Brain fog, weight gain, mood changes, disrupted sleep, and a fading sense of feeling like yourself can all become part of the perimenopause experience. But why do these changes happen—and why are so many women still struggling to find informed care? In Episode 347 of Money Matters, Christopher Hensley, RICP, CES, speaks with Dr. Susan Hardwick-Smith, a nationally recognized OB-GYN, certified menopause practitioner, author, and founder of Complete Midlife Wellness Center. Dr. Hardwick-Smith explains the hormonal transition from the fertile years through perimenopause and menopause, including how changing estradiol, progesterone, and testosterone levels may affect the brain, sleep, metabolism, muscle, mood, and sexual wellness. She also discusses the continuing debate around menopausal hormone therapy, why specialized menopause training matters, and how women can begin planning for a longer health span. In this conversation What perimenopause is and why symptoms vary Brain fog, mood, memory, and sleep changes Metabolism, insulin resistance, and midlife muscle loss Sexual wellness and the role hormones may play Questions surrounding the 2002 Women's Health Initiative reporting How to find a qualified menopause practitioner Practical steps women can begin taking in their 40s and 50s Chapters 00:00 Compliance disclosures and show introduction 00:38 Cold open: hormones and brain function 01:04 Welcome and episode introduction 02:46 The three hormonal phases of a woman's life 04:35 How perimenopause may affect the brain 06:14 Why symptoms vary from woman to woman 08:19 Hormone therapy and the 2002 WHI debate 13:03 Metabolism, muscle loss, and midlife weight changes 15:57 Sexual wellness, desire, and testosterone 19:13 Who may benefit from treatment and finding informed care 21:29 Advocating for yourself in the medical system 23:17 Why Complete Midlife Wellness Center was created 24:46 Create Her and planning for a longer health span 27:11 Three practical steps for women in midlife Resources mentioned Complete Midlife Wellness Center The Menopause Society practitioner directory Create Her: Aging Into the Healthiest Version of Yourself by Dr. Susan Hardwick-Smith — book details and preorder information (publishes February 2, 2027) Subscribe to Money Matters for practical conversations about the financial, physical, and personal decisions that shape a well-planned life. This episode is for educational purposes and is not personal medical advice. Treatment decisions should be made with a qualified healthcare professional. Medical interpretations and treatment perspectives expressed in the conversation belong to the guest.
