<p><a href="https://peterattiamd.com/ama52/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=231016-pod-ama52&utm_content=231016-pod-ama52-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=231016-pod-ama52&utm_content=231016-pod-ama52-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=231016-pod-ama52&utm_content=231016-pod-ama52-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this "Ask Me Anything" (AMA) episode, the discussion zeroed in on the practical application of hormone replacement therapy in women. Peter walks through the signs, symptoms, and hormonal changes in women approaching – and going through – menopause. He provides an overview of the FDA-approved HRT formulations and explains how women might go about choosing the right option for themselves. Peter also describes the significant changes in testosterone levels in women over time and the options, as well as the considerations and challenges of testosterone replacement therapy (TRT) for women. Lastly, Peter highlights the necessary role of compounding pharmacies in HRT, underscores concerns regarding the quality and sterility of compounded drugs, and offers guidance on locating a trustworthy pharmacy.</p> <p>If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=231016-pod-ama52&utm_content=231016-pod-ama52-podfeed">private RSS feed </a>or our website at the <a href="http://peterattiamd.com/ama52/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=231016-pod-ama52&utm_content=231016-pod-ama52-podfeed">AMA #52 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=231016-pod-ama52&utm_content=231016-pod-ama52-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Why hormone replacement therapy is such an important topic [2:00];</li> <li>The onset of menopause: symptoms, blood tests, and when to consider HRT [6:00];</li> <li>Tests that may provide indications of perimenopause and their implications for fertility [9:15];</li> <li>Vasomotor symptoms: hormonal changes that cause hot flashes/night sweats, and HRT therapies that can help [13:45];</li> <li>The role of estrogen in menopausal HRT [17:30];</li> <li>The limited role of progesterone in HRT protocols [25:15];</li> <li>What is a "bioidentical" hormone? [28:30];</li> <li>Overview of the FDA-approved HRT formulations [31:45];</li> <li>Determining HRT dosing and considerations for perimenopausal women [37:45];</li> <li>Choosing the right HRT formulation: pros and cons [43:30];</li> <li>Examining the link between certain forms of estrogen and breast cancer [46:45];</li> <li>Changes in testosterone levels in women over time and why it matters [50:00];</li> <li>Recognizing low testosterone in women: common symptoms and diagnosis [53:45];</li> <li>Testosterone replacement therapy for women: options, considerations, and challenges [57:30];</li> <li>The long-term use of testosterone in women: examining the limited data [1:00:15];</li> <li>What is a compounding pharmacy? [1:09:30];</li> <li>Reasons to opt for a compounding pharmacy over a pharmacy that adheres to stricter regulations [1:16:00];</li> <li>The tragic incidents that heightened concerns about compounding pharmacies [1:20:45];</li> <li>Tips for finding a reputable compounding pharmacy [1:27:45]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Seek Professional Medical Advice
Always seek assistance from healthcare professionals for any medical conditions, as this podcast is for general informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment.
2. Men: Pay Attention to Women’s HRT
Men should pay close attention to discussions about women’s hormone replacement therapy, as the underlying principles are applicable to male hormones and can help them understand and support women in their lives.
3. Track Menopause with Blood Tests
To get a sense of a woman’s trajectory towards menopause, measure follicle-stimulating hormone (FSH) and, to a lesser extent, luteinizing hormone (LH) via blood tests.
4. Optimal Hormone Test Timing
For women still having a period, the gold standard is to measure FSH, LH, and estradiol on day five of the menstrual cycle, with day one being the day the period begins.
5. Predict Menopause with AMH
If a woman is over 40 and her Anti-Müllerian Hormone (AMH) level is below 0.2, there is a very high probability she will go through menopause in the next five years.
6. AMH for Perimenopause Status
If a woman’s AMH is above 1.5, even if she is over 40, she is likely not perimenopausal, and menopause is probably at least six years away.
7. Understand Menopause Diagnosis
Menopause is clinically diagnosed retrospectively, requiring 12 months of amenorrhea (not having a period) without any other obvious pathologic or physiologic cause.
8. Become a Premium Member
To access the complete version of AMA episodes and other exclusive content, become a premium member by subscribing at peteratiamd.com/subscribe.
9. Leverage Premium Membership Benefits
Premium membership includes comprehensive show notes, monthly AMA episodes, a premium newsletter, access to a private podcast feed, and ‘The Qualies’ podcast featuring episode highlights.
10. Watch Female Hormone Video
Watch the video on female reproductive hormone systems (linked in the show notes) to understand what FSH and LH are doing and how they change throughout a cycle.
11. Watch Podcast Video
Subscribers can watch the full video of this podcast on the show notes page, and non-subscribers can watch a sneak peek of the video on the YouTube page.
Follow Peter Attia on YouTube, Instagram, and Twitter using the handle @peteratiamd for additional content and updates.
13. Leave a Podcast Review
Support the podcast by leaving a review on Apple Podcasts or whatever podcast player you use.
14. Review Disclosures
For a full list of Peter Attia’s disclosures and the companies he invests in or advises, visit peteratiamd.com/about where an up-to-date and active list is kept.