BETTER! Building bodies women can trust with Dr. Stephanie Estima

Saving Marriages & Bedroom Comebacks: Midlife Women on Testosterone with Shalin Shah

Jan 12, 2026

Shalin Shah, CEO of Marius Pharmaceuticals and developer of Kaisotrex, challenges the misconception that testosterone is solely a male hormone. He reveals how low testosterone in women during menopause can lead to brain fog, disrupted sleep, and loss of vitality. The discussion highlights the significance of testosterone for overall health and the need for effective therapies. Shalin also emphasizes the importance of personalized hormone therapy, environmental factors affecting levels, and the groundbreaking development of oral testosterone options for women.

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ANECDOTE

Hormone Gaps Fuel Midlife Relationship Strain

Stephanie shares a friend’s observation that lack of hormone access led to widespread midlife divorces.
She links couple mismatches in treatments (man treated, woman not) to relationship breakdowns.

INSIGHT

Aim For Physiologic Dosing

Physiologic replacement (not supraphysiologic) is the goal to restore function while minimizing risk.
Shah emphasizes dosing that mimics normal levels rather than pushing high pharmacologic doses.

ADVICE

Avoid Long High-Dose Pellets

Avoid long-lasting superphysiologic pellet dosing because it raises virilization risk in women.
Prefer titratable therapies so you can adjust dose and stop if side effects appear.

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Think testosterone is just a male hormone? Think again. In this game-changing conversation, Shalin Shah, CEO of Marius Pharmaceuticals, debunks a major myth in women’s health. Spoiler alert: women have more testosterone than estrogen, and when those levels drop during perimenopause and menopause, it affects more than just libido. Brain fog, disrupted sleep, stubborn belly fat, and a feeling of losing strength and vitality are common symptoms. While men have had access to testosterone therapy for decades, women have been left in the dark until now.

Shalin explains the importance of testosterone for various bodily functions, debunks myths that prevent proper treatment, and shares the revolutionary science behind the first effective oral testosterone therapy that aligns with the body’s natural rhythms.

Episodes Overview (timestamps are approximate):
(0:00) Intro/Teaser
(3:00) Understanding Testosterone in Men and Women
(6:00) Clinical Signs and Symptoms of Low Testosterone
(11:00) Testing and Diagnosing Testosterone Levels
(13:00) Challenges in Hormone Therapy for Women
(21:00) Environmental and Lifestyle Factors Affecting Testosterone
(23:00) Increasing Natural Testosterone Levels
(30:00) Modes of Testosterone Delivery
(35:00) Female Hormone Therapy: Standardized Dosing
(39:00) Debunking Myths About Testosterone
(44:00) Dosage and Monitoring for Testosterone Therapy
(51:00) Challenges in Accessing Hormone Therapy
(54:00) Global Availability and Future of Oral Testosterone
(58:00) The After-Party with Dr. Stephanie

Resources mentioned in this episode can be found at: https://drstephanieestima.com/podcasts/ep451/

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