Why Midlife Women Need Attention

SPEAKER_01 0:00

It's something that needs so much more attention. You know, for far too long, like women's health just wasn't given the, you know, concentration and and the really the research and everything that it's needed. We focus so much on pregnancy and fertility and wellness during reproduction, but it's almost like everyone kind of forgot about us after we're done having babies. Right. And and now that pendulum is swinging and women are demanding better. And it's so rewarding being able to help women through this, you know. And I think that, you know, ultimately we have this saying at Winona that we want to make the second half of your life better than the first. And that I think is is so important. Like let's keep each other healthy and vital and focus on longevity and keeping ourselves the healthiest we can be. You know, there's no reason that we have to think of it as a decline. It's not, it's just a metamorphosis of sorts,

Show Intro And Medical Disclaimer

SPEAKER_01 0:53

you know.

SPEAKER_03 0:53

Welcome to Hormone Heroes, where I share testimonials from real people who have experienced bioidentical hormone therapy. Men and women share the symptoms they have experienced and the difference proper hormone replacement has made. I'm your host, Dr. Kelly Hopkins, and I have been in the functional medicine space for over 30 years, with a focus on hormones for 20 years. Please keep in mind this podcast is for educational and entertainment purposes only. Please consult with your physician or practitioner for medical advice. Let's get started with today's guest.

Meet Dr. Kat And Her Background

SPEAKER_03 1:28

I am so excited to have Dr. Kathleen Brown, also known very fondly as Dr. Kat. She is a board-certified OBGYN, Menopause Society certified practitioner, and medical director of Winona, a national telehealth provider focused on menopause care. She has spent her career caring for women across different stages of life, from pregnancy and labor through perimenopause and menopause. Dr. Brown began her medical career in the U.S. Army. Thank you for your service, Dr. Brown. Thank you. She completed her OBGYN residency at Tripler Army Medical Center in Hawaii, and she has served women on Army bases across the country for 12 years. Today she lives in Philadelphia with her three children. And she continues to work in labor and delivery in Philadelphia while helping women nationwide access personalized evidence-based menopause care through Winona. Her approach centers on giving women clear practical information about hormonal changes, treatment options, and what symptoms should and should not be simply dismissed as aging. So, no further ado, welcome Dr. Kat. Well, thank you so much for having me.

ROTC Scholarship And Army Residency

SPEAKER_03 2:47

So just tell us a little bit about what made you go into the army.

SPEAKER_01 2:53

Well, yeah. So I came from a family where really no one had gone to college before me. And so very much blue-collar workers. My mom had actually gone to a junior college and was a court reporter, but no one had done like a four-year degree. And so when it came time for me to go to school, you know, I had waitressed all throughout high school. And so when it came to college, you know, there was no magic college fund. And I remember actually being on the campus of my college and there were these people repelling off the field house, you know, which is our big gem basically. I thought, wow, that that class looks kind of cool. And so I signed up and it was ROTC. Oh wow. Yeah. So a couple, a couple months into it, like the the teachers, which were, you know, actual active duty officers in the army that were assigned there to teach, you know, military studies and military history, said, We're, you know, we're giving out scholarships, and anybody can apply. And me and two other girls were like, whatever, let's go ahead and apply for these scholarships and just see what happens. And we all got them. And so, you know, we signed on the dotted line, took the scholarships, and and you know, they paid for the rest of our college education, which was great. And I knew I wanted to go to medical school, and so I knew I was going to need a lot more money to pay for school. So then when it came time for medical school, I also applied for the health profession scholarship program. And so they paid for medical school as well. And so my payback then to repay my education that they paid for was to then go active duty and pay my time back in years. So, but it was a great opportunity. And I met wonderful people throughout my time in the army. And I served as an OBGYN. So I did my training in the Army, which was one of the best OBGY and residency programs, in my opinion. Of course, I'm a little biased, but you know, I moved from Philadelphia out to Hawaii and had a complete culture shock, you know, moving across the country, across the world. But it was an amazing experience, you know, because when you're in residency, you basically we call them residents because we live at the hospital almost, you know. Yes, you do. But then when I was off duty and I wasn't working, I kind of pretended like I was a tourist and I did snorkeling and went sightseeing around the island. And it was a fabulous place to to learn and to work. And, you know, we were all kind of landlock on the island and from all over the country. I met people from all over the country that were, you know, in my residency program and met some amazing teachers that, you know, taught me how to be the best doctor I could be, which was great.

Why She Chose OB-GYN For Life

SPEAKER_00 5:20

Uh-huh.

SPEAKER_01 5:20

Yeah. So that that's kind of how I got into the army was that really a means to pay for my education. And did you always know you wanted to be a doctor? It's funny. When I was little, my mom had this like, you know, school time book, you know, where you put a picture and you write who your friends are. And when you look at that book, the early years, like six, seven, eight years old, it was always like doctor slash rock star, doctor slash ballerina. You know, I back then I thought I could do it all, but I always had that pervasive, you know, idea that I wanted to be a doctor. And one of my earliest memories, I remember going to the pediatrician. I remember them having these like big wooden hobby horses in their lobby and giving up pretzel sticks when you checked out. And I thought, I want to do that job. That like seems cool. Uh-huh. But when it came time to learning pediatrics, I wasn't too fond of pediatrics. I didn't like that the patients couldn't tell you what was wrong. And I didn't like, you know, giving kids shots and stuff like that. I just naturally started gravitating toward women's health. And where I went to medical school, which is the Philadelphia College of Osteopathic Medicine here in Philadelphia, they really tried to kind of groom us to go into primary care. You know, they wanted to really graduate a lot of primary care doctors, you know, both internal medicine and family medicine. And I liked all my rotations. I felt like I could have done any of them, but every rotation I did, I kind of gravitated toward women's health. And then the people that were training me found out, well, she's pretty good at pap smears and pelvic exams. So they would like give me all their work to do when I was and you know, when it came time to choosing a residency and a specialty, someone gave me very good advice. They said, you know, forget about all the nice people you met on your rotations and forget about all the cool things they do. When you're hungry and you're tired and your body hurts, do you still love it? And if and if you do, that's what you should do. And and you still loved it. And I still loved it. Like no matter what. Even I was actually on call last night and delivering babies at 3:30 this morning. Bless you. So, you know, because babies don't come on the nine to five for sure. But yeah, OBGYN is a specialty unlike any other. You know, we get to do emergency care for women, we get to do primary care for women and have that continuity of care with women. But then you also get to do surgery and you get to deliver babies, which delivering babies is like the best job in the world. 99% of the time it's happy. Like that one other 1% is hard. But and then now, you know, taking care of women in midlife and after, you know, with my other job at Winona, that has been so rewarding as well. You know, and it's it's something that needs so much more attention, you know, for far too long, like women's health just wasn't given the, you know, concentration and and the really the research and everything that it's needed. We focus so much on pregnancy and fertility and wellness during reproduction, but it's almost like everyone kind of forgot about us after we're done having babies.

SPEAKER_02 8:20

Right.

SPEAKER_01 8:21

And and now that pendulum is swinging and women are demanding better. And it's so rewarding being able to help women through this, you know. And I think that, you know, ultimately we have this saying at Winona that we want to make the second half of your life better than the first. And that I think is is so important. Like let's keep each other healthy and vital and focus on longevity and and keeping ourselves the healthiest we can be. You know, there's no reason that we have to think of it as a decline. It's not, it's just a metamorphosis of sorts,

WHI Fallout And Menopause Advocacy

SPEAKER_01 8:51

you know.

SPEAKER_03 8:51

That that's that's so well put because you know, the WHI study, the women's health initiative really screwed a lot of women out of their hormones. You know, my grandmother's generation, uh, a lot of those women had had hysterectomies because that was the answer for everything back then. And they were just ripped off their hormones and and told to get it out. And there's been so much more research done now. And you and I were talking about a recent development over this past weekend where tell us what you were telling me about that.

FDA Workshop On Testosterone For Women

SPEAKER_01 9:29

Well, yeah, last week was a very big week for women's health, and that on Wednesday, several physicians and lobbyists went to, you know, DC to actually go to Congress to appeal to them to, you know, put more effort and more research money and more funding into women's health, specifically menopause. And they actually, you know, testified to why and and why we need this. And there are some lawmakers involved that are like for this. Like, let's let's start putting money toward researching and funding this. And then on Thursday, there was a big all-day workshop at the FDA where several OBGYNs, endocrinologists, and neurologists that are very um, you know, outspoken and and very uh big in the space of menopause and helping advocate for women's, you know, health and women's rights were there to talk about testosterone for women. Woohoo! Yeah. Yes. Giving the FDA the evidence and the medical information to talk about how safe testosterone is, but how vital it is toward women's health. And not a lot of women realize that they actually have testosterone too.

SPEAKER_02 10:37

Right.

SPEAKER_03 10:38

And and when we're young and healthy and cycling, we actually make 10 times more testosterone than we do estrogen. So it's a very important hormone.

SPEAKER_01 10:48

It is for females. And right now in this country, testosterone is treated like a controlled substance. And so, and for those listening, not knowing like what what is what does that mean, a controlled substance category? It means that it's treated like a narcotic. Right. It's treated like a medication that can become addictive to people. When this is really a hormone that is flowing through our body naturally, and with the loss of it, we lose our muscle mass, we lose our energy, we lose our balance, our stamina, but also libido and sex drive, which is an important part of life. But, you know, it it works alongside estrogen to keep our keep our bones healthy, to keep our heart healthy.

SPEAKER_03 11:30

100%.

SPEAKER_01 11:31

It's not like a, you know, a posh or you know, an exogenous thing, you know, extra thing that's just for luxury. Right. It's a necessary hormone, right? Yes. And so up until now, anybody that wanted to prescribe testosterone, you have to prescribe a male form of testosterone. There are no products made for women. Right. And so this workshop that they had was a huge deal in the in menopause, you know, land, basically. Yes, yes. Because, you know, the last time the FDA had a huge work workshop related to any kind of hormone therapy was last summer. They had a big workshop to talk about estrogen. And as a result of that expert panel that they had, they removed the black box warning office. Thank goodness, yes. I know, yeah. So, you know, these things that they hold and and getting all this consolidated evidence from the experts like really goes a long way to changing patterns and making things better, hopefully.

SPEAKER_03 12:27

Yes. So yeah.

Her Perimenopause Symptoms Got Missed

SPEAKER_03 12:28

Well, do you have a personal story you'd like to share about your own journey?

SPEAKER_01 12:34

Yeah, yeah. You know, it's it's interesting. I've told this story before, and anybody that's ever seen, like I have a personal, I have a professional Instagram as well. And I think I've told this story on a reel before. So they may have heard it before if they've seen me before. But when I was going through my training as an OBGYN, like we studied hormone therapy in my residency very briefly. It was like, study this for the exam. You know, we had to take an in-service exam every year that prepared us for a board certification when we were graduate. And I remember our attendings telling us, you know, study this, learn this, learn about primary, and learn about all these things. But as soon as you're finished the test and as soon as you're done your board certification exam, you're never going to use this because of the women's health initiative study. We know this is so dangerous, you're never going to use this. And so I spent the bulk of my career never really treating anyone with hormone therapy. I, you know, we focused on period management and everything. So for me personally, as an OBGYN and as a woman, I just I was really clueless. I thought I was going to be totally fine until I turned 50. And I thought overnight, around 50, things would start happening and I'd start noticing symptoms. You'll, you'll address it then. Right. And I just thought, I'll just keep pushing it off and pushing it off, right? And so then I ended up having a hysterectomy for other reasons. And then shortly after that, in the months to follow, I started having symptoms, but I kept my ovaries. I didn't have my ovaries removed. So in my doctor brain, I was like, there's no way. That's not it. It's got to be stress, it's got to be changing jobs. I was going through a divorce from my kid's dad. Yeah. There were so many other things happening in my life that I kept blaming it on other things. And that I remember making Thanksgiving dinner for my family. And I remember being in the kitchen thinking, there is no way I can stay in this room. I kept going out my front door in the dead of November when it's cold without my sweater on and just standing outside, just hoping to cool down. Steam's rising off of you. Yes. And my face is flushed and red. And here I am, like, you know, in my early 40s as an OBJYN. And I was completely clueless and I was having hot flashes. I just thought it had to be the oven, right? Right. So then ultimately it started to dawn on me. I'm not sleeping as good. Then I started dating again after my divorce several years later. And I was like, my body's not responding the way it used to. My vagina's not responding the way it used to. What is going on? And then I thought, oh, I'm going into perimenopause. You know, like I started reading and reading and learning. And it was really a lot of self-education because everything I had learned in residency was like, learn this, learn the medications, move on. Like, don't, don't dwell on this. And we never used it. And so I really started doing a deep dive to try to help myself. And then I went to my own family doctor and like brought my log of symptoms and told her what was going on. And she was like, no, you're too young. But I've done the re the reading. Like I've been all over the menopause site. I've been reading everything. I have like 20% of this symptoms, and I have all this constellation of this. She's like, Well, I I'm not going to treat you with anything unless your hormones are abnormal. So she sent me for lab tests. And of course, on that particular day, all my labs were completely normal.

SPEAKER_03 15:52

So she's already normal for perimenopause. But she said, No, no, come on.

SPEAKER_01 15:57

Come back after you're, after you're really, really suffering, you know, in your early 50s, then we could talk. And so around the same time, the chief medical officer of the company I work for now actually approached me because they were an early startup telemedicine company. They started in California and then expanded to Texas and they were looking to expand to Pennsylvania. And we worked for the same national company for a labor, like a laborist organization to provide labor and delivery coverage. And so we were in like a network, you know, together. And he reached out and he's like, hey, would you ever be interested in doing telemedicine? I, you know, I'm in this company. We're providing menopause care and we're looking to expand to Pennsylvania. And so we met up at a conference and he kind of showed me the platform. And I was like, yeah, this is something I'm interested in. Because in my mind, I was like, I am going through this. I need help too. So let me start helping other women with the education I have. And then it just expanded from there. You know, and so I've learned so much from my patients over the years. I started working with Winona in 2021. And then just last year, I finally sat for the the menopause society certified practitioner exam. And just to put all my knowledge, you know, down so that, you know, I would have that credential so that patients knew that I had the experience and the knowledge to help them. And so that's that's been my journey. It was really self-driven, honestly. Yes and self-driven.

SPEAKER_03 17:24

Well, and you you have the experience of doing it all yourself. And the treatments, you know, work and your symptoms are all allevi alleviated. And then to have the credentials behind your name, that that's so comforting

What Winona Telehealth Actually Does

SPEAKER_03 17:40

for women. So buywanona.com. Tell us about the name first of all, and and then we can talk about the website.

SPEAKER_01 17:50

Yeah, so Winona itself is an old term. If you go to our website, there's lots of free information. You don't have to actually be, you know, one of our patients to actually, you know, go on there and read the information and and read stuff that we have about you know the care that we offer. But Winona, it comes from it's from the Sioux Dakota language. Okay. And and it was the word is Winona, which means firstborn daughter. So it's, you know, it's basically to represent the essence of womanhood, is why they chose that name. And so, you know, we really want to take care of women as they're really getting into that deep part of their womanhood in midlife. And so we're an online telemedicine platform that provides hormone therapy to women between the ages of 35 and 60. So we really focus on your low risk patients, people that um, you know, uh really have no medical issues that are gonna make hormone therapy more complicated for them to take. Not that women like that can't take hormone therapy, but they're better served by an in-person doctor who can monitor them more closely. Yeah. But we we exist for those women who've gone to the doctor, who've been trying to get answers, who are told, no, we're not gonna prescribe, or maybe they've seen several different doctors in their lives and they just keep getting that shut door and not getting the help that they need. That's why these online telemedicine platforms like ours exist.

SPEAKER_02 19:16

Right.

SPEAKER_01 19:17

So we have our own pharmacy. We do compounded estrogen and progesterone cream, but we also supply FDA-approved versions like the bioidentical estrogen pills, patches, and micronized progesterone. We don't do any synthetic hormones whatsoever. Everything's bioidentical.

Bioidentical Vs Synthetic Hormones

SPEAKER_03 19:35

Let's talk about the difference for someone that may be listening that doesn't know the di Can you describe the difference between bioidentical hormones and synthetic?

SPEAKER_01 19:45

Yeah, basically, bioidentical is just an adjective that describes that that particular hormone is identical to one of the hormones your body is creating on its own or was creating on its own in normal amounts. So, as human female women, we have three types of estrogen flowing in our body, and that's estradiol, estriol, and estrone. And then we also have progesterone. All of our sex hormones come from the cholesterol pathway. We have, you know, several different things in our body and enzymes and hormones that convert hormones from one to the other. Our body converts testosterone that it makes in itself to estrogen and back and forth. But when we're talking about bioidentical, you're taking a medication that is exactly the same as what your body was making naturally on its own. Whereas synthetic, these are slightly different versions of those hormones. These are chemically made in a lab. If you remember from like high school chemistry, these are isomers of the bioidentical hormones. So when you think about synthetic hormones, the most popular one that everyone is familiar with is birth control pills, right? So when we look at the name, like all these birth control pills have fancy women's names now, like Lilith and all kinds of different names. But when you look at the actual medication that's in it, it's generally ethanol estradiol, drospyrinone, which is a form of progesterone, or progest different forms of progestins, which are synthetic. So these are all like chemically made similar compounds, but not chemically identical to what your body makes on its own naturally. So, in general, bioidentical is considered to be safer just because these chemicals your body recognizes more readily. It incorporates them more readily. And so you don't have to use as high of a dose for your body to recognize and use it.

SPEAKER_03 21:33

That's fantastic. And what a great explanation because synthetic hormones don't interact with the hormone receptors quite the same way a bioidentical hormone does. So when you're introducing these wonderful bioidentical hormones, your body doesn't know if it if it came from your ovaries or adrenals or fat cells or if it came from a pill you took or a patch you have on or whatever or cream. So the Safety of bioidentical hormones is so much higher. And but hormones in general have gotten a bad rap because of the WHI studies. That WHI, yes.

SPEAKER_01 22:13

I mean, everybody reflexively it told it caused such a global panic to hormones. And everyone took women off of hormones. Doctors were cutting people off. And it was it was this fear that, you know, you're gonna get breast cancer if you continue taking this. And it's widespread fear. But, you know, there were some good things that we learned out of the WHI. We learned about the appropriate time to start hormone therapy. We learned that it's actually safer the earlier you start it rather than waiting too long after you've gone through menopause. I mean, we and there's so many more good studies that have come out since then that we've learned so much more about the safety profile. And just comparatively, I think that most women in America have been on some kind of birth control pill at some point in their lifetime.

SPEAKER_02 22:56

Yes.

SPEAKER_01 22:57

The dosage in their birth control pill is so much higher than the bioidentical dosage they would take for hormone therapy. And the risks involved with birth control pills are so much higher than it would be with hormone therapy. So your risk of getting a blood clot, and you know, a DVT or a pulmonary embolism, blood clot that goes to your lung is dramatically increased with birth control and so much lower with a hormone therapy. Yes. And I think women don't really realize that. You know, I think that they think the birth control is a safe thing because it's just preventing pregnancy. But hormone therapy is by far safer of a medication when you compare the two. But yet everyone prescribes birth control like nothing, right? Right.

SPEAKER_03 23:38

So I don't know. What what what the heck?

How Online Treatment Works Step By Step

SPEAKER_03 23:42

So uh walk us through if someone was interested in going to your website and looking into being treated online with you guys. What tell us walk us through that process?

SPEAKER_01 23:54

So it's really easy. When you go to the website, there's a button basically on that main page that says get started. And the first thing it will ask you is what state you're located in. So our telemedicine platform is active in 38 of the 50 states. And so first thing is to find out if we're available in your state. And if you are, if you put in your state and it says, great, we are available in your state. If we're if we're not in your state, you'll get a notice that says, I'm so sorry we're not in your state yet, but we might be soon. We'll keep you updated and you can put your information in. And we also have information on how to find resources if you're not in one of the states that we serve.

SPEAKER_03 24:32

Sorry, I was just gonna point out that if they go to your website, there are so many good resources that are free that you don't have to become a patient to to get your hands on. But also the knowledge, yeah. You're you're able to refer them to someone in their state appropriately until you you guys become available. And I do want to point out that Dr. Kat is actually in 22 of the states. So the chances that you would actually get to work with Dr. Kat are pretty high. But I just wanted to interrupt you and say that.

SPEAKER_01 25:07

Yeah, no problem. So after you select your state, it'll take you through an interactive onboarding questionnaire, basically, which is an adaptive questionnaire which will ask you medical issues in the past. We screened for the most common medical issues that might make hormone therapy a little bit more complicated for someone to take. Like if you've had a blood clot in the leg or the lung, if you've had a heart attack, if you've had a breast cancer or a GYN-related cancer, that that does make you a little higher risk for taking hormones, especially if your cancer was hormone receptor positive. So that can, it doesn't mean you're not a candidate for hormone therapy. It just means that whoever's going to prescribe hormone therapy for you really needs to collaborate with your cancer doctors very closely so they can make sure that you're safe and they can monitor you very closely. And so it'll ask you for those things and we ask you things like your medical history, and we don't really care if you broke your leg at age five. We're asking you things that are related to your women's health, your cycle. Have you had a hysterectomy? Have you not? Do you still have your ovaries? Do you not? And because some women can start going through perimenopause as early as their mid-30s, we also ask about are you trying to still get pregnant? Because some women are still maybe dealing with the challenges of fertility while also starting to have symptoms of perimenopause. And it's important that we know that if we're going to treat you with hormone therapy, because if you were to become pregnant, we'd want you to stop it right away. Right. Yeah, just because you don't want to, you know, be exposed during a pregnancy to something like that. But it'll go through all of that. And once you go through the questionnaire, you put all your medical information in, then your information, it'll it'll go through our treatment options and all the different forms of estrogen that we offer. Um, and your chart will be forwarded to one of our board certified doctors in your state who will review everything. If you have questions and you want to talk to the doctor before anything is prescribed, you would select that and you're on boarding. Like pre-please contact me before any prescriptions are placed. But if you don't and everything is straightforward and you're a low-risk patient, you really could get a prescription ordered the same day your chart is reviewed.

SPEAKER_03 27:10

That's a that's incredible. So let's talk about. I love that you're so well versed and educated, the the company as a whole, that you would be able to talk to someone, learn enough about them through their medical history and their symptoms that you would know enough to treat them without doing blood testing, saliva testing, urine testing. I mean, what a way to take that block away for some women that don't have access to that kind of testing. Or this is a a lovely resource for someone that that either can't afford testing or can't get their hands on it.

Treating Symptoms Without Hormone Labs

SPEAKER_01 27:54

Yeah. And and honestly, I mean, the American College of OBGYN and the Menopause Society recommend treating based on symptom profile. Okay. And so labs really aren't necessary. Like for us as experienced providers in taking care of women with menopause, like I can look at a patient's symptoms and know based on, you know, what the degree of their vasomotor symptoms are, how often they have night sweats and hot flashes, that they need estrogen versus, you know, and when they need progesterone, when their body needs more testosterone, you know, how, and we can look at their symptom constellation and figure out what they really need. But so much of treating with medications and especially with treating with hormone therapy, it's really like I tell women, it's kind of like trying on clothes, right? So we might have an idea as the practitioner, as you know, as the physician, as to what we need to treat them with. But it's really about trial and error. It's about ordering something, having a woman try it, get that hormone incorporated into her body, seeing how her symptoms respond, and then we adjust fire and we adjust the dose based to, you know, to get her feeling better. Yeah. And so there's some tweaking and some art to it too. But we have to start somewhere. So we start with a with a dose with, you know, based on an algorithm looking at the patient's BMI and their constellation of symptoms, and then we go from there. And and many women do very well. I would say probably our our most popular treatment option is our compounded cream. And there's a lot of different telemedicine platforms out there available on the web. Like we've had quite a few competitors pop up since Winona started, but none of them offer any compounded cream. That's something that we do very different. Uh-huh. And we can do that because we actually own the pharmacy that's making the compounded cream. And so we can put our quality standards the best that we can. And we know that we're, you know, giving a good product that's reliable from batch to batch of each prescription. And and women love the cream. Oh, yes.

SPEAKER_03 29:53

I've I've used cream since 20 years. I hate to say my age on the podcast, but at least 20 years. Yeah. Let's talk a little

Compounded Hormones And FDA Confusion

SPEAKER_03 30:04

bit. I know there's some arguments back and forth about FDA approval and compounded things not being FDA approved. I personally love everything compounded in in our clinics. We treat the patients with compounded pellets and creams and trochies and all these things. So what what's your what's your stance on on the FDA approval situation with compounds?

SPEAKER_01 30:31

I mean, I think when you look at the big scale of things, it's impossible for the FDA to approve all compounding pharmacies, right? Most of the time, like if I were to write a prescription for a local compounding pharmacy, that's my corner pharmacy, that I know the pharmacist, I communicate with them, and I know, you know, his skills and his experience, and I have experience with what he's making, right? The FDA does not have the ability to go through and to really regulate all that on a grassroots level. Right. So that's why these larger larger organizations can't give a blanket approval for compounding products because there's so much variability from one location to the next, right? A compounding pharmacy near you compared to New York City, compared to like rural Mississippi or somewhere else in the country, it might not be the same, right? Everybody's skill level in making a compounded product is different. You know, we can't always, you know, verify the uniformity of everything across every single place that can make compounded stuff. Right. That's why like these larger, large organizations like ACOG and the FDA can't, you know, put their stamp of approval on it. But when we're taking the individual ingredients, when we're making a compounded cream, it has estradiol and it has progesterone in it. Those individual ingredients are FDA approved before they're put into the compounded product.

SPEAKER_03 31:53

Yes. Thank you. I was hoping you would say that.

SPEAKER_01 31:55

Yes. So, you know, we're taking the same estradiol that's being pressed into tablets in a factory in a in a big pharma factory, but it's in powder form, it's being put into the cream. Once it goes into the cream, it's no longer FDA approved, but the individual ingredients were before they were mixed into it. Thank you. Yes. Yeah.

unknown 32:14

Yeah.

SPEAKER_01 32:14

So I think that, I mean, yes, I think that a lot of the experts out there, like if you look at a lot of the menopause doctors that are like big gurus on the internet, the ones that, you know, have been interviewed by Oprah, and I'm not going to say names. Right. They they're very anti-compounded, but they're you can't finesse the dosage of all FTA approved medications for patients, right? So you can like they only make two different estradiol pill doses, one milligram, five mil or two milligrams. So if someone needs a three, they're having to get a pill splitter and do this. Whereas with compounded products, we can finesse and change their dose unique to them. Yes. Which is which is really nice. And honestly, some women just do so much better on them. I've had a lot of patients over the last five years at Winona who have, you know, started with us because no one was willing to prescribe. And then they come to me and they say, guess what? My family doctor sees how great I look, how much better my labs look, and how great I feel. And now they're willing to prescribe. Like we've converted them. But then what happens is they go, they go off of our meds, they go get an FDA-approved product and use their prescription plan and then get, guess what? They don't feel as good. Right. Right. And so some of them have been gone like six months or a year or even two years, and then they come back and they say, can I please go back on the compound? Yes. And we've got a lot of patients like that. Yeah.

SPEAKER_03 33:36

Yeah. And just to mention, compounded, compounding pharmacies do have have boards and things they answer to. So it's not like everybody's just, it's the wild wild. It's not everyone's like rogue making little cocktails in the basement.

SPEAKER_01 33:53

Yeah. Right, right. There are standards. There are start state pharmacy boards too that pharmacies have to abide by their own state regulations and you know, of how much variability there's allowed to be in a product that they're making and they get randomly tested. So I don't think patients realize that. Right. Yeah. So it's a valuable tool that we have that not enough people use, I think.

SPEAKER_03 34:18

Right. But more and more are every day, though.

Shipping Convenience And Patient Reviews

SPEAKER_03 34:21

And I do want to talk about your reviews on buywona.com. Okay. Uh five-star reviews. And there's a lot of good videos of people telling their stories, which I I think is always valuable. So, you know, talk the the reviews are are glowing about symptom relief and uh just things like that and the ease of the use of the of the website and things like that.

SPEAKER_01 34:52

So and I think the big thing too is like getting getting a prescription ordered and having it mailed directly to you, not having to go through like dropping off a prescription, waiting to see if it's going to be approved, waiting to have the pharmacy get it in stock, and then having to go back and pick it up. You know, you're saving so much in the you know scope of your time. And the convenience of having it mailed directly to your home is is really nice. A lot of our patients really like that.

Cost Without Insurance And HSA Options

SPEAKER_03 35:20

Does insurance cover any of that?

SPEAKER_01 35:24

So we we've decided not to do insurance. We're all self-pay, but we have lots of patients that use, if they have an insurance plan where they get an FSA or an HSA card, you know, a flexible space spending card, they're able to use that to pay for the medication. And I want to know on our website, you're never going to pay to have an additional initial consultation with your doctor. You're not going to pay to communicate with your doctor. The only thing that you're paying for is for the actual medications. Okay. Which is nice. Yeah. And then we've had a lot of patients over the years too that are able to, you know, get a receipt and submit it to their insurance to get reimbursed too. But the the way, the reason why we do this is we didn't want any barriers, right? So medical insurance in this country, there are so many barriers. There's so many insurances that require prior authorization for medication to be approved, and then things not being in stock. And so that's it's just another roadblock for women. So we understand that sometimes financially that could be difficult for some women. There are other platforms out there just like ours that do accept insurance. And so there's alternatives if you must use your insurance. There's there's so many out there, and and we welcome the competition because that just means there's more care available for women across the country. Yes.

SPEAKER_03 36:37

You know, out of the gazillions of women going through menopause, and we'll always continue to go through menopause. There's enough work for everyone for sure. Absolutely. I just want to thank you so much, Dr. Brown, for the education you've given us today. The website, everything is in the show notes, but it's by why Nona.com, and that's B-Y-W-I-N-O-N-A.com. And chances are pretty good you might actually get to work with Dr. Kat Brown. So that would what a treat that would be. But I appreciate your time so much. Is there anything thank you so much? Any lasting, uh any last words of wisdom you'd like to give us as a hormone hero?

Advocacy Mindset And Midlife Freedom

SPEAKER_01 37:23

If women like the way that I explain things, I also have an Instagram page you can follow. Yes. There's a lot of menopause educators out there, but I think that it's important to find somebody that you kind of, you know, resonate with and you like the way they explain things. And so if if you like the way that I talked about it today, follow me at Dr. Catobg Y N on Instagram. I think there's a Facebook page and a TikTok and a Reddit and all kinds of stuff now.

SPEAKER_03 37:50

Uh-huh. And all that will be listed in the show notes as well.

SPEAKER_01 37:54

Yeah. But I think that I just encourage women everywhere to learn as much as you can about your body. Learn what's happening with your hormones. You are the best observer of what's happening in your body and you know your body best. And so don't be afraid to advocate for yourself. Don't be afraid to empower yourself with the knowledge. And don't take no for an answer. You know, so if you're suffering and you're not getting the help that you need, platforms like mine exist, but do not take no for an answer. Do not continue to suffer. And share this information with other women in your life. When you're meeting with your book clubs and you're going for coffee with girlfriends and you're talking with women at work, talk about this stuff. We need to help each other, right? Yes. You know, the how women help each other is so important and how we can help each other through this transition. And I think that, like I said earlier when we were talking, like, this is not the end of the world. This is menopause is such a freeing time too. Like when we age as women, we become so much more knowledgeable, so much more assured of ourselves and so comfortable in our own skin. We don't really care what anybody thinks anymore.

unknown 39:04

That's wrong.

SPEAKER_01 39:05

But you know, I think that there's the freedom in that. And, you know, other societies have really revered aging women in their populations, you know, like medicine women and elders, and you know, look look toward this transition as your chance to really transform into your best self. You know?

SPEAKER_03 39:23

Oh, I love that. Yes. And you're you have all this wisdom and life experience. Plus, now you have your hormones back. So you're you're gonna you'll be so much more productive in the second half of your life than you had time to be when you were younger and raising families and things like that. So it's it's a it's a beautiful thing. Hormones are a beautiful thing. They are. All right. Thank you, Dr. Kat. I'll let you get back to your patients. Thank you so much.

SPEAKER_01 39:52

It's been lovely talking with you. Thanks for having me.

SPEAKER_03 39:55

Uh-huh.

Subscribe Review And Share Your Story

SPEAKER_03 39:56

Thanks for listening to Hormone Heroes. Take a moment to subscribe wherever you listen to podcasts so you don't miss the next episode. While you are there, help us spread the word by leaving a rating and a review. If you would like to share your bioidentical hormone story or need help finding a physician in your area, please email us at drkelly at hormoneheroes.org. That's D R K E L L I at H O R M O N E. H E R O E S dot org. We want you to be a hormone hero.