If you have ever had your testosterone checked and been told the number was “normal,” or “too high,” or “out of range,” there is something important you were probably not told.

The blood test is not measuring what most women think it is measuring.

It is measuring one slice of testosterone. A small one. And the lab range printed next to that number was built for a different purpose than guiding hormone treatment. Once you understand what the test actually shows, the whole conversation about dosing, safety, and “normal” levels changes.

You’ve probably heard people talk about estrogen like it’s either the hero or the villain when it comes to women’s health, especially breast cancer. The truth is, this area of women’s health is full of complexity, outdated research, and evolving science. But it’s also important. Because the way your body breaks down estrogen—your estrogen metabolism—can influence everything from mood and energy to long-term risks like breast cancer.

I'm often asked whether nonhormonal remedies are an effective alternative to hormone replacement therapy (HRT) for women transitioning from perimenopause to menopause (and beyond).

The vagina, vulva, urethra, bladder, and pelvic floor muscles are loaded with estrogen receptors. When estrogen declines, these organs and tissues are no longer exposed to estrogen. Women wind up with vaginal atrophy, loss of elasticity, thin tissue, changes in vaginal pH, and changes in the vaginal microbiome.