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Menopause Masterclass: When "Normal Labs" Are Lying to You

Dr. Mary Claire Haver, MD

20,034 views

In this episode of unPAUSED, Dr. Mary Claire Haver delivers a solo masterclass on the lab work every woman in perimenopause, menopause, and post menopause should understand and request from her doctor. Dr. Haver explains why standard annual labs, built for a general population, routinely miss the specific hormonal, metabolic, cardiovascular, and bone related changes that happen during the menopause transition, and she walks through seven categories of testing that give a far more complete picture of a woman's health.

She starts with an advanced lipid panel, explaining why LDL alone is not enough and why ApoB, Lp(a), and small dense LDL particles matter for women whose cardiovascular risk shifts as estrogen declines. She covers fasting glucose and fasting insulin together, showing how the HOMA IR score can reveal insulin resistance long before a diabetes diagnosis. She addresses bone health in depth, arguing that waiting until age 65 for a baseline DEXA scan is far too late given how much bone density can be lost in the years surrounding menopause, and she details safe vitamin D supplementation ranges and optimal target levels.

Guest links:
The ‘Pause Life https://thepauselife.com/?srsltid=Afm...
The 'Pause Wellness https://thepausewellness.com/
Dr. Mary Claire Haver (Instagram) Instagram: drmaryclaire
Dr. Mary Claire Haver (YouTube) @drmaryclaire
The Pause Life by Dr. Mary Claire Haver (Facebook) https://www.facebook.com/drmaryclaire...
The Menopause Quiz (The Pause Life) https://thepauselife.com/pages/new-me...
The Menopause Empowerment Guide (The Pause Life) https://thepauselife.com/pages/menopa...
Lab Test Checklist (The Pause Life) https://thepauselife.com/pages/lab-ch...
Clinicians List (The Pause Life) https://thepauselife.com/pages/recomm...

Books
“The New Menopause,” by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-...
“The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again,” by Dr. Mary Claire Haver https://www.amazon.com/New-Perimenopa...

For full show notes, please visit: https://bit.ly/unPAUSEDHowtoReadYourLabs

00:00:00 – Why Standard Bloodwork Misses Menopause
00:04:12 – Advanced Cholesterol Tests Every Woman Needs
00:09:04 – Hidden Insulin Resistance & Blood Sugar
00:13:29 – Bone Density & Vitamin D Before It's Too Late
00:23:07 – Thyroid Tests That Mimic Menopause
00:24:44 – Iron Deficiency & Heavy Periods
00:29:10 – When Hormone Testing Actually Helps
00:32:10 – The Inflammation Test to Ask For
00:39:20 – How to Advocate for Yourself at the Doctor
00:41:35 – "You're Too Young for Perimenopause"
00:43:26 – Birth Control vs. Hormone Therapy
00:44:31 – When Your Doctor Says Hormones Are Too Risky
00:47:14 – Why "Normal" Symptoms Still Deserve Treatment
00:49:22 – Weight Gain Isn't Just Calories
00:53:08 – The New Perimenopause & Final Takeaways
00:55:12 – Finding a Menopause-Informed Doctor
00:56:07 – Why Life Can Get Better After Menopause

Never miss an episode—sign up for The ’Pause Life Newsletter: https://thepauselife.com/pages/newsle...

Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The ’Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.

20 Comments

@drmaryclaire Creator 2 months ago Pinned

Thank you for watching! Did you enjoy the episode? If so, please consider subscribing to our channel so you never miss an episode! xoxo, Mary Claire

@TheRawDose 2 months ago

Key Points to Remember After You Watch The Video. (Thank Me Later):
1. Standard annual medical tests often miss important changes that happen to women during the menopause transition (0:00).

2. You should ask for an advanced lipid panel that includes ApoB and Lp(a) because standard cholesterol tests might not show your true heart risk (4:12).

3. You need to check your fasting insulin along with your glucose to calculate a HOMA IR score, which helps find hidden insulin resistance (9:04).

4. Do not wait until age 65 for a bone density scan, because bone loss often happens fastest right around the time of menopause (13:29).

5. Aim for vitamin D levels between 60 and 100 to support your bone health, as many women have levels that are too low (13:29).

6. Make sure to get your thyroid checked with a TSH, free T4, and free T3, because thyroid problems can feel exactly like menopause symptoms (23:07).

7. If you have heavy periods or feel very tired, ask your doctor to test your ferritin level to check for low iron stores (24:44).

8. Blood tests for hormones like estradiol are only helpful in specific situations and are not usually needed to diagnose perimenopause (29:10).

9. A high sensitivity C reactive protein test is a good way to see if you have chronic inflammation in your body (32:10).

10. You deserve to be heard, so if a doctor dismisses your concerns, try using specific scripts to explain that your symptoms are affecting your daily life (39:20).

11. You can look for menopause informed doctors or use trusted virtual clinics if your current provider is not able to help you (55:12).

12. Perimenopause and menopause are normal life stages, but you do not have to just suffer through them without support or treatment (47:14).

13. Understanding your body and its changes can help you thrive in the second half of your life (56:07).

14. You can use resources like the menopause quiz and laboratory checklists to feel more prepared for your next doctor visit (42:27).

I hope I can get to 1 million subscribers soon. 💪💪💪

@sheliawilliams4982 12 days ago

My ldl has gone crazy. Post menopause..

@padma.9999 1 month ago

Run from the doctor who is not qualified enough. Find the good ones, less stress❤

@Dbj007 2 months ago

I have had a hysterectomy years go and I have had anxiety attacks my PCP said “it’s stress go for walks and lower the caffeine and was quick to give me depression pills”. No labs no blood work…not even asked if I wanted to see a therapist or hormones were ok. I never went back to see that doc
Called my OBGYN and sure enough low on hormones and high cholesterol levels

@queen-b9414 2 months ago

I wish doctors actually cared about each patient as an individual. I sent a message to mine before my yearly and requested insulin, A1c, ferritin to be added to my labs. They only added A1c and then charged me extra for having to discuss my A1c lab that was at 5.7 Our healthcare system is so broken.

@breewebster6078 1 month ago

Keep up the amazing work you are doing! I always learn something and can now advocate for myself. 👏🎬

@jjbailey3972 2 months ago

Another great, informative episode! Thank you Dr Mary Claire💕

@yanyperez3609 2 months ago

I would NOT have the patience to convince or educate my doctor…lol
As I hear you and read comments, I feel SO blessed to have such a wonderful PCP. He’s been on top of mammograms, DEXA, colonoscopy, any/every blood work I ask for, HRT prescriptions, etc… Thank you for the excellent content! ❤

@thelaundress11 2 months ago

Amazing. Wonderful information. I have passed this to everyone.

@kr1221E 2 months ago (edited)

Perimenopause nearly took me out 💀 . Thankfully I am still here. I bled heavily in very late perimenopause, I'd been bleeding months lightly but feared going to the GP because of all the cancer propaganda I believed at the time. I'd decreased my BI progesterone to 100mg daily as the 2 weeks on 2 weeks off was destabilising. I had to have a hysteroscopy. The medics meant well, they looked after me, but all this was not needed. I only got my education 2 years ago, here in the UK at 58. I am glad you said about the bleeding Dr MCH because I blamed myself for "tinkering" with my HRT back then, now it only happens as I struggle to get levels up due to poor absorption but I am on the case. Now that I am educated I went and saw a Dr who I know whose knowledge is in this era. I am Gen X, and I still think too many gen Xers have the boomer mentality around this, because it does not seem to land when I talk about the advances in menopause knowledge.

@soggymoggytravels 2 months ago

Thank you!

@wendydefranzo4471 2 months ago

Great information!

@CosmoCookie1 2 months ago

They only got ten minutes but they sure do overcharge for those ten minutes that they spend not listening to their patient.

@DE_123 3 weeks ago

Where is your clinic 😅

@aprillikins 1 month ago

Dr. Mary Claire, can you please interview Professor Bob Yang, a leading urological surgeon in Berkshire with expertise in complex and recurrent urinary tract infections and the Uromune UTI vaccine widely and successfully used in Europe? He treats many women in the US with recurrent UTIs and we need Uromune available in the US.

@PeriMenopauseUnfiltered 2 months ago

Symptoms of thyroid dysfunction may mimic perimenopause, so first rule out thyroid issues. and yes ApoB, Lp(a), and small dense LDL and also estradiol (LC/MS) and testosterone levels is required to rule out the peri menopause signs,

@sheriplatte1151 1 month ago

Have you seen the study that showed a statistical error in the recommendation for vit D? The 600 iu is significantly too low; the error shows 8,800 iu is closer to get the majority of the population therapeutic. Thoughts?