This week we are talking about our broken medical system, and how it’s completely biased against women, prevention, and optimizing your health and wellness. We’re gonna talk about why you can’t get your hormone levels checked. Why doesn’t your doctor know how to balance your hormones. Why you can’t get any answers to make you feel better, you just keep getting more medications.
My guest on today’s episode is Dr. Angela De Rosa. She is a fellow DO, who, luckily for her found the world of integrative medicine early in her career. She has been on this mission for a long, long time, which is to help you guys have a voice and another choice to get well.
In this blog post, we are going to talk about…
How the medical system and the FDA are broken and biased against women.
Why women can’t get hormone testing and how doctors and even gynecologists aren’t really educated on women’s hormones.
The woeful lack of understanding of menopause and hormones in American medical training.
How women don’t get the same concern and care when it comes to medical care as men do.
About Dr. Angela De Rosa
Dr. Angela De Rosa is on a mission to change the face of women’s health and wellness. She has more than 25 years of experience in the medical field both on the pharmaceutical side and in clinical practice. As an internationally recognized authority in women’s Hormonal Health, Dr. De Rosa understands the range of health issues women face leading up to and during menopause as she herself was in full-blown menopause by the age of 35.
Dr. DeRosa’s enthusiasm for educating patients on the realities of menopause and the risk factors of hormonal health imbalances was the driving force behind her first best-selling book “How Your Doctor is Slowly Killing You: A Woman’s Health Survival Guide.”
In 2018 She launched the Hormonal Health Institute executive instruction for medical professionals, which is a Hormonal Health Care consulting designed to instruct medical care professionals and provide practice development training on bioidentical hormone replacement therapies.
Dr. DeRosa serves as the medical director for Belmar Pharma Solutions, where she provides clinical and scientific-technical support for all aspects of the business as well as clinical expertise for internal and external customers.
I really liked this interview, because Dr. De Rosa uncovers a lot of issues that we’re having in the American Medial System. It is run by big pharma. The FDA is corrupt. She’s going to explain, why this is happening. How it could impact you personally, in your ability to stay balanced and healthy, because they are now trying to shut down compounding pharmacies. They’re trying to create a monopoly and limit where you can receive medication, hormones, vitamins, and everything. It’s really eye-opening. I don’t want you to be scared, but I want you to be a little bit pissed off and start to speak up.
I believe that we need to have choices in our health, how we receive our care and where. Our ability to get hormones if we need them. This is a big deal. Please share this episode with everybody you know, because it’s so important. Even if you don’t need hormones right now, I promise there’s gonna come a time when you wish that this was available.
Welcome Dr. D to the Functional Gynecologist
Thanks for having me. It’s always nice to be with like-minded folks like yourself who are fighting the same fight.
Dr. Tabatha: Yes. Oh my gosh, we need to band together and keep working to change this broken system, don’t we?
Dr. D: Oh, my gosh, Ain’t that the truth? Holy smokes? Yeah.
Dr. Tabatha: Let’s get right into it. Why did you write such a controversial book “Your Doctor’s Slowly Trying to Kill You”? What was your thought process? I’m sure you had a lot of colleagues questioning you and asking what you were doing going against the system.
Why Did You Write Your Book?
Thank you for being one of the few physicians that weren’t, who have a sense of humor about the title and understand that it wasn’t meant to be a complete slap in the face to clinicians. It was really meant to be a wake-up call to women in particular. Unfortunately, and mostly unintentionally, the medical profession is slowly killing them.
As you and I both know, when we go to medical school, we don’t really learn about the root causes and a lot of the symptomology that could be treated by hormones. Yet we’re so quick to dole out loads and loads of medications to treat that symptomology without any thought or discussion about what the risks of that could be to our metabolism. Women need to be armed with that knowledge. So the book was really largely written to educate and arm the layperson so they can question the status quo.
Dr. De Rosa’s Book “How to Prevent Your Doctor From Slowly Killing You, A Woman’s Hormonal Health Survival Guide”
A Lot of My Colleagues Weren’t Happy About It
Unfortunately, a lot of my colleagues weren’t too happy about it. They saw it as a complete slap in the face. I really just want them to understand that it’s not. It’s an opportunity. If I saw something like that, the first question I would ask is what am I missing? Unfortunately, some doctors tend to have egos.
To answer your question, this book started with my own journey. I went to menopause at the age of 35 while I was in medical school. My experiences of medical care weren’t good and I vowed that I would never allow another woman to be treated the same way.
Dr. Tabatha: I’m guessing you probably went into premature menopause because you became a doctor. The training to become a doctor is bad for your health. It’s stressful, you are up late studying and working long hours.
Dr. D: Oh, yeah, I certainly think it had a contribution to that. I wish I could say I knew that it was genetically programmed. Both my mom and grandmother had hysterectomies, so God knows what their timeline was. Who knows what our environmental exposures stressors are that we put on ourselves and the studying, the hours, the lack of proper foods, lack of exercise, lack of sleep, etc. all of that affects your body.
My Perimenopause Symptoms Were Completely Dismissed
My perimenopausal symptoms in medical school, were completely dismissed. I was patted on the head, told that that was crazy, and to go away.
Dr. Tabatha: Why do you think that is?
Dr. D: I had all the hot flashes, night sweats, weight gain, mood swings, all the typical stuff. It’s so maddening because if I walked in, and I was a man in a physician’s office, they would get treated with such extreme urgency. They would leave no stone unturned until they figured it out.
What was really most alarming to me is I was having an unusual symptom. Most women get heart palpitations with estrogen deficiency, but I was getting Ventricular Tachycardia, which was causing syncope from my estrogen deficiency. My doctors poo-pooed it and I was put on a beta-blocker. Nobody really did proper workups. If a man walked in with those same exact symptoms, they would go to the ends of the earth, to figure out what was wrong, instead of just giving them an antidepressant and telling them to go on their merry way.
You would think in the last 25 years that that would have gotten better. Honestly, I don’t think it has. Although we see more and more women coming into the field. The same traditional teachings are still being taught. Also, menopause doesn’t get the reverence that andropause does, because men demand more from their health care system. Women tend to want to be the mediators and the ones that bring the world together. We don’t like upsetting the status quo. I think that’s part of it, we assume that what we’re being told is correct. Most of the time it is, but a lot of times it’s not and we are afraid to ask questions.
If we say anything, we’re viewed as inferior, as if you can’t handle it because you’re not a man. Men get the products, testosterone, erectile dysfunction treatments, everything they need. They have everything available, FDA-approved. Women get prescribed psych medications. They want to keep us quiet and medicated instead of getting to the real root of the problem.
How Long Did it Take You to Get to the Root of the Problem?
Dr. Tabatha: So how long did it take for you to figure it out?
Dr. D: It really came from aggressive research, searching, and finding out what was wrong with me for me. I vowed to learn as much as I could about Hormonal Health. It wasn’t until 2020 that I really figured out what was happening to me. I figured out that I was in perimenopause. It really took meetings with some key people in my life. I started working at Procter and Gamble and helped them on their women’s health line. We launched a female testosterone patch, which got approved in other parts of the world, but we didn’t get it here because our FDA is corrupt.
I learned that in the United States, we are so behind in Hormonal Health and women’s health compared to other parts of the world like Italy, Spain, and other areas, like the United Kingdom. It was really through meeting people, learning all I could, and then finally figuring out that I was having perimenopausal symptoms. I was a guinea pig for myself for a long period of time. I know I did a lot of damage at some points, but I figured it out. I understood that it was perimenopause and then menopause. I realized that I needed hormones.
Why it’s Crucial to Diagnose Hormone Deficiency Earlier
Dr. Tabatha: Let’s talk about that because that is really the premise of your book. If you are in hormone deficiency earlier, especially earlier than you should be, you’re increasing your risk of developing diseases that are preventable, right?
Dr. D: Yeah. What’s really concerning is that we really focus on estrogen as women, but that’s not the only hormone at play. Estrogen protects our endothelial cells so that we don’t get high blood pressure. It helps with brain synapses, it helps with vaginal health, skin, health, bone health, it does all these wonderful things. However, our most predominant hormone is actually testosterone in women and we dismiss it. We think it’s a man’s hormone, but it’s not. It’s actually our most abundant hormone surging through our body at any given day. We’ve pigeonholed it into a sex hormone for men, however, it affects many things.
Why is Testosterone Important in Women?
It increases your libido and your desire, it improves clitoral sensitivity and orgasmic strength, all those wonderful things. But those are a bonus. Testosterone really is essential for serotonin production and synapses in the brain. It affects our mood. Without it we get depressed, anxious, have panic attacks develop apathy, which is the worst thing. It helps with executive function, thinking cognition, bone health and keeps inflammation down so we don’t develop cancers.
The most important thing is it helps us to process sugar. When we eat a meal, it’s testosterones’ role to mobilize it and move it into the muscle, so it burns as clean energy. When we lose that, we gain weight in the midsection, we burn out our pancreas, because now the pancreas is stuck with the task of dealing with the sugar. Then we get pre-diabetes, which then leads to diabetes and heart disease and that whole cascade. If we just replace women’s testosterone at the appropriate time, that wouldn’t happen.
The lack of recognition of these hormone deficiencies and understanding of their roles in causing chronic disease development. In other countries, this isn’t happening. They see pre-diabetes and one of the first things they think about is do I need to check testosterone levels. Here, the first thing we think about is metformin and insulin.
What Can Women do to Look Into Hormone Imbalances
Dr. Tabatha: It’s so frustrating, and we need to keep spreading this word. Let’s talk about this a little more because I think it’s so important. I’m seeing women younger and younger with PCOS. They don’t understand that it’s not just a problem with your ovary. It’s a metabolic syndrome from a hormone imbalance. What can women do to even start to look into hormone imbalances? Because doctors frequently don’t listen or tell patients that you can’t check hormones.
Dr. D: What they’re telling you is, I don’t know. There are doctors out there who can draw hormone labs and interpret them correctly.
Right, just because you’re seeing a gynecologist it doesn’t mean the gynecologist is a hormone expert. If anything, they are minimally trained in hormones. We are surgeons by training. We spent all of our time in the O R, and in delivery rooms, using our hands doing procedures. We didn’t sit and study the endocrine system and all of these intricate physiological processes.
Watch the full video version of this interview here
What Should Women Look for in a Doctor to Help with Hormone Issues?
What do you recommend women look for when they’re trying to find a physician to help with these issues? At the very back of my book, I put in some checklists of things to look for. If you tell your doctor about your symptoms and they tell you to go on a date night, rest, eat better and exercise more without checking anything or they tell you that there is no data around hormone therapy, they aren’t a good doctor to help with hormone issues. You want to look for physicians who specialize in the optimization of hormones, restorative medicine, functional medicine, hormone, bioidentical hormone, those are kind of keywords that you should be looking for on your doctor’s websites. You want doctors who are going to look at the whole picture versus just one body part.
I’m kind of on mission right now to really try to educate about young women in particular, because in the OB-GYN space, we are doing so much damage with oral birth control pills to women, because we don’t understand the indirect metabolic effect. Birth control pills cause testosterone deficiency very quickly after starting them. These women gain weight, they get depressed, they have low libido, they have cognitive issues, they have all these things going on. Everyone dismisses it. It’s not that I’m against birth control pills. They are right for contraception and sometimes they help with controlling bleeding, but you have to understand that indirect consequence. If you don’t address it, those women are going to gain weight, they’re going to get depressed, they’re going to have low libido, they’re going to feel terrible, and everyone’s going to dismiss them. They’ll get labeled as crazy or as having fibromyalgia. We should know what we are doing when we prescribe this medication and how to manage it.
This just illustrates the kind of dichotomy and complete gender bias. Why don’t they have a birth control pill for men? Well, they’ve studied them and they’ve done trials, but no man will ever agree to stay on them because it creates testosterone deficiency in them and creates impotence, weight gain, mood disorders, and all these different things. It does exactly the same thing to us, but we’re expected to take it. Men won’t do it. They say hell no. Yet, we take them every single day. That’s the expectation.
What About IUDs?
I mean, IUDs are fantastic. And they’re not the old IUDs that used to cause all the problems. It’s the perfect form of birth control because it lets your ovaries function normally and naturally. They are designed to release a small amount of hormones over time to prevent pregnancy.
What is the Difference Between Synthetic Hormones and Bioidentical Hormones
Dr. Tabatha: I would love for you to talk a little bit about the difference between synthetic hormones and bioidentical hormones because we really need to get into the discussion of replacing our hormones when we are deficient and getting optimized so that we can feel amazing again.
Hormones really aren’t medications when they’re done properly. They’re a medication, if they’re synthetic, meaning they don’t look exactly like the molecule that your body is making. For instance, birth control pills have a synthetic estrogen called ethylene Ester dial, which is a synthetic chain that doesn’t look like the estrogen that our bodies make. Our ovaries actually make 17 beta-estradiol. That’s the bio-identical hormone. If you take estrogen, you should take 17 beta-estradiol because the body recognizes it. It knows what to do with it.
When you take synthetic estrogen, your body doesn’t know what to do with it. Synthetic hormoness put you at risk for adverse effects. The body doesn’t know how to process it. You may need more of it in order to get the symptomatic benefit, which can also lead to more side effects and problems. You should always ask your doctor if a hormone they are prescribing for you is bioidentical. If they say that bioidenticals are made up, they don’t exist, or aren’t necessary, then you need to find another doctor.
Compounding pharmacies have a bad rap too. These are highly specialized and trained providers who are pharmacists. They are state-regulated, the pharmacy board regulates them, the FDA regulates them, there’s a ton of regulation. Big Pharma is trying to attack them because they’re taking $8 billion of revenue and profits away from them every year. I love compounding pharmacies because you can order the medication the way that you want it. It’s kind of like going to a restaurant. You kind of look at the menu, decide what you want, and you can say, I want this with a little less this. The chef gets your order and puts it together especially for you. Compounds are the same thing. So they start with FDA-approved ingredients. Every ingredient that goes into that compound was already approved by the FDA. It’s the same stuff the big pharmaceutical companies use, but they can customize it for the specific patient.
Dr. Tabatha: There is a big push for compounding pharmacies to not to no longer make these hormones right?
The FDA is trying to shut down the ability for compounders to make hormones. Although the FDA does great things and they have a role in medicine, but when you try to exclude an area of medicine, that’s also really helpful and synergistic. That’s where I have a major issue. We shouldn’t be eliminating either side, we should be working together and not using pharmaceutical drugs, at the exclusion of something that may be helpful and good for patients. Unfortunately, although people think the FDA is an independent body, it’s far from it. It’s heavily influenced by big pharma. Over 60% of it’s funding comes from big pharmaceutical companies. They have strong lobbying groups that push for their interests.
These big pharmaceutical companies are trying to push out compounding because they’re taking significant profits away from them. They hired a commission that was an “independent committee” a couple of years ago. I actually presented to that committee along with several other providers, but they had already predetermined what they wanted to do. They came to the conclusion that there’s no clinical utility for compounding hormones, and in particular for women. They based it on 13 studies that one of their folks brought to the table. We submitted 1000s of studies that supported the use of compounded hormones, but they completely ignored them.
It becomes more and more challenging for folks like us to practice in this area of medicine and women to get what they need. But the good news is that there’s a lot of money, lots of people, lots of us that are ambassadors and fighting this fight. I encourage all of your listeners to go to a website called savemycompounds.com. They’ll tell you how to get with your legislators, how to provide your own testimonials, because the more we scream that’s how we get to our representatives in Congress and the stakeholders who are making these decisions to listen. You should all be a little scared because if these compounds go away, men will be just fine. They have all the FDA-approved commercial products that they would need to continue with. Women would be screwed because there’ll be zero testosterone products. We would be left to take the man’s products, which is ridiculous and medically inappropriate.
One of the good things that came out of COVID is that telemedicine has opened the door wide open for you to access functional medical professionals no matter where you live.
What are Some Other Common Scenarios You See With Your Patients?
About two-thirds of women by the time they are perimenopausal also have sub-functional or sub-optimal thyroid function. Unfortunately, traditional medicine waits till you’re on death’s door before they even intervene. Make sure your doctor is looking at all the labs, not just a TSH. They need to look at the whole thyroid panel for the whole picture. You need to find someone who’s looking at thyroid, estrogen, testosterone, and progesterone because they’re all working together.
Also, no one is testing for vitamin deficiencies that can contribute to symptomatology. Something as simple as a severe vitamin D deficiency can present as Fibromyalgia or depression. These people are often labeled with depression or put on pain medications and all they might have needed was really high doses of vitamin D for a period of time. Taking that whole-body approach to look at the big picture, instead of just looking at symptoms is important.
Doctors Need to Look at the Big Picture
Most functional folks look at the big picture because we want to know if you are showing signs of infection or other things that could mimic hormone deficiencies. We want to make sure that we’re not just assuming everything is hormonal. We don’t want to miss a cancer diagnosis or other things going on in the gut. As doctors, we have to be cautious that we don’t get tunnel vision when we treat our patients. We need to look at the big picture.
Dr. Tabatha: You mentioned cancer. I think that’s one we should mention with hormones because many of us have heard that hormones cause cancer or are dangerous. Can you talk about that?
The Women’s Health Initiative (WHI) released the results of the largest study ever done on synthetic hormones in early 2002. The ongoing media hype ended up scaring the crap out of women and their doctors. The problem is that the WHI study results were skewed, misreported, and misunderstood, resulting in doctors and women avoiding HRT for the next decade.
In fact, the worst estrogen drug in the WHI study, Premarin (a synthetic drug made from the urine of pregnant mares) actually showed a decrease in risk for breast cancer. Prempro, the other drug studied, showed no statistical increase for breast cancer at all. The media and medical professionals got it all wrong and continue to get it wrong, and women’s health has suffered for it.
When properly done, hormones are going to be very advantageous to your health, when done at the right time, with the right hormones and the right doctor looking at the overall picture of the patient. We shouldn’t be clumping everybody in one size fits all box.
Testosterone is Very Breast Protective
What people also don’t talk about is that testosterone is very, very breast protective. There’s now great literature suggesting that women who have active breast cancer can go on testosterone with estrogen blockers and actually improve their outcomes and have a reduced risk of breast cancer reoccurrence.
Women who don’t have breast cancer and are on testosterone will have a reduced risk of actually getting cancer. So when I look at this all in total, if you’re getting bioidentical hormones done at the right time, you actually will benefit your overall health, including your breast health, you just need to know the information.
Dr. Tabatha: Thank you for explaining that. We have to just keep tackling this issue. We need to speak up for other women. I love this. Thank you so much for this great conversation!
Dr. D: You’re welcome. Thanks for allowing a great conversation.
How Can my Readers Connect with You?
Do You Take One on One Patients?
You can work with my team of highly trained nurse practitioners. I’m not currently taking patients myself because I’m training clinicians across the country now to do this type of medicine. I’m also doing a lot of public speaking and working for a compounding pharmacy. It’s all designed to empower women and get more information out there. I love seeing patients, but if I do that, I can only affect change, one person, at a time. This way, I can affect change on a global level.
To Wrap it Up
I hope that episode really got you thinking. You know, you should always be questioning and asking yourself, am I seeing the right physician or provider? That’s a very intimate relationship that should be respectful. You should feel heard and you should have choices. There shouldn’t be this dictatorship or parental authority like here’s what you have to do, we’re not going to have a discussion about it. It should be a respectful two-way street to help you figure out what you need as an individual.
I want you to feel heard, and have your thoughts and questions. answered. If they’re not, then I want you to seek out someone else like myself, Dr. De Rosa’s team, or another provider. There are so many women and men who specialize in women’s health and want to bring you back to optimal health to help prevent disease as opposed to managing it. Once you have the diagnosis, anybody can manage the disease, but let’s talk about reversing and preventing it. Let’s talk about optimizing your health.
I really encourage you to take ownership of your body, your health, and don’t be afraid to question speak up if things don’t feel right. Don’t hesitate to reach out to me if you want help. I’m licensed in over half the country. This is what I do all day.
You don’t have to put up with taking a birth control pill as your hormonal solution. You don’t have to put up with gaining weight and feeling tired and blah, and not wanting to do anything in your life. That’s probably a medical issue. It could be a hormone imbalance and those are all fixable. You can feel amazing, you deserve to feel amazing.