And so the question is, are we actually seeing progress or are we still stuck with testosterone in women?

Okay, there's a couple of things.

This is such a great topic.

And I'm actually, there's a couple of things I want to say.

Number one, this is the year that women's health is getting a lot of attention.

In the early part of the year with the FDA finally lifting the black box warning on estrogen after 20 years of data showing it's safe and it doesn't.

cause issues and cancers and all of those things.

So explain to people, what do you know about that?

And so what are kind of some of the things that you'll see in your 30s as a woman as your hormones change symptom wise and just feeling wise?

Yeah, so, you know, our 20s are supposed to be our main reproductive years, and I think that's part of it.

A lot of women are waiting later to reproduce.

But especially if a woman has already had babies in their 20s, the combination of that and then turning 30 just really decreases our testosterone production.

And the first thing that a lot of women don't even realize that we make testosterone, it's been...

You know, purported as a male hormone.

And women actually make testosterone.

And then as they transition into their 40s, you know, right around 40, I feel like it starts to get really bad because I feel like not only are you losing more testosterone, but then they start to lose progesterone too, right? Is that what you see? And so what do you see in your 40s typically?

Mm-hmm.

And it's like the body just kind of doesn't really bounce back from its testosterone production, but it's more than just the production.

It has a lot to do with binding globulins when, after so many babies, you know, sex hormone binding globulin tends to go up.

Could be Mother's, nature's way [laughs] of saying, "Slow your roll.

We don't need any more babies," and binds up all that free testosterone.

I don't know, but we see that consistently.

And it, there's a lot of other things that are happening as we age with receptor sites, and then of course, metabolic function, how we're functioning, that impacts our receptors.

Hmm.

it starts with your gut and your insulin, and that's what are the issues.

Well, and I think, too, what's interesting, you know, I'm thinking about a patient that I had one time that before all this reclass, it was really many years ago, when I understood that PCOS was really a metabolic iss- issue, and then we could talk about the gut because now the literature that's coming out is like, "Well, the etiology is really probably in the gut first," so which thing first.

This is what your book is all about.

But she, she was just normal body type.

She didn't look, you know, she wasn't super hairy or had a lot of, you know, mid-line hair growth that is possible.

The one and only symptom she had was irregular menstrual cycles.

And she was, was diagnosed with PCOS, and they...

I mean, the big one just got shut down for selling online Retatrutide.

How the peptides turn on certain metabolisms and seem to really help us rou- uh, right now in inflammation and muscle growth, uh, bone, skin.

Yeah.

Boy, I'll tell you, the peptide conversation is, is so amazing.

So, you know, just to educate, uh, the, the number one peptide people understand about is insulin.

It's a natural peptide.

Peptides are naturally occurring sequences of amino acids in our body.

They're so safe.

... fuel.

This is a bold, nuanced, and incredibly important conversation, so let's get into it.

Dr. Cassie Smith, we're here at the Avexa Pel training, and I couldn't not do a podcast with you since we're together because you're just such a wealth of information.

And I wanted to talk to you about, I was telling you earlier before we started, about a month or two ago, I dropped a solo episode about the misunderstanding of cardiovascular disease and where it really stems from and the concept of the gut and LPS and inflammation, and I started talking about statins and how they're really not very well studied, especially in women.

I don't know if there might be some female studies, but I haven't seen them yet.

But yet we're giving them out like candy.

We're, you know, I laid the groundwork about the association between statins and dementia, and it got a lot of interesting comments, a lot of positive.

A lot of people were on the feed going, "This makes so much sense.

Correct.