Hormone Myths That Keep Women Stuck Part 1

Have you ever been told your labs are “normal” while your body insists something is off? We’re pulling apart the hormone myths that keep women stuck in that exact gap, where fatigue, brain fog, sleep problems, weight changes, mood shifts, and low libido get chalked up to stress or “just getting older.” I’m Dr. Sheri Erwin, an integrative nurse practitioner, and I want you to leave with real biology and clear clinical patterns you can bring to your next appointment.

We start with a myth that quietly derails most conversations: estrogen and testosterone are not opposites. They’re closely related hormones built from the same pathway, and your body is constantly converting and adapting based on tissue needs. That’s why symptom context matters and why a single lab number rarely tells the full story. We also take on the “normal labs mean you’re fine” problem and explain how reference ranges are designed to catch disease, not define optimal hormone health, thyroid function, or metabolic health for an individual woman.

Then we get direct about testosterone in women: what it does for energy, strength, muscle mass, bone density, libido, mood, motivation, cognitive clarity, and metabolism, and why it’s so often left out of standard care. We close by challenging the most damaging narrative of all: hormone symptoms are not automatically “just aging,” especially during the perimenopause and early postmenopause window that shapes long-term cardiovascular health, bone health, and brain health.

If this helped you, share it with a woman who needs it, subscribe so you don’t miss part two, and leave a review or message with the question you want answered next. 

Look for Part 2 next week, where we discuss another four hormone myths. 

Start Here: Take the Healthspan Baseline quiz. About three minutes, covering energy, brain fog, mood, sleep, and long-term health patterns. You'll see where to focus and receive a one-page guide: 👉 https://rootremedyic.involve.me/next-decades-healthspan-quiz

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Transcript

When Normal Results Feel Wrong

Speaker 0:00

Have you ever walked out of your doctor's appointment with your lab results and a confident everything looks normal and still felt like something was wrong? This particular episode is for you. We've been handed an oversimplified story about hormones. The estrogen and the testosterone are opposites, that hormones are either fine or they're not, that numbers tell the whole story. None of that is fully accurate. And the gap between what women are told and what is actually happening in their bodies is exactly where symptoms live unaddressed for years. Today we're going to bust those first four hormone myths that show up in most practices and the questions women ask almost on a weekly basis. Real biology, real clinical patterns, and real answers. I'm Dr. Sheri Erwin. I'm an integrative nurse practitioner with over 30 years of clinical experience specializing in women's health, hormones, and functional medicine. This podcast is built around one idea that you have more control over how you feel and how you age than most women are ever told. When you understand your current clinical health, your risk, and even what your family history may be pointing towards, you can take real steps now that change what your next decades look like. That is what we do here. Today is part of one of two series on hormone myths. We are covering the foundational science in this episode because you cannot make good decisions about your health without understanding what hormones are actually doing. Part two drops next week and covers what to do about it. So before we begin, everything I share on this podcast is for general educational purposes only. It is not medical advice and does not create a provider-patient relationship.

Why Hormone Myths Matter

Speaker 2:12

I'm an integrative nurse practitioner licensed in specific states. Please bring everything that resonates with you to your own clinician who knows your full history. If you would like to work with me specifically and you are in a state where I am licensed, please feel free to contact me. The details are in my show notes. So let's move on why this conversation really matters. Women in their 30s through 60s are navigating hormone changes that affect energy, mood, sleep, weight, cognition, libido, bone density, and your cardiovascular health. That is not a small list. That is essentially everything about you and how you feel and how you function on a daily basis. And yet that information most women receive is either dismissed entirely or told it is just stress or aging, or is reduced to a single number on a lab panel without context. Health span is the idea that how long you feel well and functional is just as important as how long you live. Hormones are essential to that conversation at every decade. So let us get into the real information.

Estrogen And Testosterone Work Together

Speaker 3:33

Let's talk about myth number one. Estrogen and testosterone are opposites. This is actually a myth that frames every hormone conversation in a way that limits it from the start. Estrogen is a female hormone. Testosterone is a male hormone. They compete. One dominates. Choose your team. Here's what is actually true. Real answers. Estrogen and testosterone are one carbon atom apart in their molecular structure. They are built from the same precursor molecules, cholesterol, and then a cascade of conversions through the pathway. Your body does not produce them in isolation and then pit them against each other. That's actually somewhat ridiculous. It produces them as part of an interconnected network that is consistently converting, signaling, and adapting. Estradiol, which is the primary form of estrogen in perimenopausal women, and testosterone differ by essentially one carbon and a few bonds. That is from a chemistry standpoint. What this actually means clinically is significant. When a woman is given testosterone therapy, some of that testosterone will convert to estrogen through an enzyme called aromatase. That conversion happens in the fat tissue, the brain, the bone, and other areas. It is not a side effect. It is a normal physiological process. When we reduce the conversation to do you need more estrogen or more testosterone, we are asking the wrong question. The better questions are what is your body producing? What is it converting? What is it using? And what do your symptoms tell us about where the gaps are? For women in their 40s and 50s especially, both estradiol and testosterone decline. That is not a coincidence. It is the same system shifting. Understanding that it is that part is the first step towards making sense of this whole system picture. Why this matters for your health span? Women who understand this are better equipped to ask informed questions about hormone therapy options. They're better able to understand why a single number on a lab panel does not tell the whole story. And to recognize that the goal is not to restore one hormone, but to support an entire system. So hopefully that helps you understand. I know there was a little bit of extra science in there, but knowledge is power.

Normal Labs Are Not The Goal

Speaker 6:29

So let's move on to myth number two. If your labs are normal, your hormones are fine. This is one of the most common and most consequential myths in women's health. And it causes real harm because it ends conversations that should actually be continuing. Your labs are normal is information. It is not a full answer. The real answer should be reference ranges on lab panels represent a broad population average. They are designed to catch disease at the extremes. They are not designed to identify the gap between normal and optimal for an individual woman. That gap is often exactly where symptoms live. Here is a concrete example. A TSH, thyroid stimulating hormone of 3.8 falls within the standard refer ranges at most labs. So does a TSH of 0.8. Those are very different physiological states for many women. The woman with a TSH of 3.8 who also has a low normal free T3, experiencing fatigue, brain fog, cold intolerance, and hair shedding may be told she is fine while her quality of life tells a completely different story. The same applies to esterdiol, testosterone, progesterone, and insulin. A fasting insulin of 14 is technically within normal ranges on most labs, but research consistently shows that a fasting insulin above eight or ten correlates with increased metabolic dysfunction. Normal is not optimal. We want you to be in optimal. This is also why symptoms matter as much as numbers. A clinician who listens to what you are experiencing and evaluates labs in that context is doing something fundamentally different from the one who scans the results for out-of-range flags and sends you home. Why this matters for your health span? Waiting until labs are definitely abnormal before addressing symptoms means years of functional decline that was not addressed, but could have been addressed. The health span argument is not to treat numbers, it is to optimize function. Those are different goals and they require different tools. Practical questions worth bringing to your provider. What is the optimal for someone my age and activity level, not just what's within range? Can we look at the full pattern of symptoms alongside the numbers rather than just the numbers in isolation? These are reasonable questions for you to ask, to be an advocate for your optimal health.

Why Women Need Testosterone

Speaker 9:46

So let's move on and look at myth number three. Testosterone is a male hormone, and women do not need much of it. This one has staying power because it sounds intuitive, right? Men have high testosterone, women have high estrogen, therefore, testosterone is not really a woman's hormone. Except that is not how any of this works. The real answer is women produce testosterone through their entire lives. In fact, throughout most of a woman's reproductive years, she produces more testosterone than esterdiol by volume. Testosterone is not incidental in a female physiology. It is a central part of it. Testosterone in women in particular influences energy and physical stamina, muscle mass and your strength, your bone density, libido and sexual function, cognitive clarity and focus, mood and motivation, and metabolic function. Testosterone levels in women peak in the mid-twenties and decline gradually from there. By the time a woman reaches her forties, her testosterone is often half of what it once was when it was at the peak. Once again, testosterone levels in women peak in the mid-twenties. That decline accelerates around menopause. And yet testosterone is rarely discussed proactively in women's health care. I think it's getting better, but we still have a long ways to go. It is not part of a standard hormone panel either. Many providers have not been trained to evaluate it in women because it is not currently FDA approved as a treatment option for women. And so it is not part of that process, a standard process. And when women do ask about it, they are sometimes told it is not relevant or that it will cause masculizing effects. There is also an important nuance here that connects back to the myth one that we talked about, because testosterone converts to estrogen through aromatis. So optimizing testosterone in a woman who is also estrogen deficient may address both problems. And in a woman with sufficient estrogen who also receives testosterone, monitoring that conversion matters. The hormones do not operate independently. So why does this matter for your health span? Testosterone is one of the most underaddressed hormones in women's health care, and one of the most relevant to how women feel and function in midlife and beyond. Especially when we look at things like muscle mass, bone density, energy, cognitive function. These are all health span issues, and testosterone is part of that conversation.

Aging Is Not A Diagnosis

Speaker 12:58

So now let's move on and take a look at myth number four. Hormone symptoms are just part of aging. This one does the most damage because it closes the door before the conversation can even begin. Of course you're tired. Of course you can't sleep well. Of course your sleep is disrupted. Of course your metabolism is slower. You're getting older. Some changes with age are real and expected. But suffering is not a baseline. And the framing of symptoms as inevitable aging is often what keeps women from getting answers for many years. The right answer is symptoms most commonly attributed to aging in women in their forties, fifties, and sixties are fatigue, brain fog, weight changes, mood shifts, sleep disruptions, low libido, joint pain, and reduced exercise tolerance. These are very frequent symptoms of physiological changes that are identifiable and in many cases addressable. The question is not whether change is happening. The question is whether the change is being supported or is it being ignored. Women who feel worse in midlife are often the ones whose hormone transition went from unrecognized for too long, not because they were weaker or less resilient, but because they were told this was normal, just part of aging, and pushed through it, and they really didn't get the support that they were needing. There is also a timing element that matters for health span. The window around menopause and perimenopause. So if we take a look at the window around perimenopause in particular, and the years immediately following menopause is one of the most significant bone health, cardiovascular health, metabolic health, and cognitive function times. What happens in that window has consequences for decades to follow. Dismissing symptoms as aging during that window is not natural. It has a downstream effect. This does not mean that every symptom requires a hormone intervention. It just means that every symptom deserves an honest clinical evaluation rather than a reflexive attribution to just age. Why this matters for your health span? Health span is about compressing the period of decline toward the end of life and extending the period of feeling well and functioning well. That requires intervening before things deteriorate significantly. The it is just aging framework directly goes against the entire goal related to health span.

Part Two Preview And Next Steps

Speaker 16:08

Those are the first four myths. Estrogen and testosterone are opposite, that normal labs mean hormones are fine, that testosterone is not a woman's issue, and that symptoms are just aging. What connects all four is the same thing, an oversimplified story that leaves women without real information at a moment when real information matters the most. Next week in part two, we're going to cover the myth about what to do about it, the truth about hormone therapy, and the WHI study, how to recognize perimenopause before it disrupts your life, what postmenopausal window actually means for long-term health, and why lifestyle alone has limits that deserve an honest conversation. I am a huge supporter of lifestyle, but there are limitations and we are going to talk about that. If this episode gave you something useful, I would love for you to share it with a woman who needs it as well. I would love to see you subscribe so you can hear all the future episodes and be alerted of them. And if you have a question you want to address, go ahead and send a message, comment, send a review. I'm Dr. Sheri Erwin, and I would like you to take one small respectful step for your body this week, and I'll talk to you next week.