The Trusted Pharmacist

What if the estrogen missing from your hormone therapy wasn't left out because it failed, but because no one could build a profitable drug around it?

Your body naturally produces three estrogens: estrone, estradiol, and estriol. Yet most hormone therapy replaces only estradiol. It is easy to assume that estriol was studied, found ineffective, and discarded. But that is not what happened. It didn't necessarily lose a scientific argument; it lost a business one, and over time, we mistook that silence for proof.

That missing conversation matters because estrogen does not produce the same effect everywhere in the body. And this could help explain why some women see their hot flashes disappear on estradiol while continuing to struggle with mood changes, disrupted sleep, brain fog, gut problems, recurrent UTIs, or unexplained inflammation. Their treatment may not be failing; it may simply be addressing only part of the hormonal picture.

In this episode, I talk about why you never hear about estriol, why it's not about effectiveness, and when to consider asking your doctor about it.

What You'll Discover in This Episode

• Why your body produces three estrogens, while most hormone therapy replaces only one

• How estriol may have lost a business argument, not a scientific one

• Why the absence of an FDA-approved estriol product does not automatically prove that estriol is ineffective

• The crucial difference between a hormone binding to a receptor and fully activating it

• How estrogen receptor alpha and estrogen receptor beta can produce very different effects throughout the body

• Why estradiol can successfully relieve hot flashes while mood, sleep, memory, gut, or inflammatory symptoms remain

• What research involving the brain, gut, immune system, and urogenital tissue suggests about receptor beta

• What human multiple sclerosis trials may reveal about estriol's potential immune effects, and what those studies cannot yet prove

• Why elevated cholesterol and metabolic health may further complicate estrogen receptor signaling

• The strongest scientific objections to combination hormone therapy—and why they deserve serious answers

• Why estriol being a "weaker" estrogen may be a feature in some formulations, not necessarily a flaw

• How poorly timed blood tests can make a compounded hormone cream appear ineffective

• What to ask your provider if your current estrogen therapy is helping, but you still do not feel like yourself

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

Research Referenced in This Episode

Every study below includes a PubMed ID (PMID), which you can use to find the original paper at PubMed.

This episode discusses hormone therapy for educational purposes only. It is not medical advice or a substitute for a conversation with your healthcare provider about your symptoms, medical history, and treatment.

• Binding affinities of 74 naturally occurring estrogen metabolites at estrogen receptors alpha and beta. Estriol demonstrated preferential binding to ERβ. Zhu BT, et al. Endocrinology. 2006. PMID: 16728493

• Comparative transcriptional activity of estradiol at ERα and ERβ. Bhavnani BR, et al. Endocrinology. 2008. PMID: 18599548

• Crystal structure research examining how estradiol interacts with ERβ. Souza PCT, et al. Scientific Reports. 2017. PMID: 28615710

• 27-hydroxycholesterol as a negative allosteric modifier of estradiol binding at ERβ. Starkey NJE, et al. Endocrinology. 2018. PMID: 29579190

• Effects of an ERβ-selective agonist and estradiol on serotonergic neurons after ovariectomy. Suzuki H, et al. Molecular Psychiatry. 2013. PMID: 22665260

• Antidepressant effects of estradiol and an ERβ-selective agonist after long-term ovarian hormone deprivation. Hou Y, et al. Journal of Psychiatry & Neuroscience. 2019. PMID: 30565903

• Effects of ERβ activation on synaptic proteins, hippocampal signaling, and memory performance. Liu F, et al. Nature Neuroscience. 2008. PMID: 18297067

• Estriol treatment, cortical atrophy, remyelination, and neuronal preservation. Meyer CE, et al. Laboratory Investigation. 2023. PMID: 37245852

• ERβ-mediated neuroprotection independent of peripheral anti-inflammatory effects. Tiwari-Woodruff S, et al. Proceedings of the National Academy of Sciences. 2007. PMID: 17785421

• Effects of ERα- and ERβ-selective agonists and estradiol on intestinal cell proliferation and apoptosis. Schleipen B, et al. Carcinogenesis. 2011. PMID: 21856997

• The role of ERβ in intestinal tight junctions and gut permeability. Braniste V, et al. American Journal of Physiology—Gastrointestinal and Liver Physiology. 2011. PMID: 21252046

• How the gut microbiome and the estrobolome influence circulating estrogen. Baker JM, et al. Maturitas. 2017. PMID: 28778332

• Immune markers in postmenopausal women receiving oral estradiol. Itaborahy RM, de Medeiros SF. Climacteric. 2016. PMID: 27593223

• Estriol treatment and changes in inflammatory and anti-inflammatory immune signals in women with multiple sclerosis. Soldan SS, et al. Journal of Immunology. 2003. PMID: 14634144

• Estriol-generated tolerogenic dendritic cells in an autoimmune model. Papenfuss TL, et al. Journal of Immunology. 2011. PMID: 21317386

• Estriol and pulmonary inflammatory gene expression during influenza infection. Vermillion MS, Ursin RL, Klein SL, et al. Endocrinology. 2018. PMID: 30032246

• Estriol regulation of TNF and IL-6 responses in a murine endotoxemia model. Zuckerman SH, et al. Inflammation. 1996. PMID: 8979148

• Review of estriol's immunomodulatory role across multiple sclerosis and other immune-mediated conditions. Ali E, Mangold C, Peiris AN. Menopause. 2017. PMID: 28375935

Human Clinical Trials of Estriol

• Phase I trial of oral estriol in women with relapsing-remitting multiple sclerosis. Inflammatory brain lesions decreased during treatment, returned after withdrawal, and decreased again when treatment resumed. Sicotte NL, et al. Annals of Neurology. 2002. PMID: 12436153

• Phase II randomized, placebo-controlled trial of estriol added to standard therapy in 164 women with relapsing-remitting multiple sclerosis. Voskuhl RR, et al. The Lancet Neurology. 2016. PMID: 26621682

• Ovarian transplantation and immune function in post-reproductive mice. King A, et al. Frontiers in Endocrinology. 2023. PMID: 36755910

• Changes in C-reactive protein among postmenopausal women using different hormone preparations in the PEPI trial. Circulation. 1999. PMID: 10500035

• Effects of oral and transdermal estradiol on C-reactive protein and other inflammatory markers. Zegura B, et al. Atherosclerosis. 2003. PMID: 12732395

This research includes receptor pharmacology, animal studies, and human clinical trials conducted in specific patient populations, most notably women with multiple sclerosis. These different forms of evidence cannot automatically establish that estriol will produce the same benefits for every woman using menopausal hormone therapy.

There is currently no large randomized controlled trial directly comparing estradiol alone with combined estradiol-and-estriol therapy in postmenopausal women. There is also no equivalent trial establishing that estradiol alone replaces everything women may lose when natural production of all three estrogens declines.

The purpose of sharing this research is not to present estriol as a miracle or to suggest that women who are doing well on estradiol should change their treatment. It is to show why the scientific conversation remains open—and to give women and their healthcare providers the sources they need to examine the evidence for themselves.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

What if your go-to sleep aid was keeping you from deep, restorative sleep?

People come into the pharmacy every day looking for over-the-counter sleep aids or sleep supplements, so I reached out to neurologist and sleep expert Dr Stasha Gominak.

She has a very different view on what's disrupting our sleep, and practical steps we can take to transform our sleep.

What You'll Discover In This Episode

• How moving indoors wrecked the brain chemical our body needs

• How common sleep aids disrupt our body's natural sleep process

• The link between Vitamin D and sleep

• Sleep Trackers: The only metric that might actually be correct

• The dosing mistake that might push you into Vitamin D deficiency

• Practical dosing and timing for key vitamins

About the Guest

Dr Stasha Gominak is a former practicing neurologist and the creator of RightSleep®, dividing her time between helping individuals, through virtual coaching sessions and teaching clinicians and coaches how to use RightSleep concepts to improve their patients' health and well being.

Dr Gominak completed a Neurology residency in 1989 at the Harvard-affiliated, Massachusetts General Hospital. In 2004 Dr. Gominak began to concentrate on treating neurological illness by improving sleep. She published a pivotal article in 2012 proposing that the global struggle with worsening sleep was linked to reduced sun exposure.

In 2016 she followed with a second article linking the change in the intestinal microbiome to the epidemic of poor sleep, and described a simple process for normalizing sleep and the intestinal bacterial population, called RightSleep®.

Learn more about RightSleep® at https://drgominak.com/

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

Why do mitochondria come up so often in conversations about energy and longevity, but rarely when women are trying to understand what is happening to their bodies in menopause?

Most people have heard mitochondria described as the "powerhouse of the cell." But they also play a role in muscle function, recovery, cellular communication, and hormone production. As we age, damaged mitochondria can build up while the body becomes less efficient at clearing them away.

Could some of the fatigue, brain fog, reduced strength, and poor recovery women are told to accept as part of menopause or aging also be connected to declining mitochondrial health?

Perimenopause dietitian-nutritionist, Jen Scheinman, explains why mitochondria deserve a bigger place in the menopause conversation.

We explore the connection between estrogen and mitochondrial function, how mitophagy helps remove damaged mitochondria, and how urolithin A may support that process.

What You'll Discover In This Episode

• Why mitochondria are often overlooked in menopause conversations

• What mitochondria do beyond producing energy

• How mitochondrial decline may contribute to fatigue and poor recovery

• The connection between estrogen and mitochondrial function

• What mitophagy is and why it slows with age

• How urolithin A supports mitochondrial cleanup

• How urolithin A differs from CoQ10 and NAD boosters

• What the research suggests about strength, endurance, and recovery

• Why mitochondrial support cannot replace sleep, exercise, and nutrition

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About the Guest

Jen Scheinman is a perimenopause dietitian-nutritionist, longevity and healthy aging expert, and women's health advocate. She holds a master's degree in integrative and functional nutrition and is the founder of Next Jen Health.

Jen also serves as Director of Science Communication at Timeline, where she helps translate emerging research on mitochondrial health, nutrition, and aging into practical guidance people can use to support their health and longevity.

Her expertise has been featured in publications including Vogue, Glamour, Mindbodygreen, and Eat This, Not That! To learn more, visit timeline.com and follow Jennifer on Instagram.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

What if the medication that's helping one health problem is quietly contributing to another?

Many of the most commonly prescribed medications for cholesterol, diabetes, acid reflux, allergies, anxiety, and pain can affect nutrient levels, hormones, sleep, memory, and energy over time. But common doesn't mean the medication is harmless.

In this episode, I explain why medications should never be put on autopilot. From statins and metformin to acid blockers and antidepressants, I share the questions every patient should be asking to better understand the long-term effects of the medications they take every day.

What You'll Discover In This Episode

• Why "normal" blood work doesn't always tell the whole story

• How common diabetes medications may contribute to fatigue, brain fog, and nerve problems

• The hidden nutrient deficiencies linked to acid reflux medications

• What statins can (and can't) tell you about your heart health and cholesterol

• Why some allergy and sleep medications may affect memory as you get older

• How certain antidepressants, pain medications, and anti-anxiety drugs can impact mood, balance, and cognition

• The questions every patient should ask before automatically refilling a prescription

• Why medications should be monitored just as carefully as the conditions they're treating

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

What happens if the thyroid medication that finally helped you feel like yourself becomes harder to access?

Natural desiccated thyroid has been used for decades, and many women prefer it because it provides both T4 and active T3. Proposed FDA changes have raised questions about its future, but they also bring a much bigger issue into focus.

Why do so many women still struggle with fatigue, brain fog, weight changes, cold intolerance, and low energy even when they are taking thyroid medication and their lab results are considered "normal"?

Pharmacist and compounding expert Nat Jones explains what more complete thyroid care can look like for women in perimenopause and menopause. We explore why T4 alone may not be enough for every woman, how stress and cortisol can interfere with thyroid function, and how compounded T4/T3 therapy can offer a more individualized approach.

What You'll Discover In This Episode

• Why some patients prefer natural desiccated thyroid to levothyroxine

• T4 vs. T3: why having both can make a meaningful difference

• What your options are if desiccated thyroid becomes harder to access

• Why women still feel hypothyroid when their TSH is "normal"

• How compounded T4 and T3 can be customized to the individual patient

• Why standard thyroid ratios do not work equally well for everyone

• The overlooked role of cortisol and chronic stress in thyroid treatment

• The additional thyroid markers that may reveal what TSH misses

• How ferritin and nutrient deficiencies can affect thyroid function

• Why Hashimoto's requires more than simply replacing thyroid hormone

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About the Guest

Nat Jones is a pharmacist and internationally recognized expert in pharmaceutical compounding. After more than 20 years as a compounding pharmacy owner, he joined Professional Compounding Centers of America (PCCA) in Houston, Texas, in 2014, where he serves in the Pharmacy Clinical Services Department.

Dermatology is Nat's primary specialty, with additional expertise in wound and scar care, autoimmune disease, endocrinology, pain management, low-dose naltrexone, GLP-1 therapies, methylene blue, ENT, urology, and men's health. He has spent decades delivering continuing education lectures at medical seminars and webinars around the world and is known for translating complex compounding science into practical strategies healthcare providers can use.

Nat was awarded Fellowship status by the International Academy of Compounding Pharmacists in 2010. He has authored numerous professional articles, e-books, case studies, and consumer publications, and has helped develop hundreds of innovative compounding formulations used by practitioners across the United States.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

What if all the work you're doing to feel younger and healthier on the inside isn't being reflected in your skin?

As women age, collagen loss can accelerate, leaving the skin thinner, less resilient, and more prone to fine lines, wrinkles, and a crepey texture. But there are ways to support the collagen you still have and help your skin better reflect how good you feel.

Pharmacist Nat Jones joins us to explain what happens to women's skin as they age and what we can do about it. We explore the role of hormones, inflammation, gut health, and collagen loss, as well as emerging ingredients such as GHK copper peptide, estriol, exosomes, and methylene blue.

His message? Supporting aging skin is not just about choosing the right ingredient. It's about understanding how the skin changes and making sure the products you use are actually formulated to work.

What You'll Discover In This Episode

• Why your skin may not reflect how healthy you feel inside

• Why preserving collagen is easier than trying to rebuild it

• The connection between hormones, inflammation, gut health, and aging skin

• GHK copper peptide: how it supports collagen and skin renewal

• Why more copper peptide does not always mean better results

• The formulation mistakes that can make skincare products ineffective

• Why vitamin C and copper peptide should not be used together

• How estriol may support thinner, aging skin

• What exosomes add to anti-aging skincare

• The surprising potential of methylene blue for sun-damaged skin

• How long it takes to see visible changes in fine lines and skin texture

About the Guest

Nat Jones is a pharmacist and internationally recognized expert in pharmaceutical compounding. After more than 20 years as a compounding pharmacy owner, he joined Professional Compounding Centers of America (PCCA) in Houston, Texas, in 2014, where he serves in the Pharmacy Clinical Services Department.

Dermatology is Nat's primary specialty, with additional expertise in wound and scar care, autoimmune disease, endocrinology, pain management, low-dose naltrexone, GLP-1 therapies, methylene blue, ENT, urology, and men's health. He has spent decades delivering continuing education lectures at medical seminars and webinars around the world and is known for translating complex compounding science into practical strategies healthcare providers can use.

Nat was awarded Fellowship status by the International Academy of Compounding Pharmacists in 2010. He has authored numerous professional articles, e-books, case studies, and consumer publications, and has helped develop hundreds of innovative compounding formulations used by practitioners across the United States.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

Perimenopause, testosterone, estrogen patches, pellets, and peptides are finally getting the attention they should have had years ago. More women are asking better questions. More providers are taking symptoms seriously. And more patients are realizing that brain fog, poor sleep, weight gain, anxiety, joint pain, skin changes, and muscle loss are not things they simply have to tolerate. But this hormone renaissance isn't always a good thing. When every social media post is talking about hormones like they are magic, some very important points and questions get missed. Are we using hormones, peptides, GLP-1s, or regenerative therapies in the right order, for the right patient, with the right testing, the right monitoring, and the right clinical judgment? In this episode, I'm joined by women's health, hormone and peptide expert Lexi Yoo. We talk about what women and practitioners are still getting wrong about hormone therapy, how to think about estrogen delivery when patches are hard to find, and why peptides should sit on top of the foundations rather than replace them. What You'll Discover In This Episode Why women don't have to wait until they are fully menopausal to start talking about hormone therapy The hormone myth Lexi wishes would disappear, especially around testosterone and women's brain health How perimenopause can change cycles, sleep, mood, metabolism, stress tolerance, and body composition Why symptoms matter, but testing still plays a critical role in responsible hormone care Why hormone therapy isn't automatically off-limits for women with a family history of breast cancer Why estrogen patches are becoming harder to find, and what other options may be worth discussing with a knowledgeable provider How pellets can be helpful for some women, and why poor monitoring creates so many bad experiences How hormone metabolites can reveal whether the body is processing estrogen in a favorable or unfavorable way Why gut health, detox pathways, methylation, bowel regularity, and inflammation can all affect hormone outcomes How peptides like BPC-157, tesamorelin, thymosin beta-4, and GHK-Cu may be used in gut health, recovery, body composition, skin, and hair conversations Why peptide sourcing, provider education, pharmacy quality, consent, and follow-up matter so much How the peptide conversation has been distorted by black-market products, online misinformation, and regulatory confusion Why GLP-1s can be a net positive when used correctly, but risky when prescribed without body composition monitoring Why muscle preservation has to be part of every serious weight loss conversation What women entering their 40s, 50s, and beyond should understand about hormones, strength training, skin, collagen, recovery, and long-term health PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About the Guest Lexi Yoo is a double board-certified nurse practitioner, functional medicine–certified clinician, women's health expert, and longevity medicine educator. She is the CEO of Yoo Direct Health, where she helps patients get to the root of complex hormone, metabolic, and wellness concerns through a more comprehensive, functional medicine approach. Her work is especially focused on the women who have been dismissed, rushed, or told to "come back when it gets worse" despite struggling with symptoms like brain fog, poor sleep, weight changes, anxiety, low libido, fatigue, skin changes, and the physical shifts of perimenopause and menopause. In addition to seeing patients clinically, Lexi trains and mentors other providers through her academy, helping clinicians better understand hormone therapy, peptides, GLP-1s, body composition, aesthetics, and longevity medicine. Her work lives at the intersection of clinical care and education, with a focus on helping both patients and providers approach women's health with more precision, curiosity, and clinical judgment. To learn more, visit https://lexiyoonp.com/ and follow Lexi on Instagram.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

Perimenopause and menopause are inevitable. But you can either crash into this transition or glide into it, and a few key factors make all the difference. This phase can feel like your entire body changed overnight and you didn't get the memo. Suddenly, you feel like a foreigner in your own skin. The clothes that used to feel fine suddenly feel irritating. Words disappear mid-sentence. You walk from one room to another and forget what you were doing. You're used to being sharp, capable, and dependable, but now getting ready, getting out the door, leading a meeting, keeping up at work, or holding the day together can feel harder than it used to. Then there is the part many women are least prepared to talk about: intimacy. Libido can shift. Sex can become painful, with burning, dryness, and discomfort showing up in ways they never used to. Then there's the impact this can have on your relationships and how this phase can leave you feeling confused, disconnected, and alone. But it doesn't have to be this way. Women are often told they have to push through or just accept this as a part of aging and carry the blame for how their bodies are changing. To glide into perimenopause and not crash, you need healthcare practitioners who understand that "normal labs" do not always tell the whole story. You need real conversations about estrogen, progesterone, testosterone, vaginal health, stress, sleep, metabolism, and the nervous system. You need a partner who listens without making the changes personal, and families, workplaces, and communities that understand this transition is real and support you. And you need to face an uncomfortable truth: that the stress, over-functioning, and constant responsibility that you used to carry effortlessly just won't work the same way anymore. In this episode, I'm joined by Dr. LaKeischa McMillan, an OB-GYN, hormone expert, author, and speaker known as "The International Menopause Whisperer." We talk about what is really happening in the body during perimenopause and menopause, why some women feel blindsided by the transition, how stress can shape the experience, why progesterone deserves a much bigger conversation, why vaginal health is medical health, and how the right support can help women move through this season with more clarity, confidence, and care. Things You'll Learn In This Episode Menopause is bigger than the ovaries Perimenopause and menopause are not just sex-hormone events. Adrenals, gut, thyroid, brain chemistry, metabolism, and nervous system all shape this transition. What gets missed when women are treated as if only their ovaries are changing? The problem with "no uterus, no progesterone" Progesterone is often treated as estrogen's "accountability partner," or as something women only need if they have a uterus. But its role may extend into sleep, calm, anxiety, palpitations, and overall quality of life. How many women are missing support because progesterone has been framed too narrowly? Vaginal symptoms are medical, not personal Burning, dryness, painful sex, and vaginal atrophy are often misdiagnosed. How much confusion and distress could be avoided if women were given better language for what is happening in their bodies? Stress is not just a lifestyle issue Stress does not cause perimenopause, but it can shape how the body moves through it. When the adrenal glands and nervous system have been in overdrive for years, what happens when the body can no longer carry stress the same way? Partners need to listen before they fix Perimenopause can affect mood, touch, libido, patience, identity, and the way a woman feels in her own body. How can partners support women without blaming, minimizing, or taking the changes personally?

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About the Guest Dr. LaKeischa McMillan is an Integrative OB-GYN, hormone specialist, and Amazon best-selling author, the International Menopause Whisperer™. She's also the host of the Hormone Hottie Hotline™️ Podcast. Through her practice, programs, and writing, she helps women (and the practitioners who care for them) move beyond confusion and dismissal toward clarity, balance, and energy. To take Dr. LaKeischa's free quiz, go to hormonequiz.co or go to https://www.talkhormones.com/ to register for a consultation. Follow @drlakeischamd on Instagram and TikTok.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!

Most people think testosterone is either a man's hormone, a gym hormone, or a dangerous hormone. So when a man in his 40s starts gaining belly fat, losing drive, struggling with focus, sleeping poorly, recovering slowly, and feeling like he's not quite himself, he's usually told one of two things: his testosterone is "normal," or he should jump straight into replacement. And when a woman in perimenopause or menopause loses her libido, energy, muscle, confidence, motivation, and sense of vitality, testosterone often isn't even part of the conversation. But the truth is more complicated and more important. Testosterone is not poison, and it is not magic. It is a powerful human hormone that plays a role in libido, metabolism, muscle, mood, bone health, brain function, recovery, and overall vitality. The problem is that too many providers are either afraid of it, casually prescribing it, or treating one number on a lab report instead of looking at the full picture. That's why the testosterone conversation has to move beyond the simple question of whether someone is low or not. The better question is: Is the hormone signal actually working? In this episode, I'm breaking down what testosterone really does in both men and women, why "normal labs" can miss the bigger picture, how poor dosing and delivery can create side effects, and what patients need to know before starting testosterone. Things You'll Learn In This Episode Women need testosterone, too Testosterone can play a role in libido, energy, mood, muscle maintenance, confidence, recovery, and vitality for women. Why are so many women still left out of this conversation entirely? More testosterone is not always better Too much testosterone can convert into estrogen or DHT, raising the risk of side effects. How do you find the lowest effective dose instead of chasing the highest number? Testosterone can affect male fertility For men who want children, testosterone replacement can suppress LH and FSH, the signals needed for sperm production. What should younger men ask before starting therapy? The delivery method matters more than most people realize Creams, gels, injections, sublingual forms, oral products, and pellets all behave differently in the body. Why can the wrong route or dosing schedule create problems even when the hormone itself is appropriate?

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

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When it comes to heart disease, conventional medicine has told us the same thing: watch your cholesterol, take the medication if you need it, eat less saturated fat, and follow the guidelines. And most women do. They get the labs done, they fill the prescriptions, they cut the butter, and they trust that the system has thought this through.

What they're rarely told is that the approach they're following has been shown, in study after study, to have almost no impact on whether heart disease actually progresses.

The marker their doctor is treating, LDL cholesterol, turns out to be the wrong target. And the dietary advice they've been given may be making things worse.

The thing that actually moves the needle looks nothing like a prescription. For thousands of patients, it started with removing one food most of them considered healthy.

Dr. William Davis is a cardiologist and the New York Times number one bestselling author of Wheat Belly. He spent nearly two decades performing cardiac interventions before concluding that the system he was trained in was treating the wrong problem, too late.

In this episode, he breaks down why the standard prevention advice doesn't work, what wheat is actually doing to the body, and what women can do right now that most cardiologists will never tell them.

Things You'll Learn In This Episode Standard heart disease protocol doesn't always work

Studies show it has almost no impact on whether coronary disease actually progresses. Why does the conventional approach keep getting recommended when the evidence doesn't support it?

Wheat does far more damage than most people realize

When patients cut wheat, they lost weight, reversed diabetes, and resolved conditions unrelated to their reasons for coming in. Why does one food affect so many different systems in the body?

GLP-1 drugs may be trading one problem for a much bigger one.

When weight is lost through calorie reduction, muscle loss follows, and the research suggests it may be permanent. What does that mean for women's long-term health?

A bacterial strain that does things no supplement is supposed to do.

Patients reported better sleep, muscle retention, improved skin, and mood shifts from something that looks like yogurt and costs almost nothing to make. What is this microbe actually doing, and why does it matter especially for women?

PS. If you enjoy the show, remember to leave a review on your favorite podcast app! Reviews help the podcast reach a wider audience and help more people.

About the Guest Dr. William Davis is a well-known preventive cardiologist and the #1 New York Times bestselling author of Wheat Belly. He's also a major advocate in the health and wellness world. He is also the author of many other bestselling books, including Undoctored: Why Health Care Has Failed You and How You Can Be Smarter Than Your Doctor. Dr. Davis works to provide powerful, personally empowering health information that frees you from the doctor and the healthcare system. His newest book, Super Body, is available to order now. https://drdavisinfinitehealth.com/2026/01/what-is-a-super-body/. To learn more, you can also go to williamdavismd.com and innercircle.drdavisinfinitehealth.com. For Dr. Davis Infinite Health lifestyle tools, supplies, supplements, and "yogurt" making go to: https://drdavisinfinitehealth.com/shop/.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today, Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 1M on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

Stay Ahead with Steve the Pharmacist!

Loving the show? Want more insights into how your body works? Head over to TheTrustedPharmacist.com and sign up with your email! You'll get the latest episodes, plus exclusive health tips to help you take charge of your wellness. Don't miss out – join me today!