The Dr Louise Newson Podcast - 46 - Why understanding your hormones changes everything

Episode Date: February 10, 2026

In this episode, Dr Louise Newson is joined by Professor Mary Ryan, Consultant Endocrinologist, Adjunct Associate Professor at Trinity College Dublin and author of It’s Probably Your Hormones. Together, they explore why hormones are far more than just “reproductive messengers”, and how they influence almost every system in the body, including the brain, immune system, metabolism, bones and cardiovascular health. The conversation moves through perimenopause, menopause, autoimmune disease, thyroid conditions, PCOS, endometriosis and fertility, highlighting how hormone imbalance is often overlooked or misunderstood in both research and clinical practice.  This episode is a reminder that when we understand hormones properly, we don’t just treat symptoms. We change long-term health, quality of life and outcomes for women, as well as for society as a whole. Want more from the podcast? Sign up to my premium offer: https://www.drlouisenewson.co.uk/premium-podcasts LET'S CONNECT  Subscribe here 👉 https://www.youtube.com/@menopause_doctor Website 👉 https://www.drlouisenewson.co.uk/Instagram 👉   / @drlouisenewsonpodcast  Download balance app 👉 / https://www.balance-menopause.com/balance-app/ LinkedIn 👉     / https://www.linkedin.com/in/drlouisenewson/ TikTok 👉   / https://www.tiktok.com/@drlouisenewson Spotify 👉 https://open.spotify.com/show/7dCctfyI9bODGDaFnjfKhg LEARN MORE Download my balance app 👉 https://www.balance-menopause.com/balance-app/Get tickets for my new theatre tour, Breaking the Cycle 👉 https://www.nlp-ltd.com/dr-louise-newson-breaking-the-cycle/

I have a professor of endocrinology, which is the study of hormones on my podcast today. Mary Ryan has come over from Ireland. We talk a lot about hormones in general, what they are, how they all work together, how magical they are for our bodies to function well, and how they so often have been misunderstood. So enjoy this episode. So Mary, I'm really excited to finally meet you in real life. Thank you, Louise.

Because we've been corresponding for a while. And in fact, when you first wanted to come on my podcast, I wasn't doing it out of the studio. And now you're here. You've flown over from Ireland with your lovely son. Thank you. And, you know, I had Fenella on my podcast talking about Ireland. And I wish you could say that it's better than over here for access to hormones.

But I don't think it is really, is it? No, no. A lot of our patches like Easterdot are unavailable and with generic patches that don't absorb as well and they're falling off. And patients are sticking them on with tape, which isn't ideal. but we're both empowered women, Louise, so we're going to just keep advocating. Yes. And we really believe that women need treatment.

And it's just, you know, when we think what women, and one of the reasons I and you got involved in all this area was that we heard the stories. And as doctors, we hear stories and the real stories. And I think that's what we're privileged as doctors to hear the real stories. But unfortunately, we heard the stories of suffering of women in their 60s and 70s and 80s and 80s. who told me how they were severely anxious, severely depressed.

You know, one woman said how she had dreadful perennial itching, dryness, intimacy was absolutely not able. And it completely destroyed her marriage. So we heard all those stories of suffering. And, you know, those women lived what should have been the best years of their lives, postmenopause. They lived them in a dreadful way. And I was really anxious and you were very anxious to change that. And I think that's what we're doing. we're empowering women and we're empowering society.

Because not only women are we empowering, but if women are healthier, then their sons, daughters, partners are healthier. It's a healthier society for all. So this is so important. And that's what we're about, really. Absolutely. And you're right there. You know, I feel every day I'm so privileged being a doctor

and being a practicing clinician as well because the stories that we hear and we can't choose the people we speak to. It's so true. Which, again, is the real privilege. When I was a junior doctor, I used to find it very scary. Because the consultations would change so much or people would tell you things that you've never heard before.

Yes. You think, gosh, this is a huge responsibility. This is a confidential consultation. Yes. They're telling me things that perhaps they've not told other people before. Yeah, yeah, true. They're looking at you to help them. Yes, yeah.

You might not have all the answers. Yeah. But you really, really want to help them. And you learn. I mean, every day is a learning day when you're practicing clinician. Incredible. Incredible. We're so privileged to be able to help them.

But I think that's why we're such a profound duty as well. And particularly as women, I think. Because women, we have a great understanding of women. And I suppose, you know, women weren't always in medicine. It's a hard to be in a woman in medicine. Thankfully, there's a lot more of us now. But I think, you know, we're very anxious that women's health comes forward. And just as much as I want men's health to come forward to.

There's a lot of research to be done in that area because I have two sons and I want that and you, similar. But, you know, women's health has been so left behind. that I really, really want to make a difference and I know you're doing that in space and we're all anxious to do the same. Tell me about your background being a medic. So I'm a consultant and astrologist which basically enticologist means hormones

and hormones as we know are chemical messengers and they basically operate everything so every organ in the body is operated by hormones the bowel is operated by hormones we have a little hormone control centre on the top As you know, I always talk about the master control plan called the petultery, and that controls everything. And the hormones work in a very circadian rhythm. And we have such control and a lot because there's a positive and negative feedback.

And as women in particular with periods, you know, if we've heavy periods, perimenopause, where there's hormone imbalance, that all affects the hormone control center. And that therefore affects everything else. So that's, you know, I always say to patients, you know, that's why your bowel is off because hormones, your bowel muscle. And it's important people know that because I'm wondering, why am I bloating? Why am I, you know? And it's all hormonal. It's not in your head. You're not making it up. And I think that's

the pre-sative thing that patients love is that education. So I'm a consultant oncologist which traditionally always dealt with diabetes, thyroid, polycystic ovaries. But I think as a woman, I was very anxious as female intraecologist

to, you know, I heard the stories about the menopause. I heard about, I knew were trying to prevent osteoporosis and I said we need to do more because we're not treating it adequately if we're not giving these women estrogen when they should be getting it or if the women were coming in with desperate sweating and flushing and restless legs it wasn't enough just to be giving them you know drugs that for peripheral nerve why why not try estrogen which we know helps and reduces the histamine release and the itch and then you know the vaginal estrogen pestarase to prevent the uTIs and the sepsis that we know women get as they get older and

prevent hospitalisation. So there was a whole learning car and even the heart disease. We know that Eastern reduces bad cholesterol and improves the good cholesterol. So there was all of this that we weren't doing and wasn't being done. So I really felt that it was important as a woman to talk. And we live in a very institutionalised medicine. So what I did was I went out and I spoke to the public and educated the public. And that was a very good way because you got all the stories, you really

created a momentum. And then what happened at Ireland was Joe Duffy, who was a famous presenter and RET, inviting me on to his radio show. And he asked me to tell me some of the stories and talk to a woman who was saying she's a creepy crawly sensation on her face. And I said, but that's a symptom. You know, because you have a little nerve going to the bustle.

Hormons go down the peripheral nerve. If the hormones are off, that's why you get the creepy carol station. And the next thing, the phone lines were flooded and all these women are ringing in about their stories. It was wonderful because it created change in Ireland and suddenly we had the, you know, menopause really taken centre and we now, you know, have the HRT free in Ireland, which is absolutely fantastic.

Yeah. So, as I said, entranity has opened up. And it was always about hormones anyway, and we should all be involved in improving hormonal health. So that's what I do. I mean, endocrinology, I think, is really interesting because often when we talk about hormones in women, people always think just about estrogen.

They don't even think about... You're so right. They don't even realise there are other types of estrogen, but also all the other hormones as well. Totally. You know, endocrinology I used to love as a junior doctor. I worked for an endocrinologist, and people would come in to have various tests,

like the short synacting test. And they'd have a day case unit where people would come and do these amazing tests looking for diseases like Cushing's disease and various things. Very rare and occasionally, you know, you'd pick something up. A lot, like you say about thyroid, and I used to work in a diet, diabetes clinic as well. But I was never talked about menopause then at all. No, no, it wasn't.

No, it wasn't. It was almost like that part of the brain and the body and those hormones were ignored by endocrinologists. And also the fact that autoimmune disease was way more common in women, particularly around postpartum when estrogen levels dropped, particularly around perimenopause

when estrogen levels dropped. That was never looked into. And of course, we now know research that estrogen is very important with the whole innate adaptive immune system and reducing, you know, inflammation. And so, so the questions weren't asked back then. And I think we're now asking the questions, which is wonderful. Absolutely right. And even now, you know, I see quite a few patients who've had a pituitary adenoma, so a growth in the pituitary gland and it stopped, there are a hormone production.

They're given ad back hormones, but not progesterone, estradiol testosterone. It's almost like that signal, oh, you don't need those. And I see women who then have osteoporosis or they've had extreme fatigue or they've had all sorts of other symptoms. And it's only like, oh, only have those hormones if you need, or if you're thinking about becoming pregnant. And they're not just fertility hormones. Totally. And I was speaking to a female gynecologist recently and she said one of the practices that she doesn't like is that, you know, a lot of gynaecologists before used to take out ovaries when a woman was menopausal. But they forgot the fact that those ovaries, 10 years postmenobos, produced testosterone, which can be converted into estrogen. So they have a

purpose. So unless they need to be taken out, don't take them out. You know, and this is all education that we have to do because you said, Louise, it wasn't done in medical school. No, it wasn't. And, you know, I've said it before so people know, I had a historic to me a few years ago. Yes. Yes. And I was early 50s and I decided to keep my ovaries in. Whereas if 10 years ago I was going to have a historic to me, I probably would have said, I'd take them out because then I'll never get ovarian cancer because that's obviously why a lot of people take them out. Of course. And then my gynecologist said to me, well, when you're 55, you need to come back and we'll take them out for you. When I'm now 55,

I'm not going to have my ovaries taken out. And that's because they still secrete hormones. And we're very simplistic when we talk about hormones because we talk about progesterone. We talk about estradiol, Eastryl, Eastryl, Eastern, different types of estrogen. We talk about testosterone, but there's loads

of other hormones as well. Totally, totally. But they've just not been looked at, have they? No, no, no, not at all. And I suppose that, yeah, I always say to patients, you know, we've such control in eating healthily, in recharging, in resting and meditating. Because the more that we all are at 10 out of 10 energy, the better our hormone control centre is, the better it is at helping whole hormonal, you know, controlling it with that

lovely circadian rhythm and just helping all our organs. Because hormones control everything, whether we laugh, whether we cry, whether we're happy, you know, whether we fall in love. It's massive. And I think it is really interesting because our hormones work in conjunction with each other's as well. And for so long, people have thought about them being ovarian hormones, reproductive hormones, period hormones, just like down in the pelvis. Whereas when I see people, I've got some patients who are athletes, and they say, gosh,

when I'm doing a really long race, I think I need to increase my Easter die. And I say, well, you probably do because you've got more adrenaline, you've got more cortisol, you've got more other hormones. And there's this balance. They all work together. Yes, exactly. And then we see it's a lot of people who are peri-made. panopausal, their thyroid hormones become off kilter. Totally. And they often have seen maybe an endocrinologist had lots of different thyroid hormone treatments.

Still haven't been quite right. And then you give them Easterdial, maybe progester and testosterone. And their thyroid just works so much better. Totally, totally. And I think one of the things we really need is more research, you know, for all of us. Because we all have great knowledge and we are all now, this better understanding and we're reading around it all the time. And the one thing we do need, though, as physicians, is more research.

And of course, this wouldn't have happened, only that we're all having the conversation. And now we want that research done on testosterone. We want the research done where, you know, I believe that we will be rewriting the books. At the moment, they're now saying we give it a 60, right? I believe, and we now know that as individualized, we're looking after patients where you try to win it off and they're not, they don't do well and you put them back on it. But I believe that's all going to change because when we see the research, which hasn't been on to date of how this will help heart.

Because we know it lowers, it helps the, you know, before 60, it does lower the bad cholesterol, increase the good and helps with the arterial wall. But therefore, you know, that must help later on. And we need to see that. And the same with, it'll just give patients more confidence and also physicians more confidence. So that research has been done. But it won't be done unless we advocate for it. So that's what we're doing.

Absolutely. And in the meantime, when we haven't got the research, we can still look at common sense We've always treated patients as individuals. They can't be done as a big group. You know, we're all very individual. And we always listen to their histories and everyone has a different history. So, yeah, as good physicians, we have always done that. Absolutely.

And I think also we can unpick the science. Totally. And the problem is with the WHOHI, the Women's Health Initiative study that came out in 2002, it wasn't using the hormones that we prescribed now. So they were synthetic chemicals. Totally. You know, the estrogen was made from pregnant horses. order when they got H or T.

Of course they were. Rather than getting them younger, which is what we do now. Absolutely. They started it older, but the big problem was really the progesterone. Oh, totally. With the mejecti-progesterone acetate is a synthetic progesterone. Yes. And we don't prescribe that. So the risks we've always known are there for cardiovascular disease for clot.

Totally. Even for cancers as well. It's only small risk. Yes, yes. But actually now, if I see a woman in her 60s, 70s, 80s, I've had one lady who was 90 who wanted to start HRT, we can say, well, we don't have the studies, but we do know that the hormones work. And we're making new cells all the time.

Absolutely. And each cell has got an Easter dial receptor on it, progesterone receptor, testosterone receptor, they work, as you say, to reduce inflammation. Absolutely. So I can't see in the body how, like, our bodies know, oh, you're 61 now, you're going to respond differently to the hormones.

It doesn't make sense. Absolutely. And bone health is huge. Of course this is. You know, and it's huge as we get older, particularly as women. We all know women that's going on and dowager hump

and we're thinking that's so preventable and yes, diet is important and we all advocate that and we all advocate our resistance exercises and our vitamin D but we know

estrogen works so well and testosterone as well so all of this is so important for women and that's why I'm so thrilled that we're talking this but also we know the research is ongoing

and it's going to help more and more women so we think about bonehouse it's interesting because there was an article in the British Medical Journal about osteopenia. Yes.

And they presented a woman. I can't remember exact age. I think she was 52 or she was early 50s. Because they often do a case and then what would you do and then they do the evidence. So it was great article. But it was talking about somebody who had osteopenia. So this is reduced bone density. And then they went through whether she needed a scan and the frack score and all these things.

And then there was one sentence about HRT. But it was basically saying if her frack score was great, she had a really high risk of fracture, then consider treatment. And obviously there were all the treatments with bisphosponates and various other things. But what they never said was, you know, about menopause, about HRT being licensed as a treatment to prevent osteoporosis. And in my mind, if anyone is menopause or perimenopoles are regardless of their age and they have reduced bone density, they should be considered for hormones. Without question. Absolutely. Particularly now with the safe methods of giving it. And even for the patients with the family history,

we can do the bracketing testing. It's wonderful. We have all this available now for us. So there's so much because I think for too long there's been the scare tactics out of a whatever. But the reality is, breast cancer is much lower than obesity. And I saw your study that come out on the patients as you follow.

Obesity and smoking are much higher risks of breast cancer than HRT. And as we now know, as you said, with the transdermal and the sprays, that's a much safer method of giving it. And the other thing that I don't think they advocate enough for is the mood. We all know with women coming in. They're saying, oh my God, I feel a different person.

And progesterone, you know, it's a natural way of helping our GABA, which is our calming neurotransmitter. I mean, that's wonderful. And now they're suggesting that also helps in inflammation and reducing it. Absolutely. So, you know, as well as helping women's mood and feeling better and the whole family feeling better, you're

also helping their immune system. Yeah. And that's got to help too with heart and to stop developing plaque as well because we know that that's inflammation. So as you said, everything is related. So I'm super excited to announce to you that my next book is now available for pre-order. It's coming out on May the 21st.

It's called The Power of Hormones, break free from fear and misinformation about hormones and harness them for a healthier, happier life. It's very historical, it's very factual. It talks about how hormones work in our body. and the mess that we're in actually when we don't have them. There's a lot of information. It's taken a lot of work and I really hope you enjoy it when it comes.

So you can find out more about it on my website, on my social media and pre-order it. Because I've got a pathology degree and I really spent a lot of my time in my science degree looking at the role of the macrophage. And I love that. I love that. You did a great job with that in Australia. I enjoy that. Thank you. Well, it's the most amazing cell because it protects us from inflammation if it's working well in the right microenvironment, but it can turn against us very quickly.

So it not only doesn't work as well, it works against us. And this is what a lot of people don't realize. It can become pro-inflammatory. So that's really can be detrimental to our health. And it's very interesting when you think about autoimmune diseases. Which is hiring us women. Yeah, which is, they're more common in women. They're more common in the late 40s. Like what else is going on then?

And when I did a rheumatology job many years ago, we would just be dishing out prednisolone and methotrexate. And I know things have moved on. The biologic agents are now available to people. And of course these drugs have a role. But if you could prevent, would it be fabulous. Wouldn't it be great to actually target the problem? So if we can change our immune system so that it's working better for us,

it's not working against us. Totally. And thyroid disease is the same way. Women have a much higher instance of thyroid disease. I mean, the bulk of it is women. Yeah. And it's autoimmune. So in the same way. And we do believe it has, you know, we know it happens at key times in the cycle.

It's either right after having a baby. Or it's around perimenopause, menopause. So it's all at times of hormone imbalance. Yeah. Absolutely. And so I think we need to really think about hormones in very different ways. And also just, take it away from the ovary a bit. Yes. Because even our heart muscle produces eustodial.

Our muscles in general are very metabolically active. And I'm sure a lot of women who exercise regularly don't need as much hormones because they're producing them from their muscles. Exactly. We've not done good studies to really see. True. You know, and I see it in the clinic, you know, I start off on a dose of hormones for somebody and then they feel better. So they're exercising more, they're eating more, maybe their body shape change. They have less fat, they have more muscle, and then they need a different amount of hormones. And they're like, what's going on, Doctor? And it's like, well, your body, your metabolism has changed.

Your requirement for hormones has changed. And maybe parts of your body are producing more of those hormones. But it's always been the ovaries. Totally, totally. And that's actually one thing I love about in charge, you do the holistic approach. You see the person as a whole because you have to, because it's all related. And that's really what we're saying here. Hormones, it's, you know, everything is interconnected.

Yeah. And if you don't see that, you can't. And that's why I always say to patients, you know, keep it the diet as unprocessed. It's not organic as you can because we know that interferes with hormones. You know, make sure you get your rest, your pace, make sure you exercise, but don't overdo it. Because otherwise you're getting a prolactin hormone up that's going to interfere with ovulation and getting cortisol too high and so forth. So it's about moderation and it's about listening to your body. and the body will dictate.

But that's all about hormones really, isn't it? It's absolutely. And, you know, it's interesting. I had a patient many years ago who was in her 70s, and she'd had her ovaries removed in her 40s. And she always experienced really bad PMDD, so premencerial dysphoric disorder. Her mood dropped at the beginning of the month just before her periods.

And she had her ovaries removed to try and cure this, and it hadn't helped at all. And she saw me and she said, Dr. Still at the beginning of every month, I get this drop in my mood, and I wonder if there's anything that could be done. Now, she had never had hormones, and I gave her hormones for her bone health and heart health and so forth. But it niggled me. Like, why was she talking about this change? Because this was several years ago, and I thought, well, her ovaries produced a cycle, so she doesn't have ovaries.

And now, of course, the hormones are made in our brain as well, and they're determined by pulses that come from hypotheraumous and so forth. and I thought, gosh, this is really interesting. It's still very simplistic medicine that often gynaecologists choose to remove the ovaries because they say that will remove the hormonal problem. And we see it a lot in people with PNDD. Yes. The ovaries go in the bin or they're given something like Zolodex

which blocks their hormones. Absolutely. But actually it's not really helping the underlying cause or problem. No, no. And progester deficiency is a huge problem. A lot of women in those situations, you know, and that's not. And I even live with heavy periods.

You know, rather than let women suffer for years, why don't, you know, we need to be educating at medical school level to say to GPs, you know, and teach them how to go in early. Don't be just firing them on the pill first, you know, because I do believe progesterone in the luteeal phase would help hugely and we've shown that. I absolutely agree. And I do think a lot, you know, women with PCOS, a lot of those women before we've always been talking about, they've got testosterone. But actually, I think a lot of them have got very low. progesterone. Totally. And we can't really measure progesterone very easily. So it's more of giving a therapeutic trial, but giving the proper progesterone, not the synthetic progesterone. Totally. And many times if you come across patients where they've had the bar in, they put on weight and solid of

VCOS, so I believe, because I've heard it so much, we've never looked at the root cause of PCS. I believe that, you know, once you interfere with that FSA, the rhythm, that if you then get it into overdrive, you, of course, it's still mass receptor. Yeah. Next thing you're going to get your sis. And next thing we have the whole thing. So, you know, I think we need to look at how do we prevent these things rather than we're going in too late. And I think with endometriosis, it's the same.

We need to be going in much earlier than having these women suffering and they're only presenting when they want to have a baby, which is terrible. I totally agree. Endometriosis and PCOS, I think, have been misinterpreted by the medical establishment, really. And because people are given the contraceptive to try and regulate their hormones, supposedly. Yes. And it can,

it obviously will stop fluctuations, but it often just switches off the hormones. That's it. And it's not what you want. No. No. Having, like you say, progesterone in the second half of the cycle

can often make periods lighter, regular, they have less discomfort, you know, and heavy periods cause a lot of school loss. A lot of, real, a lot of problems. And they're just dismissed.

losing loads of oxygen, which the whole body needs, you know. And these women at the prime of their lives are going around, young girls going around, you know, really exhausted, tired, can't participate in sport. You know, it's a huge effect. So I really think it's been an area that was being ignored for too long. Yes, it has been ignored, although it has been written about. You know, we've got Katrina Dalton who wrote about it. She sadly died now. And that was ignored because when she was talking about natural progesterone,

then the synthetic progestogens were all coming in in the 60s of the contraceptive pill. So people were trying to silence her and she had a very difficult time with the medical establishment. But if you read her books and her papers, it's very clear giving the natural progesterone for postnatal depression, PMS, PMDD. When you take a step back, it makes a lot of sense, actually. Totally, totally, totally. And as you said, it's trying to understand the science and then extrapolate that to help people. That's what we need to start doing.

And I think sometimes in medicine it's quite disjointed because I understand the science. You understand the science because you go back to the basics. Yes. But then if you look at guidelines, they're often not focusing on the science. They're focusing on a treatment, a medical treatment. Totally. And, you know, sometimes pharma influence as well. So always when it's about women with PCRs endometriosis, PMDD, they don't really mention natural hormones.

Absolutely. Absolutely. and it would just be so wonderful to help those women. You know, even, you know, individual suffers, what they suffer. Oh, yeah. The pain, you know, it's just horrendous. So it would be lovely to be able to, and infertility causes so much agony for so many couples. Yes.

So it'll be lovely to, you know, with, and this is what we're advocating. Yes. Is, you know, do the research and, you know, let's ask the questions. Yes. And let's get the answers. Yeah. And in the meantime, involve women so they can make choice. Because, you know, we see a lot of women from fertility clinics and people have quite rightly focused on whether they're pregnant or not.

But they've not thought about giving some natural hormones to try and help. I wrote a book, Louise called it's probably hormones. And in it I talked about there was a couple that came to me. And it's a true story. They came to me and they had been through IVF six or seven times, right? Because unfortunately, it's given, you know, when people have tried it at home and they're not looked at what else. And it's a wonderful thing to have. but not first line.

And anyway, the thyroid was off. So I corrected her thyroid. And they came in with the third pregnancy. So literally one after the other. And they were a lovely couple. And the husband said, we feel so bad. But what do we do now? Because we just getting pregnant so easily.

And I said, well, I'm afraid it's your time now to have your vasectomy. She's done it all. And it's about empowering men. But it's just a true story of, Unfortunately, her tarot was off and we know tarot is critical. No, it had been missed. So tarot is critical. Yeah, yeah.

So it's just so important. And even testosterone, you know, I was reading a paper the other day. And testosterone can improve fertility by 24%. Yes. Because it helps the ovulation. Ovalation, yes. And I was watching someone on social media the other day because someone had sort of alerted to me.

And it's a couple, lovely young couple, but she's trying to get pregnant and can't. So she's now having, letrosol, which is an aromatase inhibitor. Yes, yes. For several days a month. And I can understand why it's given, but it does seem really barbaric as well, because they're basically switching off the hormones and then hoping to have a rebound effect when they stop. Exactly. But in my mind, I was thinking, wouldn't it be kinder and more logical to give progesterone first for a few cycles to try and help? Absolutely. And maybe think about testosterone as well. But I think people think,

think if someone's taking testosterone and gets pregnant, they're going to just have some awful pregnancy. But they're getting confused between natural testosterone and synthetic testosterone. Yes, I agree with you. And I think the questions, the questions, it was never discussed. No. You know, you're asking the questions and you're making

people think, which is wonderful. Yes. You know, and that's what needs to be done. And with your science background, is fabulous as well, you know, because it's just all falls into place. But we need to think differently because, you know, we've had some pregnancies in the clinic. Yeah. you know, just because the women then have their hormones and the ovaries can then work a bit better.

And I've seen this before. I've got one patient recently who's now reducing her hormones. And it's been really hard to get, you know, her under control. And I've been increasing and changing her hormones, her dose and her type. And then she was fine. And then suddenly things were worsening a bit. Did her blood levels and they were fairly high of Easterdial and testosterone. So we've reduced them.

But she's only a little. her 30s. So I think her own ovaries are just coming back into function again. And probably not just her ovaries, the rest of her buddy. Brilliant. But I'm sure that's something in England as well in Ireland. We're trying to, you know, people aren't testing when we're on our HRT, what is there a Easter dial?

Is there a testosterone adequate? Yes. That's something we're trying to educate people to do. You know, because they don't do it as part of the norm, which it should be done, of course. Yeah, I think it's very... It is useful, but the range is really very. Yes, yeah. Had somebody

in fact today contacted me this one is so I've just seen my testosterone level it's 0.1 above the normal but I feel really well should I reduce and it's like no because if I do another test tomorrow it will be a slightly different result they're just a guide but they are useful to put in contact

yeah definitely definitely so I mean there's so much we need to do there's so much more research but I do think going back and looking at the basics is really useful because that's been forgotten in the noise of hormones and men And I do think, you know, as endocrinologist, people should be joining the dots more and

think about all the hormones. So it's great. Like the work you're doing, we need to keep going. Thank you, Louise and you equally. Oh, thank you. So before we finish, just three take-home tips. So three things that you think all doctors should know about hormones. That they control absolutely everything. That without hormones we wouldn't be here. Yeah. That we have. can influence them by our diet, with our exercise, with how we look after ourselves, we have a huge personal responsibility

to help our hormones. But in addition to that, we need to understand our hormones more. We need to understand how life interferes with hormones and also how different times, like hormones control the immune system, particularly in those women,

around times of stress, around times of perimenopause, even heavy periods. So we need to understand the whole interlinked between hormones and inflammation because we could prevent serious amount of disease if we just did that. And listening to women more, listening to their stories, listening to what you said, the amount of autoimmune disease that you're seeing, and actually studying that, how much rheumtides and lupus if you diagnose you're on paramedopause and menopause?

And for people to look and ask questions, why? What are we doing here? How can we prevent this? instead of just throwing them on drugs that are just going to suppress the immune system and cause more problems, great to have them, but could we prevent it? And I think that with our knowledge and expertise

and putting all our heads together, we can do that. And we owe it to society to do that. I love it. So keep curious. It's a big campaign message. Thank you so much for coming today. It's been great. Not a toy, Louise, delighted. Delighted.

Delighted.