Dearest: My guest tonight is C. W. (Randy) Randolph, Jr., M.D., a Board Certified practicing gynecologist, trained pharmacist, and co-author with Genie James, of the new book, "From Hormone Hell To Hormone Well: Discover Human-Identical Hormones As A Safe & Effective Treatment for PMS, Perimenopause, Menopause or Hysterectomy." For more than a decade, Dr. Randolph has built a sound foundation of clinical evidence to support the safety and efficacy of treating patients with human- identical hormones vs. synthetic hormone replacement therapy. Dr. Randolph is a much sought-after speaker at national women's health forums. He is the founder of The National Hormone Institute of America and divides his hands on patient-care time between his practices in Jacksonville and Apalachicola, Florida. With devastating reports coming out about synthetic hormones and the halting of the Women's Health Initiative Study in 2002 (which used the synthetic hormones in PremPro), Dr. Randolph was urged to write, "From Hormone Hell To Hormone Well." It was written to help women understand how their bodies can be treated effectively by using human-identical natural hormones to treat the symptoms associated with PMS, perimenopause, menopause, or hysterectomy. With more than 38,000,000 women now hitting the perimenopause or menopausal years, Dr. Randolph discusses safe and effective treatments for weight gain, depression, osteoporosis, mood swings, premature aging, breast health, hot flashes, low sex drive, fluid retention, and fatigue. Dr. Randolph, it's a pleasure to welcome you to Power Surge :) Dr. C.W. (Randy) Randolph: Thank you very much for having me to discuss such an important topic and welcome to everyone! Dearest: My pleasure. Thank you for joining us. Dr. Randolph, I've noticed that PremPro is doing a great deal of advertising again. I wonder if we've learned from the abrupt halting of the WHI (Women's Health Initiative) Study (which used PremPro) in 2002 which was to continue to 2005. Do you think it's changed the way conventional health care practitioners treat and prescribe for their menopausal patients, or now that the initial "scare" is over, are doctors minimizing the significance of the findings of the WHI Study? Dr. C.W. (Randy) Randolph: What a great question. I believe that conventional doctors have still not gotten the message and that's due to lack of education and understanding about the basics of hormones. What has occurred is that the manufacturer of PremPro has reduced the dosage by 1/3 and has begun promoting that to doctors, saying that we are giving you less poison. Dearest: So, it's basically what you refer to as A business opportunity - pharmaceutical hype and spin? Dr. C.W. (Randy) Randolph: Yes, that is very true. The good news is that there are biopharmaceutical companies that are beginning to promote human-identical hormone therapy. Dearest: It makes no sense to me. If doctors have so readily prescribed synthetic hormones for the past 50+ years and now prescribe strong medications for menopause symptoms, such as anti-depressants, anti-seizure medications, tranquilizers. Why do you think it's so difficult for women to get their doctors to prescribe bio-identical hormones? Dr. C.W. (Randy) Randolph: I believe it's the lack of education and most medical schools are funded by pharmaceutical companies, and therefore, promote their own products. A doctor has to learn about bio-identical hormones by reading the journals. Dearest: Is that a fact, that most medical schools are funded by pharmaceutical companies? It's almost conspiratorial, no? Dr. C.W. (Randy) Randolph: It's definitely true. Dearest: Scary! Thanks, Dr. Randolph. Hot: Hello Dr. I've just read Dr. John Lee's book "What Your doctor May NOT Tell You About Menopause. Will your book provide me with a different kind of information that Dr. Lee's book did not cover? Dr. C.W. (Randy) Randolph: Dr. Lee was my mentor, and his book is very foundational, but I believe that our book is easier to read and more comprehensive, particularly with it's offering of real-life case studies. What we are hearing, is that our readers are better able to understand what their core issues are and what they can do in a practical way to impact their hormone imbalance and help themselves. Graham1: Dr., how does hypothyroidism interact with perimenopause and can this be controlled bioidentically (if that's the right phrase)? Dr. C.W. (Randy) Randolph: In peri-menopause, estrogen levels are usually normal and progesterone levels are low. This estrogen dominance causes the thyroid to be underactive (hypo-active). There is a direct correlation. Dearest: You refer to estrogen dominance as a very common and extremely dangerous condition. Can you explain exactly what estrogen dominance is and why it's so dangerous? Dr. C.W. (Randy) Randolph: Yes, I'll be happy to. Estrogen dominance generally begins in the mid-30s and is a situation where the estrogen level is normal and the progesterone level is low. This condition whereby the breasts, the uterus and the ovaries are saturated with overabundance of estrogen without the balance of progesterone contributes to life threatening conditions including cancer, blood clots and cardiovascular disease. Gramz: I am 53, postmenopausal and stopped synthetic hormones 2 and 1/2 years ago. My Estradial was less than 30 so I have now started NHRT because of depression, night sweats, hot flashes, etc. But I'm still having the depression and they just keep upping the dose of estrogen. Could to much estrogen be causing the depression to continue? Dr. C.W. (Randy) Randolph: Gramz, the answer is absolutely too much estrogen equates to a situation of estrogen-dominance which causes depression, weight gain, and insomnia and mood swings as well as many other symptoms. AverageWoman: I have tried several types of vaginal estrogens, the latest being the Estring. All give me yeast infections or vaginal irritation. I cannot have intercourse because of vaginal dryness/atrophy. I took Triest and that made me feel premenstrual. I'm 53. What is left for me to do? I've had my hormone levels checked and estrogen level was low but testosterone level and progesterone was ok. Dr. C.W. (Randy) Randolph: good question, AverageWoman. Estriol suppositories would help you immensely, and should be used vaginally at bedtime two to three nights per week. AverageWoman: Wouldn't those give me the same reaction? Dr. C.W. (Randy) Randolph: very doubtful, this form of human identical hormone is natural for the vagina, unlike synthetic and does not contribute to yeast infections. Dearest: If, as the expression goes, "progesterone is the "feel good hormone," why do so many women experience depression, irritability and other adverse symptoms when using either over the counter progesterone creams and/or prescribed bio-identical micronized progesterone? Dr. C.W. (Randy) Randolph: In my experience, the incidents of those side effects are very low when micronized progesterone is used transdermally (applied to the skin). JeanieM: I am a breast cancer survivor (DCIS) and want to get started on bioidentical hormones. Some say yes, some say no, what do you think? Of course, my oncologist says no, says a hormone is a hormone. He does not have a clue but how to prescribe toxic medications. I have all the symptoms of menopause and am desperate! I have tried OTC (over the counter) progesterone and it does not help. Dr. C.W. (Randy) Randolph: Jeanie, very common question. Progesterone inhibits cell growth and therefore, decreases the likelihood of breast cancer. Estrogen promotes cellular growth and can increase the likelihood of breast cancer. All breast cancer patients can benefit from human identical (bioidentical) progesterone cream to inhibit cellular growth. As I've said before, many physicians continue to be confused about the benefits of human identical progesterone versus the risk of synthetic hormone replacement. My guess is that your oncologist is a well educated physician with your best interest at heart, who has yet to be exposed to the medical information supporting the medical benefits of human identical progesterone therapy. SuzanneBerg: Postmenopausal women are not talked about a lot. My problems: vaginal dryness, tummy fat, weight gain, sugar cravings, depression/irritability. Do you have any ideas? Dr. C.W. (Randy) Randolph: I see women like yourself every day in my practice. It's all about having a hormone balance. Most menopausal women can be overlooked for their needs to re-establish a hormonal equilibrium of all three hormones. Estrogen, progesterone and testosterone. MrMcCoy: I'm 55. What can I use other than PremPro (used for 5 years) to stop hot flashes? Estroven extra-strength hasn't worked (suggested by ob/gyn). Dr. C.W. (Randy) Randolph: Bless your heart. The answer is not Estroven, it is human identical (bio identical) hormone replacement therapy. PremPro is dangerous. Find a physician who is knowledgeable in saliva testing and Human Identical hormones. Dearest: If you go to Power Surge's Recommendations page at www.power- surge.com/recommend.htm - you'll find many suggestions including bio-identical hormones, MrMcCoy. KYDewLady: How safe are these bio hormones and can you take them with script medications, (like lopressor for a fast heart rate) and is this fast heart rate one of the problems you spoke of earlier? Dr. C.W. (Randy) Randolph: As we discuss in "From Hormone Hell to Hormone Well," these hormones are identical to the hormones made in the human body. They do not interfere with lopressor or any other medication. They are very safe and effective. There are many causes of fast heart rate and only your physician can determine the underlying condition. JustMe5324: I am 57 and have 4-periods a year. Perimenopause is driving me nuts! I have lost all sexual desires and am wondering if those bio hormones will help? Dr. C.W. (Randy) Randolph: Absolutely! We share case studies regarding the positive impact of human identical hormone therapy on sexual libido in the book. SamBoy4: Do you recommend taking the estrogen and progesterone in a cyclic manner, in other words, do you recommend that estrogen be used every day, and the progesterone only 2 weeks of the monthly cycle, as to imitate a regular menstrual period, which results in monthly bleeding? Or do you recommend taking a combination of estrogen and progesterone every day? Dr. C.W. (Randy) Randolph: Great question! If you are still menstruating, I would recommend the cyclic regimen. if you are not menstruating, I recommend the estrogen, progesterone daily continuous regimen because most women do not want to continue to have periods. Stella0324: Dr. Randolph, I'm 52, my last hormone test showed estradial to be at 99, yet I was getting night sweats, occasional hot flashes and erratic bleeding. My has me on .5 mg of estradial and 100 mg of Prometrium. Still, one month I don't bleed, the next month I'm bleeding heavy and prolonged. Should I get off the estradial or what? I'm also afraid of taking soy in addition to the estradial for fear of causing more problems. Conventional doctors usually don't know anything about the progesterone creams. Dr. C.W. (Randy) Randolph: Stella, your estradial level is normal, but Prometrium is an oral progesterone which is drastically metabolized in the liver and is not as good as transdermal (through the skin) progesterone cream. My recommendation would be to use human-identical progesterone cream, 30 mg applied twice daily and this would probably stop your bleeding. Stella0324: For 2 weeks a month? Dr. C.W. (Randy) Randolph: Use it every day, in addition to the estradial. Victoria1: Thank you for being here tonight Dr Randolph. I think that I need to begin to take bio-identical but feel overwhelmed about starting and the potential roller coaster ride while my body adjusts. How do I begin and are these expensive? Dr. C.W. (Randy) Randolph: Victoria, it's a pleasure being with you all tonight. If you have not been on synthetic (HRT), you probably will not have a roller-coaster ride adjusting to human-identical (bio-identical) hormones at all. They are exactly like what your body normally makes. Dearest: One way you can begin is by going to www.power- surge.com/educate/yourhormones.htm - which is all about bio-identical hormones and read Dr. Randolph's book, "From Hormone Hell to Hormone Well". Victoria1: Thanks. That's encouraging. SissyBee: I have lots of symptoms of perimenopause. What about progesterone cream? How much do you use and how often? I started on it a couple of months ago and cannot tell a difference. Dr. C.W. (Randy) Randolph: Sissy, there are a variety of over the counter progesterone creams on the market with varying strengths. I don't know which brand you are using. You need at least 30 mg. twice daily of progesterone cream. In the book we list several over the counter creams or on our website. SissyBee: How much would 30 mg be? A half teaspoon or so? Dr. C.W. (Randy) Randolph: Sissy, every progesterone cream is different, you need to be educated about the cream you are using and the concentration of progesterone it contains. Graham2: Dr, would the removal of one ovary after an ectopic by Power Surge. All Rights Reserved.