(Ruth Jacobowitz's sixth visit to Power Surge)

Dearest:    Our guest tonight is Ruth Jacobowitz, Author of (among others) "The Estrogen 
Answer Book: 150 Most-Asked Questions About Hormone Replacement Therapy".  


Ruth Jacobowitz is listed in Who's Who in the World and Who's Who in American 
Women. Pretty amazing when most of us menopausal gals don't know who we are <g>. 
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 have appeared 
in major newspapers and magazines.  She also has a syndicated column, "Health Matters" 
and writes for "Your Health" -- Magazine and "The Chagrin Valley Times."

Ruth, welcome back to Power Surge, dear, brilliant women's health spokesperson :)


Ruth Jacobowitz:  I am very happy to be back with you on the number one internet 
menopause site.


Dearest:    Thank you, Ruth. It's always wonderful having you visit with us. Tell us about the 
feedback you've received from your latest book,  "The Estrogen Answer Book: 150 Most-Asked 
Questions About Hormone Replacement Therapy".


Ruth Jacobowitz:  The response has been fairly amazing. Women like the choices and the 
information. One half of the book is about pharmaceuticals and the other half about 
"natural" solutions to menopause.


Dearest:    Ruth, is there one solution for everyone?  So many doctors think there is. 


Ruth Jacobowitz:  Absolutely not! The solutions to symptoms have to be individualized. One 
size never fits all. 


Dearest:    Share with us your thoughts on the benefits and disadvantages of HRT, please. 



Ruth Jacobowitz:  I think that the benefits of estrogen therapy outweigh the risks for some 
of us, but I would certainly be careful if there is cancer in the family, particulary breast 
cancer. I also know that gall bladder disease and blood clotting issue may make estrogen 
replacement out of the question for some women. 


knessgone:   Thanks.  I have a large fibroid (as big as uterus), 49 years old, pain five days 
a month. Is hysterectomy the only option?


Ruth Jacobowitz:  No, there are other options today that you should discuss with your 
physician. 


knessgone:   What are some other options? 


Ruth Jacobowitz:  Certainly there are too many hysterectomies performed today. One of the 
options might be vaginal removal of the fibroid itself. Also after menopause when your 
estrogen supply diminishes the fibroid should shrink significantly because of lack of 
estrogen. What is your physician advising? 


knessgone:   Wait and see with frequent sonograms. 


Ruth Jacobowitz:  Good advice. 


Menobud:   Are you familiar with Revival?  And if so, what is your opinion of this form of 
soy as an alternative to HRT? 



Ruth Jacobowitz:  I have heard good reports of Revival and I have heard some questions 
about the efficacy of soy. I wish there were more studies and that results were available to 
us now.


Dearest:    Ruth is the author of numerous women's health books, including her latest, 
"The Estrogen Answer Book: 150 Most-Asked Questions About Hormone Replacement Therapy". 



Guest28:   I have had excellent results with natural progesterone cream, Vitex, and recently 
have also begun using Indole3/Carbonol. What is you experience with these options? My 
fibroids, as well as a cervical fluid-type cyst on the site of a conization of my cervix, 
have both shrunk completely since I started using natural progesterone. 


Ruth Jacobowitz:  I have to say that I do know that progesterone works and must admit that 
I am unfamiliar with Indole3. Sorry. 


Dearest:    Enlighten everyone, please, about Indole3/Carbonol. 


Guest28:   It's a nutriceutical product extracted from cruciferous vegetables that is mildly 
estrogenic. I get it from a compounding pharmacy. 


Ruth Jacobowitz:  I believe if what you are using works to achieve what you need, then it 
may be right for you. 


Ruth Jacobowitz:  Are you having your estrogen levels checked? 


Guest28:   It is supposed to normalize hormones, when they are either too high or too low, 
and since I've been using it the last 3 months, my periods have regulated themselves for the 
first time in a couple of years, even with the progesterone. I'm nearly 53.



Ruth Jacobowitz:  And I am sure you have discussed this with your physician who agrees. 
Yes? 


Guest28:   I had an FSH test a couple of years ago, but unfortunately at present I don't 
have any insurance, so I don't have a physician, like so many of us in the country. 



Ute:   Ruth I love your books and your website. Thank you so much for all that you are doing 
to help us at this confusing &difficult time in life. I emailed you a month ago and took 
your advise. 43 and in full nonsurgical menopause. I am now on the vivelle patch and the 
progestrone. However hot flashes are still happening. Could the estrogen need to be 
increased? I am on the lowest .0375. Since I still want to have my period I am using the 
progestrone 14 days on.



Dearest:    Ruth is the author of "The Estrogen Answer Book", among many others.



Ruth Jacobowitz:  Thank you for your kind comments about my books. You may need to go on a 
higher dose of estrogen and you can also add Vitamin E, which for many women lessens or 
stops hot flashes. 



Ute:   600 IU of E?



Dearest:    Just remember to use doses of only 200 IU of E at a time, Ute.


Ruth Jacobowitz:  Usually 400 IU in the a.m. and another 400 at bedtime does the trick for 
many women.



Dearest:    Many women don't know that vitamin E can elevate their blood pressure in higher 
doses.



Ruth Jacobowitz:  That's true and that's why it's good to let you doctor know what vitamins 
and minerals you are taking. 


Ute:   Thank you Ruth and Dearest!


Dearest:    Absolutely, Ruth. Women with history of hypertension should be especially 
careful. Hormonequeen, go ahead, please.



hormonequeen956:   Do you find more and more women looking for more natural options to HRT. 
I have been on so many hormones and now I am on the Vivelle Dot Patch. Had everything 
removed last July and just wonder if combining the patch with natural options are 
recommended? My doctor has never checked my estrogen levels and that concerns me. Should it? 



Dearest:    A doctor who puts a woman on HRT and doesn't check her hormone levels?


hormonequeen956:   Thats right, not since way before the surgery.


Dearest:    I find that very odd.  Let's see what Ruth has to say about it.



Ruth Jacobowitz:  Yes, more women talk about natural.  I've never been sure what natural 
really means. I have my hormone levels checked once each year. I think you should, too. 


hormonequeen956:   Is that the FSH or something else?


Dearest:    Ruth, I think many women don't realize that even naturally compounded hormones 
have their risks, too...as do vitamins and herbs.


Ruth Jacobowitz:  That's it and it is easier to check hormone levels on the patch.


hormonequeen956:   Why is it easier with the patch? 


Dearest:    Why is it easier?


Ruth Jacobowitz:  It's easier than on tablets, because the transdermal system (patches) do 
not go through the liver and are not significantly changed on their first pass through the 
body. 


hormonequeen956:   Thanks so much Ruth. I will either find another doctor or make sure he 
does the tests needed!



Dearest:    LZ, go ahead, please.



LZ:   I also read an article about the use of progeesterone instead of estrogen for HRT.  
The article said that there are too many things that estrogen can cause and that natural 
progesterone did not pose side affects that estrogen does.  I can't seem to find any other 
articles about the subject.  I just started menopause and am very concerned about all I 
read about estrogen use.  My doctor is pushing estrogen use and tells me that it's the 
way to go.  


Ruth Jacobowitz:  Great!  I think that estrogen probably is the way to go, if you have no 
reason that you cannot take it. 


LZ:   My cholesterol levels are high.  What can I do?


Ruth Jacobowitz:  Certainly the whole family of statin drugs lower cholesterol. Lipitor 
seems to have the fewest side effects.


Dearest:    LZ, if you read the  there are many recommendations  for addressing cholesterol 
problems. Also, be sure to visit the  Power Surge Message Boards , specifically the Cholesterol Board 
for more information. 


maggie:   If you are still having your period but having signs of menopause, what should you 
be taking?


Ruth Jacobowitz:  Oatmeal and fiber help lower cholesterol reducing fat in the diet helps 
and so does exercise. 


Dearest:    That's why you should buy Ruth's wonderful series of books on menopause and 
midlife health. Her latest is "The Estrogen Answer Book".  You can buy a copy right on the 
Internet at amazon.com.


Ruth Jacobowitz:  I would suggest that you are in perimenopause and should list your 
symptoms carefully and see if you can get a simple blood test to check your estrogen levels. 
FSH. 


maggie:   Moodiness, some hot flashes, swelling, etc.



Dearest:    Maggie, if you E.mail me at Dearest@aol.com, I'll send you a list of the 34 
symptoms of menopause and a link to Ruth's books on amazon.com.


Dearest:    Linkaloo, perhaps you should go ahead now.



linkaloo:   Hi Ruth, what do you find is the most efficient type of HRT to control heart 
palpitations? I started the Estrace (estradiol only) with 100 mgs. progesterone and haven't 
seen much difference.  Only been a short time on HRT though. I also drink Revival but still 
don't tolerate heat and the palps well.


Ruth Jacobowitz:  Palpitations were my worst menopause symptoms. I got them under control 
with estrogen and by giving up caffeine completely!


Dearest:    Ruth, I might also recommend 500 mg. of magnesium for palpitations <and 
migraines>. It's very effective for many women in menopause. The expression goes,
"if it spasms, give it magnesium."


Ruth Jacobowitz:  That's true, too. 


jdcislander:   Why do you have your hormone levels checked once a year? 


Ruth Jacobowitz:  I just want to make sure that the amount of estrogen I am taking is still 
the amount my body requires.


Daisy   I took estrogen for longer than 16 years and stopped 4 months ago. I have tried soy 
isoflaves and calcium, black cohosh.  What supplements would help?



Ruth Jacobowitz:  Why did you stop? 


Daisy   After 15-16 years I felt the risks were getting  too great. Cancer of breast and so on.


Ruth Jacobowitz:  That's a good reason; however if you feel so awful, you might wish to 
reconsider or wait it out. Often when we discontinue estrogen, it takes many weeks/month to 
get over some of the symptoms that recur after 16 months. 


Daisy   Maybe I should go back on them.


LZ:   What is the test you're suppose to get from the doctor to determine your estrogen 
levels? 


Ruth Jacobowitz:  A simple blood test that checks your estradiol levels.


Dearest:    Ruth, why do phytoestrogens, natural plant estrogens, work to eliminate 
menopausal discomforts for so many women?



Ruth Jacobowitz:  Because they contain estrogen. In fact in the book I have a long, long 
list of where estrogen is found in foods like cherries, asparagus, and other foods that you 
would least suspect. 


Dearest:    I know. It's a wonderful book, replete with the most comprehensive list of 
hormone therapies available today PLUS a list of the amount of calcium in the foods we eat. 
Thanks!


Ruth Jacobowitz:  Estrogen eliminates symptoms usually. 



linkaloo:   My gyno is testing my DHEAS levels.  She says I may be suffering from adrenal 
exhaustion due to excessive anxiety and stress.  Do you know what can be done for stressed 
adrenals? (Just in case my tests is positive)?  Also, what estrogen were you on to help with 
your pvc's?


Ruth Jacobowitz:  Dearest. I am so delighted that you like the book's contents. I tried! 


Dearest:    And you always succeed, my friend  :) Thanks for all the great books. I recommend 
them highly.


Ruth Jacobowitz:  Over the years I have taken many diffeent kinds of estrogen. The one that 
works so well for me currently is Estrace, but others have helped as well. 


Ute:   Ruth, since I am on HRT now and my FSH went from 5 to 55 in 6 month. Do I have to 
stay on HRT for the rest of my life? How will I know when it's all over?Is there still a 
possiblity of some good eggs if I wanted to have another child? Thanks!:)



Ruth Jacobowitz:  I don't know much about stressed adrenals. Sorry. Big question. Many 
physicians suggest that estrogen is forever, because we are merely replacing what our bodies 
made from puberty onward. Re the idea of another child is a question for your dr. who has 
your complete history, etc. 


Dearest:    Ruth, if women are supplementing estrogen and progesterone, why do so many come 
to Power Surge and say their tests don't show any difference in their hormone levels?  


Ruth Jacobowitz:  Good question, Dearest.


Dearest:    We just had a sample above with an FSH level that went from 5 to 55 in 6 months.


Ruth Jacobowitz:  That's surprising because usually when the dose of estrogen is right it 
drives the hormones to an acceptable and comfortable level. And as she noted once on 
estrogen her levels rose, which is what they're supposed to do.


Dearest:    I mean, if the hormone levels aren't increasing, what's the point to taking 
hormones?  Thanks :) Sammie, go ahead, please.


Ruth Jacobowitz:  I love all your excellent questions. 


Dearest:    Only because we know we'll get excellent answers :)


Ruth Jacobowitz:  Thank you.  I am really concerned about the continued medical confusion 
about menopause which is truly a normal event.


sammie:   I believe I have just started going thru changes the past year, fatigue, joint 
aches and pains, periods changing, wondering where to start to feel better.  Until finding 
this site recently, never realized the joint pain was associated.


Dearest:    I know what you mean, Ruth. I think we're all concerned and confused.


Ruth Jacobowitz:  Oh yes, joint pain is a symptom of menopause. There are so many symptoms 
some common like the hot flash others rare like formication.


Dearest:    So glad Power Surge has been helpful, Sammie :)


sammie:   I have hot flashes also.  Are soy and calcium supplements helpful?


Ruth Jacobowitz:  Vitamin E and soy can be helpful. Calcium supplements are good for your 
bones.


sammie:   What about exercise.  I used to walk all the time.  now I get so tired and sore.


Dearest:    Sammie, after you buy Ruth's book, The Estrogen Answer Book, be sure to check out 
the Recommends Page on the Web site at http://www.power-surge.com/recommend.htm


Ruth Jacobowitz:  Don't give up exercise, it may be the elixir of life. Do however little 
you can, but do it and walking is the number one exercise for many women and men. 


Dearest:    Very true. Thanks, Ruth. Bernie, go ahead, pleasee.


bernie:   Is it normal to have chills instead of hot flashes?  I do get hot flashes, but 
majority of the time I'm freezing!  Thank you for this opportunity to get my questions 
answered by someone who's been through it!


Ruth Jacobowitz:  Yes, chills occur often when your body is trying to reset its internal
thermostat following a hot flash.  We're either too hot or too cold. 


sammie:   Thank you...  it's good to have support.


bernie:   But I don't always have the chills following a hot flashes sometimes I have chills 
only



tiptoe:   I am 50 years old and had a complete removal 5 years ago. I am  on the Vivelle dot and 
never had my estrogen levels checked. No hot flashes but problems with intercourse such as 
difficult penetration any advice.


Ruth Jacobowitz:  That's true and that's because your body is reacting that way to the 
symptom. But before I would be positive, I would talk with your doctor to make sure nothing 
else is going on.  Yes. It sounds as if your estrogen is not fulfilling it's need to stop 
vaginal thinning and drying,which is probably the cause of the penetration problems. You 
might wish to change products, doses, or add an estrogen ring, Estring, which is vaginally 
inserted and works in that area with little of it absorbed into your system.


Tiptoe:   I thought the v.dot would prevent that? Should it be increased? 


Dearest:    Tiptoe, I recommend Ruth's book, "The 150 Most-Asked Questions about Midlife Sex, 
Love and Intimacy". Excellent advice about just this subject.


Ruth Jacobowitz:  Perhaps it should be increase. Have you tried vaginal moisterizers 
available over the counter, like Replens or Astroglide (my favorite name). 


tiptoe:   Yes.  I am not having problems with dryness. 


Dearest:   Astroglide -- conjures up all sorts of images :)


Ruth Jacobowitz:  Oh yes. 


linkaloo:   Does anyone know if the bleeding gets less and less after say six months on HRT? 
After a six month absence of my period, my gyno put me on Prometrium and then HRT to get me 
regulated again.  My last three periods have been gully washers! Will it ease up with time? 
Also, I've heard the new idea is NOT to cycle your HRT, but to take everyday.  What do you 
think? I am 47 yrs. old.


Ruth Jacobowitz:  There is much to recommend taking HRT 365 days a year and having no 
periods. Prempro comes to mind so does the CombiPatch. 


Dearest:    Ruth, I don't understand the progesterone dichotomy. On the one hand, it's
given to alleviate so many discomforts of menopause, but so many women develop irritability, 
anxiety, depression and a host of other uncomfortable symptoms from progesterone. Why is 
that? 


Ruth Jacobowitz:  That's the problem with many of the progestins like Provera which are 
synthetic. Prometrium, a natural micronized progesterone seems to eliminate all or many of 
those symptoms for women.


Dearest:   I don't know. I tried Prometrium and had the same problems, plus many women write
to me about the same thing. I find the least invasive form with the fewest side effects to be natural 
progesterone cream, such as Progest .


Ruth, thank you SO much for another wonderful, stimulating, caring and always 
informative guest visit to Power Surge. Everyone, be sure to buy Ruth's books.
"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" 

They're wonderful. I use them as reference books for Power Surge all the time. 
Also, be sure to stop by  Ruth's Web site 


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


Dearest:  Goodnight, everyone. See you next week for another Power Surge  Guest Chat .

Read Ruth Jacobowitz's first transcript
Read Ruth Jacobowitz's second transcript
Read Ruth Jacobowitz's third transcript
Read Ruth Jacobowitz's fourth transcript
Read Ruth Jacobowitz's fifth transcript
Read Ruth Jacobowitz's seventh transcript



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Dearest
aka Alice Stamm
Power Surge
Founder, Facilitator, Host


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