Two weeks. That’s all it took.
One minute, I’m running the Boston Half Marathon and crushing a personal record. Feeling strong, vibrant, like I could outpace Father Time himself.
Two weeks later? I couldn’t stand up without wincing.
My joints felt like someone swapped them for rusty hinges. My brain? Foggy. My sleep? Gone. My mood? Let’s just say… unstable. And my LDL cholesterol, my pride and joy, sailed past 100 for the first time in my life.
I was eating clean. Lifting weights. Meditating.
I was a doctor, for heaven’s sake.
And still, I felt like my body had been hijacked by something deeply hormonal and deeply rude.
So I did what I always do when something doesn’t add up:
I went full nerd. Dug into every journal article, guideline, and biochemistry rabbit hole I could find.
What I discovered floored me.
Turns Out, This Isn’t “Just Aging”
Most of us grow up thinking menopause is about hot flashes and mood swings. Maybe some sleep issues. Nothing a fan and some chamomile can’t handle.
What no one says—like really says—is that menopause can flip your metabolism upside down.
Estrogen doesn’t just keep your periods regular.
It helps your cells burn energy.
It protects your heart.
It keeps your insulin in check.
It reduces inflammation.
It even helps your mitochondria make brainpower and muscle.
So when estrogen drops?
It’s not just a hormone shift.
It’s a biological earthquake.
Your body doesn’t know how to process carbs the same way.
It starts storing more fat—especially in your belly.
Your cholesterol changes. Your blood sugar spikes.
You feel tired, achy, moody, and slightly insane.
And most doctors? They’re still handing out pamphlets from 1998.
The Medical Guidelines Are Silent
I dove into the medical guidelines for managing dyslipidemia—you know, the ones that tell us how to manage cholesterol and heart disease.
They talk all day about statins and triglycerides. But menopause? Barely a blip.
Which is wild—because this is exactly when women start showing up with:
Insulin resistance
Dangerous belly fat
Climbing LDL
Worsening blood pressure
Increased cardiovascular risk
You know what I didn’t see?
A section titled:
“Hey, You Just Lost Your Primary Metabolic Regulator. Here's What to Do.”
So I Made One
After going through the mess myself, and becoming a certified menopause practitioner, I built the course I wish had existed the moment I collapsed onto the couch wondering if I was dying or just hormonal.
It’s called Master Menopause & Feel Fabulous.
And it’s not about “balancing your hormones with moon dust” or shaming you into a keto diet you hate.
It’s about:
What’s actually happening to your metabolism
Why weight gain isn’t your fault
What your mitochondria, muscles, and mood need to bounce back
Whether MHT (menopausal hormone therapy) makes sense for you
And how to advocate for yourself in a system that still thinks menopause is a footnote
This Is for the Woman Who’s Done Guessing
If you're thinking:
“Why does my body feel like a stranger?”
“Why am I gaining weight even though I eat like a squirrel and train like a Marine?”
“Why is no one talking about this?”
You are exactly who I made this for.
This course gives you:
The science
The strategies
The permission to stop blaming yourself
And the tools to build your metabolism back—better than before
Join Me Inside the Course
Inside, you’ll get:
A full ebook that breaks it all down—simple, honest, no fluff
Real answers to the questions even your doctor might not know to ask
Click here to join Master Menopause & Feel Fabulous »
This isn’t just about managing menopause.
It’s about reclaiming your body, your clarity, and your power.
Free Resource Below
Menopause: The Missing Manual—Doctor’s Checklist Edition
This handout is your no-nonsense guide to:
The tests to ask for
The symptoms to track
The red flags to bring up
And how to talk to your doctor without getting dismissed
Download the checklist below. UPDATE: There is a technical glitch with the download for the moment. I am working with Substack to fix it. It is however the same information as below. Thank you for your patience.
Please share this with your friends if they too are confused by the mysterious menopause.
Menopause: The Missing Manual—Doctor’s Checklist Edition
By Laurie Marbas, MD, MBA
(drmarbas.com)
This checklist is designed to help you walk into your doctor’s office prepared, informed, and empowered. It includes symptom tracking, key labs, and talking points—because menopause is not just a phase. It’s a metabolic, hormonal, and emotional transition that deserves clarity and care.
1. Know Your Story
Discuss the following with your doctor. These give important context for your transition.
Your Menstrual History
Last menstrual period or changes in bleeding patterns
Any gynecological surgeries (hysterectomy, oophorectomy)
Current use of birth control or hormone therapies
Risk of pregnancy or contraceptive needs
Personal Medical History
Blood clots (DVT/PE)
Breast or uterine cancer
Thyroid disease
High blood pressure, heart disease
Osteoporosis or bone fractures
Type 2 diabetes or insulin resistance
Depression, anxiety, postnatal depression
Frequent UTIs
Liver disease
Family History
Heart disease
Osteoporosis or fractures
Dementia
Cancers (breast, ovarian, uterine, colon)
Lifestyle & Wellbeing
Smoking or alcohol use
Sexual wellbeing (discomfort, libido)
Emotional or social support
2. What Your Doctor Might Check
These simple checks help build a picture of your overall health:
Height, weight, BMI
Blood pressure
Breast exam (if due or relevant)
Note: Bring up any recent changes in your weight, blood pressure, or breast health.
3. Do You Need Hormone Testing?
If you’re 45 or older:
Diagnosis is typically based on symptoms.
If you’re under 45 or have unusual symptoms:
Blood tests for FSH and estrogen may help clarify your stage.
Note: Hormone levels fluctuate wildly in perimenopause and may be unreliable—especially if you’re taking hormonal contraceptives.
4. Protect Your Whole Body: Recommended Bloodwork
These tests provide a fuller picture of what’s happening beneath the surface as your hormones shift. They help identify risks early and guide smart, targeted care. Ask your provider which ones apply to you.
Lipid Panel (LDL, HDL, Triglycerides)
Estrogen helps keep your cholesterol in check. As levels drop, your LDL (the “bad” cholesterol) can rise, while HDL (the “good” kind) can fall—raising your risk of heart disease. This test tracks that shift.
Hemoglobin A1c and Fasting Blood Glucose
Menopause can trigger insulin resistance, making it harder for your body to regulate blood sugar. These tests detect prediabetes and type 2 diabetes—both of which are more common post-menopause.
Fasting Insulin
Elevated insulin—even with normal glucose—can be an early sign of metabolic imbalance. It’s a clue your body is struggling to keep up, and it often precedes weight gain, fatigue, and blood sugar problems.
Thyroid-Stimulating Hormone (TSH)
Fatigue, brain fog, weight changes, mood swings—sound familiar? These overlap with thyroid dysfunction. Since thyroid issues are more common in midlife women, ruling them out is essential.
Complete Blood Count (CBC)
This test checks for anemia, infections, and other blood abnormalities. If you’re feeling unusually tired or run-down, a CBC can help explain why.
Kidney and Liver Function Tests
Before starting hormone therapy—or even certain supplements—it's important to know how well your liver and kidneys are working. These tests provide that baseline.
Iron Panel with Ferritin
Heavy or erratic perimenopausal bleeding can deplete iron stores, even if your hemoglobin is “normal.” Ferritin checks your body’s iron reserves and can explain lingering fatigue.
High-Sensitivity C-Reactive Protein (hs-CRP)
This is a marker of inflammation. Chronic low-grade inflammation is linked to everything from heart disease to fatigue and weight gain—and it tends to rise during and after menopause.
Lipoprotein(a)
This genetic form of cholesterol doesn’t show up on a basic lipid panel. It increases cardiovascular risk and becomes more relevant once estrogen’s protective effect fades.
Fecal Occult Blood Test (FOBT)
Colon cancer risk increases with age. This simple test checks for hidden blood in your stool—a potential early sign of colorectal cancer.
Vitamin D (for at-risk women)
Low vitamin D is common in midlife and contributes to bone loss, mood changes, and immune dysfunction. It’s especially important for women with fatigue, low sun exposure, or osteoporosis risk.
5. How Menopause Is Showing Up for You
Common Symptoms
☐ Hot flashes
☐ Night sweats
☐ Vaginal dryness
☐ Mood swings
☐ Brain fog
☐ Fatigue
☐ Weight gain
☐ Joint pain
☐ Low libido
Less Common, Still Normal
☐ Heart palpitations
☐ Hair thinning
☐ Skin changes (dryness, acne)
☐ Burning mouth
☐ Electric shock sensations
☐ Digestive issues (bloating, gas)
☐ Changes in taste or smell
☐ Frequent or urgent urination
Add your own here:
6. Start the Conversation: What to Say
Use these phrases to guide your visit confidently:
“Could these symptoms be related to perimenopause or menopause?”
“Can we review this checklist together to see what applies to me?”
“What are my options for managing symptoms—including hormone therapy?”
“Are there any labs or screenings I should consider now?”
7. Your Notes
Write down symptoms, questions, or things to follow up on:
Georgia, me too. I had my HRT stopped 12 years ago. Then I had good energy and was fit. Now I’m 74, with joint aches and pains, poor sleep, pain with sex. I want my life back, but once you’re older and have been off HRT, it’s been impossible for me to get anyone to prescribe it.
Oh my, Dr. M, I would buy all of your books, courses, and merch if it would correct the mistakes of "modern medicine" It's too late and the damage is compounded. "When did menopause start?" they ask. The answer is at 40 when they did a TAH and ripped out all hormone producing equipment. What about estrogen replacement therapy and so forth? The doctors were more concerned about their profits and liability insurance than me. They read online or in some journal that hormone therapy increases cancer and they can be sued. I'm left to age and die on my own, with any help. Decade after decade all of those symptoms you list showed up and nobody... I mean, nobody paid attention to me asking at every annual physical, "This isn't right. Can't we do anything?"