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Archive for the 'Men & Women' Category

Will Wyeth Bully You Out of Your Estriol?

From NaturalNews.com

The FDA has begun 2008 by forbidding compounding pharmacists to use estriol in their natural hormone formulations because the agency doesn’t have a specified approved use for it. They took this action because Wyeth complained about it. And yet, Wyeth-Pharma sells two types of estriol drugs in Europe, so we know this is not a safety and efficacy issue.

In case you’ve forgotten, Wyeth is the giant pharmaceutical company that makes Premarin and PremPro, synthetic hormones found to cause heart disease, strokes and cancer. If we do some rough calculations based on statistics from the Women’s Health Initiative (WHI), Wyeth’s hormone replacement drugs have killed tens of thousands of women over the past few decades. Sales of these dangerous drugs have plummeted since the WHI results were announced, and women who were injured by them and sued, are winning millions in damages in courtrooms around the U.S. (You go girls!) .

Estriol is a Safe Alternative

Estriol, on the other hand, is a mild (natural) estrogen that’s primarily used in cream form for vaginal dryness and urinary tract problems in menopausal women. It’s been in common use in Europe for 30 years, and its safety and effectiveness are well established. Many doctors in the U.S. who use natural hormones prescribe tri-est and bi-est, estrogen cream formulations made by compounding pharmacies that contain estriol. These formulations appear to be what Wyeth perceives as its competition. If you’d like to know more about estriol, Dr. David Zava wrote an entire chapter about it in What Your Doctor May Not Tell You about Breast Cancer ((http://www.virginiahopkinstestkits.com/…) .

Here’s what the medical literature states about Ovestin, an estriol cream made in Europe: “Ovestin contains the natural hormone estriol, which is a weak estrogen. It treats urogenital symptoms without causing adverse changes to the endometrium, which means that it can be used without a progestogen in women with an intact uterus… The absence of progestogen-induced withdrawal bleeds with Ovestin makes it highly acceptable to women.”

The doctors and pharmacists can take the estriol out of the formulas and they’ll still work well because they also contain estradiol, but ironically they probably won’t be quite as safe. Estriol may have some protective properties that balance estradiol’s cancer-promoting effects. In fact, estriol is so safe that it’s the primary estrogen of pregnancy - the fetus is bathed in it.

The Bully in the Neighborhood

It’s shameful of Wyeth to use its clout and money to bully and beat on the competition through the FDA, but by now we expect that behavior from them. The real shame is that the FDA can’t seem to stop itself from being bullied. You can bet there was some major arm twisting going on to push the FDA into this action, because they just have to know that it’s been proven safe and effective in Europe, and that thousands of annoyed menopausal women are going to be sending them e-mails. We can only hope that the FDA responds by quickly reviewing the body of excellent research available on estriol and taking action to assign it some specific and approved uses.

In the meantime, if big bad Wyeth succeeds in taking your estriol away, and you can’t have sex because of vaginal dryness, send your partner to Washington to march on the FDA’s doorstep. Just kidding.

This is an especially poignant issue for women with breast cancer or who have had breast cancer, because estriol is a safe alternative to estradiol. The estrogen-blocking drugs such as tamoxifen that are used to treat breast cancer can cause terrible vaginal dryness and urinary tract problems, and even without the drugs, these are serious problems for many menopausal women.

Estradiol cream is an effective, albeit less safe, treatment for vaginal dryness and urinary tract problems. Please use the lowest dose possible that relieves symptoms and use progesterone cream for balance. For details, I recommend that you read Dr. John Lee’s Hormone Balance Made Simple

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Fertility study builds buzz around cellphones

From USATODAY.com

Are men speed-dialing infertility by talking for hours a day on their cellphones?

A new study suggests that might be the case, but before potential papas ditch the devices, they should know that lead author Ashok Agarwal says the data are “quite preliminary.”

Cellphones emit radiofrequency electromagnetic waves. Scientists have reported potential adverse effects of the waves on the brain, heart, endocrine system and DNA, Agarwal, director of the andrology lab at the Cleveland Clinic Foundation, and his co-authors write in the journal Fertility and Sterility.

Agarwal’s team studied 361 men under 40 who were being evaluated for infertility; men whose personal or family history might explain a low count or other sperm abnormalities were excluded.

The scientists divided the patients into four groups, based on how long they said they talked on a cellphone each day. Then they analyzed the men’s semen and found a strong association between length of time spent on a cellphone and sperm count and quality. Those who talked more than four hours a day had lower counts and more poor “swimmers” and abnormally formed sperm.

One reason could be the heat generated by the phones; sperm production is sensitive to temperature, Agarwal says.

The researchers didn’t ask the men about other potential sources of electromagnetic wave exposure, like laptop computers, or where the men usually kept the phone when they talked. Next to their ear? In a pocket while using a headset? Says Agarwal: “There are hundreds of variables that can affect our conclusions.”

Location, location, location makes a big difference, says British infertility specialist Iwan Lewis-Jones, who, like Agarwal, is conducting laboratory studies of cellphones’ impact on sperm specimens. “To get an effect, I think you’ve got to have the phone very close to the sperm.”

In research still ongoing, Agarwal says, he has found that sperm quality decreases in semen specimens left sitting next to a phone in talk mode for as little as an hour. Lewis-Jones says he isn’t ready to report results from his research, in which phones in talk mode are left next to semen specimens.

“We are not saying that mobile phones affect fertility,” he says. “All we’re trying to do is see what effect they have on the sperm cell.” In other words, he says, changes seen in laboratory experiments probably are not occurring in real life.

The only way to answer that question definitively, he says, is to randomly assign men to use a cellphone or not. But, he says, considering “I don’t know anybody who hasn’t got a mobile phone now,” few men would volunteer to go without one.

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Strokes Among Middle-Aged Women Triple

From Forbes.com

Strokes have tripled in recent years among middle-aged women in the U.S., an alarming trend doctors blame on the obesity epidemic. Nearly 2 percent of women ages 35 to 54 reported suffering a stroke in the most recent federal health survey, from 1999 to 2004. Only about half a percent did in the previous survey, from 1988 to 1994.

The percentage is small because most strokes occur in older people. But the sudden spike in middle age and the reasons behind it are ominous, doctors said in research presented Wednesday at a medical conference.

It happened even though more women in the recent survey were on medicines to control their cholesterol and blood pressure - steps that lower the risk of stroke.

Women’s waistlines are nearly two inches bigger than they were a decade earlier, and that bulge corresponds with the increase in strokes, researchers said.

In addition, women’s average body mass index, a commonly used measure of obesity, rose from 27 in the earlier survey to 29. They also had higher blood sugar levels.

No other traditional risk factors like smoking, heart disease or diabetes changed enough between the two surveys to account for the increase in strokes.

In a “pre-stroke population” of middle-age women, a tripling of cases is “an alarming increase,” said Dr. Ralph Sacco, neurology chief at the University of Miami Miller School of Medicine.

The study was led by Dr. Amytis Towfighi, a neurology specialist at the University of Southern California in Los Angeles, and presented at the International Stroke Conference in New Orleans.

She used the National Health and Nutrition Surveys, a federally funded project that gives periodic health checkups and questionnaires to a wide sample of Americans. Participants are routinely asked whether a doctor had ever told them they had had a stroke, and about 5,000 middle-aged people answered that question in each survey.

Researchers saw that the stroke rate had spiked in middle-aged women but stayed about the same - around 1 percent - in middle-aged men. So they looked deeper at the responses to see if they could learn why.

Belly fat stood out, Towfighi said. The portion of women with abdominal obesity rose from 47 percent in the earlier survey to 59 percent in the recent one. The change in men was smaller, and previous studies have shown that “abdominal obesity is a stronger risk factor for women than men,” she said.

Men traditionally have had a greater risk of stroke than women, and “women start catching up to men five or 10 years after menopause,” said Dr. Philip Gorelick, neurology chief at the University of Illinois in Chicago and chairman of the stroke conference.

The new research means “we need to redefine our textbooks about stroke in women,” because they may now be more at risk in middle age than men.

Obesity “sets the stage for all the other risk factors to come in” like diabetes and heart disease, Gorelick added.

In other news at the conference, two studies found that stroke patients were more likely to die if they went to hospitals on nights or weekends, echoing other recent studies that found similar risks for heart attack and surgery patients.

Michigan State University doctors analyzed 222,500 stroke cases at more than 850 hospitals participating in an American Heart Association quality improvement program from 2003 to 2007.

In-hospital deaths were about 6 percent for those who arrived during normal business hours and had strokes caused by a clot, compared with 5 percent of those who entered the hospital after-hours. Deaths were 27 percent for off-hour strokes caused by bleeding in the brain versus 24 percent during normal hours.

A second study of 2.4 million stroke patients in California found death rates of 10 percent on weekends and nights versus 8 percent during weekdays.

Despite the poorer outcomes, doctors said no one should ever delay getting help, since any delay raises the risk of death. The best treatments can only be given in the first few hours after symptoms appear.

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Embolization Effective for Fibroids

Most Patients Satisfied With Treatment

From WebMD

A relatively new treatment for uterine fibroids is a reasonable alternative to hysterectomy for women who want to avoid surgery, new research shows.

Outcomes among patients who had the treatment, known as uterine artery embolization (UAE) or uterine fibroid embolization (UFE), were compared to those of hysterectomy patients in the trial from the Netherlands.

Both groups reported significantly improved health-related quality of life two years after treatment, but nearly one out of four women initially treated with UAE ended up having hysterectomies because of treatment failure.

“For those women seeking absolute certainty of being asymptomatic after treatment, I would recommend a hysterectomy,” study researcher Jim A. Reekers, MD, PhD, says in a news release. “But for women who wish to retain their uterus and who desire a fast recovery, I would definitely recommend UAE.”

Fibroid Treatment Options

As many as one in four women have symptoms from uterine fibroids, which are benign tumors of the uterus.

Symptoms of uterine fibroids can include heavy, painful menstrual bleeding, pelvic pain or pressure, and frequent urination.

According to the National Women’s Health Information Center, uterine fibroids are the reason for about one-third of the 600,000 hysterectomies performed in the U.S. each year.

Introduced just over a decade ago, uterine artery embolization is a minimally invasive catheterization treatment designed to choke off uterine fibroids.

A small tube is inserted into a leg artery and guided into the blood vessels feeding the uterus. Tiny particles are then strategically injected to block the blood supply that feeds the fibroids.

In most cases, the fibroid tissue shrinks or dies, leading to relief of symptoms. Recovery time after UAE is typically around a week, compared to six weeks with hysterectomy.

This is also far shorter than recovery times for another surgical fibroid treatment known as myomectomy, in which the fibroids are removed but not the uterus.

The EMMY Findings

Reekers and colleagues report two-year follow-up from their Embolization versus Hysterectomy (EMMY) trial in the March issue of the journal Radiology.

The study included 177 women with uterine fibroids and heavy menstrual bleeding, half of whom were initially randomly assignedto treatment with UAE and the other half to hysterectomy.

During two years of follow-up, no significant differences in health-related quality of life were reported among the two treatment groups. Nine out of 10 patients in both groups reported being at least moderately satisfied with the treatment they received.

A total of 20% of women who had undergone embolization did end up having hysterectomies, however.

Georgetown University interventional radiologist James B. Spies, MD, tells WebMD that the UAE failure rate was higher in the EMMY study than in many others.

In Spies’ own UAE study involving 200 patients, the symptom-recurrence rate was still 20% with the nonsurgical treatment five years after treatment.

Spies says UAE has proven to be as effective as any uterus-sparing treatment, including myomectomy, for the long-term relief of symptoms related to fibroids.

“Women now have a choice, and they can weigh the factors that are most important to them before making a decision about treatment,” he says.

Another UAE researcher tells WebMD that myomectomy offers the best chance of preserving fertility, while hysterectomy is the best choice for patients who aren’t concerned about fertility, recovery time, or surgical complications and want to make sure their fibroids don’t come back.

“Obviously, there is no re-treatment after hysterectomy because once the uterus is gone, it’s gone,” Scott C. Goodwin, MD, of the University of California, Irvine, tells WebMD. “But UAE has been proven very effective for women who want a shorter recovery time with fewer treatment-related complications.”

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Study Says Implants Double Risk of Infection in Breast Reconstruction

From New York Times

Breast cancer patients who had reconstructive surgery using implants immediately after mastectomies were twice as likely to acquire infections as women who immediately had breast reconstruction using their own tissue, according to a study published yesterday.

The article in Archives of Surgery, which examined the medical records of breast surgery patients at Barnes-Jewish Hospital in St. Louis from mid-1999 to mid-2002, found that 50 of 949 patients acquired an infection at the surgical site within a year after surgery.

Roughly 12 percent of the infections occurred in mastectomy patients who immediately had implant surgery, compared with roughly 6 percent of infections in those who immediately had breast reconstruction using their own abdominal tissue, the study said. In noncancer patients, about 1 percent of infections occurred after breast reductions and no infections occurred after breast augmentation using implants, the study said.

The bottom line is that implants are associated with an increased risk of infection in breast cancer patients, said Margaret A. Olsen, the lead author of the study and a research assistant professor of medicine at Washington University School of Medicine in St. Louis. The question is what factors contribute to this increased risk and what can be done to prevent it?

The study noted whether patients had other medical conditions like diabetes, but it did not report how many underwent radiation or other treatments that might have played a role in the infections.

The study did analyze the cost to the medical center of each infection

about $4,100 per patient

a hospital-acquired complication not covered by managed care, she said.

But both kinds of reconstructive surgery entail risk.

Dr. Stephen R. Colen, the chairman of plastic and reconstructive surgery at Hackensack University Medical Center in New Jersey, said operations using abdominal tissue took several hours longer than implant surgery, increasing the risk of blood clots and lung embolisms. In 2 percent of patients, the transplanted tissue dies, requiring further surgery, Dr. Colen said.

But implant reconstruction inserts a foreign object into the body, providing a surface on which bacteria may grow. And implantation involves a series of procedures

including one surgery to insert a skin-stretching device in the chest, followed by saline injections to expand the breast, another surgery to put in a permanent implant and a final surgery to attach a nipple

creating more occasions for infection to occur, Dr. Colen said.

Dr. Keith E. Brandt, a professor of plastic and reconstructive surgery at Washington University and an author of the study, said all patients received prophylactic antibiotics at the time of surgery. But postsurgical treatments for breast cancer, like radiation, may weaken the bodys ability to fight infection.

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