In this episode of unPAUSED, Dr. Mary Claire Haver delivers a solo masterclass on the lab work every woman in perimenopause, menopause, and post menopause should understand and request from her doctor. Dr. Haver explains why standard annual labs, built for a general population, routinely miss the specific hormonal, metabolic, cardiovascular, and bone related changes that happen during the menopause transition, and she walks through seven categories of testing that give a far more complete picture of a woman's health.

She starts with an advanced lipid panel, explaining why LDL alone is not enough and why ApoB, Lp(a), and small dense LDL particles matter for women whose cardiovascular risk shifts as estrogen declines. She covers fasting glucose and fasting insulin together, showing how the HOMA IR score can reveal insulin resistance long before a diabetes diagnosis. She addresses bone health in depth, arguing that waiting until age 65 for a baseline DEXA scan is far too late given how much bone density can be lost in the years surrounding menopause, and she details safe vitamin D supplementation ranges and optimal target levels.

Dr. Haver also explains why thyroid dysfunction so closely mimics perimenopause symptoms and why TSH alone can miss the full picture, why ferritin testing catches iron depletion long before anemia develops, and how heavy or irregular bleeding in perimenopause contributes to that iron loss. She discusses when and why to check estradiol and testosterone levels, and why one time hormone tests are not reliable for diagnosing perimenopause itself. The seventh lab category is high sensitivity C reactive protein, a marker of chronic inflammation tied to declining estrogen.

The second half of the episode is devoted to twelve common ways women feel dismissed by their doctors, from being told they are too young for perimenopause to being offered an antidepressant without any hormonal discussion. For each scenario, Dr. Haver gives specific language women can use to advocate for themselves, along with pointers to the Menopause Society guidelines, the validated Menopause Quiz, and a clinician directory available at thepauselife.com. She ends with a personal reflection on her own post menopausal life, encouraging listeners to seek out informed care rather than accept dismissal as the final word.

Guest links:

• The ‘Pause Life
  
• The 'Pause Wellness
• Dr. Mary Claire Haver (Instagram)
  
• Dr. Mary Claire Haver (YouTube)
  
• The Pause Life by Dr. Mary Claire Haver (Facebook)
  
• The Menopause Quiz (The Pause Life)
  
• The Menopause Empowerment Guide (The Pause Life)
  
• Lab Test Checklist (The Pause Life) 
  
• Clinicians List (The Pause Life)

Books

• “The New Menopause,” by Dr. Mary Claire Haver
  
• “The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again,” by Dr. Mary Claire Haver

Articles:

• Determining the status of small dense low-density lipoprotein cholesterol level in women undergoing menopausal transition (Endocrinology of Aging)
  
• High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial (Journal of Bone and Mineral Research)
  
• Changing trends in the mortality rate at 1-year post hip fracture - a systematic review (World Journal of Orthopaedics)
  
• Transdermal oestradiol and testosterone therapy for menopausal depression and mood symptoms: retrospective cohort study (The British Journal of Psychiatry)

Other Resources:

• The Menopause Society
  
• ACC/American Heart Association Issue Updated Guideline for Managing Lipids, Cholesterol (American Heart Association)
  
• HOMA-IR Calculator 
  
• Position Statements (The Menopause Society)
  
• Menopause Education for Patients (The Menopause Society)
  
• How to Find a Certified Menopause Practitioner (The Menopause Society)
  
• Heather Hirsch Academy (Heather Hirsch)
  
• Education (Dr. Rachel Rubin, MD)