Women's Health is not men's health + extra hormones

Women’s health is not just men’s health with estrogen and progesterone sprinkled on top. If only it were that simple. Instead, it’s a beautifully complex, ever-changing, sometimes frustrating, and entirely unique entity—because women’s bodies don’t just operate on a daily rhythm like men’s. They also follow a monthly cycle that influences everything from metabolism and mood to insulin sensitivity and inflammation.

I recently had a patient tell me that she felt it was unfair that everything health-related seemed harder for women. And honestly? I wanted to scream, YES, IT IS UNFAIR! Not just feels that way, but actually is. The reality is that almost all health research, dietary recommendations, and even exercise protocols are based on men’s physiology—and women are expected to just adjust. But women’s biology doesn’t play by the same rules. And this becomes even clearer when we talk about interventions.

So, let’s break it down—because understanding these differences isn’t just about reproductive health. It’s about how every system in the body operates differently for women.

1. Insulin Resistance: A Different Beast in Women

Insulin resistance is bad news for everyone, but in women, it comes with an extra layer of complexity—hormones.

Here’s how it plays out:

Insulin resistance increases androgen production (aka more testosterone) in women.
At the same time, sex hormone-binding globulin (SHBG) binds to testosterone, making it less available.
So what’s left? Higher free estrogen levels, which can wreak havoc on menstrual cycles, mood, and metabolism. And oh, excess estrogen predisposes to cancer. Yep!

This hormonal rollercoaster is why insulin resistance in women often shows up as PCOS (Polycystic Ovary Syndrome), irregular cycles, acne, and weight struggles—while in men, it’s more about belly fat and metabolic dysfunction.

2. Stress: The Cortisol Conundrum

Let’s talk about cortisol, the stress hormone. In men, cortisol spikes and drops predictably, but in women, stress responses are more… let’s say, negotiable.

Chronic stress in women can suppress ovulation and lead to irregular periods.
It also reduces progesterone (which has a calming effect), leading to more anxiety and sleep issues.
Oh, and let’s not forget: chronic stress can also make PMS symptoms worse (as if they needed any help).

3. Fat Storage & Energy Use: Not the Same Playbook

Women’s bodies are biologically designed to prioritise fat storage, especially in the hips and thighs. This isn’t just about aesthetics—it's an evolutionary advantage for energy reserves during pregnancy and breastfeeding.

Women burn more fat at rest than men but rely more on carbs during exercise (which is why low-carb diets sometimes backfire for active women).
During the luteal phase (the second half of the menstrual cycle), metabolism increases, but so do hunger and cravings. If you’ve ever wondered why you’re ravenous before your period, there’s your answer.
The drop in estrogen right before menstruation also affects serotonin, which is why mood swings and carb cravings hit at the same time.

4. The Heart Disease Gap

Heart disease is the number one killer of both men and women, but the symptoms and risk factors don’t look the same.

Women are more likely to have “silent” heart attacks, with symptoms like fatigue, nausea, and jaw pain, rather than the classic chest pain.
Estrogen offers some protection against heart disease—until menopause, when risk levels skyrocket.
Women’s blood vessels respond differently to stress and inflammation, meaning traditional risk calculators often underestimate women’s heart risk.

5. Autoimmune Disease: The Overachiever of the Female Body

Here’s a fun (read: not fun) fact: Women make up nearly 80% of all autoimmune disease cases.

Estrogen can enhance immune activity, which is great for fighting infections but terrible when the immune system starts attacking its own tissues.
This is why conditions like Hashimoto’s, lupus, and rheumatoid arthritis are far more common in women.
Pregnancy (when progesterone is dominant and estrogen is kept under check (mostly)) can sometimes put autoimmune diseases into remission—only for them to flare up postpartum when hormone levels crash.

6. Women Need a Different Approach to mTOR and AMPK

When it comes to longevity, metabolism, and performance, the balance between mTOR (growth & repair) and AMPK (catabolism & energy regulation) is a critical dance—and it’s not the same for men and women. OK, this is a bit technical and aimed at those who want to live forever, but feel free to skip to the next.

For men, frequent fasting and aggressive caloric restriction can work well to activate AMPK, burn fat, and enhance longevity.
For women, too much fasting or caloric restriction can tank hormones, disrupt menstrual cycles, and increase cortisol, leading to worse metabolic outcomes instead of better ones.
Women need to cycle between mTOR activation (muscle-building, recovery) and AMPK activation (fat-burning, autophagy) strategically to avoid long-term hormonal disruptions.

How? Menstrual cycle syncing.

Follicular phase (first half of the cycle): Women tend to handle fasting, higher-intensity workouts, and lower carbs better.
Luteal phase (second half of the cycle): Energy needs increase, fasting can be counterproductive, and more carbs can support hormonal balance.
Post-menopause: More structured cycles of resistance training and protein intake become even more essential as estrogen declines.

7. Sleep: A Different Circadian Rhythm

Sleep is often overlooked in women's health, but it's crucial.

Women have a slightly longer circadian rhythm than men, making them naturally inclined to go to bed and wake up later.
Progesterone plays a role in sleep regulation, which is why sleep disturbances are common before periods and during menopause.
Women are more prone to insomnia, restless sleep, and disrupted deep sleep cycles, which can impact metabolism and cognitive function.

8. Gut Microbiome & Nutrient Absorption

Women’s gut microbiome isn’t just about digestion—it shifts with hormonal changes and impacts mental health, immunity, and metabolism.

Estrogen influences gut bacteria, which is why women experience bloating, IBS-like symptoms, and changes in digestion during different cycle phases.
Gut bacteria also play a role in metabolizing hormones, which affects overall endocrine balance.
The gut-brain connection is stronger in women, meaning stress and anxiety hit harder through gut-related pathways.

9. Exercise & Recovery: Not the Same Playbook

Women don’t recover from exercise the same way men do. Their hormonal cycles impact energy availability, muscle recovery, and endurance.

Women tend to burn more fat at rest and rely more on carbs during high-intensity workouts.
High-intensity training is better tolerated in the follicular phase (first half of the cycle) but can increase stress and fatigue in the luteal phase (second half).
Women need longer recovery periods due to higher inflammatory responses after training sessions.

10. Bone Health & Aging: The Estrogen Factor

Estrogen does a lot for bone health. When it declines, things change fast.

Women naturally have lower peak bone mass than men, putting them at greater risk for osteoporosis.
Post-menopause, bone loss accelerates rapidly, increasing fracture risk.
Strength training and sufficient protein intake become even more critical in midlife and beyond to maintain skeletal strength.

Women Shouldn’t Just Follow What Works for Men

One of the biggest misconceptions in health, wellness, and longevity is the idea that what works for men will work for women—just with slightly adjusted doses. That’s simply not the case.

Many longevity protocols, wellness strategies, and exercise plans are designed around male physiology and don’t account for the unique hormonal, metabolic, and immune variations in women.
If you’ve ever tried a fasting protocol, a ketogenic diet, or an intense exercise routine that seemed to work wonders for a man you know—but left you feeling exhausted, moody, or struggling with your cycle—you are not the problem. The approach just wasn’t designed with women’s biology in mind.
Women need cyclical rather than linear approaches. This means adjusting nutrition, fasting, and exercise based on their cycle or life stage rather than following a rigid, one-size-fits-all model.
Even in longevity medicine, interventions need to be tailored. Whether it’s hormone replacement, metabolic strategies, or recovery methods, what extends lifespan and healthspan in men may need a different approach in women.

The Bottom Line: Women’s Health is Its Own Science

The takeaway? Women’s health isn’t just about reproductive organs—it’s about how every single system in the body operates differently.

Insulin resistance? More androgens, more estrogen fluctuations.
Stress? Different cortisol response, more anxiety.
Metabolism? Shifts with the cycle, different fuel utilization.
Heart disease? Different symptoms, different risks.
Immunity? More powerful, but also more prone to self-destruction.
Longevity? Requires a different AMPK/mTOR balance than men.

So, the next time someone says, “Women’s health is just men’s health with extra hormones,” feel free to politely (or not-so-politely) correct them. Because the reality is, women’s health is its own science. And it’s time we treated it that way. The takeaway? Women’s health isn’t just about reproductive organs—it’s about how every single system in the body operates differently.