Empowering Midlife Wellness with Dr. Susan

Testosterone gel and testosterone cream may sound interchangeable—but does the formulation actually change how much testosterone gets into your bloodstream?

I recently came across research that made me take a much closer look at this question, and the difference surprised me.

In this video, I compare research looking at topical testosterone in postmenopausal women and explore why the same milligram dose does not necessarily produce the same blood testosterone level when delivered in different formulations.

We’ll talk about what the studies show about absorption and serum testosterone levels, why blood tests don’t always tell the whole story, and how factors including SHBG and protein binding, androgen receptor variation, and intracellular testosterone production can complicate the picture.

I also take a closer look at the Global Consensus recommendations for testosterone therapy in women—and an important limitation: much of the evidence behind current recommendations comes from studies using a low-dose testosterone patch that is not currently available.

I’m also currently participating in a large testosterone study in collaboration with Baylor College of Medicine. The study is still underway, so we don’t yet have final results, but we are already seeing preliminary data that adds another interesting piece to this conversation. I share some of those early numbers in the video and explain why they caught my attention.

The bigger point? Testosterone therapy in women is nuanced. Dose matters. Formulation matters. Blood levels matter. But so does the individual woman and how she responds.

This is something I just learned more about, and I couldn’t wait to share it with you.Studies discussed:
1. Fooladi E, et al.
Pharmacokinetics of a Transdermal Testosterone Cream in Healthy Postmenopausal Women
https://pubmed.ncbi.nlm.nih.gov/24845394/
2. Heald A, et al.
Testosterone Gel and Serum Levels in Postmenopausal Women with HSDD
Clinical Endocrinology. First published March 15, 2026.
https://onlinelibrary.wiley.com/doi/10.1111/cen.70119
3. Global Consensus Position Statement on the Use of Testosterone Therapy for Women 
https://pubmed.ncbi.nlm.nih.gov/31474158/

Want to learn more about testosterone?Watch my must-see Testosterone for Women playlist, where I break down the science, myths, treatment options, emerging research, and the questions women should be asking about testosterone therapy.

Watch the Testosterone for Women playlist on YouTubehttps://www.youtube.com/playlist?list=PLXB0Z6uY3JgE

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When we talk about GLP-1 medications like semaglutide and tirzepatide, the conversation usually centers around diabetes and weight loss.

But there may be a much bigger story unfolding.

Researchers are increasingly interested in the effects GLP-1 receptor agonists may have beyond the scale—including their relationship with systemic inflammation, cardiovascular health, metabolic function, and the brain.That raises an intriguing question: Could very low doses of GLP-1 medications eventually have a role in conditions where chronic inflammation is part of the problem?In this video, I explore why GLP-1 microdosing has caught my attention and the potential implications for conditions such as:

• Autoimmune disease• Chronic pain syndromes• PCOS• Mood and mental health conditions• Alzheimer's disease and cognitive decline• Cardiovascular disease

It's important to be very clear: GLP-1 microdosing for these conditions is not established medical therapy. We don't yet have large-scale clinical trials showing that microdosing treats or prevents these diseases.

What we do have is an expanding body of research into the broader biological effects of GLP-1 receptor agonists—and some fascinating questions worth following.

In this conversation, I'll explain what we're learning, what remains unknown, and why careful medical supervision is essential when considering any off-label approach.

At Complete Midlife Wellness Center, we believe good medicine requires both evidence and curiosity: following the science we have today while paying close attention to where it may take us tomorrow.

Interested in learning more about our approach to GLP-1 microdosing? Visit CompleteMidlifeWellnessCenter.com to learn more or schedule a consultation.

Click here: https://completemidlifewellnesscenter.com In-person care in Houston and Cypress
Virtual medical care across Texas, California, and New Mexico

Bleeding after menopause can be frightening—but not all bleeding means the same thing, especially if you're taking menopausal hormone therapy (MHT).

In this video, I explain the updated guidance from the American College of Obstetricians and Gynecologists (ACOG) on the evaluation of postmenopausal bleeding and what these recommendations mean for women both on and off menopausal hormone therapy.

This distinction is incredibly important. Women using a combination of estradiol and progesterone often require a different clinical approach than women who are not taking hormones. In many cases, bleeding while on MHT does not mean you should panic or stop your hormones. It may simply indicate that your hormone regimen needs to be adjusted.

I'll walk you through:

The latest ACOG recommendations When a transvaginal ultrasound and an endometrial biopsy are recommended How evaluation differs for women taking MHT versus those who are not Why individualized care is essential When bleeding is expected, when it should be evaluated, and what I recommend based on current evidence
Understanding these differences can help you make informed decisions and avoid unnecessary fear while ensuring that any concerning symptoms are appropriately evaluated.
Reference:Updated Guidance Regarding the Role of Transvaginal Ultrasonography and Endometrial Sampling in the Initial Evaluation of Postmenopausal Bleeding (ACOG, 2026)https://journals.lww.com/greenjournal/fulltext/10.1097/aog.0000000000006275

Interested in booking an appointment? Click here: https://completemidlifewellnesscenter.com

We offer virtual medical care in Texas, California, and New Mexico

Can a shingles vaccine do more than prevent shingles?

Emerging research suggests it might.

A recent study published in Alzheimer's & Dementia found that older adults who received the two-dose recombinant shingles vaccine (Shingrix®) had a significantly lower risk of developing dementia, including Alzheimer's disease and vascular dementia, compared with those who were not vaccinated. While this research does not prove that the vaccine prevents dementia, it adds to a growing body of evidence suggesting a potential protective effect on brain health.

In this video, I explain:

What shingles is and why it occurs
Who should receive the Shingrix® vaccine The latest research on shingles vaccination and dementia risk What these findings mean—and what they don't

As always, medical decisions should be individualized. Talk with your healthcare provider about whether the shingles vaccine is right for you.

Subscribe for evidence-based conversations about menopause, healthy aging, and women's health.

Read the research:Susan dos Reis, et al. Reduced Risk of Dementia with Recombinant Zoster Vaccine in US Adults Age 65 or Older.

Alzheimer's & Dementia. March 2026.
https://doi.org/10.1002/alz.71407

Interested in booking an appointment with me? Click here: https://completemidlifewellnesscenter.com

Creatine has been part of the conversation in sports nutrition for decades, but it may be even more important for women in midlife.

As estrogen declines, maintaining muscle becomes more difficult, bone loss accelerates, and many women notice changes in energy, strength, and even cognitive function. Creatine is one of the most extensively researched supplements available and has been shown to support muscle strength, healthy aging, bone health, and brain function.

In this video, I explain:

Why creatine matters for women in midlife The science behind its benefits Common myths and safety concerns Who should consider taking it—and how to use it

If you're looking for one evidence-based supplement that can make a meaningful difference as you age, creatine deserves your attention.

Interested in the creatine I personally recommend?

Thorne Creatine: https://bit.ly/4dfg6Po