This week, I had a wide-ranging, super informative conversation with Dr. Gillian Goddard, endocrinologist and assistant professor at NYU Langone Hospital. With 15 years of clinical experience, Dr. Goddard specializes in thyroid health, PCOS, menopause, nutrition, weight management, and diabetes.
This episode dives deep into the complex world of hormones during perimenopause and menopause, going far beyond just estrogen to explore the full endocrine picture.
Prefer reading? Get the episode transcript here:
Let’s start with this quote from Dr. Goddard: “The endocrine system is endlessly complex.” And so no conversation on hormones at perimenopause and menopause is going to be complete in 35 minutes. But I did my best to ask Dr. Goddard the questions I think cover what we experience and have questions about.
Topics Covered
The Hidden Hormone Story
- Why estrogen is just one piece of the menopause puzzle
- The role of FSH (follicle-stimulating hormone) in symptoms
- How thyroid, cortisol, aldosterone, and parathyroid hormones are affected
- The metabolic hormone connection: insulin, glucagon, and blood sugar regulation
Finding the Right Healthcare Provider
- How to assess your GP’s comfort level with menopause
- Questions to ask your doctor to gauge their expertise
- When to seek out a specialist vs. staying with your current provider
- Using The Menopause Society to find certified practitioners
Telehealth and Online Menopause Care
- What to look for in online menopause platforms
- Pros and cons of virtual care vs. traditional practice
GLP-1 Agonists (Ozempic, etc.) in Menopause
- Why are these weight loss drugs hormone analogs
- How they might interact with other menopause treatments
- Potential effects on oral hormone absorption
- The complexity of introducing new hormones during perimenopause
Natural Alternatives and Supplements
- Berberine and inositol for insulin sensitivity
- The truth about allulose as a “natural Ozempic”
- Why do current natural options pale in comparison to prescription medications
Birth Control Pills During Perimenopause
- How low-dose pills can regulate heavy, irregular periods
- The contraception factor: pregnancy is still possible
- How birth control acts like hormone therapy
- Safety updates from early high-dose formulations
Non-Hormonal Treatment Options
- SSRIs vs. SNRIs for mood and physical symptoms
- Viosa: the current non-hormonal option for hot flashes
- Upcoming Bayer medication targeting mood and sleep
- The expanding pharmaceutical interest in menopause
Individual Variability in Menopause
- Why do some women “sail through” while others struggle significantly
- The mystery of symptom variation between women
- Potential connections between childbirth experiences and menopause
Resources Mentioned
- The Menopause Society: For finding certified menopause practitioners
- MIDI: Telehealth platform example (fee-for-service, accepts insurance)
- Viosah: Currently available non-hormonal medication for hot flashes
Connect with Dr. Gillian Goddard
- Dr. Goddard’s Newsletter: “Hot Flash” at savvy patient.substack.com
- Practice: Park Avenue Endocrinology, Upper East Side, Manhattan
Stay rebellious,
Gregory Anne
This episode is part of the Rebellious Wellness Lifestyle movement – challenging conventional wisdom and empowering you to question limitations that don’t actually have to exist.
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Disclaimer: This podcast is for informational purposes only and is not intended as medical advice. Always consult with your healthcare provider before making changes to your treatment plan.