EP 1392
1392. Why Doctors Can’t Fix Women in 2026
In this episode of The Human Upgrade, Host Dave Asprey sits down with Dr. Sarah Daccarett, MD, physician, longevity expert, and founder of Inner Balance, to expose why conventional medicine has failed women for decades and what actually works to restore hormones, reclaim energy, and extend healthspan. They cover why hormone replacement therapy is not a menopausal last resort but a foundational longevity and anti-aging strategy every woman should consider starting in her 20s, how low estrogen destroys your gut lining, gallbladder, immune system, mitochondria, and libido long before hot flashes ever appear, why vaginal delivery of bioidentical progesterone and estrogen outperforms every patch, pill, and topical cream on the market, how progesterone converts to testosterone in women and why most women never need a separate testosterone prescription, why SSRIs are being prescribed to women who actually have a hormone deficiency, how COMT genetics determine how fast your body burns through estrogen and testosterone and what to do about it, why a carnivore or animal-based diet raises estrogen levels while excess fiber actively strips hormones from your body, how oxalates from superfoods like matcha, spinach, almonds, and sweet potatoes accumulate in your ovaries, uterus, and kidneys and drive chronic pain, UTIs, and kidney stones, why iodine deficiency is fueling fibrocystic breast disease and disrupting estrogen metabolism in women of all ages, and why fixing your hormones may be the single highest-leverage biohacking move available for human performance, brain optimization, and longevity.
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In this Episode of The Human Upgrade™...
Most women are suffering for years from anxiety, gut problems, low libido, and brain fog because no one is treating the real cause: their hormones. This episode is a masterclass in women’s hormone optimization, covering everything from vaginal delivery of bioidentical hormones to why low estrogen destroys your gut, your sex drive, your mitochondria, and your marriage.
Host Dave Asprey sits down with Dr. Sarah Daccarett, MD, a physician, longevity expert, and the founder and CEO of Inner Balance, a modern women’s health company redefining hormone therapy, sexual wellness, and aging. She has treated tens of thousands of women across all 50 states and is known for challenging outdated medical models and building science-driven solutions that reflect female biology rather than borrowing protocols designed for men. She created Oestra, a revolutionary hormone therapy delivery system, along with Libida, an on-demand libido solution that targets desire at the brain level, making her one of the most credible and innovative voices in functional medicine and women’s longevity today.
Together, they expose why conventional medicine has failed women for decades, why patches and pills are nearly useless, and what actually works for anti-aging, metabolism, longevity, and human performance. Dr. Sarah makes the case that hormone replacement therapy is not a last resort for menopausal women. It is a foundational longevity strategy that every woman should consider starting in her 20s.
You’ll Learn:
- Why vaginal hormone delivery outperforms every other delivery method for women
- How low estrogen destroys your gut lining, gallbladder, and immune system long before menopause symptoms appear
- Why a carnivore or animal-based diet raises estrogen and why fiber lowers it
- How progesterone converts to testosterone in women, and why you may not need a testosterone prescription
- The real reason SSRIs get prescribed when hormone replacement therapy should come first
- Why iodine is essential for breast health, estrogen metabolism, and thyroid function
- How oxalates from “superfoods” like matcha, spinach, and almonds accumulate in your ovaries, uterus, and kidneys
- Why both partners need hormone replacement therapy for a relationship to thrive
- How hormones control mitochondria, dopamine, norepinephrine, and every system in your body
Keywords: Dr. Sarah Daccarett, Inner Balance, women’s hormone therapy, bioidentical hormones, vaginal hormone delivery, estrogen deficiency, progesterone therapy, hormone replacement therapy, perimenopause, testosterone women, COMT genetics, FSH hormone, iodine deficiency, oxalates health, leaky gut hormones, women’s longevity, biohacking, Dave Asprey, human performance, functional medicine, anti-aging
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"If you have hot flashes, you've waited about a decade too long."
Sarah Daccarett
0:00 – Trailer
Dave and Dr. Sarah preview why hormone replacement therapy may be the most overlooked longevity tool available to women today.
1:15 – Introduction
Dave shares how discovering his own testosterone was lower than his mother’s at age 26 set him on a lifelong path of hormone optimization and biohacking.
2:43 – The Gender Gap in Hormone Care
Dr. Sarah flips the script by asking Dave to imagine being told he can’t have testosterone until he stops making sperm for a year, exposing how absurd the standard of care for women actually is.
5:14 – Why Women’s Hormone Therapy Is Stuck in the 1960s
No one has meaningfully innovated on women’s hormone delivery since the 1960s, and the formulations still in use were designed by men for a completely different purpose.
8:09 – Why Young Women Are Losing Their Hormones
Women in their 20s are showing up with hormone levels of a 90-year-old, and the period is not the relevant marker most doctors think it is.
9:33 – Toxins, Birth Control & Hormone Disruption
Pesticides, phthalates, parabens, and synthetic birth control are binding to estrogen receptors and suppressing hormone function in women at younger and younger ages.
14:07 – How Fiber Steals Your Hormones
Eating more than 30 grams of fiber a day actively lowers estrogen levels, and the constipation most women blame on low fiber is actually a sign of low estrogen.
19:53 – Hormones, Libido & Brain Chemistry
Estrogen behaves like MDMA in the brain, flooding the limbic system with receptivity and desire, which is why testosterone alone will never fully restore a woman’s libido.
32:13 – Pills, Patches & Why They Fail
Only 30 percent of topical hormones absorb through the skin, oral progesterone gets largely destroyed in the liver, and the metabolites that remain are basically a sleeping pill.
36:54 – Why Vaginal Delivery Works Best
The vaginal wall is porous and bypasses the liver entirely, allowing hormones to enter the bloodstream and be metabolized through the uterus the way nature intended.
44:36 – Symptoms of Low Hormones
The first signs of hormone deficiency in women are not hot flashes but anxiety, irritability, mild depression, bloating, and food sensitivities that send women chasing their diet for years.
46:07 – Leaky Gut Is a Hormone Problem
Estrogen and progesterone produce mucin, close gap junctions, and tell the immune system what to do, meaning leaky gut is not the cause of hormone problems but a symptom of them.
47:38 – How Low Hormones Destroy Relationships
Dr. Sarah describes clients who could not stand their husbands, got on hormone replacement therapy, and realized the irritation was never about him at all.
52:28 – Thyroid, Iodine & Sex Hormones
Iodine deficiency is driving fibrocystic breast disease and disrupting estrogen metabolism, and avoiding iodine because of Hashimoto’s may be one of the most damaging pieces of advice in conventional medicine.
1:00:29 – Progesterone for Men
Men produce progesterone too, and supplementing it can raise testosterone levels, smooth out the peaks and valleys of injection cycles, and improve sleep without the side effects most men expect.
1:05:18 – Oxalates, Kidney Stones & Your Diet
Oxalates from matcha, spinach, almonds, sweet potatoes, and cinnamon form razor sharp calcium crystals that accumulate in the ovaries, uterus, kidneys, and joints and drive chronic pain and recurring UTIs.
1:11:13 – Where to Find Dr. Sarah
Dr. Sarah shares how to access Inner Balance and its women-first hormone therapy protocols across all 50 states.
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