Why Oprah Likes Bio-identical Hormones

[30A Skunkape]

isn't it true that the WHI study was on older women using only Prempro (premarin+progestis). Premarin is horse hormones. progestin is synthetic version of progresterone, but is NOT progesterone.

proponents of BHRT tell us that premarin is the least desirable form of HRT - the metabolic breakdown/products of premarin in the human female are stronger, more active and can be damaging. these products are not identical to a woman's hormones and they are not prescribed at the lowest effective doses possible. they are basically one size fits all.

the study provides excellent information, but not the whole story by far.
it seems there are still not enough studies to evaluate synthetic HRT, much less BHRT.

HRT is an ongoing experiment. let us hope the medical profession continues to evaluate and refine best practices in HRT for women and men.

I do take issue with the above article and its statement that hormones can only be effectively taken orally/pill form. that is like saying only blood tests can measure all hormone levels. we know better. I am no doctor, but I can read and listen to doctors and women who are doing much in this field. Northrup and many experts tells us that research has shown high effectiveness of bioidentical transdermal hormone replacement regimens. absorption through the skin allows hormones to enter directly into the bloodstream - and many MD's specializing in HRT say this is by far the most appropriate way to take hormones and bypasses the liver and many of the clotting and other risks associated with oral forms. we know there are products available now made by formulating pharmacies that women find to be highly effective for them. these products are made to fit the hormone needs of each woman.

Sometimes I just want to say to the medical profession and their "unbiased" sources (no offense skunky): Give me a break, pharmaceuticals rule you, and DUHHHH - BHRT is so common sense even with its need for much more research. but, I realize the medical profession moves very slowly, and this is probably a good thing overall. so thank you doctors, scientists and women everywhere.

Estrogen-progestin combinations and estrogen alone are available by prescription as pills, patches, gels, and sprays, as well as vaginal creams, tablets, and rings. All formulations are effective, and none has any clear advantage over the others for symptom control, so you usually can choose what you prefer.

 

[Teresa]

for women, I highly recommend Christiane Northrup's book, The Wisdom of Menopause. She provides so much information, including information such as the above article - but she goes so much further. providing women with an education based on what is known in the medical field, current advances and practices, so that they can decide if HRT is right for them, how to take hormones safely, and a wealth of alternatives. Her approach to HRT is very conservative even though she definitely recommends BHRT over synthetic (when and if a woman chooses to use hormone therapy), and for all the right reasons.

I'm finding there are the Christiane Northrup-type MDs specializing in women's health who are cautious about the use of HRT, but emphatic about BHRT. and there are the Suzanne Somers folk who believe most people (men and women) will need some BHRT as you age in order to feel good and stay healthy throughout later (advanced age) life. I'm betting on Christiane's approach, but you can bet there will be much discussion about all of this in the years to come. thankfully!

 

[Teresa]

Estrogen-progestin combinations and estrogen alone are available by prescription as pills, patches, gels, and sprays, as well as vaginal creams, tablets, and rings. All formulations are effective, and none has any clear advantage over the others for symptom control, so you usually can choose what you prefer.

oh, you are right. I mis-read another part about vaginal creams not delivering as much estrogen

Relatively little estrogen from these products is absorbed into the bloodstream, so they do not have the same risks as hormone tablets, gels, or patches.

, and had just read another article about topicals not being controlled or effective. I apoligize for getting these confused. multi-tasking is not my forte'. shhhhh.. i'm trying to work, read articles and post at the same time.

I think the article is pretty well balanced and had already edited my post radically after re-reading it and realizing that I had responded to you based on another article. I also realized in the many edits of my post that doctors are doing something very good. they are listening. they urge great caution in this debate, but they are listening and they are studying and working with women and definitely moving forward. I had not truly realized this even though I have read works of experts, attended 2 seminars, learned a great deal from my ob/gyn and made a decsion about my own treatment, and I've listened to doctors in the media debating this subject. they are definitely with the program at one level or another.

 

[rancid]

Really? What CPT and dx codes would you use?

It wouldn't be covered if you coded it properly and interest in BHT was the sole purpose of the visit. And if it was an add on that aspect of the exam would not be covered -- ie, you might be venturing into 99214 and documentation of covered services would only justify a 99212 or 3. A fifteen minute appointment becomes a half hour. Insurance companies do not cover the services because peer reviewed studies have shown no difference in outcome between classic HRT and BHT, and as we all know HRT has been linked to increased incidence of breast cancer and heart disease. No insurance company will cover the therapy because they don't want to repeat the mistakes of HRT by approving it before it can be properly studied and proven not to cause similar side effects.

All insurance coverage is dictated by the standard of care, and BHT is too new to be the standard of care. That doesn't mean it doesn't work, or that the benefits might not outweigh the risks in many cases, but it does mean that it won't be covered. It's the same principle as when an insurance company denies a pelvic ultrasound for one woman if the ICD9 indicates the study was done because of infertility, but pays for the same procedure when the doctor is trying to diagnose a suspected fibroid.

I would code a level 3 visit. Menopausal syndrome-- 627.2, Hormone imbalance-- 259.9 these codes would be justified if you discussed conventional and alternate treatments which I think I would in almost all circumstances.

 

[kipkaboodle]

Can bio-identicals cure common <a href="http://www.thewileyprotocol.com">hormonal problems</a>?

 

[Gidget]

i don't know but I was wondering if she gained her weight back before or after the hormones
These bioidenticals sound like a good thing but I was wondering how you can control the dosage by rubbing in a lotion as Dr. Phils wife was shown doing

The cream I use has a measured dosage pump. I use natural progesterone and it SAVED MY LIFE! I had hot flashes like every 20 minutes and night sweats. GONE A MUNDO! I can't say enough great things about it. My mood is better too.

Now I have a friend who has an implant of bio identical hormones and she has progesterone and testosterone. Her libido is like wild. Not going to go the testosterone route myself, as the progesterone has helped me so much.

The cream I use doesn't require a prescription and since I am in menopause I use it for 25 days on and 5 days off.

G

 

[Gidget]

for women, I highly recommend Christiane Northrup's book, The Wisdom of Menopause. She provides so much information, including information such as the above article - but she goes so much further. providing women with an education based on what is known in the medical field, current advances and practices, so that they can decide if HRT is right for them, how to take hormones safely, and a wealth of alternatives. Her approach to HRT is very conservative even though she definitely recommends BHRT over synthetic (when and if a woman chooses to use hormone therapy), and for all the right reasons.

I'm finding there are the Christiane Northrup-type MDs specializing in women's health who are cautious about the use of HRT, but emphatic about BHRT. and there are the Suzanne Somers folk who believe most people (men and women) will need some BHRT as you age in order to feel good and stay healthy throughout later (advanced age) life. I'm betting on Christiane's approach, but you can bet there will be much discussion about all of this in the years to come. thankfully!

I read her book as well as Dr Lee's (What Your Doctor May Not Tell You About Menopause). For me, lifestyle, exercise, and the progesterone cream are the bomb. As well as little to no caffeine or booze. That's what works for me anyway.

Christine goes into mental aspects also - are you happy, etc... I believe she got divorced in order to become complete. So hormones weren't enough for her. Good books both.

G

 

[Teresa]

I read her book as well as Dr Lee's (What Your Doctor May Not Tell You About Menopause). For me, lifestyle, exercise, and the progesterone cream are the bomb. As well as little to no caffeine or booze. That's what works for me anyway.

Christine goes into mental aspects also - are you happy, etc... I believe she got divorced in order to become complete. So hormones weren't enough for her. Good books both.

G

Hormone therapy isn't what Dr. Northrup is all about although she does think they are useful for some/many women at some point. she provides a great deal of information about HRT's based on her extensive work. However, as a doctor in women's health, HRT is only one piece of the puzzle - and not needed by everyone. I think a range of reading resources is necessary for any woman to educate herself. because the bottom line is that your health, and what works for you, is going to be your decision. along with a good doc of course. but we each have to do the work for ourselves to find what works from peri to post, to keep ourselves as healthy as possible. Lifestyle behavior (diet, exercise, etc) is number one in women's health at any age, especially in later years - which any medical provider will tell you right up front, regardless of their views or experience in HRT.

Dr. Northrup gives her experience (very briefly) about her divorce during menopause, and her take on what happens to women emotionally and why - I found this interesting - but only anecdotal - like so much in the field of women's health. reading about how women kind of exit from their estrogen haze and wonder how the hell they got to this point in their lives... well, many many many women experience that kind of thing, and yes, some divorce. not sure how all this correlates, but it is quite interesting.

 

[Gidget]

Yep - that's what I was getting at. She is about way more than just hormones. Many aspects need to be looked at when "fixing" menopause.

Have you read Dr Lee's books?

G

 

[Teresa]

Yep - that's what I was getting at. She is about way more than just hormones. Many aspects need to be looked at when "fixing" menopause.

Have you read Dr Lee's books?

G

I don't remember reading Dr Lee - what is a title or full name? I'll look it up. we had an earlier HRT thread where folks shared a lot of resources, if anyone is interested in doing the research. There are many doctors specializing and publishing in women's health - but you have to seek them out - Suzanne Somers actually provides a lot of excellent information - even though her BHRT is rather extreme (anti-aging medicine - bioidenticals plus a zillion supplements, etc) which is cutting edge but not really what most of us are seeking. still, she provides a lot of information she's gathered from a range of specialists.