Re: Bioidentical Hormone Replacement Therapy
From: Karen Lee (karen@karenlee.org)
Sun May 9 13:27:51 2004
I'll send you my outline and my overheads. I'm
not yet power point literate:-(
--- Larry Glazerman <l.glazerman@rcn.com> wrote:
> Karen:
>
> 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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