Despite the numerous well known benefits of menopausal hormone therapy, it's important to talk about some common side effects. The most common frustrating side effect that we seen our practice is a new onset of bleeding, which affects about 5% of patients. The good news this is very rarely anything to worry about. It is certainly a major annoyance that needs to be addressed. Today I'll discuss why this happens in both menopausal and perimenopausal patients, how to evaluate it and most importantl...
Oct 24, 2024•22 min
During the last decades of confusion about menopausal hormone therapy, many well-meaning solutions were offered to patients claiming to be safer than the feared traditional HRT. These include combinations of estrogens, progesterone and testosterone in the form of topical creams and sublingual preparations. Now that we are emerging from this fog of confusion, and understand that estradiol, progesterone and testosterone are not only safe, but also provide numerous health benefits for women, it's i...
Oct 17, 2024•19 min
Managing the time leading up to menopause, known as "peri-menopause," can be particularly challenging due to fluctuating hormone levels and their often unpleasant side effects. These years can feel like an unpredictable roller coaster, making it difficult for both patients and providers to find balance. However, understanding what's happening in your body during this period is key. With the right knowledge, we can develop a treatment plan that includes effective options to alleviate symptoms and...
Oct 02, 2024•43 min
As science progresses, it's so important to recognize when we got something wrong and tell patients that we have learned something new and better. Too often, doctors are stuck in their old ways and are not up-to-date in the latest science, and are continuing to practice out-of-date medicine without recognizing that they were wrong. Today I'm addressing the top five things that I personally got wrong, and I told patients these things for years before learning that there was a better way based on ...
Sep 25, 2024•22 min
With metabolic dysfunction on the rise (including everything on the insulin resistance/pre-diabetes and diabetes spectrum) it's critical to understand how we are metabolizing glucose and carbohydrates. When you come to the doctor's office, we typically check glucose, insulin and other markers in a fasting state, but we have no idea what happens later in the day. Until recently, continuous glucose monitors have only been approved by insurance for diabetic patients and have required a prescription...
Sep 18, 2024•15 min
Now that we are all aware of the multiple health benefits of taking menopausal hormone therapy, let's dig into some of the questions regarding timing, particularly for estrogen. There's no doubt that starting estradiol as soon as possible after menopause helps keep our blood vessels healthy, and reduces the risk of cardiovascular disease as well as multiple other diseases, including Alzheimer's. But what if you were not offered hormones and you are now more than 10 years past menopause? Today I'...
Sep 12, 2024•19 min
This has been an exciting year with much more attention being paid to midlife women's hormonal health. Finally perimenopause/menopause is getting a voice, and the use of MHT (menopausal hormone therapy) is becoming widely accepted. Once we have decided to take menopausal hormone therapy, there are multiple options of products and routes of administration. Today I'll be discussing the different options for bioidentical menopausal hormone therapy, and the pros and cons of each. It's also important...
Aug 28, 2024•40 min
Vitamin D is the subject of a lot of controversy right now after the Endocrine Society made new recommendations in June 2024 suggesting that routine screening for vitamin D was not necessary, and routine supplementation was not beneficial for the average person. Today I'm looking into how they came up with this recommendation and what hundreds of studies have shown over the years, to put this recommendation in context. Everyone agrees that vitamin D is critical for life and no one is suggesting ...
Aug 19, 2024•37 min
Creatine is a naturally occurring peptide consistent of 3 amino acids, and has been widely studied for its numerous benefits and low side effect profile. In fact creatine is the most studied supplement in the world. Well known to improve muscle mass and sports performance, creatine is particularly relevant in midlife when losing muscle and bone accelerate, and gaining muscle can be more challenging. As well as the numerous health benefits related to muscle and bone, creatine also has important i...
Aug 19, 2024•24 min
Most of us have heard a lot about insulin resistance but many of us still don't understand why it should be considered a disease in and of itself, separate from diabetes. Insulin resistance affects more than 50% of our patients and causes weight gain around the middle, as well as increasing heart disease, Alzheimer's disease and of course, diabetes and its related complications. My hope is that with a better understanding of how this process works we can each get more involved in doing the thing...
Jul 25, 2024•25 min
Today I'm back with my partner, Dr. Leah Antoniewicz, discussing Nitric oxide. This fascinating molecule is made of one nitrogen and one oxygen atom (NO), and reduction in nitric oxide has been shown to be associated with an increase in multiple diseases as we age. Today, I'll be talking to you about the science of how nitric oxide works, as well as how to naturally increase it and some things to avoid that might be decreasing it.
Jul 04, 2024•22 min
Our understanding of the vital importance of the gut biome has skyrocketed in the past 10 years, yet we are still just beginning to learn all of the incredible functions of these healthy bacteria. Today I'll be reviewing the role of healthy gut bacteria in the prevention of multiple disease processes, including the most common diseases that affect American women- obesity, insulin resistance, diabetes and cardiovascular disease. I will particularly be talking about a really interesting key bacter...
Jul 02, 2024•28 min
Iron is a vital micronutrient that is sub-optimal in more than 50% of women. This is frequently missed because it masks as many other things, and most doctors don't check the labs that are necessary to evaluate this completely. Today I'll be talking about where we find iron in our diet, how to diagnose low iron and how to address it by evaluating our input, absorption, and ruling out any sources of blood loss. I'll also tell you about my own story with low iron, how I corrected it, and how both ...
Jun 19, 2024•25 min
We all know that alcohol is a toxin with numerous effects on our health - from weight gain, to sleep and mood disruption as well as causing multiple cancers, diabetes, heart disease, gut dysbiosis, liver damage and dementia - even at "socially acceptable levels." Many of us drink in moderation and don't consider it to be a "problem"- but today I'm discussing an interesting way of reframing your relationship with alcohol and being very clear about where it might be causing problems in your life. ...
Jun 12, 2024•20 min
The most common killer of both men and women is heart attack, so understanding how to reduce our risk could not be more important. Since the 1980's, studies have consistently shown that menopausal hormone therapy (particularly estrogen) reduces the risk of heart disease in women. The now infamous Women's Health Initiative study surprised the medical community in 2002 by suggesting that hormone therapy increased the risk of heart attack in a small subset of women. After 22 years of gathering more...
Jun 04, 2024•22 min
Many people have strong opinions about compounding pharmacies, although few people know what they really are, how they are regulated and what the difference is between one type of compounding pharmacy and another. There is a perception that compounded drugs are not FDA approved, not regulated or somehow not safe or reliable. Today I'm going to explain what these pharmacies are, why we might choose to use them (or not) and why the perception that compounding is inferior or not safe is quite inacc...
May 29, 2024•22 min
This past two decades has brought so much confusion about menopausal hormone replacement and breast cancer risk, but we now are entering a modern time with a much better understanding of how all this works. Today I'm going to review how this controversy ever started and what the modern understanding is regarding estrogen and breast cancer. You may be surprised that we are now flipping the script and realizing that estrogen not only has no effect on increasing breast cancer risk, but actually red...
May 22, 2024•30 min
While the safety and benefits of menopausal hormone therapy (MHT) are becoming widely accepted, hot debate continues around dosing, delivery methods and how to monitor levels. Advisory boards including the American College of Ob/Gyn and the Menopause Society support the use of (MHT), but much confusion continues regarding ideal blood levels, whether to check blood levels at all, and optimal route of delivery. The dosing of both estradiol and testosterone varies 5-10 fold between methods such as ...
May 15, 2024•25 min
Sometimes we have to be our own advocate and ask for the tests that we need since many doctors don't offer very high-level labs that can be critical to maximizing your healthspan and helping you to feel great. Today I'm going to go through a real patient's lab panel and show you what we look for in our office during a hormone consultation. I'll be discussing the difference between "reference ranges" and "optimal ranges" so that you can interpret your own lab values with a critical eye and make s...
May 08, 2024•41 min
So much has changed in our understanding of cholesterol and how it affects our risk for heart disease since I was in med school! Until recently we talked about "good cholesterol" and "bad cholesterol" with very little understanding of what those words actually meant. Today I'll attempt to unwind a little bit about what cholesterol does in our body, how to test for the particular lipoproteins that put us at highest risk for heart disease, the importance of ApoB, and most importantly what we can d...
Apr 30, 2024•25 min
Have you been as confused as me about all the controversy that you hear about which fats are the healthiest? Which ones we should avoid and which we should consume more of? What does MUFA, PUFA, trans fat or saturated fat mean? Is a low-fat diet healthy or should we aim for 30% fat or higher? Today I'll go through a basic introduction to the types of fat that are available in foods, which ones appear scientifically to be the most healthy, and which ones we should avoid.
Apr 24, 2024•28 min
Last month my video with Dr. Antoniewicz (@drleahatoz) started the discussion about the importance of diagnosing and treating insulin resistance, not only for weight management but for lifelong health and disease reduction. Today we are digging more into this really important and complex topic, and highlighting some more details about what IR is, why it’s important, how we diagnose it and how we can treat it with simple concepts surrounding Nutrition, Movement, Rest and Stress (emotional and phy...
Apr 17, 2024•1 hr 2 min
Today I'm discussing a fantastic option for dealing with one of the most difficult problems that we experience in menopause, which is vaginal dryness and pain, as well as decreased sexual sensation. While hormone therapy is the mainstay for restoring vaginal health, vaginal laser therapy is another tool in the toolbox that is safe for patients who cannot take estrogen due to current or recent breast cancer, or even for patients like myself who just want a little extra boost! This week was time f...
Apr 10, 2024•28 min
I am delighted to see more attention paid every month to issues regarding menopause and perimenopause, with articles popping up in every magazine and newspaper, often with celebrities talking about their experiences. We're finally starting to have a voice in the world about this critical time in life. While this is a fantastic development, one of the dark sides is that it has opened up a market for companies to sell products that claim to help with menopause symptoms, but have no scientific back...
Apr 02, 2024•25 min
Every day I am asked several times if the HORMONE REPLACEMENT causes WEIGHT LOSS, and the answer is a little bit complex - but generally YES! The important thing to know is that it is not the hormone replacement itself that causes weight loss, but the different ways in which it increases your energy, improves with sleep, improves mental outlook, muscle mass, physical strength, and all of those things that we need in order to move more and stick to our healthy nutrition plan. Apart from ovarian h...
Apr 02, 2024•13 min
Discover the untold story of testosterone in women and join the call for equitable healthcare options. This video describes how testosterone occurs naturally in women, how to safely replace it, and some curious history of how testosterone replacement for women has been overlooked. 💡 Why is testosterone treatment for women overlooked? Uncover the biases & advocate for change. Learn about crucial hormonal health and why we need FDA-approved testosterone therapies for women now more than ever—...
Mar 21, 2024•22 min
We have SO many requests to join our weight loss optimization program from outside of Houston, or even outside of Texas or the United States - and finally, we have created a plan that can make this work for you no matter where you live! Today I'll be describing how our weight loss optimization plan works, reminding you about the "six pillars for success" over our 12-week program, and how this could work for you if you live in Texas... or anywhere!
Mar 08, 2024•24 min
Most of us know now that all calories are not the same, and the old model of calorie deprivation for weight loss simply doesn't work long-term. Especially in midlife, we can turn into fat storing machines due to hormone change: most importantly, insulin resistance. Today I'm talking to Dr. Leah Antoniewicz all about insulin resistance- what is it, why does it happen and how do we overcome it with several simple and easy to implement lifestyle changes. Her positive message will show you how you C...
Feb 14, 2024•40 min
Do you ever feel like there is just way too much information to absorb about how to be healthy that it can sometimes leave us paralyzed and not knowing where to start? Everyday we get more information about what to do and what not to do to be healthy, so today I'm focusing on what I call the "low hanging fruit". If we start with just one or two of these things (or a little bit of each of them), we will start moving forward in a positive direction. You don't need to be stuck feeling paralyzed bec...
Feb 12, 2024•1 hr 1 min
Decreased sexual desire is the most common complaint I hear regarding our changing sexuality in perimenopause and menopause. Today I'm talking about the diagnosis, causes and potential treatments of decreased sexual desire in women. I'll go over 5 categories of potential treatments, including the science as well as my own personal experience (and that of my thousands of patients) regarding what works and what doesn't. Most importantly, this is not something that we need to just accept as part of...
Jan 31, 2024•32 min
