In this episode of The Curious Cardiologist, Dr. Sanjay Bhojraj sits down with Dr. Jennifer Pfleghaar (aka Integrative Dr. Mom) – a board-certified emergency physician and integrative medicine doctor who now focuses on perimenopause, hormones, and true root-cause care. Dr. Jen shares how years in the ER watching the same patients come back with the same problems pushed her toward integrative medicine, nutrition, and hormone optimization. She opens up about her own journey with Hashimoto’s, residency-fueled burnout, and becoming “the crunchy mom” who started questioning everything she’d been taught. Together, we dig into: Why 90% of ER visits are really chronic lifestyle problems How women in perimenopause (ages ~35–55) are routinely gaslit, misdiagnosed, and put on antidepressants or birth control instead of having their hormones addressed The truth about bioidentical hormones vs. synthetic hormones, and why the Women’s Health Initiative scared a generation of doctors away from hormone therapy Why pellets, megadose creams, and med-spa hormones can be dangerous when they’re not monitored correctly How GLP-1 drugs are being used as the “easy button” for weight loss – and what a responsible, short-term protocol should actually look like The role of environmental toxins, mold, endocrine disruptors, and even your frying pan in weight, fatigue, and hormone disruption Dr. Jen also talks about her new book, The Perimenopause Reset, which walks women through a body–environment–spiritual reset, a 28-day devotional, and a practical guide to navigating this overlooked season of life. If you’re a woman in your mid-30s to 50s (or you love one), this episode will give you language, validation, and a roadmap to start asking better questions and demanding better care. 3. Key Episode Highlights (for show notes / bullets) Use these as bullet points in show notes: Dr. Jen’s journey from burned-out ER doctor to integrative medicine and perimenopause care How seeing the same patients, same scans, same symptoms opened her eyes to the failures of conventional medicine The motherhood moment that made her realize her health decisions affected her children – and sent her down the “holistic, crunchy” path Why she went back for a formal integrative medicine fellowship and board certification (and why credentials matter in this space) How 90% of ER visits she saw were the downstream result of chronic lifestyle disease The power of simple, hands-on tools like osteopathic ear drainage for kids’ ear infections – and why prevention isn’t profitable Dr. Jen’s personal story of Hashimoto’s, inflammation, and being told there was “nothing she could do” Why patients are conditioned to believe “there’s a pill for that”, and how that strips away agency Perimenopause 101: symptoms, misdiagnosis, and why so many women are handed SSRIs and birth control instead of hormone support Bioidentical vs. synthetic hormones: what the Women’s Health Initiative really studied, and why progestins ≠ progesterone Progesterone’s role in vascular health, sleep, mood, and nitric oxide vs. the risks of synthetic progestins Why Dr. Jen rarely uses estradiol in perimenopause, and focuses on progesterone first The hidden dangers of DIY hormone creams, high-dose OTC products, and pellets How med spas and influencer medicine can overprescribe GLP-1s and testosterone without proper labs or follow-up A discussion on curiosity vs. arrogance in medicine, and the importance of staying humble and always learning What’s inside The Perimenopause Reset: body, environment, and spiritual reset; devotional; workouts; and a 28-day plan Why 80–90% of patients improve with lifestyle foundations before you ever need to chase mold, Lyme, or other root causes