Hormone Therapy: Where We Are & Where We’re Going with Carla DiGirolamo, MD, PhD (Episode 126)

Hit Play Not Pause

Health & Fitness, Education, Self-improvement, Mental Health

4.9 • 696 Ratings

🗓️ 19 April 2023

⏱️ 63 minutes

🔗️ Recording | iTunes | RSS

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Summary

Now that menopause is mainstream news, interest in hormone therapy is exploding. And so is the confusion and controversy surrounding it, as menopausal hormone therapy (aka hormone replacement therapy), which is undeniably a game changer for millions, has also become a massive business. Some practitioners are reportedly prescribing “megadoses” of estrogen–in some cases twice or even 3 or 4 times the maximum licensed dose, causing myriad medical societies to sound the alarm. Meanwhile, researchers are working overtime to catch up to provide clarity on what hormone therapy does, what it doesn’t do, who it benefits most, and for how long. This week we dig into it all with our favorite hormone doc, Dr. Carla DiGirolamo.

Carla DiGirolamo, MD, PhD, is a Double Board Certified Reproductive Endocrinologist and Obstetrician/Gynecologist specializing in infertility and menopausal medicine. She is also a Crossfit Level 1 trainer, Certified Nutrition Coach, and member of CrossFit Health. She is a MedFit Care provider and provides weekly workouts and medical updates at her Substack Athletic Aging. She has most recently become an Endocrine Consultant for Wild Health.

Resources:

The Daily Mail article on high doses of HRT here

The Joint BMS, FSRH, RCGP, RCOG, SFE and RCN Safety Alert here

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Transcript

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0:00.0	You are listening to Hit Play, Not Pause, a feisty menopause podcast for active performance-minded women.
0:14.6	I am your host, Celine Yeager. Each week, I bring you advice from athletes, scientists, researchers, and other experts to help you feel and perform you best no matter what your hormones are doing.
0:25.0	This show is a production of Live Feisty Media.
0:31.0	Hello, hello, strong feisty women.
0:34.9	So when I started this show in October 2020, we were really just on the tipping point
0:41.6	of menopause in the mainstream and menopause hormone therapy exploding into the mainstream.
0:48.8	And women were just getting the news via books like Estrogen Matters by Avram Blumen and Carol Tabras, who were both
0:56.1	on the show early on, that hormone therapy was largely safe, and women should be offered
1:02.5	it when they reach the menopause transition. Well, fast forward two and a half years later,
1:09.0	and we have reached a place where celebrities are proudly
1:12.8	having hot flashes on television, which is awesome, and menopausal hormone therapy or hormone
1:18.6	replacement therapy is a massive business. And this is all largely positive and progress.
1:27.8	And as is always the case when something becomes massive mainstream news and big business,
1:35.9	there have been some concerning outcomes.
1:39.2	One is an issue that has arisen in the UK, where some women are reportedly being prescribed
1:45.4	what could be called megadoses of hormone therapy, particularly estrogen. And in some cases,
1:51.8	they're getting more than twice or even three or four times the maximum licensed dose.
1:57.4	The article that covered this story, and I'll link it in the show notes, also noted that
2:02.2	it was questionable because some of these women were not being given enough progesterone
2:07.5	to accompany these high doses of estrogen, as there have been women reporting endometrial
2:13.3	hyperplasia, which is an abnormal thickening of the uterine lining and a precursor to endometrial
2:18.9	cancer. And the whole thing has been concerning enough that there was a joint safety alert
	...

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