Aging Gracefully: Sexual Health, Wellness, and Longevity Tips for Women with Dr. Mirela Cernaianu

Get ready to transform your understanding of women's health in this groundbreaking episode of the Crackin Backs Podcast featuring Dr. Mirela Cernaianu, a leading Ob/GYN expert. Dr. Cernaianu delves deep into the transition from traditional disease prevention to a modern wellness-focused approach, highlighting the profound impacts this shift has on women's healthcare and the challenges it presents.

Join us as we unpack the complexities of Hormone Replacement Therapy (HRT). Dr. Cernaianu provides a balanced view of the benefits and risks, guiding women on when to consider hormone testing and intervention. For those hesitant about HRT, discover alternative therapies like pellet therapy and lifestyle changes that can effectively manage menopause symptoms.

In this episode, we also tackle the often-overlooked topic of sexual function as women age. Dr. “C” shares her expert advice on maintaining sexual health, addressing issues from vaginal dryness to muscle atrophy, and even secrets to get that “Fire” back!

Explore the double standards in aging treatments for men and women, and learn about off-label products that can help women manage aging just as effectively as men. We also discuss the evolving lack of need for mammograms and the importance of personalized healthcare strategies.

Listen, subscribe to the show and learn how to be healthier for a better YOU.

If you would love to hear more from Dr. “C” you can subscribe and listen to her podcast HERE

We are two sports chiropractors, seeking knowledge from some of the best resources in the world of health. From our perspective, health is more than just “Crackin Backs” but a deep dive into physical, mental, and nutritional well-being philosophies.

Join us as we talk to some of the greatest minds and discover some of the most incredible gems you can use to maintain a higher level of health. Crackin Backs Podcast

Transcript

Dr. Spencer Baron: 0:00

Welcome to a groundbreaking episode with the gynecologist, Dr Marella. We're diving into the revolution of women's health, uncovering the truths about hormone replacement therapy, hormone testing, mammograms, as well as revealing the secrets to Aging Gracefully. Don't miss out on her expert insights on wellness, sexual health and the double standards when it comes to aging. Tune in now for a transformative discussion that every woman and man needs to hear

Dr. Terry Weyman: 0:39

have on this show today. Dr Siriano, how's that? That pretty good. We're gonna call it, Dr Steve, just for the for the show. But I think what I'm really excited about this we have, she's a an OB GYN, and we have so many questions asked all the time about women's health, and we haven't really had this kind of discussion on the show yet. So we're really, really excited to have you on the show. Dr, C,

Dr. C: 1:04

awesome. I'm excited to be here. Hi, well,

Dr. Terry Weyman: 1:08

yeah, we were talking even on text. And traditional health is always been centered around disease prevention. And you're seeing this, this wave from books and TV shows and all that. We're seeing this wave that that people actually starting to think maybe about their wellness and and you have, you have a wellness focused Model Transfer well women's health care, what challenges you see in this transition of getting mindsets changed from prevent these disease prevention to a more wellness body.

Dr. C: 1:39

So we need to change the perspective, and we need to change the way people look at what health means to them, because right now, everybody's focused the medicine, the way we practice medicine, the way we are trained in medicine as doctors, is just pretty much focused on disease. The way insurance reimburses is based on disease, diagnosis, symptoms. So if somebody comes in for a wellness check, you code for that one time a year, and then that's the end of it. And it's very limited. It's super limited. So it's people don't worry sometimes about their pension fund until they're about to retire, which is obviously a bad idea. But smart people invest in their pension fund early on, like I started putting money in my 401 k as soon as I was able to here in the United States. So it's been about 20 some years that I've been putting money in my 401 k. And I believe that the concept of wellness be needs to be very similar to our financial investments. Actually, you should be more worried about investing in your health than you are about investing in your 41k because if you end up with a big amount in your 41k but your health is in tatters and you're sick and you're dying of cancer, then who cares about your pension fund? So people focus on the little things, which is not the right way to go about it. And I think if we wait to feel sick or to actually have a symptom and then go to the doctor, is going to change the perspective, and it's not going to be anymore, okay. I'm well, let me make sure everything's all right. It's more about and how can I keep being well? It's more about okay. Now I have a problem. Let me fix it so it's very few people think about it this way, and I think we need to change the perspective. I do have my own podcast, and I have a episode where I entitle it. Do we need expert wellness experts? Because right now, no one's teaching wellness. There are associations like a 4m American Academy of anti aging American Holistic Board of Medicine, you can get additional training. People talk about wellness. So in order to understand wellness, you need to understand a lot of things, how cellular interaction works, the metabolic pathways, how the hormones interact with everything else in the body. And it's more about preventing, restoring back to normal and keeping the back to normal. Now, on the side of the patient, they're like, Why feel good? I don't need to go to the doctor until I feel bad. And that's a mentality that needs to change.

Dr. Terry Weyman: 4:16

Perfect. Yeah. Would

Dr. C: 4:18

you like my 401?

Dr. Spencer Baron: 4:21

K, love, yes. What's set that up and flowed right into it. That was,

Dr. Terry Weyman: 4:25

I use analogy of cars all the time I go. Why we spend so much money on trying to restore our car, but we don't put anything into our bodies. You know, I call most of the anti aging clinics in the United States dent repair. Yeah? You're to otherwise the guy thing, yeah, that's a guy. And I'm like, you put, you fixed your dents in your car. But if it can't get out of the driveway, what's the point? You know? So, you know. So I love the 401 K analogy. Awesome. Yeah. And one of the questions I got asked when I when people knew you were coming on the show, especially from men. Yeah, you know, my wife is getting ready to go through menopause, and what's this hormone replacement therapy? And my wife asked me to ask you, to ask this doctor about HRT or hormone replacement therapy, and it's such a contentious topic, in your opinion, what are some of the significant benefits and risks of HRT, and what point should women consider even being tested or innovated with it?

Dr. C: 5:28

So there's multiple questions in that question, right? So first of all, let me start going backwards, because you asked about, when should women consider testing? And that's an excellent question, and we go back to the model of disease versus wellness. So when we test hormones, what is the reference point? We don't have a reference point. So when people decide to test hormones, it's like, I don't feel good. Let me test my hormones. So then your best reference point would be what your hormones look like when you felt your best, and nobody talks about that. Nobody advises anybody to go test their hormones, except for me on my instagram and podcast. But ideally, women, when they feel their best and not on any hormone replacement. They're not on birth control pill or any birth control method. For them, for that matter, they should go and test their hormones at a certain time in their cycle to see what they're doing and what's the reference point. That's a wellness indicator, because it varies from person to person. And testosterone is highly variable. It varies from person to person. So people start testing hormones when they're already down, they're already decreased, diminished. So they look at something like, okay, it's in range at the lab. So the doctor that interprets the hormones, if they're not trained, they don't understand the optimal values, they don't have a reference point. They're just going to go with whatever the quest lab range is, and it's going to say, Okay, well, you're in range, you're normal. They're not going to say it that way. They're just going to say you're normal. So people feel frustrated, and they're like, wait a minute, I'm normal, but I don't feel normal. So what is going on? So then they get all this conflicting information, and then they go to a doctor who's trained in hormones, and they're like, Well, no, your hormones are not normal. And if they have the time and the patients, they would sit down and explain, so your estradiol is 67 Yes, that's in range, but it probably used to be 200 so if it used to be 200 and now it's 67 you're not going to feel good at 67 it's a big difference. And same for testosterone. For men, if your testosterone used to be 800 to 1000 or more when you were young and healthy and fit, and now it's 400 sure it's in range. The range is 200 to 1000 or 1100 but that's not normal. You're not going to feel good. So that's one question. So when do we need to start worrying about the hormones? Well, when we start not feeling good, women have this large transition period, which actually happens for some women in their late 30s, for some women in the early to mid 40s, and then it's called perimenopause. So their estrogen doesn't go from 200 to zero in like this in a few months. It starts declining because the ovarian function, the our ovaries, I'm doubt, with a certain amount of eggs, and they keep, you know, popping and ovulating every month, and eventually we're going to run out of eggs. But as we get older, the quality of these eggs are not up to par. So that's why we already, everybody knows you should get pregnant when you're young, because you're more likely to be fertile and have a good outcome and a good pregnancy. The reason why that changes as you get older is because our eggs get older as well. So the quality is not there, and the quality is not there, which determines lower hormones. So you're going to have lower hormones because of that situation. So that's perimenopause, and that most women, I use this analogy a lot, and because it drives it home for people, when you're at menopause, there's zero hormones. You don't have any more hormones. As far as sex hormones, estrogen, testosterone, progesterone, for women, they're pretty much done. For most women, if the testosterone, there's no andropause for men. So that's a totally different situation. But you asked about your wife, so we'll stick to the women for now. At menopause, you have no hormones, so it's kind of like you're on a lake with no wind, in a boat with no sail, no oars, so you can't move. So unless you use your little hands to just kind of float around, you're gonna be stuck. You're just not moving. For women who are perimenopausal, you have the boat, you have oars, you have sail, but you're in a tempest. You have waves. They go up, they go down. So your hormones are crazy. You go from highs to lows, from highs to lows, and that's very bad for most women, and then they don't understand what's happening. I'm getting irritable, I'm getting cranky, I'm gaining weight. I have cravings. I don't sleep at night. My periods are weird, and then I start. Biting and you know, back to my children, back to my husband. I don't want to have sex anymore. Sex is gone and pleasure is gone. Maybe I put along, I go along for for the drive, I put up with my husband. But that changes the mood, that changes the relationship. And if we honestly look at divorces, most of them happen unless you really made a big mistake and married the wrong person, which you should figure that out in six months. Most of them happen in their 40s and 50s, and that's because women are having such a rough time with their hormones. They're not seeking help. They're not getting help. We could probably save way more marriages, in my opinion, if women would test their hormones early. Wow.

Dr. Spencer Baron: 10:40

What hormones do you test for?

Dr. C: 10:41

So we would test the estrogen, the progesterone, the testosterone, and again, when we test the hormones in one cycle, I talked about the eggs, how some eggs would be good, some eggs would be kind of weak and not up to par. That can happen every two months. Every three months. It can happen every month for a while, and then you have good cycles. So looking at one cycle one time, it's a really skewed view, so you always have to take the things and the symptoms the woman presents in context. You don't look at just the lab. We don't treat the lab. We treat the person. And it's important to listen to the woman or the man and talk to them and find out what their symptoms are and if they have any cyclicity, if their symptoms come and go. So there's a lot of art in taking an appropriate interview and discussing with the person what are their symptoms and how do they feel. But we have estrogen, testosterone, progesterone, cortisol is the stress hormone, and there's different different ways of looking at cortisol and testing for it. Insulin, it's a very important hormone. As estrogen changes and testosterone changes, we become more insulin resistant. So we're going to have all kinds of changes in the body that raise our insulin and screw up our sugar levels. And then we have the other adrenal hormones, like DHEA and pregnant alone, those are actually pro hormones, and you can actually buy them over the counter as supplements. So there's growth hormone that a lot of people unless they've had training in anti aging therapy they don't know anything about. Endocrinologists only know to treat acromegaly, which is too much growth hormone or growth hormone deficiency is someone who's born with a hormone deficiency or has a tumor, they don't really treat the aging deficiency of growth hormone. So those are the two, the major hormones that are impacting our body. And then we have other little hormones, aldosterone, sodium, potassium, regulation hormone. We have oxytocin, prolactin, we have all kinds of additional hormones.

Dr. Spencer Baron: 12:46

You don't test for those, though.

Dr. C: 12:48

Do you you oxy prolactin, you can test because it interferes with the sex hormones, because it's coming from the pituitary. Oh, I forgot thyroid, that's a very important hormone, so I'm not ignoring it. I just forgot about it, but yes, you oxytocin, it's more experimental. It's also called the love hormone. So we don't really test levels for oxytocin, and there's no because it's experimental totally we use it a lot in women who have given birth for postpartum to support their uterine contractions. But otherwise we use it for women that and men who have issues with connection, with social connection, low libido, kind of blah mood, and they don't want to go to antidepressants, they don't want to go to sex hormones. They don't want to go to other things. You can actually try oxytocin, and it's intranasal spray, and it can be titrated depending on the symptoms and response. But yeah, there's quite a few hormones, and we have about maybe 20 some hormones in the body, and the sex hormones is where this divide in our Medical Society is and exists and has been going on for probably about 20 some years, since 2001 when the Women's Health Initiative study came out. That was a study that was actually sponsored by Wyeth Earth, the company that made Premarin, which, in case, do you know what Premarin is? So it's horse urine containing 17 equine types of estrogen in a pill form, HCG,

Dr. Spencer Baron: 14:28

HCG, or the No, just,

Dr. C: 14:31

just equine estrogens. Just estrogen.

Dr. Terry Weyman: 14:35

I heard about that. Yeah, just

Dr. C: 14:37

estrogen produced by pregnant mares, collected in the urine because estrogen gets eliminated. Estrogen gets pooped out. Peed out, your body gets rid of it. Your body produces it every day. So they actually had a big situation when they bred a lot of horses to get the urine and make this primer, which they thought is going to be the miracle drug, and it's going to save a. Lives and do all these things. Wow. Everybody's gonna, you know, go for it and have a good outcome. Now, what we don't know, and what's not talked about, other than small circles, is that this study had two arms to it. It had the primary arm, which had only estrogen in an oral form, which was again derived from pregnant mayor's urine in a form of a synthetic pill, and then it had Premarin with primpro. Primpro was medroxyprogesterone acetate, which is a synthetic progestin. And these two arms had very different outcomes. So the study that had the primpro in it with the medroxyprogesterone acetate was the one that created all the hype, all the bad name, because that's the one that created high risk of stroke and cardiovascular disease and heart attacks and dementia and urinary incontinence and breast cancer. So everybody freaked out. Said, Oh my god, estrogen is bad. No, estrogen is not bad. But if you took and the arm of the primary and only didn't have any of those outcomes, but they didn't talk about that. So they didn't increase risk of breast cancer. They didn't have all these problems and another weakness of that study, which has been debunked by so many people in so many ways, but people still talk about it. Then there's doctors who don't even know any better, which is very unfortunate, and the there's been 20 years of debate going on about this specific issue, is estrogen bad or good for women? So first of all, what we established is that if you add a progestin, which there's a lot of interchange between estrogen and between progestin and progesterone, they're used interchangeably, but they're very different. Progesterone, it's our natural bioidentical hormone that our body produces. Progestin, it's a name given to a class of drugs that has a wide variety of synthetic chemical synthetic structures that are totally different than progesterone, and they could be called ethanol, gestural levonogesogesterone, medroxyprogesterone acetate, all kinds of things based on their chemical structure. So the again, what we established with the study was that estrogen is actually not bad, but if you put a progestin in the mix. It's very bad. Now, I went to a seminar, an educational symposium a long time ago, probably when I started getting into anti aging. And I heard Dr, I think his name is Terry, her talk talk, and he's one of the founding fathers of anti aging therapy and hormone replacement therapy. And he put it very simply. He said, as people who understand hormones and we know how hormones work, we could have told them that they took the wrong hormone. They give it in the wrong form orally to the wrong population, which is women 10 years after menopause, not even immediately after menopause, we could have told them that they're gonna have a bad outcome. So of course, they stopped the study early. There was all this hype and fear, which mass media loves a good fear producing event, and just spreads it out like a virus. And it was okay, well, estrogen is bad, and that's all people got from it. And obviously the truth is that estrogen is not bad testosterone is not bad for men. Do you agree? Correct? Yes. So we're born with testosterone. Men are born with testosterone. Women are born with estrogen and testosterone, and they start producing it when they go through adolescence, and their ovaries start coming online at like 10 to 12, and they have estrogen in their bodies for decades, and suddenly, when you turn 50, you drop off a cliff and estrogen becomes bad for you. That makes zero sense. There's no logic in it. There's no explanation why we're being sold that narrative. Okay, so. And then there's this whole hype about okay, well, estrogen causes cancer. Well, that's great, but how do you explain that when we have all these cancers that happen past 50? So the breast cancer risk for a woman goes up by the time they're 80, independent of any hormones, taking hormones, not taking hormones, by the time they're 80, the risk is almost one in 12. So that's very high. As opposed to when you're 20, your risk is one in 2000 so maybe looking at it inversely, what that tells us is that having estrogen, it's actually good for you and protects you. And when you lose your estrogen, the longer you go without estrogen, the higher risk of breast cancer you have. Wow. But again, we get older. So as we get older, that's it's complicated, because we get exposed to toxins, estrogen disruptors. And that's the the, excuse me, the whole kicker is that is the amount of exposure to estrogen disruptors which we surround ourselves with. They're probably in everything we touch every. We eat, everything we drink, which mess up our hormones, and again, that's probably the key why we get so much metabolic syndrome, obesity, depression and hormone deficiencies and cancer. It's not because of our hormones. It's because of what our chemical industrial development and modern lifestyle is doing to our hormones. All right, sorry, women,

Dr. Spencer Baron: 20:24

no, no, not at all. No, it's very informative. Testosterone in women, though,

Dr. C: 20:29

you tell Oh yeah. I call testosterone in women the magic hormone no one knows about because it is a magic hormone. So testosterone, it's actually produced in larger quantities than estrogen, and it's an awesome hormone. First of all, if you're going to be alone in an island as a woman, you want testosterone with you. Estrogen, there's some debate about it. We don't know. Does it cause cancer? Does it not? You need to pair it with progesterone. It can make you bleed. So there's all kinds of things that are tied up to estrogen. You have to make sure you balance it right. You have to make sure it's not too much, not too little. Yes, you worry about testosterone being too much, but women can tolerate a significantly a large amount of testosterone, which is surprising, and they feel awesome. I feel women who come into my office after I give them testosterone, and they're like, Oh, my God, this is how men feel. I have energy. I am great, I feel good, and I want to have sex. I understand now how men feel. And testosterone, it's an antidepressant, mood stabilizing hormone. It is an energy, stamina, endurance hormone. It makes a woman driven motivated. It drives up her ambition. It and most women, it's an anabolic hormone. It builds muscle mass, and as we know, muscle mass is important to burn off fat and to keep us fit and lean and mobile and agile. So testosterone does all these things for women. So most women that start testosterone therapy, they're not really excited about the libido stuff. They're like, Yeah, whatever they start with libido. They're like, yeah, sex is not a deal. My husband just wants just wants it. And then they come after this, they feel better, they want to have more sex. And they bring their husbands along. They're like, okay, yeah, my husband can't keep up. He needs to come in. You need to check his testosterone. Do you do testosterone for men? And I'm like, Yes, I do test one for men.

Dr. Terry Weyman: 22:19

Wow, that's

Unknown: 22:20

fantastic. I think other

Dr. Spencer Baron: 22:23

guests are going to be calling you. Yeah, I

Dr. Terry Weyman: 22:25

think, I think we're 20 minutes in, and people are gonna stop listening to show and picking up the phone.

Dr. C: 22:32

There are large individual situations. That's it's not the all encompassing all problem solving hormone. It is a great hormone. And there are people who are hyper responders. They come in just like I told you. And there are people who are like, yeah, no, no, my libido still low, buddy. I feel better. I you know, I lost some weight. So it depends. There are other things going on the body. You can't look at it like this, okay, it's testosterone. Let's fix it. There's so many things. And all these hormones interact with each other. That's why it's complicated. And the body is a complex entity that has so many moving parts, and you really have to look at the big picture and address all the moving parts. That's why the most successful hormone therapy doctors are successful, because they look at everything, they're like, Okay, well, let's fix your estrogen, let's fix your insulin. Let's fix your growth hormone, your estrogen, progesterone, are not balanced. We got to talk about that. Let's look at your mitochondria. What are your vitamins? How are those working? So it is complicated. When people just come in and they're like, Okay, I want hormone replacement. Yeah, sure, here's the prescription, but what do you do with the rest of it? And how is your hormone? How is your body going to process these hormones? What's going to happen ultimately?

Dr. Spencer Baron: 23:45

Let's I want to take I understand that also, oh, sorry, I was just going to mention about testosterone. Can also be

Dr. C: 23:53

here goes the dog I told you about. Let me, let her, let me, let her out of the room. Just give me one sec. Sure she likes to

Dr. Terry Weyman: 24:00

greet people. That's fine.

Dr. Spencer Baron: 24:03

That's good. Testosterone has a tendency to increase appetite. Yes, it does build muscle mass, and some women gain weight from it. They're not too excited about that. Is that? Is that possible? So the only reason I understand

Dr. C: 24:18

it helps, the only reason why women gain weight from testosterone is because, number one, if they do work out, testosterone drives more muscle mass formation, they will look a little heavier on the scale as they build muscle mass, reversal of body fat composition and replacing muscle mass with fat takes time, so when they start a therapy, they need to be aware that they need to give that therapy, especially if it's hormonal therapy, at least a year, because the body needs time to change. I personally went through this transition myself, and I started pellet hormone therapy in 2018 and. I had gained 15 pounds. I was pretty upset. I was doing yoga five times a week and walking almost every day, and I would save two hours in the day or more for exercising. I was gluten free, this free, that free. My husband was so upset. He was like, I can't eat out with you. You look at the menu beforehand and you tell me if you want to go eat at this restaurant. Because I was restricting my diet, I was exercising like crazy, and I gained 15 pounds. So I played with creams, this, that and the other. I gained the weight in spite of that. So when I started the pellet, I did gain like five pounds in the first three months. And I was like, okay, was supposed to go in the other direction. What the heck is happening? But I stuck with it, because I knew my hormones were not balanced, right? I wanted to go low and I wanted to adjust them gradually. So after six months, I noticed, within the next from six months to nine months, I actually dropped 15 pounds without any effort, no change in diet or exercise, to the point where I was like, Oh, my God, do I have cancer? What the heck is going on with me? So I actively trying to gain weight. I gained a few pounds, I was like, okay, I'm good. I can gain weight. So at this point, people need to understand to reset your metabolic rate and to lose weight on hormones, unless you're a hyper responder, and all you needed was that hump of testosterone to get you motivated, to get you in the gym, to restore your metabolism back to the one of a 30 year old or 20 year old, then it's much more complicated than that. So you have to wait for your body to reset and do its own job. But the weight gain with testosterone is number one, more muscle mass, which is heavier, and number two, there is a water retention component. If you live in a hot, humid environment like California, or even hot and dry environment, we are more prone to retain water due to some testosterone. And there's a lot of doctors out there who do testosterone therapy for women, and they overdose a lot, so they're going to have water retention as a side effect. They're going to feel a little bloaty. They're going to retain water. So they're going to easily notice their rings. They don't come out very easily. They see it on the ankle with their socks, but they don't pay much attention to it. They don't realize it. They're just okay. I got five pounds on the scale, and my clothes don't fit me in the midsection. What's going on? So a lot of the time is that now, if you work out more, you might get more hungry, and that's just the body's way of telling you you need to bring in the adequate protein intake to support the muscle growth that's being driven by what's happening. And that's another thing. If you're not balanced right, then you're going to have cravings, you're going to eat all kinds of bad things instead of high protein, and that could lead to complications and problems. So again, there's, it's, it's like fine tuning, just like a car, like you got to, you know, tweak the engine this way, and that there's so all kinds of moving parts, and weight is complicated. It's the result of weight so many factors. Is not just one thing.

Dr. Terry Weyman: 27:49

You know, you women, some women are hesitant on or unable to do hormone replacement therapy. And you mentioned, just now, you mentioned pellet therapy. Can you elaborate on what pellet therapy is?

Dr. C: 28:03

Sure. So one of the key issues that we have introducing anything in the body is the fact that it doesn't last long, and your body just processes it really quickly and gets rid of it. I'm going to use the example of Tylenol, and I'm going to ask you, do you know how long Tylenol works for in the body?

Dr. Terry Weyman: 28:25

No, I actually have no idea. Taking Tylenol, I would probably I don't take it, so I would probably say four to six hours.

Dr. C: 28:34

You correct that's how long Tylenol rests. Ibuprofen, it's about eight hours, if it's a high dose. But everything that you introduce in the body will have a high peak level. As soon as you take it orally or you apply it to the skin as a cream, it will surge the level, and then the level will drop. And the drop in the levels could take six hours. Could take eight hours or 12 hours. But ultimately, anything that's introduced in the body in an oral, transdermal form that needs to be given to the body every day, or two to three times a week. It's because it's processed so fast, it doesn't last. So you will not necessarily experience these ups and downs with hormones, you will get some improvement, but it's not going to fix a lot of things, like the neurotransmitter influence, the catabolic rate, the muscle mass formation, the bone mass, impact, all of those, your mood, your sexual desire. Need, daily, steady, 24/7 levels. The only thing that gives you that it's pellet therapy. So pellets are these tiny little things. They look about this big. This is about the size of a testosterone pellet, yeah, this is about the size of an estrogen pellet. Is very, very small. And then they get inserted into the upper back area. It's kind of like an injection in your butt, okay, um. Um, it's about three to four times a year. They're biodegradable, so the body eats them up and gets rid of them. So we use the analogy, and this is how I was trained. And I love this analogy from Dr Tutera, who was my, my my trainer. It's like licking a lollipop or waves on the beach. You constantly have this come to the pellet, go away from the pellet to your heart, and then spreads into the entire body based on your heart rate. So if your heart rate beats 60, you got a certain release. If your heart beats 80, the same, so your heart is always 60 to 80. So you're going to get a steady amount of release, unless you work out at the gym and you're going to be 160 in which case you get double amount, which actually physiologically, is very beneficial, because it helps the repair that needs to happen and the extra hormonal activity that we need to enhance our reparation after a huge workout. So that's the difference between pelotherapy and everything else, and it's called bioavailability. How available are these hormones that you give into your body, that you administer into your body for how many hours, and what is the level? So for example, I test women an hour after their testosterone cream, they search their level as high as 900 testosterone. That's a hormone male testosterone level, and then by six o'clock, actually, by four o'clock in the afternoon, they're back down to 30. So those swings I personally call a hormone hammer, your body gets hit with a with a hammer, and what happens? The After Effects, the aftermath. The science is not there molecularly, cellularly, to understand exactly, but you have benefits from it, but they're not as much as having steady, constant testosterone. Let's say, at 151 50 all the time, versus you get from 900 to 40, down, up, down, up. So that's the difference between pellet and everything else that's out there, and that's the same difference for male testosterone pellets. As far as getting injectable testosterone, most men inject testosterone once a week, every two weeks. Sometimes they start with once a month. But as soon as you get that injection, it surges your level very high. And if you want to know how high, you just test the levels two days after injection, and then you test them again. It's seven days after injection, and you see the huge drop. So you get the injection, you get like, 20 503,000 which is hyper, super physiologic, and then you go down to like 200 or 300 again, needing another shot. So that surge in hormones, it's what drives our body to shift it kind of like dirt under the carpet, and do all kinds of things that metabolically are not healthy. So it shifts your testosterone to dehydro testosterone, which is the skin testosterone. So then you get more balding, then you get more prostate enlargement, then you get more membs, all kinds of other things that are not good, it also shifts it into estrogen. And a lot of men that use testosterone, there's a big concern for aromatization, which is conversion to estrogen. So when you we know we have that data that when you surge testosterone super high, your body will drive more estrogen formation. So idea of the pellet is that once you raise your testosterone to 1500 then it kind of settles at 1200 it's going to stay at 1200 to 1100 to 1000 whatever it is, or 800 depending on the dose. But it's staying there for three to four months. It's not going to vary. It might vary only when you exercise for an hour a day, but it's not going to cause that surge that drives a lot of estrogen formation or a lot of dehydro testosterone formation, so it is safer. And there's a lot of bad reputation for pellet. And a lot of doctors who do not do pellet are not trained in pellet therapy, do not understand it. Do talk badly about it. And I was, I listened to a podcast. I think Mel Robbins had a guest, and this lady was a GYN doctor who was debunking myths, and she says, teletherapy is just so terrible. You shouldn't do it. I don't really know much about it, but you really shouldn't do it. So I'm like, Okay, well, if you think it's so bad, why don't you at least learn about it, go to a course about it, open the internet and search about it and understand what it does. If you're going to talk bad about it, and at least you know, trash it in public. Say, don't say, I don't know anything about it. So there's a lot of misinformation. We love this word, since covid, right? But there's a lot of misinformation about hormones, and that's and patients are confused. I mean, if you're a patient and you listen to me, you're like, Man, this lady makes sense. It's just she knows what she's talking about. But then you go, and I had a patient who came to see me yesterday, who I haven't seen in two years, and she. Desperate because her patch was dropped to a lower dose. And she says, I listen to the doctor and I understand I don't want to die of stroke, I don't want to have a heart attack, I don't want to die of breast cancer. I understand all these risks, but I feel so terrible. She says, I'm irritable. I'm biting everybody's head off. I yell at people on the phone. I am gaining 20 pounds in one year. I do not I can't live like this. She says, I don't care about breast cancer. I just care about living my life. And can you please give me back the patch? This lady's trying to take me off the patch, and I understand the logic behind it. So I said, Okay, let me give you a different version of what she said. So I explained the study, I explained everything. And, you know, people are so foggy, and unfocused and forgetful. There's such a huge amount of information that's downloaded in the process of a visit, sometimes they leave frustrated, like, I don't remember anything. So again, hormones are really important for the brain, and I have the majority of people that come to see me, and they do hormones, they're like, Oh my God, my mental clarity is back. The fog is lifted. I feel so good. I forgot about that. That's a huge benefit. So again, patients are frustrated. They hear I could tell looking at a face, she was like, Who should I believe? And I'm like, Well, you should go with whatever your internal belief mechanisms say is the right version of the truth. So whoever you believe is right for you, that's who you should probably beg.

Dr. Terry Weyman: 36:26

On that topic you talked earlier about, you know, environmental toxins and stuff like that. And we have such a society that quick pill, quick shot, and that's all they want. They don't want to do the work. They don't want to do all that. So you can give all the pellet, all the best HRT, but if their lifestyle is terrible, nothing's gonna work, or it's gonna make it worse. How do you correct how can people that can correct their the bad lifestyle first? So then when you test them, you have a better baseline to know what they actually need versus this cloud of crap?

Dr. C: 37:04

That's a great question. And, you know, we talk about lifestyle a lot. There's actually a word lifestyle, and people don't understand how important every food, every drink that they put in their body is for their health. They don't understand how much time they spend digitally looking at a screen. It's affecting their vision. It's affecting their mental health. They don't understand that the lack of exercise and being seated in a for a long time in a seated position, by the way, we should all move and stretch a little bit. How impactful that is for your joints, for your muscles, and even for your brain and mood. So lifestyle is very, very important, and we always look at the big picture. When I treat patients, I don't just give them hormones, because I know it's a small piece of the puzzle. So we always ask, what kind of diet are you on? Do you exercise? And I explain, if you don't exercise, you're not going to get that little surge that you get when you exercise once, once a day or twice a day, and your pellets are probably not going to burn out as quickly as they should. They're probably going to linger. You also might not get the detoxification that comes with exercise, because when we exercise, and I can talk about exercise for a long time. It's it's got so many benefits, and so many people disregard it. They ignore it. They're like, so and you have actually people that are kind of sound like, I exercise. And there are people who are paranoid about it, and they're obsessed with exercise. They do a lot of it. They're not that many, but there are. And then there's people who are like, Yeah, I don't have any time now. I'd love to exercise, but I feel tired, and that's their excuse. And I'm like, Well, I understand. Well, let's get your fatigue better so you can actually exercise, and you can reverse that with hormones and vitamins. But again, if people don't have a good night's sleep and they wake up in the morning exhausted, they're not going to have any stamina, endurance motivation left to actually want to exercise, so you have to look at the big picture. So yes, lifestyle is wellness. So if you wake up in the morning, you're like, oh my god, it's a wonderful day. Let's go. You keep going all throughout the day. You eat healthy foods. You consider a little bit of intermittent fasting. So you don't really if you had dinner at seven or eight, you're like, Okay, I'm gonna let my liver take a break. I'm not gonna do anything until one or 2pm in the afternoon. Then you have a narrow window four to six to maximum eight hours where you eat if you do all these things. Those are wellness principles, so they're going to impactfully help a huge amount of people, yes, and if they people use these wellness principles, I'm going to eat less, I'm going to exercise as much as I can. I'm going to pay attention to my body and not drag through the day. I'm actually going to see someone about that. I'm not sleeping through the night. I'm going to see someone about that rather than just go and get Ambien or Lunesta. Yeah, which is really we can talk about that for a while, because if you have all these issues, then yes, your hormones are not going to work. But sometimes the hormones are the initial trigger that makes people feel this way. So if you catch it early and you're like, Well, I'm tired. I lost my energy. I lost my sleep, I wake up hot. I throw the covers. I'm cold. I put them back on. If you address this early on, then you give your body the chance to recover really quickly, instead of lagging and developing all these areas of problems, because now you get insulin resistant, now you get too much cortisol. Now you get all these other things that push you into adrenal fatigue, and now your thyroid is dysfunctional, and now you have again, insulin resistance, and now you gain weight. Then those are very hard to reverse. Now you have to do more work to reverse them, so if people would pay attention to what happens to their bodies. But again, we live for our work. We live for our family, and sometimes women. And I'm gonna there's two different reasons why women wait and why men wait, and we can talk about that too. That's a totally different topic. But yeah, women like to wait until they're pretty much the knife gets down to the bone because they're caregivers. They give to everybody else before they give to themselves, right? So, they take care of their children, they take care of their career, they take care of their husband, not necessarily in this order. They take care of their pets, they take care of their household, and at the end of the day, they're like, I know, I'm done, I'm spent, but I have nothing, and I don't have time to make an appointment to go to your doctor. Yeah. Yeah. Very true. Whereas men, there's different reasons, you know, yeah, yeah.

Dr. Spencer Baron: 41:45

So from what I understand, there's, and I've heard this from some women regarding general health, you know, that you started to touch off on a couple of these things and some of the solutions. But, you know, dryness, atrophy in the muscles, discomfort, pain, pain, orgasm, health, things like that. What? And I also found out that there's a Doppler ultrasound for clitoral blood flow. Is that. I've never even heard of that.

Dr. C: 42:16

Yeah, it's likely experimental. It's not that widespread in use. But yes, you can test blood flow everywhere. But sometimes you don't even need to test the blood flow. You can take a look at the person's genital area, and you can say, You know what? I don't eukatory says shrunk. Did you notice that? And she's like, Oh yeah, it's hard to get an orgasm. And again, many doctors are not trained. They don't know anything about addressing this issue. And that's the first thing that probably happens before a woman would get vaginal dryness and painful sex and avoid sex completely, is they lose their orgasm. They're along for the ride. They're like, Yeah, whatever. You know, my husband's having fun. I'm just along to the point where they'd be like, okay, yeah, this is not no longer working for me, so, but that's when they should really look into what is the problem? What can I do about it? Because if you have orgasms as a young woman, and you have a beautiful lifestyle, sexually beautiful intimacy, and suddenly you it's not there anymore, and it's really hard, you need to address it, and we need to look at what is happening before it gets to the point where, yeah, sex is painful, and I haven't had sex in three years, that's going to take time, energy and money and dedication and commitment to spend in order to reverse and get it back to normal. Fantastic.

Dr. Spencer Baron: 43:37

Interesting when, when a patient comes into your office, how, how? What's, what is your usual protocol,

Dr. C: 43:44

protocol for approaching the problem?

Dr. Spencer Baron: 43:49

Oh, no, no, just in general. Okay,

Dr. C: 43:51

when? Yeah. So we sit down with a patient, and we dedicate at least 30 minutes for new patients trying to get a sense of what the reason for the visit is, and trying to uncover as much as we can in 30 minutes. So there's a lot of information gathering that has to happen. And you mentioned the magic pill injection. Fix me with one injection. Fix me with one drug. Approach patients don't understand, and I'm one of the few doctors that does regenerative, restorative, anti aging medicine holistically. And I take insurance so patients don't understand. I The insurance won't pay me to spend two hours with you in a day. They just won't. They cap it out that maximum 60 minutes, and then after 60 and that 60 minutes is reimbursed at about 150 to 200 and I don't think my hourly rate would really cover that. So a lot of times, people don't understand we need multiple appointments to kind of figure out what the problem and the situation is. So if they live in the insurance world and they want to use their insurance, they would need a few appointments. So we would sit down, we would try to explain that process. As much as possible. And if people go to approach it from a functional medicine standpoint, and they actually want to be I want a functional medicine approach, and pay cash, then we do dedicate an hour, and we spend longer with them, and then we talk, we try to gather as much information as possible in the first session, so but then we order blood work, and the patient needs to come back, so we need to look at everything. I would like to every single patient that I see, ideally, I'd like to give them something to go home with. And sometimes it's there's so much things happening and there's so much cleanup that needs to happen in their personal lives, that the people that come to see me sometimes they're not ready for that, and they they come and they want, like you said, the magic pill, the magic shot. There's no such magic pill. Magic shot, if you're super stressed, you have a bad, horrible job, and you're in a bad relationship, and you have an abusive family member that you have a toxic relationship with, or you have abusive, toxic colleague at work that's making your life miserable. So a lot of the times, it's sitting down with the patient trying to find out every single possible aspect. And I ask people, are you stressed? They're like, Oh, yeah. So what stresses you? I try to sit down and understand what are the stressors. So we do try to dig deeper as much as we can in the first visit. And then we order blood work to get a sense of what exactly is happening metabolically. What are the hormones look like? What are the vitamins look like? And then we sit down with the next at the next appointment, we look at the data, and we make a treatment plan, but that's pretty much the approach that we have.

Dr. Spencer Baron: 46:47

Thank you. Thank you. Another similar topic, but you know, there's been a lot of conversation for men with testosterone replacement, you know, Viagra, Cialis, there's all these solutions out there. What are? What is out there for women? I understand that there was, there was some. I read something about women's Viagra, you know, and even that was not met with a lot of approval. Your thoughts on that?

Dr. C: 47:21

Well, Viagra and sialis, they actually open blood flow, so that's the main mechanism through which they're able to enhance the erection, or allow a man to have an erection when he's not ready or not in the mood or be able to sustain an erection for a longer time. Obviously, the dose for inducing an erection in men needs to be adjusted for women. But I've had patients who told me so and so gave me Viagra, which is clearly a very open minded physician, and that was the best thing that ever happened to me. So there is a different dosing. You have to compound it. But yes, Viagra should be used for women and can be used for women. The problem with women is that, yes, you want the clitoris to have Doppler flow, but if your clitoris is already small to start with, it's going to be very hard to get it stimulated during intercourse. So that's going to become a problem. Also, women's desire to be sexually intimate with a partner. It's different than men. Men, like I said, they got testosterone. They get horny. You know, a woman walks around naked, they're like, oh, what's up? What's going on? So flag goes up. Everything's good for women is different. They need to be in the mood. They need to feel intimately and connected to the partner, they need to feel physically at the top of their game, like if they're going to be exhausted, they're not going to want to have sex. If they spend all their day cleaning and doing laundry and doing other things, they're not going to want to have sex. So they need to look at the big picture, and also, if they're depressed, they're on antidepressant medications. And I don't know if you know, but 25 to 30% of women or more are antidepressant medications. So we're looking at a large majority of female population that's taking these antidepressants, which clearly impact their ability to have an orgasm, to enjoy sex, or to want to have sex. So it's impacting their sexual desire. So there are things that we can do. Obviously, testosterone is very helpful. Estrogen is helpful for women, because you can drive a woman's sexual desire as much as you want, if she's not going to have the sensitivity of the tissues in order to enable her to feel pleasure doing intercourse, you can give her all the testosterone the world. She's gonna need estrogen for that. That's the tissues, the female, delicate tissues down there, are sensitive to estrogen. That's what they need in order for the tissues to be plump and erotically charged and in upon friction with the penis. To enjoy and give pleasure, you need them to be moist and to have the receptors for pleasure, they probably go away once it's all, you know, dried up and thin. So it's we need to restore all of that. So we have estrogen, we have lasers. They can do something similar to estrogen, but in a different way. But it's it's an improvement, and I've had women who are getting 80% to 90% improvement, and their lives are changed. We also have PRP do you know about PRP injections? Oh, yeah, exactly. So guess what? We can inject, like tutorials, we can inject the g spot. And women can have enhanced sexual pleasure. They can they have an enhanced sensation. It's called the it can be injected in the penis, and that's called the P shot. So, yeah, we inject PRP, all kinds of things.

Dr. Terry Weyman: 50:59

Lord Baron, yeah, let me know how it works.

Dr. Spencer Baron: 51:03

I'm making an appointment flying. Yeah,

Dr. C: 51:06

I do. There's doctors that do that. There don't. You don't need to fly all the way here. I

Dr. Terry Weyman: 51:11

do want to, I do want to ask up, because you and I want people listen that I think there's a solution. And I, in our practice, I always, tell patients, there's a solution for everything, but you the solution isn't the cure. You know, don't go, don't go first quick. Take this pill, take this shot, and life is good. We gotta figure out the why in the first place. Why is this, all this happening? And then if you fix the why, then the solutions have a better outcome. So I think that's what I hear from you that I want people to understand that yes, there's shots, there's pills, there's this, all that can help, but if we don't know why the lifestyle or or what's going on in the first place, chasing symptoms around will just drive us crazy. Is that? Is that? Am I hearing that correctly? Yes.

Dr. C: 51:56

So I'm going to give you a very simple example. I had a patient, and obviously I'm not going to use any names, but I had a patient who came in and she wanted better sexual desire. She and I was like, Okay, well, here's your hormones. You've tried creams for eight years. Let's try the pellets. So we did the pellet for a year. She would always complain, no, my sex life is low, low, low. So I'm like, Okay, people don't open up to you immediately. It takes time for them to learn who you are, to trust you and then open up. So as it turns out, she lived. She was in a marriage that pretty much was loveless. She says she told me one time, unless my husband suddenly looks like Brad Pitt, I'm not going to want to have sex with him. So I'm like, I can't drive sex and desire and intimacy and pleasure into such a marriage that where we start with that mentality, she lived in a household where she felt that the husband and the son that had moved in with them was a 30 year old, were ganging up on her. So she was a very unhappy woman. So I am not going to fix that with testosterone and estrogen, you know, and women are stuck sometimes, and they feel stuck. And she had no job, she felt stuck in the marriage because she felt no she was physically and financially, well, financially dependent on her husband, not physically, and couldn't get out of the marriage. So there's no way I'm going to fix that with a magic hormone pellet that's not fixable, that needs to come from the patient. Now, I've had situations where a patient comes to see me, and this is a different story. And she was assistant of an orthodontist, the office manager of an orthodontist out of out of town, came in, gave her the pellet came back. A few months later, she's like, Doc, this bullet is magic. I lost 20 pounds, and she did. I told my boss to f off, and either he can give me a raise or I'm leaving. So he she got promoted. She was actually sleeping with the boss. She stopped sleeping with the bosses. This is not going to happen anymore. So she stopped sleeping with the boss. She got a promotion, she got a raise, and she lost 20 pounds, and she like, this is the best I've ever felt. I've ever felt. So there's obviously something within that whatever we do, it's going to be augmented and driven to the surface. So if that's something within, it's dark and there's like despair and unhappiness, and you're not happy with the situation, with your life, with your financial situation, with your family, with your career, with your job, there's going to be limitations to what you can achieve with functional medicine, with pelotherapy, with vitamin injections, with PRP, with anything. So yes, I mean, happiness comes from within, right? And that's really important, and people always ignore that, and they're like, fix me. Where's the magic shot, right?

Dr. Spencer Baron: 54:48

I have a quick two questions for you, only because we're getting near the end. Yes, Your information is absolutely fantastic, without a doubt. What I asked. You about, think You're welcome. I want to ask you about mammograms. You know, I've heard, you know, yearly mammograms. You know, it reminds me of of veterinary veterinarian, since we all have dogs, they they urge you to get, you know your your shots every year. And now there's this underground group of veterinarians that believe otherwise in doing maybe blood titers on your dog is there? What is your philosophy on day? Excuse me, yearly mammograms and things like that. Okay? And

Dr. C: 55:30

this is my personal opinion, and this is not sustained, and it's not standard of care, and it's not what I actually tell my patients, unless they ask me, they're like, hey, when was your last mammogram? I'm like, Well, I'm gonna tell you my my first mammogram was at the age of 40, and then I was like, a good patient. I'm like, Okay, I never had kids. I'm high risk for breast cancer. I'm gonna go get my mammogram at 40, because that's what everybody says. Did mammogram, they found something little density, they wanted to follow up. So come back in six months, come back in six months, come back in six months after four sessions of six months mammograms. I had enough and I literally mammograms are painful. Your get your breast squished between these two plaques. You get radiation. Even though it's minimal radiation, yes, it's radiation, your tissue gets radiated. It's painful, it's uncomfortable. Somebody else has to touch your breast. It's not there. And I really wanted to slap that lady who did my mammogram every time, because it was so painful. So anyway, long story short, after my age of 42 I was like, I'm done with this stuff. So I think one time I was with my mom getting a mammogram, and the doctor was like, Hey, doctor, see, you haven't been here in a long time. I'm like, Oh, really? How long has it been? She's like, five years. I'm like, Okay, well, I'm here. Do you want to do a mammogram now? She's like, Fine, let's do one. So I do not necessarily, personally, believe that annual mammograms is the way to go. We have more and more non invasive technology, like ultrasounds, 3d, 4d, we have thermography that nobody talks about thermography. It's not approved because there's not enough statistical analysis in our databases. I mean, all they have to do is gather all the thermography databases. You have tons of data, but people don't want to look at the data. There's the organizations like North American menopause society, where I don't know, the CDC, the FDA, whoever looks at these things, they don't have the money and the energy and they don't want to do it. Why would you look at thermography? We have mammograms. We've lived with mammograms for a long time. They're approved. We got those approved. Why do we need to worry about thermograms? That's like a whole different ball game. So there is a very significant, you know, like, you have a huge mass, and you move it, it's there's a huge inertia in approaching healthcare for women. So more and more women are aware of that, and they come say, Can I get a thermogram instead? Sure it's your body, your choice. I have to say that the standard of care is to get a mammogram, but if you're on hormones, let's do some kind of imaging. So I have a lot of women who do not want mammograms. They come to me because they're holistically oriented, and I'm like, let's do an ultrasound. It's not necessarily, there's no radiation. It's a little uncomfortable when they go with the probe over your breast, but it's not nothing like a mammogram. There's no radiation. So most people are choosing that the thermogram you get out of network, you have to pay out of pocket. And they range anywhere from 300 to $800 depending on the intensity of the mammogram. And I mean the thermogram. And if you do, you know neck to knee or head to toe, but thermogram is great. It looks at infrared technology. So if you think about the principles of how you pick up cancer early, that would be much earlier pickup than waiting for a mass to develop or a density or an abnormality, which is what the mammogram would pick up. So this would look at abnormal blood vessels and blood vessel flow, which would be early on picked on, probably even before something gets organized in a mass for breast cancer, in order to grow to the size of a detectable lump, like one to two centimeters. So something that's about this big, it needs to have been in the body for at least two years. So you're not going to pick something up that's point half, you know, this little unless, because you're not going to feel it on self exam, unless you do a breast ultrasound, unless you do a thermogram. And again, we do have mammograms and digital mammograms, which is less radiation, but however you think about it, if you start radiating a woman's breast every year, once a year, from the age of 40 or 45 or 50, all the way to 80. This 30 years, this 30 sessions of radiation, how much does the breast tissue can withhold before on its own, combined with toxins and other genetic predispositions, is it going to start to shift? Words malignancy. We don't. Nobody's asking that question. And I actually asked this question at a symposium, what about the risk of radiation? What about the risk of exposing the breast 30 times or 50 times in a woman's life? Because sometimes you go back at six months and it's six months and it's six months, and there's women that are braca that have to go more often, and the answer is, no, it's minimum radiation. It's minimum radiation for one session. But what about 30 to 50 sessions? How much radiation is that? So that's

Dr. Spencer Baron: 1:00:31

great. Dr, C, we're going to close with a last question that will probably wrap up everything, and it is based on your opinion and your experience. But what are the top five aspects of health and functionality that women should prioritize as they age? You know, something to ensure high quality life and longevity.

Dr. C: 1:00:53

So let me give you my top five, and this is for women and men. So top one thing that we need to worry about, to preserve as we age, is a good mind. And a good mind means we want to be functionally able to function in our life and in our society. So that's one aspect. The second aspect of a good mind is we need to have a good mood, because you can be the most logical, analytical person that can solve all these problems. If you're deep down in the pits of depression, there's not going to be both. You're not You're not going to be able to function in society in a in a good manner, and you're not going to have a beautiful life. So we need our minds. Our brains are super, super special. Number two, my favorite, it's mobility. It's our joints and our muscles, our musculoskeletal system. People don't and I know because I've had two knee surgeries on my right and five knee surgeries on the left, I know, and I value my loss of mobility, because it's really hard to do anything as you age, if you can't get in and out of the car, if you can't get in and out of your toilet, if you can't reach a cupboard to pick up something, if you can't bend to load your dishwasher, it's impossible to live life like that. So investing in our mobility is top two. Number three, we want vision. It's very hard to do interact with your environment, to do anything you can't drive if you can't see. So a lot of times, people worry about vision when they lose it or they start having a problem. So again, eye doctor appointments, checking your vision. Is your vision deteriorating, altering? Very, very important. Number four, what's the engine that makes all this go our heart. So we want our heart and our vascular system to be functional optimally. The problem is the heart is hidden. And unless it gives you signs and symptoms like, oh, have some chest pain, that's too old, that's way too advanced, palpitations, irregular heartbeat, you need to have a heart check. And I think for women specifically, because men know, men know heart, yes, I gotta check it, but women don't. And the top killer of women after 50, it's actually heart disease. And very few women consider having a cardiologist on their team of wellness experts. So it's important to have your heart checked. And I tell women, sometimes I'm sending them to the cardiologist. They're like, do I need to see a cardiologist? I'm like, yes, it's more important than your Pap smear. As you turn 50, come to see me for other things, but I'd rather you see your cardiologist once a year, because it's more important than your Pap smear, the chance of getting cancer of your cervix, as opposed to the cancer, the chance of dying of a heart attack. It's not even like comparison, top five, the number five, it's intimacy. Because we want intimacy with our partner. We want to feel intimate with someone as we get older. And a lot of women think, Okay, well, I don't care for it. It's gone. I don't want to bring it back. But again, that's the separation and divorce rate that we talked about, and it's very hard for women to get old alone. They want someone. And it's not unusual for women to say, I want a partner and I want to feel like I want to be intimate with a partner. So that's, that's pretty much my top five.

Dr. Terry Weyman: 1:04:14

Oh, that was brilliant. And you know, on that, I don't want anybody else to think about anything else so on that we're going to we're going to say, thank you. That was for having me. That was you were wonderful. And and I'm going to reserve the right that hopefully down the road we can have you back for part two, because I think people need to hear this kind of stuff to be healthy, you know? And the whole point of the show is to get people healthy. And so as long as we can keep people healthy, mentally, physically, nutritionally, I think that's a huge goal. So thank you so much for your time and your expertise. Thank

Dr. C: 1:04:49

you very much.

Dr. Spencer Baron: 1:04:51

Oh, that was fantastic. Really, really good. I have a good feeling that a lot of women are going to watch this. Thank you. Well,

Dr. C: 1:04:58

as long as it opens their mind. Yes, and then they seek out their opinions and do things that are different for them, we've made a difference. That's what matters. Perfect. Thank

Dr. Spencer Baron: 1:05:07

you so much.

Dr. C: 1:05:08

Okay, thank you very much.

Dr. Spencer Baron: 1:05:11

Thank you for listening to today's episode of The cracking backs podcast. We hope you enjoyed it. Make sure you follow us on Instagram at cracking backs podcast, catch new episodes every Monday. See you next time you.