Does Hormone Replacement Therapy Cause Cancer? The Myth, the History, and What Women Should Know

All right, and then we wait a little bit a few seconds so that people can join in. We can start the Instagram live, things like that. And then go live on Instagram. What have you been doing today besides seeing patients? Have you had like a little downtime? Not not really. Uh it's been it's been pretty busy and uh Hello. [laughter] We have a guest. Sorry. Very excited for this um podcast episode. Yeah. Yeah, so that that's uh it's been pretty busy. So, I finished seeing patients and now I'm here with you. All right. Yeah. Well, um there's two people in right now. One one person on Instagram. I'm just looking at the live streams right now, so maybe we'll wait another minute. Just have people join in and then get started. We have limited time and we have a lot to talk about. Sure. So, let's see. Maybe we should just get started. How about that? Before my cat attacks me. Super excited. He's so excited about this episode. Me, too. All right. Well, thank you everyone for joining. If you are here, um welcome to the Med Matrix Method Podcast. For the first time, we have one of our providers, Sophia, on, which we are very excited and very happy to have. Um during this podcast, we're going to be talking about hormone replacement therapy for both men and women. We hear a lot about low testosterone. We hear a lot about menopausal symptoms and everything in between for, again, both men and women, how hormone replacement therapy can be helping you and how to, I guess, navigate through that. Um very quickly, um this is for this podcast is for educational purposes only. This is not medical advice. Do not take this as replacement of medical advice. We are here to educate. All right, and make sure that for the Q&A at the end, the live Q&A that we do, make sure that you are um leaving comments of all your questions, any questions you might have, and we can get to them at the end and answer them. Um so, let's get started. Sophia, we would love to get Why don't you give us an introduction? Of Yes, well, first of all, thank you so much. Very excited for this podcast. Um so, I'm Sophia, nurse practitioner, um here at Mid Matrix. Been a nurse practitioner for many years, 20 years. For the past uh 5 years, I've been doing functional medicine. Um graduated from Institute of Functional Medicine, and this is has been my passion since since since then. That's amazing. And why are you excited to talk about hormone replacement therapy today? This is very very close to home. Um my age, being perimenopausal, also requiring some hormonal help. Um and uh a lot of my friends, family members. Uh so, yes, that's that's been a quite a journey. Yeah. It's very exciting. All right. So, let's get started and just can you define what is hormone replacement therapy? What are we talking about? So, when we are talking about hormone replacement therapy, we're talking about uh replacing estrogen, progesterone, testosterone uh in perimenopausal and menopausal females and males when the levels start to decline. Okay, and why why all of a sudden are we hearing all about it? Because uh it is very important because when hormones start to decline, people start experiencing symptoms. Uh there are many different symptoms for females, uh could be hot flashes, night sweats, could be anxiety, insomnia, could be mood swings, you know, fatigue. The same thing for males, it could be a fatigue, low libido, brain fog, and that's when we, you know, start feeling that there's something wrong and and we need some help. And I guess my follow-up question to this is why all of a sudden are we hearing all about it? Have have we always had these symptoms? We always have Yeah, we always I mean, you know, female goes through, you know, perimenopause, menopause. Males also go through the same hormonal changes, but since 2002, there was a study done, a Women's Initiative Study was done in 2002. They came up with uh um a a conclusion that hormones cause cancer. Conclusion wasn't exactly right correct because the study used synthetic hormones, where we use bioidentical hormones. And since the study came out and concluded that hormones cause cancer, that caused a lot of chaos and um you know, hormones were forbidden from use. So, that's But all of a sudden, just recently, you know, there was a lot of discussion around hormones and and replacing hormones and FDA just recently lifted the black box warning from from estrogen, vaginal estrogen, and I think it's there's more and more education out there about hormones and benefits of hormones. Oh, interesting. Okay. So, why does this really matter? Like what Why does hormone balance matter beyond these symptoms that HRT might, you know, fix. [snorts] Well, hormones, you know, they are matters. Like I said, it's matters. It's It's everything. It helps with our metabolic health, energy, with you know, sexual life. So, it It matters for quality of life, for longevity, for, you know, for healthy lifespan, I'd say. Mhm. And And how Can you go a little bit deeper into that? Like how it impacts our lifespan? Uh so, when we, you know, when we enter menopause in then in female men enter and and menopause, uh you know, we start when you we start losing hormone, we start losing protection from hormone. Especially, we talking about cardiovascular protection, bone protection, brain protection. Uh and that's where the, uh you know, lifespan or a longevity comes. You know, being healthy, having cardiovascular system, healthy cardiovascular system, healthy brains, strong bones. That's where it becomes very important. Interesting. So, we talked about it being, you know, historically misunderstood. But how, I guess, has that changed kind of now? And how are we thinking about hormone therapy now in contrast to how we were 20 years ago when that 2002 study came out? I think So, now I think, uh as a providers, we are more open to start discussion with patients about hormone replacement therapy. And uh patients are more more open to hear about hormone replacement therapy. So, it's both ways communication. Interesting. Yeah. Um And we talked about how, I guess, yeah, we clinicians are more willing to, you know, prescribe and to notice when people need hormone replacement therapy and people's acceptance of it. But, how do you think it's changed the way that clinicians will utilize it? And and how it's changed their care when it comes to hormone deficiency? And hormone deficiency. How it will So, it can clinicians again nowadays is more open to utilizing hormones in you know, or discussing hormone replacement therapy with with patients. And they're more willing to utilize those hormones in in patient care. Um Yeah. Yeah, so how has that changed their care process? Like, how has that changed the way that like what How did they care for, let's say, menopause in the past and how are they caring for it now? So, in the past it was while you were getting old, it's it's it's a process, it's age. Uh go through it. You just, you know, if if you have symptoms, they will go away. Just just stick with the symptoms or they they'll they'll go away and that's it. But, now we you know, now that we have more education about hormone replacement therapy, we realize that uh people don't have to suffer through through menopause, through their uh stages of life. They can utilize all the tools that are available and and feel better. Well, interesting. And what about for men? The same for men. We have not heard a lot about, you know, low testosterone until the most recent years. So, what How is it impacting men? Yeah, it's it's impacting men the same way. Uh you know, we hear a lot of uh complaints of fatigue, brain fog, you know, low libido for men. So, they go through the same process as females do. So, it's really important for for males as for females. Interesting. Well, so I guess for both male and females, how would hormone changes affect, you know, we covered that affects aging, metabolism, your body composition. It affects those things. How can you kind of break that down how that happens? Well, what are you referring to? How the decline happens or what's Yeah, like how the decline happens and what that would do to the person and and if that's So, let's let's Yeah, let's start if we talking about female patient, you know, as female enters perimenopause and it can happen at any uh age starting, I would say, age 35 on. Perimenopause can happen and female can start experiencing uh unexplained anxiety, mood swings, you know, insomnia, and you know, all those unexplained or depression, unexplained depression that that never was there before, was happy person and then woke up one day and felt very depressed and anxious. So, uh so, that's those are symptoms that sort of uh you know, can be uh uh uh symptoms of perimenopause. Yes, when when when we start talking about hormone replacement therapy. Interesting. And and you know, for male. Sorry? The same for male. Feeling fatigue, feeling libido, low libido, uh you know, brain fog. So, it um I guess knowing that these symptoms will mimic like these or give us mental instability. Let's say that in in the general scope of depression, of anxiety, things that will become a mental hindrance to our life, our day-to-day life, and cause problems. How was How are those symptoms usually treated or dealt with in in like before hormone therapy, you know, not knowing that hormone your hormone decline is like this root cause. How would that work? So, before it was uh and even now it still is uh you know, female are given SSRIs and uh or just patients given SSRIs and that's that's basically the treatment for anxiety, depression, um mood instability, yeah. Um, Dr. Rose actually told me a couple weeks ago that there is a statistic on the number of women that are one once they hit menopause, I think it's like the year after menopause, there is 20% of women who a year after menopause are now on SSRIs, and then after that uh like 2 years later the number doubles to 40%. Which is a crazy statistic, you know? True. Yeah. What are your What are your thoughts on that? Well, like I said, it's it's it's closely related to hormonal changes and uh when we lose uh hormones, we you know, become more we can become more depressed cuz you have hormone receptors all over the place from starting from your brain uh from brain from head to toe. So, and when you lose hormones, you you know, it's very individual individualized, but you can experience anxiety, depression, mood swings, and many kind of psychological symptoms. Well, and this is for both men and women, correct? for both men and women. Yes. Yes, we can forget that. What are the male statistic is then? Because we know about, you know, the the menopause statistic with SSRIs. I wonder what that male statistic is. I'm sure it's around the same, honestly. Yeah. Yeah, I agree with you. So, these symptoms, I guess this is part of like these symptoms that can overlap between women and men. Yes, absolutely. Yes. Mhm, interesting. And what are some of the root causes of hormone imbalance in Let's step away from menopause, cuz I mean, we can that is a root cause. But what are some of the other causes in women of hormone imbalance? So, other causes can be metabolic imbalances. Can be thyroid issues can cause imbalances. So, yeah, so it's not only it's only it's not only hormone cortisol can also cause imbalance. So, it's a lot of different um imbalances that create can create hormonal imbalance. So, how if there's all these different things that kind of build off of each other? Because I know that um What is it? I know that we just talked about how hormone imbalance can cause metabolic imbalance, right? So, if metabolic imba- imbalance can cause hormone disba- imbalance, how do we figure that out? Where that root cause lies? So, yeah, so here at MedMatrix, we'll look at uh you know, we'll look at everything. We look at hormone health. We look at, you know, your insulin level, your glucose level. We'll look at your lipids. We'll look at entire picture including hormones. And that's how we can uh you know, find out the root cause of the issue with uh yeah. Right. Interesting. So, what are some of these root causes for men then? Are they the same? The same. Um you know, insulin resistance, uh sleep apnea is a very big one, too. I see a lot of sleep apneas. When I see low testosterone levels in younger males, I always question sleep apnea. So, that's the big one. Insulin resistance is also a big one. Stress level, you know, nutritional deficiencies, uh lifestyle is also very important. It's very important, you know, to healthy eating, exercising. Uh also all those factors. Oh, interesting. And and again, we're going to go back to you know, why this root cause, why it matters. Why is this root cause so important before starting hormone therapy? Well, because it's like laying out a foundation. Yes, hormone therapy is very helpful and very much needed, but you also have to balance out other system. Uh because everything works in synergy. It's it's nothing works just by itself. You you know, you have hormone, you have thyroid, you have cortisol, everything working synergistically. Um interesting. Okay. Um so, going on to how this has been conventionally approached, right? Like how have have in the past, I know we kind of touched on this. How have we approached menopausal care? Uh before hormone sort of became more widely used? Yes. Yes. So, it was before um again, it was very individualized, but based on uh you know, just you know, just here's your you know, the smallest amount for the short shortest period of time and this is this is it. Now we are uh you know, more and more studies are coming out and we are becoming more and more educated and we we uh we can we use hormones a little bit differently that we used before. Can you elaborate on that? How are you using hormones differently? So we're using it maybe maybe differently is not a a correct word. We're using we have more open approach with using hormones that we that that was before. Yes. Interesting. Okay. And what about men? What about testosterone therapy? Uh same with men. Uh so also with men, you know, if if if you go to more conventional doctor, they only test uh total testosterone. We we test free and total testosterone. Um and uh optimal levels could be also a little bit different for uh conventional versus a functional um uh medicine. The optimal levels of of where Like in conventional medicine? of where where males feel uh so so for in conventional medicine, your your testosterone levels are uh you know, have to be very low like at 300 less than 300. And and and for in order to start treatment. In functional medicine, we are looking at a little bit higher levels uh of testosterone and and it for starting treatment. Mhm, interesting. Okay. And where does this conventional approach kind of fall short? Yeah, so it's it's very short visits. It's usually uh you know, and again, you know, they're not checking all the biomarkers that we check uh with functional medicine here at functional medicine. Uh you know, we like I said, we're looking at more of a metabolic health, thyroid health, insulin resistance where maybe conventional medicine due to due due to the lack of time doesn't look into all those biomarkers. Interesting. So, what are some things that I guess the patient or side effects a patient could should consider before starting hormone therapy? Side effects of hormone therapy? Side effects, are there any? [snorts] Besides feeling better? [laughter] Uh well, I mean, you want to make sure that uh you know, we you know, that we we take a very extensive history where we sit down with a female, history of her you know, breast cancer in the family, history of blood clots, uh making sure the uh you know, female is up to date with uh mammogram and pap smear. And for male, making sure we have a PCA levels available. Um so, that would be those um uh that would be the plan that before you start hormone replacement therapy, you want to have this information available. Mhm, okay. Um So, we talked about conventional medicine, let's shift more into functional medicine, our domain, what we're doing. How does functional medicine approach hormone therapy differently? So, we approach here at with functional here's at at Mid-Matrix we approach hormone therapy again looking at the root cause of uh [snorts] uh well, looking at hormone replacement therapy from many different angles and it's not only treating hormone replacement therapy but looking at the person's stress level, the person's uh sleep, person's lifestyle, person's you know, diet and and exercise and uh you know, um again, what's person's insulin level, what's the glucose level, what thyroid looks like. Uh that does this is this is a functional medicine approach. This is the uh functional medicine lenses. And how is evaluating that before somebody's considered or you know, starts HRT or before you create an HRT plan for somebody? How why is that so important? Because you it's you can't correct one without correcting the other. So, for example, you can't just concentrate on hormone replacement therapy without, you know, making sure the person is sleeping 8 hours a night which is a 7 to 8 hours a night, making sure, you know, patient is not under stressful situation, making sure that the diet is uh um you know, the the right diet or patient is person is exercising. So, all those factors are really, really important uh and looking at the whole picture, not just hormone replacement therapy. Well, so, um what are some I know that for women we look at testosterone, too. Can you elaborate on that? And for men, we look at estrogen, progesterone. Yeah, yeah. So, so so for We don't hear about that. Not not not really because we actually produce females produce all three hormones, estrogen, progesterone, and testosterone. We always think that testosterone is only a a male hormone, but it's also a female hormone. And uh there are times where uh you know, a female has uh symptoms of low libido, low very low energy, you know, also brain fog. That's where testosterone can, you know, can be checked and uh come handy as far as testosterone replacement. And uh for a male, uh in the body, testosterone converts to uh estrogen in the body. So, when we look at uh when we look at testosterone in males, we also And if we start replacing uh testosterone, we also look at uh uh estradiol levels because of that testosterone to estrogen conversion. Interesting. What is What does estrogen do in a man? What does What does testosterone do in a woman? Uh well, estrogen Right. So, estrogen in man is the same. It's cardiovascular protection. It's bone. It's brain. It's It's the same hormone. And for for females, again, it's it's libido. It's energy. It's mental clarity. Wow. Yeah. That's That's a learning curve. So, let's go into testosterone in general. Can you tell me more about like total testosterone? And I know that total testosterone is a different number that's looked at than, you know, there's a lot of different testosterone numbers, right? Yeah. So, so there's total testosterone and there's free testosterone. So, uh so free testosterone when we measure free testosterone, we measure testosterone that it's not bound to to sex hormone binding globulin, to the protein. So, when protein binds to testosterone, then less testosterone is left for cells to use. So, that's why it's very important also to measure free testosterone because that is the free testosterone is what our cells are using for energy, for um you know, libido and everything else. Yeah. Wow. Interesting. So, and switching right back to functional medicine, how does functional medicine, or you know, functional medicine at MedMatrix, how do we kind of tailor this approach? How do we personalize it? Uh again, when we meet with the uh women at MedMatrix, when we meet with the patient, we uh you know, discuss we start with uh you know, lifestyle, what what what what your day look like, how how are you feel, how is your stress level, are you sleeping, what's what's your family relationship. So, and then we build on this information and we uh you know, uh then look at lab work, look at uh what's what's uh what's the insulin, what's the glucose level, what's the thyroid, cholesterol, and everything else. So, that's what we do at MedMatrix. Yes, it's you know, a really in-depth approach to to uh uh to health. All right. And I I mean, how is that different than any functional medicine, or or any medicine in general? Well, medicine in general, you're you know, you usually have 15 minutes, uh you know, maybe 25 the most with your doctor and you address just one problem and uh that's all and uh this is it. So, there is no looking into uh you know, a lifestyle and and nutrition, which is very important and and uh as a foundation for everything, lifestyle. And that's what we at Men's Matrix do here is uh utilize all the tools and and and really look into every detail of person's life. Oh, interesting. So, somebody coming to Men's Matrix and asking about HRT, where would that process begin? So, that process begin initially with a discovery call when when uh we have uh uh the person who is again conducting a a phone conversation with that person uh uh uh uh asking details of what what brings that person to Men's Matrix and and after the discovery call, there's a we book a blood work. A person uh uh have their blood work done and then after that uh there's a meeting with a provider at Men's Matrix. Interesting. Okay. So, what um what do we what are we evaluating before we decide if hormone therapy is appropriate for somebody? Like I said, well, it's well, it depends on uh person's symptoms and complaints, uh but we like I said, we're looking at everything. We looking at metabolic health. We looking at thyroid health. We looking at cholesterol. We looking at many different things uh that that really goes into decision-making um of hormone replacement therapy. Wow. Okay. So, what might a personalized hormone plan look like for a a woman or a man? A what? The personalized plan would look like uh you know, nutritional plan, uh exercise plan, supplements, you know, a very important supplement plan based on finding from lab work. It would be you know, um uh you know, supporting thyroid health, supporting uh you know, uh insulin metabolic health, um and then HRT if needed. Okay. And what would, you know, this approach look like outside of like low T or outside of menopause? Like if it's someone who does not have uh it could be a gut health, you know, which is very important. We uh I didn't touch about gut, but it's very important. Everything begins in the gut in the gut. So, making sure, you know, there's you know, gut is healthy, gut health, uh you know, food sensitivities is also very important. Uh so, there's many other different uh tests that we can here at MedMatrix offer to patients uh if needed. Um So, um what does success look like then at MedMatrix? Success at MedMatrix looks like a person who comes back and says to me, "I feel great. Thank you. You you know, I came to you with so symptoms A X Y Z and and now I feel much, much better. Uh I can function better. I can be a better person. And this that's what success mean to me that we are, you know, helping and that that feels good. Yes. Yeah, it does. So, somebody listening to this segment, this podcast, what is a takeaway? What do you want somebody to take away from this? So, I would say uh do not ignore your symptoms. If you If you feel that there's something wrong and it's you've never experienced it before and now you you don't feel well and listen to your body. Don't ignore. Check check your blood work. Come see us and there's definitely help and we are here available for uh you know, to to offer that help. Amazing. Yeah. Well, thank you so much for going through this whole discussion. Um this has been enlightening for me as well. Um do you have a case study prepared to share? I don't have any particular case study. Do you want me to just I I don't I don't have any case study, but do you want me to discuss a patient or Well, we never want to like discuss patient details, but Well, no, I'm not going to say names [clears throat] or anything. to discuss success stories and I mean, if you work with a lot of women going through menopause, men with low testosterone, a lot with hormone therapy, then um but if not, that's okay. Well, I can Well, no, I can just tell you even from today's uh appointment, uh I saw a patient for a follow-up who uh started seeing us back in January and she came with she spent her menopause and came with symptoms of you know, brain fog and weight gain and fatigue and and you know, I started her on hormone replacement progesterone and testosterone and just today she said I feel much better. I feel I feel much better. She's not 100% optimized yet, but she definitely feels different from from when she first started. So I consider this a success. How have how have her labs kind of reflected that? Cuz we do the follow-up labs. So we did a follow-up labs. So her numbers are improved and yeah, so and she was pretty pretty happy and but it's work in progress. It's we we work with you know, we're going to see her back again and but even now three or four months after her initial appointment she already felt the difference. So that's that's I consider success. Oh, thank you for sharing. Yeah. All right. So it looks like we don't have really many questions. Um we do have one, but if you guys do have some questions, please feel free to go through like go comment them and then we'll be able to answer them. So let's start with this one. How can I get my testosterone up in natural ways? Yeah, so natural testosterone production is comes starts with lifestyle. Healthy lifestyle. So no smoking, no alcohol, healthy eating, you know, it's very important if person can get to sauna or do like detoxing every two twice a week is also very good. Exercising very important and supplements such as you know, magnesium, zinc, boron. Um, those are natural ways to boost testosterone production. Wow. All right. Well, thank you. Yeah. Um I don't think we really have any more questions, but this has been a fantastic episode. Thank you so much, Sophia, for jumping on. I'm so excited that you are going to be starting doing to do these live webinars and being these podcasts. You have a lot to share. You have a lot of experience and I'm excited for everybody else to be able to listen. So, thank you so much for your time. Thank you. All right. Thank you so much. All right. Catch the next one, guys. Bye. Bye-bye.