Podcast Summary: On Purpose with Jay Shetty

Guest: Tamsen Fadal
Episode: "You Are Not Going Crazy… Your Hormones Are Changing! (THIS is the GUIDE to Navigate Menopause & Take Back Control of Your Mind, Body & Life)"
Date: September 1, 2025

EPISODE OVERVIEW

This episode features Emmy-winning journalist and menopause advocate Tamsen Fadal, who joins Jay Shetty to break the silence around menopause. The conversation covers the realities, myths, symptoms, and social stigma of perimenopause and menopause, the impact on women’s lives and relationships, and provides a roadmap for navigating this transition. The dialogue empowers women and informs men on how to be more supportive, emphasizing that menopause is a natural phase—not the end of a woman’s best years.

KEY DISCUSSION POINTS & INSIGHTS

1. Why Menopause is a Taboo Topic

[02:06–06:02]

• Tamsen: Menopause is taboo due to ageism and sexism—society and the medical system often treat women's post-reproductive years as their "decline."
• Quote: “We've just kind of said goodbye to women after the reproductive years... their best years are behind them.” – Tamsen Fadal [02:32]
• Even as a major news journalist, Tamsen rarely heard, let alone said, the word "menopause" on air.

2. What is Menopause? (Definitions & Timeline)

[06:13–07:45]

• Perimenopause: 4–10 years before menopause, marked by unpredictable symptoms due to hormone changes.
• Menopause: The point when a woman has had no period for 12 months.
• Post-menopause: Everything from that point onward—can represent a third to half of a woman’s life.
• Quote: “Perimenopause is the time leading up to menopause, four to ten years of struggle … All the symptoms haven't stopped yet. But that could be a third to half of your life that we're talking about.” – Tamsen Fadal [07:20]

3. SYMPTOMS: Physical, Emotional, and Cognitive

[07:45–09:33]

• Physical: Brain fog, hot flashes, joint pain, dry skin, weight gain, low libido, sleep disruption.
• Emotional: Mood swings, anxiety, depression, loss of sense of self.
• Quote: “I look in the mirror and I don't recognize myself. And that, to me, was one of the most hurtful things...” – Tamsen Fadal [08:44]
• Impacts daily functioning, work, and relationships; women often feel they're "going crazy."

4. Work, Relationships, and the Broader Impact

[09:33–12:08]

• Menopause affects performance at work and can influence divorce rates.
• Quote: “We see a lot of divorces happening in the 40s, and I don't think that's a coincidence. … Maybe their libido's low, so their partner doesn't understand what's going on.” – Tamsen Fadal [11:00]

5. Debunking Menopause Myths

[12:08–13:41]

• Myths addressed:
  • Menopause means your best years are over. False.
  • Feeling “crazy” or “not yourself” is uncommon. False; it’s widespread.
• “You are not alone and you're not crazy.” – Tamsen Fadal [13:03]
• Symptoms and timings are highly variable among women.

6. The Science: What’s Happening Biologically

[13:41–15:04]

• Declining estrogen & progesterone cause symptoms.
• Estrogen receptors are everywhere in the body, especially the brain—hence cognitive symptoms.
• Many women worry they're developing dementia or serious illnesses before realizing it's menopause.

7. Societal Messages & Misinformation

[15:46–17:09]

• Celebrities like Halle Berry believed they could “outwork” menopause—this isn’t possible.
• Young women are led to believe menopause is only a concern for the elderly.
• Health risks like bone and heart health are often ignored till symptoms arise.

8. Early Warning Signs of Perimenopause

[17:17–18:35]

• Top symptoms: Irregular periods, sleep disruption, mood/anxiety changes.
• Doctors often dismiss these as stress, compounding women’s frustration.

9. Menopause Diagnosis & Doctor Experience

[22:39–24:51]

• Many doctors are not trained to recognize or manage menopause; only 1 day of training on average.
• 75% of women report symptoms remain untreated.
• Only 2% of medical research focuses on women’s health, with menopause being a fraction of that.

10. Health Risks of Ignoring Symptoms

[29:49–31:34]

• Osteoporosis, heart disease, cognitive decline (Alzheimer’s) can all be worsened by untreated menopause symptoms, yet few are warned.
• Early prevention and awareness are crucial.

11. Differing Experiences by Ethnicity & Geography

[31:34–32:47]

• Black women often experience earlier/more intense symptoms.
• Asian women may have more joint pain, fewer hot flashes.
• Environmental, genetic and lifestyle factors play a role.

12. The Trouble with Diagnosis & Antidepressants

[32:47–35:58]

• No single test for perimenopause; diagnosis is symptom-based.
• Too often, women are misdiagnosed and prescribed antidepressants instead of real menopause solutions.
• Tamsen recounts being given antidepressants before discovering the root cause.

SOLUTIONS & STRATEGIES FOR NAVIGATING MENOPAUSE

1. Hormone Therapy (MHT/HRT)

[36:37–39:53]

• Estrogen and progesterone (sometimes testosterone/vaginal estrogen) can dramatically reduce symptoms.
• Not every woman is a candidate; risks exist but must be weighed against suffering.
• “Hormone therapy is a very viable option for a lot of women. … It was very helpful for me.” – Tamsen Fadal [37:47]
• Past studies created fears around HRT, sharply reducing its use, but understanding and guidelines have since evolved.

2. Lifestyle Changes

[39:56–42:43]

• Sleep: Foundation for managing symptoms.
• Strength Training: Prioritize bone health, not just cardio.
• Nutrition: Watch for inflammation, eat enough protein and fiber.
• Balance: Progress over perfection; give yourself grace when symptoms disrupt routines.
• Stress Management & Community: Share experiences, build support.

3. Building Community

[42:47–43:38]

• Friends might not understand, but a community of women facing menopause provides vital support.
• “I have a core group of women right now where I can pick up the phone and say, hey, like, I am not myself... And I think that's a really important part of this process.” – Tamsen Fadal [43:01]

WHAT MEN NEED TO KNOW

[44:10–46:10]

• Men should educate themselves ("What is menopause? How does it manifest?").
• Ask: “Is everything okay? What’s the hardest part? How can I help?”
• Presence, patience, and practical support matter more than solutions.
• “Awareness is a huge part of it… sometimes the person outside of you can see those better than you can see them yourself.” [45:06]

IMPACT ON SEXUAL HEALTH

[47:27–49:53]

• Sex drive fluctuates, often decreases, and sex can become painful due to dryness.
• Emotional impact: Relationships suffer without understanding from partners.
• This is hormonal/chemical, not just psychological or a lack of attraction.
• “All of a sudden it doesn’t feel good anymore. … Those are really tough things to contend with.” – Tamsen Fadal [49:55]

PREPARING FOR PERIMENOPAUSE / ADVICE FOR YOUNGER WOMEN

[61:18–62:31]

• Start healthy habits young: sleep, strength training, nutrition.
• Get a bone density test early for a baseline.
• “If you didn't make them in your 20s or 30s, it's not too late, too late to make those changes.” – Tamsen Fadal [72:23]

BIRTH CONTROL AND PERIMENOPAUSE

[63:34–64:38]

• Birth control may mask or regulate period irregularities but is not a solution for other perimenopause symptoms.
• Not known to worsen perimenopause experience, but can make tracking onset/ending of periods tricky.

COMMUNITY, KNOWLEDGE, AND HOPE

[65:31–67:16]

• Women who are informed and connected feel “like themselves,” empowered for their next chapter.
• Ignorance/ambiguity causes the most anguish; knowledge is liberating.

THE IMPORTANCE OF ADVOCACY AND DOCTOR EDUCATION

[67:55–70:25]

• Doctors often dismiss symptoms as age-related due to lack of training.
• The burden is on women to self-educate and advocate.
• More research, funding, and medical training are urgently needed.
• “There's so much that can be done about this and there's so many different ways to help women.” – Tamsen Fadal [69:18]

CLOSING THOUGHTS & MEMORABLE MOMENTS

[71:58–73:38]

• Tamsen discovered purpose through menopause: helping women and validating their experiences.
• “I do feel like a mom now. You know, I do feel like I’m helping young women ... menopause gave me a purpose.” – Tamsen Fadal [71:58]
• Hope: It’s never too late to change your health, and the conversation around menopause is starting to shift.

NOTABLE QUOTES & MOMENTS (with timestamps)

• “We’ve just kind of said goodbye to women after the reproductive years.” – Tamsen Fadal [02:32]
• “Perimenopause is the time leading up to menopause, four to ten years of struggle… it could be a third to half of your life that we’re talking about.” [07:21]
• “I look in the mirror and I don’t recognize myself… One day I woke up and I was like, I’m a shell of who I am and I don’t know how to find the light switch in this room.” [08:44]
• “You are not alone and you’re not crazy.” [13:03]
• “If you eat perfectly, if you work out perfectly, if you do all these things perfectly, you’re gonna be okay down the line. But the truth is, we hit perimenopause and there are some real long term health concerns that you have to pay attention to.” [15:54]
• “Only 2% of all medical research goes towards women's health… a tiny sliver of that goes to menopause and perimenopause.” [24:01]
• “I wish that every couple’s counselor … would educate themselves about the changes that happen during this time in a woman’s life, because I think it would solve so many problems.” [58:43]
• “It's never too late to make these changes.” [72:23]

TAKEAWAYS FOR NEW LISTENERS

• Menopause is a universal, natural phase—not a disease or the end of purpose for a woman.
• Symptoms are widespread, variable, and can be debilitating—but they are manageable with knowledge and support.
• Open conversations, community, and advocacy must replace silence and stigma.
• Partners, families, and workplaces should be educated and compassionate—everyone benefits.
• It's never too early or late to take charge of your health.

For more, check out Tamsen Fadal’s book How to Menopause, her podcast The Tamsen Show, and follow her on social media for science, solidarity, and support.