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cover of episode 597: Expert insights on hormone replacement therapy for women

597: Expert insights on hormone replacement therapy for women

2025/5/22
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The mindbodygreen Podcast
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A
Amy Killen, M.D.
J
Jessica Shepherd, M.D.
M
Maddy Dychtwald
M
Marty Makary, M.D.
Topics
Maddy Dychtwald: 我认为即使关于激素的讨论开始开放，仍然存在很多错误信息。特别是关于更年期的讨论正在开放。但早期的妇女健康倡议研究存在缺陷，因为参与者是60岁或65岁以上从未接受过激素替代疗法的女性，而且使用的是合成激素。该研究因为显示与心脏病有很小的关联而被停止，但该研究存在缺陷。如今，更年期专家和医生普遍认为，对女性来说，进行某种激素替代疗法是非常好的主意。 Marty Makary, M.D.: 我认为绝经后妇女开始雌激素或雌激素加孕酮的激素替代疗法非常有效，可以延长寿命，降低心脏病和认知衰退的风险，并增强骨骼。激素替代疗法是改善绝经后妇女健康的最有效的医疗干预措施之一，但由于对乳腺癌的错误认知，许多妇女被剥夺了这种疗法。大约80%的医生仍然认为激素替代疗法会导致乳腺癌，因此拒绝开处方，导致数百万女性错失了这种健康益处。睾酮替代疗法（TRT）对男性也有一些好处，但不如女性的激素替代疗法研究得透彻，需要在内分泌学家或专业医生的指导下进行。医生开出的睾酮替代疗法可以帮助男性改善睡眠、提高能量水平、辅助锻炼和减肥，但需要在专业医生的指导下进行，以避免身体的女性化特征。 Amy Killen, M.D.: 我认为优化激素对女性的健康至关重要。激素替代疗法是改善长期健康和延长寿命的最佳方法之一。应该在围绝经期开始考虑雌激素、孕酮和睾酮的治疗，通常在绝经前5到10年，症状包括体重增加、睡眠不好、易怒、焦虑或经前头痛等。血液测试是检查激素水平的金标准。即使没有症状，我也建议在绝经期考虑激素治疗。 Jessica Shepherd, M.D.: 我认为药物最初是通过混合制成的，现在我们既有混合药物，也有合成药物。激素替代疗法既可以通过药房配制，也可以通过制药公司合成，而且有生物同源的药物和非生物同源的药物。制药公司可以生产生物同源的激素替代疗法，但并非所有生物同源的药物都必须是配制的。生物同源的药物激素替代疗法已经过FDA批准，而配制的药物虽然受到严格监管，但未经FDA批准。如果医生不支持激素替代疗法，你应该更换医生，因为你是自己健康的CEO。你的健康、健康寿命和长寿比与医生的亲密关系更重要。

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Shownotes Transcript

“HRT is probably the best thing that you can do to improve long term health and longevity,” explains Amy Killen, M.D.

In this episode, we’re covering everything you need to know about hormone replacement therapy, including the incredible benefits of HRT and when you should consider starting HRT. 

You’ll hear from:

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Maddy Dychtwald, author, longevity expert, and co-founder of Age Wave, on the study that changed the way HRT was viewed and why it’s time to rethink that narrative 

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**Marty Makay, M.D., **the US Commissioner of Food and Drugs, a Johns Hopkins surgeon, public health expert, on why hormone replacement therapy may be one of the most powerful tools for women 

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Amy Killen, M.D., a longevity and regenerative medicine physician, on when to consider HRT and how it supports long-term health

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Jessica Shepherd, M.D., OB/GYN and menopause expert, on the different types of hormone therapy and how to find a provider who supports your goals

We’ll cover:

  • The flawed study that changed HRT perception (~1:05)

  • The incredible benefits of HRT (~4:15)

  • What about TRT for men? (~7:20)

  • Hormone health is longevity (~8:45)

  • When to consider HRT (~9:48)

  • The different types of HRT (~11:10)

  • You are the CEO of your health (~13:48)

Listen to the full episodes here: 

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