Dr Jerilynn Prior discusses the accurate naming of women's midlife transition and what to look for to define whether you're perimenopausal.
The Women’s Health Initiative (WHI) Estrogen plus Progestin (E plus P) trial was prematurely stopped because it caused harm (1). Until the Estrogen in women with hysterectomy arm (E only) of the WHI was also halted prematurely in 2004 (2), progestin was blamed for the lack of heart disease prevention. But now, five years later, doctors and media are still discussing Hormone Replacement Therapy (HRT) and menopause as estrogen deficiency. The fundamental question is: Given these huge, great science WHI studies showing harm is caused by HRT, why has medicine not changed?
The largest and best-controlled trial testing whether hormone “replacement” therapy prevented heart disease was stopped three years early in July 2002. The Women’s Heath Initiative (WHI) study included over 16,600 healthy menopausal women without symptoms. These women were randomized to daily conjugated equine estrogen (Premarin, 0.625 mg) plus medroxyprogesterone (Provera, 2.5 mg) or an identical placebo. Hormone therapy increased breast cancer significantly (by 26% over placebo) and caused higher rates of heart attacks (29%), strokes (41%) and blood clots (211%). These risks outweighed this therapy’s significant benefits in preventing osteoporotic fractures of the hip (decreased by 34%) and colon cancer (decreased by 36%).
Since July 2002,hundreds of talk shows and editorials across North America have discussed these results. Many doctors and medical groups have offered criticisms. However, no one has yet identified what I believe is most important.
When periods are very heavy or you are experiencing “flooding” or passing big clots you have what doctors call menorrhagia. The purpose of this article is to define normal and very heavy menstrual bleeding, to explain what causes heavy flow, and to show what you yourself can do in dealing with heavy flow. This, and the article called “Managing Menorrhagia—Effective Medical Treatments” for your doctor or health care provider, are to help you avoid surgeries for heavy flow (hysterectomy and endometrial ablation) if you can.
We hear a lot of things about hormone therapy (often wrongly called Hormone Replacement Therapy or HRT) (1). Most of the time when “HRT” is used it is referring to the treatment of women who had natural (not surgical) menopause at a normal age. Before about 1998 we believed that estrogen made everything better, but now most of what we hear is bad. And that bad news doesn’t apply to you! Early or surgical menopause needs hormone therapy, but natural, normally timed menopause does not. Some women with early menopause have told me that their doctors stopped their hormone treatment when the Women’s Health Initiative results came out. That’s how confused even doctors are! The purpose of this is to help you feel confident about knowing how and when to take ovarian hormone therapy for a long and healthy life.
Answering questions about “polycystic ovary syndrome” (also called PCOS but which CeMCOR calls Anovulatory Androgen Excess or AAE) and exploring new and helpful information about this mysterious condition.
Painful periods are known as cramps. This section looks at what causes cramps and how to ease the discomfort. Doctors call painful periods or cramps “dysmenorrhea.” They are caused by high levels of prostaglandins, a kind of hormone that increases the normal squeezing or contraction of the muscle in the wall of the uterus.
Women in midlife increasingly hear the words “estrogen deficiency” spoken as the ultimate in bad news. “Everyone knows” that low estrogen levels cause heart disease, osteoporosis, Alzheimer’s and frigidity. Our purpose here first is to put women’s midlife concerns into a new and more accurate hormonal picture. Specifically, to present information about high estrogen levels in the perimenopause; how a woman can tell when her estrogen levels are high and out of balance with progesterone and then we’ll review the many ways a woman can help herself through perimenopause.
Progesterone is one of two important hormones for women (estrogen is the one we usually hear about). Menstrual cycle hormone levels can be disturbed, even during regular cycles. The most common disturbance is of ovulation causing progesterone levels to become too low or absent.
Your doctor may prescribe progesterone to control heavy periods, severe menstrual cramps (dysmenorrhea) or to help with irregular periods, acne, unwanted hair, low bone density, or sore and lumpy breasts.
When a woman comes to you saying that her periods are "heavy" she's "flooding" or she's passing clots, what do you normally do to assess and treat her? The purpose of this paper is to define normal menstruation and how to clinically assess menstrual flow. In addition, you will learn how to make a diagnosis of menorrhagia some practical medical ways in which you can manage menorrhagia.
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