The Perimenopause Masterclass: Anxiety, Brain Fog, Broken Sleep, Weight Gain & GLP-1s

unPAUSED with Dr. Mary Claire Haver

Mary Claire Media, LLC

Medicine, Health & Fitness, Society & Culture

4.8 • 1.2K Ratings

🗓️ 31 March 2026

⏱️ 68 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode of “unPAUSED,” Dr. Mary Claire Haver answers the questions she gets asked most, sitting down solo to address what perimenopause actually is, why it starts in the brain before it ever shows up in bloodwork, and why so many women experiencing anxiety, brain fog, broken sleep, and unexplained weight gain are dismissed, misdiagnosed, or handed prescriptions for symptoms that have a hormonal root. Perimenopause is not a waiting room. It is its own distinct biological phase, a seven to ten year hormonal transition that begins long before periods stop and touches every organ system in the body. And yet most women are never taught to recognize it. Dr. Haver breaks down the hormonal chaos of perimenopause, revealing why estrogen does not simply decline but surges and crashes erratically as the brain floods the ovaries with luteinizing hormone (LH) and follicle stimulating hormone (FSH) in a desperate attempt to produce more, and why a single blood draw will almost never tell the full story. She answers the metabolic questions she hears constantly, explaining how visceral fat can double or triple during the transition with no changes in diet or exercise, why LDL cholesterol rises an average of 20%, and how cardiovascular risk, insulin resistance, bone density loss, and inflammation are all woven into the same story medicine has largely failed to tell women. Guest links: The 'Pause Wellness The ‘Pause Life Dr. Mary Claire Haver (Instagram) Dr. Mary Claire Haver (YouTube) Books: “The New Perimenopause,” by Dr. Mary Claire Haver "The New Menopause" by Dr. Mary Claire Haver “Weightless: A Doctor's Guide to GLP-1 Medications, Sustainable Weight Loss, and the Health You Deserve,” by Rocio Salas-Whalen To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Transcript

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0:00.0	Perimenopause is not early menopause. It is its own distinct biological phase and deserves its own
0:09.7	episode. Perimenopause is about a seven to 10 year transition before period stop. This is not a
0:17.0	gentle decline. Hormones fluctuate wildly. This is when many women first experience,
0:23.0	anxiety, brain fog, sleep disruption, weight changes, mood shifts, joint pain, loss of resilience,
0:27.9	and that unsettling feeling of, I don't feel like myself anymore, long before anyone says
0:33.7	the word menopause. Perimenopause often starts quietly. It shows up in the brain first,
0:40.0	then the body, then everywhere else. Most women are never taught to recognize it and are told
0:45.9	nothing is wrong. If you've thought, why didn't anyone warn me? This episode is for you.
0:53.4	I'm Dr. Mary Claire Haver, a board-certified obstetrician and
0:57.1	gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics
1:02.4	and gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where
1:08.0	we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
1:23.4	The views and opinions expressed on pause are those of the talent and guests alone and are provided for informational and entertainment purposes only.
1:32.3	No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.
1:44.0	Music I'm 44 and my periods are all over the place. My doctor says I'm too young for menopause. What is actually happening to my body? I would guess that it is
2:04.9	actually perimenopause. And since the theme of today's masterclass is perimenopause,
2:12.8	let's start with some basic definition. So we're all on the same page. So perimenopause is more than just
2:20.1	the waiting room, right, for your menopause. It is its own distinct hormonal and biological
2:26.8	transitory state. So if you think of back when you were premenopausal, premenopausal, okay, menopause had not entered the chat,
2:37.9	all right? You're steadily losing your egg count supply, and we can talk about that in a minute,
2:41.5	but you are still ovulating on a fairly regular basis. Now, for those of you who don't ovulate
2:46.7	regularly or are you on suppression for birth control pills or whatever, you have to take this
	...

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