Are you feeling lost in the maze of menopause and perimenopause? You’re not alone! Join host Heather Carey as she dives deep into this often overlooked yet critical phase of women’s health with Kristen Mallon and Michelle Whispelway, the innovative co-founders of Femgevity. Together, they explore how to empower your menopause experience through personalized healthcare tailored specifically for women navigating these hormonal changes.

In this enlightening episode of Real Food Stories, we shine a light on the inadequacies of traditional gynecological care and how Femgevity is redefining the landscape of menopause health. Kristen and Michelle share their insights on the importance of hormone testing and the benefits of hormone replacement therapy (HRT), which can play a vital role in preventing long-term health issues such as osteoporosis and heart disease. With a focus on customized care, they emphasize how empowering women with knowledge can transform their experiences during this transitional phase.

Listeners will gain valuable nutrition advice and healthy eating tips that can support their journey through perimenopause and menopause. Discover how personal food journeys and mindful eating practices can contribute to overall well-being during this time. Kristen and Michelle also address the stigma surrounding HRT, advocating for open conversations about women’s health and the importance of education on menopause.

Join us as we unveil the seven pillars of abundance that can help you thrive in midlife, with a focus on heart health and the Mediterranean diet. This episode is not just about managing symptoms; it’s about embracing a healthy lifestyle that empowers you to take charge and empower your menopause journey. With the right support and knowledge, you can navigate this phase with confidence, making informed choices that align with your personal food beliefs and cultural influences.

Whether you’re experiencing weight loss journeys or seeking to overcome food confusion, this episode is packed with practical cooking tips and insights from Heather, a culinary nutritionist who understands the unique challenges women face. It’s time to empower your menopause and celebrate midlife body positivity! Tune in to Real Food Stories and discover how to make informed decisions about your health and nutrition as you embark on this transformative journey.

Don’t miss out on this opportunity to learn from experts who are passionate about women’s health and nutrition. Listen now and start your journey towards a healthier, more empowered you!

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Transcript:

Speaker #0
Well, hello, everybody, and welcome back. And if you are just tuning in with me for the very first time, it’s so nice to meet you. And I’m really glad you’re here with me today. I am your host, Heather Carey, nutritionist, chef, mom, and a woman who has been around the block with food. I want to open up about real food in relation to health, weight, and our bodies so you can make peace with what you eat. Hello everybody and happy spring. I have been giving so much thought and attention to the topic of perimenopause and menopause because I think that it is that important that women get well educated on this extremely important time of our lives. Menopause and perimenopause happens to every woman. you do not get a hall pass. So I want to give you as much information as I possibly can from a nutrition standpoint and just from an education standpoint. So today I had the privilege of speaking to Kristen Mallon and Michelle Whispelway, founders of Femgevity, which is a telemedicine company focused on menopause. and Feminine Longevity. They provide concierge care for women seeking personalized health care. You call them, they take care of you and all of the things that have to do with your hormones and menopause. It is a fantastic service in this day and age of doctors really not being specialized in menopause and hormones. I would highly recommend if you are curious about hormone replacement therapy, what it is, what it can do for you, and all the other hormones that go into it. Give this one a listen. It’s a really important talk that I had with them, and I think that you are going to love it. Today, I have Michelle Whistleway and Kristen Mallon with me. Michelle and Kristen co-founded Femgevity, a telemedicine company focused on menopause and feminine longevity. providing concierge care for women seeking personalized health care. Michelle is a visionary leader in the femtech and digital health care industry, leveraging her passion for travel and art to create innovative solutions that increase access and reduce long-term health risks for women of all backgrounds and ages. With her sharp ability to identify gaps in patient care, Michelle has successfully coached top-ranked health care experts to drive organizations. for its clear and efficient pathways, and her telehealth platform designed to provide integrated services for women is a testament to her ingenuity. And Kristen is a board-certified nurse midwife, menopause and feminine longevity expert, breast health expert, published author, and mother of four. She graduated from the University of California, Berkeley with a degree in psychology and completed her bachelor’s degree in nursing at Johns Hopkins in Baltimore. So welcome, Michelle and Kristen. I’m so happy to have both of you on the podcast today. So the business of menopause, it is booming right now as far as I see it. And I am all for it because every single woman on this planet will go through menopause and it can affect women for decades, the downside And in my experience is that many doctors, including gynecologists, are, I think, totally in the dark about how to really help women. And I’m going to guess that both of you saw this as an opportunity to start your business. So tell me about Femgevity, how it got started and how it helps to fill in the gaps in health care for women.

Speaker #1
So Femgevity is a digital telehealth company, as you said, and thank you for having us. We’re really excited to be here. So this is an honor on our part. And, you know, we fill in the gaps on this one size doesn’t fit all for women to ensure that anytime throughout this menopause journey, they have someone to turn to with questions, someone to guide them through their unique and evolving experiences to alleviate confusion and fears. And we just treat each woman as a unique individual to make sure they’re seen and heard. And there’s some vital stepping stones that we help them through to really empower them to redefine their relationship with aging. And, you know, this level of sustained and individualized care that we give for concierge care is really groundbreaking and you don’t see it anywhere else. And we offer cutting edge precision medicine services with it at an attainable price. And menopause comes with 100 plus symptoms. So. Women have debilitating joint pain. They have heart palpitations that could lead them to fear of heart disease. They have anxiety and depression and they’re overprescribed these medications when really it’s a, you know, it’s a depletion of their estrogen levels or progesterone, whatever it may be. So, yeah, that’s really where we kind of came to grips with creating Femgevity and coming together for it.

Speaker #0
Yeah, I think that the one size does not fit all model is good because, just at least in my experience, and I know the experience with just other women I have spoken to, is that you either, you go into your gynecologist’s office and either they have some education around menopause or they don’t. And they just give you the one size fits all hormone replacement, or they even talk you out of it. which I think is sometimes a little unethical. They do. Yeah, I mean, I’ve had doctors who are just so uneducated and have said, you know, I’d rather go to jail than have to take hormones. And how could you be taking hormones? And so I think getting tested and really looking at each woman as an individual is so important. And you’re right, there are dozens of different symptoms. So tell me how it works when a woman reaches out to you. And what is the advantage of something like a concierge service versus just finding a gynecologist?

Speaker #2
Yeah. So when a woman is looking to kind of get help with any perimenopausal or menopausal symptoms. And I always kind of encourage women that if you’re experiencing something, even as early as your late thirties, 38, 39 into your forties and fifties, you should, even if it’s something that you wouldn’t necessarily equate with a hormonal change, like it doesn’t relate to your period. Maybe it relates to sleep or relates to mood changes. It’s good to stop and think, could it be hormonal related or could it be perimenopausal related? Because so many things like joint pain or things like bloating and gas pain and, um, gas, abdominal change or gastrointestinal changes are associated with perimenopause and they’re kind of brushed off as something else. So I always really encourage any woman really 38 plus to kind of consider, is this a perimenopausal menopausal or postmenopausal concern? And so they can come to our website with it, which is femgevityhealth.com and schedule an initial consultation. We usually go through a About an hour, you know, 45 minutes to an hour is how long it kind of takes to kind of go through and really understand everything that’s going on with a woman, where she’s at, what her family history is, how different people in her family have kind of experienced menopause, so that we can get a really good picture of where she’s coming from, where she’s potentially going, what questions, what concerns she has. Then we usually come up with a comprehensive laboratory. analysis recommendation. So sometimes it’s just regular general hormone balancing, hormone testing. Sometimes it’s what you would get at a regular annual exam, like your hemoglobin A1c and your CBC, which is a complete blood count and your chemistry levels and cholesterol levels. And sometimes it’s more involved precision medicine testing, which includes gut microbiome testing or micronutrient testing or genetics or genomic testing. or epigenetic testing. So we kind of really meet the woman where she’s at in terms of like how far down the rabbit hole of her own health does she want to go. And then we kind of start peeling back the layers to having her feel optimal. It doesn’t usually happen all in one visit. You know, Rome was not really built in a day. And a lot of times women wait really long. They wait until they’re feeling pretty bad. They’re pretty far into the symptoms. You know, on a scale of one to 10, they’re rating their symptoms as a 10 or nine. And so it takes a while for us to kind of peel back what’s happening, solve one thing at a time. You know, we solve the tens and the eights and the nines, and then something else will come up. And then she’ll be like, it’s like the gateway theory, like something will. was bothering her like insomnia or hot flashes on a 10, then we solve those. And she’s like, well, actually now I’m feeling constipated and bloated and I have abdominal weight gain. So then we solve that. So we usually work with women on a month to month basis. So we’re checking in with them every month and adjusting with them as the months go on, because when you’re going through perimenopause and menopause, a lot is changing month to month still. And you’re not kind of in that consistent cycle that you’re experiencing in your twenties and thirties. You’re in a much more. evolving cycle now in your forties and fifties, even when you stop menstruating, you’re still sometimes having a cycle.

Speaker #0
Yeah. You can, you’re sometimes like in a, I likened it sometimes to like, you’re in a hurricane. I mean, you’re so, you know, I mean, at least that’s been my experience. I mean, so I know some women just float through menopause. I mean, they’re like barely even notice. And that has not been my experience. And I definitely started having menopausal symptoms. in perimenopausal symptoms. I mean, when I was probably in my early forties, but I had no idea. I mean, and that’s, and that’s a question because you said, you know, women should start to come to see you in their late thirties. I honestly, I had no idea. I knew that there was menopause, but this whole concept of perimenopause, no one really told me about that. I mean, no one really educated me and no one was talking about it, including my gynecologist. So how would women know to come to see you in their 30s? I mean, is there a movement to start really educating women more? Because we don’t learn about this in health class. I mean, even we learn about our periods, you know, in like health class at school. But learning about perimenopause and menopause is, I don’t know. I mean, I remember asking my mom, you know, like when she went into menopause. She barely remembers. She doesn’t really, you know. So what do you think is the future for just educating women? And I agree with you. I think starting right, knowing that like in your 30s, you should start thinking about this and getting yourself set up is a great idea and a great plan.

Speaker #1
So one of the things that, you know, we are going to be doing at Femgevity and you see a lot of other. you know, menopause companies doing is creating these communities and for where women could speak freely, private, privately about it and educate each other on what’s going on. And I, you know, I think there’s a lot to be said about a lot of, you know, social media that talks about their experiences and what they’re going through it. Um, you know, even as. you know, influencers, right? When they’re talking openly about how they’re going through it, what they’re doing, what they’re feeling, how their partner feels about them going through it. And it’s not just about education and community for the women, but it’s also education and community for the men. And the more we start doing this, we’re ingraining it in our daughters. and younger generations to be more open about speaking about it. And this also goes into play in the workforce too, right? The more the workforce ingrains and companies ingrain in this community to have education and, you know, paid leave and time off towards menopause, because this is, it could be anywhere from like seven to… 10 plus years of your life, depending when you start going through perimenopause symptoms, that is also going to trickle down into younger generations to be more open about it. And it’s just, and I think it’s just, you know, I speak to my young daughter about it and changes, and it’s just being, it’s going to take time. You know, this femtech world was coined in 2016. And I think we’ve made amazing strides since then, even if you look in the past year of just how much menopause has been spoken about, about things that get spoken about in the New York Times and the Washington Post. And Kristen and I being here today speaking to you about it just shows that we have there’s a lot of longevity that we’re going to get out of it. And it’s also, it hasn’t been spoken about because it’s not been seen as this sexy phase in life, but we’re changing that.

Speaker #0
Yeah. Well, I think it, right. It hasn’t been spoken about in like my mother’s generation because it’s just like something you have to go through, right? Something you have to just kind of go through and get out onto the other side. Or I don’t know, honestly, my mother is like, I don’t even remember going through menopause. Like you had to have remembered something. Thank you. You know, she blanked, she blanked it out, but I agree with you that, that, you know, that is probably the benefit of social media. You know, one of the benefits is that I think the conversation is, is happening and starting to happen and that it can reverberate through social media. Now, I mean, there’s a lot of,

Speaker #1
yeah, that’s very controversial.

Speaker #0
There can be a lot of like quackiness on social media, which drives me crazy. But I think. just continuing to have the conversations. And like you said, you talked to your daughter about it. I have a daughter who’s in her twenties and I certainly am very open about it because I want her to, to know what’s, what she’s going to be up against, you know, in, in, in a number of years. So I think that’s, and I, and, and the communities too. So it’s, it sounds like you are starting. Is that something that you do now?

Speaker #1
We are. And we’re actually even actively building out our website for Section for Men. Because we have partners and spouses that reach out to us on a daily basis of the woman in their life going through these situations and they don’t know. And it’s a real, you know, our marketing company actually found that 50% of the Google searches are men too, but they don’t speak about it.

Speaker #0
Interesting. That’s very interesting.

Speaker #1
Very.

Speaker #0
So I wanted to just. now like circle back about, you know, what you do at Femgevity, you mentioned that you do testing and tell me a little bit more about that, because that sounds very individualized. When I went to see my gynecologist who I actually, I had to go through a number of gynecologists and now I have one that I like, but they were just like, oh, you’re having a hot flash. Okay, here, take this, you know, so there was no testing. I mean that, you know, and so tell me about. the benefits of getting tested, what you do and how that then individualizes your treatment plan.

Speaker #2
Yeah. I think that, you know, what you’re talking about kind of with your experience about going to a lot of different doctors is really one of the fundamental reasons why we started Femgevity. And it’s, you know, not that I’m looking to get my OBGYN physicians off the hook, my colleagues off the hook, but so they’re kind of. defense, I think it’s not really fair that the medical institution has forced on them to be experts in so much when it comes to women’s health care. And we haven’t, and we are starting to now take women’s health care much more seriously. To think that someone has to be an expert in pregnancy, obstetrics, delivery, the complications and the surgeries that are required for that specialty. Then they also need to be an expert in gynecology, gynecological surgeries, and the complications that go along with each of those. And then they also need to understand endocrine and the hormonal changes that are happening with a woman. It’s a lot to put on one physician. And most physicians get their education about menopause from drug reps that come in to see them and try to sell them on a patch. And so it makes sense why women are lost. And that’s why we really feel very emboldened and empowered to kind of bring this message that women should seek menopausal specialists or someone who, you know, like myself, I call myself a menopause expert who has the confidence and the know-how to use multiple different modalities and multiple different treatment options and multiple different testing options, like you mentioned. So the different types of testings are kind of as wide as how a woman kind of sees her own health. you. We do standard testing. So the kind of like what’s generally covered by your health insurance, which includes, you know, basic hormone testing, basic annual blood work testing. But we also offer much more extensive testing. And this is for a woman who’s kind of looking for a functional medicine approach or an integrative medicine approach or precision medicine approach, which really encompasses so micronutrient testing, which is really more the nutrients on the cellular level, the plasma level, rather than just the blood level, you know, making you can test you you know, vitamin B and zinc and magnesium on a serum level, on a blood level. And your blood is going to, your body’s going to do a really good job of trying to keep that perfectly balanced and pulling. vitamins from other places, but when you get to a micronutrient level or a cellular level or metabolite level, you’re able to see where true deficiencies lie. And so this testing, you know, usually runs about several hundred dollars a test, but gives you a much more comprehensive view of all types of amino acids you could be deficient in, what type of organic acids, omegas, what types of heavy metals might you have toxicity in, every single vitamin that you could possibly imagine under the sun. the fat-soluble vitamins, the water-soluble vitamins, all the B vitamins, things like glutathione and other antioxidants. So it’s a very comprehensive bird’s eye view of what’s going on. We also have, you know, the gut microbiome is very important and how you absorb things through your gut will also affect how you metabolize a lot of your hormones. And so that’s a much more comprehensive and usually a little bit of a longer approach to hormone balancing, but some women do pick the gut microbiome. biome balancing way to balance their hormones. So that’s usually a stool sample that’s sent out for analysis. And, you know, you can find everything under the sun from pathogens to yeast to SIBO, which is small intestinal bacterial overgrowth. You can find out if you have how much good bacteria, how much bad bacteria, what type of digestive enzymes are being used, how the bile is excreted. If there’s blood in the stool, what type of blood, what type of um, how immunoglobulins are present, if there’s any inflammation, what type of inflammation, what types of sensitivities are found in the gut. So there’s a lot of information we can get from the gut itself. There’s also genetic testing. So there’s a lot of different types of genetic tests that can be run in terms of nutrigenomic testing. And this is fascinating to me. So, you know, it was very, it’s a big popular test is the MTHFR test. That’s a test that a lot of people know in women’s health because it affects pregnancy. It affects how we metabolize folic acid. folate versus folic acid. And that, you know, a woman who has an MTHFR mutation, homozygous for certain types of MTHFR mutation to need specific types of methylated folate. So, I mean, that might be getting like a little too nerdy and sciencey. So there’s that example and then times about 3,000. So we have about 3,000 different known genetic SNPs that really play a role into how we metabolize. Just yesterday, I was in a consultation with someone and it was really cool because we had, she had done a lot of testing. And so she had done a micronutrient test and then the genetic test takes much longer to get back. And then when her genetic test came back, we were able to see why she had all these nutrient deficiencies and then what, what we needed to do to correct them. So that was really, um, it’s really kind of satisfying to see all of it come full circle in, in ways like that. And then, um, we also offer epigenetic testing, which is another kind of much more experimental type of testing where you can, this is where you have different companies that are looking at biological age and they’re looking at like the epigenome is the layer above the genetic code that turns genes on and off. So you might have a gene for lupus, let’s say, but if that gene never gets turned on, then it’s not something that you would ever even know of or experience in your lifetime. So there’s a lot of different ways that mainly through methylation and oxidation that epigenetic tests are kind of being run nowadays. And I think that that’s one of the biggest ways that we’re going to kind of see technology come into play is with the genetics, nutrigenomics, and epigenetic tests that kind of come about in the next months, years, five years. I think that there’s going to be major, major strides made in that department. So I think that’s really exciting. And that’s kind of a lot of fun, a lot of the fun things that we do. We also do, we also offer a genetic cancer screen as well. And so that’s because we do a lot of longevity in addition to menopause management. We also do look at cancer genetics as well. So that’s kind of like the whole picture of the different types of precision medicine testing we offer. And then depending on what a woman is kind of interested in learning or the approach that she wants to take, because if you’re kind of going through the gut microbiome approach, that usually requires a lot of different changes in the diet and a lot of times of supplementation and kind of gut balancing versus, you know, doing a hormone balancing or doing a micronutrient balancing.

Speaker #0
So that’s a lot of testing. I mean, and I just want to circle back to one thing that you said is that, you know, doctors are sometimes expected to be experts on everything. And that But I agree with you. I think that they’re not… And shouldn’t be experts on everything. I see as a nutritionist, like I see women come in and they complain that their doctors don’t know anything about. food and what to prescribe to them and like, you know, what, what they should eat. And, and I say that to them all the time. They’re not experts. They’re not nutritionists. That’s why you’re coming to see a nutritionist. They, they can’t be expected to be experts in everything. And so I think that’s a really good point is that we sometimes have expectations of our doctors to be the be all end all. And, and so then it’s nice that there’s a company like yours that just specializes in women’s longevity. Now going back to the testing. So that’s a lot of testing. Is that something that you expect women to do? I mean, if I walked into your company, or if I called you up and said, I’m just, I am suffering from like hot flashes and therefore I’m like sleeping at night. Would you recommend all this testing or is there just something as simple as like, Yeah, just hormone testing.

Speaker #2
Yeah, so… You know, we have kind of two tracks. So we definitely have the track of women who are kind of looking for menopause symptom management. And those are the women that we kind of just recommend the general hormone testing. But we have the longevity track where women are looking for, you know, the four horsemen of disease. So the four horsemen of disease, I think, is really cancer, metabolic disease, cardiovascular disease, and then neurodegenerative disease. And women kind of tend to know their own family history and to be concerned about too. That’s just kind of been my experience kind of counseling women about longevity medicine in general, is they come in and they say, I have a strong cancer history in my family, or, you know, a lot of cardiac. My mother had, her mother had a heart attack. My father had a stroke. And, you know, they kind of are aware of two of the four that are something that they’re kind of worried about. So that’s when we kind of steer them towards those types of testing, when it’s something that they kind of want to understand about themselves more, more on the longevity track, when they’re like, okay, I want to understand what my cardiac risks are. And I want to understand what my cancer risks are. Or we might recommend gut microbiome testing if there’s, if they say, I want to understand what my metabolic risks are because I have diabetes or liver disease or kidney disease in my family. So that’s really where those kinds of precision medicine tests come into play. Sometimes we do have women who… are coming in for hot flashes and they are really, for whatever reason, you know, they are very hormone adverse. They don’t want to be taking hormone replacement therapy. And so they do kind of want to go down a more natural route and are interested in more of a micronutrient test, or they’re interested in more of a gut microbiome balancing test to see how far they can get with those tests and balancing their system that way first before they consider hormone replacement therapy, but it kind of runs the gamut. for all different types of women and all different kind of desires. And that’s what we really mean when we say like concierge customized precision medicine is we really meet the women where they’re at and we try to kind of understand what their goals are and then make recommendations based off of that.

Speaker #0
Yeah. I mean, it’s exciting that you can really uncover all of this genetic testing and really find out about your, your just. your genetics, how things affect you. And, and there’s a lot of information to be had. Sometimes it can feel a little overwhelming, right? There’s like almost like too much for me sometimes, at least, you know, like too much information, but, but I think it is really exciting, especially if you do have health concerns and health histories that would warrant that.

Speaker #2
What’s really cool too. Sorry. Just one other thing too, the genetic testing certainly isn’t for everyone at all. And, you know, it’s, runs around $300. It’s not really, it’s not really necessary. Sometimes exactly like you said, it gives you like way TMI, like way too much information, but sometimes it is really helpful. Like we found for people that have like just these like totally elusive symptoms that like they’ve, you know, they’ve spent years trying to uncover certain conditions. Like they can’t get to the root of it, you know? And a lot of times like women that are maybe diagnosed with fibromyalgia pain or nerve pain, or just kind of these vague. vague symptomatic pain or arthritis at a really young age, those are kind of when we’ve had success with the genetic testing. A lot of times for other women, it’s kind of like exactly like you said, it’s like drinking from a fire hose. It’s just way too much information and it’s not necessary either. You know, you get a lot of what you need from their symptoms, from their regular testing or, you know, micronutrient tests and that’s plenty. So that’s kind of how we’ve used that too.

Speaker #0
But it is enticing too. unearth things and uncover things and get to the why of some symptoms. It is, you know, so that is, that’s very exciting. I’m so curious about… You mentioned that you could do this microbiome testing if women are averse to taking hormone replacement therapy. And I want to get into that too and the pros and cons of that. But microbiome testing and then address hormone imbalances or menopausal symptoms that way. How do you address menopause symptoms with microbiome?health or, you know, what?

Speaker #1
Yeah. So we don’t, we’re not necessarily using the microbiome testing and replacement as just treating alone menopause symptoms. So every woman, like Kristen said, these genetic, the microbiome, the epigenetics, the nutrigenomic testing, those are all optional, but our number one assay that we do recommend to be able to treat a woman’s menopause symptoms properly is a hormone assay, which is an in-depth hormone, you know, it’s about, we run, I think maybe it’d be like 15 to 20 panel hormone assay and really allows us to get granular on like various different levels to give a woman that personalized treatment plan, whether she needs like bioidenticals or nutraceuticals or a supplement. or just maybe some alternative medicine options, things like, you know, it could be as simple as, you know, an acupuncture, things like that, but we’re not substituting a microbiome test and using that exclusively to treat on menopause symptoms. So a lot of things that women don’t realize is that if your gut microbiome is out of sync and, you know, it’s not aligned, it could actually affect your estrogen levels. And Kristen could talk more on that from the clinical side. But- It’s that’s something that we would use in conjunction. And that’s really where our longevity medicine comes into place. And that’s one of the things that like differentiates us because we have this hormone balancing menopause management and it’s tied into longevity medicine, which is figuring out, you know, your health span on how long you could live healthy to prevent disease. And part of those tests that we offer in that bucket are disease prevention.

Speaker #2
So using the gut microbiome to your point is, you know, sometimes women, we do run the hormones, but sometimes women will want a go at balancing the gut first before they will take hormone replacement therapy or bioidenticals. And some, in some cases that works and that’s all a woman needs. So it’s really interesting because menopause women are so different, just like pregnancy. So, you know, 80% of women in pregnancy experience nausea and vomiting through pregnancy, but 20% of women. don’t and they don’t have any nausea or vomiting and they kind of sail through their pregnancies and we all have had friends like this i’m sure that are like oh pregnancy is no big deal i had my kids and i could be a surrogate right menopause is really no different um and similarly with pregnancy you know you you do have women who can you know take the ginger tabs and wear the c-bands on their wrist and kind of get through with things like that with menopause We do tend to find that hormone replacement therapy or bioidenticals really are the gold standard. And the majority of women do phenomenal on them. And it works wonders. And they feel absolutely optimal. But for some women, they can get by with alternative treatments, including gut microbiome balancing.

Speaker #0
I think that there is a stigma for hormone replacement therapy. I mean, a lot of women that I know, I mean, I think we all know about that study that happened in the early 2000s, right? The hormone study. Yeah. And that just scared the daylights out of everybody. And a lot of women went off of hormone replacement therapy. And then that’s been debunked, that study. But I think it’s reverberated all the way through. And I think that a lot of women are really scared. I mean, they’re scared of medicine. I think in general. So they’re just like, this is just another medicine that if I don’t have to take it, I won’t. But I see women struggling and suffering and losing sleep and having hot flashes all day long. So let’s just talk about the benefits of hormone replacement therapy. And then I also want to talk about this, you mentioned bioidenticals versus hormone replacement therapy, because I think that… also has a lot of confusion.

Speaker #2
Yes.

Speaker #0
A lot of women think, well, if I’m going to go on something, I’m going to do it more naturally and I’m going to go on bioidenticals, but there’s a lot of unregulation with bioidenticals, right? You can literally walk into Whole Foods, I think, and like buy progesterone cream. So I want to just talk first about the benefits that you see with hormone replacement therapy.

Speaker #2
Yeah. So, and I think to your point too, you know, you talk about when you go into your OBGYN or your internist and they talk to you about the risks of taking hormone replacement therapy, they also should tell you about the risks of not taking hormone replacement therapy because it is known that hormone replacement therapy, specifically estrogen, has cardiovascular protection effects. It has bone loss protection, and it also has cognitive and Alzheimer’s protection. So those are like the, aside from what it does for vasomotor symptoms or hot flashes. along with the plethora of other symptoms that go along, the loss of libido, the vaginal dryness, the sexual dysfunction, the mood changes. The depression, I mean, the list is over 100 symptoms long. The longevity benefits, which is why we’ve tied longevity into menopause in this company, Femgevity, because we feel that when reproductive longevity ends, women are ready to have the conversation about long-term longevity. And it starts with menopause, the conversation about perimenopause and menopause. So those are like the significant… major significant benefits of hormone replacement therapy, whether using bioidenticals or I call them pharmacologics because some pharmacologics are bioidentical and, and vice versa. Um, so, you know, in addition to the reduction in symptoms and the really good thing about using, um, hormone replacement therapy is it doesn’t have to be forever. It’s not something that is going to be it the doses can be adjusted and changed as your symptoms change so it’s not like a statin where you start taking a statin and then you’re on a statin for the rest of your life you know hormones are meant to be to are meant to kind of ebb and flow and also to to adjust as you adjust and um so i’m very pro hormones and hormone replacement therapy obviously starting a company like pangevity

Speaker #0
Tell me about your version of bioidenticals, because like I said, I mean, I feel like you could walk into, you can get them anywhere. They’re very unregulated. I mean, out in the real world.

Speaker #2
Yes. Yeah. So bioidenticals, you know, are meant to be synonymous with what you actually produce in your body. So they’re meant to be chemically identical. And so there’s kind of a lot of confusion because… for example, with progesterone. So progesterone or micronized progesterone, that’s the only way it can really be stable enough to be utilized topically or even orally, is a bioidentical progesterone. It’s the exact same progesterone that your body produces. This can be, you can get this, like you said, at Whole Foods in a lot of over-the-counter products. There’s even an oil that we recommend to some of our patients that are looking for very low dose of micronized progesterone. There’s also bioidenticals that are sold by compounding pharmacies. So these are pharmacies where they make their own formula of the medication. And then you can also get micronized progesterone from a Walgreens or CVS, which is regulated by the FDA. So it’s confusing because it goes both ways. The same thing with estradiol. Estradiol is also bioidentical, but it’s seen in the compounding pharmacies, but it also is available in some prescription medications. So there’s a lot of overlap and there’s a lot of confusion. And my recommendation about compounding and getting something that isn’t highly regulated is So there is a governing agency that regulates compounding pharmacies. Compounding pharmacies, they participate, they self-enroll. And they got together because they wanted to have pretty high standards. The FDA goes into compounding pharmacies once a year. Their standards are usually that they self-regulate themselves once a month. They have other standards that they don’t use shakers for. compounding that they use blenders, which means that the concentration of the medication is more homogenous throughout any pills that they’re prescribing. And there’s a couple other ways that they’ve regulated their compounds. The other thing that I always say about whenever prescribing compounding medications and what we use is that we only use nationally recognized compounding pharmacies that follow these very strict guidelines. And what’s great about Thank you. using compounding pharmacies is that you’re able to kind of get a very personalized dose. So you’re not, you’re not at the, um, the will of whatever is available in a pharmacologic. So pharmacologics only have certain dosing with, with compounding. You can get very specific about what type of estrogen you want and how much of each estrogen you want. So I don’t know if, you know, but biased is like a very… And I’m not sure if I’m getting too nerdy or technical to hear, but bias is a very popular compounding estrogen to give. So bias is estradiol and estriol. Estriol is a very popular estrogen that’s available in Europe. Estriol you can’t really get in a pharmacologic. So that’s where like the benefits of using a bioidentical can come into play versus using a pharmacologic. What’s great about Estriol, Estriol is the estrogen that’s produced by a placenta in pregnancy. Estriol is really thought to be the gentlest of all the estrogens, even though estradiol is the estrogen that’s found most often in pharmacologics and thought to kind of have the highest risks of side effects. So it’s just, and that’s kind of, I think what you get when you get someone who’s kind of accustomed to using all the different formularies available versus someone who’s just using like a straight up estradiol patch is you can kind of understand, okay, where’s a woman coming from? What’s her risk profile look like? look like? What is she willing to tolerate? What is she willing to try? Where her kind of thoughts lie in terms of like administration and how she wants to take this medication. Does she want a patch? Does she want a cream? Does she want a pill? Does she want a vaginal insert? Does she want a ring? You know, all these kind of different things that go into play in terms of what you’re thinking about when you prescribe a medication to a patient or kind of make a recommendation to a patient.

Speaker #0
So it sounds like it’s very personalized. I mean, even down to the types of estrogen. Oh,

Speaker #1
yeah.

Speaker #0
And that you can really, and so through your testing and through, you know, your company, you can really get laser clear on type of estrogen. Do different estrogens affect different symptoms?

Speaker #2
So yes and no. I mean, estrogen. A lot of estrogen ultimately will convert to the same type of estrogen in the body, but not always. And this is where if you really want to get down to it, that’s where the genetics really kind of tells us a lot of information. We don’t always have that information. And so sometimes we kind of have to use symptoms to kind of gauge how a woman’s responding to different types of estrogen that she’s given. And also, you know. Different prescribers do have their estrogens that they like to and that they feel comfortable with. You know, some prescribers prefer estradiol, some prescribers prefer estriol, some prescribers prefer a combination. And I think it just kind of has to do with your comfort level and your experience and where, you know, the feedback that you’ve been getting from clients over the years.

Speaker #0
I know that the FDA has approved hormone replacement therapy for it. hot flashes, night sweats, and vaginal dryness. I know, for example, a friend of mine just went to her gynecologist and said, I’m not having any of those, but my mood is concerning to me. Like my moods, I feel depressed, I’m exhausted, my energy is in the tank. And her doctor was like, well, you don’t need to be on hormone replacement therapy. Like you’re not a candidate. So if someone came to you With those symptoms, not with the classic hot flashes and dryness and everything, what would you say to them?

Speaker #2
So I love this question because we got this question from someone who was, they were trying to get us, they were trying to get us into a gotcha. So we use off-label medications in medicine all the time. And I’ll give you an example. So there’s a medication called Cytotec, which is called misoprostol. Cytotec was an anti-ulcer medication. Cytotec is used probably in every hospital in the US on pregnant women every single day. It is an off-label use for pregnant women. Now, pregnant women are probably the most protected class when it comes to FDA regulation. They can’t have anything. And we saw that with the COVID vaccine, right? So it was like, these are the people that can’t have COVID vaccines, like people under two and pregnant people. You know, that was like, they’re incredibly, you know, encapsulated when it comes to risk. So to use medication off-label, as long as it’s an approved medication, that it’s safe for use, it doesn’t bother us that we’re using a medication for a different purpose than what the FDA originally intended it for.

Speaker #0
That makes sense. So are you saying that you would still go ahead and prescribe someone hormone replacement therapy if they’re coming to you with like, I’m having…

Speaker #2
Yeah.

Speaker #0
I just don’t feel myself. I just don’t feel right.

Speaker #2
Yeah. Especially if we did laboratory testing on this person and found there to be deficiencies that could be fixed by, um, by hormone replacement. Absolutely.

Speaker #1
We don’t just put people on hormone replacement just because based on a symptom and that’s what sets us apart from other, other organizations or menopause companies like us, we are getting diagnostic data. First, and then they’re doing labs. And then based on that, we will still use, you know, a compounding or bioidentical or a supplement. And if someone’s not comfortable with, with. in estrogen or progesterone, we’re not going to make them take it. It’s based on what’s comfortable for them and we’ll rework their treatment plan for them. But it’s always going to start with laboratory testing to see what their levels are. And, you know, a lot of things with what doctors do and you can’t blame them because it’s just in their training and they don’t get anything additional in medical school, but they, you have these universal laboratory ranges and just they see that it’s within a range, so then they don’t treat them. And then they have no idea of what a baseline is or based on the woman’s age or what she’s gone through or her environmental factors. And they don’t take that into account. And we’re also taking those things into accountability for the way we’re treating them. So sometimes a woman’s progesterone may be within those normal levels, but we’re not sending them away based on how they feel. So there’s a lot of different factors. And like you said, that’s why we’re getting laser focused and very granular with it. But we would never just give hormones without testing if it matched the analytical data that we’re gathering on them.

Speaker #0
Yeah, that makes a lot of sense. I wanted to ask a question about sexual health and just libido because a lot of women say Thank you. you know, I just hear like a word on the street that they’re done having sex. Like they’re not interested anymore. They’re just, do you feel like hormone replacement therapy is, you know, just talking about these other, like these symptoms that like kind of lie around like the outer ring of like of symptoms as one of those 100 plus symptoms that we could have. What’s your feeling about sexual health and sexual function? I know that vaginal dryness is, you know, When that’s a problem, that can affect everything. Beyond that, I started taking hormone replacement therapy and it just like wowed my sex life. And is hormone replacement a miracle cure for everything, especially when it comes to sexual health?

Speaker #1
I’m still a baby. Yeah.

Speaker #2
I think that it definitely can be for a lot of women. And I think one of the things that you bring up is that it’s sometimes the often forgotten, And, you know, we don’t talk about. sexual function. We don’t talk about libido. We don’t talk about orgasm. We don’t talk about, sometimes it’s not even about lack of orgasm or orgasms. It’s that the orgasms have changed, the quality of change, the consistency has changed. And so those are sometimes the forgotten symptoms. And we think so much about estrogen, but there’s so many other hormones that are in play. And phenotypically women are definitely, we have estrogen, we have more estrogen than men, But we have… more testosterone. When you compare apples to apples and the amount of testosterone to estrogen, we actually have more testosterone than estrogen. And you don’t hear a lot about testosterone when it comes to hormone replacement therapy. A lot of it is surrounded on estrogen. So just even the fact that testosterone is an option, that testosterone often drops before estrogen drops. And also that progesterone and DHEA are two other hormones that drop before estrogen drops. So Estrogen is actually kind of the last. the last woman standing, so to speak, the last, the straw that breaks the camel’s back and kind of like what starts most women kind of seeking treatment and seeking care. But there’s all these other hormones that are kind of falling first. And we often will see this loss of libido that you’re talking about, or the change in the quality and characteristic of orgasm or the frequency a lot of times before the menopausal time in the perimenopausal time. And you There are so many things that can be done that we just want to encourage women so much to reach out to us or reach out to a menopause specialist to get help because there’s so many options. It can be better.

Speaker #0
Yeah. I mean, there’s really, I mean, there’s so many different, right. It’s not just estrogen, right. We, which plays a huge role, but I mean, there are all these different hormones and testosterone is, is one of those hidden or we think of it as a male hormone. most women. I mean, so we don’t consider that you could maybe be a little deficient in that, and that might affect libido. And yeah, no, I agree. Do you think that, I mean, overall, every woman should be on hormone replacement therapy or some kind of hormones for their health, for their well-being, you know, for longevity? I mean, I know that I, you know what, I take that back. I know that not every woman is a candidate. I mean, if you’ve had a history of cancers and stuff. I mean, you’re certainly not a candidate, but. do you think if you are a candidate that most women should just be for their health?

Speaker #1
Yeah, absolutely. If you’re a candidate. There is, you know, studies beyond studies that show that the not being on estrogen actually causes more harm than good. You know, as, as, you know, we spoke about with the osteoporosis, the heart disease, if you look at dimension Alzheimer’s, they’ve done studies with the neurons and the cellular regeneration in the brain cells with women that have had estrogen versus have not had estrogen. And just as far as, you know, anxiety and your mental health and physical too. And it’s beyond, you know, emotional with relationships. If you go even like even deeper on things that people don’t talk about with, you know, libido and then becomes issues and relationships and marital issues and a lot of things kind of crumble and don’t need to. Um, and there’s a lot of damage that happens when you, your hormones are depleting and they’re not replaced, um, from, you know, clinic clinical and emotional levels.

Speaker #0
Well, that’s, I think a great way to just end our conversation. I have learned so much today from both of you, Michelle and Kristen. So thank you so much. Just tell me again, where people can find you. and how they start the process of working with you and Femgevity.

Speaker #1
So you could find us at femgevityhealth.com, hashtag Femgevity. And we also have our Instagram, our LinkedIn, our Twitter, our Facebook, and we have some videos on YouTube as well.

Speaker #0
Great. Well, I will put all of those links in my show notes. And I know that my listeners are going to be. really interested in everything that we have to talk about today. I think this is such an exciting time for feminine longevity and, you know, and, and not just this like weird, like, oh, we can age in reverse, but we want to protect our, our health and our wellbeing for as long as we can. And so this is really exciting.

Speaker #1
Yes.

Speaker #2
Yeah. Thank you so much, Heather. It’s been so fun to talk to you.

Speaker #0
Oh, sure. And thank you for coming on and have a great day.

Speaker #1
Have a good day, Heather. Bye. Bye.

Speaker #0
And as always, if you loved this podcast, please consider gifting me with a five-star review. It is so helpful for me to get the word out on real eating, our real bodies, and real food stories. Thank you so much and have a great week. Bye for now.