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In this Meet the Nurse Practitioner episode of Per and Pause, nurse practitioner Jaime Davis shares how her background in primary care and labor and delivery shaped her patient-centered approach and her focus on midlife women’s care. She discusses how perimenopause is often missed because symptoms can look like stress or anxiety, and highlights early signs such as brain fog, insomnia, word-finding difficulty, and menstrual changes influenced by hormone fluctuations like declining progesterone. Jaime recounts her own experience of years of severe pain after a traumatic C-section that was initially dismissed, later diagnosed as subcutaneous endometriosis and resolved with a short surgery, underscoring the importance of trusting your body and finding providers who listen. She explains her commitment to connecting symptoms, tailoring plans to patient goals, and helping women feel heard, supported, and empowered.
00:00 Meet Jaime Davis
00:54 Labor and Delivery Lessons
02:24 Path to Midlife Care
03:50 Why Perimenopause Gets Missed
06:47 Dismissed Pain Story
11:08 Finding the Real Cause
13:29 What Listening Really Means
15:27 Beyond Rigid Guidelines
16:56 Early Perimenopause Clues
17:06 Brain Fog Sleep Anxiety
19:46 Symptoms Are Connected
21:29 Menopause Education Gaps
23:45 Care After Dismissal
25:10 The Peri Pause Experience
26:15 Closing Thanks Farewell
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This podcast exists to normalize, explain, and elevate the midlife healthcare conversation—so women feel informed, believed, and empowered to demand better care for their bodies and lives.
Visit https://periandpause.com for more info
Creators and Guests
Host
Jamie Gallagher DNP, FNP-C, MSCP
Jamie is a doctoral-prepared, board certified family nurse practitioner and a Menopause Society Certified Practitioner. She is the owner and founder of Peri & Pause. She has served as a nurse practitioner in the Triangle area of North Carolina since 2009 in family medicine, urgent care and women's health. She is an active member of The Menopause Society, the HERmedicine Provider Alliance, the National Association of Nurse Practitioners in Women's Health, and the International Society for the Study of Women's Sexual Health. She is also a proud military spouse, mother of four and grandmother of three.
What is Peri & Pause The Podcast?
The Peri & Pause Podcast is for women in midlife who know something in their body has changed—but haven’t been given real answers, or have been left overwhelmed by conflicting information.
Hosted by Jamie Gallagher, DNP, FNP-C, MSCP, a nurse practitioner specializing in perimenopause and menopause care, the show explores hormones, metabolism, mental health, sleep, sex, weight changes, and chronic conditions through an evidence-based, deeply practical lens. We unpack the physiology of midlife alongside the lived experience of women navigating careers, relationships, finances, and identity during this transition.
Every woman deserves this conversation—and the clarity, language, and confidence to advocate for better care.
Because “Your Labs Are Normal” Is Not the Whole Story.
07 - Peri & Pause
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[00:00:00] Welcome back to Per and Pauses the podcast. So glad you're here. We are doing the fourth of our Meet the Nurse Practitioner series, and today I have Jamie Davis. She is a nurse practitioner with Per and Pause, and she has a background in primary care, labor, and delivery. We're gonna get into all those details and how she came to find herself in midlife women's care.
Jamie: . She gives a really unique perspective on women's healthcare across the lifespan. She also brings clinical depth and personal understanding to midlife care.
She's deeply committed to helping women who may have felt dismissed, feel seen and empowered. Welcome.
Jaime: Thank you for having me on your podcast. I appreciate it.
Jamie: Yeah. So let's jump right in. So you started as, um, earlier in your career as a labor and [00:01:00] delivery nurse. So how did that shape the way. You, um, think of women's bodies, their experiences.
Yeah. Talk about that.
Jaime: Absolutely. So labor and delivery is something that everyone, as a woman, well not everyone, but everyone that has a baby goes through. Um, and so a lot of people will think about it. Oh, it's all exactly the same. Don't you get bored? Absolutely not. Every woman is completely, entirely unique and so is their birth experience, and that is part of what I loved about labor and delivery.
I got to spend time with those women. I got to hear their experience during pregnancy, and I got to tweak their care to tailor it to them and what their birth experiences that they wanted, and that really helped me to hone in on listening to women. Picking up on those cues. Sometimes you can read those emotional things that, um, they may not wanna say in front of their partner.
They may not want to, um, admit that they're having pain or something like that, but you can, [00:02:00] you can start to pick up on those nuances of women that they may or may not say, but you can feel it. It very much helped me hone into my empathetic portion of my skills.
Jamie: Yeah. You're, you're. Present with a woman in her most powerful forward slash vulnerable time.
Um, one of those most vulnerable times in her, in her life. Yeah. So that's awesome. I love that. So how did you find your way into midlife women's health and what made you realize this is where you wanted to be?
Jaime: Yeah, absolutely. So, um, there were many things that led me into midlife women's health. Um, so obviously I have a love of women with my labor and delivery history. Um, so that, that kind of sparked my interest in.
Women's health in general. Um, and as I'm aging, of course, I'm starting to notice different things about myself. And so that sparks me into a journey of discovery and learning things about, you know, perimenopause and menopause. And then that's just a fascinating journey all of itself. Yeah. As well. [00:03:00] Um, but also too, I have experienced some issues in my life where I've, I've had problems and been dismissed and things like that, and that has helped me to.
So in my journey through this, um, I just didn't find that many providers were able to really, um, make those connections with what the women were experiencing and, and really delve into it. And they, they are very much. Rushed in some of their visits because they have to see patients.
Um, and there's so many patients on their panel. And so just being able to spend that time with a woman, recognize those patterns of, of the symptoms that she's having, and not just chalk it all up to, well, there's a lot of stress in your life and anxiety and things like that. And actually see the bigger picture of what's going on is important.
Jamie: Yeah, absolutely. Um, what do you think most providers miss? When women try to explain their symptoms,
Jaime: I think a lot of [00:04:00] times providers can miss just the nuances of, especially if you're in perimenopause, menopause is a little bit easier because you've had, you've stopped having your periods. It's very easy, yeah.
To diagnose that. Particularly now there are a lot of symptoms in menopause that you might miss as being part of it. Yeah. But. Knowing that you're in menopause is definitely something that's easier to diagnose than perimenopause because you're in perimenopause for so long before you actually go into menopause.
And it's also one of a woman's busiest times in life. And so we have so many changes going on. We have a. Kids that we're taking care of. We've got teenagers that are starting to go in and their hormones, and we have our husbands and our, our parents are aging. All of those things. We're trying to have a career, and so a lot of times it presents itself as stress.
Right? You know, our, maybe our periods are a little more frequent than they used to be, which is not something you would think of necessarily with menopause. Or perimenopause. Um, you think about [00:05:00] missing a cycle, but a lot of times it starts out with those more frequent, just different cycles than what you're experiencing, heavier cycles than what you were experiencing.
All of that is related to those hormone fluctuations. And so people are going, oh, well I'm just stressed and my body's doing this, or, oh, I have anxiety because of this, and that's what's going on. Um. I'm not eating well. So that's why my hair's falling out. I don't take good time for myself, so that's why my skin is dry.
Yeah. And it all is in part of a connection. Mm-hmm. And so I think sometimes providers look at the busy picture of the modern woman and miss those things being connected together. They miss that pattern connection. Absolutely.
Jamie: The pattern recognition is where it's at. Mm-hmm. And like, I'm glad you. You jumped into that because even the menopause society, their, their, um, definition of menopause starts with subtle changes in the menstrual pattern.
And I think it starts with subtle changes in the brain because you can have a regular menstrual pattern [00:06:00] and early on, the earliest symptoms I find in the women in late, mid, late thirties, early forties are the brain fog, the insomnia. Absolutely the difficulty word finding. Perimenopause or hormone changes are not, you know, in the, the differential at that point because how are your periods Fine, but my brain is not working.
I, I think we sh the definition should be switched because the other part of their definition is other symptoms associated with menopause, but the other symptoms come first before the menstrual cycle changes. And for those of us who've had ablations, hysterectomies. Um, who, who have IUDs. We don't have that bleed to tell us.
So as, as we progress on upper forties, early fifties, when we're like, I don't really know. Mm-hmm. Um, so it, that takes nuance, nuance as well in diagnosing that. So share a little more about your experience, um, like that you shared with me earlier about feeling kind of dismissed with your own health
Jaime: concerns.
Yeah, absolutely. So, um, to kind of back up a [00:07:00] little bit, to give you a little, um. Hip background history of where I started from. I had a pretty traumatic birth with my son. Um, I ended up having an emergency c-section. Um, lost a lot of blood, ended up in ICU for several weeks, um, because of a prenatal complication.
Yes. Um, but my C-section was just a very fast, kind of messy C-section because they were trying to stop the bleeding and everything else. Um, so. Fast forward about maybe a year later, I've been dealing with, you know, the pain of having a c-section, a newborn that doesn't sleep. Yes. Trying to have a job, all those fun things and everything.
And I've just noticed that I've had a lot of pain. Um, it doesn't make sense. It doesn't, it's just there most of the time there's nothing that sets it off that I can quite put my finger on, right. But I know that it's there and I know that it's not right. And my husband,
Jamie: that in and of itself. Midlife woman pain.
Jaime: Mm. [00:08:00]
Jamie: You know, just take some ibuprofen. Yeah. It kinda gets dismissed and we're expected to have. Pain that we just pushed through. Mm-hmm.
Jaime: Yeah. Well, and you just had a major C-section,
Jamie: right?
Jaime: And it was a messy one. It was a quick one,
Jamie: granted it was a year ago, but yeah. You know,
Jaime: well, they'll look at, they'll tell you, oh, well you can have pain from your C-section for up to a year, or, you know, and some people have it longer than that.
And so I, I just kind of was like, oh, okay. I'm just. Being extra, you know? Right. Being a whiny woman. Yeah. Let's go down that road know. And so, yeah. And my poor husband, you know, he had to deal with all of that. And so like, I keep trying to push through it and I keep trying to push through it and I keep hurting and it just, it hurts really bad and it doesn't make sense to me while it hurts.
Yeah. And um, and eventually I sort of felt like, I felt like there was something. In my side, like that hurt. Like it felt like having a stone in your body. And I was like, I know my body enough that this isn't normal. This isn't. Me. [00:09:00] Like, that's not part of my body. There's something else going on. Yeah. And so when I went back to my provider, it was somebody I trusted.
It was somebody I have a relationship with and I, you know, I mentioned it to him and he was like, oh, you know, well, you know. We can kinda look into it and see, but it's probably just a little bit of, of pain from where you had the C-section Scar tissue. Yeah. Yeah. Scar tissue. Sometimes your body doesn't like where you have a suture in there.
Yeah. You know, maybe, you know, we'll just kinda look into it that way. And at the time I was getting a tubal ligation and he said, when I go in and do my tubal ligation, I'll look around and see what's in there and you know, um, you know, whatever's in there, I'll let you know. And so we got done and he was like, well, you had a little bit of adhesions.
Maybe that's what was causing your pain. I ly them. Nothing else is going on. Everything looks good. So I'm gonna trust that because you had a visual of the inside of my body and you're telling me nothing is, [00:10:00] nothing's wrong. You, you've looked at it and so I am, you know, the pain got a little bit better.
Yeah. After the adhesions. Yep. Um, we're lyed. And so I just kind of pushed forward and then for another two and a half years, like it came back. And again, that just like rock hard feeling and I felt like I could palpate something, but I again mentioned it and palpated didn't feel anything and, and, you know.
The response was, well, you know, it's all in
Jamie: your head. No,
Jaime: I'm just teasing. Well, the response was that, you know, sometimes the adhesions can come back. Maybe we're gonna have to go back and license the adhesions. Mm-hmm. You know, maybe you just need to, you know. Maybe it's because you're a little heavier than you used to be and it's pulling on some of the scar tissue and all of that.
And so then I'm thinking, okay, it's in my head. Maybe I'm too fat. Maybe I just need to do a little bit more.
Jamie: Yeah.
Jaime: And so I'm trying to push through this and I'm trying to get through it and like people at work are noticing me. 'cause it'll just take me all of a sudden like. [00:11:00] Like something is wrong. And I, and they're like, what's wrong?
Like, you look like you're really in pain. And I'm like, I am really in pain. How did you notice? Thanks. Thanks
Jamie: for acknowledging.
Jaime: And so finally, my husband is like, you just, you know, you're in pain all the time. It makes you grumpy at home. Mm-hmm. Like, please go see someone else. And so it really took that push from my husband to go.
It's okay to admit that maybe it's not all in my head. Maybe there's something else going on. Maybe there's an ovarian torsion, maybe that, you know, maybe it's not something as simple as, as just some adhesions and, and pain and things like that. Mm-hmm. And so I ended up going to a female provider who, um.
Spent a little bit longer with me, she was able to do like a really good pelvic exam. Mm-hmm. Um, she also felt as well, and then she said, you know, I kind of feel like maybe I feel something there. Mm-hmm. And she ordered some ultrasounds and things like that and they were able to find a small area of endometriosis that had missed.
And so I had never had a history of endometriosis. Right. So it wasn't [00:12:00] something that was on the radar necessarily, but because of that messy C-section mm-hmm. And because of how it was, the endometriosis wasn't on the inside where he would've seen. Right. It was on the subcutaneous layer from where they were closing up those layers of the C-section.
And so it wasn't in a normal spot, but I knew something was wrong and I was, I, I took that relationship that I had and I took his advice that everything was okay. Said, I must be, I must just be blowing something outta proportion instead of trusting my gut and knowing my own body and knowing that something wasn't right and seeking help.
And I spent five years in severe pain that I didn't necessarily need to have, and it was a 15 minute surgery and I felt amazing afterwards. And
Jamie: Wow.
Jaime: I'm like, and I think about, mm-hmm. How, mm-hmm. Much different. My, maybe my son's life would've been, my husband's life would've been, my life would've been if I had taken that time to [00:13:00] find a provider that didn't necessarily dismiss me.
And so it's so important that we know our bodies and that we trust ourselves and not get bogged down with, oh, we just need to push through this. This is just normal.
Jamie: Right?
Jaime: And things like that.
Jamie: Right? And that is difficult to do if you're a provider. In a short amount of time.
Jaime: Mm-hmm.
Jamie: Um, and that's not how providers want to be ever.
Jaime: Absolutely.
Jamie: Ever.
Jaime: Absolutely.
[00:14:00] [00:15:00] What does it mean to you to truly listen to a patient that comes to us?
Jaime: Yeah. Or you. Absolutely. So for me to truly listen to a patient, it's not about just what. What can I like? Sometimes, you know, people come in and they tell you their symptoms, and I've not, not me necessarily, but providers will jump to a conclusion, jump to a diagnosis before even finishing the whole history, before listening to everything the, the, the patient has to say.
And so I think it's so important to allow the patient to tell their entire story. With an open mind before I'm starting to jump on different symptoms, jump on different diagnoses and things like that.
Jamie: Right.
Jaime: Um, and really just listen to all of it and put the puzzle together instead of just saying, oh, you know.[00:16:00]
You're tired all the time. You're, you're can't think you're anxious. Oh, you must have anxiety. Let's get you a pill for that and move on. Like, and so it's important to listen to all of it, but also too, it's important to find out what that patient's goal is.
Jamie: Mm-hmm.
Jaime: Like what, what do you want improved? What do you.
How do you want to improve it? Are you somebody that wants to seek pharmaceutical options? Do you want to seek wellness options? Like things like that and find out what their, their goal is? Because I can come up with a great plan all by myself, but if you don't wanna do that or it's not something that you feel that you're going to do.
It's a great plan that nobody's gonna do and nobody's gonna get better, right? And so we have to come up with a solution that's gonna work for each individual patient. It's not a cookie cutter type. Medicine. And unfortunately medicine has been pushed really far in the last several years to be like, we all [00:17:00] need this, we all need this, we all need this.
Mm-hmm. Um, guidelines are great. Guidelines are perfect. They're there to guide.
Jamie: Yes.
Jaime: And what ends up happening is people go, it has to be like this and it has to be like this. And that's. Especially with women, we are so nuanced. We are not all in one box and you, we can't all be approached exactly the same way.
We have to nuance that medicine a little bit. Our body systems have so many different hormones in them. They have so many things going on that the way that we absorb and metabolize medicine is different. The side effects that we experience are different. Think about a heart attack. We don't have the same textbook symptoms that men do, like things like that.
You have to really pay attention to the whole woman, what she's experiencing and everything, and then really tailor and optimize that health and that plan for her and what's gonna work for her body.
Jamie: Yes, absolutely. And she is always part of this decision. Absolutely. And I don't ever give just one plan.[00:18:00]
Here's, we can take this plan, this plan, this plan what works best for you. We can mix match. Mm-hmm. Um, and she deserves that. Us to trust what she knows. Mm-hmm. She needs and wants as well. Yeah. . So what do you think are some early signs of perimenopause that, um. Providers not. In this space tend to miss.
Jaime: Yeah, absolutely. Um, like you were mentioning earlier, that brain fog mm-hmm. That difficulty concentrating. So I mean, we've seen a rise of like A DHD and midlife women, and a lot of that is not necessarily a DH ADHD because you don't just all of a sudden come up with a DHD.
It's that brain fog of those hormones fluctuating. Our body does not love, especially our brains do not love brain. Fluctuations in hormones, right? You know, we're high one day, we're low the next, and our brain's like, what is going on? I can't think through this. I'm not as sharp as I used to be. I can't quite remember.
I'm putting my keys in the freezer like, you know, you know, all those things. And again, we pair that with [00:19:00] our crazy busy lives and we think, oh, it's just normal. But that's one of those things that we miss. But I mean. For people that have a history of a family history of dementia and things like that, you start worrying mm-hmm.
That those brain changes are something that are a sign of dementia to come.
Jamie: Right.
Jaime: And so like those early brain signs like that. Not being able to sleep. You think about, you know, I always think about my mother-in-law and my mother, you know, they started waking up at like 5:00 AM all of a sudden and like, and they're like, oh, it's just part of being old.
Everyone I know that's old gets up at 5:00 AM and or 4:00 AM 'cause they can't sleep. Right. Um, and that's not necessarily, that doesn't have to be the case. Right. Um, but that sleep changes those happen, you know, and again, because we're so busy and we're so, there's so many. Worries in our lives, we chalk it up to, oh, we're anxious about this, and we think about that and that's why we woke up early.
But a lot of times it's those hormonal changes. You know, progesterone really calms us [00:20:00] down and helps us sleep and everything. And those changes in progesterone, we. We don't have as much as we used to. And so we start waking up a little bit earlier. We, you know, maybe we can't fall asleep. Um, and that's where progesterone really comes into play.
Progesterone also is really calming. And so that anxiety piece that, you know, your body is starting to have more anxiety and more worry, and you're like, I never used to worry this much before. And part of that is that lack of progesterone that we're having.
Jamie: Yeah. It's piecing out because. We have less and less of a chance of becoming pregnant as we age.
And it's just kind of, Hey, you know, call, call you later. Yeah. Um, but women will say, I don't have two days of PMS symptoms. I have two weeks now.
Jaime: Mm-hmm.
Jamie: And, and that's it. 'cause the progesterone's just kind of sputtering and the first one to, to decide. He's, he's packing up. He or she, he's packing up and, and heading out.
Jaime: Yeah.
Jamie: . So what connections are you making in your patient visits that surprise [00:21:00] patients? What is their aha moment?
Jaime: I think the big connection that we make, um, with women that provides them with the aha mm-hmm. Is that a lot of these symptoms are connected.
Jamie: Yeah.
Jaime: Um, we think about, you know, why is my shoulder.
Bothering me. Mm-hmm. Being connected, frozen. Yes. That's connected with my, my dry vaginal area. Like how
Jamie: Absolutely sis
Jaime: how do those go together and my hair falling out. All of those are connected, but it is, we have estrogen receptors everywhere in our bodies. Mm-hmm. And. As our bodies start going through those changes and everything, what happens is our musculoskeletal system says, I don't like this.
Our, you know, our vaginal and reproductive system says, Nope, not good for me, friend. And then, you know, our hair is having issues and everything. And I think people realizing that all of that's interconnected and that. They're not crazy is the aha moment.
Jamie: Right. They, the women, they're like, I'm just falling apart [00:22:00] everywhere.
Jaime: Mm-hmm.
Jamie: Everywhere. Yep. And we'll laugh about it. Or sometimes we'll literally come in and sob about it. Mm-hmm. With the confusion. They're like, it's, this is like my last resort. A friend told me to come.
Jaime: Yeah.
Jamie: And let's talk about this.
Jaime: Yeah.
Jamie: The freedom of that. The freedom of making that connection and the reassurance is so therapeutic to a lot of our women.
Jaime: Absolutely. And to have that safe space where you can just. Not vent, but let somebody know and somebody else who's also experiencing that with you. Yep. And, and just really who's gonna listen to you Yes. Is empowering to women.
Jamie: Yep. Yeah. Where do you see the biggest gaps in education around midlife health for women?
Jaime: I mean, there's a lot of gaps in education around midlife health and women.
Jamie: Mm-hmm. It's changing, thank goodness.
Jaime: Yes. Yeah. I was gonna say, I think back to when, you know, we were in, late elementary, early middle school, and you have sex ed. Nobody talks about menopause. I was gonna say, they don't ever give you a menopause class when you start going through [00:23:00] midlife, yet we're expected to figure it out all of ourselves.
And so I think because there's a huge. Lack of just understanding for most women about menopause, all they can think about is hot flashes. I feel like that's the one. They say hot flashes, menopause. That's what menopause is. That's it. That's the only symptom
Jamie: I've had women say, I didn't go through menopause.
I didn't have hot flashes, and you know, they're 65. I'm like, you did, and if you don't remember it, I'm so happy for you. Yes, yes. Super, super jealous.
Jaime: My mother said the same thing. Yes. And I was like, oh no, you definitely went through menopause. Ma'am. You might not have had too many hot flashes, but you definitely went through menopause.
I can tell you exactly what you're sending.
Jamie: Your perception. Oh, that was that.
Jaime: Yes. And also, you know, it's not just that we don't necessarily understand what's going on in our bodies. But the, the whole system and training for medical providers, for nurse practitioners, for every kind of provider out there has been really lacking in menopause education.
There's, we're a whole body and we gotta get through it all. And unfortunately, hormones and menopause takes a backseat [00:24:00] because, you know, they don't, we gotta get to what we can get to in education wise, and so that tends to be the area that tends to be. Missed a lot in education. And then of course we had the WHI initiative, which put out a lot of incorrect information about hormones.
And so people just would rather not touch that.
Jamie: Right.
Jaime: Exactly. If they can help it.
Jamie: And if a hundred percent of women experience this, and this is normal and natural, why would we intervene?
Jaime: Exactly.
Jamie: And the why we would intervene is because our quality of life and our healthspan Hard stop.
Jaime: Yeah.
Jamie: Hard stop.
Yeah. So if a woman comes to you having felt dismissed elsewhere, what do you want her to know?
Jaime: I want her to know that I am here for her. I am here to listen to you every day. Yes? Yes. Yeah. I have time for you. I'm here for you. I want to know. Why you felt dismissed. I want to know how we can make you not feel dismissed.
How can I make you feel heard? And how can I get you back to where you wanna be? Or at least improve your quality of life? Yes. In a [00:25:00] positive manner. Because you don't have to be stuck in this place. You don't have to. You do not have to be broken. And feel like you're not yourself for the rest of your life, because that is the most depressing thought.
Mm-hmm. To think that you're halfway through your life, you have another 40 years, and then I'm not myself anymore and this is what I'm gonna have for the next four years, years. This is,
Jamie: yeah.
Jaime: No, we're gonna fix that.
Jamie: Absolutely. . So what kinda experience do you want women to have when they sit with you, when they come to see you at Perry? And pause.
Jaime: Yeah. I want it to be the best experience you've ever had with a provider. Be
Jamie: right
Jaime: Don. All. Yes.
Jamie: A plus. Plus,
Jaime: yes. No, but I definitely want them to know that.
Um, that I was here, I was present in the moment, and that I listened to you and that we have come up with a plan for you that's gonna make your life better. I [00:26:00] want you to feel like you have somebody that has been through it, that is going through it with you, that you are not alone, and that we're gonna come out on the other side of this better.
Jamie: Absolutely. As practitioners, I, I am glad you said that. As practitioners, we. We want our women to feel empowered and stronger and just get back to life. And that, that subtle reward inside of us to say, Hey, you know, I'd made an impact, is so humbling and empowering at the same time, I think I would say.
Jaime: I'm so excited to be part of Perry and Paul's. I love working with you guys. You have the, the best group of women, the best group of practitioners. Thank you so much. Um, and I love being here with you guys.
Jamie: Thank you so much. All right. We appreciate you spending time with us today and meeting Jamie Davis. Um, we will see you next time on Perion. Pause the podcast. [00:27:00]