Mary Claire Haver 1 source tracked
Board-certified OB/GYN and menopause specialist; founder of The Galveston Diet and author of books on midlife women's health.
About Mary Claire Haver →
Mary Claire Haver is a board-certified obstetrician-gynecologist who focuses on menopause, midlife women's health, and nutrition. She is the founder of The Galveston Diet, an anti-inflammatory nutrition program aimed at women in midlife, and the founder of Mary Claire Wellness, a clinic dedicated to menopause care. She is the author of "The Galveston Diet" and "The New Menopause," and has built a large social media following educating women about perimenopause and menopause. She hosts the podcast "unPAUSED with Dr. Mary Claire Haver."
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In a protocol
Addyi is an FDA-approved daily pill for libido that stimulates dopamine; also somewhat sedating.
“Addi is a pill you take every day
UW▶ 36:36DosageDaily, taken at bedtimeCaveatsCauses sleepinessCertaintyexplicitrecommendation -
Alternative
Alloy is a telemedicine menopause option (not insurance-based but reasonably priced).
“Alloy Health, Midi Health are great places to start
UW▶ 1:03:25CaveatsDoes not take insuranceCertaintyexplicitrecommendation -
Sponsor read
Prescription estriol-based skincare for hormonal skin changes in midlife.
“prescription strength formulas made with estriol
UW▶ 38:37DosageCode MCH20 for $20 off at myalloy.comCertaintyexplicitrecommendation -
In a protocol
Jump training such as box jumps stimulates the bone unit for bone density.
“I'm doing box jumps to try to stimulate that bone unit
UW▶ 19:35Certaintyexplicitpersonal use -
Cardiac CTA may be a better test than coronary calcium score in women because it detects soft plaques.
“cardiac haths may be a better indicator
UW▶ 25:45CaveatsSpeaker speculative on superiorityCertaintyhedgedrecommendation -
In a protocol
CombiPatch (estradiol+norethindrone) is an alternative for women intolerant of micronized progesterone.
“I was on CombiPatch for a couple of years
UW▶ 33:00Certaintyexplicitpersonal use -
In a protocol
Creatine benefits women in perimenopause/menopause beyond muscle—mental health and cognition; ease in.
“start with about three milligrams per day
UW▶ 56:55DosageStart 3 g/day, can increase to 5 g; up to 10 g on heavy training, travel, or sleep-deprived daysCaveatsSpeaker said 'milligrams' but standard is gramsCertaintyexplicitstrong endorsement -
In a protocol
Aim for 25g minimum, 35g optimal of dietary fiber per day from varied whole food sources; increase gradually.
“Optimal for heart health is 35 for women
UW▶ 54:35Dosage25g min, 35g optimal/day; increase graduallyCaveatsSudden increase causes bloatingCertaintyexplicitstrong endorsement -
In a protocol
Duavee is an option for women with persistent HRT bleeding or high breast cancer risk—bazedoxifene downregulates estrogen receptors in breast/uterus.
“DUAV for those patients to bind, block, and down-regulate
UW▶ 30:30DosageOne fixed dose; no genericCaveatsDoesn't work for everyoneCertaintyexplicitrecommendation -
Family history of breast cancer is not a disqualifier for HRT; WHI showed estrogen-only arm reduced breast cancer risk 30%.
“estrogen-only arm had a 30% relative risk decrease of developing breast cancer
UW▶ 4:39CaveatsGenetic carriers (e.g., BRCA pre-vivors) need nuanced specialist discussionCertaintyexplicitrecommendation -
Use FDA-approved HRT formulations rather than compounded hormones for routine therapy.
“my go-to for HRT is the FDA-approved options
UW▶ 33:50CaveatsCompounding has some valid usesCertaintyexplicitstrong endorsement -
In a protocol
Follow orthopedic surgeon Dr. Jocelyn Wittstein for bone health and exercise alternatives, especially for women who can't lift heavy.
“I would invest in following her on Instagram
UW▶ 43:00Certaintyexplicitstrong endorsement -
Starting hormone therapy within 10 years of menopause or before age 60 captures the cardiovascular window of opportunity.
“window of opportunity for cardiovascular disease prevention
UW▶ 11:00DosageWithin 10 years of menopause or before age 60CaveatsAfter window, CV benefit unlikely; possible harmCertaintyexplicitrecommendation -
Sponsor read
Sponsor read for a multi-use makeup balm.
UW▶ 40:10DosageCode UNPAUSED at jonesroadbeauty.comCertaintyexplicitrecommendation -
Sponsor read
Sponsor read for a lightweight hair dryer designed to dry hair quickly.
UW▶ 2:13DosageCode UNPAUSED for 20% off at langehair.comCertaintyexplicitrecommendation -
Use menopause.org's list of certified menopause providers to find trained clinicians.
“certified by the Menopause Society
UW▶ 1:03:00Dosagemenopause.org provider listCertaintyexplicitrecommendation -
Sponsor read
Telemedicine clinic specializing in evidence-based menopause care, accepts insurance in all 50 states.
“clinicians trained in the latest menopause and longevity science
UW▶ 22:50Dosagejoinmidi.comCertaintyexplicitstrong endorsement -
In a protocol
Progesterone-containing IUDs are an alternative for progesterone intolerance.
“doing a Mirena IUD or a Loleta
UW▶ 33:10Certaintyexplicitrecommendation -
Alternative
Nordic Naturals makes a vegan/vegetarian algae-based omega-3 supplement.
“Nordic Naturals makes a really nice one
UW▶ 53:30Certaintyexplicitoffhand mention -
In a protocol
Supplement ~2,000 mg/day omega-3 (DHA+EPA), more for vegan/vegetarian using algae-based form.
“around 2,000 milligrams of omega-3 fatty acids
UW▶ 52:50Dosage~2,000 mg/day EPA+DHA; higher if veganCertaintyexplicitrecommendation -
Sponsor read
Sponsor read for Peloton Tread Plus with AI strength coaching.
UW▶ 41:48Dosageonepeloton.comCertaintyexplicitrecommendation -
Pelvic floor PT should be standard for women post-pregnancy, post-pelvic surgery, or with incontinence.
“Pelvic floor physical therapy can change your life
UW▶ 49:10Certaintyexplicitstrong endorsement -
Sponsor read
Sponsor read for Primally Pure's Blue Tansy soothing skincare collection for calming sensitive, irritated skin.
“Blue Tansy is a calming blue antioxidant that helps soothe inflammation
UW▶ 0:48DosageUse code UNPAUSED for 15% off at primallypure.comCertaintyexplicitrecommendation -
Patients with endometriosis history, even post-hysterectomy, should pair estrogen with a progestogen to suppress endometriosis implant reactivation.
“couple those patients with a progestogen to counteract the potential activity of estrogen
UW▶ 6:12CaveatsRequires specialistCertaintyexplicitrecommendation -
Alternative
Psyllium-husk-based fiber supplement is a reasonable, cheap option if dietary fiber is insufficient.
“Using something with a base of psyllium husk
UW▶ 56:10Dosage~8 g/day (her personal use)Certaintyexplicitpersonal use -
Sponsor read
Sponsor read for affordable premium basics.
UW▶ 21:02Dosagequince.com/unpausedCertaintyexplicitrecommendation -
In a protocol
Heavy lifting is essential for preventing osteoporosis and maintaining muscle in midlife.
“I am serious about heavy lifting
UW▶ 18:00Certaintyexplicitstrong endorsement -
For persistent symptoms despite HRT, evaluate hypothyroidism, autoimmune disease, inflammation markers, and nutrition labs.
“Hypothyroidism, looking for autoimmune thyroiditis
UW▶ 27:05Certaintyexplicitrecommendation -
In a protocol
Check serum estradiol levels to ensure ~60 pg/mL ultrasensitive level for maximum bone benefit on HRT.
“you want to be around 60
UW▶ 14:18DosageTarget serum estradiol ~60 pg/mL (ultrasensitive); over 80 no additional bone benefitCaveats~20% are poor absorbers of transdermalCertaintyexplicitstrong endorsement -
Women with patterns of nighttime hypoxia on trackers should be evaluated for sleep apnea; it's underdiagnosed because women snore less.
“you deserve to be evaluated for sleep apnea
UW▶ 45:45Certaintyexplicitrecommendation -
In a protocol
Get baseline testosterone, recheck at 3 months after starting therapy, then annually to avoid supraphysiologic levels.
“we get a baseline. Then we start therapy. We check three months later
UW▶ 20:30DosageBaseline, then 3 months, then yearly; target <100, never >200Certaintyexplicitrecommendation -
In a protocol
Consider testosterone therapy for HSDD; benefits may include libido, bone/muscle maintenance, mood, and well-being.
“if you have hypoactive sexual desire disorder, I'm going to have a conversation
UW▶ 34:40DosagePhysiologic doses; serum level not above ~100, never above 200CaveatsUnwanted hair growth, scalp hair loss, clitoromegaly, irreversible voice deepening at high dosesCertaintyexplicitrecommendation -
In a protocol
Book by Dr. Wittstein with bone-protective exercises and recipes.
“the total body bone and joint plan
UW▶ 43:20Certaintyexplicitrecommendation -
Haver's book on life after ovaries stop producing hormones—protecting brain, bones, heart, muscles, metabolism.
“The new menopause is about life after the ovaries stop
UW▶ 1:05:40Certaintyexplicitstrong endorsement -
Haver's new book covering the 7-10 year perimenopause transition and how to address symptoms.
“My new book, The New Perimenopause
UW▶ 1:05:15CaveatsSelf-promotionCertaintyexplicitstrong endorsement -
Alternative
For women with clotting risk, history of migraine, or thrombophilia, use transdermal estradiol (patch, gel, cream) instead of oral.
“transdermal, such as the gels, the creams
UW▶ 9:00Caveats~20% are poor absorbers; check serum estradiolCertaintyexplicitrecommendation -
In a protocol
Counseling/therapy for ACE/childhood sexual assault history is critical because untreated trauma reduces longevity comparable to smoking.
“We can bring your risk down if you get help, if you go through counseling
UW▶ 1:03:55Certaintyexplicitstrong endorsement -
Vaginal estrogen acts locally, isn't systemically absorbed meaningfully, and doesn't increase clotting risk.
“vaginal estrogen is locally acting
UW▶ 9:20Certaintyexplicitstrong endorsement -
First-line treatment for urinary urgency and leak is restoring vaginal estrogen.
“give your general urinary system estrogen back
UW▶ 48:00Certaintyexplicitstrong endorsement -
In a protocol
For progesterone intolerance, use oral micronized progesterone gel cap vaginally to bypass first-pass liver metabolism.
“go vaginal progesterone and kind of skip that first pass effect
UW▶ 32:17DosageInsert oral estradiol/progesterone gel cap vaginally at bedtimeCaveatsNot formally measured for endometrial protection but works clinicallyCertaintyexplicitrecommendation -
In a protocol
Supplement vitamin D and target serum levels of 60-100; many women are deficient.
“reaching a level of 60 to about 100
UW▶ 52:08Dosage2,000-4,000 IU/day maintenance; 50,000 IU loading dose if deficient; target serum 60-100Certaintyexplicitstrong endorsement -
Avoid clinics that only push pellets; pellets are one option but should not be only choice and require monitoring to physiologic levels.
“if they're like, nope, we just do pellets here, run
UW▶ 1:01:30DosageIf used, monitor levels; not above ~100, never above 200Certaintyexplicitstrong warning -
Insufficient data in menopausal women; speaker not recommending NAD.
“I haven't seen enough data done in menopausal women
UW▶ 58:20Certaintyexplicitmild caution -
Avoid oral estrogen in patients with blood clot history or high clotting risk because it raises clotting factors via first-pass liver effect.
“don't want to be on any form of oral estrogen
UW▶ 8:41CaveatsTransdermal forms are safe alternativesCertaintyexplicitstrong warning -
Oxybutynin (or long-acting forms) treats urge incontinence by calming bladder wall spasms.
“oxybutynin is usually one of the meds that we use
UW▶ 47:50CaveatsSide effects: dry mouth, dry eyesCertaintyexplicitrecommendation -
In a protocol
Vyleesi is an FDA-approved on-demand injection for libido that releases melanocortin stimulating dopamine.
“Vilesi is an injection
UW▶ 37:00DosageInject ~45 minutes before activityCaveatsLess popular—anticipation issueCertaintyexplicitrecommendation