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dr. phuli's blog

Hormones For “Older” Women

Monday, February 1st, 2010

Okay, in the last 2 days I have stumbled across 2  letters to “Dear Annie” in the Boston Globe concerning “older” women lacking sex drives.

One of the women was in her early 60’s, the other was only 48 years old. Both were  lumped into the, “sorry that menopause has taken it’s toll,” category. The advice offered to both was pretty much, “suck it up,”  (literally), and  see a counselor. In both instances NO mention of hormone support was offered. Such a sad state. Unfortunately I am certain we are not the only state where this is happening!

So, for you “older” women out there, here is my advice: you can, and SHOULD use hormone support if you are suffering, no matter what your age. Yes, you are hearing me correctly, there is NO age ban for women to use hormones, even though we have been ill-advised to run from all hormones, especially women over the age of 60.

Why all the misinformation? It stems from the infamous WHI study that showed an increase in heart disease and stroke in women 60 years old and over. As you know from my book, the WHI study had many flaws such as: only carcinogenic Provera was used to substitute for progesterone, only oral horse estrogen (Premarin) was used, by mouth, most women studied had not previously used hormones, so they were already at an increased risk for heart disease and stroke, many women had preexisting heart disease, and most of the women had no complaints, so they did not need hormones at all.

Nothing, and I mean NOTHING improves a woman’s sex drive better than estrogen. Sure testosterone helps, but without estrogen there is no bell ringing and probably a little too much soreness to be thrilled. I know from years of clinical experience with hundreds of women, and I know firsthand, as I am “an older” woman myself.

You can safely use estrogen. I recommend vaginal Estriol (my favorite brand, made by Bezwecken, is available  on the internet), and transdermal Estradiol, (balanced with Progesterone), available from your doctor. If he or she is unenlightened please slip them a copy of my book which has hundreds of references supporting my advice.

Studies have clearly shown that transdermal estrogen does NOT increase clotting, but  estrogen given by mouth does. Natural forms of Progesterone are not the same as Provera, chemically or biologically. Provera has been shown to increase the risk of heart disease.

Transdermal estrogen is available using skin patches, gels, sprays, or creams. All are FDA approved, except compounded creams which cannot be FDA approved because compounded things MUST be regulated by their own approval boards, not the FDA.

In addition to sex hormones, DHEA has been shown to increase a woman’s “vitality,” (yes that’s the term used in the study), and also raises testosterone in women. Viagra does not do much for the sex drive of men and women. Viagra, and similar drugs, pushes the “joy stick,” but it does not make the driver more amorous. Testosterone in men (and some women) is necessary for that. Please go forth and enjoy at all ages!

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Mammogram Debate

Wednesday, November 18th, 2009

Okay, once again we woke up to new recommendations, from the latest study, telling us to change everything we’ve been indoctrinated to do about our breasts.

Until now we’ve been “ordered” to endure mammograms, no matter who we are, and what we think, every year,only to be told this morning, “Oops, we got that  that wrong- let’s not do mammograms at all, at least until you are 50.” Confused? Who wouldn’t be. That’s why I always tell women to take control of their health, and not be swayed by the latest headlines. Look critically at all the facts, stay calm, and listen to your own body.

I can pretty much guarantee that in 5 years the latest hormone recommendations, which have for now swung away from any hormone support, will swing back and we’ll be waking up in years to come thinking “I knew I should have been doing that!”

So, what do I think about the latest recommendations? Like always it comes back to common sense and being proactive with your health. Regarding mammography, if you have a strong family history, get a baseline at age 40 and if all looks good i.e. no calcifications, or other suspicions, get another by age 45 and continue to monitor as you and your doctor see fit.

You can even do better. Make sure that your estrogen is balanced by progesterone. Studies have shown that women with progesterone deficiency have an increased risk of breast cancer. Iodine deficiency is also linked with breast cancer. At any age I recommend doing genetic screening for problems with hormone metabolism. There are several companies out there, I use Genovations. The important thing is to find a lab that has a doctor that you can follow with to review results and advise supplementation to improve your metabolism.  I discuss this in detail in the  “Hormone Safety” chapter  in my book.

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Attitude

Wednesday, November 18th, 2009

As many of you are aware, I have been recovering from disseminated Lyme. I am doing much better and hope to be regualarly blogging and speaking in the very near future.  I recently found this quote and thought I would share it with you, as it has brought me inspiration.

“The longer I live the more I realize the impact of attitude on life. Attitude is more important than education, than money, than circumstances, than failures than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. The remarkable thing is we have a choice everyday regarding the attitude we will embrace for the day.

We cannot change our past.
We cannot change the fact that people will act in a certain way. We cannot change the inevitable.

The only thing we can do is play on the one string we have and that is our attitude…

I am convenienced that life is 10% what happens to us and 90% how we react to it.”

By Charles Swindoll

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