Most women are suffering for years from anxiety, gut problems, low libido, and brain fog because no one is treating the real cause: their hormones. This episode is a masterclass in women's hormone optimization, covering everything from vaginal delivery of bioidentical hormones to why low estrogen destroys your gut, your sex drive, your mitochondria, and your marriage. 

Watch this episode on YouTube for the full video experience: https://www.youtube.com/@DaveAspreyBPR 

Host Dave Asprey sits down with Dr. Sarah Daccarett, MD, a physician, longevity expert, and the founder and CEO of Inner Balance, a modern women's health company redefining hormone therapy, sexual wellness, and aging. She has treated tens of thousands of women across all 50 states and is known for challenging outdated medical models and building science-driven solutions that reflect female biology rather than borrowing protocols designed for men. She created Oestra, a revolutionary hormone therapy delivery system, along with Libida, an on-demand libido solution that targets desire at the brain level, making her one of the most credible and innovative voices in functional medicine and women's longevity today. 

Together, they expose why conventional medicine has failed women for decades, why patches and pills are nearly useless, and what actually works for anti-aging, metabolism, longevity, and human performance. Dr. Sarah makes the case that hormone replacement therapy is not a last resort for menopausal women. It is a foundational longevity strategy that every woman should consider starting in her 20s. 

You'll Learn: 

• Why vaginal hormone delivery outperforms every other delivery method for women 
• How low estrogen destroys your gut lining, gallbladder, and immune system long before menopause symptoms appear 
• Why a carnivore or animal-based diet raises estrogen and why fiber lowers it 
• How progesterone converts to testosterone in women, and why you may not need a testosterone prescription 
• The real reason SSRIs get prescribed when hormone replacement therapy should come first 
• Why iodine is essential for breast health, estrogen metabolism, and thyroid function 
• How oxalates from "superfoods" like matcha, spinach, and almonds accumulate in your ovaries, uterus, and kidneys 
• Why both partners need hormone replacement therapy for a relationship to thrive 
• How hormones control mitochondria, dopamine, norepinephrine, and every system in your body 

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Dave Asprey is a four-time New York Times bestselling author, founder of Bulletproof Coffee, and the father of biohacking. With over 1,000 interviews and 1 million monthly listeners, The Human Upgrade brings you the knowledge to take control of your biology, extend your longevity, and optimize every system in your body and mind. Each episode delivers cutting-edge insights inhealth, performance, neuroscience, supplements, nutrition, biohacking, emotional intelligence, and conscious living. 

New episodes are released every Tuesday, Thursday, Friday, and Sunday (BONUS). Dave asks the questions no one else will and gives you real tools to become stronger, smarter, and more resilient. 

Keywords: Dr. Sarah Daccarett, Inner Balance, women's hormone therapy, bioidentical hormones, vaginal hormone delivery, estrogen deficiency, progesterone therapy, hormone replacement therapy, perimenopause, testosterone women, COMT genetics, FSH hormone, iodine deficiency, oxalates health, leaky gut hormones, women's longevity, biohacking, Dave Asprey, human performance, functional medicine, anti-aging 

Resources:   

• Visit Sarah’s Website and use code ‘PODCASTDRSARAH’: https://www.innerbalance.com/ 

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• Join My Substack (Live Access To Podcast Recordings): https://substack.daveasprey.com/ 

• Upgrade Labs: https://upgradelabs.com   

Timestamps: 

0:00 – Trailer 

1:15 – Introduction 

2:43 – The Gender Gap in Hormone Care 

5:14 – Why Women's Hormone Therapy Is Stuck in the 1960s 

8:09 – Why Young Women Are Losing Their Hormones 

9:33 – Toxins, Birth Control & Hormone Disruption 

14:07 – How Fiber Steals Your Hormones 

19:53 – Hormones, Libido & Brain Chemistry 

32:13 – Pills, Patches & Why They Fail 

36:54 – Why Vaginal Delivery Works Best 

44:36 – Symptoms of Low Hormones 

46:07 – Leaky Gut Is a Hormone Problem 

47:38 – How Low Hormones Destroy Relationships 

52:28 – Thyroid, Iodine & Sex Hormones 

1:00:29 – Progesterone for Men 

1:05:18 – Oxalates, Kidney Stones & Your Diet 

1:11:13 – Where to Find Dr. Sarah 

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