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Host Elsa welcomes Dr. Rachel Smith, founder of Aspect Wellness, who shares her path from early motherhood to a career delivering over a thousand babies as a nurse midwife, then transitioning through burnout and perimenopause into obesity medicine and a cardiometabolic longevity-focused practice. They discuss the joy of parenting adult children, how midwifery differs philosophically from traditional OB care, and why perimenopause can bring “hormone chaos” with symptoms like mood changes, sleep disruption, anxiety, decreased libido, brain fog, joint issues, weight gain, and hot flashes. Dr. Smith explains the evolving landscape of hormone replacement therapy, including recent FDA label changes, and emphasizes individualized care. They also cover GLP-1 medications’ benefits and safety concerns, skepticism about “microdosing” as marketing, cautious use of peptides, and considerations around postpartum depression, including hormone-related treatment options.

00:00 Welcome to the Circus

00:24 Meet Dr Rachel Smith

01:14 Motherhood With Adult Kids

05:09 Early Parenting Wake Up Call

09:31 Tornado Meets Midwife

12:37 Fast Track Through Training

17:40 Building a Midwife Career

20:26 Midwife vs OB GYN

24:43 Perimenopause Career Pivot

29:57 Hormone Therapy Updates

33:04 Hormone Chaos Symptoms

34:02 From Weight Clinic to Coaching

36:14 Private Practice and Lifelong Learning

38:21 Data Driven Longevity vs Biohacking

40:03 HRT as the Original Biohack

42:38 GLP Ones Benefits and Risks

44:55 Microdosing Myth Busting

48:43 Peptides Hype and Safety

51:43 Who She Helps in Practice

56:43 Postpartum Hormones and Depression

01:01:47 Personalized HRT and the Magic Window

01:05:02 Wrap Up and Final Thoughts

IG: https://www.instagram.com/aspectwellness/

Website: https://aspect-wellness.com/

Rachel Smith, DNP, FNP-C, CNM is the founder of Aspect Wellness, a precision health and longevity practice focused on helping high-performing men and women optimize metabolism, hormones, recovery, and long-term vitality.

With 20 years of clinical experience spanning women’s health, family medicine, and obesity medicine, Rachel combines evidence-based medicine with performance-focused coaching to help clients maintain the energy, clarity, resilience, and physical capacity needed to lead ambitious lives.

Her work focuses on the intersection of longevity science, metabolic health, behavior change, strength, stress physiology, and hormone optimization—cutting through health industry noise to help people focus on what truly drives long-term outcomes.

Rachel is known for translating complex medical science into practical, actionable strategies that help busy professionals protect their health before decline becomes their new normal.

Through her clinical practice, speaking, and media appearances, she advocates for a modern approach to health optimization rooted in data, physiology, and sustainable performance—not trends, quick fixes, or fear-based wellness culture.

Thanks for listening to It’s a Circus Podcast — Unfiltered stories of motherhood, identity, and the art of Self care

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