May 15, 2022 • 54 mins
Our Sexy And Single Sisters Over 50 Podcast welcomes Allison Fox, MSN FNP, to this Special Edition!
Whether you're over 30, over 40, or over 50, SASSover50 is talking openly about menopause, hormones, and sex drive. From mood swings, depression, and hot flashes to vanishing libidos personal dryness, and facial hair this podcast might just change your life (and help you to enjoy sex again)!
As a Registered Nurse specializing in Hormone Replacement Therapy (HRT), and menopause for 18 years, Allison reminds us that, 'women have been sold a lie that they just have deal with menopause', but that's simply not true! We ask all the questions about Estrogen, Progesterone, Testosterone, DHEA, pellets, and libido that you wanted to know, but didn't know who to ask! Share this podcast with women of all ages who may be approaching their "change of life".
DISCLAIMER NOTE: This podcast is for informational purposes only. All information, content, and material is to inform our listeners about what we have learned or experienced. It is in no way intended to serve as medical advice, medical consultation, medical diagnosis, and/or substitute treatment from a qualified physician or healthcare provider. The listener assumes full liability for their medical care. All persons and businesses associated with this podcast, any platforms on which it is shared, or otherwise associated with the podcast or any of its creators and contributors, expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result information provided in this podcast.
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Episode Transcript
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Unknown (00:14):
Welcome to another episode of sexy and singles.
Over affinity. Welcome toanother episode. Hello, ladies.
Hello. Oh, what a fun night wehave in store. I'm very excited
about this topic. We've beentalking about it especially. I
(00:35):
think Danny and I have talkedabout a little bit extra. And
Kate's a little bit younger thanwe are. So the hormone issue
isn't as big of a deal yet. Itis just
common knowledge from Yes.
Yeah. So there's, you know, ofcourse menopause. Many of us are
(00:58):
either going through it or havebeen through it or are still
going through it or are Perimenopause. So I'm so excited. We
have a wonderful guests, I wouldsay expert because this is right
in her wheelhouse. We haveAllison box, who is an MSN FNP,
which I have no idea what thatmeans, but she's definitely
going to tell us what thatmeans. And give us a quick
(01:19):
overview of what she does. Iknow the nurse part, but I'm
excited to introduce Allison. Sowelcome, Allison.
Hey, thank you for having me.
Yes, I'm a nurse practitionerand I work in Portland, Oregon
and community health and I havebeen working for almost 18 years
and helping people along thatwhole time with their journey
into menopause and helping themyou know, some people don't have
(01:42):
many needs during menopause, butmost people are the majority of
women do. And so I am happy tobe here today to kind of help
your audience you. Yeah,absolutely.
We're so happy to have you andwe have so many questions, but
I'm just gonna kind of fly offwith first of all, menopause.
When does it typically start ifyou can just give us kind of and
(02:05):
then I know there'sperimenopause or Peri menopause,
perimenopause. How many stagesare there and when do you
typically start? There's threestages in menopause. So
perimenopause is the in between.
So hormones are starting yourovaries are starting to kind of
peter out. And that can last ifyou know, a year to a couple of
(02:26):
years, maybe even six years.
Sometimes people will start togo into early, you know
perimenopause. And they'retypically mid 40s is when people
are gonna start having someperiod menopausal symptoms.
There's some genetic, so somedifferent races, people will
have different Asian people tendto go through earlier menopause.
(02:46):
So there there are some geneticvariations, but usually between
45 and 52, you're going to starthitting that current menopausal
window. Okay.
And did you say that was themiddle one? Is there one before
then and one after then?
So perimenopause is the firstone and then a year of not
(03:07):
having your menstrual cycle youare considered officially in
menopause? Okay. And then afterthat there is just post causal.
So changes sort of down theroad?
Is there a typical time periodthat menopause takes place? I
mean, is that usually going tolast for five years or 10 years
or two years? In theory thatmuch?
(03:28):
Yeah, it's variable depending onthe person. Some people get away
really easily. And it's a maybea year of a transition, and
other people will tell me 10 or15 years, which it's the best
indicator when you're gonna gothrough menopause is when your
mom went through menopause. Soif you're lucky enough to know,
if you weren't adopted, or yourmom didn't have a hysterectomy,
(03:50):
something like that, that wouldhave kind of you don't have that
information. Mom's age ofmenopause is
that's interesting. I didn'trealize that. So it's almost
like a hereditary, you know, andand as far as the actual
menopause symptoms, we all knowabout the whole hot flashes. And
I guess vaginal dryness is apretty common thing. Like
(04:12):
lethargy, there's so manydifferent symptoms, and I'll let
you review those. But first, I'mgonna just ask if Kate and Danny
have any specific questions. Ithink that something that our
listeners would want to know iswhile there are the more common
things like the hot flashes,like you said, but I think
there's still a world of womenout there that don't know that
this is a possibility orcapability of being able to
(04:35):
rejuvenate so to speak with thewith hormone therapy, and like,
there was a woman I was talkingto a couple of weeks ago and she
was talking about the weightgain in the hair on her face and
just not caring about thingsanymore. And I think menopause
is more than just the hotflashes. It creeps up on us.
(04:55):
Like what is it that you wouldhave encourage women to be aware
of more so than just a hotflash. You know what, um,
because I, I think depression,like, it's not just a mood swing
like PMS, I don't think, um, butI feel like I've gone through a
lot of different changes. Somewere probably depression that
(05:18):
was not related to menopause.
But it just happened that thebig life changes happened at the
same time, which brought thaton, but I don't know, maybe one
made the other worse.
So maybe like the symptoms orthat type thing. Things that
look for. What do you thinkAllison?
Yeah, absolutely. Um, yeah, Ithink that, you know, I'm, I'm
(05:41):
glad that we're here talkingabout this, because I think that
women are often sold this liethat they have to suffer, right?
And that it's part of thejourney and just suck it up,
buttercup, right? Oh, you youwant to do you know, change, you
know, feel better during thistime, you know, then you're,
(06:02):
then you're not doing it right?
Or somehow that's like, you'redoing womanhood wrong. And
absolutely, there are somepeople who become almost
murderous, like their mood, youknow, shifts are so volatile,
that they go from feeling prettycommon normal to feeling like
the ground is out, and you know,from under them. So that's one,
but it's also just a lack of sexdrive. And so we'll I think
(06:27):
we'll talk about a little bitlater with hormones. But I think
on a fundamental level, if menexperienced what women do, where
their testicles just stoppedgiving them sex hormones, I
think there would be a lot moreinformation for women, honestly,
becauseit is, is that kind of the
(06:51):
equivalent? No, no. That's whatI'm asking.
Yeah, men and get testosterone,you definitely declines decade
by decade, but you can be 60 or70, and still have testosterone
levels where that's not the casefor women. And it really, yeah,
so I think that women had beensold a lie that they have to
(07:12):
suffer. I think it'sunnecessary. And I think, you
know, maybe we'll get intolater, the whys about that. But
I think that women need to beeducated that they have options.
Good.
Oh, I'm so glad to have you.
Because this is exactly. I mean,it's on our minds anyway. And
Kate, you're not going throughit yet. But I mean, you're gonna
be so wise, you'll, you'll be soready for it.
(07:37):
I do have a question, though.
So, you know, I'm still so youknow, I'm still on birth
control. So like, you know, ifI'm on birth control, and I
going to feel this change,basically. I mean,
what, what kind of, are youtalking about oral
contraception? Like, yeah, birthcontrol pills? You didn't? You
(07:59):
wouldn't know. But I mean,you're over 4.0? Yes. Okay.
Yeah. Usually, providers willstart to have conversations
after I call it 4.0. That's myway to get around, you know, a
gene is I make it like adecimal.
That's pretty clever, actually.
Yeah.
(08:19):
Yeah. 4.5, just to be totallytransparent here, your problem.
And usually people will have aconversation with you about it,
because people try to pull youoff of those types of hormones.
They aren't bioidentical, whichis not ideal. But you wouldn't
know, though if and when basedon your cycle, which is a good
(08:43):
way to start to say, Oh, hey, mycycles are getting irregular and
Oh, my diet hasn't changed, myactivity level haven't hasn't
changed. You're not going tohave that marker when you're on
a birth control pill becauseit's going to keep you regular.
So you would have to look outfor other signs and symptoms of
like, your mood, you know,becoming like your mood shifting
(09:05):
or something like that. Becauseyour cycles, your cycles would
still be the same.
Okay. Yeah. And that's kind ofwhat I was. I was thinking you
were gonna say because I wasthinking, well, if my hormone
level is you know, consistent,basically then, you know, how am
I going to know basicallyhopefully, you're not going to
be on oral contraception forthat much longer because Is it
(09:25):
risky? I thought I alwaysthought that was a risky thing.
Thatdoesn't smoke. But you know, I I
really like Mirena IUDs I justthink they're easier. You don't
get any of that. Most of theestrogens are from I think most
people know by now like horseurine. That is that is like
(09:46):
Premarin based and so. Yeah, Ithink IUDs are just easier all
around. You don't have toremember to take a pill every
day, but it's Not necessarilydangerous unless someone had
migraines. It was making theirmigraines worse,
like, oh, we'll cross thatbridge in a second. Okay,
(10:07):
Danny's got a little somethingabout that situation. It's
funny. We were talking aboutthat before you came on. You
know, I know we all have alittle, a few examples of things
we've been through. But I thinkit's really helpful just to kind
of get the some of these majorquestions out of the way and
kind of dive into some of thathormonal treatment, because I
think that's what most of us arelooking for. And I had no idea
(10:29):
it was actually Danny, who hadsaid something about taking
testosterone or DHEA, and allthis stuff. And I was like, What
is she talking about, though? Istarted looking into it
literally this weekend. And Iknew Alison, you were coming on
board. So I'm like, during myquest for question, or in my
kind of my research forquestions to talk to you about
it. I learned a lot, but Iordered something. So you and I
(10:51):
talked, I was in just brieflyyou mentioned what did you
order? You said you orderedsomething I did. I ordered
Wynonna and it's allprescription. Okay, so yeah, so
it's the estrogen therapy andthe pedestrian mix together in
the cream.
Okay, great. It's a cream. Soit's an intra vaginal cream. No,
(11:12):
it's,um, skin. Yeah. Topical, and
then the DHEA pill. Right. Sothat's, that's what so
that's great. Yeah, I'm gladthat you mentioned, I think that
the lack of vitality, you know,people can consider it just part
of aging. And like you said, Oh,I'm just, you know, getting in
(11:33):
my 40s or 50s. Or life isslowing down. This is what's
common. I'm just more fatigued.
And sometimes it really is, if Iwrote thing, you know, thyroid
issues are really common inperimenopause. So they, some
things can actually happensimultaneously. But I do think
that Western medicine oftenfails and women around this time
because we are taught to not gochasing hormone labs. Right. And
(11:57):
it's not considered standard ofcare, which means it's it's a
it's our way of saying just tellwomen to suck it up. Yeah,
exactly. Like the client. Yeah,yeah. And so we'll deal with it.
Yeah. So if someone comes to me,of course, I feel really
strongly about this because I'mwant to go to bat for my
(12:18):
patients. And I don't want toget keep that I'll check their
hormones, particularly FSH is afollicle stimulating hormone
will be really elevated insomeone who's in menopause.
How do you check them if I canenter just a lab test? Okay,
it's it. Yeah, it's a simplelab test. And it's not even that
expensive. And so I thinkencouraging your listeners, if
you're a provider, if you bringup these concerns that your 38
(12:41):
would be the young end of it,but particularly if you're in
your mid 40s, you know, Istarted when I menopause or
perimenopause when I was 3738.
But it's pretty uncommon, but ifyour periods are to be irregular
around that time, or you'recurious, you know, asking your
provider and if they say no, youknow, I think it's it were it
(13:03):
bears some thought as is is theprovider for you. Because if
they're not taking your concernsseriously, you know, maybe that
means you also then you find anaturopath or find a naturopath
tend to be a little bit morethey have more time with
patients and will often dodeeper dives with hormones. But
the FSH is an easy lab test tobe able to see if someone is
(13:24):
their hormones are starting togo offline. And yeah, a common
complaint is like the lack ofsex drive that the vaginal
dryness but also just lack ofvitality.
I think for me, just from aperimenopause perspective, just
to put this out for people toknow from an experience
perspective, I was in my early40s. And I was the mood swings
(13:47):
were so bad. It was the more ofit like angry like the temper,
and I wasn't that type ofperson. But anyway, I had gone
to my gynecologist he tried meon birth control. He wanted me
to be he wanted to try to flipmy hormones. That was a
disaster. And I don't rememberif he did labs or not. Now this
was 10 years ago. I was aSuzanne Somers hormone
(14:11):
cheerleader. So then I found awoman who did deemed that she
was a gynecologist that didbioidentical. I went to her. Not
one lab said, here's the combopill based on your symptoms go
take this, which was I thinkthey were bioidenticals but it
was just it was a pill and Icouldn't tell you what was in
it. Other than some mixture ofwhatever. So I took that it
(14:35):
didn't work. By the third visit.
I went to see her she said tome, you need to admit that
you're depressed and go see ifthey're honey. Oh, so then I
finally another amount of timehas gone by and a company had
started doing hormone therapy.
They called themselves 25 Again,and finally got the labs done.
(14:58):
And they started me on justprogesterone because I was still
projet producing estrogen. Andonce you get that level of
progesterone, right, my husbandwould go, where is it? Do not
Did you pack it like we're goingon? You cannot forget your
progesteronewas a miracle. That's awesome.
I go to the mountaintops abouthow well that helps me and I did
(15:19):
do the thyroid thing not becausemy thyroid was it, what is it
about your if your thyroid isn'tperforming at peak? They just
want to give it a boost? orSo yeah, yeah, like the
supplements like somethingsome iodine? Yeah, for so I was
doing that. So I just stayedwith that program. And don't I
don't even talk to mygynecologist about it anymore.
Yeah, I think that if someonedoesn't do baseline labs on you,
(15:43):
and you're going in with aconcern that's hormonally
related to me, then how do youknow what's working and what's
not? I know, it's not one sizefits all. There's just Yeah.
And that's a lot ofexperimentation to be adding and
taking away more hormones fromsomebody who's already crazy.
(16:05):
I have had patients who come inand say, I think I'm in
impossible, or peri perimenopausal, can you check some
hormone labs, and I've hadpeople who have all of these
complaints and their hormoneslook great. And I and I do have
to say, hey, like, you're, it'snot right now. So maybe it is
something mental health can beoverlapped, you know, and some
(16:27):
people need to hear that islike, okay, that go see the
counselor, right, that sort ofthing. So that does happen
occasionally, or am I boo,you're making your May, it's
working all that seems to befine. You know, so yeah, that's
that's a good point. Yeah, justnot the one size fits all
because yeah, it's so I thinkchecking those hormone levels.
(16:51):
And then also, you know, doing atestosterone panel, not just a
regular testosterone, becausethere's free testosterone and
there's there's boundtestosterone and really,
whatever your free is, is allit's circulating in your system.
And so, sort of jump ahead totestosterone before we even talk
about the estrogen but you know,your adrenals make testosterone
(17:15):
and if your free testosterone isnot circulating in your body,
then you don't have access toit. So if your provider just
does a regular testosteronelevel and gives you a number it
could look okay, but it youknow, if you have to do the
panel, which shows your sexheight like hormone binding
(17:36):
globulin like someone whoprobably hopefully self
identifies is doing somehormones or you know, and I
think with with Google, it'spretty easy. Now you just type
in your city and hormonespecialist, I would I would hope
that these people are, you know,are doing those kinds of panels
that can look a little bit morejust under the surface levels.
(17:56):
Excuse me, I wanted to that'sexactly one of my questions was,
where would somebody go to get apanel like that? So you could
Google that? And yeah, and justgo to that type of a specialist.
And so they wouldn't have to belike an ongoing care doctor
necessarily, but they definitelybe the labs people. Okay.
Yeah. And honestly, and ofcourse, this is not just the
disclaimer first, this is notmedical advice, you know, but
(18:20):
even I mean, I'm in westernmedicine and I have not found my
gynecologist or my regularWestern medicine, it's, she's an
integrative medicine. They, it'snot I go to a naturopath because
I have found that thegynecologist sort of said, Oh,
you're 42 I said, my boobs aregetting saggy. My vagina is
(18:41):
getting dry. And I want tocontinue to like not to be TMI,
but enjoy sex and I getting wetis part of like how I stay.
Yeah, like, you know, it's onething when they think you just
tell a patient like oh, there'slupus, but then when it happens
(19:01):
to you, you're like, No, I don'twant to use like organic cherry
glue. So when the gynecologisttold me that like oh, your boobs
are getting saggy, just likedeal with it. I was like, No,
I'm going to I'm going to seekcare elsewhere. And so yeah, I
would be Google hormonespecialist and and you know,
whoever was covered by insuranceso me there I'm sure there are
(19:24):
Western medicine people like methat are out there doing it. But
I don't I think people often arecan run into some some
gatekeeper. Oneof the things that when I moved
to Florida, and I was trying tofind a new hormone health care
specialist in Florida is I didGoogle women's hormone health.
And that's a good way to find itbecause some offices are just
(19:44):
doing women's health and theyspecialize in hormones. So I
mean, I think those are keywords. Right? Um, one more
thing, Allison that I think isimportant is our generation
mothers grew up with hormonesbeing a controversy of when they
started giving women hormonesfor menopause, they were
(20:06):
creating the scare of heartattacks and strokes. And I don't
know, I don't know the wholething. I just know that a lot of
us had mothers who stoppedtaking it because of the
controversy. And I think thathas since changed, but I don't
know that it's been loudlyspread.
(20:27):
It has since changed. And yeah,in my in my mother was a person
who was on hormones and smokedand then had a stroke. So there
were a wow, I'm sorry. Thanks.
So yeah, we did some somethings. First of all, the
hormone doses and themedications in the 70s and 80s.
The estrogen levels were muchhigher, they're at least like a
third of what they were backevents, smoking tobacco, any
(20:50):
kind of, you know, veryprevalent. Yeah, exactly. And we
didn't have it was, you know,after the 60s or 50s, that you
know, they ads for it's like,you know, these are the best,
this is the way to say it's Premthose kinds of ads. So yeah,
it's smoking and I it, I do notgatekeeper. But I would be
really cautious if you're stillsmoking cigarettes, and you want
(21:15):
to start a hormone journey,because I do think that that
combo is not ideal. I would usea patch. If if someone really
and I've had patients who arelike, if you don't help me, I'm
gonna kill my husband. Well, Idon't I don't want you to
murder. I know, that's that. Sowe'll do a low dose hormone
(21:36):
patch or, you know, blackcohosh, until symptoms are
relieved, something like that.
Um, but yeah, absolutely. Ithink that the cardiovascular
risks and even you know,honestly, brain health, those
things were, or thecardiovascular risks were
overblown, and I don't thinkthat that's accurate anymore. If
(21:59):
anything, I think having sexhormones can be protective to
organs and the brain, your brainneeds sex hormones. So your
brain starts to decrease insize. When you go through
menopause andeverything the crazy you eyes.
Your boobs, like your brain likeOh, shut up. Yeah, I difference.
(22:24):
Yeah. So I think that when Igive women a pep talk, you know,
it's usually like, I want you tocontinue to enjoy your life. And
that includes sex, sex as partof being human and enjoy and
having pleasure in the humanbody that we exist in. And for
some women, that means if if,let's say vaginal dryness is
(22:47):
your only symptom that might bejust targeting your, you know,
with a intra vaginal estrogenproduct, which can be great, or
if someone is a smoker, and theyare having vaginal dryness, and
they're like, Well, I'm havingthis issue, but I don't really
want to put myself at risk. Youknow, I'll quit smoking in two
years. And we can talk aboutdoing it, you know, a different
(23:08):
type of estrogen. But there canbe spot treatments. Now, that
used to be hundreds of dollars amonth. And now badger femme is a
tablet that you put into yourvagina once a week. It's a Wow.
10 to $20 a month. That's aboutthat's incredible.
And what does that dospecifically?
It just helps with that. So yourvagina as you start to lose your
(23:31):
ovaries start to peter out thevaginal lining atrophies or
thins out so you it getsthinner, and then it stops
creating its own lubrication.
And so there's also a vaginalcream that has estrogen but that
tends to be messy and when youare still sexually active
putting a cream inside yourvagina that sex and I say I you
(23:51):
know, it's again Yeah, yeah, itdoesn't usually
just go right into sex. Usuallythere's foreplay and there might
be some flavor situation. Yeah.
Yeah, not alone. I hope yes,there's cream and I think when
people haven't gone through itthemselves, I was shot. Yeah. On
someone's penis, and I wanted tosay like, Have you never heard
(24:18):
this from a person that likeliterally you're you didn't warn
me that like yeah, so um, soyeah.
Visualizing, I put this cream inmy bed and the guy's going down
on me. He comes up he's got likeyes, like no, no, get that off.
(24:43):
And don't try and even thinkabout kissing me with that.
Anyway, I'm sorry. I had animage emoji person. Oh, yeah.
That's hilarious. So so that'sit and you call it bad pill
badger Finnis that da g i FTM Okay,
okay. All right. Well, hey,listeners who you may have heard
(25:04):
it first here. I know I did. Sothank you for sharing that. That
that might be the ticket, youknow,
that might be the ticket. Andthat's easy and low hanging
fruit and no kind of systemic,you know, sort of issues. But I
don't I am not worried about asfar as if someone had a heart
attack already, that might putthem in a different category of
(25:28):
risk. So I'm not saying youknow, in medicine, it's not
hard. Everything has a risk.
Yeah, yes. Exactly. It's allabout risk, like, you know,
mitigation and recognizingwhat's more important to you at
the time. I think the only truereally contra indication or a
reason that I would notprescribe is if someone had an
estrogen positive breast cancer.
(25:49):
So if someone had been diagnosedwith breast cancer, they get it
gets typed and they there can beno estrogen and progesterone
that that would be your reasonthat would be a hard stop for
me. In migraine with aura is aconversation that's another one
that if anyone out there hasmigraine aura, it I would use
patches which tend to be a bitsafer as far as just it bypasses
(26:12):
your the first pass of theliver. And so there's less
clotting risks with topicaltopical or the or patches. But
yeah, I think that for mostwomen, it's a conversation of
the plus and minuses about it.
That isvery interesting. I'm learning
so much. I look good inmenopause, but I've already had
(26:33):
it. But for some reason thispast week, I had been so many
hot flashes, I thought they weregone. I was getting like one or
two a year. And this week hasbeen and I'm thinking what have
I changed and I haven't changedanything yet. I have been eating
a little bit more sugar. And Idon't know if that impacts it or
not if sugar is a bearing orbrings it on, but I definitely
(26:54):
that's the only thing I come upwith. There's no other reason
but I've tried a lot of hotflashes. So I'm very excited
because I did just order thecream. Now I went to Wynona
online, it's my wet Wynonna likeWinona Ryder. It's my n o n a.
So I'm very excited because Ithink I'm getting kind tomorrow.
My kit, if you will, it's allprescription but it's the cream
(27:17):
with the and I mentioned earlierbefore you jumped in. But it's
it's the combination. So it'sthe estrogen and progesterone
and the cream and then the oralDHEA for the testosterone. So so
let's let's talk about thedifferences on the green. It's
my understanding that estrogenand progesterone cream. That's
(27:39):
the best way to trends, isn'tit? Right. And there's two
different kinds of estrogens. Isthat right?
Well, yeah, I've been there. Itend to use Estrid die all
that's the one that'sbioidentical. So there might be
other ones, but that that's whatI use in my practice. And there,
there's compounded cream thatyou can put on your forearm or
(28:01):
there's patches, I tend to usepatches just because I think
it's a little easier and costeffective. Compounding is a
little bendy, and it's notcovered by insurance.
How much would you say justthrowing it out there?
Yeah, like 60 bucks every 60 to90 every maybe two or three
months depending on your goesbad is actually the patches are
(28:21):
yours. They're not compounded.
They're not bioidentical, right.
They're from the horse urine.
I think no, they're bioidentical. Okay, the patches are
two patches are two and they areit depends on your insurance.
This is where it gets a littlebit tricky. It depends on your
insurance coverage. Like I'vegot pretty good insurance. And
so my co pays I $10 a month. Soit I think cheaper for me to do
(28:45):
patches to so you have to kindof price things out and see how
it works for you. But when youstart to add, I guess everything
in like the testosterone, someprogesterone and extra dial, it
can get spendy when you are kindof either way. So I think it's
good to do a little research.
I'd like with your insuranceplan and figure out like, okay,
(29:06):
if I'm going to be spending $60a month with insurance, maybe it
is more cost effective just toget something compounded at a
compounding pharmacy.
Okay, well, that's veryinteresting. Okay, I want to
kind of ask the questions thatI'm thinking our listeners would
be interested in knowing and nowI know I've heard of the pellets
(29:26):
I don't personally know. I knowtwo people who have used them
and they really like them thatwhen I hear pellets, they just
sound painful. I feel likesomebody's shooting something in
my butt. And I think that's whatthey do, if I'm not mistaken,
but nonetheless, we do not haveany experts here on that. And
nor maybe that's for anotherconversation, but it sounds like
a lot of people are going moretowards these creams and the
(29:49):
topicals and some of the oralsand the patches and all that so
different.
Yeah. And I know people whoreally love the pellets. I don't
do it as part of my practicebecause it's pretty bendy, it's
you know, it's I heard Yeah,five to $600. And that would be
just for extra dial or justtestosterone and to me, yeah,
(30:10):
it's great that you get aconsistent amount of hormones,
but it just seems pretty. It's alittle bougie that like a little
too much i Yeah.
Ready just have no, that's veryit is very expensive. I know
people have told me I'm like,Oh, I mean, they're talking five
$600 A quarter.
Yeah, yeah. And then it's labson top of that, and then you get
co pays with labs. And I thinkthat there's a way to do it just
(30:33):
as well, without it being youknow,
I think is as important aboutwell, there are a couple of
things. I they I didtestosterone pellet a few years
back in my numbers, my labs cameback that I should have been
screaming with testosterone, butI physically felt nothing
different. And they said,there's some some people the
(30:54):
makeup of their body doesn'tabsorb or transfer something I
don't know. So pellets don'treally work for me. But um, the
other thing when you do a combo,where you've got estrogen and
progesterone together with adose that's mixed in, like, how
do you adjust, like, I've alwaysdone mine separate, and we are
(31:16):
in but I only started takingestrogen last six months, which
is really been I've been allover the place with my estrogen,
Rush. Um, so I have anappointment Thursday to talk
about it again. Yeah, but like Iforever for years have done 200
milligrams of progesterone, butit's by mouth. And so when I
(31:36):
started taking the estrogen,they sort of have me still take
that even though that's a higherdose, but I'm used to take a
higher dose they said stay withit. But when you do a combo, how
do you know especially if you dopellet, aren't you kind of just
stick with those pellets atwhatever dose they just put in
there until they're done?
Yeah, I think so. Yeah, usethem. So that's why I don't I
(31:56):
can't speak to them. But yeah, Ithink it's three or four months
that they you know, theyprobably start you out at a like
a lower dose. And so then youhave to Yeah, add I like mine
being separate. I've had themcompounded together and I've had
them creams. I've had the MS.
tro keys where I put them undermy tongue and the recipes can
always change. But I you know,I'm happily like a bit of a
(32:18):
control freak. I like to justhave everything kind of be
separate. And I like theprogesterone is the metabolites
of the progesterone causesedation, so taking it before
asleep. We like helpful forsleep and so
sleep is an issue with menopauseand perimenopause, too.
(32:41):
So I like it being separatebecause I if I was on a lower
dose of progesterone, like 50milligrams, but took it during
the day, I'm like, Is thismaking me sleepy? Like, I don't
really want to be takingprogesterone first thing in the
morning. Yeah. So So what,what's a low dose versus a high
dose? Since you mentionedprogesterone, progesterone,
I use micronized progesterone,and it's usually it's either 100
(33:04):
milligrams or 200. So I startpeople on 100 at nighttime and
then move up to 200. If they'reeither having heavy periods
which can happen duringperimenopause, especially, you
know, it's very common for womento have fibroids and they'll
start to get the heaviestperiods. You know, they're 4748,
(33:24):
and then they're going out withthe Bing and clothes and sheets.
And you know, it's like really,so I would go up on their
progesterone and that might beyou might have some mood
adjustment issues those firstcouple of days that you go on it
you know, progesterone switchesare what cause like PMS
symptoms, but once you stay onit after that week, they should
(33:47):
fall into the background. Andthat's what I was going to ask
is about how long is the theperiod is now that's for
progesterone, so your body takesabout a week to kind of
acclimate? Roughly obviously,we're not doing any medical
advice here, right? Because thenumbers because you said you
have about 1200 patients in youroffice and you would know you're
you're an authority topic. Yeah.
(34:08):
And I would say if you're stillnot well or feeling like it's
hitting the spot and thebullseye and three weeks I would
tell your provider becausesomething especially after a
couple weeks Okay, so I thinkgreen takes
a bit doesn't like takingprogesterone by mouth seemed
like that was sort of a moreinstant but the cream getting
does it take like a certainamount of time for your body to
(34:29):
regulate the cream.
I think it's just harder toabsorb. Okay, I think it's more
an absorption issue. It just isa you try to put it on this part
of your forearm because it'svery thin skin. So it's yeah,
the absorptionand they have me do it on my
lower abdomen or my lower back.
That's unusual. That's part ofmy problem.
(34:52):
Yeah. Yeah, it says use it here.
Yeah. I've always done theforearm just because otherwise
because it doesn't it you wantthe least amount of tissue to
get it intotell me to put it as close to my
ovary.
This is I would, I would checkwith a pharmacist because the
(35:15):
pharmacists are the ones wholike, yes, you're black and
white. Just see because thatmight be intuitively what you
know what you think. But that'syeah, that's not what I what are
ya? Howare ya? I'm calling tomorrow. I
think Danny, Danny started tomove it. Wouldn't that be great
though? Like, you just put it onyour forearm now and then it
(35:42):
solves all your issues.
Fabulous. Okay. Myoh my lord. I like that is my
problem. Can you imagine? Ohmy gosh. And I literally try to
line it up like, oh, there's gotto be an ovary there.
You get you have to eat? Or yousay like, yeah,
(36:06):
yes, yes. No. Oh, yeah. We'llwe'll do the email unless you
know, if any progress. Could youimagine if it was that simple?
Oh, my God, that'd be great.
Let's move on to the estrogen.
And because I'm sure you know,there's estrogen is what
everybody goes in our mindsthinking. And first of all, I
want to ask there's over thecounter things like Prem oven or
(36:27):
whatever these names are, do anyof those things actually work?
And are they estrogen based? Orwhat is what are those things on
the shelf?
Honest, I other than thesupplements? Like black hole
harsh? I don't know. Because Idon't prescribe things that are
over the counter. And they'renot FDA regulated. So I Yeah,
(36:49):
that's fine. I just thought I'llask that in case it was in the
mind of one of our listeners. Somoving on to estrogen do that.
Now if somebody's going throughmenopause it could it be
possible that they would. It's apossibility, they might just be
prescribed estrogen. Is thatright? It may also be
progesterone, if theydon't have a uterus, you can be
prescribed just estrogen. But ifsomeone has a uterus, you have
(37:12):
to be on both estrogen andprogesterone. That's very
important. Otherwise, it couldlead to an increase in uterine
like cancer. That'sokay. I thought I read something
that's I wanted to ask thatquestion. That's important.
If you've had a hysterectomy,you could be just on estrogen
alone and yeah, there's there'soral there is topical to either
(37:34):
patches or compounded. And thenthere's the pellets or their
shots. There's extra thought, ifyou do oral I would probably
sublingual worry melts underyour tongue. But most people I
like patches because like Isaid, they stay on your skin, it
lasts for me, you know, threeand a half days. So it's just
twice a week, I put it out withmy supplements and just have it
(37:57):
you know, twice a week so soit's easier to me it decreases
my pill burden too. So if youare on supplements, you know,
I'm talking about you alreadyfeel like you're taking like
your turmeric or whatever, allthese things
pharmacy in the bedroom.
They're like stuff there. Butthey're still like a lot of
pills. So I I prefer patches.
And so I usually kind ofencourage my patients to go that
(38:20):
route too. But and I said youstart with the lowest dose until
you either relieve symptoms andso I don't choose lab values as
much as I do symptoms. So ifpeople feel good on a dose I
still check lab so I can makesure that something's not at
like super out of range. Okay,it's congruent with what
(38:42):
someone's experienced, but Itrust their experience over what
a blood test me.
Okay, so I want to mentionsomething about the estrogen
that's so common for many of usand myself included is the low
libido. Is that not where theestrogen would help? I mean,
more so than the progesterone ordo they both or how does that
work? Sothis is I want to be clear, too,
(39:02):
that this is anecdotal. Okay, sothis is there is not a lot of
evidence that anything helpswith sex drive. Even testing
testosterone is not eventestosterone, but there is
plenty of anecdotal evidencewhere people will tell me and
that it helps so I just to beclear there and I don't know if
(39:23):
it's a paucity of researchfunding, you know, who who is
paying for these things or who'snot like putting money forth to
it so Imean, women enjoying sex doesn't
matter. Hey,that men would be pretty freakin
like invested in. Right, right.
(39:44):
Yeah, yeah. So I always prefaceit with Hey, there's not a lot
of research but at the sametime, you will know if it's
something that helps and I thinkthat it low dose testosterone,
I've seen a lot of women at helpand also DHEA a lot Other women,
their DHEA level is, is lowerand especially if someone's DHEA
(40:06):
is under 100 getting them on alittle bit of DHEA sometimes in
three or four days I'll get amessage back that like that was
it and it's not like all of asudden you're you know horny now
like like your first couple ofmonths meeting someone but it
yeah it is a noticeable you canfind that that sex drive feel
(40:26):
that passion again in your bodyand it? Yeah, again vitality and
life like this is this is yeah.
Do you thinkhow much of it do you think is
also related to just theconfidence of knowing so that I
kind of like to think about itas when we go through menopause,
they they would have read yourestrogen falls off like a cliff.
And then like you said, theirtestosterone goes down slowly
(40:48):
over time. We literally go from100 to zero. I mean, and all of
a sudden, everything doeschange. And we feel crappy and
we we don't like our guys, buteven when you're single you
might not feel like datingbecause you don't feel sexy.
Things are drying up. You feeldifferent. You're cranky, you're
hot. Who wants to go on a datewhen the back of your neck is
(41:09):
ringing wet? I mean. So when youstart taking the hormones, even
if it's not, you know, makingyour clit light up. Yeah, the
confidence and just knowing thatyou're not going to have a hot
flash or you don't have to feellike you're 100 years old,
literally. Yeah, makes your sexdrive go. Yeah.
(41:32):
I was thinkingyeah, I think it's part of self
care. And you're right there. Ithink that there is a there's
can be a magic element to takingcare of yourself and putting
that effort in. It can be reallyhelpful. And I think absolutely,
if you're not having hotflashes, that's sure it's gonna
make you feel sexier. You knowthat you're not like stringent
who your sheet? Yeah,yeah, no, for sure, too.
(41:54):
I didn't even oh my gosh, canyou imagine on a day over?
I was laying in my bed. I'm notthis I'm not lying. Last night,
I'm laying in bed and I'mthinking I'm really warm. I'm
actually having to turn my fanon what is with my body this
week? It's like, it'santicipating that I'm getting
all of these hormones. And it'slike willing me to take them.
(42:15):
It's a strangest thing. I mean,I just the timing couldn't be
more uncanny. But I'm layingthere and I'm thinking, I think
my sheets are gonna be wet. AndI touched my sheets. And I'm
like, Oh my gosh, I'm thinkingwhile I'm glad nobody is
spending the night that exactthought crossed my mind less
than 24 hours ago.
Yeah. And then you're cold, youknow, and you're like, you wake
up and then you're wet and cold.
Yeah, it's not fun, it doesn'tfeel and it doesn't feel then
(42:36):
you want to shower so that youfeel clean and that you you
know, goback into bed on a cold wet,
sweaty cheat nowto put towels down before I got
because I you know, I was liketoo tired to change the sheets,
but then I'm like, Okay, I'mgonna tell down so
(42:57):
it's not done that I'm sure.
Yes, yeah, that's what we wantto do. But so that's, that's
super interesting. And, and Iknow, I know, you know, we
thought we could taper this downto such a short conversation.
There's it's just so important.
There's that many questions andwe haven't even hit them all. So
I did want to kind of skip overover to the DHEA unless there's
(43:18):
something else we need to knowabout the estrogen that you
don't think so? No, I thinkstruggle low start you know,
start slow go low and you don'tyou know, more is not always
better. I think that that goingbefore it gets to be a 10 out of
10 problem. Okay, you start isideal, it just because then you
(43:38):
just are kind of aiding yourbody along and kind of helping.
If you've already waited threeor four years, not a big deal.
You can still I still thinkthere's a lot of benefit to
things. But I Yeah, more is notalways better, I think is just
the other venue. Not everyonehas a high dose
so Okay, so don't Okay, okay.
Well, that's good to know. Okay,so the DHA, I think that's kind
(43:59):
of the third prong here. Now,this isn't something for
everybody, either. From whatI've read about it. It's a
hormone that's naturally made byour bodies, specifically
testosterone. So that's what Iread about it. So I wanted to
kind of note some things downbecause I really, I'm like to
learn, what are we doing to ourbody? So you're educating us,
but we'll pick it up from there,if you will.
(44:20):
Totally, it's a precursor totestosterone. And so sometimes
that can be an easy over thecounter thing to do. It's I
usually it's a 10 I think it'sMiller it might be micrograms i
It's 10 milligrams ormicrograms. I should know that.
But if people can start that andat least try it, there isn't
(44:42):
there aren't negative sideeffects to it. And you would
know that testosteroneincreasing is something that it
occurs pretty quickly. So thebenefit of getting your DHEA it
depends on the pathway. There'stwo kind of pathways of how much
it's actually going to increaseand you don't know that unless
do you get a much more extensivekind of hormone panel done, but
(45:06):
you know which kind of kind ofhundreds of dollars but it
you'll know within three or fourdays because when your
testosterone level comes back init, it's not usually subtle, a,
you know, estrogens, I kind offeel like people sometimes can
feel it sometimes can't orsometimes will feel more
emotional. But testosterone, youfeel the things a lot more
quickly. And promising.
(45:27):
Yes. And isn't it supposed to begood for waking as well, and
brain fog and changes? I thinkall of those things are
possible. It's all the those arevery nebulous kind of symptom
that it Yeah, they they're notalways black and white, but I
think it's worth you know, thatDHEA cost me $4 a month. Okay.
Andthat one is an oral Oh, that's
an oral that's. Now, is thissomething that somebody would
(45:50):
take every day? Yes. Okay. Okay,and is this something that what
would you say would be a lowdose on the DHEA versus a higher
dose?
Five to 15? And so I usuallystart at 10. Just like in the
middle oni 25 milligrams, because that
seems high. Yeah,I thought it was five to 15.
Yeah, I think that's howi That's why I'm asking because
(46:13):
I'm like, tell me because I wantto know, this feels like it's
going to be too muchinteresting. Yeah. I'm not
saying it's wrong. It's not how,when I looked it up, it's not
what I what I remember and whathow I
practice but yeah, that's a guygo make now it's, no, this is
only for women, but but maybeevery other day,
(46:34):
if they specialize in hormonesthat you know, trust the trust
and plan that you're on with theprovider. And if it if it feels
like something's too much, Imean, I guess the worst that's
gonna happen is what if you Imean, too much testosterone is I
don't think you're gonna getthere from honestly from DHEA.
But you know, too muchtestosterone can cause you to
get a little chin here.
(46:55):
Yeah, that's what I was going toask is what makes you hairy, and
I didn't know which one it was.
But so it sounds like thecombination of these things that
these are such great, viableoptions that nobody has to
suffer. I can't even believeit's taken me six years to even
think about or learn about, andI'm just so grateful. I mean,
Danny really brought it to theattention and then I mean,
Alison, what a fluke how we met,you know, we on social media,
(47:17):
completely other topic. We'renot going there. But anyway, how
neat, you know, but this is thewhole concept between sexy and
single sisters over 50 I mean,not every single necessarily,
but but just learning from eachother. And I really wanted to
get some good information that'sgoing to help all of us be not
just be more sexy, but do moresex. Yeah, yeah, it means a lot
(47:38):
to make yourself feellike yourself.
And normally, that is so true,Kate, because you don't feel
when you start having thosehormone shifts, and you just sit
and go what is wrong with rightlike,
why am I unhappy? I was happytwo hours ago, what's going on?
And I I'm so excited to try thisstuff,
or the people around you and themen in your life or whatever our
(48:01):
like, you gottathink that take away is find a
provider that takes youseriously. And if you say like,
Hey, I want my sex drive back orhey, I want to feel some more
vitality, if you don't feel kindof heard. I think that you know,
we all have those instincts ofwhen someone is listening to us
(48:24):
and hearing us and we trust andand if you don't have that, then
it is worth sticking around andfind somebody Yeah, ask around,
you know, or Google what's agood you know, to find that
person because I think thatyou're I don't think that we
have to spend decades without asex drive and with Drive
policies and and honestly justnot feeling like sexy and
(48:50):
the mood. Yeah.
So Allison, I haven't I do havea question for you. So like, so
what's perimenopause, right. Isthere any way? I mean, you said
early on that basically youknow, menopause is based on your
mother's age, you know, when shehad it is a good you know, gauge
when you're going to have it. Isthere any way to make the
(49:14):
perimenopause part, you know, alot easier is there naturally
that will help Yes, supplementsthat you can take or even you
know, medication that can beprescribed during the process
basically be set before you getto all that we just talked
about, you know, yeah,black cohosh would be the one if
you are starting to haveirregular periods or hot
(49:35):
flashes, black cohosh is asupplement that you start again
low and you go up to when youryour symptoms are relieved, but
I'm actually advocating forduring that perimenopause to to
get things checked out and justsee at least get some labs on to
check in on it so that way, youknow kind of along the way, even
(49:57):
if It's once a year or onceevery other year, let's say
you're 44. And you're like, Ikind of think something might be
going on. I've had people comein and I'll check, I'll be like,
No, boo, everything looks great.
But you know, come back in ayear or two, and we'll check it
again. So you can kind of see,because I think that doing it on
(50:18):
your own without, I mean, Iguess there's not a ton of risk,
but I think that it costs I'm amedical provider. So I feel like
it's it's good to have someoneon your team to help guide you.
Right. Yeah. And with blackcohosh, if you're, if you're not
having an estrogen problem, it'sprobably not going to it's not
going to help you. And so thenit sends people down these like
(50:39):
Doctor go rabbit holes.
If you're on birth control, youwouldn't be able to take
anything to help it anyway,because you wouldn't feel it.
But I wasn't on birth control.
But we I did start onprogesterone, which help level
out least my mood, right,because my moods were crazy. So
just around during periods, Itook progesterone, probably six
years before I ever went throughmenopause, right? Oh, wow. Okay.
(51:02):
And it just helped level me out.
I mean, it was the Godsend that,that progesterone for that
period of my life was a godsend.
Wow. Had you not gone and got itchecked? Right? You would be
doing all these other littleremedies? I don't know. And
yeah, I know, exercise issupposed to be good naturally.
(51:23):
Because you do get and Kate,you're a gym enthusiast. So I
have to imagine that you're notgoing to probably have as many
but I don't know, I feel likepeople who are more fit tend to
have less is that. Is there anyfactual or any anecdotal
evidence testing to thatexercise helps everything.
Right. Right. Okay. And it justwater? Yeah, it just helps mood
in general. So I don't knowabout anything specific to like
(51:47):
menopause. But I think thatexercise can probably help or
dissolve your stress hormone andyou know, chill out and that's
going to help your your ovarieskeep kind of going without it
just being like an up and downkind of thing.
And how does alcohol interactwith any of these? I need to ask
that because for sexy and singlesisters, after all, so there
(52:08):
might be a cocktail tonight. I'mhaving one. You're having one.
I'm actually having a DietPepsi, which I probably
Yeah. And I mean, I think it'simportant in your life, you
know, I mean, there are lots ofthings coming out about alcohol
and cancer risks. And so we tellpeople really, like want no more
than one a day. And that's truefor men and women. Now, it used
(52:28):
to be just true for women. Iknow. Like just in general
alcohol is a littleinflammatory. So but yeah, okay.
And I think um, there's just onelast tiny question before we
segue and wrap this up, but Iasked you, and I'll ask the the
other ladies if they havequestions, but any final
thoughts? About how long wouldsomebody be on this? Are we
(52:48):
talking like for the rest oftheir life?
I keep swimming on it for therest of their lives. Yeah. Why
would I? Why would I takeoff so it doesn't really help
your body to do its own thing.
It's always going to need thatassist. I got Yeah, that's what
I was wondering. Okay, so getused to it. Yeah. That's good.
Some people just want to takeit, you know, and then they're,
they're 70. And they might notneed it. Or they I mean, or they
(53:10):
might not want it anymore anddifferent time in their life.
And they don't really knowthey're either their spouse or
you're single or why. Yeah,you're not accurate. Yeah. Okay.
This is okay. Ladies, do youhave a last question? We do have
to let Allison go because sheactually was supposed to have a
meeting a while ago. I think hemay have been more fine.
(53:32):
I'm sure listeners to Danny.
Kate. Any more questions,no questions, but I just want to
say thank you, Alison, forjoining us and sharing your
I think this has been awesome.
Absolutely Fabulous. Thank you.
very compassionate. Yes. Yeah.
So excited. So when you saygoodnight now. Thanks,
listeners. Shout SAS overfifty@gmail.com Follow us on
(53:53):
Instagram. That's over 50 Weappreciate it. Thank you.
Welcome to another episode of sexy and singles.
Over affinity. Welcome toanother episode. Hello, ladies.
Hello. Oh, what a fun night wehave in store. I'm very excited
about this topic. We've beentalking about it especially. I
(00:35):
think Danny and I have talkedabout a little bit extra. And
Kate's a little bit younger thanwe are. So the hormone issue
isn't as big of a deal yet. Itis just
common knowledge from Yes.
Yeah. So there's, you know, ofcourse menopause. Many of us are
(00:58):
either going through it or havebeen through it or are still
going through it or are Perimenopause. So I'm so excited. We
have a wonderful guests, I wouldsay expert because this is right
in her wheelhouse. We haveAllison box, who is an MSN FNP,
which I have no idea what thatmeans, but she's definitely
going to tell us what thatmeans. And give us a quick
(01:19):
overview of what she does. Iknow the nurse part, but I'm
excited to introduce Allison. Sowelcome, Allison.
Hey, thank you for having me.
Yes, I'm a nurse practitionerand I work in Portland, Oregon
and community health and I havebeen working for almost 18 years
and helping people along thatwhole time with their journey
into menopause and helping themyou know, some people don't have
(01:42):
many needs during menopause, butmost people are the majority of
women do. And so I am happy tobe here today to kind of help
your audience you. Yeah,absolutely.
We're so happy to have you andwe have so many questions, but
I'm just gonna kind of fly offwith first of all, menopause.
When does it typically start ifyou can just give us kind of and
(02:05):
then I know there'sperimenopause or Peri menopause,
perimenopause. How many stagesare there and when do you
typically start? There's threestages in menopause. So
perimenopause is the in between.
So hormones are starting yourovaries are starting to kind of
peter out. And that can last ifyou know, a year to a couple of
(02:26):
years, maybe even six years.
Sometimes people will start togo into early, you know
perimenopause. And they'retypically mid 40s is when people
are gonna start having someperiod menopausal symptoms.
There's some genetic, so somedifferent races, people will
have different Asian people tendto go through earlier menopause.
(02:46):
So there there are some geneticvariations, but usually between
45 and 52, you're going to starthitting that current menopausal
window. Okay.
And did you say that was themiddle one? Is there one before
then and one after then?
So perimenopause is the firstone and then a year of not
(03:07):
having your menstrual cycle youare considered officially in
menopause? Okay. And then afterthat there is just post causal.
So changes sort of down theroad?
Is there a typical time periodthat menopause takes place? I
mean, is that usually going tolast for five years or 10 years
or two years? In theory thatmuch?
(03:28):
Yeah, it's variable depending onthe person. Some people get away
really easily. And it's a maybea year of a transition, and
other people will tell me 10 or15 years, which it's the best
indicator when you're gonna gothrough menopause is when your
mom went through menopause. Soif you're lucky enough to know,
if you weren't adopted, or yourmom didn't have a hysterectomy,
(03:50):
something like that, that wouldhave kind of you don't have that
information. Mom's age ofmenopause is
that's interesting. I didn'trealize that. So it's almost
like a hereditary, you know, andand as far as the actual
menopause symptoms, we all knowabout the whole hot flashes. And
I guess vaginal dryness is apretty common thing. Like
(04:12):
lethargy, there's so manydifferent symptoms, and I'll let
you review those. But first, I'mgonna just ask if Kate and Danny
have any specific questions. Ithink that something that our
listeners would want to know iswhile there are the more common
things like the hot flashes,like you said, but I think
there's still a world of womenout there that don't know that
this is a possibility orcapability of being able to
(04:35):
rejuvenate so to speak with thewith hormone therapy, and like,
there was a woman I was talkingto a couple of weeks ago and she
was talking about the weightgain in the hair on her face and
just not caring about thingsanymore. And I think menopause
is more than just the hotflashes. It creeps up on us.
(04:55):
Like what is it that you wouldhave encourage women to be aware
of more so than just a hotflash. You know what, um,
because I, I think depression,like, it's not just a mood swing
like PMS, I don't think, um, butI feel like I've gone through a
lot of different changes. Somewere probably depression that
(05:18):
was not related to menopause.
But it just happened that thebig life changes happened at the
same time, which brought thaton, but I don't know, maybe one
made the other worse.
So maybe like the symptoms orthat type thing. Things that
look for. What do you thinkAllison?
Yeah, absolutely. Um, yeah, Ithink that, you know, I'm, I'm
(05:41):
glad that we're here talkingabout this, because I think that
women are often sold this liethat they have to suffer, right?
And that it's part of thejourney and just suck it up,
buttercup, right? Oh, you youwant to do you know, change, you
know, feel better during thistime, you know, then you're,
(06:02):
then you're not doing it right?
Or somehow that's like, you'redoing womanhood wrong. And
absolutely, there are somepeople who become almost
murderous, like their mood, youknow, shifts are so volatile,
that they go from feeling prettycommon normal to feeling like
the ground is out, and you know,from under them. So that's one,
but it's also just a lack of sexdrive. And so we'll I think
(06:27):
we'll talk about a little bitlater with hormones. But I think
on a fundamental level, if menexperienced what women do, where
their testicles just stoppedgiving them sex hormones, I
think there would be a lot moreinformation for women, honestly,
becauseit is, is that kind of the
(06:51):
equivalent? No, no. That's whatI'm asking.
Yeah, men and get testosterone,you definitely declines decade
by decade, but you can be 60 or70, and still have testosterone
levels where that's not the casefor women. And it really, yeah,
so I think that women had beensold a lie that they have to
(07:12):
suffer. I think it'sunnecessary. And I think, you
know, maybe we'll get intolater, the whys about that. But
I think that women need to beeducated that they have options.
Good.
Oh, I'm so glad to have you.
Because this is exactly. I mean,it's on our minds anyway. And
Kate, you're not going throughit yet. But I mean, you're gonna
be so wise, you'll, you'll be soready for it.
(07:37):
I do have a question, though.
So, you know, I'm still so youknow, I'm still on birth
control. So like, you know, ifI'm on birth control, and I
going to feel this change,basically. I mean,
what, what kind of, are youtalking about oral
contraception? Like, yeah, birthcontrol pills? You didn't? You
(07:59):
wouldn't know. But I mean,you're over 4.0? Yes. Okay.
Yeah. Usually, providers willstart to have conversations
after I call it 4.0. That's myway to get around, you know, a
gene is I make it like adecimal.
That's pretty clever, actually.
Yeah.
(08:19):
Yeah. 4.5, just to be totallytransparent here, your problem.
And usually people will have aconversation with you about it,
because people try to pull youoff of those types of hormones.
They aren't bioidentical, whichis not ideal. But you wouldn't
know, though if and when basedon your cycle, which is a good
(08:43):
way to start to say, Oh, hey, mycycles are getting irregular and
Oh, my diet hasn't changed, myactivity level haven't hasn't
changed. You're not going tohave that marker when you're on
a birth control pill becauseit's going to keep you regular.
So you would have to look outfor other signs and symptoms of
like, your mood, you know,becoming like your mood shifting
(09:05):
or something like that. Becauseyour cycles, your cycles would
still be the same.
Okay. Yeah. And that's kind ofwhat I was. I was thinking you
were gonna say because I wasthinking, well, if my hormone
level is you know, consistent,basically then, you know, how am
I going to know basicallyhopefully, you're not going to
be on oral contraception forthat much longer because Is it
(09:25):
risky? I thought I alwaysthought that was a risky thing.
Thatdoesn't smoke. But you know, I I
really like Mirena IUDs I justthink they're easier. You don't
get any of that. Most of theestrogens are from I think most
people know by now like horseurine. That is that is like
(09:46):
Premarin based and so. Yeah, Ithink IUDs are just easier all
around. You don't have toremember to take a pill every
day, but it's Not necessarilydangerous unless someone had
migraines. It was making theirmigraines worse,
like, oh, we'll cross thatbridge in a second. Okay,
(10:07):
Danny's got a little somethingabout that situation. It's
funny. We were talking aboutthat before you came on. You
know, I know we all have alittle, a few examples of things
we've been through. But I thinkit's really helpful just to kind
of get the some of these majorquestions out of the way and
kind of dive into some of thathormonal treatment, because I
think that's what most of us arelooking for. And I had no idea
(10:29):
it was actually Danny, who hadsaid something about taking
testosterone or DHEA, and allthis stuff. And I was like, What
is she talking about, though? Istarted looking into it
literally this weekend. And Iknew Alison, you were coming on
board. So I'm like, during myquest for question, or in my
kind of my research forquestions to talk to you about
it. I learned a lot, but Iordered something. So you and I
(10:51):
talked, I was in just brieflyyou mentioned what did you
order? You said you orderedsomething I did. I ordered
Wynonna and it's allprescription. Okay, so yeah, so
it's the estrogen therapy andthe pedestrian mix together in
the cream.
Okay, great. It's a cream. Soit's an intra vaginal cream. No,
(11:12):
it's,um, skin. Yeah. Topical, and
then the DHEA pill. Right. Sothat's, that's what so
that's great. Yeah, I'm gladthat you mentioned, I think that
the lack of vitality, you know,people can consider it just part
of aging. And like you said, Oh,I'm just, you know, getting in
(11:33):
my 40s or 50s. Or life isslowing down. This is what's
common. I'm just more fatigued.
And sometimes it really is, if Iwrote thing, you know, thyroid
issues are really common inperimenopause. So they, some
things can actually happensimultaneously. But I do think
that Western medicine oftenfails and women around this time
because we are taught to not gochasing hormone labs. Right. And
(11:57):
it's not considered standard ofcare, which means it's it's a
it's our way of saying just tellwomen to suck it up. Yeah,
exactly. Like the client. Yeah,yeah. And so we'll deal with it.
Yeah. So if someone comes to me,of course, I feel really
strongly about this because I'mwant to go to bat for my
(12:18):
patients. And I don't want toget keep that I'll check their
hormones, particularly FSH is afollicle stimulating hormone
will be really elevated insomeone who's in menopause.
How do you check them if I canenter just a lab test? Okay,
it's it. Yeah, it's a simplelab test. And it's not even that
expensive. And so I thinkencouraging your listeners, if
you're a provider, if you bringup these concerns that your 38
(12:41):
would be the young end of it,but particularly if you're in
your mid 40s, you know, Istarted when I menopause or
perimenopause when I was 3738.
But it's pretty uncommon, but ifyour periods are to be irregular
around that time, or you'recurious, you know, asking your
provider and if they say no, youknow, I think it's it were it
(13:03):
bears some thought as is is theprovider for you. Because if
they're not taking your concernsseriously, you know, maybe that
means you also then you find anaturopath or find a naturopath
tend to be a little bit morethey have more time with
patients and will often dodeeper dives with hormones. But
the FSH is an easy lab test tobe able to see if someone is
(13:24):
their hormones are starting togo offline. And yeah, a common
complaint is like the lack ofsex drive that the vaginal
dryness but also just lack ofvitality.
I think for me, just from aperimenopause perspective, just
to put this out for people toknow from an experience
perspective, I was in my early40s. And I was the mood swings
(13:47):
were so bad. It was the more ofit like angry like the temper,
and I wasn't that type ofperson. But anyway, I had gone
to my gynecologist he tried meon birth control. He wanted me
to be he wanted to try to flipmy hormones. That was a
disaster. And I don't rememberif he did labs or not. Now this
was 10 years ago. I was aSuzanne Somers hormone
(14:11):
cheerleader. So then I found awoman who did deemed that she
was a gynecologist that didbioidentical. I went to her. Not
one lab said, here's the combopill based on your symptoms go
take this, which was I thinkthey were bioidenticals but it
was just it was a pill and Icouldn't tell you what was in
it. Other than some mixture ofwhatever. So I took that it
(14:35):
didn't work. By the third visit.
I went to see her she said tome, you need to admit that
you're depressed and go see ifthey're honey. Oh, so then I
finally another amount of timehas gone by and a company had
started doing hormone therapy.
They called themselves 25 Again,and finally got the labs done.
(14:58):
And they started me on justprogesterone because I was still
projet producing estrogen. Andonce you get that level of
progesterone, right, my husbandwould go, where is it? Do not
Did you pack it like we're goingon? You cannot forget your
progesteronewas a miracle. That's awesome.
I go to the mountaintops abouthow well that helps me and I did
(15:19):
do the thyroid thing not becausemy thyroid was it, what is it
about your if your thyroid isn'tperforming at peak? They just
want to give it a boost? orSo yeah, yeah, like the
supplements like somethingsome iodine? Yeah, for so I was
doing that. So I just stayedwith that program. And don't I
don't even talk to mygynecologist about it anymore.
Yeah, I think that if someonedoesn't do baseline labs on you,
(15:43):
and you're going in with aconcern that's hormonally
related to me, then how do youknow what's working and what's
not? I know, it's not one sizefits all. There's just Yeah.
And that's a lot ofexperimentation to be adding and
taking away more hormones fromsomebody who's already crazy.
(16:05):
I have had patients who come inand say, I think I'm in
impossible, or peri perimenopausal, can you check some
hormone labs, and I've hadpeople who have all of these
complaints and their hormoneslook great. And I and I do have
to say, hey, like, you're, it'snot right now. So maybe it is
something mental health can beoverlapped, you know, and some
(16:27):
people need to hear that islike, okay, that go see the
counselor, right, that sort ofthing. So that does happen
occasionally, or am I boo,you're making your May, it's
working all that seems to befine. You know, so yeah, that's
that's a good point. Yeah, justnot the one size fits all
because yeah, it's so I thinkchecking those hormone levels.
(16:51):
And then also, you know, doing atestosterone panel, not just a
regular testosterone, becausethere's free testosterone and
there's there's boundtestosterone and really,
whatever your free is, is allit's circulating in your system.
And so, sort of jump ahead totestosterone before we even talk
about the estrogen but you know,your adrenals make testosterone
(17:15):
and if your free testosterone isnot circulating in your body,
then you don't have access toit. So if your provider just
does a regular testosteronelevel and gives you a number it
could look okay, but it youknow, if you have to do the
panel, which shows your sexheight like hormone binding
(17:36):
globulin like someone whoprobably hopefully self
identifies is doing somehormones or you know, and I
think with with Google, it'spretty easy. Now you just type
in your city and hormonespecialist, I would I would hope
that these people are, you know,are doing those kinds of panels
that can look a little bit morejust under the surface levels.
(17:56):
Excuse me, I wanted to that'sexactly one of my questions was,
where would somebody go to get apanel like that? So you could
Google that? And yeah, and justgo to that type of a specialist.
And so they wouldn't have to belike an ongoing care doctor
necessarily, but they definitelybe the labs people. Okay.
Yeah. And honestly, and ofcourse, this is not just the
disclaimer first, this is notmedical advice, you know, but
(18:20):
even I mean, I'm in westernmedicine and I have not found my
gynecologist or my regularWestern medicine, it's, she's an
integrative medicine. They, it'snot I go to a naturopath because
I have found that thegynecologist sort of said, Oh,
you're 42 I said, my boobs aregetting saggy. My vagina is
(18:41):
getting dry. And I want tocontinue to like not to be TMI,
but enjoy sex and I getting wetis part of like how I stay.
Yeah, like, you know, it's onething when they think you just
tell a patient like oh, there'slupus, but then when it happens
(19:01):
to you, you're like, No, I don'twant to use like organic cherry
glue. So when the gynecologisttold me that like oh, your boobs
are getting saggy, just likedeal with it. I was like, No,
I'm going to I'm going to seekcare elsewhere. And so yeah, I
would be Google hormonespecialist and and you know,
whoever was covered by insuranceso me there I'm sure there are
(19:24):
Western medicine people like methat are out there doing it. But
I don't I think people often arecan run into some some
gatekeeper. Oneof the things that when I moved
to Florida, and I was trying tofind a new hormone health care
specialist in Florida is I didGoogle women's hormone health.
And that's a good way to find itbecause some offices are just
(19:44):
doing women's health and theyspecialize in hormones. So I
mean, I think those are keywords. Right? Um, one more
thing, Allison that I think isimportant is our generation
mothers grew up with hormonesbeing a controversy of when they
started giving women hormonesfor menopause, they were
(20:06):
creating the scare of heartattacks and strokes. And I don't
know, I don't know the wholething. I just know that a lot of
us had mothers who stoppedtaking it because of the
controversy. And I think thathas since changed, but I don't
know that it's been loudlyspread.
(20:27):
It has since changed. And yeah,in my in my mother was a person
who was on hormones and smokedand then had a stroke. So there
were a wow, I'm sorry. Thanks.
So yeah, we did some somethings. First of all, the
hormone doses and themedications in the 70s and 80s.
The estrogen levels were muchhigher, they're at least like a
third of what they were backevents, smoking tobacco, any
(20:50):
kind of, you know, veryprevalent. Yeah, exactly. And we
didn't have it was, you know,after the 60s or 50s, that you
know, they ads for it's like,you know, these are the best,
this is the way to say it's Premthose kinds of ads. So yeah,
it's smoking and I it, I do notgatekeeper. But I would be
really cautious if you're stillsmoking cigarettes, and you want
(21:15):
to start a hormone journey,because I do think that that
combo is not ideal. I would usea patch. If if someone really
and I've had patients who arelike, if you don't help me, I'm
gonna kill my husband. Well, Idon't I don't want you to
murder. I know, that's that. Sowe'll do a low dose hormone
(21:36):
patch or, you know, blackcohosh, until symptoms are
relieved, something like that.
Um, but yeah, absolutely. Ithink that the cardiovascular
risks and even you know,honestly, brain health, those
things were, or thecardiovascular risks were
overblown, and I don't thinkthat that's accurate anymore. If
(21:59):
anything, I think having sexhormones can be protective to
organs and the brain, your brainneeds sex hormones. So your
brain starts to decrease insize. When you go through
menopause andeverything the crazy you eyes.
Your boobs, like your brain likeOh, shut up. Yeah, I difference.
(22:24):
Yeah. So I think that when Igive women a pep talk, you know,
it's usually like, I want you tocontinue to enjoy your life. And
that includes sex, sex as partof being human and enjoy and
having pleasure in the humanbody that we exist in. And for
some women, that means if if,let's say vaginal dryness is
(22:47):
your only symptom that might bejust targeting your, you know,
with a intra vaginal estrogenproduct, which can be great, or
if someone is a smoker, and theyare having vaginal dryness, and
they're like, Well, I'm havingthis issue, but I don't really
want to put myself at risk. Youknow, I'll quit smoking in two
years. And we can talk aboutdoing it, you know, a different
(23:08):
type of estrogen. But there canbe spot treatments. Now, that
used to be hundreds of dollars amonth. And now badger femme is a
tablet that you put into yourvagina once a week. It's a Wow.
10 to $20 a month. That's aboutthat's incredible.
And what does that dospecifically?
It just helps with that. So yourvagina as you start to lose your
(23:31):
ovaries start to peter out thevaginal lining atrophies or
thins out so you it getsthinner, and then it stops
creating its own lubrication.
And so there's also a vaginalcream that has estrogen but that
tends to be messy and when youare still sexually active
putting a cream inside yourvagina that sex and I say I you
(23:51):
know, it's again Yeah, yeah, itdoesn't usually
just go right into sex. Usuallythere's foreplay and there might
be some flavor situation. Yeah.
Yeah, not alone. I hope yes,there's cream and I think when
people haven't gone through itthemselves, I was shot. Yeah. On
someone's penis, and I wanted tosay like, Have you never heard
(24:18):
this from a person that likeliterally you're you didn't warn
me that like yeah, so um, soyeah.
Visualizing, I put this cream inmy bed and the guy's going down
on me. He comes up he's got likeyes, like no, no, get that off.
(24:43):
And don't try and even thinkabout kissing me with that.
Anyway, I'm sorry. I had animage emoji person. Oh, yeah.
That's hilarious. So so that'sit and you call it bad pill
badger Finnis that da g i FTM Okay,
okay. All right. Well, hey,listeners who you may have heard
(25:04):
it first here. I know I did. Sothank you for sharing that. That
that might be the ticket, youknow,
that might be the ticket. Andthat's easy and low hanging
fruit and no kind of systemic,you know, sort of issues. But I
don't I am not worried about asfar as if someone had a heart
attack already, that might putthem in a different category of
(25:28):
risk. So I'm not saying youknow, in medicine, it's not
hard. Everything has a risk.
Yeah, yes. Exactly. It's allabout risk, like, you know,
mitigation and recognizingwhat's more important to you at
the time. I think the only truereally contra indication or a
reason that I would notprescribe is if someone had an
estrogen positive breast cancer.
(25:49):
So if someone had been diagnosedwith breast cancer, they get it
gets typed and they there can beno estrogen and progesterone
that that would be your reasonthat would be a hard stop for
me. In migraine with aura is aconversation that's another one
that if anyone out there hasmigraine aura, it I would use
patches which tend to be a bitsafer as far as just it bypasses
(26:12):
your the first pass of theliver. And so there's less
clotting risks with topicaltopical or the or patches. But
yeah, I think that for mostwomen, it's a conversation of
the plus and minuses about it.
That isvery interesting. I'm learning
so much. I look good inmenopause, but I've already had
(26:33):
it. But for some reason thispast week, I had been so many
hot flashes, I thought they weregone. I was getting like one or
two a year. And this week hasbeen and I'm thinking what have
I changed and I haven't changedanything yet. I have been eating
a little bit more sugar. And Idon't know if that impacts it or
not if sugar is a bearing orbrings it on, but I definitely
(26:54):
that's the only thing I come upwith. There's no other reason
but I've tried a lot of hotflashes. So I'm very excited
because I did just order thecream. Now I went to Wynona
online, it's my wet Wynonna likeWinona Ryder. It's my n o n a.
So I'm very excited because Ithink I'm getting kind tomorrow.
My kit, if you will, it's allprescription but it's the cream
(27:17):
with the and I mentioned earlierbefore you jumped in. But it's
it's the combination. So it'sthe estrogen and progesterone
and the cream and then the oralDHEA for the testosterone. So so
let's let's talk about thedifferences on the green. It's
my understanding that estrogenand progesterone cream. That's
(27:39):
the best way to trends, isn'tit? Right. And there's two
different kinds of estrogens. Isthat right?
Well, yeah, I've been there. Itend to use Estrid die all
that's the one that'sbioidentical. So there might be
other ones, but that that's whatI use in my practice. And there,
there's compounded cream thatyou can put on your forearm or
(28:01):
there's patches, I tend to usepatches just because I think
it's a little easier and costeffective. Compounding is a
little bendy, and it's notcovered by insurance.
How much would you say justthrowing it out there?
Yeah, like 60 bucks every 60 to90 every maybe two or three
months depending on your goesbad is actually the patches are
(28:21):
yours. They're not compounded.
They're not bioidentical, right.
They're from the horse urine.
I think no, they're bioidentical. Okay, the patches are
two patches are two and they areit depends on your insurance.
This is where it gets a littlebit tricky. It depends on your
insurance coverage. Like I'vegot pretty good insurance. And
so my co pays I $10 a month. Soit I think cheaper for me to do
(28:45):
patches to so you have to kindof price things out and see how
it works for you. But when youstart to add, I guess everything
in like the testosterone, someprogesterone and extra dial, it
can get spendy when you are kindof either way. So I think it's
good to do a little research.
I'd like with your insuranceplan and figure out like, okay,
(29:06):
if I'm going to be spending $60a month with insurance, maybe it
is more cost effective just toget something compounded at a
compounding pharmacy.
Okay, well, that's veryinteresting. Okay, I want to
kind of ask the questions thatI'm thinking our listeners would
be interested in knowing and nowI know I've heard of the pellets
(29:26):
I don't personally know. I knowtwo people who have used them
and they really like them thatwhen I hear pellets, they just
sound painful. I feel likesomebody's shooting something in
my butt. And I think that's whatthey do, if I'm not mistaken,
but nonetheless, we do not haveany experts here on that. And
nor maybe that's for anotherconversation, but it sounds like
a lot of people are going moretowards these creams and the
(29:49):
topicals and some of the oralsand the patches and all that so
different.
Yeah. And I know people whoreally love the pellets. I don't
do it as part of my practicebecause it's pretty bendy, it's
you know, it's I heard Yeah,five to $600. And that would be
just for extra dial or justtestosterone and to me, yeah,
(30:10):
it's great that you get aconsistent amount of hormones,
but it just seems pretty. It's alittle bougie that like a little
too much i Yeah.
Ready just have no, that's veryit is very expensive. I know
people have told me I'm like,Oh, I mean, they're talking five
$600 A quarter.
Yeah, yeah. And then it's labson top of that, and then you get
co pays with labs. And I thinkthat there's a way to do it just
(30:33):
as well, without it being youknow,
I think is as important aboutwell, there are a couple of
things. I they I didtestosterone pellet a few years
back in my numbers, my labs cameback that I should have been
screaming with testosterone, butI physically felt nothing
different. And they said,there's some some people the
(30:54):
makeup of their body doesn'tabsorb or transfer something I
don't know. So pellets don'treally work for me. But um, the
other thing when you do a combo,where you've got estrogen and
progesterone together with adose that's mixed in, like, how
do you adjust, like, I've alwaysdone mine separate, and we are
(31:16):
in but I only started takingestrogen last six months, which
is really been I've been allover the place with my estrogen,
Rush. Um, so I have anappointment Thursday to talk
about it again. Yeah, but like Iforever for years have done 200
milligrams of progesterone, butit's by mouth. And so when I
(31:36):
started taking the estrogen,they sort of have me still take
that even though that's a higherdose, but I'm used to take a
higher dose they said stay withit. But when you do a combo, how
do you know especially if you dopellet, aren't you kind of just
stick with those pellets atwhatever dose they just put in
there until they're done?
Yeah, I think so. Yeah, usethem. So that's why I don't I
(31:56):
can't speak to them. But yeah, Ithink it's three or four months
that they you know, theyprobably start you out at a like
a lower dose. And so then youhave to Yeah, add I like mine
being separate. I've had themcompounded together and I've had
them creams. I've had the MS.
tro keys where I put them undermy tongue and the recipes can
always change. But I you know,I'm happily like a bit of a
(32:18):
control freak. I like to justhave everything kind of be
separate. And I like theprogesterone is the metabolites
of the progesterone causesedation, so taking it before
asleep. We like helpful forsleep and so
sleep is an issue with menopauseand perimenopause, too.
(32:41):
So I like it being separatebecause I if I was on a lower
dose of progesterone, like 50milligrams, but took it during
the day, I'm like, Is thismaking me sleepy? Like, I don't
really want to be takingprogesterone first thing in the
morning. Yeah. So So what,what's a low dose versus a high
dose? Since you mentionedprogesterone, progesterone,
I use micronized progesterone,and it's usually it's either 100
(33:04):
milligrams or 200. So I startpeople on 100 at nighttime and
then move up to 200. If they'reeither having heavy periods
which can happen duringperimenopause, especially, you
know, it's very common for womento have fibroids and they'll
start to get the heaviestperiods. You know, they're 4748,
(33:24):
and then they're going out withthe Bing and clothes and sheets.
And you know, it's like really,so I would go up on their
progesterone and that might beyou might have some mood
adjustment issues those firstcouple of days that you go on it
you know, progesterone switchesare what cause like PMS
symptoms, but once you stay onit after that week, they should
(33:47):
fall into the background. Andthat's what I was going to ask
is about how long is the theperiod is now that's for
progesterone, so your body takesabout a week to kind of
acclimate? Roughly obviously,we're not doing any medical
advice here, right? Because thenumbers because you said you
have about 1200 patients in youroffice and you would know you're
you're an authority topic. Yeah.
(34:08):
And I would say if you're stillnot well or feeling like it's
hitting the spot and thebullseye and three weeks I would
tell your provider becausesomething especially after a
couple weeks Okay, so I thinkgreen takes
a bit doesn't like takingprogesterone by mouth seemed
like that was sort of a moreinstant but the cream getting
does it take like a certainamount of time for your body to
(34:29):
regulate the cream.
I think it's just harder toabsorb. Okay, I think it's more
an absorption issue. It just isa you try to put it on this part
of your forearm because it'svery thin skin. So it's yeah,
the absorptionand they have me do it on my
lower abdomen or my lower back.
That's unusual. That's part ofmy problem.
(34:52):
Yeah. Yeah, it says use it here.
Yeah. I've always done theforearm just because otherwise
because it doesn't it you wantthe least amount of tissue to
get it intotell me to put it as close to my
ovary.
This is I would, I would checkwith a pharmacist because the
(35:15):
pharmacists are the ones wholike, yes, you're black and
white. Just see because thatmight be intuitively what you
know what you think. But that'syeah, that's not what I what are
ya? Howare ya? I'm calling tomorrow. I
think Danny, Danny started tomove it. Wouldn't that be great
though? Like, you just put it onyour forearm now and then it
(35:42):
solves all your issues.
Fabulous. Okay. Myoh my lord. I like that is my
problem. Can you imagine? Ohmy gosh. And I literally try to
line it up like, oh, there's gotto be an ovary there.
You get you have to eat? Or yousay like, yeah,
(36:06):
yes, yes. No. Oh, yeah. We'llwe'll do the email unless you
know, if any progress. Could youimagine if it was that simple?
Oh, my God, that'd be great.
Let's move on to the estrogen.
And because I'm sure you know,there's estrogen is what
everybody goes in our mindsthinking. And first of all, I
want to ask there's over thecounter things like Prem oven or
(36:27):
whatever these names are, do anyof those things actually work?
And are they estrogen based? Orwhat is what are those things on
the shelf?
Honest, I other than thesupplements? Like black hole
harsh? I don't know. Because Idon't prescribe things that are
over the counter. And they'renot FDA regulated. So I Yeah,
(36:49):
that's fine. I just thought I'llask that in case it was in the
mind of one of our listeners. Somoving on to estrogen do that.
Now if somebody's going throughmenopause it could it be
possible that they would. It's apossibility, they might just be
prescribed estrogen. Is thatright? It may also be
progesterone, if theydon't have a uterus, you can be
prescribed just estrogen. But ifsomeone has a uterus, you have
(37:12):
to be on both estrogen andprogesterone. That's very
important. Otherwise, it couldlead to an increase in uterine
like cancer. That'sokay. I thought I read something
that's I wanted to ask thatquestion. That's important.
If you've had a hysterectomy,you could be just on estrogen
alone and yeah, there's there'soral there is topical to either
(37:34):
patches or compounded. And thenthere's the pellets or their
shots. There's extra thought, ifyou do oral I would probably
sublingual worry melts underyour tongue. But most people I
like patches because like Isaid, they stay on your skin, it
lasts for me, you know, threeand a half days. So it's just
twice a week, I put it out withmy supplements and just have it
(37:57):
you know, twice a week so soit's easier to me it decreases
my pill burden too. So if youare on supplements, you know,
I'm talking about you alreadyfeel like you're taking like
your turmeric or whatever, allthese things
pharmacy in the bedroom.
They're like stuff there. Butthey're still like a lot of
pills. So I I prefer patches.
And so I usually kind ofencourage my patients to go that
(38:20):
route too. But and I said youstart with the lowest dose until
you either relieve symptoms andso I don't choose lab values as
much as I do symptoms. So ifpeople feel good on a dose I
still check lab so I can makesure that something's not at
like super out of range. Okay,it's congruent with what
(38:42):
someone's experienced, but Itrust their experience over what
a blood test me.
Okay, so I want to mentionsomething about the estrogen
that's so common for many of usand myself included is the low
libido. Is that not where theestrogen would help? I mean,
more so than the progesterone ordo they both or how does that
work? Sothis is I want to be clear, too,
(39:02):
that this is anecdotal. Okay, sothis is there is not a lot of
evidence that anything helpswith sex drive. Even testing
testosterone is not eventestosterone, but there is
plenty of anecdotal evidencewhere people will tell me and
that it helps so I just to beclear there and I don't know if
(39:23):
it's a paucity of researchfunding, you know, who who is
paying for these things or who'snot like putting money forth to
it so Imean, women enjoying sex doesn't
matter. Hey,that men would be pretty freakin
like invested in. Right, right.
(39:44):
Yeah, yeah. So I always prefaceit with Hey, there's not a lot
of research but at the sametime, you will know if it's
something that helps and I thinkthat it low dose testosterone,
I've seen a lot of women at helpand also DHEA a lot Other women,
their DHEA level is, is lowerand especially if someone's DHEA
(40:06):
is under 100 getting them on alittle bit of DHEA sometimes in
three or four days I'll get amessage back that like that was
it and it's not like all of asudden you're you know horny now
like like your first couple ofmonths meeting someone but it
yeah it is a noticeable you canfind that that sex drive feel
(40:26):
that passion again in your bodyand it? Yeah, again vitality and
life like this is this is yeah.
Do you thinkhow much of it do you think is
also related to just theconfidence of knowing so that I
kind of like to think about itas when we go through menopause,
they they would have read yourestrogen falls off like a cliff.
And then like you said, theirtestosterone goes down slowly
(40:48):
over time. We literally go from100 to zero. I mean, and all of
a sudden, everything doeschange. And we feel crappy and
we we don't like our guys, buteven when you're single you
might not feel like datingbecause you don't feel sexy.
Things are drying up. You feeldifferent. You're cranky, you're
hot. Who wants to go on a datewhen the back of your neck is
(41:09):
ringing wet? I mean. So when youstart taking the hormones, even
if it's not, you know, makingyour clit light up. Yeah, the
confidence and just knowing thatyou're not going to have a hot
flash or you don't have to feellike you're 100 years old,
literally. Yeah, makes your sexdrive go. Yeah.
(41:32):
I was thinkingyeah, I think it's part of self
care. And you're right there. Ithink that there is a there's
can be a magic element to takingcare of yourself and putting
that effort in. It can be reallyhelpful. And I think absolutely,
if you're not having hotflashes, that's sure it's gonna
make you feel sexier. You knowthat you're not like stringent
who your sheet? Yeah,yeah, no, for sure, too.
(41:54):
I didn't even oh my gosh, canyou imagine on a day over?
I was laying in my bed. I'm notthis I'm not lying. Last night,
I'm laying in bed and I'mthinking I'm really warm. I'm
actually having to turn my fanon what is with my body this
week? It's like, it'santicipating that I'm getting
all of these hormones. And it'slike willing me to take them.
(42:15):
It's a strangest thing. I mean,I just the timing couldn't be
more uncanny. But I'm layingthere and I'm thinking, I think
my sheets are gonna be wet. AndI touched my sheets. And I'm
like, Oh my gosh, I'm thinkingwhile I'm glad nobody is
spending the night that exactthought crossed my mind less
than 24 hours ago.
Yeah. And then you're cold, youknow, and you're like, you wake
up and then you're wet and cold.
Yeah, it's not fun, it doesn'tfeel and it doesn't feel then
(42:36):
you want to shower so that youfeel clean and that you you
know, goback into bed on a cold wet,
sweaty cheat nowto put towels down before I got
because I you know, I was liketoo tired to change the sheets,
but then I'm like, Okay, I'mgonna tell down so
(42:57):
it's not done that I'm sure.
Yes, yeah, that's what we wantto do. But so that's, that's
super interesting. And, and Iknow, I know, you know, we
thought we could taper this downto such a short conversation.
There's it's just so important.
There's that many questions andwe haven't even hit them all. So
I did want to kind of skip overover to the DHEA unless there's
(43:18):
something else we need to knowabout the estrogen that you
don't think so? No, I thinkstruggle low start you know,
start slow go low and you don'tyou know, more is not always
better. I think that that goingbefore it gets to be a 10 out of
10 problem. Okay, you start isideal, it just because then you
(43:38):
just are kind of aiding yourbody along and kind of helping.
If you've already waited threeor four years, not a big deal.
You can still I still thinkthere's a lot of benefit to
things. But I Yeah, more is notalways better, I think is just
the other venue. Not everyonehas a high dose
so Okay, so don't Okay, okay.
Well, that's good to know. Okay,so the DHA, I think that's kind
(43:59):
of the third prong here. Now,this isn't something for
everybody, either. From whatI've read about it. It's a
hormone that's naturally made byour bodies, specifically
testosterone. So that's what Iread about it. So I wanted to
kind of note some things downbecause I really, I'm like to
learn, what are we doing to ourbody? So you're educating us,
but we'll pick it up from there,if you will.
(44:20):
Totally, it's a precursor totestosterone. And so sometimes
that can be an easy over thecounter thing to do. It's I
usually it's a 10 I think it'sMiller it might be micrograms i
It's 10 milligrams ormicrograms. I should know that.
But if people can start that andat least try it, there isn't
(44:42):
there aren't negative sideeffects to it. And you would
know that testosteroneincreasing is something that it
occurs pretty quickly. So thebenefit of getting your DHEA it
depends on the pathway. There'stwo kind of pathways of how much
it's actually going to increaseand you don't know that unless
do you get a much more extensivekind of hormone panel done, but
(45:06):
you know which kind of kind ofhundreds of dollars but it
you'll know within three or fourdays because when your
testosterone level comes back init, it's not usually subtle, a,
you know, estrogens, I kind offeel like people sometimes can
feel it sometimes can't orsometimes will feel more
emotional. But testosterone, youfeel the things a lot more
quickly. And promising.
(45:27):
Yes. And isn't it supposed to begood for waking as well, and
brain fog and changes? I thinkall of those things are
possible. It's all the those arevery nebulous kind of symptom
that it Yeah, they they're notalways black and white, but I
think it's worth you know, thatDHEA cost me $4 a month. Okay.
Andthat one is an oral Oh, that's
an oral that's. Now, is thissomething that somebody would
(45:50):
take every day? Yes. Okay. Okay,and is this something that what
would you say would be a lowdose on the DHEA versus a higher
dose?
Five to 15? And so I usuallystart at 10. Just like in the
middle oni 25 milligrams, because that
seems high. Yeah,I thought it was five to 15.
Yeah, I think that's howi That's why I'm asking because
(46:13):
I'm like, tell me because I wantto know, this feels like it's
going to be too muchinteresting. Yeah. I'm not
saying it's wrong. It's not how,when I looked it up, it's not
what I what I remember and whathow I
practice but yeah, that's a guygo make now it's, no, this is
only for women, but but maybeevery other day,
(46:34):
if they specialize in hormonesthat you know, trust the trust
and plan that you're on with theprovider. And if it if it feels
like something's too much, Imean, I guess the worst that's
gonna happen is what if you Imean, too much testosterone is I
don't think you're gonna getthere from honestly from DHEA.
But you know, too muchtestosterone can cause you to
get a little chin here.
(46:55):
Yeah, that's what I was going toask is what makes you hairy, and
I didn't know which one it was.
But so it sounds like thecombination of these things that
these are such great, viableoptions that nobody has to
suffer. I can't even believeit's taken me six years to even
think about or learn about, andI'm just so grateful. I mean,
Danny really brought it to theattention and then I mean,
Alison, what a fluke how we met,you know, we on social media,
(47:17):
completely other topic. We'renot going there. But anyway, how
neat, you know, but this is thewhole concept between sexy and
single sisters over 50 I mean,not every single necessarily,
but but just learning from eachother. And I really wanted to
get some good information that'sgoing to help all of us be not
just be more sexy, but do moresex. Yeah, yeah, it means a lot
(47:38):
to make yourself feellike yourself.
And normally, that is so true,Kate, because you don't feel
when you start having thosehormone shifts, and you just sit
and go what is wrong with rightlike,
why am I unhappy? I was happytwo hours ago, what's going on?
And I I'm so excited to try thisstuff,
or the people around you and themen in your life or whatever our
(48:01):
like, you gottathink that take away is find a
provider that takes youseriously. And if you say like,
Hey, I want my sex drive back orhey, I want to feel some more
vitality, if you don't feel kindof heard. I think that you know,
we all have those instincts ofwhen someone is listening to us
(48:24):
and hearing us and we trust andand if you don't have that, then
it is worth sticking around andfind somebody Yeah, ask around,
you know, or Google what's agood you know, to find that
person because I think thatyou're I don't think that we
have to spend decades without asex drive and with Drive
policies and and honestly justnot feeling like sexy and
(48:50):
the mood. Yeah.
So Allison, I haven't I do havea question for you. So like, so
what's perimenopause, right. Isthere any way? I mean, you said
early on that basically youknow, menopause is based on your
mother's age, you know, when shehad it is a good you know, gauge
when you're going to have it. Isthere any way to make the
(49:14):
perimenopause part, you know, alot easier is there naturally
that will help Yes, supplementsthat you can take or even you
know, medication that can beprescribed during the process
basically be set before you getto all that we just talked
about, you know, yeah,black cohosh would be the one if
you are starting to haveirregular periods or hot
(49:35):
flashes, black cohosh is asupplement that you start again
low and you go up to when youryour symptoms are relieved, but
I'm actually advocating forduring that perimenopause to to
get things checked out and justsee at least get some labs on to
check in on it so that way, youknow kind of along the way, even
(49:57):
if It's once a year or onceevery other year, let's say
you're 44. And you're like, Ikind of think something might be
going on. I've had people comein and I'll check, I'll be like,
No, boo, everything looks great.
But you know, come back in ayear or two, and we'll check it
again. So you can kind of see,because I think that doing it on
(50:18):
your own without, I mean, Iguess there's not a ton of risk,
but I think that it costs I'm amedical provider. So I feel like
it's it's good to have someoneon your team to help guide you.
Right. Yeah. And with blackcohosh, if you're, if you're not
having an estrogen problem, it'sprobably not going to it's not
going to help you. And so thenit sends people down these like
(50:39):
Doctor go rabbit holes.
If you're on birth control, youwouldn't be able to take
anything to help it anyway,because you wouldn't feel it.
But I wasn't on birth control.
But we I did start onprogesterone, which help level
out least my mood, right,because my moods were crazy. So
just around during periods, Itook progesterone, probably six
years before I ever went throughmenopause, right? Oh, wow. Okay.
(51:02):
And it just helped level me out.
I mean, it was the Godsend that,that progesterone for that
period of my life was a godsend.
Wow. Had you not gone and got itchecked? Right? You would be
doing all these other littleremedies? I don't know. And
yeah, I know, exercise issupposed to be good naturally.
(51:23):
Because you do get and Kate,you're a gym enthusiast. So I
have to imagine that you're notgoing to probably have as many
but I don't know, I feel likepeople who are more fit tend to
have less is that. Is there anyfactual or any anecdotal
evidence testing to thatexercise helps everything.
Right. Right. Okay. And it justwater? Yeah, it just helps mood
in general. So I don't knowabout anything specific to like
(51:47):
menopause. But I think thatexercise can probably help or
dissolve your stress hormone andyou know, chill out and that's
going to help your your ovarieskeep kind of going without it
just being like an up and downkind of thing.
And how does alcohol interactwith any of these? I need to ask
that because for sexy and singlesisters, after all, so there
(52:08):
might be a cocktail tonight. I'mhaving one. You're having one.
I'm actually having a DietPepsi, which I probably
Yeah. And I mean, I think it'simportant in your life, you
know, I mean, there are lots ofthings coming out about alcohol
and cancer risks. And so we tellpeople really, like want no more
than one a day. And that's truefor men and women. Now, it used
(52:28):
to be just true for women. Iknow. Like just in general
alcohol is a littleinflammatory. So but yeah, okay.
And I think um, there's just onelast tiny question before we
segue and wrap this up, but Iasked you, and I'll ask the the
other ladies if they havequestions, but any final
thoughts? About how long wouldsomebody be on this? Are we
(52:48):
talking like for the rest oftheir life?
I keep swimming on it for therest of their lives. Yeah. Why
would I? Why would I takeoff so it doesn't really help
your body to do its own thing.
It's always going to need thatassist. I got Yeah, that's what
I was wondering. Okay, so getused to it. Yeah. That's good.
Some people just want to takeit, you know, and then they're,
they're 70. And they might notneed it. Or they I mean, or they
(53:10):
might not want it anymore anddifferent time in their life.
And they don't really knowthey're either their spouse or
you're single or why. Yeah,you're not accurate. Yeah. Okay.
This is okay. Ladies, do youhave a last question? We do have
to let Allison go because sheactually was supposed to have a
meeting a while ago. I think hemay have been more fine.
(53:32):
I'm sure listeners to Danny.
Kate. Any more questions,no questions, but I just want to
say thank you, Alison, forjoining us and sharing your
I think this has been awesome.
Absolutely Fabulous. Thank you.
very compassionate. Yes. Yeah.
So excited. So when you saygoodnight now. Thanks,
listeners. Shout SAS overfifty@gmail.com Follow us on
(53:53):
Instagram. That's over 50 Weappreciate it. Thank you.
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