Should We All Be On Hormone Therapy? with Professor Susan Davis, AO (Episode 187)

Hit Play Not Pause

Health & Fitness, Education, Self-improvement, Mental Health

4.9 • 696 Ratings

🗓️ 17 July 2024

⏱️ 63 minutes

🔗️ Recording | iTunes | RSS

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Summary

The conversation around hormone therapy for menopausal symptoms is pretty clear. Hormone therapy is the gold standard for treating hot flashes and night sweats and can help with many other common symptoms that come with the menopause transition. It’s very effective and broadly safe. But recently, the conversation has evolved past symptom management and into preventative health with many experts suggesting that hormone therapy may play a larger role in extending a woman’s healthspan, if not lifespan. That maybe we should all start taking hormones to protect our hearts and cognitive health. And there’s promising research in those areas. Yet none of the medical associations recommend hormones for those purposes. Why? That’s what we dig into this week with Professor Susan Davis, AO, who is a pioneer and leading expert in women's health as a clinical endocrinologist, researcher, and educator. She reflects on her decades of research on various forms of hormone therapy and shares what we know–and still don’t know–today regarding traditional hormone therapy as well as testosterone therapy for women’s health post menopause.

Professor Susan R Davis AO, MBBS, FRACP, PhD, FAHMS is a clinician researcher with expertise in the role of sex hormones in women across the lifespan. She is Head of the Monash University Women’s Health Research Program and holds a Level 3 NHMRC Investigator Grant. Susan is a Consultant Endocrinologist and Head of the Women’s Endocrine Clinic, Alfred Hospital Melbourne and a consultant at Cabrini Medical Centre. She is a Fellow and Council Member of the Australian Academy of Health and Medical Sciences. She is a past President of the Australasian Menopause Society and the International Menopause Society. She has over 435 peer-reviewed publications and has received numerous national and international prestigious research awards. Susan was appointed an Officer of the Order of Australia for distinguished service to medicine, to women's health as a clinical endocrinologist and researcher, and to medical education. You can learn more about her and her work at Monash University.

Resources

2023 Practitioner’s Toolkit for Managing Menopause here

Menopausal Hormone Therapy and Cardiovascular Disease: The Role of Formulation, Dose, and Route of Delivery here

Use of MHT in women with cardiovascular disease: a systematic review and meta-analysis here

Studying Studies: Part I – relative risk vs. absolute risk by Peter Attia, MD, here

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Transcript

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0:00.0	You are listening to Hit Play, Not Pause, a feisty menopause podcast for active performance-minded women.
0:14.6	I am your host, Celine Yeager. Each week, I bring you advice from athletes, scientists, researchers, and other experts to help
0:21.2	you feel and perform you best no matter what your hormones are doing.
0:25.0	This show is a production of Live Feisty Media.
0:30.9	Hello, strong, feisty women.
0:33.3	I hope you all are well.
0:35.4	So I have a great one for you this week. As everyone hearing my voice
0:39.5	has seen and heard, the conversations around menopause hormone therapy, MHT, HRT, HT, HT,
0:45.6	whatever initials you prefer, have been evolving at breakneck speed since we launched the show in the fall
0:51.1	of 2020. And the landscape is now super confusing.
0:56.2	Scroll through any menopause social media feed and you'll see messages that hormone therapy
1:00.9	will reduce your risk of dying prematurely by a third and it'll cut your risk of heart disease
1:05.9	by half and many similar statistics. And there's a lot of promising research out there.
1:11.6	But then you turn around and you look at the guidelines from medical bodies like the
1:16.5	Menopause Society and the American Heart Association and pretty much all the governing bodies.
1:20.9	And they clearly state that they do not recommend hormone therapy for the prevention of
1:26.2	chronic diseases like heart disease, stroke,
1:28.9	cancer, and dementia. And it is 100% natural to throw up your hands and be like, what the
1:34.7	hell is going on? I do it almost daily. And objectively, I can see what's going on. For one,
1:41.6	often the statistics are presented in relative, not absolute risk, which we'll
1:46.5	talk about in a bit, but relative risk is almost always more dramatic sounding. And also,
1:52.3	importantly, the research landscape is just incredibly messy. Hormone therapy is not one thing.
	...

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