OvaryActive

Perimenopause is still taking the blame… but in this unexpected third installment (because Amy just got too excited), we're talking about functional hypothalamic amenorrhea (FHA). 
Dr. Chrisandra Shuflet joins the Docs in this episode of OvaryActive to explain FHA, tell us why it is often missed or dismissed, and how it's diagnosed. The conversation explores how disrupted brain signaling leads to low estrogen, why it's a diagnosis of exclusion, and how this condition shows up most often in younger women, even though its impact can follow you well into perimenopause and beyond.
As a condition that can look like perimenopause but is actually your brain hitting the pause button on your ovaries. If your cycle disappears and you're nowhere near your forties, it's probably not peri… it's your body responding to stress, under-fueling, over-exercising. Or maybe all of the above.
What you'll hear in this episode:
[0:34] Welcome Chrisandra Shufelt, MD
[3:46] What is FHA?
[6:02] A diagnosis of exclusion
[7:00] Lab patterns to distinguish FHS, PCOS, POI
[8:45] Who is most at risk:
[13:42] Why do so many women go years without a diagnosis?
[18:14] Long-term risks
[20:30] Cardiovascular connection
[22:38] ARCH study
[29:13] What does a history of FHA mean in perimenopause?
[33:34] Treatment approach (sorry, no Rx)
[37:22] Final takeaways: you are NOT crazy still applies!
 
Links:
Reveal trial: https://www.mayo.edu/research/clinical-trials/cls-20570285
Dr Shufelt: https://www.mayo.edu/research/faculty/shufelt-chrisandra-l-m-d/bio-20542101
@chrisandra-shufelt-md-ms-facp-mscp on LinkedIn
 
Follow the show @OvaryActive Instagram | YouTube
 
Meet the Docs:
More information about Dr. Rebecca Dunsmoor-Su: 
Gennev:  www.gennev.com/clinician/dr-rebecca-dunsmoor-su
LinkedIn @rebecca-dunsmoor-su
 
More information about Dr. Amy Voedisch:
Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

This episode was produced by Audiotocracy Podcast Production.

Perimenopause gets blamed for a lot of things – mood swings, weird cycles, rogue chin hairs – but sometimes the culprit isn't peri at all. In Part 2 of When It's NOT Peri, the Docs are talking about polycystic ovarian syndrome (PCOS), a condition that looks suspiciously like perimenopause but actually comes from a completely different hormonal playbook.
The hosts explain what PCOS actually is, why insulin resistance sits at the center of the syndrome, and how symptoms like irregular periods, acne, hair growth, and weight changes can overlap with perimenopause. They also walk through how doctors diagnose PCOS, the famous Rotterdam criteria, and why clinicians often have to rule out several other endocrine issues before landing on the diagnosis.
The episode also explores how PCOS evolves across the lifespan and why the metabolic side of the condition still matters long after the reproductive years are over.
What you'll hear in this episode:
[1:11] PCOS defined and misnamed
[3:29] Symptoms that overlap
[5:55] Ethnicity and different presentations
[7:42] Rotterdam diagnostic criteria
[12:16] Who gets diagnosed and when
[18:00] Hormone signaling and ovulation disruption
[20:48] Fertility timing, OPKs, & birth control
[29:54] Lifestyle and metformin
[33:22] PCOS in perimenopause
[37:10] Research gaps and advocacy
[40:09] Takeaways
 
Follow the show @OvaryActive Instagram | YouTube
Meet the Docs:
More information about Dr. Rebecca Dunsmoor-Su: 
Gennev:  www.gennev.com/clinician/dr-rebecca-dunsmoor-su
LinkedIn @rebecca-dunsmoor-su
 
More information about Dr. Amy Voedisch:
Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

This episode was produced by Audiotocracy Podcast Production.

Perimenopause gets blamed for a lot… but sometimes it's innocent. In this first episode of our two-part series When It's NOT Peri, the Docs talk about what happens when symptoms that look like perimenopause are actually something else entirely. Sometimes the ovaries aren't "transitioning"… they're waving a much earlier white flag.
This episode of OvaryActive zeroes in on premature ovarian insufficiency (POI). This is a condition where ovarian function declines before age 40. Dr. Rebecca Dunsmoor-Su and Dr. Amy Voedisch walk through what POI is and what it isn't. They also talk about why diagnosis can take years, how it differs from typical perimenopause, and the detective work involved in ruling out other causes like thyroid issues, genetics, or prior treatments. 
Along the way, listeners will understand why symptoms can feel confusingly similar yet require a completely different medical approach. POI is more than a cycle change. It's a long-term health consideration affecting bone, heart, brain, fertility, and mental health. And early treatment matters. 
Think of this episode as the "wait, could it be something else?" guide: equal parts validation, science, and practical next steps to help you recognize when maybe it's NOT peri.
What you'll hear in this episode:
[1:52] Maybe it's NOT peri. Maybe it's POI
[6:15] The workup: genetics, fragile x, turner syndrome, & more
[9:41] Causes to rule out
[12:09] We treat POI aggressively, here's why
[15:46] Long-term health stakes bone health, heart & brain, mental health, & sexual health

[23:43] How to treat POI
[26:25] Contraception options in POI
[30:12] Long-term planning
[32:54] Special cases
[39:06] Key takeaways & wrap-up: POI is NOT peri
 
Follow the show @OvaryActive Instagram | YouTube
 
Meet the Docs:
More information about Dr. Rebecca Dunsmoor-Su: 
Gennev:  www.gennev.com/clinician/dr-rebecca-dunsmoor-su
LinkedIn @rebecca-dunsmoor-su
 
More information about Dr. Amy Voedisch:
Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

When we talk about perimenopause, we talk a lot about symptoms, but not nearly enough about what's happening to your heart. Since February is Heart Health Month, it's the perfect time to take a "beat" to focus on your cardiovascular health.
In this episode of OvaryActive, the Docs zoom out from hot flashes and hormones to talk about the number one killer of women: cardiovascular disease. They also explain why the menopause transition is a critical (and often ignored) window for heart health. 
Preventive cardiologist Dr. Beth Abramson joins Dr. Rebecca Dunsmoor-Su and Dr. Amy Voedisch to connect the dots between perimenopause, estrogen changes, and rising cardiovascular risk. 
They talk about why cholesterol and blood pressure tend to creep up after ovarian function declines and how lifestyle factors actually matter more than we'd like them to. This conversation reframes midlife as an opportunity, not a countdown. 
The takeaway? You're not doomed, but you do need to pay attention. Your heart has been quietly keeping score this whole time.
What you'll hear in this episode:
[0:28] Welcome Dr. Beth Abramson
[1:20] Heart health 101
[5:21] Understanding risk factors and prevention
[7:30] Diet & exercise: practical advice
[12:34] Menopause & cardiovascular health
[16:30] Pregnancy & long-term heart health
[24:11] Lp(a) explained
[26:29] Hormones ≠ heart shield
[32:14] Risk–Benefit Math
[40:16] What the future holds
[44:07] Basic health practices are important
[44:36] A few final thoughts on heart health
 
Resources:
cardiometabolicprevent.ca
Follow the show @OvaryActive Instagram | YouTube
 
Meet the Docs:
More information about Dr. Rebecca Dunsmoor-Su: 
Gennev:  www.gennev.com/clinician/dr-rebecca-dunsmoor-su
LinkedIn @rebecca-dunsmoor-su
 
More information about Dr. Amy Voedisch:
Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

Birth control or hormone therapy? Why does this decision feel like a personality test you didn't study for? 
In this episode of OvaryActive, the Docs tackle one of the most confusing (and hotly debated) topics in perimenopause: when birth control is actually the right choice, when menopausal hormone therapy makes more sense, and why TikTok might not be the best place for medical nuance.
Dr. Rebecca Dunsmoor-Su and Dr. Amy Voedisch walk listeners through how clinicians actually think about this decision. The process includes contraceptive needs, bleeding patterns, symptom "greatest hits," and medical history that actually matters. 
The Docs will guide you through the options and even cover what a combination approach might look like. Most importantly, shared decision-making, not social media panic, should guide treatment choices.
This episode reminds you that perimenopause is real, complicated, and highly individual. And the right plan is the one that treats your physiology, not someone else's algorithm.
What you'll hear in this episode:
[1:05] Birth control vs. hormone therapy
[2:49] Contraception needs during perimenopause
[5:34] Understanding menopausal hormone therapy
[7:45] Assessing symptoms
[16:59] So many choices! How do you choose?
[22:03] Breakthrough symptoms
[23:51] Combination approaches (Amy's FAV)
[29:58] You didn't miss the window!
[35:32] Alternative methods & why they may not be a good fit
[40:22] You're NOT crazy!
 
Follow the show @OvaryActive Instagram | YouTube
 
Meet the Docs:
More information about Dr. Rebecca Dunsmoor-Su: 
Gennev:  www.gennev.com/clinician/dr-rebecca-dunsmoor-su
LinkedIn @rebecca-dunsmoor-su
 
More information about Dr. Amy Voedisch:
Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html