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Diagnosing Perimenopause: Practical Clarity in a Foggy Transition

In this episode of the MenopauseWize Podcast, Dr. Sukhpreet Patel is joined by Dr. Suzanne Gilberg-Lenz, a renowned OB-GYN, menopause expert, and advocate for women’s midlife health, to unpack one of the most overlooked and misunderstood stages of a woman’s life: perimenopause.

Despite affecting millions of women, perimenopause is still frequently missed, misdiagnosed, or dismissed. Many women are told their symptoms are due to stress, anxiety, aging, or lifestyle, often after being reassured that their blood tests are “normal.” In this conversation, Dr. Gilberg-Lenz explains why perimenopause is fundamentally a clinical diagnosis, not a lab diagnosis, and why relying on hormone levels alone can lead to delayed care and unnecessary suffering.

Together, we explore how fluctuating hormones drive a wide range of symptoms, from irregular periods and sleep disruption to mood changes, brain fog, weight shifts, and changes in sexual health. Dr. Gilberg-Lenz shares how clinicians can recognize perimenopause earlier, what questions truly matter in the consultation room, and how validating a woman’s experience is often the first and most powerful step in care.

This episode is essential listening for women who suspect they may be in perimenopause and for healthcare providers who want to diagnose earlier, listen better, and offer more effective, evidence-based support.

Key Topics Covered:

• What perimenopause really is and why it is so commonly missed
• Why blood tests often fail to diagnose perimenopause
• The wide and often unexpected symptoms of hormonal fluctuation
• How to take a symptom-based, clinical approach to diagnosis
• Common myths that delay care for midlife women
• When to start conversations about treatment and support
• Why early recognition can change a woman’s quality of life

This episode empowers women to trust their symptoms, ask better questions, and seek care that reflects the realities of midlife hormonal change.

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The information provided in all episodes of the MenopauseWize podcast, including content shared by Sukhpreet Patel or any guest or representative, is for informational and educational purposes only. It is not intended as medical advice or a substitute for professional healthcare consultation, diagnosis, or treatment. Always consult your physician or qualified healthcare provider regarding any medical condition or treatment decisions.

SheRise Healthcare Pvt. Ltd., MenopauseWize, Sukhpreet Patel, or any representative will not be held responsible or liable for any direct, indirect, incidental, or consequential damages arising from the use or reliance on the information provided in this podcast. Listeners are encouraged to use the information at their own discretion and always seek advice from a licensed medical professional before making any healthcare decisions.

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In this episode of the MenopauseWize Podcast, Dr. Sukhpreet Patel sits down with Dr. Shafeena Premji, a nationally recognized menopause expert and founder of multiple women-centered clinics in Calgary, including the upcoming Milestone Menopause Centre of Southern Alberta. Known for her ability to translate evidence into compassionate, accessible care, Dr. Premji helps us unpack one of the biggest regulatory shifts in women’s health in years: the FDA’s removal of the Black Box Warning from estrogen products.

For decades, the Black Box Warning shaped public perception, prescribing patterns, and women’s fear of hormone therapy. But what exactly was this warning? Why was it applied broadly to all estrogen formulations, from low-dose vaginal estrogen to systemic hormone therapy? And now that the warning is being removed from all estrogen products, what does this change actually mean for women, for clinicians, and for safer, evidence-based menopause care?

Dr. Premji brings clarity to the science, explains the differences between systemic and vaginal estrogen, discusses age and timing of initiation, and offers practical guidance for women who are wondering how to interpret this shift.

Whether you're a clinician navigating counselling conversations or a woman seeking accurate information amidst the noise, this episode will equip you with the facts, the nuance, and the confidence to make informed decisions about hormone therapy in midlife and beyond.

Key Topics Covered:
• What the original Black Box Warning said and why it was created
• The impact of the warning on women’s health, care access, and stigma
• Why the FDA removed the warning and what this reflects about updated evidence
• Differences between systemic and low-dose vaginal estrogen
• How dose, route, and timing influence safety
• What this regulatory shift means for women
• Practical considerations for clinicians and patients
• How to balance evidence, nuance, and individualized care

Tune in for a clear, evidence-based conversation that cuts through fear and confusion.

Support the show

The information provided in all episodes of the MenopauseWize podcast, including content shared by Sukhpreet Patel or any guest or representative, is for informational and educational purposes only. It is not intended as medical advice or a substitute for professional healthcare consultation, diagnosis, or treatment. Always consult your physician or qualified healthcare provider regarding any medical condition or treatment decisions.

SheRise Healthcare Pvt. Ltd., MenopauseWize, Sukhpreet Patel, or any representative will not be held responsible or liable for any direct, indirect, incidental, or consequential damages arising from the use or reliance on the information provided in this podcast. Listeners are encouraged to use the information at their own discretion and always seek advice from a licensed medical professional before making any healthcare decisions.

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Episode 23: Brain Fog Demystified — Hormones, Memory, and Midlife Clarity

In Episode 23 of the MenopauseWize podcast, we sit down with Dr. Alison Shea to demystify one of the most talked-about — and misunderstood — symptoms of menopause: brain fog. Dr. Shea is an Associate Professor in the Departments of Obstetrics & Gynecology and Psychiatry at McMaster University. She completed her fellowship in Menopause and Reproductive Mental Health, and her residency in ObGyn at the University of Toronto. She is a board member for the Canadian Menopause Society, a Menopause Society certified practitioner and the Chair of their examination committee, responsible for certifying North American Menopause Practitioners. You can find her sharing evidenced-based content on Instagram @hormone.md.hamilton.

Many women describe feeling “not as sharp,” forgetting names, or losing track of thoughts during midlife. But what’s really happening in the brain during this transition? Dr. Shea helps us understand how hormonal changes, sleep disturbances, hot flashes, and mood shifts that influence memory and focus — and why these changes are real, common, and often frustrating.

We explore what science tells us about estrogen’s role in cognition, and how to separate everyday forgetfulness from early signs of something more serious. Dr. Shea also shares practical, evidence-based strategies to support brain health, including lifestyle, exercise, sleep, and heart health.

This episode is all about clarity — both in the science and in how women can feel more confident about their cognitive health in midlife and beyond.

Key Topics Covered:

• What “brain fog” really means — and why it happens during menopause
• The connection between estrogen, memory, and attention
• How sleep, mood, and hot flashes affect cognitive performance
• Whether hormone therapy helps with brain fog
• Everyday steps to protect and improve brain health

Join us as we clear the fog — one insight at a time — and empower women to trust their minds again.

Support the show

The information provided in all episodes of the MenopauseWize podcast, including content shared by Sukhpreet Patel or any guest or representative, is for informational and educational purposes only. It is not intended as medical advice or a substitute for professional healthcare consultation, diagnosis, or treatment. Always consult your physician or qualified healthcare provider regarding any medical condition or treatment decisions.

SheRise Healthcare Pvt. Ltd., MenopauseWize, Sukhpreet Patel, or any representative will not be held responsible or liable for any direct, indirect, incidental, or consequential damages arising from the use or reliance on the information provided in this podcast. Listeners are encouraged to use the information at their own discretion and always seek advice from a licensed medical professional before making any healthcare decisions.