Hormone Therapy Myths EXPOSED What the WHI Study Got WRONG

0:10 Hey, you're right. This is Hunter Williams. I hope you were doing amazing wherever you got in the world. Today's video is going to be all about the women's health initiative study around hormones. So this was more or less a crowdsource video because I think on a Q and a video I had mentioned that I have wanted to do a deep dive video on women hormones, I haven't went on testosterone therapy for women, but the preconceived notions that many people, but a lot of women have around hormones causing bad things

0:41 to happen in the body if they supplement with hormones. And most of the mass consciousness or common consciousness that people have, like if you walked up to the average woman on the street and you said, hey, are hormones good for women to take as they age? Muslims say, no, they cause cancer. I won't call it wisdom, but information out there around women's hormones. Um, it's false.

1:11 It's completely false and so this video is not going to be necessarily anything that I'm teaching, But I do hope it will be an enlightening video for people that may be on the fence about hormone optimization therapy as to why they should never be On the Fence and why, as, uh, I think every man should look into hormone Optimization therapy, after menopause, they don't really have a choice. And that's the thing that is tough for women is the only choice a woman has after manopausal is either to suffer or not to suffering because they're not

1:41 going to have any hormones in the body and they can choose to replace those hormones with bioidentical hormone replacement therapy or they are just going choose the suffer. So it's really sad because millions and millions of millions women suffer every year in silence around the hormones and because of their hormones. What I want this video to be is more or less, I guess you could probably think of it as like an argument in a court case of why hormones should be a part of everyone's repertoire, but particularly post-menopausal women's repertory.

2:11 Um, so I think that's kind of on the forefront of a lot of women. So I seem to have a good amount of my audience that wanted a video like this. I said, let's do it. And I went, you know, knee deep in, uh, scouring some research and stuff and putting it together. At the very least, if you're watching this video, you are probably on board with the things I talk about. I guess they say that I'm preaching to the choir in that sense. But I think this will be a good video because what my aim to do is to have you be able to share this with someone in your life that probably needs hormones

2:44 but is resistant to this idea. of hormone therapy because she was like, well, hormones cause cancer. I would never do that. Um, and she very, very resistant to that because this information was out there. So hopefully, um, again, I know I'm preaching the choir if you're watching this, but it can be something that you share with other people. That is a very effective, uh, communication of the idea that hormones are good for you. And I want to walk us back through what went on with the women's health initiative and why it's completely wrong.

3:15 That's what we're going to talk about today. I've got all my slides on it. Uh, probably again, going be a longer video. Um, uh, so hang in there and I know it's not, you know, the best peptide for fat loss site video, um, but I think this will be really good one that you'll at least for your own knowledge, want to be able to, have for yourself as you age and then also share with friends, family members, and loved ones about hormone therapy because really, you know, the whole reason we do this is not to look jacked or look good for social media and that stuff is to feel good and live a life of purpose, fulfillment and love to other people.

3:46 So as always links down in the description, if you want to download the peptide cheat sheet, any of that good stuff, is down there. And thank you guys for tuning in and let's strap up. I'm going to share my screen and we're going get into the women's health initiative today. All right, I am Hunter Williams, and today we're going over the WHI study and why it matters now, all these 20 or 30 years later. So let's take some background information on the WHO. It was initially a large scale government funded study launched in 1991 by the National Institutes of Health, NIH, those who love us so much.

4:20 The reason was to investigate major causes of morbidity and mortality in post-menopausal women. So it remains one of the most ambitious and expensive research projects to date on women's health that was ever conducted. And there were over 160,000 women aged 50 to 79 across the United States who are enrolled in this study. Um, and it aimed to assess how various health interventions such as HRT, dietary changes, calcium and vitamin D supplementation affected the risk of heart disease, cancer, an osteoporosis.

4:51 So at the time hormone therapy was widely prescribed to postmenopausal women to manage symptoms like hot flashes, bone loss and mood swings, and was also believed to offer cardiovascular protection based on early observational studies. So the WHO sought to test this idea in a randomized controlled trial considered the gold standard of scientific research. More or less, I guess, right? So that's kind of the background. Now let's look at what went on, like what were we examining here? So a lot of this conversation today is going to be based around estrogen and progesterone, but I do have some information around testosterone.

5:24 I think testosterone is actually the frontline defense of what we would go to. But again, I'm looking at the WHO, looking what they did because testosterone wasn't really involved here. So we're going be looking in what it was. There was two major trials. The first one was estrogen plus projestin trial. for women with an intact uterus. So participants took a combination of conjugated equine, that means horse, conjugating equines estrogens at 0.625 milligrams per day and Madroxyprogesterone acetate,

5:54 otherwise known as MPA, at 2.5 milligrams a day, So in this study, there was many more people taking this at the time, but in the study there were 16,608 women enrolled and it was stopped prematurely in 2002 after about five years due to findings of increased risk of breast cancer, stroke, heart disease and blood clots. The second cohort was the estrogen only trial for women who had undergone a hysterectomy. Participants took the conjugated equine estrogens alone at 0.625 milligrams a day.

6:25 This was called Primrin. 10,739 women were enrolled in this one and it continued longer but was stopped in 2004 due to an observed increased risk of stroke, though no increase in breast cancer was found. So, okay, that's a context of what was going on here when we were measuring and that is what they were taking. Here's what was reported and found in 2002. So when the first results from the estrogen and progestin trial were published in 2000, they made headline news. Study found that compared to the placebo group, women taking hormone therapy had the following, 26% increased risk of invasive breast cancer,

7:02 relative risk, not absolute risk. 29% increase risk heart disease, relatively risk 41% percent increased of stroke, double the risk of blood clots, deep vein thrombosis and pulmonary embolism, primarily 37% lower risk for colorectal cancer. Okay, I guess I'm not that bad. And then a 33% reduction in hip fractures. So even with the colerectial cancer and hip fracture, holy crap, those numbers scare me, right? So these results led to a massive drop in hormone replacement therapy prescriptions.

7:33 Within a few years of this information coming out in 2002, hormone for replacement prescriptions were reduced by 80% and there was a shift in medical guidelines advising aging routine or excuse me, advising against routine hormone therapy for aging women and menopause. So millions of women stopped taking hormones and many doctors became reluctant to prescribe them fearing liability. That's what happened. We gave women horse urine, estrogen and progestin, which is synthetic, and then had these results, what we're going to talk about.

8:06 We're not really the results anyway. And then boom, within a couple of years, 80% of hormone therapy gone overnight. Then I would argue that was kind of a precursor to humanity going downhill from there, but we'll see. Let's talk. I don't want to be Debbie down. So let's look at fact versus fiction. The WHI tested a very specific HRT regimen. This was the conjugated equine estrogen delivered via an oral administration plus a synthetic progestin, which was a madroxyprogesterone acetate.

8:38 So this was one size all fits approach and it is obviously not reflect what we were even talking about when we're talking bioidentical hormone replacement. So, hormone therapy, especially the methods, can have very, very different results. So observational studies indicate HRT using bioidentical hormones like 17 beta estradiol patches coupled with natural micronized progesterone appears to carry lower risk of blood clots, heart disease, and even breast cancer than the conjugated equine estrogens and the medroxyprogesteron-acetate combo used

9:11 in the WHI. Continuous daily MPA, which is the progesterone used in the WHI use, may have negated estrogen's cardiovascular benefits, to which there are many, and slightly increased breast cancer risk, whereas micronized progeserrone or certain safer projescins does not have the same risk profile. I would just stick to the micronize progesterone. Likewise, giving estrogen through the skin, transterminal patch or gel or injection avoids the liver metabolism that raises clotting factors that they were increasing when they're taking oral progesterone.

9:42 And as a result, transterminal estrogen has a much lower risk of stroke and deep vein thrombosis than oral estrogen pills. So in short, the WHO's findings only definitively apply to the specific regimen tested, which was again, conjugated equine estrogens from horse urine and MPA, which is a synthetic progestin in an order of core hold and cannot be generalized to all forms of hormone therapy. However, if it bleeds, it leads. And once it's out there, and then people have preconceived notions around it. So what happened?

10:12 With the early trial stop, another little discussed issue is that most participants did not stick with therapy for long. So the WHI HRT trials had high dropout rates. By the end, over 70% of women had stopped taking their study medication. I wonder why, because they're not taking the thing that they should have been taking in the first place. But again, we'll go into that later. Many in HR group quit early due to adverse side effects like bleeding or breast tenderness or concern over emerging risk. And the placebo group had a high discontinuation as well. The poor adherence and the premature halting of the trial after around five years meant researchers were often comparing women who had already stopped

10:46 HRT to those who would never even taken it, which obviously throws off the risk benefit picture. It also meant that the potential long-term effects like cancer or dementia outcomes or decades really weren't fully assessed. and the trials really stopped magnifying some of the early hazard signals like clotting vents that occur soon after starting therapy, but didn't allow observation of whether benefits like the reduction in heart disease or mortality might emerge later because it was such a short time. Now let's look at some the misinformation and media hype. I think in all of this, the biggest flaw was not the trial itself, but in how the results were communicated.

11:19 So the initial WHR report emphasized relative risk increases, 26% higher breast cancer risk. For instance, you hear that you're like, holy crap, without clearly highlighting that the absolute risk for an individual was small, i.e. 0.08 higher percent higher per year. It really wasn't 26%. It was 08 higher percentage higher because it was a relative At the same time, positive findings for HRT such as fewer fractures and less colon cancer were downplayed. The media, as they often do, sees on the scary headlines and the nuance that these findings applied to an older population on specific drug regimen that

11:55 was not bioidentical hormones was lost. And as one letter noted, failing to present absolute risk makes it difficult for anyone to assess the meaning of the results. And the result of this was that millions of women overnight, 80%, stopped hormone therapy, and then from there on out just had the idea in their brain that hormones are dangerous and they're going to cause cancer. In reality, there was a whole misunderstanding on all this of what was being done and what actually led to the Let's look at correcting the record.

12:26 So what does modern research show? So in the year since the WHI, a tremendous amount of research and reanalysis has painted a far more nuanced and good for us reassuring picture of hormone therapy. Experts now emphasize one individualized approaches and the risks and benefits of hormones depend on which hormone and which patient started at what time. and how it's administered, which is very important. And when used under the right circumstances, hormone therapy is not only safe for most women, it can provide very significant health advantages to their

12:58 physiology and their psychology. So here are some key findings. One, age matters. When we look at the timing, It's now well established that women in their 50s or within 10 years of menopause onset have a very different risk profile on HRT than women who start in the 60s and 70s. Now, why does that matter? Because if a woman is starting in her 60 or 70, she's likely already been through menipause for several, if not a lot of years. So say they're starting in their seventies, they've already been through menopause. So they'd had maybe 10, 15 or 20 years where they had no hormones in the body.

13:31 If you look at what is going on to someone that's never had hormones, their body for 20, then you give them hormones and then they get a heart attack and you blame the hormones. That's not really accurate. So the risk profile is very different for someone who has been devoid of hormones in their body for 20 years. You know, it's kind of like looking at a dead animal on the side of the road and saying that the vultures or the buzzards killed it. It got killed because it was hit by a car. The buzzard is just there because. And blaming the hormones and a woman that started when she was 70. and then dies three years later of dementia, blaming the hormones is not really accurate

14:04 because she's already maybe had 20 years in her body where she was devoid of hormones that had caused all the damage to begin with. So a sub analysis of the WHO itself showed no increase in cardiovascular disease in women who began HRT within 10 years of menopause. In fact, many observational studies and meta-analyses suggest that starting estrogen around age 50 may reduce coronary heart disease risk and even reduce overall mortality. Another men analysis pulling 30 trials found hormone therapy in women under 60 was associated with a 39% reduction in all-cause mortality with no mortality

14:39 benefit in woman over 60. Similarly, the long-term follow-up of the WHO reported that women who were 50 to 59 years old at initiation had a lower risk of death on HRT, a 31% percent reduction all cause mortality. versus placebo where no survival difference with semen in women who started in their sixties. So again, if they're starting later, it's not really going to matter because they've already had like a substantial period of their life to which they had no hormones to, which, they were creating a lot of damage in the body.

15:10 So in simple terms, for a healthy woman in early menopause, being on estrogen therapy itself is at least safe as not being in it. It may help live longer and healthier. So at the very least, we know that you are as good as you without it, you're obviously going to be better, but at very there is no downside when you look at all these meta-analyses. The timing phenomenon is often called the critical window or timing hypothesis of HRT and explains why the WHO with its own cohort found harm while younger women tend to experience benefit. Now, let's look at the modern guidelines and consensus today.

15:40 So leading medical organizations have updated their position to reflect this improved understanding. The North American Menopause Society, the Indian Society and the International Menopath Society all agree that for most healthy, newly post-menopausal women, benefits of hormone therapy outweigh the risk when used for symptom management and prevention of osteoporosis. As the 2012 North American Menopause Society concluded, most healthy recently menopausal women can use hormone replacement therapy for relief of their symptoms,

16:13 and a 2015 follow-up of WHOI participants concurred that for most recently, menoppausa women, benefits of HRT do in fact outweigh the risk. So the current best practice is to tailor therapy to the individual using the lowest effective dose delivered by the safest route. Often transvermal, I would say injectable would be better, but at least not oral estrogen and starting early in menopause rather than a decade later. For the right patient at the the time hormones can be safe and effective therapy, both in the short term and long term. In fact, one expert noted that for an appropriate candidate, five to 10 years of HRT started at menopause is very reasonable and carries low risk.

16:48 So the blanket denial of H.R.T. to all women is no longer justified and there should no long be a stigma around it. Instead, the decision should consider a woman's personal risk factors as always and the type of hormones used should be optimized for safety. And what I'm going to talk about too is when we're looking at this, we are just looking estrogen. But testosterone is going be even that much more important. to a woman pre-peri or post-menopausal. But first look at estrogen causing cancer. So no, estrogen does not always cause cancer, the WHI did find a slight increase in breast cancer diagnoses after around five years of combined estrogen

17:25 progestin therapy. However, let's put that into context. So the absolute increase was on the order of one extra breast cancer per 1,000 HRT users per year. That's literally 0.01%. Moreover, estrogen alone without projestin did not increase breastcancer in WHO. In fact, women on estrogen only had a lower incidence of breastcancers than those on placebo itself. Huh, so why would women using estrogen have a lower risk of breast cancer than women who do not have estrogen? Maybe because estrogen is cardio protective, it's neuro protective and is protective against things that we may be susceptible to.

18:01 So estrogen alone is only given to women, who had a hysterectomy since adding progesterone is necessary to protect the uterus if it is present. Follow-up studies have also shown no rise in breast-cancer mortality due to HRT. Notably, among WHI participants, breast cancer mortality was not higher in the HRT group, and in an estrogen-only group it was actually significantly lower than the placebo group over 18 years. As one menopause specialist put it, yes, HRP might slightly increase the chance of being diagnosed with breast-cancer, but does not increase chance for dying for breast.

18:32 The cancers that did occur in HRT users tend to be detected early and were highly treatable. And to put this in perspective, the breast cancer risk from five years of combined HRRT is lower than the risk for being overweight or drinking a couple of glasses of wine each night. So you actually have much more, much, higher risk of breast every night or every other night, or being fat than you do from HRT. Go figure. Such lifestyle factors confer greater risk, yet many women fear HRRT more than they fear obesity or alcohol.

19:02 And obviously this is a gross misunderstanding. Avoiding HRD at menopause just for breast cancer is definitely not warranted, especially if they're good candidates otherwise. So I would throw that out in the water. So cardiovascular outcomes with hormones depend on age of route administration. So in younger women, estrogen has beneficial effects on cholesterol, blood vessels, and arterial health. And a lot of that has to go with the endothelial lining. The WHO and other studies confirm that HRT substantially reduces osteoporosis related fractures because estrogen helps with bone mineral density,

19:38 and some data suggests it also reduces the risk of type 2 diabetes. So on the other hand, oral estrogen, especially in older women, can increase the risks of blood clots and stroke, which is I recommend creams or injections. And the consensus today is that if a woman starts HRT in her 50s and has no underlying cardiovascular disease, it will not increase her heart attack risk and it may slow the progression of heart disease. So in fact, long-term HRT users starting at menopause have shown less coronary calcification and plaque buildup in some studies, which I firmly believe has to do with estrogen itself.

20:09 A Harvard-led follow-up of WHOI concluded that 18 years later, there was no difference in all cause or cardiac mortality between HRTs users and placebo, Which reassures us that HRRT isn't shortening women's lives or causing heart damage. Among women under 60, some analyses even showed a trend toward a lower heart disease rates and mortality with HRT. And then the elevated stroke and clot risk that scared everyone in WHI is very age dependent, route dependent. It's for a healthy 50 something, the absolute risk of a clot on oral HRRT is still quite low, even through oral administration and comparable to the clot,

20:44 risk a pregnancy or birth control pills, which obviously millions of people take even in their teens. So hormone therapy does not inherently clog arteries or cause heart attacks. Um, it's actually cardio protective. And then the timing and form of therapy are key and women with significant risk factors like uncontrolled hypertension, previous clots of smoking need careful consideration and they should not be doing those things to begin with. Now, let's go in the positive direction. So we kind of dispelled some of those myths around it, but let us look at the health benefits of HRT for aging and fitness.

21:17 The first one is going to be muscle mass and strength. the amount of muscle we have on our body, to a point, is the leading indicator of our longevity and health as we age. Aging and menopause are associated with sarcopenia, which is a loss of muscle mass and function. And estrogen in women has a significant influence on muscle physiology. So skeletal muscle cells have estrogen receptors, and estradiol helps stimulate muscle stem cells or satellite cells to maintain and grow muscle fibers. When estrogen levels fall, women experience more fat accumulation and difficulty building or maintaining muscle, even with exercise.

21:51 This is why women, as they age, they feel like they're dieting harder and training harder but they're getting fatter and they are losing muscle. And it makes no sense, right? Because it's like, how can I be doing these things? Cause there's no gas in the tank. There's not hormone. So, uh, hormone therapy obviously can counteract these changes. The research indicates that menopause related gains of fat and loss and lean muscle can be reversed by estradiol therapy. In one study, women who started HRT and early postmenopausal had greater muscle cell regeneration and improved muscle strength and mobility compared to

22:24 those who've started later or not at all. And this aligns with the experiences of many menopausal athletes. Getting on HRT often helps them regain their stamina, improve exercise recovery, and increase lean body mass. And again, I know this is preaching to the choir, but I want this to serve as an example of what is possible and why women don't have to suffer. Now, while estrogen, which is what we've been talking about up to a lot lately, is the main hormone for women. For muscle maintenance, testosterone is going to play a very crucial role.

22:55 So women produce small amounts of testosterone naturally, and it contributes to muscle and bone strength. And we oftentimes will have to replace this postmenopause as well. In post menopausal, women with low libido or injury adding a low dose of Testosterone to their HRT has been shown to improve physical vitality and more importantly, sexual function. Comprehensive meta analysis of testosteron therapy in women found significant gains in sexual desire, go figure, arousal pleasure and satisfaction along with modest improvements and lean mass reported in some trials.

23:25 Now, here's the caveat. There were no serious adverse effects aside from mild acne or increased hair in a few patients. Well, if I have to have a good little bit of acne to add my life restored, so be it. And, you know, increased here, okay, it is what it, but again, we're doing a cost benefit here. Um, and now for men, the role of testosterone muscle is obviously more pronounced as men age testosterone declines, which contributes to sarcopenia and fat game. And TRT and hypogonadal men increases muscle mass strength and bone density while reducing fat.

23:57 not been born out in recent studies. In fact, no significant increase in prostate cancer has been seen with physiological testosterone therapy. And some data suggests it might even be protective in normalizing levels. However, most doctors will still not tell you that in short, optimal hormone levels help maintain muscle critical for metabolism strength and staying biologically young. So very, very crucial in that sense. Now let's look at bone density, because this is obviously one of the leading indicators of, um, when a woman is going to die is how fast these organs are

24:29 losing her bone density. And this is where estrogen is very important. Perhaps the greatest benefit we get from hormone therapy is bone health. So estrogen as a powerful anti-resorptive agent, which means that it slows the breakdown of bone that accelerates after menopause. Women can lose 10% of their bone mass in the first five years of menopus, greatly increased osteoporosis and then fractures from falling. Hormone therapy can almost completely prevent this loss. So WHO demonstrated a 33% reduction in hip fractures even in the wrong use case of these hormones.

25:01 And so a recent combined analysis of the WHO hormone trials confirm that menopausal hormone therapy significantly reduces fracture risk in postmenopause women. This holds true regardless of individuals baseline fracture, risk or age. So in other words, every subgroup saw a bone benefit to hormone therapy. So no other intervention, I don't care, vitamin D, calcium, no, other intuition aside from specific drugs has a similar positive impact on bone density across the board. The Royal Osteoporosis Society and other bodies did recognize HRT as a frontline option for osteoporesis prevention in recently menopausal women.

25:38 And then stronger bones means fewer fractures, which translate to maintaining mobility and independence with age. So for fitness enthusiasts or athletes, preserving bone mass is crucial for continuing to train and avoid injury. And it's worth noting that testosterone in men to a lesser extent in women also supports bone density. estrogen is one piece, but testosterone is as important to estrogen, probably almost more important for women than men, I would say, which is why men with low T often develop osteoporosis and can benefit from TRT as well. So again, TRTs or HRT keeps bones dense and resilient, helping prevent the devastating hip fractures that can shorten the lifespan for so many women.

26:18 And I'm sure like we know someone in our lives has been affected by that, you know, postmenopause. Now, this is where it gets a little interesting, because with cognitive function and brain health, people still do not realize how important estrogen is for our brain. So many women describe brain fog during perimenopause, memory lapses, trouble concentrating, word finding difficulties, and often these symptoms improve on estrogen therapy. Spoiler alert, I inject a microdose of estrogen alongside of my testosterone. And I would say that my brain health has never been better, or at least I think it has, which is that really what matters anyway,

26:51 is to think that your brain is better. Because if you think, it is, then it probably is. So estrogen has numerous effects on the brain. It promotes blood flow, helps neurons, use glucose, may reduce beta amyloid accumulation implicated in Alzheimer's disease. There's always been a debate about HRT's long-term influence on dementia. So initial WHI memory study results for women who started HRT in their mid-60s showed a higher incidence of dementia in those on estrogen or progestin, suggesting that starting HRTs very late might not help the brain and could be harmful for cognition.

27:23 However, emerging data hints that There's a potential cognitive benefit when HRT is used in the critical window around menopause. And then interestingly enough, the WHO 18 year followup found that women who took estrogen only therapy had a 26% lower risk of death due to Alzheimer's and other dementias compared to placebo. My grandmother actually died of dementia. She never used hormones once and probably could have benefited or at least stem the tide of the dementia she ended up passing away from. This was not seen in the combined therapy group, possibly implicating the progestin or the older age of starting.

27:54 So while this funding is considered exploratory, it aligns with some observational studies in that 80s and 90s, which noted that lower Alzheimer's rates in women who used postmenopausal estrogen. So estrogen might protect the aging brain if given before irreversible damage occurs, but it's not effective if started very late. So the earlier the better, even if you're doing this pre-menopause. Estrogen also helps with sleep and directly benefiting brain function with our sleep. And then hormone optimization is obviously an area that you should be looking into if you're worried about Alzheimer's dementia.

28:28 Ironically enough, I think that's what actually led my mom to be able to listen to me and understand some of this stuff. get on hormones because she saw what happened to her mother and started to understand what was going on because you had no hormones in her body. And that ended up being one of the main drivers of her dementia. So ongoing trials are exploring if HRT or testosterone therapy might delay cognitive decline. Definitely will come to find that if they do the studies right. At very least using HRRT to relieve menopausal sleep issues and depression will secondarily improved cognitive health.

28:59 And, you know, no one really talks about that, but let's talk about mood while we're on the topic of depression. So replenishing hormones can have a profound effect on mood and wellbeing. so estrogen influences serotonin and dopamine in the brain and progesterone interacts with GABA receptors, which provides the anxiolytic effect that we know that progeterones gives. It's common for women and menopause to experience depression or anxiety for the first time. in their lives. So a lot of them are like, where does this come from? I've never experienced this. Nowadays, it's very common for 20-year-old women to have anxiety.

29:30 That's actually probably more of the rule rather than the exception. HRT has been shown to alleviate menopausal depression and even augment antidepressants in some cases. In fact, guidelines note that antidespressant medications do not effectively treat menipausa low mood if the underlying issue is hormonal. Well, how many people's depression is hormone and we just don't realize it? Menopause or not? But by treating the root cause, HRT can improve mood stability, energy, and overall quality of life. There's also multiple studies have shown that users report better sleep, sexual function, and higher quality adjusted life years compared to those just

30:05 toughing it out. So one analysis found a substantial increase in quality-adjusted life-years in women who start HRT near menopause and deemed HRTs a highly cost-effective strategy for improving long-term quality of life. That's what no one talks about too. It's like, if you just use these medications, you end up not needing pretty much any of the other medications. But, you know, hormones help you feel like yourself again. Obviously I wrote a book about that for men called Testosterone the God Molecule, but biohackers often chase enhancements in mood and productivity. And for Menopausal women, restoring estrogen can be life-changing in this regard.

30:37 For men with andropause and low testosterone TRT often yields market improvements in motivation and confidence, reducing the risk of depression. So testosterone estrogen for both men and women is very important as we age. Let's look at metabolic health and disease prevention. because this is another thing that people, you know, they just think that they have to move more and eat less. And it's actually like, couldn't be further from the truth when we look at the hormones in the body. So optimized hormones have systemic benefits that can guard against chronic disease. Estrogen helps prevent the central weight gain around the belly and the hips that often appears after menopause by improving insulin sensitivity and modulating

31:14 fat distribution. The WHO noted a 21% reduction in new onset diabetes among women on combined HRT. So estrogen's effects on insulin and body fat likely contribute to this anti-diabetic effect. And so when we add testosterone, both women and men experience better metabolic function when levels are optimized. We'll have more muscle which burns glucose and less visible fat translate to lower risk of metabolic syndrome and diabetes and ultimately all sorts of chronic disease. Hormone therapy has also been associated with favorable changes in cholesterol.

31:46 No one talks about using hormones. They want to put you on a statin, right? So oral estrogen raises good HDL cholesterol and lowers LDL testosterone. Men can decrease HDl but improve insulin and fat mass. So again, I don't recommend the oral estrogens, but it has been shown to do that. And then another often overlooked benefit from the WHO data was a significant reduction in colorectal cancer. The estrogen progestin combo is associated 40% fewer colon cancers and has been confirmed by other studies. So again, I wouldn't recommend do those, but even those alone had a beneficial effect on that specific disease.

32:21 While HRT isn't prescribed specifically to prevent colon cancer, it's reassuring that it may lower risk for disease that is a major killer. There's also evidence to suggest that optimal hormone levels support immune function and endothelial function, like we talked about, which contributes to lower rates of inflammatory diseases and autoimmune diseases. Men and women with deficient sex hormones often have higher inflammatory markers and then correction via HRT and testosterone therapy can reduce those markers. So when we keep hormones at youthful levels, it's going to help the body maintain healthier body composition, metabolism,

32:54 and lower the risk profile from these inflammatory or inflammation diseases like diabetes, colon cancer, heart disease. It's not everything, but it is a lot of it. Now, let's look at sexual function. Obviously, this is one of those quality of life things. We obviously have to look at libido and sexual health, which are important for quality of life factors. So menopause often brings a precipitous drop in sexual desire, arousal, and comfort due to vaginal dryness and is oftentimes the result of a lot of these later stage divorces after people have been married for 20 or 30 years.

33:27 So estrogen therapy can actually reverse vaginal atrophy and dryness, making intercourse comfortable again, and often does improve libido in women. It's funny enough, estrogen actually has more to do with libid and men than it does women, progesterone can also influence libida and mood, but the most significant game changer in this regard is going to be testosterone. So testosterone for women actually has more to do with their sex drive than it does for men in a lot of cases. So women naturally have a fraction of the testosterone men do, but those small amounts are very, very important. And clinical trials have shown that giving postmenopausal women a low dose of testosterone via creamer injection, which I would recommend an injection

34:03 lead to significant improvements in frequency of sexual activity, orgasm, satisfaction, and desire. Women on testosterone reported less sexual distress and more satisfying sexual events without serious side effects. And based on this, we've seen several medical societies endorse the use of testosterone therapy in women with hypoactive sexual desire disorder after menopause, to which I would say you pretty much are going to experience at menoppause if you don't have testosterone as a woman. For men, adequate testosterone is obviously crucial for libido, and TRT can help restore a man's sex drive and performance if he is androgen deficient,

34:38 which he likely is. as he gets older in today's world. And so the net effect for both sexes, the optimizing hormones will oftentimes rekindle their intimacy and is shown a cascade of emotional and physical benefits like stress relief, better sleep, strong relationships, which obviously are not just important for themselves, but are also important Just looking at, you know, close out with the slides, the cost of misinformation. So the WHO panic has led a generation of clinicians and patients being unduly wary of hormone therapy, sort of announcing the consequences of misinformation

35:14 in the form of declining health metrics for aging individuals. less healthier than ever now. Yes, we have people live older than they did to one extent, but you know, you have access to all these things now and so much of the medicine that we just could be eliminated if we had hormone therapy. So, beyond the symptomatic toll, the drop in HRT use has likely contributed to higher rates of osteoporosis and fractures in the last 20 years and possibly

35:44 more cases of heart disease in past few decades. So one analysis estimated that tens of thousands of extra osteoperotic fractured occurred in years after women in masks quit HRTs. Go figure. Likewise, women who could have been protected by estrogen's cardiovascular benefits during the critical first decade postmenopause went without it, potentially increasing their cardiac risk. And many have suffered in silence, not realizing how effective hormone therapy can be. A 2015 study found that 50% of women still believe HRT was very risky and increases cancer, reflecting the ongoing confusion.

36:17 So just as recently as 10 years ago, 50 percent of woman still believed that it's very risk and they're going to get cancer from using hormones. So this hormone phobia isn't just like when women men too have been victims of stigma around hormone therapy. testosterone therapy in men was wrongly tied to prostate cancer for years based on outdated 1940s data, leading many men with legitimate low testosterone to avoid treatment and even reducing testosterone, to treat prostate. And we now know there is no compelling evidence that TRT causes prostate and treating low T can improve men's muscle mass,

36:51 mood and cardiac risk factors. Some clinicians still remain overly cautious and some men fear steroids because hormones in general have been painted with a broad And I think they're just on steroids. So in both sexes, the hormone equals cancer meth has prevented people from optimizing their health span. Now, whether that or not is by design, I will leave that up to you to decide once this video is over. It's important to recognize that hormone therapy is not a cure-all or a choice to be made lightly. And for the vast majority of aging women, experiencing menopause and for many aging men with low testosterone symptoms, judicious use of hormone on therapy

37:21 can really be transformative. That has been in my life and thousands of other people that I've helped. And obviously misinformation and fear have been the biggest barriers to these benefits. So it's telling that in countries or clinics where HRT is embraced, women often look and feel healthier as they age, continuing to stay active in their 60s and 70s. Dr. Louise Newson, who is a renowned menopause specialist, remarked, the negative publicity from the flawed WHOI study led many women needlessly suffering menopod symptoms and increasing the risk of osteoporosis and heart disease by avoiding HRTs. And ultimately that is the crux of this argument is that without hormones, men are worse off, but women are absolutely worse and there's really two options

38:01 after menopause and that's whether you're going to suffer or whether your going replace your hormones. So that it it for the slides. And that is my overview analysis of the WHI and what went on there. So hopefully by now through positive reinforcement, you have a much clearer picture of where this idea of hormones cause cancer and hormones are bad for me came from. I think to anyone with an ounce of discernment and an out of critical thinking, you would realize that when hormones decline in the body, we now have the ability to safely, effectively, and in a proper manner, replace them.

38:38 To restore our health, but just to ultimately restore livelihood, I thin the health stuff is great. Obviously the heart disease prevention, the osteoporosis prevention and the dementia prevention. All those things are great, It really comes down to living a higher quality of life. These physical bodies are at one time or another going to expire. None of us escape that. Being in third density, that's something that we're all going experience. But I know for me, I want to maximize the time I'm here. And through whatever it is and whatever means I have access to, and I think for so many people, so millions of people they needlessly suffer in silence

39:16 because they do not have hormones in their body, whether it's men, Whether you're young, whether you are old. So many people have depression, anxiety, lack of zest for life because they don't have hormones in their body. And in this case, there was a clearly concerted effort to diminish and basically create confusion around hormones to scare people away from doing it. So again, I don' know how wide of an audience this video will reach. I hope it goes far and wide.

39:46 Again, if you're in my audience, you probably already understand all this stuff. But hopefully this will be a video that kind of teaches and shows people how we got to where we're at and what went wrong. And I think if we look at all the stress and anxiety on the planet right now, so much of that could be alleviated at an individual level, but also at a system-wide, mass, global level in terms of our institutions and things that people just had access. The hormone replacement's there with me. That's it for this one. I know a little bit longer than I usually go.

40:18 No, it wasn't about peptides, but hopefully this was educating, informative, and also maybe a lot of entertaining at the same time. So if you guys can leave me feedback, let me know if this is something that you'd like to see. There's probably much more stuff. of like prostate cancer and heart disease in men around testosterone therapy. So maybe that would be the part two to this because there's so much, there is an overwhelming abundance of evidence to also show that a lot of that fear

40:48 around testosterone therapy in a man was completely unjustified. Yeah, let me know your feedback on this one. I do look at all that and it does help inform my content. I appreciate you guys. Don't forget, you know, check out Peptide Cheat Sheet. Check out Fully Optimized Health, the best private membership community on the planet. And, um, I just close out every video. Thank you, guys, so much. I truly, truly love what I do and to be able to bring this to you is a joy, a privilege. It's an honor. So thank you. You know whatever shape or form of support you give, even if it's just watching the videos all the way to the people buying from BioLongevity Labs and

41:25 helping support that mission. And I mean that from the bottom of my heart. So I appreciate you, love you and I'll talk to you in the next one. Peace.