Some know her as the sexually outspoken Samantha Jones, but today her three closest gal pals from Sex and the City 2 call her, "The hormone whisperer." The oldest of four friends, Samantha, is finally a 50-something woman who is not about to give up her uninhibited lusty appetite or her youth to menopause.
To survive the inconvenience of menopause, Samantha takes daily doses of supplements by the handful and rubs hormones on her arms and privates. When Miranda asks Samantha about the logic of taking so many supplements, and where she got her menopause treatment strategy, she replies, "from Suzanne Somers." Surprised, Miranda asks, "you are getting information from someone who invented the thigh master?"
When her hormones are confiscated at customs in Abu Dhabi, Samantha resorts to consuming and applying yams and chickpeas, hoping she is getting a "natural" dose of hormones so she does not "ricochet back into menopause." This Somers devotee makes for good comedy, but propagates gross misinformation about hormones and menopause management options.
Many remember and love Suzanne Somers from Three's Company, but it is time to come clean. I was a victim of Suzanne Somers' irresponsible claims that her way of managing menopause is the "natural" way using compounded bioidentical hormones. Today I want to set the record straight.
I slammed into menopause, suffering from hourly hot flashes, itchy skin, horrible weight gain and miserable moodiness. Desperately wanting to feel normal and sexy again, I purchased Suzanne Somers' book, Ageless: The Naked Truth About Bioidentical Hormones.
I assumed Somers word to be trustworthy, because a publisher printed her book. Living in Southern California, I splurged for Somers' expensive Beverly Hills doctor recommendation, assuming he must have the answers. He confirmed I was menopausal and gave me tubes of compounded triple estrogen gel and compounded 10 percent micronized progesterone gel, with orders to apply them regularly. I was just like Samantha in Sex and the City 2. It was also suggested that I apply the estrogen gel to my face to "soften your wrinkles." I dutifully rubbed in the compounded "bioidenticals" religiously.
After a few months of visiting this overpriced Beverly Hills doctor, my menopause symptoms were exaggerated and my moodiness turned into depression. Once again desperate and now at the lowest point of my life, I returned to a previous gynecologist. A blood test revealed that my estrogen levels were seven times higher than normal, my increased weight now placed me into the overweight BMI category, and my severe crankiness made it impossible to work.
What went wrong? I trusted a resource not supported by science. I was taking unregulated hormones. Like many other women, I was gullible and uneducated about my options, leaving me vulnerable to buying anything labeled HOPE in a bottle.
After the 2002 Women's Health Initiative results, many women were scared of hormone therapy, myself included. Somers repackaged hormone therapy using the buzzwords "natural," "bioidentical" and "compounded" as the new healthy menopause management option.
What I found when I started to burrow into the scientific research was a far cry from the claims made by Suzanne Somers. It was eye-opening to learn that natural compounded bioidentical hormones were unregulated by the FDA. There was no standardization for producing the product, and no tests on the formulations. There are NO real natural hormone products available.
When we see Samantha from Sex and the City 2 rubbing yams on her face in hopes of getting a dose of estrogen, the only thing she got was a good laugh.
10 Hormone Therapy Facts Every Woman Should Know
The North American Menopause Society, a non-profit organization of expert scientists and clinicians, "does not recommend custom-compounded products over well-tested, government-approved products for the majority of women."
The Endocrine Society has stated that, "Post-market surveys of such (compounded) hormone preparations have uncovered inconsistencies in dose and quality."
All hormones, whether made in compounding pharmacies or in manufacturer's laboratories, are synthetic in the sense that they are made by a chemical process. All estradiol, even "compounded," is derived from similar chemical compounds.
The North American Menopause Society says, "Saliva testing to determine if a woman has the 'right amount' of hormones has not been proven accurate or reliable. Even blood testing of hormone levels has the drawback that levels vary throughout the day as well as from day to day. More important, the desired levels in postmenopausal women have not been established. In addition, an individual woman's physical comfort may not even be related to her absolute hormone levels."
When we see Samantha squirting hormones on her arms in Sex and the City 2, we are watching drug dosing that is uncontrolled and dangerous. Hormone therapy, whether bioidentical or not, whether compounded or manufactured, is a drug with benefits and risks that must be taken seriously.
Somers says in her blog, "I just wanted to feel good when I went into menopause and I didn't want to take drugs... When I found total and complete relief from natural non-drug hormones ... I thought wow, women and men need to know this. And that's how it began."
While Somers had good intentions in sharing her "natural" hormone therapy strategy, she remains misinformed and misleading. Her "non-drugs" are still drugs, and her "natural" products are derived from synthesized chemical compounds.
Unregulated formulas and inconsistent compounded dosing can be dangerous and has jeopardized the health of many women, including myself. I wished I had known the dangers involved with compounded-hormones.
The North American Menopause Society reviewed Somers' book saying, "Ageless is a tribute to pseudoscience, to safe and wishful thinking against facts, to claims of safety without proof ... the uninformed reader is misled to believe the fallacies rather than the truth ... the result is a book with overwhelming misinformation. The dangers are to women who may be misled into 'buying into' the products, thereby putting themselves potentially at greater risk than protection."
After my menopause symptoms were stabilized with a standard prescription of bioidentical estradiol, I found a new way of eating, lost 30 pounds and updated my beauty regime without cosmetic surgery or alterations. I have never been healthier.
Being informed is the first step to managing your symptoms. Know where your health information is coming from. Make your decisions based on the solid scientific research that is readily available. You CAN take control of your health and beauty during menopause.
References
The North American Menopause Society. Menopause Practice: A Clinician's Guide,
3rd Edition. Cleveland: The North American Menopause Society, 2007.
Sturdee, David W., The Facts of Hormone Therapy for Menopausal Women. New York: The Parthenon Publishing Group, 2004.
Somers, Suzanne. Ageless: The Naked Truth About Bioidentical Hormones. New York, NY: Three Rivers Press; 2006.
International Menopause Society, Recommendations on Postmenopausal Therapy,
27 February 2007
The North American Menopause Society, Early Menopause Guidebook. Cleveland:
NAMS, 2006.
Hemelaar, Marjorie; van der Mooren, Marius J.; van Baal, W. Marchien; Schalkwijk,
Casper G.; Kenemans, Peter; Stehouwer, Coen D A, "Effects of Transdermal and
Oral Postmenopausal Hormone Therapy on Vascular Function: a Randomized,
Placebo-controlled Study in Healthy Postmenopausal Women", biomedexperts,
New York, 2005;12(5):526-35.
Simon, James A. "Understanding the Controversy: Hormone Testing and Bioidenticals Hormones" 17th Annual Meeting of The North American Menopause Society, October 11, 2006, p. 5, 6, 7
Vogel, John J. "Understanding the Controversy: Hormone Testing and Bioidentical Hormones" 17th Annual Meeting of The North American Menopause Society, October 11, 2006, p. 23, 24, 26
Richardson, Marcie K. "Understanding the Controversy: Hormone Testing and Bioidentical Hormones" 17th Annual Meeting of The North American Menopause Society, October 11, 2006, p. 28
Allen, Loyd V. "Understanding the Controversy: Hormone Testing and Bioidentical Hormones" 17th Annual Meeting of The North American Menopause Society, October 11, 2006, p. 12, 13
The Endocrine Society. Bioidentical Hormones. Position Statement.
Patsner, Bruce. "Understanding the Controversy: Hormone Testing and Bioidentical Hormones" 17th Annual Meeting of The North American Menopause Society, October 11, 2006, p. 10, 11
Department of Health and Human Services, "Questions and Answers About the WHI
Postmenopausal Hormone Therapy Trials", National Heart, Lung and Blood
Institute, April 2004.
Haimov-Kochman, Ronit and Hochner-Celnikier, Drorith, "Are There Second Thoughts
About the Results of the WHI Study?", University Medical Center, Jerusalem,
Israel. Department of Obstetrics and Gynecology, 4 March 2006, p. 387-393.
Kalvaitis, Katie, "Compounded Hormone Therapies: Unproven, Untested - and
Popular", Endocrine Today, 25 March 2008.
Pines A.; Sturdee, D.W.; Birkhauser, M.H.; de Villiers, T.; Naftolin, F.; Gompel, A.;
Farmer, R.; Barlow, D.; Tan, D.; Maki, P.; Lobo, R.; Hodis, H., et. al., "HRT in the Early Menopause: Scientific Evidence and Common Perceptions", International
Menopause Society, 29-30 March 2008. The Hormone Foundation, January 2008
Medline Plus, "Complementary and Alternative Approaches to Health", 2008.
National Center for Complementary and Alternative Medicine.
Follow Staness Jonekos on Twitter: www.twitter.com/staness
Hormone therapy: Is it right for you? - MayoClinic.com
Hormone replacement therapy (trans) - Wikipedia, the free encyclopedia
Hormone Replacement Theraphy >> Medical Questions, Weight Loss ...
The "inconvenience" of menopause?? I could hardly get past this phrase to read the article!
I cannot believe that a woman who chooses to write about menopause would ever use such language that trivializes the severe impact menopausal problems have on some women's lives. It's more like "life debilitating" for many women.
Obviously, I am one of those women - and am searching for knowledge and remedies. (Yes, you know the "intensity" factor that comes with this wild ride!)
I hope you will consider your choice of words more thoughtfully in the future.
Thank you - and wishing good balance to you and all of us ladies!
Inconsistency in compounding is old news, and needed is third party analytic testing with results listed in public. This gives physicians the information they need to select the best pharmacies. As Staness noted, FDA approved bioidentical hormones are available. These are preferable to the synthetic "monster" hormones. For more information, see the web sites and articles by David Brownstein, Kent Holtorf, Bruice Kenton, Sangeeta Pati, C. W. Randolf, Erika Schwartz, and Jonathan Wright.
Well stated and fanned.
I am a younger woman with hormone issues.
Bioidentical hormones have helped me a great deal with mood, sleep and hair loss.
I thank God for doctors like you.
1. Neither Dr. Wendy Klein nor I are associated with “Big Pharma.” We do not make money from the pharmaceutical industry nor from promoting any menopause products, drugs or tests. Our work is meant to provide women with accurate information supported by sound scientific research and by reputable professional organizations, such as The North American Menopause Society and the Endocrine Society. Our interest rests solely with promoting women’s health.
2. Hormone testing of serum or saliva to monitor levels is not recommended in the routine management of menopausal symptoms, as is stated by The North American Menopause Society Fact #7. The standard of care is treating the symptoms, not the blood or saliva levels. However, when symptoms are refractory to treatment, or are atypical or unusual, serum testing may be warranted. In my particular case, compounded HT led to unanticipated and troubling symptoms. This necessitated serum testing which indeed showed excessively high estradiol levels.
3. As stated by the Endocrine Society regarding compounded hormone therapy, Fact #3: "Post-market surveys of such (compounded) hormone preparations have uncovered inconsistencies in dose and quality." For some women who need a dose not provided by FDA-approved hormone therapies, HT produced by a compounded pharmacy is an option.
Compounding pharmacies provide many solutions to health problems, but the HT products they produce are “individually mixed recipes that have not been tested to prove that the active ingredients are absorbed appropriately or provide predictable levels in blood and tissue.
4. There are bioidentical formulations of estradiol and micronized progesterone that are FDA-approved. Nowhere in this article does it state that bioidenticals are “unregulated” – what is stated is that compounding pharmaceutical products are not regulated by the FDA in the same way as standard manufactured medications.
5. Regarding bioidenticals and synthetic hormones. There are hormones that are bioidentical (such as estradiol) and hormones that are not bioidentical (such as conjugated estrogens).
6. Yes, I take a bioidentical progesterone that is FDA-approved, as well as a bioidentical transdermal estradoil that is also FDA-approved. I do not use compounded formulations.
After reading these comments, it appears that the confusion over compounded and manufactured hormone therapy continues. It is simply misleading for bloggers and others to claim that compounded hormone therapy products are safer. There simply are no randomized, controlled, blinded trials of adequate size or duration to support such statements.
It is worth noting that there is a huge industry that surrounds the sale of “natural” and compounded products and saliva testing. It is no different from any pharmaceutical industry, in that its aim is to make money for those who manufacture, sell, and promote those products. Buyer beware.
There are risks and benefits associated with all hormone therapy. Dr. Klein and I stand behind the hormone therapy facts listed.
Read more at :
http://jeffreydach.com/2010/06/27/10-ten-bioidentical-hormone-fallacies-of-staness-jonekos.aspx
Firstly, the above article maligns bioidentical hormones as unregulated, non-FDA approved and not supported by science. These claims are all false. Secondly, the article tries to confuse the difference between bioidentical hormones and synthetic, chemically altered hormones made by the pharmaceutical industry. Do not be confused, they are very different. Synthetic hormones are chemically altered monsters that cause cancer and heart disease. Bioidentical hormones are identical to hormones found naturally in the human body, the safe and effective choice. Thirdly the article contradicts itself in number 7, stating that blood testing is not needed, while the author earlier reported that blood testing revealed a high estrogen level. Obviously, blood testing was needed. Fourth, the article quotes the Menopause and Endocrine Societies as authorities without revealing their financial ties to the synthetic hormone manufacturers. Fifth, the author says that bioidentical hormones did not work for her. Quite to the contrary, millions of women use bioidentical hormones every day for relief of menopausal symptoms and quality of life. Bioidentical hormones work quite well. Sixth, After telling us bioidentical hormones don't work, the author reports they DO work, and she uses estradiol, a bioidentical hormone. Estrogen alone without progesterone causes increased risk of endometral cancer Therefore I would agree with Virgina Hopkins' previous comment in which she hoped the author is also taking progesterone.
For More: http://jeffreydach.com/2008/06/27/the-safety-of-bioidentical-hormones-by-jeffrey-dach-md.aspx
jeffrey dach md
Great post! The responses a priceless peek into both sides of the compounding issue. I haven't' dipped my toe into the HRT yet, but I'm on the verge of trying something. I know it's possible to be a sexy vibrant energetic woman but right now there are a lot of days when I'm faking it! I want my MOJO back!
In my quest to recapture my mojo, I put all my friends on an email list and started writing about issues related to how we deal with mid-life, menopause included. My goal was to take look at aspects of ourselves that might need a little tweaking to get us in gear for the next 50 years; image, attitude, confidence, health, and beauty, we want it all. But there’s no having it all without first addressing how to feel our best.
I have thousands of friends now. I call them Flashionistas ( http://flashionista.com/). Researching HRT is now high on my list of possibilities to make the next 50 years the best yet!
I went through menopause fairly early, and I guess was lucky as it wasn't that bad. I'm just left wondering, forever, if those compounds perhaps had something to do with my triple negative cancer.
Yet you say "A blood test revealed that my estrogen levels were seven times higher than normal," How could that be guaged when "they" don't know what "normal" is?
The truth is that they do have a pretty good idea what normal ranges for pre, peri and post menopausal women should be. It is just that there is no published/agreed standards unlike other health benchmarks like Blood Pressure or Cholesterol. Plus there is the whole saliva versus serum debate. So, bottom line, no-one is willing to stand by these de facto standards.
Every day doctors are prescribing FDA approved drugs that effect hormone levels, e.g. the contracepetive pill or HRT, and then saying we don't know what normal should be?
Not good enough.