In this episode of Holistic Health Radio, we dive into the fascinating world of hormones and their impact on our health and performance. Our guest, Dr. Nicky Keay, is an expert in exercise endocrinology and author of “Health Hormones and Human Potential: A guide to understanding your hormones to optimise your health and performance.”
Here is a breakdown of what we cover in this episode:
- Introduction to Dr. Nicky Keay and her work in exercise endocrinology
- What hormones are and their role in the body
- Debunking common myths about hormones and health
- The consequences of suboptimal hormone levels, including relative energy deficiency in sport (RED-S)
- The impact of undereating and over-exercising on hormones
- Lifestyle changes we can make to support optimal hormone function, including nutrition and sleep
- The varied role of sex hormones in the body
- The importance of the menstrual cycle in protecting our bones and heart health
- How Hormone Replacement Therapy (HRT) can be a safe and effective option for those in perimenopause and menopause
Join us as we explore the science of hormones and how we can optimise them to improve our health and performance.
Follow Nicky on instagram @nickykfitness
Check out Dr. Nicky Keay’s website and book here.
Episode Transcript
Sarah K.
So a big warm welcome to the show. Nikki, how are you today?
Nicky Keay
Very well. A bit cold in London.
Nicky Keay
A bit cold in London.
Sarah K.
We were just having this discussion before how I’m sweltering and you’re like, It’s freezing here.
Nicky Keay
Yeah, let’s swap for a day or two, yeah?
Sarah K.
Yes. I’m mean, I’m envious of anyone that has air conditioning living in Australia right now, but I digress. We’re going to talk a lot about hormones, performance, all of that kind of thing, but before we get into that, I always like asking my guests some really fun get to know you questions, the first of which is, what is your coffee order?
Nicky Keay
Cappuccino.
Sarah K.
Cappuccino. Straightforward. Normal milk.
Nicky Keay
Oh, yeah, normal milk. And I do like a little bit of chocolate sprinkle on top.
Sarah K.
Yeah, a little hint of sweetness. What are you grateful for today?
Nicky Keay
Well, being relatively healthy for an old person, as my children like to remind me. I’m pretty old. No, listen, yeah, grateful to be happy to be reasonably healthy and actually still doing four dance classes, ballet classes a week. And since having two new hips, thank you to my orthopedic surgeon, I actually think I’m dancing better than I used to. So, yeah, I’m feeling grateful for that.
Sarah K.
All a big plus. Thank goodness for Western medicine, for the ability to kind of keep us moving in different ways, even if it means kind of having surgery to get there.
Nicky Keay
Yeah. I mean, obviously, I have to be honest, I was really scared.
Sarah K.
Yeah.
Nicky Keay
Because I thought it could make me worse because most people, hip hop, hip replacement, probably, you conjure up someone like my mother, who’s older and just wants to walk to the shops. That wasn’t me, frankly. I didn’t really walk much. I just walked into the ballet studio and that was it. But ballet was my thing, so the surgeon kept reassuring me that, no, you’ll be fine, you’ll be able to do ballet better. But I’m still a little bit apprehensive. But I can honestly say that, yeah, I’m really grateful. He did a good job. I’m very grateful that he is a perfectionist. When the nurse said, oh, he’s a perfectionist, I was like, Brilliant. I like the sound of a perfectionist doing my operation.
Sarah K.
That’s one of those times you’re like, Cool. Actually, we’re grateful that you are a perfectionist to what you do.
Nicky Keay
Exactly.
Sarah K.
What is the best gift you’ve ever been given or they’ve ever given someone?
Nicky Keay
Well, my best gift, I don’t know if I can really call it that, is that I’ve got two children, two boys, and at one point I didn’t think that was possible. And so it’s like, oh, wow, the body is amazing. If you treat it nicely, it is better than I used to, let’s put it that way. Then it will do what it’s meant to do. So they’re my best gifts, as it were, I’ve received myself.
Nicky Keay
If you say to me, yes, and I think the body is incredibly resilient when we said you treat it well. It will kind of take its time to heal and get back to what it feels and knows is optimal, but sometimes it takes a little while.
Sarah K.
My last question before we kind of get into the main part of the podcast is what are your daily non negotiables that make you feel your best?
Nicky Keay
I do have to have coffee in the morning. Not necessarily cappuccino, I have to say, but just an instant. If I’m well, I’m always in the house, and non-negotiables are, for me personally, full fat milk, actually, with my coffee and my cereal in the morning. I have to do that. What are the non negotiables? Non negotiables in the sense that I have to do my bally classes, unless, of course, I’m reasonable if I have to work and I’ve got to do an electoral meeting or it used to be parents evenings, which I did grumble about why they always came on a ballet evening. But in general, if there isn’t a work commitment, or I try and make it so there isn’t a work commitment, more to the point, on ballet. So that is my non negotiable. That’s my priority. That’s my special thing that I always try and get to within reason. Within reason, yeah.
Sarah K.
I think that’s important, though. You have to have those things that kind of give you that element of self care and brain.
Nicky Keay
Wake up the day, especially if you’re working. I find, like, just having whatever it might be, whether it’s dance or going for a walk or just having that time to decompress, is so essential to let that part of your day end and then move into the next part of your day or if you’re doing the morning to set you up for your day.
Sarah K.
Now, I’m obviously a big fan of your work, but for those people who’ve who may not know that much about you, can you tell us a little bit about who you are as a person and a human being, but also what you’re currently doing and what you have done for many years in this wonderful life?
Nicky Keay
Thanks. From a work point of view, I’m a medical doctor. And at a very early age, I have to be honest. It wasn’t that I want to be a doctor, but because I was so in love with dancing and movement and exercise, it was like, actually, wouldn’t it be amazing if I could understand better why we respond to exercise, why it’s so important and what exactly is going on inside our bodies to help us respond to that exercise? And the answer was hormones, as I sort of realized, starting my medical studies. And so, really, that’s been what I’ve been doing for the last 35 years or so. Even as I was going through medical school and studies, I was already realizing that that’s what I wanted to do. I wanted to focus on really understanding hormones and using that my knowledge to to guide people to reach their full potential. And that’s why I wrote a book, because it was like a summary of everything I’ve learned over the last 35 years, the first the top tips and all that sort of thing. And actually, by the way, when I was doing my medical studies, I actually came to Australia on a six month placement because Australia was, and I think still is, we can argue, the best place for sports medicine and dance medicine as well.
Nicky Keay
So I had a great time there in Sydney, Melbourne, the Olympic sports park. They were doing research on dances. Newcastle, just above Sydney, over there with you guys in Australia. And so that was really refreshing to see what was going on. And so that helped inspired me continue doing that. So I’m heavily involved with dancers. I’m Scottish advisor to Scottish ballet, but also any sorts of sports. I mean, I used to be a competitive swim myself and play tennis and stuff, so I understand certainly dance, but also sport and exercise, that that really should be important to people. But on the other hand, helping people get the most from their exercise for their life and not overdoing things in terms of exercise or underdoing the fueling and underdoing the recovery, that’s what I’ve ended up really focusing on and trying to take that more personalized approach. Of course, we all want to try and avoid getting ill, but really it’s all about health, in my opinion. We want to be our best. Health is not just the absence of disease, it’s positive well being. So that’s why changed. Obviously, as a junior doctor, you have to deal with medical emergencies and that’s really important you understand what’s going on.
Nicky Keay
But ultimately now I’m realizing that, as you said, the body is a fantastic millions of years of evolution. And thankfully, in general terms, most of us are okay, pretty healthy. So actually I want to that’s my mission, to make sure each individual is healthy and doing the best that they can, whatever that might be. It might not be an Olympic goal, but it might be like, me, I want to go to my ballet classes, whatever it is, to try and help people get there. But in my opinion, it’s through their hormone.
Sarah K.
Yeah, I mean, that perfectly encapsulates the title of your book, which is Hormones, Health and Human Potential, which I will link in the show notes for anyone interested in reading that. But can you actually explain what hormones are and their role within the body?
Nicky Keay
Well, if you look at a textbook or anything, you will see this definition of a hormone. A hormone, it says a chemical messenger. So it’s a molecule that travels around in the bloodstream. By the way, if that’s already take note of that. In the bloodstream. Blood goes everywhere in the body. So it’s like, oh, that’s good. The hormones can go everywhere is the first thing. But that’s what it says, but doesn’t really say anything more. It’s like, okay, so they whizz around in the bloodstream and what? And do what? Well, what they do is actually bring your DNA to life. So when a hormone whizzing around in the bloodstream arises cell. It goes into the cell and it goes straight to the nucleus where the DNA resides. And it tells the DNA, instructs the DNA, what proteins to make direct gene expression, as we say in sort of medical terms. Just let it rest there for a minute. So you got your DNA. That’s the blueprint for life. But how’s that going to come to life? How does the body know which bits of the DNA to translate to make this protein that protein? And the answer is the hormones.
Nicky Keay
They conduct health, right? That’s whether the directors of health and the word hormone. The clue comes from the derivation of the word hormone, ancient Greek means setting in motion. That’s what hormones do. They set in motion our DNA and set in motion our path, hopefully to help.
Sarah K.
Yes. That’s such an amazing way to articulate that concept. And it really kind of speaks to the fact that hormones have a very wide impact on our well being. I think we mostly think of hormones having an impact on our physical health. Do they have an impact on other parts of our health as well?
Nicky Keay
Yeah, very good point. Well, again, the definition of health, not just absence of disease well being in terms of physical, mental and social health. So absolutely. All the physical things, everything sort of like below the neck, as it were, your bones, your muscle, reproductive system, the gut, the nervous system, skin, the whole list, right? But also, yes, they go to the brain and they influence neurotransmitters, the connection between the neurons. And so, yeah, they influence our mental health in terms of our mood. How do we feel today? Happy, sad, whatever, indifferent, something like that. And also the connection between the neurons. So, of course, the connections of the brains to the rest of the nervous system. So they’re really influential in that. But I think the important thing to say about the hormones are really they’re the boss, making sure everything is in tune within the body, homeostasis, keeping everything nice and calm and where it should be for you. But that’s not where it ends. We don’t live in hermetically sealed boxes just by ourselves, do we? We’re out. I’m going to go off, actually, it’s this evening. I’m going to go out, I’m going to do my Bally class.
Nicky Keay
We do stuff, we eat, we sleep, we exercise the environment. It’s very cold today, right? So I’ve got to respond to that. So they almost also take care of what situation you’re in and what you do, your behaviors, your lifestyle behaviors. What are you doing today? The hormones are going to keep an eye on that and more to the point, the master controller for your hormones in your brain, the neuroendocrine gatekeeper, the hypothalamus sitting right next to the pituitary. Pituitary, beautifully described as the conductor of the endocrine orchestra, the hypothalamus just above it is the boss. It keeps an eye on what’s going on inside your body, but it also no surprise, it’s located literally deep in the brain, where the optic nerves cross over. So it’s ideally situated, it can literally survey what’s going on outside, what was happening, and so it will modulate the production of hormones, depending on what you’re doing. So I did quickly have my breakfast before I came on to speak to you. So it’s registered that I’ve eaten something and hopefully now some insulin has kicked in and all that’s happening. And when I go to ballet later and move, it’s going to obviously register and realize that I’m doing exercise and it needs to change up the hormone.
Nicky Keay
And when I go to sleep this evening, then it’s going to make sure that hopefully I’m adapting to the ballet I’ve done and making muscle, protein, et cetera. So that is what hormones do. They bring your DNA to life, keep everything nice and happy inside your body. But they’re not just doing that, they’re keeping an eye on what’s going on outside. You can see why I love hormones. I think they’re brilliant.
Sarah K.
Yeah, they are. And you’ve kind of created this picture where our hormones are obviously reflexively responsive to our environment and our lifestyle and the way that we eat and the way that we move and how much of an interlink there is between those things. I know a lot of people that listen to this podcast are dancers and they’re active people and they are so interested in getting the most out of performance wise. But they may have fallen into this trap of what you’ve described before, of maybe under recovering and undernourishing their bodies and thinking that they can still get the most out of themselves. What happens from that perspective when a person places themselves in a situation where they kind of fall into this relative energy deficiency? What hormones are actually impacted in terms of that response? Yeah.
Nicky Keay
So I do like like my ancient Greeks, by the way. So I’ll just give you a little quote in my book from Hippocrates who said that if we could give each individual just the right amount of nourishment, just the right amount of exercise, not too little, not too much, we would have found the surest way to health. This chap knew a thing or two, right? Father of medicine or father of health, really, we should say so. He was articulating the fact that, yes, we need to balance our lifestyle choices, the exercise and the nutrition. But the thing is another thing to point out what happens is if we get our behaviors out of balance. So we are exercising every single day, not having a rest day, not having sufficient recovery and maybe not fueling adequately to cover the energy demands of that, then the body, the hypothalamus, is going to register that there’s a problem there’s now not enough energy to keep everything working as it would like. Okay. In women, we’re talking about menstrual cycles and things like this. So number one, it’s got a problem because it realizes it’s an energy deficit. There isn’t enough energy to keep all the hormones doing all their marvelous actions of maintaining bone health, reproductive health, etc.
Nicky Keay
And also the stress of not recovering enough. So when you exercise, yes, you do put the body under stress, but in a way that’s a good thing. A certain amount of stress is good. Keep everything literally on its toes. But if you haven’t got enough recovery, you haven’t given the opportunity for the hormones to drive the positive adaptations. I don’t get fitter when I’m actually in the ballet class. It’s in the evening when I’m asleep, sleep and recovery. And the rest is when the hormones spring into action and drive the positive adaptations. So now the body’s got two problems, hasn’t got enough energy to maintain all the health, right? And it hasn’t got enough time literally to drive the positive adaptations. So it’s got a real problem on its hands. So it’s got to adapt. The hormones have got to adapt, right? They’ve got to change because the priority is to keep you alive, not how good you are at dancing. I’m afraid that’s not the priority. So what does the body do? It will go into energy saving mode, eco mode, like when your phone says low power and it will power off and all that sort of thing.
Nicky Keay
So basically it powers off nonessential apps, which in the case of women, for example, menstrual cycles, because definitely it’s not a good time to get pregnant. This also affects men, by the way. So it’s like, well, a similar thing, it will down regulate testosterone because this is not the time to be reproducing, right, and got enough energy to do that. But unfortunately, the knock on effect is if these sex steroids are not just about reproduction, they’re also about bone health and all the other things we’ve talked about gut health and mental health, lulla. So that’s why you’re not going to be at your best because of the energy saving and also excessive stressors. The non lack of recovery also will reinforce this down regulation or adaptation of the hormones. But the one hormone which is up regulated in this situation, because it’s stressful for the body, is cortisol. And as I said, a little bit of cortisol is fine, but too much cortisol will favor the deposition of fat. Interestingly, because it’s like an emergency store of energy. And also it will reinforce that down regulation of other hormones because it trumps all the others, you see.
Nicky Keay
But listen, this is not the fault of the hormones. Personally, I really dislike that term, unbalanced hormones. Don’t blame the hormones. The hormones have had millions of years of evolution. They know perfectly well what to do, thank you very much. They’re just responding and adapting to what you’re doing. The problem is the imbalance you’ve got in your behaviors. But this is good and bad news. I mean, on the one hand, it’s not good that your woman have responded and down regulated. But on the other hand, if the original cause of this is because you’ve got this imbalance of what you’re doing, you’ve got a control over what you’re doing. So you need to recognize that and adjust. Listen, this is not easy. I’ve been there myself, as I sort of alluded to earlier, so I totally understand that you might be listening to this and thinking, oh, well, either you might think, I’ll feel guilty, it’s like, oh gosh, why am I doing that? That’s stupid. Or you might be thinking, well, how can I change? This is my routine. This is what I do. But I want to say, you absolutely can and must change.
Nicky Keay
It’s not easy if you’ve got an entrenched behaviors. But if you realize that’s what’s happening, and I see lots of dancers and athletes, Sarah, who come and say, look, I’m feeling fine. Look, I’ve got in a dance company, and all this sort of thing, my periods have stopped. It’s like, yeah, well, so what I’m doing fine, and I haven’t had a stress fracture yet. But this is what I’m saying about potential, the word potential in my book, you won’t reach your full potential. You might be okay, doing reasonably well, but imagine just selling yourself short. Imagine what you could achieve if you harness your hormones and really get those positive adaptations.
Sarah K.
Yeah, because a lot of the times, obviously, all we see is that missing menstrual cycle. And we don’t know the fact that obviously sex hormones are one of those things that are very beneficial for physiological adaptations to training. But also, there’s other things that we don’t often talk about, like insulin like growth factor (IGF-1) and growth hormone that often get impacted at the same time as that down regulation of your sex hormones. And they play such an essential role in you getting that benefit from the training that you’re doing. And I think that’s the missing piece. People often kind of go, oh, well, it’s not that big a deal.
Nicky Keay
It is.
Sarah K.
It’s a massive deal.
Nicky Keay
Yeah, well, that’s the thing, because even I call them reproductive hormones. Yes, that is their evolutionary role. And that’s what happens when you have a menstrual cycle, by the way. The hormones are doing their beautiful choreography. So it’s true, it is for reproduction. But these hormones, even the sexteroid hormones, it’s not just reproduction, it’s also bone, right? The queen of bone health is estradiol. And by the way, guys, you make that as well. Testosterone gets converted to estradiol. So number one, bones. Number two, gut health. We know that these hormones are important for gut health. Number three, neurological function, mood, et cetera. And also, we know from studies in athletes whose periods have stopped because they’re not fueling sufficiently, got reds relative to deficiency in sport, they’ve got slower reaction time and peak power production. So important for soft tissue and those neurological connections. The list could go on. In fact, I will add one now, cardiovascular health, low estrogen, menopausal women whose periods have stopped for physiological reasons. The main cause of death in menopausal women is cardiovascular disease, not breast cancer, by the way. Anyway, so even the reproductive hormones themselves, that’s a misnomer.
Nicky Keay
They’re reproduction and bone and rule that you wicked the whole list. They are hormones for health. But as you quite rightly say, it’s really super important to stress and emphasize everyone talks about loss of menstrual cycles because that’s like an obvious clinical sign, no periods. But actually, you’re absolutely right. The IGF one, insulin growth factor one is reduced. That is really important hormone for body composition, supporting muscles, and also for bone as well, by the way. Also, the other hormones which would be impacted are the thyroid hormones. And the thyroid hormones control metabolic rate, so it will down regulate metabolic rate, energy saving eco mode, like turning down thermostat I must turn mine up. Anyway, all the hormones, everything across the board go down all the ones, I won’t go into all the details of them, but those are the key ones. But cortisol goes up. So now, yes, there is not this ideal combination of hormones occurring in your body. And the irony of this situation is that people at first is true. At first you might feel good, you might be feeling buzzing because of the high cortisol, so you might be feeling like good.
Nicky Keay
And at first you might yes, it’s true, you might because you’re buzzing and you’re running on fumes, literally, you might think, get a few good performances and everything, but it’s full scold. You won’t be able to sustain that because you haven’t got your hormones back in you. So in the long run, you will stagnate your performance, even decrease, and certainly you’re a way higher risk of injury, bone stress injuries and soft tissue and getting ill and all this sort of thing. So that’s what I really want to emphasize that at first. And I listen, I’ve been there, I’ve done that, I know what it’s like. You feel good and you think everyone else is wrong.
Sarah K.
Yes.
Nicky Keay
I feel fine, I’m doing fine. Yeah, exactly. So I know that feeling, by the way. I recognize that. But then the most important thing is, well, yeah, read my book, but also because it’s got the information there. But just be honest with yourself almost and be aware that it’s not going to end well in the long term.
Sarah K.
Yes, and I think a lot of people that definitely listen to this podcast, their eyes are open, they kind of have this willingness to change. I think one thing that I often hear from people is, oh, I’ve done so much damage, will my body ever recover now that I’ve been through this? For example, I’ve put myself through years and years of having really low estrogen. What are my risks for cardiovascular disease later on if I do recover? Do you have anything, I guess, speak to in terms of those kind of situations?
Nicky Keay
Well, listen, first of all, don’t beat yourself up. What’s done is done. The most important thing is get onto it as soon as you can. Be honest and move forward and be positive about this. Certainly you can for a woman, getting your periods back and getting the estrogen up. Absolutely. You’re going to see improvements in your bone health and all the other things we mentioned. The honest answer is, can I get back to what I should have been? We can never answer that. Right, because, for example, bone health that we measure, doing a DEXA scan, you get BMD, bone mineral density. The thing is, some of that is determined genetically. So I see quite a lot of people who have got actually quite bad reds and may have even had stress fractures, yet you do the DEXA scan, the BMD isn’t too bad, you see. So it’s the usual thing in medicine, a measurement does that translate to the health. But anyway, unless you have an identical twin who has not been through reds, then we can compare because with the similar genetics what are you shooting for, as it were? Your bone health will go down for sure.
Nicky Keay
If you’re a woman, your period stop because of RED-S. That’s indisputable. But what was your starting point and what were you destined to be? You see, so you can definitely recoup or improve your bone health. For example, if we take that as an example, you can quantify that. You can see percent. I’ve seen dexus when people put in place what I’m suggesting and then we repeat the dexter a year afterwards after their periods have come back. And absolutely the bone health has improved. So that’s really, really positive. But then they say, oh, well, am I back to normal? I don’t know, because I don’t know what your normal was destined to be. But certainly we can see an improvement. So I think that’s the key message. The body is amazing, honestly. The body tries to work for you, by the way, and millions of years of evolution, of hormones, they will do its best to keep healthy. So if you give them a chance, it’s always worth making those changes because definitely your health will improve. Whether it improves back to what it was destined to be, we can never answer that. But it’s better than just staying where you were, that’s for sure.
Nicky Keay
That’s what I can definitely tell you. You’re definitely in a better position making those changes and rejoicing and celebrating those improvements.
Sarah K.
Yes. Now, obviously we’re talking a lot about the reproductive years and how making sure that you have a healthy menstrual cycle is obviously a vital sign to ensure that you’re going to get the best from your health and your performance. For women that then start to go through perimenopause and menopause, how do we start to look at supporting their health and their potential when their physiology and their hormones are down regulating and their estrogen is drastically dropping?
Nicky Keay
Well, as it goes the first thing to do is look at your lifestyle choices because if your hormones are changing, then you need to change what you’re doing. So you have to cry and keep in step with your hormones. The perimenopause menopause. Yeah, it can be challenging, but also to stress, it’s not disease, it’s not an illness. It’s a natural physiological event. So try and stay ahead of the curve. Be aware and accept and almost rejoice graduating to menopause. But you will need to change what you’re doing. So your exercise, you will need to do more strength training. I have to admit that’s not my favorite thing either. But you can find ways of doing strength, such as I do pilates and resistance bands and hand weights and quite a lot of the stuff I do, especially in ballet, that is actually sort of strength anyway. So strength training because the hormones, as you say, especially the female hormones going low and the growth hormone, the IGF one, by the way, is going low as well. So you’re going to have to change your training, your exercise, to include specifically strength, not just endless cardio, by the way, okay?
Nicky Keay
And you will need more recovery because you haven’t got so many hormones. You will need to give them more of a chance to drive adaptations. So strength and more recovery. Nutrition have a certain opportunity to review how’s your nutrition going, have you got a nice balance for the food group, consistent intake, et cetera. Are you taking probably make sure you’re really hitting those protein demands because again, you need to give your hormones every chance, even though they’re lower, you need to give them all the help they can. So protein for muscle number one, be aware that your hormones are changing and therefore change what you do. So that’s sort of good for all Masters athletes. And then secondly, of course, we have to do disaster HRT. So hormone replacement therapy, as the name suggests, is replacement. It’s just replacing, bringing you back to physiological levels. And unless you’ve had a hysterectomy, you will need estrogen and progesterone, both of those two hormones together in combination, as it was when you were having regular cycles. And now there was all these sort of scare stories and incorrect social media attention and headlines saying that HRT causes breast cancer, all this sort of thing.
Nicky Keay
Now in the cool light of day, looking at all the facts and figures, whilst it’s true there is a slight increase in breast cancer, taking HRT and extra four cases per 1000 women, this is the same as taking the contraceptive pill. And also it’s way less than if you’re not exercising regularly, if you’re not looking at your diet, if you’re smoking and drink, drinking alcohol, all those things, whopping extra 24 cases of breast cancer compared to a little measly four for HRT. And also, if you are doing the exercise and the lifestyle things I’ve just described, that decreases your risk or the number of cases, should I say, by seven. So if you do your maths, you’re actually better off taking care of the lifestyle, I’ve said, the exercise and the nutrition and taking HRT and bringing those hormones back to where they should be. And certainly my experience working well, my personal experience, I have to say, and also my experience working with many Masters athletes and dancers, they’ve universally come back and said, actually the HRT made a big difference, that they could continue training or enjoying their exercise. Yes, they had to modify, like I said, with the strength training, but they’re feeling they will actually felt good.
Nicky Keay
They could still enjoy that training and get benefit from that training and everything. So certainly it’s something worth considering. But also to say that you might I was lucky actually when I started HRT, I’m still on the same day as I was when I started and I’ve had no problems. In fact, it’s fine, it’s great. But sometimes for some women, it does take a little bit of time, three months for it to actually kick in and have an effect. So don’t expect you’re going to be Wonder Woman the next day, by the way, and don’t expect it’s not the elixir of youth that’s the realistic, you’re not suddenly going to feel like 21 again. Sadly, that’s not possible. And also, it might take a little bit of personalization of the dose. For some women I’ve come across, we might start at a low dose and actually they need a bit more or, you know what I mean? So just to warn women that be patient with it, you might just have to have a little bit of time to adjust and find out what the right dose is and all this sort of thing.
Sarah K.
Yeah. And I think it’s so important to touch on that because there is so much fear mongering around HRT that isn’t founded for reasons like you said. And I think for a lot of women, they often go, oh, well, this is just what I have to struggle through. Because they hear so much of that fear mongering, they don’t want to explore the concept of HRT. And so a lot of what I reinforce, is no, it can be really helpful in allowing you to get back to doing all of the life things that are going to help you be a healthy human well into your senior years. Because with exercise, you have to continue doing it to get the benefits of it. You can’t just go for a run and that’s going to save you for the rest of your years. You have to be consistent with it over time.
Nicky Keay
By the way just to touch on that, I think absolutely, it’s really well, to be absolutely honest, it’s just scandalous. And those are not my words, by the way. The Vice president of All College Observatory Gynecology here in the UK is particularly vocal about this, the story of the misinformation, as I say in my book, about HRT. And unfortunately, media, they want the headlines, they want the shocking headlines, but playing to a woman’s worst fears about breast cancer when it’s not founded, that’s just inexcusable, right? The thing is, don’t just listen to this and take, please all women, I encourage you. Well, read my book, I’ve put all the information and references there, but go and look up the facts for yourself, don’t rely on headlines or social media or anything. Look, and I’m sure in Australia there’s the Australian menopauses sighting. Here in the UK, we have the British Menopause Society, which I’m sure you can look at their website if you’re there. But anyway, look at the facts and figures. I’ve got all the references in my book, so you can be absolutely confident, do the research. For yourself. So you’re making an empowered decision, you know, that this is a good choice to at least try the HRT, see how you get on with it, be a little bit patient, adjusting the dose and seeing what it’s like.
Nicky Keay
You know, what have you got to lose by at least trying, you see? And also, the other thing that’s changed a lot recently is that there used to be this arbitrary thing, or you can only take it for five years, but again, like the British Menopause Society says, there should be no arbitrary limit on how long you take it for. They’re probably going to have to price it out of my hands. But anyway, you see what I mean? So there are lots of things that are changing. And of course, the type of HRT now, compared to what it was, is now really great. You can take estrogen through the skin, which is already a lot safer than taking a tablet and going through the liver and all that sort of thing. And remember, it’s the same risk as taking the contraceptive pill. No one talks about that. You see what I mean? So put it in context. Yes, and that you’re going to be much better off continuing the exercise, reducing your risk of breast cancer. You see what I mean? So there are lots of other factors at play. And going back to what we said earlier, that the main cause of death in women, menopause or women, sadly, it’s cardiovascular disease, it’s not breast cancer.
Nicky Keay
And in the long term, of course, HRT estrogen will help prevent cardiovascular disease. So there are lots of positive things. When people hear me talk about this, they say, oh, you’re really in favor of it and you’re pushing it. Listen, I haven’t got any shares in HRT company, right? I’m setting the record straight. I’m giving women the facts and giving them the information they need to make an informed choice. And also the thing about, oh, well, women have had to put up with this. They didn’t have HRT before. Yeah, but guess what? Lots of them were dying before they even reached the menopause. In the Elizabethan ages, for example, and even in my grandmother’s generation, we didn’t have that. So, yes, they had no option but just to get on with it. But now we have the option. And also with the life expectancy, we’re going to hopefully live a third of our life in the menopause status. So it’s not just, oh, well, it’s just for a year, it’s bad, and then whatever, it’s like, actually, it’s your long term health, you see. You want to reach your full potential throughout your life, not just up until menopause.
Nicky Keay
And now you throw the towel in. Why would you do that?
Sarah K.
Yeah, so, I mean, obviously this question is quite a broad question, because we’ve been talking about health and human potential and that’s obviously going to change based on that life stage that we’re in going to be our potential when we’re a younger person versus when we’re in our reproductive years versus when we get older. But if you had to give, I guess, some advice or tips for looking after our hormones so that we can look after our health and human potential, what would some of those recommendations be?
Nicky Keay
Well, I go back to Hippocrates, right, for you, for everybody listening or everybody in the world. You know how old you are, you know where you are in your life. But the the tools, the three tools you have in your power, your control, are exercise. What exercise are you doing? How much you’re doing? It not too little, not too much, all that sort of thing. And recovery, sleep, are you getting enough sleep and recovery? The sleep is the chief nourisher in life’s great feast at Beth Shakespeare’s. So make sure you’ve exercised your sleep and your nutrition. Of course, nutrition in general terms, because like you say, there’s going to be all sorts of it’s going to vary according to your age and your individual demands. But that’s the thing. Make sure you’re having just the right amount of nutrition, as Hippocrates says. Are you? Not too little, not too much. So, of course, we’re not encouraging overdoing it, but definitely we’re also saying don’t underdo it because lots of people today, they are rushing around, doing lots of things, doing lots of exercise and sport, especially you, Aussies down there. You know, you’re doing lots of exercise, which is great, but are you fueling for your personal requirements according to your age?
Nicky Keay
Obviously, a growing teenager is going to need more energy than an old person like me who’s not growing anymore. You see what I mean? So, again, it’s very individual. But those are the three tools under your control, and so you just need to personalize them for you, for your age and you your personal situation, what you’re doing.
Sarah K.
Yeah. And you cannot get that from PDFs online, people. You need to go see qualified health professionals if you’re unsure whether you’re on the right track for hitting those three things. And of course, like we’ve said many times, read your book.
Nicky Keay
Well, exactly, that’s the other thing. Okay, I’m very old, and so I don’t like social media. I don’t understand it anyway. But also just to end on that, yes, make sure you’re getting good advice. So, yes, a big plug for my book, please. I spend a lot of time putting all that, and it’s got lots of references if you want to go and delve into the details. So, yeah, that’s one source. But especially for nutrition, come and see someone qualified like you, Sarah, because there are a lot again, this misinformation with social media and stuff, you see, oh, this is the way you should eat. And that well, how can that possibly be ripe for the whole world population? That this is the perfect way to eat all these strange diets. And I call them diet in the sense of regimes, if I can put it that way. It just makes no common sense, does it? But listen, we all want a quick fix, who doesn’t? But sometimes that’s not the answer. You do have to come and discuss with someone that’s qualified in that field, like my hip operation. There’s no way I’m qualified to be an orthopedic surgeon.
Nicky Keay
So why would other people step into different things? You see what I mean? So try and get the good information, get yourself informed, and then you can make the best choices for you.
Sarah K.
Yes, and I so appreciate you coming on the show and talking us through all things hormones. I’m fascinated by them. I could talk for hours on them. And I will be sure to link your book in the show notes so people can find it if any of our listeners want to connect with you further. Is there any kind of I know, social media maybe not your thing. Is there any best way for people to get in touch with you?
Nicky Keay
Yeah, well, my website, Nicki K Fitness, maybe you could include that in the show notes as well, Sarah. So on there I put my publications, my blogs, presentations, podcast, stuff I’m doing, and so people can see what I’m up to on my website. And also there’s a contact form, so if you have a specific question or you want to book in for a virtual discussion appointment, for example, then that’s where to go. I am on social media, all right? And you can look there if you really want. Or I’m on LinkedIn is probably more, but anyway, probably going to my website, I would say, because I’m in total control of that, all the content is mine, you know, so what I mean? But if you are a social media person, you can have a look on there. But I might sometimes post my post is just like, I’m doing this, I’m doing that, you know what I mean? This is the talk I’m doing. I’ll be talking about the podcast today, so you won’t find anything, I’m afraid.
Sarah K.
Don’t worry, I’ll include it anyways. We’ll just let people have their exactly.
Nicky Keay
So have a look. Yes. Okay.
Sarah K.
Well, thank you again for coming on. If anyone has really enjoyed today’s podcast, I highly recommend you take a screenshot of wherever you are listening. You can tag myself at Sarah Liz King. I will also put Nikki’s handle there on Instagram, so she can reshare those as well. And obviously, if you want to check out any of the links to Nikki’s books and any of the events that she’s doing, all of that will be available on her website. So just scroll on down, click the link and it’ll take you straight there. So, thanks again for joining us.
Nicky Keay
Brilliant. Thanks so much. Being a real blast, real fun talking about hormones. I always love it.
Sarah K.
Great. All right. Thanks, guys, for tuning in.
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