In this eye-opening episode of The Curious Cardiologist, Dr. Sanjay Bhojraj — a recovering interventional cardiologist turned functional medicine physician — sits down with Emily Sadri (APRN, CNM, WHP-BC), a nurse practitioner and certified nurse-midwife who has built a thriving hormone and metabolic health practice.

Together they unpack the real story behind menopause, metabolic decline, and the cardiovascular consequences of ignoring hormone health. Emily shares her journey from hospital midwife to functional practitioner, the “aha” moment that meditation improved her gestational diabetes more than diet ever did, and how the Women’s Health Initiative (WHI) study derailed an entire generation’s access to hormone therapy.

They explore:

• Why estrogen is far more than a “female hormone” — it’s a vascular, metabolic, and cognitive protector.
• How perimenopause is often the hidden root behind rising LDL, fatigue, anxiety, and weight gain.
• The difference between oral and transdermal hormones (and why route matters for heart health).
• How estrogen loss disrupts nitric oxide production, vagal tone, and even sleep and mood.
• Practical lab workups every woman in midlife should request.
• Why replacing hormones without fixing lifestyle is like “mopping up the ocean.”
• How functional and precision medicine can redefine women’s health and longevity.

Emily and Sanjay weave humor, humility, and heart into a candid conversation that will change how you think about hormones — whether you’re a clinician, a patient, or a partner trying to understand what’s happening behind the scenes of midlife.

🧬 Key Takeaways

• Menopause isn’t a single event — it’s a 10–15-year metabolic and hormonal transition that starts in the 30s.
• Declining estrogen is directly tied to rising cardiovascular and metabolic risk.
• Transdermal estradiol + oral micronized progesterone remain the safest, most physiologic forms of HRT.
• Estrogen improves nitric-oxide production, insulin sensitivity, vagal tone, and arterial elasticity.
• Vaginal estrogen reduces UTI risk and supports the vaginal microbiome — even in breast-cancer survivors.
• The “menopausal machismo” mindset of “toughing it out” may actually shorten lifespan and healthspan.
• Functional medicine and hormone therapy must work together — lifestyle, nutrition, sleep, and stress are the foundation.

🧪 Guest Bio

Emily Sadri, APRN, CNM, WHP-BC is a board-certified nurse practitioner, women’s health specialist, and former midwife who now leads Aurelia Health, a telehealth practice focused on personalized hormone therapy and metabolic medicine for women in midlife and beyond. Her mission is to redefine menopause care through education, precision hormones, and holistic root-cause healing.
🔗 Connect with Emily:

• Instagram → @EmilySadri_NP