Sara Szal

Sara Szal Sara Szal MD helps you return to health even in times of crisis with integrated multiomic care Want guidance? No medical advice.
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Sara Gottfried MD is the three-time New York Times bestselling author of The Hormone Cure, The Hormone Reset Diet, and Younger. Her latest book, Women, Food, and Hormones is available for preorder now. Comments and posts come from Dr. Gottfried and her team.

08/28/2026

Five articles. Five conversations I believe more women need to be having about their bodies, hormones, health, and longevity.

These are some of the most-read articles on The Female Edge, where I go deeper into the research, clinical protocols, and questions women are too often left to figure out on their own.

Join me on Substack to read them and become part of the conversation.

Comment SUBSTACK for the link.

A woman fully in her body is harder to deceive.Harder to extract from.Harder to override. I've been thinking about the s...
08/26/2026

A woman fully in her body is harder to deceive.
Harder to extract from.
Harder to override.

I've been thinking about the systems that depend on women doing the opposite.

Corporate systems.
Institutional systems.
Relational systems.
Digital systems.

Many work remarkably well when women are able to disconnect from what their bodies are telling them and keep going.

▪ Tired? Keep going.
▪ ▪ Something feels wrong? Gather more evidence.
▪ ▪ ▪ This relationship is costing too much? Explain why it shouldn't.
▪ ▪ ▪ ▪ This pace is unsustainable? Become more efficient.
▪ ▪ ▪ ▪ ▪ You don't want this? Find a sufficiently rational reason before you say no.

Women who have survived through competence can become exceptionally good at cognitive override.

Which is why embodiment, as I define it, has very little to do with wellness culture.

It's the ability to receive your body's signals with enough accuracy that you can act on them.

Sometimes that means recognizing depletion before burnout.
Sometimes it's sensing that something is wrong in a relationship, contract, job, or room before your mind has assembled the argument.

Sometimes it's simply knowing: I do not want this💥

That's a very different kind of female authority.

👉Comment FULLY below for the article link 👉👉 A Fully Embodied Woman Is Harder to Control

Resistance training three times a week is one of my prescriptions for women after 35.Women lose an estimated 3 to 5 perc...
08/24/2026

Resistance training three times a week is one of my prescriptions for women after 35.

Women lose an estimated 3 to 5 percent of muscle mass per decade after 30, and that loss can accelerate during perimenopause.

This matters because muscle is not aesthetic. It is metabolic currency.

It affects insulin sensitivity, bone density, strength, mobility, and how well you age.

Zone 2 cardio supports mitochondrial and cardiovascular health.

But it doesn't replace resistance training.

I recommend both, with strength training three times per week as the foundation for preserving and building muscle.

When I first wrote about this on Substack, it generated so many questions that I created a much more comprehensive muscle protocol.

Inside you'll find:

▪ Grip strength norms by decade
▪ Body composition targets
▪ The lab panel I use + optimal levels for women
▪ Female-specific supplement dosing
▪ The muscle-preservation plan I believe should accompany every GLP-1 prescription

It's all in You Are Probably Losing Muscle Right Now. Here Is the Protocol to Stop It.

Comment GRIP and I'll send you the article.

💥For the next 2 days, you can also get a full year of The Female Edge for $99, less than $2/week, with access to my deeper protocols, lab guidance, and clinical frameworks.

💪 How strong is your grip? 💪It sounds almost too simple, but grip strength is one of the easiest functional measures of ...
08/22/2026

💪 How strong is your grip? 💪

It sounds almost too simple, but grip strength is one of the easiest functional measures of your overall muscle health. Lower grip strength has also been associated with higher all-cause and cardiovascular mortality.

You can purchase a hand dynamometer for around $30 online. The test takes about 30 seconds: squeeze as hard as you can with your dominant hand three times and record your average or best score.

For women, very rough benchmarks are:

💪20–39: ~35 kg
💪40–54: ~32 kg
💪55–69: ~28 kg

And a score below about 16 kg deserves a closer look at muscle mass, protein intake, resistance training, and body composition.

I go much deeper into muscle loss after 35 in my latest Substack article:

💪You Are Probably Losing Muscle Right Now. Here Is the Protocol to Stop It.💪

In the article, I share all the details on what to measure, including details on what dynamometer I recommend. PLUS as a paid subscriber you’ll get my protocol for protecting and rebuilding muscle.

Comment GRIP and I’ll send you the article link.

08/20/2026

What if the deepest work you can do as a clinician… isn’t more work?

It’s learning how to think differently.

A typical morning conversation with Bradly Jacobs and me in the morning light:

Medicine.
Our bodies.
Longevity.
Sexuality.
Culture.
What we’ve been taught to believe.
And what we’re finally willing to question.

Because deeper clinical work isn’t always about knowing more.

Sometimes it’s about becoming curious enough to see what everyone else has stopped seeing.

And asking the questions your training never taught you to ask.

Also: note the work shirt + pajama pants.

My favorite combination. 😂

What question are you asking in your work right now that you were never taught to ask? Let us know👇🏼

I'm really excited about my good friend David Perlmutter, M.D.'s new book BRAIN DEFENDERS.Some of the most exciting adva...
08/20/2026

I'm really excited about my good friend David Perlmutter, M.D.'s new book BRAIN DEFENDERS.

Some of the most exciting advances in Alzheimer's research are coming from our growing understanding of the brain's immune system.

It's a hopeful look at how metabolism, inflammation, and lifestyle influence brain health, and why our cognitive future is not predetermined.

ORDER YOUR COPY TODAY
https://drperlmutter.com/books/brain-defenders/

🔬Here are the lab tests I order for women over the age of 35.Most women aren't getting all of these at their annual phys...
08/19/2026

🔬Here are the lab tests I order for women over the age of 35.

Most women aren't getting all of these at their annual physical.

✓ Fasting Insulin
✓ FSH
✓ Estradiol
✓ AMH
✓ Progesterone
✓ Free + Total Testosterone
✓ DHEA-S
✓ SHBG
✓ TSH
✓ Free T4 + Free T3
✓ Reverse T3
✓ Thyroid antibodies
✓ Morning Cortisol

👉Save this list for your next doctor's visit.

But remember, knowing what to test is only part of the picture.

Timing matters.
Ranges matter.
And trends over time matter.

In my latest Substack article:

🔬Hormone Tests That I Order on Every Woman Between 35 and 50

I share what each test tells us, when to test, and the ranges I use clinically in the full article.

👉Comment LIST and I'll send it to you.

I am noticing the cultural tendency to explain women’s distress through pathology rather than the true root causes. A wo...
08/18/2026

I am noticing the cultural tendency to explain women’s distress through pathology rather than the true root causes.

A woman feels overwhelmed. Medicine and the culture label it anxiety or depression or “hormonal,” and medicates her. We don’t look at what’s wrong with her workload, pay, marriage, metabolism, sleep, or the fact that no one has asked her what she wants in the past 10-20 years.

That’s the move. Let’s examine the inner life. The burden of caretaking that she does for free. The needs she was taught to swallow. The rules, written and unwritten, that say her job is to hold everyone else together and not complain about it.

Her distress gets a diagnosis instead of a deep listening. She takes the prescription and goes on Xanax or Celexa or Lexapro or hormone therapy. The conditions that produced the distress stay exactly the same as they were.

The truth is simpler and more uncomfortable. A lot of women’s suffering isn’t anything she’s doing wrong, it’s a woman with normal needs, unmet, in a system meant to keep her quiet about it.

Bottom line: When a woman says she’s overwhelmed, that’s not always a symptom to medicate. It’s information about her life.

Ask what’s wrong with the conditions before you decide what’s wrong with her.

xo, Dr. Sara

When you visit your doc, they have about one minute for each topic you bring up.Now think about everything women are try...
08/17/2026

When you visit your doc, they have about one minute for each topic you bring up.

Now think about everything women are trying to understand after 35:

▪▪ Perimenopause
▪▪ Sleep
▪▪ Protein
▪▪ Stress
▪▪ Muscle
▪▪ Brain fog
▪▪ Bone density
▪▪ Heart health
▪▪ Breast cancer risk

and the list goes on...

Perimenopause unfolds over many years and no doctor can explain the decades of changing female physiology in the short time they have for your visit.

I'm not blaming doctors.

This is about recognizing the limits of a healthcare system that gives complex questions about women's bodies so little time.

That's one reason I've shared so much here over the years, and continue to share, everything I learn with you.

The research. The physiology. The questions to ask. The things I wish more women were told before they walked into the exam room.

Follow me for evidence-based conversations about women's health after 35.

👉💥What is the most pressing question you have right now you wish your doctor would answer for you?

08/15/2026

Brain fog during perimenopause may be about more than memory lapses.

Hormonal shifts can affect focus, stress tolerance, emotional filtering, and how women experience the world around them. The good news is that these changes can be addressed proactively and thoughtfully.

I’m the Director of the Precision Medicine Program whose Optimal Brain Health Program evaluates brain health from multiple angles—neurological, hormonal, metabolic, and more.

and I share our top tips to help you feel sharper and protect your brain health.

Comment REBOOT below for the 7-Day Brain Reboot video.

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