Dearest: I'd like to introduce my guest tonight, Medical journalist, writer and editor. My guest has has authored 23 books on a host of medical subjects. We'll focus tonight on her, "The Perimenopause Handbook", and "The Hypericum (St. John's Wort) Handbook". CAROL TURKINGTON has worked for numerous publications, such as TIME. She was the senior clinical psychology writer in the American Psychological Association magazine. For the past eleven years, Carol has been a freelance medical writer. Carol is associated with many prestigious medical organizations. "Women's issues are one of the areas in which I'm particularly interested." Her articles have appeared in numerous national publications including, "Vogue," "USA Weekend," "Psychology Today," "Self," "Redbook," "Modern Maturity," and "New Woman." Carol's upcoming book will be, "The Unofficial Guide To Women's Health". Carol, welcome back to Power Surge :) The 4th edition of "The Hypericum Handbook" will soon be out. Carol, many women in Power Surge have used St. John's Wort to treat their depression. I realize that depression is very common during menopause, but why is it at epidemic levels in this country? Carol Turkington: Hi and glad to be here! Well...in answer to that question, I think in part we are more willing to recognize our depression. It's not that we are all more depressed --but the social pressure against admitting a problem may be lessening that, plus the fact that there are many helpful treatments both drugs and herbs like St. John's Wort. Dearest: Thanks. Since "eating" is so pleasurable, is there any connection between the obesity we see today and the epidemic levels of depression? Dearest: <where IS my chocolate> Carol Turkington: Well, that's an interesting point. Are we eating to drown our sorrows?? Perhaps. Certainly life is far more stressful these days (at least, it seems so). Dearest: Carol, since you first wrote "The Hypericum Handbook," have there been any new treatments to come along to treat depression? Carol Turkington: Yes, there have -- and in addition, the government study on St. John's Wort is continuing; results should be available within a year or so. Regarding new treatments: just last year a brand-new SSRI (a drug in the same class as Prozac) was approved -- Celexa. It's been used many years in Europe and seems to be extremely successful in easing depression. There have also been several new drugs used to treat manic depression (bipolar disorder). Dearest: Other than the typical "feeling down" symptom, what are the other symptoms of depression we should look for? Carol Turkington: Lack of interest in everyday activities, lack of interest in sex, fatigue, insomnia, memory problems, feelings of hopelessness and worthlessness not being able to get out of bed in the morning or not being able to take care of everyday responsibilities. For some women, all they notice is just "being tired all the time." They may not connect it to depression. Dearest: Thanks, Carol. Let's go to the queue now. RWarte4742: How come doctors aren't familiar with Revival or other soy products? Carol Turkington: Well, in my experience, some doctors seem to be leery of anything they perceive to be "natural" -- one doctor recently asked me, "how come that everyone always thinks natural is better?" They seem to be reluctant to endorse "natural" products. Often they point to a lack of research, since research-based science is what they are used to. Unfortunately not all doctors are open to less conventional treatments... if you feel uncomfortable with your doctor's opinions, or you feel your doctor isn't open to treatments you'd like to try, seek another doctor -- but also remember that just because it's natural it's not necessarily harmless. (I am not talking about soy here). Doctors tend to rely on articles in peer reviewed mainstream journals and many natural products aren't always backed by that sort of research). Again, soy is not included in this group, of course. It's quite clear that soy is beneficial. Joyce2005: What do you think of the new drug Evista? Carol Turkington: Frankly, I'm torn...I'm right with everyone here -- in the same boat. I'm perimenopausal, and I am at high risk for breast cancer. VERY high risk. I find the early research interesting and intriguing...I'm frustrated that research does not seem to be able to tell us definitely that it will protect us from breast cancer or not. Dearest: Carol, do you think there are going to be any stunning revelations in 2005 as a result of the Women's Health Initiative Study? Carol Turkington: I'm afraid that there will be just more questions. I know a lot of people are hoping for "the big answer" -- but I'm afraid that we will simply have more questions than answers. Dearest: Sad.. very sad. Seems it's one big guessing game. Thanks. Lake810: My Doctor put me on Estratest and progesterone. I am bleeding again. Is the progesterone causing it? Carol Turkington: Had you stopped bleeding when the Doctor put you on Estratest and progesterone? Lake810: Yes, post menopausal for 6 years. Carol Turkington: I would contact your doctor immediately if you are bleeding after being postmenopausal for 6 years. CRZYFOX: What do you think of SamE for depression? Carol Turkington: I find SamE seems to be effective but I confess to not being an expert -- haven't read the research behind it. But it is certainly in the news JEWELSNLULU: I have been suffering from depression so long. I have hypothyroidism and just had a radical hysterectomy. Carol Turkington: Jewel, I'm so sorry to hear of your struggle. Depression can be so awful. Have you tried anything for it? JEWELSNLULU: No, I'm just down emotionally. Carol Turkington: What many people don't realize is that about 70- 75% of people with depression, from mild to severe, can be helped either by an herbal product such as St. John's Wort, or by an antidepressant. The new ones have very few side effects. JEWELSNLULU: Is there anything that does not have side effects or becoming addictive? That's another issue. Carol Turkington: Antidepressants are not addictive. As to side effects... well, I'm afraid that there is no antidepressant with NO side effects... but they cause different ones. For example, SJW may cause a slight nausea in a few people. Or a bit of nervousness. That's nothing, really, when compared with depression. JEWELSNLULU: Do you think that St John's is worth a try and how long before I would notice a change? Dearest: Carol, along with using St. John's Wort and other natural anti-depressants, what natural things can women do to alleviate the depression during this rite of passage? Jewels, E- mail me. I have something that will be very helpful to you. Ok? Carol Turkington: SJW is worth a try; it may take up to a month to notice a difference. Some of the newer antidepressants work faster. Now, Dearest... JEWELSNLULU: Thanks Carol Turkington: ...to your question about natural things to do. Someone talked about exercise. That is a wonderful way to deal with depression -- it is VERY effective. (and it also will help your heart, your bones, your weight, etc.) Groups like this can be very helpful -- social support is effective. Getting plenty of rest, eating a good diet and getting plenty of fluids (water) are all important. Dearest: Carol, thanks for reminding us. I don't think many women are even aware of how effective exercise is in treating both depression and anxiety. PianoMary: Since my original question about SAM-e was already asked...If it's not too personal... you said you are at a very high risk for breast cancer, what are you doing personally to help alleviate your perimenopause symptoms? Carol Turkington: Good question, and no, it's not too personal. That's what we're here for! I've been struggling with symptoms for several years, and then they gradually stopped. I thought that I had become postmenopausal, but recently the hot flashes have begun again!! I've used black cohosh, and yam cream. I also tried to exercise (sigh!), eat LOTS of soy (ask Dearest about her soy shake!), and less fat. WISCODUCK: I tried Black Cohosh with no alleviation of symptoms. What else? Carol Turkington: It depends what symptoms you are talking about... ginseng may help with fatigue and sexual problems, wild yam root helps regulate your cycle... dong quai may help ease hot flashes, vaginal dryness and depression... ginkgo may help memory (I'm going to be trying THAT soon!:)) Sally1019: I'm perimeno, using Revival soy shakes with good results but still have a couple of days of feeling depressed usually right before or during my period. Exercise helps but wondering if Saint John's Wort can be taken as needed or needs to be taken on a continual basis. Carol Turkington: I have heard of some people who take SJW "as needed", but everything I have read indicates it should be taken on a continual basis to be most effective. In Germany, many folks take SJW on a daily basis not just for depression but as sort of a "general tonic". It's probably one of the safest herbs I know. Ute110: What is your opinion on the use of natural progesterone creams for perimeno? Carol Turkington: Well, I do believe that over the counter creams aren't very strong...but I think people make the assumption that "natural" products are always better. I think they may be effective, but are no more safe than any other form of added hormones (pardon my typing. I have a killer cold and I'm sneezing all over the keyboard). Ute110: Thanks Dearest: Carol, do you think doctors too readily prescribe things like Prozac, Zoloft and Paxil when they might suggest first trying St. John's Wort? Sorry about your cold <try some vitamin C> :) Carol Turkington: In a word, yes. I had a friend who just went to the doc with mild depression...crying... bad mood... he prescribed Zoloft and two days later she had her period. I advised SJW instead since she confessed she "didn't want to be on drugs." I think that certainly antidepressants are extremely effective and doctors trust that. But I think SJW is also effective in MILD TO MODERATE depression. Dearest: It amazed me when I was first experiencing perimenopause- related depression that I was prescribed Prozac. I said, "No way." St. John's Wort has helped me and Revival Soy has completely removed my menopausal depression. MELADONNA: At the age of 60 shouldn't I not be waking up with a warm body and hair like Frankenstein? Dearest: Not you, Donna. MELADONNA: Yep, me Dearest: It could be worse, Donna. You could be waking UP with Frankenstein <ducking> Carol Turkington: LOL YouStoleDaCovers: lol PianoMary: lol MELADONNA: <GG> Dearest: Well, ya know...I've known a few myself <g> Carol, the floor is yours :) Carol Turkington: (I think I lost the question in here!!) Dearest: Donna, what is the question actually? MELADONNA: 60, feel warm and hair matted down like Frankenstein, normal??? Carol Turkington: Yup. MELADONNA: Is this norman? Normal, not norman (duh) Dearest: Norman? LOL Carol Turkington: If you mean, is it normal to have hot flashes at sixty?? MELADONNA: Yes Carol Turkington: If that is your question, yes it can be that late. Menopause usually averages around age 50, but it can be as early as 40 or as late as 60. EARL345: My mother had hot flashes until 85. Carol Turkington: Or 85!! MELADONNA: Gulp. thanks. YouStoleDaCovers: OMG PianoMary: A comment for Sally...I just wanted to say that I can take SJW as needed and it works very well for me that way. It might work better if I took it longer, but I don't usually see any need to do so :) Dearest: Same here, Mary. Thanks. Sally1019: Thanks, Mary PianoMary: You're welcome :) WISCODUCK: Are any of these natural products, SJW, ginkgo, dong quai, contraindicated for someone with uterine cancer? Dearest: Good question. Carol Turkington: Well, SJW will not be a problem. (In fact, they are studying it in the treatment of cancer). As to dong quai, it contains plant estrogens (phytoestrogens); If it were me, I would avoid adding estrogens in that case. Dearest: Carol, is St. John's Wort contraindicated for women on any particular medication such as MAO inhibitors? Carol Turkington: Yes, absolutely. If you are taking ANY antidepressant, but especially an MAOI or an SSRI (such as Prozac, Zoloft, etc.) you should wait at least TWO WEEKS between stopping one product and starting SJW (or vice versa). Also, if you are senstiive to caffeine, I would not take a lot of caffeine together with SJW. Also, it is very important to advise your anesthesiologist if you are undergoing surgery that you take SJW; many anesthesiologists want you to go off SJW for two weeks before having surgery. Dearest: Thank you, Carol. I'm afraid many women don't realize that even certain herbs and medications don't mix. RWarte4742: Dearest, did your doctor advise you to take Revival? Dearest: No, RWarte, but he's now advising many of his other menopausal patients to take it. My total cholesterol came down over 100 points since using it. The rest of my story is here Pmsnds: How to handle - losing it, crying, instead of "handling" stress, now 1 year after surgery. Carol Turkington: Are your emotions tied to the surgery? (what kind?) Pmsnds: Yes, full hysterectomy. Carol Turkington: There are several ways to handle this, depending on how you feel about medications, counseling and "natural" ways to ease depression. Pmsnds: I am open. Carol Turkington: If it's interfering with your life, and it sounds as if it is, then I think you might want try counseling and possibly SJW to start. Pmsnds: Thanks MOOMITA1: Menopausal since 30. I have fibromylagia and unexplained spotting. How to know what is making me miserable? All tests to know were done. Carol Turkington: Do you mean, you want to know why you are spotting and the doctors don't know why you are? Spotting is a normal symptom of menopause due to uneven levels of hormones. MOOMITA1: My body is going through changes. I feel it's when I spot. They feel it's the lupus but I only feel real bad when I spot a day for an hour. Carol Turkington: It's hard for me to tell, but if you feel unhappy with the diagnosis from your doctor, I think you need another opinion. Dearest: Moomita, why don't you Email me and I'll send you some information as well as links to an area in Thrive where you can get more help with the Fibro and Lupus questions, ok? MOOMITA1: I have four different ones in three states and the same state. Why don't doctors listen to patients? Dearest: Moomita, email me. If we had the answer to that question, we'd all be millionaires. Email me, Moom, ok? Ute, please make your question brief. Thanks :) Ute110: When all is said and done will we ever be the same women we were when this process started? Carol Turkington: Change isn't necessarily a bad thing... I know I wouldn’t want to be the same woman I was 20 years ago... with luck, we'll all be much wiser, kinder women. Sally1019: I've never bought SJW before - any specifications I should be aware of? Carol Turkington: Yes, it's very important to buy SJW from a reputable company and to look for tablets of 300 mg. strength standardized to 0.3% hypericin (the active ingredient). You should take 3 a day for a total of 900 mg. Dearest: Carol, when is the new book, "The Unofficial Guide To Women's Health" coming out? Carol Turkington: In mid year 2000. Dearest: And the 4th edition of "The Hypericum Handbook"? Carol Turkington: Again, the year 2000. Dearest: Carol, thanks so much for joining us in Power Surge tonight. I highly recommend Carol Turkington's books, "The Perimenopause Handbook", "The Hypericum Handbook", and the soon to be published, "The Unofficial Guide To Women's Health". You can find Carol's books on the Power Surge Web site's Bookstore or at amazon.com on the Internet. Please join me in thanking Carol Turkington for a stimulating and informative chat tonight :) Read Carol Turkington's First Transcript Disclaimer: Every guest in Power Surge is a highly respected professional whose opinions are his/her own. An appearance in Power Surge does not constitute an endorsement of a guest's views. None of these transcripts may be reprinted or reproduced without the express permission of Power Surge™ and the respective guest. Read other transcripts by returning to the Library. Dearest aka Alice Stamm Power Surge Founder, Facilitator, Host Copyright©1994- by Power Surge. All Rights Reserved.