Ep. 472 What Women Aren’t Told About Menopause & HRT with Jaclyn "Jackie" Piasta

Everyday Wellness with Cynthia Thurlow ™

Cynthia Thurlow

Alternative Health, Nutrition, Science, Life Sciences, Health & Fitness

4.8 • 1K Ratings

🗓️ 7 June 2025

⏱️ 71 minutes

🔗️ Recording | iTunes | RSS

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Summary

Today, I am thrilled to reconnect with my friend and colleague, Jackie Piasta. Jackie is a Vanderbilt-trained nurse practitioner. She is board-certified in women's and gender health, and has been practicing since 2010. She serves on medical advisory committees for several foundations and co-hosts the justASK Podcast. In our discussion today, we dive into the challenges menopausal women face with hormone replacement therapy due to the lack of provider education on the effects of oral estrogen, the importance of bio-individuality, and how nuanced messaging can make all the difference for women. Jackie unpacks the latest guidelines from the American Urological Society, which address vulvovaginal, urinary, and sexual health symptoms, and explains the importance of addressing those issues proactively. We also explore fertility tracking in perimenopause, especially for women using long-acting reversible contraception (LARCs), and the latest trends in hormone testing. You will not want to miss this insightful conversation where Jackie sheds light and offers practical guidance on the often-missed details of women’s health. IN THIS EPISODE, YOU WILL LEARN: Why bio-individuality is essential in menopause treatments The challenges OB-GYNs and other clinicians face in staying updated on menopause treatments. Why healthcare providers must become more educated about hormone therapy Jackie explains the historical context surrounding the vilification of oral estrogen. How the new American Urological Society guidelines are now addressing symptoms of perimenopause and menopause Why vaginal laser therapy might be harmful for some individuals Why diagnosing menopause in women using long-acting reversible contraceptives (LARCs) is so challenging Why hormone level labs are needed to guide clinical decision-making on menopause treatments Jackie highlights the need for more research to understand the hormone levels that protect bone health. Connect with Cynthia Thurlow Follow on Twitter Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Jaclyn Piasta Monarch Health Jackie on all social media: Jackiep_gynnp The justASK Podcast

Transcript

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0:00.0	Welcome to Everyday Wellness Podcast.
0:03.7	I'm your host, nurse practitioner, Cynthia Thurlow.
0:07.4	This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals.
0:13.9	My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and
0:21.5	impact over a million lives.
0:28.9	Today I had the honor of reconnecting with friend and colleague Jackie Piausta.
0:33.8	She's a Vanderbilt trained nurse practitioner and board certified in women's and gender health.
0:39.8	She's been practicing since 2010 and serves on the advisory medical committee for several
0:45.0	foundation and co-hosts the Just Ask podcast.
0:49.0	Today we spoke about messaging to women and why bioindividuality is so important as well as nuanced conversations,
0:56.4	why menopause and menopause hormone replacement therapy can be challenging due to the void
1:03.0	of education for providers, the impact of oral estrogen, and again, why there's a research
1:08.6	void, new guidelines for the American Urological Society, specific to vulva vaginal, urinary,
1:15.0	and sexual symptoms, and why it is so important to address these proactively,
1:20.7	discussions around things that are not effective or potentially even harmful,
1:25.1	fertility tracking in perimenopause, especially for women on long acting reversible contraception
1:31.8	or larks, why lab work can be helpful in many instances.
1:36.4	And last but not least, trends and labs in the hormone space and some of the things that
1:42.3	require more research before they can become
1:45.0	frontline therapies. As always, an invaluable, insightful conversation with Jackie and one,
1:50.6	I hope we will continue to do so throughout the next several years.
1:55.7	Well, Jackie, such a pleasure to have you back on the podcast. I've been so looking for this
	...

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