Dr Louise Newson: [01:00:00] So on the podcast today, we're talking about natural versus synthetic hormones. I've got with me Sara Hover, who's a pharmacist. It's a great listen that everybody should be listening to, whether you take hormones or you've got a daughter, niece, somebody at work who's maybe taking synthetic hormones, it's really crucially important to know the difference between the natural bioidentical or body identical hormones and synthetic so-called labelled hormones, which are actually chemicals made to act like hormones, but they're not. So have a listen and let us know what you think.  [01:00:34][34.2]
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Dr Louise Newson: [01:00:36] So Sara, you're over from the US. It's always exciting having real life patients from abroad in the studio. So thank you so much for making the effort to come over.  [01:00:46][9.8]
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Sara Hover: [01:00:46] Absolutely, very excited to be here.  [01:00:47][0.9]
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Dr Louise Newson: [01:00:48] So you probably know more about hormones than me, although I'm catching up, but because you've been in it for a lot longer than me. I feel really cheated as a doctor because I've only really known so much over the last 10 years, whereas you've being in this for a bit longer, haven't you?  [01:01:03][15.3]
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Sara Hover: [01:01:04] A bit longer. I've been a pharmacist for 30 years and before I even got my licence I was working for a pharmacy in the Dallas area, I'm from Texas, and they were doing hormone replacement and it really opened my eyes. I had one particular patient that came in, her insurance changed so she had to see a different practitioner and she then also needed something for sleep and depression. And she was like, I don't want to be on all these, her blood pressure went up. All these things started, the wheels were coming off the bus.  [01:01:34][30.1]
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Dr Louise Newson: [01:01:34] Yes.  [01:01:34][0.0]
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Sara Hover: [01:01:35] And she told her husband, I don't care what it costs. I'm going to go back to that doctor. I'm gonna go back to that pharmacy. And that was my big a-ha moment of the nutrition we were supplying to her along with the bioidentical hormone replacement was, made all of those things, other medications go away. And so it became my mission to help educate women because we've been lied to for decades. [01:01:56][21.9]
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Dr Louise Newson: [01:01:57] We have, and I want to talk about this. So, I've been a medical writer for many years. I've trained as a physician, so I'm not a gynaecologist, and I've also got a pathology degree. So I like basic science, but I've worked as a medical writer for for many, many years for healthcare professionals, but also for lay people. But about 12 years ago, I went to a lecture and the doctor there was talking about micronised progesterone and saying how different it is to synthetic progestogens. Now, back then, the progestogen-only pill was called the progesterone only pill. So I thought, well, we've got progestorone. And then I read about micronised progesterone. So then I wrote an article about it. I used to write a weekly article, and it was called GP. So it was a magazine that was given freely to every GP. And it was sort of key topics so It was to keep people up to date. So I wrote an article about hormones and I wrote about progesterone, micronised progesterone and Utrogestan, which is one of the ones that we've prescribe quite a lot over here. And there were letters of complaint that came in, and one doctor wrote to say, how dare Dr Newson write about a drug that isn't even able to be prescribed on the NHS. Now it was, and it still is, able to  be prescribed on NHS, it's in the British National Formulary, it's no more expensive than synthetic hormones, and I was really shocked that someone could be so rude about me without knowing the facts. But I'm not shocked now because lots of people are rude about me without knowing the facts, but I thought then, gosh, it's because it's something different and it's something about women and its hormones that these people got very cross. Whereas if I was writing about a new ACE inhibitor for hypertension, they'd probably go, oh, this is interesting. So I was really, and so then I started to use it in my practice, but it wasn't on our formulary. So in, I don't know if you know, in the UK each region has different formularies. So although we've got the British National Formulary, which is like our bible of drugs, if you like, so we can theoretically, as licensed doctors, prescribe any, each formulary will say what you can and can't prescribe, and it's usually on cost. So when I, after hearing this lecture, I went and read about the differences between natural and synthetic progesterone and progestogens, I thought, well, I'm going to prescribe Utrogestan. It wasn't on the formulary. Like the drop-down box on my computer, it wasn't there. So I initially had to hand write the prescription and I got into trouble for it. So then I went to the local authorities and I said, I'd like to change it for Utrogestan. They said, well, no, you can carry on giving medroxyprogesterone acetate or norethisterone. And I said but they're completely different and they said, no and I had to write so much and in fact, I left the practice by the time and now they've changed it, but it took about three years to change. And I look back now and I'm really shocked by that episode because no-one would listen to me, no-one would understand the difference. And if you go back to basic chemistry, just explain to me the difference between these different progesterones. Because there is only one progesterone isn't there? [01:05:07][189.6]
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Sara Hover: [01:05:08] All of the progestin, progestogen, progesterone, they all get used interchangeably and it's frustrating because there is a lack of understanding. I used to talk to physicians, and I would talk to them about the differences. And they're like, they didn't understand. I said, well, would you prescribe medroxyprogesterone to a pregnant woman? They're like oh, absolutely not. I go, well then they're not the same thing because you would give progesterone to someone to help maintain their pregnancy. So that was always my big, kind of getting them to think.  [01:05:37][28.8]
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Dr Louise Newson: [01:05:37] To think, yeah.  [01:05:38][0.8]
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Sara Hover: [01:05:38] Because with hormones and receptors, it's like a lock and key. And so it may fit into the lock, but it's not going to turn it the way that we want it to turn. And if you just even look at the molecular structures, they are very far from even looking the same. So it's very, very different. And it's frustrating. The literature, I always tell pharmacists and providers, please read in the literature. A couple years ago, I was planning to do a talk on hormones in the brain, and I had turned in my learning objectives and I hadn't written my PowerPoint yet, but there was an article that came out that said, hormones cause dementia. And I was like, oh, this is perfect. And I had a student at the time, I was like, here, I am doing this talk on hormones in the brain, and here's this article, and she looks at me like I'm crazy that I'm excited that this article has come out. And so I'm like, just, I want you to dig down into it. She comes back and she was like, on the very last table, had to dig down into it. It was all synthetic hormones. I'm like, exactly. They cause dementia, progesterone, estradiol, testosterone, promote brain health. And so, I loved that I could use that article as an example of you can't just read a title. You can't even just read the abstract. You have to dig.  [01:06:53][74.8]
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Dr Louise Newson: [01:06:53] You have to, and it's so important. And because the terminology is quite confusing and it is banded around in the wrong way, and all hormones are lumped together, so any insert will talk about risks, whether it's the bioidentical, the natural estradiol, progesterone, testosterone, or the synthetic versions, it still has the same risks for the consumer, for the patients, same warnings when we try and prescribe it through our computer systems. So you can understand how this confusion happens. But often, if I'm not sure about something, I've got quite a simplistic brain, so I'll go back to basics. I'll be like a sort of annoying two-year-old asking why, why, just explain. And so going back to very molecular, like the key and lock analogy is so brilliant because so many people understand when, we have all had the dodgy key cut. And sometimes it does fit into the lock and then it just doesn't turn, does it. But there are two problems with that, firstly it doesn't unlock, like you say, this lovely cascade of biological processes that occur in the cells. But if it's in the lock and you've got the new key, you've got to take out the old one first. And that is a real problem with the synthetic hormones, isn't it?  [01:08:04][70.8]
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Sara Hover: [01:08:04] They hang onto the receptor for a long time. It can take three, six, nine months sometimes before we start to see, you know, the bioidentical be able to do what we want it to do because that synthetic's on board. And it's hard. It's frustrating. You know, I usually talk about how we taper off of a synthetic, especially if we've been on it for a long time, it's not an easy process.  [01:08:27][22.4]
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Dr Louise Newson: [01:08:27] Yeah, so I've written a lot about this in my book because the history, I think is really important. It's all about commercialisation at the end of the day and when they discovered the structure of the hormones, they wanted to make them commercial so they could sell them through pharmaceutical companies. So they altered the structure just very slightly, but a small difference in chemical structure can make a massive difference in the body and how this substance works. But also the research was done on the lining of the womb. So they were very much focusing on, will this woman bleed or not with this synthetic progestogen? But they didn't look up or look down. So they weren't looking at, if you look down, looking at the muscles, looking at their nerves, looking at, even the skin. And then looking up, my goodness, they didn't go to the heart or the lungs and certainly didn't go to their brain. So they've got this synthetic chemical, I don't even like calling it a hormone because it's not a hormone, that has been tested on for bleeding. It hadn't really been tested whether it was a contraceptive or not when it was licensed, was it?  [01:09:38][71.4]
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Sara Hover: [01:09:39] No, it really wasn't. There was an article that came out about comparing medroxyprogesterone acetate to progesterone, and they were testing it on rhesus monkeys. Do you remember that? It was before the WHI.  [01:09:52][12.4]
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Dr Louise Newson: [01:09:52] Yes, it was a long time ago.  [01:09:53][0.5]
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Sara Hover: [01:09:53] And they basically they internalise stress like we do. And they gave one group, I don't know how they stressed out these monkeys. I don't want to think about that. But they were able to see that medroxyprogesterone acetate caused vasoconstriction, and progesterone caused vasodilation. So when I first read the WHI, I'm like, did they not read the rhesus monkey study? Like it wasn't a surprise that medroxyprogesterone acetate caused stroke and, you know, more risk for women because of the vasoconstriction.  [01:10:20][27.2]
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Dr Louise Newson: [01:10:22] Absolutely. And they can negate these beneficial effects of those hormones, probably because the key is stuck in the receptor really, isn't it. But they have their own effects too. And some of them we just don't know. But we, I mean, we as clinicians, I've spoken to so many women who have been given synthetic hormones, whether it's in contraception, whether it's in older types of HRT, whether it is in an implant, the Depo, injection. Whether it's the hormonal, inverted commas 'hormonal', but the synthetic progestogen coils, they've had negative effects affecting their mood and their memory and their sleep and their cognition. Yet they've often been told, oh, you're probably depressed. It won't be related to your hormones.  [01:11:05][42.4]
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Sara Hover: [01:11:05] Exactly, or they're, oh, I've had so many patients that thought that a hysterectomy was gonna solve all of their problems. And that's just the beginning of it. It was hormonal imbalance that was causing their problems and just taking out the component that is bleeding doesn't solve the issue. And I look at those patients as medical victims, like it just really breaks my heart. Many times I'm like, oh if I had talked to you sooner, I could have helped you sooner. But, you know, we do what we can to help as many people as we can, but education is key.  [01:11:37][31.6]
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Dr Louise Newson: [01:11:37] It's really crucial, isn't it, because I was talking to someone at the Royal College of GPs recently about the difference between natural and synthetic hormones. And he just said, Louise, you've just lost me there. Just stop talking now. And I said what! It's not that difficult. Once you understand, it is really not difficult. So just to recap, really, in all contraceptives that are marketed as hormonal, they don't contain natural hormones. We've got one in the UK called Zoely which contains estradiol, not ethinylestradiol, but all the others that contain inverted commas 'estrogen' is ethinylestradiol, which is a synthetic estrogen. It's like estradiol with an ethinyl group, so it doesn't have the same. And actually we've known since 1979 it's a carcinogen. So it can cause cancer and there are risks with it, but all contraception that's marketed as hormonal contains synthetic progestogens, doesn't it? [01:12:32][55.3]
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Sara Hover: [01:12:34] It does, it does. And how many young women and young ladies have problems that, you know, it's difficult.  [01:12:40][6.4]
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Dr Louise Newson: [01:12:42] It's very difficult. Because a lot of people, like I say, aren't believed, they're not believed that it's associated with their hormones and it's very hard to prove because you can't do a blood test and say, oh yes, you're having a side effect to your progestogen. So a lot of people are being told, well, it's trauma, it stress, it something else, or you've got a psychiatric diagnosis. A lot of people also, and I was taught it, told that if you have a hormonal coil, so a coil that contains the synthetic progestogen. It doesn't get in the bloodstream. And so therefore, you can't have systemic side effects from it. [01:13:15][32.8]
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Sara Hover: [01:13:19] I strongly disagree with that. And the same thing, even with, I believe, with vaginal estrogen. There was an article that I was doing a, I was asked to do this talk on kinetics, and I'm like a very simplistic pharmacist, like, you know, if I left it in my trunk, I'm not going to do the degradation right, I am going to say, oh, let's replace it, you know, but I had to do a kinetic talk, so I thought, okay, well, I'll dig down into some literature, and I found this article on vaginal estrogen and how they that it only stays in the vaginal tissue. But in the same article, they went on to mention that it helped with vasomotor symptoms. And I'm like, it's not just staying there. It's getting everywhere. So if that is absorbed systemically, certainly a synthetic progestin is going to be absorbed.  [01:13:59][41.0]
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Dr Louise Newson: [01:14:01] The thing is if you put anything on an area where there's blood supply, the blood will go around. And actually with vaginal estrogen, these are natural body identical, bioidentical, it doesn't matter. But I've seen people, especially when they've got very thinning of the skin, they get absorbed quite quickly and you can get, you know, it's a very small amount. It's not enough to be concerned about.  [01:14:21][20.8]
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Sara Hover: [01:14:22] Correct.  [01:14:22][0.0]
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Dr Louise Newson: [01:14:22] But if you've got something going into the womb, that's touching the lining of the womb. The womb is a lot more vascular than the skin or the vulva or the vagina. So you will get some going into the uterine vessels, which will then get into the bloodstream. And I've seen people that have had really severe mental health symptoms. One lady was a psychiatrist and she actually took it out. It was a weekend. She couldn't get to see a doctor. So she actually just pulled the threads and took it out herself. And she said, you know, within minutes she felt better.  [01:14:51][29.0]
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Sara Hover: [01:14:52] I heard the exact same story recently that someone else was like, nope, this is not for me. It needs to come out of there. So no, it can definitely be systemic. I mean, there are a lot of progesterone receptors in the vaginal area. So I mean it makes sense that maybe some is going to stay there because of the attraction to those receptors. But we have progesterone receptors all throughout our body and that's why I get frustrated when they say a woman that's had a hysterectomy doesn't need progesterone. [01:15:16][24.4]
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Dr Louise Newson: [01:15:19] Oh don't get me started. I was at a presentation, I went to ISSWSH Conference, a really great conference in Los Angeles recently, and there was a talk by one of the menopause societies talking about POI premature ovarian insufficiency, so menopausal women under the age of 40, and she showed the flow diagram, which you will have seen many times before, has a woman, you know, had a hysterectomy or not, yes or no, therefore if she's had a hysterectomy, she only needs estrogen. So I went up, I took the microphone and I said, oh, I'd just like to ask, we all know that our ovaries produce progesterone, estradiol, and testosterone, actually. But just thinking about progestorone first, we know it works all around the body. We've got receptors on every cell, especially in our brains. So when women have their ovaries and womb removed, why are we only suggesting estrogen? It just doesn't make sense. And she said, because that's what the guidelines say.  [01:16:14][54.7]
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Sara Hover: [01:16:15] Oh, wow.  [01:16:15][0.4]
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Dr Louise Newson: [01:16:15] And I said, well, yes, but I'm just wondering why. So then she said, well, some people don't tolerate progesterone. And the audience actually laughed. And then she said, next question, please and that was it. She didn't want to engage in any further... But some people don't tolerate a certain dose of progesterone. But some women crash their car. Does that mean we can never drive?  [01:16:35][19.6]
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Sara Hover: [01:16:36] Right.  [01:16:36][0.0]
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Dr Louise Newson: [01:16:39] I wanted to take a quick pause from our conversation to tell you about my new book, The Power of Hormones. Many of the topics we discuss on this podcast are explored in much greater depth in my book. I look at how hormones really work in the body, why they've been misunderstood for decades, and how confusion between natural hormones and synthetic hormones has influenced medical practice and public perception. Most importantly, I explain why understanding hormones is essential for improving both current health and future health. So if you'd like to continue learning beyond the podcast, my book, The Power of Hormones, is available now and I've included a link to buy in the episode show notes.  [01:17:23][44.5]
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Dr Louise Newson: [01:17:26] And we get quite a few letters of complaint in the clinic because we're giving progesterone to women who've had a hysterectomy. And the doctors are saying, how dare you prescribe. And when I sort of interpret it, it's like, how do you prescribe a natural hormone to somebody whose hormone is missing.  [01:17:42][15.4]
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Sara Hover: [01:17:42] Right.  [01:17:42][0.0]
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Dr Louise Newson: [01:17:43] It's really weird, isn't it?  [01:17:44][1.0]
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Sara Hover: [01:17:44] And progesterone makes estrogen receptors work better, and vice versa. And like you said, there's receptors in the thyroid, the breast, the brain, you know, the intestines. I mean, our body is so, it's such a miracle. Like it never does, has one way to do something. And so it's not going to just have one job. It has many jobs throughout the body.  [01:18:06][21.2]
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Dr Louise Newson: [01:18:07] Yeah and it's interesting because we see people when they're perimenopausal and they're producing their own progesterone, they sometimes don't tolerate progestorone so well then, but then as they become older and they're menopausal and their progestrone really drops, then they really enjoy having the progesterone back. But they're quite nervous because they said, oh, I didn't like it when I tried it before, or we might change them from oral to a pessary or a cream. And then they feel very different because they're metabolised quite differently, aren't they? [01:18:34][27.1]
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Sara Hover: [01:18:36] Oh, absolutely. I mean, I do love oral progesterone just because of the metabolite, the allopregnanolone. It can really, really help with anxiety, depression, and obviously sleep is fabulous. But there are some ladies, I usually ask, like, how did you feel when you were pregnant? And some will say, I was pregnant. And others are like, it was the best time of my life. I enjoyed every minute of it. And others like, I hated every second of it, that kind of gives me an idea like... [01:18:59][23.4]
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Dr Louise Newson: [01:19:00] What they're going to be like with progesterone.  [01:19:00][0.9]
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Sara Hover: [01:19:01] How they're gonna do with progesterone. I mean, we can still work around that and work through different dosage forms, different strengths. And that's the beauty of personalised medicine is we can fine tune it.  [01:19:12][11.9]
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Dr Louise Newson: [01:19:13] Totally, and that's really important. We do it with every other aspect of medicine and somehow with HRT, certainly when I started to prescribe it in the 90s, it was fixed dose. It was one dose and you either like it or you don't. And often people then, if they didn't feel better, they would say, well, it can't be a hormones because you've been on HRT. And I look back and I think, oh my goodness, that was a, well it used to be the estrogen from pregnant horse's urine and medroxyprogesterone acetate. No wonder they didn't feel better.  [01:19:43][30.2]
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Sara Hover: [01:19:44] Oh my gosh.  [01:19:44][0.2]
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Dr Louise Newson: [01:19:44] You know, it's, but things have moved on.  [01:19:47][2.2]
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Sara Hover: [01:19:47] Yes.  [01:19:47][0.0]
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Dr Louise Newson: [01:19:48] So giving personal or prescribing personalised hormones is really important because you've got flexibility. So we always prescribe the progesterone, estradiol, testosterone separately. Certainly initially. I mean, they can be combined when we know the right dose, but having them separately gives real control, doesn't it. [01:20:06][17.9]
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Sara Hover: [01:20:07] Absolutely. And that's what I would recommend to my patients or my providers when I had my pharmacy was, let's start out separate so we can see how you respond. Because if they're all combined, we're going to have to raise or lower them together. And there were a couple of times patients talked me into that, and I regretted it every time I did it, because then there would be an issue. Maybe they had some fluid retention, and maybe we need to back their estrogen down. There were things that we needed to tweak, and we couldn't because it was combined. But I got to the point where it was like a hard no, we can't start combined, but I would tell them that was an ultimate goal.  [01:20:42][34.8]
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Dr Louise Newson: [01:20:42] Yes, yeah and it's the absorption is a real issue and there's still confusion out there. We have had, and we still have so many patients whose doctors refuse to prescribe them a higher than licensed dose of patches or gel, yet their estradiol levels, which I know are only a guide, are low but they've got symptoms that improve when they increase their dose. And I feel very strongly about optimising dose for two reasons. Firstly, because I've had a whole Panorama documentary made about doses against me. But secondly, as a patient, I've been using higher than licensed doses for the last 11 years. And if I didn't, I wouldn't have been able to work and function. But I also get very frustrated with the patches. So the gel doesn't absorb at all. It just literally floats. You can see it floating off my skin. But the patches sometimes are brilliant and I have no worries and problems. And other times they don't stick very well. So it's almost been like perimenopausal again. I'm sure I'm getting intermittent absorption. And because I'm a migraine sufferer, it triggers a lot of migraines and a lot joint pain as well, actually. So the tiredness and the mood things, that can be due to so much, but it probably is related to hormones, but migraine and joint pain is something that you can't really make up. And I find that really frustrating because you think you've just got there and then you can't. So having alternatives like a cream can be really just life-changing actually.  [01:22:20][97.3]
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Sara Hover: [01:22:21] Oh yeah, absolutely. And the migraine sufferers, I'm always super, super careful with, because it's the change in hormones.  [01:22:27][6.0]
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Dr Louise Newson: [01:22:28] Of course it is.  [01:22:28][0.0]
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Sara Hover: [01:22:28] And so, you know, even though they might be extremely low, like, we're going to start out with baby doses and just barely fill up the cup. Even though we want to fill it up right away, we need to just kind of drip it in so that it doesn't kind of throw things off in our body. So, yeah, those patients are definitely more difficult. But yeah, it's, the patch is... A lot of patients do great with it, obviously. I live in Dallas, so Texas in August, September. I wouldn't recommend that would be a time to visit because it's hotter than it can be. And I had a patient that was a semi-pro golfer and she was on the golf course, 100 degree. I mean, it's fahrenheit, so I'll let you do the conversion. And she told me, as soon as I put the patch on, I feel like it's gone. And that was the first time it made me think, and like you, thinking about chemistry, thinking about physics and like heat transfer.  [01:23:22][53.6]
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Dr Louise Newson: [01:23:22] Yes, of course.  [01:23:23][0.7]
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Sara Hover: [01:23:23] Her body is super hot. They probably didn't test that. She was probably sucking every little bit of estrogen out of the patch and then nothing. So if someone is super active, they're outdoors, they work out a lot, even if they tolerate the adhesive and it stays stuck, they might not be getting the even delivery that they need.  [01:23:42][18.9]
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Dr Louise Newson: [01:23:41] Well this is the thing, but we've known it for decades actually when you look at some of the studies because it's not just between different women you can get differences it's also the location whether it's on the back or the bottom or the thigh but also like you say the temperature of the skin there's so much and it's basic pharmacology actually so it seems madness that people are worrying about the doses because actually it's all about absorption and penetration through the skin, isn't it. [01:24:08][26.7]
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Sara Hover: [01:24:10] Absolutely, yes, what we're absorbing. And then the other part that I heard a doctor talk about not that long ago just really made me think twice about things is what's going on at the receptor. We don't even know that. You know, we don't know what's going on at the receptor. We can measure how it's getting in. We know how much we're giving but that part is kind of like a mystery that I think is the next next thing we have to solve.  [01:24:30][19.7]
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Dr Louise Newson: [01:24:30] It is. And also, you know, I see a lot of women in our clinic who have very severe mental health symptoms. One in six have suicidal thoughts and a lot come from psychiatrists. A lot of them have been inpatients and a lot of them have been mislabeled really with treatment resistant depression. But they've been on antipsychotics for many years, which can obviously block their hormones. And increasingly, some of them need higher doses for their mental health. And it's impossible, isn't it, to know, you know, blood tests will tell you what's in the blood at the time of the blood being taken, but it doesn't tell you what's going on in the brain. We spend time with our patients. We're very lucky we see our same patients coming back and we work with them very closely and you learn a lot when you do that and you think you've just got there. And then I always say to the patients, I don't know whether it's true or not, but it's almost like the ovaries have a bit of a swan song just before they go. There's this sort of heightened activity and you know, they can get breast tenderness, they can get bloating, they can get bleeding, and they come back and say, my hormones, and it's like, actually, I don't think it is the hormones I've prescribed for you, I think it's your own. Just give it a bit of time and then they settle, don't they. And yeah, it's, but we're all different.  [01:25:44][74.0]
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Sara Hover: [01:25:44] Absolutely.  [01:25:44][0.0]
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Dr Louise Newson: [01:25:45] I think that's important. I know a lot of people will be listening and thinking, right, what am I going to do either for my contraception, or for my daughter's contraception. And there's no easy answer at all really, is there? [01:25:57][11.6]
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Sara Hover: [01:25:58] There is not. I have a 25-year-old, a 21-year old daughters and an 18-year old son and you know I've been doing this for 30 years and so when I first was learning about, after pharmacy school, was learning the negative things with synthetics, that's the first thing I thought of is what am I going to tell my girls. And you know abstinence sounds great.  [01:26:20][21.7]
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Dr Louise Newson: [01:26:21] But it's not going to happen.  [01:26:22][1.1]
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Sara Hover: [01:26:22] It's not reality, and I realise that. But I just, you know, and they've heard me talk for years about the negativity of synthetics. So we opted for copper IUD. I felt like it's, you, know, not perfect, but it was at least a non-hormonal option. There was a non-hormonol contraceptive that came out, and that's, like to change the pH. I don't know that I trusted that like I wanted my girls to get through school, you know. [01:26:53][31.1]
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Dr Louise Newson: [01:26:55] And of course, they can still have natural hormones on top, can't they, if they need to. [01:26:59][4.0]
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Sara Hover: [01:26:59] Absolutely, yeah. So just getting everything balanced is really key.  [01:27:02][2.8]
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Dr Louise Newson: [01:27:03] Really important and yes, certainly with Balance app, we're doing a lot more education about younger people with PMS, PMDD, PCOS, about having those natural hormones back. Women with endometriosis, often the inflammation lowers when they have progesterone, maybe testosterone as well. So looking at those hormones beyond just for perimenopause and menopause is really key, isn't it.  [01:27:27][23.0]
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Sara Hover: [01:27:27] Absolutely, absolutely, and just, yeah, and looking at the whole patient, you know, it's, we can't just narrow in just on these hormones, these female hormones, we have to broaden and look at adrenals and thyroid, their gut, what's their lifestyle like, it's, you, know, just, are they sleeping? That's key for so many things, do they need to lose weight? Like, just really, I'm just more functional medicine of really looking at the whole individual, but hormones is really the key piece to so much. [01:27:52][25.4]
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Dr Louise Newson: [01:27:52] So much, isn't it. So I'm really grateful for your time. Before I end, I always ask for three take home tips. So three reasons, and we will have talked about it already, of course, but three reasons why the, when I say natural, bioidentical, body identical, so the three reasons why these natural hormones are a lot better and safer than synthetic hormones.  [01:28:14][21.7]
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Sara Hover: [01:28:16] One, I'm all about brain health. With what I do with education, I want to make sure my brain is always functioning. And so brain health is number one. We also want to feel good and live longer. I mean, in a healthy health span, not a life span. And I do think that the bioidentical helps us to do those sort of things. Let's see, number three, It's just, you know, overall happiness. You know, I've had ladies come to me that were, their hormones weren't balanced and they stopped doing the things that they used to love, their hobbies. Once we get their hormones balanced, then they have that zest for life again. And so to me, it's all about quality of life as well. So the health span, the quality of life and brain health.  [01:29:07][50.5]
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Dr Louise Newson: [01:29:07] That is so important, really important things to end on. So thank you so much, Sarah, for coming to the podcast today.  [01:29:12][5.3]
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Sara Hover: [01:29:13] It's been my pleasure. Thank you.  [01:29:14][1.3]
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Dr Louise Newson: [01:29:17] So just a quick one, it would be really great if you could follow or subscribe to this podcast. This will really help me reach more people with evidence-based information about hormones and their future health, and also means you never miss a future episode. Thank you.  [01:29:17][0.0]