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This podcast originally ran on October 21, 2023.

This week we get down to basics, and basics are exactly what we need in this confusing world right now. This is THE podcast to listen to if you are confused about all things to do with taking hormone therapy.

Dr Vikram Sinai Talaulikar is a specialist in reproductive medicine at University College London Hospital’s NHS Foundation Trust and an associate professor in Women’s Health at the University College London. He graduated in medicine in India in 2003 and completed a postgraduate degree in obstetrics and gynecology in 2007. He is a certified menopause specialist by the British Menopause Society, a menopause trainer and he is constantly educating others on this transition as well, via online webinars, events and through social media.

He is also part of the trio who established the Menopause Research Education Fund, alongside medical journalist Fiona Clarke and groundbreaking menopause campaigner Diane Danzebrink.

Highlights of our discussion:

• Hormone therapy (HT) 101
• WHI: good, bad and what we can learn from it 20 years on
• Estrogen in the pill vs estrogen in HT
• All the kinds of estrogen and what they are used for strogen too ethinyl estradiolEstrone, Estriol, Estradiol, and Estetrol.17 beta estradiol
• Getting to the bottom of body simila, body identical and bioidentical – and why that varies from country to country
• Pharmaceutical company produced HT vs compounding pharmacy versions
• the big “Catch-22” with compounding pharmacies that keeps their bioidentical hormones out of official recommendations
• the pill, HRT and breast cancer risk
• why problems with the pill don’t get flagged and HRT does
• Evidence over estrogen and breast cancer risk (and randomized trials versus observational data)
• What’s what: progesterone, progestin and progestogens (how they work and which one carries a slight risk for breast cancer)
• how long you really need to take HRT to see if it’s working
• why HT works for some people and not others
• Dr Talaulikar’s favourite non-hormonal treatments

Where to find Dr Talaulikar:

X: @VikramSinai

Web: Menopause Clinic London

Menopause Research and Education Fund

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FULL DISCLOSURE: Jen and I recorded this interview last year. Almost a year ago. It was and is so important to me that I am sharing it with you now, with Jen’s blessing. (It fell into the “I took a short break to build my business and then my dad died suddenly” gap. You know the one ;)

Anyway, Jen is a very hardworking, accomplished entrepreneur and champion of midlife women. She runs the Jen Marples Agency and her goal is to help women over 40 get seen, heard, paid and to make an impact. She’s also the host of The Jen Marples Show: You’re Not too F***ing Old (soon to be called just You’re Not Too F***ing Old). We talk about it all: why you need to find supportive groups and new tribes (and what to do when yours isn’t working), ending friendships, dealing with ageism and the profound beauty and peace that comes with middle age and menopause. Jen believes you have to be a strong advocate for your own health. And she shares her own challenging journey, with endometriosis, IVF, perimenopause/massive burnout and ultimately reclaiming her vitality through rest, reinvention and getting her sleep back through the power of hormone therapy (thanks for delaying your nightly progesterone wind-down for us, Jen! The episode also touches on the essential book The Upgrade by neuroscientist Dr Louann Brizendine and offers advice on how and why you need to prioritize health care, making investments even when it’s not covered by insurance.

01:42 The power of language

03:00 Challenging ageism

05:41 Embracing midlife

10:06 Financial impacts of ageism

12:15 Navigating negative programming

26:15 Dealing with friendship loss

28:46 Navigating toxic relationships

29:44 Embracing new friendships

32:08 Perimenopause and Burnout

35:42 Hormone therapy journey

39:29 Advocating for women's health

49:59 Starting over at midlife

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

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Joe Sealey is a former UK footballer who is married to UK businesswoman Nicole, and they are both cast members of The Real Housewives of Cheshire. He's also comforting and cracking men and women alike up with his ongoing commentary on living with a woman in menopause. Joe jokes a lot, but he also gets serious about the challenges and changes experienced during Nicole's perimenopause and menopause, the importance of communication between partners, and how the couple navigates their journey together. Joe also offers some solid menopause tips for men and women alike.

Find Joe on:
TikTok @Joe_Sealey
Instagram @JoeSealey

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

See hotflashinc.com/privacy-policy for privacy information

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Hotflash inc founder and host Ann Marie McQueen talks about the first-ever perimenopause month, Hot Flash Day (courtesy of Stripes) and the annual meeting of The Menopause Society of North America.

She talks about sleep, hot flashes, weird quirks of research; hypnosis and cognitive behavioral therapy. Some new numbers on how many women in the US are taking hormone therapy (it’s way less than you think) and asks why only estrogen is considered hormone therapy. She talks about three of her best friends, who were transformed by exogenous hormones. And she talks about her own spiritual awakening through menopause, which sounds annoying but hopefully is not.

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

See hotflashinc.com/privacy-policy for privacy information

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Today Hotflash inc founder Ann Marie McQueen is speaking with a board-certified gynecologist whose surgical career was focused on fibroids and endometriosis before she discovered her love for functional medicine and holistic therapy and discovered what it could do for women struggling with menopause, hormones and wellness. Dr Masghati, who offers virtual consults worldwide in four languages, talks about treating patients from Lebanon to the Philippines, about the balance of estrogen and progesterone, the role of testosterone, the relevance of detoxification, ADHD in midlife, why some people want compounded hormones and why no matter what, we all need individualized treatments. The conversation also delves into the misconceptions about hormone therapies, such as pellets, and how to support women as they undergo psychological and physical changes.

01:59 Dr Masghati’s journey to holistic medicine

03:35 Understanding hormonal imbalances (and estrogen dominance, even if you call it something else)

03:56 Global perspectives on women's health

06:02 Environmental factors affecting hormones

10:27 The importance of progesterone

17:58 Challenges in hormone treatment

20:02 The role of functional medicine

29:03 Liver health and hormone balance

34:11 Thyroid and insulin resistance

34:44 Liver detox and macronutrients

35:13 Hormones and sleep

36:12 Diet and exercise tips

38:28 ADHD and hormonal changes

41:19 Managing ADHD symptoms in perimenopause

47:29 Hormone therapy options

52:07 Risks and side effects of hormone therapy

57:55 Hormones and disease prevention

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

See hotflashinc.com/privacy-policy for privacy information

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In part 2 of her interview with Buff Bones' Rebekah Rotstein tells Hotflash inc founder Ann Marie McQueen about the complexities of health during perimenopause and menopause, highlighting the importance of both mineral density, muscles, tendons, collagen and fascia.

She outlines the Buff Bones comprehensive exercise plan to hit all the targets in a week, emphasizing personalized care and the importance of mobility and motor control exercises. They explore the impact of collagen, estrogen and (briefly) progesterone on bone health and dive into the fascinating role of fascia in the body's connective tissue system – and in menopause.

02:01 Building bone and muscle through menopause
04:38 The importance of mobility
07:03 Collagen and bone density
09:40 Hormone therapy and bone health
18:46 The role of fascia in health

NB: These episodes were recorded in late 2023.

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

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In this episode, host Ann Marie McQueen tries to explain her long and convoluted relationship to and quest for hormone therapy.

This is an episode about her experiences, made more complicated by living abroad, reluctant doctors and by years spent wandering in a wilderness of emotional and physical symptoms no one could explain.

Until everything blew up. And let's not forget the gut issues.

In it you will see that even with all her resources, and a global platform all about menopause and midlife, Ann Marie is still trying to find the right recipe for her. The search continues.

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

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In this episode, host and Hotflash inc founder Ann Marie McQueen interviews Rebecca Rotstein.

Rebekah is the founder of Buff Bones, a medically endorsed exercise method for bone and joint health with on-demand classes and trained instructors in more than 30 countries. Rebekah is a former ballet dancer who has trained athletes and deeply studied the body, including cadaver dissections, along with coursework and fascia research, somatic studies, and visceral manipulation.

She serves on bone health working groups in the US, contributing to their recommendations. She's a Pilates teacher, advocate and well-known speaker.

Part 1 of this conversation delves into into the intricacies of bone and joint health, sharing evidence-based studies that emphasize the need for high-intensity exercise to increase bone density after menopause. They discuss societal misconceptions, the importance of understanding one's body type, the critical roles of muscle tension and gravity in bone health, and the impacts of early life habits on long-term bone health.

Next week in Part 2: What you do to keep your bones, muscles, tendons and fascia strong.

NB: These episodes were recorded in late 2023.

02:52 The Importance of bone health
04:00 Research and misconceptions in bone health
05:49 Backlash and misunderstandings
10:46 Rebekah's personal journey with osteoporosis
19:03 The interconnectedness of bones and muscles
33:14 Preventing bone problems from early life

Thank you to our sponsor, Midi Health. They provide holistic, insurance-covered care by perimenopause and menopause specialists. Check out JoinMidi.com

Join the Hotflash Inc perimenoposse:

Web: hotflashinc.com
TikTok: @hotflashinc
Instagram: @hotflashinc
X: @hotflashinc

Episode website: Hotflashinc

See hotflashinc.com/privacy-policy for privacy information