A patient asked me recently, with genuine frustration: “Why does nobody talk about testosterone in women?” She was 47. She had researched oestrogen extensively, was well-informed about progesterone, and had taken a proactive approach to her hormonal health. But testosterone had been conspicuously absent from every conversation she’d had, every article she’d read, every consultation she’d attended. She was right to be frustrated. Testosterone is produced in women — by […]

She was forty-eight, ran a regional team for a financial services company, and had been seeing a psychiatrist for eighteen months for what had been diagnosed as anxiety disorder with mild depression. She was on an SSRI. It was helping, somewhat, but she still described a quality of mental life that she found alien to herself — difficulty concentrating, a flatness of motivation, an inability to retrieve words and ideas […]

I hear this at least twice a week. A woman in her mid-to-late 40s, sometimes 50, sits across from me and says some version of the same thing: “I haven’t changed what I eat. I haven’t changed my exercise. And my body is completely different.” She’s not imagining it. The distribution of weight has shifted. There is more fat around the abdomen than before. The arms look different. The legs […]