Weight and HRT for Women In Menopause

Foreign. Talk to you about weight gain, weight loss for women. And this is a big topic right now because we're using a lot of These drugs called GLP1 agonists and GIP agonists, semiglutide, tirzepatide, and you know, we're using that kind of an episodic fashion to get the weight down. The medicines are kind of expensive. It's a shot you give yourself every week. What are the things can you do to lose weight that really doesn't include diet and exercise? I think diet and exercise goes without saying. That's that's the most important thing you can do. But what about other interventions? So as we're seeing most commonly perimenopausal or postmenopausal women. And prior to 2002 or 2004, right around that time, we put pretty much all women on hormone replacement when they hit menopause. And there was a big study came out in 2002, 2004 came out in two different years. There was probably the biggest disservice to women's health in history. And that was called the Women's Health initiative trial where Dr. Mistakenly interpreted the results that suggest that HRT could cause women health problems. There was really nothing further from the truth. There's a way they did this study that had a very slight increase of risk. But we found subsequently that women that went on hormone replacement therapy within 10 years of menopause had a much lower chance of dying in the next 10 or 20 years to get cardiovascular disease. But what about weight? So let's talk about that. These are not new studies. I'm going to take some studies from the 90s that when we were, we were supporting using hormone replacement therapy for women to support a lot of things such as reducing vasomotor symptoms or to menopausal symptoms, support weight, prevent weight gain from happening quite as fast to help with mood with bones and help with longevity. Okay, so let's go through three studies here from the 90s and these. Some of these references are included in my book Testosterone stronger for a Man made for a woman. This is a 1999 beneficial effect of hormone replacement therapy on weight loss in obese menopausal women. So beneficial effect of hormone replacement therapy on obese and weight loss obese Menopausal Women, 1999 and they used hormone replacement therapy and they found combined hormone replacement therapy not only prevented weight gain but favor weight loss by significantly increasing lipid oxidation after three months of treatment. If they really influenced insulin response and Plasma lipids on energy expenditure. They did waist their hip ratio weight fat, visceral fat. They found on average about six pounds of weight loss in three months with hormone replacement therapy. Also better glucose hemoglobin when seeing glucose levels. 1999. So we knew this back then again, we abandoned it. Study in general American Medical Association, 1996. This is a study of 670 women age 65 to 94 in San Bernardino. Rancho Bernardino. Hormone replacement therapy, whether used intermittently or continuously for 15 or more years, is not associated with the weight gain and central obesity that is commonly observed in postmenopausal women. Now, this study, we could say, well, how good of a study is it? Because they didn't have a control Group. Well, 15, your study, there's not going to be a control group. So control group would be your women that are observed that are not in hormone replacement therapy. But it's not going to be a double blind, placebo controlled study, which is the gold standard. You can't do that for 15 years. But this is an example where they looked at 671 women, 15 year prospective cross sectional cohort study. This is a good study. And they showed that hormone replacement therapy used intermittently or continuously for 15 or more years is not associated with the weight gain and central obesity that is seen in postmenopausal women. Okay, favorable. Less heart attacks, less breast cancer, less weight gain, less obesity. Third study, 1998. Effective androgen replacement therapy, testosterone therapy for postmenopausal women. This is 39 healthy postmenopausal women with increasing body weight were studied for six months. They did a DEXA scan, which is the most accurate way of determining whether or not you're losing fat or muscle mass or gaining fat or muscle mass. They found that androgens are capable of reducing abdominal fat accumulations as well as total body weight in postmenopausal women with unexplained weight gain. These studies are all predating the 2002 and 2004 women's health condition Trial where doctors more or less abandoned hormone replacement therapy for maybe about 10 years, which again was a big disservice to women. We know that women who are in menopause suffer from menopausal symptoms. Hot flashes, night sweats, fogginess, brain fog, weight gain, decreased bone mass, started getting increased rates of cancer, heart disease, neurocognitive decline. And between about 2002 and about 2015 or so, we pretty much were putting women in menopause on psychiatric drugs, treating menopause like a Psychiatrist disorder. We could not have been further from the truth. Hormone replacement therapy is not only safe, but it protects life. Our practice, we've been doing hormone replacement therapy during that entire time. And we were using the bioidentical hormone creams at first, which were working well. It was really hard to get enough testosterone into a woman through creams. So we switched over to the pellets which are much more stable. So testosterone pellets about the size of a piece of rice. The estrogen pellet is about one twentieth that size. And then progesterone, which is another natural hormone, is taken orally and the pellets go into your skin using the buttocks. We can go anywhere. You can put it where there's a scar in the abdomen from a C section or appendix scar in the last about three months or so. And we're seeing that testosterone has a very strong inhibitory effect on development of breast cancer. Doesn't make it impossible. Reduces the rate by about 40 to 70% with or without estrogen. Studies with estrogen alone have not shown a strong favorability for increased risk of breast cancer. Actually reduced risk of breast cancer on estrogen only in a Women's Health Initiative trial. However, we know that testosterone should be kind to reduce it substantially versus just a minor decrease. And both estrogen taking somehow topically or transdermal or in a pellet and testosterone favor weight maintenance or in cases of somebody gain weight, weight loss. So I tell you, if you're using semaglutide and lost some weight and you're, you should start exploring hormone replacement therapy to see if it's right for you. Talk to your doctor about it. You can go to Allure Medical Books and you can download our book for free. You can buy it on Amazon. We can download it for free. It's called testosterone. Strong enough for a man to make for a woman. And back around 2010 or so, I was using testosterone products by themselves because that does help solve all symptoms of menopause. And there was such a political fight or fear over using estrogen because of the misinterpretation by doctors and the public and the media about the dangers of estrogen, which was misplaced estrogen only women were perfectly fine. It was a drug called progestin that had some risk, which was really a drug, not a hormone. But doctors were spooked by using any hormone replacement therapy. They really know what testosterone was for the most part for women. So. So they didn't discourage repairing patients from taking it. Then around the 2000 teens, we learned that estrogen is extremely, when I say extremely, like 40% reduction in cardiovascular events. That's, I would still call that extreme since that's the number one killer of women still today. And it happens in menopause. But testosterone replacement therapy started within about 10 years of menopause. Reduce a woman's risk of breast cancer. I'm sorry, of heart disease. We combine those together. We have the things that are remote, you know, heart disease, neurocognitive decline, breast cancer, might or might not happen, all negative. Then we have the immediate better protection of weight. Weight loss, favors weight loss. If you gain weight, weight protection. If you're just worried about that happening. And I think this should be part of your overall health. These drugs semaglutide and tirzepatide, which are known as Wegovia, Zempic, Zepbound and Manjaro, they're all very healthy drugs. We're seeing more and more benefits from them. I'm not downplaying those at all. We use them regularly, very happy with them. But I always ask what else can we do to help people live your healthier life? And there's obviously lifestyle intervention and quite frankly pharmacology is part of it. And as we think about living longer lives, there's sometimes pride in not taking any medications at all. But once things happen, you get metabolically unsound such as an obesity or being overweight. Drugs do prolong life. You go through menopause or males and men. Andropause we're talking about menopause here. That menopause starts the aging clock much faster. Where things such as heart disease, cancer, neurocognitive decline, weight gain come on a much faster rate. We can really attenuate those. We're seeing a society that's going to live well past the current projection of 80 if you're say a 50 or 60 year old woman. And I think pharmacologists with accept that that is part of it. Your ovaries are tiger. They're pooped out, they're no longer making the hormones and you can take them exogenously, they can be taken as a pellet. And I'm really big proponent of weight maintenance. We know that if you look at lifespan the predictors are going to be, you know, your lean muscle mass as a percentage of your body weight. There's a lot of times there's a misunderstanding thinking that it's total lean muscle mass or totally body weight. Now hear that a lot in the popular media media but that's not correct. A small person can live a long time as well as a big person, but it's your percentage of lean mass to total weight. And lean mass is not just your muscles and your bones, it's your organs and your blood vessels and your circulation. We have skeletal muscle mass, which is our bone, scalp muscles, which would be everything besides the heart. And then we have lean muscle mass and then we have fat that's really your three compartments. Lean mass includes skeletal muscle mass and testosterone therapy. Replacement therapy promotes lean mass. Estrogen replacement therapy promotes lean mass. These are something that we've written about, blogged about, podcasts about and I'm going to be continuously trying to get the message out. And I see a shift in doctors opinions or attitudes towards HRT. They were afraid of them. Doctors in their 50s and 60s, maybe even 70s are afraid of HRT because they were told by CNN and Fox News they shouldn't be using them. Nothing could be further from the truth. We should not be taking our medical advice from media, but we did as a society. A big study called the AWARE trial. AWARE trial and they found that based on the Women's Health initiative trial in 2002, 2004, the majority of women went off their HRT because of how they perceived the information. The information was actually trying to show something else other than if you start menopausal medicines within 10 years of menopause. They did not. That was not the group of people that had an issue. So HRT I want you to learn about a little bit more. You can read my book, I encourage you to get a free copy of that, talk to your doctor about it and thank you very much.