Chapter 1: Does hormone replacement therapy (HRT) cause weight gain?
On this episode of the Dr. Tina Show, we're gonna talk about a very interesting topic. And if you're on hormone replacement therapy as a middle-aged woman, you're gonna wanna listen. HRT can actually induce weight gain. And going on HRT doesn't necessarily promise weight loss. And so I'm gonna break it down for you today on this episode. So let's jump in.
Chapter 2: Why might I be gaining weight on progesterone?
You are tuned into the Dr. Tina Show with Dr. Tina Moore. For more, visit drtina.com. Okay, we're just going to hop right into it. I'm going to get personal here. I spent my entire life as a very low hormone girly. I have been testing my hormones since my 30s and they have always come back just bone dry.
Chapter 3: What is the 'Goldilocks' range for estradiol levels?
I am a low hormone girly. I feel best low hormone. I don't tend to do well on hormones. And... Going all the way back to college days when I was on oral birth control, contraceptive did terribly on it, had to discontinue it almost immediately, gained a ton of weight on it like that. Fast forward to years later, I'm pregnant, blew up like a balloon during my pregnancy. Did not enjoy it.
Chapter 4: How does estrogen affect metabolism during perimenopause?
Was not one of those women who was like, oh, being pregnant feels so great. Did not feel great. My autoimmune disease was not happy. None of my body was happy pregnant.
Chapter 5: How does HRT influence insulin resistance?
Did not enjoy it. at all. It was a rough go. Had my beautiful daughter, couldn't lose a pound. Was not one of those women who went straight into breastfeeding and everything was great and lost all the weight. Didn't happen. Didn't actually lose a pound until I discontinued breastfeeding and I dropped 10 pounds like that. Just boom, gone.
Chapter 6: What role does oral micronized progesterone play in appetite changes?
And in every situation that I just shared with you, I'm going to continue this story. The weight gain or loss is like that. So I know it's the hormones. All right, so we fast forward to my daughter's a few years old. I have a Mirena IUD inserted. That is a supposed to be local only progestin wrapped IUD that goes in intrauterus.
And it did not stay local because I had the same exact experience that I did on oral birth control, which was I felt batshit crazy. I was in my first year of chiropractic college. I had a two-year-old. I could not manage what was happening. So I actually went into the restroom and pulled. I remember I was in a radiology course where you're in a dark room and you're looking at x-rays all day.
I went into the bathroom in that building and I put my foot up on the toilet seat and I pulled my IUD out. I would not recommend anyone do that. It was completely painless. I've had multiple IUDs inserted and removed and I don't have a lot of pain with that. So, but it's not something, go to your doctor and have your IUD removed if you wanna have it removed. But I pulled it out.
It was shockingly small and I flushed it.
Chapter 7: Why is muscle mass important when on HRT?
And I was like, F that, not fun. So that would basically be like Depo-Provera, except in a IUD form. Did not do well on it. Do not like it. Have never recommended a Mirena for a woman ever or Depo-Provera for that matter. And now we've got lawsuits coming out around Depo-Provera and brain tumors. So I don't have all the details on that, but you can go look that up. So then...
lost the weight immediately. Had gained a bunch of weight on that, lost it immediately. Years pass, I have used topical progesterone for years, decades at this point, on and off. Sometimes, obviously at lower doses when I was younger, but I have been on a topical progesterone cream since my 30s, somewhere in my 30s. And more recently, obviously, kind of the whole arsenal of HRT, right?
The estrogen, the progesterone, the testosterone. Now, in all cases, I am a proponent of natural progesterones or bioidentical progesterones. And so the creams, the topicals, the oils, those are all available over the counter. I'm not recommending you start them without some direction because you too can gain a ton of weight on them or feel lousy if it's not done appropriately.
I had another episode in my... 30, my late 20s, I would guess. I was on a road trip and I was using a ton of topical progesterone because my doctor at the time had really ramped my dose up because of the symptoms I was having. And I felt like a crazy person again, and I gained a ton of weight. And what I remembered specifically about that trip to note was that my appetite went through the roof.
And it got me thinking at the time, boy, I have always had a voracious appetite when I take too much progesterone. And so more recently, I am on a micronized oral progesterone, which is a prescription that you can get through a traditional pharmacy. This does not need to be compounded. I am on a, I've tried topical estrogens, estradiol, bi-est, which is estriol and estradiol.
don't get as good of results with a topical as I have with the patch, the topical patch. And so I have been using a very small dose of that. When you're in perimenopause, I do like to test hormones in all women, all ages. But when you're in perimenopause, you're kind of like riding the lightning, right?
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Chapter 8: How can lifestyle factors impact the effectiveness of HRT?
Like you're all over the place. And sometimes you have estrogen and progesterone and sometimes you don't. Depends on the month. Depends on what your eggs are doing. Depends on your stress levels and a lot of different variables. So have been playing around with that dose and it's, I wish I could say this was certain, but it's never the same dose twice.
And I, at this point, I'm like, can I just get through with it? Can I just get through the menopause and actually just then I can control the exogenous supply of hormones into my body so I can get them regulated. But this is a... This is a crazy time.
And any of you perimenopausal ladies, now, any of you perimenopausal ladies that are lucky enough to go on a dose of whatever hormone that your doctor gives you and just, it's great. And you just, it works every month the same. Bless you, because that has not been my experience and it's not the experience of many of my patients and clients. And then a topical testosterone.
I have done injectable testosterone. I've done topical. In female doses, I think it's a really valuable asset to have on board. But I would say that the one thing that has made me gain weight the most quickly and just kind of out of nowhere has been when I have used testosterone at too high a dose.
All of a sudden my body likes to do the aromatization process of my aromatase enzyme kicks up and I convert all my testosterone into estrogen and it doesn't go well for me. And I will get weight gain like that.
This is similar to those of you who are menstruating of whatever age and you find yourself that week before your bleed, right before your period starts, all of a sudden you've got like a sheet of fat on your stomach or your stomach gets real fluffy. And you're like, what is going on here? It's not just bloat. It's like all of a sudden you feel like you just puffed up like the Pillsbury Doughboy.
You just puff up, right? And...
that had been my story all the way through my life I mean really I just would get I felt fat every week before my period all of a sudden I gained a bunch of weight nothing fit it wasn't just like intestinal bloat it wasn't just bloat it was like I don't know turns out I do know now it was insulin resistance you become transiently insulin resistant I'm gonna get to that
Testosterone will do it to me quickly. Too much estrogen will definitely do it to me. Man, estrogen really is that Goldilocks spot. All of these are. All of these hormones, you have got to be finding that Goldilocks spot. But unfortunately, the...
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