The Myths of HRT & More

On my live today, I am talking to my functional medical doctor, Dr. Warren Willey all about hormone replacement therapy. The myths, the pros and cons and more.

If you missed it, here is the link to watch: https://www.instagram.com/reel/C8XQY9ouWmt/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==

Dr. Willey and I have know each other for over 20 years. He has been a functional medical doctor for over 30 years and currently practices in Idaho. He has also worked at the Mayo clinic as well. He builds his practice on listening to his patients so they feel heard and then treats them accordingly. Everyone is an individual. Dr. Willey specializes in women’s health and hormones.

This quote sums up Dr. Willey’s practice and it is a quote I think all women need to hear to find the right doctor for them: “If you listen, the patient will tell you the problem”

Here are some notes from our live:

What is HRT?
- Hormone repleacement therapy
- Usually sex hormones
- Estrogen, progesterone, testosterone, DHEA
- There are dozens of hormones
Types of HRT:
- Primary Hormones:
  - Estrogens (3 of them)
  - Progesterone - more than just a “pregnancy” hormone
  - Testosterone - steady state release hormone, realeased by skin, ovaries, and adrenal glands
Pros and Cons:
- Cancer risk?
  - This comes from the scare of the women's health initiative
  - Esposure to toxins, sleep, sympathetic tone, stress levels is more indicative
  - Senescent cells don't go through natural desctruction cycle and can become cancerous or cancer-triggering
- Pros: protects your brain, emotional state, libido, quality of life, heart, skin, metabolic balance, bone
  - Improving quality of life increases healthspan and life span
- Cons: with synthetics or providers who don't know how to prescribe
Who is a candidate:
- OBGYN procedures can “throw” you into early menopause
- Any woman is a candidate
- Age “limit”?
  - Perimenopause can start 15 years before actual menstrual cessation
  - Starting at age 35 for women, this can become important
Bioidentical vs. synthetic
- Bioidentical - From wild yam or soy, chemical structure is identical to your endogenous production
- Synthetic - e.g. Premarin - animal urine, not bioidentical, “progestin”
Understanding lifestyle factors that influence this:
- How you move
- How you eat
- How you interact in relationships
- How you sleep
Helpful things:
- Quercetin - over the counter supplement to help with cell senescence

Q&A:

Dutch testing: “normal” levels can be very misleading, what status was the woman in, what part of her cycle was she in. Listening to symptoms first.
“I've gone to multiple providers and they won't treat me”
- You need to see a provider who will treat your symptoms above your labs
Changing levels, cream adjustments
- Lots of different “delivery” systems for hormones
- Pellets - must be appropriately dosed and not given “unopposed” without
- Biest cream (estradiol and estriol, often 80/20)
- DHEA is an adrenal hormone - cortisol's “antagonist”
  - Tropic hormone “before” testosterone
  - Too much makes them irritable and short-tempered
- OTC progesterone creams are yam derived, very low dose, may or may not help depending on if you need prescription strength
What is estradiol: prominent estrogen in childbearing years
Which hormone causes weight gain? ALL OF THEM
How long does it take for HRT to start working?
- At least 3 weeks
- Injectable, oral, and troches are pretty quick
- Depends on where you are in your cycle and your age
There are providers who listen, there are providers who know, there are a growing number of practitioners who
Vagifem: for painful sex - just estrogen is missing something
- Not complete
- Recommend local DHEA cream
- Try 0.01 mg E2 + 1-2 mg DHEA + 1-2 mg Test + Viagara