124: REPLAY: Ob-gyn Dr Vikram Talaulikar's straight talk on hormone therapy

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This podcast originally ran on October 21, 2023.
This week we get down to basics, and basics are exactly what we need in this confusing world right now. This is THE podcast to listen to if you are confused about all things to do with taking hormone therapy.

Dr Vikram Sinai Talaulikar is a specialist in reproductive medicine at University College London Hospital’s NHS Foundation Trust and an associate professor in Women’s Health at the University College London. He graduated in medicine in India in 2003 and completed a postgraduate degree in obstetrics and gynecology in 2007. He is a certified menopause specialist by the British Menopause Society, a menopause trainer and he is constantly educating others on this transition as well, via online webinars, events and through social media.

He is also part of the trio who established the Menopause Research Education Fund, alongside medical journalist Fiona Clarke and groundbreaking menopause campaigner Diane Danzebrink.
Highlights of our discussion:

• Hormone therapy (HT) 101
• WHI: good, bad and what we can learn from it 20 years on
• Estrogen in the pill vs estrogen in HT
• All the kinds of estrogen and what they are used for strogen too ethinyl estradiolEstrone, Estriol, Estradiol, and Estetrol.17 beta estradiol
• Getting to the bottom of body simila, body identical and bioidentical – and why that varies from country to country
• Pharmaceutical company produced HT vs compounding pharmacy versions
• the big “Catch-22” with compounding pharmacies that keeps their bioidentical hormones out of official recommendations
• the pill, HRT and breast cancer risk
• why problems with the pill don’t get flagged and HRT does
• Evidence over estrogen and breast cancer risk (and randomized trials versus observational data)
• What’s what: progesterone, progestin and progestogens (how they work and which one carries a slight risk for breast cancer)
• how long you really need to take HRT to see if it’s working
• why HT works for some people and not others
• Dr Talaulikar’s favourite non-hormonal treatments

Where to find Dr Talaulikar:

X: @VikramSinai

Web: Menopause Clinic London

Menopause Research and Education Fund

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