Hormone Replacement Therapy Decoded: Why the FDA Removed the Blackbox Warning on HRT

**Dr. Gabrielle Lyon** (0:00)
The FDA just removed the black box warning on HRT for metaphors. Who should not go on hormone replacement therapy? Active breast cancer or active cancers if someone has not worked up vaginal bleeding and stroke. Benefits of hormone replacement therapy include a reduced risk of all-cause mortality, fractures, HRT has also been associated with a 50% reduction in heart attack risk, 64% reduction in cognitive decline, 34% lower risk of Alzheimer's.
We think about testosterone and we think about muscle mass, but there are testosterone receptors all over the body. There are estrogen receptors all over the body. It's not just, oh my gosh, I'm going to give you testosterone and then you're going to grow a beard and muscles. It's not going to happen. You know, we think about testosterone replacement therapy for men. No one blinks an eye. Women aren't even thinking about that. Similarly, just how men aren't even thinking about estrogen, which is equally important for men and women.
What's up, friends? I'm Dr. Gabrielle Lyon. And before we jump into this episode, I want to put together a handful of definitions so that we are all on the same page. And the first definition that you are going to hear is called virulization. And this is the development of male characteristics by being exposed to an androgen, an androgen-like testosterone. They include the following. Deepening in the voice, coarse hair on your body, increase in clitoris, increase in muscle mass, and that is called virulization. The second definition that you might hear is something called hematocrit. And this is a simple blood test and it refers to the oxygen carrying capacity in the blood. The higher your hematocrit, the more oxygen that you carry. The third definition that I think is important is something called an androgen. And an androgen is a steroid hormone. And this is typically related to the development and maintenance of male sex characteristics. But it's present in both men and women. And finally, something called liquid chromatography. And this is a way or a chemical technique that allows us to identify certain compounds in the body like testosterone. You've heard me say before, muscle is the organ of longevity. Now I'm putting the playbook in your hands. My new book, The Forever Strong PLAYBOOK, is your road map to building real strength. Not just in your body, but in your health, your energy, your life. This isn't theory. Inside, you'll find the exact workouts, protein forward recipes, recovery strategies, and mindset tools I use with my patients and live by myself. This book is for anyone and everybody who wants to age powerfully, stay vibrant for their family, and show up strong every single day. When you pre-order, you're not just getting a book, you're joining a movement. The link's in the show notes, and I cannot wait for you to dive in. We have some really important stuff that we have to cover.

**Nick Berenger** (3:10)
Yes.

**Dr. Gabrielle Lyon** (3:11)
The FDA just removed the black box warning on HRT. I saw that. I know, for menopause. And why is this important? This is important because for the last, since 2003 or so, women have stopped using hormone replacement therapy for risk of breast cancer, cancers, heart disease, stroke. And it's really changed the landscape of health and wellness for women. And we're now entering a new landscape.

**Nick Berenger** (3:39)
Is that because of your advocacy? No.

**Dr. Gabrielle Lyon** (3:41)
But what I think has really happened is that up until 2003, women were prescribed hormones. These hormones include estrogen, progesterone, and testosterone. So testosterone replacement therapy has been around for, I don't know, 80 years, very effectively. And then all of a sudden, the Women's Health Initiative came out and that changed the trajectory. And people became afraid both of the hormones and also prescribing. But again, now we get a review. What the science says? What are the logistics? Should women take testosterone? You were asking me, will women grow a beard?

**Nick Berenger** (4:18)
That's what I want to know. Will they grow a beard? That's what my wife would want to know. Be like, am I going to grow a beard?

**Dr. Gabrielle Lyon** (4:24)
No. And if you look at the normal laboratory values of total testosterone in women, it is dependent on age and menopausal status. Also, the type of testing used. Depending on the assay used, depending on the lab, you might get a higher number or a lower number. And the gold standard is liquid chromatography.

**Nick Berenger** (4:46)
OK.

**Dr. Gabrielle Lyon** (4:47)
Just thought I'd throw that out. So if you're getting...

**Nick Berenger** (4:49)
Is that specific, like... So should that be something when you go to your physician?