What is HRT? Who should be considering it? How are we going about this?

Yeah.

Well, I'll start with saying that we don't have a female framework in our medical system, right? Like, when you go to a primary care doctor, aside from maybe getting referred for a mammogram versus a, you know, pink, well, p- a prostate screening, there's not a lot of difference, right? In the way that a, a doctor is evaluating you as a woman versus a man, but we have a totally different operating system.

And my philosophy, I coined the term hormones first because I believe that for women across the lifespan, not just in perimenopause and menopause, if we're gonna do our job and our due diligence as healthcare providers really evaluating how well they are, how well their metabolic health is, how well, you know, their brain health, their gut health, all of the things, we really need to be looking through an endocrine first framework.

Because women, so much, and you know this because you're in the fat loss world, right? So much comes from what's happening in the endocrine system first, and things can go awry with that across the lifespan, not just in perimenopause, not just at age 45 or 52, right? Everyone's familiar with that chart that shows how your fertility falls off a cliff after 35.

Do we all have that image burned into our brain, and we have this sort of, this number and this deadline that we, you know, internalize as women? But we're not extrapolating that and saying that after 35 your hormone architecture is changing.

Does that mean that you need to go on a full-blown HRT plan at 35? No.

Ooh, why not?

wanted me,

which is, you know, their loss.

And a friend said, why don't you start your own practice? And I was pretty reluctant, I think, because many clinicians, as you know, are not told that they can start their own business.

They're not taught the skills.

Any of the stories that I knew about starting your own business were horror stories like practices that will make you broke.

You'll end up divorced.

You know, your life will suck.

Wow.

Yeah.

Right? And I think it's important for people to remember that when the patch was first developed, it was FDA approved for hot flashes, right? And so symptom resolution of hot flashes was the only outcome.

That was it.

We weren't having this like longevity conversation, this chronic disease prevention conversation.

In fact, I mean, in the guidelines, it still isn't really standardized, right? There's not standard guidelines around prevention and HRT as prevention.

So many times the patch dose is too low, right, to produce physiologic benefit, which I know that your audience understands, and we see typically that, you know, with the highest dose patch, right, even many people still don't fall into a range that is gonna confer bone protection.

So in particularly in a perimenopause population, I think this population, again, for so long has just been put into the bucket of management.

No.