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Welcome to the youe Are Not Broken podcast. I'm your host, Dr. Kelly Casperson, a board certified urologist, thought leader and conversation starter on midlife living, hormones and sexuality. Enjoy the show. Hello everybody. Welcome back to the youe're Not Broken podcast. We are going to do several things today. One of them includes talking about this amazing paper about skin and estradiol. Every time I want to break the Internet I just tell people on Instagram that I use estradiol on my face as and then we basically break the Internet. One thing I wanted to tell you about is go to kellycaspersonmd.com and go to my events page. It's the beginning of the header on the you can get this via phone or laptop. If you go to the events page, which is brand new, you will see all of the upcoming events for the book tour. September, October and a teeny bit of November. Six city tour. We're doing Chicago, New York, Denver, LA, Palo Alto, Seattle, and then Orlando in November. And I have a Bellingham. Wait, how? Okay, I gotta start over. Chicago, New York, LA, Palo Alto, Denver, Orlando, Seattle, Bellingham. That is an eight city tour. Come one, come all. Go to the events page. When we get links for the events, we are putting them up. If my I have a retreat in Sedona in the middle of all that, does that count? Can I say nine city tour on most of these events just to make you go secure your ticket. Most of these events are small. So the biggest ones are going to be Chicago, which I think is like 250. And New York's going to be big. So a couple of events in New York that are actually pretty big, but the Palo Alto is pretty small. LA is pretty small. Sedona's sold out. Orlando will get sold out. So go to the events page starting Sunday September 14th with me at Dr. Susan Gilbert Lenz's office in Santa Monica Boulevard. That we'll get that link. I don't see that link on the events page right now. That small. That's like that's going to be like 30 people. And that is like literally two days before the book comes out. For any of you guys who are new to following me, the book is called the Menopause Moment Mindset. Hormones and Science for Optimal Longevity. Pre orders are available now and it comes out September 16th in the United States of America and it's coming out September 18th in Canada, UK, Australia, New Zealand's been able to pre order Canada. I mean Canada. I live like right next to bc so just plan an event and you know, we can make it happen. So I just heard from somebody in Mexico that they can't pre order and get it shipped down there. I don't know what's happening with Mexico right now. But the other book, you are Not Broken, is being translated into Spanish. So I'm hoping that the menopause moment will also and I will let you guys know, especially on Instagram, as soon as we know. So you are Not Broken is being translated into Spanish and Polish, which is very cool. All right, so starting off the book tour, Sunday, September 14th, Santa Monica Boulevard at Dr. Susan Gilbert Lentz's clinic. Very small. I think that's going to be 30 people. And we're going to be talking about testosterone for women, a new frontier or just hype. I mean, you got to love that title. So that's going to be an exciting thing. Come one, come all and see us there. Tickets. I don't have the ticket event link up on the website yet, but it is coming. So go to kellycaspersonmd.com events or just look at the top ticker and say events. Then I'm going to do some podcasts. I'll be in LA for four days and the next event will be on the 17th in Los Angeles at a fitness at a fitness studio in La Brea. And that is going to be with Joy J O I, which is an online clinic. They're awesome. And they're going to do an event. I don't know the size yet. I don't have the link up yet for that. So that's September 17th. Then I'm flying to Palo Alto. I'm doing two book events in Palo Alto. One of them is on books at Books Inc. That's September 18, 7pm I do I have links? Do I have links up on there? I don't click here to learn more about event details. Okay. Yep, links are up. 30 bucks for those tickets. Most of these events you get a book at too, which is really exciting. Okay, so then the next night and the, the tickets aren't out yet as of this recording is going to be a private event with me and mitty at the CEO's house. Bespoke, kind of higher end, nice event. But again, the tickets are not much. I think they're like 45 bucks. So come to a lovely, lovely home. So that's the two events September 18th and 19th in Palo Alto. And then we're gonna go to Chicago. The next we're gonna do the Menapalooza in Chicago on Fulton street. And that's awesome. Again, the links are not up yet on the events page, but they will come one, come all for that one. That's a bigger event. That's going to be a couple hundred, but it'll sell out because Chicago is big. Then I'm going to go to New York. I'm going to do a book. Oh, hold on. I don't have my book signing. There's going to be a book signing in what is not, is it. I'm going to do Barnes and Noble book signing in Santa Monica and I think Palo Alto. I don't have those up yet on the events page. Okay, so the third book signing at Barnes and Noble will be in New York City September 30th from 12 to 1. So no tickets for book signing. You just come and see, come and hang out. September 30th, fireside chat with book signing at Loopwell in Montclair, New Jersey. Oh, Montclair, New Jersey. That's nine. That's nine cities. That's technically not New York City. So that's going to be a nice event. Again, up on the events page is where you're going to find the links to all of these. And then Friday, October, there's probably going to be another event in New York City. It's just not up yet or planned. But stay tuned. October 3rd with the Swell, the new Perimenopause at the Hotel Chelsea in New York. So that's going to be fun. That'll definitely sell out. October 4th, then we have two events. We have the new Pause symposium at Convene New York City, Liberty street. And then October 4th from 5:30 to 10pm is going to be Palladium Times Square. And that's a bigger event, so you should be able to still see get tickets, that is with Commune and it's gonna be awesome. And then I'm gonna fly the next day to Denver for the Thrive Summit, which is awesome. And that's at Santa Fe Drive in Denver at the Moss center. Half a day immersion. October 5th, it's like 1:30 to 6:30pm so come check out that my retreat in Sedona is sold out. And stay tuned. In a month or two, I will be announcing location and dates for retreat. 2026, it might not be in America. Okay, then we've got our hometown book event in Bellingham, October 20th at Village Books. And then October 29th is going to be down in Seattle. That one's not up yet. And then November will be in Orlando. Women's health conversations. That is a good friend Dr. Vonda Wright. Her event which was amazing last year and sold out and so much incredible energy. So if you're down in Florida at all, people traveled from all around the nation to come to that last year. So events page to find all the links. Come one, come on. All right. A lot of these do have virtual options as well. So I wanted you guys to know about that. All right, so that is that who if you have not pre ordered yet, know that a, a a cash free thank you is to pre order an author's books. So if you can do the pre order for the menopause moment, it is very, very, very awesome. Orlando date October. What did we say for well there's the menopause conference, right? But then there's also the November date for the Vonda Wright women's health conversations and that'll be in November. So see you. If you're just going to the menopause conference to learn otherwise, us on stage, Kelly and friends. Vonda and friends. Mary Claire Kelly, Vonda, Dr. Corinne Men, Dr. Susan Gilbert Lentz. All those things. Audible. Yes, it's me reading the audible. So thank you. For those who like the audiobooks. People loved my. You are not broken in audible. I'm going to read to you the table of contents. Part one, what is happening to my body? Part two, meet the sex hormones. Part three, Hormone deep dive. Part four, special considerations for menopause. Part five, great sex in midlife. Part six, lifestyle changes aren't scary because not just about hormones. They are magic for some people, but they are not a magic pill. I'm gonna say that again. They are magic for some people, but they are not a magic pill. So you need to know all the other things. So those were the parts and now let's go through the chapter. So in part one, what is happening to my body? Chapter one, biopsychosocial is a big sex word. Chapter two, what is menopause? Then we go to part two, meet the sex hormones, which is chapter three, fear is so 2002. Why are we afraid of hormones? Chapter four, testosterone, the forgotten quarterback. Chapter five, estrogen wrongful imprisonment. Chapter six, progesterone, the vindicated soul. Okay. Part three, hormone deep dive. Chapter seven, hormones prevent death and other beneficial things. Chapter eight, the midlife brain. Chapter nine, why boomers should be pissed, the timing hypothesis. Chapter ten, how to talk to your doctor about hormones and midlife symptoms. Part 4, special considerations for hormones. Chapter 11, how to talk midlife with men. Chapter 12, perimenopause from bong hits to serious risks. Chapter 13 breast cancer. Chapter 14 special considerations for hormones. Your health history. Part 5 great sex in midlife. Chapter 15 the senile vagina genital urinary syndrome of menopause. Chapter 16 desire, sex and hormones. Chapter 17 pro tips for better sex. Part 6 lifestyle changes aren't scary. Chapter 18 muscles and bones. Chapter 19 alcohol is toxic. Chapter 20 more tools non hormonal medications and supplements. Chapter 21 bullshit and bullshit adjacent non hormonal solutions. Chapter 22 midlife mindset makeover. Chapter 23 can hormones be preventative medicine? Chapter 24 can menopause be a Choice? Pre order it today. I want to see the numbers. I want to see the numbers on Amazon. My friends. If you don't like Amazon, you can order it in Barnes and Noble. And if you want a Mom and pop number one, contact your mom and pop bookstore locally. But I also on my website under books have a bunch of links to mom and pop retailers that you book is I think $21, which is you guys. I just bought a textbook. I posted it on my Instagram yesterday. I just bought a textbook and it's, it's 400 pages of textbook. I do not recommend this for the general population but people who are like, you have to be moderately to advanced in hormone therapy to I think to really get this book because it is for the advanced practitioner. But that book is 220 and I'm like, oh my God, my book is 21. It is 10% the cost of that book. Now that book is an academic publisher. Academic books like college books, right? Academic books are at a higher price point. But I'm like, my book is legitimately 10%. Yes, it is available in the, at the UK. In the UK. Go get it now. Tell me if you can't get it. But yes, it's available in the uk. Please get it. So this is basically Gen X getting feisty. Yes, it is available via Audible. Just go on Amazon. You can pre order it now. I recorded it took three days straight of reading because I'm like, this book is like a hundred pages more than the you are not broken book. Like sorry, not sorry. I needed to get it in. So that is the book that is the News. That is 14 minutes into a podcast already. So now I'm going to talk about skin, skin, skin, skin. As long as I can find it. Oh, here we go. Here it is with all the notes. I will put the the citation for it in the podcast show notes. This is a review article. It is free. It is open access. That Means you can to print it out and read it and bring it into your doctor. But this is not going to tell your doctor how to give you hormones for your face. That's not what this. This is. This is basically for all the people who say that there's no data because this is a nice review article. Quote. This is the title of the Love the article book is available in Australia. Go order it. I have a massive fan base in Australia. Ever since Sydney, March 1, 2025, the Australians realized my sense of humor is awesome. I have a very Australian sense of humor. You guys direct. Direct and sassy, I think might be the best way. So yes, Australia pre order it. Go get it. Somebody from New Zealand pre ordered it today. So apparently you're able to do pre orders in New Zealand as well. Thank you very much. And thank you to my publisher for having it available in multiple countries. Because newsflash, menopause doesn't just happen to Americans. Europe. I know you can get it at the uk, Try other countries and let me know because I can always pass that on to the publishers that people are interested. So do it. Okay. So the title of the article, Managing Menopausal Skin Changes A Narrative Review of Skin Quality Changes Their Aesthetic Impact and the Actual Role of Hormone Replacement Therapy in Improvement. That is a great title. Okay, showing it one more time for the people who care. So this is written by Bianca Viscomi, Mariana Muniz and Sonia Sattler. They are from Brazil and Germany. Get them to speak at your conference. Like, give them the thank you for writing this because it's awesome. So I read it and I loved it. And the thing about facial estrogen products, most commonly In America, estriol, 0.3%, 1 gram to the face. Q day is. It's cheap, it's generic. There is no money in a pharmaceutical company actually getting this FDA approved. So don't hold your breath. And if your doctor says you couldn't put estradiol on your face, ask them, why not print out this article and bring it in. Why would you put estradiol on your face? It's an alcohol based. Yeah, yeah, yeah. Don't use the estradiol gel. That's used for systemic. You gotta make it nice for the face. That's why it's a compounded product. All right, so there's no money to study this. Don't wait around for the FDA to approve this. It's not gonna. It's not gonna happen. It's gonna be still like difficult and compounded, but it literally like, you know what this, it's the kind of thing where it's like, you don't, you don't know until you know with this thing. Like, I started mine. I probably have been using it for two years now. I started mine and I didn't tell anybody that I started it. And literally a couple of months later, people are like, oh my God, your skin's amazing. And I'm like, you are effing kidding me. And then I. So I just recently started a woman on it and she was like out in public and she's like, strangers are coming up to me, telling me that my skin is good. And she's like, maybe they're just being nice. And I'm like, no, people say that your shirt is nice or your purse is nice if they're just being like nice. But strangers aren't coming up to you to tell you that your skin is good unless like your skin is really good. So that's why most people compound it. You're not supposed to use like the systemic gel on your face that's not tested and it's higher dose Estriol for your face is a, is local only, just like vaginal, low potency, non systemic. What's the difference between local and systemic? Dosing, Dosing, dosing, dosing. Okay, so that was my first comment, is like cosmetic companies won't profit from this because it's a prescription, right? So nobody's going to put a lot more data into this. The other issue I had with this review article, and I freaking love this review article, but these are the issues I had with it, they didn't address testosterone at all. I would like to see more data on the role of testosterone and hair growth, specifically eyebrows, highly interested in that. So they don't talk about testosterone at all with this article. And the other thing I want to talk about is that some people just seem to freaking not get it, is that your skin is an organ, your bones are an organ. What's happening to your skin is happening to your bones. Thinning, wrinkling. Not that your bones are wrinkling, but like you're losing your collagen, you're losing your extracellular matrix, you're losing the repair mechanisms. So understand that. Understand that what's happening to your skin is also happening inside to other organs. Your skin's just the outward manifestation of it. I just think that's very important. And I think the other bias about all of this, and I've been waiting to talk about it, is we're like, oh my God, should I get a facelift? Should I get a facelift? Should I get a facelift? Women are willing to spend like $20,000 and the risk of anesthesia, but then they flip out about a little bit of estradiol or estriol on their face. And I just think that's like complete risk benefit combined with like. Well, once you're, once you've shown sign of age, you can fix it but don't do anything to prevent it. Right? Like it's a f'd up way of thinking. And if we support women in their decision to get faceless, why are we supporting women in their decision to do things preventative health wise? Right? So that was my other thing is like, like all the celebrity facelifts and fillers and Botox that everybody uses, but then you demonize just putting back what your body naturally makes, like make it make sense. Okay, those are my thoughts about this paper and I love this paper. Okay, background info. The decline in estrogen during menopause contributes to structural and functional skin changes, including decreased collagen production, reduced elasticity and moisture loss, resulting in dryness and wrinkling. Today, hormone replacement therapy enhances skin quality by promoting collagen synthesis, elasticity and hydration. So don't forget estrogen works in the cells. It works in your mitochondria helps. It's, it's estrogen is anti inflammatory. Like I want you guys to understand that hormones actually do things and there are consequences to not having these hormones. All right? Introduction Aging leads to predictable changes in the skin, connective tissue, subcutaneous fat tissue and bone of the face and body, influenced by factors like genetics, ethnicity, smoking and sun exposure in soft tissues. These changes arise from the gradual loss and disorganization of collagen and elastic fibers contributing to the appearance of an age faced and body with increasing alterations in density, moisture levels, texture and skin tone. These changes can negatively impact self esteem as skin appearance strongly impacts emotional well being, self image, life satisfaction and social interactions. In addition to these gradual changes, shifts in hormones, specifically those which accompany menopause, cause significant changes in skin appearance within a comparatively short period of time. The perimenopausal years are marked by an accelerated decline in skin quality largely due to declining estrogen levels, which impair collagen production and the integrity of the extracellular matrix. Estrogen replacement can diminish many of these effects by enhancing the context and quality of collagen, increasing vascularization and improving epidermal hydration, elasticity and thickness. This paper conducts a comprehensive literature Search on how menopause hormones and HRT affect skin quality. In this review, we use skin quality to refer to measurable features such as elasticity, hydration, thickness and texture, or skin health to encompass both these structural properties and physiologic function and skin aging to describe age related structural and functional changes. Alright. While aging related skin changes develop gradually in men, those associated with menopause can be abrupt and distressing for women. It is important to note that changes in fluctuations in hormone production start two to eight years before menopause. This is why we treat perimenopause. Remember, for those of you living in a cave or who've just met me, end of periods is a symptom which is there because of low hormones. And menopause means when you're of no natural periods, but it's a symptom of low hormone and low hormones. Start before your last period. All right. The skin functions as an endocrine organ with its cells both producing and responding to estrogen and other hormones, making it a key target for hormone regulation. Adequate levels of hormones, primarily estrogen 17 beta estradiol, are required for the skin's optimal structural integrity and functional capacity. After menopause, estrogen production from the ovaries ceases, shifting the burden to peripheral tissues like the skin. Specifically, peripheral tissues convert DHEA into estradiol and estrone post menopause. All of these act through estrogen receptors. Estrogen receptor beta is the predominant receptor subtype in the skin.
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Evening. Buyer's remorse. Buy a new car. I'll be moving in. Let's get started.
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Sorry, I think there's been a mistake. I bought it from Carvana.
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You what?
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Yeah. Great price. I even have seven days to love it or return it.
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So there's no.
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No, no Buyer's remorse More like buyers rejoice.
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I guess I'll let myself out. Congratulations. I mean it.
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Buyers rejoice. Buy your car today on Carvana. Limitations and exclusions may apply. See our seven day return policy at Carvana.com the scarce availability of estrogen in aging skin is reflected in the reduced levels of estrogen receptors in the skin following menopause. There are three underlying mechanisms driving menopausal skin changes. Number one, reduced systemic estrogen levels due to diminished ovarian synthesis. Number two, lower local estrogen production within the skin. And three, decreased expression of estrogen receptors in the skin. The resulting hypoestrogenism leads to skin thinning, atrophy, reduced collagen, decreased elasticity and reduced vascularity. Dryness results from the loss of hydrophilic glycoaminoglycans contributing to a direct reduction in water content. Together these changes contribute to a wrinkling, a weakened skin barrier and impaired wound healing. You guys, Living without hormones has consequences.
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Okay.
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Observational and histologic studies by Brincat et al show skin collagen content declines with menopausal age rather than chronological age at an average rate of 2.1% per postmenopausal year over a 15 year period. Having low hormones is the gift that keeps on giving. Changes in skin visoelasticity also occur with declines in elasticity at 1.5% per year. Somebody says I want to just bathe in it. Yeah, right. The weakening of the extracellular matrix and loss of its mechanical properties also compromise the structural support of dermal fibroblasts, accelerating their senescence and functional decline. Senescent fibroblasts in turn secrete matrix degrading enzymes in pro inflammatory cytokines that exacerbate extracellular matrix degradation, creating a self reinforcing loop that amplifies the skin aging process. So too long. Didn't read years of no hormones accelerates the skin more than just your age. Okay. Estrogen prevents age related dryness and maintains the skin's water holding capacity by stimulating the production of glyco aminoglycans such as hyaluronic acid. Here's the big irony. Nobody lets you have estriol for your face and then all the skincare products sell you hyaluronic acid, which is what estrogen helps promote naturally in the first place. Do you ever feel like maybe the deck is. The deck is stacked against you? All right? And then they're saying that their sebum from sebaceous glands decreases and that makes problems too such as dryness. Wrinkling results from the gradual deterioration of structural components in the dermis. Look at all my notes. For those of you can see. Look at all my notes. I like to print out papers and read them. I had so much fun reading this paper. In a cross sectional analysis of Korean women, the risk of facial wrinkling increased significantly with years since menopause. Additionally, women. I'm going to pause. You're going to need to to leave this to hear this one. Women with a history of hormone replacement therapy had a significantly lower risk of facial wrinkling compared to those without hormonal therapy. Okay. The other thing they do do a little. They do a little history lesson about hormone replacement therapy. And again, these people are like dermatology experts, not menopause hormone therapy experts. So they're a little bit wrong in some of this, uh, if you are actually to read the paper. But they do say that, remember, before 2002, 40% of women in America were on hormones. Right now it's 5% for FDA approved prescriptions. Probably more than that with compound. It's hard to count compounded people. That's how much I like, I want to, I want to normalize hormones is like, you guys, there was a place, there was a place in a time called the 90s when 40% of women in America were on hormones. I will have you know. Okay, and this, this is another thing where they're wrong. They say, although HRT appears to offer benefits for skin thickness, elasticity and collagen, when given near the onset of menopause, it is not currently indicated solely for treating estrogen deficient skin. I would technically disagree with that because vaginal estrogen is FDA approved for vaginal atrophy, genital urinary syndrome and menopause, which is estrogen deficient skin of the vulva and vagina. So I would. My lens is a GSM lens. They're dermatologists. So I'd say, actually we do have an FDA approved indication for skin, which is vaginal atrophy. So there you go. And then they, they say another wrong thing. They say initiating HRT more than 10 years after menopause or after age 60 is associated with increased risk of coronary heart disease, not true. Stroke, not true. Clot, not true, and dementia unknown. Mixed results on that one. So remember, that's WHI data, which is oral synthetic medications which we don't use anymore. Transdermal estradiol patches, 0.05 or less doses has no increased risk of clot or stroke. So it is a inaccurate statement to say that. But you know what? Not everybody, not everybody knows as much as me, but I like to correct them where they need correction. Okay, and here's the next part for when people say there's no data on this. When they say there's no data for estrogen for the face, it says to better understand estrogen's specific role in skin aging. Many studies have compared postmenopausal women receiving HRT to those who not using both clinical and histological endpoints to assess changes in collagen elasticity and hydration. See, now a lot of these studies are old. Remember, because of the whi, there was basically a moratorium on researching hormones ever since 2002. So a lot of these studies are old. Nobody was Funding data on hormones for about two decades. So we do have to go back, but for anybody to say there's no data is incorrect. Okay. Numerous early small studies reported associations between HRT and improved skin characteristics via both systemic and topical administration. For example, in a randomized double blind placebo controlled trial of 60 postmenopausal French Canadian nuns chosen to minimize variability in lifetime sun exposure, smoking and diet, they showed that 12 months of systemic conjugated equine estrogen, so not estradiol, significantly increased the thickness of the skin by 11.5% and dermis thickness by 33%, with no statistically significant difference observed in the control population. In a non randomized placebo controlled study, they found a 6.49% increase in dermal collagen after six months of systemic HRT. In a third trial of 40 postmenopausal women aged 44 to 55, they showed significant improvements in skin elasticity, thickness and hydration after 7 months of oral 17 beta estradiol. There you go. Don't tell me there's no data. Another line of evidence, this one is a pellet data. So this treatment with subcutaneous 17 beta estradiol and testosterone pellet in perimenopause was shown to prevent or reverse collagen loss. So very cool. It says despite these positive findings, not all studies have reported consistent effects. And then they cite one which did not show consistent effects, but it was synthetic progestin and ethanol estradiol. So this was birth control. So they're basically like, not all studies show a good effect. And here's one that doesn't show a good effect, but it's actually using birth control pills, not hormone therapy. And again, I think these are dermatologists, they're not hormone experts. So they're not picking out the fact that birth control is not PET therapy. For those of you who don't know, pet is the new nomenclature for hrt. PET, meaning progesterone, estrogen, testosterone or precision endocrine therapy. All right. The KEEPS trial, which was a four year randomized placebo controlled trial, evaluated the effects of hormone therapy on facial wrinkles. They found no statistically significant improvement in wrinkle score after 4 years of 17 beta estradiol or conjugated equine estrogen compared to placebo. And notice that black women had statistically less total wrinkle scores compared to white women. But they said it could be that it was underpowered and it used relatively low HRT doses. So I looked it up. It was.05 of transdermal estradiol. Not. Not the lowest dose of transdermal estradiol, but it's the middle dose. All right, what else should we do? It says, although placebo controlled trial results on the effects of pet therapy are inconsistent, large observation observational data sets also support beneficial skin effects of HRT. There's a Japanese study, HRT reversed the decline in elasticity, showing a 5.2% gain over 12 months. In another study, elasticity increased from approximately 40% to 60% in menopausal women receiving pet therapy compared to controls. So, yeah, again, a too long didn't read is. Don't let anybody tell you there's no data. This is a really nice summary. And again, it's free online. So there is another one. Looking at the National Health and Nutrition Examination, or NHANES, study of 3,800 postmenopausal women, estrogen use was associated with statistically significant decrease in the likelihood of dry skin and wrinkling. So I, like, can keep going. Like, literally, it keeps going. But wait, there's more. So this just becomes a podcast of me telling you there's a lot of data about skin and hormone therapy specifically, like, systemic and topical. So we like data. I get so pissed when people say there's no data, and then I get all like, Let me read you all the data. So estradiol again? Estradiol helps make hyaluronic acid via glycoaminoglycans. So why would it make sense that we're telling people they can't have estradiol, but then you have to, like, go buy the $150 hyaluronic acid product? Right. It's madness. What else do we want to talk about? Menopause related skin concerns are often dismissed as purely aesthetic rather than medical, despite their psychological impact, highlighting the need for a shift in clinical priorities. 47% of postmenopausal women report not being informed about low hormones effects on the skin, hair, or nails. That's true. Okay. Approximately one third of adults with aesthetic concerns are increasingly focused on skin quality. Yet this issue is often overlooked by medical professionals. That's true. So I don't know what else to tell you. People who say hormones don't work don't understand how hormones work. This is like the most obvious statement in the entire world. Okay, so their conclusions, the steep decline in estrogen levels during menopause drives marked changes in skin quality, leading to decreased collagen elasticity and moisture. I want to encourage you as we wrap up this podcast and I see if there's any questions, I want to encourage you to listen to two previous podcast episodes. The best way to search for these if you literally google you are not broken podcast. And then you know Skin and hair. So I did a skin one with Dr. Ellen Gendler. I did a hair one with Dr. Omer Ibram and who's going to be in Chicago with me on the Chicago book tour date. I'm pretty sure he's coming. Maybe talking about skin and hair. He's amazing. He's a dermatologist based in Chicago who gave an amazing lecture on menopausal hair at the 2024 Menopause Conference, which was awesome. So go listen to those two podcast episodes. They did very well because people care greatly about hair and skin. This is a good question. Let me answer it as we're wrapping up. Does the estrogen patch provide the same benefits as an oral estrogen? Very good question. I would refer you to this amazing book that's coming out September 16th called the Menopause Moment. I talk about that in there. Mindset. Hormones and Science for Optimal Longevity. Please pre order now. Oral and transdermal are different things. They are not apples and oranges. That said oral estradiol. Transdermal estradiol are very similar. You're never going to get a head to head study on them. They're generic medications. Nobody cares enough. There are increased risks with taking things orally, but there also might be increased benefits. So I would say traditionally, currently transdermal is the gold standard, but I think oral estradiol is going to be used more and more for people. Let's see, what do I think about estra test? That's a good question. Estro test is, it's cheap, it's been around for years. It's not FDA approved for anything. Pause for emphasis. How does, how is something available by prescription and not FDA approved for anything? I don't know. It snuck through. But the testosterone is a synthetic testosterone. It's not bioidentical. So I would. I don't like the data from it. They also pulled that off the market for men. So I don't like that it's on the market for women. If you pulled it off the men for safety issues, why is it still available for women? The book is called the Menopause Moment Mindset. Hormones and Science for Optimal Longevity. Somebody asked gel or patch? Just see what one works for you. There's a lot of patch shortage issues right now, so I don't know if that's going to push more people into gel use. But just to know it's not just America. Australia has a massive patch shortage issue. All right, guys, I love you. Check out the books. Thanks for listening to the podcast. Share. This podcast is doing incredibly well right now. It's. It's like growing at like 10% month on month. I've got a little competitive edge in me that I am waiting to beat out another podcast which shall not be mentioned. But we're getting very close. So with your help, let's show that women's health matters. Let's show that women's voices matter. Let's show that women can be in the top 10 of the health and fitness on Apple podcasts. I am vying for that spot. We are coming around the corner at five and a half years doing this podcast. So if you're new, welcome for the new people. Keep in mind, people start at the beginning and listen all the way through. And now we have over three. What are we at? We're like 330 some podcast episodes. But people, I do have my OGs that met me and they start at the beginning and listen all the way through. So if you're a beginner, if you have beginner questions, just start at the beginning of the podcast and by the, by the time you catch up, you're gonna know a shit ton of information. All right? And I, you know, I also, I really love is.
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I love.
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I'm two. I'm gonna say two things, two things I love. Number one, that this is a resource for patients and providers. Late breaking news. At the end of this podcast episode, we are setting it up so that this podcast can get cme. So stay tuned for info on that. As soon as I get info and links, you'll get it. Because you should get CME for listening to me, because this is a medical podcast. And then the second thing I am very proud of is that really all walks of life, women listen to this. And I truly believe you all feel valued. This is not for elitists. I try to keep things as low cost as possible when I recommend things. This is for my farmers in Iowa. This is for my fisher women in Alaska. Like, I see you. I know that you're hardworking. I know that you're smart. I know that you're not getting the help that you deserve. And I want you to feel seen. And I kind of feel. I was, I was talking to somebody very recently and I always ask people, like, how'd you find me? Right? And they were like, oh, I was. They were at some event and And a bunch of farmers were talking about me. Female farmers. And she's like, that's how I knew you were legit. It wasn't like the wealthy, you know, unobtainable, whatever. I don't want to say influencer, but like it came from a place of like, trust. And she's like, because the farmers said they were listening to you. That's how I knew you were legitimate. And I was just. My mom's side of the family is fifth generation farmers in Minnesota, so I'm heavily bonded to the farmers in this country because that's where my roots came from. So. So if the farmers are listening to you, you're legitimate. I'll just say that. And urologists, Yay. Urologists, gynecologists. And I tell it like it is. And so far I haven't pissed off too many people. I think I've pissed off less people than I've helped at this point. So I will keep it going on. All right, you guys, that is a podcast episode that's all about the skin. Estriol, 0.3%, 1 gram per pump per day per face. And it's very safe. It's been well studied. It's non systemic. You can be on both if we use estrogen cream for the face or for the skin of the vulva and vagina. Tell me again why we can't use it for the face. I will wait. Don't let people scare you about things that your body naturally makes. All right. I love you so much. Until next time, remember you are not broken and check out the events page and go get my book. I love you. Bye bye. Hey friends, if you love the you're Not Broken podcast, please show me your support by liking, subscribing and sharing it with someone you care about. Your support helps more people find this empowering information for courses, clinic info, and all things midlife mastery. Head over to kellycaspersonmd.com and don't forget, you can grab your copy of you Are Not Broken. Stop shoulding all over your sex life at Barnes and Noble, Amazon or ask your local bookstore to order it for you and a friend. While you're there, make sure to pre order my upcoming book, Menopause, Science, Hormones and Mindset for optimal longevity. Coming September 16, 2025 Medical Disclaimer the youe Are Not Broken podcast, Instagram and content created by Dr. Kelly Caspersen is presented solely for general information, education and entertainment purposes. The use of information on this podcast or materials linked from this podcast or website is at the user's own risk. It is not intended as a substitute for the advice of a physician, professional coach, psychotherapist or other qualified professional. This podcast does not diagnose or treat you. Users should not disregard or delay in obtaining medical advice for any medical or mental health condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. And as always, I got you, I got your back and you are not broken. Thanks for listening.