Introduction
If you’re a woman over 35 and you’re feeling exhausted, moody, or like your body just isn’t cooperating anymore—you’re not alone. Hormone imbalances, misdiagnoses, and metabolic dysfunctions are common, but they’re often brushed off as “normal aging.” They’re not.
In a recent episode of the 1st Optimal Podcast, Joe Miller sat down with DJ, a health strategist and hormone expert who combines years of experience in fitness, medical lab consulting, and women’s health. The conversation dove deep into hormone replacement therapy (HRT), gut health, insulin resistance, lab testing, and why most women are dismissed or underserved by conventional medicine.
Here’s what every high-performing woman should know.
The State of Women’s Hormone Health
Why Standard Care Often Fails Women
In traditional medicine, most general practitioners were never trained to diagnose or treat hormonal fluctuations in non-menopausal women. That’s not a slight on the provider—it’s a system problem.
Doctors are overworked and under-resourced. They rely heavily on pharmaceutical reps for continuing education and are trained to treat diseases, not optimize function.
As DJ said:
“Women’s health sits in a weird gray area. It’s not quite gynecology, and it’s not quite endocrinology. We don’t have a place to go—so we have to find providers who went above and beyond for continuing education.”
‘Normal’ Labs Aren’t the Same as ‘Optimal’
Many women are told “your labs are normal” while they’re barely able to get out of bed. That’s because “normal” is based on population averages—not ideal functioning. Optimal ranges vary by cycle phase, lifestyle, and goals.
Common but Overlooked Symptoms of Hormonal Imbalance
You don’t have to be in menopause to experience hormonal dysfunction. Common early symptoms include:
- Fatigue (especially needing daily naps)
- Decreased libido
- Vaginal dryness or discomfort
- Mood swings
- Insomnia or poor sleep quality
- Brain fog or difficulty concentrating
Women often feel dismissed or “crazy.” But what they’re experiencing could be early perimenopause or even subclinical thyroid or sex hormone shifts.
“So many women seek psychiatric help because they think they’re going crazy, when it’s really their hormones. That’s heartbreaking.” – DJ
Lab Testing: What to Ask For
Most primary care providers don’t run complete hormone panels or even understand the cycle timing needed for accurate results. At 1st Optimal, comprehensive lab testing is the cornerstone of treatment.
🧪 Here’s what to request:
Sex Hormones:
- Estradiol (E2)
- Progesterone
- Total Testosterone
- Free Testosterone
- SHBG (Sex Hormone Binding Globulin)
- DHEA-S
- LH (Luteinizing Hormone)
- FSH (Follicle Stimulating Hormone)
Thyroid Markers:
- TSH
- Free T3
- Free T4
- Reverse T3 (when applicable)
Metabolic Markers:
- Fasting Insulin
- Fasting Glucose
- HbA1C
- Lipid panel
- Cortisol (serum or saliva)
- GI-MAP test (for gut health insights)
Pro Tip: Ask for your labs to be timed according to your cycle. For example, test progesterone ~7 days after ovulation—not during your follicular phase when it’s naturally low.
HRT: Customization Matters
Why Pellets Aren’t Always the Answer
Pellet therapy offers a “set it and forget it” approach—but the downside is massive hormonal fluctuations. You feel good for a short window, then crash. Adjustments aren’t possible until the next pellet, and overdosing is common.
“Why would we want massive swings in hormones when we’re trying to fix the exact symptoms caused by those fluctuations?” – DJ
Oral Testosterone? A Red Flag 🚩
Oral testosterone (especially for women) is often poorly absorbed and can result in zero improvement—at a high cost. Worse, it can increase liver strain or androgenic effects.
Custom-Compounded HRT is Best
Creams, injectables, or micronized oral progesterone (when indicated) allow for precision dosing. Compounding pharmacies can adjust for lifestyle, weight, symptoms, and lab values.
Gut Health, Inflammation & Hormones
Your Gut Is Your Second Brain—and Hormonal Hub
DJ recently completed a GI-MAP, revealing bacterial imbalances, low diversity, and inflammation, likely driven by chronic stress—not diet.
“Even with dialed-in nutrition, my gut flora was off. It was eye-opening. Stress was the culprit.”
Gut dysbiosis can:
- Worsen hormone detoxification
- Increase systemic inflammation
- Lead to nutrient deficiencies
- Raise cortisol and disrupt insulin sensitivity
Supportive Compounds:
- BPC-157 & KPV – Anti-inflammatory peptides for gut lining repair
- L-Glutamine – Supports gut mucosa
- Digestive enzymes & bitters – Improve breakdown and absorption
GLP-1s & the Metabolic-Hormone Connection
GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) are now mainstream, but their impact goes far beyond weight loss.
PCOS, Insulin, and Hormones
GLP-1s can reduce insulin resistance, regulate appetite, and indirectly improve sex hormone balance in women with PCOS or metabolic syndrome. One study published in Obesity Reviews (2022) showed a significant improvement in ovulatory function in PCOS patients using GLP-1s.
DJ shared how even lower-income clients, who can’t afford weekly supplements or coaching, can benefit from cost-conscious GLP-1 protocols that include:
- Low doses
- Twice-weekly dosing to reduce side effects
- GDA (glucose disposal agents) like berberine on off-days
Trending Now: What’s Changing in Women’s Health
🚨 The Rise of Weight Loss Medications = More Female Health Conversations
The mainstreaming of GLP-1s has opened the door for more women to ask questions about their health. And it’s not just about weight loss anymore—it’s about energy, libido, sleep, and feeling vibrant again.
Shift from Performance to Longevity
DJ noted a positive cultural shift:
- From extreme biohacking to sustainable, evidence-based optimization
- From gym aesthetics to real-world performance and aging gracefully
FAQ: What Women 35+ Are Asking
What’s the best time in my cycle to test hormones?
Ideally, 7 days after ovulation to test progesterone and compare it to estradiol. For FSH and LH, early follicular phase (days 2–5) is best.
Can I start HRT before menopause?
Yes. Symptoms of hormonal decline begin years before menopause (aka perimenopause). Early intervention can prevent long-term issues.
How do I know if my labs are “optimal”?
“Optimal” means you function well and feel well—not just that you’re inside a wide reference range. Work with a provider who understands functional ranges.
What are signs I need gut testing?
- Bloating or irregular bowel movements
- Fatigue after eating
- Skin flare-ups
- Autoimmune issues
- Recurring infections or food sensitivities
Is HRT safe long-term?
When monitored correctly, bioidentical HRT has been shown to improve bone density, reduce cardiovascular risk, and enhance quality of life. It’s not a blanket prescription—it’s personalized medicine.
What are GLP-1s and should I consider one?
GLP-1s are medications that mimic gut hormones to regulate appetite and insulin. They’re especially helpful for insulin resistance, PCOS, and stubborn weight gain. Work with a functional provider to assess candidacy.
Conclusion
Hormonal health is too complex, too personal, and too important to trust in outdated systems. Whether you’re a high-level executive, athlete, mom—or all three—your well-being affects everything you do.
🔍 Don’t settle for feeling “fine.”
If you’re feeling off, tired, or dismissed, you’re not crazy. You might just be hormonally misaligned.
📞 Book a complimentary call with a specialist at 1st Optimal.
🧬 Or order a personalized lab panel and get the data you need to take action.
Your health isn’t just about survival. It’s about thriving.
