September 24, 2025 • 57 mins
Dr. Carrie Jones isn’t just another voice in the hormone space... she’s been prescribing and teaching HRT for over 20 years, and it shows. In this episode we cover some epic ground when it comes to perimenopause and hormone replacement therapy with straight talk on what works, what doesn’t, and why so many women are being dismissed or mismanaged.
We dig into the real differences between bioidentical vs synthetic hormones, why progesterone is usually the first to decline, how testosterone fits into women’s health, and the messy reality of managing symptoms when cycles start shifting all over the shop. Dr. Carrie shares the side effects to look out for, what doctors often get wrong, and why it’s okay (sometimes necessary) to 'cheat' on your GP.
If you’ve ever wondered whether HRT is safe, whether you're too young, too old, when's the best time to start, or why you’re still feeling flat on it, this is the conversation you've been waiting for.
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Episode Transcript
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Speaker 1 (00:01):
She said, it's now never I got fighting in my blood.
Speaker 2 (00:09):
I'm tiff. This is Roll with the Punches and we're
turning life's hardest hits into wins. Nobody wants to go
to court, and don't My friends at test Art Family
Lawyers know that they offer all forms of alternative dispute resolution.
Their team of Melbourne family lawyers have extensive experience in
(00:29):
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reach out to Mark and the team at www dot
test Artfamilylawyers dot com dot au. Doctor Carrie Jones, if
(00:54):
I wasn't looking forward to today's chat before, I definitely
am now welcome to Roll with the Punches.
Speaker 3 (01:00):
Oh my gosh, thank you so much for having me on.
Speaker 2 (01:03):
I'm feeling sprightly all of a sudden. I just told
you I was a bit under the weather and a
bit snuffly, and we've been chatting for like what three minutes,
and you've just pepped me right up. I've been laughing.
We've been talking about dogs and drawl and all.
Speaker 3 (01:16):
Of the things how great. It's the way to kick
off a podcast, that's for sure.
Speaker 2 (01:20):
That's what I think. That's what I think. Tell everyone
what your thing is. What's your thing?
Speaker 3 (01:25):
My thing is women's health and hormones, especially as women
had above forty years old. That's my thing.
Speaker 2 (01:31):
Step inside my office or hang on, I've stepped in yours.
I have stepped in yours. Yes, and all of my
listeners are leaning in there all every time I have
a conversation on this topic. Because I've just recently opened
the door on myself, I'm like.
Speaker 3 (01:46):
Oh, oh, we're here.
Speaker 2 (01:49):
Good. Great that it'll never have happened to me. I'm
just a kid and I've started sharing a bit of that,
and wow, you wouldn't be no surprise to you. But everybody,
everybody around my age, he's like, oh, tell me more.
All this is happening to me.
Speaker 3 (02:04):
And it's wild because at a certain age, so let's say,
puberty to about mid forties, all your doctor's appointments, all
the medical research, everything on social media is whether like
how to get pregnant or how not to get pregnant.
There seems to be no in between. It's very annoying,
(02:24):
and so women don't even know they can have hormone dysfunction,
imbalance things going on in their twenties, in their thirties,
in their forties, they're just like if it's pregnancy or nothing.
But so when they hit their forties, like for real,
hit their forties, yeah, they a lot of women have
already have hormone stuff going on, not even realizing it,
(02:45):
and then they slam into their forties. Congratulations, perimenopause, and
they're like, what just happened? But now we have a
lot of focus on it, Thank goodness. Now now it's
getting a lot more media, press books, social media, so
ready to talk about it?
Speaker 2 (03:01):
So good? How long? Like, what was your background and
how long have you been in specifically working in this,
especially perimenopause. Someone said that it's only really been a term
that's used the last five to six years. Is that right?
Speaker 3 (03:14):
It's been used, Actually, it's been used a lot longer
than that. It's just become popularized, especially on social media,
in the last couple of years. So, we've been a
doctor twenty years and I was in women's health and
hormones right from the get go. I on a minute,
you've been a doctor twenty years. Yeah, I'm forty eight,
so I've been a doctor twelve. I'm like, this chick's
half my age, So how is she even here? How
(03:37):
she even she even hit perimenopause? Yeah, I'm almost fifty. Woah,
wait I am now I'm in the thanks, I'm in enthrosy.
Speaker 2 (03:46):
Bit.
Speaker 3 (03:46):
I can got catfished. Everyone. It's the it's the congestion,
it's the snuffliness, it's blacks. The mucus has gone across
your eyes.
Speaker 2 (04:00):
Okay, carry on, I rudely interrupted.
Speaker 3 (04:03):
So well, I knew I wanted to be in women's
health and hormones my whole career. I did not get
the best up bringing in this. My health class when
I was way younger, was taught by the school football coach.
Well we American football coach, so you can imagine how
that went. Right, Like a random man who taught phized
(04:25):
and football and he was like, well, let me teach
you about health, and I thought, well, this is gonna
go well. So we didn't get a whole lot of education.
And when I got in medical school, I realized everybody
around me, all my friends, all my non doctor friends,
were like, I don't really know how the body works.
I don't really know, I had full grown women who'd
had multiple kids, and they're like, I don't even know
how the menstrual cycle works. I'm like, you got pregnant
(04:46):
multiple times. They're like, yeah, I don't know how. God
you know, God bless them. So I just kept going,
staying in the route. And as I got older, because
I graduated when I was twenty eight, so I did
a lot of hormones, a lot of perimenopause, but I
did a lot of all age hormones. And then as
I got older, my patients got older, my interests got older,
(05:07):
and once I hit forty four, forty four years old
was when I first noticed my first perimenopausal symptom. I
started not sleeping that great, and I didn't have immediate
recall my memory and I have an amazing memory of
a partially photographic memory, which has really helped me get
through medical school. And I went to open something on
my computer. I was like, I have a brilliant idea.
(05:28):
I'm gonna do this right now. Literally put my finger
to the computer and thought, what wait a minute, hold on,
what was I going to do? What was the brilliant idea?
And I knew in that moment what I was. I
knew it was. I was like, ah, hormones, they got me.
It got me, and I felt like you. I was like,
it's never gonna happen. I'm in the field, I know
(05:48):
what I'm doing. I take really good care of myself.
And I mean my newest symptom, which is very recent
the last couple months, I get ocular migraines, which is lovely.
So when you're hormone my hormone shift, I will lose
some vision. It gets like gray and specky in my
right eye. And when at first time it happened, it
(06:08):
happened a couple months ago. For the first time, it
helped being a doctor because I was like, I know
what this is. I can diagnose myself. It's not a tumor,
but also, what the heck is a terrible symptom? Who
thought of this? And I've had so many women come
out and tell me like me too, me too. I
started getting migraines or I started getting But the amount
of symptoms that kind occur at this age with hormone
(06:31):
changes coupled with life, just wild things you won't even
think of, like itchy ears and burning tongue and smelling
random things that don't exist, like, I'm why who thought
of this?
Speaker 2 (06:45):
Oh? Two things. One, Now I'm concerned that I'll need
to expect mogriines because I got magrines horrifically for months
lading into me fist getting a period is and that's adolescent,
So I will be surprised if that is something that
hits my world at some point. Would be super annoying
because they were awful, they were debilitating. They were like
(07:07):
twenty four hours in bed, throwing up every hour on
the hour, horrific. And a good friend of mine, she's
also going through and she's a little bit older than me.
I'm forty two now I've just gone on hit she'd
gone on a little bit before me. And in a
voice message we do back and forth voice message. It
was a great download for Wednesday. We call it shout
(07:30):
out to Vicki and she said, I am logging my
I'm up to symptom thirty because I was like, I'm
you know, I started HT. I've had some really great
like I really felt a huge lift from it, but
I'm still tired and I'm still having some really flat days,
(07:50):
like my mood still isn't amazing and She's like, symptom
number thirty, and I went, oh, that is nahly, and
my memory is always being a bit closer to your
new symptom memory.
Speaker 3 (08:04):
Rather than your prey memory.
Speaker 2 (08:06):
So I'm like, oh, I can't even remember if this
is normal for me or not normal anymore.
Speaker 3 (08:11):
You know, it's wild. It's so, I mean, obviously, a
lot goes into energy, and a lot goes into mood,
a lot of hormones. We have over fifty hormones in
the body, but estrogen, the main estrogen is called estradyle
e two, and estradile is a big supporter of all
things women's health. It is involved heavily in all twelve
(08:32):
systems of our body. But it's involved heavily in the
creation or direction or help for our neurotransmitters, which is
a fancy word for your brain hormones. So to make
brain hormones such as serotonin, which does play a role
with mood, to make hormones such as dopamine, which plays
(08:53):
a role in things like motivation, Estrogen plays a role.
And so women will notice their sen is wobbling or
going crazy or declining completely, and they'll notice their mood
at the same time. The amount of research papers that
are out now on women going through hormone changes, and
hormone changes can happen at any age. We're specifically talking
(09:15):
over forty perimenopause and in depression and anxiety and lack
of motivation, and the number of articles I'm reading now
of like is it ADHD or is it perry menopause?
Like why do I feel like I didn't have ADHD?
And I feel like I have it now? And now
we're having this really interesting debate on have you always
(09:37):
had it and it was underdiagnosed or is it newly
because the hormones are changing. And so for people listening
who are going, holy crap, yep, that's me, You're not crazy,
Like this is really how the brain and the body
can function. And then unfortunately you layer over stress life
right now right, diet, nutrition, habits, foundations, lack of sleep,
(09:59):
all the things, and that can perpetuate it to feel
like it's hitting your HODR.
Speaker 2 (10:04):
One hundred percent. I just had an episode that I
recorded with an old school friend from Tazy. So was
someone who went to school with and she reached out
last years. She started with sleep issues. Within one month,
she had admitted herself to a respite sentimental health respite center.
She did that twice. She ended up in a psych ward.
(10:25):
She ended up having shock therapy seven times. And then
after that she landed in the office of someone who
deals with perimenopause and menopause. They looked at her symptoms
and they said, why has nobody clocked this? And she's
been on HRT since then, and she's back down to
one antidepressant and on the path. And it's really like
(10:49):
that for me that I mean, that's a really intense story,
but how quick the decline is, yes, and how terrifying
the journey can be. Like I've got goosebumps now just
relaying that story. I'm like, oh, and there'd be so
many women that have a vision of that happening.
Speaker 3 (11:05):
I see it in my comments, I see it in
the DMS. I see it in emails that I get
from women who say, you are like, oh my, this
is the worst thing ever. My life is completely falling apart,
especially from a mental perspective, and no one has prepared them.
And what's interesting is there's this debate on why do
we go through this perimenopause into menopause, Like why don't
(11:28):
we just glide in gracefully like a princess, Like, why
don't we have to slam into it like a car
wreck for some women? Right, for some women. And there's
this whole thing of like, well, our mothers or our
grandmothers or other cultures didn't suffer, And I'm like, yes
they did. They did and didn't talk about it. They
did and were silenced and suppress they did, or were
(11:49):
told that, you know, buck it up, You're fine, it's
just what you have to do. They absolutely suffered. They
didn't have social media, and they were a quieter generation,
that old steady, whereas Gen X and the millennials are mauthe.
We are mauthy, and we have social media and we're
going to tell you about it. And so we're hearing
(12:09):
the truth. I think, I think it's opinion. We're hearing
the truth, true truth of ancestors before us, who are
just quieter and more you know, centered about it, even
though they suffered and we're not going to put up
with that.
Speaker 2 (12:25):
Yeah, well, they didn't have a platform, and like they
didn't have Holly. You don't go to your mate task
and go, hey, my hormones have lost their shit.
Speaker 3 (12:35):
You carry for tea and biscuits exactly, much more stoic,
much more stoic. They weren't talking about their you know,
their vaginal symptoms and they're how they feel crazy, and
you know that's that was just uncouth. You didn't talk
about that. Yeah, yeah, and now we don't care. Now
we tell everybody, Oh, I am leading the challenge with that.
I'm like hanging out the window.
Speaker 2 (12:58):
I know.
Speaker 3 (12:58):
I read an article about we have a brain hormone
called gabba. Gabba is our inhibitory neurotransmit or it calms
things down inhibbits. So we read this great article and
it says, is humans age, we lose gabba. So we
are so men and women doesn't matter, So we're prone
no more anxiety, maybe we don't maybe sleep as well.
(13:18):
But they said women get hit doubly hard because we
lose hormones that support GABBA, such as progest your own
and with age we lose gabba. And it was going
on to talk about how gabba again is like the
break system of the brain, and it talked about filters,
and I thought, oh, there it is. You know, you
hear of women hit a certain age and then they
just don't care what they say just comes right out
(13:39):
of their mouth. And I'm like, yeah, when you don't
have your break system, maybe you can't break your anxiety
or you can't relax to fall asleep. But you're also rageful,
angry your mouth never you know, you say what you
really feel, which can actually be quite liberating, you know,
if you've been stuffing it down and filtering for so long,
(14:00):
and now you can be your true self and let
it out. Just don't get arrested. Orange is not your color, right,
just just be mindful of like how it comes out.
But when women say this to me, I'm so annoyed.
I'm so angry, I'm so rageful. I'm like, yeah, girl,
your filter, your break is gone, let it out. Just
be you know, careful.
Speaker 2 (14:22):
Yeah, what can we talk about HT? Yeah, of course, good, bad, great, amazing.
So I mean, I'm a big fan and it depends.
I'm a big fan.
Speaker 3 (14:36):
Of the HRT. That is what like looks like our body.
So we have we have. Some people call it body identical,
some people call it bioidentical babies. Basically, it's estrogen, it's progesterone,
it's testosterone. It looks like what you make. Then there's
this synthetic which doesn't look like what your body makes,
(14:56):
but can bind to the receptors and be supportive, but
it can also come aside effects. So that's like the
birth control pill. That's like some of the some of
the metapausal treatments are synthetic estrogen synthetic what they're called progestins,
So you just have to be mindful of what you're on.
(15:18):
When we looked at the research study on the slight
risk towards breast cancer, it was a combination of estrogen
used with the progest stin, the synthetic or fake progesterone. Nowadays,
more people are leaning towards what's called the bioidentical estradiol
(15:39):
esterreiol progesterone way. In fact, all this study, most all
the studies looking at estrogens of some sort had less
breast cancer. It's only when you add in the progestin
that you get into a little bit of a bump,
a little bit of trouble.
Speaker 2 (15:57):
What might be the raisins look Abbott reasons why doctors
might suggest progestine or non biod bioidentical hormones or is
it a lack of maybe moving with the times or knowledge.
Speaker 3 (16:14):
Both The main reason is it's so common in the
birth control pill. It's so common in the progestin iud
or coil. It's so common there is I don't know
if you all have it there, but here we have
a very common form of it called pro Vera. And
because it's readily available and it's been around for a while,
(16:36):
if you've been if you're an old school doctor, then
you just write the prescription. Oh, perimenopause, go on the
birth control pill. Oh perimenopause, go on pro vera, this progestine,
whereas not even realizing that we have other options available,
or if they haven't gotten the education gone through training.
A lot of my you know, obg yn obgin doctor
(16:59):
friends are like, we did not get this training. I
could deliver a baby in the back of a car,
I could deliver an emergency situation, but managing menopause, we
did not get that training. I'm like, oh my gosh, yeah,
times are changing, but slowly.
Speaker 2 (17:13):
Yeah, yeah, what are some of the sad effix of
being on a progistant or a birth control top hormone
rather than.
Speaker 3 (17:24):
Ident So some women, I mean we all know somebody
or maybe we've had the done the birth control ourselves
and they you're just like some women love it, you know,
there's a time and a place, you know. They're like, oh,
that worked amazing, and others are like, hated it. It
made me lose hair, it made me break out, it
killed my sex drive, it made me depressed. I gained weight,
My GI track was a mess. I got heartburned, I
(17:45):
felt bloated. So because it's hormonal and hormones impact every
system in the body, it could be a plethora of symptoms.
I do still want to put the caveat on there.
Someone go in the birth control pill and have an
excellent time, they have no problem, but it is not
without risk. I always warn women like, hey, if you
get any of these symptoms, let me know if you're
(18:07):
on it. Yeah, and I'll be honest. The birth control pill,
you know, if you're in your forties or fifties, unless
you if you need it for birth control, that's one thing.
But I feel like we have much better options if
you don't need it for birth control. I think estra
dial like the real estrogen progesterone. The real progesterone, I
(18:29):
think is much much much better balanced, better suited for
what you're going through versus here just take the pill.
Speaker 2 (18:36):
And is there a time where we're too young to
be looking at being on HT or not? So you
too old?
Speaker 3 (18:46):
The thankfully the too old is a no. And it
depends which form of HRT we have. You know, we
have a couple hormones. We have the estrogens, we have progesterone,
we have testosterone, So which one are we Starting with women,
there are probably women in their twenties who have been
told to go on progesterone, real progesterone, like their body makes,
maybe their doctor has it, has them on progesterone for
(19:06):
something for fertility, for PMS, for heavy periods while they're
working to figure out why and what's going on. Usually
estrogen and testosterone are saved for a little bit later.
You don't usually hear of a twenty is somebody in
their twenties on estrogen or testosterone. It's not impossible, it's
just not common. Usually that's saved for the perimenopause menopause transition.
(19:30):
As far as too old, they used to say, yes,
they used to say ideally, may still say this. Ideally
you would start HRT within ten years of your last period,
so either before or after you get the maximum benefits.
And now they say, actually you can start HRT more
(19:52):
than ten years past your last period. So I have
women that will say, I'm maybe five and I have symptoms,
or I'm sixty five, I have simp can I do HRT?
And I'll say, as long as you have a good workup,
Because the concern is around the heart. Heart disease is
still the number one killer of humans. So let's get
your heart worked up, Let's get your cholesterol, let's make it,
(20:12):
see what your plaque situation is. And as long as
you're good and you don't have any of the any
major risks like ongoing cancer, then yes, you are. The
guidelines have changed and you can start HRT at least
the guidelines here in the States and the guidelines in
the UK have changed.
Speaker 2 (20:31):
And what with someone around that old age black seventy
eighty plus, what would the symptoms be.
Speaker 3 (20:40):
Yes, the most common symptoms I hear are either I
still can't sleep, I still get hot flashes and night sweats,
I still have brain fog, I still have mood issues,
and a lot of what we call genito urinary symptoms
vaginal dryness, pain with sex, chronic urinary TRAC infections, and
so they don't have the hormone anymore to make that area,
(21:03):
that tissue juicy and lubricated and happy. And so they'll say,
I keep I'm seventy, and I keep getting yease infections,
and I don't know why I keep getting treated for
urinary tract infections. Or it feels super dry and irritated
and itchy down there. Hormones can be the lack of hormone,
the lack of estrogen and testosterone or DHA play a
(21:25):
huge role. It's called genito urinary syndrome of menopause GSM,
and it's getting a lot more traction, Thank goodness, because
what happens is a lot of doctors who are hospitalists,
emergency room doctors, gerontologists. They realize that these women get
admitted to the hospital for urinary tract infections that quickly
(21:49):
become very significant and systemic. And if we can prevent that,
if we can reduce that risk by doing vaginal estrogens,
vaginal DTA, vaginal to STARSTERONN hallelujah, let's do it. Why
would we make them suffer? Oh?
Speaker 2 (22:07):
I love this conversation. When I was talking to my mom,
my own mum about HIT and in my own experience,
and I said to him, I feel like you should
have been on this, And so it was one of
the things I want to do and also one of
the things that made me think of it. She has
terrible sleep issues, she has for a long time, terrible,
but she also has chronic exma and she had as
(22:29):
hated as a kid. And I thought, and I wondered,
and I don't know what the answer is, maybe you know,
but when I was looking up some of the benefits
of estrogen, it was skin health, and I was like, well,
if someone like my mom should have been on that,
if that's something that she needed, maybe that would have
helped her skin as well. She has injections for her skin.
(22:51):
It's got to that point now where she's yeah, it's
quite debilitating. So that is a really interesting piece of information.
Speaker 3 (23:00):
Yeah. Yes, And unfortunately, since about two thousand and two,
the big study that came out that's called the Women's
Health Initiative. It's a big study that came out. It
made Time magazine, all the big magazines and the States
and it basically it was the research article that said
hormones cause cancer. Now, since that time, the main authors
(23:21):
have retracted a lot of that. A lot of studies
have come out realizing there were some serious mistakes in
that study, and that did not make the news. So
people are still stuck on the news of two thousand
and two, and we have some amazing articles since then
that the benefits can definitely far away the risks. I'm
(23:45):
not saying there's no risk, but we're finding when we
look at the ratio risk benefit like, the benefits really
are there. And again, like I said, women will worry
about breast cancer, and I'm like, there is a solid
chance heart disease. It's cardiometabolic disease. It's a break a hip,
you know, like Grammar breaks a hip. We all know, like,
(24:07):
oh no, Graandma broke a hip. This isn't gonna end well.
It's ending up in the hospital with chronic urinary tract
infections and then being on IVY and a by it
like that's going to get you. It's Alzheimer's dementia, Like
those are the things that are gonna get you. No,
I'm not downplaying breast cancer, but that to me, I'm
like that it's not the scariest thing. I do not
(24:28):
want to break a hip. I do not want to trip, fall,
break a hip, and end up in the hospital. And
that's where I stay. And I don't think women realize that.
Speaker 2 (24:37):
Yeah, And I think about the like the quality of
life if some people's symptoms are quite debilitating. Yeah, and
you get this marginal increase in risk on a maybe
with when we have a lot of control over lifestyle
factors that we can counter things like that with to
the best of our ability. But it's like, well, do
(24:58):
you want to not improve your experience of life now
for a just in case? Yes, because some terrible study
said so.
Speaker 3 (25:08):
Yes, that's been retracted and redone since then. Yeah, that's
the big issue. That's why I know, tell women there
could be a lot of benefit you're not even thinking about.
I was in the airport last weekend, flying to a conference,
and I watched this very frail, very elderly couple shuffling
(25:29):
to their gate and she just fell. I mean, she
just I don't know, she tripped over her feet. I
don't know if she bumped into I don't know what happened,
but all of a sudden I heard this giant thump.
It turned around and she was flat on her back
and I was like, oh my gosh, this is not
going to be end well. She ended up being on
my flight. I didn't realize it. We got on her flight,
(25:51):
and everyone rushed to a sister, you know. The airline
employees brought her a wheelchair, and of course adrenaline kicks in.
She's like, I'm fine, I'm fine, I just need to
go to the bathroom. My hip hurts and my dirty.
It was really sweet, you know, she was like, I
need to clean myself up. And so I ain't got
on my flight, not realizing she was also in my flight.
So as we land in the airport were supposed to be,
(26:12):
they said, can everybody please stay seated? We need to
have authorities or we need to have personnel enter the plane.
And so we're all watching because we're all curious cats.
It's like, who's getting arrested? Like what happened? You know,
And it turned out to be medical professionals and they
get on the plane and it was her, and then
she had to be carried off, and I thought, oh
my gosh, I bet I hope to goodness it's just
(26:34):
a bruise, but I hope she didn't break something. And
she just sat in that seat for five hours because
she looked so frail, and things like hormones other obviously
a lot plays into bone health, exercise, vitamin D, vitamin
K two, et cetera, glucose control, lifting weight to exercise,
but hormones do too, And I thought, Oh, my gosh,
(26:57):
what if she had broken her hip and just sat
there for five hours and didn't realize it. She was
up on adrenaline. The adrenaline came down and I was like, Oh,
people don't even realize that's a risk.
Speaker 2 (27:07):
Oh yeah, yeah, what about testosterone? Talk about testosterone entering
the conversation with Women's homod therapy.
Speaker 3 (27:16):
Yes, I am a big fan of testosterone. We don't
have testosterone in the States. I think you guys do,
but we don't, So we use it off label. We
use the men's version just we just use a much
smaller dose, or we get it specialty made at a
compounding pharmacy. I usually when I start hormones with women,
I start with progesterone first, it's the first hormone to
(27:37):
generally decline. Then I generally consider estrogen, and then I
generally consider testosterone. And the reason I go in that
order is because testosterone doesn't fall in all women at
the same rate. Some women maintain their testosterone pretty well
through their fifties into their sixties, then it starts to fall.
Other women lose their testosterone right away. And the reason,
(28:00):
and this is important, is if you jump on the
testosterone bandwagon and you don't necessarily need it, or you
probably should have done estrogen first, your body can There's
some research to show your body can get like a
misperception that you have an imbalance between testosterone and estrogen.
So you start a testosterone you have this really low
(28:21):
level of estrogen and the body goes, wow, that's a
lot of testosterone relative to estrogen, and it tends to
increase visceral fat around the middle as a result. So
you can get this, it'll shift where you store a
fat so you're a Lobido go up, which is great,
and your motivation might improve, which is great. But then
(28:41):
women go unfortunately, I'm also gaining weight around the middle,
and so it's not a guarantee. But I always just
say to women before I put you on testosterone, I
like to do blood work. I like to see your
levels of testosterone because I don't want that risk for you.
I don't want you to get the weight gain around
the center. So we're starting to see a little research
(29:04):
on that, and I've seen it with my own eyes
where women go, I don't have any libido. I went
on a lot of testosterone, and I had a libido,
and but also I gained weight. I'm like, ah, I know, wrong, order.
Speaker 2 (29:15):
Oh well, I started testosterone, I got my levels tested
and always tanked.
Speaker 3 (29:21):
Yeah.
Speaker 2 (29:23):
And I had a bit of a rant about it
because I couldn't believe that it wasn't a question like
I'd had conversations on the podcast with someone from the
States and he said, testostera check testosterone. It never gets
talked about, and so I went and asked about it,
and then I was just raging that they didn't test it, which,
based on what you've said, I understand, I can understand,
(29:44):
but there's no it wasn't a conversation that was had.
Speaker 3 (29:46):
Oh see, and I always test it. I just explained.
Some women will say, I don't have any libido, so
we'll check my hormones, and I always test it always
because if you need it, I'll give it to you, absolutely. Yeah,
But what will happen some times as women go I
have no libido, and they will just get put on
testosterone and then if they get side effects, I'm like, oh,
(30:07):
that could have been avoided. We could have easily managed
that if they would have just checked your levels. So
I'm always advocating go get your blood work, Go get
your blood work, ask ask for it. But it is
hard because it's for some reason, it's viewed as like
only a man's hormone. And I'm like, women have a lot.
Women have a lot of testart. We have more than
you think we need it.
Speaker 2 (30:29):
And for something that the symptoms are so debilitating, yes, yes,
Well can we not move on past the idea of
gender around hormones. I had another friend she got hers
tested after I was talking about it. So she went
had hers tested and she was lower than what I
(30:51):
mine mine initially was. But her doctor said, well, women
don't take testosterone, and I just thought, why'd you what
fucking til?
Speaker 1 (31:02):
Then?
Speaker 2 (31:03):
What did you test it for if you had no
intention to do anything about it?
Speaker 3 (31:08):
Such a disservice. It plays such a role, you know.
I mentioned libido, but motivation. Mood I had a piece
of hermonion. She called her a battery pack. She's like, oh,
my gosh, I power up. I have so much energy.
It's helpful for bones.
Speaker 1 (31:21):
Now.
Speaker 3 (31:21):
Just like any hormone, too much can cause side effects.
But if you're on the right amount, like you, you'll feel better.
You just feel back to yourself again.
Speaker 2 (31:29):
Yeah, yeah, what's the So when did I go on
I went on hrt in at the end of May
May the twentieth, okay, and I'd had it prescribed a
year before, and then I had to go and have
breast skins and all this thing. And then I went
off and I was just still in that exploration stage
(31:49):
of is this hormonal or have I just burned myself
out for forty years. I'd recently, for a couple of
years before, been diagnosed with ADHD. I was trying intermittently
trialing the stimulant medication. I was like, I don't know,
if this just ramps up my nervous system, maybe that's
what's training me. So there's all these questions. So when
I went off it to get these breast scans checked,
(32:12):
I thought, I'm just going to stop taking those stimulants
and I'm just gonna rest, fix my sleep and get
a baseline and just check. And then it was a
year later, and then I went back on the HRT
and then a month two months after that, I went
and got the testosterone added to it. What's the time
frame generally look like for people? And how smooth does
(32:35):
it tend to be in terms of getting symptom free
or is symptom free just an elusive dreams.
Speaker 3 (32:43):
A little bit of a trick.
Speaker 2 (32:44):
Is it just going to be symptom management and symptom
a little bit easy in this?
Speaker 1 (32:49):
Ah?
Speaker 3 (32:49):
Yes, and yes, some women absolutely kneel it. They're like,
I feel fantastic, I don't have any symptoms. This is great,
and other women is The conference I was just out
last week was hormones specifically hormone therapy conference, and so
it was great. On the panel, we had a bunch
of different doctors. We were all discussing how we approach
hormones and what we experience. And I would say across
(33:11):
the panel, even though the way we prescribe is a
little different, all of us were like, yet, it's management
because if you are still getting a menstrual cycle but
you need hormones, we're working with your menstrual cycle. So
some months or times you might need more hormone therapy.
Others you may need less. There may be a time
(33:31):
where you skip a couple months, which is different. Then
if you're fully menopausal, you don't bleed at all. You
kind of have these low, flatlined hormones. It's a little
easier to manage because you don't have the roller coaster
going on all the time. So I say, it's an
art and a science and like a dab of reality,
(33:52):
like where are you in your cycle? How are your cycles?
What's going on? How far have you progressed? But I
don't want people to get overwhelmed by that. I'm like,
most women are intelligent, smart, they know their body, and
so I can say, hey, if you get these symptoms,
cut the dose in half, or skip a day, or
you know, come off of it for a while. If
your symptoms come back it was too long, start it
up again, go back to your full dose. And most
(34:15):
women are like, not a problem. I know how to
manage this. Like that sounds smart. I can do this now.
As far as side effects go, depends on the hormone
is and it depends the route, because remember we have estrogens, progesterone, testostrum,
we have multiple routes. You can swallow it inject it,
slather it on your skin, put a patch on. You
(34:36):
can have a pellet inserted. You can shove it up vaginally, Like,
we can do all sorts of things, right, So, depending
on the person and what route it is, you may
prefer one way over the other. You may really sensitive
when you swallow things, so you want it like a
lotion or a cream or a gel. You might have
really sensitive skin, so you don't want the gel. You
don't want to patch because you know you're allergic to adhesive.
(34:59):
You Right, Like, there's all these options, and then I
just explained, as we decide what's right for you, it
also depends on like what's going on in your life.
Some women in perimenopause have little kids. They're ready for hormones,
and yet they have toddlers. And I'm like, well, we
need to be careful that we don't use topical per.
Speaker 2 (35:16):
Se cat or cats carry on or dog my cat hormonal. Yeah.
For a few weeks before I chat, JPT and May
were having a chat about hormones, and I put two
and two together and went, oh, yeah, that's what is
going on with my cat being more of an asshole lately, Yes,
(35:36):
which was quite terrifying because I realized that the actual
long term effects of that with it was it was estrogen.
She was laying on the arm yes, put the estrogen on, yes,
and turning into a psychopath.
Speaker 3 (35:50):
These are things I've had vets. I have had veterinarians
reach out to me and say, we see this all
the time. Do you think it's possible? I said, yes,
It's called ferens. You can just like if you were
wearing a lotion, you know, and you rubbed your arm
on somebody else, they'll pick it. They'll be like, oh,
that smells so good, Like what are you wearing? They
pick it up. It's hormones. Hormones in general, estrogen's progesterone, testosterone.
(36:14):
We call them lipophilic, which means they love fat. We
have a lot of fat under our skin. And so
if you rub it in your skin and your cat
lays across it, or your friend hold your hand, or
somebody you know, come in contact with, they can pick
it up. If they pick up your bottle and you're
if you've got a like a gel or a cream,
(36:35):
and let's say you did, we're kind of sloppy when
you applied it, and there's some cream on the outside
like a lotion bottle and they pick it up. They're like, oh,
this is cool. What are you taking? Like they can
they can transfer it can get transferred to them. Need
to be careful full.
Speaker 2 (36:51):
Yeah, yeah. One thing that I like what you just
said before about the management and it's like a now
I feel still so head of my depth. One luck
because I find it frustrating. I have a GP up
the road. She's not from a metopause clinic, but I'd
put a shout out in the local community. I'm like,
I'm looking for someone who deals with this, and it's
(37:11):
someone to have anyone, because my general GPS just bloke
down the road and I'm one of those people that's like,
I don't go there for advice. So I figure out
what I need and then I go tell them what
I need. Basically, again, I need someone that knows about
this stuff. But the frustration still felt like I didn't know.
(37:32):
So when I went back for the second prescription to
be feeled, I said, can I get the progesterone and
the astrad dial gel prescribed separately because they don't last
the same amount of time and I'm getting him in
a pack. How often you taking the progester. I'm like, oh,
every day because because she didn't tell me how to
use it, so I was taking every day and fortunately
(37:53):
I only had a month's worth. So but even then
it was like knowing when to take it in my
cycle and then my cycle was sure, but then my
cycle changed a couple of times, and like, I'm consulting
chat fucking.
Speaker 3 (38:05):
Gp T too.
Speaker 2 (38:06):
I'm like, if I'm what day should I be starting
this if my cycle's only that long? Because I know
that this has got a protective mechanism for me, so
it's kind of important that I get it right. Where
do people find like myself, if they are not getting
that from the prescribing doctor, where's the best place? And
this might be a great I've got dates written down
(38:27):
for an awesome thing you've got coming up, a mastercliff.
Speaker 3 (38:30):
Free Master Hot masterclass.
Speaker 2 (38:33):
I've written down the Australian dates and times because I
know I'm going to tune into it and there are
times that will make so share that. But also anywhere
where people can or anything you've got where people can
further understand how to use this stuff.
Speaker 3 (38:45):
Yeah, so think, well, it's a good thing you have
me on this podcast. We'll use this podcast as a resource.
So if you still get your period, ideally often you're
going to cycle progesterone, so that usually means you are
flee two weeks off, so you get your period, stop
your progesterone, don't take it during your period, you bleed,
(39:06):
get your period if you still ovulate. Some women feel it.
Some women are like, oh yeah, my mucus changes or
I can tell or i'm testing. Don't still don't take
it after you ovulate after about the middle of your cycle,
then you start progesterone. Progesterone only naturally comes out in
that second half of the cycle. It's you don't make
(39:28):
it during your period leading up to ovulation, and then
you make it after. So for the women though, who
were like, Okay, that was cool last year when I
was pretty regular, kind of twenty eight days, I can
figure that out. But now I'm all over the place.
Now I'm like twenty one days, then I'm thirty five days,
so I'm not really sure when to take the progesterone.
So in that case, obviously talk to your prescribing doctor
(39:51):
who or whoever's given you the hormone. But in general,
I'll tell women, don't do it during your period, Wait
a couple of days if you're that regular, and then
start it. It's not it doesn't have to be rocket science.
I don't want to stress you out. You're probably already frustrated, impatient,
and anxious. So just don't take it during your period.
(40:12):
Wait a couple of days and start the progesterone to
give you that break. Now, if you're listening and you're
completely menopausal, Like say you're listening and you're like, I
haven't at a period in years? Am I supposed to
cycle it? You can definitely give yourself breaks. So I
have had women that feel better giving themselves the occasional break.
So they're like, I just don't do it one day
(40:34):
a week, or I take two days off a month.
They don't have to cycle cycle it because they're not
cycling anymore, but they do say they do. Sometimes they're like,
I just feel like it builds up a little bit,
And I'm like, well, then stop it for a day
or stop it for a weekend, and.
Speaker 2 (40:48):
Then what would feel luck? What would a symptom of
building up? Well, what would if symptom feel luck? If
we would to want to take a break.
Speaker 3 (40:56):
So when it comes to progesterone. So sometimes women will say,
like if if they're menopausal, they'll be like, I feel
like I'm getting groggier and groggier in the morning, or
I feel like I used to feel really good, but
I feel like when I take progesterone, like as a capsule,
I'm getting bloated, or I'm getting heartburn or I'm getting
just like I take it and I just don't love
how I feel when I'm taking it. I'm like, okay,
(41:17):
could be dose, could be route it. Also, we just
need to take a break, like take that weekend off,
reset your system, get it out of your system, and
then we'll start over, you know, come Monday or come
Sunday night as an example. And other women are like, no,
I will never give this up. I don't stop. I
take it every day, you know, Try and stop me,
and I'm like, that's fine too. So I just work
(41:40):
with the physiology of the person who's in front of
me on how we do progesterone.
Speaker 2 (41:47):
This is so informative. Kind of blows my mind.
Speaker 3 (41:50):
Doug.
Speaker 2 (41:50):
Thank you for this conversation and coming to chat to me,
because I feel like I've had a lot of conversations
lightly and I think to myself, you didn't having the
same conversation with a lot of people. But it's amazing
what you can bring that just hasn't been covered. Yeah,
and I haven't understood.
Speaker 3 (42:09):
I've been prescribing hormones. Let's say I started when I
was in medical school, when I was a second year
medical school. That's when that study came out that's at
hormones caust cancer. And my attending said, there are the
hormones we naturally make in our body, like, we'll be careful,
but we're not going to stop prescribing. So I had
a wonderful attending who taught me how to prescribe hormones
(42:30):
very early in my career. I was still in medical school.
When I got out, I did a residency prescribed hormones.
I went right into practice prescribed hormones. And I've done
it all. I've done what we call like the typical
get at your pharmacy type of hormones. I've done. I've
prescribed compounding hormones other than insert a pellet. I've done everything.
(42:53):
And so I have a lot of experience that sometimes
people will talk about hormones, but they don't actually have
the license to describe, or they don't have a license
at all, or they're brand new. You know, they're like
just getting they're just dipping their toe into it as
a doctor, and you know, like that's understandable. I stay
in my lane, like, hormones is my lane. I don't
do surgery, I don't do pediatrics. I'm not going to
deliver your baby. This is what I don't want to
(43:15):
treat your husband like, this is what I do, and
this is what I stick to. So when I when
I talk about it, and I don't want to stress
somebody out, they're already stressed out. This is already a
stressful time. It's like I said, it's not rocket science.
We're just gonna adjust your hormones until it works for
you and we can do that.
Speaker 2 (43:32):
Yeah, what do you have You had any experience with
non bonary people who are experiencing menopouls and how how
how are you guys managing that?
Speaker 3 (43:42):
So do you like you mean non binary or so
I should say I've done.
Speaker 2 (43:47):
Both assan female at BTh So they have the female
hormones and they're going through perimenopolse or hormonal changes. But
obviously that's quite a turbulent time for them, and it's
bought a time of identity crossis and I just want
the how if that's something that you're experiencing.
Speaker 3 (44:07):
And yeah, so a lot of times what I do
is I explain the physiology what's going on, because they don't.
Nobody seems to know, and it goesn't taught to any
of us, male, feel female and everybody in between. And
so I'm like, if they're if they're an established patient,
I'm like, hey, here's what's coming up. Just FYI like
we need I need to mentally prepare you for this
now because I couldn't get out of it, and like,
(44:28):
you're not going to get out of it. I can't
get out of it. You can't get out of it,
and so and then I let them just take the lead.
How do you how do you want to talk about this?
What are your thoughts on hormones? Talk to me about
your symptoms? And I let them take the lead on
what makes them comfortable. Some of them want hormones, some
of them don't want hormones. It just sort of depends
on the person. Now, what I thought you were going
(44:49):
to ask me, was uh, female to male, transgender and
I always say it depends on the level of transition
they've had. So for example, if somebody identifies as male
but they haven't done any hormonal suppression or they're not
using testosterone, no surgery is nothing, they just identify, then
(45:12):
I warn them, here's what's coming, like, you still have
your ovaries, you haven't suppressed anything. I need you to
be aware of the physiology of probably what's gonna happen,
like we need to talk about it. If they have
gone through and they're on tistosterone, on estrogen blockers in tystosterone,
they generally, am my experience, so far, do really well.
(45:32):
I mean, they've suppressed it and so there's not happened anymore.
Of course, if they have had a surgery, they don't
have their ovaries anymore. And I'm like, well, the minute
you went through surgery, you're considered metapausal. But then you're
on hormones, male hormones, estrogen blockers in testosterone, so you're
probably not going to you're not gonna like it's a
moot point, like it's not gonna happen. So I have
(45:54):
to also ask like where are you in your journey
if you are either identifying as or transitioning to male. Yeah,
that will tend to give me, give me an idea
of how to talk to him about the hormones that
shifts that are going to have. But it can be
really hard because there are depending in any of that
(46:16):
entire spectrum. Potentially they're already struggling. And then I'm like, ooh,
it's hard for me and you. It's not always easy
for you and I and uh, the buckle up. I
need to have a conversation with you, which is always
appreciated because they're like, what you know, thanks always for you.
Speaker 2 (46:38):
When when people are transitioning their agenda and they'refore taking
a stringen blocks. If we're going through this went out,
estrogen naturally declines, that must be a shit of a tom.
Does it do the same thing.
Speaker 3 (46:52):
They have the test If they're on the testosterone and
they're consistent with their testosterone, they generally do okay. The
problem is when they're you're regular with it. So I
had a patient due to financial reasons, couldn't always afford
testosterone and estrogen blockers. So he would go on for
a couple months, He would go off for a couple months.
He would go on for a couple months. He would
(47:13):
go off for a couple months, and that was a
heck of a roller coaster because the body had no
idea what was going on. Yeah, and you know that
was a big deal. Consistent, if they're very consistent, they
have access, they take their hormones as prescribed. I do
find that's easier. I'm not saying it's easy. Easier for sure.
Speaker 2 (47:34):
Yeah, And when we take HT estrogen mainly, I guess
I'm talking about what are the physical luck I talked
about skin health, but I know that estrogen and testosterone
both make our fat distribution change. Yes, are their physical
I guess changes over time that we will experience if
(47:57):
we're on HT.
Speaker 3 (48:00):
So estrogen in general, and you know, you probably talk
about this, Estrogen tends receptors tend to concentrate in the
lower body, so the hips, the thighs, the booty, which
is what gives women some curve, whereas androgens like testosterone,
tends to concentrate around the belly area and the upper body,
so do cortisol receptors. So does insulin. For a lot
(48:23):
of people, so they'll get that belly and everyone thinks,
oh it must be stressed or oh it must be
blood sugar and insulin, which it could be, but it
could also be an imbalance or mismatch with testosterone. And
so when women say I've gained all this weight at
this age, I'll say where all over in the lower part,
in the upper part, Like what has changed? What are
(48:44):
we talking about here? The other thing that I will
notice from a like a external symptom are things like
their strength. Will you probably notice this, Like you will
notice their strength. You'll notice like if you go, if
you touch them, I'm doing an exam that instead of
having like firm muscles, they're squishier, right, because they're getting
the loss of muscle mass and unfortunately the increase in fat.
(49:08):
In some women, their grip strength might go down though,
like I'm not as strong as I used to be,
Like it's harder for me. Their balance could be off,
I mean skin we see it. Like again, these are
like changes in decline. So if we go on hormones
coupled with exercise, coupled with all this other stuff, the
goal is that we reverse this is best that we can.
(49:29):
They rip strength improves, there, the quality of their muscle improves,
their skin improves, the shininess and the luster of their
hair improves, even their voice. I had a mentor say,
you can tell women who are on hormones or not,
because like women who are not on hormones, as they
get a lot older, they she goes, they get that.
(49:50):
And this woman is my mentor, she's in she's seventy eight,
so she can say this. She goes, they get that
old lady voice, she said, because their vocal cords change.
And she they turn to these old ladies and she's
and she's on hormones. And she said, I'm not doing that.
She said, I'm maintaining my vocal cords. I'm not going
to get old lady boys. But even like again, like
I said, hair thickness, hair luster, So you can see
(50:13):
different external signs in some women. Now, it's not absolute.
I don't want people listening to this thinking like, oh
my gosh. Obviously a lot of the foundations to health
play into this as well. Estrogen alone is not going
to build muscle right. Progesterone alone is not going to
get your glucose under control. Like you have to do
(50:33):
those things yourself or make you happy, per se, Like
if your life sucks, we got to get that in order.
But still we can see with if you're working on
those things, and we add in the HRT is the
extra bonus, the cherry on top I do. I can
see physical changes, I can hear it.
Speaker 2 (50:53):
Yeah, yeah. Is there anything that I haven't asked that
I should ask that you think I would buckle up?
Speaker 3 (51:04):
I know said we can't have to do a part too.
There's so many things about hormones. One of the big
things I always say, and you've already alluded to this,
which I love, is that you can love your GP
and they can have no idea what to do with hormones.
It's okay to cheat on your doctor on your GP,
like it's okay to go find somebody who specializes in hormones.
(51:25):
It's okay to advocate for yourself. If you go see
somebody and they say to you they don't believe in hormones,
or they don't believe in this or that's not you know,
they're they're really downplaying, dismissing, demeaning, thank you for your time,
go find somebody else. It's you would do the same
thing for your dog or cat at the vet. You
would do the same thing for your kid with the pediatrician.
You didn't like like you thank you for your time.
(51:47):
Absolutely not. I'm going to go somewhere and advocate for myself.
Do that love that?
Speaker 2 (51:54):
Love that? One last question we talked about. You talked
about Gabba the Full and bought my attention because I
went on a range of supplements based on a DNA
test i'd had based on a rabbit hole I'd scurried
on down after seeing some menopause carry on reels on
(52:15):
Instagram related to ADHD and some of the methylation pathways
and things, and I went, oh, okay, right, I better
go look at this. So checked out my DNA how
to look at some things that were a bit had
a bit of a lag, and supplemented. One of the
things I've gone on is Gabba. Now I've always had
sleep issues for as long as I can remember, but
(52:37):
Gabba is the only thing I've ever taken that has
just it will send me to sleep nice. Yeah.
Speaker 3 (52:45):
It is, like I said, it is the inhibitory. It's
the emergency break for your brain, just like it. Just Yeah,
we have a lot of excitation in our brain right
because as humans, we need to think, we need to remember,
we need to focus, we need to go, We need
to activate and gabba. Gabba is the opposite Gaba's like
(53:06):
no stop that, So Gabba is can be a really
good one. There's a few things that support again, like
I said, progesterone when it breaks down can support gaba.
There is to make gabba, you need vitamin B six,
so you want to make sure you're not BE six deficient.
There is another popular amino acid. It's called elf fiannin
(53:27):
elf THEI inning ye yep. Gaba supportive as well. There
are some herbs passion flower, which sounds beautiful, can be
GABA supportive as well. So some people who are like
I don't know about gabba, but they like herbs. Passionflower
is something to look at. So there are a lot
of ways we can support gabba. Like I said, remember
(53:50):
it declines with age researches. Like any other hormone, it declines,
and men and women men same thing. Have you ever
been around in old man? They have no filter and
they can't sleep, so they probably need it too.
Speaker 2 (54:04):
Gabba, load up, load up. My mouth is big enough
without me losing gabba. So I'm going to double one
and I might double that dough. Your workshop is on
for Australians the first of October at either nine am,
nine am or twelve noon. Would you like to tell
the rest of the world when it's on and a
(54:25):
little bit about it? Because I think it's I want
to tune in. It sounds brilliant and I don't normally
promote stuff like this on the show, but it's well,
it's yeah.
Speaker 3 (54:33):
I appreciate it. It's an HT one O one course.
And basically I was getting all these questions of I
think I'm ready, Kerry, I think I'm ready, or I
just started it, I sell have questions, or I'm kind
of curious, and I thought, easy, Breezy, I can do this.
We're going to talk about what it is, what it isn't,
what are the contraindications, does it cause cancer, what to
(54:56):
watch out for in different forms, because I want you
to be really educated when you go talk to your
GP or to help answer some questions for you on gosh,
I don't know I had a blood clot when I
was pregnant, or gosh, I don't know my great grandmother
had breast cancer. Does that mean I can't take it?
Or gosh, I don't know I'm sixty am I too
(55:17):
old like, we're gonna cover all of that. We're gonna
just we're gonna cover those basics. So in my time zone,
I am on the West coast of the United States,
so the Pacific time zone. It is September thirtieth at
four pm seven pm for the East coasters. If you
are in the US listening, there will be a replay.
(55:38):
It is at doctor Carrie Jones.
Speaker 2 (55:40):
So it's not twelve o'clock. I write down two times, right, None,
I am only God, None, I am only yes.
Speaker 3 (55:47):
So four o'clock my time, the night before seven o'clock
East Coast time, the night before brilliant.
Speaker 2 (55:54):
And if you're anyone anywhere else, go and look it
up on time convent. I go ahead to.
Speaker 3 (55:59):
As chadjy P chat GPT. I'll tell you Chat is.
Speaker 2 (56:02):
Nice everything chat. This is my best mate.
Speaker 3 (56:05):
My husband was in Switzerland recently and he brought me
back chocolates. But it's all in Swiss and I can't
and I can't eat gluten, so I screenshot. He goes, Babe,
I don't you know, they're the cutest chocolates in the
whole world. They're little fox and little ground groundhogs. He goes,
But I don't know if they're gluten free. I can't
read this, so I took a screenshot, uploaded a chat GPT.
(56:25):
I said, is there gluten in this? He said yes,
These two words mean in wheat wheat protein. So I
said yea. I said to my husband, I'm so bab
about these are the cutest, but I can't eat them.
He goes, how did you figure that out so fast?
And I was like, chat GPT, obviously, obviously, obviously, yes
I have it.
Speaker 2 (56:44):
Where else can we find you?
Speaker 3 (56:45):
Doctor carry website including the master class doctor carry jones
dot com and if you go to doctor carry Jones
dot com slash masterclass, then you can sign up for
free and get the replay.
Speaker 2 (56:55):
I'm so right now. Thank you so much. If you can,
I have you back. I will have you back. So yeah,
expected big nudge from me soon. Thank you so much
for today. Thank you, thanks everyone.
Speaker 1 (57:10):
She said, it's now never. I got fighting in my blood.
Speaker 3 (57:19):
Got it, quolocaust, gotta got it, got it,
She said, it's now never I got fighting in my blood.
Speaker 2 (00:09):
I'm tiff. This is Roll with the Punches and we're
turning life's hardest hits into wins. Nobody wants to go
to court, and don't My friends at test Art Family
Lawyers know that they offer all forms of alternative dispute resolution.
Their team of Melbourne family lawyers have extensive experience in
(00:29):
all areas of family law to facto and same sex couples,
custody and children, family violence and intervention orders, property settlements
and financial agreements. Test Art is in your corner, so
reach out to Mark and the team at www dot
test Artfamilylawyers dot com dot au. Doctor Carrie Jones, if
(00:54):
I wasn't looking forward to today's chat before, I definitely
am now welcome to Roll with the Punches.
Speaker 3 (01:00):
Oh my gosh, thank you so much for having me on.
Speaker 2 (01:03):
I'm feeling sprightly all of a sudden. I just told
you I was a bit under the weather and a
bit snuffly, and we've been chatting for like what three minutes,
and you've just pepped me right up. I've been laughing.
We've been talking about dogs and drawl and all.
Speaker 3 (01:16):
Of the things how great. It's the way to kick
off a podcast, that's for sure.
Speaker 2 (01:20):
That's what I think. That's what I think. Tell everyone
what your thing is. What's your thing?
Speaker 3 (01:25):
My thing is women's health and hormones, especially as women
had above forty years old. That's my thing.
Speaker 2 (01:31):
Step inside my office or hang on, I've stepped in yours.
I have stepped in yours. Yes, and all of my
listeners are leaning in there all every time I have
a conversation on this topic. Because I've just recently opened
the door on myself, I'm like.
Speaker 3 (01:46):
Oh, oh, we're here.
Speaker 2 (01:49):
Good. Great that it'll never have happened to me. I'm
just a kid and I've started sharing a bit of that,
and wow, you wouldn't be no surprise to you. But everybody,
everybody around my age, he's like, oh, tell me more.
All this is happening to me.
Speaker 3 (02:04):
And it's wild because at a certain age, so let's say,
puberty to about mid forties, all your doctor's appointments, all
the medical research, everything on social media is whether like
how to get pregnant or how not to get pregnant.
There seems to be no in between. It's very annoying,
(02:24):
and so women don't even know they can have hormone dysfunction,
imbalance things going on in their twenties, in their thirties,
in their forties, they're just like if it's pregnancy or nothing.
But so when they hit their forties, like for real,
hit their forties, yeah, they a lot of women have
already have hormone stuff going on, not even realizing it,
(02:45):
and then they slam into their forties. Congratulations, perimenopause, and
they're like, what just happened? But now we have a
lot of focus on it, Thank goodness. Now now it's
getting a lot more media, press books, social media, so
ready to talk about it?
Speaker 2 (03:01):
So good? How long? Like, what was your background and
how long have you been in specifically working in this,
especially perimenopause. Someone said that it's only really been a term
that's used the last five to six years. Is that right?
Speaker 3 (03:14):
It's been used, Actually, it's been used a lot longer
than that. It's just become popularized, especially on social media,
in the last couple of years. So, we've been a
doctor twenty years and I was in women's health and
hormones right from the get go. I on a minute,
you've been a doctor twenty years. Yeah, I'm forty eight,
so I've been a doctor twelve. I'm like, this chick's
half my age, So how is she even here? How
(03:37):
she even she even hit perimenopause? Yeah, I'm almost fifty. Woah,
wait I am now I'm in the thanks, I'm in enthrosy.
Speaker 2 (03:46):
Bit.
Speaker 3 (03:46):
I can got catfished. Everyone. It's the it's the congestion,
it's the snuffliness, it's blacks. The mucus has gone across
your eyes.
Speaker 2 (04:00):
Okay, carry on, I rudely interrupted.
Speaker 3 (04:03):
So well, I knew I wanted to be in women's
health and hormones my whole career. I did not get
the best up bringing in this. My health class when
I was way younger, was taught by the school football coach.
Well we American football coach, so you can imagine how
that went. Right, Like a random man who taught phized
(04:25):
and football and he was like, well, let me teach
you about health, and I thought, well, this is gonna
go well. So we didn't get a whole lot of education.
And when I got in medical school, I realized everybody
around me, all my friends, all my non doctor friends,
were like, I don't really know how the body works.
I don't really know, I had full grown women who'd
had multiple kids, and they're like, I don't even know
how the menstrual cycle works. I'm like, you got pregnant
(04:46):
multiple times. They're like, yeah, I don't know how. God
you know, God bless them. So I just kept going,
staying in the route. And as I got older, because
I graduated when I was twenty eight, so I did
a lot of hormones, a lot of perimenopause, but I
did a lot of all age hormones. And then as
I got older, my patients got older, my interests got older,
(05:07):
and once I hit forty four, forty four years old
was when I first noticed my first perimenopausal symptom. I
started not sleeping that great, and I didn't have immediate
recall my memory and I have an amazing memory of
a partially photographic memory, which has really helped me get
through medical school. And I went to open something on
my computer. I was like, I have a brilliant idea.
(05:28):
I'm gonna do this right now. Literally put my finger
to the computer and thought, what wait a minute, hold on,
what was I going to do? What was the brilliant idea?
And I knew in that moment what I was. I
knew it was. I was like, ah, hormones, they got me.
It got me, and I felt like you. I was like,
it's never gonna happen. I'm in the field, I know
(05:48):
what I'm doing. I take really good care of myself.
And I mean my newest symptom, which is very recent
the last couple months, I get ocular migraines, which is lovely.
So when you're hormone my hormone shift, I will lose
some vision. It gets like gray and specky in my
right eye. And when at first time it happened, it
(06:08):
happened a couple months ago. For the first time, it
helped being a doctor because I was like, I know
what this is. I can diagnose myself. It's not a tumor,
but also, what the heck is a terrible symptom? Who
thought of this? And I've had so many women come
out and tell me like me too, me too. I
started getting migraines or I started getting But the amount
of symptoms that kind occur at this age with hormone
(06:31):
changes coupled with life, just wild things you won't even
think of, like itchy ears and burning tongue and smelling
random things that don't exist, like, I'm why who thought
of this?
Speaker 2 (06:45):
Oh? Two things. One, Now I'm concerned that I'll need
to expect mogriines because I got magrines horrifically for months
lading into me fist getting a period is and that's adolescent,
So I will be surprised if that is something that
hits my world at some point. Would be super annoying
because they were awful, they were debilitating. They were like
(07:07):
twenty four hours in bed, throwing up every hour on
the hour, horrific. And a good friend of mine, she's
also going through and she's a little bit older than me.
I'm forty two now I've just gone on hit she'd
gone on a little bit before me. And in a
voice message we do back and forth voice message. It
was a great download for Wednesday. We call it shout
(07:30):
out to Vicki and she said, I am logging my
I'm up to symptom thirty because I was like, I'm
you know, I started HT. I've had some really great
like I really felt a huge lift from it, but
I'm still tired and I'm still having some really flat days,
(07:50):
like my mood still isn't amazing and She's like, symptom
number thirty, and I went, oh, that is nahly, and
my memory is always being a bit closer to your
new symptom memory.
Speaker 3 (08:04):
Rather than your prey memory.
Speaker 2 (08:06):
So I'm like, oh, I can't even remember if this
is normal for me or not normal anymore.
Speaker 3 (08:11):
You know, it's wild. It's so, I mean, obviously, a
lot goes into energy, and a lot goes into mood,
a lot of hormones. We have over fifty hormones in
the body, but estrogen, the main estrogen is called estradyle
e two, and estradile is a big supporter of all
things women's health. It is involved heavily in all twelve
(08:32):
systems of our body. But it's involved heavily in the
creation or direction or help for our neurotransmitters, which is
a fancy word for your brain hormones. So to make
brain hormones such as serotonin, which does play a role
with mood, to make hormones such as dopamine, which plays
(08:53):
a role in things like motivation, Estrogen plays a role.
And so women will notice their sen is wobbling or
going crazy or declining completely, and they'll notice their mood
at the same time. The amount of research papers that
are out now on women going through hormone changes, and
hormone changes can happen at any age. We're specifically talking
(09:15):
over forty perimenopause and in depression and anxiety and lack
of motivation, and the number of articles I'm reading now
of like is it ADHD or is it perry menopause?
Like why do I feel like I didn't have ADHD?
And I feel like I have it now? And now
we're having this really interesting debate on have you always
(09:37):
had it and it was underdiagnosed or is it newly
because the hormones are changing. And so for people listening
who are going, holy crap, yep, that's me, You're not crazy,
Like this is really how the brain and the body
can function. And then unfortunately you layer over stress life
right now right, diet, nutrition, habits, foundations, lack of sleep,
(09:59):
all the things, and that can perpetuate it to feel
like it's hitting your HODR.
Speaker 2 (10:04):
One hundred percent. I just had an episode that I
recorded with an old school friend from Tazy. So was
someone who went to school with and she reached out
last years. She started with sleep issues. Within one month,
she had admitted herself to a respite sentimental health respite center.
She did that twice. She ended up in a psych ward.
(10:25):
She ended up having shock therapy seven times. And then
after that she landed in the office of someone who
deals with perimenopause and menopause. They looked at her symptoms
and they said, why has nobody clocked this? And she's
been on HRT since then, and she's back down to
one antidepressant and on the path. And it's really like
(10:49):
that for me that I mean, that's a really intense story,
but how quick the decline is, yes, and how terrifying
the journey can be. Like I've got goosebumps now just
relaying that story. I'm like, oh, and there'd be so
many women that have a vision of that happening.
Speaker 3 (11:05):
I see it in my comments, I see it in
the DMS. I see it in emails that I get
from women who say, you are like, oh my, this
is the worst thing ever. My life is completely falling apart,
especially from a mental perspective, and no one has prepared them.
And what's interesting is there's this debate on why do
we go through this perimenopause into menopause, Like why don't
(11:28):
we just glide in gracefully like a princess, Like, why
don't we have to slam into it like a car
wreck for some women? Right, for some women. And there's
this whole thing of like, well, our mothers or our
grandmothers or other cultures didn't suffer, And I'm like, yes
they did. They did and didn't talk about it. They
did and were silenced and suppress they did, or were
(11:49):
told that, you know, buck it up, You're fine, it's
just what you have to do. They absolutely suffered. They
didn't have social media, and they were a quieter generation,
that old steady, whereas Gen X and the millennials are mauthe.
We are mauthy, and we have social media and we're
going to tell you about it. And so we're hearing
(12:09):
the truth. I think, I think it's opinion. We're hearing
the truth, true truth of ancestors before us, who are
just quieter and more you know, centered about it, even
though they suffered and we're not going to put up
with that.
Speaker 2 (12:25):
Yeah, well, they didn't have a platform, and like they
didn't have Holly. You don't go to your mate task
and go, hey, my hormones have lost their shit.
Speaker 3 (12:35):
You carry for tea and biscuits exactly, much more stoic,
much more stoic. They weren't talking about their you know,
their vaginal symptoms and they're how they feel crazy, and
you know that's that was just uncouth. You didn't talk
about that. Yeah, yeah, and now we don't care. Now
we tell everybody, Oh, I am leading the challenge with that.
I'm like hanging out the window.
Speaker 2 (12:58):
I know.
Speaker 3 (12:58):
I read an article about we have a brain hormone
called gabba. Gabba is our inhibitory neurotransmit or it calms
things down inhibbits. So we read this great article and
it says, is humans age, we lose gabba. So we
are so men and women doesn't matter, So we're prone
no more anxiety, maybe we don't maybe sleep as well.
(13:18):
But they said women get hit doubly hard because we
lose hormones that support GABBA, such as progest your own
and with age we lose gabba. And it was going
on to talk about how gabba again is like the
break system of the brain, and it talked about filters,
and I thought, oh, there it is. You know, you
hear of women hit a certain age and then they
just don't care what they say just comes right out
(13:39):
of their mouth. And I'm like, yeah, when you don't
have your break system, maybe you can't break your anxiety
or you can't relax to fall asleep. But you're also rageful,
angry your mouth never you know, you say what you
really feel, which can actually be quite liberating, you know,
if you've been stuffing it down and filtering for so long,
(14:00):
and now you can be your true self and let
it out. Just don't get arrested. Orange is not your color, right,
just just be mindful of like how it comes out.
But when women say this to me, I'm so annoyed.
I'm so angry, I'm so rageful. I'm like, yeah, girl,
your filter, your break is gone, let it out. Just
be you know, careful.
Speaker 2 (14:22):
Yeah, what can we talk about HT? Yeah, of course, good, bad, great, amazing.
So I mean, I'm a big fan and it depends.
I'm a big fan.
Speaker 3 (14:36):
Of the HRT. That is what like looks like our body.
So we have we have. Some people call it body identical,
some people call it bioidentical babies. Basically, it's estrogen, it's progesterone,
it's testosterone. It looks like what you make. Then there's
this synthetic which doesn't look like what your body makes,
(14:56):
but can bind to the receptors and be supportive, but
it can also come aside effects. So that's like the
birth control pill. That's like some of the some of
the metapausal treatments are synthetic estrogen synthetic what they're called progestins,
So you just have to be mindful of what you're on.
(15:18):
When we looked at the research study on the slight
risk towards breast cancer, it was a combination of estrogen
used with the progest stin, the synthetic or fake progesterone. Nowadays,
more people are leaning towards what's called the bioidentical estradiol
(15:39):
esterreiol progesterone way. In fact, all this study, most all
the studies looking at estrogens of some sort had less
breast cancer. It's only when you add in the progestin
that you get into a little bit of a bump,
a little bit of trouble.
Speaker 2 (15:57):
What might be the raisins look Abbott reasons why doctors
might suggest progestine or non biod bioidentical hormones or is
it a lack of maybe moving with the times or knowledge.
Speaker 3 (16:14):
Both The main reason is it's so common in the
birth control pill. It's so common in the progestin iud
or coil. It's so common there is I don't know
if you all have it there, but here we have
a very common form of it called pro Vera. And
because it's readily available and it's been around for a while,
(16:36):
if you've been if you're an old school doctor, then
you just write the prescription. Oh, perimenopause, go on the
birth control pill. Oh perimenopause, go on pro vera, this progestine,
whereas not even realizing that we have other options available,
or if they haven't gotten the education gone through training.
A lot of my you know, obg yn obgin doctor
(16:59):
friends are like, we did not get this training. I
could deliver a baby in the back of a car,
I could deliver an emergency situation, but managing menopause, we
did not get that training. I'm like, oh my gosh, yeah,
times are changing, but slowly.
Speaker 2 (17:13):
Yeah, yeah, what are some of the sad effix of
being on a progistant or a birth control top hormone
rather than.
Speaker 3 (17:24):
Ident So some women, I mean we all know somebody
or maybe we've had the done the birth control ourselves
and they you're just like some women love it, you know,
there's a time and a place, you know. They're like, oh,
that worked amazing, and others are like, hated it. It
made me lose hair, it made me break out, it
killed my sex drive, it made me depressed. I gained weight,
My GI track was a mess. I got heartburned, I
(17:45):
felt bloated. So because it's hormonal and hormones impact every
system in the body, it could be a plethora of symptoms.
I do still want to put the caveat on there.
Someone go in the birth control pill and have an
excellent time, they have no problem, but it is not
without risk. I always warn women like, hey, if you
get any of these symptoms, let me know if you're
(18:07):
on it. Yeah, and I'll be honest. The birth control pill,
you know, if you're in your forties or fifties, unless
you if you need it for birth control, that's one thing.
But I feel like we have much better options if
you don't need it for birth control. I think estra
dial like the real estrogen progesterone. The real progesterone, I
(18:29):
think is much much much better balanced, better suited for
what you're going through versus here just take the pill.
Speaker 2 (18:36):
And is there a time where we're too young to
be looking at being on HT or not? So you
too old?
Speaker 3 (18:46):
The thankfully the too old is a no. And it
depends which form of HRT we have. You know, we
have a couple hormones. We have the estrogens, we have progesterone,
we have testosterone, So which one are we Starting with women,
there are probably women in their twenties who have been
told to go on progesterone, real progesterone, like their body makes,
maybe their doctor has it, has them on progesterone for
(19:06):
something for fertility, for PMS, for heavy periods while they're
working to figure out why and what's going on. Usually
estrogen and testosterone are saved for a little bit later.
You don't usually hear of a twenty is somebody in
their twenties on estrogen or testosterone. It's not impossible, it's
just not common. Usually that's saved for the perimenopause menopause transition.
(19:30):
As far as too old, they used to say, yes,
they used to say ideally, may still say this. Ideally
you would start HRT within ten years of your last period,
so either before or after you get the maximum benefits.
And now they say, actually you can start HRT more
(19:52):
than ten years past your last period. So I have
women that will say, I'm maybe five and I have symptoms,
or I'm sixty five, I have simp can I do HRT?
And I'll say, as long as you have a good workup,
Because the concern is around the heart. Heart disease is
still the number one killer of humans. So let's get
your heart worked up, Let's get your cholesterol, let's make it,
(20:12):
see what your plaque situation is. And as long as
you're good and you don't have any of the any
major risks like ongoing cancer, then yes, you are. The
guidelines have changed and you can start HRT at least
the guidelines here in the States and the guidelines in
the UK have changed.
Speaker 2 (20:31):
And what with someone around that old age black seventy
eighty plus, what would the symptoms be.
Speaker 3 (20:40):
Yes, the most common symptoms I hear are either I
still can't sleep, I still get hot flashes and night sweats,
I still have brain fog, I still have mood issues,
and a lot of what we call genito urinary symptoms
vaginal dryness, pain with sex, chronic urinary TRAC infections, and
so they don't have the hormone anymore to make that area,
(21:03):
that tissue juicy and lubricated and happy. And so they'll say,
I keep I'm seventy, and I keep getting yease infections,
and I don't know why I keep getting treated for
urinary tract infections. Or it feels super dry and irritated
and itchy down there. Hormones can be the lack of hormone,
the lack of estrogen and testosterone or DHA play a
(21:25):
huge role. It's called genito urinary syndrome of menopause GSM,
and it's getting a lot more traction, Thank goodness, because
what happens is a lot of doctors who are hospitalists,
emergency room doctors, gerontologists. They realize that these women get
admitted to the hospital for urinary tract infections that quickly
(21:49):
become very significant and systemic. And if we can prevent that,
if we can reduce that risk by doing vaginal estrogens,
vaginal DTA, vaginal to STARSTERONN hallelujah, let's do it. Why
would we make them suffer? Oh?
Speaker 2 (22:07):
I love this conversation. When I was talking to my mom,
my own mum about HIT and in my own experience,
and I said to him, I feel like you should
have been on this, And so it was one of
the things I want to do and also one of
the things that made me think of it. She has
terrible sleep issues, she has for a long time, terrible,
but she also has chronic exma and she had as
(22:29):
hated as a kid. And I thought, and I wondered,
and I don't know what the answer is, maybe you know,
but when I was looking up some of the benefits
of estrogen, it was skin health, and I was like, well,
if someone like my mom should have been on that,
if that's something that she needed, maybe that would have
helped her skin as well. She has injections for her skin.
(22:51):
It's got to that point now where she's yeah, it's
quite debilitating. So that is a really interesting piece of information.
Speaker 3 (23:00):
Yeah. Yes, And unfortunately, since about two thousand and two,
the big study that came out that's called the Women's
Health Initiative. It's a big study that came out. It
made Time magazine, all the big magazines and the States
and it basically it was the research article that said
hormones cause cancer. Now, since that time, the main authors
(23:21):
have retracted a lot of that. A lot of studies
have come out realizing there were some serious mistakes in
that study, and that did not make the news. So
people are still stuck on the news of two thousand
and two, and we have some amazing articles since then
that the benefits can definitely far away the risks. I'm
(23:45):
not saying there's no risk, but we're finding when we
look at the ratio risk benefit like, the benefits really
are there. And again, like I said, women will worry
about breast cancer, and I'm like, there is a solid
chance heart disease. It's cardiometabolic disease. It's a break a hip,
you know, like Grammar breaks a hip. We all know, like,
(24:07):
oh no, Graandma broke a hip. This isn't gonna end well.
It's ending up in the hospital with chronic urinary tract
infections and then being on IVY and a by it
like that's going to get you. It's Alzheimer's dementia, Like
those are the things that are gonna get you. No,
I'm not downplaying breast cancer, but that to me, I'm
like that it's not the scariest thing. I do not
(24:28):
want to break a hip. I do not want to trip, fall,
break a hip, and end up in the hospital. And
that's where I stay. And I don't think women realize that.
Speaker 2 (24:37):
Yeah, And I think about the like the quality of
life if some people's symptoms are quite debilitating. Yeah, and
you get this marginal increase in risk on a maybe
with when we have a lot of control over lifestyle
factors that we can counter things like that with to
the best of our ability. But it's like, well, do
(24:58):
you want to not improve your experience of life now
for a just in case? Yes, because some terrible study
said so.
Speaker 3 (25:08):
Yes, that's been retracted and redone since then. Yeah, that's
the big issue. That's why I know, tell women there
could be a lot of benefit you're not even thinking about.
I was in the airport last weekend, flying to a conference,
and I watched this very frail, very elderly couple shuffling
(25:29):
to their gate and she just fell. I mean, she
just I don't know, she tripped over her feet. I
don't know if she bumped into I don't know what happened,
but all of a sudden I heard this giant thump.
It turned around and she was flat on her back
and I was like, oh my gosh, this is not
going to be end well. She ended up being on
my flight. I didn't realize it. We got on her flight,
(25:51):
and everyone rushed to a sister, you know. The airline
employees brought her a wheelchair, and of course adrenaline kicks in.
She's like, I'm fine, I'm fine, I just need to
go to the bathroom. My hip hurts and my dirty.
It was really sweet, you know, she was like, I
need to clean myself up. And so I ain't got
on my flight, not realizing she was also in my flight.
So as we land in the airport were supposed to be,
(26:12):
they said, can everybody please stay seated? We need to
have authorities or we need to have personnel enter the plane.
And so we're all watching because we're all curious cats.
It's like, who's getting arrested? Like what happened? You know,
And it turned out to be medical professionals and they
get on the plane and it was her, and then
she had to be carried off, and I thought, oh
my gosh, I bet I hope to goodness it's just
(26:34):
a bruise, but I hope she didn't break something. And
she just sat in that seat for five hours because
she looked so frail, and things like hormones other obviously
a lot plays into bone health, exercise, vitamin D, vitamin
K two, et cetera, glucose control, lifting weight to exercise,
but hormones do too, And I thought, Oh, my gosh,
(26:57):
what if she had broken her hip and just sat
there for five hours and didn't realize it. She was
up on adrenaline. The adrenaline came down and I was like, Oh,
people don't even realize that's a risk.
Speaker 2 (27:07):
Oh yeah, yeah, what about testosterone? Talk about testosterone entering
the conversation with Women's homod therapy.
Speaker 3 (27:16):
Yes, I am a big fan of testosterone. We don't
have testosterone in the States. I think you guys do,
but we don't, So we use it off label. We
use the men's version just we just use a much
smaller dose, or we get it specialty made at a
compounding pharmacy. I usually when I start hormones with women,
I start with progesterone first, it's the first hormone to
(27:37):
generally decline. Then I generally consider estrogen, and then I
generally consider testosterone. And the reason I go in that
order is because testosterone doesn't fall in all women at
the same rate. Some women maintain their testosterone pretty well
through their fifties into their sixties, then it starts to fall.
Other women lose their testosterone right away. And the reason,
(28:00):
and this is important, is if you jump on the
testosterone bandwagon and you don't necessarily need it, or you
probably should have done estrogen first, your body can There's
some research to show your body can get like a
misperception that you have an imbalance between testosterone and estrogen.
So you start a testosterone you have this really low
(28:21):
level of estrogen and the body goes, wow, that's a
lot of testosterone relative to estrogen, and it tends to
increase visceral fat around the middle as a result. So
you can get this, it'll shift where you store a
fat so you're a Lobido go up, which is great,
and your motivation might improve, which is great. But then
(28:41):
women go unfortunately, I'm also gaining weight around the middle,
and so it's not a guarantee. But I always just
say to women before I put you on testosterone, I
like to do blood work. I like to see your
levels of testosterone because I don't want that risk for you.
I don't want you to get the weight gain around
the center. So we're starting to see a little research
(29:04):
on that, and I've seen it with my own eyes
where women go, I don't have any libido. I went
on a lot of testosterone, and I had a libido,
and but also I gained weight. I'm like, ah, I know, wrong, order.
Speaker 2 (29:15):
Oh well, I started testosterone, I got my levels tested
and always tanked.
Speaker 3 (29:21):
Yeah.
Speaker 2 (29:23):
And I had a bit of a rant about it
because I couldn't believe that it wasn't a question like
I'd had conversations on the podcast with someone from the
States and he said, testostera check testosterone. It never gets
talked about, and so I went and asked about it,
and then I was just raging that they didn't test it, which,
based on what you've said, I understand, I can understand,
(29:44):
but there's no it wasn't a conversation that was had.
Speaker 3 (29:46):
Oh see, and I always test it. I just explained.
Some women will say, I don't have any libido, so
we'll check my hormones, and I always test it always
because if you need it, I'll give it to you, absolutely. Yeah,
But what will happen some times as women go I
have no libido, and they will just get put on
testosterone and then if they get side effects, I'm like, oh,
(30:07):
that could have been avoided. We could have easily managed
that if they would have just checked your levels. So
I'm always advocating go get your blood work, Go get
your blood work, ask ask for it. But it is
hard because it's for some reason, it's viewed as like
only a man's hormone. And I'm like, women have a lot.
Women have a lot of testart. We have more than
you think we need it.
Speaker 2 (30:29):
And for something that the symptoms are so debilitating, yes, yes,
Well can we not move on past the idea of
gender around hormones. I had another friend she got hers
tested after I was talking about it. So she went
had hers tested and she was lower than what I
(30:51):
mine mine initially was. But her doctor said, well, women
don't take testosterone, and I just thought, why'd you what
fucking til?
Speaker 1 (31:02):
Then?
Speaker 2 (31:03):
What did you test it for if you had no
intention to do anything about it?
Speaker 3 (31:08):
Such a disservice. It plays such a role, you know.
I mentioned libido, but motivation. Mood I had a piece
of hermonion. She called her a battery pack. She's like, oh,
my gosh, I power up. I have so much energy.
It's helpful for bones.
Speaker 1 (31:21):
Now.
Speaker 3 (31:21):
Just like any hormone, too much can cause side effects.
But if you're on the right amount, like you, you'll feel better.
You just feel back to yourself again.
Speaker 2 (31:29):
Yeah, yeah, what's the So when did I go on
I went on hrt in at the end of May
May the twentieth, okay, and I'd had it prescribed a
year before, and then I had to go and have
breast skins and all this thing. And then I went
off and I was just still in that exploration stage
(31:49):
of is this hormonal or have I just burned myself
out for forty years. I'd recently, for a couple of
years before, been diagnosed with ADHD. I was trying intermittently
trialing the stimulant medication. I was like, I don't know,
if this just ramps up my nervous system, maybe that's
what's training me. So there's all these questions. So when
I went off it to get these breast scans checked,
(32:12):
I thought, I'm just going to stop taking those stimulants
and I'm just gonna rest, fix my sleep and get
a baseline and just check. And then it was a
year later, and then I went back on the HRT
and then a month two months after that, I went
and got the testosterone added to it. What's the time
frame generally look like for people? And how smooth does
(32:35):
it tend to be in terms of getting symptom free
or is symptom free just an elusive dreams.
Speaker 3 (32:43):
A little bit of a trick.
Speaker 2 (32:44):
Is it just going to be symptom management and symptom
a little bit easy in this?
Speaker 1 (32:49):
Ah?
Speaker 3 (32:49):
Yes, and yes, some women absolutely kneel it. They're like,
I feel fantastic, I don't have any symptoms. This is great,
and other women is The conference I was just out
last week was hormones specifically hormone therapy conference, and so
it was great. On the panel, we had a bunch
of different doctors. We were all discussing how we approach
hormones and what we experience. And I would say across
(33:11):
the panel, even though the way we prescribe is a
little different, all of us were like, yet, it's management
because if you are still getting a menstrual cycle but
you need hormones, we're working with your menstrual cycle. So
some months or times you might need more hormone therapy.
Others you may need less. There may be a time
(33:31):
where you skip a couple months, which is different. Then
if you're fully menopausal, you don't bleed at all. You
kind of have these low, flatlined hormones. It's a little
easier to manage because you don't have the roller coaster
going on all the time. So I say, it's an
art and a science and like a dab of reality,
(33:52):
like where are you in your cycle? How are your cycles?
What's going on? How far have you progressed? But I
don't want people to get overwhelmed by that. I'm like,
most women are intelligent, smart, they know their body, and
so I can say, hey, if you get these symptoms,
cut the dose in half, or skip a day, or
you know, come off of it for a while. If
your symptoms come back it was too long, start it
up again, go back to your full dose. And most
(34:15):
women are like, not a problem. I know how to
manage this. Like that sounds smart. I can do this now.
As far as side effects go, depends on the hormone
is and it depends the route, because remember we have estrogens, progesterone, testostrum,
we have multiple routes. You can swallow it inject it,
slather it on your skin, put a patch on. You
(34:36):
can have a pellet inserted. You can shove it up vaginally, Like,
we can do all sorts of things, right, So, depending
on the person and what route it is, you may
prefer one way over the other. You may really sensitive
when you swallow things, so you want it like a
lotion or a cream or a gel. You might have
really sensitive skin, so you don't want the gel. You
don't want to patch because you know you're allergic to adhesive.
(34:59):
You Right, Like, there's all these options, and then I
just explained, as we decide what's right for you, it
also depends on like what's going on in your life.
Some women in perimenopause have little kids. They're ready for hormones,
and yet they have toddlers. And I'm like, well, we
need to be careful that we don't use topical per.
Speaker 2 (35:16):
Se cat or cats carry on or dog my cat hormonal. Yeah.
For a few weeks before I chat, JPT and May
were having a chat about hormones, and I put two
and two together and went, oh, yeah, that's what is
going on with my cat being more of an asshole lately, Yes,
(35:36):
which was quite terrifying because I realized that the actual
long term effects of that with it was it was estrogen.
She was laying on the arm yes, put the estrogen on, yes,
and turning into a psychopath.
Speaker 3 (35:50):
These are things I've had vets. I have had veterinarians
reach out to me and say, we see this all
the time. Do you think it's possible? I said, yes,
It's called ferens. You can just like if you were
wearing a lotion, you know, and you rubbed your arm
on somebody else, they'll pick it. They'll be like, oh,
that smells so good, Like what are you wearing? They
pick it up. It's hormones. Hormones in general, estrogen's progesterone, testosterone.
(36:14):
We call them lipophilic, which means they love fat. We
have a lot of fat under our skin. And so
if you rub it in your skin and your cat
lays across it, or your friend hold your hand, or
somebody you know, come in contact with, they can pick
it up. If they pick up your bottle and you're
if you've got a like a gel or a cream,
(36:35):
and let's say you did, we're kind of sloppy when
you applied it, and there's some cream on the outside
like a lotion bottle and they pick it up. They're like, oh,
this is cool. What are you taking? Like they can
they can transfer it can get transferred to them. Need
to be careful full.
Speaker 2 (36:51):
Yeah, yeah. One thing that I like what you just
said before about the management and it's like a now
I feel still so head of my depth. One luck
because I find it frustrating. I have a GP up
the road. She's not from a metopause clinic, but I'd
put a shout out in the local community. I'm like,
I'm looking for someone who deals with this, and it's
(37:11):
someone to have anyone, because my general GPS just bloke
down the road and I'm one of those people that's like,
I don't go there for advice. So I figure out
what I need and then I go tell them what
I need. Basically, again, I need someone that knows about
this stuff. But the frustration still felt like I didn't know.
(37:32):
So when I went back for the second prescription to
be feeled, I said, can I get the progesterone and
the astrad dial gel prescribed separately because they don't last
the same amount of time and I'm getting him in
a pack. How often you taking the progester. I'm like, oh,
every day because because she didn't tell me how to
use it, so I was taking every day and fortunately
(37:53):
I only had a month's worth. So but even then
it was like knowing when to take it in my
cycle and then my cycle was sure, but then my
cycle changed a couple of times, and like, I'm consulting
chat fucking.
Speaker 3 (38:05):
Gp T too.
Speaker 2 (38:06):
I'm like, if I'm what day should I be starting
this if my cycle's only that long? Because I know
that this has got a protective mechanism for me, so
it's kind of important that I get it right. Where
do people find like myself, if they are not getting
that from the prescribing doctor, where's the best place? And
this might be a great I've got dates written down
(38:27):
for an awesome thing you've got coming up, a mastercliff.
Speaker 3 (38:30):
Free Master Hot masterclass.
Speaker 2 (38:33):
I've written down the Australian dates and times because I
know I'm going to tune into it and there are
times that will make so share that. But also anywhere
where people can or anything you've got where people can
further understand how to use this stuff.
Speaker 3 (38:45):
Yeah, so think, well, it's a good thing you have
me on this podcast. We'll use this podcast as a resource.
So if you still get your period, ideally often you're
going to cycle progesterone, so that usually means you are
flee two weeks off, so you get your period, stop
your progesterone, don't take it during your period, you bleed,
(39:06):
get your period if you still ovulate. Some women feel it.
Some women are like, oh yeah, my mucus changes or
I can tell or i'm testing. Don't still don't take
it after you ovulate after about the middle of your cycle,
then you start progesterone. Progesterone only naturally comes out in
that second half of the cycle. It's you don't make
(39:28):
it during your period leading up to ovulation, and then
you make it after. So for the women though, who
were like, Okay, that was cool last year when I
was pretty regular, kind of twenty eight days, I can
figure that out. But now I'm all over the place.
Now I'm like twenty one days, then I'm thirty five days,
so I'm not really sure when to take the progesterone.
So in that case, obviously talk to your prescribing doctor
(39:51):
who or whoever's given you the hormone. But in general,
I'll tell women, don't do it during your period, Wait
a couple of days if you're that regular, and then
start it. It's not it doesn't have to be rocket science.
I don't want to stress you out. You're probably already frustrated, impatient,
and anxious. So just don't take it during your period.
(40:12):
Wait a couple of days and start the progesterone to
give you that break. Now, if you're listening and you're
completely menopausal, Like say you're listening and you're like, I
haven't at a period in years? Am I supposed to
cycle it? You can definitely give yourself breaks. So I
have had women that feel better giving themselves the occasional break.
So they're like, I just don't do it one day
(40:34):
a week, or I take two days off a month.
They don't have to cycle cycle it because they're not
cycling anymore, but they do say they do. Sometimes they're like,
I just feel like it builds up a little bit,
And I'm like, well, then stop it for a day
or stop it for a weekend, and.
Speaker 2 (40:48):
Then what would feel luck? What would a symptom of
building up? Well, what would if symptom feel luck? If
we would to want to take a break.
Speaker 3 (40:56):
So when it comes to progesterone. So sometimes women will say,
like if if they're menopausal, they'll be like, I feel
like I'm getting groggier and groggier in the morning, or
I feel like I used to feel really good, but
I feel like when I take progesterone, like as a capsule,
I'm getting bloated, or I'm getting heartburn or I'm getting
just like I take it and I just don't love
how I feel when I'm taking it. I'm like, okay,
(41:17):
could be dose, could be route it. Also, we just
need to take a break, like take that weekend off,
reset your system, get it out of your system, and
then we'll start over, you know, come Monday or come
Sunday night as an example. And other women are like, no,
I will never give this up. I don't stop. I
take it every day, you know, Try and stop me,
and I'm like, that's fine too. So I just work
(41:40):
with the physiology of the person who's in front of
me on how we do progesterone.
Speaker 2 (41:47):
This is so informative. Kind of blows my mind.
Speaker 3 (41:50):
Doug.
Speaker 2 (41:50):
Thank you for this conversation and coming to chat to me,
because I feel like I've had a lot of conversations
lightly and I think to myself, you didn't having the
same conversation with a lot of people. But it's amazing
what you can bring that just hasn't been covered. Yeah,
and I haven't understood.
Speaker 3 (42:09):
I've been prescribing hormones. Let's say I started when I
was in medical school, when I was a second year
medical school. That's when that study came out that's at
hormones caust cancer. And my attending said, there are the
hormones we naturally make in our body, like, we'll be careful,
but we're not going to stop prescribing. So I had
a wonderful attending who taught me how to prescribe hormones
(42:30):
very early in my career. I was still in medical school.
When I got out, I did a residency prescribed hormones.
I went right into practice prescribed hormones. And I've done
it all. I've done what we call like the typical
get at your pharmacy type of hormones. I've done. I've
prescribed compounding hormones other than insert a pellet. I've done everything.
(42:53):
And so I have a lot of experience that sometimes
people will talk about hormones, but they don't actually have
the license to describe, or they don't have a license
at all, or they're brand new. You know, they're like
just getting they're just dipping their toe into it as
a doctor, and you know, like that's understandable. I stay
in my lane, like, hormones is my lane. I don't
do surgery, I don't do pediatrics. I'm not going to
deliver your baby. This is what I don't want to
(43:15):
treat your husband like, this is what I do, and
this is what I stick to. So when I when
I talk about it, and I don't want to stress
somebody out, they're already stressed out. This is already a
stressful time. It's like I said, it's not rocket science.
We're just gonna adjust your hormones until it works for
you and we can do that.
Speaker 2 (43:32):
Yeah, what do you have You had any experience with
non bonary people who are experiencing menopouls and how how
how are you guys managing that?
Speaker 3 (43:42):
So do you like you mean non binary or so
I should say I've done.
Speaker 2 (43:47):
Both assan female at BTh So they have the female
hormones and they're going through perimenopolse or hormonal changes. But
obviously that's quite a turbulent time for them, and it's
bought a time of identity crossis and I just want
the how if that's something that you're experiencing.
Speaker 3 (44:07):
And yeah, so a lot of times what I do
is I explain the physiology what's going on, because they don't.
Nobody seems to know, and it goesn't taught to any
of us, male, feel female and everybody in between. And
so I'm like, if they're if they're an established patient,
I'm like, hey, here's what's coming up. Just FYI like
we need I need to mentally prepare you for this
now because I couldn't get out of it, and like,
(44:28):
you're not going to get out of it. I can't
get out of it. You can't get out of it,
and so and then I let them just take the lead.
How do you how do you want to talk about this?
What are your thoughts on hormones? Talk to me about
your symptoms? And I let them take the lead on
what makes them comfortable. Some of them want hormones, some
of them don't want hormones. It just sort of depends
on the person. Now, what I thought you were going
(44:49):
to ask me, was uh, female to male, transgender and
I always say it depends on the level of transition
they've had. So for example, if somebody identifies as male
but they haven't done any hormonal suppression or they're not
using testosterone, no surgery is nothing, they just identify, then
(45:12):
I warn them, here's what's coming, like, you still have
your ovaries, you haven't suppressed anything. I need you to
be aware of the physiology of probably what's gonna happen,
like we need to talk about it. If they have
gone through and they're on tistosterone, on estrogen blockers in tystosterone,
they generally, am my experience, so far, do really well.
(45:32):
I mean, they've suppressed it and so there's not happened anymore.
Of course, if they have had a surgery, they don't
have their ovaries anymore. And I'm like, well, the minute
you went through surgery, you're considered metapausal. But then you're
on hormones, male hormones, estrogen blockers in testosterone, so you're
probably not going to you're not gonna like it's a
moot point, like it's not gonna happen. So I have
(45:54):
to also ask like where are you in your journey
if you are either identifying as or transitioning to male. Yeah,
that will tend to give me, give me an idea
of how to talk to him about the hormones that
shifts that are going to have. But it can be
really hard because there are depending in any of that
(46:16):
entire spectrum. Potentially they're already struggling. And then I'm like, ooh,
it's hard for me and you. It's not always easy
for you and I and uh, the buckle up. I
need to have a conversation with you, which is always
appreciated because they're like, what you know, thanks always for you.
Speaker 2 (46:38):
When when people are transitioning their agenda and they'refore taking
a stringen blocks. If we're going through this went out,
estrogen naturally declines, that must be a shit of a tom.
Does it do the same thing.
Speaker 3 (46:52):
They have the test If they're on the testosterone and
they're consistent with their testosterone, they generally do okay. The
problem is when they're you're regular with it. So I
had a patient due to financial reasons, couldn't always afford
testosterone and estrogen blockers. So he would go on for
a couple months, He would go off for a couple months.
He would go on for a couple months. He would
(47:13):
go off for a couple months, and that was a
heck of a roller coaster because the body had no
idea what was going on. Yeah, and you know that
was a big deal. Consistent, if they're very consistent, they
have access, they take their hormones as prescribed. I do
find that's easier. I'm not saying it's easy. Easier for sure.
Speaker 2 (47:34):
Yeah, And when we take HT estrogen mainly, I guess
I'm talking about what are the physical luck I talked
about skin health, but I know that estrogen and testosterone
both make our fat distribution change. Yes, are their physical
I guess changes over time that we will experience if
(47:57):
we're on HT.
Speaker 3 (48:00):
So estrogen in general, and you know, you probably talk
about this, Estrogen tends receptors tend to concentrate in the
lower body, so the hips, the thighs, the booty, which
is what gives women some curve, whereas androgens like testosterone,
tends to concentrate around the belly area and the upper body,
so do cortisol receptors. So does insulin. For a lot
(48:23):
of people, so they'll get that belly and everyone thinks,
oh it must be stressed or oh it must be
blood sugar and insulin, which it could be, but it
could also be an imbalance or mismatch with testosterone. And
so when women say I've gained all this weight at
this age, I'll say where all over in the lower part,
in the upper part, Like what has changed? What are
(48:44):
we talking about here? The other thing that I will
notice from a like a external symptom are things like
their strength. Will you probably notice this, Like you will
notice their strength. You'll notice like if you go, if
you touch them, I'm doing an exam that instead of
having like firm muscles, they're squishier, right, because they're getting
the loss of muscle mass and unfortunately the increase in fat.
(49:08):
In some women, their grip strength might go down though,
like I'm not as strong as I used to be,
Like it's harder for me. Their balance could be off,
I mean skin we see it. Like again, these are
like changes in decline. So if we go on hormones
coupled with exercise, coupled with all this other stuff, the
goal is that we reverse this is best that we can.
(49:29):
They rip strength improves, there, the quality of their muscle improves,
their skin improves, the shininess and the luster of their
hair improves, even their voice. I had a mentor say,
you can tell women who are on hormones or not,
because like women who are not on hormones, as they
get a lot older, they she goes, they get that.
(49:50):
And this woman is my mentor, she's in she's seventy eight,
so she can say this. She goes, they get that
old lady voice, she said, because their vocal cords change.
And she they turn to these old ladies and she's
and she's on hormones. And she said, I'm not doing that.
She said, I'm maintaining my vocal cords. I'm not going
to get old lady boys. But even like again, like
I said, hair thickness, hair luster, So you can see
(50:13):
different external signs in some women. Now, it's not absolute.
I don't want people listening to this thinking like, oh
my gosh. Obviously a lot of the foundations to health
play into this as well. Estrogen alone is not going
to build muscle right. Progesterone alone is not going to
get your glucose under control. Like you have to do
(50:33):
those things yourself or make you happy, per se, Like
if your life sucks, we got to get that in order.
But still we can see with if you're working on
those things, and we add in the HRT is the
extra bonus, the cherry on top I do. I can
see physical changes, I can hear it.
Speaker 2 (50:53):
Yeah, yeah. Is there anything that I haven't asked that
I should ask that you think I would buckle up?
Speaker 3 (51:04):
I know said we can't have to do a part too.
There's so many things about hormones. One of the big
things I always say, and you've already alluded to this,
which I love, is that you can love your GP
and they can have no idea what to do with hormones.
It's okay to cheat on your doctor on your GP,
like it's okay to go find somebody who specializes in hormones.
(51:25):
It's okay to advocate for yourself. If you go see
somebody and they say to you they don't believe in hormones,
or they don't believe in this or that's not you know,
they're they're really downplaying, dismissing, demeaning, thank you for your time,
go find somebody else. It's you would do the same
thing for your dog or cat at the vet. You
would do the same thing for your kid with the pediatrician.
You didn't like like you thank you for your time.
(51:47):
Absolutely not. I'm going to go somewhere and advocate for myself.
Do that love that?
Speaker 2 (51:54):
Love that? One last question we talked about. You talked
about Gabba the Full and bought my attention because I
went on a range of supplements based on a DNA
test i'd had based on a rabbit hole I'd scurried
on down after seeing some menopause carry on reels on
(52:15):
Instagram related to ADHD and some of the methylation pathways
and things, and I went, oh, okay, right, I better
go look at this. So checked out my DNA how
to look at some things that were a bit had
a bit of a lag, and supplemented. One of the
things I've gone on is Gabba. Now I've always had
sleep issues for as long as I can remember, but
(52:37):
Gabba is the only thing I've ever taken that has
just it will send me to sleep nice. Yeah.
Speaker 3 (52:45):
It is, like I said, it is the inhibitory. It's
the emergency break for your brain, just like it. Just Yeah,
we have a lot of excitation in our brain right
because as humans, we need to think, we need to remember,
we need to focus, we need to go, We need
to activate and gabba. Gabba is the opposite Gaba's like
(53:06):
no stop that, So Gabba is can be a really
good one. There's a few things that support again, like
I said, progesterone when it breaks down can support gaba.
There is to make gabba, you need vitamin B six,
so you want to make sure you're not BE six deficient.
There is another popular amino acid. It's called elf fiannin
(53:27):
elf THEI inning ye yep. Gaba supportive as well. There
are some herbs passion flower, which sounds beautiful, can be
GABA supportive as well. So some people who are like
I don't know about gabba, but they like herbs. Passionflower
is something to look at. So there are a lot
of ways we can support gabba. Like I said, remember
(53:50):
it declines with age researches. Like any other hormone, it declines,
and men and women men same thing. Have you ever
been around in old man? They have no filter and
they can't sleep, so they probably need it too.
Speaker 2 (54:04):
Gabba, load up, load up. My mouth is big enough
without me losing gabba. So I'm going to double one
and I might double that dough. Your workshop is on
for Australians the first of October at either nine am,
nine am or twelve noon. Would you like to tell
the rest of the world when it's on and a
(54:25):
little bit about it? Because I think it's I want
to tune in. It sounds brilliant and I don't normally
promote stuff like this on the show, but it's well,
it's yeah.
Speaker 3 (54:33):
I appreciate it. It's an HT one O one course.
And basically I was getting all these questions of I
think I'm ready, Kerry, I think I'm ready, or I
just started it, I sell have questions, or I'm kind
of curious, and I thought, easy, Breezy, I can do this.
We're going to talk about what it is, what it isn't,
what are the contraindications, does it cause cancer, what to
(54:56):
watch out for in different forms, because I want you
to be really educated when you go talk to your
GP or to help answer some questions for you on gosh,
I don't know I had a blood clot when I
was pregnant, or gosh, I don't know my great grandmother
had breast cancer. Does that mean I can't take it?
Or gosh, I don't know I'm sixty am I too
(55:17):
old like, we're gonna cover all of that. We're gonna
just we're gonna cover those basics. So in my time zone,
I am on the West coast of the United States,
so the Pacific time zone. It is September thirtieth at
four pm seven pm for the East coasters. If you
are in the US listening, there will be a replay.
(55:38):
It is at doctor Carrie Jones.
Speaker 2 (55:40):
So it's not twelve o'clock. I write down two times, right, None,
I am only God, None, I am only yes.
Speaker 3 (55:47):
So four o'clock my time, the night before seven o'clock
East Coast time, the night before brilliant.
Speaker 2 (55:54):
And if you're anyone anywhere else, go and look it
up on time convent. I go ahead to.
Speaker 3 (55:59):
As chadjy P chat GPT. I'll tell you Chat is.
Speaker 2 (56:02):
Nice everything chat. This is my best mate.
Speaker 3 (56:05):
My husband was in Switzerland recently and he brought me
back chocolates. But it's all in Swiss and I can't
and I can't eat gluten, so I screenshot. He goes, Babe,
I don't you know, they're the cutest chocolates in the
whole world. They're little fox and little ground groundhogs. He goes,
But I don't know if they're gluten free. I can't
read this, so I took a screenshot, uploaded a chat GPT.
(56:25):
I said, is there gluten in this? He said yes,
These two words mean in wheat wheat protein. So I
said yea. I said to my husband, I'm so bab
about these are the cutest, but I can't eat them.
He goes, how did you figure that out so fast?
And I was like, chat GPT, obviously, obviously, obviously, yes
I have it.
Speaker 2 (56:44):
Where else can we find you?
Speaker 3 (56:45):
Doctor carry website including the master class doctor carry jones
dot com and if you go to doctor carry Jones
dot com slash masterclass, then you can sign up for
free and get the replay.
Speaker 2 (56:55):
I'm so right now. Thank you so much. If you can,
I have you back. I will have you back. So yeah,
expected big nudge from me soon. Thank you so much
for today. Thank you, thanks everyone.
Speaker 1 (57:10):
She said, it's now never. I got fighting in my blood.
Speaker 3 (57:19):
Got it, quolocaust, gotta got it, got it,
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