How to Put Out the “Fires of Menopause,” according to Dr. Mary Claire Haver

Mary Claire Haver, MD, a board-certified ob-gyn, a certified menopause practitioner, and the author of The New Menopause has been at the forefront of reshaping the conversation around menopause—so having her on The goop Podcast this week was long overdue.

After stepping away from traditional ob-gyn, Haver made it her mission to empower women as they navigate the hormonal rollercoaster—starting with unpacking the “menopause trauma” from years of having symptoms dismissed or misdiagnosed. With her refreshingly candid approach, she’s built a dedicated community of over 2 million Instagram followers by busting myths and sharing practical strategies for thriving through this transition.

In this episode of the goop Podcast, Gwyneth asks Haver her most pressing questions, including why sleep can suddenly go haywire during perimenopause and the truth about hormone therapy (and its potential to protect against Alzheimer’s). Plus, Haver shares how lifestyle changes—like focusing on nutrition and building muscle mass—can help put out the “fires of menopause” and help women feel their best (and yes, have the best sex of their lives, too).

Read on for a few highlights—and listen to the full conversation below.

On the perimenopause “zone of hormonal chaos” and mental health:

“If you think about what’s happening in the brain during the menopause transition, neurotransmitters, especially GABA, serotonin, dopamine, and norepinephrine are heavily influenced by estrogen, progesterone, and testosterone, and the balance between the three. Your brain once you go through puberty gets very used to this cyclical pattern—for those of us who are healthy and have regular cycles—and we all have like our good days and bad days of cycle days of our period, but you learn how to sleep and maneuver through that.

In perimenopause, we call it the zone of hormonal chaos because the feedback signals from the brain—what used to look like an EKG each month, you know, this like bloop, bloop, bloop—now you have much higher levels of estradiol than you’ve ever had and they’re not at all temporal…It’s all over the place. It is completely unpredictable, and our brains hate chaos. During the transition of going from regular cycles to no period—and that’s a seven to 10 year transition for most women—we see a 40 percent increase in mental health [concerns], usually depression and or anxiety.”

 

“This is the last third of our lives. This isn’t a few hot flashes overnight. This is changing the trajectory of our health in so many ways.”

On the menopause education gap:

“It wasn’t until I was traversing my own perimenopause and menopause that I realized I don’t know enough. There’s a huge gap here. I think in medical school we had one lecture on menopause. And then I chose ob-gyn for my specialty …you learn so much about childbirth and postpartum and getting pregnant and staying pregnant and everything to do with your female organs—the ovaries, the uterus, the vagina, the vulva… but when I look back at how much of like practical clinical menopause education did I have, I think it was six hours total in a four year curriculum. And that’s just scratching the surface. This is the last third of our lives. This isn’t a few hot flashes overnight. This is changing the trajectory of our health in so many ways. The biggest thing I was never taught is there are estrogen receptors in every organ system of our body and they’re all affected and each of us has a very individual expression of our menopause…. So it’s a systemic problem that we’re not prioritizing the health of women after reproduction ends.”

On putting out the “fires of menopause”—and extending healthspan:

“Usually my patients in my clinic come in with what I call the “fires of menopause”—debilitating brain fog or, horrific hot flashes, debilitating sleep disruption, musculoskeletal pain. They have lost control of their lives and they are very, very worried that they’re not able to function. They’re thinking about quitting their job, getting a divorce, you know, libido’s in the tank…

I do a ton of blood work and then we figure out where she is in her menopause journey—I’m not just slapping a hormone pouch on her and sending her on her way. We’re trying to set her up for success not just to fix the immediate symptoms that she’s having, but to set her up for a life where she’s going to thrive for the next 30 years.”

On building muscle mass—and having the best sex of her life at 56:

“I’m 56, and I’m literally living my best life I ever, ever, ever had. I have better sex, I have better relationships, I have better boundaries, I have better nutrition, I understand my needs more, and I’ve completely flipped from trying to be a thin person to trying to be a bigger person. Because why? I’ve put out the fires of my menopause and now my focus is staying out of a nursing home and not burdening my children…

My muscle mass was low—it’s always been low. I wanted more muscle mass so I don’t break my hip like my mom just did, you know, at 80. I was like, let me try testosterone—this would be off-label for me, but I know that women with higher percentiles of testosterone have better muscle mass and bone strength and bone density, so I said, let me just do it for that. I never complained of my libido, like no one complained—we were fine. But you definitely there’s an uptick in the area. And it’s not chandelier sex, but it’s more than vacation sex. I’m a little more interested and maybe even initiate once in a blue moon, which had not happened in a very long time. So, you know, that’s just one person’s experience, but my patients overall are pretty happy with it.”