In this conversation, Dr. Polly Watson interviews Dr. Felice Gersh on the benefits of hormone replacement therapy and cardiovascular health. Dr. Gersh clarifies the difference between bioidentical hormones and non naturally occurring hormones, particularly in terms of cardiovascular health. She discusses the Women's Health Initiative study and its impact on the perception of hormone replacement therapy as well as the larger implications of how this study was designed.

Dr. Gersh emphasizes the importance of proper dosing and the need for individualized hormone therapy based on the specific needs of each woman. She also highlights the lack of clinical data and the need for more research in this area.

Quotes

“Everyone agrees that exercise, sleep, and eating organic fruits and vegetables are good for health. It's also understood that the benefits depend on consistency and quantity, as sporadic efforts won't yield significant results.”

Links

Connect with Dr. Felice Gersh:

Website: https://integrativemgi.com/

Instagram: https://www.instagram.com/dr.felicegersh/?hl=en

Facebook: https://www.facebook.com/felicegershmd/

YouTube: https://www.youtube.com/channel/UCrbn9RUdGuc6Wq-FT7V4u3g

Publication: ​​https://www.sciencedirect.com/journal/progress-in-cardiovascular-diseases

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

New Patient: https://hormonewellnessmdacademy.teachable.com/p/are-we-a-good-fit-new-patient-welcome-course

Instagram: https://instagram.com/hormonewellnessmd

Facebook: https://www.facebook.com/hormonewellnessmd

YouTube: https://www.youtube.com/channel/UCG4Tw8oHGR_6wBZmXrTu9xA

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Navigating midlife hormonal changes requires personalized mental health strategies. In this episode, Dr. Polly Watson continues her discussion with Dr. Elizabeth Cox, a board-certified psychiatrist specializing in reproductive psychiatry from UNC Chapel Hill. With over a decade of experience, Dr. Cox highlights the critical impact of hormonal changes on women’s mental health during midlife.

The episode explores the use of antidepressants for perimenopausal women, focusing on the decision-making process for pharmaceutical intervention, especially when anxiety or mood disruptions affect quality of life. Dr. Cox emphasizes tailoring treatments to each patient’s values and lifestyle goals.

Addressing concerns like weight gain and sexual dysfunction, Dr. Cox suggests strategies such as adjusting medication dosages, using supplementary medications like Buspar or Wellbutrin, and exploring topical agents like CBD oil. Open communication between patients and providers is key to managing these side effects.

Dr. Cox also discusses the role of genetic testing in personalizing mental health treatments, particularly for those with multiple unsuccessful medication trials or severe side effects. Her approach in reproductive psychiatry emphasizes caution, minimalism, and collaboration, creating a supportive environment for women during hormonal transitions.

Quotes

• “If consistently you’re feeling like your anxiety or your mood symptoms are in the driver’s seat and that you’re in the back seat, just kind of like along for the ride, that feels problematic.” (03:05 | Dr. Elizabeth Cox)
• “The weight gain typically should be like 5-10 pounds max, more of like water weight. But that being said, everybody’s different. So I’m always open-minded here.” (08:37 | Dr. Elizabeth Cox)
• “What I feel from this conversation with you is this balance, this gentleness, a lot of choice, a lot of partnership, right? And I think so often women are offered antidepressant medication without a lot of this kind of more nuanced conversation and they feel like they’ve been put off and then they’re closing themselves off to something that might actually be helpful, but they have fear around it, they felt shame around it, they felt judgment around it.” (16:24 | Dr. Polly Watson)

Links

Connect with Dr. Elizabeth Cox:

Website: https://www.resetyourhealthandwellness.com/

Instagram: https://www.instagram.com/reset_healthandwellness/

Facebook: Reset Health & Wellness, PLLC

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

New Patient: https://hormonewellnessmdacademy.teachable.com/p/are-we-a-good-fit-new-patient-welcome-course

Instagram: https://instagram.com/hormonewellnessmd

Facebook: https://www.facebook.com/hormonewellnessmd

YouTube: https://www.youtube.com/channel/UCG4Tw8oHGR_6wBZmXrTu9xA

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm

“We think that different women’s brains have different sensitivities to changes in hormones,” says Dr. Elizabeth Cox. “It’s not so much about absolute levels of hormones that we think are the issue, but the actual fluctuations and changes,” she elaborates. In this episode, Dr. Cox, alongside Dr. Polly Watson, discusses the impact of these hormonal fluctuations on women’s mental health throughout menstruation, postpartum, and menopause. Dr. Cox highlights the importance of identifying women at risk due to heightened sensitivity to these changes and advocates for preventive strategies such as lifestyle changes and therapy.

The episode covers Cognitive Behavioral Therapy (CBT) for alleviating menopausal symptoms, the role of antidepressants, and the importance of cautious medication use. Dr. Watson and Dr. Cox shed light on the vital need for personalized care and encourage women to take active steps in prioritizing their health during the menopausal transition.

Quotes

• “We think that different women’s brains have different sensitivities to changes in hormones. It’s not so much about absolute levels of hormones that we think are the issue, but the actual fluctuations and changes.” (02:18 | Dr. Elizabeth Cox)
• “I recommend therapy to everyone. I think it can be so nice to be able to process relationships and stressors, changes when you’re nearing that phase of life—like you’re entering a new chapter and there’s a lot to process there too. So adding in some therapy can be another wellness initiative to do.” (09:05 | Dr. Elizabeth Cox)
• “Some amount of anxiety is good and creates resilience and it’s part of our life and being human. I still want you to be able to feel sad sometimes if something really sad happens or to feel excited. If you feel apathetic and like a zombie and numb, you’re on the wrong medicine or you’re on too high of a dose. But you should still feel like you, but just not as stressed and your bandwidth should feel better.” (18:58 | Dr. Elizabeth Cox)

Links

Connect with Dr. Elizabeth Cox:

Website: https://www.resetyourhealthandwellness.com/

Instagram: https://www.instagram.com/reset_healthandwellness/

Facebook: Reset Health & Wellness, PLLC

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

New Patient: https://hormonewellnessmdacademy.teachable.com/p/are-we-a-good-fit-new-patient-welcome-course

Instagram: https://instagram.com/hormonewellnessmd

Facebook: https://www.facebook.com/hormonewellnessmd

YouTube: https://www.youtube.com/channel/UCG4Tw8oHGR_6wBZmXrTu9xA

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm

“I retired from my pediatric practice to make a broader impact on children's wellness,” says Dr. Hope Seidel, a seasoned pediatrician and parenting coach. “I strongly believe that wellness begins at home,” she asserts. Together with Dr. Polly Watson, they address the challenges parents face as their children transition to college and adulthood, offering insights on fostering independence and resilience in young adults.

Dr. Seidel focuses on critical issues affecting adolescent wellness, including the harmful effects of excessive academic and social pressures. She emphasizes the importance of self-efficacy, enabling young adults to tackle their own challenges, and equips them with essential life skills such as handling failure, being financially literate, and setting personal boundaries.

Dr. Watson and Dr. Seidel address questions from listeners and provide guidance on managing complex situations like co-parenting with a difficult ex-partner, urging parents to focus on being the healthiest version of oneself so that children can recognize the difference between healthy and unhealthy parenting. Dr. Seidel advocates for transparent conversations about college costs and the necessity for children to navigate their educational journeys independently, avoiding parental interference.

This episode encourages parents to support their college-aged children by fostering autonomy and carefully considering their own motivations when communicating, to avoid imposing their emotional needs on their children.

Quotes

• “Change your narrative – that being a good parent is defined by other people in your life. We all get to decide what it means for us and we don't want to have our kids be accountable for our feelings of adequacy as parents. It's not their job to make us feel like good parents.” (04:55 | Dr. Hope Seidel)
• “When it comes to life skills, we grossly underestimate what our kids can do or should do. We pressure them to excel in this kind of hyper-competitive world, thinking that that's the way to success. Frankly, we're teaching them that's the way to success. Then we sometimes don't teach them the basic skills that truly fuel the capacity for self-efficacy. We interfere with their building blocks of feeling self-confident. Self-efficacy is the belief in your ability to complete your own tasks, to reach a goal, to be able to manage your own situations.” (06:54 | Dr. Hope Seidel)
• “When I really feel sad, I look at my kids' life through their lens, of all that's possible, which is sometimes all that's ending. I can feel so much hope when I can look at it through what they have to look forward to. I would recommend you do that with your kids. Their life is full of possibility and excitement right now. We don't want to steal that from them while we're dealing with our own kind of emotional stuff as we figure this time out.” (49:57 | Dr. Hope Seidel)
• “Our kids are going to live different lives than ours if we're doing it right. They are going to learn to trust a compass that's their own, not ours. They are going to be exposed to things that they have to figure out how to navigate because we won't always be there. The better we get at providing them with that opportunity, with this soft place to land on the other side, the greater their capacity for success. (51:34 | Dr. Hope Seidel)

Links

Connect with Dr. Hope Seidel:

Learn more about Dr. Seidel: www.parentwithhope.com

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm

“Glucose impacts everything,” says Kate Willis, a nurse practitioner certified in functional medicine from the Institute for Functional Medicine. Alongside Dr. Polly Watson, she discusses glucose control for midlife women's health. This episode uncovers the foundational role of glucose in energy regulation, mood stability, mental clarity, and the avoidance of long-term health risks such as metabolic syndrome, cancer, heart disease, and neurocognitive disorders.

Kate brings her expertise to the forefront, explaining the complexities of insulin resistance—a condition in which the body requires more insulin to process glucose, potentially leading to serious health complications, including inflammation, weight gain, and an increased risk of cardiovascular disease. She highlights a common but often overlooked issue for women undergoing perimenopause and menopause: the changing dynamics of carbohydrate processing. This sheds light on the necessity of lifestyle and dietary changes to maintain optimal insulin sensitivity, emphasizing the pivotal role of nutrition in managing these transitions.

Dr. Watson and Kate advocate for the use of continuous glucose monitors (CGMs) as a safe and informative tool for patients to gain a deeper understanding of their metabolic health. This is especially beneficial for those struggling with weight issues, PCOS, or who are at risk of developing prediabetes. They assert that CGMs enable patients to proactively manage their health during the challenging midlife years. Furthermore, they stress the importance of incorporating a nutritional perspective into glucose management, aiming for a holistic approach that encompasses dietary adjustments to ensure the best possible health outcomes.

Quotes

• "We have glucose receptors all over our body. Our glucose levels impact how we feel and how we stay healthy as we age." (01:30 | Kate Willis)
• "One of the things that happens during perimenopause and menopause is we tend to develop some relative insulin resistance. This does not mean that every woman who is going through menopause will develop type 2 diabetes or need medication. But it does mean that we will have a shift in the way that our bodies handle carbohydrates. We may need to make some changes in our lifestyle, our diets, or the way we exercise to really support being insulin sensitive." (05:06 | Kate Willis)
• "When we're having a lot of ups and downs with blood glucose levels, a CGM can be a great tool to clue us into why we may feel tired at certain times of the day." (08:44 | Kate Willis)
• "To be able to see in real time what food is doing to your blood sugar level is very powerful. I think that data helps inform change and helps fuel change for many people." (13:10 | Kate Willis)
• "I think about women who are struggling with their weight, women who are struggling with things like PCOS. We know there's often some insulin resistance that is going along with PCOS. For people who are having trouble identifying what to eat, and what nutrition plan works for them, blood sugar is not the only thing we look at when we're choosing a food plan or choosing nutrition, but it certainly is part of the equation. And so, I think it's helpful to give people a tool to use to help navigate their food choices." (19:09 | Kate Willis)

Links

Connect with Kate Willis:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Meet Kate Willis: https://hormonewellnessmd.com/kate-willis

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm

"Midlife women are often caught up in a sea of symptoms," says Dr. Polly Watson. "Too often, they're overwhelmed by the lack of support from mainstream healthcare. They're inundated with so-called experts who are selling solutions which may lack credibility." Dr. Polly addresses the common mistakes and misconceptions related to weight gain in midlife women. She emphasizes the importance of personalized approaches to health and weight loss, debunking the myths of calorie restriction and macro tracking as universal solutions.

Highlighting the importance of adequate protein intake, Dr. Polly cautions against the pitfalls of excessive fasting and alcohol consumption. She highlights the often underestimated impact of stress hormones, exercise habits, and sleep quality on managing weight during menopause.

By exploring ways to balance life's stressors, Dr. Polly encourages her listeners to tune into their bodies and adapt their health strategies accordingly. She provides practical advice on evaluating the effectiveness of weight loss efforts, which includes tracking sleep patterns and leveraging technology such as continuous glucose monitors and the innovative Lumen device.

This episode is a call to action for women in midlife to prioritize self-care, acknowledge their distinct health needs, and eliminate unnecessary stressors. By making informed health decisions in consultation with healthcare professionals, they can go through a more personalized journey towards achieving optimal health and weight management during menopause.

Quotes

• "Fasting can have a lot of benefits, but I think that many people do well with short periods of fasting and times where they're allowing themselves to eat more. We're encouraging metabolic flexibility." (03:22 | Dr. Polly Watson)
• "A lot of women struggle with stress hormones which promote weight loss resistance. When our cortisol is high, we're going to become more insulin resistant. We're going to kind of get that SpongeBob SquarePants look–the belly fat look. We all need to have active stress management." (06:16 | Dr. Polly Watson)
• "I've seen plenty of women end up being depleted and exhausted by constant restriction. To make matters worse, as they continue to restrict and restrict, they're often not losing just fat mass, but they're also losing lean muscle mass because they're eating so much less; they're not eating enough protein and they're too tired to exercise. So if they do lose weight, they end up being less metabolically healthy than when they started because they've lost lean muscle. Your body is smart. As you continue to restrict calories, your body will adapt to use less fuel. So calories in, calories out isn't good science. It's not true. And eventually it can often lead to you gaining more weight back because you're less metabolically healthy when you started." (11:50 | Dr. Polly Watson)
• "There are some simple things we can look for that can help give us clues if we're being a little too intense and we're pushing too hard. The first one's really basic. I would say: “what's going on with your sleep? Are you sleeping through the night? Do you wake up feeling refreshed?” A lot of times when we start restricting carbs, when we start doing a lot more fasting, sometimes sleep gets disrupted. So if you're really struggling with sleep after starting a new health-promoting behavior, I would argue that sleep is probably one of the most important things we can do for our health." (20:00 | Dr. Polly Watson)
• "Give yourself permission to find a solution that works for you and give yourself permission not to keep beating your head against the wall and really pushing harder and harder and harder with something that may not be working. Maybe the solution is to do less." (26:51 | Dr. Polly Watson)

Links

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm

At a point in a woman's life when balance seems like it should come effortlessly, menopause introduces complexities that can tip the scales. Dr. Polly Watson tackles the common issue of weight gain during menopause—a concern for many, despite their best efforts at maintaining a healthy lifestyle.

Dr. Polly explains the hormonal upheavals that lead to increased insulin resistance. This shift predisposes the body to store glucose as fat, especially around the abdomen. It is further exacerbated by factors such as sleep disruption and stress, making the weight management journey more challenging.

Highlighting the importance of muscle mass in energy expenditure, Dr. Polly advocates for a combination of adequate protein intake and resistance training. She delves into the complexities of maintaining metabolic rate during menopause, emphasizing that the focus should extend beyond achieving a specific physique to fostering a body that’s strong and resilient.

In part two of the discussion, Dr. Polly will delve into the many pieces of weight management advice found on social media and various media outlets. She aims to provide a discerning look at common weight loss recommendations, evaluating their potential benefits and pitfalls to guide listeners toward a personalized approach to maintaining their health.

Quotes

• "We're living in a culture that promotes thinness as health, which is actually not often accurate. Our goal should be metabolic health. So what does that mean? Metabolic health means that your body has normal blood pressure, normal triglycerides, normal lipids, normal blood sugar, and your waist circumference is less than 34.6 inches in women. So when I'm thinking about health promoting behaviors at midlife and menopausal transition, I'm thinking about resolving insulin resistance, maintenance and promotion of lean muscle mass, quality sleep, diverse exercise with an emphasis on lifting heavy weights and doing the mobility work so we don't get injured, an anti-inflammatory diet, and fulfilling social connections." (04:46 | Dr. Polly Watson)
• "Sleep disruption is another huge reason why midlife women are gaining weight. And we see sleep disruption affect weight at a lot of moments in the reproductive life cycle." (08:19 | Dr. Polly Watson)
• "Women who are having hot flashes, night sweats, sleep disruption, and who are getting less than six hours of sleep a night have a much more difficult time losing weight than women who are getting adequate restorative sleep." (08:56 | Dr. Polly Watson)
• "As we age, we are losing muscle mass each year. And as our lean muscle mass goes down, our metabolic rate goes down because muscle burns more energy than fat. So this is one thing that makes me so crazy is that a lot of times I see women restricting, restricting, restricting, and they're not eating enough protein. And so they're really promoting loss of lean muscle, which if they do lose weight on that very restrictive plan, they're gonna end that plan less metabolically healthy than they started. And they're more likely to gain all the weight back and then some because they have less muscle mass than when they started." (13:41 | Dr. Polly Watson)
• "Understanding some of the hormonal effects that affect our whole body will really help give you the tools to feel like you have a little bit more control over what's going on with your health." (18:53 | Dr. Polly Watson)

Links

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm

Understanding the menopause transition involves addressing common misconceptions, particularly about hormone replacement therapy (HRT). Dr. Polly Watson addresses the enduring myth that associates all forms of HRT with breast cancer, tracing its origins to a misinterpretation of the Women's Health Initiative study. She clarifies the distinction between bioidentical progesterone and synthetic progestogens, highlighting their differing effects on breast cancer risk. Furthermore, she emphasizes the significance of personalized HRT protocols.

Dispelling the belief that HRT's sole purpose is to combat hot flashes, Dr. Polly delves into its FDA-approved benefits and beyond. These include easing joint pain, improving mood, supporting cardiovascular health, and preventing osteoporosis. She also addresses the crucial, yet often overlooked, aspect of vaginal health in menopausal well-being.

This episode goes further to clarify that not all HRT is created equal, distinguishing between the forms of estrogen administration and their associated risks, and debunking the common fear that HRT invariably leads to weight gain. Dr. Polly explains that menopause itself, not HRT, often triggers changes in the body that can affect weight.

Moreover, Dr. Polly explores the world of FDA-approved bioidentical hormones, debunking the myth that only compounded hormones fit this category. She offers a reality check on testosterone's role in libido and introduces promising non-hormonal treatments for those unable to use HRT due to medical reasons.

Dr. Polly encourages listeners to approach menopause armed with facts and to seek customized care from their healthcare providers.

Quotes

• “If we're talking about hormone replacement therapy and breast cancer risk, the type of progesterone or progestogen really matters in relation to that risk.” (05:58 | Dr. Polly Watson)
• “We live in a really polluted world. There are lots of complicated facts, family history, lifestyle, alcohol use, body mass index, breast density, all of those things come into breast cancer risk. So we can never guarantee anyone, there's no risk of breast cancer, but we can make more insightful choices when we're offering hormone replacement therapy.” (06:26 | Dr. Polly Watson)
• “It's important to understand that hormone replacement therapy is FDA approved only for four things: hot flashes, night sweats, urogenital symptoms like vaginal dryness, sexual pain, and the prevention of osteoporosis. So we know that giving estrogen, particularly earlier in the menopause transition, can delay bone loss.” (07:21 | Dr. Polly Watson)
• “I think where I see the greatest positive health change is if we can get people to sleep, if you can treat their vasomotor symptoms and get them to be able to sleep, then they have the bandwidth to do all the work they need to lift weights, eat more protein, build more lean muscle mass, glycemically balanced nutritional load, et cetera. ” (15:05 | Dr. Polly Watson)
• “Women need a very clear and honest conversation about sexual health and libido.” (22:23 | Dr. Polly Watson)

Links

https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf

Links

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

Podcast production and show notes provided by HiveCast.fm