Posts made in February, 2009

Toasted

Posted by Liz on Feb 27, 2009 in humour | 5 comments

Happy Friday! Hope it’s flash-free!

Wednesday Bubble: Just say “no”

Posted by Liz on Feb 25, 2009 in bone health, breast cancer, hot flash, HRT, nightsweats | 4 comments

Gonna burst that hormone bubble at least one more time. Seems that the synthetic hormone Livial, which is billed as an alternative to HRT, significantly increases the risk of breast cancer recurrence. Ouch!

Livial is a selective tissue estrogenic regulator (SERM), which mimics estrogen’s activity with regards to strengthening bones. The agent has mostly been marketed in Europe for treatment of hot flashes, night sweats and bone loss, as well as a treatment for osteoporosis.

In a study reported in the current issue of The Lancet Oncology, researchers evaluated the effectiveness of 2.5 mg/day of Livial compared to placebo  in more than 3,000 women with a history of breast cancer. Although the agent had a positive effect symptoms and bone density, the trial was stopped six months early because women taking Livial had a 40% increased risk of having their breast cancer return.

The researchers state that the likely reason for this increase is that Livial interferes with the protective effect of different cancer drugs and might stimulate dormant tumors to become active again.

Clearly, Livial should not be used in women with a history of breast cancer. Then again, with data definitively showing an increased risk of cancer and heart disease with use of hormone therapy, why take a chance to begin with?

What are your thoughts? Is estrogen worth the risk for a few less symptoms? Or are you better off taking an alternative route?

Talking the talk: hormone therapy

Posted by Liz on Feb 23, 2009 in health, general, HRT | 2 comments

Is your healthcare provider more or less likely to suggest hormone therapy (HT, estrogen only) when you see them for menopausal symptoms? What’s more, how do you know?

Results of a study in the Ahead of Print edition of the journal Menopause suggest that certain factors do influence prescriber habits.

Researchers measured how often 249 primary care (i.e. internists and family practitioners) and ob/gyns prescribed HT to their patients (ages 45 to 80) in a given year based on electronic pharmacy data. In addition to examining information on the providers themselves, data on perceptions of patients’ views on the Women’s Health Initiative trial results (WHI, which examined the link between HRT and heart disease), provider views on the WHI study and how prepared they felt to counsel patients were also analyzed. 57% of the providers in the study were women.

The findings? How often HT was prescribed appeared to vary by geographical location and the number of years a provider had been at a specific organization (which may reflect the age of the provider). More than half of those surveyed believed that they had expert knowledge about data coming out of recent HT trials.

In fact, primary care providers who felt that they had this degree of knowledge were significantly more likelier than their colleagues who did not to recommend hormone therapy.  In contrast, ob/gyns who were more likely to prescibe HT were those who believed that they well prepared to counsel their female patients on hormone therapy. These practitioners also tended to believe that the results of the trials had been exaggerated.

Regardless of specialty,  younger patients and patients who did not have other diseases that may exacerbate risk were most often prescribed HT.

So, what do these study results mean exactly?

The researchers write that HT prescribing may be “driven by factors outside of evidence-based medicine,” such as prescriber self-perception and age. If this is true, then the lack of provider bias could potentially influence prescribing habits and in turn, exposure to HT.

As the researchers say, “women, who when inquiring about HT risk and benefits, deserve unbiased and well informed counseling to make informed decisions.” And that it “is likely that some doctors need additional training to ensure this level of advice.”

For you, this means to be sure to be prepared when you make that first appointment to discuss therapeutic options for troublesome menopausal symptoms. Do the homework before you enter your provider’s office so that you are ready to ask the right questions.

In addition to the link provided above, which discusses the WHI data in detail, I encourage you to visit the following sites for unbiased information about menopause and its treatment:

Women to Women

Dr. Christiane Northrup, M.D.

Health E Woman

Consumer Reports Health.Org

The bottom line is that if your provider is talking the talk, be sure that you know why you’re going to walk the walk.

There ain’t no men in menopause…and other musings for a Friday

Posted by Liz on Feb 20, 2009 in general | 4 comments

[youtube=http://www.youtube.com/watch?v=1ZJQlddwuvY&feature=related]

Have I got your attention now? Hope so. ‘I’ve said it before and I’ll say it again.  More times than those two and a half men can sing “men.”

It’s. Not. All. About. You.

Here’s some information from an earlier post:

There’s a misnomer going around (can a misnomer go around?). It’s called “male menopause.” Now mind you, I’ve got no beef with da guyz but to call a gradual decline in testosterone “menopause,” seems a bit extreme. So, what’s the buzz about?

According to the Mayo Clinic, menopause and “andropause” are two distinct animals. During menopause, women undergo a cessation of menstruation and a rapid plummet in hormone production. On the other hand, men experience gradual declines in testosterone production after age 40. However, some men continue to produce high levels of testosterone well into their older years. What’s more, the problem does not appear to be universal; symptoms of testosterone decline, which may include reduced sexual desire and spontaneous erection, swollen breasts, a loss of hair from the body and around the genitals, loss of muscle mass, depression, and rarely, hot flashes and sweats vary from man to man and some men never experience any symptoms whatsoever.

In fact, back in October, I cited data suggesting that there is insufficient evidence supporting a decline in androgen in a majority of men and that “the extent to which an age-dependent decline in androgen levels leads to health problems that might affect or alter the quality of life remains under debate.”

Further, the medical community is not only in disagreement over “male menopause” but also its treatment.
There’s lots of controversy over testosterone replacement therapy and whether or not it actually helps the symptoms of androgen deficiency. What’s more, research suggests that a large majority of men experiencing symptoms of androgen deficiency do not seek care. (No surprise there, right?!)

Okay, so now that we’ve got that straight, may I reiterate that it’s not all about you?

I  ran across a disturbing piece in this past Tuesday’s Washington Post about how and why the country’s economic crisis is taking a greater toll on men.  Entitled “Economic Crisis Hits Men Harder,“ the article relies on the psychotherapist and author Jed Diamond who is at the forefront of the male menopause movement. In addition to expounding on the distinction between male menopause and irritable male syndrome (for which Diamond continues to claim that he has supportive data)  Diamond says:

“The loss of jobs, economic situations, crashing — it affects men in a profound way. The chaos is affecting men in very, very powerful and negative ways…Men have a less resilient emotional system; women’s brains are more networked from left to right. They are balanced socially. Men tend to be more isolated” (and therefore, don’t have as much social support).

I agree with Diamond’s point that women tend to turn to social support in times of stress and therefore, may be able to deal with it more effectively than their male counterparts. However, to  minimize the impact on a majority of the population, many of whom work multiple jobs while simultaneously caring for families, well, that’s just wrong. In fact, economic development expert Sara Gould writes that “the current instability roiling Wall Street’s markets will lead to an increasingly dire economic situation for women. This is especially true for low-income women, women of color, single mothers and others who have long experienced the disproportionate impact of flawed economic policies.”

So, if women are bearing the brunt of the crisis and are facing increasingly dire situations, is it accurate to say that the economic crisis hits men harder? And likewise, is it reasonable to take a life transition that is as natural to women as breasts and recreate it in the male image?

What do you think? I smell a rat and his name is Jed.

[You can find this post and other goodies on BitchBuzz]

News Flash! HR 584

Posted by Liz on Feb 19, 2009 in Uncategorized | 2 comments

I just learned that Representative Barbara Lee (D-CA) is sponsoring a new legislation (HR-584) that would provide  “for coverage of hormone replacement therapy for treatment of menopausal symptoms, and for coverage of an alternative therapy for hormone replacement therapy for such symptoms, under the Medicare and Medicaid Programs, group health plans and individual health insurance coverage, and other Federal health insurance programs.”

This is huge. I’m tracking it down to see if I can learn more. If you have any additional information, write to me at flashfree111@gmail.com.