Episode 9: Reinvention Is a Permission Slip

In this episode Kate Thomas, an AHPRA-registered pharmacist with 25 years of clinical experience, covers:

• Midlife reinvention as access, privilege, momentum and integration rather than burning everything down
• Why learning at midlife is uniquely powerful and what it feels like to hold deep expertise alongside digital naivety
• What testosterone actually does in women and why it is not a male hormone
• How testosterone affects drive, energy, cognition and libido during perimenopause and menopause
• Testosterone as part of a team sport with oestrogen in hormone replacement therapy
• Indications, monitoring and side effects of testosterone therapy for women
• Oral DHEA: why it is not a reliable or safe alternative to prescribed testosterone

Episode 9 opens with Kate on stage at a menopause education event in Sydney, asking herself a quiet but clarifying question: how did I get here? The answer is not a sudden increase in qualifications. It is permission. Permission to be visible, to let 25 years of clinical experience show up in new places, and to integrate deep medical expertise with brand new skills. Kate reflects honestly on what midlife reinvention actually looks like when you are still paying bills and packing lunches, and why the permission to evolve is something many women in perimenopause and menopause are quietly waiting for someone to hand them. 

Testosterone is consistently framed as a male hormone, but women produce it and need it throughout their lives. During perimenopause and menopause, testosterone levels gradually decline, affecting drive, energy, motivation, cognition and libido in ways that are frequently dismissed or misattributed to stress or ageing. In Episode 9, Kate breaks down what testosterone actually does in women with clinical clarity, explaining why it belongs in the hormone replacement conversation alongside oestrogen and progesterone rather than being treated as an optional extra. 

Kate makes the case in Episode 9 that hormone replacement therapy works best as a team sport. Oestrogen, progesterone and testosterone each play distinct and interconnected roles, and treating them in isolation misses the full picture. For women whose libido, energy or cognitive drive has declined significantly during perimenopause or menopause, testosterone therapy may be an important part of a comprehensive HRT approach. Kate covers indications, monitoring requirements and side effects clearly and practically, and explains how to start a sensible, grounded conversation with your prescriber about whether testosterone is right for you. 

One of the most practical sections of Episode 9 covers how to approach the conversation with your GP or specialist about testosterone therapy. Kate explains what to ask, what to expect, and how to advocate for yourself if the response is dismissive. A telehealth pharmacist consultation with Kate is also a great way to prepare for this conversation, helping you understand your options and arrive at your appointment with the right questions and the confidence to ask them. 

Oral DHEA has become the internet's favourite almost-hormone, marketed as a natural way to boost testosterone and support adrenal function. In Episode 9's Wellness Woo of the Week, Kate explains why swallowing raw hormonal precursors and hoping the body converts them into the right hormones in the right amounts is not how biology works. It is wishful thinking. The difference between oral DHEA, vaginal DHEA and properly prescribed testosterone therapy matters enormously, and this segment gives women the information they need to make genuinely informed choices. 

If this episode has raised questions about testosterone, HRT, libido, drive or your perimenopause symptoms, a telehealth pharmacist consultation with Kate is a great next step. In a dedicated one-on-one session you can go through your symptoms, your current medications and your treatment options in plain language, without rushing. 

Kate Thomas offers a range of in-depth telehealth medication consultation and medication review services to help you understand your body and your medications.

You can view the transcript for this episode below