Jay Shetty PodcastTamsen Fadal: ''How to Lose Weight, Stop Brain Fog, and Take Back Control During Menopause!''
CHAPTERS
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.
- •Menopause impacts over half the population, yet remains under-discussed at home, school, and clinics
- •Tamsen’s background: journalist, author of "How to Menopause," producer of "The M Factor"
- •The conversation is positioned as essential for men and women—not a niche topic
- •Silence contributes to confusion, shame, and delayed care
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.
- •Taboo is intertwined with cultural ageism and sexism
- •Midlife women are often framed as "past their best years"
- •Medical and media narratives have reinforced silence
- •Goal: separate the words “menopause” and “taboo” permanently
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.
- •Perimenopause = lead-up stage (often 4–10 years) with fluctuating hormones and symptoms
- •Menopause = the single point after 12 consecutive months without a period
- •Post-menopause = the years after; symptoms may continue
- •This can represent a large fraction of a woman’s lifespan
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.
- •Symptoms can be physical, cognitive, and emotional—not just hot flashes
- •Brain fog can be debilitating (forgetting words, losing train of thought)
- •Sleep issues and midsection weight gain are common and frustrating
- •Many women report: “I don’t feel like myself anymore”
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.
- •Workplace impact: concentration issues, fatigue, and fear of disclosure
- •Risk of women being penalized professionally during a career peak
- •Relationship impact: misinterpretation of low libido or irritability
- •Divorce in the 40s may correlate with unmanaged or unrecognized transitions
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.
- •Myth: menopause means decline; reality: post-menopause can be a strong chapter
- •Myth: symptoms mean you’re “crazy”; reality: hormone shifts drive real changes
- •Experience varies widely—no single menopause story
- •Validation reduces fear and improves help-seeking
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.
- •Estrogen and progesterone fluctuate and decline; symptoms can feel like a “wild ride”
- •Estrogen receptors exist throughout the body, including the brain
- •Brain fog can resemble dementia/Alzheimer’s fears (word-finding, memory lapses)
- •Women may pursue extensive testing before menopause is considered
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.
- •Three early signs: irregular/heavy/missing periods; sleep disruption; mood/anxiety/rage/depression shifts
- •Symptoms are often misattributed to stress or “just aging”
- •Perimenopause diagnosis is often clinical (symptom + age pattern), not a definitive blood test
- •Many women are offered antidepressants as a first-line “band-aid”
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.
- •Many clinicians receive very limited menopause training
- •Only a small fraction of medical research funding targets women’s health; even less targets menopause
- •Women report frequent dismissal and undertreatment
- •Ethnic differences appear in symptom intensity/duration (e.g., Black women often hit harder/earlier)
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.
- •Long-term risks to monitor: osteoporosis, cardiovascular health, brain health
- •Some studies explore correlations (e.g., hot flashes and heart markers)
- •Knowing your baseline (e.g., cardiology check, bone density) can be protective
- •Earlier habit-building (30s+) can improve resilience later
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.
- •Two broad approaches: lifestyle-only vs. medical support (including hormone therapy)
- •WHI headlines (2002) sharply reduced hormone therapy uptake due to fear
- •Hormone therapy may include estrogen + progesterone; sometimes testosterone or vaginal estrogen
- •Effectiveness: endorsed as a leading option for hot flashes and vaginal dryness for eligible women
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.
- •Sleep is the first lever—bedtime routines, magnesium, and (for some) progesterone support
- •Strength training rises in importance for bone health and body composition
- •Protein and fiber intake support energy, muscle, and metabolic changes
- •Reduce inflammation triggers; manage bloating; practice “grace, not perfection”
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.
- •Community reduces isolation and provides practical coping ideas
- •Men’s role: awareness, patience, curiosity, and supportive habit changes together
- •Normalize language beyond stereotypes of “crazy” or “hysterical hot flashes”
- •A single informed person can spread knowledge through families and relationships
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.
- •Libido may fluctuate or drop sharply; desire for closeness can remain
- •Painful sex and dryness are common and rarely discussed
- •Misinterpretation can threaten relationships without education
- •Options include vaginal estrogen and broader symptom treatment plans
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.
- •Perimenopause can overlap with fertility years; pregnancy remains possible until menopause is reached
- •Symptoms can be confused with postpartum or life stress without informed care
- •Birth control pills may regulate cycles; some women later transition to hormone therapy
- •Preparation: build sleep, nutrition, strength training habits; consider early baseline bone density discussions
