Latest / Clearly Hormonal / Ep 01: My Love Letter to Women's Health

Transcript

Ep 01: My Love Letter to Women's Health · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to the Reset Recharge podcast with your host, Dr.
• 0:05
  Dr. Komal Patil-Sisodia: Komal Patil Sisodia, a board certified endocrinologist, internist, and obesity medicine specialist.
• 0:11
  Dr. Komal Patil-Sisodia: This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health, and recharge the conversations you are having with your healthcare providers.
• 0:22
  Dr. Komal Patil-Sisodia: While I am a physician, this podcast is purely for educational purposes.
• 0:26
  Dr. Komal Patil-Sisodia: No individualized medical advice is being given on this podcast.
• 0:29
  Dr. Komal Patil-Sisodia: If you do find information that is helpful, please discuss it with your healthcare provider at your next visit.
• 0:40
  Dr. Komal Patil-Sisodia: Hi everyone.
• 0:41
  Dr. Komal Patil-Sisodia: I'm Dr.
• 0:41
  Dr. Komal Patil-Sisodia: Komal Patil Sisodia.
• 0:43
  Dr. Komal Patil-Sisodia: Welcome to my new podcast called Reset Recharge.
• 0:47
  Dr. Komal Patil-Sisodia: I'm so excited to have you here today for our first episode, which I've titled My Love Letter to Women's Health.
• 0:53
  Dr. Komal Patil-Sisodia: Actually this entire podcast is my love letter to women's health.
• 0:58
  Dr. Komal Patil-Sisodia: I'm an endocrinologist by background and an obesity medicine specialist.
• 1:02
  Dr. Komal Patil-Sisodia: I've been in practice for about 15 years and I am seeing a trend in my office that is starting to freak me out a little bit.
• 1:10
  Dr. Komal Patil-Sisodia: As a woman in my 40s, I've noticed that my patients who are in the same demographic and going as young as 35 all the way up through their 40s and 50s are not getting answers when they go to the doctor's office.
• 1:24
  Dr. Komal Patil-Sisodia: A lot of times we're taught power through, muscle through, it will be okay.
• 1:28
  Dr. Komal Patil-Sisodia: And our symptoms of fatigue and hot flashes and joint pain, weight gain, all of those things are being ignored.
• 1:38
  Dr. Komal Patil-Sisodia: A lot of times women will end up in my office thinking, Gosh, I really hope it's an endocrine problem because then there's a fix.
• 1:45
  Dr. Komal Patil-Sisodia: And they hope that it's their thyroid or their adrenals and we do the testing and it comes back negative.
• 1:51
  Dr. Komal Patil-Sisodia: What nobody is talking to women about is that we're in perimenopause.
• 1:56
  Dr. Komal Patil-Sisodia: And these are symptoms of perimenopause, and that's something that we need to work on and impact now so that we can improve our quality of life over time.
• 2:07
  Dr. Komal Patil-Sisodia: The Women's Health Initiative hormone therapy trials that were published in 2002 have had a lasting impact on the quality of women's health.
• 2:15
  Dr. Komal Patil-Sisodia: And so, Unfortunately, that quality has been a decline.
• 2:19
  Dr. Komal Patil-Sisodia: When I was in my fellowship in 2007, my program director, Dr.
• 2:23
  Dr. Komal Patil-Sisodia: Lopresti, who is a brilliant endocrinologist and an amazing advocate for women, very much a he for she, sat me and my co fellow down to make sure we understood the ramifications of the study.
• 2:36
  Dr. Komal Patil-Sisodia: And we understood it on a clinical level.
• 2:38
  Dr. Komal Patil-Sisodia: We knew that it was a bad study design, that it looked at the wrong group of women, they used too high of doses of hormones, and they drew the wrong conclusion, which was hormone replacement therapy is bad for women.
• 2:50
  Dr. Komal Patil-Sisodia: We knew that we were taking women off of hormones right and left, and that is what everyone supported on the basis of this study.
• 2:58
  Dr. Komal Patil-Sisodia: But he was quick to point out something else.
• 3:01
  Dr. Komal Patil-Sisodia: He sat us down and told us, We're about to take away hormones from the women who fought for Roe vs.
• 3:06
  Dr. Komal Patil-Sisodia: Wade.
• 3:07
  Dr. Komal Patil-Sisodia: We're not going to give them to the next generation of women who are needed to carry on that fight.
• 3:13
  Dr. Komal Patil-Sisodia: And when Roe vs.
• 3:14
  Dr. Komal Patil-Sisodia: Wade goes back to the Supreme Court, which will happen during your lifetime, you will see it overturned.
• 3:23
  Dr. Komal Patil-Sisodia: That's a heavy statement.
• 3:25
  Dr. Komal Patil-Sisodia: And in 2007, I'm embarrassed to admit that I thought that it could never happen.
• 3:33
  Dr. Komal Patil-Sisodia: Well, June of 2022 rolled around and I was totally wrong.
• 3:38
  Dr. Komal Patil-Sisodia: And here we are.
• 3:41
  Dr. Komal Patil-Sisodia: So this podcast is meant for all of the women who are out there who are struggling right now, who are not getting answers.
• 3:49
  Dr. Komal Patil-Sisodia: My goal is to give you really good information so that you can take it back to your doctors and be empowered to have some really important conversations around your health.
• 4:00
  Dr. Komal Patil-Sisodia: Menopause is inevitable.
• 4:01
  Dr. Komal Patil-Sisodia: We will all go through it.
• 4:04
  Dr. Komal Patil-Sisodia: Some of us are currently going through it.
• 4:06
  Dr. Komal Patil-Sisodia: And it is not a fun place to be.
• 4:08
  Dr. Komal Patil-Sisodia: But, there are so many treatments that are out there in terms of either hormonal or non hormonal depending on whether you can or cannot have hormones based on your personal or family history.
• 4:21
  Dr. Komal Patil-Sisodia: We're just not talking about them.
• 4:23
  Dr. Komal Patil-Sisodia: Um, and I think it's very important that we start the conversation and we start shifting the narrative so that we can maintain control over our own bodies.
• 4:33
  Dr. Komal Patil-Sisodia: It's very, very important.
• 4:35
  Dr. Komal Patil-Sisodia: We have to stand up together.
• 4:38
  Dr. Komal Patil-Sisodia: One of my main motivations for going into medicine was watching my mom struggle with her health when I was younger.
• 4:45
  Dr. Komal Patil-Sisodia: When I was a senior in high school, my mom was diagnosed with coronary artery disease.
• 4:50
  Dr. Komal Patil-Sisodia: She had an 80 percent blockage of one of her coronary arteries that goes to the left side of her heart.
• 4:57
  Dr. Komal Patil-Sisodia: I was 17 at the time and I remember that she was having more difficulty just walking up the slope of our driveway and it wasn't that steep.
• 5:07
  Dr. Komal Patil-Sisodia: Her doctors were stumped, nobody could really figure out what was happening because she was so young at the time.
• 5:13
  Dr. Komal Patil-Sisodia: It took several months to diagnose her, and when they finally found the blockage, it was determined at that point that she needed to undergo a major surgery, where they bypassed the artery in her heart.
• 5:25
  Dr. Komal Patil-Sisodia: It's called a single vessel bypass.
• 5:27
  Dr. Komal Patil-Sisodia: So, my mom went through the surgery, and unfortunately, her post operative course, or course after she had her surgery, was really complicated.
• 5:36
  Dr. Komal Patil-Sisodia: She didn't heal quite as well, and her life was never really the same.
• 5:40
  Dr. Komal Patil-Sisodia: A few years later, when I was away at college, we got news that the graft had reoccluded.
• 5:45
  Dr. Komal Patil-Sisodia: And again, the doctors were stumped.
• 5:48
  Dr. Komal Patil-Sisodia: Why was this happening to my mom?
• 5:50
  Dr. Komal Patil-Sisodia: Well, additional testing showed that she had an elevation of a level called lipoprotein little a, which is a cholesterol particle that when elevated is highly associated with people developing blockages in their heart or what we call coronary artery disease.
• 6:07
  Dr. Komal Patil-Sisodia: It's, it's genetic and I have kept that in my mind for a long time.
• 6:13
  Dr. Komal Patil-Sisodia: So when I hit my mid 30s, I thought, gosh, I have this information.
• 6:18
  Dr. Komal Patil-Sisodia: I know my family history.
• 6:19
  Dr. Komal Patil-Sisodia: There's something that I can actually do about this.
• 6:21
  Dr. Komal Patil-Sisodia: Maybe I can prevent the same outcome that my mom had, maybe.
• 6:27
  Dr. Komal Patil-Sisodia: So I'm going to double down on the lifestyle that I'm preaching to my patients.
• 6:31
  Dr. Komal Patil-Sisodia: I'm going to.
• 6:32
  Dr. Komal Patil-Sisodia: I'm going to work out, I'm going to cook healthy, I'm going to eat mostly at home, I'm going to meditate, I'm going to do yoga, I'm going to do all the things to keep myself in a really healthy place.
• 6:45
  Dr. Komal Patil-Sisodia: And I did that.
• 6:46
  Dr. Komal Patil-Sisodia: I did that for five years.
• 6:48
  Dr. Komal Patil-Sisodia: And five years ago, when I had all of my levels checked, my lipoprotein little a was normal.
• 6:54
  Dr. Komal Patil-Sisodia: I did not have any evidence of blockages in my heart based off of a treadmill stress test and a specialized CT scan that you do to look at the arteries of the heart.
• 7:04
  Dr. Komal Patil-Sisodia: And I thought, great, this is awesome.
• 7:06
  Dr. Komal Patil-Sisodia: I'm going to kick some butt.
• 7:07
  Dr. Komal Patil-Sisodia: I'm going to do this and things are going to be great.
• 7:10
  Dr. Komal Patil-Sisodia: Well, this year I went to my physical and I am lighter than I was.
• 7:15
  Dr. Komal Patil-Sisodia: I'm doing all the things that I said I would do.
• 7:18
  Dr. Komal Patil-Sisodia: And you could only imagine my surprise when my lipoprotein little a level came back elevated.
• 7:25
  Dr. Komal Patil-Sisodia: I felt like I was failing at life.
• 7:27
  Dr. Komal Patil-Sisodia: My brain basically exploded and I thought, Oh my gosh, I'm going to suffer the same fate as my mom.
• 7:33
  Dr. Komal Patil-Sisodia: No matter what I do, this feels hopeless to me.
• 7:36
  Dr. Komal Patil-Sisodia: So I, I started to think back on what could possibly be different.
• 7:43
  Dr. Komal Patil-Sisodia: from five years ago to now, and a light bulb went off in my head, and I thought, oh my gosh, I am perimenopausal.
• 7:51
  Dr. Komal Patil-Sisodia: So I'm gonna go into this deep dive into the data to look at whether lipoprotein little a responds to estrogen And guess what I found?
• 7:59
  Dr. Komal Patil-Sisodia: It doesn't respond to statins, doesn't respond to diet, well if you go completely vegan it can.
• 8:06
  Dr. Komal Patil-Sisodia: If you, it doesn't respond to exercise and it doesn't respond to another class of medications called PCSK9 inhibitors.
• 8:14
  Dr. Komal Patil-Sisodia: But what I found was there were studies showing that lipoprotein little a responds to estrogen.
• 8:22
  Dr. Komal Patil-Sisodia: So I went and talked to my primary care doctor and she is wonderful and she said, you know what, you're right, let's try it.
• 8:28
  Dr. Komal Patil-Sisodia: I saw a preventative cardiologist who said, you know, you're doing all the things so we should definitely try this and there's data to back it up.
• 8:36
  Dr. Komal Patil-Sisodia: I finally felt a little bit at peace thinking okay, there's an option for me.
• 8:40
  Dr. Komal Patil-Sisodia: So I decided to go back to my mom and tell her about this and talk to her a little bit more.
• 8:45
  Dr. Komal Patil-Sisodia: And I came to find out that she had a hysterectomy about ten years before She ended up getting heart disease and nobody had discussed hormone replacement therapy with her.
• 8:56
  Dr. Komal Patil-Sisodia: Now, she can't remember whether she had her ovaries removed or not, but she was never on hormone replacement therapy after that.
• 9:04
  Dr. Komal Patil-Sisodia: And there are studies that show even if you have a hysterectomy to only remove your uterus and you leave your ovaries behind, you go into menopause faster than somebody who never had surgery at all.
• 9:16
  Dr. Komal Patil-Sisodia: That's kind of scary.
• 9:18
  Dr. Komal Patil-Sisodia: And you can't convince me otherwise that the two are not related, especially since I knew everything was normal beforehand.
• 9:25
  Dr. Komal Patil-Sisodia: So, in a quest for my own health, and for all of you, I am going to bring you episodes that help us look at what perimenopause does to us from head to toe.
• 9:37
  Dr. Komal Patil-Sisodia: I will be featuring some experts on my podcast.
• 9:40
  Dr. Komal Patil-Sisodia: I'm really excited to invite some of my colleagues here so that we can talk through all of the different changes that are happening from the lens of their specialty.
• 9:50
  Dr. Komal Patil-Sisodia: The good news is there are so many physicians out there who are finding the same thing and who are already in this space talking about perimenopause and menopause and what we need to do for women to improve their metabolic health.
• 10:04
  Dr. Komal Patil-Sisodia: Our quality of life matters.
• 10:07
  Dr. Komal Patil-Sisodia: It matters.
• 10:07
  Dr. Komal Patil-Sisodia: We have to show up for ourselves, for our families, for our friends, in the workplace.
• 10:16
  Dr. Komal Patil-Sisodia: It's hard to do all of that when you're not feeling your best.
• 10:19
  Dr. Komal Patil-Sisodia: So I think that if we all stand up together and we start pushing this narrative, things will change for the better.
• 10:27
  Dr. Komal Patil-Sisodia: We need to take our power back and knowledge is power.
• 10:30
  Dr. Komal Patil-Sisodia: Thank you so much for joining me today.
• 10:32
  Dr. Komal Patil-Sisodia: I'm really excited for our next episode of the podcast, which I've called Mother Nature is Not a Feminist, and you'll see why.
• 10:39
  Dr. Komal Patil-Sisodia: And we will go through the natural history of aging in women.
• 10:42
  Dr. Komal Patil-Sisodia: In the meantime, if you want to subscribe to get updates about upcoming podcast episodes, you can go to my website, resetrecharge.
• 10:51
  Dr. Komal Patil-Sisodia: com and subscribe to follow along.
• 10:55
  Dr. Komal Patil-Sisodia: Thank you so much for joining me for this first episode.
• 10:58
  Dr. Komal Patil-Sisodia: I'm so excited that you're here and I'm really looking forward to seeing you on future episodes.
• 11:03
  Dr. Komal Patil-Sisodia: Thank you and bye.