Rethinking Women’s Hormonal Health
Women’s hormonal health has long been shaped by incomplete data, normalized symptoms, and limited options.
But that conversation is starting to shift.
In recognition of Women’s Health Month, we sat down with Valerie Richards, PharmD, clinical leader at Strive Pharmacy and incoming President of the Arizona Pharmacy Association, to discuss where care has fallen short and how providers can think differently about personalization, access, and patient experience.
Valerie Richards’ Path into Pharmacy and Clinical Leadership
Q: Tell us about your background and how you got into pharmacy?
Valerie Richards, PharmD: I grew up in Gilbert, Arizona, and studied communication at Arizona State University. Pharmacy wasn’t originally my plan—I started as a pharmacy technician right out of high school and found my way into the field from there.
After graduating, I stayed in the pharmacy space and moved into a recruiter role, which is where I began seriously considering pharmacy as a career. I went back to complete my prerequisites and attended Midwestern University.
I spent several years in retail pharmacy and eventually became a pharmacy manager. Over time, though, I was looking for something more clinically focused.
I had a long-time connection with Andrea Daniels, Strive’s VP of Clinical Services—we went to high school together and had both worked as pharmacy technicians. When I learned more about what she was building at Strive, I became really interested and decided to apply.
At the time, Strive was much smaller, which gave me the opportunity to work across multiple areas of the pharmacy—from operations to patient-facing roles. That experience helped me understand how everything connects across the patient and provider experience.
Over time, I became more involved in helping shape the clinical and clinical liaison function, which has continued to evolve as the company has grown.
Today, my focus is on provider education and supporting clinical initiatives, which has been incredibly rewarding.
Why Provider Education Matters in Hormone Regimens for Women
Q: Is there one moment or story at Strive that reaffirmed for you why this work matters?
It comes down to the interactions we have every day with providers.
Many of the protocols we work with may be less familiar in some traditional settings, so there’s often a learning curve. Being able to support providers with education—and seeing the confidence that builds—has been incredibly meaningful.
That’s been a core focus for Strive. We created Strive Sessions to make clinical education more accessible, without barriers like paywalls.
You can see the impact of that in real time, and that’s what makes the work so rewarding.
Why Collaboration Matters in Women’s Health Care
Q: During Women’s Health Month, we’re celebrating the women we serve. What do you admire most about the women you work with?
There’s so much to learn from each other.
At Strive, I don’t just work with pharmacists—I work with people across different departments. Marketing, compliance, leadership—everyone brings a different perspective.
It’s been really valuable to be able to learn from people outside of my direct role.
We also have a Women in Leadership book club, which has been great. It gives us a chance to focus on leadership development and continue growing together.
It’s a largely collaborative environment, and that’s something I appreciate.
What Healthcare Gets Wrong About Women’s Hormones
Q: What do you think healthcare gets wrong about women’s hormonal health?
There are a few key gaps.
First, access. Certain regimens —like testosterone for women—don’t always have commercially available options.
Second, how we think about hormones. Women still need testosterone, and men still need estrogen. The goal isn’t elimination—it’s balance.
And third, the lasting impact of past research. The Women’s Health Initiative shaped how hormone regimens have been viewed for years, but more recent analysis has raised questions about how that data was interpreted and applied.2
Because of that, we may not have served women as well as we could have—and we’re now starting to re-evaluate those assumptions.
The Research Gap in Women’s Hormonal Health
Q: What do you think healthcare still gets wrong about women’s hormonal health?
For a long time, women weren’t consistently included in research.1
Inclusion in clinical trials didn’t become more standard until the 1990s, and recognizing sex as a biological variable in research is even more recent.
As a result, much of what we’ve historically understood has been based on male physiology.
But women’s bodies respond differently—across hormones, metabolism, and more—and we’re still catching up.
You can see this gap across multiple areas of healthcare, and it helps explain many of the challenges providers and patients continue to face today.
Symptoms of Hormonal Imbalance Women Are Often Told to “Live With”
Q: What’s a symptom you see women normalize that they shouldn’t have to live with?
A few come up consistently:
- Midday fatigue, especially that 2–3 PM crash
- Hot flashes
- Mood changes
- Sleep disruption, particularly waking in the middle of the night
- Changes in libido or vaginal dryness
One that comes up a lot is sleep—waking up at 2 AM and not being able to fall back asleep. I’ve even had friends text each other like, “Are you up right now too?”
These are often brushed off as “just part of life,” but they can significantly impact quality of life—and they don’t always have to be accepted as baseline.
Underdiagnosis in Women’s Hormonal Health: Why It Still Happens
Q: Where do you see the biggest gaps in diagnosis or care?
Underdiagnosis is a major issue.
I’ve seen so many women struggle for years to get diagnosed with conditions like endometriosis.
I have a family member who went through this—multiple doctors, ongoing pain, constant symptoms—and it took a long time before someone finally listened. After getting the appropriate intervention, even during recovery, she said she felt dramatically better than she had in years.
You hear stories like this all the time.
Even with fertility, we’ll often say “unexplained infertility” in women, while male fertility is much more directly measured. There’s still so much we don’t understand.
That’s frustrating for patients—and for providers trying to help them.
Menopause and Hormonal Health: Why the Conversation Is Changing
Q: If you could change one thing about how society talks about menopause and midlife health, what would it be?
More openness.
We should be talking about menopause and hormonal health more openly, just like we’ve started to do with other areas of health.
Social media has helped with this—more women and providers are sharing information, and that’s making it easier for people to recognize symptoms and seek support.
The more we normalize these conversations, the better.
Why Personalized Medicine Matters in Women’s Health
Q: Why is it important to defend personalized medicine?
“Because one-size-fits-all doesn’t work—especially with hormone regimens.” — Valerie Richards, PharmD
We see that every single day. Every patient is different—how they metabolize medications, how they respond, what symptoms they experience.
And we’re limited by what’s commercially available.
There are only certain strengths, certain dosage forms, and certain combinations that exist on the market. And those don’t always align with what a patient actually needs.
So being able to personalize—whether that’s adjusting a dose, combining medications, or changing how something is delivered—can make a big difference.
Especially in areas like hormone support.
There’s also sexual wellness. There are not a lot of options available for women; specifically, being able to tailor something to the patient is important.
It allows us to meet patients where they are, instead of trying to fit them into something that already exists.
And that’s really what it comes down to.
How Personalized Hormone Support Shows Up in Clinical Practice
Q: Strive emphasizes personalization in medicine. How does that philosophy show up in your day-to-day work—especially in conversations with providers about women’s health?
Every patient is different—and that becomes clear quickly in practice.
People respond differently to medications, metabolize medications differently, and present with different symptoms. While tools like pharmacogenomics are evolving, much of clinical care today still involves adjusting based on patient response over time.
We see this with medications like GLP-1s, where there’s growing interest in how different dosing approaches may support different goals beyond traditional use cases. There’s also an emerging conversation around broader applications, like inflammation, though research is still evolving.
Personalization also shows up in areas like hormone support and women’s sexual wellness, where standard options may be limited, and care often needs to be tailored to the individual.
At the end of the day, it comes back to this:
Every patient is different—and the approach should reflect that.
Defying the Odds in Women’s Health: Addressing Gaps in Care
Q: When we say “defy the odds,” what does that mean to you?
It starts with acknowledging the gaps—especially in research, diagnosis, and access to care.
Women’s health has been under-studied for years, and that shows up in real ways. Conditions like endometriosis or PMOS (previously known as PCOS) often take years to diagnose, with many patients being told their symptoms are “just how it is.”
I’ve seen this firsthand. I have a family member who went through multiple providers, dealing with constant pain and symptoms, before finally finding someone who listened. Even during recovery from surgery, she said she felt better than she had in years.
That experience isn’t unique.
And again, in fertility, we’ll often say “unexplained infertility” for women, while male factors are more clearly measured. There’s still so much we don’t understand.
So when we say “defy the odds,” it’s not about doing something extraordinary—it’s about closing gaps that shouldn’t exist in the first place, and making sure patients feel heard and supported along the way.
“Defying the odds, when it comes to women's health, isn’t about pushing limits—it’s about correcting what was overlooked.” - VR
What a More Patient-Centered Approach to Women’s Health Requires
Q: If you could redesign one part of healthcare, what would it be?
Access—and time.
I’ve seen situations where someone finds something concerning, like a lump, and can’t get in to see a provider for weeks or even months. That shouldn’t happen.
Even when patients are able to get an appointment, time with providers is often limited. It can feel rushed, and patients don’t always feel fully heard.
A lot of this ties back to how the system is structured—how care is reimbursed, how practices operate, and the constraints providers are working within.
But from a patient perspective, it often means needing to advocate strongly just to be seen or taken seriously.
If I could change one thing, it would be improving access and allowing for more meaningful time between patients and providers.
Career Paths in Women’s Health and Clinical Pharmacy
Q: What advice would you give to women considering healthcare careers?
Healthcare—and pharmacy specifically—can be an incredibly rewarding path. I’ve met amazing people and had experiences that have shaped both my career and my life.
That said, the field is evolving.
Not every path will be the right fit, and some environments can lead to burnout—especially in more traditional settings. It’s important to explore what’s out there, connect with others in the field, and understand the different directions your career can take.
If your goal is to make a difference, there are many ways to do that—whether through research, patient care, education, or clinical innovation.
You will have moments of frustration. There are systems, regulations, and constraints that can feel limiting at times. But there are also moments where meaningful progress happens—and those moments matter.
Overall, it’s been a very rewarding career for me, and I would still encourage it.
Just take the time to understand your options—and choose the path that aligns with what matters most to you.
Key Takeaways on Women’s Hormonal Health for Providers
Women’s health is still evolving—and providers are at the center of that shift.
The opportunity is to:
- Question outdated assumptions
- Stay engaged in ongoing education
- Consider where personalization may support care
Because for many patients, the goal isn’t just symptom management. It’s finally being heard.
Continue the conversation:
- Watch Strive Sessions
- Connect with our clinical team
- BECOME A PROVIDER
About the Speaker
Valerie Richards, PharmD, is a clinical leader at Strive Pharmacy, where she helps lead provider education and clinical initiatives. She is also the incoming President of the Arizona Pharmacy Association and is actively involved in advancing pharmacy advocacy and clinical education.
References
- Whelan AM. Unequal representation: women in clinical research. Cornell Law Review Online. 2021;106:87-127.
- Schweitzer K. New analysis of Women’s Health Initiative data aims to “clear the air” over menopausal hormone therapy. JAMA. 2025;334(15):1318-1320. doi:10.1001/jama.2025.14187
- Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396(10250):565-582
