We recently connected with Aoife O’Sullivan and have shared our conversation below.

Aoife , looking forward to hearing all of your stories today. When you’ve been a professional in an industry for long enough, you’ll experience moments when the entire field takes a U-Turn, an instance where the consensus completely flips upside down or where the “best practices” completely change. If you’ve experienced such a U-Turn over the course of your professional career, we’d love to hear about it.

Over the past few years I have participated in a massive U-Turn within the world of medicine. I spent years in primary care treating women with vague, frustrating symptoms – fatigue, brain fog, night sweats, anxiety, tanking libido, weight gain and the development of metabolic syndrome, and trying to paper over the cracks with blood pressure medications, anxiety medicines, antidepressants, sleeping pills, cholesterol medications, antibiotics and osteoporosis meds. The underlying message? “You’re just getting older. Hang in there.”

But the U-Turn came when I started digging into the actual science behind menopause – not the watered-down, outdated, fear-based guidelines many of us were taught in training. I discovered that the ovaries don’t just shut down like a light switch at menopause, they gradually lose neuroendocrine function, and that function affects the entire body, from temperature regulation to cognition to cardiovascular health.

These weren’t mystery symptoms. They were hormone deficiency symptoms.

And they were treatable.

That discovery, along with revisiting the flawed interpretation of the Women’s Health Initiative (which wrongly scared a generation of women and clinicians off hormone therapy), lit a fire under me. I realized I didn’t want to keep practicing general medicine and quietly watching women suffer while putting out fires instead of treating the underlying cause of most of these issues. I wanted to specialize in menopause, dig into the data, and help women feel like themselves again.

So I pivoted. Fully. I left the traditional system, opened a menopause-focused telemedicine practice, and now I spend my days helping women thrive in what should be one of the richest, most powerful phases of life – not the most dismissed.

The U-Turn wasn’t just clinical. It was personal, professional, and philosophical. And I’ve never looked back.

Aoife , before we move on to more of these sorts of questions, can you take some time to bring our readers up to speed on you and what you do?

Hi, I’m Dr. Aoife O’Sullivan, a board-certified family physician and certified menopause practitioner with a deep love for evidence, honesty, shared decision-making… and calling out outdated medical myths when I see them.

After more than two decades of practicing medicine across urgent care, HIV care, gender-affirming care, and general outpatient settings, I realized there was one area being wildly neglected: Women’s ovarian neuroendocrine health. Women were hitting their 40s and 50s, showing up with hot flashes, anxiety, joint pain, insomnia, brain fog, and a sex drive that went on sabbatical, and because we hadn’t be taught how to help them we told them it was “just aging” or handed them an antidepressant.

But here’s what I learned, this wasn’t just aging. This was “hormonal transition”, puberty in reverse (x 1000) and there were safe, effective, evidence-based ways to treat it.

So I created my company, Portland Menopause Doc, a telemedicine practice that provides individualized, compassionate menopause care for women in Oregon and Washington. I offer a membership-based model where patients get longer visits, ongoing support, education, and access to me between appointments. I help patients navigate both hormonal and non-hormonal treatment options, manage tricky perimenopausal symptoms, address sexual health concerns, and, most importantly, make them feel seen.

With two incredible friends and colleagues I co-host a podcast called The Dusty Muffins, we use this platform to reach women and doctors in the community and provide free, accessible, evidence-based information about women’s midlife care. We are hosting a women’s health and wellness seminar in October on the East coast which I am really looking forward to.

I speak nationally on menopause and women’s health, and am part of a badass group of four doctors/friends who are changing the way menopause education is delivered to both women and clinicians. We’re not here to whisper about hot flashes. We’re here to rebrand midlife as powerful, connected, and worth investing in. Our group is called The Portland Menopause Collective and we are currently brainstorming our upcoming destination conference for women which is set for March on the Oregon Coast at the beautiful Salishan Resort and Spa.

What sets me apart? I combine science and soul. I don’t rush people. I don’t push prescriptions. I give women real information, and I respect their ability to choose what’s best for them.

What I’m most proud of? That my patients tell me they feel better. That they feel heard. That they feel like themselves again.

If you’re someone navigating the hormonal rollercoaster and wondering, “Is it just me?” the answer is no. And I’m here to help.

Learning and unlearning are both critical parts of growth – can you share a story of a time when you had to unlearn a lesson?

One of the biggest lessons I’ve had to learn, and unlearn, as a doctor is letting go of the idea that I always know best. In menopause care, that mindset just doesn’t work. This isn’t a field where you can prescribe something, set it and forget it. Hormone needs fluctuate, symptoms evolve, and most importantly, the patient is the only one living in her body. I’ve learned that it’s not only safe, but often essential, to allow patients to make small, thoughtful adjustments to their treatment between appointments. It gives us real-world data. It deepens trust. It tells me what’s actually working.

The rest of medicine doesn’t always work like this so it requires a real reframing of how we work with and treat patients. In most specialties, the doctor is driving the treatment plan. But with menopause, the patient has to be in the front seat. We’re guiding care based on how someone feels, and that makes shared decision-making non-negotiable. Acting patriarchal or rigid in this space just doesn’t serve anyone. When you really listen, patients will tell you exactly what’s wrong, and often, how to fix it. Our job is to hear them and partner with them, not assume we already know.

Because in menopause medicine, if you’re not listening to your patient, you’re just guessing—and she deserves better than that.

If you could go back in time, do you think you would have chosen a different profession or specialty?

If I could go back, I would absolutely choose the same path. I wanted to be a doctor since I could talk, before I even understood what it really meant. And somehow, it has been everything I hoped it would be and more. I’ve had the privilege of caring for people through every stage of life, across continents, specialties, and settings. I’ve worked in HIV care, gender-affirming care, urgent care, and now, in menopause medicine, which feels like the some of the most meaningful work I’ve ever done.

But the truth is, while I went through medical school and two residencies to learn how to help people, I’ve learned just as much, if not more, from my patients. They’ve taught me how to listen better, how to pivot, how to hold space for complexity, and how to let go of the illusion that there’s always one right answer. I’ve had the honor of caring for some of the most remarkable humans – smart, funny, resilient, vulnerable, and I carry their stories with me every day.

Medicine has changed a lot since I started, but the heart of it, being present, building trust, and working with people to make their lives better, still feels like a calling. And I wouldn’t trade it for anything.

Contact Info:

• Website: https://portlandmenopausedoc.com/
• Instagram: https://www.instagram.com/portlandmenopausedoc/
• Facebook: https://www.facebook.com/
• Linkedin: https://www.linkedin.com/in/aoife-o-sullivan-46b9251/
• Youtube: https://studio.youtube.com/channel/UC6ljN8LCIbjX2-BtydfFFFA/videos/upload?filter=%5B%5D&sort=%7B%22columnType%22%3A%22date%22%2C%22sortOrder%22%3A%22DESCENDING%22%7D
• Other: The Dusty Muffins Podcast:
  https://www.youtube.com/channel/UCWzozdul6g__cKF0m_sO7Mghttps://podcasts.apple.com/us/podcast/the-dusty-muffins/id1799704881

  The Dusty Muffins IG:
  https://www.instagram.com/thedustymuffins/

  M/Pause IG:
  https://www.instagram.com/pdxmenopausecollective/?hl=en

  We are about to rebrand from the portland menopause collective to M/Pause

Image Credits

Jen Borst Photography
https://www.instagram.com/j.noelphoto/?hl=en