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September 19, 2025 58 mins

In this interview, Andrea Donsky, nutritionist, menopause educator, and published menopause researcher and co-founder of WeAreMorphus.com, discusses how hormonal birth control can mask where you are in the menopausal transition, what labs help, and how to talk to your doctor about safer options. Elizabeth Katzman specializes in Functional Diagnostic Nutrition for women in perimenopause and menopause. She'll help you connect the dots if you've taken the pill in the past or are on the pill now. 

Topic Covered: 

  • What the pill does (synthetic estrogen + progestin), why the “period” on it is a withdrawal bleed, and how it can hide your true perimenopause status.
  • Why progestins can raise anxiety/depression risk, and how bioidentical progesterone supports sleep, mood, bones, and thyroid.
  • Thyroid connection: How the pill can deplete nutrients and interfere with T4→T3 conversion, and raise hypothyroid risk when midlife thyroid issues already spike.
  • Leaky gut, depleted lacto/bifido, and why protecting your mucosal lining matters for autoimmune risk.
  • Testing that helps (and when): Why FSH/E2/Progesterone timing matters off the pill, plus affordable bloodwork that gives clues even when hormones fluctuate.
  • How to think about nutrient repletion (methylated B’s, magnesium, zinc, selenium) and why an IUD or mini-pill (progestin-only) isn’t automatically a better choice.
  • Topical/oral/vaginal progesterone options, DHEA and pregnenolone basics, and why “fit + formulation + timing” often matter more than the dose.
  • Red meat, ferritin, and genetics: Why iron can climb post-menopause, when to watch ferritin, and how genetics (MTHFR, APOE) affect it.
  • When your long-time GYN isn’t the right HRT partner, and how to add a practitioner who actually understands midlife hormones.

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