The Dr. Gabrielle Lyon Show
The Dr. Gabrielle Lyon Show

The Testosterone Myth Women Have Been Lied To About│Dr. Susan Hardwick-Smith, MD

September 8, 2026

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5 min read

The Testosterone Myth Women Have Been Lied To About

Dr. Susan Hardwick-Smith spent 18 years building one of the largest OB-GYN practices in the country, with 20 providers. Then she went through menopause herself. "Being a very prominent OB-GYN, I knew absolutely nothing about it," she says. "I'm an athlete. I lost my sex drive. I lost my energy. I felt terrible." In 2020, she left her practice entirely and launched into menopause care. Now she runs a growing practice with 12 providers, three offices, and a virtual platform, with a particular focus on what she calls "such a big gap in understanding about"—testosterone for women.

What Testosterone Actually Does in Women

The first thing to understand: women produce far more testosterone than estrogen. The numbers look deceptive on lab reports because the units of measurement differ. If your estradiol reads 50 and your testosterone reads 50, a tenfold conversion is required to make them comparable—meaning the testosterone is actually 500. "Nobody taught me that," Hardwick-Smith says. "When I found that out, I was like, oh what?"

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What you'll learn

  • 1 (00:00) **The Testosterone Myth for Women** - Dr. Hardwick-Smith introduces the core surprise: women make more testosterone than estrogen, and the FDA has approved zero testosterone products for women.
  • 2 (01:36) **Dr. Hardwick-Smith’s Personal Menopause Awakening** - The host introduces Dr. Hardwick-Smith, who left a large OB-GYN practice in 2020 to focus on menopause care after her own debilitating experience.
  • 3 (03:35) **Zero Training on Testosterone for Women** - Dr. Hardwick-Smith reveals she received no medical training on testosterone’s role in healthy women, only in pathological conditions like PCOS.
  • 4 (05:26) **Defining Testosterone’s Role in Women** - A breakdown of what testosterone actually does for female bodies, from sexual function to cognition and athletic performance.
  • 5 (06:46) **The Timeline of Hormone Loss** - Explains the specific trajectory of testosterone decline in women, which often begins years before menopause.
  • 6 (09:31) **Warning Signs of Low Testosterone** - The specific symptoms of low testosterone in women, which mirror those in men.
  • 7 (11:40) **Why No FDA-Approved Testosterone for Women?** - The history of regulatory failure, focusing on the 2004 rejection of Procter & Gamble’s patch.

+ Full timestamped outline available in the app

Show Notes

You have probably been told that testosterone is a male hormone. Women produce more of it than estrogen, and for many of us it is the first hormone to go, sometimes reading zero five years before menopause while periods are still regular. Dr. Susan Hardwick-Smith and I get into what that costs you in muscle and bone, why there are thirty-one approved testosterone products for men and none for women, and what the number on your own lab report is measuring.

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Create Her: Aging into the Healthiest Version of Yourself by Susan Hardwick-Smith MD https://www.amazon.com/Create-Her-Healthiest-Version-Yourself/dp/1637636644/ref=sr_1_3?s=books&sr=1-3

Dr. Gabrielle Lyon with Amy Pearlman Podcast

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Connect with Dr. Susan Hardwick-Smith

Website: drsusan.com

YouTube: https://www.youtube.com/@drsusan

Instagram: https://www.instagram.com/drsusanofficial

TikTok: https://www.tiktok.com/@drsusanofficial

Facebook: https://www.facebook.com/drsusanofficial/

LinkedIn: https://www.linkedin.com/in/drsusanhardwicksmith/

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