January 15, 2025 • 27 mins
This episode dives deep into the confusion surrounding menopause hormone therapy, discussing the historical stigma, outdated research, and contradictory medical advice women face. By understanding these complexities and advocating for themselves, women can navigate their menopause journeys with more confidence and clarity.
• Examination of outdated beliefs about hormone replacement therapy
• Discussion on the impact of the WHI study on public perception
• Insights on the inconsistencies in medical advice from doctors
• Analysis of misinformation in digital spaces, including social media
• Exploration of compounded hormones versus FDA-approved therapies
• Overview of emerging changes in menopause care, including specialization
• Suggestions for women on how to advocate for themselves
• Emphasis on the importance of community support and education
Links Mentioned in The Podcast
Menopause Society click HERE
International Menopause Society click HERE
Books I Recommend
Menopause Manifesto by Dr. Jen Gunter
Estrogen Matters by Dr. Avrum Bluming
You Are Not Broken by Dr. Kelly Casperson
I would love to hear from you! What did you think of the episode? Share it with me :)
Let's Be Friends
Hang out with Heather on IG @greenpalettekitchen or on FB HERE.
Let's Talk!
Whether you are looking for 1-1 nutrition coaching or kitchen coaching let's have a chat. Click HERE to reach out to Heather.
Did You Love This Episode?
"I love Heather and the Real Food Stories Podcast!" If this is you, please do not hesitate to leave a five-star review on Apple or wherever you listen to podcasts.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello everybody and welcome back to the Real Food
Stories podcast.
Today we're diving into a topicthat so many women are
frustrated by, and I thought itwas important to address this
because I talk to and coach many, many women in midlife and
(00:21):
going through the menopausetransition, and the frustrating
and confusing thing that we'regoing to talk about today is
hormone replacement therapy,which is now called menopause
hormone therapy, only just toadd to our confusion.
Now, why is there so muchconfusion about menopause
hormones in general?
And I know I've talked aboutthis in great detail on this
(00:45):
podcast.
I even have a whole course onthis topic called Nourish your
Menopause Journey, which, by theway, is relaunching in March,
and if you didn't take it thefirst round, please consider
taking it again.
It will give you the clarityand confidence and, I think,
peace of mind you need aboutyour menopause journey.
(01:07):
But back to hormones.
Why is there so much confusionabout hormones in general?
If you asked your friends a fewyears ago, it was very taboo to
say that you were even onhormones.
I had almost no friends sharingthe space with me back then.
No one talked about it andhormones just seemed risky.
(01:27):
I would have hoped by now thatwomen are past this fearful
thinking and I know that we cantalk more openly about being on
hormone therapy.
It's much more accepted now andwomen are more than ever open
to trying it, because hormonetherapy is really your best
(01:49):
solution for so many menopausesymptoms and perimenopause
symptoms.
It is well-tested, it'swell-studied and I'll say it
again, if I have to get pastthat old, outdated study from
the 2000s, it's been debunked.
So my question is why do somewomen get completely different
(02:12):
advice from their doctors, theirfriends or even what they read
online?
This is where the confusionbegins and ends.
Honestly, I think it's kind ofa mess.
I had one friend of mine whohas been using hormones for a
few years just tell me that herdoctor told her to go off of
(02:32):
hormones now that she is 60,while I have two other friends
who literally just startedtaking menopause hormone therapy
and they are both 61.
Some doctors prescribecompounded hormones despite
clear evidence that they are notsafe, and others stick rigidly
(02:53):
to outdated guidelines.
I'll say this again it'sconfusing, it's frustrating and
it leaves us wondering why can'twe just have one clear,
consistent answer aboutmenopause and hormones?
So today I'm tackling this headon.
We're going to explore why thisconfusion exists and how the
(03:13):
system is failing women andkeeping them scared.
Honestly, we'll discuss thelack of training for doctors,
the lingering fears surroundinghormone therapy and the
inconsistent interpretation ofthe guidelines.
By the end of this episode, Iwant you to feel like you have a
better understanding of thiscomplex issue and, most
(03:34):
importantly, know how toadvocate for yourself moving
forward.
Because here's the thingmenopause is hard enough without
feeling like you're navigatingit blindfolded.
So let's pull back the curtainand figure this out together.
All right, let's start with thebig question why is there so
much confusion about hormones inmenopause?
(03:54):
There's no single answer, butthere are a few key factors that
all work together to createthis perfect storm of
misinformation and mixedmessages.
First, let's talk about the lackof education among doctors.
Many physicians, especiallythose trained decades ago,
received little to no formaleducation about menopause or
(04:17):
hormone therapy.
Women's health as a specialtyhas historically been
underfunded and underprioritizedin medical training, and
menopause, being a naturaltransition, was often overlooked
entirely.
And let's not forget thegenerational biases.
For years, the approach tomenopause in medical school was
(04:39):
often about simply managingsymptoms rather than
understanding how to trulysupport women through this stage
of life.
I have talked about my ownpersonal story with my general
physician, who told me when Imentioned hormones to her years
ago, she told me that she wouldrather be in jail than go on
(05:01):
hormones.
She was very misinformed.
I don't talk to her abouthormones anymore and I wonder if
she's changed her tune,hopefully but that back then she
thought that hormones were verydangerous.
We know much better now, becausethen there's the fallout from
the 2002 Women's HealthInitiative study.
(05:21):
This was a turning point thatcannot be overstated.
The study linked hormonetherapy to increased risks of
breast cancer, heart disease andstroke, and it caused
widespread panic among bothpatients and doctors.
What was the issue?
The study was deeply flawed.
It used older formulations ofhormones at higher doses and
(05:45):
focused on women who were, onaverage, in their mid to late
60s, long past the typical onsetof menopause.
Modern studies have since shownthat hormone therapy is
generally safe and effective formost women when started within
10 years of menopause or beforethe age of 60.
Started before the age of 60,not end at age 60.
(06:08):
But by the time theseclarifications came out, the
damage was pretty much done.
The fear was embedded in thispublic psyche and many doctors
still haven't updated theirunderstanding of the research.
And what makes this worse isthat patients often trust their
doctors to have the latestinformation, and when they don't
(06:29):
, confusion grows.
Imagine one doctor saying toyou hormones are safe and
beneficial, while another warnsyou to avoid them completely.
I mean that still goes on rightnow.
This disconnect creates aripple effect of uncertainty and
women are left wondering who doI believe?
Finally, let's talk about themisinformation on the internet.
(06:50):
While access to healthinformation has been empowering
in so many ways, it's also adouble-edged sword.
Social media is full ofinfluencers, wellness gurus and
even doctors promotingconflicting messages about
menopause and hormones.
Some push quote-unquote naturalalternatives that lack
(07:10):
scientific evidence, whileothers oversimplify the science
to fit their brand or product.
It's no wonder women areoverwhelmed.
They're being pulled in everydirection and it's hard to know
which path is the right one.
So, to sum up, the confusionand where it started.
This comes from a combinationof outdated doctor training,
(07:32):
lingering fear from flawedstudies and an overload of
conflicting information online.
It's a perfect storm andunfortunately, women are just
caught right in the middle.
Now let's dig into another majorfactor contributing to this
confusion the disconnect betweenmedical guidelines and how they
are actually applied inpractice.
(07:53):
You'd think that clearguidelines would give us clarity
, but instead they often add tothe confusion.
Why?
Because they leave room forinterpretation.
For example, guidelines fromorganizations like the Menopause
Society, which was formerlycalled the North American
(08:14):
Menopause Society, so you mightstill see it worded like that.
Guidelines from the MenopauseSociety recommend hormone
therapy for most healthy womenunder 60 or within 10 years of
menopause.
But what happens if you're 61and you're otherwise healthy?
Some doctors interpret theguidelines strictly and treat 60
(08:36):
as a hard cutoff.
But that's not what theMenopause Society says.
They say that it is up forinterpretation and if you are
healthy, you can stay onhormones.
So then there is those otherdoctors who take a more nuanced
approach, considering theindividual patient's health and
symptoms.
(08:57):
This is so inconsistent becauseit leads to wildly different
advice for women in similarsituations, and another issue is
that not all doctors keep upwith the latest updates to these
guidelines.
The medical field evolvesrapidly, and unless a doctor is
actively engaged in menopausecare, they might be relying on
(09:18):
outdated information.
This can mean telling a womanto stop her hormones at 60
because that's what they learned20 years ago, even though
current guidelines say it's notnecessary for many women.
And then there's the influenceof personal bias.
Doctors are human, after all.
Their own experiences, theirtraining, even their comfort
(09:41):
level with hormone therapy canshape these recommendations.
Meaning even their comfortlevel with hormone therapy can
shape these recommendations.
Some doctors are still hesitantto prescribe hormones because
they remember the panicsurrounding the WHI study the
Women's Health Initiative studywhile others are more open
because they've seen thebenefits firsthand.
This variability creates apatchwork of care that leaves
(10:03):
women wondering why is mydoctor's advice so different
from what I've heard elsewhere?
And lastly, we have the issuesof compounded hormones, which
adds another layer of complexityand confusion.
Compounded hormones arecustom-made formulations that
some doctors prescribe as analternative to FDA-approved
(10:27):
hormone therapy.
Compounded hormones are oftenmarketed as natural or
bioidentical.
You have probably heard thesewords out in the world of
women's health.
But here's the problem they'renot regulated in the same way as
standard therapies.
That means their safety,efficacy and dosing really can
(10:49):
vary widely.
They're not FDA approved, andthe FDA is the gold standard for
drugs and medications.
Now there's also a widespreadbelief that compounded hormones
are safer because they'remarketed as natural.
But in reality compoundedhormones come with significant
(11:10):
risks.
Without FDA oversight, there'sno guarantee of consistent
dosing or purity, which can leadto unpredictable effects.
The irony here is that manyFDA-approved hormones are also
bioidentical, meaning they arechemically identical to the
hormones your body produces.
So did you hear that?
(11:31):
I want to make sure thateveryone listening hears that,
because a lot of women come tome and they think bioidentical
is more natural and better.
But many FDA-approved hormoneformulations are bioidentical,
so you can feel okay taking theFDA-approved medications.
(11:52):
These options have undergonerigorous testing and are much
safer than compoundedalternatives.
Unfortunately, many women stilldon't realize this and they
turn to compounded hormones,thinking they're making the
safer choice, when the oppositeis often true.
All right, I don't want toberate this point, but I have to
(12:13):
say one more thing about thisthat the availability of
bioidentical hormones throughnaturopaths and alternative
health providers only addsanother layer of confusion.
While these providers oftenhave the best intentions,
sometimes they may not alwaysfollow the same evidence-based
practices as mainstream medicine.
(12:34):
This can lead to women beingprescribed treatments that sound
appealing but again lack thescientific backing to ensure
their safety and effectiveness,lack the scientific backing to
ensure their safety andeffectiveness.
So this disconnect betweenguidelines and practice leaves
women totally confused again andfrustrated.
How can you trust the adviceyou're getting when it varies so
much depending on who you see?
(12:55):
And how do you know if yourdoctor is truly up to date or
influenced by outdated studiesand biases?
These are the questions that somany women are grappling with,
and they highlight the urgentneed for better education and
consistency in menopause care.
Now let's shift gears and talkabout how misinformation one of
(13:18):
my favorite subjects, and themarketing machine behind it,
exploits women's fears aboutmenopause and aging.
This is one of the biggestreasons we're seeing so much
confusion about hormones, andit's a problem that extends far
beyond the medical field.
Again, let's talk about thatword natural for a minute and
(13:39):
talk about how the word naturalis used in marketing.
You see it in food, you see iton food labels, you see it on
medications.
It's everywhere right.
Products marketed as natural orplant-based are often framed as
a safer or healthier alternativethan FDA-approved medications.
(14:00):
Even when you see the wordnatural on food products, you
think that they are healthier,but the word natural is really a
meaningless term.
Compounded hormones, forexample, are sold as natural
bioidenticals, which make themsound superior to standard
hormone therapy, but, as wediscussed earlier, compounded
(14:21):
hormones are not regulated andtheir safety and efficacy are
not supported by robust clinicalevidence.
The term natural is just amarketing buzzword designed to
tap into our fears aboutsynthetic or pharmaceutical
products.
Now the same thing happens evenwith supplements.
Walk into any health food storeor Whole Foods, or scroll
(14:44):
through social media and you'llsee countless supplements
claiming to balance hormones,boost your energy, reverse aging
.
These claims are rarely backedby solid science, but they're
incredibly appealing becausethey promise an easy,
one-size-fits-all solution tocomplex problems.
And, let's face it, whowouldn't want an easy fix when
(15:06):
they're feeling overwhelmed?
So I want to talk about thisrole of fear in all of this.
Women in midlife are oftenbombarded with messages that tap
into their deepest insecuritiesour fear of aging, our fear of
weight gain, our fear of justlosing our vitality.
These fears make us morevulnerable to buying products
(15:30):
that promise, to quote, fixmenopause, even when those
products aren't proven to work.
So, whether it's a supplement,a cream, a detox program, the
marketing is designed to make usfeel like we need it to stay
healthy, beautiful and relevant,because women in their 50s and
(15:51):
60s going through this menopausejourney can really start to
feel invisible sometimes.
And then let's throw in theinternet, social media platforms
and wellness influencers havebecome hotbeds of misinformation
.
Some of these influencersgenuinely believe in what
they're promoting, but othersare simply capitalizing on the
(16:12):
menopause conversation to sellproducts.
The problem is, it's incrediblyhard to tell the truth and what
you are supposed to believe.
So where does that leave us?
If the current state ofmenopause care feels like a
confusing maze, what does thefuture hold for us?
I think, thankfully, there's areason to feel hopeful.
(16:34):
We're almost like sifting like.
It's almost like sifting flourthrough a colander.
We're getting rid of some ofthe not so desirable things and
we're highlighting the thingsthat are really starting to work
.
And the conversation is growing.
And as the conversation aroundmenopause grows louder, we're
starting to see really promisingchanges.
(16:56):
I feel hopeful about this and afew shifts that could transform
the way women experience thisstage of life.
Transform the way womenexperience this stage of life
Now.
One of the biggest shiftshappening right now is the
growing emphasis on education,specialization in menopause care
.
So organizations like theMenopause Society and I will put
a link to them in the shownotes so you can go on there and
(17:21):
they've got lots and lots ofreally good, credible
information, but they areleading the charge by certifying
healthcare providers inmenopause medicine.
My gynecologist, for example,is certified through the
Menopause Society.
That's how I found her.
I went onto their website.
They have a whole database ofpractitioners and you can find
(17:43):
your own doctor too.
This ensures doctors areequipped with knowledge that
they need to guide theirpatients confidently and
accurately.
So imagine a world where everygynecologist or primary care
provider has a deepunderstanding of menopause and
doesn't shy away from discussinghormone therapy.
That's where we're headed, butwe're not there totally yet.
(18:07):
Another exciting developmentthat I see on the rise is the
beginnings of personalizedmedicine.
Researchers are beginning toexplore how a woman's genetics
from medical history andlifestyle can inform more
tailored approaches to menopausecare.
For example, we might soon seetools like genetic testing
(18:28):
playing a role in determiningwho would benefit most from
hormone therapy or otherinterventions.
While this field is definitelystill in its early stages, it's
a glimpse of a future where careis not only more effective but
also more empowering for women,and technology is definitely
playing a role here.
Apps and telemedicine platformsdedicated to menopause are
(18:52):
emerging, providing women witheasier access to expert care.
Imagine being able to connectwith a menopause specialist
through a video call or trackyour symptoms in an app that
offers personalizedrecommendations.
This is the kind of innovationthat is beginning to make
menopause care more accessible,especially for women in rural
(19:13):
areas or underserved areas orwho cannot get access to good
medical care.
But perhaps the most encouragingchange that's happening right
now that I see is on a culturallevel.
Menopause and taking hormonesfor menopause symptoms is
finally starting to lose itsstigma.
(19:34):
Women are talking about itopenly, sharing their
experiences and demanding bettercare.
I see this all the time.
Like I said at the beginning,10 years ago, when I was on
hormone therapy, none of myfriends were.
No one was talking about it,and that's when I started
getting really interested inthis field, because not only was
(19:56):
I going through it, but so manywomen were not talking about it
.
It was a big, deep, dark secret.
But that's changing.
Celebrities, authors, advocatesare shining a light on
menopause, making it a moremainstream topic rather than a
taboo one.
The more we normalize theseconversations, the harder it
(20:17):
will be for outdated practicesand misinformation to persist.
So, while the present mightfeel frustrating, the future of
menopause and the future ofhormones is really looking
brighter.
I think.
I'm encouraged.
I feel very positive about it.
It's just up to all of us tokeep pushing for changes, to ask
questions, demandevidence-based care and support
(20:40):
organizations that are workingto improve the system, and to
let go of those social mediainfluencers, supplements that
promise a one-size-fits-all fixand really learn to advocate for
yourself.
Okay, so we've unpacked whythere's so much confusion about
(21:00):
menopause and hormones.
Let's talk about what you cando to navigate it.
While we can't fix the systemovernight but we are trying
there are concrete steps you cantake to cut through the noise
and advocate for yourself.
The first thing you need to dois to find the right health care
provider.
This might mean seeking out amenopause specialist or a
(21:21):
provider who's certified by theMenopause Society.
Again, link in show notes.
Don't be afraid to askquestions during your
appointments.
How familiar are they with thelatest research on hormone
therapy?
Are they comfortable discussingthe full range of treatment
options, including evennon-hormonal approaches?
The right doctor will welcomethese questions and not get
(21:45):
scared off, and they'll work tocreate a plan tailored to your
needs.
They'll work to create a plantailored to your needs.
Second, I want you to educateyourself with credible resources
.
In our age of totalmisinformation and there is a
lot out there.
It's critical to know where toturn for trustworthy information
(22:06):
.
Again, start withevidence-based organizations
like the Menopause Society, orthere's even another
organization called theInternational Menopause Society.
There's books written byrespected researchers or
clinicians, and that can lead tosome of its own confusion.
I've talked about this in otherepisodes, about how even some
(22:26):
doctors can take the reins andrun with it, because they know
that there's business inmenopause right now.
So we want to be careful.
When you see doctorsoverselling supplements and
diets and stuff, just be alittle wary of that.
But there are a lot of goodbooks out there that discuss
(22:49):
menopause, and I'll actuallylink a few of my favorites in
the show notes.
The third thing I want you to dois to just be cautious of those
quick fixes and marketing hype.
If a product or program claimsto balance your hormones
overnight or promises resultsthat sound way too good to be
true, it probably is.
So look for treatments andinterventions that are backed by
(23:12):
solid science, not justanecdotal success stories.
Remember, this is your healthand it's worth more than falling
for clever marketing.
And the fourth thing I want youto consider is to advocate for
transparency in your care.
If your doctor recommends atreatment, ask why.
What's the evidence supportingit.
(23:34):
What are the risks and benefits?
If your doctor advocates nottaking something, ask why.
Where's the evidence?
Where's the evidence that Ihave to go off of hormones at
age 60?
Where's the evidence that I canstay on hormones after 60?
This isn't about beingdifficult.
It's about being an activeparticipant in your own health
journey.
(23:55):
A good provider will respectyour questions and take the time
to answer them thoroughly.
So don't be afraid to ask forquestions and to speak up and
finally connect with a community.
You're listening to this podcast.
That's fantastic.
There's other women just You'relistening to this podcast.
That's fantastic.
There's other women just likeyou.
Listening to Navigatingmenopause can feel isolating,
(24:18):
but you're not alone.
So you can join a support group, like my online course, nourish
your Menopause Journey, which,again, I told you I'm starting
in March.
I'll have the link to that, too, in my show notes which, again,
I told you I'm starting inMarch.
I'll have the link to that, too, in my show notes and that
(24:39):
provides us with a unwaveringsupport of women who understand
exactly what you are goingthrough.
In that group, we shareexperiences, tips and even the
frustrations, and this can becredibly empowering to know and
feel like you are not alone inthis journey.
So, at the end of the day, you,and only you, are your own best
(25:00):
advocate.
By staying informed, askingquestions and pushing for the
care you deserve, you're helpingnot only yourself, but also the
women who will navigate thisjourney after you.
I think about my daughter, who'sonly in her 20s, but I want to
know that by the time she'sgoing through menopause, this is
(25:21):
not going to be the samemenopause experience.
She's going to have it veryeasy.
That's my hope.
Together, we can create afuture where menopause care is
clear, consistent and empoweringfor everyone.
So I hope this has been helpfulfor you and I really would love
to hear from you.
(25:41):
Drop me an email and let me knowabout your menopause hormone
experience.
Are you on hormones?
Are you considering taking them?
How do you feel about them?
Do you feel nervous abouttaking them?
Are you still caught up in theold studies where the belief is
that hormones are dangerous ornot safe?
Maybe you don't even havesymptoms to justify them, but
(26:04):
you're sort of hormone curious.
I'd love to hear from you andabout your experience.
So drop me a line.
All right everybody.
Thank you so much for tuning intoday and listening.
Know that you're not alone inyour menopause journey and your
hormone experience, and I can'twait to see you next week.
(26:25):
Have a great day.
Hello everybody and welcome back to the Real Food
Stories podcast.
Today we're diving into a topicthat so many women are
frustrated by, and I thought itwas important to address this
because I talk to and coach many, many women in midlife and
(00:21):
going through the menopausetransition, and the frustrating
and confusing thing that we'regoing to talk about today is
hormone replacement therapy,which is now called menopause
hormone therapy, only just toadd to our confusion.
Now, why is there so muchconfusion about menopause
hormones in general?
And I know I've talked aboutthis in great detail on this
(00:45):
podcast.
I even have a whole course onthis topic called Nourish your
Menopause Journey, which, by theway, is relaunching in March,
and if you didn't take it thefirst round, please consider
taking it again.
It will give you the clarityand confidence and, I think,
peace of mind you need aboutyour menopause journey.
(01:07):
But back to hormones.
Why is there so much confusionabout hormones in general?
If you asked your friends a fewyears ago, it was very taboo to
say that you were even onhormones.
I had almost no friends sharingthe space with me back then.
No one talked about it andhormones just seemed risky.
(01:27):
I would have hoped by now thatwomen are past this fearful
thinking and I know that we cantalk more openly about being on
hormone therapy.
It's much more accepted now andwomen are more than ever open
to trying it, because hormonetherapy is really your best
(01:49):
solution for so many menopausesymptoms and perimenopause
symptoms.
It is well-tested, it'swell-studied and I'll say it
again, if I have to get pastthat old, outdated study from
the 2000s, it's been debunked.
So my question is why do somewomen get completely different
(02:12):
advice from their doctors, theirfriends or even what they read
online?
This is where the confusionbegins and ends.
Honestly, I think it's kind ofa mess.
I had one friend of mine whohas been using hormones for a
few years just tell me that herdoctor told her to go off of
(02:32):
hormones now that she is 60,while I have two other friends
who literally just startedtaking menopause hormone therapy
and they are both 61.
Some doctors prescribecompounded hormones despite
clear evidence that they are notsafe, and others stick rigidly
(02:53):
to outdated guidelines.
I'll say this again it'sconfusing, it's frustrating and
it leaves us wondering why can'twe just have one clear,
consistent answer aboutmenopause and hormones?
So today I'm tackling this headon.
We're going to explore why thisconfusion exists and how the
(03:13):
system is failing women andkeeping them scared.
Honestly, we'll discuss thelack of training for doctors,
the lingering fears surroundinghormone therapy and the
inconsistent interpretation ofthe guidelines.
By the end of this episode, Iwant you to feel like you have a
better understanding of thiscomplex issue and, most
(03:34):
importantly, know how toadvocate for yourself moving
forward.
Because here's the thingmenopause is hard enough without
feeling like you're navigatingit blindfolded.
So let's pull back the curtainand figure this out together.
All right, let's start with thebig question why is there so
much confusion about hormones inmenopause?
(03:54):
There's no single answer, butthere are a few key factors that
all work together to createthis perfect storm of
misinformation and mixedmessages.
First, let's talk about the lackof education among doctors.
Many physicians, especiallythose trained decades ago,
received little to no formaleducation about menopause or
(04:17):
hormone therapy.
Women's health as a specialtyhas historically been
underfunded and underprioritizedin medical training, and
menopause, being a naturaltransition, was often overlooked
entirely.
And let's not forget thegenerational biases.
For years, the approach tomenopause in medical school was
(04:39):
often about simply managingsymptoms rather than
understanding how to trulysupport women through this stage
of life.
I have talked about my ownpersonal story with my general
physician, who told me when Imentioned hormones to her years
ago, she told me that she wouldrather be in jail than go on
(05:01):
hormones.
She was very misinformed.
I don't talk to her abouthormones anymore and I wonder if
she's changed her tune,hopefully but that back then she
thought that hormones were verydangerous.
We know much better now, becausethen there's the fallout from
the 2002 Women's HealthInitiative study.
(05:21):
This was a turning point thatcannot be overstated.
The study linked hormonetherapy to increased risks of
breast cancer, heart disease andstroke, and it caused
widespread panic among bothpatients and doctors.
What was the issue?
The study was deeply flawed.
It used older formulations ofhormones at higher doses and
(05:45):
focused on women who were, onaverage, in their mid to late
60s, long past the typical onsetof menopause.
Modern studies have since shownthat hormone therapy is
generally safe and effective formost women when started within
10 years of menopause or beforethe age of 60.
Started before the age of 60,not end at age 60.
(06:08):
But by the time theseclarifications came out, the
damage was pretty much done.
The fear was embedded in thispublic psyche and many doctors
still haven't updated theirunderstanding of the research.
And what makes this worse isthat patients often trust their
doctors to have the latestinformation, and when they don't
(06:29):
, confusion grows.
Imagine one doctor saying toyou hormones are safe and
beneficial, while another warnsyou to avoid them completely.
I mean that still goes on rightnow.
This disconnect creates aripple effect of uncertainty and
women are left wondering who doI believe?
Finally, let's talk about themisinformation on the internet.
(06:50):
While access to healthinformation has been empowering
in so many ways, it's also adouble-edged sword.
Social media is full ofinfluencers, wellness gurus and
even doctors promotingconflicting messages about
menopause and hormones.
Some push quote-unquote naturalalternatives that lack
(07:10):
scientific evidence, whileothers oversimplify the science
to fit their brand or product.
It's no wonder women areoverwhelmed.
They're being pulled in everydirection and it's hard to know
which path is the right one.
So, to sum up, the confusionand where it started.
This comes from a combinationof outdated doctor training,
(07:32):
lingering fear from flawedstudies and an overload of
conflicting information online.
It's a perfect storm andunfortunately, women are just
caught right in the middle.
Now let's dig into another majorfactor contributing to this
confusion the disconnect betweenmedical guidelines and how they
are actually applied inpractice.
(07:53):
You'd think that clearguidelines would give us clarity
, but instead they often add tothe confusion.
Why?
Because they leave room forinterpretation.
For example, guidelines fromorganizations like the Menopause
Society, which was formerlycalled the North American
(08:14):
Menopause Society, so you mightstill see it worded like that.
Guidelines from the MenopauseSociety recommend hormone
therapy for most healthy womenunder 60 or within 10 years of
menopause.
But what happens if you're 61and you're otherwise healthy?
Some doctors interpret theguidelines strictly and treat 60
(08:36):
as a hard cutoff.
But that's not what theMenopause Society says.
They say that it is up forinterpretation and if you are
healthy, you can stay onhormones.
So then there is those otherdoctors who take a more nuanced
approach, considering theindividual patient's health and
symptoms.
(08:57):
This is so inconsistent becauseit leads to wildly different
advice for women in similarsituations, and another issue is
that not all doctors keep upwith the latest updates to these
guidelines.
The medical field evolvesrapidly, and unless a doctor is
actively engaged in menopausecare, they might be relying on
(09:18):
outdated information.
This can mean telling a womanto stop her hormones at 60
because that's what they learned20 years ago, even though
current guidelines say it's notnecessary for many women.
And then there's the influenceof personal bias.
Doctors are human, after all.
Their own experiences, theirtraining, even their comfort
(09:41):
level with hormone therapy canshape these recommendations.
Meaning even their comfortlevel with hormone therapy can
shape these recommendations.
Some doctors are still hesitantto prescribe hormones because
they remember the panicsurrounding the WHI study the
Women's Health Initiative studywhile others are more open
because they've seen thebenefits firsthand.
This variability creates apatchwork of care that leaves
(10:03):
women wondering why is mydoctor's advice so different
from what I've heard elsewhere?
And lastly, we have the issuesof compounded hormones, which
adds another layer of complexityand confusion.
Compounded hormones arecustom-made formulations that
some doctors prescribe as analternative to FDA-approved
(10:27):
hormone therapy.
Compounded hormones are oftenmarketed as natural or
bioidentical.
You have probably heard thesewords out in the world of
women's health.
But here's the problem they'renot regulated in the same way as
standard therapies.
That means their safety,efficacy and dosing really can
(10:49):
vary widely.
They're not FDA approved, andthe FDA is the gold standard for
drugs and medications.
Now there's also a widespreadbelief that compounded hormones
are safer because they'remarketed as natural.
But in reality compoundedhormones come with significant
(11:10):
risks.
Without FDA oversight, there'sno guarantee of consistent
dosing or purity, which can leadto unpredictable effects.
The irony here is that manyFDA-approved hormones are also
bioidentical, meaning they arechemically identical to the
hormones your body produces.
So did you hear that?
(11:31):
I want to make sure thateveryone listening hears that,
because a lot of women come tome and they think bioidentical
is more natural and better.
But many FDA-approved hormoneformulations are bioidentical,
so you can feel okay taking theFDA-approved medications.
(11:52):
These options have undergonerigorous testing and are much
safer than compoundedalternatives.
Unfortunately, many women stilldon't realize this and they
turn to compounded hormones,thinking they're making the
safer choice, when the oppositeis often true.
All right, I don't want toberate this point, but I have to
(12:13):
say one more thing about thisthat the availability of
bioidentical hormones throughnaturopaths and alternative
health providers only addsanother layer of confusion.
While these providers oftenhave the best intentions,
sometimes they may not alwaysfollow the same evidence-based
practices as mainstream medicine.
(12:34):
This can lead to women beingprescribed treatments that sound
appealing but again lack thescientific backing to ensure
their safety and effectiveness,lack the scientific backing to
ensure their safety andeffectiveness.
So this disconnect betweenguidelines and practice leaves
women totally confused again andfrustrated.
How can you trust the adviceyou're getting when it varies so
much depending on who you see?
(12:55):
And how do you know if yourdoctor is truly up to date or
influenced by outdated studiesand biases?
These are the questions that somany women are grappling with,
and they highlight the urgentneed for better education and
consistency in menopause care.
Now let's shift gears and talkabout how misinformation one of
(13:18):
my favorite subjects, and themarketing machine behind it,
exploits women's fears aboutmenopause and aging.
This is one of the biggestreasons we're seeing so much
confusion about hormones, andit's a problem that extends far
beyond the medical field.
Again, let's talk about thatword natural for a minute and
(13:39):
talk about how the word naturalis used in marketing.
You see it in food, you see iton food labels, you see it on
medications.
It's everywhere right.
Products marketed as natural orplant-based are often framed as
a safer or healthier alternativethan FDA-approved medications.
(14:00):
Even when you see the wordnatural on food products, you
think that they are healthier,but the word natural is really a
meaningless term.
Compounded hormones, forexample, are sold as natural
bioidenticals, which make themsound superior to standard
hormone therapy, but, as wediscussed earlier, compounded
(14:21):
hormones are not regulated andtheir safety and efficacy are
not supported by robust clinicalevidence.
The term natural is just amarketing buzzword designed to
tap into our fears aboutsynthetic or pharmaceutical
products.
Now the same thing happens evenwith supplements.
Walk into any health food storeor Whole Foods, or scroll
(14:44):
through social media and you'llsee countless supplements
claiming to balance hormones,boost your energy, reverse aging
.
These claims are rarely backedby solid science, but they're
incredibly appealing becausethey promise an easy,
one-size-fits-all solution tocomplex problems.
And, let's face it, whowouldn't want an easy fix when
(15:06):
they're feeling overwhelmed?
So I want to talk about thisrole of fear in all of this.
Women in midlife are oftenbombarded with messages that tap
into their deepest insecuritiesour fear of aging, our fear of
weight gain, our fear of justlosing our vitality.
These fears make us morevulnerable to buying products
(15:30):
that promise, to quote, fixmenopause, even when those
products aren't proven to work.
So, whether it's a supplement,a cream, a detox program, the
marketing is designed to make usfeel like we need it to stay
healthy, beautiful and relevant,because women in their 50s and
(15:51):
60s going through this menopausejourney can really start to
feel invisible sometimes.
And then let's throw in theinternet, social media platforms
and wellness influencers havebecome hotbeds of misinformation
.
Some of these influencersgenuinely believe in what
they're promoting, but othersare simply capitalizing on the
(16:12):
menopause conversation to sellproducts.
The problem is, it's incrediblyhard to tell the truth and what
you are supposed to believe.
So where does that leave us?
If the current state ofmenopause care feels like a
confusing maze, what does thefuture hold for us?
I think, thankfully, there's areason to feel hopeful.
(16:34):
We're almost like sifting like.
It's almost like sifting flourthrough a colander.
We're getting rid of some ofthe not so desirable things and
we're highlighting the thingsthat are really starting to work
.
And the conversation is growing.
And as the conversation aroundmenopause grows louder, we're
starting to see really promisingchanges.
(16:56):
I feel hopeful about this and afew shifts that could transform
the way women experience thisstage of life.
Transform the way womenexperience this stage of life
Now.
One of the biggest shiftshappening right now is the
growing emphasis on education,specialization in menopause care
.
So organizations like theMenopause Society and I will put
a link to them in the shownotes so you can go on there and
(17:21):
they've got lots and lots ofreally good, credible
information, but they areleading the charge by certifying
healthcare providers inmenopause medicine.
My gynecologist, for example,is certified through the
Menopause Society.
That's how I found her.
I went onto their website.
They have a whole database ofpractitioners and you can find
(17:43):
your own doctor too.
This ensures doctors areequipped with knowledge that
they need to guide theirpatients confidently and
accurately.
So imagine a world where everygynecologist or primary care
provider has a deepunderstanding of menopause and
doesn't shy away from discussinghormone therapy.
That's where we're headed, butwe're not there totally yet.
(18:07):
Another exciting developmentthat I see on the rise is the
beginnings of personalizedmedicine.
Researchers are beginning toexplore how a woman's genetics
from medical history andlifestyle can inform more
tailored approaches to menopausecare.
For example, we might soon seetools like genetic testing
(18:28):
playing a role in determiningwho would benefit most from
hormone therapy or otherinterventions.
While this field is definitelystill in its early stages, it's
a glimpse of a future where careis not only more effective but
also more empowering for women,and technology is definitely
playing a role here.
Apps and telemedicine platformsdedicated to menopause are
(18:52):
emerging, providing women witheasier access to expert care.
Imagine being able to connectwith a menopause specialist
through a video call or trackyour symptoms in an app that
offers personalizedrecommendations.
This is the kind of innovationthat is beginning to make
menopause care more accessible,especially for women in rural
(19:13):
areas or underserved areas orwho cannot get access to good
medical care.
But perhaps the most encouragingchange that's happening right
now that I see is on a culturallevel.
Menopause and taking hormonesfor menopause symptoms is
finally starting to lose itsstigma.
(19:34):
Women are talking about itopenly, sharing their
experiences and demanding bettercare.
I see this all the time.
Like I said at the beginning,10 years ago, when I was on
hormone therapy, none of myfriends were.
No one was talking about it,and that's when I started
getting really interested inthis field, because not only was
(19:56):
I going through it, but so manywomen were not talking about it
.
It was a big, deep, dark secret.
But that's changing.
Celebrities, authors, advocatesare shining a light on
menopause, making it a moremainstream topic rather than a
taboo one.
The more we normalize theseconversations, the harder it
(20:17):
will be for outdated practicesand misinformation to persist.
So, while the present mightfeel frustrating, the future of
menopause and the future ofhormones is really looking
brighter.
I think.
I'm encouraged.
I feel very positive about it.
It's just up to all of us tokeep pushing for changes, to ask
questions, demandevidence-based care and support
(20:40):
organizations that are workingto improve the system, and to
let go of those social mediainfluencers, supplements that
promise a one-size-fits-all fixand really learn to advocate for
yourself.
Okay, so we've unpacked whythere's so much confusion about
(21:00):
menopause and hormones.
Let's talk about what you cando to navigate it.
While we can't fix the systemovernight but we are trying
there are concrete steps you cantake to cut through the noise
and advocate for yourself.
The first thing you need to dois to find the right health care
provider.
This might mean seeking out amenopause specialist or a
(21:21):
provider who's certified by theMenopause Society.
Again, link in show notes.
Don't be afraid to askquestions during your
appointments.
How familiar are they with thelatest research on hormone
therapy?
Are they comfortable discussingthe full range of treatment
options, including evennon-hormonal approaches?
The right doctor will welcomethese questions and not get
(21:45):
scared off, and they'll work tocreate a plan tailored to your
needs.
They'll work to create a plantailored to your needs.
Second, I want you to educateyourself with credible resources
.
In our age of totalmisinformation and there is a
lot out there.
It's critical to know where toturn for trustworthy information
(22:06):
.
Again, start withevidence-based organizations
like the Menopause Society, orthere's even another
organization called theInternational Menopause Society.
There's books written byrespected researchers or
clinicians, and that can lead tosome of its own confusion.
I've talked about this in otherepisodes, about how even some
(22:26):
doctors can take the reins andrun with it, because they know
that there's business inmenopause right now.
So we want to be careful.
When you see doctorsoverselling supplements and
diets and stuff, just be alittle wary of that.
But there are a lot of goodbooks out there that discuss
(22:49):
menopause, and I'll actuallylink a few of my favorites in
the show notes.
The third thing I want you to dois to just be cautious of those
quick fixes and marketing hype.
If a product or program claimsto balance your hormones
overnight or promises resultsthat sound way too good to be
true, it probably is.
So look for treatments andinterventions that are backed by
(23:12):
solid science, not justanecdotal success stories.
Remember, this is your healthand it's worth more than falling
for clever marketing.
And the fourth thing I want youto consider is to advocate for
transparency in your care.
If your doctor recommends atreatment, ask why.
What's the evidence supportingit.
(23:34):
What are the risks and benefits?
If your doctor advocates nottaking something, ask why.
Where's the evidence?
Where's the evidence that Ihave to go off of hormones at
age 60?
Where's the evidence that I canstay on hormones after 60?
This isn't about beingdifficult.
It's about being an activeparticipant in your own health
journey.
(23:55):
A good provider will respectyour questions and take the time
to answer them thoroughly.
So don't be afraid to ask forquestions and to speak up and
finally connect with a community.
You're listening to this podcast.
That's fantastic.
There's other women just You'relistening to this podcast.
That's fantastic.
There's other women just likeyou.
Listening to Navigatingmenopause can feel isolating,
(24:18):
but you're not alone.
So you can join a support group, like my online course, nourish
your Menopause Journey, which,again, I told you I'm starting
in March.
I'll have the link to that, too, in my show notes which, again,
I told you I'm starting inMarch.
I'll have the link to that, too, in my show notes and that
(24:39):
provides us with a unwaveringsupport of women who understand
exactly what you are goingthrough.
In that group, we shareexperiences, tips and even the
frustrations, and this can becredibly empowering to know and
feel like you are not alone inthis journey.
So, at the end of the day, you,and only you, are your own best
(25:00):
advocate.
By staying informed, askingquestions and pushing for the
care you deserve, you're helpingnot only yourself, but also the
women who will navigate thisjourney after you.
I think about my daughter, who'sonly in her 20s, but I want to
know that by the time she'sgoing through menopause, this is
(25:21):
not going to be the samemenopause experience.
She's going to have it veryeasy.
That's my hope.
Together, we can create afuture where menopause care is
clear, consistent and empoweringfor everyone.
So I hope this has been helpfulfor you and I really would love
to hear from you.
(25:41):
Drop me an email and let me knowabout your menopause hormone
experience.
Are you on hormones?
Are you considering taking them?
How do you feel about them?
Do you feel nervous abouttaking them?
Are you still caught up in theold studies where the belief is
that hormones are dangerous ornot safe?
Maybe you don't even havesymptoms to justify them, but
(26:04):
you're sort of hormone curious.
I'd love to hear from you andabout your experience.
So drop me a line.
All right everybody.
Thank you so much for tuning intoday and listening.
Know that you're not alone inyour menopause journey and your
hormone experience, and I can'twait to see you next week.
(26:25):
Have a great day.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.