Everything Nobody Warned Us About Perimenopause; Brain Fog, Mood Swings, Weight Gain and the Truth About Hormones with Karalee Massie

SPEAKER_04 0:04

Hello and welcome back to Kind of Preachy. I'm Steph Moore. I'm with Casey Bryant.

SPEAKER_00 0:09

And we have a special guest today. We do. I I want to say all of your things, but really the most important thing is you're my sister. Aww.

SPEAKER_01 0:17

Of course is the most important thing.

SPEAKER_00 0:20

But her name is Caroline Massey. And what are all of your what's your what's your official title?

SPEAKER_01 0:26

I mean, do you want all the alphabet soup or like what I just call myself? Sure.

SPEAKER_00 0:32

Whatever. All right. What do you call what do you call yourself?

SPEAKER_01 0:34

I'm a nurse practitioner.

SPEAKER_00 0:35

That's easy.

SPEAKER_01 0:36

But I have lots of letters after my name.

SPEAKER_00 0:38

Oh fun. And you have started mainly focusing on women's health. Or actually not just women's, but mostly women.

SPEAKER_01 0:46

We do have some men, but yeah, mostly women's health.

SPEAKER_00 0:49

And especially women who are going through menopause.

SPEAKER_04 0:54

Yeah, so we could have had a whole episode where we just bring somebody on to talk trash about Casey.

SPEAKER_01 0:59

100%. And I'm not sure.

SPEAKER_00 1:02

I already warned her because we went to we went and got Starbucks some coffee before this, and I said there's a distinct possibility we will go off rails. And Carolie was like, Well, I was kind of planning.

SPEAKER_04 1:13

She will be directing those rails to the stories she wants to tell. There's a lot. So yeah, so we're gonna do our best to stay on topic. Yes. But you know us.

SPEAKER_00 1:23

I know.

SPEAKER_04 1:24

We won't. We won't. That's why you love us. Or why you turn us off. I don't know. I don't know which game you call it.

SPEAKER_00 1:31

Either one. But we talk a lot about menopause, and you know, Caroline, she is an expert on this subject and yells at me all the time because I say, like, for right now, like I'm I'm on my period. TMI already. Yay, look at us. It's okay. I announced it last week. I know you did. You did. And it is like the it's horrible. Like these periods. We've talked about them before. They're there, it's just horrible. And asking, is that normal? Are our hot flashes normal? Are sweating normal? Like, what's perimenopause? What's menopause? How long is this gonna last? Forever. For no, don't say that. I can't do forever.

SPEAKER_04 2:10

I can't. I mean, I think the thing is, is you and I are constantly having conversations. Is this normal? Is this not normal? So I think we've all Googled, you know, at some point, like, is this normal? Am I dying? When will this stop? Do I have a disease? Yes, I mean, or or am I crazy?

SPEAKER_00 2:26

Because if you type in our symptoms into what is what like the medical, what is that? What is that website? What WebMD? Oh, WebMD is I don't think anybody should be using that.

SPEAKER_01 2:37

Nobody should ever use Google Doctors.

SPEAKER_00 2:40

Because if you do that, like it's like you're dying. Like legitimately, you put in all of your your symptoms. Yes, yes. I've gained 50 pounds in one month, which is not true, but it feels like it sometimes. I get that. I get that.

SPEAKER_04 2:54

So I think yeah, I'm thrilled that we have somebody who is not only an expert, but somebody who is living in the same generation that we are and is also working with people. So you have the ability to say, like, yes, this is normal, or no, you guys really are a teeny bit crazy. Yeah.

SPEAKER_01 3:13

I mean, we're all a little bit crazy.

SPEAKER_04 3:14

A little bit.

SPEAKER_00 3:15

A little bit. You know, one of the questions is like, it's just been within the last what, five, ten years that more doctors and more nurse practitioners, more med medical people in the field are now talking about and be like, no, this really is an issue. Before it was just like, that's just normal. You just deal with it.

SPEAKER_01 3:31

It's a well, it's a generational thing. Yeah. Right? And I and in your podcast last week, I was listening to, and you were like, Oh, did you know, is this just us? Or, you know, is it that we're going through this earlier? Is that what is Yeah?

SPEAKER_04 3:46

I I am curious.

SPEAKER_01 3:48

Do you see that trending that it's it is not? It is, it is, it is really, it starts around age 40, is when it starts.

SPEAKER_00 3:55

So that's perimenopause?

SPEAKER_01 3:57

Yeah. Okay. And I'll totally dive into the facts behind it. Hold on.

SPEAKER_04 4:00

So are you saying that our like our moms and aunts, they are all just badasses and suffered this in silence? 100%. That is bonkers to me. Because I just thought like maybe hormonally things, environmentally, like things were happening earlier.

SPEAKER_01 4:17

No. Now there were a group of rogue women who were progressive that I see still to this day it in my office that were on hormone therapy when it was not cool.

SPEAKER_00 4:30

Oh, like when people didn't talk about it.

SPEAKER_01 4:32

When people didn't talk about it. And I started when I I've been in hormone therapy professionally and personally for nine years at this stage of the game. Uh and when I started into this, it really started because I was working in an acute care clinic, and these women would come in and they would be in tears. I mean, and there's there was nothing. There was nothing for them to do, no one, nowhere for them to go. And so I found a company that was really progressive and on the front end of what hormone therapy looks like now. But it was like almost like back alley practicing. Like I would send letters to doctors to to be official and ask for permission, you know, somebody that had cardiac concerns or somebody that had already some GYN concerns. And I would send a letter to their G Y N or send, you know, a letter to their cardiologist, and their cardiologist, or these doctors, would lose their ever-loving mind that I would even consider putting them on hormones. Putting them on hormones. Well, now, looking back, now that the FDA has come out and they've come out and said, oh, the study that happened in the early 2000s was actually wrong and they reported it wrong. So what was that study? I you're gonna I don't know what the name of it was. But high level, like what Oh, it was it was a study of over the course of time of women, menopa premenopausal, perimenopausal, menopausal women. Oh, this is the cancer one that says this is the one that said that women who went on therapy who went on hormone therapy had a higher chance of breast cancer. We're going to get cancer, period. I mean, it was just cancer, period. So that's now there is an arm to that study where there were more incidences of cancer, but it there were two arms of the study. One was synthetic, one was bioidentical. The bioidentical women were doing fabulous, felt great, felt amazing. The synthetic arm did not do well. That's where they started having all these cancer things come up and issues come up. And so they came out, the these physicians who were running the study came out and said, Hormones are bad for women, period. Regardless of the fact that we make them ourselves, regardless of the fact that we didn't have cancer prior to having anything synthetic, with our own natural hormones, we were fine.

SPEAKER_04 7:00

Yeah.

SPEAKER_01 7:01

So it's I mean, it was the introduction of these synth these synthetic hormones that really kind of put a stamp on it for these doctors, and they said, nope, no hormones for women.

SPEAKER_04 7:15

And I think that there has just been a I mean, I know we're talking about it more. Like I think it's like in the it's in the front lines. I mean, like I I I don't think I mean probably it's my algorithm of things, but a daily I'm seeing things, and people are more likely to talk about it where I think like the generations prior to us, like they just suffered through it. They were suffering, and they had to have been.

SPEAKER_01 7:38

Well, let's be honest, our generation is pretty feral, right? And we don't like to do what we're told.

SPEAKER_00 7:43

Gen X. Okay. All right, right, right.

SPEAKER_01 7:46

So let's start there. I I did. And we were kicked out of the house and told, come back when the street lights come on. Yeah. And then our parents were told, hey, check and make sure your kids are in bed at 10 30 every night.

SPEAKER_03 7:58

We know where your children are. Right.

SPEAKER_00 8:01

That was the best commercial ever. But our parents And my mom would not know where I was.

SPEAKER_01 8:06

Just a true story. I was sneaking in and out of the basement windows that are now glass blocked in. So you can't She snuck out.

SPEAKER_00 8:12

I walked right out the front door.

SPEAKER_01 8:13

Yep.

SPEAKER_00 8:15

Love being the baby. Being the baby is a lot different.

SPEAKER_01 8:19

I mean, our mom was fairly old, was an older mom when she had us. So she was she wasn't quite a boomer, but pretty close. And that generation was told to that their doctors were correct, that what they said was it was the law. You don't question it, you do what they say, and you walk out the door. And so when these physicians are saying you're gonna get cancer if you go on hormones, you just gotta suffer through it, they believed them. Our generation is, like I said, more feral, and we're like, what do you know?

SPEAKER_04 8:56

Yeah. I also think we are more adaptable to like things change. Yeah. Because I mean, even th, you know, I'm thinking back of like, I know, like when I was born, which was, you know, 1980, and you know, the years prior to that, and just after that, it was like breastfeeding was like, don't do that. Oh, yeah, it was bottle fed, was yeah, was like bottle was best. So, like that, and I mean, can you imagine somebody saying that now?

SPEAKER_01 9:20

No.

SPEAKER_04 9:21

I mean, right, I think they say fed is best, which is, but I mean it was like absolutely like that you whatever, what now yeah, whatever is like whatever works for you, like either either will work. But I mean, like my mom was specifically said, like, you don't do that because there's concerns for you later on down the road if you do that. So I remember like when I had, you know, my first baby and it was like, okay, I'm gonna try and nurse, and my mom was like, you could get cancer. Because one doctor told her that randomly in an appointment, and like that was now gospel as far as like what that looked like. And I do think, you know, as we're kind of like our age, you're right. I ferrell is probably a super accurate description, but we are like, we don't just take one thing, you're like, we need to see all the things. Like, give me, I wanna, I want to research everything.

SPEAKER_01 10:04

And research is the key. I mean, we are we tend to do that. We tend to go out and find every bit of information about something and look at it from all sides, whereas the previous generations did not do that. They just, like I said, accepted what physicians said and moved forward. And you know, they said that this is what's gonna happen. So this is what's gonna happen. I mean, I can remember when our mother was diagnosed with cancer, with melanoma, the first time she was diagnosed with cancer. And they were like, you can never be in the sun, you can never have caffeine, you can never have the. I mean, this whole list of things. When in all actuality, was that really I mean, was caffeine really gonna give her cancer again? No.

SPEAKER_04 10:45

No, but that's enough to scare you. Right.

SPEAKER_01 10:47

Well, well, and she said they told her the same thing about hormones. She can't have any hormones because of this melanoma, it could cause it to grow again. But at the same time, she was also told the melanoma came from one specific source, one burn when she was in her early 20s. So if the melanoma came from one burn in your early 20s, how can caffeine or accelerate or correct?

SPEAKER_04 11:09

Gotcha.

SPEAKER_01 11:10

Correct. So, you know, who do you believe? And our generation is gonna go out and research the, you know.

SPEAKER_00 11:18

Or we're just not gonna do anything.

SPEAKER_04 11:19

Well, well, we just don't go to the doctor. I think that could be totally in. And if my husband is listening, I don't need you smirking that I don't go to the doctor enough because I know he's on me all the time.

SPEAKER_00 11:28

Like, I was just so I just was at the doctor today to get weighed in, and they keep asking me to get my blood work done because I'm supposed to have it every year. And they're like, your last blood work was 2023. I'm like, okay, great. So every week they're like, you need to get your blood work done, and they hand me a slip. Yeah. And they keep asking me, but I said eventually I'll go do it. I just don't want to do it.

SPEAKER_01 11:47

Mind you, she goes to my office.

SPEAKER_00 11:49

I do.

SPEAKER_01 11:51

So she, I she is not my patient, by the way. My sister is not my patient.

SPEAKER_04 11:55

But she'll be no HIPAA violations. Right.

SPEAKER_01 11:59

So she, but they come back and they're like, Your sister needs her labs. I'm like, I am aware. I can only lead a horse to water. This is true.

SPEAKER_04 12:08

Okay, well, I mean, let's kind of get back into the meat of kind of we're we're talking about we're talking about perimenopause. What is the difference between perimenopause and menopause? Ooh, good question.

SPEAKER_01 12:18

So, perimenopause is the lead up to menopause. Tech or the technical definition definition of menopause, which is a really bad definition, if you want my personal opinion.

SPEAKER_00 12:28

Okay.

SPEAKER_01 12:28

Is 12 months without a period.

SPEAKER_00 12:30

That's it.

SPEAKER_01 12:31

That's it. Okay. That is the definition of menopause.

SPEAKER_00 12:34

So what happens if you have a period after that? You start all over again?

SPEAKER_01 12:36

Yes. Oh, wow. But if you get to that 12-month period mark, I should say, then there's there's all this people that think that you're golden. That that that those are the ones who get pregnant. Right. So perimenopause starts around the age of that.

SPEAKER_00 12:56

Yes.

SPEAKER_01 12:57

Perimenopause starts around the age of 40. It is when our hormones start the decline. So our hormones act on a bell curve. Like you start as a baby and you don't produce anything, and then you go through puberty and you start producing all of your hormones. And then by about the time for women, like 25, 30, between 25 and 35, our hormones kind of max out.

SPEAKER_00 13:20

Okay.

SPEAKER_01 13:20

And then they crest the hill and they start on the downside.

SPEAKER_00 13:22

Is that why at age 36, 35, is you're now considered geriatric. Yeah.

SPEAKER_01 13:31

That's why I was uh it's advanced maternal age now.

SPEAKER_00 13:33

Advanced maternal age.

SPEAKER_01 13:34

You're not no longer gestationally geriatric. Now you're advanced maternal age.

SPEAKER_00 13:38

That's what I was thinking.

SPEAKER_01 13:39

But yes, that's why, because your hormones are actually on the decline, or starting down the decline at that point in time.

SPEAKER_04 13:44

Okay.

SPEAKER_01 13:44

So perimenopause is at the beginning of and through that decline, which can take five to ten years, to be quite honest. Sometimes longer. So that's when Sometimes longer. Oh, yeah. So that's when you start to see we call it the wheels falling off, right? You start to see sleep doesn't happen any longer. You start to notice where's my keys? Where's my car? Where'd I put my phone? That brain fog sets in. Fatigue. It is a fatigue. Perimenopause and menopausal fatigue is a fatigue that you cannot explain. It is a melt into the couch fatigue.

SPEAKER_04 14:21

I'm gonna need husbands to turn this up. You know, if you if you have a wife, if you're a wife or you have a partner, you know, that you are just like, I'm I'm relating to this so hard. I need you to just pause, get your partner, get your husband, put them on the put them on the, yeah, just share earbuds with them, turn this on in the car. They need to hear this exhaustion and brain fog is normal.

SPEAKER_01 14:46

It is 100% normal.

SPEAKER_00 14:48

Okay, so wait, what's up with the weight gain and the bad periods?

SPEAKER_01 14:51

So the bad periods happen because your hormones themselves are fluctuating, right? Okay. So instead of getting the normal wave of estrogen and progesterone that you would that you would get through your 25, you know, through 25 to 35, or even when you start your period, it's still a little shaky at the beginning, but it normalizes and it evens out. As you get crest that hill and you start down the perimenopause cycle, your hormones, and this is a horrible word, do what we call squirt. So you'll I told you it was a horrible word.

SPEAKER_03 15:26

Wrong word for this podcast. We just told you it was a horrible word.

SPEAKER_04 15:33

It's a horrible. We are 12-year-old boys.

SPEAKER_01 15:36

One, oh, I they are about to be a 17-year-old bodies. I tell people that all the time.

SPEAKER_00 15:42

That's a horrible okay. I know.

SPEAKER_01 15:44

So what it just means is that your ovaries will basically produce a whole bunch of estrogen or a whole bunch of progesterone at one time. Okay. So you end up having this horrible aggressive, if you want, if for lack of a better word, cycle, period.

SPEAKER_04 16:01

Okay, so that makes sense to why my all my cycles are not like that. But then it's like all of a sudden, I just always like would make excuses of like, I don't know if it's my right side or my left side that hates me, but I'm like, that's what I've always just where you are in the in the grand scheme of things.

SPEAKER_00 16:15

I'm just squirting. What you're squirting. So when it's like when it's like a horrific one, when it feels like you have these huge clots coming out of your body and you're going through a tampon, sorry, TMI again, every 15 minutes. That's just because of this overload squirt of hormones.

SPEAKER_04 16:32

Because we're on the decline. It's just like, okay.

SPEAKER_01 16:35

Your ovaries are like crapping out, to be quite honest, and they're like squeezing everything they have out of them, and all of a sudden, this huge burst of estrogen and progesterone happened.

SPEAKER_04 16:44

And see, this is the stuff that are not in textbooks.

SPEAKER_01 16:49

No, these are things that I'll be honest with you. One of my very good friends was like, You need to start a podcast about things that mom never told you. And I was like, Yep, these are things that mom never told us. She never told us our muscles were gonna fall off.

SPEAKER_04 17:02

I because mom didn't know. You gotta you gotta I'm sorry.

SPEAKER_00 17:06

You gotta you can't you talk with your hands, you're worse than I know.

SPEAKER_04 17:09

But the truth is, is that's not that mom didn't just tell you, she didn't know. No.

SPEAKER_02 17:13

Because she just told it was normal.

SPEAKER_00 17:16

Yeah, right. Wow. Okay, so so okay, so that's the period. So what's up with the weight gain?

SPEAKER_01 17:23

So weight gain happens because testosterone and estrogen fall off.

SPEAKER_00 17:30

Okay.

SPEAKER_01 17:31

Now they come, they're starting to fall off.

SPEAKER_00 17:33

And women have testosterone in their system.

SPEAKER_01 17:35

So women are actually testosterone dominant until we're about age 40. We have about three times as much testosterone as we have estrogen, which is something that we were never told either. We were always told testosterone, men have testosterone, women have estrogen. The fact of the matter is we both have both. Men have very little estrogen and a lot of testosterone. We actually have more testosterone than you think, but we also can have a lot of estrogen too, depending on where you are in your cycle.

SPEAKER_04 18:02

Oh gosh. So someone who had well, now they're called Okay, I have PCOS. Correct. Now they're calling it PMOS. I think is what it's like. Oh, I'm so thrilled about it because I actually think that's going to, because like right now, I mean, because I've always been incredibly high on the testosterone.

SPEAKER_01 18:19

Absolutely. That's part of PCOS, PMOS.

SPEAKER_04 18:21

I had no idea that women had more to begin with.

SPEAKER_01 18:24

Yes. 100%. Actually, brand new information too. It is the so testosterone cuts itself in half. So if you think of, you know, testosterone, you have this much testosterone in your body, cuts itself in half at 40, and then at around 40, I should say. And around 45, it does it again, and all of a sudden we go from being testosterone dominant to now we're estrogen dominant. And estrogen is what causes bloating, it what's cause what causes irritability. It it the Karens that we all see out there, I want to sprinkle a little testosterone on all of them because that's what keeps us level. Estrogen does not. Estrogen gives you just giant emotional weight.

SPEAKER_00 19:01

That's why people will go on these estrogen or testosterone shock treatments. Yes.

SPEAKER_01 19:06

Yes. Wow. So things, the things that we were just talking about. I'll get back to weight loss or weight gain. Okay, here fine.

SPEAKER_00 19:13

Just keep going. This is very informational. Things like brain fog. Yeah.

SPEAKER_01 19:19

The uh fatigue, the sleep, the inability to keep your muscle mass. When I talked about, you know, you you lose your muscle and all of a sudden you bingo arms, you know, where they wave for you.

SPEAKER_03 19:30

Uh-huh.

SPEAKER_01 19:31

That is a lack of testosterone. That is because your body can no longer build as much muscle as you used to have because you don't have the testosterone to do it. Exercise recovery is a thing. Joint pain, as you know, when you like creak and crack when you roll out of bed in the morning. Testosterone is a natural anti-inflammatory, as is estrogen. But without testosterone, that joint pain sets in and the aches and the pains. And then you can also, for women, it's a little bit different. Men, as soon as their libido wanes, or as soon as they're not as functional as they used to be. That was so well put. Thank you. Um they immediately are in the doctor's office, like, test my testosterone. And if it comes back low, they're immediately treated, it's covered by insurance, you know, great. Yes. Women have this laundry list of things that before we ever get to any kind of uh sexual symptom. Or I mean libido, dryness, those kinds of things. So they we go through this entire huge laundry list of things, and then at the bottom we're like, oh yeah, and by the way, I don't really care about being intimate with my husband any longer or with my partner or whoever it might be. However, the FDA's only reason for covering women for testosterone treatment is hypoactive sexuality.

SPEAKER_03 20:57

Really?

SPEAKER_01 20:58

But it is for I mean, I've been, like I said, nine years, I've been doing this. We, you know, I have over 6,000 patients in our practice. And I can go through their we feel they fill out a checklist every time they walk in and talk about their symptoms. And every single one of them is like, yeah, but I don't care about that because that's the least of my worries.

SPEAKER_04 21:16

The sex life.

SPEAKER_01 21:16

Intimacy is the least of my worries.

SPEAKER_04 21:18

Because well, and I I my guess uh just to speak personally, like sometimes that's why. Stop it. I feel but think about it. Like when your body feels totally out of whack, you feel like it's an out-of-body experience. That part does feel like the least because it's like I don't even feel like a human right now. I'm not myself. I'm not myself.

SPEAKER_00 21:40

So I can't even get into that place where like that's a priority because I feel Well, it's like don't touch me, don't do anything to me.

SPEAKER_04 21:47

So why am I going to even try to have sex with you if if I well it's it's the yeah, it's not just irritability, but like I feel so bad. Like the self confidence like is so in the gutter because you just don't feel good. Correct. And I'm not talking about just like I don't feel good, but want to see it in the mirror. I'm like, I feel bad all the time. All the time. Yeah. I'm telling you. It's like, how can I even like gear myself up for this when I feel like trash?

SPEAKER_00 22:11

Correct. But I bet if women go on testosterone, I their husbands are like, thank you.

SPEAKER_01 22:16

They are.

SPEAKER_00 22:16

Oh, that's a legit.

SPEAKER_01 22:18

It is legit. It is legit a thing. Now the first year on testosterone is is usually a little bit more hyperactive as far as intimacy is concerned. And then it levels out. But that first year, we have husbands that walk in all the time and are like, thank you.

unknown 22:38

Okay.

SPEAKER_01 22:39

I have my wife back. But it's not just sex life. Intimate intimacy. It's the brain fog is gone and they have the energy to do things again. And they're out in the yard again and they're participating in their family again, where a lot of times they've checked out.

SPEAKER_00 22:58

Because yeah.

SPEAKER_01 22:59

Because they just don't feel like themselves. They don't even know who they are anymore. So, you know, giving them back their livelihood and their functionality again to me is more important than intimacy ever is.

SPEAKER_04 23:14

I mean, in some ways, I love you, Lord, and I know you've created us, you know, the way that we are supposed to be. But it does feel like a little bit of a cruel joke that things like start to deteriorate. We feel like everything's super out of whack. At the same time as I think in 40, you also have this weird surge of I it's not confidence necessarily in ourselves, but it's like a whole like, okay, what am I doing with my life? It's kind of like you have this, like I think we talked about it when Lori was here. It's like it's not, yeah, just midlife kind of re-evaluation of things where we have all these things, but like your body, it's like when you're just starting to think, okay, I can do more, because not everyone's relying on me, but then your body's like, hey, you can't rely on me either. You may not have to like pack lunches on a daily basis anymore, but or play taxi. I mean, although we're still doing that. I make my own kids, like the only kids pack their lunches. I mean, I'm not even sure what's in it anymore. But but yeah, it just it kind of feels cruel that you know, like when you were like, okay, I'm just feeling like, okay, maybe I can do something different with my life. And it's like, oh wait, the rest of me is not working.

SPEAKER_01 24:21

So think about it this way up until the 17th or 18th century, we didn't live past 40. I what well the average human human lived to about 38, 39 in the 17th century. The only reason we do live longer is because of Western medicine. The majority of the population.

SPEAKER_00 24:41

Okay.

SPEAKER_01 24:42

There are going to be obviously outliers where they outlive whatever. But the majority of the population did not survive past the age of 40. So we were never intended to live without hormones that we are now living half our life with. Interesting.

SPEAKER_00 24:56

I have so many questions regarding that, but that's a different subject.

SPEAKER_04 24:59

So okay, so let's circle back a little bit because one of the I think is the most, I mean, I think we we suffer with the brain fog and the night sweats and you know the hot, you know, like these things. But you specifically mentioned the weight gain. Yes. See, I said I was gonna get back to it in a 2019. No, no, no, it's it's okay because I think I I know for me at 41 is where I was for between 40 and 41, I was like, I'm where I had had regular rhythms to lose weight in the past, like all of a sudden it didn't work anymore. Yes. Like the exercise and diet, like it didn't matter what I was doing. It just wasn't wasn't working. Correct.

SPEAKER_00 25:41

So, however, our husbands could literally say, Oh, I'm just gonna change one thing in my diet, and then they lose 20 pounds.

SPEAKER_04 25:48

I'm gonna cut carbs for a week and go on the carnivore diet, you know, and it's like all of a sudden you're looking like, I hate you. I love you, but I I hate you because it is taking me four months and I'm on a thousand calories a day. And it's a pound, and it's not sustainable.

SPEAKER_01 26:03

No, no, it is not.

SPEAKER_04 26:04

So, where in this age, like due to like how does hormones fit into why we are all of a sudden gaining and not being able to lose?

SPEAKER_01 26:15

Good question. So, what happens as our hormones start to wane is our ovaries for females, testes for males, slow down production. And so our the only other place, well, one of the only other places in your body that you produce sex hormones is your adrenal glands. They look like little Santa hats that sit on top of your kidneys, right? They are what produces cortisol. Cortisol is your stress hormone. I've heard that word so anybody like she's I will tell you about cortisol. You cannot get a cortisol blood test that is accurate, FYI. So anybody out there who wants a cortisol blood test, it only will help you treat Addison's disease and Cushing's disease. It is not going to help anything else. Just FYI.

unknown 26:55

Good.

SPEAKER_00 26:56

Okay, great. So the more you know, the more you grow.

SPEAKER_04 27:03

And if you're our age, you saw that star. Everyone's solid. Everyone's solid.

SPEAKER_01 27:07

So your adrenal glands start to try to produce your sex hormones, but they can't produce as much. The other problem is your adrenal glands fire while you're sleeping. So what we see in people who are starting to wane in their in their hormones, specifically testosterone and estrogen, as you as they fall off, your testosterone or your adrenal glands start to take over, and so they start firing while you're sleeping. So we see instead of somebody when they lay down to go to sleep and going into REM sleep and getting really good sound sleep, this is where the sleep issue comes in, which leads into the weight thing, your pulse actually spikes because your adrenal glands are also your fight or flight hormones. So the whole time you're sleeping, your pulse is going up and your body is producing cortisol because it's it thinks it's in fight or flight, trying to produce the amount of hormones that you need, the amount of sex hormones that your body needs. So by giving it back, it relaxes your adrenal glands, it relaxes, it allows them to shut down, sleep gets better, and then things improve. Where weight loss comes in is estrogens primarily, but other hormones as well, is involved in making sure that your body responds to sugar. Making sure your insulin responds to any intake of carb. When your adrenal gland starts firing, it starts trying to produce these androgens. It starts trying to produce testosterone, but it can't produce enough. So it protects your belly fat because it doesn't think that you're going to make enough food for yourself. It thinks you're in fight or flight, right? So it puts you into stress mode. You produce excess cortisol, you produce excess belly fat. And then the androgens that are being produced by your adrenal glands protect it. And so lack of estrogen makes us insulin resistance, which gives us belly fat. So PMOS is a totally different story because it happens like double time for you all.

SPEAKER_04 29:03

I feel that. Thank you for validating that.

SPEAKER_01 29:07

I mean, it really does. And until we can find something.

SPEAKER_00 29:10

Which is why like holding on to belly fat is such like why we have not say the apron, but like why, like why women our age, you seem like they might be, we like for me, I'm losing weight, but however, I'm still holding it in my stomach.

SPEAKER_01 29:22

Correct. Because until we settle down or give you back those hormones, your body's gonna protect that belly fat with wow, with the androgens that it is producing.

SPEAKER_00 29:35

It's so sad to get older.

SPEAKER_01 29:37

I mean, you I mean, you talk about wheels falling off. I had a 30-year-old patient the other day that said, I feel like the wheels fell off. I was like, girl, you ain't got nothing. You don't know yet. Yes.

SPEAKER_04 29:48

Well, I can I just say when you just going back just a little bit when you said, you know, like what cortisol and you know, the your body that's like trying to produce things and it's like in fight or flight. And I'm like, I honestly have never heard a better description of what perimenopause feels like than your body constantly feeling like you're in fight or flight. Yes. And I've honestly never heard anybody else say that. So to me, I'm like, that I mean, really, it's I I'm not saying it's revolutionary, but it's just I It's like a ha-a-ha mm. Aha, like yes, doesn't it? I mean, when do you I honestly don't know the last time that my body just felt like it was resting. Like even at sleep. With it whether I'm resting like because I'm exhausted mentally, physically, emotionally, like my brain is, and I don't, and I just always kind of thought maybe it was just I just have an overactive brain. But what you're telling me is like my hormones are triggering things.

SPEAKER_01 30:39

100% your hormones are triggering things.

SPEAKER_00 30:42

It makes sense why I you can't shut off your brain. Like I cannot shut off my brain at night. I just start going into I spiral and yes, I can't sleep. And even when I finally fall asleep, like I can't, I can't sleep in. I mean, I used to be able to sleep in all the time. Yeah, can't do that anymore. Like I wake up and I'm like, well, I guess I'm up in my three hours of sleep.

SPEAKER_04 30:59

I got woohoo, let's do this. I think somewhere between 3 and 4 a.m., it's like my body starts like, this is a good time to start, you know, thinking about conversations you had 10 years ago.

SPEAKER_01 31:09

That's literally when your adrenal glands are firing, right? So that's when your body is typically your pulse is spiking, you're going into fight or flight, it wakes you up and all of a sudden your mind starts spinning, right?

SPEAKER_04 31:21

Yeah. I mean, I used to blame the dog for getting me up, but now I'm getting the dog up and like, is it time to get up and go? Cause like I'm already up. So we might as well just kind of get this show on the road. So yeah, this makes so much sense. So now that we know kind of what things are, why don't and I feel like we maybe like glossed over this. Where do you work and where do you fit into helping us? I probably should have done that. We should have asked.

SPEAKER_01 31:47

It happens. I work at a facility called Figure Weight Loss and Figure Vitality. Figure weight loss is exactly what it sounds like. We are specific, a an office specific to weight loss. It is physician supervised. It is, we have dietitians. We love the dietitians.

SPEAKER_00 32:04

I I worked with them to help me.

SPEAKER_01 32:06

They're fabulous.

SPEAKER_00 32:08

Which is very eye-opening when you sit down with a dietitian and you go through your list when you think you're eating healthy, and they're like, okay, that may sound healthy, but let's let's talk about that.

SPEAKER_04 32:19

Well, yeah, I would recommend. I mean, I did thought um even when I was dieting, I, you know, trying to do things on my own. It was like I was just cutting calories. But I was certainly like, I mean, I know there's a protein phenomenon right now, but protein and fiber, I mean, all the things I'm like, just because you're, you know, you're cutting calories, you know, that doesn't make things sustainable or what's best for you or your body. And if you're not feeding it correctly, it's not gonna work with you. Well, that's the whole point. And we're already fighting a losing war. That's what I'm hearing.

SPEAKER_01 32:45

The whole carb battle, right? You hear people say, oh, you don't need carbs at all. You actually do. A carb is anything that is made from something that grows from the ground or grows from the ground. So that means every fruit, every vegetable, and anything that is made with any fruit, vegetable, grain is a carb. Right? Yeah and the goal, especially in perimenopause and menopause, is to have less carbs than you have protein. Period. But not to eliminate carbs because when you reintroduce your carbs, your body is going to crave them and then you are going to overeat them.

SPEAKER_00 33:17

Because you always re-introduce, no matter what. You're always going to reintroduce. But you know, talking with a dietitian, the the best thing that they well, you you say it too, but you're my sister, so therefore I don't listen to you. I have to listen to somebody else. True story. It's the way it goes. Yeah. The best thing they said is like, great, your carb, like your baked potato, if you want to have it, great. Just do it at lunch.

SPEAKER_01 33:36

Gives you the whole day to burn those calories off.

SPEAKER_00 33:38

Don't don't eat your your carb at dinner. I like that. And don't have it at breakfast or starches. Have it, you know, because I love pasta. Freaking love.

SPEAKER_01 33:46

Bread pastas, rice, potatoes, corn, bananas, apples, pears.

SPEAKER_00 33:50

Have them at lunch if you're gonna eat it.

SPEAKER_01 33:51

All lunchtime foods.

SPEAKER_00 33:53

If you're gonna eat it. If you're gonna eat it.

SPEAKER_01 33:55

Yes. So the other place I work, which is the second half of my job, is I work with Figure Vitality, which is hormone replacement therapy for both men and women. I've, like I said, been professionally and personally doing hormone therapy for over nine years. Uh women's health. I was in women's health before I became a nurse practitioner. Worked mother baby, so the whole breastfeeding thing that when I was on mother baby, bottle fed was bad.

unknown 34:24

Yeah.

SPEAKER_01 34:24

Bottle fed was bad. We, I mean, I can't tell you how many women I taught how to breastfeed. I have like eight breastfeeding awards as a nurse because I was that good.

SPEAKER_04 34:33

But I bet when you're doing that, you probably had some mothers and be like, do you need to do that? What you know, like you know, like mother slow down. Not like the mother's having the babies, but the mothers of the mothers.

SPEAKER_00 34:43

Yes. Well, also, and when you're doing I I still remember like you just sit there and and you just let the nurse grab your boob and be like, okay, do what you need to do to get this this my nipple, sorry, yeah, into the baby's mouth.

SPEAKER_04 34:53

I'll just never forget, you know, it's like a hamburger. You know, it's like the squishing of all these things, and it's like, and everybody's in the room, and it's like it is what it is. When you have your first baby, like there is just like your body is no longer your own. There is no such thing as privacy.

SPEAKER_00 35:08

Everyone who thinks they're not gonna poop, guess what? You poop during labor. True story. Did you?

SPEAKER_01 35:14

Yes. We all do.

SPEAKER_00 35:15

I did not.

SPEAKER_04 35:16

Your nurse looked. I didn't. No, I had a mirror. I watched it.

SPEAKER_02 35:19

Good for you. Good for you.

SPEAKER_04 35:21

I wanted to see it.

SPEAKER_00 35:22

Doug was like Doug will have to tell you. Yeah, he he likes to replay that first story of when I of when I had bell.

SPEAKER_04 35:30

Maybe, maybe, maybe the first one because I said, well, I didn't watch the first one because I was well, the mirror was there, but I was in so much pain. My epidural did not work. I had back labor and it was like a whole different experience of like, I why is this not working? Right. I literally yelled at holy ring of fire, and they're like, Yeah, you're not supposed to feel that. And I was like, Oh, I do. I'm feeling everything. This is what I'm saying. It was it was like it was like a whole yeah, it was a whole thing. But yeah, I that time I was like, if I do poop on the table, I need you to not tell me. Yeah. And then I was so worried about it.

SPEAKER_00 35:58

Until afterwards.

SPEAKER_04 35:59

Then I was so worried about it, and I was like, I asked like months later, and I was like, did I? And he was like, No. And now I'm like, maybe I didn't, maybe you didn't tell me the truth. Doug was very graphic. But two and three I watched, so I know for sure I didn't on two and three. Three sneezed or you know, she coughed herself out, to be honest with you.

SPEAKER_01 36:17

Up is these first-time moms that think that babies are like cats, they you know, crawl up and instantly latch on, and it's so easy. And it is not. There's nothing easy about breastfeeding.

SPEAKER_04 36:29

I mean, if anything about childbirth that should tell you and nothing about how you think your body's going to work is is probably going to be surprising.

SPEAKER_00 36:36

There's some women who tried to breastfeed and they have inverted nipples and no one knows.

SPEAKER_01 36:40

I don't have inverted nipples, but I did I just I don't have enough fat in my b in my breast to to breastfeed. Never was able to.

SPEAKER_00 36:47

And then some like I I did with Faith for I think six or eight weeks, but she started crying every 15 minutes, and then we realized I just wasn't producing enough enough milk. And I think it was Doug threw a bottle in her mouth and she drank it and she fell asleep for like six hours. And I'm like, okay, she was hungry. I that was not Devin.

SPEAKER_01 37:06

I think Devin was on cereal by a month. I think he was a month old, and we were putting cereal in his bottle because he wouldn't.

SPEAKER_04 37:14

And you know what? You probably have some new mom listening somewhere, like, I just can't even imagine. What I'm telling you is that things change over time. We find new things out. There are always there is it's an aggressively changing, evolving thing as we learn more.

SPEAKER_00 37:28

That's why it's a practice of medicine and not you know the Oh, our mom used to say that all the time.

SPEAKER_01 37:34

It's why they call it practice. It's why they call it practice.

SPEAKER_00 37:38

Yeah.

SPEAKER_04 37:38

Well, I that's life too, right? Yes. I mean, like no, nobody's mastered it.

SPEAKER_01 37:42

See, see, I'm 100%ing today. I I didn't want to call that to your attention. You should have because I am aware of it and I keep trying to stop myself.

SPEAKER_04 37:51

Because we've joked that, you know, we could have a drinking game.

SPEAKER_01 37:54

We could.

SPEAKER_04 37:55

Definitely for this podcast. But back okay, but I'm But it's never the same one. It's never the same word. It is never the same word.

SPEAKER_01 38:00

Season was a was one for a couple episodes.

SPEAKER_00 38:03

Oh, season. Oh, I didn't know we didn't even pick up on that.

SPEAKER_01 38:05

Oh, season is a good thing.

SPEAKER_00 38:07

Don't be sorry. But I going back to who you are and what you do, so you're now in hormone therapy. Yes. And you you treat women, and I I know this because some patients who maybe not see you but go to your practice, like seeing them their night and day when they start night and day. Treatment.

SPEAKER_01 38:27

Night and day. There's, I mean, there's a a percentage of women who come in, get their labs drawn, get one insertion, feel nothing or see nothing, because our philosophy is we start low and go slow, right?

SPEAKER_04 38:41

Okay, can I can I pause you just for a second? Yeah. Because you just said insertion. Now as somebody said okay, that came out so much dirtier than I anticipated. My point was just like squirt. I'm so I'm sorry. My point was somebody who's not on hormone therapy, and I'm not either. Tell me what that looks like because I don't know what you mean at all.

SPEAKER_01 39:02

So hormone, there are many, many routes of hormone therapy. There is an oral pill that's called estra test. It, I mean, we've seen some patients on it. It doesn't get patients to where we want them. We want to optimize our hormones. We want to put them back where you were when you were felt when you felt you know your best around age 30, around age 35. Estra test is really not going to get you there. It is bioidentical. It is not synthetic, so it is one of those positive hormones.

SPEAKER_00 39:32

So clearly, I'm hearing you say, like, if you're trying this, you definitely want to go more towards the You want bioidentical.

SPEAKER_01 39:39

Synthetic, I mean, there are synthetic things out there that are great. There are synthetic things that are not great. As far as estradiol is concerned, I would never do oral estradiol. I don't prescribe oral estradiol for anyone, um, which is bioidentical as well. Or estradiol processed by the liver is what puts women at risk for blood clots. Because your clotting factors are produced in your liver. So it affects, so your estradiol, when it is broken down and metabolized by the liver, it affects those clotting factors. That's what increases your risk for blood clots completely understands.

SPEAKER_04 40:14

Well, you know, but you know what, to be honest with you, what I'm hearing is, I mean, because I think we covered that this generation, we are constantly doing research, and like if we're told no by one thing, uh, you know, like I know, like I was just talking about, you know, having PCOS now, PMOS, it's gonna be hard for me to transition. But I mean, like, there hasn't been a lot of things that they could do for me over the course of I guess I've known for 24 years when I was originally diagnosed. I think it's more common now than even what it was. But they were like, you can do oh shoot. There was like one drug that I could take, but that was like it wasn't sperinolactone, is you know, yeah, like things it just didn't formint. Yeah, metformin. Yes, yeah, the big ones. Yes, that's what they put me on. I'm like, that's not really changing any of the other things. It was just like one tiny thing. And when I had inquired about a GLP one, because I was like, I'm I'm seeing that these things could help, and was like, well, okay, well, first of all, your insurance A does not cover it. It's a thousand dollars out of pocket, if not more. And I'm like, okay, so what I'm hearing is I can't afford to feel better. Correct.

SPEAKER_00 41:23

But they're just what I'm saying. Insurance gonna be.

SPEAKER_04 41:25

Yes, but what I'm hearing from you is that like, but so what I did, and I think what many people did is when a doctor shuts you down, I can't help you, and insurance isn't gonna cover it anyways. We go to these rogue sources. So when I hear you say like process through your kidneys, or you know, I'm like, oh, wait a minute.

SPEAKER_01 41:43

So when you're saying synthetic, I'm wondering when we're going rogue on these things, that could be pretty dangerous because we're we see a lot of a lot of patients that come from these online companies, you know, and then they come to us and they say, There was never a physician I talked to. There was never a provider that I talked to. They asked me to report my weight, they sent me the medicine, and that was it. And while we may start seeing the weight loss things, though, like, okay, great, so it must be working, we might be doing like some other damage by not having so then you start worrying about you know muscle depletion because that's one of the big side effects of GLP1s. If you are not getting enough protein in, if you are not getting the calories in, your body actually becomes malnourished, which is where we see the hair loss, the muscle loss. You see that osempic face where people look like they're melting.

SPEAKER_04 42:31

Like, wait, do I have osempic face? You do not. All right, thank you. Here's where I get. Ooh, go ahead.

SPEAKER_01 42:37

Okay.

SPEAKER_04 42:38

All right, Elena, we're gonna pause. I'm just giving you lots of time to find this. You're gonna go back about a minute and we're gonna take out any names.

SPEAKER_00 42:46

Please do. Oh, yes. Whoops.

SPEAKER_04 42:48

This goes against the non-judgy part of our podcast. We can't judge people's bodies. True story. Love you, but we're not gonna do that. Okay, great. Okay, so we're going back on to I said, Do I have Ozempic face? And you said no, and we're gonna cut it off at that and we'll start again.

SPEAKER_01 43:03

So there are other forms of estrogen, testosterone that are out there. They there are estrogen patches, they are bioidentical. I use them a lot in women who are close to menopause, meaning they're at the tail end of perimenopause. So they're starting to have night sweats, they're starting to have hot flashes, they're starting to have those lack of estrogen symptoms. We can slap a patch on them because you can take them off very easily.

SPEAKER_00 43:29

Okay.

SPEAKER_01 43:29

You know, should they produce estrogen and have a period, we can take those patches off really easily. There are creams that are out there that are also bioidentical. Again, we typically don't see them get to the levels that we want where we are solving problems, we are eliminating and resolving symptoms. They're good. Uh vaginal estrogen is awesome for women who have lots of UTIs, who seem dry or feel dry down there, who feel like burning. Because because the skin is thinning, vaginal estradiol cream or vaginal suppository estradiol are actually really good for that. As far as testosterone is concerned, like I said, there is injections, those are synthetic. Testosterone injections, I'm gonna repeat that, are synthetic. They have the testosterone chemical. What is that? My brain just farted. Chemical makeup, right? It is the testosterone molecule, but they take one uh end of the molecule off and they attach something to it so that it becomes stable in an oil for shelf life. That is synthetic. That is changed in a lab. Your body does not recognize that.

SPEAKER_00 44:45

Wow. So your body will take it, it has to manipulate it to figure out what it is.

SPEAKER_01 44:52

It has to cut off that end that they put on there to make it stable for shelf life and then uh try to use it. So it comes with synthetic uh testosterone comes with other side effects as well. Things like increased uh red blood cells, increased uh hemoglobin hematocrate, which are just lab levels that we like to watch. Uh doesn't really get dangerous until it gets really high, but it is something that we watch in our patients, and we have very few that are on injectables. So we really don't like to play with them. What we do is pellet therapy. So they are bioidentical pellets that are made by a compounding pharmacy that is FDA approved, and they are inserted into the subcutaneous fat of your hind end, of your bum.

SPEAKER_00 45:35

Of your butt.

SPEAKER_01 45:36

Your butt.

SPEAKER_00 45:36

Your hiny, your doobie. My mom used to call it a doopy. That came from new grandma. Old grandma.

SPEAKER_01 45:41

Oh, really?

SPEAKER_00 45:42

Oh, came from old grandma. That's our grandmas were called old grandma and new grandma.

SPEAKER_01 45:47

I know, right? Well, one was old. One was old, one was 12 years younger than the other. And so new grandma we never saw, and she was much younger.

SPEAKER_00 45:57

And so when we did see her, she was new. She was new. So new grandma.

unknown 46:02

Okay.

SPEAKER_04 46:03

All right. I had a lammy. I can't judge. Oh, you had a lammy. I had a lammy and a grandma and a guma.

SPEAKER_00 46:09

Oh, yeah, three.

SPEAKER_04 46:11

Well, Gooma and Grandma were the same. It was just that her name evolved over time. Got it. Got it. As it does, as you add new people into the family and new babies start talking and calling different things, and then everybody just adopts it. Yeah. So let me ask you into your butt for how long?

SPEAKER_01 46:25

Into your butt. For women, it lasts somewhere between three and four months. Oh, wow. That long. It does. For men, somewhere between four and six months. Of course. When you think of testosterone dosing men versus women, right? Our average female, and we go, we treat all the way down to 35 for those who are early perimenopause, early early menopause of women. Our female doses of testosterone probably start somewhere around 100 milligrams. And I I mean, we max out, we we there is no max, but I think we may have a handful of patients that are on 200 milligrams, but the majority of them sit in the middle of that.

SPEAKER_00 47:06

I'm raising my hand.

SPEAKER_01 47:06

I know you got hold on a second. Men are getting testosterone doses between 1600 and 2400 milligrams of testosterone, if that tells you the difference between what women get and need and what men need.

SPEAKER_04 47:21

Can I just say I think my ovaries must be squirting because I'm so afraid I'm going to forget the questions I have in my head for you as we're talking. Because I'm like the brain fog of like, oh my gosh, if I don't ask right now, I'm gonna forget. No, you had your hand raised first.

SPEAKER_00 47:34

Oh, I might because we talk we've talked about this before it's like one of the signs of perimenopause, or maybe it's not a sign, it is hair growth all of a sudden. You're like, you have chin hair or uh, you know, women growing a mustache. So if you go on testosterone and you're already growing, like sorry. Oh, it means it's gonna get worse. Like I said, we're weep, we're I'm gonna be. But why do we grow? Like if we're losing testosterone, why am I growing hair? Shouldn't it be going the opposite?

SPEAKER_01 47:59

I mean, technically, yes, it should, but I mean it's just a matter of your hormones falling off the thin.

SPEAKER_00 48:07

So they said, let's decide to to grow hair. Where you shouldn't I don't know if I'm a good candidate for this. Get friend, get a waxer.

SPEAKER_01 48:16

Get get your friend, get yourself an IPL, a personal IPL laser. Oh yeah.

SPEAKER_04 48:21

Can can I just tell you for people who with PCOS or PRS, like it does not work on your face.

SPEAKER_01 48:27

It it it it really doesn't. I will tell you that I have many PMOS patients, and we I mean, they're highly dosed. I mean, they're dosed fairly high with testosterone because their body is used to having that much testosterone.

SPEAKER_04 48:42

Oh, okay, well.

SPEAKER_01 48:43

So when they so typically when a PMOS patient comes in and we do their initial lab work, their testosterone is gonna come back and it's gonna read probably untreatable for us because there's a certain level where I can give you as much testosterone as you think, but it's not going to make you any better because the where you are and where you're going is not that far apart. With PMOS, they're a totally different story because you are used to having a high amount of testosterone. So when you drop, you drop to what looks good, but that's what not what your body needs.

SPEAKER_04 49:18

No.

SPEAKER_01 49:19

Does that make sense?

SPEAKER_04 49:20

It does. I was just hoping I wouldn't have to wax my chin weekly anymore, but like that's gonna be a life. I I've already told my children, like, if you have to put me in a home, I'm going to need you like to slip, you know, a nurse or an orderly or somebody something that they're like, you know what? Even just like one of those like like little face trimmer things. Like, I just I don't want to be the person you come to visit and I've got like a full beard. And for me, and this is a weird, like this is a TMI thing, the left side of my face pre creates more hair than the right side of my face. And now every mole on my body is producing hair. It's like I'm like, I'm like, which for what is happening? Abby is like always like playing with my arm, and I'm like, is it growing again? I just took care of this three days ago, and it's like I have an inch long hair on my body now that I'm like, I w why are the I don't understand why the the hair that is not supposed to be there grows at rates so much faster than the hair that I do want to grow. Yes, like the on your head. I do not understand.

SPEAKER_01 50:18

It is unfortunately part of it. Just part of it.

SPEAKER_04 50:21

Yeah. You did you had a question? Okay, let me see if I can remember. I knew this was gonna happen. This is what the brain thought.

SPEAKER_00 50:28

Well, I mean, we were talking about insertions, testing. Okay.

SPEAKER_04 50:31

Oh, okay. So we are talking about hormone therapy, and I know we've landed a little bit on like GLP1 things. So in your office, is this something because I kind of feel like these things work hand in hand. Because do hormones help with the other things, or we still kind of need that extra? You need the extra.

SPEAKER_01 50:49

So hormones are not going to help with weight loss. Okay. What hormones do is give you the energy and the ability to build muscle again, so you get body composition changes. So your body will burn fat easier, will get rid of the visceral fat, which is the the bad fat that's in between your organs. It's so there, it's as a side effect, you may lose weight, but what happens is you become more solid and more stable. So we're building muscles so that your bones stay strong. So we're avoiding, we're trying to prevent osteoporosis.

SPEAKER_04 51:27

And that was, I'm I my mom had, you know, kind of talked about like when she was talking to her doctor about the the things and he told her that like it's really important that you do strength training now. It is. Because that's going to what's going to protect your bones.

SPEAKER_00 51:41

So it's just not walking.

SPEAKER_01 51:43

No. And you hear we'll hear that a lot. You know, oh, I walk, you know, two miles with the dogs. Great. Great. If you were sedentary, it would make a difference. But walking two miles with the dogs, if you can carry on any kind of conversation while you're walking, it's not effective. Number one. You should not be able to talk or sing. If you can, pick your pace up.

SPEAKER_04 52:05

Okay, I'm feeling a little called out. Oh, that was unintentional. It's okay. I know it's unintentional, but I it it's one of those things that I'm like, I know I have lost a considerable amount of weight, and I mainly do walking. Like I made and it's helped me. Yeah.

SPEAKER_01 52:20

But I'm, you know, so what I'm also so what cardio does is it's gonna help reduce the number of calories that your body needs for the day, right? Or it actually increases it so that you have more wiggle room with your calorie count for the day, right? Yeah. What weights and resistance do is help burn body fat and help build muscle. So as we age and we stop producing the hormones that we that helped us keep our muscle mass, adding weights and resistance is is really important because we're trying to prevent osteoporosis, right? Especially in women with the lack of estrogen. So the only way to keep your bones strong is to make sure that your musculature can keep them strong. And the only way to build your muscles is weights and resistance.

SPEAKER_00 53:10

So it it's a it's a whole combination of when we're older, like that can really help us is one hormone therapy. So what what is it? HMT, is that what was that?

SPEAKER_01 53:20

HRT.

SPEAKER_00 53:20

HRT, cracked.

SPEAKER_01 53:22

Hormone replacement therapy.

SPEAKER_00 53:23

So HRT, if you're on a GLP one, great. Great. Love it.

SPEAKER_01 53:28

Yes.

SPEAKER_00 53:29

If you're on if if you're on the one that works for you. Yes. And also healthier diet and working out. Yeah. I mean Which seems like a lot.

SPEAKER_04 53:41

It does. It does. I mean, I was just thinking of, okay, well, I know for me, like, you know, the, you know, just speaking of strength training, you know what I mean? Like, I mean, gosh, like I feel not confident to be able to do it. It does feel like it's a good thing. You know, because it's because to me it feels scary. Like I need somebody. And then it's like, okay, with the additional cost. You know, it's like confidence and cost.

SPEAKER_01 54:01

And like so it does not have to be anything crazy, right? You can go to TJ Maxx and get some resistance bands. And there are free seven-minute videos on YouTube on how to do resistance bands at home. And that's enough starting out. I mean, that's enough. Okay. A five-dollar resistance band and you know, a video off of YouTube, we have all of So it can still still walk, like still.

SPEAKER_00 54:26

Oh, absolutely.

SPEAKER_01 54:27

Don't stop your cardio.

SPEAKER_00 54:28

Yeah. But add in some resistance.

SPEAKER_01 54:30

I always tell people get some two-pound ankle weights or get some two-pound wrist weights. And then when you're walking, that's good. That's that is you're adding things in. You're adding things in, correct.

SPEAKER_04 54:41

Okay. So I think for people listening, and also for my brain, it's like because I'm a very all-in personality. Once I'm committed to an idea, I'm like, I'm all in. Sure. And I that is a blessing and a curse. Sure. So in my mind, I'm like, I need, I need a personal trainer.

SPEAKER_01 54:57

I need I need all the, you know, like you can do all of it on your own at home without any exercise.

SPEAKER_04 55:01

So that piece you can do on your own. Absolutely. But the hormone replacement, do not go find synthetic things online.

SPEAKER_01 55:08

That is a true story. Well, and I hear a lot of people, and no offense to those that are out there that have these products that, you know, increase your testosterone or increase this by taking, you know, this supplement, that supplement.

SPEAKER_04 55:22

Supplements are not FDA regulated.

SPEAKER_01 55:24

They're not FDA regulated, so you don't know what you're getting from pill to pill. You don't know what you're getting from bottle to bottle. And they don't have to be the same. Like each pill, your capsule does not have to be the same because they're not FDA regulated. The other thing is that we can give you things all day long that help free up testosterone in your body so that it's more usable. But the fact of the matter is you are never going to make more. Once you cross crest that hill, your body will never make more hormones. So I hear a lot of people that come in and they're like, oh, hormone therapy, bioidentical hormone therapy is gonna shut my own production down. True. That is absolutely a true story. We are going to shut your own hormone therapy down by giving you exogenous or hormones from the outside, right? And then they say, and I'm never gonna make my own hormones again. Well, that's not true, right? So if you think about the bell curve, right? And let's say you're five years past the crest of your your bell curve, and you start hormone therapy, and you go on here on hormone therapy for nine years, where I am, you are not five years past the crest anymore. Now you're 14 years past the crest. So you're right, you're not going to produce as many hormones as you did when you went on therapy because now where you are on the bell curve is naturally just less hormones because you're at the tail end of that bell curve. So it's not that hormone therapy or hormones are going are are going to cause you to stop making your own permanently. It's that you naturally are just going through that aging process where you aren't going to produce any anyway.

SPEAKER_04 57:06

So I feel like I could ask you a hundred more questions, but we are like nearly out of time. Oh, are we really? Yeah, I just checked the time and I'm like, oh my gosh, I just feel like I'm learning so much. So we're going to have to have you back for sure because I didn't hear any dirt on Casey.

SPEAKER_01 57:21

Oh, I've got all the dirt on Casey.

SPEAKER_04 57:23

So we're gonna have to do a follow-up part two.

SPEAKER_01 57:26

But you should ask Casey about being a pterodactyl one day.

SPEAKER_04 57:29

I love it. Mental note that I will probably forget later. But let me just ask you like just one last thing. So we are located in northern Kentucky, which is the greater Cincinnati area. Right. So I want you to give the information of where we can find you if we're if people are in similar boats to we are thinking, like, okay, I think this can help me. And if we have a large audience that is not in this area, where can you steer them to find the best practice that's going to be similar to what you do? Like, what would be the things that they should be looking for in a provider to start navigating down this road?

SPEAKER_00 58:05

And my question is with you guys, they can go to a consult for free, right? They can come talk to you and just get correct for free.

SPEAKER_01 58:13

Correct. What's and what's really cool about our practice is that we are run by an OBGYN. Our medical director is an OBGYN. So our women feel very, very comfortable coming to see us because he is a board certified OBGYN.

SPEAKER_04 58:27

Are we allowed to say his name? Because we just totally said his name.

SPEAKER_01 58:30

I mean, you can.

SPEAKER_04 58:30

I mean, if you look it up, you're gonna see it. His name's right on the sign.

SPEAKER_01 58:33

It is it is on the sign out, friends.

SPEAKER_04 58:35

He did, he did he delivered one of my babies. Yes. No, he did.

SPEAKER_01 58:37

He sure did.

SPEAKER_04 58:38

So he's not allowed to deliver mine.

SPEAKER_01 58:39

He was not allowed to deliver mine.

SPEAKER_04 58:41

We know him well.

SPEAKER_01 58:42

Well, he delivered mine. We did. Yeah. Yeah. So he's not allowed, he was not allowed to deliver mine.

SPEAKER_04 58:47

Oh, it's such a small world. Small world. I'll tell you stories later.

SPEAKER_01 58:50

So I can only imagine. God love him. Um, so in addition to Dr. Crawford, we also have two other OBGYNs that moonlight with us. They're all so our women feel very, very protected and covered as far as their gynecological health is concerned with us.

SPEAKER_04 59:09

Which makes a huge difference.

SPEAKER_01 59:10

So again, this is We are in Edgewood, Kentucky, off of Turkey Foot Road. It is Figure Vitality. So, what would be a website that would be like a really FigureVitality.com.

SPEAKER_04 59:20

Okay. And by going through that, they're going to be able to find links and resources for a consult for all of the things.

SPEAKER_01 59:28

Absolutely. There's there's a link for consults or for making an appointment for a consult. There's information, obviously, about what we do and how we do it and why we do it. Sitting down with one of the providers, there are two other one PA and another nurse practitioner that do hormone therapy with us, with me and Dr. Crawford. They're phenomenal ladies. And we all are probably over-educated in what we do because we are so passionate about what we do. So sitting down with us and just having a conversation is really kind of important because we all our plans, there it is not one size fit all fits all. Like we are at every dose and every consultation and every bit of hormone therapy is unique to that patient that is walking in the door.

SPEAKER_04 1:00:19

I love that you said that because it's not like we're just gonna dose you up and shoot you up with something that it's not a standard thing. It is going to personalize to exactly where you are, which is why you need to get your labs done, Casey. So I know I need to get my labs done. So, but but let me just say that like now for the people who are not located in our area, what are the things they should be looking for in a provider that you guys excel in that is going to be super important to making sure they're getting the best care?

SPEAKER_01 1:00:46

So you really want somebody who is backed by an educational company. There are several that are out there, three that I know of that are the big ones. I'm not going to name them by name because I have not gotten permission from them to name them by name. But there are three big educational companies. So they come in, they train you, they give you all of the education behind why we do what we do. They provide the clinical decision-making software, they provide all of all of the training that the providers go through. And it is constant, I mean, it is constant.

SPEAKER_00 1:01:22

We are constantly but but providers, I think that's the big thing. You want to make sure that you're going to somebody who is actually a a a physician. Or a nurse practitioner.

SPEAKER_01 1:01:33

Like somebody who is a provider. Well, and the key is to remember that testosterone is a controlled substance. So at least in the state of Kentucky, you have to have a physician over top of us. We have to have a physician that signs off on everything that we do. Uh because testosterone is a controlled substance. Uh that's just part of the nursing, nurse practitioner uh rules of the state, whatever. Uh but I mean the kicker is you need to find a provider that is trained by somebody professionally that has an education through one of these companies, or, you know, these three or another one, where they are and they are constantly being updated and doing constantly doing education to keep their certification up. You need somebody who is going to listen. There's a lot of people that uh just like you said, throw pellets in people or throw cream at people, and your labs come back and they, you know, sure, they look great. See you bye. Well, we don't base all of our treatment on labs. We drive a lot of what drives when we change therapies or we change dosing on patients is because of the way they feel. And that's how functional medicine is really driven, is symptom-based. We're really preventative medicine as opposed to traditional Western medicine, which is which is reactive. We wait for you to get sick and then we treat you. Our goal is to prevent you from ever getting sick to begin with.

SPEAKER_04 1:02:57

Well, I I love that. So, I mean, I guess we probably need to just close this out for today because we are out of time. Even though that we have so much more, and I'm I'm getting so and I have so many more questions. We'll just we'll have to follow up another time. We sure didn't. But what I did get out of this is this is a good reminder that you as a person are not falling apart. Yeah, well, your wheels may be falling off for feeling like it, but this unfortunately is normal. It is and fixable. And fixable. That's which things I think maybe we just feel like maybe we have to get to that menopause and then maybe it will fall, you know, like it'll get better. But you know, I think what I'm hearing is you have to stay on top of these things. So if you're like me, if confidence or cost is like the thing that's been prohibiting you from doing things, a conversation is free.

SPEAKER_01 1:03:47

Conversation is free.

SPEAKER_04 1:03:48

So if you It's not gonna hurt to talk to someone, it's not gonna hurt to talk to someone. And I also think it's like important for you to talk to your partners of like, you know, like, hey, like, I know you think I'm going crazy, I might be, and maybe like like start opening those doors of opening those lines of communication to figure out what's going on here. So thank you so much for coming. Yeah, thank you. I it's my pleasure. I'm gonna need you to stay for 10 minutes off air so I can get some more dirt. Listen, if you're sweaty, tired, and all these things, like you know, join the club and then um make a phone call because we don't have to live that way, is what I'm hearing.

SPEAKER_01 1:04:24

Correct.

SPEAKER_04 1:04:24

You do not love it. All right, we'll see you guys next week.