Understanding Integrative Medicine

What is Integrative Medicine?

I believe our health care system needs to be more patient- centered and engage patients in their own care. American medicine excels at crisis intervention with innovative drugs and surgical procedures. Yet chronic illness comprises the majority of problems that most physicians see in their office. Chronic health problems are adversely affected by poor diet, lack of exercise, obesity, smoking and excess alcohol. Another factor affecting chronic disease management is that insurance companies typically do not reimburse for measures to prevent disease. They instead wait until a serious disease has occurred that generally is much more costly to treat.

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Where Do We Stand Now?

Although the debate over the safety of hormone replacement still rages in the press, it appears some semblance of common sense is beginning to be heard. Yes, we need more confirming studies, but today’s women – myself included – cannot be put on hold and forced to wait another 10 to 20 years until all of the definitive studies have been completed. As with so many other issues in medicine, physicians have to use their best clinical judgment based on the information available now. Each woman needs to make these decisions with input from her own physician.

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Gina’s Journey: A Hysterectomy Story

Dr. Marina Johnson explains hysterectomies, What is a  Hysterectomy? Undergoing a hysterectomy is major surgery and when you have cancer, severe uterine prolapse or any serious condition that has failed medical therapy, it is warranted. Gina's Journey: A Hysterectomy Story

I often have women tell me – “I wish I’d never had my ovaries removed because all my problems started after I had that surgery.” Women with benign disease are sometimes told, “You’ve had all your children. You might as well take everything out so you can’t get ovarian cancer.”

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Considering Breast Cancer-Reducing Your Risk – Part 4 of 4

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Where Do We Go From Here?

Key Points About Breast Cancer & Other Hormone Related Cancers

  1. More deaths occur from heart disease than the next 16 causes of death combined including diabetes, all cancers, AIDS and accidents
  2. A first pregnancy before age 25 protects against breast cancer
  3. Dense breasts on mammography increase risk of breast cancer
  4. Small breast cancers less than 2.1 cm (2.5 cm = 1 inch) have a lower mortality than large breast cancers
  5. Positive family history occurs in only 15-20% of women with breast cancer but is an indication for closer monitoring and possible genetic testing
  6. Bad estrogen” byproducts increase risk of breast cancer, ovarian cancer and uterine cancer
  7. Good estrogen” byproducts lower risk of breast cancer, ovarian cancer, and uterine cancer and lower the risk of heart disease

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Considering Breast Cancer-Reducing Your Risk – Part 3 of 4

The Flexing woman symbol is a registered trademark of Kathys Divas

 

Screening: The Importance of Early Detection

Tumor size greatly affects mortality. The smaller the tumor, the more likely it is to be confined to the breast and therefore more responsive to treatment. In a study of 83,686 cases of women with primary breast cancer with tumor sizes ranging from 0.3 cm to 5 cm, and no lymph node involvement, the smallest tumors were associated with a mortality of 10% while the larger tumors were associated with a mortality of 25%. In women with tumor sizes ranging from 0.3 cm to 5 cm and positive lymph nodes, those with the smallest tumors had a 20% mortality and those with the larger tumors had a 40% mortality. Studies show improved mortality when breast cancer is detected as a small lesion, especially if it’s less than 2 cm.

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Considering Breast Cancer-Reducing Your Risk – Part 2 of 4

Flexing woman symbol is a registered trademark of Kathys Divas

 

Risk Factors You Can Modify To Decrease Your Risk of Breast Cancer

Obesity

Obesity and weight gain during adult life increases risk of postmenopausal (but not premenopausal) breast cancer because fat tissue increases estrogen levels. The adverse effect of obesity on breast cancer is strongest in women who do not use HRT. In the Nurses’ Health study, women gaining 22 pounds or more after menopause increased their risk by 18% while losing at least 22 pounds lowered their breast cancer risk by 57%.

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Considering Breast Cancer-Reducing Your Risk – Part 1 of 4

Flexing woman symbol is a registered trademark of Kathys Divas

 

DEDICATION

Breast cancer is the most feared health problem for women.  In a previous blog, I’ve pointed out that women experience more deaths each year from heart disease and strokes than breast cancer. I’ve given you specific data on the absolute risk of breast cancer.

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Can Estrogen Protect Women Against Heart Disease?

Can Estrogen Protect Women Against Heart Disease?

 

Topical Estrogen Gives Better Protection Against Heart Disease – A compelling recent study in the European Heart Journal, September 2008 was designed to answer the question: Does estrogen cause heart attacks? A group of 698,098 healthy Danish postmenopausal women were followed for six years. The women were divided into groups by the TYPE of HT they were taking and compared to those women on no HT. The women on oral estrogen plus progestin had a 35% HIGHER occurrence of heart attacks as compared to women on no HT. The women on topical estrogen (patches, gels, NOT COMPOUNDED) had a 38% LOWER occurrence of heart attacks compared to women on no HT. So in essence, oral estrogen causes heart attacks while topical estrogen protects against heart attacks!

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The Silent Connection Between Estrogen and Osteoporosis

Dr Marina Johnson Discusses Osteoporosis and Estrogen Deficiency

 

After menopause without the use of estrogen, a woman can lose up to 20% of her bone mass. This increases her risk for osteoporosis leading to loss of height, hip fractures, chronic pain, and disability. Of women who suffer hip fractures, 24 percent die of complications within a year of the injury. Osteoporosis of the spine leads to the familiar “dowager’s hump.” A dowager’s hump is a prominence on the back resulting from collapse of the spine from spontaneous vertebral fractures. When it’s severe, the woman is totally bent over and cannot stand up straight. It is tragic to see a woman suffering from something that could have been prevented.

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Testosterone: Achieving a Delicate Balance

Testosterone and women

 

When a woman goes through menopause and her ovaries stop producing estrogen and progesterone, the pituitary responds by increasing FSH, a hormone from the pituitary gland that has regulated these hormones throughout her reproductive life. However, when all the eggs have been depleted, no further estrogen or progesterone can be produced. Nonetheless, the pituitary, which is “hard-wired” to respond to low estrogen, continues to make increasingly higher levels of FSH.

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MARINA JOHNSON
M.D., F.A.C.E.
MEDICAL DIRECTOR

BOARD CERTIFIED
IN ENDOCRINOLOGY
& METABOLISM AND
INTERNAL MEDICINE

10670 N Central Expressway
Suite 510
Dallas, Texas 75231-2111

214.574.4376 office
214.574.4377 fax

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