In this episode I'm concluding our conversation about hormone optimization. Previously, we've discussed the difference between hormone therapy and hormone optimization, as well as the myths and benefits about hormone use for health optimization. Today, we're looking at the bigger picture of overall health and how the rest of your body plays a role in hormone balance.

How well our bodies function as we age is highly dependent on how balanced our hormones are. For women, that's not just about estrogen. It's also about how all the other major hormones in your body are balanced together. The integrity of your digestive lining is also a very important aspect of maintaining optimal hormone balance, as it plays a critical role for metabolizing and eliminating hormones.

An unhealthy, highly processed diet, a sedentary lifestyle, and common use of some medications can seriously harm your gut health—and therefore your body's ability to process hormones effectively. There are also environmental factors and stress factors that can cause inflammation and further harm your hormone and overall health.

Inflammation of the gut lining needs to be addressed if you want to improve your overall health. When estrogen is lost during menopause, it will impact the levels of all other hormones. A loss of estrogen can also reduce thyroid function too. Simply replacing estrogen during menopause is not enough to ensure a woman is feeling her best.

When estrogen declines in menopause, it affects insulin sensitvity, and this can lead to weight gain that seems more difficult to lose as you age. The earlier you start optimizing your hormones, the better you'll feel through menopause and beyond.

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Last week, I introduced the concept of what hormone optimization is and how it differs from hormone therapy. In this episode, let's focus on exploring the myths about using hormones and how you can use hormone optimization to age on your own terms.

Going through menopause means experiencing significant changes in hormone levels, including estrogen, testosterone, and progesterone. These hormone shifts will have an impact on how you feel (both mentally and physically) and may even lead you to feel a loss of control over things you had a handle on before.

Hormone therapy, especially hormone optimization, gives women the opportunity to age the way they desire. It helps women experience these changes gradually and gracefully while maintaining physical and mental function as much as possible.

The process of repair is driven by anabolic hormones, and these are the very hormones we lose with age. The earlier you start hormone optimization, the more likely you are to maintain the physical strength you have and protect yourself against osteoporosis. Despite what you may hear, hormone therapy is not risky or dangerous. When facilitated by a medical expert and professional, you can look forward to a lot of benefits.

If you choose not to look into hormone therapy or hormone optimization, you deserve to do it with both eyes open. If you're worried about being judged for asking your medical professionals about it, you're not alone. But don't let misinformation stop you from making an empowered decision for your health, especially one that can significantly impact the later years of your life.

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Hormone optimization is a new and complicated topic, and we're going to begin covering it in today's episode. As women enter menopause and seek hormone replacement therapy as a solution, it's important to have an understanding of how aging impacts the body and how hormone optimization can help.

I recently listened to a podcast which compared hormone therapy to home renovation. The host, a retired doctor, discussed using the estradiol patch with oral progesterone (a common pair used in hormone therapy today). Taking into account the doses available for these products, there are only 10 possible dose combinations available.

Do we honestly believe that these 10 combinations are going to balance the hormones of all individually unique women? While hormone replacement therapy can reduce unwanted symptoms like hot flashes, it doesn't necessarily mean you're achieving the best quality of life and highest function possible.

Optimal functional levels reflect peak performance and wellbeing—not just the reduction of one or two symptoms. It goes beyond replacing what's deficient, but instead focuses on restoring hormone levels to mirror a time in life where you looked and felt your best. Knowing the difference can help you manage expectations, should you pursue hormone replacement therapy.

Menopause management should be (and may become over the next decade or two) its own specialty. It takes vast knowledge to truly help a woman reach a balanced, optimal state through hormone replacement treatment. I believe every woman should know what hormone optimization is and the benefits it can offer.

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On today's episode we're concluding our conversation about prolapse, specifically focusing on pelvic prolapse. These pelvic floor muscles are a small yet crucial aspect of your overall muscle structure. Women who have given birth vaginally are more susceptible to experience pelvic floor prolapse, making this area of muscles even more important to know about.

Menopause can also cause various changes in the pelvic area, and the farther ahead a woman when she started menopause, the more likely she is to experience pelvic prolapse. Yes, this is in large part due to hormonal changes, however after menopause many women stop having sex. Overall, their body may be healthy, but this lack of intimacy impacts the pelvic area too.

Women tend to become highly motivated to pursue pelvic floor therapy and other types of support only after they've experienced prolapse. Essentially, they're waiting until it's too late. Pelvic prolapse is usually diagnosed in an advanced state, and women aren't usually informed about it in any meaningful way during their lives.

The earlier you start working on your pelvic health, the better results you'll have. It's important to have a significant amount of control over those muscles already in order to strengthen them. There's also a treatment called EMSELLA which is designed to help you work on your pelvic floor muscles.

There's another device called the VTone which uses electrical stimulation. This intravaginal device makes contact with the appropriate muscle groups that women can control to their level of comfort. Neither of these treatments works overnight. It takes multiple treatments to produce significant results.

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Let's continue on with our conversation about prolapse. A great number of women experience prolapse after childbirth trauma, but this can also come up many years after menopause when the loss of estrogen starts to impact a woman's pelvic floor muscles and tissues.

Women on some form of hormone therapy can still experience issues with prolapse, especially since the replacement dose is nowhere near the level a woman has when she is younger. Even a relief of symptoms, like hot flashes for instance, doesn't necessarily mean that her estrogen is back to the same level it was pre-menopause.

A woman's pelvic organs are held up by muscles, ligaments, tendons, and bones. These muscles also play a crucial role in bodily functions related to bladder control, bowel control, sexual function, and stabilizing organs during physical activity. When this is compromised, the uterus can descend into the vaginal canal to the point where you may even be able to feel it. This is called uterine prolapse.

Something similar can happen with the bladder, which is called bladder prolapse. It can lead to significant urinary incontinence and discomfort. The rectum can also prolapse into the posterior wall of the vagina. This can cause difficulty passing stool. Generally speaking, women can usually recall the event that triggered their prolapse. Before this, they have likely already experienced a gradual weakening of the pelvic floor.

Childbirth greatly increases the risk for pelvic floor prolapse. Delivering a baby through the vaginal opening results in great pressure and stress on the pelvic organs and tissues. The bigger the baby's head, the greater the risk is for prolapse. Increased abdominal fat (obesity) can also weaken pelvic floor muscles. Some individuals may also have genetic disorders that impact muscle groups, including the pelvic floor.

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In this episode we're talking about something I haven't yet approached on this show: prolapse, specifically as it relates to a very specific female condition. Many women aren't aware of the vital connection between estrogen and the health of the tissues of their pelvic floor, but you'll learn about it today.

A prolapse is caused by a weakening of the pelvic floor that supports the female organs, and this displacement can lead those female organs to descend towards the vaginal opening. There is no pill or cream that can correct this condition, especially if it's more advanced. Surgery can help, but sometimes only temporarily due to the underlying cause of the issue.

Prolapse is associated with the trauma of childbirth, but other women may never experience it until after they've gone through menopause. The loss of estrogen impacts the elasticity, tone, and consistency of the connective tissues of the pelvic floor and vaginal walls. If you maintain a strong pelvic floor, it may help you avoid prolapse as you get older.

Estrogen plays a vital role in the health of your pelvic floor, but for years, women have been told that estrogen therapy is bad for them. Therefore, so many are missing out on something that could really help them maintain the flexibility and integrity of the ligaments and connective tissue of their pelvic floor.

For women, estrogen is your best friend when it comes to your health. An optimal level helps women support their pelvic floor. Estrogen enhances blood circulation, which also brings oxygen and nutrients to the tissues (including pelvic tissues). Estrogen therapy, applied early, can prevent a severe prolapse. Consider consulting with a health professional who is trained in estrogen therapy who can give you more information.

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Today we're continuing our conversation about health insurance, health expenses, and what to consider when you're budgeting for your health. We often forget that health insurance is a business. And just like any other business, there's a lot to know, and it takes a few extra intentional steps to truly understand it.

Last episode, we discussed how your health insurance plan is not designed to maintain your health, but rather to treat diagnosed conditions and illnesses. Many people find it difficult to save for their health expenses while also paying for their insurance. So what can normal people who want to stay healthy and keep their insurance do?

More than likely, your doctors (and their support staff) are far removed from what is happening with your specific insurance plan. Between their busy schedules and managing their own work environment, they're not able to keep up with individual patient health insurance plans. The onus is on you to be prepared for your bill after each visit.

In an ideal world, insurance plans would be a lot clearer and easier to understand. The financial burden on the patients is real, but so is the financial burden on the clinic. By the time your bills are generated for your medical services, weeks may have gone by. Delayed bills confuse patients and cripple doctors, but this is just how the process goes.

Spend the time it takes to become educated on your health insurance plan. You will save yourself a lot of stress at the doctors office if you know what to expect. It's not fun to talk about it, but it is very important. Don't renew your plan without doing your due diligence, and be sure to check if your coverage will be the same as it was in previous years.

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In this episode we're diving deeper into health expenses to help you gain insight into where your money is best allocated. In the last episode, we explored how your health insurance is designed to treat illness, not to keep you healthy. Often, saving for your health treatments is the best option if you want to stay healthy.

Unfortunately, that's not an option for everybody, especially those who are already paying for expensive health plans. Be aware that most physicians, especially those working for corporations, are removed from the process of healthcare expenses. Their schedule is full and they don't have time to deeply guide you through your healthcare expenses and options.

Educating yourself is so important, especially as you get older. You have to know the basics of your insurance plan and be prepared as to what your bills will look like when you go visit your doctor. The four main numbers you need to know are: copay, coinsurance, deductible, and maximum out-of-pocket cost.

Your copay is what you have to pay every time you see your doctor, no matter what the visit is for. Your coinsurance is a percentage of the medical cost for the services you receive, and percentages vary greatly. The deductible is the amount you must pay before your health insurance plan covers any expenses. Lastly, your maximum out-of-pocket cost is the ceiling you have to meet before your insurance will pay 100% your in-network healthcare expenses.

Privately-owned, independent practices accepting health insurance are becoming less and less common. This is because their reimbursement is delayed, low, and there is poor coverage. Plus, there is also a rising cost of building a workforce, medical supplies, and more. If you can begin by educating yourself on your health insurance plan, you will make your life and your doctor's life much easier.

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Let's talk about your health goals for this year and beyond. The truth is that basic self-care practices don't always restore us to the level we desire. That's where seeking additional support comes in, but in order to use that, we first have to understand insurance plans.

The first basic question you can ask yourself is this: What kind of expense can actually bring the greatest value to your health? This can help you uncover where your money is best spent. Dedicating more time, effort, and money to your self-care now is the key to avoiding many of the health issues that some people accept come with aging.

Having an insurance plan is vital if you have a serious health condition. Not after it happens, but at the point of diagnosis. The purpose of health insurance is to support treatment of disease, not to help you maintain your health. In fact, coverage often discourages care unless it's part of an approved treatment plan for a diagnosed disease.

Don't invest in a health insurance plan if your goal is to maintain your health. The majority of people who purchase health insurance with the intention of safeguarding their health end up experiencing a rude awakening at their doctors office. It's not the best place to put your money, especially considering the other expenses many people face today outside of their health.

You may not know this, but your health insurance plan may be charging you triple (if not quadruple) what services used to cost, and here's the catch: Doctors are being paid less by insurance companies than ever before. When you find out where your money is really going, you may want to take another look at your health insurance plan and what it's really offering.

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How you can achieve your health goals in 2026 and in all the years to come? Life can (and does) get busy, and time can move by quickly. Self-care doesn't always feel easy, but prioritizing self-care is so important if you want to achieve a truly optimal state of health

Many people struggle to intentionally dedicate time to their selfcare. Why? It's often due to putting other people's health and wellness before our own, and this is especially true for women. For me, rest is going to be at the top of my priority list this year. I have a lot of obligations, responsibilities, and goals, and if I want to do all those things well I need to maintain a feeling of restoration and balance.

Our culture of achievement has its upsides. It pushes us to do more and pursue our goals, but if you want to be at your best to accomplish those things, you have to be at the top of your game. And being at the top of your game requires the best, most cared-of version of yourself.

When you take care of yourself, you're better able to deal with stress. You don't have to fight through fatigue or brain fog while working towards your goals. Self-care looks different for everybody, but for me it includes doing activities I enjoy (like pickleball and reading) and getting lots of sleep.

For you, self-care activities could include balanced hormones and hormone therapy. It may also mean eating well and getting outside. You can also include what you love to do, whether that's yoga, a community activity, or somewhere else you feel your best. I hope you'll go into each week this year remembering to put yourself first.

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