Perimenopause is the season we were warned about—but no one really prepared us for what it actually feels like to live in it. In this episode of Found at 40, I start with my friend Carrie Youell, talking honestly about what it’s like to be in the thick of perimenopause—brain fog, mood swings, sleep issues, and that unsettling feeling of not quite recognizing yourself anymore. Then, we bring in expert insight with Dr. Jackie Piasta, a Doctor of Nursing Practice and board-certified women’s health nurse practitioner, for a listener Q&A that breaks down what’s happening hormonally, what’s normal, and what actually helps. This episode is about validation, clarity, and realizing you’re not crazy—you’re just in your 40s.

Episode Timeline

• (0:00) 🎢 The perimenopause plot twist we were warned about—and didn’t fully understand
• (4:00) 🧠 Brain fog, chin hair, and the early signs something feels “off”
• (8:00) 😵‍💫 Emotional whiplash, rage moments, and not feeling like yourself
• (13:00) 😴 Sleep issues, night sweats, and why exhaustion hits differently in your 40s
• (18:00) 🎭 Identity, marriage, motherhood, and how perimenopause affects relationships
• (23:00) 🔥 Hot flashes vs. internal overheating—and how symptoms really show up
• (27:00) 🧬 Hormones, bloodwork, testosterone, and navigating confusing lab results
• (31:00) 💬 Feeling dismissed by doctors and learning to advocate for yourself

Expert Q&A with Dr. Jackie Piasta

• (35:00) 🎙️ Introducing Dr. Jackie Piasta + why perimenopause is having a cultural moment
• (38:00) 🩺 How do you actually know if you’re in perimenopause—and not dealing with something else?
• (42:00) 🧪 Why isn’t there a clear test for perimenopause?
• (46:00) 🩻 Which doctors should women have in their healthcare lineup after 40?
• (50:00) 🧍‍♀️ What’s causing hair loss in perimenopause—and what actually helps?
• (55:00) 💊 When is hormone replacement therapy (HRT) the right next step?
• (1:00:00) 💡 What women in their 40s should know now to make this season easier later

Find Dr. Jackie Piasta on Instagram at @jackiep_gynnp or at https://www.mymonarchhealthco.com/

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Keywords:

Perimenopause, perimenopause symptoms, signs of perimenopause, perimenopause in your 40s, hormone imbalance in women, brain fog in perimenopause, mood swings in midlife, anxiety and perimenopause, sleep problems in perimenopause, hot flashes and night sweats, hair loss in perimenopause, hormone replacement therapy (HRT), when to start HRT, women’s health after 40, feeling like yourself again in midlife, Dr. Mary Claire Haver, Leanne Morgan, We Do Not Care Club