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Apr 16

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You don't have to have low testosterone on your blood test to benefit from testosterone therapy. 🥺

Women with normal range testosterone who have symptoms of low testosterone, especially sexual symptoms, still benefit from therapy.

Classic low T symptoms include low desire, arousal problems, org@smic problems. ✅

Less classic (and less studied) symptoms include low motivation, fatigue, brain fog, difficulty forming muscle, difficulty making decisions.

Have you tried testosterone therapy? What were the effects? ⁉️

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Apr 15

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The ovaries are the pacemakers of healthy aging.

Today I attended the QB3

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Apr 13

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Apr 11

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It's spreading! 💥

The word is spreading.

I began talking about the benefits of hormone therapy for women in 2013.

13 years later, the tide has turned. 🌊

We're not there yet but we're on our way to offering all women, at a minimum, a conversation.

Let's go!!!! 💪

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Apr 10

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200k! 💥

I started on this platform 8+ years ago, talking about HRT when few others were.

It's been such a Wild Ride. 🐴

I feel so damn grateful to have this place, this community. You.

Thank you. 🙏

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Apr 6

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Which hormones actually build muscle in women? ❓

A head-to-head RCT tested estrogen, testosterone, and progesterone on muscle
protein synthesis (MPS) in menopausal women.

The results surprised everyone — including the researchers.

Progesterone therapy increased muscle protein synthesis by 50%. ✅
Testosterone therapy increased muscle protein synthesis by 50%. ✅
Estrogen therapy ... had no effect. ❎

Why? Swipe through to find out.

Save this. Send it to your gym friend who's on HRT. 💪

What's your experience been with building muscle in (peri)menopause? Share! ❓

#hormones #perimenopause #menopause #testosterone #progesterone #estrogen
#musclebuilding #HRT #womenshealth #longevity #ageragingly

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Apr 4

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Estriol vs Estradiol ? 🥺

They can both be effective for vaginal health and GSM symptoms.

But the concentration is different.

Estradiol is commonly given as 0.01% cream, applied as 0.5 - 1 g several days a week. ✅

Estriol is more often dosed as a 0.3% cream, also applied 0.5 - 1 g several days a week. ✅

You can use either and have good effects.

And, vaginal DHEA is also an excellent choice.

What have you had the best experience with?? ⁉️

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Apr 2

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Are GLP-1 weight loss drugs affecting your sex life? 😒

In a Kinsey Institute study, 52% of people said "yes".

Some people saw improvements while others saw reductions in libido and sexual function.

In men, some studies show increased risk of ED (ex: non-diabetic obese men) and some show reductions in ED (ex: diabetic men).

TLDR: The jury is still out on the effects of GLP-1s and sexual health. The key is to pay attention to your own symptoms and let your doctor know if things are changing.

Have you noticed changes to your sex life since starting GLP-1s? Good, Bad, Ugly? ❓

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Apr 1

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Four things. Actually. 😏

Thermal receipts are coated in BPA, a known endocrine disruptor and reproductive toxicant.

Holding a receipt for 5 minutes can lead to BPA in your urine for up to 9 days. 🥺

Washing your hands after holding a receipt does not remove all of the toxin, as it's absorbed quickly.

BPA can cause fertility problems, pregnancy problems and is associated with obesity (among other things).

So... Opt out. Good riddance. ✅

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Mar 30

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📣 The GLP-1 conversation is loud.
‼️ And wildly incomplete.

These drugs can work better,
🤯 OR worse,
Depending on hormones, protein, training and more.

📖 Most people are missing the playbook.
Get all the details no one is telling you about this drug in this week's read.
10 Things You Didn't Know About GLP-1s! ✅

Check out this week's Substack (link in TapBio).

P.S. All references are available for free in my Substack.

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Mar 28

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I'm so grateful to be on the first ever @lancomeofficial Longevity MD Advisory Board. 💥

Today Lancome reveals its new longevity skincare line, which incorporates Urolithin A (@miropure_official ) from @timeline_longevity .

The idea is to bring the ideals of longevity medicine to skin health.

You'll hear more about this soon! 💃

P.S. Thanks to @drdavidluu for introducing me to this opportunity.

Thanks to @drgabriellelyon and @tiffanymoonmd for joining me in this adventure!

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Mar 27

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1 in 6 perimenopausal women experience suicidal ideation — and most
doctors are missing it completely. 😟

Standard depression screening wasn't designed for hormone-driven mood changes. A new study from Liverpool John Moores University found that HRT reduced suicidal ideation by over
90%!

If you're in perimenopause and struggling, ask your doctor about your hormones — not just an antidepressant.

Have you had depression or mood changes in perimenopause? What did your doctor offer you? ❓

Study: Improving detection and treatment of psychological distress during menopause: evidence from a clinical hormone replacement therapy cohort | BJPsych International | Cambridge Core. Jan 2026.

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Mar 26

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Checking estradiol and progesterone in perimenopause should not prevent you from getting hormone therapy. ❎

You should still get other labs, such as metabolic markers, lipids and inflammatory markers at least yearly (ideally more).

I generally prefer serum (blood) testing for hormones but it's not wrong to also use other tests in the decision-making process.

The standard of care in medicine is classically 14 years behind the cutting edge curve. We need to be open to reviewing new science instead of waiting for someone else to do it for us.

My two cents. 💰

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Mar 25

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I still have the side shave. It reminds me of my daughter, who is fearless.

It reminds me that now is the time. ⏳

To take risks.
To be bold.
To not care if it makes sense to other people.

You'll never be as young as you are today.💪

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Mar 23

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🫠Mind the gap orgasm gap.

95% of men finish,
While only 65% of women do.
Yet somehow we decided women were the problem??

From the G-spot myth to “you should orgasm from penetration,”
This is the sex ed we should’ve gotten.

👉 Comment "SUBSTACK" to get this sent right to you before you blame your body for bad information.

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Mar 21

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Women's strategically placed glute/hip/thigh fat is more metabolically beneficial than centrally-placed belly fat. 💥

Before menopause, this gives us a serious advantages. 🙏

Estrogen and progesterone loss at menopause shifts that "good" fat into the "bad" zones, where it becomes more inflammatory. 😩

I recommend DEXA scans + metabolic blood testing (fasting glucose, fasting insulin, Hbg A1c, hsCRP, lipids) to all midlife women.

Know your baseline so you know when things are changing. ✅

Have you had metabolic testing in the last year? ❓

P.S. While curves certainly have benefits, too much fat is problematic, no matter where it's sitting on the body.

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Mar 20

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Your age at menopause influences cardiovascular disease risk. 😲

Women who go through menopause earlier (if untreated) have a higher risk of heart disease.

Why?

Estrogen protects the CV system through multiple mechanisms, including effects on...
🔺 Lipids
🔺 Inflammation
🔺 Blood sugar
🔺 Blood vessel elasticity
🔺 Vasodilation

Did you go into menopause early? Has your doctor discussed the need to be proactive in CV disease screening with you? ❓

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Mar 19

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Are you at risk? ❓

Early menopause is associated with a 40% increased risk of cardiovascular disease.

Black women are three times more likely to go into early menopause. 🥺

Loss of key hormones, especially estrogen, are a key contributor to the increased risk.

It turns out that the ovaries do a lot more than just make babies. Who knew 🤔😏

Freaney PM et al. Premature Menopause and Lifetime Risk of Coronary Heart Disease. JAMA Cardiol. Published online March 18, 2026. doi:10.1001/jamacardio.2026.0212

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Mar 16

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I love you, but I gotta say it...

Biest is Bull$shit. 🤑

1) Even at concentrations of 1:20 (estradiol: estriol) the estriol doesn't bind the estrogen receptor in any meaningful way.
2) Even if estriol WERE binding the receptor, it would have agonist effects, not antagonist effects, like you're taught (because of the consistent serum steady state of estriol).
3) Estriol as a stand-alone is a crap systemic hormone. It requires very high doses (4-8 mg orally) to improve VSM at at least 2 mg to improve bone density.

Estriol doesn't help with insulin sensitivity, visceral fat, CV prevention, or brain health. ❎

For a full list of sources, see the free section of my Substack article. Comment SUBSTACK below for a link.

P.S. Biest isn't harmful. But it commonly underdoses estradiol, which is the hormone we care about.

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Mar 15

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Your patients are asking about hormones. Are you ready to answer? 🤔

I built the HOT Provider Course because I got tired of watching brilliant clinicians feel lost when their patients asked about hormone therapy. 23 video lessons. 300-page guidebook. 💥

Everything I wish someone had handed me when I started.

But first — grab the free HOT Quick-Start Guide. It's a one-page clinical cheat sheet covering:

✅ The SMARDT prescribing framework
✅ Baseline labs checklist
✅ Key contraindications for male and female hormone therapy
✅ Next steps

Comment "QUICK START" and I'll send you a link to my website. Scroll to add your email and I'll send you the HOT Quick Start Checklist.

Or visit dramykillen.com/hot-provider-course 💪

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