08/21/2026
I donโt like commenting on public events, but I do want to say something about the Lindsay Clancy trialโฆ
๏ฟผThis case is devastating. Three children lost their lives, a motherโs life and an entire family were changed forever, and now the Lindsay Clancy trial is forcing a very public conversation about something women have been saying for years:
Women deserve better healthcare.
One piece of this trial that has stayed with me is the discussion surrounding how limited some of her medical evaluation appears to have been. Testimony has specifically raised questions about thyroid and hormonal testing that was reportedly never performed.
I want to be careful here: I am not saying progesterone deficiency caused what happened, nor that progesterone alone prevents or treats postpartum psychosis. Postpartum psychosis is a psychiatric emergency and requires immediate, comprehensive treatment.
But I am asking why hormones are so often left out of the conversation when we evaluate women during one of the most profound hormonal transitions of their lives.
Pregnancy and birth produce enormous changes in estrogen, progesterone, allopregnanolone, thyroid physiology, sleep, metabolism, inflammation and the nervous system. Yet too often, womenโs symptoms are treated as isolated psychiatric complaints without asking enough questions about the physiology occurring underneath them.
And this isnโt some fringe concept. Two newer medications developed specifically for postpartum depression, brexanolone and zuranolone, work through the neurosteroid/GABA-A pathway related to allopregnanolone, a metabolite of progesterone. Research is even beginning to investigate neuroactive steroid therapy in postpartum psychosis.
That doesnโt mean we replace appropriate psychiatric medication with hormones. It means womenโs healthcare should be comprehensive instead of fragmented.
Medication can absolutely save lives. But medication management and root-cause investigation should not have to be competing philosophies. We should be asking: What is happening hormonally? What is happening with thyroid function? What is happening nutritionally and metabolically? What medications is she taking? How are they interacting? Is she sleeping? What changed after pregnancy? What else are we missing?
And weโve seen this story before.
After the Womenโs Health Initiative was released in 2002, hormone therapy use plummeted. Years of subsequent analysis showed that the original findings were too broadly generalized, particularly to younger, symptomatic women near menopause. Modern guidance now emphasizes individualized decision-making, and hormone therapy remains the most effective treatment for menopausal vasomotor symptoms for appropriate patients.
A generation of women became afraid of hormones while suffering through symptoms that deserved treatment.
We cannot keep repeating that pattern.
And when there is a molecule our bodies naturally produce, I think it is reasonable to ask why physiologic or bioidentical options are sometimes treated as an afterthought while entirely new synthetic medications targeting related pathways are developed and embraced.
That doesnโt mean โnaturalโ automatically means safer. It means we should be willing to study and discuss all evidence-based options rather than dismissing hormones simply because they are hormones.
Women deserve more than symptom suppression.
They deserve physicians and practitioners who understand female physiology, recognize hormonal transitions, investigate contributing factors, use medications appropriately when they are needed, and treat the whole woman.
The Lindsay Clancy case is unspeakably sad. Whatever the jury ultimately decides about criminal responsibility, I hope one legacy of this tragedy is that we finally start taking maternal mental health, postpartum physiology, and womenโs healthcare as seriously as they deserve.
Women deserve better. We have to do better.
