The Pause Life

09/15/2026

Recurrent UTIs that never resolve are one of the most common stories I hear, and one of the most misdiagnosed. New research in The Journal of Sexual Medicine, reported by NPR this morning: in 253 women carrying a recurrent UTI diagnosis, only 15 percent had a problem limited to the bladder. The rest had hormonally driven v***ar inflammation, pelvic floor dysfunction, or both. Important context: this was a specialty referral population, meaning antibiotics had already failed these women. The finding is not that UTIs are imaginary. The finding is that when antibiotics keep failing, nobody is examining the v***a. Clinical observation, not statistic: in my own practice, the women who cycle through antibiotics for years are almost always the women whose v***ar tissue has never been looked at. Three questions for your next appointment: Was my urine CULTURE positive, or only my urinalysis? Has my v***ar tissue and pelvic floor been examined? Am I a candidate for vaginal estrogen or DHEA? If you have fever, flank pain, or you feel truly sick, that is a different situation. Get seen. Source: Uloko et al., The Journal of Sexual Medicine, via NPR, Aug 31 2026.

09/13/2026

The most effective treatment for recurrent urinary tract infections in a post menopausal women is restoring the health of the ge***al urinary system with vaginal estrogen.

09/12/2026

I have a feeling this is going to be all over the map. I’ll go first. Between estrogen, testosterone, and progesterone, I am spending about $60 a month.

09/11/2026

When should women get their first bone density scan? Many women are told to wait until age 65 for a baseline DEXA scan. In this episode, I explain why waiting until 65 may be too late for many women. Bone loss begins years earlier, accelerates during the menopause transition, and you can lose up to 20% of your bone mass in the first 5 to 7 years after menopause. We also discuss why vitamin D matters for bone health, what levels we aim for in our clinic, and why understanding your individual risk factors can help you have more informed conversations with your healthcare team. The goal isn't to wait for a fracture. The goal is to protect your bones before one happens. ✨Listen to the full unPAUSED Menopause Masterclass episode on labs at the link in bio.

09/10/2026

Perimenopause raises psychological symptom burden 52%. And it's not what you think. A new peer-reviewed study of 7,975 women across 20 countries measured it on the Menopause Rating Scale: 7.3 in perimenopause versus 4.8 in premenopause. We assume that load is anxiety and depression. It isn't. The single largest jump was exhaustion, up 56%, followed by irritability. Depressive mood and anxiety rose too, but they were the smallest movers, not the headline. And this is the part most coverage skips: the increase held after adjusting for age, education, income, ethnicity, BMI, smoking, alcohol, and an existing diagnosis of anxiety or depression. Something in the transition itself is driving it. The authors point to variability in estradiol and low progesterone, alongside psychosocial factors. Clinical takeaway: perimenopausal exhaustion is not a productivity problem or a character flaw. It is a hormonal signal, and it is measurable. If you are wiped out, foggy, and forgetting words, that is not you failing. That is data. Save this and send it to a woman who has been told it is just stress. Source: Cunningham AC, Hedges MS, Hewings-Martin Y, Castaneda R, Karam J, Zhaunova L, Faubion SS, Shufelt CL. Psychological symptoms during perimenopause: a global perspective. Menopause. 2026;34(6). doi:10.1097/GME.0000000000002872

09/09/2026

Could low ferritin be contributing to your fatigue? Fatigue, hair thinning, brain fog, restless legs, and difficulty exercising can have many causes. One that often gets overlooked is low ferritin, your body's stored iron. ✨Listen to the full unPAUSED Menopause Masterclass episode on labs at the link in bio. In this episode, I share my own experience with low ferritin and explain why checking ferritin, not just your iron level, can be so important. Your iron level may appear normal while your iron stores are steadily declining, which is why ferritin can provide valuable information that a standard iron test may miss. We also discuss why heavy menstrual bleeding can increase the risk of low ferritin, how iron deficiency symptoms can overlap with menopause symptoms, and why identifying a nutritional deficiency is an important part of understanding what's contributing to the way you feel.

09/08/2026

"Your labs are normal" is not the same as "you are healthy," and the difference is costing women years. A reference range is a statistical band, not a health target. You can sit inside it and still feel awful, because the markers that actually explain midlife symptoms often never get ordered in the first place. Fatigue, brain fog, the weight that won't shift: the answers are frequently in the bloodwork no one ran. This is not you being dramatic. It's a system that was never built to look closely at women at midlife. In the new Menopause Masterclass I walk you through how to read your own labs, line by line, so you can stop being dismissed and start asking for exactly what you need. Full episode on unPAUSED, link in bio. What's a lab result you were told was "fine" when you knew something was off? Tell me below.

09/07/2026

Bloating is not a personal failure.

09/05/2026

09/04/2026

Why does cholesterol often increase in midlife?

Many women are surprised to learn that LDL cholesterol increases by an average of 18% across the menopause transition, even when their diet and exercise habits haven't changed.

✨Listen to the full unPAUSED episode about the most important lab tests for women in midlife.

In this episode, I explain why declining estrogen changes the way your liver handles cholesterol, why elevated cholesterol isn't just an aging event but also a hormonal one, and which additional tests, including ApoB and Lp(a), may provide a more complete picture of your cardiovascular risk.

Understanding these changes can help you have more informed conversations with your healthcare team and take a more proactive approach to protecting your heart health.