Guillermo Antiñolo, gynecologist and geneticist: "Many women don't even consider hormone therapy and age critically."

He has faced death three times in recent months, two of which were spent in the ICU of one of the centers where he works as head of Maternal-Fetal Medicine, Genetics, and Reproduction, the Virgen del Rocío Hospital in Seville. “The doctors asked my wife to look for a funeral home,” he recalls now. He was admitted for treatment for bladder and prostate cancer, diagnosed last August, but subsequent complications have brought him to the brink of death. This is the recent experience of Granada-based geneticist Guillermo Antiñolo , who this year turned 68, or three times that, considering that each recovery has been a rebirth.

This professor of Obstetrics and Gynecology at the University of Seville is now reemerging with the strength his convalescence has allowed him, with a sense of humor and a clear commitment: "I know I'm alive, but what I want is to live." And this ambition includes the dissemination of his latest work , The Revolution of the Female Genome (Planeta, 2025), a work in which he warns of how the interruption of estrogen production, a crucial aspect for half the population, triggers cognitive effects (memory and concentration), mental health (depression), sexual health, bone and muscle health, skin health, metabolism, and the cardiovascular system, the leading cause of death in women. For the researcher, taking it into account in preventive health policy, in diagnoses, in treatments and in research would allow savings in the costs of care, would facilitate more precise and effective therapies and would even favor personal relationships, since, as Antiñolo says from one of his favorite songs, To Know You Is To Love You (composed by Stevie Wonder and Syreeta Wright and covered by BB King, among others).

Q. How are you feeling?

A. We never thought I'd make it out alive. I still have three months to recover from being stuck in the ICU without moving and from all the things they did to save my life. I made it out alive, but I value the concept of living, the quality of life, so I can return to my full potential. This is a real struggle, and every day I have to make a significant effort to move. Something as pleasant and fun as showering is a real agony. But I don't complain, because it doesn't do me much good. I feel encouraged, eager to fight. Since I've made it this far, I'm not going to give up now.

Q. What is The Female Genome Revolution , the title of your book?

A. The book offers many keys to women's health and suggestions for aspects that need to be changed. I can't do that, nor do I intend to, but I can encourage it. It addresses issues that affect us all and our daily lives for a long time.

Q. How did it come about?

A: It has a lot to do with my way of thinking about the concept of fertility, which is the central idea of ​​the book. Fertility isn't just having children, but normal ovarian function and, therefore, the generation of estrogen. When it's interrupted, women's health changes and they age twice as fast as men. Estrogen controls the cognitive and cardiac aspects, and also the way we get sick. During my stay in the ICU, a colleague came to the hospital with chest pain. They sent her home with a painkiller and didn't run any tests. She later returned and remained in the ICU with a coronary spasm. If you dig a little deeper, you find many such cases, and what a coincidence, almost all of them are women!

Fertility isn't just about having children. Estrogens control cognitive function, heart function, and also how we get sick.

Q. What about hormone replacement therapies?

A. Many healthcare professionals completely lost sight of the importance of these and other therapies since 2004, and they haven't changed their minds, opened a book, or read a research article since then, when a study was published linking hormone replacement therapy with an increase in breast cancer cases and severe circulatory and thrombotic conditions. Over time, it has been clear that this study had several biases, and we've also been using treatments other than those for many years now, checking the risks and administering them carefully. There are still many urban legends about this, and many women don't even consider it and are aging critically, with mood swings, memory loss, cholesterol, strokes, and other cardiovascular diseases.

Q. Do women live longer, but worse?

A. When you apply the age and sex filter in research, men maintain a stable line while women form two curves: one below 55 and another above. In terms of comorbidity [the coexistence of two or more diseases] and problems such as diabetes, hypertension, or heart disease, it's very striking. Everything is related to the loss of estrogen production. People have internalized that it's normal, a process that occurs with age. But it's not normal; it can be treated and improved with hormone replacement therapy or other therapies appropriate for gender and age. Menopause, at its core, is a global health problem that affects half the population, but even the education of medical students is profoundly androcentric, and some concepts of physiology and health in men have been focused on women without going through the starting line and without taking into account that women suffer more problems related to aging than men. These are perfectly preventable events.

Some concepts of physiology and health in men have been extended to women without going through the starting box.

Q. Are the effects of menopause treatable?

A. Many women say they haven't felt its effects, but if you dig a little deeper, you realize they have indeed. Many try to normalize this situation, and many professionals come in and say: no way, that's normal. However, new medicines can address the problem, and with data and the use of artificial intelligence, we can anticipate many models of early diagnosis and treatment. But, above all, there must be an awareness that women's health is different from that of men, and therefore, their problems must be addressed from their perspective.

Q. How?

A. First, from the perspective of health systems, we need to begin to convey the concept. They need to see it; there needs to be a consensus that this is necessary. But we also need to change the way patients and doctors are educated… many things need to change, and it's not simple. We need to internalize everything and resolve it differently. We need to convince women that, when they begin to feel the symptoms of estrogen deficiency, they go to the doctor seeking solutions . We need to convince patients that they are patients. They need to demand specific care within the system. We also need to develop guidelines that consider the role of women, who may respond to medications quite differently than men. Cardiac remodeling [the heart's progressive response to damage] behind a heart attack is completely different in men and women, stroke is very different in men and women, who have many more after-effects... These are the most apparent or the most striking in terms of health, but there is everything else: changes in the skin, in the cognitive area, anxiety, hot flashes... They can be treated and are safe.

It's all related to the loss of estrogen production. People have internalized that it's normal, a process that occurs with age. But it's not normal and it can be treated.

Q. Is there a standard treatment?

A. The treatment is relatively standard in terms of the products used and the medications, but it must be personalized for each woman . There are women for whom a more standard treatment just won't work or poses risks to their health. In this case, the treatment needs to be changed or the symptoms addressed, but all of this is a very long road because research on women is practically nonexistent because it's not considered a health problem.

Q. Does the loss of testosterone in men have similar effects to the loss of estrogen in women?

A. In men, there isn't a total loss of testosterone function. We don't have a cycle; we don't have hormonal production that more or less maintains our entire system like women do. The role of testosterone and estrogen is completely different. It has nothing to do, for example, with cognitive function. Andropause doesn't have a very relevant critical impact in general terms, except in very specific clinical situations. However, estrogen does support, let's say, female metabolism and biology.