The thing is, people always ask me, like, what's the one thing I should do?

There is no one thing.

The one thing is sunblock, probably if there's a one thing really depends on how old you are.

Your skin quality, your facial structure, your budget, you know, your comfort level with trying new things.

There's so many variables.

Should we be eating all organic?

I'm sure that people in my wellness world want to hang me for this, but I think that the jury is still out.

You know, I'm so glad you brought up sexual health, because I think that that is such a topic that women don't feel comfortable talking about all the.

Things that are in your.

In your head.

Because we know that your brain is your largest and most sex organ.

So you start with there.

So start with the mind.

What are the signs that women should look for to see if their hormones are off?

All women should be getting basic hormone testing at least once a year.

And that's like thyroid.

That's, you know, if you're over 35 or so, probably testosterone.

Yeah.

I mean, unfortunately, doctors just don't receive training, you know, very much training at all in any of this stuff.

Even the gynecologist, even the endocrinologist.

Consistency.

You don't have to go hard every day.

You just gotta go.

Today's guest is one of the boldest, smartest, and most forward thinking voices in women's health and regenerative medicine.

Dr. Amy Killen is a board certified physician and expert in anti aging, hormone optimization, aesthetics and sexual wellness.

And she's not afraid to talk about the stuff most doctors avoid.

In this episode, we break down the science behind midlife aging.

From hormones and libido to peptides, PRP and exosomes.

We talk about what actually works, what's just clever marketing, and how to advocate for your body when the system keeps telling you you're fine.

We also go deep on why so many women are misdiagnosed or ignored.

What's really driving, low energy, low sex drive, and accelerated aging.

And how regenerative medicine is rewriting what's possible for women in midlife and beyond.

This conversation is smart, grounded, and packed with information you're not getting from your average doctor or your for you page.

Follow the iconic Midlife wherever you get your podcasts and send this one to the friend who's wondering if it's just hormones or something deeper.

Amy, welcome to the Iconic Midlife.

So excited to have you today.

Thank you so much for joining us.

Yeah, thanks for having me.

I'm excited to be here.

Great.

How's your day going so far?

It's been busy already.

I was up early today, but so it's good.

I saw you were at a lake, I think yesterday.

Is that right?

You were traveling?

Oh, yeah.

I was just.

It's like an hour from my house, so it wasn't that big of a travel.

But yeah, we go there every year.

It's amazing.

Oh, that sounds so refreshing and so nice.

Right now.

I could use a lake.

I'm in Texas right now.

It's a little hot.

Texas is hot.

It is, it is.

Particularly in August.

Yep.

Amazing.

So I would love to dive right in.

You know, I opened up my DMs to my followers and the amount of questions that we got blew my mind.

I mean, there's so many things to discuss.

You know, I feel like midlife is sort of one of those times of life where, you know, you kind of go into it, you don't really know what's happening.

And so just trying to find your way.

So I just, you know, I wanted to start with kind of, you know, your expertise and your background.

And I love that you talk so much about regenerative medicine.

This is so important, you know, and it really.

As the future of aging.

So for some women in midlife who were just hearing that term for the first time, can you talk a little bit about what regenerative medicine is?

Yeah, regenerative medicine basically just means using tools.

There's various tools we could talk about, but getting your body to repair itself, to heal itself in.

In sort of novel ways.

So essentially, whether we send growth factors in from PRP or from stem cells or even like, light therapy or.

Or other things like that, essentially getting your body to be like, oh, I actually need to start repairing this tissue and wake up and act like more youthful version of, you know, myself.

And how does that differ from, like, what we've been taught, you know, with health, especially with women's health?

Like, how is that different from, like, our mom's generation or Even our generation 10 years ago, you know?

Well, we use regenerative medicine.

You know, it's most.

It's most commonly used for, like, repairing, you know, a hurt knee or shoulder injury.

Like musculoskeletal pain is where we start.

This is where it started is using like, stem cell therapies and similar to repair muscle, muscle tissue, you know, tendons, ligaments.

But I've been using regenerative therapies for.

For skin health, for scalp health, so to help regrow hair, for sexual Health and even for potentially kind of longevity purposes for the last 10 years.

And it's all the same.

You know, we're using the same kind of technologies and biologics, but we're trying to kind of kind of approach aging and healing in a different way.

You know, I'm so glad you brought up sexual health, because I think that that is such a topic that women don't feel comfortable talking about with their doctors, with even their friends, you know, their partners.

So I think that that is such an important thing to talk about.

So as it relates to aging and clinical health, what are some ways that we can help improve our sexual health, you know, and not feel so ashamed and like, stigmatized about talking about it?

Yeah, I mean, I think sexual health is.

It's just like any other health, right?

Like, we, we should, we should be able.

We go to the doctor.

We have, you know, my knee is not working properly, and it's no big deal.

But like, we don't want, we don't go to the doctor and say, my clitoris or my vag.

We were very nervous about, say, like, this other area is not working properly.

So part of it is just kind of getting over that.

But, you know, I think of sexual health as being kind of.

I have kind of a four pronged approach to sexual health.

So the first one is mind.

The mind.

So you always start with thinking about the brain, whether that's, you know, social relationships, that's your stress, that's your past trauma, like all the things that are in your.

In your head.

Because we know that your brain is your largest and most important sex organization.

So start with there.

So start with the mind.

And then the second part of it is boost blood flow, you know, blood flow to the sexual organs.

We know in men it's super important for, you know, for erections to have blood flow.

And in, actually, in men, the most common cause of sexual dysfunction is lack of blood flow, because we can see it like that's what causes lack of erections.

What's interesting is that in the women, that's probably also one of the most common causes of sexual dysfunction, but it's not talked about in women because it's harder to measure in women.

So, but, but blood flow is very important.

So anything you can do to help with your, you know, cardiovascular health is going to be helping with your sexual health as well.

Then the third piece of that is hormones, so making sure that your hormones are optimized.

And then the fourth piece is the actual structures themselves and, you know, making sure the pelvic floor muscles are, you know, appropriately tight and making sure that you're all the structures themselves, the vagina, the clitoris, et cetera, are all in working order, if you will.

So where should.

Because that is like, like a very needed approach.

We need to do all four of those things.

What do you think is the most important place for a woman to start when it comes to sexual health?

I mean, I think it's very dependent on what's going on.

You know, women's sexual health is, is, is extremely complicated.

It's not just as easy as taking a Viagra and everything is perfect, you know, So I, I, I think the, the first place to start if you're by yourself, is to start, you know, thinking about, you know, easy things are, Start thinking about how stress is affecting your sex life, how lack of sleep, how you're, you know, lack of exercise, like some, like how the, how you're, the way that you feel about yourself.

Some of these things are much more in our control than other things.

But just keeping in mind that, that the daily practices like that can make a huge difference in how, you know, whether or not you're, you have a libido or not, or, you know, how, how your arousal is coming across.

What do you think is the most misunderstood thing about women's libido?

Like, is there like a certain, almost like a mythbuster?

You know, I think a lot of.

I think people think that women don't, don't have as much libido as men.

Like, we're not as interested in sex as men.

And that is true sometimes, and certainly it waxes and wanes throughout our lives.

I think that it's totally normal to have some periods where we're not interested in sex and some periods where we're much more interested.

And it kind of comes and goes.

But I think that women do get this, they get kind of a bad rap is like, we're not really that interested in insects.

But I think that's, that's not true a lot of times.

Yeah.

And I think it's like you're saying it's, it's a multifaceted approach.

And I love your idea of like, treating the body holistically as it relates to sexual health because it is so important to kind of prioritize yourself, take care of your fitness and your wellness, while also, you know, just like, really looking at your body as a whole.

Yeah.

I mean, you know, we, we know that there's a very close relationship between sexual health and longevity.

And that you know, like there's actually, there was actually a study in 20, 20, 20 in the Journal of Sexual Medicine that was like 15,000 men and women.

And they found that people who had sex at least once a week had a, they had a 50% lower all cause mortality rate compared to people who were not having sex.

So they were half as likely to die.

And it doesn't mean that sex makes you live longer, but it does mean that there's a close correlation between having, having an active, healthy sex life and being healthy in general, both from an emotional, mental, physical standpoint.

So essentially, sexual activity can sometimes be an indicator.

Like if you're having sexual problems, it can be an indicator that something else is going on in your health.

It sounds like it really just also helps, like quality of life, you know, like your enjoyment and your pleasure and, you know, I feel like a lot of women, especially at this time, have just left, lost that mojo, you know, kind of like lost themselves a bit.

You know, they're kind of, maybe they're dealing with some aging parents, maybe they're dealing with kids going away and being empty nesters and reconnecting with their partners.

I mean, is that like, what would you say to a woman like that who just feels lost, like she's lost her sexual mojo?

I mean, I feel like we've all been there, right?

Like, it is, it's, it's a hard time.

It's a, it's a tumultuous time, whatever that word is.

It's a, it is a hard time to be a woman.

Like, and I think a lot, you know, a lot of us have had partners for 15, 20 plus years.

So there's also that part of it.

Like maybe there's some boredom in there.

We have kids that are getting older and going to college.

Like, that's stressful.

We have aging parents.

That's stressful.

Our hormones are crazy.

That's stressful.

Our bodies are changing.

So I think, you know, give yourself a little bit of grace.

But if you're interested in, in maintaining, you know, sexual vitality and, and sexual activity, just know that there are a lot of things that can be done both from a psychological, emotional, mental standpoint, but also from a physical standpoint.

And I love this too of what you said about aging kind of being optional, you know.

So what do you think are some of the biggest needle movers to help women, especially in midlife and on a cellular level, you know, reach their full potential for longevity?

I mean, there's so many, there's so many needle Movers, I think certainly hormones.

I mean, I talk about hormones all the time and you know, I'm a big fan of estrogen and testosterone and progesterone.

And I think all women should at least have that discussion with their doctors that, you know, about the possibility of taking hormones whether they choose to or not.

That's up to them.

But I think hormones are key.

But other things, like mitochondrial health is super important for overall health.

And actually the, you know, the mitochondria are the little powerhouses of your cells, right?

They make your cellular energy.

And starting about age 25 or 30, every lose about 1% of mitochondrial function.

And mitochondrial function goes down significantly when we lose estrogen.

So estrogen and mitochondria are like BFFs.

And so when you lose estrogen at late perimenopause menopause, mitochondrial health suffers significantly.

And all of a sudden you're much more tired.

You can't get things done.

You're, you know, you're wired and tired maybe.

But so working on mitochondrial health specifically, I think is a, it's a key part of health that most doctors don't even talk about.

So how do we analyze that in ourselves?

Like, how do we find out if our mitochondrial health is optimal?

Even There aren't a lot of great tests.

There are a couple of advanced lab tests out there that will look, that can look at mitochondrial function if you have like a functional health doctor.

But, but there really aren't that many tests.

You kind of have to go by symptoms and also probably just know that if you are in midlife, you probably don't have peak mitochondrial health unless you're doing everything right.

So certainly healthy lifestyle, you know, getting enough sleep, getting, working on stress management, exercising, like high intensity interval training can be helpful.

Maybe even a little bit of intermittent fasting to give mitochondria a break can be helpful.

There are, there's a whole number of supplements that can kind of support mitochondrial health as well, including things like ketones, like exogenous ketones that you can drink, which are great because it kind of, it's like an alternate fuel source for your body and gives your mitochondria a little break.

So there's a lot of different strategies that we can use, but you kind of have to work with someone who understands, you know, that this, what this is.

Absolutely.

And I'm glad you brought up the hormones too, because I think that that is obviously such a hot button topic right now.

You know, recently it's the FDA approved, like vaginal estrogen and said it was of course safe and everything, which is a change from what was told to us, you know, 20 years ago.

So for the women though, I mean, I know there is a small population of women who actually can't take pregnancy hormones.

What would you say to them?

Like, is there, are there natural resources or supplements or things like that that they can take?

I mean, I, I think that no.

Hormones are, are a piece of the puzzle.

They are not the entire puzzle.

And certainly if you can't take hormones because you've had breast cancer, for instance, which is the most common reason that women can't take them, then you, you just want to understand what those hormones would be doing in your body.

And, and then you can start to kind of replace that in terms of your lifestyle or your food or your supplements.

So for example, loss of estrogen at menopause is a major driver of bone loss and osteoporosis because estrogen, you know, keeps your bones healthy.

And we know that.

So if, if you know this is come, this is coming and your bones are going to start becoming less healthy because you're losing estrogen, then you have to be very strategic about keeping your bones healthy with weight training, with, you know, heavy lifting, resistance training, with like jumping exercises.

So you're, you have some high impact on your joints with, you know, the appropriate nutrition with, with supplements like vitamin D and vitamin K and magnesium and some of these things and you know, sort of essentially taking bone health and like making it one of your like part time jobs because you don't have the help of estrogen, you have to do it yourself.

And are you concerned at all about the heart too?

Like with heart health and loss of it?

Is that.

Absolutely, yeah, absolutely.

What would you recommend for that?

Heart attacks are the number one killer of women.

So one in every three women will die of a heart attack or a heart related illness.

So it is absolutely.

We know estrogen is very cardio protective.

So you know, again, like taking cardiac health very seriously, looking at your blood pressure, you know, in all of these things, traditional medicine has kind of a cutoff of what's considered too high or, you know, or abnormal.

But there's also like this whole range below that that's maybe not like too high, but it's still, still like not optimal.

Right.

So understanding what is the optimal blood pressure, what is the optimal blood sugar?

Like, maybe you aren't diabetic, but you also don't want to be pre diabetic.

You want to be like optimal, you want to be way down Here for blood sugar, Same thing for cholesterol.

Keeping your cholesterol like be, you know, your cholesterol low, your, your ldl, C, your apob, but essentially like understanding what are the drivers of heart disease and then going like hog wild in terms of making sure that you don't have those things so that you don't develop heart disease.

That's such a great point.

So when I opened up my DMs, one of the questions that I asked was about three specific things.

It was about peptides, PRPs and exosomes.

And I know you are on the forefront of all of those things.

So before we start diving into each one of those in five years, what do you think of those three, or maybe even all of them will be the most mainstream thing like the go to for women.

I love that question.

I don't think prp.

PRP has been around forever and I don't think it's going to be.

That's just essentially you take your blood, we spin it, we get your platelets and we put that back, you know, in some part of your body to help repair.

It's a great therapy.

I just don't think that it is going to be the next generation thing.

Certainly stem cell therapies include including exosomes.

Exosomes, if you don't know, essentially stem cells, the way that they communicate with each other and with other cells is they release these little bubbles of information that are called exosomes.

And within those you have like growth factors and messenger RNA and cytokines and all these like things that tell other cells what to do.

And so you could actually, we have products that we can, we could just use the exosomes or we can also use the entire stem cell, depending on what we're doing.

But they're both really great ways to help repair.

And there's new, there's new versions of these stem cell therapies coming out all the time, like, that are more specific for, you know, like for instance, if we wanted to inject them into your scalp to regrow hair, there are new versions coming out that are specific for hair, hair regrowth versus or for, you know, repairing and whatever.

So we're getting better and better at that.

And so I think in the future we'll have much, many more of these products that are approved and that can be used even by like your general doctor.

Okay, are we ready to take the deep dive?

Here we go.

What is an exosome exactly?

For the women who maybe have never heard of this or maybe they, you know, you're starting to see it more in skin care, I'd say, you know, you see exosomes or you do it maybe after some plastic surgery or some treatments.

But for like, those women that are not so familiar with the exosomes, how can exosomes help them?

So exosomes, like I said, they're basically these messenger bubbles that come from stem cells.

So when we give, for instance, if I was to give you stem cells into your face, if I injected your face with stem cells, which is something I do, the way that those stem cells work is they release these exosomes and other growth factors, and then those things kind of float around and then they get captured by the cells in your face and those exosomes get internalized, and then those exosomes change.

Change the way that your cell behaves.

So, for instance, if I want your fibroblast in your skin to make more collagen and elastin to give your face, you know, better health and structure, then theoretically we could give you exosomes directly.

And that's like a, it's like a blueprint that's being transferred to the cell, but it doesn't have any DNA in it.

It's, it's got just growth factors.

So essentially it's a way to communicate that we want to increase healing, increase rejuvenation, regeneration.

But you're using your own body to do that.

Okay, and for exosomes, that's primarily for skin, Correct?

Like skin and face.

And exosomes are not FDA approved for anything, but they can't, they're, they are allowed to be used topically.

So that's why we see them so much if, you know, like after micro needling of the face or after micro needling of the scalp.

So they're, they're, they are used other ways.

Certainly they're around, but, but that they're approved mostly just for aesthetics.

Okay, now peptides, this is like the hot, hot, hot topic right now.

They're so having a moment.

It's like, I feel like I look on social media and I see peptides here and peptides there.

So also for women who may not be so aware of what peptides are, can you just kind of go through what they're used for and how they really help with regenerative treatments and health?

So peptides are just short proteins.

So proteins are like these very long complex amino acid chains, right?

But peptides are very short amino acid chains.

Maybe they're four or five or six amino acids long.

So they're very short.

And so they each have, and they come from like you have them within your own body.

So essentially the ones that we use in practice are just taking what your body's already making and we're just, we're just taking that and we're multiplying it essentially.

So, so there's all different peptide.

They do different, many different things.

For example, one of the most common ones is BPC157.

That's the one that everyone hears about.

Like, it's the, it's the most common one normally in your body.

It's found in your stomach juice, it's actually in your gastric juice.

But it does a lot for healing the gut, for instance.

It also does a lot for helping to repair and heal musculoskeletal pain.

If you had a, you know, rotator cuff injury or Achilles tendonitis or things like that, then that BPC157 potentially be helpful.

The thing about peptides that you should know, however, is that most of these are not regulated by the fda.

Like, they're not, they're not, they, they haven't gone through the FDA process to become full drugs, except for a few, a few versions like the GLP1s, like, like semaglutide, tirzepatide.

Those are peptides, but they've gone through the full FDA drug application process.

Right.

So those are drugs, but there's a whole class of peptides that haven't gone through yet.

Yet.

Who, so they're not as well studied.

They are, a lot of them are not even studied in humans.

So we do have to be careful and say, you know, these are still very much experimental, even though we think that they could help with a lot of things.

Absolutely.

And for peptides, what is the best method of taking them?

Like, is it the injections?

Is it, you know, I've even seen like GLP gummies and powders and things like that.

What do you, what do you think is the best way to take these things?

I mean, most of them are going to be the best, best taken by injections, like little subcutaneous injections, like a little insulin needle, like in your stomach, for instance.

There are some peptides that are, that can be taken either like as a nasal spray or a sublingual like, like underneath the tongue or even a pill.

Some of, some of them, like the BPC actually does survive through in the stomach.

It does survive the stomach acid because it comes from stomach acid.

So that one is one that's bioavailable orally but most of them are going to be better, have better bioavailability if they're injected.

Okay.

One of the questions that I got also was about Tess Morlin and test more than they wanted to know.

Is tesmoreland better than CJC and what your thoughts were on that?

So Tessamorelin and CJC 1295 are both examples of peptides that help to increase your own growth hormone production.

And they are used.

Tesmorelin is actually FDA approved.

It is a, it is a drug.

CJC 1295 is not that one is commonly used with something called ipamorelin.

But basically, long story short, I prefer Tess Marellin.

It is, it's better, but it's also a lot more expensive.

So it is, it's one of those things that you have to kind of decide the, that how much you can afford kind of thing.

And they do, they both sort of target weight loss and muscle building and things like that.

They are.

So they increase your body's ability to make growth hormone.

So you're making it yourself.

And so it works better.

You know, people who are generally a little bit younger, not, not in your 70s or 80s, but yeah, you're increasing growth hormone, which growth hormone is important for everything from muscle building to, yeah, potentially weight loss to, you know, your joint health to brain health.

I mean, it really, it spans all the systems in the body.

Sometimes we'll use it, for instance, with people if we're using, if they're using GLP1 medications, they're using like Ozempic and they're losing weight.

But we want to make sure that they're also maintaining a little bit of muscle.

So sometimes we'll add like one of these growth hormone peptides to try to help them maintain muscle because they're, you know, as they're also lifting weights and doing all the lifestyle things because we don't want to, we don't want them to get skinny but not have muscle.

Good point.

Also, we're hearing a lot about NAD and NAD plus injections.

So what are your thoughts on that?

Do you think that that is an effective treatment to take?

You know, I've had, I've had a lot of back and forth on this.

I actually, you know, I have a supplement company for women called Hotbox and we chose to put a precursor to nad and they're called nr, which is nicotinamide riboside.

And the reason we chose that one is because it actually crosses the cell membrane and gets into the cell much easier than either NAD itself.

Which doesn't do that, or in a min, which is the other one.

So I prefer, I think that in our.

Just taken as a daily supplement orally is.

Is better than doing, you know, IV NAD or even NAD injections, because NAD is a.

It's a big, big molecule.

It doesn't actually.

It's not able to get into the cells, into the mitochondria like we wanted to as that big chunky molecule.

Oh, interesting.

So are we wasting our money if we're buying NAD supplements without the nr?

In the studies that have been done looking at NAD iv, for instance, what they found is the nad, it does eventually get broken down into components that can be transported into the cell and used.

So I, I don't.

I wouldn't say necessarily you're wasting your money.

However, instead of having to take something that gets broken down and transported, it's.

Why don't you just take the thing that's already broken down?

Like, you're essentially like nr.

You're skipping the step of having to break something down.

It just goes straight into the cells.

And you can take it in a daily supplement, like in Hotbox, and you get your levels up, they stay up, and you don't have to, you know, spend $1,000 on an IV.

Good point.

We like that.

Also, needles, you know, I mean, who likes a needle?

I don't like a needle.

Same.

So who is a good candidate for peptides?

Is there like a certain age bracket or maybe body composition?

What are your thoughts on that?

Like, how do you know if peptides.

Peptides would be good for you or not good for you?

There are like.

I mean, there are hundreds of peptides, probably about 20, 25, that are commonly used.

But I mean, there, there's, there's one.

There's peptides for sleep.

There's peptides for sexual health.

There's peptides for healing musculoskeletal injuries.

There's peptides for skin, for hair.

Like, there's a, you know, it's for immune function and helping to fight illnesses.

So there's, there's peptides that for all different things.

So I think, you know, most people are candidates.

We don't tend to give peptides to people.

Certainly if you're pregnant, we don't give you anything experimental because it just hasn't been studied.

If you have active cancer, we're not messing with your.

We're not giving you anything experimental.

So there are people who we don't get, you know, we just say, this is not a good choice for you.

But Other than that it, most of them we think are pretty safe because they're all, they all come from your body.

But they also, you know, you do want to have a medical practitioner who knows about peptides.

Like I do not recommend just going onto the Internet and buying research peptides and you know, injecting them into your body.

I think that's probably not a good idea.

That's a good point.

Is there like an age where it sort of tops off, like it stops maybe at a certain, maybe 70 or something?

Or can you take it throughout your whole life?

I mean, as far as we know you can take it throughout your life.

I haven't, you know, we, I haven't had any people in our, in their like 80s or so that are on a lot of peptides most of the time.

That's just not something that they're interested in doing.

But, but you know, we, as far as we know that they can be used forever.

It depends on again what the peptide is trying to do in your body and whether or not it's going to make sense with your body.

Absolutely.

And you know, we were talking a little bit earlier about PRP and I think sometimes when people think prp they're thinking the vampire facial for example, you know, and so that's kind of what, where the knowledge stops.

But PRP is actually used for a lot more than just something like that.

So are you a fan of PRP and what would you recommend PRP for in midlife women?

Yeah, I mean PRP is when you think about the like regenerative biologic.

So things that are biologic that we inject.

You know, PRP is kind of the, one of the, like the most used one.

It's been around for decades.

It's super safe.

It just comes from your own blood and it's just platelets from your own blood that we re inject.

So PRP is, is great, but you do generally need a few treatments.

So like if you're doing it for your scalp, you need at least three treatments.

If you're doing it for your face, you know, you generally want to do about two or three treatments.

Same thing for your knee.

So it's like, it's a good therapy.

It's very safe.

It's not as strong as like the next level up which would be probably stem cells or exosomes or some of these other kind of higher level regenerative therapies where they're going to be more expensive, but they also generally have better outcomes with a single treatment versus prp.

But they're all kind of the same.

They all work in a similar way.

So PRP is relatively safe for most people?

Yeah.

Oh, yeah.

PRP is extremely safe.

The only thing that, the only potentially dangerous part are the injection.

So, you know, you could get a, you could get a joint injection, infection in your knee if someone used a dirty needle or if you had, you know, like, like there's some technique, things like that.

But the PRP itself is extremely safe.

You know, hormone optimization is so important in your practice and what you talk about.

So what are the signs that women should look for to see if their hormones are off?

You know, and how should they be, like, you know, reevaluating their own lives to make sure that hormone optimization is there?

Well, I think, I think all women should be getting, you know, basic hormone testing at least once a year.

And that's like thyroid.

That's, you know, if you're over 35 or so, probably testosterone, you know, cortisol, if there's any concerns, like there's some hormones like insulin, things like that that you should be getting every year.

And then as you get into perimenopause, which is, you know, can happen in the five to 10 years before menopause, so often starts as early as 35 or so, then having a, a physician who understands the symptoms to look for, because there's, you know, 30 plus symptoms in perimenopause that are.

That could be still stem from progesterone going down and testosterone going down and estrogen going down, and then eventually menopause.

I don't, you know, you don't have to necessarily check labs like estrogen and progesterone to know that they're low.

But I do, I do recommend checking them at some point, especially if you're going to start therapy.

You know, I think it's interesting, too, a lot of women, when they go to their doctors and they say, you know, I feel off or, you know, I feel like my levels aren't quite right.

A lot of them are gaslit by their doctors and, and said, you know, what if you're still having your period, you're fine.

You know, come back and talk to me when you miss a year's worth of a period.

And so I think a lot of women are, you know, unsure what to do.

So what advice would you give women in sort of that situation that feel like they're being gaslit by their doctor?

Yeah, I mean, unfortunately, doctors just don't receive training or, you know, very much training at all in any of this stuff, even the gynecologist, even the endocrinologists, like, these are great doctors and they know a lot, but these, the training on how to care for a woman in perimenopause and menopause and how to use and how to optimize hormones, you know, across all ages is really not taught.

And I think that that's it.

It's really a matter of we need to give more education for doctors.

Like, I'm working on a course right now for doctors for that same reason.

But, you know, I, I guess you just kind of do keep asking.

And also, if your doctor is not familiar with how to treat this or, you know, understand how to even diagnose problems, you may have to find a new doctor.

Like, that's.

Unfortunately, your doctor may not be able to be educated quickly enough for, for your needs.

Is there an age that is too young to start getting a baseline test for your hormones or is that some, like, somebody, women in their twenties should be doing?

Well, it depends on what hormones you're talking about.

If you're talking about like things like thyroid, your insulin, you know, these hormones you should be checking every year as, like starting as an adult, like every year you'd have those checked.

If you're talking about things like estrogen and progesterone, then it is true that if you're having really normal cycles and aren't having any problems, you probably don't need to check those labs.

Like, if you're 25, 30 years old and you, you know, don't have any cycle problems or they're, you know, everything is pretty fine, then your, your hormones are probably fine.

If, however, you're, you are 25 or 30 years old and you have irregular cycles or no cycles, or, or, you know, you're skipping several months at a time, or you're having like, severe bleeding or pain or all those kinds of symptoms, then absolutely you should be, you should get your estrogen, your progesterone, your testosterone, like your fsh, your lh.

All these hormones should be checked.

And there is a right time to check the hormones.

There's a right way to look at, like, it's not something as easy as just like, what's the normal, like, what's the optimal level?

Because it's, you know, they're changing every day right during your cycle.

So you need to have a doctor who understands what, when to check the hormones.

What are the, what are the optimal levels, what's too high, what's too low, what else to look out for.

It's it's complicated.

Right.

And it's holistic.

Right.

It's like the whole body because of something you have inflammation maybe that ties.

Right.

There's just so many moving parts.

Right.

100%.

Like, you know, you could be having, you know, irregular periods because you are stressed out and you're, and you're not making, you know, you're not ovulating properly because you're stressed.

And then your progesterone is not high enough.

And so now you're having insomnia and we worsening stress.

Like, it is a, it is a complex system.

And so you do have to think of it, like you said, like holistically, not just, you know, how are your ovaries doing?

Absolutely.

So let's talk skin because, you know, we like to look good.

Let's, let's be honest, you know, so I love that you are, you know, preventative in that way, especially with the regenerative health.

And so we're not, we want to talk about interventions that will make sense and help us.

So what are the three things that you think women over 40 should stop wasting their time on as it relates to, you know, having great skin, looking good, feeling youthful, all those things.

Ooh, that's a hard one.

You know, I don't, I think that most of the.

I'm, I'm a fan of many of almost all of the different cosmetic interventions.

Whether it's something like microneedling or an apply, you know, applying PRP afterwards or, or, or just doing good skincare with, with sunblock and retinoids, which are fabulous.

I do, you know, there are some of the, some of the, like the deeper treatments.

I'm not as big a fan.

Like, I don't think that the, the radio frequency microneedling treatments are right for everyone.

That's like the Morpheus and the things where it has the needles that heat up inside your skin, those were all the rage for a while.

But then people started noticing that that was actually causing a lot of volume loss, like fat loss in the face, which is making, which makes you look older.

And so, you know, I think that there's a right way to do it, but I also think that there's a wrong way to do it.

So, you know, there's all these things kind of come in and out of vogue, but any, you know, all of these treatments, these lasers, radio frequency treatments, you know, like ultrasound based heating treatments, like ultrapy, all of them have a place again, but with someone who knows how to use these tools.

So, okay, so you're not a big fan of Morpheus 8?

You know, I've done a lot of it myself, but I think, I do think it's, I do think it could be helpful at the, like, the, like, the less deep needle, you know, levels.

But I don't think it's a good idea to go deep in the skin.

If you have someone who is getting older, you don't want to lose fat in the face.

Okay.

So that maybe you want to be very careful when you, when you do that one.

How about like Botox fillers?

That whole realm, you know, I actually think all of those things are great.

It, again, if, if done properly.

I am not worried about Botox.

I know that a lot of people have concerns that it's dangerous to your brain or things like that.

But I mean, it's been, you know, this is one of the most used, utilized and studied, you know, treatments that we've had for decades now.

So I don't think, I think it's fine.

I certainly don't think you have to do it.

I don't think we should, any of us should feel pressure to do anything.

But I think that Botox and these, these toxin treatments are appropriate in, in, you know, small doses.

I think fillers could be great fillers and sculpture.

But again, you have to know what you want your doctor to know what they're doing to be.

Yeah, because there are potential side effects that could be really dangerous if you get in the wrong hands.

Do you think we need to be worried about the migration of, you know, we've heard like sometimes it can migrate in your face and things like that.

Is that something to worry about?

I, I haven't seen a lot of migration.

I, I do think that it could, that these fillers do stick around longer than we thought when we used to think that they were just stick around for six months to a year.

But, and I don't do, you know, I don't do facial surgery.

So I, but I just know that a lot of my surgery friends, when they're going in and doing facelifts or, you know, things like that later, they're finding filler in there that was there from, you know, five years ago.

And so I do think it's.

They're lasting a lot longer than we think and that, you know, and certainly at some point it doesn't make sense just to keep adding more and more and more filler.

You know, at some point, if you want that look, you may just need to get a facelift.

Yeah, exactly, exactly.

Just go for the big one.

Yeah.

And I have a Had.

You know, I haven't had a facelift, but I've done.

I've done filler.

I've done sculpture.

I've done all the different.

I did many lasers.

I've done talk, you know, toxic.

I did.

I've done all of it on myself.

So for you, is there.

Is sculpture sort of the filler kind of thing that you liked the most?

I do like sculpture.

Sculptra is.

Sculptura is not.

You know, you're not filler.

You're looking at, like, one area, and you're kind of trying to, you know, get that one area to be filled.

Sculpture is more like you're looking at the whole face, and you're doing little bits here and there.

So it's.

It's.

They're different in how they work.

And sculpture is kind of getting your own body to create the.

The collagen also.

So they both have their place.

There's not.

The thing is, people always ask me, like, what's the one thing I should do?

There is no one thing.

Like, the one thing is.

The one thing is sunblock, probably if there's a one thing, and then maybe retinoids second.

But there after that, like, it really depends on how old you are, Your skin quality, your facial structure, your budget, you know, your comfort level with.

With trying new things.

It's.

There's so many variables.

So many.

Do we need to be worried that any of these treatments will affect our hormone health?

No.

No, not that I know of.

Okay, so we're pretty safe on that end.

You know, I loved.

I was watching one of your videos last week about alcohol, you know, because that is something that we all feel nowadays.

I feel like, you know, whatever, going out, talking to the friends, doing, like, a girls night.

You have a couple glasses of.

Of wine, and the next day you feel like you've been hit by a truck.

I mean, it's just.

Yeah.

Remember, like, back in the day, in your 20s, you'd have, like, three or four glasses of wine, and you were fine the next day.

Now it's a different story.

So why is this happening?

Is it just like that?

We just basically can't process it like we did before?

Like, take it.

Tell me, like, start to finish.

Why is this happening?

There's a.

There's a few reasons.

One is, yeah, you can't process it the way you did.

We.

We.

The.

The alcohol dehydrogenase enzyme in your liver that metabolizes alcohol starts to slow down as you get older.

And so your liver is literally able to process alcohol much slower.

So you're getting it staying in your body longer.

Another thing that happens is as you get older, you're losing muscle because that happens with age.

And so, and muscle carries a lot of water.

So when you lose muscle, you actually start to become more dehydrated and you have a lower volume of water in your body.

Estrogen also keeps you hydrated, so if you, you lose that, that's also making it worse.

So you become more dehydrated and then you drink alcohol.

And then so it's like essentially it's more concentrated in your bloodstream because your bloodstream, you have less blood, less hydration in your blood.

So that's happening.

And then there's also a lot of things in your brain.

The way that alcohol affects your, your, your neurotransmitters, your dopamine, things like that changes with age also, especially in midlife, and that's also makes it harder.

And so it just becomes a lot worse for us.

It's true.

You just feel terrible the next day, you know, and I feel like a lot of women are really looking, looking at that and saying, you know, I want to cut back on alcohol or maybe only drink once a week as opposed to like two or three times a week.

You know, it's kind of implementing these lifestyle changes.

Right?

Yeah, I think, I mean, a lot of women in midlife just decide to stop drinking.

It's just not worth, you know, it's not worth it anymore because our, you know, our sleep is already disrupted.

Like we're already waking up with potentially hot flashes or nights was they're just waking up and can't go to sleep at 3am and then if you add alcohol to that, that's obviously going to make that worse.

And so a lot of us are just like, you know, that's, that's not for me.

I know I still drink a little bit here and there socially, but I have, I definitely have cut back.

I don't, I don't drink every day by any means.

And when I do, it's always one drink.

Because if I do more than one, I know it's not going to go well for me.

Right, right.

Why is it that 3am that's the time every time I had wine, I know 3am Wake up.

Why?

I don't, I don't know why exactly.

You know, alcohol is a depressant.

So it actually, it does, it makes you kind of, it makes you sleep, but it also does interrupt your REM sleep.

But I don't know why it is 3am for me as well.

It's true.

It's always that time.

Are there any things that we can take the next day to help us feel better if we do indulge a little too much?

I mean, there are a lot of products out there that are like, you know, the hangover kind of pill packs and, you know, IVs and things like that.

I honestly, I don't know if they work or not.

There are a lot of them.

Target liver health and trying to get your liver to, you know, work faster.

I. I haven't seen if there.

If those things really work.

Probably just hydrate, make sure that you're.

That you're getting some good food in your body and maybe get some sunlight.

Like that's what I recommend.

Yeah, it sounds like a good play.

Maybe head to the beach and, you know, have some water, cool water on your skin.

You know, you see both men and women in your practice.

So what are the things that you think that women over 40 are doing better than men as it relates to taking care of themselves and helping, you know, with their health?

That's a great question.

You know, I do.

I think that women are becoming, especially now, are becoming more knowledgeable about perimenopause and menopause and these hormonal changes.

So one thing, a trend I've seen now is women just asking a lot more detailed questions about their health than men.

Like, you know, men, a lot of them know about testosterone, but they don't necessarily.

They haven't been, you know, inundated with all this information that we're.

We're now seeing on social media for women.

So I think a lot of them just don't understand other things they should be asking about, you know, insulin sensitivity or thyroid function or, you know, like muscle mass and visceral fat or things like that.

But I think that I feel like women are becoming more educated because of the great people that are out there, you know, the doctors and the influencers and people who are talking about this so much now.

Absolutely.

That's something we really want to do here on the show is like, you got knowledge is power.

Like, women should know these things, and they should be armed with, you know, all of this knowledge when they're going into their doctors or when they're even going out with their girlfriends.

You know, it's such a great time to talk.

Yeah, absolutely.

And I think that women, women, you know, we all seeking answers like, we're a lot more complicated than Men, for sure.

You know, our hormones can go crazy in a lot of different ways, whereas men's usually.

It's just like a couple of ways, but.

But luckily, we also are more.

You know, we're.

We all.

We are.

We tend to talk more with our friends and to discuss.

And we have the social component that I think is a little bit different than a lot of men do.

The men also suffer from, like, hormone drops in their midlife.

Do they kind of go through.

Really, they do.

Well, you know, but in both men and women, testosterone starts going down starting at about age 25 to 30.

But it's like the slow, gradual descent.

So testosterone in men and women is.

Is very different than estrogen and progesterone, which at menopause, you know, kind of falls off a cliff.

Like, you go from like, it's fine, it's fine, it's fine to oh, my gosh, I'm out.

Testosterone is a much slower decline.

But that.

But it happens in both men and women.

So men often about age 40, start feeling effects that are related to low testosterone.

Not all men, but.

But some men.

So that's.

That's.

It's a common.

It's common for men in that age to come in and say, I just don't feel like myself these days.

Interesting.

Um, so how do we, you know, for.

For those of us that have partners who are men and going through midlife as well, like, what are the things that we can do to kind of help them?

Because, you know, men tend to be more closed.

They don't want to talk to about it.

You know, it's almost like I have to force my husband to go to the doctor, you know, so how can we support them during this time?

Well, I mean, I would recommend getting your testosterone check.

That's easy enough to do.

Get a total and a free testosterone.

There's a couple of other lab tests that we do at the same time that checks your pituitary gland function and things like that.

But, you know, get some lab tests done.

But the good thing about testosterone, this is different than with women.

There are a number of lifestyle changes that you can make to improve testosterone in men.

So, like lifting, lifting heavy weights, you know, getting exercise, losing belly fat, reducing stress, making sure you have enough, like, of some of the micronutrients, like, like selenium and zinc and vitamin D and things like that.

But like, so lifestyle changes actually can make a difference in men, especially younger men, in helping their body to make more testosterone.

So what do you think about this whole thought too about microdosing GLPs.

Have you heard that?

Like, I've seen it on social media where women are like, I'm just microdosing just because, you know, I'm in midlife and I feel like it's helping me.

Is it helpful to do something like that or what do you think about that?

You know, I think that we need to learn more about microdosing.

And you're certainly, you know, it's basically just any dosing that's outside of the normal parameters.

You know, it's lower than the normal FDA approved versions.

But I do think that these medications are, are fabulous and that there are a lot of indications for these medications outside of just weight loss that we're learning about every single day.

So I do, I have a lot of, I have a lot of patients who are taking small doses, these micro doses to try to help with things like inflammation or arthritis pain or, or polycystic ovarian syndrome or mast cell dysfunction or autoimmune diseases.

All these things that are, that are these, these medications, Ozempic, et cetera, are helpful at, but we don't have the data to say what the dose is yet or, you know, exactly how helpful they are at those baby doses.

What is the one thing that you wish all midlife women knew about their health?

I think the most important thing for women is to know that, that, that you have a lot of control of your health, but also you don't have all the control and you oftentimes need to get a kind of a co pilot, you know, medical provider who can help you with the pieces that you can't control.

So a healthy lifestyle is absolutely important.

It goes a long way to staying healthy, feeling good.

But it is not necessarily going to mean that you don't have perimenopausal symptoms or menopausal symptoms.

You know, it doesn't, it does not go all the way.

So yes, you have a lot of control, but also find that person that can help you if you need it.

And what about the women who have had hysterectomies?

Are they still going to, you know, have menopausal symptoms and the hot flashes and the brain fog and all that kind of stuff?

Oh, yes, they, when you have a surgical hysterectomy, you have your ovaries taken out.

With ovaries taken out, you essentially go, you go through entire perimenopause in the course of like 24 hours.

So essentially you go from normal production to no hormone production or very minimal.

And so the symptoms could be very severe.

And you know, unfortunately a lot of doctors, at least in the kind of old school doctors, weren't even replacing those hormones.

Like even in fair, you know, I've seen, I have several, I've had young women who messaged me and said, you know, I had a hysterectomy with my ovaries taken out at age 30 and no one told me that I should be on hormones.

And like there.

That's, it's, it's crazy.

It's absolutely crazy.

That's insane.

That is crazy.

And what are like the three supplements that you think that every woman should have in her medicine cabinet no matter what?

I love creatine, I love vitamin D3 with K2.

I consider that to be just one thing, but it's actually two ingredients and probably magnesium is the third thing I like.

Okay, yes.

Magnesium is something we really lack, right?

Yeah, a lot of people lack it and it's, there's multiple different types of magnesium.

My favorite is magnesium glycinate because it's like, it's just easy, easily digested, it's great for sleep, it's great for kind of calming you.

But there's many types of magnesium.

But almost, almost, you know, a lot of people are deficient within magnesium.

When we take vitamin.

Cuz you said D&K2, should we also be taking vitamin A and vitamin E with it?

So it's like a, like the four of them together or do we just need the D and the K2 together?

You don't necessarily.

I mean, yeah, those are all the fat soluble vitamins but, and you certainly can take them together.

Most of the formulations are going to be vitamin D3 and K2 together.

And then you may have the other vitamins in like a multivitamin or something.

You know, I don't think the problem, the thing with vitamin D is we don't tend to get enough of it in our diets.

And unless you're out in the sun, you know, at least 10, 15, 20 minutes a day, day, you don't get it from the sun either.

So women are like oftentimes deficient in vitamin D for that reason.

We're inside too much, we're on our computers too much.

So you know, a lot of the vitamins you can get in your food, if you have a healthy diet, you don't need to necessarily take a multivitamin.

Although obviously our diets are a little bit different than they used to be.

And the food sources aren't quite as quality as they used to be.

Absolutely.

And oh, should we be eating all organic?

That's an interesting question.

I think that the jury is still out and I'm sure that people in the wellness world would want to hang me for this, but I think that there are certainly foods that are going to be better organic.

All the dirty dozen foods, the ones that are on the list that have the thin skin, like apples and things that have a thick skin, organic is probably better.

But the thing is though, organic foods, oftentimes they're using, whether it's pesticides or versions of pesticides that are, because they still have to keep the bugs away.

And so they're sometimes using less regulated pesticides or alternatives than, you know, this sort of other, other crop, you know, manufacturers.

And so I don't necessarily think that organic is always healthier, although certainly in some cases it probably is.

And with the meats and everything, do you think it's best to go organic?

You know, with meats, I recommend if you can afford it to do like, you know, the grass fed or pasture raised and free range, you know, obviously the sustainably raised is, agriculture is going to be better for the, for the environment and probably healthier as well.

Unfortunately, those also cost quite a bit more.

So you kind of have to balance like what can your budget afford with, you know, what's the healthiest.

Absolutely.

So what advice would you give your 25 year old self?

Oh, that's a great question.

You know, I, I think that I would just, I would tell myself just to, to hang on and it's going to get, it's just going to get super fun.

Like I feel like I'm having such a good time.

I'm 49.

You know, certainly there's hard days, but I also, I, I love, I love the space of life.

I think it's, it's, it's as challenging as it is.

I also feel like it, it's very empowering and I, I love, you know, the person that, that I am trying to become.

I don't necessarily love who I am all the time, but I like this journey of a lot.

Yeah.

What is the best part of midlife for you right now?

You know, I just, I feel like I'm just stretching myself a lot.

Like I have, you know, I have several companies.

I do, you know, I do a lot of social media, I do a lot of teaching.

I'm getting to do, I'm getting to do all the things that I like to do.

Like I used to be an ER doctor, which was fun for a little While.

But then I left and I didn't.

I had no idea what I was going to do with.

For my profession, for my job.

I had no income, you know, for a while.

And so it's, it's just fun for me.

I get to.

I'm.

I'm getting to create exactly what I want to, you know, even though it's a lot of work, I just love this field of medicine so much.

It is, it's an exciting field.

There's so many developments and changes and things like that.

How are you living iconically right now?

Iconically?

Oh, my goodness.

I don't know.

I don't know if I'm living iconically.

You are?

I don't know if I am.

I. I don't know if I am.

But I do try.

I try to.

I try to have fun.

I try to.

One of my biggest beliefs is like, you know, in terms of whether that's the way we live and where we educate other people is to bring a playfulness and a fun, like a funness to it.

I feel like that's lacking in a lot of, in health care and wellness.

Like the play.

The play part of it I think is so important.

So I think one of, one of my.

I don't know if it's a gift or a Fitch is something that I've kind of forced on the world is that I try to bring that fun to my teachings, to the things I'm doing to, you know, to my teams.

So hopefully that's, that's something.

It is.

It makes it more digestible for people too.

You know, they're.

They're having fun with it, like you're saying and smiling and having a good time.

So on the iconic midlife, we like to wrap up the show with a game.

Are you down?

Oh, okay.

I'm ready.

All right, so it's a rapid fire game and it's going to be called Science or Science Snake Oil.

So basically I'll kind of name a hot button topic or, or a buzzword and you let me know what you think.

If it's, you know, grounded in research and worth, like doing or snake oil meaning, like we should just pass.

Okay, I'm ready.

Perfect.

Okay.

Collagen powders and drinks.

Snake oil for skin.

Science for bones and joints.

Really?

So there is a difference.

Yeah.

I just wrote a sub stack on this and went into all the studies.

There's so, so yeah, check out my sub stack.

And it, it's.

I went into it pretty deep.

Okay.

Good to know.

Ozone therapy for anything I, I would.

Say to be determined.

I mean, I, I think that there is some good science out there.

I'm not sure we know quite how to harness it best, but I think it's.

I do think it's.

It's a.

It's a maybe.

Okay, a maybe.

NAD plus IV drips.

I don't like them as much as I like the pills.

I like the NR pills better than NAD iv.

Oh, really?

So you think it's.

The pills are more effective or.

I just think that it's a less expensive, easier way to get the NAD that you're wanting to get.

Okay, good to know.

Red light masks for anti aging science.

As long as it is a good quality mask.

Okay.

Semi glutide for biohacking aging and not weight loss science.

Okay.

Hormone pellets for everyone.

It's snake oil for everyone.

However, I don't think that they're always bad.

I think that I, you know, pellets can.

They do have uses.

There are people who do great on them.

I think the idea that nobody should have pellets is silly.

Okay.

Or do you prefer various methods of, like, the hormone delivery system?

Is there one that you think is more universal, maybe for people, or is it just totally individual?

It depends on the hormones.

Like, you know, for, for estrogen, I like transdermal.

I also like oral.

For testosterone, I like injections or trans or transdermal progesterone or like oral or vaginal.

Oh, okay, good to know.

Suppository, vitamins and vaginal detox.

Pearls.

Snake oil.

Oh, yeah.

What do you think about the.

That whole.

The egg.

Right?

There's like the, the egg that you.

The jade.

The jade egg, that's right.

I mean, it's just silly.

It's.

It's.

It's just a marketing propaganda.

Okay, good to know.

IV glutathione for skin health.

I don't know specifically for skin.

I do think that glutathione is important.

I don't.

And again, I haven't.

I haven't seen.

Seen.

I guess it's kind of middle.

I haven't seen a lot of studies on IV glutathione, but we do know it's important in our bodies for many parts of detoxification and things like that.

So I'm not sure.

Okay.

Vaginal steaming snake oil.

Good.

One less thing to have to worry about.

Okay.

Cold plunges for hormone health.

It's.

I would say snake oil for hormones, but I do like.

I do like cold plunges for recovery from workouts, reducing Muscle soreness and for stress relief and kind of neurologic stress adaptation.

Okay, so you do like it for women because I've also kind of heard maybe it's more effective for men just because of their, like their makeup.

What do you think about that?

Yeah, yeah, I just actually am working on a sub psych on this too that we don't actually.

So most of the studies have been done in men.

We have a lot more data on men than we do women, but we don't really have good evidence that they're problematic for women.

In both men and women, the cold plunges should be a little warmer than we thought.

They should be between 50 and 60 degrees and you should be going between around 10 minutes.

So it's a little warmer and a little longer than we thought is probably ideal for both men and women.

But I do think that, that women can, can certainly do cold plunges.

Just understanding.

Listen to your body.

Da da, da da.

Okay, and should we be doing it at a certain frequency or like once a week or more?

It's, it's usually about two to three days a week is probably about right.

You don't want to do it necessarily every day because you, you get habituated to it.

But if you, you know, two or three times a week, you want to do it ideally within an hour of like a aerobic exercise.

Like if you go out and run a long time, you want to do that within an hour.

You don't want to do it after strength training exercises because that will actually blunt muscle growth.

So you want to wait at least four hours after your weight training exercise to do any kind of cold water.

So if we do the, the heavy strength training, should we be going in like an infrared sauna after that?

Like it's like the opposite.

Or just.

You can't.

Yeah, you, you certainly can.

You can do sauna.

Sauna is fine anytime.

But cold.

The cold water, you know, if you to do it, do it before your weight training workout or, you know, or just do it like the next day.

Oh my God.

So much good knowledge.

Okay, now I'm like planning it out already for the rest of the week.

And check out, check out my substack.

Subscribe.

I'm gonna have a great article on that coming out.

Oh my gosh.

Absolutely.

And last one.

Well, second to last one celebrity endorsed wellness brands.

I think it's probably hit or miss on the celebrity and what the brand is.

There's a lot of, there's a lot of fluff out there for sure.

But I think there's probably some good ones in there as well.

Okay.

And fill in the blank on this one.

Optimizing midlife isn't about perfection.

It's about consistency.

Consistency.

So doing something, a little bit of something every day.

Yeah, you don't have to go hard every day.

You just gotta go.

Yeah, exactly.

Make that move.

So how many times a week should we be doing the heavy lifting?

I would say at least three days a week is, is appropriate.

Three to five, depending on the person.

But I would say again, if you can get three to four good, good lifting days in there, that's great.

Okay, good to know.

And cardio.

Cardio.

You know, there's two different kind of types.

There's the lower key, like zone two, which is like going for a, you know, a fast walk or, you know, things like that.

I think you should try to get some of that most days, and then the sort of sprinting and high intensity intervals that at least twice a week I like.

Well, thank you so much, Amy.

It's been such a pleasure.

You gave us so much amazing knowledge.

No doubt this is going to resonate with women everywhere.

Do you mind telling everybody where they can find you and anything you want them to keep their eye out for?

Okay, so it's Dr. Amy, Dr. Amy B. Killen on Instagram.

And then doctoramykillen.com is my website.

And then I also have my supplement company, Hotbox is Hotbox Life as well.

Well, thank you so much.

I really appreciate it.

The name is perfect for this time of life right now.

I'm like, I feel like I'm in a hot box most days.

Yeah, that was Dr. Amy Killen.

And if you're feeling a little more powerful, a little more informed and a lot more curious right now, then good.

That's the point.

Because your hormones, your libido, your skin, your energy, none of it is just in your head.

And midlife isn't something to fix, it's something to optimize.

You can follow Dr. Killen at Dr. Amybkillen and check the show notes for links to her clinical work programs and everything she's exploring in the world of regenerative medicine.

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