What Women Need to Know About Longevity Before It’s Too Late | Dr. Amy Killen

Summary

---

Podcast Summary: The Neuro Experience

Episode: What Women Need to Know About Longevity Before It’s Too Late | Dr. Amy Killen
Host: Louisa Nicola
Guest: Dr. Amy Killen
Date: March 17, 2026

---

Episode Overview

This episode delves deep into the unique factors affecting women's longevity, with a special focus on ovarian aging, hormone replacement therapy (HRT), and cutting-edge regenerative therapies. Host Louisa Nicola interviews Dr. Amy Killen, physician and Chief Medical Officer at Humanot Health, about the intersection of hormonal health, immune system function, stem cell therapy, and modern longevity strategies for women. The discussion highlights actionable insights and controversies, empowering women to better understand and advocate for their own aging process.

---

Key Discussion Points & Insights

1. Ovarian Aging as the "Pacemaker" of Longevity

• Ovarian Health and Lifespan: Dr. Killen repeatedly emphasizes that ovarian aging is not just reproductive—it is central to overall lifespan and healthspan in women.
  • “The aging of the ovaries affects your overall lifespan. Women who go through menopause early, if we don't replace hormones, tend to live shorter lives.” – Dr. Amy Killen [00:05]
  • "The ovaries are the pacemakers of aging in the human body." – Dr. Amy Killen [11:42]
• Egg Reserve Decline: Women are born with a finite number of eggs, and lose hundreds to thousands each month, not just the one ovulated. Genetics, inflammation, environmental toxins, and lifestyle all affect the rate of loss.
• Menopause as an Accelerator of Aging: Loss of ovarian hormones—estrogen, progesterone, and testosterone—triggers rapid aging in the cardiovascular system, brain, bones, muscles, and more [11:42].

2. Hormone Replacement Therapy (HRT): Benefits, Risks, and Myths

• Prevalent Underuse & Misunderstandings: Only about 4% of American women use HRT, largely due to outdated fears and poor education among practitioners.
• Benefits of HRT: When timed appropriately (ideally within 10 years of menopause onset), HRT can:
  • Prevent osteoporosis and bone loss [21:35]
  • Lower risk of cardiovascular disease and possibly dementia [21:35]
  • Maintain mitochondrial health, muscle mass, and neuroprotection
• Addressing Breast Cancer Concerns:
  • “We've definitely debunked the relation. … Estrogen as hormone therapy does not increase breast cancer.” – Dr. Amy Killen [34:33]
  • Bioidentical estrogen paired with progesterone does not increase risk; older, synthetic progestins carry some risk [35:22]
  • For women with BRCA mutations, short-term HRT post-oophorectomy does not appear to raise breast cancer risk [35:48]
• Systemic vs. Localized Estrogen:
  • Systemic: Patches, creams, pills—benefit the whole body (bones, brain, heart) [25:02]
  • Localized (vaginal): Extremely low-dose; targets pelvic health (UTI prevention, vaginal atrophy) without systemic effects [26:01]
• Window of Opportunity: Significant neuroprotection is seen when HRT is started close to menopause; starting late may be less beneficial for dementia prevention [62:10]

3. Hormones Beyond Estrogen: Testosterone & DHEA

• Testosterone in Women:
  • “Women make three times more testosterone than estrogen… the idea that you wouldn't need testosterone when that starts to go down with age is kind of preposterous.” – Dr. Amy Killen [32:41]
  • Benefits: Motivation, mood, muscle mass, libido, energy
  • Side effects: Acne, body hair, occasional hair loss
• DHEA Use: Can be beneficial but may cause side effects like acne for some women [32:10]

4. Innovative & Experimental Regenerative Therapies

• Stem Cell Therapy:
  • Used for musculoskeletal pain, skin, sexual health; acts mainly as "messengers" to stimulate tissue repair [04:48]
  • “We're using the cells as a way to communicate with your own cells, to tell your cells to behave differently, to act more youthfully …” – Dr. Amy Killen [04:48]
  • Regulatory issues limit certain uses in the US; more is permitted abroad [06:49]
• Exosomes & Brain Repair:
  • Exosomes from stem cells (not the cells themselves) can cross the blood-brain barrier, under research for TBI, stroke, neurodegenerative diseases [08:31]
• Peptides:
  • Exciting, promising, but lack robust human RCTs apart from GLP-1s (semaglutide, etc.) and insulin
  • Concerns about stimulating unintended cell proliferation (e.g., cancer) [46:16]
  • “I do think that the lack of data is a little concerning. … We certainly haven’t researched what you do when you’re combining five peptides…” – Dr. Amy Killen [47:16]
• Therapeutic Plasma Exchange (TPE):
  • Removes plasma, replaces it with albumin; piloted for Alzheimer’s, microplastics, hyperlipidemia [48:05]
  • Expensive, time-consuming, not widely accessible

5. Lifestyle & Environmental Interventions

• Foundations First:
  • "Lifestyle is first." Sleep, stress, movement, relationships, purpose are more foundational than any high-tech intervention [43:37]
  • “If you live on a farm ... eat healthy foods ... you probably don't need red light therapy.” – Dr. Amy Killen [52:42]
• Modern Environmental Risks:
  • Toxins (e.g., phthalates in cosmetics, smoking, alcohol) increase ovarian aging [17:54]
  • “Women who had the highest exposure to phthalates went into menopause two or three years before women with low exposure.” – Dr. Amy Killen [17:54]
• Mitochondrial Health as a Longevity Target:
  • Ovaries are the most mitochondria-rich organ
  • Supplements like CoQ10, urolithin A, and possibly melatonin, DHEA, NAD precursors under study to support ovarian & overall aging [40:22]

6. The Female Immune System & Inflammation: A Longevity X-Factor

• Role of Estrogen in Immune Regulation:
  • Menopause triggers a loss of immune “master coordination,” leading to more inflammation, more disease risk [53:39]
  • “You lose this … security director of the immune system. … We see this really big increase in inflammation at perimenopause.” – Dr. Amy Killen [53:39]
• Autoimmunity: Women’s hypervigilant immune system protects across the reproductive years but raises risk for autoimmune diseases [57:12]
  • “80% of all autoimmune diseases are women.” – Louise Nicola [57:03]
• Testing: Limited, but HSCRP can be used to track systemic inflammation during menopausal transition [54:43]

7. Advocacy, Power & Education

• Patient Advocacy:
  • “There's so many women out there who want hormones ... but they can't write themselves prescriptions. So we have to educate doctors. … Then we need women to continue to advocate for themselves.” – Dr. Amy Killen [37:42]
• Empowering Women:
  • Primary mission of guest’s upcoming book: to educate women and doctors about the real science of women’s aging and how to take control of it [59:24]

---

Notable Quotes & Memorable Moments

• “The aging of the ovaries affects your overall lifespan.” – Dr. Amy Killen [00:05]
• “The ovaries are the pacemakers of aging in the human body.” – Dr. Amy Killen [11:42]
• “We could go to Mars, but we have not solved ovarian aging.” – Louisa Nicola [10:47]
• “We've definitely debunked the relation. … Estrogen as hormone therapy does not increase breast cancer.” – Dr. Amy Killen [34:33]
• “If you live on a farm and you work out all day and you're outside … you probably don't need red light therapy.” – Dr. Amy Killen [52:42]
• “Women make three times more testosterone than they do estrogen … the idea you wouldn’t need testosterone when that starts to go down with age is preposterous.” – Dr. Amy Killen [32:41]
• “When estrogen goes away, collagen takes a big dive.” – Dr. Amy Killen [28:48]
• “I want women to understand the power that we have in how we age.” – Dr. Amy Killen [59:24]

---

Timestamps for Key Segments

| Timestamp | Segment Description | |----------------|-----------------------------------------------------------------------------------| | 00:00–01:19 | Ovarian aging, loss of eggs, health consequences of early menopause | | 04:10–09:10 | Dr. Killen’s background, regenerative medicine, stem cell therapy explained | | 10:28–13:01 | Hormonal changes in perimenopause, individualizing HRT | | 15:23–19:57 | Environmental toxins, genetic factors, reducing egg loss, ovarian health strategies| | 21:35–26:51 | Systemic vs. localized estrogen therapy; indications and safety | | 32:01–33:40 | Testosterone and DHEA for women: benefits and side effects | | 34:33–36:16 | HRT and breast cancer risk; data from WHI revisited | | 38:49–41:50 | Supplements to support ovarian/mitochondrial health | | 43:37–45:44 | Lifestyle foundations, modern environment, prioritizing basics over biohacks | | 46:16–48:30 | Peptides, safety/efficacy, real-world evidence | | 48:45–50:37 | Therapeutic plasma exchange studies and practicalities | | 53:39–58:34 | Ovarian aging and immune system: inflammation, HSCRP, autoimmunity | | 59:24–60:33 | Education and empowerment: Dr. Killen’s book and vision | | 62:10–62:50 | HRT “window of opportunity” for brain/cognitive health |

---

Final Takeaways

• Ovarian function is central to women's healthspan—affecting bone, brain, immune, cardiovascular, and overall longevity.
• Modern HRT with bioidentical hormones, begun early in the menopausal transition, is safe for most women, and offers extensive benefits—while prior fears about breast cancer risk are largely outdated.
• Lifestyle (nutrition, sleep, movement, stress management, relationship) always comes first.
• Regenerative therapies (stem cells, peptides, plasma exchange) and supplements are promising but still experimental for most anti-aging applications.
• Women should be proactive: educate themselves, seek out informed practitioners, and advocate for their health needs, especially regarding hormones and longevity.

---

For deeper insights and updates, look forward to Dr. Killen’s upcoming book on women’s longevity, and follow Louisa Nicola for ongoing discussions at the intersection of neurology, performance, and aging.

Transcript

[Dr. Amy Killen]

You ovulate one egg, but five hundred or a thousand eggs are essentially lost along the way.

[Louise Nicola]

What?

[Dr. Amy Killen]

Yeah, it is true. The microenvironment where they live becomes more like hostile. It makes it worse and worse and worse. The aging of the ovaries affects your overall lifespan. Women who go through menopause early, if we don't replace hormones, tend to live shorter lives. And so when your ovarian function goes down, your cardiovascular system, your brain, your bones, like everything starts to really age rapidly. You know, when I talk about longevity in women, we have to start with the basics.

[Louise Nicola]

Let's talk about what it is that do.

[Dr. Amy Killen]

I want women and doctors to understand the power that we have in how we age. All of the multi system dysfunction that we see get much worse after hormone loss. It's the women who are not getting treatment that we know have increased cardiovascular disease and dementia risk. Estrogen can be used for potential prevention of diseases like that. Estrogen is such an important molecule for women. And then testosterone, of course, is another hormone that women have a lot of as well. Several years ago my mom fell and broke her hip. She was in her mid-70s and you know, 25% of people who break their hip in that live a year. My mom did what I realized at that time, seeing the doctors who did not understand anything about hormones, they took her off of her estrogen when they sent her home. And it was a whole fiasco. There's so many women out there who want hormones, who know about them, who've learned about them, but they can't write themselves prescriptions.

[Louise Nicola]

What do they do?

[Dr. Amy Killen]

We need women to continue to.

[Louise Nicola]

I'm Louise Nicola and this is the neuro experience. Dr. Amy Killen. What is it about longevity that excites you?

[Dr. Amy Killen]

I am really excited about women's longevity as a kind of stuff, separate entity than men's longevity. Because I think there's so much that we're not talking about and there are so many differences in the way that we age. And so I love the idea of focusing on how are we different and how can we make it better for women to age?

[Louise Nicola]

Well, the reason I ask that is because we're at this funny juncture in the world of longevity as it applies to medical practitioners, physicians, scientists, and I think the word is just getting thrown around a lot. What does aging well and longevity mean to you?

[Dr. Amy Killen]

To me it just means aging as well as you can for as long as you can. So it's not necessarily about increasing lifespan, although obviously that would be amazing eventually. We do not have any tools right now that can reliably do that. But we do have a lot of tools that can help us live better for longer with higher function. Do the things you want to do, you know, not be stuck in bed. I think that's like the first goal we have to get through.

[Louise Nicola]

I want to talk to you about obviously female longevity, what you do on a day to day basis and hormonal health. I first saw you on social media and it was around hormonal health. Right. Estrogen and menopause is having its time right now. It's on the spotlight and rightfully so. So it should be because every single woman will go through this if they're lucky enough to live that long. So it's just been so much, you know, it's been understudied, under researched and we have around 4% of the entire population taking hormone replacement therapy and we're

[Sponsor/Ad Voice 1]

still in the weeds.

[Louise Nicola]

And this is where what I do and my area of expertise comes in, looking at the intersection of hormone replacement therapy or the role that hormones play on brain health and neurodegenerative diseases. So why don't we start with what it is that you actually do as a physician in your day to day.

[Dr. Amy Killen]

So my day to day I have a few different jobs. I am the chief medical officer of human eyed health. So I create the clinical protocols and oversee all of the physicians and mid level staff like PAs NPs with, you know, there are different cases, hard cases, what do we do, those kinds of things. I also practice part time in neurogenerative medicine clinics. We do stem cell procedures for musculoskeletal pain, for scalp and skin and sexual health and things like that. So that's kind of a part time job. But most of my time is spent in this clinical protocol role with humanot and helping with education, creating easy protocols that hopefully can scale and then overseeing directly the, you know, the NPS and the PAS and the doctors for the

[Louise Nicola]

sole purpose of improving healthspan and lifespan.

[Dr. Amy Killen]

Yes, exactly. So yeah, taking everything that you know, we talk about in longevity, the lifestyle pieces plus the hormone pieces plus you know, maybe some in office techniques or you know, therapies. What are the best practices to put those together for different people for different problems and how do we do it safely and that's kind of my job.

[Louise Nicola]

Can we actually spend some time talking about stem cells?

[Dr. Amy Killen]

Sure.

[Louise Nicola]

I think it's really interesting and I'm seeing so much happening right now. Stem cell therapy for regeneration of actually everything. I don't know Enough about it. So can you actually introduce us to what stem cells are and what stem cell therapy is?

[Dr. Amy Killen]

You know, you have stem cells all over your entire body. So do I. And they're the cells that are responsible for the upkeep of all the different organ systems. Right. It's like they're the ones who can. They can regenerate and make more of themselves and they into different types of cells potentially. But the way we use stem cells clinically is we're taking cells either from you or from something else, like a birth tissue product, like an umbilical cord cell. And we're using those cells as, like, messengers, essentially. We're trying to. We give you the cells, maybe inject them into a knee or we put them in your face or whatever. But we're essentially just using the cells as a way to communicate with your own cells, to tell your cells to behave differently, to act more youthfully, to increase growth factors, to increase blood flow, things like that decrease inflammation. So we're really using them more as messengers than we are as, like, stem cells. But the idea is to improve the way that you heal and potentially even kind of repair or regenerate tissue.

[Louise Nicola]

Do they become dysfunctional? So we've all got stem cells all over our body. We're born with a certain amount, Right. Do they die off or do they become dysfunctional as we get older?

[Dr. Amy Killen]

Yes, both. So as you get older, you get reduced numbers of stem cells, and you also get stem cells that are not as active and able to message and communicate with other cells. So that's the idea is we take cells from areas like maybe your fat, where the stem cells in your fat don't tend to change much as you get older. So we can take. You can do a little liposuction, get some fat, put it, you know, do process it and put it in your knee, or same thing with bone marrow. And those cells can still then send those messages to, you know, to the areas around your knee, to the blood flow, to the nerves, to the, you know, the cartilage to regenerate. Yeah. See, like, we're. It almost like. It's almost like the cell. You had an injury in that area, like tricking your body into thinking that you had an injury, and then your body responds appropriately to that, and it can help with healing.

[Louise Nicola]

I heard that this is a controversial, this field.

[Dr. Amy Killen]

It is controversial, yes. There's a lot of regulations about what can and can't be used.

[Louise Nicola]

Why?

[Dr. Amy Killen]

Well, I guess there's a lot of reasons. The bone marrow stem Cells from you. Like, if you used your own stem cells is not a problem. That is something that's been used for a. And the FDA is fine with that. But they don't like, for instance, using your fat cells in you because they think that in order to use the fat cells, we have to change the fat, get rid of the fat itself. And they think you're manipulating the cells too much and you're turning them into a drug. And they want to be able to regulate that as a drug.

[Louise Nicola]

Oh, so it's controversial because there is no money to be made if it's coming from you endogenously.

[Dr. Amy Killen]

I mean, that is definitely part of it. There's definitely. And there are pharmaceuticals, you know, companies and big pharma that are obviously creating regenerative products themselves that can be used more on a mass level. But there is, there is quite a bit. Like, we can't do certain things in the US like, we can't take umbilical cord cells and expand them in culture, like grow them out in culture and then use those stem cells in you, for instance. So we're not allowed to do that here in the US but you can in Mexico or South America. So that's why some people travel out. But there are some things that we can still do here that are still allowed.

[Louise Nicola]

And where is the major areas? I don't know if this is going out of your wheelhouse, but the major areas of stem cell research, in terms of organ specific, are we looking at people using it for their heart, their liver, their brain? I haven't really seen it in the academic research yet. For neurodegenerative diseases.

[Dr. Amy Killen]

Yeah, there's definitely research. I mean, the brain is tricky because if you give. You can give stem cells iv, but they can't get into the brain because of the blood brain barrier. Unless you have diagnost, like an injury, an acute injury. But like exosomes or other messaging molecules which come from stem cells, they're like these little messenger bubbles that come from the cell. Right. And they're communicating. And exosomes, actually, you can give IV and they can get into the brain. So there's actually quite a bit of research on like traumatic brain injury. You know, we're seeing some more in stroke. There are people doing Alzheimer's and Parkinson's even here in the US but certainly in other countries as well to see if these modalities may be helpful.

[Louise Nicola]

I think, I think that that's so new to me, but I wouldn't be opposed to it. Yeah, I don't know, I just have to. Might fly to Mexico to do it. Okay, so let's, let's talk about women's health and women's aging. As I mentioned earlier, it is in the spotlight right now, you know, to take hormone replacement therapy or to not take hormone replacement therapy. I think it's in its infancy as it relates to Alzheimer's disease. But at the. Around the age of, let's say, call it 42, generally it can be earlier or later, women start to see a dip in their estrogen, progesterone, even testosterone. And this is where things start to change. Maybe you get the, you know, the fat accumulation around the. The stomach, you get some brain fog, you get some night sweats, hot flash, all of these things. And it's really debilitating, I hear. And, you know, 60% of women in menopause report having a hot flash at night, which causes them to have fragmented sleep, which causes them to get up the next day and feel not their best. So what is it that you're seeing right now with women who are going through this perimenopause transition? And how are you, you know, treating them? Are you treating them all as like, okay, great, everyone should be on hormone replacement therapy, or are you doing an individual approach?

[Dr. Amy Killen]

Well, I think it's always individual, but keeping in mind that as the hormones are going down, as estrogen and progesterone are going down, because you're obviously losing the ability to make them because you don't have enough eggs, when that happens, there's nothing that you can do from a lifestyle standpoint that is going to bring those hormones back Yet. Yet. Yeah. Yeah, it is true.

[Louise Nicola]

I mean, you know, I think to myself, we can go to Mars, but we're not. We haven't solved ovarian aging.

[Dr. Amy Killen]

If we put as much energy into ovarian aging as we have, like, you know, reducing LDL cholesterol or something like that, like, we would have solved it 10 years ago, but is there a

[Louise Nicola]

way do it because you're born with a certain number of eggs. Yeah. And there's some people who are actually experience a rapid decline. You know, it's advanced. I don't know. Is it advanced ovarian aging? I don't know. Diminished ovarian reserve? I don't know the nomenclature for that, but yeah. Why is that?

[Dr. Amy Killen]

Yeah, there's premature ovarian aging. And what we know about the aging of the ovaries is the aging of the ovaries affects your overall lifespan. Right. Like, we know that women who go through menopause, early or premature ovarian insufficiency, where they go into menopause, you know, maybe they're 35 or 40 instead of 50. Those women, if we don't replace hormones, tend to live shorter lives. And women who go into menopause later live longer lives.

[Louise Nicola]

Why?

[Dr. Amy Killen]

Because the ovaries are the pacemakers of aging in the human body. And so when your ovaries go, you know, your ovarian function goes down. It sets off this cascade of rapid aging in, you know, your cardiovascular system, your metabolic system, your brain, as, you know, your bones, your muscles, your joints, like everything starts to really age rapidly when we see a fall of those sex hormones. You know, when I talk about longevity in women, the first thing I think about is ovarian health. Keeping your ovaries as healthy as you can for as long as possible and then replacing hormones if possible. And then there are people studying, you know, can we, for instance, take out part of the ovary when you're younger and freeze it and then put it back in when you're older? This is already being done. Yeah, this is being done for. Mostly for women who have cancers and they want, you know, they want to have children later. So they'll take out the ovary, freeze 25% of it maybe, and. And then. And put it back in and they're. This is, you know, it's not something that's being done widely for menopause, but there's research into like, could we do this? Or can we regenerate eggs or regenerate ovaries or the cells that are making the. Just the. Just the hormones and not the eggs. So it's a really interesting field of research.

[Sponsor/Ad Voice 1]

One of the best ways to improve brain energy metabolism is to make sure that you have adequate ketones circulating in your body. This is why I ingest ketone iq. I'm obsessed with ketones. They're one of the brain's most efficient energy sources, especially as we age and glucose handling changes. I use it for deep work or for long days when I want to focus without caffeine or crashes. But I also use it just in my day to day to make sure that I am neurologically adequately fueled. If you haven't tried ketones, you must. These ones taste great and you can get 30% off your [e-mail] neuroplus get a free gift with your second shipment. Let's talk about regenerative skin repair, because when I think of skin aging, I think of it the same way of my brain aging. Right. I don't want to look old and wrinkly. It's not just about appearance though, it's about how well cells repair and communicate over time. That's what drew me to cellular. Their complete skin repair kit focuses on regenerative actives, peptides, growth factors and repair supporting ingredients. And this is designed to help skin where natural repair slows down with age. I'm currently using the peptide Hydro Lift Serum. It's become one of my go to favorites. It gives this immediate tightening and smoothing effect. But what I love is that it's actually working at a cellular level to support elastic and resilience. So if you're thinking long term about your skin health and if you really want really good skin cream, this is the very different approach that you can take. All you have to do is go to cellular.com and use neuro for 20% off at checkout. The link is below.

[Louise Nicola]

Yeah, I mean, I think this whole AMH issue because I bring so many experts on here and everybody, believe it or not, Amy, you can have a board of like 10 different OB GYNs and fertility experts. They all say something different when it comes amh. So I'm like, what do you mean? You know, I don't understand how you can have a, you know, a 50 year old with a higher AMH than that of a 38 year old. And the 38 year old is doing everything to, you know, she's exercising, she's living well, but it's just her AMH is just so low, her egg reserve is so low. So how is somebody like that meant to preserve?

[Dr. Amy Killen]

Yeah, I mean, I think there's certainly genetic pieces that we can't change. You know, you're just born with a certain number of eggs and we can't change that. What the things that are being looked at though are can we change the. Can we reduce the inflammation in the ovaries? Can we reduce the fibrosis, the scarring that happens with age, the senescence of the cells where they become zombie cells with age? Can we reduce the number of eggs that are lost each month? Because every month of a woman's cycle you don't just ovulate one egg and that's all that's lost. You ovulate one egg, but 500 or 1,000 eggs are essentially lost along the way. And so can we reduce that number? So maybe you don't lose 1,000 eggs every month. Maybe you just lose 20 or 30 or 100.

[Louise Nicola]

And how would somebody go about doing that?

[Dr. Amy Killen]

Well, for instance, the. We don't know this is the short answer, but, like, there are studies right now on rapamycin. Rapamycin, you know, is a drug that's being looked at. It's actually an immune modulator, but it's been looked at in the longevity space specifically for ovarian aging, thinking that it's almost like if you can trick your body into thinking that you are calorically deficit, you know, in a caloric deficit, maybe your ovaries don't release as many of those follicles or let them die. And maybe we can kind of preserve some of those eggs as we get older. We don't know for sure, but the vibrant study is ongoing right now, and the early results look promising. So people are doing the work because they finally, I think, realize that the ovaries are, like, they really control so much about how we age.

[Louise Nicola]

So let's go a bit deeper on that, if you will. We've seen a lot of people experimenting, let's just say, with GLP1s, and I don't know, this may sound very juvenile of me. Okay, GLP1s. And they've experienced massive weight loss, so they are skipping their menstrual cycles. Not menopausal at all. Right. Would that be, in essence, what you're saying as well? Because they've restricted themselves with food and calories, and maybe Instead of getting 12 menstrual cycles a year, they may be getting seven or eight. I'm not sure. Is that what you're talking about? And that means they're preserving their eggs?

[Dr. Amy Killen]

Not. Probably not. Because we know that women who take, like, birth control pills and never, you know, just continuous birth control pills, but don't have cycles and don't ovulate, they don't have any more preservation of eggs than anybody else.

[Louise Nicola]

Okay.

[Dr. Amy Killen]

So their body is still kind of getting rid of those follicles that contain the eggs. You know, they're looking at. Can medications help with this? Maybe GLP1s could help by reducing inflammation that happens in the body.

[Louise Nicola]

Systemically, it does.

[Dr. Amy Killen]

And in the ovaries, one thing that happens is that, you know, you're losing these eggs along the way, but as you get older, get more inflammation in the ovaries, just like you do other places of the body. And that actually exacerbates the loss of the eggs, and the microenvironment where they live becomes more, like, hostile. And that is like. It's like this sort of feedback loop that makes it worse and worse and worse. So you know, potentially some kind of medication like GLP1s, certainly lifestyle changes. We know that women who have high exposures to certain environmental toxins, like phthalates, for instance, they will have faster ovarian aging. In one study, they found that women who had the highest exposure to phthalates had. They went into menopause, I think, two or three years before women who had low exposure phthalates, meaning phthalates like that you find in, like, skincare products and shampoos. And, you know, the hormones that are in the environment are in our products, personal care products. They can affect how our ovaries age. And smoking, we know smoking is another one that's really bad for your ovaries and probably drinking.

[Louise Nicola]

And then you also said scarring. How can a woman know if she's scarring in that area?

[Dr. Amy Killen]

I mean, you wouldn't know unless you could get ultrasounds and looked at that area. But there are some metabolic diseases.

[Louise Nicola]

Internal ultra.

[Dr. Amy Killen]

Yeah, you can do it. You can do it in transvaginal ultrasounds. Things like polycystic ovarian syndrome sometimes will be associated with changes, obviously, in the ovary health. And it's not the cysts that are the problem. It's that you have this metabolic dysfunction that comes with it. So you have. Oftentimes, not always, because it's a mixed bag, but oftentimes they've got. These women have high, you know, insulin resistance, they have high androgens, they don't have enough progesterone, but they have high estrogen or, you know, these hormonal imbalances. And so that can cause issues now like with infertility and weight gain and things like that. But it also sets you up and increases your risk for breast cancer and heart disease and, you know, problems later on, further infertility. So the ovaries are so interconnected to everything else that's going on. And I just think it's.

[Louise Nicola]

It's.

[Dr. Amy Killen]

I love that we're finally studying them and talking about them.

[Louise Nicola]

Yeah, me too. I think there's just so much for people to know, but I didn't really. You know, you're the first one to actually tell me that the link between female aging is between that and the. And their ovarian health, which I think is, you know, it's. It makes sense. But I think the root of that, what you're trying to get to is because of estrogen. Yes, that's it. Yes. So. And there. And that's where that window of opportunity comes in, where, you know, we women get a Choice. And hopefully they're going to their, the practitioner who is actually trained in menopause therapy to take hormone replacement therapy or not. So we can talk about that. And I, I know that when we talk about this, we get a lot of comments about, you know, but I've got the breast cancer gene and doesn't it increase your risk of getting breast cancer? And there's so many different forms of estrogen therapy. And just to let you know, I, I have very close relatives back home in Australia, where there's hardly any menopause. I know that there's like, I know three actually menopause specialists. But I have a, I'll call her a friend because she might be listening very, very close to me. And I said, did you go to your doctor? She's 48. I said, did you go. Because she's having, she doesn't sleep at night. I said, did you go to your doctor? I think you might be in perimenopause. She said, my doctor said, I'm fine, my sight, my hormones are fine. And she just won't listen to me. She is 48, right? She said she's still getting her menstrual cycle. So why would somebody like that who's been told you're menstruating regularly, your hormones are fine, why should she go on hormone replacement therapy then?

[Dr. Amy Killen]

I think that certainly everyone can decide for themselves. I'm pro choice in terms of decide for yourself whether it's a good idea. But what happens is even if you don't have symptoms, things are happening under the surface. So for instance, we know that bone loss starts to really accelerate in the two to three years before you stop having your cycle. So you're in perimenopause, you're still having cycles, but all of a sudden you're losing 2 to 4% of your bone mass every year. And, you know, there's so many other things like that that are happening under the surface. The mitochondrial estrogen connection is very interesting in that when your estrogen's going down, even if you are still having cycles, even if you feel pretty good, you are starting to lose the ability. Your mitochondria are starting to not function as well. Of course, all the cells in your body have mitochondria. They all need them for their power source. And so everything from your brain to your blood vessels to your muscles can start to suffer. And I think that it's worth understanding that these hormones can be used for symptoms. And they should be. If you have symptoms, you should consider hormones. But they also should be used for potential prevention. At the very least, we know we can prevent osteoporosis. We can probably prevent a lot of heart disease. I agree. The brain is not quite as clear with the dementia whether we can actually prevent dementia, but there is at least a relationship between estrogen and the brain.

[Louise Nicola]

Yeah, we know the relationship exists. What is estrogen?

[Dr. Amy Killen]

Estrogen is a hormone and it is the kind of favorite of the female hormones. The female body is most responsive to estrogen. Progesterone is like the yin and the yang with estrogen. So it helps kind of make estrogen work in a safe way. And then testosterone, of course, is another hormone that women have a lot of as well. But it's just a hormone in women. But it does multiple different things across the body.

[Louise Nicola]

Released from the ovaries.

[Dr. Amy Killen]

Released from the ovaries. And you also get a little bit released from other, like fat tissue, get aromatized from testosterone, but primarily released from the ovaries, which is why when the ovaries stop making it, it's such a big deal.

[Louise Nicola]

The ovaries will stop making it when you have no eggs left.

[Dr. Amy Killen]

Yes.

[Louise Nicola]

Okay. Yes. And so we can now replace it with something called bioidentical hormones, meaning that it mimics the natural hormones already in your body.

[Dr. Amy Killen]

Yeah, yeah. The chemical structure is exactly the same as what your. Yeah, that's what bioidentical means. Yeah, exactly.

[Louise Nicola]

So you have.

[Sponsor/Ad Voice 1]

Then that would mean that you would

[Louise Nicola]

have to get on some form of hormone replacement therapy when you've already got the estrogen in your body.

[Dr. Amy Killen]

No, you don't have to. It's just that your body, my body, our bodies make estradiol as the primary hormone for estrogen. That's the type of estrogen. So when we give you back estrogen, we want to give you ideally estradiol versus some kind of similar hormone like Premarin, which was used in the kind of the old days that was made from pregnant horses urine. And that was what we call a synthetic. I don't like that word really, but synthetic estrogen, that looked like estrogen, it binds to the receptors, but it doesn't bind exactly the same way. And so you can actually get some side effects and problems long term because of that.

[Louise Nicola]

And when women, they go to their. Let's just say they go to the obgyn. One of the main reasons for taking vaginal estrogen. So there's the patch, right? There's vaginal estrogen. Are they both the same thing?

[Dr. Amy Killen]

No, they're different.

[Louise Nicola]

Very different. Let's talk about the different forms. We get so many questions, and especially, you know, on YouTube as well, we get so many questions from women asking, you know, what's the difference between them all? So why don't we go through that and then we'll talk about.

[Dr. Amy Killen]

So I like to think of hormones like estrogen as there's sort of two main categories. There's systemic, meaning it affects your entire system, whole body, and then there's localized, which just affects a small area and the difference become, it just turns out to be about the dose. So for instance, vaginal, low dose vaginal estrogen, which I recommend to basically every woman over age 50, if you're not taking it, talk to your doctor. But low dose vaginal estrogen is a vaginal estrogen that you put in your vagina three times a week. But it just affects the pelvic floor, so the bladder, the urethra, the vagina. It doesn't affect the rest of your body for good or for bad. It just really stays put because it's a very low dose versus an estrogen patch or a cream you put on your arm or a pill that you take or a spray or any other method that is out there is generally going to affect your entire body. And so they're very different in terms of what you can expect, in terms of how they benefit you as well as potentially side effects.

[Louise Nicola]

Now the primary indicator for the vaginal estrogen is urinary tract infections.

[Dr. Amy Killen]

That's one indicator, you know, when you lose estrogen, which again happens to everyone who goes through menopause, the pelvic floor is one of the things that suffers the most because all of a sudden, you know, it becomes less acidic. So you get this overgrowth of bad bacteria. You start getting UTIs. We also start getting like urinary urgency, where you have to run to the bathroom, or urinary incontinence or pain with sex, or, you know, all of these things that happen and it happens to, you know, 60, 70 plus percent of women. But even the ones who aren't complaining, it's still happening. And so that's why vaginal estrogen is so safe. It's a three times a week medication. It doesn't have any other side effects and it markedly reduces bladder infections, pain, you know, urinary urgency, et cetera.

[Louise Nicola]

What about atrophy?

[Dr. Amy Killen]

Yeah, for sure. It improves the health of the vaginal tissue. So it's helping to support the sugar molecules in there, the microbiome, the acidity,

[Louise Nicola]

everything that's just for that localized Area and then the patch, which is what most women are on.

[Dr. Amy Killen]

It's a common method.

[Louise Nicola]

It's a common method. And it's this little patch that you put on how many times you have to change it.

[Dr. Amy Killen]

You change it twice a week.

[Louise Nicola]

You change it twice a week. And that's systemic? Yes. So that's even helping with the brain.

[Dr. Amy Killen]

Yeah, exactly. So when you have a higher dose, it's systemic, then. I'm sorry, then you are affecting. You know, that's going to help with your bones, for instance. It could help with your brain, it could help with your blood vessels and reducing, you know, cardiovascular disease potentially. We're still learning about that, but for sure, helps with your bones and joints and things like that.

[Louise Nicola]

Have you seen this craze right now? Oh, you know, social media is so interesting, this craze right now of putting putting vaginal estrogen cream on your face to help, I guess, stimulate collagen production, maybe, or just because we have estrogen receptors on our face and skin cells as well, I guess. And then you've got one, you know, camp of women saying it hasn't been studied and you shouldn't be doing it and it's not good at all. Is there a place for putting vaginal estrogen on your face as face cream?

[Dr. Amy Killen]

Yeah, I think it's great. I love vaginal estrogen on the face. Keeping in mind that if you put a bunch of estrogen on a bunch of areas of your body, eventually it can get to be a high enough dose that it is a systemic estrogen. It's not just gonna stay locally, but there is research. It's small studies with small numbers of women, but that low doses of estrogen applied to the face, either estradiol or estriol, a very weak estrogen, can help with barrier function and hydration of the skin and potentially elasticity of the skin. So this is for women who are perimenopausal or menopausal because they don't have a lot of their own estrogen. Estrogen is such an important molecule for collagen production in the body.

[Louise Nicola]

Yes.

[Dr. Amy Killen]

And when we lose estrogen at perimenopause and menopause, our full body collagen goes down about 30%. So that's collagen that's being used for your skin, for your bones, for your joints, for all of the structural kind of scaffolding in your body. But estrogen is so important for collagen production that when estrogen goes away, collagen takes a big dive.

[Sponsor/Ad Voice 1]

I wanted to Simplify my nutrition without sacrificing quality. That's why I use Cachava. It's an all in one nutrition shake with plant protein.

[Louise Nicola]

So much better for you. It tastes so much better than whey

[Sponsor/Ad Voice 1]

protein, fiber, greens, adaptogens and essential vitamins. I use Cachava on busy days, which is seven days a week. It keeps me full first and foremost. It satiates me and it gives me steady energy and a clear head. If you want to rewild your nutrition, you [e-mail] and use code Neuro at checkout. New customers actually get $20 off an order of two bags or more. That is cachava.com code neuro. So one of the newest hacks that I have been doing, it's not going

[Louise Nicola]

to be new for you, it's new

[Sponsor/Ad Voice 1]

for me is I have started to introduce probiotics into my system. And that's because stress doesn't just affect how we feel, it affects absolutely every

[Louise Nicola]

aspect of my life.

[Sponsor/Ad Voice 1]

And this is why I've been interested in the work Just Thrive is doing with their products.

[Louise Nicola]

Just Calm and Just Thrive probiotic.

[Sponsor/Ad Voice 1]

Just Cal uses psychobiotics and B vitamins to support the gut brain connection and help regulate the stress response. While their spore based probiotics supports digestion and serotonin production. You know, I don't really trust a lot of the probiotics on the market, which is probably why this is so new to me. But when your gut is functioning well, it has a ripple effect across the entire body like from your mood, your sleep and your overall resilience. So, so I have researched Just Thrive and Just Calm. And let me tell you, this is the one for you, it's the one for me. If you want to try the dynamic duo bundle, which is what I'm doing, you can get 20% [e-mail] neuro or just go to the website and use code Neuro. Everything is linked in the show notes below. They also offer a risk free money back guarantee.

[Louise Nicola]

I'm remarkably excited about testosterone actually. And so I took, I have testosterone cream, right? And in Australia we have our own FDA approved testosterone cream for females. And I, I noticed a difference when I took it, so I stopped taking it. But I mean regardless of libido effects, I felt like, I felt energized, I felt in control. I can't explain how I felt. I was trying to tell my friend, one of my girlfriends and she's like, it wasn't like taking a coffee. I Said like having a hit of caffeine. I said no, it. I felt like I could just take over the world. I felt, I felt myself but 10xed in a more powerful way.

[Dr. Amy Killen]

Why'd you stop? I know, sounds amazing.

[Louise Nicola]

And then you know what else I got as well from a very good friend of mine. I got vaginal DHEA.

[Dr. Amy Killen]

Yes.

[Louise Nicola]

But every time I use DHEA, I break out. And if you're watching this on YouTube, I'm so transparent. I had a pimple there that I'm overcoming. But it, for some reason, every time I take dhea, because I do my blood work quite often I'm trying to get to a dhega of around 180 and it was like 98 maybe. And so I started doing 75 milligrams and then I brought it back to 50. But even the, it just, so it just disrupted me. So. And it happens with the estrogen, with the testosterone. So that's why.

[Dr. Amy Killen]

Yeah. Thank you for sharing. Yeah. Testosterone is amazing. I mean, it is amazing. But it does have side effects. It can, you know, it can increase body hair, make it thicker, make it darker. I don't need any, I don't need that.

[Louise Nicola]

By the way, as a Greek woman, I don't need to increase my body hair.

[Dr. Amy Killen]

Acne, you know, even scalpel hair loss can sometimes happen. It's. But, but if you find the right dose and it's not too high for you, then it can be really powerful, certainly for libido. And that's where the best evidence is for like what we call hypoactive sexual desire disorder, libido arousal problem. So we have great evidence for that in women. I don't know why it's not FDA approved, honestly, but there is at least a lot of anecdot data and some published data on testosterone for mood, for motivation, for muscle building, you know, for like turning your brain on. And it makes sense because women make three times more testosterone than they do estrogen, like you have in your body right now two or three times more testosterone than estrogen. So the idea that you wouldn't need testosterone when that starts to go down with age is kind of preposterous.

[Louise Nicola]

I'm going to jump into the life of a, let's just say a 14, 45 year old female. Right. So I'm experiencing some of these symptoms. I don't know too much about the medical space and hormone replacement therapy, but I'm scared that it causes breast cancer because that's what my doctor told me. You know, quite a number of Years ago. So I don't want to get on any hormones. What do I do?

[Dr. Amy Killen]

Well, if you don't want to get on hormones, then you certainly, you support the systems that the hormones were supporting or will stop supporting soon. So I, you know, I have a lot of patients who have, have had breast cancer, for instance, and they've been told you can't have hormones. Maybe it's just a few years ago. And so maybe hormones are not on the table for them or they just don't want to do it. And you want to think about what's going to happen when I lose hormones. What are the systems most affected?

[Louise Nicola]

But the relationship between. We've debunked that, right? The relationship between breast cancer.

[Dr. Amy Killen]

We've definitely debunked the relation. Yeah. We know that in multiple studies, estrogen as hormone therapy does not increase breast cancer. And that's through about 10 years of use that's been studied. So out to 10 years. We haven't studied more than that.

[Louise Nicola]

Human evidence.

[Dr. Amy Killen]

Human evidence, randomized controlled trials. We don't see increased breast cancer risk with estrogen either as a standalone or paired with bioidentical progesterone. And in fact, in the Women's Health Initiative, the very study that made everyone petrified of these hormones, when they went back, looked at the data again, the women who took estrogen, by itself, they had a 25, 29% reduced breast cancer risk compared to women who are not using hormones.

[Louise Nicola]

But doesn't that then, if you take a bite, shouldn't you be taking it in conjunction with progesterone because of uterine cancer?

[Dr. Amy Killen]

Yes, yes.

[Louise Nicola]

Yes.

[Dr. Amy Killen]

Yeah. The problem with the WHI and other studies like that is that they were using a synthetic progestin which does slightly potentially increase breast cancer risk.

[Louise Nicola]

But even today, you want to pair it, is that correct?

[Dr. Amy Killen]

You want to pair it with progesterone and progesterone does not increase breast cancer risk? Yes, but. Yes, you want to use estrogen and progesterone. If you have a uterus, even if

[Louise Nicola]

people have got the BRCA gene, it's fine.

[Dr. Amy Killen]

There's actually several studies on BRCA women who have, for instance, if they'll have their ovaries removed because they've got BRCA1 or BRCA2 increase ovarian risk, they'll have their ovaries removed and they've studied them, they put them on hormones and watch them, and there is not an increased risk of breast cancer in those women, at least, least through age 50 or so, when they, when they Usually stop the hormones. We don't have long term data on women with broncho mutations and estrogen, but we have, you know, five to 10

[Louise Nicola]

year data who shouldn't take hormone replacement therapy.

[Dr. Amy Killen]

The main contraindications are if you have severe liver disease because you have to be able to metabolize the hormones. If you have dysfunctional uterine bleeding that has never been worked up like you're bleeding, we don't know why, you know, you gotta check that out first, make sure it's not cancer or something dangerous. And then if you have an active hormone sensitive cancer, you have active breast cancer, you have active, you know, ovarian cancer, there are some melatomas that are, that are hormones. So if you have an active cancer that is going to sensitive to hormones, you shouldn't take hormones. Everything else is a relative contraindication, meaning that it's a maybe depending on your circumstances.

[Louise Nicola]

So I can see the, I can't see why somebody wouldn't get on this. If we know that the hormone itself is A, A in the brain, it's a bioenergetic B in the muscle. You know, estrogen helps with muscle protein, so synthesis estrogen helps with recovery and regeneration of muscle cells. Estrogen is what's going to help you get up in the morning and push you to go to the gym and actually produce more muscle. We have it in cardiac, we've got receptors on our cardiac cells and muscles blood vessels. It's going to help with the lining of the blood vessels to in turn help with atherosclerosis and cardiovascular disease. So there is just so much benefit. So then maybe the problem is what is it advocacy, is it education amongst doctors and everybody else?

[Dr. Amy Killen]

Yeah, I think that's a big part of it. Several years ago my mom fell and broke her hip. She was in her mid-70s. And you know, as you probably know, hip fractures, which happen fairly commonly, they come with like a 25% one year mortality rate. Like 25% of people who break their hip in that age don't live a year. My mom did. But what, what I realized at that time, seeing her go through the medical system and seeing the doctors who did not understand anything about hormones and estrogen and progesterone, they took her off of her estrogen when they sent her home and it was a whole fiasco. But we need to educate doctors first because there's so many women out there who want hormones, who know about them, who've learned about them, but they can't write themselves prescriptions. So we have to educate doctors. And I have a course that I put together just for that. But. And then we need women to continue to just advocate for themselves and say, this is what I deserve, this is what I need. And just. You have to kind of doctor shop for a while, unfortunately, until you find someone sometimes.

[Louise Nicola]

Do you think going back to ovarian reserve, do you think that it could help preserve your ovaries or your eggs over. Over time if you're taking just a little bit of estrogen, like having a patch?

[Dr. Amy Killen]

We don't have any evidence of that yet. We don't have any evidence that taking hormones helps keep your eggs intact. I think that, I mean, there's, you know, people are studying dhea. It's an interesting molecule. And there are some other supplements being studied to try to help slow down ovarian aging. Melatonin is actually one dhea, NAD precursors. Some of the different things like that NR in mn, but, you know, that's mostly animal studies. We don't have human studies on that stuff yet.

[Sponsor/Ad Voice 1]

Yeah.

[Louise Nicola]

And what I remind everybody is that we are not rats.

[Dr. Amy Killen]

I keep telling people this, like, you

[Louise Nicola]

know, there's all this, you know, this with amazing stuff, you know, this that. Actually funnily funny that you said that. There's this huge study now that a lot of people are talking about in MySpace, which was done on NAD and Alzheimer's disease. And I remind people you are not a mouse. This was a. And we know, like, I, I don't know what your take is on NAD. Right. But I do NRIVs. Again, am I wasting my money and time? I'm not sure. But I know that it's much more worthwhile doing nr, which is the precursor to nad, than doing nad, because NAD can't get in the cel, cannot penetrate the cell. So there's a lot of nuance in that area. But melatonin's interesting.

[Dr. Amy Killen]

Yeah, it's an antioxidant. You know, it's a strong antioxidant and it is obviously used for sleep, but it's also something that goes down with age. Just like the other hormones, we make less as we get older. And so, yeah, there is some research looking at and it seems to help in animals with ovarian aging. I just haven't seen any studies in humans yet.

[Louise Nicola]

I think in terms of supplementation for ovarian aging, the biggest One might be COQ2 10.

[Dr. Amy Killen]

COQ 10 is being studied. Yeah. Any of the mitochondrial health, you know. Yeah, things, you know, urolithin A, things like that. Because we know that the ovaries are the most mitochondrial dense organ in the body. You've got, you know, 100 to 500,000 mitochondria in the ovaries. And so if you can keep your mitochondria healthy, then that is certainly one step further in keeping your ovaries healthy.

[Louise Nicola]

Yeah. So let's switch gears and actually talk about longevity, Gravity. Right. Love and hate it. The space. Right. I'm a realist. I, you know, I, I work with real patients. I see real life. And I'm sure you do too. I see real life, humans who are at the mercy of a disease that they never asked for, that they didn't deserve. I'm talking about brain cancer, you know, really severe diseases. And I look to them and I think, well, I mean, am I gonna chuck you in a red light bed? Right. And so that's the part that I hate about the space, that we see so many modalities. We're looking at hyperbaric oxygen therapy. There's, you know, these IVs, we've got red light beds, so many different things, but that can't be offered to the general person. And we've got no studies on the effectiveness. Right. But then there's this other camp of, you know, prevention. Right. And I think that all of these modalities that we're about to speak about come down to mitochondrial health.

[Dr. Amy Killen]

It's a big part of it, for sure.

[Louise Nicola]

It is, yeah. Right. And by the way, I just did an episode talking about is mitochondria at the seat of cancer and neurodegenerative diseases and autoimmune diseases. Right. So I'm at this intersection and I bang my head. Now, again, transparently, I try and tell my audience a lot about me. I do do the red light bed once a week, mainly because I'm really nervous about my hair, actually. Actually, it's thinning out as I'm getting older.

[Dr. Amy Killen]

Yeah.

[Louise Nicola]

Also trying to do everything I can to preserve my ovarian reserve. Right.

[Sponsor/Ad Voice 1]

I heard that red light is something that could help.

[Louise Nicola]

So I'm doing it.

[Dr. Amy Killen]

It's not going to hurt.

[Louise Nicola]

It's not going to hurt. So let's talk about everything that you're excited about. For longevity. We will talk about peptides.

[Dr. Amy Killen]

For better or for worse.

[Louise Nicola]

For better or for worse. Okay. So you can start. Start anywhere.

[Dr. Amy Killen]

Yeah. I mean, I think you're. I definitely, always. Lifestyle is first. And I absolutely agree with you. I think that there's so many modalities that are inaccessible to so many People and that sometimes we latch onto the things that we think are easy or they look cool, you know, like. But we don't. We're still skipping the main things. So obviously. Gosh, I keep hitting this. Sorry. Obviously we have to start with the basics. The sleep, the stress, the, you know, the movement, the relationships, you know, belonging, purpose, all those things. But once you get those established, I do think that there are some cool things out there depending on what you're trying to do. Like, I, like, I think hyperbaric oxygen and has some great research behind it and is really exciting as, you know, potentially a longevity molecule, but also just something that can be helpful for recovering from surgery or recovering from an injury or, you know, like there are specific use cases that are outside of like longevity that we know it works for.

[Louise Nicola]

Well, yeah, we know within the first 72 hours of even having a traumatic brain injury or a knock to the head, we know that it can definitely enhance the healing of that. Yeah, we know that post surgery. I think it actually should be included in every, in every hospital. We have looked at it with scalp wound healing in neurosurgery. What I don't know yet about is what's the use of me in. I'm in my 30s.

[Dr. Amy Killen]

Yeah.

[Louise Nicola]

Why would I spend my time in a hyperbaric chamber?

[Dr. Amy Killen]

I will say that, you know, there is some research, like there's the Israeli study that where they did like, I think they did 40 different sessions of hyperbaric oxygen and had some improvement in some sort of biological age testing, which even that we could talk about. But 40 sessions is a lot of sessions. Right. Like, I don't have 40 different hours plus getting there and getting back. And so I think that there are. You have to be strategic with all of these things. You know, red light therapy. It's not going to harm you. I do it every day on my face. I lay down and take a little face nap and wrap it around my face and I think it's great. How much is it moving the needle? I don't know. I mean, is it helping you more than if you just go outside for 10 minutes? I don't know.

[Louise Nicola]

It depends on the wavelength.

[Dr. Amy Killen]

Yeah, it does. And for hair actually, red light actually does have a lot of good evidence. That's very. It's very strongly.

[Louise Nicola]

I really want to invest in a helmet.

[Dr. Amy Killen]

Yeah, those actually work really well. That the red light hair research is. Is solid. The skin, especially for skin healing, like after lasers or things like that. That's really solid. There's some research even for red light on, like blood sugar regulation, which is interesting that I think, you know, small studies, but I don't think it's going to harm anyone. And I do, I would say one benefit of red light is, is a lot of the lights that we're around in our environment now are LED lights, which you're missing that red and near infrared spectrum. And so a lot of us are spending all our time indoors in these environments that are actually not great. And the mitochondria are missing that activator, which is that type of light, the 600 to 1000 nanometer red light range. So sunlight has that light in it. So getting a little sunlight is, is actually helpful. But then also red light therapy, you know, if it's, if it's New York in the winter and you need a little bit of light, then red light therapy is great.

[Louise Nicola]

We've covered like the, you know, what a lot of people know about. So let's talk about peptides.

[Dr. Amy Killen]

Right.

[Louise Nicola]

So I put out a wild statement apparently that I looked at the data. Right. And the data now shows that, by the way, I'm not against peptides. Peptides, right. I was just trying to say that we just don't have any human clinical RCTs on peptides outside of insulin and GLP1s, such as Ozempic, tirzepatide and.

[Dr. Amy Killen]

Yes.

[Louise Nicola]

Redatrutide. Yes. I can't say properly. A lot of people now are taking BPC157TB100. That copper one for your face. Great.

[Dr. Amy Killen]

Copper. Yeah.

[Louise Nicola]

Yes, Like I said, GH copper.

[Dr. Amy Killen]

Okay.

[Louise Nicola]

It's great. What I'm concerned about is the lack of safety data, meaning that we don't know yet what you are accelerating and healing. So if you've got stage two that you don't know about and you take these peptides for, you know, correct me if I'm wrong, you could be accelerating the growth of those cancer cells. Because when I was reading the data and the research, it says that sometimes these peptides don't know if they're increasing a cell in your knee and helping with reg of that, helping you to sleep or increasing the cancer cell itself. And that's where I come into it. So I know that a lot of. I got a lot of backlash on that with a lot of people telling me, well, I've been taking BPC157. I feel great. I'm like, I'm not refuting that.

[Dr. Amy Killen]

Right.

[Louise Nicola]

Where do you stand?

[Dr. Amy Killen]

Yeah, I think I stand kind of in the middle. I think that I do. I'm excited about peptides. I think they're a really good, it's a modality that we can use in strategic ways. I do think that the lack of data is a little concerning. I would like to see, and I understand why we don't have data on some of these, like BPC150. We've, you know, it's been around a while, like no one wants to pay for it. You know, it's expensive to do these studies, so I understand why we don't have them, but I do agree that we don't know for sure. And we also even each peptide we haven't researched. And we certainly haven't researched what you do when you, you know, combining five peptides, like, what does that do? So I think there's, you know, we should be cautious, but I also think that we can gather real world evidence. You know, I tell patients if I'm doing, if we're using something that's, that's more experimental, whether it's stem cells or peptides or TPE for longevity, that's plasm.

[Louise Nicola]

Tpe.

[Dr. Amy Killen]

Therapeutic plasma exchange. Oh yeah. Which is something else we do. These are all considered to be experimental, you know, to some degree. And I think it's always worth having a discussion with the patient. Like we, here's what we know, here's what we don't know, here's what we think.

[Louise Nicola]

Yeah.

[Dr. Amy Killen]

And you know, I feel like a lot of patients, they can help come to those decisions. Like I want to have these as options for people as long as we think that they're safe. Safe, but always with that really good informed consent.

[Louise Nicola]

Well, what would be the contraindications for therapeutic plasma exchange? Because from what I know is that basically for the people that don't know, they go in and they. You replace your plasma, you replace it with albumin.

[Dr. Amy Killen]

Yeah, you basically take the, take some of the plasma out and then you put the red blood cells back in and you put. Yes, albumin, usually and sometimes ivig, which is an immunoglobulin. And there's some early research, research that's been really exciting that looks like, you know, it potentially could reverse some of those epigenetic aging markers, biological clock markers. If you do a series of these sessions, usually two or three. So I think it's, you know, the main contraindications are things like, you know, you have low blood pressure or you have electrolyte abnormalities, or, you know, you can't get good veins to, you know, you don't have two Good veins or things like that. Usually it's not a long list, but you gotta be careful with anyone who's really sick to do any of, you know, these kinds of therapies.

[Louise Nicola]

The reason why it excites me is because we saw a pilot study of people who are getting tested for these Alzheimer's disease markers. You know, P Tau217. You've also got amyloid beta. And looking at the ratio between the two and then somebody going in and doing therapeutic plasma exchange and it's actually taking with it some of these proteins, which was really interesting to me.

[Dr. Amy Killen]

Yeah. And maybe microplastics is something else that's being looked at. You know, are we able to. To pull out some microplastics with these therapies? Certainly things can we. It's hard, we think, but the microplastics tests are not super reliable, but we think that we can. Lipids, like if you have, you know, hyperlipidemia, like high L.P. for instance, and nothing is working on it, TPE can bring those down. So there are some well studied indications. And then, you know, Dr. Dobry did a study on a small population for Alzheimer's. Like there's some early Alzheimer's work, you know, that maybe these therapies could help with some of that. So. But they're also, you know, four to something, four to five hour long treatments. You have to have two good veins. They're expensive. Like it's one of those things. Like they can.

[Louise Nicola]

Exactly.

[Dr. Amy Killen]

I think they can be fantastic. But they're not available currently for everybody.

[Louise Nicola]

Yeah. I think at the end of the day, if you didn't have any access to these, like we have to think about what are they actually doing? If it's not just the acute process, then we. What, what are all these tests doing? Because you can look at my grandmother who didn't do any of these tests, who birthed 10 kids. I know, I know. I just, I don't know how. I don't think she was aware of contraception. Lived until 98, around that, I think maybe 96. And. And she was fine up until her last years where she had some, definitely some cognitive impairment. But up until until then.

[Dr. Amy Killen]

Yeah.

[Louise Nicola]

And she just ate from her garden.

[Dr. Amy Killen]

That's my grandma too. Lived to be 102 plus and had homegrown green beans and.

[Louise Nicola]

Yeah.

[Dr. Amy Killen]

Weekly bridge game.

[Louise Nicola]

Yeah. Now the reason I bring that up is because we have to think what are we trying to do modern day, you know, with all of these, with all of these tools available to us and technology Are we trying to mimic an environment that we had evolutionarily 20, 50 years ago? Evolutionarily 50 years ago, but let's just say 100 years ago. Are we trying to mimic that? And if so, what will we mimicking whirlwind. Mimicking going into a dark cave at night, being able to secrete melatonin at the appropriate time, getting up at the sunrise, getting those photons of light into our eyes. What else are we doing? Probably at the seat of it is downregulating inflammation. You know, if you look at the, if you look at the data on actually like damage, adding neuronal level, we can filter it back to microglia. Just going crazy. Right. We can filter back to neural inflammation and obviously dysfunctional mitochondria. So if we're thinking what, what can we do to downregulate inflammation and neural or systemic inflammation and how can we fix our mitochondria? That's what we're doing. Yeah, right. And the reason why we've got these tools available, I don't know what your take is, is the reason why we would do these is because modern day, like I live in Manhattan, I'm at the mercy of bad air, bad weather, bad this, bad that. Food. Yeah. So I have to do something like this to make, mitigate it.

[Dr. Amy Killen]

Yeah. I think 100%. I think we don't get outside, we don't move our body that much. Even if we work out, we're still sitting most of the day. We have bad food. So we're getting our insulin shooting up, our inflammation shooting up. So there's so many things that I definitely think that if you live on a farm and you work out all day and you're outside and you eat healthy foods and you don't have a lot of stress because your only stress is whether the cows get fed and then you just go to bed. I, I feel like, yeah, you probably don't need red light therapy if that's you. You probably don't need, you know, a lot of these things because you are getting what you need from your environment and you're, you know, your stress and sleep are good, you've got family, you play cards at night. Like all of that is good for you.

[Louise Nicola]

What is it that you think that you can, like that we haven't covered today, that I probably don't know. When it comes to aging and longevity,

[Dr. Amy Killen]

one of the things that's really interesting that I'm just learning about myself, I'm writing a book on women's longevity is the relationship between ovarian aging and the immune system. System.

[Sponsor/Ad Voice 1]

Oh, tell me.

[Dr. Amy Killen]

Which I think is. So it's, you know, we know, we talked about mitochondrial health and how that changes with menopause. But the other thing, you know, one of the main things that keeps women healthy and actually is probably one of the reasons that we live longer than men in general, you know, everywhere across the world, every culture, is that we have a very strong kind of hypervigilant immune system. Our immune system is like, you know, it is going to protect us and potentially our babies, you know, at all costs, which is why we have more autoimmune diseases. But we have a very strong immune system. And one of the things that happens at menopause with loss of estrogen again is that you lose this like almost like the security director of the immune system. Like you still have the immune system, you have to have the cells, but you don't have anyone to tell them kind of like where to go, when to turn off, when to, you know, when to hold off. And so all of a sudden we see this really big increase in inflammation at peri menopause. And in fact, if you are in perimenopause, you still have, you know, you still have cycles, but you're not quite feeling off. You know, a simple test to do is go get like a HSCRP and check your inflammation.

[Louise Nicola]

Below zero, below one, below one.

[Dr. Amy Killen]

And you want to see what it's doing over time. Like if it's starting to trend up, this is potentially an indicator that your estrogen is trending down because that immune system has lost its master coordinator. And then we, you know, we see that in many disease states. We know that, you know, inflammation is contributing to heart disease, it's contributing to Alzheimer's disease, it's contributing to osteoporosis. So like all of the multi system kind of dysfunction that we see that seems to get much worse after hormone loss. A lot of it comes down to things like the immune system not being regulated, the mitochondria not working as well. You know, the blood flow not being as good, like it's multifactorial for everything. It's super interesting, I think.

[Louise Nicola]

So let's just go into the relationship between ovarian health and the immune system system. The Nobel Prize this year was given for T regulatory cells, which is like the master communicator of the, of the T cells. And I think that that's really interesting. What's, what are we saying? Are we saying that there's estrogen, are there estrogen receptors on these immune cells?

[Dr. Amy Killen]

Yeah, the cells have receptors on them. And, you know, the estrogen influences both the innate immune system, T cells, the antibodies, as well as the adaptive immune system. So it has roles in all of those things. Things. And, you know, when estrogen goes down, those. Those cells can still do their job. They're just not getting this sort of signal from estrogen about how to do their job well.

[Louise Nicola]

So what does that have to do. Because I'm. I'm thinking about women who are just bored with, like, they've got a low amh, right? And when you ask fertility specialists about that, they say maybe it's an underlying autoimmune disorder that you don't know about. What if somebody goes and corrects that?

[Dr. Amy Killen]

Yeah, I don't know. I don't know. Yeah, I don't know.

[Louise Nicola]

I'm going so deep into this now.

[Dr. Amy Killen]

I think it's. I think. I mean, autoimmune disease is very interesting in that estrogen and progesterone both affect the immune cells. And depending on the autoimmune disease, sometimes those hormones can make it better, sometimes they can make it worse. So we can see, like, a big change in those diseases. And, you know, there's. There's talk of. Of Alzheimer's as having an autoimmune component. There's talk of, you know, of course, it's microvarian health. So like every. It feels like everything is so interconnected. And in women, estrogen is such an important controller of all that, and progesterone to a lesser degree.

[Louise Nicola]

Do you think this is my hypothesis. Do you think that estrogen could play a role in why 80% of all autoimmune diseases are women?

[Dr. Amy Killen]

Yes, I think it's definitely part. I think estrogen is part of it. But I think it's also that the way that women's immune system is just built to be so vigilant. Like, we as women, you know, evolutionarily speaking, you know, we're designed to have eggs, to have babies, to carry them, and to care for those children. Right. And so I think that part of the autoimmune issue is that we're designed at all costs to keep ourselves safe from infections, keep the baby safe. And even after the baby is out of your body, you could still transmit infections to that child through breast milk or other things. And so if so, we have to have an immune system that is like an attack dog. It has to be super strong for us as well as for the bab babies. But with that attack dog feature, Then you also have the potential for attacking yourself.

[Louise Nicola]

So then how can I test my immune system?

[Dr. Amy Killen]

You can.

[Louise Nicola]

It's white cell count.

[Dr. Amy Killen]

Yeah. White blood cell count with cbc, with differential. We'll show you the different types of cells. There are more extensive tests that you can do. You can look at inflammatory markers, you can look at, you know, you can. Most of these, though are like research based tests that you're. It's not, it's not really easy to get. Certainly you can do the autoimmunity test. Like if you're worried about your thyroid, you know, you can check your thyroid ant and things like that, but it's not a lot of easily accessible tests outside of the CBC that I know of for the immune system.

[Louise Nicola]

So then how would you know?

[Dr. Amy Killen]

Yeah, I think you go based on your test that you can do your symptoms. And then if you're worried about autoimmune disease, you test whatever organ that is. You know, you can check the thyroid for thyroid antibodies. That is a test for that.

[Louise Nicola]

I did a full thyroid panel as well that tested for antibodies.

[Dr. Amy Killen]

Yeah, there you go. And there's, you know, you can check anti nuclear antibodies for some of the other autoimmune. There is an entire autoimmune panel. Panel that you can look at for lupus and RA and some of those different diseases. If you're worried about those, your doctor should be able to run those panels on you.

[Louise Nicola]

What are you hoping to achieve with this book? I mean, where did you go to med school?

[Dr. Amy Killen]

UT Southwestern in Dallas.

[Louise Nicola]

Can only imagine that when you went to med school, you didn't think that you'd be, you know, doing, you know, public policy on, you know, and democratizing women's health. What do you want to achieve with this book? What's your mission?

[Dr. Amy Killen]

I want women and doctors to, to understand the power that we have. I think women oftentimes don't see themselves as having a lot of power in terms of how they age, like determining how they age. And I want women to understand how much power they have. I think that as a generation, we as women, we have more information, we have more power than we've ever had, even if we don't seem like we have that much because we can read about topics, we can learn about topics, we have access to experts online. And so I think that we have a lot of power. But I also really think it's important to understand exactly what's happening in our bodies. The things that people have never told us, you know, that, that are happening in our bodies. So that we can be proactive in how we age.

[Louise Nicola]

What you're saying because you said at the start of the podcast that the ovaries are the, you know, the seat of women's longevity. Right. Let's just say a woman does lose all her eggs. It doesn't mean that she has to die earlier.

[Dr. Amy Killen]

No, no, no, no, no.

[Louise Nicola]

Because you did mention that who do go into menopause earlier tend to have shorter lives.

[Dr. Amy Killen]

Yes. On average.

[Louise Nicola]

On average.

[Dr. Amy Killen]

On average. But that's women who are not taking hormones.

[Louise Nicola]

Correct.

[Dr. Amy Killen]

So, you know, the standard of care if you have like premature ovarian insufficiency or you have your ovaries taken out early is we're supposed to be putting you on hormones. Like there's actually not a lot of debate in the literature. If you're 30 years old and you go into menopause or premature ovarian insufficiency, then you should be starting started on hormones most of the time. And we know that now it's not happening for all women, but that is the standard of care. So we know how to treat women who go into early menopause in terms of hormones. It's the women who are not getting treatment that we know have some increased cardiovascular disease risk, there's increased dementia risk. And also with. This is not talked about a lot, but women who have any kind of like hormonal issue like pcos or maybe they have amenorrhea, like they're not cycling because they've been overtraining for several years, or athletes or, or they have an eating disorder, anything where you're not having regular cycles, even endometriosis and some of these sort of diseases like that, where you're having these growths in your tissue, those are all risk factors for heart disease. Those are all risk factors for some of them for cancers. So we have to start thinking of the female reproductive system as something that's not just reproductive. It's actually an indicator of full body health and, and it can increase disease at risk if we're not careful.

[Louise Nicola]

I got an email from a woman asking me, which was out of my wheelhouse. She said, hi, Louisa, I'm a 62 year old female. I'm scared of getting Alzheimer's disease. I've never taken hormone replacement therapy. Am I too late to take it? Because I hear about this window of opportunity.

[Dr. Amy Killen]

We have a lot of mixed research when it comes to the brain and hormone replacement therapy, as you I'm sure well know. I will say that so far the data that we have that shows the hormones are protective, it's when we give them early. So giving estrogen early in menopause, within the first, ideally 10 years, maybe even earlier, seems to be the most protective in terms of potentially reducing cognitive decline and dementia. The late start hormones I don't think are dangerous unless you're giving like an oral synthetic estrogen, for instance, or oral, you know, progestin or like the kind of the older versions of hormones. I don't think that they're dangerous to do hormones late. I just don't know if they're going to be beneficial for the brain.

[Louise Nicola]

Wow. Dr. Amy Kill, thank you so much. I can't wait to read your book. I am uber excited about immunology and the crossover between immunology, ovarian health, and overall female longevity. So thank you so much for being on the podcast with me.

[Dr. Amy Killen]

Thank you so much.

[Sponsor/Ad Voice 2]

Monster Energy Everybody knows White Monster Zero Ultra. That's the og. It kicked off this whole zero sugar energy drink thing. But Ultra is a whole lineup now. You've got Strawberry Dreams, Blue Hawaiian Sunrise, and Vice Guava, and they all bring the Monster Energy punch. So if you've been living in the White can, branch out. Ultra's got a flavor for every vibe, and every single one is Zero Sugar. Tap the banner to learn more, take

[Sponsor/Ad Voice 3]

the scenic route in Abercrombie's new spring collection, designed for weekend getaway ways full of layers like sweaters, dresses and matching sets that take you from happy hour straight to a weekend upstate. The piece on everyone's radar is their new reversible trench coat. It's navy on one side and a coastal plaid on the other. The perfect spring staple. Get your closet ready for spring plans. Shop Abercrombie in the app online and in stores.