The Rich Roll Podcast Decoding Women's Health: Dr. Elizabeth Poynor On Midlife Hormonal Changes, Interventions That Actually Work, & Why Medicine Left Women Behind
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Jan 26, 2026 
Dr. Elizabeth Poynor, gynecologic oncologist and Chair of Women’s Health who focuses on midlife hormonal care, walks through ovarian aging, metabolic and brain shifts that start in the late 30s and 40s. She discusses modern transdermal hormone approaches, timing HRT for brain and bone protection, GLP-1s and metabolic strategy, plus practical testing and partner support.
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Early Metabolic And Mood Shifts
- Ovarian function begins declining in the late 30s and triggers subtle metabolic and mood changes long before menopause.
- Early insulin resistance, visceral fat gain, sleep disruption, and mood shifts often start in the late reproductive years.
Personal Turnaround With Estrogen Patch
- Dr. Elizabeth Poynor recounts her own mid-40s mood change and how an estrogen patch, suggested by her mother, rapidly improved her symptoms.
- That personal experience propelled her to study and advocate for modern hormone approaches.
Seek Evaluation — Don’t Normalize Symptoms
- Don't accept feeling 'off' as inevitable; seek evaluation and rule out other causes like thyroid or cancer first.
- Use knowledgeable GPs, gynecologists, or reputable telehealth women's-health platforms to get answers.
