I’ve interviewed dozens of clinicians on Medical Disruptors, but this episode hit different.
My guest, Dr. Lakeischa, is a board-certified OB/GYN who was trained to guide women through menopause—but never expected to experience full-blown perimenopause at 40. Not only was she blindsided by the symptoms, but when she ran her own labs, they showed something even more jarring: zero measurable testosterone. A specialist in women’s health caught off guard by her own hormonal crash? The irony wasn’t lost on either of us.
We laughed. We got personal. We also got clinical—because this wasn’t just a conversation about hot flashes. It was a breakdown of everything conventional medicine gets wrong about midlife women, from hormone testing to trauma histories to functional medicine strategy.
If you’re a woman in your 30s or 40s and you’re exhausted, gaining weight, anxious for no reason, or waking up at 2 a.m. like clockwork… keep reading. You might be living in the shadows of perimenopause and not even know it.
The Hormone Hottie Origin Story
Dr. Lakeischa didn’t just wake up one day and leave conventional medicine. She loved her job. She was delivering babies, running a busy practice, doing Da Vinci robotic surgeries. But after the back-to-back loss of her father and grandmother, she hit a wall. Her blood pressure spiked. Her energy tanked. She started feeling disconnected from her patients—and from herself.
Then came the lab work. No measurable testosterone. DHEA in the toilet. At just 40 years old.
As a physician trained to see menopause as a distant phase beginning in the mid-50s, perimenopause wasn’t even on her radar. But that was the beginning of her shift—professionally and personally.
Today, she runs a thriving practice rooted in functional medicine, guiding women (or as she calls them, her hormone hotties) through the messiness of midlife hormones with precision, empathy, and actual results.
What Is Perimenopause Really?
Let’s clear this up once and for all. Perimenopause isn’t a quick on-ramp to menopause. It’s a multi-year hormonal rollercoaster that can begin as early as your 30s. And because it doesn’t announce itself with missing periods right away, most women—and many providers—completely miss the signs.
Mood swings. Anxiety. Sleep disturbances. Brain fog. Midsection weight gain. These aren’t personality problems. They’re physiological red flags that your hormones are shifting.
As a nurse practitioner, I’ve seen far too many patients dismissed by their doctors with a “you’re just getting older” or “let’s try an SSRI.” That’s not care. That’s gaslighting.
Dr. Lakeischa and I agree: perimenopause needs to be on the radar much earlier—and approached with more than just birth control and antidepressants.
The Testosterone Taboo
When people hear “testosterone,” they think libido. But Dr. Lakeischa breaks down how it’s essential for brain health, bone density, metabolism, and mental clarity. For women, too.
She shared how restoring her own testosterone levels didn’t just bring her sex drive back—it brought her back. The brain fog lifted. Her energy returned. She felt like herself again. And she wasn’t alone—her patients were experiencing the same transformation.
Testosterone isn’t just a “men’s hormone.” It’s foundational to women’s health, and we need to stop pretending otherwise.
The Truth About Progesterone and Estrogen
Another myth Dr. Lakeischa smashes? That you don’t need progesterone if you’ve had a hysterectomy. Not true. Progesterone isn’t just about protecting the uterus—it supports sleep, calms the nervous system, and acts as a natural mood stabilizer.
And estrogen? It got a bad rap from the WHI study, but as Dr. Lakeischa explains, that study was based on synthetic hormones. We now have safer, bioidentical options that work with the body—not against it.
Estrogen is neuroprotective, heart-protective, and crucial for long-term bone health. Yet too many women are denied access to it, based on outdated fear rather than evidence.
It’s Not Just Hormones—It’s the Whole System
One of the most valuable parts of our conversation was around testing. Dr. Lakeischa doesn’t guess—she tests. She uses DUTCH tests, GI mapping, adrenal panels, and blood work to build a full picture of what’s happening in the body.
This is where functional medicine shines. It’s not about band-aids. It’s about finding the root cause.
She also talked about the connection between perimenopause and metabolic dysfunction. As estrogen and testosterone decline, insulin resistance rises. That’s why so many women suddenly gain weight despite eating and exercising the same way they always have. It’s not willpower—it’s biology.
And if your nurse practitioner isn’t talking to you about how your gut, thyroid, adrenals, and hormones all connect? It might be time to find someone who will.
Trauma Informed, Data Driven
One of the most powerful moments in the episode was when Dr. Lakeischa shared how she started asking her patients about trauma. Why? Because even the best hormone protocol won’t stick if the nervous system is dysregulated.
“I realized the labs weren’t telling me the whole story,” she said.
That line stayed with me.
You can take all the supplements. You can optimize your progesterone and testosterone. But if your body is stuck in fight-or-flight? Healing stalls.
As nurse practitioners, we have to do better. That means asking better questions. It means creating space for women to feel heard—not just medicated.
What We’re Taking (and What Didn’t Work)
Dr. Lakeischa and I didn’t just talk theory—we shared our own protocols. She opened up about her experience with testosterone pellets (they worked but overshot), why she transitioned to cream, and how she’s supporting her adrenals and thyroid with targeted supplements.
I shared my own journey, too—starting progesterone before menopause, using estrogen patches, and how I learned (the hard way) that waking up at 2 a.m. wasn’t just anxiety. It was hormone depletion.
We’re both still tweaking, still learning, still evolving our care. And that’s exactly the point.
This is not a one-size-fits-all moment in women’s health. It’s a moment for personalization, education, and empowerment.
The Bottom Line
Perimenopause doesn’t come with a roadmap—but it does come with warning signs. If you’re not sleeping, not thinking clearly, not feeling like yourself… listen to your body. Not just your labs.
As a nurse practitioner, I’m telling you: you don’t have to settle for “fine.”
You deserve to feel vibrant. Sharp. Strong. And supported.
This episode with Dr. Lakeischa is more than a conversation—it’s a call to action. Whether you’re 35 or 55, whether you’re already in perimenopause or still wondering what it even means, this is a must-listen.