August 26, 2025 • 53 mins
Hormone therapy can feel like one of the most confusing and controversial topics in midlife, but Dr. Maria Sophocles is here to set the record straight. With nearly 30 years of experience in women’s health, Dr. Sophocles breaks down the myths, explains the real science, and shares how hormone therapy can not only ease hot flashes, brain fog, and sleep struggles, but also protect your bones, heart, and brain for the decades ahead. We also talk about why menopause has been ignored for so long, the future of treatments like testosterone, and how women can finally reclaim their vitality, confidence, and joy in midlife and beyond.
What You’ll Learn in This Episode:
- The truth about hormone therapy and why it’s safer than you think
- Common myths that keep women from getting the care they need
- How estrogen and progesterone impact long-term health
- The role of testosterone in women’s wellbeing
- Why better conversations about menopause matter for every woman
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✨Read the blog: 292 🌼 Your Essential Guide to Menopause Management with Dr. Maria Sophocles at https://wendyvalentine.com/hormone-therapy-truths/
👉 Connect with Dr. Maria
https://www.instagram.com/mariasophoclesmd/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
>> Dr. Maria Sophocles (00:00):
If you look at what estrogen does to
(00:02):
every single, practically every single organ system in your
body, it's literally just keeping it
healthier, longer. And I, I sort of like
that idea. I just, I mean, walk, walk into
an, old age center someday and see what
85 looks like for some people. And it's
not their fault. I mean, they didn't have the benefit of this. Even their
(00:22):
doctors maybe told them not to take this. And their,
their hip is fractured and they can't ever get out of bed again.
>> Wendy Valentine (00:29):
Hey there, beautiful. I'm Wendy Val, your host
of the Midlife Makeover show where it's never too late
to wake up to your best life. Whether you're
navigating a career change, empty nesting,
menopause, or wondering what's next, you're in the
right place. Every week I'll bring you real
talk, laughs and inspiring conversations
(00:49):
with experts and extraordinary women who have
transformed their lives from self care and
relationships to starting over and finding freedom.
This is your time to reinvent,
rediscover and reignite the woman you were
always meant to be. So hit that subscribe button. and
let's rewrite the rules of midlife. Your new
adventure starts now.
(01:22):
Hello lovely ladies. Mark your calendars
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Order your copy today at,
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welcome to the Midlife Makeover Show. I'm your
host, Wendy Valentine and today's guest is
someone every woman in midlife needs in
her corner. Dr. Maria Sophocles has
spent nearly 30 years at the cutting edge
(02:47):
women's healthcare, specializing in menopause
management and female sexual health.
From her academic days at Duke and Jefferson
Medical College to leading Women's Health Care of
Princeton, Dr. Sophocles has made it her
mission to empower women with real
science backed solutions and bust
(03:08):
the myths that keep so many of us
confused. My gosh. Especially when it comes to
hormone therapy. In today's episode, we're
diving into the world of hormones. The most wonderful world
of hormones. What they are, how they work,
and most importantly, how they can help you
reclaim your health and vitality during midlife and
(03:28):
beyond. If you've ever felt overwhelmed by the
mixed messages about hormone therapy, you're going
to love this conversation. Please welcome Dr.
Maria Safaklis to the show.
>> Dr. Maria Sophocles (03:40):
Yay. Hi, Wendy.
>> Wendy Valentine (03:42):
Hello. We finally started. We talked for,
you know, like a half an hour before.
>> Dr. Maria Sophocles (03:47):
I know because it's so much fun, it's great topics to
discuss and so much.
>> Wendy Valentine (03:53):
Yeah. For women to come together. Like when
I posted a reel about this earlier today, it's like, you
think about it, what one woman can do just on
her, on her own, between answering
emails and flipping pancakes and making the grocery
list, to managing our hormones
to. Okay, let me put some mascara on.
(04:14):
We do, so much. And if we
all join together, oh my gosh,
boom. The world would be so
amazing.
>> Dr. Maria Sophocles (04:24):
So, yeah, there's a, there's a crazy statistic
about just the healthcare
gap, the gender gap, like what women aren't getting
in health care. And a, consulting firm, kind
of infamous consulting firm called McKinsey actually did a
study to value it and they said globally
it's valued at a trillion dollars. So
(04:44):
if we could get the women with hot flashes to not
have hot flashes and be at work, or if we could fix
the women who have endometriosis, cure their pain and get them back
to work, we could inject a trillion
dollars into the global economy of all
of third world countries, even more than first world
countries. And that's kind of staggering, right? So we
definitely. It's amazing what women do without
(05:06):
that is my point, that even without that, we get
up, we deal with our period pain or our endo
pain or our, our joints or our
menopause symptoms and we, we kind of shut up and go
to work and shut up and move the,
and lead countries and lead boardrooms and lead
classrooms and, you know, get on pickleball
(05:27):
courts. And I think, I think women are incredible. They really
are.
>> Wendy Valentine (05:30):
We are such badasses. Right?
>> Dr. Maria Sophocles (05:33):
Totally.
>> Wendy Valentine (05:34):
What inspired you to go into
women's health?
>> Dr. Maria Sophocles (05:39):
I think when I was in medical school, I thought I
wanted to be a cardiologist because I thought the heart was cool. And then I
realized it was a lot of older people and I wasn't
really helping anyone. I was just sort of like watching them get
older. And then when I went into women's health, I was
kind of drawn to the fact that I could help a 12 year
old, a 22 year old, a 42 year old, 62 year old and
(05:59):
82 year old. And they all had different needs and they
all seem to be getting underserved. the teenage
girls were sort of stuck with pediatricians who
were, you know, asking them if they were wearing bike helmets,
but not really comfortable talking about their
periods. And the 82 year olds were sort of in old
age homes and like, call us after you fall. And
nobody was really saying, wait, what if we could prevent the
(06:21):
osteoporosis or the urinary tract infection
in the first place? And the midlife women were just getting totally
left out to dry. So, you know, pun intended.
>> Wendy Valentine (06:30):
I was going to say pun intended. Yeah, yeah.
>> Dr. Maria Sophocles (06:33):
So I just felt like there was a lot of work and improvement that
could be done in the status quo. And even
after I became an OB gyn,
I started to realize there was even an imbalance in the OB
and GYN world, that when you went to private
practice, all the money was made by delivering babies
and all the emergencies were an urgent baby
delivery. And the GYN patients were sort of
(06:56):
just hope they come in and get them out. And I thought,
nah, that doesn't seem right. So in 2008,
I started a practice just for GYN
and, did no more OB and it turned out
to be very successful. Women came from really all over
the region and eventually all over the the country because we pioneered
a lot of things for menopause and because
(07:17):
we picked up what I called the crumbs of
gyn. The cancer survivors, the urology,
the geriatric patients, the teens,
the midlife. Now it's not crumbs. Now everyone talks
about midlife M and menopause, but
at the time in 2008, no one was really,
really caring about that. but yes, those women
(07:37):
needed to be.
>> Wendy Valentine (07:37):
I think that is. Why is it. I mean, it's wild now, and
maybe it's just because I'm in this space of
menopause and midlife and all the
things that goes along with that. Why did it
take us so dang long
to finally talk about all this stuff? Is this just things that we
had not figured out?
>> Dr. Maria Sophocles (07:56):
Yeah, three. Three things I'M going to do three things and they're all,
they're all talked about in my book because there's actually a
sexual fallout to it too. But number one,
sex ed in this country is taught that sexual
sex is for male pleasure. Sex is for
procreation, and it's fear based, not pleasure
based. Don't have sex, you'll get chlamydia and die. Remember,
(08:16):
for mean girls.
>> Wendy Valentine (08:16):
Yes.
>> Dr. Maria Sophocles (08:17):
As opposed to sex is about pleasure and
pleasure for both of us. So sex ed, I think needs
to be a little revamped because we don't really teach
perimenopause or menopause and sex ed. We just say
here's puberty, here's what's going to happen in your teenage years,
but nobody finishes the story. Every
sex ed course should say, oh, oh, and by the way,
(08:38):
this is what's going to happen at the other end. And not when you're
95, but when you're 45 and having a career and
juggling kids. You're going to get hormonally kind
of betrayed and ambushed. So you're ready for
it and good luck. Yeah, at least people would know
it's coming. That's the first thing. The second reason
we don't really talk about it or it hasn't really found
(08:58):
its place in medicine is that medical
education does not count
it as worthy. People get like one
lecture in four years on menopause and it's kind of
like physiologic. It's like the ovaries shut down
and women get some hot flashes. Okay, next
subject is the kidney and you're like, wait a minute,
(09:18):
there's a lot more to it than that. So one of
my missions is to revamp, get medical education
revamped about menopause. And
some peers of mine have actually put together a movie called
the M M Factor, which is now going to, is shown not
only to women around the U.S. but in medical
schools, which is really cool. but the third part
(09:39):
is, so we've gotta fix sex ed so that when teens
are sitting in that boring 10th grade classroom,
they actually do get to understand
what sex should be like and what happens in
puberty and what happens in perimenopause. Second,
revamp medical schools so that no matter what
specialty you end up going into, you know that
(10:00):
menopause can be your patients,
can bring you problems. If you're an orthopedic surgeon, you
have to know that frozen shoulder in a 52
year old woman is not necessarily just from a bad
water Skiing accident. It can be from menopause.
If you're an ophthalmologist, you have to know that visual changes
can be menopausal. If you're a dentist, dry mouth,
(10:20):
burning mouth syndrome, menopausal. So it's
not just hot flashes. And then the third thing is, women like you and
I need to get the message out. But
women who are in the public eye need to say,
hey, guess what, everybody? This affects.
Wait for it, 100% of
women who have ovaries in a uterus, not, like,
(10:40):
just some rare person. Now, all of us might not have
symptoms, but all of us are going to have
the experience of menopause affecting our
longevity, our heart health, our bone health, our brain
health. So it's absolutely crazy not
to at least understand it.
>> Wendy Valentine (10:56):
I saw, something somewhere online. It was like a pie
chart or something like that. The amount of time that we
spend it in menopause, in our third
of.
>> Dr. Maria Sophocles (11:05):
Our lives, more than a third of our lives.
>> Wendy Valentine (11:08):
Crazy. And then, like, we. But then it's never talked about. Like,
well, how are you supposed to spend that one third?
I mean, I. I'll admit, I
thought, like, oh, first of all, I
didn't even know about perimenopause. Did not. I.
I didn't find out this is
crazy about perimenopause until after I
(11:28):
had already gone through menopause and after I
started this podcast because I had this lady
on the show, and I was like, what is this perimenopause
crap? And I was like, oh, my God, if
I had only known. I mean, sometimes
just knowing that you're not crazy, that
your body is crazy, falling apart for no
(11:48):
reason, it's like, oh, I was. That's what
I was going through, you know?
>> Dr. Maria Sophocles (11:53):
Right, right.
>> Wendy Valentine (11:54):
Just to have.
>> Dr. Maria Sophocles (11:55):
Your doctor doesn't know, then you're. Then you
don't feel comfortable saying to your doctor, I'm crying all the time.
My hair's falling out. I'm only 47. What?
What is it? So, And so women do get
dismissed a lot by male and female doctors, by the
way, who say, hey, you know what? I don't
know, maybe you're stressed or drink some wine
(12:16):
or try to take a yoga class. All those things
might help you feel better. But a doctor should
be able to say, your ovaries are
in a roller coaster free fall of, like,
up, down, up, down, up, down. This triggers
stuff in your brain and makes you forget
where your keys are and cry at a Disney movie and
snap at your kids. It's not you. You're not
(12:38):
overstressed. You're not crazy. You. Your
hormones are not doing the predictable rise
and fall that they're supposed to. They're sort of a jaggedy,
roller coaster with lots of twists and turns, and
it's out of your control, really. I mean,
obviously you can help yourself with mindfulness and
breathing and meditation, but you can't just tell your
ovaries. Could you guys just chill? I mean, they're going to do what they want to
(13:01):
do, so.
>> Wendy Valentine (13:03):
I wish. Well, drink more water. Let's see if that will,
you know.
>> Dr. Maria Sophocles (13:06):
I mean, like I said, drinking more water is a good thing, so
sleeping better. But nobody
tells you and just nobody tells you that. And then
the whole. Why did no one tell women what's going to
happen in the last third of their lives? Remember, Wendy, in the
whole history of humans, women only lived
past childbearing in, the last couple hundred years, really.
(13:27):
So for most of recorded
history, we haven't even been around after menopause. But
now we are. And now we want to be part of the
story. We want to be able to have career 2.0.
Heck, we want to be able to have a kid in our. Our mid-40s if we want.
We want to be able to remarry or date or marry
for the first time or be polyamorous or whatever.
(13:48):
We want. We want to be sexually vibrant. We want to
be intellectually sharp. We want to be able
to say, gee, I've been a senior VP in my 40s. Heck,
I want to be the CEO in my 50s and not
be, shanghaied by what
somebody didn't tell us. So I think we are
changing as a gender in our
desires and our needs. And life is changing.
(14:10):
Dating is changing. You know, it used to be like, if you got
widowed or divorced, I mean, you're done.
Yeah, yeah. Maybe you could find some nice person at
church, you know, or something. But now you can
swipe left, swipe right there. You know, you can go
on bumble where women have an advantage, you know,
and you can, you can own, you know,
(14:31):
what your future looks like in terms of partner, in terms of.
Of, sex life. And that's really cool.
That's really cool. But it's not really cool if you don't know how
to keep yourself healthy, you know?
>> Wendy Valentine (14:41):
Right. And it's so great that there's
finally options of treatment for
us, because I can remember even,
you know, observing, like, my mom and
my aunts and things like that. Their option was
back then Was like, well, if it's not working right, let's just take it out,
just have a hysterectomy.
>> Dr. Maria Sophocles (15:00):
I know, I know.
>> Wendy Valentine (15:01):
And I think about how many women back then
ended up because they listen to the doctor, like, okay,
let's just rip everything out when there
were act, there's more options.
>> Dr. Maria Sophocles (15:12):
And, and even those women, nobody
explained. Doctors didn't tell you what they took out, by
the way. Then you were just like a little woman, you know? And
they didn't even explain the difference between, if I
take your uterus out, you want a period anymore,
but I'll leave your ovaries in and you can go through menopause
naturally, or, heck, I'm, there, I'll just rip the ovaries out too.
In which case you are surgically in menopause
(15:34):
that day. Y. Brutal. And
then the doctor just waits for you to call in tears saying, what
happened to me? Oh, yeah, I took your ovaries out. Like,
there wasn't even communication about
that. And whether you weren't even offered that option
often, the doctor just decided for you. How
patriarchal. What patriarchal bullshit is that?
(15:55):
Like, because they were all male surgeons, so I know
what's best for you, little lady. Yeah.
Wait, do you?
>> Wendy Valentine (16:02):
Do you? Yeah. And I'm sure if,
just like for you, it's like, if it was way back,
they probably were barely even teaching about menopause. Like,
if they were barely teaching.
>> Dr. Maria Sophocles (16:15):
So basically the doctor would decide, do I want Mrs. Smith
to have a lower risk of ovarian cancer,
which is great news, and I'll just take her ovaries out.
And I think they were doing, I think they
were doing, you know, they thought they were doing a service,
but not really understanding. Now you're, now you're going to
develop osteoporosis. Now you're going
(16:36):
to develop heart, disease at a more advanced rate.
Now you probably are going to have
Alzheimer's and dementia happen earlier. Like, what? You know, if
you sit a woman down and go through all that, I think more women would
say, leave, those in. I don't want those.
So, yeah, we have a lot. We've learned a lot. and hopefully now
more doctors have that kind of conversation,
and more women know to ask about that. But bottom line is
(16:59):
surgeries also become thankful. Gosh, hopefully,
like the last resort, not the first thing. And we've
ways to fix periods and fibroids
and endometriosis that don't involve that,
medications, you know, kind of thing.
>> Wendy Valentine (17:12):
Let's talk about hormone therapy.
>> Dr. Maria Sophocles (17:14):
Yeah.
>> Wendy Valentine (17:15):
And actually let's. And even add in there
about some of these, the myths about
hormone therapy. Because I feel like for
me, when I thought that that might be a solution for
me, there was all these like, oh, you don't want to do that because da
da, da, da, da. so what are some of those
myths about hormone therapy and what are the
(17:35):
different kinds? That's a loaded question.
>> Dr. Maria Sophocles (17:38):
Yeah, yeah, no, it's a good question. so when people say
hormone therapy, they really mean what
we used to call hrt, hormone replacement therapy or
estrogen and progesterone given to replace
what the ovaries don't make anymore. Now the ovaries
also make testosterone, but in
America right now, in 2025, we do not
have FDA approved testosterone for use
(18:01):
as hormone therapy. So that's a whole different topic.
But if you want to have testosterone replaced,
you have to either use an FDA approved for
men formulation and cut the dose in
1 10, which is kind of tricky to do, but you can do it.
Here's a little packet of testosterone. Please make it last
10 days. It's not easy. Or
you come to a specialist like myself and
(18:24):
we have a compounding pharmacy formulate
female level testosterone cream that
is transdermal. You put it on your leg a little bit, gets up to
your brain and it helps you with libido and
energy and lots of good stuff. so hormone
therapy today in America is available as
estrogen plus progesterone. If you don't have a
(18:45):
uterus, if you had a hysterectomy, you only need the
estrogen part because the progesterone part is really
just to keep the uterus safe and healthy.
So that's what HT is, E plus
P. The E is usually
a patch or a gel. It's through the
skin. It is safer through the skin. So that's the
(19:06):
way you want to take it. You do not want to
use it through pellets. The American College of
OBGYN has said, no, no, no, not
safe. Very high doses of hormones in
those. You might feel great, but we have no idea
if it's safe. We don't have long term studies.
So you can use it. Just buyer beware. Use it at your own risk.
But I don't want something.
>> Wendy Valentine (19:29):
They're like little tic tacs.
>> Dr. Maria Sophocles (19:31):
Yeah. And some people love them. So I don't, you know, and
people do feel really good on them. So I feel bad
saying that. I'm just telling people what the
powers that Be the American
College of obgyn, which is sort of our governing body and
tells us what's safe, has said that's not safe. We
don't have enough studies to tell you whether that's safe.
That is not approved by the fda, just
(19:53):
FYI. Same with stuff you'd buy online.
it's just if it, if it promises you that it's hormones,
just beware. It's probably not
actually what it's advertising. A lot of stuff
that's sold as something is not that. If it's
a supplement, an over the counter supplement,
you can go on the NIH website
(20:14):
to see if it's safe. And I encourage people
to do that. I think it's called like the dietary,
label labeling,
dietary supplement labeling part of the
NIH website. And it can tell you, you know, Ashwagandha is
safe at this dose, but at that dose it causes
liver toxicity. I think it's really smart for people
(20:34):
to know that one of the most common reasons that
people go to an emergency room in liver failure is because of
supplements. So, they seem super safe because they
all say the word organic and natural and everybody's
yay. But they can still damage your liver.
Absolutely. As easily as a prescription medication. Just a
little sidebar, but good to know.
>> Wendy Valentine (20:53):
Yeah, yeah, very interesting.
>> Dr. Maria Sophocles (20:55):
So hormones are used for two reasons. Wendy, I'm
just going to finish the thought. I didn't really answer your question. They're
used for two reasons. So we use hormone therapy
either to control the symptoms of
menopause or perimenopause. And there's at least
like 34 that people experience
commonly. Everything from hot flashes to joint pain to
palpitations to brain fog and forgetfulness.
(21:19):
So ht, estrogen and progesterone will help
that efficiently, quickly and safely.
We know they do not cause cancer.
That's a really important distinction. That's
the number one thing people fear. And that's from
that old study 23 years ago that was done
inappropriately. It's been disproven
time, time and time again. Thank goodness. In
(21:42):
fact, we know that
women who use estrogen,
as part of their HD actually have
better longevity and lower deaths
from cancer, Lower cancer recurrence.
And like colon cancer, I think it's like
40% lower. So it's
crazy. Dementia, less later
(22:03):
onset heart disease, less. Congestive
heart failure, less. I could go on and on,
but when you really list that out,
people who use estrogen after menopause
have a much, much higher level of Health
and lower risk of disease. It's
really stunning.
>> Wendy Valentine (22:22):
That's fascinating. So I'm even thinking too, for
women, those lucky women out there that
don't have much symptoms from
perimenopause or menopause, that still there's
benefit to using estrogen.
>> Dr. Maria Sophocles (22:35):
Yeah. So that's the second reason, right? The first is get
rid of these symptoms. The second is, is health
and longevity. And so, if you have no
symptoms at all and you stop having
periods a year ago, now I call you
menopausal. You from today to the
rest of your life are without the benefits
of estrogen. And if I give that to you in a safe,
(22:58):
tiny little dose, you will have,
better health benefits, tremendous health benefits. And
now we've been able to study women long enough
retrospectively to see the benefits.
I mean, the bone is the biggest no brainer,
right? And osteoporosis is not something
40 and 50 year old women think of because they're just
(23:19):
thinking about, oh, God, I'm, gaining some weight, my hair's falling
out. They're not thinking what's happening to silent things
like bone and heart. But it
pays dividends later. I don't know about you, but I want to be
an 80 year old woman who's still able to get on a stand up
paddle board and right, I
do.
>> Wendy Valentine (23:37):
I'll race you.
>> Dr. Maria Sophocles (23:38):
Yeah, I'll erase you. Right. And if one of us
takes estrogen from age 52 and up, and
one of us doesn't, granted there's family
history effects too. Genetics play into it.
But we can't change our genetics. But assuming
you and I have similar genetics, genetic risk. If
one of us takes estrogen from 52 to 82 and
(23:58):
one of us doesn't, I can tell you who will have the stronger
bones for sure. And who will break
something if she falls off that stand up.
>> Wendy Valentine (24:06):
That is so inspiring.
I did not know that. See, I love, I
love my own episode.
>> Dr. Maria Sophocles (24:13):
I love, I know, isn't it fun?
>> Wendy Valentine (24:14):
Like, a motivational workshop for me, like, oh, this is
so great. I did not know that. And I literally had
thought, here's another, you know, myth or whatever, is
that h, you know, HT hormone
therapy is only for the women that are really
having a hard time going through
perimenopause or menopause.
>> Dr. Maria Sophocles (24:33):
Well, it's for them too.
>> Wendy Valentine (24:34):
Because it's for them too.
>> Dr. Maria Sophocles (24:35):
But other things we have over the
counter things that actually do help with hot flashes.
We have, you know, sheets that can wick
away moisture. We have a little device called the
Ember Wave that actually is
incredible that you can wear Embr.
Embr Wave. And it, it works with the brain
to stop the hot flashes. And that's no
(24:58):
medication. So there's cool stuff out there. I don't
want to pretend there isn't.
>> Wendy Valentine (25:02):
Right.
>> Dr. Maria Sophocles (25:03):
But. But nothing works as well as
fast as a tiny, tiny bit of
estrogen. And, and so it's great for
that. But like I said, you're getting a double whammy because
you're also helping your slow down bone
loss and that kind of stuff.
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And now back to the show. At what point
do you know when it's time to start taking
hormone therapy?
>> Dr. Maria Sophocles (27:27):
Yeah. So if you're taking it for symptoms, the time to start when you
have the symptoms.
>> Wendy Valentine (27:31):
Right.
>> Dr. Maria Sophocles (27:31):
People ask me every day, can I take it? I'm only in
perimenopause, meaning I'm still having periods,
but I'm also having symptoms. That really
sucks. Like, that's the worst because you're kind of
still dealing with periods while you're already having
symptoms. And you can take, actually, a lot of
women use a birth control pill for that, which will soften the
symptoms and control your periods. Some women
(27:54):
do the patch and do proper HT
even then, so that's when you can start. The more
common question is, how long do. Can I be
on it? Or do I have to stop at a certain time and
I tell people, you know, think of it like you would
sunblock. Nobody says, wende, I, want you to use
sunblock till you're 53. Make sure you don't get skin
cancer. After that, it doesn't really matter. Not true.
(28:16):
As soon as you expose yourself to the sun, you're
damaging that skin. Same thing. As soon as your body
is devoid of estrogen, you
are having problems. Your, coronary arteries are
affected, your brain neural pathways are affected, your bone
is affected. So you tell me, when would you like that
damage to start? I don't want it to start. Ever.
>> Wendy Valentine (28:37):
Yeah.
>> Dr. Maria Sophocles (28:38):
So, the best thing we could do is when we're
a year out from no periods. That's when we can
safely say, hey, those ovaries are quiet.
They're not making stuff, and it's not coming back.
And that is when the big loss of
bone begins. The most rapid loss
of our bone mineral density happens in the
(28:58):
first five years. After that, menopause.
After menopause begins. So if. If you're only going
to use it for five years. If you said, I don't care what Maria
Sophocles says, I'm only using it for five years. Use
it for those five years. Yeah, so that you can
stand a paddle board at 80.
But me, I will keep using it because,
(29:19):
frankly, after five years, the, the
degradation restarts. And I'd
like to keep my bones as strong for as long as
I can.
>> Wendy Valentine (29:28):
What about the progesterone, then? Is that so?
>> Dr. Maria Sophocles (29:31):
Why do I keep just saying estrogen? because
the progesterone is not helpful
to our bones. It doesn't. I mean, as far as
a research today knows, 10 years from now, they may find it helps.
But what we know is the bones are full of estrogen
receptors, and they need those estrogen receptors
to make new bone cells and to,
(29:51):
make the cells that clean and clear out the bone. Estrogen
helps calcium metabolism, so estrogen helps
our bone in several ways, and we just
don't. I have never read about
progesterone benefits. so you take
progesterone for a couple reasons. Number one, it does help you
sleep. We know that it clears the brain. It's like a
whiteboard eraser. So when you get in bed and you've got
(30:13):
80 things on your brain, it's progesterone. That
clears, cleans it out so you can fall
asleep and stay asleep. And so when we lose
progesterone, that's why sleep is so disturbed for
so many women. But the safety
reason for progesterone is that in the uterus,
estrogen and progesterone are yin and yang. You need
both to grow tissue and stop
(30:35):
growing tissue. That's how we have a period.
But when you're menopausal, you don't want to grow any tissue in
there. And if you just take estrogen, you'll grow
tissue and it could even become abnormal tissue.
So you never want to have a uterus. Take estrogen, feel
better, but no progesterone. You need the progesterone so
the uterus is shushed and doesn't grow tissue.
(30:55):
Does that make sense?
>> Wendy Valentine (30:57):
It totally makes sense.
>> Dr. Maria Sophocles (30:59):
All right. It's a little weird to understand.
>> Wendy Valentine (31:00):
So always, the recommendation is,
yes, keep taking the estrogen, but the
progesterone, keep taking as long as you.
>> Dr. Maria Sophocles (31:08):
Have a uterus, you got to keep taking it because again,
no matter how. Yeah. They go
both till the end. When you come off of one, you come
off of both. If you said to me, I'm, going to do it till
70, because I just feel like that you don't just
stay on one, you just come off of both.
>> Wendy Valentine (31:27):
Now, question for you, because there's a lot of companies out there
now where you can just order the cream
or the pill or the pad, whatever.
Right?
>> Dr. Maria Sophocles (31:36):
Yeah.
>> Wendy Valentine (31:37):
Is there a difference between what
they would just send to you
and you start applying that
versus having one that is made
specifically according to your test
results. According to like, maybe I have more
or less estrogen or progesterone, does it really matter?
>> Dr. Maria Sophocles (31:56):
Yeah, great question. And there's a whole, not
very ethical kind of world that's come up that
preys on that. Oh, you need all kinds of test results.
And, and, and I, it's, I got to order and then follow
and track your blood. You don't have to. The former is
actually the right way to do it. Whether it's getting it through a doctor's
office or a very well respected
telemedicine company like Midi,
(32:18):
Midi, or
Evernow or Alloy. These employ
board certified doctors and nurse practitioners who
use FDA approved, estrogen and
progesterone. Now, I get asked all the Time. Oh, I want
bioidentical. That is bioidentical.
So bioidentical estrogen is made by
big pharma companies. I'm going to say it again because people
(32:40):
don't believe it. They think it has to be some custom
made estrogen dominance
estriol thing. That's bs. You don't need
any of that. You need bioidentical
estrogen. It's called estradiol D I
O L. That is bioidentical estrogen.
And all the bioidentical estrogen you
could ever want is made FDA approved
(33:02):
formulations by big pharma companies. You can order your.
You're wherever you get it, you can pick it up from Walgreens,
cvs, wherever. So you do not need
specially customized stuff for
estrogen or progesterone. You do not need trochees
where they're mixed together. You do not need pellets. You can
go again online and have an
appointment and they'll send, you know, and get a
(33:24):
patch or a gel of estradiol.
the only blood work. I'm not saying there's zero blood work.
The blood work we use the most is with testosterone
because we don't have a classic formulation.
We have to draw your blood to make sure you're in a safe
range. But really the blood work for the
estrogen progesterone is it.
(33:45):
You don't need it repeated and repeated. If I give you
a patch, I know that that patch because
it's been studied so much, your levels are going to be in
a safe range. I'm treating the symptoms
or I'm treating your bone health preventatively. And
the patch does it without any need for levels.
And that's strange, you know, like. It is.
>> Wendy Valentine (34:07):
Yeah, I mean, I'm learning a lot about this right now.
Just with. And I had, I did. why not
win? Wynonna. Wynonna. I think it's another one
of those companies where, you know, you meet with a
doctor and then they'll just. You kind of tell them
your symptoms and then they'll just send you the cream
or the patch or whatever.
>> Dr. Maria Sophocles (34:26):
Yeah.
>> Wendy Valentine (34:27):
So there's really no, like, the formulation is going to
be the same.
>> Dr. Maria Sophocles (34:31):
Predictable. Yeah. The patch comes in about five
different doses and we change the dose based on
symptom control. We don't, you know, in other words, we don't
change it based on your blood levels. We change it
because I gave you a dose. Let's say I gave you the
middle dose and you and I talk Again in a month. And you
say, you know, my hot flashes are 10% better, but I was kind of
(34:51):
hoping for better control in that. Wow. Sorry.
Okay, let's tweak the dose up.
Or I give you a dose and in a month we talk and you say,
I feel great, but my breasts are really swollen
and tender. I hate it. Oh, sorry. I think we better
try a slightly lower dose. Notice I didn't say,
let's get your blood drawn and see the numbers. I'm
training you by listening to you because
(35:14):
all those doses will help your bone. So
for symptoms, I just want the one that covers the
symptoms the best. yeah,
I mean, there is place for blood work in medicine for sure,
but you don't. If you're going to a clinician
or a hormone center or
longevity center and they're just drawing your blood over and over
(35:34):
again and telling you about estrogen dominance and all
kinds of different estrogens, they're doing things they
don't need to do. That doesn't get you living
longer. That doesn't get you healthy on the stand up paddle board and
any better than me or
Winona sending you that patch.
>> Wendy Valentine (35:50):
Right. I can see, though, how women would
not end up getting HT because they think
that they would have to go get all this testing and the testing can
be expensive and like, oh, well, shoot,
well, then I guess I just won't do anything at all. And that's.
That's.
>> Dr. Maria Sophocles (36:05):
That's a shame. Yes. Yeah. And that's, that's
where social media and influencers can be
dangerous. When they say, I went to
Joe's hormone bar and all I
do is I get my blood work every three weeks. You know what she
doesn't tell you is Joe's making a ton of money
from that, from the labs. And I'm getting
(36:25):
everything balanced. And anyone who's using balancing,
be very aware. Or dominance. Estrogen
dominance. But that's not a medical thing. That
doesn't help your brain, bones, and heart. And
anyone who's prescribing different kinds of estrogen,
estronegates, estriol, those just get
turned into estradiol. So you don't. You don't need
that. All you need is estradiol. It's all you
(36:48):
need. And I think when you get it more,
it seems more fancy and more refined. It's not
giving you any health benefits. That's what this should be
about, right? How do I feel? Better? So that's all
you need, is the estradiol. And sure,
if someone Wants to draw your blood for it, have at it. But
truly, it's not changing the blood.
>> Wendy Valentine (37:07):
Not necessary.
>> Dr. Maria Sophocles (37:09):
No.
>> Wendy Valentine (37:09):
What do you think about the testosterone? I mean, where are they at
with all of that?
>> Dr. Maria Sophocles (37:13):
And I think it's great. I think in five to 10 years
we'll have an FDA approved testosterone. I think it's
insane that it's been overlooked. It almost got
approved by the FDA many years ago. It was one vote
shy. And that was just totally a shame.
And it was just someone in the FDA who said, I mean,
do women really need this?
>> Wendy Valentine (37:32):
I was going to say, had to have been a man.
>> Dr. Maria Sophocles (37:35):
I hate to tell you, but there were men and women in the room
and it's like, damn it, why didn't someone stand up and say yes?
but, it's coming, it'll, it'll happen. It's in the
works. But for you and I now, I think
it's, it's wonderful to have, I think it actually helps
us. And, and it's very safe. I've been using
it with my patients for probably 15 years. I have never had
(37:56):
anyone have a side effect ever.
but, and if you look at, even if you look at
trans patients, right, we're giving
genetic women high, high, high, high, high, high
doses of testosterone. And do they get
cancer from that? Nope. Do they get dangerous side
effects? No, they get a beard. But they're, they're, they're getting
that because we're giving them really high doses.
>> Wendy Valentine (38:18):
Right.
>> Dr. Maria Sophocles (38:18):
The doses you and I would take are a teeny fraction of
that. And yes, if we do a little too much, our
skin might get oily. We could get a chin hair. That's
not fun. But if you do, then you talk
to your clinician and go, I think this is a little too much for me.
And we back the difference.
>> Wendy Valentine (38:34):
Yeah, I'm trying to, I'm needing to shave every day.
>> Dr. Maria Sophocles (38:38):
I think if that's your side effect, you should speak up.
>> Wendy Valentine (38:41):
Yeah. What, what does it help with?
>> Dr. Maria Sophocles (38:43):
It helps. I think libido is, is the no brainer
that it helps with. but I find even women
have more energy and they build lean muscle mass
better. So if, if you and I go to a gym three times a
week and I have testosterone and you don't, I will
probably feel and see strength and
muscle differences. Now
again, we don't have a lot of
(39:06):
guidelines yet on what, you know, the powers that
be. The North American Menopause. Now it's called the Menopause
Society, the American College of Ob gyn. They're saying
we don't really want to be given women doses that do
that. We just don't know about the safety of that.
So, people, we need more studies. So what
experts like myself do is we give teeny, teeny little
(39:27):
doses compounded, and they're not going to.
They're not going to have the amazing energy and muscle benefits
as, as wonderfully as I'm painting. They're going
to nudge your libido. So you're lying in
bed, you put your head on your partner's shoulder, and it just feels a little
more masculine or feels a little more sexual.
You look at your partner mowing the lawn, your. Your neighbor
(39:47):
mowing the lawn, and you're like, damn, I didn't know. I didn't
realize he looked so good. You know, you're not going to rip
anyone's clothes off, but you're just more aware you're watching a
sexy scene on Netflix and you're like, aware
of the sex, you know, So, I mean,
that'll do for now.
>> Wendy Valentine (40:02):
It's a whole lot more arousal, right?
>> Dr. Maria Sophocles (40:05):
Yeah, you're more. You're more in. Tuned
to erotic stimuli. That's the easiest way I
can explain it. And what I tell women when I
give them the testosterone, I say, look, think of this as
the little receptors for erotic info in your
brain are kind of rusty and closed. The testosterone
is like this nice little lube that's going to go to your brain and sort
(40:26):
of open them up. You have to now
stuff those receptors with erotic
info. Books, magazines,
porn, audio porn.
If your listeners don't know what audio porn is, they should.
It's an unfortunate name, but I call it Oral
sex. A U R A L. Oral sex. Sex
for your ears. So you, you know, like a good
(40:48):
site is Quinn, right? You can go on Quinn, the
app. And there's stories in every flavor you can
imagine, from hot vampires to men on horseback
to, you know, lesbian sex to women and,
you know, bears or whatever you want, and you
find what is fun for you, and you climb
in bed and you just listen for 15 minutes and
(41:09):
that imagery, those
stories get stuffed into your brain and we are
like a savings account. Women store
erotic information so that
again, even if you're just washing the dishes and your
husband comes up or your partner comes up behind you and gives you a back
rub or rubs your scalp or whatever, it has
a different. It hits differently. You know what I mean?
(41:33):
So it helps. It really does. And the test.
>> Wendy Valentine (41:35):
And I would, I would guess then testosterone
naturally kind of starts to go down
as you m. Yeah. In menopause. Right.
So is that something that is just kind of like
a voluntary thing? It's not required, but you kind of
take it just to have a little boost?
>> Dr. Maria Sophocles (41:52):
Yes, yes. And even estrogen,
progesterone aren't required. I mean, you don't. You don't have to do
anything. You can age quote naturally. like I
said, I. But natural
aging involves acceleration
of deterioration.
>> Wendy Valentine (42:07):
Yes.
>> Dr. Maria Sophocles (42:08):
Right. So I. I'd be very careful about that
word natural. We do a lot of things, you know, you and I aren't
naturally aging right now with our lips, we both have lipstick
on. We made a decision that, we kind of. This is the vibe
we want to bring to our life. This is the color we want
our hair. This is, you know, whatever. And I would vote
that if you look at what estrogen does to
(42:28):
every single. Practically every single organ system in your
body, it's literally just keeping it
healthier, longer. And I sort of like
that idea. I just. I mean, walk. Walk into
a, old age center someday and see what
85 looks like for some people. And it's
not their fault. I mean, they didn't have the benefit of this. Even their
doctors maybe told them not to take this. And
(42:51):
their hip is fractured and they can't ever get out of bed again.
And I don't know, I'm like, they're.
>> Wendy Valentine (42:57):
Not doing stand up paddleboard, you know?
>> Dr. Maria Sophocles (42:59):
No, exactly. And, you know, I'm not trying to live to be
120. I just want the years that I
live and my patients live to be healthy
and agile and. And they can be with their kids and
grandchildren if they choose to have that. And be.
>> Wendy Valentine (43:12):
Can you, can you think of a patient that you've had
that was just an extreme case
of perimenopause menopause, just like the worst of
the worst symptoms. And then after starting
hormone therapy, just.
>> Dr. Maria Sophocles (43:27):
Her whole life changed when I cannot
think of one, but I can think of 10,000, you know?
Yeah, I think I've seen about 80, 90,000
patients in the last 30 years. So. So it's a lot
in my practice. I have a virtual practice, Wendy,
and I'm licensed in many states, so people from all
over the US and from other countries can find me.
(43:47):
And so that's what I do now. I don't.
I don't do surgery anymore. I just handled a,
tsunami of women. After my TED Talk came out,
it sort of went global. So people would find me in other countries and say,
hey, I'm in Argentina and I'm miserable. Can you help
me? Hey, I'm in Singapore and I'm not happy and I'm
in Portugal.
>> Wendy Valentine (44:06):
Can you help me?
>> Dr. Maria Sophocles (44:07):
Yeah, exactly. Exactly. And
it's fun in some cases even to do the visits in other
languages. I enjoy that. But certainly,
and in the U.S. you know, I have to be licensed in other states, so
I've gotten that. So now if someone in Texas or.
Or Utah or Connecticut calls me, I can actually
care for them. And, so that's
(44:28):
been great. So. So I do this all day long, is
listen and take in. What do you need? Do you need
acute help with perimenopause, or do you have a
family history of osteoporosis and you don't want to end up like your
mom and grandmom, you know? Or do you want to sand a paddle
board at 80 and we build a treatment plan for
you that may involve hormones, it may not.
(44:49):
Depending, you know, they. They're not for everyone. There are people who should
not take them. If you have an estrogen
receptor positive cancer, breast or
uterine, you can't take it. It's not for you. I'm sorry.
You just can't take it. but otherwise, there's very
few people who cannot, so almost everyone can.
>> Wendy Valentine (45:07):
Yeah. I can tell you they made a huge difference
for me. And I. I
ended up when I came, over to, you know, I live on
the island of Madeira.
>> Dr. Maria Sophocles (45:17):
Yeah.
>> Wendy Valentine (45:18):
And I ended up. I ran out of, the hormones
I was taking, you know, back in the States, and then I was like,
you know, I'll just. I'll just go without for a while.
Yeah, no, it did. It
didn't work out for a while.
>> Dr. Maria Sophocles (45:31):
How'd that work out for you?
>> Wendy Valentine (45:32):
It did not. Yeah, like, yeah, right. Was it Dr. Phil?
How's that working for you? Not very good.
The hot flashes came back and the night sweats
and the, my skin was dry and
my muscle tone, everything. I just
cranky and brain
fog. I couldn't, I was like, no.
(45:54):
I mean, it was almost trying to resist it. Trying to, like,
go the natural route, if you will. And I was like,
you know, well.
>> Dr. Maria Sophocles (46:01):
Again, that's for some people and they want it. And, for my
patients, I will meet you where you are if you say to
me, I don't care what you say. I'm scared. I don't want to get cancer.
I say, guess what? I don't want to get cancer either. I know
I won't get cancer from this. But if you're worried, let's find
a way to help you. What else is out there for bone strength?
Let's talk about, about axial
loading, about strength exercises that actually
(46:24):
help you reduce your risk of osteoporosis.
So if you don't want to take medication, what can we do
nutrition wise? What can we do exercise wise? I mean,
there's, there's a lot of. How can we optimize your sleep?
Because if you sleep well, you are healthier. We know that. and
you can combat hot flashes better if you've had good
sleep. So it's not only about hrt,
(46:44):
Obviously, I'm a fan, but I don't
ever shame or make someone feel like they're wrong.
If they say to me, I just don't want that, I say,
great, no worries. Let's. So let's, let's build on what would
be okay for you, and let's optimize your health that way.
So.
>> Wendy Valentine (46:59):
Yeah, well, I tell you, I feel good now. I
mean, it's, it's, it truly, it does make
a huge difference on your life and your sleep
and everything. So I'm, I'm for
it. And I love.
I was going to ask you that if you do work virtually.
>> Dr. Maria Sophocles (47:15):
So I almost only work virtually. I
have an office in Princeton, New Jersey. I have one in
New York and I've one in London. But, I don't, I don't
honestly use the offices that much because,
because people are like, well, you know, I'm in
Salt Lake City, and I would rather just do it by zoom. I'm like,
I don't blame you. I wouldn't want to fly. You know, why fly?
(47:35):
And every so often, I actually fly to my patients.
like, if I have a whole bunch of patients in one place, I call
them all and say, hey, I'm going to be in California next week for
three days. And we honestly, we get lunch or breakfast and we
have an hour meeting together in person, which is so
lovely. But then the rest is virtual. So it's kind
of medicine how I want. I would want it practiced on
(47:56):
me, meaning someone giving me an hour or two at
a time. It's just really been nice and it
lets women be heard.
>> Wendy Valentine (48:04):
And then you're able to just prescribe,
at a local pharmacy?
>> Dr. Maria Sophocles (48:09):
Yeah, yeah, I am, because I'm licensed. if for some reason
they're from a state where I don't have a license, I, I say, hey, can
you give me the name of your primary care And I talk to them and
say, would you mind ordering this? And it's never, never been an issue
at all. And in other countries, actually, it's, it's
even easier. So, it's great.
So, yeah, I have to, I have to do Portugal. I definitely need to.
>> Wendy Valentine (48:29):
I know, yeah, let's, let's have a hormone party over
here in Madeira, you know.
>> Dr. Maria Sophocles (48:35):
I know. Well, it's nice to educate it, really. I love
it. I love seeing women go, oh, my. Oh my
gosh, I didn't know. I've been suffering.
>> Wendy Valentine (48:42):
Yeah, I mean, see, there's stuff I learned today. I had
no idea.
>> Dr. Maria Sophocles (48:46):
That makes me so happy. I hope other people did too.
And I'm sure you'll post like my Instagram or my
website so people can find me. That's how I.
>> Wendy Valentine (48:55):
So where, where, where's the best place to find you?
>> Dr. Maria Sophocles (48:58):
My website is Maria
sophoclesmd.com and on that
website you can learn about the book and the TED Talk. You
can see I have a documentary film I'm working on
about sex and midlife. So people can learn about that.
They can learn about what I'm doing in Africa, trying to build a clinic
in Kenya, but also they can reach me as a
patient. There's a tab, I think, for patients, and
(49:20):
a way to connect with me there. sometimes people have
a quick question. They just post it on Instagram and say, hey, I.
I heard you and Wendy talking and I. That
prompted a question for me. And, you know, that's easy too. So
please DM me. Well, I'm not going to put myself. Just find me on
Instagram and message me on there or my website. I think that's the
easiest.
>> Wendy Valentine (49:38):
Yeah, yeah, yeah. And then the book comes out,
let's see, in February. That'll be go.
It'll, probably be available for pre order pretty soon. I think by
the time this airs, it might be ready for pre order.
I think, probably in August. And then,
what's, what's the name of the book?
>> Dr. Maria Sophocles (49:54):
The Bedroom Gap. The Bedroom Gap.
So the Bedroom Gap is this term, this concept
of, darn it, in midlife, more and more women have
lower sex drive and they're dry and sex is
painful. Men have Viagra. So they're like, I have a great
idea. Let's have really long sex for
like eight times a day. You know, and it's like,
(50:14):
wait a minute, I thought we were going to age in parallel.
So I think, the pharma industry hasn't really done
us any Service, the lack of research, the
fact that women couldn't be research subjects
till 1993. Crazy.
So we're lacking research. And
then culture sort of saying
(50:35):
it's for patriarchal pleasure. So I think you put
all that together, and you get this big bedroom gap. And the book. The
book really looks at all of that. It's part how to. It's
part how to have great sex and how to help yourself
be in the moment. It's a lot about mindfulness, and
it's a lot of cool kind of thinking, and I hope
people like it. I think they will. Yeah.
>> Wendy Valentine (50:54):
And I'll, definitely add the link in the show notes there
for that. So, so helpful. I'm so glad
you're doing what you do.
>> Dr. Maria Sophocles (51:01):
I am so glad you had me on. It has really been
fun to chat. I feel like, I just need a ticket to
Portugal now to go do it live. It would be fun. It'll
be fun.
>> Wendy Valentine (51:10):
Yeah. I want to teach a retreat here someday, so
that would be great. Right? I know.
>> Dr. Maria Sophocles (51:15):
Love it. I would love it.
>> Wendy Valentine (51:16):
Awesome. I have a great time. and Madeira is gorgeous.
>> Dr. Maria Sophocles (51:19):
Beautiful.
>> Wendy Valentine (51:20):
Is the most beautiful place, I think, on Earth. It is so
amazing. And the weather.
>> Dr. Maria Sophocles (51:25):
Help you do one there. If you'll come help me do mine in Greece,
so we'll just.
>> Wendy Valentine (51:29):
Yes.
>> Dr. Maria Sophocles (51:30):
Yeah. I'm in Greece doing them, so that would be really
fun.
>> Wendy Valentine (51:34):
Isn't that awesome? We. Yeah, we women have come
a long way.
>> Dr. Maria Sophocles (51:38):
We have. We have. I'm so glad we're here today. Thank
you so, so much for. For giving the
time.
All right.
>> Wendy Valentine (51:44):
All right. Thank you, everyone. Have a great day.
Did this podcast inspire you? Challenge you?
Trigger you to make a change or spit out your coffee
laughing? Good. Then there are three ways you can
thank me. Number one, you can leave a written review
of this podcast on Apple iTunes. Number
two, you can take a screenshot of the episode
(52:05):
and share it on social media. And tag me
Wendy Valentine. Number three, share
it with another midlifer that needs a makeover. You
know who I'm talking about. Thank you so much for
listening to the show. So get out there and be bold,
be free. Be you.
If you look at what estrogen does to
(00:02):
every single, practically every single organ system in your
body, it's literally just keeping it
healthier, longer. And I, I sort of like
that idea. I just, I mean, walk, walk into
an, old age center someday and see what
85 looks like for some people. And it's
not their fault. I mean, they didn't have the benefit of this. Even their
(00:22):
doctors maybe told them not to take this. And their,
their hip is fractured and they can't ever get out of bed again.
>> Wendy Valentine (00:29):
Hey there, beautiful. I'm Wendy Val, your host
of the Midlife Makeover show where it's never too late
to wake up to your best life. Whether you're
navigating a career change, empty nesting,
menopause, or wondering what's next, you're in the
right place. Every week I'll bring you real
talk, laughs and inspiring conversations
(00:49):
with experts and extraordinary women who have
transformed their lives from self care and
relationships to starting over and finding freedom.
This is your time to reinvent,
rediscover and reignite the woman you were
always meant to be. So hit that subscribe button. and
let's rewrite the rules of midlife. Your new
adventure starts now.
(01:22):
Hello lovely ladies. Mark your calendars
because Women Waking up, the Midlife
Manifesto for Passion, Purpose and Play
officially comes into the World on September
9th. That's right, she's almost
here. And this isn't just a book. It's
a midlife revolution in motion.
Inside you'll find guided exercises,
(01:44):
soul stirring meditations, and real life
tools that turn reflection into
reinvention. It's like having your own personal
coach, cheerleader and roadmap all
rolled into one. If you're ready to
stop sleepwalking through midlife and actually start
living with soul, this book is your wake up
call. And guess what? There's still time
(02:07):
to grab over $500 in pre order
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@womenwakingup.com
you'll get the Women Waking up playbook, My Freedom
Meditations, a vision board template,
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voucher for freedom at Midlife and even
a Spotify playlist to to lift you up and
(02:27):
light you up.
Order your copy today at,
womenwakingup.com
welcome to the Midlife Makeover Show. I'm your
host, Wendy Valentine and today's guest is
someone every woman in midlife needs in
her corner. Dr. Maria Sophocles has
spent nearly 30 years at the cutting edge
(02:47):
women's healthcare, specializing in menopause
management and female sexual health.
From her academic days at Duke and Jefferson
Medical College to leading Women's Health Care of
Princeton, Dr. Sophocles has made it her
mission to empower women with real
science backed solutions and bust
(03:08):
the myths that keep so many of us
confused. My gosh. Especially when it comes to
hormone therapy. In today's episode, we're
diving into the world of hormones. The most wonderful world
of hormones. What they are, how they work,
and most importantly, how they can help you
reclaim your health and vitality during midlife and
(03:28):
beyond. If you've ever felt overwhelmed by the
mixed messages about hormone therapy, you're going
to love this conversation. Please welcome Dr.
Maria Safaklis to the show.
>> Dr. Maria Sophocles (03:40):
Yay. Hi, Wendy.
>> Wendy Valentine (03:42):
Hello. We finally started. We talked for,
you know, like a half an hour before.
>> Dr. Maria Sophocles (03:47):
I know because it's so much fun, it's great topics to
discuss and so much.
>> Wendy Valentine (03:53):
Yeah. For women to come together. Like when
I posted a reel about this earlier today, it's like, you
think about it, what one woman can do just on
her, on her own, between answering
emails and flipping pancakes and making the grocery
list, to managing our hormones
to. Okay, let me put some mascara on.
(04:14):
We do, so much. And if we
all join together, oh my gosh,
boom. The world would be so
amazing.
>> Dr. Maria Sophocles (04:24):
So, yeah, there's a, there's a crazy statistic
about just the healthcare
gap, the gender gap, like what women aren't getting
in health care. And a, consulting firm, kind
of infamous consulting firm called McKinsey actually did a
study to value it and they said globally
it's valued at a trillion dollars. So
(04:44):
if we could get the women with hot flashes to not
have hot flashes and be at work, or if we could fix
the women who have endometriosis, cure their pain and get them back
to work, we could inject a trillion
dollars into the global economy of all
of third world countries, even more than first world
countries. And that's kind of staggering, right? So we
definitely. It's amazing what women do without
(05:06):
that is my point, that even without that, we get
up, we deal with our period pain or our endo
pain or our, our joints or our
menopause symptoms and we, we kind of shut up and go
to work and shut up and move the,
and lead countries and lead boardrooms and lead
classrooms and, you know, get on pickleball
(05:27):
courts. And I think, I think women are incredible. They really
are.
>> Wendy Valentine (05:30):
We are such badasses. Right?
>> Dr. Maria Sophocles (05:33):
Totally.
>> Wendy Valentine (05:34):
What inspired you to go into
women's health?
>> Dr. Maria Sophocles (05:39):
I think when I was in medical school, I thought I
wanted to be a cardiologist because I thought the heart was cool. And then I
realized it was a lot of older people and I wasn't
really helping anyone. I was just sort of like watching them get
older. And then when I went into women's health, I was
kind of drawn to the fact that I could help a 12 year
old, a 22 year old, a 42 year old, 62 year old and
(05:59):
82 year old. And they all had different needs and they
all seem to be getting underserved. the teenage
girls were sort of stuck with pediatricians who
were, you know, asking them if they were wearing bike helmets,
but not really comfortable talking about their
periods. And the 82 year olds were sort of in old
age homes and like, call us after you fall. And
nobody was really saying, wait, what if we could prevent the
(06:21):
osteoporosis or the urinary tract infection
in the first place? And the midlife women were just getting totally
left out to dry. So, you know, pun intended.
>> Wendy Valentine (06:30):
I was going to say pun intended. Yeah, yeah.
>> Dr. Maria Sophocles (06:33):
So I just felt like there was a lot of work and improvement that
could be done in the status quo. And even
after I became an OB gyn,
I started to realize there was even an imbalance in the OB
and GYN world, that when you went to private
practice, all the money was made by delivering babies
and all the emergencies were an urgent baby
delivery. And the GYN patients were sort of
(06:56):
just hope they come in and get them out. And I thought,
nah, that doesn't seem right. So in 2008,
I started a practice just for GYN
and, did no more OB and it turned out
to be very successful. Women came from really all over
the region and eventually all over the the country because we pioneered
a lot of things for menopause and because
(07:17):
we picked up what I called the crumbs of
gyn. The cancer survivors, the urology,
the geriatric patients, the teens,
the midlife. Now it's not crumbs. Now everyone talks
about midlife M and menopause, but
at the time in 2008, no one was really,
really caring about that. but yes, those women
(07:37):
needed to be.
>> Wendy Valentine (07:37):
I think that is. Why is it. I mean, it's wild now, and
maybe it's just because I'm in this space of
menopause and midlife and all the
things that goes along with that. Why did it
take us so dang long
to finally talk about all this stuff? Is this just things that we
had not figured out?
>> Dr. Maria Sophocles (07:56):
Yeah, three. Three things I'M going to do three things and they're all,
they're all talked about in my book because there's actually a
sexual fallout to it too. But number one,
sex ed in this country is taught that sexual
sex is for male pleasure. Sex is for
procreation, and it's fear based, not pleasure
based. Don't have sex, you'll get chlamydia and die. Remember,
(08:16):
for mean girls.
>> Wendy Valentine (08:16):
Yes.
>> Dr. Maria Sophocles (08:17):
As opposed to sex is about pleasure and
pleasure for both of us. So sex ed, I think needs
to be a little revamped because we don't really teach
perimenopause or menopause and sex ed. We just say
here's puberty, here's what's going to happen in your teenage years,
but nobody finishes the story. Every
sex ed course should say, oh, oh, and by the way,
(08:38):
this is what's going to happen at the other end. And not when you're
95, but when you're 45 and having a career and
juggling kids. You're going to get hormonally kind
of betrayed and ambushed. So you're ready for
it and good luck. Yeah, at least people would know
it's coming. That's the first thing. The second reason
we don't really talk about it or it hasn't really found
(08:58):
its place in medicine is that medical
education does not count
it as worthy. People get like one
lecture in four years on menopause and it's kind of
like physiologic. It's like the ovaries shut down
and women get some hot flashes. Okay, next
subject is the kidney and you're like, wait a minute,
(09:18):
there's a lot more to it than that. So one of
my missions is to revamp, get medical education
revamped about menopause. And
some peers of mine have actually put together a movie called
the M M Factor, which is now going to, is shown not
only to women around the U.S. but in medical
schools, which is really cool. but the third part
(09:39):
is, so we've gotta fix sex ed so that when teens
are sitting in that boring 10th grade classroom,
they actually do get to understand
what sex should be like and what happens in
puberty and what happens in perimenopause. Second,
revamp medical schools so that no matter what
specialty you end up going into, you know that
(10:00):
menopause can be your patients,
can bring you problems. If you're an orthopedic surgeon, you
have to know that frozen shoulder in a 52
year old woman is not necessarily just from a bad
water Skiing accident. It can be from menopause.
If you're an ophthalmologist, you have to know that visual changes
can be menopausal. If you're a dentist, dry mouth,
(10:20):
burning mouth syndrome, menopausal. So it's
not just hot flashes. And then the third thing is, women like you and
I need to get the message out. But
women who are in the public eye need to say,
hey, guess what, everybody? This affects.
Wait for it, 100% of
women who have ovaries in a uterus, not, like,
(10:40):
just some rare person. Now, all of us might not have
symptoms, but all of us are going to have
the experience of menopause affecting our
longevity, our heart health, our bone health, our brain
health. So it's absolutely crazy not
to at least understand it.
>> Wendy Valentine (10:56):
I saw, something somewhere online. It was like a pie
chart or something like that. The amount of time that we
spend it in menopause, in our third
of.
>> Dr. Maria Sophocles (11:05):
Our lives, more than a third of our lives.
>> Wendy Valentine (11:08):
Crazy. And then, like, we. But then it's never talked about. Like,
well, how are you supposed to spend that one third?
I mean, I. I'll admit, I
thought, like, oh, first of all, I
didn't even know about perimenopause. Did not. I.
I didn't find out this is
crazy about perimenopause until after I
(11:28):
had already gone through menopause and after I
started this podcast because I had this lady
on the show, and I was like, what is this perimenopause
crap? And I was like, oh, my God, if
I had only known. I mean, sometimes
just knowing that you're not crazy, that
your body is crazy, falling apart for no
(11:48):
reason, it's like, oh, I was. That's what
I was going through, you know?
>> Dr. Maria Sophocles (11:53):
Right, right.
>> Wendy Valentine (11:54):
Just to have.
>> Dr. Maria Sophocles (11:55):
Your doctor doesn't know, then you're. Then you
don't feel comfortable saying to your doctor, I'm crying all the time.
My hair's falling out. I'm only 47. What?
What is it? So, And so women do get
dismissed a lot by male and female doctors, by the
way, who say, hey, you know what? I don't
know, maybe you're stressed or drink some wine
(12:16):
or try to take a yoga class. All those things
might help you feel better. But a doctor should
be able to say, your ovaries are
in a roller coaster free fall of, like,
up, down, up, down, up, down. This triggers
stuff in your brain and makes you forget
where your keys are and cry at a Disney movie and
snap at your kids. It's not you. You're not
(12:38):
overstressed. You're not crazy. You. Your
hormones are not doing the predictable rise
and fall that they're supposed to. They're sort of a jaggedy,
roller coaster with lots of twists and turns, and
it's out of your control, really. I mean,
obviously you can help yourself with mindfulness and
breathing and meditation, but you can't just tell your
ovaries. Could you guys just chill? I mean, they're going to do what they want to
(13:01):
do, so.
>> Wendy Valentine (13:03):
I wish. Well, drink more water. Let's see if that will,
you know.
>> Dr. Maria Sophocles (13:06):
I mean, like I said, drinking more water is a good thing, so
sleeping better. But nobody
tells you and just nobody tells you that. And then
the whole. Why did no one tell women what's going to
happen in the last third of their lives? Remember, Wendy, in the
whole history of humans, women only lived
past childbearing in, the last couple hundred years, really.
(13:27):
So for most of recorded
history, we haven't even been around after menopause. But
now we are. And now we want to be part of the
story. We want to be able to have career 2.0.
Heck, we want to be able to have a kid in our. Our mid-40s if we want.
We want to be able to remarry or date or marry
for the first time or be polyamorous or whatever.
(13:48):
We want. We want to be sexually vibrant. We want to
be intellectually sharp. We want to be able
to say, gee, I've been a senior VP in my 40s. Heck,
I want to be the CEO in my 50s and not
be, shanghaied by what
somebody didn't tell us. So I think we are
changing as a gender in our
desires and our needs. And life is changing.
(14:10):
Dating is changing. You know, it used to be like, if you got
widowed or divorced, I mean, you're done.
Yeah, yeah. Maybe you could find some nice person at
church, you know, or something. But now you can
swipe left, swipe right there. You know, you can go
on bumble where women have an advantage, you know,
and you can, you can own, you know,
(14:31):
what your future looks like in terms of partner, in terms of.
Of, sex life. And that's really cool.
That's really cool. But it's not really cool if you don't know how
to keep yourself healthy, you know?
>> Wendy Valentine (14:41):
Right. And it's so great that there's
finally options of treatment for
us, because I can remember even,
you know, observing, like, my mom and
my aunts and things like that. Their option was
back then Was like, well, if it's not working right, let's just take it out,
just have a hysterectomy.
>> Dr. Maria Sophocles (15:00):
I know, I know.
>> Wendy Valentine (15:01):
And I think about how many women back then
ended up because they listen to the doctor, like, okay,
let's just rip everything out when there
were act, there's more options.
>> Dr. Maria Sophocles (15:12):
And, and even those women, nobody
explained. Doctors didn't tell you what they took out, by
the way. Then you were just like a little woman, you know? And
they didn't even explain the difference between, if I
take your uterus out, you want a period anymore,
but I'll leave your ovaries in and you can go through menopause
naturally, or, heck, I'm, there, I'll just rip the ovaries out too.
In which case you are surgically in menopause
(15:34):
that day. Y. Brutal. And
then the doctor just waits for you to call in tears saying, what
happened to me? Oh, yeah, I took your ovaries out. Like,
there wasn't even communication about
that. And whether you weren't even offered that option
often, the doctor just decided for you. How
patriarchal. What patriarchal bullshit is that?
(15:55):
Like, because they were all male surgeons, so I know
what's best for you, little lady. Yeah.
Wait, do you?
>> Wendy Valentine (16:02):
Do you? Yeah. And I'm sure if,
just like for you, it's like, if it was way back,
they probably were barely even teaching about menopause. Like,
if they were barely teaching.
>> Dr. Maria Sophocles (16:15):
So basically the doctor would decide, do I want Mrs. Smith
to have a lower risk of ovarian cancer,
which is great news, and I'll just take her ovaries out.
And I think they were doing, I think they
were doing, you know, they thought they were doing a service,
but not really understanding. Now you're, now you're going to
develop osteoporosis. Now you're going
(16:36):
to develop heart, disease at a more advanced rate.
Now you probably are going to have
Alzheimer's and dementia happen earlier. Like, what? You know, if
you sit a woman down and go through all that, I think more women would
say, leave, those in. I don't want those.
So, yeah, we have a lot. We've learned a lot. and hopefully now
more doctors have that kind of conversation,
and more women know to ask about that. But bottom line is
(16:59):
surgeries also become thankful. Gosh, hopefully,
like the last resort, not the first thing. And we've
ways to fix periods and fibroids
and endometriosis that don't involve that,
medications, you know, kind of thing.
>> Wendy Valentine (17:12):
Let's talk about hormone therapy.
>> Dr. Maria Sophocles (17:14):
Yeah.
>> Wendy Valentine (17:15):
And actually let's. And even add in there
about some of these, the myths about
hormone therapy. Because I feel like for
me, when I thought that that might be a solution for
me, there was all these like, oh, you don't want to do that because da
da, da, da, da. so what are some of those
myths about hormone therapy and what are the
(17:35):
different kinds? That's a loaded question.
>> Dr. Maria Sophocles (17:38):
Yeah, yeah, no, it's a good question. so when people say
hormone therapy, they really mean what
we used to call hrt, hormone replacement therapy or
estrogen and progesterone given to replace
what the ovaries don't make anymore. Now the ovaries
also make testosterone, but in
America right now, in 2025, we do not
have FDA approved testosterone for use
(18:01):
as hormone therapy. So that's a whole different topic.
But if you want to have testosterone replaced,
you have to either use an FDA approved for
men formulation and cut the dose in
1 10, which is kind of tricky to do, but you can do it.
Here's a little packet of testosterone. Please make it last
10 days. It's not easy. Or
you come to a specialist like myself and
(18:24):
we have a compounding pharmacy formulate
female level testosterone cream that
is transdermal. You put it on your leg a little bit, gets up to
your brain and it helps you with libido and
energy and lots of good stuff. so hormone
therapy today in America is available as
estrogen plus progesterone. If you don't have a
(18:45):
uterus, if you had a hysterectomy, you only need the
estrogen part because the progesterone part is really
just to keep the uterus safe and healthy.
So that's what HT is, E plus
P. The E is usually
a patch or a gel. It's through the
skin. It is safer through the skin. So that's the
(19:06):
way you want to take it. You do not want to
use it through pellets. The American College of
OBGYN has said, no, no, no, not
safe. Very high doses of hormones in
those. You might feel great, but we have no idea
if it's safe. We don't have long term studies.
So you can use it. Just buyer beware. Use it at your own risk.
But I don't want something.
>> Wendy Valentine (19:29):
They're like little tic tacs.
>> Dr. Maria Sophocles (19:31):
Yeah. And some people love them. So I don't, you know, and
people do feel really good on them. So I feel bad
saying that. I'm just telling people what the
powers that Be the American
College of obgyn, which is sort of our governing body and
tells us what's safe, has said that's not safe. We
don't have enough studies to tell you whether that's safe.
That is not approved by the fda, just
(19:53):
FYI. Same with stuff you'd buy online.
it's just if it, if it promises you that it's hormones,
just beware. It's probably not
actually what it's advertising. A lot of stuff
that's sold as something is not that. If it's
a supplement, an over the counter supplement,
you can go on the NIH website
(20:14):
to see if it's safe. And I encourage people
to do that. I think it's called like the dietary,
label labeling,
dietary supplement labeling part of the
NIH website. And it can tell you, you know, Ashwagandha is
safe at this dose, but at that dose it causes
liver toxicity. I think it's really smart for people
(20:34):
to know that one of the most common reasons that
people go to an emergency room in liver failure is because of
supplements. So, they seem super safe because they
all say the word organic and natural and everybody's
yay. But they can still damage your liver.
Absolutely. As easily as a prescription medication. Just a
little sidebar, but good to know.
>> Wendy Valentine (20:53):
Yeah, yeah, very interesting.
>> Dr. Maria Sophocles (20:55):
So hormones are used for two reasons. Wendy, I'm
just going to finish the thought. I didn't really answer your question. They're
used for two reasons. So we use hormone therapy
either to control the symptoms of
menopause or perimenopause. And there's at least
like 34 that people experience
commonly. Everything from hot flashes to joint pain to
palpitations to brain fog and forgetfulness.
(21:19):
So ht, estrogen and progesterone will help
that efficiently, quickly and safely.
We know they do not cause cancer.
That's a really important distinction. That's
the number one thing people fear. And that's from
that old study 23 years ago that was done
inappropriately. It's been disproven
time, time and time again. Thank goodness. In
(21:42):
fact, we know that
women who use estrogen,
as part of their HD actually have
better longevity and lower deaths
from cancer, Lower cancer recurrence.
And like colon cancer, I think it's like
40% lower. So it's
crazy. Dementia, less later
(22:03):
onset heart disease, less. Congestive
heart failure, less. I could go on and on,
but when you really list that out,
people who use estrogen after menopause
have a much, much higher level of Health
and lower risk of disease. It's
really stunning.
>> Wendy Valentine (22:22):
That's fascinating. So I'm even thinking too, for
women, those lucky women out there that
don't have much symptoms from
perimenopause or menopause, that still there's
benefit to using estrogen.
>> Dr. Maria Sophocles (22:35):
Yeah. So that's the second reason, right? The first is get
rid of these symptoms. The second is, is health
and longevity. And so, if you have no
symptoms at all and you stop having
periods a year ago, now I call you
menopausal. You from today to the
rest of your life are without the benefits
of estrogen. And if I give that to you in a safe,
(22:58):
tiny little dose, you will have,
better health benefits, tremendous health benefits. And
now we've been able to study women long enough
retrospectively to see the benefits.
I mean, the bone is the biggest no brainer,
right? And osteoporosis is not something
40 and 50 year old women think of because they're just
(23:19):
thinking about, oh, God, I'm, gaining some weight, my hair's falling
out. They're not thinking what's happening to silent things
like bone and heart. But it
pays dividends later. I don't know about you, but I want to be
an 80 year old woman who's still able to get on a stand up
paddle board and right, I
do.
>> Wendy Valentine (23:37):
I'll race you.
>> Dr. Maria Sophocles (23:38):
Yeah, I'll erase you. Right. And if one of us
takes estrogen from age 52 and up, and
one of us doesn't, granted there's family
history effects too. Genetics play into it.
But we can't change our genetics. But assuming
you and I have similar genetics, genetic risk. If
one of us takes estrogen from 52 to 82 and
(23:58):
one of us doesn't, I can tell you who will have the stronger
bones for sure. And who will break
something if she falls off that stand up.
>> Wendy Valentine (24:06):
That is so inspiring.
I did not know that. See, I love, I
love my own episode.
>> Dr. Maria Sophocles (24:13):
I love, I know, isn't it fun?
>> Wendy Valentine (24:14):
Like, a motivational workshop for me, like, oh, this is
so great. I did not know that. And I literally had
thought, here's another, you know, myth or whatever, is
that h, you know, HT hormone
therapy is only for the women that are really
having a hard time going through
perimenopause or menopause.
>> Dr. Maria Sophocles (24:33):
Well, it's for them too.
>> Wendy Valentine (24:34):
Because it's for them too.
>> Dr. Maria Sophocles (24:35):
But other things we have over the
counter things that actually do help with hot flashes.
We have, you know, sheets that can wick
away moisture. We have a little device called the
Ember Wave that actually is
incredible that you can wear Embr.
Embr Wave. And it, it works with the brain
to stop the hot flashes. And that's no
(24:58):
medication. So there's cool stuff out there. I don't
want to pretend there isn't.
>> Wendy Valentine (25:02):
Right.
>> Dr. Maria Sophocles (25:03):
But. But nothing works as well as
fast as a tiny, tiny bit of
estrogen. And, and so it's great for
that. But like I said, you're getting a double whammy because
you're also helping your slow down bone
loss and that kind of stuff.
>> Wendy Valentine (25:21):
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And now back to the show. At what point
do you know when it's time to start taking
hormone therapy?
>> Dr. Maria Sophocles (27:27):
Yeah. So if you're taking it for symptoms, the time to start when you
have the symptoms.
>> Wendy Valentine (27:31):
Right.
>> Dr. Maria Sophocles (27:31):
People ask me every day, can I take it? I'm only in
perimenopause, meaning I'm still having periods,
but I'm also having symptoms. That really
sucks. Like, that's the worst because you're kind of
still dealing with periods while you're already having
symptoms. And you can take, actually, a lot of
women use a birth control pill for that, which will soften the
symptoms and control your periods. Some women
(27:54):
do the patch and do proper HT
even then, so that's when you can start. The more
common question is, how long do. Can I be
on it? Or do I have to stop at a certain time and
I tell people, you know, think of it like you would
sunblock. Nobody says, wende, I, want you to use
sunblock till you're 53. Make sure you don't get skin
cancer. After that, it doesn't really matter. Not true.
(28:16):
As soon as you expose yourself to the sun, you're
damaging that skin. Same thing. As soon as your body
is devoid of estrogen, you
are having problems. Your, coronary arteries are
affected, your brain neural pathways are affected, your bone
is affected. So you tell me, when would you like that
damage to start? I don't want it to start. Ever.
>> Wendy Valentine (28:37):
Yeah.
>> Dr. Maria Sophocles (28:38):
So, the best thing we could do is when we're
a year out from no periods. That's when we can
safely say, hey, those ovaries are quiet.
They're not making stuff, and it's not coming back.
And that is when the big loss of
bone begins. The most rapid loss
of our bone mineral density happens in the
(28:58):
first five years. After that, menopause.
After menopause begins. So if. If you're only going
to use it for five years. If you said, I don't care what Maria
Sophocles says, I'm only using it for five years. Use
it for those five years. Yeah, so that you can
stand a paddle board at 80.
But me, I will keep using it because,
(29:19):
frankly, after five years, the, the
degradation restarts. And I'd
like to keep my bones as strong for as long as
I can.
>> Wendy Valentine (29:28):
What about the progesterone, then? Is that so?
>> Dr. Maria Sophocles (29:31):
Why do I keep just saying estrogen? because
the progesterone is not helpful
to our bones. It doesn't. I mean, as far as
a research today knows, 10 years from now, they may find it helps.
But what we know is the bones are full of estrogen
receptors, and they need those estrogen receptors
to make new bone cells and to,
(29:51):
make the cells that clean and clear out the bone. Estrogen
helps calcium metabolism, so estrogen helps
our bone in several ways, and we just
don't. I have never read about
progesterone benefits. so you take
progesterone for a couple reasons. Number one, it does help you
sleep. We know that it clears the brain. It's like a
whiteboard eraser. So when you get in bed and you've got
(30:13):
80 things on your brain, it's progesterone. That
clears, cleans it out so you can fall
asleep and stay asleep. And so when we lose
progesterone, that's why sleep is so disturbed for
so many women. But the safety
reason for progesterone is that in the uterus,
estrogen and progesterone are yin and yang. You need
both to grow tissue and stop
(30:35):
growing tissue. That's how we have a period.
But when you're menopausal, you don't want to grow any tissue in
there. And if you just take estrogen, you'll grow
tissue and it could even become abnormal tissue.
So you never want to have a uterus. Take estrogen, feel
better, but no progesterone. You need the progesterone so
the uterus is shushed and doesn't grow tissue.
(30:55):
Does that make sense?
>> Wendy Valentine (30:57):
It totally makes sense.
>> Dr. Maria Sophocles (30:59):
All right. It's a little weird to understand.
>> Wendy Valentine (31:00):
So always, the recommendation is,
yes, keep taking the estrogen, but the
progesterone, keep taking as long as you.
>> Dr. Maria Sophocles (31:08):
Have a uterus, you got to keep taking it because again,
no matter how. Yeah. They go
both till the end. When you come off of one, you come
off of both. If you said to me, I'm, going to do it till
70, because I just feel like that you don't just
stay on one, you just come off of both.
>> Wendy Valentine (31:27):
Now, question for you, because there's a lot of companies out there
now where you can just order the cream
or the pill or the pad, whatever.
Right?
>> Dr. Maria Sophocles (31:36):
Yeah.
>> Wendy Valentine (31:37):
Is there a difference between what
they would just send to you
and you start applying that
versus having one that is made
specifically according to your test
results. According to like, maybe I have more
or less estrogen or progesterone, does it really matter?
>> Dr. Maria Sophocles (31:56):
Yeah, great question. And there's a whole, not
very ethical kind of world that's come up that
preys on that. Oh, you need all kinds of test results.
And, and, and I, it's, I got to order and then follow
and track your blood. You don't have to. The former is
actually the right way to do it. Whether it's getting it through a doctor's
office or a very well respected
telemedicine company like Midi,
(32:18):
Midi, or
Evernow or Alloy. These employ
board certified doctors and nurse practitioners who
use FDA approved, estrogen and
progesterone. Now, I get asked all the Time. Oh, I want
bioidentical. That is bioidentical.
So bioidentical estrogen is made by
big pharma companies. I'm going to say it again because people
(32:40):
don't believe it. They think it has to be some custom
made estrogen dominance
estriol thing. That's bs. You don't need
any of that. You need bioidentical
estrogen. It's called estradiol D I
O L. That is bioidentical estrogen.
And all the bioidentical estrogen you
could ever want is made FDA approved
(33:02):
formulations by big pharma companies. You can order your.
You're wherever you get it, you can pick it up from Walgreens,
cvs, wherever. So you do not need
specially customized stuff for
estrogen or progesterone. You do not need trochees
where they're mixed together. You do not need pellets. You can
go again online and have an
appointment and they'll send, you know, and get a
(33:24):
patch or a gel of estradiol.
the only blood work. I'm not saying there's zero blood work.
The blood work we use the most is with testosterone
because we don't have a classic formulation.
We have to draw your blood to make sure you're in a safe
range. But really the blood work for the
estrogen progesterone is it.
(33:45):
You don't need it repeated and repeated. If I give you
a patch, I know that that patch because
it's been studied so much, your levels are going to be in
a safe range. I'm treating the symptoms
or I'm treating your bone health preventatively. And
the patch does it without any need for levels.
And that's strange, you know, like. It is.
>> Wendy Valentine (34:07):
Yeah, I mean, I'm learning a lot about this right now.
Just with. And I had, I did. why not
win? Wynonna. Wynonna. I think it's another one
of those companies where, you know, you meet with a
doctor and then they'll just. You kind of tell them
your symptoms and then they'll just send you the cream
or the patch or whatever.
>> Dr. Maria Sophocles (34:26):
Yeah.
>> Wendy Valentine (34:27):
So there's really no, like, the formulation is going to
be the same.
>> Dr. Maria Sophocles (34:31):
Predictable. Yeah. The patch comes in about five
different doses and we change the dose based on
symptom control. We don't, you know, in other words, we don't
change it based on your blood levels. We change it
because I gave you a dose. Let's say I gave you the
middle dose and you and I talk Again in a month. And you
say, you know, my hot flashes are 10% better, but I was kind of
(34:51):
hoping for better control in that. Wow. Sorry.
Okay, let's tweak the dose up.
Or I give you a dose and in a month we talk and you say,
I feel great, but my breasts are really swollen
and tender. I hate it. Oh, sorry. I think we better
try a slightly lower dose. Notice I didn't say,
let's get your blood drawn and see the numbers. I'm
training you by listening to you because
(35:14):
all those doses will help your bone. So
for symptoms, I just want the one that covers the
symptoms the best. yeah,
I mean, there is place for blood work in medicine for sure,
but you don't. If you're going to a clinician
or a hormone center or
longevity center and they're just drawing your blood over and over
(35:34):
again and telling you about estrogen dominance and all
kinds of different estrogens, they're doing things they
don't need to do. That doesn't get you living
longer. That doesn't get you healthy on the stand up paddle board and
any better than me or
Winona sending you that patch.
>> Wendy Valentine (35:50):
Right. I can see, though, how women would
not end up getting HT because they think
that they would have to go get all this testing and the testing can
be expensive and like, oh, well, shoot,
well, then I guess I just won't do anything at all. And that's.
That's.
>> Dr. Maria Sophocles (36:05):
That's a shame. Yes. Yeah. And that's, that's
where social media and influencers can be
dangerous. When they say, I went to
Joe's hormone bar and all I
do is I get my blood work every three weeks. You know what she
doesn't tell you is Joe's making a ton of money
from that, from the labs. And I'm getting
(36:25):
everything balanced. And anyone who's using balancing,
be very aware. Or dominance. Estrogen
dominance. But that's not a medical thing. That
doesn't help your brain, bones, and heart. And
anyone who's prescribing different kinds of estrogen,
estronegates, estriol, those just get
turned into estradiol. So you don't. You don't need
that. All you need is estradiol. It's all you
(36:48):
need. And I think when you get it more,
it seems more fancy and more refined. It's not
giving you any health benefits. That's what this should be
about, right? How do I feel? Better? So that's all
you need, is the estradiol. And sure,
if someone Wants to draw your blood for it, have at it. But
truly, it's not changing the blood.
>> Wendy Valentine (37:07):
Not necessary.
>> Dr. Maria Sophocles (37:09):
No.
>> Wendy Valentine (37:09):
What do you think about the testosterone? I mean, where are they at
with all of that?
>> Dr. Maria Sophocles (37:13):
And I think it's great. I think in five to 10 years
we'll have an FDA approved testosterone. I think it's
insane that it's been overlooked. It almost got
approved by the FDA many years ago. It was one vote
shy. And that was just totally a shame.
And it was just someone in the FDA who said, I mean,
do women really need this?
>> Wendy Valentine (37:32):
I was going to say, had to have been a man.
>> Dr. Maria Sophocles (37:35):
I hate to tell you, but there were men and women in the room
and it's like, damn it, why didn't someone stand up and say yes?
but, it's coming, it'll, it'll happen. It's in the
works. But for you and I now, I think
it's, it's wonderful to have, I think it actually helps
us. And, and it's very safe. I've been using
it with my patients for probably 15 years. I have never had
(37:56):
anyone have a side effect ever.
but, and if you look at, even if you look at
trans patients, right, we're giving
genetic women high, high, high, high, high, high
doses of testosterone. And do they get
cancer from that? Nope. Do they get dangerous side
effects? No, they get a beard. But they're, they're, they're getting
that because we're giving them really high doses.
>> Wendy Valentine (38:18):
Right.
>> Dr. Maria Sophocles (38:18):
The doses you and I would take are a teeny fraction of
that. And yes, if we do a little too much, our
skin might get oily. We could get a chin hair. That's
not fun. But if you do, then you talk
to your clinician and go, I think this is a little too much for me.
And we back the difference.
>> Wendy Valentine (38:34):
Yeah, I'm trying to, I'm needing to shave every day.
>> Dr. Maria Sophocles (38:38):
I think if that's your side effect, you should speak up.
>> Wendy Valentine (38:41):
Yeah. What, what does it help with?
>> Dr. Maria Sophocles (38:43):
It helps. I think libido is, is the no brainer
that it helps with. but I find even women
have more energy and they build lean muscle mass
better. So if, if you and I go to a gym three times a
week and I have testosterone and you don't, I will
probably feel and see strength and
muscle differences. Now
again, we don't have a lot of
(39:06):
guidelines yet on what, you know, the powers that
be. The North American Menopause. Now it's called the Menopause
Society, the American College of Ob gyn. They're saying
we don't really want to be given women doses that do
that. We just don't know about the safety of that.
So, people, we need more studies. So what
experts like myself do is we give teeny, teeny little
(39:27):
doses compounded, and they're not going to.
They're not going to have the amazing energy and muscle benefits
as, as wonderfully as I'm painting. They're going
to nudge your libido. So you're lying in
bed, you put your head on your partner's shoulder, and it just feels a little
more masculine or feels a little more sexual.
You look at your partner mowing the lawn, your. Your neighbor
(39:47):
mowing the lawn, and you're like, damn, I didn't know. I didn't
realize he looked so good. You know, you're not going to rip
anyone's clothes off, but you're just more aware you're watching a
sexy scene on Netflix and you're like, aware
of the sex, you know, So, I mean,
that'll do for now.
>> Wendy Valentine (40:02):
It's a whole lot more arousal, right?
>> Dr. Maria Sophocles (40:05):
Yeah, you're more. You're more in. Tuned
to erotic stimuli. That's the easiest way I
can explain it. And what I tell women when I
give them the testosterone, I say, look, think of this as
the little receptors for erotic info in your
brain are kind of rusty and closed. The testosterone
is like this nice little lube that's going to go to your brain and sort
(40:26):
of open them up. You have to now
stuff those receptors with erotic
info. Books, magazines,
porn, audio porn.
If your listeners don't know what audio porn is, they should.
It's an unfortunate name, but I call it Oral
sex. A U R A L. Oral sex. Sex
for your ears. So you, you know, like a good
(40:48):
site is Quinn, right? You can go on Quinn, the
app. And there's stories in every flavor you can
imagine, from hot vampires to men on horseback
to, you know, lesbian sex to women and,
you know, bears or whatever you want, and you
find what is fun for you, and you climb
in bed and you just listen for 15 minutes and
(41:09):
that imagery, those
stories get stuffed into your brain and we are
like a savings account. Women store
erotic information so that
again, even if you're just washing the dishes and your
husband comes up or your partner comes up behind you and gives you a back
rub or rubs your scalp or whatever, it has
a different. It hits differently. You know what I mean?
(41:33):
So it helps. It really does. And the test.
>> Wendy Valentine (41:35):
And I would, I would guess then testosterone
naturally kind of starts to go down
as you m. Yeah. In menopause. Right.
So is that something that is just kind of like
a voluntary thing? It's not required, but you kind of
take it just to have a little boost?
>> Dr. Maria Sophocles (41:52):
Yes, yes. And even estrogen,
progesterone aren't required. I mean, you don't. You don't have to do
anything. You can age quote naturally. like I
said, I. But natural
aging involves acceleration
of deterioration.
>> Wendy Valentine (42:07):
Yes.
>> Dr. Maria Sophocles (42:08):
Right. So I. I'd be very careful about that
word natural. We do a lot of things, you know, you and I aren't
naturally aging right now with our lips, we both have lipstick
on. We made a decision that, we kind of. This is the vibe
we want to bring to our life. This is the color we want
our hair. This is, you know, whatever. And I would vote
that if you look at what estrogen does to
(42:28):
every single. Practically every single organ system in your
body, it's literally just keeping it
healthier, longer. And I sort of like
that idea. I just. I mean, walk. Walk into
a, old age center someday and see what
85 looks like for some people. And it's
not their fault. I mean, they didn't have the benefit of this. Even their
doctors maybe told them not to take this. And
(42:51):
their hip is fractured and they can't ever get out of bed again.
And I don't know, I'm like, they're.
>> Wendy Valentine (42:57):
Not doing stand up paddleboard, you know?
>> Dr. Maria Sophocles (42:59):
No, exactly. And, you know, I'm not trying to live to be
120. I just want the years that I
live and my patients live to be healthy
and agile and. And they can be with their kids and
grandchildren if they choose to have that. And be.
>> Wendy Valentine (43:12):
Can you, can you think of a patient that you've had
that was just an extreme case
of perimenopause menopause, just like the worst of
the worst symptoms. And then after starting
hormone therapy, just.
>> Dr. Maria Sophocles (43:27):
Her whole life changed when I cannot
think of one, but I can think of 10,000, you know?
Yeah, I think I've seen about 80, 90,000
patients in the last 30 years. So. So it's a lot
in my practice. I have a virtual practice, Wendy,
and I'm licensed in many states, so people from all
over the US and from other countries can find me.
(43:47):
And so that's what I do now. I don't.
I don't do surgery anymore. I just handled a,
tsunami of women. After my TED Talk came out,
it sort of went global. So people would find me in other countries and say,
hey, I'm in Argentina and I'm miserable. Can you help
me? Hey, I'm in Singapore and I'm not happy and I'm
in Portugal.
>> Wendy Valentine (44:06):
Can you help me?
>> Dr. Maria Sophocles (44:07):
Yeah, exactly. Exactly. And
it's fun in some cases even to do the visits in other
languages. I enjoy that. But certainly,
and in the U.S. you know, I have to be licensed in other states, so
I've gotten that. So now if someone in Texas or.
Or Utah or Connecticut calls me, I can actually
care for them. And, so that's
(44:28):
been great. So. So I do this all day long, is
listen and take in. What do you need? Do you need
acute help with perimenopause, or do you have a
family history of osteoporosis and you don't want to end up like your
mom and grandmom, you know? Or do you want to sand a paddle
board at 80 and we build a treatment plan for
you that may involve hormones, it may not.
(44:49):
Depending, you know, they. They're not for everyone. There are people who should
not take them. If you have an estrogen
receptor positive cancer, breast or
uterine, you can't take it. It's not for you. I'm sorry.
You just can't take it. but otherwise, there's very
few people who cannot, so almost everyone can.
>> Wendy Valentine (45:07):
Yeah. I can tell you they made a huge difference
for me. And I. I
ended up when I came, over to, you know, I live on
the island of Madeira.
>> Dr. Maria Sophocles (45:17):
Yeah.
>> Wendy Valentine (45:18):
And I ended up. I ran out of, the hormones
I was taking, you know, back in the States, and then I was like,
you know, I'll just. I'll just go without for a while.
Yeah, no, it did. It
didn't work out for a while.
>> Dr. Maria Sophocles (45:31):
How'd that work out for you?
>> Wendy Valentine (45:32):
It did not. Yeah, like, yeah, right. Was it Dr. Phil?
How's that working for you? Not very good.
The hot flashes came back and the night sweats
and the, my skin was dry and
my muscle tone, everything. I just
cranky and brain
fog. I couldn't, I was like, no.
(45:54):
I mean, it was almost trying to resist it. Trying to, like,
go the natural route, if you will. And I was like,
you know, well.
>> Dr. Maria Sophocles (46:01):
Again, that's for some people and they want it. And, for my
patients, I will meet you where you are if you say to
me, I don't care what you say. I'm scared. I don't want to get cancer.
I say, guess what? I don't want to get cancer either. I know
I won't get cancer from this. But if you're worried, let's find
a way to help you. What else is out there for bone strength?
Let's talk about, about axial
loading, about strength exercises that actually
(46:24):
help you reduce your risk of osteoporosis.
So if you don't want to take medication, what can we do
nutrition wise? What can we do exercise wise? I mean,
there's, there's a lot of. How can we optimize your sleep?
Because if you sleep well, you are healthier. We know that. and
you can combat hot flashes better if you've had good
sleep. So it's not only about hrt,
(46:44):
Obviously, I'm a fan, but I don't
ever shame or make someone feel like they're wrong.
If they say to me, I just don't want that, I say,
great, no worries. Let's. So let's, let's build on what would
be okay for you, and let's optimize your health that way.
So.
>> Wendy Valentine (46:59):
Yeah, well, I tell you, I feel good now. I
mean, it's, it's, it truly, it does make
a huge difference on your life and your sleep
and everything. So I'm, I'm for
it. And I love.
I was going to ask you that if you do work virtually.
>> Dr. Maria Sophocles (47:15):
So I almost only work virtually. I
have an office in Princeton, New Jersey. I have one in
New York and I've one in London. But, I don't, I don't
honestly use the offices that much because,
because people are like, well, you know, I'm in
Salt Lake City, and I would rather just do it by zoom. I'm like,
I don't blame you. I wouldn't want to fly. You know, why fly?
(47:35):
And every so often, I actually fly to my patients.
like, if I have a whole bunch of patients in one place, I call
them all and say, hey, I'm going to be in California next week for
three days. And we honestly, we get lunch or breakfast and we
have an hour meeting together in person, which is so
lovely. But then the rest is virtual. So it's kind
of medicine how I want. I would want it practiced on
(47:56):
me, meaning someone giving me an hour or two at
a time. It's just really been nice and it
lets women be heard.
>> Wendy Valentine (48:04):
And then you're able to just prescribe,
at a local pharmacy?
>> Dr. Maria Sophocles (48:09):
Yeah, yeah, I am, because I'm licensed. if for some reason
they're from a state where I don't have a license, I, I say, hey, can
you give me the name of your primary care And I talk to them and
say, would you mind ordering this? And it's never, never been an issue
at all. And in other countries, actually, it's, it's
even easier. So, it's great.
So, yeah, I have to, I have to do Portugal. I definitely need to.
>> Wendy Valentine (48:29):
I know, yeah, let's, let's have a hormone party over
here in Madeira, you know.
>> Dr. Maria Sophocles (48:35):
I know. Well, it's nice to educate it, really. I love
it. I love seeing women go, oh, my. Oh my
gosh, I didn't know. I've been suffering.
>> Wendy Valentine (48:42):
Yeah, I mean, see, there's stuff I learned today. I had
no idea.
>> Dr. Maria Sophocles (48:46):
That makes me so happy. I hope other people did too.
And I'm sure you'll post like my Instagram or my
website so people can find me. That's how I.
>> Wendy Valentine (48:55):
So where, where, where's the best place to find you?
>> Dr. Maria Sophocles (48:58):
My website is Maria
sophoclesmd.com and on that
website you can learn about the book and the TED Talk. You
can see I have a documentary film I'm working on
about sex and midlife. So people can learn about that.
They can learn about what I'm doing in Africa, trying to build a clinic
in Kenya, but also they can reach me as a
patient. There's a tab, I think, for patients, and
(49:20):
a way to connect with me there. sometimes people have
a quick question. They just post it on Instagram and say, hey, I.
I heard you and Wendy talking and I. That
prompted a question for me. And, you know, that's easy too. So
please DM me. Well, I'm not going to put myself. Just find me on
Instagram and message me on there or my website. I think that's the
easiest.
>> Wendy Valentine (49:38):
Yeah, yeah, yeah. And then the book comes out,
let's see, in February. That'll be go.
It'll, probably be available for pre order pretty soon. I think by
the time this airs, it might be ready for pre order.
I think, probably in August. And then,
what's, what's the name of the book?
>> Dr. Maria Sophocles (49:54):
The Bedroom Gap. The Bedroom Gap.
So the Bedroom Gap is this term, this concept
of, darn it, in midlife, more and more women have
lower sex drive and they're dry and sex is
painful. Men have Viagra. So they're like, I have a great
idea. Let's have really long sex for
like eight times a day. You know, and it's like,
(50:14):
wait a minute, I thought we were going to age in parallel.
So I think, the pharma industry hasn't really done
us any Service, the lack of research, the
fact that women couldn't be research subjects
till 1993. Crazy.
So we're lacking research. And
then culture sort of saying
(50:35):
it's for patriarchal pleasure. So I think you put
all that together, and you get this big bedroom gap. And the book. The
book really looks at all of that. It's part how to. It's
part how to have great sex and how to help yourself
be in the moment. It's a lot about mindfulness, and
it's a lot of cool kind of thinking, and I hope
people like it. I think they will. Yeah.
>> Wendy Valentine (50:54):
And I'll, definitely add the link in the show notes there
for that. So, so helpful. I'm so glad
you're doing what you do.
>> Dr. Maria Sophocles (51:01):
I am so glad you had me on. It has really been
fun to chat. I feel like, I just need a ticket to
Portugal now to go do it live. It would be fun. It'll
be fun.
>> Wendy Valentine (51:10):
Yeah. I want to teach a retreat here someday, so
that would be great. Right? I know.
>> Dr. Maria Sophocles (51:15):
Love it. I would love it.
>> Wendy Valentine (51:16):
Awesome. I have a great time. and Madeira is gorgeous.
>> Dr. Maria Sophocles (51:19):
Beautiful.
>> Wendy Valentine (51:20):
Is the most beautiful place, I think, on Earth. It is so
amazing. And the weather.
>> Dr. Maria Sophocles (51:25):
Help you do one there. If you'll come help me do mine in Greece,
so we'll just.
>> Wendy Valentine (51:29):
Yes.
>> Dr. Maria Sophocles (51:30):
Yeah. I'm in Greece doing them, so that would be really
fun.
>> Wendy Valentine (51:34):
Isn't that awesome? We. Yeah, we women have come
a long way.
>> Dr. Maria Sophocles (51:38):
We have. We have. I'm so glad we're here today. Thank
you so, so much for. For giving the
time.
All right.
>> Wendy Valentine (51:44):
All right. Thank you, everyone. Have a great day.
Did this podcast inspire you? Challenge you?
Trigger you to make a change or spit out your coffee
laughing? Good. Then there are three ways you can
thank me. Number one, you can leave a written review
of this podcast on Apple iTunes. Number
two, you can take a screenshot of the episode
(52:05):
and share it on social media. And tag me
Wendy Valentine. Number three, share
it with another midlifer that needs a makeover. You
know who I'm talking about. Thank you so much for
listening to the show. So get out there and be bold,
be free. Be you.
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