Insulin Resistance in Perimenopause: HRT, GLP-1s & Muscle | Clinically Well Ep. 2

Why does belly fat show up in your 40s when nothing about your diet or workouts has changed? Often, it's insulin resistance. In episode 2 of Clinically Well, Tiffany Bailey, PA-C, and Dr. Pat Taylor, Belle's Chief Medical Officer and a board-certified family physician and menopause specialist, explain why perimenopause makes your body more insulin-resistant and what you can do about it.

In this episode:

- Why falling estrogen makes insulin resistance more likely in midlife

- Why A1C and fasting glucose can look normal for years, and the labs worth asking about (fasting insulin, hs-CRP, triglyceride-to-HDL ratio)

- Why building muscle is the first treatment, before any medication

- What's changed with HRT since the 2002 Women's Health Initiative study, and why transdermal vs. oral matters

- What new research shows about combining HRT with GLP-1 medications

- Why you don't have to wait for your last period to get help

- Where peptides fit in, and why insulin resistance comes first

Belle's women's hormone therapy program is launching soon. Join the waitlist: https://www.joinbelle.com/womens-health/waitlist?from=hero_consult

Peptides for Perimenopause E-book: https://livevital-perimenopause-guide.vercel.app/#doctor

Chapters

00:00 Welcome to Clinically Well

00:23 Why insulin resistance shows up in midlife

03:03 Why standard blood work can miss it

06:00 Labs that flag insulin resistance: hs-CRP, triglycerides, HDL ratios

07:30 Rising cholesterol after 40, even when nothing changed

08:39 Estrogen, muscle and insulin sensitivity

09:44 What to do first: why muscle comes before medication

14:12 Treatment options: HRT, GLP-1s and peptides

15:21 The 2002 WHI study and the HRT black box warning

16:40 Bioidentical vs. synthetic, transdermal vs. oral HRT

19:43 HRT plus GLP-1s: what the studies show

22:59 GLP-1s and perimenopause symptoms

25:16 You don't have to wait for your last period

27:24 Peptides for perimenopause: the four buckets

29:58 Belle's women's hormone therapy program

30:51 The Pause Project and what's next

Next week: building muscle in midlife. Why it matters, how to start, and the myths that keep people out of the weight room.

Got a question or a topic you want us to cover? Answer this episode's Q&A or leave a comment.

Clinically Well is presented by Belle Health. This episode is for education only and is not medical advice. Talk to your provider before starting or changing any treatment. Questions for Belle's care team: [email protected]