Cardiovascular disease, osteoporosis and HRT | The Dr Louise Newson Podcast

This week, Dr Louise speaks to Italian Menopause Society president Dr Marco Gambacciani.
Early in his career Dr Marco specialised in reproductive endocrinology. He became interested in the occurrence of cardiovascular disease and osteoporosis during the menopause, and his menopause clinic was the first in Italy to have a bone density scanner. On a personal level, Dr Marco saw the devastating effects of osteoporosis firsthand after his grandmother was diagnosed with the condition. Dr Marco also shares his frustrations on the lack of understanding of how hormones can affect women’s cardiovascular health. On a more hopeful note, he is urging the Italian government to make menopause clinics available all over Italy.
Finally, Dr Marco shares the three reasons why he believes women should consider HRT when they're younger:
1. To improve quality of life. By reducing menopause symptoms, you improve quality of life and you help prevent chronic diseases.
2. To help improve your performance at work - why should a woman have to lose opportunities just because she's having flushes or not sleeping well?
3. It’s important for women to maintain the possibility of an enjoyable sex life - low oestrogen levels can lead to low sexual desire or painful sex.

[@jimhollyjarrad2221]

Would love to hear more about menopause with PCOS as well, Nearly all the pcos ladies I know are 'off licence' for oestrogen. As menopause and pcos symptoms are very similar, it would be great to find more info on how it affects pcos ladies too who already has had fluctuating hormones all her life.

[@kathleengonzales2904]

I am so grateful for your work and thank you for educating me. It took me 3 yrs to find a practitioner in Connecticut/New England. My gynecologist offered me little help and was not comfortable prescribing. Another doctor I followed advised to go to the North American Menopause Society and look for the practitioner designation as one has to take a difficult exam to Achieve this title. There I found an endocrinologist who is fantastic. I share your podcasts with so many. I have 3 friends just starting HRT. They are so grateful. Let’s start a Revolution ♥️

[@beau2118]

Fantastic to listen to im so grateful for all the work that you are doing . My rheumatology, proffeser bruce has been on board with me having hrt and even consulted hematology because he wasn't to sure but still he supported myself . I'm now on testostarone and it's been a game changer . I appreciate all that you do

[@MS-sr1fe]

Loved the talk . Ty v much

[@janemasini2810]

I had to push for a dexi scan , apparently you have to have history in your family to have one!
Every woman should have one and men, u lose your bone density having children, my sister got Ostrperosis when she was in her 30s,
I lived in Italy and had my 3 children there, there the best gynologist s in italy❤❤

[@kychpal6236]

I have had scoliosis since my teens, no surgery. Being concerned about osteoporosis have got osteopeana, as my vertibrae are compromised, I asked GP for hrt. Was discouraged, first put on biphosphonates by GP. When I visited my spinal expert they told me not to take biphosphonates because although a dexa will show improved density, bone surgeons have found that on the operating table when attaching metal screws, with those on biphosphonates the bones were crumbling!!! So have had a battle to stay on hrt, and am concerned that I might not be on the correct dose, plus I am not on testosterone?

[@yogaexercise9637]

I saw my doctor the other day wanting to start HRT due to moderate-to-severe symptoms. But I do have microvascular ischemic disease, which as I understand is a normal finding as we age, and for that reason the doc is afraid of stroke and is strongly recommending I don’t start HRT. I am 68, 13 yrs past menopause, in otherwise good health, all bloodwork is normal, I’m on no meds at all, but my symptoms of fatigue and brain fog, and poor sleep are hugely, negatively impacting my quality of life. Is there any literature or research to indicate that HRT at this point would increase my risk of stroke? I know to stay away from oral estrogen, but thinking transdermal would not increase my risk of stroke at all? So hard to navigate this on ones own. Thank you for everything you do!!!!!

[@Hollowmoon007]

Wondering if estradiol needs to be started first for some reason before testosterone. That was not offered to me during perimenopause but T and progesterone was.

[@yogaexercise9637]

Also...so estrogen is protective against cardio-vascular disease--if taken at the time of menopause...but then suddenly, after this 10-yr window, does it (estrogen) become actually harmful?

[@helenstewart3417]

I don't know if it becomes harmful or if there is little benefit?

[@helenstewart3417]

Is there any point at 66 and 11 yrs post menopause of starting HRT?

[@55ma310]

i am 21 met a heart attack 6 months ago

[@nancyjane888]

So don't take DHEA supplements?

[@christobasson3745]

He was talking about DHA, which is fish oil known to be high in Omega 3.