Podcast Summary: The Neuro Experience

Episode: You’re Not Depressed—You’re Hormonal: The Hidden Women’s Health Crisis
Host: Louisa Nicola & Pursuit Network
Guest: Dr. Suzanne Gilberg-Lenz, Board-certified OB/GYN, Integrative Health Practitioner, Author, Founder of Menopause Bootcamp
Date: December 2, 2025

Episode Overview

This episode tackles the intersection of women’s mental health, neurology, and hormonal shifts during midlife, with special focus on perimenopause and menopause. Louisa Nicola and Dr. Suzanne Gilberg-Lenz illuminate the misunderstandings and misdiagnoses that pervade women’s healthcare—especially the over-prescription of antidepressants when hormonal volatility is often the root cause. They break open stigmatized topics: “rage flashes,” mood swings, and the lived experiences of women, while advocating for nuanced care, education, and empowerment.

Key Discussion Points & Insights

1. Misdiagnosis and Over-Prescription: Depression vs. Hormonal Change

• Antidepressant Epidemic:

  • Nearly 1 in 4 American women in their 40s and 50s are prescribed SSRIs or antidepressants.
  • Dr. Gilberg-Lenz observes that after the decline in hormone therapy post-2002 (after the Women’s Health Initiative scare), prescriptions for antidepressants and other meds "doubled" ([00:21]).
  • Quote:
    “When you take away a tool that works really, really well for people, they're still going to have some of the issues and the problems that they're having, and they're going to reach for other tools.”
    —Dr. Suzanne Gilberg-Lenz [00:21]

• SSRI vs. Hormone Therapy:

  • SSRIs treat serotonin deficiency, but mood symptoms in perimenopause are more complex, involving fluctuations in estrogen, progesterone, and testosterone.
  • Estrogen, in particular, has global effects on neurotransmission, not just serotonin but also GABA, acetylcholine, and more ([09:49]).
  • Many women put on antidepressants might actually need hormone support instead.

2. What’s Happening in the Female Brain During Midlife?

• Hormonal Fluctuations:

  • Women experience unpredictable estrogen/progesterone swings, and a steady decline of testosterone.
  • These changes disrupt neurotransmitters and global brain function, resulting in mood instability, anxiety, panic, and even “rage flashes” ([04:48], [05:01]).
  • Quote:
    “It’s not just that... people, lady people are done. They're frickin done. And now you add in their hormones are shifting and they're no longer capable of or wanting to suppress how they feel.”
    —Dr. Suzanne Gilberg-Lenz [05:14]

• Progesterone’s Role:

  • Progesterone induces GABA receptors, has a sedative/calming effect.
  • Loss of progesterone intensifies PMS/PMDD symptoms, rage, anxiety, and sleep disruptions ([13:12], [18:55]).
  • Hormone replacement can stabilize symptoms for many.

• Estrogen’s Neuroprotective Effects:

  • Controls glucose metabolism in the brain.
  • Loss of estrogen linked to reduced brain glucose metabolism; increased risk of cognitive decline and even Alzheimer’s ([18:33]).
  • Quote:
    “Estrogen rapid, unpredictable fluctuations in perimenopause... has way more global impacts on neurotransmission. Neurotransmission, neurotrans production and not just serotonin.”
    —Dr. Suzanne Gilberg-Lenz [09:49]

3. Rage, Anxiety, and Mood—Not Just ‘Typical’ Depression

• Unique Emotional Manifestations:

  • New or exacerbated anxiety, panic, and “rage flashes” are common.
  • External stress + internal hormonal shifts can “unroof” repressed feelings, reducing resilience ([05:14]).
  • Cultural changes: Women are less willing to suppress their emotions as they age.
  • Divorce rates spike in midlife, possibly linked to these shifts ([06:20]).

• Testosterone’s Effect:

  • “Makes you more of who you are”—not a universal ‘rage cure’ ([06:44]).
  • Hormonal balance, not just a single hormone, is key.

4. Gaps in Medical Knowledge & “The Chilling Effect”

• Significant R&D Lag:
  • The Women’s Health Initiative study and resultant panic led to dramatic declines in hormone therapy and a stall in women-specific research ([13:57]).
  • “Women haven’t been studied to begin with.”

5. Integrative and Personalized Medicine

• Holistic Assessment:

  • Dr. Gilberg-Lenz prioritizes cycle tracking, symptoms, and patient history over isolated lab results ([48:37]).
  • Labs have limited use—timing and personal baseline matter.
  • Individualized protocols for hormone therapy; flexible and evolving, not one-size-fits-all.

• Advocacy for Education and Empowerment:

  • “Women deserve to know about their bodies. And how can we live on this planet and not understand our bodily experience? … that's just like basic human rights.”
    —Dr. Suzanne Gilberg-Lenz [01:39], [31:24]

6. Intersection with Fertility, Genetics, and Aging

• AMH and Early Menopause:

  • Anti-Müllerian Hormone (AMH) misunderstood by the public; not a reliable predictor of natural fertility or menopause timing ([21:22]).
  • Stories of women conceiving naturally into their 40s—even on hormone therapy.
  • Menopause experiences (symptoms, timing) are partly genetic but also cultural—our mothers’ silent struggles versus today’s openness ([25:56]).
  • “Postpartum at 42 is not the postpartum at 32... you need a village.” ([24:41])

• Testing & Prevention:

  • Importance of body composition testing, bone mineral density, cardiac markers, micronutrients ([64:04]).
  • Early prevention and optimization—especially key for women focused on longevity and avoiding frailty ([64:33]).

7. Gut Health, Ayurveda, and Mind-Body Connection

• Eastern Medicine Integration:

  • Dr. Gilberg-Lenz, trained in Ayurveda as well as Western medicine, brings gut health and nutrition into the hormonal conversation ([34:48]).
  • The gut is central to neurotransmitter and immune system production.
  • Ancient healing systems long recognized the centrality of digestive health, now vindicated by modern microbiome research.

• Mindset, Stress, and Inflammation:

  • Persistent negative thinking patterns may drive neural inflammation and even dementia risk—potentially mediated by cortisol and hormonal volatility ([43:01]).

8. Systemic & Societal Challenges

• US Healthcare Shortcomings:

  • Health insurance encourages volume over time-intensive, personalized care ([52:00]).
  • Older patients and menopausal women are often deprioritized; prevention under-emphasized ([54:00]).
  • Institutional change is slow; women’s voices and specialized care are often undervalued.

• Advocate for Yourself:

  • Self-tracking, informed consent, and a trusting relationship with a knowledgeable practitioner are key ([28:32], [50:48]).
  • “It's not informed consent if you don't have the information.” —Dr. Suzanne Gilberg-Lenz [31:24]

9. Supplements, Peptides, and Cutting-Edge Trends

• Peptides & GLP-1s:

  • GLP-1 agonists (for diabetes, obesity) show promise for brain and cardiac health, especially combined with hormone therapy ([58:11]).
  • Some excitement and much caution around less-researched peptides (e.g., TB500, BPC157); safety and efficacy data limited ([59:17]).
  • Dr. Gilberg-Lenz is cautiously optimistic but does “not prescribe peptides” without sufficient evidence ([58:48], [59:36]).

• Biohacking & Performance:

  • Importance of foundational health: nutrition, movement, sleep, stress, social connection, spirituality ([62:20]).
  • There is no quick fix or “supplement your way out of menopause.”

Memorable Quotes

• On the gender data gap:
  “We don't know enough about it because we haven't been studying it, because women have not been studied well.”
  —Dr. Suzanne Gilberg-Lenz [13:55]

• On midlife liberation:
  “This to me, it's the return to your authentic self... There's this incredible sense of restoration, of confidence, of calm, of purpose, of joy, really a liberation from not only your cycle.”
  —Dr. Suzanne Gilberg-Lenz [31:24]

• On menopause’s certainty:
  “You can't supplement your way out of menopause. You can't think your way out of it. It is death, taxes, and menopause.”
  —Louisa Nicola [36:54–37:03]

• On the medical model’s failure:
  “I think you're looking for health care. We provide medical care.”
  —Paraphrased by Dr. Suzanne Gilberg-Lenz from a patient’s primary care provider [55:35]

• On preparation for perimenopause:
  “Let’s reframe the narrative around this as not a fearful, terrible situation... It’s the puberty of midlife… It’s about optimizing your foundation—nutrition, movement, sleep, stress, connection, spirituality… The foundation is everything.”
  —Dr. Suzanne Gilberg-Lenz [62:20]

Key Timestamps & Segments

• [00:00–04:00] – Setting the stage: Overprescription of antidepressants, misdiagnosis in women, intro to hormonal context
• [05:00–07:00] – Emotional volatility: “rage flashes,” anxiety, resilience loss in midlife
• [09:30–13:15] – How estrogen/progesterone affect brain neurotransmitters; why SSRIs may only “mask” symptoms
• [18:00–20:00] – Estrogen as neuroprotective; brain metabolism and Alzheimer's links
• [21:00–24:00] – Fertility, AMH, and postpartum vs perimenopause intersections
• [31:24–34:00] – Women’s health as a human right, the power of midlife self-actualization
• [34:48–37:00] – Gut-brain axis, Ayurveda, ancient and modern integrative insights
• [48:37–52:00] – Best practices for patient-centered hormonal care; need for personalization; lab limitations
• [58:11–61:35] – Peptides, GLP-1s, and trends in hormone optimization; safety and skepticism
• [62:20–67:16] – Advice for women approaching perimenopause; importance of prevention and baseline testing

Final Thoughts

This episode delivers a powerful message: depression, rage, and anxiety in midlife women are often not “just in your head”—they are deeply physiological, rooted in hormonal transitions society and medicine routinely overlook. The conversation, both scientific and personal, is a call for more research, more personalized integrative care, and above all, respect for women’s bodily experiences at every age.

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Guest Contact:
Dr. Suzanne Gilberg-Lenz – [Menopause Bootcamp, Instagram, website]
Louisa Nicola – Instagram: @louisanicola_

For further information or to schedule with Dr. Gilberg-Lenz, visit her practice links at the end of the episode.