I recently listened to a podcast that stopped me in my tracks.

Steven Bartlett, on Diary of a CEO, interviewed four leading experts in women’s hormonal health: Dr. Vonda Wright (Orthopedic Surgeon), Dr. Mary-Claire Haver (OB/GYN), Dr. Natalie Crawford (OB/GYN), and Dr. Stacey Sims (Exercise Physiologist and Sports Nutritionist).

As you might imagine, the conversation was wide-ranging. They covered everything from exercise and bone health to menopause, fertility, and hormone replacement. I consider myself fairly well informed about women’s health—I work in this space, I read the research, I’ve lived in a female body for nearly five decades. And still, there were moments in this conversation that genuinely surprised me.

Some of what I heard reframed my own health story in ways I didn’t expect.

The Foundation We Build Young (Whether We Know It or Not)

We often talk about hormones as something that becomes relevant in our 40s or 50s, when symptoms show up loudly and demand attention. But one of the strongest themes in this conversation was how much of our hormonal foundation is built much earlier.

Our teens and 20s are critical years for:

Building muscle mass
Laying down bone density
Establishing hormonal signaling patterns that carry us forward

These processes happen most efficiently when we are young. And if they don’t happen well—or are disrupted—those gaps tend to show up later.

This part wasn’t new to me.

What was new was how many factors can interfere with those processes long before we ever think to question them.

My Own Story

Personally, I was not athletic growing up. I wasn’t lifting weights, I wasn’t training for strength, and once I left home after high school, my diet was… fine, but far from balanced.

When I did exercise, it was entirely to be thin—not to be strong, resilient, or well-fueled.

At the time, that felt normal. Encouraged, even.

The result was that I entered my 30s with relatively low muscle mass. And by my late 40s, I was diagnosed with osteopenia—low bone density.

For years, I assumed this was the natural outcome of my earlier lifestyle choices. And to be clear, those choices absolutely played a role.

But listening to this podcast made me realize that there may have been more happening beneath the surface.

The Birth Control Conversation We Haven’t Fully Had

Before I go any further, I want to be very clear about something.

This is not an anti–birth control article.

I firmly believe that women should have access to the full range of birth control options at every stage of life. Women should control their bodies, their fertility, and their family planning—full stop.

What this conversation highlighted, though, were some of the less-discussed, long-term considerations of hormonal suppression starting at a very young age.

Not to shame.
Not to scare.
But to inform.

“Is an Irregular Cycle a Problem?”

“Yes.”

One of the most striking moments in the podcast came when Steven asked a simple question: “Is having an irregular cycle something to be concerned about?”

Every doctor answered immediately and without hesitation: YES.

That single word opened up a much deeper discussion about why irregular cycles happen and what they signal about the body.

Many women—especially those who were very athletic or very thin as teens—experienced periods of time when they didn’t menstruate regularly, even without birth control. In some cases, their periods disappeared entirely.

For many girls, this was seen as a bonus. One less inconvenience. In athletic environments, there was often an unspoken belief that being lighter or leaner improved performance.

But here’s the part that doesn’t get explained clearly enough.

No Period Often Means Low Estrogen

Those years without a cycle were not just years without bleeding. They were often years without adequate estrogen production.

And estrogen is not just about reproduction.

Estrogen is crucial for:

Bone development
Muscle growth and maintenance
Joint health
Brain function

When estrogen is consistently low during formative years, the body misses critical opportunities to build strength and density that are very difficult to recover later.

That realization alone reframed a lot for me.

Where Birth Control Enters the Picture

Now layer hormonal birth control onto this.

Many women I know—clients, friends, myself included—were placed on birth control at a young age due to painful, heavy, or irregular periods. At the time, there were (and often still are) very few tools offered beyond hormonal suppression.

Birth control was framed as the solution.

And in many cases, it absolutely did reduce symptoms. But as the doctors explained, in “fixing” one problem, we may unknowingly create others.

For example, I learned that for some women using a progestin IUD, the level of progesterone can be high enough to fully suppress ovulation.

Ovulation doesn’t just produce progesterone. It also contributes to estrogen production. When ovulation is suppressed long-term, estrogen levels can remain chronically low.

And bones, especially, suffer.

Decades of Suppression Add Up

I know women who have been on birth control or an IUD since they were 18 and are now in their 40s or beyond. Outside of pregnancy, their natural hormonal cycles have been suppressed for decades.

Again, this isn’t about blame. Many of us made the best choices we could with the information we had.

But it does raise important questions:

What does long-term ovulation suppression mean for bone health?
For muscle mass?
For brain health?

As Dr. Natalie Crawford noted, if someone chooses oral contraceptives, using a formulation that includes 7 placebo days and a withdrawal bleed can be beneficial—not just hormonally, but neurologically as well.

Estrogen and progesterone have profound anti-inflammatory and protective effects on the brain. This matters more than we’ve been taught to consider.

Signs of Chronic Low Estrogen

One of the most actionable parts of this conversation was the reminder that low estrogen can show up at any age, not just around menopause.

Common signs include:

Hot flashes
Night sweats
Vaginal dryness
Low libido
Joint pain
Itchy or thinning skin
Mood changes
Depression

If someone is on birth control, not getting a period, and experiencing these symptoms, it deserves a closer look—regardless of age.

The good news is that it is possible to support estrogen or progesterone while on birth control. Many providers aren’t trained in this, but options exist. Changing contraceptive type or reassessing whether hormonal suppression is still necessary can also be part of the conversation.

A Message for Parents of Young Girls

This podcast also made me think deeply about the messages we send young women.

If you’re a parent or caregiver, a few things feel especially important:

Avoid letting diet culture or thinness dominate the household narrative
If your daughter is athletic, don’t assume missing periods are “normal”
Sometimes gaining a small amount of weight can signal safety to the body and restore cycling
Consider family history—osteoporosis often runs in families
If medical intervention is needed, address lifestyle factors alongside it

Hormonal health is never just about hormones alone.

Why This Isn’t Just a “Women’s Issue”

There was a time when I would have addressed this message only to women.

I no longer believe that makes sense.

Men are partners, fathers, coaches, healthcare providers, and decision-makers. They need to understand how women’s bodies work—not as a niche topic, but as foundational knowledge.

Listening to Steven Bartlett ask thoughtful, informed questions was a powerful reminder of that.

This information benefits everyone.

I don’t share this to rewrite the past or create regret. I share it because information creates choice.

Understanding how our hormonal health is shaped—sometimes decades before symptoms appear—gives us the ability to ask better questions, advocate for ourselves and our daughters, and make decisions with both short-term relief and long-term health in mind.

If this resonated with you, pass it along. These are conversations worth having—out loud, across generations, and without shame.

And if you want help addressing lifestyle factors that support hormone health at any age, you know where to find me.

Frequently Asked Questions About Women’s Hormonal Health, Cycles, and Birth Control

Why is having a regular menstrual cycle important?

A regular menstrual cycle is often a sign that the body is producing adequate levels of estrogen and progesterone. These hormones play critical roles not only in reproduction, but also in bone density, muscle development, joint health, brain function, and mood regulation. When cycles are consistently irregular or absent, it can signal hormonal suppression or imbalance that may have long-term health implications.

Is it normal to lose your period if you’re very athletic or very thin?

It is common, but that doesn’t mean it’s optimal. Losing a period due to intense training, low energy intake, or low body fat often reflects low estrogen levels. During adolescence and early adulthood, this can interfere with bone and muscle development. While the absence of a period may feel convenient, it can carry long-term consequences if left unaddressed.

How does estrogen affect bone and muscle health?

Estrogen plays a key role in building and maintaining bone density and muscle mass. During the teen and early adult years, estrogen helps the body lay down bone that protects against osteoporosis later in life. Chronically low estrogen—at any age—can accelerate bone loss and make it harder to maintain muscle and joint health.

Can birth control affect hormone levels beyond preventing pregnancy?

Yes. Some forms of hormonal birth control suppress ovulation, which can reduce the body’s natural production of estrogen and progesterone. While this can be helpful for symptom management or pregnancy prevention, long-term suppression may have effects on bone, muscle, and