197. Women’s Mental Health Across Reproductive Transitions: PMDD, Menopause & More with Psychiatrist Dr. Ariel Dalfen

In this episode, I’m joined by Dr. Ariel Dalfen, a psychiatrist and women’s mental health specialist, to explore the intersection of reproductive hormones, mental health, body image, eating disorders, and metabolic health.

We talk about why reproductive transitions—from the menstrual cycle to pregnancy, postpartum, perimenopause and menopause—can be particularly vulnerable times for mental health, and how clinicians can distinguish expected changes from symptoms that warrant treatment.

We also discuss:
- PMDD: what it is, how it differs from PMS, and why tracking symptoms across the menstrual cycle can be so helpful

- Mental health during perimenopause and menopause, including anxiety, depression, sleep disruption and emotional dysregulation

- How a history of PMDD, postpartum mental health concerns, or other psychiatric illness may influence risk during the menopause transition

- When menopause hormone therapy, psychiatric medication, or a combination may be appropriate

- How we should consider weight gain and metabolic health when choosing psychiatric medications

-The significant impact of menopause on body image and the risk of eating disorder relapse

- The growing pressure around food, exercise, protein, and body composition—and when healthy behaviours can become obsessive

- What we know, and what we still don't know, about the relationship between GLP-1 medications and mental health

- Why individualized, multidisciplinary care matters so much in women's mental health

Most importantly, we talk about the importance of listening to women, taking their symptoms seriously, and looking at the whole person rather than reducing complex experiences to either "just hormones" or a psychiatric diagnosis.

Dr. Dalfen is the CEO and co-founder of BRIA, a virtual women's mental health and hormone clinic. She is also an Assistant Professor of Psychiatry at the University of Toronto and previously led the perinatal mental health program at Mount Sinai Hospital in Toronto.

Learn more about BRIA at betterbria.com and BRIA Academy at briaacademy.com.

Follow BRIA on instagram: @bria.health