8 Hormone Health Facts That Most Women Don’t Learn Until It’s Too Late

If you’ve ever been told your hormones are “fine” by a doctor who spent four minutes with you, or been diagnosed with PCOS and handed zero guidance beyond “come back when you want to get pregnant,” you’re not alone. On We Met at Acme, host Lindsey Metselaar sits down with Rachel Blank, founder and CEO of Allara Health and a PCOS patient herself, who shares what she wishes every woman knew about their hormones. Here’s what stood out.

You can be thin and still be insulin resistant

Blank is naturally on the thin side, which meant no doctor ever thought to check her insulin levels. Until her Allara provider ran a calculation called HOMA-IR and found out she is, in fact, insulin resistant. “You can be insulin resistant even if you’re not overweight or obese,” she explains. “And it still impacts your metabolism. It still impacts your metabolic health. It still leaves you at increased risk of diabetes.” If nobody has ever tested yours, it might be worth asking.

Metformin might be worth looking into even if you’re not trying to get pregnant

Blank started metformin a couple months before her wedding, not for fertility but for overall management. “I noticed a massive difference in terms of carb cravings, sugar cravings, night cravings,” she shares. “I just felt so much better on it and it also has really helped me with regulating my cycle.” Metselaar, also a PCOS patient, admits she’s never had a doctor suggest it to her. Blank’s response? “I think that’s an issue…I actually don’t think it should be on the patient. I would not have known to ask my doctor, ‘Can you check my insulin levels and can you tell me if metformin makes sense?’”

Your PCOS shouldn’t only be managed in a fertility context

Metselaar shares that the only person who ever discusses her PCOS with her is her fertility doctor. Blank confirms that’s exactly the problem. “If you are somebody where you’re maybe only managing it in a fertility context, then your fertility doctor is really only looking at your fertility metrics,” she points out. “Whereas in an ideal world, a provider is looking at you from a whole health perspective.”

Get tested before you’re trying to conceive, not after months of frustration

“I think it is such a shame when you start trying to conceive, you’re excited, you try for a bit, you can’t get pregnant, you don’t know what’s going on, and then only in that process…you find out that you have this diagnosis,” Blank shares. By then you’re dealing with the mental burden of a new diagnosis while also trying to get pregnant. “Getting that testing done earlier before you’re trying to conceive can be really helpful because then you can plan ahead and maybe make different decisions versus feeling like you’ve wasted time already.”

Birth control isn’t the enemy

“I can’t believe I feel like this is a hot take right now, but I love birth control,” Blank admits. She points out that for PCOS patients who aren’t getting regular periods, skipping that shedding of the endometrial lining can actually increase risk of uterine and endometrial cancer. “You do need some sort of intervention, whether it’s birth control or progesterone, to help manage that risk.” So if you’ve been feeling guilty about being on the pill, this might ease your mind a bit.

PCOS patients are nearly 5x more likely to have anxiety and depression

“Women with PCOS have a nearly five times higher likelihood of having anxiety and depression,” Blank shares. “I personally am somebody who has anxiety and I’m sure that that did not help my dating life when I was super anxious and dating.” Allara actually does mental health screeners on all their patients because the overlap is that significant.

Don’t just test hormones, test your full metabolic health

“Don’t just get your hormones tested, get your metabolic health looked at, get your insulin levels looked at, see what your cholesterol looks like,” Blank recommends. “It’s not just about can you get pregnant or not. It’s about how do you live a really healthy life for the next 40 years, which our hormones really impact.” Especially in your 20s when nobody is telling you to do any of this yet.

Women’s health doesn’t start and end with fertility

“I wish people stopped thinking of women’s health as just fertility and pregnancy,” Blank shares. “We don’t spend that much of our life in that fertility and pregnancy moment. We spend so much of it either in our 20s before we get pregnant or after.” The earlier you start paying attention, the more choices you actually get to make about your own body instead of scrambling to catch up later.

Listen to the full episode on We Met at Acme with Lindsey Metselaar, available wherever you listen to podcasts.

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