(Ruth Jacobowitz's 3rd visit to Power Surge)           

OnlineHost:	Ruth Jacobowitz has entered the room.


Dearest:	Tonight's Power Surge guest is women's health 
advocate, lecturer and Author of: 
"The 150 Most-Asked  Questions About Menopause"
"The 150 Most-Asked Questions About Questions About Osteoporosis"...
"The 150 Most Asked Questions About Midlife Sex, Love & Intimacy
 What Women and Their Partners Really Want To Know" ...

Also the co-author with Dr. Wulf Utian,  "Managing Your Menopause."

And, due out this winter, "The Estrogen Answer Book: The 150 Most Asked Questions About 
Hormone Replacement Therapy" (Little Brown & Co).

Welcome back..... R U T H    J A C O B O W I T Z  ....

Ruth is affiliated with numerous national health organizations, and has 
appeared as an expert on numerous national radio and TV shows.

Her articles have appeared in many publications. Ruth has a syndicated
column, "Health Matters," and writes for "Your Health"  magazine and "The
Chagrin Valley Times."

Welcome back, Ruth :) You end "150 Most Asked Questions About
Menopause" with, "Menopause is not our enemy. Aging is not our
enemy." You then use a quote --- "Our number one enemy is boredom -
not the boredom of nothing to do, but the boredom of not doing anything
that thrills or delights us."  Can you expand on this "boredom" with
regard to menopause?   Thank you :)


Ruth Jacobowitz:	Thank you.  Glad to be here. When I commented on 
boredom at the end of the book I felt it important to tell my 
readers that boredom can do as much damage and keep us from 
attaining our potential. 


Dearest:	How do you think boredom can be reflected in the life 
of a woman in menopause?  And how can it affect her menopause?


Ruth Jacobowitz:	I think it can affect her by keeping her from doing 
all she can to assure herself a first-rate second half of adult 
life. 


Dearest:	So, you think many women just accept the changes 
without trying to improve their health and well being? 


Ruth Jacobowitz:	I absolutely do and that's a waste. 


Dearest:	And use menopause as a sort of crutch?  
Fascinating, Ruth. Thank you :) Marylinden, go ahead, please :)


MARYLINDEN:	I recently switched to Estrace after being on Premarin 
for 20 yrs.  What is the equivalent dose of .625 Premarin for 
Estrace, and do you think it's better for our bodies? 


Ruth Jacobowitz:	Estrace comes in two strengths--1 mg. and 2 mg. which 
are you taking ?


MARYLINDEN:	Yes, but which one is the same as .625 of Premarin?


Ruth Jacobowitz:	Neither one is the same. It's a different product. 
Both work to protect bones and heart, etc.  Again, which one are 
you taking?


MARYLINDEN:	I am taking 1.0, but I wonder if it's enough.  And 
do you think Estrace is better than Premarin for our bodies?


Dearest:	Ruth, hasn't it been said that Estratest contains too 
much testosterone for women? 


Ruth Jacobowitz:	I'm not quite aware of that. I believe Estratest is 
the one with testosterone.


Ruth Jacobowitz:	Your right. Although Estratest has been around for 
almost 50 years and works wonders for some women particularly 
when lack of libido is the concern. 


Dearest:	Right, but I've read articles that it has too much 
testosterone. Is this true? 


Ruth Jacobowitz:	You could be right on target. 


Dearest:	JWildes, go ahead.


JWildes:	Why does Provera 2.5 cause stomach upset or nausea. 
I am also taking Climara .05 patch.  I am 51 yrs. old and FSH was 
60 in 12/97. This is all new for me Estrogen was great but they 
tell me I can't take it w/o the Provera.


Ruth Jacobowitz:	60 is a high FSH number and usually means that you've 
arrived at menopause. You might want to discuss with your DR. the 
benefits of HRT. 


Dearest:	Catalina, go ahead, please :)


Catalina5:	How does boredom compare with fear of starting 
something new? 


Ruth Jacobowitz:	Boredom usually keeps one from starting something new. 


Dearest:	Leenie, go ahead.


Leenie8432:	I had a surgical menopause at 38.  I began taking 
Premarin .625 for hrt.  I developed side effects and now take 2 mg 
of Estrace.  That works about the same for me.  I was exposed to 
DES in utero and am frightened of cancer, but really need hrt.  Do 
you recommend hrt for DES babies? 


Ruth Jacobowitz:	This is a discussion you must have with your own 
physician taking into consideration your medical history. 


Dearest:	Absolutely,  Mthrgtnirt, go ahead, please.


MTHRGRNIRT:	 Never done this before. Do you have to take hrt?  
Taking premarin. 


Dearest:   Everyone is new at some time, MTHR :) That's what
we're here for.


Ruth Jacobowitz:	If you have an intact uterus you usually do take both 
estrogen and a progestin which then is called HRT--hormone 
replacement therapy. If you have no uterus, then estrogen alone 
is usually all you need. 


MTHRGRNIRT:	I just took my last pill. I didn't know I would have 
to take it for twenty years.  I had a hysterectomy  in 1976.


Dearest:	Mthr, no one says you have to take HRTnor if you do, 
that you have to take it for years.  Do you want to comment on 
that, Ruth? 


Ruth Jacobowitz:	That's right.  Taking HRT or ERT is a matter of 
personal choice. 


MTHRGRNIRT:	Thank you both. 


Dearest:	Marylinden, go ahead, please :)


MARYLINDEN:	Is it true that there was a study in Sweden of women 
on Estrace, and that they had a incidence of breast cancer than 
other hrt? 


Ruth Jacobowitz:	I am unaware of such a study, which since I just 
completed research for the new book, makes me doubt that finding. 


Dearest:	SDemilly, go ahead with your question :)


SDemilly:	Can a blood test reveal if you are in need of hrt? 


Ruth Jacobowitz:	A blood test, the FSH, can tell you whether you have 
passed menopause. If so, your dr. may suggest HRT at that time. 


Dearest:	How reliable is the FSH test, Ruth? 


Ruth Jacobowitz:	Pretty reliable, but if it doesn't agree with your 
symptoms, sometimes it need to be repeated at another time of 
the month. 


Dearest:	Let me remind everyone that Ruth's series of books....
"The 150 Most-Asked questions About.... is wonderful... and in 
a Q & A format...with questions most of you ask :)  See the Power 
Surge Reading List for these books.


Dearest:	Debjeffd, go ahead.


Debjeffd:	My dads sister and mother died of breast cancer. 
Would that put me at risk taking HRT?  FSH 34, mothers family 
no breast cancer.. Even on fathers side?


Ruth Jacobowitz:	Often with breast cancer in the family, HRT is not a 
good choice, but there are new products available that "mimic" 
estrogen in the bones, but offer protection from breast and 
uterine cancer. One such product is call Evista. 


Dearest:	MimiSusan, go ahead :)


MIMISUSAN:	Wouldn't the boredom really be lack of anticipation?  
Sort of is that all there is? 


Ruth Jacobowitz:	That's it! And when we believe that that is all there 
is, we're not excited about what's yet to come. And the 
postmenopausal woman is having a great time. No menstrual cramps; 
no fear of pregnancy. 


Dearest:	Excellent reply, Ruth... LAndr42, go ahead.


LAndr42:	How does a person know if there on too much HRT? 


Ruth Jacobowitz:	Another simple blood test can give that answer.

 
Wingy54:	What is a safe estrodial blood level for a women 
taking HRT? 


Ruth Jacobowitz:	There is a range. Check with your physician. 


Dearest:	Lylas, go ahead, please.


Lylas103:	Why is follow up blood work not routinely done after 
starting Hrt to check levels? 


Ruth Jacobowitz:	Good question. I know that I actually request blood 
work when I go in for my exam and suggest that we all do that. 


Dearest:	Ruth, your thoughts on Tamoxifen, please? 


Ruth Jacobowitz:	I'm fairly excited about the new studies that are 
showing breast protection for the healthy breast and that it's 
use in younger women may be beneficial. 


Dearest:	MTa, please go ahead.


MTa3011:	I am 36 and I am going through menopause but no sex 
Life.  Is that normal


Ruth Jacobowitz:	Do you mean sexual desire? 


MTa3011:	both


Ruth Jacobowitz:	Some women lose desire, because when they've gone 
through menopause they lose that little bit of testosterone we 
women have and testosterone is the only hormone of desire. Often 
these women do well with testosterone added to their hormone 
regimen. As THRV Dear mentioned earlier, testosterone can be a 
benefit. 


Dearest:	Mur72, go ahead with your question.


Mur72:	I just found out that I will have a hysterectomy next 
Tues.  What symptoms can I expect right after surgery and what hrt 
should I take?  I am 46 yrs. old.


Ruth Jacobowitz:	A hysterectomy usually throws a woman into menopause 
and often the symptoms are immediate and full blown. Often 
physicians will put an estrogen patch on right in the operating 
room to curb symptoms?  Have you discussed that with your own dr.? 


Mur72:	At the last discussion there was still the question 
of the ovaries staying or not.  Since I would have started taking 
a hrt in a few yrs. I think they will probably go too.


Ruth Jacobowitz:	If the ovaries stay, sometimes menopause will be 
delayed, but usually not beyond the average age for menopause 
which is 51.4. 


Dearest:	Ruth, do you hear a certain mindset, or is it my 
Imagination  When someone says, "I just found out I'll have a 
hysterectomy next Tuesday." 


Ruth Jacobowitz:	Please explain. 


Dearest:	Are doctors making women's choices for them without 
offering options? Better yet, are women allowing doctors to do so?


Ruth Jacobowitz:	I think you are 100 % right. I hope women are finding 
Drs. who will be their partners not their bosses. 


Mur72:	He is not making the choice/I have no choice I have 
fibroids so large that my bowel and bladder function is being 
compromised and I am in pain.



Dearest:	Okay, Mur, you didn't make that clear. glad you and 
your doctor have discussed it and I wish you good health.


Ruth Jacobowitz:	And I wish you a speedy recovery. 


Dearest:	Debbreak, go ahead, please.


Debbreak:	Taking 5 mg Provera 10 days every other month.  Still 
having night sweats, etc.  I'm 43 & been in it for 5 years, any 
suggestions? 


Ruth Jacobowitz:	Are you taking estrogen as well? 


Debbreak:	No only the Provera, isn't estrogen in it? Doctor says 
I'm still producing my own estrogen.  I'm in perimenopause.


Ruth Jacobowitz:	Estrogen is not in Provera. It is a progestin. 


Debbreak:	So do you think I need more estrogen than I'm 
producing? Symptoms haven't let up.


Ruth Jacobowitz:	Debbreak, I do think you need more estrogen?


Debbreak:	thank you


Dearest:	Ruth, in your research, what have you found to be 
menopausal women's greatest concern? 


Ruth Jacobowitz:	I think women are most concerned about aging and about 
breast cancer even though it is heart disease that is 9 times more 
likely to kill us. 


Dearest:	Thank you, Ruth... AnnamCara, go ahead.


AnnamCara:	I have polycystic ovaries, does it affect secretion 
of FSH?


Ruth Jacobowitz:	Sometimes yes sometimes no. Depends on the degree of 
polycystitis. 


Dearest:	Ruth, how viable are alternative treatments for women 
who can't or won't take HRT? 


Ruth Jacobowitz:	There are really some excellent alternative choices. 
Soy, Evening primrose oil, Vitamin E for hot flashes, all kinds 
of stress-busting therapies like meditation, relaxation, massage, 
yoga, tai chi, I could go on and on...


Dearest:	Thanks, Ruth... Pandoralou, go ahead.


Pandoralou:	Testosterone test ok for me, still no sex drive, any 
suggestions?  Also VERY fatigued ) - total hysterectomy 10 yrs. ago, 
on climara .05.


Ruth Jacobowitz:	Often lack of libido and fatigue go hand in hand with 
lack of testosterone. If that's not the problem, then perhaps it 
is psychological. If something is really bothering you it's easy 
to feel fatigued all the time and to have no sexual desire. 


Dearest:	Lylas, go ahead.


Lylas103:	If progesterone is needed to protect against estrogen 
dominance, wouldn't a woman without a uterus benefit as well? 


Ruth Jacobowitz:	That's not the scientific thinking at this time. 


Dearest:	MTa, go ahead, please.


MTa3011:	Testosterone, what is it? I am taking a hormone pill 
called prempro. What is hrt ?


Ruth Jacobowitz:	Testosterone is the "so-called" male hormone. Prempro 
is HRT--a combination of estrogen and progestin--hormone 
replacement therapy. 


Dearest:	EP3131, go ahead.


EP3131:	What about taking Provera when I have had Breast 
Cancer and am currently taking Nolvadex?


Ruth Jacobowitz:	I doubt whether that is a good choice. Ask your dr. 


Dearest:	Ruth, what are the advantages of taking micronized 
progesterone, for example, over the synthetic progestins?  


Ruth Jacobowitz:	Great question. According to the results of the PEPI 
study, women taking oral micronized progesterone fared much better 
that women on the synthetic progestins. That is probably because 
the micronized progesterone is broken into tiny particles enabling 
the body to use it more easily. It is available from most 
compounding pharmacies with your own physician's prescription. 


Dearest:	When will we finally see the results of the Women's 
Health Initiative?  


Ruth Jacobowitz:	The Women's Health Initiative results should be 
available in 2005. Still a long way away. 


Dearest:	Thanks, Ruth.. looking forward to them :)  
TKOVIA, go ahead.


TKOVIA:	Am taking prempro(.625/2.5mg), vitamins, effexor, 
suffer much with irritability any suggestions?


Ruth Jacobowitz:	Perhaps your dosages need to be adjusted. Perhaps your 
Estrogen product is not quite right. It is amazing how many 
different kinds of Hrt are available now and sometimes we have to 
try different ones in order to rid ourselves of symptoms. 


TKOVIA:	thank-you


Dearest:	Thanks, Ruth... Lylas, go ahead.


Lylas103:	Are saliva tests as reliable as blood tests for 
determining hormone levels? 


Ruth Jacobowitz:	Saliva tests do determine hormone levels and some 
peoples are more comfortable with them than others. 


Dearest:	GMAMATT, go ahead.


GMAMATT:	How long do you feel a person should stay on Hrt? Is 
there more chance of breast cancer the longer one takes estrogen?  


Ruth Jacobowitz:	There is a greater chance of breast cancer the longer 
one stays on estrogen and yet that has to be weighed against the 
other benefits of estrogen to our bones, hearts, brains, etc. 
When I was at the International Menopause Society meeting in 
Stockholm most physicians suggested that 15 years was the limit. 
Other say less; and still others that perhaps we should be on 
estrogen for the rest of our lives. 


Dearest:	Ruth, how long does a woman have to be on HRT before 
she receives the heart protection it promises? 


Ruth Jacobowitz:	Probably forever. 


Dearest:	I think many women think the minute they start HRT 
they're protected.


Ruth Jacobowitz:	I think your right and yet once we stop estrogen our 
heart risk goes back up. 


Dearest:	Amazing. Thanks... Missailor, go ahead, please.


Missailor:    When you mention libido and menopause, how is it 
affected?


Ruth Jacobowitz:	When we lose estrogen and progesterone at menopause, 
we may also lose testosterone and when testosterone is gone so is 
libido. 


Missailor:	 Thanks


Dearest:	MGoody, go ahead.


MGoody1111:	My dr. absolutely won't test my hormone levels he says 
it is not necessary. Why?


Ruth Jacobowitz:	I'd see another doctor. 


Dearest:	Ruth, thanks so much for joining us in Power Surge 
tonight and sharing	your expertise in the area of hormone
replacement therapy and menopause. Anyone interested in reading Ruth
Jacobowitz's excellent books, can	buy them at www.amazon.com.

Be sure to look for Ruth's newest book,  
"The Estrogen Answer Book: The 150 Most-Asked Questions About Hormone 
Replacement Therapy" this winter (Little Brown & Co).

Ruth Jacobowitz's other books can be found at amazon as well:

"The 150 Most-Asked  Questions About Menopause" 
	
"The 150 Most-Asked Questions About Questions About Osteoporosis" ...

"The 150 Most Asked Questions About Midlife Sex, Love & Intimacy
 What Women and Their Partners Really Want To Know ...

Ruth is also co-author of "Managing Your Menopause."


Dearest:	Please join me in thanking Ruth Jacobowitz for another 
stimulating and informative chat  :)

LORACURA:	{S applause
PianoMary:	{S applause
RCHCTH:	thank you so very much
Mint104:	Thank you
THRV Sue:	Thank you for coming again!
Lylas103:	thanks
MGoody1111:	thank you so much.
TZdoe:	Thank You
MIMISUSAN:	{S women
RCHCTH:	Please come again.
VeryVenus:	thank you
Ruth Jacobowitz:	I loved being with all of you and hope I helped. 
E jane a:	Thank you

Dearest:	Thanks, Ruth... excellent answers (but who'd expect 
otherwise) :)

Oleford:	thank you
Missailor:	Thank you, very informative.
KARROLI:	thank you

Dearest:	Best of luck with your upcoming book, Ruth. I'm 
anxious to read it.

Ruth Jacobowitz:	You shall get an early copy. 

Missailor:	Is a log available of this chat?

Dearest:	All guest chats are on the Web site, Missailor, including
two previous chats of Ruth's -- you can find them all in the Power Surge
Library

Dearest:	Thanks, Ruth :)

Ruth Jacobowitz:	Thank you for having me. 

Dearest:	Thanks.. take care... hope you'll come back soon :)

Ruth Jacobowitz:	I'd love to. 

Dearest:	I think we can arrange that :)

Ruth Jacobowitz:	Great!



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Dearest
aka Alice Stamm
Power Surge
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