Joanna Strober of Midi Health Bets on Telehealth to Deliver Quality Menopause Care
Show Snapshot:
Like so many women in the swirl of perimenopause, health care founder and venture capitalist Joanna Strober found herself in midlife, suffering the fallout from fluctuating hormones and repeatedly misdiagnosed. What came next was Midi Health, a virtual care company for women 40+, offering high-quality medical care to women in perimenopause and menopause in all 50 states—covered by insurance. We dive into the ways the current healthcare system fails women 40+, cover menopause and its collateral impact ranging from disrupted sleep to depression to “toxic rage,” and get into capital raising as a female founder in the femtech space. Bonus: Joanna and Katie share a peek at their personal meno care routines, products, and must-haves.
About Joanna Strober: Joanna Strober is the founder and CEO of Midi Health, a virtual care platform for perimenopause and menopause covered by insurance in all 50 states. She was named to TIME100 Health, Forbes' 50 Over 50, and CNBC's Changemakers list in 2025.
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Transcript:
Joanna Strober [0:00]
If you're a woman and you have anxiety and depression and you're in your 40s, think hormones before you put someone on an antidepressant. For example, if you are a woman in your 40s and you're not having a sexual libido, think hormones — not that the marriage needs to fall apart.
Katie Fogarty [0:19]
Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. Beauties, if I told you that you could get hooked up with medical experts in a virtual care clinic that can treat your hot flashes, mood swings, disrupted sleep, and painful sex life, would you be in? My guest today is betting yes. I'm joined by Joanna Strober, the CEO of Midi Health, the only virtual care platform for women in midlife covered by insurance. Joanna started Midi after menopause affected not just her sleep, but her energy, weight, and mood — all of which improved when she finally got connected to the right treatment. Joanna started asking questions: Why isn't expert care for midlife women easily accessible and covered by insurance? Why don't more women know about the hormone transition and all the potential ways to manage it, whether with HRT, non-hormonal prescriptions, or supplements? What came next was Midi Health. Joanna is my favorite kind of guest — a woman who continuously evolves her work, her career, her creativity, and her contributions. She has founded several companies, spent years in venture capital and private equity, and is an author and a member of the Forbes 50 Over 50 list. And she has the best headshot — she's wearing a sweater with the phrase "Menopause is hot." We love a woman who is shaking things up and speaking her mind. Welcome, Joanna.
Joanna Strober [1:46]
Oh, what an amazing introduction! Thank you.
Katie Fogarty [1:48]
Well, thank you for the amazing work that you're doing. We often hear that necessity is the mother of invention — we know that famous phrase — but this podcast has featured so many midlife brand builders: women who are laser-focused on launching companies, products, services. I think we need an update: midlife is the mother of invention. Can we start by having you share the origin story of Midi?
Joanna Strober [2:12]
You just did a great job telling it. When I was around 47, I stopped sleeping. I was one of those people waking up in the middle of the night, and I was also still having my period. So when I went to the doctor, I was asking what's going on, and they said, "Well, maybe you need a sleep study." They sent me to get a very expensive sleep study and gave me some sleeping pills that they said I could take, but only once in a while because they were addictive. I found that because I was waking up in the middle of the night, I was eating too much during the day to get more energy, and it was a really downward spiral. I also got brain fog — I was losing my car in the parking lot, and I actually took an Alzheimer's test because I was so scared that I was developing early Alzheimer's. What's so interesting to me is that because I was still having my period, the doctor never even brought up menopause or perimenopause. So I didn't get the right treatment, and eventually someone suggested to me that maybe this was related to my hormones. I drove to San Francisco to see this amazing provider — I paid $750 for the visit — who figured out pretty quickly that I had some hormone issues and put me on the right hormone treatment. I was sleeping within two weeks. It was so frustrating that it had taken so long for me to get the right care, and that I had wasted so much time and emotional energy unnecessarily. That's really what led to the creation of Midi — thinking, this should be more accessible. It has to be covered by insurance. People shouldn't have to drive to San Francisco and pay a ridiculous amount of money to get this care. That was really the evolution of it.
Katie Fogarty [4:01]
That sounds like such a painful period of time, and I've heard that story from so many women — I experienced it myself. I sometimes joke that hot flashes have a very good PR agent, because they're synonymous with menopause, and if you're not experiencing hot flashes and you're experiencing other symptoms, sometimes it just gets overlooked. Sleep is a huge disruptor. I was having big mood swings, and it wasn't until I was safely through perimenopause and that hormonal roller coaster stopped that I really learned the suffering I was going through was directly related to menopause. Why — yes, another big stage-setting question — is menopause still so misunderstood? You had sleep issues. I had what I joke was "toxic rage," not hot flashes. Still, too many women don't understand that their symptoms are coming from perimenopause and then menopause, and they're not being treated. Why do you think so many women have been suffering in silence?
Joanna Strober [5:07]
Part of it is that the concept of menopause itself is problematic, because menopause technically means you haven't had your period for a year. So doctors know that, and that's the question they ask you: "Have you had your period?" I don't know how annoyed you get when you go to the doctor and the first thing they ask is, "When was the last time you had your period?" But the period of life for women — which really starts around 35 or 40, when estrogen starts to decline — is what brings about a lot of the changes to our bodies and brains that are related to this estrogen decline. The issue is there are very few providers trained in that. Most of us have stopped going to our OB-GYN, who might be keyed into this. Primary care doctors are absolutely not keyed into it. I joke that the people who probably need to be most keyed into it are marriage therapists — or therapists in general — because so many women start going through a lot of emotional anxiety, anger issues, a lot of emotional challenges that happen in this age category. If they had the appropriate medical care, that would go away. But therapists aren't trained in this either. I include myself in the group of women who went to a marriage therapist and talked about sex and sexual desire that had disappeared, and the marriage therapist never once said, "Well, maybe this is related to your hormones, and maybe that's why you're not interested in having sex." No one is trained to have that discussion. And if you haven't been trained to have the discussion, you end up giving women the wrong care. I hear that a lot from people.
Katie Fogarty [6:50]
Yeah, it's really incredible how women are being underserved, which is why we're grateful that companies like Midi are stepping into the breach. I'd love if you could take a minute to walk our listeners through how Midi works. You offer treatments across a range of modalities — what does that look like?
Joanna Strober [7:07]
At Midi, we really started with the concept of protocols. What we said is that women deserve the best expertise for any of the symptoms they have during this period of their life — that could include hormones, it could include medicine that isn't hormones, it could include supplements, it could include lifestyle changes. We spent about a year interviewing providers, experts, and professors about what would be the ideal treatment plan for each of the different symptoms women are experiencing — whether that's joint pain, painful sex, anxiety and depression, or some of the more esoteric things, like itchy ears. There are a lot of weird symptoms. It's wild.
Katie Fogarty [7:56]
Dry eyes — there's a whole host of things. Dry mouth.
Joanna Strober [8:00]
Yeah, or estrogen-depleted skin, which gets itchy. So we went out and created a bunch of protocols, and then we created something called Midi University, which is our training program. We now train providers on all of these different protocols. Before anyone provides care on our platform, they have to go through a very extensive training program covering all of these protocols, and then we hire them. We hire the providers to come work for us — they're not just part-time hourly workers, they're Midi employees. As a patient, you come to our website, book a visit with one of our providers, and fill out a pretty extensive questionnaire about your health history and the symptoms you're experiencing. Then you have a visit with one of those expertly trained providers, and that visit — now in all 50 states — can be covered by insurance. We don't have every insurance plan yet; we're working on that, but we're hoping that by the end of the year we'll have most of the PPOs in the country covered. You'd come and have a visit with one of our providers, and they'd give you a prescription. They might give you a blood test or send you to get one. That prescription gets sent to your local pharmacy, you'd use the prescription or the supplement, and then come back in about a month. It requires a little titrating, so usually you try one thing, and we check in — are you feeling better? We might make a few changes, but it usually takes two to three visits before someone is on their way to feeling better. Then they come back annually for titrating visits.
Katie Fogarty [9:46]
Okay, fantastic. I want to pick up, when we come back from this break, this notion of insurance and coverage across 50 states.
[ AD BREAK ]
Katie Fogarty [9:46]
Joanna, we're back. Before the break, you shared what a woman who's arriving at Midi can expect: an intake session, a questionnaire, and follow-up visits to make sure she's on track. I want to ask you about insurance coverage, because I know from reading your own personal story on Midi's site that when you were experiencing your symptoms and went in search of a healthcare provider, you wound up paying out of pocket. You said on the show it was $750, which is an expensive visit, and you had to go through tests that weren't covered. Why is it so important to make sure this kind of treatment is available and covered by insurance?
Joanna Strober [10:42]
Our company's mission is to give all women access to the highest-quality care, and to do that, you need insurance coverage. Our mission isn't just to provide high-quality care to women who can afford it. One thing that's happened in our society — and I don't fault any providers for this — is that once physicians are trained in this, they often go concierge, because they're able to make a lot more money. They become a concierge practice and charge $750 for the type of care they're providing, and there are so few providers trained in this that that's become the default. A lot of the people you see on Instagram, for example, who are phenomenal providers, charge $1,000 to $2,000 for visits. I give them credit — I admire all the ways women make money. But that's not, to me, the mission of Midi. The mission of Midi is to truly democratize access to this great care, and to do that, you need insurance coverage.
Katie Fogarty [11:52]
Yeah, it's interesting, because the insurance model is obviously a challenge. I have a good friend who's a gynecologist, and she went into private practice in part because she was driven there by the six-minute visits she was forced to give patients over the course of a day, where she felt the women weren't getting the attention they deserved, and she felt so stretched thin. So she launched her own practice where she doesn't take insurance, but she's able to give people the time and attention they want. In doing my research for this conversation, I saw the wonderful write-up you had in USA Today a couple of weeks ago. A journalist tested a bunch of different telehealth providers and shared that she had such a positive experience with Midi, because her first session was 60 minutes with one of your providers, who really took the time to do a deep dive into her symptoms and medical history. Is that something you're able to give every woman on her first visit? What does a first visit look like, and what do follow-up visits look like?
Joanna Strober [13:04]
On average, our visits are 30 minutes. That journalist got lucky — probably no one was booked after her. But we've found that 30 minutes is enough to get started: to get the first medication, figure out the next steps. The follow-up visits are a combination of 15-minute and 30-minute visits, depending on the severity of the symptoms and the type of care required. Going back to your friend — we do know that most doctors actually only have six minutes per visit. That's actually standard of care. Most of the nurse practitioners who come work for us had been doing 30 to 40 visits a day at other organizations. With us, they do 13 to 15 visits a day, so we're able to give our patients a lot more time. We do this by using technology — we don't have to pay for in-person care, and we use technology to make our systems more efficient. We also use AI to make sure the care is high quality. We have a bunch of technology tools that let us scale so the business model works with 13 to 15 visits a day, rather than the 40 visits a day that happen in most in-person organizations.
Katie Fogarty [14:27]
Yeah, 30 minutes is definitely far preferable to six, which is just an astonishingly quick turnaround for a visit. So I'm curious — you're now available through insurance in all 50 states, and you've been delivering care for a while now. What are women coming to you with, primarily? Are they coming in search of HRT? What are the biggest sources of complaint and challenge for your patients?
Joanna Strober [15:01]
One thing that's been very interesting to me is that when we started the company, we thought of ourselves as a perimenopause-menopause company. We thought women would come to us to get HRT, and that was our original hypothesis. We've actually found we're much more than that. Around 45% of the women who come to us haven't seen a doctor in four to ten years. They haven't had mammograms. They haven't had colonoscopies. They haven't done a lot of the preventive care a primary care doctor would provide, because honestly, they've been taking care of their kids, they've been working, and they haven't had time to take care of themselves. So a broad spectrum of women come to us and we actually become their primary care provider, because they don't have another one. They're interested in perimenopause and menopause symptoms, but then we end up diagnosing them with diabetes, or thyroid issues. There's a lot we find about these women because they really lack the primary care support they need. And the average woman comes to us with five symptoms, not just one, so we're addressing a lot of different things. Finally, we have real expertise in survivorship. Dr. Mindy Goldman from UCSF is one of the world's experts in women who had cancer and then experience early, often quite severe menopause symptoms. We have a survivorship track, and a lot of women come to us who had breast cancer or other types of cancer and are experiencing menopause symptoms because of it — and we can treat those women because we have protocols developed specifically for them.
Katie Fogarty [16:49]
Yeah, it's phenomenal — the whole notion of surgical menopause. I was introduced to that, honestly, by launching this podcast. I'm not in that category, so I was sort of blissfully unaware that when you're treated for breast cancer or other cancers, surgical menopause often results, and those women — especially if they're young — don't necessarily have a community of support. At 54, when I went through menopause around the time most people do, I was able to talk about it with my friends. So I love hearing that you've created a survivorship community as part of Midi. I want to switch gears for a minute and ask you about the business side of Midi. I know you've raised $25 million in a Series A, and now you're looking to raise $60 million in a Series B. Raising money is never easy, and I know you know this because you worked in venture capital and private equity for years. Menopause is now firmly in the zeitgeist — everyone from Naomi Watts to Oprah is talking about it. We had that big blockbuster New York Times article by Susan Dominus several months ago. Do you feel it's gotten easier to capture investors' attention about the size and scope and importance of this market now that there's been more conversation, or is it still challenging to get people to recognize that this enormous block of consumers needs care?
Joanna Strober [18:21]
Is menopause a niche? Maybe that's the question.
Katie Fogarty [18:24]
That's a much tighter, shorter question — I'll put you in the driver's seat. But I don't think menopause is a niche. We're more than 50% of the population, and we spend a third of our lives in menopause and postmenopause.
Joanna Strober [18:40]
No, that's right. It's funny that we actually have to explain that to people. I guess I have two answers. Answer number one: it's always hard to raise money in this environment — it's hard to raise money in any environment. Women entrepreneurs only get 2% of funding, so when women are raising money, it's hard. I do believe there's increasing awareness of this category as interesting, and honestly, what you have to do is show traction to get funding. The first round of funding we did was incredibly challenging — explaining to people what we were doing and why we were doing it, there was a lot of skepticism. It was very hard to get that first round of money. The difference now is that we're growing so quickly, we have a lot of patients, and we have health systems and employers working with us. So it's easier now because we're showing that we're scaling a business and that there's a big opportunity here. It's not because people think, "Oh, menopause is interesting" — it's because we have revenue, we have patients, we have a business model that really works, and that's fun.
Katie Fogarty [20:01]
Got it, got it. All right, well, cheers to getting the money you need to build this business and serve a greater number of people. Are you able to share the number of patients that come through Midi? Is that something you're disclosing?
Joanna Strober [20:16]
I think we're on track for 100,000 women this year.
Katie Fogarty [20:18]
Wow, okay, that's phenomenal — let's get you there. If you're listening and you're in need of a healthcare provider, go check out Midi and see if they take your insurance. And if they don't, maybe ask your insurance to put this on their radar.
Joanna Strober [20:35]
And honestly, we take cash pay too — about 5% of our patients are cash pay. It's still cheaper than going anywhere else to get this type of care.
Katie Fogarty [20:46]
Yeah, absolutely. I've learned from doing this podcast and attending menopause events, and from hearing people active in this space, that there's a provider desert across great swaths of this country. There are no OB-GYNs or other healthcare practitioners in a lot of counties, and it's hard for patients to find care. So, is all of your care telehealth, or is there any in-person component to your services?
Joanna Strober [20:46]
We do not have an in-person component. It's all telehealth.
Katie Fogarty [20:46]
Okay, great. So if you're having trouble finding a provider in your area, I'd definitely recommend you check out Midi. Joanna, let's do another switch of gears. I know from prepping for this that you had an early career — you launched and sold another digital health platform, you worked in VC and private equity for 15 years. I learned that you've written a book, and I'd love for you to share what it is with our listeners, and then I want to ask you some specific questions about it.
Joanna Strober [21:49]
We wrote a book called Getting to 50/50, starting in 2004, and it came out in 2008 — it took us four years to write. The goal of the book was to help women stay in the workforce after having children. We saw so many of our friends who had worked really hard to build their careers leaving because they found it difficult to manage staying in the workforce while having children, and we wanted to support them in that. That was the concept behind the book. It came out in 2008 and sold a lot of copies — it was a really rewarding experience.
Katie Fogarty [22:30]
Nice. The book offers strategies for making it work, but it's really rooted in myth-busting — busting the myth that you can't have a career and a family, that they're mutually exclusive. You wrote an entire book to dispel that myth. I think menopause has a lot of myths associated with it too, and midlife in general. I'd love to start by asking: what do you think the biggest myth about menopause is that you'd like to dispel?
Joanna Strober [23:02]
For me, it gets back to the word "menopause," honestly, because menopause technically means you haven't had a period. What people don't understand is that the symptoms of this stage of being a woman — I don't know how else to say it — start around 40. If you go to a doctor and you're a woman, most doctors don't think that way. I joke that when you hear hoofbeats, think horses, not zebras. If you're a woman with anxiety and depression in your 40s, think hormones before you put someone on an antidepressant. If you're a woman in your 40s and you're not having sexual desire, think hormones — not that the marriage needs to fall apart. There's been this lack of understanding that a lot of things happening in women's bodies are related to hormones and aren't being appropriately treated, and it ruins a lot of women's lives.
Katie Fogarty [24:02]
Yeah, I've heard that. I've had a number of listeners reach out to me over DMs saying things like, "I wish I'd listened to your show before I blew up my marriage."
Joanna Strober [24:12]
Yes.
Katie Fogarty [24:12]
"I wish I'd had this information ten years ago, before I made myself crazy and really doubted myself." It's so painful to hear that. Frankly, I put myself in that category too. I had really volcanic mood swings that I thought had to do with the pandemic, and in part they did — sheltering in place with everyone I gave birth to, my husband, and my new puppy was challenging. But a lot of it was just this roller coaster of hormones and lack of sleep. It's challenging. There's something so supportive about recognizing, for yourself, that this is just a moment in time and it'll pass. When you don't know that — when you're in the undertow of a hormonal tsunami — you don't know it's ever going to end. But if somebody had let me know that some of the big turbulence calms down once you make it through, even though you need to manage symptoms for the rest of your life, that would have helped.
Joanna Strober [25:17]
Yeah, I don't know about you — I remember my husband saying, "You are so angry all the time. I feel like I can't do anything right. You're so angry." I wish someone had told me then, "Actually, this is just related to your hormones," and put me on hormones earlier. I think we would have had a much easier time.
Katie Fogarty [25:41]
Yeah, 100%, I feel the same way. I've had wonderful conversations with women who've shared that they're communicating with their husbands about this, communicating with their children about it. I wasn't able to give my husband that life raft at the time, when we were all in the tsunami of my hormones — we didn't know what was going on. My kids actually edit my podcast transcripts. My daughter, who's 23, and my son, who's 20, make extra spending money cleaning up the AI transcripts. It's great — the best part is that they'll never be confused when this happens to them or someone they love. They already know so much more than many adults do about this time of life. I love that. If we're doing some myth-busting, what about midlife in general? Do you have any midlife myths you keep bumping up against that you think need to go the way of the dinosaur — or the dodo?
Joanna Strober [26:41]
I'm having the most amazing midlife right now. My kids are leaving, and I'm actually finding it an incredibly empowering time of life, because I have a lot of time. It's funny — for so many years, if I was at a networking event or work event, I was so stressed about getting home to be with my kids. Now that they're not here, it's actually incredibly liberating. I can stay out late, I can work. I think as you get older, you actually have more energy and more time to work if you want to, and I'm finding that incredibly empowering.
Katie Fogarty [27:16]
Yeah, I love that — I do too. There's something sad about your family dynamics changing, but I'm so delighted watching the adults my kids are becoming, and watching them go off and live their own lives and have their own adventures. It's really exciting — I feel like you've done the job well when you see them head out the door. I should say I still have one at home who's younger, so maybe I'm not a full empty nester yet. I may feel differently when everyone's totally gone, but I love this moment too. We're nearing the end of our time, but before we move into our speed round, I want to ask about the non-negotiables in your menopause care routine, if you don't mind sharing. One of the things I loved about the Midi website is that the leadership team, including you, shares your own personal menopause stories, which I thought was really open and transparent — we want a lot of sunlight on these topics. You each also share a bit about your own self-care routines. I'm always super curious what's in another woman's handbag, so I'd love to know what's in your menopause care handbag, if you don't mind sharing.
Joanna Strober [28:39]
Yeah, so I'm on the estrogen patch — 0.1 now. I actually went up recently; I was at 0.075, and now I'm at 0.1. I'm on progesterone, 200 milligrams, at night. I also take a cortisol manager that's a combination of ashwagandha and L-theanine, to help manage stress. I also take lavender pills, which have also been shown to reduce stress. So I'm trying both the supplement route and the prescription route for my care. Midi does make an estrogen skin cream that I use, and I'm quite confident it's made an impact on my face — I'm kind of addicted to using estrogen on my face too — and I also use vaginal estrogen. I joke that I have a lot of estrogen: estrogen in my vagina, estrogen on my face, and estrogen in my body. I'm very addicted to estrogen.
Katie Fogarty [29:37]
You're an estrogen activist! I had Monica Molenaar from Alloy Health on the show once, and she said we should all be estrogen activists — I just love that.
Joanna Strober [29:45]
That's exactly right. I like estrogen, but I actually really believe that the cortisol manager with ashwagandha and L-theanine works for me, and I think the lavender pills are working too. Oh, and magnesium for sleep — I recently added magnesium, and I love it.
Katie Fogarty [30:02]
I love it too. I don't take it all the time — I sort of reserve it for when I need a knockout punch, because I've personally found that if I take it once a month or so, it really helps me sleep on days when I need to, like if I've been traveling, or if I'm in a high-stress moment, or if I have public speaking the next day, I'll hit the magnesium bottle. I think it's really effective. So we're moving into our speed round — this is just a one- or two-word answer, so we can end on a high-energy note. Okay, let's do this. I could talk about this menopause topic again and again.
Joanna Strober [30:46]
Estrogen.
Katie Fogarty [30:47]
You have a section on your website called Midi Explains. You cover great topics like pelvic floor health and pain with sex. What's the number one concern you hear from women?
Joanna Strober [30:59]
Sleep issues.
Katie Fogarty [31:00]
Entrepreneurship is a roller coaster. What lifestyle hack keeps you sane and the trains on the tracks?
Joanna Strober [31:07]
Walking, and doing as many walking meetings as I can.
Katie Fogarty [31:11]
Ooh, I love that! Midi recently received a glowing write-up in USA Today. What's been another fun review, or place Midi has taken you?
Joanna Strober [31:22]
This is a really fun podcast. I've loved this discussion.
Katie Fogarty [31:25]
Oh, good — I love that, I love to be the fun place. Thank you! You have a fabulous headshot, as I mentioned earlier, and you're wearing a sweater that says "Menopause is hot," right? I love it because it's like you're owning it. Navigating menopause sometimes gets a bad rap — yes, there are challenges, but there are also benefits. What's been an unexpected benefit of menopause, or of getting to midlife?
Joanna Strober [31:50]
I've become braver. I think I'm definitely braver now that I'm in midlife.
Katie Fogarty [31:57]
I so agree, I love that. This is more than a one-word answer, but why do you think that is?
Joanna Strober [32:04]
Finally, you know what — I just want to do, at this point, what makes me happy and what makes a difference to help people. I'm much less worried about what people think of me, how they're perceiving me. I just want to be really brave and pursue this passion as strongly and audaciously as I can, and I feel like I've earned the ability to do that, which is super exciting.
Katie Fogarty [32:30]
It is exciting, right? Cheers to being audacious! All right, finally, this last question: what's your one-word answer to complete this sentence — as I age, I feel...
Joanna Strober [32:40]
Braver.
Katie Fogarty [32:41]
Braver — nice, nice, nice, nice. I love that, Joanna. This has been such a treat, thank you so much for your time. Before we say goodbye, how can our listeners keep following you and Midi?
Joanna Strober [32:53]
I post a lot of articles on LinkedIn about menopause and perimenopause, so if you want to learn about a lot of the research, I do post that on LinkedIn — you can follow my profile, which is just Joanna Strober. I'd also recommend the Midi website, joinmidi.com, and we have, as Katie mentioned, a blog section there where we write a lot of really good articles. We also share a lot of good data on our Instagram — if you follow us there, we take that seriously as a place to share research and information on perimenopause and menopause treatments. We also host a number of events with experts to talk about different health issues — last week we had one on heart health and women. We believe that in addition to being a care company, we're an education company, and our job is to educate women. So whether you're on my LinkedIn, our website, or our Instagram, you'll find a lot of education about navigating midlife.
Katie Fogarty [34:01]
Phenomenal — I'll put that all in the show notes. Thank you so much, Joanna.
Beauties, don't go anywhere — we're starting a new segment today to close every show. I'm taking questions from you, the listening audience. If you have a question, if you're curious about something, please email me at katie@acertainagepod.com, or hop over to Instagram — you can DM me there, I'm hanging out on Instagram a lot, it's super fun, come join us at A Certain Age Pod.
The first question comes from Carol T. Carol asks, "Katie, are you using HRT, and if you are, what has your experience been?" I love this question — the answer is yes, I am. The second part of the answer might be: it took me too long. This fell to the bottom of my to-do list forever — I kept meaning to explore this with my doctor. It took recording, I don't know, my fifth or sixth show with an expert talking about the importance of HRT for navigating menopause and managing overall health, to finally get me into action. So that's my first recommendation: talk to your doctor. This is a decision that needs to be made with you and your medical care provider. If you have a doctor who doesn't get it, who isn't up on the latest science, who kind of discourages you, find a different doctor. You can find menopause-trained specialists at this wonderful nonprofit whose board I sit on, Let's Talk Menopause — hop over to letstalkmenopause.org to get connected to a caregiver in your area.
Okay, so on to the HRT that I do: I use a transdermal patch — my estrogen, my estradiol patch. I simply peel it off — it's a little sticky — and you put it on your bikini line, and change it twice a week. I'll share that I started off with the full dose at one point and had massive cramping and some bleeding. My doctor, in consultation with me, decided to halve the dose. So I literally cut the estrogen patch in half, and I put half on on a Monday, and the second half on on a Wednesday — I change it twice a week, and it's been super easy to do, and I've been feeling great on it. It definitely made a difference in terms of libido, energy, and all that good stuff. So that's number one.
Number two, I take progesterone at night, which is something you need to do if you're taking estrogen and you still have your uterus. I also use testosterone cream — this is a compounded cream I get from my gynecologist; she's a believer in testosterone. If you're curious about testosterone therapy, I encourage you to go listen to my last show of 2023, when I featured urologist and sexual wellness expert Dr. Rachel Rubin — she does a big download on testosterone therapy.
And finally, I use vaginal estrogen. I'm supposed to use this three times a week, but I'm going to be honest with you — I probably do it once. I forget. I'm not as good as I should be, but I want to get better. I'm very religious about the HRT I take in terms of my estrogen patch, progesterone, and testosterone cream, but I've got to be better, truthfully, about using my vaginal estrogen. I've heard from so many doctors that it's a key component to keeping your tissues healthy, to pain-free sex, and to preventing things like UTIs.
So there you have it, beauties — that's my HRT routine. Any questions, hit me up. But again, talk to your doctor. Thanks so much for this question, Carol. If you have your own, please send me an email or DM me on Instagram.
So that's it, beauties — this wraps A Certain Age, a show for women who are aging without apology. Before I say goodbye, you know what my favor is: I would love a podcast review. If you learned something on today's show, if you feel smarter, more informed, more supported, please take five minutes to write a short review over on Apple Podcasts or Spotify. Special thanks to Michael Lamancini, who composed and produced our theme music. See you next time, and until then, age boldly, beauties.
