477: From Hormone Fear to Hormone Pressure: HRT Isn’t Black and White for Midlife Women

Anyways, here's the truth to the whole thing. There is just literally not one single right answer. And you are not neglecting yourself by not taking hormones if you choose not to. And if you do choose to take hormones, I think that's great, too. But we cannot continue to be naive and just assume that because somebody told us it's safe or not safe that it is. We are all very unique. Welcome to Midlife Conversations. I'm your host, Natalie Jill, and I'm passionate about having amazing conversations that matter to us midlife women. On this podcast, I do what I do best, taking complicated health topics and breaking them down simply so that we can optimize aging together. I share actionable steps to help you thrive in what I believe are our best years to come. Join me as I interview the most inspiring people living their best midlife years and dive into essential topics like hormone changes, health optimization, weight management, blood sugar, emotional well being, relationships, beauty, and so much more. Twenty years ago, women were told that hormones are dangerous. Today, women are told they're crazy if they don't take them. In the middle of all this, real women like me and you were left confused, pressured, and sometimes even shamed. Now, I'm not gonna be giving medical advice. I am certainly not a doctor. I am a girl with a mic and a podcast here. But I'm gonna share my personal story, my questions as of late, and some wisdom from experts to show you why this is not so black and white. My intention here is just to get us opening up the conversation, get us having a conversation, finding a gray area, because I do not believe everything is very black and white. And I really do believe that we are all so unique. We have different DNA, we have different pathways, we have different stories in our lives, and we're all very unique. And hormone replacement when it comes to that. It is very important that we're asking these questions and that we are really educating ourselves on this. So let's start kind of with the backstory. Back in the 1990s, the government launched a massive, massive women's health study, and this was called the Women's Health Initiative. Many of you have heard of this, but basically 160,000 women joined. The average age of them was 63. So most of them were already a decade or more post menopause. Now, they tested two types of hormone therapy on them. Premarin, which was estrogen made from horse urine from for women who had had hysterectomies. And then they also tested Prempro, which was Premarin plus. A synthetic progestin for women who still had a uterus. So that's how it started. So in 2002, the study made huge headlines. Some of you remember this. They made headlines everywhere because they reported more cases of breast cancer, stroke, heart disease, blood clots in the groups taking the estrogen, and synthetic progestins. So overnight, what happened was doctors pulled women off their hormones, prescriptions dropped, by my gosh, 80%, and women were terrified. I literally remember my mom walking through this and her talking about being pulled off of it. Now, why do people say this was a flawed study, and why was it misleading? Well, number one, the women were in the study. They were a lot older, so they were not newly menopause or pre menopause. Two, they were given synthetic hormones, not bioidentical estradiol and progesterone that many women use today. The increased numbers were actually very, very small. In absolute terms, basically about eight breast cancers per 10,000 women per year. So later research showed that women who started hormones earlier in their 40s, their 50s, or within 10 years of menopause, many often had benefits. Better bone density, fewer fractures, less diabetes, and possibly heart protection. So why does this matter now? Well, the media made it sound like all hormones are dangerous for women, and that fear has stuck for decades. Many of you have experienced this with your own gyns. You go and they say, no, no. Can't do it. They're dangerous. But today, most experts agree that this study was overgeneralized. But instead of a balance, the pendulum, it sort of swung the other way. Now, many are told that hormones are very safe and they're preventative for everyone. Now, I bring that up because that word everyone is has what is concerning me lately. Because the truth is, it's nuanced. It's very nuanced. Age, timing, the type of hormone, genetics, and health history. This all changes the risk and the benefits. It's kind of like. I'll explain it this way. It's kind of like testing whether running is safe, but only studying people in their 60s who have never ran or exercised in the last 20 years, and they have bad knees, and then announcing to the world that running is dangerous for everyone. I mean, that's basically what happened with the hormone study. And I'm concerned that the pendulum is actually swinging the other way now. It's just not absolute. So why do I bring this up right now? I'm noticing this shame factor coming about. So kind of like there's this old n. This old narrative, which was sh. If you stayed on hormones because, my gosh, they're dangerous. And now there's this new narrative where the pendulum swung, where, hey, no, it's protective. It's great. If you choose not to be on them, shame on you for not being on them. Now, I believe that, that both options are toxic. Like to say an extreme absolute on either way, that is not good. I mean, there's valid reasons to be on that, on hrt, and there's valid reasons to not be on hrt. Example, your individual clotting risk or side effects or your DNA or your toxic load or your personal choice. So where does that leave the rest of us? I think kind of in this. In this gray zone. So why is this important to me lately? Like, where did this even come from? Well, I've been very vocal that I am a huge fan of HRT or I had been a huge fan of hrt. I'm at the time of recording this for you. I am almost 54 years old, and I have been on progesterone and a small amount of testosterone for many years, starting in perimenopause. And then I started estradiol replacement within the last year. And I thought I found the magic bullet. I'm like, this is amazing. I feel so good. This is incredible. And for those of you wondering what I personally am doing currently at the time of recording this, right now I have a 0.1 patch literally on my butt of estradiol. I have progesterone where I was taking 200 milligrams a night. I'm now taking 400. I'll explain why. And I do a twice a week small dosing of testosterone, which I've stopped feeling. So why did this come up with me recently? I was feeling great and I was definitely of the camp. In fact, I've had many, many, many, many experts. Many of you have heard on this show where I've interviewed them about hormone replacement, the. The benefits and why we all need to be considering it, despite our history. And then I myself started having these random cramps. Now I'm postmenopausal. For those of you that don't know, menopause is actually one day. Menopause is the day that you haven't had your period in exactly a year. And then everything after that is post menopause. So I'm post menopause and I started having some nighttime cramps and a little bit of hot flashes again. And the cramping, though, kept feeling like I'm going to get a period, but I'm not. And anyone I was asking, just within interviews, they'd say, oh, you're probably too low on estrogen. Okay. So that wasn't really fully sitting right with me. So I asked my doctor, my personal doctor is Dr. Anna Kabeca and I'll be featuring her a little bit later in this episode. And she is a triple board certified GYN and she, her advice to me was we're not going to stop anything right now, but you do need to get an ultrasound. So I got an ultrasound and what showed up on the ultrasound was an 11 centimeter thick uterine lining. And a lot, and I mean a lot, probably 30 fibroids. Okay, why is this relevant and why am I bringing that up? Well, uterine lining and fibroids are both estrogen driven. Now if you are menstruating, if you're still getting your cycle, you are perimenopause, you are still cycling, then it's okay, it's normal. And usually when you shed your lining once a month, that leaves. So you clear it. The question that started going in my brain though was if I'm post menopause, I no longer have a period and my lining is thickening and I have fibroids, where does that go and what does that become? And no one's been able to answer me. So my. So it, so when you look at a period, it's shedding the lining. Right? But if you don't have a period, where is that going and what feeds it? Well, I'll tell you what feeds it, what feeds it is estrogen. So what does that mean for me? So these are, these are questions I started asking and this is why I'm doing this whole episode on this I wanted to share with you is I don't have all the answers. I'm going to share what I'm uncovering, but I don't have all the answers. But what I do know for sure is estrogen feeds those things. And if you don't have a period, where does it go? So what's the answer to that? Well, we're going to dive into this in just a second here, but I want you to start asking yourself that question too. Where does, where does that go? Where does that go? So questions that I'm wrestling with as I'm about to get into this episode and what made me deep dive into this episode is one, do I yank my hormone replacement off now or do I wait, do I get a biopsy? And when I do, what if it shows nothing? Like what do I do? Then what if the lining doesn't shed on its own? Are other estrogens, things like soy foods, tofu, edamame, helping or hurting me? I also started wondering why I had been on birth control pills in my early 20s like many of you had, 20s and 30s. And I remembered being on those pills and switching to a brand called Loestrin because I used to get fibroids as a 20 and 30 year old. And I remember my gynecologist at the time saying, let's go on low estrogen so we don't feed those. So I had all these questions in my head and brings me to the next questions of maybe hormone replacement doesn't directly create cancer. However, if we're creating excess lining in our uterus and fibroids and we keep feeding that, could that turn into cancer? So again, I'm saying all this not as a doctor. I'm a girl with a mic here with a curious brain. Fun side note about me is I used to get in trouble as a kid for asking a million questions. So now I get to do it publicly with you. So these are the questions in my head. So, okay, so let's back up. This is where I'm coming into. This is not black and white and customization is everything. So hormone replacement, it is not like a multivitamin. It's more like adjusting constantly. We are all unique, every one of you listening every woman's body, we have unique settings. And this is not like just popping a vitamin C. This, it takes some finesse. This takes some customization. This isn't what your best friend is doing. This is not what just one doctor says. This is not just with the latest study. This takes fine tuning and asking questions. Here's what we know. Too much estrogen absolutely can feed fibroids and uterine lining growth. We know that too little estrogen can lead to hot flashes, bone loss and brain fog and maybe some other things. We also know that progesterone, when you counter estrogen with progesterone, it can calm the lighting, the lining, but it can also make some women foggy headed or exhausted. Okay, that gets confusing, right? Testosterone can be energizing for some, but for others, like me and maybe you, it converts to estrogen in our body, which again, estrogen feeds the fibroids and the lining. So bottom line, we cannot copy our friend's protocol. Okay, so now it gets a little deeper here. Detox pathways, they matter. So hormones, once you put them in your body, once you're adding them, they have to be broken. Down and cleared. Just like taking your trash out on garbage day, right? Like you can put trash in a trash can, but it can't just sit in the trash can forever. You gotta eventually just take it out somewhere. You gotta get rid of it. So some of us have very slow clearance. And if you have a slow clearance, a slow detox pathway pathway, that means your estrogen, it can build up, it can fuel fibroids, it can fuel pms. If you're still in perimenopause, it can fuel fibroids, it can also store in your fat. Some of us have fast clearance, which means your estrogen leaves too quickly, it leads to crashes, it leaves low level symptoms, even if you're on hrt. So you're wondering why, hey, why is this never working for me? You might be someone with fast clearance. Another aspect is our gut health. So your gut health really, really matters. So how estrogen leaves our body, it leaves our body through going to the bathroom, basically. So if you are constipated or you have gut dysbiosis, your estrogen, it keeps recycling back in. So if you're taking HRT in basic terms and you're not pooping every day, we might have a problem. It's recycling in your body. So there's different phases of detox. There's, it's phase one, phase two, and phase three. And they're all important. Basically, phase one is going to basically break up the hormones. Phase two basically clears it away. And then phase three, it basically it gets rid of it. But if any step breaks down, you're basically living with the, with the, with the used up hormones. And where does it go? Where does it go? Okay, I've got more questions, so I'm gonna bring them up here. So your DNA also matters. So your DNA is basically your personal settings. So it explains why maybe you and me and your best friend, we all can feel totally different, but on the same exact dose or protocol. So some people's DNA are slow processors, meaning your estrogen, for example, lingers longer in your body. And then some are very fast processors, meaning you burn through it too quickly. Same thing with testosterone. Some women keep it, and others it turns into estrogen. So our DNA also makes a very big difference on how hormones that we are adding in are processing in our body. Okay, then there's a third component here. Are you with me here? There's a third component, toxic load. So your liver is juggling hormones, but it's also juggling just toxic loads in our environment. So think like plastics and Pesticides and meds and mold and alcohol and even stress hormones. So aside from all the crazy stuff we know is toxic, like your, the perfume that we talk about or the, the weird lotion or the nail polish, your liver is juggling a lot and then it starts juggling hormones on top of it. So the more toxins we are exposing to, exposed to basically your toxic load, the less capacity to manage actual hormones. So I bring this up because if you are somebody that, you know, you had, you're living in mold or you have old amalgam fillings, and now you know that all the hairspray and the makeup you're using is toxic. And you've just got this big amount of toxic load in your body and now you're adding hormones on top of it. Your body cannot process all of that. So what happens? Once again, estrogen dominance, fibroid growth, mood swings, feeling off no matter what the dose. So it's like you're just adding more. And we are not going to really get far when we've got all of these nuances here. Now, I want to play two quick clips from you because I did bring in a bunch of my friends that are doctors into this conversation, and I'm gonna be sharing them along the way as I'm talking today. But I want to first share this clip from Dr. Tina. Now, many of you know Dr. Tina Moore. She's talked a lot about. She's kind of like the first one to be talking about the IDE of microdosing GLPs. But she is one of these practitioners that has always talked about the nuances of hormones and inflammation. So I want you to take a listen to this.

The one thing that I wish that everybody understood, particularly doctors, is that when we're talking about hormone replacement therapy, the terrain really matters. And so we have to have an integrative approach. I don't think there's any way to do this successfully without a fully integrative approach. We can't just slap hormones on someone and hope for the best. We have to be really considerate of their metabolic health Overall. You know, 94% of U.S. adults have busted cardiometabolic health. We need to take into consideration how much excess adiposity or fat they have on their bodies, which is driving inflammation. We need to take into consideration what their comorbidities are. Do they have type 2 diabetes, blood sugar, dysregulation? Because all of these things can be improved upon with hrt. But if we throw hrt, particularly estrogen and or testosterone, at an infection, inflamed, obese body, the potential of these hormones going down unfavorable pathways is more likely. And so I always say it's like trying to hit a moving target. When we're dealing with somebody who's severely metabolically compromised and they're rocking a lot of inflammation, it's like trying to hit a moving target and it's very difficult and the patients are often unhappy. We can be dealing with histamine issues, we can be dealing with all kinds of things. And so taking an integrative approach, starting with a metabolic health first approach, is absolutely critical in my opinion.

Next, I want you to hear from Dr. Anna Kabeca. She is my personal gym. I want you to hear what she had to say here on this topic.

Here's my black and white answer. There's no black and white answer. I am famous for saying that it takes more than hormones to fix your hormones. And this is absolutely true. As a hormone expert for now going on 30 years, I can tell you there are no two exactly right regimens. And it's not a one size fit all paradigm. Each of us are uniquely different and we need to approach hormone therapy, even whether or not we should consider bioidentical hormone therapy in a very individualized way. So when it comes to looking at balancing our hormones, we have to look at four key factors. Nutrition and lifestyle, gut health, detoxification pathways. And this is where DNA and metabolic testing, as well as urinary hormone testing comes in to be extremely beneficial. And fourth is mindset and personal preference. I think we can't underestimate the impact of other things that promote our longevity. But yet when it comes to our hormones, is there a right way and a wrong way? Absolutely. And there are many right ways. This again has to be individualized and we need to consider all of these factors.

The next part I wanted to bring up here was testing and why this is also very nuanced. So you'll find some clinicians that will say, blood test is all we need. But I have found that blood tests alone just isn't enough. Is just a snapshot of what's floating around right then when you're testing. That's why normal labs don't always match the symptoms that we're feeling. So, so blood, blood tests are good for the raw levels. Like you can see your actual estradiol level, your progesterone, your testosterone, your fsh, you can see all that, but it's a snapshot only it does not show the pathways. So we've Got to go deeper. So let's talk about urine for a minute. And it's what Dr. Anna Kabeca just mentioned. Um, so urine can show your total production and your excretion. Now the limitation is it doesn't necessarily break down every detailed pathway. When you do like a 24 hour urine, there's also what's called a Dutch test which reveals pathways and metabolites. So it'll basically show you for estrogen, for example, they'll talk in code. But I'll tell you what this means. Like if you have a two dash OH pathway that means your body is really eliminating it in a safe way. It's metabolizing it in a safe way. A 4 oh basically is a little bit more spicy, means that it can be DNA damaging if it gets stuck. And then 16 oh growth basically means it's linking to fibroids and lining. Then you also can look at things on a urine test like testosterone. Does it actually stay as testosterone? Does it convert to dht, which creates hair loss, acne that deepened voice, or like in myself, does it aromatize to estrogen? Meaning you can take testosterone all you want, but it basically turns into estrogen in your body. And then with progesterone it'll show if you're actually making the calming metabolites or not. So they're really all important. It's not just the blood, it's also during this, during this type of urine test and knowing that you're working with somebody that knows how to read that. And then there's a third layer that I love to talk about and that's your DNA, because your DNA, it'll show like your actual blueprint. So how your body is wired to even process hormones to begin with. So even though you can kind of change things based on what you're doing, your DNA is the raw blueprint. So it'll predict if you are slow or fast at metabolizing estrogen. It'll show if you're prone to flipping testosterone into estrogen and it'll show if you're going to be efficient or inefficient at detoxing. It's so your DNA, you can't change it or manipulate it. It's not going to change. But it definitely explains why maybe your friend thrives on a patch but you don't feel good on it. It'll explain a lot of that. So all of this is so important and so many doctors tend to dismiss this. Why do they dismiss it? Well, one, it's not the gold standard. In medical school, typically, insurance is not going to cover it. It can definitely be more out of pocket to you or me, and they're looking out for that. But these matter because it shows how your body handles hormones and not just what's circulating at any given moment during that blood test. And it absolutely will explain why your labs don't match your symptoms. And it can help guide the types of hormones you should do or how you should approach detox, or the supplements you should be adding in. So the big picture analogy on that, I mean, blood, yes. But I think knowing what I've dug into, I feel any woman that is going to be on hormone replacement, we need to be looking at all these areas, not only just educating ourself, but really not just taking blood and what your friend's doing, but really understanding and saying, I'm going to look at urine testing, I'm going to understand how my body's metabolizing, and I'm going to understand my DNA is too important to skip. If you skip that, you could have problems later with your hormone replacement. Okay, I want you to hear this little clip from Dr. Betty Murray. This is her studies. She studies pathways. She studies how estrogen metabolizes, all because of her own personal journey. I want you to hear this, but.

I really think this is such an important information and such an important topic. And I think today we have to understand that because of the Women's Health Initiative, what was once considered standard of care, which is providing hormone replacement for women in perimenopause and menopause, the Women's Health Initiative basically took that off the table. And several major things happened during that time. First, we were sort of sold a bill of goods that hormones are dangerous and that they cause cancer and stroke and heart disease. And we have a lot of evidence proving otherwise, both beforehand and after. However, it's also ludicrous to assume that every woman needs a cookie cutter approach to their hormones. If you were to line up 100 women and look at each one of us, we all look different. And our DNA and how our body manages our hormones, both in the production of hormones and then how they get packaged to get excreted through the liver, have a big impact on your total hormone burden. And then if you add the toxins that we come in contact with, the pesticides, the herbicides, the plasticizers, the fragrances, and all of those, what we would call xenoestrogens, those all add to the burden. And then our gut health can also either increase or decrease this burden. And then when you're in different time periods of your hormonal picture, like fertility in our 20s and 30s, perimenopause in our 40s and 50s, and then menopause all the way and beyond, all of those things are different. So the idea that we would treat somebody the same, regardless of where they are on that journey and who they are individually is critically poor science. So when you look at DNA, DNA defines in a broad stroke, your propensity for how your body makes hormones and then how they can also package those hormones to get excreted. And you are either very, very good at that, moderately good at that, or not great at that. And it's very, very important. And then it comes down to what's the health of the body, how hydrated are you, what's your gut health? Because even those things can make a difference on how well you excrete those leftover byproducts of hormones out of the body. So when we look at it, we have to look at DNA and we have to look at how you. How you excrete these hormones and personalize down to your symptoms and also your labs. So blood work is a great way to understand if we're getting close to effective. Looking at hormone metabolites in the urine absolutely can start pointing fingers to where there might be problems, and then also looking at digestive health, fiber, water, all of those other things, and the lifestyle pieces on top of that. So I think it's inappropriate personally to treat without doing that extra step to understand each woman's unique biochemistry. Especially today when we have the opportunity to personalize medicine. Just because 50 years ago we were able to figure out population health, it doesn't mean that we should use the same standards today when we have the ability to do personalized medicine. And so for all your listeners that happen to be listening, it is 100% okay to intuitively say, you know, maybe I don't need hormones on my perimenopause and menopause journey, because there's lots of things that we can do to improve your health and sustain your health. We can't put back the hormones that are no longer being produced, but we don't necessarily all have to have them. And then for the women who are on their journey who maybe have tried hormones and they don't seem to work well or don't work. The method of delivery, a patch, a cream, a sublingual, a pellet, an oil, all absorbed differently in different people, and so one size does not fit all. And then for the women that are the 20% like me, I had a terrible perimenopause. It's why I went back to study hormone metabolism and get my PhD. I personally had just a terrible experience. And so I understood that despite functional medicine, personalizing medicine to me, that there was more to to it. And when I found my DNA and looked at my hormones and how I excrete them in the urine, everything was elucidated. I could see that I was unique. I needed a more nuanced approach. And so for the women that are on your like I like to say, the 20% that are like, this doesn't seem to be working right. It means you probably need a different approach. And even though it might work for the other 80%, it doesn't take hormones off the table completely. But you need a better personalized approach to understand your unique needs. Because this isn't a one size fits all. I think Louise Newsom's study showed it best. When they looked at their own patient base using a standardized dose in the UK for hormone replacement, they found that 50% of the women were undertreated with a standardized dose and 25% at the same dose were over treated. So what that tells us is we no longer need to use cookie cutter medicine. We need to personalize medicine to the woman in front of us. And that also is okay if they choose not to do hormones.

Are you starting to see why this is not as black and white as every woman should be on hormone replacement? And the shame that women that are not on hormone replacement are starting to feel about that pressure? I, I just don't think it's as black and white as we, we've been told. So let's go a little bit deeper into kind of like the, the detox stuff. So let's just say you want to be on hormone replacement, you want to stay on it, and you don't have the right DNA or the right detox pathways. And I'll tell you right now, I do not either does Betty Murray, who I just played from you. I don't, I don't have the right DNA for it. I do not have the right detox pathways. And my body is telling me you are getting fibroids now. You're getting a thick uterine lining. This is your warning. So do I stay on them? Do I not stay on them? I got a lot of questions, so let's talk about that. And I don't have all the answers to myself yet either. I just wanted to open up this conversation as we're all navigating this, how do we detox? How do we. If we choose to do hormone replacement or stay on them, what do we do? Well, there are a couple things we can do and they don't also always work for everyone. So I'm gonna talk about three specific foods or supplements that actually help with this. So number one, broccoli sprouts. We've all heard of broccoli sprouts. You can get them freeze dried, you can get them in capsules, you can actually eat the real thing. This is probably the most gentle everyday support you can do. So basically, broccoli sprouts are sulforaphane and they help you excrete excess estrogen daily. Now I do that every single day. But despite doing that every day, y', all, despite doing that every day, I still got the 11 centimeter thick uterine lining. So have more questions then you can look at some of the big, the big boys. Diminish Dim. Dim is a supplement you can get. It helps shift estrogen, but it can over clear. So like for me for example, if I take dim daily, I get hot flashes back and my estrogen numbers drop on my blood work to negligible. So dim for some of you works great. But if you are taking dim with your estrogen and you're wondering why you're not getting relief from the things that you were feeling before, that might be why. Calcium deglutrate, that's another great one, especially with our gut, helps clear estrogen. So calcium deglutarate is also pretty darn powerful and that will help clear estrogen. But same problem, if you take it every day, you can start reducing your entire estrogen number. So what I personally am doing here is I'm doing broccoli sprouts every day and then twice a week I'm taking calcium deglutarate and dim just twice a week. I do it the night before I change my patch. That's what I am doing. But again, even doing that, I got that thicker uterine lining, then there's definitely some evidence and support around having enough fiber. And why fiber? Well, we need to poop every day. You gotta go. If you're not going every day, we are already creating an issue. So your gut supports create a critical. You got to go to the bathroom every day, you got to be having your fiber, probiotics, hydration, really, really important. And then there's the other lifestyle detoxes. And by the way, y', all, I do every one of these. So you know, when I shared this on Instagram, I Had all kinds of people say, well, you just. Even with bad detox, you could just do all the detox things. Well, I'm going to tell you right now, I do every one of these detox things and I still got the fibroids and the uterine lining. Still got them. So I don't know, I mean, would it have been a lot worse without those things? Probably. Are all of us wired different? Absolutely. But these are all important things. So lifestyle things like sauna walking, cleaning out our products, sweating every day, infrared, all important, all help with detoxing, even hydrogen breathing, which is something new I brought on. But again, are we fighting an uphill battle if you're adding it in and then trying to take it back out? So just all stuff I want you to think about, think about. Then there's another area here. Let's talk about testosterone, because that's getting a lot of buzz lately. I know everyone was very estrogen focused, but testosterone is another really, really important one that we hear a lot about. I've featured experts about testosterone. But just know also, this depends on our pathways too. Remember, depending on how you process it, some of us can feel great on it. Others leads to acne, hair loss, oily skin, vocal cord changes, hair growth in places we don't want it, and male pattern baldness on our heads. But to some people, it converts to estrogen. That's what's happening to me. Which feeds fibroids, lining and breast tissue. So again, we can't make an extreme statement and say hormones don't create a cancer problem. If hormones are driving and feeding fibroids, lining and breast tissue, what happens to all that over the years? Can that turn into cancer? I don't know. It's influenced by DNA, inflammation, our body fat. There's so many, there's so many variables, which is why this is all important to understand and look at. Okay, then we got to look at these, these things that are also very, very real. The, the whole body connection. Right? Like we want to take hormone replacement because we want to feel our best. We want to protect our hearts, our brain, our bones. But we need to weigh all of this. We need to weigh all this. Now, I do want you to hear right now. I want you to hear from two friends, two very different opposing views. My friend Dr. Amy, thyroid expert, and then my friend Jen. Both of them, cancer diagnosis, both of them are on hrt. Both of them have chosen to handle this very different. I'm going to have you listen to Dr. Amy first, who decided after a cancer Diagnosis and a hysterectomy to go back on high levels of hormones. Let me let you hear her first.

I would say that most people, after they have a cancer scare, tend to avoid hormones because that's the message we're given, and that's the message I was given by conventional medicine. However, after my hysterectomy, after they took out the uterine cancer that was in a container, I chose to continue on with hormones, and here's why. I know the benefits of hormones and I know how they make me feel. There was a time right after the diagnosis that I dropped my estrogen level and I felt horrible. It was an instant influx of symptoms from crepey skin to vaginal dryness to pain during intercourse, insomnia, hot flashes, the whole menopause thing just came on like a flat flood. So after my hysterectomy, I chose to go back on all hormones at my normal dose, at a higher estrogen dose, because that's what my body likes. But I chose to do this in a very, very smart way and stay on top of testing. So I am doing regular Dutch testing to test how I process and methylate my hormones. I'm doing regular blood testing, and I'm doing all the things to make sure that I detox my hormones properly. I'm not being lazy about this. If I'm choosing to do hormones, and this was the deal that I made with myself and my doctors, if I'm choosing to do hormones, then I am going to be responsible and stay on top of the testing and the supplementation needed to keep my body in check and keep it detoxing so these hormones don't build up in my system and wreak havoc or cause excess growth, I. E. Cancer.

So that is Amy's choice. She's very knowledgeable when it comes to this topic. That's the path she's going down, and I think she's doing it responsibly. I don't know what I would personally do in that situation. I do want you to hear from my friend Jen Duvall. She a little bit different situation. Breast cancer diagnosis stopped all hormones. And I want you to hear her reasoning and what she's doing.

About a year before my diagnosis, I started experimenting with hormones with my doctor. Of course, we did some testing. I wasn't feeling good. I was in perimenopausal, and I felt kind of like a little bit of a mess. And we realized I was low in progesterone and testosterone. So she put me on progesterone and she put me on a testosterone pellet, which actually spiked my levels way too high. So she switched me to a testosterone trochee. Fast forward to one year later, and I was diagnosed with a hormone positive breast cancer. And the doctors were like, stop everything immediately. And I was terrified. I was scared. I was like, did taking these hormones, was this a contributing factor to my diagnosis? I mean, we'll never know. And I never think it's one thing. It's usually multiple things. It's that perfect storm that can cause a diagnosis. But did it contribute? Possibly. Especially with what I know about my body now. So I was thrown into menopause overnight, and now I can't take hormones. And I did a ton of research and, you know, I was worried about my cardiovascular and brain and bone. So I tried to do all the things on my own to support my body without using hormones. And I'm gonna share that in a minute. But what kept happening and what kept coming up is all these experts and doctors talking about HRT and how important it is. And I kept thinking, gosh, should reconsider this. I read the book Estrogen Matters. I got curious and I really started considering doing this. In fact, somebody had on my show, my podcast was telling me, yes, you should be taking hrt. I'm like, really? After hormone positive breast cancer. Thankfully, I didn't listen to her and I decided to work with a functional doctor because I really, really, really think we are so individualized. All of our bodies are so unique. And so I think that you need to test before you consider this, especially if you've gone through a diagnosis. So I did the Dutch test, and that actually showed that my estrogen detox goes down the wrong pathway. I also have the MTHFR gene mutation and my detox is harder. So I learned that absolutely I am not a candidate for hrt. But so what I do instead and how I support my body and how you can support your body if you are similar to me and you are not detoxing correctly is number one through food. First, soy. Soy is so protective, it reduces hot flashes. And it's actually so good for us. You just want to make sure you're getting the whole food forms like tofu, tempeh, edamame, miso, soy milk. You just want to avoid soy isolates. That's usually found in a protein powder or protein bars, but the whole food soy is so good and so protective. Flaxseeds is another great one. This is lignans that block strong estrogens that shifts metabolism and supports menopause. There's cruciferous vegetables, of course, dim plus sulforaphane which pushes estrogen down that safe pathway. And then lifestyle, strength training, daily movement, stress management like breath, work, meditation, sleep, hygiene, sweating, making sure you're getting your body to detox. And then as far as supplements, I take, I really again think it's so individualized. So check with your doctor. But I do take calcium D glucarate, I take dim and sulforaphane, I take methylated B12s, omega 3 D3 plus K2. I take probiotics and fiber our gut. Health is really important. And then I do also microdose a GLP one not for weight loss. And I do this through a doctor and I make sure that I made sure that it was right for me before I jumped into that. But there is some emerging research showing that GLP1s could be helpful for cardiovascular, brain and bone. And those are the issues. When we don't have estrogen, it can cause issues and this could potentially support with that. But again, talk to your doctor about that. So I think the takeaway for this is just to remember HRT isn't an option for everyone. And if it isn't an option for you, there are so many powerful ways and safe ways to support your body and just remember that we are all different, we are all unique and testing and personalization matter.

So are you confused after listening to all of this? My goal was not to confuse everybody and I hope I didn't. I wanted to really provoke thought that it's not so black and white and I was guilty of black and white thinking, thinking everyone should be on hormone replacement placement. And I've got to tell you, I've changed my tune. What am I doing personally? What am I going to do personally? Well, I'm going to, I'm going to continue to dig and learn and ask questions. I personally am getting a biopsy on the thick uterine lining just to rule out that it's anything. I have doubled my progesterone right now Based on my Dr. Anna Kabeca's suggestion and she wants me to do that right now to counter the estrogen. So I doubled, I went from 200 to 400 milligrams of progesterone for a couple weeks. Then she's going to have me cold stop the progesterone, like literally cold stop it for five days. And her reasoning is she wants to force a shed. So this is something they do commonly in medical. You'll basically to try to Force that lining to shed so it'll mimic basically a period, we hope. If it does not do that, then I'd have to look at getting that lining removed because you can't have that buildup. That's not a good thing. And then my plan as of right now is to really reevaluate what I'm doing with hormone replacement. I can tell you right now I'm already ordering a 24 hour urine test. I'm going to be really digging deeper into how mine is personally metabolizing. I will likely completely stop the testosterone. I don't think it's doing anything for me. And I do know it's converting to estrogen. I will very likely lower my patch. I'm on a 0.1 right now. I plan to gradually lower it 0.75, then a 0.5, then maybe even a 0.35. I want to do the very, very minimum that I can do to basically not have hot flashes. I feel I'm doing all of the other things personally to protect heart, bone, brain and I will continue to do those to me with my DNA. The way that my body metabolizes, it's just not worth the risk to increase that lining and have the fibroids. So this could change. By the time you're listening to this, I could have new information. But my plan is to personally dwindle down and do what I need. To not have the 10 hot flashes an hour.

Right.

To be protective, but not overboard and to really be emphasizing checking, being consistent with checking how I'm metabolizing, checking my blood work. That's. That's my personal journey. Anyways, here's the truth to the whole thing. There is just literally not one single right answer. And you are not neglecting yourself by not taking hormones if you choose not to. And if you do choose to take hormones, I think that's great too. But. But we cannot continue to be naive and just assume that because somebody told us it's safe or not safe, that it is. We are all very unique and we need to really dive in and look at our bodies. Anyways, to be continued on this topic, I do want to mention that if this is something you want to go deeper on with me, I am going to continue digging down the rabbit hole featuring more and more guests, my own solo episodes, even sharing more about this. I. I do also want to mention, depending on when you're listening to this and I'll put a link down in the bottom of the show notes, I am doing a class with Dr. Annika Becca, my doctor to go deeper on this very topic and on all the things you can do outside of or in addition to hormone replacement if you choose to stay on it or if you don't want to be on it, to navigate menopause successfully. And you can find that link@midlifeconversations.com forward/magic Again, it's midlifeconversations.com Forward/Magic. If you enjoyed this episode, please share it with others and let me know. By leaving a review you help me reach others so the reviews really help. If you are open to leaving a review, I would greatly appreciate it. Thanks for tuning in to midlife conversations today. If you enjoyed this episode, please share it and tag me Natalie, Jill, Fitz and our guests on social media the best way to support the show is by leaving a review. Send a screenshot of your review to supportnataliejill fitness.com for a free digital DSR journal download. And just a friendly reminder, I'm here with a microphone, not a medical degree. Half the time I'm sharing things that I read on the Internet or learned just as you were learning it while I'm interviewing the guest. I'm not an MD or your therapist or your mom, though I do give excellent mom style pep talks. This podcast is purely for entertainment, curiosity and educational purposes. When in doubt, please ask your own doctor. For advertising inquiries, contact sales admin category 3ca and this podcast is not intended to be a substitute for professional medical advice. Always seek advice from your physician. Some episodes of midlife conversation may be sponsored by products or services and I may receive compensation for advertisement of your purchases through affiliate links.