This new administration has started out with a bang! A journey that’s taking the American people in an uncertain spiral to the “bad, old days”.

As I watched the “pro-life” march on T.V., I couldn’t help but get frustrated with their inaccurate message…. If they reverse Roe vs Wade and make abortion illegal, then it will somehow go away?!  No-oooo!!  It won’t go away. It will just lead to unsafe procedures for women to terminate their pregnancies. This administration wants to eliminate funding to Planned Parenthood and other facilities that perform abortions. What they don’t realize is that by eliminating funding to facilities that perform abortions, they are also eliminating the resources for these women to be educated and receive effective birth control.  If women don’t receive effective birth control, then they are more likely to have an unintended pregnancy that leads to abortion.
With no funding, we find women performing their own abortions leading to unsafe procedures that leads to infection, illness and even death.
Taking away Roe vs Wade doesn’t take away abortions. It makes these procedures unsafe.

More then 5000 American women died each year as a direct result from unsafe and largely self-induced abortions before Roe vs Wade. Now, with the legalization of abortion, less than 1 in every 100,000 women who use a medical abortion die making it safer than childbirth according to the World Health Organization!

According to the CDC, the rate of abortions has continued to decline through the 1990’s with the total number, rate and ratio of reported abortions decreasing by 5% from 2012-2013.

So if you take away funding (and the Affordable Care Act), the rate of abortions will go up with women using unsafe practices and the rate of deaths will also increase. This will increase our national health care costs in trying to save women from these unsafe procedures that could have been prevented. The primary method for preventing unsafe abortions is less restrictive abortion laws and greater contraceptive use and education!
Please don’t let us go back to the “bad old days”. We have come so far…

I have contacted my local senators and I ask that you do the same. I have asked that they please respect women and their reproductive rights.

This means open access to safe, legal, affordable abortion and birth control for all people, regardless of income, location, or education.

I often have women complain about added weight gain during the peri-menopause and menopausal years. After going through a thorough search of any lifestyle changes such as  intake of sugar or carbs, lack of exercise, recent surgery, etc. I try to let women know that even if you continue to have healthy eating habits and exercise. When women are struggling with night sweats, hot flushes, lack of sleep, fatigue and mood swings, it tends to exacerbate the problem. Offering bio-identical hormones not only helps symptoms but can assist in weight management. Again, hormone replacement therapy does NOT cause weight gain! That is, if hormones are started less than 10 years after starting menopause.

Studies indicate that estrogen therapy improved insulin-stimulated glucose uptake among women in early menopause. What does that mean?

Many women have something called insulin resistance which occurs sometimes as early as age 35 and increases as we age. The insulin receptors on our cells stop functioning adequately and this dysfunction causes us to make more insulin which then has a very easy time converting excess glucose into fat.

Investigators in one study assessed the effects of short-term high dose transdermal (topical patch) estradiol on these insulin receptors in 22 women. These women were on average 56 years old and less than 6 years into menopause. They compared this group with 24 women that were on average age 63 and over 10 years after menopause. Mean BMI (basal metabolic index-weight) and GDR (A measure of insulin-stimulated glucose uptake) were the same in both groups.

After 1 week of transdermal estrogen where women used a patch delivering 0.05 mg daily, investigators found that the women using the estrogen patch raised the GDR in the women who were less than 6 years after menopause, but lowered the GDR in those women more than 10 years after menopause.

This demonstrates a difference in the change in glucose uptake due to years since menopause. There was a beneficial metabolic effect only in recently menopausal women. Another popular study, known as the Women’s Health initiative, also found a similar reduction in risk for diabetes with estrogen therapy across all age groups. This supports the “timing hypothesis” which proposes that hormone therapy slows atherosclerosis progression in recently menopausal women but has neutral or adverse effects in women who are at least 10 years past menopause onset.

Talk to your health practitioner on whether hormones may give you additional benefit of preventing diabetes in additional to helping other symptoms.

Reference: Pereira RI et al. Timing of estradiol treatment after menopause may determine benefit or harm to insulin action. J Clin Endocrinol Metab 2015 Dec; 100: 4456.

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder caused by hyper-stimulation of ovarian cells which produces androgens, mainly Testosterone. It effects other hormones such as raising DHEA and increasing Insulin levels. Symptoms can vary from obesity, infertility, to acne, increased hair growth and infrequent menstrual periods.

This small study used a common supplement, Resveratrol to help reverse the hype- insulin and hyper-androgenic markers associated with this condition. A significant improvement was made with reducing Testosterone, DHEA and insulin levels after 3 months of treatment compared to placebo.

Resveratrol is an antioxidant that is in a variety of foods. Some of these include dark chocolate, pistachios, peanuts, berries, and of course red wine. To achieve the benefits of the study one would have to drink 100 bottles of red wine per day…..don’t do that!  The home in the treatment group used an oral supplement of micronized trans resveratrol at a dose of 1500 mg daily. Much more practical.

The improvement observed was comparable to or greater than that found in the usual treatment for PCOS which is birth control pills or Metformin. This supplement may help reduce the risk of metabolic problems associated with PCOS which includes diabetes and some cancers. More studies and larger trials should be done before we can strongly recommend this as a treatment for women. But this is very promising…

Early Indication That Resveratrol Corrects PCOS Abnormalities: “”

You have read a lot about the gut microbiome. But you may not have known that the breast also has its own microbiome. This mix of microbes could equally have an important effect on health, according to a new study in Applied and Environmental Microbiology. The results showed that microbes in the breast, even in low amounts, may play a role in preventing or increasing breast cancer risk.

One in eight women are diagnosed with breast cancer in their lifetime. We know that many variables are associated with this risk including age, genetics and environmental factors. With this new growing body of research, bacteria may be considered as one of those environmental factors. We know that breast feeding, since the early 60’s has been associated with a lower risk of breast cancer. Recent work suggests that breast milk supports the growth of beneficial bacteria in the breasts.

According to immunologist Delphine Lee who studies breast cancer at the John Wayne Cancer Institute in Santa Monica California, “It isn’t surprising in and of itself that the breast harbors microbes” The breast is exposed to the environment through the nipple and ductal system. Lactation also lowers breast cancer risk through the release of Oxytocin which clears the ducts of inflammatory debris. Dry brushing and nipple stimulation can actually create a healthy epithelial lining in the ducts.

Gregor Reid, a professor of microbiology and immunology at Western University in Ontario was the senior author of a study that analyzed bacterial DNA in breast tissue samples of 58 women who were undergoing lumpectomies or mastectomies for either benign or cancerous tumors. He and the other researchers also looked at 23 healthy women who underwent breast reductions or enhancements.

Findings showed that women with breast cancer had higher levels of some types of bacteria, including Enterobacteriaceae, Staphylococcus and Bacillus. Women without cancer had higher levels of other bacteria types, such as Lactococcus and Streptococcus. What we don’t know is whether certain bacteria found near breast tumors are the cause of breast cancer or whether they just thrive in the tumor environment.

These long named bacterial species may not mean anything to you now, but it will later as upcoming research will be able to use a patient’s bacterial makeup as a biomarker for cancer screening or to develop probiotics for improving prognosis and treatment outcomes.

Reference: Sheikh, K. “The Breast has its Own Microbiome”. ScientificAmerican.com, Oct 2016. p. 21.

Breakell, D. “Reducing your Risk for Breast Cancer.” Wellcast.org. Keynote, June 2014.

A 10-year study was conducted to compare the effects of transdermal (skin patches) and oral estrogen therapy on risk for cardiovascular events. The study looked at over 5000 women with the average age of 55. They excluded women who had a prior history of blood clots or coronary heart disease or who filled a prescription for any progestin, estrogen injection, gel or spray or a contraceptive pill during the study period or 6 months prior to starting the transdermal or oral estrogen.

Participants were exposed to an average of 16 months of estrogen therapy. Results showed lower venous thromboembolism (blood clots) and strokes among transdermal estrogen users. This is consistent with numerous observational studies. This is biologically plausible with the fact that transdermal application does not elevate liver production of clotting proteins. This supports the view that transdermal estrogen is indeed safer than the oral route with respect to blood clots. The European menopause Society (Maturitas 2011; 69:195) and the Endocrine Society (J Clin Endocrine Metab 2015; 100:3975) both recommend the transdermal formulation for menopausal women at risk for blood clots. This includes women with a previous history of blood clots, smokers and those who are obese).

This information may also explain the statistically significant increase in venous thromboembolism in women that participated in the Women’s Health Initiative Study launched in 1991 who were using oral Prempro (oral estrogen and progestin). That study was primarily looking at the risks and benefits of that particular drug vs hormone replacement therapy. As you can see, not all estrogens are alike nor do they get metabolized the same in the body. Personalizing a women’s hormone therapy is important. Discussing the types of estrogen and explaining the risks and benefits of route of administration is vital in helping women make the right choice that is effective and safe for them.

Reference: Simon JA et al. Venous thromboembolism and cardiovascular disease complications in menopausal women using transdermal versus oral estrogen therapy. Menopause 2016 June; 23:600.

Canonico M and Scarabin P. Y. Oral versus transdermal estrogens and venous thromboembolism in postmenopausal women: What is new since 2003? Menopause 2016 June; 23:587.