The Truth About Hormone Replacement

Hi, I'm Dr. Tabitha, the gutsy gynecologist. I'm a triple board certified, OB, GYN and Functional Medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey. And I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyne health and your overall health. And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more band aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. Hi ladies. So this week I really want to talk about bioidentical hormone replacement therapy, because hormone replacement gets a bad rap and I constantly have women tell me they're scared of hormones. And it all stems from the Women's Health Initiative study that came out in 2002. So it was right when I was in medical school and beginning my residency training. All of the pieces of this study started to come out and the media jumped on it and skewed the results and caused a lot of fear and panic. Essentially what I saw was doctors just flat out taking everybody off of their hormone replacement therapy overnight. No weaning, no regard for how women felt. And it was a really sad time for women in our health history. And I just, I have so many stories in my mind of women suffering and all of the devastation that they went through. Being taken off of their hormones abruptly or going through menopause and being very scared of their hormones and assuming they were going to get breast cancer and die and all of these terrible things because of what was being portrayed in the media from this study. So I really want you to understand that this study is about synthetic hormones. And it very much matters what type of hormones you're studying when you go and tell the results and the outcomes and the risks involved. So the study had two arms to it. It was one where women were just given estrogen if they didn't have uterus, because the conventional thought is that progesterone is only needed to protect the uterus from unopposed estrogen. We now know that your whole body needs progesterone to be protected from unopposed estrogen. So it is still standard of care. Unfortunately, for many Gynecologists to give you only estrogen if you no longer have a uterus. And you can probably attest to the fact that it doesn't feel very good or balanced if that's you. Some women will finally feel relief from hot flashes, night sweats, things like that. But when you have unbalanced estrogen and no progesterone, it usually feels like weight gain or constant bloating, swelling, brain fog, anxiety, insomnia. Those are all symptoms of low progesterone and imbalanced estrogen. It turns out we need progesterone for more than just our uterus. Anyway, back to the study. The study had women with no uterus taking estrogen, and that was conjugated equine estrogen made from horse urine. It's a synthetic hormone. Then the other portion of the women who had uteruses were taking conjugated equine estrogen and a synthetic progestin. At the time, it was thought that synthetic progestins work just as the same as our body's natural progesterone. It turns out that it actually works the opposite in most systems. The only place that it really has the same benefit or effect is in the uterus. Synthetic progestins do seem to protect the uterus from any kind of estrogen. But synthetic progestins cause weight gain, mood swings like anxiety, depression, fatigue, all of these side effects that none of us want. Right. And so synthetic progestins are what's in birth control pills, NuvaRing's, Nexplanon, Rod that goes in your arm, the depo shot, the IUDs like Mirena, Kyleena, Skyla, they're all at varying doses and different forms of synthetic progestins, but nonetheless, they're not progesterone. You can potentially have all of these side effects. The study had these two arms of women, that's what they call them in a study is an arm. What they found was the women on estrogen alone had increased risk of blood clot and stroke. The women with the estrogen plus progestin had an increased risk of breast cancer. That is why the study was stopped. The evidence was misconstrued right from the get go. Estrogen was demonized for causing breast cancer when it was actually the progestin in the study that was causing that. That's the same progestin that's in all of our birth control, mind you. So the study was stopped, people panicked, and it was regarded that hormone replacement therapy was dangerous. There's some missing Other missing pieces to that puzzle. The average age woman in that study was 63. So she was already 10 plus years into menopause. She had already gone 10 years without making her own hormones naturally, her own estrogen and progesterone, and then she was given synthetic hormones. The majority of women in the study were smokers or had heart disease or diabetes, diabetes and obesity. So they were already unhealthy with these disease processes to begin with before they were given synthetic hormones way past their menopausal. There are many, many flaws in this study. Essentially what this study did show us was that synthetic hormones are not safe. They do have risks associated with them, and we should be very careful when taking synthetic hormones. Unfortunately, for many political reasons, we have deemed menopause as the cutoff for that concern before menopause. We're not concerned if you're on synthetic hormones. But we know from the research that synthetic hormones cause increased intestinal permeability. They cause vitamin and nutrient deficiencies, they cause your ovaries to stop producing your own hormones, they cause low testosterone, they cause a lot of issues long term. So I just want you to be aware that medicine often makes big blanket statements in the heat of panic and then comes back later and puts their tail between their legs and says, okay, we were wrong. We weren't doing this right. We saw that with the low fat, no fat diet of the 90s, cardiologists said, yes, cholesterol, cholesterol causes heart disease. And two decades later they say, oh, we were wrong. It doesn't actually cause heart disease. It's very necessary and healthy for living. So this stuff happens all the time. But what I want you to understand is bioidentical hormone replacement therapy is totally different than hormone replacement therapy with standard synthetic hormones. And the cool thing is there are bioidentical hormones out there in prescription form that your regular doctor can give you. Unfortunately, they're not trained or taught about them and how to give them. That is the only problem. But they are available, so they're not available in a ton of doses. So that's why we often have to rely on compounding pharmacies to give us more minute doses, differing doses for each individual. There's actually a huge push in Congress right now. Big Pharma is lobbying to shut down compounding pharmacies. They literally do not want us women to have compounding pharmacies available for bioidentical hormones. That's a travesty. It makes me super angry. And we need to stand against that. Because not only does big pharma not care about us as women, but they want to profit off us at any cost? And so it's really important that you support the, you know, women's health and legislation to support compounding pharmacies, to support us being in research and like, actually being seen and heard in the medical system. So that's a whole nother podcast. But I want you to realize that you don't have to suffer. And here's the thing, you guys, like, I get so much pushback, like, oh, well, menopause is natural and we should be able to live without our hormones. And, you know, why are you pushing this issue? I'm 47. I am almost there. I am almost done making my hormones. And in the year 1900, so just 120 years ago, the average lifespan of a woman was 49. So I was going to die in two more years. I wasn't going to live past my menopausal years. Neither were you. So all of a sudden, we have advanced so much as a society in such a short time that we are just in the prime of our lives when we are going into menopause. I am just getting started with my businesses, right? I am trying to enjoy my family. My kids are still little. And so the idea of me no longer having my hormones to support my health and my vitality, like, heck, no. That is really scary. No, thank you. It feels miserable. And I feel like we are, as women should have the right to prolong that inevitable menopause, put that on hold for a few years or a few decades if we're busy. And we want to keep kicking ass in life the way that we have been doing, right? So we are just getting started. We're running businesses. We're being amazing employees. We're trying to run households and take care of our families and be fit and run marathons and do all of these things. You literally need hormones to do that. You guys, they affect everything. As soon as you no longer produce or make reproductive levels of estrogen and progesterone and testosterone, aging and disease set in. Those are the facts that you start to develop insulin resistance that leads to diabetes. You put on weight, that leads to obesity. You have hardening of your arteries, that leads to cardiovascular disease. You have less neurotransmitter function in your brain, and that leads to dementia. You have less estrogen feeding your bones, and so your bone turnover increases and you have bone loss and bone thinning. I mean, look at our skin. As soon as our hormones go away, our skin gets thinner, our collagen starts to disappear. We get like these skinny faces and we lose our cheeks and things start to sag. That is all hormone related, you guys. So if you are not ready to just quote, unquote, age gracefully or whatever, it's really not about just the looks. It's about your ability to function. It's about your ability to think cognitively, to do things, to produce and all the stuff that you need to do. So I would really love it if you would take a step back, realize that hormones are our friend. It's the imbalance or the lack thereof that gets us in trouble. But when our hormones are balanced, life is amazing and we feel amazing and it keeps us healthy and young and vibrant. So I would encourage you to embrace the idea of balancing your hormones, whatever age and level they're at. You don't have to be at reproductive age levels after menopause, but you might want to be at protective levels. You might want to have enough to protect your other organ systems. So that is just my soapbox for today because the word needs to get out there and I feel like there's a plot against us to, to be healthy, successful women after midlife. There's a, there's a real push, unfortunately, in the government, in the medical system, system that does not want us to thrive and to be in charge and do all the amazing things we're doing. And the quickest way to cut us off at the knees is to take away our hormones. So that's just my soapbox for today. I hope you found this helpful. Let me know DM me. Tell me what else you want to hear about. I want to hear your comments. If you find, if you find this helpful, like please hit me up with a five star review. Let Apple itunes know this is what you want to hear and that you want more of this. That is how we get the word out. So please, please, please do that. Awesome. If you have any questions you want to work with me one on one, just go to D R T A B A T H A dot com. Dr. Tabitha dot com. You can fill out the paperwork. I am here for you ladies. Go have a kick ass week.