Latest / Age Like a Badass Mother / Ep. 109: Think You've Heard Enough About Hormones? Not If You Have Brain Fog, Hot Flashes, or Low Libido

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Ep. 109: Think You've Heard Enough About Hormones? Not If You Have Brain Fog, Hot Flashes, or Low Libido · Age Like a Badass Mother

• 0:00
  Hi friend. Yes, you do need one more podcast about hormones.
• 0:04
  Why? Because as my friend Tracy just said on the phone to me, it helps me absorb the material when I hear it a bunch of different times from a variety of experts because we're just now getting attention about menopause.
• 0:18
  So we need to soak it all up. And you never know what's gonna help you.
• 0:23
  And yes, we even talk about libido and how a different friend of mine is at the point where she said she doesn't even want her vibrator anymore.
• 0:30
  So stay tuned for my guest, Dr.
• 0:33
  Tiffany Ruder. It's an eye-opening conversation.
• 0:36
  But first, this episode is brought to you by Grand Teton Ancient Grains.
• 0:42
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• 0:47
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• 0:52
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• 1:33
  Dr. Tiffany Ruder is a pharmacist, hormone specialist, and founder of Better Health and Hormone Balance.
• 1:39
  She works with women in perimenopause and menopause to address common but often overlooked symptoms such as weight gain, cognitive changes, fatigue, mood shifts, sleep disruption, and changes in sexual health.
• 1:52
  Her work focuses on translating hormone and metabolic science into practical, individualized care.
• 2:00
  Please welcome doctor Tiffany Ruder.
• 2:01
  Hello, doctor Tiffany.
• 2:04
  Hello, hello. Thank you so much for having me.
• 2:06
  I'm so excited to be here.
• 2:08
  I'm excited to talk to you. ~ so I just want to first say before anybody else gets to this, you you look a little younger than my typical guests.
• 2:20
  Can you tell me how old you are?
• 2:20
  Yeah.
• 2:22
  Yeah, no problem. I'm 39 years old.
• 2:24
  ~ already experiencing probably some early signs of perimenopause.
• 2:28
  But ~ you know, ~ just because you go see a male gynecologist doesn't mean he he doesn't know what's going on.
• 2:35
  So just ~ yeah, through all of my ~ training, studying, and certification, I have just fallen in love with hormones and the female body and trying to help women in perimenopause and menopause because it's it's a crazy time.
• 2:47
  It's a WTF kind of moment for sure.
• 2:48
  Yeah, for sure. ~ yeah, So for sure.
• 2:52
  and I I think you and I have talked about this before.
• 2:55
  So I'm 57, I'm gonna be 58 in August.
• 2:58
  Mm-hmm. Yeah. Woo. Woo.
• 2:59
  I just started going through menopause.
• 3:01
  Just, just I'm four months without a period.
• 3:01
  Okay.
• 3:05
  And ~ finally started having, Okay.
• 3:09
  I wouldn't say even hot flashes, I would say warm flashes. They're so bizarre.
• 3:11
  that's good. Okay. Yeah.
• 3:13
  ~ and it's not really bothersome and If I ha I don't have them every day, but like if I do, it's really just like warm.
• 3:22
  Like my body warms up for a second and then I'm okay.
• 3:24
  Yeah. Okay. I love that.
• 3:25
  So it hasn't been horrible. I don't know.
• 3:28
  Well, Mm-hmm.
• 3:30
  that's get it. Good for you.
• 3:33
  I know.
• 3:35
  It's a mixed bag, if you will, of symptoms. You never really know what you're gonna get.
• 3:40
  and I love that you're already still kind of thriving through it, Right.
• 3:44
  so that's fantastic. Yeah.
• 3:45
  Yeah, yeah.
• 3:46
  Okay, before we get too far into that, can you kind of tell me about your practice and what you do and how you help Sure. So tr I'm still pharmacist, traditional pharmacist. I did the retail route, you know, just like the CVSs, the Walgreens, the big big chains. ~ trained very, you know, very the medical model of medicine,~ is my formal background. And and it was.
• 4:10
  It was it was a lot of just counting pills and filling prescriptions and verifying and checking and all the things and answering the questions and and it got to a point where it got ~ a little overwhelming and a little bit like I started just recognizing it was a very like pill for the ill.
• 4:23
  Like it was very like you have the symptoms, so you take this thing and then you get side effects.
• 4:28
  So now you gotta take this other thing and It made me take pause and kind of reevaluate like what really are we doing our health and like really the healthcare system.
• 4:38
  I started working at a compounding pharmacy.
• 4:40
  It's an independent pharmacy where we specialize in hormone replacement therapy.
• 4:44
  And it was through that that I fell in love with I was like, what is this? Because it's not it's not formally talked about, it's not really formally trained in pharmacy school or not at the time that I was there. ~ perimenopause was definitely not a word.
• 4:55
  We talked about menopause, the definition of it, and maybe like two therapies you could take, and it was very minimal.
• 5:02
  So it was beautiful to to d rediscover like a new passion and a new love and what really I felt like was a calling because, you know, I would get woman after woman in the pharmacy that has seen ten different per like providers.
• 5:14
  They're getting dismissed. They're telling them that their labs are normal.
• 5:17
  They're telling them, it's part of aging, or you're just getting older, you just have a mom body, or, you know, it's part of being a mom.
• 5:23
  Like they're just getting like the runaround and excuses and they're my gosh. Yeah.
• 5:26
  not really fully being treated.
• 5:28
  And I realized that the 30 seconds I had at the pharmacy.
• 5:32
  was just not I mean that that's that's it.
• 5:35
  Like that is not enough time to give these women the attention, the support that they truly deserve.
• 5:41
  And so I really felt it was a calling to start my own business.
• 5:44
  It's better health and hormone balance where I get to work with women one on one and help them through this beautiful season, this new transition of life, but it brings on a lot.
• 5:53
  So it brings on weight gain and brain fog and sleepless nights and low energy and you know it's it's it's a crazy, crazy time and they deserve all the health I mean women's health care in general.
• 6:04
  I could go on a whole tangent about that.
• 6:05
  ~ please, yeah. Yeah.
• 6:07
  However, yeah, I just really wanted to make sure that women were supported the best that they can and I used holistic therapy.
• 6:15
  So ~ while we will do Dutch testing, I still I mean I still gotta use my nerdy science part, my nerdy pharmacist part of me.
• 6:21
  I need the data. So we are gonna look at like your hormones and like What's d how are you breaking them down?
• 6:25
  Yeah.
• 6:26
  what's Dutch testing?
• 6:28
  Dutch is a dried urine test of comprehensive hormones.
• 6:31
  So it is a urine test and we get a look, take a peek, ~ at your hormones.
• 6:36
  So are you making them? What are your levels?
• 6:38
  are you breaking them down? So you know, your body needs to be able to use them.
• 6:43
  Because you have receptors for hormones all over your body.
• 6:45
  That's one of the things I don't think people realize is that the reproductive hormones, estradiol, progesterone, and testosterone,~ you actually have like little ~ locks, I guess so it would call them, all of your body. Those are your receptors.
• 6:57
  And then the hormones are like the little key that unlock it to cause a change.
• 7:01
  So help your brain function, help your heart function, help your bones grow. Like you have receptors for them all over your body, and ~ understanding how they play out in the body.
• 7:12
  But as they shift in periodopause, sometimes that communication kind of gets messed up.
• 7:17
  And then that's when we kind of start seeing the symptoms.
• 7:19
  So just being able to piece together what's really going on below the surface because you have the right to have high quality testing and not just be told your labs are normal, not be told it's part of aging, you actually deserve answers. And so we do that to start.
• 7:32
  Okay.
• 7:33
  And then from there we build out a 12-week support program where you're getting that one-on-one support to opt Your health to mitigate those symptoms, help you lose the weight, help you sleep through the night, help you get your energy back, help you not be so dependent on caffeine and cortisol, help you actually like, I don't know, be present with your kids and not snapping at them or crashing out on the couch at three o'clock. Just kind of get you back to you.
• 7:55
  And so it's been a passion. It's been amazing to see the transformation.
• 8:01
  And it's and I'm just so honored to be a part of this show and be able to chat with you about it. So let's let's dive in.
• 8:07
  Yeah, thank you. And Yeah.
• 8:09
  and so that's the the thing that ~ so you design programs for women and that can be hormones, it might not be hormones.
• 8:19
  So I just want people to understand that.
• 8:21
  Yeah, yeah.
• 8:21
  But I okay, so you brought up ~ hormone receptors.
• 8:26
  And so is that what is actually happening in menopause?
• 8:26
  Yes.
• 8:32
  Is that what's happening? Like your hormone receptors are on the blink or Shutting down or what is happening?
• 8:38
  What's a physical thing?
• 8:38
  Well, as you ate Yeah, for sure. So some basic biology, just so we're kind of all on the same page, your ovaries that release an egg, those are also ~ they get signaling to release estradiol and then after the egg is released, it gets signaling to release progesterone.
• 8:55
  And I won't go into too many details'cause I just I just don't this isn't a biology class, right? This isn't healthcare or a health class.
• 9:00
  Yeah.
• 9:01
  This is just like us chatting.
• 9:02
  ~ As you go through perimenopause, you are your reproductive capabilities are decreasing.
• 9:09
  So you're not having an ovulation like you normally would.
• 9:12
  And you're not producing some of those same hormone levels like estradiol testosterone and progesterone like you used to.
• 9:18
  So now those receptors are getting somewhat starved of those hormones.
• 9:23
  And if they're not being used, a lot of times sometimes those receptors will regress.
• 9:26
  They won't make as many. Sometimes they'll make an uptick of them because they're trying to just grab up whatever's like remaining, like, my gosh, let me soak up whatever little bit is left.
• 9:35
  ~ but when there's not that consistent key to unlock the lock.
• 9:42
  ~ it can cause downstream effects.
• 9:43
  So, like when your brain is used to having being bathed in estrogen and progesterone and now it's no longer there,~ sometimes that's when the brain fog sets in.
• 9:52
  Or when we don't have progesterone to help us sleep better at night, that's when we're waking up at 2 a.m.
• 9:57
  and 3 a.m. and 4 a.m. So our bodies truly rely on these repr quote unquote reproductive hormones for a multitude of functions.
• 10:06
  Unfortunately, a lot of the science has only focused on the reproductive part and not the whole whole health part that a woman is.
• 10:14
  And so now we're thrown into this world of hot flashes and night sweats and brain fog and well weight gain and we just like we just don't even know which side is up. And it's tough because our body is like it's trying to communicate, it's trying to keep the signaling going.
• 10:27
  It just truly can't because those hormones are declining a little bit less and a little bit less and a little bit less.
• 10:32
  can you t describe what's happening when people have a hot flash?
• 10:36
  When women have hot flashes? What is physically going on?
• 10:39
  Why do we have those?
• 10:40
  ~ so the Yeah, so it's the the core like your core body temperature actually increases to a point that your like your thermal regulating signals in your brain are no longer in control and the core body temperature does increase.
• 10:53
  So like I don't know if you've seen those videos online where like women are literally like there's like steam almost coming off of them.
• 10:57
  Yes, I've seen that.
• 10:58
  yeah. So it is, I mean, it is a it's a very physiological response.
• 11:03
  So any woman that has ever been told, it's all in your head, or like, you just need to calm down, sweetie.
• 11:08
  Like, no, it is a f like physiologically, like they're is a change, a switch that's going on in your body.
• 11:14
  And a lot of that is due to the declining estrogen.
• 11:17
  A lot of it is also due to progesterone as well.
• 11:19
  So like depending on the situation, we you know we might need to use both ~ therapies to help support the body through that. ~ but it is I mean it is hormonally drived because those those hormones are declining and it is harder for your body to therm like thermal regulate itself.
• 11:36
  So weird. What why do women get it it's such a bizarre thing?
• 11:37
  I know, I know we're cra Thanks, God. Yeah. Thanks.
• 11:42
  Yeah, thank you. ~ why why do women get frozen shoulders in perimetopause?
• 11:47
  That is also so the skelet the skeletal muscle tissue, I don't know exactly the proper mechanism, but I do know it is linked to estrogen declining.
• 11:56
  ~ and again, shocking, we have receptors.
• 12:01
  in our muscles and in our bones.
• 12:03
  And when those those feedback loops, when those things, those communication lines get cut off, you're gonna see things show up.
• 12:11
  So you're gonna see like a frozen shoulder or you're gonna see ~ like arthritis.
• 12:15
  I see a lot of women with almost like arthritis type symptoms.
• 12:18
  You also see a lot of autoimmune systems start popping or like autoimmune kind of stopping start popping up in middle age, like thyroid conditions or rheumatoid arthritis.
• 12:26
  And we had some of these like protective Mm-hmm.
• 12:30
  anti-inflammatory like regulating benefits with our ~ reproductive hormones because again we have receptors for them all over and as they're shifting and as they're changing, you know, the body is responding to all of those signals.
• 12:42
  So yeah, you start seeing some of this stuff kind of pop up that you wouldn't have normally seen.
• 12:46
  Okay. So then I guess that kind of brings us to hormone replacement therapy.
• 12:51
  Yeah, it's therapy. Yeah.
• 12:52
  So would that be like if you're having those symptoms, is that the way to go?
• 12:58
  It is one of many tools in the tool belt.
• 13:00
  So I'm a firm believer in bioidentical hormone replacement therapy, which just means the molecule we're giving you, like the the therapy we're giving you, is an exact replica of the hormone you're no longer producing at the level we would like to see you produce it.
• 13:15
  So we would give you an estradiol patch.
• 13:18
  if you're no longer like produ you if your estradiol is fluctuating or not at a level we would like to see.
• 13:23
  ~ or to help, you know, soften those symptoms.
• 13:26
  We would give you a progesterone capsule.
• 13:29
  If you're not producing the progesterone we would like to see.
• 13:31
  ~ and same with con like ~ testosterone as well, because testosterone is very important for women as as well.
• 13:37
  ~ whether it's compounded, which is something I do at the compounding pharmacy we make it, it's individualized to you.
• 13:42
  We can make s really specific dosing, we can do creams, we can do ~ capsules, we do these little melts on your tongue.
• 13:48
  We have a lot of options. ~ or whether you do a commercially available product.
• 13:52
  There's a ton of, you there's estradol patches and sprays and creams, and there's prometrium, which is your progesterone capsule.
• 13:59
  So There are lots of options commercially or~ compounded.
• 14:02
  That would definitely be a good conversation between you and your~ but it can help relieve because you know, if you're no longer producing those hormones at that level and your receptors are clearly responding, your body's responding to it, it can be very ~ it can help relieve symptoms.
• 14:17
  And then I definitely like to see it in my menopausal or you know, very end perimenopausal menopausal women from a longevity standpoint.
• 14:23
  So a lot more studies are supporting that women that initiate hormone bioidentical hormone replacement theory.
• 14:29
  therapy early on, they're seeing, you know, more benefits of decreased heart disease, which were high risk for heart disease after menopause.
• 14:37
  decrease osteoporosis, which again, one in two women over the age of fifty will have an osteoporotic bone bone break, which is me it's I mean one fifty percent of women are gonna break a bone from osteoporosis after the age of fifty and no one's talking about it.
• 14:48
  Crazy.
• 14:51
  And hormone replacement therapy is a great tool to help mitigate that.
• 14:54
  ~ and same with dementia we're kind of seeing more about the brain benefits that hormone replacement therapy can do for our women because again we had these receptors our body was so used to having these hormones on board and now they're not there.
• 15:07
  so it can really be a great tool from a longevity standpoint as well to, you know, so we're still B A's when we're 80 years old and we're not Yeah, yep. Well, in the nursing home with a hip fracture.
• 15:18
  why okay, so then why wouldn't somebody take hormone therapy?
• 15:23
  It sounds like there's so many benefits.
• 15:25
  So many benefits. ~ a lot of practitioners aren't familiar with it or aren't comfortable with it.
• 15:29
  ~ there was a WHI study that came out.
• 15:33
  over almost three decades three decades ago and so it like scared Yeah. Right.
• 15:36
  the whole ~ medical community into prescribing hormones.
• 15:39
  Everyone got off of hormones. They thought, you know, it was causing cancer, Right.
• 15:41
  it's causing stroke, all these things.
• 15:42
  All of that has been like overturned.
• 15:43
  The women's health initiative.
• 15:44
  Yeah, yeah. ~ a lot of the black box warnings that were originally Yep. Mm-hmm.
• 15:47
  on hormone replacement therapy have also gotten removed.
• 15:50
  ~ so but not every woman qualifies.
• 15:50
  Right.
• 15:52
  It really depends. So sometimes there's history of cancer or breast cancer.
• 15:56
  also other, you know, other family history that might ~ or other ~ health conditions that might not qualify you.
• 16:03
  ~ also there's a window. ~ so like if you've had a history of like ~ blood clot Such as like tell me.
• 16:09
  or stroke, ~ you may not qualify for or ~ like some of the estrogen therapies, we really want to look at your we you know, at the end of the day, we want to make sure it's like the safest route and not something that's gonna set you up for you know a ~ complication later on.
• 16:23
  And so we would wanna make sure that we have a full family history Okay.
• 16:27
  and health history. ~ Okay.
• 16:29
  And then also there's a window.
• 16:29
  You were saying window, okay.
• 16:30
  Yeah, so Ideally, right now, we are looking at within 10 years of menopause.
• 16:36
  So menopause, just to define it for your listeners, it's 12 consecutive months of no period.
• 16:39
  Yes.
• 16:42
  So you said you're at like four months, Right. Right. So so you would need eight more. But if in the next month or two you have a period, you gotta start all over. So it's twelve yeah, Start over. Okay. Okay.
• 16:50
  so it's twelve consecutive months of no period.
• 16:52
  Now if you've had a hysterectomy and you're no longer cycling,~ you would need to talk to your doctor.
• 16:57
  There's sometimes some testing we can do to kind of to to estimate if you're in menopause. ~ But we won't have to discuss that.
• 17:04
  But so yeah, so if you're in menopause, we are saying within 10 years of being like, you know, truly menopausal is an ideal time to start hormone replacement therapy in which we know most of the benefits, most of the benefits are gonna outweigh some of the risks that might occur.
• 17:20
  Okay, okay.
• 17:20
  After 10 years, it gets a little dicey because ~ the you know, the body's aged.
• 17:27
  more complications may have occurred and we it really needs to be on an individualized basis.
• 17:31
  I mean it should always be on an individualized basis, but we really want to, you know, if you've considered it, if you've talked about, I'd love to talk to you about it.
• 17:39
  But if you're, you know, if you're considering hormone replacement therapy, just know that there is somewhat of a timeline in which it might be the most appropriate for you and then maybe not appropriate.
• 17:47
  Right, okay. And then so I've heard that if you have a uterus, you have to use progesterone with estrogen, Yeah. Estrogen too. Yes. So that is that correct? Mm-hmm.
• 17:57
  is the one black box warning that is still remaining on estrogen containing products.
• 18:01
  ~ and that would be that if you have an intact uterus, you do need to have progesterone.
• 18:05
  So estrogen helps kind of grow and thicken the uterine lining.
• 18:08
  Progesterone helps ~ protect that so you don't get an overgrowth.
• 18:13
  Potential, you know, like you know, when cells start undivide like growing undivided, we worry about like tumor type situations.
• 18:19
  So progesterone and estrogen are like a yin-ing yang.
• 18:22
  They really need to balance each other out.
• 18:23
  And before hormone replacement therapy, if you are perimenopausal or you're actively cycling a lot of your cycle the breast tenderness, the heavy bleeding, the clots, that is because you have too much estrogen and progesterone isn't balancing it out.
• 18:36
  She's not showing up the way she needs to.
• 18:38
  So, same goes for hormone replacement therapy.
• 18:40
  Estrogen and progesterone balance each other out, kind of like a yin-ing yang.
• 18:44
  And it is important that you do take progesterone.
• 18:48
  Whether, and really, I highly recommend in a capsule form, most of the research shows that you're gonna get good absorption of that.
• 18:54
  The research is a little bit out on a topical form because progesterone is a large molecule. We kind of worry about absorption rate.
• 19:01
  We wanna protect the uterus number one.
• 19:04
  I highly recommend if you're able to handle the capsule, that you would take it as an oral form for progesterone.
• 19:10
  Now, my lens, every woman should be on progesterone.
• 19:13
  progesterone, regardless of your like whether you have a uterus or not, because like I said, you have receptors for these hormones all over your body, not just in your uterus. So ~ especially for brain function, my women that aren't sleeping through the night, my women that have anxiety, my women that are having depression issues, my women that are snapping at everyone for two weeks straight, Progesterone binds to a receptor in your brain called GABA, or like to the GABA receptor, and it helps exhibit that calm, cool, collected feeling. So if you're not sleeping very well at night and you don't have a uterus, I would still highly recommend you have a discussion about progesterone because it has more therapeutic benefits than just protecting the uterus. Again, we have these receptors all over our body.
• 20:01
  You know, I tried, ~ you and I talked before and I I was having head heavy and I ~ before my period stopped because like you said,~ it my progesterone wasn't there anymore.
• 20:13
  That's res Yeah. Right.
• 20:14
  And okay, so I was taking that and I have to tell you, I did not love it. It was making me feel not myself, Yeah. Okay.
• 20:22
  but I also did not get a compounded version of it.
• 20:25
  Would the compound so would they compound that into capsules and would that be yeah.
• 20:25
  Okay.
• 20:29
  We yeah, it can be compounded into capsules, you know. The the the commercially available product, I probably should have done that, I think.
• 20:34
  there's only like two strengths, so there's one hundred or two hundred.
• 20:36
  Mm-hmm. Mm-hmm.
• 20:37
  ~ they are synthesized in peanut oil.
• 20:41
  And for some women, even if you don't have a peanut allergy, the peanut oil can s for some women feel like inflammatory.
• 20:46
  ~ so I don't know if that was part of it.
• 20:48
  It wasn't that. I just kind of felt not myself, In a fog. Okay.
• 20:52
  like a little blue, I would say.
• 20:52
  Okay, okay.
• 20:54
  Just yeah, I'm just very normally upbeat and positive.
• 20:58
  Yeah.
• 20:59
  And I was like, meh, I just felt meh.
• 21:01
  And as soon as I got off of it, I went back to feeling normal.
• 21:05
  But like I said, it wasn't compounded.
• 21:05
  Okay. Yeah. And it maybe So I I would be open to trying that.
• 21:09
  it mm you know, maybe even at a lower dosing.
• 21:11
  ~ Mm-hmm.
• 21:13
  to you know, to help with the symptoms, like of like you know the time to help with like the heavy the heavy bleeding.
• 21:17
  and that's the beauty of compounding because there's only I'm not doing that anymore. Yeah.
• 21:20
  two specific strengths commercially available 100 and 200, Right.
• 21:24
  you know, we could have gone down to 50 or 75.
• 21:27
  Right.
• 21:27
  Like something where we kind of find like that sweet spot where we're gonna help Mm-hmm.
• 21:30
  support some of these symptoms.
• 21:32
  You know, if your progesterone is not showing up naturally the way it should~ without causing some of these extra side effects.
• 21:39
  I know for a lot of women GI issues come up because progesterone is a lot of it is in our gut. So sometimes they get like constipation or they're having some of those issues. So definitely worth a conversation with your provider if you're not fully happy with like the therapy you're on, or I mean obviously reach out to me, I'd be happy to guide you on like kind of what we're looking at.
• 21:56
  But you know, compounding is a beautiful option to give some of those individualized dosing that you might not find commercially available.
• 22:02
  Mm-hmm.
• 22:03
  Yeah. And I think I've mentioned this before, but I want to say this because I feel like compounding sometimes gets a bad reputation. And I spent my career adjacent to compounding.
• 22:10
  Yeah.
• 22:14
  Yes. Yeah.
• 22:16
  My real before I became a podcaster, I was the director of advertising for ~ a journal that went to compounding pharmacists. And I went to all these forums and conferences and I Mm.
• 22:28
  Yeah.
• 22:29
  was around compounding pharmacists and I found them to be just such ~ kind, loving, really ~ people who want to help people.
• 22:40
  Yeah, yeah. Yes, They they are problem solvers.
• 22:43
  And that's what I found is that they are trying to help somebody.
• 22:43
  yeah.
• 22:47
  ~ and so, you know, you can just take i something and make it in a different dosage form. Like I saw it a lot of kids who had autism, Yeah.
• 22:56
  like they couldn't have dyes or coloring.
• 22:57
  Mm right, right.
• 22:58
  So They would make, you know, some kind of ~ a liquid they could drink that didn't have Yeah.
• 23:04
  any dyes or colorings for hospice.
• 23:06
  They did a lot of, you know, ~ suppositories and things like that~ yeah. Minique.
• 23:10
  Yeah.
• 23:11
  for people who couldn't take pain by pain medicine by mouth anymore.
• 23:14
  Right.
• 23:14
  So I want people to understand, I think there's a bunch of people out there claiming to There is.
• 23:20
  be compounding pharmacists now, but they're kind of just people who are maybe trying to Mm.
• 23:26
  Yeah.
• 23:28
  make a book and not real I you know, I I want to suggest to find a real compounding pharmacy, you could go to a website called A, then the number four, then the letter P like Paul and C like cat dot dot org, A four P C and find an accredited compounding pharmacist.
• 23:49
  Or what would you say? How do you find a an accredited or somebody Yeah. That that's you would trust for compounding?
• 23:55
  That's definitely ~ that would be one of the websites.
• 23:57
  I would also go to PCCA, that's the pharmacy compounding centers of America.
• 24:00
  PCC eight. Mm-hmm.
• 24:01
  they also have a list, literally a directory you can put in like your city Yes.
• 24:06
  and state, and it will show you what compounding pharmacies that honestly that have vetted. So they've done the research, Yes.
• 24:12
  so you don't have to. that would be a great way to also start.
• 24:16
  I love so that's I because I agree, especially with some of these, and we I think at some point we're kinda talk about like some of these new compounds coming like peptides and GLP ones.
• 24:23
  Uhhuh. Yes. Let's talk You know, you see about that. Yeah. And that's all they're doing.
• 24:27
  And I I And I am, there is, you know, I agree, we are problem solvers. I love, like, honestly, it's like a puzzle, right? So you give me the situation, they can't take it this way, or you know, like it's I I love it. Like that is why I went to pharmacy school was Mm hmm exactly. Mm-hmm.
• 24:43
  to help people with this unique issue that needs a unique solution.
• 24:46
  And I love being that problem solver.
• 24:47
  That's right.
• 24:49
  I worry about some of these compounding pharmacies that are almost turning in, not to say like all of them are, but there are some that's almost like a cash cow, right? They're popping up out of one nowhere, Right.
• 24:57
  they're just gonna churn out all this.
• 24:59
  product ~ a lot of it's made like really large batch and they're just kind Yep. And that's they're not supposed to be doing that.
• 25:03
  of like sending it out the assembly line and so I would just be cautious Right. You're s yeah, you're supposed to Right.
• 25:07
  I would just be cautious yeah because you're they're not manu they're not a manufacturer they are not a Pfizer they're not a Tiva they are you know they're an independent pharmacy that should be individualizing their care to customer and so I you know that that I would agree there's a little bit of that concern that I have too ~ and then I would say from practitioner standpoint a lot of providers which even my doctor said it to my face she's like Compounding is not FDA approved, and I do not use their products.
• 25:31
  That's right. Mm-hmm. Yeah.
• 25:32
  And I was like, well, I guess we're done here.
• 25:34
  because and it's and it's it's true.
• 25:35
  I agree with that a hundred percent.
• 25:37
  That's baloney.
• 25:38
  Yeah, it's and so they're only putting on this FDA approval stamp.
• 25:41
  Compounding pharmacy cannot do that.
• 25:43
  We are not a Pfizer, we are not churning out 30,000 pills of progesterone that's gonna go through, you know, multiple studies and research.
• 25:52
  Because we're turning out 25 milligram of progesterone for Miss Lauren that needs a lower dose, right? Like, I'm not gonna go through.
• 25:59
  like the studies that the FDA would require for every single individualized to be FDA approved. Like there's just no way.
• 26:06
  They have a ton of training. And It's just yeah, it's not feasible.
• 26:09
  and so again, I yeah, and I love PCCA.
• 26:12
  They were actually one of my cups customers.
• 26:13
  So it was PCCA.org, right? And yeah, they're green. Yeah. Actually I think it's PCCA R X. I can actually pull it up right now.
• 26:20
  you and yeah, I think you're right.
• 26:20
  Yeah, PCC A and then R as in Roger X is an X, Let's let's give that up.
• 26:25
  right? PCA ~ R X. Because they yeah.
• 26:27
  P C C A R X dot org, right? Or is it dot com?
• 26:31
  Yeah, let me yeah, I'm I'm Let's look let's make sure we literally I'm literally time with giving let me give it a goog.
• 26:39
  PC dot com. P C C A R is Roger X is an X-ray.com.
• 26:40
  dot com. Dang it. Okay, we'll we'll put that in the show notes.
• 26:43
  Yep. Yeah.
• 26:45
  Pccca R X dot com is a great place to find a real compounding pharmacist who has who buys the right chemicals, who goes probably had accreditation.
• 26:52
  Yes. Yes.
• 26:56
  And then also A the number four PC.org also.
• 26:59
  Yeah. I'm that.
• 27:00
  ~ so those are two organizations that I personally know, I have personally worked with.
• 27:05
  Yes. Mm-hmm.
• 27:07
  I know that they are on the up and up.
• 27:10
  And they do all the right things.
• 27:11
  They are not some of these people who have just popped up to make you peptides and GLP ones. And those people don't care.
• 27:18
  Well, I shouldn't say they don't care.
• 27:18
  Mm-hmm. No, they I should say that they might not have the proper training and I'd be weary of them if they're not on one of these two~ lists.
• 27:26
  But let's talk about that. Let's talk about ~ okay.
• 27:26
  Yeah. Yeah, let's do it.
• 27:30
  I I I mean, you can't turn around without hearing about peptides, Peptides.
• 27:34
  but w what are they? Or is it something our body makes?
• 27:37
  And if we didn't get them, w You know, w if we didn't have them compounded or whatever, where would we get them? Do do we produce them?
• 27:46
  What are they? Do we need them?
• 27:47
  So it's tough because peptides has become this umbrella term for I think a lot of things that people aren't really familiar with. Like I mean honestly, GLP one is like kinda considered a peptide.
• 27:55
  Insulin is a peptide. So, you know, Okay.
• 27:59
  so it's it's kinda tough because we're not I think we're starting to make it more of a buzzword without actually giving a lot of information about it.
• 28:06
  I I don't have ~ as much experience with peptides because we only do non-sterile compounding. So you first have to know peptides are part Okay.
• 28:15
  of sterile compounding, which means injectable, which means if you're putting it into your body, Okay.
• 28:20
  you would want zero microbes to be involved.
• 28:22
  Yes, exactly.
• 28:23
  So it is a process, ever, you know, it's a sterile process to ensure that that product you're popping into your body is super safe. ~ similar with GLP1s.
• 28:34
  Those are, you know, the those are usually injectable type products.
• 28:37
  And so again, you would want to make sure that you, you know, your compounding pharmacy is is been vetted and ~ now different peptides have different responses.
• 28:45
  ~ I know the biggest one right now is like BCP157, and it's it's essentially elicits a response to help with like muscle growth and tissue repair and restoration.
• 28:55
  And so you're seeing it a little bit more in the longevity space for like almost like anti-aging.
• 29:00
  but again, you would just want to be cautious.
• 29:02
  I don't have as much information or research from it just because I don't work it on a day-to-day basis.
• 29:07
  basis, I have worked and met multiple providers that are using it properly.
• 29:12
  So I've met ~ he is a non-opioid pain doctor, which means he does no opioid medications and he is using peptide for like regenerative medicine, right? So when you've had a major knee surgery and you need to get those cells regenerated quickly. When you've had Fibromyalgia or some of these other conditions, chronic pain conditions, he's using them appropriately, but he's gone through certification courses, he's been studying it, he's been bringing you know, so like it's just really important that the provider you're talking to is not a five questionnaire on some shady website.
• 29:46
  Right.
• 29:46
  Like that is my first qu like if you're finding Dr.
• 29:49
  So and so on telehealth and they're asking you two questions and they're gonna send Uh-huh.
• 29:53
  you a peptide, I'd be a little bit cautious about that because I don't know certification. I don't know if they've studied it.
• 29:58
  They don't do the do they even take a history?
• 30:01
  Do they know your history? Is it gonna work for your body?
• 30:03
  When is the end point? When is the stop point?
• 30:05
  What are also what are your markers of success?
• 30:07
  Like, how do you know that this therapy is actually working for you?
• 30:11
  What are you gonna notice? What are the side effects?
• 30:13
  If you're having a 30-second conversation and only filling out like 10 questions on a questionnaire, I would be a little bit leery about the peptides that you're gonna get.
• 30:20
  Yeah. Mm-hmm.
• 30:20
  And I don't know what pharmacy they're using either.
• 30:22
  So again, just do your homework, be smart about it. ~ do some research and I mean that was that's kind of like my biggest thing to o the audience is that's let's not do this blindly.
• 30:32
  Let's not just jump on this like fountain of youth situation.
• 30:35
  Let's really make sure that we are making the most informed decisions Right.
• 30:39
  for our body because you are you're putting it into the body and you know Okay.
• 30:42
  we wanna make sure we're not a science experiment of our own.
• 30:45
  Okay.
• 30:46
  So did that me to did so our bodies do produce these things Yeah.
• 30:51
  and they're not producing them as we age?
• 30:52
  Some s Is that what it is?
• 30:55
  some of our bodies are producing these peptides naturally.
• 30:57
  Some of them are like exogenous peptides that will elicit an another response, like a downstream response in the cells, or in, you know, like there's a lot of stuff going on about like mitochondria health. It's about like inducing a response in those cells by using the peptides to to cause an like to cause an upregulated response or, you know, whatever it is at like a cellular level.
• 31:18
  Okay, okay. So so we it it's it is something that we make and then as we age we're not making it to to help ourselves or no, I'm sorry, I'm still not understanding.
• 31:33
  Yeah, no no no. that's a good question. And it might be harder for me to explain.
• 31:36
  So some peptides we do make naturally, but also like I'm just gonna use insulin as an example just because like everyone Okay.
• 31:41
  I think on the at this point knows what insulin is.
• 31:44
  What is a big thing we're hearing about as we're aging?
• 31:46
  Insulin resistance, right? So it's a your body's ability, not that you're not making it, the cells, the receptors, they don't know how to utilize it.
• 31:54
  So now it's feeding back to your body.
• 31:54
  Okay.
• 31:56
  Make more, make more. And so now you have these high levels of circulating insulin.
• 32:01
  The receptors are still not, you know, they're not communicating to each other.
• 32:05
  And this is part of the aging process, but this is also just a part of the world we live in.
• 32:11
  You know, if you're eating a standard American diet, Which we call the sad diet for a reason.
• 32:16
  That's right.
• 32:16
  It's harder on your butt. It's harder on yourself.
• 32:19
  Like you're s, you know, we have to remember we're not just this like.
• 32:23
  We're not just like I'm not just Tiffany, like I have a heart that has like that is made out of cells.
• 32:28
  I have a liver and a pancreas that is made out of these itty bitty cells.
• 32:31
  And if you look at the cell, then there's all these other structures inside that cell, right? We you know, from cellular biology, like the mitochondria is the powerhouse of cell.
• 32:38
  You also have like ~ a a frame, like a protective wall around the cell.
• 32:42
  There's so many processes going on a a thousand different times, and you're not even consciously aware of them.
• 32:50
  However, the decisions we make every single day of the things we're putting on our skin, the things we're putting in our body, the way we're feeling ourself or not feeling ourselves, even the things we're putting into our mind, the things we're scrolling on Instagram, you know, the things that we are putting in has a direct impact on how our body's gonna respond. ~ and so it's not just that we're getting older, but we're not really aging as gracefully as I think we used to.
• 33:11
  And I think it is some of the environments, some of the decisions we're making.
• 33:15
  And so these peptides can be useful tools to help mitigate that.
• 33:20
  ~ but you know, truly if I'm talking to, you know, suit like Karen down the street and she's just looking to lose five pounds, I feel like there's a lot of work we can do ahead of time before we go straight to peptides.
• 33:33
  Okay, thank you.
• 33:34
  However, if you feel like that is a path you want to explore, like I said, just do your due diligence and and do some research to make sure that you are fully aware of that of that path you're going on.
• 33:45
  ~ but yeah, so I mean, it's part aging, it's part environment, there's there's a lot of factors going into it.
• 33:51
  ~ and if you feel like peptides is the most aligned decision for you to get you to like the goal that you want, to the result that you want, then definitely explore it.
• 34:00
  But also know there there can be some other options for you as well.
• 34:02
  Okay.
• 34:03
  Thank you for explaining that.
• 34:05
  ~ before we move on, I want to clarify a couple things.
• 34:10
  So we talked about if you have a uterus, you have to have progest progesterone with estrogen.
• 34:14
  Sure. Yeah. Yes, ma'am.
• 34:15
  Does that include if like you have a patch estra a patch?
• 34:21
  Yes. If a estradi estradiol, Yeah, if it's yes, yeah. So estradyl how if you're estra whatever.
• 34:27
  Yeah, so any type so the only caveat is if your o if your only estrogen product is estradiol vaginal cream, you would not need a progesterone.
• 34:35
  Vaginal. Okay, then you don't need it.
• 34:37
  Okay.
• 34:39
  But if you want estradiol spray, a mist, a patch~ oral. If you're on, ~ you know, there's still I still see it out there, like conjugated estrogens, like primarin type situation.
• 34:50
  God, ~ huh, ~ huh.
• 34:51
  We can talk about that on another podcast.
• 34:54
  But if you're on it, we know yeah, Well, that we don't want that's from mare urine, if you're on it, progesterone for sure, right? That's you don't wanna be.
• 34:59
  if you have it intact with yours.
• 35:01
  Now There is a weird like flip-flop.
• 35:04
  You can be on progesterone as a solo therapy.
• 35:08
  And I see a lot of women start that way.
• 35:10
  Their progesterone isn't producing as much as their estrogen.
• 35:14
  They're already kind of over-estrified anyways from, Okay.
• 35:16
  you know, from our our the xeno, you know, just like some of our environment, you're maybe you're still producing estradiol at a decent rate, but the progesterone isn't showing up.
• 35:24
  So a lot of women, don't be alarmed if your doctor's only starting Okay. So then you you on progesterone.
• 35:28
  That's okay. Okay. Okay.
• 35:29
  Without estrogen, yeah, it's completely fine.
• 35:31
  And that's usually how I see the step rise process go.
• 35:34
  Usually it's progesterone first.
• 35:35
  Honestly, sometimes then it's testosterone second.
• 35:38
  And then finally at the very end, then I see the estradiol coming into play.
• 35:42
  Estradiol hangs around for a while.
• 35:43
  Progesterone, testosterone, they will leave the group chat real fast.
• 35:46
  So we we try we try and get them back on board.
• 35:47
  Okay. They're going fast. We're gonna talk about testosterone in a minute, Yeah. Yeah. Yeah.
• 35:52
  but I wanna talk about ~ we talked about estrogen vaginally.
• 35:57
  Should everybody be on that? It sounds like everybody sh I mean, Yeah.
• 36:00
  I've kinda heard that that's like a cure all for what?
• 36:03
  ~ UTIs and what tell me tell me about vaginal est estrogen.
• 36:10
  Yeah. so vaginal estradiol, it's very, very low dose. We're talking 0.01%.
• 36:15
  Very, very low dose. It's used locally, so it's used in the vaginal tract.
• 36:20
  Sometimes you also can use it on the vulva externally.
• 36:23
  And it is beautiful. It's a beautiful medication.
• 36:26
  So ~ just so we don't receptors, shocking. We have a our vaginal tract, our vulva, it is flush.
• 36:34
  with estradiol and estriol receptors.
• 36:36
  And ~ estriol is another version of estradiol, but it is flush with those receptors.
• 36:41
  And as we talked about, when the when the when that's not showing up, those receptors, those cells actually start to atrophy.
• 36:49
  So literally the tissues become thinner, they come ~ become more ~ like They fray easily, they can get damage easier.
• 36:58
  the protective barrier that's there decreases.
• 37:01
  Your microbiome, which is basically like your good bacteria in your vaginal tract, that actually changes during perimenopause.
• 37:07
  And so, and then now you don't have the estradiol that used to show up.
• 37:11
  And so that tissue is at very high risk for infection.
• 37:15
  So a lot of UTIs that you'll know if you're noticing more UTIs, you are probably in periamenopause.
• 37:20
  And that would be a time to talk to your doctor about vaginal estradiol, because the research is showing it actually helps prevent UTI is because it it reestablishes not only the vaginal floor, like the microbiome that's has shifted the good bacteria, but it also thickens up that tissue.
• 37:36
  ~ it helps make it not so, you know, not so frayable, not so easily damaged, because also intercourse is kind of like a high contact sport.
• 37:46
  We want to make sure we are protecting that tissue, and ~ vaginal estradiol is a great way to do that because it gives back what the body just no longer has and those tissues can become thicker.
• 37:57
  They can ~ and it also helps, you know, if you're also having pain in intercourse, if you're having a lot of vaginal dryness.
• 38:02
  ~ Again, we talked about like the UTIs.
• 38:05
  I mean, I've even seen estradiol vaginally in nursing homes because of the incontinous issues. They're having a lot of UTIs.
• 38:11
  Yes.
• 38:13
  And you know, for especially for older women, one of the first signs of UTIs is is cognitive impair.
• 38:19
  So they're kind of getting confused or not because they're getting like almost like Yeah.
• 38:22
  this ur you know, the it's like a urine like the increased urination.
• 38:27
  Anyways, it's a whole it's a whole effect, but Right.
• 38:30
  It's safe enough to use on my eighty-five-year-old grandma in the your forty-five-year-old body will be just fine.
• 38:35
  Okay.
• 38:35
  So I think people still freak out, like, it's hormones, but it's a very low dose.
• 38:39
  It's used locally, so you're not absorbing it systemically.
• 38:42
  Now, if your doctor wants to put you on estrogen therapy to help whole body, it would not be appropriate to only use vaginal estrogen because it's not at a dose that your body is gonna absorb all over.
• 38:54
  It's literally local to the to the vagina.
• 38:54
  Okay.
• 38:56
  So and the vulva, you know, the vaginal tract.
• 38:58
  So it's only used really a local effect. So your doctor may still also add on an estradiol patch, even if you're using it vaginally.
• 39:06
  So just keep that in mind that it it's not too much.
• 39:07
  Okay.
• 39:08
  You're not gonna overdose. It is it's just it's another tool.
• 39:12
  It's another tool in the toolbox to help with, you know, especially if you're having intimacy issues, if you're having a lot of pain with intercourse and you're not, you know, it that it can be really hard for women because nobody's really talking about it. Nobody's really approaching it.
• 39:25
  But there are options out there and we you don't need to suffer in your forties.
• 39:30
  And in your fifties, like there are s there are a lot of there are a lot of therapies and a and vacuum estradiols is definitely one of them.
• 39:35
  Yeah. And how long do you have to wait to have intercourse after you've had that dose in your vagina?
• 39:42
  ~ that's a good question. So ~ typically what I see The dosing is two weeks. So 14 days of ~ using the vaginal estradiol as like what we call like a loading dose. so that's 14 days to consecutively.
• 39:53
  Uh-huh.
• 39:55
  Usually it's used at night at bedtime, just because when you're lying flat, you don't have to worry about gravity moving things out of you.
• 40:02
  ~ and then after that, it's either two to three times a week.
• 40:06
  ~ which I mean, if you have like a an amazing sex life and you're having nights a week, then ~ my advice to you would just be enjoy, enjoy the intimacy, enjoy the time, and then use it.
• 40:16
  afterwards. I would not use it right before intercourse, Okay.
• 40:20
  just because there is a chance you might transfer a little bit of that Yeah, no doubt.
• 40:23
  to your partner. ~ and we wouldn't want that.
• 40:23
  Yeah, you don't want that.
• 40:26
  so we wouldn't we wouldn't want that transference, but I would just recommend then afterwards~ to use it.
• 40:31
  sometimes you can't always plan these things, so I get it. Like, you know, these situations kind of can occur.
• 40:36
  ~ but yeah I mean it's usually just a couple of nights a week so it's also Okay.
• 40:39
  Okay, so you can plan that. Okay.
• 40:40
  to manage. Yeah, it's not a daily thing.
• 40:42
  Yeah.
• 40:42
  Yeah, muzzle if you're having tech sex three times a week.
• 40:46
  Okay, good for you. ~ okay, so the so yeah, Yeah.
• 40:51
  let's talk about that. Like my friend,~ who's my same age said that, you know, she's single and she's on these dating apps and she's starting Mm-hmm.
• 41:00
  to see all these men who have been married for 30 years and with their wife's permission.
• 41:05
  They have sent them out on the dating app because they don't want to screw them anymore. They're like, he's your problem. Go ahead. And she's like, Are you kidding me? I don't want your used~ married man thing.
• 41:17
  so what why are women losing desire?
• 41:22
  Like, what is happening that they're losing desire and what can be done for So they're not telling their husband to go get on a dating app to have sex.
• 41:28
  ~ Yeah, that like well, that kinda like breaks my heart.
• 41:32
  I know, right?
• 41:34
  Like, God. That is really sad.
• 41:34
  I know, it's sad. She's Right.
• 41:37
  And also, what a pig, if you're like actively like, And you're like, Okay, that's a great solution.
• 41:39
  okay, I'll go do that. Okay, thanks, hon. that is n yeah. ~ so that I mean I that alone I think you and Okay, yes.
• 41:46
  I can have another podcast about that.
• 41:48
  ~ so ~ it's tough. So women, God bless us.
• 41:52
  We're so complex. We're not so simple as men.
• 41:54
  Yeah, no kidding. No.
• 41:55
  ~ Unfortunately, be libido can be really complex.
• 41:59
  Sometimes it's as simple as a testosterone issue, right? So sometimes it's just that we're not making as much testosterone, which does, you know, impact libido.
• 42:07
  But there's a lot going on. Like we are the sandwich generation, you're raising kids, you got a demanding job.
• 42:13
  I know more women.
• 42:15
  reinventing themselves and starting a new business at the age of 40.
• 42:18
  ~ so there's a lot going on like psychologically, a lot physically going on, right?
• 42:23
  You're going through these like hormonal changes, your body's demanding more of you.
• 42:27
  stress is impacted. Now you're not sleeping very well at night.
• 42:31
  And when does everyone want to have sex?
• 42:33
  Like is that like when you're already crashed out and exhausted from the day and you're carrying a heavy load and you're doing the dishes and you're doing all the things.
• 42:41
  And so it is very complex. I wish it was as simple as like one Hormone. Like I really wish it was like, girl, just get on testosterone.
• 42:48
  You'll like, you know, ready. You're gonna be the energizer bunny.
• 42:51
  It's not always that way. Because even when we correct for those testosterone issues, if we haven't addressed some of the stress issues, if we haven't addressed some of the other mental load that you're carrying, you know, for women, it's not just at the moment of intimacy, like it's every it's all the things that had been built up.
• 43:08
  It's all day. Mm-hmm. Exactly.
• 43:09
  Yeah, it's all day. It's it's the text message you sent her in the morning, or you didn't send her in the morning.
• 43:14
  That's right. Mm-hmm.
• 43:15
  It's the comment you made two weeks ago, or maybe you didn't make.
• 43:18
  It's the laundry that she's been asking you to help change out that you didn't do.
• 43:23
  So like it's not I I really wish it I could just put it down to like a one hormone thing. I will say what I have seen in the labs.
• 43:32
  Is the women that I've been working with, as they're in their 40s, their cholesterol, they are in survival mode. So instead of thinking like they have high cholesterol, I must be high cholesterol, I'm high stress, they're no longer producing hardly any cholesterol.
• 43:45
  They're literally in survival mode.
• 43:46
  And your adrenals are also responsible for producing testosterone.
• 43:50
  And if your body is stuck in survival mode, it's not gonna think about reproduction.
• 43:55
  It is literally going to get you through the day the best that it can.
• 43:59
  And so for a lot What are you saying about cholesterol?
• 44:01
  I don't understand that. ~ okay.
• 44:02
  sorry, not cholesterol, cortisol.
• 44:03
  I'm so sorry, did I miss smoke?
• 44:04
  cortisol. Cortisol, cortisol. No, I was like, I I'm so confused.
• 44:06
  Okay, cortisol. Okay. That's okay.
• 44:07
  no, no. So cortisol. High cortisol.
• 44:08
  So sorry. I I must have I must have had a brain must have had some brain fog.
• 44:10
  I was like, I'm so confused. Okay.
• 44:12
  That's right. It happens. Okay, Yeah, cortisol, cortisol. So you think so cortisol. So they're okay.
• 44:17
  you're high stress, you're high cortisol.
• 44:18
  What I've actually seen in my women, like we are now in burnout. We've been we've done too much to our body for the past 20-some years, and the body is saying like no more.
• 44:26
  It's waving its right flag. And so we are literally in like this survival mode.
• 44:27
  Okay.
• 44:30
  And I see when my women finally get that regulated and kind of back, then they can kind of come back to themselves and actually have desire, actually have motivation, actually kind of have some of those original libido responses. But when your body is truly stuck in survival mode.
• 44:40
  Mm-hmm.
• 44:44
  It is not gonna think about reproduction.
• 44:46
  And so for any men that's listening, like you can have a conversation, but also like Maybe do the dishes once, you know?
• 44:53
  Be nice to your woman.
• 44:53
  Like help like be nice to your woman.
• 44:56
  I call it chore play. So chore So it's like, Yes, thank you. No shit.
• 45:00
  yeah, like start like doing the things to because the more you take off of her plate and off of her to do list, the more you can come back onto her plate and on her to do list.
• 45:06
  Uh-huh. Chore play. I like that.
• 45:09
  Mm-hmm.
• 45:10
  Like she might think about you at the end of the night and not the thirty thousand other things that she hasn't done yet.
• 45:15
  So like I think it's it's a very complex situation.
• 45:18
  I think it takes both partners.
• 45:20
  It is not the woman's job to figure out her quote unquote libido issue on her own.
• 45:25
  If you are in a marriage, if you're in a partnership, it really needs to be the two of you not having the man quote unquote fix it either for you. It's about you two partnering together and finding solutions, finding options that can help support you, support your body, take you out of survival mode and back into ~ bed mode.
• 45:41
  Yeah. Okay. I think you're absolutely Like get you get you back.
• 45:44
  right. And I th yes, a hundred percent.
• 45:47
  So let's say though, because I I do ~ you know, my friends are all late fifties and I think a lot are in happy relationships.
• 45:58
  they've been married a long time, Yeah. Yeah.
• 46:00
  but still maybe their libido is a little low.
• 46:03
  W would you say testosterone might be a good thing?
• 46:07
  ~ some testosterone cream or ~ huh.
• 46:07
  It would it could definitely be an option, for sure. And~ yeah, so I mean I'm not saying like just Yeah, And that has to be compounded, right?
• 46:14
  well Yes. I would ideally you're getting it compounded because we can Okay.
• 46:19
  use very low doses, right? We don't we're not giving you man doses and Right.
• 46:22
  ~ we don't want you to turn into that.
• 46:25
  We use very low doses. We can also compound it in a way where you can also it vaginally or to the vulva like thirty minutes before ~ activity, before intimacy. That can help as well.
• 46:37
  ~ there's so testosterone.
• 46:40
  Regularly. I still feel like women should be on it regularly, not at very low doses that you would lose like more locally, but as a regular dosing because testosterone isn't really important for our sense of self, like how we see ourselves, our confidence. It's important for drive and motivation.
• 46:54
  It's important for brain function and brain ~ mental clarity and focus.
• 46:58
  It's also really important for keeping our muscles strong.
• 47:01
  So we our muscles naturally are gonna atrophy as we get older.
• 47:04
  And our muscles are really important to keep our bones strong.
• 47:08
  And we're already naturally at risk for like osteoporosis.
• 47:10
  So just Testosterone helps mitigate all of that.
• 47:12
  And it might help bring your libido back.
• 47:14
  So again, it's not always just, you know.
• 47:18
  we are complex, but if that is part of the issue, if the desire isn't there, ~ if the motivation is lacking, testosterone might be a really great tool to help kinda get that spark back.
• 47:28
  And so I just wouldn't put all your eggs in the basket if you haven't also some of these other like psychological, like relationship things, right?
• 47:34
  Right.
• 47:35
  ~ but yeah, it can definitely be I mean, I've definitely seen some women that kinda go, you know, from one to the next, it goes pretty quick that they are, you know, not desiring it to all of a sudden like now they're, you know, they kinda feel like a teenager again because of yeah, Yeah.
• 47:50
  because you know there that testosterone that was once there that we were relying on, our bodies were relying on, is no is now being repleted again.
• 47:57
  And so it can be a very useful tool.
• 48:00
  I mean, like I have a friend who's single and she's like I she's like I don't even want my vibrator anymore and I know she's not mad at her vibrator for not emptying the dishwasher.
• 48:09
  So I mean she's just she probably just needs some testos she really probably just Yeah.
• 48:15
  needs that, right? She's She she might, but I mean again and I think that's the the problem is ~ every person is individualized, but you know what?
• 48:23
  Yes.
• 48:23
  That's I and I I don't wanna just keep coming back to the labs because I'm kind of an honestly I'm an anti lab person.
• 48:29
  I just don't like chasing a number on a lab, right? Like I think a lot of doctors just start chasing this like number.
• 48:32
  Uh-huh.
• 48:34
  But Yes.
• 48:37
  That is why I am a big proponent of let's do like a holistic lab because honestly her testosterone might be fine.
• 48:43
  It may be like DHEA, it may be estradiol, it may be the way she's metabolizing her testosterone.
• 48:49
  and honestly, it could be her cortisol.
• 48:51
  So like if her body's in survival mode, of course it's not thinking about making testosterone.
• 48:56
  so like there there's a lot of factors.
• 48:56
  Mm-hmm.
• 48:59
  Now, could testosterone potentially help her?
• 49:00
  Maybe. My biggest concern is that women are being put on hormone therapy without knowing how their body is.
• 49:06
  gonna use it and metabolize metabolize just means break down.
• 49:11
  after it's done using it and excreting it.
• 49:13
  and I always wanna make sure that those what we call detox pathways, the way your body detoxifies itself.
• 49:19
  I'm not talking about these creepy juice cleanses.
• 49:21
  I'm talking about like your body's natural way of ridding itself of the things it no longer needs. I wanna make sure that those detox pathways are clear before Yes.
• 49:29
  I start you on testosterone therapy because I've seen other you know, I've also seen where they start on therapy and they get sick, they do not feel good. they're cranky, they're moody, like they have not had a good experience with it.
• 49:40
  And so again, that's why it needs to be individualized.
• 49:42
  This is why we need to look maybe at some labs and just making sure that we're putting all those pieces of the puzzle together before we say definitively, like, okay, this looks like the next most logical option.
• 49:52
  Yeah.
• 49:52
  Okay. Thank you for that. I think that's wise. I while we're still talking about testosterone, I what do you think about the pellets?
• 49:58
  Yeah.
• 50:02
  Think they can be done really well, especially for women. Cause girl, Okay.
• 50:05
  I get it. Like taking a pill every day or putting a cream on yourself for two minutes, like rubbing it in, Yeah.
• 50:11
  ~ timing it with like, ~ like we're we're gonna have sex, so I I can't use this insert, this vaginal insert.
• 50:17
  Like, well, life is lifing. And the pellets can be a really great way.
• 50:22
  You put them in, they're there for I think roughly 90 days.
• 50:26
  And I think they can be a great option for especially for women with our like busy lives and you just kind of set it and forget it.
• 50:30
  Okay.
• 50:32
  However, just like the peptides, I would v highly vet the doctor.
• 50:37
  Did they go to like a Yes.
• 50:40
  five hour course on how to do peptides and now they're certified.
• 50:43
  You know, like I would make sure they are f fully familiar with the peptides.
• 50:46
  They know how to do pellets. Pellets.
• 50:47
  Yeah. Or sorry, the pellets. Sorry, the pellets. That they're fully, you know, they're fully vetted and certified with the pellets because I've it go wrong. So once that pellet is inserted, that dose is there. And I've seen a lot of women have too high a testosterone and they're having a bad reaction because the testosterone level is actually too high. And once it's there, it's there. You have I mean you're just gonna have to ride through it for 90 days.
• 51:09
  There's not a lot you can do.
• 51:10
  ~ I've worked with multiple practitioners that they are going lower than any recommendation. So like it it gives you some recommendations based on labs like what the dosing should be for the pellet.
• 51:20
  And I've worked with several that actually go a little bit lower to ensure that we're starting low, Yeah. Okay.
• 51:25
  going slow. And we can, you know, we can change the dosing as needed.
• 51:28
  ~ A lot of the pellets I see though are estrogen or estradiol with a testosterone.
• 51:34
  Rarely do I see the progesterone added.
• 51:37
  So again, that would be the next conversation.
• 51:39
  If you have an intact uterus, are you also going to be prescribed progesterone?
• 51:43
  So just making sure that we're covering all the bases.
• 51:46
  ~ not opposed to pellets, I think they can be done really well, Okay.
• 51:49
  but they can also be done not so well.
• 51:52
  So just making sure, yeah, you know, that we're kind of vetting and like and looking at looking at those options.
• 51:57
  How do you find somebody who's well versed in pellets?
• 52:00
  Is there a way or just asking them questions?
• 52:01
  The that I ha You know, I haven't I haven't actually found like a website to vet the doctors that do the pellets. ~ I've worked with with a few here in just the Houston area.
• 52:13
  ~ and honestly it was just from a conversation we had and I was just kinda like, like how do you do the pellets and how does that work?
• 52:18
  And like just having that conversation with them, but you know, I would honestly go to their website, I would probably look at some of the reviews, but then also just have that conversation.
• 52:28
  Go in for that consultation, ask them like how do you assess you know, how do you assess the dosing and What does labs look like? And what does follow up look like?
• 52:35
  Are you just gonna put it in me and then forget about me?
• 52:38
  For 90 days and you're not gonna talk like what you know what you would wanna make Yeah. Mm-hmm.
• 52:42
  sure that your practitioner is following up with you in a couple of weeks, like, hey, how are you feeling?
• 52:46
  How is the dose? You know, so making sure that you are fully cared for ~ would be, you know, would be probably part of would be a part of the conversation.
• 52:55
  ~ unfortunately, I wish I had a website that showed like Vedit pellet providers.
• 52:58
  Yeah. I got that. Okay.
• 53:00
  If I find one, I will absolutely send that over to you because I think it's important women have that.
• 53:02
  And this would be an OBGYN or a a physician's assistant who works with an OBGYN?
• 53:07
  Sometimes~ you know, to be quite honest, I don't see a lot of OBG EYNs doing them.
• 53:13
  I actually see functional medicine practitioners are the ones that are gonna be more open to pellets and more They're gonna put in the time to do the proper research and training with it,~ as part of their functional medicine practice.
• 53:28
  So I would actually probably start there.
• 53:29
  I have not seen very many OBJ ~ ob OBGENs do do pellets and really I haven't seen a whole lot of them do hormone replacement therapy.
• 53:37
  ~ I again it's you know, it's just part of their training and their schooling Shocking.
• 53:41
  and ~ it's a it's a little unfortunate, but I'm hoping that over time we can kind of close the gap on education and options and and hopefully have it more readily available to more women.
• 53:51
  Yeah.
• 53:52
  Blows my mind that the OBGYNs don't know about hormone therapy.
• 53:56
  ~ okay. So moving on from that.
• 53:59
  So is all right, Yeah.
• 54:02
  but let's talk about like I've heard about D-Manos and creatine.
• 54:07
  Should okay.
• 54:08
  What is that? Is that what are those for?
• 54:11
  Is that also for Those are yeah. So they're two separate things.
• 54:14
  ~ D manos is a a potential option.
• 54:17
  You can find it over the counter to help maybe prevent UTIs.
• 54:20
  Okay.
• 54:20
  ~ it has a potential, so the idea is that it helps prevent the bacteria from cleaning to the the urethra, like the lining of the the bladder and of the urethra.
• 54:31
  ~ if you're having recurrent UTIs though, truly, I would prefer you have a conversation about maybe some estr vaginal The estrogen. Okay.
• 54:38
  estradiol.
• 54:39
  Like what we talked about.
• 54:40
  Yeah.
• 54:40
  because that, you know, that's really getting more to like the root of the issue than just constantly like being on this like supplement therapy Uh-huh.
• 54:47
  to prevent it. I would really like to get to more of the root.
• 54:48
  Okay. Okay. Creatines for muscles or now creatine is is a supplement.
• 54:53
  Yeah. So but it's so much more.
• 54:55
  So there's so much more research, especially for women as we're aging.
• 54:58
  Not only does it help preserve muscle mass, which I'm I'm a huge creatine user and advocate of.
• 55:03
  Like I love it.
• 55:05
  It can help preserve muscle mass, which again is important for osteoporosis prevention, keeping our bones strong, keeping our muscles strong.
• 55:10
  But there's a lot more ~ research coming out from cognitive benefits.
• 55:15
  So brain focus, mental clarity,~ recovery, you know, ~ faster like recovery, like just healthy agey, you know, so there there's been a lot more information that creatine is not just for like the gym bros. Like I think that's kind of what we thought it Yeah.
• 55:31
  as of these like bodybuild builders that are bulking up.
• 55:34
  I wish I could bulk up.
• 55:37
  I've been trying for like a couple of years now.
• 55:40
  So trust me when I say creatine is not gonna make you bulk up because girl I've Okay.
• 55:44
  trying and it's not working. But the cognitive benefits definitely~ like today I took it because you knew it was gonna be on the podcast.
• 55:51
  Like, I want to make sure like my brain is like ready to go.
• 55:54
  ~ I've even seen creatine used for when you've done a lot of like traveling from time zones, especially if you're going like overseas or like drastic time zones, really?
• 56:03
  they're using creatine to help the body readjust.
• 56:06
  ~ again, from the mental focus, the brain fog, that the time zone change.
• 56:11
  Like it's been it's been pretty incredible.
• 56:13
  Lots of benefits. Verily rarely do you see side effects.
• 56:17
  So some women say they might get bloaty.
• 56:18
  with it. I would just be cautious of the type of creatine you're using.
• 56:22
  I use a ~ one that just it's made from crea pure is how they describe it.
• 56:27
  And that is a water wash synthesis, right? Creatine is a synthesized.
• 56:31
  It's a processed product. ~ I use one that says crea So water washed?
• 56:36
  So water wash as opposed to acid wash.
• 56:39
  Sometimes the acid wash products of creatine, Okay.
• 56:43
  so again, you would just want to look at the label and just see how is it like It would say that on the label.
• 56:45
  Okay.
• 56:46
  see if it says like creapure or what it says on the label.
• 56:49
  ~ but yeah, the the acid wash sometimes maybe has more side effects potentially.
• 56:53
  I use one that just it's it's a water wash synthesis product.
• 56:57
  ~ and I personally I I mean not saying like I'm like everyone else, everyone might react differently, but ~ I I love it. I'm I'm pro creatine.
• 57:05
  Is it is what about dosing? Is that so it's typically it's five grams daily.
• 57:10
  Now there as you tolerate it, you can get up to ten grams a day, and that's when the research is really showing more of those cognitive benefits.
• 57:19
  ~ again, for some women, maybe it causes upset stomach a little bit.
• 57:23
  ~ again, I I I don't quite understand the bloating, like if they feel bloaty or if they look puffy.
• 57:28
  ~ but if you're noticing that they even start like three grams and then work your way up to five, and then from five up to ten, it's it's a it's a long pro you it's a it's a slow process.
• 57:37
  Don't feel like you gotta scale up quickly.
• 57:39
  ~ but that's that's about the range I would have you as like five to ten.
• 57:43
  How how long would it you think it would take to scale up from five grams to ten grams?
• 57:48
  ~ if you're tolerating it well, probably in the course of two to three weeks that you could probably get up You know, if you're using it daily.
• 57:56
  Now, if you're only using it a couple of times a week, it might take a little bit longer because you're kind of like readjusting.
• 58:00
  but I would I would, you know, highly recommend try it like thirty days of consistent creatine use, maybe three to five grams for a couple of weeks and then work your way up to ten grams and just and just see, see if there it makes a difference for you.
• 58:13
  ~ again, it's not like the miracle like, you know, pill. I think, you know, sometimes we get so fixated on like, I just need this one thing. But it's a great tool in the toolbox and I'm I'm very pro-creatine.
• 58:25
  Mm-hmm.
• 58:25
  Good, good. Okay. And then ~ bacterial vaginosis.
• 58:29
  Is this more what is that? Is that more like a UTI?
• 58:30
  Yes.
• 58:32
  And would the answer be estrogen again in your vagin vagina or what?
• 58:35
  It So, yeah, bacteriovaginosis is really just the descriptive term for infection of the vagina. And it and it can be different bacteria that infect it, Okay.
• 58:46
  different than a UTI. So usually UTI is E.
• 58:49
  coli, is typically the bacteria, but it's more infected in the urethra, right? Your bladder, like the the that tract.
• 58:56
  Yeah, yeah. Uh-huh.
• 58:57
  Bacteriovaginosis is actually more of an infection of the vagina itself.
• 59:03
  And so again, as we age and we're losing the estradiol and Our body is more at risk for some of these infections because also our protective bacteria has changed.
• 59:15
  The vaginal tract itself should be very like somewhat acidic.
• 59:19
  Your pH or that balance of acid to base that actually changes during perimenopause and to menopause. So you are just put at higher risk for some of these unique infections. ~ most of the time they call it BV or bacteriovaginosis as ~ you know, like a descriptor. ~ there are some therapies at the compounding pharmacy we make boric acid suppositories that are used vaginally that can help with that but again if you're having recurrent infections this is when we're gonna look at this is when I put on the lens of like what is really causing this not just how are we managing symptoms but what are we gonna do to make sure you don't keep having this over and over and I would highly again like recommend yeah the estr the vaginal estradiol Yeah.
• 1:00:01
  to help help prevent some of these these their common infections But you know, what's common isn't always normal.
• 1:00:08
  And like I wanna give you the best quality of life, because girlfriend, like you're stepping into your power decade.
• 1:00:11
  Yes.
• 1:00:13
  Like you need to be able to like live your best life for sure.
• 1:00:16
  Yes, for sure. And then so would would you recommend like a a probiotic for that? Or I i i for me like I always think about fiber being~ the best probiotic, right? But I don't know if that's true.
• 1:00:31
  Or do you need So there are probiotics out there that can help with the balance of the vaginal pH.
• 1:00:41
  ~ which can be a useful tool. I would don't I mean, I would not say that they always help prevent BV because again, if it's more of an estradiol issue, we're still kind of just putting like a band-aid on the issue.
• 1:00:53
  however, if you do have if your gut health is compromised, it's gonna compromise some other issues, right? So ~ you know, it's definitely something we would want to address.
• 1:01:01
  That's what I'm thinking.
• 1:01:04
  Now, fiber, I think, is more of like what they call like a prebiotic, so it helps feed the good bacteria.
• 1:01:08
  but if your gut health is compromised, we might actually actually need to use a probiotic to re-establish that good bacteria.
• 1:01:15
  ~ and similar with the vaginal tract,~ sometimes we need to reestablish the good bacteria there.
• 1:01:22
  ~ I have seen where you do like some probiotics used vaginally.
• 1:01:27
  I've also seen them taken orally.
• 1:01:29
  It it again it's a it's a tool.
• 1:01:31
  It kinda just depends on the nuance of the situation.
• 1:01:33
  which again like one right answer I guess.
• 1:01:36
  Is there my yeah.
• 1:01:38
  If it's Is there one you recommend? Like a feminine probiotic for that or?
• 1:01:44
  There is no not one that I would put like my stamp on.
• 1:01:46
  Okay, okay, gotcha. Thank you for being honest about that.
• 1:01:47
  Yeah. Yeah.
• 1:01:50
  ~ and then I guess what how long if we get on hormone therapy, how long do we s figure out how to stay on it?
• 1:01:57
  Mm-hmm.
• 1:01:59
  Do we just stay on it the rest of our lives?
• 1:02:02
  ~ you can. I've seen it. ~ again, we know we talked about the window.
• 1:02:06
  So once hormone replacement therapy is established, unless if there's a change in health status, a complication comes up, something that might change in the future, there's Not really a reason why you would need to actually get off of hormone replacement therapy unless it's also just your own values, right? If you're using hormone replacement therapy to just help you with symptoms of menopause or perimenopause, I have seen in menopause, usually all the hormones are just very low, but they're not fluctuating wildly.
• 1:02:38
  So a lot of perimenopause, the way we don't feel very good, it's because they're going up and down and sometimes they're there and sometimes they're not. It's those fluctuations that kind of throw our body for a loop. Not to say every Every woman in menopause just feels fantastic because I promise you they~ But for some women, it's easier to manage symptoms because now all the hormones are just kind of low and they're steady.
• 1:02:58
  So they're almost kind of at like an even steady balance.
• 1:03:02
  If that's really your goal is just to minimize symptoms, then you could easily consider not continuing hormone replacement therapy menopause. I dislike it there in menopause again from what we talked about with the osteoporosis prevention, you know, cardiovascular like decreasing cardiovascular risk, maybe potentially decreasing some dementia risk.
• 1:03:20
  So I like seeing my women on it again, maybe adjusting the dose over time,~ as needed, but that they're on it, you know, as as you know, somewhat indefinitely until there's a really a to stop it or to try and get off of it.
• 1:03:33
  but again, if you get off of it outside the window, it may be harder to like restart or re-establish.
• 1:03:39
  So just kinda understanding ~ your values and what makes the most sense for you from, you know, your goals of longevity.
• 1:03:46
  So like for me, I I really didn't suffer during perimenopause and now Yeah.
• 1:03:52
  not having a real bad time and I I mean, Yeah, you're you're coasting.
• 1:03:56
  I I'm really I I really feel like I am knockwood.
• 1:04:00
  I hope I don't, you know, curse myself now.
• 1:04:01
  Yeah.
• 1:04:04
  But ~ so but I would definitely be open to getting on hormones.
• 1:04:08
  And so then ~ just for those benefits that you recommended, Yeah.
• 1:04:11
  Yeah.
• 1:04:11
  but then what? ~ I just stay on them the rest of my life?
• 1:04:15
  How do I know?
• 1:04:16
  How would I figure that out if I can get off of them or not?
• 1:04:19
  Or you're saying I shouldn't.
• 1:04:19
  Yeah, I mean I think Yeah, I mean I'm saying there's not a reason for you to consider getting off of them. Unless, again, God forbid something happens later in life.
• 1:04:26
  Okay.
• 1:04:29
  Like like a blood clot or a stroke.
• 1:04:30
  Such as okay. Okay.
• 1:04:34
  I mean, if we're talking like, God forbid, catastrophic event happens to your health.
• 1:04:38
  Okay.
• 1:04:40
  that we would need to re-evaluate is continuing hormone replacement therapy the safest option for you? And that honestly might just be reevaluating Okay. What about cancer?
• 1:04:49
  is the estrogen component, the you know, project like, you know, the therapy that you are given, is it still the safest option now that we know like this event had occurred?
• 1:04:58
  Okay. What if~ so that is when I would like, you know, we would want to like re-evaluate it.
• 1:05:04
  Okay. And what if, God forbid, you get cancer? Is that a time to reevaluate?
• 1:05:09
  Absolutely. So and it also depends on the type of cancer.
• 1:05:12
  ~ I don't want to get into crazy conversation, Okay, good. Don't get into it.
• 1:05:18
  Yeah, no.
• 1:05:18
  but depending on the type of cancer, it may be appropriate for you to stop certain hormone therapy, Okay.
• 1:05:25
  but cancer is not an absolute contraindication.
• 1:05:29
  I think a lot of doctors think that, and it's not. ~ the research supports it.
• 1:05:31
  Okay. Okay.
• 1:05:34
  But ~ progesterone is some researches support.
• 1:05:35
  The research s ~ supports what?
• 1:05:38
  Staying on Not through staying?
• 1:05:40
  the therapy, but that you would be able to reinitiate hormone replacement therapy, so many years of ~ like a clean I'm so sorry, After I can't remember the terminology.
• 1:05:50
  It's not that you're a you're a cancer survivor, After cancer.
• 1:05:53
  so it's like so many years of surviv like where you're Yeah.
• 1:05:54
  Like five years after or ten years after?
• 1:05:56
  Yeah, so there there is some and I can't remember the timeline again, Yeah, okay.
• 1:06:00
  I apologize, but I know that there I have seen some research where they are reinitiating hormone replacement therapy.
• 1:06:06
  Okay.
• 1:06:07
  ~ and and and really it's looking at breast cancer specifically.
• 1:06:10
  Okay.
• 1:06:10
  Other types of cancer, if I mean if there may not be a reason for you to necessarily even get off the hormones if it's not a hormone even Okay.
• 1:06:20
  of cancer. And even the hormone-derived types of cancer, like the estrogen and stuff. Here's the thing: the crazy thing about the WHI study, the women that were actually had decreased cancer rates, and they're not talking about the ones that actually had their cancer rate were on estrogen only.
• 1:06:36
  Only right.
• 1:06:37
  And now everyone's thinking estrogen is causing estrogen breast cancer.
• 1:06:40
  Right, right, right.
• 1:06:41
  But the like, so it's not, I think it's just we just need to take a step back, reevaluate the situation. Obviously, your oncologist, they're the expert, not a pharmacist that's been working in a compounding pharmacy, Sure, sure.
• 1:06:53
  okay? So we need to follow the directive of your oncologist.
• 1:06:57
  ~ and what is like what makes most sense for your specific type of cancer, what makes most sense for your risk of it coming back, what makes most sense of you know, your hormone replacement therapy.
• 1:07:07
  But I depending on all of those situations, I am not saying like, ~ you're gonna be off hormones for the rest of your life, we're never gonna be able to introduce them.
• 1:07:14
  Okay. Okay.
• 1:07:15
  There is gonna be a speci you know, it's gonna be nuanced and it's gonna be individualized.
• 1:07:20
  I just don't I want any woman to think, I'll never be able to have hormones again.
• 1:07:23
  There may still be a chance, yeah.
• 1:07:24
  Yes. Okay.
• 1:07:26
  Okay. So is there anything that I didn't ask you that we need to talk about?
• 1:07:31
  ~ my goodness. we covered a ton.
• 1:07:33
  Feel like we covered a lot. Okay,~ yeah. so honestly, but what is there anything?
• 1:07:39
  I would just also highly encourage women, just because as I feel like it's we just to I feel like we should just say it.
• 1:07:44
  First of all, you're not crazy.
• 1:07:46
  Even if you feel like you're you know, Yes.
• 1:07:47
  if you keep being told like your labs are normal, your labs are normal, it is really tough because you start questioning yourself.
• 1:07:54
  And not the system that you're in.
• 1:07:54
  Yes. Right.
• 1:07:55
  So you start thinking, what is wrong with me?
• 1:07:57
  Why can't I get it together? ~ you're trying all these like band-aid fit, you and a and a lot of it is one size fits all.
• 1:08:02
  So like intermittent fasting and and you know, take this this supplement and you know, it's tough because we want it, we do, we want to grab for that one thing.
• 1:08:10
  But I just really want every woman listening, like, first of all, you're not crazy, you're not imagining it. These symptoms are real.
• 1:08:16
  It is really a biological response happening in your body, and I am going to recognize that, Hundred percent.
• 1:08:20
  and I want you to recognize that.
• 1:08:22
  there are options out there.
• 1:08:24
  There, I don't want you to only think hormones or no hormones are gonna feel trash. There are other options outside of hormone replacement therapy, which is a lot of the work I do because I work holistically, whether you're on hormone replacement therapy or not on hormone replacement or you're thinking about it. I just want women to know I don't want you to think this is an all or none thinking, that it your only option is hormone replacement therapy, or I'm just gonna feel like trash for the next 10 years.
• 1:08:50
  There are things we can do holistically.
• 1:08:53
  There are other options you can have and ~ as a gift to all your listeners I actually have a free cortisol reset guide that I'd be happy to share with the all your This is a great place to start to just get your body out of that survival mode Yeah.
• 1:09:07
  we talked about. Just increase our capacity for a little bit more.
• 1:09:10
  Help the body kind of like take that breath right and we talk about all the stuff on our plate and we got the thousand tabs open you're doing all the things and you're killing it and you're the sandwich generation you're da da da da da what if we took a breath?
• 1:09:22
  kind of give our body a just a little bit of a a warm hug and a little bit of support. I would love to give that to all of your listeners for them.
• 1:09:27
  Yeah, how do they get there?
• 1:09:29
  ~ and just let's just start there and then just look at your options.
• 1:09:33
  Like so that's the biggest thing.
• 1:09:33
  I just want to make sure that women understand that there are multiple options out there. And if your provider or if you're hearing a podcast or like not but like if you're hearing something that's trying to pigeonhole you and force you into only one modality, take a pause and recognize you have so many other options.
• 1:09:49
  There's so much out there to explore and you need to make the most informed decision for yourself and your health.
• 1:09:54
  Yeah, I think that's good advice. We're I'll put this in the show notes, but where do they get your cortisol reset?
• 1:10:00
  so you can actually find it honestly on my Instagram is probably the easiest place just because I have the link right there.
• 1:10:04
  Okay, okay.
• 1:10:05
  So I'm the Optimize Her Pharmacist, O P T I I Z E H E R, Optimize Her Pharmacist, P H A R A S I S I T. If I Spelled That All Right, Probably Not. ~ Yeah, I'll put it yeah, I'll I'll put in the show show notes and put I'll put a link to I was gonna say your Instagram.
• 1:10:19
  Yeah, if you want to put a link there and then I will also give you just the direct link if they want the cortisol guide directly from Yeah, I'll put that in there. I'll put it all in the show notes.
• 1:10:25
  for sure. Because I just wanna Yeah.
• 1:10:27
  I want every woman to feel empowered and like they actually can, you know, I want you to feel like you can take back the control of your health because you are the CEO of your body and you, you know, this is your time to shine.
• 1:10:37
  This is time for you to step into your power era and not feel so blindsided, you know, by perimenopause or menopause.
• 1:10:42
  That's right.
• 1:10:44
  I want, you know, I want you to feel like Beyonce all the time.
• 1:10:48
  ~ my God, that'd be nice. ~ okay, Yeah.
• 1:10:50
  and so they can also find you at Better Health and Hormone Balance, right?
• 1:10:55
  so I don't have that's not you they can honestly Instagram would be the best way to find me. ~ yeah, yeah, my website's like under construction Okay, just find you at Instagram.
• 1:11:04
  and it's it's been that way for a little while.
• 1:11:05
  Yeah, I get it.
• 1:11:06
  but you know, I'm just having so many great conversations on Instagram.
• 1:11:09
  I get to meet so many amazing people and women.
• 1:11:10
  Okay.
• 1:11:12
  ~ it's been like a really great ~ it's been a great way to connect with with with Yeah. Instagram can be good.
• 1:11:16
  people because every woman has a story and every woman deserves to be heard for sure.
• 1:11:20
  Yeah.
• 1:11:21
  that's so good. Yeah. That's that's the dang truth.
• 1:11:24
  let's see. I think that was that was it.
• 1:11:28
  ~ all right, Tiff Dr. Tiffany.
• 1:11:29
  Okay.
• 1:11:31
  Thank you so much. We've talked for a while and and you've just been really Thank you.
• 1:11:37
  But I appreciate all of your yeah, This is fantastic. Thank you.
• 1:11:39
  thank you so much. Take care. Bye-bye.
• 1:11:40
  You too.
• 1:11:41
  Thank you.