Sounds like a great talk. Do you happen to have a Powerpoint presentation
you'd be willing to share?
--
Larry R. Glazerman, MD
Ob-Gyn at Trexlertown, PC
610-402-0161
l.glazerman@rcn.com
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Karen Lee
Sent: Sunday, May 09, 2004 10:41 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Bioidentical Hormone Replacement Therapy
I recently gave a community talk on
"Hormones..."The Fear Factor" where I explained
the WHI findings in terms that made the absolute
risk understadable (so the audience said) and I
had the benefit that the Premarin arm of the
study had been published showing the Premarin
results:-) As part of that talk I explained the
saliva testing that is being touted by a local
compounding pharmacy and showed an over head re
the menstrual cycle and the insanity that a
saliva test will "tell me where I am in
peri-menopause". Then I explained "natural",
"synthetic" and "bio-identical" with emphasis on
the fact that you can eat a bushel of soy or yams
and it is not estrogen! Hence everything has to
be synthesized, even the 'compounded
bio-identical' hormones are synthesized. I then
showed them the labels on Estradiol pills,
patches, Prometrium, etc. Then explained the
delivery systems and the fact that we have no
useful study on the compounded creams that they
are told to apply to various body parts,
including the clitoris. In my practice I have
narrowed that talk down to a few minutes, since
most of my practice is women who have been with
me a long time and already trust me. For the new
ones I give them the audio and the handout notes
from the 'fear 'factor' and make it homework and
continue the talk in one week if necessary, often
just over the phone as they usually make up their
mind by then that anything I prescribe that I say
is bio-identical will be ok with them. So, yes,
even Premarin! But not Prempro.
--- Angela DeTie CNM <Angcnm@aol.com> wrote:
> Recently I have had numerous women inquiring
> about Bioidentical Hormone
> Replacement Therapy (BHRT). Since I'm working
> and unable to watch
> OPRAH, I seem to know less than my patients!
> AND, they find it shameful
> that as a midwife, I don't know about it!
> Frankly, I've been selectively
> tuning out anything that I hear of lately that
> has to do with hormones!
> Does anyone have any experience with BHRT, or
> know of any "reliable"
> literature? Has anyone had any difficulty with
> compounding pharmacies.
> Does this pose any different risk to us as
> compared to prescribing
> traditional HRT (obviously after thorough
> counseling)? I tell you, we've
> had several calls recently regarding the
> lawsuits for taking HRT and it
> makes me sick. I even hate reading the paper
> anymore because I see the
> ad everyday. It makes me want to remove this
> component of care from my
> pratice. But alas, I'm a midwife and we are
> "With woman...For a
> lifetime of care". Besides, it seems that as
> everyone throws out their
> PremPro, they'll be running to this soon and "I
> don't know" doesn't seem
> to b a suitable answer aymore.
> Thanks for any info you can provide.
>
> Angela DeTie APN, CNM
> "clueless in Vegas"
>
=====
Karen Lee, ARNP
OB/GYN Nurse Practitioner
Certified Menopause Practitioner
Mount Vernon, WA
"Courage is the opposite of the instinct to keep everything under control.
It is against inertia and death, toward intensity and life. The little
courages of life add up to big courage over time. Resist the offers of small
safe quarters in your mind."
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