Balancing Hormones: What Your Doctor Never Told You with Dr. Daved Rosensweet - SUMMER REBOOT - Episode 281 - Sandy K Nutrition - Health & Lifestyle Queen

Episode Transcript
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Sandy Kruse (00:02):
Hi everyone, it's me, sandy Kruse of Sandy K
Nutrition, health and LifestyleQueen.
For years now, I've beenbringing to you conversations
about wellness from incredibleguests from all over the world.
Discover a fresh take onhealthy living for midlife and

(00:25):
beyond, one that embracesbalance and reason without
letting only science dictateevery aspect of our wellness.
Join me and my guests as weexplore ways that we can age
gracefully, with in-depthconversations about the thyroid,

(00:48):
about hormones and otheralternative wellness options for
you and your family.
True Wellness nurtures ahealthy body, mind, spirit and
soul, and we cover all of theseessential aspects to help you
live a balanced, joyful life.

(01:10):
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Always remember my friendsbalanced living works.
Friends, balanced living works.

(01:31):
Hi everyone, welcome to Sandy KNutrition, health and Lifestyle
Queen.
This is my checkpoint for mysummer reboot series.
I haven't recorded anypreambles because, honestly, I'm
enjoying my summer, my friendsand I feel we all should do that
and we all should take a stepback and then recharge and then

(01:52):
come back really in our own full, true power and essence.
But today I thought I wouldcheck in just because this
episode was one of my mostpopular.
I think it was in 2024.
And I have Dr David Rosensweetcoming back again for part two

(02:17):
in the fall.
So I am going to ask you to doa couple of things for me.
Number one share this episodewith as many friends as you
possibly can.
Share it on social media.
Share it wherever it is thatyou share information.
Number two I'm going to ask youto follow me on Instagram.

(02:42):
I am most active there.
I am active there all summerlong.
I provide really informativeinsights on our wellness from
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Number three I'm going to askyou to review my podcast.

(03:05):
I think the best place to dothat would probably be Apple or
Spotify, and if you rate it andreview it when I say review,
that means provide me with a fewkind words on how my podcast
has helped you.
It is five and a half years now,or so, just shy of five and a

(03:29):
half years that I have beenbringing really important
conversations with amazingpeople in the industry of
wellness, not to dictate whathealth means for you or not to
speak at you, but to provide youwith just those breadcrumbs to

(03:49):
help you understand your ownwellness and if it applies to
you.
Because one thing I say all thetime is that we are all
bio-individuals and we are suchcomplex human beings we are not
robots.
So anything I talk about on mypodcast is really not advice for

(04:14):
you.
You'll need to go and speakwith a practitioner who knows
you and your own uniquesituation.
One of the things I've beentalking about for a while is how
we become so accustomed to takeadvice from people through
social media and podcasts whenthat's not really what it's

(04:36):
meant for.
We can't take advice frompeople who don't know us and our
unique health history and ourunique genetics and how we grew
up and our traumas and all thosethings.
So that's what this podcast isfor.
It's here just to give youthose little breadcrumbs that

(04:58):
you can take with you asinformation in your back pocket
to speak with your ownpractitioner that knows you.
I just really really wanted tostate that I've written a few
amazing, amazing articles andnot to toot my own horn.
But I'm going to do thatbecause they're amazing, because

(05:18):
you're not going to hear aboutmenopause like this, spoken
about menopause like this, likeI did in a few articles, recent
ones, in Substack.
So follow me there.
It's sandycruzsubstackcom andit's S-A-N-D-Y-K-R-U-S-E.
Be sure that you are subscribedto my podcast, so you're going

(05:42):
to get all of my newest episodescoming this fall.
Lastly, I want to thank you allfor hanging in there with me
all these years and supportingme and my primary goal, which is
not to give you a milliondiscount codes of products that

(06:06):
I don't even believe in or evenknow.
My goal is to share informationwith you so that you might use
it to help you live your bestlife and age better.
That's my goal.
It's always going to be passionover profit for me, so I want

(06:31):
to thank you all so so much forhanging in there with me and I
hope you all have an amazing,amazing summer with family and
friends.
Hi everyone, welcome to Sandy KNutrition, health and Lifestyle
Queen.
Today with me I have Dr DavidRosensweet.
He is the founder of theMenopause Method and I wonder

(06:55):
doctor.
Dr Rosensweet graduated fromthe University of Michigan
Medical School in 1968.
Medical School in 1968.
He's been in private medicalpractice since 1971 and has had
offices in New Mexico,California and Colorado, and is
currently in practice inSouthwest Florida.

(07:15):
Dr Rosensweet was the clinicalphysician involved in the very
first nurse practitionertraining program in the US and
in charge of health promotionfor the state of New Mexico.
He teaches health professionalsabout the treatment of women in
menopause with bioidenticalhormones.

(07:36):
Dr Rosen sweet is a nationallyknown lecturer and frequent
presenter at A4M, a principalinvestigator for a scientific
study of female hormones, theauthor of the books Menopause
and Natural Hormones and HappyHealthy Hormones how to Thrive

(07:56):
in Menopause, and the organizerof a national summit committee
on the treatment of women inmenopause with Bioidentical
Hormones.
And today we're going to betalking about hormone
replacement therapy using anapproach that will be actually a
very new concept for many women, and this is Dr Rosensweet's

(08:22):
the Menopause Method.
Now, that's quite the bio.
Dr Rosensweet, I'm really happyto have you here and I'm
excited and I want to understandyou've got an extensive
background and so much historywhat led you to where you are
today?
And you have to tell me howlong has the menopause method

(08:44):
been around.
It's been a while, right, about30 years, yeah, yeah.
So I'm happy to bring this tolight for many women, because
this is not the standard of care.
So tell us your history on whyyou got involved in women's
hormones.

Dr. Daved Rosensweet (09:00):
Well, when I graduated medical school
which I loved, I loved medicalschool I kept looking for other
tools and got into nutrition andtoxicity and what eventually
became functional medicine orholistic medicine.
Santa Fe, a patient that I knewreally well, came storming into

(09:28):
my office one morning beforeoffice hours and was desperate.
It was so unlike her.
She was so brilliant, she hadretired in her 40s and to see
her upset was really remarkable.
And she said I'm telling you,I'm going crazy, don't pretend
you know me, I am reallymiserable.
And I had well, serendipitously,or there's always divine
guidance in our lives, andcertainly in mine and certainly

(09:52):
in my career.
And I had just spoken to aworld expert on progesterone.
This was 1992.
And I gave her someprogesterone.
She was in her mid-40s and twoweeks later I got a letter from
her saying oh my God, I can'tbelieve this stuff, it's helped
me so much.
I'm myself again and that wasvery impressive.

(10:14):
But I haven't really taken holdof the reins of my career so
much as it's unfolded.
And before I knew it shereferred other women and you
know, there I was going down apathway that was very familiar
to me.
I love biochemistry, I lovehormones and sure enough, my

(10:35):
practice was pretty muchmenopause and now andropause as
well.
That's how it happened, deborah.

Wow, that's amazing .
So you know it's.
I do believe that you know ourexperiences lead us to where we
belong right, yeah.
And I have to say I hear on myend.
So I'm a registered holisticnutritionist but a holistic
health practitioner and I amcertified in endocrinology and

(11:05):
hormones for nutritionists and Ihear so much, Dr Rosen, sweet,
I hear women suffering, I hearit.
It's a big problem and I'm surethat you read that huge article
.
Uh, women have been misledabout menopause.

(11:25):
It was in the New York Timeslast year.
It was a big article and now itseems to have more and more
people are actually payingattention that this is a very
real thing.
It's not in our heads and itcan be very drastic for many
women know it can be verydrastic for many women.

(11:49):
So perhaps define what ismenopause and what's the
difference between menopause andperimenopause.

Well, give you a little background.
Young women and young men putout their peak amount of ovarian
for women, testicular, for menhormones at the age of 20.
And there's a gradual declineover the years for both, and it
never stops.

(12:12):
That decline never stops.
Women have this rather profoundevent midlife is there's no
longer enough estrogen to form alining to menstruate.
So it's pretty clear thatsomething went on there, and
both for women and men.
These are some of the mostpowerful biochemicals in our

(12:34):
body and they're everywhere.
They affect our brain, ourbones, our arteries, our sexual
functions, our sexual functions,our energy, and so when we get
depleted in them, traumaticsymptoms occurred.
And that's been happening for along, long time, and what was

(12:55):
pretty silent about it was backin the 40s and 50s, 1940s and
1950s.
There was remedies for this.
So there was 40% of Americanwomen were actually on hormones.
They were on horseurine-derived estrogens and

(13:21):
sometimes with a cousin of it,and so it wasn't that big of a
topic because the women who area lot of women sought the help,
got the pills.
And then it become a muchbigger topic because, in 2002, a
false reporting of a studysuggesting there was risk when
it wasn't so, scared everyoneaway from the whole field.

(13:42):
And 18 million American womenwho were on Premarin and PremPro
and also some, compounded it,dropped down to less than 2
million.
And the consequences of notbeing with these hormones at an
age when women were speaking up,they collided and there was

(14:04):
great misery because, uh, youknow, it's actually a fortunate
event that midlife so many 80 ofamerican women have such tough
symptoms to deal with, becauseit's the purpose of illness is
to get to attract our attentionand answer the question what's

(14:25):
going on here?
And the stronger those symptoms, the stronger the calling.
And menopause has a very strongcall to it, because for 80% of
the women, the symptoms are sointense and then the ideal
response is what's going on andwhat can I do about this?
So it's a good thing that thesymptoms happen, because they

(14:47):
inspire many women to get theremedy.
And just although it's notrelevant for our talk, the same
thing happens to men.
Men have been losing theirerection midlife for a long time
and it's getting worse.
It's occurring earlier andearlier.
Yes, men experience the samelosses.

(15:08):
We didn't know about it.
It was pretty silent untilViagra and Friends came out, in
which we became one of the mostpopular drugs of all time, so
it's not unique to women.
And along with the loss oferection from men, there's a lot
of other losses that havereally changed the nature of
men's life.
So yeah, it's a big deal.

(15:32):
Perimenopause menopause, youcould say.
Perimenopause begins at the age20.
Yeah.
But nobody experiences thoseissues of the slight declines,
or very few women do.
But by 30, there's women outthere who are having experiences
that are different, and by 40,there's more women who are

(15:56):
having experiences related toinsufficient ovarian hormones.
So it's a spectrum.
Spectrum perimenopause.
We define menopause when therehasn't been a period for 12
months.
What do you think of that.
It's pretty great because thedecline never ends.
Well into your eighties, womenare still declining and reaching

(16:18):
and approaching zero.

Okay, I have to ask you about that, because that
whole wait one year before youdo anything.
A lot of women are suffering inthat one year.
You know they don't have aperiod, let's say for eight
months.
Their doctors won't help them.
There's a misconception there,sandy.

Yeah, the one year has to do with one
thing, okay.
The one year has to do with onething Gynecologists have
identified that women can stillbe fertile until one year
without a period.
That covers almost every singlewoman.
It relates to fertility.

(17:01):
It has nothing to do with whenit's optimal to start dealing
with hormonal decline.
And we're dealing with hormonaldecline right now in women in
their 20s, women in their 30s,because these declines, which I
describe very much in detail inmy book Happy Healthy Hormones

(17:26):
and your audience is welcome tothe latest edition, If you wait
a week, we're just publishingthe eighth edition of it I
define how that decline playsout first in the loss of
progesterone, usually then soyeah, I'm glad you said that.
It's only to fertility.
I'm so glad Tell a man who's 45that he's losing, and he's

(17:50):
losing his erection, that well,he should probably wait till
he's 50.
It's absurd to wait.

That's not going to happen.
There's a misconception there.
Yeah, I mean, I'm so glad yousaid that because, yeah, there
are so many doctors that Afollow that study that you
mentioned, that antiquated studythat was pretty severely flawed
, and B follow this one-year.

(18:18):
No periods rule.
Meanwhile, how much damage isbeing done, you know, to bone,
to brain health, like in thatone year of severe suffering.

Well, you're bringing up the elephant
in the room of menopause.
Yeah.
And I've never seen anythinglike it in medicine.
There's no field of medicinethat got such distorted
information with such an adverseimpact as the false reporting
of that study, and let's look atthat.
Okay, of that study and let'slook at that.

(18:52):
In 2002, it was common practicefor physicians of many, many
different types to woman goesinto menopause, give her
treatment for it.
Not a big hullabaloo was madeabout it because it was so
available, like Premarin, wasthe most popular and profitable
drug of all time at that time.

(19:14):
So there wasn't much thoughtabout it.
And along the way from the1980s, the compounding the
holistic doctors we were gettingonto compounded and the
individualization could occur.
So that was also occurring.
Then in 2002, out comes thisstudy that was falsely reported

(19:34):
and what was reported was therewas increased risk for breast
cancer, heart attack and strokeif you're on hormones yes it
scared providers and women allover the world.
Yeah, I say false reportingbecause even in the study itself
there was no legitimatescientific reason to come out
and say that it was wrongreporting.

(19:57):
And yet, once the press got ahold of that fear story it
exploded and you couldn't putthe cat back in the bag and very
few people read the details.
I did.
I had been already treatingwomen for many years by then and
I read the report and I wentwait a minute, women who are on
Premarin in this study.

(20:18):
They have a reduced risk ofbreast cancer in the study.
And wait a minute, they'rereporting increased risk with
PremPro.
But they are saying in thestudy it's statistically
insignificant.
What that means in medicalscience is don't draw any
conclusions.
But it was way too late.

(20:39):
It scared everybody and 18million women on hormones went
down to less than 2 million Wow.
And for all these years it'snot become the real scientific
truth has not come out.
So I'd like to give you whatthat is.

Yeah, tell it to us .

And that we're all at risk for thousands
of diagnoses.
We're all at risk for hundredsof cancers.
As a man, I'm at a relativelyincreased risk for prostate
cancer, and there's reasons forit.
And women have a smallincreased relative risk for

(21:21):
breast cancer, and there'sreasons for this.
But given all these risks, theactual medical science is this
Women who are treated withhormones are at less risk for
breast cancer, heart attack andstroke than women who go
untreated.
Women who've had breast cancerand have had that breast cancer

(21:46):
properly treated with surgeryand chemo or whatever, they
happen to have an increasedrelative risk for recurrence
than a woman has for developingcancer brand new.
But given that increasedrelative risk, they're at less
risk if they've had breastcancer and had that breast
cancer properly treated, if theyare then treated with hormones,

(22:07):
than if they are not treated.
Wow.
Now.
This information became publicwhen the original study
committee published in theoriginal journal a retraction of
the 2002 study 2017, theypublished it.
They said after 18 years offollow-up, there is no increased

(22:30):
risk.
But so few people have heardabout that, so few medical
professionals.
So if you go to a traditionalmedical doctor or a nurse
practitioner, they don't want tohurt their patients.
They're still swimming in whatthey falsely learned and they

(22:51):
haven't become aware of theretraction.
That did not get the press.
It's leaking in.
There's warriors out theretrying to awaken the medical
profession and women all overthe world that that was false
information and actually theopposite is true.
It doesn't mean we're not atrisk.
There's risk, but women who aretreated with hormones are at

(23:13):
less risk for breast cancer,heart attack and stroke than
women who are not treated.

So why is that, Dr Rosenzweig?
Why are we at less risk if weoptimize our hormones?

our hormones.
Well, the science has not beendone on this, but it's pretty
easy for me as a physician tounderstand why.
Just the mechanism of cancer.
You know, you've got thesegenetic abnormal cells
developing in us all the time.
But we also have a protectionto those abnormal cells.
We've got an immune system thatcan identify those cells and

(23:58):
get rid of them.
And the immune system is a verypowerful system and but but
it's it requires a lot of energy.
And what we know about our livesis that over time, for various
various reasons, we lose energy.
We lose, I mean, older peopleare usually more tired, weaker,

(24:21):
and I mean, what did COVID showus?
Yes, what every plague has evershown us that it was the older
people who were so vulnerablebecause they didn't have the
immune systems to handle thevirus.
So what does the immune systemsto handle the virus?
So what does the immune systemneed?
It needs everything functioningon full cylinders, and without

(24:41):
hormones you lose everything.
You lose the ability to producethe amount of energy and
vitality and have a vital immunesystem.
Women who have estrogen hadless trouble with COVID.
It's that direct, that adequatehormones lead to a healthy

(25:01):
metabolism, which lead to ahealthy energy production and
the immune system is heavilyenergy dependent.
Just to give you one simplereason why the risks increase
Well, okay.

Now the other thing .
I hear a lot and, by the way,dr Rosenzweig, it's so
interesting when you're talkingabout these studies, how it
triggers some people.
So I actually had a post whereI just simply said estrogen in
and of itself doesn't causecancer.
Right, it's like what's goingon with the estrogen in your

(25:41):
body.
So many people were sotriggered by that because they
you know, they refer to thestudy that you were saying and
nothing was ever mentioned aboutthe study.
That was the follow-up.
Nobody hears the good.
Nobody hears about that 2017.
So I'm going to make sure thatI link it in this description.

(26:04):
I think it's very important.

There is an oncologist, a cancer
specialist who, specialized inbreast cancer, has written,
along with his scientificpartner, a book that goes into
the details about what I justsummarized In chapter three of

(26:28):
the book that you're welcome tohave your followers can download
a free copy.
In chapter three I describe thewhole subject in a little more
detail than I have on thispodcast, but the real reference
is this book by Dr AvramBlooming and Carol Tavris.

(26:50):
It's called Estrogen Matters.

I've heard of that.

For the scientific amongst you, you will
really get the details of whatI just said and you know the
human race.
Since we were born, since we'veall been around, we've had this
element in us called fear.

(27:17):
And it really speaks to theneed, as part of our healing
process, to put in a lot of time, energy, commitment and courage
to healing our emotions.
Lot of time, energy, commitmentand courage to healing our
emotions, Because if we don'tuncover and unravel and heal

(27:41):
this tremendous burden of fearthat we're all walking around
with, save for those who'vereally done the heavy lifting,
that fear will jump out and grabanything and get its hands on,
including be the source of a lotof unbeneficial human behavior.
And so what sells?
When someone puts out anarticle that we're at risk for

(28:02):
breast cancer, that's even false.
Oh man, that spread like anexplosion when someone, when
that gets retracted by the verysame study committee that
published the original study inthe very same journal, hardly
anyone's heard of it.
Yep.
So you know human life.
Yeah exactly.
There's some complexities to it.

So another thing that I hear quite often is well,
our ancestors didn't needhormone replacement therapy.
My grandmother certainly didn'tuse it, didn't need it, so why
would I need it now?
What would you think of that?

Well, one of the main reasons that our
ancestors didn't need it isbecause they were dead.

Yes, that's one thing I say.
They don't live as long.

Throughout human history, menopause was a
rare event because women didn'tlive that long.
Yeah.
And men lived even shorterlives.
And then, yes, your grandmother.
But if you die, you're notgoing to want the health of your
grandmother necessarily, andthere are some examples.

(29:16):
And there was cleaner living.
And you, as a health coach, youknow some of the details about
this.
But very few of these women hadlibido, Very few of these women
had vaginas that were able tohave penetrative intercourse
with.
A lot of these women theirbladders weren't working.
And if you really get down toit, you know, 50 years ago, when

(29:42):
I was in medical school, 55years ago, we had a lecture from
a gerontologist.
That's an expert in aging,specializes in what happens to
older people, and thegerontologist told us you know,
you medical students, you knowthousands of diagnoses.
That's great.
Let me tell you what's reallyhappening to old people.
They're losing their muscle.

(30:03):
They can't.
They're going from canes towalkers, to wheelchairs, and
that moment from wheelchairs towalkers is where they have very
much trouble living at home.
They wind up in assisted livingfacilities and nursing homes.
They've lost their bladder andmany have lost the ability to
think.
So there are the rareexceptions of the grandma or

(30:25):
grandpa who did really well,could walk and talk.
Let's put it that way.
Didn't mean the men were havingerections, Didn't mean the
women were having a lot of otherbenefits.
But yeah, when those hormonesfall midlife, the majority of
folks don't do well.

(30:45):
Yeah.
And it's worse.
Now there's other challenges toour hormones.
They have to be factored in andas a health care coach, you
know a lot about the other stuffthat's really changing human
life here.

Oh, I agree, I agree.
I mean we could talk about foodin and of itself and have a
whole podcast on how foodaffects our health, right?
But yes, I would agree, there'sthat factor.
Now, you know, here's somethingreally interesting.
I know you'll find thisinteresting.
So the first time I had a hotflash was in October 2022.

(31:23):
And, as a physician, you mayfind this I know it's an N of
one, but you've probably seenthis During that same time, I,
as a nutritionist, became Iguess you could say I was in a
pre-diabetic state.
My HbA1c climbed to 6.1 and Ideveloped chronic pain in my

(31:45):
wrist, which I mean.
Since then, I have startedbioidentical estrogen and I've
been on progesterone a while now.
But you know, we talk a lotabout symptoms and we don't.
It's like mysterious.
It's like why did all thisbegin right around the same time
I started having hot flashes?
Is there a correlation?

(32:07):
I know we can't go back andtest now, but in your clinical
experience, it's possible.

Why do so many things happen midlife?

Why did that happen , right around the time that I
was clearly having symptoms ofdropping estrogen, like?
The pain in your wrist the painin my wrist, higher HBA1C.
It was like sure I was havingalmost like a little cluster of
symptoms right around the sametime that obviously I was having

(32:39):
changes in my period.

I was having hot flashes starting, so
I was feeling physically manydifferent symptoms many
different symptoms, yeah, andthe list of midlife symptoms in
a woman whose hormones aredeclining, and men as well it's
really long, yeah, and I list,and anyone could Google, what

(33:03):
are symptoms of menopause andyou'll go whoa, there's a lot of
stuff there, there and they allhave an explanation.
And in order to maintain a goodhemoglobin a1c, which means that
you're really managing glucosewell, you have to have a lot of

(33:24):
things going for you, includingyour hormonal system, and once
you lose hormonal contributionto glucose regulation and the
stress comes in, because stressis a glucose raiser you've time
and dietary indiscretions andI'm not saying that's true about

(33:54):
you, but there's a lot ofthings that coincide midlife.
The pain issue is a reallyinteresting one.
Why should women develop jointpain so commonly Severe?
I had a 55-year-old womanpatient who was a high-end real
estate agent who was onOxyContin.
Wow.

(34:14):
For her joint pain, for her hippain, and what turned out is
that when we started treatingher menopause, five weeks later
I meet up with her in the healthfood store parking lot.
She said I can't believe it, Ihave no more pain, I'm no longer
on OxyContin.
She dropped cold.
She was not an OxyContin addict, like I had been concerned.
She was having.

(34:35):
Severe pain, went away.
When you look at theinflammatory conditions that can
occur and the vulnerability ofjoints, well, there are many
symptoms that relate to hormonaldecline, outside the obvious

(34:56):
hot flashes right, yes, yes,which are very stressful, by the
way, and can lead to increasedadrenaline and cortisol, which
can give your immune systemtrouble.
So the knee bones connected tothe thigh bone and you wind up
with a lot of stuff yes that goaway wonderfully.
Not perfectly, not necessarilyeverything, but this is what I
teach to physicians when a womanof midlife comes in with a long

(35:21):
list of symptoms, treat hermenopause first, prior to doing
any some significant majormedical workup, and see what
symptoms remain.
And very often they'reastounded it's like, oh my God,
so many things related to theloss of hormones.

(35:42):
No big surprise.
These are amongst the mostpowerful biochemicals in our
body.
We don't do well when we loseour powertrain.
There goes in our body.

We don't do well when we lose our power train
there.
And then you know there's a lotof you know you mentioned
vitality we were talking about.
You know.
I know myself I feel better nowthan I did in my 40s.
I had thyroid cancer in myforties so it took me a while to
get back up to that feelingvital again, but now I never

(36:19):
want to go back.
I never want to go back to that, and so I won't stop at, you
know, doing my own research.
But what you do is youindividualize hormones for women
.

How is what you do different than what
most doctors that prescribehormones do.
Well, most doctors thatprescribe hormones have not
taken on the treatment of womenin menopause or men in
andropause as a specialty.
They have broad-based practicesand treatment of menopause and

(36:59):
andropause is a small portion ofthat practice, which is a very
unusual thing in medicine.
When I was growing up inmedicine, specialization was
occurring Like wild.
Instead of generalists, you hadthis army of specialists take
place and at first I wascritical of it until I realized

(37:19):
what was going on is that nosingle physician can get their
mind around and become expert atthe whole field of medicine.

No.

And so what people started doing is,
like urologists started,focusing in on the kidneys and
the bladder and the prostate.
And when you narrow it downlike that, you can get so much
knowledge and so much experiencethat you can become an expert
at it.
And it's very rewarding to bean expert and that's a wonderful

(37:55):
thing, that specialization.
But because of that Women'sHealth Initiative in 2002, when
all medicine was differentiatingout into specialties, nothing
happened in the world ofmenopause.
When you look at these variousbodies of knowledge urology,
neurology, internal medicine,diabetology you see these

(38:18):
tremendous expertise occurringand in those fields there might
be some discussion at theperiphery, but the core body of
knowledge and practice is reallysolid as gold.
Not so in hormonal medicine,because there hasn't been a
specialty.
I'm one of the few physiciansI've ever met that have

(38:40):
specialized only in this andthat's a big deal and there is
no standard of care and it'slike the wild west.
So when you go out to yourstandard provider, they haven't
specialized in it.
Well, we're working on that.
We have.
I have a big team.
We're working to createstandard of care.

(39:01):
We believe we already have andget board certification and the
most significant thing about itis I don't even think we have a
method.
We called it the menopausemethod.
But what happened is, when Istarted out, there was so little
known, and what I did is I juststarted paying a lot of
attention to what was going onin women and partnering with

(39:23):
them to find our way to.
How do you do this right?
Yeah, 30 years later.
So all I think we did is whatthe urologist did, is what the
cardiologist did.
They paid a lot of attention,got a lot of experience and
figured out how to work with itbest, and so it's not a method.

(39:47):
It's not a method we apply tomenopause.
What it really is is how do youtake women and men and treat
them excellently?
And here's one of the firstdiscoveries Women vary
individual to individualenormously, as do men.
Like you have some young womenthat they have a lower amount of

(40:11):
estrogen, but they're perfectlyhealthy, they're fertile, they
have regular menstruations.
They can carry a pregnancy toterm.
You have other women that needthree times that amount three
times that amount to beperfectly healthy, carry a
pregnancy to term, regularlymenstruate.
There's tremendous individualvariation in there.

(40:32):
There's a lot of differentother variables in there.
It's not a problem If you startout with the intention of
figuring each woman out.
She'll arrive at what is anoptimal program for her and all
you have to do is partner withthe woman and listen to her
symptoms.
See whoa.
Is she estrogen rich?

(40:53):
Is she progesterone rich?
Let's start out with low doses.
Gradually increase those doses.
Have symptoms disappear.
Discover the perfect balancejust by symptom alleviation.
Don't go too high or you'll getsymptoms of overdose.
You back down and then we do24-hour urine hormone testing on

(41:14):
all women.

Oh, I was going to ask you about that, because just
doing a point-in-time bloodwork is, I mean, just because
we're in menopause it doesn'tmean we're flat and we're the
same all the time, right?

Well, the opposite is actually true and
you're really uncoveringsomething that matters.
Yeah, well, the opposite isactually true, and you're really
uncovering something thatmatters, yeah, Is that even a
young, healthy woman whoseclockwork, menstruating
clockwork, I mean every 28 days,every 27 days, those women are
ovulating and those women weknow when in the month we have

(41:51):
to test them.

We have to test them on week three.
Yes, yeah, like day 19.
Right, it's usually right.
Yeah, that's when you testhowever, um, these aren't.

The women are showing up to doctor's
offices because they're doingreally well, so testing is
really a challenge in women'shormones.
In the the perimenopause,everything gets worse Because a
woman's general body levels ofestrogen are declining.
Her pituitary gland and brainare trying to reawaken the

(42:23):
ovaries and it pumps out thesesurges of stimulating hormones
to the ovaries to get them towake up again.
Yeah.
And it works.
You get a low estrogen.
You put out some extra fsh tostimulate that ovary.
It puts out a level of estrogenthat is higher than a woman
ever had in her young life, butthe ovary can't keep up with it.

(42:46):
So you get highs and lows inthe perimenopause, that is.
But the good news is you don'thave to test the perimenopause.
It's a waste of money to testbecause we can tell by symptoms
that the woman's low.
She's having hot flashes in themiddle of the night, she's not
sleeping, her mood is down.
Yeah, so we don't test in theperimenopause, and that's a very

(43:08):
, very important thing.
And then testing in themenopause.
24-hour urines work great.
They're gold standards sincethe 1960s.
Everything else does not, andthere's reasons, and there's a
lot of popular testing methodsout there.
It's the Wild West in testing,but the one that works is the

(43:29):
24-hour urine hormone test andnothing else does.

Are you referring to the Dutch or no?

Well, I'm referring to the dried spot
urine.

Because the Dutch is also dried urine.
I mean, everybody talks aboutthe Dutch.

I'm just going to talk about the dried
spot urine.
Okay, just to be politicallycorrect.

I understand, but it's pretty obvious, it's
possible.

But we've done cross-testing on this.
We do not see the evidence thatwe need to see that it
correlates.
Well, we're still doingcross-testing on it.
Split specimens.
We have women that we'retesting by 24-hour urines and by
spot urines.
But there's a lot of scientificweaknesses in the dried urine,
so I will not.

(44:14):
I'm just going to give you mybest shot.
Yeah.
What I know is great is 24 hoururine hormone testing.
Okay.
Everything else no.
Okay.
And blood testing is fabulousfor so many things, thousands of
things.
However, when you have a womanwho's being treated with

(44:36):
hormones, when do you draw herblood?
After she put on her morninghormones?
An hour after, before she puton her hormones?
When a woman puts on herhormones, you get a rise and
then you get a fall.
So it's very hard to bespecific with each woman is how

(44:57):
high is she really getting?
Are you going to test her everyhalf hour to find out when she
is an individual peaks and thenyou're going to.
You're going to keep checkingthat this work has not been done
.
It's too impractical to do it.
I love blood testing for athousand things, but not for
hormone levels, that is, in awoman that we're treating with

(45:18):
hormones.

Okay, so that's good to know.
So you're saying when a womanis taking hormones it's best to
do the 24 hour urine?

Yeah, absolutely.

Most accurate, Absolutely Okay, that's good to
know.
Now we started to touch onsymptoms.
I want to get back to thatbecause you may you raised a
really important point.
You are working with eachpatient, you're understanding
their symptoms, you're kind of,you know, you're, you're

(45:51):
customizing, and I think thatvery few doctors have that time
and that expertise to hone in onthat customization.
So this is probably why you seea lot of women go on
antidepressants when they'regoing into menopause, because
it's easier to just let's justtreat the mood issues and you

(46:16):
must see that a lot or know ofthat happening with but
apparently that is one of thetreatments for menopause, right?
Instead of getting to the rootof why is that mood
dysregulation?

Exactly the symptoms for most women are
coming from the low hormones, soyou'd want to treat with
hormones.
I'd like to say that when awoman goes into menopause and
gets hormonal treatment almostof any kind from a decent
provider, they're going tobenefit, yep.
And then the question is whatdo you want?

(46:56):
Do you want something that'spretty general that's going to
make you sort of good, or areyou going to want something
that's individualized?
And to me it was really obviousthat what women and men really
want is a high degree of skill.
Women and men really want is ahigh degree of skill.
Like, for example, if you're aman and you've got a prostate

(47:17):
issue and you need surgery,you're going to want to go out
there and spend a lot of timefinding out who's the best knife
, of course, of course, andyou're going to want to go for
the best methods developed bythe people who care about it the
most.
You could get some decent workfrom almost anyone who's trained
, but these kind of thingsmatter so much that you're going

(47:41):
to want to seek out good stuff.
It's like we do in anything inlife, and it's true in the world
of hormones too.
So almost any hormones donedecently, without symptoms of
overdose, have benefits.
And yet you're going to wantsomething that's individualized
to your body the balances, thetype of administration, the

(48:05):
carriers.
There's a lot of detail there.
I describe it in the book, so Imentioned this word.
Well, you're going to payattention to the details.
Why go into the details inHappy, healthy Hormones?

Okay, so we talked a little bit about the symptoms,
but here's where it gets reallyconfusing, because sometimes
the symptoms of too muchhormones can be the same as too
little.
Much hormones can be the sameas too little Like is that when
you test or is that when youback off?
And the reason I say this andwe will get into the differences

(48:40):
.
Maybe we should get into thedifferences between what is
bioidentical hormones versuswhat is a regular HRT.
That might be a better place tostart, because there's also a
lot of confusion there, where Ihave actually had numerous women
say oh yeah, yeah, I've been onprogestin for a while and they

(49:00):
don't understand that it's notprogesterone.
So maybe you can explain thedifference.
That would be really helpful.

There's two good topics there.

Oh yeah, we got two .
We got lots to talk about.

I think what you're identifying is a
bigger subject.
I should go there, but I canalso go to that other one which
is very interesting.

Well, maybe let's first describe what is
bioidentical versus regular.
So that's got to be clear.

So the human body, the human ovary,
puts out very chemicallyspecific hormone structures.
They have a very specificmolecular structure.
It's highly technical and it'shighly exact.
And when hormones were first,when we have record from

(50:01):
hormones first being given tohuman beings, it's been about a
thousand years ago first beinggiven to human beings, it's been
about a thousand years ago theChinese figured out to collect
the urine of young women and dryit out and the powder residue
was fed to the aristocratsbecause hormones were in that

(50:22):
urine.
And they did the same thingwith men.
They collected the urine ofyoung men.
So back in the day it wasbioidentical.
Wow, the same molecule,interesting.
That was being given to theChinese aristocrats.
Wow.

(50:44):
And then time went on and in the1940s, when people were
becoming aware that women wereliving longer and that these
menopausal symptoms were a muchbigger deal than they were made
out to be Prior, thepharmaceutical industry wanted
to come up with a way to develophormone products for women.
And they knew that the hormoneswere in the urine.

(51:06):
And they actually did a bout ofcollecting urine and drying it
out, but that disappeared, thatthat that never materialized.
They actually chose the horse,the pregnant mare.
But the big animal puts out atremendous amount of urine with

(51:27):
a tremendous amount of hormonesin it, especially when pregnant.
They collected the urine ofpregnant mares, dried it out and
came out in the 40s with thispill form called Premarin from
pregnant mare urine.
And you know what Premarin dida lot of good.
I myself was never attracted toit.

(51:48):
I've never written aprescription because when I came
along other things wereavailable.
And then they realized that ifthey fed estrogen alone,
pregnant Mary urine alone, towomen that had a uterus, they
increased the rate ofendometrial cancer.
So they wanted to copy naturesomewhat.

(52:10):
So they instead of choosingpure progesterone, which they
could have.
But they can't patent pureprogesterone.
You cannot patent a moleculethat already exists in the human
body.
They took that progesteronemolecule and messed with it and
produced something called aprogestin that you named.
Took that progesterone moleculeand messed with it and produced
something called a progestinthat you named as a progestin.

(52:32):
And on our medical board we'vegot a wonderful medical board.
We have a world expert who didthe original molecular research
on progestins to point out theproblems that they were.
But the original major treatmentprior to 2002 was a combination
of Premarin and Prempro.
If a woman had a uterus, acombination of Premarin and

(52:54):
Provera and a Progestin, well,if that's the only tool you have
, it's pretty good.
But like I was sitting havinglunch with a pharmacist once a
compounding pharmacist and hesaid to me did you ever wonder
why Premarin had such a thickcoating?
I had never seen Premarin.

(53:16):
I said no.
He said well, I did so.
I bit into it and out comesthis profound odor of urine.
No way, they were trying todisguise the urine odor and
there was something that didn'tappeal that to me.
And chemically it doesn'teither, because 50% of the
estrogens in Premarin are uniqueonly to horses.

(53:40):
The human female has never seenthem.
But, like I say, premarin andPrembro did a lot of good.

Yeah, it's kind of like a better than nothing
situation, right.

Yeah Well, it was a breakthrough.
Yeah.
Because you want to manufactureit so a lot of women could have
advantage of it.
Yeah.
Well, in the early 1980s,almost at the same time, a
wonderful medical doctor,Jonathan Wright.

I know who he is Dr Jonathan Wright.

Oh, yeah, yeah, yeah, I know who he is.
Yeah, he thought you know.
What I have a suspicion is thepharmaceutical industry has
learned how to produce purebioidentical hormones same
molecule because they've comeout with it in the birth control
pill.
The estrogen in the birthcontrol pill begins with
estradiol.
It's changed, but they've gotpure estradiol.

(54:36):
So he asked a compoundingpharmacist could they find pure
same molecule as is in thefemale body?
And they did, and they came upwith these bioidentical same
molecule.
It turned out that thepharmaceutical manufacturers, in
order to produce birth controlpills, were buying up soy fields

(54:58):
and extracting a precursor tosteroid hormones called
diastrogenin.
Because plants are not thatdifferent than us.
They got the precursors tothese hormones too and
extracting and putting themthrough a process very elegant,
very exquisite process and sothey take that diastrogenin from

(55:19):
soy you can get it from yamstoo.
It's very rich in yams, butthere's not as many yams out
there and you put it through avery sophisticated chemical
process and you wind up withpure estradiol.
That's what the ovary isputting out same molecule yeah
pure estriol, same molecule thatthe ovary puts out.

(55:40):
Pure testosterone same moleculethe ovary puts out.
And lo and behold, the maletesticles put out same molecule.
And when that came along andthere was also a pharmacist who
did the same thing, he got ahold of the pure estradiol, put
it in a gel for his wife who wasin that phase.

Jim.

Pertzer in Dallas, bioidentical hormones
became available and by the timeI came around, these
compounding pharmacists wereprocuring these ultra pure same
molecule hormones and I thoughtgee, horse versus bioidentical.
I think I'm going to go for thesame molecule type thing.

(56:22):
Yeah, yeah.
And so it's wonderful you gotright.
These days you got 8,000compounding pharmacies in the
United States putting togetherthese individualized
prescriptions.
Yeah.
So I can get highly specific,individualizing it to the
individual woman, about what wegive her and what we're giving

(56:45):
her is molecularly pure.
So that's the difference.
That's great.
And, like I say, decent medicaltreatment by a caring and
somewhat knowledgeable physicianor nurse practitioner, with
almost any hormone that they canget a hold of, can have some
merit and value.
But what do you want?
What do I?

want Right value.
But what do you want?
What do I want Right?
So just before we get into thesymptoms, I have to ask you
treating a woman with estrogenonly, is that safe?
Or should you always have alittle bit of progesterone,
always kind of balancing the two?

of progesterone, always kind of
balancing the two.

Speaker 3 (57:32):
Well, I'm going to look at it from a different
perspective.

Okay, a woman's body puts out four
different hormones from theovary, puts out estrogens, a
family of them, three major ones, yep and it puts out
progesterone every single month.
And it puts out, molecule formolecule, 100 times more
progesterone every month and itputs out the most potent

(57:55):
estrogen.
So, gee, why in the world wouldwe want to invent a different
human being?
Yeah.
Biologically at least.
There's a lot of perfection inthe human being, so anyone who
paid a lot of attention to thiswouldn't dream of leaving out

(58:17):
progesterone.
Yes.
In fact would lead withprogesterone, because it's
usually the deficiency thatstrikes first.
Yes, that strikes first, yes,and so good treatment.
If you want to copy nature, asDr Wright coined pretty good
idea to copy nature you put alot more progesterone in any

(58:37):
formulation than you're doing,than you do estrogen, because
that mimics.
Now, when you get down to theweeds, in the sense that you
really pay attention to themerits of progesterone, you
wouldn't dream of leaving it out.
It's so important for mood andsleep and bones, just to name a

(58:57):
few.
Huge, Not only to mentionprotecting the uterus, and it's
got a myriad of importantfunctions.
So one of the things we do withprogesterone is we always like
the word optimize, but reallyoptimization in the world of
progesterone is maximizing it.

(59:18):
Keep on increasing the dose ofa woman with progesterone until
we go so high, we go over thetop and she's got symptoms of
overdose, and then back her down.
Keep her up at optimal, robustlevels of progesterone, because
that's what her body did andthat's what's really good for

(59:38):
her.

Yeah, I mean, I started progesterone way before
estrogen and it was my lifesaverwhen I saw that I wasn't
sleeping well.
And I mean, let's face facts.
I don't know about men I can'treally say for men, but as women
, if we have children, that'swhen sleep really, from when

(01:00:04):
they're babies to when they'regrown up, we still they have an
effect on our sleep, let's justsay, and our nervous system too.
So progesterone helps with thatright.

Dr. Daved Rosensweet (01:00:14):
Oh yeah, it's well.
Progesterone is the greatcalmer.
It's a very unusual, powerful,biochemical, powerful hormone.
Most hormones are energizing.
They can even be recruited forfight or flight.
Progesterone is the greatcalmer.
If I were to injectprogesterone at the right dose

(01:00:37):
into anyone's veins IV includingmy own I could be put to sleep
so deep that surgery could beperformed on me.
Wow to sleep so deep thatsurgery could be performed on me
Wow.
So when women start losingtheir progesterone, sleep is one
of the first things that goes,and progesterone is so related

(01:00:58):
to calm mood.
You've got some young women intheir 20s and 30s.
They're doing fine with thestresses of life, but they got
this weird thing that they feellike they've got this anxiety.
It doesn't make sense.
They're strong, they're doingwell.
They've got this anxiety.
You can bet most of those womendo not have enough progesterone

(01:01:18):
even in your 20s.
Yeah.
Yeah, so we really want tobecome aware of that and assist
these young women withprogesterone to sleep and mood.

Sandy Kruse (01:01:29):
So progesterone is essentially pretty safe on its
own, even at a younger age, ifit's needed.

Yeah, I mean, let's look at it again
from the flip side.
A young woman is used tocruising on a very robust amount
of progesterone.
What happens when she doesn'thave it?
That I would call unsafe.
Yeah.
It's too powerful a hormone and, let's just face it, anyone

(01:02:03):
lose a night's sleep or twolately.
How's that go for you?
Or mood A person can develop aself-image.
A young woman can develop aself-image like she's got
anxiety disorder.

Yes.

Most of these women don't have anxiety
disorder.
The stresses of life havethrown off their period.
They're either lower inprogesterone than they ought to
be, so they lose the calmer, orthey're not ovulating, in which
case there are basement levelsof progesterone.

Right.

And so the unsafety for living and there's
more to it too.
I mean progesterone is soprofound that in order for
thyroid hormone to work well,you have to have adequate
progesterone.
What fascinated me when I firstfigured it is this too much

(01:03:00):
information.
Sandy, how are you doing?

Oh no, you want to talk thyroid?
Listen, I don't have one.
I love talking thyroid and it'sall connected, right it's super
connected.

Yes, I mean, I didn't ever get this.
What I knew as a medicalstudent and as a young doctor
was that if you want to know ifa woman's ovulating, one of the
ways you can tell is if hertemperature goes up mid-cycle.
So if she takes her temperatureevery day and she sees a rise,

(01:03:32):
she's probably ovulating.
If she does not see that rise,she's probably not ovulating and
I never put two and twotogether.
Why does that?
Why does her temperature go up?
Because, well, one thing weknow is that mid-cycle if a
woman ovulates, she gets thisburst of progesterone huge
amount.
If she doesn't ovulate, there'sno burst, it's just the low

(01:03:56):
amount of progesterone.
And it turns out thatprogesterone facilitates the
action of thyroid hormone.
And one of the majormultifunctions of thyroid is to
inspire metabolism, which is howyou combine oxygen that you
breathe with the food that youeat.
You burn it, you oxidize it andthe rate of metabolism

(01:04:18):
determines how much energy youget and how much heat you put
out.
So if thyroid is working reallywell, mid-cycle for a woman,
you get so much more heat thatyou can actually measure it
Because progesterone facilitatedthe action of thyroid.
So the knee bone is connectedto the thigh bone, so
progesterone figures intoadequate metabolism.

(01:04:41):
Holy mackerel, remember I saidthe immune system needed energy.
Yes, remember I said the immunesystem needed energy.
A young woman, to be healthyand to not gain weight, needs a
really honking metabolism toburn off some of that food.
So hypothyroid, lowprogesterone, I mean the knee
bones connected to the thighbone.

(01:05:03):
It's amazing.

Fascinating.
And then even still, if youwere to bring estrogen into the
conversation, as it relates tothyroid.
When estrogen goes off, thatalso can affect thyroid function
, like when you have a severedrop in estrogen.

Your body wants the same amount, the right
amount.

Speaker 3 (01:05:26):
Yeah, it wants the right amount of estrogen and it
wants the same amount, the rightamount, yeah.

It wants the right amount of estrogen and
it wants the right amount ofthyroid.
And if you give too muchestrogen treatment, you throw
off the thyroid.
So when a woman's been withoutestrogen and she's cruising
around long with her thyroid andyou give her estrogen and she's
taking thyroid, by the way, youhave to pay attention to what

(01:05:49):
happens to the thyroid because,again, everything is so
interrelated and so.
But all you have to do as ahealthcare provider is
understand the field and youknow about these things.
So a woman who's hypothyroidand is on thyroid medication to
alleviate it, it's great, greatstuff.
Who's hypothyroid and is onthyroid medication to alleviate
it, it's great, great stuff.

(01:06:10):
When you're treating her inmenopause, you, somewhere along
the line, like in the beginning,you do some sophisticated
thyroid tests on her and thensee what's happening three
months later to make sure thatyou've got these two exquisite
hormones in balance.

Trust me, I know I'm going through menopause
without a thyroid and takingbioidentical hormones, so I'm
lucky that I have anendocrinologist that does check
my levels regularly, becauseI've seen a lot of this in the
last couple of years.

Are you on T4 and T3?

So I'm on a beautiful mix of T4, t3, and
desiccated because I wanted tohave more of the symphony of the
thyroid, which is why we addedin the porcine, because I had
done so much research on it andI do understand my body and I do

(01:07:06):
understand my body and I dounderstand symptoms.
But it gets a little hazy whenwe're talking about symptoms,
because some symptoms can bemenopause, some symptoms can be
too much estrogen, too muchprogesterone, or maybe it's my
thyroid, and they all can kindof intertwine and get very

(01:07:28):
confusing.
This is a great segue intosymptoms, right?
What do you think?

And it is a great segue.
And you're also bringing up,though, prior to speaking about
that segue, how important it isto become somewhat familiar with
your own body.
Yes, to become somewhatfamiliar with your own body, yes
, and you know, if we didn'tlive into these midlife years,

(01:08:00):
we wouldn't maybe not have to.
But when you start losinghormones and you start taking
nutritional supplements andpaying attention to your health,
it's nice to know a little bitand to do what you're doing,
because ultimately, thesehormones are going into your
body and women vary and men vary, and so you know a little bit,

(01:08:21):
and this is how I figured it out.
Really, I knew a certain amount.
I knew the hormones were goinginto a woman's body, we teamed
it and we did what you did.
We adjusted this, we adjustedthat, we tested, and so it's
good to individualize.

(01:08:42):
You can do a lot of goodwithout individualizing.
I don't want to underplay that.
But when you want to feelreally good, you really get
specific.

I think some women are also more sensitive than
others.

You betcha .

You know, like some of us, I know that even if I
take certain supplements and Iknow that, for example, if I
take my thyroid medications tooclose to having my coffee I have
one cup of coffee a day, but Imake sure that I don't I don't
take it within two hours so Ipay attention to these things

(01:09:15):
because I can see and feel adifference when I don't.
So, educating women, which issomething that you do, which is
so powerful, because we havethis wisdom within and we need a
great doctor to help us be likean advocate, to help us feel
our best.

Yeah, it's like me and my auto mechanic.
Without that auto mechanic, Ican keep my older cars going.
It's much more important, it'smuch better.
How you said it?
And being super sensitive, youknow, I think we all are that

(01:09:58):
sensitive, but some people aremore conscious of it.
Yes, we need that sensitivityand it's the sensitive ones
amongst us who are teaching ushow to do the rest of the work.
And you know, I've had manypatients who were super
sensitive.
I know this one really well andI began to realize about them

(01:10:20):
that at a very early age you'reforced to a level of detail to
work well with your own bodythat can make you an expert at
it for your whole life, whereasother people who aren't feeling
these things, yeah well, youknow.
So it's a, it's a, it's a powerthe sensitivity and we train
all of our physicians and nursepractitioners that you want to

(01:10:42):
treat the sensitive onesdifferently.
We want to.
We want to go lower, startslower, go lower.
Sensitivity does exist and itneeds to be respected.
When you're designing theseovarian hormone replenishment
programs, we definitely pay alot of attention to sensitivity.

So you would treat my husband very differently than
myself because he doesn'tnotice anything.
And I would treat my husbandvery differently than myself
Very because he doesn't noticeanything.

And I'm like your husband.
Well, I could.
I could take a gallon ofsomething and not feel it.
It would still have the sameeffects on me.
Yeah, Ultimately.

Yeah, exactly.
So I have to ask you thisbecause I didn't ask about.
Um.
I've heard and researched a lotas it relates to estrogen
orally.
What is your take on oralestrogen?

Well, like I said in the beginning, um,
almost any hormones that are outthere, especially if there's
been some pharmaceuticalmanufacturing or bioidentical
compounding involved, are goingto do some good.
And then there's what's thegood, the better and the best In

(01:12:06):
order to get a hormone level upin the body when you take it by
mouth, you've got to givesomeone quite a bit of a bigger
dose.
Because the very first thingthat happens when you give an
oral hormone is it goes into thestomach, then the small
intestine and then it's pickedup by the liver immediately and

(01:12:27):
the liver does its thing and 80to 90% of it is totally
metabolized, never made it tothe full body.
So you got to give quite a bithigher dose, and that's part of
the issue, because we don't wanthigher dosages and we don't
want to deal with a bunch ofliver metabolites.
But that's not the main reason.

(01:12:48):
When the birth control pill cameout that has oral estrogen in
it, and what we learned?
That a small number, butsignificant number of women were
getting blood clots in theirlegs called thrombophlebitis,
and some of those women werehaving pulmonary embolus.
That clot was breaking loose,going to the lungs, and even

(01:13:08):
some women died from that andthat was from the oral estrogen.
And what we've learned aboutoral estrogen is that it
promotes and I think it'sthrough this first pass, through
the liver coagulation proteinsto be produced and inflammation
proteins to be produced in theliver be produced and

(01:13:34):
inflammation proteins to beproduced in the liver.
So we have a general rule andI've only given oral estrogen to
one human being over 30 yearsbecause she was old enough that
she couldn't put togetherapplying things to her skin.
She had enough dementia that shecouldn't figure it out.
So her pill giver could giveher a pill but couldn't deal
with the topicals.
Our rule is give every womantopical estrogen and topical

(01:13:58):
testosterone.
Start every woman with topicalprogesterone.
Some women are going to needoral progesterone which is safe,
which doesn't have to be.

That's what I'm on now.
I had to upgrade, yeah.

Well, part of the reason you did is that
until recently, you couldn't getthe higher milligrams on
topical progesterone.
It was unaffordable.
That's changed.
That's changed with our method.
So we have a new way to do that.
So we have a new way to do that.
But yeah, oral progesterone isfine, but not oral estrogen.

(01:14:32):
Why would you in the world,would anyone, take oral estrogen
if it's going to promoteincreased coagulation and
increased not everyone's goingto get a clot, but the ones who
have other vulnerabilitiesaround coagulation.
They're the ones that you gotto watch out for.
And so we always give estrogentopically, apply it to your skin
, and we always givetestosterone to 100% of the

(01:14:56):
women.
It's one of the most importantfemale hormones that exist is
testosterone.
It's the main hormone that'llkeep women out of assisted
living facilities and nursinghomes the main one.

Really Not Astrodial, not Astrogen.

Well, they all matter.
Yeah.
But the gerontologist told us.
Here's what's happening to oldpeople they're losing their
muscle.
Yes, they can't stand or walkwith stability.
They fall on their osteoporoticbones, they fracture a hip and
they die.
Yes.
You want to help older people,help them retain their muscle.
For over 90% of the people,even if they're good exercisers

(01:15:37):
and of course there is no youcan't live on this earth and not
exercise.
You pay way too big of a price.
But without the testosteronetreatment of women, they lose
their skeletal muscle and theywind up with canes.
Why do women wind up with canes, walkers and wheelchairs Loss

(01:15:57):
of testosterone.
So I think one of the greatestservices that we do for women.
Everyone gets excited about theshort-term benefits, but I see
all different ages and I'veexperienced directly what it's
like to have relatives go intonursing homes.

(01:16:18):
This is a living facility.
This is a definitive moment inmost women's lives if they have
to do that.
And we have another doctor onour board.
She spent 30 years of hercareer assisting nursing home
patients and I asked her oncewhat percentage are in there
because of low hormones.
She said 80.
80% of the women in nursinghomes are there because of low

(01:16:43):
hormones ovarian hormones andmost of them are there because
of low hormones ovarian hormonesand most of them are there
because of low testosterone.
So we always replenishtestosterone and we always
replenish testosterone topically.

Is it possible for okay, I'm going to assume that
you do the estrogen or thetestosterone topically Is there
less probability of it kind ofmetabolizing down that more
androgenic pathway when you doit topically than taking
capsules?
Well because women are alwaysafraid of hair growth on their

(01:17:19):
face and you know, I'm sureyou've heard the story many
times- Well, here's what happensto 100% of women.

They put out rich testosterone levels
when they're young, and thenmidlife the testosterone starts
declining and by three years ofno period, every single woman
that we've ever tested has way,way low, low, low, low, way too
low testosterone levels.
So the idea is replenishtestosterone, but the right

(01:17:52):
amount.
If you give too muchtestosterone, you're going to
get hair growth.
Yeah, no, thanks you don't wantit, but that's not the
objective.
Our objective is not to givetoo much of anything.
These are the most powerfulbiochemicals and we know what
the right levels are.

Okay, Then that's key.
I know you're a big fan ofBiast for estrogen.
Now isn't that always an 80-20estradiol with estriol, but then
different levels?

Should I explain what Biast is Sure?
Sure, the female ovary puts outthree different estrogens
Estradiol, estrone and Estriol.
And Estradiol is the mostpotent one.
And then here's what elsehappens to women.
Once a month, in this magicalthing called the menstrual cycle

(01:18:47):
, women prepare for pregnancy.
They produce brand new cells inthe uterus to become a cushion
and a garden for the receivingof a possible fertilized egg New
cells, endometrial lining of apossible fertilized egg, new

(01:19:09):
cells, endometrial lining.
If there is no fertilization,that whole endometrial lining
sheds.
All the new cells disappearonce a month.
It's amazing, not only that,every single cycle a woman
prepares as if she was going toget pregnant.
So she starts preparing forbreastfeeding, and most women

(01:19:30):
that I've ever spoken to, theycould feel it.
Their breasts would get fulleras the cycle advanced.
Yep, that fullness is about newcells.
There's new breast glandularcells being formed, there's cell
division and that's how you getnew cells Mitosis, a very
vulnerable time in a cell's life.

(01:19:53):
And if there's no fertilization,these cells disappear by a
process aptly named apoptosis.
Well, that whole proliferativephase where the uterine lining
is being formed, where thebreast glandular cells are
multiplying, that's under theinspiration of hormones, it's

(01:20:15):
under the inspiration ofestrogens, and the main estrogen
that is inspiring proliferationis estradiol.
If there's no fertilization,there's a whole deep
proliferation.
These cells are disappearing.
That's action of a secondestrogen receptor site called

(01:20:35):
estrogen receptor site beta, andthe primary stimulant of the
estrogen receptor site beta isestriol.
Every single cycle, young womenput out more estriol than they
do the sum of estrone andestradiol.
How do I know that?

(01:20:57):
That's medical studies, wow,studies that took place in the
1960s, in which an oncologist, acancer specialist, hope this
isn't too much information.
No.
A specialist at the Universityof Nebraska tested the urine of
young, healthy women and womenwho had breast cancer and that

(01:21:22):
oncologist saw that the younghealthy women had 1.3 times as
much estriol as they did the sumof estrone and estradiol in
their urine.
Wow.
I was funded, given quite agrant of a lot of money, to

(01:21:43):
repeat that study in the early2000s and we enrolled 600
nursing students.
A hundred of them wereregularly menstruating.
We couldn't work, we couldn'tgather samples on anyone else.
Think of that.
One out of six nursing studentswere menstruating regularly.

(01:22:04):
We did the same test and wecame up with 1.1 times as much
estriol as the sum of estroneand estradiol.
This is 50 years later.
Same technology.
It was 24-hour urines used inthe 1960s by Dr Lemon, and
that's what we did for repeatingthat study.

(01:22:27):
So the main thing is there mustbe a reason for some of these
hormones.
There must be a reason whyestriol is there.
Well, we didn't know anythingabout this.
Dr Lemon postulated thatestriol was protective.
He had no understanding.
It wasn't until the 1990s thatthe estrogen receptor site alpha

(01:22:48):
, the proliferative receptorsite, and estrogen receptor site
beta, the deproliferativereceptor site stimulated by
espriol primarily, werediscovered.
The reasons discovered 30 yearsafter.
What the actual biology was?
Moral of the story we like tocopy nature as Dr Wright came

(01:23:08):
out with in the 80s.
He didn't want to give out pureestradiol, he said rocket
surgery.
Why don't we just copy nature?
Yeah, and so nature.
In order to produce that 1.3 inmost women you need to
administer 80% estriol, 20%estradiol, even though estradiol

(01:23:33):
is eight times as potent asestriol.
That's where the 80-20 came up.
But when we do 24-hour urines,sometimes we don't see the right
ratio.
So we tweak the ratio of thetreatment.
We'll go to 70-30, 60, 40, butI recommend as an absolute don't
be playing with that ratiountil you see the 24 hour urine

(01:23:54):
and you've got a reason, because80% of the women that we treat
over 30 years, they do greatwith 80, 20.
Okay, 20% need a differentratio.
Okay, that makes sense.
Yes, that's what we're trying todo.
We're trying to copy nature.

That makes sense.
Yeah, I reversed it.
I said 80% estradiol.
I meant estriol, what you said,yeah, and then 20 estradiol.
So isn't estriol the hormonethat is highest when a woman is
pregnant?
Because I've done a littleresearch on estriol myself and I

(01:24:29):
don't know what you're going tothink of this, dr Rosensweet,
but when I started to see alittle bit of crepiness in my
skin, I started to put just alittle estriol under the eyes
and a little here.
And you know, because I wasdoing some research, I'm like,
hmm, you know, pregnancy glow,women who have that pregnancy

(01:24:50):
glow, that beautiful skin Isn'tEstriol really high when a
woman's pregnant?

Well, they're all high.

They're all high Okay.

Estriol is high.
Estriol is high, Progesteroneis high, they're all super high,
like super high.
But gee whiz, what are yousaying here?
What are you saying, Sandy?
That Estradiol could be goodfor the skin?

I'm saying it could be pretty amazing because you
know you would laugh at me.
But I had a viral TikTok.
Dr Rosen.
Sweet, because women are likewhat, what is she doing?
And then you know the researchthat I saw.
It said estradiol could causemelasma.
I'm like nobody wants that whenyou're over 50.
But still I'm like estradiol ispretty.

Let me give you a little history about
that.

Okay.

This has been known for 100 years, 150
years, 100 years, 150 years.
What's also been known is thatthe French were putting
estrogens in their expensiveskin creams and not revealing it
, not listing it as aningredient.
Oh, and every singlecompounding pharmacy in the

(01:26:10):
United States there's about8,000 of them.
They got their favorite facialcombination and they all have
estriol in it.
But here's how I found outabout it.
30 years ago, women patientswould come to me and say this
estrogen is good for your skin.
What would it be like if I putsome on my face and my neck and
the back of my hands?
It's so vulnerable.
And I said, well, I don't seeany reason.

(01:26:32):
I don't think you should putestrogen on your breasts, but it
makes sense to me.
Sure, do it.
And they said, well, we alreadyhave.
And take a look at my skin.

I'm telling you it's I'm.
I'm a big beauty skincare buff.
I like to take care of my skin.
Obviously, it starts in theinside.
What are you feeding your body?
Are you exercise, Like allthose things?
Sunscreen on the face.
But I like to explore otherthings, and this by far has been

(01:27:04):
better than any other skincream that I've ever used, is
just straight up Astral.

So okay, yes, yes, yes, that is
absolutely true.

I and it doesn't like it's.
It shouldn't raise your urineor will it?

It will, but so what?
I mean you're looking for theright amount and if you're
eventually doing 24-hour urinesand paying attention to symptoms
, no matter where you put it onyour body, it's going to absorb.

Yeah, there's got to be a downstream yeah.

What women told me is they would rub their
hands, they would put most ofit on their inner arms, but
they'd save a little bit and rubthe final amount onto their
face.
So they're still getting thesame amount.

Yes, that makes sense.

So every time that they put the bias on
their forearms, they wouldn'tput all of it on their forearms,
they'd save a little bit ontheir skin, on their hands and
rub it on their face, neck andback of hands.
And that's in our book.
That's been in.

It is.
I got to get your book.

That was in the.
Yes, you'll be able to downloada free copy of it.
Okay, that was in the.
Let me say something else aboutskin.
Okay.
If I can.
Yes 15 years ago my pharmacistsent a bias prescription that he
usually mailed to my patientsto my office and I had been

(01:28:33):
treating women well.
It was about 20 years ago for10 years without ever seeing the
hormone.
I would fax in a prescriptionto the pharmacist.
He'd ship it to the patient.
So this white cosmetic jararrives I'm sure you've seen
them Full of bias and I wasfascinating and I broke the seal
on it and opened it up and outcame this really strong odor.

(01:28:54):
And I did some research and Ilearned that these very poorly
soluble steroid hormones werebeing put up in strong solvents
and as a health coach you knowabout solvents.
They're not safe.
And I did the math and I wasdetoxifying my patients, at the
same time asking the women toapply a quart a year of these

(01:29:19):
potentially toxic solvents,because over 99% of what was in
that jar was the base or thesolvent that dissolved up poorly
soluble steroids.
So my son and I went on todevelop and even patent an
organic oils formulation for thedelivery of the hormones.

(01:29:41):
Oh, amazing.

Certified organic oils formulation for the
delivery of the hormones ohamazing.

Certified organic oils.

That's amazing.

So we have 35 compounding pharmacists in
the United States that arealready dispensing in these
organic oils.
So why do I want to say that?
Because there's all kinds ofspectrum, almost any hormones
decently done, without anoverdose or an underdose, a lot
of underdosing going on A lotyeah.

(01:30:08):
Yeah, is good.
And then there's what makes itgreat when you tailor it for
each individual woman, when youapply estrogen and testosterone
to the skin and when you use asyour base an organic oil and you
test with 24-hour urine hormonetesting and you learn about

(01:30:29):
individual dosing throughstarting low and gradually
increasing until you get theright amount and right balance,
and then you test to confirm andthere is good treatment of
menopause.
In a nutshell, 10 seconds.
I laid down the whole road, manthere you go.

Okay, I have to ask a couple more questions.
I can't leave you yet.
We did cover a lot, though.
Um, what about protectiveadjuncts like sulforaphane?
You know broccoli, cruciferous,cooked cruciferous vegetables.
They say that that helps you tometabolize your estrogens down

(01:31:09):
a healthier pathway.
What are your thoughts on that?

I sure have suggested a lot of those
products, dim, I know you knowwhat that is yeah, yeah.
What we're really talking aboutis affecting how your body
processes estrogens, and thereare these wonderful biochemical

(01:31:39):
pathways that are normal, andthen there's some ways of
processing them that aredifferent than normal, and so I
like to ask the fundamentalquestion why are some people not
processing biochemically in themost standard ways that most
women process this?
And usually it comes down to aliver issue.

(01:31:59):
The liver is not as healthy asit ought to be, and when you're
dealing with the liver, you knowthe whole route here, you know
the whole roadmap.
This is what your bread andbutter is.
You're dealing with the liver,you better look at the gut and
you better look at thatnutrition and you better look at
toxicity.

(01:32:20):
So that's what you're trying toovercome with these abnormal
metabolic pathways, and so Ialways say go right to the liver
and go right to the gut.
Why?
Because I sure suggested a lotof DIM and I3C indole-3.

Yeah, indole-3 carbonyl yeah.

Yeah, and I sure gave out a lot of it, and
because I had the privilege ofseeing how the hormones were
metabolizing, I didn't see theimprovement that was touted to
occur.
And then I started thinkingdeeply into it and I said, yeah,
by the time you're notprocessing this stuff in a
healthy way.

(01:32:59):
Why Is it merely a broccolideficiency?
Yeah.
Because that's where this stuffcomes from.
Good stuff, I mean.
I like to eat broccoli everyday.
Sure.
For a lot of good reasons, andmy beloved just showed me a head
of broccoli yesterday that Ithat's the healthiest head of
broccoli I've ever seen and ittasted amazing and but that's

(01:33:24):
what a lot of these products arederived from.
I say go to the source.
When you, when you're lookingat a 24-hour urine hormone test,
you can see abnormal patternsof biochemical processing called
metabolizing.
You want to do the wholefunctional medicine.
You want to do the wholefunctional medicine.
Search for why.

Yeah, I agree.
What about genetics?
Like I, well, I already know Ihave gut issues because they're
directly tied to thyroid disease, which I had for many years
before I had thyroid cancer.
It's face facts.
But I didn't know the signs, Iwasn't educated on the symptoms.
This is going back so manyyears ago.
But do you think genetics comesinto play?

Well, man Sandy, these topics you have.

I'm just throwing them all out at you.

You're just throwing out a little
mannered question here.

I know.
But you know, like, I wonder,see, I had an aunt that, yes,
had an aunt that because my auntdied of uterine cancer.
So but I also, I'm alsobelieving that I want to
optimize, but I want to dowhat's the most protective for
me.
Knowing my family genetics,I've run them up and down and

(01:34:39):
all sorts of ways.

So let me come in on what I think genetics
are.
Okay.
Ideally we'd be geneticallyperfect, we'd be designed for
perfect health for 100 years or200 years, and then we'd pass on
.
But the human race I don't knowif you've noticed there's a
little vulnerabilities andweaknesses and imbalances that

(01:35:02):
are sort of run through thewhole human race.
Yes.
And they show up on every level.
Everything is multidimensional.
Anything that's present on anylevel is present on every level.
And genetics is a very uniqueposition.
It's right at the junction ofinformation and physicality.

(01:35:23):
In other words, something'stalking to these genes and
they're behaving in a certainway and if they're talked to
properly, they behave in thedirection of health.
And if you mess with the genes,you can throw off a physical
body.
And there's a lot of things thatwill mess with genes, right

(01:35:44):
down from the mind and thoughtsand beliefs down to toxicity and
all kinds of things In general.
I find most of us aregenetically designed for health.
But if we mess with the genesby throwing threats at the human

(01:36:05):
body, the genes are going to bethe point that are going to
have the power to alter how werespond.
So, for example, if there'sconstant exposure to some kind
of toxin, the human body, asit's designed, had better adapt,
or it's not, it's going to getpoisoned.
So the best, the only place ofadaptation, or it all begins

(01:36:34):
with change the genes to changethe outcome.
So it's a very unique position.
You can change things if youtalk to the genes, right or
wrong.
I want to look at it.
So how we talk to our genesthrough the very thing you're
devoting your professional lifeto, which is talk to these genes
properly, especially if you'vegot vulnerabilities, and
everybody's got vulnerabilities.
I agree, everybody does Yep.

(01:36:56):
And when you look at how someonedeveloped an illness, and when
you look at how someonedeveloped an illness, you'll see
that there was a myriad ofadversities that eventually
added up to a diagnosis.
Yes.
And you could probably nameyours.
The way I like to do it is Isay this to a patient.
I say see that wall over there.
Pretend I have a video of yourwhole life, that a videographer

(01:37:26):
took photos, took videos of youfrom the time you were conceived
until yesterday.
And then the videographer tookall that material and had a
magic editing button and theypressed that button and all the
good stuff disappeared from thefootage.
All the good food you ate, allthe good exercise you did, all
the fun you had, all the goodthoughts you had, all the love

(01:37:48):
that you felt, all the givingthat you did.
Got rid of all the good stuff.
What would be left behind wouldbe a trail of tears.
Yes.
When you didn't eat right, whenyou didn't exercise right.
That's what throws the body off, and it throws it off at every
juncture, including genes.
So I don't want toovercomplicate it.

(01:38:08):
I want to look at it anotherway.
You asked the question.
Yeah yeah, I'm merely.

Let's go there.

I had a privilege of working with a
world-famous holisticneurologist for a while and his
father had Alzheimer's.
And we know about genetics ofAlzheimer's.
A certain number of people havethis double ApoE gene, yeah,
and those that do are at specialvulnerability for developing

(01:38:41):
Alzheimer's as well as a fewother things.
And, as this doctor said, Isaid, did you ever test out your
own genetics?
And he said no.
And this is a world expertholistic physician.
He said I didn't want to knowIf the genetics were not good.
I still have the exact samething that I need to do, it's

(01:39:05):
take care of my health in everyway I possibly can.
Speak kindly and lovingly to mygenes in the language that they
understand, which is nutrition,detoxification and all the rest
of the stuff.
And so he never wanted to findout his genetics because he
didn't want to also hurt himselfby running into some

(01:39:26):
vulnerabilities there when hisaction was going to be the same.
So you know there's a lot ofways to look at it.
Genetics is fascinating.
It was one of the mostfascinating college courses I
ever took.
But as far as practical, well,my granddaughter is playing with
CRISPR.
I mean, she got her degree incollege with genetic alterations

(01:39:52):
.
So I don't want to ruleanything out, but in this space
industry we're not at the pointwhere we can take a thyroid
vulnerability and alter the geneand you won't ever develop
issues.
So I say shy of that.
Take care of yourself, justlike you've devoted your
professional career to.

Yeah, no, it all makes sense.
But you know, the way that Ilook at it is I try and educate
my children on some of theirpotential vulnerabilities to
perhaps and again, it's alwaysgoing to be in their hands that
maybe they can do thingsdifferently than I did.

(01:40:27):
You know, I used to be a smokerand I, like I didn't even think
about this.
I was like a 1970 baby.
Oh yeah, like you know, when Iwas in the eighties, everyone
was smoking as a teenager.
Now it's vaping.
So you know, we all do our bestwith our knowledge and I think
that we were never educated like, say, my kids are, so they're

(01:40:50):
told, do not smoke.
So they don't smoke, but theyvape instead, right?
So I guess we all do our best.
I guess we all do our bestright, and maybe some of us
don't and don't care.
So this has been such anamazing conversation, dr
Rosensweet.
I so thank you.

(01:41:12):
I mean I could talk to you allafternoon, but I'm sure you have
other things you've got to getto.
So please let us know.
Where can we find moreinformation?

Karina, who you've spoken to, can give
you access to the book, so allof your listeners can have a
free PDF copy of the book.
There is a printed copy, butyou can have a free PDF copy of
it.

Amazing.

And I want to pause for a moment and say
these are always co-creations.
Sandy, your vitality, your loveof the work that you do.
It was you and I just comingtogether and synergizing, so
this particular interview is acombination of both of us here.
I can tell the difference, youcan tell the difference.
So thank you for your devotionand what you're doing out there.

And thank you so much.
So thank you for your devotionand what you're doing out there
and thank you so much.
I hope you enjoyed this episode.
Be sure to share it withsomeone you know might benefit
and always remember when yourate, review, subscribe, you
help to support my content andhelp me to keep going and

(01:42:24):
bringing these conversations toyou each and every week.
Join me next week for a newtopic, new guest, new exciting
conversations to help you liveyour best life.

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Balancing Hormones: What Your Doctor Never Told You with Dr. Daved Rosensweet - SUMMER REBOOT - Episode 281

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Balancing Hormones: What Your Doctor Never Told You with Dr. Daved Rosensweet - SUMMER REBOOT - Episode 281