of the week to start with, because most of us have to figure out how to make it a habit.Lesley Logan 33:15  Yeah.Amy Loden Tiffany, MD, MBA 33:15  But movement for 10 minutes after eating, it's, it's crucial. I cannot stress that enough.Lesley Logan 33:20  I didn't realize it was. It makes total sense moving your body after eating because I like to go for a walk after I have lunch. Otherwise, I'm tired. Correct. I can't go back to work now. Amy Loden Tiffany, MD, MBA 33:30  The reason you're tired though is because your glucose goes up and your insulin went up to match it. When you walk right after you eat, glucose still goes up, but it's less, and so you have less insulin spike. Insulin is the bright driver here, and so you've got to do the movement after. And if it helps to understand why, think back to what our ancestors did 1000 years ago. Right? We weren't checking hormones. We weren't checking insulin. We weren't talking about hacks. We were trying to survive most of the time. Yeah. But the things they did is they, if they, what, after they ate, they moved around. Right? Like they were building their shelters. They were taking care of the kids. They were moving in the community, helping build, create, relocate, whatever. They were always moving, and they did not get the whole three square meals a day. That's bogus. You don't need three meals a day, okay? And most of my ladies don't realize that they're eating their nutrients potentially in the wrong order for their body. That they're eating them in the wrong time for the cycle of the month they're in, they're not getting enough protein, not getting enough fat for their hormones and their brain, and it doesn't happen quickly, right? It's months, years, maybe even a couple decades before they're, I don't know what happened, but my body in the mirror is not the body in my head. This is not who I am. There's a disconnect, and they finally are at that place where they have to do something, where the body is forcing them to stop because they've pushed it as hot as you know.Lesley Logan 34:44  Oh my God, that's a whole episode. We're having you back. I'm just telling you right now because I want to have a whole episode on the whole. Because what I do know is if you eat certain things, if you work out too late, if you get your cortisol up, sleep that. I have been trying to figure out sleep for over a decade, and I, I get good-quality sleep most of the time. But I'm obsessed with it because I'm like, I don't want Alzheimer's. I do not want heart problems. It doesn't really matter what I'm doing at the gym if I'm not sleeping. None of that matters. Doesn't matter what you're, If you don't get good sleep, all the rest is gonna just fall apart anyways. So it's interesting. It makes sense about the food because I remember when I was having problems with my cycle and I had my one of my doctor friends, she said you should try seed cycling because I just, the worst cramps and, like, the worst everything was just the worst in the world, and so I tried seed cycling and my goodness, you know, I'm not a woo-woo girl, but the seed cycling makes, I got, I had no more zits, my boobs didn't hurt as bad, everything leveled out, and I didn't need any extra hormones for it. I was, whoa, so now there must be more. We need to know about it. So we'll have to have you back for that. I can talk to you forever. So we'll just, this is part one of many. I'm just going to take a brief break and then find out if people can find you, follow you, and work with you. All right, Dr. Amy Loden, where do you hang out? You mentioned St. Louis. Can people work with you if they're not in St. Louis? How does this work?Amy Loden Tiffany, MD, MBA 36:03  Yes, absolutely. Best way to get into contact with our office is just going to our website, www.vitalitymwc.org. They can sign up for a consultation, and we can go through what their options are. There is also lots of opportunity if you don't want to work with us directly, but you want to continue the conversation and hear what we're seeing. I do all the social media I can so that people can hear what's being said in their exam rooms and have it in their real lives too. So you can do that on follow me at Dr. Amy Tiffany, whether it's on Instagram or TikTok or Facebook. You find it where they're also on LinkedIn at Dr. Amy Loden. So lots of places depends on what their needs are. One special offer I do have for your audience: we talked about pregnancy and perimenopausal bit through this conversation, they can contact my office for a free physical copy of my book, The Postpartum Pivot. And before you stop listening, ladies, and you think, "Well, I'm not postpartum." If you've had a baby, you're postpartum even it's 20 years ago. Your body's different than it was before that baby, and so you can understand what does this look like for perimenopause and other types of areas that we go through as we grow less young, but grow more wise.Lesley Logan 37:03  Oh my God! Every one of my female females, that's where your Christmas present is. Sorry, just gonna get a doctor because they don't. It's, if their doctor doesn't tell them, they don't know, right? And then they are just going through it. And I feel so bad because every woman in my life is such a badass, and then they get their body doesn't keep up with what they're wanting to do in life, and then it just becomes not just like a liability, but like this hangup. So you are amazing. Okay, you've given us some great stuff already. I mean, we're gonna have to rewind, and I'll listen to this. I've got, you know, getting my notepad out, but our bold, executable, intrinsic, or targeted steps people can take to be it till they see it. What do you have for us?Amy Loden Tiffany, MD, MBA 37:37  I want each one. When you be it as you see it, I want you to be true to what your body's telling you, and recognize nothing's gone wrong. Listen when things are happening and they seem like it's a crisis. Nothing's gone wrong. Your body's talking to you. Listen, and when you listen, you become more wise. You become a better version of yourself.Lesley Logan 37:55  Okay, I really love that. We talked about that earlier, but it's true. Some of us think our body is against us, and it's doing something to us. But really, it's like, hello. The alarm bells. Amy Loden Tiffany, MD, MBA 38:05  It's doing exactly what it should do for the situation we've put it in. That doesn't mean we like it. You get diabetes. No one's like, oh yeah, my body did exactly what it's supposed to do. But if we understand that, then it becomes a neutral thought. It's not bad or wrong. It's I didn't listen, so now I'm going to stop, and the best place to reverse is as soon as you realize you're going in the direction. Right? It's not to keep going in the wrong direction. So nothing has gone wrong. We just need to listen. We need to turn around, create a better story.Lesley Logan 38:33  Love it. Love it. This is and then so enlightening. This is so fun. Thank you so much for being you and your and and the journey that you've been on is something we can all benefit from. So thank you for that, you guys. We all need to share this episode with all the women in our lives, and I would love for you to make sure that Dr. Amy knows your favorite takeaways. Send them to the Be It Pod as well. And since I'm going to have her back, not that I even like asked her beforehand, but I'm just going to tell her she's doing that. You can send your questions, and we'll make sure we get that. So, beitpod.com/questions. Until next time, my loves, Be It Till You See It. Lesley Logan 39:03  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 39:45  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 39:50  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 39:54  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 40:02  Special thanks to Melissa Solomon for creating our visuals.Brad Crowell 40:05  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

The frozen shoulder. The 3 a.m. anxiety. The brain fog and the rage that come out of nowhere. For decades, women were told it was "just stress" and sent home with an antidepressant. This week, Dr. A and Mary Alice welcome back the woman changing that — Dr. Mary Claire Haver, the OB-GYN The New York Times calls the "Menopause Queen" — for a full masterclass on perimenopause.It can start in your late 30s, it lasts 7 to 10 years, and almost no one warned us. Dr. Haver explains what's really happening in your body and brain, why so many women are dismissed, and what you can actually do about it — HRT, progesterone, vaginal estrogen, sleep, mood, and the myth that you have to wait until it's "bad enough" to get help. Because suffering isn't the price of admission.Subscribe to SHE MD Podcast for expert tips on PMOS, endometriosis, fertility, hormonal balance, mental health, and more. Share with friends and visit SHE MD website and Ovii for research-backed resources, holistic health strategies, and expert guidance on women's health and well-being.SponsorsTalkiatry: Head to talkiatry.com/shemd to complete the short assessment and get matched with an in-network psychiatrist in just a few minutes. Babbel: Right now, Babbel is offering listeners up to 60% off. Go to Babbel.com/SheMD Egglife: Find Egglife chillin' in the fridge at Aldi, Whole Foods, Kroger, Target, Walmart & more. Visit egglifefoods.com to find a retailer near you. Acely: Visit Acely.com and use code SHE MD for 20% off. Ladder: If you have an iPhone, head to ladder.fit/SHEMD and take a quick quiz to find your perfect Ladder plan. Use our link and get a free 7-day trial with NO credit card, and $10 off your first month if you join. Skylight Frames: Right now, Skylight is offering our listeners $30 off their 15-inch calendars by going to myskylight.com/shemd. What You'll LearnWhat perimenopause actually is and how it differs from menopauseWhy perimenopause can begin in your late 30s or 40sWhy brain fog, sleep disruption, anxiety and mood changes can be early symptomsWhen hormone therapy may be considered during perimenopauseThe difference between HRT/MHT, birth control and vaginal estrogenWhat we know, and still don't know, about HRT and cardiovascular and bone healthHow GLP-1 medications can affect muscle and bone healthThe role of protein, resistance training, vitamin D, omega-3s, fiber and creatineWhat declining estrogen can mean for vaginal and urinary healthWhat women should know about HRT and breast cancer riskWhy listening to your symptoms and advocating for yourself mattersKey Timestamps00:00 Why Every Vagina Needs Estrogen01:32 Welcome Back Dr. Mary Claire Haver05:44 What Perimenopause Actually Is08:44 The "Zone Of Chaos" And Brain Glitching18:08 How To Evaluate A Perimenopausal Patient20:01 All Vaginas Need Estrogen24:50 Why Perimenopause Is The Best Time To Start HRT32:13 GLP-1s, Muscle Loss, And Bone Health36:41 Patches, Pellets, Creams: What Actually Works40:23 Debunking The HRT-Breast Cancer Myth50:33 Creatine, Vitamin D, And Key Supplements54:56 The Histamine-Hormone Connection58:12 Vulvar Changes Nobody Warns You About1:04:37 Lightning Round: Hormone Myths Busted1:07:19 Three Takeaways For Every WomanKey TakeawaysPerimenopause is a years-long biological transition, not simply the period immediately before menopause.Symptoms can appear before periods become irregular or hot flashes begin.Brain fog, sleep disruption and mental health changes can be among the earliest signs of fluctuating hormones.Hormone therapy does not necessarily have to wait until a woman is fully menopausal; treatment should be individualized based on symptoms, risks and benefits.Bone health, cardiovascular health, muscle mass and metabolic health all deserve attention during the menopause transition.If using GLP-1 medications, Dr. Haver emphasizes adequate protein, resistance training and monitoring body composition rather than focusing solely on the number on the scale.Vaginal and urinary symptoms can be related to declining estrogen and may be treated with local estrogen therapy.The goal of understanding perimenopause is not simply to get through it, but to enter the next stage of life informed, healthy and empowered.Guest Bio: Dr. Mary Claire HaverDr. Mary Claire Haver is a board-certified OB-GYN and a leading voice in menopause and women's health. She has dedicated her career to helping women better understand the biological changes that happen during midlife and has been called the “Menopause Queen” by The New York Times. She is the author of the bestselling The New Menopause and her newest book, The New Perimenopause, which focuses on the years leading up to menopause. She also hosts the podcast Unpaused and shares women's health education across social media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Does catching cancer earlier with surveillance always translate to better outcomes for gynecologic cancer patients? On this episode of BackTable Women's Health, hosts Dr. Mona Guo and Dr. Marcia Ciccone interview Dr. Ritu Salani, Professor of OBGYN at UCLA and lead author of the updated SGO surveillance clinical practice statements. They discuss how post–curative-intent surveillance has evolved amid limited prospective evidence, review the latest guidelines, and highlight the real-world challenges of balancing early detection, patient safety, and cost. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:05 - Evolving Guidelines and Consensus10:02 - Lead-Time Bias and Cost Considerations12:05 - Maintenance Therapy and Surveillance Nuances14:44 - Ovarian and Endometrial Cancer: Imaging vs Exam20:24 - Key Takeaways from the TOTEM Trial24:04 - Future Tools, Lifestyle Counseling, and Shared Care27:21 - Cytology, HPV Testing, and Post-Radiation Surveillance31:13 - Hormone Therapy Considerations34:37 - ctDNA and MRD Testing37:39 - Emerging Technologies and Limitations43:22 - Rapid Fire Takeaways45:33 - Closing Thoughts --- More about this episode The conversation explores practice variability, the lack of clear survival benefits from routine imaging and tumor markers, and the risks of cascade testing and lead-time bias. Dr. Salani reviews the TOTEM trial data for endometrial cancer, the importance of symptom review and pelvic exams (especially for lower genital tract cancers), and the reduced role of cytology, even in cervical cancer after radiation. They also discuss shared-care models, lifestyle counseling, hormone therapy considerations, and the promise and limitations of emerging technologies like ctDNA and MRD testing during maintenance therapy. --- Resources TOTEM Trialhttps://ascopubs.org/doi/abs/10.1200/jco.22.00471 2010 Ovarian Cancer CA-125 Trialhttps://pubmed.ncbi.nlm.nih.gov/20888993/ Society of Gynecologic Oncology Clinical Practice Statement on Surveillancehttps://pubmed.ncbi.nlm.nih.gov/41308226/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

This conversation explores the critical topic of mental health during the perinatal years, focusing on the integration of mental health services in OB-GYN practices, the barriers women face in accessing care, and the common symptoms of perinatal mood disorders. Carrie McCahan, a psychiatric physician assistant, discusses the importance of normalizing conversations around mental health, the impact of parental mental health on families, and the necessity of support systems for new parents. The dialogue emphasizes that it is okay to experience complex emotions during this transformative time and highlights the need for community and understanding.For more information on Dr. Erin Buggy, or Alethia Wood, please visit PCS' website here. For more information on Carrie McCahan, please visit here. You can now find her helping expecting parents at Uptown Psychiatry.

Today, I am thrilled to reconnect with a previous guest, Dr. Mary Claire Haver.  Dr. Haver is a board-certified OBGYN, a certified menopause provider, and the founder of Mary Claire Wellness, a private medical practice focusing on women in midlife. Her best-selling book, the Galveston Diet, and her latest New York Times best-seller, The New Menopause, are fabulous resources for middle-aged women. In today's discussion, we dive into various aspects of perimenopause and the associated challenges. We discuss factors accelerating ovarian aging, the role of contraception, mental health shifts, and the often delayed diagnosis of premature ovarian insufficiency. We examine the differences between hormone replacement therapy and oral contraceptives, discussing the importance of advocacy for women's health and the benefits of vaginal estrogen. We explore the disparity in federal funding for women's health research, the impact of the Women's Health Initiative, body composition changes, the estrabolome, the 30 Plant Challenge, and the advantages of HRT. Dr. Haver also talks about her preferred supplements.  I'm sure you will find this conversation a valuable resource that you will likely revisit several times. IN THIS EPISODE YOU WILL LEARN: Why perimenopause is so fraught with chaos Some of the factors that hasten ovarian aging How perimenopause causes significant changes in neurotransmitters, leading to cognitive changes The differences between HRT and oral contraceptives How estrogen loss during menopause affects vaginal tissue The benefits of vaginal estrogen for symptoms of menopause  How women's health research funding prioritizes reproduction over menopause and perimenopause How HRT can help with fat loss and muscle mass in postmenopausal women The emergence of eating-disordered behaviors in menopausal women Some of the lesser-known symptoms of menopause and ways to overcome them How HRT could impact the longevity and cognitive health of women Bio: Dr Mary Claire Haver Dr. Mary Claire Haver is a board-certified OB-GYN who has devoted her adult life to women's health. When she began experiencing the changes of menopause and midlife weight gain, she created her online program, The Galveston Diet, which currently has over 80,000 students. The Galveston Diet is the first and only nutrition program in the world created by a female OB-GYN, designed for women in menopause. As part of her ongoing research, she became certified in Culinary Medicine in 2019, specializing in medical nutrition. In 2021, Dr. Haver opened Mary Claire Wellness; the clinic grew out of repeated requests from Galveston Diet students and Dr. Haver's social media followers for personal guidance.  Dr. Haver lives with her husband and two daughters in Galveston, Texas. She is the author of The Galveston Diet (Rodale; January 10th, 2023). Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Mary Claire Haver On the⁠ Mary Claire Wellness website⁠ ⁠Instagram⁠ ⁠TikTok⁠ ⁠Facebook⁠ ⁠YouTube⁠ Books Mentioned Dr. Haver's books, ⁠The Galveston Diet⁠ and ⁠The New Menopause ⁠ ⁠The Menopause Brain⁠ and the⁠ XX Brain⁠ by Lisa Mosconi Previous Episode Mentioned ⁠Ep. 308 Dr. Mary Claire Haver: Weight Gain in Middle Age, Perimenopause and Inflammation

Why isn't my body healing? Dr. Tabatha Barber — a triple board-certified OBGYN and robotic surgeon who walked away from the operating room — says the variable nobody tests for is the story running in your head. Liz and Becca get into negative self-talk and inflammation, why an emotion only lasts 90 seconds, what happens when a doctor tells a 24-year-old with PCOS she'll never conceive, and why your genes load the gun but don't fire it. If your labs are "normal" and you're still exhausted, start here.***Connect with Dr. Tabatha: Instagram | Web***Lets Connect:Connect with Liz: Instagram | YoutubeConnect with Becca: Instagram | YoutubeJoin our private community: FitMom Society***Have questions? Ask HereLooking for answers? Work with us***Want to win FitMom Mystery Box?Leave us Apple Review | Spotify Review

The longer we treat menopause as something to survive quietly instead of understanding fully, the more women get left without real answers.Dr. Shepherd is an OB-GYN, and we use menopause as the entry point into a much bigger conversation — the myths still circulating about menopause and sexual health, why clinician expertise and actual hands-on experience matter more than a lot of people realize, and how insurance and the broader healthcare system quietly shape what choices women even know they have. We also get into AI and new technology in medicine — where it genuinely helps, and where it's moving faster than anyone can vet it. And we land on something I keep coming back to on this show: aging well is not a solo project. Community and connection are part of the medicine.Dr. Jessica Shepherd is a board-certified OB-GYN focused on women's health, menopause, and sexual wellness in midlife. Generation M - Dr. Jessica Shepherd's bookWhat We CoverMenopause as a gateway. Why menopause is so often the first time women start really engaging with their own health, and what that says about the gaps earlier in the system.The myths that won't die. Common misconceptions about menopause and sexual health that Dr. Shepherd still has to correct in the exam room, every week.Expertise actually matters. Why the clinician you choose, and how much hands-on experience they have, changes the quality of care you get, especially in a field this nuanced.The system shapes the choice. How insurance coverage and healthcare structures quietly limit what options get presented to women in the first place.AI in medicine — promise and risk. Where artificial intelligence and new technology are genuinely useful in healthcare, and where the pace of change is outrunning oversight.Community as medicine. Why connection and support are not a "nice to have" in aging well, they're part of the actual strategy.Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/piThanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Braverman is a Clinical Professor with a joint appointment in the Department of Obstetrics and Gynecology and Psychiatry and Behavioral Medicine at Thomas Jefferson University. Dr. Braverman is the Associate Director for the Educational Core for OB/Gyn. She is a health psychologist with a specialty in medical health management, infertility counseling, and third party reproduction issues. She received her M.A., M.S. and Ph.D. in psychology from the University of Pennsylvania. Dr. Braverman has lectured internationally on treatment issues and reproductive medicine before medical and patient audiences. Dr. Braverman has published in medical journals about the psychological aspects of infertility, issues involved in the decision to end treatment, and psychological issues involved in using third-party donors. Dr. Braverman received the Timothy Jeffries Memorial award in 2011 for outstanding contributions as a health psychologist from the American Psychological Association and the 2021 Suheil J. Muasher, M.D., Distinguished Service Award from the American Society for Reproductive Medicine. CONNECT WITH DVORA ENTIN: Website: https://www.dvoraentin.com/ Instagram: https://www.instagram.com/dvoraentin YouTube: https://www.youtube.com/@misconceptionspodcast  

Labor Live is your chance to practice navigating labor before you're actually in it. This interactive birth simulation delivers real-life labor scenarios straight to your phone, letting you make decisions, explore your options, and learn what questions to ask your provider along the way. Labor Live starts September 1. Head to https://joinlaborlive.com/ to save your spot! Low amniotic fluid can be one of those pregnancy diagnoses that sends you straight into a Google rabbit hole. So in this episode, HeHe sits down with board-certified OBGYN Dr. Lawren Honken to break down oligohydramnios, what it actually means, how it's diagnosed, and when low fluid may or may not mean it's time to induce. Dr. Lawren explains how providers measure amniotic fluid, including the difference between the single deepest pocket and AFI, and why one measurement may give us a more useful picture than the other. They also dig into what can contribute to low fluid, from dehydration and placental function to hypertension, preeclampsia, fetal growth restriction, ruptured membranes, and other pregnancy complications. And then we get into the big question: Does low amniotic fluid automatically mean you need an induction? Spoiler: it's more nuanced than that. HeHe and Dr. Lawren talk through hydration and repeat ultrasounds, fetal monitoring, the risks associated with truly low fluid, ACOG guidance for isolated oligohydramnios, and what happens when you're trying to decide whether to continue the pregnancy or move toward delivery. They also have a really important conversation about informed consent, trauma-informed care, provider communication, and why a diagnosis shouldn't automatically mean you're rushed into a decision without understanding your options. Because sometimes the most empowering thing your provider can give you isn't another intervention. It's information, context, and the space to make an informed decision about your own body and baby. If you've been told you have low amniotic fluid, you're being monitored for oligohydramnios, or you're trying to understand when an induction is actually medically indicated, this is one you want in your back pocket. Chapters 00:00 Induction Shockwave 01:12 Pregnancy Diagnosis Minefield 03:42 Meet Dr. Lawren Honken 07:52 What Is Low Amniotic Fluid? 10:55 Hydration, Placenta & Clues 14:34 What Causes Low Fluid? 19:20 Amnioinfusion Explained 22:25 When Does Induction Make Sense? 29:08 Individualized & Trauma-Informed Care 33:31 HeHe Shares a Personal Birth Story 36:41 When Your Water Breaks Without Contractions 39:13 How Accurate Is an Ultrasound? 41:00 The Risks of Low Amniotic Fluid 46:49 Advocating for Your Options 51:27 The Triage Reassurance Algorithm 54:20 Provider Compassion & Burnout 01:00:26 Questions to Ask Your Provider 01:02:03 Where to Follow Dr. Lawren 01:03:17 Final Wrap & Subscribe Guest Bio: Dr. Lawren Honken is a board-certified OB/GYN, Certified Menopause Practitioner, surgeon, mother of four, and creator of Your Friend the OB/GYN. She is passionate about helping women understand their options through evidence-based education so they can make informed decisions that align with their values, goals, and unique circumstances. Her approach emphasizes patient autonomy, shared decision-making, and compassionate, individualized care. Connect with Dr. Honken here: YourFriendTheOBGYN.com SOCIAL MEDIA: Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/  Connect with Dr. Honken on IG: https://www.instagram.com/yourfriendtheobgyn/ LINKS MENTIONED: IG account measure the placenta: https://www.instagram.com/measuretheplacenta/ Listen to our episode with Dr. Florescue here: ​​https://www.youtube.com/watch?v=VEex1HJId2o BIRTH EDUCATION: Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what's really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/ Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app

How do you know when to continue the same fertility treatment and when it is time to change course? In this episode of the As a Woman podcast, fertility doctor Natalie Crawford, MD, answers your questions about failed IVF transfers, IUI, embryo banking, low AMH, thin uterine lining, progesterone levels, sperm morphology, pregnancy after methotrexate, and recurrent implantation failure. She explains what your results can tell you, what they may miss, and when a different protocol or second opinion deserves a conversation. IN THIS EPISODE: 00:00 Fertility Q&A 00:14 What Causes a Thin Uterine Lining After Surgery? 03:21 What Progesterone Level Is Needed for Embryo Transfer? 05:42 How Many Embryos Do You Need for 2 or 3 Children? 08:09 Can IUI Help With Low Sperm Morphology? 09:52 How Many IUI Cycles Should You Try? 11:06 Can AMH Change From Month to Month? 11:42 Do You Need Estrogen or Progesterone After IUI? 12:37 Can High Cholesterol Affect Fertility and Pregnancy? 13:54 When Should You Repeat a Semen Analysis? 14:46 What Is a Pregnancy of Unknown Location? 15:30 Why Should You Wait After Methotrexate to Conceive? 15:49 Do You Need an HSG After an Ectopic Pregnancy? 16:08 Can IUI Help With a Varicocele? 16:48 What Should You Do After Pregnancy Loss With a Euploid Embryo?18:15 What Are the Different Embryo Transfer Protocols? 19:19 What Testing Can Help After Failed Implantation? 20:20 When Should You Get a Second Opinion? AS A WOMAN WITH DR. NATALIE CRAWFORD: YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l  Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339  Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk  HOST RESOURCES: Order The Fertility Formula: https://www.nataliecrawfordmd.com/book  Newsletter: https://www.nataliecrawfordmd.com/newsletter  Instagram: https://www.instagram.com/nataliecrawfordmd  YouTube: https://www.youtube.com/@NatalieCrawfordMD  Become a patient: https://www.forafertility.com  Earn FREE CE/CME: https://learnatpinnacle.com/education  This episode is brought to you by The Pinnacle Podcast Network. ABOUT DR. NATALIE CRAWFORD: Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies. Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Egg Whisperer Show, I'm joined by Dr. Brooke Winner, a board-certified OB/GYN and fellowship-trained minimally invasive gynecologic surgeon. We dig into fibroids and endometriosis—two of the most common conditions that can affect fertility. Dr. Winner sheds light on when these issues need surgical intervention, highlights the benefits of minimally invasive procedures, and discusses how to manage symptoms while supporting reproductive health. In this episode, we cover: How fibroids and endometriosis can impact fertility, implantation, and IVF outcomes The signs, symptoms, and most effective diagnostic approaches for both conditions When surgery is recommended and the advantages of minimally invasive techniques What to expect during recovery and how to prepare your mind and body Patient advocacy tips for navigating care and finding personalized treatment options Read the full show notes on Dr. Aimee's website Find Dr. Brooke Winner's website here Do you have questions about IVF? Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, September 14 at 4 pm PST, where Dr. Aimee will explain IVF and Egg Freezing, and there will be time to ask her your questions live on Zoom. Other ways to follow Dr. Aimee: Visit my YouTube channel for more fertility tipsSubscribe to the newsletter to get updatesJoin The Egg Whisperer SchoolRequest a Consultation with Dr. Aimee   Dr. Aimee Eyvazzadeh is one of America's most well‑known fertility doctors. Her success rate at baby‑making gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

Want more exclusive content from Dinky? Join the Patreon!EVERYONE who signs up to our giveaway wins a FREE spicy toy or gift card for toys! https://www.bboutique.co/vibe/dinky-podJOIN US FOR Christmas Markets 2026!!! OR Colombia 2027!!!! Our returning guest today is the fearless Dr. Danielle Gershon. Dr. Danielle is an OBGYN working and living in Alabama. She is a fellow of the Physicians for Reproductive Health and she is also childfree by choice. We are so excited to chat with her about her experiences as an abortion provider in the South, recent trends she's noticing, Black maternal mortality, and more. Shop items from our Dink Yourself segment. PLUS: Treat yourself to new merch!Wanna connect with us on social media? You can find us on Substack, Instagram, TikTok, and Threads at @dinkypod.Follow us on YouTube.If you have a question or comment, email us at dinky@dinkypod.com#bbpartnerBecome a supporter of this podcast: https://www.spreaker.com/podcast/dinky--5953015/support.

Most women don't hear about perimenopause until they're already deep into it, sometimes a decade in. This week, guest host Karen Walrond talks with OB/GYN and Generation M author Dr. Jessica Shepherd about the actual, gradual shape of that transition, the real math behind hormone therapy decisions, and why nearly 40% of a woman's life happens after menopause even begins. It's less a symptom checklist than a new starting point for the next several decades.What you'll explore:The gas-tank way to picture where you actually are between reproductive years and menopauseWhy symptom severity has almost nothing to do with how "together" you otherwise areThe difference between the "symptom bucket" and the "longevity bucket" in deciding on hormone therapyWhy perimenopause itself splits into an early, mid, and late phase, and why the late phase is the window with the most protective upside for starting hormonesWhat the SWAN study found about how menopause symptoms differ by race, and why that matters long-termIf you've been treating menopause as a phase to survive rather than a stage to prepare for, this resets the starting point.You can find Jessica at: Website | Instagram | Episode TranscriptNext week, we're sitting down with Priya Parker to talk about why conflict, handled well, might be one of the things that makes your closest relationships stronger instead of weaker, and what most of us get backwards about the moment right before it happens. Be sure to follow Good Life Project wherever you get your podcasts so you don't miss any upcoming episodes!Check out our sponsors and resources: Visit Our Sponsor Page Hosted on Acast. See acast.com/privacy for more information.

Rip sits down with OB-GYN, women's health expert, and author of Generation M, Dr. Jessica Shepherd, for a candid, empowering conversation about perimenopause, menopause, hormones, nutrition, sex, sleep, strength, and what it really means to thrive in midlife and beyond.For too long, menopause has been framed as a decline — something to dread, hide, or simply suffer through. Dr. Shepherd is here to change that narrative. She explains that menopause is not a failure of the body, but a natural biological transition — and one that deserves far more education, support, and celebration.In this conversation, Rip is joined by PLANTSTRONG Podcast producer Carrie Barrett, who, at 53, brings her own lived experience in perimenopause to the discussion. They eplain why estrogen, progesterone, and testosterone affect far more than reproduction — influencing the brain, bones, heart, muscles, metabolism, skin, sleep, and sexual health.And because this is Plant Strong, they also dive into the power of nutrition. Dr. Shepherd emphasizes that food is one of the most important tools in the menopause toolbox, especially during the 10–12 year perimenopausal window. A colorful, plant-centered diet rich in beans, greens, whole grains, berries, legumes, soy foods, fiber, and fermented foods can help support heart health, gut health, metabolic health, inflammation, muscle maintenance, and long-term vitality.This episode is not about one magic fix. It is about building the full toolbox: plants, movement, resistance training, sleep, self-advocacy, and, when appropriate, hormone therapy. As Dr. Shepherd reminds us, women deserve agency, options, and the chance to live their 70s, 80s, and 90s with strength, clarity, and confidence.Learn More About our 2026 Live PLANTSTRONG Events: https://plantstrongevents.com/ Let Us Help Your PLANTSTRONG JourneyLearn More About Our Corporate Wellness Program: https://liveplantstrong.com/corporate-wellness/ COMPLEMENT: Use code PLANTSTRONG for 30% off at https://lovecomplement.com/pages/plantstrong-special-offer Follow PLANTSTRONG and Rip Esselstynhttps://plantstrong.com/ https://www.facebook.com/GoPlantstrong https://www.instagram.com/goplantstrong/https://www.instagram.com/ripesselstyn/ Follow the PLANTSTRONG Podcast and Give the Show a 5-star RatingApple PodcastsSpotifyEpisode WebpageWatch on YouTube

The Lindsay Clancy trial has sparked a national conversation about postpartum psychosis and maternal mental health. In this episode, Mo News Producer Sari Soffer sits down with Dr. Noa Sterling, an OB-GYN and mental health expert, for a broader conversation about the Clancy trial, postpartum mental illness, and why many women fall through the cracks in the existing medical system. The conversation covers the differences between intrusive thoughts, postpartum depression, anxiety, and psychosis; risk factors like sleep deprivation and bipolar disorder; and the challenges of diagnosing and treating serious postpartum mental health conditions. They examine the systemic barriers for new mothers including a fragmented health system, lack of sustained support, and the burden to coordinate their own care during a time of intense struggle. They also discuss what better postpartum care could look like. Dr. Noa Sterling is also the creator of a paid app called Obi, which helps women through pregnancy and postpartum. She has made the following resources available free for the Mo News audience: - Mental Health Support Guide: Everything You Need to Know - A Letter to the Partner of Someone Struggling With Their Mental Health Postpartum If anything in this conversation resonated with you or someone you love, Postpartum Support International's HelpLine is ⁠1-800-944-4773⁠, call or text, and 988 is the Suicide and Crisis Lifeline.

Pregnancy, birth, and postpartum care should support the whole person, physically and mentally. In this episode, Dr. Rebecca Dekker talks with board-certified OB/GYN and perinatal coach Dr. Jessica Vernon about how integrative medicine can create a more holistic and personalized approach to obstetric care.   Dr. Vernon explains how integrative care combines traditional Western medicine with complementary approaches such as therapy, physical therapy, acupuncture, yoga, breathwork, meditation, and nutrition. She also shares how her own experience with postpartum anxiety and depression transformed the way she practices medicine and deepened her understanding of the physical, emotional, and identity-related transitions into parenthood. Plus, get practical guidance for changing providers, asking informed questions after a prior Cesarean, and navigating the overwhelming, and sometimes unreliable, health information found through social media and artificial intelligence.   (00:02:03) Dr. Vernon's journey into obstetrics and the influence of midwifery (00:05:47) Understanding matrescence and the transition into parenthood (00:07:14) What integrative medicine looks like in pregnancy and postpartum care (00:09:59) Bringing perinatal mental health and integrative medicine into obstetric practice (00:12:19) Gaps in traditional perinatal care and the need for individualized support (00:16:59) Supporting parents after infertility, pregnancy loss, birth trauma, or a difficult postpartum experience (00:21:32) Why it is okay to change providers (00:24:31) How infertility and pregnancy loss can shape a subsequent pregnancy (00:27:25) Practicing evidence-based, person-centered care that protects patient autonomy (00:29:02) Finding trustworthy pregnancy information online (00:32:27) Balancing medical evidence with personal intuition and individual circumstances   Resources Connect with Dr. Vernon and learn more about her 1:1 perinatal coaching: https://www.drjessicavernon.com/ Follow Dr. Vernon on Instagram: https://www.instagram.com/dr.jessicavernon/ Then Comes Baby: An Honest Conversation About Birth, Postpartum, and the Complex Transition to Parenthood by Dr. Jessica Vernon: https://www.bloomsbury.com/us/then-comes-baby-9781538195925/ Matrescence: On Pregnancy, Childbirth, and Motherhood by Lucy Jones: https://www.penguinrandomhouse.com/books/714054/matrescence-by-lucy-jones/ Free Postpartum Support International online support groups: https://postpartum.net/get-help/psi-online-support-meetings/ PSI Perinatal Mental Health Provider Directory: https://postpartum.net/get-help/provider-directory/   For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

We talk a lot about long-term couples growing together emotionally—but what happens when their physical selves begin to change, too? As we age, our bodies change, and those changes can have a real impact on intimacy, confidence, sexual function, and relationships. In this episode, we take an honest and often lighthearted look at what happens to both women and men as they grow older—and why these changes are something couples should face together, rather than allowing them to create insecurity, doubt, or blame. We're joined by Dr. Castillo, a fellowship-trained Female Pelvic Medicine specialist and the founder and director of Swan Medical Intimate Wellness in Los Gatos, California. Dr. Castillo brings extensive expertise in the changes that can occur as a consequence of childbirth, aging, and menopause, as well as the emerging treatments designed to improve sexual health and overall quality of life. We start with women, exploring some of the most common changes in sexual function that occur with age, including the impact of menopause and shifting hormones. We also talk about the enormous beauty standards women face—and whether men might need to start “playing the game” a little more when it comes to maintaining their physical health and appearance. Then we turn the conversation toward men. What changes can they expect as they age? What treatments and options are available? And, yes, we even ask the question you may have been wondering about: Are penile fillers for increased girth actually a thing? Most importantly, this conversation is about removing the shame and stigma surrounding sexual health. Aging doesn't have to mean giving up intimacy, confidence, or connection. Understanding what is happening to our bodies—and knowing that there are options—can help couples approach these changes with compassion, humor, and a willingness to work through them together. About our guest: Dr. Castillo completed his OB/GYN residency at St. Barnabas Medical Center in New Jersey before completing a three-year fellowship in Reconstructive Pelvic Surgery and Female Pelvic Medicine at the Cleveland Clinic Foundation. After five years of clinical practice at Kaiser Permanente, where he oversaw resident research and education and taught medical students as an Assistant Clinical Professor at Stanford University, he founded the first private Intimate Wellness Center in the San Francisco Bay Area. Dr. Castillo remains actively involved in clinical research and serves on several women's health advisory boards, helping shape emerging therapies and advanced treatment protocols for conditions that affect intimacy and quality of life. His mission is to address the root causes of common symptoms associated with aging while empowering women to embrace longevity and helping erase the stigma surrounding female sexual health through education, seminars, and compassionate care. To learn more go to https://swanmd.com, and mention Shameless Sex for a special gift. And click here to set up a free 15 minute consult to discover if you are in menopause Come to our October 2026 Couple's retreats! Learn more and reserve your spot here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.shamelesssex.com/retreat⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Do you love us? Do you REALLY love us? Then order ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠our book⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ now! Go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠shamelesssex.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to snag your copy Support Shameless Sex by sending us gifts via our ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon Wish List⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Follow us on IG ⁠⁠⁠⁠⁠⁠⁠⁠⁠@shamelesssexpodcast ⁠⁠⁠⁠⁠⁠⁠⁠⁠ Other links: Get 10% off getting soaking wet with code SHAMELESS at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://soakingwet.com⁠⁠⁠⁠⁠⁠ Get 45% off our favorite ethical (and educatonal) porn with code PLEASURE at ⁠⁠http://erikalust.com ⁠⁠— that's Erika with a K Get 10% off + free shipping with code SHAMELESS on Uberlube AKA our favorite lubricant at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://uberlube.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Get 15% off the best sex toys with code SHAMELESSSEX at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://purepleasureshop.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Work with some of our favorite sexual health and hormone specialists at ⁠⁠⁠https://swanmd.com⁠⁠⁠ + mention Shameless Sex for a discount

Your periods are still regular and your labs may even look “normal.” So why aren't you sleeping? Why has your mood changed? And why do you suddenly feel like a different version of yourself? In this episode of the As a Woman podcast, Dr. Natalie Crawford talks with Dr. Alicia Robbins, a board-certified OB/GYN, certified Menopause Society Practitioner, and founder of The Elm. They discuss why sleep and mood can change before hot flashes or irregular periods begin, how cycle tracking may reveal patterns, and how progesterone, estrogen, and testosterone are considered in individualized perimenopause care. They also explain the connection between fertility and perimenopause, what else should be ruled out, and how to advocate for better care when your symptoms are dismissed. IN THIS EPISODE: 00:00 What Is Perimenopause and When Does It Start? 03:20 Why Dr. Alicia Robbins Changed Her Approach to Perimenopause 09:55 Perimenopause vs. Menopause: What's the Difference? 11:23 Fertility and Perimenopause 12:22 How Do You Know if You're in Perimenopause? 14:47 How to Track Perimenopause Symptoms 16:02 Hormone Therapy During Perimenopause 17:38 Symptoms of Low Progesterone 18:11 Hormone Therapy, Birth Control, and Pregnancy 20:17 Testosterone and Pregnancy 21:21 Testosterone for Women 23:43 Symptoms of Low Estrogen 25:12 When to Start Hormone Therapy 27:04 Estrogen Patches vs. Pills 27:40 Do You Need Hormone Testing for Perimenopause? 30:01 Is It Perimenopause or Something Else? 32:13 How to Advocate for Better Perimenopause Care GUEST RESOURCES: Instagram: https://www.instagram.com/aliciarobbinsmd/ Website: https://www.theelmgreenwich.com/ Podcast: https://www.draliciarobbins.com/podcast AS A WOMAN WITH DR. NATALIE CRAWFORD: YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l  Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339  Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk  HOST RESOURCES: Order The Fertility Formula: https://www.nataliecrawfordmd.com/book  Newsletter: https://www.nataliecrawfordmd.com/newsletter  Instagram: https://www.instagram.com/nataliecrawfordmd  YouTube: https://www.youtube.com/@NatalieCrawfordMD  Become a patient: https://www.forafertility.com  Earn FREE CE/CME: https://learnatpinnacle.com/education  This episode is brought to you by The Pinnacle Podcast Network. ABOUT DR. NATALIE CRAWFORD: Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies. Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices

How does an OB-GYN earning a fairly typical physician income build a net worth of more than $20 million? In this episode of the Milestones to Millionaire Podcast, Dr. Jim Dahle talks with Carlos, an OB-GYN who has spent 25 years steadily building wealth through disciplined investing, consistent saving, and thoughtful real estate investments. Carlos explains how he and his wife started by saving roughly 30% of their income and investing in broad stock market index funds. As their career progressed, they expanded into commercial real estate, purchased medical office buildings, and eventually added short-term rental properties to create additional cash flow. One of the biggest milestones came after refinancing their home in 2011 and using $100,000 to purchase a Florida foreclosure near the bottom of the housing market. Through appreciation and multiple 1031 exchanges, that investment ultimately grew into approximately $3.6 million while allowing them to defer capital gains taxes. They also discuss balancing a portfolio between equities and real estate, using leverage responsibly, building income-producing properties, estate planning, and preparing for retirement after decades of disciplined investing. This conversation is a reminder that extraordinary wealth rarely comes from chasing the next hot investment. It is far more often the result of earning well, investing consistently, remaining patient, and allowing compounding to work over many years. This podcast is sponsored by Bob Bhayani at Protuity. He is an independent provider of disability insurance planning solutions to the medical community in every state and a long-time white coat investor sponsor. He specializes in working with residents and fellows early in their careers to set up sound financial and insurance strategies. If you need to review your disability insurance coverage or to get this critical insurance in place, contact Bob at https://whitecoatinvestor.com/protuity today by email info@protuity.com or by calling (973) 771-9100. Celebrating your stories of success along the journey to financial freedom! Tune in every Monday to the Milestones to Millionaire Podcast, where we celebrate the financial achievements of our listeners and share practical tips for reaching your own milestones. We want to celebrate your milestones—no matter how big or small—and help inspire others to follow your lead. Every week, these episodes feature one listener who has recently achieved a milestone they are proud of and want to celebrate, and they give any advice they have for those who want to follow their example. Make sure to listen every Monday to be inspired by your fellow white coat investors. Celebrate YOUR Milestone on the Milestones to Millionaire Podcast: https://whitecoatinvestor.com/milestones  Website: https://www.whitecoatinvestor.com  YouTube: https://www.whitecoatinvestor.com/youtube  Student Loan Advice: https://studentloanadvice.com  TikTok: https://www.tiktok.com/@thewhitecoatinvestor  Facebook: https://www.facebook.com/thewhitecoatinvestor  Twitter: https://twitter.com/WCInvestor  Instagram: https://www.instagram.com/thewhitecoatinvestor  Subreddit: https://www.reddit.com/r/whitecoatinvestor  Online Courses: https://whitecoatinvestor.teachable.com  Newsletter: https://www.whitecoatinvestor.com/free-monthly-newsletter