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Dive headfirst into the complex world of hormone replacement therapy in this part 2 episode with Kate Boyce, of Endo Girls Blog as we strip away the one-size-fits-all approach to HRT for conditions like endometriosis and adenomyosis. This discussion isn’t about blanket solutions; instead, it’s a deep exploration into the personalized nature of treatment, from the role of progesterone to the surprising impact of testosterone. We’re challenging the status quo and simplifying the process to focus on what really matters – your unique health journey.
Navigating the minefield of hormone balance and the risks of HRT can be daunting, but we’re here to guide you through it with the latest insights and research. We’ll tackle the body’s remarkable but complex survival mechanisms and the importance of symptom-based treatment adjustments. And let’s not shy away from the controversies and risks – knowledge is power, and we’re empowering you to partner with healthcare providers who truly understand your needs.
We round up the discussion by addressing the broader health implications of HRT, such as the potential link to dementia prevention, and dissect the ongoing debates within the medical community. By sharing personal anecdotes and critically analyzing the research, we’re cutting through the noise to bring you evidence-based, accessible information. This episode is more than just a discussion; it’s a call to action for informed consent, education, and advocacy in the evolving field of women’s health. Join us for an episode that is as thought-provoking as it is informative, with the goal of bringing you to the forefront of your health decisions.
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Hormone Replacement Therapy for Endometriosis
Speaker 1
0:03
Welcome
to
Indobattery
,
where
I
share
about
my
endometriosis
and
adenomyosis
story
and
continue
learning
along
the
way
.
This
podcast
is
not
a
substitute
for
professional
medical
advice
or
diagnosis
,
but
a
place
to
equip
you
with
information
and
a
sense
of
community
,
ensuring
you
never
have
to
face
this
journey
alone
.
Join
me
as
I
navigate
the
ups
and
downs
and
share
stories
of
strength
,
resilience
and
hope
.
While
navigating
the
world
of
endometriosis
and
adenomyosis
,
from
personal
experience
to
expert
insights
,
I'm
your
host
,
elana
,
and
this
is
Indobattery
charging
our
lives
when
endometriosis
drains
us
.
Welcome
back
to
Indobattery
.
Grab
your
cup
of
coffee
or
your
cup
of
tea
and
join
Kate
Poisoni
from
Indogirl
blog
at
the
table
as
we
continue
our
discussion
on
hormones
.
This
is
where
we
left
off
and
where
we're
going
.
The
other
seed
of
this
is
that
the
progesterone
.
We've
talked
about
this
.
You're
not
a
progesterone
person
,
but
then
there's
other
people
in
the
progesterone
camp
who
find
significant
benefits
for
them
and
how
they
feel
.
What
are
your
thoughts
on
that
?
Like
with
any
of
them
.
Speaker 2
1:14
I'd
see
that
as
well
.
People
who
are
like
well
,
I
feel
so
much
better
on
the
progesterone
.
But
I
will
say
that
typically
changes
once
they
get
their
testosterone
levels
right
.
From
a
non-clinical
perspective
here
,
just
as
a
patient
advocate
perspective
and
working
through
that
typically
it's
like
oh
,
the
progesterone
was
good
enough
to
help
me
sleep
,
or
a
good
enough
to
help
with
anxiety
,
but
oh
,
magically
that
anxiety
went
away
when
my
testosterone
levels
got
better
.
Oh
,
everything
else
calmed
down
when
my
testosterone
levels
got
better
.
This
isn't
really
that
uncommon
because
you'll
see
that
a
lot
of
providers
,
once
you've
had
a
hysterectomy
,
they
won't
even
prescribe
progesterone
with
hormone
replacement
therapy
.
It
seems
to
be
only
pushed
by
.
The
wellness
space
or
the
holistic
places
are
the
only
ones
that
ever
seem
to
be
pushing
the
progesterone
.
That's
because
way
back
in
the
day
I
don't
know
if
you
remember
this
book
it
was
like
what
your
Doctor
Won't
Tell
you
About
Minipause
.
I
don't
know
if
you
remember
that
.
Speaker 2
2:12
My
mom
had
bought
that
in
the
90s
it
was
this
provider
that
pushed
progesterone
cream
.
Everybody
in
the
wellness
space
just
clung
to
that
.
It
has
stuck
as
this
.
Progesterone's
like
this
woman
hormone
that's
needed
for
rest
and
calmness
and
sleep
,
whatever
,
like
estrogen
.
We
don't
continue
to
make
it
forever
.
Speaker 2
2:37
Progesterone's
genuine
.
Its
primary
purpose
really
does
have
to
do
with
pregnancy
.
It's
one
that
,
like
,
I
don't
want
to
say
it
doesn't
have
a
role
,
but
it's
the
one
that
I
see
people
ever
need
the
least
.
But
it's
the
most
accessible
because
it's
pushed
the
most
,
especially
in
the
wellness
space
and
it's
so
easy
to
access
.
It
seems
to
be
the
most
popular
,
and
then
people
will
see
maybe
a
couple
benefits
and
be
like
,
oh
,
that's
it
,
that
was
good
,
that's
what
I
needed
and
that's
fine
if
that's
where
they
want
to
stay
.
Speaker 2
3:08
But
I
also
let
people
know
that
,
since
there
are
side
effects
with
progesterone
that
seem
to
be
pretty
intense
for
a
lot
of
people
the
inability
to
lose
some
way
,
a
lot
of
water
retention
,
too
sleepy
it
just
for
me
too
,
like
I
cannot
stay
on
progesterone
and
it
actually
does
interact
with
our
androgen
receptors
and
so
a
lot
of
the
time
,
once
you
know
someone
gets
their
hormones
figured
out
with
estrogen
and
testosterone
,
they'll
come
off
the
progesterone
,
they're
like
okay
,
I
didn't
even
need
that
.
That's
just
kind
of
how
I
feel
with
it
,
and
especially
working
with
providers
who
don't
even
utilize
it
if
there's
already
been
a
hysterectomy
.
Of
course
,
if
someone
has
a
uterus
,
they
absolutely
have
to
be
on
it
if
they're
on
estrogen
.
Speaker 2
3:46
There's
no
question
,
right
the
,
you
have
to
induce
a
period
,
you
have
to
shed
the
lining
of
the
uterus
,
otherwise
you
risk
endometrial
hyperplasia
,
which
can
then
lead
to
,
you
know
,
endometrial
cancer
.
So
I
definitely
get
scared
when
I
see
people
who
are
like
well
,
I'm
on
estrogen
,
but
I
won't
take
progesterone
and
I
haven't
had
a
hysterectomy
,
oh
God
please
just
go
to
any
doctor
Any
doctor
.
Speaker 1
4:06
Go
to
the
ER
now
.
Speaker 2
4:09
Please
do
not
do
that
.
And
that
part
is
scary
.
But
when
it
comes
to
you
know
you've
already
had
the
hysterectomy
it's
like
it
gets
once
again
.
It's
nuanced
If
somebody
wants
to
be
on
it
and
it's
not
expensive
whatever
.
But
if
someone's
going
to
some
pricey
wellness
coach
that's
putting
them
on
a
progesterone
cream
,
that's
when
I
,
like
raise
the
eyebrow
,
you
know
,
as
their
advocate
,
cause
I'm
like
,
okay
,
well
,
let's
take
a
better
look
at
this
,
let's
take
a
step
back
,
right
.
That
is
just
often
the
case
that
I
see
with
the
testosterone
.
Speaker 2
4:35
Once
the
testosterone
gets
leveled
out
,
right
with
estrogen
,
I
see
a
lot
of
these
patients
I
work
with
being
like
,
okay
,
I'm
coming
off
the
progesterone
.
I
feel
like
the
consensus
with
us
is
let's
be
on
the
least
amount
of
stuff
possible
,
right
.
Same
with
supplements
right
.
I
just
was
like
I
want
off
so
tired
.
Same
.
Like
what
can
I
want
to
be
on
the
least
amount
of
everything
?
So
okay
.
Speaker 2
4:55
Fortunately
,
I
get
80
to
100
milligrams
,
depending
on
levels
of
testosterone
pellet
every
12
to
13
weeks
and
that's
like
a
set
it
and
forget
it
,
which
is
great
,
you
know
,
yeah
.
And
then
everything
else
.
I
try
to
just
keep
really
simple
,
because
once
I
got
that
level
right
,
I
was
able
to
get
rid
of
the
skin
care
stuff
right
for
my
burning
skin
care
,
the
hair
care
stuff
,
the
supplements
for
that
I'm
really
big
on
.
Let's
make
it
more
simple
rather
than
I
feel
like
a
lot
of
these
med
spas
or
scammy
places
or
wellness
coaches
.
They
just
overcomplicate
,
it's
like
they
just
throw
more
at
you
.
We
got
to
owe
you
this
.
We
got
to
fix
this
.
We
got
to
throw
it
at
this
and
this
and
this
.
Speaker 1
5:31
Right
,
and
I
do
think
there's
a
reason
why
you
don't
want
to
overdo
it
because
they're
still
reacting
in
your
body
.
They're
still
doing
something
,
otherwise
they
wouldn't
be
telling
you
to
take
something
,
so
the
reaction
is
still
very
much
there
.
So
I'm
a
person
that
is
,
I
don't
do
supplements
,
and
I
know
some
people
will
like
roll
their
eyes
at
me
,
oh
my
gosh
.
But
here's
the
thing
I
don't
have
good
kidneys
.
First
of
all
,
I
can't
process
all
that
extra
.
Speaker 1
5:53
You
know
and
I
think
that
we
have
to
take
that
in
consideration
how
is
our
body
processing
all
of
this
?
It's
not
a
harmless
supplement
.
When
you're
doing
that
,
it's
not
a
harmless
whatever
.
Do
it
with
intention
.
But
also
,
when
you
go
to
get
hormones
or
look
at
your
hormone
replacement
therapies
,
make
sure
that
you
provide
information
to
your
provider
that
you're
on
these
supplements
,
because
they
can
react
negatively
if
you
are
taking
something
that
maybe
would
react
to
that
,
even
skincare
products
can
.
Speaker 2
6:25
So
if
you're
not
,
maybe
you
bought
something
that
is
like
I
don't
know
.
I
know
people
will
buy
things
that
are
like
cellulite
reduction
creams
or
whatever
.
Right
,
so
even
something
that
simple
,
because
testosterone
relies
on
oil
to
get
into
the
bloodstream
through
the
skin
.
If
you're
putting
something
on
your
skin
that
could
be
creating
an
additional
barrier
,
you're
going
to
be
wasting
money
.
You're
not
getting
all
of
that
cream
Isn't
getting
absorbed
into
creating
testosterone
in
your
body
,
right
?
So
it's
just
so
many
small
variables
that
people
don't
consider
.
Speaker 2
6:56
They'll
be
like
well
,
this
isn't
working
,
or
I'm
having
this
reaction
,
and
I
meet
people
all
the
time
who
haven't
just
taken
a
step
back
and
looked
at
all
of
the
details
of
what
they're
taking
.
People
don't
get
their
supplements
.
They
dislike
the
consider
part
of
their
diet
rather
than
when
someone's
like
can
you
list
off
what
you're
taking
?
And
I
learned
the
hard
way
.
Zinc
actually
can
metabolize
testosterone
faster
and
I
was
taking
a
ton
of
zinc
Interesting
,
so
OK
,
well
,
let's
not
do
that
.
I
also
learned
that
zinc
can
lead
to
anemia
,
and
that's
another
thing
.
There's
just
so
many
facets
to
this
that
get
really
out
of
control
when
we
just
start
to
take
supplements
and
people
will
say
,
well
,
but
it
was
through
my
coach
,
it
was
through
my
naturopath
and
I'm
like
I
still
always
suggest
,
at
least
at
the
very
least
,
talk
with
a
pharmacist
,
because
they're
going
to
know
a
lot
more
.
Speaker 2
7:48
They'll
know
more
than
your
doctor
.
They'll
know
more
than
that
holistic
coach
.
If
you
get
prescribed
something
,
just
say
hey
,
because
they'll
ask
when
you
go
pick
up
a
drug
,
do
you
want
to
do
a
consult
with
a
pharmacist
?
You
could
say
yeah
and
be
like
I'm
taking
these
.
Do
you
know
of
any
interactions
or
resources
where
I
can
look
into
this
some
more
?
And
it's
really
important
because
a
lot
of
people
end
up
having
they'll
be
like
,
oh
,
I'm
having
this
new
symptom
,
or
they'll
think
it's
something
unrelated
,
and
it
really
just
boils
down
to
they
have
two
things
that
are
interacting
.
Speaker 1
8:16
Right
,
and
I
feel
like
that's
something
that
we
have
to
be
aware
of
all
the
time
.
When
any
medication
,
any
supplement
,
you
have
to
know
what
you're
putting
in
your
body
and
how
it's
going
to
respond
and
play
nice
with
other
things
that
you're
putting
in
your
body
.
And
there's
something
that
I
think
that
we
do
need
to
be
aware
of
as
well
.
So
,
because
I've
had
an
ophrectomy
bilaterally
,
which
means
both
ovaries
are
gone
,
I
cannot
produce
more
of
something
that
I'm
not
producing
at
all
.
So
I
know
a
lot
of
people
will
say
,
take
this
supplement
or
try
natural
yams
and
that's
going
to
increase
your
testosterone
.
I
don't
have
a
hormone
factory
,
I
don't
got
it
,
so
I
can't
produce
something
more
if
I
am
not
producing
it
.
Speaker 2
8:59
Right
,
you
have
to
have
those
building
blocks
,
and
there
is
some
to
be
said
,
for
there
are
tissues
throughout
the
body
that
have
the
capacity
for
synthesizing
the
hormones
,
but
they
typically
act
locally
or
they're
not
enough
to
raise
the
blood
levels
.
So
,
yes
,
testosterone
is
made
in
other
parts
of
the
body
.
Clearly
for
me
,
in
a
lot
of
us
we
still
need
to
supplement
with
it
.
Right
,
right
,
estrogen
can
be
made
in
a
lot
of
tissues
.
That
doesn't
mean
that
your
adipose
tissue
,
which
is
fat
,
is
going
to
be
able
to
make
enough
estrogen
to
make
your
hot
flashes
go
away
.
Right
,
because
with
fat
it's
funny
to
me
,
because
with
fat
mentality
it's
like
,
ok
,
well
,
just
get
fat
,
because
fat
makes
a
lot
of
estrogen
.
So
I
guess
a
natural
way
to
increase
your
estrogen
levels
is
to
get
really
,
really
fat
.
Speaker 2
9:45
Just
increase
that
adipose
tissue
and
yeah
it'll
be
great
.
Speaker 2
9:49
It'll
be
great
,
whatever
you
want
to
do
.
So
I
mean
,
I
just
think
that's
how
my
brain
gets
when
it
comes
to
this
stuff
.
I
look
at
the
biochemistry
of
it
,
and
that's
why
testosterone
is
really
interesting
in
that
way
,
because
it's
only
made
in
a
specific
part
of
the
ovary
and
it
has
a
completely
different
method
of
interacting
in
the
body
than
estrogen
does
.
Right
,
and
so
that's
another
thing
to
keep
in
mind
.
Right
,
it's
not
OK
.
Testosterone
and
estrogen
are
made
in
the
ovaries
.
Well
,
they
are
,
but
they're
made
in
different
cells
and
they're
made
in
different
ways
.
And
everyone
knows
I
feel
like
a
lot
of
people
know
testosterone
can
convert
into
estrogen
.
Speaker 2
10:24
Yes
,
and
so
that's
another
thing
,
people
are
like
oh
,
we
got
to
be
careful
because
your
estrogen
levels
arise
.
I
will
tell
you
that
in
the
four
years
we've
been
tracking
my
hormone
levels
as
long
as
my
dosing
is
right
with
my
pellet
I've
never
once
had
elevated
estrogen
levels
.
And
I
know
estrogen
fluctuates
significantly
so
it
can
be
really
hard
to
determine
what
is
even
a
normal
estrogen
level
.
But
we've
tracked
mine
so
closely
for
four
years
that
we
know
where
I'm
at
.
The
only
time
my
estrogen
is
ever
spiked
is
when
my
testosterone
plummets
.
Speaker 2
10:55
It's
like
,
oh
my
god
,
it's
like
my
ovary
is
over-correcting
.
It's
very
bizarre
.
And
then
my
ovary
hurts
.
When
my
testosterone
levels
are
higher
,
my
estrogen
levels
are
super
chill
and
my
ovary
never
hurts
and
it's
like
calm
down
.
But
those
reactions
do
happen
,
right
Like
there
is
a
constant
flow
with
how
the
body
is
making
hormones
and
it
can
do
backward
reactions
and
it
can
do
forward
reactions
.
And
we've
got
three
types
of
estrogen
right
,
when
you
take
hormone
replacement
therapy
,
you're
only
on
one
of
those
types
,
but
that's
OK
because
we
do
make
the
other
types
of
estrogen
as
well
.
Speaker 1
11:32
Interesting
.
See
,
these
are
things
that
we
need
to
talk
more
about
because
it's
not
Simple
,
but
I
think
the
more
we
understand
it
,
the
better
we
can
advocate
for
our
care
.
Speaker 2
11:46
Yes
,
and
I
even
speak
with
a
this
is
brilliant
woman
that
speaks
with
me
.
She's
a
molecular
biologist
PhD
.
Her
and
I
get
into
this
.
Her
and
I
both
go
through
literature
.
We're
like
,
okay
,
so
let's
look
at
this
type
of
estrogen
and
like
someone
will
be
like
,
well
,
I
don't
have
any
free
testosterone
or
total
testosterone
,
but
I'm
having
all
these
high
testosterone
symptoms
and
it's
like
,
well
,
there's
actually
a
pathway
where
a
progesterone
can
turn
into
something
called
DHT
,
which
is
stronger
than
testosterone
.
It's
just
like
the
biochemical
pathways
,
and
that's
my
education
is
in
biochemistry
,
right
,
so
I'm
always
looking
at
these
pathways
and
how
can
they
be
happening
?
Hormone Balancing and Risks in Therapy
Speaker 2
12:27
And
the
body
the
first
thing
we
learn
in
biochemistry
is
that
the
body
is
a
survival
machine
and
it
will
find
a
way
.
So
it
will
create
,
however
,
the
pathways
it
needs
to
create
to
get
to
what
it
wants
as
it's
in
goal
.
Sometimes
that
doesn't
mean
good
for
us
.
Sometimes
that
just
means
survival
for
the
body
.
So
you
get
into
these
situations
where
it's
like
,
okay
,
you're
not
having
enough
testosterone
,
but
it's
making
DHT
.
But
that's
not
good
because
that
causes
a
lot
of
those
like
the
PCOS
type
of
care
growth
and
whatnot
.
Speaker 2
12:56
So
and
I
think
that's
what
people
intend
when
they
say
hormone
balancing
.
I
think
that's
what
they
mean
,
because
they'll
say
we'll
have
one
camp
that's
like
you
gotta
balance
your
hormones
,
so
the
other
camp
that's
like
you
can't
balance
hormones
because
they're
always
fluctuating
.
But
I
think
the
middle
ground
is
hey
,
how
do
we
give
your
body
the
right
building
blocks
so
the
body
can
do
its
natural
balancing
act
?
We're
not
gonna
be
able
to
do
it
.
We're
not
gonna
be
able
to
tell
it
what
to
do
.
Necessarily
which
is
another
thing
I
laugh
about
when
people
are
like
let's
detox
your
estrogen
through
your
liver
and
it's
gotta
go
this
pathway
,
I'm
like
you
are
never
going
to
be
able
to
control
it
that
way
.
That
would
be
like
the
most
precise
medicine
that
we're
not
there
yet
with
.
Speaker 2
13:42
We
can
just
give
it
what
it
needs
to
hopefully
promote
it
to
go
the
right
way
.
And
so
that's
really
important
with
what's
happening
when
we're
giving
it
these
building
blocks
.
And
,
like
you
were
saying
,
if
you
don't
have
the
building
blocks
they're
not
gonna
happen
anyway
.
So
sometimes
you
just
gotta
get
it
,
however
you
can
,
and
then
go
from
there
.
Speaker 1
14:03
I
like
to
think
of
it
.
I
was
talking
to
a
friend
of
mine
the
other
day
about
this
with
you
know
,
balance
is
very
ambiguous
when
we're
talking
hormones
,
right
?
So
I
like
to
think
of
like
the
lines
of
like
the
different
hormones
in
between
a
bracket
.
Where
is
your
balance
?
Like
,
where
are
you
gonna
thrive
the
most
and
feel
the
best
?
If
one
is
way
over
here
and
the
other
is
over
here
,
you're
not
.
There's
no
middle
ground
.
You're
gonna
feel
awful
either
way
.
But
if
you
have
those
markers
of
what
is
your
balance
and
where
you
thrive
and
where
your
body
is
not
in
survival
mode
anymore
,
that's
your
balance
,
as
long
as
it's
not
swinging
one
direction
or
another
to
create
long-term
bad
effects
.
Speaker 2
14:49
It
should
be
long-term
and
that's
.
You
know
,
in
defense
of
a
lot
of
the
you
know
what
you
would
call
like
more
like
traditional
doctors
.
In
their
defense
,
they're
right
when
they
say
there's
just
no
good
way
to
know
.
Right
,
there
is
a
good
way
to
know
,
but
it
requires
a
lot
of
time
and
effort
.
For
me
,
with
the
amount
of
data
I
have
on
my
body
over
four
years
,
I
understand
like
that
is
a
massive
privilege
,
but
I
do
my
best
to
utilize
that
as
like
an
example
.
Right
,
right
Doctor
can
say
,
well
,
you'll
never
know
your
estrogen
levels
.
It
varies
too
much
.
You'll
never
know
this
and
I'm
gonna
know
that
we
just
can't
get
it
with
one
snapshot
.
They're
right
,
you
can't
.
Speaker 2
15:20
But
if
you
find
the
right
provider
and
I
always
think
one
of
the
green
flags
defining
a
good
provider
is
them
wanting
to
be
your
partner
and
you
know
,
not
just
rolling
over
every
time
you
say
,
well
,
I
want
this
,
but
then
you
know
having
a
collaboration
there
,
like
,
hey
,
I'm
really
curious
.
Do
you
think
we
can
test
this
right
now
,
which
my
provider's
always
done
for
me
,
cause
I've
been
,
like
you
know
,
I
feel
really
off
.
I'm
really
curious
to
know
where
am
I
at
like
right
now
.
It
also
helps
that
I
have
access
to
a
lab
that
will
give
me
my
results
within
like
12
hours
,
yeah
,
which
I
know
is
really
unheard
of
in
a
lot
of
places
and
so
sometimes
within
like
eight
.
So
I've
got
this
data
where
I
was
telling
you
,
like
I
can
see
,
you
know
we're
testing
.
Testosterone
plummets
down
,
estrogen
skyrockets
.
Well
,
why
would
that
happen
,
right
?
Everyone's
like
well
,
testosterone
makes
it
turns
into
estrogen
.
Speaker 2
16:03
It's
like
,
well
,
clearly
,
my
body
is
using
what
it
can
you
know
,
and
it's
I
don't
have
a
reserve
and
it's
just
turning
into
estrogen
,
whatever
,
but
it's
being
able
to
collect
that
data
,
to
find
out
where
you
feel
best
.
Bye
,
because
that
data
is
hard
to
collect
.
I
think
that
the
best
providers
and
clinicians
that
I've
met
are
typically
ones
that
say
we're
going
to
just
do
everything
based
on
how
you
feel
.
That
is
good
enough
,
honestly
,
because
someone
may
get
their
test
off
,
surrounded
in
a
way
that
I
think
is
inferior
,
but
then
they
get
lab
work
that
shows
good
and
their
symptoms
are
resolved
and
they
feel
amazing
.
That's
,
honestly
,
what
matters
.
At
the
end
of
the
day
,
the
good
providers
they
will
say
that
we
just
go
based
on
symptoms
,
we
adjust
dose
based
on
symptoms
.
Speaker 2
16:49
As
long
as
the
rest
of
your
health
comes
back
as
fine
,
go
in
for
your
physical
and
nothing
else
is
out
of
line
.
Your
lip
profile
is
good
and
everything's
healthy
.
A
doctor
may
know
a
couple
of
people
who've
provided
has
been
like
your
testosterone
is
too
high
.
It's
not
,
it's
literally
like
90
.
They're
like
well
,
that's
way
too
high
.
They're
like
but
this
I
feel
so
good
and
they're
not
having
side
effects
.
It's
like
why
are
they
enforcing
their
belief
Based
?
Speaker 1
17:14
on
no
data
right
,
there's
no
clinical
data
.
Speaker 2
17:17
It's
based
on
just
this
idea
that
they've
stuck
to
.
It's
frustrating
Really
.
It's
like
we
have
to
find
a
provider
that
is
just
willing
to
work
in
a
collaborative
nature
and
willing
to
go
based
on
how
we
feel
.
Speaker 1
17:33
What
are
some
of
the
things
that
we
should
be
aware
of
?
In
doing
hormone
replacement
therapies
?
Are
there
risks
involved
that
we
need
to
be
looking
at
now
,
but
even
long
term
.
Speaker 2
17:43
I
think
when
it
comes
to
the
long
term
data
,
what
we
have
currently
is
based
on
that
women's
health
initiative
,
which
is
incredibly
flawed
.
Everyone
knows
it's
flawed
.
At
least
now
it's
publicly
known
and
everyone's
like
okay
,
ignore
it
,
because
it
was
based
on
conjugated
estrogens
that
we
don't
even
use
anymore
.
Well
,
I
guess
some
people
out
there
may
still
use
permarin
,
but
the
long
term
data
is
slowly
coming
out
better
on
that
.
I
think
it's
safe
to
say
that
going
off
clinical
guidelines
for
estrogen
use
is
pretty
solid
at
this
point
.
You
can
go
to
the
North
American
Menopause
Society
and
see
a
consensus
statement
from
them
.
I
would
say
,
for
the
most
part
,
staying
away
from
anything
too
fringe
I
say
that
a
lot
but
anything
that's
too
radical
.
Maybe
try
to
find
the
middle
ground
on
that
,
because
I
know
again
there's
a
lot
of
fear
mongering
with
estrogen
replacement
therapy
.
But
let's
look
at
the
other
side
of
that
coin
as
well
the
dangers
of
losing
estrogen
.
I
think
it
should
resound
even
more
in
the
endometriosis
community
.
Just
because
we
know
what
happens
when
we're
put
on
or
ELISA
or
Lupron
,
we
know
firsthand
what
happens
when
we
deplete
the
estrogen
.
I
think
we
know
what
happens
long
term
.
I
think
that
when
it
comes
to
estrogen
.
It's
a
lot
easier
now
to
find
that
data
.
When
it
comes
to
what
to
look
for
with
testosterone
,
that's
a
lot
harder
,
right
.
Speaker 2
19:08
I
feel
like
the
best
way
to
navigate
that
is
,
honestly
,
just
if
you're
accessing
a
pellet
,
make
sure
that
it's
not
super
expensive
.
I
will
say
I
think
mine
breaks
down
to
$25
a
week
.
That's
so
bad
?
No
,
it's
not
.
That
includes
the
visit
.
The
doctor
is
not
covered
in
network
,
so
my
office
visit
is
$60
.
Then
the
pellet
itself
may
be
like
$180
,
$200
.
It
can
go
up
depending
on
how
much
more
milligram
I
get
put
in
.
Then
you
can
extend
it
between
12
and
14
weeks
.
But
when
I've
met
people
who
will
go
and
they'll
say
like
$500
for
a
console
and
then
$500
every
visit
,
and
I'm
like
,
okay
,
that
is
just
a
rip-off
,
at
that
point
I'm
like
just
go
to
somebody
and
get
a
cream
,
right
,
if
that's
more
valuable
.
Speaker 2
19:56
At
that
point
it's
like
no
,
no
,
that's
a
rip-off
.
I'm
always
like
,
first
and
foremost
,
let's
look
at
this
financially
,
right
.
I
don't
think
anybody
should
be
spending
that
kind
of
money
for
it
,
because
I
know
at
that
point
you
can
just
get
it
another
way
.
I
think
when
you're
looking
for
when
it
comes
to
the
testosterone
.
That's
probably
the
biggest
thing
,
honestly
is
the
cost
,
then
your
dosing
.
You
just
want
to
make
sure
that
whoever
is
doing
it
actually
cares
about
monitoring
.
I'll
meet
people
who
are
like
well
,
I
got
my
testosterone
pellet
and
then
they're
not
even
going
to
check
me
for
six
weeks
.
That's
a
red
flag
.
Insurance
should
cover
blood
work
.
Insurance
does
no
problem
,
even
though
they're
not
.
My
provider
is
not
covered
.
Insurance
covers
the
blood
work
part
.
If
you're
getting
a
cream
,
make
sure
that
your
doctor
can
at
least
tell
you
where
it's
compounded
from
what's
in
it
?
Speaker 2
20:43
and
then
also
,
do
they
have
reasoning
behind
the
dose
they
want
you
to
be
on
?
When
are
they
willing
to
test
you
again
?
Are
they
willing
to
change
the
prescription
based
on
how
you're
feeling
?
Sometimes
,
because
testosterone
gets
metabolized
so
quickly
,
sometimes
patients
need
to
apply
it
twice
a
day
,
right
,
so
every
12
hours
,
because
some
providers
will
butt
heads
on
that
and
be
like
,
no
,
we're
not
going
to
do
that
.
I
mean
that's
just
absurd
,
honestly
,
because
that's
that
doesn't
really
matter
.
It
should
be
based
on
the
patient
,
not
their
belief
system
,
but
it'd
be
a
red
flag
For
me
.
That's
a
red
flag
.
Speaker 2
21:21
They
need
to
be
at
least
monitoring
your
symptoms
.
How
are
you
feeling
If
we
do
it
this
way
?
Does
it
make
you
feel
better
?
And
that's
the
same
way
for
my
prescription
drugs
,
right
,
right
,
like
.
I
have
one
that's
broken
up
kind
of
weird
.
My
doctor
the
first
time
he
saw
that
he's
like
that
is
a
weird
dosing
schedule
,
but
it
doesn't
matter
because
that's
what
works
.
It's
worked
.
And
the
progesterone
progesterone
I'm
actually
more
concerned
about
because
when
it
gets
dispensed
through
a
med
spot
or
a
wellness
coach
or
something
,
just
because
that
seems
to
be
made
more
on
the
black
market
than
anything
else
Interesting
yeah
.
Speaker 2
21:54
You
just
don't
know
what's
in
that
.
I
mean
you
can
find
a
progesterone
cream
anywhere
.
Speaker 1
21:59
It's
just
like
sold
everywhere
.
Speaker 2
22:00
It's
wild
,
and
so
I
trust
that
even
less
.
And
then
,
of
course
,
there
is
a
.
I'll
have
to
send
this
to
you
.
There's
an
amazing
publication
on
estrogen
dosing
and
route
of
administration
and
which
type
of
estrogen
,
and
it
is
so
phenomenal
they
do
different
types
of
vaginal
estrogen
insert
and
how
much
the
blood
levels
actually
increase
in
estrogen
Cause
there's
always
that
argument
does
vaginal
estrogen
actually
increase
your
serum
levels
or
not
?
And
it
is
based
on
dosing
and
even
where
you
place
it
,
when
you
put
it
in
Interesting
.
Speaker 2
22:35
Yeah
,
it's
really
,
really
interesting
.
And
then
,
of
course
,
the
different
types
.
You
know
,
the
patch
,
the
oral
.
They
even
use
the
old
school
primary
in
it
and
it's
it's
a
really
great
publication
.
It's
really
technical
,
yeah
,
but
it's
also
just
invaluable
data
that
everybody
should
have
who's
taking
estrogen
of
any
kind
,
cause
it
goes
into
risks
,
benefits
,
how
fast
the
levels
rise
in
the
blood
after
taking
it
,
and
it's
really
really
great
,
and
so
I'm
hoping
in
the
future
we
can
have
something
like
that
for
testosterone
Hormone Replacement Therapy Considerations and Controversies
Speaker 2
23:06
right
.
Speaker 2
23:06
Because
you
know
the
different
ways
that
you
can
get
it
,
safety
profiles
,
and
I
will
say
a
friend
of
mine
really
wanted
to
do
the
pellets
but
,
as
with
case
with
a
lot
of
endometriosis
patients
,
she
has
this
a
bizarre
,
bizarre
comorbidities
and
one
of
them
is
her
scarring
.
Yeah
,
she's
really
bad
,
and
so
her
body
wouldn't
actually
accept
the
pellet
.
It
just
kept
spitting
it
out
Like
and
she
would
just
scar
horribly
.
So
it
wasn't
a
fit
for
her
.
Speaker 2
23:32
And
that
kind
of
was
like
a
.
That
was
one
of
those
things
where
I
was
like
,
oh
,
I
hadn't
even
considered
that
before
as
a
possibility
.
Speaker 1
23:37
Yeah
.
Speaker 2
23:37
So
for
her
it
didn't
work
,
and
I
know
that
I've
.
Actually
,
I
was
getting
a
hundred
milligrams
and
I
learned
that
I
couldn't
get
a
whole
100
milligrams
.
And
this
is
the
other
issue
with
some
of
the
med
spas
they
don't
have
the
ability
to
like
do
more
precise
dosing
with
the
pellets
.
Right
,
I
got
a
hundred
milligrams
pudding
,
so
it
was
easy
.
Well
,
my
body
kicked
it
out
pretty
easily
.
Speaker 1
23:59
Like
.
Speaker 2
23:59
I
was
riding
and
I
was
probably
more
active
than
I
should
have
been
,
but
it
came
out
and
my
doctor
was
mortified
.
He's
like
you're
ruining
my
like
.
Patients
never
have
a
pellet
come
out
.
But
what
we
ended
up
doing
was
breaking
it
into
two
fifties
so
50
milligram
,
50
milligram
and
placing
them
differently
inside
.
Speaker 2
24:19
It's
like
so
that's
one
of
those
things
where
it's
like
,
okay
,
based
on
your
level
of
activity
body
,
yeah
Right
,
you
go
to
a
bio
team
head
spot
and
they're
just
going
to
,
not
,
they're
just
gonna
put
it
in
out
the
door
,
yeah
.
Speaker 1
24:34
I
think
that's
well
,
and
that's
part
of
it
too
is
like
knowing
who's
putting
it
in
,
how
they
are
gonna
cater
to
your
body
and
to
your
needs
and
your
lifestyle
,
because
not
everyone
is
gonna
react
the
same
to
everything
,
and
that's
why
I
think
it's
so
individualized
.
But
the
thing
about
estrogen
,
too
,
that
more
research
is
starting
to
back
up
is
,
if
you
go
into
early
menopause
and
or
surgical
menopause
,
your
risk
of
dementia
is
much
greater
without
that
estrogen
replacement
,
and
I
think
that
it's
a
fairly
new
thing
that's
starting
to
come
out
more
and
more
like
no
,
this
is
not
just
about
dry
,
that's
not
just
about
your
skin
getting
loose
although
that
is
for
some
of
us
a
hard
thing
but
it
is
about
the
memory
.
What
is
your
longevity
without
it
?
What
is
your
longevity
with
it
?
Speaker 1
25:29
You
have
to
look
at
the
big
picture
,
but
you
also
have
to
consider
where
you
are
now
.
You've
gotta
feel
better
,
you've
gotta
be
able
to
,
you
know
,
not
just
survive
in
life
,
and
I
think
that's
where
a
lot
of
us
have
been
,
because
we
lack
the
education
to
give
us
informed
consent
and
there's
so
much
coming
out
right
now
.
I
think
a
lot
of
the
people
that
you
probably
listen
to
on
podcasts
or
online
are
probably
similar
to
me
,
and
there's
so
much
that
even
they're
learning
right
now
.
That
has
just
been
like
oh
,
I
never
even
thought
that
it
would
affect
this
system
of
my
body
,
but
clearly
it
is
,
and
how
intertwined
that
is
.
Speaker 2
26:05
It's
frustrating
because
my
doctor
he's
probably
like
he's
in
his
mid-80s
and
he's
been
doing
this
for
so
long
,
for
so
many
decades
.
And
it's
frustrating
because
he'll
just
sit
back
and
he's
like
yeah
,
yeah
yeah
,
yeah
,
you've
known
this
,
but
the
thing
is
,
there's
always
been
such
a
pushback
,
right
?
Speaker 2
26:24
And
even
though
he's
like
,
I'm
an
OBGYN
by
trade
.
Technically
,
you
know
,
he's
like
,
but
I've
never
done
obstetrics
outside
of
school
.
He's
like
,
I've
only
done
gynecology
.
And
it's
sad
that
,
because
of
the
way
the
institutions
work
,
nobody
knows
about
someone
like
him
,
but
it's
colleagues
do
within
the
network
,
right
,
right
,
you
know
,
they
know
,
but
he
you
know
.
And
now
it's
like
if
you're
not
writing
a
book
or
you're
on
social
media
and
no
one's
gonna
know
who
you
are
.
And
unfortunately
,
when
it
comes
to
the
hormone
replacement
therapy
space
,
we
have
two
very
differing
camps
right
now
.
And
it
is
I
don't
know
if
you've
seen
it
,
it's
like
drama
and
I
love
to
watch
it
from
afar
.
You've
got
these
big
time
like
self-reclaimed
menopause
experts
,
new
York
Times
best
sellers
,
and
they
really
think
that
they
are
the
best
ever
,
fighting
with
these
other
ones
that
are
actually
considered
maybe
the
fringe
,
but
they're
the
ones
actually
working
with
patients
,
not
just
screaming
on
the
internet
.
Speaker 1
27:19
Right
.
Speaker 2
27:20
You
know
it's
being
the
difference
that's
happening
,
rather
than
just
standing
by
old
doctrine
.
You
know
the
high
and
mighty
,
the
high
like
we
were
talking
about
before
.
Speaker 2
27:28
Rather
,
you
know
and
these
are
like
the
more
outside
the
box
thinkers
that
are
realizing
the
human
body
is
not
just
cut
and
dry
,
right
,
and
I'm
loving
this
interaction
.
And
then
,
of
course
,
there's
like
Rebecca
Glaser
.
I
was
telling
you
about
her
.
She
just
stays
completely
silent
.
I
wish
I
could
get
her
on
social
media
,
but
that's
just
not
her
jam
.
But
you
know
,
she's
actually
out
there
doing
the
publications
Challenges With Medical Guidelines and Research
Speaker 2
27:50
on
it
.
Speaker 2
27:50
Couple
of
years
ago
,
menopause
organization
from
Australia
,
they
were
rewriting
their
guidelines
.
I
had
emailed
them
because
I
said
I
was
looking
for
your
guidelines
and
you
don't
have
anything
from
Rebecca
in
your
guidelines
.
And
they
responded
and
like
,
well
,
we
don't
like
her
research
.
Essentially
is
what
they
said
.
They
were
like
well
,
you
know
,
it's
not
rigorous
enough
.
And
I
said
but
your
clinical
guidelines
include
quote
expert
opinion
and
that's
not
based
on
any
data
.
I
was
like
,
because
I
know
how
clinical
guidelines
were
.
Speaker 2
28:17
Anyway
,
they
didn't
want
to
talk
about
it
.
They
were
just
like
okay
,
well
,
yeah
,
and
you
mind
handing
out
this
pamphlet
that
we're
doing
in
a
survey
on
I
don't
know
what
it
was
some
sort
of
hormone
replacement
therapy
that
they
were
going
to
be
trialing
for
updating
their
guidelines
.
And
I
looked
through
the
nice
guidelines
in
England
they
only
have
testosterone
listed
for
sex
drive
and
that's
it
,
nothing
else
one
tiny
sentence
and
again
you'll
bring
up
well
,
what
about
like
Rebecca
Glaser's
work
?
And
they're
like
,
oh
well
,
you
know
it's
not
rigorous
enough
,
and
I'm
like
you've
got
to
be
kidding
me
.
It's
the
same
thing
with
in
vitriosis
.
Speaker 2
28:49
You
point
out
these
excision
studies
,
like
not
rigorous
enough
.
I'm
like
half
the
stuff
that
you're
relying
on
is
much
more
flawed
.
And
so
it's
just
frustrating
because
there
is
data
there
but
they
will
come
up
with
whatever
they
can
to
try
to
discount
it
,
and
I
find
that
really
it's
fascinating
.
But
the
people
who
follow
those
camps
,
they
fall
in
line
with
that
.
Right
,
you
know
the
very
doctrine
camp
.
They're
like
well
,
there's
nothing
in
the
guidelines
and
they
just
stop
at
that
.
They
don't
understand
the
complication
behind
you
know
,
developing
the
guidelines
.
But
then
you've
got
the
other
group
that's
like
,
hey
,
the
guidelines
aren't
right
,
we
need
to
update
the
guidelines
.
Speaker 2
29:28
And
so
it's
funny
to
see
the
parallel
there
with
the
in
vitriosis
,
yep
,
and
the
hormone
thing
.
They're
like
that's
the
same
thing
.
Fortunately
we
have
bigger
names
fighting
for
hormone
replacement
therapy
than
we
do
for
.
You
know
,
on
the
endometriosis
side
,
yeah
,
for
both
camps
the
voices
are
kind
of
getting
evened
out
.
But
I'm
enjoying
that
.
I
think
that's
going
to
help
us
move
forward
.
Speaker 2
29:53
Honestly
,
more
Mm-hmm
.
And
I
think
we're
as
you
go
through
it
and
as
we
move
through
it
,
because
I
know
at
the
beginning
of
my
journey
I
was
a
lot
different
than
I
am
now
.
I
was
more
like
hard
line
and
now
working
with
more
patients
.
Every
time
I
work
with
a
new
patient
or
I
chat
with
somebody
,
I'm
humbled
in
some
way
.
Mm-hmm
,
you
know
,
yeah
,
I'm
like
,
oh
,
wow
,
okay
,
that
doesn't
work
for
everybody
Like
I
thought
it
would
,
and
so
I
see
that
with
,
like
these
coaches
that
I
can
tell
they
have
figured
out
some
of
that
worked
for
them
and
they
wanted
to
work
for
everybody
,
and
they're
going
to
apply
it
to
everybody
.
Speaker 2
30:25
I'm
like
no
,
I
used
to
think
that
too
,
and
now
it's
like
we
just
have
to
,
like
you
said
,
get
out
of
the
survival
mode
and
just
find
a
way
to
at
least
improve
quality
of
life
.
That's
what
I
always
say
and
like
let's
improve
quality
of
life
first
and
then
move
from
there
.
And
staying
hard
lined
about
following
a
guideline
based
on
sub-hard
data
just
to
follow
it
but
still
have
feel
miserable
,
that
doesn't
make
sense
to
me
.
Speaker 1
30:50
That's
not
logical
.
Speaker 2
30:53
And
that's
a
poor
provider
,
you
know
.
Speaker 1
30:56
I
also
think
those
that
are
foundationless
in
their
research
we
have
to
be
aware
of
.
On
social
media
,
I
mean
,
this
is
something
that
when
you're
looking
at
following
a
provider
or
getting
advice
from
,
it's
important
to
look
at
where
is
the
research
coming
from
?
If
they're
making
big
,
bold
claims
of
something
,
yeah
,
because
and
this
includes
endometriosis
but
hormone
replacement
therapies
you
need
to
know
,
just
like
you
said
,
where
it's
compounded
,
what
it's
compounded
with
.
If
they're
trying
to
sell
you
something
,
a
program
,
for
thousands
of
dollars
,
chances
are
it's
not
got
a
good
foundation
.
Speaker 2
31:36
Yeah
,
and
,
like
I
point
this
out
to
people
,
yes
,
I'm
lucky
to
have
found
my
provider
and
to
be
able
to
get
to
him
.
I
would
hands
down
argue
he
is
one
of
the
best
in
the
world
when
it
comes
to
hormone
replacement
therapy
.
And
I
pay
$25
a
week
,
right
,
right
,
I'm
not
paying
something
that's
completely
unattainable
.
My
ADHD
,
like
the
vibrance
,
is
more
expensive
every
month
.
Yeah
,
if
I
didn't
have
insurance
then
this
would
be
.
You
know
what
I
mean
,
right
?
That's
why
I'm
like
it
should
be
within
the
realm
of
possibility
.
So
that's
why
the
pricing
thing
I
look
at
and
I'm
just
like
,
don't
get
conned
.
Speaker 1
32:09
You
know
,
and
it's
so
easy
when
we're
desperate
.
Speaker 2
32:11
We
want
everything
to
work
.
I
almost
did
too
,
because
I
was
looking
at
different
hormone
providers
and
I
found
this
one
.
It
was
like
,
oh
,
this
looks
like
a
really
great
one
.
And
then
it
was
like
a
$500
consult
oh
my
God
,
what
.
That
just
kind
of
blew
my
mind
.
So
it's
definitely
,
it's
just
important
to
maintain
,
you
know
,
like
a
middle
ground
of
some
kind
,
right
,
try
to
find
.
Speaker 2
32:30
I
always
say
the
truth
is
somewhere
in
the
middle
of
the
extremes
,
and
then
where
your
truth
lies
is
going
to
be
somewhere
on
a
spectrum
,
and
then
where
you
feel
best
is
also
going
to
be
on
a
spectrum
.
Speaker 2
32:41
And
it's
good
for
me
to
remember
that
when
I'm
working
and
chatting
with
other
people
,
basically
what
I
have
to
remind
myself
is
,
instead
of
being
like
,
okay
,
is
this
person
doing
what
I
want
them
to
do
or
what
I
think
they
should
do
,
I
have
to
stop
and
ask
how
do
you
feel
right
now
?
You
know
like
,
what
do
you
think
could
improve
?
And
you
know
,
if
I'm
working
with
someone
as
a
patient
advocate
,
you
know
we
sit
down
and
we
look
at
you
know
what
have
they
tried
?
What
kind
of
providers
are
they
seeing
?
Right
,
or
it's
like
somewhere
in
there
there's
always
a
well
,
I'm
following
this
person
on
Instagram
,
or
well
,
I'm
like
this
is
where
we're
going
to
go
wrong
and
it's
always
like
they've
thrown
in
some
weird
supplement
or
they've
are
hard-lined
with
this
one
doctor
that
says
you
have
to
follow
every
guideline
and
they
haven't
opened
up
their
mind
to
maybe
trying
something
else
.
Speaker 2
33:26
It
is
just
very
nuanced
and
I
hope
that
,
as
the
information
continues
to
come
out
,
it
doesn't
get
always
into
the
wrong
hands
Right
,
because
that
happens
too
,
and
,
again
,
anybody
.
Navigating Research and Hormone Replacement Therapy
Speaker 2
33:40
You
just
have
to
be
so
careful
with
the
way
information
is
interpreted
as
well
.
Yes
,
because
you
know
there's
one
really
outspoken
menopause
expert
that
will
take
things
and
write
on
their
blog
about
it
as
an
expert
,
and
I've
read
through
their
analysis
of
some
of
this
information
and
it's
not
good
Interesting
.
I'm
like
she's
actually
interpreting
data
in
a
very
skewed
way
.
She's
very
emotional
and
so
I
think
she
interprets
it
emotionally
as
well
.
Yeah
,
and
I
like
to
take
a
step
back
and
look
at
the
data
.
The
reason
that
a
lot
of
stuff
can
get
published
now
is
because
a
lot
of
it
is
pay
to
play
.
Speaker 1
34:18
Right
.
Speaker 2
34:19
And
so
in
a
lot
of
these
publications
,
when
you're
looking
at
them
,
if
you
just
read
their
analysis
without
digging
into
it
yourself
and
saying
that's
what
you're
interpreting
,
you'll
get
this
very
biased
approach
.
For
instance
,
I
wasn't
sure
I
agreed
with
one
of
her
analysis
,
so
I
looked
at
the
publication
she
was
citing
and
I
looked
at
the
actual
numbers
,
which
is
normally
you
have
to
like
download
in
a
different
accessory
file
or
something
right
,
it's
not
just
always
in
the
paper
,
right
?
And
I
was
actually
looking
at
the
numbers
and
I
was
like
,
no
,
no
,
this
isn't
actually
what
that
was
showing
,
because
they
can
say
statistically
significant
,
but
that
doesn't
mean
anything
meaningful
,
right
,
and
they
love
to
throw
that
in
there
.
Well
,
there
was
a
statistically
significant
and
I'm
like
,
oh
my
God
.
Speaker 1
35:02
One
way
or
the
other
.
Speaker 2
35:03
Was
it
clinically
meaningful
?
Did
it
even
matter
,
right
?
So
,
anyway
,
that's
a
whole
other
thing
when
it
comes
to
research
,
but
if
somebody
is
presenting
research
like
that
,
it's
important
to
be
like
well
,
did
you
?
Speaker 1
35:13
look
at
the
data
.
You
know
,
Did
we
look
at
the
data
?
Good
at
that
.
Is
that
something
that
we
could
say
?
Hey
,
Kate
,
I
came
across
this
research
.
Do
you
mind
looking
at
it
and
seeing
if
this
is
valid
?
Because
I
feel
like
for
a
lot
of
us
.
We
see
this
research
and
we're
very
confused
by
okay
,
is
this
valid
,
is
this
not
?
And
sometimes
,
what
they
state
we
don't
have
access
to
,
which
is
,
I
think
,
absurd
,
because
it's
like
medical
journals
and
things
like
that
.
Speaker 1
35:41
So
if
it's
something
like
that
,
it
is
always
better
to
ask
someone
that
can
analyze
that
data
that
is
,
a
third
party
,
not
someone
who
is
connected
to
that
research
or
that
paper
,
because
it
is
going
to
be
biased
one
way
or
another
.
And
so
finding
someone
that
can
analyze
that
data
,
making
sure
that
it's
accurate
,
give
you
an
accurate
description
of
what
they're
actually
saying
in
that
data
,
is
gonna
benefit
you
in
making
your
next
steps
or
,
and
maybe
help
in
your
opinion
one
way
or
another
.
Speaker 2
36:15
Yeah
,
that's
one
of
my
.
That's
actually
one
of
the
formal
like
roles
of
a
patient
advocate
can
be
,
you
know
,
obtaining
data
like
that
and
looking
at
through
with
the
patient
.
And
when
it
comes
down
to
,
you
know
,
looking
at
data
,
I
have
my
own
network
.
Sometimes
there's
data
that
I'm
there's
some
types
of
statistical
analysis
that
I'm
really
awful
at
,
so
I
have
my
own
resource
group
.
You
know
,
I
have
friends
that
I
can
reach
out
to
and
they'll
,
you
know
,
like
,
oh
,
yeah
,
no
,
this
is
what
that
means
or
doesn't
mean
.
And
,
like
you
know
,
like
gut
check
with
others
,
and
so
I
have
no
problem
when
people
you
know
send
me
something
,
or
like
,
kate
,
you
know
,
what
do
you
think
about
?
Speaker 1
36:46
this
,
and
I
always
have
an
initial
reaction
right
.
Speaker 2
36:48
I'm
always
like
oh
yeah
,
this
is
gonna
be
horrible
.
Speaker 1
36:50
And
then
sometimes
I'm
wrong
.
Somebody
sent
me
one
yesterday
.
Speaker 2
36:52
They're
like
,
hey
,
I'm
thinking
about
buying
this
.
It
was
not
related
to
endometriosis
.
What
do
you
think
it
had
to
do
with
water
?
Oh
yeah
.
And
I
was
like
,
oh
yeah
,
this
is
totally
a
trash
product
.
They're
just
trying
to
make
money
.
So
I
dug
into
it
for
quite
a
while
,
looking
at
research
,
and
went
oh
well
,
actually
there
is
some
.
There's
like
there
actually
is
some
evidence
here
that
it
can
do
X
,
Y
and
Z
.
Here's
the
literature
on
that
.
Don't
know
if
it
can
do
what
it's
claiming
health-wise
Right
.
But
I
had
to
realize
that
my
initial
reaction
to
it
was
not
accurate
.
Speaker 2
37:24
There
actually
is
some
research
done
and
evidence
that
it
did
something
right
.
We
just
don't
know
if
it
did
exactly
what
it
was
claiming
.
So
that's
another
part
of
it
.
But
yeah
,
when
it
comes
to
the
research
part
,
the
gut
check
part
digging
in
with
somebody
else
,
it's
really
important
because
I
will
see
a
lot
of
these
,
like
health
coaches
,
say
that
they're
looking
at
the
data
and
they'll
give
their
analysis
,
and
I
can't
tell
you
how
many
times
it's
been
wrong
.
Speaker 2
37:50
There
are
some
wonderful
well-meaning
ones
on
social
media
that
I've
direct
message
and
said
,
hey
,
actually
this
is
what
I
looked
at
and
this
is
the
result
I
got
from
the
data
and
they've
actually
taken
it
down
or
modified
,
and
that
I
really
appreciated
that
because
I
would
have
no
problem
with
a
peer
doing
that
to
me
either
.
Right
,
kate
,
you
actually
looked
at
this
data
wrong
.
Okay
,
great
.
That's
why
we
have
the
review
process
.
But
unfortunately
now
with
publications
they're
mostly
paid-to-play
and
this
is
why
we
have
retractions
.
I
try
to
tell
people
articles
get
retracted
.
There
was
one
recently
I
reached
out
to
the
editor
about
and
he
thanked
me
because
they
had
approved
a
publication
that
was
citing
a
retracted
article
and
that
can
happen
depending
on
the
dates
.
So
I
double-checked
the
dates
the
article
had
already
been
retracted
by
the
time
they
published
or
had
even
started
writing
,
because
it
had
been
like
six
years
and
I
caught
that
,
like
you
,
can't
cite
a
retracted
publication
.
Speaker 1
38:51
Interesting
Things
,
that
if
you're
not
looking
for
that
stuff
or
you're
not
aware
of
it
,
something
that
you
would
completely
miss
.
And
not
everyone
has
that
skill
set
,
and
that's
why
I
think
it's
important
to
know
like
different
people
that
do
have
that
skill
set
,
so
that
you
get
better
information
.
Speaker 2
39:06
Yeah
,
and
there's
all
.
You
know
.
I
have
my
list
of
resources
.
I
tell
people
I'm
like
like
who
should
I
follow
for
this
?
I'm
like
,
go
here
,
go
there
.
You
know
,
these
people
I
trust
.
Of
course
don't
take
it
as
like
gospel
,
but
you
know
it's
a
start
,
you
know
.
And
then
I'm
always
like
do
your
due
diligence
.
At
the
end
of
the
day
,
that's
.
Speaker 1
39:22
And
what
you
have
to
do
.
That's
for
everything
.
Speaker 2
39:24
That's
for
your
providers
,
that's
for
medications
,
that's
for
supplements
,
everything
that
you're
going
to
take
.
But
I
feel
like
,
when
it
comes
to
hormones
,
when
you're
having
surgery
for
whatever
reason
,
maybe
you
need
to
have
the
ovaries
out
,
maybe
you
just
need
to
hysterectomy
,
but
I
think
it's
important
to
know
that
all
of
that
can
impact
how
your
ovaries
function
long
term
.
And
then
,
just
because
you
left
your
ovaries
doesn't
mean
you
can't
be
having
some
sort
of
issue
that
would
necessitate
hormone
replacement
therapy
.
So
it's
totally
OK
to
find
a
provider
that
will
work
with
you
in
that
,
because
people
will
often
say
I'm
not
going
to
be
like
,
well
,
I'm
not
in
full-blown
menopause
and
I
send
them
to
somebody
that's
called
a
menopause
expert
.
They're
like
does
this
make
sense
?
And
it
does
,
still
should
see
somebody
.
That's
just
their
focus
.
And
so
your
primary
care
physician
may
say
well
,
you're
fine
,
you
still
have
your
ovaries
.
It's
OK
to
pursue
that
further
.
I
think
it's
important
for
people
to
know
,
and
I
think
it's
important
even
if
you
have
both
ovaries
,
one
ovary
,
no
ovaries
.
Speaker 2
40:23
You
can
go
through
any
variety
of
these
fluctuations
.
It
is
so
nuanced
and
customized
for
each
individual
so
it's
hard
to
find
a
provider
that
can
treat
all
of
these
things
.
But
I
think
it's
important
to
note
that
our
OBGYNs
general
OBGYNs
just
like
they
aren't
cut
out
for
endometriosis
surgery
,
they're
not
cut
out
for
proper
hormone
replacement
therapy
.
And
,
as
wonderful
as
our
surgeons
are
,
they're
also
not
hormone
experts
.
So
a
lot
of
people
will
be
like
well
,
I
went
to
so-and-so
and
I'm
like
yes
,
he's
an
exceptional
surgeon
,
really
wonderful
.
Great
that
they
put
you
on
an
estrogen
patch
after
removing
both
ovaries
.
But
it
doesn't
stop
there
.
Unfortunately
,
they're
not
going
to
be
the
expert
in
that
.
So
that
journey
continues
on
and
a
lot
of
people
get
frustrated
.
They're
like
I
thought
I
went
to
an
expert
.
I'm
like
you
did
for
Indo
.
Speaker 1
41:09
But
not
a
hormone
replacement
.
This
is
a
whole
nother
beast
.
Speaker 2
41:12
This
is
a
whole
nother
thing
that
we
did
.
So
I
try
to
.
You
know
it's
important
.
We
need
to
start
working
on
that
beforehand
.
Ideally
,
these
surgeons
would
have
someone
they
could
refer
patients
to
.
But
again
,
who
are
they
going
to
refer
them
to
when
it's
so
difficult
,
right
?
So
I
think
that's
the
trajectory
for
a
lot
of
us
.
I
think
that
it's
just
important
to
track
those
symptoms
,
Even
not
in
full
blown
menopause
,
still
track
the
other
symptoms
that
could
be
hormonally
related
,
and
then
do
your
best
to
find
a
provider
that'll
at
least
do
some
initial
testing
and
have
that
data
so
you
can
take
it
to
maybe
somebody
else
that
you
find
as
a
provider
.
Sometimes
you
just
have
to
start
with
a
simple
search
.
Speaker 2
41:49
Yeah
which
can
also
be
scary
.
Speaker 1
41:53
It
does
,
yeah
,
it
does
.
Speaker 2
41:54
That's
what
I
hate
that
we
even
have
to
say
that
.
But
it's
like
top
hormone
specialist
,
best
hormone
specialist
or
something
like
that
,
and
then
sift
through
it
.
Does
their
website
look
scammy
?
Speaker 1
42:04
Sometimes
you
need
to
go
to
three
different
ones
to
get
a
good
vibe
,
and
that's
OK
,
yeah
$500
consult
.
Speaker 2
42:11
Totally
OK
,
you're
not
going
to
miss
out
on
anything
.
Great
if
you
can't
afford
that
?
Speaker 1
42:14
No
,
no
,
there's
other
options
for
sure
.
Ok
,
thank
you
so
much
for
breaking
that
down
for
us
,
for
talking
about
that
,
because
I
think
it's
something
that
every
person
,
through
change
of
life
or
surgical
menopause
,
is
going
to
go
through
at
some
point
.
So
understanding
it
is
going
to
help
people
better
navigate
their
journey
and
making
sure
that
their
life
is
just
a
little
bit
easier
to
live
honestly
.
So
thank
you
so
much
for
taking
the
time
.
It's
always
great
to
talk
about
this
so
thank
you
so
much
.
Speaker 1
42:43
Thank
you
for
having
me
.
I
really
appreciate
it
.
Yes
,
and
until
next
time
,
continue
advocating
for
you
and
for
those
that
you
love
.