In this episode, Dr. Steven Youngblood and Crystal Burke, NP, co-founders of the Menopause Clinic, explain:

• Why progesterone decline makes it hard to fall asleep
• Why low estrogen and rising FSH cause the 3 a.m. wake-up
• Why Ambien, Benadryl, and melatonin often stop working
• What hormone replacement actually does for sleep, and how fast it works
• Crystal's own experience with months of four-hour nights

An important note from Dr. Youngblood: Hormones can fix a lot of perimenopausal sleep issues, but they don't fix everything. If you snore loudly, your partner notices you stop breathing or gasp at night, you wake up with morning headaches, or your sleep doesn't improve with hormone treatment, please ask your provider about a sleep study. Sleep apnea is significantly underdiagnosed in women and tends to worsen in perimenopause as estrogen — which helps keep the airway open at night — declines. It's a separate, treatable condition, and missing it has real cardiovascular consequences.

Have a question you want answered on the show? info@menopauselouisiana.com

Ready to talk to someone? www.menopauselouisiana.com/book-a-visit

www.menopauselouisiana.com

If someone sent you this, it's because she's trying to reach you in the best way she knows how. And if you're willing to listen for 17 minutes, this episode will give you more clarity than most men ever get about what's actually happening to the woman they love.

Crystal Burke, NP and Dr. Steven Youngblood — partners in life and in medicine — talk honestly about what perimenopause looks like from both sides of the relationship. Steve shares what it was like to watch Crystal go through it without either of them knowing what it was. Crystal explains what was actually happening in her body, her brain, and her sense of self.

In this episode:

🔹 Why she's not doing this on purpose and has almost no control over it 

🔹 Why her emotional reactions may seem completely out of proportion — and why that's physiological, not personal 

🔹 What's actually happening to her libido and why it's not about you 

🔹 How to bring it up if you figured it out before she did 

🔹 What to do if she doesn't want treatment 

🔹 The one thing every partner needs to hear

Plus a rapid fire Q&A answering the questions partners are actually asking but don't know how to say out loud.

It's not you. It's not her. It's biology. And now you'll know what to do with that.

🎙️ Perimenopause Explained by The Menopause Clinic in New Orleans. 

Learn more at menopauselouisiana.com

www.menopauselouisiana.com

If you're in your late 30s or 40s and your desire has quietly disappeared, there's a reason. It's not you. It's not your relationship. It's your hormones — and it's one of the most common things that happens in perimenopause that nobody warns you about.

In this episode, Crystal and Steven walk through what's actually happening in your body: why estrogen and testosterone both matter for desire, why sex can start to feel different or painful, why orgasms take longer or feel weaker, and why your libido can seem fine one week and gone the next.

You'll also hear about the grandmother theory — an evolutionary explanation for why your body may be wired to lose interest, and why that doesn't mean you have to accept it.

If you've been quietly wondering what happened to that part of you, this one's for you.

www.menopauselouisiana.com

But new research suggests the story may be more complex.

In this episode, we break down a recent study published in the Journal of Clinical Endocrinology & Metabolism that found higher fasting insulin levels early in perimenopause were associated with:

• Earlier onset of hot flashes
• Longer duration of vasomotor symptoms
• Greater overall symptom burden across the menopausal transition

Importantly, insulin predicted symptom trajectory independent of BMI.

This means metabolic health — not just body weight — may influence how perimenopause unfolds.

Who tends to have higher insulin levels?

Women with:

• Abdominal weight gain
• History of PCOS
• Prediabetes or gestational diabetes
• Family history of type 2 diabetes
• Sedentary lifestyle
• Chronic stress and poor sleep
• Diets high in refined carbohydrates

Many of these women are told their labs are “normal” because glucose and A1c may still fall within standard ranges — but insulin can be elevated years before diabetes develops.

What We Discuss in This Episode

• What the study actually showed
• Why insulin may affect hormone dynamics (including SHBG and androgens)
• The relationship between metabolism, inflammation, and vasomotor symptoms
• Why perimenopause isn’t “just an estrogen problem”
• How early metabolic health may influence long-term symptom patterns

We also answer social media questions about weight gain, “normal labs,” insulin resistance, and whether women should request fasting insulin testing.

Why This Matters

Perimenopause is not just something that happens to you.

Emerging evidence suggests there may be modifiable risk factors that influence symptom severity and duration. That opens the door to earlier intervention, prevention, and more individualized care.

If you’re in your late 30s or 40s and noticing changes, this conversation is for you.

www.menopauselouisiana.com

In this first episode, we share the personal and professional story behind The Menopause Clinic — how confusing symptoms, “normal” lab results, mood shifts, and brain fog led us to a deeper understanding of midlife hormone changes. 

We talk about: 

• What perimenopause actually is 

• Why labs can look normal while you feel anything but 

• The difference between menopause and perimenopause 

• Why so many women are first told it’s anxiety or stress 

• How this experience led us to build a clinic focused exclusively on midlife women 

 If you’ve felt dismissed, confused, or like you’re not yourself — this episode is for you. 

Women deserve better than “everything looks normal.” 

 About Us 

Crystal Burke, FNP-C, MSCP and Steven Youngblood, MD are the founders of The Menopause Clinic, a membership-based practice specializing in perimenopause, menopause, and women’s sexual health. 

Learn more: www.menopauselouisiana.com

www.menopauselouisiana.com