The guest
Dr. Mary Claire Haver: A board-certified OBGYN and menopause specialist, author of 'The New Menopause' and creator of the Galveston Diet. She is a leading public voice pushing for better menopause care, research funding, and physician education.
What this episode covers
Huberman and Dr. Haver redefine menopause as the end of ovarian function rather than just the absence of a period, and describe perimenopause as a 7-10 year 'zone of hormonal chaos' that begins before the final cycle. They cover the wide-ranging effects of declining estrogen on the brain, heart, bones, gut, skin, and urinary system, and detail nutrition, protein, fiber, resistance training, and weighted-vest strategies women can adopt early. A large portion dissects the 2002 Women's Health Initiative study, arguing its alarming breast-cancer headline was a misinterpretation that scared a generation of doctors away from beneficial hormone therapy. Dr. Haver explains the 'timing hypothesis,' the case for non-oral estrogen, testosterone for women, vaginal estrogen, and how to weigh risks. The episode closes with audience Q&A on libido, sleep, mental health, GLP-1 drugs, and supporting a partner through the transition.
Recommended on this episode
ProductRecommended
Creatine monohydrate
“I'm recommending creatine for muscle”
“I'm recommending creatine for muscle I'm recommending um there's a specific bioactive collagen that was studied in menopausa”— Mary Claire Haver
ProductRecommended
Weighted vest
“I love the way to vest”
“I love the way to vest for a hack I'm like do the dishes with it on go walk the dog”— Mary Claire Haver
The guest's own work
BookBy the guest
The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and the Facts
Mary Claire Haver
“as well as the link to her terrific book the new menopause navigating your path through hormonal change with purpose power and the facts”— Andrew Huberman
Also referenced (named, not recommended)
BookReferencedISBN verified
It's Not Hysteria
Karen Tang
“Karen Tang just published um it's not Hyster wait hysteria it's uh it's not hysteria and she's a gynecologic surgeon”— Mary Claire Haver
ProductReferenced
FORTIBONE bioactive collagen peptides
GELITA
“this forone did the studies five years doing bone density scans on these women it was a small study but they saw improvements”— Mary Claire Haver
ProductReferenced
VERISOL collagen peptides
GELITA
“I found these articles on something called verisol and it was a college in made in Germany and they'd studied actually done like really high quality studies”— Mary Claire Haver
ProductReferenced
Turmeric
“I do think there's some okay data on turmeric for maybe hot flashes but I'm not saying to take that instead of replacing the estrogen”— Mary Claire Haver
ProductReferenced
Vitamin D
“80% of my patients are deficient in vitamin D and struggling to get it absorbed you know um I'm recommending”— Mary Claire Haver
ProductReferenced
Intrarosa (prasterone vaginal insert)
“there's a great vaginal preparation for DHEA called inosa and then the receptors there will start converting it into to both testosterone and estradi”— Mary Claire Haver
ProductReferenced
Premarin
“the estrogen at the time was primin which was the number one prescription for HRT at the time”— Mary Claire Haver
ProductReferenced
Vyleesi (bremelanotide)
“there are two FDA approved medications for libido one is VII it's an injection you give yourself and actually works for men as well”— Mary Claire Haver
ProductReferenced
Addyi (flibanserin)
“and then there is um Addie addyi works at the level I think of dopamine in the brain so it's more in the family of ssris”— Mary Claire Haver
ProductReferenced
Ozempic
Novo Nordisk
“what are your thoughts onic monjaro um I think that they can be a really important tool for a lot of patients”— Andrew Huberman
ProductReferenced
Mounjaro
Eli Lilly
“what are your thoughts onic monjaro um I think that they can be a really important tool for a lot of patients”— Andrew Huberman
Big reveals from this episode
- One in five women quits their job because of menopause symptoms, per UK data now mirrored in the US.
- Only about 0.03% of NIH funding goes to menopause, despite it covering roughly one-third of a woman's life.
- Haver calls the fallout from the Women's Health Initiative 'the worst misinformation campaign in the history of medicine.'
- The WHI estrogen-only arm actually showed a 30% DECREASED breast cancer risk, which went largely unreported.
- American Heart Association data shows starting HRT between 50-59 cut cardiovascular disease and all-cause mortality risk by ~50%.
- Statins have never been shown to prevent a primary heart attack or reduce cardiovascular death in women.
- Haver says she will 'probably die with my estradiol patch on' unless she develops a reason to stop.
- Of a thousand OBGYNs, she estimates only ~10% understand the WHI was flawed; board exams have no menopause category.
Worth remembering
- Women are born with 1-2 million eggs; by age 30 only ~10% remain, and by 40 about 3%.
- A hysterectomy that leaves the ovaries still costs about four years of ovarian life; tubal ligation about 18 months.
- Women lose ~11,000 eggs each ovulation cycle to release just one, so egg-freezing harvests don't shift menopause timing.
- Visceral fat jumps from ~8% to ~23% of body fat across the menopause transition with no diet or exercise change.
- The Zoe study found the gut microbiome shifts from a typical female pattern toward a male pattern through menopause.
- Women naturally have higher levels of testosterone than estrogen in absolute terms.
- Vaginal estrogen is the best treatment for recurrent UTIs in menopausal women and could keep many out of the ER.
- 50% of women will have an osteoporotic fracture before they die; one-year mortality after a surgically repaired hip fracture over 65 is ~30%.
- Oral progesterone at night, likely via GABA, helps settle the brain and improve menopausal sleep.
- All nursing-home residents arguably should be on prophylactic vaginal estrogen to prevent urosepsis.
More from Andrew Huberman
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