A Hormone Therapy Roadmap: What, When & Why

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What are you waiting for? Good night. Have you wished there was a hormone therapy roadmap? Well, it's your lucky day. Actually, it was my lucky day. It's exactly what I had hoped that this episode would be, and I'm confident it will be that for you. On the regular, for the last 10 years with this show exclusively, I'm approached by, or I meet functional doctors who do hormone therapy therapy for clients. But this is a unique episode, a unique guest, and I've crafted my questions hoping to answer yours, the ones you have and the ones you don't know to have. My goal during this interview was not to let my own bias enter in, but to ask curious questions as if I were naive, haven't worked with functional doctors and clients and supported them as a liaison for what to ask or demand and when to second opinion. I've shared the difference between norms and optimal levels of labs, supported health coaches and trainers within our Flipping 50 Menopause Fitness Specialist training in understanding a hormone therapy intervention and how trainers and coaches can, within scope of practice, support their clients. But today I try to fly blind and look at the options and the facts and the science. And I asked my guest in advance to do just that. And I have to tell you, 10 years is a long time. And I'm not talking about one episode a week, every week. I'm talking about multiple episodes, as many of you know who are tried and true loyal listeners. And thank you for being here. And thank you in advance for potentially sharing it with someone if nothing else, this episode I believe will be one you want to share. This is perhaps one of my favorite. It was a favorite interview. It flowed. We actually tackle a question, and I think with integrity, and talking about an area of expertise that a guest has, and yet he delivers it with without bias, with integrity for you to get the information, but also he stopped himself short of delivering it for you, giving you an opinion and instead suggested, "No, I'm not going to go there with you." And instead, what I want you to do, listeners, is to do your own research and just to understand where he comes from in making a statement. You will know what I mean as you listen. My guest, David Rosensweet, is the founder of the Institute of Bioidentical Medicine and the Hormone Method, as well as author of 3 books on the subject, including his latest, Happy Healthy Hormones. By the way, you're getting a free download at the show notes. With over 30 years of experience specializing in andropause— that's for men— and menopause treatment, Dr. Rosensweet is an internationally known lecturer and presenter. Early in his career, he trained the first nurse practitioners in the United States and was in charge of health promotion for the state of New Mexico. Currently, Dr. Rosensweet spends the majority of his time as the medical director of the Institute of Bioidentical Medicine, where he trains medical practitioners to specialize in menopause and andropause medicine. I'm Debra Atkinson. You're listening to Flipping 50, where I address your top struggles and concerns, and this is definitely one. I share what to eat, how to move, and how to change your mindset. So that you can have the energy and the vitality that you want, need, and deserve in this second and better half. And that today is enough about me. I cannot wait for you to meet my guest and thank you again in advance for sharing it. By the way, listen all the way to the end because there's a mic drop in the very last couple of minutes that I don't want you to miss. Dr. David Rosentweet, thank you so much for joining me.

You're so welcome.

I'm really excited to dive into this topic. I kind of built you up, so you're gonna have to deliver here.

Okay.

Yes, you are. There is— this is a topic that we've covered many times, but I don't believe ever in this way. So really finding the ability to let our listeners unpack a lot of questions that I think they've got, questions behind their questions, maybe things they don't even know to ask, things they didn't know were, were options. I think you're going to give a great deal of insight. You're going to be a very popular person by the time we're done. So setting you up for that, I would love to know your backstory. How did you find your way here? The Institute of Bioidentical Medicine, that's pretty prestigious. The Menopause Method.

How—

why this? Why not a lawyer or a teacher? Did you always know you wanted to get here?

Why? Oh, I knew from a very young age I wanted to be a doctor, and I don't know how I knew that, but I felt it. And I wrote my high school physics civics paper on what— when asked, what do you want to be? I wanted to be a surgeon. And I had uncles that were doctors, and I love medical school. I went to the University of Michigan, and when I got out of medical school in 1968, I kept on asking the question, yeah, what tools do I bring to general practice? And I kept searching for tools, and I wound up looking into nutrition and emotions and consciousness and life and stress and toxicity. And really, it was the ground floor of what has become functional medicine. And then 30 years ago, in a functional medical practice that I had in Santa Fe, New Mexico, a woman in her mid-40s, a patient of mine who I knew really well, and I knew she was brilliant— she had retired in her mid-40s, think about that— and she came storming into my office one morning before office hours and said to me that she was going crazy and that I want— she really wanted me to listen to her. And serendipitously, shall we say, although I don't think that's how the world works, I had been speaking to a world expert on progesterone. This is 1993. And I gave her some progesterone. And 3 weeks later, I got a letter from her saying that, oh my God, I can't believe this stuff. I feel myself again. And that's very rewarding. To hear that. And but not really being the one to guide the evolution of my career. Before I knew it, I was seeing a lot of women in menopause, and it suited me really well because I love biochemistry. And here's midlife women, a lot of whom were highly motivated towards health, were already taking care of themselves, but they fell off of a cliff when they lost their hormones.. And instead of being immersed in chronic illness, which is a challenge all of its own, God bless the people who really address it. Here was something that within a short period of time, 3 to 6 months, they could be feeling themselves again and back doing their great work. And I saw the leverage there that how can I really support the change of this planet that we so desperately need empower empowered women is what we— is part of our mission. And so it grew from there. And then soon thereafter, I decided to specialize in treating women in menopause and men in andropause because I couldn't keep my arms around the functional medicine database. There was too much information to be great at all things. So I narrowed it down to hormones. And that's when I started really learning what was going on there. And then started to teach it, brought together a summit, um, went to Washington to communicate in front of the National Academy of Science, and on and on and on. So does that do it? That was a lot of words. Sorry, Debra.

Don't be sorry at all. That was a great story and a great line. Something you said I want to pull out. You said, quote unquote, lost their hormones. Say more about that. Was that an on-purpose statement or by an accident statement? And what's true about that? Do we lose them and we want to find them again?

Yes, we want to find them in some form. Well, every man and woman on this planet, we put out the maximum amount of ovarian or testicular hormones at the age of 20, plus or minus 2 years. And then all of us, every single one of us, these hormone levels gradually decline. And in midlife, there comes this event called the ovaries stop working, and women lose their estrogen, progesterone, testosterone, and DHEA. That is extremely consequential. Men are on a slower decline, but some men get much lower hormones earlier, even in their 30s and 40s. And all men eventually lose their testicular hormones. And these are the most powerful biochemicals in our body. And we— and in order to think clearly, protect our arteries, protect our bones, protect our muscles, and on and on and on, mood, energy, metabolism, These are really important. And just to give you an example, as a physician, I've been able to see people at every stage of life, from intrauterine, because I used to deliver babies, to women and men in their 80s and 90s, and just before they pass away. And what I started seeing over time was a certain high percentage of women and men lose so much function. They lose their muscles, for example, and they can't walk with stability, and they go from canes to walkers to wheelchairs. They lose the muscle that holds up the bladder, they lose bladder control. And that's very definitive. That's when they go into assisted living facilities and nursing homes. And, you know, strong people do what they need to do. But I can tell you, I've been present for people who've made that transition. It's really, really a challenge. They want to stay at home. They want to walk and talk and think and be with their families. And I see that, you know, almost universally. And I started asking the question, well, how— is there any way to prevent that? Well, I had been given the answer by a gerontologist as a senior medical student, 1968. The gerontologist said, you senior medical students, you know so many diagnoses, thousands of them. Let me tell you what's really happening to older people. They're losing their muscles. They can't walk or stand with stability. They fall on their osteoporotic hips, they fracture them, and they die, or they lose their cognition. You want to do something for older people? Help them with their muscles, bones, and brains.

Yep.

Amen. And, you know, you can't— it would be— everyone would like to think that you could do that au naturel.. But it's very, very rare that you see an elderly person that without using hormones, they're able to succeed at retaining their muscles, et cetera. So, that's the biggest leverage we can do to do for, to live strong and long and function properly into our 70s, 80s, and 90s, not to mention our 50s and 60s.

I love that. I really love that. And I want right now, while we have everybody's attention. I mean, you, you hit on both things. Number one, muscle, bones, and brain— it's all we talk about here. How, how do we exercise in the, in the way that we support that? And there is that a lot of people think that we should be able to do it all natural. And I think that's where some of our listeners right now may be in personal conflict. They feel like— and I believe truly that this is because We're the first real generation that may start hormone therapy and do it till we die. And so we don't have that message out there. We don't have that example. We're going to be it. We're raising the glass ceiling. What do you say to a woman listening who feels like there's this incongruency, like, yes, I want that, and yet I feel like I shouldn't do that? Should we do that? Should we mess with nature or I mean, they're at a rock and a hard place.

I love that question, and I want to tell you, it wasn't a question that was prevalent forever. It got really— because there's poison in the room. Humans have been replenishing hormones for over 1,000 years. The Chinese did it. They collected the urine of young women and dried it out and gave it to the aristocratic women. And they did the same for young men because there's hormones in the urine. And then the pharmaceutical industry, um, started producing en masse. That's what they needed was a mass way to produce female hormones through collecting the urine of pregnant mares, horses. And that turned out to be the most popular and profitable drug on the planet. 40% of American women, 18 million of them, prior to 2002 were on these hormones, and they did a lot better than the others. And then along comes this false reporting of a study that scared everybody, and it made women afraid and providers afraid that if they took hormones, they were putting themselves at risk for breast cancer. Yeah. And so this question arose, gee, maybe I ought to do this naturally because I do not want to put myself at risk for this. And so this whole field has been poisoned by that. There are, of course, other reasons, uh, wanting to live a natural lifestyle has been emerging and emerging and emerging as a preference for many of us. But the big question was the big scare. Now that was a false reporting of a study. And if you want, I could pause and tell you what I know about the science as far as risk goes.

Yes, please.

Yep. Okay, thank you. We're all at risk for thousands of diagnoses, and a lot of them are not okay. And we're, we're at risk for hundreds of cancers, all of us., and as a male, because of specific factors that are new to this time in history, I'm at an increased relative risk for prostate cancer. In women, something that's new, wasn't true when I was in medical school, there is an increased relative risk for a woman acquiring breast cancer, and there's reasons. Now, given that we're all at risk, here's the actual science. Women who are treated with hormones are at less risk for breast cancer, heart attack, and stroke than women who go untreated. The same is true for men as far as treatment with testosterone and prostate cancer. That's the science, and it's elaborated amazingly in a, a book by a breast cancer specialist, a cancer specialist, uh, Avram Bluming and his, uh, writing partner Carol Tavris called Estrogen Matters for someone who wants to dive into the science. Yet that's not what everybody heard. Yes, everybody got scared because there was a false reporting of that study. The study itself did not declare that there was a statistically significant increased risk. What the study declared was that women who are on Premarin This is horse urine-derived estrogens, 50% of which a human female has never seen. They had a 21% risk reduction for breast cancer. That was right in the study. The issue was the Prempro arm, or Premarin, was combined with a, a molecule that, uh, not a lot of people love in, in the holistic world called, uh, progestin. And it had a statistically insignificant increase in risk. That means in science, don't, don't draw any conclusions, folks. There's no real evidence here. That study committee knew that that risk reduced to zero by 2006 because they followed up on these women. And then by 2017, the original study committee issued a retraction in the same journal that they had published the original study. Millions and millions of people all over the earth have heard about the original study. Very, very few providers or women have seen the retraction. That retraction stated, after 18 years of follow-up, there is no increased risk of breast cancer, heart attack, and stroke. So thank you for letting me air out. I also describe this in my book, Happy, Healthy Hormones, and Chapter 3, I really go into it because it's the poison pill in the room. And going back to your original question, Why do people very concerned about maybe I should do this natural is because of the poison pill of that false reporting of that study.

Yeah, no, I so appreciate you saying that. I mean, we've got several mic drops here and I'm afraid you're going to have to— we're putting you on lockdown. We're not going to let you leave because I know we got a lot of juicy stuff here, but that was worth the price of admission right there. So thank you for sharing that. And I think every woman out here who's listening to this podcast, share it with every woman you know, right? Okay, let's, let's unpack our options. So this may be the first time, listeners, that you've heard that information about the retraction, as you just heard from Dr. Rosentreit, that not many women have, not many women's physicians have. So it may be the first time and you may need to hear it again. We often do need to hear things 7 times before we really absorb them, pay attention to them, realize they're true. But we are giving you a download of Dr. Rosenthal's book. I will put the other link to Estrogen Matters, to that book, also in the show notes. But let's unpack What are the options? So there are pills and creams and pellets and shots, and there's a trochee. Talk about the pros and cons of each. I'm eventually— or you can start here with how does a physician like yourself decide which one is the best one for a patient that's in front of them?

It's a, it's a great question. And the main key operative there is the physician or nurse practitioner. If they are skilled in the field, they have a lot of choices. But what this field is loaded with is unskilled folks. And the reason is because of that study. While in the course of my professional lifetime, uh, these specialties were individuating out in that there was neurologists and orthopedic surgeons and endocrinologists and obstetric gynecologists for good reason, because nobody could keep their arms around the whole field of medicine and still be great at it. But that study stunted the growth of treating women in menopause and men in andropause. We're talking about every human being on the earth has this, and there is no specialty. And so when people venture into learning about it and having their opinions, you're going to see a tremendously wide variety of expertise. The majority of people that I've ever run into, and I'm, I'm very deeply immersed in the field, I'll tell you, is that people have taken on this subject mostly as part of their broad-based practices. So they never become specialists. So they get their little corner of knowledge, bless their hearts. They're going to be doing a lot of good, providing they really know how to avoid the harm. So in general, it's hard to make big errors in treating women with hormones. For example, I'll single out women because these hormones are so powerful that for a majority of women, if you get a dose too high, You are not going to like it. You're going to get side effects. So there's a protection of that if the provider themselves don't know their numbers and know their dosages. And if you have too little of the hormone, for most but not all women, you're going to have symptoms of insufficiency. So there is some safety there. And having said that, even the least informed of the providers, if they give women hormones they're going to do some good. And yes, you can make some mistakes, and many people have made mistakes, but for the majority, is there's a lot of hormones out there, and take hormones. That's what my recommendation is. Now, having said that, I definitely have my preferences, and I think that's what you might have been wanting.

Well, it is, although now you have me asking another question. And as I said, you, you— I hope you don't have any hard plans after this because I'm not done with you yet. So How do I determine— a woman is asking right now— how do I determine a skilled versus an unskilled practitioner? Is it safe to say that if they don't have a big toolbox, if they go right for one thing and this is the format they want to use, that they're less of an expert?

Well, I'm heavily opinionated, and I spend my career mostly training and mentoring physicians and nurse practitioners on how to treat women in menopause and how to specialize in it. And so, you know, I can give you my favorite links that you, you, you connect with someone who has these trainings, but there's a lot of different ways to do it. One is to access us and ask us for someone we've trained. Another way is to ask your friends, because you may not know it, but some one of your friends is probably on hormones. And what you want to hear from them is, I really like that provider and they really seem knowledgeable to me. And you know what? After a couple of months, I really started feeling good. So you're looking for that referral because this is the most— this is the job of women in menopause, the core job. Find a provider, go shopping until you find someone that you like and trust. Great advice. That's your job. It's fun to learn things about it. I always knew that it was very important that women know a certain amount so they could be an active part of their own individual process because these hormones behaved differently in every single woman and man on Earth. We're so individual. We need precision individualization. So but your main job is to find someone who's done the heavy lifting, has the medical training, and has got the additional training because we did not learn about this in medical school or residency. As you have to go into postgraduate education to get exposure to this, and there's varying quality of postgraduate education. But here's another way to do it besides going to our website and asking, have you trained any provider in my state? Here's another way to do it. There's 7,500 compounding pharmacists in this country. They're everywhere. And they're the ones— I mean, I'm going to cut to the chase right out of the gate. I started using bioidentical hormones prepared by compounding pharmacies for a lot of reasons. I mean, like I say, hormones, Premarin, that did a lot of good. But when I was given the choice that I could get a molecule that was identical to what the woman's ovary put out that appealed to me a lot more. And plus, I could do the individualization. I can write any highly precise prescription to a compounding pharmacist, they make it up. They love this stuff. That's what they love doing. And here's the deal. A lot of them know a lot. And so if you walk into the pharmacy, and I do suggest that, don't try and do it through a phone call, these are busy folks. But if they see you in person, they're very patient-friendly, and they'll walk up to you and you can engage them even if they don't know you. And what you say to them is, you're writing prescriptions for— you're fulfilling prescriptions for a compound of bioidentical hormones. I'm looking for a provider in my area. Is there anyone that you think is really good at this? Because they know, because they're interacting with these physicians and nurse practitioners, and they can tell the ones who know what they're doing and the ones who don't, because they themselves very often, uh, it's very— and, um, very often they're very knowledgeable. They're not actually— most of them are not actually seeing patients, but they have been around the hormone world and they've had their own education in it. So they're going to be able to tell you, yeah, for sure, Dr. Jones, she's really great. She's been doing this for a long time. We love her prescriptions. Check her out. So that's a second way to do it. And yeah, our website the local compounding pharmacist, or there's websites that you can— that train providers, and if— and they'll let you know who they've trained in hormones. And then also your friends. So those 4 sources, that's your job. Go find someone who really knows what they're doing here.

That was great. Really, really great. Okay, talk to me a little bit and, and tell me if I've missed anything. So in terms of forms, Pills, creams, pellets, shots, trochee.

Did I miss a form? Your injection. But I love this topic, and I'm going to give you my best shot. Okay. For estrogen, the best is coming out of compounded bioidentical hormones, and it's a combination of two estrogens, estriol and estradiol. It's called Bi-Est.. And that's a criteria you can use. You want your provider to be providing BiEst rather than just estradiol. And you can look at my book, you'll— I teach you a lot about that. Because I try and tell you what the best thing is. And estrogens, they are best and safest by far, applied to the skin. And topical application, and creams and gels, And my favorite is the organic oil space that we ourselves invented and patented. Because the creams and gels, if they're the only tool I had, and there was a time when that was the only tool I had, they're really, they're really a great thing. But they're solvents, they're strong solvents. And as a functional medicine doc, solvents have some toxic potential. So we went on to invent these organic oils base. And you can see that on our website. That's my favorite, topical estrogen. Testosterone. Women need testosterone. There's more testosterone in a woman's body than there is estradiol, her most potent estrogen. It is not a male hormone. It is a human hormone to preserve your muscles, to preserve your bones, to preserve your mood, metabolism, and other things. Testosterone is imperative for women, and that should only be administered topically. And right now, the only place that you can get it is through prescription through a compounding pharmacy. Testosterone and estradiol. Progesterone, my favorite way to do it is topically, but progesterone works orally quite well. And so those two choices, and again, I prefer compounding because I can get highly specific on the dosage I give a woman. And we, how do we find that out? We start low and we gradually increase until symptoms of progesterone insufficiency are alleviated. But if we go too high, like progesterone is the great calmer, so it can really help with sleep. So if we give it at nighttime and a woman wakes up groggy like she'd been overdosed with a sleeping pill, we go, oops, too high. Let's cut the dose down 25 milligrams. So progesterone works topically or orally. And DHEA, we like to do it topically. We like to combine it with the testosterone, but it's also fine orally if a woman does 15 milligrams or less. Don't go higher than 15 milligrams, no matter what you see out there. And so yeah, my favorite is, and I'm very adamant about topical Biast and testosterone, and then there is room for oral progesterone plus topical and oral DHEA.

Fantastic. These were great. You don't mention, like, under the tongue, sublingual trochee.

Why? Why? Because yes, and thank you for zeroing in on this. The ovary puts out hormones and the testicles put out hormones gradually over the course of a day. And what the human body doesn't do the best with is a one-rush-and-gush of an application. For example, Injections work. They work for men, they're very common amongst men injecting testosterone, but they go right into the body, they raise the body levels really high, really quickly, and then they gradually taper off. That's in the world of hormones is called peaking, peak levels. You get these highs that you don't ordinarily get out of an ovary. Well, that causes some issues. For example, in men, that can cause an increase in the red blood cell count, and I'm not gonna go through the mechanism of it, And they can get too many red blood cells. That's risky. We don't want that. Peaking in general is not physiologic. So I do not like trochees and I do— I'm not a fan of injections. Because when you, when you stick a trochee under your tongue, great. A lot of it absorbs really quickly, and you get a peak, but you know, part of it gets swallowed. Anyone who's ever had a trochee, no, it all doesn't go under your tongue. No way.

It—

some of it you swallow, which gives you mixed results in And you can't do the level of accuracy and you can't test. You cannot test estrogen levels by 24-hour urine if you're swallowing some of it. So 24-hour urine is the gold standard. And so for those several reasons, I'm not a fan of troches. If it was the only tool I had, I'd celebrate it. That would be what I would, what I would give out. But there's so many better tools. Pellets.

We didn't mention pellets. Yeah, that was my next attack right there.

Thank you. I think that there could be a physician on earth that could get expert at pellets, know the proper dosages, but that's not what we see. We see these pellets being given for financial motivations partially, and we see pellet— troubled pellet patients all the time. And I want to let you know that on this planet Earth, there is a lot of pressure to cut out these compounding bioidentical hormones. And one of their targets is pellets, because they've— the FDA has seen trouble with the pellets. And I went, I testified in front of the National Academy of Sciences, that was their first presentation, was the dangers of pellets. My favorite people in the world of hormones, they're not doing pellets. Now, some people will just argue with me about this, but I'm going to recommend not doing pellets. For one thing, you have to go to a physician and have a procedure being done on you, and you get enough pellet in there for 3 months. How does that work? Something lasts 3 months, it's got perfect delivery day after day after day? I don't believe it. And I've never seen a study that shows that the dosages stay Even no. And I have tested women who've come to me because they've had a lot of trouble with the pellets. I've tested women like recently, a couple of weeks ago, I tested one of my patients. She wanted bioidenticals, but we had to wait for the pellets to wear off. She was 2 months beyond the pellet and she had outrageously high testosterone levels, non-physiologic, which people can get high from. Not everybody, but yeah, I'm not a fan of pellets and I don't stand alone there.

Can you say a little bit more? So you mentioned the motivation for some may be financial motivations. The— how is that working? Just define that a little bit better, if you would.

No, that's not true. I wanted to give you my best shot, and I want other people to uncover the out-of-integrity stuff that goes on in medicine.

Got it, got it. Okay, so I've got a question for you, a personal one, if you'll let me ask this. Sure. So I was trying to do the math. So you mentioned being in the '60s, an instructor who challenged you with, quote unquote, was it, you want to do something for older adults, help them with their muscle, bone, and brains? So I'm trying to math here, my question for you is, are you on hormone therapy?

Me, myself? Mm-hmm. Yes, you betcha. Oh, I sure am. I'm on our hormones, our organic oils. I'm 81. I got full function going. So for you men out there, think about that.

Well, let's just say women too.

Okay, so good. Every woman in my family— and I have got a lot of nieces and sister-in-laws— everyone in my family is on hormones. So good. When you look at movie stars and you look at politicians and the older women look good, they're on hormones. Yeah. Why are they on hormones? Because they—

a lot of them are motivated to live long and strong, and you need them. Yeah, agree. I would say, you know, and I've shared this with our audience many times, so in terms of, you know, just looking anecdotally at the students who've gone through our programs, we've had 270,000 people, you know, through programs I've worked with private clients, fewer and fewer of those based on time crunching. But I can say that those who are on HRT— everyone gets results, but those who are on HRT have more impactful influence of increasing muscle, increasing bone density, optimizing their body composition.

It's just easier.

270,000 is not a small number. It is not. It's a small army, small army of women.

Yeah, I didn't understand this until being years into treating women and hormones. And other doctors, they have various challenges, and I wasn't having these challenges. They have challenges around motivation, they have channels of challenges around inspiring folks to be concerned about their health and their life. And I wasn't having these challenges. Then I started realizing for the last 30 years I've been working with the most privileged demographic of any physician I've ever known. These are intelligent thought leaders, healthy, you know, strong in their home, strong in their life, motivated, brilliant women. And you want to ask, what are they choosing? You know, what's she taking? And I started noticing, and I went, wow, I'm such a— I have such a privileged demographic. And so it's another way to look at it. Yeah, it didn't surprise me, but I woke up and thought, man, I don't have any of these problems that so many physicians have.

Yeah, I so love that. We have a statement here, it's kind of our overarching motivation, and we believe There's no more powerful influencer in the world than a midlife woman. She changes her story, she changes history. It's a healthcare change. That's it.

Yeah.

Okay, so I'm going to ask you one more tough question, and I know you're going to ace this one. But before I let you go, because this has been golden from open to close so far, what's a question that I should ask you based on and every listener here is probably interested. They came to me for fitness, but we hope that they're staying for the, the what else that happens to their life when they get more strength, more power. What should we be asking you right now that I haven't yet?

Well, it's a funny thing. I get interviewed frequently very frequently, and it always interests me how the interviews go. And because they're always a co-creation, they're always a team effort between me and the interviewer and you. And it's been special with you, and, uh, and we've been in sync here. I bet you it's been your experience as well. And you've asked me some really core questions, so I have to ponder a moment where should I go here. Thank you. That's generous. Yeah, I— let's see, I think I want to circle back. A lot of strong, motivated women and men— let's just leave out the risk question. And if I could, I could— I'd like to say one more thing about risk. Um, this will seem like a tangent, but I think it's an important one. These hormones are so beneficial that even women who have had breast cancer and have that breast cancer properly treated, they happen to have an increased relative risk of recurrence of that cancer than a woman who's never had cancer has in getting that cancer. But knowing that, women who've had breast cancer and had the breast cancer properly treated are at less risk for recurrence if they're treated with hormones than if they're not. Why did I want to say this? Because I think I'm dealing with a very sophisticated audience, and I wanted to go in depth in the usual, uh, most challenging thing for women. The other place I wanted to go was natural. What is natural? I don't think we know what natural is, really, in the sense that for a couple hundred thousand years, it was natural to have no menopause. Because most everybody was passing away prior to anything called menopause, and women were going in their 40s and men were going earlier than that. And there were exceptions, of course. We're in this whole new era because of nutrition and hygiene and other reasons that we're living long, and we have to— and yet the end of childbirth really does occur midlife for women. And one could make a case it's a good idea for men too to become grandparents rather than fathers in their 60s. Better for the children very often. So how do you handle that piece of information? We have to invent our way. We invented new good nutrition, we invented hygiene, and the hormones, they're still falling. So the perspective— I think I'm repeating myself, Debra. I think I'm wandering into repeating, so I probably shouldn't do it. But my perspective as a physician is you don't have access to what you're gonna become in your 70s, 80s, and 90s. Physicians do. They're seeing these people. And if you had a sneak preview, now you have been seeing family members, many of you, and you see what happens to them. And I'm gonna assert that 90% of you are not going to be able to prevent what's happening to them, even though you have better lifestyle habits. Unless you also include hormones in your, in your program. You're eating carrots, you can take bioidentical hormones. Not quite as easy. That's my best shot. As I want to, I want to give you what my, I think so strongly about is you're going to want to live long and strong and you're going to want to continue. The world needs your expertise. It needs your awakening and needs your lightness. And so you, you need your wisdom in these elder years. And in order to have the oomph to keep on putting it out, I assert that most of you are going to need hormone replenishment to do it.

Thank you so much for your time. And I already know that listeners are probably gonna run, not walk. Even those who say they never run unless they're chased by a bear are gonna want to follow you. Where can they best get in touch with you?

Oh, thanks. Um, via some channels through bright.live, B-R-I-T-E dot live. And for professionals that are interested in our training program, that's a different website.

That's iobim.org, instituteofbiodentalmedicine.org, iobim.org. So good. And we will put also your social media links, all that, and will be in the news in the show notes. And by the way, everybody who's listening, so you can download Dr. Rosensweet's book, Happy Healthy Hormones, for free at the site. We'll put the link in the show notes too. So if you're walking, you're lifting, and definitely if you're commuting, don't try to memorize these. We've got you covered. You'll go to the show notes at flipping50.com/hormonetherapyroadmap. And what are you waiting for?

Let's start flipping 50 today.