Dr. Sara Gottfried argues high rates of constipation in women are linked to a combination of factors including a longer colon, subclinical thyroid dysfunction, and the physiological manifestation of perceived stress and trauma, described as a need to "hold things in."
A significant and rarely discussed side effect of oral contraceptives is clitoral shrinkage. This is presented as a crucial piece of information often omitted during informed consent, which might convince women to seek alternatives for non-contraceptive uses like acne or painful periods.
The conventional view of hot flashes as temporary menopause symptoms is dangerously dismissive. They are significant indicators of underlying health issues, including increased cardiometabolic disease risk, bone loss, and changes in the brain, and should be taken seriously.
Testosterone, the most abundant hormone in the female body, is essential for psychological traits like confidence, agency, and risk-taking. Oral contraceptives can suppress free testosterone by raising SHBG, potentially impacting these vital aspects of a woman's personality and ambition.
High-endurance exercise like long-distance running can be counterproductive for individuals with high perceived stress, as it further elevates cortisol levels. More adaptive exercises like Pilates or yoga may be more effective for lowering stress and rebalancing hormones.
Polycystic Ovary Syndrome (PCOS) is often incorrectly viewed solely as a fertility issue. However, it represents a significant risk factor for cardiometabolic disease throughout a woman's entire life, becoming particularly important to manage after age 50 due to high androgen levels.
Dr. Sara Gottfried strongly recommends a Coronary Artery Calcium (CAC) score, a CT scan of the chest, for all women by age 45. This simple, self-orderable test provides a critical assessment of cardiometabolic health, enabling early, personalized intervention for heart disease risk.