Lecture 80: Hormone Replacement Therapy in Women: Benefits and Misunderstood Risks with Dr. Bikman

Learn more about becoming an Insider on my website: https://www.benbikman.com In this week’s episode of The Metabolic Classroom, Dr. Bikman delivers a comprehensive lecture on hormone replacement therapy (HRT), focusing on its role in addressing metabolic health challenges faced by women during menopause. He begins by explaining the different types of estrogens—estradiol, estrone, and estriol—and their varying roles in the body. Estradiol, the most potent estrogen, plays a critical role in regulating metabolic functions such as fat distribution, glucose regulation, and inflammation. Menopause leads to a dramatic decline in estradiol levels, which significantly impacts a woman’s metabolic health, including insulin sensitivity, fat storage, and inflammation, while increasing the risk of type 2 diabetes and other metabolic disorders. The loss of estradiol causes fat to redistribute from healthier storage areas, like the hips and thighs, to the abdominal region, where larger fat cells become more insulin-resistant and pro-inflammatory. This shift contributes to systemic inflammation and elevates the risk of cardiometabolic diseases. Ben explains how HRT, particularly with estradiol, can mitigate these effects by improving insulin sensitivity, reducing inflammation, and promoting healthier fat storage patterns. He also addresses historical concerns about HRT, including risks of blood clots and cancer. Dr. Bikman explains that oral estrogens may slightly increase clotting risks due to their first-pass metabolism in the liver, but transdermal delivery methods like patches and gels do not carry this same risk. Regarding cancer, he highlights how older studies, such as the Women’s Health Initiative, overstated the connection between HRT and breast cancer, particularly when using estrogen-only therapies. Ben emphasizes the importance of evaluating the absolute risks, which are relatively small. Beyond its metabolic benefits, HRT also shows promise in protecting against conditions like Alzheimer's disease. Ben discusses studies suggesting that HRT, when started early in menopause, may improve cognitive outcomes, preserve brain volume, and reduce the risk of Alzheimer’s, particularly in women with the APOE4 gene. These findings suggest that timely HRT may support brain health alongside its other benefits. In conclusion, Ben underscores the substantial metabolic and overall health changes women face during menopause and the potential for HRT to improve quality of life, metabolic health, and long-term outcomes. He stresses the importance of individualized HRT plans tailored to each woman’s unique circumstances, allowing for a nuanced approach to mitigating menopause-related challenges. visit https://www.benbikman.com Ben’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/1BA884 Ben’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10) Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15) Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20) Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15) Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15) Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10) Show Notes/References: Due to YouTube’s character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: [email protected] with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 80 - Hormone Replacement Therapy in Women”. 00:00 - Introduction to Hormone Replacement Therapy (HRT) 01:03 - Overview of Estrogens and Their Role in the Body 03:03 - The Impact of Menopause on Hormones and Metabolic Health 06:24 - Hot Flashes and Their Connection to Estradiol 07:38 - Metabolic Changes During Menopause 08:40 - Estradiol’s Role in Insulin Sensitivity and Glucose Control 09:50 - Fat Distribution and Inflammation After Menopause 12:17 - Components of Hormone Replacement Therapy 13:19 - How HRT Improves Insulin Sensitivity and Metabolic Health 15:49 - Cellular Mechanisms of Estradiol’s Effects on Insulin 19:15 - Blood Clot Risks: Understanding the Context 23:19 - Oral vs. Transdermal HRT and Blood Clot Risks 25:16 - Cancer Risks and Reassessment of HRT Studies 27:31 - Benefits of HRT: Type 2 Diabetes and Brain Health 28:30 - HRT’s Role in Reducing Alzheimer’s Risk 30:37 - Additional Benefits: Bone Health and Quality of Life 33:00 - Conclusion: Tailored HRT Plans for Improved Health #hormonereplacementtherapy #HRT #MenopauseHealth #MetabolicHealth #EstrogenBenefits #InsulinSensitivity #FatStorage #MenopauseRelief #Estradiol #WomenMetabolism #AlzheimersPrevention #MenopauseSupport #HealthyAging #BioidenticalHormones #Type2DiabetesRisk #MetabolismScience #HRTBenefits #DrBenBikman #HormoneBalance #WomensHealth