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Dr. Oz: Well, lots of advice. And just to start off, the key to long-term shapeliness is a physical activity plan that puts muscle on your bones. There's just no way for you to continue to eat any reasonable amount of food without muscle mass, because muscle burns so many more calories than fat does. Now, that in mind, you've got exercise. Interestingly, when you exercise you also build testosterone levels, you stimulate growth hormone, and if you combine it with sleep, you'll actually reshape some of the hormones in the body. If you're going through menopause and you've already sort of shot your adrenal glands, then you're going to be more prone to some of the sequelae, some of the complications of losing estrogen and losing progesterone. So for some people, once they've checked their thyroid glands and once they've made sure that the other major issues in their life are taken care of, it does make sense for a short period, I think, to add hormone replacement therapy. But then that becomes a little bit of a tug-of-war as you figure out how long you need to be on it and what the right dose is for you.

Oprah: Okay. All I have to say, Val, is this Thursday on The Oprah Show we're doing the entire show devoted to hormone replacement therapy and what that can mean in your life. That is this Thursday, day after tomorrow. What day is this?

Dr. Oz: Day after tomorrow.

Oprah: Okay. Day after tomorrow. Really big show on it. Okay?

Val: Okay. I'll be watching.

Oprah: You should be watching that. You'll get lots of information. And I would say the best book I've ever seen on this is Dr. Christiane Northrup's book called The Wisdom of Menopause. Do you have that book?

Val: No, I don't.

Oprah: That is worth—it's in paperback now, and it is the Bible to women who are perimenopausal or—or menopausal because, you know, you're perimenopausal for sometimes 10 years before your period actually stops. And go to Chapter 5 in that book, and it will explain everything you need to know.

Val: Okay.

Oprah: The Wisdom of Menopause by Christiane Northrup. Okay? Thank you, Val.

Val: Thank you. I'll check it out.

Oprah: And watch Thursday.

Dr. Oz: It's also a soulful book, and what I love about it is it talks through all the aspects of changing your life when you're going through menopause.

Oprah: It's emotional, spiritual, physical. It recommends things, you know. 

Dr. Oz: Sometimes you do knees the hormones, and when that's there you actually need to take them. I think Christiane is right on track with that.

Oprah: Okay. So you're in favor of hormones if you need them.

Dr. Oz: Absolutely. I think just putting numbers on it, I bet you that just a third of women probably just have no problems at all going through it. Understanding why that's so is pretty cool. 

Oprah: Yeah. Why? Why is that so?

Dr. Oz: Well, I think part of it's dietary. I do think that the kinds of fats you have in your body are important predictors of how you're going to be able to cope with menopause. So if you have a lot of the omega-3 fats, you don't have a lot of saturated fats, those people seem to have less issues. With the hot flashes in particular because, you know, these hormones, they're changing, and as they change, they cause a disharmony. That's what causes the symptoms more than the actual values. Some people have adrenal glands that are shot. They're just completely washed out. And so you don't have the reserves to back up the ovaries when they stop making the normal amounts of progesterone, which is the first thing to fail, and Christiane goes through this in great detail. And then when you lose the estrogen, you don't have anymore backup, and of course the big problem losing estrogen is you also lose testosterone. And that's where the muscle mass is important.

Oprah: And estrogen seems to be the juice of life because when you lose the estrogen, you lose not just—for me it was a look of sleep, not being able to sleep for two years. You also lose sort of your zest. You lose your, you know embracing life. You lose a lot.

Dr. Oz: You don't lubricate as well. You get joint issues. Probably heart issues, which we link to your bones get weaker. It's critical. However, I don't want to paint it as just an estrogen issue.

Oprah: No, it is not. It's a hormonal balance issue.

Dr. Oz: So the key is make sure the thyroid's okay—

Oprah: Every woman's different.

Dr. Oz: Exactly right. And progesterone and estrogen and—

Oprah: Testosterone.

Dr. Oz: —testosterone across the board. And once those are in balance—

Oprah: And the adrenals.

Dr. Oz: And the adrenals, of course. They are the hardest ones to measure actually.

Oprah: Yeah.

Dr. Oz: And that's actually where—

Oprah: It's a saliva test. Can't you get it through—

Dr. Oz: Yeah.

Oprah: It's a saliva test.

Dr. Oz: But the accuracy of it, because it changes. Your adrenal glands secrete much more in the afternoon than in the morning, so it's a moving target for doctors to try to aim at. And doctors—this is the big battle I think your show is going to start in this country. We're used to as physicians measuring numbers out and say, "Okay, you're within the normal range."

Oprah: Absolutely.

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