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A recent article on hormones for menopause caught my attention. I was puzzled by the fact that the author, Staness Jonekos, has no medical credentials, training or even a rudimentary knowledge of biological science. Rather, she is an actress with a theater arts degree from UCLA. She chronicled her menopause experience with a book and blog entitled Menopause Makover. To make up for her lack of medical knowledge, Staness joined up with Wendy Klein MD , an academic physician who advocates synthetic, chemically altered hormones (progestins), and SSRI antidepressants for menopausal symptoms. The latest article by the two women, "10 Hormone Therapy Facts", is a compilation of nonsense, falsehoods, and half truths, with a hidden agenda promoting the synthetic hormone industry by maligning natural bioidentical hormones.
Above left image: Bioidentical Hormones represented by Natural Redhead courtesy of wikimedia commons.
10 Ten Hormone Facts should be renamed 10 Ten Hormone Fallacies
Firstly, the Jonekos article maligns bioidentical hormones as unregulated, non-FDA approved and not supported by science. These claims against bioidentical hormones are false, and a smoke screen to hide the really scary fact that synthetic hormones are monsters that cause cancer and heart disease. (Women's Health Initiative)
Secondly, the article tries to confuse the difference between bioidentical hormones and synthetic, chemically altered hormones made by the pharmaceutical industry. Do not be confused, they are very different. Synthetic hormones are chemically altered monsters that cause cancer and heart disease. Bioidentical hormones are identical to hormones found naturally in the human body, the safe and effective choice.
Thirdly the article contradicts itself in number 7, stating that blood testing is not needed, while the author earlier reported that blood testing revealed a high estrogen level. Obviously, blood testing was needed.
Fourth, the article quotes the Menopause and Endocrine Societies as authorities without revealing their financial ties to the synthetic hormone makers such as Wyeth.
Fifth, the author says that bioidentical hormones did not work for her. Quite to the contrary, millions of women use bioidentical hormones every day for relief of menopausal symptoms and quality of life. Bioidentical hormones work quite well.
Sixth, After ranting that bioidentical hormones don't work, the author reports they DO work, and she uses estradiol, a bioidentical hormone. Estrogen alone without progesterone causes increased risk of endometrial cancer. This important information is omitted from the article, possibly harming women readers who accept Staness as a medical authority, incorrectly concluding that estrogen without progesterone is acceptable. It is not acceptable, and is a disservice to women.
Let's go through the article in detail. Note: the Jonekos article text is in italics:
Bioidentical hormone treatment made my menopausal symptoms worse.
"I splurged for Somers' expensive Beverly Hills doctor recommendation, assuming he must have the answers. He confirmed I was menopausal and gave me tubes of compounded triple estrogen gel and compounded 10 percent micronized progesterone gel, with orders to apply them regularly. After a few months of visiting this overpriced Beverly Hills doctor, my menopause symptoms were exaggerated and my moodiness turned into depression. "
My comment: This bioidentical hormone program of estrogen gel and progesterone is the correct one, used by millions of women daily. It is safe and effective. However, close patient monitoring is required, and the patient should be alerted to watch out for signs of hormonal excess.
"A blood test revealed that my estrogen levels were seven times higher than normal, my increased weight now placed me into the overweight BMI category, and my severe crankiness made it impossible to work. There is no need for testing of hormone levels, either in saliva or blood. The science has shown that there is no predictable correlation between hormone levels in saliva or in blood and severity of symptoms. "
My comment: Apparently, Jonekos visited a bioidentical hormone doctor in Beverly Hills. Uzzi Reiss MD is well known in Beverly Hills and prominently mentioned in Suzanne Somer's book. Jonekos obviously did not read Reiss's books on bio-identical hormones which explain the symptoms of estrogen excess. These are fluid retention, bloating, breast enlargement and tenderness. Once these symptoms are identified, the patient holds off using the estrogen cream until symptoms are relieved. Educating the patient about estrogen excess symptoms, and when to hold hormone dosage is the key to successful treatment program.
An omission Jonekos revealed in a blog posting elsewhere is the story of birth control pills for many years. Birth control pills are synthetic hormones, and when these are abruptly stopped, this causes onset of menopausal symptoms. This complicates the story considerably. Birth control pills are a form of chemical castration, halting ovulation. Birth control pills cause artificial cycles without ovulation. Once the pills are stopped, there is usually a delay of months before normal ovarian function and normal cycling resumes. Until ovarian function returns, there is no hormone production and patients experience typical menopausal symptoms with low hormone levels.
Let's assume such a scenario took place. When such a patient begins a bioidentical hormone program, hormone levels will go up with relief of menopausal symptoms. The patient feels better. However, a few months later, there is resumption of ovarian function which pumps new hormones into the patient's body, added to the levels produced by her hormone creams. This causes hormonal excess with all the usual symptoms of bloating, breast enlargement and mood disorder. This is not a failure of the bioidentical hormone medication. Hormonal excess means the hormones are working too well, raising estrogen levels too much. This is not a failure of the medication, rather it is a failure of patient monitoring and failure to alert the patient to these symptoms. Blood testing is useful here to show elevated estrogen levels.