The Rich Roll Podcast Decoding Women's Health: Dr. Elizabeth Poynor On Midlife Hormonal Changes, Interventions That Actually Work, & Why Medicine Left Women Behind
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Jan 26, 2026 
Dr. Elizabeth Poynor, gynecologic oncologist and Chair of Women’s Health who focuses on midlife hormonal care, walks through ovarian aging, metabolic and brain shifts that start in the late 30s and 40s. She discusses modern transdermal hormone approaches, timing HRT for brain and bone protection, GLP-1s and metabolic strategy, plus practical testing and partner support.
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Consider Early Hormone Support When Appropriate
- Consider early menopausal hormone support for symptom relief and possible cardiometabolic and brain protection after individualized risk assessment.
- Discuss family history, timing, delivery method, and risks with a specialist before initiating therapy.
Estrogen’s Role In Brain Metabolism
- Estrogen supports brain energy metabolism, blood flow, and may reduce dementia risk when given near the menopausal transition.
- Timing and delivery (transdermal vs oral) likely influence cognitive outcomes and inflammation.
Ask About Hormone Prescribing Up Front
- Ask clinicians whether they prescribe hormone support and their approach to its timing; use that to screen for up-to-date women's-health expertise.
- If they never prescribe hormones, seek a practitioner experienced in modern menopausal care.
