Epi 48 - What If We Don't or Can't Take Hormone Replacement Therapy?

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You're a woman over 35. More than likely, you have heard about hormone replacement therapy, also known as HRT or bioidentical hormone replacement therapy, BHRT. And more than likely, you're thinking to yourself, I need to get on some of that too.

But before you go ahead and you start clicking on those Instagram ads or rushing to your doctor begging for HRTs, let's pause, let's evaluate, and let's explore the nuance of this conversation just a tad bit. So we are going to answer the question or at least pose the question of whether or not you should be taking hormone replacement therapy. If you're down for that conversation, then let's jump right in.

So these are my thoughts. This is my own opinion. You may agree with my opinion or not, but I'm going to stir the pot a little bit when it comes to this discussion of hormone replacement therapy.

Because yes, I see it absolutely everywhere from medical doctors to doctors in chiropractic medicine to influencers on Instagram to nutritionists. We are all talking about hormone replacement therapy. And here's the deal.

I do not love extremes. I actually shy away from them. When I see the herd going to the left, then I typically go to the right.

That's why I've never been huge into organized religion. It just doesn't feel right for the kind of person that I am. But our culture absolutely loves extremes.

And I'm not saying it means anything about you if you go with a herd or not. I'm just saying let's open this conversation up because it's more than just black or white or this or that. Rarely do we embrace the both and perspective as humans, which is often the most balanced approach.

But we've seen this in topics like GLP agonists like Ozempic, that weight loss shot. I am sure that you have heard so much information about Ozempic being horrible for you. And then it went the other direction.

And all of this information and research came out because it's a really older peptide than we had originally thought. The media and people reading news had originally thought. And they said, oh, wait, there's actually a lot of long-term benefits to the heart, to the brain, for people with chronic pain, for osteoarthritis, for rheumatoid arthritis, so many other areas that it actually really showed to be beneficial.

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So then the herd went all to the right. And now you can see GLP-1 agonists in your feed on a constant basis. And on most podcasts that have people come on and talk about Ozempic, they are also screaming from the rooftops about the benefit of Ozempic.

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So as a little side note myself, I put my dad on Ozempic. He is a long-term diabetic, so it seemed like a really healthy choice for him anyway. He's 81.

And he was on a really high dose of insulin. And he had been on a high dose of insulin for over 20 years. He also was on two to three different types of blood pressure medication.

And his cognitive function was declining. So I recommended that he speak with his doctor about getting on Ozempic and showed him the studies and the research that was supportive of not only controlling his diabetes, but also for these other aspects of his cognitive and cardiac improvement. And he is doing so well.

He's lost a tremendous amount of weight. He has decreased inflammation. He is more cognitively with us.

He is a different person in a lot of ways because of Ozempic. So I'm right here telling you right now that I fully believe in what I like to call bridge medicine. It's when we need something, a little oomph, a little extra thing external to us to get us feeling better to where we can start moving our bodies or we feel more clear-headed and energized to take the steps we need to take.

But I also want to remind you that this is your body and you have control of your body. And if you try something out and it doesn't feel right for you, then you can walk away and it's okay because there are many other tools that you have available to you. And most of them are free that you can turn to.

So you don't have to have Ozempic to lose weight, just like you don't have, have to be on hormone replacement therapy to have a vibrant, beautiful midlife and beyond. Okay. So I really want you to hear that from me hear what I'm trying to say to you is that you have the choice.

Even if you feel like you need to do something because all of these experts are telling you to, it doesn't mean that you have to. I just want you to hear me say that you do not have to do anything that doesn't feel aligned with you. So you may try out hormone replacement therapy.

You might try out Ozempic. You might try out some antidepressants, but if you're taking them and they just don't feel like they settle, then talk to your primary care provider about it and know that there are so many other options that can help support you that don't require medication. Again, I'm not opposed to medication.

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I like this idea of bridge medicine in that way, but we can get sometimes so caught up in what we're hearing that we feel like we have to be on these things. And when it comes to HRTs, the hormone replacement therapy, I'm extremely intrigued by it and also very cautious because again, the pendulum always swings back the other way until it finally hits somewhere in the middle where we can be like, oh, women need to be on HRTs that can be, and then it will maybe come back somewhere in the middle a little bit later. And I've done the research and it is well documented.

There are well-documented benefits of improved bone health, heart health, and cognitive function in the longterm with HRT. It can also reduce those pesky perimenopausal symptoms like hot flashes. And they're not so pesky and very real if you're living with a woman who's in peripenopause, which is mood stabilization.

It can help stabilize your mood. Oh, I'm telling you, my mood swings are something to document. I can't believe who I am sometimes, and I know that it's hormone fluctuation, and it's hard for me to control.

I have these hormonal rages at times, and I've never been a rageful person. So I get you. I hear you.

I see you. It is all so real. But what if hormone replacement therapy isn't an option for you? Or what if you just don't want to take it? It doesn't feel like it aligns with who you are and your beliefs.

And what I mean by what if hormone replacement therapy isn't for you, I want to gently remind the population of the world that approximately one in eight women develop breast cancer during their lifetime. And having a history of breast cancer, although it doesn't exclude you from HRT as an option, it does make the conversation extremely more nuanced. Because if you have a hormone-positive breast cancer, then the risk of progesterone or estrogen feeding that cancer, depending on what kind of positive hormone breast cancer you had, increases the risk.

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And many doctors who don't specialize in hormone replacement therapy will consult an oncologist who will urge you against taking a hormone replacement therapy if you've had a history of breast cancer because of the risk-to-benefit ratio. So it just makes things more nuanced. So it drives me nuts when I hear all over the media and social media the importance of taking a hormone replacement therapy to protect your bones and your heart and your cognitive function later on when one in eight women won't be able to take it more than likely.

It just drives me crazy because then it makes the person who's unable to take it because of their health history feel like they're missing out on something. But are we missing out on something? HRT is not a magic bullet. I saw this YouTube interview, you guys should google it, it was with Dr. Mindy Pelz.

She wrote Fast Like a Girl and the Menopause Reset and or the Menopause Rest, something like that. And then she was interviewing Dr. Marie Claire Haver. She is a woman who has a whole site on the paused life.

She's written a book called The Gaviston Diet and also she has been instrumental in really highlighting the fact that hormonal health in women in perimenopause has just been overlooked. That there hasn't been enough research or the research that's there hasn't been really taken seriously. And so she has done a beautiful job of really getting this information out into the world, out into mainstream for we as women to demand hormone replacement therapy if we feel like it's a right fit for us.

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So I saw this beautiful interview with the two of them. I really highly highly recommend that you watch it. But what I heard from this was so honest and I feel like it needs to be highlighted is that Dr. Mindy wanted clarification from Dr. Haver and she was like, hey so let me just confirm that slapping on a hormone patch won't instantly make you feel 30 again.

And Dr. Haver immediately emphasized that no, absolutely not. You have to overhaul your nutrition. You have to look at your movement.

You have to look at boundaries and lifestyle modifications and the way that you think about yourself and about the world and your mindset. She says those are all essential for her and how she went from where she was to who she is now, but she's in her mid fifties and says that she's living the best life that she has ever had, but she would not have been able to do that with just the hormone patch alone. Okay.

So for those of us who think or don't want to take hormone replacement therapy, we can always bring back like, you know what? That's only one piece of the puzzle anyway. It's only one tiny piece of a really large puzzle even, and it really might sound like that I'm against hormone replacement therapy and I'm not. What I'm actually against is we as women feeling like we have to take it because of what we're getting from online, from what we're consuming online.

And this is our opportunity to pause when we get into this midlife, when we get into our third season, then we get to really evaluate what works for us. Like what's true for us because we have so much wisdom that we get to pull on and we are not afraid to say I'm not going to go with the herd. I'm going to make my own decisions because I've earned it.

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So a few years ago when perimenopause really smacked me in the booty, I was at work and I had a menstrual flood. I soaked through my clothes and it was actually horrible because my husband was out of town. I was at work.

I was the only provider at work. I didn't have any way to leave work so I had to get a white coat to wear, a long white coat to wear over my pants. And during my break I ran up to Whole Foods.

I worked a Whole Foods so I got to run up there and get whatever sort of skirt they had on the rack and then come back and put it on. But that was one of my foyer into perimenopause and I didn't know what the heck was happening. I didn't even know I was going to be starting my period around that time but with perimenopause the cycle, the length of my period started to change and then also the frequency and the heaviness of my period.

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And then with that came these migraines. I never had headaches before, never remotely, anything close to a migraine. So then I started having cyclical migraines and then on top of that severe cramping.

And again I had been pretty lucky with short light periods most of my life with minimal cramping. So after about a year of suffering from that and seeing my primary care doctor nothing really came about. So I ended up seeing an acupuncturist and I still see her to this day.

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It's been four years later. I don't see her as frequently but I started seeing her twice a month and she put me on supplements to help balance my hormones as well as different points of my body to help process my liver, kidneys, and all sorts of things. But really one of the biggest things is that it helped decrease my cortisol.

Cortisol is really the first thing that you need to look at when you're looking at managing your hormones because cortisol, once that domino has fallen, so once that's out of whack, then it will affect, it will have this cascade on all other systems in your body and your hormones being one of those. And so managing your stress is key when you're looking at how to support your body with hormone replacement therapy or without hormone replacement therapy. You should do these together because again the hormone replacement therapy is your bridge.

It's the bridge medicine, right? So if HRT isn't an option or it isn't aligned with your preference or you want to make sure that you are boosting up any hormone that you have left or if you are post-menopausal that you're just feeling the best and strongest that you possibly could, then I am going to invite you to try some of these things out. So one thing is nutrition. This is probably something that you've heard about online as well, but it's eating a high protein diet.

And just based on my experience alone with eating a high protein diet, this has increased my muscle ache. So I was getting muscle aches and perimenopause and I did a small stint of testosterone, which was so good. And then my intuition just told me that I no longer should be on it, so I stopped taking it.

And during that time I started eating a higher protein diet and so my elbows and my knees and my body just felt heavy and achy in the morning. But when I increased my that went away and I had more energy as well. It also helps with muscle mass and hormone production, but really for me I found it most with energy.

If I eat 25 to 30 grams per meal, small meal, so do that four or five times a day, then my energy stays up as well as my joint pain or inflammation it decreases. Of course, reducing sugar and alcohol to low or none. When I eat sugar, I can absolutely feel the inflammation that occurs in my body and it can make me crash a little bit harder.

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I do eat carbs like rice and sweet potatoes and potatoes and Ezekiel bread. I stay away from processed white flour and try to stay away from sugar for most days, right? I do have some occasionally, but I do really notice the effects of it. But these can worsen, oh and then and then with alcohol that can worsen your hot flashes and disrupt sleep.

I mean it is just unfortunately a major party pooper. So if I have a glass of wine or a cocktail out and about, I usually try to have it earlier in the day. Just one, maybe two and then I'm pretty much flipping the coin on whether I'm going to have a bad night's sleep or not.

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And so it's something that you have to decide if you want to trade off and most of the time it is not worth it. So reducing or low, low to no and that's alcohol. Balanced carbs and healthy fat when you're looking at your nutrition.

So this is the whole grains, the omega-3 rich foods like salmon, which I do not like, which is so sad to me. But highly recommended for those who do like it because this really supports our energy and brain health. And so on the idea of healthy fat, it's actually trying not to eat too much fat either and especially too much fat later on in the day.

So I used to eat like an avocado a day. I would eat some in the morning and then some in the evening. I would mix it with my tuna.

I would put it on everything as well as a lot of olive oil on pretty much all my foods as well as putting flax seed. I mean I had a lot of fat in my diet before I was really working with a coach to clean up my foods to where I could actually start burning fat. And I had been on a high protein like macro diet for a year and I only lost like three pounds and didn't budge after that.

And so he really helped me like see oh yeah it's because you eat a lot of fat and you eat a lot of not so amazing carbs. So now I eat like the better carbs with the protein multiple times a day which really helps with that energy. Okay the second one is sleep hygiene.

Cold room. I battle with my husband all the time about this. I need it cold.

I need it 68 degrees in my bedroom in order for me to sleep well. If it gets warmer than that or my dog is under the covers I just don't sleep well. And then with this a consistent routine.

Now I want to mention this and I'm going to talk about this in a different episode. So I used to be an early to bed and early riser. Now I don't when I go to bed early I don't go to sleep.

I lie there. I think about things where I start like that's when my creative juices come through. And so now I'm like you know what I am no longer an early to bed person.

I am more of a night owl which also means I'm no longer the woman who wakes up early. I used to love waking up at 5 30. I would have all this time to myself.

That's when I would journal and drink my coffee and be alone. And now I realize nope that's my time. I need to sleep.

And so now I get up closer to 6 45 7 and that's OK because life has just changed. I no longer have little kids anymore. Now they're 9 and almost 13 and like a few days.

Oh my God. What am I going to do. So yeah.

So I just want you to recognize that your sleep hygiene or your sleep routine might change. And instead of getting upset about it instead of saying you know you can't believe that you're either you're so tired and you not be or you're staying up later or you wake up in the middle of the night and you not kind of just be OK with it. And it's taking me a while to realize that this is just the phase of life that we're in.

And it's all for a reason. So it's allowing me to have these creative moments or these moments to really think and reflect that I hadn't had before. Another good thing for sleep hygiene is taking some magnesium.

So it's the magnesium glycinate the one that you can do in like a relaxing tea which I can't do at night because then I have to pee all night. But that really helps with sleep. Some supplements you can take of course check with your doctor about this but omega 3 fatty acids take vitamin D. I actually use this spray that vitamin D 3 K 2 and it's amazing because you can just spray it underneath your tongue.

And this is great for bone health as estrogen levels drop. Magnesium we talked about that it helps relax the muscles improve sleep in your mood. Ashwagandha.

This is amazing adaptogen that can really support us during our stress response and our energy levels be complex vitamins. And I'm trying to think if I take anything else. I go on hiatus where I have these periods of time where I don't take any of my supplements and I'm OK with that.

In one of those right now I believe that that's kind of the staple the core of what I take. Stress management tools are so important because again cortisol is that first domino that will affect everything else. So my big things are breathwork and meditation.

Calms our nervous system and reduces cortisol. Acupuncture is my other stress management tool. I do it once a month now which helps with migraines and cramps and hormonal imbalances as well as puts me in this massive bliss state.

Journaling and mindfulness this helps shift of focus from being worried to gratitude. And I know that for me in midlife that the worry meter has gone way up. I used to never be a worry wart and now I am.

So hello. Lighthearted activities like watching comedy or like a lighthearted show on Netflix. I can't watch anything serious or any drama anymore.

This is too much for my fragile self and engage in things that you really enjoy and with people that you really enjoy. Movement is number five. Strength training is where it's at.

Yoga Pilates and lower and low impact sports like walking and then six hydrate hydrate hydrate proper hydration is so important for skin elasticity and for overall function of our cells and collagen supplements. This improves skin health and joint comfort. Another thing I've been doing recently which I think would fall under supplements although it's not a supplement at all.

It's these little patches that you put on your body and they use the light from your body to reflect back into yourself in order to create stem cells peptides cellular regeneration. And you know I was like I'm a try it out. I'm a skeptic.

Actually I'm not a skeptic. I just was. I'm just a woman who was born in the 70s who has definitely been told that if something is too good to be true it is.

And I've been trying to beat that story out of me ever since I heard it heard it because I absolutely do believe that things and magic are possible if we believe it. I do. So but anyway with these patches I was I was like really are they supposed to really do much.

And I've been very surprised at the effects that they've had on my mood clarity energy. But also I have this really gruesome scar that's on my chest from a mole that I had and the biopsy that I take was really large. And so it's a nasty scar right in the center of my chest near my heart center.

And it's healing like so fast like the scar is getting smaller shorter. It is completely going away. So I'll show you guys pictures at some point when I feel like this is like a real true thing that's happening.

But I'm just amazed and shocked. More on that later. But y'all will ever we're calling this for kindness midlife reset or the third act like Carl Young describes it or the pause or whatever the heck we're calling it menopause menopause whatever.

It's a natural transition. It's not a problem to be fixed. So whether you choose H.R.T. supplements lifestyle changes remember that it is your journey that you are in control of what you decide.

Embrace what feels right with you. But always check back in with yourself with your body. Are these things working for you.

Are they making you feel better. And if so continue it. If they're not if you're feeling off with it then don't.

Or if you can't take it for whatever reason then recognize that that is absolutely 100 percent OK too because there are supplements and lifestyle changes that you can do to support your journey. Always prioritize self-care to feel vibrant and empowered in this chapter of your life. Let me know what you enjoyed most about this episode.

And as always if you feel like this would resonate with someone else please pass it along and head on over to your favorite place where you listen to podcasts and give me a five star review. Thank you so much.