About Annette Thompson

Who I Am

I’m Annette Thompson. In 1995, I built adoption.com from scratch, before the internet was a real industry and before most people knew what a website was. It became one of the largest adoption resources in the world. Over the next 20 years, I founded orphanages and international adoption programs in Ethiopia, Kenya, and Haiti. I adopted 7 kids. I moved countries. I started over more than once.

I am what you might call a recovering optimist — someone who keeps betting on the possibility that information changes outcomes, that ordinary people can do extraordinary things when they have the right tools, and that scaling compassion is actually possible if you think hard enough about systems.

I split my time between Boulder, Colorado and Ajijic, Mexico. Both are good places to think.

Why I Write About Hormonal Health

My mother has Alzheimer’s disease.

I didn’t know — until I started reading the research obsessively — that estrogen is a major neuroprotective hormone. That the Window of Opportunity (the years immediately around menopause) is when estrogen therapy offers the most brain protection. That the WHI study in 2002 scared an entire generation of doctors away from prescribing hormone therapy based on findings that, in retrospect, didn’t apply to the average menopausal woman. That during the 23 years when doctors undertreated women out of fear, excess deaths from breast cancer, osteoporosis, and cardiovascular disease were estimated in the tens of thousands — and the cognitive cost may be immeasurable.

I carry this. My mother’s doctors could have protected her brain. They didn’t know. Or they were afraid. Or the guidelines hadn’t caught up yet. I don’t know which. What I know is that I’m APOE4 positive — I carry the genetic variant that roughly triples Alzheimer’s risk — and that what I do with my hormones in the next ten years probably matters more than almost any other health decision I’ll make.

Then there’s the testosterone story. At 57, I had lost something I couldn’t name. The drive, the clarity, the feeling that ideas could become things. I’d been told it was perimenopause, depression, burnout, “just aging.” A doctor finally checked my testosterone. It was almost undetectable. Six weeks after testosterone therapy started, I was building companies again. With AI, with urgency, with the kind of ambition I thought I’d lost permanently.

I write SmartStrongAlive because I couldn’t find the newsletter I needed when my own hormones crashed. Not the pink-ribbon, soft-light, “embrace your journey” version. The version that reads the PubMed studies, names the bad science, explains the mechanisms, and tells you what to actually do.

What SmartStrongAlive Is

SmartStrongAlive is a Substack newsletter about women’s hormonal health. Specifically: the research the medical mainstream has been slow to adopt, the clinical decisions that cost women decades of quality life, and what the evidence actually says about testosterone, estrogen, progesterone, brain protection, and aging.

I am not a doctor. I do not give medical advice. I am a researcher, a writer, and a woman who has done the reading — and wants to share it with other women who are smart enough to handle the real version of this conversation.

Every article cites its sources. Every claim is traceable. I make the distinction between strong evidence and weak evidence. I tell you when the science is contested.