Felice Gersh MD

04/02/2026

Tonight, let’s talk about fatigue in menopause. Usually, when people talk about fatigue, it’s in the context of sleep, which is obviously very important. And sleep definitely suffers for many women throughout the menopause transition. But menopause fatigue is more than lack of sleep.

Loss of estradiol affects metabolism on a cellular level. Metabolism is the creation, utilization, and storage of energy, and it is foundationally tied to the health of mitochondria.

So let’s dig into what happens to energy when estradiol drops. And then we’ll explore ways to support your mitochondria so you can restore your energy levels and get back to doing what you love.

⏰ Live Thursday, tune in for my talk.

Thurs, 4/2 at 7:30 PM Pacific
Watch live on Instagram.
Or check YouTube for the recording in a few days.

I’ll be checking Instagram for questions. Please share your thoughts and questions below, and I’ll do my best to address them during tonight’s conversation or in a future talk.

03/30/2026

I tell all of my patients: Don’t take peptides. We have no data and the dangers are very real.

Peptides are simply chains of amino acids, similar to proteins; there are thousands of them, and they do a thousand things—much more than we’ve even begun to study and understand. They regulate metabolism, repair tissue and signal between cells. I feel absolutely certain that in the future, we will have powerful pharmaceuticals built from synthetic peptides. And we will have data on proper dosing, risks and benefits, and which ones to take for which conditions and for how long.

But injecting proprietary peptide cocktails without clarity on dose, duration, purity, or interaction? That’s allowing someone to profit from experimenting on you without any safety protocols in place.

Fortunately, there’s a better way. Every peptide your body needs is made within you. Instead of “Where can I buy it?” you should ask, “Why am I not producing it?”

So what does your body need in order to produce peptides? You need exercise, real food, and optimal hormones. You’ll stimulate endogenous production, even for peptides like GLP-1.

Learn more, watch my full talk,
Longevity Medicine: healthspan or hype? And what I recommend to my patients
https://youtu.be/Vl6zGd7iJT4

03/30/2026

I tell all of my patients: Don’t take peptides. We have no data and the dangers are very real.

Peptides are simply chains of amino acids, similar to proteins; there are thousands of them, and they do a thousand things—much more than we’ve even begun to study and understand. They regulate metabolism, repair tissue and signal between cells. I feel absolutely certain that in the future, we will have powerful pharmaceuticals built from synthetic peptides. And we will have data on proper dosing, risks and benefits, and which ones to take for which conditions and for how long.

But injecting proprietary peptide cocktails without clarity on dose, duration, purity, or interaction? That’s allowing someone to profit from experimenting on you without any safety protocols in place.

Fortunately, there’s a better way. Every peptide your body needs is made within you. Instead of “Where can I buy it?” you should ask, “Why am I not producing it?”

So what does your body need in order to produce peptides? You need exercise, real food, and optimal hormones. You’ll stimulate endogenous production, even for peptides like GLP-1.

Learn more, watch my full talk,
Longevity Medicine: healthspan or hype? And what I recommend to my patients
https://youtu.be/Vl6zGd7iJT4

03/29/2026

What is the secret to healthy longevity? Spoiler: It’s not a pill.

What do I prioritize in my “longevity practice”? Clean, healthy living. Because longevity doesn’t start in a prescription pad—it starts in the air you breathe, the water you drink, the food you eat. Air purifiers. Water filtration. Whole, uncontaminated food. If you care about health span, you must care about your environment.

And when we talk about diet, the principles are not mysterious. The Mediterranean diet. The DASH diet. The MIND diet. Different names. Similar foundations. Legumes, whole grains, vegetables, fruit, olive oil, fish, and minimal processed foods.

Strip away the labels and it comes down to this: real food. Mostly plants. Nutrient-dense. Clean. That’s the backbone of healthy longevity.

Learn more, watch my full talk,
Longevity Medicine: healthspan or hype? And what I recommend to my patients
https://youtu.be/Vl6zGd7iJT4

03/28/2026

Hate va**nal estrogen cream? Here’s a better way to use it (and why you should!)
https://youtu.be/OmFo9IHuAE4

In this talk, I explain why va**nal estrogen is one of the most important therapies for women in perimenopause and menopause and why so many women stop using it.

The standard approach, placing a “blob” of estrogen cream into the va**na, can be messy, uncomfortable, and disruptive to intimacy. In fact, studies show that nearly half of women stop using va**nal estrogen within the first month. But it doesn’t have to be this way.

I share a more practical, sustainable approach to using va**nal estradiol cream that allows you to receive the benefits without the mess, while still supporting the health of the va**nal tissues, bladder, and urethra. This includes maintaining a healthy microbiome, reducing the risk of urinary tract infections, preventing incontinence, and preserving comfort and function.

We also review the different forms of va**nal estrogen, why ultra-low-dose options may not be sufficient, and why starting early in perimenopause can help prevent long-term complications.

If you’ve struggled with va**nal estrogen—or avoided it altogether—this discussion may change how you think about this essential therapy.

In this talk, I explain why va**nal estrogen is one of the most important therapies for women in perimenopause and menopause and why so many women stop using...

03/26/2026

Tonight, let’s talk about va**nal estrogen for pelvic region, genitourinary health. First, I’ll review how it’s generally prescribed, which is messy, unpleasant, uncomfortable, and really pretty bonkers if you think about it. Then we’ll talk about what va**nal issue is, what va**nal estradiol is, how it works, and why there is a better way.

I hope you’ll join me for this conversation. I think it’s really important to acknowledge that the current approach (filling the va**na with blobs of cream every few days) is actually a huge barrier to regular va**nal estradiol use. And va**nal estradiol is a key tool for maintaining the health of all of the genitourinary organs, especially the bladder and uretha in addition to, of course, the va**na.

I’ll share what I recommend to my patients, why it works, and why adopting a regimen that is comfortable could make the difference in supporting longterm genitourinary health.

⏰ Live Thursday, tune in for my talk.

Thurs, 3/26 at 7:30 PM Pacific
Watch live on Instagram.
Or check YouTube for the recording in a few days.

I’ll be checking Instagram for questions. Please share your thoughts and questions below, and I’ll do my best to address them during tonight’s conversation or in a future talk.

**nalhealth **nalestradiol

03/24/2026

Why does the common approach to hormone therapy suddenly change at age 50?

When ovarian function stops before 40, by definition, that is premature ovarian insufficiency. Before 45, it’s early menopause. Surgical. Genetic. Chemical. Unknown. The cause doesn’t change the consequence. Losing ovarian hormones years or decades too soon is not benign. It carries real, measurable risk to long-term health.

So what is the standard of care? True hormone replacement. Cyclic therapy is commonly recommended and widely discussed in the literature as a preferred approach. Not every woman receives it—but it is consistently presented as a strong, evidence-supported option. And at physiologic levels.

Why? Because studies support that younger women do best with with natural hormone levels and rhythms.

And what about women aged 50 and over? Nothing magically changes at age 50 but the most common approach to hormones is that they are suddenly optional and if you get them, it’s only at very low, static doses.

Learn more, watch my full talk,
Why I recommend physiologic cyclic HRT, not low-dose static hormones in menopause
https://youtu.be/g1D7YxzD2Qs

03/24/2026

Do hormones become dangerous at age 50? No.

So why are we giving women 50+ teeny tiny doses of hormones?

If a younger woman loses her hormones prematurely, the standard of care is to replace those hormones at a physiologic level, and deliver them cyclically – exactly as I prescribe them! But if a woman loses her hormones in menopause, we only give her low dose, static hormones.

What exactly happens at age 50 that suddenly makes physiologic hormones unnecessary? Nothing. There is no biological cliff. No magical expiration date. The same estradiol and progesterone that protect younger women who’ve lost them early don’t suddenly become dangerous because a calendar page turned.

Cells don’t carry birth certificates. They don’t know your age. Cells are constantly renewing—born, functioning, dying, replaced. Very few cells in a woman’s body were present the day she was born. Biology is dynamic, not dictated by decades.

So why withdraw the very hormones that support optimal function? Maintain physiologic, cyclic levels aligned with health. There is no reason not to.

Learn more, watch my full talk,
Why I recommend physiologic cyclic HRT, not low-dose static hormones in menopause
https://youtu.be/g1D7YxzD2Qs

03/24/2026

Do hormones become dangerous at age 50? No.

So why are we giving women 50+ teeny tiny doses of hormones?

If a younger woman loses her hormones prematurely, the standard of care is to replace those hormones at a physiologic level, and deliver them cyclically – exactly as I prescribe them! But if a woman loses her hormones in menopause, we only give her low dose, static hormones.

What exactly happens at age 50 that suddenly makes physiologic hormones unnecessary? Nothing. There is no biological cliff. No magical expiration date. The same estradiol and progesterone that protect younger women who’ve lost them early don’t suddenly become dangerous because a calendar page turned.

Cells don’t carry birth certificates. They don’t know your age. Cells are constantly renewing—born, functioning, dying, replaced. Very few cells in a woman’s body were present the day she was born. Biology is dynamic, not dictated by decades.

So why withdraw the very hormones that support optimal function? Maintain physiologic, cyclic levels aligned with health. There is no reason not to.

Learn more, watch my full talk,
Why I recommend physiologic cyclic HRT, not low-dose static hormones in menopause
https://youtu.be/g1D7YxzD2Qs

03/23/2026

Check out my latest talk!
Why menopause accelerates wrinkles and tips to keep your skin healthy & vibrant
https://youtu.be/J1aOzOcrlqg

In this talk, I explain why skin aging accelerates during the menopausal transition and what is really happening beneath the surface. Skin is not just cosmetic. It is a vital organ, deeply influenced by hormones, inflammation, the gut microbiome, and mitochondrial health.

I walk through how the loss of estradiol leads to rapid declines in collagen, elastin, hydration, blood flow, and skin repair, which contributes to wrinkles, sagging, dryness, and increased fragility. I also explain why skin aging reflects what is happening throughout the entire body.

Most importantly, I share a comprehensive, preventive approach to maintaining healthy, vibrant skin—from hormone optimization and gut health to nutrition, mitochondrial support, stress reduction, and targeted skin therapies. While aging is inevitable, there is so much we can do to slow the process and support skin health from the inside out.

In this talk, I explain why skin aging accelerates during the menopausal transition and what is really happening beneath the surface. Skin is not just cosmet...