Sky Women's Health

The menopause headlines keep contradicting each other — hormones and Alzheimer’s, testosterone as a miracle fix, and a week later, “none of it holds up.” In this episode, Dr. Carolyn Moyers reads the actual studies behind this month’s headlines and tells you what’s real, what got oversold, and what it means for you.In this episode:• Two new studies on hormones and dementia — and the part the headlines skipped: the benefit didn’t clearly apply to women in typical, natural menopause• Why the benefit concentrated in women who lost estrogen early — and how that lines up with what guidelines already recommend• Risk reduction vs. prevention: why the difference is the whole point• Testosterone for women: what the newest review shows it truly helps — and why it’s not a brain or energy drug• Why there’s still no FDA-approved testosterone product for women — what it means to microdose the men’s version, and what an approved product would change• The FDA public workshop on testosterone in menopausal women (Sept 17, 2026) — and how to add your voice to the official record• A question you can use on the next headline you seeThis episode is for education and is not medical advice. Talk with your own doctor about what’s right for you.• The FDA workshop “Testosterone Use in Menopausal Women” is open to the public: register to watch, and submit a public comment through docket FDA-2026-N-5479 (comments open through Oct 19, 2026). Find it at fda.gov by searching the workshop title.https://event.skywomenshealth.com/world-menopause-day-8703https://event.skywomenshealth.com/world-menopause-day-8703🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com

First, the part no one should miss: for most healthy women, hormone therapy is safe and beneficial — and in November 2025 the FDA removed the decades-old boxed warnings that scared a generation away from it. So this isn’t an anti-hormone episode. It’s for the woman who was told she can’t use hormones, or who has chosen not to, and needs to know what comes next.Sparked by a listener’s Instagram comment, Dr. Carolyn Moyers names who genuinely can’t use hormone therapy — then turns to what patients ask about most: protecting your bones, heart, and brain through menopause, with or without hormones. (For the full non-hormonal hot-flash menu, this episode points you back to Episode 132, “Nonhormonal Management of Menopause Hot Flashes.”)In this episode:Why most healthy women can use hormone therapy safely — and what the FDA’s 2025 warning change meansThe genuine hard stops — and why many of them are more open than they sound (route, and exact diagnosis)Your bones: why menopause accelerates bone loss, and the plan that protects your skeleton without hormonesThe evidence-based non-hormonal menu for hot flashes — what works, and what to stop wasting money onYour heart: the leading cause of death in women, and the levers that actually move itYour brain: what really reduces dementia risk (and why there’s no magic pill)Why bones, heart, brain, and symptoms are one connected system — and the single change that moves all of themWhere to start: the numbers to know and the questions to bring to your doctorReferenced Episodes:Nonhormonal Management of Hot Flashes Episode 132 - AppleDementia Prevention Episode 251 - AppleWhy 65 Is Too Late to Screen Your Bones Episode 261 - Apple🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com#menopause #perimenopause #hormonetherapy #nonhormonal #hotflashes #breastcancersurvivor #gyncancer #bloodclot #bonehealth #hearthealth #brainhealth #GSM #tamoxifen #midlifewomen #skywomenshealth #drcarolynmoyers

You're waking up at 3 a.m. drenched, your moods don't feel like your own, and your once-predictable period has gone haywire. You finally ask for help — and you're told to just take a birth control pill, or to come back when your cycles stop.Here's what I want you to know: you don't have to wait to feel better, and the pill is one option, not the only one.In this episode, I take that myth apart and lay out the whole menu. I start with what I rule out first — because thyroid disease and insulin resistance can masquerade as perimenopause — and the full lab panel I run to catch them. Then the two questions that actually decide your treatment: do you need contraception, and what are your cycles doing? You'll hear why a birth control pill and menopausal hormone therapy are not the same medicine, how the hormonal IUD can cover contraception and protect your uterine lining while you add estradiol for symptoms, and why the delivery form — patch, gel, spray, ring, or pill — is part of the decision.Whatever you start with, hormone therapy is never one-and-done. The magic happens in the edits.Referenced in this episode:Progesterone vs. Progestins (Episode 253) → https://podcasts.apple.com/us/podcast/episode-253-the-hormone-question-i-answer-multiple/id1541657642?i=1000769336110Come work with us at skywomenshealth.com.🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com

Your bones are not static. They're living tissue that rebuilds your whole life — and in the years around menopause, that balance can tip toward loss, fast. So why are most women told to wait until 65 for their first bone density scan?In this episode, Dr. Carolyn Moyers welcomes back bone health specialist Dr. Kristi Tough DeSapri of Bone and Body Women's Health to talk about why 65 is too late for many women, when you should actually get screened, and what to do at every step — from a scary "osteopenia" result to a full osteoporosis diagnosis.In this episode:Why your bones aren't static — how bone actually rebuildsWhat estrogen does for bone, and why loss speeds up in perimenopauseWhy the standard age-65 screening guideline is too late for many womenWhen to get your first (baseline) DXA scan — and who's higher riskHow to read your results: T-scores and FRAX, without the panicOsteopenia diagnosis — what it means and what to do nextWhere hormone therapy fits for bone protectionHow osteoporosis is treated: bone-preserving vs. bone-building medicationsThe exercise, calcium, vitamin D, and protein that actually protect boneIf you want the foundation, go back to Episode 149: Bone and Body Health, where Dr. Tough DeSapri first joined us.This episode is for educational purposes only and does not constitute medical advice.🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗 Connect with Dr. Kristi Tough DeSapri📸 Instagram: @boneandbodywh🌐 Website: www.boneandbodywh.com

You've eaten the same foods for decades — and suddenly, in your 40s, wine gives you a headache, your skin itches at night with no rash, you're congested year-round, and hives show up out of nowhere. If you've ever typed "why am I suddenly allergic to everything" into Google, this episode is for you.Perimenopause changes more than your cycle — it changes your immune system. Estrogen and histamine are in constant conversation, and when hormones start fluctuating, that conversation gets loud. Board-certified OB/GYN and menopause specialist Dr. Carolyn Moyers sits down with Dr. Karen Kaufman, a double board-certified allergist-immunologist and founder of Corneva Clinic, to explain the midlife allergy surge no one warned you about.In this episode:• Why new allergies, wine intolerance, and food reactions show up in perimenopause• What estrogen does to mast cells and histamine — and why fluctuation matters more than decline• Hormone or histamine? How two doctors tell apart flushing, palpitations, insomnia, and headaches• Itchy skin at night, itchy ears, hives, and year-round congestion — what's actually driving midlife itch• Histamine intolerance and MCAS: what the evidence says, and where social media gets ahead of the science• Low-histamine diets — what's reasonable, what's over-restriction• Hives or flushing after starting hormone therapy: why it's information, not a reason to quit, the magic happens in the edits• What to track before your appointment, and whether to see your menopause doctor or an allergist first🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗Connect with Dr. Kaufman📸 Instagram: @dr.kaufmanallergy🌐 Website: https://kaufmanallergy.comhttps://cornevaclinic.com

You call the pharmacy to refill your estradiol patch — and it’s on backorder. Again. Or the brand changes every month, the adhesive won’t stay on, and nobody can tell you when your medication is coming back.Estrogen patches are in shortage across the United States, and the strain is spreading to progesterone capsules and estradiol gels and creams. In this episode, Dr. Carolyn Moyers sits down with Lauren Darisse, General Counsel and COO of The HRT Club, to explain what is actually happening in the hormone therapy supply chain — and what you can do about it.In this episode:– Why estradiol patches are so hard to find, and why demand for menopausal hormone therapy has surged– Why brand consistency matters with patches — adhesives, wear time, and absorption are not interchangeable– How a direct-from-manufacturer membership pharmacy works– What to do first if your patch, progesterone, or gel is on backorder this week– How to spot a legitimate hormone therapy source onlineAbout the guest: Lauren Darisse, Esq. is the General Counsel and Chief Operating Officer of The HRT Club, where she built the legal and operational infrastructure behind an insurance-free hormone therapy platform. She brings more than a decade of healthcare legal and compliance leadership from digital health companies including The Pill Club, One Medical, and Iora Health.Learn more about The HRT Club: thehrtclub.comDr. Carolyn Moyers is a board-certified OB/GYN, Menopause Society certified physician, and founder of Sky Women’s Health in Fort Worth, Texas — in-person in Fort Worth and virtual across Texas and West Virginia. Learn more at skywomenshealth.com.This episode is for education only and is not medical advice. Talk with your doctor before starting, stopping, or changing hormone therapy.🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗Connect with HRT Club📸 Instagram: @thehrtclub🌐 Website thehrtclub.com

She's been told to have a glass of wine. To just relax. That the pain is in her head. And she is still in pain — every time she has sex, every time she uses a tampon, sometimes just sitting at her desk. What she may have is a hypertonic pelvic floor: muscles stuck in a state of tension they cannot release on their own. In this episode, Dr. Carolyn Moyers sits down with Dr. Chailee Moss, board-certified OB/GYN at the Centers for Vulvovaginal Disorders in Washington, DC, and one of the country's leading experts in sexual pain — to talk about a treatment most women have never been offered: vaginal Botox.In this episode:• What a hypertonic pelvic floor actually is — and why it is so often missed• Why painful sex in midlife is not always "just hormones"• Who is a candidate for vaginal Botox, and what has to be tried first• What the procedure is really like: units, timeline, results, and side effects• Whether pelvic floor physical therapy is still necessary alongside Botox• Dr. Moss's current clinical study on incobotulinumtoxinA for pelvic floor dysfunction• Her published JAMA research on medical gaslighting in vulvovaginal careIf sex hurts, tampons hurt, or exams hurt — and no one has been able to tell you why — this episode is for you.🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗Connect with Dr. Moss📸 Instagram: @drchaileemoss🎥Podcast: https://podcasts.apple.com/us/podcast/vulva-talk/id1800293848?l=vi🌐 Website: https://vulvodynia.com/Study refererenced: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711?__cf_chl_f_tk=OLsdlLvt_yGlGELQw_cAXUG3OvtyeWEIHUOmORJNnKg-1783169445-1.0.1.1-pul.JSpT5O0ZhZ3a2S4.ewkDiByn6Lwj3LUpBR3DIng

What does your hormone history — birth control in your twenties, hormone therapy at menopause, or even the age you went through menopause — actually do to your brain? A landmark 2026 brain imaging study gives us a structural answer.Published in NeuroImage (Honea, Watts et al., 2026), this secondary analysis from the IGNITE trial scanned 459 women ages 65 to 80 using high-resolution MRI and measured gray matter volume and cortical thickness — two markers directly tied to brain aging and Alzheimer's disease risk. The paper is open access, meaning anyone can read the full text for free. Link below.Key findings: Women who had used hormonal birth control had significantly larger gray matter volume in the temporal lobe, inferior frontal gyrus, and parahippocampal gyrus. The longer the duration, the larger the fusiform gyrus volume. Women who used menopausal hormone therapy had larger volumes in the cuneus, precuneus, inferior temporal cortex, and inferior parietal cortex, plus thicker cortex in the middle temporal region. Women who used both showed the strongest structural brain picture of all. Later natural menopause onset was associated with greater cortical thickness across multiple regions.Dr. Moyers covers: What gray matter volume and cortical thickness tell us about brain aging and why they matter for Alzheimer's risk, which specific brain regions were affected and why their anatomy is relevant, how this connects to Dr. Lisa Mosconi's work on exercise and dementia risk (Episode 185), what the Critical Window Hypothesis says and where this study lands, the real limitations of this research, and what it means for hormone decisions today.Study: Honea RA, Watts A, et al. NeuroImage. 2026;334:121974. doi:10.1016/j.neuroimage.2026.121974 (Open access — free to read)Episode 185: What's the Brain Got to Do with Menopause? - https://podcasts.apple.com/us/podcast/sky-womens-health/id1541657642?i=1000662974536 🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com#menopause #hormonetherapy #brainhealth #alzheimersprevention #womenover50 #skywomenshealth #estrogenmatters

Burning. Itching. Tearing during sex. Told it's "just dryness" or "just menopause" — but the treatment never works.It might be lichen sclerosus or lichen planus — two skin conditions that affect the vulva and are diagnosed late (often years late) because they get mistaken for recurrent yeast infections or normal aging.In this episode, I sit down with Dr. Jill Krapf of the Center for Vulvovaginal Disorders to talk about:🔹 How to tell LS and LP apart from "just" dryness or yeast🔹 Why untreated lichen sclerosus carries a real (small) cancer risk🔹 What effective treatment actually looks like🔹 When surgery or further intervention becomes part of the picture🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗About Dr. Jill Krapf: Dr. Jill Krapf is a board-certified OB/GYN and founder of the Center for Vulvovaginal Disorders, specializing in the diagnosis and treatment of complex vulvar and vaginal conditions, including lichen sclerosus, lichen planus, and pelvic pain disorders.📸 Instagram: @jillkrapfmd🌐 Website: https://jillkrapfmd.com/

If you've ever had urinary symptoms that antibiotics didn't fix — and your cultures kept coming back negative — this episode is for you.A new 2026 study in the Journal of Sexual Medicine followed 253 women with recurrent UTIs and persistent urogenital symptoms despite negative urine cultures. What researchers found reframes everything: 85% of these women had hormonally mediated vestibulodynia, 75% had pelvic floor hypertonicity, and only 15% had a classic urologic cause for their symptoms.This isn't a bladder problem. It's a hormone problem — and the vulvar vestibule, urethra, and bladder are one integrated, estrogen- and androgen-responsive system. Whether it presents as genitourinary syndrome of menopause (GSM) in a postmenopausal woman or hormonally mediated vestibulodynia in a younger one, the tissue-level pathophysiology is the same.In this episode, Dr. Carolyn Moyers breaks down:• Why persistent urinary symptoms after negative cultures have a hormonal explanation• The shared embryologic origin of the vestibule, urethra, and bladder trigone — and why it matters• How androgen deficiency drives vestibular inflammation, pelvic floor guarding, and bladder dysfunction in a self-perpetuating cycle• Why this affects premenopausal women too — 98.9% of premenopausal patients in the study had below-range free testosterone• What the Rubin et al. 2025 data adds: vaginal prasterone (DHEA) was associated with meaningfully lower UTI rates in women with vulvovaginal atrophy — treating the hormone environment changed the urological outcome• What integrated treatment looks like — vaginal estrogen for GSM, compounded estradiol/testosterone gel for vestibulodynia, pelvic floor PT for hypertonic muscles• The honest limits of this research: selection bias, non-uniform hormonal evaluation, absence of long-term outcome data — and what prospective studies still need to answerThis episode builds directly on Episode 149 — When Sex Hurts with Dr. Jill Krapf. If you haven't listened to that one, it is linked below and is essential companion listening.https://podcasts.apple.com/us/podcast/sky-womens-health/id1541657642?i=1000630939731🔗 References & Resources:• Agrawal et al., Journal of Sexual Medicine, 2026 — Hormonally Mediated Vestibulodynia and Persistent Urogenital Symptoms• Rubin et al., Menopause, 2025 — Prevalence of UTIs in Women with Vulvovaginal Atrophy and the Impact of Vaginal Prasterone• Sky Women's Health Podcast — Episode 149: "When Sex Hurts" with Dr. Jill Krapf [link in show notes]• skywomenshealth.com🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com

Muscle loss in midlife is real, it is measurable, and it starts earlier than most women are told. Declining estrogen during perimenopause directly affects skeletal muscle — reducing mass, impairing muscle protein synthesis, and accelerating a process called sarcopenia. By the time many women notice it, they've already lost meaningful ground.In this episode, Dr. Carolyn Moyers is joined by Dr. Dianah Lake — emergency medicine physician, fitness and weight loss coach, and menopause wellness expert — to talk about what's actually driving muscle loss in midlife and what the evidence says about reversing it.🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗 Connect with Dr. Dianah Lake Schedule a complimentary consultationInstagram: @drdifitlifeFacebook: Dr. Di Fitness Free Community:Professional Women Getting Fit

Is progesterone the same as a progestin? It sounds like it should be. It is absolutely not. And that distinction matters more than most women — and many providers — realize.This is the conversation Dr. Carolyn Moyers has multiple times a day in clinic — especially with women in perimenopause who are trying to understand their options, figure out why a previous hormone regimen made them feel worse, or advocate for a prescription that actually fits their biology. It is also one of the most consequential mix-ups in all of menopause medicine, and it is long overdue for a dedicated episode.Bioidentical progesterone and synthetic progestins are not interchangeable. They have different molecular structures, different receptor profiles, and meaningfully different effects on your breast tissue, your cardiovascular system, your sleep, and your brain. The WHI study — the one that scared a generation of women off hormone therapy — tested a synthetic progestin, not bioidentical progesterone. And the breast cancer finding it reported was not even statistically significant. That context has been almost entirely missing from the public conversation. Until now.In this episode:• What bioidentical progesterone actually is — and how it differs from synthetic progestins at the molecular level• The WHI study: what it actually tested, and why its results have been misapplied for 20+ years• Breast cancer risk: the ESTHER study and what the evidence actually shows• Cardiovascular differences between progesterone and MPA (Provera)• Why progesterone is a neuroactive steroid — and what that means for your sleep, anxiety, and mood• Uterine protection: what it is, why it matters, and whether bioidentical progesterone is sufficient• What to do if you don’t have a uterus — and whether you still need progesterone• Perimenopause: why the progestogen conversation is completely different when you still have cycles, variable ovarian function, and potentially need contraception• The levonorgestrel IUD, norethindrone acetate 5mg vs. the minipill, and Slynd (drospirenone 4mg) — what each one does and who it’s for• Exactly how to advocate for yourself at your next appointmentResources mentioned:• ESTHER Study (Fournier et al.) — progesterone vs. MPA and breast cancer risk• Women's Health Initiative (2002)• Prometrium prescribing information• Labia Logic (@labialogic) — vulvovaginal specialists | Memorial Day vulvar health post: instagram.com/p/DYqK9uvj2M8• Sky Women’s Health Podcast — Episode 158: Progesterone Intolerance | podcasts.apple.com/gb/podcast/episode-158-progesterone-intolerance/id1541657642?i=1000640152675Work with Dr. Moyers: skywomenshealth.com | In-person: Fort Worth, TX | Virtual: Texas & West Virginia🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.comSky Women's Health Podcast is for educational purposes only and does not constitute medical advice. Please consult your own provider for personalized care.

You asked — Dr. Moyers answered. In this Ask Me Anything episode, Dr. Moyers — board-certified OBGYN, Menopause Society Certified Physician, and Fellow of the International Society for the Study of Women’s Sexual Health — tackles 18 of the most pressing questions she hears from midlife women every day in her clinic.From hormone therapy and blood clots to low libido, vaginal changes, bladder leaks, and medications for desire — no topic is off limits. If you’ve ever left a doctor’s appointment feeling dismissed, unheard, or more confused than when you walked in, this episode is for you.In This Episode• What to do when you’re on hormone therapy and still have symptoms• CombiPatch and progesterone — is it safe?• Blood clots and hormone therapy — is it really off the table?• Breast cancer and hormone therapy — the nuanced truth• Bioidentical vs. conventional HRT — what’s the difference?• How to know if you’re in menopause when you have an IUD and no period• Options to stop heavy perimenopausal bleeding without a hysterectomy• Why normal hormone levels don’t always mean you feel normal• Postmenopausal bleeding — what it means and what to do• Low libido and vaginal dryness — there is more than lube• How labia change during menopause and what a proper vulvar exam should include• How Addyi works in the brain and its interaction with antidepressants• Testosterone in women — normal levels, superphysiologic levels, and side effects🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com

Two-thirds of dementia cases are women. Two-thirds of caregivers are women. And the brain changes that lead to dementia begin 20 to 30 years before symptoms appear — which means, for most women, that window falls directly during the menopausal transition.That's not a coincidence. It's a clinical reality that neurologist Dr. Ashanthi Gajaweera has built her entire practice around.Dr. Gajaweera is the founder of Healthspan Neurology PC in New York and one of a rare few clinicians who holds dual expertise as a board-certified neurologist and a Menopause Society Certified Provider. With 25+ years of clinical experience, she specializes in cognitive longevity and dementia prevention — with a particular focus on women.In this episode, we cover:• Why dementia is, above all else, a women's disease — and what that means for prevention• What is actually happening in the menopausal brain — and why it matters• The 14 modifiable risk factors identified by the Lancet Commission — and the four critical factors specific to women that don't appear on that list• Why the menopausal transition is the most powerful window a woman has to protect her brain• Evidence-based strategies you can start nowThe brain is resilient. The window is open. This episode will show you what to do with it.🔗 Connect with Dr. Carolyn Moyers🔗 Connect with @dr.gajaweera on YouTube, Instagram, LinkedInwww.healthspanneurology.com 📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com

Did you know that declining estrogen weakens your body's natural ability to buffer stress? Dr. Moyers and yoga therapist Tatiana Miller (Rx4Life) explain exactly what happens to your stress response in perimenopause and menopause — and what you can do about it today. No overwhelm. No jargon. Just real science, simple tools, and a conversation that might make you feel seen for the first time in a while.Mentioned in this episode: Shift from Surviving to Thriving — a Nervous System Reset & Restore Day at Sky Women's Health. Sunday, May 31 | Fort Worth, TX. Spots are limited.Register here: https://luma.com/pt71wg1v🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com