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The Modern Midlife Collective

The Modern Midlife Collective

By: Dr. Ade Akindipe DNP MBA APRN FNP-C and Dr. Jillian Woodruff MD FACOG NCMP
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Welcome to The Modern Midlife Collective—where midlife isn’t a crisis, it’s a rebirth. Hosted by Dr. Ade Akindipe, DNP, and Dr. Jillian Woodruff, MD, this is the podcast for women ready to unapologetically own their power, thrive through the ups and downs of hormones, weight, and self-care, and show the world that thriving at 40 and beyond isn’t just possible—it’s your birthright. Biweekly, we bring you science-backed insights on hormones, menopause, longevity, and sexual health—real tools to empower women in midlife and beyond. With a fearless blend of functional medicine, real-life wisdom, and no-nonsense empowerment, we’re here to challenge the norms, break through the barriers, and help you step into a life of vitality, confidence, and unstoppable strength. Ready to rise? Let’s do this.© 2026 Dr. Ade Akindipe, DNP, MBA, APRN, FNP-C and Dr. Jillian Woodruff, MD, FACOG, NCMP Hygiene & Healthy Living Physical Illness & Disease
Episodes
  • Episode 35: Am I Crazy, or Is This Perimenopause?

    Episode 35: Am I Crazy, or Is This Perimenopause?
    Jun 17 2026
    Am I Crazy, or Is This Perimenopause?The Modern Midlife Collective PodcastEpisode OverviewHave you been told your labs are normal -- but you still don't feel like yourself? Are you waking up at 3 a.m., snapping at people you love, forgetting words mid-sentence, and wondering what is happening to your body? Before you assume the worst, there's something you need to hear: you are not crazy. You may be in perimenopause.In this foundational episode, Dr. Jillian Woodruff, MD, FACOG, MSCP, and Dr. Ade Akindipe, DNP, break down everything women need to know about the menopausal transition -- what it actually is, why it begins earlier than most women expect, and why the symptom list goes so far beyond hot flashes. They explain why perimenopause is a clinical diagnosis rather than a laboratory one, what the research actually shows about hormones and brain health, and what to do if you have already been dismissed by a provider who told you your numbers look fine.This episode also addresses why so many perimenopausal symptoms are misattributed to anxiety, stress, or aging -- and what the full, evidence-based picture actually looks like. If you have been searching for someone to finally connect the dots, this is that conversation.Key Takeaways• Perimenopause can begin in the late 30s and lasts an average of four to ten years -- and women can be fully symptomatic while still having regular menstrual cycles.• Hormone levels fluctuate dramatically during this transition. A single blood draw is a snapshot, not the full film. Perimenopause is a clinical diagnosis based on symptoms, history, and patterns over time.• Estrogen receptors are found in the brain, bones, heart, blood vessels, bladder, skin, and muscles. When estrogen fluctuates, women feel it throughout their entire body -- which explains why the symptom list seems so disconnected.• The SWAN Study (Study of Women's Health Across the Nation), one of the largest long-term studies of the menopausal transition, confirmed that sleep disruption, mood changes, cognitive complaints, and hot flashes commonly emerge during perimenopause -- often well before the final menstrual period.• Cognitive changes -- word-finding difficulties, brain fog, and memory lapses -- are common during perimenopause and are typically temporary and hormone-related. They are not early dementia.• Tracking your symptoms over four to six weeks -- including sleep, mood, energy, cycle changes, hot flashes, brain fog, and joint pain -- gives your clinician critical information that a single lab result cannot provide.• Evidence-based treatment options exist. There is no clinical or moral virtue in suffering through this transition without support.Topics DiscussedWhat perimenopause is and how it differs from menopause, why perimenopause can begin in the late 30s, the hormone fluctuation pattern during perimenopause and why it is not a steady decline, the full symptom spectrum of perimenopause including neurological, cardiovascular, musculoskeletal, urogenital, and metabolic symptoms, the SWAN Study and what it tells us about the menopausal transition, estrogen and the brain including research from Harvard Medical School and Brigham and Women's Hospital, the ACOG position on perimenopause symptom onset, why perimenopause is a clinical diagnosis and not a laboratory diagnosis, the limitations of hormone testing and what labs actually tell us, conditions that mimic perimenopause including thyroid disease, iron deficiency, and insulin resistance, why perimenopausal anxiety is frequently misattributed to stress, the cognitive changes of perimenopause and why they are temporary, building your midlife foundation using the CARESS framework, how to find a Menopause Society certified practitioner, listener questions addressing the most common perimenopause misconceptionsYour Five-Step Perimenopause Action Plan1. Track your symptoms for four to six weeks. Include sleep, mood, energy, hot flashes, brain fog, cycle changes, joint pain, and libido. Patterns are data your clinician needs.2. Know your family history. Ask when your mother or sisters reached menopause and whether they experienced osteoporosis, heart disease, or cognitive changes.3. Build your midlife foundation. Prioritize protein at every meal, resistance training two to three times per week, daily movement, stress management, and sleep. The CARESS framework is a place to start.4. Find a clinician with menopause-specific training. The Menopause Society maintains a certified practitioner directory at menopause.org.5. Give yourself grace. You are not weak. You are not lazy. You are moving through a transition -- and you deserve support during it.Resources MentionedThe Menopause Society certified practitioner directory: menopause.orgACOG (American College of Obstetricians and Gynecologists): acog.orgSWAN Study (Study of Women's Health Across the Nation): swanstudy.orgModern Gynecology and Skin: moderngynalaska.comRejuvenate Health and ...
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    43 mins
  • Episode 34: "I'm in Perimenopause — How Do I Know When It's Time to Start Estrogen?"

    Episode 34: "I'm in Perimenopause — How Do I Know When It's Time to Start Estrogen?"
    Jun 3 2026
    I’m in Perimenopause — How Do I Know When It’s Time to Start Estrogen?Episode OverviewIn this solo episode, Dr. Jillian Woodruff tackles one of the most common and nuanced questions in menopause medicine: How do you know when it’s time to start estrogen?Recorded while on a family vacation on the East Coast — because some topics are too important to wait — Dr. Jillian walks through the practical clinical framework she uses every day in her practice. She covers the signals she looks for, why laboratory results alone are not enough to guide this decision, and why perimenopause is often the optimal time to begin the conversation — not years later when symptoms have already disrupted sleep, mood, cognition, intimacy, and quality of life.The episode also covers the relationship between estrogen and periods — including why estrogen can sometimes make bleeding worse in early perimenopause — the non-negotiable role of progesterone in any woman with a uterus on systemic estrogen, and a full discussion of Genitourinary Syndrome of Menopause (GSM) and why painful sex, vaginal dryness, and recurrent UTIs are treatable and should never be accepted as inevitable parts of aging.Key TakeawaysYou do not have to wait until symptoms become severe before discussing hormone therapy.Perimenopause is often the ideal time to begin evaluating treatment options.New symptoms matter more than isolated laboratory values.Hot flashes and night sweats are more than inconveniences and can affect overall health and quality of life.Early bone loss may be an important reason to discuss hormone therapy.Mood and cognitive changes may have hormonal contributors.Progesterone is often the first hormonal intervention considered in early perimenopause.Women with a uterus who use systemic estrogen require endometrial protection with progesterone or a progestin.Vaginal estrogen is a separate treatment category from systemic hormone therapy and has a different risk profile.GSM is common, progressive, and highly treatable.Resources MentionedThe Menopause Society certified provider finder: www.menopause.orgSend your questions: connect@modernmidlifecollective.comWatch the video version: youtube.com/@drjillianwoodruff (available June 10, 2026)www.modernmidlifecollective.comAbout Dr. Jillian Woodruff, MDDr. Jillian Woodruff, MD is a board-certified OB-GYN, gynecologic surgeon, and Menopause Society Certified Practitioner. She is the founder of Modern Gynecology & Skin in Anchorage, Alaska, and co-host of The Modern Midlife Collective podcast with Dr. Ade Akindipe, DNP.SCIENTIFIC REFERENCES AND BIBLIOGRAPHYProfessional GuidelinesThe Menopause Society. The 2022 Hormone Therapy Position Statement of The Menopause Society. Menopause. 2022;29(7):767–794.American College of Obstetricians and Gynecologists. Hormone Therapy for Menopause. ACOG Practice Guidance and FAQ. Washington, DC: ACOG; updated 2022.SWAN Study — Vasomotor Symptoms and DurationAvis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531–539.SWAN Study — Vasomotor Symptoms and Cardiovascular RiskThurston RC, El Khoudary SR, Sutton-Tyrrell K, et al. Vasomotor symptoms and cardiovascular risk in midlife women. Menopause. 2011;18(2):146–151.Perimenopausal Depression and PMDD HistoryCohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL. Risk for new onset of depression during the menopausal transition: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry. 2006;63(4):385–390.Freeman EW, Sammel MD, Liu L, Gracia CR. Association of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry. 2004;61(1):62–70.GSM — Management and TreatmentFaubion SS, Larkin LC, Stuenkel CA, et al. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer. Menopause. 2018;25(6):596–608.Faubion SS, Sood R, Kapoor E. Genitourinary syndrome of menopause: management strategies for the clinician. Mayo Clin Proc. 2017;92(12):1842–1849.Bone Loss and Estrogen in PerimenopauseSowers MR, Zheng H, Jannausch ML, et al. Amount of bone loss in relation to time around the final menstrual period and follicle-stimulating hormone staging of the transmenopause. J Clin Endocrinol Metab. 2010;95(5):2155–2162.Perimenopause as Clinical Diagnosis — Lab LimitationsSantoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metab. 2021;106(1):1–15.Endometrial Protection — Unopposed EstrogenGrady D, Gebretsadik T, Kerlikowske K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol. 1995;85(2):304–313.
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    25 mins
  • Episode 33: Why Your Doctor Says You're Fine — And Why You're Not" The Complete Protocol for Midlife Fatigue (Part 3)

    Episode 33: Why Your Doctor Says You're Fine — And Why You're Not" The Complete Protocol for Midlife Fatigue (Part 3)
    May 20 2026
    You have been exhausted. You went to the doctor. Your labs came back normal. And somehow that made it worse — because now you have no explanation, no answers, and a quiet suspicion that something is still very wrong.You are not imagining it. And this episode is where it finally gets addressed.In the third and final episode of our fatigue series, Dr. Jillian and Dr. Ade deliver the complete clinical protocol: the labs that actually reveal what is driving your fatigue, the supplement stack with the full reasoning behind every ingredient, and the exact language to use when you sit down with your provider so you walk out with something more useful than a recommendation to sleep more.This is the episode you bring to your next appointment.Free Download Fatigue ProtocolEverything covered in today's episode — the complete lab panel organized by tier, the supplement stack with ingredient breakdown and dosing, patient advocacy language, and a quick-reference symptom guide — is available as a free download.Get the Complete Fatigue Protocol at modernmidlifecollective.com/fatigueMissed Parts 1 and 2?Episode 31 — Why Am I Always Tired? The Root Causes of Fatigue Part 1 Covers: sex hormone dysregulation, thyroid dysfunction, and HPA axis dysregulationEpisode 32 — Why Am I Always Tired? The Root Causes of Fatigue Part 2 Covers: blood sugar dysregulation, nutrient deficiencies, and chronic low-grade inflammationLabs Discussed in This EpisodeTier One — First Visit EssentialsHormones: Estradiol (E2), Free and Total Testosterone, Progesterone, DHEA-S, FSH, LH, SHBGThyroid: TSH, Free T3, Free T4, TPO AntibodiesMetabolic: Fasting Insulin, Fasting Glucose, HOMA-IR, Hemoglobin A1c, Comprehensive Metabolic Panel, Fasting Lipid PanelNutrients: Ferritin (target 70 to 100 ng/mL), 25-OH Vitamin D (target 50 to 80 ng/mL), Vitamin B12Inflammation: High-Sensitivity CRP (hsCRP)Tier Two — Added Based on Clinical PictureThyroid extended: Reverse T3, Anti-Thyroglobulin AntibodiesAdrenal: 4-Point Salivary Cortisol and DHEA (functional lab — typically requires a functional medicine or integrative provider)Metabolic extended: Continuous Glucose Monitor (CGM) trialNutrients extended: RBC Magnesium, Folate, Zinc, IGF-1Gut: Comprehensive Stool Analysis (functional lab)Supplements DiscussedFull supplement collection available through Dr. Jillian's professional dispensary: https://us.fullscript.com/plans/moderngynecology-modern-midlife-collective-s-fatigue-protocolMagnesium Glycinate — sleep, nervous system support, restless legs. 300 to 400 mg at night.Magnesium Malate — daytime energy and muscle function. 200 to 400 mg with food.CoQ10 Ubiquinol — mitochondrial energy chain. Non-negotiable for statin users. 100 to 300 mg daily.Berberine — insulin sensitivity and metabolic support. 500 mg with meals, titrate slowly.Myo-Inositol with D-Chiro-Inositol (40:1 ratio) — insulin sensitivity and hormonal balance. 2 to 4 grams daily.Ashwagandha standardized extract — HPA axis and cortisol rhythm support. 300 to 600 mg daily.Rhodiola Rosea — cognitive fatigue and stress resilience. 200 to 400 mg in the morning.Phosphatidylserine — evening cortisol reduction; wired-but-tired pattern. 100 to 300 mg at night.Methylated B Complex — neurological energy and cortisol metabolism. Critical for women on oral contraceptives, PPIs, or metformin.Vitamin D3 with K2 MK-7 — immune, hormonal, and energy support. 5,000 IU D3 with 100 mcg K2 daily with food.Omega-3 EPA and DHA — anti-inflammatory and cardiovascular support. 2 to 4 grams of combined EPA and DHA daily.Full curated supplement collection with professional-grade brands: modernmidlifecollective.com/fatigueResearch CitedWomen's Health (London) — 67% Fatigue Prevalence in Perimenopausal Women (n=3,000+) Menopause Journal (March 2025) — AUB, Iron Depletion and Fatigue During Perimenopause (n=2,300+) AIMS Molecular Science (2024) — Estrogens and Mitochondrial Biogenesis Frontiers in Endocrinology (2024) — Mitochondrial Dysfunction and Insulin Resistance The American Journal of Medicine (2025) — HPA Axis Dysregulation: Integrative Review PMC UK Survey (2025) — Fatigue in Treated Hypothyroidism (n=1,251; 89% abnormal fatigue) XX Midlife Women's Health Study — Stress-Fatigue Coupling Across Menopause Transition WellnessExtract Research (2025) — IL-6, TNF-alpha, and Perimenopause InflammationConnect With UsWebsite: modernmidlifecollective.com Free Fatigue Protocol: modernmidlifecollective.com/fatigueInstagram: @modernmidlifecollective Email: connect@modernmidlifecollective.comWork With Dr. Jillian Modern Gynecology and Skin | Anchorage, Alaska Instagram: @drjillianwoodruff Transcend Retreat Waitlist: https://moderntranscend.com/retreat-waitlistWebsite: www.moderngynalaska.com Work With Dr. Ade Rejuvenate Health and Wellness | Anchorage, Alaska Website: www.rejuvenatehealthak.com Download Dr. Ade’s Metabolic Reset Cheat Sheet https://rejuvenatehealthakrlt.com/...
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    58 mins
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