Part 2 of the Women's Health Series

Your digestion suddenly feels different, your sleep is falling apart, your mood and patience are all over the place — and you start wondering whether it’s stress, aging, or something bigger. Joined by two extraordinary Mayo Clinic experts, Drs. Chrisandra Shufelt and Jami Kinnucan, we pull back the curtain on perimenopause and menopause, explaining how shifting estrogen and progesterone can ripple through the entire body — from constipation and bloating to metabolic health, cardiovascular risk, and even the gut microbiome. Most importantly, this episode reminds women that these changes are real, common, and worthy of attention.

• Defining perimenopause versus menopause as a life stage and why symptoms vary so much
• Linking estrogen and progesterone changes to motility, constipation, bloating, and visceral sensitivity
• Discussing microbiome shifts, dysbiosis, and how gut health may influence estrogen recycling
• Outlining cardiometabolic changes including central weight gain, lipid changes, blood pressure, and insulin resistance
• Clarifying brain fog, sleep disruption, and increased anxiety and depression risk during perimenopause
• Reviewing SSRIs and SNRIs as options that may also reduce hot flashes
• Covering bone loss timing, hormone therapy limits, and when DEXA scanning makes sense
• Summarizing what is known about IBS symptom severity and what is less clear in IBD
• Debunking hormone panels in perimenopause and pointing to menopause-trained clinicians
• Breaking down soy, supplements, placebo effects, and lifestyle factors like weight loss and exercise snacks
• Detailing vaginal estrogen for dryness, painful sex, and recurrent UTIs, including how to use it correctly

This episode has been sponsored by Ardelyx.

References for this episode:

The 2022 hormone therapy position statement of The North American Menopause Society

The association between metabolic dysfunction-associated steatotic liver disease diagnosis and vasomotor symptoms in midlife women

Impact of Menopause and Clinical Considerations in Patients With Inflammatory Bowel Disease

Understanding the sexual concerns of older women presenting for care to women's health clinics: a cross-sectional study

Find a Menopause Practitioner: Menopause.org

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.