Dr. Jennifer Garrison is a long-standing champion of bringing clarity to hormone therapy for women, working with others to dispel the myths and misconceptions around the replacement of estrogen, progesterone, and sometimes testosterone in female bodies.
The Food and Drug Administration validated her work, as well as that of others in this cause, after removing the black box labeling on hormonal therapy after 20 years, just weeks after she spoke at DOC 2025.
“Female bodies have been underserved, understudied, and underfunded,” says Dr. Garrison, Faculty at the UCSF Dept of Cellular and Molecular Pharmacology and the USC Leonard School of Gerontology. “We’re all here to demand better.”
You can hear the rest of Dr. Garrison’s thoughtful talk during the “The Science of Women’s Health” session at DOC 2025 in the video below or read our lightly edited transcript.
TRANSCRIPT:
Dr. Jennifer Garrison
Thank you. I’m really excited to be here. And thank you to Jordan, to John, to Stephanie, to Julia, to the entire team. I think this is really exciting. I’m really actually pleased that you’re all listening to this because I think, you have the opportunity to take what I tell you right now, and what we all talk about here on this panel, and transmit it to a much larger audience.
I’m here to tell you, just to set the stage for what we’re talking about. Then, hopefully by the end of my eight minutes, you will agree with me that understanding female bodies will actually help everyone live longer and healthier, including men. So stick with me here. You don’t have to be a scientist or a doctor to understand that female and male bodies are different.
You can see it with your eyes, but that extends further down to the cellular, to the molecular level. There’s lots of diseases that manifest the same between the sexes, some that manifest differently, like heart disease and some that are only in one or the other, like endometriosis or prostate cancer. But it’s pretty clear that we know a lot more about male bodies than about female bodies.
We are not here today to rehash all the things that we can agree on, societal taboos, systemic sex bias and biomedical research, underfunding for research, and also a lack of funding for women’s health companies has led us to this point where the female body is like a puzzle that we have not yet solved.
I think most people actually don’t understand that at baseline, females have a shorter health span than males. So if you’re female and you’re lucky enough to live to old age, then you are going to spend a significant period of time at the end of your life in poor health, suffering from one or more age related disease, about 25% longer than if you were a man. So let that sink in for a second. In America, that means that for most women who live to old age, they will spend about 12.5 years on average at the end of their lives, suffering from one or more age related disease. Why is that? That was something that really, drove me kind of crazy.
It’s because we have these organs, ovaries that are aging faster than the rest of the tissues in our bodies. We call them the canary in the coal mine for aging. The fact that that’s happening is what setting up this disparity in health span. It has a profound impact on female health span.
I’m here to tell you that ovaries are not just egg factories. They are for more than baby making. I beg of you, if you don’t remember anything else that I say, please stop calling them reproductive organs. They are important for more than just fertility. And for menopause. They are sitting at the center of a really complex signaling network, a beautifully complex signaling network, and they are talking to almost every tissue in the female body.
They’re talking to your heart, to your bones, your brain, to your skin. I could go on and on. There’s the list. But what they’re doing is they’re promoting health. We do not understand with any resolution what those chemical conversations are. That’s the gap in the science. But what we do know is what happens when you take them away or when they’re not working properly.
One way to think about it is that they are promoting health throughout a woman’s life. And they are important for health at every age. So if ovaries are not working properly, that uncovers different risks for your health depending on your age. So if you’re ten and you’re female and your ovaries aren’t working properly, that means that you might have issues going through puberty.
If you’re 20 and your ovaries aren’t working properly, that might uncover risk for things like primary bone insufficiency or primary ovarian failure in your 30s. If your ovaries aren’t working properly, that uncovers health risks for things that we’re more familiar with, like miscarriage and infertility. And in a woman’s 40s, when her ovaries start to fluctuate and function, that uncovers all of the 135 symptoms that are associated with perimenopause risk for those symptoms. The reason that there’s so many is because if you believe what I told you about ovaries sitting at the center of this complex network, all of those different conversations can change in different ways. When ovarian function starts to fluctuate at perimenopause and so at an after menopause, it uncovers risk for things like increased risk for cardiovascular disease and a whole host of other things that we’ll get to in our panel.
But the key is that throughout adult life, ovaries are important for immune function, for metabolic function. If they’re not working properly, it can change your health risk profile. We call them the architects of health and female bodies, and they are also the pacemaker for aging. Again we don’t understand how they’re working. This is the gap. This is where the science needs to catch up. But what we can say is that the cost of not including female data in our knowledge base, it actually extends beyond adverse effects in women. It’s actually when we miss sex differences, we are missing opportunities for breakthroughs that would impact health in men as well.
One example out of dozens that I could tell you about if you catch me later, is that, you know, male and female immune systems are different. Female immune systems are much better at responding to viruses and dealing with vaccines. If you think about the Covid 19 pandemic, men died at twice the rate of women. We have absolutely no idea why. But differences in immune function, had we understood them better, might have helped us change that that stat. There’s a lot of things like that.
It’s a compelling shift that, that we’re looking at here. For every one of you in the room, whether you participate in terms of philanthropy, investment in women’s health companies, or whether you personally get involved in some way, you all have the opportunity to help us change this trajectory.
These are the statistics. Every $350 million invested in women’s health research, that’s not very much money, should generate around $14 billion for the economy. Now that’s a 40 X return on investment, which I think is better than most markets. That’s on the research side. On the investment side, we are talking about 4 billion people on the planet. There are female.
This is a huge market. I’m not going to go through all the numbers. But we’re talking about tens if not hundreds of billions of dollars in terms of market opportunity. There’s literally no reason not to think about this as a place to get involved. When we talk about these puzzles, solving them is a plus for everybody.
We’re going to talk on this panel. You’re about to hear from two amazing physicians who are going to dive into the clinical aspects of ovarian aging, and also some of the more practical things that we can do. But what I would say is that while we’re waiting for the science to catch up, there are a lot of things that are available right now in modern medicine that are not being applied to women.
There’s a huge opportunity for women to take control of their own health care trajectories. We’ll talk about that. But thinking about cardiovascular health, thinking about understanding your normal approaching menstrual cycles as a superpower that you should leverage instead of something that you have to deal with. Thinking about preventative health. For women’s health, female physiology is complex, and we need to actually acknowledge it and treat it that way. That means that personalized medicine, personalization of approaches like hormone therapy, these are going to become really important as we move forward.
I just want to set the stage for some of the conversations we’re going to be having. Hormone therapy for women right now, is really underutilized. It’s a bandaid. It’s not perfect. It doesn’t work for everyone. What we do know about hormone therapy is that it reduces all cause mortality if it started within ten years of menopause by 30%. We need to turn the conversation around, and certainly it’s a conversation between a woman and her doctor about risk and benefit.
It’s not perfect and it’s not right for everyone. But it should be that we start with hormone therapy, and then we discuss whether there are reasons you shouldn’t take it. We have 50 years of data to show that estrogen is going to reduce your risk of cardiovascular disease, osteoporosis, cognitive decline, and a whole host of other things.
I’ll just end by saying that, for centuries now, female bodies have been underserved, understudied and underfunded. We’re all here to demand better. We can do better. We as a group, you as a group can help with this directly. I’m asking you to do that. I think we want to choose knowledge over ignorance. We want to invest in understanding all human bodies. Because at the end of the day, women’s health is human health. So thank you.