Latest / The Dr Louise Newson Podcast / 15 - Championing hormones, healing and strength with Christine D’Ercole

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15 - Championing hormones, healing and strength with Christine D’Ercole · The Dr Louise Newson Podcast

0:03
On my podcast today, I've got Christine De Cole, who is a
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master world champion in track cycling.
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She's also a Peloton instructor. We cover so much in such a short
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time. We talk about eating disorders.
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We talk about pelvic floor urinary incontinence.
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We talk about being put down as a woman and who you listen to
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and who you shouldn't listen to. We also talk about hormones and
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about testosterone, especially with sport loads to get into.
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And I just hope you really enjoy it as much as I did.
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So Christine, I am really super excited about doing this
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podcast. I've been waiting it feels like
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months for you to come. And obviously you're not here in
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the studio, but you're here in real life.
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And my husband has a, he got his Peloton bike in lockdown and he
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uses it, I don't know, 3-4, five times a week.
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He's really, and he's very competitive.
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So he knows that he's a lot better than all his friends.
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But I said to him, oh, do you know this lady?
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And he's like, what? Yes.
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So like, that's really great. And, and I actually do Peloton
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nearly every morning actually, but I do yoga and I get into a
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lot of trouble if I log on as him, as you can imagine.
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I of course, that's very don't do.
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That, but you know, exercise is so important.
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We know that that's just obvious.
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Like that's nothing about hormones, but it's still a man's
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world out there and men are expected to do certain exercises
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and women maybe shouldn't or can't or whatever.
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So you've really changed the narrative and what you're doing,
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which is wonderful. But just talk me through a bit
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about like how you came to be such an amazing cyclist, but
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also how you've come to work with Peloton and, you know, just
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get out there and share everything with people.
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All right, well, I could not have imagined this career
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growing up. I wanted to be a ballerina.
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And I was told, as as many young girls are told, your body's not
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right for the part. Specifically, I was told your
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thighs are too big. And how old were you?
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Yeah, we believe. Oh, gosh.
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I mean, this is going back. It is as far back as like
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9/10/11 being told that I didn't fit the part trying, you know,
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approaching puberty in the body is changing.
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And my dance instructor coming up and poking her finger in my
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stomach and saying suck in those marshmallows.
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And I look back at pictures of myself as a kid and it doesn't
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matter whether I was big or, or tiny, but the, the fact that we
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believe what we're told creates such dysmorphic realities in our
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minds and, and creates ingrained belief systems that some people
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never shake. Some people never shake.
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And it becomes what we tell ourselves, which is the most
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powerful thing anyone can say to us is what we're saying to
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ourselves because we internalize what other people say.
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So I took that and believed I am too big to be obviously be a
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dancer. I am too big to be lifted.
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I'm too big to be loved, to be successful.
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It translated into I'm too big for this world in a negative way
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and I tried acting. I moved to theater on
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recommendation from a therapist when I was 1516.
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The therapist came because I was doing everything I could to make
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myself smaller as a dancer. The eating disorder, the self
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harm, everything I possibly could.
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Stealing liquor from my parents basement.
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I mean, it was self medicating, self harming as a very, very
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young girl. And the therapist suggested
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theater that that might be a good outlet for me since dance
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was not working out. And I got myself into Carnegie
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Mellon University for the theater program, which I
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thought, you know, I am definitely on the right track
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now. This is a sign I can can act at
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any age, any size, any type. This is perfect.
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But one summer I caught a glimpse of a feedback form from
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an audition I did. And it said loved her
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Shakespeare, loved her comedy, that she's a little heavy in the
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thigh. And I, I, I remember seeing that
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and, and just like, felt like I got slammed to the floor.
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How could it be that I have all of these aspirations and dreams
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of I want to be on stage because I want to tell stories that
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inspire people. What the hell does that have to
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do with the size of my thighs? And like, it's a cruel joke to
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have all of this aspiration and desire to do something important
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and to be told that your body's problem.
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So when I can I just ask, when you, when you had your eating
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disorder, what what was happening with your periods
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around that time? Can you remember?
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I, I always had, pretty much always had.
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I think there was a brief period of time where it disappeared
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because I was, I was never good at starving myself.
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And I still hate. I mean even at 5 foot 6 I got
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down to 112 lbs which is thin. But it was still on your mind.
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I mean, the reason I'm asking is I, I see a lot of women and
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whose periods have stopped when they were younger, but we see it
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a lot when people then become perimenopausal or menopausal
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because the same hormonal changes occurring in the brain
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and so and, and body shape can change.
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Of course, when we are hormones alter.
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And, and you're really right, I think what you said really
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resonated. If somebody says something, it's
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really hard to erase, especially when it's something negative.
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Positive things can come and go, but it's negative.
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But, but these things, this come back and a lot of things come
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back when our hormones change. But there are lots of people who
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have eating disorders, their periods stop or there might be
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extreme athletes, but then no one's thinking about their
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hormones or they're giving them contraception, which is not the
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same as the natural hormones. And it's blocking testosterone
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as well, which can be a real problem.
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So it's, it's like a double whammy really, isn't it?
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You've got things going on and then it can affect your
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hormones, but then it can come back and haunt us when we're
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perimenopausal or menopausal. Yeah, the We're not taught
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enough about it as young women and we're, I, I suppose with,
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with birth control, as you said, it sort of messes up the
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process, a process that has an unfortunate state as we get.
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Hold of so then tell me about your cycling.
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OK, so I had been very attached to my bicycle growing up, all
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through dancing and all through acting.
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And I took my bike to college. I was very impatient.
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I did not want to wait for the bus.
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I could not stand that. And I would smoke a cigarette
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while I was riding my bicycle to class.
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And then I, I took a year off from college and I went to New
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York City and trying to learn the city, I got very, very
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terrified of the subway. I was sure someone was going to
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mug me. I mean, New York City in the
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1990s was very different. So I, I used my bicycle to get
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around. I learned this city on the top
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instead of underneath. And I got fired from a
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bartending job. And I was looking through the, I
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was giving away way too much liquor.
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I was looking through The Wanted ads in the newspaper and I saw
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careers needed. All you need is a bicycle and a
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chain, perfect. And a bag.
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No experience necessary. I'm like, this is perfect.
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I had no idea the world I was about to enter.
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It was, it's like a underground sort of Mad Max bicycles, New
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York City situation. And I was welcomed in and shown
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the ropes and I I changed my chemistry to be riding a bike
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for 8 hours a day to be constantly active pulls me out
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of a depression. There was 1 funny detail though.
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We had these walkie talkies and they gave us all handles.
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There was like somebody called Zippo, somebody called Bastoro,
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and they called me Legs. And I remember telling them, can
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you please just not call? I'm really like that.
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Just please give me another name.
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You're like, but why? Your legs are so fast, you're so
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strong. In fact, you should race.
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And I connected with some of the guys who raced and they showed
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me the track and that was it. I started winning races and
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suddenly this body that I have always been told was wrong.
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Wow, it was your secret power. Capable of being successful.
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I could be successful because of my body, not because of somebody
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else's opinion of my body. I could own that.
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You can't own someone else's wavering opinion.
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You can't own that kind of success.
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So that was a major revelation for me to in self acceptance and
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in changing the narrative of who I am and and who I'm capable of
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being. And kept racing.
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I did go back to school and then when I came back to New York
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City again after graduating, I was auditioning.
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I was trying to get cast in a show.
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I would also I was messengering again as I would be ready to go
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to an audition. In between delivering packages,
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I would sometimes fold up a skirt under my jacket and then
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I'd have packages in my bag. I'd lock up my bike, go up, do a
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Shakespeare audition and come back down and tell dispatch that
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I had a flat and sorry I'm late, I was trying to make it all
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happen. And then finally it became very
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clear that if I don't dig into racing now and we're going back
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to 969798, I was like, I've got a limited time to do this.
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That's what I thought at the time.
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I only have my 20s and 30s to race my bike.
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And so I told my acting agent, I'm going to, I'm going to
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pursue this now. And I did for a couple of years.
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And then I got pregnant with my daughter and I gained a lot of
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weight and I was finally actually was the big girl.
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Everybody was telling me that I was right.
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And I thought, well, it's really awesome that I've just, I
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discovered the unknown athlete in me.
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I know that I, I, I've done this thing and, but in order to raise
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my daughter a strong, confident female, I have really got to
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accept that I, I am the big girl.
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I really am the big girl now. And I need to celebrate that.
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I need to celebrate what my body can do.
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So I decided I'll become A plus size model.
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That's what I'll do for work. So I go to QVC and I auditioned
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and very much like that audition form from acting where they said
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she's great but her thighs are big, plus size modeling.
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They said we love your walk, we love your energy, we love your
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look, but you're not big enough and what's happening.
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They told me, though, that if I wore this set of pads, I could
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do the spring, I could do the fall and winter line, but not
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the spring and summer line because for spring and summer
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I'd have short sleeves on and my arms would look too small next
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to my body. So I did it.
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I didn't for a while. And every time you had to go on
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set, you had to stop and check in the mirror, make sure
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everything you know, your lapels were flat, your hat was at the
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right angle. And as you're walking into this
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mirror about to go on live TV, you're you're posturing proud
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and like psychological gesture where if you stand up proud,
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eventually you're going to create that sort of chemical
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sensation in your body. If you walk around hunched over,
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you can also exacerbate sadness. Your posture not only reflects
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how you feel, but you can change how you feel by changing your
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posture. And I feel like I, I
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strengthened my proud muscles. If that is right, it's possible.
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And it one day I was going up to that mirror to go on set and I
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caught my eye. I did a double take because
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something in me, I was talking to myself and suddenly I
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listened to myself and I told myself you've been missing the
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mark. There is no too big or too
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small. There's no too much of anything
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at all. It's it's all about you and and
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being your strongest. What makes you feel strong?
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I was like, I need to get back on my bicycle.
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I need to get back on my bike. It was a revelation.
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I finished the day I did not go back.
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And that's when I started teaching cycling and I years
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later got back into racing. And that's being racing as a
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master's athlete, realizing that there is a whole world for
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people. Master starts at 35 and up and
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to recognize you see how many fields of women in their 40s and
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50s and 60s. We even have a few 70s and 80's.
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The fields get smaller as we get older, but there's there's a
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place for us. Absolutely.
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And it changes what, like what I think of my mother's 53 and my
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53. These are completely different
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universes. And so I want to keep racing,
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right? This is the most empowering
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thing I do. I use bicycles at Peloton as a
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vehicle to help inspire people to think more deeply about what
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they're capable of. And, and by continuing to race,
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I hope I'm setting an example of that we might be able to be more
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active than we thought and, and make ourselves proud in more
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ways that we knew were possible. I've gotten quite a few women,
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grown adult women to try track cycling.
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And even if they don't get into racing, it's like at least they
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tried it, you know, tried something wildly different.
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It's, it's, it's great, isn't it?
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I used to cycle a lot when I was a student just because it was
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cheaper than obviously going on the bus.
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And I used to cycle for miles and love it, you know, but, but
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I've got a lot of patients who are in their 40s, fifties and
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started up racing and I've got covered in patients who are
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doing so well, but then their personal best times have
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dropped. They've been getting muscle and
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joint pains, they've been reduced stamina.
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They've realised themselves that they're having hormonal changes,
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they go on HRT, they feel a bit better, but their testosterone
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is in their boots really low. And if they're professional, a
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few of them are professional athletes.
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They're not allowed testosterone because it's not.
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Allowed. This is exactly where I'm at.
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And I have a real issue with this.
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And we've just done a paper that's just come out in a peer
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reviewed journal actually showing that women are really
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struggling. And I and people are now trying
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to decide between their career or having testosterone and it
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feels so wrong. And I, we've been sort of
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contacting various authorities about it and they're like, oh,
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it's on our committee meeting. It's not really our problem.
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But men can have a medical exemption certificate if they
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need testosterone. Women are allowed Easterdial,
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they're allowed progesterone, but they're not allowed
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testosterone because they're worried that it's an anabolic
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steroid and it might like really affect people.
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But the the synthetic testosterone that's injected is
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an anabolic steroid, but the natural testosterone we're just
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replacing. And I feel really sad because
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even if you just look at the data in women about
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testosterone, we know it improves libido.
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You know, that's that. No one's really arguing that.
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We also know it improves muscle and joint pain, it improves
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sleep, it improves mood, it improves stamina and so forth.
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But does that mean that women aren't allowed a libido if
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they're a professional cyclist with low testosterone?
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I am so very much with you on this.
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And I'm, I have been deep in the question of my knees.
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My back hurt. And you know, I'm on the HRT and
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there are, it's better sometimes, but I'm training and
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if I make one false move, I'm going to tweak that knee.
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I'm going to tweak my lower back.
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It's a whole you know how the body works.
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Absolutely. But but are you?
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Are you? Because of the chain.
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Yeah. And are you taking testosterone?
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No, because of racing this and I'm at the I'm at the crux of a
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decision. Like do I, if taking
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testosterone, the tiny amount to replace what my body naturally
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had when I did not have all these aches and pains?
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If that's going to improve my quality of life and help
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facilitate keeping my bones strong and avoiding osteopenia,
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osteoporosis, and help me maintain some muscle, then yes,
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that's going to improve my quality of life.
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And if. If I don't have those aches and
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pains, that will potentially improve my performance, but is
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that considered performance enhancing?
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Well, it shouldn't be, it should be.
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It should be just performance resuming really to what what you
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are. And it's a difference.
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You know, when we give testosterone, we're just giving
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it in a physiological way. So when I had low testosterone,
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I found my yoga practice very difficult.
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I had a lot of stiffness, a lot of muscle and joint pain.
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I had low stamina. I just, I couldn't be bothered
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really, you know, my, I, I felt quite flat and joyless, but but
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musculoskeletal really common. I had frozen shoulder a couple
20:59
of times, had steroid injection. I just didn't feel.
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And it's not just me. I see it with thousands of women
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that I see through the clinic and, and it improves and it's
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new, new surprise because testosterone works in our
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muscles. It works in our joints, it works
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in our in our brains really important.
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And I, and I can't really understand, you know, even if if
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you were 20 and you had your ovaries removed and your
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testosterone would then decline very quickly with that
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operation, you're still not allowed testosterone if you're a
21:29
professional athlete, which is just madness.
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I don't. I don't really get it.
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The three all, there's so many hormones in our body and they
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all work together. Like how do you like pick and
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choose? You can have these ones.
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You can have those ones because we said.
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Seriously, I mean, if you're, if you're low in iron, you can have
21:47
a little iron. If you're low in thyroxin, you
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can have thyroid hormone. Like they're not going to stop
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you having insulin as an athlete.
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But there's something about testosterone because there's
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misunderstanding of what it is and what it does, but it, it
22:00
feels really, really wrong. But so that we've got to do work
22:04
on that and I'm and I'm committed to trying to help
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because I, I feel very sad when I speak to women who are really
22:09
struggling. But the other thing.
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Because if I gave up cycling, that's I'm all, then I'm
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compromising my quality of life because I'm not doing the thing
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that brings me joy anymore. Absolutely.
22:18
But why should you? You're young, you're in your
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50s, you're not in your 90s. Like even then, like it
22:23
shouldn't be determined by your hormones.
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You know you shouldn't be. It's wrong, but the other thing
22:29
that you've been very vocal on when I'm very grateful and I'm
22:32
sure lots of women is, is just talking about your urinary
22:34
tracts, talking about. Incontinence.
22:37
Because, you know, lots of people don't want to talk about
22:40
their symptoms that they don't want to talk about, you know,
22:43
their libido or their vaginal dryness or soreness.
22:46
But urinary symptoms are really common.
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But they're so common, they're normalised.
22:50
You know, so many of my friends will say, well, I, I won't jump
22:53
or sneeze because I'm going to have a leak.
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But I'm like, why? Why aren't you using general
22:58
hormones? Why aren't you thinking about
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it? Oh, when I do my pelvic floors,
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but that's not enough. If you haven't got those
23:04
hormones in your pelvic floor, your urinary tracts and so
23:07
forth. But but you've been very out
23:09
there, haven't you? About your.
23:11
Urinary symptoms, you know, I, I did those box jumps at the gym a
23:15
couple weeks ago and I, you know, I, I think that I have
23:20
gotten so accustomed to not doing things that put me at risk
23:28
for leaking. That's I that day I just thought
23:34
I'm going to, I'm going to see if I can do these, see if I can
23:38
do the box jumps and wasn't really thinking about it.
23:42
And then I hop up there and I'm like, whoa, yeah, that's why I
23:48
don't do these. And I remember I, I did all
23:55
three sets. I was like, well, I'm in it now.
23:57
Like, what am I going to do? And I kept turning to the mirror
24:03
to the back to see if you could see.
24:10
And I finished the set because I was angry.
24:15
I was angry. I was really angry.
24:18
And, and I had other exercises that I had to do which would
24:25
have required me to sit on a machine to do my cable rows.
24:30
And I, I said I can't, I can't, I won't do that.
24:36
I'm not going to sit on the machine.
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I'm damp. That's not OK.
24:41
And my husband was still working out.
24:45
And I, I, I, I felt like I was on fire emotionally.
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I was so upset. I mean, felt humiliated.
24:53
I felt ashamed. I felt embarrassed.
24:57
And so I went out and sat in the car and I wanted it to journal.
25:05
I wanted to write about it. And I opened my phone to write
25:09
about it. And it occurred to me,
25:15
Christine, you should share this story.
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You know, you're not the only one going through this.
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And I said to myself, I, oh, this is too much.
25:23
This is too much. And then my other inside voice
25:29
said, no, this is exactly why you should share this.
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Oh, but you're going to come off like you're performing like, no,
25:36
this is really happening. And so I said, forget I'm doing
25:40
it. And I, I shared my authentic
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thoughts and feelings in that video.
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And I'm so glad that I did because the responses were
25:51
profound. I knew I wasn't alone, but
25:54
sharing that vulnerability made me realize it in like, you know,
26:01
by the stats, you're not alone by the metrics out there.
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But this, this was, I knew I was not alone because of their
26:08
stories, because they shared their stories with me.
26:12
And I said, my God, I had no idea that this was the response
26:19
I was going to get, but it seems like it's contagious.
26:24
It what? It's so common, and we've just
26:26
written a paper, actually, with some American doctors and nurses
26:29
and clinicians trying to change the terminology because we call
26:34
it GSM. You probably had genital urinary
26:37
syndrome of menopause, but it's not of menopause because
26:40
perimenopausal women have urinary symptoms, but also women
26:44
who've had a baby, women who are on the contraceptive pill, women
26:48
in general. You know, you don't have to have
26:51
a certain, but a lot of it is due to hormonal changes, but
26:56
it's not being picked up. So if you're on the
26:58
contraceptive pill that will block your natural hormones, it
27:00
will block your testosterone. If you've had a baby, your
27:03
hormone levels fall off a Cliff. If you're perimenopausal, your
27:06
hormone levels are changing. If you're menopausal, you have
27:08
no hormones. And these hormones, all three,
27:11
estudal progesterone, testosterone have really
27:14
important roles and functions in the pelvic floor, the bladder,
27:19
the ureter that the urethra that we, we out of all of this is
27:23
really crucially important. So you can be as fit as you like
27:27
and obviously you're super fit, but that's not if you haven't
27:30
got those hormones, the tissues will change and they won't
27:33
support the bladder in the same way.
27:35
The muscles won't be as strong, the collagen won't be there, the
27:37
blood supply won't be there. And that's a real problem.
27:41
And we know that although the majority of women with age will
27:45
have urinary symptoms around, you know, 5% or less will
27:50
receive vaginal hormones. So this is an HRT, this is
27:53
different. This is just, they go in the
27:55
vagina, but then they leak out obviously through to the
27:58
surrounding tissues with the bladder and they're very safe.
28:01
And we actually, I, I first line use something called prasterone,
28:05
which converts to estrogen and testosterone just locally in the
28:10
bladder and it reduces urinary tract infections, but it can
28:14
help with incontinence. So it's like I always, well, I,
28:18
I spend a lot of my life really frustrated because it's so sad,
28:21
the suffering, but even sadder for me as a clinician, knowing
28:25
that there's a treatment that's really readily available, that
28:28
you know, your followers, my followers, whereas people out
28:31
there will not be even offered, let alone be prescribed.
28:36
Exactly. I was just speaking with a woman
28:38
yesterday who all of these symptoms, she's in the
28:43
perimenopause state and she says she went to her doctor and
28:50
explained all the symptoms and she's like, it's normal.
28:53
This yeah, it's just aging. And but we don't have to know.
29:00
We don't have to age that way. No, we don't have to.
29:03
We don't have to just accept it and like, lie down and take it.
29:08
And you're so, you're so right, you know, I'm so grateful for
29:12
you being so open. But there's so much more we need
29:16
to do by just empowering women. And a lot of my work is really
29:18
about empowering women with knowledge and then they can make
29:21
choices that is right for them. So just before we end really,
29:25
because the sadly, we've got to wrap it up, but there's lots
29:27
more. I really want to ask you, you
29:30
know, your work is just so empowering.
29:33
And I think also, I don't know if I'm allowed to say this or
29:35
not, but being American, you do go for things stronger than we
29:38
do. And once you've made your mind
29:41
that it is brilliant, but you're so forthright, you know, you
29:45
you've got to be really strong to keep going in what you're
29:49
doing and what you believe in. But what I always ask for three
29:53
take home tips at the end of my podcasts.
29:56
What three things do you think women should be really doing to
30:01
change the narrative going forward so that they are not
30:03
dismissed as just being older? We've got to speak up and keep
30:09
speaking up until we get to a productive conversation.
30:15
Yeah, absolutely must. And in order to do that, we need
30:22
to have a sense of agency. I think that our culture has
30:28
taught us that we need permission to have agency.
30:33
Yeah, which is does not make sense.
30:38
And I believe that we create a sense of agency, which is the
30:45
the sense that you can take action about something.
30:49
We create that sense of agency by managing how we're talking to
30:55
ourselves because that's the voice we listen to in our head
31:00
and that's the voice that drives our action.
31:04
So in managing our self talk, which is another whole world of
31:10
the work that I do in my word shops and my words work
31:14
retreats, is learning how to manage what we're saying to
31:20
ourselves. Recognize when we are defeating
31:23
ourselves, when we are being our own oppressor.
31:27
Changing the words now, changing your words is not going to
31:31
change a diagnosis, not going to change what happens to your
31:37
words is not going to change your life, but will change how
31:38
we handle the challenges in life.
31:41
And understanding that we can change the narrative and then
31:46
change what we do, which means to keep speaking up.
31:49
Make the appointment. If your doctor, if your
31:52
caretaker is not addressing your needs, is dismissing your
31:59
concerns, then find somebody else.
32:03
And I have encouraged thousands and thousands of people to start
32:08
a conversation, make an appointment, start a
32:11
conversation. And there's so many women who
32:16
are like, oh, I can't do HRT because of breast cancer and the
32:21
estrogen. And just have a conversation
32:25
because we all know what happened with the studies.
32:29
There's always options. Speak up, speak up, speak up,
32:32
speak up. Have a conversation.
32:34
Keep keep asking questions because no one should suffer
32:39
like this. Absolutely, really really
32:42
important and great advice. So thank you so much for your
32:45
time and I will remotely wave to you next time I'm doing a
32:48
Peloton when I if I'm allowed to sneak onto my husband's bike.
32:54
Awesome. Thank you so much.
32:56
I really appreciate the conversation.
33:02
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