unPAUSED with Dr. Mary Claire Haver

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Sara Reardon, board-certified pelvic floor physical therapist, founder of The Vagina Whisperer, and author of Floored, to talk about the muscles 68% of postmenopausal women say no one ever taught them they had. Nearly 1 in 3 women lives with a pelvic floor disorder — urinary leakage, prolapse, pain with sex — and the US spends over $20 billion a year managing it rather than fixing it, while women are offered a device, surgery, or “just live with it.” Dr. Reardon explains why leaking isn’t just part of being a woman, why diapers aren’t your destiny, and why these symptoms are treatable at every age.Dr. Reardon walks through what happens at a pelvic floor PT appointment (you can self-refer in every US state, covered by insurance), why over 50% of women do Kegels incorrectly — and why Kegels alone were never the answer — the difference between a weak and a too-tight pelvic floor, and stress vs. urge incontinence. They dig into night-time…

In this episode of unPAUSED, pulled from the archive because it’s one worth hearing again, Dr. Mary Claire Haver sits down with Dr. Rachel Rubin, board-certified urologist, nationally recognized expert in sexual medicine, assistant clinical professor of urology at Georgetown University, and a lead advocate behind the 2025 American Urological Association guidelines on genitourinary syndrome of menopause. The conversation starts with the number that explains everything: three training programs in the last three years even acknowledge women’s sexual health — men have more than 27. The reason your doctor doesn’t know how to talk to you about libido, arousal, orgasm, or pain is that no one ever taught them.Dr. Rubin delivers the anatomy lesson medicine skipped — why the clitoris and penis are the same tissue, why the cervix is triply innervated despite being taught as nerve-free, and why “my orgasm changed after my hysterectomy” is biology, not psychology. They cover why sex should never hurt and pain always…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with entrepreneur Mark Cuban, cofounder of the Mark Cuban Cost Plus Drug Company, to unpack the estrogen patch shortage and why so many women in perimenopause and menopause struggle to find and afford hormone therapy. Holding up her own patch, Dr. Haver asks the question her patients keep asking: why is this so hard to get? Mark explains why the shortage hit so hard — patches require specialized manufacturing that pills don't, demand surged after the black box warning was removed, and supply couldn't keep up — plus how Cost Plus Drugs has worked to buy every patch manufacturers can produce, and who gets served first when a generic drug runs short.Then they take apart how drug prices are really set: how pharmacy benefit managers (PBMs) decide what your insurance covers, how rebates drive list prices higher, and why a handful of conglomerates now own the insurer, the pharmacy, the PBM, and the physician practice all at once. They compare what a…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Pamela Brown, CNN anchor and chief investigative correspondent, and host of the network's new women's health streaming series Body Language by CNN — born from an experience Pamela nearly kept hidden. In the same year she lost her mother, while covering the White House, she was blindsided by postpartum OCD: intrusive thoughts that grew louder and scarier, hidden from everyone — including her husband — while she reported live on air. Dismissed when she flagged the highest score on a postpartum screening form, she finally found her own diagnosis through an article online, and turned the experience into an eight-part series covering perimenopause, GLP-1s, egg freezing, PCOS, thyroid disease, the fourth trimester, and Alzheimer's.Pamela and Dr. Haver dig into what the series uncovered: why intrusive thoughts are not psychosis — and why that distinction matters so much for new mothers — with Dr. Haver sharing her own postpartum intrusive thoughts as…

In this episode of unPAUSED, recorded on location at the Aspen Ideas Festival, Dr. Mary Claire Haver sits down with Dr. Trisha Pasricha, neurogastroenterologist at Beth Israel Deaconess Medical Center, assistant professor of medicine at Harvard Medical School, and author of the new book You've Been Pooping All Wrong. Women in perimenopause and menopause who describe bloating, new constipation, or digestion that suddenly feels unfamiliar are often told it's stress or age — Dr. Pasricha explains the real biology, starting with the estrogen receptors inside the gut's own nervous system, and makes the case for treating the gut as a second brain rather than plumbing. She breaks down why IBS affects women about twice as often as men, and why women with gut pain are so often told it's all in their heads — in her words, it's not the stress causing the symptoms, it's the symptoms causing the stress.They cover the less obvious causes of bloating — including pelvic floor dysfunction — accidental bowel leakage after…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Erica Kelly, board-certified dermatologist, Clinical Professor at the University of Texas Medical Branch, and founder and director of UTMB's Cosmetic Dermatology Division and this time it's the practical half: sunscreen, routines, treatments, and hair. Dr. Kelly settles the questions filling everyone's feed — chemical vs. mineral sunscreen, whether the endocrine-disruption fears are backed by evidence, why some filters are banned in the US but not Europe — and explains why the best sunscreen is simply the one you'll actually wear, every day, including the spots everyone forgets: scalp, ears, and lower lip. Mary Claire also shares her own recent diagnosis: a squamous cell carcinoma on her nose — which Dr. Kelly removed.Guest links:- Dr. Erica Kelly at UTMB Health Aesthetics https://utmbhealth.com/aesthetics/about/erica-kelly- Dr. Erica Kelly (UTMB Health) https://doctors.utmbhealth.com/profile/005428Recommended Books:- "The…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Erica Kelly, board-certified dermatologist, Clinical Professor at the University of Texas Medical Branch, and founder and director of UTMB's Cosmetic Dermatology Division — and the first physician who ever connected the dots for Mary Claire between estrogen, collagen, and what happens to women's skin in midlife. Dr. Kelly explains why so many women feel their skin change almost overnight in their 40s and 50s — the sudden dryness, sensitivity, sagging, easy bruising, and acne all at once — and the mechanism behind it: women lose around 30% of their skin's collagen in the first five years after menopause, while estrogen receptors throughout the skin lose the hormone that kept the barrier, moisture, and elasticity working. Dr. Kelly walks through what's really happening layer by layer — why skin gets rough and pores dilate, why moisturisers you've used for years suddenly cause reactions, why acne and wrinkles show up together, the truth…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Gabrielle Lyon, board-certified family physician, founder of the Institute for Muscle-Centric Medicine, and bestselling author of Forever Strong — this time with the practical roadmap for building muscle in your 40s, 50s, 60s and beyond. Dr. Lyon explains why your first meal of the day matters most and why 30–50 grams of protein at that meal can change your body composition on its own. She breaks down anabolic resistance — why the diet and training that worked at 20 stops working at 58 — and the research showing it's reversible: women over 60 got no muscle response from 15 grams of protein, but at 30 grams responded just like 20-year-olds.They get specific: what a 50-gram breakfast looks like, why two eggs won't stimulate aging muscle, how essential amino acids and creatine fill the gap, why the protein RDA is a floor rather than a target, the truth about red meat and saturated fat, the honest state of the evidence on…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Gabrielle Lyon, board-certified family physician, founder of the Institute for Muscle-Centric Medicine, and bestselling author of Forever Strong, to explain why skeletal muscle — not body fat — determines how well women age. Dr. Lyon shares the case that changed her career: a patient in her mid-fifties who had done everything she was told — dieting, cardio, the food pyramid — yet showed signs of accelerated brain aging. The problem wasn't her fat. It was her muscle.Dr. Lyon explains why muscle is the body's largest site for glucose disposal — meaning low muscle mass can cause insulin resistance and prediabetes even in lean women — and why muscle quality, not just quantity, drives the metabolic dysfunction usually blamed on obesity, yet still isn't measured in routine care. She and Dr. Haver dig into why 60–70 grams of protein a day isn't enough to protect muscle through perimenopause and menopause and why women should aim for closer to 100…

In this solo episode of unPAUSED, Dr. Mary Claire Haver tells the truth about hair loss in women over 40 — a medical condition with real, identifiable causes, not a vanity complaint to be dismissed as stress or aging. She breaks down the biology of the hair growth cycle and the hormonal mechanism driving midlife thinning: as estrogen declines, androgens like DHT take over at the follicle, shrinking it with every cycle. She walks through the five most common causes of hair loss in midlife women — female pattern hair loss, telogen effluvium (including the dramatic shedding triggered by illness, surgery, stress, and rapid weight loss on GLP-1 medications), iron deficiency, thyroid dysfunction, and nutrient deficiencies and medications — plus the red flags, like bald patches, a receding hairline, or scalp scarring, that need a dermatologist immediately.Dr. Haver then details exactly how to advocate for yourself: the full lab workup to request (and why ferritin must be checked even when standard blood counts look…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Melinda French Gates, philanthropist and founder of Pivotal, to talk about her call for a "menopause revolution" — including the $215 million in new funding for women's health she announced in her New York Times essay, bringing her total investment in women's health to more than $600 million in two years. Melinda opens with the numbers driving her urgency: nearly one in three women over forty has menopause symptoms severe enough to disrupt her life, only about one in four gets treated, fewer than a third of OB-GYN training programs teach menopause at all, and just five cents of every dollar spent on medical research goes to women's health.Melinda shares her own story — how, despite what she calls unbelievable privilege and access to the best health care in the world, it took three doctors to get the right care for her symptoms, and how chronic insomnia and brain fog left her doubting herself walking into meetings with world leaders and CEOs.…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Mohit Khera, board-certified urologist and Professor of Urology at Baylor College of Medicine, where he holds the F. Brantley Scott Chair in Urology, to tell women the truth about testosterone — the hormone women actually make more of than estrogen, yet still cannot access in a single FDA-approved formulation.Dr. Khera explains why testosterone is one of the most biologically active hormones in the female body, with receptors in the brain, heart, bone, muscle, and genitalia, and why the research to prove its full benefits for women has simply never been funded. He walks through what low testosterone really looks like, how to get tested properly, why women with low libido are so often handed an SSRI that makes things worse, the truth about pellets, creams, and injections, which side effects are reversible and which are not, and the red flags to watch for when looking for a prescriber. He also shares why sexual dysfunction is a couple's…

This episode of unPAUSED was recorded live at the Wiltern Theater in Los Angeles in front of an audience gathered to talk about perimenopause, menopause, hormones, sex, brain health, and bone health. Dr. Mary Claire Haver is joined on stage by Dr. Rena Malik, a board certified urologist, pelvic medicine specialist, and sexual health expert, for a wide ranging conversation about what is actually happening in women's bodies during the menopause transition, and what every woman navigating midlife health should know.The conversation moves through the zone of chaos that is perimenopause, the hormonal unpredictability behind mood changes, sleep disruption, brain fog, and rising inflammation. Dr. Haver traces how estrogen loss drives increases in cholesterol, insulin resistance, and cardiovascular risk, and explains why the fastest rate of bone loss happens in perimenopause, two years before a woman's final period, making a bone density baseline in your forties, not your sixties, the smarter move against…

What if weak bones and muscle loss aren't just "normal aging" but the result of decades of misinformation? In this episode double board-certified orthopedic surgeon Dr. Vonda Wright joins Dr. Mary Claire Haver to shatter the myth that frailty, fractures, and decline are inevitable for women in midlife.Dr. Wright explains why women can lose up to 20% of their bone mass in just five years after menopause—and more importantly, what we can do to prevent it. She reveals how stress, inadequate nutrition, and neglecting strength training and hormonal health create the very outcomes we've been taught to accept as unavoidable.From the "musculoskeletal syndrome of menopause" that affects 70-80% of women (yet most doctors never discuss) to the science of building bones through strategic lifting, Dr. Wright provides the blueprint for aging with power instead of resignation.Guest links:Dr. Vonda WrightDr. Vonda Wright (Instagram)BooksUnbreakable: A Women's Guide To Aging With Power, by Dr. Vonda WrightYounger in 8 Weeks,…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Lucy McBride, a Harvard and Johns Hopkins trained primary care physician and author of the new book Beyond the Prescription: A Doctor's Guide to Taking Charge of Your Health. Dr. McBride has spent twenty five years watching patients bounce between a rushed medical system and a wellness industry.The conversation opens with a hard truth about modern healthcare: doctors interrupt patients within eleven seconds of them speaking, and fifteen minute appointments leave almost no room to understand the whole person behind the diagnosis codes. Dr. McBride explains why this happened, how insurance incentives reward volume over conversation, and why trust and rapport, not just lab values, are the real birthplace of health. She and Dr. Haver share stories from their own practices, including patients who were given thousands of dollars in tests but never asked a single question about their actual lives.Guest links:Dr. Lucy McBrideDr. Lucy McBride…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Kristen Holmes, Vice President of Performance Science at Whoop and author of the new book Aligned, moving from the science of circadian rhythm into a practical recovery plan a woman can start using tonight.Dr. Holmes lays out a realistic strength and cardio prescription for women who only have thirty minutes a day, and explains how sleep governs the release of growth hormone and the capacity to build and preserve muscle as we age. She introduces the idea of alignment over willpower, framing consistent habits as infrastructure built around what someone actually values rather than a matter of discipline, and connects that back to the four core psychological needs, purpose, autonomy, self efficacy, and connection, that predict anxiety and sleep quality.The conversation turns to wearables, including what to look for in a tracker, the pitfalls of obsessing over data, and simple, no cost markers like a regular menstrual cycle,…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Kristen Holmes, Vice President of Performance Science at Whoop and author of the new book Aligned, to unpack why sleep and circadian rhythm matter as much as hormones when it comes to the symptoms women feel in perimenopause and menopause.Dr. Holmes explains the concept of circadian amplitude, the contrast between activity and rest, light and dark, and fed and fasted states that keeps every system in the body running on time, and why women with lower amplitude tend to report more frequent and more severe symptoms. She walks through why morning light exposure is one of the most powerful and underused tools available, how getting outside within the first part of the day sets the timing for melatonin release that night, and why a window is not a substitute for actual daylight.The conversation moves into meal timing, including why the body is more insulin sensitive earlier in the day and how consolidating calories into a shorter window can…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Sasha Hamdani, a board certified psychiatrist and ADHD clinical expert who wrote Self-Care for People with ADHD and the forthcoming Too Sensitive, moving from diagnosis into what to actually do once ADHD and perimenopause or menopause start colliding.Dr. Hamdani explains how ADHD symptoms and medication effectiveness shift across the menstrual cycle, tracing the pattern back to the drop in estrogen and rise in progesterone that hits right before a period, and walks through where nonstimulant medication options fit for women who want an alternative to stimulants. She lays out her version of a menopause toolkit, prioritizing sleep, exercise, and nutrition ahead of any prescription, and explains why psychiatrists have reprioritized sleep given new data on how stimulant medication works in the brain.The conversation moves through nutrition and appetite regulation, the role GLP1 medications can play in quieting food noise, and…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Sasha Hamdani, a board certified psychiatrist, ADHD clinical expert, and author of the forthcoming book Too Sensitive, for the first half of a two part conversation on why so many women are discovering ADHD for the first time during perimenopause and menopause.Dr. Hamdani reframes ADHD as a regulation issue rather than a simple attention deficit, and explains why perimenopause does not create the condition but instead unmasks it, as the estrogen scaffolding that lets women mask and compensate for a lifetime starts to fall away. She and Dr. Haver walk through how ADHD tends to present differently in women, often as the inattentive, easily overlooked type rather than the hyperactive presentation the diagnostic criteria were built around, and why that gap has left generations of high achieving women undiagnosed.The conversation moves into the biology behind the brain fog so many women describe in perimenopause, tracing the connection between…

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…

In this episode of unPAUSED, Dr. Mary Claire Haver talks with Dr. Jennifer Garrison, a neuroscientist and entrepreneur, about why the ovary should never have been labeled a purely reproductive organ. Dr. Garrison explains that ovaries function like a second brain in the body, sending and receiving chemical signals to nearly every tissue system including the heart, bones, brain, immune system, and metabolism. She walks through her research on the hypothalamus and the brain ovary signaling network, describing how inflammation in this part of the brain may be one of the earliest drivers of aging across the whole body.The conversation covers why the ovary ages roughly two and a half times faster than the rest of the body, a gap that helps explain the health span difference between women and men. Dr. Garrison and Dr. Haver discuss how poor ovarian function shows up across a woman's life, not only at menopause, contributing to conditions like polycystic ovarian syndrome, infertility, early menopause, depression,…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with exercise physiologist and nutrition scientist Dr. Stacy Sims, moving from what does not work to what actually does for women in perimenopause and menopause. They cover why strength training, not endless cardio, is one of the most powerful tools women have for protecting muscle, bone, and brain health at midlife, and Dr. Sims walks through exactly how to structure a 20 minute strength session for maximum benefit.The conversation turns to creatine, including why women between 18 and 65 see some of the strongest benefits for brain and heart health, proper dosing, and why timing and mixing matter for bioavailability. Dr. Sims and Dr. Haver also discuss why distance runners can still develop osteoporosis despite years of training, and how chronic under fueling and calcium loss play a role.Guest links:Dr. Stacy SimsDr. Stacy Sims (Facebook)Dr. Stacy Sims (YouTube)Dr. Stacy Sims (Instagram)Stacy T. Sims, PhD (LinkedIn)Dr. Stacy Sims…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with exercise physiologist and nutrition scientist Dr. Stacy Sims to unpack why so much fitness and diet advice built on male physiology leaves women confused about why the scale will not move, and why weight loss can feel so much harder for women than for men on the exact same plan. Dr. Sims, author of Roar and Next Level, a former professional cyclist who has taught and coached at Stanford, breaks down why women following the same diet and training program as their male partners often end up tired and stuck rather than leaner and fitter. The conversation covers the biological reasons women conserve fat in a calorie deficit, how female circadian rhythm differs from male circadian rhythm, and why eating within an hour of waking helps regulate cortisol and appetite hormones like ghrelin and peptide YY. Dr. Sims explains why fasted workouts can backfire for women, why front loading calories earlier in the day supports better metabolic outcomes, and…

Guest links Karen Tang, MD (Instagram) Karen Tang, MD (Facebook) Karen Tang, MD (YouTube) Karen Tang, MD (LinkedIn) Karen Tang, MD (TikTok) GynoMight with Karen Tang, MD (Substack) Thrive Gynecology Books “It's Not Hysteria: Everything You Need to Know About Your Reproductive Health (but Were Never Told),” by Dr. Karen Tang “The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again,” by Dr. Mary Claire Haver “The New Menopause"⁠ by Dr. Mary Claire Haver For a list of full show notes, please click here.

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Karen Tang, a board certified gynecologist and minimally invasive gynecologic surgeon, and author of It's Not Hysteria: Everything You Need to Know About Your Reproductive Health But Were Never Told. This is part one of a two part conversation. Together they take on a question that most women entering perimenopause have never been given the tools to answer: what happens to the gynecologic conditions you have been managing for years when your hormones start to shift? Dr. Tang opens with endometriosis, dismantling two of the most persistent myths in gynecology: that it goes away after menopause, and that it is cured by pregnancy or hysterectomy. She explains what endometriosis actually is, why it so often goes undiagnosed for an average of seven years, why imaging studies frequently miss it, and what the full range of treatment options looks like for perimenopausal women dealing with painful periods, pelvic pain, and chronic inflammation,…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Amy Shah, a physician trained in internal medicine and immunology with a nutrition background from Cornell, and author of the new book Hormone Havoc. Dr. Haver and Dr. Shah begin the conversation with the gut-hormone-brain connection, explaining how 40% of estrogen is recirculated through the gut, how the estrobolome, the collection of gut bacteria responsible for metabolizing estrogen, determines how much the body retains, and why declining estrogen in perimenopause and menopause triggers a cascade that loosens the tight junctions meant to keep food particles, toxins, and viruses from entering the bloodstream. This leaky gut drives inflammation that accelerates every symptom women are already experiencing, from weight gain and mood changes to sleep disruption and brain health decline. The gut-brain axis, the constant two-way communication between the gut and the brain, means that what is happening in the gut is directly shaping cognitive…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Sue Varma, a board certified psychiatrist, distinguished fellow of the American Psychiatric Association, and author of Practical Optimism. They open by taking on a question that sits at the intersection of psychiatry and menopause medicine: why do some women thrive through the most difficult biological transition of their lives, and what can the rest of us learn from them? Early in the conversation, Dr. Varma shares a finding that reframes everything: only 25% of people are born optimistic, and there is actually a gene for it. The other 75% have to learn it. Dr. Varma explains why optimism is not toxic positivity, what practical optimism actually means, and why both extreme optimists and extreme pessimists end up paralyzed into inaction in different ways. She also addresses what happens when depression, anxiety, and brain fog layer on top of the hormonal changes of menopause and perimenopause, and why so many women are being undertreated…

In this solo episode of unPAUSED, Dr. Mary Claire Haver answers one of the most asked questions she receives: what hormones do you actually take, and why? Rather than a general overview of menopause hormone therapy, this is a fully transparent, clinically grounded walk through her personal protocol, including every formulation she uses, why she chose it, and what the FDA-approved alternatives are for women whose needs or circumstances differ. Dr. Haver opens with systemic estrogen, explaining why she uses a transdermal patch as her primary delivery method, why she added a small dose of oral estradiol for bone protection after finding her serum levels were not reaching the threshold needed to preserve bone density, and why she believes routine estradiol level testing should become standard of care even though current guidelines do not yet reflect the latest absorption data. She walks through the key FDA-approved transdermal and oral estrogen options, including patches, gels, sprays, and oral formulations,…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Natalie Crawford, double board certified obstetrician, gynecologist, and reproductive endocrinologist, and author of The Fertility Formula. In part two of this conversation, Dr. Crawford gets specific about the forces working against our hormones every day, chronic stress, disrupted sleep, inflammatory food, and the endocrine disrupting chemicals most women have never been warned about. She explains how cortisol triggers insulin resistance, how insulin resistance drives inflammation and ovarian dysfunction, and why resistance training and building skeletal muscle is one of the most direct interventions a woman can make at any age, including perimenopause. On sleep, she makes the case that it is the single most under addressed factor she sees clinically, explaining how FSH and LH are released in the early morning hours and why disrupted sleep directly interferes with ovulation, estrogen, and progesterone production. The…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Natalie Crawford, a double board certified obstetrician, gynecologist, and reproductive endocrinologist, and author of the new book The Fertility Formula. Both physicians open by sharing their own fertility journeys, including pregnancy losses and dismissal from the medical system, before turning to the science that most women are never given access to. Dr. Crawford challenges one of the most persistent myths in women's health: that the biological clock is about running out of eggs. It is not. It is about egg quality, and those are completely different problems with completely different solutions. She explains how inflammation damages the chromosomes and mitochondria inside eggs, how chronic inflammation can actually deplete the ovarian reserve by penetrating the ovarian vault, and why the standard message to women, hurry up or give up, is not supported by the science. Guest links Natalie Crawford, MD Natalie Crawford, MD (Instagram)…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Michelle Gordon, a board certified obesity medicine physician and diplomate of the American College of Lifestyle Medicine, with surgical fellowships from the American College of Surgeons and the American College of Osteopathic Surgeons. Through her practice Thrive Span Medical, she works with midlife women across 39 states whose metabolic and hormonal symptoms have been dismissed as normal aging. Dr. Gordon opens by dismantling the calories in, calories out framework, not as a vague wellness talking point but on a physiological level. She explains why biology determines the burn rate, why fat oxidation drops by 32% in perimenopause, why visceral fat accumulation accelerates when estrogen declines, and why insulin resistance and leptin resistance make it nearly impossible for midlife women to lose weight through willpower alone. She also covers how sleep deprivation compounds all of it, creating a cycle of cravings, brain fog, and weight…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Hillary McBride, a psychologist, researcher, and author whose work focuses on women's lived experience of embodiment across the lifespan, and particularly what happens during the perimenopausal and menopausal transition. She brings a feminist, biopsychosocial lens to the work, looking at the intersection of biology and culture and how the stories we are handed about aging as women can shape what we actually feel, right down to measurable health outcomes. Dr. McBride opens by naming what the research literature has gotten wrong. Women's voices have been largely absent from the empirical conversation about perimenopause and menopause, and what women are actually saying when asked about their experience is strikingly different from what the medical literature reflects. They are describing not just difficulty but clarity, not just loss but a deepening sense of self, not just symptoms but a portal. Guest links: Hillary L. McBride Hillary L.…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Tony Youn, board certified plastic surgeon, bestselling author of Younger for Life, and the most followed plastic surgeon on social media. In part two of this conversation, Dr. Youn moves from skincare into devices, lifestyle, and the bigger picture of how women can think about aging and anti-aging without getting swept up in the extremes. Dr. Youn walks through the most commonly asked about in-office treatments, explaining what each one actually does and where the limitations are. He covers IPL for hyperpigmentation and sun damage, fractional CO2 lasers and how they differ from older more aggressive approaches, chemical peels and how depth determines results, and radiofrequency microneedling including what it can realistically achieve and where it falls short. He also addresses at-home devices, covering red light therapy and what the studies actually show about collagen and elastin, and what to look for in a dermal…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Tony Youn, a board certified plastic surgeon nationally recognized as one of the top plastic surgeons in the United States, bestselling author of Younger for Life, and the most followed plastic surgeon on social media with more than five million YouTube subscribers and eight million TikTok followers. In part one of this two part conversation, they take on a question that sits at the intersection of hormones and skin health that most doctors have never connected for their patients: what estrogen is actually doing to the skin, and what women can do about it. Dr. Youn opens with a statistic that women lose 30% of the thickness of their collagen in the first five years after menopause, and then continue losing collagen at twice the rate of men for every year that follows. He explains exactly why this happens, how estrogen interacts with the fibroblasts that produce collagen and elastin, what declining estrogen does to hyaluronic acid and skin…

In this episode of unPAUSED, Dr. Mary Claire Haver answers your most asked questions about hormone therapy, menopause symptoms, and how to advocate for yourself when your doctor doesn't have answers. She walks through who actually qualifies for HRT, what the real contraindications are versus conditions that simply require a different delivery method, and how to think about continuing estrogen, progesterone, and testosterone therapy after 60. Dr. Haver explains the estrogen patch absorption problem, with research showing that up to 20 percent of women on transdermal therapy never reach physiologic estradiol levels regardless of dose. She breaks down SHBG, the protein that can bind your hormones and render them inactive even when your numbers look adequate on paper, and walks through what optimal estradiol levels look like for bone density and osteoporosis prevention specifically. Books: “The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,” by Jocelyn Wittstein“The New…

In this bonus episode of unPAUSED, Dr. Mary Claire Haver is joined by Dr. Zachary Rubin, double board certified allergist and immunologist and New York Times bestselling author of All About Allergies, to dig into the connection between histamine, mast cells, and women's hormonal health. Dr. Rubin breaks down what mast cells are, how histamine works across multiple organ systems, and why women are disproportionately affected by mast cell related conditions including mast cell activation syndrome (MCAS). The two dig into the estrogen and histamine connection, why perimenopause can trigger or worsen symptoms like anxiety, brain fog, and histamine intolerance, and what MCAS actually is and how it is diagnosed. Dr. Rubin also addresses the viral H1 and H2 blocker combination that has been circulating online, explaining the real science behind why it may be helping some women with PMDD, endometriosis, and perimenopausal symptoms, while being honest about what we still do not know. They also cover quercetin, DAO…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Tami Rowen, an obstetrician, gynecologist, and leading gynecologic surgeon at the University of California San Francisco, and an internationally recognized expert in sexual health and sexual medicine. Together they get precise about some of the most misunderstood terrain in women's health: estrogen, progesterone, progestins, and testosterone for women, what they actually do in the body, how the confusion around them began, and what becomes possible for women when care is evidence-based and not fear-based. Dr. Rowen opens with something most women have never been told: that contraceptive estrogen and menopausal estrogen are fundamentally different molecules with different goals, different mechanisms, and different effects on the body. She walks through why ethinyl estradiol, the synthetic estrogen in most birth control pills, binds to the estrogen receptor 300 times more strongly than natural estradiol, why that matters for everything from…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Kim and Penn Holderness, the husband and wife content creators behind the widely popular Holderness Family, bestselling authors, and winners of The Amazing Race Season 33. Together they built an audience of millions by finding the humor in real life, and in this conversation they turn that same lens on perimenopause, ADHD, marriage, and the particular chaos of midlife. Kim opens up about the perimenopausal symptoms that arrived before she had any name for them: the anxiety that made everything feel like being chased by a bear, the panic attacks triggered by nothing she could identify, and the growing sense that something was fundamentally wrong with her. She describes walking out of her doctor's office with no treatment after being told her symptoms were normal, the financial reality of having to seek out a functional medicine doctor to finally get the estrogen and progesterone support she needed, and the combination of hormonal and…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Kelly Casperson, urologist, author, and host of the podcast "You Are Not Broken." Part 2 goes deep on testosterone therapy for women, the most misunderstood hormone in women's health, and covers the full range of what it actually does in the female body, why every woman will experience declining levels over time, and why there are still zero FDA approved testosterone products for women while men have more than a dozen. Dr. Casperson opens with the basics: ovaries make testosterone, the hormone pathway runs one way from cholesterol through progesterone to testosterone to estradiol, and women in normal cycling years carry four times more testosterone than estrogen in their bodies. She explains where testosterone receptors are found, which is everywhere from the brain to bone to muscle to the clitoris to the tear ducts, and why reducing testosterone in women to a libido drug misses the full picture entirely. Guest links:…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Kelly Casperson, a urologist, author, and host of the podcast “You Are Not Broken”. Dr. Casperson trained in a specialty that treats both men and women, which gave her an early and clear view of the gender gap in sexual healthcare. That disparity became the driving force behind her work, her two books You Are Not Broken and The Menopause Moment, and her clinic, the Casperson Clinic. Together they cover the full landscape of what women were never taught, what medicine has missed, and what actually works for female sexual health, libido, desire, and sexual dysfunction in midlife. The conversation gets straight to what most women were never told: that the orgasm gap between heterosexual men and women has not improved in decades, and that the silence around female sexual health has never been about a lack of science. It has been about a lack of priority. Guest links: Kelly Casperson, MD Kelly Casperson (Instagram) Kelly Casperson (YouTube) You…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Suzanne Gilberg-Lenz, a board-certified OB-GYN, integrative medicine expert, and author with nearly 30 years of clinical experience, including training in Ayurvedic medicine spanning almost two decades. Dr. Gilberg-Lenz is the Chief Clinical Officer of Monarch, a membership-based healthcare practice built to restore what modern medicine has nearly eliminated: time, relationship, and trust between women and their clinicians. Dr. Haver and Dr. Gilberg-Lenz open with a question that sits at the heart of women's midlife health: why does the current healthcare system consistently fail to see women clearly? Dr. Gilberg-Lenz explains why the system is not built for humans but for shareholders, reimbursement structures, and productivity metrics that reward procedures over listening. She breaks down the difference between burnout and moral injury, why physicians are leaving traditional medicine in record numbers, and what it actually costs women…

In this episode of unPaused, Dr. Mary Claire Haver sits down with Dr. Kerry Burnight, a gerontologist and national leader in aging research who spent 18 years teaching geriatric medicine at the University of California Irvine School of Medicine and is the author of Joyspan: The Art and Science of Thriving in Life's Second Half. Dr. Burnight brings a framework that is especially relevant for women navigating menopause and midlife: the key to good longevity is not how long you live. It is how much you love the life you are living. Dr. Haver and Dr. Burnight begin with the concept of joyspan itself, a term Dr. Burnight coined to name the missing piece between lifespan and healthspan. Drawing on the American Psychological Association's definition of joy as wellbeing and life satisfaction, they explore why joy is not a luxury add-on to healthy aging but a measurable, cultivatable vital sign. Dr. Burnight explains the distinction between joy and happiness, why happiness is circumstantial while joy is an inside…

In this episode of “unPAUSED,” Dr. Mary Claire Haver answers the questions she gets asked most, sitting down solo to address what perimenopause actually is, why it starts in the brain before it ever shows up in bloodwork, and why so many women experiencing anxiety, brain fog, broken sleep, and unexplained weight gain are dismissed, misdiagnosed, or handed prescriptions for symptoms that have a hormonal root. Perimenopause is not a waiting room. It is its own distinct biological phase, a seven to ten year hormonal transition that begins long before periods stop and touches every organ system in the body. And yet most women are never taught to recognize it. Dr. Haver breaks down the hormonal chaos of perimenopause, revealing why estrogen does not simply decline but surges and crashes erratically as the brain floods the ovaries with luteinizing hormone (LH) and follicle stimulating hormone (FSH) in a desperate attempt to produce more, and why a single blood draw will almost never tell the full story. She…

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Lisa Mosconi, neuroscientist and associate professor of neuroscience in neurology and radiology at Weill Cornell Medicine, New York Presbyterian Hospital. Dr. Mosconi directs the Alzheimer's Prevention Program, including the NIH-funded Women's Brain Initiative and the Alzheimer's Prevention Clinic, and was recently named director of the $50 million Program in Women's Health, Cutting Alzheimer's Risk Through Endocrinology. She is also the author of the bestselling book The Menopause Brain. Dr. Mosconi and Dr. Haver go deeper into why brain fog, memory lapses, and cognitive changes in midlife are not just frustrating. They are biologically significant, and for some women, they may signal an inflection point for Alzheimer's risk. The conversation covers the statistics women are rarely given starting at age 45, a woman has twice the risk of Alzheimer's as a man of the same age. Women are also twice as likely to be diagnosed…

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Lisa Mosconi, a neuroscientist and associate professor of neuroscience in neurology and radiology at Weill Cornell Medicine, New York Presbyterian Hospital. Dr. Mosconi directs the Alzheimer's Prevention Program, including the NIH-funded Women's Brain Initiative and the Alzheimer's Prevention Clinic, and was recently named director of the $50 million Program in Women's Health, Cutting Alzheimer's Risk Through Endocrinology. She is also the author of the bestselling book The Menopause Brain. This conversation is about prevention. Dr. Mosconi has spent decades building the science that shows Alzheimer's risk in women is neither inevitable nor untreatable and that the choices women make in midlife around hormones, sleep, and nutrition have a direct, and measurable, impact on the brain's long-term health. Together, they explore why two thirds of all Alzheimer's patients are women and what role menopause plays in that disparity. Dr. Mosconi…

Poor sleep during perimenopause and menopause isn't just exhausting—it's linked to increased cardiovascular disease risk, depression, anxiety, weight gain, cognitive decline, and reduced quality of life. Yet for decades, women's sleep complaints have been minimized, dismissed, or blamed on just getting older. In this episode, Dr. Mary Claire Haver sits down with board-certified sleep medicine specialist Dr. Andrea Matsumura to unpack what's really happening to women's sleep during the menopause transition and what we can actually do about it. Dr. Matsumura completed her medical degree at the University of Texas Health Science Center San Antonio and her internal medicine residency in Portland, Oregon before returning to Oregon Health & Science University for a fellowship in sleep medicine, where she discovered the critical connection between women's hormones and sleep disorders. Guest links: Dr. Andrea Matsumura (Instagram) Dr. Andrea Matsumura (Facebook) Dr. Andrea Matsumura (LinkedIn) Dr. Andrea Matsumura…

From her groundbreaking televised colonoscopy to her breast cancer journey, Katie Couric has turned personal experience into powerful advocacy for the health issues medicine has overlooked. This week on unPaused, Dr. Mary Claire Haver sits down with Katie Couric, award-winning journalist, founder of Katie Couric Media, co-founder of Stand Up To Cancer, and author of the New York Times bestseller Going There. Katie spent 15 years co-hosting the Today Show, served as the first solo female anchor of CBS Evening News, and has interviewed nearly every president, world leader and cultural voice of the last four decades. Together, they explore Katie's journey from growing up in Arlington, Virginia, where her parents instilled the importance of education and financial independence, to breaking barriers in network news while navigating profound personal loss. Katie opens up about losing her husband Jay to stage four colon cancer when her daughters were six and two, how that tragedy launched her into cancer advocacy,…

Most women go through decades of marriage, menopause and midlife without ever having an honest conversation with a doctor about their sex life. Not because they don't want one — but because most physicians were never trained to have it. This week on unPaused, Dr. Mary Claire Haver sits down with Dr. James Simon, a professor of obstetrics and gynecology at George Washington University, board-certified OB-GYN, reproductive endocrinologist, and certified sexual counselor with more than 800 published papers in menopause and sexual medicine. Dr. Simon is a past president of the International Society for the Study of Women's Sexual Health (ISSWSH) and one of the most published clinicians in modern menopause care. Dr. Simon has spent his career treating what most doctors never address — the full picture of how sex, desire, pain and intimacy change for both women and men as they age. He treats couples together, and what he has witnessed across thousands of relationships is that the problems are rarely one person's…

This week on unPaused, Dr. Mary Claire Haver sits down with Naomi Watts, Academy Award nominated actress, entrepreneur, and New York Times bestselling author of Dare I Say It. Naomi's career spans decades in Hollywood, from her breakthrough role in David Lynch's Mulholland Drive to recent work with directors like Ryan Murphy and Lena Dunham. After receiving a shocking early menopause diagnosis at 36 while struggling with fertility, Naomi spent years navigating untreated symptoms in silence before becoming an unexpected advocate for millions of women facing midlife transitions. In 2021, she founded Stripes Beauty, a menopause focused skincare and wellness brand built on community, education, and celebrating womens earned wisdom rather than promising to reverse time. In this conversation, Dr. Haver and Naomi explore the reality of growing up across continents after losing her father at eight years old, the decade long struggle to break into Hollywood, and the moment at 30 when her acting career finally…

This week on unPaused, Dr. Mary Claire Haver sits down with Cindy Eckert, founder and CEO of Sprout Pharmaceuticals and creator of Addyi, the first FDA approved treatment for low libido in women. Cindy is a pharmaceutical entrepreneur who began her career at Merck before founding her first company in 2007, focusing on undermarketed FDA approved products. After successfully building and selling a male sexual health company, she became the only woman running a sexual health company and witnessed firsthand the stark contrast between how medicine treats male versus female sexual dysfunction. Her journey to bring Addyi to market became a cultural battle about whether women's sexual desire matters, leading to two FDA rejections, public hearings, and ultimately a historic approval in 2015 after a six year fight. In this conversation, Dr. Haver and Cindy explore how Addyi works differently from Viagra, targeting brain chemistry and desire rather than blood flow and arousal. Cindy explains that Addyi is a mood drug…