Brittany (00:01.37)

Hello everyone and welcome to the Hormone Harmony podcast. If you are listening, you can live stream this anywhere that you listen in; Apple Music, Spotify. We are diving into hysterectomies today and hormone imbalances and how you can restore your balance after a hysterectomy. I am with the amazing Jordan and Raquael if y'all would like to introduce yourself.

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Jordan Colwell (00:28.761)

Absolutely. Thank you so much Brittany for having us today. It is an honor. My name is Jordan Colwell, I'm the VP of Patient Care. I have worked in the medical field the last 15 years. First in cardiology and then urology and migrated to hormones five years ago. My interest in hormone health peaked when it was recommended I have a total hysterectomy at the age of 27. The recommendation came from a diagnosis of endometriosis and fibroids. Due to the severity, it was required my ovaries be removed as well. A total hysterectomy at such a young age was not something that I wanted, but definitely did some research to understand the pros and cons. Now my passion is sharing my story to help others like me not suffer with symptoms and have a great quality of life. Thank you so much for having me today. Raquael, over to you.

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Raquael Flores (01:28.707)

Hi, I'm Raquael. I'm one of the Directors of Patient Care at Thrivelab, but I too also have a personal history of hysterectomy. I was a little bit older than Jordan. I was 37 at the time. And I found myself in a situation that they had thought that I had cancer and took my IUD out to biopsy and I ended up getting pregnant because that's what my body does. I have six children and why I had an IUD in, but I didn't know where to navigate through. They recommended a complete or radical hysterectomy, leaving my ovaries. They thought going into my ovaries wasn't a big deal, and I was so young that they wanted to keep those. But ended up keeping my ovaries, but had everything else removed, ended up I didn't have cancer. And then similar to Jordan, like just navigating through and not having really the help that I needed. I worked in women's health at the time. I'm a lactation consultant also. And, it was tough. I mean, even being a professional in the industry, I didn't really know how to navigate through that. So I'm really excited about this because I talk to a lot of women every day that are in similar situations as Jordan and I, and it's a really good topic.

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Brittany (02:59.37)

I can't wait to dive in with you guys further, you know, on the provider end of things and we're constantly hearing this revolving door of women not being aware of what hysterectomies can do to the body. And I think we're really shining light that no one's in the dark with this. And as we understand hysterectomies and hormone imbalances, I think it's really important to shine light on, for those saying, well, what does it even a hysterectomy mean? I mean, there's so many different ones. My mom had a partial, my friend had a total. I mean, what does that look like?

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So diving into that, there's really three different ones. And a total hysterectomy is really more involved of the uterus and the cervix and the ovary. So everything is completely removed. And if you have a partial hysterectomy, really that's the uterus, not the cervix. And sometimes a doctor may call it a subtotal hysterectomy. And then Raquael, you already touched base on the radical hysterectomy, right? 

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The surgeon removes the uterus, the cervix, and surrounding tissue, and that's usually recommended for patients that possibly have cancer. And so what we find with these different hysterectomies is definitely hormones becoming affected by it. So when y'all are speaking with patients and kind of on that side of things, or even of y'all in general, because y'all have personally gone through this. What are some symptoms that are experienced because of these hormonal changes with those procedures?

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Raquael Flores (04:34.898)

Yeah, I think that probably the most common things I see are really signs of perimenopause/menopause where people are starting to feel some people may be getting hot flashes, a lot of anxiety and depression. And I know we all were chatting ahead of time about that mental health piece of it. You know, there's so many things that you're trying to grasp as far as you were kind of thrown into this and all of a sudden, you're making a choice and then you're dealing with the aftermath of it. And I know for me, I also had major gut issues that developed afterwards. And now knowing more about hormones, I think that a lot of that inflammation in the body, there's a lot of things that kind of go hand in hand. And it was explained to me, even though I had my ovaries left. They took my tubes too out of that, that lack of blood supply can definitely throw you like in that perimenopause phase. But yeah, and I hear the same thing from women every day with that.

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Brittany (05:54.042)

Jordan, I'm curious on your experience, especially post op, you know what symptoms you're experiencing because it sounds like there is no age that determines when these symptoms occur. 20s, 30s, 40s, it's not a, oh, at this age, maybe possibly you're experienced this. Age does not matter in this. It is the surgery that is causing this. And it sounds like with y'all and especially patients, they have no idea. So when did you realize Jordan, what is going on and what's happening and what did that look like for you? Especially as a mom of four.

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Jordan Colwell (06:24.302)

Yes, absolutely. Similar to Raquael, the hot flashes, things along those lines based on my personal experience post-op, before I ever started hormone replacement, I had symptoms such as night sweats. I would wake up with matted, wet hair, wet clothes, the trouble sleeping, loss of sleep, hair loss, weight gain. A lot of these other symptoms that doesn't really get discussed. And like we briefly touched on, the mental aspect. I was dragging myself out of bed every morning. No amount of coffee could perk me up. And that energy and fatigue side of things, it really hampered me being able to keep up with my kids. Being a mom of four kids, I don't have the time to not have the energy. 

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Jordan Colwell (07:17.31)

So that fatigue, lack of sleep, it was all super challenging. And like I said, the mental aspect of it, trying to understand not just the physical symptoms, but navigating how I could get to a safe mental health side of things to continue pushing not only myself, but children. 

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Brittany (07:51.522)

Wow, that's, I can't even imagine. And you know, it sounds like really with this surgical menopause, right, that happens is, even research shows, you know, one third of women in the United States have had a hysterectomy. And so research states that 60 to 70% of women experience a decrease in hormones to menopausal levels within three to four years of the operation. And for most women, that's progesterone. They'll fall within the first several months. So when I hear these young patients having lack of sleep and irritability and feeling emotional and feeling hot and all of these things, progesterone is just plummeting within the first couple of months. Well then as time goes on, estrogen declines, right? And patients who are listening or those streaming are like, well, what's progesterone, what's estrogen?

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Oh my goodness, I'm glad you thought go to thrivelab.com. We have all of the podcasts on there that you know, goes over all of those hormones specifically. But the biggest takeaway from this is that these levels decline within one to two years. And so, you know, the biggest change in that is because like Raquael said that uterine artery when they cut it and tie it off during a hysterectomy. That starts to decrease blood flow to your ovaries. Well, what are your ovaries do? They are the ones powering your body with all of those hormones. And so it really does affect you know, testosterone levels. And again, as it goes, you're really kind of on a straight and narrow path to menopause. So Jordan, I'm thankful that you share that and Raquael too. 

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And, you know, with kind of diving in further as well with the importance of acknowledging now these hysterectomies, acknowledging as women, it's hard for us to kind of take our symptoms seriously as we are with as mothers, right? It's like, I can get through this, but as time goes on, it gets so hard. So we want to really shine light on the importance of not, you know, suffering and having a voice to know that I'm not happy with how I'm feeling. I have a family, I have work, I have life. I can't not sleep, I can't not, you know, cry in the shower, right? We wanna give our voice and ourselves power. And so with doing that, we wanna treat it, right? Get to the root issue of why this is happening and what we're feeling. So I'm just curious on y'all's perspective, what is so important about treatment options for women post-hysterectomy, right? We come across patients all ages, all backgrounds, all stages in life. Why is this important?

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Raquael Flores (10:30.054)

I think for me, it was not only like the things you were talking about, but it affects other things like your relationship, partnerships, sexual health. Like, you know, I remember, like you said, like it wasn't, I went on bioidentical hormones, topically I did estrogen and testosterone, but it was a couple of years post surgery because I was breastfeeding at the time. And, you know, when sex feels like little tiny razor cuts, you know, like, you know, I was like, okay, my body, like there was so many things that, you know, I just, I didn't feel like myself. I didn't feel like a woman. I didn't feel sexual. I, you know, and I too have had five daughters at home and like trying to navigate around career life and have the energy, but then also have the energy to be a mom. Like, you know, it's again, things that I hear every day, like it's just the overall quality of life from, and there's other things that can happen. Like I remember I'm not a person to get UTIs and because of lack of estrogen, I started getting chronic UTIs and I'm like, what is this? Like, you know, like there were, there were so many pieces that came. 

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I also am a genetic history of arthritis. And so I remember times getting out of bed feeling like my back was going to break. And I was like, this is just all, you know, and that's what I hear from a lot of people like they're trying to put the pieces together and they're having all these symptoms. But, you know, they come and that's the one nice thing about us that we have a great assessment. And when they take that assessment, like it's eye opening for them, like they're like, I'm not crazy. Like this is tied into all of that. Yeah, that's kind of my take on that.

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Jordan (12:08)

Absolutely. That's a beautiful take, Raquael.

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Brittany (12:31.898)

Absolutely. And I find, for me, at least 80%.

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Jordan Colwell (12:32.374)

And I hear it too from patients, you know, a lot of times they have already been to their OBGYNs. They've already been to primary care. They've already gotten labs that are saying that they're normal, but they're still fighting these symptoms. They're having marital relationship problems. They're not able to have sex. 

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Brittany (13:05.738)

Okay, so it sounds like possibly that the storm has gotten in the way with Jordan's testimony on this. And so I'm really thankful she was able to hop on and share her experience. And it just really shines light that we're not alone in this and as women we can come together and find our voices and really share that importance. Because when it comes to treatment options for women, Raquael you mentioned getting on estrogen and testosterone and I'm sure feeling the benefits of it you know and women who still have ovaries though they'll go get labs done and say hey doctor I'm feeling bad please run my hormones they have to ask right and you're within a normal range, you can't sleep, let's maybe do a sleep aid. And if you feel hot at night, you know, maybe try, you know, getting blood sugars checked, or I've heard so many different stories. So it's really interesting to kind of find that the different things that they're told, but you know, I want to really look at the main hormones in HRT and how they help restore hormone imbalances. I mean, there's three hormones, right, that the ovaries make, and that's estrogen, progesterone, and testosterone. And so really, bioidentical hormone therapy replenishes it naturally, and patients go naturally. How? Well, it's amazing. You know, it's derived from wild yams, and when we think of bioidentical, we think that, that derived wild yam that molecule mimics your own body's molecule. And it goes, Oh, my gosh, this is our own, we remember this versus something synthetic with animal products and dyes and just different additives that can just make us feel even worse, right? We're already getting enough of that in our food and plastics and stuff. So this is the most bioidentical, natural way to replace that. And so when we do that with our hormones, it really helps benefit those surgical induced patients of menopause and just menopause and perimenopause in general without the surgery. So the goal is to alleviate and allow patients to have their life back, which then allows stopping the hot flashes, stopping the mood swings, stopping the sleep disturbances. And I tell women too, it's a beautiful thing that we are alleviating your symptoms. But let's go to what's happening internally, right? estrogen rebuilds the osteoblasts in your bones. Do we see 20 and 30 year olds, you know, going for bone density scans? No, why? Oh, well, they have, you know, thriving hormone levels, ideally, right. And so do we see, you know, a 20, 30 year olds, you know, having a hip fracture or God forbid, it's not very common. It happens as we get older because of hormones, right? So what is your thought on that, Raquael? I mean, you know, the main hormones being involved and benefiting our hormone balances as women.

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Raquael Flores (16:04.126)

Yeah, that's what I tell patients all the time. I'm like, especially if you're, you know, you're predisposed, like for myself, I was diagnosed with like osteoarthritis at a really young age. My grandma had it. So that was a huge concern to me was like my bone joint health. But it confirmed to me also. And again, patients will ask, like, how do I know that this is going to work for me? And I'm like, you don't until you try, right? Like the worst thing that's gonna happen is you don't get the relief that you need. The best thing that's gonna happen is it gives you your quality of life back. And to me, it's also like 50% provider, 50% patient success that if you don't have that skillset as if your provider doesn't have that skillset or that knowledge.

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You may not have a good outcome with that because I also get a lot of people that maybe have tried in the past or, you know, dabbled a little bit in it for like a month or two. And it's so important. I tell people you've got to give it time. You got to work with your provider. You've got to give feedback as far as, you know, how you're feeling and symptoms, because we don't know unless you tell us. And then it's also, like I said, on the patient side, like that communication is so important to have between provider and patient as far as outcome goes with hormones.

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Brittany (17:38.666)

I love that because I find I get asked too, right? How do I know this is going to help me and I have to say, you know, again, like you don't, but there is really nothing that is more of a coincidence per se or really scientific that you had this procedure done, here we are and something switched, something switched and you feel bad. I mean, I even had a friend who was having hormone fluctuations and really thought, God bless her, that she had cancer. She was feeling hot at night and she was like, what is going on? And you know, went down the rabbit hole of Google, right? And it came out to be her hormones. But I really, you know, tell patients again, and I love that you shine importance on the provider-patient relationship because that is huge. I tell every patient I encounter, do not suffer in silence.

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Do not suffer in silence. I can help you on demand. If I don't know, I'm not able to help you. Message me, you know, and we'll go through Thrives incentices as far as what we offer patients with our chats and our support team, but it's all hands-on care, so you're not suffering in silence, and that's the biggest goal of this outcome. So, you know, we really wanna also look at, you know, more of the benefits of women with hysterectomies, their specific benefits of undergoing treatment after a hysterectomy, and there's lots of great success stories.

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Obviously, Raquael, you're here to kind of, you know, at the top of your lungs, share your story and be a testimony for patients and that they're not alone in this and that there's great benefits on it. So you know, I would kind of say that it's very interesting that as you undergone, you know, this major surgery, did you ever have any consulting about it on, hey, this might happen in a couple of years, you might be reaching.

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Raquael Flores (19:29.938)

No, it was, I think especially because like everything ended up being okay with me afterwards. It was like, okay, great. Like this bigger health thing that we were worried about, like, you're good. You should be good. Like you have your ovaries, you're good to go. And again, I was, it was not, it was outside of the group I was working in. I was in gynecology at the time. And it wasn't for me, because of being pregnant, like I was trying to sort through like, is this postpartum, is it, you know, hormones? And then about six months into it, I was like, I'm miserable. And that's when I kept asking the gynecologist I worked with, like, can I be tested? Can I be tested? And I think that's what we all think going into it, that you're gonna take a test and it's gonna have a magical answer as, and it was almost heartbreaking to me to get that test back because I was like, I mean, she's like, actually, your levels look good. And I'm like, this doesn't make sense. Like, you know, I'm, I don't feel good. I'm not myself. And then I had a cool provider. And she was like, well, let's try it. Like, you know, same thing, like the best thing that's gonna happen is you get relief, and then we know that it's working for you. But yeah, it wasn't talked about and some of it was my own research, probably like many of our patients, like you just start digging around and finding information and that's how I came across, you know, getting therapy.

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Brittany (21:06.866)

Wow, you know, it's so interesting because in my previous specialty, you know, general surgery, there was a specialty of bariatric patients, right? And so for those who are curious what that means, it's patients wanting to lose weight surgically, right? And so you can do a gastric bypass where they're kind of rerouting things. It's more intense or a gastric sleeve. They kind of just make your stomach lining a little bit thinner. And so what they have to do to get this surgery, to reverse comorbidities and to lose weight is see, you know, a medical health professional to clear them. Do they, do they pass the psychiatric evaluation? Can they go to the dietitian and, um, you know, start those recommendations. Sometimes there's eight to ten visits and insurance is very, very big on it. And what's so interesting is we have these diagnoses, which can cause hysterectomies, right? Fibroids, endometriosis, very heavy disruptive periods, the list goes on. And usually the goal is, well, let's just take out the parts, right? Take out the uterus or let's just do a hysterectomy. You don't want kids anymore? No. Okay, let's just do it right. There's no counseling, there's no therapies, there's no, well before we get you into menopause at the age of, gosh, in your 20s or 30s, let's get you consulted to know, like this is what your future holds. It's not like that, but for different surgeries and procedures it is, and so that can really shine light on the mental health challenges that arise. And that's why I love our Thrivelab support team because we have coaches to help with that, right? We have our life coach, we have a registered dietitian, we have our care team and I think it's really, you know, meeting you where you are and not saying, this is your prescription, hope it helps, there you go. It's no, this is your prescription. Here we have, you know, Raquael that can help guide you through this. We have Jordan, we have a registered life coach that can guide you through this new kind of chapter in your life. You're having, you know, now eating concerns or craving concerns with this. Here's a registered dietitian to kind of ramp you up. I mean, it's really beautiful that holistically we're diving deep with the patient and addressing it in all aspects. And none of that was offered, right, before this procedure.

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Raquael Flores (23:25.91)

No, I, it was probably, that was probably the, on top of the hormones was the most difficult thing to navigate around. I wasn't prepared for it. Kind of like what you said, like you're, I was in the middle of everything at the time and you're like, okay, well, I guess I need to be doing this. And then when it happened, like I said, on that aftermath, all the feelings, like, I don't know about other people, but I think we were all talking about this and Jordan had a similar feeling as well, that you almost go through a mourning, right? Like because it wasn't that I had my children, I wasn't really planning on having more children, but I didn't realize how much mentally my uterus was tied to my femininity. Like that's what I felt like. So it was almost like, I didn't feel like a woman anymore. I'd like that sexuality that, you know, everything I was, and I thought I was losing my mind, like on top of like the mental side of it, which I'm sure my hormones were going crazy. And we talked about this hiding in the shower and crying, you know, between the kids because I don't want the kids to see and I remember looking up help, like, how can I get help? And then life would get busy and I just never saw anyone not much till much later in life. But how beneficial that would have been to have somebody hold my hand and be like, you are not losing your, like, let's walk through this together and help you. And then the gut issues too. Like I started having major like dietary issues, gut issues, and I look back now, no one ever really tied those two together, but I look back now and I'm like, that's not a coincidence. Like, you know, like that definitely went hand in hand with the surgical hysterectomy.

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Brittany (25:24.846)

Wow. And you know, it's so interesting. And what I love about what we do too, Raquael, is labs are a guide. You know, they're a guide. And in a world of medicine where if you're within this huge range, men, women, all ages, you get this lab and you're looked at within the same range. And it's, you're good. And I see patients. And can you please look at my labs? And my doctor said they're good. And I'm like, I mean, you're in a range but my goodness, your symptoms say otherwise you feel otherwise your skin's kind of communicating to you and your hair, your sleep. You're ‘within range’, but you're like three numbers away from being out of range. So let's get ahead of it. And so I really find it's beautiful with our care, with our patients that we can meet them where they're at and optimize their range versus saying you're within range. It's kind of in your head. Let's kind of find maybe a way that you can, you know, maybe drink more water and try exercising, right? That's always the, you know, do this, do that. Let's not address what this range looks like and what your body's communicating at. So with that being said and tying that into these labs, there's a lot of misconceptions on bioidentical hormone therapy and why you shouldn't do it. And there's a lot of concerns of cancers and, ‘my doctor said menopause isn't real’. I was told that yesterday by a patient. She looked at me and said it wasn't real and just to deal with it, that this is what you're supposed to go through, but I can't sleep. I get two hours of sleep at night. I feel like I'm going crazy. My marriage is on the rocks. My kids don't wanna talk to me. And it's like, why do we have to even go there, right? So what are some kind of concerns you've heard about hormone therapy or precautions about considering hormone therapy after a hysterectomy? What have you heard from patients?

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Raquael Flores (27:16.054)

The biggest concern of course is cancer, like breast cancer. And kind of similar to the explanation you gave, I tell patients hormones have come a long way and our knowledge and our, you know, not only just the overall care that you get with hormones is different than it was for our grandmothers, great grandmothers, but the bioidenticals is a big piece of that safety concern. The other side, and I always recommend to patients, and you could probably touch on this, I know a lot of our viewers would probably like this conversation of what does an exit plan look like? Like I get a lot of people of ‘how long do you stay on hormones?’. Is it a one to three year, like you feel better and you get off, or can I stay on them for a really long time and feel great with that too? That's probably a big one that I hear a lot is, okay, I'm feeling great, but do I have to get off of them? And what does that look like? Yeah.

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Brittany (28:18.581)

That's a good, that's a good point on the exit plan, I get that asked a lot. And I say I am here to help you and relieve you as long as you would like me to. And as long as you're feeling good, I'm really feeling good, right? My job is to advocate for your treatment and support you for you to feel your best. That is my goal. And really what I find with an exit plan is it can be as long as you want it to be. And I think as Thrive, we really voice compare it to a supplement, right? If you stop taking your vitamin D and get natural vitamin D. Are you going to completely plummet within a week? No. Are you going to feel the effects after a couple weeks or months of like, oh, I'm kind of feeling like a little bit defeated or even taking B12, right? You're used to that, you feel good and just know that you'll go back to baseline, right? And so it's really the patient's perspective. And I'm not one to say, well, no, we need to do this a year or three months. I always want to meet patients where they're at, because we're all on our own journeys on what feels comfortable. And as time goes on, the doors kind of open and there's a little bit more of a opening eye moment when it comes to patients realizing the benefits, but also too like today, our podcast to shine light on even more information. But I find too that you know, it was amazing. I went to an A4M conference and in Vegas and it was amazing that the provider said at the conference, put 100 patients, all ages, on hormone therapy and not. Put them in a room and I will point out who is and who isn't. Well, how? Skin, hair, nails, energy, joints, how are they walking? How are they feeling? How are they acting? It's not all about symptoms, but what it does to our bodies and our minds and our physicality. And so it's just you can tell. And I think I'm sure with you too, right call you love seeing the before and the after. I mean, it's like a 180. It's almost like a magic wand. Like, just, it's just so magical and beautiful to see that just transform someone's life. And they have their life back, they feel in control, which is how it should be. So I would say, you know, that exit plan, it's really meeting you with what you feel comfortable with. Of course, we like to have screenings, pap smears, mammograms, I mean, just any screenings to make sure that you're taking care of your own health, but also too that really precautions of considering after a hysterectomy of bioidentical therapy, we will get labs, but we wanna treat your symptoms because the ACOG states, hey, treat the patient's symptoms, don't worry about a lab value, they're suffering. And so that would really be some precautions with that. So you know, with this takeaway of, kind of hormone imbalances and improving quality, what other things have you thought about shining importance on bioidentical treatment and what this can do for women as a whole?

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Raquael Flores (31:16.758)

Well, and you were touching on something that was reminding me of a conversation that I have a lot with patients because they're like, well, when is the right time to start? Like I'm young or I'm, and I having a skincare background, I'm like, think of this like sunscreen or, you know, doing those treatments to maintain your skin like you would. It's much harder to go, to let it get so bad and so where you're in a hole, it's not that it's not manageable, but it's gonna take a lot more work to dig yourself out of that and to level out versus being on top of it and start doing something now that you can, keep that line steady so you don't have so many peaks and valleys in there and get your quality of life and maintain that instead of totally hitting rock bottom and then being like, oh, I guess I need to go do something, or before their provider may say like, okay, now you're at rock bottom, you can get help, but meanwhile, you've lost what? Years in that of quality of life. And I think that is important too. A lot of people have that question of, when is a good time to start hormone therapy for myself?

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Brittany (32:40.942)

That's a really, really great point with the sunscreen because we all hopefully use sunscreen at some point in our lives, but it's true if we don't, it's kind of like, well, we can still use it, but hitting that rock bottom, and that's the biggest thing with our patients too, we say give it 90 days to optimize, right? Give your body time. We are peeling back the onion of years and years and years because we have to think too, before the hysterectomy, there was already really hormone imbalances, right? Fibroids and endometriosis and all these hormonal concerns. And so it went from like, imbalance to the surgery to dropping and it's like, Whoa, I mean, we have layers to unfold here to alleviate, but the goal is at least 90 days to optimize it. And you know, given that if we get a head start on it, like your sunscreen, you can look back and be like, well, thank God I use that sunscreen all this time because I would really be hurting and so would my relationship and so with all the things so I always say why suffer in silence when there's like really great treatment out there. I mean, we look at our iPhones and technology and we're like, this is crazy. We have electric cars and all these things. Think of the medicinal aspect of things. We've really come far and there's a lot of phenomenal research on it. So I would really say that those who are listening and they've had personal experience with bioidentical therapy or they're thinking about it, seek professional guidance. I mean, our providers and team at Thrivelab, this is our specialty, right? We are able to help you on bioidentical treatment. And it's really tailored to your preferences and your needs. There is not a one blanket fits all because we're all different and we all need different things. So I think the biggest concern is for patients, how do I even like, what do I do? And so that would just be easily go to thrivelab.com, fill out a self assessment, just fill it out. Does it cost money? No, but you can at least get insight on what those results look like. And it's not just hormone therapy, right? Right? How we'll look at the different hormones that thyroid but even our blood levels, what about vitamin D? What about B12? What about DHEA? What about your blood levels? Are you anemic? Right? So we're not just really scratching the surface of hormone therapy, but getting to you as a whole the root cause. And I think too, with even our thyroid therapy, right? Is there a thyroid condition? Do you have an autoimmune Hashimoto's? So this is kind of scratching the surface of hormone therapy and hysterectomies particularly, but as a patient of Thrive, it goes much, much deeper than that. And that is the goal to treat you from head to toe and have that care team accessible to do so as well, right?

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Raquael Flores (35:25.399)

No, I totally agree with you. Again, that's probably what I tell patients on a daily, that we really try to not put people in boxes, look at everyone individually. We realize people run at different optimal levels. And if you're having symptoms, then something's not balanced because you know your body. And to me, the biggest asset that we have is our providers, like, and because they listen and they have a conversation with you, and then they'll take that information and actually do something with it. You know, it's not that, okay, well, do you have a test to back up what you're saying? Like we said, that isn't always so because those value ranges are so wide in those tests that unfortunately, none of us get tested when we're running Optimal. So how… how do we really know? You could be a person that operates really high on that end of normal, and now you're mid to lower end, and you're symptomatic because that's not your range. And I think it's important to have that conversation because people feel sometimes that they're just categorized as, like we said, like, oh, okay, well, you had hysterectomy, your ovaries are in, you're good. Like, you know, we ran tests, like, you're good with that. Or you had your ovaries taken out and here's kind of a baseline of treatment, but we're not going to really tailor that to you as a person. And I love the flexibility in bioidenticals also versus having to just only have those standardized dosages as well. You could probably speak a little bit better on that and how they work, but I really love that part of bioidenticals.

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Brittany (37:22.138)

That is such a good point, though we never get tested when we're optimized. We never go to the doctor and say, I feel amazing to see where my labs are at unless it's someone who's just going for a standardized routine care evaluation who gets the average blood work, but never the hormones, right? And so why go into all these deep dive tests if you're feeling good? No one does that. And that's an amazing point. So when we see them, it's like, well, don't you want to do labs? I mean, we can but my god, your body is communicating to you.

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Brittany (37:52.234)

And it's even true that that's the number one like white flag of the body is if you're not sleeping at night, that's the first symptom of a hormone imbalance. And that's because the dumpster is really coming out at night and cleaning up the body. And if you're not sleeping, it's not doing that. And that's a huge, huge sign of a you know, hormone imbalance. And a lot of our patients that's when they're like, God, I'm not sleeping. And then time goes on. Oh my gosh, I'm so irritable. And then time goes on. I have no libido and my husband and family just make me so upset. And then it's all of these months that go into years that go into years where they're like, you know, they're so sick and tired of being sick and tired. And I think that's the beautiful thing with treatment is, you know, you can meet them where they're at and also treat accordingly to that symptom. Because I say my first goal is for you to at least feel better. And then I'm going to get labs to make sure how you're responding. Do we need to kind of ramp it up?

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Is there an underlying thyroid issue? Because I know that you're not going to feel great if you have a horrible thyroid and your hormones are balanced, you're going to be like, I feel good, but something's missing. And that's never what you want to hear from a patient, right? Like, I always ask if I could wave a magic wand right now and fix one thing, what would it be? Oh, my God, I just want to sleep or it's like, ah, okay, this is what we need a target for right now. Because if that works, then everything else kind of catapults, right? And so

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I love that analogy, though we don't get evaluated when we feel optimized. So where were you anyways, right? I mean, different levels. I really, really love that. But I feel too, if this really kind of hits home for anyone or loved ones or friends, please go to thriv lab.com fill out a self assessment. You can even learn how to book an appointment with Miss Raquael or Jordan and kind of dive into all things hormones and outcomes.

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And you know, Raquael, I'm so thankful that we got to, you know, be on this together and hear some background and your personal story that I know that our patients are thankful for, because it makes them know like, it's not just me, right? Like it's not just me. And I'm thankful that you were able to share this with the world through Apple and, you know, Spotify and all of our streaming services. So if you want to, you know, continue listening to our podcast on Hormone 

Harmony, feel free to go you know, to Spotify, Apple Podcasts, Amazon, we are trying to spread the word that for yes, women and men, there are opportunities for you and you can listen and dive into anywhere that you listen to your podcast, or even you know, streaming services for these health and wellness topics.

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And so it's been so amazing, Raquael. Thank you for hopping on and for those listening. If you want a part two, three, four, five, believe me, I agree, because this is just the beginning on what this can do to our bodies. But until next time.

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Raquael Flores (40:47.374)

Thank you.