"Estrogen is not a hormone; it's a family of hormones,” says Dr. Felice Gersh. “You can't say fat does this or fat does that—you have to say which fat. The same with estrogen.” That’s right, she is back to challenge the conventional "lowest dose for the shortest time" approach to menopausal hormone therapy, explore why menopause creates a default pro-inflammatory state, how different estrogens activate different receptors, and why understanding these distinctions matters for cardiovascular health, bone density, brain function, immune response, and metabolic health. Episode Overview (timestamps are approximate): (0:00) Intro/Teaser (2:00) Welcome to an Estrogen Masterclass (6:00) The Estrogen Family: E1, E2, E3, E4 Explained (15:00) Alpha vs. Beta Receptors & Why It Matters (27:00) Menopause, Inflammation & Gut Health (33:00) Menopause as a Hormone Deficiency State (45:00) Why the Women’s Health Initiative Got It Wrong (59:00) When to Start Hormone Therapy (Age 35?) (1:13:00) Bioidentical vs. Synthetic Hormones (1:22:00) Vaginal Estrogen: Canary in the Coal Mine (1:32:00) BiEst & Topical Estrogen for Skin (1:40:00) After Party: Dr. Stephanie’s Takeaways Resources mentioned in this episode can be found at: https://drstephanieestima.com/podcasts/ep453 We are grateful to our sponsors: KENETIK - You think carefully about how you fuel your body but are you fueling your brain? Learn more about Kenetik and try it for yourself by going to https://drinkkenetik.com/BETTER and use code BETTER for 15% off your purchase. TIMELINE - A new year means a new gym membership - but you can’t out-train low energy; it starts deeper than that. So grab 35% off your one-month subscription of Mitopure Gummies at https://Timeline.com/BETTER35 while the offer lasts. BIOPTIMIZERS - Your digestion can take a hit in midlife, but you don't have to suffer. Learn how enzymes can help at https://bioptimizers.com/better and use code BETTER to get 10% off your order. ONESKIN - Harness the power of peptides for fuller hair and glowing skin. Save 15% at https://oneskin.co/better with code BETTER. **************************** P.S. When you're ready, here are two ways Dr. Stephanie can help you: Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife. Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results. Hosted by Simplecast, an AdsWizz company.