The Blog

a flat lay of women's health items.
A flat lay of general health items.
Your Cholesterol Numbers Changed at Menopause. Your Risk Assessment Probably Did Not.
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

Your Cholesterol Numbers Changed at Menopause. Your Risk Assessment Probably Did Not.

LDL up forty points, total cholesterol across a line it never approached in twenty years, and nothing about how she eats or what she weighs has meaningfully changed. The note says watch your diet, recheck in a year. That advice skips the actual question — whether her risk category has changed, and whether the calculator used to answer that even knows she's in menopause.

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Antihistamines in Perimenopause: What Allergy Season Costs You Beyond the Sneezing
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

Antihistamines in Perimenopause: What Allergy Season Costs You Beyond the Sneezing

The ragweed decision gets made in a pharmacy aisle in about ninety seconds, somewhere between the box that says non-drowsy and the one with a "D" after the drug name. Three weeks later, the dryness is worse, the sleep is stranger, and the blood pressure has crept up — and nobody has connected those three things to the medication sitting in the middle of them. Here's what each class actually does, and why it lands differently at 49 than it did at 29.

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Weight Gain: Thyroid Problem, Hormonal Shift, or Both?
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

Weight Gain: Thyroid Problem, Hormonal Shift, or Both?

Gaining weight over a year without changing how you eat or move, and being told to eat less and move more anyway, is a familiar loop. At least two hormonal systems regulate metabolic rate, and their symptoms overlap almost perfectly — which is why symptoms alone can't answer the question and a single lab value usually doesn't either. Here's how the diagnostic thinking actually works before anyone talks about treatment.

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Hair Thinning in Midlife: Thyroid, Hormones, or Both?
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

Hair Thinning in Midlife: Thyroid, Hormones, or Both?

More hair in the drain, on the pillow, in the brush — and the usual response is a shrug, a multivitamin, and a suggestion that it's just aging. At least two separate systems can drive hair thinning in midlife, and they call for different next steps. This one stays diagnostic: what's actually causing it, how the patterns differ, and what a real evaluation includes before anyone starts buying supplements.

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How Long Can You Stay on Hormone Therapy? What Current Guidance Actually Says
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

How Long Can You Stay on Hormone Therapy? What Current Guidance Actually Says

A patient six years into hormone therapy recently asked whether she was supposed to have stopped by now. No new symptoms, normal labs — she'd just absorbed the idea that five years was the ceiling. That number has been repeated for two decades without ever having been a rule, and the guidance it came from has since changed considerably. Here's what current evidence actually says about duration.

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Progesterone's Role: Why It's Not Just "The Other Hormone"
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

Progesterone's Role: Why It's Not Just "The Other Hormone"

Most women arrive at their menopause appointment knowing plenty about estrogen and almost nothing about progesterone beyond one line: it protects your uterus. True, but it leaves out the part where progesterone acts on the same brain receptors as anti-anxiety medications and measurably changes how you sleep. Here's the fuller explanation, from a physician trained in both internal medicine and menopause care.

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Why Women Need Longer Doctor Visits: The Problem With Rushed Healthcare
WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP WOMEN'S HEALTH Jennifer Kostacos, MD, MSCP

Why Women Need Longer Doctor Visits: The Problem With Rushed Healthcare

For a woman who has been waiting weeks to discuss fatigue, irregular cycles, unexplained weight changes, and a general sense that something is off — a 15-minute appointment closes before she finishes her second concern. This is not an occasional failure. It is a structural problem, and it falls disproportionately on women.

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