Transcript
WEBVTT
00:00:00.021 --> 00:00:00.621
This is the eat.
00:00:00.621 --> 00:00:00.951
Well, think.
00:00:01.072 --> 00:00:02.302
Well live well podcast.
00:00:02.331 --> 00:00:12.141
I'm Lisa Salsbury, and this is episode 41, navigating perimenopause and menopause with hormone replacement therapy and how it affects weight loss with Dr.
00:00:12.172 --> 00:00:13.282
David Rosensweet.
00:00:13.944 --> 00:00:18.684
Now before you younger listeners tune out thinking that this isn't affecting you.
00:00:18.923 --> 00:00:20.684
You're going to learn from Dr.
00:00:20.684 --> 00:00:30.763
Rosensweet, that once you reach your thirties, your hormones are declining and you are in peri-menopause as this is the time proceeding menopause.
00:00:31.064 --> 00:00:41.543
So just by virtue of your age, once you reached the thirties, you may not be having classic symptoms, but things that you may not attribute to menopause or perimenopause rather.
00:00:41.963 --> 00:00:45.713
Are actually occurring because of the decline in hormones.
00:00:46.194 --> 00:00:50.154
I loved editing this episode and listening and learning from Dr.
00:00:50.154 --> 00:00:50.643
Rosensweet.
00:00:50.664 --> 00:00:54.863
Again, we recorded this about a month ago and I've been dying to put it out.
00:00:54.863 --> 00:00:59.454
I was saving it to do a whole series on menopause, but those other interviews just haven't happened yet.
00:00:59.454 --> 00:01:08.453
So I will put those out when we get them scheduled and keep talking about these things that are affecting us in this peri-menopause time and how to combat them.
00:01:08.843 --> 00:01:14.825
So please feel free to send me any questions about this and I will be sure to ask the next expert I have on this topic.
00:01:15.209 --> 00:01:22.290
I will tell you too, that after doing this interview, I did ask my regular gynecologist about bioidentical hormone replacement therapy.
00:01:22.769 --> 00:01:27.540
And she agreed with me and started me on a very tiny dose of topical estrogen.
00:01:28.367 --> 00:01:29.596
She isn't trained in Dr.
00:01:29.596 --> 00:01:38.477
Rosensweet menopause method, but just for those listening, wondering when we get to the point in the interview talking about HRT and what doctors will prescribe it.
00:01:38.716 --> 00:01:43.307
You totally can start with your regular gynecologist and see what she can do for you.
00:01:43.337 --> 00:01:44.986
It is totally worth an ask.
00:01:45.496 --> 00:01:47.326
So don't forget also to download Dr.
00:01:47.326 --> 00:01:51.287
Rosensweet, free book to have a little bit more language around this topic.
00:01:51.316 --> 00:01:53.656
And that link of course, is in the show notes.
00:01:55.299 --> 00:02:02.198
Welcome to Eat Well, Think Well, Live Well; the podcast for women who want to lose weight, but are tired of counting and calculating all the food.
00:02:02.828 --> 00:02:04.388
I'm your host, Lisa Salsbury.
00:02:04.778 --> 00:02:10.438
I'm a certified health and weight loss coach and life coach, and most importantly a recovered chronic dieter.
00:02:11.049 --> 00:02:16.989
I'll teach you to figure out why you are eating when you aren't hungry, instead of worrying so much about what you are eating.
00:02:20.074 --> 00:02:23.373
Welcome back to the Eat Well Think Well Live Well podcast today.
00:02:23.373 --> 00:02:24.574
My guest is Dr.
00:02:24.574 --> 00:02:25.544
Daved Rosensweet.
00:02:25.563 --> 00:02:26.524
I'm super excited.
00:02:26.524 --> 00:02:36.213
He reached out to me and thought that his knowledge about menopause and his expertise was really gonna be a value to my audience, and I totally agreed.
00:02:36.274 --> 00:02:36.903
So.
00:02:37.383 --> 00:02:40.864
We have had a couple of questions recently about menopause.
00:02:40.864 --> 00:02:47.824
A little bit about perimenopause, so I know this is kind of the age range that my listeners are in, so I'm super excited to have him.
00:02:47.829 --> 00:02:51.033
I'm gonna let him introduce himself and then we'll jump into our conversation.
00:02:52.753 --> 00:02:53.604
I'm a medical doctor.
00:02:53.813 --> 00:02:55.283
I was traditionally trained.
00:02:55.283 --> 00:02:59.153
I I love medical school, I love my traditional training.
00:02:59.903 --> 00:03:02.693
It was like arriving at temple or synagogue for me.
00:03:03.653 --> 00:03:12.114
And then, uh, when I left medical school, I started getting interested in things that really related to health and, and root cause.
00:03:13.243 --> 00:03:20.693
So I did a lot of work with nutrition and, uh, the exposure we have to toxicity and detoxification.
00:03:21.368 --> 00:03:34.239
With exercise and with the elephant in most people's room, a dysfunctional response to the stresses of life because that disrupts the immune system, disrupts the hormonal system.
00:03:34.959 --> 00:03:39.278
Yeah, we can do fight or flight biology, but it takes a toll on us.
00:03:39.338 --> 00:03:42.218
Cuz I was really interested in what's getting my patients ill.
00:03:42.429 --> 00:03:43.088
I mean, how do we.
00:03:45.068 --> 00:03:52.343
And then, um, about 30 years ago, a patient of mine that I knew really well stormed into my office.
00:03:52.343 --> 00:03:56.243
She was in her mid forties She did not have an appointment.
00:03:56.248 --> 00:04:07.883
She flew open my examining room door, my consultation room door, and she told me, look, I'm going crazy and don't pretend, you know, I'm telling you I'm going crazy.
00:04:07.883 --> 00:04:08.454
This is big.
00:04:10.778 --> 00:04:15.788
and, uh, serendipitously, so to speak, although I don't think life works like that.
00:04:16.598 --> 00:04:21.399
Um, I had been speaking to a world expert on progesterone and I gave her progesterone.
00:04:21.399 --> 00:04:28.838
She was in her mid forties and she, three weeks later, I got a letter from her saying, my God, this stuff is miraculous.
00:04:28.928 --> 00:04:30.608
I mean, I feel so much better.
00:04:31.608 --> 00:04:32.809
That was pretty dramatic.
00:04:32.809 --> 00:04:46.158
You don't often people, by the time they've gotten ill, it's, it is often a slow moving process to do the various changes we need to do, and we don't necessarily see these tremendously dramatic results.
00:04:46.158 --> 00:04:52.769
Well, I, these were tremendously dramatic and before I knew it, I was seeing a lot of women in the perimenopause and menopause.
00:04:53.598 --> 00:04:56.869
And then I decided to specialize in it for the last 30 years.
00:04:56.899 --> 00:05:02.838
I, I've really headed towards total specialization in it because it's a, it's an amazing thing.
00:05:02.838 --> 00:05:05.088
It happens to a hundred percent of men and women.
00:05:05.869 --> 00:05:12.499
We start out at the age of 20, and that's when we're putting out our peak ovarian or testicular hormones,
00:05:13.093 --> 00:05:13.704
Mm-hmm.
00:05:13.848 --> 00:05:15.588
and then it's declined from that moment.
00:05:17.084 --> 00:05:23.689
and in the thirties a lot of women don't really feel that decline, but it's taking place.
00:05:24.168 --> 00:05:24.814
And some women do.
00:05:25.189 --> 00:05:29.439
They periods start getting irregular and they start getting, uh, return of ps.
00:05:30.019 --> 00:05:34.819
They start not sleeping as well, mood issues because they're losing their ovarian hormones.
00:05:35.218 --> 00:05:35.829
Mm-hmm.
00:05:36.548 --> 00:05:42.649
And then comes the magic day when the period ceased entirely and there's a almost a full.
00:05:43.548 --> 00:05:52.369
Of, of the most powerful biochemicals in a woman's body amongst them, there's other powerful biochemicals of that magnitude.
00:05:52.369 --> 00:05:55.548
Thyroid hormone, some adrenal hormones.
00:05:55.548 --> 00:06:09.601
But these ovarian hormones, estrogen, progesterone, a woman's body treasures these and without them, the declines that you see that ultimately result in assisted living facilities, nursing homes.
00:06:10.278 --> 00:06:11.309
Adult, diapers.
00:06:11.309 --> 00:06:13.048
Why do people wind up there?
00:06:13.889 --> 00:06:16.995
And most Women wind up there because of the loss.
00:06:16.995 --> 00:06:18.130
of ovarian hormones,
00:06:18.870 --> 00:06:19.105
Hmm.
00:06:19.331 --> 00:06:20.951
the loss of muscle and bones.
00:06:21.446 --> 00:06:23.576
big cause of like generalized aging then?
00:06:23.576 --> 00:06:24.425
Is that what you're
00:06:24.850 --> 00:06:28.781
there there's very specific declines because these hormones are so important.
00:06:29.021 --> 00:06:30.430
Yeah, we could say generalized.
00:06:31.766 --> 00:06:49.136
But specifically, there's loss of bones, loss of muscle, loss of cognitive ability, loss of energy, loss of libido, loss of vagina, loss of bladder control, loss of arterial protection, that estrogen confers vulnerability to a heart attack and stroke.
00:06:49.586 --> 00:06:54.355
These all derive primarily from the loss of ovarian hormones.
00:06:56.680 --> 00:06:57.130
Yeah.
00:06:57.190 --> 00:06:57.670
Yeah.
00:06:57.761 --> 00:07:03.011
I'm a big fan of, I've, I've said this phrase on the podcast before and I got it from someone else.
00:07:03.011 --> 00:07:07.451
I don't, I don't even remember who, but just the idea of making our health span.
00:07:07.930 --> 00:07:09.610
match our lifespan.
00:07:09.940 --> 00:07:15.761
And so this is really critical here because I don't just wanna live to a hundred.
00:07:16.420 --> 00:07:23.050
I wanna live to a hundred and be completely functional and still be driving and getting up and down off the floor in my nineties.
00:07:23.350 --> 00:07:32.362
I really want to be As healthy as possible, yes, I'm gonna have beautiful wrinkles, and yes, I'm gonna have gray hair and that is all completely fine with me.
00:07:32.721 --> 00:07:38.601
I just wanna be able to get my own groceries and not worry that I'm gonna fall down.
00:07:38.932 --> 00:07:43.762
And so this is really critical then to pay attention to those female hormones.
00:07:44.791 --> 00:07:52.831
When we start having these symptoms and we could go over things like what are like menopause and perimenopause symptoms.
00:07:53.192 --> 00:07:55.411
I think you kind of covered some of them.
00:07:55.682 --> 00:07:58.682
I recently had I, well, let me just be honest.
00:07:58.742 --> 00:08:06.872
I have a marina i u d and I know that that's, some people are like, it's not a problem at all.
00:08:07.052 --> 00:08:08.701
Other people are like, rip that thing out.
00:08:09.151 --> 00:08:10.291
I don't know how you feel about that.
00:08:10.291 --> 00:08:12.992
And my listeners can decide what they want, but in any.
00:08:13.742 --> 00:08:16.021
Very, very, very light periods because of it.
00:08:16.848 --> 00:08:18.588
but I've noticed, even though I have that.
00:08:19.634 --> 00:08:27.499
it's getting more irregular and all of a sudden, like I have like this tiny period and then 10 days later I'm like, gushing, wait for the first time.
00:08:27.619 --> 00:08:30.079
Like since I've even been on it and I'm like, okay.
00:08:30.108 --> 00:08:31.009
Hello, hello.
00:08:31.014 --> 00:08:31.819
Perimenopause.
00:08:32.479 --> 00:08:36.349
Uh, this morning I woke up in, um, a complete sweat.
00:08:36.379 --> 00:08:39.078
I was like, why are my pajamas so, so wet this morning?
00:08:39.078 --> 00:08:39.979
That's fun.
00:08:40.458 --> 00:08:42.619
So it's just these tiny little things.
00:08:42.624 --> 00:08:45.259
I think most women probably are pretty aware.
00:08:45.259 --> 00:08:47.418
But what do you think is, what do you think are symptoms.
00:08:48.583 --> 00:08:52.849
we aren't aware, like we know irregular periods, night sweats.
00:08:52.899 --> 00:08:53.739
most women know this.
00:08:54.009 --> 00:09:04.453
What are some things that are happening that are perimenopause that women don't realize or don't attribute to that and are maybe signals for them to start getting help?
00:09:05.385 --> 00:09:15.615
Well, it's a, it's a great question because although 75% of women have really dramatic symptoms, such as the ones you just named.
00:09:16.196 --> 00:09:27.668
Welcome to Perimenopause Year in, um, 25% of women don't have symptoms and they look around, they say, what's this big deal about menopause?
00:09:27.673 --> 00:09:38.328
It's my menopause is easy yet for a hundred percent of women, as estrogens decline, you start losing bone.
00:09:38.389 --> 00:09:39.259
We don't feel.
00:09:41.344 --> 00:09:43.323
you start losing cognitive function.
00:09:43.323 --> 00:09:49.234
You start having memory issues and o often the ability to think clearly.
00:09:49.624 --> 00:09:52.803
You start having mood issues from the loss of these hormones.
00:09:53.681 --> 00:10:04.416
I've heard women tell me that they didn't even realize it until they started getting treated with testosterone, that they lost some core drive there in decision making.
00:10:05.989 --> 00:10:08.149
Because testosterone is not a male hormone.
00:10:08.149 --> 00:10:09.739
That's very, very incorrect.
00:10:10.249 --> 00:10:15.828
Women have twice as much, testosterone as they have estrogen, estrodiol, the most potent estrogen.
00:10:16.818 --> 00:10:19.278
So mood sleep.
00:10:19.980 --> 00:10:32.400
a natural calmness can be replaced by a subtle anxiety, you know, it's not a hundred percent of the day, but, uh, this, there can be a, a declining mood and the ability to sleep deeply.
00:10:32.520 --> 00:10:35.880
Or you can wake up in the middle of the night and and be in a sweat.
00:10:36.691 --> 00:10:44.201
Now by the time you make it to sweats, you have got major estrogen.
00:10:45.321 --> 00:10:48.321
And the optimal time to address it is now.
00:10:48.990 --> 00:10:55.490
we love, when we're able to interact with a woman who's in the perimenopause, it's the easiest time.
00:10:56.480 --> 00:11:05.421
It's a, it's a more complex time to treat because of the erraticness of the hormonals, Environment in the perimenopause.
00:11:05.421 --> 00:11:07.071
But it's the best time of all.
00:11:08.211 --> 00:11:11.240
So best to really start treatment.
00:11:11.421 --> 00:11:13.760
When we're first seeing signs of perimenopause.
00:11:13.760 --> 00:11:16.581
Is there a certain age or just watch for symptoms?
00:11:16.956 --> 00:11:21.546
Well, it cha it's different women, woman to woman for a lot of different reasons.
00:11:21.995 --> 00:11:30.155
Some women start picking up on irregular periods and the kind of symptoms that you're having in their thirties.
00:11:31.206 --> 00:11:31.985
Well, for sure.
00:11:31.985 --> 00:11:33.895
Here's the, the, the benchmark.
00:11:35.145 --> 00:11:43.160
your optimal ovarian output took place when you were 20 plus or minus a couple years, and it gradually declined.
00:11:43.701 --> 00:11:50.870
So what's the impact of that decline and when does it lead to really life alerting symptoms?
00:11:51.260 --> 00:11:59.150
Sometimes it's in the thirties, if a woman is regular, is used to clockwork periods and she realizes she's not clockwork.
00:12:00.875 --> 00:12:06.365
And that there's even some cycles where she gets breast tenderness or irritable, or PMs, oops.
00:12:06.816 --> 00:12:08.796
She stopped ovulating that cycle.
00:12:09.186 --> 00:12:11.735
She didn't ovulate, she didn't put out progesterone.
00:12:12.456 --> 00:12:14.936
The greatest calmer that exists for women.
00:12:16.196 --> 00:12:24.446
So the best thing I could offer is, and I believe my team has done this, is that your listeners could receive a.
00:12:25.841 --> 00:12:28.451
PDF copy of our, the book we wrote for women.
00:12:29.020 --> 00:12:29.890
We wrote it for women.
00:12:29.890 --> 00:12:39.370
It's called Happy, healthy Hormones, and it describes insignificant detail, the kind of things to be on the lookout for and how to address it.
00:12:39.370 --> 00:12:43.750
I think, uh, we've really laid down the roadmap, the best way to address this,
00:12:45.010 --> 00:12:47.410
And you're a fan of, of hormone treatment.
00:12:47.471 --> 00:12:48.311
oh, am I
00:12:48.701 --> 00:12:49.061
Yeah.
00:12:49.061 --> 00:12:50.051
Tell us about that.
00:12:50.051 --> 00:12:54.941
So, so we are like, okay, it's time to get treatment, it's time to like, address this.
00:12:55.384 --> 00:12:57.364
what is the best treatment?
00:12:58.129 --> 00:13:02.928
Well, the things that you focus your professional career on, they all matter.
00:13:03.708 --> 00:13:12.469
Big time, proper nutrition, detoxification, proper exercise, they all matter.
00:13:12.739 --> 00:13:15.678
But when it comes to hormones, you're gonna do one of two things.
00:13:15.678 --> 00:13:17.479
Those ovaries and that those testicles.
00:13:18.269 --> 00:13:19.083
they do decline.
00:13:19.083 --> 00:13:20.494
And I've never seen it different.
00:13:21.364 --> 00:13:22.443
It happens to everybody.
00:13:23.104 --> 00:13:26.764
You know, for the couple hundred thousand years humans have been alive.
00:13:27.063 --> 00:13:30.994
There was no such thing as menopause women.
00:13:31.683 --> 00:13:32.344
That's right.
00:13:32.349 --> 00:13:32.823
Yeah.
00:13:32.823 --> 00:13:35.403
Little, little death therapy took care of that.
00:13:36.663 --> 00:13:45.514
But when hygiene improved and all the other agriculture improved, nutrition improved, uh, we started living beyond the natural design here.
00:13:45.803 --> 00:13:46.413
Mm-hmm.
00:13:48.538 --> 00:13:49.969
the Chinese figured this out.
00:13:49.969 --> 00:13:57.168
They, for over a thousand years, they have been administering hormones to their aristocracy.
00:13:57.895 --> 00:14:05.446
What they figured out doing was they sent healthy young women into an outhouse and collected vast amounts of healthy young women urine.
00:14:07.586 --> 00:14:17.365
And they sent healthy young men into a different outhouse, collected their urine, dried it out, and the aristocracy took the powder that was left behind because they contained hormones.
00:14:18.655 --> 00:14:27.673
That was the beginning of bioidentical hormones, same molecule, but in medicine when something's not working like it used.
00:14:29.062 --> 00:14:30.717
you've got two choices.
00:14:31.168 --> 00:14:34.317
You either figure out some medicine or herb.
00:14:34.347 --> 00:14:41.427
Herbs are medicine that forced the body to react in such a way that you get the desired outcome.
00:14:42.148 --> 00:14:48.758
So for example, could you take an herb that would jolt those ovaries back into production?
00:14:50.535 --> 00:14:51.316
It doesn't work.
00:14:51.885 --> 00:14:56.416
Can you take a variety of herbs cuz people seem to be more friendly to herbs.
00:14:56.416 --> 00:14:59.745
I certainly, uh, I'm a holistic medical doctor.
00:14:59.745 --> 00:15:02.115
I love herbs for their medicinal use.
00:15:03.225 --> 00:15:08.416
Could a woman take something that's sort of simulated the effects of these powerful biochemicals?
00:15:08.475 --> 00:15:10.666
Yeah, but it doesn't work.
00:15:10.721 --> 00:15:20.921
You're gonna run across very, very few women who say, oh yeah, I took this Herb Cohosh or Vitex and everything returned to normal.
00:15:21.160 --> 00:15:23.350
These women don't exist out there,
00:15:23.625 --> 00:15:24.235
Mm-hmm.
00:15:25.081 --> 00:15:26.285
Yeah, Jining helps.
00:15:26.495 --> 00:15:40.475
There's things you can do or we've, we've had this opportunity since the 1980s to take plant derived same molecule as produced in the ovary or the testicles.
00:15:41.645 --> 00:15:48.336
We can take it in topical form, we can rub it onto our skin, cuz that's the healthiest way to take estrogen is to rub it on your skin
00:15:49.640 --> 00:15:52.041
So that's considered a bioidentical hormone.
00:15:52.100 --> 00:15:54.591
Yeah, same molecule as the ovary used to put out.
00:15:54.770 --> 00:15:56.931
Same molecule as the testicle used to put out
00:15:57.500 --> 00:16:04.791
And when, when people say they're on bioidentical hormones for menopause treatment, what hormone is that?
00:16:04.971 --> 00:16:05.811
What are they taking?
00:16:05.990 --> 00:16:24.239
Well, there there's a wide variety of beginners treating women Menopause or very at the other end of the spectrum experts, very few experts, a lot of beginners, a few intermediates, and so it depends on the quality of what the woman is receiving.
00:16:24.899 --> 00:16:28.979
When you get into the compounded bioidentical world, it gets a lot better.
00:16:29.729 --> 00:16:30.828
and that's what you do.
00:16:31.783 --> 00:16:32.474
For your patients.
00:16:32.474 --> 00:16:33.104
So what do you
00:16:33.448 --> 00:16:39.869
because we, because we individualize the treatment of every individual woman, because women are so individual, as are men.
00:16:40.528 --> 00:16:46.739
There's some women who they function beautifully and are very healthy with this level of estrogen.
00:16:47.578 --> 00:16:53.369
They have periods or the periods of regular, they, uh, can, they're fertile.
00:16:53.369 --> 00:16:57.649
They can have babies, but there's other women who need three times that amount.
00:16:58.749 --> 00:17:00.418
to be healthy regular periods.
00:17:00.629 --> 00:17:03.509
So there's a tremendous variance, individual woman.
00:17:03.509 --> 00:17:12.118
So the best approach to this is you individualize the treatment with each individual woman and you go on a journey to do that.
00:17:12.493 --> 00:17:12.913
yeah.
00:17:12.943 --> 00:17:16.273
That's why people don't say I'm on bioidentical estrogen.
00:17:16.273 --> 00:17:19.993
They say I'm on bioidentical hormones because it's customized
00:17:20.532 --> 00:17:21.673
Then they get four, they.
00:17:22.768 --> 00:17:26.127
Well, every woman loses all four.
00:17:26.923 --> 00:17:27.282
okay?
00:17:27.448 --> 00:17:33.837
The estrogen family, progesterone, testosterone, and D H E A, they're all coming out of the ovary
00:17:34.163 --> 00:17:34.772
Mm-hmm.
00:17:35.667 --> 00:17:38.127
and, and women lose all of them.
00:17:39.448 --> 00:17:41.097
Women are in nursing homes.
00:17:41.758 --> 00:17:44.188
The major reason is the loss of testosterone.
00:17:44.637 --> 00:17:45.538
You lose muscle.
00:17:45.982 --> 00:17:52.522
Which I've always taught is the natural sarcopenia is a natural muscle wasting that happens with age.
00:17:52.522 --> 00:18:03.442
And I encourage my clients to continue weight training and that sort of thing lifestyle-wise, but we also then need some of that testosterone to, to carry on.
00:18:03.448 --> 00:18:03.712
Okay.
00:18:04.853 --> 00:18:06.502
and sarcopenia.
00:18:06.563 --> 00:18:08.303
There's nothing natural about it.
00:18:09.472 --> 00:18:11.093
It's just happened
00:18:11.782 --> 00:18:12.173
right.
00:18:12.173 --> 00:18:20.772
I just mean like it's kind of like what happens with aging as far as you're not so much doing anything wrong is this is just what happens if you don't do anything.
00:18:20.982 --> 00:18:24.792
If you don't do anything to combat it, that's what will happen.
00:18:26.248 --> 00:18:27.837
that's a hundred percent accurate.
00:18:28.317 --> 00:18:33.538
As a gerontologist taught us in medical school, sarcopenia is the bane of the elderly.
00:18:34.502 --> 00:18:34.853
Mm.
00:18:34.917 --> 00:18:45.387
they're all losing muscle, and the ones who aren't losing muscle, sometimes you can really achieve decent things with vigorous, robust exercise programs,