Full Transcript Women's Health Initiative and hormone therapy backlash 0:05 We talked about sources of medical information. 0:08 When the Women's Health Initiative came out in 2002, when the results of it broke, we doctors were not informed. 0:15 That was the study that showed that women had, you know, a greatly increased risk of breast cancer on premarin and that synthetic progesterone provera. 0:24 And here's how it came down. 0:25 This was in July of 2002. July 9, 2002 was a Sunday night. 0:31 They called a press conference. 0:34 and gave out the results, the preliminary results. 0:37 It was supposed to be an eight-year study. 0:39 They stopped it after three years because they had a much higher rate of breast cancer in the women using Premarin with Provera. 0:45 And they held a press conference. 0:48 So it got blasted out across the airwaves and in newspapers. 0:52 I came to work on Monday morning and didn't know what hit. 0:54 That wasn't put out in a medical journal. 0:57 We weren't given advanced information. 1:02 What study, like, you know, what were the results? 1:05 What were statistics? 1:07 And so that was a really incredible example. 1:11 It was the National Institutes of Health, and I had the opportunity at a women's medical conference to ask the director of the Women's Health Initiative 1:19 from the NIH whether she would do that again. 1:23 I said, You have no idea what it created, it create a pandemonium. 1:28 Women went off their hormones, wholesale, I never had the opportunity to talk to people. 1:33 They just got scared and went off. 1:36 And it's actually estimated that in the first 10 years after that result came out and women went of their hormones, there was anywhere from an excess 20,000 1:48 to 90,00 excess deaths in women aged 50 to 59 due to cardiovascular disease because they were not on their hormone. 1:56 Nobody thought about that. 2:01 it was horrible you know and I had like I said all patients didn't contact me so I saw some people like for their annual exam a year later and they'd be 2:10 like oh I haven't slept in a Let me tell you, sleep deprivation is not good for healthy longevity. 2:19 It will shorten your life and cause premature aging. 2:22 So things that everybody makes fun of, you know, the hot flash, oh, there she goes again, get the fan, really has serious health implications. 2:31 If not just an inconvenience. 2:34 So I had a particular bone to pick about how the Women's Health Initiative results came out. 2:39 It did not come out in a professional way. 2:41 And it put the country in pandemonium and women couldn't find out fast enough from a limited number of people who could give them information what to do
Big Pharma, low-T clinics, and testosterone controversy 2:49 and they went off their hormones. 2:53 Big Pharma, the pills in here are little dollar signs. 2:58 They are really trying to close down compounding pharmacies. 3:03 The makers of Premarin have been on a warpath for the last 15 years to close down compounding pharmacies, trying to get legislation in place, 3:15 not wanting people to have the ability to choose what they want to do. 3:20 So big pharma plays a very big role in this whole issue of hormones. 3:26 You asked about low T centers and low-T. 3:31 Everybody wants to cash in, right? 3:33 So the pharmaceutical companies, Rob and I just looked at something. 3:36 You found a very nice website online talking about the effects of low T. 3:40 And I said, Robin, this is like really slick. 3:42 Let's look up who these ABV people are. 3:45 Sure enough, it was the manufacturers of Androgel, which is one of the commercial androgen testosterone preparations. 3:51 So you've got like the pharmaceutical companies fomenting the low T. 3:55 You've this low-T clinic, which as far as I could tell, maybe there are physicians involved, but mainly it's physician assistants and nurse practitioners 4:04 that staff those clinics. 4:06 And they have a formula. 4:09 You get it done, you know, really fast, and you're back out. 4:13 And they said, oh, here it is. 4:15 At low T center, your testosterone replacement therapy is performed in a comfortable, casual atmosphere, not a stuffy doctor's office. 4:23 We can usually get you in and out quickly. 4:25 Anyhow, I think being in the stuff doctor office, if it's a doctor that looks at your overall health, is a good thing. 4:34 Okay. 4:35 Oh, then who else do we have in the mix? 4:37 We have the lawyers. 4:38 So I told you there were a couple of studies on testosterone that came out earlier this year. 4:43 And one of them was from the VA Medical Center. 4:48 It was published in The Journal of the American Medical Association, called JAMA, J-A-M-E. 5:00 It had men who were on testosterone. 5:02 They did not measure their levels. 5:04 they didn't follow them up with levels or really any blood test. 5:08 It just gave them testosterone I used to work at the Veterans Hospital. 5:12 I can tell you that is a very ill population and so they gave these really ill guys testosterone and some you know the older age group had higher incidence 5:22 of heart attacks. 5:24 it turns out that And there was another study that showed older men had a higher incidence of heart attacks. 5:30 One of the studies was published in JAMA, and a group of knowledgeable doctors, some of them anti-aging doctors got together and really delved into the 5:40 statistics and found that the statistic were so poorly done, it actually showed the opposite, that it cut down on heart attack. 5:48 forced JAMA's editors to retract the article. 5:51 That never happens. 5:53 I can tell you that never happened that medical journals retract articles. 5:57 that article got retracted. 5:58 Well, who knew that?
Myth vs. truth on estrogen, testosterone, and bioidentical hormones 6:00 Was that splashed all over the front pages? 6:02 No. 6:03 So who gets in the mix? 6:05 The lawyers. 6:06 Low T complication? 6:08 Give us a call. 6:11 Testosterone therapy heart attacks? 6:14 give us the call contact us today So you've got the lawyers, they're all over the internet. 6:21 So of course you get scared, oh my god, my testosterone's gonna give me a heart attack. 6:26 You know, is it any wonder that people are confused? 6:32 Female hormones are only for reproduction. 6:35 Myth or truth? 6:37 Myth. 6:37 Myth, very good. 6:40 We talked a lot about this. 6:41 You don't have any questions about that, do you? 6:43 Okay. 6:44 Low testosterone is only a problem for old men. 6:55 Hormones should only be used in menopause for relief of hot flashes. 6:59 They should be at the lowest dose for the shortest time. 7:03 Myth? 7:04 Truth. 7:06 Yeah, estrogen has over 400 functions in the body. 7:11 It does help with hot flash and night sweats, but it does a lot more than that, and we talked about that. 7:17 Helps to maintain muscle, enhance sleep, improve mood. 7:21 Only men need testosterone. 7:27 Testosterone, you know, muscle building is important for women, libido. 7:31 Women have an overall sense of well-being when their testosterone levels are adequate. 7:37 This rather nondescript well being. 7:40 What does that mean? 7:41 I don't know. 7:42 They just, they feel good. 7:44 Let's see. 7:45 Myth versus truth. 7:46 Estrogen is dangerous. 7:47 It causes breast cancer. 7:50 Okay. 7:51 The wrong estrogen is dangerous, especially if it's paired with the wrong progesterone. 7:57 And that was the Premarin and the Provera that were in the Women's Health Initiative. 8:04 Definitely increased risk of breast cancer. 8:06 Okay, so that is the first thing that came out, you know, got blasted all over the place July 9, 2002. What then came, I don't know how many years later, 8:15 four years Oh, we reworked the data and looked at it, and the women who were only on Premarin, they didn't have any increased risk of breast cancer. 8:24 That didn' get blasted all over the place. 8:27 So it turns out it really wasn't the Premrin. 8:29 It wasn' the estrogen. 8:30 it was that progesterone. 8:33 A product that causes like double to triple the rate of cancer, why is it still on the market? 8:40 Ask yourself that, the Provera. 8:43 Why is that not off the mark? 8:44 It's a known carcinogen. 8:47 Big Pharma. 8:49 Okay. 8:50 Estrogen causes heart attacks and strokes myth or truth? 8:56 Okay, the wrong estrogen causes heart attacks and stroke. 9:00 Premarin was given as a pill. 9:03 You had asked about oral testosterone. 9:06 Well, oral estrogen for women ends up causing increased blood clotting. 9:11 It thickens your blood. 9:12 And so what the Women's Health Initiative did, um, The average age of the women that were enrolled was age 67. So remember I said the usual age in menopause 9:22 is 51. They were 16 years into menoppause. 9:25 Remember what I said about once you hit menopause for women, your protection against cardiovascular disease really drops. 9:33 So there were 16 years into menoppause. 9:35 They probably had a bunch of plaque. 9:37 Now we're giving them a pill that thickens their blood. 9:39 And yes, they had an increased risk of clot, venous thrombosis in their legs, heart attacks, and dementia, not Alzheimer's, 9:48 dementia caused by many strokes. 9:52 Why is that estrogen still on the market? 9:58 Okay. 9:59 Testosterone is only involved in sexual function in men. 10:03 Myth or truth? 10:05 Myth. 10:06 Okay, testosterone is dangerous. 10:08 It causes prostate cancer. 10:13 Okay, this is where it gets a little muddy. 10:16 Okay. 10:18 What we do think is like what your oncologist said about breast cancer is that if you have a prostate cancer, testosterone may help it grow. 10:25 It does not actually cause it. 10:28 But then there are all of these contradictions. 10:32 Men with low T have more prostate cancers. 10:38 Giving testosterone after prostate cancer treatment when things are stabilized does not increase recurrence. 10:46 So it's a little hard to figure out and there's some theories about either very high levels of testosterone or very low maybe the problem and in the middle 10:55 is okay. 10:55 It hasn't all been worked out. 10:57 So I agree with if someone's been, we just had a gentleman who got started on hormones who had high PSA at his first visit and I said you really, 11:06 you need to get this checked and he has an early prostate cancer. 11:09 His doctor said come off testosterone. 11:11 I agreed with that. 11:12 But after a period of time, if his PSA goes down and stays down, I would feel comfortable reinstituting it. 11:20 Okay, now the last myth. 11:22 Bioidentical is just a marketing term. 11:25 Biodentical hormones are the same as synthetic ones. 11:29 Yeah, that's a myth. 11:30 And I used to think that before I got into this field. 11:34 I was like, oh, and I tell my patients that, Oh, bioidentical hormones, it's just a marketing term. 11:38 It's no different than, than the commercial product. 11:41 There are some commercial products that are bio identical. 11:45 Prometrium is a progesterone that is bioidentical natural progesterone. 11:50 And there are some of the skin gels in women that are bio identical estradiol, but they don't have a balance with the protective estrogen in them. 12:00 The androgel in men, that's a bio-idental testosterone. 12:04 So I don' necessarily knock that, But to say that they're the same as the synthetic ones, like the oral testosterone, That is not true. 12:12 Their risk breakdown is totally different. 12:16 So, let's see, any other things that I wanna, oh yeah, the Premarin-only users in the Women's Health Initiative actually had 20% reduced breast cancer risk. 12:28 So they had less breast on estrogen. 12:31 50% reduce Alzheimer's risk in estrogen users.
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