unPAUSED with Dr. Mary Claire Haver

In this episode of unPAUSED, Dr. Mary Claire Haver answers your most asked questions about hormone therapy, menopause symptoms, and how to advocate for yourself when your doctor doesn't have answers. She walks through who actually qualifies for HRT, what the real contraindications are versus conditions that simply require a different delivery method, and how to think about continuing estrogen, progesterone, and testosterone therapy after 60.

Dr. Haver explains the estrogen patch absorption problem, with research showing that up to 20 percent of women on transdermal therapy never reach physiologic estradiol levels regardless of dose. She breaks down SHBG, the protein that can bind your hormones and render them inactive even when your numbers look adequate on paper, and walks through what optimal estradiol levels look like for bone density and osteoporosis prevention specifically.

Books:

“The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,” by Jocelyn Wittstein“The New Perimenopause,” by Dr. Mary Claire Haver

Resources:

Women’s Health Initiative
Estradiol (University of Rochester Medical Center) Meet Dr. Heather Hirsch
Alloy Health
Midi Health
Menopause Quiz
Lab Test Checklist
Blueprint to close the women's health gap

For full show notes, please click here.

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In this bonus episode of unPAUSED, Dr. Mary Claire Haver is joined by Dr. Zachary Rubin, double board certified allergist and immunologist and New York Times bestselling author of All About Allergies, to dig into the connection between histamine, mast cells, and women's hormonal health.

Dr. Rubin breaks down what mast cells are, how histamine works across multiple organ systems, and why women are disproportionately affected by mast cell related conditions including mast cell activation syndrome (MCAS). The two dig into the estrogen and histamine connection, why perimenopause can trigger or worsen symptoms like anxiety, brain fog, and histamine intolerance, and what MCAS actually is and how it is diagnosed. Dr. Rubin also addresses the viral H1 and H2 blocker combination that has been circulating online, explaining the real science behind why it may be helping some women with PMDD, endometriosis, and perimenopausal symptoms, while being honest about what we still do not know.

They also cover quercetin, DAO supplements, low histamine diets, and how to think about self experimentation safely. If you have been wondering whether histamine could be a piece of your hormonal health puzzle, this conversation is a great place to start.

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In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Tami Rowen, an obstetrician, gynecologist, and leading gynecologic surgeon at the University of California San Francisco, and an internationally recognized expert in sexual health and sexual medicine. Together they get precise about some of the most misunderstood terrain in women's health: estrogen, progesterone, progestins, and testosterone for women, what they actually do in the body, how the confusion around them began, and what becomes possible for women when care is evidence-based and not fear-based.

Dr. Rowen opens with something most women have never been told: that contraceptive estrogen and menopausal estrogen are fundamentally different molecules with different goals, different mechanisms, and different effects on the body. She walks through why ethinyl estradiol, the synthetic estrogen in most birth control pills, binds to the estrogen receptor 300 times more strongly than natural estradiol, why that matters for everything from blood clotting to testosterone levels to bone density, and why modern contraception is still valuable and worth defending even as we get more precise about how it works.

Guest links:

Dr. Tami Rowen (UCSF Health)

Dr. Tami Rowen (ISSWSH)Dr. Tami Rowen (Instagram)


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In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Kim and Penn Holderness, the husband and wife content creators behind the widely popular Holderness Family, bestselling authors, and winners of The Amazing Race Season 33. Together they built an audience of millions by finding the humor in real life, and in this conversation they turn that same lens on perimenopause, ADHD, marriage, and the particular chaos of midlife.

Kim opens up about the perimenopausal symptoms that arrived before she had any name for them: the anxiety that made everything feel like being chased by a bear, the panic attacks triggered by nothing she could identify, and the growing sense that something was fundamentally wrong with her. She describes walking out of her doctor's office with no treatment after being told her symptoms were normal, the financial reality of having to seek out a functional medicine doctor to finally get the estrogen and progesterone support she needed, and the combination of hormonal and psychiatric care that eventually helped her feel like herself again. She also speaks with real honesty about her postpartum anxiety, perimenopause and depression, and her OCD diagnosis, and how all of it left her desperate for a voice that would simply say: this is hard.

Guest links:

The Holderness Family 

The Holderness Family (Instagram)

The Holderness Family - Music (YouTube)

The Holderness Family - Comedy (YouTube)

The Holderness Family (Facebook)

The Holderness Family (Substack)

The Holderness Family (TikTok)

Laugh Lines with Kim & Penn Holderness (Apple Podcasts)

PC’s Playbook Podcast (YouTube)

Books:

“ADHD Is Awesome,” by Penn and Kim Holderness

“Everybody Fights,” by Penn and Kim Holderness


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In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Kelly Casperson, urologist, author, and host of the podcast "You Are Not Broken." Part 2 goes deep on testosterone therapy for women, the most misunderstood hormone in women's health, and covers the full range of what it actually does in the female body, why every woman will experience declining levels over time, and why there are still zero FDA approved testosterone products for women while men have more than a dozen.

Dr. Casperson opens with the basics: ovaries make testosterone, the hormone pathway runs one way from cholesterol through progesterone to testosterone to estradiol, and women in normal cycling years carry four times more testosterone than estrogen in their bodies. She explains where testosterone receptors are found, which is everywhere from the brain to bone to muscle to the clitoris to the tear ducts, and why reducing testosterone in women to a libido drug misses the full picture entirely.

Guest links:

Kelly Casperson, MD

Kelly Casperson (Instagram)

Kelly Casperson (YouTube)

You Are Not Broken (Apple Podcasts)

Books:


“You Are Not Broken,” by Kelly Casperson, MD


"The Menopause Moment," by Kelly Casperson, MD 


“The New Perimenopause,” by Dr. Mary Claire Haver


“The New Menopause,” by Dr. Mary Claire Haver

"Sexual Behavior in the Human Female," by Alfred Kinsey


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