Brain fog, weight gain, mood changes, disrupted sleep, and a fading sense of feeling like yourself can all become part of the perimenopause experience. But why do these changes happen—and why are so many women still struggling to find informed care?

In Episode 347 of Money Matters, Christopher Hensley, RICP, CES, speaks with Dr. Susan Hardwick-Smith, a nationally recognized OB-GYN, certified menopause practitioner, author, and founder of Complete Midlife Wellness Center.

Dr. Hardwick-Smith explains the hormonal transition from the fertile years through perimenopause and menopause, including how changing estradiol, progesterone, and testosterone levels may affect the brain, sleep, metabolism, muscle, mood, and sexual wellness. She also discusses the continuing debate around menopausal hormone therapy, why specialized menopause training matters, and how women can begin planning for a longer health span.

In this conversation:

- What perimenopause is and why symptoms vary
- Brain fog, mood, memory, and sleep changes
- Metabolism, insulin resistance, and midlife muscle loss
- Sexual wellness and the role hormones may play
- Questions surrounding the 2002 Women's Health Initiative reporting
- How to find a qualified menopause practitioner
- Practical steps women can begin taking in their 40s and 50s

### Chapters

00:00 Cold open: hormones and brain function
00:26 Welcome and episode introduction
02:08 The three hormonal phases of a woman's life
03:57 How perimenopause may affect the brain
05:36 Why symptoms vary from woman to woman
07:41 Hormone therapy and the 2002 WHI debate
12:25 Metabolism, muscle loss, and midlife weight changes
15:19 Sexual wellness, desire, and testosterone
18:35 Who may benefit from treatment and finding informed care
20:51 Advocating for yourself in the medical system
22:39 Why Complete Midlife Wellness Center was created
24:08 Create Her and planning for a longer health span
26:33 Three practical steps for women in midlife

### Resources mentioned

- Complete Midlife Wellness Center: https://completemidlifewellnesscenter.com/
- The Menopause Society practitioner directory: https://menopause.org/
- Dr. Hardwick-Smith's forthcoming book: Create Her: Aging Into the Healthiest Version of Yourself

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This episode is for educational purposes and is not personal medical advice. Treatment decisions should be made with a qualified healthcare professional. Medical interpretations and treatment perspectives expressed in the conversation belong to the guest.

#Perimenopause #Menopause #WomensHealth @drsusan