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Sally G Robinson's avatar

Continued... My 77 year old sister was just diagnosed with breast cancer. She had surgery and radiation.

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Sally G Robinson's avatar

I am 73 and have never been on hormones. My doctor is suggesting that I start now to prevent osteoporosis and cognitive decline. Is it too late to start bio-identical hormones?

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Melissa Scala's avatar

I have a GYN appointment this month and I am thinking of asking about HRT. I am in perimenopause and don't have any symptoms that are horrible - I would say mild, but I have gained some weight and working on that. Does HRT address the weight gain issue? I suppose as I transition to menopause my symptoms may increase so HRT now may be the right path.

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Annie Fenn, MD's avatar

Hi Melissa. I think it is ideal to be discussing pros/cons of HRT early in the perimenopause. If opting in, many women can now do so before they are actually menopausal. WRT the weight gain, yes there is evidence that HRT helps push back against the body's tendency towards a prediabetic state, like visceral fat deposition and rising LDL cholesterol. Take a look at this post if you haven't already. There's a lot more detail about this exact topic there! https://brainhealthkitchen.substack.com/p/how-perimenopause-affects-metabolic

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Tanya Fokina's avatar

I am 50 and had my menopause 5 years ago. Is it too late to start HRT?

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Annie Fenn, MD's avatar

Not too late. It is worth discussing with your health care professional!

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Amber Wilson's avatar

What are the benefits of taking progesterone and testosterone? Are they also brain protective?

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Annie Fenn, MD's avatar

Progesterone is primarily prescribed to balance the estrogen in women who have an intact uterus. Women who have had a hysterectomy usually take estrogen without progesterone. But many women take progesterone because it can help with sleep. Natural micronized progesterone (such as Prometrium) is the preferred formula, not the older synethetic progestins that were common years ago. It's not known if progesterone i brain protective, but we do know that synthetic progestins were linked to developing heart disease. Testoterone can be added to HRT to relieve symptoms of low sex drive, loss of energy, lack of enthusiasm, or to improve sexual response. There is a huge gap in our knowledge about whether testosterone may help protect cognitive health. The studies just haven't been done. But testosterone deficiency (from surgical or natural menopause) definitley impact many impacts of brain function.

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Grace Hartman's avatar

I've been taking HRT (Angeliq) since I began menopause at age 52. I'm now 57. I've not had any symptoms of menopause since I started HRT. Nor have I noticed any adverse effects to taking HRT. I exercise regularly and eat as closely to the MIND diet as I can. Is there a specific age where I should stop taking it or should I just take it for the rest of my life?

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Annie Fenn, MD's avatar

Hi Grace! I would say you have done a great job managing your symptoms with lifestyle + HRT. The recommendation that a woman get off HRT after 5 or 10 years is outdated. There's no firm cut-off and each case should be individualized, weighing the pros and cons of continuation with your HCP each year. Healthy women who do not develop heart disease will continue to gain benefit from HRT as they age.

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Carol Riffle's avatar

I have a request for a future topic. I'd like to learn more about how modern chemical exposure affects brain health. We are surrounded by VOCs, cleaning products, and skin care products. What is safe to use? There's tons of information but it's hard to sift through it all.

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Annie Fenn, MD's avatar

That's a great question Carol. I've been doing some research on this and will share soon. It is staggering how many chemicals we expose ourselves to, and without any knowledge of how they impact brain health.

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