Jay Shetty PodcastTamsen Fadal: ''How to Lose Weight, Stop Brain Fog, and Take Back Control During Menopause!''
Jay Shetty and Tamsen Fadal on menopause decoded: symptoms, hormone therapy, lifestyle shifts, and support systems.
In this episode of Jay Shetty Podcast, featuring Tamsen Fadal and Jay Shetty, Tamsen Fadal: ''How to Lose Weight, Stop Brain Fog, and Take Back Control During Menopause!'' explores menopause decoded: symptoms, hormone therapy, lifestyle shifts, and support systems Menopause remains taboo largely due to ageism and sexism, which leads society and medicine to dismiss midlife women and minimize their symptoms.
At a glance
WHAT IT’S REALLY ABOUT
Menopause decoded: symptoms, hormone therapy, lifestyle shifts, and support systems
- Menopause remains taboo largely due to ageism and sexism, which leads society and medicine to dismiss midlife women and minimize their symptoms.
- Perimenopause can last 4–10 years and menopause is defined as the point after 12 months without a period, meaning many women spend a third to half of life managing related changes.
- Symptoms extend far beyond hot flashes—brain fog, sleep disruption, mood shifts, weight redistribution, joint pain, dryness, and libido changes can be debilitating and disruptive to work and relationships.
- Medical gaps are substantial: many clinicians receive minimal menopause training, women are often misdiagnosed (e.g., stress/depression) or prescribed quick fixes, and only a tiny fraction of research funding targets menopause.
- Effective help typically combines informed medical care (including hormone therapy for eligible women), targeted lifestyle changes (sleep, strength training, protein, inflammation management), and community/partner support.
IDEAS WORTH REMEMBERING
5 ideasThe biggest problem is silence, not just symptoms.
Fadal argues taboo and stigma keep women from naming what’s happening, which delays care and makes normal hormonal changes feel like personal failure or “going crazy.” Normalizing the vocabulary (especially “perimenopause”) is a first intervention.
Perimenopause is often the long, confusing phase—plan for years, not weeks.
She frames perimenopause as 4–10 years of fluctuating estrogen/progesterone that can overlap with peak career and caregiving years, so women need expectations, tracking, and proactive medical conversations early.
Brain fog can be frightening and misread as cognitive disease.
Because estrogen receptors exist throughout the brain, declining/erratic estrogen can impair recall and word-finding, prompting fears of dementia/Alzheimer’s and even unnecessary neurological workups if menopause isn’t considered.
Misdiagnosis and dismissiveness are common because clinician training is limited.
Fadal cites minimal medical-school coverage and notes many women are told “it’s stress/aging” or are quickly prescribed antidepressants, which may help mood but won’t address the full symptom set (e.g., hot flashes, irregular cycles, painful sex).
Hormone therapy is a key option for eligible women, but fear persists from past headlines.
She describes how the 2002 Women’s Health Initiative messaging (“estrogen causes breast cancer”) dramatically reduced uptake (from ~44% to ~4–5%), despite current menopause-society guidance that hormone therapy is among the most effective treatments for hot flashes and vaginal dryness.
WORDS WORTH SAVING
5 quotesOver half the population is gonna go through menopause, yet we don't talk about it at home. We haven't learned about it at school. We don't talk about it in the doctor's office. We often feel like our body is betraying us, and we don't know who we are anymore.
— Tamsen Fadal
We look at women that are in midlife, and we say, "Wow, their best years are behind them." Society has done that for a very, very long time, especially here in the US, and that's kind of what the medical system has done as well.
— Tamsen Fadal
One day I woke up, and I was like, "I'm a, I'm a shell of who I am, and I don't know how to find the light switch in this room. I just am in the dark."
— Tamsen Fadal
OBGYNs, their specialty sometimes got a day of training in medical school to talk about this.
— Tamsen Fadal
I love it. I wanna kiss you. I wanna be with you. You know, you're amazing. I wanna be close to you. But I didn't wanna have sex, because it was painful, quite frankly.
— Tamsen Fadal
QUESTIONS ANSWERED IN THIS EPISODE
5 questionsYou mention there are now “100+” symptoms—what are the most overlooked ones that most commonly get mislabeled as stress or depression?
Menopause remains taboo largely due to ageism and sexism, which leads society and medicine to dismiss midlife women and minimize their symptoms.
For someone in their late 30s with irregular periods and sleep disruption, what’s the clearest way to distinguish perimenopause from thyroid issues, postpartum effects, or anxiety disorders?
Perimenopause can last 4–10 years and menopause is defined as the point after 12 months without a period, meaning many women spend a third to half of life managing related changes.
You recommend prioritizing sleep—what specific sleep routine changes did you find most effective before hormone therapy (timing, supplements, habits to stop at night)?
Symptoms extend far beyond hot flashes—brain fog, sleep disruption, mood shifts, weight redistribution, joint pain, dryness, and libido changes can be debilitating and disruptive to work and relationships.
How should couples talk about libido loss and painful sex in a way that reduces shame while still addressing intimacy needs—what scripts or approaches work?
Medical gaps are substantial: many clinicians receive minimal menopause training, women are often misdiagnosed (e.g., stress/depression) or prescribed quick fixes, and only a tiny fraction of research funding targets menopause.
Given the legacy of the 2002 WHI headlines, what are the most common misconceptions about hormone therapy risks today, and what questions should patients ask to assess eligibility safely?
Effective help typically combines informed medical care (including hormone therapy for eligible women), targeted lifestyle changes (sleep, strength training, protein, inflammation management), and community/partner support.
Chapter Breakdown
Menopause affects half the population—but we’re taught to stay silent
Jay introduces Tamsen Fadal and frames menopause as a massive, universal transition that’s still rarely discussed. Tamsen shares how even after decades in journalism, she almost never heard or said the word publicly, reflecting broader cultural avoidance.
Why menopause is still taboo: ageism, sexism, and “goodbye after reproduction”
Tamsen explains the taboo as rooted in ageism and sexism—society often treats women’s value as tied to reproductive years. That same bias has influenced the medical system and media, shaping menopause as something to hide or minimize.
The basic roadmap: perimenopause, menopause, post-menopause—and how long it can last
Tamsen breaks down the terminology and timeline: perimenopause can last 4–10 years, menopause is the point after 12 months without a period, and post-menopause follows. She emphasizes this transition can span a third to half of a woman’s life, making the lack of education especially damaging.
More than hot flashes: the symptom load and identity disruption
They explore how symptoms affect daily functioning and self-perception. Tamsen highlights brain fog, mood changes, weight shifts, sleep disruption, dryness, joint pain, and libido changes—often leaving women feeling like they don’t recognize themselves.
Real-world fallout: work performance, relationships, and divorce patterns
The discussion moves from biology to life impact—how symptoms can undermine confidence at work and strain partnerships at home. Tamsen notes women are often at career peak in midlife, yet may feel penalized or dismissed, and relationship tension can rise when libido and mood shift without explanation.
Myths that keep women stuck: “best years are behind you” and “you’re going crazy”
Jay and Tamsen address common misconceptions—especially the idea that menopause signals decline or that symptoms are purely psychological. Tamsen stresses variation between women and reinforces the message: symptoms are biological, real, and treatable.
What’s happening in the body and brain: estrogen/progesterone shifts and scary cognitive symptoms
Tamsen explains hormonal fluctuation and loss—especially estrogen and progesterone—and why the brain is affected due to estrogen receptors. They discuss how cognitive symptoms can mimic serious disease fears, prompting some women to seek neurological testing.
Early warning signs and why perimenopause is missed so often
Tamsen outlines three common early signs—irregular periods, sleep disruption, and mood/anxiety changes—and explains why they’re frequently dismissed as stress or aging. They also touch on how diagnosis is often symptom-based rather than reliant on a single blood test.
Medical blind spots: limited training, low research funding, and inequities by ethnicity
They confront systemic gaps: minimal menopause education in medical training and tiny research investment in women’s health, especially midlife care. Tamsen also notes research suggesting Black women may experience more intense/longer symptoms and earlier onset, emphasizing the need for more targeted studies.
Why ignoring symptoms can be risky: bone, heart, and brain health over the long term
Tamsen explains that menopause isn’t just about comfort—it can connect to long-term health trajectories. They discuss osteoporosis, heart disease, and brain health concerns, emphasizing that awareness can prompt earlier prevention and baseline testing.
Treatment paths: hormone therapy, lifestyle shifts, and finding what works for you
Tamsen lays out a practical framework: some women use lifestyle changes alone, others consider hormone therapy depending on symptoms and eligibility. They revisit the 2002 Women’s Health Initiative messaging that scared many away from hormones and discuss hormone therapy components and typical concerns.
Lifestyle strategy that actually helps: sleep first, strength training, protein, inflammation, stress
Tamsen details the habits she prioritizes and why—starting with sleep as the foundation. She emphasizes strength training for bone protection, adequate protein, inflammation-aware nutrition (fiber, bloating triggers), and realistic stress management with self-compassion.
Community and communication: why partners (especially men) need to be part of the solution
They distinguish friendship from community—people who truly understand the shared experience—and stress the importance of partner awareness. Jay asks what men should do; Tamsen emphasizes learning the basics, asking supportive questions, and recognizing symptoms as biological rather than personal failings.
Sex, intimacy, and painful dryness: what changes and how couples can navigate it
Tamsen speaks candidly about libido shifts, painful sex, and whole-body dryness—often misread by partners as loss of attraction. The key is naming what’s happening, discussing it openly, and seeking appropriate treatments so intimacy can evolve rather than disappear.
Fertility overlap, birth control, and preparing earlier: what younger women can do now
They address the overlap between perimenopause symptoms and reproductive/postpartum changes, and the reality that pregnancy can still occur during perimenopause. Tamsen also explains why birth control may be used to regulate irregular cycles and offers preparation advice for younger women—especially strength training, sleep habits, and baseline bone density awareness.
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