Full Transcript Introduction 0:02 Hey, Margie here. Are you ready to delve 0:02 Hey, Margie here. Are you ready to delve into hormones? Because they can be so 0:05 into hormones? Because they can be so 0:05 into hormones? Because they can be so important for our bones and overall 0:07 important for our bones and overall 0:07 important for our bones and overall health, but we need to know what are the 0:10 health, but we need to know what are the 0:10 health, but we need to know what are the myths, where did they come from, and 0:12 myths, where did they come from, and 0:12 myths, where did they come from, and what does the research really show us? 0:15 what does the research really show us? 0:15 what does the research really show us? Well, today that's what we're going to 0:17 Well, today that's what we're going to 0:17 Well, today that's what we're going to discuss with our very special guest, Dr. 0:20 discuss with our very special guest, Dr. 0:20 discuss with our very special guest, Dr. Feliz Gersh. And Dr. Gersh is a double 0:23 Feliz Gersh. And Dr. Gersh is a double 0:23 Feliz Gersh. And Dr. Gersh is a double boardcertified OBGYn and integrative 0:26 boardcertified OBGYn and integrative 0:26 boardcertified OBGYn and integrative medicine physician. She's a best-selling 0:29 medicine physician. She's a best-selling 0:29 medicine physician. She's a best-selling author and someone I've known and 0:31 author and someone I've known and 0:31 author and someone I've known and admired for years. She's done so much 0:35 admired for years. She's done so much 0:35 admired for years. She's done so much for women's bone health and I just can't 0:38 for women's bone health and I just can't 0:38 for women's bone health and I just can't wait for you to hear from her. She This 0:41 wait for you to hear from her. She This 0:41 wait for you to hear from her. She This interview is full of so much great 0:43 interview is full of so much great 0:43 interview is full of so much great information. So stay tuned. 0:52 Welcome, Feliss, where you've [music] 0:52 Welcome, Feliss, where you've [music] been friends for such a long time and 0:55 been friends for such a long time and 0:55 been friends for such a long time and it's always such an amazing pleasure to 0:59 it's always such an amazing pleasure to 0:59 it's always such an amazing pleasure to be with you because the truth is you are 1:01 be with you because the truth is you are 1:01 be with you because the truth is you are a women woman ahead of your time. I 1:04 a women woman ahead of your time. I 1:04 a women woman ahead of your time. I mean, I have known you probably for 1:06 mean, I have known you probably for 1:06 mean, I have known you probably for around 10 years and you were talking 1:08 around 10 years and you were talking 1:08 around 10 years and you were talking about things that now only are getting 1:10 about things that now only are getting 1:10 about things that now only are getting out into the public such a long time ago 1:14 out into the public such a long time ago 1:14 out into the public such a long time ago and you're just always on top of 1:15 and you're just always on top of 1:15 and you're just always on top of everything and always researchbased. So, 1:18 everything and always researchbased. So, 1:18 everything and always researchbased. So, I just so appreciate the work you do and 1:21 I just so appreciate the work you do and 1:21 I just so appreciate the work you do and thank you so much for being here today. 1:24 thank you so much for being here today. 1:24 thank you so much for being here today. Well, it's always such a fun experience 1:26 Well, it's always such a fun experience 1:26 Well, it's always such a fun experience and yes, what you said is true. I have 1:30 and yes, what you said is true. I have 1:30 and yes, what you said is true. I have lived a lot of what to some of the 1:32 lived a lot of what to some of the 1:32 lived a lot of what to some of the younger doctors is history. So I was 1:36 younger doctors is history. So I was 1:36 younger doctors is history. So I was there upfront center when the women's 1:38 there upfront center when the women's 1:38 there upfront center when the women's health initiative came out about 25 1:41 health initiative came out about 25 1:41 health initiative came out about 25 years ago and I was screaming in the 1:44 years ago and I was screaming in the 1:44 years ago and I was screaming in the wind for decades about the importance of 1:46 wind for decades about the importance of 1:46 wind for decades about the importance of hormones but now they've been like 1:49 hormones but now they've been like 1:49 hormones but now they've been like discovered you know so but I'm really 1:51 discovered you know so but I'm really 1:51 discovered you know so but I'm really thrilled that finally menopause is 1:54 thrilled that finally menopause is 1:54 thrilled that finally menopause is seeing the light of day but you know a 1:56 seeing the light of day but you know a 1:56 seeing the light of day but you know a lot of things still need a lot of work. 1:59 lot of things still need a lot of work. 1:59 lot of things still need a lot of work. >> Absolutely. But it is true cuz my 2:02 >> Absolutely. But it is true cuz my 2:02 >> Absolutely. But it is true cuz my generation was the generation that 2:04 generation was the generation that 2:04 generation was the generation that really missed out when we're talking 2:06 really missed out when we're talking 2:06 really missed out when we're talking about bones and so many things. You 2:09 about bones and so many things. You 2:09 about bones and so many things. You know, this that this was the generation 2:10 know, this that this was the generation 2:10 know, this that this was the generation with the women's health initiative that 2:12 with the women's health initiative that 2:12 with the women's health initiative that estrogen hormones were stopped 2:15 estrogen hormones were stopped 2:15 estrogen hormones were stopped completely. And so only now is there 2:18 completely. And so only now is there 2:18 completely. And so only now is there resurgence and there's a lot of 2:20 resurgence and there's a lot of 2:20 resurgence and there's a lot of confusion. So, we're going to go go 2:22 confusion. So, we're going to go go 2:22 confusion. So, we're going to go go through that because I really want to 2:24 through that because I really want to 2:24 through that because I really want to clear up the picture and there's just 2:27 clear up the picture and there's just 2:27 clear up the picture and there's just nobody better who's done with worked 2:29 nobody better who's done with worked 2:29 nobody better who's done with worked with us for so long and that can do that 2:32 with us for so long and that can do that 2:32 with us for so long and that can do that than you. Let's get started. Let's start 2:35 than you. Let's get started. Let's start 2:35 than you. Let's get started. Let's start out. Do you want to just start out with
History of hormone replacement therapy (HRT) 2:37 out. Do you want to just start out with 2:37 out. Do you want to just start out with what the problem was and why now all of 2:40 what the problem was and why now all of 2:40 what the problem was and why now all of a sudden there's this resurgence and 2:43 a sudden there's this resurgence and 2:43 a sudden there's this resurgence and it's coming back into the picture where 2:45 it's coming back into the picture where 2:45 it's coming back into the picture where people were told no, no, no, that's not 2:47 people were told no, no, no, that's not 2:47 people were told no, no, no, that's not an option for you. You want to just go 2:49 an option for you. You want to just go 2:49 an option for you. You want to just go back just a little bit of history to 2:51 back just a little bit of history to 2:51 back just a little bit of history to make sure everybody 2:51 make sure everybody 2:52 make sure everybody >> Yeah. You know, that's a good idea 2:53 >> Yeah. You know, that's a good idea 2:53 >> Yeah. You know, that's a good idea because what is so like like ingrained 2:56 because what is so like like ingrained 2:56 because what is so like like ingrained into me and you is is really not for 2:59 into me and you is is really not for 2:59 into me and you is is really not for many women it's still what happened you 3:01 many women it's still what happened you 3:01 many women it's still what happened you know what's going on. So back if we go 3:05 know what's going on. So back if we go 3:05 know what's going on. So back if we go back in history in the 1970s 3:11 back in history in the 1970s 3:11 back in history in the 1970s estradile 3:13 estradile 3:13 estradile was not yet available. 3:16 was not yet available. 3:16 was not yet available. So in which is the estrogen that the 3:18 So in which is the estrogen that the 3:18 So in which is the estrogen that the human ovaries make. So what was 3:20 human ovaries make. So what was 3:20 human ovaries make. So what was available because you know you can only 3:22 available because you know you can only 3:22 available because you know you can only use what's actually on the market 3:24 use what's actually on the market 3:24 use what's actually on the market [clears throat] 3:24 [clears throat] 3:24 [clears throat] was conjugated equin estrogens. And what 3:29 was conjugated equin estrogens. And what 3:29 was conjugated equin estrogens. And what are they? That was the brand name is 3:31 are they? That was the brand name is 3:31 are they? That was the brand name is Premaran for pregnant mayor urine. Okay. 3:36 Premaran for pregnant mayor urine. Okay. 3:36 Premaran for pregnant mayor urine. Okay. What they did was they took the urine of 3:38 What they did was they took the urine of 3:38 What they did was they took the urine of a pregnant horse and then they dried it, 3:41 a pregnant horse and then they dried it, 3:41 a pregnant horse and then they dried it, turned it into like a powder and then 3:43 turned it into like a powder and then 3:43 turned it into like a powder and then put it into a tablet and they gave it to 3:46 put it into a tablet and they gave it to 3:46 put it into a tablet and they gave it to human women and it the horse estrogens 3:50 human women and it the horse estrogens 3:50 human women and it the horse estrogens which they call ecoin and it came 3:53 which they call ecoin and it came 3:53 which they call ecoin and it came through the liver first from the horse 3:55 through the liver first from the horse 3:55 through the liver first from the horse so that it could be converted from a fat 3:58 so that it could be converted from a fat 3:58 so that it could be converted from a fat to a water soluble product so it could 4:01 to a water soluble product so it could 4:01 to a water soluble product so it could go out in the water which is what urine 4:03 go out in the water which is what urine 4:03 go out in the water which is what urine is like water. So they called it 4:05 is like water. So they called it 4:05 is like water. So they called it conjugated. That's the process in the 4:07 conjugated. That's the process in the 4:07 conjugated. That's the process in the liver. Equin for horse estrogens because 4:10 liver. Equin for horse estrogens because 4:10 liver. Equin for horse estrogens because there was a variety of different equal 4:13 there was a variety of different equal 4:13 there was a variety of different equal or horse estrogens plus other stuff that 4:16 or horse estrogens plus other stuff that 4:16 or horse estrogens plus other stuff that just got in there. Those estrogens were 4:19 just got in there. Those estrogens were 4:20 just got in there. Those estrogens were unique to a pregnant horse. Never found 4:23 unique to a pregnant horse. Never found 4:23 unique to a pregnant horse. Never found in human females. Well, but that's all 4:26 in human females. Well, but that's all 4:26 in human females. Well, but that's all that was available and it did 4:28 that was available and it did 4:28 that was available and it did significantly reduce night sweats and 4:31 significantly reduce night sweats and 4:31 significantly reduce night sweats and hot flashes. Okay. So that was available 4:34 hot flashes. Okay. So that was available 4:34 hot flashes. Okay. So that was available and it became quite popular but then it 4:37 and it became quite popular but then it 4:37 and it became quite popular but then it was recognized that some women would 4:41 was recognized that some women would 4:41 was recognized that some women would develop uterine cancer endometrial 4:43 develop uterine cancer endometrial 4:43 develop uterine cancer endometrial adnocarcinoma at a higher risk like 4:46 adnocarcinoma at a higher risk like 4:46 adnocarcinoma at a higher risk like seven times the higher higher incidence 4:49 seven times the higher higher incidence 4:49 seven times the higher higher incidence than women who were not on prem. That 4:52 than women who were not on prem. That 4:52 than women who were not on prem. That didn't make it a high incidence. It just 4:54 didn't make it a high incidence. It just 4:54 didn't make it a high incidence. It just still made it seven times higher. So 4:57 still made it seven times higher. So 4:57 still made it seven times higher. So then estrogen use dropped and then they 5:00 then estrogen use dropped and then they 5:00 then estrogen use dropped and then they discovered if they added a fake I'll 5:03 discovered if they added a fake I'll 5:03 discovered if they added a fake I'll call it a fake mimic of progesterone 5:06 call it a fake mimic of progesterone 5:06 call it a fake mimic of progesterone because at that time there was no human 5:09 because at that time there was no human 5:09 because at that time there was no human available progesterone on the market 5:11 available progesterone on the market 5:11 available progesterone on the market either. And that particular molecule is 5:15 either. And that particular molecule is 5:15 either. And that particular molecule is called a progesterine. So it's a 5:17 called a progesterine. So it's a 5:18 called a progesterine. So it's a man-made product and the name of that 5:20 man-made product and the name of that 5:20 man-made product and the name of that product is madroxy progesterone acetate. 5:23 product is madroxy progesterone acetate. 5:23 product is madroxy progesterone acetate. Now, it has the word progesterone in it, 5:25 Now, it has the word progesterone in it, 5:25 Now, it has the word progesterone in it, but there's no progesterone in it, okay? 5:28 but there's no progesterone in it, okay? 5:28 but there's no progesterone in it, okay? It's just in the word. So, it does bind 5:31 It's just in the word. So, it does bind 5:31 It's just in the word. So, it does bind like supercharged binding to the 5:34 like supercharged binding to the 5:34 like supercharged binding to the progesterone receptors in the uterine 5:37 progesterone receptors in the uterine 5:37 progesterone receptors in the uterine lining, which it turned out would be 5:39 lining, which it turned out would be 5:39 lining, which it turned out would be protective against the proliferative or 5:42 protective against the proliferative or 5:42 protective against the proliferative or growth factor effects of the the primer, 5:46 growth factor effects of the the primer, 5:46 growth factor effects of the the primer, the conjugated ecoin estrogens. So, by 5:49 the conjugated ecoin estrogens. So, by 5:49 the conjugated ecoin estrogens. So, by giving that in a cyclic, and that's what 5:51 giving that in a cyclic, and that's what 5:52 giving that in a cyclic, and that's what they did. So you'd have a cycle. You 5:54 they did. So you'd have a cycle. You 5:54 they did. So you'd have a cycle. You would use the progesterone mimic for 14 5:58 would use the progesterone mimic for 14 5:58 would use the progesterone mimic for 14 days or 12 days and then you'd have a a 6:00 days or 12 days and then you'd have a a 6:00 days or 12 days and then you'd have a a bleed, like a fake period, and you would 6:02 bleed, like a fake period, and you would 6:02 bleed, like a fake period, and you would do like a pretend cycle. And that 6:05 do like a pretend cycle. And that 6:05 do like a pretend cycle. And that reduced the risk of uterine cancer back 6:07 reduced the risk of uterine cancer back 6:08 reduced the risk of uterine cancer back to square one. And that's what then 6:11 to square one. And that's what then 6:11 to square one. And that's what then caused a very big resurgence in the 6:14 caused a very big resurgence in the 6:14 caused a very big resurgence in the popularity of hormones because the risk 6:16 popularity of hormones because the risk 6:16 popularity of hormones because the risk of uterine cancer was gone. So that 6:19 of uterine cancer was gone. So that 6:19 of uterine cancer was gone. So that became the popular product. And then 6:22 became the popular product. And then 6:22 became the popular product. And then over time they found that they could 6:25 over time they found that they could 6:25 over time they found that they could combine both the estrogen product the 6:28 combine both the estrogen product the 6:28 combine both the estrogen product the conjugated ecoin estrogens premorrin 6:30 conjugated ecoin estrogens premorrin 6:30 conjugated ecoin estrogens premorrin with the madroxy progesterone acetate 6:33 with the madroxy progesterone acetate 6:33 with the madroxy progesterone acetate provera and they called that product 6:36 provera and they called that product 6:36 provera and they called that product prem pro. So it was a combination of the 6:39 prem pro. So it was a combination of the 6:39 prem pro. So it was a combination of the two molecules. They're hormones if you 6:42 two molecules. They're hormones if you 6:42 two molecules. They're hormones if you can call them hormones not human 6:44 can call them hormones not human 6:44 can call them hormones not human hormones. Never either one of them would 6:46 hormones. Never either one of them would 6:46 hormones. Never either one of them would ever be naturally in a human ever. And 6:49 ever be naturally in a human ever. And 6:49 ever be naturally in a human ever. And they marketed that and then it became 6:52 they marketed that and then it became 6:52 they marketed that and then it became super popular like close to half of 6:54 super popular like close to half of 6:54 super popular like close to half of women were on this product and they felt 6:57 women were on this product and they felt 6:58 women were on this product and they felt better and they started doing 7:00 better and they started doing 7:00 better and they started doing observational studies like the women's 7:03 observational studies like the women's 7:03 observational studies like the women's health study. There were other 7:05 health study. There were other 7:05 health study. There were other observational studies and what did they 7:07 observational studies and what did they 7:08 observational studies and what did they find that women who were on this product 7:11 find that women who were on this product 7:11 find that women who were on this product either prein and cycling with pre 7:14 either prein and cycling with pre 7:14 either prein and cycling with pre provera or the combination that they 7:17 provera or the combination that they 7:17 provera or the combination that they seemed to do better particularly in the 7:20 seemed to do better particularly in the 7:20 seemed to do better particularly in the area they noticed of cardiovascular 7:23 area they noticed of cardiovascular 7:23 area they noticed of cardiovascular health and also bone health. So they had 7:26 health and also bone health. So they had 7:26 health and also bone health. So they had fewer fractures and they seem to have 7:28 fewer fractures and they seem to have 7:28 fewer fractures and they seem to have fewer heart attacks and strokes. So they 7:31 fewer heart attacks and strokes. So they 7:31 fewer heart attacks and strokes. So they started promoting it like into the whole 7:34 started promoting it like into the whole 7:34 started promoting it like into the whole population for those purposes and they 7:37 population for those purposes and they 7:37 population for those purposes and they said you know you should use it to 7:39 said you know you should use it to 7:39 said you know you should use it to prevent heart attacks to prevent aging 7:41 prevent heart attacks to prevent aging 7:42 prevent heart attacks to prevent aging to be you know and then even way back 7:44 to be you know and then even way back 7:44 to be you know and then even way back there was a book written in the late 7:47 there was a book written in the late 7:47 there was a book written in the late 1960s. It was either forever feminine or 7:50 1960s. It was either forever feminine or 7:50 1960s. It was either forever feminine or feminine forever. I keep forgetting the 7:52 feminine forever. I keep forgetting the 7:52 feminine forever. I keep forgetting the the you know because it was the idea 7:54 the you know because it was the idea 7:54 the you know because it was the idea that hormones were really a healthy 7:57 that hormones were really a healthy 7:57 that hormones were really a healthy longevity tool and it became so popular. 8:01 longevity tool and it became so popular. 8:01 longevity tool and it became so popular. So the FDA said, "Wait a minute." Okay, 8:04 So the FDA said, "Wait a minute." Okay, 8:04 So the FDA said, "Wait a minute." Okay, you're now saying that this hormone 8:07 you're now saying that this hormone 8:07 you're now saying that this hormone product can help prevent heart attacks 8:09 product can help prevent heart attacks 8:10 product can help prevent heart attacks and strokes. Meanwhile, they actually 8:13 and strokes. Meanwhile, they actually 8:13 and strokes. Meanwhile, they actually gave it FDA approval for prevention of 8:17 gave it FDA approval for prevention of 8:17 gave it FDA approval for prevention of osteoporosis. 8:18 osteoporosis. 8:18 osteoporosis. So it actually got the FDA approval for 8:23 So it actually got the FDA approval for 8:23 So it actually got the FDA approval for two uses for systemic use, total body 8:25 two uses for systemic use, total body 8:25 two uses for systemic use, total body use. One was reduction of night sweats 8:28 use. One was reduction of night sweats 8:28 use. One was reduction of night sweats and hot flashes. The other was 8:31 and hot flashes. The other was 8:31 and hot flashes. The other was prevention of osteoporosis. 8:33 prevention of osteoporosis. 8:33 prevention of osteoporosis. Well, the FDA said you can't keep 8:35 Well, the FDA said you can't keep 8:35 Well, the FDA said you can't keep promoting it for cardiovascular health 8:38 promoting it for cardiovascular health 8:38 promoting it for cardiovascular health unless you prove that it's going to 8:41 unless you prove that it's going to 8:41 unless you prove that it's going to reduce heart attacks and strokes. not 8:43 reduce heart attacks and strokes. not 8:43 reduce heart attacks and strokes. not all this observational stuff where they 8:46 all this observational stuff where they 8:46 all this observational stuff where they would look at a group of women and they 8:47 would look at a group of women and they 8:48 would look at a group of women and they would say, "Oh, the women on the hormone 8:50 would say, "Oh, the women on the hormone 8:50 would say, "Oh, the women on the hormone products had fewer heart attacks and 8:52 products had fewer heart attacks and 8:52 products had fewer heart attacks and strokes than the women not, but it 8:53 strokes than the women not, but it 8:53 strokes than the women not, but it wasn't placebo control, double blinded, 8:56 wasn't placebo control, double blinded, 8:56 wasn't placebo control, double blinded, all that kind of stuff." You know, it 8:57 all that kind of stuff." You know, it 8:58 all that kind of stuff." You know, it was just observational. So, they said, 8:59 was just observational. So, they said, 9:00 was just observational. So, they said, "Well, you because if observational, 9:01 "Well, you because if observational, 9:01 "Well, you because if observational, there could be a bunch of variables. 9:03 there could be a bunch of variables. 9:03 there could be a bunch of variables. Maybe the women who used hormones had 9:06 Maybe the women who used hormones had 9:06 Maybe the women who used hormones had ate a better diet. They were more 9:07 ate a better diet. They were more 9:07 ate a better diet. They were more educated. They were from an upper strata 9:09 educated. They were from an upper strata 9:09 educated. They were from an upper strata of the economy and that kind of thing. 9:11 of the economy and that kind of thing. 9:11 of the economy and that kind of thing. So maybe there are other confounders 9:13 So maybe there are other confounders 9:13 So maybe there are other confounders that would make them have a better 9:15 that would make them have a better 9:15 that would make them have a better outcome. So they said, "You need a 9:17 outcome. So they said, "You need a 9:17 outcome. So they said, "You need a double blind placebo control trial if 9:20 double blind placebo control trial if 9:20 double blind placebo control trial if you're going to make claims that this is 9:22 you're going to make claims that this is 9:22 you're going to make claims that this is good for women's hearts and prevents 9:24 good for women's hearts and prevents 9:24 good for women's hearts and prevents heart attacks and strokes." So the first
How the Women's Health Initiative changed HRT 9:27 heart attacks and strokes." So the first 9:27 heart attacks and strokes." So the first thing they did was the HERS study. And 9:29 thing they did was the HERS study. And 9:30 thing they did was the HERS study. And the HERS study looked at women who 9:32 the HERS study looked at women who 9:32 the HERS study looked at women who already had a heart attack or a stroke 9:34 already had a heart attack or a stroke 9:34 already had a heart attack or a stroke and they had known cardiovascular 9:36 and they had known cardiovascular 9:36 and they had known cardiovascular disease. And then they gave them 9:37 disease. And then they gave them 9:37 disease. And then they gave them Prempro. These were on average 9:40 Prempro. These were on average 9:40 Prempro. These were on average significantly, you know, women older 9:42 significantly, you know, women older 9:42 significantly, you know, women older like in their late 60s and 70s who 9:46 like in their late 60s and 70s who 9:46 like in their late 60s and 70s who already had known cardiovascular events. 9:48 already had known cardiovascular events. 9:48 already had known cardiovascular events. They already had a heart attack or 9:50 They already had a heart attack or 9:50 They already had a heart attack or stroke. And what they found in that 9:52 stroke. And what they found in that 9:52 stroke. And what they found in that study when they gave them Prem was that 9:55 study when they gave them Prem was that 9:55 study when they gave them Prem was that in the first year of use there was a 9:58 in the first year of use there was a 9:58 in the first year of use there was a higher incidence of bad things happening 10:00 higher incidence of bad things happening 10:00 higher incidence of bad things happening with the cardiovascular system like 10:02 with the cardiovascular system like 10:02 with the cardiovascular system like heart attacks in the women who were put 10:05 heart attacks in the women who were put 10:05 heart attacks in the women who were put on this hormone product. It seemed the 10:08 on this hormone product. It seemed the 10:08 on this hormone product. It seemed the study went for about four years and as 10:10 study went for about four years and as 10:10 study went for about four years and as time went by it seemed like the women on 10:13 time went by it seemed like the women on 10:13 time went by it seemed like the women on the hormones did better and better but 10:15 the hormones did better and better but 10:15 the hormones did better and better but the first year more died. So they then 10:18 the first year more died. So they then 10:18 the first year more died. So they then said no this is bad. So don't use it for 10:22 said no this is bad. So don't use it for 10:22 said no this is bad. So don't use it for secondary prevention. That's what 10:25 secondary prevention. That's what 10:25 secondary prevention. That's what secondary prevention means. Women 10:27 secondary prevention means. Women 10:27 secondary prevention means. Women already have known heart disease and 10:30 already have known heart disease and 10:30 already have known heart disease and cardiovascular badness. Don't give this 10:33 cardiovascular badness. Don't give this 10:34 cardiovascular badness. Don't give this to prevent a second stroke or heart 10:36 to prevent a second stroke or heart 10:36 to prevent a second stroke or heart attack. Don't do that. That's secondary 10:38 attack. Don't do that. That's secondary 10:38 attack. Don't do that. That's secondary prevention. So then they said, okay, 10:41 prevention. So then they said, okay, 10:41 prevention. So then they said, okay, well maybe that's not the right group. 10:43 well maybe that's not the right group. 10:43 well maybe that's not the right group. Let's look at it for primary prevention. 10:46 Let's look at it for primary prevention. 10:46 Let's look at it for primary prevention. Women who who don't have known 10:48 Women who who don't have known 10:48 Women who who don't have known cardiovascular disease. So they needed 10:51 cardiovascular disease. So they needed 10:51 cardiovascular disease. So they needed to do the study and it couldn't last for 10:53 to do the study and it couldn't last for 10:53 to do the study and it couldn't last for 30 years. So that would be too 10:55 30 years. So that would be too 10:56 30 years. So that would be too expensive, too hard to do. So they 10:59 expensive, too hard to do. So they 10:59 expensive, too hard to do. So they created the same exact study, the same 11:01 created the same exact study, the same 11:01 created the same exact study, the same study with the same product. Only now 11:04 study with the same product. Only now 11:04 study with the same product. Only now the study subjects did not yet have a 11:07 the study subjects did not yet have a 11:07 the study subjects did not yet have a heart attack or a stroke. But they 11:09 heart attack or a stroke. But they 11:09 heart attack or a stroke. But they weren't like what they talked about 11:10 weren't like what they talked about 11:10 weren't like what they talked about healthy women. No, they they couldn't 11:13 healthy women. No, they they couldn't 11:13 healthy women. No, they they couldn't find thousands of women who were all 11:15 find thousands of women who were all 11:15 find thousands of women who were all healthy who were in a high higher risk 11:19 healthy who were in a high higher risk 11:19 healthy who were in a high higher risk age group for having something like a 11:21 age group for having something like a 11:21 age group for having something like a heart attack or stroke because they 11:22 heart attack or stroke because they 11:22 heart attack or stroke because they couldn't take women who were a bunch of 11:24 couldn't take women who were a bunch of 11:24 couldn't take women who were a bunch of women who were just entering menopause 11:27 women who were just entering menopause 11:27 women who were just entering menopause who were 50. Number one, many of those 11:29 who were 50. Number one, many of those 11:29 who were 50. Number one, many of those women like 80% would have heart attacks 11:32 women like 80% would have heart attacks 11:32 women like 80% would have heart attacks would rather many of those women would 11:35 would rather many of those women would 11:35 would rather many of those women would have night sweats and hot flashes. So, 11:37 have night sweats and hot flashes. So, 11:37 have night sweats and hot flashes. So, as soon as you gave them the Prem Pro, 11:39 as soon as you gave them the Prem Pro, 11:39 as soon as you gave them the Prem Pro, which is what they used, the combination 11:41 which is what they used, the combination 11:41 which is what they used, the combination product Prem Pro, they would all know 11:43 product Prem Pro, they would all know 11:43 product Prem Pro, they would all know that they were on the real product 11:45 that they were on the real product 11:45 that they were on the real product because their hotter their hot flashes 11:47 because their hotter their hot flashes 11:47 because their hotter their hot flashes and their, you know, night sweats would 11:49 and their, you know, night sweats would 11:49 and their, you know, night sweats would dissipate and the ones who had them and 11:51 dissipate and the ones who had them and 11:51 dissipate and the ones who had them and they didn't get better would know they 11:52 they didn't get better would know they 11:52 they didn't get better would know they weren't on it. So, then they wouldn't 11:54 weren't on it. So, then they wouldn't 11:54 weren't on it. So, then they wouldn't really be very blinded, would it? 11:56 really be very blinded, would it? 11:56 really be very blinded, would it? Because they would all figure it out. So 11:58 Because they would all figure it out. So 11:58 Because they would all figure it out. So they had to take women who had no 12:00 they had to take women who had no 12:00 they had to take women who had no symptoms and also were in an age group 12:02 symptoms and also were in an age group 12:02 symptoms and also were in an age group where if you gave it you could actually 12:04 where if you gave it you could actually 12:04 where if you gave it you could actually see a difference in heart attacks or 12:06 see a difference in heart attacks or 12:06 see a difference in heart attacks or strokes because very few women happily I 12:09 strokes because very few women happily I 12:09 strokes because very few women happily I call it the halo effect of hormones for 12:11 call it the halo effect of hormones for 12:11 call it the halo effect of hormones for the first decade after they go into 12:13 the first decade after they go into 12:13 the first decade after they go into menopause they usually don't have any 12:16 menopause they usually don't have any 12:16 menopause they usually don't have any overt bad things like they don't usually 12:19 overt bad things like they don't usually 12:19 overt bad things like they don't usually break their hips break their spel their 12:21 break their hips break their spel their 12:21 break their hips break their spel their pelvis have you know vertebral fractures 12:24 pelvis have you know vertebral fractures 12:24 pelvis have you know vertebral fractures they don't usually have heart attacks or 12:25 they don't usually have heart attacks or 12:25 they don't usually have heart attacks or strokes in their 50s I because they're 12:28 strokes in their 50s I because they're 12:28 strokes in their 50s I because they're still riding the wave of the hormones 12:30 still riding the wave of the hormones 12:30 still riding the wave of the hormones that they used to have because they, you 12:32 that they used to have because they, you 12:32 that they used to have because they, you know, they're sort of things can be 12:34 know, they're sort of things can be 12:34 know, they're sort of things can be happening that they don't know, covert, 12:36 happening that they don't know, covert, 12:36 happening that they don't know, covert, but not overt. So, they couldn't use a 12:39 but not overt. So, they couldn't use a 12:39 but not overt. So, they couldn't use a whole bunch of women who were 50. That 12:40 whole bunch of women who were 50. That 12:40 whole bunch of women who were 50. That wouldn't make sense for their study 12:42 wouldn't make sense for their study 12:42 wouldn't make sense for their study purposes. So, they had to take older 12:44 purposes. So, they had to take older 12:44 purposes. So, they had to take older women who were more likely to have a 12:47 women who were more likely to have a 12:47 women who were more likely to have a heart attack or stroke. So, they could 12:48 heart attack or stroke. So, they could 12:48 heart attack or stroke. So, they could see the difference between the placebo 12:50 see the difference between the placebo 12:50 see the difference between the placebo group and the study group on the 12:53 group and the study group on the 12:54 group and the study group on the hormones. and they wouldn't know 12:56 hormones. and they wouldn't know 12:56 hormones. and they wouldn't know presumably if they were on the real 12:58 presumably if they were on the real 12:58 presumably if they were on the real hormones or the placebo because they 13:01 hormones or the placebo because they 13:01 hormones or the placebo because they wouldn't have night sweats or hot 13:02 wouldn't have night sweats or hot 13:02 wouldn't have night sweats or hot flashes as a clue when they all got 13:05 flashes as a clue when they all got 13:05 flashes as a clue when they all got better on when they were on the 13:06 better on when they were on the 13:06 better on when they were on the hormones. So, but B, by the way, many of 13:09 hormones. So, but B, by the way, many of 13:09 hormones. So, but B, by the way, many of them figured it out because they had a 13:11 them figured it out because they had a 13:11 them figured it out because they had a lot of breast tenderness. They had 13:12 lot of breast tenderness. They had 13:12 lot of breast tenderness. They had bleeding. I mean, it wasn't so double 13:14 bleeding. I mean, it wasn't so double 13:14 bleeding. I mean, it wasn't so double blinded like you might think because 13:16 blinded like you might think because 13:16 blinded like you might think because most of the women on the hormone product 13:18 most of the women on the hormone product 13:18 most of the women on the hormone product really figured it out that I'm on the 13:20 really figured it out that I'm on the 13:20 really figured it out that I'm on the hormone product. So, there you go. And 13:22 hormone product. So, there you go. And 13:22 hormone product. So, there you go. And there were a lot of dropouts, huge 13:24 there were a lot of dropouts, huge 13:24 there were a lot of dropouts, huge dropouts because they had so much 13:26 dropouts because they had so much 13:26 dropouts because they had so much irregular bleeding and breast 13:27 irregular bleeding and breast 13:27 irregular bleeding and breast tenderness. They a lot because these 13:29 tenderness. They a lot because these 13:29 tenderness. They a lot because these were women who hadn't seen a hormone 13:31 were women who hadn't seen a hormone 13:31 were women who hadn't seen a hormone like this. And and these are not human 13:33 like this. And and these are not human 13:33 like this. And and these are not human hormones either for like 15 years. You 13:36 hormones either for like 15 years. You 13:36 hormones either for like 15 years. You know, they were so far out in menopause. 13:38 know, they were so far out in menopause. 13:38 know, they were so far out in menopause. The average age was 63. They took women 13:41 The average age was 63. They took women 13:41 The average age was 63. They took women all the way up to 79 to start this 13:44 all the way up to 79 to start this 13:44 all the way up to 79 to start this study. And remember, they didn't have a 13:46 study. And remember, they didn't have a 13:46 study. And remember, they didn't have a heart attack or a stroke, but many of 13:48 heart attack or a stroke, but many of 13:48 heart attack or a stroke, but many of them were on drugs for for high lipids. 13:50 them were on drugs for for high lipids. 13:50 them were on drugs for for high lipids. They were on blood pressure drugs. They 13:52 They were on blood pressure drugs. They 13:52 They were on blood pressure drugs. They were, you know, they had like insulin 13:55 were, you know, they had like insulin 13:55 were, you know, they had like insulin resistance. This was like, where are you 13:57 resistance. This was like, where are you 13:57 resistance. This was like, where are you going to find thousands and thousands of 13:59 going to find thousands and thousands of 13:59 going to find thousands and thousands of American women in their mid and late 60s 14:03 American women in their mid and late 60s 14:03 American women in their mid and late 60s and 70s who have perfect cardiovascular 14:06 and 70s who have perfect cardiovascular 14:06 and 70s who have perfect cardiovascular health? I mean, let's be real. So, they 14:09 health? I mean, let's be real. So, they 14:09 health? I mean, let's be real. So, they didn't have a heart attack or stroke, 14:11 didn't have a heart attack or stroke, 14:11 didn't have a heart attack or stroke, but in many ways, they weren't terribly 14:13 but in many ways, they weren't terribly 14:13 but in many ways, they weren't terribly different from the group of the previous 14:15 different from the group of the previous 14:15 different from the group of the previous study, the HERS study. And like so why 14:18 study, the HERS study. And like so why 14:18 study, the HERS study. And like so why would you think there'd be a hugely 14:20 would you think there'd be a hugely 14:20 would you think there'd be a hugely different outcome when this study was 14:22 different outcome when this study was 14:22 different outcome when this study was designed already at that point we 14:25 designed already at that point we 14:26 designed already at that point we already had bioididentical human 14:28 already had bioididentical human 14:28 already had bioididentical human identical estradile and progesterone and 14:31 identical estradile and progesterone and 14:31 identical estradile and progesterone and they were gaining momentum but they did 14:34 they were gaining momentum but they did 14:34 they were gaining momentum but they did the study with all this you know the 14:36 the study with all this you know the 14:36 the study with all this you know the prempro because they said well still 14:37 prempro because they said well still 14:38 prempro because they said well still that's what most women are still using 14:40 that's what most women are still using 14:40 that's what most women are still using but we already knew that that was not a 14:43 but we already knew that that was not a 14:43 but we already knew that that was not a good choice. I knew if I knew I was just 14:45 good choice. I knew if I knew I was just 14:46 good choice. I knew if I knew I was just a regular OBGYn in private practice. If 14:49 a regular OBGYn in private practice. If 14:49 a regular OBGYn in private practice. If I knew that that wasn't a good choice, I 14:51 I knew that that wasn't a good choice, I 14:51 I knew that that wasn't a good choice, I knew the result of the previous HERS 14:53 knew the result of the previous HERS 14:53 knew the result of the previous HERS study and I knew that this would show 14:55 study and I knew that this would show 14:55 study and I knew that this would show the same thing. I mean, so like what the 14:57 the same thing. I mean, so like what the 14:58 the same thing. I mean, so like what the heck are you doing spending bazillion 15:00 heck are you doing spending bazillion 15:00 heck are you doing spending bazillion dollars of taxpayer dollars doing all 15:02 dollars of taxpayer dollars doing all 15:02 dollars of taxpayer dollars doing all this stuff and the outcome is already 15:04 this stuff and the outcome is already 15:04 this stuff and the outcome is already shown from the previous study and we 15:07 shown from the previous study and we 15:07 shown from the previous study and we don't want this product, but they went 15:08 don't want this product, but they went 15:08 don't want this product, but they went ahead and forged forward with it anyway. 15:12 ahead and forged forward with it anyway. 15:12 ahead and forged forward with it anyway. So duh, exactly what I believed would 15:15 So duh, exactly what I believed would 15:15 So duh, exactly what I believed would happen happened. So in the outcome, they 15:18 happen happened. So in the outcome, they 15:18 happen happened. So in the outcome, they found that women who were on the 15:21 found that women who were on the 15:21 found that women who were on the prempro, they didn't do as well. Now, 15:23 prempro, they didn't do as well. Now, 15:23 prempro, they didn't do as well. Now, originally, they said they had more 15:25 originally, they said they had more 15:25 originally, they said they had more heart attacks. Turned out when they did 15:26 heart attacks. Turned out when they did 15:26 heart attacks. Turned out when they did a reanalysis, they didn't. They 15:28 a reanalysis, they didn't. They 15:28 a reanalysis, they didn't. They definitely had more strokes and blood 15:31 definitely had more strokes and blood 15:31 definitely had more strokes and blood clots because it's been found that that 15:34 clots because it's been found that that 15:34 clots because it's been found that that combination prem will increase the risk 15:36 combination prem will increase the risk 15:36 combination prem will increase the risk of blood clots. Oh, like about 400% over 15:39 of blood clots. Oh, like about 400% over 15:40 of blood clots. Oh, like about 400% over baseline. like so duh that's we know you 15:43 baseline. like so duh that's we know you 15:43 baseline. like so duh that's we know you get a a a blood clot in your brain 15:46 get a a a blood clot in your brain 15:46 get a a a blood clot in your brain that's a stroke and they also they said 15:49 that's a stroke and they also they said 15:49 that's a stroke and they also they said had more breast cancer a small amount 15:53 had more breast cancer a small amount 15:53 had more breast cancer a small amount but it turned out that was only from the 15:55 but it turned out that was only from the 15:55 but it turned out that was only from the hydroxy progesterone acetate and not 15:58 hydroxy progesterone acetate and not 15:58 hydroxy progesterone acetate and not actually from the premer but it took 16:00 actually from the premer but it took 16:00 actually from the premer but it took years and years before that all came out 16:02 years and years before that all came out 16:02 years and years before that all came out real and never really came out very 16:04 real and never really came out very 16:04 real and never really came out very loudly. So in the end, oh by the way, 16:07 loudly. So in the end, oh by the way, 16:07 loudly. So in the end, oh by the way, they did find a statistically 16:10 they did find a statistically 16:10 they did find a statistically significant reduction in fractures. So 16:13 significant reduction in fractures. So 16:13 significant reduction in fractures. So that was sort of nice thing. They also 16:15 that was sort of nice thing. They also 16:15 that was sort of nice thing. They also found a statistically significant 16:17 found a statistically significant 16:17 found a statistically significant reduction in colon cancer, but none of 16:20 reduction in colon cancer, but none of 16:20 reduction in colon cancer, but none of that seemed to matter to too many 16:22 that seemed to matter to too many 16:22 that seemed to matter to too many people, you know, like bones and cancer 16:25 people, you know, like bones and cancer 16:25 people, you know, like bones and cancer didn't the the colon, which is huge in 16:27 didn't the the colon, which is huge in 16:28 didn't the the colon, which is huge in terms of deaths of women, that sort of 16:30 terms of deaths of women, that sort of 16:30 terms of deaths of women, that sort of got brushed under the rug, too. and the 16:33 got brushed under the rug, too. and the 16:33 got brushed under the rug, too. and the so and then they did the spin-off study 16:37 so and then they did the spin-off study 16:37 so and then they did the spin-off study which was the whim study which looked at 16:39 which was the whim study which looked at 16:39 which was the whim study which looked at brain and because you get more blood 16:41 brain and because you get more blood 16:41 brain and because you get more blood clots you're going to have more strokes 16:43 clots you're going to have more strokes 16:43 clots you're going to have more strokes you're going to have more vascular 16:45 you're going to have more vascular 16:45 you're going to have more vascular dementia so they found that women on 16:48 dementia so they found that women on 16:48 dementia so they found that women on prempro the older women had more 16:50 prempro the older women had more 16:50 prempro the older women had more dementia so they put this all together 16:53 dementia so they put this all together 16:53 dementia so they put this all together and the headlines were if you use 16:55 and the headlines were if you use 16:55 and the headlines were if you use hormones they didn't say what hormones 16:58 hormones they didn't say what hormones 16:58 hormones they didn't say what hormones if you use hormones you're going to have 17:00 if you use hormones you're going to have 17:00 if you use hormones you're going to have more breast cancer heart attacks, 17:02 more breast cancer heart attacks, 17:02 more breast cancer heart attacks, strokes, blood clots, and dementia. So, 17:05 strokes, blood clots, and dementia. So, 17:05 strokes, blood clots, and dementia. So, what woman would want to get it, take 17:07 what woman would want to get it, take 17:07 what woman would want to get it, take it, right? And what doctor would want to 17:10 it, right? And what doctor would want to 17:10 it, right? And what doctor would want to prescribe it? So, it was crazy. So, 17:13 prescribe it? So, it was crazy. So, 17:13 prescribe it? So, it was crazy. So, there the the it went from like close to 17:17 there the the it went from like close to 17:17 there the the it went from like close to half of women being on hormones in their 17:19 half of women being on hormones in their 17:19 half of women being on hormones in their say their 50s to two to maybe at most 17:23 say their 50s to two to maybe at most 17:23 say their 50s to two to maybe at most 4%. It just plummeted. It was wildly 17:27 4%. It just plummeted. It was wildly 17:27 4%. It just plummeted. It was wildly unpopular and women felt horrible. And I 17:31 unpopular and women felt horrible. And I 17:31 unpopular and women felt horrible. And I begged my patients because I was in 17:33 begged my patients because I was in 17:33 begged my patients because I was in practice 25 years ago and I begged them 17:35 practice 25 years ago and I begged them 17:35 practice 25 years ago and I begged them to stay on the hormones. I said, "I'm 17:38 to stay on the hormones. I said, "I'm 17:38 to stay on the hormones. I said, "I'm not even prescribing this for you. The 17:40 not even prescribing this for you. The 17:40 not even prescribing this for you. The results of this study only apply to what 17:43 results of this study only apply to what 17:43 results of this study only apply to what was studied, which actually is what it 17:45 was studied, which actually is what it 17:45 was studied, which actually is what it says in the study itself." But that 17:47 says in the study itself." But that 17:47 says in the study itself." But that didn't happen. They applied it to every 17:49 didn't happen. They applied it to every 17:49 didn't happen. They applied it to every hormone combination, every dose, every 17:51 hormone combination, every dose, every 17:51 hormone combination, every dose, every everything. Like it was all the same. It 17:53 everything. Like it was all the same. It 17:54 everything. Like it was all the same. It would be like you do a study with trans 17:55 would be like you do a study with trans 17:55 would be like you do a study with trans fat and then you say fat from a walnut 17:58 fat and then you say fat from a walnut 17:58 fat and then you say fat from a walnut is evil. It will kill you. fat from an 18:00 is evil. It will kill you. fat from an 18:00 is evil. It will kill you. fat from an avocado is evil will kill you. It's like 18:03 avocado is evil will kill you. It's like 18:03 avocado is evil will kill you. It's like no trans fat can kill you, but it's not 18:06 no trans fat can kill you, but it's not 18:06 no trans fat can kill you, but it's not all fats. But it was and this these are 18:09 all fats. But it was and this these are 18:09 all fats. But it was and this these are people coming out of Harvard. It's like 18:11 people coming out of Harvard. It's like 18:11 people coming out of Harvard. It's like what's wrong with these people, you 18:13 what's wrong with these people, you 18:13 what's wrong with these people, you know? And then the the North American 18:15 know? And then the the North American 18:16 know? And then the the North American Menopause Society, which I was an active 18:18 Menopause Society, which I was an active 18:18 Menopause Society, which I was an active me member of, came out and basically 18:20 me member of, came out and basically 18:20 me member of, came out and basically supported all of this nonsense in terms 18:23 supported all of this nonsense in terms 18:23 supported all of this nonsense in terms of hormones being evil and and that they 18:26 of hormones being evil and and that they 18:26 of hormones being evil and and that they supported all of this craziness. So, I 18:29 supported all of this craziness. So, I 18:29 supported all of this craziness. So, I canceled my membership and that was 18:30 canceled my membership and that was 18:30 canceled my membership and that was that. I just said, "I'm not giving you 18:32 that. I just said, "I'm not giving you 18:32 that. I just said, "I'm not giving you my money." Like, what are you doing for 18:34 my money." Like, what are you doing for 18:34 my money." Like, what are you doing for women? The American College of OBGYn 18:37 women? The American College of OBGYn 18:37 women? The American College of OBGYn supported this nonsense of hormones are 18:39 supported this nonsense of hormones are 18:39 supported this nonsense of hormones are bad for you. Use That's when the mantra 18:42 bad for you. Use That's when the mantra 18:42 bad for you. Use That's when the mantra came out. The smallest dose for the 18:44 came out. The smallest dose for the 18:44 came out. The smallest dose for the shortest time. And only use it if you 18:47 shortest time. And only use it if you 18:47 shortest time. And only use it if you absolutely have to cuz you're going to 18:49 absolutely have to cuz you're going to 18:49 absolutely have to cuz you're going to die from night sweats and hot flashes. 18:51 die from night sweats and hot flashes. 18:51 die from night sweats and hot flashes. Bones disappeared from the conversation 18:53 Bones disappeared from the conversation 18:53 Bones disappeared from the conversation altogether. So, very few women were 18:56 altogether. So, very few women were 18:56 altogether. So, very few women were going to use it. They were all afraid. I 18:58 going to use it. They were all afraid. I 18:58 going to use it. They were all afraid. I begged my patients. I said, "I'm not 19:00 begged my patients. I said, "I'm not 19:00 begged my patients. I said, "I'm not even prescribing that. What I'm giving 19:03 even prescribing that. What I'm giving 19:03 even prescribing that. What I'm giving you is human identical hormones." 19:06 you is human identical hormones." 19:06 you is human identical hormones." Hormones don't go from good for you to 19:09 Hormones don't go from good for you to 19:09 Hormones don't go from good for you to evil for you just because you hit the 19:11 evil for you just because you hit the 19:11 evil for you just because you hit the age of menopause, which is so variable. 19:13 age of menopause, which is so variable. 19:14 age of menopause, which is so variable. The so-called normal age of menopause is 19:16 The so-called normal age of menopause is 19:16 The so-called normal age of menopause is 45 to 55. So, a woman who's 46 and goes 19:20 45 to 55. So, a woman who's 46 and goes 19:20 45 to 55. So, a woman who's 46 and goes into menopause, which is still 19:22 into menopause, which is still 19:22 into menopause, which is still considered the normal range, but on the 19:23 considered the normal range, but on the 19:24 considered the normal range, but on the earlier side, her hormones become evil. 19:27 earlier side, her hormones become evil. 19:27 earlier side, her hormones become evil. But if a woman is lucky and she doesn't 19:29 But if a woman is lucky and she doesn't 19:29 But if a woman is lucky and she doesn't go into menopause till 57, 19:31 go into menopause till 57, 19:31 go into menopause till 57, like 11 years later, she has 11 more 19:34 like 11 years later, she has 11 more 19:34 like 11 years later, she has 11 more years of these hormones and then 19:36 years of these hormones and then 19:36 years of these hormones and then hormones are good, but then they become 19:37 hormones are good, but then they become 19:37 hormones are good, but then they become evil for her when she's 57. It's like 19:40 evil for her when she's 57. It's like 19:40 evil for her when she's 57. It's like these are the same hormones that your 19:41 these are the same hormones that your 19:41 these are the same hormones that your body is making. What are they talking 19:44 body is making. What are they talking 19:44 body is making. What are they talking about? They're talking nonsense. None of 19:46 about? They're talking nonsense. None of 19:46 about? They're talking nonsense. None of this makes any sense. Look at the 19:48 this makes any sense. Look at the 19:48 this makes any sense. Look at the science. Look at what hormones do in the 19:50 science. Look at what hormones do in the 19:50 science. Look at what hormones do in the body. You know, there was a lot of 19:52 body. You know, there was a lot of 19:52 body. You know, there was a lot of research on hormones. It's not like we 19:54 research on hormones. It's not like we 19:54 research on hormones. It's not like we didn't know anything. We did know. If I 19:57 didn't know anything. We did know. If I 19:57 didn't know anything. We did know. If I knew, it's because I read the research. 19:59 knew, it's because I read the research. 19:59 knew, it's because I read the research. So, if I knew, anybody could know. But 20:01 So, if I knew, anybody could know. But 20:01 So, if I knew, anybody could know. But yet, it was all lost. It was like 20:03 yet, it was all lost. It was like 20:03 yet, it was all lost. It was like screaming in the wind for me. Like, 20:05 screaming in the wind for me. Like, 20:05 screaming in the wind for me. Like, hormones are good. Hormones do good 20:07 hormones are good. Hormones do good 20:07 hormones are good. Hormones do good things. Don't Don't listen to this 20:09 things. Don't Don't listen to this 20:09 things. Don't Don't listen to this nonsense. I dropped out of all my 20:11 nonsense. I dropped out of all my 20:11 nonsense. I dropped out of all my organizations. I quit my membership in 20:13 organizations. I quit my membership in 20:13 organizations. I quit my membership in the American College of OBGYn, in the 20:15 the American College of OBGYn, in the 20:15 the American College of OBGYn, in the North American Menopause Society. I 20:17 North American Menopause Society. I 20:17 North American Menopause Society. I never went to another one of their 20:19 never went to another one of their 20:19 never went to another one of their meetings. I said, "I'm not giving you a 20:20 meetings. I said, "I'm not giving you a 20:20 meetings. I said, "I'm not giving you a penny of my money until you apologize," 20:23 penny of my money until you apologize," 20:23 penny of my money until you apologize," which neither organization has ever 20:26 which neither organization has ever 20:26 which neither organization has ever openly apologized for their position 25 20:29 openly apologized for their position 25 20:29 openly apologized for their position 25 years ago and was ongoing. So, the women 20:33 years ago and was ongoing. So, the women 20:33 years ago and was ongoing. So, the women at that time were all getting off 20:36 at that time were all getting off 20:36 at that time were all getting off hormones and women who were going into 20:38 hormones and women who were going into 20:38 hormones and women who were going into menopause were refused hormones or told 20:41 menopause were refused hormones or told 20:41 menopause were refused hormones or told you can take a tiny dose for a very 20:44 you can take a tiny dose for a very 20:44 you can take a tiny dose for a very short period of time. And so I call it 20:47 short period of time. And so I call it 20:47 short period of time. And so I call it the lost generation of women. All the 20:49 the lost generation of women. All the 20:49 the lost generation of women. All the women who were denied and or removed 20:53 women who were denied and or removed 20:53 women who were denied and or removed from their hormones. And now they are so 20:56 from their hormones. And now they are so 20:56 from their hormones. And now they are so many I see them. They're very angry. 20:59 many I see them. They're very angry. 20:59 many I see them. They're very angry. They're very resentful for the fact that 21:02 They're very resentful for the fact that 21:02 They're very resentful for the fact that they are now told and there's issues 21:05 they are now told and there's issues 21:05 they are now told and there's issues involved in this as well, but they're 21:07 involved in this as well, but they're 21:07 involved in this as well, but they're told now you're too old lady. Like you 21:09 told now you're too old lady. Like you 21:10 told now you're too old lady. Like you missed the window of opportunity. So you 21:12 missed the window of opportunity. So you 21:12 missed the window of opportunity. So you missed it and now you can suffer from 21:15 missed it and now you can suffer from 21:15 missed it and now you can suffer from all of these medical problems, all of 21:17 all of these medical problems, all of 21:17 all of these medical problems, all of these what we would call degenerative 21:20 these what we would call degenerative 21:20 these what we would call degenerative diseases of aging which I call 21:22 diseases of aging which I call 21:22 diseases of aging which I call degenerative diseases of hormone 21:25 degenerative diseases of hormone 21:25 degenerative diseases of hormone deficiency state. Okay. And yep. So it 21:30 deficiency state. Okay. And yep. So it 21:30 deficiency state. Okay. And yep. So it was quite a wild ride all these years 21:33 was quite a wild ride all these years 21:33 was quite a wild ride all these years and now I so I've been lecturing 21:35 and now I so I've been lecturing 21:35 and now I so I've been lecturing [clears throat] for you know all this 21:37 [clears throat] for you know all this 21:37 [clears throat] for you know all this time about what do hormones do in the 21:39 time about what do hormones do in the 21:39 time about what do hormones do in the body? Because if you understand what 21:41 body? Because if you understand what 21:41 body? Because if you understand what they do in the body, then you'll get a 21:44 they do in the body, then you'll get a 21:44 they do in the body, then you'll get a glimpse of what happens when you lose 21:46 glimpse of what happens when you lose 21:46 glimpse of what happens when you lose them. And for women, this is like the
Why HRT may be necessary before official menopause 21:49 them. And for women, this is like the 21:49 them. And for women, this is like the crazy, you know, split thinking on this. 21:52 crazy, you know, split thinking on this. 21:52 crazy, you know, split thinking on this. for women who go nowadays and it's been 21:55 for women who go nowadays and it's been 21:55 for women who go nowadays and it's been for a while women who lose their 21:57 for a while women who lose their 21:57 for a while women who lose their hormones early. So we would say like 22:00 hormones early. So we would say like 22:00 hormones early. So we would say like early menopause is 40 up to 45 or 22:04 early menopause is 40 up to 45 or 22:04 early menopause is 40 up to 45 or premature you know ovarian insufficiency 22:07 premature you know ovarian insufficiency 22:07 premature you know ovarian insufficiency they call it which would be like early 22:09 they call it which would be like early 22:09 they call it which would be like early early onset of menopause before the age 22:12 early onset of menopause before the age 22:12 early onset of menopause before the age of 40 like say could be you know the 22:15 of 40 like say could be you know the 22:15 of 40 like say could be you know the worst case scenario is like in their 22:17 worst case scenario is like in their 22:17 worst case scenario is like in their teens but it could be in their 20s or 22:19 teens but it could be in their 20s or 22:19 teens but it could be in their 20s or their 30s. So that would be premature. 22:23 their 30s. So that would be premature. 22:23 their 30s. So that would be premature. So you have either early or premature. 22:25 So you have either early or premature. 22:25 So you have either early or premature. The current standard of care. Okay. The 22:29 The current standard of care. Okay. The 22:29 The current standard of care. Okay. The standard practice that's recommended is 22:31 standard practice that's recommended is 22:31 standard practice that's recommended is that you give physiologic levels of 22:35 that you give physiologic levels of 22:35 that you give physiologic levels of hormones to mimic the levels. 22:39 hormones to mimic the levels. 22:39 hormones to mimic the levels. You know, it was always an ish of women 22:41 You know, it was always an ish of women 22:41 You know, it was always an ish of women who would be at their healthiest like in 22:44 who would be at their healthiest like in 22:44 who would be at their healthiest like in their 20s to mimic the hormone estrogen 22:47 their 20s to mimic the hormone estrogen 22:47 their 20s to mimic the hormone estrogen levels of that time along with cyclic 22:51 levels of that time along with cyclic 22:51 levels of that time along with cyclic progesterone. Of course, all 22:53 progesterone. Of course, all 22:53 progesterone. Of course, all bioididentical 22:55 bioididentical 22:55 bioididentical that's recommended as the primary best 22:58 that's recommended as the primary best 22:58 that's recommended as the primary best option as opposed to like hydroxy 23:01 option as opposed to like hydroxy 23:01 option as opposed to like hydroxy progesterone acetate which very very few 23:04 progesterone acetate which very very few 23:04 progesterone acetate which very very few doctors prescribe anymore. that fell 23:06 doctors prescribe anymore. that fell 23:06 doctors prescribe anymore. that fell off, you know, the popularity wagon a 23:09 off, you know, the popularity wagon a 23:09 off, you know, the popularity wagon a long time ago. And very little Premrin, 23:12 long time ago. And very little Premrin, 23:12 long time ago. And very little Premrin, although that's still prescribed by 23:14 although that's still prescribed by 23:14 although that's still prescribed by some, it's all on the market, but very 23:16 some, it's all on the market, but very 23:16 some, it's all on the market, but very few are using that. And that's not like 23:18 few are using that. And that's not like 23:18 few are using that. And that's not like the the recommended preferred form of 23:21 the the recommended preferred form of 23:21 the the recommended preferred form of estrogen. It would be transermal 23:24 estrogen. It would be transermal 23:24 estrogen. It would be transermal estradile. You know, estradile, the one 23:26 estradile. You know, estradile, the one 23:26 estradile. You know, estradile, the one that the ovaries make, along with human 23:29 that the ovaries make, along with human 23:29 that the ovaries make, along with human bioididentical progesterone. And for the 23:32 bioididentical progesterone. And for the 23:32 bioididentical progesterone. And for the young women who lose their hormones, 23:34 young women who lose their hormones, 23:34 young women who lose their hormones, it's recommended that you give it to 23:36 it's recommended that you give it to 23:36 it's recommended that you give it to sort ofish mimic what a young woman 23:39 sort ofish mimic what a young woman 23:39 sort ofish mimic what a young woman would have. But that's recommended 23:43 would have. But that's recommended 23:43 would have. But that's recommended although there's no like absolute. It's 23:45 although there's no like absolute. It's 23:45 although there's no like absolute. It's like you can do joint decision making. 23:47 like you can do joint decision making. 23:47 like you can do joint decision making. Those are the the words that are used 23:49 Those are the the words that are used 23:49 Those are the the words that are used now. Joint decision making the patient 23:51 now. Joint decision making the patient 23:51 now. Joint decision making the patient and the health care provider to decide 23:54 and the health care provider to decide 23:54 and the health care provider to decide what to do. But in general, it's 23:57 what to do. But in general, it's 23:57 what to do. But in general, it's recommended that once you hit the 23:58 recommended that once you hit the 23:58 recommended that once you hit the so-called normal age of menopause, like 24:01 so-called normal age of menopause, like 24:01 so-called normal age of menopause, like in the 50 to 52 range, that you just 24:04 in the 50 to 52 range, that you just 24:04 in the 50 to 52 range, that you just don't do that anymore. That you don't 24:06 don't do that anymore. That you don't 24:06 don't do that anymore. That you don't give physiologically dose cyclic 24:08 give physiologically dose cyclic 24:08 give physiologically dose cyclic hormones. Instead, you give lowd dose 24:11 hormones. Instead, you give lowd dose 24:11 hormones. Instead, you give lowd dose continuous or static or none at all. 24:14 continuous or static or none at all. 24:14 continuous or static or none at all. That you give tiny doses. you suddenly 24:16 That you give tiny doses. you suddenly 24:16 That you give tiny doses. you suddenly way drop the doses and you change the 24:19 way drop the doses and you change the 24:19 way drop the doses and you change the regimen because you hit that magical age 24:22 regimen because you hit that magical age 24:22 regimen because you hit that magical age when women typically go into menopause 24:25 when women typically go into menopause 24:25 when women typically go into menopause as if that is sort of a prerequisite for 24:28 as if that is sort of a prerequisite for 24:28 as if that is sort of a prerequisite for aging that you just really should lose 24:30 aging that you just really should lose 24:30 aging that you just really should lose your hormones ladies you know or get 24:33 your hormones ladies you know or get 24:33 your hormones ladies you know or get very tiny amounts you know not to defy 24:36 very tiny amounts you know not to defy 24:36 very tiny amounts you know not to defy nature well I defy nature all the time 24:39 nature well I defy nature all the time 24:39 nature well I defy nature all the time that's what medicine is is defying 24:41 that's what medicine is is defying 24:41 that's what medicine is is defying nature why do we do have artificial 24:43 nature why do we do have artificial 24:43 nature why do we do have artificial joints why do we have replacement lenses 24:46 joints why do we have replacement lenses 24:46 joints why do we have replacement lenses when you get cataracts. I mean, why do 24:48 when you get cataracts. I mean, why do 24:48 when you get cataracts. I mean, why do we have pharmaceuticals? Why do we have 24:51 we have pharmaceuticals? Why do we have 24:51 we have pharmaceuticals? Why do we have stances in arteries for coronary artery 24:53 stances in arteries for coronary artery 24:54 stances in arteries for coronary artery disease? Is that not defying nature? We 24:56 disease? Is that not defying nature? We 24:56 disease? Is that not defying nature? We want to help people to have healthy 24:58 want to help people to have healthy 24:58 want to help people to have healthy longevity. And that means when nature 25:00 longevity. And that means when nature 25:00 longevity. And that means when nature takes us down the wrong path, we try to 25:03 takes us down the wrong path, we try to 25:03 takes us down the wrong path, we try to do something to make it better. Because 25:06 do something to make it better. Because 25:06 do something to make it better. Because if you don't believe that medicine is 25:08 if you don't believe that medicine is 25:08 if you don't believe that medicine is about defying nature, then you know, 25:11 about defying nature, then you know, 25:11 about defying nature, then you know, then you don't know what medicine is. 25:12 then you don't know what medicine is. 25:12 then you don't know what medicine is. Because everything I do in medicine, 25:15 Because everything I do in medicine, 25:15 Because everything I do in medicine, like when I did tons of obstetrics, if 25:18 like when I did tons of obstetrics, if 25:18 like when I did tons of obstetrics, if someone had, you know, a placenta pia, I 25:21 someone had, you know, a placenta pia, I 25:21 someone had, you know, a placenta pia, I wouldn't say, "Well, let's see what 25:23 wouldn't say, "Well, let's see what 25:23 wouldn't say, "Well, let's see what happens when they go into natural labor 25:24 happens when they go into natural labor 25:24 happens when they go into natural labor and they hemorrhage to death." No, I 25:27 and they hemorrhage to death." No, I 25:27 and they hemorrhage to death." No, I would do a preemptive C-section. I mean, 25:30 would do a preemptive C-section. I mean, 25:30 would do a preemptive C-section. I mean, that's defying nature. Come on. So the 25:33 that's defying nature. Come on. So the 25:33 that's defying nature. Come on. So the fact that women naturally go into 25:35 fact that women naturally go into 25:35 fact that women naturally go into menopause, so we should naturally just 25:37 menopause, so we should naturally just 25:37 menopause, so we should naturally just get rid of the hormones or if we're 25:39 get rid of the hormones or if we're 25:39 get rid of the hormones or if we're giving hormones, we give these tiny 25:40 giving hormones, we give these tiny 25:40 giving hormones, we give these tiny doses because it's so unnatural to have 25:43 doses because it's so unnatural to have 25:43 doses because it's so unnatural to have physiologic levels like you had when you 25:45 physiologic levels like you had when you 25:45 physiologic levels like you had when you were younger. I say, you know, hogwash. 25:49 were younger. I say, you know, hogwash. 25:49 were younger. I say, you know, hogwash. You know, I want to give what's going to 25:51 You know, I want to give what's going to 25:51 You know, I want to give what's going to give women the healthiest longevity. And 25:54 give women the healthiest longevity. And 25:54 give women the healthiest longevity. And of course I can't make people immortal 25:57 of course I can't make people immortal 25:57 of course I can't make people immortal but all the bad things that happen when 26:00 but all the bad things that happen when 26:00 but all the bad things that happen when this I call my halo of hormones is gone 26:03 this I call my halo of hormones is gone 26:03 this I call my halo of hormones is gone and the you know the visible problems 26:06 and the you know the visible problems 26:06 and the you know the visible problems the become overt the loss of hormones 26:10 the become overt the loss of hormones 26:10 the become overt the loss of hormones becomes more obvious when women are 26:12 becomes more obvious when women are 26:12 becomes more obvious when women are going into their 60s and then certainly 26:14 going into their 60s and then certainly 26:14 going into their 60s and then certainly in their 70s whereas it may not be as 26:17 in their 70s whereas it may not be as 26:17 in their 70s whereas it may not be as obvious in their 50s but there are 26:20 obvious in their 50s but there are 26:20 obvious in their 50s but there are things happening that they don't know 26:21 things happening that they don't know 26:21 things happening that they don't know about like with their bones with their 26:24 about like with their bones with their 26:24 about like with their bones with their arteries with their brains. Some of the 26:26 arteries with their brains. Some of the 26:26 arteries with their brains. Some of the things are not less are not so unobvious 26:29 things are not less are not so unobvious 26:29 things are not less are not so unobvious like they may start having incontinence 26:31 like they may start having incontinence 26:32 like they may start having incontinence and vaginal changes, sexual changes. So, 26:35 and vaginal changes, sexual changes. So, 26:35 and vaginal changes, sexual changes. So, you know, they look in the mirror, their 26:36 you know, they look in the mirror, their 26:36 you know, they look in the mirror, their skin on their face looks changed, you 26:39 skin on their face looks changed, you 26:39 skin on their face looks changed, you know, they can see visible aging. So 26:41 know, they can see visible aging. So 26:41 know, they can see visible aging. So it's not all invisible in the 50s, but 26:43 it's not all invisible in the 50s, but 26:43 it's not all invisible in the 50s, but it becomes more physically evident with 26:45 it becomes more physically evident with 26:45 it becomes more physically evident with hypertension and insulin resistance and 26:50 hypertension and insulin resistance and 26:50 hypertension and insulin resistance and osteoporotic fractures as women get into 26:53 osteoporotic fractures as women get into 26:53 osteoporotic fractures as women get into their 60s and beyond. So anyway, that's 26:55 their 60s and beyond. So anyway, that's 26:55 their 60s and beyond. So anyway, that's a long history, but understanding 26:58 a long history, but understanding 26:58 a long history, but understanding history helps you to understand where we 27:01 history helps you to understand where we 27:01 history helps you to understand where we are today and what is still in my view a 27:05 are today and what is still in my view a 27:05 are today and what is still in my view a nonsensical approach to hormone therapy 27:09 nonsensical approach to hormone therapy 27:09 nonsensical approach to hormone therapy in menopausal women which is still I 27:12 in menopausal women which is still I 27:12 in menopausal women which is still I call it the horrible legacy of the 27:15 call it the horrible legacy of the 27:15 call it the horrible legacy of the women's health initiative has not gone 27:17 women's health initiative has not gone 27:17 women's health initiative has not gone away. It still is pervasive in not 27:22 away. It still is pervasive in not 27:22 away. It still is pervasive in not understanding menopause un Understanding 27:24 understanding menopause un Understanding 27:24 understanding menopause un Understanding that menopause comes with a lot of bad 27:27 that menopause comes with a lot of bad 27:27 that menopause comes with a lot of bad things is what is now being really 27:29 things is what is now being really 27:29 things is what is now being really acknowledged. But what to do about it 27:32 acknowledged. But what to do about it 27:32 acknowledged. But what to do about it both in terms of emphasizing lifestyle 27:35 both in terms of emphasizing lifestyle 27:35 both in terms of emphasizing lifestyle approaches, you know, like exercise, 27:39 approaches, you know, like exercise, 27:39 approaches, you know, like exercise, nutrition, stress reduction, sleep 27:41 nutrition, stress reduction, sleep 27:41 nutrition, stress reduction, sleep optimization, toxin reduction in terms 27:44 optimization, toxin reduction in terms 27:44 optimization, toxin reduction in terms of exposure. That is not emphasized 27:46 of exposure. That is not emphasized 27:46 of exposure. That is not emphasized anywhere near enough. Not hardly at all 27:49 anywhere near enough. Not hardly at all 27:49 anywhere near enough. Not hardly at all in many medical practices and certainly 27:51 in many medical practices and certainly 27:51 in many medical practices and certainly less in a lot of the dispensaries that 27:54 less in a lot of the dispensaries that 27:54 less in a lot of the dispensaries that just give out hormone the hormone 27:55 just give out hormone the hormone 27:55 just give out hormone the hormone dispensaries where they just say, you 27:57 dispensaries where they just say, you 27:57 dispensaries where they just say, you know, you don't even have to be talked 27:59 know, you don't even have to be talked 27:59 know, you don't even have to be talked to. You just do a text message and you 28:01 to. You just do a text message and you 28:02 to. You just do a text message and you get your medication, you know, and 28:03 get your medication, you know, and 28:04 get your medication, you know, and nobody knows anything. And you know, in 28:06 nobody knows anything. And you know, in 28:06 nobody knows anything. And you know, in terms of how the hormones are prescribed 28:09 terms of how the hormones are prescribed 28:09 terms of how the hormones are prescribed matters. It's not like every hormone 28:12 matters. It's not like every hormone 28:12 matters. It's not like every hormone regimen gives you the same outcome. So a 28:14 regimen gives you the same outcome. So a 28:14 regimen gives you the same outcome. So a lot of the hormone terribleness I've 28:18 lot of the hormone terribleness I've 28:18 lot of the hormone terribleness I've called the legacy of the women's health 28:19 called the legacy of the women's health 28:19 called the legacy of the women's health initiative is still living with us. 28:23 initiative is still living with us. 28:23 initiative is still living with us. There's still an underlying fear of 28:25 There's still an underlying fear of 28:25 There's still an underlying fear of hormones. I say there's many things to 28:27 hormones. I say there's many things to 28:27 hormones. I say there's many things to be afraid of. But hormones from human 28:30 be afraid of. But hormones from human 28:30 be afraid of. But hormones from human bioididentical hormones, human identical 28:33 bioididentical hormones, human identical 28:33 bioididentical hormones, human identical hormones from the ovary should not be on 28:35 hormones from the ovary should not be on 28:35 hormones from the ovary should not be on the list of things to be feared. I mean 28:38 the list of things to be feared. I mean 28:38 the list of things to be feared. I mean like do you walk around are you afraid 28:40 like do you walk around are you afraid 28:40 like do you walk around are you afraid of thyroid? I mean it's like who like 28:42 of thyroid? I mean it's like who like 28:42 of thyroid? I mean it's like who like what is that? You know, it's like, whoa, 28:44 what is that? You know, it's like, whoa, 28:44 what is that? You know, it's like, whoa, I want the t if I have low thyroid, I 28:47 I want the t if I have low thyroid, I 28:47 I want the t if I have low thyroid, I want the tiniest amount of thyroid 28:49 want the tiniest amount of thyroid 28:49 want the tiniest amount of thyroid hormone that will keep me alive. Like, 28:52 hormone that will keep me alive. Like, 28:52 hormone that will keep me alive. Like, no, you want an optimal dose to give you 28:55 no, you want an optimal dose to give you 28:55 no, you want an optimal dose to give you what is physiologically most beneficial. 28:58 what is physiologically most beneficial. 28:58 what is physiologically most beneficial. I'm just translating the same kind of 29:01 I'm just translating the same kind of 29:01 I'm just translating the same kind of thinking to human female hormones. You 29:05 thinking to human female hormones. You 29:05 thinking to human female hormones. You want an optimal regimen to make you the 29:08 want an optimal regimen to make you the 29:08 want an optimal regimen to make you the optimally healthy. Not the smallest 29:11 optimally healthy. Not the smallest 29:11 optimally healthy. Not the smallest amount to keep you from having the worst 29:13 amount to keep you from having the worst 29:13 amount to keep you from having the worst symptoms. You want optimal health. But 29:16 symptoms. You want optimal health. But 29:16 symptoms. You want optimal health. But nevertheless, right now there is no FD 29:20 nevertheless, right now there is no FD 29:20 nevertheless, right now there is no FD FDA approval for anything for hormones 29:24 FDA approval for anything for hormones 29:24 FDA approval for anything for hormones except for the same old same old 29:26 except for the same old same old 29:26 except for the same old same old reduction of night sweats and hot 29:28 reduction of night sweats and hot 29:28 reduction of night sweats and hot flashes and osteoporosis 29:31 flashes and osteoporosis 29:31 flashes and osteoporosis prevention. That's all we got now for 29:34 prevention. That's all we got now for 29:34 prevention. That's all we got now for FDA approval. Fortunately, it's not 29:37 FDA approval. Fortunately, it's not 29:37 FDA approval. Fortunately, it's not illegal to use medications off label for 29:41 illegal to use medications off label for 29:41 illegal to use medications off label for other uses and many of us are for 29:45 other uses and many of us are for 29:45 other uses and many of us are for healthy longevity. So anyway, that's 29:48 healthy longevity. So anyway, that's 29:48 healthy longevity. So anyway, that's maybe more than you ever wanted to hear 29:50 maybe more than you ever wanted to hear 29:50 maybe more than you ever wanted to hear about the history of hormones, but if 29:53 about the history of hormones, but if 29:53 about the history of hormones, but if you don't know the past, it's really 29:56 you don't know the past, it's really 29:56 you don't know the past, it's really hard to understand the present. 29:59 hard to understand the present. 29:59 hard to understand the present. Hey, Margie here. As a physical 30:01 Hey, Margie here. As a physical 30:01 Hey, Margie here. As a physical therapist, I know firsthand how 30:03 therapist, I know firsthand how 30:03 therapist, I know firsthand how important exercise is [music] for our 30:05 important exercise is [music] for our 30:05 important exercise is [music] for our bones, overall health, and happiness. 30:08 bones, overall health, and happiness. 30:08 bones, overall health, and happiness. And unfortunately, there's a lot of 30:10 And unfortunately, there's a lot of 30:10 And unfortunately, there's a lot of confusion [music] on what exercises are 30:13 confusion [music] on what exercises are 30:13 confusion [music] on what exercises are safe and effective for people with 30:15 safe and effective for people with 30:15 safe and effective for people with osteoporosis. [music] 30:16 osteoporosis. [music] 30:16 osteoporosis. [music] That's why I created this handout that 30:19 That's why I created this handout that 30:19 That's why I created this handout that contains a 30inut video [music] where I 30:21 contains a 30inut video [music] where I 30:21 contains a 30inut video [music] where I explain the concepts so you understand 30:24 explain the concepts so you understand 30:24 explain the concepts so you understand the dos and don'ts [music] when it comes 30:26 the dos and don'ts [music] when it comes 30:26 the dos and don'ts [music] when it comes to exercise. And this is important 30:28 to exercise. And this is important 30:28 to exercise. And this is important because this way you can go into any 30:30 because this way you can go into any 30:30 because this way you can go into any [music] class and know what you should 30:32 [music] class and know what you should 30:32 [music] class and know what you should be doing and what you should avoid 30:35 be doing and what you should avoid 30:35 be doing and what you should avoid because too many people are doing 30:37 because too many people are doing 30:37 because too many people are doing exercises that [music] actually increase 30:39 exercises that [music] actually increase 30:39 exercises that [music] actually increase their risk of spinal fractures. I also 30:42 their risk of spinal fractures. I also 30:42 their risk of spinal fractures. I also included videos of me demonstrating 30:44 included videos of me demonstrating 30:44 included videos of me demonstrating [music] 30:45 [music] 30:45 [music] effective balance, posture, and 30:47 effective balance, posture, and 30:47 effective balance, posture, and weightbearing exercises [music] you can 30:49 weightbearing exercises [music] you can 30:50 weightbearing exercises [music] you can put into your day right away. So, all 30:52 put into your day right away. So, all 30:52 put into your day right away. So, all you need to do to access this [music] 30:54 you need to do to access this [music] 30:54 you need to do to access this [music] handout, it's free, is go to 30:57 handout, it's free, is go to 30:57 handout, it's free, is go to tinyurl.com/steoporosis 31:06 exercises. So, it's t i n yurl.com 31:06 exercises. So, it's t i n yurl.com again/oststeoporosisex [music] 31:09 again/oststeoporosisex [music] 31:09 again/oststeoporosisex [music] exercises or you can click the link in 31:11 exercises or you can click the link in 31:11 exercises or you can click the link in the show notes. Now, back to the show. 31:15 the show notes. Now, back to the show. 31:15 the show notes. Now, back to the show. Yes, I think I think that was so 31:17 Yes, I think I think that was so 31:17 Yes, I think I think that was so important and to me I look at it, yes, 31:21 important and to me I look at it, yes, 31:21 important and to me I look at it, yes, that was the past, but I see so much 31:23 that was the past, but I see so much 31:23 that was the past, but I see so much good happening. I mean, the fact that 31:25 good happening. I mean, the fact that 31:25 good happening. I mean, the fact that people can't even get their patches 31:27 people can't even get their patches 31:27 people can't even get their patches because they're sold out because 31:30 because they're sold out because 31:30 because they're sold out because everyone is starting the resurgence. But 31:32 everyone is starting the resurgence. But 31:32 everyone is starting the resurgence. But so interesting what you said and I think 31:34 so interesting what you said and I think 31:34 so interesting what you said and I think that's why I have you on here to really 31:37 that's why I have you on here to really 31:37 that's why I have you on here to really clear up how to do this properly. Who is 31:40 clear up how to do this properly. Who is 31:40 clear up how to do this properly. Who is it safe for? Who is it not safe for? 31:42 it safe for? Who is it not safe for? 31:42 it safe for? Who is it not safe for? Because this happens suddenly, you know, 31:45 Because this happens suddenly, you know, 31:45 Because this happens suddenly, you know, suddenly it's removed that blackbox 31:47 suddenly it's removed that blackbox 31:47 suddenly it's removed that blackbox warning. And it's interesting because I 31:50 warning. And it's interesting because I 31:50 warning. And it's interesting because I was at the conference, the osteoporosis 31:52 was at the conference, the osteoporosis 31:52 was at the conference, the osteoporosis conference, and they are so excited now 31:55 conference, and they are so excited now 31:56 conference, and they are so excited now people are when they go through 31:57 people are when they go through 31:57 people are when they go through menopause, we're going to prevent 31:58 menopause, we're going to prevent 31:58 menopause, we're going to prevent osteoporosis. And these were physicians, 32:00 osteoporosis. And these were physicians, 32:00 osteoporosis. And these were physicians, conventional physicians, very excited 32:02 conventional physicians, very excited 32:02 conventional physicians, very excited about this. And at the same time, only 32:07 about this. And at the same time, only 32:07 about this. And at the same time, only only for people who were less than 10 32:10 only for people who were less than 10 32:10 only for people who were less than 10 years past menopause. like this was only 32:12 years past menopause. like this was only 32:12 years past menopause. like this was only for those people. So the question is you 32:17 for those people. So the question is you 32:17 for those people. So the question is you know why has it translated to that and 32:21 know why has it translated to that and 32:21 know why has it translated to that and my people in so many people in this 32:23 my people in so many people in this 32:23 my people in so many people in this community are in my generation where you 32:26 community are in my generation where you 32:26 community are in my generation where you know nobody would you know people were 32:28 know nobody would you know people were 32:28 know nobody would you know people were not put on hormones because of all 32:30 not put on hormones because of all 32:30 not put on hormones because of all everything you talked about and now 32:32 everything you talked about and now 32:32 everything you talked about and now they're wondering well is it safe for me 32:34 they're wondering well is it safe for me 32:34 they're wondering well is it safe for me is it not safe for me and what are the 32:37 is it not safe for me and what are the 32:37 is it not safe for me and what are the guidelines so why don't we start with so 32:40 guidelines so why don't we start with so 32:40 guidelines so why don't we start with so people now I think it seems like people 32:43 people now I think it seems like people 32:43 people now I think it seems like people if they're going through menopause 32:44 if they're going through menopause 32:44 if they're going through menopause Because they they now the doctors are on 32:48 Because they they now the doctors are on 32:48 Because they they now the doctors are on board. Am I right about this? I mean, 32:50 board. Am I right about this? I mean, 32:50 board. Am I right about this? I mean, they didn't even learn those obes about 32:52 they didn't even learn those obes about 32:52 they didn't even learn those obes about estrogen. No, they didn't learn 32:54 estrogen. No, they didn't learn 32:54 estrogen. No, they didn't learn anything, right? It's like the education 32:57 anything, right? It's like the education 32:57 anything, right? It's like the education on hormones and menopause disappeared. 33:00 on hormones and menopause disappeared. 33:00 on hormones and menopause disappeared. The only message that was being 33:01 The only message that was being 33:02 The only message that was being delivered was hormones are really 33:04 delivered was hormones are really 33:04 delivered was hormones are really dangerous. You want to use the smallest 33:06 dangerous. You want to use the smallest 33:06 dangerous. You want to use the smallest dose for the shortest amount of time if 33:08 dose for the shortest amount of time if 33:08 dose for the shortest amount of time if you use them at all. Then so let's talk 33:11 you use them at all. Then so let's talk 33:11 you use them at all. Then so let's talk now what what is the optimal like
How to access HRT in a safe and effective way 33:14 now what what is the optimal like 33:14 now what what is the optimal like talking to people what you know how do 33:17 talking to people what you know how do 33:17 talking to people what you know how do you tell people what they where they 33:20 you tell people what they where they 33:20 you tell people what they where they should go who they should work with how 33:22 should go who they should work with how 33:22 should go who they should work with how to do this in a safe and effective way 33:26 to do this in a safe and effective way 33:26 to do this in a safe and effective way because what I'm seeing which is just so 33:29 because what I'm seeing which is just so 33:29 because what I'm seeing which is just so amazing a prevention b I always look at 33:33 amazing a prevention b I always look at 33:33 amazing a prevention b I always look at the CTX to see bone breakdown and when 33:35 the CTX to see bone breakdown and when 33:35 the CTX to see bone breakdown and when people start the bio identical you know 33:38 people start the bio identical you know 33:38 people start the bio identical you know it's amazing to see that number really 33:42 it's amazing to see that number really 33:42 it's amazing to see that number really reduce from the hormones. It's 33:44 reduce from the hormones. It's 33:44 reduce from the hormones. It's incredible. You see it pretty quickly. 33:46 incredible. You see it pretty quickly. 33:46 incredible. You see it pretty quickly. Within a couple months, you're not 33:48 Within a couple months, you're not 33:48 Within a couple months, you're not getting that bone breakdown. So, we know 33:50 getting that bone breakdown. So, we know 33:50 getting that bone breakdown. So, we know how powerful this is for our bones, 33:53 how powerful this is for our bones, 33:53 how powerful this is for our bones, which has always been known. But, it's 33:55 which has always been known. But, it's 33:55 which has always been known. But, it's just exciting to me that now this is 33:57 just exciting to me that now this is 33:57 just exciting to me that now this is back in the forefront and people are 33:59 back in the forefront and people are 33:59 back in the forefront and people are realizing how important, but we want to 34:02 realizing how important, but we want to 34:02 realizing how important, but we want to do it properly and we want as many 34:04 do it properly and we want as many 34:04 do it properly and we want as many people as possible to benefit. Well, in 34:07 people as possible to benefit. Well, in 34:07 people as possible to benefit. Well, in terms of menopause, the official 34:09 terms of menopause, the official 34:09 terms of menopause, the official definition is man-made and it is late in 34:14 definition is man-made and it is late in 34:14 definition is man-made and it is late in the game of ovarian aging. The official 34:17 the game of ovarian aging. The official 34:17 the game of ovarian aging. The official definition is 12 consecutive months with 34:20 definition is 12 consecutive months with 34:20 definition is 12 consecutive months with no vaginal bleeding. That's it. Okay? 34:24 no vaginal bleeding. That's it. Okay? 34:24 no vaginal bleeding. That's it. Okay? So, you don't know when you're 34:26 So, you don't know when you're 34:26 So, you don't know when you're officially in menopause based on this 34:28 officially in menopause based on this 34:28 officially in menopause based on this definition until 12 months have passed 34:31 definition until 12 months have passed 34:31 definition until 12 months have passed and you haven't had a period. So, what 34:33 and you haven't had a period. So, what 34:33 and you haven't had a period. So, what what is that? That is man-made. And by 34:36 what is that? That is man-made. And by 34:36 what is that? That is man-made. And by the time that happens, you've already 34:39 the time that happens, you've already 34:39 the time that happens, you've already suffered all kinds of harm. And there 34:42 suffered all kinds of harm. And there 34:42 suffered all kinds of harm. And there are many doctors that still think you 34:44 are many doctors that still think you 34:44 are many doctors that still think you don't start hormones until you reach 34:47 don't start hormones until you reach 34:47 don't start hormones until you reach that official time of menopause, which 34:49 that official time of menopause, which 34:50 that official time of menopause, which is completely absurd. If a woman goes 11 34:52 is completely absurd. If a woman goes 11 34:52 is completely absurd. If a woman goes 11 months and then starts bleeding, there's 34:54 months and then starts bleeding, there's 34:54 months and then starts bleeding, there's not an OB/GYN that says, "Oh, I see 34:57 not an OB/GYN that says, "Oh, I see 34:57 not an OB/GYN that says, "Oh, I see you're fertile again. You're ovulating 35:00 you're fertile again. You're ovulating 35:00 you're fertile again. You're ovulating after 11 months." That would be 35:01 after 11 months." That would be 35:02 after 11 months." That would be suspicious bleeding. Like, why are you 35:03 suspicious bleeding. Like, why are you 35:03 suspicious bleeding. Like, why are you bleeding after 11 months? It's 35:05 bleeding after 11 months? It's 35:05 bleeding after 11 months? It's arbitrary. Just because we have 12 35:07 arbitrary. Just because we have 12 35:07 arbitrary. Just because we have 12 months of the year doesn't mean you have 35:09 months of the year doesn't mean you have 35:09 months of the year doesn't mean you have 12 months of no bleeding and then you're 35:11 12 months of no bleeding and then you're 35:11 12 months of no bleeding and then you're suddenly automatically called 35:12 suddenly automatically called 35:12 suddenly automatically called menopausal. So if you think of it 35:16 menopausal. So if you think of it 35:16 menopausal. So if you think of it differently, forget the uterus. The 35:18 differently, forget the uterus. The 35:18 differently, forget the uterus. The uterus is just a target organ among all 35:21 uterus is just a target organ among all 35:21 uterus is just a target organ among all the other organs that have receptors, 35:23 the other organs that have receptors, 35:23 the other organs that have receptors, which is all of them for these hormones. 35:26 which is all of them for these hormones. 35:26 which is all of them for these hormones. So it's just an obvious thing. Like I've 35:28 So it's just an obvious thing. Like I've 35:28 So it's just an obvious thing. Like I've had patients, they had a hyerectomy. 35:29 had patients, they had a hyerectomy. 35:29 had patients, they had a hyerectomy. They said, "Does that mean I don't go 35:31 They said, "Does that mean I don't go 35:31 They said, "Does that mean I don't go into menopause?" It's like doesn't work 35:32 into menopause?" It's like doesn't work 35:32 into menopause?" It's like doesn't work that way. It's not about the uterus. 35:35 that way. It's not about the uterus. 35:35 that way. It's not about the uterus. It's that's just one organ that you can 35:38 It's that's just one organ that you can 35:38 It's that's just one organ that you can see the effects of when the hormones are 35:40 see the effects of when the hormones are 35:40 see the effects of when the hormones are changing. So, it's about ovarian aging. 35:44 changing. So, it's about ovarian aging. 35:44 changing. So, it's about ovarian aging. It's about ovarian hormones. And we now 35:47 It's about ovarian hormones. And we now 35:47 It's about ovarian hormones. And we now know there's this period of time called 35:49 know there's this period of time called 35:49 know there's this period of time called the perry menopause. Of course, life is 35:52 the perry menopause. Of course, life is 35:52 the perry menopause. Of course, life is always a continuum. You could say 35:53 always a continuum. You could say 35:54 always a continuum. You could say pmenopause is the day you're born. But 35:56 pmenopause is the day you're born. But 35:56 pmenopause is the day you're born. But you know in terms of when things really 35:58 you know in terms of when things really 35:58 you know in terms of when things really escalate we call it the decade before 36:01 escalate we call it the decade before 36:02 escalate we call it the decade before the official menopause is pmenopause and 36:05 the official menopause is pmenopause and 36:05 the official menopause is pmenopause and things really escalate in the five years 36:08 things really escalate in the five years 36:08 things really escalate in the five years before the official menopause. Now how 36:11 before the official menopause. Now how 36:11 before the official menopause. Now how would anybody know what those five years 36:14 would anybody know what those five years 36:14 would anybody know what those five years when that's happening? Right? Well, some 36:16 when that's happening? Right? Well, some 36:16 when that's happening? Right? Well, some women will have symptoms that if you 36:18 women will have symptoms that if you 36:18 women will have symptoms that if you actually do a little investigative 36:20 actually do a little investigative 36:20 actually do a little investigative reporting, you'll find that they do have 36:23 reporting, you'll find that they do have 36:23 reporting, you'll find that they do have altered sleep or mood or achiness or 36:27 altered sleep or mood or achiness or 36:27 altered sleep or mood or achiness or vaginal symptoms or bladder symptoms, 36:30 vaginal symptoms or bladder symptoms, 36:30 vaginal symptoms or bladder symptoms, things like that. So, but if you just 36:32 things like that. So, but if you just 36:32 things like that. So, but if you just know the normal age of menopause is 45 36:35 know the normal age of menopause is 45 36:35 know the normal age of menopause is 45 to 55, then by age 45, 36:39 to 55, then by age 45, 36:39 to 55, then by age 45, statistically speaking, virtually all 36:42 statistically speaking, virtually all 36:42 statistically speaking, virtually all women would be in pmenopause. So there's 36:46 women would be in pmenopause. So there's 36:46 women would be in pmenopause. So there's nothing wrong and there's nothing 36:47 nothing wrong and there's nothing 36:47 nothing wrong and there's nothing dangerous in giving some I call it 36:50 dangerous in giving some I call it 36:50 dangerous in giving some I call it supple supplemental hormones and of 36:53 supple supplemental hormones and of 36:53 supple supplemental hormones and of course you can do some measurements you 36:55 course you can do some measurements you 36:55 course you can do some measurements you can certainly do like CTX you can look 36:57 can certainly do like CTX you can look 36:57 can certainly do like CTX you can look for bone breakdown products and see is 37:00 for bone breakdown products and see is 37:00 for bone breakdown products and see is that happening you know are you losing 37:02 that happening you know are you losing 37:02 that happening you know are you losing bone because we know that you can lose a 37:04 bone because we know that you can lose a 37:04 bone because we know that you can lose a lot of collagen in your skin you know 37:07 lot of collagen in your skin you know 37:07 lot of collagen in your skin you know like skin changes occur before the 37:09 like skin changes occur before the 37:09 like skin changes occur before the official menopause you can lose a lot of 37:12 official menopause you can lose a lot of 37:12 official menopause you can lose a lot of bone before the official menopause OS 37:15 bone before the official menopause OS 37:15 bone before the official menopause OS you can have vascular changes all these 37:17 you can have vascular changes all these 37:17 you can have vascular changes all these things happening before the official 37:19 things happening before the official 37:19 things happening before the official menopause. So understanding that these 37:22 menopause. So understanding that these 37:22 menopause. So understanding that these hormones particularly estradiol 37:26 hormones particularly estradiol 37:26 hormones particularly estradiol prevent these things. Okay. And 37:28 prevent these things. Okay. And 37:28 prevent these things. Okay. And progesterone has a role as well. But so 37:31 progesterone has a role as well. But so 37:31 progesterone has a role as well. But so if you start the hormones and this is 37:33 if you start the hormones and this is 37:33 if you start the hormones and this is becoming more trendy too because I 37:36 becoming more trendy too because I 37:36 becoming more trendy too because I wasn't doing this my whole career. If 37:38 wasn't doing this my whole career. If 37:38 wasn't doing this my whole career. If you start the hormones as a supplemental 37:41 you start the hormones as a supplemental 37:41 you start the hormones as a supplemental hormone in the permenopausal 37:44 hormone in the permenopausal 37:44 hormone in the permenopausal years, even if they're having regular 37:46 years, even if they're having regular 37:46 years, even if they're having regular cycles, like I'll do menstrual mapping 37:49 cycles, like I'll do menstrual mapping 37:49 cycles, like I'll do menstrual mapping where using urine metabolites of these 37:51 where using urine metabolites of these 37:51 where using urine metabolites of these hormones, you can map out a normal 37:53 hormones, you can map out a normal 37:53 hormones, you can map out a normal menstrual cycle and we'll say a classic 37:55 menstrual cycle and we'll say a classic 37:55 menstrual cycle and we'll say a classic perfect menstrual cycle hormone. We'll 37:58 perfect menstrual cycle hormone. We'll 37:58 perfect menstrual cycle hormone. We'll say for estrogen, it starts low, it 38:00 say for estrogen, it starts low, it 38:00 say for estrogen, it starts low, it builds up, you get like a spike, and 38:01 builds up, you get like a spike, and 38:01 builds up, you get like a spike, and then it dips and then it comes up. So, 38:03 then it dips and then it comes up. So, 38:03 then it dips and then it comes up. So, it's at this level. Okay? And then you 38:05 it's at this level. Okay? And then you 38:05 it's at this level. Okay? And then you do the same thing in a woman who's 45. 38:07 do the same thing in a woman who's 45. 38:07 do the same thing in a woman who's 45. She's still having cycles, but the same 38:10 She's still having cycles, but the same 38:10 She's still having cycles, but the same hormones are like here. It's like 38:11 hormones are like here. It's like 38:11 hormones are like here. It's like they're miniaturaturized. Everything is 38:13 they're miniaturaturized. Everything is 38:14 they're miniaturaturized. Everything is lower. Okay, that's you know their eggs 38:16 lower. Okay, that's you know their eggs 38:16 lower. Okay, that's you know their eggs are older. They're not fertile 38:18 are older. They're not fertile 38:18 are older. They're not fertile particularly. They can they're not 38:20 particularly. They can they're not 38:20 particularly. They can they're not sterile, but their fertility at age 45 38:22 sterile, but their fertility at age 45 38:22 sterile, but their fertility at age 45 is so much reduced. You know, women who 38:25 is so much reduced. You know, women who 38:25 is so much reduced. You know, women who say I want to have a baby and I'm 45. 38:27 say I want to have a baby and I'm 45. 38:27 say I want to have a baby and I'm 45. The probability is not great. It's like 38:30 The probability is not great. It's like 38:30 The probability is not great. It's like pretty low, not impossible. But their 38:32 pretty low, not impossible. But their 38:32 pretty low, not impossible. But their hormones, their eggs, you know, you have 38:34 hormones, their eggs, you know, you have 38:34 hormones, their eggs, you know, you have to have healthy eggs to make healthy 38:36 to have healthy eggs to make healthy 38:36 to have healthy eggs to make healthy hormones. And it's like all linked in 38:38 hormones. And it's like all linked in 38:38 hormones. And it's like all linked in together and it becomes like a downward 38:40 together and it becomes like a downward 38:40 together and it becomes like a downward spiral in terms of the less estrogen you 38:43 spiral in terms of the less estrogen you 38:43 spiral in terms of the less estrogen you have, the less estrogen you make because 38:46 have, the less estrogen you make because 38:46 have, the less estrogen you make because the estrogen estradi is made in the 38:49 the estrogen estradi is made in the 38:49 the estrogen estradi is made in the mitochondria in the ovaries. And in 38:52 mitochondria in the ovaries. And in 38:52 mitochondria in the ovaries. And in order for mitochondria to be healthy and 38:54 order for mitochondria to be healthy and 38:54 order for mitochondria to be healthy and functioning optimally, you need estradi. 38:57 functioning optimally, you need estradi. 38:57 functioning optimally, you need estradi. And so when you have less estradiol your 38:59 And so when you have less estradiol your 38:59 And so when you have less estradiol your mitochondria which are the energy 39:02 mitochondria which are the energy 39:02 mitochondria which are the energy powerhouses but they also that's where 39:04 powerhouses but they also that's where 39:04 powerhouses but they also that's where you make steroid hormones. So they 39:06 you make steroid hormones. So they 39:06 you make steroid hormones. So they become less functional. So then less 39:09 become less functional. So then less 39:09 become less functional. So then less estradi less mitochondrial function less 39:12 estradi less mitochondrial function less 39:12 estradi less mitochondrial function less estradi production and it comes like a 39:15 estradi production and it comes like a 39:15 estradi production and it comes like a downward spiral. And understanding this 39:18 downward spiral. And understanding this 39:18 downward spiral. And understanding this can help to get doctors and health care 39:21 can help to get doctors and health care 39:21 can help to get doctors and health care pro professionals to start prescribing 39:24 pro professionals to start prescribing 39:24 pro professionals to start prescribing these hormones that are so critical for 39:26 these hormones that are so critical for 39:26 these hormones that are so critical for every organ system. And you know we 39:28 every organ system. And you know we 39:28 every organ system. And you know we focus on bone because bone has not been 39:31 focus on bone because bone has not been 39:32 focus on bone because bone has not been as popular an organ system. You know the 39:34 as popular an organ system. You know the 39:34 as popular an organ system. You know the muscularkeeletal system has not been as 39:37 muscularkeeletal system has not been as 39:37 muscularkeeletal system has not been as talked about as the cardiovascular 39:39 talked about as the cardiovascular 39:39 talked about as the cardiovascular system, the neurological system. You 39:41 system, the neurological system. You 39:41 system, the neurological system. You need all these systems, you know, and 39:43 need all these systems, you know, and 39:43 need all these systems, you know, and and bone is in, interestingly enough, an 39:45 and bone is in, interestingly enough, an 39:45 and bone is in, interestingly enough, an endocrine system, you know, it's like so 39:47 endocrine system, you know, it's like so 39:47 endocrine system, you know, it's like so many functions that have not been really 39:49 many functions that have not been really 39:49 many functions that have not been really talked about enough. So all of these 39:51 talked about enough. So all of these 39:52 talked about enough. So all of these systems will be benefited by getting 39:55 systems will be benefited by getting 39:55 systems will be benefited by getting hormones on board to a somewhat 39:58 hormones on board to a somewhat 39:58 hormones on board to a somewhat mimicking physiologic level so that you 40:01 mimicking physiologic level so that you 40:01 mimicking physiologic level so that you don't have that miniaturization of your 40:03 don't have that miniaturization of your 40:03 don't have that miniaturization of your hormone levels years before you actually 40:06 hormone levels years before you actually 40:06 hormone levels years before you actually lose all your hormones and lose all your 40:09 lose all your hormones and lose all your 40:09 lose all your hormones and lose all your cycles when you go into the official 40:10 cycles when you go into the official 40:10 cycles when you go into the official menopause. So my recommendation is for 40:13 menopause. So my recommendation is for 40:13 menopause. So my recommendation is for those of you who haven't yet reached 40:15 those of you who haven't yet reached 40:16 those of you who haven't yet reached that official menopause which is not a a 40:18 that official menopause which is not a a 40:18 that official menopause which is not a a lot of us have already missed that 40:20 lot of us have already missed that 40:20 lot of us have already missed that window that you start hormones and find 40:24 window that you start hormones and find 40:24 window that you start hormones and find a practitioner who understands hormones 40:26 a practitioner who understands hormones 40:26 a practitioner who understands hormones whatever that takes to get you on board 40:28 whatever that takes to get you on board 40:28 whatever that takes to get you on board with some hormones. Not heavyduty high 40:31 with some hormones. Not heavyduty high 40:31 with some hormones. Not heavyduty high high doses but just enough so that 40:33 high doses but just enough so that 40:34 high doses but just enough so that because we know even a small amount of 40:36 because we know even a small amount of 40:36 because we know even a small amount of additional like you mentioned a small 40:38 additional like you mentioned a small 40:38 additional like you mentioned a small amount of additional hormones can really 40:40 amount of additional hormones can really 40:40 amount of additional hormones can really help the bones a lot. So the bones are 40:42 help the bones a lot. So the bones are 40:42 help the bones a lot. So the bones are very sensitive to hormones. So even a 40:45 very sensitive to hormones. So even a 40:45 very sensitive to hormones. So even a tiny amount of estradiol can help 40:48 tiny amount of estradiol can help 40:48 tiny amount of estradiol can help prevent bone loss. To have bone growth 40:50 prevent bone loss. To have bone growth 40:50 prevent bone loss. To have bone growth you need much higher amounts but to 40:52 you need much higher amounts but to 40:52 you need much higher amounts but to prevent bone loss is not not that much. 40:55 prevent bone loss is not not that much. 40:55 prevent bone loss is not not that much. It's amazing. So it's really important 40:58 It's amazing. So it's really important 40:58 It's amazing. So it's really important but we lose so much bone before you even 41:00 but we lose so much bone before you even 41:00 but we lose so much bone before you even have a clue that you're already 41:02 have a clue that you're already 41:02 have a clue that you're already officially in menopause. So starting 41:05 officially in menopause. So starting 41:05 officially in menopause. So starting hormones early I you know in men perry 41:07 hormones early I you know in men perry 41:07 hormones early I you know in men perry menopause is is important and then 41:10 menopause is is important and then 41:10 menopause is is important and then [clears throat] in my opinion you just 41:12 [clears throat] in my opinion you just 41:12 [clears throat] in my opinion you just keep going once you get on the hormones 41:14 keep going once you get on the hormones 41:14 keep going once you get on the hormones you never stop like why would people up 41:18 you never stop like why would people up 41:18 you never stop like why would people up it's changing now but until relatively 41:21 it's changing now but until relatively 41:21 it's changing now but until relatively recently there was considered a hard 41:23 recently there was considered a hard 41:23 recently there was considered a hard stop like if you were on them not 41:25 stop like if you were on them not 41:25 stop like if you were on them not starting but ending so now they don't 41:28 starting but ending so now they don't 41:28 starting but ending so now they don't want to start women who are over 60 but 41:31 want to start women who are over 60 but 41:31 want to start women who are over 60 but it wasn't long ago that they wanted to 41:33 it wasn't long ago that they wanted to 41:33 it wasn't long ago that they wanted to stop all women on hormones when they hit 41:35 stop all women on hormones when they hit 41:35 stop all women on hormones when they hit 60. It's like, you're too old, lady. Now 41:37 60. It's like, you're too old, lady. Now 41:37 60. It's like, you're too old, lady. Now you have to stop your hormones. It's 41:39 you have to stop your hormones. It's 41:39 you have to stop your hormones. It's like so that you can just start the 41:41 like so that you can just start the 41:41 like so that you can just start the clock ticking and start losing all your 41:43 clock ticking and start losing all your 41:43 clock ticking and start losing all your bone, all your collagen, your joints 41:46 bone, all your collagen, your joints 41:46 bone, all your collagen, your joints will degrade, and then all the other 41:47 will degrade, and then all the other 41:48 will degrade, and then all the other organ systems will follow suit. So, what 41:50 organ systems will follow suit. So, what 41:50 organ systems will follow suit. So, what is there about age 60 that would dictate 41:53 is there about age 60 that would dictate 41:53 is there about age 60 that would dictate that you should suddenly stop the 41:54 that you should suddenly stop the 41:54 that you should suddenly stop the hormones? Nothing. So, that that's 41:57 hormones? Nothing. So, that that's 41:57 hormones? Nothing. So, that that's fading away, but not everywhere. There 42:00 fading away, but not everywhere. There 42:00 fading away, but not everywhere. There are still some doctors that haven't 42:01 are still some doctors that haven't 42:01 are still some doctors that haven't gotten the message. I don't know. 42:03 gotten the message. I don't know. 42:03 gotten the message. I don't know. They're in a La La Land and they just 42:05 They're in a La La Land and they just 42:06 They're in a La La Land and they just don't know that you don't have to ever 42:08 don't know that you don't have to ever 42:08 don't know that you don't have to ever stop hormones. I mean, ever. There's no 42:10 stop hormones. I mean, ever. There's no 42:10 stop hormones. I mean, ever. There's no hard stop date. It's like I call it the 42:13 hard stop date. It's like I call it the 42:13 hard stop date. It's like I call it the end of life. That's your hard stop date. 42:15 end of life. That's your hard stop date. 42:15 end of life. That's your hard stop date. So, why would I stop them? Because as 42:18 So, why would I stop them? Because as 42:18 So, why would I stop them? Because as soon as you stop hormones, bone loss 42:20 soon as you stop hormones, bone loss 42:20 soon as you stop hormones, bone loss escalates rapidly. Why on earth would 42:23 escalates rapidly. Why on earth would 42:23 escalates rapidly. Why on earth would you just stop them? But many women have 42:25 you just stop them? But many women have 42:25 you just stop them? But many women have been, you know, they were on hormones 42:27 been, you know, they were on hormones 42:27 been, you know, they were on hormones and then they reach 60, maybe 65, and 42:30 and then they reach 60, maybe 65, and 42:30 and then they reach 60, maybe 65, and then they're stopped. If you're on 42:32 then they're stopped. If you're on 42:32 then they're stopped. If you're on Medicare, Medicare doesn't want to cover 42:35 Medicare, Medicare doesn't want to cover 42:35 Medicare, Medicare doesn't want to cover hormones if you're 65 or older. They 42:38 hormones if you're 65 or older. They 42:38 hormones if you're 65 or older. They think you're too old. And they used to, 42:40 think you're too old. And they used to, 42:40 think you're too old. And they used to, I'm not sure if they still do, but they 42:41 I'm not sure if they still do, but they 42:41 I'm not sure if they still do, but they would send a letter to women saying, 42:43 would send a letter to women saying, 42:43 would send a letter to women saying, "You're no longer going to have coverage 42:45 "You're no longer going to have coverage 42:45 "You're no longer going to have coverage for your hormones, but you can go on 42:47 for your hormones, but you can go on 42:47 for your hormones, but you can go on Prozac." 42:49 Prozac." 42:49 Prozac." >> That's 42:51 >> That's 42:51 >> That's crazy. I just have a quick question for 42:52 crazy. I just have a quick question for 42:52 crazy. I just have a quick question for you. Early on, do you do blood value so 42:56 you. Early on, do you do blood value so 42:56 you. Early on, do you do blood value so you know their blood levels early on 42:59 you know their blood levels early on 42:59 you know their blood levels early on that 45year-old? like are you starting 43:01 that 45year-old? like are you starting 43:01 that 45year-old? like are you starting blood work at that point and monitor? 43:03 blood work at that point and monitor? 43:03 blood work at that point and monitor? >> I will sometimes get like the menstrual 43:05 >> I will sometimes get like the menstrual 43:05 >> I will sometimes get like the menstrual mapping. The problem with estradi is 43:09 mapping. The problem with estradi is 43:09 mapping. The problem with estradi is that the levels are shifting throughout 43:11 that the levels are shifting throughout 43:11 that the levels are shifting throughout the entire cycle. So if you're going to 43:15 the entire cycle. So if you're going to 43:15 the entire cycle. So if you're going to do it, which I do sometimes do, you 43:17 do it, which I do sometimes do, you 43:17 do it, which I do sometimes do, you would want to get it at a timed point. 43:20 would want to get it at a timed point. 43:20 would want to get it at a timed point. So you'd want to get it on one week 43:23 So you'd want to get it on one week 43:23 So you'd want to get it on one week before if you have a 28 day cycle. You'd 43:26 before if you have a 28 day cycle. You'd 43:26 before if you have a 28 day cycle. You'd want to get the levels of estradile and 43:28 want to get the levels of estradile and 43:28 want to get the levels of estradile and progesterone on day 21, which is what 43:30 progesterone on day 21, which is what 43:30 progesterone on day 21, which is what we've done for women who are having 43:32 we've done for women who are having 43:32 we've done for women who are having fertility issues to see are you getting 43:35 fertility issues to see are you getting 43:35 fertility issues to see are you getting a good spike of progesterone. Where are 43:38 a good spike of progesterone. Where are 43:38 a good spike of progesterone. Where are you at with your estradile? Because then 43:40 you at with your estradile? Because then 43:40 you at with your estradile? Because then you would be at your peak ludial phase 43:43 you would be at your peak ludial phase 43:43 you would be at your peak ludial phase levels. So that would be but even that 43:47 levels. So that would be but even that 43:47 levels. So that would be but even that has a a significant range even in like 43:50 has a a significant range even in like 43:50 has a a significant range even in like healthy 25 year olds like progesterone 43:53 healthy 25 year olds like progesterone 43:53 healthy 25 year olds like progesterone like what's a normal peak progesterone 43:55 like what's a normal peak progesterone 43:56 like what's a normal peak progesterone level well it should be over 10 it could 43:58 level well it should be over 10 it could 43:58 level well it should be over 10 it could be up to 30 I mean that's like one heck 44:01 be up to 30 I mean that's like one heck 44:01 be up to 30 I mean that's like one heck of a big range and I've seen it so many 44:03 of a big range and I've seen it so many 44:03 of a big range and I've seen it so many times that we test it and it's like oh 44:06 times that we test it and it's like oh 44:06 times that we test it and it's like oh it's just 11 and then they have a 44:08 it's just 11 and then they have a 44:08 it's just 11 and then they have a perfectly normal pregnancy you know or 44:11 perfectly normal pregnancy you know or 44:11 perfectly normal pregnancy you know or it's like 25 and then they don't get 44:13 it's like 25 and then they don't get 44:14 it's like 25 and then they don't get pregnant you know so you know it's h the 44:16 pregnant you know so you know it's h the 44:16 pregnant you know so you know it's h the range of normal is so significant if you 44:20 range of normal is so significant if you 44:20 range of normal is so significant if you look at the ludal phase levels for 44:22 look at the ludal phase levels for 44:22 look at the ludal phase levels for estradiol it could be I mean if you got 44:25 estradiol it could be I mean if you got 44:25 estradiol it could be I mean if you got a ludial phase level and it was 50 44:27 a ludial phase level and it was 50 44:27 a ludial phase level and it was 50 you're in trouble okay this is poggrams 44:29 you're in trouble okay this is poggrams 44:29 you're in trouble okay this is poggrams per mill but so normal could be up to 44:32 per mill but so normal could be up to 44:32 per mill but so normal could be up to over 200 but it could be like 125 in 44:36 over 200 but it could be like 125 in 44:36 over 200 but it could be like 125 in some women and they have a healthy 44:37 some women and they have a healthy 44:37 some women and they have a healthy pregnancy you know it would be great if 44:39 pregnancy you know it would be great if 44:39 pregnancy you know it would be great if we got lots of like every year from the 44:42 we got lots of like every year from the 44:42 we got lots of like every year from the time you're 25 we did, but nobody's 44:44 time you're 25 we did, but nobody's 44:44 time you're 25 we did, but nobody's doing this. You know, you get like peak 44:47 doing this. You know, you get like peak 44:47 doing this. You know, you get like peak ludial phase levels, assuming you're not 44:49 ludial phase levels, assuming you're not 44:49 ludial phase levels, assuming you're not on birth control pills, in which case 44:50 on birth control pills, in which case 44:50 on birth control pills, in which case you have no none of this is applicable, 44:53 you have no none of this is applicable, 44:53 you have no none of this is applicable, but you get a peak level of the ludal 44:56 but you get a peak level of the ludal 44:56 but you get a peak level of the ludal phase like day 21 of a 28 day cycle and 44:59 phase like day 21 of a 28 day cycle and 44:59 phase like day 21 of a 28 day cycle and you do it every year, you know, and then 45:01 you do it every year, you know, and then 45:01 you do it every year, you know, and then you see, well, how is this changing over 45:04 you see, well, how is this changing over 45:04 you see, well, how is this changing over time? That would be really interesting. 45:06 time? That would be really interesting. 45:06 time? That would be really interesting. Nobody's doing that. I haven't been 45:08 Nobody's doing that. I haven't been 45:08 Nobody's doing that. I haven't been doing that, but that that would be like 45:10 doing that, but that that would be like 45:10 doing that, but that that would be like to me really amazing to do that and then 45:14 to me really amazing to do that and then 45:14 to me really amazing to do that and then see if there's a trend over time as you 45:17 see if there's a trend over time as you 45:17 see if there's a trend over time as you get say around age 40 where it's really 45:19 get say around age 40 where it's really 45:19 get say around age 40 where it's really clearly dropping even though it could be 45:22 clearly dropping even though it could be 45:22 clearly dropping even though it could be so-called in the normal range. Right. So 45:25 so-called in the normal range. Right. So 45:25 so-called in the normal range. Right. So very very interesting. 45:27 very very interesting. 45:27 very very interesting. >> Basically though what you're saying is 45:29 >> Basically though what you're saying is 45:29 >> Basically though what you're saying is the low dose at that point just to give 45:32 the low dose at that point just to give 45:32 the low dose at that point just to give you a little additional can make all the 45:34 you a little additional can make all the 45:34 you a little additional can make all the difference in the world. 45:34 difference in the world. 45:34 difference in the world. >> It's like a safety net. 45:35 >> It's like a safety net. 45:36 >> It's like a safety net. >> Yeah. Yeah. So that's great. And then 45:37 >> Yeah. Yeah. So that's great. And then 45:37 >> Yeah. Yeah. So that's great. And then once people hit menopause and they're 45:40 once people hit menopause and they're 45:40 once people hit menopause and they're not cycling, that's when we can do more 45:42 not cycling, that's when we can do more 45:42 not cycling, that's when we can do more monitoring. So talk about okay, so now
What Dr. Gersh says about different HRT regimens 45:45 monitoring. So talk about okay, so now 45:45 monitoring. So talk about okay, so now what is safe? Because you also hear all 45:49 what is safe? Because you also hear all 45:49 what is safe? Because you also hear all different things and you know sometimes 45:51 different things and you know sometimes 45:51 different things and you know sometimes you just want to cringe. You hear 45:53 you just want to cringe. You hear 45:53 you just want to cringe. You hear pellets, you hear this, you hear that. 45:55 pellets, you hear this, you hear that. 45:55 pellets, you hear this, you hear that. Do you want to share your feelings on 45:57 Do you want to share your feelings on 45:57 Do you want to share your feelings on what's safe and how to go about it in 46:00 what's safe and how to go about it in 46:00 what's safe and how to go about it in the best way? 46:01 the best way? 46:01 the best way? >> Sure. Well, the current most popular 46:06 >> Sure. Well, the current most popular 46:06 >> Sure. Well, the current most popular hormone regimen is not in any way 46:09 hormone regimen is not in any way 46:09 hormone regimen is not in any way physiologic. It's actually not based on 46:11 physiologic. It's actually not based on 46:12 physiologic. It's actually not based on any science. It's just convenience. And 46:15 any science. It's just convenience. And 46:15 any science. It's just convenience. And I there's a certain point in having 46:17 I there's a certain point in having 46:17 I there's a certain point in having something that's easy to use and 46:19 something that's easy to use and 46:19 something that's easy to use and convenient. But I'm a very sort of if it 46:22 convenient. But I'm a very sort of if it 46:22 convenient. But I'm a very sort of if it doesn't match with human physiology, 46:24 doesn't match with human physiology, 46:24 doesn't match with human physiology, it's not my favorite. Okay. Is it better 46:27 it's not my favorite. Okay. Is it better 46:27 it's not my favorite. Okay. Is it better than nothing? Well, clearly for the 46:29 than nothing? Well, clearly for the 46:29 than nothing? Well, clearly for the bones it is better than nothing. Is it 46:31 bones it is better than nothing. Is it 46:31 bones it is better than nothing. Is it better for the brain than nothing? 46:33 better for the brain than nothing? 46:33 better for the brain than nothing? That's so that's unclear. That's like 46:36 That's so that's unclear. That's like 46:36 That's so that's unclear. That's like which we can touch on. So the most 46:38 which we can touch on. So the most 46:38 which we can touch on. So the most common popular method protocol for 46:41 common popular method protocol for 46:41 common popular method protocol for hormones now is a very small dose not 46:46 hormones now is a very small dose not 46:46 hormones now is a very small dose not like minute although some people are on 46:48 like minute although some people are on 46:48 like minute although some people are on like the patch comes in five different 46:50 like the patch comes in five different 46:50 like the patch comes in five different doses. Many women are put on the very 46:53 doses. Many women are put on the very 46:53 doses. Many women are put on the very lowest dose 0.025 025, which is not an 46:57 lowest dose 0.025 025, which is not an 46:57 lowest dose 0.025 025, which is not an ideal dose even for reducing nights, 46:59 ideal dose even for reducing nights, 46:59 ideal dose even for reducing nights, sweats, and hot flashes. That's not the 47:01 sweats, and hot flashes. That's not the 47:01 sweats, and hot flashes. That's not the ideal dose at all. But most women are 47:03 ideal dose at all. But most women are 47:04 ideal dose at all. But most women are probably on the 0.05. That's like the 47:06 probably on the 0.05. That's like the 47:06 probably on the 0.05. That's like the most popular. That is the dose that was 47:09 most popular. That is the dose that was 47:09 most popular. That is the dose that was used in the study called the keep study 47:13 used in the study called the keep study 47:13 used in the study called the keep study that they did for just a few years back 47:16 that they did for just a few years back 47:16 that they did for just a few years back I don't know like around 2007 something 47:18 I don't know like around 2007 something 47:18 I don't know like around 2007 something like that to see if that by using more 47:23 like that to see if that by using more 47:23 like that to see if that by using more bioididentical hormones that study used 47:26 bioididentical hormones that study used 47:26 bioididentical hormones that study used a 045 millgram dose of primer and the 47:30 a 045 millgram dose of primer and the 47:30 a 045 millgram dose of primer and the women's health initiative was 625 so 47:33 women's health initiative was 625 so 47:33 women's health initiative was 625 so they used a smaller dose of primer and 47:35 they used a smaller dose of primer and 47:35 they used a smaller dose of primer and they used an estrogen patch of 0.05 47:39 they used an estrogen patch of 0.05 47:39 they used an estrogen patch of 0.05 and then they combined it with oral 47:43 and then they combined it with oral 47:43 and then they combined it with oral progesterone 200 mg for 12 days and in a 47:48 progesterone 200 mg for 12 days and in a 47:48 progesterone 200 mg for 12 days and in a cyclic regimen. They measured the 47:51 cyclic regimen. They measured the 47:51 cyclic regimen. They measured the estradiol levels and the vast majority 47:54 estradiol levels and the vast majority 47:54 estradiol levels and the vast majority of women never got out of the menopausal 47:57 of women never got out of the menopausal 47:57 of women never got out of the menopausal range of estradi on that dose. It was 48:01 range of estradi on that dose. It was 48:01 range of estradi on that dose. It was higher than like some women in menopause 48:03 higher than like some women in menopause 48:04 higher than like some women in menopause their levels will be like less than 10 48:06 their levels will be like less than 10 48:06 their levels will be like less than 10 like like rock bottom it'll be like 48:08 like like rock bottom it'll be like 48:08 like like rock bottom it'll be like seven eight it's like really really 48:10 seven eight it's like really really 48:10 seven eight it's like really really really low levels of estradile some will 48:12 really low levels of estradile some will 48:12 really low levels of estradile some will be more like 20 and their levels were 48:15 be more like 20 and their levels were 48:15 be more like 20 and their levels were higher but it rarely got above like a 40 48:18 higher but it rarely got above like a 40 48:18 higher but it rarely got above like a 40 which is anything below 50 is still 48:20 which is anything below 50 is still 48:20 which is anything below 50 is still considered in the menopausal range so I 48:23 considered in the menopausal range so I 48:23 considered in the menopausal range so I wouldn't call that like that would not 48:25 wouldn't call that like that would not 48:26 wouldn't call that like that would not be a level that you would see in women 48:28 be a level that you would see in women 48:28 be a level that you would see in women who were healthy 25 y olds for more than 48:31 who were healthy 25 y olds for more than 48:31 who were healthy 25 y olds for more than just maybe a couple of days of the 48:33 just maybe a couple of days of the 48:33 just maybe a couple of days of the menstrual cycle. That would be at the 48:35 menstrual cycle. That would be at the 48:35 menstrual cycle. That would be at the like when they're bleeding when the 48:36 like when they're bleeding when the 48:36 like when they're bleeding when the estradiol level is the lowest. It would 48:38 estradiol level is the lowest. It would 48:38 estradiol level is the lowest. It would not be a continual that's their level 48:41 not be a continual that's their level 48:41 not be a continual that's their level because that's what they would give the 48:43 because that's what they would give the 48:43 because that's what they would give the estradiol patch at 0.05 every day. That 48:46 estradiol patch at 0.05 every day. That 48:46 estradiol patch at 0.05 every day. That was the dose of patch that was on them. 48:48 was the dose of patch that was on them. 48:48 was the dose of patch that was on them. So their levels would never get above 48:50 So their levels would never get above 48:50 So their levels would never get above that which is not physiologic 48:53 that which is not physiologic 48:53 that which is not physiologic but it does do good some good stuff for 48:56 but it does do good some good stuff for 48:56 but it does do good some good stuff for bone. So I have to say that and then it 48:59 bone. So I have to say that and then it 48:59 bone. So I have to say that and then it would be combined with an nowadays the 49:02 would be combined with an nowadays the 49:02 would be combined with an nowadays the most common is oral progesterone 49:06 most common is oral progesterone 49:06 most common is oral progesterone typically at 100 milligrams. Now oral 49:10 typically at 100 milligrams. Now oral 49:10 typically at 100 milligrams. Now oral progesterone 49:11 progesterone 49:11 progesterone when you take it like we have moved away 49:13 when you take it like we have moved away 49:14 when you take it like we have moved away most of us from oral estrogen because we 49:17 most of us from oral estrogen because we 49:17 most of us from oral estrogen because we know it has what's called the first pass 49:20 know it has what's called the first pass 49:20 know it has what's called the first pass through the liver. When you swallow it 49:23 through the liver. When you swallow it 49:23 through the liver. When you swallow it goes through the digestive tract and it 49:25 goes through the digestive tract and it 49:25 goes through the digestive tract and it goes to the liver. The liver is the 49:27 goes to the liver. The liver is the 49:27 goes to the liver. The liver is the master organ of metabolic 49:29 master organ of metabolic 49:29 master organ of metabolic transformation. It has all these enzyme 49:32 transformation. It has all these enzyme 49:32 transformation. It has all these enzyme systems that convert one molecule into 49:35 systems that convert one molecule into 49:35 systems that convert one molecule into another molecule primarily for the 49:37 another molecule primarily for the 49:37 another molecule primarily for the purpose of either making proteins or 49:41 purpose of either making proteins or 49:41 purpose of either making proteins or converting something from fat to water 49:43 converting something from fat to water 49:43 converting something from fat to water soluble so you can exit it from the body 49:46 soluble so you can exit it from the body 49:46 soluble so you can exit it from the body because that's part of the like bot 49:48 because that's part of the like bot 49:48 because that's part of the like bot transformation or detoxification 49:51 transformation or detoxification 49:51 transformation or detoxification function of the liver. So when the liver 49:53 function of the liver. So when the liver 49:53 function of the liver. So when the liver was never designed to suddenly see these 49:56 was never designed to suddenly see these 49:56 was never designed to suddenly see these large bololises of hormones showing up 49:59 large bololises of hormones showing up 49:59 large bololises of hormones showing up because that's not how it works from the 50:01 because that's not how it works from the 50:01 because that's not how it works from the ovaries. When the ovaries produce these 50:03 ovaries. When the ovaries produce these 50:03 ovaries. When the ovaries produce these hormones, it goes into the bloodstream 50:05 hormones, it goes into the bloodstream 50:05 hormones, it goes into the bloodstream in little pulses throughout the day and 50:07 in little pulses throughout the day and 50:07 in little pulses throughout the day and night. It doesn't have like whoa a big 50:10 night. It doesn't have like whoa a big 50:10 night. It doesn't have like whoa a big bunch comes out at first thing in the 50:11 bunch comes out at first thing in the 50:12 bunch comes out at first thing in the morning and just you know like just 50:14 morning and just you know like just 50:14 morning and just you know like just inates the body with hormone. It's not 50:16 inates the body with hormone. It's not 50:16 inates the body with hormone. It's not how it works. So when you have the liver 50:19 how it works. So when you have the liver 50:19 how it works. So when you have the liver suddenly seeing this huge amount of 50:22 suddenly seeing this huge amount of 50:22 suddenly seeing this huge amount of estradile, it's like what the heck is 50:24 estradile, it's like what the heck is 50:24 estradile, it's like what the heck is going on here? Anyway, it converts the 50:26 going on here? Anyway, it converts the 50:26 going on here? Anyway, it converts the vast majority of it to a different form 50:28 vast majority of it to a different form 50:28 vast majority of it to a different form of estrogen called eststerone 50:31 of estrogen called eststerone 50:32 of estrogen called eststerone which has a different binding ability to 50:34 which has a different binding ability to 50:34 which has a different binding ability to different receptors. It binds to one 50:37 different receptors. It binds to one 50:37 different receptors. It binds to one predominantly the alpha whereas estradi 50:40 predominantly the alpha whereas estradi 50:40 predominantly the alpha whereas estradi has affinity for all the different 50:42 has affinity for all the different 50:42 has affinity for all the different receptors the three receptors alpha beta 50:44 receptors the three receptors alpha beta 50:44 receptors the three receptors alpha beta and groin coupled receptor. It's in the 50:47 and groin coupled receptor. It's in the 50:47 and groin coupled receptor. It's in the family of estrogens. But just like all 50:50 family of estrogens. But just like all 50:50 family of estrogens. But just like all fats are not the same. There's 50:51 fats are not the same. There's 50:51 fats are not the same. There's saturated, monounsaturated, 50:54 saturated, monounsaturated, 50:54 saturated, monounsaturated, you know, there's polyunsaturated, all 50:56 you know, there's polyunsaturated, all 50:56 you know, there's polyunsaturated, all these different fats, even though they 50:57 these different fats, even though they 50:57 these different fats, even though they belong to the family of fats. So they're 50:59 belong to the family of fats. So they're 50:59 belong to the family of fats. So they're different estrogens. They belong to the 51:01 different estrogens. They belong to the 51:01 different estrogens. They belong to the family of estrogens, but they have 51:02 family of estrogens, but they have 51:02 family of estrogens, but they have different abilities to do different 51:04 different abilities to do different 51:04 different abilities to do different things in the body. So you swallow 51:06 things in the body. So you swallow 51:06 things in the body. So you swallow estradi, but in the blood, it comes in 51:08 estradi, but in the blood, it comes in 51:08 estradi, but in the blood, it comes in as estrone. So we've moved away from 51:11 as estrone. So we've moved away from 51:11 as estrone. So we've moved away from that because we want estradi. That's the 51:13 that because we want estradi. That's the 51:13 that because we want estradi. That's the estrogen that the ovary pops into the 51:16 estrogen that the ovary pops into the 51:16 estrogen that the ovary pops into the bloodstream. Well, what happens when you 51:18 bloodstream. Well, what happens when you 51:18 bloodstream. Well, what happens when you swallow progesterone? Well, it goes to 51:20 swallow progesterone? Well, it goes to 51:20 swallow progesterone? Well, it goes to the liver just the same through the 51:22 the liver just the same through the 51:22 the liver just the same through the digestive tract. And about 90% of that 51:26 digestive tract. And about 90% of that 51:26 digestive tract. And about 90% of that progesterone is converted by the liver 51:28 progesterone is converted by the liver 51:28 progesterone is converted by the liver into other stuff called metabolites. 51:32 into other stuff called metabolites. 51:32 into other stuff called metabolites. Like over 30 different molecules are 51:34 Like over 30 different molecules are 51:34 Like over 30 different molecules are made from progesterone. And only a small 51:37 made from progesterone. And only a small 51:37 made from progesterone. And only a small amount, really small amount of 51:39 amount, really small amount of 51:39 amount, really small amount of progesterone actually gets into the 51:41 progesterone actually gets into the 51:41 progesterone actually gets into the bloodstream. and it gets in like a 51:43 bloodstream. and it gets in like a 51:43 bloodstream. and it gets in like a little spike and then it's down pretty 51:45 little spike and then it's down pretty 51:45 little spike and then it's down pretty fast. Like within two hours it's all 51:47 fast. Like within two hours it's all 51:47 fast. Like within two hours it's all gone. It goes drip pretty much. And the 51:50 gone. It goes drip pretty much. And the 51:50 gone. It goes drip pretty much. And the dominant metabolite that's coming from 51:52 dominant metabolite that's coming from 51:52 dominant metabolite that's coming from progesterone through this change of it 51:54 progesterone through this change of it 51:54 progesterone through this change of it in the liver is called alopregnanolone. 51:57 in the liver is called alopregnanolone. 51:58 in the liver is called alopregnanolone. Now alopreganolone is not progesterone. 52:00 Now alopreganolone is not progesterone. 52:00 Now alopreganolone is not progesterone. It doesn't bind to the same receptors. 52:02 It doesn't bind to the same receptors. 52:02 It doesn't bind to the same receptors. It's a different molecule but it's a 52:04 It's a different molecule but it's a 52:04 It's a different molecule but it's a very important molecule in the brain in 52:06 very important molecule in the brain in 52:06 very important molecule in the brain in the right amount. When you have the 52:08 the right amount. When you have the 52:08 the right amount. When you have the right amount of alopignolone in the 52:10 right amount of alopignolone in the 52:10 right amount of alopignolone in the brain, it seems to be neuroprotective. 52:12 brain, it seems to be neuroprotective. 52:12 brain, it seems to be neuroprotective. It may reduce the risk of Alzheimer's 52:15 It may reduce the risk of Alzheimer's 52:15 It may reduce the risk of Alzheimer's and it binds to the GABA A receptor. 52:18 and it binds to the GABA A receptor. 52:18 and it binds to the GABA A receptor. GABA is an a neurotransmitter and of 52:21 GABA is an a neurotransmitter and of 52:21 GABA is an a neurotransmitter and of course it's elsewhere because all these 52:22 course it's elsewhere because all these 52:22 course it's elsewhere because all these things are multitasking. But in the 52:24 things are multitasking. But in the 52:24 things are multitasking. But in the brain, it's an inhibitory 52:26 brain, it's an inhibitory 52:26 brain, it's an inhibitory neurotransmitter. 52:28 neurotransmitter. 52:28 neurotransmitter. So it kind of calms the brain down. It 52:31 So it kind of calms the brain down. It 52:31 So it kind of calms the brain down. It makes you sleepy. It like reduces 52:33 makes you sleepy. It like reduces 52:33 makes you sleepy. It like reduces anxiety. It facilitates sleep. Okay, 52:36 anxiety. It facilitates sleep. Okay, 52:36 anxiety. It facilitates sleep. Okay, that's why you know people like GABA. 52:39 that's why you know people like GABA. 52:39 that's why you know people like GABA. And when you take a tranquilizer like 52:42 And when you take a tranquilizer like 52:42 And when you take a tranquilizer like Valium or Xanax, it also works on GABA, 52:46 Valium or Xanax, it also works on GABA, 52:46 Valium or Xanax, it also works on GABA, it works on the GABA A receptors at a 52:48 it works on the GABA A receptors at a 52:48 it works on the GABA A receptors at a different spot, but in a similar manner 52:51 different spot, but in a similar manner 52:51 different spot, but in a similar manner to facilitate calmness and sleep. So 52:54 to facilitate calmness and sleep. So 52:54 to facilitate calmness and sleep. So that's why a lot of women, they take 52:56 that's why a lot of women, they take 52:56 that's why a lot of women, they take progesterone orally, and they say, "Wow, 52:59 progesterone orally, and they say, "Wow, 52:59 progesterone orally, and they say, "Wow, I'm sleeping better, lady. I'm sorry to 53:03 I'm sleeping better, lady. I'm sorry to 53:03 I'm sleeping better, lady. I'm sorry to tell you this. You're taking a sleeping 53:05 tell you this. You're taking a sleeping 53:05 tell you this. You're taking a sleeping pill. you're taking a tranquilizer 53:07 pill. you're taking a tranquilizer 53:07 pill. you're taking a tranquilizer because it's being converted in the 53:09 because it's being converted in the 53:09 because it's being converted in the liver to the molecule alopreganolone 53:12 liver to the molecule alopreganolone 53:12 liver to the molecule alopreganolone which is not a benzoazipene. It's not 53:15 which is not a benzoazipene. It's not 53:15 which is not a benzoazipene. It's not you know it's not addicting in the same 53:17 you know it's not addicting in the same 53:17 you know it's not addicting in the same sense like if you took Valium all the 53:19 sense like if you took Valium all the 53:19 sense like if you took Valium all the time but it works in a very similar 53:23 time but it works in a very similar 53:23 time but it works in a very similar comparable manner to increase GABA. And 53:27 comparable manner to increase GABA. And 53:27 comparable manner to increase GABA. And you know, it's like you're like you're 53:29 you know, it's like you're like you're 53:29 you know, it's like you're like you're taking a sleeping pill or tranquilizer 53:31 taking a sleeping pill or tranquilizer 53:31 taking a sleeping pill or tranquilizer every night and you're getting very 53:33 every night and you're getting very 53:33 every night and you're getting very little progesterone, but you're using it 53:35 little progesterone, but you're using it 53:35 little progesterone, but you're using it really as what is called, this is the 53:37 really as what is called, this is the 53:37 really as what is called, this is the official word, a pro drug. You're using 53:40 official word, a pro drug. You're using 53:40 official word, a pro drug. You're using it, you're taking it as progesterone, 53:42 it, you're taking it as progesterone, 53:42 it, you're taking it as progesterone, but it you're actually liking it because 53:44 but it you're actually liking it because 53:44 but it you're actually liking it because it's turning into something else. Okay? 53:46 it's turning into something else. Okay? 53:46 it's turning into something else. Okay? And you get very little progesterone. 53:48 And you get very little progesterone. 53:48 And you get very little progesterone. And progesterone has a whole bunch of 53:50 And progesterone has a whole bunch of 53:50 And progesterone has a whole bunch of really good effects, but you don't get 53:51 really good effects, but you don't get 53:51 really good effects, but you don't get much of them when you do that. But the 53:53 much of them when you do that. But the 53:53 much of them when you do that. But the interesting thing is that somehow it 53:57 interesting thing is that somehow it 53:57 interesting thing is that somehow it alters the genetic priming of the 54:00 alters the genetic priming of the 54:00 alters the genetic priming of the endometrial cells, the lining cells of 54:02 endometrial cells, the lining cells of 54:02 endometrial cells, the lining cells of the uterus to lower the risk of uterine 54:05 the uterus to lower the risk of uterine 54:05 the uterus to lower the risk of uterine cancer. It doesn't actually convert it 54:07 cancer. It doesn't actually convert it 54:07 cancer. It doesn't actually convert it to like the way that progesterone 54:09 to like the way that progesterone 54:09 to like the way that progesterone converts the uterine lining to 54:11 converts the uterine lining to 54:11 converts the uterine lining to secrettory like the change effect in a 54:14 secrettory like the change effect in a 54:14 secrettory like the change effect in a normal menstrual cycle. It doesn't 54:15 normal menstrual cycle. It doesn't 54:15 normal menstrual cycle. It doesn't really do that. It does something 54:18 really do that. It does something 54:18 really do that. It does something genetically to the uterine lining cells 54:21 genetically to the uterine lining cells 54:21 genetically to the uterine lining cells that lowers the risk of turning into 54:23 that lowers the risk of turning into 54:23 that lowers the risk of turning into cancer. That said, continuous 54:27 cancer. That said, continuous 54:27 cancer. That said, continuous progesterone with estradiol does not 54:30 progesterone with estradiol does not 54:30 progesterone with estradiol does not seem to be so protective once you get 54:32 seem to be so protective once you get 54:32 seem to be so protective once you get five years out and that all the data is 54:34 five years out and that all the data is 54:34 five years out and that all the data is with also that 0.05 dose. So you 54:37 with also that 0.05 dose. So you 54:37 with also that 0.05 dose. So you shouldn't be like so cocky, you know, 54:39 shouldn't be like so cocky, you know, 54:39 shouldn't be like so cocky, you know, anybody out there. Oh, I'm so protected 54:41 anybody out there. Oh, I'm so protected 54:41 anybody out there. Oh, I'm so protected from uterine cancer because it seems 54:43 from uterine cancer because it seems 54:43 from uterine cancer because it seems that effect seems to dissipate by 3 to 5 54:45 that effect seems to dissipate by 3 to 5 54:45 that effect seems to dissipate by 3 to 5 years and it's only really been shown 54:48 years and it's only really been shown 54:48 years and it's only really been shown with that one dose of estradiol, the 54:50 with that one dose of estradiol, the 54:50 with that one dose of estradiol, the 0.05. So, you still have to be alert if 54:52 0.05. So, you still have to be alert if 54:52 0.05. So, you still have to be alert if you start having random bleeding or 54:54 you start having random bleeding or 54:54 you start having random bleeding or whatever because it's not like you're 54:56 whatever because it's not like you're 54:56 whatever because it's not like you're guaranteed you can't get uterine cancer 54:58 guaranteed you can't get uterine cancer 54:58 guaranteed you can't get uterine cancer from like an opposed estrogen effect 55:01 from like an opposed estrogen effect 55:01 from like an opposed estrogen effect because that progesterone is really not 55:03 because that progesterone is really not 55:03 because that progesterone is really not not as good as people like to think it 55:05 not as good as people like to think it 55:05 not as good as people like to think it is for that purpose. But here's where 55:08 is for that purpose. But here's where 55:08 is for that purpose. But here's where the problem is. We don't have human 55:11 the problem is. We don't have human 55:11 the problem is. We don't have human data. We only have rodent data like mice 55:15 data. We only have rodent data like mice 55:15 data. We only have rodent data like mice and rats. But if you gave a bunch of 55:18 and rats. But if you gave a bunch of 55:18 and rats. But if you gave a bunch of rats the same protocol where you gave 55:21 rats the same protocol where you gave 55:21 rats the same protocol where you gave them continuous progesterone that in 55:24 them continuous progesterone that in 55:24 them continuous progesterone that in that manner and you gave them a small 55:27 that manner and you gave them a small 55:27 that manner and you gave them a small amount of estradile all the time that 55:31 amount of estradile all the time that 55:31 amount of estradile all the time that constant exposure to stimulated GABA 55:35 constant exposure to stimulated GABA 55:35 constant exposure to stimulated GABA which is inhibitory. 55:37 which is inhibitory. 55:37 which is inhibitory. It can also inh like you're not going to 55:39 It can also inh like you're not going to 55:39 It can also inh like you're not going to have the most amazing brilliant thoughts 55:41 have the most amazing brilliant thoughts 55:41 have the most amazing brilliant thoughts as you're falling asleep. You may think 55:43 as you're falling asleep. You may think 55:43 as you're falling asleep. You may think you are but you're not. you don't 55:44 you are but you're not. you don't 55:44 you are but you're not. you don't remember stuff because it impairs memory 55:46 remember stuff because it impairs memory 55:46 remember stuff because it impairs memory and it impairs cognitive function 55:49 and it impairs cognitive function 55:49 and it impairs cognitive function because you're falling asleep. Okay? 55:51 because you're falling asleep. Okay? 55:51 because you're falling asleep. Okay? You're not your brain is supposed to be 55:52 You're not your brain is supposed to be 55:52 You're not your brain is supposed to be resting. So if you're constantly 55:54 resting. So if you're constantly 55:54 resting. So if you're constantly exposing your brain to supraysiologic 55:58 exposing your brain to supraysiologic 55:58 exposing your brain to supraysiologic doses when you take oral progesterone 56:01 doses when you take oral progesterone 56:01 doses when you take oral progesterone like a 100 milligrams the amount of GABA 56:05 like a 100 milligrams the amount of GABA 56:05 like a 100 milligrams the amount of GABA stimulation the amount of alopanolone 56:08 stimulation the amount of alopanolone 56:08 stimulation the amount of alopanolone that circulates in the blood is 56:10 that circulates in the blood is 56:10 that circulates in the blood is something like like two and a half three 56:13 something like like two and a half three 56:13 something like like two and a half three times the level you would ever naturally 56:16 times the level you would ever naturally 56:16 times the level you would ever naturally ever have at a peak in a a natural 56:18 ever have at a peak in a a natural 56:18 ever have at a peak in a a natural menstrual cycle. And if you're on 200, 56:20 menstrual cycle. And if you're on 200, 56:20 menstrual cycle. And if you're on 200, it's like five times the level of alop 56:23 it's like five times the level of alop 56:23 it's like five times the level of alop pregnanolone. And if that and in a human 56:25 pregnanolone. And if that and in a human 56:25 pregnanolone. And if that and in a human female, it would only be for a much less 56:27 female, it would only be for a much less 56:28 female, it would only be for a much less amount for only 14 days a month. But so 56:30 amount for only 14 days a month. But so 56:30 amount for only 14 days a month. But so if it's every day, every day, every day 56:33 if it's every day, every day, every day 56:33 if it's every day, every day, every day in rodents, they get demented. 56:37 in rodents, they get demented. 56:37 in rodents, they get demented. Now, we don't have human data. So the 56:40 Now, we don't have human data. So the 56:40 Now, we don't have human data. So the way I look at it, and I don't have a 56:42 way I look at it, and I don't have a 56:42 way I look at it, and I don't have a better way to look at it because I don't 56:44 better way to look at it because I don't 56:44 better way to look at it because I don't have human data. If I had a study and I 56:47 have human data. If I had a study and I 56:47 have human data. If I had a study and I gave a bunch of rats a drug and most of 56:51 gave a bunch of rats a drug and most of 56:51 gave a bunch of rats a drug and most of the rats died, I probably wouldn't 56:53 the rats died, I probably wouldn't 56:53 the rats died, I probably wouldn't prescribe that drug to all my patients. 56:55 prescribe that drug to all my patients. 56:55 prescribe that drug to all my patients. If I have a study with rodents and most 56:58 If I have a study with rodents and most 56:58 If I have a study with rodents and most of them get demented, I don't really 57:01 of them get demented, I don't really 57:01 of them get demented, I don't really want to give that regimen to my patients 57:03 want to give that regimen to my patients 57:03 want to give that regimen to my patients or to myself. Do I have the absolute 57:06 or to myself. Do I have the absolute 57:06 or to myself. Do I have the absolute answer? No, I do not. We know that small 57:10 answer? No, I do not. We know that small 57:10 answer? No, I do not. We know that small amounts maybe of of oral progesterone to 57:13 amounts maybe of of oral progesterone to 57:13 amounts maybe of of oral progesterone to get more physiologic levels of alop 57:16 get more physiologic levels of alop 57:16 get more physiologic levels of alop pregnanolone which do tend to decline 57:18 pregnanolone which do tend to decline 57:18 pregnanolone which do tend to decline with aging may actually be beneficial. 57:21 with aging may actually be beneficial. 57:21 with aging may actually be beneficial. So we definitely what do we need? We 57:23 So we definitely what do we need? We 57:23 So we definitely what do we need? We need human studies desperately. So with 57:26 need human studies desperately. So with 57:26 need human studies desperately. So with a lack of human studies and with the 57:29 a lack of human studies and with the 57:29 a lack of human studies and with the standard recommendation that in early 57:32 standard recommendation that in early 57:32 standard recommendation that in early onset of menopause women that you give 57:35 onset of menopause women that you give 57:35 onset of menopause women that you give physiologic cyclic regimens. That's what 57:39 physiologic cyclic regimens. That's what 57:39 physiologic cyclic regimens. That's what I think is the preferred regimen pending 57:42 I think is the preferred regimen pending 57:42 I think is the preferred regimen pending more data. So I don't want to do 57:46 more data. So I don't want to do 57:46 more data. So I don't want to do anything that could increase dementia 57:49 anything that could increase dementia 57:49 anything that could increase dementia risk in my patients. I do not want to do 57:51 risk in my patients. I do not want to do 57:51 risk in my patients. I do not want to do that even for the convenience of not 57:54 that even for the convenience of not 57:54 that even for the convenience of not having well hopefully not having 57:57 having well hopefully not having 57:57 having well hopefully not having bleeding. Many women will have what we 57:59 bleeding. Many women will have what we 57:59 bleeding. Many women will have what we would call unscheduled bleeding the 58:02 would call unscheduled bleeding the 58:02 would call unscheduled bleeding the first year that they're on these 58:03 first year that they're on these 58:03 first year that they're on these continuous dose regimens. But some women 58:06 continuous dose regimens. But some women 58:06 continuous dose regimens. But some women will have them just randomly anytime. 58:09 will have them just randomly anytime. 58:09 will have them just randomly anytime. And I already mentioned that three to 58:10 And I already mentioned that three to 58:10 And I already mentioned that three to five years out we don't really have 58:13 five years out we don't really have 58:13 five years out we don't really have great great data that it's really as 58:15 great great data that it's really as 58:15 great great data that it's really as protective as people thought for 58:18 protective as people thought for 58:18 protective as people thought for preventing uterine cancer. So you know 58:21 preventing uterine cancer. So you know 58:21 preventing uterine cancer. So you know there's a lot of still research that 58:23 there's a lot of still research that 58:23 there's a lot of still research that needs to be done in terms of there was a 58:25 needs to be done in terms of there was a 58:26 needs to be done in terms of there was a wonderful study that was in France the 58:29 wonderful study that was in France the 58:29 wonderful study that was in France the E3N study and that looked at human 58:34 E3N study and that looked at human 58:34 E3N study and that looked at human identical hormones and it looked at both 58:37 identical hormones and it looked at both 58:37 identical hormones and it looked at both constant dosing and sequential or you 58:40 constant dosing and sequential or you 58:40 constant dosing and sequential or you know like cycling dose and both of them 58:44 know like cycling dose and both of them 58:44 know like cycling dose and both of them did not increase the risk of breast 58:46 did not increase the risk of breast 58:46 did not increase the risk of breast cancer. I just want to bring that in 58:48 cancer. I just want to bring that in 58:48 cancer. I just want to bring that in because that's often a just a fear for 58:50 because that's often a just a fear for 58:50 because that's often a just a fear for women. That is not not an issue anymore 58:53 women. That is not not an issue anymore 58:53 women. That is not not an issue anymore with the bio identicals, but they did 58:56 with the bio identicals, but they did 58:56 with the bio identicals, but they did show potentially a reduced risk of 58:59 show potentially a reduced risk of 58:59 show potentially a reduced risk of breast cancer with the cycling. So that 59:03 breast cancer with the cycling. So that 59:03 breast cancer with the cycling. So that is another kind of interesting thing. So 59:06 is another kind of interesting thing. So 59:06 is another kind of interesting thing. So cycling seems to be re 59:10 cycling seems to be re 59:10 cycling seems to be re not having a breast cancer effect than 59:13 not having a breast cancer effect than 59:13 not having a breast cancer effect than continuous. It's just so 59:15 continuous. It's just so 59:15 continuous. It's just so non-physiologic. There's no human female 59:17 non-physiologic. There's no human female 59:17 non-physiologic. There's no human female that ever has a regimen like that. So I 59:20 that ever has a regimen like that. So I 59:20 that ever has a regimen like that. So I I just say, okay, what is the biggest 59:23 I just say, okay, what is the biggest 59:23 I just say, okay, what is the biggest failed experiment of we're smarter than 59:26 failed experiment of we're smarter than 59:26 failed experiment of we're smarter than nature? We can create something better 59:28 nature? We can create something better 59:28 nature? We can create something better than nature created. I call it 59:30 than nature created. I call it 59:30 than nature created. I call it ultrarocessed food. We can make food 59:33 ultrarocessed food. We can make food 59:33 ultrarocessed food. We can make food that tastes better. It'll have more 59:35 that tastes better. It'll have more 59:36 that tastes better. It'll have more salt, sugar, and fat. Tastes better than 59:39 salt, sugar, and fat. Tastes better than 59:39 salt, sugar, and fat. Tastes better than any natural food. And guess what? It 59:41 any natural food. And guess what? It 59:41 any natural food. And guess what? It won't spoil. You know, we'll put in 59:42 won't spoil. You know, we'll put in 59:42 won't spoil. You know, we'll put in trans fat. So you can eat that Twinkie 59:45 trans fat. So you can eat that Twinkie 59:45 trans fat. So you can eat that Twinkie from, you know, a time capsule in a 59:47 from, you know, a time capsule in a 59:47 from, you know, a time capsule in a hundred years and enjoy it. Well, guess 59:49 hundred years and enjoy it. Well, guess 59:49 hundred years and enjoy it. Well, guess what? Real food spoils. And real food 59:52 what? Real food spoils. And real food 59:52 what? Real food spoils. And real food tastes great when it's grown, you know, 59:54 tastes great when it's grown, you know, 59:54 tastes great when it's grown, you know, especially organically when you can get 59:56 especially organically when you can get 59:56 especially organically when you can get it. And the failed experiment of 59:59 it. And the failed experiment of 59:59 it. And the failed experiment of ultrarocessed food is what has hugely 1:00:02 ultrarocessed food is what has hugely 1:00:02 ultrarocessed food is what has hugely contributed to our massive epidemic of 1:00:07 contributed to our massive epidemic of 1:00:07 contributed to our massive epidemic of diabetes and obesity worldwide. So my 1:00:10 diabetes and obesity worldwide. So my 1:00:10 diabetes and obesity worldwide. So my thinking is why would we think that we 1:00:12 thinking is why would we think that we 1:00:12 thinking is why would we think that we can create a hormone regimen that's 1:00:14 can create a hormone regimen that's 1:00:14 can create a hormone regimen that's better than physiologic hormones and 1:00:17 better than physiologic hormones and 1:00:17 better than physiologic hormones and somehow women will be better off with 1:00:19 somehow women will be better off with 1:00:19 somehow women will be better off with that. I just figure nature knows best 1:00:22 that. I just figure nature knows best 1:00:22 that. I just figure nature knows best and if I'm going to go against nature 1:00:24 and if I'm going to go against nature 1:00:24 and if I'm going to go against nature and keep hormones going after menopause 1:00:26 and keep hormones going after menopause 1:00:26 and keep hormones going after menopause because I want the benefits of hormones 1:00:29 because I want the benefits of hormones 1:00:29 because I want the benefits of hormones minus the fertility part that comes from 1:00:31 minus the fertility part that comes from 1:00:31 minus the fertility part that comes from hormones. Forget that part. I just want 1:00:33 hormones. Forget that part. I just want 1:00:33 hormones. Forget that part. I just want the other benefits of hormones. Then I 1:00:36 the other benefits of hormones. Then I 1:00:36 the other benefits of hormones. Then I think why am why why would I think that 1:00:38 think why am why why would I think that 1:00:38 think why am why why would I think that I can create a hormone regimen that 1:00:40 I can create a hormone regimen that 1:00:40 I can create a hormone regimen that never exists in any human female or any 1:00:42 never exists in any human female or any 1:00:42 never exists in any human female or any creature on the planet and that's going 1:00:44 creature on the planet and that's going 1:00:44 creature on the planet and that's going to be better than what nature created 1:00:47 to be better than what nature created 1:00:47 to be better than what nature created that kept women at their peak health 1:00:49 that kept women at their peak health 1:00:49 that kept women at their peak health like in their 20s and 30s. So anyway 1:00:52 like in their 20s and 30s. So anyway 1:00:52 like in their 20s and 30s. So anyway that's my simple thinking and so you 1:00:56 that's my simple thinking and so you 1:00:56 that's my simple thinking and so you know I say take hormones in the most 1:00:58 know I say take hormones in the most 1:00:58 know I say take hormones in the most physiologic way you know but you can do 1:01:01 physiologic way you know but you can do 1:01:01 physiologic way you know but you can do it however you want. I'm just saying 1:01:03 it however you want. I'm just saying 1:01:03 it however you want. I'm just saying that I'm just I'm actually really 1:01:04 that I'm just I'm actually really 1:01:04 that I'm just I'm actually really conservative. I say why am I 1:01:06 conservative. I say why am I 1:01:06 conservative. I say why am I experimenting with regimens that have no 1:01:09 experimenting with regimens that have no 1:01:09 experimenting with regimens that have no long-term good data and are scary in 1:01:11 long-term good data and are scary in 1:01:11 long-term good data and are scary in rats. So why would I do that when I know 1:01:14 rats. So why would I do that when I know 1:01:14 rats. So why would I do that when I know the good data that we have on human 1:01:16 the good data that we have on human 1:01:16 the good data that we have on human physiologic cycling and doses and I say 1:01:20 physiologic cycling and doses and I say 1:01:20 physiologic cycling and doses and I say never stop them. Start them early and 1:01:23 never stop them. Start them early and 1:01:23 never stop them. Start them early and not worry that it's unnatural because 1:01:25 not worry that it's unnatural because 1:01:26 not worry that it's unnatural because everything we do in medicine is 1:01:27 everything we do in medicine is 1:01:27 everything we do in medicine is unnatural. natural is you just age and 1:01:31 unnatural. natural is you just age and 1:01:31 unnatural. natural is you just age and you take you take your lumps. You know, 1:01:33 you take you take your lumps. You know, 1:01:33 you take you take your lumps. You know, you have all the degenerative diseases 1:01:35 you have all the degenerative diseases 1:01:35 you have all the degenerative diseases of aging as they come. And women have 1:01:38 of aging as they come. And women have 1:01:38 of aging as they come. And women have more degenerative joints and joint 1:01:41 more degenerative joints and joint 1:01:41 more degenerative joints and joint replacements than men. As you know, and 1:01:44 replacements than men. As you know, and 1:01:44 replacements than men. As you know, and hopefully all your watchers know, women 1:01:46 hopefully all your watchers know, women 1:01:46 hopefully all your watchers know, women make up 80% of those suffering from 1:01:48 make up 80% of those suffering from 1:01:48 make up 80% of those suffering from osteoporotic fractures. They have 23 of 1:01:53 osteoporotic fractures. They have 23 of 1:01:53 osteoporotic fractures. They have 23 of all the dementia patients are women. You 1:01:56 all the dementia patients are women. You 1:01:56 all the dementia patients are women. You know, women live longer, but they live 1:01:59 know, women live longer, but they live 1:01:59 know, women live longer, but they live with more chronic diseases. By age 65, 1:02:05 with more chronic diseases. By age 65, 1:02:05 with more chronic diseases. By age 65, women 75% of women have hypertension. By 1:02:09 women 75% of women have hypertension. By 1:02:09 women 75% of women have hypertension. By age 75, 85% of women have hypertension. 1:02:14 age 75, 85% of women have hypertension. 1:02:14 age 75, 85% of women have hypertension. Women by age 65 suffer more ruptured 1:02:17 Women by age 65 suffer more ruptured 1:02:17 Women by age 65 suffer more ruptured aneurysms and strokes than do men. Women 1:02:21 aneurysms and strokes than do men. Women 1:02:21 aneurysms and strokes than do men. Women have a lot of problems. Women have high 1:02:25 have a lot of problems. Women have high 1:02:25 have a lot of problems. Women have high levels of incontinence, vaginal prolapse 1:02:28 levels of incontinence, vaginal prolapse 1:02:28 levels of incontinence, vaginal prolapse issues, joint issues. I said, you know, 1:02:31 issues, joint issues. I said, you know, 1:02:31 issues, joint issues. I said, you know, all these things are happening and all 1:02:34 all these things are happening and all 1:02:34 all these things are happening and all of these things can be not prevented, 1:02:37 of these things can be not prevented, 1:02:37 of these things can be not prevented, but we'll say the onset delayed. So, 1:02:40 but we'll say the onset delayed. So, 1:02:40 but we'll say the onset delayed. So, it's like delay the inevitable. Well, 1:02:42 it's like delay the inevitable. Well, 1:02:42 it's like delay the inevitable. Well, bad things are going to happen to all of 1:02:44 bad things are going to happen to all of 1:02:44 bad things are going to happen to all of us because we're mortal, but I call it 1:02:46 us because we're mortal, but I call it 1:02:46 us because we're mortal, but I call it kicking the can down the road. If you 1:02:48 kicking the can down the road. If you 1:02:48 kicking the can down the road. If you can prevent a bone fracture by having 1:02:51 can prevent a bone fracture by having 1:02:51 can prevent a bone fracture by having good bones, even a little bit stronger 1:02:53 good bones, even a little bit stronger 1:02:53 good bones, even a little bit stronger bones, can delay a fracture by a decade. 1:02:57 bones, can delay a fracture by a decade. 1:02:57 bones, can delay a fracture by a decade. It's like amazing the effect of just a 1:02:59 It's like amazing the effect of just a 1:02:59 It's like amazing the effect of just a little more bone. And then I just want I 1:03:03 little more bone. And then I just want I 1:03:03 little more bone. And then I just want I don't want to end without just giving a 1:03:05 don't want to end without just giving a 1:03:05 don't want to end without just giving a little bit of of you know a praise to 1:03:08 little bit of of you know a praise to 1:03:08 little bit of of you know a praise to progesterone for bone health because you 1:03:10 progesterone for bone health because you 1:03:10 progesterone for bone health because you know estradile everyone should know is 1:03:14 know estradile everyone should know is 1:03:14 know estradile everyone should know is really important for bone health. It 1:03:16 really important for bone health. It 1:03:16 really important for bone health. It even has the FDA seal of approval to 1:03:20 even has the FDA seal of approval to 1:03:20 even has the FDA seal of approval to give estradile to prevent osteoporosis. 1:03:23 give estradile to prevent osteoporosis. 1:03:23 give estradile to prevent osteoporosis. Although that has never been like a 1:03:25 Although that has never been like a 1:03:25 Although that has never been like a standard practice. It has not. But it 1:03:27 standard practice. It has not. But it 1:03:27 standard practice. It has not. But it should be but it has not. Okay. In my 1:03:30 should be but it has not. Okay. In my 1:03:30 should be but it has not. Okay. In my practice it is, but not generally 1:03:31 practice it is, but not generally 1:03:32 practice it is, but not generally speaking. But progesterone 1:03:35 speaking. But progesterone 1:03:35 speaking. But progesterone is really not appreciated. you know, the 1:03:38 is really not appreciated. you know, the 1:03:38 is really not appreciated. you know, the dose that you get when you take oral 1:03:39 dose that you get when you take oral 1:03:39 dose that you get when you take oral progesterone is so little because most 1:03:42 progesterone is so little because most 1:03:42 progesterone is so little because most of it's converted to other stuff and 1:03:44 of it's converted to other stuff and 1:03:44 of it's converted to other stuff and then it's just shortlived. But 1:03:46 then it's just shortlived. But 1:03:46 then it's just shortlived. But progesterone has its own really unique 1:03:48 progesterone has its own really unique 1:03:48 progesterone has its own really unique benefits for bone. So, have you talked 1:03:51 benefits for bone. So, have you talked 1:03:51 benefits for bone. So, have you talked about this in with in your podcast 1:03:54 about this in with in your podcast 1:03:54 about this in with in your podcast before about progesterone and bone? 1:03:55 before about progesterone and bone? 1:03:55 before about progesterone and bone? >> We really haven't gone in detail into 1:03:57 >> We really haven't gone in detail into 1:03:57 >> We really haven't gone in detail into this, but we have to have you come back 1:04:00 this, but we have to have you come back 1:04:00 this, but we have to have you come back because we have so many other things to 1:04:02 because we have so many other things to 1:04:02 because we have so many other things to talk about, but 1:04:03 talk about, but 1:04:03 talk about, but >> Well, you tell me. I'm happy about two 1:04:06 >> Well, you tell me. I'm happy about two 1:04:06 >> Well, you tell me. I'm happy about two more things before you leave. Talk about 1:04:07 more things before you leave. Talk about 1:04:07 more things before you leave. Talk about the progesterone and just talk about for
HRT after 60: did women really miss their window? 1:04:10 the progesterone and just talk about for 1:04:10 the progesterone and just talk about for people who are in their 60s because this 1:04:12 people who are in their 60s because this 1:04:12 people who are in their 60s because this is a large part of our community way 1:04:14 is a large part of our community way 1:04:14 is a large part of our community way beyond 10 years past menopause and now 1:04:17 beyond 10 years past menopause and now 1:04:17 beyond 10 years past menopause and now they hear this. 1:04:18 they hear this. 1:04:18 they hear this. >> Okay. 1:04:18 >> Okay. 1:04:18 >> Okay. >> And you know, is it a good idea? Is it 1:04:21 >> And you know, is it a good idea? Is it 1:04:21 >> And you know, is it a good idea? Is it not a good idea? Who should they see 1:04:23 not a good idea? Who should they see 1:04:23 not a good idea? Who should they see about this? That's 1:04:24 about this? That's 1:04:24 about this? That's >> yeah, that's the problem. Who do they 1:04:26 >> yeah, that's the problem. Who do they 1:04:26 >> yeah, that's the problem. Who do they see? Well, if you go back to the women's 1:04:29 see? Well, if you go back to the women's 1:04:29 see? Well, if you go back to the women's health initiative, that seems to be the 1:04:31 health initiative, that seems to be the 1:04:31 health initiative, that seems to be the anchor that weighs us down, okay? That, 1:04:34 anchor that weighs us down, okay? That, 1:04:34 anchor that weighs us down, okay? That, you know, it it it sort of, you know, an 1:04:37 you know, it it it sort of, you know, an 1:04:37 you know, it it it sort of, you know, an anchor could be good or bad, right? And 1:04:39 anchor could be good or bad, right? And 1:04:39 anchor could be good or bad, right? And a lot of this is bad. So the women's 1:04:41 a lot of this is bad. So the women's 1:04:41 a lot of this is bad. So the women's health initiative as we mentioned 1:04:43 health initiative as we mentioned 1:04:43 health initiative as we mentioned earlier incorporated older women and 1:04:47 earlier incorporated older women and 1:04:47 earlier incorporated older women and because of you know all the different 1:04:49 because of you know all the different 1:04:49 because of you know all the different prerequisites that they were trying to 1:04:50 prerequisites that they were trying to 1:04:50 prerequisites that they were trying to show and what they did seem to show 1:04:55 show and what they did seem to show 1:04:55 show and what they did seem to show because women in their 50s in the 1:04:58 because women in their 50s in the 1:04:58 because women in their 50s in the women's health initiative surprisingly 1:05:00 women's health initiative surprisingly 1:05:00 women's health initiative surprisingly when they went back and did reanalysis 1:05:02 when they went back and did reanalysis 1:05:02 when they went back and did reanalysis of the data actually had a 30% reduction 1:05:07 of the data actually had a 30% reduction 1:05:07 of the data actually had a 30% reduction in all cause mortality. In other words, 1:05:10 in all cause mortality. In other words, 1:05:10 in all cause mortality. In other words, women in their 50s who went on this drug 1:05:13 women in their 50s who went on this drug 1:05:13 women in their 50s who went on this drug prempro died from everything that you 1:05:16 prempro died from everything that you 1:05:16 prempro died from everything that you could think of 30% when you you know as 1:05:20 could think of 30% when you you know as 1:05:20 could think of 30% when you you know as a cumulative kind of a picture 30% less. 1:05:23 a cumulative kind of a picture 30% less. 1:05:23 a cumulative kind of a picture 30% less. There's no drug on the market that 1:05:25 There's no drug on the market that 1:05:25 There's no drug on the market that reduces you've your risk of dying from 1:05:27 reduces you've your risk of dying from 1:05:28 reduces you've your risk of dying from everything [clears throat] by 30%. But 1:05:30 everything [clears throat] by 30%. But 1:05:30 everything [clears throat] by 30%. But that's what you know here it is when you 1:05:32 that's what you know here it is when you 1:05:32 that's what you know here it is when you have a study you either believe all the 1:05:33 have a study you either believe all the 1:05:34 have a study you either believe all the data or none of the data. You can't 1:05:35 data or none of the data. You can't 1:05:35 data or none of the data. You can't cherrypick I'm only going to believe 1:05:37 cherrypick I'm only going to believe 1:05:37 cherrypick I'm only going to believe this data and not this data. So it's a 1:05:39 this data and not this data. So it's a 1:05:39 this data and not this data. So it's a package of data. So if you believe 1:05:41 package of data. So if you believe 1:05:41 package of data. So if you believe anything from that study, you have to 1:05:43 anything from that study, you have to 1:05:43 anything from that study, you have to believe that giving hormones, even that 1:05:45 believe that giving hormones, even that 1:05:46 believe that giving hormones, even that sort of ridiculous combination, Prempro, 1:05:49 sort of ridiculous combination, Prempro, 1:05:49 sort of ridiculous combination, Prempro, lowered the risk of dying from 1:05:51 lowered the risk of dying from 1:05:51 lowered the risk of dying from everything by 30%. But once you got 1:05:54 everything by 30%. But once you got 1:05:54 everything by 30%. But once you got older, then suddenly more things 1:05:57 older, then suddenly more things 1:05:57 older, then suddenly more things happened. So what they came out with was 1:06:00 happened. So what they came out with was 1:06:00 happened. So what they came out with was the window of opportunity sort of study. 1:06:04 the window of opportunity sort of study. 1:06:04 the window of opportunity sort of study. And then there was also the elite study 1:06:07 And then there was also the elite study 1:06:07 And then there was also the elite study that came out. The elite study you used 1:06:10 that came out. The elite study you used 1:06:10 that came out. The elite study you used oral I like I love these doctors who did 1:06:13 oral I like I love these doctors who did 1:06:13 oral I like I love these doctors who did these studies but I wish they knew more 1:06:15 these studies but I wish they knew more 1:06:15 these studies but I wish they knew more about hormones before they created their 1:06:18 about hormones before they created their 1:06:18 about hormones before they created their studies. So in the elite study they used 1:06:21 studies. So in the elite study they used 1:06:21 studies. So in the elite study they used oral estradiol 1:06:23 oral estradiol 1:06:23 oral estradiol one milligram of like why did you do 1:06:25 one milligram of like why did you do 1:06:25 one milligram of like why did you do that? because you it turns into estrone 1:06:28 that? because you it turns into estrone 1:06:28 that? because you it turns into estrone and it's like a silly dose. But they 1:06:31 and it's like a silly dose. But they 1:06:31 and it's like a silly dose. But they gave estradi 1:06:33 gave estradi 1:06:33 gave estradi one milligram orally and then they 1:06:35 one milligram orally and then they 1:06:35 one milligram orally and then they combined it with a very small dose 45 1:06:39 combined it with a very small dose 45 1:06:39 combined it with a very small dose 45 milligrams of a progesterone gel given 1:06:42 milligrams of a progesterone gel given 1:06:42 milligrams of a progesterone gel given for only 10 days. So it was inadequate 1:06:45 for only 10 days. So it was inadequate 1:06:45 for only 10 days. So it was inadequate progesterone dose and it was not a good 1:06:48 progesterone dose and it was not a good 1:06:48 progesterone dose and it was not a good choice of estradile. But what did they 1:06:50 choice of estradile. But what did they 1:06:50 choice of estradile. But what did they show in that study anyway? So it 1:06:53 show in that study anyway? So it 1:06:53 show in that study anyway? So it included two groups. One group was women 1:06:56 included two groups. One group was women 1:06:56 included two groups. One group was women who were very close to menopause and one 1:06:59 who were very close to menopause and one 1:06:59 who were very close to menopause and one group of women who had to be at least 10 1:07:02 group of women who had to be at least 10 1:07:02 group of women who had to be at least 10 years out. So they would be in their 1:07:04 years out. So they would be in their 1:07:04 years out. So they would be in their 60s. And what did they show in the 1:07:07 60s. And what did they show in the 1:07:07 60s. And what did they show in the younger women on this unfortunate 1:07:09 younger women on this unfortunate 1:07:09 younger women on this unfortunate hormone regimen? They actually had some 1:07:12 hormone regimen? They actually had some 1:07:12 hormone regimen? They actually had some reduction in the incidence of thickening 1:07:16 reduction in the incidence of thickening 1:07:16 reduction in the incidence of thickening of the lining of their corateed 1:07:18 of the lining of their corateed 1:07:18 of the lining of their corateed arteries. Reduction compared to placebot 1:07:21 arteries. Reduction compared to placebot 1:07:21 arteries. Reduction compared to placebot treated women. So, it showed some 1:07:24 treated women. So, it showed some 1:07:24 treated women. So, it showed some benefit for the cardiovascular system, 1:07:27 benefit for the cardiovascular system, 1:07:27 benefit for the cardiovascular system, which has never been really talked about 1:07:29 which has never been really talked about 1:07:29 which has never been really talked about and publicized. They just poo poo that. 1:07:32 and publicized. They just poo poo that. 1:07:32 and publicized. They just poo poo that. Well, it wasn't that big a deal. I mean, 1:07:34 Well, it wasn't that big a deal. I mean, 1:07:34 Well, it wasn't that big a deal. I mean, yes, it was a big deal, but they poo poo 1:07:37 yes, it was a big deal, but they poo poo 1:07:37 yes, it was a big deal, but they poo poo it. Even though that was the wrong 1:07:38 it. Even though that was the wrong 1:07:38 it. Even though that was the wrong hormone regimen and everything else, it 1:07:40 hormone regimen and everything else, it 1:07:40 hormone regimen and everything else, it still showed reduction in vascular 1:07:42 still showed reduction in vascular 1:07:42 still showed reduction in vascular progression of, you know, damage to the 1:07:44 progression of, you know, damage to the 1:07:44 progression of, you know, damage to the inside lining of the artery. What did 1:07:46 inside lining of the artery. What did 1:07:46 inside lining of the artery. What did they show in the women who were in their 1:07:48 they show in the women who were in their 1:07:48 they show in the women who were in their 60s or older? no harm, no benefit. They 1:07:53 60s or older? no harm, no benefit. They 1:07:53 60s or older? no harm, no benefit. They didn't see any benefit on that regimen. 1:07:56 didn't see any benefit on that regimen. 1:07:56 didn't see any benefit on that regimen. They also saw no harm. And so that's 1:07:59 They also saw no harm. And so that's 1:07:59 They also saw no harm. And so that's what we got. Okay. So based on that, the 1:08:03 what we got. Okay. So based on that, the 1:08:03 what we got. Okay. So based on that, the so-called window of opportunity theory 1:08:06 so-called window of opportunity theory 1:08:06 so-called window of opportunity theory came up based on the women's health 1:08:08 came up based on the women's health 1:08:08 came up based on the women's health initiative heavily and somewhat the 1:08:11 initiative heavily and somewhat the 1:08:11 initiative heavily and somewhat the elite study that you have a window up to 1:08:15 elite study that you have a window up to 1:08:15 elite study that you have a window up to age 60. when if you're older, you know, 1:08:18 age 60. when if you're older, you know, 1:08:18 age 60. when if you're older, you know, more than 10 years out or 60 plus, then 1:08:20 more than 10 years out or 60 plus, then 1:08:20 more than 10 years out or 60 plus, then you're too old. You missed the boat. 1:08:22 you're too old. You missed the boat. 1:08:22 you're too old. You missed the boat. Okay. Well, if you look at the elite 1:08:24 Okay. Well, if you look at the elite 1:08:24 Okay. Well, if you look at the elite study, it showed no harm. That's pretty 1:08:27 study, it showed no harm. That's pretty 1:08:27 study, it showed no harm. That's pretty good with that, you know, regimen. And 1:08:30 good with that, you know, regimen. And 1:08:30 good with that, you know, regimen. And they didn't study everything. I mean, 1:08:32 they didn't study everything. I mean, 1:08:32 they didn't study everything. I mean, and and it only went for a very few 1:08:33 and and it only went for a very few 1:08:34 and and it only went for a very few years. So, we really have very limited 1:08:36 years. So, we really have very limited 1:08:36 years. So, we really have very limited knowledge. So, what is the women's 1:08:40 knowledge. So, what is the women's 1:08:40 knowledge. So, what is the women's health initiative re-evaluation? They 1:08:42 health initiative re-evaluation? They 1:08:42 health initiative re-evaluation? They did more that study has been 1:08:44 did more that study has been 1:08:44 did more that study has been re-evaluated like a thousand times plus. 1:08:47 re-evaluated like a thousand times plus. 1:08:47 re-evaluated like a thousand times plus. They found that there was no harm in 1:08:50 They found that there was no harm in 1:08:50 They found that there was no harm in using Premro this like really not good 1:08:54 using Premro this like really not good 1:08:54 using Premro this like really not good choice drug combo in women under 70. So 1:08:58 choice drug combo in women under 70. So 1:08:58 choice drug combo in women under 70. So there was no increased risk of bad stuff 1:09:01 there was no increased risk of bad stuff 1:09:01 there was no increased risk of bad stuff happening if you were under 70. So if 1:09:04 happening if you were under 70. So if 1:09:04 happening if you were under 70. So if you're going to create a window of 1:09:06 you're going to create a window of 1:09:06 you're going to create a window of opportunity, it should be up to 70, not 1:09:11 opportunity, it should be up to 70, not 1:09:11 opportunity, it should be up to 70, not 60. So in my opinion all women in their 1:09:15 60. So in my opinion all women in their 1:09:15 60. So in my opinion all women in their 60s should be evaluated to start on 1:09:18 60s should be evaluated to start on 1:09:18 60s should be evaluated to start on hormones and then you have to choose 1:09:20 hormones and then you have to choose 1:09:20 hormones and then you have to choose wisely like if a woman maybe has a lot 1:09:24 wisely like if a woman maybe has a lot 1:09:24 wisely like if a woman maybe has a lot of existing diseases maybe you know we 1:09:27 of existing diseases maybe you know we 1:09:27 of existing diseases maybe you know we don't have good data I mean you have to 1:09:29 don't have good data I mean you have to 1:09:29 don't have good data I mean you have to say we live in a world of absent data on 1:09:32 say we live in a world of absent data on 1:09:32 say we live in a world of absent data on so many things regarding women's health 1:09:35 so many things regarding women's health 1:09:35 so many things regarding women's health so then you have to well what are you 1:09:37 so then you have to well what are you 1:09:37 so then you have to well what are you going to do you know if you have like if 1:09:39 going to do you know if you have like if 1:09:39 going to do you know if you have like if you've already had a heart attack and 1:09:41 you've already had a heart attack and 1:09:41 you've already had a heart attack and two strokes Well, you know, we don't 1:09:42 two strokes Well, you know, we don't 1:09:42 two strokes Well, you know, we don't have data. We don't know. So, what's the 1:09:45 have data. We don't know. So, what's the 1:09:45 have data. We don't know. So, what's the risk anyway? Like what how could harms 1:09:47 risk anyway? Like what how could harms 1:09:47 risk anyway? Like what how could harms how could you get harmed from hormones? 1:09:49 how could you get harmed from hormones? 1:09:49 how could you get harmed from hormones? The idea is that as you get older or 1:09:52 The idea is that as you get older or 1:09:52 The idea is that as you get older or you're metabolically unhealthy, which of 1:09:55 you're metabolically unhealthy, which of 1:09:55 you're metabolically unhealthy, which of course can happen at any age, your 1:09:57 course can happen at any age, your 1:09:57 course can happen at any age, your estrogen receptors, particularly the one 1:10:00 estrogen receptors, particularly the one 1:10:00 estrogen receptors, particularly the one called alpha, becomes damaged or aged 1:10:03 called alpha, becomes damaged or aged 1:10:03 called alpha, becomes damaged or aged and doesn't work as well. And so if you 1:10:07 and doesn't work as well. And so if you 1:10:07 and doesn't work as well. And so if you don't have fully functioning estrogen 1:10:10 don't have fully functioning estrogen 1:10:10 don't have fully functioning estrogen receptors, 1:10:11 receptors, 1:10:11 receptors, then when you add in estrogen, it's not 1:10:13 then when you add in estrogen, it's not 1:10:13 then when you add in estrogen, it's not going to have the same effect because a 1:10:15 going to have the same effect because a 1:10:15 going to have the same effect because a hormone generally there's other 1:10:17 hormone generally there's other 1:10:17 hormone generally there's other mechanisms. It's complex, but the most 1:10:20 mechanisms. It's complex, but the most 1:10:20 mechanisms. It's complex, but the most common mechanism is that the hormone 1:10:22 common mechanism is that the hormone 1:10:22 common mechanism is that the hormone goes into a receptor like turns the 1:10:25 goes into a receptor like turns the 1:10:25 goes into a receptor like turns the lock, you know, and then things happen. 1:10:27 lock, you know, and then things happen. 1:10:27 lock, you know, and then things happen. But what if that hormone receptor, you 1:10:30 But what if that hormone receptor, you 1:10:30 But what if that hormone receptor, you know, you have the hormone, but the 1:10:31 know, you have the hormone, but the 1:10:31 know, you have the hormone, but the receptor is like it's like should be 1:10:34 receptor is like it's like should be 1:10:34 receptor is like it's like should be like this, like that. So it's not 1:10:35 like this, like that. So it's not 1:10:35 like this, like that. So it's not working right. Then there's other 1:10:37 working right. Then there's other 1:10:37 working right. Then there's other processes like you could end up 1:10:39 processes like you could end up 1:10:39 processes like you could end up triggering like collateral issues that 1:10:42 triggering like collateral issues that 1:10:42 triggering like collateral issues that you don't want because the hormone can't 1:10:44 you don't want because the hormone can't 1:10:44 you don't want because the hormone can't get into the proper receptor and create 1:10:46 get into the proper receptor and create 1:10:46 get into the proper receptor and create what is the normal effect because of the 1:10:49 what is the normal effect because of the 1:10:49 what is the normal effect because of the receptor issue. So that is the sort of 1:10:52 receptor issue. So that is the sort of 1:10:52 receptor issue. So that is the sort of mostly hypothetical because we don't 1:10:54 mostly hypothetical because we don't 1:10:54 mostly hypothetical because we don't really have any human studies that show 1:10:56 really have any human studies that show 1:10:56 really have any human studies that show this harm. It's all like the 1:10:57 this harm. It's all like the 1:10:58 this harm. It's all like the hypotheticals because the only real 1:11:00 hypotheticals because the only real 1:11:00 hypotheticals because the only real study we have that's using not Prempro 1:11:03 study we have that's using not Prempro 1:11:03 study we have that's using not Prempro which is not still the right stuff 1:11:04 which is not still the right stuff 1:11:04 which is not still the right stuff anyway is the elite study and it didn't 1:11:07 anyway is the elite study and it didn't 1:11:07 anyway is the elite study and it didn't show harm. It didn't show benefit but it 1:11:09 show harm. It didn't show benefit but it 1:11:09 show harm. It didn't show benefit but it didn't show harm. So we know we're 1:11:11 didn't show harm. So we know we're 1:11:11 didn't show harm. So we know we're living in a world of absence of data. 1:11:14 living in a world of absence of data. 1:11:14 living in a world of absence of data. But we do know from the women's health 1:11:17 But we do know from the women's health 1:11:17 But we do know from the women's health initiative that in older women they 1:11:19 initiative that in older women they 1:11:19 initiative that in older women they still had benefit to the colon and to 1:11:22 still had benefit to the colon and to 1:11:22 still had benefit to the colon and to the bone. So even if you don't have as 1:11:25 the bone. So even if you don't have as 1:11:25 the bone. So even if you don't have as much cardiovascular benefit and we know 1:11:28 much cardiovascular benefit and we know 1:11:28 much cardiovascular benefit and we know from Dale Bredesen's studies on 1:11:31 from Dale Bredesen's studies on 1:11:31 from Dale Bredesen's studies on cognitive decline and Alzheimer's 1:11:33 cognitive decline and Alzheimer's 1:11:34 cognitive decline and Alzheimer's disease and he gave all his women 1:11:36 disease and he gave all his women 1:11:36 disease and he gave all his women patients and these were women up to 75 1:11:39 patients and these were women up to 75 1:11:40 patients and these were women up to 75 and these were women who had not been on 1:11:41 and these were women who had not been on 1:11:41 and these were women who had not been on hormones and these are not healthy women 1:11:43 hormones and these are not healthy women 1:11:43 hormones and these are not healthy women these are women with significant stages 1:11:46 these are women with significant stages 1:11:46 these are women with significant stages of dementia and there was no harm. I 1:11:49 of dementia and there was no harm. I 1:11:49 of dementia and there was no harm. I spoke to them about their study. There 1:11:51 spoke to them about their study. There 1:11:51 spoke to them about their study. There were no incidents and it was like 1:11:53 were no incidents and it was like 1:11:53 were no incidents and it was like year-long study. There was not a single 1:11:55 year-long study. There was not a single 1:11:55 year-long study. There was not a single incident of a heart attack or stroke in 1:11:57 incident of a heart attack or stroke in 1:11:57 incident of a heart attack or stroke in these women who were really high risk. 1:11:59 these women who were really high risk. 1:11:59 these women who were really high risk. So that's in like an interesting study. 1:12:01 So that's in like an interesting study. 1:12:01 So that's in like an interesting study. They were all put on hormones all of 1:12:03 They were all put on hormones all of 1:12:03 They were all put on hormones all of them. So I mean that so we actually do 1:12:06 them. So I mean that so we actually do 1:12:06 them. So I mean that so we actually do have data that it's probably safe and if 1:12:09 have data that it's probably safe and if 1:12:09 have data that it's probably safe and if you start with a low dose in this case I 1:12:11 you start with a low dose in this case I 1:12:12 you start with a low dose in this case I would start you know at low and try to 1:12:15 would start you know at low and try to 1:12:15 would start you know at low and try to revamp like reawaken the receptors and 1:12:19 revamp like reawaken the receptors and 1:12:19 revamp like reawaken the receptors and you know I've done some research on how 1:12:21 you know I've done some research on how 1:12:21 you know I've done some research on how can you reinvigorate the receptors of 1:12:25 can you reinvigorate the receptors of 1:12:25 can you reinvigorate the receptors of estrogen and there is actually research 1:12:27 estrogen and there is actually research 1:12:27 estrogen and there is actually research on that and so you know looking at 1:12:30 on that and so you know looking at 1:12:30 on that and so you know looking at antioxidants mitochondrial booster 1:12:33 antioxidants mitochondrial booster 1:12:33 antioxidants mitochondrial booster supplements suppments. Exercise. Oh my 1:12:35 supplements suppments. Exercise. Oh my 1:12:35 supplements suppments. Exercise. Oh my gosh. Exercise. Exercise, which I know 1:12:37 gosh. Exercise. Exercise, which I know 1:12:37 gosh. Exercise. Exercise, which I know you're a big fan. Exercise can also help 1:12:39 you're a big fan. Exercise can also help 1:12:40 you're a big fan. Exercise can also help to like revamp and rejuvenate the 1:12:43 to like revamp and rejuvenate the 1:12:43 to like revamp and rejuvenate the estrogen receptors. So, you go and 1:12:45 estrogen receptors. So, you go and 1:12:45 estrogen receptors. So, you go and giving low doses of estradile can also 1:12:48 giving low doses of estradile can also 1:12:48 giving low doses of estradile can also help to like wake like reawaken the 1:12:51 help to like wake like reawaken the 1:12:51 help to like wake like reawaken the receptors. So, there's ways that we can 1:12:54 receptors. So, there's ways that we can 1:12:54 receptors. So, there's ways that we can help improve receptor function. We can't 1:12:56 help improve receptor function. We can't 1:12:56 help improve receptor function. We can't measure it. I can't like I'm going to do 1:12:58 measure it. I can't like I'm going to do 1:12:58 measure it. I can't like I'm going to do the receptor test. I I don't have that, 1:13:00 the receptor test. I I don't have that, 1:13:00 the receptor test. I I don't have that, you know? So, it's all like 1:13:02 you know? So, it's all like 1:13:02 you know? So, it's all like hypothetical. It's all research oriented 1:13:05 hypothetical. It's all research oriented 1:13:05 hypothetical. It's all research oriented and so on. But if you're under 70, I 1:13:09 and so on. But if you're under 70, I 1:13:10 and so on. But if you're under 70, I don't think you should be written off at 1:13:11 don't think you should be written off at 1:13:11 don't think you should be written off at all. I think, you know, that there are 1:13:14 all. I think, you know, that there are 1:13:14 all. I think, you know, that there are ways that we can work with it. We have 1:13:16 ways that we can work with it. We have 1:13:16 ways that we can work with it. We have no proof of harm. I can't say we have 1:13:18 no proof of harm. I can't say we have 1:13:18 no proof of harm. I can't say we have proof of lots of benefit, but we do have 1:13:20 proof of lots of benefit, but we do have 1:13:20 proof of lots of benefit, but we do have some benefit. And we know we can monitor 1:13:23 some benefit. And we know we can monitor 1:13:23 some benefit. And we know we can monitor bone. I mean, of all the wonderful 1:13:25 bone. I mean, of all the wonderful 1:13:25 bone. I mean, of all the wonderful things that we can monitor really well, 1:13:27 things that we can monitor really well, 1:13:27 things that we can monitor really well, it's monitoring bone. And we need more 1:13:30 it's monitoring bone. And we need more 1:13:30 it's monitoring bone. And we need more studies and we wish we had more money 1:13:32 studies and we wish we had more money 1:13:32 studies and we wish we had more money put into women's health for women over 1:13:35 put into women's health for women over 1:13:35 put into women's health for women over 70. You know, I would say we also have 1:13:38 70. You know, I would say we also have 1:13:38 70. You know, I would say we also have some lack of data for bioididentical 1:13:40 some lack of data for bioididentical 1:13:40 some lack of data for bioididentical hormones is the elite study wasn't 1:13:42 hormones is the elite study wasn't 1:13:42 hormones is the elite study wasn't looking at that group. So we don't have 1:13:44 looking at that group. So we don't have 1:13:44 looking at that group. So we don't have data. We don't have data showing that if 1:13:47 data. We don't have data showing that if 1:13:47 data. We don't have data showing that if you give bioididentical human hormones, 1:13:49 you give bioididentical human hormones, 1:13:49 you give bioididentical human hormones, you're going to hurt women. We do not 1:13:50 you're going to hurt women. We do not 1:13:50 you're going to hurt women. We do not have human studies like that. It's all 1:13:52 have human studies like that. It's all 1:13:52 have human studies like that. It's all hypothetical based on estrogen receptor 1:13:55 hypothetical based on estrogen receptor 1:13:55 hypothetical based on estrogen receptor function. So I think every case has to 1:13:57 function. So I think every case has to 1:13:57 function. So I think every case has to be looked at individually. Start low, go 1:14:00 be looked at individually. Start low, go 1:14:00 be looked at individually. Start low, go slow, you know, and decide like is this 1:14:03 slow, you know, and decide like is this 1:14:03 slow, you know, and decide like is this the best way to go at this age or should 1:14:05 the best way to go at this age or should 1:14:05 the best way to go at this age or should you focus more on eating phytoestrogens 1:14:08 you focus more on eating phytoestrogens 1:14:08 you focus more on eating phytoestrogens which are helpful at every age and they 1:14:10 which are helpful at every age and they 1:14:10 which are helpful at every age and they bind to the receptors. So like duh, 1:14:12 bind to the receptors. So like duh, 1:14:12 bind to the receptors. So like duh, there's got to be something there. We 1:14:14 there's got to be something there. We 1:14:14 there's got to be something there. We know that estrogen receptors are alive 1:14:16 know that estrogen receptors are alive 1:14:16 know that estrogen receptors are alive and kicking because you can give 1:14:18 and kicking because you can give 1:14:18 and kicking because you can give estrogen vaginal cream or other forms of 1:14:22 estrogen vaginal cream or other forms of 1:14:22 estrogen vaginal cream or other forms of hormones to the vagina at any age. You 1:14:24 hormones to the vagina at any age. You 1:14:24 hormones to the vagina at any age. You can give it to a 90-year-old and the 1:14:26 can give it to a 90-year-old and the 1:14:26 can give it to a 90-year-old and the vagina is going to improve. It won't be 1:14:29 vagina is going to improve. It won't be 1:14:29 vagina is going to improve. It won't be 20 again, but it's going to improve. So, 1:14:31 20 again, but it's going to improve. So, 1:14:31 20 again, but it's going to improve. So, we know that many organs of the body, 1:14:33 we know that many organs of the body, 1:14:33 we know that many organs of the body, their receptors are still working 1:14:36 their receptors are still working 1:14:36 their receptors are still working because there's studies that you could 1:14:37 because there's studies that you could 1:14:37 because there's studies that you could take estrogen cream and put it on the 1:14:39 take estrogen cream and put it on the 1:14:39 take estrogen cream and put it on the face and in two weeks you have visibly 1:14:41 face and in two weeks you have visibly 1:14:41 face and in two weeks you have visibly fewer wrinkles. These we know with bone 1:14:44 fewer wrinkles. These we know with bone 1:14:44 fewer wrinkles. These we know with bone these receptors are not dead everywhere. 1:14:46 these receptors are not dead everywhere. 1:14:46 these receptors are not dead everywhere. The main worry is cardiovascular. So we 1:14:49 The main worry is cardiovascular. So we 1:14:50 The main worry is cardiovascular. So we if we can have even neutral 1:14:51 if we can have even neutral 1:14:51 if we can have even neutral cardiovascular benefit neutral but not 1:14:54 cardiovascular benefit neutral but not 1:14:54 cardiovascular benefit neutral but not harmful not beneficial but we can help 1:14:56 harmful not beneficial but we can help 1:14:56 harmful not beneficial but we can help all the other organ systems especially 1:14:58 all the other organ systems especially 1:14:58 all the other organ systems especially like bone like why would we not do that 1:15:01 like bone like why would we not do that 1:15:01 like bone like why would we not do that so you know with with informed consent 1:15:05 so you know with with informed consent 1:15:05 so you know with with informed consent I'm not willing to write off any woman 1:15:08 I'm not willing to write off any woman 1:15:08 I'm not willing to write off any woman at any age not at all but every case has 1:15:11 at any age not at all but every case has 1:15:11 at any age not at all but every case has to be individualized once you get over 1:15:14 to be individualized once you get over 1:15:14 to be individualized once you get over 60 and especially over 70. 1:15:17 60 and especially over 70. 1:15:17 60 and especially over 70. >> Okay well Dr. Please tell people how 1:15:19 >> Okay well Dr. Please tell people how 1:15:19 >> Okay well Dr. Please tell people how they can so if you live in California 1:15:22 they can so if you live in California 1:15:22 they can so if you live in California right or you're willing to travel to 1:15:23 right or you're willing to travel to 1:15:23 right or you're willing to travel to California tell people how for those who 1:15:26 California tell people how for those who 1:15:26 California tell people how for those who are thinking oh my gosh I have to work 1:15:28 are thinking oh my gosh I have to work 1:15:28 are thinking oh my gosh I have to work with Dr. Gersh actually you call 1:15:29 with Dr. Gersh actually you call 1:15:29 with Dr. Gersh actually you call yourself. So um yeah how could you know 1:15:32 yourself. So um yeah how could you know 1:15:32 yourself. So um yeah how could you know just share how you work in your clinic? 1:15:35 just share how you work in your clinic? 1:15:35 just share how you work in your clinic? >> Well I'm in my office right now. I have 1:15:36 >> Well I'm in my office right now. I have 1:15:36 >> Well I'm in my office right now. I have a patient in a few minutes and this is 1:15:39 a patient in a few minutes and this is 1:15:39 a patient in a few minutes and this is actually a converted exam room that 1:15:41 actually a converted exam room that 1:15:41 actually a converted exam room that [laughter] I'm in here. And so my office 1:15:44 [laughter] I'm in here. And so my office 1:15:44 [laughter] I'm in here. And so my office practice is in Irvine, California. 1:15:46 practice is in Irvine, California. 1:15:46 practice is in Irvine, California. That's beautiful Southern California. 1:15:48 That's beautiful Southern California. 1:15:48 That's beautiful Southern California. And it's called the Integrative Medical 1:15:50 And it's called the Integrative Medical 1:15:50 And it's called the Integrative Medical Group of Irvine. And I'm oldfashioned. I 1:15:53 Group of Irvine. And I'm oldfashioned. I 1:15:53 Group of Irvine. And I'm oldfashioned. I see patients in person. I can do tele 1:15:55 see patients in person. I can do tele 1:15:55 see patients in person. I can do tele medicine in California for anybody any 1:15:58 medicine in California for anybody any 1:15:58 medicine in California for anybody any time in another state they have to come 1:16:00 time in another state they have to come 1:16:00 time in another state they have to come and see me initially because I don't 1:16:02 and see me initially because I don't 1:16:02 and see me initially because I don't have a license in all those different 1:16:04 have a license in all those different 1:16:04 have a license in all those different states and then we can do some tele 1:16:06 states and then we can do some tele 1:16:06 states and then we can do some tele medicine and then periodically you come 1:16:07 medicine and then periodically you come 1:16:08 medicine and then periodically you come back and visit me and have a little 1:16:09 back and visit me and have a little 1:16:09 back and visit me and have a little vacation here and I have an Instagram 1:16:12 vacation here and I have an Instagram 1:16:12 vacation here and I have an Instagram that's pretty busy. I try to keep 1:16:14 that's pretty busy. I try to keep 1:16:14 that's pretty busy. I try to keep posting. I have a YouTube channel that 1:16:16 posting. I have a YouTube channel that 1:16:16 posting. I have a YouTube channel that has a lot of stuff. I'm starting my own 1:16:19 has a lot of stuff. I'm starting my own 1:16:19 has a lot of stuff. I'm starting my own podcast called Female Healthspan. So, 1:16:21 podcast called Female Healthspan. So, 1:16:21 podcast called Female Healthspan. So, that should be coming out in the next 1:16:22 that should be coming out in the next 1:16:22 that should be coming out in the next few weeks. And I just have a mission of 1:16:26 few weeks. And I just have a mission of 1:16:26 few weeks. And I just have a mission of educating. I have three books out and 1:16:28 educating. I have three books out and 1:16:28 educating. I have three books out and I'm hoping to have more come out in the 1:16:30 I'm hoping to have more come out in the 1:16:30 I'm hoping to have more come out in the next year or so. And I'm just having a 1:16:33 next year or so. And I'm just having a 1:16:33 next year or so. And I'm just having a lot of fun learning new things and, you 1:16:36 lot of fun learning new things and, you 1:16:36 lot of fun learning new things and, you know, meeting people and talking. I 1:16:38 know, meeting people and talking. I 1:16:38 know, meeting people and talking. I speak all around the world at lectures, 1:16:40 speak all around the world at lectures, 1:16:40 speak all around the world at lectures, giving lectures and at conferences, 1:16:43 giving lectures and at conferences, 1:16:43 giving lectures and at conferences, having lots of fun and really just 1:16:46 having lots of fun and really just 1:16:46 having lots of fun and really just striving to think logically, 1:16:49 striving to think logically, 1:16:49 striving to think logically, scientifically to optimize women's 1:16:52 scientifically to optimize women's 1:16:52 scientifically to optimize women's health and still waiting for a few 1:16:54 health and still waiting for a few 1:16:54 health and still waiting for a few apologies from some of those medical 1:16:55 apologies from some of those medical 1:16:55 apologies from some of those medical societies, but you know, we just move 1:16:58 societies, but you know, we just move 1:16:58 societies, but you know, we just move forward. We never we look back to learn, 1:17:00 forward. We never we look back to learn, 1:17:00 forward. We never we look back to learn, but we look forward to a beautiful 1:17:03 but we look forward to a beautiful 1:17:03 but we look forward to a beautiful future. 1:17:04 future. 1:17:04 future. >> Oh, I love that. and you really you are 1:17:07 >> Oh, I love that. and you really you are 1:17:07 >> Oh, I love that. and you really you are a voice who's making a difference and 1:17:10 a voice who's making a difference and 1:17:10 a voice who's making a difference and this is what we need using the evidence 1:17:12 this is what we need using the evidence 1:17:12 this is what we need using the evidence so we can make forward and benefit 1:17:14 so we can make forward and benefit 1:17:14 so we can make forward and benefit everyone. So, I can't thank you enough 1:17:16 everyone. So, I can't thank you enough 1:17:16 everyone. So, I can't thank you enough and I'm gonna have you come back because 1:17:18 and I'm gonna have you come back because 1:17:18 and I'm gonna have you come back because we have a lot more things to do. 1:17:19 we have a lot more things to do. 1:17:19 we have a lot more things to do. >> Yeah, we'll come back. Well, this is 1:17:21 >> Yeah, we'll come back. Well, this is 1:17:21 >> Yeah, we'll come back. Well, this is like a a cliffhanger. What does 1:17:23 like a a cliffhanger. What does 1:17:23 like a a cliffhanger. What does progesterone do? Tune in later. 1:17:25 progesterone do? Tune in later. 1:17:25 progesterone do? Tune in later. >> Yes. And we have some other DHEA and we 1:17:28 >> Yes. And we have some other DHEA and we 1:17:28 >> Yes. And we have some other DHEA and we have some other things. 1:17:29 have some other things. 1:17:29 have some other things. >> Oh, yeah. Testosterone. Oh my gosh, 1:17:31 >> Oh, yeah. Testosterone. Oh my gosh, 1:17:31 >> Oh, yeah. Testosterone. Oh my gosh, there's so much to talk about. 1:17:32 there's so much to talk about. 1:17:32 there's so much to talk about. >> Part two will be coming. [laughter] 1:17:34 >> Part two will be coming. [laughter] 1:17:34 >> Part two will be coming. [laughter] Thank you so much for joining me today. 1:17:38 Thank you so much for joining me today. 1:17:38 Thank you so much for joining me today. I hope you enjoyed my interview with Dr. 1:17:40 I hope you enjoyed my interview with Dr. 1:17:40 I hope you enjoyed my interview with Dr. Gersh as much as I did. It's so 1:17:43 Gersh as much as I did. It's so 1:17:43 Gersh as much as I did. It's so important that we understand where we 1:17:44 important that we understand where we 1:17:44 important that we understand where we were with hormones, where we are now, 1:17:47 were with hormones, where we are now, 1:17:47 were with hormones, where we are now, and what's possible. All the links that 1:17:49 and what's possible. All the links that 1:17:50 and what's possible. All the links that Dr. Gersh talked about will be in the 1:17:51 Dr. Gersh talked about will be in the 1:17:51 Dr. Gersh talked about will be in the show notes, ways to get in touch with 1:17:53 show notes, ways to get in touch with 1:17:53 show notes, ways to get in touch with her. Also, I wanted to mention that I 1:17:56 her. Also, I wanted to mention that I 1:17:56 her. Also, I wanted to mention that I have a membership, the Happy Bones Club, 1:17:58 have a membership, the Happy Bones Club, 1:17:58 have a membership, the Happy Bones Club, where every month we have a question 1:18:00 where every month we have a question 1:18:00 where every month we have a question answer. So you can ask your questions 1:18:02 answer. So you can ask your questions 1:18:02 answer. So you can ask your questions and I can help you on your path to both 1:18:04 and I can help you on your path to both 1:18:04 and I can help you on your path to both optimal bones and overall health. So 1:18:07 optimal bones and overall health. So 1:18:07 optimal bones and overall health. So that will be that link will also be in 1:18:09 that will be that link will also be in 1:18:09 that will be that link will also be in the show notes as well. So thank you so 1:18:11 the show notes as well. So thank you so 1:18:11 the show notes as well. So thank you so much for tuning in and I look [music] 1:18:13 much for tuning in and I look [music] 1:18:13 much for tuning in and I look [music] forward to seeing you on the next 1:18:15 forward to seeing you on the next 1:18:15 forward to seeing you on the next episode.
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