Tamsen Fadal22 July 2025

Episode 469: Tamsen Fadal: Breaking the Menopause Silence (100+ Symptoms Your Doctor Never Mentioned)

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12Insights

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Self-Mastery5 steps

Menopause Self-Advocacy Loop

Turn symptoms and evidence into a better care conversation

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Insights & moments

The myth-busts, hot takes, explainers, and tools worth keeping.

Myth Buster· 1

Myth Buster29:30

Why Endless Cardio Can Work Against Midlife Goals

The conversation challenges the old assumption that women should rely on hard cardio to control weight. They argue that preserving and building lean muscle becomes increasingly important with age, making strength training a more useful focus than simply trying to sweat off calories.

Many women were taught to prioritize cardio and avoid weights
Lean muscle becomes more important with age
Excessive cardio may conflict with muscle-preservation goals
Strength training requires a learning curve for many women

“especially as you get older you need more muscle.”
Jennifer Cohen · 31:00

“I really did change workout routine like immediately as soon as I realized what was going on with strength training.”
Tamsen Fadal · 43:00

#strength training#cardio#muscle#fitness

Hot Take· 1

Hot Take12:00

Menopause Is Not a Moment—It Is a Long-Overdue Conversation

The speakers argue that menopause awareness is not a passing trend but a correction to decades of silence and age-related shame. Fadal sees younger women openly identifying as perimenopausal as evidence that the stigma is beginning to loosen.

Menopause has historically been associated with aging and social invisibility
Silence left many women without language for their experience
Open conversation makes it easier to seek information and support
Younger women are increasingly treating perimenopause without embarrassment

“I'm glad people are loud about it because I think we got a lot of making up to do”
Tamsen Fadal · 14:00

“no woman is the same. The symptoms you have or I have or any will always be different and always it's so unique.”
Tamsen Fadal · 14:30

#stigma#ageism#awareness#community

Explainer· 5

Explainer07:00

Perimenopause, Menopause, and Postmenopause Explained

Fadal distinguishes the stages by menstrual timing rather than treating menopause as a single short event. Perimenopause can begin years before the final period, menopause is confirmed after 12 months without a cycle, and the years afterward are postmenopause.

Perimenopause covers the years before menopause
Menopause is confirmed after 12 months without a cycle
The transition can last four to ten years
The average US menopause age is 51

“menopause is that 12 months without a cycle and then everything after that is considered postmenopausal”
Tamsen Fadal · 07:30

“the average age of women in menopause in the US is 51.”
Tamsen Fadal · 07:30

#perimenopause#menopause#postmenopause

Explainer04:00

The Unexpected Symptoms Beyond Hot Flashes

Menopause symptoms can appear throughout the body because estrogen receptors are widespread. Fadal highlights less familiar experiences including burning tongue, itchy ears, brain fog, joint pain, dental issues, frozen shoulder, and irregular periods, noting that a Canadian researcher recorded more than 100 symptoms.

Symptoms extend far beyond hot flashes
Dryness can affect unexpected areas such as the ears and mouth
Brain fog may show up as lost words or forgotten intentions
Joint pain and frozen shoulder can be overlooked signs
More than 100 symptoms have been recorded

“burning tongue, where your tongue feels like it's burning, like kind of a little tingly.”
Tamsen Fadal · 05:30

“joint pain is another one that I think women are not aware of”
Tamsen Fadal · 06:00

#symptoms#brain fog#joint pain#estrogen

Explainer19:00

What Exists Beyond Systemic Hormone Therapy

Fadal acknowledges that some women cannot or do not want to use systemic hormone therapy and says their concerns cannot simply be argued away. She mentions symptom-specific prescriptions, vaginal estrogen, and lifestyle changes while emphasizing that options differ in what they address and should be discussed with a clinician.

Fear from older hormone-therapy research remains influential
Some non-hormonal prescriptions target hot flashes specifically
Vaginal estrogen may be discussed for painful sex
Lifestyle measures matter but do not necessarily replace medical care
Individual comfort and clinical context shape the decision

“but that's what it helps with is hot flashes.”
Tamsen Fadal · 22:30

“there is vaginal estrogen that is pretty safe for all women and that's helpful for uh painful sex”
Tamsen Fadal · 22:30

#hormone therapy#nonhormonal#hot flashes#vaginal estrogen

Explainer27:30

Menopause Care Is Also a Health-Span Conversation

Fadal says the discussion should not stop at short-term symptom relief. She was surprised by the possible longer-term implications for bone, brain, and heart health and reframes menopause care as part of longevity and health span.

Symptom management is only one part of the picture
Bone, brain, and heart health deserve attention
Dismissal can obscure longer-term risks
Menopause belongs in health-span planning

“long-term health ramifications that are possible when it comes to bone and brain and heart”
Tamsen Fadal · 27:30

“We're talking about long-term longevity, you know, health span.”
Tamsen Fadal · 28:00

#health span#bone health#brain health#heart health

Explainer36:30

When Menopause Symptoms Look Like Relationship Problems

Fadal describes how painful sex and lost libido can be mistaken for fading attraction or a broken relationship. She argues for treating sexual health as a legitimate part of menopause care and says improvement may require medical options, practical tools, open conversation, and sustained commitment rather than silence.

Low libido can be misread as loss of attraction
Painful sex can destabilize dating and long-term relationships
Sexual health is connected to the wider menopause experience
Partners need language for what is changing
Conversation and commitment matter alongside products or prescriptions

“sex wasn't comfortable. I had no libido.”
Tamsen Fadal · 36:30

“it really did have to take conversation and commitment to it”
Tamsen Fadal · 43:00

#libido#relationships#sexual health#communication

Story· 2

Story08:30

The News-Desk Hot Flash That Changed Fadal's Career

Fadal recounts struggling with word recall on air before an intense hot flash forced her off the news desk in 2019. After stress explanations, antidepressants, poor sleep, and a terse patient-portal diagnosis, she began researching women's questions and eventually left a 30-year journalism career to focus on menopause education.

Brain fog appeared before she recognized menopause
An intense hot flash forced her to leave a broadcast
Early explanations focused on stress rather than menopause
Online questions turned her journalism skills toward menopause research

“I was one night doing the evening news in 2019 and I was having kind of brain fog, but I didn't know what it was.”
Tamsen Fadal · 08:30

“I would research. They'd be like, "I can't sleep." Blah blah blah. And I'd be like, "Okay, I'm going to answer this question."”
Tamsen Fadal · 11:00

#tamsen fadal#career change#hot flashes#journalism

Story47:30

Replacing the Goal of Skinny With the Goal of Strong

Fadal shares that an eating disorder once drove her to log every calorie and exercise compulsively until illness led to hospitalization and therapy. Although the old mindset can still surface, she now anchors exercise to strength and satisfaction rather than an endless sense of not being enough.

Her earlier fitness behavior was tied to an eating disorder
Illness and therapy began a long recovery process
Old beliefs can remain in the background
Strength is now the goal rather than thinness
Satisfaction replaces the pursuit of never enough

“I had an eating disorder then. I read a true one where I would not eat or I'd eat and I'd go to the gym”
Tamsen Fadal · 47:30

“my why is not skinny. My why is to be strong”
Tamsen Fadal · 48:30

#eating disorder#body image#strength#recovery

Takeaway· 3

Takeaway25:30

What Menopause Support at Work Can Look Like

Workplace support can combine education, benefits, and practical accommodations rather than relying on a generic policy. Fadal suggests HR conversations, women's groups, speakers, telehealth access, desk fans, and uniform changes tailored to the realities of different jobs.

Start with education and a safer conversation
Review whether benefits cover appropriate care or coaching
Adapt accommodations to each work environment
Include factory and frontline workers, not only office staff

“can everybody have a fan at their desk, you know, if you're working in a factory, can you change uniforms?”
Tamsen Fadal · 26:30

“we all work in a different environment.”
Tamsen Fadal · 26:30

#workplace#hr#accommodations#benefits

Takeaway28:00

The First Sleep Levers to Pull During Menopause

Sleep became a major focus of Fadal's research because disruption can worsen everything else. She recommends starting with controllable basics: a repeatable routine, consistent sleep and wake times, morning movement, and attention to light exposure, while acknowledging that hormonal fluctuations can still cause 3 a.m. wakefulness.

Build a repeatable sleep routine
Keep bedtime and wake time as consistent as possible
Get moving in the morning
Use light exposure deliberately
Treat better sleep as a foundation for tackling other symptoms

“the importance of that sleep hygiene, a sleep routine”
Tamsen Fadal · 28:30

“make sure that you're in bed at the same time as best as possible and getting up at the same time”
Tamsen Fadal · 28:30

#sleep#sleep hygiene#light#routine

Takeaway42:00

Fadal's Daily Routine: Walk, Yoga, Strength, and Earlier Nos

Fadal's current routine centers on manageable practices rather than marathon workouts: a morning walk, 10 to 15 minutes of yoga, strength training when appropriate, and more deliberate stress management. The deeper shift is accepting reduced capacity, going to bed early, and declining plans that would leave her depleted and resentful.

Walk outside first thing in the morning
Use short yoga sessions as meditation
Lift weights without turning exercise into an ordeal
Accept changing focus and energy
Say no before overcommitment becomes resentment

“Even if I can do 10 15 minutes, like that is my that is my meditation really.”
Tamsen Fadal · 45:30

“I'm just gonna go to bed early because I just really need to like I need to like take care of myself tonight.”
Tamsen Fadal · 46:30

#daily routine#yoga#boundaries#stress