In this episode of Keeping Abreast, Dr. Jenn Simmons sits down with Dr. Betsy Greenleaf, the first board-certified female urogynecologist in the world, to dismantle the lie that estrogen causes breast cancer, expose the hormone training gap hiding inside every OB/GYN office in the country, and explain why the online HRT explosion isn't liberation; it's the setup for the next Women's Health Initiative.
At 41, Dr. Greenleaf was surgically menopausal, prescribed antidepressants for symptoms her doctors blamed on hormones, and living with a lupus diagnosis she'd carried since age 18. When she stopped treating the symptoms and started treating her gut microbiome, the mood swings resolved, the immune dysfunction cleared, and the lupus markers that had defined her health for decades simply disappeared. The conventional medical system had no framework for what happened to her so she went looking for one.
If you've ever been handed a hormone prescription with no questions asked, or been told your labs look "normal" while you feel anything but, this episode will give language to what you've already suspected.
In this episode, you'll learn:
Why your gynecologist, urologist, and endocrinologist almost certainly received zero formal training in sex hormones
Why only 23% of residents finishing training today feel prepared to treat midlife women
How chronic stress hijacks your sex hormones and converts them straight to cortisol
Why when tens of millions of women stopped HRT after the Women's Health Initiative, breast cancer rates went up, not down
Why estrogen is not cancerous and why progestins are a different story entirely
How 90% of your serotonin and 80% of your immune system live in your gut
Why putting a 20-something on testosterone is masking the real problem
The five lactobacillus strains that actually rebalance the vaginal microbiome and why most probiotics don't contain them
Why no probiotic will work until the tissue itself is healthy and the full menu of options that can fix it
How the brain-gut-vagina connection drives libido, and why testosterone is rarely the answer for low sex drive
Episode Timeline 00:00 Introduction to Urogynecology and Dr. Betsy Greenleaf 03:48 Awakening to Functional Medicine 06:34 The Importance of Gut Health 08:14 Training Gaps in Hormonal Health 11:09 The Dangers of Hormone Mismanagement 14:00 Stress and Hormonal Balance 16:46 The Role of Lifestyle in Hormonal Health 19:21 The Fear of Hormones and Cancer 21:55 Understanding Estrogen and Cancer Risks 24:01 The Holistic Approach to Health 28:38 Integrative Medicine and Continuous Learning 31:30 The Role of Tools in Health Management 34:19 The Shift from Conventional to Holistic Medicine 37:15 Understanding Microbiomes: Gut and Vaginal Health 40:05 The Interconnection of Health Systems 43:58 Intimacy and Libido: The Psychological and Physical Connection 50:38 Navigating Midlife Symptoms and Hormonal Health 53:33 Innovations in Health Tracking and Patient Empowerment
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