The School of Doza Podcast

HRT after the FDA label change: what changed on menopause hormone therapy labels, what didn't, and why experts still disagree. Nurse Doza walks through five things to understand before you talk to your provider: estrogen's wider role, progesterone, delivery methods, testosterone, and which labs to ask about.

Featured Product

Your digestion is one of the simplest places to start taking care of yourself day to day. The Good Poops Protocol from MSW Nutrition is a two-month, three-product protocol: Gut (4 grams of L-glutamine a day) to support digestive health, Liver Boost to support liver and gallbladder health, and Berberine Plus (dihydroberberine) to support healthy blood sugar regulation.

This is separate from hormone therapy and is not a replacement for anything your provider prescribes. If you take any medication, including hormone therapy, check with your provider before you start.

Extra 20% off the Good Poops Protocol is applied automatically at checkout through November 30, 2026. No code needed.

👉 Get the Good Poops Protocol here: https://mswnutrition.com/products/good-poops-protocol

Join the School

If this episode left you with more questions than answers, you are exactly who the School of Doza is for. Inside, you get menopause and hormone education you can actually use, plus a community of women asking the same questions you are. Every Wednesday we host a live Ask Me Anything that runs like a group consult: bring your questions about menopause, labs, and how to talk to your provider, and get direct answers live. The Wednesday AMA is live-only.

👉 Get the All Access Pass, starting at $35: https://community.schoolofdoza.com/c/start-here

5 Key Takeaways

The warning changed, but not all of it. The FDA asked to remove the boxed-warning language on heart disease, breast cancer and probable dementia, and to remove the dementia warning from the labeling. The boxed warning on endometrial cancer stays for systemic estrogen-alone products, and information on heart disease and breast cancer remains in the label, just not in the box.

Starting age and timing now appear on the label. New guidance points to considering therapy before age 60 or within 10 years of menopause. A label that is clearer about who it fits is not the same as saying there is no risk.

Estrogen does more than reproduction. Estrogen receptors are found in the brain, heart, gut and bones, and research reviews link falling estrogen with higher risk in several of those areas. Trial results on dementia and Alzheimer's remain mixed, so this is a conversation for you and your provider.

How you take it matters. Oral estrogen passes through the liver first, while patches, gels and sprays bypass that first pass. Progesterone comes in different forms, and the only evidence-based use of testosterone in women is for low sexual desire after menopause.

Go in with a plan. Ask your provider which labs make sense for you, such as estrogen, progesterone, testosterone, FSH, LH and DHEA-S, and keep supporting your gut and liver whether or not you ever start HRT.

Timestamps

00:00 START – Welcome and episode overview

03:08 – Where the black box warning came from (2003)

03:20 – What the FDA label change did and did not do

05:10 – Why experts still disagree, and #1 Estrogen is more than a sex hormone

08:57 – Estrogen, brain health and mood

14:50 – Estrogen, gut and insulin

18:34 – Estrogen, heart and bones

22:02 – #2 Progesterone might not be the answer

25:22 – #3 Delivery methods and the liver's first pass

28:39 – Liver, gallbladder and estrogen metabolism

34:38 – #4 Testosterone is also prescribed to women

38:51 – #5 Ask about adrenal and full hormone labs

44:25 – Your takeaway: labs to ask your provider for

46:03 – The Good Poops Protocol

48:04 – Closing and your questions

 

Resources

Visible URLs on purpose, so they survive pasting into YouTube.

1. HHS fact sheet, FDA removal of HRT black box warnings (Nov 2025): https://www.hhs.gov/press-room/fact-sheet-fda-initiates-removal-of-black-box-warnings-from-menopausal-hormone-replacement-therapy-products.html

2. FDA news release, HRT warnings (Nov 10, 2025): https://www.fda.gov/news-events/press-announcements/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy-1

3. The Role of Estrogen across Multiple Disease Mechanisms (2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC11352819/

4. Prescribing Testosterone and DHEA: The Role of Androgens in Women (2021): https://www.ccjm.org/content/88/1/35

5. Menopausal hormone therapy review, delivery routes and progestogens: https://pmc.ncbi.nlm.nih.gov/articles/PMC12463494/

6. Androgens in women review: https://pmc.ncbi.nlm.nih.gov/articles/PMC13157292/

 

Connect Block

🔗 Connect with Nurse Doza: JOIN MY SCHOOL, All Access starting at $35: https://community.schoolofdoza.com/c/start-here • YouTube: https://www.youtube.com/channel/UCwcKyagDi468WscAOWM5VHA • Instagram: https://www.instagram.com/nursedoza/ • Website: http://www.nursedoza.com/ • LinkedIn: https://www.linkedin.com/in/jonathan-mendoza-dc-aprn-np-c-0609a038/ • TikTok: https://www.tiktok.com/@nursedoza • Twitter: https://twitter.com/nursedoza

In this Supplement Stack Series episode, Nurse Doza introduces the Good Poops Protocol — a two-month routine built on three MSW Nutrition supplements: Liver Boost, Berberine, and GUT (L-glutamine powder). He explains how liver, gut, and gallbladder issues travel together — even for people who no longer have a gallbladder — and how supporting all three at once, alongside a healthier diet, can bring noticeable changes over the two-month protocol.

FEATURED PARTNER
The Good Poops Protocol bundles three MSW Nutrition supplements into one simple daily routine: Liver Boost, for everyday liver support; Berberine, which supports healthy blood sugar, appetite, and cholesterol levels already in a healthy range, along with overall metabolism; and GUT, a single-ingredient L-glutamine powder taken first thing in the morning on an empty stomach. Together, the combination is designed to support regularity, and better digestion tends to go hand in hand with a healthier liver, gut, and gallbladder.

👉 Get the Good Poops Protocol here: https://good-poops.mswnutrition.com

Extra 20% off the Good Poops Protocol — $223.20 for the 60-day supply, automatically applied at checkout. Live now through November 30.

These statements have not been evaluated by the Food and Drug Administration. This protocol is not intended to diagnose, treat, cure, or prevent any disease. If you take medication (especially for blood sugar), are pregnant or nursing, or are managing a gallbladder condition, talk with your provider before starting.

JOIN THE SCHOOL
Trying to fix your gut, liver, or gallbladder is a lot easier when you're not doing it alone. All-Access gets you every self-paced course in the School of Doza, live Tuesday classes, and a weekly live Ask Me Anything with Nurse Doza that runs like a group consult — labs, nutrition, supplements, whatever you're noticing in your own body. You bring the question, Nurse Doza answers it directly, live.

Every course. Plus Nurse Doza, every week. $35 a month, cancel anytime.

👉 See All-Access: https://community.schoolofdoza.com

5 KEY TAKEAWAYS

Liver, gut, and gallbladder issues travel together. Nurse Doza frames the three as one connected system — including for people who've had their gallbladder removed and are still looking for support.

Liver Boost covers the daily liver-support piece. One capsule format is designed to give the liver the everyday support it needs, which in turn supports healthier digestion and regularity.

Berberine is the metabolic anchor. It supports healthy blood sugar, appetite, and cholesterol levels already in a healthy range, and supports overall metabolism — which overlaps with gut and digestive support.

GUT (glutamine) is as simple as it gets. A single-ingredient L-glutamine powder, mixed with water first thing in the morning on an empty stomach, starting with 1–2 scoops.

Diet does the rest. Pairing the protocol with a healthier diet — cooking more meals at home — is part of the routine, with many people noticing initial changes within a few weeks and fuller improvement building out over the two-month protocol.

HOW TO TAKE IT
1–2 scoops of GUT powder first thing in the morning, on an empty stomach, with water. Follow with Liver Boost and Berberine as directed on the label. Pair with a healthier diet — more home-cooked meals — and give the full two-month protocol time to work.

Talk with your provider first if you take blood sugar medication, are pregnant or nursing, or are managing a gallbladder condition.

RESOURCES
Based on peer-reviewed literature:

The gut–liver axis — Review of how the gut, microbiome, and liver communicate and why the intestinal barrier matters for liver health. Journal of Hepatology, 2020. https://pubmed.ncbi.nlm.nih.gov/31622696/

Berberine, metabolism, and blood sugar — Systematic review of berberine's effects on glucose, gut microbiota, and metabolic outcomes. Biomed Pharmacother, 2020. https://pubmed.ncbi.nlm.nih.gov/32353823/

Glutamine and the gut lining — Review of how glutamine supports intestinal barrier function and permeability. Curr Opin Clin Nutr Metab Care, 2017. https://pubmed.ncbi.nlm.nih.gov/27749689/

NAFLD prevalence (liver–gut overlap) — Global epidemiology of non-alcoholic fatty liver disease. Lancet Gastroenterol Hepatol, 2022. https://pubmed.ncbi.nlm.nih.gov/36400097/

Milk thistle / silymarin for liver support — Narrative review of silymarin as supportive treatment in liver disease. Advances in Therapy, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140758/

🔗 Connect with Nurse Doza:
JOIN MY SCHOOL — All-Access, $35/month: https://community.schoolofdoza.com

YouTube: https://www.youtube.com/channel/UCwcKyagDi468WscAOWM5VHA

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Website: http://www.nursedoza.com/

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TikTok: https://www.tiktok.com/@nursedoza

Twitter: https://twitter.com/nursedoza

Menopause belly fat isn't only about hormones and metabolism. In this episode, Nurse Doza explains how estrogen has quietly supported your liver for years, what changes when it drops, and why your waist, your liver, and your blood sugar are so closely tied after menopause. Learn five things every woman should understand about her liver in this season, plus questions to bring to your provider. Educational, not medical advice.

FEATURED PRODUCT
👉 Get the Good Poops Protocol here: https://mswnutrition.com/products/good-poops-protocol

Your liver and your gut do a lot of the behind-the-scenes work in this season of life. The Good Poops Protocol from MSW Nutrition is a two-month, three-product set: Gut (L-glutamine to support digestive health), Liver Boost (N-acetyl-L-cysteine, milk thistle, and selenium to support liver and gallbladder health), and Berberine Plus (dihydroberberine to support healthy blood sugar regulation).*

It's support alongside the diet and lifestyle work, not a magic fix. If you're on hormone therapy or any medication, talk with your provider before you start.

🎁 Right now, take an extra 15% off the Good Poops Protocol bundle price, applied automatically at checkout through November 30. Shop it at mswnutrition.com.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

JOIN THE SCHOOL
If this episode sounded like your week - stubborn belly fat, riding blood sugar highs and lows, or a body that changed even though your eating didn't - and nobody has walked you through how the liver ties it together, you're not alone. That conversation rarely fits into a 15-minute appointment. Inside the School of Doza, it's the conversation we're having every week.

All-Access gets you every self-paced course in School of Doza, live Tuesday classes, and a weekly live Ask Me Anything with Nurse Doza that runs like a group consult - labs, nutrition, supplements, what you're noticing in your own body. You bring the question, Nurse Doza answers it directly, live. The AMA is live only, so you have to be in the room.

Every course. Plus Nurse Doza, every week. $35 a month, cancel anytime.

👉 See All-Access: https://community.schoolofdoza.com

5 KEY TAKEAWAYS

Menopause is linked with a higher risk of fatty liver. Research shows the odds of fatty liver (now called MASLD) rise after menopause, and Nurse Doza explains why the groundwork often starts years earlier, which is why early attention matters.

Estrogen has been quietly supporting your liver. The liver has estrogen receptors, and estrogen helps regulate how the body handles fat and insulin. When estrogen drops, some of that support goes with it.

Estrogen and insulin work together. Lower estrogen is associated with rising insulin resistance and more fat stored around the middle, which is one reason menopause belly fat can show up even when eating habits have not changed much.

Your liver (and gut) still help process estrogen after menopause. After menopause, the main estrogen the body makes is estrone, produced largely in body fat. The liver and the gut microbiome both play a role in how estrogens are processed and cleared.

How estrogen is delivered may matter, so ask your provider. Oral estrogen passes through the liver first, while transdermal options (patches, creams) do not. Nurse Doza encourages you to ask your provider which option fits you, along with how to support your liver and gut at the same time.

TIMESTAMPS
00:00 START – Welcome and episode overview

00:30 – Why belly fat after menopause is about more than hormones

02:55 – #1: Menopause and a higher risk of fatty liver

04:28 – #2: How estrogen supports the liver

06:15 – #3: Estrogen, insulin, and the liver

11:09 – #4: The liver, estrone, and how estrogen is processed

16:20 – The gut connection: the estrobolome

20:24 – #5: Oral vs. transdermal estrogen and questions for your provider

26:50 – Supporting your liver and gut: the Good Poops Protocol

28:50 – Closing thoughts

RESOURCES

The menopause-obesity axis in MASH progression: from estrogen decline to liver fibrosis (Frontiers in Gastroenterology) — 2026: https://www.frontiersin.org/journals/gastroenterology/articles/10.3389/fgstr.2026.1889458/full

Estrogens in the Regulation of Liver Lipid Metabolism — 2017: https://pmc.ncbi.nlm.nih.gov/articles/PMC5763482/

Gallbladder disease and use of transdermal versus oral hormone replacement therapy (BMJ) — 2008: https://pmc.ncbi.nlm.nih.gov/articles/PMC2500203/

The estrobolome: estrogen-metabolizing pathways of the gut microbiome and breast cancer: https://pmc.ncbi.nlm.nih.gov/articles/PMC12178105/

CONNECT
🔗 Connect with Nurse Doza: JOIN MY SCHOOL for FREE: https://community.schoolofdoza.com/c/start-here

YouTube: https://www.youtube.com/channel/UCwcKyagDi468WscAOWM5VHA

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Website: http://www.nursedoza.com/

LinkedIn: https://www.linkedin.com/in/jonathan-mendoza-dc-aprn-np-c-0609a038/

TikTok: https://www.tiktok.com/@nursedoza

Twitter: https://twitter.com/nursedoza

Hume Health makes health-tracking gadgets with a free app and a 10-year warranty. In this episode, Nurse Doza shows how he uses the Hume Band to look at sleep, HRV, and overnight oxygen together. It gives him a fuller picture of how his body responds to daily life, not just to workouts.

👉 Shop Hume Health: https://humehealth.com Code NURSEDOZA for 20% off.

Hume is a wellness-tracking device and is not intended to diagnose, treat, cure, or prevent any disease. Talk with your healthcare provider about any readings that concern you.

🎁 HUME GIVEAWAY (INSTAGRAM)
In partnership with Hume Health, one winner gets their choice of a Hume Pod 1 or a Hume Band 2.0.

How to enter (about 10 seconds):

Follow Hume on Instagram: @humehealth

Comment HUME on the giveaway video on Nurse Doza's Instagram: https://www.instagram.com/nursedoza/

Open: Thursday, October 29, 2026 through Thursday, November 5, 2026 at 11:59 pm CT. One winner, chosen at random.

No purchase necessary. A purchase, including through the Hume link above, does not improve your chances of winning. Open to legal residents of the US, UK, and Canada who are 18+ (or the age of majority where they live). Void where prohibited. Canadian winners must correctly answer a skill-testing question. Entry is on Instagram only; full official rules are in the Instagram caption. This giveaway is not sponsored, endorsed, or administered by, or associated with, Instagram or Meta.

JOIN THE SCHOOL
Making sense of your own data is easier with support. Inside the School of Doza, members work through topics like sleep, stress, and recovery together, and every Wednesday at 1 PM Central there's a live group consult where you can bring your questions.

👉 Start your free trial: https://community.schoolofdoza.com/c/start-here

5 KEY TAKEAWAYS

What happens outside the gym and kitchen matters. You can eat well and train hard and still feel stuck. Sleep, stress, and recovery are often the missing piece.

Look at sleep quality, not just hours. Depth of sleep and the number of times you wake up add context that total hours can't. A rough night with little ones in the house is useful data, because it helps you adjust.

HRV is a personal trend, not a competition. HRV reflects how your nervous system is responding to stress and recovery. Generally, higher readings may point to better recovery and lower ones to accumulating stress. The key is to compare yourself to your own baseline, not someone else's.

Overnight oxygen is worth a look, and a provider is worth a call. Oxygen saturation typically sits in the mid-90s to 100% in healthy adults. If your readings keep dipping at night, don't self-diagnose. Bring the data to your provider.

Treat beta features as trends. The Hume app's blood pressure feature is still in beta, so Nurse Doza uses it to watch direction over time and doesn't base decisions on it. Together, these metrics show how your body is handling your whole life, not just your workouts.

RESOURCES
Based on peer-reviewed literature:

Sleep & recovery – Review of how sleep affects physical performance, recovery, injury risk, and mental health. Clocks & Sleep, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC9960533/

Stress & HRV – Meta-analysis and review of the relationship between stress and heart rate variability. Psychiatry Investigation, 2018. https://pubmed.ncbi.nlm.nih.gov/29486547/

HRV monitoring – Narrative review of how HRV is selected and applied for monitoring in sport and exercise. https://pmc.ncbi.nlm.nih.gov/articles/PMC13510882/

Overnight pulse oximetry – Overview of how overnight oximetry is interpreted. https://pmc.ncbi.nlm.nih.gov/articles/PMC5886424

Wearable sleep tracking – Meta-analysis comparing consumer wrist-worn sleep trackers to polysomnography. https://pmc.ncbi.nlm.nih.gov/articles/PMC11874098/

🔗 Connect with Nurse Doza:
JOIN MY SCHOOL for FREE: https://community.schoolofdoza.com/c/start-here

YouTube: https://www.youtube.com/channel/UCwcKyagDi468WscAOWM5VHA

Instagram: https://www.instagram.com/nursedoza/

Website: http://www.nursedoza.com/

LinkedIn: https://www.linkedin.com/in/jonathan-mendoza-dc-aprn-np-c-0609a038/

TikTok: https://www.tiktok.com/@nursedoza

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Wondering about the signs your liver needs help? Nurse Doza breaks down five everyday cues - low energy, stubborn weight, blood sugar swings, trouble focusing, and restless sleep - and explains how your liver, gut, and fat cells work together. Plus simple lifestyle habits and ways to support your liver, even if you don't think you need extra help.

Featured Product
Your liver handles a lot every day, and what you eat, drink, and take all pass through it. Liver Boost by MSW Nutrition is a 16-ingredient formula designed to support your liver's natural phase I and phase II detoxification pathways.*

👉 Get Liver Boost here: https://mswnutrition.com/products/liver-boost

Join the School
If this episode sounded like your week - tired by mid-afternoon, stuck on the scale, riding blood sugar highs and lows, or not sleeping well - and nobody has walked you through how the liver ties it together, you're not alone. That conversation rarely fits into a 15-minute appointment. Inside the School of Doza, it's the conversation we're having every week.

All-Access gets you every self-paced course in School of Doza, live Tuesday classes, and a weekly live Ask Me Anything with Nurse Doza that runs like a group consult - labs, nutrition, supplements, what you're noticing in your own body. You bring the question, Nurse Doza answers it directly, live. The AMA is live only, so you have to be in the room.

Every course. Plus Nurse Doza, every week. $35 a month, cancel anytime.

👉 See All-Access: https://community.schoolofdoza.com

5 Key Takeaways

Feeling sluggish all day can be a cue to look at your liver. Nurse Doza explains that the liver processes everything you eat, drink, and take, so how you eat and sleep shows up in your energy.

Stubborn weight and your liver are connected. Fat tissue behaves like an organ that sends hormone-like signals, and a liver that is supported helps your body manage inflammation and metabolism.

Blood sugar swings matter. If you crash a few hours after meals or cannot go long between meals, it is worth looking at how your body handles insulin, and how your meals are built.

Focus and mood start in the gut. Much of your serotonin and dopamine activity is tied to the digestive tract, so supporting your gut and liver supports how you feel and focus.

Sleep and your liver go hand in hand. Nurse Doza walks through why consistent, adequate sleep is one of the simplest ways to support your liver, and why lifestyle beats excuses every time.

Important: These five signs are general cues, not a diagnosis. Fatty liver in particular often has few or no symptoms, so ask your healthcare provider about testing if you are concerned.

Timestamps
00:00 START – Welcome and episode overview

02:28 – Sign 1: Feeling sluggish and tired

11:29 – Sign 2: Gaining weight and stubborn belly fat

16:21 – Your fat cells are an organ: hormone-like signals and metabolism

18:20 – GLP-1 medications, insulin resistance, and inflammation

20:08 – Sign 3: Blood sugar swings and constant hunger

24:27 – Sign 4: Trouble focusing and low mood

26:52 – Supporting focus: why your gut matters for dopamine

29:18 – Sign 5: Sleep and your liver

29:39 – Lifestyle, wrap-up, and how to get started

Resources

NIDDK: Nonalcoholic Fatty Liver Disease (NAFLD) & NASH: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash

Short sleep duration and risk of NAFLD, meta-analysis — 2016: https://repository.li.mahidol.ac.th/handle/123456789/41057

Sleep duration and risk of fatty liver disease, meta-analysis — 2016: https://pmc.ncbi.nlm.nih.gov/articles/PMC4994071

Sleep duration, sleep quality, and NAFLD development, cohort study: https://pmc.ncbi.nlm.nih.gov/articles/PMC8528229

Liver Boost by MSW Nutrition: https://mswnutrition.com/products/liver-boost

Start your free trial: https://community.schoolofdoza.com/c/start-here

Connect with Nurse Doza
🔗 Connect with Nurse Doza: JOIN MY SCHOOL for FREE: https://community.schoolofdoza.com/c/start-here

YouTube: https://www.youtube.com/channel/UCwcKyagDi468WscAOWM5VHA

Instagram: https://www.instagram.com/nursedoza/

Website: http://www.nursedoza.com/

LinkedIn: https://www.linkedin.com/in/jonathan-mendoza-dc-aprn-np-c-0609a038/

TikTok: https://www.tiktok.com/@nursedoza

Twitter: https://twitter.com/nursedoza