OpenTube

Perimenopause Is Real: What Every Woman Needs to Know

Dr. Kelly Casperson, M.D.

8,838 views

Are your hormones a mystery? You’re not alone. In this episode of You Are Not Broken, Dr. Kelly Casperson sits down with WHNP Jackie Piasta to unpack the truth about perimenopause — the misunderstood phase that often starts in your 30s.

We break down symptoms, bust myths, and explain how hormonal changes like estrogen dominance and progesterone decline can affect everything from migraines to mood to long-term health risks. Whether you’re curious about birth control as a treatment, unsure if you’re entering perimenopause, or just looking to better understand your body — this conversation is for you.

🔗 Referenced Studies & Resources:
-- Brinton RD et al. Perimenopause as a neurological transition state. Nat Rev Endocrinol. 2015;11(7):393-405.
-- Wu B et al. Trajectories of Blood Lipids Profile in Midlife Women. J Am Heart Assoc. 2023;12(22):e030388.
-- Wu B et al. Trajectories of Blood Lipids Profile in Midlife Women. J Am Heart Assoc. 2023;12(22):e030388.
-- SWAN Study: Lipid trajectory insights through the menopausal transition
-- SWAN Study: Lipid trajectory insights through the menopausal transition

Jackie Piasta on Social:
Instagram: jackiep_gynnp
https://www.mymonarchhealthco.com/

Chapters
00:00 Understanding Perimenopause: Myths and Realities
03:10 The Importance of Hormonal Awareness
06:08 Navigating Symptoms and Treatment Options
08:52 The Role of Age in Perimenopause
12:10 The Impact of Hormonal Fluctuations
14:58 The Need for Comprehensive Care
18:04 The Science Behind Ovarian Function
21:05 Exploring the Role of Testosterone
24:05 Living Vibrantly Through Menopause
25:38 Understanding Estrogen Dominance
32:02 Navigating Perimenopause Treatment Options
35:32 The Roller Coaster of Hormonal Changes
38:50 The Two Stages of Perimenopause
41:55 The Role of Birth Control in Perimenopause
46:28 The Impact of Fluctuating Hormones
49:06 Accelerated Health Risks in Perimenopause
50:46 Understanding Perimenopause and Its Impact
57:38 The Role of Hormones in Women's Health
01:03:23 The Connection Between Pregnancy and Menopause
01:09:12 Navigating the Future of Women's Health

🔎 Keywords: perimenopause, menopause, hormone therapy, estrogen dominance, birth control, migraines, women's health education

Subscribe: @kellycaspersonmd

Dr. Kelly Casperson is a board-certified urologic surgeon, sex educator, and CEO of The Casperson Clinic, specializing in hormones, sexual health, and midlife wellness. This channel is your go-to resource for science-backed insights on intimacy, desire, and thriving in midlife.

Through expert advice and candid conversations, Dr. Kelly helps women overcome myths about sexual health, demystify hormones, and create fulfilling relationships. Whether you’re navigating menopause, seeking to improve intimacy, or simply want to prioritize your health, this channel offers practical tips to help you live confidently and vibrantly.

Fix Your Sex Life with the book You Are Not Broken: Stop “Should-ing” All Over Your Sex Life – https://a.co/d/h8SOIrV

#youarenotbroken #drkellycasperson #hormonetherapy

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20 Comments

@butyoulooksohealthy-fibrom920 1 year ago

I started peri at 37. Told I was too young and was refused help. Hit menopause at 46. I never skipped periods. They just stopped. Found out I have osteoporosis at 48. I was a heavy weightlifter. I’d love to sue all of the bullshit doctors that gaslit me!! They ruined my bones!!

@Millennial86JMR 1 year ago

I'm in Perimanapause 38 years old. (Millennial) Started at age 36. Getting my Rx filled tomorrow for HRT estrodiol and progesterone...thank God!!! I have been losing my mind and gaining 50 pounds and constantly waking up soaked in sweat. I'm thankful for my functional medical doctor who believed me without question and got me the help I deserve. All women deserve this help! 💯💖💖

@JustDee7 1 year ago (edited)

Gen X- I’m 45 and I’ve been gaslighted for the last 10 years or more . Your podcast has given me courage to make my own decisions on my health and wellness. We’re all brainwashed to believe that all hormones give you cancer. And when everyone around you is getting breast cancer that are “estrogen” based well we get told HRT BAD , it’s such an injustice.

@michellewilson7868 10 months ago

A while ago, I shifted my mindset for my farm animals and pets to "Thriving not just Surviving" after lots of people were always poo-pooing my extra efforts to make their lives great. Now in response to "they don't need that" I just casually say, "We focus on Thriving not just Surviving for all our animals." It's an immediate change in the tone of the conversation. Because it makes so much sense.
For a long time I was barely Surviving with hormone issues. I recently adopted the same mentality for myself and I'm now working toward Thriving not just Surviving. Big thank you to all the doctors on YouTube sharing their wealth of information on women's health!

@allier.9193 1 month ago

I’m 37 and I feel like I am on the verge of dying most days I’m so overwhelmed fatigued severally anxious and depressed. I asked to have my hormones checked they say I’m too young

@ginnyvagher106 6 months ago

42 in perimenopause. I wanted to do something about my symptoms when I was 40. I was told by OBGYN I was too young.
Thankful my oncologist referred me to a urologist 2 weeks ago. Got prescribed progesterone and testosterone gel. I can feel a shift. Also, had double mastectomy going on 8yrs ago due to breast cancer.
Thankful for HRT and looking forward to the future for women💪

@tamarasonmez 1 year ago

One big issue is…”regular” doctors that take insurance will not prescribe and are not educated or experienced with HRT. Then if you seek out a specialist or functional or non insurance Dr etc. they charge an unrealistic amount of money. $2500 for the year…$500 or $400 a Visit…$200 for follow ups. With peri meno needing so much adjusting of hormones etc. how can a normal regular woman afford help.

@MoonGoddess0323 1 year ago

The gatekeeper is a larger ethical issue. If women are not being listened to the problem will continue.

@karissaquiles 1 year ago

I’m 44 and I’m in perimenopause. I’m thinking I’ve started to have some symptoms since my mid 30s or even before and I didn’t realize that I needed to talk to somebody. I thought I was just getting old. Can you please talk about women that are in perimenopause with horrible symptoms but have never being pregnant.

@JustDee7 1 year ago

This is an amazing and validating conversation, thank you!

@brooke0130 1 year ago

I am 44 in perimenopause. I adjust my estradiol according to how I feel so some weeks I need more than others. No one knows our body more than we do. Getting on estradiol has changed my life. I am now starting to add in low dose testosterone. So far I am feeling better!

@sweetcaroline5982 11 months ago (edited)

Thank you so much for posting this. As a 39 year old…. This made me feel so validated and much less crazy. I the “tamagotchi” millennial you described who is data driven and being dismissed! So many things you mentioned described what I’ve been through!

@cyndi01 1 year ago

I love Kelly, she’s no nonsense, brilliant and a ton of fun!

@Dee-rg9yb 1 year ago

Thanks for covering Perimenopause!!

@lalainemoreira9729 1 year ago

Thank you for your info at the fda panel as well 👏👏👏

@limeladybug 3 months ago

59:30 that is so interesting that you say this because I also feel that I went into perimenopause after having babies at 34 & 36. I'm not exactly sure which one did it because I had really bad postpartum depression after my second baby and developed reactive hypoglycemia. Then after my third baby, my cholesterol suddenly went up for no apparent reason and I have not been able to lose a single pound of the weight I gained during pregnancy- even now, a year and a half after giving birth- which is not normal for me at all. I've always been able to lose weight pretty easily when I tried.

@karissaquiles 1 year ago

Thank you for all this great information.

@saranieuwenhuis 9 months ago

Thank you for this! It explains a lot of what I'm going through.

@lonenugget4301 10 months ago

Currently 46. Anxiety hit at 32 and gradually got worse, then tinnitis and heart palpations started at 38, followed by shorter periods and dry eyes at 40/42. So, looking back I think I've been in Perimenopause since my early 30s GP said I was too young, so I wasn't provided the option for MHT until I pursued it with a gyn more recently. Now feeling much better.