Is Hormone Replacement Therapy in Menopause Helpful or Harmful: Sifting Through the Science for a Personalized Approach to Relieve Suffering and Improve Your Healthspan

Mark Hyman

Mar 15, 2024

Episode description

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An estimated 85% of women experience symptoms of menopause that vary from hot flashes to weight gain, brain fog, low mood, sex drive, chronic fatigue, and more. Recognizing menopause as a gradual, uniquely personal transition rather than an abrupt change is crucial. This insight can help empower women to take proactive, supportive measures early on, ensuring a smoother journey through this natural phase of life.

Today, Dr. Cindy Geyer from the UltraWellness Center joins me as we unravel the Functional Medicine perspective and approach to menopause. Our conversation highlights the crucial role of lab testing in uncovering the root causes of symptoms, paving the way for tailored nutrition and lifestyle interventions. Moreover, we critically examine the limitations of traditional medical approaches and discuss the nuances of hormone replacement therapy, the different forms, and who may benefit the most from this treatment.

Dr. Cindy Geyer received her Bachelor of Science and her Doctor of Medicine degrees, with honors, from the Ohio State University. She completed residency in internal medicine at Strong Memorial Hospital in Rochester, N.Y. and is triple board certified in internal medicine, integrative medicine, and lifestyle medicine. She joined The Ultrawellness Center in 2021 after practicing and serving as the medical director at Canyon Ranch for 23 years.

This episode is brought to you by AG1 and FOND.

Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get a year's worth of D3 and 5 Travel Packs for FREE with your first order.

Get FOND's amazing bone broth today. Just go to fondbonebroth.com/drhyman and use code HYMAN20 to get 20% off your purchase.

In this episode we discuss:

How the Nurse’s Health Study caused backlash about hormone replacement therapy (3:35)
The issues with how menopause is treated in our society today (6:35)
Symptoms of menopause and their root causes (8:20)
The conventional medicine approach to menopause (17:57)
The functional medicine approach to menopause (19:38)
Lab testing (24:00)
The importance of the Estrobolome and gut microbiome testing (27:11)
The role of insulin, sleep, and stress (31:49)
Dr Cindy Geyer’s patient case study (34:21)

Episode description

View the Show Notes For This Episode

Get Free Weekly Health Tips from Dr. Hyman

This episode is brought to you by AG1 and FOND.

Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get a year's worth of D3 and 5 Travel Packs for FREE with your first order.

Get FOND's amazing bone broth today. Just go to fondbonebroth.com/drhyman and use code HYMAN20 to get 20% off your purchase.

In this episode we discuss:

How the Nurse’s Health Study caused backlash about hormone replacement therapy (3:35)
The issues with how menopause is treated in our society today (6:35)
Symptoms of menopause and their root causes (8:20)
The conventional medicine approach to menopause (17:57)
The functional medicine approach to menopause (19:38)
Lab testing (24:00)
The importance of the Estrobolome and gut microbiome testing (27:11)
The role of insulin, sleep, and stress (31:49)
Dr Cindy Geyer’s patient case study (34:21)

Mindsip insights from this episode:

Address childhood trauma to mitigate menopause depression risk

Women who experienced two or more adverse childhood events have a significantly increased risk of a first onset of major depression during the menopause transition.

#menopause

#trauma

Apply low-dose testosterone drops to enhance libido in menopausal women

Applying very low-dose topical testosterone drops directly on the clitoris can be a highly effective way to address low libido in menopausal women.

#menopause

#testosterone

Initiate estrogen therapy in perimenopause to protect cognition for ApoE4 carriers

For women who carry the ApoE4 allele, a genetic risk factor for Alzheimer's, estrogen therapy started in the critical perimenopausal window is associated with more preserved cognition.

#APOE4

#estrogen

Start bioidentical hormones within 5-10 years of last menstrual period for optimal benefits

The 'timing hypothesis' suggests that starting bioidentical hormones within a 5-10 year window of the last menstrual period is when the benefits are most likely to outweigh the risks.

#HRT

#menopause

Recognize menopause's impact on sleep apnea risk

The risk for sleep apnea and sleep-disordered breathing goes up fourfold in the menopause transition because declining estrogen makes the airway tissue more collapsible.

#menopause

#sleep-apnea

Focus on insulin to manage menopausal symptoms

If you had to pick one hormone to focus on for managing menopausal symptoms, it would be insulin, as estrogen levels will often regulate themselves once insulin is balanced.

#insulin

#menopause

Balance gut microbiome to regulate hormone recycling

An enzyme called beta-glucuronidase, produced by an imbalanced gut microbiome, can unpackage and allow for the recirculation of estrogens, stress hormones, and toxins.

#enzyme

#gut

Leverage your gut's estrobolome to regulate estrogen levels

Your gut microbiome contains genes that can produce and regulate hormones, influencing your circulating estrogen levels, a concept known as the estrobolome.