Ep. 508 Perimenopause Uncovered: From Heavy Periods to Stubborn Weight Gain – A Talk with Dr. Heather Hirsch

Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

Cynthia Thurlow

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

4.8 • 1K Ratings

🗓️ 11 October 2025

⏱️ 54 minutes

🔗️ Recording | iTunes | RSS

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Summary

I am delighted to connect with a physician friend and colleague, Dr. Heather Hirsch, today. Dr. Hirsch is an entrepreneur and a board-certified internist by the American Board of Internal Medicine. She is also the Founder and CEO of Health by Heather Hirsch, and has a telemedicine practice offering best-in-class individualized care for perimenopause and menopause. In our discussion, we explore heavy menstrual cycles and the benefits of journaling and shared decision-making. We discuss common and frustrating causes of weight loss resistance in middle age, the power of strength training and adequate protein intake, and estrogen as a metabolic regulator that is intricately linked to many physical systems, including digestion. We also examine how educating clinicians on shifts in estrogen, progesterone, and testosterone during perimenopause could prevent countless ER visits, and we tackle concerns surrounding contraception and pregnancy prevention in perimenopause, a biopsychosocial approach to low libido, and the often-overlooked silent symptoms Dr. Hirsch often sees in perimenopause and beyond. Today’s conversation with Dr. Hirsch is truly invaluable. I highly recommend her Perimenopause Survival Guide, written by an internal medicine doctor extremely well-versed in perimenopause and menopause. IN THIS EPISODE, YOU WILL LEARN: How hormonal fluctuations disrupt the body and create confusion in perimenopause The benefits of journaling How hormonal and lifestyle shifts disrupt metabolism, weight, and insulin sensitivity during perimenopause Why body composition changes matter more than your weight How declining estrogen affects insulin resistance, metabolism, and diabetes risk The value of shared decision-making How hormones, medications, sleep, relationships, and past trauma can cause changes in libido How siloed healthcare often leaves perimenopause symptoms misunderstood How irregular ovulation increases pregnancy risk and why hormone therapy is not a contraceptive Connect with Cynthia Thurlow Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Heather Hirsch On her website YouTube Social media: @Heather Hirsch MD

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 impact
0:22.1	over a million lives.
0:29.0	Today I had the honor of connecting with physician friend and colleague Dr. Heather Hirsch.
0:34.3	This has been one of these interviews that I have been manifesting for a long time,
0:40.0	and I'm so grateful to be able to share her expertise with my community. She's an entrepreneur
0:44.9	and an American Board of Internal Medicine, board certified internist, and CEO and founder of Health
0:50.9	by Heather Hirsch. She also has a telemedicine practice offering best in class individualized care for perimenopause
0:57.9	and menopause.
0:59.2	Today, we spoke at length around concerns around heavy menstrual cycles, the impact of journaling
1:04.9	and shared decision making, common and frustrating reasons for why we can become weight loss resistance in middle age, the value of strength training, and proper protein intake, why estrogen is a metabolic regulator, and how it is intricately related in many systems in the body, including digestion, how many ER visits can be prevented by educating
1:31.1	all clinicians about the shifts in estrogen, progesterone, and testosterone in perimenopause,
1:37.9	concerns around contraception and preventing pregnancy in perimenopause, a biopsychosocial approach to low libido at this stage of life.
1:47.7	And last but not least, silent symptoms the Dr. Hirsch sees with some frequency in perimenopause
1:54.2	and beyond. This is a truly invaluable conversation. I highly recommend Dr. Hirsch's the perimenopause
2:00.4	survival guide, which is written through the lens of internal highly recommend Dr. Hirsch's the perimenopause survival guide, which is written
2:02.5	through the lens of internal medicine doctor who is incredibly well versed in not only perimenopause,
2:08.8	but menopause as well. Well, Dr. Hirsch, I'm so excited to introduce you to the podcast community. I know it's taken
2:19.2	a while to make this happen and I'm really excited to share your expertise with everyone at
2:24.7	everyday wellness. Yeah. I'm so excited to be here. I know we've been wanting to get together
	...

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