Bioidentical (body identical) HRT is safer than the old synthetic hormones, so why do so few women take it?

Dr Jerrold Weinberg spent 25 years delivering babies in Detroit before moving into menopause medicine, and has since treated around 4,000 women. When he began prescribing bioidentical hormones, colleagues stopped referring patients to him, a story he tells in his book, Menopause Mended.

Louise and Jerrold explain why the Women’s Health Initiative study tested horse-derived estrogen and a synthetic progestogen rather than the estradiol and micronised progesterone used today, and why many women on HRT still feel unwell because their dose is too low or they aren’t absorbing it. They also talk about compounded creams, menopause supplements and why rushed appointments leave women without answers.

Jerrold closes with three take-home tips, including how to walk into an appointment prepared and be your own advocate.

Let’s connect

👉 Understand what your hormones actually do before your next appointment. Read The Power of Hormones: https://bio.to/ThePowerofHormones
👉 Follow the podcast on Spotify or Apple Podcasts so you never miss an episode: www.DrLN.co.uk/podcast
👉 More from Dr Louise Newson: https://linkin.bio/drlouisenewson

More from Dr.Weinberg

Instagram: @menopausemended

https://jhweinbergmd.com/

Link to purchase book on Amazon: Menopause Mended

Chapters

00:00 Why should doctors question what they're taught?
02:59 Why did colleagues stop referring patients to him?
05:13 Is menopause a hormone deficiency, like low thyroid?
06:09 Why was the first HRT made from horse urine?
07:09 Why do women go through the menopause?
09:28 Why does oral estrogen affect blood clotting?
10:29 What did the 2002 WHI study actually test?
12:05 Why is synthetic progestogen still a concern?
13:36 Which estradiol and progesterone are used now?
14:05 Why use a compounded estrogen cream?
16:22 What's the fear about compounded HRT?
19:07 Is your HRT dose too low to work?
20:57 Does HRT protect your long-term health?
22:19 Can HRT lower your risk of osteoporosis?
23:43 Do menopause supplements actually work?
26:28 Why are menopause appointments so rushed?
29:48 Could nurse practitioners improve menopause care?
31:17 How can more women get the HRT they need?

Is bleeding on HRT normal? It’s a common side effect that usually settles and there’s often a simple explanation.

Consultant gynaecologist Tony Chalhoub worked for years in a rapid-access clinic for postmenopausal bleeding and helped establish Newcastle’s accredited endometriosis centre. He shares how a health scare ofhis own changed the way he listens to patients.

In this episode, Dr Louise Newson and Tony Chalhoub talk about how a few missed days of progesterone, patch that didn’t stick or a urine infection can all lead to bleeding, why a careful history matters so much, and why stopping an evidence-based treatment can bring symptoms straight back.

They also discuss why Louise kept her ovaries at hysterectomy, why estrogen alone may not be enough after surgical menopause, and why women with endometriosis deserve to be believed even when their scans are normal.

If you have any bleeding on HRT, speak to your doctor so it can be properly assessed.

Follow Tony: @drtonychalhoub

Chapters

00:00 Why does listening to women matter so much?
00:22 Why aren't gynaecologists taught about HRT?
02:24 What did training across the UK teach Tony?
03:39 Can a hysteroscopy be done without going to sleep?
06:41 Why were women told fibroid surgery was too risky?
07:29 Does bleeding on HRT mean cancer?
10:25 Should you stop HRT if you have bleeding?
11:20 What did a cancer scare teach a gynaecologist?
12:40 Could bleeding after sex be vaginal dryness?
13:05 Why are doctors scared of vaginal oestrogen?
13:50 Can women have HRT after cancer?
15:17 Should you keep your ovaries with womb cancer?
16:39 Why would a breast cancer survivor try HRT?
17:22 Why did Louise keep her ovaries at hysterectomy?
19:18 Is oestrogen enough after surgical menopause?
21:26 Should HRT be part of gynaecology training?
22:31 Does oestradiol cause womb cancer?
24:06 Is it OK for doctors to say I don't know?
25:19 Why are women with endometriosis not believed?
27:13 Why doesn't endometriosis pain match the scan?
28:40 Can men get endometriosis?
30:36 What needs to change in endometriosis care?

👉 Bleeding on HRT? Trackyour symptoms and treatment in the balance app so your doctor gets the fullpicture: https://balance-app.com/?utm_source=DLN&utm_medium=biolink&utm_campaign=crosspromo
👉 More from Dr Louise Newson: https://linkin.bio/drlouisenewson

Doctor dismissing your menopause symptoms? Dr Phyllis Nsiah-Kumi explains how to get heard and get the right care.

Dr Phyllis Nsiah-Kumi, MD, MPH, is a US physician with more than 25 years in women’s health and public health, much of it with underserved communities. She regularly sees women for whom she is the third, fourth or fifth doctor, after years of being told their symptoms just come with age.

Dr Louise Newson explains why symptoms of hormonalimbalance, from night sweats and joint pain to low mood and memory problems, are so easily dismissed when they can’t be seen on a scan. She also explains why so many women are told the only option is an antidepressant, and why many are now learning about hormone treatments, including testosterone, fromeach other.

Phyllis closes with three take-home tips for women and the people supporting them: pause, pivot and proactivate.

Let’s connect👉 Take your symptoms to your next appointment: complete the free symptom questionnaire in the balance app: https://balance-app.com/utm_source=DLN&utm_medium=biolink&utm_campaign=crosspromo
👉Follow the podcast for more: https://open.spotify.com/show/7dCctfyI9bODGDaFnjfKhg
👉More from Dr Louise Newson: https://linkin.bio/drlouisenewson

Chapters

00:00 Why is health information so confusing for women?
02:28 Why are people so scared of the word hormone?
02:45 Why is "Do you understand?" the wrong question?
03:27 What do you really want from your appointment?
04:09 How should you prepare for a doctor's appointment?
05:51 Why are women too scared to ask for an examination?
07:41 What happens when a doctor refuses to examine you?
08:42 Is it really "just your age"?
09:27 Why are so many women being dismissed?
10:27 Is it okay for a doctor to say "I'm not sure"?
11:09 What does "that's just how it is" really mean?
12:11 Why are hormone symptoms so easy to dismiss?
13:24 How can scoring your symptoms help you get heard?
14:43 Can a symptom questionnaire make you feel heard?
15:39 Why do so many women think it's just them?
16:47 Are women learning more from each other than doctors?
18:17 Should you crowdsource medical advice online?
21:06 How do we reach women in underserved communities?
24:29 How do your hormones affect your whole family?
25:23 How can partners and friends support you?
27:24 Why take someone with you to your appointment?
29:25 What are the three steps to advocate for yourself?