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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Joan’s Ordeal: What Drives a Physician?

When I was first starting my medical practice, menopausal problems were not taken very seriously. Hot flashes and premenstrual syndrome (PMS) were the source of a lot of jokes. Well, it isn’t funny when you feel awful and your life is falling apart. I can’t tell you how many times I’ve had women apologize for “wasting my time” with their complaints or tell me, “Thank you for listening to me.” I would always assure them that hearing their symptoms is essential for my finding the correct solution for their problem.

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How Long Can I Safely Stay On My Hormone Therapy?

How long can I safely stay on my hormone therapy?

I am frequently asked the question, “How long can I safely stay on my hormone therapy? and I usually ask the woman, How long do you want to continue to feel well?” In all seriousness, there are no long-term studies that enable me to answer this question. Taking hormones less than five years seems to carry very little risk. However, the longer you take hormones the higher your risk.

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Progestins Reduce The Cardiac Benefits of Estrogen

Progestins Reduce The Cardiac Benefits of Estrogen

 

All the adverse effects from the oral route of administration of estrogen as previously outlined in Outliving Your Ovaries can also occur from oral Prempro. However, the addition of the progestin seems to confer additional cardiac risk. Perhaps giving progestins daily instead of in cycles of 14 days each calendar month may be a factor in this increased risk. Earlier observational studies, like the Nurses’ Health Study, predominantly used oral cyclic progestins and did not show an increased risk of heart disease.

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Symptoms of Menopause: Spinning Out of Control

Dr. Johnson describes symptoms of menopause

A very few lucky women sail through menopause with minimal symptoms. They have usually been very healthy prior to menopause. However, they are the exception. Most women will have at least some symptoms. These can range from a mild sensation of feeling warm, to a beet red face and drenching sweats that leave the sufferer with wet hair and clothes soaked in sweat. As you can imagine, this can be especially disconcerting to a woman who’s in the middle of a business meeting.

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Is It Too Late For Me to Take Estrogen?

Dr. Marina Johnson answers the question: Is it too late for me to take estrogen?

At the time of menopause, each woman has a window of opportunity during which she needs to make the important decision of whether to take hormones. As the estrogen levels fall, her body begins to go through degenerative changes that accelerate her risk of heart disease along with the other changes we have previously described. The sooner a woman starts HRT after menopause, the fewer degenerative changes she will experience. If a woman waits 10 years to start HRT, the heart protection from estrogen is greatly diminished. The same applies brain protection; once brain cells have been lost, it becomes difficult to retrieve normal function. However, for protecting bones, estrogen is effective even when started after age 75.

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Why Is It Important To Measure Estrogen Blood Levels? Part 2 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

3. YOU CAN’T JUST GO BY “HOW YOU FEEL!”

I strongly endorse monitoring estradiol and testosterone blood levels to ensure appropriate dosage and effectiveness of hormone therapy. Monitoring estradiol levels in thousands of women since 1986 has led me to develop more precise hormone regimens producing blood levels comparable to a low physiologic range. As noted earlier, monitoring blood levels is especially important with topical therapy. Most post- menopausal women who see me initially have NEVER had their estrogen level checked!

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Why Is It Important To Measure Estrogen Blood Levels? Part 1 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

Many women who initially see me for menopause have never had their estradiol level checked. Their previous physician may have diagnosed menopause with an elevated FSH, but usually no further tests are done. I’d like to go through various reasons why I believe it is important to monitor estradiol levels.

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Does Estrogen-Only HRT Decrease Breast Cancer Risk? Here’s The Rest of The Story!

Estrogen-Only Hrt

A recent study in Lancet Oncology looking at data from the Women’s Health Initiative (WHI) reported that the use of estrogen (Premarin) alone was NOT associated with an increased risk of breast cancer and the use of estrogen-progestin (Prempro) increased the risk of breast cancer.

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Natural Menopause

Natural Menopause

The average age for menopause is 50 to 55. I’ve seen an occasional woman who has regular monthly periods and then one month has her last period and never has another. However, this is the exception rather than the rule. Typically, women begin with perimenopausal symptoms in their forties. As a woman approaches the end of perimenopause, the periods become lighter and start to become more infrequent. She may skip several months without a period, and then finally the periods stop completely. When the decline in hormones occurs very gradually, a woman may not experience severe symptoms because her body has had time to compensate for the decline in estrogen and progesterone. Often the age of menopause is genetically determined and it is helpful to ask when an older sister or mother went through menopause. A catastrophic, stressful life event can bring on menopause earlier than expected.

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The content of this website is for informational purposes only and is not intended to be a substitute for professional medical advice,diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. This website may discuss nutritional products and protocols that have not been evaluated by the U.S. Food and Drug Administration. These products or the information contained on this website is not intended to diagnose, treat, cure or prevent any disease.