On Hormone Replacement in Menopause with Dr. Leita Harris – Ep. 186

In this episode of Next Level Human Podcast, Dr. Jade welcomes Dr. Leita Harris, who is a Gynecology Specialist and Hormonal Replacement Therapy Specialist based in Corona, CA. Dr. Harris dives deep into the concepts of hormonal imbalance and bioidentical hormone replacement, demystifying some theories women tend to hear from their doctors and explaining the connection between hormones and weight loss.

Dr. Harris also explains how she works with women clinically, explaining all the stages of hormonal production and how they affect the period of reproductive life. You will also learn that when women get to the stage of the menopausal transition, the body naturally produces less or no progesterone, thus causing a hormonal imbalance. This imbalance in turn causes all kinds of ‘roller coaster’ symptoms. Tune in!

Check out the Next Level Human sponsors!

• Visit com/hormones and use code NEXTLEVEL at check out for a discount on your first patient visit with Evolve!

Connect with Dr. Leita Harris

Instagram: @drleita

Website: nurturingyou.com

Connect with Dr. Jade Teta

Website: www.jadeteta.com

Instagram: @jadeteta

TRANSCRIPTION:

Next Level Human

Episode 186- On Hormone Replacement in Menopause

Host: Dr. Jade Teta

Guest: Dr. Leita Harris

Podcast Intro: [00:14] welcome to the Next Level Human Podcast. As a human, you have a job to do. In fact, you have four jobs; to earn and manage money, to attain and maintain health and fitness, to build and sustain personal relationships, to find meaning and make a difference. None of these jobs are taught in school and that is what this podcast is designed to do. To educate us all on living our most fulfilled lives through the mastery of these four jobs. I'm your host, Dr. Jade Teta and I believe we are here living this life for three reasons and three reasons only; to learn, to teach and to love. In this podcast, I will be learning, teaching, and loving right along with you. I'm grateful to have your company; here is to our next level.

What's going on everybody? Welcome to today's show, I have a special guest today an expert in hormone replacement therapy. The good news is that most of you are always hearing me talk about hormone replacement therapy for women. And in case you didn't know I am not a woman. So I have an expert who is also a woman on here and been doing this work for a very long time. Dr. Lena Harris is with us today. Thank you so much, Dr. Leita for being here. Let's start with sort of your background and how you got into this work in hormone replacement. I know you're a gynecologist, and this is sort of your world. But when did you start sort of really getting deep into, you know, HRT for women?

Dr. Harris  1:57 

Okay, great. Well, thank you very much. First of all, for just having me here to share with your audience, I'm very excited about being able to just pour into the lives of these women that are listening, and and of course, maybe some men as well. So I've been practicing medicine for 32 years now. I left the full scope, OB GYN, with Van deliveries and surgeries and everything back in 2005, actually, so I wanted to pull away from, I guess, conventional looking at things from a standpoint of doing a lot of knee jerk prescribing and things like that is when I kind of took a journey towards looking at more natural ways of helping women get better get half lives of wellness, as opposed to just prescribing medication. So I kind of took a little hiatus, I did start teaching. And then I went into really learning about bio identical hormones probably back in around 2007 or so actually a compounding pharmacist who is who helped me initially. And I really realize after a while that I was what we learned in conventional medicine and what we were doing in conventional medicine, I almost felt guilty, I felt like we were doing a disservice as I dug deeper and did my own. Just learning and doing different conferences and seminars and things like that, really learning about hormones and the benefits of them. And so what I decided to do after a while was just break away from the whole organized structure of medicine. And I launched out my own practice seven years ago. It's been great. It's been fantastic. I love what I say is partnering with my patients to help them in their wellness journey. I tell them that we're working together to help you to be the best you can feel the best that you can live the best that you can. And I love being able to give options. I love giving them ways of finding out how and what they can use to address the various concerns that they have. I'm big on telling people you do not need to suffer. I think too many people are needlessly suffering because they don't have the right information. They've been misinformed, or uninformed. And there's been scared they've been a wave of fear that's been put into them and actually from physicians and other providers. And I think there's been a tremendous amount of disservice that's been done to people and particularly women. And so that's why I'm very, very passionate, as you probably can tell, about giving people options and helping them to just get on hormones if they're qualified. And, you know, just live lives that's going to help them feel a whole lot better than what they're currently on.

Jade  4:55 

We're certainly grateful that you're doing this work because obviously As you and I know, it's needed and those of you listening, Dr. Leita is in private practice. So you are and she is available to be seen. She's in out of California, but she also works with evolve, who was a sponsor of the podcast, and one of the reasons that I am talking to her because I told them, I want your best, you know, person on HRT to come on and educate us. And so that is why she is here. And you know, what I want to do to start if it's okay with you, you mentioned his idea of, you know, fear and this whole idea of fear around hormones, this has sort of been one of these things that I'm sure you know, me, we're always battling against this, when we have someone come to us and we say, you know, hormone replacement therapy may be a powerful option for you. And then we get right after that, oftentimes, a pushback. So I'm curious, is this all coming from, you know, mainly the Women's Health Initiative study? Is that mainly what it is? Are we still dealing with the consequences of that information? Or where do you think the fear is really coming from here? I know, there's people think there's risks for certain things. And I'm wondering how you educate people, get them to sort of understand what has happened here, and why they may not need to be afraid.

Dr. Harris  6:17 

Absolutely. And you're right. You know, I think that the Women's Health Initiative, which is now 20 years old, did a tremendous disservice to the overall health and wellness of women. And I think people like us who are a little bit more progressive, and looking at things and really analyzing, realize that it just, it just really did a disservice if I can put it that way. And unfortunately, too many doctors and other medical providers are still leaning too old. And in valid statistics that came from the Women's Health Initiative. I mean, it freaked everybody out, I remember it very well, back in 2002. And we're all of a sudden, I had to start, you know, trying to convince my patients like, okay, hey, let's look at this a little bit more closely. The problem is that I mean, several things, you know, it's it was the statistics. And it was wasn't something that was really valid. We're talking about like a very small number of people that supposedly had increased risk, we are looking at a study that was some synthetic estrogen combined with synthetic progestin. And I tell them, even in the group that was only on a synthetic estrogen, they did not have any increased risk of cancer. I really want to focus though, on what has recently come out, I'm very happy that back in 2017, and even this year, in 2022, the North American menopause society s actually put out another statement, that is almost if you if people look at that, and if other physician looking at they realize, okay, the risk of breast cancer related to hormone therapy use is low, rare occurrence. And this other confounding factors, I mean, it's almost the same as someone who's, you know, more alcohol or obese, that is the kind of comparison with the risk, unfortunately, and people are looking at this and saying, oh, okay, cancer, sorry, hormones cause cancer, and it just simply does not, in fact, there's a reduction in a lot of the different cancers is a reduction in cardiovascular problems, which, of course, more women are going to have deaths from cardiovascular disease and coronary artery disease and that type of thing at postmenopausal Lee, more than cancer, everybody freaks out about cancer, but they're not looking at the heart hormones, our course are going to be beneficial for heart health is going to be beneficial for our brain health, this is going to be beneficial for our bones for our bladder, for the vagina, all of these things are important, not only for overall health, but also you know, you know, because of just even just looking at what, what really are the cancer risks there. So I'm really happy that when I looked at some of the key points in a new statement, you know, they really did say we're that it's less at all that women can consider a hormone replacement and not necessarily look at this as something that's a high risk, and even with women that have had a history of breast cancer, I mean, this was very profound when I end when I took a look at it. So yes, the fear is still there. Unfortunately, it is coming from doctors, it's coming from medical providers who are not maybe aware or not fully informed. But I also believe that the media you know, I look at, you know, things that may be articles that come out that people search Google, okay, we know that right? And when they see and they don't understand that they're mumble jumbling all at a different, you know, estrogen therapy, menopause hormone therapy, ERTMHTE, TPL. People, the lay person doesn't understand this. And when they look at it, you know, superficially, they get fearful. And again, it's a lot of misinformation, lack of information. So some of its call coming from media from different things that there may be Googling, as well as from other medical providers that just don't have the right information, unfortunately.

Jade  10:35 

that's, there's a lot there. So I'm gonna just repeat back. Thanks so much for that. And make sure I get this right, because I just want to all of you are listening, if you're listening to what Dr. Lead is saying she's essentially saying this, this study Woman's Health Initiative, which is a big study, the first sort of results came back in 2002, was showing some things that were scary for a lot of physicians and for a lot of women, and also the media sort of jumped on that showing increased risk of certain cancers, and increased risk of other things related to hormones. If you listen to what Dr. Lena saying she also is pointing out that first of all, this was equine estrogen, so not bioidentical estrogen. And it was also progestins, right, which are not like the natural progesterone. But even if I'm hearing you correctly, and I've looked at this data as well, even in that case, with the new data coming out, and by the way, those of you who are listening, one of the things Dr. Leita was pointing us to is when you have these large cohort population studies where they're looking at one thing, there's a lot of confounding variables. And she mentioned that things like all these people alcohol, like are they obese, how old this is impacting this and the new information? Sounds like you're saying Dr. Leita is actually showing that not only were we wrong to be afraid of the WH you know, sort of research that actually that there was some decreased risk, and or no risk at all when they start looking at the data, again, over the long run, and this is with, you know, synthetic estrogens and progestins. Now, we have not yet talked about and bioidentical hormones and so maybe we want to kind of get into that a little bit because for example, I know that a lot of people point to the progestins as being they did as being the big problem here. And I am aware of several lines of research several studies showing that when you use bioidentical progesterone, the risk of breast cancer seems to go away and may actually be improved upon with bioidentical progesterone. So am I correct in that? And how should we be thinking about this? Do you still use some of the synthetic hormones? Or are you convinced that only the bioidentical hormones are appropriate? Because I know a lot of people would say, Well, my doctor is giving me the the synthetic hormones, we now know that the risk of those is probably not that great. You may even be getting some protection from those. But what do we know about these bioidentical hormones in comparison to sort of the standard traditional HRT, are we getting better outcomes?

Dr. Harris  13:16 

Sure, you know, and you know, just to define your so people can fully understand, you know, people shouldn't get like freaking out when they hear the term, you know, bioidentical hormones, because you will see Google like, okay, it's not FDA approved. And it's not this and it's not that it's not regulated, etc. Bioidentical hormones is basically just hormones that chemically, structurally, they're exactly the same as what is produced in the body. So bio bio identical identical chemically and structurally to what is normally found in the body. So estradiol is a bioidentical hormone, are there versions of bioidentical hormone that is approved? You know, through the FDA? Yes, there are, you know, this bioidentical estradiol patches, there's Astro gel, you know, this oral, okay. Now, personally, I do not do synthetic hormones. And I haven't done that for two decades. I just don't do synthetic hormones. So and I understand, you know, the whole thing of that, hey, your insurance might cover one version of it, and not another version of it. But what we have to understand is that everything that you ingest has to be metabolized. Okay. So those metabolites can affect your body in ways that you know, sometimes we don't fully understand, or it can be a negative impact on our body. So you're absolutely right. progesterone, which is like a micronized. Progesterone is exactly the same as what is chemically in our body. Now, sometimes what I do to really emphasize for women is that a pregnant woman can use a purge testosterone okay, but as contra indicated for them to use a synthetic progestin. So when you think about safety, absolutely a natural micronized progesterone is going to be, of course safer better. And yes, you're right. There has been some observational studies showing that it could even be breast protective, natural bioidentical progesterone is something that behaves differently in our body, it can't totally opposite to synthetic progestin. So it's a natural diuretic, it helps to help with our mood and our, you know, just stability in oral micronized. Progesterone interacts with a GABA receptors in our brain to help us sleep and to calm us. So you know, when you're thinking about something that behaves a certain way versus a synthetic version of it, absolutely, it's going to be better, it's going to be better for us. So by with identical again, just means that the structure is the same as what your body naturally produces, you know, just looking at things from a theoretical standpoint, you want something that's going to be more natural, so that your body recognizes it, and as it is metabolize it, those metabolites, the end products will affect us in a way that's totally opposite or different, potentially, than what a synthetic metabolite can do. So I was very happy as you share that, yes. Natural micronized progesterone can be actually protective, and behaves differently. It's going to be different as far as like, you know what it's going to do combined with, say, a natural bioidentical estrogen in our system versus a synthetic progestin very, very different.

Jade  16:45 

Yeah, that's great to know. So let's go through just clinically how you work with patients then. So you know, obviously, when we look at this, there's, you know, the peri menopausal state, which can last a pretty long time, up to 10 years, this is where, you know, essentially progesterone levels are beginning to drop and estrogen levels can be very volatile through this process. And this is oftentimes where a lot of the symptoms come from. And then of course, there's menopause, which, technically for you and I in the medical field, menopause is basically a single point in time, right? We usually define it as you know, being without menses for a year or a particular number on your FSH but there is a distinct sort of hormone. You know, sort of reality there when someone finishes perimenopause, where now rather than estrogen being high and low at times, it typically is low. So I like to think of perimenopause as sort of like this fluctuating estrogen. Sometimes it's high, sometimes it's low with lowering progesterone, and then menopause, you know, this postmenopausal period being sort of low estrogen and progesterone. So how, how do you deal with this with someone in perimenopause? Are we talking about progesterone therapy by itself to sort of balance out this this estrogen? And then And then is there any difference as we move into menopause? Just curious how you began to sort of look at this.

Dr. Harris  18:00 

Yeah, sure. Sure. Yeah. So what I what I usually explain, you know, to our women, and you're right, I mean, it's gonna last for 10 or more years. I mean, when you start kind of looking at the fact that yes, I what I tell my patients is that the thing the hormone that usually drops or declines first is progesterone. Okay, because, you know, progesterone, as you know, is, you know, produced after ovulation. And so normally you have estrogen, and it's going to be produced during the cycle. But then with ovulation, that's where progesterone comes into the game. Okay, so I tell people just think about how you feel from ovulation all the way up until your cycle, that phase that luteal phase when there's progesterone being produced, that is going to be something that's going to be fairly consistent during most of your reproductive life. However, when you start getting into that perimenopause of phase, where you may either skip ovulation altogether, you know, still producing estrogen, and like you say, up and down, but there may be less progesterone produced, or no progesterone because ovulation totally is not there, then you have a completely different balance with the hormones where estrogen may be a little bit more dominant because of high levels of estrogen or two level too low of a level of progesterone. So most of the times oh, and then symptom wise, oh my gosh, I tell them that this is the roller coaster years, right? You know, so you're kind of like, you know, you may have your period, it might be too short and it might be too long, you may skip it, you may have to in a month, you know you may be heavy, you may be light and then it's then it becomes more and more spaced out until it stops. So during the peri menopausal phase, progesterone is actually the primary thing that I support my patients with, because we don't know that estrogen still may be produced. So progesterone is the one that I usually use during perimenopause. Tom's and then I but I do let them know I said this is going to be for now. But this is a journey. Remember, this is a journey. So progesterone may be what's needed now and I will kind of throw in sometimes testosterone sometimes DHEA. But then as time goes by and ovary produces less and less estrogen, now we have to add estrogen to your regimen to your protocol. So that now you have both of those hormones working together again, to support you. And it's crazy because you know, I tell them, you know, you can have like menopausal symptoms, you know, the hot flashes and can't sleep and mood changes and weight changes and all of that and and still have your period. So it's like one of these like, oh my gosh, times of your life where you're feeling like you're in menopause, but you're still having periods. So supporting them, as you said is like with the progesterone initially, and then of course, eventually estrogen is something that is going to be added as those levels decline as well.

Jade  21:09 

And let's get back to the show. Yeah, I love the way you're speaking of this, because if all of you listening right now are paying attention to Dr. Leita, what she's essentially saying is there's a very, you know, sort of deep understanding of what is happening hormonally. So in his Peri menopausal state, notice how she's not using estrogen but primarily progesterone and the way she explained that to us about how progesterone is what's really needed to be supported here. And so then you begin to move into the menopausal state. And, you know, at what point do you perhaps start transitioning over to maybe an estrogen plus a progesterone and then I'm also interested in whenever you use maybe estrogen alone, or a testosterone and just for the listeners, so you understand normally when we're in clinic doing this, you know, menopause, normally, we can run a test called FSH, usually when it's above 30, we will define that as sort of menopause. I don't know if that's how you define it as well, Leita. And also, you know, we can just basically define it as you haven't had menses within, you know, a year, you know, so we look at both of these markers. And I'm wondering how you if you use these markers, or if you're just going on symptoms, when you start to go, okay, maybe I'm going to start using, you know, some estrogen therapy as well. And I'm just curious on how you work your clinical practice on when it's estrogen plus progesterone, when you might want to do estrogen alone when you might want to use estrogen, vaginally, and when you might want to use testosterone. Just curious. Yeah, so basically,

Dr. Harris  26:39 

so you know, given the person who's still like very much happy in their cycles, I explained to them, you know, I'm not going to give you a bunch of, you know, estrogen, because you know, that's going to make your bleeding worse, potentially, and you may not necessarily be very, very deficient at that point. So I do serum levels, I do check their blood levels. And I do let them know and I show them I say okay, hey, I look at your estrogen is fine right now. So you know, this is where you are, but just knowing what you're sharing with me, this is where the progesterone comes and we know what's going on with your body because of what you're sharing with me. Now, the transition will may happen where like, okay, there's now they're kind of skipping like long stretches, they may not get to a full year. But when they start really skipping like they're using a progesterone, they're not having any cycle, maybe some of those vasomotor, which is like the hot flashes and sweats and things like that are worsening, or they may start noticing other estrogen deficiency symptoms such as vaginal dryness and things like that, then I might kind of check again and say, Okay, looks like it may be time for us to at least start but if they haven't gone for a whole year, I always tell them at any point in time your own ovarian production of hormones might increase, okay? Remember that the perimenopause is on again off again. So even though we're supporting now with a little bit of estrogen, it There may come a point where your ovary like you may have a surge and you may produce estrogen on your own. So you have to be aware of that. And if that happens, you may notice that oh, here comes with period again. Here it comes a cycle. And yes, I look at FSH as well. But I also let someone know that if you're perimenopause, so if your estrogen is low for a long time, your FSH may be high. But again, if you have not gone through that whole time where there's no more follicles, you can all of a sudden boom, have a surge, that estrogen goes up and that FSH comes right back down. Because now you you're producing estrogen may have that moment and then SSH comes out. And then it comes down. And here we go back again to that long stretch without anything. So I do estrogen. You know, at some point in time, when a lot of times is when they may be the symptoms may be increasing the progesterone is not holding everything as well. They may be skipping their cycles. Now it's time to add on a little but I always give them a little caveat. We're going to monitor and see and see how you're doing with your own potential body's surge of estrogen. Testosterone, I truly believe in testosterone. Okay, I think it's actually amazing. Sometimes I see women's testosterone decline, even like in their 20s and 30s. They have lower testosterone, some of them I know some of it may be genetic. Some of it may be you know, environmental things. Some of it may be they've been they were on birth control pills for so long, you know, and may have suppressed and knock things off as far as their whole hormonal balance. So when I see low testosterone and a woman is complaining of you know, low libido, low energy how Have no muscle tone muscle strength, when they're exercising, they just don't feel like they're getting what they need, I go ahead and add testosterone to their regimen. And again, I do use blood levels to see where they are. And I tell them, you know, hey, let's just kind of try to get you into a better range with the testosterone. I look at DHEA as well, you know, from the adrenal glands, that's another androgen, another precursor to testosterone and estrogen that could be also replaced, if that's low. So that will help to support again, the whole hormonal structure. So that way, everything is improved, you know, over time. So

Jade  30:42 

and is your primary indication for testosterone? In your clinical experience? Do you feel like testosterone or estrogen is more enhancing libido? Is it both? Is it more than testosterone for women? And when do you when you look at that?

Dr. Harris  30:55 

I think it's both I do believe that they work, you know, in conjunction with one another, because, and I and it does vary person to person. I mean, sometimes I'm going to tell you very honestly, I've had patients that have fantastic testosterone level, and they're telling me I have no sex drive. So it's not, it's not an absolute, you know, and so, and I also say, libido is multifactorial? You know, it's not just, you know, testosterone level, it's not just estrogen level. It's, it is other factors, it's, you know, it's it's relationship issues, it's, you know, how someone feels about themselves, okay. It's also physical, sometimes in nature. So of course, if something is, if a woman has gotten to the point of discomfort, you know, physical things that are happening when they are sexually intimate. And it's it's a negative experience, then, of course, you know, they can have decreased drive, because it's connected with a negative experience. So if we help that negative experience, let it be as something better than that can also help and it may not necessarily be anything related to testosterone level, you see.

Jade  32:11 

Yeah, so yeah, library. Yeah. Yeah, a lot of factors there, actually. And let me ask you this just really quickly, because I know, you know, typically, I think about it now. And I just want to see how you think about it, you know, we usually think about giving progesterone orally, we no longer really think about, at least from my perspective, giving estrogen that way, it's usually done in creams or patches and things like that, due to the clotting issues. And you know, some issues around that. So it's just something for you listeners to be aware of. Most practitioners who are up on this are doing progesterone orally, but not giving estrogen orally, although it can be done vaginally, but it's usually creams, patches and things like that. You also mentioned to me that you you do use pellets on occasion, and I'm assuming that's for testosterone. And have you seen that? Or do you use those for estrogen as well, I'm not aware of estrogen of the estrogen pellets. But maybe you want to talk a little bit about that, because I know women are probably just like, okay, my, well, my doctor wants me on pellets versus creams versus patches and ones you like,

Dr. Harris  33:15 

sure, sure. Well, okay. So I agree 100%. With you, it's regarding, you know, with regards to the oral estrogen, and this is what I counsel my patients with, I just say, I don't do oral estrogen, because of the fact that it has to be metabolized in the liver, and potential for, you know, thrombogenic with clot forming and things like that, because oral does not behave the same as transdermal. Which is, like you said, patches and creams and things like that, nor with the pellets. So the pellets also bypass the liver metabolism as well it goes directly into the bloodstream. So yes, my preference is exactly how you said I'll use a transdermal form of estrogen. I'll use an oral form of progesterone for the reasons that we spoke of already. But then with regards to testosterone, of course, you know, there's no oral version of testosterone for a woman. Some women, you know, can use injections if they're comfortable doing that on their own, but I like to do pellets, I have hundreds of patients that use pellets, and that's their choice. And you can do estrogen and testosterone pellets, okay. But for a woman, we still give them oral progesterone. So the pellets of course, are placed subcutaneously and they're compressed is a compressed hormone that's an appellate that is a slow release. So as the cardiac you know, function increases like exercise, physical activity, and so it slowly releases it directly into the bloodstream. So what you can get essentially is a nice sustained release over a long period of time and long meaning for some women is three months. For some, it's four months for some is five months. Okay, I also do male hormone pellets as well, I do testosterone pills for my male patients as well. So I'm gonna gynecologist, but I tell them, hey, if you don't mind seeing your gynecologist, I can take care of you as well. So, but yes, you can do extra dial, as well as testosterone pellets, and it's a slow release, that's over, like I said, three, four or five months, it just depends on a woman's, are in demand metabolism, how quickly it's released, how quickly they use it, and it gives them a nice steady level of, of release of the hormones into the bloodstream.

Jade  35:42 

That's great. That's great to know. And, and, you know, we would be remiss, you and I, in this conversation, if we didn't cover something that comes up a ton. And maybe we can sort of have this discussion and here, but obviously, people when they're thinking about hormone replacement therapy, they tend to think, Oh, I'm gonna lose weight, you know, and we kind of know in the research that and I'll just give you my reading of it, and I want and then we could talk clinically, what we've each seen my reading of the research with, and of course, there's not as much of the bioidentical hormone research is that typically, these do not cause weight loss in women, Some research suggests that it may actually slightly increase weight. However, what we do see in a research pretty clearly is that it does seem to have a pretty profound effect on mid fat belly fat, it does reduce seems to reduce belly fat in women. I know this is confusing for some women. So they're like, Well, I'm not losing weight. But I'm actually losing belly fat. Part of that might be the fact that it's helping maintain muscle mass. Remember, estrogen is like a weak testosterone in a sense, and its ability to help maintain muscle. But it does seem in the research, that it does help to maintain that beautiful hourglass shape that women tend to lose as they move into menopause. Now, clinically, we see things a little differently. And of course, I'm doing a lot of lifestyle medicine. So I've always seen it be pretty advantageous for both weight loss and body shape changes. Now, of course, I'm using diet and exercise along with the hormone replacement therapy. But I'm curious from your clinical experience, what you see are the people who are just doing HRT, and no diet and exercise seeing any results, or is it that doesn't have to come along with diet and exercise? Are you seeing this reduction in belly fat? Give us a little bit about your clinical experience with the weight loss ability of these bears?

Dr. Harris  37:32 

Sure. And I'm so glad you asked that question. And I'm so glad that you shared your clinical experiences. Because you are so right. You know, we do know that of course, you know, as women start going into from that perimenopause, and menopause, like all of a sudden, this midriff comes on right out of nowhere, they're doing everything same as far as their physical activity, their eating habits, etc. But here's this come. So we know that of course, there is some change in metabolism, the change in the hormones that's going to cause that. So yes, so we do know that you know, helping to improve the estrogen. That hormone when on your say hormonal balance is going to be important, but I also share with them, you know, we're looking at everything. So I'm looking at your thyroid function, um, you know, we know looking at your stress level, you know, what your cortisol may be, you know, contributing to this, what is your insulin resistant, potentially being a factor, you know, so there's so many things that happen around the same time. So you're right, there's many things that can happen. And it's not, I tell my patients all the time, it's not just the hormones alone is not about me, just giving you hormones, and all of a sudden, everything is going to get better. No, you do have to have lifestyle, you know, factors in there to make sure that you're that you're looking at everything. So you're right, I do have some times if a patient is not really diligent with making sure that they're keeping the things healthy with the whole package that they can start noticing increase with their weight when they go on, you see, and so it's kind of Whoa, Where's this coming from? I said, Well, we have to you got to work these hormones, you can't just use hormones and just sit still, you know, you have to do things to help it work in your body to get to the tissues, where it's working, help with your metabolism, etc. So, you know, it's not just fixed hormones and sit around and do everything badly. And think that that's going to be the quick fix. It doesn't work that way. So you're right, it does require everything. It requires a full scope of looking at everything if you really want to make a full difference, but we do know that yes, the hormonal changes. Sometimes alone can be one of the things but there's other factors to keep in mind that have to be part of the protocol. Well, if I can put it that way, so

Jade  40:01 

yeah, and one thing you brought up, which I think is a critical thing that people should understand is I also have seen it pretty clearly in my clinical practice of a lot of times people will blame when they think hormones, they'll tend to think estrogen, progesterone, testosterone. And if you listen to what Dr. Leita said, she's actually saying, hey, wait a second, you know, there are other hormones, perhaps more important here, insulin, cortisol, these other hormones that are sort of playing a role here and one thing that my listeners at least know Dr. Leita, or they should, as I oftentimes talk about the idea that whenever you try to speed up metabolism, which hormones will tend to do, they will speed metabolic rate, there is a certain subset of individuals who will in response to that began to overeat. You see this with exercise, you see this with cold exposure, you see this with hormone replacement therapies and those kinds of things. We also know that fluctuations in estrogen and progesterone do have a role in thyroid. And so it's really interesting, what Dr. Leita is pointing out to us here, if you are seeing changes in weight, perhaps going up, you want to look at, okay, what happened with my thyroid function? What happened, what's going on with my eating. And so this is one of these things will help diet and exercise and lifestyle changes make a bigger difference. But they do not seem to work, at least in my clinical experience. And Dr. Leitas seems to be saying the same thing. in isolation, you're still going to need to be able to do the things that we know are necessary, it just might come a little bit easier. Once the hormones are on and having a doc like Dr. Leita to look at all these other things, what's going on with cortisol, what's going on with thyroid function in particular, can be incredibly helpful. I am so appreciative of your, you know, sort of background here and your clinical experience, it's always really nice to talk to a woman obviously, I've never had a menstrual cycle, I'm never gonna go through menopause. So I think it's really nice for me, despite the fact that I work with women, mostly, it's really nice to have a female clinician Come on, and, you know, sensory speak to this stuff. I think he just brings better credibility, and it's more important in these discussions, to have a woman specialist, is there anything else that you would like to leave us with that you feel like, you know, what, Jake, we didn't mention this, or we didn't cover this, or any final thoughts that you might have?

Dr. Harris  42:14 

Well, I mean, and I appreciate again, you having me come on and speak, you know, I, I, this is something that not only am I helping my patients with, but you know, hey, I'm 61 years old, I started my stuff when I was mid 40s. And I am on my hormones, I'm on a bunch of supplements, I'm doing all kinds of things to support my body. So I'm not just talking about it, I'm walking, I'm doing it. And so that just lends itself to just the importance of what I see as the benefits. I mean, I have patients that ask me all the time, how long do I need to stay on this? You know, and what I tell them, I said, Well, how long do you want to feel good? How long do you want to feel good? I have patients that are well into their 80s. I mean, I think the most senior patient I have is 86 years old, and she's still you. She's this palette, she still gets her pellets every six months. I have several like in their 70s and things like that. So again, we're talking about longevity. There's no magic cut off point. There's no such thing as like, oh, okay, I got to stop my hormones at 65. Why? You know, why? Why is that? You know, so what do I do now? Do I just go in a corner and shrivel up and die and age, you know? So it's not about just looking at some arbitrary number to stop, you know, hey, if you're healthy, if you're feeling good, if there's no contraindications, by all means, hormones can be used, you know, for the rest of your life. And so I think that's important for people to understand as well. It's about longevity. And, you know, hey, if there's nothing else that would warrant you stopping it, for whatever reason, by all means, you know, hey, we can use hormones, as long as we want to just keep on feeling good. And vanity as well. Looking good, right.

Jade  44:05 

And if you don't mind me saying that elite, I mean, what a testimony you are to these therapies. I mean, you're absolutely beautiful. I can't believe you're 61 I cannot believe you're 61. Like that kind of blew me away. And I'm sure you get that a lot. And these hormones do a lot in that realm. Right. They're great for skin. They're great for your brain. They're great for a lot of things. So absolutely. That's kind of cool to have that testimony. If you're I'm sure your patients are blown away. Oh my god, you're 61 That's nuts. Thank you so much for being here. By the way everyone. So I'm Dr. Leita is available through evolve. That's how we got connected Evolve is a you know a sponsor of this particular podcast and she is also in private practice if they want to keep up with you. Where can they get in touch with you besides evolve? Is there any Are you on social medias or anything like that or active anywhere online?

Dr. Harris  44:54 

Sure. Yeah, no, I My website is nurturing you that comes to my my private practice is nurturing you women's health and wellness. I'm in Southern California. I do do telemedicine visits as well. But my website is nurturing u.com. So and you are Turing y o u.com. I am on social media as well as Dr. Leita, that's my Instagram is Dr. Le ITA. And of course through we also do nurturing you also have a Facebook page as well. So, so of course, if you want to find out more information, visit our website. I have a lot of information there. And, of course, social media, we do our postings as well. So thank you.

Jade  45:35 

Yeah, well, so everyone, you all have now a new hormone expert who's been doing this for a very long time. She's also a patient, she can probably give you a ton of good information here. Dr. Leita, I am so appreciative of you, thank you so much for being here. I'm gonna go ahead and stop the record. But if you don't mind, hang on just for a minute because I want to make sure this gets all uploaded. And Thanks so much everyone for being on and we'll see you at the next ship.