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00:23I haven't felt like myself lately.
00:33I got my hormones checked and found out I'm low in progesterone.
00:44Perimenopause?
00:46I thought there was only menopause.
00:56Maybe that's why I haven't been sleeping.
01:05My name is Sadhvi Sadali Sri, I'm a Jain monk and apparently I'm in perimenopause.
01:13The scary thing is, I don't know what comes next.
01:21Menopause has the worst PR campaign in the history of the universe.
01:25The longer your body is without hormones, the less healthy you are.
01:28The research has shown that these things increase the risk of cancer.
01:31Adverse effects were increases in breast cancer and cardiovascular disease.
01:35They're dangerous.
01:36That is just not true.
01:38The men at the top have no idea what happens to a menopausal body.
01:42We are harming women.
01:44If you don't advocate for yourself, nobody else is going to do it.
01:47I wasn't being listened to.
01:49I had to start fighting for my life right away.
01:52You should begin noticing perimenopausal symptoms between the ages of 35 and 45.
01:57This is like the perfect time to get people all of the tools so the transition is easier and more
02:03pleasant.
02:03I don't think hormone therapy is for everyone, but I think that not even putting it into the equation is
02:08such a disservice.
02:09They think that if they take hormone therapy that that's going to solve everything. It's not.
02:13You're really defying Mother Nature's plan for you.
02:17We have to look at exercise. We have to look at diet.
02:20Menopause still is taboo.
02:21There's just not a lot of education.
02:23We have to teach about the journey before it's impacting us.
02:28It's going to take a generation of women that stands up and says, not me.
02:53Oh my God! How are you?
02:58So I thought we would have lunch.
03:01Okay.
03:01And then Jason, our appointment with Jason is this afternoon.
03:05Okay, cool.
03:05All of a sudden I'm starting to like feel disconnected and I'm like, who am I?
03:09I know I'm not lost because I feel steady in my soul.
03:13I feel peaceful in my soul.
03:14But why is my body, why is my mind becoming an enemy to me?
03:19People think we already achieved the peace and the calmness and the balance, right?
03:24Uh, but we're actually signing up to go through the process of achieving the balance.
03:30My kind of inspiration is obviously that history, you know, she's so strong.
03:34She's so dedicated.
03:35It's scary, you know, that like, uh oh, you know, I'm trying to achieve what she has achieved,
03:40but you know, it can be lost almost in like a second.
03:44What does a treatment plan look like to help me achieve some kind of balance inside of me?
03:56You're mentioning that you had those high levels of stress and all those factors beating down on you,
04:02which can throw things out.
04:04You're sleeping out as well, not going so well for you.
04:08Um, and so one of the things that I really want to start treating you on right now is very
04:14simple.
04:14It's going to be just some progesterone.
04:16And that's going to be done orally.
04:22All you're going to do is take one capsule by mouth at the time of sleep.
04:27Okay.
04:27And that's going to, you're going to notice a huge increase in your ability to just sleep nicely.
04:33That sounds like a great gift.
04:33And you're going to be able to stay asleep.
04:35Do I have to be on hormones for the rest of my life?
04:37Or is this something that I can do for a year or something and then I can come off of
04:44it?
04:44Do you have to stay on these for the rest of your life?
04:48Mm-hmm.
04:48Not at all.
04:49But I have a feeling you're going to notice an extreme difference and it's something that you're going to want
04:54to be on.
04:55Well, I'm excited.
04:56Let's see.
04:57Let's see what comes of it.
04:58I don't know how I'm doing with my hormones.
05:01We sent you the test and I have your results right here.
05:04As you can see, there is practically no estrogen in your system right here.
05:14I just kept thinking like, what's wrong with me?
05:17Why am I going through all these changes or why am I so depleted?
05:22I mean, I was not expecting like a perfect result, but to see the numbers just so skewed to the
05:29left, like the low levels, it was just so eye opening to me.
05:34In a way, it kind of gives me hope, like if I do change and if my hormones get balanced,
05:40it gives me hope that maybe I actually might be able to do more work and feel more energized.
05:44Things are going to change now.
05:47Things are going to change and we can't go back.
06:04We are monks.
06:06We strive for a balance and peace in our lives.
06:11We tried to keep our bodies pure through fasting, breathing and eating vegetarian.
06:16We prefer to do things naturally.
06:20So what will our spiritual teacher think about my desire to try hormone therapy?
06:26I am really not pro progesterone or any hormones.
06:32But I don't condemn it.
06:34You think it's okay for me to go the natural way and try the other alternatives first?
06:41You try it.
06:43If it works for you, then maybe you go in that route.
06:51If it doesn't work, then there is no other choice.
06:55So maybe you have to take that HRT.
06:58I will definitely start with the natural and then let's see what happens.
07:03Go HRT!
07:12I need this to work.
07:15I have books to write, films to make, workshops to teach.
07:19My biggest year and I can't fall apart.
07:24Sadhvi Anabhuti is in a similar boat.
07:27Her energy is depleted.
07:29She's unable to focus.
07:30How can we find the right solution when everything online is so confusing and contradictory?
07:47I'm so excited you guys came all this way to come and see me.
07:50It's an honor for us to be here with you.
07:52Yes.
07:52All right.
07:52Are we ready?
07:53Yes.
07:53Can we do this?
07:53Yes.
07:54Let's go learn.
07:54We only have a million questions.
07:58So each month in a normal menstrual cycle, you're living your best life, you're having your monthly periods and a
08:03healthy woman.
08:04You have this feedback cycle of hormones that are happening from the brain, the hypothalamus gland to the pituitary, the
08:10pituitary to the ovaries.
08:12As we go through perimenopause, as we reach a critical threshold in the amount of eggs we have left, that
08:19process gets harder and harder and harder to do each month, requiring more stimulating hormone and producing less hormones from
08:28the ovary.
08:28This leads to, in perimenopause, this zone of hormonal chaos.
08:33You start getting these wild fluctuations.
08:35It's a downward trend over time, but you're having massive high levels of estradiol, then dropping to very, very low.
08:42And this leads to the perimenopausal symptoms.
08:49What do you think perimenopause is?
08:53Perimenopause.
08:55Ooh.
08:57I can't say I'm familiar with that phrase.
08:59I never heard that though.
09:01Could it be...
09:05menopause that is early on set?
09:07The stage or time prior to menopause?
09:19When did you find out about the word perimenopause?
09:22I still don't even fully know what it means.
09:26I'm thinking it's before the full-on menopause happens.
09:30And I really just thought that would happen, like, closer to 50 and older.
09:35Once I started doing a little research, I'm like, this is totally me.
09:39What would you say were, like, the check marks saying it's totally you?
09:42Mmm.
09:43I sweat a lot now.
09:46Even normal tasks like getting dressed during the day, I'm sweating.
09:50I can't sleep at night.
09:52Mood swings, which I would attribute to just my cycle, but it's just really extreme.
09:59I'm just feeling, um, fighting depression sometimes.
10:04And I gained a lot of weight.
10:06I met my husband in 2012.
10:08From there to now, I gained 75 pounds.
10:11Not doing anything extra.
10:13Oh, I have chin hair growing in.
10:17I never had chin hair.
10:20But now, like, once a month, I have a cluster, and I started counting.
10:24Okay, six.
10:25It's over six now.
10:27I'm plucking out, like, ten a month.
10:28So, that was major, too.
10:33Like, I hope I don't get a beard.
10:40What are some statistics about perimenopause that we should know?
10:43It happens to 100% of women.
10:46The average age of menopause is 51 in the U.S.
10:49If you're African American, that goes down to 49.
10:53Perimenopause symptoms typically begin 7 to 10 years before your period stops.
11:0095% of women will go through menopause between the ages of 45 to 55.
11:05Let's do the math.
11:07Minus 10.
11:08You should begin noticing perimenopausal symptoms between the ages of 35 and 45.
11:14I'm not limiting this to hot flashes.
11:17When, as medical providers, we are simply utilizing the cliché symptoms of hot flashes and night sweats,
11:24as menopausal, we are harming women.
11:26Recognizing the mental health changes, the cognition changes, the musculoskeletal changes, the gastrointestinal changes, the cardiovascular changes, is key.
11:35What do you think are the symptoms that women experience during perimenopause or menopause?
11:41There might be some negative effects.
11:43Sometimes mood swings or irritability.
11:45I honestly have no idea.
11:47Changes in appetite.
11:48Have you heard anything about it?
11:50No, actually, the first time.
11:52Heat flashes.
11:53Hot flashes.
11:54Hot flashes.
11:57Menopause has the worst PR campaign in the history of the universe, right?
12:01The idea that it's just hot flashes and night sweats and they only last for a short period of time
12:05is the biggest crock of shit that's ever been delivered to people.
12:09It's a huge problem because you have hormone receptors in all of your body.
12:13And so menopause affects your whole body.
12:16And actually, the genital and urinary symptoms that happen with the loss of hormones
12:20are some of the most severe and life-threatening issues surrounding menopause.
12:25As you age and you lose hormone receptors in that very hormone-sensitive tissue,
12:30all these genital and urinary symptoms start to happen, including urinary tract infections,
12:35which can kill people and do kill people and cost the healthcare system quite a lot of money.
12:40And so urologists who deal with sexual health and quality of life,
12:44we are constantly talking about issues like incontinence, pain with intercourse, pelvic pain,
12:50urinary frequency, urinary urgency, and urinary tract infections.
12:54So a lot of the menopause issues are not even sexual-related, right?
12:57It's just urinary-related.
12:59So it's okay if you're a monk.
13:00You will still be affected by the genital and urinary symptoms in menopause.
13:04You can't escape those even if, you know, sex is not a priority.
13:08And then menopause itself, what is that?
13:11So menopause is one day in your life, medically.
13:14It is the day one year after your last menstrual period.
13:18That is your menopause.
13:19And from that day forward till you die, you are post-menopausal.
13:24So we have pre-menopause, perimenopause, menopause one day, post-menopause.
13:32So why do we call everything menopause?
13:35If it's just one day, why do we put so much emphasis on that word?
13:38So I do that a lot.
13:39I just say menopausal, meaning I'm trying to, like, let people know that,
13:44you know, we're going to spend a third or more of our lives, up to 40% of our lives,
13:51in our menopausal journey through perimenopause, menopause, and post-menopause.
13:56And that things are irrevocably changed for the rest of our lives
14:01as those hormone levels get disrupted and decline.
14:04And what do the hormones look like or the hormone levels when you're post-menopausal?
14:10Post-menopausal.
14:11Estradiol is less than 1% of its premenopausal levels.
14:15It's basically gone.
14:16Progesterone is gone.
14:18And testosterone levels have decreased 50% or more.
14:22Forever.
14:25Until HRT?
14:27Unless you replace them.
14:33We have to remember what hormones are.
14:35And hormones are chemical messengers.
14:38And actually we're only talking about three main hormones.
14:41So oestrogen, or even oestradiol, which is a really good form of oestrogen.
14:46Progesterone and testosterone.
14:48And every woman and every man produce them.
14:51And they're biologically active and they have receptors for these three hormones
14:55on every single cell in our body.
14:57So they work with cell processes.
15:00So that's what's been forgotten somehow.
15:02Because if I said to you, you're deficient in vitamin D,
15:06I think the first thing you'd say is,
15:07well, where's the vitamin D?
15:08What dose do I need?
15:09How do I take it?
15:11So if I say you're low in a natural hormone, which is called oestrogen,
15:14then you'd probably say, well, how do I increase my oestrogen?
15:18Like, it's not rocket science, is it?
15:27We're not being validated by going to doctors.
15:30You're too young.
15:31Like, we could have been ahead of this when I was 37.
15:33I know.
15:34I know.
15:34It's frustrating.
15:35I know.
15:36I know.
15:37That's usually the first response when you feel better, right?
15:39Is, like, anger.
15:40Like, seriously?
15:42Someone could have given me this patch, like, five years ago?
15:47It's such a disservice to call estrogen, progesterone, testosterone sex hormones.
15:51They're impacting receptors in our brain that can trigger or worsen anxiety,
15:57major depression, even things like bipolar.
16:01Now, maybe it's just hormones and it's not those diagnoses.
16:05Maybe it's both.
16:06Maybe one is causing the other.
16:08But this impact that the hormone decline has on mental health
16:13is so significant.
16:16I would think mental health mood changes is on 60 to 70% of my patient intake forms.
16:30How many women's shoulders are hurting them?
16:33Did you know that that was your hormones?
16:36I was doing the exercises with the bands and all of the things,
16:40and it wasn't getting any better.
16:42I had no idea that it had anything to do with perimenopause until I got some testosterone.
16:48And guess what?
16:49A couple weeks later, my shoulder didn't hurt.
16:52It was like a freaking miracle.
16:54It's a frozen shoulder.
16:56It's your hormones.
17:00I had no plan in becoming a perimenopause advocate or an influencer.
17:06I'm like your neighbor that's like, hey, I did hormone therapy.
17:09It helps with inflammation and joint pain.
17:12Women everywhere are finding out what...
17:14I don't know what happened, but my story of having experienced all of the symptoms of perimenopause
17:21without knowing about perimenopause and then finding hormone therapy and how my body all of a sudden turned back on,
17:27that whole story fell out in three minutes on a TikTok video.
17:32And the next day I woke up and it was at nine million views.
17:36Zero sex drive for years.
17:40But it was the comments, comment after comment.
17:43Women across the world saying, hey, I have every single symptom and I also went to my doctor.
17:49My doctor also said everything was normal.
17:53Where are we going?
17:58I'm 38.
17:58This is a conversation for when I'm 50.
18:01Like what's going on?
18:02Yeah, 50.
18:03We all think like 50.
18:04Right.
18:05Like it's not even on the radar.
18:07Yeah.
18:07I kind of fell in love with myself.
18:10And then the hard thing was that my body was not matching that.
18:15Right?
18:16My body hurt.
18:18It didn't want to get out of bed.
18:20I felt kind of numb.
18:22It was very strange to have found my soul and then have my body falling apart.
18:28My doctor said, you look normal.
18:31You know?
18:32I was going through all these horrible things.
18:33Not sleeping.
18:35No sex drive.
18:36My body was itching.
18:37My bones hurt.
18:38I couldn't run anymore.
18:40I thought, what is happening?
18:43Like I must be sick or depressed or something.
18:45And at 41, I got lucky.
18:48And a friend said, sounds like you should start hormone therapy.
18:52And I didn't even know what that was.
18:54And she goes, oh, you should just go to this clinic.
18:57They do Botox.
18:59And I thought, are you insane?
19:01That sounds very strange.
19:03And I went and it was about a week later that I started feeling like me.
19:09Like my body matched my soul.
19:11Did you know you were going through perimenopause?
19:14I had never heard that word.
19:15When you started doing HRT, did you know?
19:18No.
19:18Already by then?
19:19No.
19:19The only, I think the first time I heard the word perimenopause was after I had shared
19:25my story on TikTok.
19:26And somebody mentioned perimenopause in a comment.
19:39Progress.
19:40The gift of sleep returns thanks to hormone therapy.
19:44But Saibiana Bhuthi searches for a natural path.
19:47I think we should probably give you a little bit of DHEA and a little bit of pregnenolone.
19:53Both.
19:53Now, those are supplements.
19:56They're not medications.
19:57They are supplements.
19:58They're derived from plants.
19:59With your levels as low as they are, I don't think we want to go with food as medicine here
20:03because it's going to be really hard to get what you need.
20:06But I do think that a replenishing protocol where we're using those building blocks
20:10could be really beneficial for you.
20:24After learning about our journey, Alyssa Milano, who we worked with before, was eager to share
20:30her own experience.
20:37I mean, what can I say?
20:39Perimenopause was no fun.
20:41And originally, I went on bioidentical creams.
20:46And I was doing testosterone, progesterone, and estrogen.
20:51And it helped for a little bit.
20:54And then they just stopped working.
20:57Around the same time, I started getting chronically ill.
21:00And I remember just being in total pain throughout my whole entire body.
21:05My ANA panel came back positive.
21:08And the diagnosis, I have a working diagnosis of Sjogren's Syndrome, which is an autoimmune
21:15disease that impacts all the parts of your body that get moist.
21:21So your eyes, your nose, the insides of your mouth, you know, down there, everything.
21:28I think because I went so long without hormone replacement therapy, that my body just started
21:36attacking itself and thinking that I had an autoimmune disease.
21:41Try to make it rainbow.
21:42Ready?
21:43Because I'm rainbow.
21:45Red.
21:46There's two reds.
21:51I am on progesterone pills and an estrogen patch and an estrogen suppository.
22:02So...
22:03Wow.
22:04But perfectly healthy until perimenopause.
22:09And my only wish was that I started treating it with hormones earlier because honestly, it
22:16could have been a totally different last five years for me.
22:31In Washington, D.C., the Bipartisan Menopause Research and Equity Act was going to be introduced.
22:38Sadly, things didn't go as planned.
22:41But when one door closes, another one opens.
22:44So they decided to postpone the press conference and we don't know, you know, when it's going
22:49to be rescheduled.
22:50But fortunately, Dr. Sharon Malone, who's one of the top menopause specialists in the States,
22:57she's like, I'm available to meet with you.
22:59And she's like really close friends with Michelle Obama.
23:02I think she knows Oprah.
23:04So we get to interview her tomorrow and learn so much.
23:11We have gone full circle on the hormone issue, even though it was in widespread use in the
23:1760s.
23:18It kind of dipped down in the 70s and 80s.
23:20It came back with full force in the 80s because we had now long term longitudinal data on women
23:30who had taken estrogen.
23:31And what they found was that women who had been on estrogen long term had a lower risk
23:36of heart disease than women who did not take estrogen.
23:40So this is in addition to all of the symptomatic relief.
23:44And when they found that estrogen decreased the risk of heart disease, that was the magic bullet.
23:50And that is how the Women's Health Initiative was born.
23:52The Women's Health Initiative really set the stage here.
23:55They were hoping that these hormones, they were seeing a lot of studies that showed improvement
23:59in cardiovascular disease.
24:00And they said, oh, we want to study this in a big way.
24:02We want to see if it reduces the risk of cardiovascular disease in women.
24:06In order to prove that a woman would develop heart disease or not, women don't get heart
24:11disease until they're in their 60s and 70s.
24:13So the average age in the WHI was 62 years old.
24:17They had younger patients, they had older patients.
24:19So remember, we're dealing with a much older population than would be the ones who start
24:23hormone therapy.
24:24They recruited for this study and it went on and we thought, oh my goodness, now we've
24:29got this amazing double blind randomized control study that is going to prove for us that not only
24:36does estrogen relieve the symptoms of menopause, but we were also going to do something long-term
24:42for women's health, decrease their risk of cardiovascular disease, which is the number
24:47one killer of women in this country to this day.
24:50And all was well until that fateful day in July of 2002 when the study was abruptly halted.
24:58The trial has been stopped early due to the increased risk of invasive breast cancer.
25:06There was this big fear, oh my gosh, hormones cause cancer.
25:09The NIH, which spent a billion dollars on this study, did a press conference before the papers
25:15were even released saying hormones cause cancer, hormones cause blood clots, these are terrible,
25:21everyone must stop these immediately.
25:23And while much remains to be learned, today we can finally begin to offer some guidance.
25:29The key adverse effects were increases in breast cancer and of cardiovascular disease.
25:35The entire industry tanked.
25:38Everyone said, oh my God, you can't take these hormones.
25:40You must stop it.
25:41You must throw everyone through their hormones in the garbage.
25:43The US prescriptions immediately, like 80% for hormone therapy stopped immediately.
25:48About 40% of women were on hormone therapy at the time.
25:51And that dropped to, right now it's 4%.
25:544% of women in the United States right now who are menopausal are enjoying the benefits of hormone therapy.
26:00That is really the legacy of that study and how those results were presented to the public.
26:06We've had 20 years of that negative impression of hormones really sticking.
26:13And so a generation of women has been disadvantaged by not being offered hormone therapy.
26:35I have a problem of insomnia.
26:37I need to find a way to help me.
26:41The doctors always have tried to help me with treatments for depression.
26:50And I can't take medications to sleep because I have a reaction alergic to everything that is to sleep.
27:00The other day you told me you had to go to your ginecologist.
27:04Yes.
27:05Yes.
27:06I went to my review an annual with the ginecologist.
27:10And, well, a year ago I told him about some treatment based on hormones for me,
27:17to see if I can resolve or compose a little bit the situation to be able to sleep.
27:23And he told me that no.
27:26But why?
27:27He said that lately in the studies that he has taken,
27:30he said that the hormone treatment causes problems in the heart and in the brain.
27:38He said that he is a little bit liberal.
27:39You have an entire generation of doctors who never learned how to prescribe hormone therapy
27:45because they read the same headlines that patients.
27:48So you have patients who think hormones cause cancer,
27:50and you have doctors who think hormones cause cancer,
27:53and no one bothered to explain to them in a very loud way that it's more nuanced than that,
27:58that it's not black and white, and that there's so much benefit.
28:02Women can be strong and healthy whether they take HRT or not.
28:05But we have to remember that our hormones work throughout our body,
28:09and actually our cell processes work better.
28:12You only need to look at pictures of the brain before and after having hormones,
28:17and you'll see that it lights up.
28:18You know, it works.
28:20Our hormones reduce inflammation.
28:22They improve our cardiovascular system.
28:25You know, they work in so many different ways because they affect every single cell.
28:28But it's not about having to need to have it or not.
28:31It's about choice.
28:32It's about understanding.
28:34And it's also, it's just hormones, but there are different types and there are different doses.
28:40So some people will say, oh, I've been on HRT and it did nothing for me or I felt dreadful.
28:44Well, they weren't on the right dose and type for them.
28:47So it's not a binary decision either.
28:49I mean, I've been told off for even telling people that I'm on HRT by other healthcare professionals.
28:54I don't really understand why it's a problem, but it's all about choice.
28:58And this is the biggest problem.
29:00Women have this choice taken away from them.
29:03This wouldn't be a discussion if every woman who wanted hormones could have them.
29:08If you came to me with raised blood pressure, I would not say to you,
29:12sorry, you can't have that blood pressure lowering treatment.
29:14I'm not going to reduce your risk of a heart attack.
29:17But day in, day out, women are being told, you can't have HRT.
29:22You feel sick physically. You feel emotionally sick.
29:26In all aspects, it affects you not being able to rest well.
29:30You feel that you're crazy.
29:36I feel bad for your mom.
29:38I mean, just hearing her story and her struggle, I don't want to end up in her place.
29:44At least right now, we're educating ourselves and trying to find alternatives through these changes with our body.
29:52But your mom's been suffering a lot.
29:54For too long, I think. I mean...
29:56I think that's stressful maybe for you.
29:58It is.
29:59She's been suffering for too long and I really, really wish that I could do something for her
30:06and that I could find her the right help.
30:08It's a worry for me. I worry about her. I worry about her health.
30:12My hope is that maybe at least I can find the right doctor who can check her hormones
30:18and can give her some advice and guidance with treatment.
30:22I wondered, you know, if she had the right doctor, she got on HRT,
30:27she mentioned that she has and she's dealing with arthritis and, of course, her sleep issues.
30:32If she had treatment, maybe all of that could have been prevented.
30:36And that's so sad.
30:54I really think that menopause has to be viewed as Mother Nature's way of protecting women.
30:59Let's face it, reproduction is a little bit dangerous.
31:03It means you've got a lot of estrogen in your system and it's there to promote fertility.
31:08And that is risky. Too much estrogen can drive breast cancer and all kinds of other problems.
31:13So nature says, all right, I'm going to give it to you only between menarche,
31:18when you're in your late teens, say, and up to about 50.
31:22And apart from that, no, we're not going to fool around with estrogen because this is dynamite.
31:26And so the idea of, no, no, no, menopause, now that I don't have estrogen anymore, I should keep taking
31:32it as a medicine.
31:35You're really defying Mother Nature's plan for you.
31:38And we're putting ourselves at risk.
31:40You know you're going to get a lot of controversy and maybe push back against this statement because we have
31:47a lot of women and doctors promoting HRT for women in post-menopause as well.
31:54Yeah.
31:54What's your opinion on that?
31:57For reasons I cannot explain, there is sort of a near religious allegiance to certain pharmaceuticals.
32:06And we've seen it with hormone replacement therapy where people get angry.
32:10If you point out the research has shown that these things increase the risk of cancer.
32:14They really do.
32:17We don't make up the results.
32:18We just simply report the results and people get all upset.
32:21Perhaps it's because they thought they had a fountain of youth that they could prescribe for women.
32:26Perhaps they're taking money from the pharmaceutical industry for whatever reason.
32:29People do get upset when you point out there are problems with hormone replacement therapy, but they're real.
32:40Up, we're just talking...
32:48Jai staramah?
32:50Matamandami, how are you?
32:51Good.
32:52How was the interview?
32:54You went great.
32:55It was good.
32:57I mean the interview was great.
32:59He gave great information but.
33:01I am so confused.
33:05What happened?
33:06I mean I thought I would be getting closer to understanding all that.
33:10of this but honestly i'm still like just kind of confused i think this is going to be controversial
33:15because he fully opposes hrt like 100 a hundred percent not like no room he says that there is
33:24really nothing that states that hrt is safe for women that's interesting because we have a bunch
33:32of doctors that are going on social media citing and showing us the papers that are saying it is
33:38safe so that's why i think this conversation needs to be had because there is one so much confusing and
33:44and conflicting information and you know i'm taking hrt i'm on progesterone only right now
33:50it's made a huge impact on my life and i'm feeling good about it trusting you know the information of
33:58our of our doctors so um i mean i still feel strong in in my stance only because i'm taking
34:05it and i
34:05feel better and i feel the difference but i know your journey is the natural path
34:22naturopathic medicine we try to use lifestyle we try to use herbs we try to use mindset meditation
34:31all things that are not pharmaceutical first if possible so i used to view hormone replacement
34:37therapy as medication right as something that was unnatural to be put in the body so for many years i
34:45would try to alleviate menopause symptoms just using lifestyle practices and you can get pretty far
34:52doing that for the day-to-day frustrations of menopause the hot flashes and night sweats
34:58the vaginal dryness however as i got deeper into the research i realized that estrogen in particularly
35:05estradiol this hormone is so essential for so many systems in our body for our bone health for our brain
35:14health the flexibility of our joints for the collagen in our skin so as i start to understand these things
35:19i'm like well from really treating the root cause actually the decline in the absence of estrogen
35:25and progesterone and in some cases testosterone but mostly estrogen and why would i not put back in
35:32estrogen if it's available
35:36there's lots of things that happen due to nature due to us becoming older i keep talking about raised
35:42blood pressure because i think it's a good analogy because most people with raised blood pressure don't
35:47have any symptoms but we still treat it and screen for it and make sure the blood pressure is normal
35:51and there's lots of reasons why people can have raised blood pressure of course but it is a disease
35:55of aging it's a natural process that occurs but we still treat it so why is it menopause that's
36:03associated with disease risks we just say oh it's nature just to um protect you if women you know will
36:11be like angry that you're not supporting them that they feel like you're not hearing them they're suffering
36:16because you're against hrt which is being you know promoted as a way to help women can you talk
36:22about your intention i mean is your intention to prevent them from feeling great
36:28okay first of all when i raise an alarm that hormone replacement therapy is related to breast cancer
36:35and to dementia and so forth i understand that some people may have strong feelings about that as if we're
36:40preventing them from taking a treatment that makes them feel better in many ways let me be clear it's a
36:45woman's body and it's her decision what she chooses to do but my job as a doctor is to look
36:52at the
36:52literature and to share those risks let's be honest and let her go forward making the choices for herself
37:09estrogen causes breast cancer however it does it with low frequency when it manages
37:19to make a breast cancer it is almost uniformly a less aggressive more curable subtype and women
37:27on hormone replacement who get a breast cancer almost uniformly have a 50 decrease in mortality from
37:36that breast cancer versus a woman who was not on hormone replacement
37:43no one can argue that you become less healthy simply by removing estrogen this is proven in
37:50multiple organ systems estrogen is a powerful anti-inflammatory hormone and it's a powerful
37:56regulator of mental health it's a powerful regulator of our kidneys our bladder our gut
38:02and when those levels decline then you become less healthy
38:13hi welcome thank you how are you yes hi hi stacy nice to meet you both nice to meet you
38:21let me get
38:22you checked in
38:24you have a significant gap of time without hormone therapy we can continue benefits if you if you had
38:32had the opportunity to be on hormones for a long time but while you're off hormones we see an
38:37acceleration of certain disease processes so there's two things that are we need to address one is the
38:43strokes so we know that estrogen therapy in any form oral or transdermal can't does increase the risk
38:52of stroke especially in an older patient especially with a history of strokes so that probably in and of
38:58itself is going to rule out an estrogen option for her because of the risk of causing another
39:04stroke wow so that's one thing that doesn't mean you can't take progesterone that doesn't mean and that
39:10might be helpful for sleep it doesn't mean testosterone is off the table either oh she's
39:15asking yes thank you for reminding me uh vaginal cream she's asking is that something she should
39:21consider taking and having even though she's not sexually active yes the vaginal estrogen which is
39:27very safe will not increase her risk of stroke will protect her against bladder infections and sepsis
39:33as she continues to age so i would recommend it at least once a week is that over the counter
39:38is that
39:38something it's a person has to be is that something you can prescribe absolutely excellent um and so what
39:44would be is it like a daily thing so when we yeah well for her because she's not sexually active
39:49it's going to be once a week okay once a week just to kind of help that tissue stay healthy
39:54so she
39:55doesn't make her more prone to uts okay perfect she's never she's not she doesn't have like a history
40:05of it is that still good to she's not been sexually active for you know definitely if she if you
40:12get a
40:12boyfriend and become sexually active this is mandatory what i'm trying to do it can be protective
40:23for potential utis and keeping that tissue healthy
40:34i'm recording
40:37it's gonna be great it's an awesome day it is it is it's happening for 15 years we've been dreaming
40:44of
40:44our inauguration day to open our meditation park and temples years of planning coordinating and
40:51strategizing have gone into making this day possible the last three months have been very intense for
40:58us and perimenopause didn't help what are you doing um i'm just reviewing the souvenir why are you crying
41:17oh my goodness we just had like the big celebration why are you crying it's like a a mixture of
41:26emotions
41:27and feelings and accomplishment yeah yeah that was a lot it's done i mean you have to think we've been
41:35i've been dreaming of this day for like 15 15 years right being on progesterone i think
41:43fortunately that helped because it helped me to sleep but like it was just so much so much pressure
41:49so much because you want everything to go right and i just remember just i don't know i've had i
41:54had
41:54moments of snapping um and that i i felt bad about i actually made somebody cry i don't even know
42:02if i told
42:03you that yeah um ridika was helping me with some wire and then i just i don't know i just
42:09not that i lost
42:10it but it was just maybe my tone or i'm just so stressed out and i just feel like yeah
42:15i got some
42:16sleep the last week because just energy's catching up but i like this can't be our normal and i'm i'm
42:25thinking of asking and asking jason like maybe the next step for me is maybe estrogen or testosterone
42:31because sure progesterone has helped me to sleep but i still don't feel like myself and just the fact
42:38that i made someone cry like that that's not me
42:46think about physiology what do these hormones do in our body they're independent hormones but we
42:51also know that they work together in the pathway in fact our hormones come from cholesterol cholesterol
42:57gets converted to progesterone progesterone gets converted to testosterone and then testosterone gets
43:04converted to estrogen so they're all linked they're a family but increasingly i see women who haven't
43:10been given the right dose and type and balance of those hormones together and it makes sense because
43:15if we're putting too much strain on one hormone and ignoring the other the body doesn't quite know how
43:20to work but we also need to remember that these three hormones these studial progesterone
43:25testosterone work with other hormones especially in our brain such as dopamine serotonin noradrenaline
43:31adrenaline really important melatonin our sleep hormone but they all interact if you've got low
43:37estrogen or low testosterone you're going to have low dopamine low serotonin low melatonin and then if
43:45you take a step back and think why was my sleep not good why is my mood not good why
43:50is my feeling of
43:52pleasure in life not good oh it's not just the effect of those three hormones it's the effect
43:56they have on other hormones as well and then the gynaecologists are saying we look after menopause
44:01well they look after ovaries they're not trained to look after the brain and the bones and the heart
44:07and thinking in this whole way of how and how our endocrine system works
44:23so i'm excited to meet um dr hirsch yeah finally the biggest thing it's
44:31i really just i really just want her to answer why this is so complicated like why this is just
44:37so
44:37confusing which part just the whole thing with hormone replacement therapy the information on social
44:44media the the different opinions with the doctors um you know we hear one doctor saying they support one
44:53thing the other one doesn't we have to be careful because we don't want people to get hurt in this
44:59process i mean no they've already been hurt everybody right by not having any kind of treatment
45:04right but making sure that they get the right information yeah i feel like i just jumped in
45:10i'm like hrt let me sleep well i mean i can understand like i know how much my mom suffers
45:17from
45:17not sleeping so i can you know understand if somebody chooses to jump straight into hrt to just get some
45:24good sleep or just to start feeling good or better for sure when we started researching the topic we came
45:37across a lot of fear around hrt hormone replacement therapy yeah why is there so much fear around it
45:45the fear is so i pause because i understand it as a female myself i understand why women have fears
45:57and a lot of the fears about hormone therapy are really an emotional reaction they're actually not
46:04logical it's just this emotional reaction in the early 2000s the women's health initiative
46:11closed and there was a big media day and you know clinicians researchers doctors came out on social
46:16media and said oh my gosh for all these years we thought estrogen was so good and it actually causes
46:22breast cancer that wasn't the whole story it had to do with the dose of hormone therapy used in that
46:28study the age of women that were enrolled in that study the route in which it was administered
46:33the timing of menopause and so there were so many things that in 2002 and that first came out
46:40those researchers scientists clinicians didn't yet know but that message stuck
46:48the more we've learned about perimenopause and hormones the more we realize this is just one piece
46:54of a bigger conversation a conversation about the medical injustice dismissal and inequality women have been
47:01facing forever
47:03i do
47:18fully believe that this happened to me so that i could share this story
47:27it was such a big thing that happened maybe my bad experience can help someone else advocate for themselves
47:42so
47:54so
47:55so
47:55so
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