Ever wonder what it takes to age gracefully and thrive through every stage of life? In this episode, Dr. Amy Killen joins me, Dr. Jolene Brighten, for a no-holds-barred conversation on women’s health, longevity, and the game-changing science that's empowering women to live their best lives. From busting myths about hormone therapy to unveiling cutting-edge research on aging, we’re diving deep into the information every woman deserves to know.
What You’ll Learn in This Episode:
This episode isn’t just a conversation—it’s your toolkit for thriving at every age. Dr. Killen and I cover powerful strategies, surprising science, and actionable advice for reclaiming your health and vitality.
You'll Walk Away From This Conversation Knowing:
- The surprising ages when women’s aging accelerates—and what you can do about it.
- Why strength training is your secret weapon for longevity (hint: it’s not just about muscles).
- The truth about the Women’s Health Initiative and how it misled an entire generation about hormone therapy.
- How low-dose vaginal estrogen could dramatically reduce the risk of UTIs and urinary incontinence.
- The difference between progesterone and progestins—and why it matters for your health.
- A groundbreaking study showing how rapamycin may delay ovarian aging and extend fertility.
- Why birth control pills could impact your diabetes risk during menopause.
- The role of estrogen in reducing belly fat and improving metabolic health.
- How testosterone therapy for women can boost libido, muscle strength, and overall well-being.
- The shocking statistic: 25% of elderly women with hip fractures die within a year—and how you can protect your bones.
- Why vitamin D testing is being deprioritized—and why you should care.
- How astaxanthin protects your skin from sun damage and supports anti-aging.
What You’ll Learn in This Episode:
Dr. Killen and I discuss the science of aging and the powerful interventions available to help women feel their best. We debunk myths around hormone replacement therapy, explore how diet and supplements like berberine and vitamin D can support your health, and dive into exciting research like the potential of rapamycin to extend ovarian function. Whether it’s protecting your bones, balancing your hormones, or improving your energy, we’ve got you covered with actionable insights and inspiring stories.
This Episode is Brought to You By:
- Dr. Brighten Essentials use code POD15 for 15% off
- Coconu use code DRBRIGHTEN15 for 15% off
Support our sponsors and help keep this show free and packed with amazing guests!
Transcript
Dr. Brighten: If you've had questions about birth control versus hormone replacement therapy for perimenopause and menopausal management, how this might affect your lipid metabolism, your cardiovascular [00:02:00] health, your bone density, your neurological health.
Well, you're definitely going to want to tune into this episode. I'm Dr. Jolene Brighten, your host, and I'm joined today by Dr. Amy Killen. Now, in addition to having 10 years of experience as an ER doctor, Dr. Killen has also embarked on the journey of longevity, helping her patients optimize their health, which also includes the conversation of hormone replacement therapy.
I am so excited for this conversation. It was absolutely amazing. And if you are somebody who isn't a candidate for hormone replacement therapy, or it's just not something that you're interested in, I want you to know we are discussing alternatives. We are discussing certain supplements and lifestyle therapies that can help support you in feeling your best.
Now, when we talk about longevity, I just want you to understand this is not about just looking young, although that would like be a bonus, but that really shouldn't be our focus. It should be [00:03:00] about optimizing our health in a way that gives us the best quality of life through the years. As always, it is super helpful for me.
If you leave a comment, you share this with a friend, you subscribe. This helps me so so much and I am grateful beyond words for all of your support. I aim to bring you all of this information at no cost for you because I truly believe it is time that we end the gatekeeping in women's health and make sure that women have access to the information that they need so they can have the best possible outcome.
quality of life. And in order to do that, I have to thank my sponsors who make this show possible. So without further ado, let's dive in. Dr. Amy Killen, welcome to the show. Thank you so much. I'm
Dr. Killen: very excited to talk to you.
Dr. Brighten: Yeah, I am really looking forward to this conversation and we're going to get into all things longevity.
I know that you have been in this space forever talking about the best hacks so that we can age [00:04:00] in a healthy way. And I think that like really setting up this conversation for people to understand. When we talk about anti aging, this isn't like a Revlon thing. Commercial or, you know, something like that where we're like, you need to look like you're 20 for life, but we do want to have like the cellular integrity and health as closely matched as like a 20 something as we possibly can.
So this is about how to basically live your best life, not just, I mean, looking, looking your best is like a bonus outcome of it, but that's not what we're going to hyper fixate on.
Dr. Killen: Yes. Yeah, I agree. I think that the term longevity is a little confusing. Does it mean like looking like you're 25? Does it mean, you know, like harvesting your organs and saving them for later?
Does it mean cryopreservation of your brain? Like there's so many like levels to like longevity that there's some crazy stuff. And then there's more like real world. Where are we right now? What can we do
Dr. Brighten: today? Yeah, totally. So I want to dive in with some of your favorite longevity hacks, but I want to talk about this study that just [00:05:00] came out.
I do want to preface with saying it was about 108 people. I believe it was 108 or 180. Now I'm like mixing my eight up, but it wasn't a huge, yeah, it wasn't a huge sample size, but when people have criticized and said, it's not a huge sample size, I'm like, friend. If you look at how much data they collected, this was such an expensive study that you couldn't have done much more.
But what this study said. Is that there's a burst of aging? Like we don't age like gradually over time. It's 44 and 60 that hits us the heart hardest. So what's really like the takeaways from that, that people should know.
Dr. Killen: Yeah. And I think that there are certainly some criticisms of this study. I mean, like smaller sample size, the people were only also followed for like an average of 1.
7 years. So it's kind of hard to make like long term, like, you know, longitudinal data references just based on that small amount of coverage. But they did look at like. Thousands of different things, you know, proteins and different transcription factors and all kinds of stuff, as you know, [00:06:00] microbiome, um, which is interesting, but I think that, you know, I don't know the number is necessarily important.
I do think that somewhere in the 40s, we see a shift, um, especially in women, but also in men. And we, we've seen this with hormones for years. You know, we see this, the kind of dropping off of, of hormones in that age group. And then I think probably. In their study, it was 60, but I think probably 50 to 60 is sort of the other range where we see a lot of this, um, in their study, they had some people were aging quickly in there, you know, at 50, somewhere more like 60, but somewhere in that 40 to 60 range, we start aging faster.
And I think a lot of that is probably hormonal.
Dr. Brighten: Mm hmm. Yeah. And I think that's interesting because that you, you preface this conversation with like, there are some flaws of this, because I think that We need to be mindful that we've all lived different lives. We have different genetics. We've definitely, you know, made our mistakes of my own life.
Um, and so to understand and recognize that your, what. You know, what you experience might be [00:07:00] different, but to also, I, to me I'm like, this is motivation as somebody who sits at the cusp of 44. Mm-hmm . And I don't know if it's necessarily gonna hit me at 44, 'cause I think that also corresponds with like when the PerMon menopause onset really starts.
Right. Um, but to look at that and to use it as motivation and to think like, you know, when you look at like, okay, protein synthesis dropping off, like your ability to, to build muscle that was nothing new. Like, we've known this for a long time. But to use that as motivation of like, okay, if there is this tangible number, that's a maybe what can you do right now to assess your life and to start hitting it hard?
And so I think that's a great segue into some of your favorite longevity hacks that people can start employing and really, um, being mindful of in their day to day life.
Dr. Killen: Yeah, but I think that I think you'll agree that most of the things that are that are the most proven, at least right now to improve longevity aren't really even hacks.
They're just healthy lifestyle, right? Like, I think that there is that people think that you could hack your way to [00:08:00] health. And I think that that is not correct. Um, but I think for I think for women, one of the biggest things is strength training and building muscle. And I think, you know, unfortunately, we don't focus on that as women.
A lot of time we think focus on like cardio and running on the treadmill, and you think it's the best way to get super skinny, but really building muscle, especially in your forties. And then as you get older, fifties, sixties, I think it's probably the number one thing that most of us aren't doing enough of.
Um, and of course, everything else to eating healthy and sleeping and not stressing and getting sun and all those are important, but I think the muscle building is probably, it's becoming more important to me. I'm 48 and as I get closer to 50, I'm like, Oh, I got to build more muscle.
Dr. Brighten: I have felt this, like this pressure my whole life.
My research being in sarcopenic obesity when I was studying nutrition, um, and I remember being a vegetarian at the time and being like, oh my gosh, oh my gosh, like I have to be so diligent about my protein intake, about strength training. Um, and I just want to say. You know, you said [00:09:00] like people think that you can hack your way and I'm like It has become this, this real mindset that exercise, choosing whole foods, getting good sleep, all these things are considered hacks because they go against what so much of our society has ingrained in us of like, Fast, convenient food, sleep when you're dead, hustle culture.
You know, when you, when you look at the way that we live, that lots of people in the United States live in our modern society, these things are, that's why we've developed the language of like this hack because it's not, it's not commonplace. Um, and so I do appreciate you bringing that up though, that like, that this should just be part of your lifestyle.
And. You know, to dovetail on that, you recently had an experience with your mom. And I saw, you know, just watching you on social media that it really launched you into passionately advocating for [00:10:00] hormone replacement therapy. And I'm just wondering if you could share a bit about that story. Cause it really changed.
I watched it, how things evolved for you.
Dr. Killen: Yeah, yeah. So about a year ago, actually, just over a year ago, my mom, who's in her mid seventies, she's very, very active, was at the gym walking on the track and she fell and she broke her hip and she was osteopenic before. So not even osteoporotic, but she, you know, she's thin caucasian.
She has some of the risk factors. Can you
Dr. Brighten: define osteopenia versus osteoporosis so people are aware on this? Yeah, I mean
Dr. Killen: basically, and I don't remember the exact numbers on your, on your T scores, but basically osteopenia is your bones are getting weaker, but you're not osteoporotic yet. So you're kind of in that middle range between normal and, and very, very fragile bones.
But, but it's still not good to be osteopenic. Um, and she's known this for years, but you know, one of the problems with her is that she was, she was affected by the Women's Health Initiative back in 2002, which came out and said, You know, hormones are bad. They're going to give you all these problems and breast cancer is that.
And so she was taken off her estrogen at that point. I [00:11:00] did end up restarting her on estrogen 10 years later. Um, and you can talk about the pros and cons of that, but essentially I started her back on it. So she'd been on it, um, for almost 10 years, but she'd still gone a long time without it. And so she ended up breaking her hip.
And, um, it came at a time where we were having a lot of other, you know, my grandmother my dad was super sick. I and forth to texas take c just watching her trying
It was really, really difficult. And even now, a year later, she she's worked so hard and she still has a cane and she still has a limp. And it's really affected the way that she is interacting with the world. And this is someone who, you know, she's she eats whole food. She avoids. You know, all the things she should avoid.
She's been active her whole life. Um, and now she has to think to herself, like, maybe I can't go on this trip because I have to use a cane and maybe I can't get up the stairs in this foreign country. Um, it's, it's, it's really been, um, eyeopening. [00:12:00] And when she broke her hip, her doctors took her off of her estrogen.
Um, and they said, you don't need it anymore, even though estrogen is the best thing that we currently have available. to help keep bones strong. And it's better by far than any medication that's out there. Um, except maybe growth hormone, but estrogen is the most important thing. And so I got really upset.
I was like, how could you take her off her estrogen when this is the thing that she needs? So, yeah, I became much more passionate, um, about, about hormone replacement therapy in women and the fact that so many women are being denied even the opportunity to talk about potential benefits of hormone therapy.
Dr. Brighten: Absolutely. And when I see a lot of his people get. So afraid about the potential side effects of that without ever considering the potential side effects of the medications that have to come in. So if you look at things like Once we lose our hormones and your cholesterol goes up They're going to put you on statins that you start your bones start suffering those medications They can help [00:13:00] necrosis eating away your jaw.
No, thank you when you start looking at You When you have to treat the consequences of losing your estrogen and those side effects of those medications and the lack of research on women, like when you look at statins and it's like, that's cute. You've never studied us and you've never actually set guidelines specific to us.
You just treated us like men. I think. It's really frustrating. And I want anybody listening this to understand that is always your choice to choose hormones or not, that not everybody is a candidate for these hormones, but you're, I will just say, I absolutely want to echo exactly what you said. Everybody should be given the option.
They should have the conversation. They should know why they're being denied it if they are. So, um, and to talk a little bit just for people to understand the gravity of a hip fracture. When you have a hip fracture post menopause, you don't have access to things like physical therapy. You don't know. [00:14:00] You have the standard access people do to healthcare.
We're looking at like, you know, have to even 75 percent of those women not living past a year when they're not given access to the health care they need. So I bring that up because I think sometimes like, especially if you're someone in your twenties listening to this and you're like, Oh, a hip fracture, you don't understand this.
You said like there was all these stressful things, but the stress that was on you as a physician. Understanding that about your mom's health.
Dr. Killen: Yeah. And I think that, yeah, to your point, even with health care, even with the great health care system, 25 percent of people, elderly people who have a hip fracture will die in that first year.
That's even with physical therapy and with family to help you. And with, you know, that's even with the motivated patient, um, because it's so much changes the things you can do. And then all of a sudden you. spiral into this person who is no longer healthy and can't get out of bed. And then of course you have just the longterm, you know, morbidity of it, like not being able to travel like you used to and not being able to go on four or five mile walks with like you used to.
And, you know, I [00:15:00] think that there's this idea that osteoporosis doesn't kill people, like you said, but it actually absolutely does. At osteoporosis, kills people all the time. And it's as dangerous as breast cancer, which we're so scared about. Um, you know, we know now that estrogen therapy doesn't actually increase your breast cancer risk, but even if it did, we still have to weigh the risks and benefits of, you know, can we prevent, um, osteoporosis with hormones?
And the answer is yes, in many cases we can.
Dr. Brighten: Okay, so we're going to have to unpack that because I know that there are alarms going out to people. The Women's Health Initiative did an entire generation dirty, in my opinion. And the fact they never dug deeper was such a disservice, but also a testament to the just bullshit that women face in women's health.
But, to your point about the breast cancer, you gotta unpack that. Because this is the first time someone's hearing that. Okay,
Dr. Killen: so it the women's, so in 2002, the Women's Health Initiative told us that these hormones cause breast cancer. And that was why that study, that was one of the reason It was [00:16:00] Why, why it was stopped.
Um, it turns out that it wasn't the estrogen, it was actually the synthetic progestins. which by the way, those of us in the space never use. It was a synthetic ingestants that actually were increasing breast cancer risk. If you use estrogen alone, it was actually decreasing breast cancer risk by 25 to 29%.
And since that time, we've had, there's been a recent meta analysis came out, 10 different studies that they looked at. If you use just estrogen alone without that bad, progestin piece, what happens? And what happens is you reduce breast cancer risk by 22%. So the idea that estrogen is causing breast cancer is completely wrong.
And it is confusing because there are estrogen sensitive breast cancers, but the estrogen didn't cause the breast cancer. Um, and so it's, that's, that's one piece. And then of course we don't use synthetic progestins anymore. We only use progesterone, which does not also does not increase breast cancer risk.
So we know now that if you do it the right way, You don't increase breast cancer risk by taking these medications. [00:17:00]
Dr. Brighten: Absolutely. And I just want to unpack for people. So progestin, this is, this is often so confusing for people because they're told their, their doctors when they're on the pill and they're younger, you're on estrogen and progesterone.
No. Even the research sometimes will say, Oh, the combination pill of estrogen and progesterone. I'm like, that's progestin. Progestin, like, tries to look like progesterone. It's like the, you know, knockoff Beyonce or something. Like, you know, it's just like not the same. Progesterone is, you make progesterone, your ovaries do.
We do have bioidentical progesterones and those have so many more benefits that progestin has never been shown to have. Progestin's been shown to have problems in a lot of people. We're still using it for birth control because, like, we don't have a lot of options again. And, you know, just to add to that.
What is in birth control pills is very different than what we use for hormone replacement therapy. When you take the pill, for example, we give you so many hormones [00:18:00] that it stops your ovaries from working. We are not doing that when it comes to hormone replacement therapy. And I think that time sometimes lends to the confusion as well, because there is a slight increased risk for breast cancer with pill usage, like, um, and for people to understand.
We haven't, we haven't really dove into that in the research to know, is it the progestin component? Is it because we're giving so much estrogen? Is it because, hey, a lot of us who are using the pill in our 20s, we tend to drink more alcohol. We tend to do things that like, that we know are bigger risk factors for breast cancer than estrogen alone would be.
Dr. Killen: Yeah, and I mean, and there was a recent study that just came out actually, um, the last year that looked at, um, different reproductive risk factors for heart disease. It was actually a cardiovascular study and one of the, and it showed certainly people who go into menopause early. increase risk of cardiovascular disease.
We knew that. But it also showed that use of birth control pills increases heart disease risk. And that was one [00:19:00] of the big things that they found. And so again, I think it's that synthetic progestin again, that's that's causing, you know, heart disease risk and and such as well as breast cancer. And you know, the thing is, we We don't tell, and I'm not anti birth control, I know that you did a whole lot on this, I'm not anti birth control, but we spend so much time telling menopausal women how dangerous these hormones are, that they're going to cause cancer and heart disease and strokes and this and that, which is not true.
But we don't tell young women who are going to get birth control that any of this is dangerous. And it just, to me, it's just like, how are we so wrong about this?
Dr. Brighten: It is just, um, it's, it's such the dichotomy, right? Of, and I think it's also, um, It's part of the mindset of women who really are afraid that the pill will be taken away is that we can never ever question the pill say anything negative about the pill.
Like the pill is put on this [00:20:00] pedestal as the savior of women. And while it has had many benefits, I mean, undeniably, when you look at the research of the impact of the pill of our rates of college graduation, um, are, you know, acceleration to positions in the workplace, there's a lot of good that the pill has done.
And, you know, you said you're not anti pill. I'm not anti pill, but anybody who ever is critical of these hormones. Is othered and demonized as a way to stifle the conversation. And I think that has been one of the biggest disservices in women's health led by female practitioners. And that is, I take issue with that.
And you're absolutely right. We are telling women their entire life that this is completely safe for them. Just take the pill. Don't worry about these. Blood clot side effects, like don't worry about any of that stuff. Anyone who talks about it's just fear mongering. Like it's such a small risk. Why even worry about it?
It's like, well, you know, having a stroke is like a big significant thing. And then when women get into menopause, the story flips, these are so dangerous. You should never be on these. And there will [00:21:00] be people who argue, well, because during your reproductive years, you should have more of these hormones. Um, which also lends to the, the idea of like, well, Why is it that just because we stop having functional ovaries, that we no longer need these hormones yet living?
I mean, we live a large portion of our life in the worst health of our life due to the lack of these hormones. And I don't say that to scare people. I say that because this is why you and I and so many others are so passionate about really opening up the doors to these conversations. Yeah, absolutely. I think, I
Dr. Killen: think just as we, you know, just as we people, women in general, we're happy to have the pill because it gave women freedom back in the day and allowed them to make better choices for themselves.
We should be advocating for HRT now, which is much, much safer. And it offers the same kind of freedom. It offers us to work longer to travel more to, you know, do the things we want to do for longer in our lives. And it's the same kind of freedom. At a different time of our lives, but women are still being denied that [00:22:00] even to this day, even in America.
Dr. Brighten: Absolutely. That's so well said. And I've got to circle back to another controversial thing in that you put your mom back on hormones 10 years later. And I'm going to share, uh, that somebody, I haven't gotten her permission to share this. So I'm going to be like very, um, not forthcoming because without her permission, I don't want to give away all of that information, but somebody very close to me, um, was on hormone replacement therapy.
went off of that, subsequently developed neurodegenerative symptoms and ended up with a diagnosis of Parkinson's disease. And I'm so grateful that the doctor that she has, I, they right away, I was like, you should ask them about hormones. And she's like, they said right away, we need to get you back on HRT because that is going to preserve your, your neurological health.
And I was like. That seriously I could cry right now because I'm like that was such a relief because I was already like [00:23:00] I'm gonna have to go and talk to this person and be like hi Can you please help her out because she's important to me
Dr. Killen: Yeah. Yeah. Um, yeah, there's, there is the misconception that you can't start hormones, you know, if you're more than six to 10 years out from menopause.
Um, and I think that this is something, you know, certainly there are fewer benefits, at least cardiovascular benefits, because you've had all those years to, you know, potentially accumulate plaque. And once you have built plaque in your arteries, you know, estrogen doesn't seem to be as good at preventing the plaque, which you already have it, obviously, but there are still many other benefits.
Um, and, and the idea that the hormone, the hormones are not safe when given late came also from the WHI when they were giving us primarine, which again is a synthetic estrogen that they gave it late. And so what happened is you have all these women who have these arteries that are filling with plaque.
Then they give this very strong estrogen, which again is not what we're using now with estradiol. It's very strong estrogen, which actually has essentially like [00:24:00] anti plaque kind of activity. It's like a rusty pipe and you go through it with a rotarooter and the rotarooter is going to, you know, you're going to, throw off those little rusty bits and those rusty bits are going to go to your brain and cause strokes or your heart and cause heart attacks.
So that's what's been so primmer in the first few years in these late start women. They saw a little bit of an increase in heart attacks and strokes because the primarine was so strong at going in and like essentially removing the plaque. But if you started early, we didn't see that. So they said, you should never start it late.
We know now you don't give oral primarine. If you give, you know, transdermal estradiol, for instance, it doesn't go, it doesn't do that. It doesn't. You know, throw off those plaques. It doesn't disrupt plaque, so it's perfectly safe to start transdermal estradiol, um, after 10 years, even if you
Dr. Brighten: haven't been on hormones.
Absolutely. And just so people understand from the Women's Health Initiative, that was one of the big flaws is that they took women who already had established cardiovascular disease and then said estrogen makes it worse. Now, [00:25:00] estrogen. Um, you know, we've alluded to its benefits for bone health to neurological health.
It is also anti inflammatory. So those plaques that are happening that the immune system activation makes that also problematic. And so, you know, just for people to understand where did these like increased cardiovascular risk come from people who already had established cardiovascular disease and then came in to Um, big guns, too much, too fast.
So, this is where I want people, and also my vegans, hi, I know a lot of you are very concerned about HRT because Premarin did come from pregnant horses. That is no longer the case. That's not what we're using. If somebody offers you Premarin, um, run. That's a run situation. Sometimes I'm like, moonwalk your way out of that conversation.
This is a like, no, no, no, no, just run. Same thing, I think for any provider who's like, Oh, you're, you know, 50 and you're having symptoms, just start the pill, just the pill. And I'm like, [00:26:00] let's talk about that. Why don't we want to use the pill for premenopause and menopause management?
Dr. Killen: It's, it's, it's overkill in a bad way.
Um, we don't need, like it's easier for doctors because you are giving these synthetic hormones and very high doses and you're shutting down All of their own hormones. And because, you know, the hormones during this time can be a little wacky, like your, your, your progesterone is going down, your estrogen is going up and down and ultimately down and like your body's like, what the heck's happening?
And so from the doctor's perspective, if you just give them something that shuts everything down, then it's so much easier. Like I don't have to get any phone calls, you know, on a Saturday about why I'm having these symptoms. Um, but from the patient's perspective, it's so much worse because a, you're adding all of these things, which we now know the progestin super inflammatory, you know, just not good for your body in general, um, and you're showing down your own production.
Um, and you don't have the benefit of adding in those very helpful hormones, which you really need during that time. So, you know, being able to add in some progesterone to help you sleep or add in later on estradiol for other [00:27:00] things, for help your bones, et cetera. So I just think that, you know, if you need birth control and you want birth control pills, then that's an, you know, it's an option, talk to your doctor, but there is no reason to take birth control.
If you don't need birth control, if you're in, you know, if you're 50 years old and going through perimenopause or early menopause, you need HRT.
Dr. Brighten: Absolutely. Um, and I love that you said if you need birth control, like, right, because yes, you can still get pregnant in perimenopause and sometimes with twins because those ovaries are like, we're not doing anything for you.
Okay, fine. You've begged enough. Here's two eggs, like two eggs here. Um, we do have to be cognizant of pregnancy prevention. If somebody, you know, doesn't, you know, that's just not on the agenda for that stage of life. You know, the thing about the birth control pill is that it raises a protein called sex hormone binding globulin, which You and I know, we make testosterone roughly 50 50, adrenals and ovaries.
If birth control shuts down your ovaries, there goes 50 percent of your testosterone. If it raises sex hormone binding globulin, there goes more of your testosterone. [00:28:00] Why is this such a problem for women? Because you said something earlier and I'm like, we should come back to that. Yeah, so that's a
Dr. Killen: problem because, well, and I, there's a, SHBG is, it's kind of complex, there's a lot of things.
But in this case, it's a problem because then it's binding up more of your free testosterone and free testosterone is the active testosterone, right? It's the one that's actually working at the receptors to give you all the benefits of testosterone. So people who are on birth control, um, and this can happen even if you're 25 on birth control, but especially as you get older, because your own production of testosterone also going down.
Now you're binding up more free testosterone because of that high SHBG and so you can start having effects of that low testosterone. So you can start having low libido and you're gaining, you know, fat in your belly and you can't build muscle and your motivation is garbage and you're on the couch all day and you're like, Oh, I feel horrible.
And that is because potentially you have low free testosterone because you're taking oral birth control and you're not supplementing with testosterone in some
Dr. Brighten: cases. Absolutely. [00:29:00] Um, we had mentioned just talking about the pill and, you know, specifically with menopause. I don't know if you saw this study.
I talked about this in my book, Beyond the Pill, and it needs to be replicated and we need more research. At the time that Beyond the Pill was coming out, like, I feel like there was just a few of us talking about menopause and, um, Uh, that study showed that within a five year window of entering menopause, if you had been on the pill, it increased your risk of developing diabetes.
And that was so eyeopening. And I remember when I talked about it and people were like, this is just fear mongering again, and I'm like, we're at such a high risk of diabetes because of that visceral adiposity. So, um, People understand whenever we talk about belly fat, minnow belly, um, people, you know, often, especially the generation that we're in, right?
Kate Moss was like the body we were supposed to be like. I think people immediately are like, Oh, so you're just calling me fat. And it's not aesthetically pleasing. I, the aesthetics aside, I'm talking about fat packing around your organs, which is a huge, huge risk for morbidity, mortality. Like I don't want that for, I want people to live their best life.
[00:30:00] With that in mind, we have to understand that the risk for, even if you're doing the great nutrition, lifestyle, all those things, the risk for visceral adiposity and diabetes risk that follows in menopause is significant. So to see something like people using the pill and it may even contribute further, that is super problematic.
Can you talk a little bit about estrogen therapy, belly fat? That's this whole body composition change that happens.
Dr. Killen: Yeah. We know that estrogen therapy, um, you know, when you give it in menopause is it does reduce visceral fat. Uh, it may or may not change your overall weight. Like that may, you know, you have to still do all the other things to change your weight, but it does change the shift of your fat to that visceral fat.
That very impact. inflammatory, awful fat that we don't want. So that is one thing. And then, as you mentioned, um, we also have tons of evidence that estrogen is going to improve your lipids, is going to improve your blood sugar and your metabolic health. Um, you know, all the things that you can't see that are still deep inside that are going to [00:31:00] contribute to heart disease down the line.
Um, Um, many of those things are improved by estrogen. And so it's, you know, some people get worried about taking estrogen because they're worried about gaining weight. Um, and sometimes when you first start estrogen, you do have some water retention and I tell people, this is actually a good thing because it's your body, your body has been like starving for like water and hydration, your cells are like, they're like shriveled up and they're dry and they're like hungry and you give them what you finally give them estrogen and they can retain water.
So you're. skin is looking good. It's glowing. It's hydrated. But you may notice a little bit of extra water retention like, you know, in your belly and your, you know, in your pants or whatever, that'll go away. Um, with either a dose change or just a little bit of time and then kind of some lifestyle changes, but it's actually a good thing that your cells are not like starving for, but so you can notice a little water retention, but you shouldn't be noticing fat gain.
Um, if you're on the right dose of estrogen, you should notice fat loss of anything, or at least kind of staying the same.
Dr. Brighten: Mm hmm. And you've talked about oral estrogen. Oral estrogen is a big controversial [00:32:00] controversial one. And yet, um, you use it sometimes in your practice and, um, I'd love you just to speak about the research about your perspective on when should we be electing for oral estrogen?
Dr. Killen: You know, it's interesting because you're right. I think oral estradiol, and this is all bioidentical oral estrogen, it has been kind of been demonized because there is a, there is a slight blood clot risk with it. And that is true. But so far, the research that we have, and again, this may just be lack of research, but the, like the randomized controlled trials, the real research that we have, that looks at estrogens and cardiovascular disease prevention.
So far, the only ones that show benefit are the ones using oral estrogens, either oral estradiol or even Premarin. And we have several studies that have shown that. Um, there, the studies that have been done, there's not a lot, but then maybe they use too low a dose, but the ones that have been done with transdermal estradiol so far have not shown.
prevention of plaque in the arteries. Um, now I think part of that is that we don't have enough research. Um, but we do know that oral estradiol [00:33:00] is a lot better than transdermal at improving LDL cholesterol, APOB, HDL. Um, transdermal is better, better at improving triglycerides. So you kind of have these two things and we know that there are some other things with oral estradiol, like increasing SHBG, which may not be great for testosterone.
Like there's some benefits and things you have to kind of weigh, right? But I think especially if you have someone for me. If I have someone who's low blood clot risk, but worried about cholesterol or worried about cardiovascular disease, um, or doesn't want to put a cream on every day, oral estradiol is actually a great option.
Dr. Brighten: How can women know their low blood clot risk?
Dr. Killen: Um, I mean, certainly you can get your, some tests done to check for some of your clotting factors, um, to see, you know, factor V Leiden and some of these clotting, you know, risk diseases. But, you know, if you've never had a clot, that's great. Um, if you have had clots, you should Or if you are a smoker, if you are overweight, if you are very sedentary, if you do a lot of international travel and you're sitting all day for long periods, those are all risk factors for blood clots also.
Dr. Brighten: Oh my gosh. But I have to bring this up right [00:34:00] now because, uh, the long travel, I have worn compression stockings, compression leggings, like since, uh, my late I have, um, I have literally always looked to like the generations before me and like, what are they doing? I'm in it. I mean, it's a hack. I'm a bring that in.
I don't care what age you are and how unsec. Actually, they've gotten a lot better. I mean, these used to be like, um, you know, like pantyhose. Style. They were so ugly, but I just wore 'em anyways. Um, uh, to prevent clots for long travel. The other thing is a weighted vest. I just had somebody saying to me, um, uh, threads and they were like, weighted vest, like someone's just gonna walk around in it.
Because I was like, if you're doing household chores, just wear a weighted vest or like walking your dog. And they're like, who's gonna do that? Like, totally like dissing me. And I was like, I've been doing that since I was like 27. Cool. I was teaching a. group fitness class. That's how I worked my way through college and I had taken over as senior citizens class.
And there was a woman I was talking to and she was like, Oh yeah, I wear a weighted vest because I have [00:35:00] osteopenia and my doctor said, this is one of the best ways that I can like build my bone density. Now I know that I'm like, she should also have had, um, estrogen, you know, or even like, you know, uh, at very minimum, some of these soy, uh, isoflavones coming in at like extremely high doses.
They'll never match estrogen, but like, there's just, you know, some of these things, but it was at that age that it was like, Well, if you're doing that, then I should be doing that. And I bought a weighted vest and I would walk my dog in it. Um, and then it was just funny. Cause then bros would always be like, um, you know, run jogging next to me in their weighted vests.
They started seeing them everywhere. And men would be like, Whoa, that's cool. You're like training. And I'm like, yeah, for menopause, I'm training for menopause. Um, but I just want to, like, I just want people to understand, like, you don't have to wait until the moment that you arrive, like when society says that, like, you are old.
And I just, I laugh because I'm like, I don't want anyone to call me old until I'm like in my nineties. Like that's, that's when it's acceptable, uh, because I don't think that your age necessarily dictates that you're old, but I also think we shouldn't wait until we actually [00:36:00] have problems when we can prevent them.
And I say things like, you know, the, the vibration plates, I'm like, everybody should be doing squats on those. Not only does it help with bone density, but anything you can do to help with postural muscles means prevention of fractures and falls in the future.
Dr. Killen: Yeah. Yeah. That actually reminds me. Yes. I love weighted vests.
I have one too, but I was a little bit later to the party than you, but the compression socks, I also wear them. And I have a funny story for you, which is that I have like a pair of like kind of fancy, like they've got like patterns and stripes and you know, but they're like up to like my mid thigh compression socks that I wear when I travel.
And so my husband, he has this thing for like tall socks. He thinks they're very sexy. And so one day we were like, he was like looking through my socks. And he was like, Oh, Amy, you should put these socks on and put some, you know, get your, some sexy clothes on and I was like Those are my compression socks.
Dr. Brighten: They are not sexy. Okay. But like, seriously, if you, if you're someone on the fence about compression socks, let that be a testament to how far they've come. They're not the pantyhose look anymore. [00:37:00] I have like cute, like thicker ones. They look like they'd be snowboarding socks. Um, now I'm like, I should get some sexy ones.
Um, that just might be fun. Making compression stocking sexy. Uh, I love it. Um, So I'm just cracking up. So I want to talk about, um, testosterone though, cause we've brought it up a couple of times. Um, you know, I see a bit, one of the biggest pushbox that I see from patients, well, people on the internet mostly is people saying this isn't FDA approved, so let's talk about FDA approval.
Cause I think it's going to be eyeopening to people and then we'll talk about testosterone.
Dr. Killen: Yes. Um, so it's so funny, even doctors, I mean, this happened this week. I had doctors. Who were like getting very upset because I was talking about, you know, using non FDA approved therapies and, and, and I, and I'm like, you know, you're, that's illegal, you're going to lose your license.
And I was like, there is such a disconnect between what's truthful [00:38:00] and what people think is the truth. Regarding off label or non FDA therapy, so testosterone is not FDA approved for women. That is true, but it does not mean it's illegal or a problem for us to to write prescriptions for this for women.
We can use male testosterone. Um, or compounded testosterone from a compounding pharmacy, and we can adjust the dose, um, for women. And that is perfectly legal. But many doctors actually don't know that. And they think that they will lose their license if they were to prescribe testosterone for women, which is just crazy.
Dr. Brighten: Yeah, I absolutely agree. And I think so many people don't recognize how many drugs are used off label. Like you think about spironolactone for acne, so many women taking that. And that's. That's not what it's intended for. That's not what it was approved for. So this happens all the time, but there seems to be this controversy specifically to testosterone in women.
And to make it just crystal for everybody, women require testosterone. We need [00:39:00] it. And the libido, you know, side of things is very, very important. Um, even the world health organization is like sexual pleasure is a very important aspect of somebody's health It is affecting our brain it is affecting our muscles But one of the biggest reasons that women end up in nursing homes is due to urinary incontinence and we can prevent that With topical estrogen so for people to understand that we talked about oral estrogen.
We talked about topical estrogen Using something like estriol on the vaginal So using that on the vulva You That's not problematic. Even if you, even if, uh, you would be someone who's contraindicated for using estrogen therapy, we can actually use that still and support your pelvic floor, but testosterone as well, and maybe even, uh, DHEA.
And so I, you know, I've been prescribing HRT for over a decade and there's times that I would use a, um, DHEA if somebody was really concerned about using testosterone and DHEA is a hormone that converts to estrogen and [00:40:00] testosterone. We don't have as much research on that. However, I think that so often, We don't talk about pelvic floor dysfunction.
We don't talk about urinary incontinence enough. It's very embarrassing for people who have it that they don't want to just like, you're not going to just tell the world about this. Um, and yet it is something that a lot of women struggle with postmenopausally and it lands us in nursing homes and that's really concerning when you consider quality of life.
Dr. Killen: Every woman over 50 should at least be taking a low dose vaginal estrogen. That's it. There's no qualifiers like every woman, low dose vaginal estrogen. Like you mentioned, it's not absorbed systemically. So it stays in like the pelvic floor area to affect your bladder, you know, your pelvic floor, your vagina, your vulva.
It does not get into the rest of your body. So even breast cancer survivors, they've studied this, even breast cancer survivors can take low dose vaginal estradiol and, or, you know, like you said, low dose vaginal estriol, [00:41:00] which is another type of estrogen. Um, there's no reason not to. If you're taking systemic estrogen, you may not need both, but you can take both.
Um, but there at the minimum should take the one. And what's, what's, well, it's not funny at all, but when my mom broke her hip, took her off her estrogen, you know, she's now immobile. She can't get to the bathroom very quickly. It's a, it's a whole thing. And guess what? She started developing urinary incontinence.
Because she'd been on estrogen for 10 years and now they took her off of it and they didn't even give her vaginal estrogen. And so this poor woman can't get to the bathroom in time because she has a broken hip and now she's having all this, you know, urinary incontinence, which is not uncommon in women, especially if you're not taking the estrogen.
So that is so important. And I think that that's something that's not talked about. Um, even like urologist, you'll have multiple UTIs, which by the way, kill women all the time. Bladder infections kill women all the time. They become, you know, kidney infections and they get into your blood and you become septic and you die.
And so this, not all, not everyone, obviously, but this happens sometimes. And so, you know, just [00:42:00] something as simple as keeping women on a low dose of vaginal estrogen can prevent. Bladder infections recurring. It can prevent urinary incontinence. It can prevent sexual, you know, problems and pain with sex and all of that.
And it's such an easy, such a low risk thing to do. Cheap as well. And yet no one's doing it still.
Dr. Brighten: Mm hmm. I'm so glad you brought up UTIs because I look at the antibiotic resistance we have to the organisms that cause UTIs and I can't help but have a huge question mark of doctors chasing UTIs in the 60 plus population over and over with antibiotics and never considering this estrogen, have they actually set up these super organisms to, you know, be, you know, untouched by antibiotics?
Like this is an impact so much beyond the individual that we have to be considering. And for people to also understand that the health of your vaginal ecology, so your vaginal microbiome Is, is maintained by estrogen. [00:43:00] Estrogen is what gets the cells to produce the sugar that feeds the lactobacillus species that keep the pH optimal in the vagina.
The vagina can handle itself in many, many scenarios, but without that estrogen, it's really, it's like, it's completely lost its ability to throw down when creatures that should not belong there have found their way there or commensal flora. So normal things like yeast, they should be there, but left unchecked if that pH isn't right, then we've got yeast vaginitis.
And so estrogen is serving more than just the pelvic floor. It's literally helping you maintain the microbiome and immune health, kidney function, you know, these things. It's interesting because as we talked about that study early on, it was in the 60s that they were like, that's when the kidneys get hit.
And I'm like, yes. Yes, and let's do everything we can to keep them healthy.
Dr. Killen: Yeah, I, you know, I was an ER [00:44:00] doctor for 10 years before I transitioned to this, this field, um, 10 years ago, but I look back now at all my little, little women who came in with Eurosepsis. So, you know, which is essentially systemic infection that came from a urinary tract infection that are super sick and, you know, or just coming in with UTIs over and over again.
And I wish that I'd known then that I could just write them prescriptions. For vaginal estrogen, like, can you imagine an ER doctor writing prescriptions for vaginal estrogen to their ER patients, but it would have actually made a difference probably as much of, or more so than the antibiotics I was giving them.
Like those two things gotta give them both
Dr. Brighten: just the fact that as an ER doctor, you would consider going above and beyond and prescribing that. This is why I love you. Amy, you're Favorite people because you, you know, there's the algorithm that has to be followed so that we all make sure people don't die, right?
We have our algorithm and then there is the individual who sits in front of us that we need to make sure that they are having their [00:45:00] needs met. And I just absolutely love that about you. I do want to shift the conversation into talking a bit about what, what are other things people can do if they're, they're still not, they don't want to jump on HRT because like, for whatever reason.
Or they're not a candidate. Let's talk about what are some other options that can really help ourselves have the best shot at aging in the current environment that we live in.
Dr. Killen: Yeah. Well, I'm, I'm a big fan of a few things. I want to talk about rapamycin at some point. Cause we had this,
Dr. Brighten: and
Dr. Killen: that's one of the things that is possible.
It's still kind of early days. Um, I'm also a big fan of supplements. You know, I, I think, you know, you have some supplements too. I have a supplement company called Hotbox, which is like longevity focus for women. And there's some, there's certain ones I think that are really important. Like for instance, um, dihydroberberine or berberine is something that I love for women, cause it's great for blood sugar control and, you know, it's kind of, it's kind of comparable to like metformin in terms of keeping your blood sugar down.
And I think.
Dr. Brighten: Yes. Burberine is also one that [00:46:00] people often compare to GLP one and they call it the natural GLP one. So what is Burberine? Um, I will say that I actually, um, in my house in Portland where I used to live, I had an entire front yard of Burberine because I've always been a fan of it and I used to To joke that like if end of days ever happened, if I had organ grate root and I could extract berberine from it, then my blood sugar is controlled there.
It can help with infectious. Like I had my whole thing, but I know it's amazing. Yes, berberine is awesome.
Dr. Killen: Ine it's a plant. Um, and we, you know, certainly supplements for, we have berberine or dihydro, berberine, which is, uh, a more bioavailable form of it. But anyway, basically it is, it's great for blood sugar.
So lots of data on that. Keeps your blood sugar lower. Comparable again to like metformin medication, but it's also an anti-inflammatory. It also does have GLP 1 activation or kind of acts, you know, kind of get your own body to increase release of GLP 1 in the intestines, which of course GLP 1s are your, your ozympic medications have that same activity.
And those medications have a lot more activity than berberine for sure, but it [00:47:00] can have some of that. It also has a little bit of PCSK9 inhibitor activity, which, you know, these are, these are new drugs that are like being touted in like the, the lipid cardiology circles as being like the best thing in the world.
PCSK9s. Um, and they essentially keep your, your LDL cholesterol and your APOB really low. It's an alternative to statins. Anyway, berberine also has PCSK9 inhibitor activity, just like those new drugs. Again, not as much as the new drugs, but they, so they can help with lipids. It can help with sugar. It can help with inflammation.
It can help with, you know, a lot of these things that these are all the things that become problems. when we shift into perimenopause and menopause as women. These are all that we start to see problems with. So that's, I think berberine is fantastic. Not everyone tolerates it, but I do love it.
Dr. Brighten: When would you say people should consider starting berberine?
I mean,
Dr. Killen: I think 40 plus certainly earlier is fine. But I think especially as you're in that kind of perimenopause, beginning [00:48:00] perimenopause, early forties, mid forties is a great time if you have higher blood sugar or, you know, if you're prediabetic or kind of trending that way than even earlier, or you have polycystic ovarian syndrome or anything like that that has that insulin regulation problem, then starting it earlier is great.
And some people will get upset stomachs with berberine. So you want to make sure you're taking it with food and, you know, we're taking the dihydro berberine, which is a little bit more bioavailable at a lower dose. But I think it's, you know, it's, it's very safe. And it's something that doesn't have the side effects that you get with like metformin, the medications that go with it.
And so we don't have some of the same nutrient issues or our muscle building issues or things like that with berberine.
Dr. Brighten: Yeah. But, you know, berberine and myonositol. They, they rival metformin in a lot of the studies. And what I will say about them is that we always caveat with like, Oh, they can cause a little bit of an upset stomach, but anyone who's ever taken metformin and experienced the upset stomach, they're always like, what are you talking about?
Like patients that have been like, I can't tolerate metformin, uh, that, you know, I need to go a natural route. We use some of [00:49:00] these other things and I have worn against that. And they're like, compared to metformin, that was, this is like nothing. And I'm like, it's true. It really is true.
Dr. Killen: Yeah, yeah, that's a great one.
Um, I really, of course, you know, vitamin D is really important. I think a lot of people still don't get enough of that. If you're not getting it from the sun, make sure you're taking that vitamin D3 with K2. And I think the K2 is really important for women, especially because I think of K2 as being like the Robin Hood.
of like your calcium. So, you know, you have, basically it takes calcium out of your blood vessels where you don't want it. And it moves the calcium into your bones where you do. So K2 is really important for blood vessel health as well as for bone health. And a lot of the vitamin D3s will come with K2. So I like that combination a lot for women too.
And I think that people take vitamin D, women do, but they don't know about how important the K2 is as well.
Dr. Brighten: Absolutely. I just want to echo that because there are some things that people come in and their doctors like your vitamin D was low. They put them on D3 [00:50:00] 5000. I, I use and I'm like, where's the K2?
And they're like, they didn't say anything about that. And I'm like, and this is where I love that your doctor is checking vitamin D. I love that they're actually putting it on. being proactive about it. I don't love they don't get the nutrition education to understand that while these things are natural, there are consequences, right?
Like there's things like, you know, zinc is such a crucial, important nutrient. We talk about it for like 80 HD. We talk of her skin health for P. C. U. S. And yet people have to know that you can't just go out and make a dozing and not couple it with copper as well. And so you have to understand These interactions.
I really appreciate you bringing up that nuance there. Um, I, you were on a roll before I was like, tell him about Burberry.
Dr. Killen: Because did you see that the endocrine society just changed their guidelines for checking vitamin D? And so the new guidelines from the endocrine society. world, like across the U. S.
is that we should not be checking vitamin D levels on anyone unless you're over like [00:51:00] 75
Dr. Brighten: or,
Dr. Killen: you know, or you have like some, like a specific chronic disease that they think is like, essentially the guidelines are vitamin D is not that important. And why are we checking it? Um, when, then we have to do something about it.
It's
Dr. Brighten: crazy. Isn't that like seriously though? Like I feel like any patient you can leave us a comment. I feel like this is kind of what it feels like sometimes of like their doctor doesn't want to do these things because then they actually have to do something about it. I feel like it can really feel that way sometimes.
And I want people to understand that there's these societies that sit above doctors who say this and that your, your doctor's trying to be the best doctor and following, like, we fought, we look at the guidelines. Um, and I did see that. And what I saw was a huge pushback from so many of physicians across the board, regardless of their background saying, absolutely not, absolutely not when we know that low vitamin D alone is associated with increased risk of breast cancer, like the number one cancer that women are facing.
And now you're saying, don't worry about it. I don't know. Like, I, [00:52:00] I'm, I'm always cautious to use the word conspiracy theory because whenever I feel like, oh, this is a conspiracy here, it usually is true. And it usually comes out true. So I'm like, something evil is lurking underneath and I'm not here for it.
And anybody, let me just say to patients that your doctor is, is very good at critical thinking. And if they use that critical thinking cap, they're not going to be, I mean, there's been a big pushback on that because it, It doesn't have science to support it. That's the big thing. It's kind of like the food pyramid that forever and ever never had science to support it.
And people were questioning it. And then, you know, you had practitioners like you who were like, don't question the food pyramid. It's like the best thing we have. And then I mean, this has no science and the guidance it's providing. It's actually all based on the lobbyists who paid the most money to get at the bottom of the food pyramid.
Like we're subsidizing grains and, you know, All of that. So it ended up at the base of the food pyramid, the base of the American diet, the basis of why we have so many health problems now. So, okay guys, [00:53:00] I'm going on a tangent here. I just want to say like, this is why. This is why I'm doing a podcast. This is why I'm speaking to people like you, because people deserve access to information, this, the science that we do have and the ability to, um, basically have access to information that should never be gatekept so that they can think through it critically through the lens of what is true for them.
All right, let's keep rolling. I don't know what you're going to say next, but I know what I want. Axis, Anthon, I want to talk about that because I have taken that supplement, like Forever. Uh, usually around four milligrams is what I take. It's a great antioxidant. Uh, so people know this is what makes your salmon the color that they are.
This is one of the things that makes salmon so beneficial. So I'm like, you know, I'm gonna cut out the middleman. I still eat my salmon like all the time, but I'm gonna cut out the middleman. I'm gonna get me some, um, some of this. And, and, uh, did you see the study that came out on men in terms of, uh, lifespan?
Dr. Killen: No, uh, no. I don't think I tell that one.
Dr. Brighten: [00:54:00] Yeah, so there was, um, I, I don't have it all. I wish I had read it and prepped for it, uh, before we talked, but I, I believe it was almost a decade. It was like eight to 10 years increased, like lifespan intake. It was like something really significant and I was like, look, as much as I'm always like women or not just small men, that is one thing that I'm like on it, doing it.
And my husband, yes, I'm like, choke it down buddy, because like, um, this is not, I just want people to know that, um. When, and we're not making claims that supplements can make you live forever, cure disease, anything like that. Uh, and you should definitely always talk to your doctor, but when you see something like that, that a supplement is having that kind of impact, this unlikely, it's just the supplement alone, but this is like to know about this supplement is to be.
Like an extra level of health conscious and, uh, to also just understand that if a supplement is contributing to that, it's, it's so much more than just an anti aging, but let's talk about it because this is something that's in your hot box. [00:55:00]
Dr. Killen: It is. I love acetazanthin. Um, and yeah, certainly there are, uh, it's a, I call, I call it the queen of the antioxidants.
It's much, you know, it's a much stronger antioxidant than we think of as other like antioxidants that are out there, but, uh, you know, there's, there's, there's good research for Alzheimer's prevention. That's, that's one of the things for brain health. I think it's, it's got a lot of benefits and then skin health has a ton of benefits for skin health.
It's one of the few things that actually can protect your skin from Beforehand, like you put, you take it beforehand, like if you're going on vacation and like a month, start taking asanthin because it can help protect your skin from the photo damage of from the sun. So essentially can help protect your DNA from getting damage from the UVA radiation of the sun if you take it before and then after if you take it after it can help you to repair that DNA.
Damage from the sun. So it's, you know, I think the sun in small doses is very beneficial. And I think that you want to just kind of balance that, you know, with skin health. Obviously, if you get too much sun, it can cause rapid skin aging, but acid and then is an amazing tool to have in your [00:56:00] kit for just improving your skin texture and tone and hydration in general, but especially as it relates to some damage.
Dr. Brighten: Mm hmm. I live in Puerto Rico. So Astaxanthin is like my bestie because there's so much sunlight there and I think this is I would just say is much more beneficial to take that rather than try to pre tan as People will do and as you you're right. We do need we talked about vitamin D. We do need sun exposure And like right now there's this like huge, like anti sunscreen camp.
I feel like we always just like have these such extremes and then, you know, and that's what social media is like, yeah, extreme controversial, put it out there. And then there's those of us that are like, lots of truths exist in the middle. Um, and social media is like, don't put that in front of people.
That's boring. You didn't make anyone mad with that. But there's a lot of like anti sunscreen rhetoric going around. Hmm. And I, you know, I want people to understand, and I'd love to hear your take on it, that [00:57:00] yes, not aging, like not having excess wrinkles and things, that's a desire of a lot of people. But we're also talking about the integrity of the skin.
Yes.
Dr. Killen: Yeah. Yeah. I think that, you know, you don't want to burn first of all, and that I don't think anyone disagreed with that. Um, and certainly photo aging. So aging from the sun is the number one driver of just, again, like loss of integrity of the skin. Like it helped. It worsens the health of your skin. It damages the DNA of your skin, and it also causes wrinkles and problems with hydration, all of this.
So it is important to protect your skin. I say I tell people at the very least put some sunblocks or like a like a mineral sunblock is what I like. Zinc oxide, titanium dioxide. Put a sunblock on your face, your neck, you know, maybe your upper chest. I'm starting to have sun damage on my chest and I'm like, ah, but anyway, you know, put it on those places at least every day.
And then if you want to go out and get some sun exposure on other areas to get your nitric oxide and your vitamin D and your serotonin and like all the things that good things that come from the sun. That is, that's great. You just kind of want to be careful and not go [00:58:00] overboard, but the sun is important, but also, so is protecting your skin.
Dr. Brighten: Absolutely. Last question I have for you. Last topic, rapamycin. Yes, this is exciting. I'm, I'm, I'm waiting. Well,
Dr. Killen: there's a lot, you know, this is a medication that's previously been approved since the late nineties for like graft versus host disease, certain types of cancers. It's immunosuppressant medication if you give it every day.
But recently, the last several years has been talked about for longevity, and there is a recent study that the first phase of it was just reported on. It hasn't actually even come out, but we're looking at rapamycin for to delay ovarian aging and improve fertility in women. So I think that this is something that's exciting.
But in that study, they basically took, um, I think it was 50 women. They gave them low dose rapamycin, just five milligrams a week for three months, and they were looking at their ovarian reserve and like, you know, how many follicles are being thrown off and kind of killed, you know, they get thrown off and then they die like every, [00:59:00] every week or every month in comparison to before the rapamycin and they were seeing trends towards rapamycin decreasing.
The number of follicles that you're kind of throwing off that then go to die, which is horses that which is a great thing to do, because then you potentially have more eggs or follicles for longer, and then you could potentially be fertile for longer and have menopause get pushed off. And they're, you know, they're saying maybe up to 5 years.
We don't have the rest of the study yet, but the early indication is it's very safe and potentially helpful in those purposes.
Dr. Brighten: I need this before. I'm like, I need this before 50. I need to know this. So, um, let me just back up and explain to people every single cycle, you recruit a bunch of follicles and only one is chosen.
Follicles are pre eggs. Like I want to be an egg. Will you choose me to be an egg? And no, the ovary, both ovaries, they only choose one. One gets ovulated, the rest doesn't. And that goes into depleting our ovarian reserve, which can be measured via antimalarian hormone or AMH. And [01:00:00] so, the study is saying, If we can hold more in our savings account, then we don't deplete it.
We're not on a shopping spree, right? We're not just like blowing on our cash. We are delaying that over time. And by delaying the loss of eggs, we can may potentially delay the onset of menopause. And why is this a good thing? Because we live much longer now we are, you know, not just live. We're not going through menopause at 50 and living to 60.
We're living until like 80, 90, a hundred. We, it makes no sense. From an evolutionary perspective, except that maybe we've just, we've just changed our lifespan too quickly for the body to adapt, but we should be much later in menopause, given how our lifespan, and this is what science is currently trying to answer for women, because when people say like, well, menopause is natural, it actually just makes no sense.
It makes, it drives me nuts because I'm like, this doesn't make sense for how long you live and how long you go without these hormones and how much that they can impact you.
Dr. Killen: And we're [01:01:00] one of the few mammals outside of, uh, I think it's orcas, some sorts of whales that actually go through menopause midway through their lives.
Other animals, they don't, they continue to make hormones all the way up until the end. Um, and so we're, we're these weird, there's, we're a weird anomaly that really, there's not really good reason for it.
Dr. Brighten: I just have to giggle. Cause as you said, orcas, what came to mind is the orcas just crashing yachts and taking them out.
And like, I'm just like menopausal orcas being like, we've had enough of you in the ocean, enough of you all up in our space, like get in your place. Like, and that is exactly what I love about. Menopausal women is how they're like, this is my boundary. This is like how I want to live my life. I unapologetically are myself.
And I have always seen that as such a powerful aspect of menopause. And now to think about the, the orca analogy of them just being out there, just being like, we're menopausal orcas. Like we do what we want. We're all
Dr. Killen: pissed off because we don't have the proper hormones. So we're all just like.
Dr. Brighten: Get out of my [01:02:00] space.
Well, this has been such an awesome conversation. I will be putting links to where everyone can find you. But if you just want to shout out for people who are like, I'm hot right now to go chase Dr. Amy Killen. Where can they check you out?
Dr. Killen: I'm on Instagram. I'm Dr. Amy B. Killen. I'm pretty active on that.
And then I'm also have a website dramykillen. com. And, um, I have several companies that are all linked on the website as well, including Hotbox Supplements and also a Longevity Clinic franchise called Humanoid that is launching this summer in Austin.
Dr. Brighten: Um, okay. Excuse me. We're going to have to have another conversation all about that.
Well, thank you so much. You have really, I know, enlightened, inspired, and helped so many women, not just via this conversation, but social media and all of the work that you do. So, really, Thank you. It is such an honor to call you a colleague and a friend.
Dr. Killen: Thank you so much, Jolene. Thanks