bio-identical hormones
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free skin care · Tue Feb 08, 2011 9:21 pm

secretly wrote:

CONCLUSION: Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. Further randomized controlled trials are needed to delineate these differences more clearly.

There are several problems with this paper (which were pointed out in the letters to the editor in the journal):

a. The author is making the same mistake that was done earlier on when comparing HRT with placebo.
Women who seek HRT are usually more educated, and more health conscious than women who do not seek HRT. Thus, their lifestyle, on average, is different. They take better care of themselves, etc, etc. So in the beginning, observational studies showed that women who used HRT had LOWER risk of breast cancer, CV disease, etc, etc. But , as with any observational study, lifestyle factors are hard to take into account.
He’s doing the same thing but with HRT and BHRT. Women who take HRT and BHRT are different from each other. Women taking BHRT are also more highly educated than women taking HRT, have different lifestyle, healthier habits, etc. Thus it is no surprise that, as before, observational studies are saying that BHRT is better. However, I hope we learned from our past mistakes and not jump in the bandwagon as we did with HRT and remain cautious until randomized controlled trials are done.
To quote the American Menopause Society: “Most observational and preclinical studies support the
potential benefits of systemic HT in reducing the risk of CHD. Most RCTs do not. However, it is now understood that the characteristics of women participating in observational studies are markedly different from those of women enrolled in RCTs, and that some of these demographic or biologic differences, or both, influence baseline cardiovascular risks and may modify the effects of HT on cardiovascular risk.”

b. To develop cancer, etc. you need years for it to happen. So it’s not a valid conclusion to pool some studies together with follow up (and sample size) that does not compare with the WHI (women’s health initiative RCT) and thus because you did not get adverse results then conclude that it’s safe.

c. The article compares different doses of MPA and progesterone, so it’s not equivalent so it’s really comparing more apples to oranges kind of thing.

As one article correctly states: There are no peer-reviewed, randomized, controlled trials (RCTs) regarding products made by compounding pharmacies. There are no scientific RCT data to suggest that compounded BHT does not have the same risks as conventional prescription HT. There are no large studies showing that BHT reduces osteoporosis risk or prevents breast cancer (as claimed by some ofthe pharmacies). In addition, custom topical progesterone cream has not been shown to prevent estrogen-induced endometrial hyperplasia, as claimed.'

To be honest, I really wish BHRT was good and safe and great. I don't like seeing women suffering and I don't like having limited options. But the truth is that the current evidence does not show them to be any safer than regular HRT. I think after a hard stance against HRT, the ACOG and the American Menopause society softened their stance because they realized that the increased risk is not huge (though for certain things definitely high enough) and that some women have no symptom control. So now HRT is started in peri/menopause and aimed at being given for a short period of time.

free skin care · Wed Feb 09, 2011 6:36 am

Quote:

To be honest, I really wish BHRT was good and safe and great. I don't like seeing women suffering and I don't like having limited options. But the truth is that the current evidence does not show them to be any safer than regular HRT. I think after a hard stance against HRT, the ACOG and the American Menopause society softened their stance because they realized that the increased risk is not huge (though for certain things definitely high enough) and that some women have no symptom control. So now HRT is started in peri/menopause and aimed at being given for a short period of time.

But if they are so concerned about women’s health why haven’t there been any studies involving Bioidentical hormones? So now they are as you say “softening their stance” when the original protocol was to prescribe traditional HRT with no time limitations? Yet, with bioidentical hormones the protocol is “symptom control and prescribing for a short period of time.” I think this protocol is very flawed. For one thing, once a woman starts on bioidentical hormones, she immediately starts feeling better, her symptoms are greatly alleviated or totally disappear, so why on earth would she ever want to stop taking them? Her levels are most likely much lower (on bioidenticals) than during her youth, yet high enough for symptoms to disappear. If the normal process of menopause is the gradual decrease in sex hormones until you no longer cycle, then why replace for a short period of time? I can tell you that once you stop, you will be right back to square one. Whereas if you let your hormone levels decrease naturally, the belief is you will eventually get used to that decrease. So it doesn’t make any sense to increase levels for only a short period of time, only to cease taking them because the body never loses its thirst for estrogen. In fact, I believe this last statement could very easily tested on women of all ages. Even women in their 80’s would feel better on a very low dose of bioidentical estrogen + progesterone and once they stopped taking it, would start to feel menopausal symptoms again. So I don’t get it. Aprile

free skin care · Wed Feb 09, 2011 7:22 am

aprile wrote:

But if they are so concerned about women’s health why haven’t there been any studies involving Bioidentical hormones? So now they are as you say “softening their stance” when the original protocol was to prescribe traditional HRT with no time limitations? Yet, with bioidentical hormones the protocol is “symptom control and prescribing for a short period of time.” I think this protocol is very flawed. For one thing, once a woman starts on bioidentical hormones, she immediately starts feeling better, her symptoms are greatly alleviated or totally disappear, so why on earth would she ever want to stop taking them? Her levels are most likely much lower (on bioidenticals) than during her youth, yet high enough for symptoms to disappear. If the normal process of menopause is the gradual decrease in sex hormones until you no longer cycle, then why replace for a short period of time? I can tell you that once you stop, you will be right back to square one. Whereas if you let your hormone levels decrease naturally, the belief is you will eventually get used to that decrease. So it doesn’t make any sense to increase levels for only a short period of time, only to cease taking them because the body never loses its thirst for estrogen. In fact, I believe this last statement could very easily tested on women of all ages. Even women in their 80’s would feel better on a very low dose of bioidentical estrogen + progesterone and once they stopped taking it, would start to feel menopausal symptoms again. So I don’t get it. Aprile

But women don't have menopausal symptoms for ever - once you have been through the transition period of menopause, your symptoms should cease. Hormone replacement is given just to help you get through that transition period. My Mother was put on HRT in her 80s because of her osteoporosis, but she couldn't stand the symptoms, such as tender swollen breasts, so she stopped taking it.

As I said earlier, I'm really on the fence with all of this. At this point no-one seems to know for sure what the real consequences of taking HRT or BHRT are. There are some experts who claim that the original study which claimed HRT was harmful was flawed because it didn't take into account that we are living longer and are therefore more likely to contract cancer or heart disease. I'm sure I read somewhere that the additional risk of getting breast cancer by taking HRT was only 2% - a fairly insignificant risk if you factor in the benefits. I take it because I'm terrified of ending up looking like the Hunchback of Notre Dame as my Mother did. So I'll live with the 2% risk because I think there's far more likelihood of me coming to grief behind the wheel of my car!

So, if you're happy with your decision to take BHRT, then that's fine - but I would be concerned about whether I was being dosed correctly and, in the case of the creams, whether they were performing their job effectively.

free skin care · Wed Feb 09, 2011 11:34 am

Keliu wrote:

1. Natural hormones, including estradiol, estriol, estrone, and progesterone, can be expected to have the same adverse event profile as conventional menopausal hormone regimens.

2. BH are synthesized in a lab from both plant (soy or yam) and animal (pigs and horses) hormones. CH products come from the same sources.

3. I do wonder why it is really necessary to take any hormone replacement at all, given that menopause is a completely natural biological process and is not an illness.

4. there are simply NO clinical studies which prove that BHRT is any safer than HRT.

1. But they don't if prescribed properly. It takes more effort, time and knowledge on a doctor's part to prescribe the right dose of BHRT. My gyno stopped giving horse urine Big Pharma HRT because she couldn't bear the suffering of her patients. She switched them to BHRT and no problems!

2. BHRT are plant derived, Big Pharma are animal derived.

3. It used to be perfectly normal for people to lose all of their teeth. That was natural aging. Menopause is the loss of hormones. BHRT replaces those hormones. Many faith based women think it's noble to suffer from the trials of being a woman -- periods, childbirth, menopause. Punishment for the sins of Eve.

4. Clinical studies are expensive and only BigPharma can afford them. Yet BigPharma's OWN studies proved their product was killing women. Strangely, it is still being sold. Then again, cigarettes are still being sold. The tobacco lobby and medical lobbies have deep pockets and our legislators are quite happy to dig into them. Watch the DVD Sicko.

free skin care · Wed Feb 09, 2011 11:43 am

I just remembered there were at least two large studies in Europe, one in France and one in Sweden (not exactly sure) which showed the benefits of BHRT.

Personally, if I knew that Big Pharma horse piss HRT was proven to be dangerous by their own studies and if there were no studies showing BHRT was safe, I'd still take the BHRT based on doctors' anecdotal experience, since the odds are better! Laughing

Is it any wonder BigPharma is fighting BHRT tooth and nail considering the tens of billions of dollars it stands to lose? When they first invented horse urine HRT you know they had dollar signs in their eyes, i.e. every woman goes through menopause and they'll buy our product!

free skin care · Wed Feb 09, 2011 5:40 pm

aprile wrote:

But if they are so concerned about women’s health why haven’t there been any studies involving Bioidentical hormones?

You should ask that to all the compounding pharmacies making money off bioidentical hormones. The definitely do have money to distribute pamphlets at congresses!

aprile wrote:

So now they are as you say “softening their stance” when the original protocol was to prescribe traditional HRT with no time limitations? Yet, with bioidentical hormones the protocol is “symptom control and prescribing for a short period of time.” I think this protocol is very flawed.

No. What I mean by “softening the stance” was that right after WHI was published people really stopped prescribing HRT. But then when it was seeing that sometimes the only way of controlling hot flashes is with HRT, and considering the effect size of the adverse effects and some secondary analyses from the WHI, it was thought that prescribing a short course of HRT could be reasonable. ACOG and the American Menopausal society (and in reality, any physicians’ association) do not make distinctions between BHRT and HRT. Both should be given in the least amount to control symptoms and for a short period of time.
quote="aprile"] For one thing, once a woman starts on bioidentical hormones, she immediately starts feeling better, her symptoms are greatly alleviated or totally disappear, so why on earth would she ever want to stop taking them? Her levels are most likely much lower (on bioidenticals) than during her youth, yet high enough for symptoms to disappear. If the normal process of menopause is the gradual decrease in sex hormones until you no longer cycle, then why replace for a short period of time? [/quote]
Why replace it only for a short time? Because long-term effect of hormone replacement therapy has been associated with several adverse effects, such as stroke, CV disease, breast cancer, etc.

aprile wrote:

I can tell you that once you stop, you will be right back to square one. Whereas if you let your hormone levels decrease naturally, the belief is you will eventually get used to that decrease. So it doesn’t make any sense to increase levels for only a short period of time, only to cease taking them because the body never loses its thirst for estrogen. In fact, I believe this last statement could very easily tested on women of all ages. Even women in their 80’s would feel better on a very low dose of bioidentical estrogen + progesterone and once they stopped taking it, would start to feel menopausal symptoms again. So I don’t get it. Aprile

Most women, if they did not take HRT, would first experience hot flashes for a while at the beginning of menopause and perimenopause and then they would go away. It is not exactly known why hot flashes appear but it is thought to be related to the hormonal changes that happen in early menopause. Now as those changes settle, then the hot flashes will go away. If you give hormone therapy while in perimenopause/menopause, you will alleviate the symptoms but the “natural” changes in hormones (i.e. the ones that your body produce) will go on. So by the time you stop the HRT those changes again settled and thus you will interrupt your medication and not suffer from hot flashes as you did before. You can experience some symptoms while the meds wash out.

free skin care · Wed Feb 09, 2011 5:51 pm

SoftSkin wrote:

I just remembered there were at least two large studies in Europe, one in France and one in Sweden (not exactly sure) which showed the benefits of BHRT.

There are no safety RCT studies with BHRT. Observational studies showing the benefits of BHRT are no different from the observational studies on HRT that showed its benefits as well. But that all changed with the RCTs.

SoftSkin wrote:

Personally, if I knew that Big Pharma horse piss HRT was proven to be dangerous by their own studies and if there were no studies showing BHRT was safe, I'd still take the BHRT based on doctors' anecdotal experience, since the odds are better! Laughing

I actually agree with you. If I had to take hormones, I'd be more inclined to take BHRT because there's a chance that they might be safer. However, my attitude would not be “oh they are harmless, a fountain of youth, I can take them for as long as I want”. My attitude would be “there’s a risk involved, but my quality of life matters, I’ll take them cautiously, as little as possible and as short as possible” .

SoftSkin wrote:

Is it any wonder BigPharma is fighting BHRT tooth and nail considering the tens of billions of dollars it stands to lose? When they first invented horse urine HRT you know they had dollar signs in their eyes, i.e. every woman goes through menopause and they'll buy our product!

This is not just big pharma. There are many concerned professionals out there worried about the propaganda surrounding BHRT that extols unproven benefits and gives a false sense of safety. And it seems that professionals are always in a “lose – lose” situation. When some drugs are approved fast, everyone’s “oh this doctors don’t care about us, they just want big pharma to make money, etc,etc”. But then when doctors are concerned about the safety of a drug for which are no safety studies then the doctors are still being evil?

free skin care · Wed Feb 09, 2011 6:01 pm

SoftSkin wrote:

1. But they don't if prescribed properly. It takes more effort, time and knowledge on a doctor's part to prescribe the right dose of BHRT. My gyno stopped giving horse urine Big Pharma HRT because she couldn't bear the suffering of her patients. She switched them to BHRT and no problems!

I have no idea why your gynecologist would feel her patients suffer with HRT. Both HRT and BHRT, if not properly dosed, can have bad side effects. I posted in another thread forums that were devoted to people who felt their lives were ruined by certain BHRT protocols.

HRT and BHRT is a bit of a trial an error. Sometimes the first dosing is good fo the patient. Sometimes is not and the fine tuning can take time.

SoftSkin wrote:

4. Clinical studies are expensive and only BigPharma can afford them.

This is not accurate. First of all, you don't need a HUGE study to start. You can start small. Secondly, the association of compounding pharmacies has millions and is more than able to finance clinical studies yet they choose not to do so. Many naturopaths and doctors who make hundreds of thousands of dollars off their patients prescribing BHRT have all the data there to at least do a publication. Yet, no one chooses to do so. All these celebrity doctors that make millions promoting their unproven theories have also all the date to do some studies and still choose not to do so.

free skin care · Wed Feb 09, 2011 9:38 pm

Our mainstream GPs are trained in the Western Medical Model which does not tend to support Bio Identical Hormone Therapy. I believe Josee is in this mainstream model which is fine but needs to be known. The pharmaceutical industry is hand-in-glove with the AMA and highly financed to support their own designed studies and cover what is working.

I know you all may know this but I wanted to add my own two cents

Remember years ago the "Fruits and Nuts", odd people were into vitamins and supplements and took crazy stuff like algae and spirulina. Today BIG PHarma would love to get their hands on this billion dollar business and has unsuccessfully tried to do so. They try constantly.

There is no way to compare the financial gain of American Pharmaceutical companies to the BioIdentical hormone ventures. Unfortunately only the sophisticated, curious and/or educated will understand the option of Bioidentical hormone therapy.
There are pamphlets available by the bioidentical folks. They just don't have the means to get it to masse .

free skin care · Wed Feb 09, 2011 10:32 pm

sister sweets wrote:

Our mainstream GPs are trained in the Western Medical Model which does not tend to support Bio Identical Hormone Therapy. I believe Josee is in this mainstream model which is fine but needs to be known. The pharmaceutical industry is hand-in-glove with the AMA and highly financed to support their own designed studies and cover what is working.

I know you all may know this but I wanted to add my own two cents.

I have already posted earlier that I believe Josee is a Gynecologist - so if we are all supposed to take her opinion with a grain of salt just because she happens to be a qualified medical specialist in the field of womens' health - that seems a bit sad to me.

Everyone on this Forum seems to have a very low opinion of doctors - except when they want a face-lift!

free skin care · Wed Feb 09, 2011 10:58 pm

SoftSkin wrote:

Many faith based women think it's noble to suffer from the trials of being a woman -- periods, childbirth, menopause. Punishment for the sins of Eve.

I'm not sure what you mean by "faith based women". Surely periods, childbirth and menopause are biological symptoms of being a women - I don't subscribe to the theory that I'm being punished by God.

Personally I think the trend away from normal biological processes is ridiculous. We live in a society now which looks down with disdain on women who marry and have children in their teens and twenties - and yet that is when we should be procreating. Instead, women are leaving it until their late 30s and 40s to have children - only to find that they are unable to do so, and then have to resort to IVF or even surrogacy. More and more women are becoming "too posh to push" and are opting for cesareans for no medical reason. I personally believe that one of the reasons for the high incidence of breast cancer nowadays is because women are choosing not to breast feed their babies for an adequate length of time.

So where does all that leave us? It means that most women will take a birth control pill all throughout their fertile years, then they will seek medical intervention in order to fall pregnant, then they will choose to have an operation rather than give birth naturally, then they will choose to feed the baby with a formula rather than breast milk, then they will seek more medication to get them through menopause.

free skin care · Thu Feb 10, 2011 5:07 am

sister sweets wrote:

Our mainstream GPs are trained in the Western Medical Model which does not tend to support Bio Identical Hormone Therapy.

I find this funny because you cannot find BHRT in Chinese medicine or "Eastern" medicine.
HRT is very western concept. Other medicines used natural non-hormonal remedies to relieve hot flashes. Even in Chinese medicine, where people have traditionally eaten more soy, the tonics for hot flashes and menopausal symptoms are not soy-based.
In addition, the main "celebrity doctors" and proponents of BHRT are medical doctors trained just here in Western medicie as well. If you read their books, they do not link BHRT with any of the energy systems traditional in alternative medicines.
The majority of doctors are not necessarily FOR or AGAINST BHRT or HRT, but are simply being CAUTIOUS about its safety. In any other situations, most patients would be grateful for that. I prescribe both HRT and BHRT but speak at length with my patients about the risks and benefits.

sister sweets wrote:

I believe Josee is in this mainstream model which is fine but needs to be known. The pharmaceutical industry is hand-in-glove with the AMA and highly financed to support their own designed studies and cover what is working.

I find this very insulting. In case you did not know, the VAST majority of doctors have no participation in the AMA. Yes, you become member automatically, but who the heck has time to go to meetings?
The notion that the majority of doctors are evil people who are tied to the pharmaceutical industry is just ludicrous. The vast majority of researchers have nothing to do with the pharmaceutical industry either. We get most of our research money for NIH or other institutes and thus have no ties. You can see it in the disclosure in any paper.
So I guess now I’m no longer a troll working for a cosmetic industry, now I guess I’m a troll working for pharmaceuticals Rolling Eyes

sister sweets wrote:

There is no way to compare the financial gain of American Pharmaceutical companies to the BioIdentical hormone ventures. Unfortunately only the sophisticated, curious and/or educated will understand the option of Bioidentical hormone therapy.

Actually, the point here Is not who makes more money but who has the means to carry out research to prove safety. The association of compounding pharmacies has more than enough money to carry out research. Heck, if they want even extra they can apply for a grant from NIH. But… guess what? They haven’t done it.
I think that anyone besides their sophistication and/or education should realize that there are no safety studies and no guarantee that BHRT is safer than HRT. Anecdotal evidence and observational studies just don’t cut it.

free skin care · Thu Feb 10, 2011 6:19 am

I believe many of us feel a little cynical because the pharmaceutical industry has pushed through a ton of drugs onto the marketplace that were later deemed harmful. Adding insult to injury, the FDA didn't protect its citizens. Also, although I know some very fine doctors whom I respect immensely, I get the hand in glove comment. To prove that point, if you had an appointment at a doctors office around lunchtime, you could witness the practice of the sales pitch by the pharmaceutical rep. It goes like this... pharmaceutical rep brings lunch for the entire staff trying to "buy" the doctor hoping he/she will recommend their drug. I am not off my rocker, this is common practice. In fact it's so common, when I tried to make an appointment for the Audiologist I work with to meet with an ENT, their office manager asked me whether or not she'd be bringing lunch. I was more than taken back, as she was not "selling" anything. In fact, when our babies are born, they send us home with formula (the one the pharmaceutical rep pitched.) It goes on and on. So, yes we all feel more than a little jaded by these practices. So I must ask, if there were nothing to gain, why then would these fine doctors participate in these practices?

free skin care · Thu Feb 10, 2011 6:50 am

aprile wrote:

To prove that point, if you had an appointment at a doctors office around lunchtime, you could witness the practice of the sales pitch by the pharmaceutical rep. It goes like this... pharmaceutical rep brings lunch for the entire staff trying to "buy" the doctor hoping he/she will recommend their drug. I am not off my rocker, this is common practice.

Of course it is common practice. That is the drug reps job! They bring food, or other little "goodies" (pens, gadgets, etc). That is how the doctors get introduced to the new medicines. Just because the rep has brought lunch, or pens, or whatever doesn't mean the doctor is going to prescribe that drug unless he/she thinks it will help the patient.

free skin care · Thu Feb 10, 2011 6:50 am

Keliu wrote:

Personally I think the trend away from normal biological processes is ridiculous. We live in a society now which looks down with disdain on women who marry and have children in their teens and twenties - and yet that is when we should be procreating. Instead, women are leaving it until their late 30s and 40s to have children - only to find that they are unable to do so, and then have to resort to IVF or even surrogacy. More and more women are becoming "too posh to push" and are opting for cesareans for no medical reason. I personally believe that one of the reasons for the high incidence of breast cancer nowadays is because women are choosing not to breast feed their babies for an adequate length of time.

So where does all that leave us? It means that most women will take a birth control pill all throughout their fertile years, then they will seek medical intervention in order to fall pregnant, then they will choose to have an operation rather than give birth naturally, then they will choose to feed the baby with a formula rather than breast milk, then they will seek more medication to get them through menopause.

While some women may be waiting" because they are climbing the corporate ladder, others like myself had no choice. Yet thankfully, blessed at a later age and gave birth at age 41 (naturally). Blaming women for taking birth control is also absurd.. Our culture has become extremely "drug driven" so who's to blame here? Do you honestly believe women are choosing to be cut rather than push? Are you kidding me? I think the notion of the c-section became popular not because of women being too posh to push, but rather their doctors recommending it. In fact, sadly I have heard stories of "some" doctors recommending c-sections to accommodate their own schedules, rather than based on medical necessity. When questioning friends who were scheduled for c-sections and asking them why ~ their only answer was "Oh my doctor recommended it." This is common practice when often there is no real "good" reason. So don't go there.

free skin care · Thu Feb 10, 2011 6:58 am

rileygirl wrote:

Of course it is common practice. That is the drug reps job! They bring food, or other little "goodies" (pens, gadgets, etc). That is how the doctors get introduced to the new medicines. Just because the rep has brought lunch, or pens, or whatever doesn't mean the doctor is going to prescribe that drug unless he/she thinks it will help the patient.

Of course not, but the practice is insulting for the patient to witness. It resembles something akin to "bribery". My husband is in sales and there is no way that would fly in his business and he is selling ad space and programs ~ not drugs that will affect a patient's health. I would certainly hope it would not influence a doctor or sway him/her to recommend a specific drug. Nevertheless, the practice is, in my opinion disgusting.

free skin care · Thu Feb 10, 2011 7:08 am

aprile wrote:

Of course not, but the practice is insulting for the patient to witness. It resembles something akin to "bribery". My husband is in sales and there is no way that would fly in his business and he is selling ad space and programs ~ not drugs that will affect a patient's health. I would certainly hope it would not influence a doctor or sway him/her to recommend a specific drug. Nevertheless, the practice is, in my opinion disgusting.

Most patients have no clue what is going on. The reps are usually shuttled in to the back office. Also, they make their appointments at lunch time, when the doctor isn't seeing patients. Is your husbands job disgusting because he is a salesman? That is what the drug rep is, a salesman - doing his/her job. I don't see the issue?

free skin care · Thu Feb 10, 2011 7:13 am

aprile wrote:

Keliu wrote:

Personally I think the trend away from normal biological processes is ridiculous. We live in a society now which looks down with disdain on women who marry and have children in their teens and twenties - and yet that is when we should be procreating. Instead, women are leaving it until their late 30s and 40s to have children - only to find that they are unable to do so, and then have to resort to IVF or even surrogacy. More and more women are becoming "too posh to push" and are opting for cesareans for no medical reason. I personally believe that one of the reasons for the high incidence of breast cancer nowadays is because women are choosing not to breast feed their babies for an adequate length of time.

So where does all that leave us? It means that most women will take a birth control pill all throughout their fertile years, then they will seek medical intervention in order to fall pregnant, then they will choose to have an operation rather than give birth naturally, then they will choose to feed the baby with a formula rather than breast milk, then they will seek more medication to get them through menopause.

While some women may be waiting" because they are climbing the corporate ladder, others like myself had no choice. Yet thankfully, blessed at a later age and gave birth at age 41 (naturally). Blaming women for taking birth control is also absurd.. Our culture has become extremely "drug driven" so who's to blame here? Do you honestly believe women are choosing to be cut rather than push? Are you kidding me? I think the notion of the c-section became popular not because of women being too posh to push, but rather their doctors recommending it. In fact, sadly I have heard stories of "some" doctors recommending c-sections to accommodate their own schedules, rather than based on medical necessity. When questioning friends who were scheduled for c-sections and asking them why ~ their only answer was "Oh my doctor recommended it." This is common practice when often there is no real "good" reason. So don't go there.

I am going there - many of my daughter's friends have CHOSEN to have a cesarean because they didn't want the pain of childbirth - it is more common than you think.

And I am not "blaming" women for taking birth control - I took it myself. I'm simply pointing out that it is not "natural" - and that waiting until you are old enough to have what is medically known as a "geriatric pregnancy" is not ideal.

free skin care · Thu Feb 10, 2011 1:43 pm

aprile wrote:

I believe many of us feel a little cynical because the pharmaceutical industry has pushed through a ton of drugs onto the marketplace that were later deemed harmful. Adding insult to injury, the FDA didn't protect its citizens.

Ok but now there are doctors saying "hey, this drug's safety is not proven" and are also being bashed for that.
So I guess that while some people may feel cynical many doctors feel underappreciated. I think a group hug is in order Smile

aprile wrote:

Also, although I know some very fine doctors whom I respect immensely, I get the hand in glove comment. To prove that point, if you had an appointment at a doctors office around lunchtime, you could witness the practice of the sales pitch by the pharmaceutical rep. It goes like this... pharmaceutical rep brings lunch for the entire staff trying to "buy" the doctor hoping he/she will recommend their drug.

To be honest, I don't think that some lunches are going to make anyone recommend anything. I think there are a couple of things:

a. I’m sure there must be corruption at different levels but it happens a lot higher than at your regular doctor’s office. I’ve never witnessed anything but I can imagine pharmaceutical companies bribing hospital heads so that the hospital purchases XYZ medicine over ABC, or bribing government officials so that the government (in Canada) covers XYZ drug. But lunches and sponsoring congresses? I don’t think anyone would feel compelled to recommend any drug just because a certain pharmaceutical company bought a lunch. Lunches by pharmaceutical companies are really an every day thing. If I wanted, I could eat good food for free every day at the hospital because somewhere a pharmaceutical is sponsoring a talk. I’ve never seen any doctor make much out of it.

b. I, as someone said, think that pharma reps are just like any other seller. We have also all the surgical instruments sellers, etc, etc. It really gets crazy. I think that the good that they bring is that they present new drugs to the doctors and give you the main info and evidence to try it. I think that’s helpful.

c. A lot of the times the “pitch” for drug reps is that they give you samples. So you would give your sample to your patient and then the patient might stick to that as opposed to something else. For example, I get a certain iron formulation from the pharma rep that has some research behind it as it being better tolerated but it’s more expensive. So I give it to my patient and tell her to try it and then try the cheaper one and then decide. So I’m sure many of my patients who would have never tried the more expensive iron otherwise end up buying it because they do tolerate it better than the cheaper one. Same thing with other drugs that have the same price. When there are 2 equivalent drugs, many times if I have some samples I’ll just give them to the patient and then she’ll probably continue that way.

aprile wrote:

So I must ask, if there were nothing to gain, why then would these fine doctors participate in these practices?

I can’t speak for others but I think doctors participate in these practices because they do learn about new drugs, they get samples that their patients like and they get free food and perks 
So far I’ve never seen anyone being pressured to prescribe XYZ or anything like that.

free skin care · Thu Feb 10, 2011 1:54 pm

aprile wrote:

Of course not, but the practice is insulting for the patient to witness. It resembles something akin to "bribery". My husband is in sales and there is no way that would fly in his business and he is selling ad space and programs ~ not drugs that will affect a patient's health. I would certainly hope it would not influence a doctor or sway him/her to recommend a specific drug. Nevertheless, the practice is, in my opinion disgusting.

I honestly don't understand why the practice is disgusting. I think "business lunches" and gifts are part of so many industries. People sampling things is also very common.

I do think though, that there is a line. For example, I have never ever (and God willing will never) accepted any money to sponsor anything from Nestle. I think their formula marketing in other countries is a disgrace and I think it's wrong. Thus in that case I woudl not feel right accepting anything.

free skin care · Thu Feb 10, 2011 3:22 pm

If Bioidentical wasn't helping so many women with their horrid symptoms it wouldn't even be an issue, it would have gone away. I use BHRT and I understand the risks involved, just like all drugs.

I don't see compounding pharmacies making anywhere near what big Pharma is making, not even close. I know the guy who owns the one I got to and I think he makes a comfortable living but he's no millionaire.

I think Western doctors overall are way too drug oriented (Boniva seriously?????? now that's a risk/benefit trade off, necrotic jaw anyone?). I stopped seeing mainstream doctors completely, and I see nutritional MD and an osteopath who is what you'd call in the 60s a far out hippie, he's so effective that my friends are all seeing him now, I like being served tea and chocolate after I get Rieki, osteopathy and acupuncture. The guy's a genius too.

free skin care · Thu Feb 10, 2011 4:05 pm

secretly wrote:

I stopped seeing mainstream doctors completely, and I see nutritional MD and an osteopath who is what you'd call in the 60s a far out hippie, he's so effective that my friends are all seeing him now, I like being served tea and chocolate after I get Rieki, osteopathy and acupuncture. The guy's a genius too.

But didn't you have a face-lift last year? And haven't you just had stem cell/fat transfer augmentation to your breasts and face? Surely all this work was performed by a mainstream doctor and anesthesiologist.

free skin care · Thu Feb 10, 2011 4:13 pm

Yes I did!!! no long term medications involved. I should have been more clear, I love plastic surgeons Very Happy

I'm not against medicine at all, just the way it seems to be practiced now. I think there needs to be much more focus on healing, honestly I don't see that in mainstream medicine.

I was sick for 23 years and recovered after I figured out how to heal, that involved getting away from mainstream care, which for chronic illness typically includes drugs that keep you sick. I'm also a former pediatric trauma ICU RN and published author. I understand how to manage my medical care, many people don't unfortunately.

free skin care · Thu Feb 10, 2011 4:34 pm

Josee wrote:

I have no idea why your gynecologist would feel her patients suffer with HRT. Both HRT and BHRT, if not properly dosed, can have bad side effects. HRT and BHRT is a bit of a trial an error... the fine tuning can take time.

Her patients told her they were suffering miserable side effects! Example: one woman didn’t know she was allergic to horses until she took Premarin and swelled up like a balloon. Being a caring physician, she searched for alternatives, did some research and discovered BHRT. Problem solved. She also takes BHRT herself -- Vivelle Dot + ProGest. I’m guessing her age is mid-6os and she is in fabulous shape physically.

The reason most docs don't want to take the time to fine tune dosing is because they don't get paid enough by insurance companies. They make money based on volume of patients. Get 'em in and out quick! I'm surprised most gynos don't tell you to leave your panties in the car. I told a coworker what I was taking and she told her doc, who gave her MY dose, which it had taken three months for my gyno to determine. Because it wasn’t a gradual increase, it was a shock to her system and she had a bad reaction. I suspect that is what happens to many taking BHRT if their doctors are clueless. Fortunately she found an anti-aging endocrinologist who sorted everything out. But that is scary!

My gyno has banned Big Pharma reps from her practice. She also doesn’t take insurance because she won’t allow insurance companies to dictate patient care. Consequently, I get a full hour of her time. She does a lot of lab work in-house and has her own bone scan machine. I can ask any questions I want. She believes in complementary medicine, so we talk about herbs, vitamins, acupuncture, etc., in addition to conventional medical treatments. That’s the way it should be in all doctors’ offices in my opinion. Get the best of both worlds. If you need a gyno in the Beverly Hills area, PM me.

Compounding pharmacies are a red herring in this debate. Most people don’t use them and you don’t need them because you can get estradiol patches and progesterone cream easily. It’s cheaper than all the different “Prem___” HRT junk, too.

The medical establishment has always been slow to embrace change. Doctors during the 19th century were outraged when they were told to wash their hands between patients!

And don't get me started on the dangers of statins either! Bad Grin

free skin care · Thu Feb 10, 2011 6:20 pm

Josee wrote:

I honestly don't understand why the practice is disgusting. I think "business lunches" and gifts are part of so many industries. People sampling things is also very common.

I do think though, that there is a line. For example, I have never ever (and God willing will never) accepted any money to sponsor anything from Nestle. I think their formula marketing in other countries is a disgrace and I think it's wrong. Thus in that case I woudl not feel right accepting anything.

Yes, certainly business lunches and dinners do exist when a sales person wants to meet with a client during lunch hours. The client is pressed for time and thus the meeting may occur in a restaurant over lunch or dinner. The sales rep is offering the client ad space in their magazine and they may talk about ancillary products and services. It's a give and take... I have ad space to sell and you have a product you want to advertise. But, to me this just "feels" very different because we are talking about drugs and with that comes patients safety and the knowledge that many drugs end up being anything but safe. Also, just witnessing a pharmaceutical rep bringing in lavish trays of food for the entire staff is a little much. As a patient, we know they are pushing the drug they are selling and hoping the doctor will recommend their drug. Yes doctors who push formula instead of breast milk are doing women and their babies a disservice. In this day and age, everyone should know breast milk is best. Not to mention, the formulas on the market are anything but healthy for babies. Further, I have to say that the Audiologist I work with is ever so careful about how she approaches anything remotely akin to "gift giving." And she is in the business of testing hearing and dispensing hearing aids. Aprile

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