Hormone replacement therapy (HRT) is one of the most misunderstood yet powerful tools for women’s health and longevity. Dr. Sarah Daccarett — founder and CEO of Inner Balance — reveals how declining hormones drive over 100 symptoms such as fatigue, anxiety, brain fog, and sleep issues, and why properly dosed, full-spectrum HRT can be foundational for preventing heart disease, osteoporosis, and Alzheimer’s. Drawing on her own postpartum and autoimmune struggles, she explains how her product Oestra™ combines estrogen, progesterone, and testosterone in optimal ratios for real systemic benefits, not just local effects. This insightful conversation breaks down myths, highlights the disparities between men’s and women’s hormone care, and shows how accessible, affordable HRT can radically improve energy, mood, and long-term health.
The information presented in Fully Alive is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making changes to your health regimen. Guests’ opinions are their own and do not necessarily reflect those of the podcast host, production team, or sponsors.
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Why Hormone Replacement Therapy Is the Missing Link in Women’s Longevity with Dr. Sarah Daccarett
Introduction
Welcome back to Fully Alive, where we are unlocking the secrets to your healthier, happier, and longer life. We’re diving into a topic that touches nearly every aspect of our health, energy, and longevity, hormones. For women especially, hormonal balance can mean the difference between thriving and simply getting through the day. For too long, hormone therapy has been misunderstood, underutilized, or even stigmatized.
Our guest is Dr. Sarah Daccarett. She’s on a mission to change that. She’s the founder and CEO of Inner Balance, which is an innovative online hormone replacement company serving women in more than 48 states, coming to 50 soon. Her groundbreaking product, which is called OestraTM, combines estrogen, progesterone, and testosterone into a simple, effective treatment that’s affordable, accessible, and backed by clinical science.
Dr. Sarah’s own journey navigating postpartum hormone challenges and seeing firsthand how little support women often receive led her to reimagine how we approach hormone health. She’s here to share how hormones impact everything from mood, cognition, and sleep to metabolism, vitality, and even longevity, and why it’s time we stop normalizing suffering and start empowering women with real solutions. This is going to be an eye-opening conversation about innovation, accessibility, and the power of restoring balance from the inside out. Let’s jump in. Here’s my conversation with Dr. Sarah Daccarett.
Dr. Daccarett, thank you so much for being here. I’m excited to have this conversation. I’m excited for our audience to learn from you and your amazing wisdom, experience, and expertise. Thank you so much for sharing with us.
Thanks for having me on, Zach. I’m so excited.
From Engineer To Hormone Health Pioneer
You’ve had this amazing journey. I’d love to start by unpacking what led you to where you are. You shared a little bit that you were on your own health journey, which led to the work that you’re doing now. Could you share a little bit about how this all came about and the experience that inspired your mission?
The Inner Balance, my mess became my message. I went through many years, a decade, of trying to feel better, a long health journey. Looking back, I am happy that I went through it. Many years ago, nobody was talking about menopause. I’ll bring that up when I was going through perimenopause. I’m glad that we’re talking about it now, but years ago, we weren’t talking about it. I was in my mid-30s, and I felt very alone. I realize this is what women are struggling with in their 30s.
I started out as an engineer, a doctor, and a pathologist in practice. It wasn’t until I couldn’t solve my own problem with all of the tools that I was given in medical school and in training. I knew the pathophysiology of the body. I knew a lot about the body and still didn’t know how to treat my own autoimmunity or my own problems. I also wanted to live well. I wanted to look good, feel good, and not necessarily live forever, but have a long health span.
I wanted to be healthy for as long as possible. I saw my mom. She has Parkinson’s. We’ve seen family members around me suffer, too. I certainly don’t want to do that. My own health journey also became a mission to live well. Part of why hormone replacement therapy became my mission was because it is so foundational and so part of the core of any kind of longevity. I opened up a clinic a few years ago, and I treated men and women. It was an anti-aging clinic. We did peptide therapy, hormone replacement therapy, supplements, and anything that you can to live and feel the best way possible. If you go back to my story, I had every symptom possible.
I thought that maybe I burned out in medical school, that I had pushed too hard, or that it was right after I had a child, I was postpartum. I tried everything, every supplement, every diet, and every restriction. You name it. I tried every HRT product on the market. The problem is that for women, there’s a huge gap between the way men are treated for hormone replacement therapy and the way women are. For men, we truly do look at them as, “You want testosterone for longevity? You can have that.” If you want to maintain your health, testosterone is for that.
Right now, estrogen, progesterone, and testosterone therapy for women are strictly for symptom management. You have to wait until you have stopped your period for an entire year. You have to be 52 years old or older. It’s to stop hot flashes or some of these most severe symptoms. We don’t look at it for women as a longevity tool, or “Can we prevent disease with hormone replacement therapy?” We already know that we can. We have evidence to support that, but women are not looked at that way.
We have to, “Your cycling. You still have a period. You’re way too young to have hormone replacement therapy.” It’s misogynistic. It’s inappropriate. We don’t tell men, “You can’t have testosterone therapy because you’re still making sperm.” The gap is big right now for men and women. I tried every hormone replacement therapy product when I was 35 years old, but nothing worked because nothing was designed for a 35-year-old. All of the products on the market are designed for postmenopausal women or menopausal women to simply stop hot flashes. I would even say that most 52-year-olds don’t even notice the patch or the pill because it’s to treat hot flashes, but they don’t feel young again. It is what we can do with hormone replacement therapy.
We can actually get you feeling young again. We’re not using it to its fullest for women. It’s not a treatment. Hormone replacement therapy is not a treatment. It is a prevention tool. We should be keeping these hormones optimal so that it’s the environment in which the body can maintain its health and youth. The secret is hormone replacement therapy. This is why it became my mission, because it’s so foundational and it’s so easy. Women deserve the same treatment that men are getting, and they’re not. When I opened up Inner Balance, the idea was to give women the same treatment that men get.
The Gender Gap In Hormone Therapy: Why Women Are Left Behind
That’s an amazing journey that you’ve been on, first of all. I want to unpack that a little bit more. Why is there that disparity between how we treat men with testosterone versus how we treat women with estrogen, progesterone, and testosterone?
It’s systemic in medicine. A lot of information is coming out now about how we do research on men and how women are largely ignored in that space. One part of it is systemic in how we view women. It is still misogyny. The other part is that we were afraid of hormones. We thought that estrogen caused cancer because of all the misinterpreted studies and the bad data. It was the media. As Mark Twain said, “A lie can get halfway around the world before the truth can even put its shoes on.”
This is exactly what happened with hormone replacement therapy. Somebody said that estrogen causes breast cancer. They held a press conference and said that estrogen causes breast cancer, when those studies never showed that. We’re still talking about estrogen in the same sentence as cancer. Everybody still thinks that estrogen causes cancer. We thought that testosterone caused prostate cancer, but we’ve moved past that pretty quickly.
For women, it’s this bad PR campaign. Part of it is suppression. There’s a lot of misinformation. If women continue to feel sick and unwell, and they’re out of the workforce and can’t work if they have to retire early, this is keeping women suppressed. Women need to understand that not being given their own natural hormone and being told that estrogen is dangerous for them is another fear tactic. It’s keeping them small and suppressed until they realize that they need to overcome that. That’s is artly why these bad studies have happened. These microdoses that we now give women in these patches and Lotus vaginal creams, we make sure that they don’t go into the bloodstream.
All the studies show that estrogen is not systemic, that we’re giving them formulations that don’t go in the bloodstream. It’s because we thought that it was going to be dangerous for them. This has done a disservice. This is a very big disservice. Birth control is another thing that’s in the mix here. We have 300 different types of birth control. Not all of the studies are on birth control, but a big chunk of them are. We don’t have a lot of studies on perimenopausal women, this age group between 30 and 45. All the studies are 45 and above.
We ignore women from 30 to 45. We tell women subconsciously that unless you’re fertile and you can have a baby, you matter then, or you matter postmenopausal. This whole age group, with your 30 to 45, you don’t matter. This is the messaging we’re sending when they go to their doctor. They’re being told, “You’re normal. You need to workout more. This is your fault. There’s nothing we can do for you.” You’re basically telling her that she doesn’t matter. This is a very big problem.
[bctt tweet=”When you tell a woman she’s normal, that she just needs to work out more, that it’s hers and there’s nothing you can do, you’re essentially telling her she doesn’t matter.” via=”no”]
Even doctors who are trained, because we thought estrogen was dangerous for so long, now we have an entire generation of doctors who have forgotten how to prescribe hormonal therapy to women. They still tell them that it’s dangerous. I’ll have clients tell me, “I talked to my OB-GYN. They said that I’ll get cancer.” We’re still giving bad misinformation to women about this. Even traditional doctors give out the wrong information. The microdoses are based on this, and we haven’t overcome it.
Everybody is talking about menopause, but nobody is talking about how bad the formulations are. We don’t give men pills. We don’t give men creams. We don’t give men patches. We give them injections, which is a superior way to take a hormone. We’re still giving women, and they’re putting up with it. We’re giving women pills that are metabolized in the liver. We put them on a patch that falls off and barely gives them any hormones. We give them a tiny bit of vaginal cream. We’ll give men Viagra, but we won’t treat women’s vaginal dryness.
The gap is huge. Women would be outraged. They know that the treatment is different. Reflexively, if men come in and say, “I have a little bit of erectile dysfunction,” they get treated right away for testosterone erectile dysfunction. Women, if they have vaginal dryness, it’s treated like a relationship problem. “You need to date your husband. Use a little bit of lube. Read a sexy novel.” This is a health concern. She has vaginal dryness. We’re talking about pelvic floor problems where she could have urinary tract infections, yeast infections, and BV. It’s not about painful sex. This is about her pelvic health. Even doctors who don’t recognize that this is a real health concern for women, it’s bad. I’m painting this bleak picture, but it’s the state of women’s therapy right now.
I’ve heard before how even FDA trials only had to be conducted on men, up until 2017 or something like that. It’s crazy.
It’s crazy because women do cycle. Our hormones fluctuate when we do cycle. They can change the way other drugs are metabolized. Instead of figuring that out and understanding it, we exclude women from studies. “The women are going to change our statin, our lipid studies. We’ll take them out.” Dosing is based on the man. I’m a small person. Men are double my size. I’m given the same dose pharmaceutically as the male. It doesn’t even make any sense in terms of women’s needs. Our physiology is completely different. We’re different species.
Practically, when you look at our immune system, our neuroendocrine system, our needs are completely different than men. Even the fasting studies. It was something as simple as fasting for longevity. I like that the biohackers are into it, but they’re mostly male-dominated. Most of those studies are for men, too. We can’t translate a fasting study to women. We try to extrapolate all this data onto a physiology, onto a person, but it doesn’t fit.
Unveiling The Symptoms: What Happens When Hormones Decline?
This is fascinating. I want to break this down a little bit. You were having your own perimenopausal symptoms. That was causing what kinds of symptoms? What were you experiencing that led you to it?
Fatigue was the biggest. I had this crippling fatigue. I feel like I hit a wall, but it was my main concern because I was working and had a child. I would say if I looked back, I always had some issues. Knowing what I know now about metabolism and methylation of hormones, I’m probably a fast metabolizer, for example. Looking even at that bulk of time where I was not doing well, I had anxiety and insomnia. My hair and skin were not looking great. Even with low libido and vaginal dryness, I didn’t even care about that stuff because you’re so worried about the fatigue and making it through. For most women, that’s lower on our priority.
It’s the brain fog and the fatigue. It’s inhibiting work. It’s inhibiting the relationship and being able to function. I wasn’t the person that I wanted to be or that I was in my 20s. I was only 35. My biggest thing, too, is that I had autoimmunity. This was hard because it was getting worse. I didn’t know how to treat that. When you look at the immune system, if you want to live well and live healthily, everything is inflammation-related. Everything is the immune system.
[bctt tweet=”When you look at the immune system, if you want to live well and healthy, everything is inflammation related.” via=”no”]
If you keep your immune system young, you could prevent cancer, heart disease, diabetes, and Alzheimer’s. Potentially, the core of our problem is our immune system. A viral infection would go around, and I would get very sick. If you have eczema or joint pain, or you realize that your immune system is not organized, your immune system is not fighting the virus that it’s supposed to. Instead, it’s fighting your own body. Anybody should be like, “This is a worrying sign.” Women get the bulk of autoimmunity.
This is something that we suffer from that men do not. This was my challenge to myself. I had not learned about this in school. We do not treat autoimmunity very well. We don’t know how. We don’t have the tools. This is the thing that I can solve for myself. It’s hormone-related. We can talk about how longevity is directly tied to the immune system, the prevention of cancer, and everything I mentioned.
This is how OestraTM came to be as well, because it’s good at honoring and protecting a female immune system. We have to be aware that it’s so different than a man’s immune system and why. We can get into why it’s so different and why nature has done that. We ignore it. I feel like in medicine, everybody ignores it. It’s a problem we can’t solve. We have self-driving cars out there, and we can’t solve this? It’s rocket science.
A New Era Of Hormone Replacement For Women
You mentioned before that many of the hormone replacement therapies that women are prescribed don’t go into the bloodstream because of the myths that are actually false, that doctors have been perpetuating throughout the media and system. What you created with OestraTM is different. Can you explain how that’s different and why? One question before that, too, that I’d love for you to talk about is just, can you explain for our audience and those of us that don’t quite understand the mechanism? As we age, we produce fewer hormones. Can you explain some of the inner workings or those mechanisms, too, so we understand what’s lacking and then how OestraTM addresses that problem?
As we age, the question is, is it happening to 30-year-old women, are we recognizing it more, or is it a new thing? Our ancestors died when we were 35. We’re having babies when we’re 35. We’re expected to live until we’re 80, but our ovaries have not caught up. There’s talk about how men’s testosterone is dropping in their 20s. We know that, but the same things happen in women and probably at a higher rate because the chemicals in the environment bind to the estrogen receptor, like plastics, pesticides, phthalates, and all these chemicals.
They don’t bind the testosterone receptor. They bind to the estrogen receptor and prevent our own estrogen from binding. Theoretically, our hormones are actually dropping earlier and faster than men’s are because of the toxins. If you take that out of the picture, and somebody is living toxin-free, which a lot of your readers are trying to eliminate the fragrances, they don’t have to play plugins. They’re not using plastics or pesticides. Even then, at natural aging, the ovaries stop functioning that well over the age of 30, which is why we have infertility, because people were waiting until their 30s to get pregnant.
We’re not meant to be fertile in our 30s. We’ve happened to get pregnant in our 30s. I feel lucky that I got pregnant in my 30s, but biology was probably always like that. It’s that my grandmother and my mother were expected to put up with it. We didn’t necessarily have a solution. They were expected to be quiet about it. I don’t think that they talked about it as much as we are now, but they experienced it as severely as we are now. When women’s estrogen and progesterone drop, our neuroendocrine system, meaning our brain, heavily relies on estrogen and progesterone to function. We need estrogen to boost dopamine, which means that if your estrogen drops, women can’t even think clearly.
They have brain fog. They have depression. They have irritability. They have rage. They can’t control their emotions. They certainly aren’t attracted to their spouse or husband. The divorce rates skyrocket after perimenopause. This is something that we are trying to keep together. The mood and stuff happen a lot, and even sleep. If you’re not sleeping, you’re also not going to tolerate small children. You’re not going to tolerate your boss. We definitely need hormones to sleep. Women do. We get over 100 symptoms when our hormones start to drop.
Men do get some mild symptoms, but they tolerate their andropause a lot better than we can because we’re so highly dependent on these hormones. Not that men aren’t. I’m drawing this to contrast how severe women feel their symptoms. When the ovaries start failing in the 30s, the brain freaks out because it basically is a sensor of what’s going on in the body. It releases a substance that stimulates more hormones. There are markers that we can get called FSH that tell you that the ovaries are struggling or failing. We need to replace all of these hormones in order to calm the brain, lower the FSH to lower, and restore this balance.
Women don’t need one hormone. I’ll dive into why OestraTM is different. It’s because we think now that women need estrogen or they need progesterone. If I were a 35-year-old, they would have given me progesterone. “You need a little bit of progesterone. You need to take it for the last two weeks of your cycle, and you’ll be fine.” This is a common practice. This is where it all falls apart. Women need all three hormones. They need them in the right ratio. If everything’s low, then we do need to raise these like we raised testosterone for men.
Even the entire philosophy about how we think about raising women’s hormones, we should reevaluate. OestraTM is unique in that it’s able to get into the bloodstream better. It’s a vaginal application. Most of the readers will be like, “I heard that vaginal is only local. It doesn’t go into the bloodstream.” The products on the market don’t go into the bloodstream because, as I mentioned, they’re this microdose, and we actually designed them to only be local.
We put such a tiny amount in there, ladies. It’s meant to treat the vaginal tissue, and that’s it. OestraTM is an appropriate physiological dose. When it goes into the bloodstream, you can measure it. It’ll help your hair grow. It’ll make your skin nice. It’s anti-aging. People don’t understand that hormones are foundational. It’s because they’re like the CEOs of the body. Every process needs a hormone. Even maintaining your blood pressure, you need a hormone.
You need both hormones, estrogen and progesterone, to do that. If I give you only progesterone, you’re missing the estrogen part. No, you’re not making it all the time. There’s a misconception that 35-year-olds are making it. If you get blood levels back up in the right ratio, and that’s another thing with women, estrogen, testosterone, and progesterone all need to be in this pretty good ratio for them to feel better.
The Perfect Ratio: How Oestra™ Balances Hormones For Optimal Health
In OestraTM, you guys have dialed in that ratio, but is every woman different, though? Does every woman need a slightly different ratio, or have you created the perfect ratio for all women?
It’s not necessarily for all women, but it’s for a lot of women. Men all get this exact same testosterone dose in the country. Everything is the same. They convert heavily based on their genetics. Some will make DHT or estrogen. We know these conversion pathways. With women, the same thing. They have conversion pathways, too. They will also self-regulate. My ratio needs to be different from someone else’s. The ratio is not in the cream. The ratio is in your body. Your body makes its own unique ratio. Your body will regulate it.
You have different metabolism pathways based on your genes. Your diet will impact your ratio. If you eat a ton of fiber, your ratio is going to be different than a carnivore diet. Diet will impact your ratio because the metabolism will change. If you take a bunch of methylated B vitamins, your ratio is going to be different. The things that you do in your lifestyle will make it different. I can give you a starting ratio that will put you. The highest hormone needs to be progesterone.
If I were to ask you, “What do you think the female’s main hormone is? Nine people out of ten would say estrogen. It’s the main feminizing hormone. It makes us look female, but it’s not our most abundant hormone. The most abundant one is progesterone. It’s the one that needs to be 10 or 30 times higher than estrogen in order for her to feel well. This is the one that fails. This is the one that the ovaries cannot produce. This is what causes all the problems and the confusion. OestraTM is good at putting the progesterone at the highest. It puts it in the right amount. That’s the one that everybody needs to be worried about. I have women come in and say, “I’m worried about testosterone.”
I’m like, “It’s not your main hormone, first of all. You need to make sure it’s the easiest one. Testosterone is actually the easiest hormone to get. It’s the other one, progesterone, and estrogen that you need to make sure are correct first. If testosterone doesn’t fall into place, we can manipulate it. We can do that easily.” Progesterone is very hard to get into the body. It’s a huge molecule. That’s why it doesn’t get on the patches. That’s why when you swallow it, the liver metabolizes it. This is the engineering problem. Stop worrying about testosterone, ladies. You need to worry about progesterone.
[bctt tweet=”If testosterone doesn’t fall into place, we can manipulate it easily. Progesterone, however, is very hard to get into the body. ” username=””]
Who Can Benefit? Hormone Therapy For Women Of All Ages
This is amazing. There are 100 symptoms that come about as a result of efficient hormone levels. You’ve created a product that is very simple to use and utilize. It’s in the right ratios. A lot of our friends and peers are going through a lot of these same symptoms. They’re experiencing these. Some of them are trying hormone replacement therapies and not having great luck, or it takes a huge, long pathway to try to figure out the right dosing, ratios, and things like that. It’s been challenging. To me, this is super exciting because there’s an application for a lot of my friends and peers. You mentioned 30 to 45-year-olds, but could everybody over the age of 30 be benefiting from this?
It is the age of 21. We need to acknowledge that women in their 20s are also struggling, like men in their 20s are struggling, too. We have different formulations for older women. If you’re over 50, you get a little bit of a different formula. It’s because the longer you wait for hormone therapy, the longer your uterus struggles because that lining isn’t as healthy. There can be more bleeding, which is a side effect of hormone replacement therapy for women. A 46-year-old is not going to have benefits from the current formulations on the market because she’s too young for them. She’s not too young for hormone replacement therapy.
She’s too young for what’s available. If you spend all this time chasing a lab, a patch, and a pill, one is exhausted. It’s expensive, but it doesn’t work because those formulations were never built for 46-year-olds. Again, they’re built for those 55 and above. They’re built for postmenopausal women. They’re built not for a cycling woman. They’re built to do the minimum amount possible. To myself, it’s silly when they’re like, “I’m going to manipulate the patch from 0.5 to 0.75.” You are spitting into the ocean for a woman. When women get pregnant, their estrogen levels increase to 40,000 picograms per milliliter. That is for pregnancy, the third trimester.
The patch is only able to get you to 80 picograms per milliliter. The upper limit of normal is 500 picograms per milliliter. When you’re manipulating a patch, you’re trying to get a 46-year-old from 80 to 100, and she’s like, “I don’t feel better,” everybody’s banging their head against the wall. You’re working with formulations that were never meant for her. She’s never going to feel better on a patch, a pill, or even pellets because they’re testosterone.
The problem with the formulations, too, is that they can make you pretty estrogen dominant, or they can make you testosterone dominant because they don’t honor the progesterone. Women’s sensitivity to the environment and their immune system can actually get worse on these types of products, I would argue. Our endometriosis patients would get worse. Our PMDG patients get worse on oral progesterone. You’re going to make her worse by giving her these certain formulations. No, it doesn’t surprise me that your wife, your friends, and people you hear about are trying to take that.
It’s a journey. It shouldn’t be that big a journey. It is a journey, but you need to get your levels up to where they need to be. Sometimes, there’s some other healing to do. You have to heal your gut because if you have gone a long time without hormones, your gallbladder can be sluggish, and you have to spend some time with that. If you have breast tenderness, then you need to address that differently. If you have extra bleeding, you need to address that. When you start hormone replacement therapy, women have extra challenges. Sometimes, it’s water retention or bloating that they need to address. The answer isn’t to adjust your patch from 0.5 to 0.75. The answer is not to manipulate the hormone. It’s to heal that part of the body that needs to be healed.
That makes a ton of sense because then that reveals these other issues that were happening as a result of not having those hormones for such a long time.
Yes, you nailed it. When you start the hormone replacement therapy, it highlights the problem. It’s almost like you want your bloating that you had before, that you were getting by with, you start estrogen and hormone therapy, and then the bloating gets worse. Maybe we need to look at why you have all the SIBO because of your diet and the fact that your digestion is terrible, not because you haven’t done anything. It’s because you haven’t had the right tools to fix your gut health, but it’s not the actual estrogen that’s doing that. A lot of people back off, and they think that it’s making them worse, but the hormones don’t do that. Hormones are beneficial. They’re positive. It is a sign that you need to do further work. The hormones aren’t going to fix your bloating, in other words.
When someone is one of your patients, do you walk them through those other processes and recommend? How do you go?
If they have a side effect, we address it because 10%, 15%, or 20% of them will have bloating, for example. It’s not everybody who has that. We do offer supplements and tools, but it has to be the person who wants to heal themselves and go through this longevity pathway. When I counsel people and women, it’s like, “Anti-aging is a pyramid. Hormone replacement therapy is the foundation. You actually need it no matter what. It’s not going to make you lose weight, but you’re not going to lose weight without it. It’s so foundational. It is the environment for all the other pieces to fall into place. You have to have the hormone therapy.” We should be looking at it as that. It’s not the solution to everything, but you absolutely need it to have everything you want.
If you’re looking to have great skin and hair, look good, feel good, be ultra healthy as you’re aging, then you have to have the hormones in place. We need to have them at a certain level. After that, you can look at diet, exercise, and then peptide therapy. You can use peptides on top of that, and the supplements on top of that. I think that 80% to 90% of it could be hormone replacement therapy. If people did nothing else, if they did hormone therapy, they would get the biggest bang for their buck. It would be worth their time. It would be worth everything if they could get this right. If they did a sauna every now and then and all these other hacks, they’re great. It’s great on top of the hormone therapy.
I love that metaphor, like a pyramid. This is the foundation. If you don’t have enough hormones, nothing else is going to make a difference. That’s amazing. What about my friends and readers? I’m thinking of people who are 63, 73, or whatever. Maybe they’re a little bit older and haven’t had hormone replacement therapy yet. What benefits do you see for those folks?
The data show that the benefits outweigh the risks for this population as well. If you feel like you missed out or that you waited too long, and that’s okay, you don’t need to feel that way. You can get started. There are benefits for urinary tract infections and urinary incontinence. Even if you were to help this part of your body, the pelvic floor, heal, this would benefit you. We know that Alzheimer’s rises when estrogen drops.
Even at this age, we don’t know if you can protect against Alzheimer’s if you’re 65, but it’s worth trying. The studies show that as long as it’s not progestin or some fake hormone, these fake hormones could potentially increase your risk. If you’re over the age of 60, you definitely want to do bioidentical. I would encourage bioidentical for everybody, but this group especially, and not to do orals. As long as you don’t pick an oral, something you’re swallowing, because this increases your risk for stroke as you get older, and also pick a bioidentical and dose that’s appropriate for your age, then it’s fine to start hormone therapy.
We have a cutoff of age 64, but we have a different formula for you. We definitely don’t give you the same thing that we would give a 35-year-old or a 30-year-old, but you also deserve your own thing because you’re different than the 35-year-old. If you’re 60 and considering it, you can get started with us or a practitioner who’s willing to start you. We use a cream. We don’t use any orals. We start at a lower dose. You don’t need a lot.
The older you are, the less you need because the younger you are, the more you’re going to need. If you think about it, testosterone makes sense, too, for men. Older ladies, you should definitely consider it still. It’s still a foundation for you, too. It will help with mental clarity, sleep, and maybe a lot of things that you’re still struggling with that you’ve not been able to do. If you’ve made it that far, congratulations. You are now looking at your longevity. You’re looking at these tools, and hormone therapy is still an option for sure.
[bctt tweet=”The older you are, the less you need hormone replacement therapy; the younger you are, the more you’re going to need it. ” via=”no”]
Hormone Therapy’s Impact On Relationships And Empowerment
This is so fascinating and helpful for so many people. It feels like you’re debunking so many myths. You mentioned this before, too. The divorce rate is skyrocketing. It happens a lot at this stage, this middle life stage. Could you share a few stories of what you’ve seen, like the changes that you see in yourself? You get to do this every day and work with all kinds of patients all across the country here in the US. Could you share a few stories of before and after?
We can even hone in on the relationship issue because it does come up when women come into the office when I have my clinic. That was their tipping point when they realized that their relationship was in trouble. No surprise when I say this. They do take on a lot of the work. They’re taking care of the kids. They’re not watching themselves so much, like their health. It spirals, and then it’s right in front of them when their relationship is falling apart. They realized that they needed to be doing something about it. It could be because there’s a rise in infidelity.
I have a lot of male friends who will come to me and say, “My wife doesn’t want me anymore. She’s not attracted to me anymore.” It has nothing to do with them. It’s this phase of life where her hormones have completely dropped. Progesterone is nature’s Xanax. Estrogen makes women feel more feminine. Estrogen binds to the MDMA receptor, which is the same one that allows this openness and empathetic view of ourselves. It’s something that gives women this openness and receptivity to men. These are the hormones that help us tolerate men and small children.
When they drop, women will come into my office and be like, “I can’t even stand him. Even his breathing is driving me crazy.” She doesn’t know why he’s a great guy. She still loves him, but she can’t stand him. You get down into it, and she’s got all these other issues, too. She can’t sleep. She’s got anxiety. She can’t think straight. Her libido is low, and vaginal dryness, all this stuff is going on, but she’s worried about losing her family, her relationship, and her life because of it.
Women need to be paying attention to it way earlier. I would say that after they start, they’ll come into the office and be a completely different person. They’re anxious, and they have all these issues going on. A few weeks later, they’re calm. “I love my husband again.” They’ll even come and be like, “I totally love my husband. The sex is great.” It’s never about the sex when they first come in. It’s never the first thing, but it’s nice when it happens. They’ll even mention things that they didn’t expect. Their breasts become normal again. They’ll become the shape that they were when they were younger. We’re like, “This is great. It’s these feminizing features that I loved so much when I was younger that I lost after. I thought it was pregnancy, aging, or whatever.”
It was never about that. Like I said, it’s the brain fog and the fatigue, but later, when the sex is good and the breasts look good, then they’re like, “This is amazing.” You see the full spectrum of benefits. I’ve had the opposite. I’ve had women who’ve come in. You give them the hormone replacement therapy, and then they have the energy to get the divorce. It gets you out of that funk. If you are in this and you need to act, it gives you the energy and the motivation to do whatever it is that you need to be doing at the time. Those are some stories, I would say, that’s prominent. We are talking about this divorce rate more. Women are saying that they’re becoming more empowered, but it’s hormonal, a lot of it.
[bctt tweet=”Hormone replacement therapy gets you out of that funk. It gives you the energy and motivation to do whatever you need to be doing at the time. ” via=”no”]
Democratizing Health: Making Hormone Therapy Accessible And Affordable
I love that you’re working on closing this gap, which is such an amazing mission. Thank you for being courageous, making that possible, and doing that along the way. I love that you’re making this affordable and accessible because hormone replacement therapy can be very expensive. You’ve created it in such a way that it is accessible. It’s easy to go through this process. It’s not going to break the bank. Can you talk a little bit about that, too?
We’re democratizing it. Some will say that we’re more expensive than the other options, but then, when you look at what you have to do to do anti-aging, longevity, and hormone replacement therapy, women spend hundreds of dollars a month. That’s not even lab testing. If you want the patch and the pill, and you want your insurance to cover it, then you can do those. Those are basic products, but they don’t work. You get what you pay for sometimes, too.
When you have to piece together five different products, a patch is $30, Lotus vaginal cream can be $30, testosterone cream can be another $30, you have an estriol face cream that’s $30, and progesterone pills, $40. It starts to add it up. You have a regimen that’s actually not that effective. You’re paying over $150 a month for it. A lot of insurance companies aren’t paying for it. I think some do, but then some are paying out of pocket. They’re paying the doctor’s fees. They’re paying the labs. Ours is $99 a month after six months. Yes, it’s $199 for the first six months, but it’s because we follow you and there are dose adjustments. We need to go up sometimes, and things like that.
The long-term $99 a month is cost-effective for your health, your longevity. Especially if it gives you this foundational piece, it’s worth it. If it doesn’t work for you, then obviously it’s not, but it’s wildly easy. It’s a little less than 30 seconds a day. We’re talking a pearl-sized amount of cream that you can place vaginally. I would rather even do that than an injection. I see men who have to inject testosterone. It gets a little bit painful and old when you’re doing that twice a week in the butt.
I do think that we have it easy if we have a route. The vaginal delivery makes it easy and affordable. Again, we don’t do this gatekeeping. Women are being told, “No, you have to wait until you’re 51.” You’re an adult. This is safer than birth control. We’re starting you on a starting dose. You can try it and see if you feel better. You want to give it a full three months. If you try it in three months, then you can go up and dose. We’ll titrate it. We work with you. We have a staff of doctors, clinicians, and nurses.
Yes, this is accessible because one, we’re not going to gatekeep it. Also, women in rural areas, if you’re not in the big city, New York, LA, or some of the bigger cities, you may not have access to hormone replacement therapy that’s effective anyway. This can also open it up to women who don’t have a doctor to go to, for example. We give you your money back if it doesn’t work. We want to make sure that it’s a fit for you long-term. We do have a six-month money-back guarantee as well. We’re trying to make it as easy as possible to just, “This is good for your health. Give it a try.”
Can someone expect to feel better or at least some of the results within a few months? Before, you mentioned even three weeks later, they’re coming back and saying, “I feel so much different.” It works that quickly.
Yes. Women will notice things get better early on, and some take a little bit longer. Vaginal dryness, sleep, and mood, like anxiety, depression, and irritability, should get better within the first four weeks. Hot flashes should not even be a thing in illustration. You should have no hot flashes. This gets better quickly. Women will even start to notice their skin and hair within a couple of weeks because they notice the estrogen is extremely hydrating. It helps you build elastin, collagen, and hyaluronic acid. It sucks moisture into the skin. Women get their laxity in their skin. They notice that they clump up.
[bctt tweet=”Estrogen is extremely hydrating. It helps you build elastin, collagen, and hyaluronic acid. ” via=”no”]
The vaginal tissue changes quickly. Women are like, I didn’t realize I was supposed to hear a desert down there until I started the cream. I realized this is actually a problem I had to. I was masking it, using band-aids, using lube, or not paying attention to it.” This gets better immediately, practically within 10 to 14 days. You can get some early positive signs that it is working. Things that take longer are fatigue and brain fog because women go years sometimes without sleep. They go years feeling miserable. This can take a while for this part of your brain to heal.
Things like autoimmunity can take a full year. It depends on what you’re trying to heal over time. Weight loss is ten months out. This is something that sometimes, you can even gain a little bit of weight at first, it’ll even out, and you’ll lose it later. Early enough, you should see mood, your brain, and your vagina clear up pretty quickly, skin and hair, a very highly individualized libido, energy, and brain fog. Musculoskeletal, you have joint pain and muscle aches. This can get better pretty early on, but sometimes, this can take three or four months. It takes a while, and then there are some early side effects that everybody is going to get.
These clear up pretty soon, too. Irregular bleeding is a common thing for women. In three months, this levels out and this stops. Breast tenderness is common because virtually everybody is iodine-deficient these days. We recommend taking iodine, and then the breasts normalize and the pain goes away after a few weeks. There are a few side effects that are expected, like bleeding, cramping, and breast tenderness. Those go away.
There’s a smaller subset. I mentioned 10% or 15% who get bloating. We have to work through this digestion and help women with it. If you’re one of those who get a side effect like bloating, but you see your skin and hair and everything else getting better, you know that it’s easier to stick with it. I know I need to heal my gut more, but everything else seems like it’s clearing up. This is how the journey can look, very much like this.
Protecting Against Disease With Hormone Replacement
You recommend it. Give it at least 3 to 6 months. You’re going to see most of those results, but you’re going to get those early positives that it’s working. That causes you to stick with it. That’s amazing. You mentioned yes, there’s a cost involved, but you’ve democratized this. That’s accessible. There are also benefits, like preventing diseases. Could you talk about some of the things that are preventable with hormone replacement therapy?
Heart disease is the biggest one. I would think that one in three women dies from heart disease. Heart disease is the number one killer in the US. If we can prevent it with estrogen, which we know we can, that alone is a reason to take it. Prevention of heart disease is huge. Lipids will decrease or lower within six months on estrogen therapy. Osteoporosis is another big one. We know HRT prevents Alzheimer’s. We know from epidemiological data that when estrogen drops, Alzheimer’s rises.
We don’t know what level the hormones need to be to prevent these neurological diseases, but we do know that cognitive function improves. We also know that things like colon cancer have been shown to be prevented by estrogen therapy. In the Women’s Health Initiative follow-up, there was an eighteen-year follow-up from that very serious study. They followed those women and found that estrogen may even protect against breast cancer. There’s some evidence that it potentially prevents cancer as well, but it prevents weight gain, diabetes, osteoporosis, heart disease, colon cancer, and Alzheimer’s.
That is a big list. These are the main diseases of aging that we need to be worried about. We don’t have any internal studies, but women who have autoimmunity do get better on OestraTM. This is huge to think about, younger women who are suffering from this. A lot of diseases can be prevented. We would save billions of dollars. I guess maybe that’s Pandora’s box nobody wants to open because it’s a big machine, our healthcare system. If everybody were healthy, then maybe doctors would be out of jobs. Realistically, women see, on average, seven different doctors as they’re going through perimenopause for all their different problems that they have.
Nobody notices or recognizes that it’s all from the same thing and that it could be treated with something as simple as hormone replacement therapy. It would stop them from going to the psychiatrist for the antidepressant, the OB-GYN for the vaginal dryness, and the cardiologist for the palpitations. You name it. They’re trying to solve. They know that their health is declining, and they can’t figure out why. They’re trying to stop it. Doctors are so poorly informed that this is the problem, but you’re right. It would prevent. Insurance companies do not look at it that way. They do not do their accounting this way.
They don’t say, “If we pay for women’s hormone replacement therapy, we’ll save billions of dollars in healthcare costs.” They do it annually. It’s like the birth control argument. We don’t know if you’re actually going to take your HRT, but it’s going to prevent it because you might still have a bad diet. They come up with their excuses, but this might be shifting. Insurance companies could potentially be covering more of this, meaning all formulations, not just the traditional FDA-approved, very cookie-cutter formulations that they pay for now.
The Future Of Women’s Healthcare: A New Era Of Hormone Care
That’s exciting. On that note, what do you see as you look out into the next 5 to 10 years? What are you most excited about? What do you see in the future of healthcare, preventative health, and functional medicine? What excites you the most about what’s coming?
I’m excited because women are going to get better HRT care. Now that we’re talking about it, we can start recognizing that the standard of care is very poor. We can do so much better. My stuff is different. I’m radically different in terms of the way that I’m trying to push out information and get women to think about it differently. I’m hopeful that in 5 to 10 years, we’ll build on it. We’ll learn even more if more doctors get involved and see that this is actually the direction we need to be going in, and put all these great minds together.
Right now, everybody’s fixed in a box with hormone replacement therapy. It’s exciting to think that once everybody lets go of this idea that estrogen is dangerous, then we could do a lot of great things for women and get them a healthy population. Can you imagine if we had healthier aging women? I do think that women are the sickest. We’re sicker than men on average. We have the bulk of the pharmaceuticals. We take the bulk of them.
It would be pretty amazing if we could stop that and reverse it in a big way, doing big things for women. It is an exciting time. It was certainly something I wish I had years ago. I don’t have a daughter. I have a son, but I have business partners and friends who have daughters. We talk about how exciting it is for them because they don’t have to have the confusion that I had at 30. Hopefully, when they get to 30, we won’t have all this misinformation for them. They can have clear answers and a clear path. That’s super exciting, too.
That’s amazing. Thank you so much for the incredible work that you’re doing and for sharing this message. I do have one other question. We need to close this gap, but should men in the same way be thinking about testosterone therapy? Should pretty much all men past their 20s be thinking about that as well?
Yes. I would say that some of the herbs and some of the supplements do better at raising testosterone. They might even have more options at a younger age than women do. I haven’t found an herb that raises progesterone as effectively. I know there’s chasteberry, but I don’t think it works that well. There are a few out there. The youth need to be thinking about their diet and how much their diet impacts their hormones, and saying that they know when it’s going to happen, so that they can get on top of it.
[bctt tweet=”The youth need to be thinking about their diet and how much it impacts their hormones.” via=”no”]
The longer you go without hormones, the more your body deteriorates. If your hormones drop at age 30 and you wait until you’re 40 to start testosterone therapy, you have ten years of decline that you could have stopped. Yes, it’s the same for men, and testosterone is just as foundational. I don’t specialize in men, but I do think that we have a lot of work to do with them as well. We recognize that there are three hormones for women, estrogen, progesterone, and testosterone. We need to do a better job of recognizing that, actually, men have all three of those hormones as well. Yes, they do have progesterone.
If we replace it with some more savvy hormone replacement therapy, doctors replace progesterone in men, and they feel great. Their skin looks great. They’re calm. It converts to testosterone in men as well. You can optimize it a little bit better this way. We have more work to do for men, too. It’s not that we’re done with them. We need to understand their metabolism better. It’s not my mission, but I know that it’ll be taken on. It’ll get better for them, too, but I’m going to need to think of it.
This is amazing. For people to find you to start using OestraTM, they can go to InnerBalance.com. This is a telehealth virtual visit. To get set up and to get started, it’s very simple and easy to do. I think you’re in 46 states in the US. Is that right?
It is 48, and 50 in a couple of weeks.
It is pretty much anywhere in the US. Can people in other countries?
Not yet.
There’s maybe some hope for them coming, too. Anywhere in the US, go to InnerBalance.com and get started that way. It’s that simple, right?
Yes. We follow you. If you want to change the dose, you have to check in with our clinicians first. If you want a starting dose to try it, you can do that pretty easily, but it’s more of a titration and raising. If you want personalized supplement support, we’re here. We will help you get through those side effects. We’re a very easy customer service to get hold of. We’re launching an app. It will even be easier to start a community.
Even if you’re not sure yet, come check us out to answer your questions. We can be a resource as you’re doing your research because there’s a lot of information to sift through. You can come to the website or my social channel. If you go to @InnerBalanceMD or @SarahDaccarettMD, learn. Learn about it even if you’re not quite ready, but you want to know when the right time is so that you’re fully informed. It’s important.
I’m sure there are a lot of people who have daughters and granddaughters as well. They might be reading that their family members or other loved ones could benefit from this.
If you have a loved one who is suffering from endometriosis and PCOS, it is a good option for them, whereas the other hormone replacement therapies are not. If you do have a younger family member, yes.
Thank you again so much for this amazing work that you’re doing, sharing this message, and helping build the foundation, the bottom of the pyramid. It all hinges on this. I hope that many people will take advantage. Thank you so much for leading the way.
Thank you for having me, Zach.
It’s been fantastic. Thanks so much for being with us.
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I don’t know about you, but I feel like I just had a masterclass, a college course in hormones and hormone replacement therapy. Dr. Sarah has debunked so many myths for us. I hope you’ll use those as a takeaway that hormone replacement therapy doesn’t need to be scary. It does not cause cancer. In fact, it’s been proven to often prevent and potentially prevent cancer as well as many other diseases. We mentioned cardiovascular disease, osteoporosis, and even Alzheimer’s. This is something that can impact all of our lives in a very significant way.
Check her out. InnerBalance.com is a simple way to connect with her, start on her product OestraTM, and learn about that. As she said, learn about it. If you’re interested, there’s a lot on there to check out. She’s given our readers a code as well. You can click on that and get a $50 discount on your first month to get started. As she said, give it a try for a few months. This is such an amazing breakthrough for longevity and prevention. I hope that all of us can continue to learn from this and share this message. Thanks so much for tuning in here on Fully Alive, where we’re unlocking the secrets to your healthier, happier, and longer life. Hopefully, we did that a little bit more. Thanks for joining us. We’ll see you next time.
Important Links
- Inner Balance
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- Dr. Sarah Daccarett on LinkedIn
- Inner Balance on Instagram,
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