Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 I was informed by a endocrinologist that bioidentical hormones come from Hog's intestines so unless one is a hog they are not natural. Any thoughts?/ I practice in the desert and practically all the patients who come to me are on bio identical horm, unfortunately I don;t know much about them so please share info. Thanks, MalaSee what's free at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 Yes! That’s the only form of hormones I use typically, and most pts agree – they prefer them (estradiol and prometrium). Although I usually prescribe them for CV benefits (as long as <2 yrs since menopause), most women take them for symptom control. Just make sure they take ASA with it, 162mg, higher if they are a smoker, no hx of DVTs, etc. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of britneyj26 Sent: Friday, April 20, 2007 10:32 AM To: Subject: Bioidentical hormones Hi gang! It's me and my goofball questions again! Does anyone prescribe bioidentical hormones? I'm curious to hear the experience of others Hugs, Britney Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 I don't know very much about the topic, but here is something from the Mayo Clinic on it: http://www.mayoclinic.com/health/bioidentical-hormones/AN01133 There is a lot of interest in bioidentical — or so called " natural " — hormone therapy for menopause symptoms. However, there is no evidence that bioidentical hormones are safer or more effective than standard hormone replacement therapy. The Endocrine Society's Position Statement on bioidentical hormones says the same thing: http://www.endo-society.org/publicpolicy/policy/upload/ BH_Position_Statement_final_10_25_06_w_Header.pdf The controversies surrounding the safety and efficacy of “bioidentical hormones” illustrate the need for further scientific and medical scrutiny of these substances. Until such studies are completed, physicians should exercise caution when prescribing “bioidentical hormones” and counsel their patients about the controversy over the use of these preparations. Additionally, patients should educate themselves about hormone therapies and engage in candid discussions with their doctors. Much consideration should be given to the decision to undergo any hormone therapy, and “bioidentical hormones” present unique and additional concerns because of the process by which many of them are made. I take this not to imply that bioidentical hormones are bad or ineffective, but that there is insufficient evidence to say that they are better or worse than regular hormones. I have some patient who swear by them and wouldn't dream of taking anything else, but it is not for everyone. When someone like Suzanne Somers is promoting it, I can't help but wonder if this will turn out to be another medical fad. Seto South Pasadena, CA > Hi gang! > > It's me and my goofball questions again! > > Does anyone prescribe bioidentical hormones? I'm curious to hear the > experience of others > > Hugs, > > Britney > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 Bioidentical means same molecule as present in human body, is not synonymous with “natural”. Some biodentical HRT is synthesized from plant source. Some HRT is “natural” but not bioidentical such as premarin. It gets confusing. T. Ellsworth, MD 9377 E. Bell Road, Suite 175 sdale, Az 85260 From: [mailto: ] On Behalf Of DocSingh760@... Sent: Friday, April 20, 2007 10:09 AM To: Subject: Re: Bioidentical hormones I was informed by a endocrinologist that bioidentical hormones come from Hog's intestines so unless one is a hog they are not natural. Any thoughts?/ I practice in the desert and practically all the patients who come to me are on bio identical horm, unfortunately I don;t know much about them so please share info. Thanks, Mala See what's free at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 It is possible that I don't know how to dose them correctly, but I haven't been impressed that they are that much better than vivelle-transdermal estradiol and prometrium. I always tell patients that there are no studies that indicate that they are safer than regular estradiol and provera and one should assume that there is a slightly greater risk of breast cancer as with other forms of HRT. I would likely recommend a transdermal form of estradiol as it reduces the clotting risk of estrogen quite a bit. I never prescribe conjugated estrogen-provera anymore. I never know whether to use serum levels or symptoms to adjust dosage, so I do a combination approach. I don't use salivary levels anymore as they are rarely paid by insurance and serum levels are. Most places will give a fractionated estrogen level if requested. I tried bioidentical hormones myself for about a year and found that I lost more bone density than when I was on vivelle. I don't thiink that I felt much different. Lots of hot flashes,etc off HRT, much better on. I do believe that there are selected women that notice a big difference in symptoms relief. Vivelle spot is nice in that it is less than the size of a postage stamp and there is much less likelihood of developing rashes in reaction to the patch. Kathy Broman Mason City, IA >I don't know very much about the topic, but here is something from >the Mayo Clinic on it: >http://www.mayoclinic.com/health/bioidentical-hormones/AN01133 > >There is a lot of interest in bioidentical ? or so called " natural " ? >hormone therapy for menopause symptoms. However, there is no evidence >that bioidentical hormones are safer or more effective than standard >hormone replacement therapy. > >The Endocrine Society's Position Statement on bioidentical hormones >says the same thing: >http://www.endo-society.org/publicpolicy/policy/upload/ >BH_Position_Statement_final_10_25_06_w_Header.pdf > >The controversies surrounding the safety and efficacy of >?bioidentical hormones? illustrate the need >for further scientific and medical scrutiny of these substances. >Until such studies are completed, >physicians should exercise caution when prescribing ?bioidentical >hormones? and counsel their >patients about the controversy over the use of these preparations. >Additionally, patients should >educate themselves about hormone therapies and engage in candid >discussions with their doctors. >Much consideration should be given to the decision to undergo any >hormone therapy, and >?bioidentical hormones? present unique and additional concerns >because of the process by which >many of them are made. > >I take this not to imply that bioidentical hormones are bad or >ineffective, but that there is insufficient evidence to say that they >are better or worse than regular hormones. I have some patient who >swear by them and wouldn't dream of taking anything else, but it is >not for everyone. When someone like Suzanne Somers is promoting it, I >can't help but wonder if this will turn out to be another medical fad. > > Seto >South Pasadena, CA > > > >> Hi gang! >> >> It's me and my goofball questions again! >> >> Does anyone prescribe bioidentical hormones? I'm curious to hear the >> experience of others >> >> Hugs, >> >> Britney >> >> >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 Its my understanding that the estrogen in Vivelle and Climara patch are bioidentical T. Ellsworth, MD 9377 E. Bell Road, Suite 175 sdale, Az 85260 From: [mailto: ] On Behalf Of Kathy Broman Sent: Friday, April 20, 2007 12:01 PM To: Subject: Re: Bioidentical hormones It is possible that I don't know how to dose them correctly, but I haven't been impressed that they are that much better than vivelle-transdermal estradiol and prometrium. I always tell patients that there are no studies that indicate that they are safer than regular estradiol and provera and one should assume that there is a slightly greater risk of breast cancer as with other forms of HRT. I would likely recommend a transdermal form of estradiol as it reduces the clotting risk of estrogen quite a bit. I never prescribe conjugated estrogen-provera anymore. I never know whether to use serum levels or symptoms to adjust dosage, so I do a combination approach. I don't use salivary levels anymore as they are rarely paid by insurance and serum levels are. Most places will give a fractionated estrogen level if requested. I tried bioidentical hormones myself for about a year and found that I lost more bone density than when I was on vivelle. I don't thiink that I felt much different. Lots of hot flashes,etc off HRT, much better on. I do believe that there are selected women that notice a big difference in symptoms relief. Vivelle spot is nice in that it is less than the size of a postage stamp and there is much less likelihood of developing rashes in reaction to the patch. Kathy Broman Mason City, IA >I don't know very much about the topic, but here is something from >the Mayo Clinic on it: >http://www.mayoclinic.com/health/bioidentical-hormones/AN01133 > >There is a lot of interest in bioidentical ? or so called " natural " ? >hormone therapy for menopause symptoms. However, there is no evidence >that bioidentical hormones are safer or more effective than standard >hormone replacement therapy. > >The Endocrine Society's Position Statement on bioidentical hormones >says the same thing: >http://www.endo-society.org/publicpolicy/policy/upload/ >BH_Position_Statement_final_10_25_06_w_Header.pdf > >The controversies surrounding the safety and efficacy of >?bioidentical hormones? illustrate the need >for further scientific and medical scrutiny of these substances. >Until such studies are completed, >physicians should exercise caution when prescribing ?bioidentical >hormones? and counsel their >patients about the controversy over the use of these preparations. >Additionally, patients should >educate themselves about hormone therapies and engage in candid >discussions with their doctors. >Much consideration should be given to the decision to undergo any >hormone therapy, and >?bioidentical hormones? present unique and additional concerns >because of the process by which >many of them are made. > >I take this not to imply that bioidentical hormones are bad or >ineffective, but that there is insufficient evidence to say that they >are better or worse than regular hormones. I have some patient who >swear by them and wouldn't dream of taking anything else, but it is >not for everyone. When someone like Suzanne Somers is promoting it, I >can't help but wonder if this will turn out to be another medical fad. > > Seto >South Pasadena, CA > > > >> Hi gang! >> >> It's me and my goofball questions again! >> >> Does anyone prescribe bioidentical hormones? I'm curious to hear the >> experience of others >> >> Hugs, >> >> Britney >> >> >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2007 Report Share Posted April 20, 2007 TRY LOOKING AT DIANA SCHWARZBEIN'S BOOK THE PROGRAM ALSO WOMANS INTERNATIONAL PHARMACY HAS A GREAT PROGRAM ON THIS SORRY ABOUT THE CAPS THE COMPUTER GOT STUCK. > Hi gang! > > It's me and my goofball questions again! > > Does anyone prescribe bioidentical hormones? I'm curious to hear the > experience of others > > Hugs, > > Britney Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2007 Report Share Posted April 21, 2007 I looked this up recetnly for a patietn who was very colored by a suzanne somers book and decided that i would not prescribe these things. jessica is right about some of the proudcts that we know, being indeed bioidentical already. We get into this bias on the part of pattietns as not wanting to take anyhting manufactured.Partly this is becasue of real reasons people lose credibility in the maufcaured d rugs.Look at what gets taken off the market after heavy advertising(say vioxx) Natural s does not mean good. MY husbdan says Dog poop is natural Ya gonna eat that? It is always crucial that we practice evidence based medicene -adn see gary's post -there isn;t any about these products really that says better safer or more efficacious IT is important that we practice evidence based medicien inthe context of hearing the patietn out I cna hear people out and still not prescribe just what they WANT It is so feel good to jump on bandwagons Half of US have hot flashes OK maybe not gary or gordon but the rest of us.. and these thigns come fromt hese compunding pharmacies often which I looked into in depth a few yrs ago as marketing transdermal meds for pain that I could not find one spot of litaerture on, so it is best as always to go slow, listen to patietns, but not put your name on anything that you cannot back up. Is it hot in here or what ? Re: Bioidentical hormones It is possible that I don't know how to dose them correctly, but I haven't been impressed that they are that much better than vivelle-transdermal estradiol and prometrium. I always tell patients that there are no studies that indicate that they are safer than regular estradiol and provera and one should assume that there is a slightly greater risk of breast cancer as with other forms of HRT. I would likely recommend a transdermal form of estradiol as it reduces the clotting risk of estrogen quite a bit. I never prescribe conjugated estrogen-provera anymore. I never know whether to use serum levels or symptoms to adjust dosage, so I do a combination approach. I don't use salivary levels anymore as they are rarely paid by insurance and serum levels are. Most places will give a fractionated estrogen level if requested. I tried bioidentical hormones myself for about a year and found that I lost more bone density than when I was on vivelle. I don't thiink that I felt much different. Lots of hot flashes,etc off HRT, much better on. I do believe that there are selected women that notice a big difference in symptoms relief. Vivelle spot is nice in that it is less than the size of a postage stamp and there is much less likelihood of developing rashes in reaction to the patch. Kathy Broman Mason City, IA On Friday, April 20, 2007, at 12:31PM, " Seto " < glseto@... <mailto:glseto%40mac.com> > wrote: >I don't know very much about the topic, but here is something from >the Mayo Clinic on it: > http://www.mayoclin <http://www.mayoclinic.com/health/bioidentical-hormones/AN01133> ic.com/health/bioidentical-hormones/AN01133 > >There is a lot of interest in bioidentical ? or so called " natural " ? >hormone therapy for menopause symptoms. However, there is no evidence >that bioidentical hormones are safer or more effective than standard >hormone replacement therapy. > >The Endocrine Society's Position Statement on bioidentical hormones >says the same thing: > http://www.endo- <http://www.endo-society.org/publicpolicy/policy/upload/> society.org/publicpolicy/policy/upload/ >BH_Position_Statement_final_10_25_06_w_Header.pdf > >The controversies surrounding the safety and efficacy of >?bioidentical hormones? illustrate the need >for further scientific and medical scrutiny of these substances. >Until such studies are completed, >physicians should exercise caution when prescribing ?bioidentical >hormones? and counsel their >patients about the controversy over the use of these preparations. >Additionally, patients should >educate themselves about hormone therapies and engage in candid >discussions with their doctors. >Much consideration should be given to the decision to undergo any >hormone therapy, and >?bioidentical hormones? present unique and additional concerns >because of the process by which >many of them are made. > >I take this not to imply that bioidentical hormones are bad or >ineffective, but that there is insufficient evidence to say that they >are better or worse than regular hormones. I have some patient who >swear by them and wouldn't dream of taking anything else, but it is >not for everyone. When someone like Suzanne Somers is promoting it, I >can't help but wonder if this will turn out to be another medical fad. > > Seto >South Pasadena, CA > > > >> Hi gang! >> >> It's me and my goofball questions again! >> >> Does anyone prescribe bioidentical hormones? I'm curious to hear the >> experience of others >> >> Hugs, >> >> Britney >> >> >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2007 Report Share Posted April 21, 2007 Good points Jean. I think waiting 3-5 years after a new catch-phrase pops up to join the masses is usually a good idea. First off, I'm a vegetarian who tries to leave a " small footprint " and conserve energy and use minimal leather products, etc. Happy Earth Day by the way. BUT, the " natural " means " good " thing bugs me unless there's evidence to support it. When patients say something like, " but doc, it's not natural to take these medicines " , I like to remind them how little " natural " is in our standard lives... staying up late watching TV ain't natural, driving in cars ain't natural, flying in planes ain't natural, sitting in a room with fluorescent lighting wearing a polyester shirt ain't natural. Heck, half of what my patients eat ain't natural. And actually, living beyond 40 (I'm over 40) likely ain't too " natural " either! In essense, if we want " natural " we should all be hunter-gatherers. Now, other side of same coin, I do encourage patients (and myself) to add as much natural foods/activities (fruits/veg/whole grains/less-processed foods, etc, along with physical activity and rest) into their lives. But for true problems, many " un-natural " treatments are best. And with meds, I like to remind patients about how " natural " can be dangerous. For example, there's a bean that can be dried and crushed; if you filter water through it and drink the water you can start sweating and your heart can pound and you can have problems sleeping... I'm drinking it right now... it's coffee. Same goes for a natural leaf that can be ground down and treated to make a powder that can trigger heart arrythmias, paranoia and heart attacks... coca leaf and cocaine. Etc, Etc... So I advise patience with the bio-identical hormones. I've been giving estadiol for over 10 years to avoid the whole horse abuse of Premarin (PREgnant MAre urINE) and Prometrium is nice. But the true benefit of dermal patches rather than oral meds is still unclear as best I can tell. But I could be swayed if evidence is there and studies repeatable. By the way, Brittany, going back to the post that triggered this discussion, the question wasn't " goofball " at all. I, and perhaps others on the list, am a goofball, but your question was fine! ;-) Tim -- Malia, MD Malia Family Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY 14450 (phone / fax) www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com -- Confidentiality Notice -- This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments. > I looked this up recetnly for a patietn who was very colored by a > suzanne somers book and decided that i would not prescribe these > things. jessica is right about some of the proudcts that we know, > being indeed bioidentical already. > We get into this bias on the part of pattietns as not wanting to > take anyhting manufactured.Partly this is becasue of real reasons > people lose credibility in the maufcaured d rugs.Look at what gets > taken off the market after heavy advertising(say vioxx) Natural s does > not mean good. MY husbdan says Dog poop is natural Ya gonna eat that? > > It is always crucial that we practice evidence based medicene -adn > see > gary's post -there isn;t any about these products really that says > better safer or more efficacious IT is important that we practice > evidence based medicien inthe context of hearing the patietn out I > cna hear people out and still not prescribe just what they WANT > It is so feel good to jump on bandwagons Half of US have hot > flashes OK maybe not gary or gordon but the rest of us.. > and these thigns come fromt hese compunding pharmacies often which I > looked into in depth a few yrs ago as marketing transdermal meds for > pain that I could not find one spot of litaerture on, > so it is best as always to go slow, > listen to patietns, but not put your name on anything that you > cannot > back up. > > Is it hot in here or what > ? > > > Re: Bioidentical hormones > > > > It is possible that I don't know how to dose them correctly, but I > haven't been impressed that they are that much better than > vivelle-transdermal estradiol and prometrium. I always tell patients > that there are no studies that indicate that they are safer than regular > estradiol and provera and one should assume that there is a slightly > greater risk of breast cancer as with other forms of HRT. I would likely > recommend a transdermal form of estradiol as it reduces the clotting > risk of estrogen quite a bit. I never prescribe conjugated > estrogen-provera anymore. I never know whether to use serum levels or > symptoms to adjust dosage, so I do a combination approach. I don't use > salivary levels anymore as they are rarely paid by insurance and serum > levels are. Most places will give a fractionated estrogen level if > requested. > I tried bioidentical hormones myself for about a year and found that I > lost more bone density than when I was on vivelle. I don't thiink that I > felt much different. Lots of hot flashes,etc off HRT, much better on. I > do believe that there are selected women that notice a big difference in > symptoms relief. Vivelle spot is nice in that it is less than the size > of a postage stamp and there is much less likelihood of developing > rashes in reaction to the patch. > Kathy Broman > Mason City, IA > On Friday, April 20, 2007, at 12:31PM, " Seto " < glseto@... > <mailto:glseto%40mac.com> > wrote: >>I don't know very much about the topic, but here is something from the >> Mayo Clinic on it: >> http://www.mayoclin > <http://www.mayoclinic.com/health/bioidentical-hormones/AN01133> > ic.com/health/bioidentical-hormones/AN01133 >> >>There is a lot of interest in bioidentical ? or so called " natural " ? >> hormone therapy for menopause symptoms. However, there is no evidence >> that bioidentical hormones are safer or more effective than standard >> hormone replacement therapy. >> >>The Endocrine Society's Position Statement on bioidentical hormones >> says the same thing: >> http://www.endo- > <http://www.endo-society.org/publicpolicy/policy/upload/> > society.org/publicpolicy/policy/upload/ >>BH_Position_Statement_final_10_25_06_w_Header.pdf >> >>The controversies surrounding the safety and efficacy of >>?bioidentical hormones? illustrate the need >>for further scientific and medical scrutiny of these substances. Until >> such studies are completed, >>physicians should exercise caution when prescribing ?bioidentical >> hormones? and counsel their >>patients about the controversy over the use of these preparations. >> Additionally, patients should >>educate themselves about hormone therapies and engage in candid >>discussions with their doctors. >>Much consideration should be given to the decision to undergo any >> hormone therapy, and >>?bioidentical hormones? present unique and additional concerns >>because of the process by which >>many of them are made. >> >>I take this not to imply that bioidentical hormones are bad or >>ineffective, but that there is insufficient evidence to say that they >> are better or worse than regular hormones. I have some patient who >> swear by them and wouldn't dream of taking anything else, but it is >> not for everyone. When someone like Suzanne Somers is promoting it, I >> can't help but wonder if this will turn out to be another medical fad. >> >> Seto >>South Pasadena, CA >> >> >> >>> Hi gang! >>> >>> It's me and my goofball questions again! >>> >>> Does anyone prescribe bioidentical hormones? I'm curious to hear the >>> experience of others >>> >>> Hugs, >>> >>> Britney >>> >>> >>> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2007 Report Share Posted April 21, 2007 there is evidence that estrogen from pregnant mares' urine is harmful and that it has a very long half-life in humans and that estradiol has a short half life > Good points Jean. I think waiting 3-5 years after a new catch-phrase > pops up to join the masses is usually a good idea. > > First off, I'm a vegetarian who tries to leave a " small footprint " and > conserve energy and use minimal leather products, etc. Happy Earth Day > by the way. > BUT, the " natural " means " good " thing bugs me unless there's evidence to > support it. > When patients say something like, " but doc, it's not natural to take > these medicines " , I like to remind them how little " natural " is in our > standard lives... staying up late watching TV ain't natural, driving in > cars ain't natural, flying in planes ain't natural, sitting in a room > with > fluorescent lighting wearing a polyester shirt ain't natural. Heck, > half of what my patients eat ain't natural. > And actually, living beyond 40 (I'm over 40) likely ain't too " natural " > either! > > In essense, if we want " natural " we should all be hunter-gatherers. > Now, other side of same coin, I do encourage patients (and myself) to > add as much natural foods/activities (fruits/veg/whole > grains/less-processed foods, etc, along with physical activity and rest) > into their lives. But for true problems, many " un-natural " treatments > are best. > > And with meds, I like to remind patients about how " natural " can be > dangerous. For example, there's a bean that can be dried and crushed; if > you filter water through it and drink the water you can start sweating > and your heart can pound and you can have problems sleeping... I'm > drinking it right now... it's coffee. Same goes for a natural leaf that > can be ground down and treated to make a powder that can trigger heart > arrythmias, paranoia and heart attacks... coca leaf and cocaine. Etc, > Etc... > > So I advise patience with the bio-identical hormones. I've been giving > estadiol for over 10 years to avoid the whole horse abuse of Premarin > (PREgnant MAre urINE) and Prometrium is nice. But the true benefit of > dermal patches rather than oral meds is still unclear as best I can > tell. But I could be swayed if evidence is there and studies > repeatable. > > By the way, Brittany, going back to the post that triggered this > discussion, the question wasn't " goofball " at all. I, and perhaps > others on the list, am a goofball, but your question was fine! ;-) > > Tim > > -- > Malia, MD > > Malia Family Medicine & Skin Sense Laser > 6720 Pittsford-Palmyra Rd. > Perinton Square Mall > Fairport, NY 14450 > > (phone / fax) > www.relayhealth.com/doc/DrMalia > www.SkinSenseLaser.com > > -- Confidentiality Notice -- > This email message, including all the attachments, is for the sole use > of the intended recipient(s) and contains confidential information. > Unauthorized use or disclosure is prohibited. If you are not the > intended recipient, you may not use, disclose, copy or disseminate this > information. If you are not the intended recipient, please contact the > sender immediately by reply email and destroy all copies of the original > message, including attachments. > >> I looked this up recetnly for a patietn who was very colored by a >> suzanne somers book and decided that i would not prescribe these >> things. jessica is right about some of the proudcts that we know, >> being indeed bioidentical already. >> We get into this bias on the part of pattietns as not wanting to >> take anyhting manufactured.Partly this is becasue of real reasons >> people lose credibility in the maufcaured d rugs.Look at what gets >> taken off the market after heavy advertising(say vioxx) Natural s >> does not mean good. MY husbdan says Dog poop is natural Ya gonna eat >> that? >> >> It is always crucial that we practice evidence based medicene >> -adn >> see >> gary's post -there isn;t any about these products really that says >> better safer or more efficacious IT is important that we practice >> evidence based medicien inthe context of hearing the patietn out I >> cna hear people out and still not prescribe just what they WANT It is >> so feel good to jump on bandwagons Half of US have hot flashes OK >> maybe not gary or gordon but the rest of us.. >> and these thigns come fromt hese compunding pharmacies often which >> I >> looked into in depth a few yrs ago as marketing transdermal meds for >> pain that I could not find one spot of litaerture on, >> so it is best as always to go slow, >> listen to patietns, but not put your name on anything that you >> cannot >> back up. >> >> Is it hot in here or what >> ? >> >> >> Re: Bioidentical hormones >> >> >> >> It is possible that I don't know how to dose them correctly, but I >> haven't been impressed that they are that much better than >> vivelle-transdermal estradiol and prometrium. I always tell patients >> that there are no studies that indicate that they are safer than >> regular estradiol and provera and one should assume that there is a >> slightly greater risk of breast cancer as with other forms of HRT. I >> would likely recommend a transdermal form of estradiol as it reduces >> the clotting risk of estrogen quite a bit. I never prescribe >> conjugated >> estrogen-provera anymore. I never know whether to use serum levels or >> symptoms to adjust dosage, so I do a combination approach. I don't use >> salivary levels anymore as they are rarely paid by insurance and serum >> levels are. Most places will give a fractionated estrogen level if >> requested. >> I tried bioidentical hormones myself for about a year and found that I >> lost more bone density than when I was on vivelle. I don't thiink that >> I felt much different. Lots of hot flashes,etc off HRT, much better >> on. I do believe that there are selected women that notice a big >> difference in symptoms relief. Vivelle spot is nice in that it is less >> than the size of a postage stamp and there is much less likelihood of >> developing rashes in reaction to the patch. >> Kathy Broman >> Mason City, IA >> On Friday, April 20, 2007, at 12:31PM, " Seto " < glseto@... >> <mailto:glseto%40mac.com> > wrote: >>>I don't know very much about the topic, but here is something from >>> the >>> Mayo Clinic on it: >>> http://www.mayoclin >> <http://www.mayoclinic.com/health/bioidentical-hormones/AN01133> >> ic.com/health/bioidentical-hormones/AN01133 >>> >>>There is a lot of interest in bioidentical ? or so called " natural " ? >>> hormone therapy for menopause symptoms. However, there is no evidence >>> that bioidentical hormones are safer or more effective than standard >>> hormone replacement therapy. >>> >>>The Endocrine Society's Position Statement on bioidentical hormones >>> says the same thing: >>> http://www.endo- >> <http://www.endo-society.org/publicpolicy/policy/upload/> >> society.org/publicpolicy/policy/upload/ >>>BH_Position_Statement_final_10_25_06_w_Header.pdf >>> >>>The controversies surrounding the safety and efficacy of >>>?bioidentical hormones? illustrate the need >>>for further scientific and medical scrutiny of these substances. >>> Until >>> such studies are completed, >>>physicians should exercise caution when prescribing ?bioidentical >>> hormones? and counsel their >>>patients about the controversy over the use of these preparations. >>> Additionally, patients should >>>educate themselves about hormone therapies and engage in candid >>>discussions with their doctors. >>>Much consideration should be given to the decision to undergo any >>> hormone therapy, and >>>?bioidentical hormones? present unique and additional concerns >>>because of the process by which >>>many of them are made. >>> >>>I take this not to imply that bioidentical hormones are bad or >>>ineffective, but that there is insufficient evidence to say that they >>> are better or worse than regular hormones. I have some patient who >>> swear by them and wouldn't dream of taking anything else, but it is >>> not for everyone. When someone like Suzanne Somers is promoting it, I >>> can't help but wonder if this will turn out to be another medical >>> fad. >>> >>> Seto >>>South Pasadena, CA >>> >>> >>> >>>> Hi gang! >>>> >>>> It's me and my goofball questions again! >>>> >>>> Does anyone prescribe bioidentical hormones? I'm curious to hear the >>>> experience of others >>>> >>>> Hugs, >>>> >>>> Britney >>>> >>>> >>>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2007 Report Share Posted April 21, 2007 My understanding is the estradiol is plant based (from a yam, I believe) and the plant estrogen molecule is rearranged to be identical to the human estradiol. The Prometrium progesterone is bioidentical to human progesterone, and also comes from a plant source (or so I was told by a pharmacist), but I don’t know what plant. The OTC yam estrogen cannot be converted in the human body to estradiol, so they’ve got a profitable scam going on… A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of DocSingh760@... Sent: Friday, April 20, 2007 11:09 AM To: Subject: Re: Bioidentical hormones I was informed by a endocrinologist that bioidentical hormones come from Hog's intestines so unless one is a hog they are not natural. Any thoughts?/ I practice in the desert and practically all the patients who come to me are on bio identical horm, unfortunately I don;t know much about them so please share info. Thanks, Mala See what's free at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2007 Report Share Posted April 21, 2007 Estradiol and Prometrium (progesterone) are bioidentical hormones. A female cardiologist that I respect greatly has done a lot of research into HRT/ERT and CV dz. She supports use of HRT, but not with Provera/MPA – according to what she has read, it blocks up to 20% of the positive effects of estrogen. Bioidentical progesterone (ie Prometrium) does not hinder the estrogen this way. She also says the oral form of estrogen seems to be better for CV risk – although it takes higher doses, after it has been process by the liver, it seems to ‘work’ better. I use the transdermal route for my ladies that can’t remember to take a pill. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of Kathy Broman Sent: Friday, April 20, 2007 1:01 PM To: Subject: Re: Bioidentical hormones It is possible that I don't know how to dose them correctly, but I haven't been impressed that they are that much better than vivelle-transdermal estradiol and prometrium. I always tell patients that there are no studies that indicate that they are safer than regular estradiol and provera and one should assume that there is a slightly greater risk of breast cancer as with other forms of HRT. I would likely recommend a transdermal form of estradiol as it reduces the clotting risk of estrogen quite a bit. I never prescribe conjugated estrogen-provera anymore. I never know whether to use serum levels or symptoms to adjust dosage, so I do a combination approach. I don't use salivary levels anymore as they are rarely paid by insurance and serum levels are. Most places will give a fractionated estrogen level if requested. I tried bioidentical hormones myself for about a year and found that I lost more bone density than when I was on vivelle. I don't thiink that I felt much different. Lots of hot flashes,etc off HRT, much better on. I do believe that there are selected women that notice a big difference in symptoms relief. Vivelle spot is nice in that it is less than the size of a postage stamp and there is much less likelihood of developing rashes in reaction to the patch. Kathy Broman Mason City, IA >I don't know very much about the topic, but here is something from >the Mayo Clinic on it: >http://www.mayoclinic.com/health/bioidentical-hormones/AN01133 > >There is a lot of interest in bioidentical ? or so called " natural " ? >hormone therapy for menopause symptoms. However, there is no evidence >that bioidentical hormones are safer or more effective than standard >hormone replacement therapy. > >The Endocrine Society's Position Statement on bioidentical hormones >says the same thing: >http://www.endo-society.org/publicpolicy/policy/upload/ >BH_Position_Statement_final_10_25_06_w_Header.pdf > >The controversies surrounding the safety and efficacy of >?bioidentical hormones? illustrate the need >for further scientific and medical scrutiny of these substances. >Until such studies are completed, >physicians should exercise caution when prescribing ?bioidentical >hormones? and counsel their >patients about the controversy over the use of these preparations. >Additionally, patients should >educate themselves about hormone therapies and engage in candid >discussions with their doctors. >Much consideration should be given to the decision to undergo any >hormone therapy, and >?bioidentical hormones? present unique and additional concerns >because of the process by which >many of them are made. > >I take this not to imply that bioidentical hormones are bad or >ineffective, but that there is insufficient evidence to say that they >are better or worse than regular hormones. I have some patient who >swear by them and wouldn't dream of taking anything else, but it is >not for everyone. When someone like Suzanne Somers is promoting it, I >can't help but wonder if this will turn out to be another medical fad. > > Seto >South Pasadena, CA > > > >> Hi gang! >> >> It's me and my goofball questions again! >> >> Does anyone prescribe bioidentical hormones? I'm curious to hear the >> experience of others >> >> Hugs, >> >> Britney >> >> >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2007 Report Share Posted April 22, 2007 > > Hi gang! > > It's me and my goofball questions again! > > Does anyone prescribe bioidentical hormones? I'm curious to hear the > experience of others > > Hugs, > > Britney > I use them myself and I think they work well for my post-menopausal symptoms. My patients also like them. They are quite popular with a number of gynecologists in our area. Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2007 Report Share Posted April 22, 2007 Yes, they are the only hormones we should prescribe. We gave up on animal insulin and animal thyroid long ago, and now use human identical hormones. Only the continued support of Pharma has kept the animal estrogens around. I use estradiol and prometrium exclusively. Remember, the WHI study only looked at Premarin and PremPro (with its synthetic progestin). Joe ph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JScherger@...>>> " Brand" 4/21/2007 7:09 PM >>>>> Hi gang!> > It's me and my goofball questions again! > > Does anyone prescribe bioidentical hormones? I'm curious to hear the> experience of others > > Hugs,> > Britney>I use them myself and I think they work well for my post-menopausalsymptoms. My patients also like them. They are quite popular with anumber of gynecologists in our area. Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2007 Report Share Posted April 22, 2007 It is important to not get the issues mixed up, which patients often do. Bioidentical or human identical is not the same as "natural". Our levothyroxine is human identical but is manufactured in a lab. Same with Humalog insulin. Bioidentical or human identical means that we are using the same hormones that are in our body, which bind "naturally" to our receptor sites. Hormones which are not human identical may have estrogenic or progestin effects, but do not react in the body the same way as our own hormones. I tell patients that getting what our body knows is more important than the source of the hormones. Joe ph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JScherger@...>>> 4/20/2007 5:14 PM >>>I looked this up recetnly for a patietn who was very colored by asuzanne somers book and decided that i would not prescribe these things.jessica is right about some of the proudcts that we know, being indeedbioidentical already.We get into this bias on the part of pattietns as not wanting to takeanyhting manufactured.Partly this is becasue of real reasons people losecredibility in the maufcaured d rugs.Look at what gets taken off themarket after heavy advertising(say vioxx) Natural s does not mean good. MYhusbdan says Dog poop is natural Ya gonna eat that?It is always crucial that we practice evidence based medicene -adn seegary's post -there isn;t any about these products really that says bettersafer or more efficacious IT is important that we practice evidence basedmedicien inthe context of hearing the patietn out I cna hear people outand still not prescribe just what they WANTIt is so feel good to jump on bandwagons Half of US have hot flashes OKmaybe not gary or gordon but the rest of us..and these thigns come fromt hese compunding pharmacies often which Ilooked into in depth a few yrs ago as marketing transdermal meds for painthat I could not find one spot of litaerture on,so it is best as always to go slow,listen to patietns, but not put your name on anything that you cannotback up.Is it hot in here or what? RE: Bioidentical hormonesIts my understanding that the estrogen in Vivelle and Climara patch arebioidentical T. Ellsworth, MD9377 E. Bell Road, Suite 175sdale, Az 85260_____ From: [mailto: ] On Behalf Of Kathy BromanSent: Friday, April 20, 2007 12:01 PMTo: Subject: Re: Bioidentical hormonesIt is possible that I don't know how to dose them correctly, but Ihaven't been impressed that they are that much better thanvivelle-transdermal estradiol and prometrium. I always tell patientsthat there are no studies that indicate that they are safer than regularestradiol and provera and one should assume that there is a slightlygreater risk of breast cancer as with other forms of HRT. I would likelyrecommend a transdermal form of estradiol as it reduces the clottingrisk of estrogen quite a bit. I never prescribe conjugatedestrogen-provera anymore. I never know whether to use serum levels orsymptoms to adjust dosage, so I do a combination approach. I don't usesalivary levels anymore as they are rarely paid by insurance and serumlevels are. Most places will give a fractionated estrogen level ifrequested.I tried bioidentical hormones myself for about a year and found that Ilost more bone density than when I was on vivelle. I don't thiink that Ifelt much different. Lots of hot flashes,etc off HRT, much better on. Ido believe that there are selected women that notice a big difference insymptoms relief. Vivelle spot is nice in that it is less than the sizeof a postage stamp and there is much less likelihood of developingrashes in reaction to the patch.Kathy BromanMason City, IAOn Friday, April 20, 2007, at 12:31PM, " Seto" < glseto@...<mailto:glseto%40mac.com> > wrote:>I don't know very much about the topic, but here is something from >the Mayo Clinic on it:> http://www.mayoclin<http://www.mayoclinic.com/health/bioidentical-hormones/AN01133>ic.com/health/bioidentical-hormones/AN01133>>There is a lot of interest in bioidentical ? or so called "natural" ? >hormone therapy for menopause symptoms. However, there is no evidence >that bioidentical hormones are safer or more effective than standard >hormone replacement therapy.>>The Endocrine Society's Position Statement on bioidentical hormones >says the same thing:> http://www.endo-<http://www.endo-society.org/publicpolicy/policy/upload/>society.org/publicpolicy/policy/upload/ >BH_Position_Statement_final_10_25_06_w_Header.pdf>>The controversies surrounding the safety and efficacy of >?bioidentical hormones? illustrate the need>for further scientific and medical scrutiny of these substances. >Until such studies are completed,>physicians should exercise caution when prescribing ?bioidentical >hormones? and counsel their>patients about the controversy over the use of these preparations. >Additionally, patients should>educate themselves about hormone therapies and engage in candid >discussions with their doctors.>Much consideration should be given to the decision to undergo any >hormone therapy, and>?bioidentical hormones? present unique and additional concerns >because of the process by which>many of them are made.>>I take this not to imply that bioidentical hormones are bad or >ineffective, but that there is insufficient evidence to say that they >are better or worse than regular hormones. I have some patient who >swear by them and wouldn't dream of taking anything else, but it is >not for everyone. When someone like Suzanne Somers is promoting it, I >can't help but wonder if this will turn out to be another medical fad.>> Seto>South Pasadena, CA>>>>> Hi gang!>>>> It's me and my goofball questions again! >>>> Does anyone prescribe bioidentical hormones? I'm curious to hear the>> experience of others >>>> Hugs,>>>> Britney>>>>>> >>>> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2007 Report Share Posted April 22, 2007 Just shows how misguided (tempted to say stupid) some of our specialists can be. ph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JScherger@...>>> 4/20/2007 10:09 AM >>>I was informed by a endocrinologist that bioidentical hormones come from Hog's intestines so unless one is a hog they are not natural. Any thoughts?/I practice in the desert and practically all the patients who come to me are on bio identical horm, unfortunately I don;t know much about them so please share info. Thanks, MalaSee what's free at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2007 Report Share Posted April 23, 2007 Thank you, it ,makes me feel betterSee what's free at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2007 Report Share Posted April 23, 2007 I use alot of bio-identical hormone, and I don't believe any of them come from hog intestines. It was my understanding, that there are multiple sources, including yam, soy, and plain old genetically engineered in lab, produced by bacteria who have been altered to do so. Cote MD -------------- Original message ---------------------- > Just shows how misguided (tempted to say stupid) some of our specialists can be. > > ph E. Scherger, MD, MPH > Clinical Professor > University of California, San Diego > Medical Director, AmeriChoice > 8840 Complex Dr. Suite 300 > San Diego, CA 92123 > Phone: > Fax: > JScherger@... > > >>> 4/20/2007 10:09 AM >>> > > I was informed by a endocrinologist that bioidentical hormones come from Hog's > intestines so unless one is a hog they are not natural. Any thoughts?/ > I practice in the desert and practically all the patients who come to me are on > bio identical horm, unfortunately I don;t know much about them so please share > info. > > Thanks, > > Mala > > > > > > > See what's free at AOL.com. Just shows how misguided (tempted to say stupid) some of our specialists can be. ph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JScherger@...>>> 4/20/2007 10:09 AM >>>I was informed by a endocrinologist that bioidentical hormones come from Hog's intestines so unless one is a hog they are not natural. Any thoughts?/I practice in the desert and practically all the patients who come to me are on bio identical horm, unfortunately I don;t know much about them so please share info. Thanks, MalaSee what's free at AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2007 Report Share Posted April 23, 2007 I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progesterone naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the highest in horse mare u rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. Cote' MD Four Corners Family Medicine No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. Original message ---------------------- > > > Hi gang! > > It's me and my goofball questions again! > > Does anyone prescribe bioidentical hormones? I'm curious to hear the > experience of others > > Hugs, > > Britney > I use them myself and I think they work well for my post-menopausal symptoms. My patients also like them. They are quite popular with a number of gynecologists in our area. Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2007 Report Share Posted April 24, 2007 When patients in my area come in to talk about bioidentical hormones, they are usually talking about the compounded hormones that mix estradiol with estrone and estriol. So, if estradiol and micronized progesterone-prometrium are just as " bioidentical " , I guess the marketing is a bit misleading. Some pharmacists compound to use it topically and some orally. They can compound to combine with DHEA and or testosterone. Often pharmacies that do this compounding would also be doing the salivary hormone testing which would then advise women, what they needed to treat their symptoms. Now, I believe that even salivary testing needs a doctor's order, which it hadn't previously. I was never convinced that salivary testing was that accurate, although proponents feel it is more accurate than serum testing. Progesterone is either given as a troche or orally or topically when it is compounded. Those that market compounding, rave about the effects of the estrone over the estradiol as being more " natural " . There are books, about the wonders of the compounded bioidentical hormones, but I have not read them as of yet. Some written by physicians, not just Suzanne Sommers. I believe, without reading them, that they rely on patient history rather than research, but as I said, I haven't read them. The proponents also rave about it being much more safe, but I haven't seen much research on this yet, although I am hoping some studies on the way some where. I have seen some studies that document fewer episodes of DVT etc with transdermal estrogen, but I am not well versed enough in epidemiology to judge whether they are adequate studies or not. Some women that seem to prefer the compounded bi estrogen and tri estrogen for their menopausal symptoms, over the other types of pharmaceutical forms of estrogen. I don't know if most had been on premarin previously or not. It seems that the women that are most symptomatic with hot flashes, memory and mood changes, are often the ones that are most happy with compounding, as they have tried most of the other types of estrogen, but once again, I am assuming this and don't have studies to prove it. For me the osteoporosis was more worrisome than the hot flashes. Kathy Broman >I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. >The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progesterone naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the highest in horse mare u >rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. >I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. >Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. > Cote' MD >Four Corners Family Medicine >No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. > >Original message ---------------------- > >> >> > >> > Hi gang! >> > >> > It's me and my goofball questions again! >> > >> > Does anyone prescribe bioidentical hormones? I'm curious to hear the >> > experience of others >> > >> > Hugs, >> > >> > Britney >> > >> I use them myself and I think they work well for my post-menopausal >> symptoms. My patients also like them. They are quite popular with a >> number of gynecologists in our area. >> >> Brand >> >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2007 Report Share Posted April 24, 2007 I really appreciate this thread becaue while I did my own reseacrh you guys know alot and it helps me ly my patients tend to be older and they ain't a thinkin about hormones so it comes up only infrequenlty! Re: Re: Bioidentical hormones When patients in my area come in to talk about bioidentical hormones, they are usually talking about the compounded hormones that mix estradiol with estrone and estriol. So, if estradiol and micronized progesterone-prometrium are just as " bioidentical " , I guess the marketing is a bit misleading. Some pharmacists compound to use it topically and some orally. They can compound to combine with DHEA and or testosterone. Often pharmacies that do this compounding would also be doing the salivary hormone testing which would then advise women, what they needed to treat their symptoms. Now, I believe that even salivary testing needs a doctor's order, which it hadn't previously. I was never convinced that salivary testing was that accurate, although proponents feel it is more accurate than serum testing. Progesterone is either given as a troche or orally or topically when it is compounded. Those that market compounding, rave about the effects of the estrone over the estradiol as being more " natural " . There are books, about the wonders of the compounded bioidentical hormones, but I have not read them as of yet. Some written by physicians, not just Suzanne Sommers. I believe, without reading them, that they rely on patient history rather than research, but as I said, I haven't read them. The proponents also rave about it being much more safe, but I haven't seen much research on this yet, although I am hoping some studies on the way some where. I have seen some studies that document fewer episodes of DVT etc with transdermal estrogen, but I am not well versed enough in epidemiology to judge whether they are adequate studies or not. Some women that seem to prefer the compounded bi estrogen and tri estrogen for their menopausal symptoms, over the other types of pharmaceutical forms of estrogen. I don't know if most had been on premarin previously or not. It seems that the women that are most symptomatic with hot flashes, memory and mood changes, are often the ones that are most happy with compounding, as they have tried most of the other types of estrogen, but once again, I am assuming this and don't have studies to prove it. For me the osteoporosis was more worrisome than the hot flashes. Kathy Broman On Monday, April 23, 2007, at 02:37PM, < magnetdoctor@ <mailto:magnetdoctor%40comcast.net> comcast.net> wrote: >I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. >The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progesterone naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the high est in horse mare u >rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. >I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. >Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. > Cote' MD >Four Corners Family Medicine >No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. > >Original message ---------------------- >From: " Brand " < laura.j.brand@ <mailto:laura.j.brand%40gmail.com> gmail.com> >> >> > >> > Hi gang! >> > >> > It's me and my goofball questions again! >> > >> > Does anyone prescribe bioidentical hormones? I'm curious to hear the >> > experience of others >> > >> > Hugs, >> > >> > Britney >> > >> I use them myself and I think they work well for my post-menopausal >> symptoms. My patients also like them. They are quite popular with a >> number of gynecologists in our area. >> >> Brand >> >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2007 Report Share Posted April 24, 2007 The compounding processed allows for customized dosing, which is often adjusted based on how the patient feels, which of course is very subjective. Some do compounding to achieve and maintain certain hormone blood levels, again difficult to interpret. Estradiol is the dominant estrogen in the human body. I have limited my practice to estradiol from .5 to 2 mg daily and prometrium 100 mg daily (or every other day). Prometrium is not just to protect the uterus, it has a role in perimenopausal hormone balance, especially with the androgen issue. So I use it even in some women without a uterus. There is little good evidence based medicine here. One tragedy in our health system is that once a drug does generic (estradiol), only NIH is left to fund controlled trials, and this has not been a priority area. Joe ph E. Scherger, MD, MPH Clinical Professor University of California, San Diego Medical Director, AmeriChoice 8840 Complex Dr. Suite 300 San Diego, CA 92123 Phone: Fax: JScherger@... >>> Kathy Broman 04/24/07 5:47 AM >>> When patients in my area come in to talk about bioidentical hormones, they are usually talking about the compounded hormones that mix estradiol with estrone and estriol. So, if estradiol and micronized progesterone-prometrium are just as " bioidentical " , I guess the marketing is a bit misleading. Some pharmacists compound to use it topically and some orally. They can compound to combine with DHEA and or testosterone. Often pharmacies that do this compounding would also be doing the salivary hormone testing which would then advise women, what they needed to treat their symptoms. Now, I believe that even salivary testing needs a doctor's order, which it hadn't previously. I was never convinced that salivary testing was that accurate, although proponents feel it is more accurate than serum testing. Progesterone is either given as a troche or orally or topically when it is compounded. Those that market compounding, rave about the effects of the estrone over the estradiol as being more " natural " . There are books, about the wonders of the compounded bioidentical hormones, but I have not read them as of yet. Some written by physicians, not just Suzanne Sommers. I believe, without reading them, that they rely on patient history rather than research, but as I said, I haven't read them. The proponents also rave about it being much more safe, but I haven't seen much research on this yet, although I am hoping some studies on the way some where. I have seen some studies that document fewer episodes of DVT etc with transdermal estrogen, but I am not well versed enough in epidemiology to judge whether they are adequate studies or not. Some women that seem to prefer the compounded bi estrogen and tri estrogen for their menopausal symptoms, over the other types of pharmaceutical forms of estrogen. I don't know if most had been on premarin previously or not. It seems that the women that are most symptomatic with hot flashes, memory and mood changes, are often the ones that are most happy with compounding, as they have tried most of the other types of estrogen, but once again, I am assuming this and don't have studies to prove it. For me the osteoporosis was more worrisome than the hot flashes. Kathy Broman >I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. >The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progesterone naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the highest in horse mare u >rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. >I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. >Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. > Cote' MD >Four Corners Family Medicine >No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. > >Original message ---------------------- > >> >> > >> > Hi gang! >> > >> > It's me and my goofball questions again! >> > >> > Does anyone prescribe bioidentical hormones? I'm curious to hear the >> > experience of others >> > >> > Hugs, >> > >> > Britney >> > >> I use them myself and I think they work well for my post-menopausal >> symptoms. My patients also like them. They are quite popular with a >> number of gynecologists in our area. >> >> Brand >> >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 I had a conversation with one of the specialists in ne Somers's second book who said that she is funding, and finding funding for, research in BHRT, since there is little interest among established HRT manufacturers in finding out that something else is better than their product. I am watching this area closely, and I will solicit the input of a colleague of mine who is a board member of the American College for the Advancement of Medicine (ACAM) and post it here. Ms. Somers could probably deserve a degree after the efforts and knowledge she has compiled in this area. Only time will tell, though, as it does for other drugs. She will soon be heralded as the actress/infomercial icon-turned guru, or just actress/infomercial icon. Charlie Vargas lin, NC Date: 2007/04/24 Tue PM 12:01:54 CDT To: Subject: Re: Re: Bioidentical hormones The compounding processed allows for customized dosing, which is often adjusted based on how the patient feels, which of course is very subjective. Some do compounding to achieve and maintain certain hormone blood levels, again difficult to interpret. Estradiol is the dominant estrogen in the human body. I have limited my practice to estradiol from .5 to 2 mg daily and prometrium 100 mg daily (or every other day). Prometrium is not just to protect the uterus, it has a role in perimenopausal hormone balance, especially with the androgen issue. So I use it even in some women without a uterus. There is little good evidence based medicine here. One tragedy in our health system is that once a drug does generic (estradiol), only NIH is left to fund controlled trials, and this has not been a priority area. Joe ph E. Scherger, MD, MPH Clinical Professor University of California, San Diego Medical Director, AmeriChoice 8840 Complex Dr. Suite 300 San Diego, CA 92123 Phone: Fax: JScherger@... >>> Kathy Broman 04/24/07 5:47 AM >>> When patients in my area come in to talk about bioidentical hormones, they are usually talking about the compounded hormones that mix estradiol with estrone and estriol. So, if estradiol and micronized progesterone-prometrium are just as " bioidentical " , I guess the marketing is a bit misleading. Some pharmacists compound to use it topically and some orally. They can compound to combine with DHEA and or testosterone. Often pharmacies that do this compounding would also be doing the salivary hormone testing which would then advise women, what they needed to treat their symptoms. Now, I believe that even salivary testing needs a doctor's order, which it hadn't previously. I was never convinced that salivary testing was that accurate, although proponents feel it is more accurate than serum testing. Progesterone is either given as a troche or orally or topically when it is compounded. Those that market compounding, rave about the effects of the estrone over the estradiol as being more " natural " . There are books, about the wonders of the compounded bioidentical hormones, but I have not read them as of yet. Some written by physicians, not just Suzanne Sommers. I believe, without reading them, that they rely on patient history rather than research, but as I said, I haven't read them. The proponents also rave about it being much more safe, but I haven't seen much research on this yet, although I am hoping some studies on the way some where. I have seen some studies that document fewer episodes of DVT etc with transdermal estrogen, but I am not well versed enough in epidemiology to judge whether they are adequate studies or not. Some women that seem to prefer the compounded bi estrogen and tri estrogen for their menopausal symptoms, over the other types of pharmaceutical forms of estrogen. I don't know if most had been on premarin previously or not. It seems that the women that are most symptomatic with hot flashes, memory and mood changes, are often the ones that are most happy with compounding, as they have tried most of the other types of estrogen, but once again, I am assuming this and don't have studies to prove it. For me the osteoporosis was more worrisome than the hot flashes. Kathy Broman >I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. >The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progestero<wbr>ne naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the highest in horse mare u >rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. >I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. >Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. > Cote' MD >Four Corners Family Medicine >No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. > >Original message ---------------------- > >> >> > >> > Hi gang! >> > >> > It's me and my goofball questions again! >> > >> > Does anyone prescribe bioidentical hormones? I'm curious to hear the >> > experience of others >> > >> > Hugs, >> > >> > Britney >> > >> I use them myself and I think they work well for my post-menopausal >> symptoms. My patients also like them. They are quite popular with a >> number of gynecologists in our area. >> >> Brand >> >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 FYI, Suzanne Somers is a registered nurse, and worked as a nurse in San Francisco before she was "discovered" by Lucas as an actress. For you movie buffs, she was the "blonde in the window" of the car in American Graffiti. Her autobiographical play of the same title is quite good. As many of you know, she has also had breast cancer, and has gone out on a limb with taking human identical hormones. Her personal physician, Swartzbein, an endocrinologist in Santa Barbara, is featured in her book, The Sexy Years, which is a fascinating read. There is a chapter on women over 80 (for the person who said their patients are too old) and a chapter on men. Swartzbein is a controversial physician who has written several books of her own. Joe ph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JScherger@...>>> 4/24/2007 7:32 PM >>>I had a conversation with one of the specialists in ne Somers's second book who said that she is funding, and finding funding for, research in BHRT, since there is little interest among established HRT manufacturers in finding out that something else is better than their product.I am watching this area closely, and I will solicit the input of a colleague of mine who is a board member of the American College for the Advancement of Medicine (ACAM) and post it here.Ms. Somers could probably deserve a degree after the efforts and knowledge she has compiled in this area. Only time will tell, though, as it does for other drugs. She will soon be heralded as the actress/infomercial icon-turned guru, or just actress/infomercial icon.Charlie Vargaslin, NCFrom: ph Scherger <jschergerucsd (DOT) edu>Date: 2007/04/24 Tue PM 12:01:54 CDTTo: Subject: Re: Re: Bioidentical hormonesThe compounding processed allows for customized dosing, which is often adjusted based on how the patient feels, which of course is very subjective. Some do compounding to achieve and maintain certain hormone blood levels, again difficult to interpret. Estradiol is the dominant estrogen in the human body. I have limited my practice to estradiol from .5 to 2 mg daily and prometrium 100 mg daily (or every other day). Prometrium is not just to protect the uterus, it has a role in perimenopausal hormone balance, especially with the androgen issue. So I use it even in some women without a uterus.There is little good evidence based medicine here. One tragedy in our health system is that once a drug does generic (estradiol), only NIH is left to fund controlled trials, and this has not been a priority area.Joeph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JSchergerucsd (DOT) edu>>> Kathy Broman <kbroman1mac> 04/24/07 5:47 AM >>>When patients in my area come in to talk about bioidentical hormones, they are usually talking about the compounded hormones that mix estradiol with estrone and estriol. So, if estradiol and micronized progesterone-prometrium are just as "bioidentical", I guess the marketing is a bit misleading. Some pharmacists compound to use it topically and some orally. They can compound to combine with DHEA and or testosterone. Often pharmacies that do this compounding would also be doing the salivary hormone testing which would then advise women, what they needed to treat their symptoms. Now, I believe that even salivary testing needs a doctor's order, which it hadn't previously. I was never convinced that salivary testing was that accurate, although proponents feel it is more accurate than serum testing. Progesterone is either given as a troche or orally or topically when it is compounded. Those that market compounding, rave about the effects of the estrone over the estradiol as being more "natural". There are books, about the wonders of the compounded bioidentical hormones, but I have not read them as of yet. Some written by physicians, not just Suzanne Sommers. I believe, without reading them, that they rely on patient history rather than research, but as I said, I haven't read them. The proponents also rave about it being much more safe, but I haven't seen much research on this yet, although I am hoping some studies on the way some where. I have seen some studies that document fewer episodes of DVT etc with transdermal estrogen, but I am not well versed enough in epidemiology to judge whether they are adequate studies or not. Some women that seem to prefer the compounded bi estrogen and tri estrogen for their menopausal symptoms, over the other types of pharmaceutical forms of estrogen. I don't know if most had been on premarin previously or not. It seems that the women that are most symptomatic with hot flashes, memory and mood changes, are often the ones that are most happy with compounding, as they have tried most of the other types of estrogen, but once again, I am assuming this and don't have studies to prove it. For me the osteoporosis was more worrisome than the hot flashes.Kathy BromanOn Monday, April 23, 2007, at 02:37PM, <magnetdoctorcomcast (DOT) net> wrote:>I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. >The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progestero<wbr>ne naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the highest in horse mare u>rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. >I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. >Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. > Cote' MD>Four Corners Family Medicine>No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. >>Original message ---------------------->From: " Brand" <laura.j.brandgmail>>> >> >>> > Hi gang!>> > >> > It's me and my goofball questions again! >> > >> > Does anyone prescribe bioidentical hormones? I'm curious to hear the>> > experience of others >> > >> > Hugs,>> > >> > Britney>> >>> I use them myself and I think they work well for my post-menopausal>> symptoms. My patients also like them. They are quite popular with a>> number of gynecologists in our area.>> >> Brand>> >> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 I know very little about bioidentical hormones but I found this "Letter to Suzanne Somers" on a website by Dr. Schwartz and one of the co-signers is the very Dr. Schwarzbein whom you mention below. Basically, it is very critical of Ms. Somers newest book, "Ageless: The Naked Truth about Bioidentical Hormones":http://drerika.typepad.com/notepad/2006/10/letter_to_suzan.html"While some of us were interviewed for the book, a significant portion of the material in the book relies on information and opinion from T.S. Wiley, an actress with a B.A. in anthropology. Wiley has no medical or clinical qualifications. To our dismay, Wiley dispenses gratuitous advice on significant medical issues including the use of bioidentical hormone therapies, areas that are legally and ethically the domain of licensed medical practitioners.Many of the claims throughout the book are scientifically unproven and dangerous. By mixing quotes from qualified physicians who are experts in their fields and bioidentical hormone treatments, with those of a person with no medical or scientific background, this book will further confuse women and we believe, may potentially put their health at risk.We believe Ageless is detrimental and dangerous to the thousands of women who read it because the book freely and repeatedly blurs the line of medical ethics and science with hearsay. The so-called "protocols" endorsed and promulgated throughout the book may expose women to serious health dangers. They offer a "one size fits all" approach, endorsing dangerously high levels of estrogen."So while Ms. Somers may have some medical background, her opinions appear to be in conflict with those of her own personal physician. Or perhaps T.S. Wiley is her new personal "physician". Then I found this website which seems to open up a whole new can of worms: http://www.wileywatch.com/. Dueling bioidentical hormone protocols. It's confusing. SetoSouth Pasadena, CA FYI, Suzanne Somers is a registered nurse, and worked as a nurse in San Francisco before she was "discovered" by Lucas as an actress. For you movie buffs, she was the "blonde in the window" of the car in American Graffiti. Her autobiographical play of the same title is quite good. As many of you know, she has also had breast cancer, and has gone out on a limb with taking human identical hormones. Her personal physician, Swartzbein, an endocrinologist in Santa Barbara, is featured in her book, The Sexy Years, which is a fascinating read. There is a chapter on women over 80 (for the person who said their patients are too old) and a chapter on men. Swartzbein is a controversial physician who has written several books of her own. Joe ph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JScherger@...>>> 4/24/2007 7:32 PM >>> I had a conversation with one of the specialists in ne Somers's second book who said that she is funding, and finding funding for, research in BHRT, since there is little interest among established HRT manufacturers in finding out that something else is better than their product.I am watching this area closely, and I will solicit the input of a colleague of mine who is a board member of the American College for the Advancement of Medicine (ACAM) and post it here.Ms. Somers could probably deserve a degree after the efforts and knowledge she has compiled in this area. Only time will tell, though, as it does for other drugs. She will soon be heralded as the actress/infomercial icon-turned guru, or just actress/infomercial icon.Charlie Vargaslin, NCFrom: ph Scherger <jschergerucsd (DOT) edu>Date: 2007/04/24 Tue PM 12:01:54 CDTTo: Subject: Re: Re: Bioidentical hormonesThe compounding processed allows for customized dosing, which is often adjusted based on how the patient feels, which of course is very subjective. Some do compounding to achieve and maintain certain hormone blood levels, again difficult to interpret. Estradiol is the dominant estrogen in the human body. I have limited my practice to estradiol from .5 to 2 mg daily and prometrium 100 mg daily (or every other day). Prometrium is not just to protect the uterus, it has a role in perimenopausal hormone balance, especially with the androgen issue. So I use it even in some women without a uterus.There is little good evidence based medicine here. One tragedy in our health system is that once a drug does generic (estradiol), only NIH is left to fund controlled trials, and this has not been a priority area.Joeph E. Scherger, MD, MPHClinical ProfessorUniversity of California, San DiegoMedical Director, AmeriChoice8840 Complex Dr. Suite 300San Diego, CA 92123Phone: Fax: JSchergerucsd (DOT) edu>>> Kathy Broman <kbroman1mac> 04/24/07 5:47 AM >>>When patients in my area come in to talk about bioidentical hormones, they are usually talking about the compounded hormones that mix estradiol with estrone and estriol. So, if estradiol and micronized progesterone-prometrium are just as "bioidentical", I guess the marketing is a bit misleading. Some pharmacists compound to use it topically and some orally. They can compound to combine with DHEA and or testosterone. Often pharmacies that do this compounding would also be doing the salivary hormone testing which would then advise women, what they needed to treat their symptoms. Now, I believe that even salivary testing needs a doctor's order, which it hadn't previously. I was never convinced that salivary testing was that accurate, although proponents feel it is more accurate than serum testing. Progesterone is either given as a troche or orally or topically when it is compounded. Those that market compounding, rave about the effects of the estrone over the estradiol as being more "natural". There are books, about the wonders of the compounded bioidentical hormones, but I have not read them as of yet. Some written by physicians, not just Suzanne Sommers. I believe, without reading them, that they rely on patient history rather than research, but as I said, I haven't read them. The proponents also rave about it being much more safe, but I haven't seen much research on this yet, although I am hoping some studies on the way some where. I have seen some studies that document fewer episodes of DVT etc with transdermal estrogen, but I am not well versed enough in epidemiology to judge whether they are adequate studies or not. Some women that seem to prefer the compounded bi estrogen and tri estrogen for their menopausal symptoms, over the other types of pharmaceutical forms of estrogen. I don't know if most had been on premarin previously or not. It seems that the women that are most symptomatic with hot flashes, memory and mood changes, are often the ones that are most happy with compounding, as they have tried most of the other types of estrogen, but once again, I am assuming this and don't have studies to prove it. For me the osteoporosis was more worrisome than the hot flashes.Kathy BromanOn Monday, April 23, 2007, at 02:37PM, <magnetdoctorcomcast (DOT) net> wrote:>I actually use both. I rarely use Prempro, unless a patient stopped it, and then asks to get back on, after problems with other estradiol or prometrium agents. Here's some of what I tell patients. >The largest study to date only looked at Prempro, and used women average age 60, time past menopause 2-10 yr. No one would argue against the idea, that a 60 yo who hasn't had any estrogen/progestero<wbr>ne naturally for 10 yr has different arteries, than someone 49, who is currently in the perimenopause. We have no 6 y, 50,000 person study on estradiol, or any of the transdermal forms of estrogen+/- progesterone. We believe based on the idea that you can give less, and bypass the first pass effect, that transdermal anything is likely to be safer. Until we have a 50,000 person study on estradiol transdermal, cream, lotion or patch, we won't know. We believe based on smaller studies of estradiol and prometrium, and experience in other countries that these are safer, horse mare urine, has 3 estrogens, but in reverse ratio of what we produce. That is the safest estrogen is the least available in the horse urine, and the most clot inducing, cancer inducing is the highest in horse mare u>rine. I tell people it is a very hot area of research, to make a decision yrly based on their symptoms, family hx, and any new studies. >I bow to the vast research mining skills of Dr Joe Scherger, on what may be latest/greatest. >Dr Scherger, nice to see you on list, even though I no longer do obstetrics, you vastly influenced my life, for the better for several yrs, by your example. > Cote' MD>Four Corners Family Medicine>No fianancial ties to Suzane Sommers ( I hate that book, get a degree already), Prempro or any of the various forms of Estradiol now on the market. >>Original message ---------------------->From: " Brand" <laura.j.brandgmail>>> >> >>> > Hi gang!>> > >> > It's me and my goofball questions again! >> > >> > Does anyone prescribe bioidentical hormones? I'm curious to hear the>> > experience of others >> > >> > Hugs,>> > >> > Britney>> >>> I use them myself and I think they work well for my post-menopausal>> symptoms. My patients also like them. They are quite popular with a>> number of gynecologists in our area.>> >> Brand>> >> >>> Quote Link to comment Share on other sites More sharing options...
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