Managing Menopause & Navigating Hormone Replenishment with Dr. Liz Lyster

This is the transcript of an interview hosted on Ruth’s Feel Better. Live Free. podcast.

Ruth Soukup: Did you know that perimenopause lasts on average 10 years for most women? And when you consider that women make up 50 percent of the population, this is a significant amount of time for a topic that gets largely ignored. So why is that? And as women, what can we do to take more control of this piece of our life that has such a huge impact on our quality of life, even when no one’s really talking about it?

That’s exactly what we’re going to be talking about today as we dive in with best selling author and menopause expert Dr. Liz Lister. There are so many gold nuggets and takeaways in this interview that you’re probably going to want to take notes. So let’s get started.

Dr. Liz Lyster: Real.

Ruth Soukup: Today we’re going to be chatting with Dr. Liz Lister, who is an OBGYN medical doctor, a bestselling author and speaker, and an expert in perimenopause and menopause. And today she’s shedding some serious light on a topic that is still for the most part largely under ignored and misunderstood by the medical community. Paramenopause, menopause, and hormonal replenishment therapy.

It’s definitely a must listen for any woman in your 40s or beyond. So without further ado, I am so excited to be able to introduce you to today’s interview guest, Dr. Liz Lister. Dr. Liz, thank you so much for being here today. I’m so excited to talk to you. 

Dr. Liz Lyster: Absolutely. My pleasure, Ruth. Happy to be here with you.

Ruth Soukup: Yay. So let’s talk about menopause because it’s a big thing. It is a big, big thing. And I think that Before we do that, though, I need to just ask you about yourself, but I totally flaked out on my first question. Like, so excited to jump into this topic. Can’t even wait. But first, tell us a little bit about your background, because I think that’s actually really, really important.

So tell us about who you are, what you do. How you got to be doing what you’re doing now. 

Dr. Liz Lyster: Absolutely. You bet. So first of all, I’ve Dr. Liz Lister, and I want to just help you out by saying that I went into menopause when I was 43 and I’m 59 now. So everything that we’re going to talk about, all the questions you may ask and everything that we go over, I have personally experienced, asked myself those questions, looked in addition to the research as well as my own experience.

I am an OBGYN, board certified, I stopped delivering babies a long time ago because I prefer to sleep at night. Then I kept narrowing my practice, so I stopped doing the major surgeries, I have my little kids, they’re both in their 20s now. And I just kept narrowing things down. So it got to the point where I was only doing office gynecology.

And then I had the opportunity to really become a specialist, an expert in the hormone balance piece. I had written my first book by that point in time, and I really loved it. And so that’s where I’ve been now for coming up on it. Well, almost 20 years of the focus on the hormone piece but really very narrowly looking at that.

And I just love helping mostly women, men as well, really of all ages, but primarily women in their forties and fifties balance their hormones and feel great. I think it’s our birthright to feel great, to feel sexy and to really fulfill on our potential. So that’s what I’m here for. It’s my assignment.

I love that. 

Ruth Soukup: I love that. So that’s interesting. Did you, you started with hormones really focusing in on hormones about 20 years ago. So that would have been before you actually experienced menopause. Did that, did anything change for you once you started going through it yourself? Or is it like, Oh, I know exactly what’s going to happen.

Or did it all, did it like kind of throw you off a little bit? 

Dr. Liz Lyster: Okay. Great question. It didn’t throw me off too badly for a few important reasons. One is my family background is from Argentina. My mom’s retired from being a doctor, my grandma, those women were incredible models for me of getting older and getting stronger and staying vibrant.

So that was very important. The other is that I don’t really know why, but I was always tuned in to learning about hormones specifically. That really has been a theme now that you make me think about it. I remember, this is way, I was still delivering babies and I was at a lecture and it was talking about certain hormones and animal studies and the development of breast cancer.

This is before the Women’s Health Initiative. And I just remember, I remember where I was when I heard that information. So I guess I’ve always had a particular draw to that. Kind of difference that angle and when I was in medical school I followed the chief resident into an exam room because that’s what you do when you’re a student you follow other people around a lot And we went and there was this woman having a lot of menopausal symptoms and honestly Ruth I don’t remember exactly what we did for her I don’t remember if the doctor I was following wrote a prescription or not But I do remember how much better the woman felt after we listened to her You And talked with her that left a huge impression on me.

So I think that’s probably just being heard. Yes. 

Ruth Soukup: Wow. Wow. So let’s talk about that. Some of the emotional challenges that you see that for women that happened during kind of this time of life, right? Perimenopause menopause. And what is the difference? Do you think between the physical and the emotional stuff?

Dr. Liz Lyster: Well, first of all, there’s no separation. You know about this, you’ve talked about hormones as the chemistry of our emotions. That’s how I refer to hormones. So there’s really no separation. The whole, the whole phrase, mind, body, it’s a little bit misleading, right? Because our mind is completely not separate from the body.

It’s very integrated. They are integrated. And so when we take that integrated approach we do a lot better. We get a lot further. I think that there’s a big connection and not a coincidence. I remember when I turned 40, I was not very happy about it leading up to it. And I didn’t want to have a party.

And then a friend of mine who was in her early forties persuaded me. So I had a party. It was a lot of fun. And as soon as I turned 40, I was like, Oh, Hey, this feels good. This is good. You know, you come into your own, right? As opposed to like when you’re in your twenties, I think a lot of people in their twenties.

And Probably even 30s thinking back for myself is very externally motivated What are people thinking like really got focused on that and when you enter your 40s? It’s such a wonderful fabulous opportunity in 50s. It just gets better Just that’s what I hear. 

Ruth Soukup: Like, I think the forties have been my best decade so far.

Like, I’m like, this is great. If the 50 is even better than this, then bring it on. I’m going to have the biggest party ever. 

Dr. Liz Lyster: Exactly. Exactly. When I turned 50, that’s when I went and climbed Kilimanjaro. That was 

Ruth Soukup: amazing. 

Dr. Liz Lyster: That’s amazing. Anybody listening who likes hiking. You can climb Mount Kilimanjaro. I mean, you have to prepare, you have to do things to get ready, but it’s not, you know, my mother was very afraid that I was going to have ice picks and clamps on my shoes and stuff.

She was like picturing…It’s a long, beautiful hike. And so I set myself that challenge. Then I found out from one of my patients, she goes, Oh, that’s interesting. When I turned 50, I went to Italy and did a cooking class for a week. And I thought, huh, I never, I’m 

Ruth Soukup: getting all the ideas now.

I love it. I love it. So what are the, let’s take it back to. Parabenopause menopause. Like what are, are there different phases that you go through and how do you know what, which phase you’re in? 

Dr. Liz Lyster: Okay, great question. I like to answer this question going backwards. So menopause is one whole year without your period, then you’re in menopause.

That’s the more or less official definition. Average age is 51. Okay. Then there’s years before that where everything’s marching along, regular monthly period, feeling good, sleeping well, managing your weight, that things are doing pretty well, that’s good hormone balance and that’s pre. Then there’s this big space in between which is perimenopause and that can include all kinds of disruptions.

Progesterone goes down first, then estrogen starts to decline or go up and it starts to get erratic. Meanwhile, testosterone and DHEA are declining, a lot of changes going on on top of the menstrual cycle changes that are like day to day changes. You’ve got these, that, that’s the perimenopause phase.

Ruth Soukup: And how, how long does that phase last 

Dr. Liz Lyster: or more years, 10 

Ruth Soukup: or more years? 

Dr. Liz Lyster: Yes. That long. Not for everybody, not everyone, but what’s most important for women listening is that if anything seems off that not to take the doctor’s word. Unfortunately, a lot of my patients that come to me because their doctor said, well, you’re still having your period.

So it can’t be your hormones. And that’s absolutely wrong. Mm-Hmm. That’s not true. . 

Ruth Soukup: So it sounds like it’s almost like this is still kind of an ignored Oh, it’s just a woman thing kind of thing. Yeah. In medicine, modern medicine. 

Dr. Liz Lyster: Is that true? You have that problem in modern medicine. We have it in medical research.

Right, I was reading something the other day about conditions that affect less than 1 percent of the population get hundreds of millions of dollars, and then conditions that affect women, which is half of the population, will get Under 5, 000, 000 dollars funding, or some huge discrepancy like that. And that, of course, is related to the pharmaceutical industry as we currently have that.

So it’s a challenge. It’s a, it’s definitely challenging. 

Ruth Soukup: And why do you. I mean, even from a pharmaceutical standpoint, like pure profit seems like it would be higher if you’re dealing with half of the population. So why is, why are women so ignored? 

Dr. Liz Lyster: Well, first of all, when we talk about anything hormonal and hormone balancing, we want to stick to bioidentical and bioidentical means that it occurs in nature.

Which also then means that you cannot take a patent out Something so 

Ruth Soukup: they can’t make money on it. So they’re not interested. 

Dr. Liz Lyster: Yeah certain ways certain things I mean if we were focused on health and wellness and preventing illness That would be an amazing shift. And I think that women are taking that upon ourselves to, to bring that shift.

Women want to, we want to prevent illness. We’re 80 percent of healthcare consumers anyway. So we love the men and we want them to be well as well. And a lot of, and men acknowledge this. A lot of the men that I see in my practice is because a woman in their life sent them. So we really, we really are, women can be the tail that wags the dog at a societal level and for sure we have to do that at an individual level.

You have to advocate for yourself. 

Ruth Soukup: For sure. How do you think having a sense of community helps women during this stage of life? Do you think that makes a big difference? Do you see that with your clients? 

Dr. Liz Lyster: I do. I definitely think it makes a difference. I think it’s very important. I love the topic of the blue zones and there’s a particular blue zone where women form little groups of four, little groups of four, and they are just there for each other through thick and thin ups and downs.

So I think community is essential. I think that it gets a little bit tricky. In the United States, our culture is very individualistic. It’s all about, I can tough this out, I’m gonna push through. So a lot of the women, you know, I take care of busy women. A lot of them are professionals very Lots of challenges that they’re dealing with as they are growing older and going through these changes And it’s just that it’s so important to remember That we we need each other.

We need community I think that’s happening. I think that’s why Podcasts are growing. Online groups are growing. As long as it doesn’t become a place of complaining that that can be a problem with online information, it can be a little bit limited. 

Ruth Soukup: Yeah, yeah, no, I agree. And, but I also see the, the, the amazing side of that, like in our, in our program, for instance, we have the most amazingly supportive community.

And I think, you know, I’ve been doing online business for a long time. I’ve grown lots of different brands and communities and things. And the one thing that I see with this demographic, right, that we’re in this forties and fifties is almost for women. And I don’t know if you’ve too, right. When you’re Focused on your family and raising your kids.

Most of your social network tends to be the parents of your friends, kids, right? You’re in sport, you’re going to sporting events. And so your friends with all the, the sporting though, to your parents or the, whoever, and then all of the sudden your kids. Get older and they leave the house or they’re not doing those activities anymore.

And that whole network kind of falls apart. And I see that so often from women sort of hitting this stage of life where all of a sudden your kids are older. So it’s not just, you’re dealing with all the hormonal changes that are happening. You’re dealing with all of a sudden, I feel like I’ve lost my sense of self.

I don’t know who I am. Because my kids are grown and that was my whole life. And I, now I don’t really have friends because these people I used to talk to you all the time about our kids. We don’t really have that in common anymore. And so now we’re not, you’re not doing like, it’s a, it can be a very like weirdly isolating, discombobulating kind of phase of life, I think for more reasons than just the hormonal stuff that’s going on, do you see that too?

Dr. Liz Lyster: Yeah, absolutely. I definitely see that. That’s why I am so passionate about getting the hormones balanced because otherwise you could really end up in a dark place. 

Ruth Soukup: Yeah. Because of 

Dr. Liz Lyster: all those changes happening around us, I think it’s so important. I mean, we have to work our brains. We have to keep up our interests.

And so I love encouraging younger women in that area as well. What are your interests? It’s always that the, the one movie, it’s a Julia Roberts movie where, how does she like her eggs? Where it takes her a lot, she goes through a lot personally, and by the end of it, she has to face the question, well, what do I like?

Oh, I don’t think I’ve seen that movie. It’s great, I’ll think of the title, I’ll mention it. Is it 

Ruth Soukup: the? Eat, pray, love. Is that the one? 

Dr. Liz Lyster: It’s not that one. I want to say Runaway Bride. Oh, I want to say that one. I’ll, I’ll double check on that. But we’ll put it in the show notes. That’s what that’s was my takeaway from that movie.

Yeah. And she spent so much time and this is what we’re talking about is we as women. We spend so much time taking care of everybody else. One of the phrases I like is no airplane captain ever said, make sure you help everyone else before you put your oxygen mask on. 

Ruth Soukup: Yeah. 

Dr. Liz Lyster: Nobody, nobody ever said that, and nobody ever will.

Right. And I think that that’s, That’s the opportunity, that’s the, the silver lining of all of those distractions and busy that we do when the kids are younger or when we have other, earlier in our careers, that kind of thing. And then we get to paramenopause and even menopause and, and it, it’s like a whole new world.

Opportunity to see what it is that we like. What are we interested in? What do we want to spend the next few decades doing? 

Ruth Soukup: And how do you want to, and how do you want to feel good during that? 

Dr. Liz Lyster: Yes. Thank you for saying that. Cause for me, it goes without saying. So thank you for highlighting that. And I want to also, I always talk about the modern problem that we have because Ruth, only like a hundred years ago, most women didn’t reach age 50.

Really? Yes. Like 5 percent of women made it to age 50. 

Ruth Soukup: Wow. 

Dr. Liz Lyster: Yeah. Think about before all the modern medicine that we have in hospital care and childbirth and that sort of thing. Oh yeah. And now half, at least half of us can expect to live into our 80s or even more. And scientific studies show that people who envision themselves living longer actually live longer.

Yeah. 

Ruth Soukup: Is that true? Yep. That’s interesting. You know, but, but then it comes right back to what do you do right now to take care of yourself? Because I was, I just interviewed somebody for this podcast last week and she was a geriatric physical therapist. I think that’s what, what her career was. And, and she became interested.

And after she went on, on maternity leave, she became interested in helping women get healthy because she sees the end result, right? She spends, she was spending every single day working with people who have zero quality of life, right? They’re alive. They’ve made it to 80, but they’re not living. And when you see that, and when you see people getting to that phase where it’s, it’s almost at the point where it’s too late, it’s too little, too late, even you try to help them, but there’s not a lot you can do.

Then you go, where do we back up to? And it’s right now it’s right at the stage of life where now you have this. And I loved the way that you phrased that you said, it’s an opportunity. It is an opportunity to decide what do I want the next 30 years of my life to look like, and how do I want to feel during that, that time?

I like it. It like kind of gives me chills when I think about it. 

Dr. Liz Lyster: I know me too. Yeah, exactly. So, okay. Right. 

Ruth Soukup: So let’s go back. How, like, how do you differentiate between you’re having these hormonal issues, right? You’re in perimenopause, which is 10 years for, for most people. Then there’s all this other stuff going on too, right?

All of these other symptoms that we’re experiencing. So how do women differentiate between perimenopause and symptoms and other health issues that they’re experiencing and how do you. Treat them. Do you treat them separately? Do you treat them together? What is what does that look like? 

Dr. Liz Lyster: Okay? I’ll answer those kind of in reverse order Definitely treating everything together because the point is the quote is her quality of life for each of my patients My purpose is her quality of life But the first step is looking at every single thing that’s going on the circumstances and how they’re changing, what is she feeling?

Is she having sleep issues, mood issues, sexual function issues, menstrual issues, weight and metabolism issues? Any of those are usually going to at least have a hormonal component. Okay, so there’s that. Then of course, there’s all of the important lifestyle choices. As I say to my patients, I cannot out hormone your lifestyle.

I cannot give you a recipe that means that you can, like for me, go back to when I was 20s and younger and I could just go to Baskin Robbins whenever I wanted. As soon as I find that magic pill, I will let everybody know. But right now, what we have are the important choices that we have to make as well as the hormone balance.

Let’s see, where else did we want to go with that? 

Ruth Soukup: So differentiating the symptoms between the pyramids, 

Dr. Liz Lyster: right? So always a hormonal component in my view, that is my bias. That is my angle on things. And so I always, always look at that. So that’s the first thing is the symptoms. The second is very, I do very detailed lab work.

Okay. And my patients usually, by the time they get to me, they, They’ve tried to advocate for themselves. They’ve tried to request some testing. A lot of doctors, if she’s still having her period, she’s in her 40s or even into her 50s, if she still has her cycle, the doctor won’t even run any tests. And if they’re willing to, they’ll do like two or three tests.

Right. Really, really very few. So for me, the second step is very detailed Workup usually blood work and sometimes urine testing as well later on maybe saliva testing But I like to start with what people can get done on their insurance I don’t work with insurance because it’s too constricting. I spend way too much time with my patients. I did that in the past.

I tried to bill insurance and I couldn’t make ends meet with my office because I just wasn’t cramming in enough people. You weren’t fast enough. I just was taking too long with each of my patients and that was for regular gynecology. With perimenopause and menopause, there’s a lot to talk about. So differentiating.

So that’s, that’s the second step. The third is interpreting to optimal, not just. Are you in the normal range? And I’m saying air quotes because lots of my patients, again, by the time they get to me, they had this or that tested and they were told it was normal because it was in the range, like barely, like squeaked into the bare bottom of the range.

Yeah. And when I talk with them, like, no, that’s, that’s in the range, but it’s not optimal. So that’s the third. And then the fourth is what I do in terms of. Using natural approaches, bioidentical hormones, supplements, lifestyle choices, everything I can do. And then the fifth is the long term adjusting, following up.

So that’s really important, is the being aware that there’s a hormonal piece to those symptoms. And second is the detailed testing. I would say to answer the question, that’s really the two main. Those are my whole five steps, but the first two are the main, yeah, it’s important, I 

Ruth Soukup: think what stands out to me and just listening to you talk about this and the approach that you’re taking, right.

Couple of things. Number one, the fact that in order to get what you’re talking about in our Modern crappy system that we have with insurance companies and the, like, get them in, get them out, prescribe the meds, prescribe the meds as quickly as possible and go to the next one. Like you have to pay for that privately, basically is what you’re saying.

Like, and that’s not, everyone can do that. Right. That’s right. So how sad is that? And what a sad commentary on where we are with medicine when there is. Number one, so many things that you can do from a lifestyle perspective and a natural perspective to be treating what the root causes of all of the issues that your experience are, rather than just putting a bandaid on it and, and, and taking another prescription.

And. And yet, so what does somebody do if they’re like, I can’t afford to spend thousands of dollars to go to a private position. I have insurance. I need to go through the proper channels. How do you find, how do you find a doctor that is going to be willing to actually look at the whole picture? Cause that’s the second thing that stood out to me is that you’re looking at the whole picture.

You’re doing a full panel. You’re looking at all the pieces. Whereas most medicine today is. piecemeal, piecemeal, piecemeal, piecemeal, piecemeal. And it’s so fragmented that it doesn’t really, it never really gets to the root of the matter. 

Dr. Liz Lyster: Indeed. That’s a really important and challenging question. First of all, it is being true to one’s own experience.

So if I’m going to look for a doctor, I need to honor my experience. I may hear great things about the doctor, but if the staff Don’t return my calls, they’re not taking care of me, then I may need to keep looking. So that’s very important. Another is that unfortunately the generations of doctors are a problem right now.

We have a whole generation of doctors trained in replenishment therapy into big. Deep trouble. And it turns out that they studied the wrong women, used the wrong hormones and gave them the wrong, those wrong hormones, the wrong way. So there’s things that we’ve learned and there are doctors out there who keep up with the literature American menopause society, which now is.

menopause society. They do quite a good job keeping doctors up to date. They’re, they’re almost there. But they do a big review of the literature every five years. So the most recent one was in 2022. And they made a few things very, very clear. What’s nice is that it’s, I mean, it’s a long paper. It’s like 20 pages of very detailed, condensed review of literature, etc.

But they do a good job spelling things out. So, for example, in the most recent one, they realized something that I and others like me have known for a long time. So, Which was that the Women’s Health Initiative was wrong about a cutoff by when you need to use hormones, otherwise you’ll end up in trouble.

So they got rid of that cutoff start date. They also acknowledged, again, something that many of us have known for a really long time, that there really isn’t a required age to stop if someone chooses, if a woman chooses to replenish some hormones. There’s no hard age where she has to stop. That’s really important.

And then they also did a little more discussing of quality of life which for example, vaginal dryness, pain with intercourse, recurrent bladder infections, that’s all easily remedied by very low doses of vaginal estrogen, which does not get into the system. So fortunately, these kinds of efforts help regular doctors do better.

For helping their patients. So I am seeing that I’m seeing women who graduate from their care with me. What we get everything dialed in, we get them feeling great. And then by that time, maybe I’ve had the opportunity to at least do email communicating with their doctor or send them the menopause society position statement.

I don’t know if they read it, but at least they are, you know, do a little, 

Ruth Soukup: little education. I love that. 

Dr. Liz Lyster: Yes. Yeah. But I, I am hearing that. So it’s, it’s very important to make sure that you resonate with your doctor, that they’re listening to you, that they’re not gaslighting you, telling you that you are just getting older and you just have to live with it.

I call that the J word, just, 

Ruth Soukup: yeah, no, we absolutely don’t. But let’s talk a little bit more about the hormone replacement therapy. So when you’re talking about HRT, are there multiple different kinds, right? Is there. Pharmaceutical and natural versions of this, and because you were talking about bioidentical hormones, is that the same thing?

Is that different things? Explain, explain how this works to me. 

Dr. Liz Lyster: All right. I love this topic. It’s one of, one of my favorite topics. And I always like to admit straight out the gate that I’m definitely biased in favor of hormones. There are so many studies, thousands and thousands of women studied, In the U S in Europe, in other places that confirm that the right types of hormones administered the right way can be extremely helpful.

Okay. So I like to say my bias right out of the gate. Okay. I like noted. Yeah. I like to use the word bioidentical rather than the word natural. This is where doctors get a little prickly when, when we talk about natural because There are things that occur in nature that can be very dangerous for our health.

So we want to be careful with that. The word natural is used in a marketing setting to imply that it’s automatically safe. Yes. It’s important to be careful around that. So I love the word bioidentical because what it means is that the hormone that you’re replenishing with that you’re putting into your body is either Almost or exactly the same as what our female human bodies used to make plenty of.

Ruth Soukup: All right. Okay. 

Dr. Liz Lyster: So our hormone levels start to decline at least in our thirties for a lot of stuff in our world and toxins and whatnot. Some people go through it even younger, but at least by our thirties, even under perfectly healthy conditions, our hormone levels naturally start to decline, especially as well men as well, but women for sure.

And then things further change and then if we’re lucky and we live long enough, our ovaries will go into full retirement. Transcribed And then we’re in menopause. Yes. And so replenishing some of those hormones, again, not to the, not to extreme high levels, but just enough to have a great quality of life.

That is my angle, my approach. Bioidentical is particularly important with progesterone. Oh, and Lysate. Progesterone. The women’s health initiative that got the hormones in trouble because It actually issued the press release before the study was published and where we doctors could read it and see what was happening and so the headlines were instant of an increased trend towards more cases of breast cancer 

Ruth Soukup: However 

Dr. Liz Lyster: Those women, I remember I said wrong women, wrong hormones, wrong route of administration.

So they were given a non bioidentical progestin. Not, they were not given progesterone. We now know, we have many, many studies, big studies, a huge study in France that was conducted that confirms what I’m talking about, that bioidentical progesterone does not have that increased tendency. 

Ruth Soukup: Huh. How do you get one and not get, not get stuck with the other?

Dr. Liz Lyster: Luckily, it’s very easy. And there is at least one bioidentical progesterone that is pharmaceutically available, usually covered on people’s insurance. And so that’s an easy one. This is a easy one for our listeners. Okay. If they’re feeling progesterone calms, the brain helps with anxiety, lots of anxiety in our world today.

Progesterone can really help. It calms the brain to help with sleep. So women who are being given a band aid sleeping pill? Sometimes progesterone is the root cause, is lower progesterone. As you mentioned, the root cause, that’s where we want to operate. And so it’s very, very important to have it be bioidentical.

And luckily that is, it’s out there and available. Creams are available over the counter. The progesterone oral capsules for some women do even better in terms of how they are broken down and how they calm the brain and help with sleep. 

Ruth Soukup: Huh. Interesting. 

Dr. Liz Lyster: What do 

Ruth Soukup: you typically recommend for your patients?

Like what is the most common, the most common approach that you take when you say, okay, I think you need to go on bioidentical hormones. Here’s what I recommend. What does that look like? 

Dr. Liz Lyster: All right. So first of all, it looks like the measuring levels, which is to get a baseline. Okay. There’s a lot of controversy.

Is blood testing the best way? We could argue about that, but it’s a baseline. It tells us where we’re starting. It also shows if things are very low because then women think, okay, I’m not imagining things. 

Ruth Soukup: I 

Dr. Liz Lyster: actually have 

Ruth Soukup: no, it’s nice to have that confirmation, 

Dr. Liz Lyster: right? Exactly. Exactly. Exactly. So I always start with sleep.

Sleep is critically important for hormone balance. If a woman isn’t sleeping, we look at why is she waking up with hot flashes or night sweats. So progesterone could be very helpful and is a very easy starting place. Another step can be estrogen. With everything I do, starting very low dose and working up from there.

That’s my method. I think it’s a great way for women to not end up with side effects from too much of anything. Estrogen, we have now also learned the other second out of the two most important points about hormone replacement or replenishment therapy, as I like to call it, is progesterone being bioidentical and estrogen being through the skin.

Ruth Soukup: Oh. 

Dr. Liz Lyster: In the Women’s Health Initiative study, they were given oral estrogen, and that goes into the stomach over to the liver, and the liver then is stimulated to make clotting factors. So when you use estrogen through the skin, and this is something that’s happened in the last few years, is that women can now get these things online, which I think that’s okay.

But eventually sometimes some of the people who end up coming to me and like, okay, I’ve been doing this by myself for a while. I get ordered my own blood work and I ordered my own hormones and I want someone to look over all of this. Yeah. So I really would prefer that doctors get with the program and learn and, and get up to speed on the literature so they can help their patients.

So there could be a patch pharmaceutically available. It can be a gel pharmaceutically available. I definitely use compounding pharmacies. They are well regulated, contrary to popular belief. It’s different than how the pharmaceutical industry is regulated. So because doctors are only taught in that paradigm, they tend to dismiss compounded hormone preparations.

But for example, for women to be able to get any testosterone, At least in the United States requires using a compounding pharmacy and testosterone can help all kinds of issues brain sharpness So it helps clear up brain fog helps with metabolism helps with mood It can be a very it can help with libido It’s not the only thing that impacts libido for us as women, we’re very complex creatures.

A lot of things contribute to motivation and sex drive, right? Libido’s not only about sex. So all of that is to say that using the right, that, that is my approach, using the right safer alternatives, estrogen through the skin and bioidentical progesterone. Those are often going to be a really great start.

Ruth Soukup: Love it. So I feel like I could ask a billion questions about this. 

Dr. Liz Lyster: The 

Ruth Soukup: phase of life I’m in. But is there any way, so is there any way to not do hormones, right? Like, and this is just a question for myself of like, okay, at what point do I need to start thinking about this? You know, I’m eating a healthy lifestyle.

I’m advocating a healthy lifestyle. I’m talking about hormonal balance. I’m talking All the time through making the right lifestyle choices and food choices, because what you’re eating, it makes a huge, has a huge impact on all these hormones. But is there a point that none of that will work and that you have to be on hormones or do some people do just fine without the hormones?

Dr. Liz Lyster: All right. I’m again saying my bias in favor of hormones. What I will say is that every, all those good choices are so important for so many reasons. 

Ruth Soukup: Yeah. 

Dr. Liz Lyster: And. There, if we’re blessed to live long enough, there comes a point where the ovaries go into full retirement. 

Ruth Soukup: Yes. And can’t stop that no matter how good you eat.

Dr. Liz Lyster: Yeah. I mean, there’s, there’s people researching how to stop that, how to, I mean, of course they’re looking at it from a fertility standpoint, how, I mean, I’m 59, how to let women my age have babies, which I’m not against that. However, do I think that we need to not have menopause? I definitely don’t think that I’ve already said, I think it’s a huge opportunity and not having a period anymore is a okay with me.

All right. So there’s, there’s big upsides to all of this. There’s an upside. Like the smooth, lots of things smooth out. So for example, our bones, our bones, our bones, the very best thing we can do for our bones. After we go into menopause for the long term preservation of bone density is going to be a low dose of estrogen.

Ruth Soukup: That’s huge. 

Dr. Liz Lyster: It’s really, really critical. You know, my mom had breast cancer when she was in her late sixties. Now she’s in her late eighties and so she’s doing awesome. She was basically cured. I know we don’t use that word with breast cancer, but that’s what happened. It’s so. She got taken off of her hormones and she I’ve just watched her over the years.

She’s lost probably like five inches in height as her vertebrae compress in her spine and she, you know, just like trips and falls and hits the hand on a table or a counter and breaks something. So this is Really, one of the most important factors that hormone replenishment can be helpful with. 

Ruth Soukup: So it goes back to that quality of life when you’re 80s.

Dr. Liz Lyster: Exactly. Exactly. And this is reminding me to say something that I always say to patients is super important is that if a woman wants to use some hormone replenishment, it doesn’t mean she’s stuck using it forever. A lot of women, especially who are really focused on making great choices and being in great health, are concerned that, well, I’m having such bad hot flashes that I can’t sleep through the night, but if I take estrogen to help that, I’ll be stuck taking it forever and that’s not true.

Put it into these phases right now in a phase of really feeling terrible. My vaginal dryness is so bad. I can not be intimate with my husband or my partner, you know, like no quality of life. So treating, addressing those issues, I can feel comfortable that I can take care of those issues and I’m not committed forever.

I can take it a few years at a time. 

Ruth Soukup: I love that. I think that that also like feels very comforting of not having to commit to something for forever. And I also feel like I could keep talking about this for a very long time, but I want to be mindful of time. Tell us a little bit more about what it is that you do and how we can find you.

Like, how can people find you? You’ve written several books and you have some other stuff going on. So tell us about that. 

Dr. Liz Lyster: Absolutely. I have all sorts of things going on. Always. My website is always the best way for people to reach me: https://drlizmd.com/ People can write to me, ask me questions, sign up for my newsletter that I send from time to time.

I would love to give your listeners a free copy electronic copy of my most recent book, which is Go For Great: Dr. Liz’s Guide to Thrive at Every Age. Love it. GATE is an acronym, gain knowledge, which your listeners do, realize the truth about hormones, which we talked about, explore your expectations. No magic bullets.

Sorry. Spoiler alert. Advocate for yourself and T is for thrive. 

Ruth Soukup: I love it. 

Dr. Liz Lyster: Focus on feeling great at every age. I really consider menopause for me. Again, I went in when I was 43. So it was a long time ago. So I walked the walk of a lot of what I talk about and do with my patients. So I really consider it to be a huge opportunity.

So I’m creating a community called the Miracle of Menopause. And cause, cause that’s how I look at it. It’s really a miraculous time of life. We get to redefine ourselves, maybe define ourselves if we were being defined by others up to now. So I think it’s just a wonderful opportunity because when women, when we’re doing well, Everyone around us does better.

Ruth Soukup: That’s so true. So true. Oh, Dr. Liz, it was so amazing to talk to you and everything that you just mentioned and your book that you are giving to everybody, which is so incredibly generous.

So get that and definitely grab the book. Check out the Miracle Menopause Network. If this is an area of your life, you’re looking for more support. And just thank you so much for being with us today.