# The SHOCKING Truth About Women Nobody Tells You

https://www.youtube.com/watch?v=g1IDULp80lA
Translation: zh-TW

[00:00] There's five life stages on here.
  這裡有五個人生階段。

[00:01] We have puberty, your fertile years, perimenopause, menopause, and then postmenopause.
  我們有青春期、生育期、圍絕經期、絕經期，然後是絕經後期。

[00:07] When you think about a woman's hormonal journey through these different life stages, what is the sort of advice you would give them to make sure they're hormonally healthy across every life stage?
  當您想到女性在這些不同人生階段的荷爾蒙歷程時，您會給她們什麼樣的建議，以確保她們在每個人生階段都荷爾蒙健康？

[00:17] What are like the basics?
  基本原則是什麼？

[00:19] What are the tactic strategies, medications um that they should be thinking about?
  她們應該考慮哪些策略、藥物？

[00:23] And I say this because I've got women women in my life at every stage in this life phase at the moment.
  我之所以這麼說，是因為我生命中有女性正處於這個人生階段的每個時期。

[00:27] I've got, you know, I've got my nieces in the sort of puberty era.
  我有，你知道，我的姪女們處於青春期時代。

[00:30] I've got my my fiance in the fertile years.
  我的未婚妻處於生育年齡。

[00:33] I've got my mom and grandparents, etc. in the peri- and postmenopause years as well.
  我的母親和祖父母等也處於圍絕經期和絕經後期。

[00:39] Yeah.
  是的。

[00:39] So, if you look at your nieces, for example, when they were babies compared to now, there are changes happening.
  所以，以你的姪女為例，如果你看看她們，與現在相比，她們嬰兒時期和現在正在發生變化。

[00:45] Their bodies are transforming because they're getting a surge of hormones in their body, and that's estrogen, progesterone, and testosterone.
  她們的身體正在轉變，因為她們體內的荷爾蒙激增，那就是雌激素、孕激素和睾酮。

[00:51] They're cycling, which means they're getting periods.
  她們在週期性變化，這意味著她們正在來月經。

[00:53] So, let's talk about the menstrual cycle for a second.
  所以，讓我們來談談月經週期。

[00:56] I think it's helpful.
  我認為這很有幫助。

[00:57] Okay.
  好的。

[00:58] So, when women have their period,
  所以，當女性來月經時，

[01:01] they bleed for a few days, right?
  他們會出血幾天，對嗎？

[01:03] And that's when their hormones, their estrogen and their progesterone is at its lowest, okay?
  這就是他們荷爾蒙，他們的雌激素和孕酮最低的時候，好嗎？

[01:08] Okay.
  好的。

[01:08] So, hormones are at their lowest.
  所以，荷爾蒙處於最低點。

[01:10] And then the hormones start to increase.
  然後荷爾蒙開始增加。

[01:13] Your estrogen starts to go up.
  你的雌激素開始上升。

[01:14] You don't make progesterone yet in the beginning.
  一開始你還沒有製造孕酮。

[01:16] Your estrogen starts to go up, and it make There There's a a follicle in your ovary, which has an egg, right?
  你的雌激素開始上升，它會形成卵巢中的卵泡，裡面有一個卵子，對嗎？

[01:20] It's going to pop out an egg.
  它將會排出一個卵子。

[01:23] Ovulation is when the egg pops out.
  排卵就是卵子排出的時候。

[01:25] So, you get this big surge of estrogen.
  所以，你會出現雌激素的大量激增。

[01:28] And then when the egg pops out of the ovary, right?
  然後當卵子從卵巢中排出時，對嗎？

[01:31] That's what's going to make a baby if it gets fertilized, there is a shell of the egg, right?
  如果受精，那就是會孕育嬰兒的東西，卵子有一個外殼，對嗎？

[01:33] The egg has a shell, which makes progesterone.
  卵子有一個外殼，它會製造孕酮。

[01:37] So, the second half of the cycle, there's progesterone around.
  所以，在週期的後半段，會有孕酮存在。

[01:38] Okay?
  好的？

[01:40] First half of the cycle, no progesterone.
  週期的前半段，沒有孕酮。

[01:42] Mhm.
  嗯哼。

[01:42] And so, that second half of the cycle, the shell has making progesterone.
  所以，在週期的後半段，外殼正在製造孕酮。

[01:46] And then when you don't have fertilization, the shell starts to break down.
  然後當你沒有受精時，外殼開始分解。

[01:51] Okay.
  好的。

[01:52] And that natural breakdown is a drop in progesterone, which causes the lining of the uterus to shed, and you get a period again.
  而這種自然的分解就是孕酮的下降，這會導致子宮內膜脫落，然後你又會來月經。

[01:58] And so it's estrogen goes high in the beginning and then pops out an egg,
  所以雌激素在一開始會升高，然後排出一個卵子，

[02:04] progesterone gets high in the second half and then they both fall and you have a period.
  黃體酮在後半段升高，然後兩者都下降，你就來月經了。

[02:08] And so the hormones being low in the beginning, estrogen is not zero.
  所以一開始荷爾蒙偏低時，雌激素並非零。

[02:10] It's about 50.
  大約是 50。

[02:12] Okay, so when we talk about numbers, if you get your your hormones checked, if they're at their low, it's like 50, but when you ovulate, your estrogen may be 150, 200, 300.
  好的，所以當我們談論數字時，如果你檢查你的荷爾蒙，如果它們處於低點，大約是 50，但當你排卵時，你的雌激素可能是 150、200、300。

[02:20] And then when you're pregnant, your estrogen may be as high as 3,000 or higher, right?
  然後當你懷孕時，你的雌激素可能高達 3,000 或更高，對吧？

[02:25] It's very many thousands.
  是數千的量級。

[02:27] And so these hormones have actions in our bodies.
  所以這些荷爾蒙在我們的身體裡有作用。

[02:28] And so the reason it's important is cuz when we give back hormone therapy, well, are we giving back 10,000 like pregnancy?
  所以它重要的原因是，當我們進行荷爾蒙補充療法時，嗯，我們是補充像懷孕時期的 10,000 嗎？

[02:34] No, we're giving back to be like 50, 60, 70, the way that you are early in your cycle kind of a thing.
  不，我們補充的量是像 50、60、70，就像你週期早期時的水平。

[02:41] Now, testosterone's not even on this graph that everybody gets taught of estrogen then progesterone, but we do know testosterone is pretty stable through the cycle, although we do believe it peaks during ovulation, which makes sense cuz you want to have a baby, right?
  現在，睪固酮甚至不在這個每個人都被教導的雌激素然後黃體酮的圖表上，但我們確實知道睪固酮在整個週期中相當穩定，儘管我們確實認為它在排卵期間達到高峰，這是有道理的，因為你想生孩子，對吧？

[02:55] So evolution says, "Okay, you need to be horny around the time that you are going to ovulate."
  所以演化說，「好的，你在即將排卵的時候需要有性慾。」

[02:58] And so your testosterone starts to go up.
  所以你的睪固酮開始上升。

[03:00] Now, it's really important cuz you're probably not
  現在，這真的很重要，因為你可能不是

[03:03] having a conversation with your nieces about their menstrual cycles, but it's a problem because no one's talking about it if they're painful, if they're abnormal, if they're we don't have a lot of conversations around what is a normal amount of bleeding.
  與你的姪女們談論她們的月經週期，但這是一個問題，因為沒有人談論它是否疼痛，是否異常，我們沒有太多關於正常出血量的對話。

[03:17] We have so many people who have problems, whether it's PCOS, which is now called PMOS, which is a metabolic issue that cause you to have irregular periods, there's endometriosis where you have painful periods, there are so many medications we give to people that can alter their hormonal health and and sexual health for that matter.
  我們有這麼多人有問題，無論是多囊性卵巢症候群（PCOS），現在稱為代謝症候群（PMOS），這是一種導致你月經不規則的代謝問題，還有子宮內膜異位症，你會經歷疼痛的月經，我們給予人們的藥物非常多，可以改變他們的荷爾蒙健康，甚至性健康。

[03:35] And then it all starts to get even more chaotic in perimenopause, which is again age 35 to 45.
  然後一切開始變得更加混亂，進入圍絕經期，也就是再次說的 35 到 45 歲。

[03:39] If menopause we say is 45 to 55, right?
  如果我們說更年期是 45 到 55 歲，對吧？

[03:43] Is normal menopausal age. Average age is 52 and we think perimenopause is when things start to change for people about 10 and it can be about 10 years.
  是正常的更年期年齡。平均年齡是 52 歲，我們認為圍絕經期是事情開始發生變化，大約在 10 年前，這可能持續大約 10 年。

[03:51] That means 35 to 45. So, how old are you?
  這意味著 35 到 45 歲。那麼，你幾歲了？

[03:54] I don't remember. 33.
  我不記得了。33 歲。

[03:55] 33. partner's 33.
  33 歲。伴侶 33 歲。

[03:57] All right. So, 33. So, this idea that I'm too young or it's too early or I'm not there yet, the truth is things do
  好的。所以，33 歲。所以，這種認為我太年輕或太早或我還沒到那個階段的想法，事實是事情確實會

[04:04] start to change.
  開始改變。

[04:05] What changes for a woman?
  對女性來說，什麼會改變？

[04:06] So, there are so many symptoms to hormonal fluctuations.
  所以，荷爾蒙波動會引起這麼多症狀。

[04:08] So, for some people it's temperature changes.
  所以，有些人會出現體溫變化。

[04:10] For some people it's fatigue.
  有些人會感到疲勞。

[04:12] For some people it's remembering things.
  有些人會記不住事情。

[04:13] For some people it's low libido.
  有些人性慾低下。

[04:15] Some people get dry eyes, itchy ears, burning mouth, joint pain.
  有些人會眼睛乾澀、耳朵發癢、口腔灼熱、關節疼痛。

[04:20] Some people get irregular periods.
  有些人月經不規則。

[04:22] Some people get pain with sex.
  有些人性交時會疼痛。

[04:25] Some people get UTIs.
  有些人會得到尿路感染。

[04:26] I would love to talk about what why hormones are so important for the bladder and UTI prevention.
  我很想談談為什麼荷爾蒙對膀胱和預防尿路感染如此重要。

[04:30] And so, there are so many symptoms and everyone says, "Oh, we're blaming everything on hormones."
  所以，有這麼多症狀，每個人都說：「哦，我們把所有問題都歸咎於荷爾蒙。」

[04:35] And the truth is we haven't talked about hormones enough to actually start looking at this to figure out what is important and what is hormonally important.
  事實是，我們對荷爾蒙的討論還不夠充分，無法真正開始審視這個問題，找出什麼是重要的，以及什麼是荷爾蒙上重要的。

[04:44] So, when you start to lose progesterone, when you arrive at perimenopause, what are the symptoms you feel?
  所以，當你開始失去黃體酮，進入圍絕經期時，你會感覺到哪些症狀？

[04:50] Are they different symptoms to decline in estrogen?
  它們與雌激素下降的症狀不同嗎？

[04:52] So, it's hard to know for sure, but some people think that is the progesterone, so your sleep starts to get a little crazy, anxiety starts to go up.
  所以，很難確定，但有些人認為是黃體酮的問題，所以你的睡眠開始變得有點混亂，焦慮感開始上升。

[05:00] And so, some people will start with progesterone as a support for um you know, sort of
  所以，有些人會開始使用黃體酮來支持，嗯，你知道，有點像是

[05:05] perimenopausal hormone therapy, but estrogen can also help with many of those symptoms.
  圍絕經期荷爾蒙療法，但雌激素也可以幫助緩解許多這些症狀。

[05:10] So, it's not a one-size-fits-all of whether we give people everybody gets progesterone or everybody gets estrogen.
  所以，這並非一概而論，我們是給予人們黃體酮還是雌激素。

[05:16] Sometimes people just get testosterone cuz remember that falls in your 30s, uh you know, so there's sometimes where we uh do all three and there's sometimes where we do just one or two.
  有時人們只接受睾酮，因為請記住，這在你的 30 多歲時就會下降，你知道的，所以有時我們會三種都用，有時只用一種或兩種。

[05:23] Now, it's a a very evolving conversation cuz most of the book answers, most of the guidelines really talk about menopause and how we treat people in this menopause when you're flatlined.
  現在，這是一個非常不斷發展的對話，因為書本的大部分答案，大部分指南都真正談論更年期以及我們如何在進入更年期時治療人們，當你處於低谷時。

[05:34] Remember, it's that castration event where everything's zero and then we add back hormones.
  請記住，這是那個閹割事件，一切歸零，然後我們再補充荷爾蒙。

[05:37] So, now we're starting to talk about perimenopause as a place to to start giving women hormones and that's a a very important and evolving conversation that is happening.
  所以，現在我們開始將圍絕經期視為開始給予女性荷爾蒙的一個階段，這是一個非常重要且正在發生的不斷發展的對話。

[05:49] And so, this conversation that's sort of raging on about HRT, about safety, about what age you should take it, who should take it, what form you should take it in.
  因此，這場關於 HRT、關於安全、關於你應該在什麼年齡服用、誰應該服用、你應該以什麼形式服用，正在激烈進行的對話。

[05:59] What's your perspective on that and what do women need to know about that?
  你對此有何看法，女性需要了解什麼？

[06:03] Yeah, so so it's important because
  是的，所以這很重要，因為

[06:05] is HRT?
  這是荷爾蒙替代療法嗎？

[06:06] Yeah, it's a great question.
  是的，這是個好問題。

[06:08] So, hormone replacement therapy, which is a term that we used to use for hormones in menopause.
  所以，荷爾蒙替代療法，這是我們過去用於更年期荷爾蒙的術語。

[06:14] Um, it has a bunch of different names and everyone tries to change the marketing around it, but hormone therapy in general is this idea of giving back hormones when you have hot flashes, night sweats, osteoporosis, you know, sort of this over 50 crowd that has this declining estrogen and progesterone levels.
  嗯，它有很多不同的名稱，每個人都試圖改變其市場行銷，但總的來說，荷爾蒙療法是在出現熱潮紅、夜間盜汗、骨質疏鬆症時補充荷爾蒙的想法，你知道，大約是五十歲以上人群雌激素和孕激素水平下降的情況。

[06:32] And so, typically classic hormone therapy is estrogen and progesterone.
  所以，典型的經典荷爾蒙療法是雌激素和孕激素。

[06:37] Now, again, taking just estrogen, estrogen grows things.
  現在，再說一次，只服用雌激素，雌激素會促進生長。

[06:40] It helps your bone health, it helps your hair, skin, and nails, it helps you not have hot flashes, it helps you sleep.
  它有助於您的骨骼健康，有助於您的頭髮、皮膚和指甲，幫助您不出現熱潮紅，幫助您入睡。

[06:45] It can also grow the lining of the uterus.
  它還可以增厚子宮內膜。

[06:47] And so, if it gets thicker, thicker, thicker, there is worry over years that leads to endometrial or uterine cancer.
  所以，如果它越來越厚，越來越厚，越來越厚，多年來就會擔心這會導致子宮內膜癌或子宮癌。

[06:53] So, the endometrium is the lining of the uterus.
  所以，子宮內膜是子宮的內襯。

[06:56] So, here I can Okay, so this is a this is a vagina.
  所以，在這裡我可以，好的，這是一個，這是一個陰道。

[06:58] And then at the the vagina's like a socket.
  然後陰道就像一個插座。

[07:01] The very end of the socket is a tiny hole
  插座的最末端是一個小孔

[07:06] and that hole is the the pinpoint opening of the cervix.
  而那個洞就是子宮頸的那個點狀開口。

[07:10] And that hole, if you go through that tiny, tiny hole, it gets to the uterus.
  而那個洞，如果你穿過那個非常非常小的洞，就會到達子宮。

[07:15] And the uterus is a cavity where we hold babies, uh where the lining comes out.
  而子宮是一個腔體，我們在這裡孕育嬰兒，呃，在這裡內膜會脫落。

[07:20] That's what period blood is, is the lining of the uterus here, which we call the endometrial lining.
  這就是月經血，是這裡的子宮內膜，我們稱之為子宮內膜。

[07:24] So, progesterone is very important for this lining here.
  所以，黃體酮對這裡的內膜非常重要。

[07:28] If the the lining of the uterus gets too thick with just estrogen, that can lead to problems, but if you match it with progesterone, those problems go away.
  如果子宮內膜僅僅因為雌激素而變得太厚，可能會導致問題，但如果你將其與黃體酮結合，這些問題就會消失。

[07:37] Right. So, so if you just gave someone estrogen, then the linings of the uterus would get so thick that that would cause a problem.
  對。所以，所以如果你只給某人雌激素，那麼子宮內膜就會變得太厚，這會導致問題。

[07:42] But if you give it to both hormones together, it sort of balances itself.
  但如果你同時給予這兩種激素，它就會自行平衡。

[07:47] them out. And so that's why you'll hear hormone therapy talked about estrogen and progesterone just like the birth control pill your partner was on was an estrogen and a progestin.
  它們。所以這就是為什麼你會聽到荷爾蒙療法談論雌激素和黃體酮，就像你伴侶服用的避孕藥一樣，是雌激素和孕激素的組合。

[07:54] There was a combination.
  這是一個組合。

[07:55] Okay, got you.
  好的，明白了。

[07:56] And also [clears throat] the history is kind of important here of why your mothers and grandmothers weren't given access to this medication and the stigma behind it.
  而且，[清喉嚨] 這裡的歷史也很重要，關於為什麼你的母親和祖母無法獲得這種藥物以及其背後的污名。

[08:04] In the late '90s, uh a lot of
  在 90 年代末，呃，很多

[08:07] people were on hormone replacement therapies.
  人們正在接受荷爾蒙替代療法。

[08:09] And they were seeing benefits.
  他們看到了益處。

[08:10] They actually were all these observational uh studies that showed,
  實際上，所有這些觀察性研究都表明，

[08:14] "Wow, the heart disease is less and like this is during menopause."
  「哇，心臟病發病率較低，而且這是在更年期期間。」

[08:17] And a billion dollars went into the NIH to study this in women.
  十億美元投入美國國家衛生研究院研究女性的這一點。

[08:21] And they they They were They were called the Women's Health Initiative.
  他們，他們，他們被稱為女性健康倡議。

[08:24] It was thousands and thousands of people aged 50 to 79.
  有數千名五旬至七旬的女性參與其中。

[08:26] They gave a hormone pill, like a birth control pill almost, to all of these women and they followed them.
  他們給所有這些女性服用荷爾蒙藥丸，幾乎就像避孕藥一樣，並對她們進行了追蹤。

[08:35] And they stopped the study early in the early 2000s and they did a press conference.
  他們在 2000 年代初期提前停止了這項研究，並召開了新聞發布會。

[08:39] And at this press conference they said,
  在這次新聞發布會上，他們說，

[08:40] "We're shutting down the the study early.
  「我們將提前終止這項研究。

[08:41] Hormone therapy causes cardiovascular disease and breast cancer."
  荷爾蒙療法會導致心血管疾病和乳腺癌。」

[08:45] And overnight a multi-billion dollar industry went to nothing.
  一夜之間，一個數十億美元的產業化為烏有。

[08:48] Everyone was told, "Throw your hormones in the garbage.
  每個人都被告知：「把你們的荷爾蒙扔進垃圾桶。

[08:50] This is dangerous."
  這是危險的。」

[08:52] What was crazy is those people who were prescribing hormone therapy were looking around saying, "I don't understand.
  瘋狂的是，那些開荷爾蒙療法處方的醫生們環顧四周說：「我不明白。

[08:59] My patients aren't dying of heart disease.
  我的病人沒有死於心臟病。

[09:00] They're not getting extra breast cancers.
  她們沒有得到額外的乳腺癌。

[09:02] Like this doesn't make any sense."
  這根本說不通。」

[09:05] And when people actually looked at the study, it didn't say any of those
  當人們真正審視這項研究時，它並沒有說出那些內容

[09:09] things.
  事情。

[09:12] It was wild how misinterpreted this study was.
  這項研究被誤解得有多離譜，真是太瘋狂了。

[09:14] In fact, the same uh authors of this study back in the early 2000s published this year in 2025 actually that below age 70, that type of hormone therapy, which we don't really use anymore, has no increased risk of cardiovascular disease or stroke.
  事實上，這項研究的同一批作者在 2000 年代初期發表的研究，實際上在 2025 年（今年）指出，70 歲以下的女性，那種類型的荷爾蒙療法，我們現在已經不太使用了，並沒有增加心血管疾病或中風的風險。

[09:28] And yet now you have a generation of doctors who weren't taught how to do this.
  然而，現在卻有一代醫生沒有學過如何進行這種治療。

[09:33] Only 1.7% of women have are getting prescriptions for hormone therapy who who should be offered prescription.
  只有 1.7% 的女性獲得了荷爾蒙療法的處方，而她們本應被提供處方。

[09:40] So it is a disaster.
  所以這是一場災難。

[09:41] Only 1.7%
  只有 1.7%

[09:43] Only 1.7%
  只有 1.7%

[09:44] Oh, really? Hmm. Well.
  哦，真的嗎？嗯。好吧。

[09:46] And so hormone therapy is not something that I'm saying every woman must have, but every woman should have access to the toolbox.
  所以，我並不是說每個女人都必須接受荷爾蒙療法，但每個女人都應該能夠獲得這個工具箱的資源。

[09:54] I like to think about hormone therapy is really four buckets that we talk about.
  我喜歡將荷爾蒙療法想像成我們談論的四個類別。

[09:56] Hormone therapy is whole body estrogen, which helps with hot flashes, night sweats, uh bone loss, progesterone whole body progesterone therapy, which protects the uterus and is this yin-yang especially if you have a uterus, but it helps with sleep and it can help with anxiety
  荷爾蒙療法是全身性雌激素，有助於緩解熱潮紅、盜汗、骨質流失；黃體酮全身性黃體酮療法，可以保護子宮，這是一種陰陽平衡，特別是如果你有子宮，但它有助於睡眠，並且可以幫助緩解焦慮。

[10:11] reduction in many of our patients, not everybody, but a lot of them.
  我們許多病患都有所改善，不是每個人，但很多人都有。

[10:15] The third thing is testosterone, which we talked about, which can help with libido.
  第三件事是睪固酮，我們之前談過，它可以幫助改善性慾。

[10:19] Um that's what we have the most evidence for.
  嗯，這是我們證據最多的部分。

[10:20] And then the fourth thing is vaginal hormones.
  然後第四件事是陰道荷爾蒙。

[10:22] Now vaginal hormones are microdoses of uh estrogen or what we call DHEA vaginally that supports the bladder and the vagina.
  現在陰道荷爾蒙是微劑量的雌激素或我們稱之為陰道內去氫表雄酮，它能支持膀胱和陰道。

[10:30] So it helps with pain with sex, dryness, urinary frequency, urinary urgency, leakage, and it prevents urinary tract infections massively.
  所以它有助於改善性交疼痛、乾澀、頻尿、急尿、漏尿，並且能極大地預防泌尿道感染。

[10:39] It is safe for your great-grandmother in the nursing home.
  它對住在養老院的曾祖母來說是安全的。

[10:42] It is safe for your uh wife who's breastfeeding.
  對你正在哺乳的妻子來說也是安全的。

[10:46] So if you know anyone in your life who is a woman who's having urinary frequency, urgency, leakage, urinary tract infections, pain with sex, dryness, there is a magical solution that is safe for everybody on Earth um that is microdosing these hormones vaginally.
  所以，如果你認識生命中有任何女性有頻尿、急尿、漏尿、泌尿道感染、性交疼痛、乾澀的問題，有一個對地球上每個人都安全的奇妙解決方案，那就是陰道微劑量荷爾蒙。

[11:04] At any age?
  任何年齡都可以嗎？

[11:05] At any age at all.
  任何年齡都可以。

[11:07] In fact, even more important for people who are older because they are dying of urinary tract infections.
  事實上，對老年人來說更重要，因為他們死於泌尿道感染。

[11:12] it's one thing when a young person gets a urinary tract infection and they go to the urgent care and they get an antibiotic.
  當年輕人罹患尿路感染，前往急診就醫並獲得抗生素治療時，這是一回事。

[11:20] Even they deserve prevention and this is prevents those problems in those people, too.
  他們也應該得到預防，這也能預防這些人的這些問題。

[11:23] Again, what is this?
  再說一次，這是什麼？

[11:24] So vaginal hormones.
  所以是陰道荷爾蒙。

[11:26] So this is a really important topic.
  所以這是一個非常重要的主題。

[11:27] It's called genitourinary syndrome of menopause or GSM.
  它被稱為更年期泌尿生殖系統綜合症，或 GSM。

[11:33] Say GSM loudly for your listeners.
  請為您的聽眾大聲說出 GSM。

[11:33] GSM GSM, genitourinary syndrome of menopause.
  GSM GSM，更年期泌尿生殖系統綜合症。

[11:36] Genital, urinary, syndrome of menopause.
  生殖器、泌尿、更年期綜合症。

[11:42] But really, it's kind of a dumb name because it's any hormonal changes in your body can affect the bladder and the genitals.
  但說實話，這名字有點遜，因為您體內的任何荷爾蒙變化都可能影響膀胱和生殖器。

[11:49] So UTI, what is a UTI and what's what's causing a UTI?
  所以 UTI，什麼是 UTI，又是什麼導致 UTI？

[11:54] U- urinary tract infection?
  U- 尿路感染？

[11:55] Yeah, very good.
  是的，非常好。

[11:57] So urinary tract infections are when there is bacteria in the bladder and it can be a lot of of bad bacteria that can grow and create inflammation.
  所以尿路感染是指膀胱中有細菌，而且可能是很多壞細菌滋生並引起發炎。

[12:05] It causes bladder pain, pain with urination.
  它會引起膀胱疼痛，排尿時疼痛。

[12:08] It feels like razor blades.
  感覺像刀片一樣。

[12:09] Um but it can also go into your bloodstream and cause fevers and chills
  嗯，但它也可能進入您的血液並引起發燒和發冷

[12:13] and cause kidney infections.
  並引起腎臟感染。

[12:15] It can cause something called urosepsis where you have to go to the intensive care unit and need antibiotics through an IV and it can kill you if you have an infection go through your whole body.
  它會引起一種稱為尿毒症的疾病，您必須進入加護病房，並通過靜脈注射抗生素，如果感染遍及全身，它會致命。

[12:26] And this gets worse and worse as you get older.
  而且隨著年齡增長，情況會越來越糟。

[12:28] Why is there a link between hormones and UTIs?
  為什麼荷爾蒙和尿路感染之間有關聯？

[12:30] Yeah, because what happens is the the vagina is supposed to be acidic and healthy and hormones help keep it.
  是的，因為發生的情況是，陰道應該是酸性和健康的，而荷爾蒙有助於維持這種狀態。

[12:38] It is the hormones, the estrogen and the testosterone that keep healthy bacteria growing in the vagina and suppress or lower the bad bacteria.
  是荷爾蒙、雌激素和睪酮維持陰道內益生菌的生長，並抑制或減少壞菌。

[12:47] So there really is a vagina microbiome.
  所以陰道確實存在一個微生物群落。

[12:49] There is an There's There's no probiotic on Earth that is proven to do what the vagina needs quite like hormones.
  地球上沒有一種益生菌能像荷爾蒙一樣，被證明能做到陰道所需的功能。

[12:56] Hormones make the tissue go from not acidic to quite acidic and it is that acidic environment that protects it from infection.
  荷爾蒙使組織從非酸性變為相當酸性，而正是這種酸性環境保護它免受感染。

[13:04] And so perimenopause and menopause or other situations happen and it changes that microbiome so the good bacteria are are lower and the bad bacteria start to grow which can
  因此，圍絕經期和絕經期或其他情況發生時，它會改變微生物群落，導致益生菌減少，壞菌開始生長，這可能會

[13:15] increase your risk of infections.
  增加感染的風險。

[13:18] And sex, right?
  還有性行為，對嗎？

[13:21] Sex is a contact sport.
  性行為是一種接觸性運動。

[13:22] So you're bringing the outside environment into the inside environment.
  所以你將外部環境帶入內部環境。

[13:25] Ejaculate is also not acidic and that can change the microbiome as well.
  射精物也不呈酸性，這也會改變微生物群。

[13:29] And so, we know women who are sexually active also have an increased risk of urinary tract infections.
  因此，我們知道性活躍的女性也更容易患上尿路感染。

[13:35] So again, like a plant needing water, vaginal hormones help support the vagina and the bladder to maintain that acidic environment.
  所以再次強調，就像植物需要水一樣，陰道荷爾蒙有助於支持陰道和膀胱維持酸性環境。

[13:43] And research has been clear since the 1990s that using vaginal hormones prevent UTIs, urinary tract infections, by more than half.
  自 1990 年代以來，研究一直很清楚，使用陰道荷爾蒙可將尿路感染的發生率降低一半以上。

[13:52] So, what have we got here in front of me?
  那麼，我面前有什麼？

[13:53] All right.
  好的。

[13:54] So, there's a bunch of different ways you can give yourself vaginal hormones.
  所以，有許多不同的方法可以給你自己陰道荷爾蒙。

[13:59] The most common way is a cream.
  最常見的方式是藥膏。

[14:03] Now, this cream is uh $14 on Mark Cuban's pharmacy, and it lasts about 2 and 1/2 months.
  現在，這種藥膏在馬克·庫班的藥房售價約為 14 美元，可以使用約 2 個半月。

[14:08] Now, this cream, it comes with an applicator, which you don't ever have to use if you don't want to.
  現在，這種藥膏配有塗抹器，如果你不想用，可以不用。

[14:13] But, what you can do is you want to use 1 g of this cream.
  但是，你可以做的是使用 1 克這種藥膏。

[14:13] So, this amount
  所以，這個份量

[14:17] is 1 g of this cream.
  這是1克的這種乳霜。

[14:19] We'll put it on this paper here to show you.
  我們會將它放在這張紙上給您看。

[14:23] 1 g of this cream rubbed into the vagina.
  將1克的這種乳霜塗抹到陰道中。

[14:25] So, you take it, you can take it on your fingers and rub it into the walls.
  所以，您取一些，可以用手指取用，然後將其塗抹到陰道壁上。

[14:29] Like you If you put sunscreen on your face, you don't blob it on and walk out the door.
  就像您如果在臉上塗抹防曬霜一樣，您不會一次塗抹一大坨然後就出門。

[14:32] You rub it in so it doesn't look all white and filmy.
  您將其塗抹開，這樣它就不會看起來白白的、黏黏的。

[14:34] So, you put it in You take it with your finger, and you put it in the vagina, and you rub it into the walls of the vagina.
  所以，您將其塗抹進去，您用手指取用，然後將其塗抹到陰道中，並將其塗抹到陰道壁上。

[14:41] And you can rub it on the outer this area as well at the opening.
  您也可以將其塗抹在外陰部這個區域，以及陰道口。

[14:45] Let me try it.
  讓我試試看。

[14:46] Look, I don't have a vagina, but I don't know.
  看，我沒有陰道，但我不知道。

[14:48] So, you take the this What What is this cream called?
  所以，您取這個，這是什麼？這種乳霜叫什麼名字？

[14:51] It's estradiol cream.
  它是雌二醇乳霜。

[14:52] Estradiol.
  雌二醇。

[14:54] Take on your finger.
  取在您的手指上。

[14:56] You rub it inside the walls of the vagina.
  您將其塗抹到陰道壁的內部。

[14:57] Like you would rub it in like you would rub sunscreen on your face.
  就像您會將其塗抹開一樣，就像您會在臉上塗抹防曬霜一樣。

[15:01] And if you do that twice a week, you can prevent death from urinary tract infections.
  如果您每週做兩次，就可以預防尿路感染導致的死亡。

[15:03] You can help with urinary frequency, urinary urgency, leakage.
  您可以幫助緩解尿頻、尿急、漏尿。

[15:07] You make sex not painful and dry.
  您讓性行為不再疼痛和乾澀。

[15:09] It helps with arousal and orgasm.
  它有助於喚起性慾和達到性高潮。

[15:12] It's literally better than Viagra.
  它確實比威而鋼更好。

[15:14] And this is over-the-counter in the UK.
  而且這在英國是無需處方即可購買的。

[15:16] In the United States, you need a
  在美國，您需要一個

[15:17] prescription.
  處方。

[15:19] Um but, it's as little as $14 if you use Mark Cuban's online website.
  嗯，但是，如果你使用馬克·庫班的線上網站，最低只要 14 美元。

[15:24] It should be covered by your insurance.
  這應該可以由你的保險支付。

[15:26] Now, some women hate creams and so we have things that are not as messy as what you're showing right there and we have little tablet inserts.
  現在，有些女性不喜歡乳膏，所以我們有不像你剛才展示的那麼 messy 的東西，而且我們有小藥片塞劑。

[15:32] So, here is a comes with an applicator and so what a woman does is put this in her vagina and press a button and this little tablet.
  所以，這裡有一個附有塗藥器的，所以女性所做的就是將它放入陰道並按下按鈕，還有這個小藥片。

[15:39] So, instead of a cream, you could just put this little tablet in twice a week and that does the same thing as the cream.
  所以，與其使用乳膏，你只需要每週放入這個小藥片兩次，效果與乳膏相同。

[15:47] Uh okay.
  呃，好的。

[15:48] Okay, so it's a little less messy.
  好的，所以它比較不 messy。

[15:49] So, people tend to like the creams better.
  所以，人們傾向於更喜歡乳膏。

[15:51] Now, if you really don't want to do anything twice a week, this is a ring that goes in the vagina and it can stay in there for 3 months.
  現在，如果你真的不想每週做任何事情，這是一個放入陰道的環，它可以待在那裡 3 個月。

[15:59] Now, this it's sort of like a tampon.
  現在，這個有點像棉條。

[16:01] You can kind of put it in the vagina and the vagina does not feel it.
  你可以把它放入陰道，而陰道感覺不到它。

[16:03] By the way, the vagina is not very sensitive in terms of nerve endings and so when women put tampons in they don't feel them.
  順帶一提，陰道在神經末梢方面不太敏感，所以當女性放入棉條時，她們感覺不到。

[16:09] When you put this ring in that you wouldn't feel it either and it would stay in for 3 months at a time.
  當你放入這個環時，你也不會感覺到它，而且它可以一次待在那裡 3 個月。

[16:15] it's quite quite a big ring.
  它是一個相當相當大的環。

[16:16] Vagina can hold like a bowling ball of a
  陰道可以容納像保齡球一樣的

[16:19] baby can come out of a vagina.
  嬰兒可以從陰道出來。

[16:21] So, it can actually withstand quite a lot of volume.
  所以，它實際上可以承受相當大的體積。

[16:24] And there's a chemical inside this ring that's going to diffuse out.
  這個環裡面有一種化學物質會擴散出來。

[16:27] Estradiol that slowly diffuses estrogen uh for the ring.
  雌二醇，它會緩慢地擴散雌激素，用於這個環。

[16:30] So, that's nice for women who have dementia, who have very bad dexterity with their fingers, they're in a nursing home, uh for someone who's on the go and they can't remember something twice a week.
  所以，這對患有失智症的女性來說很好，她們手指的靈活性很差，她們住在養老院，或者對於那些忙碌且無法每週記住兩次事情的人來說。

[16:39] So, our ADHD patients like things like that.
  所以，我們的注意力不足過動症患者喜歡這類東西。

[16:41] And so there's just different it's all the same stuff.
  所以，它們只是不同，都是一樣的東西。

[16:43] It's just in different formulations.
  只是有不同的配方。

[16:45] Now, the one different one, this is something called DHEA.
  現在，那個不同的，這是一種叫做 DHEA 的東西。

[16:49] Now, DHEA is the precursor hormone to estrogen and testosterone.
  現在，DHEA 是雌激素和睪酮的前驅荷爾蒙。

[16:53] And remember I said the vulva, the vagina, the bladder need testosterone, too.
  還記得我說過外陰、陰道、膀胱也需要睪酮嗎？

[16:56] It So, this is a a chemical that converts into estrogen and testosterone.
  所以，這是一種轉化為雌激素和睪酮的化學物質。

[17:02] And so, DHEA is a supplement you can buy, you know, sort of in the in the supplement aisle,
  所以，DHEA 是一種你可以購買的補充劑，你知道的，在補充劑貨架上，

[17:09] but if you put it locally in the vagina, this is an FDA-approved product.
  但如果你將它局部用於陰道，這是一種 FDA 核准的產品。

[17:11] It's called Intrarosa.
  它叫做 Intrarosa。

[17:13] And if you just put this in the vagina, uh it's meant for every night, but you can do it twice a week.
  如果你只是將它放入陰道，嗯，它原本是為了每晚使用，但你可以每週使用兩次。

[17:17] It it melts at bedtime when you
  它會在睡前融化，當你

[17:22] wake up and it prevents UTIs, it helps with pain with sex.
  醒來，它可以預防尿路感染，有助於緩解性交疼痛。

[17:26] And just to be clear again, so you think a lot of people should be taking these these things?
  再說清楚一點，所以你認為很多人應該服用這些東西嗎？

[17:31] believe it's preventative, so I think and we wrote guidelines by the American Urological Association why this is so important, how to do it.
  我相信這是預防性的，所以我想，我們寫了美國泌尿學會的指南，說明為什麼這很重要，以及如何做。

[17:38] So many women have symptoms of urinary frequency, urgency, leakage, urinary tract infections, pain with sex dryness, and this is a safe option for all of those women.
  許多女性有尿頻、尿急、漏尿、尿路感染、性交疼痛、乾燥等症狀，而這對所有這些女性來說都是一個安全的選擇。

[17:48] Does that make sense?
  這說得通嗎？

[17:49] It does make sense.
  說得通。

[17:50] And one of the things that doctors sometimes tell their patients to take to help with the UTI situation is that
  醫生有時會告訴病人服用的一種有助於尿路感染情況的藥物是

[17:58] Okay, this is a disaster.
  好的，這真是太糟糕了。

[18:00] women get urinary tract infections a lot.
  女性經常會得到尿路感染。

[18:03] And so, what do we tell women? Pee after sex, wipe from front to back.
  那麼，我們該告訴女性什麼呢？性行為後小便，從前向後擦拭。

[18:08] Like that's not data-driven, by the way.
  順帶一提，這不是數據驅動的。

[18:09] That's all a folk folk tale.
  那都是民間故事。

[18:12] Like that's that's folklore.
  就像那是民間傳說一樣。

[18:13] There is some data that cranberry pills can help with preventing UTIs, but the amount that you'd have to drink is very sugary and diabetes
  有一些數據表明蔓越莓藥丸有助於預防尿路感染，但您需要喝的量非常甜，而且糖尿病

[18:22] inducing and wouldn't taste that good.
  誘導的，而且味道不會太好。

[18:25] And so, they they do make pills, but it's a small
  所以，他們確實有做藥丸，但這是小的

[18:26] These things are small things that help.
  這些東西是幫助的小東西。

[18:29] Drinking lots of water can help.
  喝大量的水有幫助。

[18:30] But vaginal hormones, vaginal estrogen or vaginal DHEA, which we just showed a bunch of, prevent UTIs by more than half.
  但是陰道荷爾蒙，陰道雌激素或陰道DHEA，我們剛才展示了很多，可以預防一半以上的尿路感染。

[18:38] They don't just prevent UTIs, they help with urinary frequency, urgency, leakage, pain with sex.
  它們不僅預防尿路感染，還能幫助緩解尿頻、尿急、漏尿、性交疼痛。

[18:45] They help your arousal, they help your orgasm, and they're safe for every age with every medical problem.
  它們有助於您的性喚起，有助於您的性高潮，並且對所有年齡和所有醫療問題都是安全的。

[18:49] If you've had cancer, blood clot, stroke, any problems at all, vaginal hormones are safe and could save your life.
  如果您患有癌症、血栓、中風，或任何其他問題，陰道荷爾蒙都是安全的，並且可以挽救您的生命。

[18:58] And so, this is such an important topic.
  所以，這是一個非常重要的話題。

[19:00] If you love the Dariva CEO brand and you watch this channel, please do me a huge favor, become part of the 15% of the viewers on this channel that have hit the subscribe button.
  如果您喜歡Dariva CEO品牌並且觀看此頻道，請幫我一個大忙，成為此頻道中訂閱按鈕的15%的觀眾之一。

[19:09] It helps us tremendously and the bigger the channel gets, the bigger the guests.
  這對我們幫助很大，頻道越大，來的嘉賓也越大牌。