138. Natural Testosterone Support

Are you doing all the “right” things—maybe even considering testosterone therapy—but still not feeling your best?

If you listened to last week’s episode on testosterone, you know how powerful hormone therapy can be. But here’s the truth: hormones don’t act in a vacuum. Your nervous system, your nutrition, your muscle mass, your sleep—they all shape how your hormones work.

In this episode, I’m walking you through the foundational, natural strategies that support hormone health in midlife—whether you’re using bioidentical hormone replacement therapy or not. Because optimal health isn’t just about being in the “normal” range. It’s about creating the right internal environment so your body can truly thrive.

This episode is a natural follow-up to our testosterone conversation —but today, we zoom out and talk about the bigger picture.

In this episode:

•  Why hormones don’t work in isolation—and what your nervous system and metabolism have to do with it
• The real reason 30 grams of protein at breakfast can change your energy, mood, and hormone signaling
• Why midlife women need healthy fats (yes, even cholesterol!) for optimal hormone production
• The truth about cholesterol in menopause—and why “just stop eating eggs” is far too simplistic
• How fiber supports gut health and hormone metabolism (and why it’s often overlooked)
• Why resistance training is “hormone medicine” for midlife women
• The surprising midlife benefits of creatine—for muscle, metabolism, and even brain clarity
• Why sleep is still the most underrated hormone support tool

Connect with me, Dr. Sara Poldmae:

Website: https://risingwomanproject.com

Instagram:  https://www.instagram.com/drsarapoldmae

Transcript

sara poldmae: 0:01

Sarah, welcome to menopause. Rise and thrive. I am Dr Sarah pulled May, and this podcast is your go to guide for navigating perimenopause and menopause. If you are feeling a little overwhelmed, trust me, you are in great company. Each week, I'll bring you expert advice, raw, honest conversations and simple tips to help you stay grounded and maybe even find some humor in the process, let's rise, thrive and tackle this wild ride together. Hey ladies, welcome back to the show. I am so excited to have you here today, as usual, thank you for tuning in. My listeners are really important to me, and I just wanted to take a moment to share gratitude. I really enjoyed this podcast. Thank you for being with me as it shifts and changes, and just welcome back to the show. And thank you, if you were here last week. We talked all about testosterone. I was lucky enough to convince Monique to be on the show with me, and we talked about testosterone, what it does, why levels drop in midlife, what you may be feeling symptomatically, and why so so many women are curious about adding it into their BioIdentical Hormone Replacement Today's episode is a natural follow up. Natural is kind of play on words, but really talking about the natural things that you can do to help your hormones. Because we're not talking about today, anything that I talk about is not necessarily instead of hormone replacement therapy, because we definitely see a lot of women benefit from testosterone and other hormone replacement therapy. But this is more about everything that we can be doing as women first, and in many cases alongside hormone replacement therapy to give your body the best environment to make use of and respond to, either your own hormones or external hormones optimally, because functional medicine is not about keeping you in safe ranges. It's keeping you in optimal ranges, really living your optimal life. But here's the truth, testosterone bioidentical or otherwise, can be life changing for many women. But hormones don't act in a vacuum. So if you take anything away, just remember that your hormones act in the context of your nervous system, your nutrition, your stress, your muscle mass. There's all of it, right? So if we ignore those pieces, we leave a lot of potential gains on the table. So let's start with eating. Start to think of your eating habits and eating as is. Your hormones depend on your diet, because they do your hormone production, assimilation. Everything depends on the basics. As far as nutrition goes and protein, I'll start with it, especially in the morning. But protein is important throughout the day. But protein, especially in the morning, gives your body the amino acids it needs to make enzymes, neurotransmitters, hormone precursors, and clinically, we want you to aim for 30 grams of high quality protein at breakfast. And I'm not going to kid you, it's not always easy to get that 30 grams of protein the start of the day. We're busy at the start of the day, so really taking a moment to start your mornings more intentionally will help, not only nutritionally, but to really start to live your life more intentionally. Protein in the morning helps to stabilize your blood sugar throughout the day, give you better energy, improve your mood, and, yes, better hormone signaling. And why is all of this important? Because if you start at the beginning of the day and everything is stabilized, and your mood and your energy are better, guess what, you'll make better decisions throughout the day. A lot of women come into my practice they are drinking a smoothie or a latte for breakfast. Obviously, a smoothie with protein powder is better than a latte because that doesn't have protein but that won't necessarily cut it midlife, and I've been seeing these protein lattes, these protein drinks at Starbucks, and I need to dive into that a little bit, because I could guarantee you that that's a pretty processed form of protein powder that they're adding to their Starbucks drinks. So not to take away your Starbucks, but please don't think that Starbucks is going to be nourishing your body. I see a lot of influencers saying, Oh, great. Now Starbucks has this way to work protein into our systems. I don't think that that's necessarily the answer your nervous system really wants, right? Regulation, and with that, we need to really nourish our bodies so that we don't produce spikes and crashes throughout the day. So I know that that's a lot to absorb, because we need to think of our diet, not just as our body and what it serves us in a physical sense, but remember, from our perspective as holistic providers, there is no separation between mind and body. So if we're rushed, rush, rush, and we're getting these easy fixes, not to say, I want things to be hard, but if we're always reaching for these easy fixes and thinking Starbucks is willing to provide us with an answer for our health, I think we need to look at that kind of step away and say, maybe not so much, right? So I think the building blocks are protein, and then we have to move on to healthy fats and cholesterol. Cholesterol is a big scary word, and legitimately so in certain respects, but all of our hormones, we have to start at the beginning. Fat helps to make hormones. So all of our hormones are actually made of cholesterol. It's the raw material starting point. Your body makes cholesterol on its own. You do not need to eat cholesterol necessarily to have your hormone production be optimal, but your body still needs enough stability, nourishment and metabolic balance to use this cholesterol well, and this is where midlife gets tricky, right? Because we're all worried about gaining weight. We all have weight that we can't get off, that we used to be able to get off easily, but when estrogen naturally declines, cholesterol can often rise, and that's not failure. But at the same time, many women, because of this, are thinking, Oh, I got to cut out all the fats, all the healthy fats, even so, women are under eating, not sleeping, they're over stressed, they're losing muscle, and all of that changes how body processes your body processes cholesterol. So there's good cholesterols and bad cholesterols, and we definitely want the right ratio. So our overall number isn't necessarily as important as the ratio of which types of cholesterol we have. So in order to really change those numbers and those ratios, your goal is not to starve your body of fats. The goal is to support your whole system with real foods, including healthy fats. You want to build muscle. You want to again stabilize your blood sugar. You want to sleep well and calm your nervous system. Because when your system is stable, cholesterol is handled more efficiently, and your hormones respond better. So I'm not saying And please, I hope again, this isn't medical advice, but I'm not and I'm not saying to ignore your heart health, because heart disease is actually a big problem for women in midlife. I'm saying that midlife women deserve a more nuanced conversation. If your doctor says, Oh, your LDL went up and stop eating eggs, I'm going to stand strong in disagreeing with that. That's too simplistic of a way of looking at your cholesterol numbers. There are so much more going on there, and that's why functional medicine can really shine in these circumstances. So again, healthy cholesterol, healthy fats. What you want to focus on is things like olive oil, nuts, seeds, avocados, oily fishes. These aren't extras. These are actually imperative in functional Hormonal Health. Another thing that I want to talk about for diet is fiber. So fiber helps to feed your gut bacteria, and your gut bacteria influence hormone metabolism, and so good fibers can help with what we just talked about, can help to clear out some of that excess, yucky cholesterol. In fact, doctors can actually prescribe prescription grade fiber. That's not necessarily necessary if we're eating the right foods and potentially taking a high quality fiber supplement. But good fiber helps to kind of recycle your hormones, sort through your hormones, instead of just dumping them. So fiber is a really important aspect of midlife Hormonal Health. Again, all of these things are still important, regardless of whether you choose bioidentical hormone replacement therapy or not. So it's not an instead of necessarily. It can be in addition to another thing besides diet that we need to pay attention to is movement. Muscles really matter. Muscles play a key part in metabolic health. So we know that as women age, our lean mass declines, and that affects insulin sensitivity, your metabolic rate, inflammation, all sorts of things there is. Is so much to be said for resistance training, for lifting weights or using bands, that's hormone medicine right there. So two or three, preferably three, sessions a week focusing on building your muscle is ideal. And so here's something that I've been really excited about in clinic lately, is creatine. So creatine used to be dismissed as like a bodybuilder supplement, but research now shows it has specific benefits for women in midlife. So not only does creatine help to improve lean muscle mass, but it also enhances strength gains from any resistance training that you do. Another thing that I find fascinating, I'm actually seeing myself, not just in women in my clinic, but I feel like, when I am using creatine consistently, my brain fires, like I really feel a huge difference in brain fog, I feel smarter so so much. Several small studies have actually shown that women over 40 supplement with creatine alongside resistance training, they gain more strength and muscle than training alone, and that's huge, because more muscle, again, means better metabolic health and better insulin control and more support for healthy hormone signaling. So I think it's really important to bring creatine into the mix. So we are getting amazing feedback, and it's definitely something if you're not doing currently, that you could potentially start creatine is not a hormone. It doesn't raise testosterone. It enhances the body's responsiveness to exercise and to some hormonal and metabolic signals that you already have, so it's not a replacement for testosterone, but can provide similar benefits. Sleep. I talk about sleep on the show. I'll keep it short because I do talk about it in so many episodes, but sleep is non negotiable. When you're short on sleep, your stress hormones are all over the place, your insulin sensitivity drops, your appetite can go haywire just from a lack of sleep, and testosterone and DHEA, if you're not sleeping well, will not be optimal. So we could talk more about sleep hygiene, but I've done that on other shows, so tune in to some of my sleep specific episodes if you want to dive in more and again, you know, we do do lab testing in our clinic. Labs are definitely one big part of how we treat women, but you do not need labs in order to do the things we've talked about so far. No lab is going to tell you that strength training is bad. No lab is going to tell you that you should not get a good night's sleep. That's the bottom line. So before you add testosterone, or while you're already using testosterone, do these foundational things, eat protein, rich meals. I know you're sick of hearing it. You hear it all over Instagram, but it's true. It's there's so many good reasons why we need more protein, prioritize healthy fats, prioritize fiber, lift weights regularly, consider creatine to help with muscle gains. Sleep seven to eight hours, consistently calm your nervous system and use labs, but use them only as a piece of the story, because these things matter with or without adding testosterone. Hormone therapy isn't magic. I mean, when the body needs it, the results are better, faster and more sustainable. But again, all of these lifestyle things are really, really important, and if you're not doing a lot of them, you can add, you know, hormones all over the place, you're still not going to be in optimal health. So if you're curious about how to personalize these strategies, nutrition, strength training plans, or starting creatine safely, just drop me a message. I'll tell you all about how we work with women in clinic. You know, point you to some resources I would love to help. And of course, if testosterone feels like the right next step for you, we can certainly see you at our clinic. If you are located in Maryland, you deserve a body that feels like your own again, but you also deserve to feel better than ever with power, with clarity and with joy. So thank you again, another moment of gratitude. Tuning in means the world to me. Any feedback you can give on the episode, on the show, I would love it, and I will see you in a couple weeks. You.