Peri & Pause The Podcast

The Peri & Pause Podcast is for women in midlife who know something in their body has changed—but haven’t been given real answers, or have been left overwhelmed by conflicting information. Hosted by Jamie Gallagher, DNP, FNP-C, MSCP, a nurse practitioner specializing in perimenopause and menopause care, the show explores hormones, metabolism, mental health, sleep, sex, weight changes, and chronic conditions through an evidence-based, deeply practical lens. We unpack the physiology of midlife alongside the lived experience of women navigating careers, relationships, finances, and identity during this transition. Every woman deserves this conversation—and the clarity, language, and confidence to advocate for better care. Because “Your Labs Are Normal” Is Not the Whole Story.

  1. 6d ago

    GSM - Genitourinary Syndrome of Menopause

    Symptoms, Risks, Vaginal Estrogen, Pelvic Floor PT & Radiofrequency Options This Peri & Pause episode features Jamie Gallagher, a nationally board-certified family nurse practitioner and Menopause Society certified practitioner, discussing genitourinary syndrome of menopause (GSM), the updated term replacing “vaginal atrophy” because it affects both vaginal and urinary tissues. They explain how declining estrogen causes tissue thinning that can lead to dryness, burning, itching without discharge, pain or bleeding with sex, urinary leakage, increased UTIs, and even life-threatening urosepsis, noting symptoms are often underreported and frequently dismissed as “normal.” First-line options include vaginal moisturizers and lubricants, with vaginal estrogen emphasized as key and not “duplicate therapy” with systemic hormones. Additional approaches include pelvic floor physical therapy and emerging energy-based radiofrequency (including microneedling RF) to stimulate collagen, improve continence and tissue health, with a typical three-treatment series and annual maintenance. 00:00 Welcome to Peri & Pause 00:39 What Is GSM 02:01 Why It Matters 03:32 Estrogen and Tissue Changes 05:10 How Common and Why Silent 06:42 Diagnosis and First Steps 08:31 Vaginal Estrogen Options 10:35 Beyond Estrogen Treatments 12:03 Radiofrequency Explained 13:36 Practice Mission Break 15:16 Expected Results Timeline 17:19 Research and Incontinence Types 20:35 Procedure and Downtime 24:04 How to Get Help 25:51 Wrap Up and Disclaimer

  2. Aug 18

    Estrogen 101

    Estrogen in Perimenopause: What It Does, Why Symptoms Happen, and the FDA Black Box Warning Update (2025–2026) Jamie Gallagher, a nationally board-certified family nurse practitioner and Menopause Society certified practitioner, explains estrogen as a whole-body hormone—not just a reproductive one—affecting the brain (temperature regulation, mood, memory, hot flashes, sleep and brain fog), bones (rapid bone loss around the final period and osteoporosis risk), vaginal/urinary tissues (dryness, discomfort with sex, UTIs and worsening symptoms post-menopause), skin and joints (collagen loss, aches, inflammation), and heart/metabolism (vessel flexibility, cholesterol, insulin response, rising heart disease risk). She outlines common symptom patterns from early perimenopause through post-menopause and emphasizes personalized care. She also reviews the Women’s Health Initiative-driven FDA black box warning placed in 2003 and describes FDA/HHS actions beginning Nov 10, 2025, and label changes approved Feb 12, 2026, removing broad warnings about heart disease, breast cancer, and dementia from several hormone therapy products while noting uterine cancer risk with estrogen-only therapy in women with a uterus. 00:00 Welcome to the Podcast 00:47 Why Estrogen Matters 01:48 Estrogen Receptors Everywhere 02:56 Types of Estrogen Explained 03:56 Brain and Hot Flashes 05:08 Bone Loss and Osteoporosis 06:32 Vaginal and Urinary Changes 07:17 Skin Joints Heart Metabolism 08:33 Symptom Timeline in Midlife 10:10 Black Box Warning History 11:22 FDA Label Changes 2025-2026 12:33 Risks Personalized Decisions 13:39 Wrap Up and Next Episode

  3. Jun 30

    What Actually Works for Menopause Weight Gain

    In this follow-up episode of Perimenopause the Podcast, Jamie Gallagher moves beyond the "why" behind menopause weight gain and inflammation and focuses on the "how." After explaining the science behind hormonal changes, inflammation, belly fat, insulin resistance, and metabolic slowdown in the previous episode, Jamie now shares practical strategies women can use to interrupt the cycle and regain control of their health.  This episode explores resistance training, high-protein nutrition, the Mediterranean diet, menopausal hormone therapy (MHT), GLP-1 medications, and why traditional approaches to weight loss often stop working during perimenopause and menopause. If you've been doing all the "right things" but still struggling with weight gain, inflammation, low energy, or changes in body composition, this episode offers a science-based roadmap for navigating this transition.  00:00 – Welcome back and recap of the previous episode00:45 – Why understanding the "how" matters01:15 – Pillar One: Rebuilding your metabolic engine01:45 – Why endless cardio isn't the answer anymore02:00 – Resistance training and reducing inflammation02:30 – HIIT workouts and visceral fat reduction03:00 – Why protein becomes more important during menopause03:30 – Protein recommendations explained03:45 – The Mediterranean diet and obesity prevention04:15 – Alcohol's impact on belly fat and metabolism04:45 – Pillar Two: Menopausal Hormone Therapy (MHT)05:15 – How estrogen influences fat distribution05:45 – Hormone therapy and inflammation reduction06:15 – What happens when hormone therapy stops06:30 – Pillar Three: GLP-1 medications explained07:00 – Semaglutide, tirzepatide, and women's health07:30 – Why women often respond differently than men07:45 – Protecting muscle while losing weight08:00 – The importance of strength training during GLP-1 use08:15 – Building a complete weight-loss strategy08:30 – The role of nutritionists, trainers, and clinicians08:45 – Changing your strategy instead of blaming yourself09:00 – Final thoughts and encouragement

  4. Jun 23

    Why Menopause Weight Gain Isn't Your Fault

    In this episode of Perimenopause the Podcast, Jamie Gallagher tackles one of the most frustrating and misunderstood challenges women face during perimenopause and menopause: weight gain and inflammation that seem to appear out of nowhere. If you've found yourself eating the same foods, exercising the same way, and still noticing stubborn belly fat, increased inflammation, joint aches, brain fog, or changes in your metabolism, you're not imagining it—and you're not alone. Jamie breaks down the science behind hormonal changes, estrogen decline, FSH spikes, insulin resistance, visceral fat accumulation, muscle loss, and chronic inflammation. Most importantly, she explains why this transition is not a failure of willpower or discipline, but a biological shift happening inside the body. This episode is packed with practical insights and validation for women who have been blaming themselves for changes that are often driven by hormones, metabolism, and immune system changes beyond their control. 00:00 – Introduction to today's Ask Us Anything episode00:45 – The frustration of midlife weight gain and inflammation01:20 – Why this isn't a willpower problem01:45 – The connection between inflammation and weight gain02:00 – Estrogen's role in metabolism and immune health02:30 – The body's "internal thermostat" explained03:00 – Why women feel puffy and inflamed during perimenopause03:15 – Understanding follicle-stimulating hormone (FSH)03:45 – How FSH contributes to belly fat accumulation04:15 – Why weight gain often begins before menopause04:30 – The vicious cycle of visceral fat and inflammation05:00 – How belly fat acts like its own endocrine organ05:20 – Insulin resistance and blood sugar changes06:00 – Why normal labs don't always tell the full story06:30 – Muscle loss and metabolic slowdown07:00 – Sleep disruption, cortisol, and cravings07:30 – Why you're not lazy, broken, or failing08:00 – The power of resistance training and muscle building08:20 – Why lifting weights helps fight inflammation08:40 – Changing your strategy, not blaming yourself08:55 – Preview of next episode: practical solutions

  5. Jun 16

    Hormone Testing During Menopause: What Every Woman Should Know

    Women often hear conflicting information online about estrogen, progesterone, and hormone testing. Jamie explains why hormone levels fluctuate dramatically during perimenopause, why a single blood test rarely tells the full story, and why symptoms often provide more useful information than lab values alone. This episode also covers stopping birth control pills in midlife, hormone testing after pregnancy, when hormone testing is appropriate, and why some women may still benefit from lab work in specific situations. If you've ever wondered whether hormone testing can confirm perimenopause or menopause, this episode will help you understand what hormone tests can, and can't, tell you. 00:00 – Welcome back to Perimenopause the Podcast00:25 – Listener questions about hormone testing00:55 – Should women routinely check hormone levels?01:15 – Why hormone levels fluctuate so dramatically01:40 – Understanding hormone changes during perimenopause02:00 – Why symptoms matter more than a single lab test02:15 – Stopping birth control in your 40s: what to expect02:40 – How birth control affects hormone testing02:55 – Could birth control be masking menopause?03:10 – Hormone testing after pregnancy and childbirth03:35 – When hormone testing may be appropriate03:50 – Testosterone monitoring and hormone therapy04:10 – New research on estrogen and bone health04:35 – Why hormone testing is trending online04:50 – The better question to ask about your symptoms05:15 – Final thoughts and listener questions

  6. Jun 9

    Surgical Menopause: The Missing Piece Many Women Never Hear About

    In this Ask Us Anything episode of Perimenopause the Podcast, Jamie Gallagher answers a heartfelt question from Tammy, a woman struggling to feel like herself after a total hysterectomy and bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes). One and a half years after surgery, Tammy describes feeling like her hormones and body are "a wreck." Jamie explains the difference between natural menopause and surgical menopause, the health impacts of ovary removal, and why many women continue to struggle when the right hormone therapy has not been explored. This conversation covers estrogen therapy, long-term health risks, surgical menopause recovery, and practical ways women in rural communities can access menopause specialists through telehealth and professional networks. If you've experienced ovary removal, hysterectomy, surgical menopause, or persistent hormone symptoms, this episode offers education, validation, and hope. 00:00 – Welcome to Ask Us Anything00:30 – Tammy's question: "My hormones are a wreck"01:15 – What is a bilateral salpingo-oophorectomy?01:50 – Why the reason for ovary removal matters02:30 – Understanding surgical menopause03:00 – Long-term health effects of ovary removal03:45 – Heart health, bone health, brain health, and libido04:15 – Why estrogen therapy matters04:45 – The hormone Tammy didn't mention05:00 – Why you don't have to accept feeling miserable05:20 – Finding menopause specialists through telehealth05:40 – How to use Menopause.org to find care05:55 – Why it's not too late to feel better06:15 – Final encouragement and closing thoughts

  7. Jun 2

    From Military to Menopause: A Partner's Perspective

    In Part 2 of the Meet the Founder series on Peri & Pause, Jamie is joined by her husband and co-founder, Stu, to discuss his background in international business and a 26-year military career, his transition into civilian life, and how mission, purpose, and service shape his leadership. They explore what Stu saw in Peri & Pause early on, the parallels between military mission-focus and building a menopause care company, and the persistent midlife women’s health care gap he witnessed through his mother’s experience and Jamie’s own perimenopause. Stu describes how perimenopause can strain relationships when symptoms are misunderstood, emphasizes addressing root causes rather than just symptoms, and encourages partners to show patience, seek help, and support women through care that can improve families, work, and overall quality of life. 00:00 Meet Stu Intro 01:33 Military Roots 03:17 Leaving Service 04:47 Vision For Peri Pause 06:10 Mission Parallels 07:47 Care Gap Reality 09:32 Partner Perspective 13:40 Mom And Family Impact 17:39 Advice For Partners 18:31 Thick Skin and Support 18:55 Men Asking for Help 20:39 Building Together Talk 22:51 Napkin to Launch 23:58 Balancing Risk and Caution 26:17 Mission Bigger Than Us 28:06 Scaling the Impact 30:11 Gratitude and Outro ------This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives. Visit https://periandpause.com for more info

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About

The Peri & Pause Podcast is for women in midlife who know something in their body has changed—but haven’t been given real answers, or have been left overwhelmed by conflicting information. Hosted by Jamie Gallagher, DNP, FNP-C, MSCP, a nurse practitioner specializing in perimenopause and menopause care, the show explores hormones, metabolism, mental health, sleep, sex, weight changes, and chronic conditions through an evidence-based, deeply practical lens. We unpack the physiology of midlife alongside the lived experience of women navigating careers, relationships, finances, and identity during this transition. Every woman deserves this conversation—and the clarity, language, and confidence to advocate for better care. Because “Your Labs Are Normal” Is Not the Whole Story.

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