Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
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
(00:26):
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):
Be sure to follow my show, rateit, review it and share it.
Always remember my friendsbalanced living works.
My friends, balanced livingworks.
Hi everyone, Welcome to Sandy KNutrition, Health and Lifestyle
(01:32):
Queen.
My guest today is Dr Bruce Dorr.
He is certified by the AmericanBoard of Obstetrics and
Gynecology in OBGYN and FemalePelvic Medicine and
Reconstructive Surgery.
He's a member of the AmericanUrogynecology Society and the
(01:53):
American Association ofGynecological Laparoscopics.
Whoa, that's a mouthful.
He became certified as a thankyou.
He became certified as a bio TEmedical practitioner in 2015
and provides hormoneoptimization with pellet therapy
(02:15):
for both men and women.
He has treated female patientsreferred to cardiologists for
irregular heartbeats,endocrinologists for weight gain
and even marriage counselorsfor vaginal dryness and loss of
libido.
Effective treatments for thesepatients were not initially
(02:36):
prescribed because changes inhormone levels were not
identified as the root cause fortheir issues.
So today we're going to talk allabout menopause.
We're going to even talk alittle bit about some of the
topical stuff that's coming outnow and the New York Times
article that came out recentlyabout women being misled about
(03:00):
menopause.
It's huge news, and who betterto speak to or speak with about
this than Dr Bruce Dorr?
So with that welcome, you canspeak to me too.
I think that's awesome.
I like speaking with you.
How about that?
It sounds better, it soundsbetter.
So I am just so excited forthis conversation because that
(03:27):
article is almost like it was aspringboard for our meeting.
Dr. Bruce Dorr (03:31):
Yes, yes.
Sandy Kruse (03:33):
Yeah, very much
needed.
Dr. Bruce Dorr (03:34):
You know it was
just a welcome across all fronts
.
When we hear about menopauseand even you may have seen it
too the Super Bowl they even hada featured segment on vasomotor
symptoms, or symptoms ofmenopause, that was in a
30-second commercial also.
So women and their needs aredefinitely getting out there,
(03:56):
which is very much a blessing.
Sandy Kruse (03:58):
Okay.
Well, my team was not on theSuper Bowl in the Super Bowl, so
you know I'm a Buffalo Billsfan over here.
Dr. Bruce Dorr (04:08):
Oh, I think we
were all hoping for the Buffalo
Bills, but yeah, it didn'thappen, so I did miss that.
Sandy Kruse (04:14):
We kind of became
America's team for a minute.
Yeah, I did miss the segment.
But you know, I have to ask youwhat got you into this field
that you're in right now?
Dr. Bruce Dorr (04:26):
Well, you know,
actually I went into medical
school to become a psychiatristbut as I got further into the
field, you know, I just found Iwas so drawn to the field of
OBGYN because the medicineinvolved, the procedures that
were involved and the charm ofthe whole labor and delivery
(04:50):
experience was just overwhelmingto me and to me it was kind of
what life was all about, andjust felt that.
And as I got into it, yes, Istarted to subspecialize in
urogynecology and you know, allthis stuff it's kind of an
evergreen area.
As far as OBGYN goes, we'reeither helping women get
(05:13):
pregnant, helping them throughtheir pregnancy or helping them
with all the stuff that happensafter their babies, and so it is
really a blessing to be in thespecialty.
And you know, I really didn'trealize how lucky I was seeing
women virtually my whole careeruntil I started seeing men.
They're a tougher crowd.
(05:34):
Oh, yeah, and so I think, youknow, women are just, you know,
they're unfortunately nostranger to medicine and
therapies and, I think, ingeneral, much more open to my
advice and that's been thebeauty of my career.
Interestingly, the wholemenopause emphasis.
(05:55):
You know, I would see womenwith unfortunately very painful
conditions, one calledendometriosis, and we would need
to remove their ovaries,sometimes at a very young age Uh
, you know, even as young as Ihad one lady so severe she was
16 years old, um that I had toperform, um, you know, and
remove her ovaries.
(06:15):
And I would when I would seewomen that I would put into
surgical menopause and althoughtheir pain was gone, they went
to this very dark area.
And I had one patientspecifically she was 38 and her
pain was gone, but she no longerwanted to have sex, she no
(06:35):
longer wanted to work out, shewas gaining weight and she just
said to me you know, I just wish, I wish I was in pain again and
had my hormones back.
And she started taking herhusband's testosterone
preparation and I saw her askind of a crazy level 700.
It was, it's very high for awoman and I referred her to an
(06:59):
endocrinologist and theendocrinologist said well, why
would you do such a dangerousthing taking your husband's
testosterone?
And she said, well, I just feelbetter, I had better energy, I
had better libido, I felt like Idid before my surgery.
And he says, well, I just don'tunderstand.
You're 38 years old.
(07:19):
And she said, yes, he goes well.
How much longer do you thinkyou're going to be having sex?
She said, yes, he goes well.
How much longer do you thinkyou're going to be having sex?
Oh, wow, I know.
So this is what is happeningwhen people see you know experts
in in hormones, that I wouldsee my patients being treated
like that, and that's how I gotintroduced to biot and and to
(07:41):
learn more to really be fullservice for my patients that
need hormones at any age andtheir husbands.
Sandy Kruse (07:49):
Yeah, I mean that,
that unfortunately.
I've heard all too many storiessimilar to that and it's it's
really unfortunate.
But then there are physiciansout there and I always say that
there's physicians out therethat will work alongside you and
help you to feel optimized,because life's too short.
(08:12):
Life's too short to go throughit.
Feeling like you're goingthrough it with no vitality, you
know, like it's justunfortunate.
So talk to us about you knowwhat exists's just unfortunate,
so talk to us about you knowwhat exists.
There's always confusion, likewhat is menopause?
Let's start with the verybasics right.
Dr. Bruce Dorr (08:33):
Well, menopause,
defined by the american college
of ob-gyn, is the sensation ofyour periods for a year, usually
combined with menopausalsymptoms, and what's going on
physiologically is that theovaries stop making estrogen and
there's a time leading up tothat total stop of estrogen is
(08:55):
what's called perimenopause.
And that's where some dayspretty good estrogen production,
some days not so good, someweeks pretty good, some not so
good Estrogen production, somedays not so good, some weeks
pretty good, some not so good,and it's that roller coaster
that can start, you know, a fewyears before, on average a
couple years before the periodstotally stop.
But some people start that asearly as their late 30s or mid
(09:18):
40s, and so that up and downwill cause irregular bleeding
which is a majority of theconsults for women in their 40s
seeing an OBGYN as irregularbleeding.
And, yes, many will address thebleeding but they don't address
the women's symptoms that aregoing on surrounding that.
So with that hormone loss thencomes all the stuff that can
(09:44):
either hurt us or kill us.
So acceleration in risk fordementia, accelerations for risk
of bone loss, for heart disease, for breast cancer, that all
happens with that loss ofestrogen.
Sandy Kruse (10:00):
Yeah, I mean, I
guess it's a good time to talk
about some of the symptomsbecause, you know, you and I
both read that article.
Women have Been Misled aboutmenopause and I think there are
a lot of pros and cons to it.
And you know, I'm not aphysician but I know a lot about
menopause and I happen to be 53years old and I'm kind of you
(10:24):
know, I'm kind of gettingthrough it pretty good.
You know, I'm feeling good andI'm feeling that I don't feel
like I have a loss of vitality,I don't feel like I want to kill
my husband every day.
So I mean, there you go.
These are all bonuses, right?
Dr. Bruce Dorr (10:40):
Well, you know,
looking at you, sandy,
everybody's going to want toknow your secret, because you
look like you're about 20 yearsold.
Sandy Kruse (10:46):
And I'm not using a
filter.
I swear to God no filter, nofilter.
But you could see I getflushing.
So there you go.
There's a symptom right there.
Dr. Bruce Dorr (10:56):
Well, people
accuse me of not using filters
either.
So that's just a problem.
Yeah, but difference to realitytogether it's just a problem.
Sandy Kruse (11:03):
Yeah, but different
story altogether.
So you know this article thewhole.
The one thing from this articlethat really stuck in my mind,
and I would love for you to talkmore to this, is the brain
lesions and the correlation tohot flashes and the intensity,
(11:29):
severity, frequency.
That was like.
I have to say, I knew a lot ofwhat the science has been saying
, but that one was huge.
It just struck me like oh wow.
Dr. Bruce Dorr (11:47):
Well, you know
they're trying to put their
finger on is what causes the hotflushes, what causes these
vasomotor symptoms, and they'rekind of coming down to, and it's
also coming down to what is theproblem for some women that
have irregular periods, acondition called polycystic
ovarian syndrome.
And that leads to irregularproduction of estrogen and
(12:11):
progesterone balance.
That goes on.
That can sometimes happen inthat perimenopausal time period.
But that is what happens with asignal that comes from an area
in our brain called thehypothalamus and that is what
pushes a signal that comes froman area in our brain called the
hypothalamus and that is whatpushes a signal to our pituitary
glands that then push thehormones to either our testicles
(12:33):
or the ovaries.
It's the thing that way too.
So what they're getting at inthat article is that that area
in the brain is havingdysfunction, brain is having
dysfunction, and so these levelsthat then happen at the
pituitary level are associatedwith night sweats, hot plushes
and those kinds of things goingon.
And it's being brought to lightbecause of a new drug that's
(12:55):
coming out on the market.
It's called an NK3 receptorantagonist and it basically is
helping with a neurokinin.
It's a brain chemical messengerthat sends these messages to
the pituitary that then activatethe ovaries, and so they're
(13:18):
finding that problems in thatarea of the brain is probably
what's the bigger cause ofvasomotor symptoms specifically.
But we know that these lesionsespecially related to
Alzheimer's disease.
It's a protein called betaamyloid and there's also another
one associated, called the tauprotein, and it's the
(13:39):
accumulation or the presence ofthese that is kind of the
diagnosis of Alzheimer's disease.
Sandy Kruse (13:45):
Is that the plaque?
Dr. Bruce Dorr (13:47):
Yes, those are
the plaques that go on and they
entangle the nerve fibers andthese pathways that allow us to
process things in our brains.
And the things that helpdecrease beta amyloid deposition
are sex hormones, so bothestrogen and testosterone are
known to decrease beta amyloiddeposition are sex hormones, so
both estrogen and testosteroneare known to decrease beta
(14:08):
amyloid deposition.
Now in her article she's sayingthat beta amyloid deposition is
starting in women in theperimenopause, but I've talked
to Alzheimer's researchers andthey've even seen beta amyloid
deposits in fetuses, and we seethat much more in the mid-30s or
(14:31):
so, when women start to losetheir testosterone, and so
that's also a problem.
Low testosterone in both menand women is also associated
with increasing in plaques andand brain and cognitive
impairment.
Sandy Kruse (14:49):
Okay.
So does this mean that and youknow it just if somebody is just
reading the article who's not aphysician like yourself, or
listening to the podcast,they're going to be like oh my
God, I have tons of hot flashesand I have them all the time and
I have them every day and Ihave many and many and, oh my
(15:12):
God, I'm going to have dementia,I'm going to have Alzheimer's
by the time I'm 60.
So, like you know people, itcan cause a little bit of panic.
Dr. Bruce Dorr (15:20):
Oh yeah, well,
and they're.
You know, panic andinflammatory statements sell.
You know, when you look atbenefits and health and doing
the right things for our bodiesand diet and exercise, that
doesn't sell as much as you knowa balloon over the.
(15:41):
Atlantic or you know, anythingthat is inflammatory or
reactionary is the deal.
So I think the key is here isthat you, if you're having
symptoms, it's good to talk tosomebody that these symptoms can
be associated with problemslong-term and it's not
(16:03):
necessarily just vasomotorsymptoms.
When you look at a reanalysisand I know we'll probably talk
about it of the WHI that everywoman went off their hormones or
majority of women went offtheir hormones, when you look at
a reanalysis, it's actually notnecessarily just hot flushes or
night sweats that causedlong-term increase in
cardiovascular disease orall-cause mortality.
(16:24):
The biggest symptom that wasassociated with all-cause
mortality was dizziness.
So you know it's not just aboutnight sweats or hot flashes.
There's like 40, some peoplesay there's as many as 100
different symptoms related tomenopause.
But there are much moresignificant symptoms that can be
(16:44):
associated with things that cankill you, not just Alzheimer's
disease.
Sandy Kruse (16:49):
Okay, so let's
let's talk about the major ones.
Then, dr Dora, let's talk aboutthe major ones.
We can be about hot flashes.
What other ones should wereally pay attention to?
Dr. Bruce Dorr (17:02):
Yes, well, you
know, and that was kind of your
intro you know to me is that asa urogynecologist, I work with a
lot of certainly female pelvicdisorders and incontinence, and
so I would see women for theirincontinence, but they had been
to the endocrinologist, they hadbeen to a cardiologist, they
had been to a rheumatologist,because really the number one
(17:25):
symptom of menopause is jointpain.
And so, you know, women stoppedexercising, they stopped
walking the dog, they, you know,and so that's really the number
one symptom over night sweats,and people just attribute that
to getting older.
Really, it's the loss of thejoints and the synovial fluid
and the ligaments and the muscleloss that go on with the loss
(17:48):
of hormones.
It can be irritability, it canbe palpitations, it can be
vaginal dryness, it can be manydifferent things that people
think, oh yeah, maybe it's mydiet or maybe it's you know
something else, and nobody'swanting to talk about menopause.
It's easier to talk to somebodyabout your heart racing than it
(18:10):
is your vaginal dryness or thosekind of things going on.
And so, you know, thecardiologists don't want to deal
with hormones, you know, and sothat's what it comes down to.
Is what is that root cause,rather than the bandage on.
You know, putting somebody onsomething that slows their heart
rate down, or putting them onMotrin or aspirin to cover their
(18:33):
joint pain, you know, get tothat root cause.
As far as what's really doingthat, it's the functional
medicine piece of this.
Sandy Kruse (18:38):
Yes, and you know
it's so interesting because that
happens in other parts ofmedicine too, and I, I have no
thyroid, right, so I know a lotabout thyroid, I studied it and
I live it and I think,experiencing it but seeing, you
(18:59):
know, seeing a client from anutritional perspective who
comes back and says that theirphysician put them on
anti-anxiety meds and thenseeing that they're severely
hyperthyroid, you know what Imean it's kind of like that same
idea of not looking at what'sthe root cause.
And you know, the fact of thematter is it's going to happen.
(19:21):
Our hormones are going todecline, right, like we kind of
like I can't be 30 forever, sothat's one fact that we have to
face.
So how?
I and I love that you mentionedlifestyle, because that was the
other big piece that was notreally talked about much in that
(19:41):
article and I was like, okay,there's a lot missing here,
because there's a lot we can doother than, you know, taking the
medications right.
Dr. Bruce Dorr (19:54):
Right.
So when you look at diet andlifestyle, when you look at
other areas of the world like,say, look at Japan, you know
their incidence of menopausalsymptoms is significantly less
than the average Canadian orAmerican get three fatty acids.
So there are things in theprecursors for our hormones and
things that help our bodies andour brains nutrition wise, that
(20:24):
help us feel better, to helpwith diet and exercise and
things like that that go on thatcan certainly mitigate the
severity of our hormone loss.
So, yes, that is another keycomponent, but the problem is
problem is you know they did arecent survey that 60 of ob-gyns
, when women come in withmenopausal complaints, prescribe
(20:45):
an ssri.
They prescribe, um, you know,an antidepressant because that's
easy and that can be handled infive or ten minutes oh, you're
having this, let's put you onthis drug.
You know I'll see you in threemonths.
But to sit down and talk tosomebody about what are you
eating, how often are youexercising, you know, are you
(21:12):
experiencing sexual dysfunctionor things like that Most people
do not want to spend.
Really.
You need a good half hour to 45minutes to talk to somebody
about their life and theirlifestyle and it's much easier
to put them on a drug.
Sandy Kruse (21:22):
Yeah, many people.
Dr. Bruce Dorr (21:23):
That's kind of
what they want.
They want a quick fix.
Sandy Kruse (21:25):
Yeah, I think we
need to, as a society, get away
from this whole quick fixBecause, just like what you do,
you know hormones.
It's this beautiful symphony,right?
And so you got to kind of playaround with it.
Like I myself, I've been onbioidentical progesterone for
years now, because that iswhat's helped with my sleep.
(21:49):
I have no issues with anxiety.
I have no issues with, you know, being overly hyper and nervous
because I rhythmically takebioidentical progesterone.
So maybe talk to us about thatsymphony of hormones.
Dr. Bruce Dorr (22:07):
Well, you know,
just like you're hinting at,
women will start to lose theirprogesterone production in their
mid-30s and that's when PMSstarts to come into play.
That's when we can start to seepregnancy loss, because
progesterone is the majorhormone of pregnancy.
So we look at that whensomebody's pregnant, but we
don't necessarily equate that tonegative symptoms that start
(22:29):
happening in the mid-30s andthen get even worse as they
approach menopause and startlosing that even more so.
So I have many women that I'llput on cyclic progesterone, just
like you're taking.
You have to go low becauseeverybody's different as far as
what their right progesteronelevel is, what their right
(22:50):
testosterone level is, whattheir right estrogen level is.
And there are many people and Ican see this as I do blood
tests that there are some womenthat their brain will tell me
it's their right estrogen dosewith a level of 30.
And for some women it shuts offor the signal is good at a
(23:13):
level of 120.
So that's why when you do astandard preparation available
in my cupboard, you know, with apatch, a gel, a pill, a spray
is way too much for some peopleand way too little for others.
So to have variability indosing it's a very individual
(23:33):
thing for every patient as faras how much they need.
That can take them to too muchor too little.
So it's finding that mama bearporridge on each individual
patient and most people you knowdon't want to take the time to
work with patients.
Like you may know, with thyroidthere's a broad range of where
people sit in thyroid and manypeople will say your thyroid is
(23:55):
normal.
Well, what is normal?
Is that an A student or is thata D student?
So same thing goes for hormones.
Hormones and say thyroid arethings that we can control.
I can't control my kids, Ican't control North Korea, I
can't control whatever is thedeal that way too.
But I can control what goesinto my body or my patient's
(24:16):
bodies, whether or not that'sfood or nutrition or these
hormones, and so the things Ican control I want to be an A
student in those and that's whyI try to take my patients is to
that best level that we cancontrol.
Sandy Kruse (24:31):
I love that you say
that, because you know there's
a difference between being inthe range and being optimized.
Dr. Bruce Dorr (24:42):
Right, right.
So we do the same thing,whether or not that is with
testosterone or estrogen.
Progesterone tends to be alittle bit less that way too,
but certainly I do the samething with my thyroid patients.
Sandy Kruse (24:54):
Okay.
So let's okay.
We know progesterone is morethat hormone that kind of makes
us more chill, it helps us tosleep, it will help with anxiety
.
Did I miss anything withprogesterone?
Dr. Bruce Dorr (25:11):
Well, it has a
number of different functions
and when you look at estrogen ortestosterone, there's over 400
different receptors for thesehormones in our body and they
activate those processes,whether or not it's your hair,
your joints, your skin, yournails, your fat.
I mean, these are activatorsall over your body.
So it manifests itself indifferent ways depending on on
(25:35):
you know what we're doing andhow our bodies are structured,
both genetically and chemically.
Sandy Kruse (25:40):
And I guess, sorry,
go ahead.
Dr. Bruce Dorr (25:43):
Go ahead.
Oh well, in general.
So you know, it helps somepeople more with their brains,
it helps some people more withtheir joints, it helps some
people more with their musclesor libido or things like that.
So it's a combination offiguring out you know what
people need.
You know on that hormonal scale.
Sandy Kruse (26:00):
And do you take?
I'm sure you do, but I guessyou would take into account
blood work on top of lifestyle,on top of symptoms.
Dr. Bruce Dorr (26:09):
Yes.
Sandy Kruse (26:10):
Yeah, and would you
say that the majority of women
that come in to see you that are, say, my age 53, they say that
they have joint pain?
Would that automatically kindof set off a bell that, okay,
estrogen, estrogen, that'sprobably related to estrogen, or
.
Dr. Bruce Dorr (26:27):
Or testosterone.
You know, when you look at DrRebecca Glazer, she is a breast
cancer surgeon out of WrightState University in Ohio she did
a 10-year study looking attestosterone replacement only in
women, and these were bothpremenopausal as well as
menopausal women and she hadrelief, you know, almost 90% in
(26:48):
all of her menopausal patientsjust on testosterone alone.
Wow so it's not always justestrogen.
It's the combination ofestrogen and testosterone.
But testosterone has this kindof juicing negative connotation
that people are scared of it.
They think of it as a malehormone, but women make three to
(27:08):
four times more testosterone ona daily basis over estrogen,
and so you can go far.
It's the balance of all thesethings, and so for years I would
treat people with standardhormone replacement.
Sandy Kruse (27:21):
You know I'm kind
of a good old boy I've been.
Dr. Bruce Dorr (27:23):
I was there
before.
You know, all the hormones kindof stopped in 2002, is the deal
that way too.
But you know I would put peopleon estradiol and they'd still
have all their symptoms.
They still have night sweatsand hot flushes and all their
menopausal symptoms.
And it wasn't until I starteddoing testosterone replacement
with my patients.
They're like this is how I usedto feel that was the missing
(27:47):
piece for some, if not many, ofmy patients.
So it's the balance of bothestrogen, testosterone and
progesterone that many peopledon't even recognize
testosterone replacement inwomen.
Sandy Kruse (27:59):
Okay, and so it's
not like myself as a woman who's
53 really.
I mean I guess I might beconcerned about getting those
chin hairs or acne from takingtestosterone.
Like we have to also be carefullike and work with a physician
(28:19):
that knows what they're doing.
Dr. Bruce Dorr (28:21):
Yeah, with any
hormone you need to do that.
And so do I return people tothat puberty stage?
Yeah, to some degree you can dothat.
There's a dual edged sword totestosterone and you can make
women into very manly lookingwomen with the amount of
testosterone.
So the difference between amedicine and a poison is the
dose.
So it's about finding thatright testosterone level.
(28:43):
So women lose half of theirtestosterone by age 40, and so
you'll see women who kind ofcrash after delivery and they're
they're like I have no libido,I have no energy, I'm not
sleeping anymore.
And they're still havingregular cycles.
They're only 38 or 40, but Idraw their testosterone and it
will be zero.
(29:04):
And some labs will say a normaltestosterone in a woman is zero
to 35, but it's not normal atall.
But people go off of labreference ranges rather than
really what is making thedifference individually for
these patients.
So I see menopausal symptoms inwomen in their 20s and it's not
(29:24):
the loss of estrogen, it's theloss of testosterone.
Sandy Kruse (29:27):
Oh, so interesting,
Because I know a lot of women.
They're just afraid of that.
But I know a lot of women.
They're just afraid of that.
But I know, you know, I'mfamiliar with Dutch tests and a
few other functional tests andwe all, we all have testosterone
people.
It's, it's, it's important,Okay.
So let's maybe talk a littlebit about we have to mention
(29:51):
some of the flawed studies thatdid such a huge disservice to so
many women and scared the pantsoff them right.
Dr. Bruce Dorr (30:01):
Right, right.
So yeah, there wereobservational studies in the 90s
, you know, and they looked atwomen on hormone replacement and
long-term, yeah, in generalthey had better hearts and they
function better.
And so they said, well, let'sreally put the pen to the paper
and see.
And it started with the HERStrial, which is the Hormone
(30:22):
Estrogen Replacement Study inthe late 90s, and it showed that
there was statistically noimprovement in cardiac outcomes
on women when you put horseurine estrogen into their bodies
.
And that became even more so inthe makers of cromerin.
So the number one prescribedhormone and the number one best
(30:43):
studied hormone ever pregnantmarriage urine 30 different
horse urine estrogens None ofthem were meant to be inside
women, be inside women that whenthey then were studying that,
because they wanted to get anFDA approval to prevent heart
disease, so they were going forgold.
(31:03):
They would then be prescribedby everybody and unfortunately,
when they looked initially atwomen that went on horse urine
estrogen and a birth controlpill type of progestin.
So when you take estrogen itcan increase um proliferation of
the inner lining of the uterusor cause bleeding.
So you have to take estrogens,counter hormone with it.
(31:26):
Progesterone progesterone iswhat's naturally meant to be in
women's bodies.
But, um, they were using achemically uh made
medroxyprogesterone acetate thatabsorbs better and is cheaper,
and so that's what they combinedit with.
And women that were taking theunnatural estrogens and the
unnatural progesterone had anincreased risk of heart attack,
(31:48):
stroke and breast cancer, andthey stopped the study early,
when the women had ahysterectomy and they didn't
have to take the progestin, thismedroxyprogesterone acetate.
They continued that study andthat went for eight years.
But unfortunately there was acrowd in the 60 to 90 year old
group that had an increased riskof blood clots and so they
(32:09):
stopped the study at that, know,and so there's been many
reanalysis of that.
But I think what it comes downto, sandy, and I think you, you
are on board with me on thisDon't put horse urine into your
body, you know.
Don't put birth control pilltype of progesterone, progestin
(32:32):
in your body.
If you put back into your bodythe same thing that was meant to
be there and you deliver it theright way you don't have these
risks of heart attack, strokeand breast cancer.
And you know, in 2012, there wasa big British medical journal
article looking at bioidenticalestrogen 17-beta-estradiol and
(32:53):
they even had an unnaturalprogesterone.
They used Norris Thindrone.
It's in Britain, so they usedifferent progesterones over
there.
It's a deal that way too.
Those women had a 50% decreasedrisk of cardiovascular disease
as they followed them.
So it's about the type.
So not all estrogen is the same.
Not all progesterone is thesame.
(33:14):
Look at it like this If you hadtwo groups of people and you
gave them both alcohol one group, you know, after a couple of
drinks of alcohol we're dancingaround and felt great and the
others went blind and died.
It's the differences in alcohol.
One got ethanol, one gotmethanol.
So not all alcohol is the same,not all estrogen is the same.
(33:36):
You want to put back into yourbody the same thing, not a
similar thing.
That's what makes thedifference.
Sandy Kruse (33:45):
Yeah, that was such
a great explanation because I
hear so many people who are likewhatever, I just went and got
hormones and they don't evenknow what they're putting in
their bodies.
And I hear this regularly and I, you know, because I almost
feel like it's a bit of a curse,dr Dore, because I talked to
(34:07):
too many physicians likeyourself and experts and I'm
like I know too much.
I'm like is it progestin or isit progesterone?
There's a difference.
Dr. Bruce Dorr (34:19):
So the women in
the WTA that didn't get
progesterone or progestin.
They did great.
And now, when you look at them,20 years later, those women,
even on horse estrogen, have a30% persistent decreased risk of
breast cancer.
Sandy Kruse (34:35):
Wow.
Dr. Bruce Dorr (34:35):
And they lived
healthier.
There's no increased risk ofall-cause mortality or
cardiovascular disease in thatgroup and now they're running a
persistent decreased risk ofbreast cancer in the
non-progestin group.
It was the progestin in thatstudy that was flawed and made
the difference.
So again, if you useprogesterone, even with
(34:56):
horseshoe and estrogen, youdon't have those risks that go
on and all the lights come backon to your bone, to your brain,
to your heart.
And combined with testosterone,testosterone decreases the risk
of breast cancer.
Sandy Kruse (35:08):
So, yeah, I like
that.
You said all the lights comeback on Like who doesn't want to
age better and live withvitality until the day we're
meant to end on this planet,right?
Dr. Bruce Dorr (35:23):
Right.
Sandy Kruse (35:24):
I'm with you.
Dr. Bruce Dorr (35:24):
What good is it
living longer if you're not
living healthy as you livelonger?
And that's what hormones dothey allow that?
You know betterment of ourbrains, of our bones, of you
know those kind of things thatgo on.
You know what good is it tolive if you don't know that
you're living, if you havedementia or Alzheimer's disease?
Sandy Kruse (35:42):
Yeah, so what?
Who are the people that are atrisk?
Who are the patients?
Or are there any patients thatyou have to handle very
carefully?
Dr. Bruce Dorr (35:55):
Well, you know,
if somebody tells me you know
they take half a Benadryl andthey pass out, okay, you don't
have to prove to me that you'resensitive to medicines, you know
.
And so you start out low andyou work your way up, and that's
great for any patient becauseyou don't know what their right
level is.
(36:16):
So titration, dosing, and thebeauty of what we do at BioT is
that there's a whole computermodel that can kick out where
90% of people hit the right dose, and so that's the beauty of
pellet therapy and BioT.
But you can do that with anydrug that goes on.
Certainly, you know people withhistory.
You have to be careful in thedelivery of hormones.
(36:39):
So we weren't meant to takehormones orally.
When you take hormones orallyit goes through your liver, it
revs up stuff in your liver thatincrease binding or problems,
but it increases blood clots.
So when you take hormonesthrough your skin or in a
pelleted form, even a history ofa blood clot or a blood clot to
the lung or anything like that,it's not a contraindication to
(37:00):
hormone therapy.
So really, you know, unlessthere is a condition like, say,
breast cancer, there's certaintypes of brain cancers that are
fed by estrogen.
That's the onlycontraindication.
So if there is a conditionwhere a patient would be
bettered by removing her ovaries, that's really the only
(37:22):
contraindication to bioidenticalhormone replacement therapy
Okay.
Sandy Kruse (37:28):
So what are your
thoughts and I don't know if you
even do anything like this inyour practice.
It just kind of came to mind.
You know how there's so manydifferent things that you can
take to redirect estrogens sothat they actually metabolize
down the healthy pathway, likeDIM, diendomethane.
Then there's sulforaphane.
(37:50):
I take sulforaphane.
I've been taking sulforaphanefor a long time because I also
know my genetics.
I have an aunt who died ofuterine cancer and a great aunt
who died of uterine cancer, andso I'm very cognizant of what's
(38:11):
happening with my estrogens.
Do you think that those aregood solutions for women who are
worried about how they'remetabolizing those estrogens, or
no?
Dr. Bruce Dorr (38:24):
So everybody
that we put on hormone
replacement, we put on dimsulforaphane products.
Sandy Kruse (38:29):
Beautiful,
beautiful.
Dr. Bruce Dorr (38:31):
You don't know
how people are genetically
modeled with that phase twoelimination of their hormones
and they can go down thatbeneficial antioxidant pathway
of the two hydroxy versus thefour of the 16 hydroxy.
And that's where you're gettingat with the Dutch testing, that
you can actually look at that.
But if you just put people onthat and I put all my men on
that too, because same thinggoes on with testosterone
(38:54):
breakdown products and ourestrogen that we break down as
men but yes, when you look atseverity of, say, pms symptoms,
it's not estrogen or estradiolitself, it's the two hydroxy
estrone that it breaks down intothat gives women breast cysts
and breast pain.
Yes, that go on.
(39:14):
So anybody that goes on birthcontrol pills with me I
recommend, you know tends to be,you know, my younger crowd in
general, so they don't want todo supplements and things like
that necessarily.
But I put everybody you know onDIMM.
We have a combination productout of two different companies
that helps with, especially ifthey're on artificial estrogens
or progestins in a birth controlpill.
(39:35):
But in general yes, anybody onhormones goes on DIM with us.
Sandy Kruse (39:38):
Yeah, it just kind
of makes sure it's doing the
right thing in your body.
That's the way I like todescribe it.
It's making sure it's not goingwonky on you and going in a
direction you don't want it togo in, right, okay, so, people,
my parents are both still alive.
(39:58):
My dad is going to be 86 inApril.
My mom will be 77.
And she's like well, my momnever had hormones, we never had
hormones.
Why do we need hormones?
You know what's the point.
And I'm like well, mom, youknow you can't say, first off,
you didn't live as long backthen, right, and then, secondly,
(40:23):
I think that life was simplerand you know like, if you look
at the way we live now, evencortisol can have an effect on
all these other hormones.
Like, what are your thoughts onthis?
Dr. Bruce Dorr (40:36):
Well, when you
look at our food supply, you
know now, versus, say, 1920, inan average bowl of spinach it
has a 10th of the dose of thenutritional content.
So our farming, our soil, ourthings like that, things that we
used to be able to replete ourbodies with the precursors for
hormones or things like that,are not great in our food supply
(40:57):
.
Is the deal that way too?
Now women have suffered withmenopause for a long time, and
there were preparations formenopause even the in the late
1800s.
Um, there was uh pulverized cowovaries that they used to give
women oh wow, wow.
Yeah, that was in the late 1800s, I think it was 1880 or
something like that is when overin is the name of it came out.
(41:20):
But when you look initially atmenopausal therapies, when the
physician death reference sothat is like this big compendium
of drugs available at least inAmerica, came, came out in 1947,
there were 53 differentpreparations from 23 different
companies to help women withmenopause.
So menopause and symptoms ofmenopause and the nightmare
(41:46):
symptoms that women had to livewith, have been around for a
long period of time, especiallyas women started living longer.
You know well, into menopauseis the deal, you know, certainly
with the advent of modernobstetrics and getting women
through the whole kind ofnightmares that can happen
obstetrically.
Women started living longer andso that's why we're seeing, you
(42:08):
know, women, you know aging andneeding the hormones.
Sandy Kruse (42:13):
Yeah, I like that,
I'm on board.
Aging and needing the hormonesyeah, I like that, I'm on board.
Okay, let's shift gears andtalk a little bit about the
Women in Workplace Survey.
Talk to me a little bit.
What is this?
What was this survey all about?
Give us the details.
Dr. Bruce Dorr (42:30):
Yeah, they took
a thousand women, you know, aged
50 to 65.
You know it was a study thatcame out through BioT in January
and they looked at them.
You know ACOG is now sayingthere's 6,000 women a day
entering menopause.
You know that is a lot ofpeople and in fact that is, you
(42:53):
know, from when I first wentinto practice in the early 1990s
.
That's roughly three to fourfold more.
But what they found was thatmany women are suffering in
silence, that you know 20percent of people never get it.
Well, it's 20 percent of theworkforce, but 87 percent of
women never bring this up withphysicians, let alone people in
(43:15):
the workplace.
And women are quitting theirjobs and that was brought up in
the New York Times article toothat you know women are leaving
their jobs over how bad theirsymptoms are.
They can't mentate or they feellike everybody sees that
they're having hot flushes inthe workplace and they're
embarrassed over bringing it up.
And over half of the practicingOBGYNs are after the WHI that
(43:40):
women stopped all their hormonesso they never got any hormone
training, so nobody is helpingall of these women you know who
are suffering silently andthey're leaving their jobs and
they're not getting appropriatetreatment or care, or they're
leaving their jobs and they'renot getting appropriate
treatment or care.
Sandy Kruse (44:01):
Or they're going on
other medicines that make them
feel worse in many ways.
Wow, that you know it's just.
Maybe I won't even say this,but what I will say, because I
have to also be careful what Isay, because I do love.
I have a great relationshipwith my team of physicians.
I have to have anendocrinologist because I have
no thyroid and I had thyroidcancer.
I have my GP, I have mynaturopath doctor and you know
(44:26):
it's interesting because I don'tfeel like I have the support I
need with the way medicine isstructured here and it does.
It makes me sad, actually, whenI think about this, because I'm
(44:48):
fortunate that I'm in thisindustry, so I advocate for
myself and you know, somebody'sput a little comment in
something that I posted about.
You know somebody put a littlecomment in something that I
posted about.
I posted a bit of a response tothat article in the New York
Times and someone said you know,thank God for people like you,
because I have a full time job,I don't have the time to
(45:15):
research this.
You know we're fortunate thatwe have a lot of women
advocators now and physicianslike yourself who take the time
out of your busy practice toeducate other women and their
partners.
Dr. Bruce Dorr (45:30):
Right, right,
you know I thought this would
just be a couple of people amonth, as I looked at hormone
replacement and certainlypelleted hormone replacement,
and it grew to 50, and it grewto 100.
And now it's like 600 people amonth that.
I'm seeing there's such a needout there for this and there's
(45:50):
such a need of validating whatpeople are feeling and the
negative symptoms that they havehormone loss in both women and
men and so you know.
She brought up how women aresuffering, but there are many
men who suffer, you know too.
Sandy Kruse (46:07):
Totally totally.
Dr. Bruce Dorr (46:10):
And their
partners.
Women suffer because their menare suffering.
You know, I see so many womenwho you know I used to have a
great sex life when my man wasmuch more on board with
everything, and so you know,sometimes women's dysfunction is
their partner's.
Oh, yes, it just led to manyareas that I never saw my career
(46:30):
going to.
Sandy Kruse (46:31):
Yeah, you know, and
here's the thing I will always
say lifestyle interventions help, they help.
I do believe that there's a lotof things that you can take to
minimize some of these symptoms.
You know, and there's nostudies backed by it, because
(46:53):
there's no pharmaceuticalcompany to back up the funding
for the studies, right, so I canspeak through firsthand
experience.
I take a lot of different herbsand they help me, and I am the
end of one because I don't havethe money to do a giant study,
right.
Dr. Bruce Dorr (47:12):
But that's what
we really need is a groundswell
of people for wellness ratherthan treating illness.
So we wait until people gettheir heart attack.
We wait until people haveAlzheimer's, which is too late,
you know.
We wait until people havebreast cancer.
But could we put people on DIMM?
Could we put people onChaseberry or Boron or black
(47:33):
things that help mitigate theirsymptoms and treat them to be
well, you know?
Or hormone replacement thattreats them and helps them be
well, rather than letting themget ill and then treating them?
That's the medical system.
Sandy Kruse (47:47):
Yeah, backtracking
is not an easy thing to do, so
this is why I'm always like getyour lifestyle in order, maybe
take a few herbs that you feelhelp and then get optimized
hormonally when you kind of setyour baseline and go okay, I've
done everything I can do, I'm ahealthy person, I'm going to go
(48:09):
and see a physician likeyourself and get myself some
hormones.
So what is BioT?
Talk to us about what that is.
And what is pellet therapy?
Because everyone talks aboutpellets in the US and I'm
Canadian so I don't know as muchabout it.
Dr. Bruce Dorr (48:26):
Right, right.
So BioT is a company that wasfounded over 10 years ago and
they are an educational andpromotional company.
And, yes, they do educate inmany different areas, but
pellets and pelleted therapy istheir focus.
And what pellets are?
(48:47):
They're like a little grain ofrice that goes through a tiny
little three millimeter incision, usually in the upper bottom,
but we can put it reallyanywhere that people have fat.
Sometimes it goes in the abdomenor flank or things like that,
but it's basically the samehormones as it's in a patch or a
gel or a spray or a pill.
It's the same stuff like Italked about.
(49:08):
Not all estrogen is the same.
This is the same stuff that ismeant to be in your body and a
pellet.
When a pellet goes in your body, surrounds it with capillaries
and then every pump of yourheart in comes the hormone.
It's like giving you a brandnew 18 year old ovary back.
How much you need.
(49:28):
So that's the.
That's the art to this is howmuch of an ovary you need back,
whether, with the estrogen andtestosterone coming back into
your system, the pellet lastsfor about three to four months
at a time.
So it's about three to fourmonths at a time, so it's about
three times a year, but youdon't forget it when you go
vacationing in Kona.
You don't forget it on acertain day, or you have your
(49:48):
patch on for two weeks andyou've forgotten it.
So it is less maintenance andit's the same hormone, delivered
the exact same way.
So that's why I see my patients90% of people that I see
continue with that therapy.
When I do other forums, it'sonly about 10 to 20%.
Sandy Kruse (50:06):
Oh, okay.
So if I want, I can't do that,though I can't fly to you and
get that done.
Can I Just curious?
Dr. Bruce Dorr (50:15):
Well, yeah, biot
is getting close to 6,000
providers more in America.
We're seeing more and more inMexico rather than going
Canadian so far.
But they're expanding all overand each year we're training a
good 1,000 to 2,000 more.
They just went public andthere's a lot of exciting stuff
that's happening with thecompany now starting in May, and
(50:38):
so it's really getting theinformation about menopause you
know out there, and the beautyof pellets is that it's one of
the most effective treatments asfar as getting hormones in.
It's just a matter of figuringout how much you know that
patient needs.
Sandy Kruse (50:55):
Okay, so you?
I know this show is aboutmenopause, but you treat men too
, so andropause, so men can getpellets as well, modified
testosterone and that increasesrisk of blood clots, or
negatives that go on, just likehorse urine in women.
Dr. Bruce Dorr (51:25):
There are these
negative things that are pushed
by pharmaceuticals because it'sagainst federal law, at least in
America, to patent and toprofit off of what is native to
the human body.
So drug companies come in.
They want a uniquely patentablesubstance which can't be native
to the human body.
So they modify it to be similarbut not the same.
So that's why we like pellettherapy is because it's the same
(51:47):
testosterone and again it'slike giving a brand new testicle
to that guy.
It's the same stuff, deliveredthe same way, just like in women
.
Sandy Kruse (51:54):
Okay, so there is
such a thing as bioidentical
testosterone as well.
Right, for the NWIM?
Yes, okay, all right, wow, okay, I think I don't know if
there's anything that we didn'tcover.
We kind of covered a lot.
Dr. Bruce Dorr (52:12):
That's a lot of
stuff, Sandy.
I think, so I have medicalstudents and practitioners that
can't follow me on a lot of that, so you were outstanding, oh
thank you, I do this every day.
Sandy Kruse (52:23):
Okay, so let's
summarize.
Let's summarize what you canactually.
By taking bioidentical hormonetherapy at the right time and
the right dose, it can help youage better.
It can help to mitigate some ofthe risks as we age as women,
(52:47):
such as heart disease, dementia,osteoporosis, and then there's
the whole other, just thesymptoms Living with
debilitating-.
Dr. Bruce Dorr (52:58):
Quality of life
is a big thing.
Sandy Kruse (53:01):
The symptoms Living
with debilitating Quality of
life is a big thing.
Yeah, I mean, we don't have tosuffer, and I know some people
will suffer for many years,right?
So yeah, let us know where canwe find you?
It's a BioT, and if there'sanything else you want to add
and summarize, please do so, drDorr.
Dr. Bruce Dorr (53:17):
Yeah, biot or
BioTcom, b-i-o-t-ecom, and you
can find a practitioner that'sclose to you in your area.
We try, and, you know, makethis a very similar process.
There are many differentproviders coming from different
backgrounds, so there are peoplethat are more functional
medicine, there are people thatare family medicine, there are
people that are OBGYNs, soeverybody comes about this from
(53:39):
a little bit different angle,but the process and the pellets
and the counseling should besomewhat similar in different
areas.
But you know, you try and findthat person that you can click
with and there should be, like Isaid, where there's providers
in basically every state andalmost 6,000 providers
nationwide.
That's amazing, and are they in?
Sandy Kruse (53:58):
Europe, yet every
state and almost 6,000 providers
nationwide.
That's amazing and are they inEurope?
Dr. Bruce Dorr (54:01):
yet you know, I
don't think so.
I know Mexico and Canada, but Idon't think they've expanded to
Europe.
Okay because I do have They'vehad pellet therapy over in
Europe, but I don't think notIOT yet.
Sandy Kruse (54:14):
Okay, wonderful,
all right, thank you so much for
your time.
This has been such a pleasure.
Maybe we're going to have to doa show on andropause.
Dr. Bruce Dorr (54:24):
I'm happy to do
it Like I see 25% men now we see
probably the most men out ofall the biotech practices is the
DLW big practice.
Sandy Kruse (54:32):
Oh well, you know
what?
I've gotten a few requests, somaybe we'll have to do that,
thank you.
Thank you so much for your time, dr Dorr.
Okay, let me know how.
So maybe we'll have to do that.
Dr. Bruce Dorr (54:41):
Thank you.
Thank you so much for your time, dr Dorr.
Okay, let me know how I canhelp, and it's been a sincere
pleasure.
Sandy, you're awesome.
Sandy Kruse (54:47):
Thank you.
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
bringing these conversations toyou each and every week.
(55:10):
Join me next week for a newtopic, new guest, new exciting
conversations to help you liveyour best life.