Perimenopause: The Missing Diagnosis

Perimenopause is one of the most misunderstood phases in a woman’s life—and too often, it’s missed entirely. Every day, I see women who have been told they’re “too young,” that their labs are “normal,” or that what they’re experiencing is simply stress or something psychological. And yet, they know something is changing. Perimenopause is not a steady decline. It’s a phase of hormonal unpredictability—where estrogen can fluctuate significantly, progesterone declines, and testosterone gradually shifts. These changes can drive a wide range of symptoms that may seem unrelated, but are deeply connected. Yet many women find their symptoms are addressed in isolation—often without a comprehensive view of their hormonal landscape. I believe we can do better. This is where the concept of midlife baseline screening becomes essential. By measuring hormones thoughtfully and at the right time, we can move from assumption to clarity—and from generalized care to a more precise, individualized approach. In this video, I walk through: – Why perimenopause is often overlooked – What is actually happening hormonally – The limitations of symptom-only care – The role of baseline screening – How to find a provider trained in perimenopause and menopause care My goal is simple: to help you better understand your body, and to ensure you are met with the level of care and expertise you deserve. If you’re navigating perimenopause, you are not alone—and there are answers. 💻 Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com We offer care across three convenient locations—in the vibrant Houston Museum District, the heart of Tanglewood/Piney Point, and in Cypress, serving Northwest Houston. For those who prefer remote access, we provide secure virtual medical care across Texas, California, and New Mexico. Coaching programs in perimenopause and menopause are available nationwide and globally. Our services are thoughtfully designed by women who understand your journey and delivered by menopause-certified professionals.

Testosterone is often misunderstood in women—and too often reduced to oversimplified or fear-based messaging. The reality is this: testosterone can be a safe and effective therapy for women—particularly for Hypoactive Sexual Desire Disorder (HSDD) and other symptoms of low testosterone—when it is dosed appropriately. And that’s the key. When dosing is right—meaning carefully adjusted for female physiology and monitored over time—women are not limited to a single option. They can choose the delivery method that fits their body and their life. In this video, I walk you through: 🌿 What testosterone actually does in the female body 🌿 Common symptoms of low testosterone 🌿 When therapy may be appropriate 🌿 The difference between FDA-approved testosterone products for men and the formulations commonly used in women 🌿 How dosing is approached in women (low, individualized, and not one-size-fits-all) 🌿 The pros and cons of different delivery methods, including gels, injections, and pellets We also touch on emerging clinical experience and ongoing research exploring pellet dosing in women, including work in collaboration with Baylor College of Medicine. Early observations suggest that, when dosing is appropriate, stable levels and low rates of side effects are achievable—and in some cases may compare favorably to the variability seen with topical therapies. This is not about one method being “right” and another being “wrong.” It’s about understanding that dose—not delivery—is what determines safety and outcomes. Testosterone is an important hormone in women. It affects libido, mood, energy, muscle, bone, and overall quality of life. We need more research. We need better education. And we need to move toward collaborative, patient-centered care—where women are informed, supported, and able to choose what works best for them. As always, hormone therapy should be individualized and guided by a qualified clinician. A must-watch video: Should Women Use Male Testosterone Products? | Real-Life Demo with Dr. Susan https://youtu.be/nQlrkWpZOAE Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com 💻 We offer virtual medical care in Texas, California, and New Mexico.

In this video, I talk about something that has quietly shaped my life—and continues to guide how I move through midlife today: learning how to truly listen to myself. This idea is deeply influenced by the work of Martha Beck—quieting the noise of expectations, stepping away from “shoulds,” and reconnecting with a deeper, more honest inner voice. I share three ideas that have become anchors for me: • Learning to recognize when something feels like a true “yes” or a clear “no” • Understanding how going against yourself creates tension and internal friction • Making small, aligned choices that shape how you feel—and who you become over time. When I began to listen—really listen—things started to feel simpler, calmer, and more clear. I also talk about the importance of stepping out of your everyday environment. Retreats, gatherings, and intentional time away create space to reconnect, reflect, and learn new ways of moving through this phase of life. This is also the foundation of the work I’m building right now, including my upcoming book and a recent video: Become Your Best Elder Self — One Choice at a Time LINK - https://youtu.be/fhgEepyXGfs Because the way you age is not accidental. It’s shaped—quietly and consistently—by the choices you make every day. Martha Beck, PhD — sociologist, author, and life coach https://marthabeck.com/

For many women, a history of breast cancer has meant an automatic “no” when it comes to menopausal hormone therapy. But is the story really that simple? In this video, we explore a more nuanced and evolving conversation—one grounded in decades of research, including the work of Avrum Z. Bluming, MD, and other leading experts who have closely examined the data on hormone therapy after breast cancer. Across multiple studies and reviews spanning over 40 years, the evidence paints a more complex picture. While certain risks—such as thromboembolism with oral formulations—are well documented, the long-held belief that hormone therapy universally increases breast cancer recurrence or mortality is increasingly being questioned. In fact, most studies have not shown an increase in breast cancer–related death, and only one trial demonstrated a limited increase in local (not distant) recurrence. At the same time, menopausal hormone therapy remains the most effective treatment for symptoms that deeply affect quality of life—while also offering potential benefits for cardiovascular health, bone strength, cognitive function, and longevity. So where does this leave us? This video is not about giving a one-size-fits-all answer. It’s about encouraging thoughtful, informed decision-making. It’s about moving beyond fear-based assumptions and toward individualized care—where risks and benefits are carefully weighed, and where women feel empowered to ask questions, seek multiple perspectives, and have meaningful conversations with their physicians. Because the most important takeaway is this: you deserve to be fully informed. Resources: Hormone Replacement Therapy After Breast Cancer: It Is Time Avrum Z. Bluming, MD LINK - https://bit.ly/4st0uji Menopausal Hormone Therapy for Breast Cancer Patients: What Is the Current Evidence? Sarah Glynne, MBBS, MSc, MRCP, MRCGP; James Simon, MD; Anthony Branson, FRCP; Stephen Payne, FRCS; Louise Newson, MBChB; Isaac Manyonda, PhD; Susan Cleator, PhD; Michael Douek, MD; Sasha Usiskin, MRCP; Jeffrey S. Tobias, MD; Jayant S. Vaidya, PhD LINK - https://bit.ly/41leKyt 💻 Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com

Regenerative medicine is one of the most talked-about areas in modern medicine — and also one of the most misunderstood. In this video, I explain several therapies that are often mentioned in the same conversation and clarify what they are, how they work, and what we currently know about them. Learning about these treatments can help us make wiser decisions about our health, our healing, and how we support our bodies as we age. In this video, I discuss the science and current understanding behind: • PRP (Platelet-Rich Plasma) — used since the 1990s in orthopedics, dermatology, hair restoration, and sexual wellness procedures. • Exosomes — tiny vesicles that act as cellular messengers, carrying proteins, RNA, lipids, and growth factors between cells. • Umbilical-derived growth factors — biologic regenerative products containing signaling molecules involved in tissue repair. • Stem cells — cells capable of differentiating into multiple cell types and releasing regenerative signals that support healing. • “Young blood” therapies — a term sometimes used when discussing regenerative products derived from younger tissues. • Plasmapheresis — a medical procedure that removes plasma from the blood and is used in certain autoimmune and toxic conditions. My goal in this video is to separate science from hype, bring clarity to a rapidly evolving field, and help you better understand the therapies that are often mentioned in conversations about longevity, healing, and regenerative medicine. When we understand the science behind these treatments, we gain something powerful — the ability to advocate for our health, ask better questions, and make informed decisions about our bodies and our wellbeing. 💻 Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com

If you’ve ever been dismissed, minimized, or given outdated advice about menopause — this video is for you. Every week in my clinic, I hear the same myths repeated to intelligent, capable women who simply want to feel like themselves again. Unfortunately, misinformation around menopause and hormone therapy is still everywhere — even inside medical offices. Today, I’m addressing 10 of the most common (and harmful) things women are told about menopause — and explaining what the science actually says. We’ll discuss: • “Hormone replacement is dangerous. Just take birth control pills.” • “You’re only 42 — you’re too young for menopause.” • “Your labs are normal, so it can’t be menopause.” • “You must wait a full year after your last period to start hormones.” • “You can’t start hormones after 60 — or you must stop at 60.” • “Hormones aren’t FDA-approved for heart disease or Alzheimer’s, so they don’t help.” • “You can’t take hormones if you have a family history of breast cancer.” • “Testosterone is only for men.” • “Testosterone is just for libido.” • “You can never take estrogen or progesterone after breast cancer.” Menopause care is nuanced. It’s individualized. And it should be rooted in evidence — not fear. I’ll walk you through what we know today about menopausal hormone therapy, testosterone therapy for women, timing, safety, and why so many women are still being told outdated information. You deserve clarity. You deserve options. And you deserve a provider who understands midlife physiology. Further Reading & Trusted Resources The Menopause Society www.menopause.org Dr. Louise Newson www.drlouisenewson.co.uk Instagram: @menopause_doctor Study referenced in this video: Effect of transdermal testosterone therapy on mood and cognitive symptoms in peri- and postmenopausal women: a pilot study Full paper: http://bit.ly/4tWR9S5 If this video helped you, please share it with a woman who needs better information. Subscribe for evidence-based education on midlife health, hormone optimization, and longevity. Because menopause is not the end of vitality — it’s the beginning of informed power. 💛 💻 Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com In-person and virtual appointments available.

At Complete Midlife Wellness Center, many women ask us if there is a GLP-1 option that doesn’t involve injections. In this video, I walk you through what truly matters: ✅ How oral absorption differs from injections. ✅ Why injectable GLP-1 medications are often more effective — and sometimes more affordable. ✅ Who is a good candidate for oral therapy, and who will likely need something stronger. 🌿 For women looking to lose about 10–20 pounds, oral semaglutide may be a thoughtful option. 🌿 For women seeking more significant weight loss — 15–50+ pounds — injectable therapies such as tirzepatide typically provide greater metabolic impact. But here is what we believe deeply: Medication is not the foundation. Hormone balance is. If estrogen, testosterone, insulin resistance, and cortisol are not addressed, weight loss in midlife becomes an uphill battle — no matter which medication is used. That’s why our 12-week Holistic Medical Weight Optimization Program begins with physiology. We layer hormone optimization, advanced nutrition, strength-focused movement, accountability, and medication. This is not a shortcut. It’s structured, medically guided care designed for midlife women. We offer both in-person and remote visits in Texas and California via telemedicine. If you’re ready for a comprehensive approach — we’re here. 💻 Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com

At Complete Midlife Wellness Center, many women ask us if there is a GLP-1 option that doesn’t involve injections. In this video, I walk you through what truly matters: ✅ How oral absorption differs from injections. ✅ Why injectable GLP-1 medications are often more effective — and sometimes more affordable. ✅ Who is a good candidate for oral therapy, and who will likely need something stronger. 🌿 For women looking to lose about 10–20 pounds, oral semaglutide may be a thoughtful option. 🌿 For women seeking more significant weight loss — 15–50+ pounds — injectable therapies such as tirzepatide typically provide greater metabolic impact. But here is what we believe deeply: Medication is not the foundation. Hormone balance is. If estrogen, testosterone, insulin resistance, and cortisol are not addressed, weight loss in midlife becomes an uphill battle — no matter which medication is used. That’s why our 12-week Holistic Medical Weight Optimization Program begins with physiology. We layer hormone optimization, advanced nutrition, strength-focused movement, accountability, and medication. This is not a shortcut. It’s structured, medically guided care designed for midlife women. We offer both in-person and remote visits in Texas, New Mexico, and California. If you’re ready for a comprehensive approach — we’re here. www.completemidlifewellness.com

Decreased sexual desire is the most common concern I hear about changing sexuality during perimenopause and menopause. In this video, I discuss how we diagnose low libido, what may be contributing to it, and the treatment options that can genuinely help. You may hear the term Hypoactive Sexual Desire Disorder (HSDD). This is a medical diagnosis used when a persistent drop in desire creates distress for a woman or strain within a relationship. Evaluation involves a thoughtful clinical conversation, review of health history, and often the use of a validated tool such as the Decreased Sexual Desire Screener (DSDS). The reasons desire changes are rarely simple. They often include a combination of: ✔️ hormonal shifts involving estrogen, progesterone, and testosterone ✔️ changes in brain chemistry and stress pathways ✔️ sleep and energy disruption ✔️ relationship or emotional dynamics ✔️ medical conditions or medication effects I walk you through five categories of treatment, combining published science with what I’ve learned from caring for thousands of midlife women — including which approaches tend to work best in real life. Most importantly, low desire is not something you are required to accept as an unavoidable part of aging. If it matters to you, there are meaningful, evidence-based ways to make it better. 📚 Get my best-selling book, Sexually Woke: Awaken the Secrets to Your Best Sex Life in Midlife & Beyond: https://amzn.to/3rm47IU 💻 Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com

In this video, I review sermorelin, a growth hormone–elevating peptide, and explain where it fits physiologically within the growth hormone axis. I begin by defining what peptides are and what is meant by a growth hormone–elevating peptide, then clarify what sermorelin is — and what it is not. HOW SERMORELIN WORKS, Sermorelin is a synthetic analog of growth hormone–releasing hormone (GHRH). It acts at the level of the pituitary gland to stimulate endogenous, pulsatile growth hormone secretion, rather than providing exogenous growth hormone. I discuss the downstream effects of growth hormone signaling, including its role in: ❇️ sleep regulation ❇️ bone metabolism ❇️ muscle and body composition ❇️ skin integrity ❇️ cognitive function I also address a common question: Why don’t we simply administer growth hormone? This section reviews the physiologic risks of bypassing hypothalamic–pituitary regulation, including suppression of natural hormone signaling and elevations in IGF-1. Finally, I conclude with an overview of clinical considerations surrounding administration, including dosing, timing, and cost. My goal is to help you understand where sermorelin fits within normal hormone physiology, so you can make informed, thoughtful decisions about your care. If you would like a physician-guided evaluation, you can visit us at Complete Midlife Wellness Center https://completemidlifewellnesscenter.com