Episode 98: Menopause Medicine: Facts, Not Fear

 Dr. Douglas Gearity is the founder and Medical Director of the Women’s Center of Orlando, one of Central Florida’s leading OB/GYN practices, with offices throughout the region. Learn more or schedule an appointment at www.wcOrlando.com

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Transcript

Robin Rountree: Welcome to Informed Aging, a podcast about health help and hard decisions for older adults.

I'm Robin Rountree I'm a former family caregiver. I've worked in the home care industry and now work for the Alzheimer's and Dementia Resource Center. The thoughts and opinions expressed belong to me and my guests, not our wonderful employers and sponsors before making any significant changes in your life or your person's life, please consult your own experts. Today we're gonna talk about something that impacts most women, that's menopause. Men. Don't be scared off 'cause you need to know what is going on with us and why we've suddenly become not ourselves. So stay tuned.

Robin Rountree: We are back today talking to Dr. Douglas Garrity. He's the medical director and founder of the Women's Center of Orlando, which has multiple locations in the central Florida area, and he's turned the Women's Center into one of the largest and most reputable private practices specializing in obstetrics in gynecology in the state, thank you so much for being here and answering questions about menopause. My pleasure. Alright, so what is happening to our bodies as we get older that brings on so many symptoms? 

Dr. Douglas Gearity: Well, age, time, and so, uh, menopause is interesting, the aspect that your ovaries over time turn off and, and then you age.

There's no other organ in the body that turns off and people shame you into not treating or taking medicine for it. 

Robin Rountree: Oh yeah. 

Dr. Douglas Gearity: Think about it. So if your pancreas turned off and you became a diabetic, you take diabetes medicine. 

Robin Rountree: Yeah. 

Dr. Douglas Gearity: You thyroid malfunctions. You take thyroid medicine, your ovary malfunctions, and people say, oh, I'll just live with it.

Or You could live with it, or I lived with it, and shame you into taking hormones almost. And yeah, the World Health Organization came out with a study, uh, probably over 30 years ago, that misinterpreted the statistics and said there was an increased risk of heart disease and cancer with taking hormones.

It is such been disproven and the statistics were wrong, that actually taking hormones lowers your risk of heart disease and lowers your risk of all cancers. 

Robin Rountree: Wow. 

Dr. Douglas Gearity: But 

the word's not out. 

Robin Rountree: No, it's not. 'cause I remember when that came out, I was quite young, but I do remember those headlines and women going, oh, you have to stop your HRT, which is hormone replacement therapy.

Dr. Douglas Gearity: Correct. 

Robin Rountree: So there was a panic there. And you're saying for most people, and obviously we want you to talk to your own doctor about this, 

Dr. Douglas Gearity: individualize the medicine for the person. 

Robin Rountree: Yeah. But hormones are not that scary thing they used to be. 

Dr. Douglas Gearity: No, no, not at all. I mean, uh, again, think about your, your ovaries produce estrogen, progesterone, and testosterone.

And, and by you turning off those ovaries and, and them slowly malfunctioning, your body changes. You get older and you're not changing for the benefit. You're not changing better, you're just changing. And so by giving back those hormones people feel better, they have more energy, they have better clarity of their brain, they increase their muscle mass, increase metabolism, increase weight loss.

And so when you were 20 and 30, you were active, life was good, and then when your forties and fifties and sixties, you're. You're changing and the same thing you've been doing for 30 years now is more difficult. 

Robin Rountree: Yeah. Yeah. And the, the range of symptoms when I was reading up on it can be, we know all about the hot flashes, 

Dr. Douglas Gearity: right?

Robin Rountree: But the brain fog 

Dr. Douglas Gearity: Right. 

Robin Rountree: Didn't see that coming. 

Dr. Douglas Gearity: Right. Your body changes, your muscle mass decreases. So now you go to the gym to survive. Versus when you were 20, you went to the gym to change your body, to get more physical fit to proceed. But now you're just saying, I just want to maintain, I just wanna not get older.

And, you know, the, the pages are turning and so what you really wanna do is have the, the building blocks and that's what hormones are, the building blocks. So you can maintain and do well. And, um, so sex drive, the ability to have relations. Um, the estrogen changes your vagina from a, let's think of a cuboidal or a brick.

A brick thickness to a very thin layer. And, and so when you're having relations, you have difficulty accommodating relations, and the estrogen maintains the vaginal mucosa so you can accommodate and, you know, uh, if something's painful, you stay away. If something is pleasurable, you go towards, so if something, the lack of hormones changes you.

Why would you not? And it's just basic. I mean, there's no other organ that would change and you say, I'm gonna live without it. If you're a diabetic, your blood sugars are three hundreds. Of course you feel great. Right. But you're, you're gonna leave sooner. 

Robin Rountree: Right? Right. Well, I love this. Uh, idea that yeah, something in your body is failing and we, we need to help it 

Dr. Douglas Gearity: address it.

Robin Rountree: Yeah. We are. For generations before ho hormone replacement therapy, we did kind of have to live with it. But, you know, we had to live with diabetes until the medication came along. Right. So, uh, what are some other symptoms that a woman might be having that she may not realize is due to her ovaries changing, 

Dr. Douglas Gearity: right? So, uh, just irritable, You just have to decide what's best for you. Everybody's an individual and medications affect people differently, and not taking a medication affects you.

So you just have to realize by doing nothing, you are making a decision. Mm. So that's, you gotta remember, you know. 

Robin Rountree: Okay, so I know when I think of a drug class like antidepressants, there are tons of different options there. Are there a lot of options with hormone replacement therapy? 

Dr. Douglas Gearity: Yep. Uh, yeah.

Uh, well, one testosterone's a controlled substance and, and so it's been reclassified. So you need to come in and see the physician, and the physician has to prescribe it to you, and then you have to repeatedly come back to see him and make sure everything's okay. Uh, estrogen, , there's

issues, clotting issues, uh, it can promote breast cancer if you have it. , So you need to discuss with that and make sure that's fine. Progesterone is basically, uh, benign, but it does have, uh, pluses and minuses. And you can take the, the hormone replacement, the estrogen testosterone can be placed in pellets that go underneath your skin.

Uh, you do that every three to four months. So that has a continuous dissolve into your bloodstream, which works really well. People like it, it lowers your risk of complications, liver disease and, and, and other things and better treatment. You can use creams that get absorbed straight into your bloodstream and you can pills.

Downside of the pills is you gotta go in your stomach, get dissolved, go to your liver, liver's, gotta digest it, and then it gets out into the bloodstream. So it's just whatever makes the patient happy, whatever they can accommodate. And then cost is always a, you know, an issue. Hmm. Uh, most of the times

the insurances don't cover, testosterone. Uh, but it's reasonably, it's cheaper than lattes. So if you get a latte a day, it's cheaper than a latte a day. Okay. 

Robin Rountree: Alright. That's a good way to look at it. And if you feel better, you may not need that latte. Exactly. 

Dr. Douglas Gearity: And you'll live longer. 

Robin Rountree: There you go. I like that.

So there's different ways to have your medications, but there's different, uh, name brands out there too, correct? Yep. Okay. Yes, 

Dr. Douglas Gearity: . There is a medication that's been around since 1950s and sixties. Astro test, uh, that's a pill form that's available at the pharmacies, so there's lots of ways of taking it.

Robin Rountree: So tons of research have gone into these hormone replacement therapies. It's not new on the scene? 

Dr. Douglas Gearity: No, it's been a long time. 

Robin Rountree: Okay. Older 

Dr. Douglas Gearity: than you and I. Because we're young. 

Robin Rountree: Oh, that's right. Let's go with that. See, a doctor said that it must be true. Exactly. Um, when you're my age and you've googled once for menopause, uh, my social media feeds are pretty filled with things that people are selling that are not coming from a doctor.

Natural remedies. I hear black cobash is one. Um, are these things as well studied and do they work? 

Dr. Douglas Gearity: Well, first off, you gotta think what you're purchasing is actually what is on the side of the bottle. Mm. And, uh, so unless it's made in an FDA approved lab, what you're buying might not necessarily be in the

pill that you're taking. So yeah, because 

Robin Rountree: that's not regulated very, it's 

Dr. Douglas Gearity: highly unregulated. It's Cowboys and Indians. And so you, if you're gonna buy a medication that's over the counter, make sure, and especially if you're doing something that wants to replace a hormone or you think it's important, uh, it's gotta be made in an FDA approved lab so you know exactly what you're taking.

Robin Rountree: Alright, so you would suggest the medication route rather than the herbs and, uh, internet Right. Solutions because 

Dr. Douglas Gearity: you don't know what you're taking. 

Robin Rountree: Alright. Very valid point. And for the men that are married to women going through this change with their ovaries what is your recommendation?

Dr. Douglas Gearity: My recommendation is, uh, they encourage them to do hormone replacement, the estrogen, protects their vagina, their bladder, the testosterone people feel better, they have better clarity of their brain, increased metabolism, increased weight loss. They generalize, do better. And then I suggest they look in the mirror, uh, because they could probably use some too.

Uh, and. So their testosterone level is decreasing. They can say it's normal, but it's normal for their age group. Uh, what was it when they were 20 and they were active and busy. I think when people get into the second stage of their life, which is where we are mm-hmm. That they need to be active and that lowers the risk of heart disease, that lowers risk of all cancers.

Uh, and so I think they need to encourage their spouses to do hormone replacement and then themselves. Look in the mirror. 

Robin Rountree: Alright, so, um, if a man's testosterone goes down, he's, is he having some of this similar issues? 

Dr. Douglas Gearity: Lethargic, tiredness, weight gain, a belly decreased energy, cloudiness of the brain.

It's, it's all equal. What happens to boys happens the girls, 

Robin Rountree: wow. They just don't get the hot flashes, right? 

Dr. Douglas Gearity: Uh, they can. 

Robin Rountree: Oh, okay. 

Dr. Douglas Gearity: But they usually, they complain. It's the 'cause they're snoring at night. Uh, sleep apnea is another big serious thing you gotta look into. 

Robin Rountree: Yeah. Thank you so much. And tell me again, uh, the Women's Center in Central Florida, where are your offices located?

Dr. Douglas Gearity: So it's wc orlando.com. Okay. And, we have offices, Hunters Creek, St. Cloud, downtown, Oviedo, Altamonte Maitland Winter Park. an office near you, if you're 

Robin Rountree: in central Florida. Yes. And 

Dr. Douglas Gearity: so, uh, wc orlando.com. You can make your own appointment online. We have lots of physicians, that are able to accommodate.

Robin Rountree: Alright. Thank you so much for dropping by. I really appreciate it. 

Dr. Douglas Gearity: Thank you for the time.

Robin Rountree: Please make sure to subscribe to our podcast Informed Aging, tell your family and friends about us too. If you'd like to support the work that we do at the Alzheimer's and Dementia Resource Center, please go to adrc cares.org/donate. You'll find us at facebook.com/informed Aging.

That's it for now. We're looking forward to our next visit.

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