Hot flashes aren’t the whole story. We sit down with Kaya Health clinicians Diane and Sierra for frank, science‑rooted talk about perimenopause, menopause, and andropause—and why so many of us feel “off” even when our labs say “normal.” If weight creeps up despite clean eating, sleep breaks at 2 a.m., or your moods swing without warning, you’ll learn what those symptoms signal and how to respond with smarter, safer care.

We break down what changes in the 40s versus the 50s, and why both estrogen highs and lows can feel confusingly similar. You’ll hear why bioidentical hormones are not the same as synthetics, how progesterone can calm night sweats and anxiety. We unpack pellet therapy pros and cons, outline safer dose‑adjustable options, and explain how delivery methods like topical estradiol can lower clot risk. For anyone with complex histories—including clots or cancer—we discuss risk‑aware paths, shared decision‑making, and why being heard matters.

Men, you’re in this too. Andropause brings a slow slide in testosterone that affects energy, libido, body composition, and brain clarity—and yes, you need some estrogen for cardiovascular protection. This is prevention, not vanity: better sleep before weight loss, nutrient‑dense food before pills, movement and muscle to protect longevity, and targeted bioidentical hormones to restore function, not chase youth. If you’ve felt dismissed by eight‑minute visits and “everything looks normal,” this conversation offers a roadmap to care that treats the person, not just the paper.