In this episode, Dr. Kate Dee interviews Dr. Naomi Bush, a specialist in menopause medicine, about the complexities of menopause and hormone therapy. They discuss the historical context and impact of the 2002 Women's Health Initiative study on hormone therapy practices, as well as newer revelations that have reshaped care for menopausal women. The conversation includes the importance of personalized treatment plans, the distinction between bioidentical and synthetic hormones, and specific therapies for symptoms like low libido and vaginal dryness. Additionally, the episode addresses controversial treatments like pellet therapy and stresses the need for better education and healthcare support for women navigating menopause.

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Find Dr. Naomi Busch at Seattle Menopause Medicine

Takeaways

• Menopause care has been historically neglected in medicine.

• The Women's Health Initiative study led to a significant decline in hormone therapy usage.

• Many doctors are now more open to prescribing hormone therapy after understanding the WHI study's limitations.

• Initial consultations for menopause care should include a thorough symptom checklist.

• Perimenopausal women can benefit from various treatment options, including hormonal and non-hormonal therapies.

• Bioidentical hormones are chemically identical to those produced by the body, but their marketing can be misleading.

• Testosterone therapy is primarily approved for low libido in women.

• IUDs can be a good option for women who cannot tolerate progesterone.

• Vaginal estrogen can significantly improve symptoms of dryness and pain during intercourse.

• Healthcare disparities in menopause treatment need to be addressed to ensure all women have access to necessary care.
  
  

Chapters

00:00 Introduction

00:21 Meet Dr. Naomi Bush

00:51 Journey into Menopause Medicine

02:44 The 2002 Women's Health Initiative Study

08:18 Impact of the Study on Hormone Therapy

09:24 Consultation and Treatment Options

16:20 Understanding Bioidentical Hormones

20:58 Testosterone in Menopause Treatment

21:57 Navigating Testosterone Therapy

24:23 Understanding Pellet Therapy

26:04 Exploring IUDs and Progesterone Options

29:10 Addressing Vaginal Dryness and Pain

34:42 Challenges in Hormone Therapy Access

39:59 Concluding Thoughts and Future Topics