Dearest:   My guest tonight, DEBORAH GORDON, M.D. completed her medical training 
at the University of California at San Francisco. She incorporates into her 
practice conventional medicine, herbal and nutritional therapies, plus mind-body 
medicine. Dr. Gordon lectures across the country. She is the co-author of 
"Menopause The Natural Way: The Women's Natural Health Series," a book providing 
user-friendly strategies to help women heal the symptoms of menopause. 

Welcome to Power Surge, Dr. Gordon :)


Dr. Deborah Gordon:   Thank you


Dearest:   In "Menopause The Natural Way," you say, "Although depression has 
been considered a sign of menopause, no clear causal relationship has been 
proven." How does one account then for the fact that so many women, who haven't 
a history of depression, begin to experience it during their perimenopausal 
years? 


Dr. Deborah Gordon:   This is particularly interesting this week.  It seems 
there has finally been a study which addressed that question and for the first 
time DID find a cause and effect relationship between hormone levels and 
depression.  However, I don't think that is the main issue.  There are other 
studies which show that women's menopausal symptoms in general, including 
depression, correlate well with the changing role of women in that particular 
society.  In some Asian countries, esteem is increased, and symptoms are not 
marked for menopausal women.


Dearest:   Yes, I understand and agree -- the depression could be part and 
parcel of the entire aging process, yes?  


Dr. Deborah Gordon:   Well, part and parcel of the aging process in a society 
that particularly reveres youth, beauty, wealth... and doesn't put a high 
premium on serenity and wisdom!!  Which is what many women start desiring at 
this time of life.


Dearest:   Understood. I was referring more to children growing up and empty 
nest syndrome and the other things accompanying natural "getting older" :)

What are your thoughts on doctors prescribing SSRI's, such as Paxil and Zoloft 
and anti-seizure medications, such as Klonopin and Neurontin to treat women's 
anxiety and depression during menopause? 


Dr. Deborah Gordon:   Not the ultimate solution, but maybe a good short term 
fix. 


Dearest:   Thanks, Dr. Gordon. 


SISOY:   Why do I feel some times that my life is over??? 49 and menopausal.


Dr. Deborah Gordon:   So, it's not an uncommon question, but one that with a 
little more attention, can probably be re-worded, what do you think SISOY?  


Dearest:   Sisoy, how do you feel as though your life is over? What are the 
symptoms and signs? 


SISOY:   Well, in general, that's how I feel


Dr. Deborah Gordon:   So... give me one example, if you would, please!  


SISOY:   I am very concerned about my osteopenia 


Dr. Deborah Gordon:   Good point:  for a lot of women, this is a real challenge.  
It's an issue that provides real opportunity for improvement, ALONG WITH some 
extras such as.. a great way to reverse is osteopenia is exercise, and a great 
way to avoid the hazards of osteopenia is dance or yoga, something that 
increases your sense of balance..   All these things (exercise, yoga, dance), 
might have the side effects of: increased sociability, fun, music, increased 
endorphins, meeting new people, weight loss..  etc.


SISOY:   It worsened the last 2 years.  Been there done.  That is not working. 


Dr. Deborah Gordon:   So there are several other options in addition to what I 
mentioned, which will not always work alone: My main therapy  is homeopathic 
medicine, I use also vitamins, herbs, and in some cases natural or even RX 
(prescription) hormones, depending on the situation.

My question for you is do you have a good health care provider you work with?


Dearest:   Would you recommend something like St. John's Wort for someone like 
Sisoy?


SISOY:   120 LBS 5" 7" I do take natural progesterone 


Dr. Deborah Gordon:   Well, StJW is for depression, which may be what you're 
referring to, .. I see you take natural progesterone, which usually isn't 
enough:  how about lots of D and calcium in a good form and magnesium and what 
kind of exercise, and how ... The question of having someone to work with is so 
important, do you have someone? 


SISOY:   Yes, I just started on that


Dr. Deborah Gordon:   How does the osteopenia make you feel that your life is 
over?


SISOY:   How much magnesium?? 


Dearest:   I would recommend you read Dr. Gordon's books for additional 
information, Perimenopause the Natural Way and Menopause The Natural Way. 


Dr. Deborah Gordon:   I usually recommend Calcium 1500 with Magnesium up to the 
same amount, but less than causes diarrhea!! 


Dearest:   Thank you, Dr. Gordon. 

Princess:   My problem is getting it together, focussing and staying focused  
and NO sleep due to hot flashes.    


Dr. Deborah Gordon:   Losing sleep is probably the best way to make anyone 
crazy, menopausal or not!  What do you do to help yourself sleep?


Princess:   I take gravol


Dr. Deborah Gordon:  Just goes to show how much info there is and how 
fast it can change, what is gravol? 


Princess:   Anti-nausea  pill.   Does help you sleep.   I have a fan blowing on 
me at night.  Hoping my doctor will give me natural progesterone.


Dr. Deborah Gordon:   So it's an antihistamine.  The fan is a good idea, keep 
one part of your body really cool.  And you can get the natural progesterone 
yourself, in the form of PROGEST or some other cream, it actually works really 
well topically, maybe with a little black cohosh: I double up on those at night 
to curb hot flashes.


Princess:   Well, here in Canada it is weak in strength?


Dr. Deborah Gordon:   Maybe you can buy direct from Transitions for Health 
in Oregon?  


Princess:   Will do. Thanks for your time.


Dearest:   While you're on the subject of progesterone, I'd like to ask one 
other question before getting back to the queue.

There are so many alleged "progesterone" products on the market. You say, "Some 
over-the-counter products only contain progesterone precursors from plant 
sources. Manufacturers claim that these products are reliable sources of 
progesterone because intestinal bacteria convert these compounds into 
progesterone. However, many experts deny this conversation ever takes place." 
Can you elaborate a bit on these plant precursors of progesterone? 


Dr. Deborah Gordon:   An area that probably cannot be clarified in an absolute 
way.  However, I think the amount of progesterone available in that 
circumstance would be very individualized, and variable.  Some people get a lot 
of relief, as if they are receiving a lot of progesterone, it may not even be 
measurable in their body, but if they feel the effect, something is working.  If 
you need to look for something stronger than a product that is NOT working for 
you then, you need to rely on products that actually contain progesterone 
itself.


Dearest:   Thank you, Dr. Gordon.  


Carmen:   In your experience Dr Gordon, is joint pain also a symptom of 
menopause, or hormone imbalance?  What are rx hormones? (43 and possibly 
perimenopausal) 


Dr. Deborah Gordon:   Yes sometimes joint or muscle pain appears at this age, 
and sometimes progesterone is helpful But I would consider it in a context of 
first knowing that something more serious isn't going on, and then incorporating 
homeopathy, exercise, diet and weight considerations. Topical progesterone 
though, has been helpful for some people, have you tried it?  


Carmen:   I am currently thinking about it.  Also homeopathy as well


Yuenlan:   Please comment on the relationship between progesterone cream, oral 
natural progesterone supplements, progestins, herbs and depression? I am using 
the cream and sometimes my depression still sets in pretty bad.


Dr. Deborah Gordon:   In terms of aggravating depression, progestin is right up 
there! However, progesterone, in cream or oral form, can cause either more or 
less depression, its an individual response.  I think depression is something 
that needs to be addressed more broadly, whereas some minor, if they are minor, 
joint pains or muscle aches, can be addressed more focally, as if it's an 
isolated symptom.


Yuenlan:   I am using about 100 mg a day, I am with PMS too.


Dearest:   Could you please say more about addressing depression separately as 
an isolated symptom? 


Dr. Deborah Gordon:   So depression is such a huge word, that means different 
things to different people, like "stress".  I always start by exploring all the 
things that "depression" mean, with general and specific examples.  It's not as 
isolated, ever, as something like a single physical symptom.  Sometimes, it's 
really a life situation that needs to be addressed, not a level of medication.  
Sometimes it may be a medical problem, or a whole life out of balance.  
Sometimes it's CAUSED by something else someone is taking.  SO I always need 
more info! 


Dearest:   Thank you for that comprehensive answer. Besides being a wonderful 
guest, I must tell you that you're probably the fastest typist I've had as a 
guest in 8 years :)
Joanna, go ahead, please.


Dr. Deborah Gordon:   I  used to think typing fast was a curse, when I was a 
secretary, before med school.


Joanna:   I take my herbs and vitamins - black cohosh, vitamin E, evening 
primrose - in morning with bran and soy in evening after swimming with soy milk - 
is soy affecting benefits of these herbs?


Dr. Deborah Gordon:   Interesting question:  several comments, taking the oils 
with bran may actually retard their absorption and the soy should be a nice 
addition to the other non-rx type estrogenic things you're taking.  Does it 
work? 


Joanna:   Yes, it is fantastique


Dr. Deborah Gordon:   Great!  always good to learn from each other! 


Carmen:   Can you please explain rx hormones - are they natural? 


Dr. Deborah Gordon:   By Rx I mean doctor-prescribed hormones.  They are natural 
in different ways, such a vague word. Premarin is "natural" if you are a pregnant horse.
Estradiol/Estrace is "natural" because it is the chemical equivalent of estrogen 
in our bodies.


Dearest:   So, what actually is the difference between synthetic 
and natural estrogen? 


Dr. Deborah Gordon:   Synthetic is another interesting word, because synthesized 
(made in a chemistry lab) hormones may actually match what is in our bodies and 
be, thus, natural!

My preference is to use estrogen and progesterone in forms that I call "natural" 
because they resemble human hormones, even if they are "synthesized", these are 
available sometimes by standard RX's, but I prefer to use the compounding 
pharmacies where the pharmacists are often highly knowledgeable and able to work 
with individual women to adjust dosages, or even find methods of dosing that 
work best for that woman.

Some women for instance, may be allergic to some of the oils that creams come 
in, or the pill constituents routinely available, and they need something 
prepared for just their own needs.


Dearest:   You refer then to "bio-identical" hormones as natural hormones? 


Dr. Deborah Gordon:   That is how I like to use the word, yes! Thanks! 


Dearest:   Thanks!  


Bubbles:   I have been menopausal for 2 years. I have a lot of anxiety, breathing problems, 
shortness of breath. Is this natural?


Dr. Deborah Gordon:   Well, it might be. Anxiety, yes, and breathing might feel 
irregular when our anxiety levels go up, many women also have some heart beat 
irregularities with hormone changes, but SHORTNESS OF BREATH would be a red flag 
for me that something else is going on, that you're out of condition, need to 
exercise, perhaps, or that you could have some asthma?  Which is not uncommon to 
develop at this time of life, and is usually a pain, and associated with food 
allergies, or something else, a good health care provider can be really useful 
for figuring out that dilemma!  


Joanna:   Follow up question, thank you. Is it okay to take herbs, vitamins, minerals 
between meals, so I do not mix oils with bran as I worry of nausea from no food with 
these supplements? 


Dr. Deborah Gordon:   You're right to worry:  both about nausea and absorption 
is better with food, it's just that bran can diminish it somewhat, so I think 
you're better off doing it just as you're doing it. 


Joanna:   Thank you. 


Dr. Deborah Gordon:   Actually, I have another vitamin comment!!  Andrew Weil 
has some good info about how to combine vitamins to maximize absorption, you 
might check out what he has to say in his Natural Healing Book, I think.


Dearest:   Dr. Gordon, isn't it also wise to start various vitamins and/or herbs 
one at a time, rather than in some compounded formula, so that if you do have a 
negative reaction to one of them, you'll know *which* one? 


Dr. Deborah Gordon:   Absolutely true!


Dearest:   Magical :)  


Irene:   My physician, although she feels soy is very beneficial and encourages 
me to use it, has some concerns that it can cause issues with increased risk of 
breast cancer and endometriosis? Can you comment on this? 


Dr. Deborah Gordon:   I do believe there is reason to individualize your dosing 
of soy. For a woman with symptomatic endometriosis, she can probably measure 
herself and determine whether the soy is excessive and aggravating, or moderate 
and helpful.  For women at risk for breast cancer, you need to think about soy 
in terms also of moderate doses which means to me eating soy (tofu is my 
favorite, or tempeh) and perhaps taking some isoflavones if necessary, to 
control menopausal symptoms, but NOT taking soy protein supplements at every 
opportunity.  I have backed away, *(ah, the changing face of medicine once 
again:..) from recommending soy protein powder as I used to, just because of 
this issue. 


Dearest:   Basically, it's everything in moderation, no?


Irene:   Thank you 


Dr. Deborah Gordon:   If you could manage excessive happiness, I think that 
would be okay. 


Dearest:   We'll make an exception there :)
Can you share with us the basics of your 6-step program to balance your hormones 
during perimenopause and for improved health during and post menopause? 


Dr. Deborah Gordon:   You know, this 6-step idea, well, it was a good first 
stab perhaps, but I so much like to individualize things, I would do that if 
there are no more individual questions, but they would be my preference, if 
they're out there.


Bubbles:   Does R 10 Help with hot flashes.


Dr. Deborah Gordon:   I hate proprietary names!!  What is R10?? 


Bubbles:   It is a homeopathic medicine.


Dr. Deborah Gordon:   Thank you!  That would mean it's a combination 
homeopathic, rather than an individual remedy, so first off, I would say if you 
have any access to a homeopathic prescriber, you would be 100 times better off 
with an individual remedy which might help you hot flashes, depression, 
osteopenia, all the different things we've been talking about tonight.  For 
individual symptom relief, if everything else is in order, I prefer to advise 
taking herbs, as homeopathics can have very deep effects, and if they're not the 
remedies for you, they may be not helpful, giving you a false idea about 
homeopathy, or even worse, may be harmful, so have you tried herbs?  


Dearest:   What are your thoughts on the anti-aging hormones, such as DHEA, 
Melatonin, et al? 


Dr. Deborah Gordon:   Complicated;  first of all, I'd say that I'm not a big 
anti=aging proponent, since death seems the only true alternative to aging!

More seriously,  however, I consider DHEA and Melatonin in certain 
circumstances, but not routinely.  I always try to use vitamin or amino acid 
precursors, first... so I recommend a GOOD reliable form of tryptophan before 
melatonin, for instance, if sleep is an issue, and I would check DHEA levels 
before recommending anyone take it.  Sometimes it's truly a wonder drug, a life 
saver! So it depends.  


Dearest: Dr. Gordon, thank you for an extremely informative and
stimulating chat tonight. 

I would recommend you read Dr. Gordon's books:

Perimenopause the Natural Way and 
Menopause The Natural Way. 


Dr. Deborah Gordon: Thank you. It was a pleasure. Goodnight, everyone. 








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