Estrogen And Your Body

Welcome to the Balanced Body Podcast, where Sherri Griggs, owner of Balanced Body Health and Wellness in Omaha, talks to us about health, wellness, and balancing hormones. We are talking with Sherri Griggs, owner of Balanced Body Medical here in Omaha. And we're talking through hormones, our body, and why balance is key. And in the past, I love this, uh, way in which we're talking about it where, you know, if you look at each piece together, it's like different parts of what makes you go, right?

Right. Yes. Because, right, we You know, for those of you who've heard it, you're gonna hear it again. And those of you maybe you're just joining in, right? We are comparing it to a car. We're comparing hormones to a car. So cortisol is your engine. Engine's gotta be running right, right? Can't be running too hot, too cold. Gotta be running right.

Can't have that engine running anything but perfectly balanced.

That's right. And, and then we have thyroid is your transmission. Run right speed, not too fast, not too slow. And then we look at the hormones that everybody considers hormones, guys, but cortisol and thyroid are hormones. Your estrogen, progesterone, testosterone, and DHEA. So I always say I could give you 4 new wheels, but if that engine and that— but that transmission aren't running right, it doesn't matter. Car's not going to go very well. And the same way, if one of those wheels are flat or bent or something's wrong, right? It's still not going to be a smooth ride.

Definitely. And they all work in tandem together to kind of make sure that we are, as our bodies go, working in balance, which I love. I just love that image. That image is perfect. And we took a, we took a time this last go-around talking about one that was kind of, you know, buzzy— testosterone. Would you say that estrogen has the same buzz about it, like that it's You know, I would say, you know, estrogen's probably more controversial. Really?

Um, than testosterone. Testosterone is kind of buzzy, you know, it's kind of a fun hormone, right? Guys like it. Um, you know, makes people feel good, gives them energy. There's like, who has ever heard testosterone is bad, you know, right? Anything can be bad if you get too much.

Sure.

Overabundance, but you don't really hear about it. But estrogen, you know, estrogen causes cancer.

That's not what people say.

That's what people think. That's what people say.

Yeah.

Right?

Yeah.

So you've got— now men have estrogen, but they don't need their estrogen replaced. Their body can turn testosterone into estrogen. And for men who don't replace their testosterone, fat cells make estrogen.

Oh, okay.

And women too. Yeah.

So just to hit it on the head, men have and need estrogen. It's just at a different level.

Correct. Just not as much.

Okay.

Now, I will tell you that some men have too much. You will see men and, and These generally are not the men that have replaced testosterone, but they'll have too much estrogen and they are the ones walking around and they're just really kind of flabby and they look like they need a bra. And, and that's generally because, you know, their body is potentially turning the testosterone they do have into estrogen and/or both. Fat makes estrogen. Estrogen causes fat cells—

Mm-hmm.

To grow. So it's just kind of a cycle. And so then you get where they have this issue of too much estrogen and that's how it affects their bodies. They might also find that they feel a little more emotional or— but that's the physical effect that you see.

So then really, even though it's much less than men, estrogen is helpful and you got to find a balance for it. And in women, it's helpful to have estrogen at a balance too. Is it the same? I mean, is it the same across men and women's bodies? Like how it comes from testosterone?

No, women get most of their estrogen from their ovaries.

Got it.

But they can also turn testosterone to estrogen, and they also have fat cells that can release estrogen. And so generally, as a woman starts to go through or get into the menopause part of their life, what they'll find is because testosterone and progesterone start to leave our body at a younger age, they will be what is called estrogen dominant. And that means they have more estrogen than they do progesterone. And that's when they start to see things like weight gain in the middle, fat gain in the middle, inability to lose weight. And so that's an estrogen dominance that can take place.

Got it.

And it doesn't tend to— sadly, once women have gone through menopause and their ovaries are not making estrogen anymore, it doesn't tend to go away. That fat just kind of stays there. And I think, you know, at that point, then we're looking at again that cycle of the fat makes estrogen and the estrogen makes fat.

It's just like a cycle.

It is. And you have to get out of it.

Yeah. So, and you kind of alluded to this, what are some, like, what are some of the core misunderstandings with estrogen Is it— I mean, obviously it's one that you said people have misinformation about it, but like, what does that lead to and what are some of the signs that somebody has been misinformed?

Right. Well, and let me just give you a little history for those of you who, who don't know, or for those of you who still feel that, oh my gosh, yes, estrogen does cause cancer. That is not true. There was a study, a Women's Health Initiative study that came out in 2002. And they screamed that the sky is falling and estrogen causes breast cancer. And at that point, they pulled all these women off that had been on hormones. Because, you know, I can even go back even further.

Yeah.

Women back in the '60s, they had realized how good hormones were for women and how it had changed the life expectancy and made their lives better in In fact, the FDA actually approved hormone replacement therapy not only for treatment of hot flashes but for prevention of osteoporosis.

Wow.

Right?

Wow. Yeah.

In 1988, they added prevention of osteoporosis. So we had all of these women on hormones, and in 2002, that study came out and they were all taken off hormones.

Man.

What happened, they found out later, as they continued to follow these women, some of who were on, still on the medication, and some of who were not, was the issue was not the estrogen. It wasn't equine estrogen, which is made from horse urine. So it is still a natural estrogen. But it wasn't— that wasn't the problem. It was the synthetic progestin. So the people that were using the medication called Prempro, were on a synthetic progestin along with their estrogen. That was the problem. That was the issue. The progestin— and don't get that confused with progesterone because they are completely different. Progesterone is what we have and make, and progestin is the synthetic. Okay?

Okay.

The synthetic stimulated breast cells. It is completely different than progesterone. Progestin. That's what stimulated the cancer.

Hmm.

Right? So then when in 2018, when they came back and said, oops, we made a mistake, the media didn't pick up on that like they did in 2002 when all of a sudden the sky was falling and estrogen causes breast cancer. They didn't come back and say, hey, guess what? It doesn't.

That's not true. So not only was it 16 years later, but then they had a retraction that was in page 45 of the newspaper. Nobody picked it up.

Right. Right. And it's finally, here we are in 2014. We are finally just starting to get some of our associations to publicly recognize and in their recommendations recognize, like the Menopause Society, that Estrogen does not cause breast cancer. In fact, one of the forms of estrogen, estriol, it has 3 forms: estrone, estradiol, and estriol. Estriol is associated with less breast cancer. So low levels of estriol after a woman goes through menopause, low levels are associated with a higher risk of breast cancer. I just said low levels of estriol, your estrogen, puts you at a higher risk of breast cancer.

Yes.

So replacing it would then put you at a lower risk. And so what they found was the women that stayed on the estrogen had less breast cancer, 23% less breast cancer than the women who were on nothing at all or the placebo.

Oh my gosh. So helpful, helpful to have it checked and monitored and leveled.

Right? And so it's a sad thing that has happened and it's unfortunate that many people don't know that that's not true. Because 23%, that's a large amount. That means that 23 out of 100 women who don't replace their hormones will get breast cancer, right?

Which is a lot. I mean, that's a big percentage.

If we could take those 23 women and prevent breast cancer, Out of 100, out of 100, 23 of 100. Right? That's 23%. So if we can help protect them from breast cancer by replacing their estrogen, why don't we?

And look, the, the, I, I just did a quick, I actually just did a quick, uh, search.

Uh-huh.

Because I'm all about, I'm all about AI and seeing, you know, what it is that we're, that we're dealing with, with the AI responses, because everybody's, You know, leaping towards that with their search.

Uh-huh.

One of the first things it talks about when you're talking about balancing your hormones, BHRT and estrogen, one of the first things it says, you should also ask your specialist about BHRT and breast cancer risk. It's like first thing on there.

Right. Right.

And yet there's the study that talks about how that wasn't true. Plus specialists have talked about how estrogen in your balance gives you a higher, a higher chance of avoiding breast cancer, or at least a percentage of women. And just balancing your hormones helps you feel better as well as all the other benefits that we've talked about. I mean, it's crazy that AI and who, you know, who's trusting AI but people who don't know. Is one of the first things is make sure you understand the risks.

Make sure you understand the risks. Now, as with everything, I'm not going to say because you replace your estrogen, you won't get breast cancer. I won't say that. That's not necessarily true because we know that the one form of estradiol can proliferate breast cells. So if you already have cancer, it's gonna help it grow quicker.

Hmm.

Okay? It's not going to cause it, but it'll help it grow quicker. What we also wanna look at is how is your body metabolizing that? So when I brought up estrone, and earlier you asked me, I'm like, yeah, we're not talking about estrone. Okay? Estrone, that's, that's the redhead. We don't want, we don't want estrone. So we wanna make sure that when our body is metabolizing our, whether we're replacing, which is estradiol and, and estriol, that we are not metabolizing it into estrone. Or the form that can be, say, toxic to us or increase our risk. So the idea is, and again, this is where balance comes in, because we know that estrogen is an anti-inflammatory, and as an anti-inflammatory, it also can help lower the risk of cardiovascular disease for women. If you think about— I was telling somebody earlier today, she's looking at replacing her hormones, her cholesterol is elevated. We know when we kind of talked about testosterone last time that sometimes a low testosterone can be the cause of an elevated cholesterol. We look at— and I said, well, when you replace your estrogen and you cut that inflammation down in the arteries, it's the cholesterol plaque that gets stuck on that inflammation. So if we're balancing, right, and we're lowering the amount of inflammation, potentially we're at— we're also adding, remember, all 4 wheels. So we're adding that testosterone. We could considerably lower her risk of heart disease or cardiovascular disease, not just a little bit, but a lot.

Man.

Now, we don't know that her cholesterol will go down. But it could. There are many people out there, generally more often with men, but also with women, you replace the testosterone and they no longer have a cholesterol issue or they no longer have a blood sugar issue.

Hmm.

And that has to do because all hormones work together and insulin is a hormone. And generally as we age, the blood sugar issue is an insulin resistance. And that's I forgot to say insulin is kind of like the COVID over the whole car. But so, again, it all works together. It's all balancing it all out. Yeah.

And it's— and it— I think one of the things I'm realizing the more I learn about this by talking, you know, with you, I mean, we're going— we're doing a deep dive into each one and, you know, finding the benefits and talking about the things to consider and questions to ask. And whatnot. But, you know, something that I just realized now while we're talking about estrogen is that it's interesting because we always try to take an approach when we're looking for how do— how can I live my life a little bit better, or what can I change in my daily habits to have just a little bit better in, you know, chance of more rest or better mood, or in some cases, you You know, I need to, to slim down so I can do the things that I wanna do, whatever. It's all just, you know, all together to help balance our lives out to, to make ourselves a little bit better. And it seems like hormones is that same thing, just on a different level. It's not like I need to do 100 pushups a day to get stronger so that I could lift up my kids. It's I need to balance my hormones so that just in general my mood is better and I'm able to kind of continue living my life the right way.

And I never put those two together for Well, and it's too bad because it has taken us a long time because balancing your hormones is more of a preventative type of a treatment.

Yeah.

And so sadly, we work in a sick care system, not really a healthcare system. And so we don't treat people until they're sick. We treat their symptoms. We don't tend to go to prevention. And hormones are prevention. I said to the gal today, I said, think about this logically. If you weren't supposed to have hormones, then why do you have them when you're in your 20s and 30s? If men aren't supposed to have testosterone because it causes prostate cancer, then why don't we have 20-year-old men running around with prostate cancer? If estrogen that women have in an abundance causes breast cancer, then why don't we have 20-year-olds? And we do, but why don't we have a large amount of 20-year-olds running around with breast cancer?

I mean, that's a sound question for me to— that makes complete sense because in our 20s, we are Not just balanced, but our bodies are rocking our hormones.

Right?

They are.

They're going to be the highest. They're going to be— all your hormones are going to be up there. You feel great. You know, you're unstoppable and you have boundless energy. And if you're healthy, that— yeah, your hormones are there, right there. And 20-something-year-olds are healthy now. I also don't want it to seem that I'm saying, well, if you just get your hormones to where you were when you're 20, you'll be healthy. Other things break down too, right? As we get older.

Well, you know, that's why—

Our bodies are breaking down. But I don't want anybody to misinterpret that when I use those examples that I am saying, well, we're just going to get your hormones where they were when you were 20 and now you are going to be 20 again.

Well, and, you know, something that you say consistently that I, I think makes 100% sense is what's right for you and your body right now, and how do we balance this for you, not for the number. There's not just 5 estrogen that you need to hit. Well, I don't even know the numbers for that, but like, you know, say the number was 5. It's like, John, we're gonna get you to 5.

Right. And what John's gonna say— or, or John's at 5. Don't feel good, don't care. You're at 5, right?

Yeah.

So I have seen women that have come to me and generally with estrogen, we will talk more about women, but women that have come to me that have said, well, I'm seeing my provider and she's replacing my hormones, but she says my numbers are fine, but I'm still having hot flashes. So what does your numbers have to do with you? What do the numbers have to do with how you feel now? we want to make sure they're a safe level. So, so my ladies— so for instance, the lady that came that I was just talking to earlier today, I said, um, here's the sheet. Now she hasn't had hormones for about 5 years, she maybe 5 to 10 years, she isn't sure how long it's been.

Right.

Um, but if it— if it's— if she's the average, she's probably been about 8 years. She's 60 years old. And I said, well, you know, we're going to start you— for her, there are different There are different ways you can give estrogen, just like in our testosterone talk, right? You can do a topical or pellets or a troche. We do not give oral estrogen. Oral estrogen increases your risk of blood clots.

Oh.

That is true. That is why birth control pills increase your risk of blood clots. So we do not give estrogen orally. We still have some people that are doing that. Um, I feel that's because that's the only form of prescription pharmaceutical estrogen is a pill. So some providers don't step outside the box to see what else might be out there. And so the bioidentical hormones are your topical ones, right? Um, insurance isn't going to pay for it, although I've heard some insurance companies are starting to step up to the plate and recognize it's less expensive to let these women have hormones than it is to treat their osteoporosis, heart disease, and incontinence, and all the other things that happen.

Interesting. So, but yeah, I, I do have a quick question. So you, you had said when we were talking testosterone that there was sort of, you know, a couple preferred ways of doing it. Is topical one of the preferred ways to administer estrogen to somebody who's balancing, or is it Absolutely. Kind of a thing?

Nope. Topical, usually the 2 ways, topical or pellets.

Okay.

For estrogen. For somebody who has never— who has been off estrogen for a while or has never replaced it, I will not just put a pellet in them. We don't know if that's the right dose for them. Like we said, everybody's different. And once it's in, I can't take it out. So it will dissolve. It will eventually go away, but they don't want the symptoms of having too much estrogen. They won't like me much. So we'll do a topical.

That makes sense. Okay.

And a little bit at a time, you know, a little bit here, a little, you know, maybe I, I like to mix my hormones in jojoba oil, which is clean. I know a lot of providers like to use creams and, and that's fine, except that Creams have solvents in them and solvents are toxic to us. And so I will put them in organic jojoba oil, just a clean oil. And they measure it out with a needleless syringe, the amount they use.

Mm-hmm.

And they will start out with a low amount and then each day, you know, stay on that low amount for a few days and then increase. And as I told the lady today, it's not— the goal is not to get to the highest dose. The goal is that you get to the dose where you feel the best.

Hmm.

And I gave her a sheet that showed symptoms of high and low. And I said, when you get to where you feel good, when we get you to where you feel great, then we'll check your level. Because there is low You know, there is the level that somebody could be at the lowest level and still be in the normal or at the highest level and still be in the normal, right? They're still in the normal range because usually the lab values are so wide.

Mm-hmm.

So we just make sure that they are within a safe range and also make sure they get enough of the hormone so that it— they get the protective qualities of it. So you also do need to have a level that comes up high enough that you have the protective qualities for the osteoporosis and the heart disease.

Man, that's a lot to think about with all of this.

It is. It is a specialty. And that's, that's why I always say I don't blame our providers because our primary care or even our OB-GYNs, they have a lot of other things they have to worry about. And a lot on their plate, and hormones are a specialty.

Absolutely. When I think also too, and this, this is probably, you know, not that I'm diagnosing the problem with our society here, but there's probably a lot of people with white coat syndrome when they go to like their OB and they're, you know, asking about, maybe asking about hormone replacement or some of the things that lead to that conversation. They might just be like, you know, the OB-GYN or their provider might just give them a solution. They're like, that's the answer to my problem. And then they don't think about it anymore, right? They're not thinking they need to go to a specialist. Right.

Right. Because maybe they're given, hey, yeah, we can replace your— here's an estrogen pill. And they are starting to get even a little bit more With progesterone, you can do an oral progesterone. Progesterone is safe oral. We can talk about that when we get to progesterone. But it's just the estrogen that we just, we just don't want to do it oral because of the higher increase of blood clots. Now, that doesn't mean that because a provider prescribes an oral estrogen that they are a quack or they don't know what they're doing, because women take birth control pills all the time.

Right.

Right?

Right.

And that's oral estrogen. But again, as we age, right, our circulation isn't as good, we're not as active, we can be at a higher risk for blood clots just for that reason. So we don't want to increase that risk with an oral estrogen if we don't have to.

Absolutely.

And we don't have to.

Man. That's, that's, it's crazy. It makes so much sense. It's so sound when you say it, but I think a lot of people don't hear what that is and they just are going off of, you know, misinformation out there. Yeah.

There are estrogen patches that are prescription, but they only contain the estradiol version of the estrogen.

Oh.

Right? So they don't contain the protective Estriol version. So generally topical will prescribe a mixture, a combination of the estradiol and estriol. Hmm.

So then when you're putting these together, or when you're prescribing something like an like a topical for it, is it something that you're having to create custom for somebody where you're like leveling out the two or three? Are the 2 versions of estrogen, or is there like just kind of a catch-all one that you work with as an amount?

John, that's a great question. It is compounded. So the compounding pharmacy, it is mixed differently for different people.

Oh.

So I have, for instance, we tend to find our younger patients will maybe do a little better with a 50/50 50/50, you know, 50% estriol, 50% estradiol. Estriol is a stronger hormone, so we usually use less of that, but we tend to find out that they'll, they'll do pretty good with that. Um, but the common is 80/20. And but I've got a patient right now that she had been off of without any estrogen for a very, very long time. And as I told her, I said most Practitioners would not prescribe this for you because they're— for the first year, even on a topical, she is at a higher risk of blood clots.

Hmm.

But she is healthy. She has no medical problems whatsoever. She exercises, she takes supplements, eats well. So because she's in such great health, she understands the risks. We are replacing her estrogen. But ever so slowly. And we— she's still on the first dose, the first level, and I had her doing it every other day. Now I'm having her do it every 2 days because she is having some side effects of excess estrogen.

Hmm.

And it's not a terrible side effect by any means. I mean, it's not misery or she's not miserable, but I would prefer that we don't put her in a state, her body in a state that her body thinks she has too much. She probably doesn't have too much, not even close. But because she hadn't had it for so long, those receptors were completely off.

Hmm.

And what studies have not proven right now, the studies show that if a woman is 10 years without estrogen, there is no— the studies are inconclusive If she starts estrogen after 10 years of not being on it, as to whether she really gets the benefits of the heart protection and the bone protection and all of that. So it's one of those things that you will have practitioners out there that absolutely will not do it.

Hmm.

But so it's definitely a case-by-case. And it is very specialized. So for her, I have dropped her dose way down and I may actually, if she keeps having issues, I may just switch her strictly. I'll change her mixture a little bit.

Hmm.

Right? So I'll put her on a super low dose and I'll change her mixture 'cause I'd rather her do it every day on a really, really low dose. than kicking her back to every 2 days. That makes sense. Yeah. If she was somebody that had symptoms like hot flashes and things like that, she would hate me because the other 2 days she'd be having hot flashes. But she doesn't. She strictly wanted to do this, although she was 100% through menopause, did not have any hot flashes, did not have any of those issues. But she wants to live to be 105.

That is quite a goal. I like that goal, actually.

Yep. We did her, her Panoy metabolic testing, and she's actually 13 years biological age younger than her chronological age. So she's already on the right track. And she has done her own research and her own study, looked everything up. Very smart woman. in the health industry and has decided that this is what's going to help her live longer and live better while she lives another 33 years.

That's— I mean, that's a long time. 33 years is forever.

35 years. 35 years. I'm sorry. She just turned 70. 69 or 70.

Yeah.

You wouldn't know it.

I mean, that's, that's awesome. And I, I would, when you were talking about that, I, I feel as if, you know, my mind went to the way of, it seems as though studies are either shown inconclusive or there's no study on it because a lot of times, kind of like what you said before, like we're kind of more in a sick healthcare society than anything else instead of being proactive? Is the study just not there?

Well, actually, there are tons of studies. There are hundreds of studies for hormones.

Okay.

Hundreds of studies for hormones. They are out there, lots and lots of studies. Because remember, you know, the FDA was approving them in 1988. The studies are out there. So there are There are studies. Let's see, there's a whole list. Let's see if studies— let me see, I'm looking at the testosterone lens, but a whole list of studies on hormones and how they help people. And I do actually have a list that's 4 pages long of medical studies of how hormones help. And they are anywhere from— We have new studies that are taking place 2020, 2024. This one is dated. Yeah. So, so lots and lots of studies. Let's see. I thought the estrogen one was right in front of me. There's progesterone. So here's— here we go. So there was a Danish study in 2012. Effective Hormone Replacement Therapy on Cardiovascular Events in Recently Postmenopausal Women, a randomized trial. Some earlier studies that were done, that were done in 2001, 1976, 1998, 2004, 2003, 2005. They're just— they're out there. There's one that's 2012. So without a question, The studies are there. So the question becomes, because the medical studies are there, why aren't there more practitioners offering women help as they go through menopause? Hmm.

That's a— I mean, I would guess, if I was to guess, treating This, uh, treating the symptom rather than the actual, you know, source.

That happens, right? So the woman comes in, I'm depressed, I'm anxious, I don't know where this is coming from. Well, we'll give you an antidepressant.

Mm-hmm.

How about we figure out what's causing it, right?

No, no time for that. No time for figuring that out.

And I had a physician say to me, There aren't any studies.

Oh my God.

So I brought him a book and it was a book from a third-generation functional doctor out of Brussels. And the book, I'd say half inch, maybe an inch, was all studies, all studies about hormones. And I plopped it down in front of him and I said, here are your studies. And he said, "I don't have time to read that. How come I didn't learn it in medical school?" Oh boy!

Wow!

We could get political, and I what did I say? There aren't any prescription hormones. We don't have a lot of prescription hormones.

Mm-hmm.

So pharmaceutical. They learn pharmaceuticals. They don't learn compounding. So, that's my thought process on why that is. I asked another doctor, I said, you treat women for high blood pressure, right? She said, yep. I said, that's a part of aging, isn't it? Yep. I said, why do you treat them? She said, what? Why do you treat them? Why are you asking me this? I said, because these women come in with menopause symptoms and you just tell them it's a part of aging, they'll get through it, and you don't treat them. Why do you treat high blood pressure then? And she said, I don't have time to learn another specialty. And that was the best answer I ever heard.

Hmm.

Because it was true.

Yeah. I mean, that makes, that, that makes a ton of sense.

And it's not that easy. It's, it is a balancing act. And like you said, John, everybody's different. Everybody's a different mix. Everybody's a different amount. Everybody's body acts differently. It is not a simple, here's your pill, I'll see you back in 3 months. It doesn't work that way.

Yeah. And if it was pharmaceutical driven, I think it would probably be a little different just because aren't pharmaceuticals offset by insurance a lot of the times too?

Yeah, but I think if we had a more, um, more of a preventative mindset in our healthcare and the insurance companies would see the studies themselves and do the studies themselves, as some of them are, They're starting to do with our Medicare people, right? You know, you'll get a discount if you go to the gym, you get a discount if you do this, you get a discount if you do that. And some of them are doing that. Those are baby steps. Those are at least positive steps that they give people more money in their HSA account if they show up and do a well check. Okay. So, we're moving in that direction, just not quick enough.

Yeah.

And, and, you know, if they found that out, then the pressure would be there. And the people would learn it in medical school. And, but it would be a specialty still. It would still be a specialty just like endocrinology is a specialty and gastroenterology, psychiatry are specialties. It would still be a medical specialty because it is very, it is complicated just like those specialties are. Primary care is not going to be managing it.

Mm-hmm.

But it would be more mainstream and more people could get help.

That is probably the best way I've ever heard of how do we flip it? How do we flip America to a different system of healthcare? Because I have nothing to argue against for that. That sounds right to me.

Easier said than done.

Easily. I mean, very— yeah, absolutely. Well, okay, so we've gone through— I mean, my head is spinning, but we've gone through a crazy amount of information about just estrogen and then pulled back into hormones in general and then healthcare as a whole, right? I mean, we have pulled back completely to refocus down to estrogen, right? Once you, once you kind of notice some symptoms of low estrogen or that your hormones are are a little off or you are high estrogen is kind of what I pulled out of the original.

Well, you can be estrogen dominant, but that doesn't mean the level is high. It just means that you have more estrogen than progesterone. So you have an estrogen dominance.

I see.

And checking the levels, that's a whole nother game. So if a woman is perimenopausal, what that means is that some months her ovaries out a bunch of estrogen and some months they don't. Maybe it's a little, maybe it's a lot. So we try to specifically measure it in the luteal phase, days 19 through 21, because we think that's a little bit more stable. Um, but maybe we get a month where they didn't spit any out, or we get a month where they spit it— spit plenty out, and we say, oh, You're not having hot flashes. You're not in perimenopause. You have plenty of estrogen that month. But I will have women all the time say, sometimes I have hot flashes and sometimes I don't. That's why. Because some months your ovaries are making enough estrogen and some months they're not.

And we haven't really talked about perimenopause too much. I mean, I know that we've touched it a couple times, but just to kind of focus that down, perimenopause is before you actually jump in, like you would want to jump into menopause, but is the So perimenopause is the stage before menopause.

That is. That's the before. So menopause, the official menopause is when a woman has not had a menstrual period for 12 months. So you might have a woman that hasn't had a period for 10 months. She's like, I'm in menopause. And then all of a sudden she has one on month 11. Well, guess what? No, you're not. But she's been suffering for 10 months and then all of a sudden the ovaries decide to work and now they go back and say, oh, nope, you're not in menopause. Right? So you're in peri. They're sputtering. They're still working sometimes, sometimes they're not. And that can be challenging in itself. And I will tell my ladies, here is your topical estrogen. Here is your symptom sheet. You are going to find that some months you need to use your topical and other months you don't. I want you to watch the symptoms of too much. And then I specifically point out the ones. That they will have. If you have any of these symptoms, I want you to stop using your topical estrogen at that time. That means your ovaries are making estrogen. You're not going to have hot flashes. Your, your body is taking care of itself. But that doesn't mean that all of a sudden you have a hot flash because your ovaries aren't making estrogen right now and you need to use it for the next 2 months. So it's, it's a lot of education. It's a lot of making sure the patient understands that they are the ones in control of what's happening with their body.

And they're going to be the beacon of, I'm feeling right or I'm not feeling right as well. I mean, they feel how they feel.

Right. They'll still need the progesterone replaced. They'll still need their testosterone replaced, but their ovaries are just kind of still putting out that estrogen.

That makes sense. So, I mean, this is the perfect segue into it. If you're feeling that way or you just want more information or you want to spend a few minutes talking with Sherri, who, I mean, I feel this is absolutely true, you are the hormone replacement extraordinaire here in Omaha.

Right? Yes. So you can, you can go to the website. It's the Balanced Body Health and Wellness website. It is actually www.balancedbodymedical.com. You can sign up for a free discovery call. We'll spend 15 minutes just talking a little bit about what's going on with you. It doesn't cost you anything. You can ask me questions and I'll tell you how I do things. If you want to come in and talk further and consider working with me, we can set a consultation up.

That sounds wonderful. And We still have to talk through DHEA and progesterone.

And progesterone. I say we go to progesterone because I brought that up a lot today when I talked about that estrogen dominance.

You did. So progesterone it is. Now, would you say— and I'm, I'm probably building this up to be too much, but Estrogen, testosterone, one was fun, one was a little, you know, has some misconceptions about it. Does anybody look at progesterone and say, that's bad for me?

No, not at all. In fact, progesterone, that's kind of that— what do we want to say about progesterone? Progesterone is just that, that safe, little, calm, sweet hormone that just makes everybody feel better.

Well, it sounds like a treat, like a golden retriever almost. So, right, excited to talk about the third wheel progesterone next.

The third wheel progesterone and how we are learning that sometimes men need progesterone replacement as well.

Oh, okay.

Cool. Yeah.

Well, we'll dig into that next time.

All right. We'll talk to you then.

This has been the Balanced Body Medical Podcast with Sherri Griggs, owner of Balanced Body Health and Wellness. If you're looking to find Sherri, go ahead and look for the website balancedbodymedical.com. If you're looking for the business and you want to find Sherri at her office, you can find her at 10815 Elm Street in Rockbrook Plaza.

Thank you.