The Truth About Hormones: What Women Aren't Being Told with Dr. Bruce Dorr - SUMMER REBOOT - Episode 282

My guest is Dr. Bruce Dorr, MD, OBGYN & Senior Medical Advisor for Biote.  We talk menopause & also discuss the article from the NY Times released on February 1, 2023 Women Have Been Misled About Menopause.

The conversation around menopause is changing dramatically, but are women getting accurate information about what's actually happening in their bodies? Dr. Bruce Dorr, a board-certified OBGYN specializing in hormone optimization, joins Sandy to challenge widespread misconceptions and reveal what many women aren't being told about their changing hormones.

This eye-opening discussion ventures far beyond hot flashes to explore how hormone imbalances affect virtually every bodily system. Dr. Dorr explains the shocking finding that joint pain—not hot flashes—tops the list of menopausal symptoms, and why so many women mistakenly attribute their discomfort to "just getting older." You'll discover the critical connection between hormone levels and brain health, including recent research linking hot flash severity to brain lesions similar to those found in Alzheimer's disease.

The conversation tackles the infamous Women's Health Initiative study that scared millions away from hormone therapy, with Dr. Dorr clarifying why bioidentical hormones differ fundamentally from synthetic options. He offers a compelling analogy: "Not all estrogen is the same—it's like comparing ethanol to methanol. Both are alcohol, but one helps you feel good while the other can kill you." This distinction proves crucial for women weighing their treatment options.

Most powerfully, Dr. Dorr addresses why standard medical care often fails menopausal women, with 60% of OBGYNs prescribing antidepressants rather than addressing hormonal root causes. He explains how pellet therapy works as an alternative delivery system and shares stories of patients whose lives were transformed once their hormones were properly balanced. If you're navigating perimenopause or menopause—or simply want to understand what lies ahead—this conversation provides essential information for making informed decisions about your health and vitality.

Chapters

• 0:00 Podcast Introduction and Overview
• 1:36 Introducing Dr. Bruce Dorr
• 3:22 Understanding Menopause and Perimenopause
• 9:33 Symptoms Beyond Hot Flashes
• 17:22 Bioidentical Hormones vs. Synthetic Options
• 28:19 Hormonal Balance for Optimal Health
• 35:57 Women in Workplace Survey Findings
• 48:17 Pellet Therapy and BioT Explained
• 54:08 Episode Wrap-up and Resources

Transcript

Sandy Kruse: 0:02

Hi everyone, it's me, Sandy Kruse of Sandy K Nutrition, Health and Lifestyle Queen. For years now, I've been bringing to you conversations about wellness from incredible guests from all over the world. Discover a fresh take on healthy living for midlife and beyond, One that embraces balance and reason, without letting only science dictate every aspect of our wellness. Join me and my guests as we explore ways that we can age gracefully, with in-depth conversations about the thyroid, about hormones and other alternative wellness options for you and your family. True wellness nurtures a healthy body, mind, spirit and soul, and we cover all of these essential aspects to help you live a balanced, joyful life. Be sure to follow my show, rate it, review it and share it. Always remember my friends balanced living works. My friends, balanced living works. Hi everyone, Welcome to Sandy K Nutrition, Health and Lifestyle Queen.

Sandy Kruse: 1:36

My guest today is Dr Bruce Dorr. He is certified by the American Board of Obstetrics and Gynecology in OBGYN and Female Pelvic Medicine and Reconstructive Surgery. He's a member of the American Urogynecology Society and the American Association of Gynecological Laparoscopics. Whoa, that's a mouthful. He became certified as a thank you. He became certified as a bio TE medical practitioner in 2015 and provides hormone optimization with pellet therapy for both men and women. He has treated female patients referred to cardiologists for irregular heartbeats, endocrinologists for weight gain and even marriage counselors for vaginal dryness and loss of libido. Effective treatments for these patients were not initially prescribed because changes in hormone levels were not identified as the root cause for their issues.

Sandy Kruse: 2:46

So today we're going to talk all about menopause. We're going to even talk a little bit about some of the topical stuff that's coming out now and the New York Times article that came out recently about women being misled about menopause. It's huge news, and who better to speak to or speak with about this than Dr Bruce Dorr? So with that welcome, you can speak to me too. I think that's awesome. I like speaking with you. How about that? It sounds better, it sounds better. So I am just so excited for this conversation because that article is almost like it was a springboard for our meeting.

Dr. Bruce Dorr: 3:31

Yes, yes.

Sandy Kruse: 3:33

Yeah, very much needed.

Dr. Bruce Dorr: 3:34

You know it was just a welcome across all fronts. When we hear about menopause and even you may have seen it too the Super Bowl they even had a featured segment on vasomotor symptoms, or symptoms of menopause, that was in a 30-second commercial also. So women and their needs are definitely getting out there, which is very much a blessing.

Sandy Kruse: 3:58

Okay. Well, my team was not on the Super Bowl in the Super Bowl, so you know I'm a Buffalo Bills fan over here.

Dr. Bruce Dorr: 4:08

Oh, I think we were all hoping for the Buffalo Bills, but yeah, it didn't happen, so I did miss that.

Sandy Kruse: 4:14

We kind of became America's team for a minute. Yeah, I did miss the segment. But you know, I have to ask you what got you into this field that you're in right now?

Dr. Bruce Dorr: 4:26

Well, you know, actually I went into medical school to become a psychiatrist but as I got further into the field, you know, I just found I was so drawn to the field of OBGYN because the medicine involved, the procedures that were involved and the charm of the whole labor and delivery experience was just overwhelming to me and to me it was kind of what life was all about, and just felt that. And as I got into it, yes, I started to subspecialize in urogynecology and you know, all this stuff it's kind of an evergreen area. As far as OBGYN goes, we're either helping women get pregnant, helping them through their pregnancy or helping them with all the stuff that happens after their babies, and so it is really a blessing to be in the specialty. And you know, I really didn't realize how lucky I was seeing women virtually my whole career until I started seeing men. They're a tougher crowd.

Dr. Bruce Dorr: 5:34

Oh, yeah, and so I think, you know, women are just, you know, they're unfortunately no stranger to medicine and therapies and, I think, in general, much more open to my advice and that's been the beauty of my career. Interestingly, the whole menopause emphasis. You know, I would see women with unfortunately very painful conditions, one called endometriosis, and we would need to remove their ovaries, sometimes at a very young age Uh, you know, even as young as I had one lady so severe she was 16 years old, um that I had to perform, um, you know, and remove her ovaries. And I would when I would see women that I would put into surgical menopause and although their pain was gone, they went to this very dark area. And I had one patient specifically she was 38 and her pain was gone, but she no longer wanted to have sex, she no longer wanted to work out, she was gaining weight and she just said to me you know, I just wish, I wish I was in pain again and had my hormones back.

Dr. Bruce Dorr: 6:46

And she started taking her husband's testosterone preparation and I saw her as kind of a crazy level 700. It was, it's very high for a woman and I referred her to an endocrinologist and the endocrinologist said well, why would you do such a dangerous thing taking your husband's testosterone? And she said, well, I just feel better, I had better energy, I had better libido, I felt like I did before my surgery. And he says, well, I just don't understand. You're 38 years old. And she said, yes, he goes well. How much longer do you think you're going to be having sex? She said, yes, he goes well. How much longer do you think you're going to be having sex? Oh, wow, I know. So this is what is happening when people see you know experts in in hormones, that I would see my patients being treated like that, and that's how I got introduced to biot and and to learn more to really be full service for my patients that need hormones at any age and their husbands.

Sandy Kruse: 7:49

Yeah, I mean that, that unfortunately. I've heard all too many stories similar to that and it's it's really unfortunate. But then there are physicians out there and I always say that there's physicians out there that will work alongside you and help you to feel optimized, because life's too short. Life's too short to go through it. Feeling like you're going through it with no vitality, you know, like it's just unfortunate. So talk to us about you know what exists's just unfortunate, so talk to us about you know what exists. There's always confusion, like what is menopause? Let's start with the very basics right.

Dr. Bruce Dorr: 8:33

Well, menopause, defined by the american college of ob-gyn, is the sensation of your periods for a year, usually combined with menopausal symptoms, and what's going on physiologically is that the ovaries stop making estrogen and there's a time leading up to that total stop of estrogen is what's called perimenopause. And that's where some days pretty good estrogen production, some days not so good, some weeks pretty good, some not so good Estrogen production, some days not so good, some weeks pretty good, some not so good, and it's that roller coaster that can start, you know, a few years before, on average a couple years before the periods totally stop.

Dr. Bruce Dorr: 9:15

But some people start that as early as their late 30s or mid 40s, and so that up and down will cause irregular bleeding which is a majority of the consults for women in their 40s seeing an OBGYN as irregular bleeding. And, yes, many will address the bleeding but they don't address the women's symptoms that are going on surrounding that. So with that hormone loss then comes all the stuff that can either hurt us or kill us. So acceleration in risk for dementia, accelerations for risk of bone loss, for heart disease, for breast cancer, that all happens with that loss of estrogen.

Sandy Kruse: 10:00

Yeah, I mean, I guess it's a good time to talk about some of the symptoms because, you know, you and I both read that article. Women have Been Misled about menopause and I think there are a lot of pros and cons to it. And you know, I'm not a physician but I know a lot about menopause and I happen to be 53 years old and I'm kind of you know, I'm kind of getting through it pretty good. You know, I'm feeling good and I'm feeling that I don't feel like I have a loss of vitality, I don't feel like I want to kill my husband every day. So I mean, there you go. These are all bonuses, right?

Dr. Bruce Dorr: 10:40

Well, you know, looking at you, sandy, everybody's going to want to know your secret, because you look like you're about 20 years old.

Sandy Kruse: 10:46

And I'm not using a filter. I swear to God no filter, no filter. But you could see I get flushing. So there you go. There's a symptom right there.

Dr. Bruce Dorr: 10:56

Well, people accuse me of not using filters either. So that's just a problem. Yeah, but difference to reality together it's just a problem.

Sandy Kruse: 11:03

Yeah, but different story altogether. So you know this article the whole. The one thing from this article that really stuck in my mind, and I would love for you to talk more to this, is the brain lesions and the correlation to hot flashes and the intensity, severity, frequency. That was like. I have to say, I knew a lot of what the science has been saying, but that one was huge. It just struck me like oh wow.

Dr. Bruce Dorr: 11:47

Well, you know they're trying to put their finger on is what causes the hot flushes, what causes these vasomotor symptoms, and they're kind of coming down to, and it's also coming down to what is the problem for some women that have irregular periods, a condition called polycystic ovarian syndrome.

Dr. Bruce Dorr: 12:06

And that leads to irregular production of estrogen and progesterone balance. That goes on. That can sometimes happen in that perimenopausal time period. But that is what happens with a signal that comes from an area in our brain called the hypothalamus and that is what pushes a signal that comes from an area in our brain called the hypothalamus and that is what pushes a signal to our pituitary glands that then push the hormones to either our testicles or the ovaries. It's the thing that way too. So what they're getting at in that article is that that area in the brain is having dysfunction, brain is having dysfunction, and so these levels that then happen at the pituitary level are associated with night sweats, hot plushes and those kinds of things going on.

Dr. Bruce Dorr: 12:52

And it's being brought to light because of a new drug that's coming out on the market. It's called an NK3 receptor antagonist and it basically is helping with a neurokinin. It's a brain chemical messenger that sends these messages to the pituitary that then activate the ovaries, and so they're finding that problems in that area of the brain is probably what's the bigger cause of vasomotor symptoms specifically. But we know that these lesions especially related to Alzheimer's disease. It's a protein called beta amyloid and there's also another one associated, called the tau protein, and it's the accumulation or the presence of these that is kind of the diagnosis of Alzheimer's disease.

Sandy Kruse: 13:45

Is that the plaque?

Dr. Bruce Dorr: 13:47

Yes, those are the plaques that go on and they entangle the nerve fibers and these pathways that allow us to process things in our brains. And the things that help decrease beta amyloid deposition are sex hormones, so both estrogen and testosterone are known to decrease beta amyloid deposition are sex hormones, so both estrogen and testosterone are known to decrease beta amyloid deposition. Now in her article she's saying that beta amyloid deposition is starting in women in the perimenopause, but I've talked to Alzheimer's researchers and they've even seen beta amyloid deposits in fetuses, and we see that much more in the mid-30s or so, when women start to lose their testosterone, and so that's also a problem. Low testosterone in both men and women is also associated with increasing in plaques and and brain and cognitive impairment.

Sandy Kruse: 14:49

Okay. So does this mean that and you know it just if somebody is just reading the article who's not a physician like yourself, or listening to the podcast, they're going to be like oh my God, I have tons of hot flashes and I have them all the time and I have them every day and I have many and many and, oh my God, I'm going to have dementia, I'm going to have Alzheimer's by the time I'm 60. So, like you know people, it can cause a little bit of panic.

Dr. Bruce Dorr: 15:20

Oh yeah, well, and they're. You know, panic and inflammatory statements sell. You know, when you look at benefits and health and doing the right things for our bodies and diet and exercise, that doesn't sell as much as you know a balloon over the.

Dr. Bruce Dorr: 15:41

Atlantic or you know, anything that is inflammatory or reactionary is the deal. So I think the key is here is that you, if you're having symptoms, it's good to talk to somebody that these symptoms can be associated with problems long-term and it's not necessarily just vasomotor symptoms. When you look at a reanalysis and I know we'll probably talk about it of the WHI that every woman went off their hormones or majority of women went off their hormones, when you look at a reanalysis, it's actually not necessarily just hot flushes or night sweats that caused long-term increase in cardiovascular disease or all-cause mortality.

Dr. Bruce Dorr: 16:24

The biggest symptom that was associated with all-cause mortality was dizziness. So you know it's not just about night sweats or hot flashes. There's like 40, some people say there's as many as 100 different symptoms related to menopause. But there are much more significant symptoms that can be associated with things that can kill you, not just Alzheimer's disease.

Sandy Kruse: 16:49

Okay, so let's let's talk about the major ones. Then, dr Dora, let's talk about the major ones. We can be about hot flashes. What other ones should we really pay attention to?

Dr. Bruce Dorr: 17:02

Yes, well, you know, and that was kind of your intro you know to me is that as a urogynecologist, I work with a lot of certainly female pelvic disorders and incontinence, and so I would see women for their incontinence, but they had been to the endocrinologist, they had been to a cardiologist, they had been to a rheumatologist, because really the number one symptom of menopause is joint pain. And so, you know, women stopped exercising, they stopped walking the dog, they, you know, and so that's really the number one symptom over night sweats, and people just attribute that to getting older. Really, it's the loss of the joints and the synovial fluid and the ligaments and the muscle loss that go on with the loss of hormones. It can be irritability, it can be palpitations, it can be vaginal dryness, it can be many different things that people think, oh yeah, maybe it's my diet or maybe it's you know something else, and nobody's wanting to talk about menopause.

Dr. Bruce Dorr: 18:06

It's easier to talk to somebody about your heart racing than it is your vaginal dryness or those kind of things going on. And so, you know, the cardiologists don't want to deal with hormones, you know, and so that's what it comes down to. Is what is that root cause, rather than the bandage on. You know, putting somebody on something that slows their heart rate down, or putting them on Motrin or aspirin to cover their joint pain, you know, get to that root cause. As far as what's really doing that, it's the functional medicine piece of this.

Sandy Kruse: 18:38

Yes, and you know it's so interesting because that happens in other parts of medicine too, and I, I have no thyroid, right, so I know a lot about thyroid, I studied it and I live it and I think, experiencing it but seeing, you know, seeing a client from a nutritional perspective who comes back and says that their physician put them on anti-anxiety meds and then seeing that they're severely hyperthyroid, you know what I mean it's kind of like that same idea of not looking at what's the root cause. And you know, the fact of the matter is it's going to happen. Our hormones are going to decline, right, like we kind of like I can't be 30 forever, so that's one fact that we have to face. So how? I and I love that you mentioned lifestyle, because that was the other big piece that was not really talked about much in that article and I was like, okay, there's a lot missing here, because there's a lot we can do other than, you know, taking the medications right.

Dr. Bruce Dorr: 19:54

Right. So when you look at diet and lifestyle, when you look at other areas of the world like, say, look at Japan, you know their incidence of menopausal symptoms is significantly less than the average Canadian or American get three fatty acids. So there are things in the precursors for our hormones and things that help our bodies and our brains nutrition wise, that help us feel better, to help with diet and exercise and things like that that go on that can certainly mitigate the severity of our hormone loss.

Dr. Bruce Dorr: 20:34

So, yes, that is another key component, but the problem is problem is you know they did a recent survey that 60 of ob-gyns, when women come in with menopausal complaints, prescribe an ssri. They prescribe, um, you know, an antidepressant because that's easy and that can be handled in five or ten minutes oh, you're having this, let's put you on this drug.

Dr. Bruce Dorr: 20:56

You know I'll see you in three months. But to sit down and talk to somebody about what are you eating, how often are you exercising, you know, are you experiencing sexual dysfunction or things like that Most people do not want to spend. Really. You need a good half hour to 45 minutes to talk to somebody about their life and their lifestyle and it's much easier to put them on a drug.

Sandy Kruse: 21:22

Yeah, many people.

Dr. Bruce Dorr: 21:23

That's kind of what they want. They want a quick fix.

Sandy Kruse: 21:25

Yeah, I think we need to, as a society, get away from this whole quick fix Because, just like what you do, you know hormones. It's this beautiful symphony, right? And so you got to kind of play around with it. Like I myself, I've been on bioidentical progesterone for years now, because that is what's helped with my sleep. I have no issues with anxiety. I have no issues with, you know, being overly hyper and nervous because I rhythmically take bioidentical progesterone. So maybe talk to us about that symphony of hormones.

Dr. Bruce Dorr: 22:07

Well, you know, just like you're hinting at, women will start to lose their progesterone production in their mid-30s and that's when PMS starts to come into play. That's when we can start to see pregnancy loss, because progesterone is the major hormone of pregnancy. So we look at that when somebody's pregnant, but we don't necessarily equate that to negative symptoms that start happening in the mid-30s and then get even worse as they approach menopause and start losing that even more so. So I have many women that I'll put on cyclic progesterone, just like you're taking. You have to go low because everybody's different as far as what their right progesterone level is, what their right testosterone level is, what their right estrogen level is. And there are many people and I can see this as I do blood tests that there are some women that their brain will tell me it's their right estrogen dose with a level of 30. And for some women it shuts off or the signal is good at a level of 120. So that's why when you do a standard preparation available in my cupboard, you know, with a patch, a gel, a pill, a spray is way too much for some people and way too little for others. So to have variability in dosing it's a very individual thing for every patient as far as how much they need. That can take them to too much or too little. So it's finding that mama bear porridge on each individual patient and most people you know don't want to take the time to work with patients.

Dr. Bruce Dorr: 23:46

Like you may know, with thyroid there's a broad range of where people sit in thyroid and many people will say your thyroid is normal. Well, what is normal? Is that an A student or is that a D student? So same thing goes for hormones. Hormones and say thyroid are things that we can control. I can't control my kids, I can't control North Korea, I can't control whatever is the deal that way too. But I can control what goes into my body or my patient's bodies, whether or not that's food or nutrition or these hormones, and so the things I can control I want to be an A student in those and that's why I try to take my patients is to that best level that we can control.

Sandy Kruse: 24:31

I love that you say that, because you know there's a difference between being in the range and being optimized.

Dr. Bruce Dorr: 24:42

Right, right. So we do the same thing, whether or not that is with testosterone or estrogen. Progesterone tends to be a little bit less that way too, but certainly I do the same thing with my thyroid patients.

Sandy Kruse: 24:54

Okay. So let's okay. We know progesterone is more that hormone that kind of makes us more chill, it helps us to sleep, it will help with anxiety. Did I miss anything with progesterone?

Dr. Bruce Dorr: 25:11

Well, it has a number of different functions and when you look at estrogen or testosterone, there's over 400 different receptors for these hormones in our body and they activate those processes, whether or not it's your hair, your joints, your skin, your nails, your fat. I mean, these are activators all over your body. So it manifests itself in different ways depending on on you know what we're doing and how our bodies are structured, both genetically and chemically.

Sandy Kruse: 25:40

And I guess, sorry, go ahead.

Dr. Bruce Dorr: 25:43

Go ahead. Oh well, in general. So you know, it helps some people more with their brains, it helps some people more with their joints, it helps some people more with their muscles or libido or things like that. So it's a combination of figuring out you know what people need. You know on that hormonal scale.

Sandy Kruse: 26:00

And do you take? I'm sure you do, but I guess you would take into account blood work on top of lifestyle, on top of symptoms.

Dr. Bruce Dorr: 26:09

Yes.

Sandy Kruse: 26:10

Yeah, and would you say that the majority of women that come in to see you that are, say, my age 53, they say that they have joint pain? Would that automatically kind of set off a bell that, okay, estrogen, estrogen, that's probably related to estrogen, or.

Dr. Bruce Dorr: 26:27

Or testosterone. You know, when you look at Dr Rebecca Glazer, she is a breast cancer surgeon out of Wright State University in Ohio she did a 10-year study looking at testosterone replacement only in women, and these were both premenopausal as well as menopausal women and she had relief, you know, almost 90% in all of her menopausal patients just on testosterone alone.

Dr. Bruce Dorr: 26:51

Wow so it's not always just estrogen. It's the combination of estrogen and testosterone. But testosterone has this kind of juicing negative connotation that people are scared of it. They think of it as a male hormone, but women make three to four times more testosterone on a daily basis over estrogen, and so you can go far. It's the balance of all these things, and so for years I would treat people with standard hormone replacement.

Sandy Kruse: 27:21

You know I'm kind of a good old boy I've been.

Dr. Bruce Dorr: 27:23

I was there before. You know, all the hormones kind of stopped in 2002, is the deal that way too. But you know I would put people on estradiol and they'd still have all their symptoms. They still have night sweats and hot flushes and all their menopausal symptoms. And it wasn't until I started doing testosterone replacement with my patients. They're like this is how I used to feel that was the missing piece for some, if not many, of my patients.

Dr. Bruce Dorr: 27:50

So it's the balance of both estrogen, testosterone and progesterone that many people don't even recognize testosterone replacement in women.

Sandy Kruse: 27:59

Okay, and so it's not like myself as a woman who's 53 really. I mean I guess I might be concerned about getting those chin hairs or acne from taking testosterone. Like we have to also be careful like and work with a physician that knows what they're doing.

Dr. Bruce Dorr: 28:21

Yeah, with any hormone you need to do that. And so do I return people to that puberty stage? Yeah, to some degree you can do that. There's a dual edged sword to testosterone and you can make women into very manly looking women with the amount of testosterone. So the difference between a medicine and a poison is the dose. So it's about finding that right testosterone level. So women lose half of their testosterone by age 40, and so you'll see women who kind of crash after delivery and they're they're like I have no libido, I have no energy, I'm not sleeping anymore. And they're still having regular cycles. They're only 38 or 40, but I draw their testosterone and it will be zero.

Dr. Bruce Dorr: 29:04

And some labs will say a normal testosterone in a woman is zero to 35, but it's not normal at all. But people go off of lab reference ranges rather than really what is making the difference individually for these patients. So I see menopausal symptoms in women in their 20s and it's not the loss of estrogen, it's the loss of testosterone.

Sandy Kruse: 29:27

Oh, so interesting, Because I know a lot of women. They're just afraid of that. But I know a lot of women. They're just afraid of that. But I know, you know, I'm familiar with Dutch tests and a few other functional tests and we all, we all have testosterone people. It's, it's, it's important, Okay. So let's maybe talk a little bit about we have to mention some of the flawed studies that did such a huge disservice to so many women and scared the pants off them right.

Dr. Bruce Dorr: 30:01

Right, right. So yeah, there were observational studies in the 90s, you know, and they looked at women on hormone replacement and long-term, yeah, in general they had better hearts and they function better. And so they said, well, let's really put the pen to the paper and see. And it started with the HERS trial, which is the Hormone Estrogen Replacement Study in the late 90s, and it showed that there was statistically no improvement in cardiac outcomes on women when you put horse urine estrogen into their bodies. And that became even more so in the makers of cromerin. So the number one prescribed hormone and the number one best studied hormone ever pregnant marriage urine 30 different horse urine estrogens None of them were meant to be inside women, be inside women that when they then were studying that, because they wanted to get an FDA approval to prevent heart disease, so they were going for gold. They would then be prescribed by everybody and unfortunately, when they looked initially at women that went on horse urine estrogen and a birth control pill type of progestin. So when you take estrogen it can increase um proliferation of the inner lining of the uterus or cause bleeding. So you have to take estrogens, counter hormone with it.

Dr. Bruce Dorr: 31:26

Progesterone progesterone is what's naturally meant to be in women's bodies. But, um, they were using a chemically uh made medroxyprogesterone acetate that absorbs better and is cheaper, and so that's what they combined it with. And women that were taking the unnatural estrogens and the unnatural progesterone had an increased risk of heart attack, stroke and breast cancer, and they stopped the study early, when the women had a hysterectomy and they didn't have to take the progestin, this medroxyprogesterone acetate. They continued that study and that went for eight years. But unfortunately there was a crowd in the 60 to 90 year old group that had an increased risk of blood clots and so they stopped the study at that, know, and so there's been many reanalysis of that.

Dr. Bruce Dorr: 32:17

But I think what it comes down to, sandy, and I think you, you are on board with me on this Don't put horse urine into your body, you know. Don't put birth control pill type of progesterone, progestin in your body. If you put back into your body the same thing that was meant to be there and you deliver it the right way you don't have these risks of heart attack, stroke and breast cancer.

Dr. Bruce Dorr: 32:45

And you know, in 2012, there was a big British medical journal article looking at bioidentical estrogen 17-beta-estradiol and they even had an unnatural progesterone.

Dr. Bruce Dorr: 32:55

They used Norris Thindrone. It's in Britain, so they use different progesterones over there. It's a deal that way too. Those women had a 50% decreased risk of cardiovascular disease as they followed them. So it's about the type. So not all estrogen is the same. Not all progesterone is the same. Look at it like this If you had two groups of people and you gave them both alcohol one group, you know, after a couple of drinks of alcohol we're dancing around and felt great and the others went blind and died. It's the differences in alcohol. One got ethanol, one got methanol. So not all alcohol is the same, not all estrogen is the same. You want to put back into your body the same thing, not a similar thing. That's what makes the difference.

Sandy Kruse: 33:45

Yeah, that was such a great explanation because I hear so many people who are like whatever, I just went and got hormones and they don't even know what they're putting in their bodies. And I hear this regularly and I, you know, because I almost feel like it's a bit of a curse, dr Dore, because I talked to too many physicians like yourself and experts and I'm like I know too much. I'm like is it progestin or is it progesterone? There's a difference.

Dr. Bruce Dorr: 34:19

So the women in the WTA that didn't get progesterone or progestin. They did great. And now, when you look at them, 20 years later, those women, even on horse estrogen, have a 30% persistent decreased risk of breast cancer.

Sandy Kruse: 34:35

Wow.

Dr. Bruce Dorr: 34:35

And they lived healthier. There's no increased risk of all-cause mortality or cardiovascular disease in that group and now they're running a persistent decreased risk of breast cancer in the non-progestin group. It was the progestin in that study that was flawed and made the difference. So again, if you use progesterone, even with horseshoe and estrogen, you don't have those risks that go on and all the lights come back on to your bone, to your brain, to your heart. And combined with testosterone, testosterone decreases the risk of breast cancer.

Sandy Kruse: 35:08

So, yeah, I like that. You said all the lights come back on Like who doesn't want to age better and live with vitality until the day we're meant to end on this planet, right?

Dr. Bruce Dorr: 35:23

Right.

Sandy Kruse: 35:24

I'm with you.

Dr. Bruce Dorr: 35:24

What good is it living longer if you're not living healthy as you live longer? And that's what hormones do they allow that? You know betterment of our brains, of our bones, of you know those kind of things that go on. You know what good is it to live if you don't know that you're living, if you have dementia or Alzheimer's disease?

Sandy Kruse: 35:42

Yeah, so what? Who are the people that are at risk? Who are the patients? Or are there any patients that you have to handle very carefully?

Dr. Bruce Dorr: 35:55

Well, you know, if somebody tells me you know they take half a Benadryl and they pass out, okay, you don't have to prove to me that you're sensitive to medicines, you know. And so you start out low and you work your way up, and that's great for any patient because you don't know what their right level is. So titration, dosing, and the beauty of what we do at BioT is that there's a whole computer model that can kick out where 90% of people hit the right dose, and so that's the beauty of pellet therapy and BioT. But you can do that with any drug that goes on. Certainly, you know people with history.

Dr. Bruce Dorr: 36:35

You have to be careful in the delivery of hormones. So we weren't meant to take hormones orally. When you take hormones orally it goes through your liver, it revs up stuff in your liver that increase binding or problems, but it increases blood clots. So when you take hormones through your skin or in a pelleted form, even a history of a blood clot or a blood clot to the lung or anything like that, it's not a contraindication to hormone therapy. So really, you know, unless there is a condition like, say, breast cancer, there's certain types of brain cancers that are fed by estrogen. That's the only contraindication. So if there is a condition where a patient would be bettered by removing her ovaries, that's really the only contraindication to bioidentical hormone replacement therapy Okay.

Sandy Kruse: 37:28

So what are your thoughts and I don't know if you even do anything like this in your practice. It just kind of came to mind. You know how there's so many different things that you can take to redirect estrogens so that they actually metabolize down the healthy pathway, like DIM, diendomethane. Then there's sulforaphane. I take sulforaphane. I've been taking sulforaphane for a long time because I also know my genetics. I have an aunt who died of uterine cancer and a great aunt who died of uterine cancer, and so I'm very cognizant of what's happening with my estrogens. Do you think that those are good solutions for women who are worried about how they're metabolizing those estrogens, or no?

Dr. Bruce Dorr: 38:24

So everybody that we put on hormone replacement, we put on dim sulforaphane products.

Sandy Kruse: 38:29

Beautiful, beautiful.

Dr. Bruce Dorr: 38:31

You don't know how people are genetically modeled with that phase two elimination of their hormones and they can go down that beneficial antioxidant pathway of the two hydroxy versus the four of the 16 hydroxy. And that's where you're getting at with the Dutch testing, that you can actually look at that. But if you just put people on that and I put all my men on that too, because same thing goes on with testosterone breakdown products and our estrogen that we break down as men but yes, when you look at severity of, say, pms symptoms, it's not estrogen or estradiol itself, it's the two hydroxy estrone that it breaks down into that gives women breast cysts and breast pain. Yes, that go on. So anybody that goes on birth control pills with me I recommend, you know tends to be, you know, my younger crowd in general, so they don't want to do supplements and things like that necessarily. But I put everybody you know on DIMM. We have a combination product out of two different companies that helps with, especially if they're on artificial estrogens or progestins in a birth control pill.

Dr. Bruce Dorr: 39:35

But in general yes, anybody on hormones goes on DIM with us.

Sandy Kruse: 39:38

Yeah, it just kind of makes sure it's doing the right thing in your body. That's the way I like to describe it. It's making sure it's not going wonky on you and going in a direction you don't want it to go in, right, okay, so, people, my parents are both still alive. My dad is going to be 86 in April. My mom will be 77. And she's like well, my mom never had hormones, we never had hormones. Why do we need hormones? You know what's the point. And I'm like well, mom, you know you can't say, first off, you didn't live as long back then, right, and then, secondly, I think that life was simpler and you know like, if you look at the way we live now, even cortisol can have an effect on all these other hormones. Like, what are your thoughts on this?

Dr. Bruce Dorr: 40:36

Well, when you look at our food supply, you know now, versus, say, 1920, in an average bowl of spinach it has a 10th of the dose of the nutritional content. So our farming, our soil, our things like that, things that we used to be able to replete our bodies with the precursors for hormones or things like that, are not great in our food supply. Is the deal that way too? Now women have suffered with menopause for a long time, and there were preparations for menopause even the in the late 1800s. Um, there was uh pulverized cow ovaries that they used to give women oh wow, wow.

Dr. Bruce Dorr: 41:14

Yeah, that was in the late 1800s, I think it was 1880 or something like that is when over in is the name of it came out. But when you look initially at menopausal therapies, when the physician death reference so that is like this big compendium of drugs available at least in America, came, came out in 1947, there were 53 different preparations from 23 different companies to help women with menopause. So menopause and symptoms of menopause and the nightmare symptoms that women had to live with, have been around for a long period of time, especially as women started living longer. You know well, into menopause is the deal, you know, certainly with the advent of modern obstetrics and getting women through the whole kind of nightmares that can happen obstetrically. Women started living longer and so that's why we're seeing, you know, women, you know aging and needing the hormones.

Sandy Kruse: 42:13

Yeah, I like that, I'm on board. Aging and needing the hormones yeah, I like that, I'm on board. Okay, let's shift gears and talk a little bit about the Women in Workplace Survey. Talk to me a little bit. What is this? What was this survey all about? Give us the details.

Dr. Bruce Dorr: 42:30

Yeah, they took a thousand women, you know, aged 50 to 65. You know it was a study that came out through BioT in January and they looked at them. You know ACOG is now saying there's 6,000 women a day entering menopause. You know that is a lot of people and in fact that is, you know, from when I first went into practice in the early 1990s. That's roughly three to four fold more. But what they found was that many women are suffering in silence, that you know 20 percent of people never get it. Well, it's 20 percent of the workforce, but 87 percent of women never bring this up with physicians, let alone people in the workplace.

Dr. Bruce Dorr: 43:16

And women are quitting their jobs and that was brought up in the New York Times article too that you know women are leaving their jobs over how bad their symptoms are. They can't mentate or they feel like everybody sees that they're having hot flushes in the workplace and they're embarrassed over bringing it up. And over half of the practicing OBGYNs are after the WHI that women stopped all their hormones so they never got any hormone training, so nobody is helping all of these women you know who are suffering silently and they're leaving their jobs and they're not getting appropriate treatment or care, or they're leaving their jobs and they're not getting appropriate treatment or care.

Sandy Kruse: 44:01

Or they're going on other medicines that make them feel worse in many ways. Wow, that you know it's just. Maybe I won't even say this, but what I will say, because I have to also be careful what I say, because I do love. I have a great relationship with my team of physicians. I have to have an endocrinologist because I have no thyroid and I had thyroid cancer. I have my GP, I have my naturopath doctor and you know it's interesting because I don't feel like I have the support I need with the way medicine is structured here and it does.

Sandy Kruse: 44:43

It makes me sad, actually, when I think about this, because I'm fortunate that I'm in this industry, so I advocate for myself and you know, somebody's put a little comment in something that I posted about. You know somebody put a little comment in something that I posted about. I posted a bit of a response to that article in the New York Times and someone said you know, thank God for people like you, because I have a full time job, I don't have the time to research this. You know we're fortunate that we have a lot of women advocators now and physicians like yourself who take the time out of your busy practice to educate other women and their partners.

Dr. Bruce Dorr: 45:30

Right, right, you know I thought this would just be a couple of people a month, as I looked at hormone replacement and certainly pelleted hormone replacement, and it grew to 50, and it grew to 100. And now it's like 600 people a month that.

Dr. Bruce Dorr: 45:47

I'm seeing there's such a need out there for this and there's such a need of validating what people are feeling and the negative symptoms that they have hormone loss in both women and men and so you know. She brought up how women are suffering, but there are many men who suffer, you know too.

Sandy Kruse: 46:07

Totally totally.

Dr. Bruce Dorr: 46:10

And their partners. Women suffer because their men are suffering. You know, I see so many women who you know I used to have a great sex life when my man was much more on board with everything, and so you know, sometimes women's dysfunction is their partner's. Oh, yes, it just led to many areas that I never saw my career going to.

Sandy Kruse: 46:31

Yeah, you know, and here's the thing I will always say lifestyle interventions help, they help. I do believe that there's a lot of things that you can take to minimize some of these symptoms. You know, and there's no studies backed by it, because there's no pharmaceutical company to back up the funding for the studies, right, so I can speak through firsthand experience. I take a lot of different herbs and they help me, and I am the end of one because I don't have the money to do a giant study, right.

Dr. Bruce Dorr: 47:12

But that's what we really need is a groundswell of people for wellness rather than treating illness. So we wait until people get their heart attack. We wait until people have Alzheimer's, which is too late, you know. We wait until people have breast cancer. But could we put people on DIMM? Could we put people on Chaseberry or Boron or black things that help mitigate their symptoms and treat them to be well, you know? Or hormone replacement that treats them and helps them be well, rather than letting them get ill and then treating them? That's the medical system.

Sandy Kruse: 47:47

Yeah, backtracking is not an easy thing to do, so this is why I'm always like get your lifestyle in order, maybe take a few herbs that you feel help and then get optimized hormonally when you kind of set your baseline and go okay, I've done everything I can do, I'm a healthy person, I'm going to go and see a physician like yourself and get myself some hormones. So what is BioT? Talk to us about what that is. And what is pellet therapy? Because everyone talks about pellets in the US and I'm Canadian so I don't know as much about it.

Dr. Bruce Dorr: 48:26

Right, right. So BioT is a company that was founded over 10 years ago and they are an educational and promotional company. And, yes, they do educate in many different areas, but pellets and pelleted therapy is their focus. And what pellets are? They're like a little grain of rice that goes through a tiny little three millimeter incision, usually in the upper bottom, but we can put it really anywhere that people have fat.

Dr. Bruce Dorr: 48:55

Sometimes it goes in the abdomen or flank or things like that, but it's basically the same hormones as it's in a patch or a gel or a spray or a pill. It's the same stuff like I talked about. Not all estrogen is the same. This is the same stuff that is meant to be in your body and a pellet. When a pellet goes in your body, surrounds it with capillaries and then every pump of your heart in comes the hormone. It's like giving you a brand new 18 year old ovary back. How much you need. So that's the.

Dr. Bruce Dorr: 49:29

That's the art to this is how much of an ovary you need back, whether, with the estrogen and testosterone coming back into your system, the pellet lasts for about three to four months at a time. So it's about three to four months at a time, so it's about three times a year, but you don't forget it when you go vacationing in Kona. You don't forget it on a certain day, or you have your patch on for two weeks and you've forgotten it. So it is less maintenance and it's the same hormone, delivered the exact same way. So that's why I see my patients 90% of people that I see continue with that therapy. When I do other forums, it's only about 10 to 20%.

Sandy Kruse: 50:06

Oh, okay. So if I want, I can't do that, though I can't fly to you and get that done. Can I Just curious?

Dr. Bruce Dorr: 50:15

Well, yeah, biot is getting close to 6,000 providers more in America. We're seeing more and more in Mexico rather than going Canadian so far.

Dr. Bruce Dorr: 50:24

But they're expanding all over and each year we're training a good 1,000 to 2,000 more. They just went public and there's a lot of exciting stuff that's happening with the company now starting in May, and so it's really getting the information about menopause you know out there, and the beauty of pellets is that it's one of the most effective treatments as far as getting hormones in. It's just a matter of figuring out how much you know that patient needs.

Sandy Kruse: 50:55

Okay, so you? I know this show is about menopause, but you treat men too, so andropause, so men can get pellets as well, modified testosterone and that increases risk of blood clots, or negatives that go on, just like horse urine in women.

Dr. Bruce Dorr: 51:25

There are these negative things that are pushed by pharmaceuticals because it's against federal law, at least in America, to patent and to profit off of what is native to the human body. So drug companies come in. They want a uniquely patentable substance which can't be native to the human body. So they modify it to be similar but not the same. So that's why we like pellet therapy is because it's the same testosterone and again it's like giving a brand new testicle to that guy. It's the same stuff, delivered the same way, just like in women.

Sandy Kruse: 51:54

Okay, so there is such a thing as bioidentical testosterone as well. Right, for the NWIM? Yes, okay, all right, wow, okay, I think I don't know if there's anything that we didn't cover. We kind of covered a lot.

Dr. Bruce Dorr: 52:12

That's a lot of stuff, Sandy. I think, so I have medical students and practitioners that can't follow me on a lot of that, so you were outstanding, oh thank you, I do this every day.

Sandy Kruse: 52:23

Okay, so let's summarize. Let's summarize what you can actually. By taking bioidentical hormone therapy at the right time and the right dose, it can help you age better. It can help to mitigate some of the risks as we age as women, such as heart disease, dementia, osteoporosis, and then there's the whole other, just the symptoms Living with debilitating-.

Dr. Bruce Dorr: 52:58

Quality of life is a big thing.

Sandy Kruse: 53:01

The symptoms Living with debilitating Quality of life is a big thing. Yeah, I mean, we don't have to suffer, and I know some people will suffer for many years, right? So yeah, let us know where can we find you? It's a BioT, and if there's anything else you want to add and summarize, please do so, dr Dorr.

Dr. Bruce Dorr: 53:17

Yeah, biot or BioTcom, b-i-o-t-ecom, and you can find a practitioner that's close to you in your area. We try, and, you know, make this a very similar process. There are many different providers coming from different backgrounds, so there are people that are more functional medicine, there are people that are family medicine, there are people that are OBGYNs, so everybody comes about this from a little bit different angle, but the process and the pellets and the counseling should be somewhat similar in different areas. But you know, you try and find that person that you can click with and there should be, like I said, where there's providers in basically every state and almost 6,000 providers nationwide. That's amazing, and are they in?

Sandy Kruse: 53:58

Europe, yet every state and almost 6,000 providers nationwide. That's amazing and are they in Europe?

Dr. Bruce Dorr: 54:01

yet you know, I don't think so. I know Mexico and Canada, but I don't think they've expanded to Europe. Okay because I do have They've had pellet therapy over in Europe, but I don't think not IOT yet.

Sandy Kruse: 54:14

Okay, wonderful, all right, thank you so much for your time. This has been such a pleasure. Maybe we're going to have to do a show on andropause.

Dr. Bruce Dorr: 54:24

I'm happy to do it Like I see 25% men now we see probably the most men out of all the biotech practices is the DLW big practice.

Sandy Kruse: 54:32

Oh well, you know what? I've gotten a few requests, so maybe we'll have to do that, thank you. Thank you so much for your time, dr Dorr. Okay, let me know how. So maybe we'll have to do that.

Dr. Bruce Dorr: 54:41

Thank you. Thank you so much for your time, dr Dorr. Okay, let me know how I can help, and it's been a sincere pleasure. Sandy, you're awesome.

Sandy Kruse: 54:47

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