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Are You Ready For It? The Eras Tour of a Woman's Life · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to Clearly Hormonal, the podcast where we stop Googling our symptoms at midnight and actually start understanding what's going on in our bodies.
• 0:09
  Dr. Komal Patil-Sisodia: I'm Dr.
• 0:10
  Dr. Komal Patil-Sisodia: Komal Patel Sasodia, an endocrinologist, internist, obesity medicine specialist, and a menopause society certified practitioner, which is really just a whole lot of words to say, hormones are kind of my jam.
• 0:21
  Dr. Komal Patil-Sisodia: I've spent 17 years watching women try to navigate their hormonal health without ever having been taught the language for what's happening in their own bodies.
• 0:29
  Dr. Komal Patil-Sisodia: And then meeting clinicians who want nothing more than to help them figure it out, but are up against 10-minute appointments in a system that just wasn't built for it.
• 0:37
  Dr. Komal Patil-Sisodia: This podcast is my answer to that gap.
• 0:40
  Dr. Komal Patil-Sisodia: We'll cover menopause, metabolism, hormones, and everything in between with real evidence, not trends, and without the overwhelm.
• 0:48
  Dr. Komal Patil-Sisodia: A quick disclaimer, I'm a physician, but this is education, not personalized medical advice.
• 0:53
  Dr. Komal Patil-Sisodia: Take what resonates and discuss it with your own healthcare team.
• 0:56
  Dr. Komal Patil-Sisodia: Now, let's get into it and talk about what's clearly hormonal and what's not.
• 1:03
  Dr. Komal Patil-Sisodia: Are you ready for it?
• 1:06
  Dr. Komal Patil-Sisodia: We are doing it today.
• 1:07
  Dr. Komal Patil-Sisodia: It's the Taylor Swift episode on the Eras Tour of a Woman's Life, the clearly hormonal version.
• 1:14
  Dr. Komal Patil-Sisodia: I have been waiting to record this one.
• 1:18
  Dr. Komal Patil-Sisodia: I became a Swiftie during Reputation.
• 1:21
  Dr. Komal Patil-Sisodia: I know, little late to the game, but when I finally got there, there's no version of where I go back.
• 1:28
  Dr. Komal Patil-Sisodia: In December 2024, I was in the arena for the second to last Eras Tour show, Vancouver.
• 1:34
  Dr. Komal Patil-Sisodia: I was there.
• 1:35
  Dr. Komal Patil-Sisodia: And something happened to me in that arena that kind of changed how I think about my work, because I'm standing there watching Taylor move through every version of herself, era by era, right in front of me.
• 1:47
  Dr. Komal Patil-Sisodia: And I just could not stop thinking about women, about how we do the exact same thing.
• 1:53
  Dr. Komal Patil-Sisodia: We move through eras, we evolve, we become someone new, and nobody, nobody hands us a map for it.
• 2:00
  Dr. Komal Patil-Sisodia: Nobody says,"Hey, this transition you're in right now, it's real, it's biologic, it makes complete sense, and every version of you deserves to be honored." And here's the thing about Taylor that I don't think gets said enough.
• 2:14
  Dr. Komal Patil-Sisodia: She is one of the greatest songwriters of our time because she refuses to let experience go unnamed.
• 2:20
  Dr. Komal Patil-Sisodia: And I feel validated in saying that, knowing that the New York Times article just came out listing her as one of the top 30 songwriters.
• 2:28
  Dr. Komal Patil-Sisodia: she finds the exact words for things we've all felt but couldn't say out loud.
• 2:33
  Dr. Komal Patil-Sisodia: And honestly, that's what I'm trying to do as a physician.
• 2:36
  Dr. Komal Patil-Sisodia: Just in a much less glamorous setting.
• 2:39
  Dr. Komal Patil-Sisodia: But here's what I see every day.
• 2:43
  Dr. Komal Patil-Sisodia: Women who've been handed a script for how they're supposed to develop, feel, think, and age.
• 2:49
  Dr. Komal Patil-Sisodia: A script they didn't write and didn't choose.
• 2:52
  Dr. Komal Patil-Sisodia: And when their actual experience doesn't match it, they think something is wrong with them.
• 2:58
  Dr. Komal Patil-Sisodia: And I just want to say clearly for the record, nothing is wrong with them.
• 3:05
  Dr. Komal Patil-Sisodia: And when I say nothing, I don't mean medical issues.
• 3:09
  Dr. Komal Patil-Sisodia: I mean, in terms of their development, in terms of the physiological changes, the emotions, all of the processing and developing that we do, nothing is wrong with that.
• 3:20
  Dr. Komal Patil-Sisodia: Their emotions are real data, their experience is valid, their story is theirs, not the script someone else wrote for them.
• 3:29
  Dr. Komal Patil-Sisodia: So, today, we're walking through the hormonal and developmental eras of a woman's life using Taylor's albums as a framework.
• 3:37
  Dr. Komal Patil-Sisodia: And I made a playlist with the songs, I think capture each era best and why.
• 3:43
  Dr. Komal Patil-Sisodia: The full list is in the show notes.
• 3:46
  Dr. Komal Patil-Sisodia: As I was putting together this episode, I was trying to figure out whether I could actually like put in snippets of her song, but I realized that's highly illegal.
• 3:54
  Dr. Komal Patil-Sisodia: And even though I used to be in an acapella group called The Ketones, my voice has not changed for the better over the years, and I will not sing to you all mostly because I don't need to humiliate myself and also because I don't want to make your ears bleed.
• 4:10
  Dr. Komal Patil-Sisodia: So let's Do this.
• 4:12
  Dr. Komal Patil-Sisodia: Era one is childhood.
• 4:14
  Dr. Komal Patil-Sisodia: So we're starting at the beginning, and honestly, so did Taylor.
• 4:17
  Dr. Komal Patil-Sisodia: This is what I call the foundation era.
• 4:19
  Dr. Komal Patil-Sisodia: And when I say foundation, I mean it literally.
• 4:22
  Dr. Komal Patil-Sisodia: The nervous system is being wired right now, stress response patterns are being set that will follow you for decades.
• 4:29
  Dr. Komal Patil-Sisodia: This is where attachment happens, where a child is learning really early whether the world is safe, whether their needs will be met, whether they are worthy of care.
• 4:41
  Dr. Komal Patil-Sisodia: That stuff doesn't just stay in childhood.
• 4:43
  Dr. Komal Patil-Sisodia: It travels with you into your body, into your relationships, into every hard season you will ever navigate.
• 4:50
  Dr. Komal Patil-Sisodia: Like Taylor's early albums, which are earnest, wide open, just absorbing everything.
• 4:56
  Dr. Komal Patil-Sisodia: This era is about becoming, not performing, not producing, just becoming.
• 5:01
  Dr. Komal Patil-Sisodia: And here's why this era matters so much clinically.
• 5:04
  Dr. Komal Patil-Sisodia: What gets set up here is whether a woman's nervous system learns that the world is fundamentally safe.
• 5:11
  Dr. Komal Patil-Sisodia: And that one thing, that baseline sense of safety, shapes everything that comes after.
• 5:17
  Dr. Komal Patil-Sisodia: Her stress response, her resilience, how her body handles difficult decades down the line.
• 5:23
  Dr. Komal Patil-Sisodia: Whether she can self-regulate or whether she's always outsourcing that to other people or other things.
• 5:31
  Dr. Komal Patil-Sisodia: It is the difference between a nervous system that knows how to come back to baseline and one that never quite gets there.
• 5:37
  Dr. Komal Patil-Sisodia: And we are still seeing the effects of it in women in their 40s and 50s, wondering why they can't handle stress the way they used to.
• 5:44
  Dr. Komal Patil-Sisodia: Why their bodies feel like they're always braced for something.
• 5:47
  Dr. Komal Patil-Sisodia: Why rest never truly feels restful?
• 5:51
  Dr. Komal Patil-Sisodia: Sometimes the answer goes all the way back here to whether the world felt safe when they were too young to have any say in that question.
• 6:00
  Dr. Komal Patil-Sisodia: So I picked two songs for this era, both from her first two albums, Taylor Swift and Fearless The first is The Best Day.
• 6:09
  Dr. Komal Patil-Sisodia: And this one is exactly what healthy early formation looks like.
• 6:13
  Dr. Komal Patil-Sisodia: Safe, warm, secure.
• 6:16
  Dr. Komal Patil-Sisodia: The nervous system being wired through consistent love and presence.
• 6:20
  Dr. Komal Patil-Sisodia: It's completely unremarkable on the surface, but foundational underneath.
• 6:25
  Dr. Komal Patil-Sisodia: And then there's tied together with a smile.
• 6:29
  Dr. Komal Patil-Sisodia: And this is the other version of this era.
• 6:32
  Dr. Komal Patil-Sisodia: The one that looks like nothing from the outside, the girl who is holding it together while quietly falling apart inside.
• 6:40
  Dr. Komal Patil-Sisodia: This is what high functioning response to early adversity actually looks like.
• 6:44
  Dr. Komal Patil-Sisodia: The nervous system learning to perform stability before it ever felt stable.
• 6:49
  Dr. Komal Patil-Sisodia: Women who grew up this way often describe feeling like they can't explain why they're struggling.
• 6:54
  Dr. Komal Patil-Sisodia: Everything looks fine.
• 6:56
  Dr. Komal Patil-Sisodia: They have no obvious reason to feel this way.
• 6:59
  Dr. Komal Patil-Sisodia: But the body knows.
• 7:00
  Dr. Komal Patil-Sisodia: The body always knows.
• 7:02
  Dr. Komal Patil-Sisodia: Both songs here are because both versions of this era are real and both deserve to be seen.
• 7:09
  Dr. Komal Patil-Sisodia: The next era, era two, is puberty.
• 7:12
  Dr. Komal Patil-Sisodia: It is the amplification era.
• 7:14
  Dr. Komal Patil-Sisodia: And can we just acknowledge Red and speak now?
• 7:18
  Dr. Komal Patil-Sisodia: These albums are Absolutely perfect.
• 7:22
  Dr. Komal Patil-Sisodia: Hormonally, estrogen shows up, progesterone enters the chat, and the brain gets fundamentally rewired to be significantly more sensitive to reward and rejection.
• 7:34
  Dr. Komal Patil-Sisodia: I want to say this loudly.
• 7:36
  Dr. Komal Patil-Sisodia: This is not drama.
• 7:38
  Dr. Komal Patil-Sisodia: This is not a personality flaw.
• 7:41
  Dr. Komal Patil-Sisodia: This is basic neurobiology.
• 7:44
  Dr. Komal Patil-Sisodia: The emotional intensity of this phase is supposed to be there.
• 7:48
  Dr. Komal Patil-Sisodia: It's biologically programmed.
• 7:51
  Dr. Komal Patil-Sisodia: It is doing exactly what it's designed to do.
• 7:54
  Dr. Komal Patil-Sisodia: And yet, almost universally, this is the era where girls first get told they are too much.
• 8:03
  Dr. Komal Patil-Sisodia: The body is changing.
• 8:05
  Dr. Komal Patil-Sisodia: Desire is emerging for connection, for identity to be truly seen.
• 8:11
  Dr. Komal Patil-Sisodia: And their voices And the voice wants to be heard.
• 8:15
  Dr. Komal Patil-Sisodia: And right alongside all of that biology comes this very clear cultural message.
• 8:21
  Dr. Komal Patil-Sisodia: Actually, you know what?
• 8:21
  Dr. Komal Patil-Sisodia: Dial it back.
• 8:23
  Dr. Komal Patil-Sisodia: Take up a little less space.
• 8:25
  Dr. Komal Patil-Sisodia: Be a little easier to be around.
• 8:28
  Dr. Komal Patil-Sisodia: That mismatch between what is biologically happening and what the world is asking for.
• 8:35
  Dr. Komal Patil-Sisodia: That's where so many women's complicated relationships with themselves began.
• 8:39
  Dr. Komal Patil-Sisodia: The echoes of it follow women for decades.
• 8:42
  Dr. Komal Patil-Sisodia: Things show up in how women relate to their own desire, their own emotions, their own worthiness of care, long after this era's over.
• 8:51
  Dr. Komal Patil-Sisodia: For this era, I picked all too well, the 10 minute version.
• 8:56
  Dr. Komal Patil-Sisodia: I will not be taking questions on this pick.
• 8:58
  Dr. Komal Patil-Sisodia: There is no song in Taylor's entire catalog that captures the emotional experience of this phase more accurately.
• 9:05
  Dr. Komal Patil-Sisodia: Everything feels like it's a full volume.
• 9:08
  Dr. Komal Patil-Sisodia: Desire and loss at an intensity that adults keep dismissing as too much.
• 9:13
  Dr. Komal Patil-Sisodia: And it's not too much.
• 9:14
  Dr. Komal Patil-Sisodia: It's estrogen, it's hormones, it's a brand new emotional brain, and it's completely physiologically normal.
• 9:22
  Dr. Komal Patil-Sisodia: The problem was never the intensity, but the problem is that nobody ever told her that she wasn't the problem.
• 9:30
  Dr. Komal Patil-Sisodia: The second song that I picked is 15.
• 9:34
  Dr. Komal Patil-Sisodia: This might seem obvious, but here's why it's the most interesting pick for me clinically, Because 15 isn't just about being 15.
• 9:43
  Dr. Komal Patil-Sisodia: It's about looking back at 15.
• 9:46
  Dr. Komal Patil-Sisodia: And that retrospective quality matters.
• 9:49
  Dr. Komal Patil-Sisodia: This era isn't only formative while it's happening.
• 9:56
  Dr. Komal Patil-Sisodia: It's formative in how we remember it.
• 9:58
  Dr. Komal Patil-Sisodia: The story we tell about it, the conclusions we drew about ourselves from it, and those beliefs about whether we are worthy.
• 10:06
  Dr. Komal Patil-Sisodia: They don't just stay in adolescence.
• 10:09
  Dr. Komal Patil-Sisodia: They actually travel forward, they show up in relationships and how women advocate for themselves in whether they feel like their needs are allowed to matter.
• 10:18
  Dr. Komal Patil-Sisodia: Era three is what I call the reproductive years and the productivity years.
• 10:23
  Dr. Komal Patil-Sisodia: And it's interesting because this is the era that everyone celebrates.
• 10:27
  Dr. Komal Patil-Sisodia: The one the whole cultural script is built around.
• 10:31
  Dr. Komal Patil-Sisodia: And 1989 and Reputation is the soundtrack?
• 10:34
  Dr. Komal Patil-Sisodia: Yes.
• 10:35
  Dr. Komal Patil-Sisodia: They're polished, powerful, and a little bit protective.
• 10:40
  Dr. Komal Patil-Sisodia: Two sides of the same coin.
• 10:42
  Dr. Komal Patil-Sisodia: One is bright and shiny and curated, and the other one is deliberately and strategically invincible based on what Taylor was going through in her life at that time.
• 10:52
  Dr. Komal Patil-Sisodia: Hormonally, things are genuinely working here.
• 10:55
  Dr. Komal Patil-Sisodia: Estrogen and progesterone are cycling predictably for most, unless there's another underlying medical issue.
• 11:03
  Dr. Komal Patil-Sisodia: Muscle is easier to build.
• 11:04
  Dr. Komal Patil-Sisodia: Recovery is faster.
• 11:06
  Dr. Komal Patil-Sisodia: There's real energy, real capacity.
• 11:08
  Dr. Komal Patil-Sisodia: I want to give this era its credit but here's the thing I want to add.
• 11:12
  Dr. Komal Patil-Sisodia: This era is incredibly good at making overextension, meaning overdoing things or doing too much look like success.
• 11:23
  Dr. Komal Patil-Sisodia: The same hormonal oomph that makes everything feel doable also makes it so much easier to override the signals, telling you that you're doing too much.
• 11:35
  Dr. Komal Patil-Sisodia: The body starts to compensate for it and your calendar keeps filling up, and nobody sounds the alarm because everything still looks really impressive from the outside.
• 11:45
  Dr. Komal Patil-Sisodia: And that's a setup.
• 11:48
  Dr. Komal Patil-Sisodia: The songs that I picked for this era, number one, Shake It Off, this song basically says,"Keep going, keep smiling, shake it off." In my opinion, this is what burnout looks like when it has really good PR or branding.
• 12:02
  Dr. Komal Patil-Sisodia: Shaking it off doesn't actually make stress disappear, it just makes it bury a little deeper each time.
• 12:09
  Dr. Komal Patil-Sisodia: The second song I picked for this era is Out of the Woods.
• 12:12
  Dr. Komal Patil-Sisodia: This is the one I really want you to sit with, because Shake It Off covers the performance, and this song covers the anxiety that's living underneath it.
• 12:21
  Dr. Komal Patil-Sisodia: Are we out of the woods yet?
• 12:23
  Dr. Komal Patil-Sisodia: That constant, low level scanning, that never quite settled feeling.
• 12:29
  Dr. Komal Patil-Sisodia: The,"Are we okay?
• 12:30
  Dr. Komal Patil-Sisodia: Are we okay?
• 12:31
  Dr. Komal Patil-Sisodia: Are we okay?" Humming in the background, even when life looks objectively fine from the outside.
• 12:39
  Dr. Komal Patil-Sisodia: And that's chronic cortisol elevations as a lived experience.
• 12:44
  Dr. Komal Patil-Sisodia: High functioning anxiety that's been there for so long, it feels like a personality.
• 12:49
  Dr. Komal Patil-Sisodia: And this is the era where that gets completely normalized, where women stop noticing it because it's just become the baseline.
• 12:57
  Dr. Komal Patil-Sisodia: And a lot of this is around society's expectations of who we need to be The last song I picked is Delicate, because Reputation as an album isn't all just about armor and protection.
• 13:10
  Dr. Komal Patil-Sisodia: Underneath all of that invincibility she's trying to project is this quiet wondering of whether anyone actually sees her.
• 13:20
  Dr. Komal Patil-Sisodia: Whether she can let someone in, whether any of this is real.
• 13:24
  Dr. Komal Patil-Sisodia: And women who spend years performing strength and doing everything perfectly in their lives based on the way society expects us to do them can lose track of what it feels like to be truly known.
• 13:36
  Dr. Komal Patil-Sisodia: And that deserves a whole other conversation.
• 13:40
  Dr. Komal Patil-Sisodia: Era four is what I call the performance peak.
• 13:44
  Dr. Komal Patil-Sisodia: This era this is the one that I have the most feelings about.
• 13:49
  Dr. Komal Patil-Sisodia: Taylor described the life of a show girl as being about the gap between what the Eras tour looked like from the outside, exuberant, electric, amazing, and what it actually cost her behind the scenes.
• 14:01
  Dr. Komal Patil-Sisodia: And when I heard that, I genuinely felt it, because that's the exact gap that I see in women in this space constantly.
• 14:09
  Dr. Komal Patil-Sisodia: Everything is still technically working, but recovery is slower, sleep isn't as good, cortisol is just always there now, and the body's sending these signals that things are not okay, but because we're so used to peak performing, the mind is overriding them because there's too much to do, and the show must go on.
• 14:32
  Dr. Komal Patil-Sisodia: The identity, it's gotten tightly wrapped up in being the person who handles everything.
• 14:41
  Dr. Komal Patil-Sisodia: Rest doesn't just feel hard.
• 14:44
  Dr. Komal Patil-Sisodia: It feels wrong.
• 14:46
  Dr. Komal Patil-Sisodia: Saying yes is so automatic to most people in this era.
• 14:51
  Dr. Komal Patil-Sisodia: It barely registers as a choice anymore.
• 14:54
  Dr. Komal Patil-Sisodia: I think on one of my earlier podcast episodes, I told this story about being behind two women on an escalator at an airport, and they were talking about all of the things they had to do, how exhausted they were, but what amazing girl bosses they were.
• 15:12
  Dr. Komal Patil-Sisodia: And while I stood there listening, it was really interesting to me to see how normalized being that busy is.
• 15:21
  Dr. Komal Patil-Sisodia: I hear it constantly.
• 15:23
  Dr. Komal Patil-Sisodia: "I'm fine.
• 15:23
  Dr. Komal Patil-Sisodia: I'm just tired all the time." This is the phase where early perimenopause gets missed because everything still looks functional from the outside.
• 15:34
  Dr. Komal Patil-Sisodia: The body is asking for something different and the signals keep getting overridden because there's no space to listen to them.
• 15:40
  Dr. Komal Patil-Sisodia: The first song I picked off of Life of a Showgirl is The Fate of Ophelia, the show going on while she's holding on underneath it, the performing of just being fine while the internal experience is something completely different.
• 15:55
  Dr. Komal Patil-Sisodia: Women in this era are often carrying symptoms they haven't mentioned to anyone, sleep changes, irregular menstrual cycles, a kind of bone deep exhaustion that goes way beyond needing a vacation, because everything still looks okay from the outside.
• 16:10
  Dr. Komal Patil-Sisodia: Most importantly, they haven't been given permission to say otherwise.
• 16:15
  Dr. Komal Patil-Sisodia: The second song I picked is Eldest Daughter, and I'm genuinely a little obsessed with this song from a clinical standpoint.
• 16:26
  Dr. Komal Patil-Sisodia: The eldest daughter wiring, meaning being the one who manages everything, the one who's holding it all together, the one whose needs are always last.
• 16:35
  Dr. Komal Patil-Sisodia: This is not just a family role.
• 16:37
  Dr. Komal Patil-Sisodia: It's a societal role.
• 16:39
  Dr. Komal Patil-Sisodia: It's a workplace role.
• 16:40
  Dr. Komal Patil-Sisodia: It's your nervous system that was shaped early to put everyone else first.
• 16:45
  Dr. Komal Patil-Sisodia: And by this era, it's so automatic.
• 16:49
  Dr. Komal Patil-Sisodia: It doesn't even feel like a pattern anymore.
• 16:51
  Dr. Komal Patil-Sisodia: It just feels like who you are.
• 16:53
  Dr. Komal Patil-Sisodia: Women who are in this phase often can't figure out why they're so exhausted because they've never been asked to consider that they might be allowed to not be okay.
• 17:02
  Dr. Komal Patil-Sisodia: Sometimes all it takes is the right question to make a lot of things make sense.
• 17:09
  Dr. Komal Patil-Sisodia: I want to stop before we hit the last two eras and talk about the album Lover.
• 17:15
  Dr. Komal Patil-Sisodia: I couldn't figure out a way to make it fit anywhere in this episode.
• 17:20
  Dr. Komal Patil-Sisodia: And I realized it was because every other era on this map is defined by a biological transition, hormone shifting, the body changing, something structural happening.
• 17:31
  Dr. Komal Patil-Sisodia: But this particular album isn't about transition.
• 17:35
  Dr. Komal Patil-Sisodia: Lover is about safety and alignment.
• 17:38
  Dr. Komal Patil-Sisodia: And it's about what becomes possible when a woman's nervous system finally feels safe enough to open up to desire, to connection, to being truly known.
• 17:48
  Dr. Komal Patil-Sisodia: And the cool thing is that this can happen at any age.
• 17:51
  Dr. Komal Patil-Sisodia: It can happen in your 20s, it can happen in your 50s.
• 17:53
  Dr. Komal Patil-Sisodia: After menopause, it's not just about how old you are, it's about how safe you feel and how aligned you feel with everything that's going on around you.
• 18:02
  Dr. Komal Patil-Sisodia: Here's what I think is actually important to say.
• 18:04
  Dr. Komal Patil-Sisodia: A lot of women have spent their whole lives performing rather than feeling, trying to earn love, trying to keep the peace at their own expense.
• 18:14
  Dr. Komal Patil-Sisodia: It can look similar from the outside, but it feels different from the inside.
• 18:18
  Dr. Komal Patil-Sisodia: A lot of women don't realize what they've been missing until they finally experience the real thing, which often happens later in life.
• 18:25
  Dr. Komal Patil-Sisodia: It's when the noise finally quiets down enough where you can hear yourself.
• 18:29
  Dr. Komal Patil-Sisodia: So think of Lover Not as a chapter in the story or one of the eras of a woman's life, but as a thread that's running through all of it.
• 18:37
  Dr. Komal Patil-Sisodia: It's available to you at any point when the conditions are right.
• 18:40
  Dr. Komal Patil-Sisodia: And the simplest way I can say it is when stress is running the show, the safety you feel disappears.
• 18:48
  Dr. Komal Patil-Sisodia: When safety returns, you are back in alignment.
• 18:53
  Dr. Komal Patil-Sisodia: The first song I picked from this album is Daylight, a calm version of love.
• 18:58
  Dr. Komal Patil-Sisodia: It is the golden, steady, chosen version of love that just feels like home.
• 19:03
  Dr. Komal Patil-Sisodia: And it sits on the playlist right at the turn between performance peak and getting into midlife, because that's where it's most likely to show up for the first time in its truest form.
• 19:15
  Dr. Komal Patil-Sisodia: Paper rings is like the fully alive version.
• 19:18
  Dr. Komal Patil-Sisodia: This is the second song that I picked, desire that isn't managed or negotiated or squeezed in between everything else.
• 19:25
  Dr. Komal Patil-Sisodia: It's completely present and in your face, unapologetic.
• 19:30
  Dr. Komal Patil-Sisodia: And a lot of women get there for the first time after menopause when everything finally quiets down.
• 19:35
  Dr. Komal Patil-Sisodia: I want to be really clear about something.
• 19:37
  Dr. Komal Patil-Sisodia: That is when you truly arrive in your life.
• 19:42
  Dr. Komal Patil-Sisodia: I'm still waiting to get there.
• 19:44
  Dr. Komal Patil-Sisodia: I've had moments of it, but being able to achieve that as a constant is an amazing possibility for most women.
• 19:54
  Dr. Komal Patil-Sisodia: Let's move on to Era five, which is midlife transition.
• 19:58
  Dr. Komal Patil-Sisodia: Eventually, and I say this a lot, so please really hear this, the body calls for a shift.
• 20:03
  Dr. Komal Patil-Sisodia: This is not failure.
• 20:05
  Dr. Komal Patil-Sisodia: This is biology doing exactly what it's supposed to do.
• 20:09
  Dr. Komal Patil-Sisodia: Estrogen is getting unpredictable.
• 20:11
  Dr. Komal Patil-Sisodia: Progesterone is declining.
• 20:13
  Dr. Komal Patil-Sisodia: Your stress tolerance is going down.
• 20:15
  Dr. Komal Patil-Sisodia: Sleep is getting worse.
• 20:16
  Dr. Komal Patil-Sisodia: The coping strategies that carried women through the last two decades, the shake it off, the turning pain into productivity, all of it, they start feeling like they don't quite fit anymore.
• 20:28
  Dr. Komal Patil-Sisodia: And something else starts happening that I find beautiful even when it's really uncomfortable.
• 20:35
  Dr. Komal Patil-Sisodia: The real questions come back, not the urgent ones, but the real ones.
• 20:39
  Dr. Komal Patil-Sisodia: What do I actually want?
• 20:41
  Dr. Komal Patil-Sisodia: What have I been tolerating that I don't have to anymore?
• 20:44
  Dr. Komal Patil-Sisodia: What kind of life do I want from here?
• 20:46
  Dr. Komal Patil-Sisodia: Like folklore and evermore, which are quieter, slower, more internal.
• 20:53
  Dr. Komal Patil-Sisodia: This is not a lesser era.
• 20:54
  Dr. Komal Patil-Sisodia: It's a more honest one.
• 20:57
  Dr. Komal Patil-Sisodia: The songs I picked for this era, the first one is This Is Me Trying.
• 21:02
  Dr. Komal Patil-Sisodia: This song captures something specific that happens in transition.
• 21:06
  Dr. Komal Patil-Sisodia: The strategies aren't working.
• 21:08
  Dr. Komal Patil-Sisodia: The pace isn't sustainable, and there's this moment where women stop pretending to be further along than they actually are, and just show up honestly with where they actually are.
• 21:18
  Dr. Komal Patil-Sisodia: That's not weakness.
• 21:19
  Dr. Komal Patil-Sisodia: That is a really healthy response to this transition, just being real about who you are.
• 21:26
  Dr. Komal Patil-Sisodia: The second song I picked is Marjorie, and this is where grief and wisdom show up at the same time.
• 21:32
  Dr. Komal Patil-Sisodia: That's midlife, in my opinion.
• 21:34
  Dr. Komal Patil-Sisodia: We define it biologically, by these hormone shifts and other things that are happening.
• 21:39
  Dr. Komal Patil-Sisodia: But there's also this change in your mind and your emotions and your psychology.
• 21:46
  Dr. Komal Patil-Sisodia: This is when women genuinely start reckoning with the women who came before them.
• 21:52
  Dr. Komal Patil-Sisodia: Their mothers, their grandmothers, their great-grandmothers.
• 21:56
  Dr. Komal Patil-Sisodia: What those women carried and weren't given and passed along without meaning to.
• 22:02
  Dr. Komal Patil-Sisodia: And there's something about this era that lets you feel that in your body in a way you just couldn't before.
• 22:08
  Dr. Komal Patil-Sisodia: The past becomes personal and it changes what feels worth fighting for.
• 22:14
  Dr. Komal Patil-Sisodia: This is what happened with me.
• 22:16
  Dr. Komal Patil-Sisodia: I watched my mom's story somewhat removed from it, and when I hit that same age, I started thinking about and reckoning with all of the things that she had gone through in her life, even though I hadn't experienced them directly.
• 22:32
  Dr. Komal Patil-Sisodia: And it's really changed how I think about and look at my life.
• 22:37
  Dr. Komal Patil-Sisodia: Now, the Tortured Poets Department album is one that I gave its own sub-era.
• 22:44
  Dr. Komal Patil-Sisodia: I'm not folding it into midlife because it's a little too distinct and a little too important.
• 22:51
  Dr. Komal Patil-Sisodia: Here's something I want you to notice, because I think it's kind of perfect.
• 22:56
  Dr. Komal Patil-Sisodia: Taylor's album Midnights came out right before Tortured Poet's department in terms of release order.
• 23:01
  Dr. Komal Patil-Sisodia: And at first, that seems a little backwards, right?
• 23:04
  Dr. Komal Patil-Sisodia: Midnights is such a reflective, self-aware album.
• 23:07
  Dr. Komal Patil-Sisodia: It almost feels like a resolution.
• 23:09
  Dr. Komal Patil-Sisodia: And a lot of women experience that exactly in early midlife.
• 23:13
  Dr. Komal Patil-Sisodia: You can finally explain your patterns, you understand your story, you know what happened and why, and you assume naturally that means you've processed it.
• 23:21
  Dr. Komal Patil-Sisodia: But here's what's actually true.
• 23:23
  Dr. Komal Patil-Sisodia: Understanding your life and actually feeling your life are not the same thing.
• 23:28
  Dr. Komal Patil-Sisodia: You can be completely clear about a pattern and still be carrying it in your body because you haven't processed the emotions.
• 23:36
  Dr. Komal Patil-Sisodia: And Tortured Poets Department is that feeling.
• 23:39
  Dr. Komal Patil-Sisodia: It almost always arrives after you thought you were done.
• 23:42
  Dr. Komal Patil-Sisodia: And that's not regression.
• 23:43
  Dr. Komal Patil-Sisodia: That's the work of processing just starting.
• 23:46
  Dr. Komal Patil-Sisodia: And what's happening biologically during this time is that as estrogen fluctuates, the effect that it has on serotonin and dopamine, which affect your mood, also fluctuate.
• 23:59
  Dr. Komal Patil-Sisodia: And emotional suppression, something that so many women have gotten incredibly good at becomes genuinely harder to sustain, and your brain starts choosing truth over harmony.
• 24:11
  Dr. Komal Patil-Sisodia: Things that were tolerable simply aren't tolerable anymore, and the feelings that you had managed are starting to find their way out.
• 24:20
  Dr. Komal Patil-Sisodia: And the sad thing is that this gets looked at as a problem constantly.
• 24:56
  Dr. Komal Patil-Sisodia: Women in this phase get called unstable, difficult, too emotional, like the hormones are creating a problem.
• 25:03
  Dr. Komal Patil-Sisodia: They're not.
• 25:04
  Dr. Komal Patil-Sisodia: The hormones are actually making it harder for you to suppress the truth.
• 25:08
  Dr. Komal Patil-Sisodia: And that's not a malfunction.
• 25:10
  Dr. Komal Patil-Sisodia: That's actually the system working.
• 25:12
  Dr. Komal Patil-Sisodia: So the songs that I picked for this album are reflective of that truth coming out.
• 25:18
  Dr. Komal Patil-Sisodia: The first one is, Who's Afraid of Little Old Me?
• 25:22
  Dr. Komal Patil-Sisodia: This, in my opinion, is anger finding language.
• 25:26
  Dr. Komal Patil-Sisodia: We are done being called difficult for having a nervous system that stopped cooperating with us suppressing our feelings.
• 25:33
  Dr. Komal Patil-Sisodia: What women in this phase experience is not a symptom to be quieted.
• 25:37
  Dr. Komal Patil-Sisodia: It's actually a signal that should be respected.
• 25:40
  Dr. Komal Patil-Sisodia: It's not falling apart.
• 25:41
  Dr. Komal Patil-Sisodia: It's finally telling the truth of who you are.
• 25:44
  Dr. Komal Patil-Sisodia: That's why I love this song.
• 25:46
  Dr. Komal Patil-Sisodia: My work bestie, Dani, Dr.
• 25:49
  Dr. Komal Patil-Sisodia: Henderson, she and I both love this song and it was one of our favorites when the album first came out.
• 25:54
  Dr. Komal Patil-Sisodia: Shout out to her.
• 25:55
  Dr. Komal Patil-Sisodia: She's a bigger Swiftie than I am.
• 25:58
  Dr. Komal Patil-Sisodia: The second song I picked for this era is So Long London.
• 26:01
  Dr. Komal Patil-Sisodia: And if Who's Afraid is anger, this one is grief and both are necessary.
• 26:07
  Dr. Komal Patil-Sisodia: This is the song for ending things that required you disappearing into them, whether it's a relationship, a job, a version of yourself that you were maintaining at an enormous personal cost.
• 26:23
  Dr. Komal Patil-Sisodia: Women in this phase often describe feeling like they've lost their patience, their tolerance, their resilience, and what's happening is the opposite.
• 26:32
  Dr. Komal Patil-Sisodia: The body is finally refusing to absorb what it was never supposed to absorb in the first place, and that's not falling apart.
• 26:41
  Dr. Komal Patil-Sisodia: That is getting clearer about what you want in life.
• 26:45
  Dr. Komal Patil-Sisodia: The third song that I picked is vigilante shit, and technically this is the midnights album, but I kind of lumped it in here.
• 26:53
  Dr. Komal Patil-Sisodia: But in my mind, it lives here, and vigilante shit is what comes after grief and anger.
• 26:59
  Dr. Komal Patil-Sisodia: It's that moment the reckoning stops being reactive and becomes deliberate.
• 27:04
  Dr. Komal Patil-Sisodia: It's calm, it's quiet, it's clear-eyed, it's like a silent assassin.
• 27:09
  Dr. Komal Patil-Sisodia: Don't say,"I didn't warn you.
• 27:11
  Dr. Komal Patil-Sisodia: That's not someone who's in crisis.
• 27:13
  Dr. Komal Patil-Sisodia: That is someone who knows exactly who she is, exactly what she will and won't accept, and she doesn't need to announce or justify it.
• 27:21
  Dr. Komal Patil-Sisodia: She just acts accordingly.
• 27:23
  Dr. Komal Patil-Sisodia: The shift from surviving to deciding is one of the most significant things that happens in this phase, and it doesn't always look dramatic from the outside.
• 27:31
  Dr. Komal Patil-Sisodia: Sometimes it's just a very quiet, very firm,"No, I won't do that anymore." Now let's move into our last era, which I call post-menopause, and it's where we really start the practice of integration.
• 27:49
  Dr. Komal Patil-Sisodia: We made it.
• 27:51
  Dr. Komal Patil-Sisodia: And I love talking about this era.
• 27:53
  Dr. Komal Patil-Sisodia: The album that is most representative is Midnights, and there's a reason why Midnights is back, because there's a version of it that arrives before the reckoning happens.
• 28:04
  Dr. Komal Patil-Sisodia: It's the,"I understand my patterns version," and then there's a version that arrives after it, after you've not just understood, but actually felt it and moved through this reckoning period where you're looking at what is important to you and what is not, what you will tolerate and what you will not.
• 28:22
  Dr. Komal Patil-Sisodia: And the after version is completely different, and that's what this era is.
• 28:27
  Dr. Komal Patil-Sisodia: This isn't the midnight songs of figuring yourself out like anti-hero.
• 28:32
  Dr. Komal Patil-Sisodia: This is the midnight of already knowing who you are.
• 28:35
  Dr. Komal Patil-Sisodia: Hormonally, things will settle into a new baseline, and that baseline needs intentional medical support, where when you come see me in my office, we're working on your muscle, your bones, your heart, your metabolism, and the body here responds best to respect and not punishment.
• 28:52
  Dr. Komal Patil-Sisodia: And I say that because so many women arrive at this point in their lives, having spent years in a punishing relationship with their bodies, waiting for a certain approach to start working or trying to make their body do at 60 what it was doing at 20 or 30, and it won't.
• 29:12
  Dr. Komal Patil-Sisodia: This is the era where you have to partner with and reckon with how your body has changed.
• 29:19
  Dr. Komal Patil-Sisodia: And the thing that I love talking about is this is often when lover, that alignment, that safety shows up most fully.
• 29:27
  Dr. Komal Patil-Sisodia: And not because hormone levels are higher, they're actually not.
• 29:30
  Dr. Komal Patil-Sisodia: It's, they're significantly lower unless you're on hormone therapy, but it's because the noise is finally lower.
• 29:36
  Dr. Komal Patil-Sisodia: We are able to love without being in a performative state.
• 29:42
  Dr. Komal Patil-Sisodia: We're able to show desire without apologizing for it.
• 29:45
  Dr. Komal Patil-Sisodia: We're able to generally connect without overextending it.
• 29:49
  Dr. Komal Patil-Sisodia: And that is the reward for the whole journey.
• 29:53
  Dr. Komal Patil-Sisodia: The first song that I picked for this era is You're On Your Own Kid.
• 29:58
  Dr. Komal Patil-Sisodia: This is the whole arc of landing somewhere that isn't defeat.
• 30:01
  Dr. Komal Patil-Sisodia: It's you looking at yourself from a position of ownership and trusting yourself from the inside.
• 30:08
  Dr. Komal Patil-Sisodia: And the line in this song that gets me every time is everything you lose is a step you take.
• 30:16
  Dr. Komal Patil-Sisodia: That's the integration of everything that came before, and that's the point of it all.
• 30:22
  Dr. Komal Patil-Sisodia: And finally, the last and one of my favorite songs on the album, Bejeweled.
• 30:28
  Dr. Komal Patil-Sisodia: This one is for every woman who hits this era convinced that her most interesting years are behind her, that she's invisible now.
• 30:35
  Dr. Komal Patil-Sisodia: And that might be what society tells her, but I wanna say this as clearly as I can, she's wrong.
• 30:42
  Dr. Komal Patil-Sisodia: What's behind her is the performance.
• 30:45
  Dr. Komal Patil-Sisodia: What's ahead is the actual thing.
• 30:48
  Dr. Komal Patil-Sisodia: Yes, we have to do real work on bone density and muscle and metabolic health but a woman's self-concept is generally the strongest it's ever been in that era.
• 31:00
  Dr. Komal Patil-Sisodia: I had this pointed out to me by a good friend, Dr.
• 31:02
  Dr. Komal Patil-Sisodia: Sonia Wright, when I gave one of my first talks on perimenopause called Mother Nature's Not a Feminist.
• 31:08
  Dr. Komal Patil-Sisodia: And I was so mad about all of the changes that I was seeing in my future.
• 31:14
  Dr. Komal Patil-Sisodia: And she pointed out to me that there's so much clarity that comes with aging and it is truly stepping into a new era and that she was on that side of things and was able to see it for what it was.
• 31:28
  Dr. Komal Patil-Sisodia: It wasn't until I embraced that and really started thinking about it and making these changes for myself that I really started to believe that.
• 31:38
  Dr. Komal Patil-Sisodia: So bejeweled isn't about recapturing your former self or recapturing the glory days of your 20s or 30s.
• 31:46
  Dr. Komal Patil-Sisodia: It is about the specific glow that hits you when you arrive, when you're finally done performing for everybody else, and you're just letting your true self shine.
• 31:57
  Dr. Komal Patil-Sisodia: Well, if you've made it this far, thank you.
• 32:00
  Dr. Komal Patil-Sisodia: This is a lot of my interpretations of songs and, trying to fit it into a framework for how I see the arc of a woman's life progress.
• 32:09
  Dr. Komal Patil-Sisodia: And the core message I want you to take home is that No era is better than another.
• 32:20
  Dr. Komal Patil-Sisodia: No era lasts forever.
• 32:22
  Dr. Komal Patil-Sisodia: And the processing that we go through, it's never in a straight line.
• 32:26
  Dr. Komal Patil-Sisodia: You can understand things in your life before you feel them.
• 32:29
  Dr. Komal Patil-Sisodia: You can feel like you arrived somewhere only to take several steps back and be back to something that you thought you had conquered, and that's not failure.
• 32:39
  Dr. Komal Patil-Sisodia: It's not really going backwards.
• 32:40
  Dr. Komal Patil-Sisodia: It's just how you are processing your life.
• 32:43
  Dr. Komal Patil-Sisodia: The goal isn't to get through the airs as fast as possible.
• 32:46
  Dr. Komal Patil-Sisodia: The goal is to be present in each one.
• 32:50
  Dr. Komal Patil-Sisodia: And the most important thing I want you to take home is that your body is not betraying you, it's transitioning you.
• 32:57
  Dr. Komal Patil-Sisodia: These are changes that are meant to happen over time, and those transitions are not the same thing as betrayal.
• 33:04
  Dr. Komal Patil-Sisodia: And that's it for episode two of Clearly Hormonal.
• 33:07
  Dr. Komal Patil-Sisodia: If this one resonated, share it with a woman in your life who's in her own era shift.
• 33:12
  Dr. Komal Patil-Sisodia: She probably needs to hear what she's feeling has a name, a biological reason, and a conversation she absolutely deserves to be having.
• 33:19
  Dr. Komal Patil-Sisodia: And that actually brings me to something I've been building, because it connects directly to everything we just talked about.
• 33:25
  Dr. Komal Patil-Sisodia: One of the things I hear most from women is,"I know something is off.
• 33:29
  Dr. Komal Patil-Sisodia: I just don't have the words for it.
• 33:31
  Dr. Komal Patil-Sisodia: Or,"I know something is off, but I don't know how to make my doctor take it seriously." Those are two different problems, and both of them are real.
• 33:39
  Dr. Komal Patil-Sisodia: The first one's about language, and the second one is about translation.
• 33:44
  Dr. Komal Patil-Sisodia: So I've spent the last year building something.
• 33:46
  Dr. Komal Patil-Sisodia: It's called the Midlife Health Compass, and it's designed to do exactly that.
• 33:50
  Dr. Komal Patil-Sisodia: Help women put language around what they're experiencing, and then translate that into something concrete they can actually bring to their provider.
• 33:59
  Dr. Komal Patil-Sisodia: Not vague symptoms, not I'm just tired, but real data, real language, and something a clinician can work with, because women shouldn't have to walk into a doctor's office hoping to be believed.
• 34:11
  Dr. Komal Patil-Sisodia: They should be able to walk in with a map and a free one at that.
• 34:15
  Dr. Komal Patil-Sisodia: More on that soon.
• 34:17
  Dr. Komal Patil-Sisodia: You can find me at clearlyhormonal.com or at my practice website, eastsidemm.com, or follow me on TikTok or Instagram.
• 34:26
  Dr. Komal Patil-Sisodia: My handle is@drpatilsisodia.
• 34:30
  Dr. Komal Patil-Sisodia: Next week, we're going to talk about perimenopause, what's happening, when it starts, and why the timeline is almost certainly earlier than you've ever been told.
• 34:39
  Dr. Komal Patil-Sisodia: Every era deserves real information.
• 34:41
  Dr. Komal Patil-Sisodia: I'll see you on the next episode.