So many women I've been meeting lately have been complaining about their symptoms, and I notice an enormous amount of misinformation and lack of information around how you can feel better when you're going through menopause.

So this episode is an explanation of the different types of hormones out there so you can be a little more informed when you go to your medical provider.

And again, I always want to emphasize that you should look for a medical provider that is menopause trained or menopause certified, which can be found at the menopause.org website, which is the North American Menopause Society.

A lot of doctors, believe it or not, do not get trained on menopause.

They may be trained in Ob GYN basics on how to help you have a baby, but they may not know much about hormone therapy or what you are going through as a woman in menopause.

I hope this episode will clarify some information for you so that you can go forward.

Informed welcome to the Taboo to Truth podcast, unapologetic conversations about sexuality in midlife.

I'm your hostess, Karen Bigman, certified life and menopause coach and sex educator.

Whether it's a dwindling libido, a dry vagina, a challenging erection, or the emotional ups and downs of midlife, we're here to talk about it all.

I'm going to bring the often quiet into the light to create a safe space where no question is too awkward or taboo.

Together, we're creating a community of support and education where you can learn, share, and laugh about the intricate beauty of sex in midlife.

So grab your favorite drink and put me on speaker.

It's time we broke the silence.

I'm going to talk to you about something I'm hearing a lot about lately, which is the misunderstanding about what the difference is between bio identical, synthetic, and natural in terms of hormone therapy.

Because there is an enormous amount of misinformation.

There's also the delivery systems, the type of delivery systems of hormone therapy, and then there is compounded hormones.

So when you are going through menopause, when you are symptomatic, now, menopause is defined as twelve months without a period.

So it doesn't mean that you won't be symptomatic because your symptoms are generally start when you're in perimenopause.

When perimenopause that's premenopausal, you may be having erratic periods.

You may be having heart flashes, night sweats, heart palpitations, tinnitus, frozen shoulder.

There are many, many parts of your body that have estrogen receptors.

And when you are going through perimenopause, your estrogen is dipping and so, and so is your progesterone and so is your testosterone.

These hormones affect not only all these systems in your body, it also affects your libido, it can affect your ability to orgasm, it can affect your mood, causing depression.

And often doctors throw antidepressants at you or therapy at you or some, they treat different things, not realizing that it's a hormonal imbalance and therefore you need to treat the hormones.

So hormone therapy has gotten a really bad rap because there was a study that was done over 20 years ago now that linked hormone replacement therapy with breast cancer, and they have debunked that study.

They have taken some good stuff from that study, which are the, that actually, hormone therapy helps on many levels.

It helps with cardiovascular health, it helps with your brain health, it helps with your bone health.

There are so many reasons to look into hormone therapy, but the most important thing is that testing your hormones is not the right way to figure out whether or not you need hormone therapy.

Hormone therapy is prescribed when you are symptomatic.

I'm not a doctor, so this is from my own research.

You definitely want to talk to your own doctor, but what you want to know is you want to speak with someone who understands that.

So if you are 40 years old and you can't sleep at night, or you have whatever your symptom is, it doesn't matter whether or not you haven't had your period for twelve months.

Because if you feel like crap, then you want to treat that.

You don't want to feel like that.

And there are long term effects of having hot flashes affecting your heart.

Okay?

And heart disease is the number one killer of women and not breast cancer.

Heart disease.

So keep that in mind.

What is hormone therapy?

Hormone therapy or hormone replacement therapy or menopause hormone therapy?

You may hear all these different terms.

We tend to think about it.

The layperson tends to think of it as HRT.

That's how it's been named.

They're trying to kind of shift to calling it menopause hormone therapy, because there are other kinds of hormones that you may have issues with, like your thyroid, etcetera.

What I'm talking about, I'm talking about hormone replacement therapy for menopause.

Your estrogen level, your progesterone level and your testosterone levels.

That's what hormone therapy is.

When you're talking about menopause, it's very important to know is the difference between synthetic, bio identical and natural.

Let me start with natural, because this one kills me.

Natural is not a regulated term.

I can tell you this is a natural podcast.

Arsenic is natural.

Natural doesn't mean anything.

We tend to think that it comes from the ground, right?

So that natural from the ground.

Okay, got it.

But it is not a regulated term.

So it may not even mean that I can make a synthetic product and call it natural.

There'll be no lawsuits, because natural doesn't mean anything.

Bioidentical hormones, which are what your doctor would prescribe for you, mimic the body's systems.

So mimic the way that the body makes the hormone.

So when you take a bioidentical hormone, it is prescribed specifically for you, for your symptoms and to your body.

And while it is created at a pharmaceutical company, in a lab, it is derived from natural sources, yams.

And I don't know all the things that they put in it, but what they do is they process it in the lab, and then the FDA looks at it and says, yes, this is a true bio identical product that you can use that will mimic your hormones and make you feel better.

Okay, so that is a, if you go and get a prescription for a bioidentical hormone, not a compounded one.

I'll talk about that in a minute.

For bioidentical hormone, for hormone therapy, like a patch, or in my case, I have an IUD with progesterone.

Sometimes people take a progesterone, micronized progesterone, which is a pill.

Those are made in labs, but they are bio identical.

They mimic your biology.

Now, if you get compounded hormones, sometimes people feel like those are more natural.

They're still using the ingredients of progesterone, estrogen, and testosterone.

However, the North American, and I'm going to read this to you, the North American Menopause Society states that even though hormone custom compounded hormones are something that people believe are bio identical, they really depend on their custom in that youre provider can say, you know, so much of this, so much of that, so much of the other.

However, once it's compounded, the FDA no longer looks at it.

So FDA approved hormone therapy products available at retail pharmacies, those meet the definition of bio identical.

It's the same chemical and molecular structure as the hormones produced by the body.

If they're in compounded formulations, they may contain other active ingredients that the FDA has not improved for binding for, you know, what they put the pellet in.

Those are all things that may or may not be safe once they're custom compounded.

Each pharmacy is different, different states, different pharmacies down the block.

How they deliver it.

Custom compounded hormones can be risky.

And this is, again, from the North American Menopause Society.

They do not have government approval because individually mixed preparations have not been tested to prove that they are absorbed appropriately or provide predictable levels in blood and tissue.

There is no scientific evidence of the effects these combinations have on the body, either good or bad.

Preparations may vary from pharmacy to pharmacy, and it means that consumers may not receive consistent medication.

Keep that in mind.

If your doctor recommends a compounding pharmacy, you want to just really understand what that means because it is not FDA approved and by testing your hormone levels, there's no test that says a right amount of hormones.

They can test your FSH, which is the follicle stimulating hormone, but they can't test whether you're in menopause and what your hormone levels are because they vary from minute to minute, day to day and time of day.

When you're prescribed hormone therapy, if you have a uterus, you should be prescribed estrogen along with progesterone, because if you don't, you'll get a thickening of the uterus and be at risk of uterine cancer.

I hope you're enjoying this episode of Taboo to Truth.

Do you have any burning questions about sex in midlife menopause, dating after divorce, or exploring the spicier side of things like polyamory or kink?

I want to hear from you.

Head over to my website, taboototruth.com, and fill out the form with your questions.

I'll answer them anonymously in upcoming episodes so you can get the scoop without revealing your identity.

It's like having a secret hotline to all your midlife sex questions.

Whatever it is, I am all ears.

So jump over to my website, tabutotruth.com, and let's keep the conversation going.

Now back to the show.

If you're prescribed estrogen, it comes with progesterone.

You may also be prescribed testosterone, which I'm going to do a whole other episode on testosterone because that's another one of these hormones that can be controversial.

But when you get your hormones, hormone therapy, you are going to get, in my case, have a patch and an IUD with the progesterone.

You may get an oral, you may get a cream.

But if it is compounded, you do not know exactly what you are getting.

Even though the hormones themselves are FDA approved, the actual formulation that you're putting in your body has not gone through FDA testing to make sure that it has been.

That it has exactly what it has, what it says it has, and it may have a binding agent or some other ingredients in it that you don't know about.

So understand that hormone therapy is something that is used to treat your symptoms, not whether you're a menopause or not menopause.

Twelve months without the period doesn't matter if you have, you are symptomatic.

Tendonitis, frozen shoulder, heart, palpitations, not just night sweats and hot flashes.

There are so many symptoms that you could be having hormone therapy, hormone replacement therapy, menopause, hormone therapy, whatever you want to call it, is how it can be.

Treat it.

You want to go to a provider that understands that.

Second, you want to know that natural is not necessarily safe.

All this belief that I want something natural.

What you're getting when you get a prescribed hormone is a bioidentical, which is derived from natural sources, but it is created in a way that it can mimic your body and make you feel better and in a regulated way, so that we know exactly, or the doctor knows exactly how much they're giving you based on your symptoms, and maybe they'll give you more, more of one or the other, or a higher dose, or a lower dose, whatever.

That is a medical decision, but that's what you want to know.

And then the last thing to know is that synthetic is.

That's the one that you want to stay away from, because synthetic is not necessarily mimicking your body.

And I don't even know that synthetic hormones are prescribed anymore.

However, premarin, which was the synthetic hormone that was so controversial, was used by women for many, many years.

That's what the study was done on.

It was done with, with some of these synthetic hormones, and they actually know that it helped women for many years before the study came out and freaked everyone out, and people stopped.

Do your own research.

You don't have to suffer.

It's really important that you understand that hormone therapy is a good thing.

It is good for you.

It is good for you to make you feel better, and it's also good for you for your long term health.

The last thing I want to talk about, which is another form of hormone therapy, is topical estrogen, which we put on the vulva, that is for vaginal dryness.

But it also helps prevent UTIs.

UTIs are a very big killer of women because we don't always know when we have them.

And they've actually done a study that proves that the government would save $10 billion in medical care.

If every woman who goes through menopause put topical estrogen on her vulva, which is not systemic so it doesn't cause breast cancer, all it does is help you feel better.

It's like putting a prescription collagen on your face, only you're putting it on your vagina.

And it's helping with many other things.

Hormone replacement therapy for systemic hormone therapy for hot flashes and all the other issues that you may be facing in menopause, topical estrogen for vaginal dryness and UTI prevention, amongst other things.

Please do your research.

Go find a provider that understands that you want to feel better and that the belief that hormone therapy can hurt you, or the fact that they don't even know about hormone therapy at all, that they should, because menopause happens to every single woman and we do not need to suffer anymore.

Thanks for joining me on the taboo to truth podcast, where I'm spicing up midlife one episode at a time.

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And until next time, grab your favorite drink and put me on speaker.

It's time we broke the silence.