Key Topics & Timestamps
- 00:00 Should You Test Your Hormones?
- 04:15 Dr. Betty Murray’s Personal Journey into Functional Medicine
07:30 The Gut-Brain-Hormone Connection Explained
13:10 Hormone Testing: Why “Test, Don’t Guess” Matters
18:30 How Stress, Birth Control, and Surgery Impact Your Hormones
23:40 The Estrobolome, Beta-Glucuronidase, and Hormone Detox
29:50 Individualized Hormone Replacement Therapy
36:55 Menopause, Fat Gain, and the Role of Estrogen
44:00 Weight Loss After Menopause: What Actually Works
51:20 The Sleep-Hormone Connection and Airway Health
57:10 Hormone Therapy After Breast Cancer: A Functional Approach
1:10:00 Gut Health, Detox, and Lifestyle for Hormone Safety
1:20:00 Self-Advocacy & Next Steps in Women’s Health
Empowering Women: Beyond the Estrogen Window
If you’ve ever wondered, “Am I too old to start hormones?” or “Is it even safe for me now?”—you’re not alone. The “estrogen window” is a concept that has frightened and confused countless women, often leaving us to suffer in silence, disconnected from our bodies and our confidence.
In this episode of The Girlfriend Doctor Show, I sat down with my friend and colleague, Dr. Betty Murray—a scientist, functional medicine pioneer, and the founder of the Minerva Project—to break down the myths and science of hormone therapy after menopause, the powerful gut-brain-hormone connection, and what truly individualized, root-cause care looks like for women.
This blog is your guide to what we covered, what really matters for your health, and why it’s never too late to reclaim your vibrance.
What’s Inside This Article
Why hormone testing is crucial—at any age, and especially beyond the “estrogen window”
What the “estrogen window” really means, and if you’re ever too old to start hormones
How your gut, brain, and hormone health are deeply connected
Why “test, don’t guess” is more than a catchphrase—it’s a clinical must
How stress, birth control, and surgical history can shape your menopausal journey
The role of the estrobolome and detox pathways in hormone safety
Real strategies for weight loss and energy after menopause
What to know about hormone therapy after breast cancer
The importance of individualized, root-cause, functional medicine for women
Actionable Q&A for your next right step
Should You Test Your Hormones? (Short Answer: Yes!)
You hear me say it all the time: Test, don’t guess.
But why is this so crucial, especially after menopause? Because every woman is unique. The way you metabolize hormones, your detox pathways, your gut health, your stress history, and your genetics all play a role in how you feel—and what you need.
Testing before starting hormone therapy (even years after menopause) gives you a baseline. It clarifies your unique biochemistry, and it helps you and your provider spot risks, optimize doses, and avoid guesswork that can lead to subpar results or unwanted side effects.
What should you test?
Estradiol, estrone, and estriol (yes, all three!)
Progesterone and testosterone
Hormone metabolites (urine testing, if possible)
Gut health markers and detox enzymes (like beta-glucuronidase)
Basic labs: thyroid, insulin, inflammation markers
What Is the "Estrogen Window"—and Are You Ever Too Old for Hormones?
The "estrogen window" is a term used in conventional medicine to describe a theoretical time after menopause (usually within 5-10 years) when starting hormone therapy is considered safest for heart, bone, and brain health. After that, many women are told it’s “too late” and that the risks outweigh the benefits.
But here’s the truth:
The data is more nuanced than most doctors admit.
Many women thrive when starting hormones later, as long as therapy is personalized, monitored, and part of a comprehensive plan.
The “window” is not a brick wall—you are not doomed if you missed it!
As Dr. Betty and I discussed, your personal risk factors, detox pathways, gut health, and genetics matter far more than any arbitrary timeline.
The Gut-Brain-Hormone Connection: Why Your Microbiome Matters
Your gut and your hormones are in constant conversation.
The gut microbiome—specifically, a subset called the estrobolome —acts as a regulator for estrogen and other hormones. These bacteria can either help you detox excess hormones safely or, when out of balance, recirculate harmful metabolites that may increase your risk for symptoms or disease.
Key points:
Beta-glucuronidase is an enzyme made by gut bacteria that can “unwrap” estrogen, ready for elimination, sending it back into circulation—sometimes good, sometimes not.
A healthy estrobolome balances hormone levels and helps protect against hormone-driven cancers.
Gut health is shaped by stress, birth control, antibiotics, surgery, food, and toxins.
No hormone journey is complete without healing your gut!
How Stress, Birth Control, and Surgery Impact Your Hormones
Both Dr. Betty and I have seen (and lived) the consequences of stress, years on birth control, and surgical interventions like tubal ligation or ablation. Here’s what you should know:
Birth control pills disrupt the microbiome, damage estrogen receptors, and mask underlying imbalances.
Tubal ligation can decrease blood supply to the ovaries, leading to lower estrogen and compensatory fat gain.
Chronic stress and overwork are major triggers for gut dysfunction, hormone disruption, and even autoimmune disease.
Your story matters. These factors should always be part of your medical history and action plan.
Why "Test, Don’t Guess" Is More Than a Catchphrase
We know that every woman’s hormone journey is different—what’s “normal” for one may be too high or too low for another. By testing before, during, and after hormone therapy, we can:
Set a personal baseline (what were your hormone levels when you felt your best?)
Adjust doses for your unique metabolism
Monitor for safety, especially if you have a history of cancer or metabolic disease
Track improvements in energy, mood, weight, sleep, and intimacy
Testing empowers you—and gives your provider the data needed to treat you as an individual, not a statistic.
Hormone Therapy After Menopause: Is It Ever Too Late?
Short answer: No, it’s not too late for most women!
Dr. Betty and I both see women start hormone therapy well after the “window,” with life-changing results. Here’s what matters:
Go low and slow—start with the gentlest dose and titrate up as needed.
Monitor not just blood levels, but also hormone metabolites (urine testing) to ensure safe detox and minimize risk.
Balance estrogen with progesterone—and, when appropriate, testosterone and DHEA.
Customize therapy to your symptoms, labs, genetics, and gut health.
Fun fact: Even after breast cancer, some women can use hormones safely under expert guidance—with careful monitoring, gut support, and focus on detox pathways.
The Real Role of the Estrobolome and Detox Pathways
Your body’s ability to detox hormones is as important as the hormones themselves.
Estrobolome health determines if estrogens are removed or recirculated.
Beta-glucuronidase activity is a double-edged sword: too much can increase cancer risk; too little and you may not get enough estrogen in menopause.
Diet, fiber, and probiotics can help modulate these pathways.
Pro tip:
If you’re constipated or your gut isn’t healthy, you won’t detox hormones well—no matter how “perfect” your prescription.
Weight Gain After Menopause: What Actually Works
Both Dr. Betty and I have experienced (and solved) the postmenopausal weight puzzle. The answers are rarely what mainstream wellness tells you:
Too much saturated fat can worsen insulin resistance in menopause (yes, even with “clean” keto).
High protein is important, but too much can turn to glucose—especially with sluggish metabolism.
Fiber is magic: aim for 30–50g/day from veggies, seeds, and low-sugar fruits.
Myo-inositol, berberine, and targeted herbs can support insulin sensitivity.
Sleep is non-negotiable. Airway issues, snoring, or poor sleep quality must be addressed for true fat loss.
Movement matters: weight training, zone 2 heart rate (fat-burning), and regular sweating.
It’s not about eating less, it’s about eating smarter for your unique biochemistry.
The Sleep-Hormone Connection: Why Airway Matters
Poor sleep is one of the most underdiagnosed causes of weight gain, fatigue, and hormone imbalance in women.
Upper airway issues, undiagnosed sleep apnea, and even mild oxygen drops can rob you of rest, increase your fat stores, and worsen hormone symptoms.
Action step:
If you don’t wake up feeling rested, get your sleep assessed—especially if you’re postmenopausal.
Hormone Therapy After Breast Cancer: A Functional, Personalized Approach
What if you’ve had breast cancer? Should you ever use hormones again?
There is no one-size-fits-all answer, but for many women, it’s possible—especially after the active treatment window.
Testing all three estrogens (E1, E2, E3) is key; estrone from fat can be unexpectedly high even with low ovarian production.
Focus on “clean” hormone metabolites with urine testing.
Diet, gut health, and lifestyle are non-negotiable.
Work with a functional medicine expert who will listen, test, and personalize.
Fear should never take away your right to feel good in your body.
The Power of Individualized, Root-Cause, Functional Medicine
Women’s health is not “one size fits all.”
Your symptoms are not all in your head.
Your family history, gut, stress, lifestyle, and genetics MATTER.
You deserve a provider who will test, track, and treat you as a unique individual—adjusting your plan as you change.
The future of women’s health is personal, collaborative, and empowering.
Your Next Right Step
No matter what stage you’re in, you are your own best advocate.
Keep asking questions. Keep putting on your “Nancy Drew detective hat.” Keep listening to your body’s wisdom.
If you want to dive deeper into these topics and get inspired by Dr. Betty Murray’s expertise, listen to the full podcast episode for science, stories, and the practical next steps you need to feel empowered.
Key Points: Q&A
Q: Should I test my hormones after menopause?
A: Yes! Testing helps personalize your care, optimize safety, and deliver better results—no matter when you start.
Q: Is it too late to start hormone therapy after the estrogen window?
A: For most women, it’s not too late. Work with an experienced provider, test regularly, and go low and slow.
Q: How does my gut affect my hormones?
A: Your gut bacteria (estrobolome) help detox or recirculate hormones. A healthy gut is essential for hormone balance.
Q: What if I have a history of breast cancer?
A: Hormone therapy may still be possible with expert guidance, regular testing, and a focus on gut and detox health.
Q: What’s the most important thing to remember?
A: You are unique. Demand care that listens, tests, and treats you as an individual—never settle for less.
Links Mentioned:
Connect with Dr. Betty Murray:
Connect with Dr. Anna Cabeca:
Ready for your next right step?
Listen to the podcast, share with a sister or friend, and keep advocating for the empowered care you deserve!
