ACUFLASH
Researchers are studying whether or not Traditional Chinese Medicine acupuncture care plus self-care can effectively relieve hot flashes.
The ongoing study, known as the ACUFLASH trial, is examining acupuncture as a complete treatment package, a standardized (rather than haphazard) approach in which following diagnosis, the patient receives treatment in specific points. Each practitioner is also free to add individualized points to treat other symptoms related to the menopause, such as depression, anxiety and insomnia. Treatment will comprise up to 10 sessions over 12 weeks, and may also include soy, dietary supplements and herbal medicine.
Study participants will receive either acupuncture treatment as described or self care alone (over the counter drugs, self-provided interventions such a soy and herbal supplements). Participants may also use any additional care such as massage or prescribed medications but these interventions will be followed up, registered, and analyzed accordingly.
Traditional Chinese Medicine Acupuncture uses diagnostic methods according to principes of Traditional Chinese Medicine. Acpunture is believed to affect the autonomic and central nervous systems which directly influence hot flash activity.
Early data looking at patient experiences demonstrates that many women receiving acupuncture treatment have reported substantial impact in terms of a reduction in the frequency and severity of their hot flashes both during the day and at night. They also report better sleep, and improvements in mood.
Sounds very promising, doesn’t it? What’s your experience with acupuncture? Care to share?
Read MoreTalking the talk: hormone therapy
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:
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.
Read MoreNews Flash! HR 584
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.
Read MoreWednesday “Bubble:” Bioidentical “hormones”
Quotation marks are used to signal the reader that something is important. Sometimes their use works counter to their intention. In this highly sarcastic editorial in Menopause Management, the esteemed Dr. Wolf H. Utian, president of the North American Menopause Society (NAMS), demonstrates what happens when quotation marks and information, go wrong.
The first indication that something was awry was a press release I received from NAMS confirming the Organization’s support of the FDA position on bioidenticals and reiterating their dangers. This release, like many others, was a direct response to informercial actress Suzanne Somers (who looks to be age 30) and her two-day miracles of plastic surgery bioidenticals sound-off on the Oprah Winfrey show last month.
No wonder the wagons have started to circle.
And yet, Dr. Utian’s assertion that supporters of bioidentical hormones be thrown into one categorical cult set out to acquire/garner the publicity around so-called “natural” therapies” does a huge disservice to the very women he proports to be protecting.
Warning that this new “cultlike” phenomenon of compounding bioidentical hormones will end in the courtroom and that folks should not anticipate supporting evidence from real experts, Dr. Utian states that the majority of the most significant national medical associations and societies are now coming out with statements of reservation about the bioidentical cult.
To healthcare practitioners everywhere, he warns that the responsibility to counsel women about risks and benefits of all pharmacotherapies is yours. You sign the prescription, you carry the liability. It’s time to tell women, “Buyers beware!”
I think it’s time to tell women to do their research, consult with an accredited practitioner, and follow your heart and head. I believe it’s time to take back our bodies and stop treating menopause like a disease for which “one size fits all.” And I think it’s time to tell government that we know the reach and influence of Big Pharma and that it time to question the rationale behind applying Western methodology to every type of integrative therapy in order measure its effectiveness.
Don’t drink the Kool-Aid
So, dear readers. Dismiss Suzanne Somers and her promise of youth forever. Don’t drink the Kool-Aid. But do your homework, talk to real practitioners not cutting edgers trying to cash in on the latest craze, and assuage your symptoms responsibly.
I wrote about bioidentical hormones last June. I am reposting it now rather than sending you back in time. The more things “change,” the more they stay the “same.”
Be safe. Be well.
Bioidenti what? [originally posted, June 13, 2008]
Bioidentical hormones (also known in many circles as “compounded biodentical hormones”) are compounds that have exactly the same chemical and molecular structure as hormones produced in the human body. The term is most often used in the context of estrogen and progesterone (and androgens), although any hormone can be made this way. Notably, there are a few of these agents that are actually FDA-regulated and available from retail and not compounding pharmacies (meaning that dosage and purity are theoretically on par with synthetic types).
There’s been a lot of hullaballoo over these products from many of the major associations that are involved in women’s health (e.g. The Endocrine Society, North American Menopause Society) primarily because: 1) they are not regulated by the FDA or have any oversight whatsoever and 2) potency is inconsistent. In fact, the FDA sent warning letters to nine pharmacies in January due to what the agency felt were unsupported claims about safety and effectiveness.
FDA does not just randomly go after pharmacists who practice traditional compounding and who don’t make false claims about their products. Traditional compounding, in fact, involves the preparation of a drug for a specific patient based on a doctor’s request.
Consequently, FDA action might have been driven, in party, by Wyeth Pharmaceuticals, who filed a Citizens Petition that claimed: 1 that compounding pharmacies were not actually compounding but “manufacturing” mimics of approved agents; 2) that they used a form of estrogen known as “estradiol” not commonly found in “traditional” hormone therapies; 3) that they were engaging in illegal promotional practices. (BTW, Wyeth manufactures several estrogen products, including Premarin, Prempro, and Premphase.) You can read the rest of the petition here.
It’s important to recognize that not all compounded products are bad. In fact, compounding pharmacies continue to provide options to patients with contraindications to commercially-produced therapies. An article in a large monograph sponsored by the North American Menopause Society explains that pharmacies were compounding micronized progesterone years before an agent (Prometrium) was approved in the US. It also goes on to highlight several advantages that compounded hormones might offer over conventional products, including greater dosing flexibility, lower doses for women who are especially sensitive and the avoidance of potential allergens.
Organizations such as the International Academy of Compounding Pharmacists (IACP) have become quite outspoken about what they consider to be the FDA’s interference in physician decisions to prescribe estriol to their patients. Congress has even introduced a bipartisan-sponsored bill (Resolution 342) to reverse the FDA’s decision on estriol. There’s a website that further explains these efforts.
In the meantime, if you decide you want to try bioidentical hormones, speak to your health practitioner. S/he can devise a regimen that best meets your needs (and not the needs of the masses) and may be able to recommend a credible compounding pharmacy. The IACP might also be able to assist with your search.
Read MoreHi ho, hi ho….
It’s off the work we go.
I’ve seen this joke a zillion times. And I’m not amused.
But seriously. A study reported in ‘Ahead of Print’ edition of the journal Menopause suggests that a majority of menopausal women report daily physical or emotional symptoms that significantly affect their daily personal, professional and social lives.
Researchers surveyed 961 members of the National Association of Female Executives about their knowledge and understanding of hormone replacement therapy. The participants were divided into subgroups based on whether or not they were pre-, peri-, menopausal or post-menopausal.
Among study participants, 88% reported personal experiences with menopause, 95% had physical symptoms and 79% had emotional symptoms. Some 40% said that these symptoms caused problems in at least one area of their lives. More than a third of women who used HRT to treat symptoms cited the health concerns as a reason for discontinuing.
Undoubtedly, individualized care is critical to improving quality of life for women in or around menopause. Indeed, the researchers cite this in their conclusion. But when it comes to our professional lives, how can we improve our daily experiences when hormones are wreaking additional havoc on daily stressors and challenges?
I would like to suggest that integrative therapies may offer a path to salvation. For example, pace respiration or meditative breathing can easily be done at your desk or even on a park bench during a lunch break. A 1995 article in Menopause found a decline in the number of hot flashes and average skin temperature among women who practiced breathing exercises.
Paced respiration involves deliberate inhalation and exhalation of air.
- Sit comfortably
- Inhale for 5 seconds through your diaphragm (the goal is to fill your diaphragm, not your upper lung area), pushing your diaphragm out
- Exhale for 5 seconds, pulling your diaphragm in and up
- Repeat several times
Another technique is known as “counting breath:”
- Sit in a comfortable position with your spine as straight as possible
- Count your inhalations and exhalations. When you inhale for the first time, think “one.” When you exhale, think “one.” Next, think “two,” and so on. Continue until you reach 10
- If you have time, start over again and do another set of 10
- The ultimate goal is to 5 sets
Meditation takes time and practice so try not to beat yourself up if your mind wanders while doing either of these exercises. The primary goal is to focus on your breathing and to calm your inner and outer fire.
Any other practices that work for you? I’d love to hear!
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