The Dusty Muffins

If you've been told that your endometriosis, adenomyosis, or fibroids will magically improve as you approach menopause—think again. In this paradigm-shifting episode of The Dusty Muffins, our expert trio—Dr. Aoife O'Sullivan (MD, MSCP), Dr. Christine Hart Kress (DNP, MSCP), and Dr. Rebbecca Hertel (DO, MSCP)—sit down with board-certified OB-GYN and minimally invasive gynecologic surgeon Dr. Karina Hoan to debunk the myths and reveal the truth about pelvic pain and hormonal transitions.
Dr. Hoan has spent nearly a decade specializing in endometriosis and complex pelvic pain at The Portland Clinic, and she brings both surgical precision and a hormone optimization perspective to this conversation. In this episode, you'll discover:
🩸 The Perimenopause Paradox: Why endometriosis and adenomyosis often worsen during perimenopause—just when many assume symptoms should be calming down—and how fluctuating hormones drive inflammation and pain.
🏥 Beyond the Ultrasound: Why these conditions can't always be seen on imaging, and how to identify them through clinical history, symptoms, and specialist evaluation.
⚖️ The Estrogen-Progesterone Balance: The critical importance of hormonal balance for women with a history of endometriosis—and why progesterone matters as much as estrogen.
🔬 Cutting-Edge Diagnosis: The exciting potential of blood-based diagnosis for endometriosis—and what this could mean for the future of managing these conditions.
🛠️ Surgical & Medical Options: A clear-eyed look at the range of treatment options—from hormone therapy to minimally invasive surgery—and how to build a personalized plan that works for you.
💊 The Hysterectomy Hormone Question: Why women who undergo hysterectomy still need hormone support, and how ovarian function impacts menopause timing.
🧠 Mast Cell Activation & More: The emerging science of inflammation in pelvic pain—and why understanding the underlying biology can change your approach to treatment.
Tune in for an episode that replaces fear with knowledge and empowers you to take control of your gynecological health—whether you're managing endometriosis, navigating fibroids, or simply tired of being told to "just live with it."
Social Media Links:
The Dusty Muffins:
📸 Instagram → https://www.instagram.com/thedustymuffins
🔗 Linktree → https://linktr.ee/thedustymuffins
Hosts:
👩⚕️ Dr. Aoife O'Sullivan → https://www.instagram.com/portlandmenopausedoc
👩⚕️ Dr. Rebbecca Hertel → https://www.instagram.com/drrebbeccaherteldo
👩⚕️ Dr. Christine Hart Kress → https://www.instagram.com/christinehartkress_dnp
Guest – Dr. Karina Hoan:
🌐 Website → https://www.theportlandclinic.com/doctor/karina-hoan
Disclaimer: The Dusty Muffins are doctors, but they're not YOUR doctors. This is for entertainment and informational purposes only. Always consult your own healthcare provider for personalized medical advice.

When should you get your first bone density scan? Is hormone therapy truly beneficial after a certain age? And what if the answers could determine your independence—or even save your life? In this essential episode of The Dusty Muffins, your expert hosts—Dr. Aoife O'Sullivan (MD, MSCP), Dr. Christine Hart Kress (DNP, MSCP), and Dr. Rebbecca Hertel (DO, MSCP)—take on the complex intersection of bone health and hormone therapy, delivering the clarity you've been searching for.
This is a masterclass in proactive, evidence-based care that cuts through the myths and arms you with the tools you need to advocate for your health—whether you're in your 20s or decades past menopause. In this episode, you'll discover:
🦴 Bone Health at Every Age: The truth about bone density testing for women in their 20s, 30s, and beyond—including what insurance covers, how to interpret Z-scores versus T-scores, and why early intervention is your best defense.
⏰ The Hormone Timing Window: Why delaying hormone therapy can be a costly mistake when it comes to fracture risk, and why the outdated "cut-off age" for starting estrogen needs to be re-examined.
🧪 Beyond the Basics: How advanced testing like bone turnover markers can monitor treatment success in real time—and why you deserve more than a standard DEXA scan.
💊 Physiologic vs. Conventional BHRT: The differences that matter—and how injectable testosterone and other innovative delivery methods fit into a personalized health strategy.
🛡️ What Your Doctor Might Be Missing: Overlooked causes of osteoporosis such as celiac disease, medication effects, and family history—and how to advocate for comprehensive bone health assessments.
⚖️ Navigating Hormone Nuance: Practical guidance on progesterone intolerance, slow dose adjustments, and tailoring therapy to your unique body and needs.
Tune in for an episode that demystifies the science and empowers you to take control of your bone health and hormonal well-being—today and for decades to come. Because when women understand their bodies, they can make better choices, and no one has to feel like they're figuring this out alone.
Social Media Links:
The Dusty Muffins:
📸 Instagram → @thedustymuffins
🔗 Linktree → https://linktr.ee/thedustymuffins
Hosts:
👩⚕️ Dr. Aoife O'Sullivan → @portlandmenopausedoc
👩⚕️ Dr. Rebbecca Hertel → @drrebbeccaherteldo
👩⚕️ Dr. Christine Hart Kress → @christinehartkress_dnp
Disclaimer: The Dusty Muffins are doctors, but they're not YOUR doctors. This is for entertainment and informational purposes only. Always consult your own healthcare provider for personalized medical advice.

Why are we so comfortable talking about almost every part of our bodies—except the one that affects everything from bladder control to intimate pleasure? In this liberating and laugh-filled episode of The Dusty Muffins, our expert trio—Dr. Aoife O'Sullivan (MD, MSCP), Dr. Christine Hart Kress (DNP, MSCP), and Dr. Rebbecca Hertel (DO, MSCP)—sit down with chartered physiotherapist and pelvic health specialist Aoife Harvey for a conversation that breaks the silence and smashes the stigma around pelvic floor health.
Aoife is the founder of Women's Health Dublin, a specialist practice dedicated to helping women navigate pelvic health through every stage of life—from pregnancy and postpartum to perimenopause and beyond. Her message is simple but revolutionary: pelvic floor issues are common, but they are not something you have to accept. In this episode, you'll discover:
🧠 The Hidden Epidemic: Why pelvic floor dysfunction affects millions but is rarely discussed—and why shame has kept women suffering in silence for too long.
🤱 Postpartum Care Gap: The shocking contrast between countries like Ireland and the U.S. (where pelvic floor therapy is rarely standard) and places like France and Belgium (where it's routine after childbirth).
🩸 Menopause & The Pelvic Floor: How dropping estrogen affects tissue integrity, bladder control, and pelvic comfort—and why vaginal estrogen is a game-changer for many women.
💪 Myth-Busting: Why exercise isn't off the table for women with pelvic issues—and how the right kind of movement can actually support healing and strength.
🥝 Simple, Practical Solutions: From the surprising benefits of eating kiwi for fiber to actionable tips for improving pelvic health at home.
🗣️ Breaking the Silence: How open conversations—and better screening by clinicians—can normalize pelvic health and ensure women get the care they deserve.
Tune in for an episode that will have you laughing, learning, and rethinking everything you thought you knew about "down there." Because your pelvic floor is not a luxury—it's a vital part of your health, at every age.
Social Media Links:
The Dusty Muffins:
📸 Instagram → https://www.instagram.com/thedustymuffins
🔗 Linktree → https://linktr.ee/thedustymuffins
Hosts:
👩⚕️ Dr. Aoife O'Sullivan → https://www.instagram.com/portlandmenopausedoc
👩⚕️ Dr. Rebbecca Hertel → https://www.instagram.com/drrebbeccaherteldo
👩⚕️ Dr. Christine Hart Kress → https://www.instagram.com/christinehartkress_dnp
Guest – Aoife Harvey:
📸 Instagram → @womenshealthdublin
🌐 Website → https://womenshealthdublin.ie/about-aoife
Disclaimer: The Dusty Muffins are doctors, but they're not YOUR doctors. This is for entertainment and informational purposes only. Always consult your own healthcare provider for personalized medical advice.

Millions of people are walking around with thyroid symptoms—fatigue, brain fog, weight struggles, hair loss—only to be told their lab work is "normal." Sound familiar? In this eye-opening episode of The Dusty Muffins, our expert trio—Dr. Aoife O'Sullivan (MD, MSCP), Dr. Christine Hart Kress (DNP, MSCP), and Dr. Rebbecca Hertel (DO, MSCP)—sit down with nationally recognized thyroid expert McCall McPherson, PA-C, founder of Modern Thyroid Clinic and Thyroid Nation, for a conversation that will change how you think about thyroid care.
McCall is a former thyroid patient herself who spent years being dismissed and misdiagnosed. Now, she's on a mission to fix thyroid care worldwide—and she believes no one should still have thyroid symptoms. In this episode, you'll discover:
🦋 Why "Normal" Isn't Good Enough: The shocking inadequacies of standard thyroid testing and why your doctor may be missing critical information about your health.
🔬 Beyond TSH: The Full Picture: The importance of comprehensive testing—including free T3, reverse T3, and antibodies—and what these markers can reveal about your metabolic function.
💊 Why T4-Only Isn't Working: The limitations of traditional levothyroxine (Synthroid) protocols and why many patients feel dramatically better when T3 medication is added to the picture.
🧠 The Thyroid-Body Connection: How thyroid dysfunction impacts your energy, mood, weight, digestion, and even your heart—and why individualized treatment is non-negotiable.
📚 The Future of Thyroid Care: McCall's upcoming clinician training program and her new book, "Take Back Your Thyroid," designed to empower both patients and providers with better tools and knowledge.
Tune in for an episode that offers hope, answers, and a clear path forward for the millions who have been told to just "live with it." Because you deserve to feel like yourself again.
Social Media Links:
The Dusty Muffins:
📸 Instagram → @thedustymuffins
🔗 Linktree → https://linktr.ee/thedustymuffins
Hosts:
👩⚕️ Dr. Aoife O'Sullivan → @portlandmenopausedoc
👩⚕️ Dr. Rebbecca Hertel →@drrebbeccaherteldo
👩⚕️ Dr. Christine Hart Kress → @christinehartkress_dnp
Guest – McCall McPherson:
📸 Instagram → @mccallmcphersonpa
🌐 Website → https://www.modernthyroidclinic.com
Disclaimer: The Dusty Muffins are doctors, but they're not YOUR doctors. This is for entertainment and informational purposes only. Always consult your own healthcare provider for personalized medical advice.

For decades, women with PCOS have been misled. The name itself—Polycystic Ovarian Syndrome—has focused attention on the ovaries while missing the much bigger picture. But a groundbreaking shift is underway, and it's about to change everything.
In this powerful, myth-busting episode of The Dusty Muffins, your hosts—Dr. Aoife O'Sullivan (MD, MSCP), Dr. Christine Hart Kress (DNP, MSCP), and Dr. Rebbecca Hertel (DO, MSCP)—take on the outdated PCOS label and introduce a new, more accurate framework: Polyendocrine Metabolic Ovarian Syndrome (PMOS) . This is a conversation about root causes, not just symptoms—and it could transform how millions of women understand their own bodies.
In this episode, you'll discover:
🔬 The Name Was Wrong All Along: Why those aren't actually cysts on the ovary (they're immature follicles), and how this misnomer has delayed proper treatment for generations.
📋 The Problem with the Rotterdam Criteria: How the current diagnostic standards have led to confusion, missed diagnoses, and an overemphasis on reproductive organs rather than whole-body metabolic health.
🩸 Insulin Resistance is the Real Driver: How metabolic dysfunction fuels excess testosterone, inflammation, and long-term health risks—even in women with a "normal" BMI.
📊 The Metrics That Actually Matter: Why fasting insulin levels, HOMA-IR scores, and continuous glucose monitoring (CGM) are essential tools for understanding your metabolic health—and how to use them.
🏥 Beyond GYN-Centric Care: Why PMOS demands an interdisciplinary approach involving endocrinology, primary care, mental health, and more—moving away from the narrow focus on fertility and ovaries.
💪 Practical, Root-Cause Strategies: Actionable approaches to addressing insulin resistance and inflammation through resistance training, strategic nutrition, and innovative medications like GLP-1s and insulin sensitizers.
Tune in for an episode that offers hope, clarity, and a roadmap for women who have felt dismissed, misunderstood, or trapped by an outdated label. Because when you treat the root—not just the ovaries—everything changes.
Social Media Links:
The Dusty Muffins:
📸 Instagram → @thedustymuffins
🔗 Linktree → https://linktr.ee/thedustymuffins
Hosts:
👩⚕️ Dr. Aoife O'Sullivan → @portlandmenopausedoc
👩⚕️ Dr. Rebbecca Hertel → @drrebbeccaherteldo
👩⚕️ Dr. Christine Hart Kress → @christinehartkress_dnp
Disclaimer: The Dusty Muffins are doctors, but they're not YOUR doctors. This is for entertainment and informational purposes only. Always consult your own healthcare provider for personalized medical advice.