Jesus Fix It with Jess & Steph!

You’re Not Crazy: Hello Perimenopause, Menopause AND Andropause! (with KAYA Health)

• Jess & Steph • Season 6 • Episode 6

Share episode

Hot flashes aren’t the whole story. We sit down with Kaya Health clinicians Diane and Sierra for frank, science‑rooted talk about perimenopause, menopause, and andropause—and why so many of us feel “off” even when our labs say “normal.” If weight creeps up despite clean eating, sleep breaks at 2 a.m., or your moods swing without warning, you’ll learn what those symptoms signal and how to respond with smarter, safer care.

We break down what changes in the 40s versus the 50s, and why both estrogen highs and lows can feel confusingly similar. You’ll hear why bioidentical hormones are not the same as synthetics, how progesterone can calm night sweats and anxiety. We unpack pellet therapy pros and cons, outline safer dose‑adjustable options, and explain how delivery methods like topical estradiol can lower clot risk. For anyone with complex histories—including clots or cancer—we discuss risk‑aware paths, shared decision‑making, and why being heard matters.

Men, you’re in this too. Andropause brings a slow slide in testosterone that affects energy, libido, body composition, and brain clarity—and yes, you need some estrogen for cardiovascular protection. This is prevention, not vanity: better sleep before weight loss, nutrient‑dense food before pills, movement and muscle to protect longevity, and targeted bioidentical hormones to restore function, not chase youth. If you’ve felt dismissed by eight‑minute visits and “everything looks normal,” this conversation offers a roadmap to care that treats the person, not just the paper.

SPEAKER_04:

Hey, welcome back or welcome to the Jesus Fix It Podcast, the show where we talk about life, the ups, the downs, a little pop culture, and everything in between. I'm Jess and I'm Steph.

SPEAKER_03:

Every other week we dive into the things we're asking Jesus to fix. And let's be real, there's a lot. You can always count on us to keep it real.

SPEAKER_04:

Share some laughs with us, and maybe a few tears as we tackle the big and small stuff with faith and honesty. So grab your coffee and let's get into it. Okay, we're gonna start by saying, guys, you are welcome. Don't leave. Don't leave. We're talking about menopause today. And very menopause. Very menopause. And anthropause.

SPEAKER_03:

There you go. Oh, don't we get the number?

SPEAKER_04:

Do we know what that is yet?

SPEAKER_03:

We're going to get into it, but it's the male version, from what my tiny little bit of understanding is. It's the male version of menopause. Okay. It happens. It's a thing. So, men, stick a stick around. You're gonna learn something with us.

SPEAKER_04:

Okay, but ladies, we know a lot of ladies have been waiting for this episode. And so we have actually been waiting. There are so many questions. Oh my gosh. We're not teaching you anything. We actually have experts here. Oh, yeah. Uh we have some friends with us from Kaya Health, and we're gonna let them introduce themselves, tell them about their practice and about what they do, and then we're just gonna get into it. And again, man, you don't have to stick around. We're praying you will, because there may be a lady in your life who uh you just may need some education. And uh there are some things for you too. So um stick around, enjoy the conversation. We have been waiting for this episode. And uh without further ado ado. Ado and you I get to talk every day. No, like how is that that I don't even know stuff know the words and you know what? Yes, you're telling me on Monday.

SPEAKER_05:

Feels like it. Um sorry, go ahead. You're fine. Um, so I'm Sierra. I've been working at Kai Health now coming up on two and a half years. Crazy. It is crazy. Originally I went to Jefferson College of Health Sciences and got my nursing degree, worked in cardiac surgery, ICU for a little bit, and then decided that I wanted to do a little bit more um with medicine and have a little bit more autonomy. And so I went back to NP school through Liberty. And during that journey, I got to meet Diane and Dr. Anderson at Kaya Health during COVID because I needed clinical hours and they were the only ones that would take me. And during that, I got to fall in love with women's health and hormones. And Diane was gracious enough to take me under her wing, thank God, and mentored me through the whole thing. And now I have been uh specialized in bioidential hormone replacement therapy, a little bit of women's health, and then direct primary care health.

SPEAKER_01:

I am Diane. I am a nurse practitioner. I actually did not start my career in medicine. I actually started in pharmaceutical advertising and did um high-level management for years. Um, my husband was injured, couldn't get doctors to listen um and actually treat the problem. They just wanted to do surgery. And so I did what I tell my patients not to do and studied myself and treated him myself. And today he still has not had surgery. We're about twenty, almost twenty years past that point. But I realized, man, you know, I'm I I kind of push hard and I ask a lot of questions and I don't take no um very, very easily. So I went back to school, um, got my nursing degree. I was a resource nurse, I knew exactly where I want to be, never wanted to really teach, just wanted to um help patients. And I love the natural, I love treating with food, with um it's the least amount of pharmaceuticals, the least amount of anything that I can try and treat with lifestyle. And so I worked in traditional medicine with insurance for years, kind of got run into the ground seeing 30, 35 patients a day, which is what the average traditional provider sees, and decided I needed to do something else. Um, during that time, because I love the natural. I'd been involved in hormones and all that from the very start of my nursing career and then further on into my nurse practitioner. So, like Sierra said, we've both been trained outside of just our nurse practitioner degrees. Um, we've taken additional classes. I've been working with hormones for 10 plus years. It's what I love, it's what I breathe. I enjoy it very, very much. Um, and so I just sent out three resumes to different places in Lynchburg and said, let the dice fall where they will, um and we'll see what happens. And Dr. Anderson was uh gracious enough to call me. Our visions aligned, and kind of the rest is history. So I've been working at Kaya. I do a lot with hormones. I had a dream come true last year, opened a PCOS clinic. Um I myself have PCOS endometriosis, and I was told I could never have children, and I have five beautiful children. And with the training and what we do, Bolsier and I have helped a number of women achieve motherhood that we're told you'll never be a mom with biological children. So it's been amazing. Um, really, really cool. There's a lot of those stories on our review page as well. So very rewarding. Yes, very rewarding. That's what we do. Um, we love it. Not just that, but like you said, about perimenopause, postmenopause, andropause. We work with it all every day.

SPEAKER_04:

I can't wait to get to that word. We're gonna talk about that. We're gonna talk about that. And we're gonna make sure that we link all of your information and make sure that if anybody wants to know more about Kyer, we're gonna make sure they have access to the case. For sure. We've got that. Yeah.

SPEAKER_05:

The website explains most things. Uh just questions answered, and then you can always call the office. Yep. And we're happy to pick up the phone and answer. We're gonna make sure they have all of your contact info and all that stuff.

SPEAKER_01:

Yeah, more providers coming in 2026 to help us out. We are getting full. Um, but if anybody's interested, yeah, for sure, go to the website. We've got a waiting list. Um, both the new providers in 2026 will be doing hormones as well. I oversee all the training and all of that. But we're very excited about that.

SPEAKER_04:

Awesome. We'll make sure to hook y'all up. Well, I mean, with you know whatever you think. I didn't mean for it to sound like that, but you know what I'm saying. They're gonna hook info with info.

SPEAKER_03:

Menopause and parry. Yeah. Just hearing those words sometimes makes you sweat. Well, it makes me sweat.

SPEAKER_04:

You sweat anyway. True. Girl. Um, some real talk about it though. Why is this such a hot topic right now? I don't feel like five, 10 years ago, people were really bringing awareness to it. And right now on my socials. Oh gosh, it's people are talking about this. And even my mom, she's I love my mom. She's an old school mama, and she's even more open to talking about it because I think we were talking about earlier before we even cut the mics on. We were talking about, you know, our generation, I'm 48, Steph, you're 44. You know, our parents, when they did talk about it, you know, it was hot flashes. And, you know, your menstrual cycle will eventually end and da-da-da-da-da. And I just thought, oh, so I'm just gonna sweat a lot. And it's so much more than that. You'll certainly do that.

SPEAKER_05:

Yes, there's a lot more to it. It didn't used to be a topic for dinner conversation. It's not a dinner table conversation, but now I think with the internet and access to information, women are advocating for themselves for the first time because women's health has been notoriously an underserved segment of medicine, because it will say it how it is, but it was a man's world for a long time when it came to medicine. And so now women are really saying, Hey, I don't feel good, and these other countries are doing this. I would like to be myself again. That's what I hear the most, is that I just don't feel like myself. Like this isn't me. And they come in wanting help and advocating for themselves. Yeah.

SPEAKER_01:

Social media has been a big part of it, you know, because everybody talks about everything on social media. So that's certainly been a big part of getting the conversation out there, and it is a great tool. It also can be a great nemesis because there's a lot of false information on um social media, but it has been a big help in getting the word out for people to be able to talk about and say, Hey, you're not the only one that's dealing with this. Maybe we need to see somebody. So it's yeah, one of the biggest things is that women will come in and say, I'm gaining weight and haven't changed anything. You know?

SPEAKER_04:

Right? Right? All the things.

SPEAKER_05:

I've I've cut out sugar, I've stopped eating. Yeah, that's I've done nothing. And I have 20 pounds, and nothing is helping.

SPEAKER_03:

Yes. And I don't have the money to go get a whole new wardrobe every other week. Every other week.

unknown:

Yeah.

SPEAKER_01:

Yeah, it's it's that is one of the big ones. Um, like you said, the sweating, yeah. Perimenopause, you drip at night, and postmenopause, you drip during the day. You know, so it's on it's on both sides of it. And during the 40s, that's typical perimenopause age. That is estrogen excess. Postmenopause, it's a depletion of estrogen.

SPEAKER_05:

And the fun thing is the too high of estrogen and a lack of estrogen cause similar symptoms when it comes to the symptom side of things. So women are like, I've been dealing with this for 10 years, and you're like, I'm so glad you walked in. Let's try to help. We can turn it around.

SPEAKER_01:

And perimenopause is like that though. You have some women who will suffer for 10 years with symptoms and be told that this is normal. Because on paper, their levels will look, quote, within normal limits. Yep. So nobody is willing to treat. But some women also have a period and then they never have a period again. And it's like, what? How'd you get so lucky? And they're like, Oh, I never felt anything. That is rare. That was my mom. Yeah. Yeah. Lucky, right?

SPEAKER_03:

Yeah, she was like, because I talk about this all the time. Sure. And she's like, I literally don't even remember having going through peri or menopause. She's like, I don't even, she didn't even know the word perimenopause. And and yeah, she's like, I didn't have any. You just go from no having a periodopause to nothing.

SPEAKER_04:

And that's the assumption, though, is that you just suffer through it. It's like you, this is as a woman, you are just this is what you do. You just suffer through it, and then when when it's over, it's over. This is what you do.

SPEAKER_05:

And I think the medical world shied away from perimenopause because for a long time the only thing that they offered for help was birth control. Well, that's still the only thing that's taught in school, isn't it? Synthetically, shout out to my mom, but they had her on birth control for 30 years until I was like, hey, you're in menopause. Let's pull this back. We can optimize some stuff. And she's my poster child for hormones. Your mom's amazing, yeah. Yeah.

SPEAKER_04:

That was my aunt. When I found out my aunt was on birth control for so long. She has breast cancer now, by the way. But she was on hormones for so many years.

SPEAKER_02:

Yeah.

SPEAKER_04:

When they were trying to test to see if she had hormone-fed breast cancer, just because she was on the birth control for so many years.

SPEAKER_01:

I was like, hormones. Yeah.

SPEAKER_04:

What? You're still on. I was like, are you planning on having me? Because she, I was like, why are you?

SPEAKER_01:

You trying to have a baby when you're 48? I was like, Yeah. And she's like, that the doctor told me, like, that's what you but to be fair, that is you get taught that in school. You know, it's hard because in school there's only so much time. That's why it's called practicing medicine. Things change on a daily basis. So you learn the basics in school and then you get out and everybody figures out what it is that they really are in love with. And then you go and you study that. And you, you know, you find what fits and what you're passionate about for us. That happens to be hormones. And a lot of people are scared about hormones. We talk perimenopause, and it's like, oh no, we can't do hormones because the media has made us scared of our own hormones. So I always tell people, what do you think creates a baby? Hormones, right? I mean, it's what keeps the baby alive in utero, it's what grows us into an adult, it's what keeps us alive in our 20s and 30s, supposed to be great years, depending on who you ask. Um and then you get to your 40s, what do you start to experience? Hormones going out. That's why you start to see aging in your 40s. That's why we have all these women saying, Man, I'm sweating at night, you know, I'm gaining weight, uh, my blood pressure's starting to go up. What is going on? My cholesterol's going up. And again, people are still really scared of hormones in their 40s because they get told you're gonna get breast cancer. Well, when do you see breast cancer? It's in the forties, right? That's mainly when the majority of diagnoses are made. Why is that? It's because estrogen goes bonkers. You get really high highs, you get really low lows. And so if you have somebody who has a predisposition towards an estrogen-dominant cancer, that's likely when it's gonna pop up. It's not because their hormones are necessarily killing them, it's because there's a genetic predisposition there and your estrogen's going crazy. So cancer, by definition, very simplified, is a cell gone rogue and it floods out the good cells, right? And so if you have that and you have these high levels of estrogen sitting there, you're kind of a sit and duck if you have a big genetic propensity. Plus, I could get on a soapbox and talk about the food we eat and what we put in our bodies, that definitely adds to the risks. But your hormones are what have kept you alive, they're what created your life. Don't be afraid of your own hormones. See somebody who has been trained in them. Unfortunately, GYN learn the same thing we do, it's birth control. They don't take classes in bioidentical hormones unless they go search it out just like Sierra and I did. So a lot of people go to GYN and they go to family and they're thinking they're they're hormone specialists. They're not. I wasn't before I went and did all the training. So I had the same information. But then what do you see in the 50s? You see, oh, now I have vaginal dryness, I'm getting UTIs, I got bacterial vaginosis, my uterus is falling out, my breast have moved about five inches south, you know? I've got hypertension, I've got osteoporosis or osteopenia. What is happening? And that's when you start seeing strokes and heart attacks, right? In the 50s. Why? Because estrogen went away now. Now you're in postmenopause. So estrogen, poor estrogen, it gets a bad rap for what happens in the 40s. But you need it. All those things I just said, you're either gonna take supplements, pharmaceuticals, or you're gonna put a little bit of estrogen back in to avoid those diseases. Those are all diseases of aging. Yeah, it's just the body kind of giving out, and that's what happens in post-menopause. Men experience it too. Speaking of andropause, their hormones slide out the door too. And when their hormones slide out the door, now you have erectile dysfunction, they start gaining weight around the middle, their skin starts getting saggy, they start losing hair. So we all go through it, but the hormones on their way out are what start the aging process and speed it up and kick it into high gear. When Sierra and I treat, we're not trying to make somebody who's 50-20 again. And that's hard right now because hormones, it's a big buzzword, right? You know, everybody's getting into hormones, everybody's doing this. We do hormones, we use it a lot for preventative medicine. There's a lot of folks who are using it for aesthetics and stuff. If that's that's your thing, by all means. But what we're doing at Kai Health is we're trying to use it for preventative medicine. We're trying to give better quality of life. If you're gonna have quantity, you want the quality to go with it, right? So we're not trying to make somebody 20 again, we're not trying to make them fertile at 50. Um, boy, that'd be miserable. Um But we're trying to give you prevent the can you imagine? I can't. No, y'all made me fall out my hair. Somebody asked me that the other day. I said, you know, I guess it's possible because you're still bleeding, but that would be biblical.

SPEAKER_05:

My goal is I want you to have your best golden years. Is right? We all fight for our golden years. We fight for retirement age, we try to live our best life, we try to do all the things that we're supposed to, but without the help of the preventative hormones, you can literally graph it. Like Diana was saying, as hormones start to tank, women, we fly off a cliff and hit menopause and they're gone. So it's more drastic. So we talk about it more. Men, they hit that anthopause, and it's a slow slide, but the testosterone is going to decline. And then as you see both of those decline, you can see all the comorbidities that everyone is talking about and wanting to avoid your heart disease, stroke, heart attack, cholesterol, high blood pressure, cancers, all of those just start to skyrocket. The one variable that you can put, it's not a causation, but it is a correlation, is your hormones.

SPEAKER_04:

My goal is for you to have your best golden years. That is so like that. First of all, thank y'all, because we need people like y'all who are willing to do the research and do hormones. Because if somebody's not researching it, if somebody is not willing to do the work, then we would just be out here floundering. Absolutely. So yeah, we need somebody willing to do that. And also when I was thinking about all the things you were saying about men, you know, how they, you know, their midsections grow too and they lose their hair too. But I noticed like when men go through that type of thing, and I'm not crapping on men right now, I'm not. I'm just making an assumption. I'm just making an observation. But when men start to go through their hormonal changes, I notice it's usually called, oh, they're having a midlife crisis. But when women spin on it, right? Yeah. But when all of those like things start happening to women, especially when we start having those uh mental um and emotional changes, oh, we're having a breakdown. Yeah. Uh-uh. Well, it feels like you're breaking. Yeah. And I'm like, why isn't anybody ever that understanding for us? And I'm not saying I'm not trying to play, you know, the victim here, but I'm just saying I just wish it's an act of observation. Yeah, you know, a little bit more understanding that this is a physical, it is something physical and a real medical thing that's happening here.

SPEAKER_01:

It is very medical. That's yeah, that's a big part of the puzzle, is it is medical to give somebody their best golden years, you have to combine the medical with the hormones. It's not just, they're not separate. It's all health, it's all preventative. And so it is a very medical thing, but hands down, almost every patient, I won't say 100%, because this is probably an exception to that, but at least 90% of the women who I have treated have come to me and said, Why isn't anybody else doing this? I told people this, you know, right? You you told us when we first met you. And the reason is because per your labs, hormones naturally decrease with age. And so the labs account for that.

SPEAKER_05:

And they say you're normal.

SPEAKER_01:

And you will always fall within normal limits as you're in your 40s and 50s, because it's normal to have zero estrogen. To have crazy estrogen and perimenopause and none in postmenopause, right? So you always fall within normal limits. So it's very hard to find somebody to treat you if they're not specialized. And what we do is not necessarily treating, it's called optimization because you are quote normal on paper, but we want to treat the person sitting in front of us. And because we're at a direct primary care, we get that opportunity. We don't have to do exactly what insurance tells us to do because they need to get their check. We get to treat the person sitting in front of us, and that is exactly why Siri and I started the careers that we started.

SPEAKER_05:

And that's where other providers are limited is that insurance is holding the strings. You can't legally treat something that's quote unquote normal, right? I mean so they can't say they're gonna say, Well, nothing's bolded, right? When you get back to your labs, you see abnormals is bolded. So they'll look at it and they'll say, nothing's bolded, you're good. But you go and you say, But I'm still having symptoms. I don't feel good. Right. I'm still tired, I'm still gaining weight. Still not sleeping. Yes. I'm depressed. I'm anxious. I've never been anxious before in my life. All of those things, right? Yeah.

SPEAKER_04:

One of the most frustrating things is going to your doctor and you say to your doctor, I just feel off. Something is wrong. Like, I'm not sleeping. Like I feel I know my body.

SPEAKER_05:

And no fault to their own. They have eight minutes to talk to you, and they're like, Well, I'm sorry you don't feel good, but your blood pressure is 160 over 100. So let's prevent you from having a heart attack. Right. And that's all they can do. And then they move on.

SPEAKER_01:

It is. It's hard for the provider. I worked in traditional medicine. It's hard for the provider. I worked through lunch, I worked an hour and a half after closing, and then I'd put my babies to bed and chart for three or four hours, you know.

SPEAKER_04:

And we're not crapping on the providers. We're just saying, it's frustrating for both. Absolutely. Yeah. 100%. So then excuse my language.

SPEAKER_01:

So we get direct primary care, you know, that's one of the great parts that why we love our job so much is because we get their shortest appointments 30 minutes with our patients. We're our appointments are either 30 minutes or 60 minutes with each patient. So we actually get to listen to the patient. And that's a huge if you look at the reviews, almost all of them will say something about I feel heard.

SPEAKER_03:

And you guys mentioned that you have what you call a cry room.

SPEAKER_01:

Well, no, it's a win up. So it's actually when a room. It would be, it would probably be, you know, you'd have to like stand in line to get in there. Um But when I first started with Dr. Anderson, it was kind of funny because he wasn't actually planning on hiring, he told me, but our views clicked um and it just worked. And so I started at the old location at Boonesboro Direct Primary Care when that was our name. I actually started in a closet because I went for an interview. He was like, I just don't have anywhere to put you. And I was like, I don't need much space. I just need a room where I can see people. And so I transitioned a closet into my office, and so many women would come in and not feel heard. And again, you know, not saying anything bad about providers, gosh, we need more of them actually. But in traditional medicine, you just don't have time to do what we're able to do in direct primary care. But women would come in and for the first time they'd be like, I feel heard, and so they would cry. And so he nicknamed my office the uh the room of tears. Um so many women were coming in crying. And again, it was more so just because they for the first time felt heard, not necessarily I like to think I'm a great provider, and I try. But I think when as a female, as any patient, really, when you get to sit with a provider and they actually hear you, that's cry worthy, you know, because that means that somebody's actually listening and willing to help. And I have the time to help, which is a huge thing being a very important thing. That's my favorite compliment. Yeah.

SPEAKER_05:

It's the most rewarding.

SPEAKER_01:

Yeah. So there's still a lot of tears. We we constantly have Kleenex in our office. Always. But again, we have time to listen, and that makes a difference for patients.

SPEAKER_04:

What do you wish every woman knew about this chapter in their lives, whether it's peri or menopause?

SPEAKER_05:

You're not crazy. There you go. Um, because you're not alone. You're not alone. I'll have once again, going back to traditional medicine, when you get taught that somebody's coming in and they're anxious and they're depressed, you treat symptoms and you band-aid it, right? Because you can't get to the root cause because you don't know any better yet. And so all these women are coming in and they're like, the only thing they offered me was an SSRI, or which is like Prozac or Symbolta or Lexapro, just to mask the depression. And then they come to me and they're like, now I'm a zombie and I'm still gaining weight. Now I have no motivation, I have no libido, I have nothing. And so it's just saying that it the band-aid can be useful in certain situations. Like once again, pharmaceuticals have increased your quantity of life, but not necessarily quality, and we can get to the root cause on most of those things, and it's just by optimizing your hormones. Now, does it fix everything? Absolutely not. Does it give you a better fighting chance? Absolutely not.

SPEAKER_01:

Yeah, so echoing that, yeah, you're definitely not crazy. You're not alone, you're not the minority, it's just no nobody else is talking. So it's very, very common um to feel and be told that you're crazy. It's very common to go to your primary care and be told everything's normal because it typically will be on paper. Find somebody who has time to treat the patient, which is somebody who has more time with you in their office, is always gonna be that person. And somebody who's interested and trained well. And I would say don't be afraid of what you're already producing. Yeah. That's the big thing is talking to people because so many of the studies that are put out, and it's really hard to find studies on bioidentical, those are hidden. What you're gonna see when you Google most of the time is synthetic hormones. The whole women's health initiative. That was not done on bioidentical, but scared every woman. And every woman thought, oh my gosh, my hormones are killing me. Quite the contrary, they're they're what brought you into this world. They will take you out of this world, but not necessarily because everybody's gonna get cancer, but because they're gonna decline one day and then they're gonna stop producing. And at that time, you got to choose, am I gonna use prolia or am I gonna use estrogen to prevent osteoporosis? So don't be afraid of what you're already producing. That's what we do. We manipulate a little bit of what you're already producing to give you better quality of life. It's just the levels are going out because that is a natural process of aging. So if you can use those as preventative medicine, do that first. You have a lot less side effects manipulating what you're already making than putting a foreign substance into your body. Again, I I use pharmaceuticals sparingly, but I do use them and they have their place. Yeah. They do have their place. It's dangerous to swing the pendulum to one end or the other. Typically in the middle is where you're gonna fit best and have the best outcomes. But uh we were created with hormones and so if we can use those first and use the pharmaceuticals just to help get you where you're going and then try and let 'em go. The goal is always the b absolute best health with the fewest amount of things that you can be on. We don't even treat with hormones if you're not symptomatic. You don't come into our office and leave with every hormone uh that you're producing as a script. We treat the person sitting in front of us, and that's really important because if you're just treating paper, you're gonna make somebody feel a lot worse. You gotta treat the person sitting in front of you, you gotta listen to them. That means you're not in menopause until you're by definition a year without a cycle. But in that time, you can have women who feel great and you can have women who feel like they're on the death's store. Everything in between is normal. I've been doing this for 10 plus years. I've yet to meet one person the same. Everybody is different, but we all metabolize different, we live different, our quality of life is different, and that is something that you gotta know about that person before you can actually treat them. And so find somebody who can listen to you, find somebody who's trained well and who cares and who cares and who can listen and uh and let them use what you're already producing first. It has the least amount of side effects. I've watched DEXA scans improve from just giving somebody estradiol. Now, not everybody is a candidate for every hormone. We do take again, it's a medical tasks. This is a medical process. It's not just hand hand everybody some progesterone and candy form. That's not what we do. It is a medical thing. You need to be medically trained and you need to understand that this is still medicine that you're dealing with in a way. But uh when it's appropriate, you give those items. But you need to know the person's history. You would never give somebody estrogen who's still making estrogen of their own. Right. That's a not a good idea. We can do a lot more harm than good that way. But what do you you were saying? Hot flashes at night. That's a big one, right? Sweating you wake up in a pool of your own sweat. What hormone is lacking there? Progesterone. Progesterone is also one of the safest hormones you can give. It's the one that balances estrogen. There are ways to decrease estrogen load by food, and I talked to patients about that. But you can help decrease uh cancer risks and things like that by just knowing how to manipulate progesterone in the 40s.

SPEAKER_05:

Especially my women that have endometriosis and PCR. That's a big one. Because you're already struggling to make progesterone consistently. And so we worry about your uterus. We worry about the endometrium. And so giving you back bioidenticity. Identical progesterone, which is not the same as progestins, which when you start reading studies, a lot of times they'll flip the word progesterone and progesterone. And progestins are your synthetic progesterone. So that's your birth control. That's what a lot of studies are based on. And so progestins, you can pull up a chart, you can Google it while we're talking, but progestins, your synthetics, will cause weight gain, issues with sleep, mood issues, whereas your bioidentical progesterone actually helps with sleep. It naturally decreases anxiety. It helps to counterbalance your estrogen. So it decreases risk for endometrial cancer, ovarian cyst, fibroid cysts that women deal with, which cause the heavy bleeding that you see. The only side effect that I see is usually maybe sometimes fatigue the next morning, which tends to go away. And I think I've had one in a hundred women have nipple tenderness, and we adjust how you take progesterone because there's a lot of different ways. This is where you go talk to an expert because there's a thousand different ways it feels like that you can compound bioidentical hormones to make it fit the individual. But you have to have somebody that has a little bit of experience and support and knowledge and willing to travel that with you, not willing to like I will always listen to a patient that says, Hey, I'm having this symptom, and I'll be like, Okay, I'm gonna take that seriously. Let's see if there's another way we can make this fit for you instead of everyone.

SPEAKER_01:

Yeah. What uh Sarah was saying was true, and you're seeing a lot of like pellet therapy and things like that coming out. And I would just say, talk to whoever's doing your hormones. Pellets, that's a big question we get. We do not do pellets at our office, and a big reason for that is again, we see it as a medical uh now. What is pellets? That's where they inject the hormones under your skin and pellet form, and it's a slow release over six months. There's supposed to not be a peak in a trough, but that's kind of impossible. Okay. When you have a slow release, there's always gonna be some kind of top of the mountain and low in the valley. And that will always happen with a slow release. You can't really get around it, but there's supposed to be a little bit to none of that. However, when we do hormones, you never know when somebody's gonna come up with something. You never know how somebody's gonna metabolize something. So if I put a bunch of pellets under your skin and I have no idea how you're gonna metabolize it, you could end up as a female if you have PCOS growing a beard. And the only way to stop that now is to give you a pharmaceutical. I don't want to give you pharmaceuticals. I'm trying to avoid that. I'm trying to use natural things to better your quality of life. And so we do not do pellets, there's a lot of complications with them. Once they're in, you cannot take them out. Period. End of story. So if you put it sounds scary.

SPEAKER_04:

That does.

SPEAKER_01:

Number one, Sierra and I, when we prescribe hormones, if somebody has a side effect, they text us personally because we're the ones who prescribed it, and we can make that side effect typically go away in 24, 48 hours.

SPEAKER_03:

Oh wow.

SPEAKER_01:

We'd have very tight control on it. Whereas with pellets, once you put them in, they're just there. You cannot get them out. So two months in, you have somebody who has a lump in their breast, god forbid it's an estrogen-dominant cancer, and you've just loaded them up with some estrogen under their skin. You're gonna have to figure out how to try and decrease that and cover it up, which means it's a very hard pharmaceutical load on that person. And so you know, pellets have their place. If you're traveling a lot, you can't get in. If you're military, you're going overseas, if you're homebound, they do have their place. And if you call the manufacturer, they're not intended necessarily for the everyday use.

SPEAKER_04:

Gotcha.

SPEAKER_01:

Um, so not when there's other options. There's safer options. And hey, if you want to do pellets, you know, we'll tell you risk-benefits. If you choose that, we'll support you the best we can. Um, we're not here to back anybody into a corner, but before you go do something, whoever is talking to you, whether it's a pharmaceutical, a vitamin, or hormones, they should be going over all the risks, all the benefits, and telling you all this information so that you can make an educated decision about what form is best for you. But at Kaya, we like to have very tight control. We're very type A. We are a little bit type A. Yeah. I appreciate that. But you know, their goal is to make you feel better. If you're not feeling better, then let me know. Tell me what's not better, or if you're feeling worse at all, I want to know that immediately because I want to turn that around. Yep. You know, I don't want you to sit there for six months and feel like crap or have to be on the pharmaceutical. Sorry, I said I don't know if I'm allowed to say that. I've already been getting away, but I don't want you to feel bad for all that time when I can adjust that and make that symptom go away. Or, God forbid, the worst happens and you get a cancer diagnosis, we just stop it immediately. We don't have to do a bunch of pharmaceuticals on the back end of it. So there's there are safer options out there. And I would just say before you go and do something, make sure that you talk through all of the options. Make sure you look at your family history and know what your risk factors are from a familial and genetic standpoint.

SPEAKER_03:

Can we dive into that for just a moment? Because I'm adopted. So when I said earlier, you know, my mom had no symptoms, no blood relations. And so I also know for myself, like I've had DVTs and PEs four times. So I am a permanent on blood thinners person. And so whenever back up for some people who sorry DVT and PCs in her legs and her lungs.

SPEAKER_05:

Okay, thank you.

SPEAKER_03:

Yep, there you go. Okay. Um so whenever I'm doing research and I'm looking into you know, what would hormone replacement therapy look like for me, it's like, yeah, no, absolutely not. Don't even touch any of that because you have all of these already.

SPEAKER_01:

Yeah, and what you're reading, unfortunately, is about your synthetic. So all of those synthetic, um, that is one of the things that you have to ask somebody if you're gonna put them on a birth control, you have to ask them if they have a history of exactly what you have a history of, because if you put them on that synthetic, then you raise the risk of them having that. Or I'm I'll pick on uh premarin. Um premarin is made from horse urine. Okay. That sounds good. It's a little old school.

SPEAKER_05:

And if you look at the makeup of it, only 17% of it is your bioidentical estradiol. Everything else is conjugated estrogens.

SPEAKER_01:

Correct. So I'm not a 1200-pound equine um mammal. Um, and most of my patients are not. All of my patients are not. So I'm not going to take um, I do have a horse. Um I don't treat it. But I'm not gonna put a hormone from a 1200-pound animal into a female and then stand back and say, Oh my god, you had a heart attack.

SPEAKER_05:

I wonder why. For the layman folk, we're referring to the WHI study that everybody gets their information.

SPEAKER_01:

The one that came out in 2000, that was about premarin. Um again, 1200-pound four-legged creature, which none of us are that we're speaking to right now.

SPEAKER_04:

Um I worked in OBGYN for 12 years, and I remember them prescribing primeran to just about everyone.

SPEAKER_01:

So that was standard of care, yeah, when it came out. Isn't that crazy? Yeah. So that's what I'm saying. Like you need to understand, and whoever you're talking to needs to be telling you. I mean, if I'm starting somebody on a pharmaceutical, I pull up, it's called Hippocrates. A lot of providers use it, and I will show them the side effect profile and say, you need to understand that these are the common side effects, these are the serious side effects. And a lot of people who I take as new patients, they're on a heavy-hitting medication. I'll be like, ugh, was this ever just are you aware of this? Are you aware of the side effect profile of this medication? You have to do the same for hormones. It's that's the fair thing to the patient. If you're going to prescribe something to somebody, they need to understand what they're taking, why they're taking it, and what the risk factors are. And that's the great part about bioidentical. You don't have those naturally occurring with your hormones. When you see the PEs, you see the blood clots and things like that. You typically see those in the 40s, right? Were those more recent? Or were you did you start having them younger?

SPEAKER_03:

Yeah, my first one that I had, I was in college, I was 22.

SPEAKER_01:

Yeah, so there may be a genetic predisposition for you. We just don't know it because you know, or you might know. Some folks who are adopted do have that information. But those are most likely not occurring because of your natural hormones. But if anyone puts you on any synthetic hormones, you would likely have a very high reoccurrence of those issues. But here's the other great thing about bioidentical hormones. We don't even have to touch you with estrogen. If you say, I'm just not comfortable with it, that's fine. Guess what? We can manipulate your thyroid, we can put you on some progesterone, and we can do them as your symptoms suggest.

SPEAKER_03:

Right.

SPEAKER_01:

I have women who have been scared to death of estrogen and they're not gonna touch it. It's not my job to sit there and bully them into taking it. We talk about the risk, we talk about the benefit. If they're not comfortable, then they're going to not feel great on it because they're gonna be constantly worried about it. That's more damage to them than good because they will be constantly worried. I'm not gonna do that to them. But there are other hormones that I can help them with that still decrease diseases. Testosterone. That is your neurovascular prevention. I have several patients I treat with Parkinson's with testosterone, and they've seen a great benefit in their symptoms from testosterone because it's neurovascular prevention. We like our licenses, and so um, even though hormones are safe, there's a lot of folks who are nervous about it. And so we're very careful who we treat. If we treat somebody who has a history of cancer, we will talk to their oncologist first and make sure that they're on board. But I had one lady she's beat breast cancer three times. She's amazing. And our poor thing was suicidal because she couldn't sleep. She couldn't handle any of the sleep meds and just just a mess. And I felt so bad for her. But she said, If you if you could just make me sleep, you know, I just need sleep. But um, she'd be up for 42, 40, 72 hours at a time. And you can imagine, I mean, lack of sleep is connected with cancer for crying out loud. You know, I mean, that's the first thing you have to treat. That's the first thing I correct, even if somebody's coming in about weight loss, and they'll be like, Did you just hear me? I said, I need to lose weight. I'm like, Yeah, you can't do that unless you're sleeping. And so I put her on progesterone. Progesterone has absolutely zero risk of causing cancer. Progesterone is your natural sleep mediator, it's your natural mood stabilizer. Think of all the women that you know who have been put on antidepressants, anti-anxiety meds, and sleep meds starting in their 50s. Uh that's postmenopause. Now you have no progesterone. So then you start getting prescribed things for anxiety, depression, and sleep because you can't handle any of that anymore. You can't sleep and you're you're anxious for no reason. So I gave her progesterone, and I did not know that she was friends with this other person that I knew. And that person came up and gave me a hug, and they said, You saved my friend's life. And I was like, I don't know who you're talking about, but I thank you. I'm so happy. Yeah, I'm so happy. She said it changed it absolutely changed my life. I just had another lady the other day say her husband said he finally has his wife back. They've been married for 30 years. So it changes lives when you do it, you do it well and you listen to somebody. That's the biggest thing. We will hear you, it's we will listen, you will be heard. If nothing else, you will be heard. And sometimes that's what people need in their 40s, you know, when you're being told you're crazy 24-7 by everybody, including your kids.

SPEAKER_03:

And this is normal, even though you're crazy. It's normal.

SPEAKER_01:

And you do feel crazy, you know. I've got five kids, they tell me I'm crazy all the time. Sometimes I think you're right.

SPEAKER_05:

And I'll circle back on estrogen for a little bit. There's a lot of fear associated with estrogen of it causing blood clots, of it causing cancer. And so when you sit down with me and I go through the risks and benefits of bioidentical estradiol, which once again is very different than your synthetic estrogens, I go through all those risks and benefits and I go through studies. And so bioidentical estradiol is never going to cause breast cancer. If it caused breast cancer, every female would have it because we all produce bioidentical estradiol, right? Especially in that period menopause period. However, if you were to develop an estrogen-based cancer, it would feed it absolutely because it is estrogen. And so that's where the risks come from. But they've done a study where they took two groups, one that they both had breast cancer, they both went into remission, and they gave one of those groups bioidentical estradiol. And the relapse rates were significantly lower in the group that took bioidential estradiol than the group that did not. And so it does show a protective factor. This is why we prescribe it. And there's a lot of studies that show that bioidentical estradiol stabilizes the plaque in your heart. And so it doesn't matter if you've been a vegan your entire life, you're gonna develop a little bit of plaque. It's part of aging. And so that helps to stabilize that and reduce your risk of heart attack, reduce your risk of stroke. It is the treatment for osteoporosis, it's the treatment for vaginal atrophy or vaginal dryness. And so we don't think of that as a health thing because we don't talk about it as women, right? But if you start looking at vaginal dryness, that puts you at an increased risk for bacterial vaginosis, which requires an antibiotic, puts you at an increased risk for UTIs, which as we age, we start seeing euroscepsis, yeast infections, all of these things that decrease quality of life. And so estradiol is a huge factor when it comes to prevention. So there's a lot of different ways that you can take bioidentical estradiol too. So for patients that do have a higher risk when it comes to blood clots and or cancer, there's a conversation of if you want to do this and understand the risks and benefits, both ways, we can do topical creams, which reduces your risk threefold because it's not going through your liver. And so there's a lot of conversations to be had. So I don't want anybody to be scared and be like, well, I've had this. It's absolutely off the table for me. Oh good. It's not it's a conversation one-on-one.

SPEAKER_03:

I just love this conversation that we've been having because there's so much information that you guys are giving us. It is a lot, and it's amazing to just sit here and think about it. That, you know, the four of us just had this lovely conversation about perimenopause, about menopause, and there's still still so much more information that could be had, whereas usually it's just not talked about, right?

SPEAKER_01:

And you mentioned andropause too. So on to piggyback on what Sarah was saying, benefits of estrogen, there are actually studies coming out suggesting giving estrogen to men, which men don't cut me off yet. Hear me out. You do need estrogen. Okay, you're not gonna grow from testosterone. Correct. It is aromatized, conjugated, whatever fancy word you want to use, but your testosterone converts into estrogen. You need that. That is cardiovascular prevention. So as you age, again, going through andropause and your testosterone levels fall, so does your estrogen. Think about when men start seeing a lot of hypertension, heart attack, strokes. It's in their 50s too. So they don't have estrogen, they have lost that protective factor. And so when that happens, if you can give the male back his testosterone, he will make his own estrogen. It is very helpful. Just like women need testosterone, we just don't need as much. But men need estrogen, they just don't need as much, right? But we all need those two hormones. It's really important for both, and that happens often. I know Siorcina just as much as I have. You treat one sp one one part of the spousal unit, and the other part comes in and says, Wait for target families because they're using whatever you did for them, do for me because they feel better.

SPEAKER_04:

So do you have men come in for treatment? Oh, a lot. Okay, absolutely.

SPEAKER_01:

We both use it on pretty much all of our patients.

SPEAKER_04:

Uh-huh.

SPEAKER_01:

Because the goal is to use the fewest amount of foreign substances for the body. The goal is always use the least amount of stuff with the highest amount of benefit for your health. So if we have to use pharmaceuticals, we will. But we're gonna try and manipulate diet, sleep, lifestyle factors, try and get your hormones straight before we throw in things that are foreign to the body, including, I mean, I love people who know me, they know I love my supplements. Um, I use Chinese herbs for H. pylori. Like, there's a lot of stuff that you can use for different things, but if you can get somebody's lifestyle right, if you can get their hormones balanced, you have to use so much less of that. And it's wonderful. It saves them money, it improves their health, it decreases side effects. There's so much, so much benefit. Um, and again, we have time to do that because our appointments are 30 and 60 minutes. Um, that's very hard to do in traditional medicine with how short of a period of time that you um see folks. But that is something that we use. I mean, I talk hormones every day.

SPEAKER_05:

Whether you're 14 or 82, I'm asking you questions. And you may not even realize I'm asking you questions about your hormones, but I'm asking a lot about a lot of symptoms that are related to hormones. And there's quite a few books, thank God now, that relate your menstrual cycle to your six vital signs. So there's not a woman out there that I'm not asking about how regular is your cycle, how heavy is your bleeding, how do you feel, what's your PMS like? Because I shouldn't have people, yeah. People listen.

SPEAKER_03:

And that's just mind-blowing.

SPEAKER_05:

Mind-blowing, right? Yeah.

SPEAKER_01:

One of my favorite books is called The Period Manual.

SPEAKER_05:

That's where the vital sound comes from. Oh man, it's such a good one.

SPEAKER_01:

It's if you want a good book to learn about your body, especially moms of teenage girls were pleased with it. For sure. And it's very easy to understand. It's called the Period Manual. Um, and I would try and say the author, but I would butcher it. It's a pink book with a white writing. I have no short-term memory anymore. That was due to a concussion, not just because I'm old. Um don't let the gray hair fool you. Laura Bryden. There you go. It's Laura Bryden. She's right. So in the US, everybody's like, oh man, my PMS is for like two weeks or one week. And that's everybody has PMS. You should not like your period should come and go without an event. Isn't that bizarre? It would be nice.

SPEAKER_05:

I want it to be a surprise each month. Yeah. I want it to be not hearing. You're here. So excited.

SPEAKER_01:

Hello. But again, that's affect it's affected by the food we eat, our sleep, the amount of stuff that we take. It there's so many factors that play into it. And so we work a lot with young women, women in their 20s, 30s. Like I said, we've helped numerous women. We even have a bell in our office now for women who get pregnant who were told you can never have a baby. Um, because it's happened so many times. We're not fertility experts, I will tell you that. We're hormone experts, um, but it kind of wraps it into itself. But we do a lot of that. But your period should not be a huge issue every month. It should not have you throwing up, running a fever, on the floor, calling out of work.

SPEAKER_05:

Absolutely not.

SPEAKER_01:

That should not be a thing. That's a big thing in the US.

SPEAKER_02:

Yeah.

SPEAKER_01:

That is not a big thing around the world. And it shouldn't be. So if it is for you, please come see Kaya. And if we don't have somebody to see you right now, we will in 2026. There's a waiting list and we will help you.

SPEAKER_04:

We could go on for hours about this, but we also want you to go see them. Uh but we do thank you for at least opening up this conversation and just making it not such a taboo thing. Right. And being able to just bring it to the dinner table. Exactly. Yeah.

SPEAKER_01:

Your spouse may not thank you. Your kids may not like that. But definitely talk more. Talk more about it because you're not alone. If you're feeling really depressed, if you're feeling like, man, I'm the only one on earth experiencing this, you're not. I promise you, you're not. If you are 40, even 38, and you're having those symptoms, you are not alone. No. So talk about it. Come see us. We will help you. But see somebody who's actually trained. Don't be shocked if your GYN says there's not help or we don't know about hormones. They're not hormone experts. GYNs are not trained in hormones. They're given the same training we were in school. They're not hormone experts. I love my GYN. He's wonderful, but he's not a hormone expert. They're mainly surgeons. I did an extended period in women's health, and I absolutely love that area. In fact, we just won the area's best GYN and OB, which is funny because we don't do a whole lot of OB, but we help a lot of women have babies. So it's really fun. But go talk to an expert. Find somebody who will sit down and listen and has the time to listen.

SPEAKER_00:

Find hope and inspiration with Justice Daily Devotion. Check out Just DailyDevo.com or search Justice Daily Devotion wherever you listen to podcasts.

Head Shot

Jess

Host

Podcasts we love

Check out these other fine podcasts recommended by us, not an algorithm.

Quirks, Bumps, and Bruises Artwork

Quirks, Bumps, and Bruises

The Morning JoyRide