Dr. Sara Gottfried: How to Optimize Female Hormone Health for Vitality & Longevity

There's one supplement that I found to be incredibly helpful for people who tend to have high cortisol at night, and that's called Cortisol Manager by Integrative Therapeutics ... It's a combination of phosphatidylserine and ashwagandha.

Intake of vegetables, polyphenols, is such an important predictor of future risk of breast cancer, like when you're at 50, 60+, and the most important time is when you're a teenager.

If you're not having a bowel movement every single morning, and you have a feeling of complete evacuation, anything less than that is constipation.

Being female is a health hazard. So, we have twice the rate of depression, insomnia. We've got 3-4x increased risk of multiple sclerosis. We've got 5-8x the risk of thyroid dysfunction.

What we know is that PCOS is not just a problem in terms of irregular periods and then difficulty getting pregnant—so those are mostly problems in your 20s, 30s, early 40s—but it is a massive risk factor for cardiovascular disease as you get older.

If women went away with one thing today, it would be to do a coronary artery calcium score by age 45—and sooner if you've got premature heart disease.

Women who use the copper IUD have the highest satisfaction rate of anyone on contraceptives ... And yet, it is the least used of all forms of contraception.

When it comes to exercise... I feel that about a third cardio, two-thirds resistance training is, based on my synthesis of the literature, the best combination.

The elevation in sex hormone-binding globulin does not seem to go away when you come off the birth control pill. To me, that is the biggest problem with prescribing oral contraceptives.

Magnesium is really the most important. And we know that somewhere around 70-80% of Americans are deficient in magnesium. That's the lowest hanging fruit.

One of the mediators that I think is important, especially for people who do what I call chronic cardio, which is what I did, is cortisol ... People who do a lot of cardio and don't do much resistance training, they tend to have much high cortisol levels.

The oral contraceptive depletes certain micronutrients ... It also affects the microbiome ... There's also an increased risk of inflammatory bowel disease, an autoimmune condition. It increases inflammatory tone...

We've got all of these women that are marching toward, potentially, a greater risk of Alzheimer's disease, and they have this opportunity in their 40s and their 50s to take hormone therapy, and they may not be offered it ... I would say, no, that is not the way to approach it.

I think it's essential that you understand what your grandmother went through ... I would probably start first with trauma and intergenerational trauma, because I think that affects the endocrine system so hugely, especially cortisol signaling.

I hope we'll have some time to talk a little bit about oral contraceptives because... I think it is the number one endocrinopathy—that is, iatrogenic—for women.

Women have a lot more constipation than men. The gut is about 10 feet longer in women compared to men.

I'm not a fan of lowering stress; I'm a fan of lowering perceived stress, and I think the distinction is really important.

Your testosterone can decline starting your 20s, depending on how much stress your matrix is under. So, for women, that can start as early as 28. Usually your testosterone declines by about 1% per year.

50% of people with major depression have high cortisol levels, higher rates of suicide, much more metabolic dysfunction.

Taking something like ibuprofen reduces the amplitude of inflammation by about 50%, but then it potentially blocks the complete resolution of inflammation.

Anytime you take oral estrogen, it raises sex hormone-binding globulin ... Sex hormone-binding globulin, I think of, as a sponge that soaks up free estrogen and free testosterone.

I look for randomized trials to support my use of probiotics, and frankly, I'm underwhelmed.