Peri & Pause The Podcast

Peri & Pause

The Peri & Pause Podcast is for women in midlife who know something in their body has changed—but haven’t been given real answers, or have been left overwhelmed by conflicting information.

Hosted by Jamie Gallagher, DNP, FNP-C, MSCP, a nurse practitioner specializing in perimenopause and menopause care, the show explores hormones, metabolism, mental health, sleep, sex, weight changes, and chronic conditions through an evidence-based, deeply practical lens. We unpack the physiology of midlife alongside the lived experience of women navigating careers, relationships, finances, and identity during this transition.

Every woman deserves this conversation—and the clarity, language, and confidence to advocate for better care.

Because “Your Labs Are Normal” Is Not the Whole Story.

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15 episodes
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Avg 17 min
English

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#14
August 18 · 14 min
Estrogen 101
Estrogen in Perimenopause: What It Does, Why Symptoms Happen, and the FDA Black Box Warning Update (2025–2026) Jamie Gallagher, a nationally board-certified family nurse practitioner and Menopause Society certified practitioner, explains estrogen as a whole-body hormone—not just a reproductive one—affecting the brain (temperature regulation, mood, memory, hot flashes, sleep and brain fog), bones (rapid bone loss around the final period and osteoporosis risk), vaginal/urinary tissues (dryness, discomfort with sex, UTIs and worsening symptoms post-menopause), skin and joints (collagen loss, aches, inflammation), and heart/metabolism (vessel flexibility, cholesterol, insulin response, rising heart disease risk). She outlines common symptom patterns from early perimenopause through post-menopause and emphasizes personalized care. She also reviews the Women’s Health Initiative-driven FDA black box warning placed in 2003 and describes FDA/HHS actions beginning Nov 10, 2025, and label changes approved Feb 12, 2026, removing broad warnings about heart disease, breast cancer, and dementia from several hormone therapy products while noting uterine cancer risk with estrogen-only therapy in women with a uterus. 00:00 Welcome to the Podcast 00:47 Why Estrogen Matters 01:48 Estrogen Receptors Everywhere 02:56 Types of Estrogen Explained 03:56 Brain and Hot Flashes 05:08 Bone Loss and Osteoporosis 06:32 Vaginal and Urinary Changes 07:17 Skin Joints Heart Metabolism 08:33 Symptom Timeline in Midlife 10:10 Black Box Warning History 11:22 FDA Label Changes 2025-2026 12:33 Risks Personalized Decisions 13:39 Wrap Up and Next Episode
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#13
June 30 · 9 min
What Actually Works for Menopause Weight Gain
In this follow-up episode of Perimenopause the Podcast, Jamie Gallagher moves beyond the "why" behind menopause weight gain and inflammation and focuses on the "how." After explaining the science behind hormonal changes, inflammation, belly fat, insulin resistance, and metabolic slowdown in the previous episode, Jamie now shares practical strategies women can use to interrupt the cycle and regain control of their health. This episode explores resistance training, high-protein nutrition, the Mediterranean diet, menopausal hormone therapy (MHT), GLP-1 medications, and why traditional approaches to weight loss often stop working during perimenopause and menopause. If you've been doing all the "right things" but still struggling with weight gain, inflammation, low energy, or changes in body composition, this episode offers a science-based roadmap for navigating this transition. 00:00 – Welcome back and recap of the previous episode 00:45 – Why understanding the "how" matters 01:15 – Pillar One: Rebuilding your metabolic engine 01:45 – Why endless cardio isn't the answer anymore 02:00 – Resistance training and reducing inflammation 02:30 – HIIT workouts and visceral fat reduction 03:00 – Why protein becomes more important during menopause 03:30 – Protein recommendations explained 03:45 – The Mediterranean diet and obesity prevention 04:15 – Alcohol's impact on belly fat and metabolism 04:45 – Pillar Two: Menopausal Hormone Therapy (MHT) 05:15 – How estrogen influences fat distribution 05:45 – Hormone therapy and inflammation reduction 06:15 – What happens when hormone therapy stops 06:30 – Pillar Three: GLP-1 medications explained 07:00 – Semaglutide, tirzepatide, and women's health 07:30 – Why women often respond differently than men 07:45 – Protecting muscle while losing weight 08:00 – The importance of strength training during GLP-1 use 08:15 – Building a complete weight-loss strategy 08:30 – The role of nutritionists, trainers, and clinicians 08:45 – Changing your strategy instead of blaming yourself 09:00 – Final thoughts and encouragement
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#12
June 23 · 9 min
Why Menopause Weight Gain Isn't Your Fault
In this episode of Perimenopause the Podcast, Jamie Gallagher tackles one of the most frustrating and misunderstood challenges women face during perimenopause and menopause: weight gain and inflammation that seem to appear out of nowhere. If you've found yourself eating the same foods, exercising the same way, and still noticing stubborn belly fat, increased inflammation, joint aches, brain fog, or changes in your metabolism, you're not imagining it—and you're not alone. Jamie breaks down the science behind hormonal changes, estrogen decline, FSH spikes, insulin resistance, visceral fat accumulation, muscle loss, and chronic inflammation. Most importantly, she explains why this transition is not a failure of willpower or discipline, but a biological shift happening inside the body. This episode is packed with practical insights and validation for women who have been blaming themselves for changes that are often driven by hormones, metabolism, and immune system changes beyond their control. 00:00 – Introduction to today's Ask Us Anything episode 00:45 – The frustration of midlife weight gain and inflammation 01:20 – Why this isn't a willpower problem 01:45 – The connection between inflammation and weight gain 02:00 – Estrogen's role in metabolism and immune health 02:30 – The body's "internal thermostat" explained 03:00 – Why women feel puffy and inflamed during perimenopause 03:15 – Understanding follicle-stimulating hormone (FSH) 03:45 – How FSH contributes to belly fat accumulation 04:15 – Why weight gain often begins before menopause 04:30 – The vicious cycle of visceral fat and inflammation 05:00 – How belly fat acts like its own endocrine organ 05:20 – Insulin resistance and blood sugar changes 06:00 – Why normal labs don't always tell the full story 06:30 – Muscle loss and metabolic slowdown 07:00 – Sleep disruption, cortisol, and cravings 07:30 – Why you're not lazy, broken, or failing 08:00 – The power of resistance training and muscle building 08:20 – Why lifting weights helps fight inflammation 08:40 – Changing your strategy, not blaming yourself 08:55 – Preview of next episode: practical solutions
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#11
June 16 · 6 min
Hormone Testing During Menopause: What Every Woman Should Know
Women often hear conflicting information online about estrogen, progesterone, and hormone testing. Jamie explains why hormone levels fluctuate dramatically during perimenopause, why a single blood test rarely tells the full story, and why symptoms often provide more useful information than lab values alone. This episode also covers stopping birth control pills in midlife, hormone testing after pregnancy, when hormone testing is appropriate, and why some women may still benefit from lab work in specific situations. If you've ever wondered whether hormone testing can confirm perimenopause or menopause, this episode will help you understand what hormone tests can, and can't, tell you. 00:00 – Welcome back to Perimenopause the Podcast 00:25 – Listener questions about hormone testing 00:55 – Should women routinely check hormone levels? 01:15 – Why hormone levels fluctuate so dramatically 01:40 – Understanding hormone changes during perimenopause 02:00 – Why symptoms matter more than a single lab test 02:15 – Stopping birth control in your 40s: what to expect 02:40 – How birth control affects hormone testing 02:55 – Could birth control be masking menopause? 03:10 – Hormone testing after pregnancy and childbirth 03:35 – When hormone testing may be appropriate 03:50 – Testosterone monitoring and hormone therapy 04:10 – New research on estrogen and bone health 04:35 – Why hormone testing is trending online 04:50 – The better question to ask about your symptoms 05:15 – Final thoughts and listener questions
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#10
June 9 · 6 min
Surgical Menopause: The Missing Piece Many Women Never Hear About
In this Ask Us Anything episode of Perimenopause the Podcast, Jamie Gallagher answers a heartfelt question from Tammy, a woman struggling to feel like herself after a total hysterectomy and bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes). One and a half years after surgery, Tammy describes feeling like her hormones and body are "a wreck." Jamie explains the difference between natural menopause and surgical menopause, the health impacts of ovary removal, and why many women continue to struggle when the right hormone therapy has not been explored. This conversation covers estrogen therapy, long-term health risks, surgical menopause recovery, and practical ways women in rural communities can access menopause specialists through telehealth and professional networks. If you've experienced ovary removal, hysterectomy, surgical menopause, or persistent hormone symptoms, this episode offers education, validation, and hope. 00:00 – Welcome to Ask Us Anything 00:30 – Tammy's question: "My hormones are a wreck" 01:15 – What is a bilateral salpingo-oophorectomy? 01:50 – Why the reason for ovary removal matters 02:30 – Understanding surgical menopause 03:00 – Long-term health effects of ovary removal 03:45 – Heart health, bone health, brain health, and libido 04:15 – Why estrogen therapy matters 04:45 – The hormone Tammy didn't mention 05:00 – Why you don't have to accept feeling miserable 05:20 – Finding menopause specialists through telehealth 05:40 – How to use Menopause.org to find care 05:55 – Why it's not too late to feel better 06:15 – Final encouragement and closing thoughts
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#9
June 2 · 31 min
From Military to Menopause: A Partner's Perspective
In Part 2 of the Meet the Founder series on Peri & Pause, Jamie is joined by her husband and co-founder, Stu, to discuss his background in international business and a 26-year military career, his transition into civilian life, and how mission, purpose, and service shape his leadership. They explore what Stu saw in Peri & Pause early on, the parallels between military mission-focus and building a menopause care company, and the persistent midlife women’s health care gap he witnessed through his mother’s experience and Jamie’s own perimenopause. Stu describes how perimenopause can strain relationships when symptoms are misunderstood, emphasizes addressing root causes rather than just symptoms, and encourages partners to show patience, seek help, and support women through care that can improve families, work, and overall quality of life. 00:00 Meet Stu Intro 01:33 Military Roots 03:17 Leaving Service 04:47 Vision For Peri Pause 06:10 Mission Parallels 07:47 Care Gap Reality 09:32 Partner Perspective 13:40 Mom And Family Impact 17:39 Advice For Partners 18:31 Thick Skin and Support 18:55 Men Asking for Help 20:39 Building Together Talk 22:51 Napkin to Launch 23:58 Balancing Risk and Caution 26:17 Mission Bigger Than Us 28:06 Scaling the Impact 30:11 Gratitude and Outro ------ This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives. Visit https://periandpause.com for more info
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#8
May 19 · 34 min
Empowering Midlife Health: The Origin of Peri and Pause
Kristen wraps the nurse practitioner series and launches the founder series with Peri & Pause founder Jamie Gallagher, who shares what drew her into nursing, her critical care background, and why she became a nurse practitioner and later earned her DNP. Jamie explains how time limits, metrics, and fragmented, symptom-by-symptom care pushed her to rethink how midlife women are treated, especially after her own perimenopause experience revealed a major healthcare gap. She describes Peri & Pause’s model as relationship-driven, evidence-based whole-woman care through the perimenopause/menopause lens, including proactive prevention, collaboration with other clinicians, and referrals when needed. Jamie discusses misinformation and clinician shaming around hormones, the need for better clinician education, core values like integrity and humility, and her vision for continued growth to meet ongoing demand. 00:00 Podcast Welcome 01:09 Jamie Nursing Origins 02:47 Becoming Nurse Practitioner 04:46 Healthcare System Friction 08:27 Perimenopause Wake Up Call 11:13 Seeing the Bigger Pattern 13:11 Biggest Care Gap 14:20 Founding Peri and Pause 18:25 Building Patient First Practice 19:21 Whole Woman Care Approach 20:20 Coordinated Care Promise 20:46 Preventive Deep Dives 21:56 Proactive Treatment Mindset 22:19 Patient Wins That Matter 23:12 Word of Mouth Growth 24:12 Building a Mission Business 25:41 Imposter Syndrome and Connection 26:57 Misinformation and Clinician Shame 30:00 Why Education Still Lags 31:13 Values Purpose and The Future 36:45 Closing Thoughts and Wrap Up
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#7
May 5 · 27 min
Breaking the Silence: Women's Healthcare Insights with Jaime Davis
In this Meet the Nurse Practitioner episode of Per and Pause, nurse practitioner Jaime Davis shares how her background in primary care and labor and delivery shaped her patient-centered approach and her focus on midlife women’s care. She discusses how perimenopause is often missed because symptoms can look like stress or anxiety, and highlights early signs such as brain fog, insomnia, word-finding difficulty, and menstrual changes influenced by hormone fluctuations like declining progesterone. Jaime recounts her own experience of years of severe pain after a traumatic C-section that was initially dismissed, later diagnosed as subcutaneous endometriosis and resolved with a short surgery, underscoring the importance of trusting your body and finding providers who listen. She explains her commitment to connecting symptoms, tailoring plans to patient goals, and helping women feel heard, supported, and empowered. 00:00 Meet Jaime Davis 00:54 Labor and Delivery Lessons 02:24 Path to Midlife Care 03:50 Why Perimenopause Gets Missed 06:47 Dismissed Pain Story 11:08 Finding the Real Cause 13:29 What Listening Really Means 15:27 Beyond Rigid Guidelines 16:56 Early Perimenopause Clues 17:06 Brain Fog Sleep Anxiety 19:46 Symptoms Are Connected 21:29 Menopause Education Gaps 23:45 Care After Dismissal 25:10 The Peri Pause Experience 26:15 Closing Thanks Farewell ------ This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives. Visit https://periandpause.com for more info
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#6
April 21 · 26 min
Empowering Women Through Midlife Transitions: A Conversation with Amanda Maingi
On Peri and Pause the podcast, host interviews women’s health nurse practitioner Amanda Maingi, who shares why she chose women’s health, her education at Georgetown, and how menopause and perimenopause received limited focus in training despite women spending a third of life in this stage. Amanda describes noticing gaps while working in a fast-paced traditional GYN clinic, where time constraints and protocol-driven care could miss the “whole woman” experience. She contrasts younger patients’ typically more straightforward visits with the complexity of midlife, highlighting under-research, life stressors, and chronic conditions. Common perimenopause symptoms often mislabeled as anxiety or depression include sleep disruption, heart palpitations, brain fog, irritability, overwhelm, and feeling out of control. The episode emphasizes validation, individualized high-touch care beyond algorithms, and addresses misconceptions that hormone therapy is inherently dangerous, stressing risk-benefit tailoring and comprehensive evaluation. 00:00 Welcome and Guest Intro 00:53 Why Womens Health 02:17 Academic Journey Highlights 04:09 Menopause Education Gap 05:24 Clinic Reality and Missing Care 08:57 Midlife vs Younger Patients 13:14 Symptoms Mistaken for Anxiety 17:43 Beyond Protocols Individual Care 19:34 Patch And Pill Problem 21:21 Telehealth Versus High Touch 22:56 Layered Whole Woman Care 26:03 Validation First Visit 28:42 Hormone Therapy Myths 30:07 New Patient Expectations 31:53 Outro And Sign Off 32:23 Recording The Closing Script 34:16 Final Takeaway Message ------ This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives. Visit https://periandpause.com for more info
- Transcript
#5
April 7 · 28 min
Meet Nurse Practitioner Nancy Chen: From Exercise Physiology to Midlife Women’s Hormone Care
In this episode of Peri & Pause - The Podcast, the second in the “Meet the Nurse Practitioner” series, the host interviews nurse practitioner Nancy Chen about her path from studying exercise physiology at Meredith College to working as a personal trainer, then becoming a nurse and moving into critical care, urgent care during the pandemic, and traditional primary care. Nancy explains how limited appointment times and “moral injury” pushed her toward specializing in perimenopause and midlife women’s health, after seeing patients struggle with symptoms, chronic disease changes, and feeling dismissed due to gaps in training. She emphasizes the importance of education, validation, realistic expectations, individualized treatment, and helping women feel heard and hopeful, including reviewing complex medication and supplement “cocktails” and supporting women through the fluctuating “moving target” of perimenopause. 00:00 Meet Nancy Chen 00:53 Exercise Physiology Roots 01:24 From Trainer to Nurse 01:52 Critical Care Wake Up 03:11 NP Path and Pandemic 04:22 Primary Care Time Crunch 05:58 Midlife Symptoms Puzzle 07:32 Personal Perimenopause Realization 09:42 Hormones and the Care Gap 15:23 What Patients Need First 16:22 Follow-Up Wins 16:59 Building the Foundation 20:59 Grace in Perimenopause 24:08 Finding Your Care Team 24:33 Medication Cocktail Reset 25:35 Message to Midlife Women 27:17 Thanks and Disclaimer
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#4
March 24 · 29 min
Navigating Menopause: A Conversation with Nurse Practitioner Kristen Nawyn
In this episode of The Peri and Pause podcast, Jamie Gallagher launch the “Meet the Nurse Practitioner” series by introducing Kristen Nawyn, a board-certified adult gerontology nurse practitioner and Menopause Society–certified menopause specialist. Kristin shares her path from ICU nursing through the pandemic to palliative care interests focused on goals, values, and quality of life, and explains how a family medicine preceptorship revealed the gaps in menopause care and shifted her career. She discusses limited menopause education in graduate school, her oncology research on chemotherapy-induced early menopause in premenopausal cancer survivors, and how sudden induced menopause differs from natural menopause. Kristin describes common “loss of self” experiences in perimenopause, the biology of hormonal fluctuations, the need for anticipatory guidance, and how she builds trust with patients, addresses long-term hormone therapy concerns, and advocates for whole-person, time-rich menopause care. 00:42 Podcast Intro and Guest Spotlight 02:08 Kristin’s Nursing Origin Story 03:10 What Palliative Care Really Is 04:35 From ICU to Nurse Practitioner 05:52 Discovering the Menopause Care Gap 08:43 Graduate School vs Real Menopause Care 10:37 Thesis on Chemo Induced Menopause 13:04 Losing Your Sense of Self 15:05 Natural vs Induced Menopause 16:52 Better Care for Cancer Survivors 17:46 Staying On Hormones 18:57 Risks Of Stopping 21:02 ICU Lessons On Aging 22:50 Earning Patient Trust 25:52 Midlife Women Carrying It All 28:24 You Are Not Crazy 29:00 Whole Person Menopause Care 30:43 Emotional Weight And Guilt 32:36 Closing Thanks And Wrap ------ This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives. Visit https://periandpause.com for more info
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#3
March 10 · 18 min
Decoding Menopause: Beyond Misunderstandings
Jamie, founder of Peri & Pause—the Menopause Center—and a board-certified nurse practitioner, explores why many women feel dismissed during perimenopause and menopause, emphasizing it’s often rooted in history and training rather than lack of care. She explains how menopause was long framed as a “normal” transition not requiring intervention, despite wide-ranging effects on brain, sleep, mood, metabolism, and cardiovascular health. Jamie highlights limited menopause education in medical training and how normal lab results can lead clinicians to default to stress or mood explanations. She details how the 2002 Women’s Health Initiative study—often misinterpreted, focused on older women and specific hormone formulations—drove widespread fear of hormone therapy, shaping practice for decades. She notes newer, more nuanced evidence is slowly changing care and previews upcoming episodes introducing the clinic’s nurse practitioners. 00:00 Why Women Feel Dismissed 02:14 Menopause Is Natural Not Simple 05:40 Training Gaps In Menopause Care 07:43 Defaulting To Stress And Labs 09:46 WHI Study Changed Everything 10:50 Who WHI Actually Studied 12:24 Hormone Types And Nuance Lost 14:05 Breast Cancer Risk Explained 15:31 Aftermath And Reassessment 19:23 Where Menopause Care Is Now 20:24 Next Series Meet The NPs
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#2
March 3 · 8 min
It’s Not “Just Stress”: How Perimenopause Affects Your Brain, Sleep, Mood & Stress Tolerance
The episode explains that while stress in midlife is real, many symptoms blamed on “stress” are actually driven by perimenopause physiology. The speaker describes how perimenopause and menopause affect far more than periods and hot flashes, impacting brain function, sleep, mood, energy, focus, and emotional regulation. She reframes perimenopause as a neuroendocrine transition, noting estrogen’s role in brain energy, neurotransmitters, sleep regulation, stress response, metabolism, and glucose use, and explains that early progesterone changes can worsen mood and sleep. Common experiences include unfamiliar anxiety, brain fog, word-finding issues, emotional reactivity, rage, and fatigue. She emphasizes that “normal” labs can be misleading due to hormonal fluctuations, and encourages symptom-based care, self-compassion, and preparation to advocate in healthcare in the next episode. 00:00 Stress vs Physiology 01:08 Band-Aid Advice 02:17 Perimenopause Brain Shift 03:43 Early Symptoms Explained 04:35 Reframing Stress Tolerance 05:12 Why Labs Look Normal 06:11 Symptom-Based Support 06:50 Recalibration Not Breakdown 07:46 Closing and Next Steps
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#1
February 17 · 9 min
Real Conversations About Perimenopause, Menopause, and Midlife
In the first episode, Jamie Gallagher, a nurse practitioner certified in menopause care, introduces a podcast focused on thoughtful, non-flashy conversations for women who feel something is off—especially those exhausted, confused, or told their labs look normal while they don’t feel normal. She describes common midlife experiences she sees in clinical practice—fatigue unrelieved by sleep, brain fog, weight changes, mood shifts, anxiety, and feeling unfamiliar in one’s body—and explains why these symptoms can feel scary, especially with family health histories or misinformation from online searches. Jamie emphasizes that not everything is menopause, that good clinicians listen and evaluate thoroughly, and that midlife women need context, language, validation, and clear explanations. She shares how gaps in her own medical training led her to research and synthesize scattered, sometimes contradictory information on menopause, shaping her clinical work and inspiring the podcast to widen access to these conversations. The show will cover perimenopause and menopause topics like hormones, brain health, metabolism, sleep, sexuality, identity, and emotional shifts, along with relationships, parenting, aging, grief, loss, finances, and empowerment, featuring solo episodes, colleagues, trusted experts, and real stories. She clarifies the podcast is educational and not personal medical advice, encouraging listeners to advocate for themselves, and closes by reframing midlife as a transition that deserves guidance and inviting listeners to subscribe, review, share, and follow the show on Facebook and Instagram. 00:00 Welcome: This Podcast Is for the Women Who Feel “Off” 00:55 What I Hear in the Exam Room: “I’m Doing Everything Right—So Why Do I Feel Like This?” 01:36 Dr. Google, Real Risks, and Why Not Everything Is Menopause 02:30 Why This Podcast Exists: Context, Language, and Being Heard 03:37 Meet Jamie: Menopause-Certified NP + Why I Started Digging Deeper 04:35 The Research Rabbit Hole: Scattered Science, Nuance, and Listening to Women 05:28 What This Show Is (and Isn’t): No Fixing, No Trends, No Panic 05:49 What We’ll Cover + Who You’ll Hear From 07:05 Important Disclaimer: Education, Not Personal Medical Advice 07:31 Midlife Isn’t Failure—It’s a Transition That Deserves Guidance 08:10 Your Invitation + Closing: You’re Not Alone, You’re Right on Time ------ This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives. Visit https://periandpause.com for more info
- Transcript
February 16 · 2 min
Trailer
Welcome to Peri and Pause, the podcast where midlife women get real answers about their bodies, their health, and what's actually changing because every woman deserves this conversation.
- Transcript

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