How Hormone Replacement Could Save Millions of Women's Lives

For over two decades, women have paid the price for the greatest travesty in medical history in our lifetime. That is from the FDA lead chairman. On July 17, a group of physicians met at the FDA to unbox estrogen. What that means is taking the black box warning off of estrogen products, mislabeling them as risk for cardiovascular disease, stroke and cancer. And this landmark conversation just starts the unraveling of the mess of women's hormones. And we are excited about this very important first step. I am joined today by Dr. David Rosensweet. He is a practicing physician for over 55 years. He graduated from med school the year I was born. And he has led the charge for bioidentical hormones, access to compounded and bioidentical hormones, and training physicians from all over the world. And he's joining me today to talk about this landmark activity with the fda. What that really means, what does it mean to women in understanding the access to hormone replacement and very important conversations about the safety of hormone replacement, when to start it, when to end it, if at all. I would say no. And what women can really look at, even if they're in their 60s, 70s and 80s and looking at hormone replacement. So join me today on Menopause Mastery and join me with Dr. David Rosensweet. All right, Dr. Rosensweet, so we're going to get started on the FDA coming straight out of the gate since this last week, we had that very important meeting at the FDA to take the black box warning off of estrogen and then also the discussion about testosterone for women. So I'd love to get your opinion. And I was between patients and business meetings and I was like trying to watch it online. And of course, I had a lot of emotion around it, let's put it that way. So I'd love to hear your thoughts and your experience, what you think about it, because I know you spoke to Congress about these things before as well.

Yeah. Overall, I'm so grateful. I think just great wonders have been done here. And when I think of my 55 year career as a physician, the word FDA always used to make me shudder because the head of the FDA was a revolving door between someone from big pharma, that's who they would appoint, and they had a vendetta against compounding because they lost so much market share to them. And for the first time, Dr. Mackerey and Dr. Brennan, they represent a whole new energy and intention of the highest quality I could possibly imagine. I'm not surprised with Bobby Kennan, his lifelong devotion to health and then I thought the committee was the expert committee really did the most important thing possible. They want to remove that black box warning, false warning that estrogen can increase the risk of breast cancer. And that is so critical because it's scared healthcare providers, not to mention women all over the world. For so long that that's been the main thing that has done the Most damage. Is Dr. Makary. I'm not quite sure how to pronounce his name.

Yeah, I think it's Macary. I think that's right. Either that or we're both wrong.

Dr. Macri is so clearly pointed out the level of injury and biggest healthcare mistake in our time. It's quite a. And I agree, I totally agree. So if they can remove that black box warning and all the publicity that that's going to get, that is the most fantastic first step. I also thought what was notable is that I wasn't there and we didn't bring up compounding bioidenticals because there's, this is a staged process and I can't imagine any more good being done than removing the black box. And then Dr. Casperson was terrific around saying, look, women need commercial testosterone. I'm not a commercial testosterone. But she's bringing up a very critical thing. All women need testosterone. And there was a couple other moments that I wasn't wonderfully satisfied with. But I think overall Dr. Mackerey and Dr. Brennan are just whole new face of the FDA that I'm so grateful for.

Yeah. You know, it's. As somebody who's been on the, you know, on the more progressive side of the science, right. Let's just call it what it is, the science. It's like, okay, the data doesn't support the argument that has been presented by the FDA and major medicine for over 20 years. You know, I always, and I think a lot of people on this, on this side are like, but that only did so much, right, you know, that we only got like to the 10, you know, the 10 yard line. But the reality is, is when you're trying to dismantle this massive machine of misinformation, you have to go yard by yard and we have to go slowly because what will happen is if you don't and you push for the truth, right, which is that the, you know, 80th yard, then everybody will throw up their hands and say we need more data. Right? Because that's the, that's the fallback line, you know, of. If you push too much for what the, you know, the real world sees is is, hey, we've gone too far. But I, you know, the black box warning. For anybody that doesn't know this, the black box warning was added to any estrogen product, including vaginal estrogen, which is so weak it, you know, barely does anything other than protect vaginal tissue. And that it was a cancer causing ingredient. When all the studies show it's the exact opposite, including the Women's Health initiative had a 23% reduced risk of breast cancer when the women were on Premarin alone. And it's still, I mean, I was responding to somebody today that sees one of our telemedicine providers and she was terrified that if her estradiol levels got to 75 on just blood work that she was going to be in toxic levels. And I was like, no, that that's where we get ballpark levels that we might protect your brain, your heart, your bones. And it's just, oh, it's so, it's such a disservice to women. I mean, I, we have an entire boomer generation and the elder, you know, the elders of that generation that are in nursing homes, my mom included, you know, that have dementia and broken bones and, and all these health concerns that had they been put on estrogen and protected with bioidentical hormone replacement, they would be so much better off.

Yes. And just to add to what you said, there was a. I wish they had gone one step further. The science actually is that women who are on hormones are at less risk for breast cancer, heart attack and stroke. And they haven't quite crossed that line. They're saying, look at the benefits. And they don't announce that science, that women who are on hormones are at less risk for breast cancer, heart attack and stroke. So we'll see how closely they play that line. But if they can remove the black box warning, a million miles will have been attained.

Right, right. And then like Casperson said, you know, we need commercially available, you know, levels of testosterone for women. Now, granted, you've been prescribing and people in our community have been prescribing testosterone for forever using bioidentical forms from compounding pharma pharmacies. Because the thing that I am frustrated by with the more conventional menopause society model is they're like, oh, just give them Androgel and you sort of guess your way through a man's dose. You know, I was like, that means you get high variability of dosing and inappropriate dosing. Why not just use compounding?

Whereas with compounding it's so easy to Be accurate. It is so easy to alleviate symptoms, then confirm with proper 24 hour urine hormone testing. You see what a woman's getting.

And yeah, so let's, let's dig into this compounding argument because this has always been what, you know, sort of big pharma pushes, right? Because they're not making money from compounded medications. That, that is, that is something that's, that's just on the fringe, never really used. It's highly variable. Can't be right. But the reality is even in hospital systems, most people that are in critical care are getting things that are compounded. This is commonly used across all areas of medicine. So let's talk about what the reality of compounding and compounding medications really is, because that is pushed as a high agenda item, particularly in the social media world.

Yeah, wonderful topic. Who are compounding pharmacists? Let's start there. And every pharmacist throughout history was a compounder. They got instructions from a licensed healthcare provider, like a physician, for example, to make up this and this. And they did it with glee. They love mixing things and making up preparations. And then things changed over time. Pharmaceutical manufacturers came in and started producing these massive amounts. And by the way, just so you know, I'm a big tent guy. I want everybody to thrive. If people want pharmaceutical hormones, bless their heart, but don't eliminate what I think is the best out there, which is the compounding stuff. So then enters the Women's Health Initiative, and it scares women away from hormones. There were 40 million American women on hormones in menopause and it dropped to about 5 million just overnight from the fear. And a lot of women weren't willing to just lose their lives or the quality of their lives. And they found their way to providers who did provide hormones. And that was a lot of the functional medicine folks who were using compounding pharmacists. Why? Because I know a lot about compounding pharmacists. I'm co chair with a CEO of the Coalition to Protect Compounding Pharmacy, which is the CEO of the alliance for Pharmacy Compounders. I know a hundred compounders and these are some of the most interested, precise. They love what they do. It's still fascinating. They're not just counting pills out and putting them in one bottle to the next. They're doing what they always did, prepare these really individualized, detailed prescriptions and they love it. And this is a group of high integrity and high interest. They're fascinated still. There's a lot of fire in their belly. And we deal with so many of them that I know the quality that's there and what they're capable of doing is for one thing, women are individuals, so are men. And there's a wide range of need and sensitivity and absorption ability. A wide range, yes. But it's no big deal. When someone understands how to individualize, how to get the right amount of and the right estrogens, the right amount of progesterone, the right amount of testosterone and the balance thereof. It's fun. It makes it more interesting. What really makes it interesting is the satisfaction and long term health benefits to the patient. So my favorite words are, oh my God, I feel myself again. This is why I went into medicine. When you really get someone who you know that you're optimizing their health and then it's going to carry forward for 10, 20, 30, 40 years. So that's very exciting. But in order to do that, I've got to be very precise, I got to be very individual, I got to deal with the wide range. Well, that's the fun of it. Compounders. When I'm prescribing compounded hormones, I can do that. There's only few choices. When you go to manufacture something, you can't manufacture infinite number of variables. And not only that, of course, what matters really to us also is that topical hormones for most part are the best. And then what's in that topical hormone? Most of it is a base. There's still a widespread use of strong solvents to get these hormones in the solution in these commercial products and even in some compounders are using this. So I'm a big fan of organic oils. So compounding to me is the most elegant, the most excellent. I'm not saying you can't do good work with what's available. And I'm not trying to cut out big pharma. There's a place for all of us. But for those of you who are going to want the very best, in my non humble opinion, you're going to find your way to compounders because they can do the level of detail and the level of quality, that's going to really matter to you.

Yeah, well, you know, I mean, you and I have had some amazing conversations. So for Everybody that's listening, Dr. Rosensweet, David and I get on a, get on a call together and we geek out for like an hour and a half and we're like, oh gosh, we got to go back to work. But so the reality is is where the data is lacking is you can have 100 women. And where we need to go therapeutically for hormone replacement is first, you know, symptom resolution. Now, some people may not have had a ton of symptoms, right. They didn't have hot flashes, night sweats, all those other things. They probably had some stuff that was noticeable, but they weren't like miserable. But the lack of symptoms doesn't mean that they didn't have high impact of loss of hormones because we know across the board there's a high impact. But the reality is we don't have really good data to go, hi, you're Sue. We know exactly what your dose is going to be and the exact perfect delivery mechanism for each individual because everybody is different. Some women absorb like let's say they're using a patch, some women absorb really well. Some people are allergic to the adhesives, some people over absorb. And so, you know, you have these different delivery mechanisms. But the other part of it is, is being able to get a woman to a therapeutic dose to provide the, the activity that we want to see, which is, you know, I always look at it from disease prevention and longevity and health span is my most important. Yes, I care about your hot flashes, but I care really about those other things. But the variability of dose is quite high. One woman can get there at a point, you know,05 on a patch or whatever that is, and another woman needs a 1 milligram, you know what I mean? And, and I think that's the other thing is conventional care, when they do hormones, which again is less than 7% of all women in menopausal range, they just go, oh, here it is. And then if you don't have a hot flash, you're cool. Right. And let's talk about that because I think that is also a huge discrepancy in how we treat women and how we identify whether we're doing the right, not necessarily the right thing, but we're getting to the most therapeutic dose.

Yeah, the common belief out there in the world is, for example, if a woman is having active symptoms such as hot flashes, for one thing, all you have to do is identify a dose that will eliminate the hot flashes and she'll be fine.

Right.

And we did a study on that, actually. We also are looking to eliminate symptoms of insufficiency. And what we do is when a woman says, oh, I feel good again, we test 100% of the women at that time and not before on a 24 hour urine hormone test, which is really the gold standard. And what we learned is 50% of the women who said, I'm Doing fine, did not have sufficient estrogen to protect their bones and their vagina. That number is known. The medical literature research was done when they were originally developing the patches. For example, they asked the question, how much do we need to put in that patch? Well, what should we use as a standard? Well, how about, bottom line, we protect the bones and the vagina because we can measure that pretty well. And so those numbers are known and we transition, we translated those into what the hormone levels were to achieve that. And once again, 50% of the women who said, I'm good, did not have sufficient to protect their vagina and bones. And 25%, even though they said I feel good and didn't have symptoms of overdose, there were dosages that put them at risk for breast glandular cell proliferation. In other words, too much. So it's not only symptom alleviation, which is a nice beginning. This must be confirmed by testing to make sure that the women are in the optimal zone, not too much and not too little.

Yeah. To me, you look at population based medicine, so you go, okay, here's the population at large. Hormones are protective, period, full stop. Individual hormones are protective. The dose you need is individual. We cannot go with population data to say that everybody's gonna be the same because we aren't.

You know, let me throw something else in there.

Yeah.

We know the numbers for if you don't have enough estrogen, you're gonna get vaginal atrophy and bone loss.

Yes.

What we don't know the numbers on is how much does it take to protect the brain and reverse cognitive loss. And what we do know about that, because there is good science on this, is it varies enormously. Some women with standard optimal zone estrogen, for example, are going to get return of cognitive function. It's very rewarding when that happens. Other women are going to need really robust, robust, robust levels of estrogen. So the range for cognition is huge. And the same for arteries. We don't know the number that protects the arteries. And half the women who leave earth do so through an arterial event like arteries.

My mom had one.

Yeah. So to individualize based on the individual risk factors for any individual woman and the wide range, well, it's fun. All you got to do is know a lot and deploy this excellent knowledge and testing ability that we do have.

Yeah. You know, it's. So that's, that's really interesting because, you know, I think, you know, a lot of women are starting to come around, they're starting to recognize, but then they fall back to, you know, a lot of the studies have looked at women going through perimenopause and menopause. So if we look pretty prior to the Women's Health Initiative, they're looking at women that are sort of in that transitional or early menopausal experience, which we would call the ideal time frame. Right. Because you're kind of halting the. You're kind of slowing the aging bus. Right. But, you know, a lot of women, because we. We have a ton of women that come to us that are, you know, in their 60s that are like, wait a minute, no one told me I could have this. I want it. But they have been. They've had it pounded into their head that they're high risk. Right. And that they can't have it or they can't have very much. And the reality is, is like you said, we can see people with cognitive issues get improved when they get adequate estrogen, and I would argue testosterone and progesterone along with it. You know, let's. But can we dive in a little bit deeper to that? Because I think. I think that's where a lot of women just get stuck and they're like, I just. I don't think I can. And we have that 10 million woman study that, you know, looked retrospectively backwards in the menopause journal that showed that we reduced risk, and I think cognitive decline was, you know, 30 something percent. So the women that were in that study were older than 65, but we didn't have definition of how many of them started earlier or not. They were just women. The women that outperformed were the ones that were like, forget it. I'm staying on hormones, you know.

Yeah, I mean, you're talking about the challenge of our unique time. Never before in history was there an interruption in menopausal care. 40% of all American women who were in menopause were on hormones in 2002. And now we've got this generation who have not had hormones for 10, 20 years, 60, 70 years old, because they were inappropriately, wrongly frightened that hormones were dangerous. And just to clarify that one, Betty, if I might take a bit of a side. Here's the actual science. Anyone who wants to investigate it, go deep. We'll give you some resources to do it. Here's the actual science. We're all at risk for all kinds of illnesses. We're all at risk for hundreds of cancers. As a male, I'm at an increased risk relatively for prostate cancer. Women knew not so when I was in medical school. Are at Increased risk for breast cancer relatively over other cancers. Given that we're all at risk, women who are treated with hormones are at less risk for breast cancer, heart attack and stroke than women who go untreated. Less risk. That's the science. It even goes further. Women who've had breast cancer and had that breast cancer properly treated happen to be at an increased risk, relative risk of recurrence than a woman has for developing cancer. Brand new. Given that increased relative risk, women who've had breast cancer and had it properly treated are at less risk for recurrence if they're treated with hormones than if they're not. Now that's the sign.

Oh, hold on, you gotta repeat that again. So I want people to hear that. Say that again. So women who have breast cancer, women.

Who'Ve had breast cancer happen to be at an increased relative risk recurrence of that cancer than a woman who's never had cancer has for developing cancer. Brand new. Given that increased relative risk for recurrence, women who've had breast cancer, had that breast cancer properly treated are at less risk for recurrence if they're treated with hormones than if they're not. And that's totally irrespective of receptor site. You can forget whatever belief system you have about receptor site the science stands at. Women are at less risk of recurrence who've had breast cancer if they're treated with hormones than if they're not.

Yeah. So what we're seeing here is if somebody has a estrogen receptor positive, whatever breast cancer, they go through treatment, all conventional treatment. Let's face it, caught early, 95% of breast cancer is 100% treatable with conventional care. Obviously from a functional side. We would throw a bunch of other things at that. But the reality is conventional care does, does that. And so they might go on an arimidex or a tamoxifen or something like that post treatment, but the starting of hormone replacement actually reduces their long term risk of reoccurrence.

That's right.

I think people need to really understand. We have a lot of women that are out, you know, 10 years, 20 years out, like on hormones, rocking and rolling, feel great, no reoccurrence. Right. And I think. Oh, go ahead.

What you were bringing up, the issue of our times is you've got women in their 60s, they got frightened, they didn't go on hormones, they've suffered some things and there's risks that they don't know about. What do you do? And this is something that I wish the Expert committee had not come down the way they did. They kept on emphasizing that what we know for sure is that women who are within 10 years of perimenopause are safe. Oh, what does that do to these women who miss the window of opportunity? Well, we've never abided by that. Just to let you know. Here I am a medical doctor specializing in treating women in menopause and men in andropause, and we do understand that there are special possible, not necessary, risks for a woman who's gone 10 years without hormones. Yes, there are. However, all you have to do in medicine is know about those risks and address them properly. So when we see, for example, A woman who's 60, she hasn't had hormones for 10 years, 15 years, and we see that her mom had a stroke and her dad had a, and her aunt had a heart attack, we know that there's special cardiovascular risk. And we focus in on testing what's her risk, and we deal with that risk, and then we turn to the hormones. You just have to pay very close attention. When someone's had a venous thrombosis, a thrombophlebitis from the birth control pill, or a pulmonary embolus, we pay attention to those kind of things and just do what we need to do to make sure they're not don't have an increased propensity to clot. Now, given all that, for a physician or nurse practitioner out there in the field, in the world, who do you meet up with? You meet up with real human beings like my mom, who didn't want me to address her female issues until she was 86. And here she was, and she was getting cognitive decline and walking with a cane. Next step, walker. And did I hesitate to treat her? Was I going to put her through? You know, I admitted as a physician who knows a lot about risk and knows a lot about the wonderfully sophisticated techniques we have to evaluate coronary arteries, for example. She wasn't going to do that. No, it was too late. So in medicine, it's always risk, benefits. So we've treated women of all ages and because when you're in actual practice, you meet up with individuals and you do what you need to do. And if they're at increased risk, you evaluate the increased risk and you deal with what you can.

Ladies, if you're noticing more fine lines and wrinkles, it's not just about aging. It's about the loss of estrogen. And that affects our skin structure, making it drier, thinner, less firm. But here's the great news. I've created Biased Mastery Cream to help. This luxurious bioidentical estrogen cream supports your natural hydration and elasticity. It's packed with nourishing oils like olive jojoba, aloe and coconut. So it feels amazing and helps soften those lines and bring back that healthy glow. I've been using it, and let me tell you, my skin has never looked or felt better. It's smoother, more radiant, and, and those little cracks and creases are way less noticeable. If you're ready to give your skin some extra love, check out by EST mastery on the Metabolic Blueprint website. And that's metabolicblueprint.com B EST mastery. That's B I E S T mastery. M A S T E R Y and your face will. Thank you. You know, I think, you know, one of the things that I thought was so great about that, you know, menopause journal study of 10 million women and retrospectively looking at causes of mortality, death, and it was the first really large study where we had like a swath of women who had been on hormone replacement and tracked, like, mortality that were on topical forms of estrogen. Right. Because Premarin was kind of the, you know, rule of thumb for the longest time until the Women's Health Initiative. And even in that study, it made it into the abstract that all of this, all of the clotting risk that's associated with a much older woman being on conjugated equine estrogen, Premarin, and things like synthetic estrogens that we would use in birth control is mitigated by topical preparation. Like it, it made it into their abstract because it was so important because that's where we start to really identify that, okay, I'm 15 years out. Maybe you have arterial, you know, atrophy, you have loss of arterial flu flexibility, and we have plaquing of the arteries. But if you're doing a topical preparation of estrogen, you're not getting that first pass metabolism through the liver that's going to make all these metabolites that are associated with that risk. Right. And I think, I think the, the, the challenging thing now is being able to tell women, hey, you know, yes, you can use topical forms. And we don't really see that increased risk. And, and we can use it to protect the brain Even if you're 20, 30 years out and you're starting to experience significant cognitive decline.

And, you know, it's an interesting approach to focus so intently on risk. And we do focus intently on risk, but what's being left out is the near certainty, not risk. The nearest certainty of big time trouble by hormone avoidance. Like when a woman loses her estrogen, the risk for coronary artery events or a stroke goes way up. The risk for bone loss, it's not a risk, it's a certainty.

Yeah.

You're going to lose your bone if you lose your hormones. And, you know, it's been pointed out over and over again that, you know, there's more women who die from a fracture of a hip from osteoporosis than die from breast cancer. Why hasn't the focus been there? What I'm trying to do is do a C shift here where we pay attention to the importance of the preventive aspects. Hardly anyone can believe in prevention in a sense, you know? Yeah, I'll take some vitamins and that'll be good for me. No, hormones are a different world.

Yeah.

You take hormones, you can prevent many, not every single case of cognitive decline, but many. Even Alzheimer's.

Yeah. Yeah. I mean, depending on the study, you're looking at like, 24 to 37% reduced risk of dementia of all forms. Right. Like across the board. And I don't know about you, but I would rather. I don't want to end up in a nursing home or assisted living in a wheelchair and unable to do activities of daily living. And I definitely don't want to want a physical body here. But my mental state is gone.

And anyone who's got a family member who's gone through that as I have, me too. Oh, my God. It's the worst. And, you know, it's not worse for the family member, it's worse for the person. People's lives matter to them when they're 80s and 90s. They matter as much as our lives do at whatever age we are. So I want to also put in a plug for what Dr. Caspersen did on that expert committee is when I was in medical school, we had this lecture, these noon lectures in the hospital. I had my white coat, I was so excited. And then one day, our noon lecture is coming from a gerontologist who's a specialist in elderly. This is 1968. Go picture that. And I say, oh, I don't want to really learn about the elderly. I'm a young guy. Medicine's about the young, isn't it? And then to this day, I remember only a few specific instances in medical school. And this one was this gerontologist said, you senior medical students, you know thousands of diagnoses. Let me tell you what's happening to older people, they're losing their muscle and they can't stand or walk with stability, and they fall and they fall on their hips. That's got bone loss, and they die. You want to do something for the elderly. You help them retain their muscle and their bone and also their brains. And what gets 80% of women. This is by an expert who is a nursing home expert physician, a medical doctor on our staff. Our medical staff says that 80% of women who are in nursing homes are there because of muscle loss. They could do the walker at home, but they couldn't do the wheelchair at home. They couldn't do the adult diapers at home. And chronic urinary tract and adult diapers and incontinence. This is. And that. And muscle loss is what gets women into assisted living facilities and nursing homes. It would so drastically change the quality of life. Because women want to stay at home. They're willing to endure. That for many is an awful transition away from their family. But we could do so much talk about prevention just on the level of muscle preservation. And to preserve muscles, women, you need testosterone. It is not a male hormone. It is a human hormone. And women need it as much as men do. And for just one thought, just to preserve the muscles. So, yes, we want Dr. Caspersen's wish on that expert committee that testosterone become widely available and popularized. It would change the nursing home situation. God bless nursing homes. I'm not trying to encourage them to lose business. They do an amazing service. Bless their hearts. It's a hard one, but the people don't want to go there.

No, nobody wants to be there. Nobody wants to live there. Nobody wants to visit there. It's not. It's not ideal, you know, and. And you look at it. So I have a group of women that I met in my neighborhood over 20 years ago, and the age range goes from 89, and I'm the youngest at 55. And we get together once a month. And it started out as kind of a wine and cheese, and it's really women just supporting women. And one of the women, you know, was older, she had some health problems, had venous insufficiency. We can thank Trump for everybody understanding what that is by this week. And so she, you know, but she had already lost some mobility and she fell, you know, had an injury, ended up in a skilled nursing, ended up with a uti and in a matter of days was sick, sepsis, and died. And all she needed was vaginal estrogen. All she needed was vaginal estrogen she would reduce that risk for that UTI by 87%. And, you know, because you're fighting an uphill battle trying to get that message into conventional care and particularly into skilled nursing, unskilled nursing and nursing homes and all those other things, because it's. Especially if you have incontinence, your risk for that is going to go up radically. But then the loss of hormones changes the pH and the bacterial and yeast sort of balance in that area. And it's. It's. I. I mean, I go to a nursing home every day and visit my mom. I go to an assisted living center and visit my mom. She had a heart attack that brought on a watershed stroke so catastrophic. She lived alone, did. I mean, she was strong, too. Lived alone and basically went to a full assist in 24 hours. And the biggest risk she had after that was she didn't know she had a stroke. So she constantly tried to get out of bed with some, you know, right side insufficiency. And it took about three months for her to break her pelvis, you know, because you can't. You can't restrain, but you have to basically have eyeballs on her at all times because she'd wait till everybody go to bed and she'd try and get out of the bed. Because my mom was very motivated kind of person and to watch that. So she's a full assist in a wheelchair. Watching her, like, lose her muscle mass even more, it's awful. And no woman should ever have to go through that.

I really appreciate you telling that story because there are so many, if they haven't experienced the story, they're going to. And it's a funny way to get the attention of women in their 40s and 50s. Look, the best thing that you can do for yourself to stay alive, stay home, stay walking and talking, and even have libido, et cetera, if you want it, is take time out, get good at this, get it right. Find a provider that you love that's going to dial you in. And like, when are they going to. When am I going to stop taking my testosterone? And the other things I take hold.

Dead hands, man. You have to drag it out of my dead hands.

That's right. That'll be the day.

That'll be the day. No, I mean, it's. Yeah, it's really true. And even if you're a woman in your 60s and even 70s, that doesn't take them off the table. I think. I think that's the. The other big message that I wish would have gotten out there. Yes, there's an ideal window in that first 10 years, but that women in their 60s, 70s and even 80s can bring hormones in to help improve their overall lifespan. Now, have we had an extraordinary amount of aging at that point? Yeah, yeah, yeah. Aging is the biggest cause of disease, right? It should be. Cause it is called a disease in itself because it is the biggest symptom that drives disease. However, they may be able to improve that health span time period at a level that they have no idea.

And we have actual evidence through test results of bone restoration.

Oh yeah.

For example, with hormone treatment and cognitive recovery from hormone treatment. So healing is possible.

Yeah, yeah. I mean I spoke to a woman who's seeing one of our telemedicine providers and you know, she had 7% gain in bone over the course of 18 months. Another woman, 12%. Right. 12% improvement. Right. Just from hormone replacement, lifting weights, doing the right diet and things like that. So the reality is, is the loss of hormones will drive bone loss in every woman. It's just to what degree and how much did you start with and what are you doing to slow it down? But you can't. If you've already, if you've already got massive loss, you cannot lift enough weights to get back into non osteoporosis or osteopenic zone. You can make it better, but you're not going to get back to a 30 year old woman. You got to have hormones on board. It's an uphill battle.

Hear, hear.

Yeah, it just really, really is. You know, so, so, you know, you've obviously been in this world for so long, you know, and you know, you testified in front of the NASAM and helping sort of get this out there. What do you think we're going to see over the next couple years? What do you think since we opened the door with the fda, what do you think we'll see? And then what would you like to see?

Well, I think this is the sea change. If they can remove that black box warning, it's going to give women permission, so to speak. They've always had it. But it's going to open up the heart to, hey, even the FDA is recommending this. And I think these doors are going to flood open. I think everyone's going to benefit by this too. Even Big Pharma is going to benefit by, I don't know why anyone would squawk against this one. And you know, I see a widespread reopening the minds and hearts of women and providers and excitement. Why excitement? Because of all the fields that I've worked in, in medicine, and I did general functional medicine for a long time in the beginning. I've never seen such wonderful results. You don't often hear, oh, my God, I feel great. I feel good again. Oh, my God, my libido is back and my function is back. Oh, you know, among other things, my mind, I'm sleeping all the. All the great things. My mood is back. I'm motivated again. I want to go back out into the world of the work that I was doing because I'm excited again.

Just.

You don't hear that level of success in medicine necessarily. There are exceptions. And why? Because these hormones are the most powerful biochemicals in our body, and they affect every cell, tissue, and organ in our body. So it's no surprise that you get wonderful results. That's the thing, the leverage for this particular work. So what I hope for is that this is reopening the door to widespread treatment of women and men, because men have got a similar issue going on. They're not as bad. And that the floodgates open and you get millions and millions and millions of women worldwide. And this, this really meets the mission of our group, our institute group. We believe that the world desperately needs more feminine energy at every level in the. In the home, in business, in politics. And this could be the floodgate that gets feminine energy back on the planet. So it's been one of the most exciting possibilities that have happened in my long career.

Yeah, yeah. It's interesting, you know, you and I are so much on the same page, because I'm like, in this time period of life as women, we have, you know, often for the first time, access. Right. So we're in a position where we have accessibility to things that we may not have had before because we're not as focused on raising children and all these other things. We have assets in many cases, so we can leverage, you know, the things that we've done over our life. And the reality is, is we can step into this world and really make an impact. And most women in their 40s, 50s, and 60s don't see that. They don't recognize it because they don't feel themselves. And I'm like, ladies, we make 87% of buying decisions, particularly medical decisions. I had this conversation with a man. He was being a little feisty about women making decisions about their own body. And I started laughing, and I. I said, oh, sweet pea, sweet pea. You don't make decisions about your body. You see your doctor because your wife tells you you See your urologist because your wife makes the appointment. She also makes the appointment for her children and probably her mom, father or whatever. The reality is all life is being ran by midlife and married women and women in relationship with other people. So the reality is we are doing this already. We just don't recognize that we can bring that feminine energy and actually change the way world. Because the reality is, is women that aren't being treated for menopause leave the workforce. You know, I think one of the calculated measures was it cost the American economy $26.8 billion because women don't move into that next role or they walk away from the workforce because they don't feel themselves right and they, you know, things aren't working properly. And you know, we need women to step into those, those positions and use their agency. Right. That's the other part is you have agency to make choice and change. And I think, you know, and so I'm so motivated to help women see.

That and just to extend upon that. I mean, I believe the divine feminine energy is not wanting to go to war and not wanting to destroy this planet. So my hope is that it happens in time.

I'm with you. Yeah. Never thought I'd see what's going on today in my lifetime. I thought I wasn't going to make it. I was like, oh my gosh, hate it when history repeats itself, you know, and I agree, you know, and I think, and I think that's the battle cry, you know. You know, I think the other side is, you know, Dr. Rosensweet and I and his institution, we're doing a lot of things behind the scenes with the Minerva project and other things to add agency, access and science to women's health. I mean, I think that's even the more important part. We need really, really well trained clinicians to be able to do hormones correctly. We need the science. That's where I want to bring in my world and actually have credible, real data where we can actually be predictive and proactive with women. Instead of like, okay, let's guess and do hormone testing and do hormone testing and guessing, we can be more proactive about it. But then we can also address things like autoimmunity, osteoporosis, osteoarthritis, osteoporosis, pmdd, pcos. There's so many hormonal based problems that we have that just basically have never been studied adequately.

I'd like to offer a second opinion on this. There's the hue and cry of whatever the community is Is, well, we need more data, we need more science. And I say, no, we know so much about hormones, about health, about medicine, so much. And then for like you talk to an ophthalmologist who does cataract surgery and you say to the ophthalmologist, you need more data and more scientific studies to prove that these are okay. And they'll go, yeah, right. I've had 82,000 cases of people who got their sight back. You're telling me we need more studies. It's not exactly the same in the world of hormones, but from my perspective it is. Yeah, there are frontiers, there's some intricacies that we want to iron out at the periphery. The body of knowledge and experience and the tools available to us are so excellent right now.

I agree with you on that.

You can get excellent care right now.

We need to prove hormones, hormones by I think we. That that ship has sailed. We are clear that hormones are protective. What I more want to understand, and we just need bigger data is we need, we need, we need data about when hormones are adequate through aging, what happens compared to the rest of the population. Because we need to look at that. Which is where I want to get the data because I want to look at other health concerns like autoimmune conditions, 10 to 1, female to male, 100% hormone related. Right. If anybody that questions that just is defying logic. But we need to normalize the treatment first to understand where it is. Because if we're constantly telling people they can't do it, then we can't get to a data that is, is sort of balanced out. Yeah, it's understanding the other, you know, trillion dollar. Like if you want to look at it from an investment standpoint, trillion dollar women's health industry that has zero research because no one wants to fund it. But we have to get women on hormones to keep them at a health. Continue the health span that comes from hormones because then we can look at how much that plays a role. Because I would argue that if we were really doing hormones, well, all the way down into our 20s, 30s, you know, we would probably not see this stuff. Right. Remove endocrine disrupting things, improve our environmental toxins, we would probably not see an extraordinary uptick in autoimmunity. That is a new problem. We did. Like if you look at old, old 1800, late 1800s medical textbooks, they describe something that looks like r. Arthritis. But like that stuff was unheard of. And people say, oh, it's because, you know, people didn't live as long. Well, Autoimmune conditions are a young condition. They, they don't strike old people, they strike young people. Mine showed up and I had episodes, but mine showed up in my early 30s. Right. So we need that data, but we need hormones to be standard of care so we can actually use that data in a way to understand disease. That's my goal.

Yeah, I see what you're saying there. Right on.

Yeah. Yeah. Obviously feisty about it.

Thank goodness.

Yeah, yeah. You know, it's like somebody has to get feisty about it. That's why I was talking with a friend about being in front of the fda and I was like, I probably would have been a little more colorful, you know, but that's. I, I'm so excited for everybody that was there. And, and, you know, it's the first step. You know, it's the big, big fan first step. So in closing. So let's, let's, let's give our women, like if they. You would. If they were to take away three things that they heard from today. What's the three big topics you want them to know?

Number one, hormones are wonderful and they're imperative from my perspective for anyone who wants to walk and talk and think clearly in their 70s, 80s, and 90s.

Yeah.

And we didn't go into details, but I think it's good for a woman to go shopping to find a provider who's specialized in treating women in menopause with hormones so you can get the best care and use your tools. You know, how does the office staff feel? What are they? How's the entry person who answers the phone? Or go to your network of women? Because someone is in menopause and someone's getting treated and they're gonna have an opinion about who the best person is in town to give you the best care. So number two is go shopping so that you can link up with a licensed healthcare provider who's really good at it.

Yeah.

And. Yeah. And get good stuff and do it for the whole rest of your life. Don't even dream of. Once you get on it, you're not gonna dream of stopping. Nobody that I meet up with is gonna dream, oh, yeah, I'll just do it for three years.

Yeah. No, no. And if. And I would say I would add to that no matter what age you are, you deserve the right to look at them. And they are, they are protective for, you know, long term health. And if you carry other risk factors, we should identify those risk factors and look at them anyway because you're at risk whether you have Hormones or not. Right. So if you have stroke and heart attack risk in your family, you carry that risk regardless of hormone. Right. There's. There's probably familial risks. Yeah.

I love that you emphasize that. Anytime you get the idea, no matter how old you are, at least investigate it. And you can get. You can get on a recovery pattern that sooner or later will include hormones.

Yeah, absolutely. Absolutely. Absolutely. Well, Dr. Rosensweet, I had so much fun talking to you. I always do.

Me too.

And we covered so much great territory today. So thank you so much for your time. And I think everybody needs to understand you've been doing this as long as I've been alive. I'm always fascinated, because anybody that's not watching this on YouTube, Dr. Rosensweet does not look like he could be practicing medicine as long as I've been alive. I'm 55. It's like, yeah, that's what. Tell you what hormones do. But. But you. You know, you've been around for a very long time, and you've got. You know, when people go, do you have the digits? Do you have the data? It's like, okay, yeah, 55 years of practice.

Yeah, Right.

Still teaching. Still teaching practitioners all over the world. Right. So I think. I think that's really valuable. So thank you.

Thank you, Betty, so much.

Yeah. And awesome. So everybody listening and watching Menopause Mastery. Thank you so much. You know, we do this because we all together rise when we are educated and we know what you need to do. If you are watching this on YouTube, don't forget to subscribe. Leave a comment below. And if you are watching this or listening to it, we would love a review. And I'll be back with you next week with Menopause Mastery.