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Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Dr. Keesha Ewers is an integrative medicine expert, Doctor of Sexology, Family Practice ARNP, Psychotherapist, herbalist, is board certified in functional medicine and Ayurvedic medicine, and is the founder and medical director of the Academy for Integrative Medicine Health Coach Certification Program. Dr. Keesha has been in the medical field... Read More
Was recently named one of “The Biggest Names in Anti-Aging Medicine” by The American Academy of Anti-Aging Medicine (A4M) Author of the books, Menopause and Natural Hormones and Happy Healthy Hormones: How to Thrive in Menopause Founder of Brite (www.brite.live) and I Wonder, Doctor (www.iwonderdoctor.com) Founder and co-chair of the... Read More
- Pick up on and dispel notorious myths about hormone safety
- Discover ways to replenish your hormones naturally
- Learn about the ins and outs of hormone testing
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Welcome back to the Reverse Autoimmune Disease Summit, everybody. This is version 5.0. We’re talking about your energy body. And my guest today is talking about the hormones and a roadmap for making sure they are healthy because, of course, they affect our energy in so many different ways. Dr. Rosensweet was recently named one of the biggest names in anti-aging medicine by the American Academy of Anti-Aging Medicine. He’s the author of the books “Menopause and Natural Hormones” and “Happy Healthy Hormones: How to Thrive in Menopause.” He’s the founder of Brite and “I Wonder, Doctor.” He’s the founder and co-chair of the Coalition to Protect Compounded Bioidentical Hormones. He’s the organizer of a national summit committee on the treatment of women in menopause with bioidentical hormones and a principal investigator for a scientific study on female hormones. Welcome to the summit, Dr. Rosensweet.
Daved Rosensweet, MD
Whew.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I know, whenever I hear my bio read, I always think that sounds like an interesting person I’d like to get to know.
Daved Rosensweet, MD
There’s a lot of work went into all those.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah. So-
Daved Rosensweet, MD
Thank you. Thank you, Keesha. It’s an honor and a pleasure to be here.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah, I’m so happy to talk to you about this. This is a cloudy subject for a lot of people who are unaware of what they often hear from their OB-GYNs, are conflicting research outcomes in some of the studies. And I kind of wanna start there and say a lot of people are afraid of hormones and will say, “Are they safe? And is this gonna put me at a risk for breast cancer?” And I would love to just start right there.
Daved Rosensweet, MD
Yes, and I’m gonna back up to something you just said. It’s cloudy to those who haven’t put time and energy and commitment.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
And specialized in it. It is not cloudy at all when anyone, even a layperson, could put in the time, the energy, do the research, get the education, see patients. Laypeople can’t do that. But it starts clearing up, and you can see, wow, this is not more complicated than any other thing going on in medicine, which is complex, and it’s individualized. But I wanted to clear that up because there is a major cloud, and that cloud occurred, perfect segue into the risk information. Because in a little background on this, men and women have been treated with hormones for over 1,000 years that we know of, 1,000 years. The Chinese were sending young women into outhouses to collect their urine and in a different outhouse for young men, collect all their urine, dry it out, put it in pill form, take it because the urine contains hormones. And the aristocracy was receiving the benefit of that. And then various other attempts were made over the course of time, but a major attempt was done in the ’40s and ’50s with the pharmaceutical industry thinking, why don’t we do something like that? And let’s choose a large animal that we get a lot of urine from, and it has a lot of hormones. So they chose the horse. They impregnated mares and put catheters in them to collect their urine in stalls. Ugh.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mm-hm.
Daved Rosensweet, MD
But they needed a large source, and they dried that urine out and put it in pills and put a heavy coating around it because it smelled like urine. If you went through that coating, it smelled like urine. It’s given the name Premarin, pregnant mare urine. And you know, since the ’50s, women have been benefiting from this. By 2002, 18 million American women, 40% of those in menopause, were on Premarin or Prempro. And they did really good. And you could tell the difference, and they could tell the difference between themselves and their friends. And then out comes this study in 2002 called the Women’s Health Initiative, and it was misinterpreted. It never had the information that exploded out by the press. It never had it in there, but what the press grabbed was women were at risk for breast cancer if they took Prempro. That was Premarin with this artificial progestin called Provera. But even in the scientific article, it said, “But the incidence was not statistically significant,” which in medicine, that means that’s junk science. However, it scared women and healthcare providers all over the planet because that’s what the press reported.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Well, and once it’s in the press, then the healthcare providers know that they’re going to be in the court of public opinion, so then they’re frightened, too, yeah.
Daved Rosensweet, MD
Well, they were frightened by the misinformation because God knows what percentage of those providers actually read the study because if they read the study, they’d see it right there that there was a reduced incidence of breast cancer with Premarin alone, reduced incidence of breast cancer. Women who were put on Premarin alone had less incidence of breast cancer than women who had no treatment at all.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I thought with WISH’s, too, that, maybe I’m thinking of a different study, but it was stopped because women that had been postmenopausal for some time and then put on estrogen were having heart issues.
Daved Rosensweet, MD
That’s a different subject. And that’s an interesting subject. But in the study, women on Prempro were said to have a 1.26 increased relative risk, which was statistically insignificant. You never publish anything that’s statistically insignificant in science. That’s called no evidence whatsoever. It’s as good as nothing, but it was too late. The cat got out of the bag. No one put it back in the bag. Very few people really saw that. I read that study and I went, “Why did they do, Why did they report this? This is statistically insignificant,” and so did several of my colleagues. But there was very few people who really got what had gone on. Well, the study committee went on to follow up on these 16,000 women that were in that study, and they finally retracted it, same study committee, same journal. They published in 2017 that after 18 years of follow-up, there was no increased incidence of breast cancer, heart attack, and stroke. Now, how many physicians and women have heard that? Very, very few.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yep.
Daved Rosensweet, MD
But the critical thing is that was misinformation. I looked in the European literature. I looked in other literature, and I went, “Wait a minute. What are they doing here? This is like a massive misogynistic event, to take these 18 million women off of these hormones.” And very few were on it after that, like a million or two. And even now in a published study in 2016, there’s only a recovery of six million women are on hormones out of the 18 million. And over half of ’em are on compounded bioidentical hormones, by the way. That’s another story. But the fear and the confusion is being clarified. Even the biggest medical societies are retracting, that relate to menopause, the North American Menopause Society and the American College of Gynecology is starting to print the retractions because the study committee printed a retraction. They’re starting to get it, but it’s just eking its way out there, and who knows what the percentage is. If you go to any healthcare provider on the planet, they care. They’re not wanting to injure women. They’re not wanting to put women at risk for breast cancer. That’s what they heard. They haven’t heard differently. Very small percentage have heard differently.
So a woman’s gonna get a very mixed message, and she’s very often gonna hear, “No, I’m not gonna give you hormones. That would put you at risk for breast cancer.” That’s false. Let me give you what the science is. And anyone, for example, who really wants to get really informed about this should read a book called “Estrogen Matters” written by Avrum Bluming and Carol Tavris. Dr. Bluming is an oncologist specializing in breast cancer. That “Estrogen Matters” goes into the scientific details, 450 references. Have a ball. It’s great. It’s a fantastic book. And he refutes and points out, and here’s the science. When you distill it down, we’re all at risk for, I’m a medical doctor. I know we’re all at risk for thousands of diagnoses. Some of ’em are very unpleasant. And we’re all at risk for hundreds of cancers. There’s reasons for that. As a male, I’m at special relative, increased relative risk for prostate cancer, and there’s reasons why that’s so. Women are at increased risk for breast cancer, relatively, and there’s reasons why that is so. However women who are treated with hormones are at less risk for breast cancer, heart attack, and stroke than women who receive no hormonal treatment. That’s the study.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
And osteoporosis.
Daved Rosensweet, MD
Well, that’s a different story. Women who are treated with hormones are at less risk for breast cancer, heart attack, and stroke, yes, and osteoporosis.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
And osteoporosis, yes.
Daved Rosensweet, MD
And several other things, significant things like cognitive decline.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Vaginal dryness, painful intercourse, yeah.
Daved Rosensweet, MD
Yeah, yeah.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah, sleep disturbances.
Daved Rosensweet, MD
That’s the science.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
That’s the actual science. So that is being pushed out there but with nowhere near the explosiveness and widespread coverage that the original falsely based fear got out there. And in case you haven’t noticed, and I bet you have, there’s misogynistic energy on this planet that is just baffling. It’s been going for a long time, and it’s still going on, and that was a great example of it. I think people would deny that that was their intention, but that was the result.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
Millions and-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I think the little pink ribbon has been really imprinted to women as like, watch for breast cancer all the time. It’s everywhere, and that pink ribbon, I think has the word estrogen laid over the top of it. They’ve been commingled, and you know how we are with our symbols and the imagery that we have that gets imprinted in our consciousness. And so it’s important that this gets out there so that those things can start getting separated and untangled inside of the narrative that we live in. So I appreciate your work and your time here.
Daved Rosensweet, MD
Mm-hm.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
So just to repeat, I know it might sound repetitious, but women who are treated with hormones, and here we’re talking about horse urine-derived estrogen and a funky molecule called MPA, medroxyprogesterone acetate, and progestin, women who are treated with those are at less risk for breast cancer, heart attack, and stroke than women who do not receive hormonal treatment, less risk. These hormones are tremendously protective.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mm-hm. Well, and there’s also a way to test to make sure that the hormone pathways, the metabolite, your liver, that all of it is doing what it’s meant to do. The days of feeding Lance Armstrong super therapeutic doses of hormone and winding up with cancer, we know a lot more now than we did 20 years ago in terms of how to check to make sure you’re not holding onto a metabolite that could possibly be carcinogenic. And I find that gets lost in the story, too. We can follow what your hormones are doing now.
Daved Rosensweet, MD
You know, I’m very familiar with those details, and I do a 24-hour urine hormone test that checks every significant metabolite. And I’m very familiar with the metabolite information as it applies to risk. And, you know, it’s pretty controversial.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I know it is.
Daved Rosensweet, MD
And it really comes down to, well, what in the heck causes cancer? And the way I like to explain it to patients is, well, let’s pretend on this wall behind me, we had a video of your whole life, 24-7 from the time you were conceived until now. And the videographer had an editing button that was magical, and they pressed that button, and all the good stuff disappeared. All the good footage disappeared, all the times you ate well and were careful about what you ate, all the good exercise that you did, all the avoidance of toxins, environmental toxins that you did, how clean you kept your own personal environment, and the elephant in the room, how much skill and tools you had to deal with the stress of life so that you didn’t trigger the biology of the stress response.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
And genetics, yep.
Daved Rosensweet, MD
The stress is part of human life, but how we deal with it can be very detrimental. Well, there, we’re talking about four of the five reasons why people get ill.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yep.
Daved Rosensweet, MD
The fifth one is mysterious. There’s things you can’t explain. I can’t explain it. But what we would see in that edited video is hundreds, if not thousands, if not a hundred thousand, indiscretions, funky food loaded with herbicides and pesticides, too many carbohydrates, all the errors, poor digestion, intestinal problems. We’d see all the errors people were making. We’d see-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Childhood trauma, you know, not even errors but things that happened and then didn’t get healed properly, too.
Daved Rosensweet, MD
Exactly.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
Didn’t have the information, tools, and support to heal the trauma.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yep.
Daved Rosensweet, MD
And ’cause it’s all healable.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yep.
Daved Rosensweet, MD
Then we would see the story of how people get ill, how the immune system gets compromised, how it doesn’t do its daily jobs, one of which is to pick up cells that don’t belong there and go, “What is that cell? It looks abnormal. Well, let’s just gobble it up.” Because we’re producing aberrant cells, cancer cells, but a good immune system will pick ’em up and chew ’em up and spit ’em out, so to speak. Well, what we would see in that video would be the thousands and thousands of indiscretions that led to illness, led to a weakened immune system. There’s the causes of something so profound as cancer, not to mention the emotions and the consciousness and what’s missing from life like happiness and love and the good stuff that keeps us really healthy and vibrant. There’s thousands and thousands of events there, and people would love to pin it down to hormones, but hormones don’t cause illness.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
They don’t cause cancer. Hormones don’t cause cancer.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
One of the things I think that our scientific model has had as a downstream effect is this reductionist way of thinking where we’re always looking for the one thing, and I always tell people it’s called critical mass. There’s never one thing. It’s critical mass. And anything that’s piled up on one side of that scale, we just have to take a look at that and then start taking them off. So yeah, this is a really important discussion about it’s not just one thing.
Daved Rosensweet, MD
And it isn’t hormones.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mm-hm.
Daved Rosensweet, MD
And for that matter, in my opinion, it’s not a metabolite. Yes, we can process metabolites in, not in the most common way. Well, why is that happening? Because someone’s liver is not behaving properly. Well, why is that happening? ‘Cause sometimes they’re dealing with too much sewage from the gut, and they’re overwhelmed by the environmental toxins. So the livers aren’t functioning properly. Now, that’s far more significant health-wise. So when I see an unusual metabolite present in greater numbers than what I expected, I immediately ask the question, how’s that person’s liver doing?
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
That’s what I do, too, yep.
Daved Rosensweet, MD
And we know how to evaluate the liver. And then once we see that the liver is compromised, like if you can’t drink a cup of, if you used to drink a cup of coffee any time of day, and it was no problem, and now you can’t drink a cup of coffee at eight o’clock at night, you got a different liver than you had when you were 20. I’m not saying you personally, Keesha. I’m just saying me personally or many others. Your liver is not functioning properly, and that’s an issue. It doesn’t mean it can’t be healed, but there’s many ways to assess the liver. And then if the liver is not working right, like I’m repeating myself, you gotta look at that intestinal tract because the liver is downstream from that intestinal tract. And intestinal imbalances and unhealthy intestines are really epidemic.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yep.
Daved Rosensweet, MD
So the knee bone’s connected to the thigh bone, and it ain’t the metabolite. It’s what in the heck caused that metabolite to be off. Now, that’s an issue.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Right. So let’s talk about, you mentioned earlier compounded, the word compounded, the word bioidentical, synthetic. So what is all of this in terms of defining it? People are exposed to lots of different ways of bioidentical hormone replacement, compounded bioidentical hormone replacement, plain HRT.
Daved Rosensweet, MD
Yes, excellent question. I’ll give you different perspectives on this. I started out treating women in menopause in 1993, and very quickly, and there was very little information, almost zero. We were taught zero in medical school, and there was very few people who had really specialized in treating women in menopause. So I was sort of winging it. And what I decided to do was inform women of the important things they needed to know because the hormones were going in the women’s body. For example, if she had hot flashes, the most likely cause was low estrogen. Well, what dose should I give her? I didn’t know. And there was no published. As far as Premarin goes, which I wasn’t going to use, I knew molecularly identical, bioidentical hormones existed, but I didn’t know what dose to use. So I did a very common process called titration. I started with low doses and gradually had her increase the dose with the hopes that her hot flashes would disappear. And they would somewhere along the line. If she’s increasing that dose, the hot flashes would disappear.
And if she got too high, she’d get breast tenderness. That’s estrogen overdose. So we’d have her back down. So, the patient herself was going through a process to discover what the optimal dose was for her. I had been taught that from a mentor of mine, Alan Gaby, who taught me how to do that with thyroid. You start low. You gradually increase. So when people get the right dose, they feel better. They got energy. They feel good. But if you go too high, they’re gonna get tremors and palpitations. There’s symptoms of overdose. These hormones are so powerful, you get to feel ’em, including overdose. And here’s what I learned. Women were coming in with all kinds of dosage needs. Some women functioned really well with this amount. Other women took three times that amount. How do I know that? I also tested them. I got into 24-hour urine hormone testing really early on. And both of these women were healthy. This goes for young women, too, who are menstruating. There’s some women that they’re healthy. They menstruate at this level of estrogen. They can get pregnant. They can carry the pregnancy to term, have healthy babies, go back to cycling.
Other women need this much estrogen. There’s a wide, wide range. Well, it didn’t matter to me because the woman would find her own dose. But the startling thing to me was there wasn’t a single dose. There wasn’t I could say, well, here, take three milligrams, and you’re gonna be fine. No, it was a very wide range. In fact, to give you an example, in using topical estrogens, the range in my practice, well, the average amount is 1.7 milligrams of estradiol equivalent, but the range is 0.8 to 2.6. That 2.6 is three times plus higher than the low end. Women fall somewhere in there. And individualizing things is a beautiful way to go. You get it for the individual. Well, you can’t do that with Premarin, which offered two doses. But from time immemorial, there was these pharmacists who took the basic stuff and made up their own gels and creams and potions and bottles. They were called compounding pharmacies. They compounded this stuff. They took one thing and another thing, and they put it together, compounding it. And they prepared these prescriptions individualized for the person. All pharmacists were compounders until about the ’50s or ’60s when we get the rise of these big-box pharmacies that are just co-dispensing. They’re no longer preparing their own stuff. They’re counting pills. But in America right now, there’s about 8,000 compounding pharmacies all around the United States. They still exist, and what they can do, which is so crucial, is I can write a prescription for exactly the amount of Biest milligrams per milliliter, and the exact ratio of what’s in Biest, estriol and estradiol. And I can specify it for the individual person. And there’s no way that a manufacturer can do that because there’s hundreds and hundreds of variations ’cause we’re all different, you know.
We might look alike. We might all walk and talk, most of us, but the individual needs vary enormously. So we wanna individualize the prescriptions. You can do that with a compounding pharmacy, who’s gonna make it up from scratch. That’s what compounding pharmacies are. The pharmaceutical manufacturers took such a hit from their loss of the most popular and profitable drug of all time, Premarin, and watching the compounding pharmacies gain traction that they’ve come up with their own version of bioidentical, but they’re limited. They’re 30 years behind, as so often the case. So bioidentical, what does that mean? Well, horse urine estrogen is different than human female estrogen. It works but not great. 50% of what’s in horse urine, estrogen, the human female has never seen. 50% of it they have, and it sort of works. Well, why do that? So, simultaneously in the early 1980s, a pharmacist, Jim Hrncir, to name his name, and a pioneer holistic medical doctor, Jonathan Wright, in Washington, simultaneously, they came up with an idea. We know that pure molecular hormones exist.
Why don’t we prescribe that? Why don’t we see if we can get that and have our compounders make up these individualized prescriptions? And sure enough, Jim is a pharmacist. He knew that he could get pure powdered estradiol, and he did, and he put it up in a gel and gave it to his wife as his first patient. And Dr. Wright came up with something called Biest. That’s a whole other story, but it’s the same molecule, and they’re derived from plants because we don’t look like plants, but we have a lot of similarities to plants. And one of them is those plants are running some hormones. And so they could extract the precursor from plants. Soy is very abundant in it, and pharmaceutically and chemically make changes in it, modify it, and turn it into a molecule that’s exactly the same as what comes out of a woman’s ovary. That’s what bioidentical is, same molecule. Whereas a lot of stuff in the market is not the same molecule. It’s different. The most extreme is Premarin, horse urine-derived estrogen. Now, when you’re making up a compounded hormone for a woman, it also matters what you put it in because, Should I go here, or should I slow down here? Maybe you wanna ask another question.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
No, absolutely go here. My compounding pharmacy here locally in the state of Washington, I always, we talk about what the carrier is. So yes, I would love to have that talked about.
Daved Rosensweet, MD
So, estrogen and testosterone are imperative for every woman in menopause. A young woman has more testosterone than she has the most potent estrogen, estradiol. Testosterone is not a male hormone. It’s a human hormone, and women need their testosterone. If they don’t have it, they lose their muscles. They lose the muscle that holds up the bladder. That along with vaginal atrophy, you get to wear adult diapers. And it’s what drives most women into assisted living facilities and nursing homes, is the loss of muscle. So you need testosterone, and testosterone and estrogens are best and safest and most effective to be applied to the skin. So compounding pharmacists make them, make up, they take the powdered hormone, and they add it to something. Now, these hormones are fat-soluble. They do not dissolve in water. So you can’t put ’em up in a water solution. And you need strong solvents, actually, to get them up into solution so that when you click your thing, or you stick a scoop in there, you’re always getting the same dose because they’re in solution. So about 18 years ago, I had been treating women for 10 years. I’d never seen a hormone. I faxed a prescription to a pharmacy in Albuquerque. I was in Santa Fe, and he shipped it to my patient. And then one day, they shipped it to my office instead of the patient. It came in this white cosmetic jar, and I was absolutely fascinated. I had never seen a hormone, and I broke the seal. I wanted to see a hormone. And I opened up the jar top and out comes this very strong odor, and it was the solvent. And I did some research on that, and there’s toxic potential in these strong solvents. So my son and I went on to invent an organic oil, certified organic oils base. We have three really strong patents on it, and here it is. This is it. So we deliver these hormones in a certified organic oil, and it’s not a solution, so you have to rotate the bottle before you use it, but that’s all it takes. So the base matters, too.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mm-hm.
Daved Rosensweet, MD
So compounded bioidentical hormones in a certified organic oil base is state of the art. And if you want to post a no-charge PDF version of our book on your website, we will gratefully give you that so women can read all about it.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah, we’ll have it as a free gift for our audience. Thank you for that.
Daved Rosensweet, MD
That’s great.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
That’ll be great, and then they can read it, yeah. My compounding pharmacist puts retinol in with mine, and I put some of it on my feet, and it works really well.
Daved Rosensweet, MD
Hormones are great for the skin and,
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah, yeah. I’m not a fan of fillers and Botox. And I started getting lip lines after I went through menopause, and I thought, oh, I’m looking kind of mean. I don’t mind wrinkles, but I don’t want to have a pursed mouth. And so I called my pharmacist at our local compounding that I order everything through, and I said, “Okay, I need to troubleshoot with you,” you know? And she said, “Oh, we do this really amazing face cream, and it works like a miracle. It’s amazing.” So, yeah, hormones can be delivered in a variety of ways and mixed with other things, too, which is what the compounding, it’s so beautiful. It’s like what you were describing, the way they used to be in the ’50s, right?
Daved Rosensweet, MD
Yeah, they’re so good at that.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mm-hm, yeah. What about women that really aren’t convinced about hormones, and they wanna take things like black cohosh or wild yam or tribulus or maca root, any of these kinds of things? What is your opinion about them?
Daved Rosensweet, MD
Well, hormones are the most powerful biochemicals in our body, and they have universal effects. There’s so many estrogen receptor sites in the brain, it’s outrageous, and in the bones. So when you lose your hormones, you lose your bones and your brain. A lot of women really lose cognitive ability. They’re in the arteries. They’re all over the place. And I know that there’s a desire to, quote, do menopause naturally, but I’ve yet to hear any woman say it works. And 25%, 75% of women have disabling symptoms when they go into menopause, can’t sleep, mood changes, problems big enough to really slow down their life. 25% don’t. So there’s many women who will say, “What’s the big problem with menopause? Go through it natural.” They lose their bone. They lose their muscle.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I’m one of those women because I didn’t have symptoms. My liver works great. My adrenals are happy. Like, I walk my talk. And so when I went through menopause, I didn’t have any of the symptomology, not one hot flash. My sleep’s still great, cognitive function, fabulous. And you know, just the lip lines happened. And then I had Adexa, and I was having rapid, I went from great bones to osteopenia in the matter of a year. And so I said, “Okay, we need to stop that plane crash, the nose dive that I’m taking.” And that was very much an argument to convince me that it isn’t just about hot flashes and overt symptomology, that there are things happening behind the scenes that will show themselves eventually. But it’s nice to prevent them.
Daved Rosensweet, MD
And it’s big stuff that happens.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Big, yeah.
Daved Rosensweet, MD
To everyone. And it creeps up on you. It doesn’t happen overnight. So even the 25% who have no symptoms, they lose their muscle, and they’re losing their bones. And you don’t wanna find out about it at the age of 80.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Yeah.
Daved Rosensweet, MD
When you have your first fracture, or you’re having cognitive decline. It’s much easier to address these things early on. They’re addressable for women in their 80s, but it’s not easy. I can tell you having experience with this. So, black cohosh, these herbs have functions, and technically they’re called medicines. They force the body into, because they’re not food, Things are either medicines or food. Food integrates into our body, becomes our skin and our bones. Medicines force the body into react. Well, you’re not gonna get those ovaries to react. They don’t do it. They stop. So you’re gonna do some artificial thing, and you can alleviate symptoms, but then to me, that’s very deceptive. And the thing with medicines is, best case with medicines, they can be beautiful, but you wanna use them properly, which is usually for a short period of time, get the effect, and then stop taking them. Hormones, I mean, I’ve been taking my testosterone, and I will take it to the last day I’m on Earth, my last breath. You wanna take ’em your whole life. And you’re just replenishing molecules that you’re no longer producing. When a woman comes to us in the first consultation, if we sense a reluctance, we do not prescribe the hormones.
And we do not encourage the woman to, “Oh, you should do it.” What I say: “Listen, this is not a medical emergency. Your body, your being your heart, your soul, you’re gonna know what’s right for you, and sooner or later. Right now, you don’t know the answer. You’re trying to gather some input, including information. that’ll help you discover whether hormones are right for you. It doesn’t matter if they’re right for somebody else. It matters what you feel about it. And what I promise you is if you keep researching it, read our book, read other books, gather information so you’re knowledgeable about your body and what’s going on, and I promise you sooner or later, you’re gonna know what the truth is for you, yes or no. And whatever that is, honor and respect it.” And the majority of those women who we do not treat right away, we see ’em later because very often the symptoms have become so severe, they’re going, “Wait a minute here.”
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Right. So we’ve been talking a lot about women. Let’s talk about men because these changes that happen for women happen for men, too.
Daved Rosensweet, MD
Yeah, nobody knew that, right, until Viagra hit the market and became exclusively popular. And we got an idea of how many men were having erectile function, and erectile dysfunction is led by low testosterone. You can bet on it. Yes, there’s other causes, but low testosterone is at the vanguard. So we’re all, I mean, men, women, doesn’t matter, we put out our highest level of hormones at the age of 20, plus or minus a couple years. Then we’re gradually declining men, women, men, women. Both of us, we’re doing the same thing, adrenal hormones, thyroid, genital hormones. Women have this little quirk where there’s a big droppage to stop menstruation, so can’t get pregnant anymore. One could make a case better to become a grandma at a certain time than a mom. So you can sort of get the evolution. Of course, nobody was going into menopause for a couple 100,000 years. No one was living beyond. There was no menopause, and men were living shorter than the women. So men are doing the same thing. And the consequences besides erectile dysfunction are severe for men, too. Men are losing their bones. Men are getting into our arterial risk. Men are having mood issues. They’re having trouble functioning with the same level of drive and enthusiasm and vitality that they did when they were younger. It’s just a different set of symptoms.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
I’m shocked at, it’s women’s health that often bone scanning is done inside of, right? Our radiology clinic that we send people to is the Women’s Health Radiology Center. And I’m sending men all the time now for Andropause, and I am shocked at how much osteoporosis I’m picking up in men. And it makes me wanna scream to the medical community, “No, this is not a women’s health issue. Bone loss is happening with everyone nowadays.”
Daved Rosensweet, MD
That’s right, and there’s a lot of reasons for it, and hormones are one of the principal reasons.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
Mm-hm, yeah.
Daved Rosensweet, MD
Not enough hormones to help those bones do what they like. They like hormones. They like a lot of hormones. They like to-
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
And for men, testosterone receptors are everywhere. It’s so important. We talk about sarcopenia, but also cognitive function, heart, the same things you were talking about for women and estrogen. So, yeah. Well, Dr. Rosensweet, thank you so much for sharing even a fraction of your wisdom here with us. And hopefully it gets people curious and investigative, and I’m so happy that you’re sharing your book with our audience. I encourage everybody to read it.
Daved Rosensweet, MD
Yes, it’s a pleasure, Keesha.
Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C
All right, thank you so much.
Daved Rosensweet, MD
Yeah, you’re so welcome.
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