Ep. 518 Finally! The FDA Fix That Could Transform Hormone Therapy Safety & Confidence

Today, I’m thrilled to welcome Dr. Doug Lucas for the first episode of a two-part masterclass on bone health. Dr. Lucas is double board-certified as both an orthopedic surgeon and an osteoporosis specialist. He is on a mission to show the world that osteoporosis is both preventable and reversible.   In our discussion today, we take a deep dive into existing guidelines and their limitations and examine how Depo-Provera and oral contraceptives affect women’s bone physiology, particularly in younger women. We clarify why no ovulation means no bone balance, how breastfeeding affects bone health, and the importance of peak bone density. We explore the importance of early interventions and screenings, risk factors for poor bone health, the concept of relative energy deficiency, and the limitations of DEXA scans compared to REMS technology. Dr. Lucas also discusses bone health markers and the effects of frailty, falls, and sarcopenia, and shares the foundational pillars of health and longevity. Stay tuned for part two of our masterclass on bone health. IN THIS EPISODE, YOU WILL LEARN: How existing osteoporosis guidelines tend to overlook the key nuances of prevention and care The importance of early bone-health screening  How Depo-Provera and the contraceptive pill disrupt bone physiology in younger women How bone balance becomes disrupted with suppressed ovulation  Why peak bone density is a critical target in early adulthood How breastfeeding affects bone density  Where DEXA scans fall short and how REMS technology offers a clearer picture of bone health How relative energy deficiency impacts bone health in active women Why muscle mass is essential for protecting bone health and preventing frailty  The lifestyle pillars for long-term bone health and longevity Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Doug Lucas The OsteoCollective Community The Dr. Doug Show

It’s Nurse Practitioners Week, and today, we have a special episode to highlight a historic moment in time. On November 11, the FDA changed the labeling on hormone replacement therapy.  Join me for a short, focused episode where I read a recently published JAMA article detailing those changes, to keep you up to date on this significant development. IN THIS EPISODE, YOU WILL LEARN: How recent FDA updates are changing menopausal hormone therapy The history of estrogen’s role in heart and bone health How past research sparked fear around hormone therapy What the new labeling means for patients and prescribers How individualized treatment is reshaping dosage and timing decisions. Updated FDA labeling now distinguishes between systemic and topical therapies Key considerations for menopause-related urinary and genital health How these updates will potentially impact women’s long-term health Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected]

I’m excited to share a new AMA episode with you today, dedicated to risk factors specific to women. In this AMA session, I dive into the lifestyle factors that influence lipids, exploring the latest research and discussing Lp(a) and ApoB. Rather than answering your individual questions, I have woven them into the overall outline to create a cohesive and informative conversation. IN THIS EPISODE, YOU WILL LEARN: How women’s lifestyle choices directly affect their lipid profiles How knowing if you’re a hyper absorber or hyper producer of cholesterol will change your treatment strategy What the Boston Heart Cholesterol Balance test will reveal about your body’s ability to handle cholesterol The best treatments for hyper absorbers, and the best treatments for hyper producers How hard plaque differs from soft plaque, and why that matters for women’s heart health How the new AI-assisted Clearly scan provides a more complete cardiovascular risk picture than a standard calcium score How chronic stress and elevated cortisol fuel insulin resistance and inflammation, and damage blood vessel linings The benefits of Mediterranean-style eating for improving lipid balance, vasomotor symptoms, and overall metabolic health The importance of managing trauma, stress, and emotional health in midlife How my “n=1” experiment with Zetia and micro-dosed GLP-1s significantly improved my ApoB and inflammation markers Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Resources:  Dietary natural products as emerging lipoprotein(a)-lowering agents The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis An Update on Lipoprotein(a): The Latest on Testing, Treatment, and Guideline Recommendations

I am thrilled to have Dr. Olivera Bogunovic and Holly Hardman with me on the show today. Dr. Bogunovic is an assistant professor of psychiatry at Harvard Medical School and the medical director of the alcohol, drug, and addiction outpatient program at McLean Hospital. and Holly directed the documentary As Prescribed. In today’s discussion, we dive into the ongoing benzodiazepine crisis in the United States, with over 92 million prescriptions written each year for medications like Ativan, Valium, Xanax, and Klonopin. We discuss the origin of those drugs in the 1970s as treatments for anxiety and how they lead to tremendous physical dependency. Holly shares her experience with the neurological effects she suffered after long-term use of Klonopin, and we examine challenges in psychiatric care, the need for informed consent, and the impact of social media. We also cover the role of lifestyle, the need for psychotherapy and psychosocial support, and the significance of hope. This conversation is truly invaluable! Given how frequently benzodiazepines get prescribed, everyone must understand their associated risks and considerations. IN THIS EPISODE YOU WILL LEARN: How prescribing practices have evolved over the last two decades The significant consequences older adults face when they suddenly stop using benzodiazepines  Holly shares how doctors misinformed her when she began taking Klonopin.  Holly describes the benzodiazepine-induced symptoms and cognitive issues she experienced Why people must get informed about the long-term effects of benzodiazepines when consenting to take them How benzodiazepines work in the body and impact the brain Why benzodiazepines are ineffective when used long-term for insomnia The challenges certain people face when accessing psychiatric care What is BIND, and what are its symptoms? The significance of diet and holistic approaches for managing mental health, and why community support is essential in the recovery process Why As Prescribed is an educational documentary for everyone Connect with Cynthia Thurlow   Follow on X ⁠Instagram⁠ ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to ⁠[email protected]⁠ Connect with Dr. Olivera Bogunovic ⁠The McLean Hospital⁠  The documentary, As Prescribed, is available in the United States and Canada on Prime Video, Apple, Kanopy, Tubi, and Google.

I am honored to connect with board-certified plastic surgeon, Dr. Berry Fairchild, today. Dr. Fairchild blends surgical precision with artistry to create natural, lasting results. Known for her expertise in facial aesthetics and complex breast surgery, she is also deeply committed to philanthropy and ongoing international surgical missions. In our discussion, we explore how societal expectations shape how women perceive themselves, the complex process of facial aging, and the benefits of a healthy lifestyle in supporting these changes. Dr. Fairchild highlights the essential elements of effective skin care, including hydration and sunscreen, and the use of retinoids, lasers, microneedling, neuromodulators, hyaluronic acid, fillers, and fat transfers, diving into the role of surgery and the value of conversations around various facial and body procedures. She also shares strategies for optimizing post-surgical recovery and how philanthropy has shaped both her personal and professional journeys. Stay tuned for a truly enlightening conversation with Dr. Berry Fairchild, who is caring and open-minded about listeners’ questions regarding the aging process and ways to address an aging face and body. IN THIS EPISODE, YOU WILL LEARN: Facial aging actually starts deep below the skin How losing even a small amount of weight can alter your facial appearance Why surgical decisions must always  be individualized The positioning of the eyebrows and the upper eyelid skin can help determine facial expression. Why you could still consider surgical improvements even after you have had previous eyelid surgery Deep-plane vs. SMAS-based facelifts Importance of choosing a plastic surgeon with proven expertise and proper credentials  Some surgeries, like breast reductions, go beyond cosmetic value to relieve pain. Preparing yourself before having surgery for a faster and smoother recovery Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Berry Fairchild On Instagram TikTok

I am delighted to reconnect with my friend and colleague Robb Wolf today. Robb is a former research biochemist and a two-time New York Times and Wall Street Journal best-selling Author of The Paleo Solution and Wired to Eat.  In our conversation today, we examine the pitfalls of diet dogmatism, the lure of oversimplified health narratives, and the effects of Giardia. We unpack the seed oil debate, exploring how the longevity craze might actually be making us sicker, and we highlight the benefits of sun exposure and targeted lab testing. We also touch on the neuroscience of obesity and how food exposure shapes overeating and palate fatigue. As always, my conversation with Robb is insightful, practical, and packed with knowledge, so I know you will find it both inspiring and invaluable. IN THIS EPISODE, YOU WILL LEARN: The problem with dogmatic diets How Giardia impacts gut health How aggressive screening often creates risks, stress, and costs without improving outcomes The health benefits of adequate sun exposure Why consuming seed oils occasionally is not a huge concern The overwhelming impact of our modern food environment Why palate fatigue could cause overeating How our culture has normalized constant indulgence Some simple lifestyle actions that can yield massive health benefits Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Robb Wolf  Robb’s Substack

Today, I am honored to be in conversation with Dr. Brooke Scheller. She is a doctor of Clinical Nutrition, a nationally recognized health expert, and the founder of Functional Sobriety, a nutrition-based program for alcohol reduction. She also wrote How to Eat to Change How You Drink.  In our conversation today, we discussed the stigmatization of alcohol use and explored the nuances of curiosity and sobriety. We dispel common misconceptions, examine the research on alcohol consumption, tackle the definition of moderation, scrutinize the influence of industry ties, and unravel the issues linked to excessive alcohol consumption. Dr. Scheller also sheds light on how poor absorption affects the gut microbiome and contributes to a leaky gut, providing insightful nutritional strategies to address these concerns. Our conversation also extends to fertility, blood sugar, and the challenges posed by initiatives like Dry January and sober challenges.   Stay tuned for today’s comprehensive exploration of the relationship between nutrition and alcohol use. IN THIS EPISODE YOU WILL LEARN: How the stigma surrounding alcohol use is changing How does alcohol affect the brain and body? How alcohol impacts the gut microbiome, intestinal permeability, and nutrient absorption Dr. Scheller shares her personal experience with alcohol  How alcohol consumption in middle-aged women could increase inflammation and oxidative stress How alcohol impacts blood sugar The link between alcohol consumption and male infertility  Some suggestions for navigating a Dry January How alcohol use impacts mental health Overcoming alcohol addiction through self-awareness and wellness Bio: Dr. Brooke Scheller DCN, CNS Dr. Brooke Scheller is a Doctor of Clinical Nutrition, the founder of Functional Sobriety, and the author of How to Eat to Change How You Drink. After finding freedom from alcohol in 2021, Dr. Brooke took her experience in sobriety and applied her expertise in nutrition and functional medicine to help others change their relationship with alcohol. Her approach results in improved brain health, mood, energy, focus, gut health, and hormone balance.  Her launch of Functional Sobriety led to the development of her online community, the Functional Sobriety Network, and several online programs with members across the globe. Functional Sobriety offers the first-ever custom supplement program for the sober and sober-curious. As a motivational speaker, Dr. Brooke helps to spread the word about functional nutrition, alcohol-free wellness, and the power of sobriety.  Connect with Cynthia Thurlow Follow on X, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to [email protected] Connect with Dr. Brooke Scheller On her ⁠website⁠ ⁠Instagram⁠ (@drbrookescheller) ⁠Functional Sobriety⁠ How to Eat to Change How You Drink

I am delighted to connect with Dr. Andrea Matsumura today. Dr. Matsumura, affectionately known as the Sleep Goddess, is a board-certified sleep medicine physician, menopause expert, speaker, and the founder of the Dream Sleep Method.  In our conversation today, we explore how different life stages impact our sleep quality. We discuss the effects of wearable technology, orthosomnia, and sleep stages, and explain why sleep quality is more important than its quantity. Dr. Matsumura highlights the red flags for sleep, breaks down how sleep deprivation affects our health, and examines specific sleep issues, including sleep-disordered breathing, Upper Airway Resistance Syndrome, chronic insomnia, and the challenges of shift work. She explains why sleep apnea is seen more commonly in menopause, and how it occurs in 67% of menopausal women, yet most fail to realize that they have it. We also tackle the risks of untreated sleep apnea and the sleep syndrome of menopause, sharing ways to address sleep issues with appliances, technology, medications, cognitive behavioral therapy, and ACT therapy, and pointing out those that have proven to be ineffective.  This conversation with Dr. Matsumura is truly invaluable, and I look forward to reconnecting once her new book is published. IN THIS EPISODE, YOU WILL LEARN: How hormone changes in menopause impact airway function and sleep quality. Why sleep apnea in women often goes undiagnosed  How fragmented sleep affects brain function and mood Why even mild sleep apnea can have significant health consequences How different hormones influence specific stages of sleep. How hormone therapy can improve sleep quality without curing sleep apnea The value of oral devices and positional strategies for supporting breathing at night How CPAP therapy can transform sleep and improve cardiovascular health The benefits of cognitive behavioral therapy for addressing insomnia  Why prescription medications and supplements seldom solve long-term sleep problems Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Andrea Matsumura On her website Instagram Pre-order Dr. Andrea’s book, The New Perimenopause.

I am thrilled to reconnect with my dear friend, Dr. Stephanie Estima, today. In this episode, we dive into questions from listeners once more, exploring topics that range from navigating the challenges of perimenopause and parenting to shifting perspectives on fasting, nutrition, and changes in hunger and thirst cues, especially during perimenopause and menopause. We also examine how dairy may become an inflammatory food item in midlife, the benefits of hormesis, hormone therapy, and so much more. Our conversation today is honest and warm, so it is like sitting down with two close friends. Both Stephanie and I look forward to sharing many more of these Q&A sessions with you in the future. IN THIS EPISODE, YOU WILL LEARN: Some advice for mothers navigating perimenopause  How to adjust your fasting in midlife What perimenopause and menopause mean for satiety and hydration signals, and how to adapt Why some women find dairy problematic in midlife, and how to experiment with reducing it How hormesis builds resilience, and how stressors, like exercise, fasting, and cold/heat exposure, can improve metabolic and overall health What you need to consider with hormones like DHEA and pregnenolone How women with MTHFR can support methylation and detox pathways The benefits of combining strength training, Zone 2 cardio, and occasional HIIT for fitness in midlife Why you should embrace your callouses as badges of honor instead of trying to remove them The value of micro-dosing with peptides and GLP-1s Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Stephanie Estima On Instagram On her weekly podcast, Better! With Dr. Stephanie

I am honored to connect with Esther Blum today! She is the bestselling author of "Cavewomen Don’t Get Fat," "Eat, Drink, and Be Gorgeous," and most recently, "See Ya Later, Ovulator!". Esther currently maintains a busy virtual practice where she helps women balance hormones, lose stubborn body fat, and treat the root cause of health struggles.  Today we speak about medical gaslighting, how weight gain does not have to be a part of aging, andropause and menopause, and the Women’s Health Initiative. We dive into physical changes and significant symptoms during perimenopause and menopause, the role of the pelvic floor, deciphering what the dreaded “menopot” is, what does not work, and advocacy in terms of testing and hormones. We also address constipation, weight loss resistance, and how our tolerance for alcohol changes as we age, especially when using bioidenticals or hormone replacement therapy.  IN THIS EPISODE YOU WILL LEARN: How women can redefine their experience and continue having an active sex life after menopause. How to surrender, lean in, and take the pressure off yourself while going through perimenopause and menopause. Why is there so much misinformation and medical gaslighting in our society? Why Esther wrote See Ya Later, Ovulator! Some common symptoms of perimenopause. Risks women may face after a hysterectomy. Changes that happen in the vaginal canal and pelvic floor during menopause. The significant and profound impact of the decline of sex hormones. How to avoid weight gain in menopause. What can menopausal women do to prevent fatty liver and digestive problems? Lab tests women should be asking their health providers for. Why should perimenopausal women avoid alcohol?  Some simple ways to address constipation. Connect with Cynthia Thurlow Follow on ⁠Twitter⁠, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Connect with Esther Blum On her ⁠website⁠ On ⁠Facebook⁠, ⁠Instagram⁠, ⁠LinkedIn⁠ Get your ⁠free copy of Esther’s Happy Hormone Cocktail⁠ Esther’s Books ⁠Esther’s book, See Ya Later, Ovulator!⁠, by Esther Blum ⁠Cavewomen Don’t Get Fat⁠, by Esther Blum ⁠Eat, Drink, and Be Happy⁠, by Esther Blum