Note from Greg
A day at the beach in the company of a bestie is good for the soul. I was lucky enough to do just that the other day. It’s one of my favorite summer treats. So is soft serve ice cream, vanilla, with rainbow sprinkles. Haven’t had any yet but I think it’s going on the list for this weekend.
Do you have a summer treat? Let me know in the comments or hit reply. I’d love to hear about it.
On to this week’s reality check, the truth about hormone replacement. It’s a 2-parter. The first one gives you some science to allay the fear I know is common around the topic and will explain how it benefits our aging bodies. Part 2 will talk about who it’s for, what the safest forms are, and how BHRT can improve quality of life.
Is it time to reconsider hormone replacement Part 1
Ready to rebel against 20 years of medical fear-mongering? It’s about to get rebellious in here, peeps.
A few weeks ago I wrote about the “other” hormones, the ones not associated with sex or reproduction, the ones we tend not to think about, like cortisol and serotonin. Now it’s time to shine a light on those three hormones that make babies, bloating, and the misery of perimenopause and menopause possible; estrogen, testosterone, and progesterone. You, dear reader, already know they decline as we head into menopause. What you need to know is how this affects the parts of you that you might not associate with this transition–heart, brain, bones– and how restoring your hormone levels is not just safe but critical to aging in good health.
Context: millions of women are struggling with symptoms brought on by a decline in those 3 important hormones because they are 1) not aware that safe hormone replacement exists, 2) afraid of all of the tin hat science journalists still reporting on a faulty study or two from the early 2000’s, 3) not experiencing any of the most common symptoms like hot flashes and weight gain but are experiencing a decline in energy and mood.
What’s going on in the background will age you whether you feel it or not.
As is my quest, I’m here to bring relief to some of those millions, maybe you, by bringing you the latest findings on the powerful, safe, life enhancing therapy.
But first, a small sampling of the science on the relationship between estradiol–one of the 3 estrogens–and three of the critical systems we rely on to keep us well for our intended lifespan.
The Brain
You know the brain, that thing that weighs very little but weighs heavily in the quality of life as we age criteria.
According to a citation from PubMed, There are 3 common physiological estrogens, of which estradiol (E2) is seen to decline rapidly over the menopausal transition. This decline in E2 has been associated with a number of changes in the brain, including cognitive changes, effects on sleep, and effects on mood.
Researchers estimate that nearly two thirds of those living with Alzheimer’s in the United States are women. The higher prevalence of Alzheimer’s in women may be due in part to women’s greater longevity, among other reasons. A leading hypothesis is that that vulnerability relates to estrogen.
From The Cleveland Clinic online blog: Receptors for estrogen molecules are found in cells throughout women’s brains, and the sex hormone has long been known not just to help steer brain development and behavior but also generally to have a nourishing and protecting role in the central nervous system. That protection doesn’t last forever, though. Estrogen levels decline steeply during the transition through menopause.
The Heart
The one muscle you can’t live without.
Heart disease is the No. 1 cause of death in the United States.
Men tend to develop heart disease earlier than women. But by age 65, the risk of heart disease in females is equal to that of men.
Why is that? What’s keeping females from developing heart disease as early? And why the catch-up in their later years?
One reason: estrogen.
“Around the age of 50, a female’s risk for heart disease starts to increase,” says cardiologist Leslie Cho, MD. “That’s also around the average age that females typically enter menopause. And during menopause, estrogen levels drop dramatically.”
Coincidence? Nope.
During your menstruating years, estrogen protects your heart in several ways. And when your estrogen drops and you enter menopause, it can leave you more vulnerable to heart conditions.
The Bones
Medical News Today reports: “Estrogen plays an important role in maintaining bone structure. Low estrogen levels can lead to porous, weakened bones and osteoporosis. Estrogen is one of the hormones, two others are progesterone and testosterone, that regulate bone metabolism. It is essential to bone health because it promotes the activity of osteoblasts, which are the cells that make new bone.”
Now that I’ve given you a Reader’s Digest version of the role estrogen, mainly estradiol, plays in a few major parts of our amazing bodies, I want to tackle that shoddy Women’s Health Initiative study data to allay some of the fear around hormone replacement.
The Great HRT Scare: How One Flawed Study Terrorized a Generation
In the 1990s, hormone therapy was widely embraced until the Women’s Health Initiative (WHI) study changed everything. They enrolled over 27,000 women (average age 63) to use a course of synthetic horse-derived hormones* and synthetic progesterone called progestin. They ended the trials early in 2002 when researchers reported increased risks of breast cancer, blood clots, and heart disease. This created widespread fear that kept millions of women from getting relief from debilitating menopausal symptoms. But here’s the truth they don’t want you to know: the 20-year follow-up data published in May 2024 showed no increase in deaths from breast cancer or cardiovascular disease, and actually revealed a decrease in all-cause mortality when hormone therapy was started in women under 60 or within 10 years of menopause. Even more shocking? There were only eight cases of breast cancer per 10,000 women per year in the study, and women on estrogen-alone therapy actually had decreased breast cancer rates – yet for over two decades, women have been denied effective treatment based on fear rather than facts.
*They literally tested pregnant horse urine on women and then declared all hormone therapy dangerous when it didn’t work out – because apparently no one thought there might be a difference between what a horse produces and what the human female body recognizes as its own hormones.
Not only were they testing horse urine estrogen on women, but they paired it with a synthetic progestin called medroxyprogesterone acetate (MPA) that literally damages brain cells. Research suggests a small increase in relative risk for breast cancer and stroke, and a decline in cognitive function, in older women using MPA with an estrogen – because when you create Frankenstein hormones in a lab, don’t be surprised when they act like monsters in your body.
Meanwhile, natural bioidentical progesterone actually protects your brain and supports mitochondrial function. But did they test that? Of course not – you can’t patent Mother Nature.
Google HRT or hormone replacement for menopause and a majority of what it will return are articles from 20 years ago when this study was published or recent articles touting those outdated findings as facts.
Enter the reality check.
Next week I’m going to go into the who, what and when considerations for those interested in Bioidentical hormone replacement therapy. I am not advocating that this is safe for every woman. I will be showing you who might not be a good candidate but one thing that is not a limiting factor–age. Despite knowing that optimal levels of hormones are an important part of healthy aging, most big medical organizations will say that if you are over 60 you’re out of luck.
This makes no sense to me if you are in good health and have experienced an improvement in cardiac and or lipid markers and mood and energy while on BHRT. I doubt you’d hear a western medicine doc say you should ween yourself off your statins after 10 years because the side effects increase exponentially at that point. Why BHRT then? Oh right, there’s no money in it.
A couple of weeks ago I saw my hormone doc. He manages my thyroid health as well as my hormone replacement. At the end of our conversation I asked which of the designer off label drugs that are supposed to help us age better, like Rapamycin or Metformin he would recommend.
His reply: “You know what? You’ve got a podcast for women right? Tell them to stop chasing designer supplements and see if they are a good candidate for BHRT. It’s the best recommendation I can give for its health protective effects – better than any anti-aging drug on the market.”
Til next week,
Stay rebellious,
