225. Boomers Should be Pissed: Menopause and Hormones in the Modern Era
Menopause and Hormones in the Modern Era AKA: Why the Boomers Should be Pissed\n\n\xa0This is a lecture I gave for the Society of Women in Urology about hormones.\xa0\n\nIf you like this episode also check out number 197.\n\n\xa0Genitourinary syndrome of menopause\n\n\xa0Men at age 60 have more estrogen in their bodies then women\n\nWhy I don\u2019t do a loading dose of vaginal estrogen.\n\n\xa0The problem with the vaginal estrogen labeling by the FDA.\xa0\n\nHow the nation used estrogen prior to the Women\u2019s Health Initiative Scare.\n\nI explain why the WHI study was created and what question it was trying to answer. \n\nMyth: you have to be a year without a period to be on hormones.\n\n\xa0I break down the three concerns about progestin and breast cancer from the WHI\n\n1)\xa0\xa0Was the placebo arm flawed\n\n2)\xa0Was it the synthetic progestin and now we use bioidentical\n\n3)\xa0\xa0Maybe progestin increases risk but it is small and perhaps benefits still outweigh\nrisk as breast cancer is so curable and all the other benefits are worth the\nsmall increased risk\n\nI discuss the \u201ccritical window\u201d hypothesis and \u201chealthy cell\u201d hypothesis and why hormones are recommended to be started \u201cearly\u201d in menopause which means less than ten years.\nWhy I think the Boomers should be pissed.\n\nVaginal estrogen for all and get an okay from your\n\n\xa0Best practices\n\n-\xa0\xa0If you have a uterus, with systemic estrogen you need a progestin\n\n-\xa0\xa0You can continue hormones for life as long as your benefit > risks\n\n-\xa0\xa0Vaginal bleeding after menopause is never normal\n\n-\xa0\xa0If there is an FDA approved product use it instead of compounded \n\n-\xa0\xa0Checking hormones is often not necessary \n\n-\xa0\xa0One size does not fit all\n\n\xa0\n\nWhat about hormones for prevention? On a national level the answer is no. But everyone needs their own analysis. \n\n\xa0National guidelines on how to give testosterone to women for low desire. \n\nHormones: are we being equitable to all genders in regards to hormones.\n\n\xa0\n\nNAMS 2022 guidelines: According to NAMS, \u201cthe benefits of hormone therapy outweigh the risks for most healthy symptomatic women who are aged younger than 60 years and within 10 years of menopause onset.\u201d For women with primary ovarian insufficiency and premature or early menopause who are at higher risk of bone loss, heart disease, and cognitive or affective disorders, \u201chormone therapy can be used until at least the mean age of menopause unless there is a contraindication to its use.\u201d\n\n\xa0\n\nWhere is the black box warning on alcohol?\n\n\xa0\n\nWhat about lasers for GSM?\n\n\xa0\n\nWhere are we on removing the FDA black box warning on vaginal\nestrogen?\n\n\xa0\n\nMy thoughts on online hormone companies.\n\n\xa0\n\nEstrogen plays a role in the gut microbiome and may affect\nthe risk of osteoporosis. \xa0\n\n\n\nOur podcast sponsor today\nis AG1. Use AG1 to build a foundation for better health.\n\nFREE ONE YEAR SUPPLY OF VITAMIN\nD3+K2, 5 TRAVEL PACKS\n\ndrinkag1.com/youarenotbroken\n\n\xa0\n\nDid you get the You Are Not Broken Book\nYet? https://amzn.to/3p18DfK\n\nDid you watch\nthe Tedx Talk yet? Why We Need Adult Sex\nEd\n\nJoin my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed\n\nJoin mymembership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. \n\nwww.kellycaspersonmd.com/membership\n\n\n--- \n\nSend in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message\nLearn more about your ad choices. Visit megaphone.fm/adchoices