Welcome to another empowering episode of The Hormone Prescription Podcast, designed specifically with you, the midlife woman, in mind. 🎙️

This week, we're tackling a topic that resonates deeply with so many of us – "Hormone Poverty And Your Brain, Vagina, Libido - How To Fix It Now". And we couldn't ask for a better guide on this journey than our esteemed guest, Dr. Cathleen Brown. 👩‍⚕️

Meet Our Guest

Dr. Cathleen Brown is not only a board-certified obstetrician and gynecologist with an exemplary background rooted in the Philadelphia suburbs, but she's also a decorated former Army physician with a heart for mentorship and a passion for holistic women’s health. 🏥🇺🇸

Her career, spanning over two decades, paints a picture of dedication - from guiding future medical practitioners to addressing the intimate concerns of women transitioning through menopause. ✨

In This Episode

• Discover: What "Hormone Poverty" means for your brain health, vaginal vitality, and libido. 🧠💕

• Learn: The profound impact hormones have on our bodies and the nuanced interplay between them and our well-being.

• Explore: Dr. Brown's insightful advice on hormone replacement therapy and how it can revitalise your life during and after the menopausal transition.

• Hear: Candid, real-life stories from Dr. Brown's extensive experience that illuminate the path to a healthier, more vibrant you.

• Get Inspired: To take control of your health and explore the options available to combat the symptoms of hormone imbalance. 💪

Dr. Brown also shares her personal interests in traveling, gardening, and the joys of motherhood, connecting with us on more than just a professional level. 🌿✈️

Actionable Takeaways

• Empower yourself with knowledge about your body's hormonal dynamics.

• Don't hesitate to seek help; quality hormone replacement therapy might just be the key you need.

• Remember that your concerns are valid, and your health matters - always.

Keep shining, lifelong learners, and remember - your body's changes are not just a medical matter; they're a pivotal part of your story. Join us as we learn from Dr. Brown how to rewrite the narrative on hormone health and reclaim our vibrancy.

Until next time, keep nurturing your body, cultivating your mind, and inspiring your spirit! 🌟

If you found value in today's conversation, please consider leaving us a review or rating on your preferred podcast platform. Every bit of support helps us reach and empower more women just like you.

Stay connected with us on social media and join the movement of women who choose to live their best lives – hormonally balanced and brimming with energy. 🌷

Dr. Kyrin Dunston (00:00):

The founder of my alma mater, Thomas Jefferson Medical College, said that knowledge is power. We're gonna empower you with some foundational knowledge about bioidentical hormone therapy and why it's absolutely necessary and how to do it right in this episode with two board certified OBGYNs. Stay tuned.

Dr. Kyrin Dunston (00:23):

So the big question is, how do women over 40 like us keep weight off, have great energy, balance our hormones and our moods, feel sexy and confident, and master midlife? If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself Again. As an O-B-G-Y-N, I had to discover for myself the truth about what creates a rock solid metabolism, lasting weight loss, and supercharged energy after 40, in order to lose a hundred pounds and fix my fatigue. Now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results and to give you clarity on the answers to your midlife metabolism challenges. Join me for tangible, natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kieran Dunston. Welcome to the Hormone Prescription Podcast.

Dr. Kyrin Dunston (01:17):

Hi everybody. Welcome back to another episode of The Hormone Prescription. Thank you so much for joining me today as we dive into one of my favorite topics, natural hormone therapy, hormonal poverty, hormonal prosperity, midlife, metabolic mayhem. You know, all the things I love talking about. The things that I presented in my TED Talk. If you haven't checked that out, it's on my YouTube channel. You'll wanna see that. Super important because hormonal poverty that's programmed for us women as we go to 35 and 40 and beyond, can cause myriad symptoms. I like to call midlife metabolic mayhem contributes to disease, including dementia and heart disease, the number one killer of women over 50 and others, and it shortens your lifespan. So you might wanna listen up today. My guest is also a board certified O-B-G-Y-N. Who gets it when it comes to natural hormone therapy and the necessity for it.

Dr. Kyrin Dunston (02:14):

Now, if you know me well enough, you know, I'm fellowship trained in anti-aging, metabolic and functional medicine as well. I had my own healing journey that included the two prescriptions you need for hormonal prosperity. One written for maybe sex hormones, estrogen, progesterone, testosterone, and the other is not a written prescription, but a lifestyle prescription. So I've really gone into even additional training further than Dr. Ka, but she gets it when it comes to bioidenticals. We do differ when it comes to what you should do for an evaluation before they're prescribed, what should be prescribed, et cetera, et cetera. So I think you'll find this interesting because she and I are on different pages when it comes to certain aspects of bioidentical hormones. But as you know, I'm not the kind of doctor who says, do this because I say it's right. I like you to educate yourself.

Dr. Kyrin Dunston (03:09):

We present the education and then you make your own decision. So is testing necessary? Hmm. You'll have to listen. Is testosterone necessary? Hmm. You'll have to listen and so much more. So I think you'll enjoy it. And I'll tell you a little about Dr. Kat. She lived near where I went to college. I went to Bryn Mawr College. She lives in the Philly suburbs where Bryn MA is. And I went to Jefferson in Philly. She went to one of the other medical schools in Philly. I think there are five or six. It might be the highest concentration of medical schools, actually, in any city in the country. So it's a very medical education focused in Philadelphia. Anyway, Dr. Kathleen Brown, she's board certified. I'm gonna try and make this a little shorter 'cause it's really long. But she's Philadelphia trained at Philadelphia College of Osteopathic Medicine. She was in the military, actually, where my cousin was in, in medical administration at Tripler in Hawaii, which is a very beautiful place. She's worked in North Carolina doing general OB GYN and she is an OB hospitalist now also in Philadelphia. And she works with a company called One Nona prescribing Bioidentical Hormones virtually. So you'll get to hear about that as well. So please help me welcome Dr. Kat Brown to the show.

Dr. Cat Brown (04:40):

Well, thank you so much Dr. Kyrin Dunston. It's very nice to be here. Thanks for having me.

Dr. Kyrin Dunston (04:44):

Yeah, I'm always excited to talk to another ob, GYN who gets it when it comes to what I call hormonal poverty of menopause, but also perimenopause that women are programmed to go into. And you totally get it. So you guys are gonna get a treat today 'cause you're gonna get two ob gyn board certified OBGYNs who get it and really understand and speak hormone, who are just kind of talking about what's important that you need to know now. So this is really a privy conversation I think you're gonna enjoy. So I always think it's fascinating for everyone to share with my guest to share, you know, you were trained like I was a traditional straight shooter, O-B-G-Y-N, pharmaceutical prescriptions and surgeries to quote unquote fix everything. And here we are in our careers later down the line, and we both realized that maybe we didn't get the whole truth in what we were thinking. So what was that path like for you?

Dr. Cat Brown (05:48):

Isn't that the truth? I mean, it's, I remember in residency being told like, oh, just memorize these hormones and just, you know, give everyone Premarin if they need to. And you're probably not gonna need this because you're not gonna prescribe hormones. I, I remember attending telling me that, you know, because of the WHI study that, you know, this was something we learned for the test, but you were never actually gonna use in real, real time practice. And for me, that changed when patients started coming to me with issues. But also when I started going through my own journey into this part of midlife too, and realizing that really the things that we were taught and the things that we were doing in practice were just not good enough. You know, it just seemed like not enough emphasis and time was put into women's health and midlife.

Dr. Cat Brown (06:36):

And then I felt, of course, you know, like many people do, like you feel gypped, right? You feel like the information is inadequate. And I also felt like, just like the same as, you know, our nutrition information and, and education that we got as physicians. And I think maybe I got an hour in medical school talking about nutrition and I, thinking back, you know, to medical school and residency, how much time was actually spent on perimenopause and menopause. It was grossly inadequate, you know? So I feel like at this point in my career, I've had to do a lot of introspection, but also a lot of research on my own and a lot of education on my own in order to help myself as well as help my patients.

Dr. Kyrin Dunston (07:15):

It's so true. I mean, you know, I have that same cut and dry education training and, and I practiced that for many years because I hadn't experienced those changes yet, which is wholly inadequate to really address the symptomatology that women have as they go into hormonal poverty. And then when I started going through it, I was like, holy, what is happening? <Laugh>?

Dr. Cat Brown (07:39):

Yes.

Dr. Kyrin Dunston (07:40):

And then realized that the solutions that we had as sports certified OB GYNs didn't really work. And so here I was at 243 pounds where I had no energy and slept all the time, and my hair was falling out. I had no sex drive. My gut was a wreck. I, you know, my digestion, I mean, I was, I was just a mess. I had chronic pain, fibromyalgia, and then I kind of saw the light and <laugh> and then figured it out. And so now, you know, I made a promise that I would spend the rest of my life teaching other women about this. So if you're listening, you're getting the insider's view of where OBGYNs go when they learn the truth. Because if you're going to your regular ob gyn right about now, you're not getting the whole story. You're not getting the whole truth, you're not getting everything that's available to you. And I'm not saying it's their fault, it's just how they were trained and they don't know any better, just like it used to be true for Dr. Kat and for me. But you wanna go to someone who's been through hell and back and, you know, has seen the light.

Dr. Cat Brown (08:45):

Isn't that the truth? Seen the light, for sure. <Laugh>,

Dr. Kyrin Dunston (08:49):

What do you think is super important? I'm a huge proponent. One of my complaints about traditional OB GYN is that their standard of care for testing everything in mainstream medicine. Test your blood pressure test, your weight test, potassium test, your total cholesterol test, you know, your rectal blood for, you know, for blood. All these things we test. And then when it comes to women's hormones, we go board certified OBGYNs, throw their hands up and go, there's no standard of care for testing. We don't test. They're all over the place. We don't know. I mean, just anyone listening to that can go, that's kind of insane. What do you make of all that? You know,

Dr. Cat Brown (09:29):

It's one of those things that I feel like not enough attention has been placed on it, but I think just even, even talking to a patient, just even simply getting a good quality interview of a patient and talking about their symptom profile, like, we can tell right away when someone tells me that, you know, they're not getting as lubricated as they used to, or their joints are hurting, or, you know, they're experiencing vaginal dryness, their skin is different. Like, in my mind right away, I can start to think about, okay, what's happening in their hormonal environment, in their body? You know? And I think that frankly, like a lot of the time you go to a traditional OB, GYN, you go to those visits, there's just not enough time for them to even have the conversation. Half the time you don't even really get to, to talk to your doc.

Dr. Cat Brown (10:11):

You might give your history and your symptoms to their ma or to their nurse, but they come in and it's like they focus on the exam and that quick in it, that quick interaction and then you're done. So I think that it's just a matter of time and having a real quality conversation. You know, I don't think that, you know, right now, like we, I can't rely on a lot of the lab tests that patients bring to me because I have no idea what the lab's doing and, and when they're drawing the labs and that kind of thing. And so there's just so much variability. There's not enough consistency for me to really look at the lab values and really value them. So for me, in my practice, I end up using the patient's history and their symptom profile and their symptom log gives me so much more information than I could, could otherwise.

Dr. Kyrin Dunston (10:55):

Yeah, I mean, certainly I hope you would agree blood work is not accurate for steroid hormones that are not water soluble. So I typically rely on the Dutch test, the dried urine hormone, which is really accurate. I know there's some others that have used it, but I just think it's kind of crazy. I would never have a patient come in and, you know, talk to them and get their symptoms and then go, you know what? It sounds like your low potassium, I'm gonna give you some potassium because you have symptoms of low potassium without checking their potassium. So I just, when I learned about accurate sex hormone testing for estradiol s trial, estro progesterone testosterone, and learned how to read it on myself, because of course I had done blood tests that all came back, quote unquote normal 'cause the range is ginormous on blood. And then I did it, and it actually gave me in four colors where I was and Oh, this is why you have the symptoms.

Dr. Kyrin Dunston (11:54):

And then over the years, as I've seen thousands of these tests, really seeing how each woman has a unique picture, right? It's not one size fits all. People have their unique flavor of what they're high on and how high, what they're low on, and how low what their estrogen phase one and two detox looks like. So I just find testing invaluable for women instead of just, like I say in medicine, there's, there's nothing that we don't test. That was a big wake up call for me. And now I see the real injustice. I don't know if you've looked into the history of gynecology, the profession of gynecology, like under the American Board of Specialties, how it started? Yeah. And kind of how it's evolved. I mean, what were your thoughts on that? I was pretty horrified when I learned some of the details about how that specialty evolved.

Dr. Cat Brown (12:46):

It was just the sense of embarrassment and like the feeling of just feeling appalled as how especially gynecologic surgery evolved and learning how so much of our field has so many roots in systemic racism is just crazy, you know? And some of the information about Marian Sims and coming out about some of the things that he did and how he experimented on his slaves to, in order to get the information, you know, for surgical advancement especially, you know, that's something that came to light, I think more in the last few years, especially since Black Lives Matter, you know, and ACOG has done some memorial lectures in in response to that. But that was probably one of the biggest things that I was just thrown back by because I don't remember hearing anything about that at all throughout my training, you know? And so to learn that, and, you know, even to move forward and, and, and hear about, you know, the Henrietta Lacks situation too, and how, how she was experimented on, but not really fully treated. And, and we still use ourselves to this day, you know, to study chemotherapies for ovarian cancer. It's insane. That was one of the biggest eye-opening moments for me as a gynecologist. I, I would say.

Dr. Kyrin Dunston (14:02):

Yeah, I agree. So, you know, for everyone listening, if you haven't heard about this, basically the profession has been developed with a kind of unethical medical and surgical use of people of color and women without consent to do research on. And some of it is very unethical, not the way we do research now, which, you know, people could argue maybe there's some problems with the ethical nature now, but it's way better than it used to be. And it really was started as a surgical specialty more than anything. And so then you have people who are surgeons who they weren't really ever intending to address women's hormones that that wasn't the intention. So you have to look at the lens at which people are viewing a problem that they're dealing with. So here you have men, you have white men who are looking at women's health through a surgical lens and really what their intention is and how they view women in general.

Dr. Kyrin Dunston (15:09):

And so it's just really clouded. And, you know, maybe I'll have to have someone come on the podcast who's a historian, sociologist, who can really break it down for everyone. But I too was embarrassed when I learned all the details. I really got a good understanding of why we're stuck with our present mainstream gynecology system of care that we have and why we know everybody's so myopic and won't move out of it and won't really see the problem because they can't. So make that discussion a larger discussion to have another time. But thank you for sharing your thoughts on that. In terms of the importance of natural hormone therapy and, and the difference between what you would get at your doctor's office, traditional mainstream doctor's office, or what you might get from a physician like us who is trained in bioidenticals, what would you say is the importance? 'cause I get a lot of questions from women. What are bioidentical hormones? Can my regular doctor prescribe that? Why not? What's the difference? So what would you explain to them?

Dr. Cat Brown (16:13):

Yeah, I mean, I think that my biggest, easiest way to discuss this, with regard to this, is really to talk about Premarin, right? Which is probably the most common hormone replacement that can be prescribed by most physicians, whether it be the topical vaginal Premarin, or whether it be the oral pills. I like to tell patients the story of Premarin, and I like to tell them what the origin of the name of it is, you know? 'cause When you break it down, I mean, Premarin really means pregnant mare's urine. And so, you know, fundamentally just the main difference from the traditional pharmaceuticals, especially given for hormone therapy compared to bioidentical, is that most traditional pharmaceuticals are not hormones that exist naturally in our bodies. Especially when you think about Premarin being the pregnant mare's urine. It's coming from the urine of pregnant horses.

Dr. Cat Brown (17:04):

And, and these have, you know, when you look at the label, I remember as a medical student even looking at it saying conjugated equine estrogens, why equine? You know? And when you finally learn like this is the, a jumbling of horse hormones that's put together, and it's almost like we're collecting as many estrogens, estrogens as we can, putting them into a pill and throwing them at a patient hoping that one will take, you know, but there's so many other compounds in those medications that aren't even biologically active and human beings that, you know, just really can't. So it can't be optimal for a patient, right? Because we're giving them horse hormones when really they need human hormones that are similar to what their body is making. And so that difference, you know, when we talk about bioidentical, it's, it's really hormones that are the same as what your body would normally make on its own, but it's incapable of continuing to create on its own and the levels that we need it, you know? And so patients are always shocked and they say, well, how could they do that? How could they be giving me horse estrogen? But we've been doing it for years, you know?

Dr. Kyrin Dunston (18:06):

Right. But the body thing that a lot of people are amazed to learn is that why, why is the next question? Oh. Because they can't get a patent on a naturally occurring substance. Yeah. So they could have created exactly what you had in your body, which would've been best for you. Right. So if you're low on potassium, what do we do? We create potassium. Exactly. It's what you have. And then give that to you. So it would be best for you. Anyone can understand that. But no, we can't get a patent on it, meaning we can't make money on it even though it's best for women. Right. So that's why we're gonna go get it from horses. So it's a whole capitalist capitalistic view. Yeah. Capitalism drives so much of our health problems and we don't even realize it <laugh>. Well,

Dr. Cat Brown (18:53):

And that's such a bigger conversation. I mean, we could get into that whole conversation about how, you know, so much of wellness and health is driven by big pharma and because they can't make money on naturally occurring things or even supplements, you know, that there's just no money or research put into that. And so they create these synthetic compounds to make new medications. And it's, it's all this big money making scheme. And pharma just keeps getting richer and richer. Whereas, you know, the medications aren't as readily available to patients. It's sad, but true <laugh>. But it extends into the women's health arena too, when it comes to not only hormones, but even birth controls. You know, that big pharma kind of rules everything. And as soon as it's something is old enough that it gets to generic and it gets more affordable for a patient, they just tweak some little thing about the medication, the color of the pill, or how many days it can last or what the package looks like, just so they can get another patent to be able to continue charging ungodly amounts for brand new medication. It's crazy, right?

Dr. Kyrin Dunston (19:57):

So Yes, it is. And so you talked a little bit about Premarin. So yes, mainstream pharmaceuticals, Premarin Provera, which wasn't progesterone, it was hydroxyprogesterone acetate. So how are these hormones, why are they important for our brain health? I think that's something that not many people don't hear enough about. Yeah.

Dr. Cat Brown (20:17):

I think the best way to describe it to patients is that estrogen has such a beneficial effect on every tissue of our body. You know, as, as female human beings, estrogen is pervasive in every tissue and even at the cellular level. And so with, without it, the junctions, especially in our brain, like our, our neurons, our neurotransmitters, things just can't function as well as they can unless there's estrogen in that environment to help those tissues act their best and, and help those connections. So I think, you know, the same is, goes through, you know, joint discomfort. And, you know, even with the cardioprotective aspect of estrogen, there's so many good things that it does through every tissue in our body that when you start removing estrogen, those areas just can't function as well as they want to. That's how I kind of describe it to patients to kind of get it to a simpler level.

Dr. Cat Brown (21:11):

But, you know, we, we see the research coming out that, you know, for patients that don't use hormone therapy, their cognitive decline is so much more rapid. Those changes are so much more noticeable in patients that aren't on hormone replacement. You know? And I think it's something that we're gonna see more and more of, especially as we in general, as patients and as consumers, are more demanding of treatment. I think we're gonna start to see a change in that, in, in that climate, you know, as far as watching patients, you know, combat that cognitive decline. And, and you know, especially when it comes to dementia, the onset of that, I think that that's important.

Dr. Kyrin Dunston (21:48):

The other thing that I found crazy, did you find this crazy too? When I learned about proper bioidentical hormone treatment used to be, and I think it's still this way, that mainstream doctors are taught that women who don't have a uterus don't need progesterone. Because the only reason you need progesterone is to prevent the uterus from creating cancer in response to estrogen. When I discovered, when I did my fellowship in anti-aging, metabolic and functional medicine, you know, I learned, well, oh, you know what, what about the breast counteracting the effects of estrogen in the breast? And then also the neuroprotective effects of progesterone where it's actually used in traumatic brain injury patients and stroke patients to help preserve brain tissue. And all the tissues, all the cells have response to progesterone. So can you talk a little bit about that? 'cause I know there are women listening who are saying, well, I'm only on estrogen, I don't have progesterone, and they're not really aware that they need that to balance it out. Mm-Hmm.

Dr. Cat Brown (22:48):

<Affirmative>. But I think it's a, you know, it's something unique to each patient. You know, I have that conversation with my patients, you know, and, and typically I have patients that, you know, that come to me with a history of a hysterectomy, maybe on estrogen only. And we have that conversation. I mean, I think that, I don't necessarily prescribe, personally, I don't necessarily prescribe progesterone for every single patient that has had a hysterectomy. It's a, it's, you know, I make it a shared decision making process with my patients. And we talk about the risks and the benefits, and it's one of those things that I have some patients that really do want it. And so we add progesterone, but it's not something that I've made universal for each patient, you know? And I think that, so a lot of my patients want as minimal amount of medications as possible. And so it's mm-Hmm, <affirmative> it's one of those things that we have the conversation about. But I absolutely have patients that feel like they function better with both hormones, with the estrogen and the progesterone. And so we do that when they want that and they need that.

Dr. Kyrin Dunston (23:46):

Yeah. I mean, I guess that's different when you're just treating based on symptoms. Like, oh, you have this symptom, I think you need that, and you have this symptom, I think, versus a test, you know, I guess it's a different viewpoint where you see the hormones as these are necessary components for optimal functioning. 'cause You have progesterone receptors in all your cells and tissues, including your brain. So I guess it's a different way of looking at it. How about the importance of testosterone? Yeah. I

Dr. Cat Brown (24:14):

Mean

Dr. Kyrin Dunston (24:14):

About that.

Dr. Cat Brown (24:15):

Sure. I don't think a lot of women realize that we also have testosterone in our system. You know, a lot of women just focus on their female hormones, but they don't realize that, you know, testosterone really drives our metabolism. It sometimes drives our energy level, helps to combat fatigue, but it really is one of the biggest drivers of our libido and sex drive too. And for us, especially trying to combat osteopenia, osteoporosis, as we age and trying to maintain our bone health and our, our strength and our muscle health, we don't, we don't realize how much testosterone is integral for that as well. And really muscle maintenance, maintaining our strength, I think it's important. And so that's something that, I think is, is something really important for patients to take into account too. And, you know, testosterone, it's, it's one of those things that we have some limitations because testosterone in, in the medical community, and especially in the bodybuilding community, especially for men, it's been so abused and misused.

Dr. Cat Brown (25:15):

And I come from a military background, you know, I was an army doctor for much of my career for 12 years. And we had a huge issue with male soldiers coming in because their wives couldn't get pregnant. And they had been taking so much high dose testosterone just for performance enhancing to make them faster, to make them better soldiers, make them run better, and be able to lift more. But then as a pro, as a result, their body wasn't creating its own endogenous testosterone. And so, you know, now as a result of all those abuses, testosterone is considered a controlled substance because with high doses, it can cause more harm than good. So for women, you know, we have to be cognizant of that. But I think that we don't realize that, you know, many pro providers out there don't realize, physicians don't realize that you can safely replenish a woman's testosterone.

Dr. Cat Brown (26:05):

You have to be very careful because our therapeutic range for testosterone is a little bit more narrow than it is for a man. We don't wanna, you know, it's, it's like walking a fine line. We wanna replace testosterone, but we don't want to masculinize our female patients either. We don't wanna cause those masculinizing side effects that women can get if they get too much of it. You know, like the male pattern baldness or facial hair growth. You know, most often I see patients come, you know, with changes in their skin and, and more acne develop, you know, as a result of testosterone. So we have to be astute to really fine tuning, like what we're giving patients when it comes to testosterone supplementation,

Dr. Kyrin Dunston (26:43):

Our narrower range for women. And that's why I think testing is so vital. And again, you know, here it's where politics and money, politics and money really rule women's health when it comes to our healthcare. We saw that in terms of Premarin, but also with testosterone, where it's considered a controlled substance because of the abuse by male bodybuilders. To my knowledge. I don't know that female bodybuilders have abused it, but that's possible. But testosterone is just as essential for women as men, right? For our muscle mass, our bone density, osteoporosis, and fractures due to osteoporosis, one of the biggest causes of death and disability of women over 50. It's important for our neurochemistry, our dopamine, our get up and go drive neurotransmitter for our mental clarity, functioning feelings of wellbeing. A lot of people think, assume it's only about libido, doctors and patients alike. And it's about so much more than that. So much

Dr. Cat Brown (27:45):

More.

Dr. Kyrin Dunston (27:45):

Yeah. So I think it's essential. And then, you know, it's also not only a controlled substance, but because of a 17-year-old boy, Ryan Haight, who was able to obtain a controlled substance from another state through telemedicine, it's also very difficult to obtain it through telemedicine. So because of teenage boys and bodybuilders, women's access to this important hormone is limited, and most doctors won't even prescribe it for women. They, I've found a lot of patients come to me and they say that, oh, my doctor told me that I don't need it, and they won't prescribe it. And let's talk a little bit about libido before we wrap up, because that's something, you know, I'm recently back from traveling the globe where one of the things I was really looking at is what is women's healthcare like in other countries and other continents, particularly around menopause.

Dr. Kyrin Dunston (28:43):

And everywhere I went, women over 40 were grabbing me when they heard what I did and sidelining me to tell me they had the same problems as women in the us. And I was really startled to learn that it's global, but I guess I shouldn't be, because as America goes, so goes everywhere else. But women really, this lack of sex drive is a problem globally. Women don't have one. I mean, it's a problem for men too, but a lot of women don't have a libido. They think that that's normal for their age, that they shouldn't have a libido. They don't talk to their doctors about it because they're ashamed and stigmatized. So can you talk a little bit about that?

Dr. Cat Brown (29:27):

I think that not enough emphasis has been placed on it, but I also think like, it's so much a, it's a bigger, like, more deeply rooted issue, I think in our, our culture as a society, not just in, in healthcare. But I feel like, you know, there's this double standard, right? You know, that I think it kind of stems back to like that purity culture too. Like, like, you know, women aren't supposed to be sexual beings. Like we're, you know, there's this kind of underlying theme that like everyone wants us to be good and to be well behaved. And so, you know, there's not enough emphasis placed on it. And then meanwhile, you see so much in the media and on the news about women or men's health, you know, and, and we've spent so much time and energy researching erectile dysfunction, <laugh>, and helping men with their situation.

Dr. Cat Brown (30:12):

But then we're not helping their partners, especially if they're in a heterosexual relationship. You know, we're, we're helping men get a hard on, but we're not helping their wives be able to be receptive or even interested in having sex at all. It really is back to like women just being treated kind of like second class citizens and not enough emphasis placed on us. I think it's that very misogynistic view of the world, and it kind of is pervasive in healthcare too. I think that not enough importance has been placed on women's health and, and that this is so, so evident when it comes to libido and, and women's sexual health. And I don't even think I knew until getting into taking care of women and perimenopause, menopause and menopause, that there even was like a society for sexual wellness. Like, I just, I just found out about ishish, you know, probably in the last five years, you know, which does extra training for physicians and providers. And as far as their sexual wellness, you know, that wasn't even something that was even discussed when I was being trained to become an ob GYN. And what a shame, because, you know, we're supposed to be the experts when it comes to female genitalia, female organs, reproductive health. But then that part of reproductive health, which is, which is so important and it's such a important part of life and a part of our health, it's not even really discussed, you know, you know, it's

Dr. Kyrin Dunston (31:37):

So true. And as, as you're talking, I'm thinking if I had to do it over, I literally would specialize in female sexuality because I think it is the most underserved area of obstetrics and gynecology. And so I was thinking, why don't we have fellowships in female sexuality that would be something, you know, just for women to understand. And I think it does come from the religious perspective that most people have of puritanical views, but I think we're growing out of it. You know, I've been watching this show on Netflix called Dating on the Spectrum, which I love. It's so heartwarming,

Dr. Kyrin Dunston (32:17):

So beautiful. Yeah. And what I love especially is seeing how the younger generation, most of these people are in their twenties, a few are in their thirties, they're open about sexuality and talking about sexuality. And I think that along with that open discussion comes an understanding, hopefully it does for them. I mean, they don't talk about it in this show about the importance of healthy sex for your overall health, vitality, wellbeing, and longevity. Yes, yes. And I think it's really time, you know, it's not too late for women over 40. It's not too late for women over 50, 60, 70. I don't care if you're in age. I think

Dr. Cat Brown (32:57):

It's never, it's never too late

Dr. Kyrin Dunston (33:00):

<Laugh>. It's never too late to have some good sex and get the health benefits. What are some of the health benefits of having regular good sex where you have orgasms? What are some of the health benefits for those who might not be aware?

Dr. Cat Brown (33:16):

Well, I think that overall, I mean, what I see is like, you know, a woman's immune system is much stronger when she has regular sex that it's pleasureful. I mean, not only that, but just opening up those pleasure centers in the brain as well. You know, it's fundamental, and when a woman allows themself to really enjoy sex and really puts importance on, on physical pleasure in that way, it gives them so many health benefits and just invigorates their life and invigorates their health too. I mean, women that tend to do that more, are more in touch with their bodies and tend to take better care of themselves than women who don't just, you know, comparing apples to oranges. But I think that not only that, but you know, the old, old saying that like, if you don't use it, you'll lose it, <laugh>. So the more we bring arousal to our female genitalia, the more healthy that tissue becomes, you know, whether it's through masturbation or whether it's through sex with someone else. The more that you use those tissues, the more healthy those tissues become, the more blood flow that they get, the more hormone rich the environment that those tissues get, the more they're, they're used in that way.

Dr. Kyrin Dunston (34:29):

Right. And then it improves your cortisol stress hormone profile. Yes. You know, I call queen cortisol and your overall health is really governed by cortisol. Yes. You know, it was interesting. A, a woman I did a consultation with last week, she had had the BRCA gene, and this is anonymous that I'm talking about this, I won't mention her name. She had had double mastectomy, bilateral ovary removal with a hysterectomy, all kinds of consequences from that. And her main concern was, I have no sex drive. Can you give me a magic pill to fix that? What would you say to a woman who's kind of in that predicament? 'cause I know she's not alone.

Dr. Cat Brown (35:10):

Yeah. I think that one of the biggest things is setting expectations. Mm-Hmm. <Affirmative>, you know, and, and there is no one magic pill. I think that fundamentally, as women, our sexuality is so much bigger than that. It's not just a matter of turning a hormone on or off. Our largest sex organ. And the most important sex organ that we have is our brain <laugh>. And so much of our sexuality is emotional and mental, because unlike men, we're wired differently. We have to be in the right mindset. We have to have the self-confidence, self-motivation to even be, allow ourselves to feel romantic or sexual and something that they have to work on and have to really put the effort into cultivating that. It's, it's not just a, a matter of having a magic pill, but sometimes I think as for us as physicians, just opening up that conversation with a patient can be empowering for them just to be able to start having the conversation and just using the language and talking about it gets their mind starting to think about, well, like what can I do to start reframing?

Dr. Cat Brown (36:18):

I think that sometimes having those surgeries, you know, having, going through hysterectomy, going through a mastectomy, dealing with either cancer risk or cancer surgery, then puts a woman in a completely different mindset. And they have a hard time thinking about themselves as sexual beings anymore. You know, and a lot of women, there's a, you know, the self-stigma that they place on themselves that, you know, having certain female organs removed changes who they are as women. Mm-Hmm. <affirmative>. But it really doesn't. And so we have to help them empower themselves to kind of change that view as well. But, but you have to put the work in, it has to come from multiple angles. I think, you know, we can help with the hormone aspect of it, but then they also have to do the work of that mental mind shift about it too.

Dr. Kyrin Dunston (37:04):

Yes. So true. And, you know, you had given me some great quotes to share before we started. I wanna wrap up and add this one. 'cause It's, I think it's attributed to several PE people, but one of them happens to be Thomas Jefferson, where I went to school at Thomas Jefferson University in Philadelphia. Knowledge is power. So hopefully you've learned something today, listening that you can use to empower yourself when it comes to hormonal poverty, getting out of it and getting to hormonal prosperity, to experience the vitality that you deserve. Dr. Kat, thank you so much for joining me. Where can people connect with you online and find out more about what you do?

Dr. Cat Brown (37:46):

Sure. I have an Instagram account at Dr. Cat obgyn and I do hormonal therapy for patients through Wyn oda, which is by wino.com. I'm also on LinkedIn, although I haven't done much with that profile lately, but <laugh>, I have to do a little bit more. But that's primarily where you can find me.

Dr. Kyrin Dunston (38:03):

Awesome. Well, thank you so much for joining me today and for your path in women's health that hopefully is empowering lots of women. Thank you so much.

Dr. Cat Brown (38:14):

Well, thank you so much for having me. It was a great conversation.

Dr. Kyrin Dunston (38:16):

And thank you for joining me for another episode of The Hormone Prescription. Hopefully you've gotten some different perspectives when it comes to natural or biologically identical hormones. Today. We've talked about testing. There are different opinions as you can see between me and Dr. Kat on whether testing is necessary and accessibility to testosterone and how important that is, and more so. I really think it's important that you take this as a note to educate yourself and make informed decisions that are right for your health. Like the founding father of my alma mater, Thomas Jefferson says, knowledge is power. Hopefully you've gotten some knowledge today that can empower you to make the right choices for yourself so you can move out of midlife metabolic mayhem, prevent disease, increase your lifespan, and get to hormonal prosperity and live the vitality that you deserve. I look forward to hearing about the changes you're making. Reach out to me on social media, so on social media. On social media, and let me know until next week, peace, love, and hormones, y'all.

Dr. Kyrin Dunston (39:25):

Thank you so much for listening. I know that incredible vitality occurs for women over 40 when we learn to speak hormones and balance these vital regulators to create the health and the life that we deserve. If you're enjoying this podcast, I'd love it if you'd give me a review and subscribe. It really does help this podcast out so much. You can visit the hormone prescription.com where we have some free gifts for you, and you can sign up to have a hormone evaluation with me on the podcast to gain clarity into your personal situation. Until next time, remember, take small steps each day to balance your hormones and watch the wonderful changes in your health that begin to unfold for you. Talk to you soon.

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