Two controversial women's health topics: breast implant illness, where anecdotal evidence of explant findings and possible mold motivates calls for more research despite large studies finding no autoimmune link, and HRT, where a flawed 1990s study using conjugated equine estrogens depressed prescribing despite claims of 50-60% cognitive decline reduction and lower Alzheimer's risk.
This idea behind breast implant illness. I'm bringing this up because I did release an interview again just several weeks ago with Dr. Robert Whitfield who specializes in breast explants based out of Austin. He reported on all these, you know, fuzzy mold covered silicone implants that he pulled from women and, you know, pleiotropic effects of all of these, you know, across everything from brain fog to gut issues to endocrine disturbances, et cetera. And then you seem to indicate in the book that perhaps this idea of breast implant illness is overblown. So I'm trying to navigate this now and kind of similar to the tongue tie question, what's going on with breast implant illness and why do you write about it in the book?
I wrote about it because the FDA banned breast implants, silicone breast implants, in the 1990s, arguing there was no long term data, that it was safe. And it and.
The silicone implant had already been given to over a million women. Surgeons said, we have long term experience. We are not seeing these, you know, a rash of these side effects that people claim. Well, at that same time, the FDA approved Oxycontin based on a 14 day follow up study and approved it for chronic pain. And it just shows how erratic our regulatory process has become. Now after silicone breast implants were banned, there were a bunch of large studies that were done to try to understand whether or not these claims of increased autoimmune diseases and chronic fatigue syndrome was actually just the normal prevalence in the population of these things or truly associated with the implant. And it found they were not associated with the implant. The class action lawsuit was thrown out. You know, like 440,000 women out of the million who had a silicone implant had signed on to the class action lawsuit. Turns out lawyers were trying to get rich.
Okay, got it. Interesting. So this doesn't necessarily mean. And then there are other forms. This might be kind of a stupid question. And I'm trying to recall, there are other forms now of breast implants besides silicone, right?
There are, but silicone is the implant of choice because of the softness and the contours of it, sort of duplicating the natural contours of the breast tissue. So to this day In America, almost 3% of women, of adult women have a silicone breast implant.
And it's not banned anymore, is it?
It's not banned anymore. Finally got back on the market when people realized when the studies came out showing no association with autoimmune diseases or these other illnesses.
Do you think Additional research is necessary on that or if research should be done on something beyond just autoimmune illnesses.
Look, I always think we need to study what we're doing instead of just taking the industry's word for it. I've heard from some plastic surgeons that if a woman has silicone implants, their spine may not be built for that added weight and a different center of gravity in their musculoskeletal frame. So they might have more back pain. Those are things that I think deserve better study.
Yeah, yeah, obviously that's solvable with some core training to go along with your new D cup. But I get more concerned about some of the stuff Whitfield talked about that obviously is anecdotal. He's pulling this stuff out in his surgical clinic. But yeah, it sounds like breast implants just need more research. I mean, if my wife were to ask me today, I'd say proceed with caution because I've got on one hand this big study that says there's no breast implant illness, at least for autoimmune disease. And then I've got this other doctor who's telling me about dozens of cases a week where he's know, fixing women and doing these explants that have what he reported as some kind of a mold or something like that on them. So sounds to me like it's kind of, kind of yet another area that needs more research.
You know, we get this pile on effect. There were claims that women were developing autoimmune diseases and rheumatoid arthritis, and there was a suggestion it was from the breast implant. So there was a pile on effect. And then finally the studies caught up. At the same time, we sort of lose sight of some giant areas where there's health benefits that we don't talk about at all. For example, hormone replacement therapy.
Oh, yeah, that was a fiasco, wasn't it?
Giant fiasco. There's probably no medication that has improved the health of a population more, with the exception of antibiotics, than replacing a woman's estrogen or estrogen plus progesterone. In menopause, women live longer, they feel better, they have stronger bones. The rate of heart attacks goes down. Cognitive decline goes down by 50 to 60%. The rate of Alzheimer's goes down by 35% in one study, and they feel better. It alleviates the symptoms of menopause. But tragically, the one doctor said it caused breast cancer even though his own study that he pointed to did not have a statistically higher incidence of.
Remind me the details of the Flaw in that study. And I believe it was even the form of hormones being used might have been different as well. Something like the pregnant horse urine extract or something along those lines.
Well, in my opinion, they used the wrong type of estrogen. They used horse estrogen, not the type that mimics the body's natural estradiol. They started it way too late. At an average age of 63, you need to start hormone replacement therapy within several years of menopause, within 10 years of the onset of menopause. And so they said, oh, we study all these other problems with taking estrogen. We started it too late, within 10.
Years of the ONS. You don't need to predict menopause 10 years in advance, but when you start to display symptoms, you would want to be on top of it within the next 10 years is what you're saying.
That's right. Within 10 years. Replacing your own estrogen or estrogen plus progesterone, depending on other factors, results in women feeling better, living longer, being healthier, having stronger bones, and reducing cardiovascular disease, which is the number one cause of death in women. And yet it's amazing. 80% of doctors don't prescribe it because of this one doctor who held a press conference 22 years ago claiming that it increased the risk of breast cancer when his own study never showed that. He misrepresented the data in his own study. And I interviewed him for the book and people can learn more about it.
How did it gain such mass adoption, though, that flawed study?
Well, breast cancer is so scary that if you dangle that out there, as he did now he believed it caused breast cancer. Before he did the study, I showed how he had written about it. We have to stop the hormone therapy bandwagon. He had written years before the study. Study was done, before it was final, he'd already.
He'd already argued himself into the results of the study.
Cognitive dissonance. Yes.
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