Medical Disruptor™ by Dr. E
Medical Disruptor™ by Dr. E
Dr. Efrat LaMandre PhD, FNP-C
Perimenopause & Menopause: Why Balancing Hormones in the Right Order Changes Everything
19 minutes Posted Jun 25, 2026 at 10:34 pm.
Introduction
Defining Menopause, Perimenopause & Hormones
Why Insulin Comes First
Cortisol & Your Stress System
Getting Your Thyroid Tested Right
Sex Hormones, HRT & Finding Balance
0:00
19:06
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Show notes
Menopause doesn't have to be miserable. Yes, we're going to age, and yes, our hormones are going to change, but we do not have to feel old, exhausted, foggy, and brushed off.
In this solo episode of the Medical Disruptor, I walk you through how to actually balance your hormones through perimenopause and menopause, in the order your body actually works. Most women get handed estrogen and sent home, and I'm going to show you why that approach so often misses the real driver, and what you need to address first.
I start by clearing up the difference between menopause and perimenopause so you know which stage you're really in, and then I explain why your sex hormones aren't the right place to begin. From there I walk through it in the order that actually matters: first insulin and blood sugar, which almost everyone skips, then cortisol and your stress system, which can quietly hog the raw ingredients your sex hormones need, and then your thyroid, where I explain why a single TSH number is not enough testing.
Only after those foundations do I get into sex hormones and hormone therapy, including the real difference between HRT and BHRT, what you're actually being offered, and why the type, dose, and route of delivery matter so much.
I also unpack the truth behind the Women's Health Initiative studies, the myth that menopause is simply estrogen deficiency, what estrogen dominance really means, and why testosterone matters for women too.
You're not stuck, and you don't have to push your way through this. I'm Dr. E, the NP with the PhD, and I help humans go from medically gaslit to medically empowered.
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