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- TODAY'S AJENDA #82
TODAY'S AJENDA #82
Welcome to TODAY'S AJENDA!


I’m thrilled to announce here first (before Instagram, LinkedIn, Facebook, or anywhere else) that I’m launching my SECOND newsletter: Off Duty with Dr. Jen!
For over a year, I’ve been flooded with questions in my Instagram DMs:
Where did you get that? Who makes it? What do you use? What do you wear? Where do you go? What do you take?
I usually never respond to these questions because I’m focused foremost on health, wellness, fitness, and nutrition (and I’m not QVC or HSN!).
But I’m also a real person. When my girlfriends ask me these questions, I answer them. And after all we've been through together, I feel that same girlfriend vibe with you. (Also, since so many of you have asked, I feel a responsibility to respond!)
While AJenda focuses on the science—evidence-based nutrition, hormones, and women’s health—Off Duty will address another aspect of life that may be just as helpful: the friend side.
That’s why I created Off Duty with Dr. Jen.
This is me taking off the white coat, stepping away from the doctor’s desk and the national TV set, and letting you in on the “off-duty” details of my real life, through the lens of a physician, nutritionist, mom, wife, friend, and woman in her 50s.
This is me sharing the things that NO ONE else will have access to. It’s not about journal citations or medical lectures. Every two weeks, you’ll get an email from me about the everyday things:
The restaurants and foods I love
Where I got my famous faux-po
The sunscreen that goes into my handbag
The skin products I use twice a day religiously
The shoes I grab to spice up my favorite jeans
The articles I’m reading and the books on my nightstand
The games I’m learning
In other words, this is the real personal life stuff. The stuff girlfriends share.
Since I want to have an impact on women’s health in the US, Off Duty with Dr. Jen will be a monthly subscription for just $7 a month. A significant portion of every subscription will be donated to Go Red For Women and The American Heart Association to fund research and services for Heart Disease in Women.
I am profoundly grateful for your support, interest and generosity, and together, we will have a major impact on women’s health.
Thank you for trusting me with both your health span and your lifestyle. I can’t wait to share this new side with you.
Join now so you don’t miss the first edition coming out this Friday (October 17th)!

When most people say “weight-loss medication,” they usually mean Ozempic, Wegovy, Mounjaro, or Zepbound. These GLP-1 drugs have skyrocketed in popularity…and price.
Zoom In: These medications can cost up to $1,500 a month out of pocket (and that’s if you can even get them!).
Unfortunately, most physicians aren’t well-informed about the clinical use of these medications. They don’t know who’s a good candidate, who isn’t, and they miss opportunities to help women struggling with post-menopausal weight gain. They may WANT to prescribe one, but they may have no experience managing patients on these drugs, so are understandably reluctant to do so.
Since I’m board-certified in Obesity Medicine, this is a topic I’m passionate about. Here’s the mini-med school on the ‘other’ weight loss medications that are FDA-approved, evidence-based, and won’t obliterate your budget:
1. Phentermine
Phentermine has been around since the 1950s and is one of the most-prescribed weight-loss drugs in the U.S.
The How: It works on your central nervous system to suppress appetite and help you feel full longer.
Typically, people see 5-10% body weight reduction over 3-6 months.
Cost: As low as $20–30 per month.
Cons: It’s a stimulant (similar to amphetamines), so it may raise your blood pressure or heart rate. It’s not an option if you have cardiac disease, hypertension, or anxiety.
It’s also FDA-approved for only 12 weeks, though some obesity specialists use it longer with careful monitoring.
2. Phentermine + Topiramate (Qsymia)
This combination drug (sold as Qsymia) pairs phentermine with topiramate, a medication used for migraines and seizures. Qsymia can be used long-term and works better than phentermine alone.
The How: It stimulates satiety, decreases appetite, and increases energy expenditure. Basically, it makes you less hungry and burns slightly more calories.
Studies show 9–10% weight loss over one year. At my former medical practice in New Jersey, this was my go-to weight loss medication for most of my patients who needed pharmacologic support.
Cost: Generic versions run about $80–100 per month.
Cons: Side effects can include tingling sensations, increased risk of kidney stones, cognitive “fog,” and serious birth-defect risk if taken during pregnancy.
3. Bupropion + Naltrexone (Contrave)
Contrave works on brain pathways tied to reward and craving. It’s particularly helpful for those who struggle with emotional eating. Trials show 4–8% weight loss.
Cost: Up to $800 without insurance. But Contrave offers savings and discount programs that can get your co-pay down to $20-$199 a month.
Cons: Can raise blood pressure, worsen insomnia, and increase seizure risk. And because Bupropion (one of Contrave’s main ingredients) affects dopamine, it’s been associated with suicidal thoughts in young adults.
4. Orlistat (Alli, Xenical)
Orlistat is the only over-the-counter option. You can buy the lower-dose version (Alli) without a prescription, or get the higher-dose version (Xenical) from your doctor. It’s safe for long-term use.
The How: Orlistat blocks your body from absorbing about 30% of dietary fat. In other words, you lose weight by reducing calorie absorption, not by suppressing appetite.
People lose around 5-10 pounds over six months.
Cost: Around $60 a month.
Cons: If you eat high-fat meals, you might get oily stools, fecal incontinence (unable to control bowel movements), and loss of vitamins A, D, E, and K.
5. Metformin
Metformin is used to treat type 2 diabetes. But recently, it’s become an unsung hero for weight management, especially in women with insulin resistance.
In the Diabetes Prevention Program trial, participants taking metformin lost about 5–6% of body weight and kept it off for over a decade.
Bonus Benefits: Metformin is being studied as an anti-cancer, pro-longevity tool. It also improves insulin sensitivity and may reduce the risk of diabetes and cardiovascular disease.
Cost: Inexpensive generics range from $4–10 a month.
Cons: Weight loss is modest compared to other options. Some people may experience mild nausea or GI upset.
It’s also not FDA-approved specifically for weight loss. However, ABOM (American Board of Obesity Medicine) experts often use it off-label.
The Bottom Line
None of these medications (and that includes GLP-1s) replaces the fundamentals of strength training, protein, and sleep. But affordable options beyond the $1,500-a-month injectables do exist.
It can be tricky to find which medication is best for you and your budget. But it’s worth finding out. Almost every negative health outcome that increases with age (heart disease, diabetes, joint problems) is connected to excess body weight.
That’s why I’m a strong believer in being proactive and treating weight gain after menopause with all the tools available in your toolbox.

The research is clear: temperature is the biggest factor in better and longer sleep, and studies show sleep efficiency is best between 68-77 °F. (I personally sleep at 66° and love it!)
Zoom In: Every night, your body undergoes a cooling process to conserve energy and help the brain clear metabolic waste.
Enter: The Eight Sleep Pod 5.* It’s a smart mattress cover that automatically regulates your temperature, from cooling you down during hot flashes to warming you when you’re freezing. The result, their studies show, is up to one full hour of extra sleep each night.
Bonus: The Eight Sleep Pod 5 adjusts independently for each side of the bed. No thermostat wars, and everyone actually rests.
Cost Comment: This next-gen or (JEN) sleep technology is not cheap. But everything in our lives is predicated on good sleep, and sleep is the glue that holds our wellness together.
In the spectrum of pricey purchases that have an impact on our well-being, this is one I personally feel deserves to be high on your list. I love it and have found a significant improvement in my sleep since using it!
Try the Eight Sleep Pod 5 risk-free for 30 days with the code DRJEN for $350 off.

The DUTCH test has been on your radar. So you Google it, but the more you research, the more confused you get. There’s one woman who claims it saved her life, and another who says it’s a total waste of time.
How can the same test get such wildly different reviews?
Let’s see if this test is worth your money or if you should spend that $500 elsewhere.
What’s The DUTCH Test?
DUTCH stands for Dried Urine Test for Comprehensive Hormones:
The How: you pee on filter paper four times throughout the day, mail it in, and get a report showing your sex (estrogen, progesterone, testosterone) and adrenal hormones.
Why Not Do a Blood or Saliva Test?
A blood draw or saliva test only captures one moment in time. But the DUTCH test tracks your hormones across an entire day:
Zoom In: That’s valuable, because your hormone levels fluctuate constantly during menopause. Multiple samples could reveal patterns that a single blood draw can’t.
The idea is that seeing your hormone patterns may reveal why menopause symptoms hit hardest at certain times of day, whether your body is absorbing hormone therapy properly, or if you need to switch dose and delivery methods.
But Can The Test Really Tell You That?
At first glance? The science points to yes.
Research shows that dried urine is as accurate as liquid urine and that four urine samples mirror a full 24-hour urine collection:
Zoom In: The gold standard for measuring hormones in urine is to collect it every single time you pee for 24 hours. DUTCH claims its four samples are as effective.
A 2023 study also found the test can detect whether you’re getting more or less estrogen based on what dose patch you’re using. This sounds like it could help adjust your hormone therapy.
HOWEVER, there is no evidence or expert consensus that we adjust doses of estrogen, progesterone or testosterone based on ANY test (be it urine, blood or saliva). We dose based on clinical feedback: how you’re feeling, not what a number is. (The only exception to this is adjustment of thyroid hormone based on TSH, as well as how you are feeling.)
Doctor’s Note: I find at-home testing (whether it’s blood, urine, or DNA) exciting on many levels.
The science looks promising, but a lot of this research comes from the company’s own laboratory. This doesn’t cancel out the validity of the science, but it does warrant caution and means we need more independent research.
So…Should You Get The Test?
The DUTCH test can accurately measure your hormones. But measuring something and that measurement being useful are two different things. (Analytical validity is not the same as clinical utility!)
Here’s why it rarely changes care:
Treatment stays the same. If you have menopausal symptoms, you'd consider hormone therapy regardless of what the test shows. The management plan doesn't hinge on these numbers.
Hormone levels fluctuate. While the test captures one “snapshot” across a day, today’s numbers can’t predict tomorrow’s.
And in most cases? Doctors can guide your care perfectly well based on your symptoms. There’s no need for a fancy test when a doctor can just listen to you instead.
Zoom In: This is why major medical organizations, from NICE, ACOG, to The Menopause Society, don’t recommend hormone tests to diagnose menopause or figure out if you need more or less hormone therapy.
Not to mention, the test is expensive ($499 for DUTCH Complete and $650 for DUTCH Plus) and rarely covered by insurance.
My Doctorly Advice
If you’re a healthy woman over 50 with classic menopause symptoms, we can usually start and adjust hormone therapy based on how you feel, your risk profile, and—when needed—standard labs like lipids or thyroid. Not a $500 urine panel.
When might it be worth it?
In rare cases, it may help explore unusual questions. For example:
If you’re using compounded hormones and want to compare them to FDA-approved products.
If there's concern that your body isn't absorbing the hormones properly.
We’re answering a very specific question where dried-urine data could add clarity.
But even then, it only makes sense with clinicians who really understand the method's limits.
Otherwise, save your money for strength training shoes and calcium-rich groceries. And yes, I’ve bought tests I didn’t need to. It happens.

How often do you get lab work or blood tests done — and would you be interested in easier access to in-person testing through Ajenda? |
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ABOUT DR. JEN
In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…
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This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material. This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.