About this episode

The episode discusses the medicalization of menopause, its hormonal basis, and recent updates on hormone therapy guidelines.

In 1889 a French physiologist injected himself with guinea pig and dog testicle extract and published a claim of self-rejuvenation in The Lancet. That announcement kicked off a 200-year medicalization of menopause that ran through leeches and bromides, Premarin, the 2002 Women's Health Initiative, and the contemporary menopause-content space. In Episode 1 of our three-part menopause series, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through what menopause actually is at the hormonal level, which midlife symptoms are menopause-driven and which are not, the KNDy neuron mechanism behind hot flashes (and the new medication that blocks it), and the 24-year follow-up on the WHI that substantially revised the original conclusions. OB-GYN Dr. Loraine Baraki walks the clinical workup, the lab panel she actually orders, and how she handles patients arriving with DUTCH panels and compounded hormone protocols. If you have heard contradictory things about menopause hormone therapy from your primary care, your menopause coach, and your sister, that is not your fault. The evidence base has been revised in significant ways since the 2002 publication, and most patient-facing summaries are…

People in this episode

Hosts: Dr. Jordan Feigenbaum, Dr. Austin Baraki

Guest: Dr. Loraine Baraki

Topics covered

• menopause
• hormonal changes
• midlife symptoms
• WHI correction
• hormone therapy
• clinical workup

Keywords

• menopause
• hormone therapy
• WHI
• KNDy neuron
• midlife symptoms
• clinical workup

Mentioned in this episode

Organizations: Women's Health Initiative, The Lancet

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• What’s Actually Driving Your Testosterone Down? | Signal Ep 3 · May 12, 2026 · 59 min

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