Hormones, Peptides and the Science of Aging Well | Renee Young, ND
When I think about the women who come into my office in their 40s and 50s, I picture a very familiar scene.
She is doing “everything right.”
She is eating carefully.
She is white-knuckling the scale.
She is dragging herself to workouts.
Yet her knees hurt more than they used to. She is exhausted in a way that sleep does not fix. She is grateful for her family, but secretly resentful that everyone needs something from her all the time.
And she is wondering, “Is this just stress? Postpartum? Getting older? Or is something actually wrong with my hormones?”
In a recent conversation with my friend and colleague, Dr. Renee Young, a naturopathic physician and founder of Young Naturopathic Center for Wellness in Los Gatos, we dug into exactly this season of life.
Dr. Young has spent decades working at the intersection of hormones, metabolism, and longevity. She treats everyone from women in perimenopause to professional athletes, using tools like hormone therapy, GLP-1 medications, peptides, IV nutrients, and hyperbaric oxygen.
This article is my “clinic summary” of that rich conversation, written for you, in plain English, so you can understand what is happening in your body and what you can actually do about it.
The Midlife Shift Starts Earlier Than You Think
One of the biggest myths is that perimenopause starts in your late 40s.
Dr. Young reminded me of something important:
At about 35, a woman’s hormones start to decline.
There is no negotiating with this. It is simply biology.
For many women there is:
A very noticeable four-year window of change
But really a 10-year span where things start to feel “off”
Here are the early symptoms she sees over and over:
Stubborn midsection weight (“midsection muff”)
That little belly pooch that will not budge, even when you diet hard.
Weight that “comes back with friends”
You lose 15 pounds, they return, plus more.
Deep, “life tired” fatigue
Not just “I went to bed late.”
A sense of being tired of everything and everyone.
Loss of joy and mild depression
You love your family, but you resent constantly picking up after everyone.
You feel less joy in helping people than you used to.
Mood changes that are not classic PMS
More irritability, less emotional resilience.
Body aches and exercise intolerance
Workouts feel harder. Recovery is slower. Everything feels stiff.
Hair changes
Hair that used to grow down your back now just stops at a certain length.
Digestive issues, especially “IBS-like” symptoms
More bloating, gas, even “farting when you walk,” as Dr. Young bluntly puts it.
Many of us are also having babies later. So we are juggling postpartum changes, nighttime awakenings, young kids, and midlife hormone shifts all at once. It is no wonder we feel confused about what is “just life” and what might be perimenopause.
Your Hormones Are a Whole-Body Network
Dr. Young talks about a “whole body hormone approach.”
She breaks hormones into three big categories:
Steroid hormones
These are made from fats.
Include: estrogen, progesterone, testosterone, and other androgens.
Immune / stress hormones
Made from proteins.
Include: epinephrine, norepinephrine, and thyroid hormones.
Peptide hormones
Built from chains of amino acids.
Insulin is a peptide hormone.
GLP-1 (glucagon-like peptide-1) medications act in this family.
Not all peptides are hormones, and not all hormones are peptides, but they are closely related.
All three categories talk to each other. When one is off, the others start to wobble.
What Happens in Midlife: Estrogen, Progesterone, and Insulin
Here is a simplified version of what Dr. Young outlined.
Estrogen: Your Quiet Metabolic Superpower
In your reproductive years, estrogen is primarily made in the ovaries by aromatizing (transforming) testosterone and other androgens into estrogen.
Estrogen does some powerful things:
It can get deep into your mitochondria (your cells’ energy factories)
It uses oxygen and NADPH to donate an electron and help produce ATP, your energy molecule
It helps you feel more energetic
In the first half of your cycle (follicular phase), estrogen:
Blocks your liver from dumping glucose into your bloodstream
So estrogen is quietly:
Supporting energy
Supporting metabolism
Protecting you from too much blood sugar
Progesterone: The Balancer With a Different Personality
In the middle of your cycle, progesterone spikes.
Progesterone does the opposite of estrogen in some key ways:
It enhances glucose release from the liver
It increases cravings
It encourages abdominal weight gain
All of this makes sense when your body is preparing for pregnancy. You need:
More energy on board
More stored fuel
What Changes Around 35 and Beyond
As you approach midlife:
Your ovaries essentially say, “One day I am going to quit my job.”
You lose the ability to aromatize testosterone into estrogen as effectively.
You lose that positive, protective effect of estrogen on glucose.
The result:
You become more insulin resistant.
Blood sugar is harder to manage.
Cortisol (your main stress hormone) spikes more easily from:
Kids
Work
Sleep deprivation
Emotional overload
And when cortisol spikes, insulin jumps in:
“I’m going to get as much sugar as I can, shove it into your cells as fat.”
And that fat does not go to your chest.
It goes right to your belly.
This is the hormonal background of that “midsection muff,” the stubborn weight, and the deep fatigue so many women feel in their late 30s and 40s.
PCOS, Estrogen, and GLP-1 Medications
Dr. Young shared a powerful clinical story that illustrates how hormones, insulin, and GLP-1 medications work together.
She had a patient with severe PCOS (polycystic ovarian syndrome):
Counting every calorie
On herbal medications, berberine, birth control, spironolactone
Doing everything “right”
And she still could not lose a pound
That patient went to Europe, came back with semaglutide (a GLP-1 medication), and had lost a massive amount of weight.
When Dr. Young dug into the science, it clicked:
GLP-1s are hormones that work with and oppose insulin.
They help insulin be used more appropriately.
In PCOS, women often have:
Higher androgens
Lower effective estrogen
Insulin resistance
Ovaries that become cystic and flood with androgens
The key is to give them back estrogen or help them access its benefits, so the ovaries are not overwhelmed by androgens and fertility can return.
For women with midlife insulin resistance and weight gain, Dr. Young often:
Uses testosterone with the right micronutrients so it can aromatize into estrogen.
Is cautious with estrogen itself before true menopause, to avoid over-thickening the uterine lining and increasing cancer risk.
Uses micro-dosed GLP-1 medications as a tool:
To improve blood sugar control
To reduce belly fat
To support the transition into hormone replacement therapy
Oxygen, VO₂ Max, and Why Blood Sugar Affects Your Joints
This is where Dr. Young’s approach gets very interesting.
She tests many patients’ VO₂ max – a measure of:
How much oxygen comes into your body
How much CO₂ leaves
Your respiratory exchange ratio (RER), which tells her whether you are burning fats or carbohydrates
If you are not burning fat well, that is a clue your hormones are not working properly.
She also connects blood sugar to oxygen:
Think of a red blood cell with yellow “sugar dots” on it.
The higher your A1c (a 3-month average of blood sugar), the more sugar coats that red cell.
The more sugar on the cell, the less oxygen it can deliver to your tissues.
Less oxygen means:
Poor healing
More pain
“Older” biological age
VO₂ max can actually estimate biological age based on how well you can use oxygen.
Now connect this to GLP-1s:
If GLP-1 medications lower your glucose load, your red blood cells are less coated in sugar.
That means they can carry more oxygen.
More oxygen = better tissue healing, including tendons and joints.
As an orthopedic surgeon, I see this clinically:
Women in midlife who are holding extra weight
Joints that hurt
Attempts to work out harder that keep backfiring
Estrogen decline does not just affect mood and hot flashes. It affects joint stiffness, tendon health, and the ability to move comfortably.
The “Whole Strategy” Visit: Testing That Matters
Dr. Young’s favorite work is longevity strategy.
She is not asking, “What is wrong with you today?”
She is asking, “What is likely to show up in 10–15 years, and how do we prevent it?”
Her approach often includes:
1. Deep History and Risk Mapping
Family history of:
Cancer
Heart disease
Dementia
Personal history and symptoms
Clarifying what is most likely to “get” you:
For her, based on her family history, it is likely cancer or a brain aneurysm.
So she prioritizes vascular health and cancer screening.
2. Strategic Testing
Depending on risks and budget, patients may get:
Hormone panels
Estrogen, progesterone, testosterone, androgens
Glucose and insulin metrics
Hemoglobin A1c
Fasting insulin
Sometimes leptin, to look for leptin resistance (when your body hangs on to fat because it does not “trust” that you have enough)
VO₂ max and RER testing
To see if you are burning carbs or fats
To get a sense of biological age
Nutrient testing
Especially for mitochondrial function and B vitamins
Cardiovascular imaging
Calcium scores
CT angiograms with AI to look at plaque
Cancer and brain risk
Full-body scans every other year (in her own case)
Blood tests that screen for certain cancers
Polygenic risk scores for conditions like Alzheimer’s, when appropriate
She also emphasizes something important to other clinicians:
Not every patient can afford every test. Strategy means prioritizing and working within a budget, while helping patients advocate for what can be done through insurance.
Tools in the Toolbox: Hormones, GLP-1s, Peptides, and Oxygen
Hormone Therapy, Done Thoughtfully
For women approaching perimenopause or early in the transition, Dr. Young often:
Starts with testosterone, plus nutrients that help convert it to estrogen.
Uses estrogen with caution before full menopause to avoid overstimulating the uterine lining.
Watches closely for side effects like:
Hair loss
Acne
PCOS-like symptoms
For men, she emphasizes that too much testosterone aromatizing into estrogen leads to:
Breast tissue (“moobs”)
Testicular shrinkage
The goal for both sexes is balance, not just “more hormone.”
GLP-1 Medications
She has been prescribing GLP-1s since 2014, long before they were trendy.
Key points from her clinical experience:
GLP-1s are hormonal tools, not just diet shots.
They help insulin work in a healthier pattern.
They can:
Reduce belly fat
Improve blood sugar
Increase oxygen delivery to tissues by lowering glucose load on red cells
She often micro-doses GLP-1s:
As a bridge into hormone replacement therapy
To protect women from developing a PCOS-like state when starting testosterone
She previously used metformin as a “longevity drug” and now often replaces it with GLP-1s in micro-doses.
She also notes that GLP-1s are heavily used now, sometimes without deep understanding. The key is appropriate use, not overuse.
Peptides and Growth Hormone Support
In the peptide world, Dr. Young uses:
Growth hormone–releasing peptides (the “morrelins”):
Ipamorelin
Sermorelin
Tesamorelin
These help your body release its own growth hormone, which can:
Improve sleep
Help build muscle
BPC-157, often called the “Wolverine peptide”:
Used for tendinitis
Has been studied in difficult-to-heal issues like anal fissures
Supports tissue healing
Some peptides are widely available, some are compounded, and some may eventually be taken on by larger pharmaceutical companies. The landscape is still evolving.
Hyperbaric Oxygen Therapy
Dr. Young recently built a hyperbaric clinic, which I know has been a major labor of love.
She uses hyperbaric oxygen because:
It is FDA-approved for radiation damage.
Many of her patients are men on testosterone who have had prostate cancer, or women who have had breast cancer, and have been through radiation.
Hyperbaric oxygen helps support tissue healing after those treatments.
IV Nutrient Therapy and B Vitamins
She sees many patients with genetic issues in processing B vitamins:
Roughly 40% of people do not use their B vitamins efficiently.
Low B12 can:
Cause chromosomal breaks
Lead to neurological symptoms
Make someone appear “demented”
IV nutrient therapy is used based on:
Genetics
Nutrient testing
Mitochondrial needs
And yes, she jokes that she blames B12 when she does something absent-minded.
Movement, Muscle, and Bone: Start Early, Protect for Life
We cannot talk about hormones and longevity without talking about movement and bone health.
I recently saw a woman in her 60s with bilateral proximal humerus fractures.
She did not fall. She was on a stair-stepper with moving handles, tripped, grabbed the handles, and that pulling motion fractured the tops of both humerus bones.
Of course we can help her now. But I walked out of the room thinking, “This started decades ago.”
Dr. Young and I agree:
Bone health starts early.
You must build bone and muscle in your 20s and 30s.
Later in life, rebuilding bone is slow and difficult, even with the best care.
A few key points from her:
Estrogen is FDA-approved to treat osteoporosis.
The question we should be asking more is, “How do we use it to prevent osteoporosis?”
Once your skeleton is fully formed:
You should be lifting heavy and hard, within safe limits.
You do not need 90 minutes in the gym with the perfect outfit:
Short, intense sessions count.
Picking up heavy things for 5–10 minutes can make a difference.
She also emphasizes proprioceptive training:
Balance work
Standing on one leg while holding a support
Closing your eyes briefly to challenge your system
Strengthening the small spinal muscles and stabilizers
These protect:
Joints
Tendons
Your ability to move safely as you age
Weighted vests can help, but, as she admitted, you cannot just wear one around like a fashion accessory and call it exercise.
Simple Daily Rituals That Support Longevity
Longevity is not only about advanced testing and prescriptions. It is also about daily rhythm.
Dr. Young shared her personal routine:
Her morning alarm label simply says: “Helping people.”
She starts each day with:
10 minutes in a hot tub
Followed by a cold plunge at 42°F
You do not need a fancy cold plunge to use the concept:
Hot shower, then:
A cold bathtub filled with hose water, or
A few minutes of cold shower
Why she does it:
Heat brings blood to the muscles and joints.
Cold drives blood back to the organs, creating a natural lymphatic massage.
It:
Helps with body aches and joint health
Supports inflammation control
Is an incredible mental reset
It is stimulating enough that she often does not need coffee afterward.
She also uses the hot tub time as mindfulness time:
Setting intentions
Remembering why she does her work
Grounding before the day starts
You can borrow this pattern in your own way:
A few minutes of quiet breathing
A short hot-cold contrast in your shower
A simple phrase on your alarm that reminds you of your purpose
Working With the Medical System You Actually Have
Many of Dr. Young’s patients come to her at the end of their rope:
They have seen multiple doctors.
They have been told, “Your labs are normal.”
They have been told, “You are not having a heart attack or cancer, so you are fine.”
Yet they feel terrible.
She makes an important distinction:
Public health / sick care is designed to keep the masses alive and safe.
Longevity medicine is about quality of life, prevention, and optimization.
They are not the same thing.
Her message is not that conventional doctors are bad. Quite the opposite:
“Your doctor is doing the best they can with the tools they have.”
Many are constrained by:
Insurance rules
System protocols
Limited visit times
Her approach:
She plays nicely in the sandbox with other doctors.
She collaborates with:
Primary care doctors
Urologists
Oncologists
Other functional medicine physicians
She sometimes even orders tests for other doctors, because their system will not allow it.
Her analogy:
You would not walk into Peet’s Coffee and demand a hamburger.
In the same way, we should not expect every primary care visit to cover deep longevity planning. That is a different kind of work.
What You Can Do in Your 20s, 30s, 40s, and Beyond
Here is a practical summary you can start from, based on our conversation.
In Your Late Teens, 20s, and Early 30s
Build muscle and bone:
Lift weights once your skeleton is fully formed.
Include interval training and hills.
Work on balance and proprioception:
Stand on one leg while brushing your teeth (safely).
Add light weights or bands.
Remember that “menopause preparation” starts now:
You are building the reserve you will rely on later.
In Your Mid-30s to Mid-40s
Take symptoms seriously:
Midsection weight gain
“Life tired” fatigue
Mood changes
Body aches
IBS-like symptoms
Ask for:
A thoughtful hormone panel
Blood sugar measures: fasting glucose, A1c, insulin
Consider:
Finding a clinician who understands perimenopause, GLP-1s, and hormone replacement in context.
In Your Mid-40s to Mid-50s
This is a critical window.
Disease starts to “puff its chest” between 35 and 45.
It often shows itself between 45 and 55.
By 55:
30% of people will have at least one chronic illness.
By 65:
70% have one
50% have two
30% have three or more
This is the time to:
Check:
Hormones
Blood sugar
Cardiovascular risk (like calcium scoring)
Talk about:
Thoughtful hormone therapy
Weight support, including possible micro-dosed GLP-1s
Movement patterns that protect your joints and bones
Beyond 55
It is never “too late,” but the work is slower.
Bone rebuilding, in particular, is a years-long project.
This is where:
Estrogen’s role in bone
Strength training
Balance work
Joint-protective strategies
become absolutely critical.
Looking Ahead: Tech, Peptides, and Smarter Patients
Dr. Young sees a future where:
Full-body MRIs and cancer-detecting technologies get more accurate.
GLP-1 medications evolve, including new receptor combinations (GLP-3s).
More peptides, like BPC-157, are standardized and possibly taken up by major companies.
Patients own their data:
Labs
Wearables
Gait analytics from their phones
AI helps detect:
Changes in gait
Risk patterns across multiple tests
Most of all, she sees a generation that is not willing to accept “there’s nothing you can do” as an answer.
As physicians, we are seeing this too. Patients are asking about:
Peptides
Regenerative therapy
PRP
Hyperbaric oxygen
Many of these are not covered by insurance, which does not mean they are not helpful. It simply means the insurance model has not caught up yet.
These are no longer “alternative” therapies.
They are therapies.
A Hopeful, Practical Takeaway
If you are:
In your mid-30s or beyond
Noticing weight, mood, and energy changes
Frustrated by “normal” labs and “you’re fine” answers
You are not imagining things.
There is a real hormonal, metabolic, and longevity story underneath what you feel.
What I love about Dr. Young’s approach is that it combines:
Solid physiology
Deep testing when needed
Practical daily habits
Modern tools like GLP-1s, peptides, and hyperbaric
Collaboration with conventional medicine
You do not need to understand every molecule to start.
You can begin with:
Moving your body with intention
Building muscle and bone
Honoring your fatigue instead of shaming yourself
Asking better questions about your hormones and blood sugar
Finding clinicians who are willing to explore strategy, not just crisis care
If you want to learn more about Dr. Renee Young’s work, you can find her at youngwellnesscenter.com, where she shares more about her clinic, her hyperbaric program, and her approach to hormone health and longevity.
Most importantly, remember this:
Feeling better is not selfish. It is the foundation that lets you keep caring, leading, and loving for a very long time.