Survivor's Guide to Surgical Menopause
Most Women US Continue to Use HRT
HRT reduces diabetes rates in some women
Many women stop combination hormone replacement therapy
Hormone replacement does not improve cognition in elderly women
Menopause Comparison of HRTs finds progesterone causes less bleeding
Breast Cancer Study confirms risk of continuous combined HRT
Bone Improvements Gained With HRT Disappear After Stopping Therapy
Menopause Study Most herbal treatments lack punch
Arterial intima-media thickness: site-specific associations with HRT and habitual exercise
Gynecologists' trends and attitudes toward prescribing HRT during menopause
Women Taking HRT at Risk for Developing Gallstones
The hormone replacement therapy controversy
Hormone replacement therapy
Use Of Combination Hormone Replacement Therapy In Light Of Recent Data From The Women's Health Initiative
Be Careful Of What You Wish For: Putting The Whi Estrogen/Progestin And Hers II Trials In Perspective
Reflections On The WHI Findings: Avoiding A Pill Scare And Taking Sensible Steps Forward
Why Individualizing Hormone Therapy Is Crucial: Putting The Results Of The WHI Trial Into Perspective
Women Taking Hormone Replacement Therapy at Risk for Developing Gallstones
Effect of Long-Term Hormone Replacement Therapy on Atherosclerosis Progression in Postmenopausal Women Relates to Functional Apolipoprotein E Genotype
Menopausal Hormone Replacement Therapy and Risk of Ovarian Cancer
MANY US BREAST CANCER SURVIVORS USE ALTERNATIVES TO HRT
Why Individualizing Hormone Therapy Is Crucial
Use Of Combination HRT In Light Of Recent Data From The WHI
Different Types of HRT Have Varying Effects on CVD Risk Factors
Wyeth Changes HRT Labels to Reflect Cancer, Heart Disease Risks
HRT, Women, and Heart Disease: What We Need to Know About Prevention
Long-Term HRT May Raise Breast Cancer Risk Disproportionately in Hispanic Women
Menopause Two new HRT reviews support findings of recently halted clinical trial
HRT Associated With Lower MI Risk Among Some Diabetic Women
NIH Studies of HRT to Continue in Areas Where Benefits May Outweigh Risks
Alzheimer Disease Long-term ERT in postmenopausal women may worsen memory
HRT Deemed Useful for Prevention but Not Treatment of Alzheimer Disease
Re NIH halts study on HRT (doctors' response please)
Time Trends in the HERS Secondary Prevention Trial: Much Ado About Nothing?
Menopause Comparison of HRTs finds progesterone causes less bleeding, December 5, 2002
Combined HRT Has Cardiac Benefits in Older Hypertensive, Overweight Women
HRT and Its Relationship to Lipid and Glucose Metabolism in Diabetic and Nondiabetic Postmenopausal Women
HRT and Incidence of Alzheimer Disease in Older Women The Cache County Study
Not all HRT regimens the same
UK Experts: Continue HRT Trial, Despite US Results
HRT, Insulin Sensitivity, & Abdominal Obesity in Postmenopausal Women
Research shows HRT safe for cancer survivours
Facts about Hormone Replacement Therapy
Long-term soy consumption does not effect hormones in postmenopausal women
The Richard and Hinda Rosenthal Center - Menopause
menopause what to expect when your body is changing - Health Facts from your Family Doctor
FemHealth - Perimenopause and its treatment.
Women's Health Interactive Midlife Health Center - designed to help you make the most of your journey through perimenopause an
Menopause - Frequently asked questions
Menopause - Links
Help for Menopause
The Hormone Foundation
International Menopause Society
AMS - Menopause - Your Questions Answered
North American Menopause Society
Welcome to Menopause Canada
Menopause Consultant; Menopause Let's Talk About it with Pat Rackowski
Menopause - National Institutes of Health - with pictures
About Estrogen, Memory and Menopause
Welcome to Menopause and Beyond
The Physician and Sportsmedicine An Active Menopause
Menopause - Another Change in Life
Menopause - Doctor's Guide to the Internet
Menopause - Suite101.com
The British Menopause Society
Women's Health Coping With Menopause
Added Jan. 23, 2003
Depomedroxyprogesterone Acetate for Hot Flashes
Postmenopausal HRT Use Decreases Oxidative Protein Damage
SERMs offer safer alternative than HRT Most Women US Continue to Use HRT
Ending HRT leads to rapid bone loss in elderly women
National Cancer Institute Press Release Questions and Answers About Hormone Replacement Therapy
Menopause Myths and Medicine - Quantum TV Special & Website
HORMONE HERESY - Part 2
Q & A on Hormone Replacement Therapy and Breast Cancer Risk
National Institute On Aging Age PageHormone Replacement Therapy Should You Take It
Synthetic Generic Conjugated Estrogens
SYNTHETIC CONJUGATED ESTROGENS
Hormone Replacement Therapy What's a Woman to Do - News & Features
HRT May Pose Modest Increase In Ovarian Cancer Risk In Postmenopausal Women
HRT Reduces Arterial Calcification Of The Breast
Increased Breast Cancer Risk Declines With Discontinuation of HRT
HRT and cancer quantifying the risk
Alzheimer Disease Studies verify HRT can improve learning
HRT May Reduce AD Risk Among Older Women
The Clinical Impact of the Women's Health Initiative (WHI) Entering a New Era in Managing Postmenopausal Health Issues
Menopause Herbs that can ease the transition - Herbs for Health Staff - HealthWorld Online
Herb Research Foundation - Herbs and Herbal Medicine for Health
Osteoporosis Effects of Menopause on Osteoporosis.
Nutritional Programs for Menopause and Bone Health - Elson Haas, M.D. - HealthWorld Online - HealthWorld Online
Menopause and Bladder Control
No, not from what I've heard. Since insulin resistance is possibly the main source of PCO for many women, this does NOT go away just because the ovaries don't work.
Department of Obstetrics and Gynecology
Hyster Sisters - Hysterectomy Recovery
2) Breast cancer rates rose, hip fractures and colon cancer rates dropped. If you have colon cancer in your medical history, but no breast cancer, then this may not be a therapy you want to stop.
3) Using relative vs. absolute figures, manipulation of the math involved. Breast cancer rates went from 30 cases per 10,000 women (.003) to 38 cases per 10,000 women (.0038). While the percentages used were XX%, there were only 8 more cases per 10,000 per year.
4) Long term effects. Although breast cancer rates per woman per year increased, the death rates from breast cancer did not change. In fact, being on estrogen increases your chances of surviving breast cancer. Questions regarding increases or decreases in the rates of Alzheimer's can't be answered.
5) Alternatives and problems of stopping the drug immediately. Going without the drugs brings back hot flashes, vaginal atrophy and potential painful intercourse, loss of skin elasticity for starters. Are there any proven alternatives?
With this knowledge, when you are confronted with more media headlines or product pitches or internet information, start asking yourself the following questions: 1) What sort of terms are they using? Are they specific or are they general? Do they accurately name the product or problem in question?
2) What are the pros *and* cons of this product? Does the specific problem apply to myself and my medical history? How many of the symptoms apply to me?
3) What are the actual figures of increases, decreases and what is the total number of people they are using?
4) Are there alternatives to this drug that might be better for me? What happens if I go without this drug?
5) Is this a true scientific study (using double blind placebo methods preferably)? Most scientific studies will include a hypothesis or objective the study is trying to prove or disprove, with certain types of people who have the problem (Insulin Resistance, PCOS) or use the product in question (Metformin, Premarin, Prempro) and those who don't have the problem or take the product (known as the control group or placebo group). When it comes to products, it is preferable to have what is known as a double blind study, meaning neither the doctors/nurses giving the medication nor the patients know whether you are getting the placebo or the real medication. You especially want to ask questions about the people allowed in the study and those who aren't. If you are overweight, a study using overweight people may be of more relevance than one without.
6) Look for studies in major journals of that specific field of medicine. PCOS, for example, has its roots in endocrinology (regular and reproductive) and gynecology.
7) Are there other studies by other authors supporting the viewpoint who practice in the field? You want to know whether the effects can be reproduced by others in the field. Do the authors have any vested interest in proving something works or not? Is there a financial incentive that would prejudice them one way or another?
8) Are you dropping articles because you don't agree with them, or because they aren't medically valid?
9) Are you reading more into the article than what was studied? One example I'm familiar with is believing that a study comparing diet and exercise (58%) to Metformin (31%) in diabetes prevention means that you will get even better improvement with all three together. You may or may not because one variable may work so well it doesn't give you as noticeable effects with another.
10) What else is out there I need to look at to see if this applies to me and my situation?
What are some issues you want to look for in websites? I can relate that when creating my own website, I searched a number of reputable sites relating to the topic and came up with the following lists (4):
1) How current is the information?
2) Does the site go back to medical information found in books or journals a practicing health professional would know? Does it link to information from sites like this?
3) What are the authors' credentials? Can they be checked?
4) Does the author state the difference between opinions and medical facts? Do they discuss the fact that new information may not be widely accepted in the medical community?
5) Does the site sell a product, or link to products? Is it for information only? Does the information lead you to buy a product?
6) Where and what types of disclaimers are on the site in regards to the information?
7) Are you encouraged to develop a personal relationship with a health professional?
8) What kinds of privacy claims do they make?
9) Does the site subscribe to the HONcode of conduct or the eHealth Code of Ethics for medical and health web sites or similiar types of sites?
One other issue I want to address is physician knowledge and education. There was a time when doctors could keep up with most advances in medicine. Now medical knowledge is doubling every 7 years (27). There pretty much is no way to keep up with it all. Especially in the area of obstetrics and gynecology, there is not only advances in ob/gyn to keep up with, but in surgery. It is therefore incumbent upon women to know and obtain a small, sound base of knowledge and familiarity with their conditions. What I want to establish with this is to reiterate some previously made points: 1) natural does not always mean completely safe or that they will work with your body better than prescription drugs
2) natural products do NOT have to be tested (such as in regular prescription drugs) before being sold
3) natural product makers do NOT have to report health problems resulting from their use
4) natural products may or may not come in a strength or delivery method your body can use
5) always let your physician (if you have one) know of any vitamin or supplement you are taking. It may or may not have an effect on any other drug you are taking
6) natural product makers can make claims that can fly in the face of regular biology/medicine
Bibliography: (1) The Truth About Hormones
(2) What Did the Study Show?
(4) VCU library
(26) Complementary And Alternative Medicine from WebMD Scientific American® Medicine, Adrian S. Dobs, MD, MHS; Bimal H. Ashar, MD, and SAMED.
(27) 40 years ago, a physician could single-handedly process enough of the existing medical knowledge to competently manage most situations. Today, with approximately 7 million medical articles in print, that is impossible.