unPAUSED with Dr. Mary Claire Haver

If you've ever struggled to put on a bra, reach behind your back, or lift your arm without searing pain in your shoulder, you're not alone. Frozen shoulder strikes women in midlife at alarming rates, yet for decades, medicine dismissed it as a mystery condition with no known cause. Orthopedic surgeon Dr. Jocelyn Wittstein saw what others missed: her patients with frozen shoulder were almost all women between forty and sixty, experiencing hot flashes, night sweats, and other symptoms of perimenopause and menopause. What she discovered is changing how we understand the impact of declining estrogen on women's joints, bones, and muscles.

Dr. Wittstein is a practicing orthopedic surgeon, researcher, and associate professor at Duke University, specializing in sports medicine and the female athlete across the lifespan. She's also a former collegiate gymnast and mother of five. Her research focuses on frozen shoulder, ACL injuries in female athletes, and the musculoskeletal syndrome of menopause. As president of the Forum for Women in Sports Medicine, Dr. Wittstein is changing how we understand the intersection of hormones, movement, and independence in women's bodies.

In this conversation, Dr. Mary Claire Haver and Dr. Wittstein explore how declining estrogen during perimenopause and menopause impacts joints, bones, muscles, and connective tissue. They discuss why frozen shoulder disproportionately affects women in midlife, with some Asian cultures having their own term for it that translates to fifty year shoulder. Dr. Wittstein explains the critical window for treatment, why early intervention can be transformative, and how hormone replacement therapy may prevent it, with preliminary data suggesting women using systemic estradiol have half the risk of developing frozen shoulder. She shares why physical therapy during the inflammatory phase can worsen it and how to recognize the early warning signs.

Guest links:

Jocelyn Ross Wittstein, MD (Duke Health)

Jocelyn Wittstein, MD (Instagram)

Duke Female Athlete Program

Milken Institute Women’s Health Initiative

Books“The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,” by Dr. Jocelyn Wittstein and Sydney Nitzkorski, MS, RD

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Award-winning British television creator Sally Wainwright joins Dr. Mary Claire Haver to discuss her groundbreaking new BBC series Riot Women, a drama about five midlife women who form a punk rock band while navigating menopause, aging parents, and the complexities of life after 50. Sally, the creative force behind acclaimed series including Happy Valley, Gentlemen Jack, and Last Tango in Halifax, shares how her own experience with perimenopause and menopause inspired the show and why she calls this life stage "identity theft."

The conversation explores Sally's journey from bus driver to one of British television's most celebrated showrunners, her commitment to portraying authentic female characters who carry grief, desire, sexuality, rage, and resilience in bodies that reflect actual lived experience, and how brain fog, joylessness, and depression led her to finally try hormone replacement therapy after initially believing outdated myths about breast cancer risk, and how that decision transformed her wellbeing.

Dr. Haver and Sally discuss the critical importance of naming menopause symptoms, from the devastating loss of motivation and confidence that can accompany hormonal changes to the sandwich generation pressures of dementia care for aging parents while raising teenagers. The episode examines why female stories, particularly those featuring women over 50, face funding challenges in entertainment, how male writers have historically constructed female characters through the male gaze, and why Sally believes women are more heroic and emotionally articulate than men.

They explore the revolutionary aspects of Riot Women, including its honest portrayal of sexual health, libido changes, medical gaslighting, and the transformative power of HRT, rarely if ever depicted on screen with such nuance and optimism. Sally discusses audience response to the series, including an unprecedented volume of thank-you letters to the BBC from viewers who felt seen for the first time, men's surprising embrace of the show despite its focus on female experience, and a handful of critics who complained about the absence of "nice men" despite the show's ensemble of complex, flawed characters of all genders. This conversation offers validation for anyone navigating the physical and emotional challenges of perimenopause and menopause, inspiration for creative midlife reinvention, and hope that entertainment is finally beginning to tell the truth about women's lives with the honesty, ferocity, humor, tenderness, and rage they deserve.

Guest links:

Sally Wainwright (Instagram)

Sally Wainwright (IMDB)

Articles

Menopausal Hormone Therapy and the Breast: A Review of Clinical Studies (Breast Care)

Anhedonia: A Concept Analysis (Archives of Psychiatric Nursing)

Other Resources

Primary Ovarian Insufficiency in Adolescents and Young Women (American College of Obstetricians and Gynecologists)

Riot Women (BBC)

Clips from Riot Women:

251105_RiotWomen_Ep1_Clip_Satisfaction_Bug.mp4

251105_RiotWomen_Ep1_Clip_WithAttitude_Bug.mp4

251105_RiotWomen_Ep1_Clip_RiotWomen_Bug.mp4

251105_RiotWomen_Ep1_Clip_OneMenopausalWomanToAnother_Bug.mp4

251105_RiotWomen_Ep1_Clip_ForTheRefugees_Bug.mp4


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Dr. Elizabeth Comen is a board certified oncologist at NYU Langone Health, co-director of the Mignoni Women's Health Collaborative, and author of the groundbreaking book “All In Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today”. In this powerful conversation about medical gaslighting and women's healthcare, she and Dr. Mary Claire Haver trace the deep roots of medical misogyny and reveal why the healthcare system still dismisses women's symptoms today.

Dr. Comen shares the story of a breast cancer patient on her deathbed who, hours from death, apologized for sweating during a hug. It's a moment that captures what nearly every woman experiences in a doctor's office, the reflexive apology for being in a normal human body. Whether it's apologizing for leg hair in stirrups or hiding underwear during an exam, women have internalized tremendous shame about their bodies. Dr. Comen explains this isn't random. It's the legacy of a medical system built by men who dismissed women's pain and symptoms as hysteria, neurosis, or anxiety.

Through meticulous research into medical history, Dr. Comen reveals how this medical gaslighting became embedded in healthcare. She discusses William Osler, one of cardiology's founding fathers, who described women's chest pain as "neurotic angina" and wrote that "these women do not die." Yet heart disease is the number one killer of women. She explains how women are twice as likely to call an ambulance for their husband's heart attack than for themselves, and when they do seek help for chest pain, they're far more likely to be misdiagnosed with a panic attack instead of receiving proper cardiac care.

Dr. Haver and Dr. Comen discuss the systemic healthcare gaps across medical specialties: why 80% of autoimmune diseases affect women yet it's not considered a women's health field, why female specific surgeries are reimbursed at significantly lower rates than comparable male procedures, why Alzheimer's disease is twice as common in women but received almost no research funding, and how the legacy of dismissing women's sexual health continues in breast cancer and oncology care today. They explore bizarre historical medical fears like "bicycle face," the myth that women would become ugly and infertile from exercise, and how plastic surgery evolved to make women "marriage material" rather than serve their actual health needs.

Despite the sobering history of medical misogyny, this conversation ends with hope. Dr. Comen shares why she's optimistic about the cultural shift happening in women's healthcare now, the importance of women advocating for themselves in medical settings, and how the next generation doesn't have to wait for menopause to stop apologizing and start demanding better healthcare.

Guest links:

Dr. Elizabeth Comen

Dr. Elizabeth Comen (Instagram)

Dr. Elizabeth Comen (LinkedIn)

Dr. Elizabeth Comen, MD (NYU)

Books

“All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today,” by Dr. Elizabeth Comen

“The New Menopause,” by Dr. Mary Claire Haver“The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again,” by Dr. Mary Claire Haver

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What happens after you lose the weight? Few are focused on this important question about GLP-1 medications. In Part 2 of this conversation on GLP-1s and Midlife Metabolism, triple Board-certified in Obesity Medicine; fellowship-trained in Endocrinology, Diabetes & Metabolism Dr. Rocio Salas-Whalen continues her discussion with Dr. Mary Claire Haver, going deeper into what happens after weight loss including the physical and emotional changes no one prepares you for, and what the future of these medications looks like.

Dr. Salas-Whalen, founder of New York Endocrinology and author of the upcoming book Weightless, tackles the questions women are actually asking: How do I know if I'm getting good care? What about compounding pharmacies? Will I need therapy? And what comes next in obesity medication?

The conversation addresses the psychological shifts that happen when you reach your goal weight for the first time in your life. Dr. Salas-Whalen shares what she's learned from following patients long-term and why the maintenance phase is actually the most important part of treatment.

Dr. Salas-Whalen also addresses the cost and accessibility crisis around Ozempic, Wegovy, and Mounjaro, the environmental impact of single-use injection pens, and why direct-from-manufacturer vials (like Eli Lilly's Zepbound vials) are making treatment more affordable. She shares her standard of care for obesity treatment and explains exactly what questions to ask before starting GLP-1 therapy.

For women experiencing perimenopause and menopause weight gain, this episode provides useful information about what to expect beyond initial weight loss, how to maintain results long-term, and why proper medical supervision with body composition monitoring is essential for protecting muscle mass and metabolic health.

Guest links:

Meet Your Endocrinologist - Dr. Salas-Whalen (NY Endocrinology)Dr. Rocio Salas-Whalen (Instagram)

Books:

“Weightless: A Doctor's Guide to GLP-1 Medications, Sustainable Weight Loss, and the Health You Deserve” by Dr. Rocio Salas-Whalen

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Are GLP-1 medications a game-changer for women in midlife—or just another quick fix? In this conversation, triple Board-certified in Obesity Medicine; fellowship-trained in Endocrinology, Diabetes & Metabolism Dr. Rocio Salas-Whalen joins Dr. Mary Claire Haver to cut through the hype and share what women really need to know about Ozempic, Wegovy, Mounjaro, and the science behind sustainable weight loss.

Dr. Salas-Whalen, founder of New York Endocrinology and author of the upcoming book Weightless, explains why GLP-1 receptor agonists represent a fundamental shift in how we understand and treat obesity—not as a willpower problem, but as a chronic medical condition with biological drivers including hormones, genetics, and metabolism.

For women navigating perimenopause and menopause, the conversation gets even more specific. Dr. Salas-Whalen breaks down why estrogen decline drives fat redistribution to the abdomen, increases visceral fat, and makes it nearly impossible to lose weight using the same strategies that worked before. She reveals how GLP-1 medications can address the metabolic changes of midlife while protecting what matters most: muscle mass.

Dr. Salas-Whalen shares her clinical experience treating thousands of patients and addresses the viral misinformation circulating online. She explains why obesity is a transgenerational disease influenced by genetics, environment, food accessibility, and even childhood trauma—not personal failure.

Guest links:

Meet Your Endocrinologist - Dr. Salas-Whalen (NY Endocrinology)

Dr. Rocio Salas-Whalen (Instagram)

Books

“Weightless: A Doctor's Guide to GLP-1 Medications, Sustainable Weight Loss, and the Health You Deserve” by Dr. Rocio Salas-Whalen

Articles

Loss of Visceral Fat is Associated with a Reduction in Inflammatory Status in Patients with Metabolic Syndrome (Molecular Nutrition and Food Research)

Increased visceral fat and decreased energy expenditure during the menopausal transition (International Journal of Obesity)

Sex-specific body fat distribution predicts cardiovascular ageing (European Heart Journal)

Association between metabolic healthy obesity and female infertility: the national health and nutrition examination survey, 2013–2020 (BMC Public Health)

The discovery and development of GLP-1 based drugs that have revolutionized the treatment of obesity (PNAS)

Skeletal Muscle as Endocrine Organ (Advances in Experimental Medicine and Biology)

Preserving Healthy Muscle during Weight Loss (Advances in Nutrition)

32nd European Congress on Obesity (ECO 2025) (S. Karger AG, Basel)

Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression (Frontiers in Endocrinology)

Adverse Events Related to Tirzepatide (Journal of the Endocrine Society)

Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use (Menopause)

Clinical development times for innovative drugs (Nature Reviews Drug Discovery)

The dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist tirzepatide: a novel cardiometabolic therapeutic prospect (Cardiovascular Diabetology)

Dose-dependent pancreatitis risk associated with GLP-1 agonists (Journal of Diabetes and Metabolic Disorders)

Mortality from type 2 diabetes mellitus across municipalities in Mexico (Arch Public Health)

The association between age of menopause and type 2 diabetes: a systematic review and meta-analysis (Nutrition & Metabolism)

Obesity in Infertile Women, a Cross-Sectional Study of the United States Using NSFG 2011-2019 (Reproductive Sciences)

Bisphenol A and the Risk of Obesity a Systematic Review With Meta-Analysis of the Epidemiological Evidence (Dose-Response)

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