Perimenopause: the phase where your body does whatever it wants, whenever it wants, and your brain has thoughts about it. So what happens when hot flashes hit, anxiety creeps in, and suddenly you're questioning everything from your wardrobe to your worth? And more importantly…what if the problem isn't just the symptom, but the story you've been told about it?

In this episode of OvaryActive, Julia Weitlauf joins the Docs to talk all about cognitive behavioral therapy (CBT) for menopause—because apparently, we can't control the hot flashes, but we can control how much they ruin our day.

They are covering what CBT is, how it's been used for decades to treat things like anxiety and insomnia, and how it's now being adapted to help women manage menopause symptoms, specifically the distress around hot flashes.

Listeners will also hear why the CBT approach doesn't eliminate symptoms, but can significantly reduce their impact, improve quality of life, and help women get back to doing the things they love.

Bottom line: menopause may still be a buzzkill… but it doesn't have to run the show.

What you'll hear in this episode:

[3:00] What is CBT?

[4:53] How CBT is used for anxiety, depression, & imsomnia

[6:23] CBT with menopause and perimenopause

[15:08] CBT session-by-session breakdown

[24:47] When menopause overlaps with anxiety and depression

[26:58] CBT improves sleep, mood, and quality of life…why?

[28:08] DIY options

[32:26] Who should use CBT?

[33:41] How to find a therapist trained in CBT?

[35:19] Final takeaway

Resources:

Julia Weitlauf on LinkedIn

Managing Hot Flushes and Night Sweats by Myra Hunter

psychologytoday.com/us

Perimenopause is still taking the blame… but in this unexpected third installment (because Amy just got too excited), we're talking about functional hypothalamic amenorrhea (FHA).

Dr. Chrisandra Shuflet joins the Docs in this episode of OvaryActive to explain FHA, tell us why it is often missed or dismissed, and how it's diagnosed. The conversation explores how disrupted brain signaling leads to low estrogen, why it's a diagnosis of exclusion, and how this condition shows up most often in younger women, even though its impact can follow you well into perimenopause and beyond.

As a condition that can look like perimenopause but is actually your brain hitting the pause button on your ovaries. If your cycle disappears and you're nowhere near your forties, it's probably not peri… it's your body responding to stress, under-fueling, over-exercising. Or maybe all of the above.

What you'll hear in this episode:

[0:34] Welcome Chrisandra Shufelt, MD

[3:46] What is FHA?

[6:02] A diagnosis of exclusion

[7:00] Lab patterns to distinguish FHS, PCOS, POI

[8:45] Who is most at risk:

[13:42] Why do so many women go years without a diagnosis?

[18:14] Long-term risks

[20:30] Cardiovascular connection

[22:38] ARCH study

[29:13] What does a history of FHA mean in perimenopause?

[33:34] Treatment approach (sorry, no Rx)

[37:22] Final takeaways: you are NOT crazy still applies!

Links:

Reveal trial: https://www.mayo.edu/research/clinical-trials/cls-20570285

Dr Shufelt: https://www.mayo.edu/research/faculty/shufelt-chrisandra-l-m-d/bio-20542101

@chrisandra-shufelt-md-ms-facp-mscp on LinkedIn

Follow the show @OvaryActive Instagram | YouTube

Meet the Docs:

More information about Dr. Rebecca Dunsmoor-Su:

Gennev: www.gennev.com/clinician/dr-rebecca-dunsmoor-su

LinkedIn @rebecca-dunsmoor-su

More information about Dr. Amy Voedisch:

Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

This episode was produced by Audiotocracy Podcast Production.

Perimenopause gets blamed for a lot of things – mood swings, weird cycles, rogue chin hairs – but sometimes the culprit isn't peri at all. In Part 2 of When It's NOT Peri, the Docs are talking about polycystic ovarian syndrome (PCOS), a condition that looks suspiciously like perimenopause but actually comes from a completely different hormonal playbook.

The hosts explain what PCOS actually is, why insulin resistance sits at the center of the syndrome, and how symptoms like irregular periods, acne, hair growth, and weight changes can overlap with perimenopause. They also walk through how doctors diagnose PCOS, the famous Rotterdam criteria, and why clinicians often have to rule out several other endocrine issues before landing on the diagnosis.

The episode also explores how PCOS evolves across the lifespan and why the metabolic side of the condition still matters long after the reproductive years are over.

What you'll hear in this episode:

[1:11] PCOS defined and misnamed

[3:29] Symptoms that overlap

[5:55] Ethnicity and different presentations

[7:42] Rotterdam diagnostic criteria

[12:16] Who gets diagnosed and when

[18:00] Hormone signaling and ovulation disruption

[20:48] Fertility timing, OPKs, & birth control

[29:54] Lifestyle and metformin

[33:22] PCOS in perimenopause

[37:10] Research gaps and advocacy

[40:09] Takeaways

Follow the show @OvaryActive Instagram | YouTube

Meet the Docs:

More information about Dr. Rebecca Dunsmoor-Su:

Gennev: www.gennev.com/clinician/dr-rebecca-dunsmoor-su

LinkedIn @rebecca-dunsmoor-su

More information about Dr. Amy Voedisch:

Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

This episode was produced by Audiotocracy Podcast Production.