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Welcome to The Modern Midlife Collective—where midlife isn’t a crisis, it’s a rebirth. Hosted by Dr. Ade Akindipe, DNP, and Dr. Jillian Woodruff, MD, this is the podcast for women ready to unapologetically own their power, thrive through the ups and downs of hormones, weight, and self-care, and show the world that thriving at 40 and beyond isn’t just possible—it’s your birthright.
Biweekly, we bring you science-backed insights on hormones, menopause, longevity, and sexual health—real tools to empower women in midlife and beyond. With a fearless blend of functional medicine, real-life wisdom, and no-nonsense empowerment, we’re here to challenge the norms, break through the barriers, and help you step into a life of vitality, confidence, and unstoppable strength.
Ready to rise? Let’s do this.
Jillian Woodruff MD (00:25)
After more than two decades of fear-based messaging, the FDA has finally removed the black box warning from estrogen products for menopause, or it will be removing this warning. But here's the real question. How do we get such a powerful warning in the first place? And how was it allowed to mislead an entire generation of women? Today, we are breaking it down. We are going to talk about the WHO study.
the statistical truth behind the headlines and what this regulatory shift finally means for your child.
Dr. Ade Akindipe, DNP (00:59)
Yeah, mean, honestly, this change is overdue, right? And I'm excited that we're gonna have this conversation about the real world consequences women have lived through. I'm sure you've seen this, how women were prescribed, you know, who are prescribed vaginal estrogen and all of a sudden they're like, nope, sorry, just kidding, we cannot give this to you anymore because of the black box hoarding. So.
Hopefully this is going to be about clarity today, this topic, science, and empowering you to seek help if you are experiencing any symptoms. But those warnings, of course, you can only imagine doctors being terrified to prescribe it. So let's get into it.
Jillian Woodruff MD (01:37)
And then even if they are prescribed it and they go to the pharmacy and they don't have a trouble, you know, have trouble there, they pick it up and then they get home and they see this terrifying warning, they're not going to take it. They're not going to use the products. Yeah. So let's talk about what happened this week. November 10th, 2025, the FDA announced that
Dr. Ade Akindipe, DNP (01:50)
Let's take it. Right. Yeah, absolutely.
Thank you.
Jillian Woodruff MD (01:59)
Right? It's going to be removing this long standing black box warning from estrogen containing hormone replacement therapy. And the warning was originally added after early findings from the Women's Health Initiative. And this is that study that took place in the 90s and ended in 2002, 2003, and that timeframe. So the findings from this study are what
promoted the addition of this warning to any product that has estrogen in it. And it was never that estrogen was unsafe. It was that the warning was dramatic and it didn't distinguish age, type of hormone you're taking, the route that you're taking, who is taking it, what they're using it for. It just really generalized the risks of
that this product increases cardiovascular disease and breast cancer and dementia and didn't clarify who these risks are, who they apply to, what they apply to, the specific type of medication that may increase or decrease your risk. It was just like a blanket statement.
Dr. Ade Akindipe, DNP (03:05)
Yeah, and that blanket statement, know, the FDA is finally saying, okay, you know, the menopause experts, thankfully, there are people out there who kept fighting for this. And I saw a couple of clips on social media and on the news who basically went and actually fought for the past two decades what these women were suffering. So that original black box warning was based on outdated, limited science.
from that WHI data, which lumped everything, different hormones, synthetic, bioidentical, it doesn't matter as long as it was estrogen. Oops, you can't have it because it was linked to cancer, right? But that's not true, now we know it. So we know that timing matters, right? Starting hormone therapy near the onset of menopause. It's not the same as starting 10 to 15 years later, that kind of formulation, whether they're bioidentical versus synthetic. We had talked about this in other episodes.
you know, about what that looks like. The delivery route versus, you know, transdermals and gels, you know, if you have a clot risk, you probably want to be very careful with that. So low dose vaginal estradiol, we talked about that too and how important it is for those women who are getting recurrent UTIs. So not all estrogen is bad for you if you're getting personalized care, you know, that's why now the FDA is now going to remove that.
and that you're getting clinical guidance from someone that can prescribe that for you.
Jillian Woodruff MD (04:27)
Right, I brought a box of vaginal style cream. so if you write, because I wanted people to see this. So it has the cream in here. And then there's also something that you can use to insert it, like the one inserter. But it is wrapped in
Dr. Ade Akindipe, DNP (04:33)
Awesome.
Jillian Woodruff MD (04:49)
all of this information that's supposed to be about the product. Right? I should, I should have put like a big X through it. So like this stuff is hard to read, but if you see a, this is, not going to be able to see this, but there is a black box. That's what it is. It's a black box around what they think should be the most important thing that you look at. So who's going to read like all of this?
Dr. Ade Akindipe, DNP (04:52)
Did you cross out the black box warning?
Thank
Jillian Woodruff MD (05:14)
front and back, information with extremely tiny print. And you know, let's be real, these are perimenopausal and postmenopausal women that would be getting this and the eyesight is not going to be the best. Okay. So you're going to get this and it, you know, it starts with warning. That's the first thing in the black box. Warning, endometrial cancer.
Dr. Ade Akindipe, DNP (05:31)
Unbelievable.
Jillian Woodruff MD (05:39)
That's uterine cancer, cardiovascular disorders, breast cancer, and probable dementia. That is in both. Right? Stay away. Right. And then in the box, it goes through each of those things and says, um, it doesn't say what it was that the people were taking and when they took it, who was taking it. It doesn't say that it just goes through like, Oh, we found increased risk of.
Dr. Ade Akindipe, DNP (05:45)
the loudest alarm bell ever. Essentially stay away from it. Doesn't matter what you do, stay away from estradiol.
Jillian Woodruff MD (06:06)
uterine cancer, increased risk of cardiovascular disorders, right? If you keep up, that's what's in the box. If you keep reading, it actually does go on to tell you the truth. And it does say what they were taking, but who's going to get there after they see warning, endometrial cancer, breast cancer, right? So the black box warning, this is the strongest safety warning that FDA issues.
Dr. Ade Akindipe, DNP (06:23)
Nobody.
Jillian Woodruff MD (06:33)
So with this black box and it says, is serious, this might cause harm, use with caution. So anything that causes like birth defects, black box warning, right? Things that are like have medications that are, that could be fatal and mixed together with other things. Black box warning. And that's what they did for estrogen, something that naturally occurs. And then it's based off of this one study, which
Dr. Ade Akindipe, DNP (06:48)
Yeah.
Jillian Woodruff MD (06:59)
As we will talk about more, there were a lot of issues with the interpretation of the study, and even when those were corrected, nobody paid attention.
Dr. Ade Akindipe, DNP (07:08)
basically just one scenario. Older women starting oral synthetic estrogen, right? Many years after menopause. So there's this blanket statement. Age, your risk profile, whether you were in your 40s or 60s, whether you had surgical, you know, induced menopause, doesn't matter. You just can't have it. So it just created this fear, unfortunately. So I'm excited for this day that has come. It should become a holiday.
Honestly, I was so excited. But ⁓ no, seriously, I mean, I just remember, you know, just remember all those days back in the ICU, those older women that were coming in confused, you know, they have dementia and they would put them on all these antibiotics and just cause more problems. These are women that could have had access to these hormones.
Jillian Woodruff MD (07:36)
Yes!
It should be a holiday.
Oh, absolutely, absolutely. We use fear to control people. So it's used in medicine, it's used in politics, it's used in so many aspects of life. But now we women, we are educating ourselves, we more access to information. We have to weave through a lot of misinformation too, but we're coming out empowered and ready to, it took several decades as you mentioned, a couple of decades.
Dr. Ade Akindipe, DNP (08:05)
Yeah.
Jillian Woodruff MD (08:27)
to get to where we are. But yeah, whew.
Dr. Ade Akindipe, DNP (08:27)
Maybe testosterone will be next. Maybe that'll be FDA approved for. Anyway,
I digress. This is about estrogen.
Jillian Woodruff MD (08:34)
Yes, but we do pray for that. Yes, absolutely. We're going to be working on that next. So let's talk about the WHI study and what was actually studied. So this is the Women's Health Initiative. This was a very large trial that took place in the 90s, like I said, that's it was started. And it was designed as a large primary prevention study.
And it was power to answer one big question, is does starting hormone therapy in older women, so either conjugated equine estrogen alone, which is primarin, like the estrogen, that's a brand that's the estrogen that is retrieved from pregnant horses and keeping in mind.
This is not estradiol. This contains many different types of estrogen, some that humans have and some that humans don't have. So using that alone versus using that type of estrogen with metroxyprogesterone acetate, which we discussed, it's synthetic progestin and it is a more powerful progestin than we use today for hormone therapy when we typically use micronized progestin.
progesterone and then they compared it to placebo. And so they wanted to see does this prevent coronary heart disease and or other chronic diseases. It was a billion dollar study. They enrolled over 160,000 women and the ages were 50 to 79. Average age was 63. Right. So these women were, you know, some of them, many of them, most of them, I think were a day past menopause when they went through menopause.
They use like 40 centers across the United States. So they're all different places treated by different providers between early to late nineties, they enroll people. But 68,000 of them or so were part of the clinical trial. The randomized trial where they randomized them to the estrogen alone, the estrogen plus the progestin or the placebo.
They planned to do this for like nine years, but it was stopped early. The first one that was stopped early was the estrogen and the progestin trial that was stopped in like 2002. They stopped that after only five and a half years of studying because they thought the overall risks outweighed the benefits.
So they said there was an increased risk of invasive breast cancer, increased risk of coronary heart disease, which is what they were studying, increased risk of stroke, increased risk of pulmonary embolism. So for those who don't know, like the blood clots that spread to your lungs and you can't breathe, they did have already at this point decreased fractures. So probably they had lower osteoporosis risk, but they also had decreased colorectal cancers.
But it was stopped early. This is even before any study was put out, but in the media it was like estrogen causes breast cancer. And then that was it, right? The other, the estrogen alone study continued on for two more years. And then they also stopped that one after like seven years. And they said that they didn't have any decreased benefit for heart disease. And they had increased risk of stroke and they had
Dr. Ade Akindipe, DNP (11:38)
That's
Jillian Woodruff MD (11:53)
increased breast cancer risk, which later we found it did not. And this will happen during my OB-GYN residency. So obviously completely changed my education where really was we learned about, you know, the how hormones are produced, you know, how you make babies, how they function in the body, and then how they start to decline and then they're gone. And then that's it, right? The end.
You have no hormones. You feel like crap, but this is natural and you just have to suffer your way through it. And that was it. And this is what everyone was taught. People were taking off their hormones. They were left to just suffer because that's what we do as women. And this is a whole generation of women, like the baby boomers, right? Like the hugest generation of women. And then they're left with nothing.
Dr. Ade Akindipe, DNP (12:17)
Ha!
Jillian Woodruff MD (12:43)
and providers, doctors, nurse practitioners, PAs, they're left with no education and no ability to help these people and just replaced with a ton of fear, stay away, don't do this, don't do that, without any information, without any clarification. And this trial isn't even made to discover these things. And if you know about research, have to
Dr. Ade Akindipe, DNP (13:02)
Yeah.
Jillian Woodruff MD (13:08)
You set your hypothesis, right? Your theory, like, think it will cause this. And then you make a study to remove other confounding factors and, and you, you choose participants that will, ⁓ that are representative. And like, we see none of this happened in this trial because it was for a different purpose. And then they changed it to try to extrapolate results and put them and, and.
What is the world extrapolators results to a completely different landscape?
Dr. Ade Akindipe, DNP (13:38)
a completely different population.
Exactly. I mean, just think about, no, it really does, it just blows my mind when you listen to everything that you just said and how the estrogen only arm was not even looked at. It was buried underneath all of that. So meaning women who had a hysteria hysterectomy, for example,
Jillian Woodruff MD (13:40)
Hmm.
the benefits.
Dr. Ade Akindipe, DNP (14:04)
and took estrogen without progestin, the outcomes were positive, right? So there was lower breast cancer incidence. There was lower breast cancer mortality. There was lower all-cause mortality. So that actually means those people, those women who took estrogen alone actually lived longer than the women who took nothing. So that...
Jillian Woodruff MD (14:26)
the
Dr. Ade Akindipe, DNP (14:30)
I think years ago, 20 years ago could have been headline news, right? Those women who had, you know, they had clinicians who were maybe they were prescribing it to them who stopped it, didn't get that information. So instead those findings were completely overshadowed. You know, the nuances were lost, ⁓ medical training at that time, you, I'm not sure you said you were your residency then and you were in residency. Did you even hear anything about that?
Jillian Woodruff MD (14:54)
Oh, we discussed this trial at length. And in fact, it was so interesting because there were so many questions that were sent in to the primary group that was researching this. And many of them were unanswered or kind of like some people, some women experience when they go see medical providers, they're just dismissed. And a big one was about
statistical significance and talking about if statistical significance is super important, right? You're trying to determine if the result could be due to chance versus being significant. And for some of these results that reported, they even said in the document that some of these things almost reached.
statistical significance. That is not the same as being statistically significant. What it's saying is that this result could have been due to chance and I don't have all of the information to prove that it wasn't. That's why we have things like statistical significance because you can't research something and report results if they aren't significant. They're not a result.
Dr. Ade Akindipe, DNP (16:06)
Right.
Right. And from a patient perspective, it doesn't matter. This is what it says. This is what it says. This is what I heard on the news. This is what I read. This is what the pharmacist told me. Hey, do you really want that? There's a black box warning is going to do this. So unfortunately these women suffered and impact their quality of life. I think about all the women that were, you know, in the nursing home right now with dementia and all these other, you know, osteoporosis, breaking hips.
⁓ recurrent UTIs, Eurocepsis. And the list goes on. These women suffered, unfortunately.
Jillian Woodruff MD (16:40)
And
you know, they're talking about the headlines were increased breast cancer. It's very, people are very, afraid of breast cancer, even knowing that more people died from heart disease than from breast cancer. Breast cancer is not that anybody wants breast cancer, right? But it is highly treatable. And most people, I mean, over 90 % of people survive. Now it's not to say that they're armed.
downsides to your quality of life is certainly there are there there's risks to your life in other ways too and other increased risk of other diseases with breast cancer so not that it's not significant for someone that has breast cancer certainly is but you know just comparing okay breast cancer incidence to cardiovascular disease incidence there is ⁓ a huge difference
Dr. Ade Akindipe, DNP (17:23)
Right.
Jillian Woodruff MD (17:32)
And we did talk about this before, the relative risk and the absolute risk. And they talked about the 26 % increased risk. mean, that sounds like a huge deal. 26 % increased risk of breast cancer in those who are taking the estrogen and the progestin. You hear that, that sounds terrifying. But the results were, and these are the ones that were almost statistically significant. But even putting that aside, when you think about 26 %
Dr. Ade Akindipe, DNP (17:36)
Yes, we did.
Bye
Jillian Woodruff MD (18:00)
This is a relative risk. And what we need to know is the absolute risk. How many more people, how many people had breast cancer in this group? How many people had breast cancer in that group? So you can kind of figure out this, a 25 % increase doesn't mean much if you don't know the numbers. So we know like there were the placebo group, about 30 cases of breast cancer for 10,000 women years. That's, know, 30 for 10,000. The absolute risk.
Dr. Ade Akindipe, DNP (18:18)
Right. Right.
Jillian Woodruff MD (18:28)
in those who were doing estrogen and progesterone 38, so about eight to nine more cases per 10,000 women. To me, that's not significant, even if it's statistically significant, even if it was, it's not significant to me. Now, you may have your own opinion about if you think that number from 30 to 38 is a big deal, right? But these are the things that as a patient, you should be able to decide for yourself, right?
Dr. Ade Akindipe, DNP (18:55)
Right.
Jillian Woodruff MD (18:56)
because somebody may think if they're in the eight, that's a big deal. But 30 to 38, like eight more cases out of 10,000 people, you know.
Dr. Ade Akindipe, DNP (19:02)
Correct.
I mean, I think
that's, and that's the thing with the, you look at the other, what was happening with the estrogen arm study, right? So then we could see that there were some benefits there. Unfortunately, that was taken away from the patient. The ability to say, hey, this could be good for me. What are my risks, right? So we know that hormone therapy is not for every woman.
And that's important to know. I think I made a little bit of a joke on this on social media after this FDA thing got approved where some women will say, yay, I can have estrogen now and I can be like Beyonce again and I can stop. All kinds of things. So you can't just go and get a prescription for hormones because yeah, hormones are great, but there has to be clinical indications for it. We have to look at your risk, what your family history is like.
Jillian Woodruff MD (19:43)
Is it Beyonce again? Were we Beyonce before?
Dr. Ade Akindipe, DNP (19:58)
So the bottom line is it is a safe alternative if it's right for you, right? So I just, don't know. It's unfortunate. I just think of all the women that used to come into these acute care clinics with recurrent, and all we did was just give them prescriptions for antibiotics and yeast infection medications and all of that. But.
We have a decision now and I'm just looking forward to the future. You know, there's just so much excitement around it and I'm hoping that more providers are enlightened now, feel safe and they can get that education, whether they're primary care doctors and just act on behalf of the patient before things get worse. Because we know hormones can do so much more, not just hot flashes, night sweats, know, weight gain, you know, that visceral, that insulin resistance that we are so prone to as we get older and we start to lose these hormones.
Jillian Woodruff MD (20:47)
You'll appreciate this. Another thing that kills me is that in the early reports of the WHO, they reported that estrogen did not have a clinically meaningful effect on health-related quality of life.
even among women who had taken it for three years. Have you seen that in enough of your patients that they are not having a benefit to their quality of life, that you would feel comfortable making that generalized statement? This is what was reported, that they did not have a benefit to their quality of life. I thought about it, and I found about there's at least 68,000 women in this study. The interesting thing that probably
Dr. Ade Akindipe, DNP (21:03)
Hmm.
⁓
Jillian Woodruff MD (21:26)
people wouldn't know unless they studied this is that the women that were enrolled in order to be enrolled, could not have vasomotor symptoms. You could not have the traditional menopausal symptoms. So if you're a hot flashes, you were not enrolled night sweats, not enrolled, know, sweating, none of that. couldn't have appreciable symptoms of menopause when you're enrolled because it would be very easy to know. There was supposed to be a blind study where they don't know who gets what.
You know, and they don't want the patients to know what group they're in. If they're getting nothing, if they're getting estrogen alone, if they're getting estrogen and progesterone, they don't need to know. So if you have hot flashes, typically the majority of the time your hot flashes go away. So they couldn't include people who had symptoms. So tell me how, how do you make a comment like this that if you don't have symptoms to monitor, how do you make a comment that you don't have improvement?
Dr. Ade Akindipe, DNP (22:19)
How do you make that comment about
quality of life?
Jillian Woodruff MD (22:21)
Yeah.
How do you relieve symptoms that you don't have? Right? Anyway. Anyway, so I think he said the CIPA, removing the black box corning does not say that hormone therapy is perfect or risk-free. It does not say that at all. It's just taking away an overly broad message that doesn't match the evidence that we know of today. And so
Dr. Ade Akindipe, DNP (22:25)
my goodness.
Jillian Woodruff MD (22:45)
It allows for the new ones. allows for personalized care, individualized assessment. Also, you brought up the UTIs and the vaginal estrogen. You know, it didn't differentiate between systemic treatment and local treatment, right? Local treatment doesn't have those systemic, any systemic risk because it's a local treatment. So this will allow people to get the local treatment that they need or the systemic treatment that they need.
Dr. Ade Akindipe, DNP (22:57)
at all.
Jillian Woodruff MD (23:10)
at least have a good conversation to discuss those risks. Right? Yeah. But another problem is going to be medical providers because we also, it's not just the patients that have had fear. We've also had 20 years of fear, do not give hormones, right? And not everyone has gone on for further training like you and I. So we haven't gone on to educate ourselves on hormones, benefits, risks.
Dr. Ade Akindipe, DNP (23:13)
good conversation.
Jillian Woodruff MD (23:36)
to be able to have that in-depth conversation with patients. And there's an invisible force that shapes the last two decades of women's health and it's confirmation bias. And it's like, when we believe something is true, we unconsciously search for information that supports that belief and we discount information that challenges it. Our brain just applies this filter. So if you expect,
hormone therapy to cause breast cancer, you will notice every piece of evidence that aligns with that fear and dismiss the evidence that contradicts it. And so even highly trained clinicians will fall into this pattern because confirmation is not about intelligence. This is how our human brains process direct and uncertainty and incomplete data. And that's exactly what happened after the WHOI announcement.
Dr. Ade Akindipe, DNP (24:04)
Everything. That's right.
Jillian Woodruff MD (24:26)
Early tests, were super alarming, they caused a lot of fear. Clinicians and patients anchored to them. And the story became simple and emotionally resonant. Hormones caused breast cancer. And once that belief took hold, it shaped how the data was interpreted. And many providers never revisited the findings. Because as you know, there were so many iterations after that from the researchers.
And because they continue to follow up with these patients and they continue to release the data that we know to be true, it didn't just end in 2002, but they clarified that the WHO was not designed to evaluate breast cancer. They showed that there was ⁓ an benefit, decreased risk of breast cancer incident and decreased risk of
both invasive breast cancer and dying from breast cancer. They clarified the age thing that we talked about. They clarified that synthetic projection was used. They clarified oral is different than transdermal or other non-oral forms of estrogen and how that affects your blood vessels. Even cardiovascular literature came to say that the more hot flashes you have increases your incidence of cardiovascular disease.
Like, and this is in the cardiovascular literature, the urologist got in there and they talked about prevention of urinary frequency, urgency, recurrent urinary tract infections with hormones. Over the last 20 years, have been many significant studies that clarify and really show the benefits of hormones and further differentiate what causes risk, what kind of risk it is to you. But despite all of this,
The early interpretation exists amongst so many providers. That's the power of information bias. Once there becomes the frame, every new piece of information is sorted through that frame.
Dr. Ade Akindipe, DNP (26:11)
That's right.
I mean, fear is a real thing, right? And it sticks around, especially when it comes from an authority like the government. It's like FDA approved, not approved, black box. Imagine going into your medical record system and you're seeing a warning like that. So it's gonna take some time for all of this to be reversed. So with the FDA removing that black box, it's really about...
reclaiming truth and reopening that conversation again that should never have been shut down in the first place. mean, but it is such a big deal. It really is a big deal. And we have to realize that, you know, unfortunately something like this could potentially happen again. So that's why the medical society and people that are people like you and I, I mean, that's what it took.
providers like you and I, and they said, hey, this is what we're seeing and they're challenging it with more studies and more, even though some of them, some of the things are still anecdotal that we're seeing in our patients, but we are seeing that, hey, what you guys are talking about, this is not what we're seeing symptomatically in our, our, in these women, they're getting better, improved quality of life. You know, they, their mood is better, their hot flashes are gone, even though it wasn't included. All of this really was happening. These women are getting better. So,
You know, it's just now we know, we know timing matters, formulation matters, delivery route matters, low dose, vaginal estrogen, local versus systemic, there's a difference. know, Whitman, you're listening out there, it's important. You know, if you've been on the fence before and you're suffering through this, I mean, I've seen this happen and women will say, absolutely not.
I don't want to do anything like that. This is your chance to really go back and have that conversation. Go and show your doctor your labs, your symptoms and all of that and start from scratch. If it's right for you, then it's absolutely something that's safe for you.
Jillian Woodruff MD (28:15)
Well, some people aren't even able to get labs. I have people come in that say that their provider won't do them. Right? Mm-hmm.
Dr. Ade Akindipe, DNP (28:21)
Absolutely. You won't even go that route at all. Yeah. So hopefully this changes
that narrative and providers are willing to respond. if they don't, yeah, go somewhere else.
Jillian Woodruff MD (28:28)
or send them to somebody who knows, right?
Because we cannot know everything. I can't be an expert in every field, but it is my job to find people or to help guide them so that they can find the person that knows more and can help. Another thing I just wanna touch on, and probably will need to speak more about this later, is the timing because...
Dr. Ade Akindipe, DNP (28:36)
Yeah. Correct.
at a referral.
Jillian Woodruff MD (28:54)
I don't want this to turn into, ⁓ well, I'm not five years or 10 years from menopause. Cause I feel like that's where it's going to lead that people feel like they can't get hormones because they're not close to menopause. It, for me in my ⁓ medical opinion, you can get your hormones at any time, right? It's individualized and right. And what the literature is talking about is
Dr. Ade Akindipe, DNP (29:14)
It's individualized. Correct.
Jillian Woodruff MD (29:19)
you know that we're seeing, okay, we have decreased risk of cardiovascular disease and decreased risk of dementia when it started close to menopause, right? But it is not saying that you do not have a benefit if you started 10 years, 15 years, 20 years. It is not saying that. There will certainly be benefits. Maybe the most benefits with the least amount of risk is when you started close to menopause because at that point, hopefully,
Dr. Ade Akindipe, DNP (29:27)
earlier.
A pause.
Jillian Woodruff MD (29:46)
you will not have a risk of having cardiovascular disease from low estrogen, right? Because we know as our estrogen levels go down, that risk goes up. But if you've waited 10, 15 years, there's a risk that you may already have like risk factors for cardiovascular disease. So then we can't say, okay, these hormones will be preventative if you started then, right? But we're not saying you're not gonna have a benefit. You may still have a benefit. It just may be a different risk benefit profile.
which it is for everyone. all have our own individual risk benefit profile and we have to discuss that with somebody who's knowledgeable and hormones that can help guide that conversation so that the woman can make her own decisions based on what her goals are. Her goals may be different than my goals, different than your goals.
Dr. Ade Akindipe, DNP (30:32)
Absolutely.
Jillian Woodruff MD (30:33)
And precision, precision medicine is really where it is right now. That's what we're leaning towards. But, you know, we have to, there's so many forces working against it because our medical system is very acute care, know, keeping you from dying. And it would be great if we could transition into the prevention and optimization and the precision. But yeah, that takes a lot of work on.
the patient's part and on the provider's part to individualize the care. That's really where you're going to get your best ⁓ wellness.
Dr. Ade Akindipe, DNP (31:07)
mean, everyone
deserves it. It's important because unfortunately, if you don't get the individualized care, this is where we start to go down the rabbit hole of disease, right? You get, well, your A1C is climbing up there or your blood pressure is, so what does your medical history look like? What are your labs really telling you? Are they optimal for you? We've been talking about this all this time about
optimal care, not just normal care, not just because your labs are within that range. And I think when it comes to hormonal care too, that needs to be individualized. Where do you stand? Where are you in your journey of hormones? Are you close to menopause? And like Dr. Jill says, your wrist might look different from somebody else, but it doesn't mean that you may not have some form of a benefit. You deserve an improved quality of life, whatever that looks like for you.
Jillian Woodruff MD (32:00)
hope that the conversation today resonated with you. think we shared a lot of information about this historic moment in women's medical care. If this conversation brought up questions or stories or moments from your own journey, we would love to hear it. So please email us
Connect at modern midlifecollective.com. There we go. There we go.
Please. We will make sure to put it in a show so you have the actual email address and you can also follow us on Instagram. And so this message there. So there you go. That's modern midlife collective, but your lived experiences really shaped the conversations we have here.
Dr. Ade Akindipe, DNP (32:26)
Cut.
Jillian Woodruff MD (32:43)
So we may share what you allow us to and do a follow-up episode on your journey and explore your questions and more depth. So share with us and thank you for spending time with us today.
Dr. Ade Akindipe, DNP (32:58)
Thank you so much. Bye bye, see you next time.