EFR 910: Muscle, Menopause & Metabolism - The Hidden Health Crisis Impacting Every Woman After 40 with Dr. Jessica Shepherd

This episod is brought to you by Cured Nutrition, Caldera Lab and Joi & Blokes.

Dr. Jessica Shepherd—OB/GYN, clinical advisor for P-Volv, and author of Generation M—breaks down everything women need to know about perimenopause, menopause, and longevity. She explains why mindset is the foundation of midlife health, how declining estrogen affects every organ system, why only 8% of symptomatic women ever receive a diagnosis, and how common comorbidities rise 45% or more between ages 40–59. Dr. Shepherd shares science-backed strategies for navigating symptoms, improving metabolic and mitochondrial health, understanding the truth about hormone therapy after the flawed WHI study (which led to an 82% decline in prescriptions), and using exercise, protein, and muscle-building to protect cognition, heart health, and overall vitality. Whether you're a woman entering midlife—or a partner wanting to better support her—this conversation is a masterclass in women's health, empowerment, and aging well.

Follow Jessica @jessicashepherdmd

Follow Chase @chase_chewning

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00:01 - Intro & shocking stats: women live longer but spend more years in poor health; HRT prescriptions dropped 82% after 2002

00:28 - Muscle as the organ of longevity; women lose 3–5% per decade, accelerated after menopause

01:18 - Why estrogen decline shifts the whole body; Dr. Shepherd introduces herself and her mission in women's health

02:15 - Redefining women's health & longevity; why women aren't thinking about longevity soon enough

04:23 – Mindset, habits, and community as the foundation of midlife health

07:13 - Barriers to staying well: socioeconomic factors, upbringing, access, and misconceptions about wellness

09:33 - Women's current wellness landscape; societal expectations, caregiving burden, and systemic gaps

12:46 – Major healthcare gaps: lack of research, exclusion of women from clinical studies until the '70s, and only 3% of VC health funding going to women

17:30 – Pharma eliminating women's health divisions; downstream effects on innovation and access

19:10 – Perimenopause 101: defining terms, symptoms vs. cycles, 34+ possible symptoms, and why diagnosis is trick

24:45 – The cardiovascular danger of estrogen decline; heart disease as the #1 killer of women

27:02 – Stress vs. perimenopause symptoms; mood disorders peak between 45–55

29:48 – How HRT has evolved in the last 10–20 years; symptom relief and longevity benefits

32:32 – Why only 5% of women are on hormone therapy today; misconceptions and new guidelines

34:20 – WHI study deep dive: media panic, misinterpretation, lack of statistical significance, and lasting fear

39:06 – Risk vs. benefit: how to think about HRT decisions with your provider

41:51 – Chase shares his TRT story; quality of life, fertility considerations, and hormone literacy

45:16 – Dr. Shepherd's personal hormone story: cognition issues, testosterone, and starting estrogen at 46

48:12 – Supplements Dr. Shepherd uses: Vitamin D, creatine, CoQ10, Urolithin A

50:10 – Muscle, mitochondrial health, sarcopenia & gluco