WEBVTT
00:00:00.000 --> 00:00:29.899
When you hear the word testosterone, I'm guessing the first word that comes to your mind probably isn't women's health Maybe it's men or muscle or libido, Or if you have spent five minutes on social media lately, you might think it's the hormone that's apparently going to fix your energy, motivation, sex drive, brain fog, muscle loss, and general enthusiasm for life And that is exactly why we need to talk about it.
00:00:30.190 --> 00:00:35.533
Women absolutely need testosterone We make testosterone naturally.
00:00:35.582 --> 00:00:38.713
It has important roles throughout our body.
00:00:39.012 --> 00:01:26.209
And for some women, testosterone therapy can be incredibly helpful But testosterone is also having a bit of a moment right now, and some of the claims being made about it have gotten ahead of the science So today I want to explain what testosterone actually does in women, what happens to it as we age, when testosterone therapy may be appropriate, and where the evidence isn't nearly as strong as social media would have you believe Before we get into it, for a little bit of context, I'm a physician assistant and I've been practicing for over 20 years, and I am going through this transition myself right now So when I talk about testosterone today, it's coming from both sides of the exam table.
00:01:26.509 --> 00:01:43.938
A little later in this video, I'm going to walk through exactly what this has looked like for me, including where we actually started with hormone replacement therapy and what we deliberately didn't start with Let's start with something surprising few women are ever taught.
00:01:44.239 --> 00:02:12.378
Testosterone is not a male hormone Men have significantly higher levels of testosterone, but women make testosterone too Before menopause, testosterone and other androgens come from both the ovaries and the adrenal glands, the little glands over your kidney And unlike estrogen and progesterone, testosterone doesn't suddenly fall off a cliff when you enter menopause Testosterone levels gradually decline with age.
00:02:12.639 --> 00:02:39.269
That's an important distinction because sometimes you'll hear that menopause causes testosterone deficiency That's not really an accurate way to describe what's happening We also don't have a clearly defined medical condition called female testosterone deficiency, where we can simply check a blood level and see that it's below a certain number and say,"There's the problem." Now, that doesn't mean that the number is meaningless.
00:02:39.558 --> 00:02:48.688
If your testosterone levels come back really low or on the low end of normal and you're dealing with symptoms that fit, that correlation matters.
00:02:48.688 --> 00:02:56.899
It is a piece of the picture that we need to take into account And that brings us to one of the most important things to understand about testosterone.
00:02:57.199 --> 00:03:12.748
A number on a lab report doesn't tell the whole story by itself Because if a testosterone level can't simply tell us whether a woman needs testosterone, how do we know when testosterone is actually part of the problem?
00:03:12.899 --> 00:03:31.149
Before we answer that, we need to understand what testosterone is doing in the first place testosterone is involved in sexual function, bone and muscle physiology, and multiple processes throughout the brain and the body This is where we have to separate two separate questions.
00:03:31.438 --> 00:03:35.348
Number one, what does testosterone do physiologically?
00:03:35.649 --> 00:03:40.318
And two, what have we actually proven testosterone therapy improves?
00:03:40.907 --> 00:03:59.986
Those are not necessarily the same thing, and that's really important We know testosterone is involved in muscle physiology, but that does not automatically mean giving additional testosterone to a midlife woman will build muscle or restore her strength We know androgens interact with the brain.
00:04:00.236 --> 00:04:27.247
That doesn't automatically mean testosterone therapy has been proven to treat brain fog, depression, or low motivation Where the evidence becomes much stronger is with sexual desire Testosterone plays an important role in sexual function, and testosterone therapy has evidence for certain women experiencing persistent low sexual desire that is causing significant distress There's actually a name for this.
00:04:27.257 --> 00:04:46.610
It's called hypoactive sexual desire disorder, or HSDD And no, that does not mean that every woman whose libido has disappeared somewhere between work and teenagers, poor sleep, vaginal discomfort, and the laundry pile has a testosterone deficiency Sexual desire is complicated.
00:04:46.910 --> 00:04:56.589
Hormones are one piece of that picture But they are not the only piece If you are enjoying this Understanding the Hormone series, I'd love for you to subscribe.
00:04:56.879 --> 00:05:13.752
My goal with these videos isn't to convince you that you need hormones or that you don't It is to give you enough information to understand your options and have a much better conversation with your healthcare provider Let's talk about why low libido isn't automatically low testosterone.
00:05:14.052 --> 00:05:25.612
This is probably the most important part of the conversation When women say that their libido has disappeared, there are a lot of things worth considering before assuming testosterone is the answer.
00:05:25.612 --> 00:05:26.692
Are you sleeping?
00:05:26.923 --> 00:05:28.023
Are you exhausted?
00:05:28.062 --> 00:05:30.043
Are you experiencing pain with sex?
00:05:30.283 --> 00:05:33.423
Has vaginal dryness made sex uncomfortable?
00:05:33.723 --> 00:05:36.612
Are medications affecting your sexual function?
00:05:36.612 --> 00:05:38.302
What's happening with your relationship?
00:05:38.603 --> 00:05:40.142
What's happening with stress?
00:05:40.382 --> 00:05:43.302
What are estrogen changes doing to your body?
00:05:43.410 --> 00:05:46.759
Because desire doesn't exist in a hormonal vacuum.
00:05:46.759 --> 00:05:51.250
Sometimes it disappears under the weakest thing in the room, not the biggest.
00:05:51.550 --> 00:05:57.589
The exhaustion that makes sex feel like one more task on a list that nobody's even grading you on.
00:05:57.889 --> 00:05:59.860
And there's another important piece.
00:06:00.139 --> 00:06:17.107
A low testosterone level by itself doesn't diagnose HSDD And a normal testosterone level doesn't necessarily tell us whether testosterone therapy could be helpful in an appropriately selected woman It doesn't mean that the lab is irrelevant.
00:06:17.257 --> 00:06:26.557
When a low or low normal number lines up with the right symptoms, that alignment is exactly what should guide the conversation.
00:06:26.557 --> 00:06:28.666
It's just never the number by itself.
00:06:28.687 --> 00:06:50.346
We need to look at the number and the symptoms and put those things together This is why the conversation has to start with the symptoms and context rather than simply chasing a lab number So if testosterone isn't something we simply replace because the lab says it's low, who actually might benefit from testosterone therapy?
00:06:50.346 --> 00:07:15.117
This is where the evidence becomes much narrower than a lot of social media would have you believe Right now, the strongest evidence for testosterone therapy in women is for that hypoactive sexual desire disorder, particularly in women after other contributors of low desire have been evaluated And this doesn't mean that researchers aren't studying testosterone for other things.
00:07:15.396 --> 00:07:23.826
They are and it doesn't mean that women aren't reporting improvements in energy, motivation, strength, and overall wellbeing.
00:07:24.127 --> 00:08:00.086
They do, but we just need more robust research to correlate it all personal experience and scientific evidence are not the same thing at this point, we do not have enough strong evidence to prescribe testosterone specifically to improve cognition, mood, energy, muscle mass, or general well-being in an otherwise healthy midlife woman And I think women need to know that distinction and you deserve to know that distinction because good perimenopause care isn't about being pro-hormone or anti-hormone.
00:08:00.086 --> 00:08:19.706
It's about understanding what we know and what we don't know yet and making an individualized decision from there I want to pause here and share my personal experience because I think it helps to hear how this actually plays out for a real woman, not just in theory And a quick caveat before I do this.
00:08:19.747 --> 00:08:21.007
This is my story.
00:08:21.007 --> 00:08:22.036
It's not a template.
00:08:22.047 --> 00:08:28.137
Your body, your history, your labs, they're going to tell a different story than mine did.
00:08:28.437 --> 00:08:33.716
This is exactly why the conversation with your own provider matters so much.
00:08:33.716 --> 00:08:36.057
No one else's timeline is yours.
00:08:36.219 --> 00:08:48.729
So for me, when I started working on my own perimenopause journey, we ran labs and my testosterone came back really low, but we didn't start replacing the testosterone.
00:08:48.729 --> 00:08:55.528
We started with estrogen and progesterone first, and we let those settle out before deciding what else was needed.
00:08:55.828 --> 00:09:01.729
Partly because sometimes bringing those hormones back into the range does some of the work on its own.
00:09:02.028 --> 00:09:10.359
Once things equilibrated for me, what was left was decreased desire and decreased energy.
00:09:10.359 --> 00:09:13.668
So that's when we made the decision to add testosterone in.
00:09:13.969 --> 00:09:16.489
Now for me, it has made an incredible difference.
00:09:16.788 --> 00:09:19.519
My desire has significantly improved.
00:09:19.558 --> 00:09:22.938
My husband is very thankful and grateful for this.
00:09:23.239 --> 00:09:32.519
But my energy has come back, and honestly, my confidence has come back with it and if I'm being honest, I probably could have used this testosterone boost 10 years earlier.
00:09:32.589 --> 00:09:37.239
But here we are, and that's part of why I wanted to make this video in the first place.
00:09:37.538 --> 00:09:39.438
This is a crazy ride.
00:09:39.448 --> 00:09:49.828
This perimenopausal phase, so much is going on, and we just need that information out there So let's talk about one of the problems that we're experiencing.
00:09:50.129 --> 00:09:51.788
There's another wrinkle here.
00:09:51.808 --> 00:10:12.339
In the United States, there is no currently FDA-approved testosterone product specifically formulated for women That means that clinicians who prescribe testosterone to women are generally using it off-label And because women need significantly smaller dosages than men, that dosing matters.
00:10:12.339 --> 00:10:18.828
More is absolutely not better There's different ways that this is being prescribed.
00:10:19.068 --> 00:10:23.818
There's compounding pharmacies that a lot of women are getting testosterone through.
00:10:24.119 --> 00:10:34.349
There are pellets, which I would advise against, and there is instances where women are being prescribed the medication meant for men and just dosing it down.
00:10:34.349 --> 00:10:46.158
Talk with your provider So going back to the more doesn't mean better, it matters because when you're desperate for relief, you might be tempted to think that more must be doing more.
00:10:46.458 --> 00:10:50.219
Unfortunately, too much of a good thing can cause problems, right?
00:10:50.219 --> 00:10:59.688
So too much testosterone can cause acne, increased facial hair or body hair, scalp hair thinning or other androgenic effects.
00:10:59.989 --> 00:11:05.749
That's also why monitoring matters The goal isn't to push testosterone as high as possible.
00:11:06.048 --> 00:11:38.369
It's to keep levels within physiologic range expected for women while assessing whether the symptoms we're experiencing are actually improving this is also why I'd be cautious about anyone selling testosterone as an anti-aging shortcut or promising that one hormone is gonna fix everything you're experiencing in midlife Hormones are powerful, and that's precisely why we deserve thoughtful use And there's one more reason why I don't think that testosterone should be the first hormone that we reach for.
00:11:38.668 --> 00:12:01.332
Sometimes the symptoms a woman attributes to testosterone are being driven by something else It could be poor sleep, hot flashes, vaginal discomfort, mood changes All of these can absolutely affect energy, motivation, sexual desire, and quality of life So before deciding that testosterone is the missing piece, it makes sense to look at the whole picture.
00:12:01.633 --> 00:12:04.552
What symptoms are actually bothering you?
00:12:04.852 --> 00:12:07.072
What else could be contributing?
00:12:07.373 --> 00:12:11.513
Are your estrogen-related symptoms adequately being addressed?
00:12:11.513 --> 00:12:14.812
Are medications or other health conditions playing a role?
00:12:15.113 --> 00:12:21.753
Before you choose one hormone, it's worth looking at the terrain that hormone is actually operating on.
00:12:21.753 --> 00:12:27.763
Because treating hormones isn't about replacing every number on a lab report until it looks like you're 25 again.
00:12:28.062 --> 00:12:34.523
It's about treating the woman sitting right in front of you If you remember one thing from today's video, let it be this.
00:12:34.552 --> 00:13:07.783
Testosterone matters in women It isn't just a male hormone and it isn't just about sex, but that also doesn't mean testosterone is the missing answer for every woman who feels tired, unmotivated, or different in midlife The science right now is strongest in one particular area, persistent, distressing low sexual desire in appropriately selected women For everything else, we're still learning, and I actually think that's an empowering place to be You don't need someone promising that testosterone will fix everything.
00:13:08.082 --> 00:13:26.663
You need good information, a clinician willing to look at the whole picture, and a treatment plan built around you rather than a specific number on a report next in our Understanding Hormone series, we're gonna tackle one of the most frustrating things that women hear during perimenopause.
00:13:26.962 --> 00:13:38.543
Your labs are normal normal hormone labs do not necessarily mean you aren't in perimenopause, and we are gonna talk about that and explain why Thanks again for watching, and I'll see you next time
00:00:00.000 --> 00:00:29.899
When you hear the word testosterone, I'm guessing the first word that comes to your mind probably isn't women's health Maybe it's men or muscle or libido, Or if you have spent five minutes on social media lately, you might think it's the hormone that's apparently going to fix your energy, motivation, sex drive, brain fog, muscle loss, and general enthusiasm for life And that is exactly why we need to talk about it.
00:00:30.190 --> 00:00:35.533
Women absolutely need testosterone We make testosterone naturally.
00:00:35.582 --> 00:00:38.713
It has important roles throughout our body.
00:00:39.012 --> 00:01:26.209
And for some women, testosterone therapy can be incredibly helpful But testosterone is also having a bit of a moment right now, and some of the claims being made about it have gotten ahead of the science So today I want to explain what testosterone actually does in women, what happens to it as we age, when testosterone therapy may be appropriate, and where the evidence isn't nearly as strong as social media would have you believe Before we get into it, for a little bit of context, I'm a physician assistant and I've been practicing for over 20 years, and I am going through this transition myself right now So when I talk about testosterone today, it's coming from both sides of the exam table.
00:01:26.509 --> 00:01:43.938
A little later in this video, I'm going to walk through exactly what this has looked like for me, including where we actually started with hormone replacement therapy and what we deliberately didn't start with Let's start with something surprising few women are ever taught.
00:01:44.239 --> 00:02:12.378
Testosterone is not a male hormone Men have significantly higher levels of testosterone, but women make testosterone too Before menopause, testosterone and other androgens come from both the ovaries and the adrenal glands, the little glands over your kidney And unlike estrogen and progesterone, testosterone doesn't suddenly fall off a cliff when you enter menopause Testosterone levels gradually decline with age.
00:02:12.639 --> 00:02:39.269
That's an important distinction because sometimes you'll hear that menopause causes testosterone deficiency That's not really an accurate way to describe what's happening We also don't have a clearly defined medical condition called female testosterone deficiency, where we can simply check a blood level and see that it's below a certain number and say,"There's the problem." Now, that doesn't mean that the number is meaningless.
00:02:39.558 --> 00:02:48.688
If your testosterone levels come back really low or on the low end of normal and you're dealing with symptoms that fit, that correlation matters.
00:02:48.688 --> 00:02:56.899
It is a piece of the picture that we need to take into account And that brings us to one of the most important things to understand about testosterone.
00:02:57.199 --> 00:03:12.748
A number on a lab report doesn't tell the whole story by itself Because if a testosterone level can't simply tell us whether a woman needs testosterone, how do we know when testosterone is actually part of the problem?
00:03:12.899 --> 00:03:31.149
Before we answer that, we need to understand what testosterone is doing in the first place testosterone is involved in sexual function, bone and muscle physiology, and multiple processes throughout the brain and the body This is where we have to separate two separate questions.
00:03:31.438 --> 00:03:35.348
Number one, what does testosterone do physiologically?
00:03:35.649 --> 00:03:40.318
And two, what have we actually proven testosterone therapy improves?
00:03:40.907 --> 00:03:59.986
Those are not necessarily the same thing, and that's really important We know testosterone is involved in muscle physiology, but that does not automatically mean giving additional testosterone to a midlife woman will build muscle or restore her strength We know androgens interact with the brain.
00:04:00.236 --> 00:04:27.247
That doesn't automatically mean testosterone therapy has been proven to treat brain fog, depression, or low motivation Where the evidence becomes much stronger is with sexual desire Testosterone plays an important role in sexual function, and testosterone therapy has evidence for certain women experiencing persistent low sexual desire that is causing significant distress There's actually a name for this.
00:04:27.257 --> 00:04:46.610
It's called hypoactive sexual desire disorder, or HSDD And no, that does not mean that every woman whose libido has disappeared somewhere between work and teenagers, poor sleep, vaginal discomfort, and the laundry pile has a testosterone deficiency Sexual desire is complicated.
00:04:46.910 --> 00:04:56.589
Hormones are one piece of that picture But they are not the only piece If you are enjoying this Understanding the Hormone series, I'd love for you to subscribe.
00:04:56.879 --> 00:05:13.752
My goal with these videos isn't to convince you that you need hormones or that you don't It is to give you enough information to understand your options and have a much better conversation with your healthcare provider Let's talk about why low libido isn't automatically low testosterone.
00:05:14.052 --> 00:05:25.612
This is probably the most important part of the conversation When women say that their libido has disappeared, there are a lot of things worth considering before assuming testosterone is the answer.
00:05:25.612 --> 00:05:26.692
Are you sleeping?
00:05:26.923 --> 00:05:28.023
Are you exhausted?
00:05:28.062 --> 00:05:30.043
Are you experiencing pain with sex?
00:05:30.283 --> 00:05:33.423
Has vaginal dryness made sex uncomfortable?
00:05:33.723 --> 00:05:36.612
Are medications affecting your sexual function?
00:05:36.612 --> 00:05:38.302
What's happening with your relationship?
00:05:38.603 --> 00:05:40.142
What's happening with stress?
00:05:40.382 --> 00:05:43.302
What are estrogen changes doing to your body?
00:05:43.410 --> 00:05:46.759
Because desire doesn't exist in a hormonal vacuum.
00:05:46.759 --> 00:05:51.250
Sometimes it disappears under the weakest thing in the room, not the biggest.
00:05:51.550 --> 00:05:57.589
The exhaustion that makes sex feel like one more task on a list that nobody's even grading you on.
00:05:57.889 --> 00:05:59.860
And there's another important piece.
00:06:00.139 --> 00:06:17.107
A low testosterone level by itself doesn't diagnose HSDD And a normal testosterone level doesn't necessarily tell us whether testosterone therapy could be helpful in an appropriately selected woman It doesn't mean that the lab is irrelevant.
00:06:17.257 --> 00:06:26.557
When a low or low normal number lines up with the right symptoms, that alignment is exactly what should guide the conversation.
00:06:26.557 --> 00:06:28.666
It's just never the number by itself.
00:06:28.687 --> 00:06:50.346
We need to look at the number and the symptoms and put those things together This is why the conversation has to start with the symptoms and context rather than simply chasing a lab number So if testosterone isn't something we simply replace because the lab says it's low, who actually might benefit from testosterone therapy?
00:06:50.346 --> 00:07:15.117
This is where the evidence becomes much narrower than a lot of social media would have you believe Right now, the strongest evidence for testosterone therapy in women is for that hypoactive sexual desire disorder, particularly in women after other contributors of low desire have been evaluated And this doesn't mean that researchers aren't studying testosterone for other things.
00:07:15.396 --> 00:07:23.826
They are and it doesn't mean that women aren't reporting improvements in energy, motivation, strength, and overall wellbeing.
00:07:24.127 --> 00:08:00.086
They do, but we just need more robust research to correlate it all personal experience and scientific evidence are not the same thing at this point, we do not have enough strong evidence to prescribe testosterone specifically to improve cognition, mood, energy, muscle mass, or general well-being in an otherwise healthy midlife woman And I think women need to know that distinction and you deserve to know that distinction because good perimenopause care isn't about being pro-hormone or anti-hormone.
00:08:00.086 --> 00:08:19.706
It's about understanding what we know and what we don't know yet and making an individualized decision from there I want to pause here and share my personal experience because I think it helps to hear how this actually plays out for a real woman, not just in theory And a quick caveat before I do this.
00:08:19.747 --> 00:08:21.007
This is my story.
00:08:21.007 --> 00:08:22.036
It's not a template.
00:08:22.047 --> 00:08:28.137
Your body, your history, your labs, they're going to tell a different story than mine did.
00:08:28.437 --> 00:08:33.716
This is exactly why the conversation with your own provider matters so much.
00:08:33.716 --> 00:08:36.057
No one else's timeline is yours.
00:08:36.219 --> 00:08:48.729
So for me, when I started working on my own perimenopause journey, we ran labs and my testosterone came back really low, but we didn't start replacing the testosterone.
00:08:48.729 --> 00:08:55.528
We started with estrogen and progesterone first, and we let those settle out before deciding what else was needed.
00:08:55.828 --> 00:09:01.729
Partly because sometimes bringing those hormones back into the range does some of the work on its own.
00:09:02.028 --> 00:09:10.359
Once things equilibrated for me, what was left was decreased desire and decreased energy.
00:09:10.359 --> 00:09:13.668
So that's when we made the decision to add testosterone in.
00:09:13.969 --> 00:09:16.489
Now for me, it has made an incredible difference.
00:09:16.788 --> 00:09:19.519
My desire has significantly improved.
00:09:19.558 --> 00:09:22.938
My husband is very thankful and grateful for this.
00:09:23.239 --> 00:09:32.519
But my energy has come back, and honestly, my confidence has come back with it and if I'm being honest, I probably could have used this testosterone boost 10 years earlier.
00:09:32.589 --> 00:09:37.239
But here we are, and that's part of why I wanted to make this video in the first place.
00:09:37.538 --> 00:09:39.438
This is a crazy ride.
00:09:39.448 --> 00:09:49.828
This perimenopausal phase, so much is going on, and we just need that information out there So let's talk about one of the problems that we're experiencing.
00:09:50.129 --> 00:09:51.788
There's another wrinkle here.
00:09:51.808 --> 00:10:12.339
In the United States, there is no currently FDA-approved testosterone product specifically formulated for women That means that clinicians who prescribe testosterone to women are generally using it off-label And because women need significantly smaller dosages than men, that dosing matters.
00:10:12.339 --> 00:10:18.828
More is absolutely not better There's different ways that this is being prescribed.
00:10:19.068 --> 00:10:23.818
There's compounding pharmacies that a lot of women are getting testosterone through.
00:10:24.119 --> 00:10:34.349
There are pellets, which I would advise against, and there is instances where women are being prescribed the medication meant for men and just dosing it down.
00:10:34.349 --> 00:10:46.158
Talk with your provider So going back to the more doesn't mean better, it matters because when you're desperate for relief, you might be tempted to think that more must be doing more.
00:10:46.458 --> 00:10:50.219
Unfortunately, too much of a good thing can cause problems, right?
00:10:50.219 --> 00:10:59.688
So too much testosterone can cause acne, increased facial hair or body hair, scalp hair thinning or other androgenic effects.
00:10:59.989 --> 00:11:05.749
That's also why monitoring matters The goal isn't to push testosterone as high as possible.
00:11:06.048 --> 00:11:38.369
It's to keep levels within physiologic range expected for women while assessing whether the symptoms we're experiencing are actually improving this is also why I'd be cautious about anyone selling testosterone as an anti-aging shortcut or promising that one hormone is gonna fix everything you're experiencing in midlife Hormones are powerful, and that's precisely why we deserve thoughtful use And there's one more reason why I don't think that testosterone should be the first hormone that we reach for.
00:11:38.668 --> 00:12:01.332
Sometimes the symptoms a woman attributes to testosterone are being driven by something else It could be poor sleep, hot flashes, vaginal discomfort, mood changes All of these can absolutely affect energy, motivation, sexual desire, and quality of life So before deciding that testosterone is the missing piece, it makes sense to look at the whole picture.
00:12:01.633 --> 00:12:04.552
What symptoms are actually bothering you?
00:12:04.852 --> 00:12:07.072
What else could be contributing?
00:12:07.373 --> 00:12:11.513
Are your estrogen-related symptoms adequately being addressed?
00:12:11.513 --> 00:12:14.812
Are medications or other health conditions playing a role?
00:12:15.113 --> 00:12:21.753
Before you choose one hormone, it's worth looking at the terrain that hormone is actually operating on.
00:12:21.753 --> 00:12:27.763
Because treating hormones isn't about replacing every number on a lab report until it looks like you're 25 again.
00:12:28.062 --> 00:12:34.523
It's about treating the woman sitting right in front of you If you remember one thing from today's video, let it be this.
00:12:34.552 --> 00:13:07.783
Testosterone matters in women It isn't just a male hormone and it isn't just about sex, but that also doesn't mean testosterone is the missing answer for every woman who feels tired, unmotivated, or different in midlife The science right now is strongest in one particular area, persistent, distressing low sexual desire in appropriately selected women For everything else, we're still learning, and I actually think that's an empowering place to be You don't need someone promising that testosterone will fix everything.
00:13:08.082 --> 00:13:26.663
You need good information, a clinician willing to look at the whole picture, and a treatment plan built around you rather than a specific number on a report next in our Understanding Hormone series, we're gonna tackle one of the most frustrating things that women hear during perimenopause.
00:13:26.962 --> 00:13:38.543
Your labs are normal normal hormone labs do not necessarily mean you aren't in perimenopause, and we are gonna talk about that and explain why Thanks again for watching, and I'll see you next time
