Vaginal vs Systemic Estrogen Explained

I sat down with Dr. Kelly Casperson, urologist, women’s health advocate, and a leading voice fighting for equality in healthcare, to explore what’s really happening to women’s bodies and brains during perimenopause and menopause.

We discuss why UTIs spike after menopause, how vaginal estrogen actually works (and why the FDA finally removed the black box warning), the truth about HRT and dementia prevention, and why estrogen receptors in your brain matter more than you think.

We also unpack why blood work interpretation matters more than ever, how compounding pharmacies work, the shingles vaccine and dementia connection, and why women need to stop waiting for permission to take control of their health.

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TOPICS DISCUSSED

00:00 Intro: Why women’s hormone health is misunderstood

02:10 Who Dr. Kelly Casperson is and why women’s sexual health became her focus

05:10 Hormone Replacement Therapy explained (estrogen, progesterone, testosterone)

08:30 Vaginal estrogen, UTIs, and restoring tissue health

12:40 Vaginal estrogen vs systemic estrogen and the FDA warning myth

15:20 Estrogen receptors, skin aging, and visible signs of hormonal decline

18:30 Estrogen, the brain, and Alzheimer’s risk in women

22:10 Why hormone research is conflicting and often fails women

26:00 Sleep, hot flashes, inflammation, and brain health

30:00 Testosterone in women: beyond libido and muscle

33:40 Compounding pharmacies and personalized medicine

38:00 Inflammation, viruses, vaccines, and dementia risk

43:00 The breakdown of modern healthcare and why women feel dismissed

47:30 Blood testing, data ownership, and the future of women’s health

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I’m Louisa Nicola - clinical neurophysiologist - Alzheimer’s prevention specialist - founder of Neuro Athletics.

My mission is to translate cutting-edge neuroscience into actionable strategies for cognitive longevity, peak performance, and brain disease prevention.

If you're committed to optimizing your brain - reducing Alzheimer’s risk - and staying mentally sharp for life, you’re in the right place.

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