(Ruth Jacobowitz's 4th visit)

Dearest:     It is with pleasure that I welcome back medical journalist, author, 
women's health advocate, lecturer. . .

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

Ruth Jacobowitz is well known for her bestselling "150 Most-Asked Questions About..." 
series of books -- on the subjects of 
"150 Most-Asked Questions About Menopause", 
"150 Most-Asked Questions About Osteoporosis", 
"150 Most-Asked Questions About Midlife Sex, Love & Intimacy", 
and the newest, "The Estrogen Answer Book: 
The 150 Most-Asked Questions About Hormone Replacement Therapy" 
(Little Brown, 1998).


Listed in Who's Who in the World and Who's Who in American Women, Ruth is a 
member of the most prestigious women's health organizations and has appeared as 
an expert on numerous national TV and radio shows.
Ruth's articles appear in major newspapers and magazines. She has a syndicated
column, "Health Matters," and writes for "Your Health"  magazine and 
"The Chagrin Valley Times."

A warm welcome back, Ruth :) One of the things I so enjoy about "The Estrogen
Answer Book" is that you share your personal menopause nightmare with the readers,
and explain what led you to the answer to the question most women in menopause 
will invariably ask, "Should I take estrogen?"  Can you share with us what finally led 
to your decision to use hormone therapy?


Ruth Jacobowiz:    Of course. I obviously was one of the 15% of women who have a 
terrible time with menopause which came upon me as such a surprise. I suffered 
hot flash, night sweats, palpitations, insomnia--you name it and when I 
sought out a new young physician in town who didn't know me (I was a hospital
administrator at the time and mistaking menopause for a nervous breakdown, 
did not choose to go to my regular group of doctors. Anyway he offered my 
Valium--did not blood test--I bolted went back to my own doctor and went on 
ERT and have felt terrific ever since. No, I did not take the Valium. 
Glad to be here again, Dearest. 



Dearest:     Glad to have you, Ruth :)  How long would you say it took the 
estrogen to kick in and alleviate the awful symptoms you were experiencing? 


Ruth Jacobowiz:    In one week my symptoms diminished. In two weeks they were gone. 


Dearest:     Amazing.. that's wonderful. Had you tried any natural methods 
prior to HRT? 


Ruth Jacobowiz:    No, but you know I do believe in exercise, proper nutrition, 
and anything else that works. 


Dearest:     RBL, please go ahead.


RBL1999:    I had several side effects from Prempro and am taking a natural 
compound.  Your thought on this question? 


Ruth Jacobowiz:    I'd need to know what you're taking to have an opinion. 


Dearest:     RBL, what natural compound are you taking now? 


RBL1999:    I am taking Estradiol and Progest 


Dearest:   Is that Progest cream or progesterone tablets?


Ruth Jacobowiz:    Are they made by a compounding pharmacy? If so they're fine. 


RBL1999:    Yes, it is compounded by a pharmacy, it works really well    


Dearest:     Sja, go ahead with your question, please.


Sja4home:    Regarding HRT for the prematurely post-menopausal woman...
From what I understand, the cycling of progesterone is supposed to produce 
a period.  If it doesn't what should be done to produce one?


Ruth Jacobowiz:    If you are taking estrogen for 25 days, adding progestin for the 
last 10-14 days and stop, you may have a period. If you are taking them both 
365 days a year. No period. 


Dearest:     Thanks, Ruth. Janice, go ahead, please.


Janice0927:    If progesterone cream not compounded, do you recommend it? 


Ruth Jacobowiz:    I am never sure how much is enough. I'm not much for over the 
counter stuff. 


Janice0927:   Thank you 


Ruth Jacobowiz:    I just want to compliment Dearest for this excellent resource for women. 


Dearest:     Thank you, Ruth :)  Thanks, too, for your wonderful remarks about
Power Surge and me in your new book :)


Dearest:     Castle, go ahead.


Castle 812:    I had a tah/tuck 8/26 then 10/3 a bso for low malignant potential 
in ovaries.   What hrt do you think I should be on I am not on anything 
at present


Ruth Jacobowiz:    I'm not sure without knowing your medical history. but I do think 
you should discuss it with your physician. 


Dearest:     A1thea, go ahead.


A1thea4:    What do you think about the soy protein shakes like Revival? 
I hear it helps alot of women. I want to get rid of these symptoms and don't 
really want the synthetic version. 


Ruth Jacobowiz:    I think soy may turn out to be a magic bullet. And that one shake 
a day is probably fine.  Once we have the results of all the research that is 
going on with soy, we'll know how much is actually good for us and, perhaps, 
what it does. 


Dearest:     Thanks, Ruth. CAudra, go ahead, please.


CAudra:    Having constant problem vaginal dryness and think that the many yeast 
infections are part of the problem - also lost of hot flashes. I had a hysterectomy 
in July and take vitamins also.  



Ruth Jacobowiz:    Have you tried Vitamin E. helps with hot flashes. And vaginal moisturizers, 
like Astroglide and Replens help with vaginal dryness. However, HRT or ERT gets 
rid of both. 


Dearest:     Ruth, in your experience, what do women say is their biggest fear 
regarding the use of hormone replacement therapy?


Ruth Jacobowiz:    Breast cancer, without a doubt and, yet, it is heart disease that is our 
number one killer! 


Dearest:     But what about the recent JAMA report that cast some doubt on 
the efficacy of HRT in protecting women from heart disease? 


Ruth Jacobowiz:    Reading that study is tricky. Your are right. And yet when I researched 
it all, I learned that women with existing heart disease should not be looking 
towards HRT for protection, but protection is there for women who are currently 
free of heart disease. 


Dearest:     So the greater deaths among the HRT users rather than the placebo 
group were among women who already had heart issues?  Heart deaths, 
that is?


Ruth Jacobowiz:    Oh, yes. 


Dearest:     Whew!  Thanks for that insight.


Ruth Jacobowiz:    As a matter of fact, the study is ongoing and what it is beginning to 
show that women with heart disease are protected after the first few years. 
So the consensus seems to be that a woman with heart disease not start HRT, 
but one with heart disease who has been on HRT for more than a few 
years stay on it. 


Dearest:     Interesting. Thanks.   Sja, go ahead.


Sja4home:    If progestin is added on days 1-14 and does not usually 
result in a period, is this okay OR should something be changed or added in 
order to produce a period?


Ruth Jacobowiz:    Yes. I would certainly check the lack of withdrawal bleeding 
with your physician. 


Dearest:     Ok, RCH, your turn :)


RCHCTH:    I have severe fibrocystic breasts, very sore when estrogen 
surges, Progest seems to help, Besides Revival, Vit. E, Prim. Oil, low salt, 
what else can I do to reduce the swelling and soreness during 
that week? 


Ruth Jacobowiz:    Watch your salt intake, give up spicy foods, caffeine, cheese, and 
chocolate and exercise! 


Dearest:     Diane, go ahead, please :)


DianeH222:    I am presently on FemPatch, I also take Paxil.  Is there 
anything to increase my sex drive? 


Ruth Jacobowiz:    Talk to your Doctor about adding a little testosterone. 


DianeH222:    Is that male hormone?


Ruth Jacobowiz:    Yes it is. But it's one we have always had a bit of and sometimes 
it runs out after menopause. Testosterone is the only hormone of desire. 


DianeH222:    Well, I have problems with facial hair - will that cause more problems?


Ruth Jacobowiz:    It can and may be a trade off. 


Dearest:     Ruth, your new book, 'The Estrogen Answer Book' is chock-a-block 
full of...designer estrogens and new protocols. Can you share with us what 
new drugs are available? 


Ruth Jacobowiz:    Of course, in The Estrogen Answer Book I list the 24 kinds of 
estrogen products currently available and all the new combination hormones 
and progesterones. There is a chart which tells you about each by ingredient, 
color, shape, dosages, and manufacturer and will let you know how many 
options we women now have. 


Dearest:     Ruth, please share with us how you devised the terrific Estrogen 
Decision Self- Evaluation Test you include in your new book. Thanks.


Ruth Jacobowiz:    I did the self-evaluation test by interviewing literally thousands 
of women to find out about their symptoms, choices, etc. Then I tried it 
out on even more women to make sure it worked. I think it will help 
us know where we are in the menopause maze. 


Dearest:     It's great, but it's the first test I failed with a HIGH score :)  
Thanks, Ruth. Catalina, go ahead with your question, please.


Catalina5:    What is your opinion of Promensil?


Ruth Jacobowiz:    I think it's an excellent new medication. It offers us natural oral 
micronized progesterone which eliminates a lot of side effects. 


Dearest:     Florso, go ahead.


Florso:    Is the natural hormones safer than the chemicals?  


Ruth Jacobowiz:    I wouldn't say that. With the pharmaceuticals we have the FDA as 
our watchdog. With lots of the naturals we don't know for sure how 
much of what to take. 


Dearest:     HDOUR, go ahead.


HD 0UR12:     I had a complete hysterectomy at age 30 and have been on Estrace 
until about a month ago I've gained about 90 pounds. Is this common? 


Ruth Jacobowiz:	I don't think so. Estrogen does not cause excessive weight gain. I think you 
may need to have a complete physical examination to see what else is going on. 


HD 0UR12:   I also have had severe panic and nervousness. Seem to feel much 
better now that I'm off this medicine and I've also quit taking Zoloft.  How does 
wild yam cream work?


Ruth Jacobowiz:    Some women swear by them. Others swear at them. 


Dearest:     JJPL, go ahead.


JPLJAXX:    With respect to the dangers of pre-menopause hrt, would you consider 
a compounded  progesterone/testosterone cream unsafe? If so, how? 


Ruth Jacobowiz:    Many physicians say today that they can take women from premenopause 
to menopause by using the low dose mini birth control pills. Since the compounded 
creams are by prescription only--and that's the only kinds I would recommend--
your physician may be able to help.


Dearest:     Why are there so many physicians still prescribing Premarin and 
Provera when there are so many better HRT options available and what are 
your thoughts about these two drugs?


Ruth Jacobowiz:    I love your question! In my book I state that many physicians 
prescribe for 90% of their patients the same drugs they've always been 
prescribing because they know they are safe.  Now with so many new products 
on the market, women may have to go into their physicians and suggest 
what they want to take. You know whether or not to take estrogen is the most 
challenging question that a healthy menopausal woman will have to make. So 
each woman has to learn what is available and discuss the many options 
pros and cons--with her doctor. 


Dearest:     Thank you, Ruth.  Sja, go ahead, please. 


Sja4home:    Do you think that smoking for 30 yrs and then quitting in your 
50's could have a delay-type effect on meno symptoms?? My mother is 
experiencing symptoms now and never did B4.


Ruth Jacobowiz:    Smoking brings on an earlier menopause does not delay symptoms 
that I know of. 


Dearest:     Ruth, 3 or 4 "male" doctors I had as guests said there's no relation 
between menopause and depression. What are your thoughts on this 
when so many women complain about depression during menopause? 


Ruth Jacobowiz:    I don't buy it! I think if we're speaking of clinical depression, 
they are right. That's a different condition. But if we are talking about minor 
depression, the blues, anxiety, a little panic, nervousness, those are all 
symptoms of hormone changes. 


Dearest:     Thanks. Florso, go ahead.


Florso:    Besides soy, which other natural hormones are there? 


Ruth Jacobowiz:    There are lots. My book contains a whole chapter on phyto or plant 
estrogens. Some things that you eat every day contain phytoestrogens 
like carrots, cherries, corn, apples, asparagus, yams and many, many more. 
The book lists them all. 


Dearest:     Toga, go ahead, please. 


TogaGirl4U:    I take prometrium days 1-12.  I stay groggy all the time.  
Is there another progesterone that is natural that I can take?  My doc 
says if I switch I will have breakthrough bleeding 


Ruth Jacobowiz:    There are others like Provera, etc. I've never heard of grogginess 
with Prometrium, but I'll check it out. 


TogaGirl4U:   Prometrium makes me sleepy at night, and I stay groggy! 


Ruth Jacobowiz:   Check with the compounding pharmacies and with your drs. prescription, 
they can compound a progesterone for you. 


Dearest:     Thank you, Ruth. Swedeborn, go ahead, please.   


Swedeborn:    What dangers are there with taking Zoloft while trying to 
become pregnant?


Ruth Jacobowiz:    That I wouldn't/ couldn't answer. Ask whoever prescribed the Zoloft and 
your ob/gyn Sorry. 


Dearest:     Rain, go ahead with your question.


Rain 3468:    I am on Prempro and Inderal La for migraines and high blood pressure. 
Now I'm cold all the time. What do you think is going on?


Ruth Jacobowiz:    Hmmm. Your blood pressure may be low. Have you checked it lately? 


Rain 3468:    No 

Ruth Jacobowiz:  You might want to see your doctor and have him evaluate your
situation and check your blood pressure.  The cold flashes can be part of
menopause, too.


Dearest:     Okay, Ruth, you can go to Sja's question now. 


Sja4home:    What is your opinion of Estratab? Any better alternatives ? 


Ruth Jacobowiz:    Estratab is a new good product that is plant based. 


Dearest:     I have yet to find a book about menopause to contain any, no less such 
an extensive calcium counter for the prevention of osteoporosis. Why did 
you think it essential to include this comprehensive list in your newest book?



Ruth Jacobowiz:    Because I believe we can get most of the calcium we need from foods, 
we just don't know where to find it. And since calcium consumption is so 
important so that we can prevent osteoporosis--that crippling and killing 
disease--when we are older, we need to get busy learning all we can about 
calcium now, making sure we and the members of our families get enough. 
1000 mgs. daily. 


Dearest:     It's an incredible list and I refer to it daily. Thanks for including it.


Dearest:     Ruth, can you take one last question from Vpslll?


Ruth Jacobowiz:    Of course. 


Dearest:     Thanks.. Vpslll, go ahead, please.


VpsIII:    Thank you, I'm a DES daughter, HRT and synthetic hormones 
are not recommended. Any suggestions? 


Ruth Jacobowiz:    Yes, I think you may find your answers within the phytoestrogens. 


VpsIII:    Miso?


Ruth Jacobowiz:    Miso, tempeh, tofu, and other foods. 


Dearest:     Ruth, what a pleasure having you back in Power Surge fielding our 
questions about estrogen, menopause and other important women's issues.
Anyone interested in obtaining Ruth's newest book, "The Estrogen Answer Book", 
or any of her other books, please visit her Web site at: http://www.ruthjacobowitz.com.
You can E-mail Ruth at RuthSJ@SAN.rr.com 



Ruth Jacobowiz:    Dearest. Thank you for inviting me and for your high praise for my new book.


Dearest:   Ruth, it's my pleasure. Thank you for coming. For those on the east coast, can 
you share the media events you'll be participating In during the next few days?  Boy, 
what a schedule!


Ruth Jacobowiz:   Sure. I don't know for sure about all the radios and others, but 
I do know I'll be on Fox Good Morning New York on Tuesday around 8:45 a.m. 


Dearest:     Great. Will certainly tune in.. continued good luck with your 
new book. It's wonderful (as all your books)


Ruth Jacobowiz:    Thank you. 


Dearest:     Thanks for coming.. everyone, join me in thanking Ruth for an 
enlightening evening.


Sja4home:    thank you Ruth 
Dearest:     Night, Ruth :
PianoMary:    {S applause
THRV Sue:    Thanks for coming
PianoMary:    Thanks so much for coming again, Ruth.  Great chat!
VpsIII:    thank you 
RCHCTH:    Thank you for coming. :)
PianoMary:    {S applause
Florso:    thank you Ruth your great
Rain 3468:    Thank you
TKOVIA:    Terrific! Bravo:)
PianoMary:    I'll have to look for your books,  They sound wonderful.
GET7339:    wonderful Ruth. Loved your book.
PianoMary:    we'd love to have you come back again...thanks :)


Ruth Jacobowiz:    Thank you all. I'd love to come back soon. I can be reached at 
RuthSJ@SAN.rr.com 


Dearest:     Great,  Ruth. Thanks for the Email address :) I always look forward 
to your visiting with us :)


Sja4home:    good night everybody -- see you Wednesday. Sorry if I hogged 
all the questions tonight!


Ruth Jacobowiz:    You're welcome and I love visiting with you and the Surgettes. 


Dearest:     Well, another Power Surge Guest Chat has come to an end :(
See you next Sunday when my guest will be Dr. John Lee.
 
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