5 • 927 Ratings
🗓️ 24 November 2025
⏱️ 86 minutes
🧾️ Download transcript
This episod is brought to you by Cured Nutrition, Caldera Lab and Joi & Blokes.
Dr. Jessica Shepherd—OB/GYN, clinical advisor for P-Volv, and author of Generation M—breaks down everything women need to know about perimenopause, menopause, and longevity. She explains why mindset is the foundation of midlife health, how declining estrogen affects every organ system, why only 8% of symptomatic women ever receive a diagnosis, and how common comorbidities rise 45% or more between ages 40–59. Dr. Shepherd shares science-backed strategies for navigating symptoms, improving metabolic and mitochondrial health, understanding the truth about hormone therapy after the flawed WHI study (which led to an 82% decline in prescriptions), and using exercise, protein, and muscle-building to protect cognition, heart health, and overall vitality. Whether you're a woman entering midlife—or a partner wanting to better support her—this conversation is a masterclass in women's health, empowerment, and aging well.
Follow Jessica @jessicashepherdmd
Follow Chase @chase_chewning
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00:01 - Intro & shocking stats: women live longer but spend more years in poor health; HRT prescriptions dropped 82% after 2002
00:28 - Muscle as the organ of longevity; women lose 3–5% per decade, accelerated after menopause
01:18 - Why estrogen decline shifts the whole body; Dr. Shepherd introduces herself and her mission in women's health
02:15 - Redefining women's health & longevity; why women aren't thinking about longevity soon enough
04:23 – Mindset, habits, and community as the foundation of midlife health
07:13 - Barriers to staying well: socioeconomic factors, upbringing, access, and misconceptions about wellness
09:33 - Women's current wellness landscape; societal expectations, caregiving burden, and systemic gaps
12:46 – Major healthcare gaps: lack of research, exclusion of women from clinical studies until the '70s, and only 3% of VC health funding going to women
17:30 – Pharma eliminating women's health divisions; downstream effects on innovation and access
19:10 – Perimenopause 101: defining terms, symptoms vs. cycles, 34+ possible symptoms, and why diagnosis is trick
24:45 – The cardiovascular danger of estrogen decline; heart disease as the #1 killer of women
27:02 – Stress vs. perimenopause symptoms; mood disorders peak between 45–55
29:48 – How HRT has evolved in the last 10–20 years; symptom relief and longevity benefits
32:32 – Why only 5% of women are on hormone therapy today; misconceptions and new guidelines
34:20 – WHI study deep dive: media panic, misinterpretation, lack of statistical significance, and lasting fear
39:06 – Risk vs. benefit: how to think about HRT decisions with your provider
41:51 – Chase shares his TRT story; quality of life, fertility considerations, and hormone literacy
45:16 – Dr. Shepherd's personal hormone story: cognition issues, testosterone, and starting estrogen at 46
48:12 – Supplements Dr. Shepherd uses: Vitamin D, creatine, CoQ10, Urolithin A
50:10 – Muscle, mitochondrial health, sarcopenia & glucose control: why resistance training is non-negotiable
52:25 – Movement, neuroplasticity, balance & cognition: why staying active protects the aging brain
55:12 – How partners can best support women in perimenopause: emotional support & shared routines
57:52 – The science of emotional support: social connection decreases pain, inflammation, and improves outcomes
59:22 – Menopause explained: average age, symptom timeline, and the hidden cellular changes
01:02:39 – Nutrition, glucose control, protein needs, alcohol & sugar intake, and metabolic health
01:07:07 – Protein requirements (1.0–1.2g/kg), resistance training, and why women must build muscle
01:09:37 – U.S. data: 55%+ of women report symptoms; only 8% diagnosed; why doctors miss it
01:12:34 – Which providers are best for menopause care & what certifications to look for
01:15:31 – Comorbidities rise 45% between 40–59: hypertension, thyroid, arthritis, sleep disorders & estrogen's role
01:18:25 – Is biohacking menopause possible? Current limits + ovarian longevity research
01:22:24 – Exercise as the ultimate biohack; sustainable movement for aging wel
01:23:19 – Final Q: How Dr. Shepherd lives Ever Forward — flexibility, pause, and growth
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Episode resources:
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| 0:00.0 | The following is an Operation Podcast production. |
| 0:03.6 | Women typically live longer than men, but they do live a significant portion of that in poor health. |
| 0:09.7 | From that 2002 through roughly, I guess you could say, 2023 or 24, the percentage decline in prescriptions was 82%. |
| 0:20.0 | In what other leg of healthcare or a drug? |
| 0:24.2 | Yeah. |
| 0:24.6 | Has that ever happened? |
| 0:26.2 | If anything, it's the opposite, right? |
| 0:27.5 | Correct. |
| 0:28.4 | When we look at muscle, to me, muscle is the organ of longevity because it has so many functions. |
| 0:34.0 | And we lose about three to five percent of our muscle mass per decade, |
| 0:37.8 | but it's definitely accelerated after you pass menopause. |
| 0:41.5 | Why? |
| 0:41.9 | Oh, I'm sure it has something to do with estrogen. |
| 0:43.8 | I don't know. |
| 0:44.7 | While over half a women aged 40 to 64 reported perimenopause or menopause symptoms, |
| 0:50.9 | only about 8% received actual confirmed diagnosis. Yeah. Adequate training on menopause and, only about 8% received actual confirmed diagnosis. |
| 0:56.0 | Yeah. |
| 0:56.5 | Adequate training on menopause and perimenopause was never a very big part of what we |
| 1:02.6 | learned. |
| 1:03.1 | Even as an OBGYN. |
| 1:05.0 | Are we saying here that these comorbidities are because of perimenopause and menopause |
| 1:10.1 | or being in perimenopause and menopause or being in perimenopause and |
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