The Top 5% Method® with Katheline Jean-Pierre

Episode: What if the anxiety, brain fog, & sleepless nights are actually SIGNS of PERIMENOPAUSE starting in your late 30s?
Guest: Dr. Jennifer Rowlands (OB-GYN, Integrative/Holistic Medicine Specialist)
Date: October 7, 2025

Episode Overview

In this episode, host Katheline Jean-Pierre sits down with Dr. Jennifer Rowlands to demystify perimenopause—a transition period preceding menopause that can start as early as a woman's late 30s. The conversation explores the signs, impact, and management of perimenopausal symptoms (anxiety, insomnia, brain fog, and more), emphasizing actionable strategies to navigate this phase with confidence and support. Both women aim to break stigma, foster open discussion, and empower listeners to prioritize their health for smooth transitions into midlife and beyond.

Key Discussion Points & Insights

1. Understanding Perimenopause and Menopause

• What is Perimenopause?

  • Transitional phase leading up to menopause (3–10 years). Characterized by declining ovarian hormone production.
  • “Perimenopause is...the transition that happens as your ovaries are not making as much hormones as they used to.” (Dr. Rowlands, 02:41)
  • Menopause: defined by one full year without menstruation.

• Common Symptoms

  • Early perimenopause (progesterone loss): sleep disturbances, anxiety, irritability, apathy, heart palpitations, joint pain.
    • “Difficulty getting to sleep, staying asleep, feeling anxious...heart palpitations, joint pain. Those can be very sort of progesterone type symptoms.” (Dr. Rowlands, 00:14 & 04:25)
  • Later perimenopause/menopause (estrogen/testosterone decline): hot flashes, mood swings, memory lapses, vaginal/bladder issues, skin changes, decreased libido.

• Personal Experience

  • Dr. Rowlands openly shares her own journey: “I’m a 48-year-old female in perimenopause and there are definitely days I’m like, whose body is this?” (Dr. Rowlands, 00:00 & 03:10)

2. The Hormonal Cascade

• Finite Egg Supply

  • At birth, women have a set number of eggs which decline with age; no way to “add more eggs”—only improve their quality through lifestyle, nutrition, and certain supplements.
    • “There’s no reset button...you can improve egg quality. Actually, people take a supplement called inositol...” (Dr. Rowlands, 06:11 & 06:23)

• Role of Each Hormone

  • Estrogen: memory, vaginal/bladder health, skin
  • Progesterone: sleep, mood
  • Testosterone: libido, muscle, focus (“vitality hormone”)

• Symptoms Progress Over Years

  • “First, declining progesterone, later declining estrogen and testosterone. Ultimately, when all those hormones are low enough, you don’t cycle anymore and then you’re in menopause.” (Dr. Rowlands, 07:13)

• Not a ‘Downfall’ but an ‘Upgrade’

  • Dr. Rowlands reframes this transition as a “midlife upgrade” often associated with increased authenticity and prioritization of self-care:
    • “The BS meter gets up there—you know, I don’t need to do that school field trip anymore…” (Dr. Rowlands, 08:19)

3. When Does Perimenopause Start?

• Timeline is Individual

  • “If it can be 10 years before menopause...you could be experiencing symptoms in your late 30s.” (Dr. Rowlands, 09:46)
  • Family history is an indicator: when your mother went through menopause often influences your timeline.

• Tracking & Talking

  • Encourages women to talk to their mothers/families about their menopause experiences to break stigma and gain insights.

    “It breaks the conversation for other women in your family to be okay with talking about it. It also helps educate that you’re not alone.” (Dr. Rowlands, 10:29)

4. Breaking the Isolation & Loneliness

• Normalizing conversation is essential; many women feel “alone” or misunderstood during perimenopause.
• “Loneliness...is like the same as smoking 10 to 15 cigarettes a day. Like, it’s that bad for your health.” (Dr. Rowlands, 11:04)

5. Actionable Steps for Navigating Perimenopause

(12:05–15:30 — Action-Oriented Advice)

• Symptom Tracking: Record all symptoms, no matter how minor. Track menstrual cycles for pattern changes.
• Apps/Calendars: Use apps or paper calendars to accurately report patterns to healthcare providers.
• Family Interviews: Talk to relatives about their menopausal experiences for context (generational support).

6. Preventative Health Measures

(15:38–19:47)

• Foundational Health
  • “How you...are in your 30s and 40s determines how you’re gonna live in your 50s and 60s.” (Dr. Rowlands, 15:51)
  • Diet: Emphasize anti-inflammatory foods, protein, fiber, lower carbs.
  • Early bone health screening: Start DEXA scans in your 40s—don’t wait until age 65.
    • “Why would we wait...after menopause for someone to check their bones? Like the cat’s out of the bag there.” (Dr. Rowlands, 17:42)
  • Muscle health and genetic risk assessments (consider preventive approaches to diabetes, heart disease, etc.)

7. The Four Horsemen of Women’s Health

• Focus on preventing: heart disease, cancer, neurodegenerative disease (like dementia), metabolic disease (diabetes)—aka “the four horsewomen.” (20:33)

8. Power of Movement

(21:09–25:38 — Exercise Discussion)

• “There’s nothing more studied than exercise. The best medicine is honestly moving your body. Because we were meant to move our body.” (Dr. Rowlands, 21:09)
• All forms count: walking, cycling, weightlifting, yoga, Pilates; best exercise is the one you enjoy and will maintain.
• Importance of resistance training, especially for bone/muscle health.
• Fun anecdote: NFL players do ballet for cross-training; Dr. Rowlands’ accountability partner is her daughter.

9. Dementia & Brain Health

(26:03–29:26)

• Estrogen is “neuroprotective,” lowering women’s risk of dementia pre-menopause.
• Increased risk of Alzheimer’s for women is due to hormonal changes—not only longevity.
• Cumulative brain inflammation post-menopause can lead to dementia; early interventions matter.

10. Hormone Replacement Therapy (HRT)

(28:46–31:17)

• HRT basics: replaces estrogen, progesterone, and/or testosterone lost in peri/menopause.
  • “It’s not a complicated thing...it’s restoring what you’re missing.” (Dr. Rowlands, 29:34)
  • Available in forms like estrogen patches, oral progesterone, etc.
• HRT is used for both perimenopausal and menopausal women, especially if symptoms are severe.

11. Managing Weight Gain during Perimenopause

(31:17–32:35)

• Caused by lack of estrogen (insulin resistance) and elevated cortisol.
• Management: address both hormone balance (possibly HRT), sleep/lifestyle, and nutrition – solutions are highly individualized.

12. Partner Support & Breaking the Stigma

(33:09–34:54)

• Encourages partners (spouses, friends, family) to learn and engage in the process, attend appointments, and read relevant books together.
  • “It’s sometimes very validating...that that partner is then aware, like, oh, yes, this is what’s happening.” (Dr. Rowlands, 33:36)

13. Recommended Resources

(35:10–35:39)

• The New Menopause by Dr. Mary Claire Haver — practical guide for expectations and transitions.
• The Menopause Brain by Lisa Mosconi — focus on brain and hormonal health.

14. Final Takeaways & Dr. Rowlands’ Contact

• Prevention and self-care in your 30s/40s is key to a healthy midlife.

• Build support, stay informed, and break the isolation barrier.

• “You’re not alone. There are other women that are feeling the way you’re feeling. You need a good community, and you need to find a right provider that’s going to be kind of in sync with your goals.” (Dr. Rowlands, 35:39)

• Connect with Dr. Jennifer Rowlands:

  • Instagram: @DrJenMaryland
  • YouTube: Dr. Jennifer Rowlands
  • Website: drjenniferrowlands.com
  • “Are You in Perimenopause?” quiz and resources available online.
  • Launching “Midlife Academy” with workshops on HRT and better sex in October (Menopause Awareness month).

Notable Quotes & Memorable Moments

• “I like to call it a midlife upgrade.”
  — Dr. Jennifer Rowlands (08:19)

• “How you what your health is like in your 30s and 40s determines how you’re gonna live in your 50s and 60s.”
  — Dr. Rowlands (15:51)

• “There’s nothing more studied than exercise...the best medicine is honestly moving your body.”
  — Dr. Rowlands (21:09)

• On breaking isolation:
  “A lot of women will say to me, God, I just feel so alone. Like, nobody gets it.”
  — Dr. Rowlands (11:04)

• On partner support:
  “It’s sometimes very validating for that person to know that their partner’s in the room and that partner is then aware, like, oh yes, this is what’s happening.”
  — Dr. Rowlands (33:36)

• Host Kathleen’s Reflection:
  “This is golden, what you’ve said.”
  — Kathleen (17:32)

Timestamps for Important Segments

• 00:00 — Honest discussion of “not recognizing” oneself in perimenopause
• 02:41 — Definition of perimenopause and menopause
• 04:25 — The hormonal cascade and symptoms
• 06:23 — Egg quality vs. quantity & influences
• 09:46 — When perimenopause can begin (family history)
• 12:05 — Actionable strategies: symptom tracking, conversations
• 15:51 — Prevention, why health in 30s/40s matters
• 17:42 — Early bone health screening
• 20:33 — The four horse(wo)men of health
• 21:09 — The critical importance of movement/exercise
• 26:03 — Dementia, brain health, and estrogen’s role
• 28:46 — Hormone replacement therapy explained
• 31:17 — Managing perimenopausal weight gain
• 33:09 — Engaging partners, breaking the stigma
• 35:10 — Recommended books
• 35:39 — Final advice and community encouragement
• 36:22 — Dr. Rowlands’ resources, Midlife Academy

Conclusion

This episode dispels myths and normalizes the emotional, physical, and cognitive changes of perimenopause—advocating for proactive health, supportive dialogue, community, and relationship engagement throughout the journey. Dr. Rowlands and Katheline empower women and their partners to see midlife as an opportunity for growth and authenticity while offering actionable steps to thrive through the transition.