New York Times Health  July 15, 2010

Q. Is there anything that healthy women should do about avoiding too much estrogen, since it is found in some cancers?

A. There is a growing body of evidence indicating that estrogen plays a role in lung cancer progression.

In the Women’s Health Initiative, a large randomized study of post-menopausal women comparing the use of hormone replacement therapy (HRT) to placebo, HRT users were more likely to die from lung cancer. Women using HRT in the Vitamins & Lifestyle (VITAL) trial were more likely to develop lung cancer, and the longer they used HRT the greater their risk of getting the disease.

In studies of women who had been successfully treated for breast cancer, anti-estrogens not only protected them from a recurrence of their breast cancer, they were also less likely to develop lung cancer.

Estrogen receptors are found in at least 70% of lung tumors - from both women and men - indicating that the connection is not specific to women.

As a consequence of these and other studies, most physicians are recommending that HRT be used only if no other therapy can control post-menopausal symptoms, and for as short a time as possible. Many oncologists are also now recommending that post-menopausal patients who are diagnosed with lung cancer discontinue HRT use as soon as they are able.

Sincerely,
Regina Vidaver, PhD
Executive Director
National Lung Cancer Partnership

NIH: National Heart, Lung, and Blood Institute:

The paper was published in Volume 15, Issue 5 of the Journal of Health Psychology.

— New research from the University of Sheffield has found that social and psychological factors have the biggest influence upon women’s sexual behaviour during the menopause, rather than biological changes such as declining hormone levels.

The study, which will be published in the Journal of Health Psychology, found that contrary to previous evidence, women’s experience of sexual activity during the menopause differs greatly between individuals, and is not always directly linked to biological factors.

The research team interviewed a group of British women to capture their perspectives on the menopause and assessed whether they had experienced change in sexual activity and satisfaction during their menopause.

Almost all had experienced some form of change but the findings indicated that these were down to a number of external factors such as providing care for a relative, partner´s low sexual desire and the quality of the relationship, alongside biological factors such as perceived changes in levels of hormones. The findings therefore concluded that women go through many lifestyle changes during mid-life which are also contributing factors.

Dr Sharron Hinchcliff, from the University´s School of Nursing and Midwifery, said: “Our study has examined the influence of psycho-social factors on sexual activity during the menopause to provide a new perspective on the increasingly medicalised view of this time of life.

“Biological research tends to report the negative impact of declining hormone levels on women´s ability to engage in and enjoy sexual activities, whereas our study found that some women actually saw an increase in sexual desire during this time. By highlighting this variability, we hope to challenge the perspectives that treat women as a homogeneous group or which regard the menopause as an event that will affect all women´s sexuality in the same way.”

A hot flash is a sudden, intense, hot feeling on your face and upper body. Hot flashes can be accompanied by a rapid heartbeat, sweating, nausea, dizziness, anxiety, headache, weakness, or a feeling of suffocation, followed by chills. Hot flashes are caused by less estrogen circulating throughout your body. When estrogen levels drop or estrogen receptors are blocked due to certain medications, the body’s temperature control system gets confused and the result is hot flashes.

Hot flashes are a symptom of menopause. Hot flashes can be intense for some women. When menopause has been medically induced some women feel it is the culprit of the intensity.

Managing hot flashes

If you’re taking hormonal therapy and want to stop talk to your doctor. Let them know  your preferences for treatment and suggest what you would like to try. If you are considering Femmerol, direct them to the website or print out information such as the ingredient list and clinical study. Keep in mind not all doctors are aware of natural treatments and the more information you are able to give them the better they can partner with you for your symptom relief.

You can also try these tips to ease hot flashes:

• Avoid hot flash triggers such as stress, cigarettes, alcohol, caffeine, diet pills, spicy food, hot food or drink, hot tubs, saunas, hot showers, hot rooms, and hot weather.
• Reduce the fat in your diet. Over time, a low-fat diet helps some people with hot flashes. Losing excess weight helps, but losing too much weight, or being too thin, can make hot flashes worse.
• Dress in layers so you can peel off one layer after another as you get warmer.
• Don’t wear heavy or thick fabrics such as wool, synthetics, or silk. Wear loose and airy fabrics such as cotton, linen, and rayon.
• Keep ice water nearby so you can sip it to cool down. Pack a small cooler full of cold water to carry with you.
• Lower the room temperature by turning down the thermostat, turning on the air conditioner, or turning on the ceiling fan.
• Sleep in cotton pajamas or a nightgown. If you have hot flashes and perspire at night, the nightclothes are easier to change than the sheets.
• Put cotton sheets on your bed. Cotton soaks up sweat and dries quickly.
• Take a cool shower before going to bed.
• Consider techniques that may help include meditation, massage, yoga, and acupuncture.
• Be patient. Your body is going through changes. Take care of yourself, keep it natural and you’ll feel more like yourself again.

A Message from Dr. Love
Moving Research Forward
Every now and again a research study grabs my attention because the investigators have gone off on a new path and have published findings that make me think: Wow, they could be on to something! In other instances, a study grabs me not because of what the researchers found, but because the media made it sound so much better than it was. And sometimes it’s a bit both—which is why I want to talk to you about the breast cancer vaccine that’s been all over the news.

Over the past few years, I’ve come to believe that it is very likely that there is a virus that is involved in the initiation of some forms of breast cancer. So, I was intrigued to learn more about this work. What these researchers have done is interesting. And while it may sound promising to hear that none of the vaccinated mice in their study developed breast cancer, it’s equally important to remember that scientists stop breast cancer from developing in mice all the time. So, it’s foolish for anyone to be acting like we have suddenly found a way to prevent breast cancer when we don’t even yet know if this vaccine will be safe or effective in women!

This is, however, a great example of why we started and why researchers need the Army of Women! If researchers are able to develop a safe vaccine that they think can prevent breast cancer, it will need to be tested in tens of thousands of women before it can be approved and then widely used. And, if and when that happens, the Army of Women would love to be a part of it! Until then, though, we’d all be much better off if everyone could remember that women are not mice, and that we should save our accolades for real breakthroughs, not media-manufactured ones. MORE >

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This article appears on FDA’s Consumer Updates page which features the latest on all FDA-regulated products.

“A natural, safer alternative to dangerous prescription drugs”

“Can slim you down by reducing hormonal imbalances”

“Prevents Alzheimer’s disease and senility”

All of these claims have been made by marketers of compounded “bio-identical” hormones, also known as “bio-identical hormone replacement therapy” (BHRT). But these claims are unproven. FDA is concerned that claims like these mislead women and health care professionals, giving them a false sense of assurance about using potentially dangerous hormone products.

FDA is providing the facts about “BHRT” drugs and the uncertainties surrounding their safety and effectiveness so that women and their doctors can make informed decisions about their use.

“BHRT” is a marketing term not recognized by FDA. Sellers of compounded “bio-identical” hormones often claim that their products are identical to hormones made by the body and that these “all-natural” pills, creams, lotions, and gels are without the risks of drugs approved by FDA for menopausal hormone therapy (MHT). FDA-approved MHT drugs provide effective relief of the symptoms of menopause such as hot flashes and vaginal dryness. They also can prevent thinning of bones. FDA has not approved compounded “BHRT” drugs and cannot assure their safety or effectiveness.

During menopause, a woman’s body produces less of the hormone estrogen, which may lead to hot flashes, vaginal dryness, and thin bones. MHT drugs contain estrogen or a combination of estrogen and another hormone, a progestin. FDA-approved MHT drugs are sold by prescription only, and FDA advises women who choose to use hormones to use them at the lowest dose that helps, for the shortest time needed.

Some “BHRT” drugs are compounded in pharmacies. Traditional compounding involves combining, mixing, or altering ingredients by a pharmacist, according to a prescription from a licensed health care professional, to produce a drug that meets an individual’s special medical needs. FDA considers traditional compounding to be a valuable service when used appropriately, such as customizing a drug for someone who is allergic to a dye or preservative in an FDA-approved medicine. But some pharmacies that compound “BHRT” drugs make unsupported claims that these drugs are more effective and safer than FDA-approved MHT drugs.

FDA is taking action against pharmacies that make false and misleading claims about “BHRT” drugs and is encouraging consumers to become informed about these products and their risks. Here is some information to help sort the myths from the facts:

Myth: “Bio-identical” hormones are safer and more effective than FDA-approved MHT drugs.

Fact: FDA is not aware of any credible scientific evidence to support claims made regarding the safety and effectiveness of compounded “BHRT” drugs. “They are not safer just because they are ‘natural,’” says Kathleen Uhl, M.D., Director of FDA’s Office of Women’s Health.

Drugs that are approved by FDA must undergo the agency’s rigorous evaluation process, which scrutinizes everything about the drug to ensure its safety and effectiveness—from early testing, to the design and results of large clinical trials, to the severity of side effects, to the conditions under which the drug is manufactured. FDA-approved MHT drugs have undergone this process and met all federal standards for approval. No compounded “BHRT” drug has met these standards.

Pharmacies that compound these “BHRT” drugs may not follow good drug manufacturing requirements that apply to commercial drug manufacturers. Compounding pharmacies custom-mix these products according to a health care professional’s order. The mix contains not only the active hormone, but other inactive ingredients that help hold a pill together or give a cream, lotion, or gel its form and thickness so that it can be applied to the body. It is unknown whether these mixtures, which are not FDA-approved, are properly absorbed or provide the appropriate levels of hormones needed in the body. It is also unknown whether the amount of drug delivered is consistent from pill to pill or each time a cream or gel is applied.

Myth: “Bio-identical” hormone products can prevent or cure heart disease, Alzheimer’s disease, and breast cancer.

Fact: Compounded “BHRT” drugs have not been shown to prevent or cure any of these diseases. In fact, like FDA-approved MHT drugs, they may increase the risk of heart disease, breast cancer, and dementia in some women. (See www.nhlbi.nih.gov/whi/index.html² for information on the Women’s Health Initiative, a large, long-term study that tested the effects of FDA-approved MHT drugs.) No large, long-term study has been done to determine the adverse effects of “bio-identical” hormones.

Myth: “Bio-identical” hormone products that contain estriol, a weak form of estrogen, are safer than FDA-approved estrogen products.

Fact: FDA has not approved any drug containing estriol. The safety and effectiveness of estriol are unknown. “No data have been submitted to FDA that demonstrate that estriol is safe and effective,” according to Daniel Shames, M.D., a senior official in the FDA office that oversees reproductive products.

Myth: If “bio-identical” products were unsafe, there would be a lot of reports of bad side effects.

Fact: “Bio-identical” products are typically compounded in pharmacies. “Unlike commercial drug manufacturers, pharmacies aren’t required to report adverse events associated with compounded drugs,” says Steve Silverman, Assistant Director of the Office of Compliance in FDA’s Center for Drug Evaluation and Research. “Also, while some health risks associated with ‘BHRT’ drugs may arise after a relatively short period of use, others may not occur for many years. One of the big problems is that we just don’t know what risks are associated with these so-called ‘bio-identicals.’”

Myth: A pharmacy can make a “BHRT” drug just for you based on hormone levels in a saliva sample.

Fact: “Advertisements that a drug can be created ‘just for you’ based on saliva testing are appealing,” says Uhl, “but unrealistic.” Hormone levels in saliva do not accurately reflect the amount of hormones a woman has in her body for the purpose of adjusting hormone therapy dose levels. A woman’s hormone levels change throughout the day, and from day to day. FDA-approved tests can tell a woman’s hormone level in a specific body fluid, such as saliva, blood, or urine, at that particular point in time. “These tests are useful to tell if a woman is menopausal or not,” says Uhl, “but they have not been shown to be useful for adjusting hormone therapy dosages.”

Myth: FDA wants all compounded hormone therapies off the market.

Fact: “We are not trying to pull all compounded hormone therapies off the market,” says Silverman. “We believe that, like all traditionally compounded drugs, a woman should be able to get a compounded hormone therapy drug when her physician decides that it will best serve her specific medical needs. But we also want women to be informed and careful about choosing products that have not been proven safe and effective. And pharmacies cannot promote compounded drugs with false or misleading claims.”

In addition, FDA has not approved any drug containing the hormone estriol. Pharmacies should not compound drugs containing estriol unless the prescriber has a valid investigational new drug (IND) application. INDs provide benefits that include allowing physicians to treat individual patients with drugs that are not FDA-approved, while also providing additional safeguards for patients.

Myth: All women who take FDA-approved MHT drugs are going to get blood clots, heart attacks, strokes, breast cancer, or gall bladder disease.

Fact: Like all medicines, hormone therapy has risks and benefits. For some women, hormone therapy may increase their chances of getting these conditions. However, there are no convincing data that there is less risk of developing a blood clot, heart attack, stroke, breast cancer, or gall bladder disease with a “BHRT” product. Women should talk to their health care professional about taking hormones. If you decide to use MHT drugs for menopause

• use at the lowest dose that helps
• use for the shortest time needed

If you are taking a compounded “BHRT” drug now, talk to your health care professional about treatment options to determine if compounded drugs are the best option for your particular medical needs.

What is sustainable healthcare?

Sustainability is a robust concept that has proven its worth across a range of different industries including energy, agriculture, forestry and even construction and tourism.

Contemporary healthcare in western countries is presently dominated by use of pharmaceutical drugs—and most indicators would suggest that these approaches have had very limited value in dealing with some of the greatest scourges facing human health, including chronic diseases, psychiatric diseases and even certain infectious diseases.

From a cost/benefit perspective, pharmaceutical-based approaches to healthcare do not fare favourably and a sea change is required if mainstream western healthcare is to deal with the ever increasing burden on the healthcare system, particularly given that this burden will be exacerbated by an ageing population.

The dichotomy between complementary & alternative medicine (CAM) and orthodox/allopathic healthcare approaches has led to increased vilification of protagonists of each approach. The use of scientific methods of evaluation that do not lend themselves well to CAM approaches have meant that the ‘medical establishment’ has been able to increasingly marginalise CAM approaches. This has occurred while the establishment has provided no significant improvement in its offering to the majority of the population that is either forced to accept or choose to accept pharmaceutical-based medicine as the most effective and scientifically-validated form of medicine.

Encouraging a paradigm shift that requires all forms of healthcare to be bound by principles of sustainability is one of the surest means of providing a level playing field for all healthcare modalities which encourages those approaches that are compatible with the complex biological and energetic systems of which are bodies are comprised.

Sustainability principles, including those applying to engineering and design, should also be applied to healthcare facilities. To read an evaluation of the state-of-the-art on this subject, read an article by Dominic Stalker, a work experience science student who worked with the ANH during the summer of 2008 entitled Engineering sustainability into hospitals.

Definition of Sustainable Healthcare

The ANH first defined sustainable healthcare in 2006 in the UK practitioner journal Nutrition Practitioner. The definition is as follows:

“A complex system of interacting approaches to the restoration, management and optimisation of human health that has an ecological base, that is environmentally, economically and socially viable indefinitely, that functions harmoniously both with the human body and the non-human environment, and which does not result in unfair or disproportionate impacts on any significant contributory element of the healthcare system.”

Read Dr Robert Verkerk’s article published by the Australasian College of Nutritional and Environmental Medicine (ACNEM).

The article was written following an inaugural lecture at the National Institute for Integrative Medicine, hosted by Australian associations ACNEM and AIMA.

Looking through the window—the paradigm shift is the other side of the wall…

Executive Summary of the ANH Sustainable Healthcare Campaign

For more than two decades the orthodox (allopathic or western) healthcare establishment has vigorously attacked the scientific basis, efficacy and safety of the diverse range of modalities befitting approaches that are commonly placed under the banner of complementary and alternative medicine (CAM). Simultaneously, the CAM community, the natural products industry, health freedom organisations and large numbers of consumers and protagonists of CAM, have argued that these attacks are unjustified and have reciprocated by exposing the apparent lack of efficacy and poor safety record of orthodox healthcare.

These differences of opinion are so deep-seated that the polarity between the two contrasting approaches has become increasingly reinforced. The relative lack of resources within the CAM community, the natural products industry and the health freedom movement, by comparison with the pharmaceutical industry and orthodox medical system which it supports, means that it is by and large proving very difficult to improve the acceptability of CAM modalities in mainstream healthcare.

All the available indicators suggest that orthodox healthcare, which is dominated by interventions with new-to-nature pharmaceutical drugs, is not sustainable. ‘Evidence-based medicine’ (EBM) is increasingly being used both as a means of justifying pharmaceutical intervention as the world’s dominant approach to healthcare and its ever-wider application to discredit or even outlaw particular CAM approaches.

The Alliance for Natural Health (ANH) proposes that the application of the principles of sustainability to healthcare may be one of the most effective ways of altering the perception of established and emerging CAM modalities from the vantage point of government authorities and the current medical establishment. In addition, such an approach could significantly assist a transition in mainstream healthcare that is characterised by improved take up of biologically compatible modalities, as found within CAM. Such a transition would, among other things, allow for much greater use of preventative approaches, especially among children, young adults and non-diseased sub-populations, better diagnosis of disease, widespread adoption of lifestyle and nutrition-based approaches, greatly reduced dependence on new-to-nature medications and marked changes in medical training. With the identification of scientifically established criteria for sustainability in healthcare, only those approaches meeting the criteria stipulated would be accepted. Sustainability has become one of the key technological drivers in a range of other industries where social or environmental degradation has been implicated, and it is incongruous that the principles of sustainability have yet to be applied to healthcare.

The ANH, its affiliates and strategic partners are well set to help trigger the transition towards sustainable healthcare. The transition will continue to require funding of independent research in academic institutions, extensive public and government-targeted awareness campaigns and the establishment of scientifically monitored pilot programs designed to demonstrate both feasibility and sustainability.

A transition towards sustainability would also help to eliminate the existing polarity between orthodox healthcare and CAM approaches and would inevitably prefer those approaches that function harmoniously with biological systems and human metabolism, rather than those that oppose them.

** Sustainable Health articles on this page provide by ANH-Europe.

ScienceDaily (May 8, 2010) — The stage for osteoporosis is set well before menopause — but exercise can help rewrite the script, according to Medical College of Georgia researchers.

Declining estrogen levels have long been associated with osteoporosis, but bone density starts to decline years before these levels drop, according to Dr. Joseph Cannon, Kellet Chair in Allied Health Sciences and principal investigator of the National Institute of Aging-funded study. It’s during that time that levels of follicle-stimulating hormone, released by the pituitary gland to help regulate ovarian function, actually increase.

Cannon theorizes that higher levels of FSH decrease bone mineral density by increasing cytokines, regulatory proteins produced by white blood cells. One cytokine in particular, interleukin-1, signals certain cells to transform into osteoclasts, which break down and resorb bone. “We hypothesize that the higher levels of FSH decrease bone mineral density by influencing the production of cytokines,” said Cannon, who presented his team’s research at the American Physiological Society’s Experimental Biology 2010 conference in Anaheim, Calif. (April 24-28).

After measuring FSH and bone mineral density in 36 women between the ages of 20 to 50, the researchers correlated higher FSH levels with lower bone mineral density. When they incubated FSH with white blood cells isolated from the women, it stimulated production of interleukin-1. Moreover, higher circulating levels of IL-1 correlated with lower bone mineral density, if the levels of interleukin-1 inhibitory factors were taken into account.

Additionally, they found that study participants who exercised more than 180 minutes a week retained greater bone density.

“Our work provides more evidence that physical activity is important for maintaining bone density. It’s a case of ‘use it or lose it,’” Cannon said, citing his team’s findings that exercise seemed to promote inhibitory factors that help keep interleukin-1 and bone breakdown under control.

The team’s next step is to determine how exercise influences the expression of interleukin-1 inhibitory factors.

Team members include Dr. Miriam Cortez-Cooper, assistant professor of physical therapy; Eric Meaders, assistant professor of biomedical and radiological technologies; Judith Stallings, assistant professor of physician assistant; Sara Haddow, assistant professor of physician assistant; Barbara Kraj, assistant professor of biomedical and radiological technologies; Gloria Sloan, research associate; and Dr. Anthony Mulloy, section chief of endocrinology and nutrition.