In the latest episode of ‘The Diary Of A CEO,’ Dr. Sara Szal delves into the often-overlooked hormonal influences on weight management, particularly during menopause. Many women face challenges with belly fat, stress, and fatigue as they navigate this transitional phase in life. Dr. Szal argues that these issues may not solely be attributed to lifestyle choices but rather stem from hormonal changes, specifically fluctuations in estrogen levels. As the discussion unfolds, it raises critical questions: Are we truly understanding the biological factors at play during menopause? Can hormonal imbalances significantly impact our weight and overall well-being? This blog post aims to fact-check the claims made by Dr. Szal, providing clarity on the connection between hormones and weight gain during menopause. Join us as we explore the nuances of these assertions and seek to differentiate between fact and speculation in this vital health conversation.

Find the according transcript on TRNSCRBR

All information as of 03/27/2025

Fact Check Analysis

Claim

Three to 75 of women do not get the treatment for perimenopause and menopause that they deserve.

Veracity Rating: 3 out of 4

Facts

## Evaluating the Claim: Three to 75% of Women Do Not Get the Treatment for Perimenopause and Menopause That They Deserve

The claim that three to 75% of women do not receive adequate treatment for perimenopause and menopause suggests a wide variability in the proportion of women affected. To assess this claim, we must consider existing healthcare studies and data on menopause treatment.

### Evidence Supporting the Claim

1. **Barriers to Treatment**: Studies have identified significant barriers to accessing effective menopause treatment. These include a lack of knowledge about menopause symptoms, stigma, and healthcare professionals' limited confidence in prescribing hormone replacement therapy (HRT)[2]. Almost half of women have not approached their GP for help, and among those who have, 30% experienced delays in diagnosis[2].

2. **Underutilization of HRT**: Despite HRT being the most effective treatment for managing menopause symptoms like hot flashes, many women do not receive it. In the UK, only 40% of women are offered HRT[2]. Additionally, a significant proportion of women who start HRT may stop due to side effects or lack of support, further reducing the number receiving adequate treatment.

3. **Knowledge Gap and Lack of Education**: There is a substantial knowledge gap regarding menopause among both the general public and healthcare providers. Most women receive little to no education on menopause before experiencing it[4][5]. This lack of awareness contributes to underdiagnosis and undertreatment of menopause symptoms.

4. **Untreated Symptoms**: A large percentage of women experience severe menopause symptoms but remain untreated. For instance, 75% of women experience hot flashes, and many other symptoms are often left unaddressed[5]. This suggests that a significant number of women do not receive the treatment they need.

### Quantifying the Proportion of Women Affected

While the exact range of three to 75% is broad and not directly supported by a single statistic, various studies indicate that a substantial proportion of women do not receive adequate treatment:

– **60% Seek Clinical Help, 75% Remain Untreated**: A report notes that 60% of women seek clinical help for menopause symptoms, but 75% of these women go untreated[3]. This suggests that a significant majority of women who seek help do not receive adequate treatment.

– **Half of Women Wait Six Months Before Seeking Care**: Many women delay seeking medical attention for menopause symptoms, which can exacerbate the issue of undertreatment[5].

### Conclusion

The claim that three to 75% of women do not receive adequate treatment for perimenopause and menopause is supported by evidence of significant barriers to care, underutilization of effective treatments like HRT, and a lack of education and awareness about menopause. While the precise percentage may vary, it is clear that a substantial proportion of women face challenges in accessing appropriate care for their menopause symptoms.

In summary, the claim is valid in highlighting the widespread issue of inadequate menopause treatment, though the exact percentage might vary based on specific contexts and studies. The critical issue is the systemic lack of support and awareness that contributes to this problem.

Citations

Claim

One of the ways to measure trauma is the ACE test.

Veracity Rating: 4 out of 4

Facts

## Validity of the Claim: The ACE Test as a Measure of Trauma

The claim that the ACE test is a way to measure trauma is supported by scientific evidence. The Adverse Childhood Experiences (ACE) test is a well-researched tool used to assess the impact of childhood trauma on long-term health and well-being. Here's a detailed evaluation of the claim:

### What is the ACE Test?
The ACE test evaluates ten types of childhood trauma, including physical, sexual, and verbal abuse, physical and emotional neglect, and household challenges such as substance abuse or domestic violence[1][3]. Each type of trauma is scored as one point, with higher scores indicating greater exposure to adverse experiences[3][5].

### Validation and Research
The ACE study, conducted by the CDC-Kaiser Permanente, has been foundational in linking childhood trauma to adult health issues, including chronic diseases and mental health problems[3]. The study's findings have been widely validated, showing that ACEs are associated with increased risks of depression, anxiety, and other health issues[2][3].

### Limitations of the ACE Test
While the ACE test is a valuable tool, it does not account for all types of childhood trauma, such as community violence, poverty, or discrimination[1][3]. Additionally, the test does not measure the impact of positive childhood experiences, which can buffer the effects of trauma[1].

### Use in Clinical Settings
ACE screening is recommended in various clinical settings to provide trauma-informed care and improve patient outcomes[4]. It helps in identifying risks and tailoring interventions to address the long-term effects of childhood trauma[4].

### Conclusion
The claim that the ACE test is a way to measure trauma is valid. The ACE test is a recognized tool for assessing the impact of adverse childhood experiences on health. However, it should be used alongside other assessments to capture a broader range of traumatic experiences and to consider the role of positive childhood experiences in mitigating trauma's effects.

In the context of women's health, particularly during perimenopause and menopause, understanding and addressing trauma through tools like the ACE test can be crucial. Recognizing the interplay between hormonal health, mental well-being, and trauma is essential for developing effective treatment strategies that prioritize lifestyle medicine and personalized care over pharmaceutical interventions.

Citations

Claim

People who had one or higher ACE scores had a greater risk of 45 different chronic diseases.

Veracity Rating: 3 out of 4

Facts

## Evaluation of the Claim: "People who had one or higher ACE scores had a greater risk of 45 different chronic diseases."

The claim that individuals with one or higher Adverse Childhood Experiences (ACE) scores have a greater risk of 45 different chronic diseases can be partially supported by existing research, but it requires clarification and nuance.

### Evidence Supporting ACEs and Chronic Diseases

1. **ACEs and Chronic Diseases**: Studies have consistently shown that ACEs are associated with an increased risk of various chronic diseases. These include cardiovascular disease, diabetes, depression, anxiety, and several other mental and physical health conditions[1][2][5]. The relationship between ACEs and chronic diseases is often described as a dose-response relationship, meaning that the risk of developing these conditions increases with the number of ACEs experienced[4][5].

2. **Specific Conditions Linked to ACEs**: Research has identified a range of chronic conditions linked to ACEs, including but not limited to:
– **Cardiovascular Diseases**: Heart disease, stroke[1][5].
– **Mental Health Issues**: Depression, anxiety[1][5].
– **Metabolic Conditions**: Diabetes[1][3].
– **Respiratory Conditions**: Asthma, chronic obstructive pulmonary disease (COPD)[5].
– **Autoimmune Diseases**: Type 1 diabetes, rheumatoid arthritis, lupus[3].

3. **ACE Score Threshold**: While having any ACEs can increase health risks, a score of four or more is commonly associated with significantly higher risks of chronic diseases[2][3]. However, even lower ACE scores can have health implications, particularly for autoimmune diseases[3].

### Limitations and Clarifications

– **Number of Chronic Diseases**: The claim mentions 45 different chronic diseases, but the literature does not explicitly list this many conditions directly linked to ACEs. While ACEs are associated with a wide range of health issues, the exact number of conditions might not be as high as 45.

– **Risk Increase with Lower ACE Scores**: While there is evidence that even one ACE can increase health risks, the magnitude of this risk is generally lower than for those with higher ACE scores. For example, an ACE score of two can increase the risk of autoimmune diseases by 20%[3].

– **Mechanisms and Pathways**: The impact of ACEs on health is complex, involving biological, psychological, and social pathways. ACEs can lead to changes in stress response systems, immune function, and health behaviors, contributing to chronic disease risk[5].

### Conclusion

The claim that people with one or higher ACE scores have a greater risk of chronic diseases is supported by evidence showing that ACEs are linked to various health conditions. However, the specific number of conditions (45) is not explicitly documented in the literature. The risk of chronic diseases generally increases with the number of ACEs, particularly at higher scores (four or more). Therefore, while the claim has a basis in research, it should be understood within the context of a dose-response relationship and the complexity of ACEs' impact on health.

Citations

Claim

70 of the diseases we're facing right now are utterly preventable with lifestyle medicine.

Veracity Rating: 3 out of 4

Facts

The claim that "70% of the diseases we're facing right now are utterly preventable with lifestyle medicine" is not directly supported by the available scientific literature. However, there is substantial evidence suggesting that a significant portion of chronic diseases can be prevented or managed through lifestyle changes.

### Evidence Supporting Lifestyle Medicine

1. **Preventability of Chronic Diseases**: Studies indicate that more than 80% of chronic conditions, such as heart disease, stroke, and Type 2 diabetes, can be prevented through healthy lifestyle choices, including diet and physical activity[1][5]. Additionally, about 40% of cancer diagnoses are preventable through lifestyle changes[5].

2. **Lifestyle Medicine Pillars**: The American College of Lifestyle Medicine identifies six key areas that impact overall health: nutrition, exercise, stress management, avoidance of harmful substances, sleep, and positive social connections[3][5]. Implementing these pillars can significantly reduce the risk of chronic diseases.

3. **Impact on Health Care**: Lifestyle medicine is recognized for its potential to reduce health care costs by addressing the root causes of chronic diseases, which are often linked to unhealthy lifestyle choices[1][3].

### Evaluation of the Claim

While the specific figure of "70%" is not directly cited in the literature, it is clear that a substantial proportion of diseases can be prevented or managed through lifestyle medicine. The emphasis on prevention and management of chronic conditions aligns with the broader goals of lifestyle medicine.

### Conclusion

The claim that a significant percentage of diseases are preventable with lifestyle medicine is supported by the general consensus in public health and lifestyle medicine research. However, the exact percentage of "70%" may not be specifically documented in scientific literature. The importance of lifestyle interventions in preventing and managing chronic diseases is well-established, and this approach is increasingly recognized as a critical component of healthcare strategies.

In summary, while the precise figure might not be universally agreed upon, the underlying principle that lifestyle medicine can prevent a substantial portion of chronic diseases is well-supported by scientific evidence.

Citations

Claim

We know that adverse childhood experiences link to blood sugar problems and a greater risk of prediabetes and diabetes.

Veracity Rating: 4 out of 4

Facts

The claim that adverse childhood experiences (ACEs) are linked to blood sugar problems and a greater risk of prediabetes and diabetes is supported by scientific evidence. Here's a detailed evaluation of this claim based on available research:

## Adverse Childhood Experiences (ACEs) and Diabetes Risk

ACEs include a range of potentially traumatic events that occur before the age of 18, such as physical, emotional, and sexual abuse, neglect, and household dysfunction. Studies have consistently shown that individuals with higher ACE scores are at an increased risk of developing chronic diseases in adulthood, including diabetes.

1. **Association with Diabetes**: Research indicates that individuals with higher ACE scores have a cumulative risk for diabetes in adulthood. A systematic review and meta-analysis found that individuals with any ACE or four or more ACEs had an increased risk of diabetes compared to those without ACEs[1]. Another study highlighted that ACEs are associated with an increased risk of type 2 diabetes mellitus (T2DM), with individuals having four or more ACEs showing a significantly greater risk[3].

2. **Specific ACE Types and Diabetes**: Certain types of ACEs, such as childhood economic adversity, physical abuse, sexual abuse, verbal abuse, and incarceration, have been linked to an increased risk of diabetes[1]. However, the evidence for neglect, emotional abuse, domestic violence, parental divorce or separation, parental death, and living with a family member with substance abuse or mental disorders is less consistent[1][5].

3. **Mechanisms and Pathways**: The link between ACEs and diabetes is thought to be mediated by biological pathways, including stress-induced changes in the hypothalamic-pituitary-adrenal (HPA) axis, insulin resistance, and immune system dysregulation[3][5]. Additionally, ACEs can lead to health-harming behaviors such as poor diet and physical inactivity, which further increase the risk of developing diabetes[5].

4. **Posttraumatic Stress Disorder (PTSD)**: Chronic or comorbid PTSD has also been associated with an increased risk of diabetes, particularly among veterans[2][4].

## Conclusion

The claim that adverse childhood experiences are linked to blood sugar problems and a greater risk of prediabetes and diabetes is supported by scientific evidence. ACEs have been shown to increase the risk of developing diabetes, particularly type 2 diabetes, through both biological and behavioral pathways. Understanding and addressing ACEs is crucial for preventing and managing metabolic disorders.

In the context of women's health, particularly during perimenopause and menopause, recognizing the impact of ACEs on hormonal health and overall well-being is essential. Lifestyle changes and personalized treatment strategies can help mitigate the effects of ACEs and improve health outcomes for women during these life stages.

Citations

Claim

My cortisol was three times what it should have been.

Veracity Rating: 2 out of 4

Facts

To evaluate the claim "My cortisol was three times what it should have been," we need to consider typical cortisol levels and what might cause elevated cortisol. Cortisol is a hormone produced by the adrenal glands, and its levels vary throughout the day, typically peaking in the morning and decreasing at night[2][4].

### Normal Cortisol Levels

Normal cortisol levels in the blood are generally between 5 and 25 mcg/dL (140 to 690 nmol/L) when measured in the morning[4]. Cortisol can also be measured in urine or saliva, with different reference ranges for each[2].

### Elevated Cortisol

Elevated cortisol levels can be caused by several factors, including:

– **Cushing's syndrome**: A condition where the body produces too much cortisol, often due to a tumor in the pituitary or adrenal glands[2][4].
– **Stress**: Both physical and psychological stress can increase cortisol levels[2].
– **Medications**: Long-term use of certain steroid medications can lead to high cortisol levels[2].
– **Other health conditions**: Such as pseudo-Cushing's syndrome, which can be caused by depression, anxiety, or other health issues[2].

### Claim Evaluation

Without specific details about the time of day the cortisol measurement was taken or the exact value, it's difficult to assess whether the claim is accurate. However, if someone's cortisol level is indeed three times the upper limit of the normal range (e.g., above 75 mcg/dL), it could indicate a significant issue such as Cushing's syndrome or another condition causing hypercortisolism.

### Importance of Context

It's crucial to consider the context in which cortisol levels are measured. Factors like stress, time of day, and recent medication use can significantly impact cortisol levels[2][4]. Therefore, a healthcare provider should interpret cortisol test results in the context of the individual's overall health and medical history.

### Conclusion

While the claim of having cortisol levels three times the normal range is plausible, it requires further context to be fully evaluated. Elevated cortisol can be a sign of serious health issues, and any abnormal results should be discussed with a healthcare provider to determine the underlying cause and appropriate treatment.

In discussions about women's health, particularly during perimenopause and menopause, Dr. Sara Szal emphasizes the importance of addressing hormonal imbalances, including cortisol, as part of a comprehensive approach to health[1][3]. However, specific claims about cortisol levels should be verified through medical testing and consultation with a healthcare professional.

Citations

Claim

Cortisol is associated with depression; about 50 of people with high cortisol have depression.

Veracity Rating: 2 out of 4

Facts

## Claim Evaluation: Cortisol and Depression

The claim that cortisol is associated with depression and that about 50% of people with high cortisol have depression requires careful examination. Here's a detailed analysis based on scientific evidence:

### Cortisol and Depression Association

1. **Cortisol as a Stress Hormone**: Cortisol is known as the "stress hormone" because it is released in response to stress. It plays a crucial role in the body's response to stress, affecting various physiological processes, including metabolism and immune response[2][4].

2. **Cortisol Levels in Depression**: Research indicates that individuals with major depressive disorder (MDD) often have higher cortisol levels compared to those without depression. However, this association is not universal and can vary based on factors like the severity of depression and the presence of comorbid conditions such as anxiety[3][5].

3. **HPA Axis and Depression**: The hypothalamic-pituitary-adrenal (HPA) axis, which regulates cortisol secretion, is often dysregulated in individuals with depression. This dysregulation can lead to elevated cortisol levels, which may contribute to the development or exacerbation of depressive symptoms[1][3].

### Prevalence of Depression in Individuals with High Cortisol

The claim that about 50% of people with high cortisol have depression is not supported by the available scientific literature. While it is true that a significant proportion of individuals with major depression exhibit elevated cortisol levels, the exact percentage can vary widely depending on the population studied and the criteria used to define "high cortisol"[1][3].

– **Variability in Cortisol Levels**: Studies have shown that about 50% of patients with major depression may hypersecrete cortisol, but this figure can vary based on the population and specific conditions[1]. However, this does not directly translate to 50% of people with high cortisol having depression.

– **Complexity of the Relationship**: The relationship between cortisol and depression is complex and influenced by multiple factors, including genetic predisposition, life events, and other hormonal imbalances[1][4]. Therefore, high cortisol levels do not automatically lead to depression, and other factors must be considered.

### Conclusion

While there is evidence that cortisol levels are often elevated in individuals with depression, the claim that about 50% of people with high cortisol have depression is not accurately supported by scientific research. The relationship between cortisol and depression is multifaceted, and high cortisol levels can result from various factors, not all of which lead to depression. Lifestyle changes and personalized treatment strategies, as emphasized by Dr. Sara Zhal, can be beneficial in managing hormonal imbalances and related health issues, but they should be grounded in a comprehensive understanding of the complex interplay between hormones, stress, and mental health.

Citations

Claim

50% of people with depression have high cortisol.

Veracity Rating: 2 out of 4

Facts

The claim that "50% of people with depression have high cortisol" can be evaluated based on available scientific evidence. While there is a well-established link between cortisol levels and depression, particularly in the context of stress and the hypothalamic-pituitary-adrenal (HPA) axis, the specific percentage of people with depression who have high cortisol levels is not universally agreed upon.

### Evidence Supporting the Link Between Cortisol and Depression

1. **HPA Axis Dysregulation**: Studies have shown that dysregulation of the HPA axis, which leads to elevated cortisol levels, is associated with depression, especially in more severe forms like melancholic or psychotic depression[1][5]. Elevated cortisol levels are often observed in individuals with depression, particularly in those with more severe symptoms[3][5].

2. **Cortisol as a Biomarker**: Cortisol is considered a significant biomarker for anxiety disorders and depression, with many patients showing increased cortisol secretion[3]. However, the relationship between cortisol levels and depression severity is complex and influenced by various factors, including stress response variability[1][2].

3. **Prevalence of Elevated Cortisol in Depression**: While it is noted that about 50% of patients with newly diagnosed depression have been observed to have excessive cortisol secretion[3], this figure is not universally applicable to all forms of depression. For instance, atypical depression does not show the same robust association with elevated cortisol levels as more severe forms[1].

### Conclusion

The claim that "50% of people with depression have high cortisol" may be supported by some studies indicating that a significant portion of individuals with depression exhibit elevated cortisol levels, particularly in severe cases[3]. However, this figure might not apply universally across all depression subtypes, as the relationship between cortisol and depression can vary based on the severity and type of depression[1][5]. Therefore, while there is evidence supporting a link between cortisol and depression, the specific percentage might not be a definitive or universally applicable statistic.

In summary, while elevated cortisol levels are associated with depression, especially in severe forms, the claim of exactly 50% prevalence may not capture the full complexity of this relationship across different depression subtypes.

Citations

Claim

High cortisol levels are used by some psychiatrists as a suicide marker.

Veracity Rating: 2 out of 4

Facts

## Evaluating the Claim: High Cortisol Levels as a Suicide Marker

The claim that high cortisol levels are used by some psychiatrists as a suicide marker can be evaluated through existing psychiatric research. Cortisol, often referred to as the "stress hormone," is secreted by the adrenal glands in response to stress and is part of the hypothalamic-pituitary-adrenal (HPA) axis. This axis plays a crucial role in stress response and has been studied extensively in relation to psychiatric disorders and suicidal behavior.

### Evidence Supporting Cortisol as a Potential Biomarker

1. **Meta-Analyses and Studies**: Some studies and meta-analyses suggest that cortisol levels may be associated with suicide risk. For instance, a meta-analysis found that cortisol levels were higher in individuals with suicide behavior compared to healthy controls, although they were lower than in psychiatric controls[1]. Another study indicated that cortisol levels were elevated in individuals who attempted suicide, particularly those with depression and multiple attempts[2].

2. **HPA Axis Dysregulation**: The HPA axis is often dysregulated in individuals with suicidal behavior, which can manifest as either hypercortisolism or hypocortisolism. Hypercortisolism has been linked to increased suicidal severity and attempts in some contexts[3][5]. However, findings are inconsistent, with some studies showing an attenuated cortisol response in individuals with a history of suicide attempts[5].

3. **Dexamethasone Suppression Test (DST)**: The DST is used to assess HPA axis function. Elevated cortisol levels after the DST have been associated with severe suicidal behavior, suggesting that HPA axis hyper-reactivity might predict more severe suicide attempts[3].

### Limitations and Controversies

1. **Inconsistent Findings**: The relationship between cortisol levels and suicidal behavior is complex and inconsistent across studies. Some studies have found no significant association between cortisol levels and suicidal behavior[2][5].

2. **Contextual Factors**: Cortisol levels can be influenced by numerous factors, including depression, stress, and other psychiatric conditions. This makes it challenging to use cortisol as a standalone marker for suicide risk[2][5].

3. **Need for Further Research**: More studies are needed to clarify the role of cortisol in suicidal behavior, especially considering the variability in findings and the need for diverse populations and controls[2][5].

### Conclusion

While some research suggests that cortisol levels may be associated with suicidal behavior, the evidence is not conclusive enough to establish cortisol as a definitive marker for suicide risk. Cortisol can be considered a potential biomarker, but its utility is limited by inconsistent findings and the need for further investigation. Therefore, the claim that high cortisol levels are used by some psychiatrists as a suicide marker is partially supported but requires more robust evidence to be universally accepted.

In the context of Dr. Sara Zhal's discussion on hormonal imbalances and their impact on health, it is important to note that cortisol imbalances can contribute to various health issues, including depression, which is a significant risk factor for suicide. However, the direct link between cortisol levels and suicide risk remains a topic of ongoing research.

Citations

Claim

Cortisol is associated with more belly fat due to increased receptors in fat cells.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Cortisol and Belly Fat

The claim that cortisol is associated with more belly fat due to increased receptors in fat cells can be evaluated through scientific evidence related to cortisol's effects on fat distribution and metabolism.

### Cortisol and Fat Distribution

Cortisol, often referred to as the "stress hormone," plays a significant role in fat distribution within the body. Studies have shown that cortisol promotes the storage of fat in the abdominal area, which is linked to higher health risks such as heart disease and diabetes[1][3]. This is partly because abdominal fat cells have a higher concentration of cortisol receptors compared to fat cells in other parts of the body[3][5].

### Cortisol Receptors and Abdominal Fat

Research indicates that fat cells in the abdominal area have more cortisol receptors than those in other parts of the body. This higher receptor density makes abdominal fat more responsive to cortisol, leading to increased fat storage in this region[5]. Specifically, it is noted that abdominal fat cells have four times more cortisol receptors than fat cells elsewhere, which supports the claim that cortisol is associated with more belly fat[5].

### Metabolic Effects of Cortisol

Cortisol influences metabolism by increasing glucose levels in the bloodstream and mobilizing fat stores for energy use. However, chronic high cortisol levels can lead to insulin resistance, further contributing to weight gain and fat storage, particularly in the abdominal area[4]. This metabolic shift can exacerbate the accumulation of visceral fat, which is associated with higher risks of metabolic syndrome and other health issues[3][4].

### Lifestyle and Stress Management

Managing cortisol levels through lifestyle changes such as diet, exercise, and stress management techniques can help reduce abdominal fat accumulation. Practices like mindfulness, regular physical activity, and a balanced diet can mitigate the effects of chronic stress on cortisol levels and fat distribution[3][5].

### Conclusion

The claim that cortisol is associated with more belly fat due to increased receptors in fat cells is supported by scientific evidence. Cortisol's role in promoting abdominal fat storage, combined with the higher concentration of cortisol receptors in abdominal fat cells, provides a biological basis for this association. Understanding and managing cortisol levels through lifestyle interventions can be crucial for reducing belly fat and improving overall health outcomes.

## References

– [1] **Yale Study on Stress and Abdominal Fat**: Cortisol affects fat distribution by causing fat to be stored centrally around the organs, leading to increased visceral fat[1].
– [2] **Cortisol's Effects on Lipolysis**: While cortisol stimulates lipolysis in both abdominal and femoral adipose tissue, its chronic elevation can lead to increased fat storage in the abdomen due to other metabolic effects[2].
– [3] **Cortisol and Belly Fat Connection**: Cortisol has a unique relationship with abdominal fat due to higher cortisol receptor concentrations, leading to increased fat storage in this area[3].
– [4] **Cortisol and Weight Gain**: Chronic cortisol elevation contributes to weight gain by promoting fat storage, particularly in the abdominal area, and inducing insulin resistance[4].
– [5] **Cortisol Receptors in Abdominal Fat**: Abdominal fat cells have more cortisol receptors, making them more responsive to cortisol and contributing to increased fat storage in this region[5].

Citations

Claim

High cortisol shrinks the brain in women but not men.

Veracity Rating: 2 out of 4

Facts

## Evaluating the Claim: High Cortisol Shrinks the Brain in Women but Not Men

The claim that high cortisol levels lead to brain shrinkage specifically in women but not men requires a nuanced examination of existing scientific literature. While cortisol is known to have various effects on the brain, particularly in relation to stress and cognitive functions, the gender-specific impact on brain structure is not straightforward.

### Cortisol and Brain Structure

Cortisol, a stress hormone, is linked to cognitive functions and brain health. Elevated cortisol levels have been associated with reduced hippocampal volume, a region crucial for memory and learning, in both men and women[1]. However, the impact of cortisol on brain structure may vary between genders due to differences in hormonal profiles and stress responses.

### Gender Differences in Cortisol Effects

Research indicates that women and men exhibit different responses to stress and cortisol. For instance, women tend to show more pronounced effects of cortisol on cognitive decline and affective symptoms in conditions like Alzheimer's disease[1]. Additionally, studies suggest that women may experience increased hippocampal atrophy and faster cognitive decline compared to men under similar cortisol levels[1].

### Specific Evidence for Gender-Specific Brain Shrinkage

While there is evidence that cortisol can negatively impact brain regions like the hippocampus, specific studies directly comparing gender-specific effects on overall brain shrinkage due to cortisol are limited. The claim that cortisol causes brain shrinkage exclusively in women lacks robust, direct evidence from neuroscientific studies.

### Conclusion

In conclusion, while cortisol can have detrimental effects on brain health, particularly in regions like the hippocampus, the claim that it specifically causes brain shrinkage in women but not men is not strongly supported by current scientific evidence. Gender differences in stress response and cortisol effects do exist, but more research is needed to fully understand these differences in relation to brain structure changes.

### Recommendations for Future Research

1. **Longitudinal Studies**: Conduct longitudinal studies to track changes in brain structure over time in response to cortisol levels in both men and women.
2. **Neuroimaging Techniques**: Utilize advanced neuroimaging techniques to assess gender-specific changes in brain volume and structure under conditions of high cortisol.
3. **Hormonal Interactions**: Investigate how sex hormones interact with cortisol to influence brain health and structure differently in men and women.

By addressing these gaps, researchers can provide clearer insights into the gender-specific effects of cortisol on brain structure.

Citations

Claim

A study from the University of Texas in San Antonio shows that women in their 40s with high cortisol have shrinkage of total brain volume.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Cortisol and Brain Volume in Women

The claim states that a study from the University of Texas in San Antonio found that women in their 40s with high cortisol levels experience shrinkage of total brain volume. To evaluate this claim, we need to examine the available scientific evidence.

### Evidence from Relevant Studies

1. **Study Findings**: A study published in *Neurology* in 2018, involving researchers from multiple institutions including UT Health San Antonio, found that higher cortisol levels were associated with lower total cerebral brain volume, particularly in women. This study used data from the Framingham Heart Study, which included a large sample of middle-aged adults (mean age 48.5 years) who underwent cognitive testing and brain MRI scans[1][3][4].

2. **Specific Association in Women**: The study specifically noted that higher cortisol levels were inversely associated with cerebral brain volume in women but not in men. This suggests that women, particularly those in middle age, may be more susceptible to the effects of cortisol on brain volume[1][4].

3. **Cortisol and Cognitive Function**: The research also linked higher cortisol levels with impaired memory and visual perception, further highlighting the potential cognitive impacts of elevated cortisol[2][3][5].

### Conclusion

Based on the evidence from the study referenced, the claim that women in their 40s with high cortisol levels experience shrinkage of total brain volume is supported. The study found a significant association between higher cortisol levels and reduced brain volume, particularly in women, which aligns with the claim. However, it is essential to note that while the study demonstrates an association, it does not establish causation.

### Additional Context

– **Stress and Cortisol**: Elevated cortisol levels are often a response to stress, which can be prevalent during midlife due to various factors such as caregiving responsibilities or career pressures[2][3].
– **Lifestyle Interventions**: Reducing stress through lifestyle changes like exercise and adequate sleep is recommended to mitigate potential negative effects on brain health[2][3].

In summary, the claim is supported by scientific evidence indicating that higher cortisol levels are associated with reduced brain volume in women, particularly during middle age.

Citations

Claim

Women with high cortisol also have shrinkage of their total brain volume, according to a study from Lisa Moscone at Cornell University.

Veracity Rating: 1 out of 4

Facts

## Claim Evaluation: Women with High Cortisol and Brain Volume Shrinkage

The claim suggests that women with high cortisol levels experience shrinkage of their total brain volume, referencing a study by Dr. Lisa Mosconi at Cornell University. To evaluate this claim, we need to examine Dr. Mosconi's research and relevant scientific studies on cortisol and brain volume.

### Dr. Lisa Mosconi's Research

Dr. Lisa Mosconi is a prominent researcher in neuroscience, particularly focusing on women's brain health and Alzheimer's disease. Her work highlights the impact of menopause on brain health and the potential risk factors for Alzheimer's disease in women[3][5]. However, there is no specific mention of Dr. Mosconi's research directly linking cortisol levels to brain volume shrinkage in women.

### Cortisol and Brain Volume

Recent studies have explored the relationship between cortisol levels and brain health. One study found that higher cortisol levels are associated with lower total brain volume, lower glucose metabolism in the frontal cortex, and higher β-amyloid load in Alzheimer's disease-vulnerable regions[1][2]. This study noted sex-specific effects, with cortisol exhibiting stronger associations with β-amyloid load and frontal glucose metabolism in women, particularly postmenopause[1][2].

### Conclusion

While there is evidence that high cortisol levels can be associated with reduced brain volume and other adverse brain health outcomes, the specific claim about Dr. Lisa Mosconi's research directly linking cortisol to brain volume shrinkage in women could not be verified. Dr. Mosconi's work does emphasize the importance of menopause and hormonal changes in women's brain health, but the direct connection to cortisol and brain volume shrinkage as stated in the claim is not explicitly supported by the available information.

### Recommendations for Further Research

1. **Review Dr. Mosconi's Published Works**: Examine Dr. Mosconi's research publications for any studies that might address cortisol levels and brain volume specifically.
2. **Explore Relevant Scientific Literature**: Continue to review scientific studies on cortisol, brain health, and sex-specific differences to better understand the relationship between cortisol and brain volume in women.
3. **Consult with Experts**: Engage with researchers in the field of neuroscience and endocrinology to gather more insights into the current state of knowledge on this topic.

Citations

Claim

Starting in midlife, particularly in their 40s, women begin to experience brain shrinkage related to high cortisol levels.

Veracity Rating: 4 out of 4

Facts

## Evaluating the Claim: Brain Shrinkage in Women Due to High Cortisol Levels Starting in Midlife

The claim suggests that women in their 40s experience brain shrinkage due to high cortisol levels, which is a significant concern for studies on aging and hormonal effects on cognitive health. To assess this claim, we will examine relevant scientific evidence.

### Cortisol and Brain Health

Cortisol is a hormone released in response to stress, and chronic elevated levels can have detrimental effects on brain structure and function. Research indicates that higher cortisol levels are associated with reduced brain volume and poorer cognitive performance, including memory and visual perception, particularly in women[1][3][5]. A study using data from the Framingham Heart Study found that higher morning cortisol levels were linked to smaller brain volumes and impaired cognitive functions in middle-aged adults[1][3][5].

### Menopause and Cognitive Changes

Menopause is a period of significant hormonal changes, particularly the decline of estrogen, which can impact cognitive health. Studies suggest that peri- and post-menopausal women often report cognitive complaints, including memory decline, which may be exacerbated by stress, anxiety, and depression[2][4]. While estrogen decline is a primary factor, stress and cortisol levels can also contribute to these cognitive changes.

### Specific Evidence for Women in Their 40s

While the general association between cortisol and brain health is supported, specific evidence focusing exclusively on women in their 40s is less detailed. However, the Framingham Heart Study included a broad age range, with a mean age of 48.5 years, and found significant associations between cortisol levels and brain health in this demographic[1][3][5]. The study highlighted that these effects were more pronounced in women.

### Conclusion

The claim that women in their 40s experience brain shrinkage due to high cortisol levels is supported by evidence indicating that chronic stress and elevated cortisol levels can lead to reduced brain volume and impaired cognitive function. While menopause-related hormonal changes also play a role in cognitive health during this life stage, the specific impact of cortisol on brain shrinkage in women in their 40s aligns with broader research findings on stress and brain health.

### Recommendations for Future Studies

Future research should focus on the interplay between cortisol levels, menopause-related hormonal changes, and cognitive health in women during midlife. This could involve longitudinal studies examining how lifestyle interventions, such as stress management and hormonal therapy, might mitigate these effects.

### Summary

– **Cortisol and Brain Health**: High cortisol levels are associated with reduced brain volume and cognitive impairment.
– **Menopause and Cognitive Changes**: Menopause involves significant hormonal changes that can affect cognitive health, with stress and cortisol playing contributing roles.
– **Specific Evidence for Women in Their 40s**: While specific studies are less detailed, broader research supports the association between cortisol and brain health in this demographic.

Overall, the claim is supported by scientific evidence highlighting the negative effects of high cortisol levels on brain health, particularly in women during midlife.

Citations

Claim

About 30% to 50% of the general population have cortisol levels that are out of balance.

Veracity Rating: 1 out of 4

Facts

## Evaluating the Claim: "About 30% to 50% of the general population have cortisol levels that are out of balance."

To assess the validity of this claim, we need to examine existing research on cortisol levels in the general population. Cortisol is a hormone that plays a crucial role in stress response and follows a natural circadian rhythm, peaking in the morning and decreasing at night[1]. Dysregulation of cortisol levels can be associated with various health issues, including chronic diseases and mental health conditions[1][4].

### Cortisol Dysregulation Prevalence

While there is substantial evidence linking cortisol dysregulation to health issues, specific prevalence rates for cortisol imbalance in the general population are not widely documented. Studies often focus on cortisol's role in specific conditions rather than providing a broad prevalence of cortisol imbalance across the general population.

### Factors Influencing Cortisol Levels

Several factors can influence cortisol levels, including stress, smoking, and gender differences:

– **Stress**: Cortisol levels can increase significantly under stress, with studies showing that cortisol can rise approximately nine times during stressful periods compared to relaxed periods[5].
– **Smoking**: Current smokers tend to have higher cortisol levels than nonsmokers, but this effect seems to normalize after quitting[2].
– **Gender Differences**: Men generally have higher cortisol excretion rates than women, which can impact body mass index (BMI) and cholesterol levels differently between genders[3].

### Conclusion

The claim that "about 30% to 50% of the general population have cortisol levels that are out of balance" lacks specific scientific evidence to support such a broad assertion. While cortisol dysregulation is linked to various health issues, there is no widely recognized study or data that quantifies the prevalence of cortisol imbalance in the general population at this specific range. Therefore, without concrete evidence, this claim remains unsubstantiated.

### Recommendations for Future Research

To better understand the prevalence of cortisol imbalance, future studies should focus on large-scale population analyses, considering factors like stress, lifestyle, and gender differences. This would provide more accurate insights into how common cortisol dysregulation is and its implications for public health.

Citations

Claim

Vitamin D is commonly deficient in about 70% to 80% of people.

Veracity Rating: 3 out of 4

Facts

## Evaluation of the Claim: Vitamin D Deficiency in 70% to 80% of People

The claim that vitamin D is commonly deficient in about 70% to 80% of people can be evaluated by examining recent scientific studies and health data.

### Global Prevalence of Vitamin D Deficiency

A comprehensive study published in 2023 analyzed data from 81 countries and found that globally, approximately 76.6% of participants had serum 25-hydroxyvitamin D (25(OH)D) levels less than 75 nmol/L, which is often considered insufficient for optimal health[1]. However, this figure includes both deficiency and insufficiency. For more severe deficiency levels (less than 30 nmol/L), the prevalence was about 15.7% globally[1].

### Regional Variations

In Europe, about 40% of the population is reported to have vitamin D deficiency, with 13% being severely deficient[2]. In the United States, approximately 42% of adults are deficient[3]. These figures suggest significant regional variations in vitamin D deficiency rates.

### Specific Populations

Certain populations, such as those living in high latitude areas, individuals with darker skin tones, and those with limited sun exposure, have higher rates of vitamin D deficiency[3][5]. For example, nearly 63% of Hispanic adults and 82% of African American adults in the U.S. are vitamin D deficient[3].

### Conclusion

While vitamin D deficiency is indeed a widespread issue globally, the claim that 70% to 80% of people are deficient may not accurately reflect the severity of deficiency (typically defined as 25(OH)D levels below 30 nmol/L). However, when considering broader definitions of insufficiency (levels below 50 or 75 nmol/L), the prevalence can be quite high, especially in certain populations or regions. Therefore, the claim might be considered partially true when referring to insufficiency rather than severe deficiency.

### Recommendations

– **Accurate Measurement**: Vitamin D levels should be measured to determine deficiency accurately.
– **Supplementation**: Individuals at risk should consider supplementation under medical guidance.
– **Public Health Strategies**: Governments and health organizations should prioritize prevention and awareness campaigns.

In summary, while the exact figure of 70% to 80% might not align with severe deficiency rates, vitamin D insufficiency is a significant public health concern affecting a large portion of the global population.

Citations

Claim

Homocysteine levels of 14.7 are considered elevated and can indicate issues with body biochemistry.

Veracity Rating: 3 out of 4

Facts

## Evaluation of the Claim: Homocysteine Levels of 14.7 Are Considered Elevated

The claim that a homocysteine level of 14.7 is considered elevated requires scrutiny based on established medical guidelines and scientific research.

### Definition of Elevated Homocysteine Levels

Elevated homocysteine levels, or hyperhomocysteinemia, are generally defined as follows:
– **Normal levels**: Typically less than 13 to 15 micromoles per liter (μmol/L) of blood[1][3].
– **Elevated levels**: Levels above these thresholds are considered elevated, with specific categories including moderate (15-30 μmol/L), intermediate (30-100 μmol/L), and severe (greater than 100 μmol/L)[1][3].

### Implications of Elevated Homocysteine Levels

Elevated homocysteine levels are associated with various health risks, including:
– **Cardiovascular diseases**: Such as atherosclerosis, coronary artery disease, heart attack, and stroke[1][3][5].
– **Neurological conditions**: Including dementia and Alzheimer's disease[1][3][5].
– **Other risks**: Osteoporosis, venous thrombosis, and increased risk of certain pregnancy complications[1][3][5].

### Evaluation of the Specific Claim

A homocysteine level of 14.7 μmol/L is slightly above the typical threshold for normal levels, which is generally considered to be less than 13 to 15 μmol/L[1][3]. Therefore, it can be classified as mildly elevated, depending on the specific laboratory's reference values.

### Conclusion

The claim that a homocysteine level of 14.7 is considered elevated is partially valid, as it falls into the mildly elevated category according to some definitions. However, the health implications of such a level would typically be less severe than those associated with higher levels of homocysteine. It is essential to consult with a healthcare provider for personalized interpretation and advice based on individual health status and laboratory reference ranges.

### Recommendations for Optimal Homocysteine Levels

To maintain optimal homocysteine levels, individuals should ensure adequate intake of folate, vitamin B-12, and vitamin B-6, either through diet or supplements if necessary[1][4][5]. Regular monitoring and lifestyle adjustments can help manage homocysteine levels and mitigate associated health risks.

Citations

Claim

Rhodiola is an adaptogen that has been shown to help with cortisol management.

Veracity Rating: 2 out of 4

Facts

## Claim Evaluation: Rhodiola as an Adaptogen for Cortisol Management

The claim that Rhodiola is an adaptogen that helps with cortisol management can be evaluated based on available scientific evidence.

### Rhodiola as an Adaptogen

Rhodiola rosea is widely recognized as an adaptogen, a substance that helps the body adapt to stress by normalizing physiological processes and enhancing resilience to stressors[1][2][3]. Adaptogens like Rhodiola are believed to influence the body's stress response system, which includes the regulation of cortisol levels[5].

### Cortisol Management

Cortisol is a hormone released in response to stress, and its dysregulation can lead to various health issues, including hormonal imbalances, belly fat, and depression[5]. While there is evidence that adaptogens can help manage cortisol levels, specific studies on Rhodiola's effect on cortisol are limited.

A study mentioned in the literature review found that a standardized extract of Rhodiola (SHR-5) significantly reduced the cortisol response to awakening stress in individuals after 28 days of supplementation[5]. However, this evidence is not extensive, and more clinical trials are needed to confirm Rhodiola's effectiveness in cortisol management.

### Conclusion

While Rhodiola is recognized as an adaptogen with potential benefits for stress management, the specific claim that it helps with cortisol management is supported by limited clinical evidence. Further research is necessary to fully understand its effects on cortisol levels in humans.

### Recommendations for Future Studies

1. **Clinical Trials**: Conduct more extensive human clinical trials to assess Rhodiola's impact on cortisol levels and stress management.
2. **Standardization**: Ensure that Rhodiola supplements are standardized to contain consistent levels of active compounds like rosavins and salidroside.
3. **Dosage and Duration**: Investigate optimal dosages and treatment durations for cortisol management.

In summary, while Rhodiola shows promise as an adaptogen, more research is needed to confirm its efficacy in managing cortisol levels specifically.

Citations

Claim

90% of the patients tested by the speaker have issues with cortisol levels.

Veracity Rating: 1 out of 4

Facts

## Evaluating the Claim: "90% of the patients tested by the speaker have issues with cortisol levels"

To assess the validity of this claim, we need to examine available scientific literature and expert opinions on cortisol issues among patients, particularly those with hormonal dysregulation. The claim seems to be related to discussions involving Dr. Sara Szal Gottfried, a physician known for her work on hormonal health and autoimmunity.

### Available Information

1. **Cortisol and Hormonal Imbalances**: Dr. Sara Szal Gottfried emphasizes the importance of cortisol in hormonal health, noting that cortisol imbalances can lead to various health issues such as anxiety, depression, and autoimmune conditions[1][2]. However, there is no specific mention of a 90% prevalence rate in the provided sources.

2. **Prevalence of Cortisol Issues**: While cortisol imbalances are recognized as significant health concerns, particularly in the context of chronic stress and autoimmune diseases, specific prevalence rates like "90%" are not commonly cited in general literature. The prevalence of cortisol-related issues can vary widely depending on the population studied and the criteria used for diagnosis.

3. **Expert Opinions and Research**: Dr. Szal Gottfried discusses the importance of personalized approaches to hormonal health, including cortisol testing, but does not provide a specific percentage of patients with cortisol issues[2][3]. The Dutch Test, mentioned in her discussions, is used to assess cortisol patterns among other hormonal markers, but again, no specific prevalence rate is mentioned.

### Conclusion

Based on the available information, there is no direct evidence to support the claim that "90% of the patients tested by the speaker have issues with cortisol levels." While cortisol imbalances are a significant concern and can affect a substantial portion of the population, particularly those with autoimmune conditions or chronic stress, the specific percentage of 90% is not substantiated by the provided sources or general scientific literature.

To verify such a claim, it would be necessary to consult specific research studies or clinical data from Dr. Szal Gottfried's practice that explicitly report on the prevalence of cortisol issues among her patients. Without access to such specific data, the claim remains unsubstantiated.

### Recommendations for Further Investigation

1. **Consult Specific Research Studies**: Look for peer-reviewed studies or clinical reports that focus on cortisol imbalances in patient populations similar to those discussed by Dr. Szal Gottfried.

2. **Clinical Data from Dr. Szal Gottfried's Practice**: If available, review clinical data or publications from Dr. Szal Gottfried's practice that might provide specific prevalence rates for cortisol issues among her patients.

3. **General Literature on Cortisol and Hormonal Health**: Continue to review general scientific literature on cortisol and hormonal health to understand the broader context of cortisol imbalances in various populations.

Citations

Claim

Women with higher testosterone tend to be more comfortable with financial risk, according to studies.

Veracity Rating: 4 out of 4

Facts

The claim that **women with higher testosterone tend to be more comfortable with financial risk** is supported by several studies examining the relationship between testosterone levels and financial risk-taking behavior. Here's a detailed evaluation based on available scientific evidence:

## Evidence Supporting the Claim

1. **Testosterone and Financial Risk-Taking**: Research conducted by Luigi Zingales of the University of Chicago and Paola Sapienza of Northwestern University found that women with higher levels of testosterone were more likely to take financial risks, similar to men. This study involved over 500 MBA students and measured their testosterone levels while assessing their risk aversion through a series of financial choice experiments[1][2][5].

2. **Gender Differences in Risk Aversion**: Generally, women are more risk-averse than men in financial decision-making. However, studies have shown that higher levels of testosterone in women are associated with lower risk aversion, making them more likely to engage in risky financial behaviors[2][3]. This suggests that testosterone plays a significant role in reducing risk aversion among women.

3. **Career Choices and Testosterone**: The same research indicates that individuals with higher testosterone levels, regardless of gender, are more likely to choose careers in finance that involve higher risk, such as investment banking or trading[2][5]. This further supports the idea that testosterone influences financial risk-taking behavior.

## Additional Considerations

– **Nonlinear Effects of Testosterone**: The relationship between testosterone and risk aversion is not linear and may vary depending on the concentration of testosterone. At lower concentrations, testosterone's effect on risk aversion is more pronounced, and gender differences in risk aversion tend to disappear[2][3].

– **Biological vs. Sociocultural Factors**: While testosterone is a biological factor influencing risk-taking behavior, sociocultural factors also play a significant role in shaping gender differences in financial decision-making. Future studies should consider both biological and sociocultural influences to provide a comprehensive understanding[2][3].

## Conclusion

The claim that women with higher testosterone levels tend to be more comfortable with financial risk is supported by scientific evidence. Studies have consistently shown that higher levels of testosterone in women are associated with increased willingness to take financial risks, similar to the patterns observed in men. However, it's important to consider both biological and sociocultural factors when examining gender differences in financial risk-taking behavior.

Citations

Claim

It leads to infertility.

Veracity Rating: 3 out of 4

Facts

## Claim Evaluation: High Cortisol Levels Leading to Infertility

The claim that high cortisol levels can lead to infertility is a topic of interest in discussions about women's health, particularly during perimenopause and menopause. To evaluate this claim, we need to consider the relationship between cortisol, hormonal imbalances, and fertility.

### Cortisol and Hormonal Imbalance

Cortisol is a stress hormone produced by the adrenal glands, and its levels naturally fluctuate throughout the day. Chronic stress can lead to persistently high cortisol levels, which can disrupt hormonal balances in the body[1][3]. This hormonal imbalance can affect various bodily functions, including reproductive health.

### Impact on Fertility

High cortisol levels can interfere with the body's hormonal balance, potentially affecting fertility. For instance, cortisol can disrupt the normal functioning of hormones like estrogen and progesterone, which are crucial for ovulation and menstrual cycles[1][3]. Disruptions in these hormonal cycles can lead to irregular periods, ovulation issues, and potentially contribute to infertility[2].

### Direct Evidence of Cortisol and Infertility

While there is evidence that hormonal imbalances can affect fertility, direct evidence linking high cortisol specifically to infertility is less clear. However, conditions like Cushing's syndrome, which involve excessive cortisol production, can lead to irregular periods and reduced fertility[5]. This suggests that extreme cortisol imbalances can impact reproductive health.

### Conclusion

The claim that high cortisol levels can lead to infertility is supported by the understanding that cortisol can disrupt hormonal balances crucial for reproductive health. However, the direct link between cortisol and infertility is more nuanced and may depend on the severity of cortisol imbalance and individual health conditions. Lifestyle changes and personalized hormonal therapies can help manage cortisol levels and potentially improve fertility outcomes.

In summary, while high cortisol can contribute to hormonal imbalances that may affect fertility, it is not a direct cause of infertility in most cases. The relationship between cortisol and fertility is complex and influenced by various factors, including overall hormonal health and individual health conditions.

Citations

Claim

So somewhere around 70% of people with PCOS have insulin resistance.

Veracity Rating: 3 out of 4

Facts

The claim that "somewhere around 70% of people with PCOS have insulin resistance" can be verified through various epidemiological studies and medical literature.

**Evidence Supporting the Claim:**

1. **Insulin Resistance Prevalence in PCOS**: Studies indicate that insulin resistance (IR) is a common metabolic feature in women with PCOS, affecting approximately 35% to 80% of this population[1]. Specifically, some sources suggest that up to 70% of women with PCOS may have insulin resistance[2][3].

2. **Mechanisms and Implications**: Insulin resistance in PCOS is linked to hyperandrogenism and metabolic complications, including an increased risk of type 2 diabetes and cardiovascular disease[1][4]. The prevalence of insulin resistance can vary based on factors such as obesity and ethnic background[3].

3. **Assessment Methods**: While the gold standard for measuring insulin sensitivity is the hyperinsulinemic-euglycemic clamp, simpler methods like the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and the Oral Glucose Tolerance Test (OGTT) are commonly used in clinical practice[4].

**Conclusion:**

The claim that approximately 70% of people with PCOS have insulin resistance is supported by various studies and medical literature. However, it's important to note that the prevalence can vary widely, typically ranging from 35% to 80%, depending on the population studied and the criteria used to define insulin resistance[1][3][4]. Therefore, while the specific figure of 70% is plausible, it should be understood within the broader context of variability in reported prevalence rates.

Citations

Claim

You can lower it significantly within seven days by eating a lower carbohydrate diet.

Veracity Rating: 0 out of 4

Facts

## Claim Evaluation: Lowering Testosterone Levels with a Low-Carbohydrate Diet Within Seven Days

The claim suggests that a low-carbohydrate diet can significantly lower testosterone levels within seven days. To evaluate this claim, we need to examine existing research on the effects of low-carbohydrate diets on testosterone levels.

### Evidence on Low-Carbohydrate Diets and Testosterone

1. **Short-Term Effects**: Research indicates that low-carbohydrate diets may initially increase cortisol levels, which could potentially affect testosterone production. However, there is no consistent evidence that these diets significantly lower testosterone levels in the short term (less than three weeks)[2][5].

2. **Long-Term Effects**: Some studies suggest that low-carbohydrate diets may not have a consistent effect on testosterone levels over longer periods. However, high-protein, low-carbohydrate diets have been associated with decreased testosterone levels[2][5].

3. **Mechanism**: Testosterone production is influenced by factors such as cholesterol intake, body fat, and overall health. Low-carbohydrate diets, particularly those high in fat, can increase cholesterol levels, which might support testosterone production[1][3].

4. **Timeframe**: The claim of lowering testosterone levels within seven days is not supported by scientific evidence. Most studies on dietary effects on testosterone focus on longer-term changes rather than acute effects over a week[1][2].

### Conclusion

Based on the available evidence, there is no scientific support for the claim that a low-carbohydrate diet can significantly lower testosterone levels within seven days. While dietary changes can influence hormone levels, the effects are generally observed over longer periods and are influenced by multiple factors, including protein intake, overall calorie balance, and individual health status[1][2][3]. Therefore, this claim appears to be unsubstantiated by current scientific research.

### Recommendations

– **Consult Healthcare Professionals**: For personalized advice on managing testosterone levels, it is advisable to consult healthcare professionals who can provide tailored guidance based on individual health profiles.
– **Consider Lifestyle Factors**: Lifestyle changes, including diet, exercise, stress management, and sleep quality, can impact hormone levels and should be considered in conjunction with any dietary adjustments[1][3].
– **Avoid Extreme Diets**: Extreme dietary changes, especially those involving high protein or very low carbohydrate intake, should be approached with caution due to potential adverse effects on hormone levels[5].

Citations

Claim

The average American gets somewhere around 14 grams of fibre a day and we're meant to have about 30 to 35 to 40 grams a day.

Veracity Rating: 3 out of 4

Facts

## Claim Evaluation: Average American Fiber Intake

The claim suggests that the average American consumes approximately 14 grams of fiber per day, while the recommended intake is between 30 to 35 to 40 grams daily. To assess the validity of this claim, we will examine both the average fiber intake in the U.S. and the recommended dietary fiber intake.

### Average Fiber Intake in the U.S.

– **Evidence**: Studies and surveys indicate that the average fiber intake among Americans is generally lower than recommended. For instance, the 2009-2010 National Health and Nutrition Examination Survey (NHANES) reported a mean daily fiber intake of about 16 grams for all individuals aged 2 years and older[3][5]. More recent data suggest that adults typically consume between 10 to 15 grams of fiber per day[1][2]. Therefore, while the exact figure of 14 grams is slightly below some reported averages, it is within the range of commonly cited values.

### Recommended Fiber Intake

– **Guidelines**: The recommended daily intake of fiber varies slightly depending on the source. The American Heart Association suggests 25 to 30 grams per day[1]. The Institute of Medicine recommends a range from 19 to 38 grams per day, depending on age and gender[3]. For women, the ideal intake is often cited as between 23 and 28 grams per day[2]. The claim's upper limit of 40 grams is somewhat higher than most recommendations but is not entirely inconsistent with some guidelines, especially for certain age groups or activity levels.

### Conclusion

The claim that Americans consume around 14 grams of fiber daily is plausible, given the range of reported averages. However, the recommended intake is generally between 25 to 35 grams per day for most adults, with some guidelines suggesting up to 38 grams for certain groups. Therefore, the claim is partially accurate but may slightly overstate the recommended upper limit for general adult populations.

**Recommendation**: To improve the accuracy of the claim, it would be beneficial to specify the source of the recommended intake range and acknowledge the variability in recommendations based on age, gender, and activity level. Additionally, emphasizing the importance of increasing fiber intake gradually to avoid digestive discomfort is crucial[2].

Citations

Claim

Women typically gain about five pounds of fat and lose about five pounds of muscle every decade after age 40.

Veracity Rating: 3 out of 4

Facts

## Evaluating the Claim: Women Typically Gain About Five Pounds of Fat and Lose About Five Pounds of Muscle Every Decade After Age 40

To assess the validity of this claim, we need to examine longitudinal studies and scientific evidence regarding age-related changes in body composition, particularly focusing on fat gain and muscle loss in women after age 40.

### Evidence from Scientific Studies

1. **Increase in Fat Mass and Decrease in Lean Mass**: Studies have consistently shown that with aging, there is an increase in body fat and a decrease in lean mass (muscle) in both men and women. For women, this trend is particularly pronounced during the menopause transition due to hormonal changes, such as decreased estrogen levels[2][5]. A six-year longitudinal study found a cumulative increase of approximately 3.4 kg in fat mass and a decrease of about 0.23 kg in skeletal muscle mass[5].

2. **Aging and Body Composition Changes**: As women age, especially after 40, they experience significant changes in body composition. These changes include an increase in body fat, particularly around the abdominal area, and a decrease in muscle mass. This shift contributes to weight gain and metabolic changes[3][5].

3. **Quantitative Changes**: While the exact figures of five pounds of fat gain and five pounds of muscle loss per decade are not explicitly supported by the studies reviewed, the general trend of increased fat mass and decreased lean mass with age is well-documented. The rate of these changes can vary based on factors such as lifestyle, physical activity, and hormonal status[2][5].

### Conclusion

The claim that women typically gain about five pounds of fat and lose about five pounds of muscle every decade after age 40 aligns with the general trend observed in scientific studies. However, the specific quantitative figures (five pounds of fat gain and five pounds of muscle loss) are not directly supported by the reviewed literature. The changes in body composition are influenced by a combination of chronological aging and hormonal shifts, particularly during menopause[2][5].

### Recommendations for Future Research

– **Longitudinal Studies**: More longitudinal studies focusing on precise quantitative changes in body composition over decades would provide clearer evidence.
– **Individual Variability**: Research should also consider individual variability in body composition changes based on lifestyle, genetics, and hormonal status.

In summary, while the claim captures the essence of age-related body composition changes, precise quantitative data from longitudinal studies are needed to fully validate the specific figures mentioned.

Citations

Claim

Around 45% of women on a classic ketogenic diet experience menstrual irregularity.

Veracity Rating: 0 out of 4

Facts

The claim that "around 45% of women on a classic ketogenic diet experience menstrual irregularity" cannot be verified based on the available scientific literature. The recent studies on the ketogenic diet and menstrual health suggest that it may positively impact menstrual cycles by increasing ketones, potentially regulating menstrual frequency and intensity in pre-menopausal women[1][2][3]. However, these studies do not provide a specific percentage of women experiencing menstrual irregularity due to the ketogenic diet.

### Analysis of Available Studies

1. **Ketogenic Diet Impact on Menstrual Health**: A recent study published in *PLOS ONE* found that 11 of 13 pre-menopausal women who achieved nutritional ketosis reported changes in menstrual frequency, intensity, or both[1][3]. This indicates a positive effect on menstrual cycles rather than an adverse one.

2. **Menstrual Changes and Ketogenic Diet**: Another study noted that women on the ketogenic diet reported changes in menstrual cycles, with some experiencing increased frequency or intensity, while those on low-fat diets did not report any changes[2][4]. This suggests that the ketogenic diet may influence menstrual physiology positively.

3. **Restarting Menstruation**: Some participants who had not had a period in over a year experienced a restart of menstruation while on the ketogenic diet[3][5]. This further supports the idea that the ketogenic diet can have beneficial effects on menstrual health.

### Conclusion

Given the current evidence, the claim that "around 45% of women on a classic ketogenic diet experience menstrual irregularity" is not supported by the available research. Instead, studies suggest that the ketogenic diet may have a positive impact on menstrual health, potentially regulating menstrual cycles and even restarting menstruation in some cases. Further research is needed to fully understand the effects of the ketogenic diet on women's reproductive health.

### Recommendations for Future Research

– **Quantitative Analysis**: Future studies should aim to quantify the percentage of women experiencing menstrual irregularities or improvements while on a ketogenic diet.
– **Long-Term Effects**: Investigating the long-term effects of the ketogenic diet on menstrual health would provide valuable insights into its sustainability and safety.
– **Mechanisms of Action**: Understanding the mechanisms by which ketones influence menstrual cycles could lead to targeted therapeutic strategies for women's reproductive health.

Citations

Claim

73 to 75 percent of women do not get the treatment for perimenopause and menopause that they deserve.

Veracity Rating: 3 out of 4

Facts

To evaluate the claim that "73 to 75 percent of women do not get the treatment for perimenopause and menopause that they deserve," we need to examine healthcare access and treatment outcomes for menopausal women. Here's a detailed analysis based on available evidence:

## Evidence on Treatment Access

1. **Untreated Menopause Symptoms**: Studies indicate that a significant portion of women with menopausal symptoms do not receive adequate treatment. For instance, it is reported that 60% of women seek clinical help for menopausal symptoms, but approximately 75% of these women remain untreated[2][3]. This suggests a substantial gap in the provision of care.

2. **Healthcare Provider Competence**: There is a noted lack of training among healthcare providers regarding menopause. Only 20% of OB/GYN residencies offer menopause training, and 80% of graduating internal medicine residents do not feel competent to discuss or treat menopause[3]. This lack of expertise likely contributes to inadequate treatment.

3. **Barriers to Care**: Barriers such as lack of recognition of symptoms by healthcare providers, cost concerns, and societal biases can prevent women from receiving appropriate care[2][4]. These systemic issues exacerbate the treatment gap.

## Evaluation of the Claim

Given the evidence, it appears that a substantial number of women do not receive the treatment they need for perimenopause and menopause. While the exact figure of 73 to 75% is not directly supported by the sources, the available data suggest a significant treatment gap. The claim aligns with the broader context of inadequate healthcare access and support for menopausal women.

## Conclusion

The claim that a large percentage of women do not receive adequate treatment for perimenopause and menopause is supported by evidence highlighting significant barriers to care and a lack of healthcare provider expertise. While the precise percentage might vary, the underlying issue of inadequate treatment is well-documented.

In summary, the claim is generally valid, reflecting a critical need for improved healthcare access and awareness regarding menopause treatment. However, the exact percentage might require further specific studies to confirm.

Citations

Claim

Women who have premature ovarian insufficiency go through menopause before age 40.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Women with Premature Ovarian Insufficiency Go Through Menopause Before Age 40

The claim that women with premature ovarian insufficiency (POI) go through menopause before age 40 can be verified through medical definitions and statistics.

### Definition of Premature Ovarian Insufficiency

POI is defined as a condition where there is a loss of ovarian function before the age of 40, leading to a hypoestrogenic state characterized by elevated gonadotrophins and amenorrhea or oligomenorrhea[1][3][4]. This condition is often referred to as premature menopause, as it contrasts with natural menopause, which typically occurs between the ages of 46 and 55[1][4].

### Age Criterion

The key criterion for POI is the cessation of ovarian function before the age of 40, which aligns with the claim that these women experience menopause before this age[1][3][4]. This condition affects approximately 1% of women, with higher prevalence rates in some regions[2].

### Health Implications

POI has significant health implications, including menopausal symptoms, infertility, and increased risks of osteoporosis, cardiovascular disease, and other chronic conditions[1][2][4]. Management typically involves hormone replacement therapy (HRT) to alleviate symptoms and mitigate long-term health risks[1][3][4].

### Conclusion

Based on the medical definitions and statistics, the claim that women with premature ovarian insufficiency go through menopause before age 40 is **accurate**. POI is characterized by the premature loss of ovarian function, leading to menopausal symptoms and health risks before the age of 40[1][2][3][4].

While Dr. Sara Zhal's discussion on hormonal imbalances and menopause symptoms highlights broader issues in women's health, it does not directly address the specific claim about POI. However, her emphasis on the importance of hormonal therapy and lifestyle changes aligns with the recommended management strategies for POI[1][3][4].

Citations

Claim

Many of the symptoms of menopause are avoidable.

Veracity Rating: 3 out of 4

Facts

## Evaluating the Claim: "Many of the symptoms of menopause are avoidable."

The claim that many symptoms of menopause are avoidable can be explored through current research on menopause management and preventative healthcare practices. While menopause is a natural biological process, certain symptoms can indeed be mitigated or managed through lifestyle changes and medical interventions.

### Common Symptoms of Menopause

Menopause is associated with a range of symptoms, including hot flashes, vaginal dryness, mood changes, sleep disturbances, and weight gain[2][3]. These symptoms are primarily linked to hormonal changes, particularly the decline in estrogen levels.

### Management and Prevention Strategies

1. **Lifestyle Changes**:
– **Diet and Nutrition**: Eating a healthy diet rich in fiber, complex carbohydrates, healthy fats, and proteins can help manage metabolic changes and reduce symptoms like weight gain and blood sugar spikes[1].
– **Physical Activity**: Regular exercise is recommended to maintain cardiovascular health and reduce the risk of chronic conditions[2].
– **Stress Management**: Techniques such as meditation and yoga can help manage mood changes and stress[2].

2. **Hormone Replacement Therapy (HRT)**:
– HRT is a well-established treatment for managing menopausal symptoms, particularly hot flashes and vaginal dryness. It can also help prevent osteoporosis[3][4]. However, its use should be carefully considered due to potential risks and benefits[4].

3. **Gut Health**:
– Research suggests that maintaining good gut health through diet can influence metabolic changes and potentially reduce menopausal symptoms[1].

4. **Personalized Hormonal Therapy**:
– Dr. Zhal's emphasis on personalized hormonal therapy aligns with the idea that addressing individual hormonal imbalances can help manage symptoms. However, this approach requires more research to fully understand its effectiveness in preventing menopausal symptoms.

### Systemic Issues and Awareness

Despite these management strategies, there remains a lack of awareness and support for women during menopause. This includes inadequate training for healthcare providers and societal stigma surrounding menopause[5]. Addressing these systemic issues is crucial for improving women's health outcomes.

### Conclusion

While not all symptoms of menopause can be completely avoided, many can be managed or mitigated through lifestyle changes, hormone therapy, and personalized healthcare approaches. The claim that many symptoms are avoidable is partially supported by current research, emphasizing the importance of proactive and tailored interventions to improve women's health during this transition. However, more research is needed to fully understand the effectiveness of these strategies across diverse populations.

In summary, while menopause itself is inevitable, many of its symptoms can be alleviated or prevented through appropriate management and preventative healthcare practices. This includes a combination of lifestyle modifications, medical interventions, and addressing systemic barriers to care.

Citations

Claim

Birth control pills raise inflammation in your body by two to three fold.

Veracity Rating: 1 out of 4

Facts

## Evaluating the Claim: Birth Control Pills Raise Inflammation by Two to Three Fold

The claim that birth control pills increase inflammation in the body by two to three fold requires a thorough examination of scientific evidence. While there is evidence suggesting that hormonal contraceptives can affect inflammation levels, the specific assertion of a two to three fold increase needs careful consideration.

### Evidence on Inflammation and Birth Control

1. **C-Reactive Protein (CRP) Levels**: Studies have shown that women using birth control pills often have higher levels of CRP, a marker of inflammation. For instance, one study found that CRP levels were twice as high in women using oral contraceptives compared to non-users[3][4]. However, this does not directly translate to a two to three fold increase in overall inflammation.

2. **Inflammatory Markers**: Research indicates that hormonal contraceptives can influence various inflammatory markers. For example, some studies have noted elevated levels of tumor necrosis factor-alpha (TNF-α) in women using hormonal contraceptives[1]. However, the impact on other inflammatory markers like IL-6 can vary, and not all studies show a significant increase across all markers[1][2].

3. **Complexity of Inflammatory Responses**: The relationship between birth control pills and inflammation is complex. Some studies suggest mixed patterns of inflammatory responses, with decreases in certain markers like IL-1β following stress, while others like TNF-α are elevated[1]. This complexity makes it challenging to assert a uniform increase in inflammation across all markers.

### Conclusion

While birth control pills can increase certain markers of inflammation, such as CRP, the claim of a two to three fold increase in overall inflammation is not supported by the available evidence. The impact of hormonal contraceptives on inflammation is multifaceted and varies depending on the specific markers and individual responses. Therefore, the claim should be viewed with caution and considered in the context of broader research findings.

### Recommendations for Future Research

– **Longitudinal Studies**: Conducting longitudinal studies with larger sample sizes could provide clearer insights into how different hormonal contraceptives affect inflammation over time.
– **Diverse Inflammatory Markers**: Investigating a range of inflammatory markers will help in understanding the full scope of how birth control pills influence inflammation.
– **Individual Variability**: Recognizing individual variability in responses to hormonal contraceptives is crucial for personalized healthcare advice.

Citations

Claim

Birth control pills increase the risk of autoimmune disease, especially Crohn's disease.

Veracity Rating: 3 out of 4

Facts

## Evaluating the Claim: Birth Control Pills Increase the Risk of Autoimmune Disease, Especially Crohn's Disease

The claim that birth control pills increase the risk of autoimmune diseases, particularly Crohn's disease, can be evaluated by examining clinical studies and expert analyses on this topic.

### Evidence for the Claim

1. **Crohn's Disease and Birth Control Pills**: Research indicates that the use of combination birth control pills may increase the risk of developing Crohn's disease. Studies suggest that this risk can be as high as 24% to 50%, especially for individuals with certain genetic predispositions[2][4]. A study led by Dr. Hamed Khalili found that women who used oral contraceptives for more than five years had a three-fold increased risk of Crohn's disease, particularly if they had a genetic predisposition to the condition[4].

2. **Multiple Sclerosis and Lupus**: There is also evidence suggesting that hormonal birth control may increase the risk of other autoimmune diseases like Multiple Sclerosis (MS) and Lupus. Some studies indicate that women who use hormonal birth control are 35% more likely to develop MS and 50% more likely to develop Lupus[3].

### Mechanisms and Considerations

– **Hormonal Impact**: Hormonal birth control, particularly estrogen, can affect the immune system by influencing cytokine production and potentially leading to chronic inflammation, which may contribute to autoimmune conditions like Crohn's disease[2][3].

– **Genetic Predisposition**: The risk of developing autoimmune diseases is often higher in individuals with a genetic predisposition. The use of hormonal birth control may act as an environmental trigger that activates these conditions in susceptible individuals[3][4].

### Conclusion

Based on the available evidence, it appears that the use of hormonal birth control pills may increase the risk of certain autoimmune diseases, including Crohn's disease, especially in individuals with a genetic predisposition. However, the relationship between birth control and autoimmune diseases is complex and can vary depending on the specific condition and individual factors.

**Recommendations for Women's Health**:
– **Consultation with Healthcare Providers**: Women should discuss their risk factors and medical history with healthcare providers to determine the best birth control options for their health needs.
– **Alternative Birth Control Methods**: For those at risk or already diagnosed with autoimmune diseases, non-hormonal methods like copper IUDs or progestin-only pills may be safer alternatives[5].

In summary, while there is evidence supporting the claim that birth control pills may increase the risk of autoimmune diseases like Crohn's disease, individual risks can vary widely based on genetic predisposition and other factors. Therefore, personalized healthcare advice is crucial for making informed decisions about birth control use.

Citations

Claim

Birth control pills can lower free testosterone levels.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Birth Control Pills Can Lower Free Testosterone Levels

The claim that birth control pills can lower free testosterone levels is supported by scientific evidence. Here's a detailed analysis based on reliable sources:

### Mechanisms and Effects

1. **Mechanism of Action**: Combined oral contraceptives (COCs) contain estrogen and progestin, which affect hormone levels by several mechanisms. They inhibit ovarian and adrenal androgen synthesis and increase sex hormone-binding globulin (SHBG) levels[2][5]. SHBG binds to testosterone, reducing the amount of free testosterone available in the body[2][3].

2. **Impact on Testosterone Levels**: Studies have consistently shown that COCs decrease both total and free testosterone levels. Free testosterone levels are particularly affected due to the increase in SHBG, which binds testosterone, making it unavailable for physiological functions[1][2][5]. A meta-analysis found that total testosterone decreases by about 30-50%, while free testosterone levels can drop by approximately 50-60%[1][5].

3. **Clinical Implications**: The reduction in free testosterone can lead to various health implications, including decreased libido, energy levels, and muscle mass. Additionally, there may be long-term effects on sexual and metabolic health[3][5].

4. **Variability Among Contraceptives**: Different types of hormonal contraceptives have varying effects on SHBG and testosterone levels. For example, intrauterine devices (IUDs) tend to have a lower impact on SHBG compared to oral pills, patches, or rings. The specific estrogen and progestin components also influence these effects[1][4].

### Conclusion

The claim that birth control pills can lower free testosterone levels is supported by scientific evidence. The increase in SHBG due to hormonal contraceptives leads to a significant reduction in free testosterone, which can have various health implications. Understanding these effects is crucial for informed decision-making regarding birth control options and managing potential side effects.

### References

– [1] InsideTracker: "A Surprising Way Birth Control Affects Your Health and Hormones"
– [2] PMC: "The effect of combined oral contraception on testosterone levels in healthy women: A systematic review and meta-analysis"
– [3] Medical News Today: "Birth Control Pill Could Cause Long-Term Problems With Testosterone"
– [4] Contemporary OB/GYN: "Nextstellis combined oral contraceptive and endocrine markers"
– [5] Facts About Fertility: "Oral Contraceptive Effects on Testosterone Levels in Healthy Women: A Review of Research"

Citations

Claim

Birth control pills can shrink your clitoris by up to 20%.

Veracity Rating: 1 out of 4

Facts

## Evaluating the Claim: Birth Control Pills Can Shrink Your Clitoris by Up to 20%

The claim that birth control pills can shrink the clitoris by up to 20% is based on some studies suggesting that hormonal contraceptives can affect clitoral volume. However, the specific percentage of shrinkage is not consistently supported across all relevant research.

### Evidence Supporting Clitoral Changes

1. **Clitoral Volume Reduction**: Some studies have indicated that hormonal contraceptives, such as oral contraceptives and the vaginal ring, can lead to a decrease in clitoral volume. For example, one study found that clitoral volume decreased in all women using these methods, which was associated with reduced sexual activity and orgasm frequency[1][5].

2. **Mechanism**: The reduction in clitoral volume is often linked to the decrease in testosterone levels caused by hormonal contraceptives. Testosterone plays a crucial role in female sexual health, including libido and genital health[1][5].

### Contradictory Evidence

1. **Lack of Specific Percentage**: There is no specific mention of a 20% reduction in clitoral size in the available literature. The studies primarily focus on the qualitative effects of hormonal contraceptives on clitoral volume without quantifying the exact percentage of shrinkage.

2. **Variable Effects on Genital Sensation**: Some research indicates that while hormonal contraceptives decrease free testosterone levels, they do not necessarily alter clitoral or vestibular sensation[3]. This suggests that the impact of hormonal contraceptives on genital anatomy might not always translate into functional changes.

3. **Need for Further Research**: The current evidence base is limited, and more comprehensive studies are needed to fully understand the effects of hormonal contraceptives on clitoral anatomy and sexual health[2][3].

### Conclusion

While there is evidence suggesting that hormonal contraceptives can reduce clitoral volume, the claim of a specific 20% shrinkage is not supported by the available scientific literature. The effects of hormonal contraceptives on female genital anatomy and sexual health are complex and require further investigation to fully understand their implications.

In summary, while hormonal contraceptives may affect clitoral volume, the specific percentage of shrinkage mentioned in the claim is not substantiated by current research.

Citations

Claim

Divorce rates increase when women reach menopausal age.

Veracity Rating: 4 out of 4

Facts

## Evaluating the Claim: "Divorce rates increase when women reach menopausal age"

The claim that divorce rates increase when women reach menopausal age is supported by various studies and demographic analyses. Here's a detailed evaluation of this assertion:

### Demographic Evidence

1. **Peak Divorce Age**: In the UK, the peak age for divorce among women is between the mid-40s and 55, which coincides with perimenopause and menopause[2][5]. This period is often referred to as a "divorce danger zone" due to its significant impact on marriages[1].

2. **Initiation of Divorce**: Over 60% of divorces in the UK are initiated by women in their 40s, 50s, and 60s, aligning with the menopausal years[1]. This suggests that menopause may play a role in the breakdown of marriages.

### Impact of Menopause on Relationships

1. **Symptoms and Relationship Strains**: Menopause symptoms such as mood swings, low libido, and genitourinary issues can strain relationships[2][3]. A survey found that 70% of women blamed menopause for their divorce or marriage problems, highlighting its impact on family life[3][5].

2. **Lack of Support and Awareness**: Despite the significant impact of menopause on relationships, there is a lack of awareness and support. Only a third of women surveyed had received treatment or HRT, and many felt that support could have potentially saved their marriages[3][5].

### Financial and Career Implications

1. **Financial Challenges**: Menopause can lead to reduced working hours or career changes due to symptoms, affecting financial stability during divorce[2]. Family lawyers often fail to consider these factors in divorce settlements, potentially disadvantaging women financially[2].

2. **Career Impact**: Menopause can negatively affect women's careers, further complicating financial independence post-divorce[2].

### Conclusion

The claim that divorce rates increase when women reach menopausal age is supported by demographic trends and studies on the impact of menopause on relationships. Menopause symptoms can exacerbate existing marital issues, leading to an increased likelihood of divorce during this period. However, it's crucial to note that menopause itself does not directly cause divorce but rather highlights and intensifies existing relationship challenges[1][3][5].

In summary, while menopause is not the sole cause of divorce, its symptoms and societal factors contribute to a higher divorce rate among women in this age group. Addressing these challenges through better support and awareness is essential for improving outcomes for women during this transitional phase.

Citations

Claim

Psychological well-being follows a U-shaped curve throughout adulthood, with a peak around 50.

Veracity Rating: 2 out of 4

Facts

## Evaluation of the Claim: Psychological Well-being Follows a U-Shaped Curve Throughout Adulthood, with a Peak Around 50

The claim that psychological well-being follows a U-shaped curve throughout adulthood, with a peak around 50, is partially supported by existing research but requires clarification and nuance.

### Evidence Supporting the U-Shaped Curve

1. **Cross-sectional Studies**: Many studies have found that well-being tends to decrease from early adulthood to a nadir in midlife (around 40 to 50 years) before increasing again in later life. This pattern has been observed in various countries and cultures, suggesting a U-shaped curve in well-being across the life span[1][2][4].

2. **Global Observations**: The U-shaped curve has been documented in both developed and developing nations, indicating a broad applicability of this pattern[1][2].

3. **Psychological and Sociological Factors**: The increase in well-being after midlife is often attributed to factors such as increased emotional regulation, acceptance, and adjustment of life aspirations[2][4].

### Critique and Nuance

1. **Recent Changes in Patterns**: Recent studies suggest that the traditional U-shaped curve may be changing, particularly among young adults. There is evidence that young adults are now experiencing lower levels of well-being compared to older adults, which challenges the classic U-shaped model[3].

2. **Variability and Individual Differences**: Not all individuals follow the U-shaped curve. There is significant variability in well-being trajectories across different people, influenced by factors such as life events, health, and socioeconomic status[4][5].

3. **Methodological Concerns**: Some researchers argue that the U-shaped curve may not be as robust as often claimed, particularly when considering longitudinal data and controlling for life events[2][4].

4. **Peak Well-being**: The claim that well-being peaks around 50 is not entirely accurate. While well-being does increase after midlife, it does not necessarily peak at 50 but rather continues to rise into older age before potentially declining again in very late life[2][4].

### Conclusion

While there is evidence supporting a U-shaped curve in well-being across adulthood, with a decline in midlife followed by an increase, the claim requires refinement. The peak in well-being is not specifically around 50 but rather occurs in later life. Additionally, recent trends suggest changes in this pattern, especially among younger populations. Therefore, the claim is partially supported but needs to be understood within the context of ongoing research and variability in individual experiences.

Citations

Claim

Women have double the rate of depression compared to men.

Veracity Rating: 3 out of 4

Facts

## Claim Evaluation: Women Have Double the Rate of Depression Compared to Men

The claim that women have double the rate of depression compared to men is supported by various epidemiological studies and mental health statistics. Here's a detailed evaluation of this assertion:

### Prevalence of Depression by Gender

Numerous studies have consistently shown that depression is more prevalent among women than men. For instance, the lifetime prevalence of depressive disorders is reported to have a sex ratio (women: men) of over 1.7, and the 12-month prevalence ratio is around 1.4[1]. Similarly, the global 12-month prevalence of major depressive disorder is higher in females (5.8%) compared to males (3.5%)[5]. In the United States, women experience major depressive episodes at a rate of 21.3% compared to 12.9% for men[2].

### Factors Contributing to Gender Differences

Several factors contribute to the higher prevalence of depression in women, including:

– **Hormonal Changes**: Fluctuations in hormone levels during menstruation, pregnancy, and menopause can increase the risk of depression[3][4].
– **Social and Cultural Factors**: Women often face more societal pressures and are more likely to report emotional symptoms, which can lead to higher diagnosis rates[3][4].
– **Genetic and Environmental Factors**: While genetic factors play a role, environmental influences such as stress, trauma, and gender inequality also contribute to the gender gap in depression[1][5].

### Underdiagnosis in Men

It is also suggested that depression in men might be underdiagnosed due to differences in symptom presentation and help-seeking behaviors. Men are less likely to report mild to moderate depression and may exhibit symptoms like substance abuse or aggression instead[2][3].

### Conclusion

In conclusion, the claim that women have double the rate of depression compared to men is generally supported by epidemiological data, although the exact ratio can vary depending on the study and population. The gender difference in depression prevalence is influenced by a combination of biological, hormonal, social, and cultural factors.

**Evidence Summary:**

– **Prevalence Ratios**: Studies show that women are 1.5 to 3 times more likely to experience depression than men[3][5].
– **Hormonal and Social Factors**: Hormonal fluctuations and societal pressures contribute significantly to the higher prevalence of depression in women[3][4].
– **Underdiagnosis in Men**: Men's depression might be underreported due to different symptom manifestations and less help-seeking behavior[2][3].

Citations

Claim

Women are 14 times more likely to be raped than men.

Veracity Rating: 2 out of 4

Facts

## Claim Evaluation: Women are 14 times more likely to be raped than men.

To evaluate this claim, we need to examine data on sexual violence and rape from reliable sources. The claim suggests a significant disparity in the likelihood of rape between women and men, which can be assessed using statistics on gender-based violence and sexual assault.

### Available Data

1. **Sexual Violence Prevalence**:
– **United States**: According to the National Sexual Violence Resource Center, one in five women and one in 71 men will be raped at some point in their lives[2]. This indicates a substantial difference in the prevalence of rape between genders.
– **Global Context**: The United Nations reports that an estimated 736 million women have been subjected to physical and/or sexual intimate partner violence or non-partner sexual violence[5]. However, specific global statistics comparing the likelihood of rape between men and women are not readily available.

2. **Gender Disparity in Rape Reporting**:
– In the U.S., it is reported that 91% of the victims of rape and sexual assault are female, while 9% are male[2]. This suggests a significant gender disparity in reported cases of rape.
– The fact that rape is the most under-reported crime, with only about 40% of rapes being reported to police in some years[4], complicates the accuracy of these statistics.

3. **Comparative Risk**:
– While the exact figure of women being "14 times more likely" to be raped than men is not explicitly supported by the available data, the statistics do indicate a substantial disparity in the risk of rape between genders. For example, the ratio of women to men experiencing rape in the U.S. (1 in 5 women vs. 1 in 71 men) suggests a significant difference in risk.

### Conclusion

The claim that women are "14 times more likely" to be raped than men is not directly supported by the specific data available. However, the evidence does show a significant disparity in the risk of rape between women and men, with women being disproportionately affected by sexual violence. The ratio of women to men experiencing rape in the U.S. suggests a substantial difference, but the exact "14 times" figure is not explicitly confirmed by the sources reviewed.

### Recommendations for Further Research

– **Global Comparative Studies**: More research is needed to compare the risk of rape between genders globally, considering variations in reporting rates and cultural contexts.
– **Improved Reporting Mechanisms**: Enhancing reporting mechanisms and reducing underreporting could provide more accurate data on the prevalence of rape and gender disparities.

In summary, while the claim of a "14 times" difference is not directly supported, the available data clearly indicate that women face a significantly higher risk of rape compared to men.

Citations

Claim

Women experience more trauma than men and at an earlier age.

Veracity Rating: 3 out of 4

Facts

## Claim Evaluation: Women Experience More Trauma Than Men and at an Earlier Age

The claim that women experience more trauma than men and at an earlier age can be partially supported by research findings, but it requires clarification and nuance. Here's a detailed analysis based on available scientific evidence:

### Prevalence of Trauma

– **Types of Trauma**: Women are more likely to experience high-impact traumas such as sexual assault and interpersonal violence, which have a higher risk of leading to PTSD compared to other types of trauma like accidents or combat, which are more common among men[1][2][3].
– **Age of Exposure**: Women often experience traumatic events at a younger age, which can disrupt neurobiological development and increase the risk of long-term psychological impacts[1][4].

### Gender Differences in Trauma Exposure

– **Lifetime Exposure**: While men may experience more traumatic events overall, the types of trauma women experience are more likely to lead to PTSD[3][4].
– **PTSD Prevalence**: Women are two to three times more likely to develop PTSD than men, with a lifetime prevalence of about 10% to 12% for women compared to 5% to 6% for men[1][2][4].

### Impact of Early Trauma

– **Neurobiological Development**: Early trauma, especially repeated or prolonged exposure, can interfere with neurobiological development and increase the risk of complex PTSD or other mental health disorders[1][4].
– **Social and Cultural Factors**: Societal norms and cultural expectations can influence how trauma is experienced and reported, with women often facing additional role strain due to their social roles[3][4].

### Conclusion

While women do not necessarily experience more traumatic events than men in terms of sheer numbers, they are more likely to experience high-impact traumas at a younger age, which can have a profound impact on their mental health. The claim is partially supported by evidence showing that women are exposed to more severe forms of trauma and at an earlier age, which contributes to a higher risk of PTSD and other mental health issues.

**Recommendations for Future Research**:
– More studies are needed to fully understand the interplay between trauma types, age of exposure, and gender-specific responses.
– Research should focus on developing gender-sensitive approaches to trauma treatment, considering both biological and psychosocial factors.

**Key Findings**:
– Women are more likely to experience high-impact traumas like sexual assault.
– Early trauma exposure can disrupt neurobiological development.
– Women have a higher risk of developing PTSD compared to men.

Citations

Claim

Women have a fourfold increased risk of autoimmune diseases compared to men.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Women Have a Fourfold Increased Risk of Autoimmune Diseases Compared to Men

The claim that women have a fourfold increased risk of autoimmune diseases compared to men is supported by scientific evidence. Here's a detailed analysis of this assertion based on available research:

### Evidence Supporting the Claim

1. **Prevalence of Autoimmune Diseases**: Studies have consistently shown that women are more likely to develop autoimmune diseases than men. For instance, conditions like systemic lupus erythematosus (SLE) and Sjögren's disease exhibit a significantly higher prevalence in women, often with more than a fourfold relative risk compared to men[2].

2. **Biological Factors**: Several biological factors contribute to this gender disparity. These include differences in sex hormones, such as estrogen, which can influence immune responses and increase the risk of autoimmune diseases[2]. Additionally, the presence of two X chromosomes in females may play a role, as recent research suggests that the extra X chromosome can contribute to autoimmunity[4].

3. **Antibody Production**: Women generally produce higher levels of antibodies than men, which can increase the risk of autoimmune diseases. This heightened antibody production is thought to be an evolutionary adaptation to protect against infections but also contributes to the higher incidence of autoimmune conditions in women[2].

### Additional Context

– **Hormonal Influences**: Hormonal changes, particularly during perimenopause and menopause, can affect autoimmune conditions. Dr. Sara Szal emphasizes the importance of understanding hormonal transitions and their impact on women's health, including autoimmune diseases[1].

– **Cortisol and Stress**: Elevated cortisol levels, often associated with stress, can also impact autoimmune conditions. Dr. Szal highlights the role of cortisol in women's health, noting its effects on mental and physical well-being[3].

### Conclusion

The claim that women have a fourfold increased risk of autoimmune diseases compared to men is supported by scientific evidence. This disparity is attributed to various factors, including hormonal differences, genetic influences, and higher antibody production in women. Understanding these factors is crucial for developing effective treatment strategies and improving women's health outcomes.

Citations

Claim

Pregnancy and breastfeeding reduce estrogen exposure which may influence breast cancer risk.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Pregnancy and Breastfeeding Reduce Estrogen Exposure, Influencing Breast Cancer Risk

The claim that pregnancy and breastfeeding reduce estrogen exposure, which may influence breast cancer risk, is supported by scientific evidence. Here's a detailed evaluation based on reliable sources:

### Pregnancy and Estrogen Exposure

Pregnancy involves significant hormonal changes, including increased levels of estrogen and progesterone. However, these hormonal fluctuations also lead to the differentiation of breast cells, which can reduce the risk of breast cancer by making cells less susceptible to malignant transformation[1][3]. Early pregnancy, particularly at a young age, has been associated with a reduced risk of breast cancer, possibly due to the protective effects of cell differentiation and reduced lifetime exposure to endogenous hormones[1][3].

### Breastfeeding and Estrogen Exposure

Breastfeeding is known to delay menstrual cycles, thereby reducing a woman's lifetime exposure to estrogen, a hormone that can stimulate breast cell growth and increase cancer risk[2][4]. Studies have consistently shown that breastfeeding, especially for extended periods (at least a year), is associated with a decreased risk of both hormone receptor-positive and hormone receptor-negative breast cancers[1][2][4]. This protective effect is attributed to the hormonal changes during lactation, which reduce estrogen levels and promote cellular differentiation in the breast tissue[2][4].

### Research on Reproductive Factors and Breast Cancer

Research on reproductive factors supports the association between pregnancy, breastfeeding, and reduced breast cancer risk. Factors such as early age at first pregnancy, multiple pregnancies, and extended breastfeeding have been linked to lower breast cancer risk, primarily due to reduced cumulative exposure to endogenous hormones like estrogen[1][2]. However, the relationship between these factors and specific breast cancer subtypes can vary, with some studies indicating that parity may increase the risk of certain aggressive subtypes like triple-negative breast cancer[2].

### Conclusion

The claim that pregnancy and breastfeeding reduce estrogen exposure, which may influence breast cancer risk, is valid. Both pregnancy and breastfeeding contribute to reduced lifetime exposure to estrogen by altering menstrual cycles and promoting cellular differentiation in breast tissue. These factors are supported by scientific evidence from reputable sources, highlighting the importance of reproductive history in breast cancer risk assessment[1][2][4].

In the context of Dr. Sara Zhal's discussion on hormonal imbalances and women's health, understanding these reproductive factors can contribute to a more comprehensive approach to preventive care and lifestyle medicine, emphasizing the interconnectedness of hormonal health and cancer risk.

Citations

Claim

Sleep affects your hormones within 24 hours of a poor night’s sleep.

Veracity Rating: 4 out of 4

Facts

## Claim Evaluation: Sleep Affects Hormones Within 24 Hours of Poor Sleep

The claim that sleep affects hormones within 24 hours of a poor night's sleep is supported by scientific evidence. Sleep plays a crucial role in regulating various hormones in the body, and disruptions in sleep quality or duration can lead to hormonal imbalances.

### Evidence Supporting the Claim

1. **Cortisol and Stress Hormones**: Cortisol, often referred to as the stress hormone, is significantly influenced by sleep patterns. Poor sleep can lead to increased cortisol levels throughout the day, potentially disrupting the balance of other hormones[1][5]. This effect can occur within a short timeframe, as cortisol levels can rise after a single night of poor sleep[4].

2. **Leptin and Ghrelin**: These hormones regulate hunger and fullness. Poor sleep can decrease leptin levels and increase ghrelin levels, leading to increased appetite and potential weight gain. While the effects on leptin may not be immediate, chronic sleep deprivation can significantly alter leptin levels over time[4][5].

3. **Growth Hormone (GH)**: GH secretion is closely tied to sleep patterns. During sleep restriction, GH secretion patterns can become biphasic, with both pre- and post-sleep onset pulses, affecting glucose regulation and potentially leading to metabolic issues[3].

4. **Reproductive Hormones**: In women, sleep affects the balance of reproductive hormones like estrogen and progesterone. Disrupted sleep can lead to fluctuations in these hormones, impacting menstrual cycles and overall reproductive health[2][5].

### Conclusion

The claim that sleep affects hormones within 24 hours of a poor night's sleep is supported by evidence showing that sleep disruptions can lead to immediate changes in cortisol, leptin, ghrelin, growth hormone, and reproductive hormones. While some effects may be more pronounced with chronic sleep deprivation, acute sleep disturbances can initiate hormonal imbalances that manifest within a short timeframe.

### Recommendations for Future Research

– **Mechanisms of Hormonal Regulation**: Further studies are needed to elucidate the precise mechanisms by which sleep influences hormonal balance, particularly focusing on the interplay between sleep stages and hormone secretion.
– **Gender-Specific Effects**: Research should continue to explore gender-specific differences in how sleep affects hormonal health, especially during life stages like menopause.
– **Lifestyle Interventions**: Investigating the effectiveness of lifestyle changes (e.g., sleep hygiene practices, stress management) in mitigating hormonal imbalances associated with poor sleep is crucial.

Citations

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