Perimenopause doesn't announce itself with a calendar invite. For business leaders who happen to be women, it often arrives as brain fog, joint pain, and a creeping sense of being a stranger in their own body — right in the middle of peak career years. This conversation between Todd Vande Hei and Regan Phillips, CEO of CASA of Orange County, is one of the most honest discussions you'll find on what happens when high-performing women enter perimenopause without a real plan — and what happens when they finally get one.
Regan had been a Stark member for seven years when the perimenopausal transition hit hard. She described the early phase as feeling like a stranger in her own body. The quick fixes that used to work stopped producing results. More alarming was the cognitive shift. Brain fog was becoming a real problem — paralyzing at times, causing her to forget basic things and lose words mid-conversation. Her GP offered birth control pills to manage symptoms, a common but increasingly questioned approach. Dr. Alice Nguyen at Stark had been raising the possibility of hormone replacement therapy (HRT) for years. Regan was not ready until she was.
Regan began HRT in October and committed fully to the Stark Naked Health Competition shortly after. The timing mattered. It was actually a lot easier to stay with it than expected, because she felt so good so quickly. Joint pain from a pre-existing elbow tear disappeared. Mental clarity returned. At the CASA of Orange County annual gala, Todd watched from backstage as Regan delivered a keynote that stopped him in his tracks. He was astounded at her mental acuity — razor sharp, relaxed, and funny in front of a room that needed her best. The compounding factor was the stack: HRT, strength training, dramatically increased protein, reduced alcohol, improved sleep, and the competitive structure of the Stark Naked program with a real deadline and community.
Todd drew an important contrast: men experience andropause — declining testosterone — beginning around age 31, but it's a slow, civilized decline over decades. Women get sharp hormonal swings that destabilize mood, cognition, and body composition rapidly. The experience is more profound emotionally because it happens so fast. That is not weakness — it is biology. And it is a biology that has been dismissed and undertreated by conventional medicine for too long. The business implication: if you lead a team with women in their 40s and 50s, you are almost certainly watching talented leaders white-knuckle through a hormonal transition while trying to appear unaffected. The most forward-thinking health strategies address this directly.
Regan's health transformation was inseparable from her professional effectiveness. She didn't just feel better — she led better. CASA of Orange County places volunteer advocates with children in the foster care system. In California, children with a CASA advocate graduate at a 96% rate versus 50% for the broader foster care population. That mission requires a sharp, energized, present leader. Investing in her own health wasn't selfish — it was a prerequisite for the people who depended on her. Taking care of yourself so you can take care of other people is the business case for proactive health in one sentence.
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Medical Disclaimer: The content in this post is for informational and educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new health protocol, hormone therapy, or supplementation program.