For the first time, we’re bringing you both the doctor and the patient—because women deserve more than one point of view, and a real look at what collaborative, nuanced care can actually look like.

If you’re in your 30s or 40s and have been feeling off—exhausted, anxious, not sleeping, breaking out, forgetting words mid-sentence—and wondering what is going on… this might be perimenopause.

And no, you’re not too young.

I’m joined by Dr. Heather Hirsch, menopause clinician and author of The Survival Guide to Perimenopause, and Joy Brown Kirst, founder of Modern Age Skin, for a conversation that’s fun, deeply relatable, and actually useful.

We get into why so many symptoms get dismissed as “just stress,” how hormones are impacting everything from your mood to your skin, and why perimenopause is often missed entirely.

We also unpack how skincare needs to shift during this phase—why your 10-step routine might actually be working against you, and how a less-is-more approach can better support the skin barrier as hormones change.

We break down what’s real vs. overcomplicated when it comes to HRT, why fixing one thing at a time (like sleep) can change everything, and how to find a care team that actually listens.

Because this isn’t in your head—and it’s not something you have to just push through.It’s your body asking for better information—and better care.

Subscribe to Off With Your Coat for more incredible conversations like this, and be sure to pass this episode on to the women in your life!

Podcast Resources

Connect with Dr. Heather Hirsch

Purchase the The Perimenopause Survival Guide

Check out The Collaborative by Heather Hirsch: Personalized, evidence-based peri/menopause care

Follow and learn more about Modern Age Skin: Skincare designed for perimenopause + menopause ("the catalyst" -our fave product!)