Ep. 30 Is Hormone Replacement Therapy Right For You? with Catherine Keenan Pharmacist

I am super excited to be speaking with Catherine Keenan today.

Catherine is a pharmacist. She is the owner and founder of Vivian Pharmacy. She manages a team of 20 staff within a busy seven day pharmacy and medical center in Vivian Street, new Plymouth. She is a wealth of knowledge and she is going to speak to us today all about H R T. Perimenopause, menopause. I am so looking forward to this talk.

So Catherine Keenan, thank you so much for joining me on the podcast. We are talking perimenopause, menopause, H R t, bio, H R T, all of the ins and outs around that. Thanks for joining us. No worries. Excited to be here. You, you have an interest in women’s health? Yes. We’ve chatted about that. Yes. Yeah. So what’s been a little bit, what sort of stimulated that journey for you in terms of this phase of life?

Perimenopause, menopause, midlife.

[00:01:52] Catherine: Yeah. So having been in the health profession for. You know, over 30 years now, I guess you identify with the stage that you’re at in, in life. And, you know, when I, before I had kids and everything, I, you know, thought I knew everything about being a mom, and then suddenly you’re a mom and it’s, you learn different things.

And I think for me, this interest has always been there in, in the health journey of women. And I’ve really investigated. You know, selfishly it’s the, they call it me search, you know, like just, you know, stuff that pertained to the, my stage in life and, you know, 10 years ago I Yeah. Was really struggling and thought, you know, this, what’s going on?

And so just, yeah. And piqued an interest in, in me. And then I saw, talked to a lot of women that I deal with in our practice and friends and yeah. So yeah. No, I think holistically, I’ve just looked at all the different options and yeah, so I am a woman, so obviously the health of women is important. And then, yeah.

Then I’ve just pertained it to my stage in, in life as well. So yeah, being in my mid fifties now, I just, yeah. I’ve found some really good answers for myself. And then I think, just wanted to shout it from the rooftops, really. So,

oh,

[00:03:09] Meegan: and honestly we need it, the amount of conversations I have every week around this phase of life and perimenopause and menopause.

Yeah, it’s just, So needed. Let’s kick off with the first question. So tell me the difference between what is the difference between Bio H r T regular h r T?

[00:03:30] Catherine: Awesome. Yeah, so obviously, you know, for the listeners, H R T means hormone replacement therapy. Thank you. So you know, when we are going through perimenopause and menopause that’s, So symptoms that we get are related to hormones starting to decline, and that happens in different stages for every woman.

So what the hormone replacement therapy does is try and replace the hormones. So there’s bio H R T, there’s body equivalent H R T, and then there’s other H rt. So the most common one we see now and. Must say, certainly the best one is the body equivalent, h r T. So that’s the ones that are in the patches.

There are gels available overseas, so your estrogen will come in a patch or a gel, and the progesterone will come as the micronized progesterone, which is an New Zealand, the funder brand is s. So that’s your body equivalent. And then there’s bio equivalent, which have a very similar structure to the natural hormones.

Sorry, the body equivalent ones are exactly the same chemical structure as the body hormones. So, The most natural way you can get it. Sorry, I didn’t cover that. Bioequivalent have a similar chemical structure but may not be exactly the same and often are made in a compounding lab. And then you’ve got your regular H R T, which is synthetic H R T, so chemically.

Based compounds that supposedly match, but not the greatest. And yeah, so we can talk about that a little bit further on, but yeah. Yeah, that would be good. So the most natural body equivalent, trying to be pretty natural by equivalent, not natural at all. Regular H R T.

[00:05:27] Meegan: Okay, so when I say Bio, H R T, I’m actually meaning body equivalent.

Body equivalent

[00:05:34] Catherine: ht. Okay, good. I mean a lot of women, or you’ll hear podcasts and they’ll talk about the bio h r T. Yeah. And they kind of mean body, h r t. So it depends. The person talking, if they’ve got more of a medical background, will definitely say the body equivalent. Yeah. Maybe haven’t had the bit Medical training might just call bio equivalent and try and mean body as well.

So yeah, there’s Sure.

[00:05:58] Meegan: Yeah. And so, so what are the, from your perspective or from your understanding, what are the, some of the most common symptoms that you would see that body identical H R T or h r t can help

[00:06:15] Catherine: with? Yeah, so as hormones decline our bodies can show. Symptoms. I think, you know, in one of the most recent trainings I did with my staff, I sort of wrote all the symptoms I could find and got to over 20.

Yeah. You know, there’s. And I think that’s probably a lot of the issue is there are a lot of symptoms related to hormones declining. So we know about hot flashes, we know about night sweats. We know you know, the anxiety, maybe feeling low mood, lack of sleep, which can relate to the night sweats and hot flashes.

But things like vertigo pain Just general fatigue and all things that you think, oh, I’m just having a bad day, or I’m just getting older, actually is because your hormones are lower, so, When when your hormones decline and you get the symptoms, if you replace your hormones, a lot of the symptoms will go away.

So I can, I can list off, yeah. Joint pain, fatigue, irritability, low mood, low libido, the genal dryness, your hair starts falling out, you get heart palpitations. Express tenderness, headaches, a regular cycle. So I mean, there’d be woman out there going, that’s me, that me, you know, like it’s, yeah. So all those things that, yeah, make them feel like you’re just having a bad day or a bad moment, or it’s all, all just in your head actually could be your hormones.

[00:07:50] Meegan: And so that, so HRT will help with those, right? And so that is a good time to start when the symptoms starts. So not necessarily once you are, you are through perimenopause, once your cycles have stopped. But actually once the symptoms are showing themselves

[00:08:06] Catherine: a hundred percent you know, you don’t have to wait till you’ve got hot flashes to get hormone replacement.

You know, it may be harder to get it because your doctor will look at other options. Talk to you about, you know, could it be hormones? I think sometimes they fall into the trap of a blood test, which may not indicate the true nature of things because that’s just a point. You know, you go and have that blood test, so at that very minute, at that time that they took your blood, that was the hormone level, but three hours later it could have gone down.

Or you know, cuz it’s fluctuating so much when in the early days. So I think you just have to keep a diary. You know, on apps or whatever and just is it cyclical in the early days? But yeah, you can use hormone replacement early on to help and women do. We, we are seeing that a lot more now, even if they cycle still.

Yep. There, if they’re still bleeding, even if it’s only every three months or every six months or, you know, heavy one month and then really light the next, or, you know, it’s changing. Yeah, that’s, that’s a real good indication that something’s going on with your hormones.

[00:09:16] Meegan: Yeah, so good to know. And so we talked you talked about the ways we can take it.

So it’s the, so the body, identical h r t, so that’s the patch and then the, the, the capsule. So is that all that’s available to us in New Zealand specifically for, or is there more for body identical?

[00:09:37] Catherine: Yeah. Yeah. So in the uk, and actually I see recently Someone is trying to push to get the gel funded here.

So I mean the Urin only got. Funded since December last year, you know? Yeah, I saw that. Oh, oh. So behind. But so yes, Essin and the patches the body, identical ones that are funded in New Zealand prescribed. Yeah. And then you’ve got Ovestin. Cream and that’s just used vaginally. And then they also make ovestin tablets, which are body identical estrogen.

But you have, you take it orally and that opens you up to more side effects. Cause it has to go through your liver. Yeah. Right. Whereas the transdermal straight into your bloodstream. Yeah. Yeah. So it doesn’t

[00:10:27] Meegan: have to go through the liver.

[00:10:29] Catherine: Yeah. First pass effect. First pass. Yeah. Less, less chance of blood clots.

All the other issues that go with oral H rt.

[00:10:38] Meegan: Yeah, so random question is I’ve been seeing some well, quite a few posts around shortages in the uk. Mm-hmm. And are we likely to get shortages here? Cuz I noticed there’s al already been a, you know, when I get my patches they’re like, oh no, we haven’t got them.

You have to have these ones or you have to cut these ones in half and I know, yeah.

[00:10:56] Catherine: So yes, there’s a worldwide shortage of estrogen patches. I actually, there’s a, well there’s a shortage in the UK at the moment of Rasin, so we’re keeping an eye on that. At the moment, that’s not an issue in New Zealand.

So at the moment, Esra Dot was, is the Goldstein brand. That’s the best brand. We don’t have any issues with that, with sticking and yeah. You know, that’s, that’s the gold standard. That’s a brand we can’t get at the moment. So the is. Two other brands on the market at the moment we’re having to use, not as good.

Still effective, but they don’t stick as well and people are reacting to this adhesive. Yeah, or right, we can cut their trot. So we’re hoping that’s coming right about July, August. Oh, good. Truly good. There should be supply, there should be supply enough to get, but you’ll have to pick it up monthly so that everyone’s got a chance.

I’ve noticed that you can’t

stockpiling not allowed to stockpile.

No.

[00:11:54] Meegan: Yeah, so it it took me, so I went through early menopause and I did all the natural, all the herbal, all the sort of complimentary avenues and it did help. It did help, but, and I was very resistant to H R T and I’ve gotta say mainly because I’d heard about that, that study mm-hmm.

Of, I’m not sure how long ago it was that h r T was maybe not good for women. And, and I sort of have a leaning to more, more natural you know, pathways. And then something, I actually saw a woman who went through the same thing and she recorded a video and she said, look, I’ve resisted this for 10 years and I’ve finally said I’m going to try Body DentiCal, H R t, and it’s completely changed my life.

And that opened my eyes up and I went and talked to my doctor and, you know, sort of went down that path. Where was I going? Oh, so talk to us about herbal support versus the body. Identical. H R T benefits Pros. There’s a lot.

[00:12:59] Catherine: There’s a lot in, there was a lot in that lead in. So there’s herbals. I’m just gonna write myself a note.

Herbals, there’s the Woman’s Health Initiative study and then there’s support of if you are already on by body identical and still wanna take some herbal products. So we’ll, we’ll, great.

Talk about herbal products first.

You know, I, I feel like a holistic approach. Every, every woman is different.

There’s not one size fits all. You do have to know your body, listen to your body, document your di diary down, your symptoms, know what is happening for you, so then you can work out what’s working and what’s not. If you try six things at once, you never know, gonna know what’s working. So start. Slow. Try, you know, I’m, I’m totally open to herbal products.

I think, you know, there’s a lot benefit to be made from a lot of these things. A lot of them have the phytoestrogens in them, so that’s the black coho. They’re not gonna come to me and into my brain. But rec clover maybe I know you’ve had some naturopaths on, so they’ve probably talked about it, but so they will mimic.

A bit of the effect of estrogen, but they’re not estrogen. So you are not replacing your hormones. You are, you know, trying, trying to get some sort of mimicking. So you will get some benefits, especially early on you might get some help with the little bit of the flashing or fatigue or headaches and things, and they’re often in with other good energy boosting herbs and vitamins.

So, you know, totally get a good practitioner. Talk to them, work it through. Yeah. I think it’s, yeah, start slow. Try one product at a time. Mm-hmm. See if it works. Then either move on or add in. But yeah, I just don’t think to do six things at once. Helps anybody. And it’s a lot of load on your body. Yeah. So yeah, find out what works for you and Yeah.

And then once you’re on the body, identical, h r t, you know, all, there’s all the good things to, for helping with your health, like B vitamins, magnesiums. Awesome. What else is, you know, fish oils, like all those good, healthy stuff? No problem. Taking those with your h rt. So yeah, I just would be careful about adding in the phytoestrogens on top of other estrogen, you feel quite sick.

You, you’ll probably get a lot of nausea. And also, again, they’re not through the skin, they’re through your tummy, so then they’ve gotta get absorbed and metabolized and excreted, so your liver and kidneys and everything having to manage it so it’s, you know, just another load on the body. So just, yeah.

You know, be careful about the Vito estrogens adding in with the H R T, but all your other supplements and supports. Great. Yeah. That helps. Beautiful. Yes, yes. Very helpful. Yeah. And then the Women’s Health Initiative study. Ugh, yes. So I guess the short answer to that is, It was done on older women. So they were predominantly over 60, had been through menopause, probably most of them 10 years.

Then they started on H R T. The H R T they put them on was some synthetic. It was made from horse urine. It was the only thing available in the nineties. Hmm. So the study was done predominantly through the mid to late nineties. This findings were reported in 2002, I think it was. Yeah. And they showed that there was an increased risk of breast cancer being found.

So it didn’t, from what I can gather, the estrogen didn’t cause the breast cancer. It just made already cancerous cells grow more so they were found easier. So that makes sense. So, and it was from something like two in a thousand to four and a thousand, so that was the increased risk. So they say it doubled from two in 1000 to four and 1000, something like that.

But still was only four and 1000. You know, like the, the risk was really still quite low. So, I mean, it’s been totally annihilated that study. We don’t. There. I think we’ve had one person be, stay on that synthetic drug. We we dispensed it by the, by heats by the thousands in the nineties. Right. Just ne you just wouldn’t use it now, you’d never start anyone on that.

You just, it’s, yeah. It’s rubbish. Yeah. Just blunt. Put I, you know, Estrogen, like I said, is a growth. It’s a growth hormone. Yeah. So, you know, it’s good for your bones, it’s good for your heart, it’s good for your brain and, and the way that it’s promoting, you know, cell renewal and it’s good for your hair and your skin and all these things.

But then if you’ve got some cancerous cells, unfortunately they’re gonna grow a little bit more too. So, yeah. Yeah. Makes sense. But there’s no increased risk of death from cancer, from breast cancer with H R t you might find, have a slightly tiny increased risk of finding a cancer, but detection’s really early now treatments are good.

Yeah. I, I don’t, I think it’s just a conversation people need to have. I have a strong family history of breast cancer. My mother died at 47 and my grandmother at 65, both of breast cancer. And I was very reluctant because of the study. And again, I went to my GP and I’d done my own research. And you know, my gp, luckily a woman the similar age to me, she just said, what are you doing to yourself?

Why are you suffering? You know, why are you. You know, like I was in a pretty bad space. Yeah. And she said, why? Why are you doing it to yourself with a very slim chance that you’re gonna get breast cancer? Because you know, you’re getting yearly mammograms, you’re very aware of what’s going on with your breasts.

Yeah. So, yeah. You know, and, and so you might, I actually just said, yeah. You just to try it and like, change my life. Yeah.

[00:19:22] Meegan: Well that’s what I was gonna say is like that struggle of years and years, and it could even be, you know, it, it is longer in terms of our quality of life. When you weigh it up, that’s an important thing to do.

So that study has pretty much been debunked,

[00:19:39] Catherine: right? That’s, yeah. It showed results for what they used at the time. A, those drugs aren’t used anymore. B, the women that were using them were. At a higher increased risk of breast cancer anyway, because they were older, you know? Yeah. The highest risk of breast cancer is age.

And then they never took into account the fact that maybe they were still all drinking alcohol or not eating well and maybe not exercising and all those things that can actually add to breast cancer risk as well. So there was just so many things that were wrong with it. And the media and sign, and dare I say it, male scientist decided to grab it and said, You know, these women should not be on H R T and no h r t.

There’s, yeah, there’s no, there’s studies coming out now about body identical hormones and estrogens having such protective and life-changing effects for women that. That, you know, it just poo-pooed that whole other study basically. Yeah.

[00:20:40] Meegan: So first of all, that’s so good to hear around in terms of that study because when I, I was laboring under the under the information from that study for probably seven years, you know, I went through early menopause for those first five to seven years.

And so that’s me. How many other women are doing the same thing, right?

[00:21:00] Catherine: Oh, just had one last week. Yeah, she was, she had a hysterectomy. She’s in late sixties now. Hysterectomy. Got told, got given hormone replacement, felt amazing, and then got told, no, this is dangerous. You have to stop. You can’t be on it any longer.

And got it whipped away from her. And so she has had 15 years of. Hell and now is being offered hormones back and you know, you just think pretty sad. Really sometimes. Yeah. Yeah. And has, and yeah, it’s, it’s pretty mean.

[00:21:37] Meegan: There’s a big, there’s a big picture there. Hey. Yeah. And then you just also talked about the protective aspects of it.

Can you speak a little bit more to that? Cause I, I was actually surprised about that having not had any knowledge around it, but I think it’s really important.

[00:21:53] Catherine: Yeah, so I mean, this is all new stuff that’s just coming out in the last 20 years because of the, the body identical hormones and the fact that women obviously are living longer and you know, the most common cause of death in women is cardiovascular disease.

So, you know, that’s, that’s the most thing, common cause of death. And what they’ve, what they’ve found is that estrogen protects your blood vessels and cardiovascular, your heart health. It protects your brain. It can reduce your risk of type two diabetes and definitely protects your bones. So yeah, so when you lose your estrogen, you can get brittle bones.

You know, heart valve problems, palpitations and you know, you get the foggy brain. We all know that. And then obviously there’s dementia risk as well. So they know that now that. And that’s why it used to be you couldn’t be on H R T longer than five years. But that’s definitely been reviewed as well.

And they’re saying now there’s no reason why women can’t stay on H R T their whole life. Wow. Cause it’s effects. Yeah. And as long as you’re keeping, you know, you look out for, you know, reporting any side effects. Sure. Checking for breast cancer risk, there’s no reason.

[00:23:13] Meegan: So for me, a woman of 52 who’s been on it for a couple of years, I, because this was something that came up in the talk that we did.

Women were saying, oh, I, you can only be on it for three years. You can only be on it for five years. The the body identical. I was like, well, I haven’t been told that. I don’t understand that. So you are saying what the research that’s coming through now. Reason, that reason why.

[00:23:35] Catherine: Mm-hmm. And that again, relates back to that women’s health initiative study, because what they found was that the, obviously the increased risk of breast cancer and that synthetic hormones, they found the risk was increased after five years, or women were over 60 because the, but it wasn’t, it wasn’t the trend, you know, it wasn’t the body identical hormones, it was the awful hormone.

And also they were older anyway. So, ah yeah, none of, I don’t know if many women in that study that were under the age of 60, whereas now we’re saying start them early. Do the body identical, get the dose right. Protective effect stay on them. Beautiful.

[00:24:20] Meegan: And there’s no so if I’m on, say, on the, is it 25 mm-hmm.

NGS for

the patches? Yeah.

If that’s keeping my symptoms, if that’s keeping things set, settled now, there’s no particular reason or no expectation that that would change. Like, I’d have to take more as time goes by in your experience.

[00:24:43] Catherine: Doesn’t seem to be okay. Yeah. They tend to start you on the lower dose and then give it about five to six weeks to really decide if that’s working.

So you, it’ll take a few weeks for it to, to build up to a level where your symptoms will be under control. And if they’re not, then they’d look at increasing your dose. So then you’d go to a 50, try that for another. Six, seven weeks. And then again, you know, there’s 75, we’ve got a few women on a hundred micrograms.

It just depends on you and on your symptoms and how your body processes it. And yeah. You know, for me, I’ve, I’ve, I tried 25, went pretty much after six weeks, went to the 50 and then, I thought for a while I thought, oh, maybe I’ll try the 75 and see. Cause I felt amazing on the 50. I thought maybe I’ll feel more amazing on the 75, but didn’t quite work that way and I got some side effects and breast tenderness and, and felt hormonal.

Like I felt it was too much, like, you know, you know when you feel a little hormonal. So I just felt no, went back to the 50 and, yeah. Pretty much sweet spot. Go with that. Yeah. And just wanted to mention about the progesterone because not all women will be on that. The micronized capsule, cuz they may have a marina, right?

So the into uterine device like an i u d marina that’s implanted into the uterus and slowly releases the progesterone. So if you’re on the marina, you can just use the patches. You don’t have to take. Oral progesterone as well. And if you’ve had a hysterectomy and had your uterus or wound removed, then you don’t have to take progesterone either because the reason you take progesterone is to counteract one of the side effects of the estrogen as that as a growth.

Hormone. So it will make this lining of your uterus grow too much and can cause complications. So you take the progesterone to counteract that buildup of cells in the uterus. Oh, right. Yeah. Yeah, that makes sense. If you still have, still have uterus or worm, then you’ll have have to be on progesterone as a protective effect.

[00:27:01] Meegan: Right. Beautiful. And so I was talking to a friend and she Started on body identical. Mm-hmm. You know, the patches in the progesterone. Mm-hmm. And she said it was, she said, oh, it was just like a, a light went on and I could, I could al, I could kind of see again, I could see my life again. So, you know, the increase in vitality.

But she said, I’ve had fibroids and. I started to get pain in that or yeah, pain like down my leg and it started to feel weird and I just didn’t like it. Can that happen? Cause I just sort of Googled after that, after we had that convo. Yeah. In terms of fibroids.

[00:27:44] Catherine: Yeah. I mean, I guess it’s getting the dose right?

I mean, it would just be particular to her symptoms. So you’d probably just have to get an ultrasound to see what was happening with the fibroids. Yeah. And see there’s a chance with the estrogen that they could be flaring up. I mean it depends where she was in, in the cycle and things. Yeah. Whether she, yeah.

So. Women do still use body identical h r t with fibroids. But if you’re getting symptoms like that, obviously that’s gonna cause you some anxiety. Mm-hmm. You definitely need to get some investigation done if you can get in an ultrasound to see, and maybe it puts your mind at rest. I mean, sometimes you do get the odd twinge in you.

Yeah. Yeah. And you think, oh, I wonder what that’s all about. Yeah. I think if it’s worrying you, you should get it looked into. Yeah. Yeah. You see it’s, there’s no reason why you shouldn’t, couldn’t stay on your H R T, but you just have to get the right advice.

[00:28:42] Meegan: That’s good to know. Yeah. And so to that you know, I’ve, myself got a fabulous gp.

They’re really up with it. But if generally speaking, if we go to our GP and say, I’m irritable, low mood, bit more anxiety, maybe a bit of hot flashes are, are they in the know around body identical h r T? Is this a common thing that is prescribed to women in perimenopause? In New Zealand,

[00:29:09] Catherine: it very much depends on the gp, right?

And it depends on their knowledge and their willingness to listen and, and learn. I would say probably five years ago if you went saying exactly what you just said, that would’ve put you on antidepressants. That doesn’t replace your hormones, and you just, you know, feel, probably don’t feel any better.

And then think something wrong with me. I’m quite strongly advocating through gps if I can. If people want, I get the GPS to ring me or I’m happy to send email links to articles, research. And things like that because I think if women don’t feel they’re being listened to, maybe they need another advocate.

Yeah. In their life to help. And I think that’s the thing. What I found once, it’s funny because I needed, I needed to have my voice at the gp. I needed to have my voice so that I was listened to. But you don’t feel like you have it when you’re in with the symptoms cuz you’re anxious and you. Sleep deprived and you’re just shitty at everybody.

Yeah, and you know, you almost have to. Fight for it and that’s not really right. But then once you get the clarity, yeah, I don’t know. I just, like I said, it sort, it’s terrible on the rooftops.

[00:30:30] Meegan: It’s a terrible irony, isn’t it? Like you, you really needing it. But it’s that the very time when you don’t have your voice, your confidence is lower, you’ve got brain fog, all the rest of it.

[00:30:41] Catherine: Yeah. Yeah. And actually one woman said to me, she said, you know, looking at it from the point of view of a, of grieving, and I’d never really thought about it like that, but you know, you are not, you’re no longer able to reproduce, you know, you’re no longer able to. To have, have that function as a woman, to have, have a child because you no longer have a cycle or whatever.

Once you through that and, and she framed it, that that was a real grief for her. And I, I’d never really thought of it like that, but I think everyone has to find. It’s, and, you know, great that we could have a conversation about it and talk it through. And that’s why I think you need your good mates, good family support you know, bless my husband, but putting up with me.

Goodness. You know, and I’ve had women come in and say, my husband thanks you for, you know, pointing me in the right direction here, because, you know, they just, I feel like you just. You know, get rid of everybody. Just, it’s, it’s, it’s awful. Yeah. So I think, yeah, you know, just, you know, back to that, speaking up to your gp, it’s quite hard because some women have, you know, don’t have that the voice at the time.

And if the GP says, oh, just try these, you know, antidepressants or whatever, and it’s getting better. You know, it’s very simple at this time. You’re starting to lose your hormones or you’ve lost your hormones, you need them back. Mm. And that’s pretty much all you need to say. And you hope that they’ll listen.

And if they don’t get a second opinion.

[00:32:16] Meegan: Yeah, good call. Yeah.

[00:32:18] Catherine: One and one woman had been to a male doctor who said, if you are my wife, I wouldn’t let you take it.

[00:32:24] Meegan: I just think seriously, what

[00:32:26] Catherine: it’s, yeah. And so you think that’s not aple by the way, but it’s, you know it’s just that whole mentality of Yeah.

Yeah. And that’s still in predictive kinda way. Well, y

[00:32:39] Meegan: yes, but it still pervades, doesn’t it? And I have also I have talked to some complimentary health practitioners who were still citing that study, so, As to why we shouldn’t be taking by body identical. And so it is, you know, your voice is so important.

I tell as many people as I women as I can about it so that they, you know, we know we have options and choices and we have an understanding of what we can do take to support ourselves.

[00:33:12] Catherine: That’s right. And, and yeah, like I said before, you know, it’s not one size fits all. I think, you know. When you go through menopause, you know, perimenopause and menopause, like previously, women never lived that long.

They just don’t need, just didn’t even know about it, you know? So now we, we live longer, we have all these health interventions that we can do. And so actually you’ve, it’s almost like you wanna embrace this new, Phase of your life and you wanna be able to do it with them and bigger, you know? Exactly. You know?

Yeah. You wanna be having, you know, great relationship with your partner and your Yeah. You know, and yeah. I think it’s, yeah, H R T can really even things out.

[00:33:57] Meegan: Yeah. And you know, for a lot of women that I’ve talked to and for myself where I was going through that phase where I had to be so careful about my health and my energy and, you know, if I did too much one day I was pretty stuffed the next day and you know, all that kind of stuff.

And, It did give me so much more vitality back in those early months. It still has, but I’ve become much more used to it now. It’s just every day now. And so, you know, I’m 50, hopefully I’ll live a good while longer, but now that, you know, if I don’t have that quality of life, what kind of life is it? You know?

And it, it’s not just physically, it’s emotionally and psychologically as well. Yeah.

[00:34:41] Catherine: And, and that’s, you know, all those things that make. Make you able to make good decisions and eat better and exercise and you know, be happier and enjoy life. That lowers all your risk of all your other things as well, like your heart disease and breast cancer and, and everything.

So there’s sort of the, there’s the clinical benefits, but there’s also the psychological whole life benefits as well. So you know, I think along with h R T, it’s just really good to ha take stock of your life and just think, you know have I been self-medicating with alcohol or recreational drugs or 10 cups of coffee or something like that with, once you get the h r t, those sort of things.

You don’t have to self medicate to get sleep or get through a stressful time because you’ve, you’ve got other things on board. Yeah, they can.

[00:35:33] Meegan: Yeah, exactly. And they, they can fall away. Those other things can fall away so much more easily because we resourced in that other area.

[00:35:43] Catherine: Yeah. A hundred percent. A hundred percent.

[00:35:44] Meegan: Yeah. Sleep was such a big thing for me. That change changed with H R T and I was like managing it and I was like, it’s okay. I can meditate, I can da, da da. But that’s such a lot of managing that I was having to do and now, Oh, amazing.

[00:36:00] Catherine: I know, my God, the sleep is insanely good. And that’s the thing about progesterone, if you’re, if you’re taking the micronized progesterone at night, yeah, it does have a mild sedative effect.

It’s not knocking you out, but it’s just calming and relaxing and yeah, so much better. And then you’re not getting the hot flushes and night sweats because you’re on the estrogen. That’s, yeah. Day. I mean, I still, I still have the odds you know, like sleep drops or, yeah, of course I have a old glass of wine.

But you know, I think it just Yeah. Keeps you, keeps you even, yeah.

[00:36:32] Meegan: Yeah. And I, yeah. I’m not expecting to wake up at four in the morning anymore around it. Yeah, yeah. You know, without Yeah. Not being able to sleep. Yeah. Yeah. And so for the few women that can’t take it, And I have talked to one or two that have tried through their doctor to take it, and one had.

Quite bad reactions to it and must say, well, okay, you know, maybe it’s not for you, but really feels like she needs some support. What? What are some alternatives?

[00:37:03] Catherine: Are there alternatives? Yeah. Oh like possibly not hormone wise, if it’s the hormones themselves and some women are just really sensitive.

They just get all the side effects and not much of the benefit. And it’s pretty rare, but, It can happen. I mean, I guess don’t give up off the first lot. Maybe look at some dose adjustment or start really super low and then slowly increase it. But you know, if, if it’s not for you then just really keep that diary of symptoms and then you’d look at how can I manage those symptoms?

So, joint pain you know, like regular exercise strength, you know, try and get your strength up. Building muscle protein in your diet you know, all that. Yeah. Just tailoring the treatment to your symptoms. So you might just need to be on regular paracetamol for that. You know, and trying the things with vertigo or the hot flashes is tricky because, You know, you can try herbal things if they do help, but generally you will just need estrogen for that vaginal dryness or painful sex there.

You know, Avastin cream is life-changing. Increased UTIs you know, that’s a quite a common symptom particularly, and like women we’re seeing, you know, between 60 and 70, you know, they start to get. You know that vaginal dryness and then increased UTIs and just some OV cream twice a week, just locally, you know, and you get minimal side effects with that cause it’s just working in that local area.

Yeah, so I think it’s just finding a good practitioner or you know, someone to talk to about it and just diary the symptoms and then they can tailor some treatment to that. Yeah,

[00:38:40] Meegan: yeah, yeah. Getting specific onto the symptoms.

[00:38:43] Catherine: Yeah. Symptoms. Yeah. Yeah. Is

[00:38:46] Meegan: there anything weve not covered that you want to speak to Catherine around this?

[00:38:51] Catherine: You know, there’s, there is a lot of information out there and I think just, you know, look at your sources. I mean, I use Dr. Louise Newsom in the UK has been amazing. She’s got the balance menopause website and app. There’s a heap of really reputable research on that. She speaks to some great people.

I think that’s, A really good place to start. Yeah. Sh Yeah. And you can, there’s an app. You can just diary your symptoms every day and then you can go to your doctor and say, Hey, you know, this is what’s happening. Yeah. No, I think, I think that’s it. Just, yeah. Think of, think of it as, you know, you’re deficient in hormones and they need to be replaced.

It’s like you’re deficient in your thyroid hormones that you take. Thyroid hormone to replace it. When you’re diabetic, you don’t have insulin hormones, so you have to replace it. So, You know, don’t think of it as that. You just have to suffer through that there’s, you know, you have a deficiency in something that is, can easily be replaced and in most part very safely.

[00:39:52] Meegan: Beautiful. That’s very, very clear. Thank you so much and hey look, really appreciate you joining me on the podcast. These are all the questions I didn’t know the answers to. So appreciate you being here so much.

[00:40:05] Catherine: No problem. Hey,

[00:40:07] Meegan: last very random question. What’s your current favorite

[00:40:13] Catherine: book? Yeah, the, the best book I’ve read lately is that Lessons in Chemistry.

I don’t know if you’ve read it. No. Yeah, I can’t think of the author. I’ll put a link in it’s coming Lesson Lessons in Chemistry. It’s coming out as an Apple TV series with freelance and it’s amazing, it’s empowering for women. She’s a scientist in the 1950s and sixties who gets a whole lot of shit from a whole lot of blokes, and she doesn’t take, she doesn’t take it and

[00:40:42] Meegan: it’s, it’s, we’re

[00:40:43] Catherine: onto it.

It’s amazing. So yeah, I recommend Lessons in Chemistry.

[00:40:48] Meegan: Thank you very much. I’m into that. Totally. Yeah. All right, Katherine, thank you so much for joining us on podcast. You’ve been amazing. Have a good rest

of

[00:40:57] Catherine: the week. Awesome. Thanks again for having me, Megan. Cheers. If you

[00:41:02] Meegan: enjoyed this podcast, share it with your friends and make sure you come and say hi over at Instagram.

Step courageously into the second stage of your life and go after your dreams. I’ll help you remove everything else that’s standing in the way. Come and coach with me over at meegancare.co.nz.