The Splitting Smart Podcast

Heartbreak or Hormones? How HRT Could Save Your Marriage (Part 2) Ep 59

• Kelly Bennett, Esq. • Season 1 • Episode 59

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Feel like something’s “off?" It might not be you—it might be your hormones.

I’m back with Dr. Diana Hoppe—OB/GYN, hormone expert, and breast cancer survivor—to get into what most doctors still aren’t telling you about hormone therapy. 

We’re talking about foggy thinking, the myths around hormone replacement theory, and what you can do to feel like yourself again.

If you’ve ever asked, “What’s happening to me?.... You’re going to want to listen to this episode.

Here’s what we get into:

  • Why brain fog is not something you “just have to deal with”
  • What really happened with that HRT study in the early 2000s
  • Dr. Hoppe’s own breast cancer story
  • What your OB/GYN might not be trained to look for
  • How men can help their partners during perimenopause
  • Natural ways to reset your system through supplements 
  • How to find the right doctor who actually listens

It's time to stop blaming yourself—and start getting answers that actually help.

About Dr. Diana: 

Dr. Diana Hoppe is a board-certified OB/GYN, best-selling author, and total rockstar when it comes to helping women feel like themselves again. She is the founder of AmazingOver40.com, a telemedicine platform focused on hormone balance and women’s wellness. 

RESOURCES: 



Kelly Bennett: You mentioned brain fog. You know, I've experienced being in court over the years as I think I was starting into these phases of all of a sudden I lose my words, I lose my phraseology as I'm advocating is it really stinks when you got somebody on the stand and you tried to do cross-examination.

You can't think of the word exhibit or whatever it is, right? 

Dr. Diana Hoppe: Men don't have to go through that because men don't have menopause. They don't go through very menopause. They just have dropping of testosterone levels, but they're a slow decline. It's not what women have to go through.

So brain fog is a wonderful topic. I love talking about it too, because some of it has to do with the lack of sleep. So I mentioned about night sweats, hot flashes, those symptoms, when your sleep is interrupted, you're not getting good REM sleep rapid eye movement sleep, which is the deep sleep, which you need for your brain to basically kind of like shut off and regenerate and get rid of toxins and kind of recharge, right?

Then the domino effect of every night not getting sleep... you can see how that will cause brain fog, irritability, all those things. And so there's a compilation of reasons why brain fog happens.  

The thing about when it occurs most is mostly in the perimenopause because of the fluctuating hormones. In menopause, the brain fog tends to be a little less. But for me, I'll just say when I turned 55 and I got diagnosed with breast cancer, the doctor says, you have to stop your hormones.

And I was on hormone therapy bioidentical and I got major brain fog. I mean, my brain didn't function. So it a symptom for some women during menopause because they for me, I just needed estrogen I couldn't remember what the patient just told me, you know?

 When you have to review the history over and over and saying, well, was there a family history of breast cancer and was there this? And you're like, okay, I just asked that question. How could I not continue forward motion here, and it was very frustrating. And so for me, I'm a breast cancer survivor and I am in hormone therapy.  

And again, there's a lot of misinformation about hormones in general and as well as hormones for women with breast cancer. So that's where my site, my Amazing Over 40 site, has a lot of blogs and information because there's so much misinformation out there.

Kelly Bennett: That's right. Your side is so good on the resources and I want to point everybody there to your resources and to get that information on all the things, brain fog and the dangers or the myths.

 So to speak, of hormone replacement therapy. I mean, I've heard that all the time. If I do that, then I'm going to get cancer. You want to dispel the myth while we're, while we're on the subject, please? 

Dr. Diana Hoppe: Let's do it Kelly. Let's dispel that myth. Okay. So unfortunately that myth was created due to the Women's Health Initiative, which was a study that was done, published 2002 in Journal American Medical Association.

So the JAMA, which is a very reputable journal. The problem is that the women in the study, the average age was 63, and so they're about 10 years post menopause. And so the goal of the study was say if we give women hormones, is it going to help cardiovascularly? Is it going to help with their health long term, et cetera.

So what they found, bottom line, is that women who on combined hormone therapy had an increased risk of breast cancer. And there was also increased risk of cardiovascular disease. So all the years of what we said, oh estrogen's the best thing that ever happened since sliced bread. They just completely took that out and made it so hormones are the worst thing that can happen. So what they didn't telL us was that 50% of the women that in the study were smokers. And we know that smoking is a huge risk factor for cardiovascular disease. So to even have them included and not somewhat subset out of that is completely unimaginable, but they just lumped 'em all together and said that, you know, basically it was increased risk of heart disease. And when they actually looked at the younger women - so the average age was 63.7 - the women who were 50 to 59, they actually had less cardiovascular disease on the hormones than those that were later.

So the goal of the study was to say, if we give Premarin, which was pregnant mare's urine, which is estrogen, to women average, 63, they range from 50 to like 70 something, but the majority were around their sixties, and that's 10 years post menopause.

And what's interesting is that window of opportunity of when to start hormones is kind of lost because now the estrogen protection is no longer there. They didn't put logic into it. When you look at the subset analysis that is analysis, after the study was published, they found that those younger women, 50 to 59, actually were cardioprotected.

That is when they were in hormones, it helped their heart. It helps decrease plaque and it helps as an anti-inflammatory. So that's one thing. Then the breast cancer part was really "miscombobulated", if that's even a word. What they did with the breast cancer, they didn't clarify really what the breast cancer was due to. So they have the Premarin group, which was the women who had a hysterectomy. So they were just on estrogen alone, Premarin only. And then they had the Prempro group, which is Premarin Plus Provera.

And Provera is for the women that was synthetic progestin that had a uterus. The women that were in the Premarin only part of the trial, they had less breast cancer than the placebo group. So basically Premarin does not cause breast cancer so the group that had breast cancer was the group on Prem Pro, which is synthetic progestin. Mm-hmm. And that they think is the cause, not natural progesterone or natural estrogen. So really what's causing the breast cancer, I think in what we're seeing is not the hormones, but hormone disruptors.

That means what are the things in our environment that are causing more cancer and that's pesticides, the plastics, the chemicals, all the things our bodies are exposed to. Mm-hmm. That we shouldn't be exposed to, which then interfere with our hormones. And so it's called hormone disruptors. The problem is, even some of the primary investigators or the principal investigators have come back and made statements that this was completely taken out of context.

These women weren't the age of menopausal. They were postmenopausal these 10 years. You can't take this. Information and use it for a 51-year-old woman. because it's completely different. The timing of hormones is very different. And if we can get a woman to be on hormones early on during that 10 year opportunity, she can stay on those hormones her whole life. There's no need to stop. 

Kelly Bennett: I'm glad you're here clearing it up because it's important. I think what happens is women aren't feeling right. They know something's up, but then they're hearing these myths and so they feel like it's just a roadblock.

And I think that would add to more hopelessness, really. 

Dr. Diana Hoppe: Absolutely. They're not being heard and they go to doctors and doctors, they see rheumatologists, they go to some other cardiologist, they go to the next person. And that, that doctor's not putting the pieces together. Maybe it could be somewhat hormonal fluctuations or maybe it could also be relationship things going on.

Or, you know, there's a lot of things that affect our health, right? And so we can't just take a pill and say, just take this and go home. Right? Right. When they come to me, they're like, you know, no one's listening to me. I'm not being heard. I have dementia, I have early Alzheimer's. 

Kelly Bennett: Well, if you can't remember exhibit in the courtroom, what else are you going to think? So, so let's jump into the fix, Diana. So when the, when patients come to you, what's the fix? 

Dr. Diana Hoppe: Yeah, so this is where there's a light, right? There's a positive thing to all of this. I mean, we're, we're being kind of lighthearted, but the point is there are a lot of really good ways and easy and simple and safe ways to take care of perimenopause and menopause. Okay? And so there's hormone therapy, bioidentical hormone therapy. There's also some testosterone replacement that can be part of bioidentical hormone therapy that can sometimes help libido, but the hormones themselves can get a woman feeling back like herself so that she can sleep at night so that things don't hurt when she has sex, that she can actually have better like skin and just feeling like more vibrant.

There's lots of ways to take hormones. There's creams, there's different capsules. There's bioidentical hormone therapy from a compounding pharmacy. There's patches. So there's a lot of things. I think the best is if a woman knows that there is help and there are doctors out there who are passionate about trying to help women during this time.

And it also helps men because if men understand what's happening to their partners, their wives or their girlfriend, whatever, they're gonna get better understanding about, well maybe she's not going crazy. Maybe it's just things are stressful. 

Like just understanding what's happening and communicating it would make so much better. 

 And I love that. You know, a lot of our listeners are men and I think it's interesting. Would you take a call from a man who says, Hey Dr. Hoppe, what do I do with this? How do I get her to come see you? Because she's so irritable and she's not sleeping and everything I say is wrong. What should I tell her? 

First, kudos for listening to the podcast because it shows that you're interested in what's happening with your partner and what's potentially might be causing some of the stress, some of the strife during this time.

Dr. Diana Hoppe: And so that's a great question. Like how do you address her when she's kind of irritable, she's not sleeping, and you're like, the last thing I want to do is like I walk on eggshells and how do I approach this? So that's a great, great question. So I would maybe come from the standpoint of, hey, I was listening to this podcast and Kelly Bennett has this great podcast, Splitting Smart.

I was in the car listening to it and they were talking to this doctor about hormone changes and how that can affect mood, brain fog, irritability, just not feeling yourself. And so, they can take it from a standpoint of, Hey, maybe there's something we can go to together if you want to talk to your doctor or get some lab tests done, or talk to someone who might specialize in this because there may be ways that we can maybe make our relationship better.

Men can be changing too . So it can be like saying, Hey, I'll go see my doctor. You go see your doctor and maybe we can try to figure out how we can get back to where we were when, you know, things were, we were getting along and we were actually having a good sex life and we were actually communicating and we're having fun and going on date nights and really enjoying our relationship. Where now it seems like it's crumbling. So I think both partners can take somewhat responsibility. And so it's not just, it's your fault and you need to work doctor. Right? 

Kelly Bennett: And I love that approach because it's very positive and it's, let's do this together, let's figure this out together. And you do a lot of telemedicine.

I have no problem telling the listening audience, you're my doctor, right? You're so accessible. If a couple were having this kind of trouble, they could make an appointment with you to talk to them about it?

Dr. Diana Hoppe: Absolutely. And actually I've moved from San Diego to Henderson, California license and a Nevada license, so yes, I would definitely love to have your clients come see me. And if they want their husbands involved too. Absolutely. And this is what I do now. I used to have an office in San Diego for 30 plus years, and then Covid, and then my mom passed away from dementia. And I wanted to just decrease my expenses and have more flexibility. Yeah. So this is my little home office here in Nevada. 

Kelly Bennett: But I love it because you're so accessible and you know, I'm sure a lot of people are in the same situation. I was in where, you know, if you're with certain PPOs and HMOs, there's still some limits around this and not as the extensive testing and it's not very expensive.

I would advocate go outside. To get to somebody like you who's so good, so thorough and gets relief immediately with the diagnosis of whatever is missing. Right. And you have a line of supplements as well, and I know that supplementing has made a huge difference in my life. 

Dr. Diana Hoppe: It's a holistic approach to taking care of a woman and then a woman's relationship with her husband, partner, you know, etc.. But it's not just take a pill and you're fine. It's more, let's look at the whole picture. Let's look at your exercise. Let's look at your nutrition, let's look at the supplements.

Like do you need, you know, more vitamin D3?. You know, do you need the supplements that I have, it's called Amazing Over 40, and so I have different supplements and I made it simple because I have a lot of patients who bring in bags and bags of their supplements and they don't know what they're for.

Right? No one told them that they might be over-dosing on certain things and underdosing on another thing. So I want to simplify it because we have enough on our plates to deal with. So I made a supplement line, private labeled it, and so that women know like, what are the five essential things they should be taking?

You don't have to take 25 supplements and have, you know, the list that goes on and on. Make the little like vitamin B, vitamin D, the thyroid, make sure it's good. Make sure your hormones are being balanced. Make sure your stress levels are as low as possible. So all of these things go into your health, and that's why you need someone that will really take a good overall 360 look at your whole life. Yeah. And then put the pieces together like a puzzle and say, okay, let's fix this. Let's put this, let's do this. And that's what the art of medicine is. 

Kelly Bennett: It's beautiful because medicine for so many people has really devolved to go to this doctor for this little piece, and then you have to go over here to this physician for this piece and this piece.

And I love that you're looking at the whole picture. I mean, I know you can't address everything that's outside of your expertise. But looking at that whole, it's just like me akin to what we do with, we've got a whole host of experts at our disposal where some of it's just, it's out a little bit outside the law or a piece of it where we need that assistance, but it, you are providing an invaluable, invaluable, service to people. 

Dr. Diana Hoppe: You are also by even having this podcast, even addressing this issue in itself is outside the box of what maybe most attorneys would do. So I think you're coming from incredibly supportive and understanding and just how do we make life better viewpoint. 

Kelly Bennett: You are an advocate for detoxing...

 

Dr. Diana Hoppe: So I have a seven day detox. It's on my Amazing Over 40 site. And the whole purpose of detox is to remove the harmful chemicals or toxins in your body, right?

And some of it is unavoidable. So we want to have clean air, but we also want to have good foods that we're eating. So we want to avoid pesticide ridden foods. So I talk about how to basically detox the negative things in what we're putting in our diet, which is a detox program that we're going to work with the liver to get rid of those toxins.

We also talk about how to detox your brain from all the stress that we're under. So it's a really a resetting and recharging of your whole metabolism, but also your life, because then you can change your mindset. Because you could do a seven day detox and then go back to the same habits you were doing before, like eating all that sugar.

Or the processed foods that we eat. And if you can change like you're vegan, you mentioned, right? So if we can avoid a lot of the meats that are of a lot of antibiotics or chemicals, if we can have grass fed meat, if that's, or lean proteins with salmon, etc. There's so many healthier versions of what we can eat that it makes our bodies feel so much better.

Our hormones more balanced, our brains more focused and clear. And it's just amazing how food can be like medicine if you use it correctly. 

Kelly Bennett: Yeah. And so to do the seven day detox that you offer, listeners can go onto the Amazing Over 40 website and jump in, or how does that work?   

Dr. Diana Hoppe: So basically they go to the website, they go to the shop button, and basically they'd see the seven day detox kit.

And that is going to be a program for them. They're going to get recipes. I have a lot on my Instagram and Facebook also. Yeah. About different ways to make smoothies and how to stay positive. And your mindset. I have a lot on my site also about mindset and ebooks. Yeah. So there's a huge amount of information on my website and some of it's under education.

A webinar of me talking about perimenopause and hormones, on my website under resources, education, and then it says perimenopause or aging. So is it perimenopause or is it aging?

Kelly Bennett: We're going to link to all these resources because I don't want anyone to miss out on that.

 It is fabulous. If a woman who's listening is saying, this sounds like a lot of what I'm going through, what would you say... here's the very first step you should take.  

That's just because sometimes just starting is the key. 

Dr. Diana Hoppe: Yeah. I think getting education, so I think actually going to my website, getting some of the resources, knowledge of what's happening, and then find a physician that you can work with who's going to be motivated to help you make the best life you can, because there's no reason for you to be miserable, unhappy, irritable.

You know, there's ways we can make life so much better, but you have to find the right person to do that with you, like a partner or coach to just say, okay, let's take the bull by the horns. Let's figure out what's happening, why it's happening, and then let's make a plan. 

Kelly Bennett: That's fantastic advice, because sometimes you'll hit some roadblocks, but I'm hearing you say, you deserve to feel good, have a great life, and so if you don't find the right physician initially, keep going. 

Well, thank you so much for your time. You're a real blessing and I know some people out there who are going to truly benefit from your time today. So thank you so much Dr. Diana Hoppe.   

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Kelly A. Bennett, Esq.

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