Perimenopause symptoms like hot flashes, sleep problems, and brain fog often go undiagnosed. Here's how Joanna Strober built accessible menopause care for women over 40.

Perimenopause symptoms went undiagnosed for years while Joanna Strober suffered through sleepless nights, unexplained weight gain, hot flashes, and anxiety. Despite seeing multiple doctors, no one mentioned perimenopause or hormone therapy. This is her story of how personal medical dismissal became a mission to transform menopause care for women over 40.

At 53, Joanna founded Midi Health—the first insurance-covered virtual care platform for perimenopause and menopause, now serving 20,000 women weekly across all 50 states.

In this episode, you'll learn:

✅ Why perimenopause symptoms start in your 30s or 40s (up to 20 years before menopause)

✅ The truth about HRT and breast cancer risk

✅ How to access insurance-covered menopause care vs. paying $1,500+ out of pocket

✅ Common perimenopause symptoms beyond hot flashes: brain fog, sleep disruption, night sweats, anxiety, weight gain, vertigo

✅ Why hormone therapy (HRT) has 5x less hormones than birth control pills doctors readily prescribe

✅ How one woman turned medical gaslighting into a healthcare company at 53

✅ The courage to talk about menopause publicly when it was considered career suicide

✅ Why perimenopause care IS primary care for women over 40

✅ The manifesting and visualization techniques that helped build a national healthcare platform

✅ How to create feedback loops that drive operational excellence (including the brilliance of frustrations@joinmidi.com)

Why This Matters for Women Over 40:

Medical studies show women 40-49 experience significant work and life impacts from perimenopause, yet symptoms are routinely dismissed or misdiagnosed. This conversation breaks down the barriers keeping women from proper care and offers practical pathways to getting help.

About Joanna Strober:

Joanna Strober is the Founder and CEO of Midi Health, the largest insurance-covered virtual menopause care platform in the United States. After her own perimenopause symptoms went undiagnosed for years, she founded Midi at age 53 to ensure other women wouldn't suffer the same medical dismissal. She was one of the first business leaders to publicly discuss menopause on LinkedIn in 2021, helping break the professional taboo around this life transition. Under her leadership, Midi now serves nearly 20,000 women weekly with accessible, expert menopause care.

Key Timestamps:

[00:00] Introduction

[03:15] Joanna's undiagnosed perimenopause journey

[06:00] Why doctors prescribe birth control instead of HRT

[07:15] The career risk of talking about menopause in 2021

[10:00] Debunking the hormone therapy and breast cancer myth

[15:00] How insurance coverage makes menopause care accessible

[18:45] The billion symptoms of perimenopause you need to know

[20:00] Starting a healthcare company at 53

[23:30] Manifesting and strategic visualization in business

[27:00] Serving 20,000 women weekly—the reality of scaling healthcare

[30:00] Why frustrations@joinmidi.com matters for courage capital

[33:00] The future: expanding to full women's primary care

Resources Mentioned:

• MIDI Health: www.joinmidi.com (insurance-covered menopause care)

• Women's Health Initiative Study (discussed in episode)

• Nutrafol (episode sponsor for hair health)

Connect with The Uplifters:

🎙 Website: theuplifterspodcast.com

📱 Instagram: @the_uplifters_podcast and @aransas_savas

📱 TikTok: @theuplifterspodcast

▶️ YouTube: @theuplifterspodcast

💼 LinkedIn: Aransas Savas

If You Liked This Story, Check Out These Episodes Next

• Isabelle Raymond (Nutrafol) - Studied women’s hair thinning in menopause to create a treatment designed just for that stage of life
• Julie Gordon White (MenoWell) - created the menopause power snack she needed during her transition
• Denise Pines (Producer of The M Factor Film) - age enthusiast, longtime community health advocate, and media pioneer
• Konika Ray Wong (Girl Power Science) - creating education that centers girls’ actual bodies and experiences

TAGS: #perimenopause #menopause #womenover40 #HRT #hormonetherapy #hotflashes #sleepmenopause #brainfog #midlifemindset #careerchange40 #burnoutrecovery #womenshealth #healthcareinnovation #femalefounder #perimenopausesymptoms #menopausecare #nightsweats #weightgainmenopause #womenshealthcare #insurancecoveredcare #virtualcare #telemedicine #midlifewellness #hormonemyths #medicaladvocacy

As someone who's built my career around [00:00:30] rigorous science, I super love that Nutriful was the first brand to clinically study hair thinning on menopausal women, which is why I am so proud to have them as a sponsor. Nutriful takes a whole body approach to [00:00:45] hair health supporting you throughout your life stages.

I've been waiting for this particular conversation for a really long time, and I mean. Half of the reason I wanted to do a whole series [00:01:30] on midlife wellness was because I wanted an excuse to talk to my friend, Joanna Strober. She is one of the baddest ass babes I have ever known. We got to work together for many years, and I just admire her as a human, as a leader, as [00:01:45] a founder, I love her voice and her way of being in the world.

Exactly. Yay. And they say menopause is hot [00:02:15] and it's, Joanna is the founder of MIDI Health, the largest virtual care platform for women in perimenopause and menopause covered by insurance. I remember in the early days as [00:02:30] Joanna was founding this company, that was a huge piece of the puzzle to put together, which was.

Tell us about how you even decided with all the things, because you've, in your [00:03:00] career, you've worked on weight loss, you've worked on children's wellness, you've worked on so many different health related topics. When did you decide, oh, there's a big gap and a big need here and I'm gonna have to be [00:03:15] the one to tackle it?

Joanna Strober: Yeah. You kind of have to be a little crazy, right? I mean,

Aransas SAvas: good. Crazy

Joanna Strober: good. Crazy. Exactly. Badass and crazy.

Aransas SAvas: Exactly.

Honestly, that creates a lot of havoc in our bodies, and I experience that firsthand. I [00:03:45] was gaining weight. I had stopped sleeping. My kids joke, they remembered me like. It would be a hot day and I would turn all the windows down in the car and go, it's so hot in here. They're like, it's not hot mom. Like they actually were making fun of me the [00:04:00] other night, my son, he was like, yeah, you used to take off your shirt at the table, like, because you couldn't get over how hot you were.

At some point I was given sleeping pills because I [00:04:30] wasn't sleeping, but sleeping pills are addictive. So they said, you know, you can't take them very often. I tried actually marijuana, but that didn't work. Didn't sleep with that sleep. The gummies just kind of made me dizzy. It didn't work. I was having a lot of [00:04:45] anxiety and it was not me.

Aransas SAvas: Right? All the signs were there. All the signs. Yes. All the, you were a woman in midlife [00:05:15] having a bunch of symptoms that could be attributed to this, but because no one was talking about it, your doctors weren't even surfacing this as a. Possible connection.

But birth control pills are actually too strong. I don't know if you know, like birth control pills have five x plus the amount of hormones [00:05:45] as hormone replacement therapy. And that actually is too much for a lot of women and for me it was too much. So I couldn't take birth control pills. I didn't have a good reaction to them.

Aransas SAvas: right, because they weren't looking at. Your [00:06:15] needs. They were looking at the needs of the person they were trained to support.

Yeah. Which was a 20-year-old woman.

Aransas SAvas: I really feel like you were the first person I heard talking about this pervasive topic now, and lucky me, I turned 50 this year and get to be 50 in a world where it feels like every [00:06:45] celebrity and super smart woman I know is looking for ways to make this road a little easier for me.

But what year was this?

Aransas SAvas: That's like a minute ago. Yeah.

Aransas SAvas: I mean, you were though in truth. Because you might as well have said, I am a convicted murderer. Let's check. I mean, it [00:07:15] was that infrequently discussed Iranis

Joanna Strober: put differently. I might as well have said, I'm old and don't hire me.

Aransas SAvas: Yes. Better said.

Joanna Strober: That is the mm-hmm. Thing that people felt I was risking.

Aransas SAvas: Mm-hmm.

And she's, they're sitting down at a table, she's interviewing her and the woman is flushed and she's having sweats and the recruiter. Not knowing any better thought she was [00:08:00] nervous and didn't put her up for the job, didn't even introduce her to the company because she thought this woman who she had heard was so impressive, looked too nervous, and so it just turned out.

She didn't even introduce her because she thought she was so nervous. Yeah. So, you know, for me, going out and saying, you know, thankfully I didn't need a job. I wasn't gonna go get a job. So I was able to go out in the world and say, [00:08:45] I'm having perimenopause and I'm having menopause, and I am just as confident as I was before.

Actually. Now that I'm on hormones, I'm ultra. And so I think a lot of it is opening this conversation and saying this to

By using it. And of course, since I've watched, yeah. Many, many people do it. But that was my first exposure Yeah. To that concept. And that is so much of what you and [00:09:30] now other women have done to, normalizing isn't even the right word. Right. It is more of a reclaiming. Yeah. And how different it is to say, whew.

Joanna Strober: Lemme just tell you, I'm having a hot flash. Okay. I'm having a hot flash. It'll go away. Yeah, and actually I'm still just as great of a manager as I was before I had the [00:10:00] hot flash.

Aransas SAvas: Lucky there. How many great leaders have been overlooked because of hot flashes?

Joanna Strober: Yeah. Right. Doesn't that make you sad? It makes me angry and sad.

All of the life stage changes that we go through, whether it's paying for your kids' college as you are taking care of your elders, your own health, losing work, losing promotion, right? And so it's [00:10:45] like the more awareness we have of how these things are impacting us, the more we can directly tackle them instead of just sort of getting overwhelmed and sitting back and saying, well, I'm screwed.

She had breast cancer twice because she took some hormones. So to hear the [00:11:30] fallacy around that really radically changed my mindset. And so I wondered if you would share a little of that research for others who maybe have been carrying around some huge misconceptions as I did.

Joanna Strober: So, it's a complicated story.

Aransas SAvas: Mm-hmm.

They initially thought that they had an outcome that said that women were getting more breast cancer, and so they made a huge announcement and people [00:12:15] remember reading this even though it was more than 20 years ago, and all these doctors said, oh, stop hormones. The reality is that there's two really important things here.

We don't use that anymore. We now know, and this is [00:13:00] the study, if you look at these same women in the study, that women taking estrogen alone, were actually at a lower risk of breast cancer. We also have zero data at all, that there's any correlation at all between [00:13:15] estrogen and breast cancer. None. So all these women, it is true.

Which is why we encourage women really strongly to get a mammogram every year to see how they're doing. But honestly, there is no [00:13:45] correlation here. You will not increase your risk of breast cancer. I can't say it enough times and loud enough. And what's so hard is that women will say to me, oh, my mom had breast cancer so I can't take hormones.

So, you know, one thing we did recently is we launched a supplement store.

Aransas SAvas: Yeah. Congrats. I saw that.

You're just a hormone

Aransas SAvas: believer because you, I'm just a hormone believer.

Right. If you wanna try other things for your brain health or your bone health, we'll get you other things. What I really want is women to know the data, to have the education, [00:15:00] and then to have the choice what they wanna do. And that's really what I'm focused on.

Aransas SAvas: I love that. And it is making all of that accessible to women.

Health. And so I think for you early on that was like job number one was to make sure that women could receive care.

Aransas SAvas: Mm-hmm.

Joanna Strober: So when I got my hormones initially, I paid 15 to this wonderful lady who was wonderful. I have nothing, not great to say about her, and her knowledge was fantastic and she got me on the right things.

If people want to do that, it's great. I have no problem. But we're playing a different game. I admit we're taking care of some of the most highly regarded women in the world, quite honestly. We're also taking care of a [00:16:30] lot of factory workers and they all get the same care and they all are able to pay for it with their insurance.

So like there's some limitations on what we can do. If you want a blood test covered by insurance, you have to come to us first for a visit. I can't just order you a blood test covered by insurance. If you come to me, I can get you a blood test covered by insurance that does all the fancy things that other [00:17:15] people's blood tests do covered by insurance.

Yeah. When you don't need, we can send you to get a mammogram, we can send you to get a colonoscopy when you are not in urgent care. We don't do urgent care. [00:17:45] We don't do sinus infections, right? Like, but if for most of the things that women need a doctor for in, you know, between 30 and 60, we can do those things.

Aransas SAvas: That's brilliant. And because you are specializing in this area, you're able to do it with so much greater insight and understanding about this specific group of [00:18:15] women.

Joanna Strober: At least a billion. Exactly.

Aransas SAvas: At least a billion.

Especially this like the tongue things I this like. [00:19:00]

Joanna Strober: Well, what about like itchy ears or vertigo? All of a sudden I noticed that I was getting some vertigo. I didn't know that was related to

Thank you, Joan.

I think the estrogen should be the same. Like as the estrogen goes down, you should get more of it. Yeah. So I think that, yeah, it's a basic thing in your body that's changing and we can help you with that. I

Joanna Strober: Yeah. Wow. How old was I? Uh, 53.

I think you said, I, I wasn't planning on going out and getting another job [00:20:45] after your last gig, but was there a part of you that thought, oh, is it too late to start a whole new company at 53?

Aransas SAvas: I didn't know if maybe you were like, I'm just an entrepreneur at heart and I'm not going back into a corporation.

Mm-hmm. I need something that's exciting and challenging. Intellectually stimulating because I know that for me personally, when I'm not intellectually [00:21:30] stimulated, I drive my entire family quite crazy. I have a lot of excess energy that needs to be channeled in the right direction. So my family's much happier when I'm working.

Joanna Strober: So I think that's pretty true. So my amazing co-founder, Sharon and I have been friends for [00:22:15] 20 something years and we started talking about this over, you know, COVID when we were kind of podding together and we got really into talking about hormones and we got very excited by. [00:22:30] The hormone research and diving into it and understanding it.

Aransas SAvas: like why, because of virtual care?

Joanna Strober: Yes. Right. So.

And we could say, here's Mindy, we wanna scale her expertise nationally. Dr. Goldman, go get yourself licensed in all 50 states, and we are going to apply for you to get insurance [00:23:30] contracts in all 50 states. So we're gonna start just with you and two other people giving care to women nationally and start getting those insurance contracts.

I'm gonna just say I've gotten very into the concept of manifesting. [00:24:00] The science of manifesting I've decided is super interesting and I've been reading a lot about it and it's not the fufu manifesting. I'm so glad we're

Aransas SAvas: talking about this because Same. Okay. Are you, I'm

So I could start to manifest and I could start to say like, what would it look like if all women had access to really high quality care? At home, like it's so great not to go to the doctor. You don't wanna sit in a gown. You don't wanna actually have [00:24:30] your scale. You don't wanna do all that, right? You just wanna have the, so what would that look like?

And we kind of manifested this big story. And then we said, okay, what would it take? Like step by step by step backwards in order to get there? That was actually really helpful to me.

We can't see through. You started to pick it apart into little [00:25:00] details and started to see how you could build each of those details to create this whole new space.

Joanna Strober: Yeah, I think that's right.

To my left is this vision board. I've become like vision board girl is this vision board where I, I put a picture of this room, I'm standing two years ago and I told my family I was, I wanna know what happens if I live and work while looking at the water all [00:25:30] day. And then the next summer we came and I was like, I think that's the house.

It's not like the universe was like, here, let me deliver this. Oh, no, no, no, no, no. We were very involved in this process. Yeah, [00:26:00] and even talking to you. Because I have just always imagined when I think about Uplifters, I always think of you because your work embodies the work that we're doing in such wonderful, powerful ways.

Joanna Strober: Well, you know, the thing is, think about where we both were five years ago, right? Mm-hmm. Like honestly, when I met you, you were doing amazing work, but you'd been at the same place for how long

Joanna Strober: 18 freaking years. 18. Yeah. That's amazing. Yeah, and you were so well regarded and everyone thought you were the best at what you were doing, so I have to imagine it was hard to think about believing when you're doing such a good job at what you are doing, [00:26:45] but now you get to do so many other really cool things.

Aransas SAvas: Now I get to do, literally, I'm like an inch away from only being in my space of genius all day.

Joanna Strober: Wow. That's amazing. That's wonderful.

Aransas SAvas: It's pretty exciting. Yeah.

Joanna Strober: Yeah.

Yeah. Was there anything about creating it that. Felt like just a huge block or barrier or [00:27:15] just scared the crap out of you.

Joanna Strober: I'll tell you what still scares the crap out of me every day is we're providing medical care to almost 20,000 women a week right now. That's insane. Joanna, that's so huge. Like what an impact.

You know, nps, they have children, those kids get work, they call out. Mm-hmm. Then I have a whole day of patients who can't get seen. Then I don't have enough people under that insurance company [00:28:00] in that state to get them in for another month. And so then they have to wait a month. And by the way, it's not just like I can get someone in that state because they have to be licensed in that state with that insurance company.

It's a really hard and trying really hard, but that doesn't mean that things don't go wrong [00:28:45] every day and it's hard to kind of keep your equanimity. I'm really appreciative to the patients who reach out and say, we make mistakes, because if I don't know that we make mistakes, I can't fix them. So I'm super appreciative to those patients who reach out and tell me this.

Aransas SAvas: [00:29:15] Yeah. I love that answer for lots of reasons. One of the things I love about it is that you've created this email address and I, I talk a lot on this show about creating courage capital. So we all understand if we wanna do big, brave things, [00:29:30] we have to raise financial capital. We have to fund it in some way.

But you have sort of disarmed that again by saying, oh no, I wanna hear it. So that. [00:30:00] I can get better and stronger and more impactful. And so the people I see who are most successful are the people who are saying, okay, I'm gonna internalize as much data as I can so that I can have the data [00:30:15] I need in order to make the right decision for what I care about.

Exactly. Yeah, exactly. Yeah. The other thing I love about that answer is that it acknowledges that big briefings aren't easy.

Joanna Strober: Yeah.

Joanna Strober: think one thing actually, I will say I'm super appreciative is I do think that people give us a lot of grace.

Or [00:31:15] they're, they can't show up to work. It can take me months to get people back in again. And that's not on the patient, that's on me. Like I wanna like say that it's on me and the insurance company will not move [00:31:30] faster. And I have a whole list of trained people waiting to practice in her state when the insurance company will let them.

And you know, then we have to say like, should we not practice in that state until the insurance company [00:32:00] will put us in faster? Like, there are a bunch of interesting operational challenges that we're trying to work through, and I, I don't have all the answers to them, but we are, we're a work in progress.

Aransas SAvas: the stuff that's outta your control, and it speaks volumes about the scale of the need. Right? Yes. It's moving fast because there [00:32:30] are so many people who need it.

Yeah. So it's a high class problem. As they say,

Joanna Strober: our demand is infinite. It's, we have to make sure we satisfy it in the right way, but the, we are not limited by the lack of demand.

Joanna Strober: so?

So I think we have [00:33:15] to get into women's primary care as well as perimenopause and menopause care. Be there for, for more women, just because the lack of care is so great that we need to train people to do more things. We need to train 'em on migraines. We need to train them on [00:33:30] thyroid care. We need to train them on just bone health.

There's so many things that women are, are lacking and so. We need to really understand what are the things they can't get in to see, and then how do we train providers to do those things?

She is a former nurse and an investor. She runs a fund and they have just completed the nation's [00:34:00] largest education platform for. Psychedelic therapies for ptsd. And so yeah, hitting that sort of root need makes a ton of sense and makes a huge impact. So as we wrap up, my two favorite questions. Number one, [00:34:15] every guest on the Uplifters nominates another woman who is doing big, brave things to share her story here.

So I know you have a massive network of inspiring women. Who would you nominate?

And I think you'd enjoy that [00:34:45] conversation.

Joanna Strober: Yeah. So, you know, getting back to the hormone question, you know, this is all about education, right?

And that is a lot of what this comes down to. No [00:35:30] more gatekeepers. I want our providers to say, you know, we are here to enable you to get the life that you want. And so that's a lot. What I think about is kind of spreading that word of also this is science. Like there is real science. There's a lot of hope out there, but you should try to [00:35:45] find, find the science, which is really important.

But my mission is just to women really to ensure that women get great care, and that's, that's really where I'm focused, and you can get that by getting education and then getting access to the right providers.

That might be a lot easier to sit at home. Yes. Great. And I dunno, maybe go work for a company and just be. Smart person on the team that you decided to [00:36:15] tackle the problem that we was tackling, and I really, really appreciate that. I'm grateful to know you and to get to watch your work in the world and to grow up in this time.

Music: Big love painted water, sunshine with rosemary. I dwell, perplexing. You find it.[00:37:15]

lift you up,

lift you up,

Lift you up.

lift.

Um,