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Straight Solutions to Some Tough Questions

Straight Solutions to Some Tough Questions

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The next discussions are supplied to assist clear up a few of the most evident (and probably harmful) misconceptions girls could have about menopause and hormones.

Q. I am solely 42 however have signs. Can I be going into menopause this quickly?

A. Sure. About 25% of us enter menopause earlier than age 47. Virtually all girls (95%) are menopausal by age 55.

Q. What is the distinction between “pure” hormones and people “bio-identical” hormones I’ve heard about? And may I purchase them on the retailer?

A. Bio-identical signifies that a hormone is precisely the identical, chemically, because the hormone nature produces within the human physique. That is why folks typically discuss with them as pure hormones.

The bio-identical hormones (BIHs) used for hormone substitute remedy (HRT) are manufactured, sometimes from substances in sure yams or soybeans.

Drug producers could combine these BIHs with different components (together with different hormones that will or will not be BIHs) or bundle them in sure varieties (drugs, patches, lotions, and so on.) which are bought to pharmacies underneath model names.

The generic pharmaceutical-grade (USP) hormones could also be bought to “com-pounding pharmacies” who can combine up customized hormone merchandise prescribed by your physician.

A few of the USP hormones can also be bought to complement producers for over-the-counter (OTC) merchandise like these you discover in a well being meals retailer.

Nonetheless, not all OTC “hormone” merchandise include hormones the human physique can use. People who do are a lot weaker than prescription merchandise.

Q. If I would like bio-identicals do I’ve to go to a compounding pharmacy?

A. Not essentially. With a physician’s prescription you will get brand-name BIHs from virtually any pharmacy.

You DO want to make use of a compounding pharmacy when the brand-name product’s hormone kind, dosage, mixture or supply media (capsule, patch, cream, and so on.) don’t meet your private wants and also you need a customized BIH answer.

Q. I took Prempro earlier than that research got here out saying it is dangerous. Am I at risk? Ought to I file a lawsuit?

A. Not essentially. First, the general dangers noticed within the WHI Prempro research have been very tiny. Even in essentially the most excessive instance (blood clots) the danger elevated from lower than one-fourth of 1 % to double that, or lower than one-half of 1 %.

Second, you possibly can’t sue except you’ve gotten been recognized with one of many ailments (coronary heart illness, stroke, breast most cancers, blood clots) the research discovered to be negatively influenced by Prempro.

Third, whereas there may be at all times an opportunity you possibly can win the case if a jury is manipulated correctly by a intelligent authorized group, the actual fact is that the information fluctuated on each coronary heart illness and breast most cancers through the 5.2 years of the research, with the Prempro group being extra in danger generally and the placebo group being extra in danger at different instances.

Fourth, if it is breast most cancers you have bought, you may have a tough time proving a causal connection. (See under.)

Q. Did the WHI research show that Prempro causes breast most cancers?

A. No. It solely indicated that Prempro could speed up the expansion of an current breast tumor. The research was too brief to find out whether or not Prempro causes breast tumors, since breast most cancers takes 7 to 10 years to develop to a detectable measurement. The very fact is that any lady recognized with breast most cancers through the research al-ready had it when she enrolled.

Q. Is it true that since I am previous the new flashes I do not want any therapies?

A. No. The new flashes, evening sweats and coronary heart palpitations are signs primarily of abrupt withdrawal of estrogen. As soon as your mind realizes that your estrogen provide shouldn’t be going to be raised to earlier ranges, irrespective of how loud it yells at your ovaries, issues often settle down and people signs fade.

Nonetheless, these apparent and annoying signs are solely the tip of the ice-berg in relation to what’s occurring inside your physique on account of having chronically low or imbalanced hormones (often each).

With out the correct therapy, you’ll stay at increased danger for coronary heart illness, stroke, sure cancers, osteoporosis and reminiscence loss.

You’re additionally prone to proceed experiencing every other signs you presently have, together with: dryness (eyes, pores and skin, mouth, vagina), temper swings or despair, insomnia, urinary tract infections, thinning or undesirable hair, excessive ldl cholesterol, worsening allergy symptoms, weight acquire and sexual issues.

In some instances, food plan and herbs or nutritional vitamins could also be efficient in serving to re-uce signs and sure illness dangers.

Q. Is it safer to take common medication for issues like sizzling flashes, ldl cholesterol, osteoporosis and moods/despair, because the FDA says all hormones are simply as dangerous as Prempro?

A. No. However let’s handle the second half first. The FDA’s recommendation that every one hormones ought to be thought of to have the identical dangers as Prempro and Premarin is a precaution. Prior to now 60 years, solely Premarin-based hormones have been examined in giant research; no different HRT merchandise are practically as nicely researched.

It may be argued that the protection of our native hormones has been confirmed by the numerous 1000’s of years human our bodies have been making and utilizing them. Nonetheless, additionally it is true that the chemically an identical (bio-identical) pharmaceutical counterparts to these native hormones that we use for HRT have by no means been comprehensively studied to see in the event that they work simply as nicely or are as protected.

However do not maintain your breath ready for these BIH research. Since nature’s formulation can’t be patented, few (if any) drug corporations might be desperate to fund costly analysis on merchandise that they’ll by no means declare unique rights to promote at a premium value.

So the FDA’s recommendation is sound: till confirmed in any other case, assume that every one hormone merchandise have about the identical dangers as Premarin and Prempro. (Simply keep in mind that even their dangers weren’t as scary because the information made them appear.)

Now to handle the primary situation: utilizing non-hormonal medication as a substitute of hormones. Realistically, the FDA’s recommendation about hormones ought to be prolonged to incorporate all medication. Solely a uncommon few medication have been studied for five+ years in over 10,000 folks like Premarin and Prempro have. Which means the dangers of these medication you are taking in your coronary heart, bones, bladder, temper, insomnia and “private summers” are no less than as unknown as these of bio-identical hormones.

Every drug has its personal unintended effects, and there could also be interactions between one drug and different medication (or with meals) that improve or diminish the affect of a number of of the medication you are taking.

Then there’s the complexity of taking a number of medication on totally different schedules, with totally different guidelines for every.

A number of circumstances that come up from a single trigger ought to, logically and most easily, be handled by addressing that single cause-in this case, low or imbalanced hormones. The logical, easy reply can be to exchange and/or stability the correct hormones. But when hormone re-placement shouldn’t be an choice you are snug with, do not assume a number of “common” medication are any safer.

Q. The brand new FDA guideline says that ladies ought to take the “lowest efficient dose” of hormones for the shortest doable time. Is Prempro the one product out there in that power? And is it safer than the Prempro they used within the WHI research?

A. “Lowest efficient dose” means what-ever quantity is acceptable in your physique to unravel the focused issues. Every lady is totally different; due to this fact, no product can realistically provide a common “lowest efficient dose,” although many merchandise provide low-dose choices.

The very fact is that even Prempro’s lowest dose could also be too robust for some girls, whereas its highest dose could also be too weak for others.

Since just one power of Prempro was used for all girls within the WHI (0.625 mg Premarin + 2.5 Provera), and the low-dose product has not been studied to the identical extent, there isn’t any proof that the low dose is any safer than the upper dose. The brand new choice merely ad-dresses the assumption that much less of one thing dangerous is best for you than extra of it.

Q. Did that large WHI research actually show hormones do not make you are feeling higher?

A. No. The WHI’s High quality of Life (QOL) research was so poorly designed that its conclusions are downright laughable.

First, girls with extreme signs have been discouraged from collaborating or have been inspired to drop out, leaving principally “completely happy campers” within the research.

Second, even the researchers stated their checks have been “too crude” to essentially monitor necessary elements like reminiscence.

Third (and most significantly), nearly all of the themes scored excessive on the preliminary baseline QOL checks. So when later checks confirmed their completely happy campers weren’t any happier after taking Prempro, they merely proved that “if it ain’t broke, Prempro will not repair it.”

In some way, that little bit of ineffective info has since been translated into the fully unfounded declare that “if it IS broke, the correct hormones will not repair it.”

What you will not hear within the information is that regardless of the declare that hormones will not enhance anybody’s QOL, the research did present that among the many 12% of topics with average to extreme signs, QOL enchancment was 77% (vs. 52% for these taking the dummy drugs). Now that is a big distinction!

Q. My intercourse drive is gone. Can Viagra work for me?

A. Possibly. There are Viagra-like merchandise for girls out there now or on the horizon, however the reality is they can not enhance your libido (intercourse drive). What they’ll do is draw blood to your genitals to make that space extra delicate and, presumably, extra responsive throughout intercourse.

However when you’ve got no sexual want, these medication will not clear up your downside.

Testosterone is the hormone of want in each ladies and men. And once we are poor in it, we are able to lose not solely our intercourse drive, however muscle tone, bone density, reminiscence, power, artistic ardour and fantasies as nicely.

Sadly, there is just one testosterone product presently out there for girls (Estratest) and it isn’t a BIH.

Intrinsa, a brand new bio-identical testosterone patch for girls, handed all the usual checks for FDA approval, however was despatched again for added testing in mild of the controversy over hormones normally, and over utilizing testosterone for girls, particularly.

Ladies can use sure merchandise de-signed for males, although many docs are hesitant to prescribe them. And due to the potential for abuse, these steroids are intently regulated.

Q. I am informed I needn’t take progesterone with my estrogen since I’ve had a hysterectomy. Is that good recommendation?

A. No. Except the surgeon additionally eliminated your mind, bones, muscular tissues, breasts and nearly each different organ in your physique, you continue to want progesterone to sup-port regular physiologic features.

Most significantly, you want progesterone to counteract probably dangerous results of the estrogens remaining in your physique. Even when you’ve got no ovaries and have by no means taken estrogen, your physique nonetheless makes estrogens in fats cells and in your adrenal glands.

However at menopause your physique produces virtually no progesterone, which creates a harmful “estrogen dominant” situation. So even in the event you do not take estrogen, you most likely nonetheless want progesterone to revive hormonal stability.

Q. Is not breast most cancers the best illness danger girls face?

A. No! Ladies are 9 instances extra prone to die of coronary heart illness than of breast most cancers! Plus, docs usually tend to misdiagnose coronary heart illness in girls or to deal with it much less aggressively than in males.

Q. Is not reducing ldl cholesterol crucial for stopping coronary heart illness?

A. No. A minimum of half of those that undergo coronary heart assaults have completely regular levels of cholesterol!

The truth is, ldl cholesterol shouldn’t be dangerous for you. All of your hormones are made from it. Solely oxidized ldl cholesterol is dangerous for you. (Which is why we take antioxidants like nutritional vitamins C and E.)

It’s miles extra necessary to check for power irritation as mirrored in C-reactive protein and homocysteine ranges, that are rather more dependable predictors of coronary heart illness than ldl cholesterol.

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Straight Solutions to Some Tough Questions

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