AMA #52: Hormone replacement therapy in women: practical applications and the role of compounding pharmacies

**Peter Attia** (0:11)
Hey, everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything episode number 52 I'm once again joined by my cohost, Nick Stenson. In today's AMA, we focus the entire conversation around hormone replacement therapy and testosterone replacement therapy as it relates to women. We've gathered many questions that have come through our recent podcasts with Joanne Manson, Sharon Parrish, and the endocrine system video series that I did on this topic.
These questions all focus around the practical application of HRT and TRT for women and how we do this in our practice with female patients. So this AMA is really centered around answering questions with the focus of helping people put into practice what we've talked about a lot in terms of theoretical application. So we've done so much work on the theory of HRT and TRT. This is kind of the how to do it.
Wrapped up in this conversation around HRT is the topic of compounding pharmacies, as it is almost impossible to disentangle the role of hormone replacement therapy of any form in compounding pharmacies. And if you don't know what a compounding pharmacy is, you're definitely going to want to pay attention. And certainly if you do know what it is, I think you're gonna want to pay attention because compounding pharmacies are still a little bit the wild, wild west, and there's the good, the bad, and the ugly associated with them. Even if you're not interested in HRT, this is probably an important discussion for anyone who falls within spitting distance of a compounding pharmacy. If you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page. And if you're not a subscriber, you can watch a sneak peek of the video on our YouTube page. So without further delay, I hope you enjoy AMA number 52

**Nick Stenson** (2:27)
Peter, welcome to another AMA, how you doing?

**Peter Attia** (2:30)
Doing very well.

**Nick Stenson** (2:31)
We got a topic you're really excited about, I think, today.

**Peter Attia** (2:34)
I am, yeah. I do find this topic to be simultaneously interesting and important, so glad we're doing it.

**Nick Stenson** (2:41)
That's always a good overlap.
For today's podcast, for those of you listening and watching me, what we're gonna do is answer questions that have come through from subscribers around recent topics covered on the podcast, specifically questions around hormone replacement therapy and testosterone replacement therapy as it relates to women. So this is a topic that's been talked about on the Joanne Manson episode, Sharon Parrish, as well as the Endocrine System podcast where Peter, you were drawing on a whiteboard. And so from those episodes, we gathered a lot of questions and these questions really focus around the practical application of HRT and TRT for women and how you use these in your practice with your female patients. So the hope is this is much more of a practical application as opposed to an educational one. Wrapped up in this conversation around HRT is the topic of compounding pharmacies. As many people who will need to get HRT and custom HRT prescriptions will use compound pharmacies. So even if you're not interested in HRT, if you ever think about or will have to use compound pharmacies, it will be a really good discussion.
With all that said, anything you wanna add before we get into it?

**Peter Attia** (3:56)
I think sometimes when you talk about something like sex hormones, there's a potential thinking that, oh, you're only speaking to half the population. But of course, while everything we're gonna talk about is directly applicable to women, it's obviously applicable to men who sort of know or care about women.
I know more about this topic than my wife, and that's gonna, I think, help me help her as she goes through these transitions. And similarly, I think if you're listening to this and you're a guy, it's worth paying a lot of attention as though we're talking about male hormones as well, which of course we spend just as much time talking about and the same argument would apply there as well.

**Nick Stenson** (4:32)
Yeah, and I think that kind of leads to a good first question, which is even though this is a topic we've covered somewhat extensively in the past, why did you kind of feel it was important to touch on hormone replacement therapy again as it relates to women and pull more questions around this?