Category Archives: Hormone Replacement Therapy

Women’s Health in Midlife: Scientists Present the Most Up To Date Research Findings at the NAMS Conference

Last week, I attended the annual conference of the North American Menopause Society (NAMS), where 1500 attendees – physicians and scientists– gathered to hear the latest research findings concerning women’s health in midlife. The conference began appropriately with a full day devoted to hormone therapy:  what is known about the risks and benefits; the safety and impact of different delivery methods (transdermal vs. oral); the effects of
estrogen on mood and memory; and a look at the myths and facts about Bioidenticals.

Research presentations on subsequent days covered a wide range of health concerns including the possible link between hot flashes and cardiovascular disease; vaginal health, and hormone-free remedies for hot-flashes.  In the next few weeks, I’ll be sharing what I learned from these presentations as well as my conversations with physicians. For now, here are some of my initial take-aways:

1. Mention bio-identicals to 1500 gynecologists, as Dr. JoAnn Pinkerton, Director of the Midlife Health Center, University of Virginia, did in her presentation and you’ll hear a loud, collective groan. Suzanne Sommers and even Oprah continue to be a flash point for this group. Many of their patients want what they have without really knowing what it is they’re asking for.
2. “Adrenal fatigue” gets the same response. “It’s not a medical term,” Dr. Pinkerton explained to me. “Adrenal insufficiency, on the other hand, is a diagnosable condition that you can test for. Often, she told me, her patients self-diagnose their “constellation of conditions” such as fatigue, lethargy, and cravings for sweets, as adrenal fatigue, based on what they’re reading on the internet or in popular books. … [Read more]

New Research Shows That Soy Doesn’t Prevent Bone Loss Or Help With Menopause Symptoms

Women who consume soy supplements thinking…hoping… that they will help reduce or eliminate menopausal symptoms such as hot flashes and insomnia will be very disappointed at the findings of a clinical trial published today in the Archives of Internal Medicine.  The study targeted women ages 45-60 years who had been menopausal for one to five years. Researchers at the University of Miami wanted  to determine whether daily intake of soy isoflavones (plant compounds that mimic estrogen in the body) in tablet form prevents the rapid bone loss associated with the initial menopausal years. … [Read more]

Beyond Free RX Samples: Now Doctors Dispense Big Pharma’s Sponsored Advice in the Exam Room

Advertisements for pharmaceutical drugs saturate  the airwaves, appear in magazines and even show up online. Now, if my doctor’s office is any indication, the examination room is the latest territory to be invaded by commercial messages for prescription drugs.

While waiting for my physician, I saw a new wall display containing a collection of ten brochures on a wide range of health topics, including menopause. Branded as “Healthy Advice,” it acknowledged “the generous sponsors who support this educational program.” I was already skeptical but curious.  I picked up the booklet on Menopause and turned to the back page to confirm who I thought the sponsor would be. Pfizer. Yes! I knew it.  They are the makers of the hormone therapy replacement drug, Prempro, which contains estrogens from horse urine and Progestin, a synthetic form of Progesterone.  Inside, under “latest findings,” the authors caution us against using soy to ease menopause symptoms because “the benefits are still questionable.”  They also caution us against trying a vitamin, supplement or other natural product to help with symptoms since “some of these may make things worse.” The brochure also advises patients on hormone therapy to “take the smallest dose that works for you for the shortest amount of time. This helps lessen the risks.”

Those hormone replacement therapy risks, barely alluded to in the sponsored brochure, were explained in greater detail today in front-page news stories about the results of an 8-year follow-up study of nearly 13,000 women who participated in the federally financed Women’s Health Initiative (WHI). That study was halted in 2002, three years ahead of schedule, when researchers saw that the hormones were causing an increased risk of breast cancer, strokes and blood clots in the lungs.  This is the first report from the WHI that includes death rates from breast cancer related to hormone use. … [Read more]

Suggested Reading: The Estrogen Dilemma

In case you missed, it, there was an excellent article, “The Estrogen Dilemma, in the New York Times Magazine this weekend. The author, Cynthia Gorney, recounted the emotional roller-coaster she experienced as a result of mid-life hormonal changes, but questioned the safety and long-term consequences of the hormone replacement therapy that seemed to put her back on an even keel.  In her own quest to find the answers, she interviewed the leading researchers and medical experts and learned the “inside story” of the Women’s Health Initiative Study, which caused thousands of women to abruptly stop taking Estrogen.  This is a “must-read” article for anyone considering whether or when to take estrogen replacement.  Here are a few of my own take-aways: … [Read more]

Arkansas Woman Prevails Against Wyeth in Appeals Court

News came today that an appeals court has upheld a jury’s finding last year that Wyeth’s hormone-replacement drugs helped cause an Arkansas woman’s breast cancer.  At stake was $27 million in actual damages, an amount that was upheld by the three-judge panel.

The appeals court said “the evidence presented could allow a jury to find or infer that Wyeth was guilty of malicious conduct.”  According to the news report, Pfizer’s lawyers argued that the plaintiff received ample warning about the cancer risks tied to the company’s Prempro and Premarin drugs and chose to continue using them.

The ruling comes a week after a Philadelphia jury ordered Wyeth to pay an undisclosed amount of punitive damages to an Illinois woman who developed breast cancer after taking Prempro.   Six million women have taken Wyeth’s hormone therapy drugs for severe menopause symptoms and there are more than 9,000 lawsuits against the company. The menopause drugs are still on the market and many physicians continue to recommend and prescribe them to their patients.You can read the court’s summary of the case here.

Are Compounded Hormone Products Safe? A Pharmacist Responds

Editor’s note:  Earlier this month, I wrote about a webinar on Bioidentical Hormone Therapy,  that was “supported” by Ascend Therapeutics, makers of an FDA-approved topical estrogen gel that competes with compounded hormone products.  There’s a companion magazine, “The Buzz on Bioidenticals,”  that is available free online and in doctors’ offices and it, too, is “supported”  by Ascend. The publication repeatedly cautions women against using compounding pharmacies and, in an article called “Why You Should Avoid Compounded Hormone Therapy” the writers suggest that doing so poses a risk to our health.

In the interest of fairness and to contribute to a balanced discussion that will help you make an informed decision about using compounded, bio-identical hormones, I contacted Christine Givant (pictured below), a pharmacist and founder of La Vita Compounding Pharmacy, in San Diego, to ask her to respond to some statements made in the “Buzz on Bioidenticals” publication.

Wendy:  First, explain what a compounding pharmacy does and why a woman on hormone therapy would choose to have her hormones “compounded.”  What does that mean exactly?

Christine:  A compounding pharmacy serves many vital purposes. To begin with, it allows the physician the opportunity to customize therapy to a patient’s individual needs. For example, Ascend Therapeutics offers a hormone product that comes in one strength, one dosage form, and one delivery device. Well, that will work for some women, but not all. A compounding pharmacy would be able to make it in the exact strength your physician determines you need and put it in a variety of dosage forms depending on your lifestyle (i.e gel, cream, suppository, lozenge, capsule, sub-lingual drop). A compounding pharmacy could also combine a daily hormone regimen into one cream, which could result in increased compliance and a lower cost to the patient. … [Read more]

If you’re considering Bio-identical hormone therapy and Oprah’s shows on the topic left you more confused than ever,  tune into a free, live webinar, “The Buzz on Bioidenticals,” scheduled next week, on August 4th.  It will feature Dr. Elizabeth Lee Vliet, author of Women, Weight and Hormones: A Weight-Loss Plan for Women Over 35 and Karen Giblin, founder of Red Hot Mamas, a menopause education organization. There’s also a free companion magazine that you can download from their website.

You should be aware that both the webinar and the magazine are supported “by an educational grant” from Ascend Therapeutics, which makes EstroGel, an FDA appproved estrogen gel that competes with the Vivelle-Dot estrogen patch  as well as hormone products formulated by compounding pharmacies.  That explains the repetitive advice you’ll find throughout the magazine against using compounded hormone products (i.e. “you don’t need to go to a compounding pharmacy to obtain bioidentical hormone therapy” and  “there is no need to risk using a compounding pharmacy.”)

As I’ve written here before, the debate continues over the safety of bio-identical hormones, the reliability of saliva tests and the safety and consistency of compounding pharmacies.  It’s hard to evaluate claims when the information we receive is “sponsored” by an interested party.  All I can say is read and listen to everything, ask questions and know the source.

Hot Flashes Can Last HOW Long?????

Some women are just plain lucky. They sail through Menopause without a minute of discomfort.  I put them in the same category as super-models.  They’re freaks of nature.  The fact is that most menopausal women experience hot flashes and/or night sweats and they can range from mildly disruptive to downright debilitating.   Hormone therapy will help with the hot flashes (vasomotor symptoms as they are called), but current guidelines recommend that it be taken at the lowest effective dose for the shortest period of time.   So,  in making the decision to take HT, wouldn’t it be a lot easier if women knew how long their hot flashes would last?

… [Read more]

Add Heartburn to the List of Estrogen’s Risks

If TV commercials for pharmaceuticals are a true reflection of what ails our population, then I have to conclude that a good percentage of people – men and women – suffer from Gerd, often called acid reflux or heartburn.   It has been commonly believed that lifestyle factors such as BMI (body mass index), diet, smoking status, alcohol consumption and the use of certain medications are the culprits.  But recent research has shown that if a post-menopausal women is complaining of Gerd-like symptoms, it’s very possible that her use of hormone therapies, or raloxifene (prescribed for osteoporosis prevention) or even over-the-counter soy estrogen products are to blame. … [Read more]

Your Brain’s RAM and Processing Speed ARE Impacted by Hormonal Changes During the Menopause Transition

Your claims of brain fog, senior moments, or whatever you want to call the small but frequent memory lapses you experience during the menopause transition are real, according to the findings of a new study just published in Neurology journal.

Researchers spent four years investigating the effects of the menopause transition and hormone use on three areas of cognitive function; processing speed, verbal memory and working memory.  They concluded that mid-life women, particularly those in the late-perimenopause stage (they haven’t have a period in three to 11 months) were not able to learn as well as they had during pre-menopause.  The good news is that their test scores eventually improved and rebounded to pre-menopause levels once they hit post-menopause (no period for 12 months), indicating that “menopause related cognitive difficulties may be time-limited.” … [Read more]