Peak MD

09/09/2026

MENOPAUSE | Episode 2: It’s Not Just Hot Flashes

For a long time, menopause basically got reduced to one thing:

🔥 Hot flashes.

But then women hit their 40s and 50s and start saying things like…

Why am I suddenly waking up at 3 AM?
Why am I more anxious?
Where did my ability to find words go?
Why do my joints hurt?
Why is my body changing even though I’m doing the same things?
And why did no one warn me about what can happen to my va**na and bladder?!

That’s because menopause is about a whole lot more than your thermostat.

Estrogen affects tissues throughout the body—your brain, bones, muscles, blood vessels, va**na, bladder and more.

And one thing I really want women to know: while hot flashes may eventually get better, va**nal and urinary symptoms often don’t. They can actually get worse over time—and we have good treatments for them.

Menopause isn’t a disease.

But that doesn’t mean we should shrug our shoulders and say, “Well, you’re getting older.”

There’s a lot we can do.

And next we’re getting into the big one:

Hormone therapy.

Who is it for? Is it safe? And why are so many of us still confused about it?

09/08/2026

I spend a lot of time telling people to train for longevity.

But lately, as I train for a half marathon with a cranky Achilles, I’ve been thinking about the part we talk about less:

You have to build a body durable enough to keep training.

Because sometimes aging doesn’t happen in a smooth decline.

Sometimes something hurts. We stop. We lose capacity. And we never quite build all of it back.

This week, From the Physician’s Desk: the fitness metric we don’t talk about enough.

From the Physician’s Desk: Why durability may matter as much as fitness as we age.

09/08/2026

We wait for confidence as if it’s something we’re supposed to have before we start.

But so often, confidence comes later.

After the first attempt.
After being uncomfortable.
After doing it badly.
After realizing we survived.

We don’t always become ready and then begin.

Sometimes we begin—and that’s how we become ready. ☕️

09/06/2026

MENOPAUSE | Episode 1: It Starts Before Menopause

I learned almost nothing about menopause in medical school.

Then I became a woman in my 40s—and started learning just how poorly prepared many of us are for this transition.

Here’s one of the biggest misconceptions:

You don’t have to stop having periods to experience symptoms of perimenopause.

Perimenopause can begin years before your final menstrual period. Hormones fluctuate—sometimes dramatically—and symptoms can come and go.

Sleep changes.
New anxiety or mood changes.
Brain fog.
Cycle changes.
Headaches.
Breast tenderness.
Joint aches.
Hot flashes—or none at all.

And sometimes it’s simply:

“Something feels different, and I don’t feel like myself.”

But here’s the other side of this: not everything that happens in your 40s is hormones.

Thyroid disease, iron deficiency, sleep disorders, depression and other medical conditions can overlap with perimenopause symptoms. A good evaluation shouldn’t automatically blame—or ignore—your hormones.

Women deserve better than being told to just deal with it.

They also deserve better than being told estrogen explains everything.

Understand what’s changing. Rule out what needs ruling out. Then talk about your options.

Next → It’s not just hot flashes. We’re talking about what the menopause transition can mean for your brain, bones, body, sleep and genitourinary health.

09/05/2026

We spend so much of our lives trying to improve ourselves.

Fitter. More successful. More productive. More disciplined. More together.

But maybe the point isn’t to keep becoming someone new.

Maybe it’s to strip away some of the noise—the expectations, comparisons, and ideas of who we’re supposed to be—and grow more fully into who we already are.

Not a reinvention.

A return.

☕️

09/04/2026

A lot of us are very good at setting goals.

Lose the weight.
Run the race.
Get the promotion.
Hit the number.

But a goal without a deeper reason behind it is surprisingly easy to abandon.

The question isn’t just:

What do I want to accomplish?

It’s:

Why would accomplishing it make my life better?

The goals that stick tend to be connected to something bigger—who we want to be, how we want to feel, and what we want to be able to do with our lives.

Start there.

Then work backward. ☕️

09/03/2026

EPISODE 8 | When Lifestyle Isn’t Enough

This may be the most important episode in the series.

For seven episodes, I’ve talked about things we can do to support our mental health: movement, light, sleep, inflammation, meditation, the microbiome.

But I never want that message to become:

“If you’re struggling, you just need to try harder.”

Sometimes lifestyle isn’t enough.

Psychotherapy is treatment.
Medication is treatment.
Asking for help is treatment.

And these things don’t have to compete.

You can exercise AND take an antidepressant.

You can meditate AND go to therapy.

You can work on sleep, nutrition and connection AND need professional help.

Mental health is health.

And sometimes the strongest thing we can do is recognize that we need more support than we can give ourselves.

I started this series talking about dancing through the lightning strikes.

We can build resilience. We can give ourselves more tools.

But sometimes dancing through the storm means letting someone help you through it. ⚡️

And that counts too.

09/03/2026

We spend so much time trying to save time.

Faster. More efficient. One more thing squeezed into the day.

But time isn’t really something we get to keep.

We only get to decide how we spend it.

And maybe that’s the better question:

Not how can I fit more in?
But is this how I want to spend my life? ☕️

09/02/2026

I think we underestimate the power of place.

The places we return to.
The landscapes that become familiar.
The paths we know by heart.
The water we recognize by sound.

The Metolius is that for me.

Not just where I live.

Home. 🌲

09/02/2026

Nearly all of my patients are on supplements of some kind and nearly all have questions and rightfully so. Complicated topic and lots to say, this helps give a little guidance/framework to how to evaluate your own stack.

From the Physician’s Desk: What’s worth taking, what’s mostly marketing, and why “natural” doesn’t necessarily mean better medicine.