Today I'm sharing some interesting facts about testosterone for women, including the surprising fact that we actually produce more than five times more testosterone than estradiol throughout our lives. Around menopause, testosterone (along with estradiol) drop to levels close to zero- and not coincidentally a number of health conditions begin to increase.

I'm sharing exciting data supporting the fact that replacing testosterone significantly decreases the incidence of breast cancer, as well as other important diseases including osteoporosis and heart disease, while improving sexual wellness and general wellbeing.  

Rebecca Glaser M.D. - www.Hormonebalance.org

Testosterone: Strong Enough For A Man, Made For A Woman: https://www.amazon.com/Testosterone-Strong-Enough-Made-Woman/dp/0998365505

The Importance of Testosterone in Women | Empowering Midlife Wellness

Today I’m talking about why I chose hormone pellets as my own form of hormone replacement for estradiol and testosterone, as well as the pros and cons of other delivery options. Pellets, patches, creams, troches or other options are all available, but which one is best for you? I”ll be discussing all of those options and sharing some tips about how to find a provider, and what to ask them when you go to your appointment!

Why I Chose Hormone Pellets | Empowering Midlife Wellness

Having just returned from the very first "Empowering Midlife Wellness" retreat, I'm still reflecting on one of my breakout sessions, which was about how to have great sex in the second half of life. This talk was really well received, and today I want to share some of the things that we discussed--  which might not be what you were thinking! While this may be obvious, we often don't think enough about the mindset that sets the foundation for having a healthy sex life. I'll be talking again about the secrets of the sexually woke that led to my book "Sexually Woke" as well as some actionable tips and tricks for you to take to improve your sex life at any age, but especially after 50!

Get my best-selling book, Sexually Woke: Awaken the Secrets to Your Best Sex Life in Midlife & Beyond: https://amzn.to/3rm47IU

How to Have the Best Sex After 50 | Empowering Midlife Wellness

There are many opinions and a lot of controversy about the ideal levels for postmenopausal hormone replacement, so today I'm going to share what I've learned from the science, as well as my own personal experience as a patient and from thousands of patients in our own practice. I'll be talking about ideal levels for estradiol, progesterone, and testosterone, as well as discussing thyroid and cortisol levels. Enjoy!

Rebecca Glaser, MD - www.hormonebalance.org
Oura Ring - www.ouraring.com

What Should My Hormone Levels Be? | Empowering Midlife Wellness

When talking about women's health, we cannot ignore that the most common killer of both men and women is heart disease, and we are 10 times more likely to die from heart disease than breast cancer --  yet traditional medicine places very little emphasis on preventative tests especially for women. Today I'm going to share some simple and relatively inexpensive tests that every person should ask their doctor to do in order to establish her risk of heart disease, and to allow early detection of problems before symptoms would lead you to the doctor. The basic lipid panel that most doctors offer during your annual exam is not nearly enough!

Today I'll teach you what to ask for, and some of these tests you can order yourself. Of course, lifestyle changes, including keeping a healthy weight, exercising, not smoking and keeping blood pressure optimal are all incredibly important- but I will explain why doing a heart scan is arguably more important than doing a mammogram, as well as some simple blood tests that can give you actionable information that could literally add decades of healthy years to your life!

Outlive by Peter Attia - https://peterattiamd.com/outlive

Advanced Body Scan - www.advancedbodyscan.com

Fasting blood tests:
Standard Lipid/wellness panel PLUS
Apo-B
Lp-a
APOE gene
HS-CRP
Homocysteine
Insulin

Life Saving Tests for Heart Disease | Empowering Midlife Wellness

Science is pretty clear about this one thing. To have a long, healthy life, the MOST important intervention is exercise, and specifically weight-bearing exercise. 
Today I have my dear friend, Kelley Workman, master personal trainer, and midlife woman herself back with me. As many of you know, Kelley is my personal trainer and has improved my health dramatically with some very simple lifestyle changes that she will discuss today. Not only does exercise improve things that might sound obvious like osteoporosis, high blood pressure, heart disease and diabetes; but we are now learning that exercise is also very important in decreasing the risk of Alzheimer's and other neurodegenerative diseases, as well as many cancers. 
By maintaining and building muscle mass, as well as protecting our cardiovascular system, we simply get fewer diseases and live longer. Kelley will also explain the importance of eating enough protein in order to support all muscles and how small changes in your daily nutrition plan can make a dramatic difference to not only how you feel now- but to  long and how well you will live in the later decades of life. Kelley is also a co-facilitator at our upcoming retreat in Costa Rica in November!

Learn more about Kelley:
http://kelleymoves.com/

Register for the Empowering Midlife Wellness Retreat: https://tri.ps/J68Pw

The MOST Important Thing for Improving Longevity | Empowering Midlife Wellness

To celebrate Menopause Awareness Month, and today being World Menopause Day, I'm sharing my collaboration with @dominiquesachsetv ! This was a very special podcast episode where I went live to answer menopause-related questions from viewers.

We tackled an array of subjects... breast cancer, estrogen replacement, why some women deal with menopause symptoms and others don't, different ways to take hormones, sleep loss, hysterectomies, and MORE!

I hope you enjoyed this episode, and that you learned something by watching or listening. If you did, share the knowledge! And Happy World Menopause Day!

Menopause Unveiled: Dr. Susan Answers Your Most Common Menopause Questions

This week I'm chatting again with one of my new partners, menopause specialist Dr. Leah Antoneiwicz. Dr. Leah has a particular interest in perimenopause since she is experiencing this time in life herself and has some fantastic advice for other women in this confusing and misunderstood phase of hormone change. She will share some secrets that have worked not only for her patients but also for herself, including hormonal optimization, healthy nutrition and exercise, optimizing sleep, and use of specific supplements.

Navigating Perimenopause with Dr. Leah Antoniewicz | Empowering Midlife Wellness

Urine leakage is one of the more annoying and embarrassing things that can happen to us after childbirth, especially in midlife. Today I'm talking about the most common forms of urinary leakage, and especially focusing on nonsurgical ways to manage this difficult problem. I'll be introducing you to the Emsella chair, which is a fantastic option to strengthen pelvic floor muscles without the effort and exhaustion of doing Kegel exercises yourself.

The Emsella chair electrically stimulates your pelvic floor muscles for 30 minutes- which is way more than any human could complete on their own -and over the course of six treatments we see up to 80% of mild stress urinary incontinence cases completely resolve or significantly improve. Having had this procedure myself, it allowed me to avoid having surgery,  so I'm excited to share my story with you and also show you how the machine works!

The Emsella Chair Eliminates Urine Leakage Without Surgery! | Empowering Midlife Wellness

Today I'm sharing my experience visiting Composition ID in Houston, which offers two really important tests that can help improve your health and longevity. I've talked a lot about body composition (which we can measure in my office), but the most accurate way to measure it is with a DEXA scan. A DEXA scan for a body composition picks up more data than an in-office test,  since it will not only measure your body fat percentage, but will also identify exactly where the body fat is located. Not all body fat is the same, and fat around the middle and particularly inside our abdominal cavity (visceral fat) is the most significant for causing metabolic health issues. DEXA also accurately measures your muscle mass and where that muscle is located, as well as bone density. 

Another important test is VO2 max which measures the amount of oxygen that you are able to use as fuel, and accurately assesses your cardiovascular fitness and establishes your personal target training heart rate zones. In well less than an hour you can obtain both of these really important metrics, which tell you where you're starting and allow you and your provider to set up a plan to move towards optimal health. As the saying goes, "what gets measured, gets managed!" 

Visit Composition ID in Houston: https://www.compositionid.com

Must-Do Tests To Optimize Your Health! | Empowering Midlife Wellness

Now just a short time after our second Empowering Midlife Wellness retreat focusing on Activating Happiness, I'm sitting down with co-facilitators Meg Ellis and Kelley Workman to tell you all about our experience and the magic that happened in Costa Rica! In this episode we go through the details of this magical, fun and connecting 4-day weekend, as well as sharing what our guests told us, and unveiling brand new plans for our next retreat in April 2024!  I can honestly tell you this was the happiest weekend of my life, and I can hardly wait to do it again! We are delighted to share this experience with a brave group of women who are willing to step out of their comfort zones to risk becoming the best version of themselves (and have more fun that you can imagine at the same time.)

The upcoming retreat is April 19th-23rd, 2024 at El Mangroove Resort in Costa Rica, and it will not go on sale to the public until January. But for those who have an interest in getting on the VIP list, we are offering a $500 discount for those who sign up prior to February 1.  Please email hannah@drsusan.com if you would like to be on that list!

Like all of our retreats, we expect this to sell out quickly and we only have 25 spots - so email us today and we will save a spot for you!

Activating Happiness in Midlife - WE DID IT!! (and we are doing it again!)

Now almost 2 years into our holistic weight management program we have been overjoyed with the success of our patients. I am excited to be chatting with my partner Dr. Gracia Wynne Duncan regarding not only our own experience with GLP-1 agonist drugs for weight loss (specifically Semaglutide) - but also reviewing the pros and cons, the history and possible future of these drugs, and everything that you might need to know in order to make an educated decision about whether this might be a good choice for you.

You can see the details about our weight optimization program here: https://completemidlifewellnesscenter.com/holistic-medical-weight-optimization-program/

Book your appointment here: https://completemidlifewellnesscenter.com/book-your-appointment/

Ozempic/GLP-1 Agonists for Weight Loss with Dr. Gracia Wynne Duncan | Empowering Midlife Wellness

After more than 21 years, I still get multiple questions a week about hormone replacement risks, specifically regarding breast cancer, but also fears of other disease risks. Today my partner Dr. Leah Antoniewicz and I are revising the risks and benefits of hormone replacement, and the curious history of the WHI (Women's Health Initiative) study.

We'll be discussing the science behind this very emotional topic, and I hope to lay it all out there for you so that you will have the best information to present to your own doctor and make your own informed choices!

We frequently referred to the book "Estrogen Matters"  by Dr.Avrum Blooming and Dr. Carol Tavris and will put a link to that here, as well as a fascinating conversation between Dr. Peter Attia the authors on Peter's podcast.

Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women's Well-Being and Lengthen Their Lives -- Without Raising the Risk of Breast Cancer https://a.co/d/gk2hd62

Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com/

HRT, Breast Cancer, and the WHI Study with Dr. Leah | Empowering Midlife Wellness

Today I'm talking about a fascinating supplement that really walks the line between being a supplement and a drug, since it has remarkable efficacy for lowering LDL cholesterol and ApoB. Red yeast rice contains small amounts of monacolin K, which in fact is a statin. Although this supplement is safe if it comes from a reputable manufacturer, I will talk about why it's very important to be monitored by a physician and follow the same guidelines that you would use if you were taking a prescription statin. I'll talk about the pros and cons of red yeast rice, the dosing, potential side effects, and why you may (or may not)  choose to take this over a prescription statin.

Red Yeast Rice Lowered My LDL Cholesterol By 35% | Empowering Midlife Wellness

Vasomotor symptoms, commonly known as hot flashes and night sweats, affect the great majority of women in perimenopause and menopause, and are a direct result of estrogen depletion.  So it stands to reason that replacing estrogen is the number one (FDA approved) way to address these often highly unpleasant symptoms at their root.

Today I'll talk about the cause of these symptoms as well as describing the many ways they can be extremely disruptive, and will share not only why estrogen remains the best treatment, but also mention 9 other options that have been shown in clinical studies to work better than placebo.

10 Treatments for Hot Flashes & Night Sweats! | Empowering Midlife Wellness

Today I'm sitting down with my partner Dr. Leah Antoniewicz to discuss one of our new service lines, which is holistic nutrition consultation. Dr. Leah has specialty training in nutrition as well as being a menopausal gynecologic specialist, and has a 10-part approach to creating the ideal nutrition plan for each of our patients. Whether the goal is losing fat, gaining muscle or simply improving health and longevity, she will discuss how we create an individualized plan that will allow you to maximize your success.

Book your nutrition consult here:
https://completemidlifewellnesscenter.com/holistic-nutrition-consultation/

Dr. Leah's 10 Point Approach to Ideal Nutrition| Empowering Midlife Wellness

Decreased sexual desire is the most common complaint I hear regarding our changing sexuality in perimenopause and menopause. Today I'm talking about the diagnosis,  causes and potential treatments of decreased sexual desire in women. I'll go over 5 categories of potential treatments, including the science as well as my own personal experience (and that of my thousands of patients) regarding what works and what doesn't. Most importantly, this is not something that we need to just accept as part of getting older, and there are truly effective ways to make it better if you want to!

5 Ways to Improve Sex Drive in Midlife | Empowering Midlife Wellness

Do you ever feel like there is just way too much information to absorb about how to be healthy that it can sometimes leave us paralyzed and not knowing where to start? Everyday we get more information about what to do and what not to do to be healthy,  so today I'm focusing on what I call the "low hanging fruit". If we start with just one or two of these things (or a little bit of each of them), we will start moving forward in a positive direction. You don't need to be stuck feeling paralyzed because you can't be perfect. Even if you do a little bit of some of these, your health will improve, and if you do a little bit of all of them, your health will dramatically improve!

There are literally hundreds of things that we could do to improve our health,  but today I am attempting to simplify it by narrowing it down to 10....which is still a lot! You might think about picking two or three to commit to, or just do a little bit of each of them, and add more as you can. But any positive movement is better than none!

Top 10 Ways to Achieve Optimal Health | Empowering Midlife Wellness

Most of us know now that all calories are not the same, and the old model of calorie deprivation for weight loss simply doesn't work long-term. Especially in midlife, we can turn into fat storing machines due to hormone change: most importantly, insulin resistance.

Today I'm talking to Dr. Leah Antoniewicz all about insulin resistance- what is it, why does it happen and how do we overcome it with several simple and easy to implement lifestyle changes.  Her positive message will show you how you CAN be successful and achieve your optimally healthy body composition,  and keep it for the rest of your life.

Drop Belly Fat by Reducing Insulin NOT Calories! | Empowering Midlife Wellness

We have SO many requests to join our weight loss optimization program from outside of Houston, or even outside of Texas or the United States - and finally, we have created a plan that can make this work for you no matter where you live! Today I'll be describing how our weight loss optimization plan works, reminding you about the "six pillars for success" over our 12-week program,  and how this could work for you if you live in Texas... or anywhere!

Lose the Fat Forever - Our 12-Week Medical Weight Loss Optimization Program is Now Virtual!

Discover the untold story of testosterone in women and join the call for equitable healthcare options. This video describes how testosterone occurs naturally in women, how to safely replace it, and some curious history of how testosterone replacement for women has been overlooked.
💡 Why is testosterone treatment for women overlooked? Uncover the biases & advocate for change. Learn about crucial hormonal health and why we need FDA-approved testosterone therapies for women now more than ever—especially for those over 50. Insightful, empowering, and a real eye-opener!

The Truth About Testosterone For Women Over 50

Every day I am asked several times if the HORMONE REPLACEMENT causes WEIGHT LOSS, and the answer is a little bit complex - but generally YES! The important thing to know is that it is not the hormone replacement itself that causes weight loss, but the different ways in which it increases your energy, improves with sleep, improves mental outlook, muscle mass, physical strength, and all of those things that we need in order to move more and stick to our healthy nutrition plan.
Apart from ovarian hormones, it's also critical to optimize thyroid and cortisol, which are both hormones that dramatically affect our ability to lose weight. Overall, it's absolutely true that optimizing hormones can help with weight loss - by helping us to stick to our healthy nutrition, exercise, and sleep protocols ....which ultimately are the cause of weight optimization.

Can Hormone Replacement Therapy Help with Weight Loss? Uncovering the Truth

I am delighted to see more attention paid every month to issues regarding menopause and perimenopause,  with articles popping up in every magazine and newspaper, often with celebrities talking about their experiences. We're finally starting to have a voice in the world about this critical time in life. While this is a fantastic development, one of the dark sides is that it has opened up a market for companies to sell products that claim to help with menopause symptoms, but have no scientific backing. 



This is particularly worrisome because it preys on women in a very vulnerable time in life who may be experiencing truly devastating symptoms that have serious future health ramifications. 



Marketing products that are not proven to be helpful, is not only unethical, but is harming women. Today I'm talking about the business of supplements sold to improve menopause symptoms, and discussing the fact that not one single supplement has any scientific backing to support the claims that menopause symptoms are reduced. In the meantime, bioidentical hormone replacement has been rigorously studied and shown not only to be safe, but to have very important health benefits that should not be ignored because of unfounded fears. 



Each of us can make her own decision but today I'm inviting you to think and be smart, and not let people pray on our vulnerability, or assume that we are not smart enough to understand scientific studies. While the ingredients in many menopause symptoms products are very good for numerous things, none of them has been shown to help with the symptoms of menopause. 



This is an invitation to be very careful and not to believe everything that you are told by celebrities who are being paid to deliver a message that is potentially harmful.

Menopause Supplements Myth! Don’t Fall For The Hype!

Today I'm discussing a fantastic option for dealing with one of the most difficult problems that we experience in menopause, which is vaginal dryness and pain, as well as decreased sexual sensation. While hormone therapy is the mainstay for restoring vaginal health, vaginal laser therapy is another tool in the toolbox that is safe for patients who cannot take estrogen due to current or recent breast cancer, or even for patients like myself who just want a little extra boost! This week was time for my annual laser treatment and I will be taking you to the office to watch my laser treatment done live by Dr. Leah. Along with the Juliet vaginal laser, I am having an o-shot with umbilical-derived growth factors, and I will walk you through the pros and cons of all of the options and show you what the experience is like for a real-life patient!

Menopause Aid: Live Vaginal Laser Therapy & O-Shot Procedure | Overcoming Dryness & Pain

Last month my video with Dr. Antoniewicz (@drleahatoz) started the discussion about the importance of diagnosing and treating insulin resistance, not only for weight management but for lifelong health and disease reduction. 
Today we are digging more into this really important and complex topic, and highlighting some more details about what IR is, why it’s important, how we diagnose it and how we can treat it with simple concepts surrounding Nutrition, Movement, Rest and Stress (emotional and physical) management. 

If you didn’t catch Part 1, you can find here!  If you struggle with your weight, sugar addiction or just feel stuck, as  Dr. Leah says, "you are not a bad person trying to get good, you are a sick person trying to get well”. While up to 40% of American women suffer with IR (largely undiagnosed) only a small fraction are getting the help that they need. My hope is that the information you will hear today will inspire you on your wellness journey, and we are here to help you. The recipe for success in healing IR is clear, it works for our patients, and it can work for you too!

Drop Belly Fat by Reducing Insulin NOT Calories! with Dr. Antoniewicz - PART 2 | Menopause Solutions

Have  you been as confused as me about all the controversy that you hear about which fats are the healthiest? Which ones we should avoid and which we should consume more of? What does MUFA, PUFA, trans fat or saturated fat mean? Is a  low-fat diet healthy or should we aim for 30% fat or higher? Today I'll go through a basic introduction to the types of fat that are available in foods, which ones appear scientifically to be the most healthy,  and which ones we should avoid.

The Truth About Fats: The Good, The Bad, and The UGLY | Metabolism 101 | Dr. Susan Hardwick-Smith

So much has changed in our understanding of cholesterol and how it affects our risk for heart disease since I was in med school! Until recently we talked about "good cholesterol" and "bad cholesterol" with very little understanding of what those words actually meant. Today I'll attempt to unwind a little bit about what cholesterol does in our body, how to test for the particular lipoproteins that put us at highest risk for heart disease, the importance of ApoB, and most importantly what we can do to reduce our risk of heart disease based on this information.  While this is often a largely forgotten subject for women, it's important to remember that the number one killer of both men and women is cardiovascular disease, and it is critical that we understand our own heart health, and how to optimize it!

Demystifying ApoB and Lipid Panels: Understanding Your Bloodwork Results

Sometimes we have to be our own advocate and ask for the tests that we need since many doctors don't offer very high-level labs that can be critical to maximizing your healthspan and helping you to feel great. Today I'm going to go through a real patient's lab panel and show you what we look for in our office during a hormone consultation. I'll be discussing the difference between "reference ranges" and "optimal ranges" so that you can interpret your own lab values with a critical eye and make sure that you're not missing any opportunities for wellness. I'll include an actual copy of this patient's labs so that you can ask for exactly the same thing when you go to your doctor and you'll be empowered with everything you need to start on your wellness journey! 

LINK - https://completemidlifewellnesscenter.com/private-practice/womens-fasting-panel/ 

If you do get these labs done, we can also discuss them with you virtually -or in person if you find your way to Houston!

Mastering Lab Values: A Vital Handbook for Women in Menopause & Perimenopause

While the safety and benefits of menopausal hormone therapy (MHT) are becoming widely accepted, hot debate continues around dosing, delivery methods and how to monitor levels. Advisory boards including the American College of Ob/Gyn and the Menopause Society support the use of (MHT), but much confusion continues regarding ideal blood levels, whether to check blood levels at all, and optimal route of delivery. The dosing of both estradiol and testosterone varies 5-10 fold between methods such as patches, gels, sublingual methods or pellets. Both doctors and patients need to understand the dose that they are prescribing to make an educated decision. Today I will help to shed light on the differences between these options, and why my strong opinion is that blood levels are critical to ensure that levels are not too high or low for your optimal health.

Hormone Therapy for Menopause: A Guide to Doses, Levels, and Delivery Methods

This past two decades has brought so much confusion about menopausal hormone replacement and breast cancer risk, but we now are entering a modern time with a much better understanding of how all this works. 

Today I'm going to review how this controversy ever started and what the modern understanding is regarding estrogen and breast cancer. You may be surprised that we are now flipping the script and realizing that estrogen not only has no effect on increasing breast cancer risk, but actually reduces the risk of dying from breast cancer if it's started early. Not only that, but estrogen also undeniably reduces the risk of colon cancer, osteoporosis, and particularly cardiovascular disease when it is started shortly after menopause. 

We no longer recommend taking hormone replacement only for treatment of hot flashes and night sweats, or stopping it after any defined time period. The health benefits of starting it as soon as possible after menopause and taking it for life outweigh any risks for most women.

~ Dr. Susan

Estrogen and Breast Cancer: A Contemporary Perspective

Dr. Susan Hardwick-Smith is dedicated to empowering women in midlife to feel fully alive – sexually, relationally, and spiritually. An award-winning gynecologist and best-selling author of Sexually Woke, Dr. Susan believes that a woman can experience her most fulfilling life and truest self at 40, 50, and beyond. 

Join Dr. Susan and her guests as they dive into the secrets of reawakening your sex life, spirituality, relationships, and how to live the second half of life as an open field of possibility in which to play, explore, and finally be your true self.

Popular tracks by Empowering Midlife Wellness with Dr. Susan