10 Good Reasons with Professor John Studd

Hello and a warm welcome to this new podcast on Hormone Replacement Therapy! On today’s episode we talk with Professor John Studd about his research on ten good reasons to be happy about taking HRT. 

This podcast is affiliated with London PMS and Menopause Clinic and is hosted by Chloe Russell. 

London PMS and Menopause Clinic 

Address: 46 Wimpole Street, Marylebone, London, W1G 8SD

Phone: 020 7486 0497 

Website: https://www.londonpmsandmenopause.co.uk

Thanks to Ben Talbot-Imber for production support and conversation editing.

Transcript

spk_1:   0:03
Hello and welcome to the hay. HRT is good for your podcasts. My name's Chloe, and this is a show for women and men of all ages, particularly emphasis on women of those who are entering the medicals. How do you have a struggled with low libido or depression, Among other characteristics of the menopause? Well, that's exactly what we're going to help you with on this week's show. You'll learn how hey, chart is effective, beneficial and a bubble else it is safe to be using now. Join May as I speak to Professor John Stud, vice president of the National Osteoporosis Society and chairman of the British Menopause Society, on his positive research on 10 good reasons to be happy about using Hate are, too Hey, Char t stands for hormone replacement therapy, by the way. Now let's get started. And I hope you enjoy the show. Hi, professor.

spk_0:   0:55
I know my love. How are you?

spk_1:   0:56
I'm good. How are you?

spk_0:   0:58
All right.

spk_1:   0:59
I've got in front of Mae your paper that you wrote in 2010 called as I see it 10 reasons to be happy about hormone replacement.

spk_0:   1:07
That's I got that fun to be now as well.

spk_1:   1:10
Have you do brilliant? Well, it seems you have lots of benefits of using hormone replacement therapy. Can you remember writing it all these years ago?

spk_0:   1:19
Just remember right things very well.

spk_1:   1:22
I wonder how much the research has actually changed and advanced since then?

spk_0:   1:26
Well, it's still up to date. There's nothing inaccurate in it. Yes, I wrote this paper about 10 years ago, and a lot of my colleagues are printed it off to give it to their patients. And it is just a a summary of the important points where HRT could be of great benefit.

spk_1:   1:47
Yeah, it seems like the most important message you want to communicate is that it's effective, beneficial and, most of all, safe to use. Well,

spk_0:   1:55
there's all those things are trying on its HRT is really a breakthrough. I started the first menopause feeling in Europe way back in 19 68 when I was a ah young trainee because I was teaching the students the the familiar storey that women didn't need hormones for the menopause. They needed some tranquillisers Onda nice husband. I taught that rubbish for a long time until I realised that there's a different way on by started this clinic in Birmingham and it was closed down following a protest from the local being A. But then he started running again and still going now. But it was quite clear that the pacers that we saw, um, with the appropriate symptoms got better.

spk_1:   2:52
Brilliant. Yeah, well, I can see from your reasons there's loads of great reasons to be taking HRT

spk_0:   2:58
well, initially, that no one would dispute that the principle of symptoms off the menopause were hot flashes, sweats and vaginal dryness. Vaginal pain that's been known for 50 years or so. And there the 1st 2 of my 10 points that HRT will stop the hot flushes and sweats.

spk_1:   3:25
Yeah, how would that work?

spk_0:   3:28
Well, the problem is, of course, that this course in storm earlier tiredness, depression, irritability is you carved three poor knights, and it's quite clear that antidepressants that have been used for this condition Third word at Eastern's always work. I'd say on the second thing is the vaginal dryness. There's a lot of of college, a lot of mucus fitness in vagina, which causes paid difficulty in intercourse, discharge and, of course, the loss of libido Now these are the two things flushes and sweats Andi surgeons for vaginal drivers, but nobody would ever dispute of worthwhile.

spk_1:   4:26
How does hate Artie actually treat painful intercourse? Is it Is it the east region that you have to take?

spk_0:   4:32
You take issue. That's right. After after menopause, women lose collagen from their skin, the vagina of the nails, hair, the bladder, the bone. All those things were affected. And we know from our studies over the years that the loss of collagen and the losses thickness in the skin even replace in one year and one year, you replace older that on the same thing applies, of course, to to the vagina and just important the bones. Because the other major problem with the menopause is that women get thinner burns on that 30% off women in the age of, say, 80. We would have had that osteoporotic fracture, that the fracture of the hip or factor the spine, and that is all all preventable by giving estrogen's.

spk_1:   5:40
And I read that it's also good for women who suffer with anorexia. Is that right?

spk_0:   5:44
Well, that's right, that that's the other group. The other group of the young women with anorexia who were thin, whether they are exercise freaks going to the to the gym for two hours every day over the erected. So athletes like belly dancers, they have problems because they lose their periods and then lose their body fats. And they have terrible bones. These women and it's all it's all related again to the loss of Eastern on the loss of coverage in and the loss off the bone matrix, the bones, scaffolding with the calcium and whatever's attached to. So it's a fundamental question. A formidable problem, shall we say, of loss of colleges.

spk_1:   6:37
If a male has anorexia, can they still take HRT as if they were women? Or is it? It's a different

spk_0:   6:45
Well, yes, men who have osteo process said it's a different storey. Actually, the men that have all supposes I have Lupus so shrewd. This is manifested. Sometimes when they go to the doctor with loss of libido, lots of erection, um, a tightness crabbiness, it said trip. They often have low bone density, and if you've given testosterone for the symptoms, it improves their boat. Dead city considerably

spk_1:   7:20
brilliant. Do you actually have a lot of male patients.

spk_0:   7:24
I have quite a few male patients

spk_1:   7:27
saw

spk_0:   7:28
more women, of course, and the male paces come with with sexual problems. And they are amazed that the test saucer is low and their bone density is low. So there's an equivalence in men, but it is much, much more common, better understood in women.

spk_1:   7:50
That's interesting. And I read here that Eastern helps depression and many women. Is that the same in males as, well?

spk_0:   7:58
No. And it's very different. Depression in men is different from depression in women and psychiatrists. Really, Ah, hardly aware of this is because psychiatrist don't recognise the hormonal factors in depression, right. Men have virtually no hormonal factors and depression, but they

spk_1:   8:22
know

spk_0:   8:23
no march. But women do, in three obvious ways. Premenstrual post a fool after the birth of a child and at the minute balls. So these three times of hormonal flux, where you have depression, premenstrual depression occurring before every period, it gets better with pregnancy. When the Hohmann lives are higher and static, and then they deliver the baby on the east, never go down on the Depression Rekers as post natal depression. Then, years later, when they're towards the menopause. They have depression then and in sport they realised that these symptoms off the menopause are at their worst before the period stalk two, you haven't got to be 55 no periods for years. You could be 45 and you're still having regular periods. And you still have these problems depression in this in these years that we called the menopause in transition.

spk_1:   9:50
Do any of these symptoms sound familiar? If you'd like to find out more about how we can help you resolve tthe um, you can reach the London PMS and Menopause Clinic, where you can speak to Professor Start and its trust the team of gynaecologists. We hope you're enjoying the show and let's get back to it.

spk_0:   10:07
Another one of these points is that HRT protects the inter vertebral discs. Now they're entirely collagen and there between the vertebral bodies, and they all acted a cushion over the years. Stopping you're developing a crush fracture ofthe bits of the spine, and that's a cause of the loss of Jai. It's that old women may get the so called Dowager's hump on DH, so not only disease Jin's protect the bones because of its a vegetable in college, in in the In the Matrix. But also it protects the discs between the bones because there are entirely collagen and the college it is protected by the east regions.

spk_1:   11:01
All right, Wow. And that's why we should protect them. But do you need to take HRT before you hit your menopause in order to protect them?

spk_0:   11:11
It's difficult to answer that you may want to start treatment before the menopause for other reasons. Like flushes, sweats on DH on depression, of course, to protect the bones well here. Women in this age group ship, probably if they're thin, should probably have a bone density scan around the menopause, even before the menopause. And if they are low, the scan. It's a shame that have osteo pina, which is a step before osteoporosis. Then they should be given eastern straightaway.

spk_1:   11:56
So it really depends on patient a patient.

spk_0:   11:58
Yes, of course, of course. And when we speak about Eastern, let's make one thing clear. The eastern should be through the skin, but not by tablets. There was a view that H. I t caused heart attacks on DH. We do know the giving aural Eastern's eases by mouth with this young girl's on the pill or older women having H. R T. There is a slight increase in from Versace because Asians by mouth, but use the regulation factors from bolivar. So there's this slight, slight increase in heart attacks and strokes and strokes with Eastern's by mouth. And therefore we always always give Eastern's through the skin transdermal e by patches or gaols, or sometimes by implants that accents. That makes a lot of sense, I think.

spk_1:   13:06
Going back. Teo Heart attacks How long do you need to be on the treatment in order to mitigate the risk of a heart attack?

spk_0:   13:13
Nobody knows that The answers were that nobody, I think it's It's enough that people recognise the transdermal HRT does reduce the number of heart attacks. That's all we can say at the moment.

spk_1:   13:33
One thing we haven't explored too much into deficit libido

spk_0:   13:37
you Can

spk_1:   13:37
you Can you explain why? Hey, try. Teo improves libido.

spk_0:   13:42
Well, a lot of libido is a very common symptom. Age to 40 plus up to 60 or wherever, and the obvious one is that you you stopped the vagina being painful and dry

spk_1:   13:58
So

spk_0:   13:58
that's it. One aspect, but also the HRT improves energy, improves mood and whatever added to the attitude to the Eastern therapy, we should also give testosterone. Testosterone is not just a male homer testosterone, because in women and its president in 10 times the quantity as a surgeon in women. So it's a very normal female hormone on giving testosterone again through the skin helps energy libido, number of orgasms, all sorts of things.

spk_1:   14:46
So it's safe for women to have additional testosterone.

spk_0:   14:49
Very safe, very beneficial.

spk_1:   14:52
Get in. It's testosterone. Help with your skin it or is that East region

spk_0:   14:57
based and Eastern alone? Testosterone can really cause problems with the skin, and then it can cause excess hair growth and excess of sports. But actually, but in the right, there's it. Dozens. And if it does, you can really stop the test on through. So that's a very rare but obvious complication. The benefits of increased libido are considerable

spk_1:   15:25
when it comes to the skin texture improving. It also helps other parts of body like your nails. Is that right?

spk_0:   15:32
Well, that's right. As I said before, around the menopause awful available is you lose college and from the vagina with mentioned the bones. We mentioned individual discs, skin certainly on the bladder and the nails and the hare. All these things I improved. Bye. Getting back your normal college and levels collagen. In many European languages, collar is glue, so let's go. A collagen is simply glue, but you're losing on the most obvious way to see it. Rather, menopause is thin. A skin.

spk_1:   16:17
Yeah, How does it affect the bladder

spk_0:   16:21
for the same reason? The same. Same reason. Bladder as two components of muscle and membrane on both of those things are related to collagen on. We do know that many women who have problems off getting up to pee about 45 times a night all they have paying with big tuition. They would frequently just have sanitation of the urethra, which is unnecessary. They're much better off having any surgeons, which will help these women. You have painful miniaturisation and to frequent passing war for eight nights.

spk_1:   17:06
It's interesting. I would never have thought that the blood it would have been affected like that.

spk_0:   17:10
It certainly is very common.

spk_1:   17:13
Does that change depending on your age, or if you have a baby

spk_0:   17:18
I don't think the pregnancy makes my much difference because you have an increase issue and that it comes down to normal new levels, then proceed as I have other effects on the skin like classmate. But we're not going there today.

spk_1:   17:34
I read on your paper that there's actually a quote from a patient that says I'm a nicer person to live with. Do you hear that a lot

spk_0:   17:41
Trying. I do hear a lot from patients and from husbands as well. Many women say that Easton's stop depression improved the libido with less irritability

spk_1:   17:55
on

spk_0:   17:56
the gender become more agreeable people. Chris. The mood is better and the happier.

spk_1:   18:02
Oh, that makes a lot of sense,

spk_0:   18:04
but that's a direct quote from a patient. I'm a nicer person to live with.

spk_1:   18:10
That's lovely. The final thing that we really want to get across from your research is hey, HRT is safe.

spk_0:   18:18
Well, that's number 10 of my boy, we'll be saying is in spite of all the occasional bad news you gets about cancer of the breast or strokes or whatever, it really isn't true and that the there was this very expensive 2002 study off orally surgeons in America, where they choose the wrong drug, the rug roots, the wrong patient, the wrong age and came to the wrong conclusions. And this is a study that cost more than $1,000,000,001 billion on the investigators are now going around the world, lecturing and apologising for the mistakes they've made for this big baby boomer generation in America who have been denied for about 10 20 years, hormone therapy for their symptoms and the long term health based upon bad data. So all the evidence now is that there are not more heart attacks, but they're fewer heart attacks. They're not more strokes for their fewer strokes. The breast cancer storey keeps popping up is not related to Easter Jin's because every study looked at season's unknown to no change or a decrease in breast cancer. It is due to the using continuous progestin gin to stop the bleeding. And they said, Well, what I don't do, um, use continuous, discontinuous progesterone that's a natural progesterone for seven or 10 or 13 days a month, and not synthetic progesterone gen every day, which is the miss factor for breast cancer. Now, that was number 10 and there's number 11 which wasn't published. Number 11 is that there is almost certainly a decrease in Alzheimer's disease. Alzheimer's is more common in women than men. It's a more common in women with energy. Menopause on DH. Logically, logically, insurgents sure prevent Alzheimer's as it does other degenerative conditions. Now it's difficult to prove this to everyone's satisfaction that we know from big population studies, including the huge Utah started in America. The Alzheimer's is less common with women. Have a long term, the surgeons Kent the pure epidemiologists must have a randomised controlled child. Now, how did you have this? With thousands of women starting from when age 50 40 30 on what happens and for the placebo group with the patients when the women's and we're saying developed symptoms, what's have hormones? So the study is invalid to begin with. So this compulsion to do a randomised controlled trial it is not possible for looking at out. Simon's and I would remind you of a little piece of history when it was first discovered that smoking causes lung cancer and that smoking doctors hello, 13 times greater incidence off lung cancer than Boxer, who didn't smoke. People still ask for a randomised trial. And Sir Richard Doll, the offer famously said, There's no point in a randomised trial to prove the bleeding obvious.

spk_1:   22:37
So that's

spk_0:   22:38
going back. That's got to medical history. That's that statement.

spk_1:   22:42
What's your opinions on the outside the case?

spk_0:   22:46
Oh, I think it's very logical. It's very logical. And all the population studies strongly suggest that women on Long Term Eastern's have less Alzheimer's.

spk_1:   22:59
Huh? When did this come to your attention?

spk_0:   23:02
Oh, years ago?

spk_1:   23:04
Really? And what we've gone through all our 10 reasons, plus an extra one.

spk_0:   23:08
That's right. 10 reasons plus one E hope. You'll convinced.

spk_1:   23:13
Yeah, I think so. Hello and welcome back. Who would have guessed that your bladder could be affected like that? I didn't. If you have any questions about today's episode, you confined us on our Twitter at Hey, HRT is good for you, and we'd love to get in touch. Next week, Professor and I will be talking in more detail about depression and how I hate Artie can help with this. Thank you for listening. And don't forget, you can find the contact details for the London PMS and Menopause Clinic on even our show notes or online by searching for the clinic. See you soon