How Women Can Improve Their Fertility & Hormone Health | Dr. Natalie Crawford

Fertility is presented here as more than the ability to become pregnant. Ovulation, fertilization, implantation, and pregnancy depend on coordinated hormonal, cellular, and metabolic function; ovarian function also shapes women’s day-to-day experience across life. Crawford links infertility at the population level with higher rates of metabolic syndrome, cancer, cardiovascular events, stroke, and early death, while stressing that infertility does not directly cause those outcomes. Instead, it can be an early warning that something else may be affecting health. These associations are not a prediction for any one person, and the episode frames them as a reason to investigate, not a diagnosis.

That broader view explains why Crawford encourages women to ask their clinicians about anti-Müllerian hormone (AMH). She describes it as a marker of the number of eggs, not a measure of egg quality. The distinction matters: egg quality relates to genetics and developmental competence, whereas AMH offers information about ovarian reserve. For someone who may want children later, knowing this number can inform how they think about future plans. The conversation does not present AMH as a stand-alone fertility forecast; it is one data point to interpret with a clinician.

The discussion also makes room for people who already have children, do not want children, or remain unsure. Their reproductive goals do not erase the relevance of hormonal and ovarian health as part of general health. Crawford’s own history of infertility informs her emphasis, but the point is broader: fertility can provide a window into underlying physiology even when pregnancy is not the immediate goal.

Huberman introduces Crawford’s book, The Fertility Formula, as a practical guide that connects reproductive health with hormone health over both the short and long term. The framing for the episode is actionable but qualified: it will distinguish documented findings from patterns Crawford has observed clinically, rather than treating every online claim as established evidence. That distinction is especially important in a field where population statistics and an individual’s experience can differ.

The conversation distinguishes hormone replacement from supplementation or augmentation. Replacement supplies a hormone the body is no longer producing adequately; in a fertility treatment cycle, for example, adding estrogen after ovulation has not occurred can also require progesterone support. Augmentation, by contrast, raises or supports levels the body still produces. Crawford says the distinction matters because treatment depends on a person’s physiology and clinical situation.

For perimenopausal symptoms, Crawford describes estrogen as a common starting point when production becomes unreliable, with delivery options including patches, pills, vaginal inserts, and creams. Progesterone may be used alone or alongside estrogen, since ovulation changes can also reduce progesterone; some patients feel well on progesterone alone. She places testosterone later in the decision sequence and emphasizes that there is no universal regimen. Tracking cycles and ovulation can help women recognize changes and advocate for care during a transition that may last five to ten years.

On environmental exposures, Crawford rejects an all-or-nothing approach: exposure cannot be eliminated entirely, but that does not make it irrelevant. She notes that microplastics can accumulate in the ovaries and says chronic inflammation is a concern for fertility. The exchange raises the question of whether a previous pregnancy makes a later pregnancy easier, but this section ends with the question rather than an answer; the comparison is difficult because people who have previously conceived are not a clean control group for those who have not.