What Is Happening to Our Midlife Hormones? with Wise and Well

I've got my favorite hormone girls back, Kristen and Maria with wise and well, they are my go to with all the hormone questions. I love following them on Instagram. They are one of my most downloaded podcast episodes. They were one of my favorite interviews on my summit. So they're who I'm messaging DMing them. Don't. I don't suggest you do this. They're doing me favors because I'm an ag. I dm DM them every time I have a question like, what the heck?

What is.

Why does my report say this? Is this true in the news? Whatever it is, they are my go to experts. I absolutely love and trust them. They are so vetted, not just by me, but many of the doctors that I've had on this show. So thank you so much for being back. I have so many new questions for you.

Oh, yay.

Okay, I want to start with the big elephant in the room. Suzanne Summers. She was a big hormone advocate. We remember learning about this years ago with her and she recently passed away, I understand, from breast cancer. They had come back and automatically on saw on social and it actually really bothered me. I don't know if it bothered you. People really using it for their own opportunity. Like, look, this happened. It's hormone replacement bad. Can you help shed some light on that? Because I saw through that right away. But I'm so curious your opinions around that.

Yeah, yeah. I mean, Suzanne was a great advocate. She really brought compounded hormones to the forefront. Right. That was her biggest thing. Because after the WHI yanked or got hormone therapy pretty much yanked from the commercial hands of anyone, you know, Suzanne was able to say, look, there are these people who are doing hormones individualized and very safe and transdermal and all these good things. So she was a phenomenal, phenomenal advocate for that. I think the hard thing for people to understand is that Suzanne, this her breast cancer wasn't her first incidence of cancer. So we had issues with endometrial hyperplasia and cancer when I think she was in her 20s, I think she had melanoma in her 30s, and then the breast cancer and whatnot. And some of it predated any hormone use. Right. So we hated it too. To see that kind of opportunistic platforming of oh, the hormones are bad, look at this. It was just really, really unfortunate. You know the other things that Suzanne had a heavy distrust of conventional medicine and a lot of things. And she chose personally to pursue some fairly non conventional and non vetted methodologies for addressing the cancer that she had. So again, to blame it all on hormones is just incredibly disingenuous and unfounded. And I think, you know, anyone that's trying to use her suffering and her death in this way just really needs to have kind of a conscience check because it's, It's. It was incredibly inappropriate and unfortunate.

Yeah. I could not believe how many people DM me forwarding me other influencers or people using that. And I thought, this is crazy to me. Like, this is.

They don't.

They don't even know the situation or the circumstances. They're just using it for their own. For their own gain. Here it really. I saw right through that. Can you shed a little bit light? I know we've done this on past episodes, but for people that are new to listening to you, shed a little bit of light about the whole cancer hormone connection?

Well, with breast cancer, we like to kind of keep it really simple and, you know, big rocks kind of thing. And that is, we always say, like, you know, women with. Women who use hormones can absolutely get cancer. And I'm just going to kind of aside into Suzanne Summers. It's like, you know, how do we know that she didn't have this amazing life that kept her healthy for 76 years versus had she not used hormones, maybe she would have just had so much lesser of a quality of life. I feel like I'm stating the obvious, like, we all die, right. You know, maybe she died a little bit younger than we would have liked. But, you know, so women who use hormones can absolutely get breast cancer, but so can women who don't use hormones get breast cancer? Probably more. Kristen, I think you're going to be better on the stats with that one. But basically the biggest risk factor for breast cancer is being a female and growing older.

Yeah. So just in general, that's going to happen whether you're using them or not. So where I know there was this study years and years ago, and it was. It has been proven flawed. But how, like, why is that still so the standard of care with so many doctors that they just. They don't even want to go to the hormone conversation with women, they say, oh, no, if you've got breast cancer in your family, they just don't want to even have the conversation.

Yeah. Yeah. So a lot of it comes from the fact that the whi use mpa, which is a synthetic progestin. And a lot of people get really, really confused by these things. And Marie and I find ourselves in DMS really trying to explain a concept that the, The Language and the terms used matter, and yet frequently the nuance is not understood by the speaker. And so they mix things up. And so progesterone is what our body naturally makes, and it can be synthesized in a lab from natural materials and be molecularly identical to that which we make endogenous. Endogenously. But then we have. Progestogen is a. An umbrella term that gets used to denote both procedures, progesterone, natural and synthetic progestins, things that are molecularly do not resemble or match what we made and are made from synthetic materials. So when you hear these studies and you hear people saying these things, you have to stop and say, was it progesterone or was it progestin? And people, to be perfectly frank, are very inarticulate. They can't even pronounce progestogen and will see the word progestogen and say progesterone. Right. So be really, really clear as to what the study said and what the speaker is attempting to say and versus what they're actually saying. So that would be kind of that. But so what we know is that the study that usually gives kind of the, you know, hallmark landmark study that everyone goes back to, and that unfortunately was still being taught in medical school curriculum up until just a couple of years ago. So we're talking, any doctor that any of us are seeing was literally trained on this bad science, which was that progesterone or hrt, I should say, caused breast cancer. What caused breast cancer was the application of endocrine disruptors into the women's body through this study, because they use synthetic hormones on women who were not prescreened for cancer. So we have no idea how many of them came into this and had other metabolic issues which we know drive cancer. So, like type 2 diabetes, obesity, smoking history, etc. Right. So what happens is that this progestin called MPA was used in the study, and it. It essentially alters the estrogen receptor in the breast. And so what happens is that estrogen and the estrogen receptor suddenly don't match. And when you have that sort of mismatch, you end up with uncontrolled growth. And that's what cancer is. It's just cells, you know, with uncontrolled growth, there's no break, they don't die, there's no autophagy, they're not being remodeled and all these good things. So you've got essentially an endocrine disruptor that triggered hyperplasia of cells at the breast, and everyone blamed hormones for it. Hormones weren't actually used in these women. These were synthetic drugs. This was pharmacology. That on a molecular level was at odds with our physiology. And it was being put into women who were 10 years past menopause, not prescreened for cancer drinkers, smokers, type 2 diabetics, obesity.

So already high risk. This is already. So it's already flawed study. It's high risk like that. You're not taking an average sampling.

Yeah. And then you add into the fact that cancer takes 10 to 15 years to develop. So when this study was started, and I think it was 1998. Maria. Right. And then it was stopped in by 2002 and we're talking four to six years maximum that these hormones, these synthetic drugs were used in these women. And we decided to blame cancer's occurrence on the drug. Well, it's impossible, except for in today's world of turbo cancers, which we're not going to get into because we know that those are being driven by something else that happened in the last few years. It's impossible that those hormones given in that study were specifically solely responsible for these women developing cancer. And it's just sad because this was taught in the medical schools. It was literally the curriculum was altered to give the messaging that these hormones are bad. And Marie and I always go back to is that that's great. If you've ever been pregnant, your estrogen levels were like in the thousands. Some women get to tens of thousands. And yet you ended up coming out of pregnancy without cancer. Right?

That's right.

So how can we blame the hormones? Right. We have to blame the vehicle, the delivery. There's so many other things to it, though.

So this, maybe this is a psychological question, but do you think most doctors, and I say most because I'm finding that most western medicine doctors, not all, but most, are steering away, steer away sometimes from. From asking about hormone replacement conversation. Is it because of the study and they misunderstand it, or is it because they're scared themselves of the risk? What do you think goes on there that they avoid?

I think it's probably both, actually.

Yeah. I think the cynical view would definitely be there's a little bit of CYA happening, you know, for these folks is that the standard of care in the United States is low dose and only for specific symptoms and shortest amount of time to get resolution to those symptoms, period. Die. What we know is true is that many of these doctors a they did get indoctrinated to believe that hormones are dangerous and never critically thought oh, wait a minute. I had a wife who had a baby and she never got cancer and all these things that happen. So there's that indoctrination and then there's also the fear of retribution that they're going to be reported if they give hormones outside the, quote, unquote standard of care. And, you know, we do know for a fact that if you're writing scripts and insurance companies looking over your shoulder and they're going to go to the credentialing board and, you know, there's all sorts of issues there. And the other piece of it is hormones are really powerful. And I think most doctors know at least that much that hormones are very, very powerful. Not a lot of doctors want to take on the responsibility to manage your hormones. Yeah, I mean, yeah, that makes sense. It's sad. It doesn't make them a bad doctor. It just means, you know, we have a very siloed approach to medicine, particularly in the United States. And so they want to stay in their known specialty lane, and that's it.

Can we talk a little bit about the benefit of hormones? I. I personally am on bioidentical hormones, probably not the levels I should be. I always learn this when I'm learning from you and talking to you more. But I am on them and I have been on them for a few years, and I'm. I'm a huge fan.

So.

So my question is, can you, from your perspective, because you've helped so many women, you've helped hundreds of women through this, what are the benefits that you see when women take this on in perimenopause and menopause?

Well, okay, so let's, before we actually talk about hormones, is we'll just kind of talk about receptors a little bit, because hormones don't work without receptors. And that's part of the forgotten kind of conversation of the whole hormone restoration or just. Just hormone health conversation. And so we do have receptors for. Well, let's talk about estrogen, because that's the rock star estradiol. We have receptors literally from your optic nerve to your breasts to hypothalamus.

Yeah.

Hypothalamus. To your immune cells have receptors for hormones. So, yeah, I mean, so. So, so much so those, those things all benefit, right, when we have estrogen. So everything from, you know, reduction in colon cancer, I'm going to jump right to something that's super vain but kind of fun anyway, and that is that, like, you have better skin when you.

Know what estrogen, you might say it's vain, but I'm telling you, and it's our joke, and it's not nice of us, but every time I see a doctor or somebody that's like super anti hormone, I send them to you. I think it's you, Maria, that I'm like, but look at them. Like, I don't want.

We do it too. We look at, like, look, who needs hormones? No, it's horrible.

Yeah, it's like that dried out, you can see, it's like, yeah, like, like.

Listen, Kristen and I were just talking today. Like, I do not mind my wrinkles at my eyes. I mean, there are other things I mind. But the thing is, you know, so we're all going to age, of course, right? But, you know, without estrogen, you will become extremely wrinkled. But again, like I said, that's a vain thing. But then let's talk about skin health elsewhere, right? You know, so vaginal health. And this is something that really does not get talked about. Like, it's a kind of a subject of embarrassment. But, you know, the health of the vagina, it goes downhill and so quickly without estrogen, right? Because the microbiome there changes, the cells change. They just don't get the glycogen that they need to stay healthy. So, you know, just, there you go. That sleep is better. And it's, you know, it's not just progesterone. It's progesterone and estrogen. Right. For a lot of women, feel like just this ability to emotionally regulate, you know, it doesn't make us super high, you know, shouldn't make us super low. Just we have better, you know, stress tolerance is better.

Right.

So even helps our adrenals and then.

Strength, I would imagine, too. I mean, I maybe I think muscle mass, huge difference.

Well, mass and architecture. So we know that as we age, we're changing the muscle architecture, right? We're losing our fast twitch, we're going to slow twitch. It's why a lot of women tend to prefer endurance sports as they hit their 50s. But the reality is, is we need both, right? We need strength and we need power and we need responsiveness. You know, you're walking out in a crosswalk and someone, you know, losing their brakes or running a yellow light or whatever, you better be able to jump out of the way. So we need to have that ability to mobilize our body. And estrogen is going to help there. I mean, we know for a fact that estrogen receptors sit on these muscle tissues, and that is exactly what they do. They signal. And as Maria was saying, you Know, we have these receptors, and then we have the hormone itself. So what are they doing with each other? Right? They're talking. They're setting up like a catalyst of events. That's their job. And that's going to be, yes, the things that we can see and feel, but it's also me things that we can't. So we hear women saying, I'm so scared of Alzheimer's. Well, guess what, ladies? We need estrogen and progesterone, uterus or not, in order to protect our brains. And that's just a fact, because those two hormone molecules signal at the receptors in our brain tissue. What is aging? Aging is the shrinking of the hippocampus. Well, guess what? If we maintain our estrogen, the hippocampus stops. It's shrinking. Right. So bone remodeling. We, Maria and I, have so many clients now after years and years of doing this, and we're crested over a thousand women now that we've helped who are literally reversing osteoporosis. They're going from osteoporosis to osteopenia. And one just went from osteoporosis all the way up to. Not even on scale. Yes. And so that's the thing, you know, is, yes, strength training is so important and eating your protein is so important, but they can't do it all. We do need these internal signals to be set off in order to create a chain of events that protect your health and your hormones do that now.

We can miss the window, too. Correct. Like, if you don't start this in perimenopause or at the beginning, is it ever too late to start hormones? Or is that a myth?

I mean, unless you are a very unhealthy woman with, like, blockages in your arteries, we would say those are. They should not use hrt. Okay, so if. If you. If you are, say, a woman who's 60 and you, you know, menopausal at 50, but, you know, you. We. And we speak to a lot of women like this.

Okay.

Great shape. And, you know, they eat well and they just. They've cared for themselves, they exercise. They're probably really great candidates for each other.

So even so, it's not true that you missed the boat. So when you. So when they. They're post menopause, they can still. Because that's also something we hear sometimes from doctors, is that they've missed.

We have clients who've started in their 70s.

Wow.

Yeah. You need a really smart provider who's trained in this and who understands some sort of pre metabolic health screening in order to ensure that we're not going to trigger any sort of events. But the reality is exactly what you said. These changes start in perimenopause before your cycle has left the room, before you know any symptoms are there. You might still have a lubricated vagina. Good for you. Guess what, the architecture of your vascular structure is changing. Right. These things are happening. Before we know it. The muscle architecture is changing. It's why suddenly we go from 30s to late 40s. We're like, what happened to my body? I haven't changed anything totally. Right? So these things are happening. So yes, it's better to start earlier because you don't. You want to capture your body when it still has the integrity of your arterial walls, when it still has the integrity of a diverse microbiome. Right. When it still has strong bones that are communicating to the system. So earlier is absolutely better. But late doesn't mean no go. It just means we need to check on some things. And the big rocks are most important for the later. You wait, so that lifestyle piece, the nutrition piece, cutting out alcohol piece, getting rid of toxins in your life, those things are so much more important. And then you can add hrt. But you know, yeah, I want to.

Talk about that a little bit because I do think a lot of. And being in fat loss space, I think women will sometimes just jump right to hormones before they're actually taking on a lot of these other things. And you both talk a lot about the importance of healthy eating, removing toxins, all the things. Can you explain a little bit more about that? Because to me that makes natural sense. Like you take care of that stuff first, then you add the hormones. But I do think in a shortcut society, a lot of people want to skip all that and just go right through the hormones.

Well, you know, putting on, putting hormones in an unhealthy body can have some bad consequences. So we, yeah, it's. We obviously we have built our platform around hrt, but that's really not the only thing we care about. So it, we still do see HRT as an optimizer. Right? So yeah, just can't. It's like Kristen likes to say, it's magic, but it's really not a magic bill.

So. Yeah, okay. Yeah, I mean the studies are very clear. You know, a lot of people think, well, I'm healthy because they don't have a disease. Right. And Marie and I are always going to say, absence of disease does not guarantee health whatsoever. You can Be insulin resistant and not have type 2 diabetes. Right. You can be, you know, mildly overweight and have massive inflammation. Right. You don't have to be obese and disease diagnosed in order to do those things or have those things. So the concern is that we do know that we can influence the breast in a way that we don't want. We can influence plaque deposits in a way we don't want when we add hormones into a body that's already got metabolic derangement. So that's why Marie and I are like, look, if you're going to work with us, you're going to work on these big rocks. We're going to make sure that you dial them in and then absolutely bring in the hormones. And, you know, is there an inflection point at which hormones might make it easier for a woman to see results or easier for a woman to have, let's say, the motivation? Right. If she's not sleeping because of lack of hormones, you don't hold off on the hormones and tell her to get her sleep better. She might need the hormones to get the sleep better in order to make the commitment to get up and work out in the morning and eat well. Right. So there is that sort of, you know, crossing of the two paths, but the one is such a huge driver of the experience of the other. That's why we say you got to focus on, you know, those low hanging fruit opportunities.

Now, do you have a preference of HRT or bioidentical hormones?

So bioidentical is baseline. That's sort of like my new message. It's like for the most part, yes. We still see some women that are given premarin and androxy progesterone acetate in the form of the depo shot and things like that. But for the most part, even with conventional medicine, like you can, it's pretty easy to get a patch like that's. And the patch is bioidentical. So bioidentical is like kind of entry level.

Okay.

So yes, absolutely. Like we have good stuff nowadays. Why would anyone really go for the synthetic stuff?

Yeah, yeah, yeah, I know someone's listening. That's on synthetic birth control. Can you speak into that? Because that is different.

It's not real hormones.

It's not hormones. It's endocrine disruptors. It's no different, honestly, than what was used in the study that had bad outcomes. So, yeah.

Having said that, though, I will say, you know, Kristen and I, we definitely orbit in reality. And we have a client. She's. She's like mid to late 40s, and she still appears pretty fertile. And she wants to start on hrt, so she's starting with bioidentical estradiol. And, you know, she needs. She needs a couple of things. She needs to not overbuild the lining of her uterus.

Right.

She needs to be able to shed that lining or manage that lining. And she needs birth control. So I said, like, unless you are willing to, you know, partner, wear a condom or get fixed or what have you, or, you know, track your cycles diligently, understand your fertile day, go for the.

So sometimes you. Yeah, so it makes sense to some people.

You have to kind of orbit in reality and meet people where they are.

Yeah.

Or do a copper iud. Yeah.

Yeah. Okay, so now some of. I'm gonna ask you some of my. My questions because I know other people think about these, too. There's two things that you talk about on social media a lot, and I'm always like, oh, that's me, that's me, that's me. But I. It's okay.

I want to fix it right now. I know exactly what you're.

You.

You know. Well, you know, I know there's probably more than two, but I'll start with these two. Okay, let's start with bias, because I use bias. I started to use it for hot flashes. I am in perimenopause, not menopause, so I still get a cycle. It's just all over the place. So to me, the bias stopped my hot flashes, and my doctors continue, like, Dutch, test all that. Keep telling me I'm estrogen dominant. So I want to talk to you about both those things. Not necessarily me personally, but why bias is not ideal. And then what does estrogen dominance really mean? And how many of us actually have it? Are we just being told we have that?

Yeah.

I'll let you take biased.

Yeah. Okay, so. So that it stopped your hot flashes is fantastic. But the amount of estrogen you need to stop a hot flash is very different than, say, the amount of estrogen. Estradiol.

Okay.

That you need to, say, repair the V lining the endothelium of your vascular vasculature.

Okay. Got.

Is probably different than the amount that you need to clear, like, tau proteins from the brain, things like that. So hot flashes, symptoms. Great. One should have to deal with symptoms.

Yeah, they're not fun.

Yeah, exactly. But that doesn't mean you're on an optimal dose.

Just got it. Makes sense. Okay.

Plus, nobody needs estriol. Nobody needs.

So explain that.

Mary.

Because we don't know.

Yeah. Explain what that means.

Biased is a combination of estradiol and estriol. It's usually 80, estriol, 20, estradiol. But because it's a compounded medication, it can be anything. So sometimes it's 70, 30, sometimes it's 50. 50. What we have found is that even though estradiol is stronger than estriol, it just. Estriol seems to bump estradiol off the receptor. And we see women with very low estradiol levels, and there's this kind of mistaken understanding, I don't know, put out by like 30 or 40 years ago by a holistic medical doctor, I think, in the state of Washington. And he was just like, well, estriol, because it's so signals primarily the beta receptor and beta receptors. There's two main estrogen receptors. Okay. There's the alpha receptor and the beta receptor. There are more, but those are the two main ones. Alpha is kind of like acceleration growth. That's not necessarily bad. You need a certain amount of growth because it's repair. Repair. Right. And then there's the beta receptor. Beta's breaks. Beta puts the brakes on excess growth. So you need both of those. And so. But because the estriol signals primarily the beta receptor, people see it as safe and gentle.

Right.

That's really a very unproven kind of understanding of estrogen. So what estradiol does is it signals equally at both the alpha and the beta receptor. So it really provides a balanced kind of stimulation at all of the receptors.

Okay, makes sense.

And the other thing, too, is that estriol is a metabolite of estradiol. So if your body, for some reason, decided it needs estriol, it can actually convert estradiol to estriol. So you're never going to be needing to supplement it. The body has a system for that. The problem is, is that estriol cannot be converted into estradiol.

So the opposite. Could estriol be creating estrogen dominance, too?

No.

Okay.

Well, no, no, no, but Maria, go into the other thing that estriol does in pregnancy and why it's an issue in bias.

So when you're pregnant, your placenta creates a lot of estriol. I mean, you have a lot high levels of estradiol as well, but estriol. But. So estriol is thought to kind of shift the immune system of the pregnant woman to. I don't know if it's TH1 or TH2, but it's. It's. It's Kind of downshifts it.

Okay.

So, and that's because, like, the sperm coming in to create the baby is foreign. Right. And so, you know, you, the body would reject something foreign. And so what Estriol. It's theorized that estriol kind of creates this downshift in immune health so that a woman can have a successful pregnancy. Okay. Now we don't need 50, 55, 60 year old women having like the immune milieu of, you know, a pregnant woman.

Right, right.

Makes sense, right?

Yeah, yeah. So there's that. Okay, so estrogen dominant. So we'll start with kind of what the parlance was originally intended to mean. Okay. Originally tended to mean essentially an overproduction of estrogen in the body, which could come from fat cells, it could come from the ovaries, it could come from the adrenals, et cetera. And people like to say that this overproduction is often what blames like heavy periods and development of fibroids and endometrial tissue and all these good things. Okay, that's great. That's a production issue. Once you hit 40, you're lucky if you're producing robust amounts of estradiol on a daily basis. Okay. That estradiol is starting to decline. Now, when they say dominance, now they're talking about this relationship between estrogen and progesterone. The problem is, is that if you were to map out a woman's menstrual cycle over 28 days, you look at the production of estrogen and compare it to the progesterone production of progesterone. You're always estrogen dominance. By their theory of that estrogen is higher than progesterone, relatively speaking, they're almost always like that. The first two weeks of the cycle. We don't produce any progesterone, but we're producing estrogen. So you're estrogen dominant by their logic. Right. And then you should have this nice robust Spike on day 12 of your Estradiol and it starts to gently come down with another little bump before it continues to decline until you get your period. In the meantime, you get a nice bump of your progesterone. That's like one day. Okay. Or one tiny bit of time in which progesterone kind of gets its spike in while estrogen isn't as high. But for the vast majority of the month, if you were to overlay the two hormones, you always have more estrogen. That makes sense. Really. What makes us women? So for them to claim that estrogen dominance is the issue in midlife. What they're missing is that we have declining progesterone, okay? But our estrogen is also declining. So we have low hormones altogether. And one of the problems with estrogen declining is that estrogen creates receptors for progesterone. So as estrogen kind of starts to go down, we lose our progesterone receptors and therefore we're not going to kind of feel progesterone's impacts as well as when we did when our estradiol was nice and robust. So we've got kind of all these different competing things, which is like, no, you're not overproducing. That's true estrogen dominance. I probably overproduced in my twenties when I had horrific periods that left me passed out in the shower and anemia. Right?

So this is just another one of those things that is being misinterpreted and.

Completely misinterpreted and twisted. And I think it's, you know, it gets a lot of play in the whole web space simply because we like to freak out about symptoms and people like to be like, symptoms, symptoms. You have estrogen dominance.

I literally have no estrogen dominance symptoms, by the way. Like, I don't have any of the stuff that you said. So I'm always like, I don't get it when it says that.

So. And when you look on, you know, a Dutch test, and we love the Dutch test, but not for necessarily measuring volumes of hormones, but if you look in the Dutch test, you kind of have these different little like speedometer looking dials, right? And so people will get trained in the Dutch and they'll think that if you're speedometer needle on your estrogen dial is further to the right than the speedometer needle of your progesterone dial, that your estrogen dominant. Okay? The problem is mine.

Right now. I'm looking at that.

Yeah. The problem is, is that the Dutch test should not be used to measure volume of hormones. Okay. The Dutch test is measuring metabolite. It's phenomenal for looking at estrogen. Methyl, you know, detoxification, methylation, metabolism, generally. It's great for looking at adrenal function, great for all these other things. But the way that you look at your hormones should be blood serum, not blood spot, not spit test, saliva, not a urine test. You do blood, Venus draw serum. And then you look, but you're never. So, like, for example, so like, if.

My blood says normal, because it does. And so that I should pay attention to that.

Absolutely. 100%, the units of measurement are Slightly different. But if you, let's say my progesterone is 5 and my estrogen is 250, I'm by their definition estrogen dominant. Okay. I'm also fully normal, like, got it. Nothing wrong with that. So, you know, by the way, those.

Of you listening, they're like, that are saying like what I'm doing. Like, but my doctor said, but my doctor said, I want you to understand, like, doctors learn a lot of things. These two specialize specifically in this. So this is like, this is where this difference. So it's not necessarily their fault. They just, this is not like their full focus. Dr.

Sometimes, yes. And I mean, not to be incredibly cynical. I mean, Marie and I have the benefit of working with a lot of doctors. We refer to many doctors. We have done mentorships, clinical mentorships with doctors. We are faculty lecturers with a whole, you know, nonprofit group of doctors. Like, we're in the space with the people who have been practicing this for 30 plus years, each of them tens of thousands of women. But the problem is, is that we have unfortunately a lot of funding. So a lot of doctors are very beholden to keeping to the talking points points of medical societies. And I don't want to make this sound like some tinfoil hat conspiracy theory stuff because we've had plenty of that the last couple years, but the reality is that they are definitely sort of required to maintain the talking points of certain medical societies to which they belong. This is no different than registered dietitians wanting to tell us that processed food is not a problem and seed oils aren't a problem and sugar's not a problem and eat what you want, whatever. So we have that problem with the messaging. These medical societies that are dictating that messaging receive a lot of their funding from the testing companies.

Makes sense.

Okay. That are providing these at home tests or these functional tests such as Dutch, such as blood spot testing, such as, you know, ZRT labs or saliva or whatever. So it's, you know, it's, they're well intentioned, these doctors, but the information that they draw from is very much provided to them by people with a vested interest in getting them to promote these functional tests that may or may not be the best way of gauging not just hormone volume, but how your HRT.

Is working makes a lot of sense.

Yeah, yeah.

Okay, let me ask about progesterone. Now this is the other thing I get a D minus on according to your Instagram post. Okay, so, and I know about cycling progesterone. What Happens when I cycle it personally is I start getting headaches the times that I'm not taking it. So my doctor again has told me, continue taking it, then it's fine. So can you share about that? Like, do we have to cycle it? What's the negative of not cycling it? Help with that one? Because also another thing that a lot of people it's, they don't, they told different information.

Yeah.

Okay, I'll, I'll start with this. Not cycling it and taking it every day. It's not the worst thing in the world.

Like.

Okay, okay, good. So it's not a D minus C by that.

But. But if we like want to get as close to mimicking like what the body did, you know, think about when we're at our, our healthiest and we have the most energy and the most muscle tone and our sleep is great. Like that's typically our 20s and 30s.

Right, right.

And so the body did not make progesterone every day. It only made it from ovulation to the end of the, the cycle. So we feel like we do best for our overall long term health.

Overall.

Like, we're talking like hormone therapy. It's got to work for, God willing, decades.

Sure.

Because we believe you should be on it forever. Ideally.

Yeah, yeah.

So, you know, we. It doesn't, it doesn't properly stimulate receptors when you're on it all the time.

Okay, makes sense. But it's not the worst in the world. So I've got. I'm not a D minus, I'm a circle.

It's not a D minus. But know that things can change if you start to get to the point where you're like, my HRT is not working as well or I'm not feeling as well. It might be that. And while Maria just said it can't hurt you, I mean, I think Maria, we would back off a little bit. We do have studies that show that there are some changes cognitively that are not as great when you take progesterone daily. Really?

Yes.

We do have plenty of studies that show that the uterine lining can become dysregulated. Meaning that, you know, a lot of. One of the big things about taking it continuously is that doctors think menopausal women shouldn't have a monthly bleed. Okay. Logically that's true because our cycle is no longer in existence from our ovaries. Right. But if we're taking HRT in order to provide the benefits that our hormones used to provide for us, we should mimic that. Which then means we're only taking progesterone two weeks out of the month, which means that when we stop taking it we would have a withdrawal bleed.

So that's why I'm having the headache probably when I stop taking, when I try to go to cycling.

Yeah. So a cyclic bleed is normal on cyclic hrt. Okay, so we want to say that. So doctors will be like, you're a menopausal woman and you're bleeding. It's like, yes, but I'm inducing that bleed, literally creating it to happen in order to have this cycle. But the problem is, is that women who take progesterone all the time, and we just had one who literally Maria, what is she, 18 years into her HRT at 64 years old and she is now having constant uterine bleeding. There's no fibroid, it's not like she just developed a pathology, but she's wedded to this sort of low dose progesterone or estrogen with this constant progesterone. And at a certain point the uterus can just eventually become so dysregulated that you bleed all the time. So Maria's and my kind of pushback on that is then to say, is it really that bad to have a managed three day bleed that you can predict like clockwork by cycling your progesterone or would it be more inconvenient and troublesome to be bleeding all the time?

No, that makes total sense. What you said when I brought up the headache, am I, is that an unusual thing or do people tell you, have you heard that before about having a headache when they stop, when they try to go to cycling progesterone when they're used to taking it?

I have not heard that.

You have not? Okay.

Yeah, yeah.

Okay.

So I could just be a one off anomaly on that.

Yeah, and it could. You know, some people do if, like sleep can be a huge issue for a lot of women and we know that progesterone sort of initiates sleep. Estrogen keeps us sleeping. People don't want to believe that estrogen just initiates it or progesterone does. And so for some women, they might stay in a low dose, like really low dose all 28 days, but then during the two week cycle they'll increase for physiologic dose of progesterone. For those women, that's just something that might be a necessity, like they literally do not, cannot sleep without it. But for the vast majority of women taking bias, again, we need estrogen to be robust enough estradiol specifically to be robust enough to induce receptors for progesterone. So, you know, it begs the question, like with someone unbiased, you're not getting robust amounts of estradiol, but I guess your blood serum levels are a lot lower than Minor Maria's, so your progesterone receptors aren't necessarily as robust as they could be. And so it makes the, you know, begs the question, sort of like when you're coming off them, is there an issue that the progesterone is doing something that's maybe not acting at the receptor that you're benefiting from? Makes sense. But that the two week cycling causes a problem because you don't have enough receptors to actually stimulate or respond to the progesterone the way it should during that two week.

So if you all are listening to this going, okay, there's a lot of information and this is, I just want you to know I have, I personally have access to so much information when hormones. And I still get, I'm, I get confused. I think there's a lot of need for what you both do because there's so much confusion out there. I feel like I go to some of the best doctors and I'm totally confused. I'm like, I, I'm like, I, I'm always confused. So what I love about what Kristen and Maria do, for those of you that are wondering now, is they, and tell me if I'm explaining this wrong. But you, you don't prescribe things to people, but you educate women. You do a really good job educating through your courses, through your, I mean, they do it on their Instagram too, but through their courses, they really educate and prepare you to be equipped. So you can go to your doctor and say, okay, this is what I'm learning. This is where I need help. And then if you don't feel you have a supportive doctor, you, even if you are in your programs, recommend doctors. Is that, do I have that accurate?

Yeah, we do. We say that HRT education should proceed the starting of.

I love that. Which is such a different, unique spin. And I think that's, that's brilliant. So you're basically, you're becoming your own health advocate because you're being equipped to learn. And you also help guide people with the right testing. Is that correct? So you can help get them, so you help them understand. And then as far as the doctors that you recommend, when people are with you, you personally have vetted them. Is that something else? Okay, that's amazing.

We, we meet like, we meet on zoom with them, we just kind of get an idea of how they practice, what they charge, what their philosophy is.

Yeah. Now, how can people join your program? Can they do this at any time? Do you have certain enrollment periods or how does that work?

It's always open. We have a nice big support staff now.

Okay. And what I also like about their program, I've had people in their program that go through my programs. You can do. You don't have to like, just do their program. Like if you're in some another fat loss program or nutrition or you're working on your gut health or whatever, that it all works along with it because it's education. Right. And you. And what I also love about them, for those of you listening that are in my programs, is that you are. They are very aligned with what I teach as far as natural and processed foods and getting your gut healthy and all like looking at mitotoxins. They're super aligned with that. So. And I do love that. And they're also very realistic about what you can expect as a midlife women. A woman. So I appreciate that about you both too.

Yeah. Thank you.

Yeah. So, okay, so listen, first of all, everyone go follow them. Make sure you're following them wise and well on Instagram. And just know if you get triggered by any of their posts, I do too. But I just know, okay, I got something to learn. Because almost every day they're saying something, I'm like, well, I'm guilty of that.

I'm guilty.

But that's okay. Do not DM them and ask them for a doctor recommendation. If you are in their program, they are more than willing to help. And they also tell say, I've seen them say this. Once you are a client of theirs, you are always a client of theirs. So you go through their program and they are supportive on questions down the road. So I just, I love everything about them. I can't wait for your book to come out next year. And thanks for being here today. Thank you. Did anything I miss of where people should find you or be looking?

No, you're good.

I don't think so. Thanks for having us though. We love interacting with you. We love your questions. We'll take your DMs anytime.

Thank you.