Latest / The Dr Louise Newson Podcast / 50 - Testosterone and breaking the stigma

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50 - Testosterone and breaking the stigma · The Dr Louise Newson Podcast

• 0:00
  You're going to really enjoy this episode with Doctor Kelly
• 0:02
  Casperson, who hopefully many of you will have heard of.
• 0:06
  She's a great advocate for testosterone in women.
• 0:10
  She was on the FDA panel recently and we talk about
• 0:14
  testosterone, what it is, what it does in our bodies, how it
• 0:18
  works in a basic physiological way, and also how women feel
• 0:22
  when they are prescribed the natural testosterone too.
• 0:25
  So enjoy it. Kelly Casperson, you are here,
• 0:31
  but you're not here, which is a real shame because I loved,
• 0:35
  loved being with you in Australia.
• 0:37
  You are my new friend, best friend forever.
• 0:39
  Because like me, you've got a really inquisitive mind.
• 0:43
  And I, I guess like me, you're quite happy to talk about things
• 0:47
  that you've learned, things that you might have got wrong in the
• 0:50
  past, things that you were taught at medical school, which
• 0:54
  now you know, we're not right, but also you've got a lot of
• 0:57
  clinical knowledge. And I, I find this with a lot of
• 1:02
  things, especially in health of women where there's seem to be
• 1:05
  very polarized views is that a lot of people that do a lot of
• 1:09
  the shouting and a really anti hormones, they never prescribed
• 1:13
  them and. That's true.
• 1:16
  There's two things I think which I want to unpick because we want
• 1:19
  to talk a lot about testosterone in this podcast, is that if I
• 1:23
  don't know something, I go back to basic Physiology and basic
• 1:26
  science. And then if I feel really down
• 1:29
  and I want to give it all up and I feel awful, I just do a day in
• 1:32
  my clinic and I do, you know, a good day week anyway, it's very
• 1:36
  busy. And I just say the
• 1:38
  transformational effects of hormones.
• 1:40
  So you have this dual effect, really.
• 1:43
  You have science supporting what you think, and then you have the
• 1:46
  art of medicine showing you what you think and learn is true.
• 1:50
  So I think we were both in a very privileged position that we
• 1:54
  can do both, can't we? Yes, yeah, yeah, absolutely.
• 1:58
  But I think, you know, if we'd had this podcast conversation 20
• 2:01
  years ago, well, I wouldn't even have it because I didn't know
• 2:05
  that women had testosterone. Like, that's madness, isn't it?
• 2:09
  Yeah, I didn't know it either. And I thought the other thing, I
• 2:12
  thought osteoporosis was a fixed state.
• 2:15
  Yeah, like, that was another thing.
• 2:17
  If, like, your bones are just osteoporotic, you can't do
• 2:19
  anything about it. Like that's another one that's
• 2:21
  coming up a lot. People just think it is how it
• 2:24
  is instead of bones react to the environment.
• 2:27
  So I was really freaked when I first learned that women had
• 2:30
  testosterone. But rather than thinking that's
• 2:33
  not true, I did what I always do.
• 2:36
  I went back to the basics and I learned a lot of Physiology
• 2:41
  about men and women because essentially our cells are pretty
• 2:44
  much the same and how testosterone works at a
• 2:46
  molecular level. And when I talk about
• 2:48
  testosterone, I talk about the hormone that we prescribe, which
• 2:52
  is the molecular copy of the testosterone we all produce, men
• 2:57
  and women, because it's the same, right?
• 2:58
  Isn't it the testosterone for men and women, but also what I
• 3:03
  have done, and I know you enjoy it, as well as looking back at
• 3:05
  the history of hormones, Because as soon as they discovered the
• 3:10
  molecular structure of testosterone, they
• 3:13
  commercialized it and they made a synthetic version.
• 3:18
  So when people are worried about testosterone, then the risks,
• 3:22
  they're actually talking about the risks of the synthetic
• 3:25
  testosterone, aren't they? Yes, that's right.
• 3:27
  I want to talk now about pure testosterone, the testosterone
• 3:32
  we make in our bodies and men make as well.
• 3:35
  Men make more than us, but we still make it.
• 3:38
  And it's a biologically active hormone, isn't it?
• 3:40
  Yeah. And it's made all over our body.
• 3:43
  It's made, obviously in our ovaries, but our adrenal glands,
• 3:46
  our brain makes it. Our muscles make it.
• 3:48
  It gets made everywhere, doesn't it?
• 3:50
  It's fun to talk about because so many people, they don't even
• 3:52
  know ovaries make it, let alone other body parts convert and
• 3:56
  make it to use locally. Yeah, I always like to go back
• 3:59
  to the basics of hormones, make healthy cells stay healthy,
• 4:04
  right That they work in in the nucleus, they help the
• 4:06
  mitochondria. As far as the brain goes, the
• 4:09
  glial cells, nobody knows what a glial cell is, but I have
• 4:12
  neuroscience undergrad. Glial cells are the support
• 4:15
  cells for the neurons. They help the myelin sheath of
• 4:18
  the neurons like testosterones everywhere in the body.
• 4:23
  But but a lot of people start the conversation too high of
• 4:26
  like, what's a good good for? What's it indicated for us?
• 4:28
  Like, understand what it does first, then we can talk about
• 4:33
  what makes sense of what. It's what it's good for.
• 4:35
  Yeah. And I think this is really,
• 4:37
  really important when we think about why we prescribe
• 4:41
  testosterone, because we know that there's all the talk about
• 4:46
  libido, sexual pleasure, Yeah, fine.
• 4:49
  We know that testosterone prescribing can help with that.
• 4:52
  But if you've just mentioned the myelin sheath, now some people
• 4:55
  might not know what the myelin sheath is, but it's like the the
• 4:58
  conducting part, it's the outside part of the nerve that
• 5:01
  helps our signals to go very, very quickly.
• 5:03
  So if I put my hand on a hot plate, I want my hand to remove
• 5:08
  quickly, but I'd only do that if the signal goes to my brain very
• 5:11
  quickly. And then the signal from my
• 5:12
  brain which says, oh gosh, that's hot, goes back down my
• 5:16
  arm and tells my arm to lift my hand off.
• 5:19
  And the myelin has to be very, there's lots of other reasons,
• 5:22
  but the myelin has to be good as we as we age, but also some
• 5:26
  autoimmune conditions. Obviously, we know multiple
• 5:29
  sclerosis, the myelin sheath gets damaged.
• 5:32
  So I put my hand on the hot plate, my myelin's not good.
• 5:36
  It's going to take longer for that signal, so therefore I'm
• 5:38
  more likely to burn my hand. So when you read, and there's
• 5:42
  lots of papers, I know you've read them as well, that shows
• 5:45
  that testosterone will help keep myelin healthy, build the myelin
• 5:49
  sheath, repair the myelin sheath.
• 5:52
  So then you suddenly start thinking, hang on a SEC, what
• 5:55
  about multiple sclerosis then? Is that more common in men or
• 5:59
  women because men have more testosterone than women?
• 6:02
  Oh no, it's more common in women.
• 6:04
  And then what about in men? Is it more common in men who
• 6:08
  have low testosterone? And Oh yes, we've got studies
• 6:11
  showing that men with low testosterone and more like this
• 6:13
  have multiple sclerosis. So then you're like, well, why
• 6:16
  don't all the neurologists know this?
• 6:18
  Why aren't we giving testosterone or measuring
• 6:21
  testosterone levels in people with multiple sclerosis?
• 6:23
  Very good question. When and neurologists.
• 6:28
  Why aren't neurologists curious about testosterone levels?
• 6:31
  Yeah, You see, it's so interesting, isn't it?
• 6:34
  When you, and this is where what you do in medicine, you, you
• 6:37
  start with a like an idea and a concept, then you go back and
• 6:40
  work it out. And then if it fits the way
• 6:43
  you're thinking, we should be exploding that and thinking more
• 6:46
  and teaching it. And I don't know why it's been
• 6:50
  ignored. I get cynical sometimes of like,
• 6:52
  because you can't make money off of testosterone because it's
• 6:55
  generic, because it's cheap, because you can't patent a
• 6:58
  hormone. I mean, if you look at how
• 7:00
  things are, how money moves science, right?
• 7:03
  Like culture and economic shape science, whether we want to
• 7:07
  believe that or not. And if there's no money in it,
• 7:11
  who's going to fund it? Unless it's got government
• 7:14
  that's funding it, right? Which I, which I would say the
• 7:16
  health of a nation is very important and worth funding.
• 7:19
  But the other problem with testosterone is we've said only
• 7:21
  one gender has it right. We've, we've made it binary.
• 7:25
  So we've people like we don't have the data in women literally
• 7:28
  because nobody's studying women. Yeah, anything.
• 7:31
  What's really interesting about that?
• 7:34
  But you're right, because people don't study women because we're
• 7:36
  too complicated because of our hormones.
• 7:38
  But there is very little data about the use of, I don't know,
• 7:44
  statins in women, for example. So the guidelines for women has
• 7:48
  been written on the evidence from men, and that seems fine.
• 7:52
  We can do that or blood pressure treatments or you know, any
• 7:55
  treatment. Sleep.
• 7:56
  Sleep Medicine. Yeah.
• 7:57
  So anything is always based on a 70 kilogram man.
• 8:01
  And so that's fine. We do that.
• 8:03
  No one argues. Whereas if we say, oh, we're
• 8:06
  looking at all the data of testosterone and men and we want
• 8:09
  to equate that with women, you're like, no, no, no, we've
• 8:11
  got to do the studies and women, which we know for, well, we'll
• 8:13
  never do. So that seems a bit weird,
• 8:15
  doesn't it? And it's a it's a bias that you
• 8:18
  know is worth pointing out because once you point it out,
• 8:22
  it clicks like, you know, once you point it out, it clicks in
• 8:25
  people's brains And like, wait, the other very interesting thing
• 8:28
  is Parkinson's disease, right? So testosterone and estrogen
• 8:31
  help the dopamine pathway to Parkinson's is a profound
• 8:35
  lowering of dopamine in a certain portion of the brain.
• 8:38
  Looking at testosterone in helping Parkinson's and off
• 8:42
  possible prevention, right? And we know in men because we
• 8:47
  have the studies low testosterone correlated with
• 8:49
  depression and dementia. These are all brain things going
• 8:53
  back to the role of testosterone in the brain, right?
• 8:56
  If brain cells work the same, I think the same is true for
• 8:59
  women. It's just very hard to do a long
• 9:02
  term testosterone study for dementia prevention.
• 9:05
  But like biochemically and extrapolating the male data, it
• 9:09
  makes sense. And my other question is when
• 9:12
  dementia effects, you know, 2 * 2 to three times the amount of
• 9:16
  women than men, women carry the burden.
• 9:19
  It's incurable. Treatments are awful and
• 9:22
  expensive. Why aren't we doing everything
• 9:25
  we can to try to figure this out and to try to preserve brain
• 9:29
  health? Like that's my big view of like
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  we don't have any data to throw. It's dangerous and we have some
• 9:35
  good knowledge to show it's beneficial.
• 9:37
  Why can't we take that great leap?
• 9:39
  We're never going to do a randomized placebo-controlled
• 9:42
  trial looking at exercise versus placebo for dementia prevention.
• 9:46
  We're never going to do it, but we always say exercise is
• 9:49
  dementia prevention. It's so true and it's so obvious
• 9:52
  as well. And, and I know Professor John
• 9:55
  Studd, he's, he's now died, but he was a great advocate for
• 9:58
  hormones and did some really great research in the in the
• 10:00
  1980s and 90s. And I remember him saying to me
• 10:03
  ages ago when I sat in his clinic once, he said, Louise,
• 10:06
  you don't always need a randomized control study.
• 10:10
  They sometimes it's so obvious that we just don't need to do
• 10:13
  it. When they discovered that
• 10:15
  smoking was associated with lung cancer, they didn't do a
• 10:19
  randomized control study to prove the harm.
• 10:22
  When they discovered penicillin and they knew how it worked in
• 10:25
  the body, they didn't do a randomized control study.
• 10:28
  And that's the same with natural hormones.
• 10:30
  The problem is the only randomised controlled study we
• 10:33
  have with HRT is with the synthetic progestogens, which we
• 10:37
  know have risks and medioxia progesterone acetate, which is a
• 10:42
  synthetic progestogen, but but with testosterone, there are
• 10:47
  smaller studies. There are a few randomised
• 10:48
  control studies. There's lots of observational
• 10:51
  studies. You, you know, even in 1940 they
• 10:54
  were doing some studies on women and men with testosterone.
• 10:58
  I think the other thing is because testosterone is so
• 11:02
  integral, it's so it's myelin sheaths, glial cells,
• 11:05
  mitochondria. It's not specific like for a
• 11:09
  shoulder problem, right? And the problem with that is
• 11:12
  when you give women and men testosterone, they say I feel
• 11:16
  more like myself. I have more motivation, the
• 11:20
  things they say, because that's an integral part of your being
• 11:23
  and your functioning. Those things are almost too soft
• 11:27
  for medicine, right? Like I can measure your blood
• 11:29
  pressure, I can X-ray your spine.
• 11:32
  I can't say Louise feels more like Louise, right?
• 11:36
  But but these hormones are so integral.
• 11:39
  That's the things they help with.
• 11:40
  I feel like more like myself. I'm more interested in the
• 11:43
  world. These are brain things that were
• 11:46
  very hard to study. And I so I think it gets
• 11:49
  dismissed of like you can't use hormones for quality of life.
• 11:53
  And I'm like, brain health is quality of life.
• 11:56
  I totally agree. Does that make sense?
• 11:59
  Like it gets dismissed because it's so integral and it acts in
• 12:02
  everything. This has happened with a lot of
• 12:03
  hormone research and This is why it went back and to just looking
• 12:08
  at fleshes and sweats. Because if you had a hot flush
• 12:10
  in front of me and I was a researcher, I could see your hot
• 12:14
  flash. I could, you know, see, but I
• 12:16
  can't see you smile in the same way.
• 12:18
  I can't see that internal thing. And even now I see people
• 12:22
  talking about the testosterone research and say, well, it's
• 12:24
  just a placebo effect. Now, firstly, you know, so many
• 12:29
  women benefit from testosterone. I don't think it's just a
• 12:32
  placebo. And also there are lots of
• 12:34
  symptoms that improve with testosterone that people aren't
• 12:37
  expecting. So a lot of people say to me,
• 12:40
  gosh, my muscle and joint pains improved, my sleeps improved, my
• 12:45
  migraines have improved. Like they weren't expecting
• 12:48
  that. I can think quicker, yeah, which
• 12:50
  is very hard to measure. How do you measure?
• 12:52
  Somebody thinking quicker? No, I, I totally agree.
• 12:55
  And it's, it's little things like I just find that life's
• 13:00
  easier. I'm not, I'm not overwhelmed as
• 13:02
  much. I I don't hit a wall at 3:00 PM
• 13:04
  is what a lot of people say, right?
• 13:06
  How do you study that? How do you study not hitting a
• 13:08
  wall at 3:00 PM? These are, and my point is
• 13:12
  there's these hormones are so integral to how the body
• 13:15
  functions that it's almost hard to study it because the human is
• 13:19
  just feels better. And let's go into that.
• 13:22
  Placebo #1 statins have a placebo effect.
• 13:26
  Nobody knows that. Number 2 SSRIs, the big studies
• 13:31
  say they probably don't work much more than placebo.
• 13:35
  And 25% of American women are on an SSRI.
• 13:40
  So that, so that dismissing testosterone because it's a
• 13:43
  placebo effect makes no logical sense when we've got 25% of
• 13:47
  American women on something that doesn't work much better than
• 13:50
  placebo and we don't blink an eye.
• 13:53
  We, we also don't have much long term studies on, on SSRIs and
• 13:57
  stat you, you give people a statin and, or, or a placebo
• 14:01
  statin and their cholesterol actually goes down.
• 14:03
  Why are we looking into that, right?
• 14:06
  Like so the the placebo argument to me falls apart so quickly.
• 14:10
  You're absolutely right. And I think it, it, it just
• 14:14
  feels like people are scared of testosterone.
• 14:17
  And I don't know whether they're scared because women are
• 14:20
  stronger and better and happier or, or the other thing is, is
• 14:25
  this confusion about the synthetic testosterone?
• 14:27
  Because we know that they chemical testosterones that are
• 14:31
  made in a very different structure do have risks
• 14:35
  associated with them of heart disease and, and, and clots.
• 14:40
  But when they made them, and like going back to your point
• 14:43
  about money, as soon as they found the structure of
• 14:47
  testosterone in the late 1930s, they wanted to make chemical
• 14:53
  estrogen, a chemical progesterone, chemical
• 14:55
  testosterone. And as you probably know, they
• 14:58
  were trying to make a chemical progesterone and they were
• 15:01
  testing it on the womb because of course, with women, it's
• 15:04
  always about the womb and bleeding.
• 15:06
  And they, they did, they saw it didn't have the same effect as
• 15:09
  progesterone on the womb, but it had other effects on muscles
• 15:13
  and, and various things. And then they thought, gosh,
• 15:15
  this is very similar to testosterone.
• 15:17
  So they forgot about progesterone and went straight
• 15:20
  to the testosterone substances that they made and pushed them
• 15:24
  to market very quickly. And now there's hundreds of
• 15:29
  different testosterones and some of them are an anabolic
• 15:33
  steroids, of course, and a lot of them have side effects.
• 15:36
  And once certain communities got hold of them, it had a really
• 15:40
  bad rap for for hold of testosterone.
• 15:44
  And that's a real problem. Isn't it?
• 15:46
  I joke now because it's so silly at this point, but I'm like the
• 15:49
  American, you know, political community did not like East
• 15:55
  Germany winning gold medals in the 1980s at the Olympics.
• 15:58
  And so an act of Congress, truly an act of Congress passed the
• 16:02
  Anti Doping Act of 1991. And that's why testosterone is
• 16:06
  on, because of doping swimmers in the Olympics.
• 16:09
  And there's a lot, there's a lot of doping in sport.
• 16:13
  Nobody wants that that I get that they're trying to control
• 16:15
  it. But what happened is they took a
• 16:17
  hormone your body naturally makes and they put it on our DEA
• 16:21
  list along with ketamine, Tylenol, with codeine, and now
• 16:25
  you need ADEA license. And that's where the reputation
• 16:28
  of this is dangerous because why else would it be on this list?
• 16:32
  It's on the list because of sport doping.
• 16:35
  And Laura knows I, I always joke, I can't make you an
• 16:37
  Olympic gold medal pole jumper on female dose testosterone if
• 16:41
  there's going to be other anabolics in there, right?
• 16:44
  And so there and there was when the Olympics, lots of anabolics,
• 16:47
  but this one natural hormone got thrown on the list.
• 16:50
  I do believe we are working to get it off the list to
• 16:54
  destigmatize the fact that this is not a threat to life at
• 16:58
  normal physiologic doses. And that's all we're talking
• 17:01
  about, keeping the doses from going low in life, not not
• 17:05
  doping, not trying to make you win a gold medal.
• 17:10
  So super excited to announce to you that my next book is now
• 17:14
  available for pre-order. It's coming out on May the 21st.
• 17:18
  It's called the power of Hormones.
• 17:21
  Break free from fear and misinformation about hormones
• 17:25
  and harness them for a healthier, happier life.
• 17:29
  It's very historical, it's very factual.
• 17:31
  It talks about how hormones work in our body and the mess that
• 17:35
  we're in actually when we don't have them.
• 17:37
  There's a lot of information, it's taken a lot of work and I
• 17:41
  really hope you enjoy it when it comes.
• 17:44
  So you can find out more about it on my website, on my social
• 17:48
  media and pre-order it. We've been doing quite a lot of
• 17:54
  campaigning over here to try and get it changed.
• 17:56
  And I have a few patients who, and some of them have been on my
• 18:00
  podcast, who are now having to make the really difficult
• 18:03
  decision to either give up their sport or take testosterone
• 18:08
  because they're very testosterone deficient and
• 18:11
  they're having lots of symptoms. But even if you take it at a
• 18:15
  really high level, just looking at the randomized control
• 18:18
  studies, we know that testosterone can improve libido.
• 18:22
  The women who I've been speaking to with very low testosterone
• 18:25
  have a myriad of symptoms, but they also have reduced libido.
• 18:30
  And so in my mind, it seems absolutely outrageous that a
• 18:34
  organization is saying that women who are professional
• 18:38
  sports players with low testosterone are not allowed to
• 18:41
  have an orgasm and not allowed to have sexual pleasure.
• 18:44
  Because that's basically, isn't it what it boils down to if
• 18:47
  they're if they're only looking. So we forget the feeling better
• 18:50
  in yourself. Forget the joint pain, forget
• 18:52
  the migraines, forget all the other symptoms.
• 18:54
  Just let's look at libido and orgasm.
• 18:57
  So how, how can a committee say that women are not able to have
• 19:03
  an orgasm because we can't give you the treatment that we're.
• 19:06
  Yeah. And they can take they can take
• 19:08
  estrogen as my understanding. Yeah, of course they.
• 19:09
  Can yeah, there's a bias in what hormone you're allowed to
• 19:12
  replace. Yeah.
• 19:13
  And so it's this is wrong and I feel sorry for the committee
• 19:16
  because I think they've been mis educated by the wrong people
• 19:20
  having this confusion between the anabolic steroids, which of
• 19:23
  course we don't even prescribe and we wouldn't recommend for
• 19:26
  people to take whether they're athletes or not with the natural
• 19:29
  testosterone where we're just replacing a hormone deficiency.
• 19:33
  To my understanding, no natural testosterone issues showed
• 19:37
  increased risk in breast, and in fact, Rebecca Glaser's work
• 19:40
  shows decreased risk of breast cancer.
• 19:43
  So whenever people say it was just like estrogen, right?
• 19:46
  Are you talking about oral synthetics or are you talking
• 19:49
  about, you know, natural transdermal?
• 19:51
  Because they're very different mechanisms.
• 19:54
  So when you talk about testosterone and the
• 19:55
  mitochondria, you talk about inflammation.
• 19:59
  It's very similar actually to a debate that's been going on for
• 20:02
  many years about testosterone and prostate cancer because
• 20:06
  people used to say, well, one of the treatments is blocking
• 20:08
  hormones for some people who've had prostate cancer.
• 20:12
  So therefore testosterone is bad.
• 20:14
  But now they know that actually if you have low testosterone,
• 20:17
  your prognosis is worse and giving testosterone back will
• 20:21
  improve the prognosis from prostate cancer and so.
• 20:25
  Yeah, that's right. Cancer, you know, obviously
• 20:27
  there are different types and different organs, but Rebecca
• 20:31
  Glaze's work is amazing, but it makes people think about
• 20:34
  testosterone. For people who've had breast
• 20:36
  cancer, there are no studies that show that natural
• 20:39
  testosterone increases incidents or of breast cancer or worsen
• 20:44
  survival if people have it afterwards if they've had a
• 20:47
  diagnosis. That's exactly right.
• 20:49
  And I think I mean it, it we know that grass roots can make
• 20:54
  things move mountains, you know, grass roots help to get the
• 20:57
  black box warning off of estrogen products in America
• 21:00
  very recently. And so I really think the the
• 21:03
  importance of conversations like this to to let people start
• 21:07
  thinking about what what we're currently doing.
• 21:10
  Does it make sense? Is it does it make sense to be
• 21:13
  afraid of this? Does it make sense to not
• 21:15
  research this? Does it make sense to not try
• 21:18
  it? If the risks are so low and your
• 21:20
  fear of dementia is so great, right?
• 21:22
  Like body autonomy and self, self, you know, advocacy of like
• 21:27
  education is the way for people to start thinking their way
• 21:30
  through this. Because just accepting the
• 21:32
  status quo, we've learned time and time again, especially in
• 21:36
  medicine, we're wrong a lot. We're wrong a lot.
• 21:39
  That's how we advance. And to be humble and curious to
• 21:44
  progress this profession forward is what is needed.
• 21:47
  Because if we just think we know everything that we know based
• 21:51
  upon what's available right now, history has proven us wrong 200
• 21:55
  times. Absolutely.
• 21:57
  And I think we can be humble and we can change and we can learn
• 22:00
  and we can advance. And, you know, we desperately
• 22:03
  need studies, but most studies are still funded by
• 22:06
  pharmaceutical companies. No one is interested in it chief
• 22:10
  as chips, testosterone. But but what we can do and what
• 22:13
  we're all doing actually is educating women to allow them to
• 22:16
  have a choice. And that's so important.
• 22:19
  And I just wanted to touch on FDA Kelly, because, you know, I
• 22:24
  felt a bit like your mother. I was so proud of you and
• 22:27
  Rachel, like, I was so tingly watching you stand there and
• 22:32
  represent millions of women because you're you're as cool as
• 22:37
  cucumber. Like, you must have been really
• 22:39
  nervous and you knew what you were doing was so important.
• 22:43
  And it just went to publicly. Yeah.
• 22:44
  Congratulate you because it's, it's, you know, and also two
• 22:48
  women you know. I think it says a lot when women
• 22:53
  are representing women. It was great, great honour, so
• 22:56
  exciting. I had tear, you know, I was
• 22:59
  sitting. I was like the I was the last
• 23:00
  one to speak and I was like, I was had to like get the tears,
• 23:04
  get the tears back because you got to speak next.
• 23:06
  Like it was very moving for me to be on that stage.
• 23:10
  Yeah, and it started a conversation, which is what's
• 23:14
  been needed for decades, actually.
• 23:17
  And I think we should be allowed to apologise and move on.
• 23:23
  And that doesn't happen enough. Actually in medicine, not, not
• 23:25
  just with hormones, but in general.
• 23:28
  People get greedy. Things changed.
• 23:30
  They, they, they, they're doing what they think is right
• 23:32
  initially, but then science might overtake or knowledge
• 23:37
  might overtake current practices.
• 23:39
  And that's fine, you know, So I think it's credible, amazing to
• 23:44
  be witnessing something in our lifetime where it's going to
• 23:47
  make such a difference. We're now in the post black box
• 23:50
  era and like this isn't this is the next one.
• 23:53
  Watch out for the patch shortages and the progesterone
• 23:56
  shortages because the women are coming wanting to try things to
• 23:58
  help them feel better and female dose testosterone.
• 24:01
  We don't have that in America. You know, you're lucky you have
• 24:04
  androfen. It's coming.
• 24:05
  It's on its way. I know it.
• 24:07
  I don't have a timeline exactly, but it's coming.
• 24:09
  It's got to, hasn't it? But you know, yes, we have
• 24:11
  Androfen that's become licensed in the UK, but we don't have any
• 24:14
  product. So it's just dangling a carrot
• 24:16
  and we can't prescribe it in the NHS but it is licensed.
• 24:22
  Like what? How did that help women?
• 24:24
  It didn't really did it. Wait, you mean?
• 24:27
  You mean it's licensed but it doesn't exist?
• 24:30
  Yeah. So at the moment in the UK we
• 24:31
  can only prescribe it privately, which we've done for many years,
• 24:34
  but the MHRA have licensed it, but we don't have any stock.
• 24:38
  So we can't actually prescribe it in the NHS.
• 24:41
  Wild. I know.
• 24:43
  We have we have you guys as the beacon of hope so.
• 24:45
  Well, I wouldn't. I wouldn't, I wouldn't because
• 24:48
  you know, the, the FDA response in like it blew up.
• 24:53
  Everything I saw on my social media was all about the FDA
• 24:55
  announcement. There was nothing in our media
• 24:58
  over here. Nothing like absolutely.
• 25:02
  I think it was firstly because it was good news for women.
• 25:06
  So if you will, standing on that stage to say we've got new data
• 25:09
  that HLT is more dangerous than we think it would probably be in
• 25:12
  the front page of our papers. I think media is very selective,
• 25:16
  we know that. But I think what for me is
• 25:18
  really disappointing is that the menopause societies in general
• 25:22
  have not come out with a really good statement.
• 25:24
  Some of them have been completely quiet and some of
• 25:26
  them have put out some very confusing messages.
• 25:29
  You know, we should be just reminding ourselves that all
• 25:34
  guidelines globally doesn't matter who's written them, say
• 25:38
  that first line treatment for menopause is HRT and they all
• 25:45
  mention testosterone and say reduce sexual desire.
• 25:50
  Some say this stupid hypersexual hyperactive sexual desire
• 25:55
  disorder HSDD which is just barbaric.
• 25:59
  It's just made-up. It's because all made-up.
• 26:01
  It is, but I think you know. Not to dismiss female sexual
• 26:05
  dysfunction at all. No.
• 26:08
  But to require, but to require a woman to have no, nothing else
• 26:11
  in her life going on to affect her desire before she can try
• 26:14
  testosterone? We don't say that with Viagra
• 26:17
  and we don't say that with male testosterone.
• 26:19
  No, but also it's not just that. They also say women have to be
• 26:22
  severely psychologically distressed for at least six
• 26:25
  months. Distressed.
• 26:26
  Yeah. I mean, what?
• 26:27
  Nobody wants to admit to that. Like, you know, we went into
• 26:30
  medicine to help people, so thinking about testosterone can
• 26:34
  improve quality of life isn't a bad thing really.
• 26:37
  Is it coming? Sometimes I wonder why I love
• 26:39
  testosterone advocacy so much because there's so many barriers
• 26:44
  to it. So like, I'm just, I'm like, I'm
• 26:47
  picking the most like forlorn hormone to try to advocate to it
• 26:52
  for because it has so many barriers against women getting
• 26:55
  its use. But once you, once you fully
• 26:58
  understand it, you're like, we can overcome all of this because
• 27:01
  this is all just myth, oppression, fear.
• 27:06
  Like it's, it's, it's an incredibly safe medication.
• 27:10
  I come back to them like doctors prescribe unsafe medications all
• 27:13
  the time because they perceive their benefits to outweigh their
• 27:17
  risks. That's what, at the end of the
• 27:19
  day, benefit risk, benefit risk. And with our natural hormones,
• 27:23
  the risk is so low and the benefit is so great that a woman
• 27:28
  really should have the opportunity to advocate and have
• 27:31
  that if she wants. Absolutely.
• 27:34
  It's a brilliant way to end the podcast thinking about that.
• 27:38
  So the three take him tips. I'm going to ask you now, what
• 27:42
  three ways do you think we can enable more women to access
• 27:47
  testosterone if they want it? Learn about their bodies, learn
• 27:50
  how it works, learn how to talk to doctors and learn how to find
• 27:54
  a doctor that is you know already does it right.
• 27:58
  We need to have enable women to go to a warm audience, right?
• 28:02
  And then and then train more doctors and clinicians.
• 28:07
  And we're doing that. But doctors and clinicians, at
• 28:09
  least in America are getting trained on hormones at a
• 28:12
  unprecedented rate right now. And I'm not just talking obese
• 28:16
  like I had AGI doctor text me yesterday being like nobody else
• 28:20
  is doing this. I see the need.
• 28:22
  I need to learn, right? So doc more and more doctors are
• 28:26
  getting trained. So I think that's it like
• 28:28
  education advocacy and then physician and clinician
• 28:32
  knowledge and education, the know how and we need an FDA
• 28:35
  approved. We need an FDA approved product
• 28:37
  because not that it's going to be absolutely superior, but it's
• 28:41
  going to blow open the conversation.
• 28:43
  It's going to give it a permission slip with which we
• 28:48
  don't have right now. Yeah.
• 28:50
  So let's hope we can all work together and keep this
• 28:53
  conversation getting busier and louder and help more women at
• 28:57
  the end of the day. So thank you so much for all
• 29:00
  your work, Kelly. Thank you.
• 29:01
  Pleasure to talk. And all your support and look
• 29:04
  forward to seeing you in the US sometime soon.
• 29:07
  Sounds good. Cheers.
• 29:09
  Thank you. Bye.
• 29:12
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• 29:15
  Every Thursday I'm going to be releasing an extra episode for
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  those of you that sign up. It's an opportunity that I can
• 29:22
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• 29:26
  research that I can share with you.
• 29:28
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• 29:31
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• 29:35
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• 29:42
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