Dearest:   My guest tonight is Dr. Carolle Jean-Murat, Obstetrician-
Gynecologist, with a special interest in perimenopause and menopause. Dr. 
Carolle is a professor and author of the wonderful book, "Menopause Made Easy: 
How To Make The Right Decisions for the Rest of Your Life". 

Welcome to Power Surge, Dr. Carolle. Let me begin by asking if it's possible 
for a woman to prepare for perimenopause in order to make it an easier passage? 


Dr. Jean-Murat:   Perimenopause, the time preceding menopause is 
different for every woman. I just tell all my patients that are in their late 
30s to have a healthy lifestyle and they should be okay.


Dearest:   Dr. Carolle, when you say live a healthy lifestyle and they should 
be okay, does that mean go through an easy perimenopause? Because I've always 
lived a healthy lifestyle and have had a difficult menopause. 


Dr. Jean-Murat:   If a patient has a particular problem, I then try to 
guide her to make the best choice for herself. Dearest, there are so many symptoms 
that a woman can have during the perimenopausal years. From hot flashes, 
irregular bleeding, forgetfulness, heart palpitations, difficulty sleeping. I 
could go on and on. 


Dearest:   A scenario -- a woman of 45 comes to your office complaining of 
palpitations, skipped periods, migraines, insomnia and anxiety. What's the the 
first thing you say and do? 


Dr. Jean-Murat:   How severe are they? And what would you like to be done
about them? Do you want to try an alternative treatment or a low-dose estrogen? 
Or sometimes progesterone? Dearest, I usually discuss all the options with my 
patients and let them decide what to do.


Dearest:   Good to know that some doctors are listening to their menopausal patients.
Thank you, Dr.Carolle. MenoMom, your question, please.


MenoMom:   I'm 50 yo and post-meno almost 2 years.  I have dry skin problems 
especially in the labia vagina area.  I've used some different OTC lubricants 
but how safe, how to use Estrogen cream and is it worth it?  What are the possible
side effects or problems?? 


Dr. Jean-Murat:   If a woman does not want to take oral estrogen, she 
can try an estrogen cream. Estrogen creams are safe. There is only a small 
amount which is absorbed through the skin the first few weeks. Afterwards, the 
skin of the vagina becomes thickenned and very little is absorbed.


Dearest:   Venus, go ahead, please :)


venusrose9:   I am experiencing  a lot of metallic taste in my mouth, and more 
anxiety than usual, and forgetfulness.. Is there anything I can take to assist 
in deterring it? 


Dr. Jean-Murat:   Venusrose9: How old are you? Are you menopausal or 
not? 


venusrose9:   I am 42, with a partial hysterctomy, still have ovaries which are 
obviously dead. Bad night sweats. Suggestions?



Dr. Jean-Murat:   About 25 percent of women who had their uterus removed and 
their ovaries left behind experience premature menopause. It could be that your 
symptoms are due to menopause. Maybe not. You need to know that women can 
experience anxiety and forgetfulness at any age. You would need to find out if 
they are related to menopause and then consider treatment. Options are HRT or 
natural remedies such as Gingko Biloba and/or Kava Kava to name a few. 


MenoMom:   Do you use or advocate saliva testing for hormone levels? 


Dr. Jean-Murat:   I usually do not do saliva testing. It has not been 
useful to me.  I treat a patient, her symptoms, not her test results.


Dearest:   I'm so glad you said that, Dr. Carolle. I have so often
reminded women that their best gauge of where they are in the menopausal
process is by what their bodies are telling them.


Dr. Jean-Murat:   You bet you!


venusrose9:   I am on Premarin 1.25 since the night sweats. And zanex for 
anxiety.


Dr. Jean-Murat:   You are on Premarin 1.25, twice the dosage of the average 
menopausal woman.



venusrose9:   well, my night sweats have gone away, it's been 5 wks since my 
last one.


Dr. Jean-Murat:   You are then taking the right dosage.


Dearest:   Dr. Carolle, please explain the difference between perimenopause and
menopause.  


Dr. Jean-Murat:   Menopause means no more menstrual period. Perimenopause is 
the time preceeding menopause. Postmenopausal is what follows. 


Dearest:   So being in menopause or postmenopausal are essentially the same, 
yes?


Dr. Jean-Murat:   Definitely!


Dearest:   Thanks for that clarification. Debbie, go ahead.


debbie:   If I am taking Ovcon birth control how will I know when I stop 
getting my periods ? Doesn't the birth control force a period ? I still get 
some hot flashes and deoression/anxiety even while on the pill. I am taking 
Trazodone for the depression, which it does not help, but it helps me sleep. 
I'm 42.Take an occasional Xanax for anxiety. My periods are only 2 days long 
now.


Dr. Jean-Murat:   The average of menopause is 41. A woman on the Pill will 
continue menstruating until she decides not to take it. You need to know that 
women of all ages do sometimes experience hot flashes. Regarding your depression 
and anxiety, sometimes pills do not do the job. I recommend a book called The 
Anxiety and Phobia Workbook. It works wonders for my patients with anxiety. 


debbie:   Thanks doctor


Dr. Jean-Murat:   You are welcome!


Dearest:  Do you recall the author's name? 
<brain fog>


lori:   Edmund Bourne PhD


Dr. Jean-Murat:   The name is Edmund Bourne, PhD.


Dearest:   Thank you. Cricket, your turn :)


cricket:   Is progesterone contraindicated after a hysterectomy


Dr. Jean-Murat:   If a woman had a hysterectomy and is taking HRT, some 
people feel that there is no need to be taking progesterone. Some people 
advocate the contrary.  Personally, I don't unless a woman is adamant about it.


Dearest:   I want to break protocol for one moment and ask the women present to 
answer a question. On a scale of 1-10, how would you rate how you feel most of 
the time?  Feel free to type your answer to screen.  Ladies?
#1 being poor and #10 being good

lori:    8
Menobud:   9
MenoMom:   4-6,  50 yo and post meno almost 2 years
Newby:    3-4 over the last 2 months. 57 yo and post meno for 2 years


cricket:   I had both ovaries removed 2 years ago and am retaining fluid so bad 
that I can't stand it.  What will help?


Dr. Jean-Murat:   Cricket, How old are you and are you on HRT?


cricket:   I am 46 and on estratab .625


Dr. Jean-Murat:   I would suggest to mention your age as well as if you 
are on HRT or not. Are you menopausal? 


cricket:   Yes


Dr. Jean-Murat:   Sometimes fluid retention may be due to the estrogen. 


Dearest:   Menobud, go ahead, please.


Dr. Jean-Murat:   I would rate my life now from 8-9 


Menobud:   Would compounded hormones taken transdermally affect the lower 
esophageal sphincter?  I became quite ill on oral Prometrium.


Dr. Jean-Murat:   Side effects can differ from one person to the next. 
The only way to know if a particular medication is causing certain side effect 
is to stop it for a while, of course with the help of your health-care 
provider.


CAROL:   How long should you be on HRT?


Dr. Jean-Murat:   How long a woman should be on HRT is something very 
personal. Her beliefs, lifestyle, family and personal history, relief of 
symptoms as well as disease prevention are to be taken into consideration.

Menopause is defined as not having menses for one year. Beware that many women 
may have no periods for a while and it can return months later. Blood test are 
even more confusing. That is why I never do them, since they cannot predict 
whether you are menopausal or not. Only time will tell.

My mother told me that what she liked the most about menopause was that there 
was no more periods, no fear of pregnancy, and that the sex was better.



Dearest:   Dr.Carolle, why do so many doctors automatically put women on HRT as 
soon as they show signs of perimenopause? Many women fill their prescriptions 
like obedient puppies without asking questions. Why don't they advise them of 
their options?  


Dr. Jean-Murat:   Only 20 percent of women are actually taking HRT.  
You need to know that most doctors believe that women should be on HRT for 
their own good.  It is then up to each woman to make her own choice. 


Dearest:   What about the preliminary results of the Women's Health Initiative 
indicating that the "heart protection" promised by HRT for so many years isn't 
there anymore?


Dr. Jean-Murat:   Believe it or not, the WHI study so far is showing 
that HRT may not be the panacea that we all believed it was. I am waiting to 
see the final results.  This somewhat vindicates Dr. Susan Love. She has been 
saying not to give HRT to all women since most studies that had been done were 
with healthy women.  Do not extrapolate results of studies done on healthy 
women to the average woman. 


Dearest:   Exactly.  Thank you.  Venusrose, go ahead, please.


venusrose9:   I do eat tofu & drink soy supplements, what can I do about the 
mettalic mouth particularly? 


Dr. Jean-Murat:   Venusrose9 . You may need to be evaluated by your 
doctor. It may be that your problem has no correlation with menopause. 


venusrose9:   Why is that? The blood tests said menopausal


Dr. Jean-Murat:   Just because you are menopausal does not mean that a 
symptom is related to it.


Dr. Jean-Murat:   What comes to mind is that you may need to have blood 
tests to check your liver.   Remember, I am a gynecologist. It could be a 
medical problem. 


Dearest:   I always remind women to be thoroughly checked before attributing 
anything to menopause.


Dr. Jean-Murat:   You are right, Dearest!


Dearest:   I don't think Dr. Carolle is assuming it. I think she's suggesting 
it might be something else.  Because it's not a commonly complained about 
symptom during perimenopause.


venusrose9:   Okay, I will do it then just in case. thanx.


Dr. Jean-Murat:   Metallic taste is not a common symptom of menopause, 
that I know of. 


Dearest:   Ellen, go ahead with your question now.


ellen629:   I haven't had my period since August and at that time my flashes 
and night sweats were bad then I started taking healty woman soy menopause 
supplements- and the flashes are gone- felt some weird things though- a little 
out of wack, weepy, very sexually aware is that normal?


Dearest:   What do you mean by sexually aware?


Dr. Jean-Murat:   These symptoms can occur at any age. 


ellen629:   I felt very sexual, like my libido had jolted into overdirve


Dr. Jean-Murat:   That's what my mom said happened to her when she became 
menopausal.


ellen629:   So I am not crazy?


Dr. Jean-Murat:   That is why I have been looking to go trhough menopause 
since I had my first period. 


ellen629:   I have a dr appt on Jan 22 I guess I will find out then


Dr. Jean-Murat:   I doubt that your doctor will be able to tell you 
why.


ellen629:   I mean if I am really into menopause.


Dr. Jean-Murat:   Could it be that your relationship is better now? Or 
that there is less stress in your life? We need to remember that sex drive 
has nothing to do with menopause. 


ellen629:   no actually my hubby and I need to work on this aspect


Dearest:  As far as I'm concerned, I would do just fine without going
through this transition.


Dr. Jean-Murat:   Dearest, don't say that. I want to go through menopause, 
no more period, and the sex being better!!! 


Dearest:   Dr. Carolle, going through perimenopause has been a nightmare for 
many of us and many women complain of reduced libido (if any).  Go ahead, Lynn.


lynn:   What causes itching of skin at night?


Dr. Jean-Murat:   Some women during the perimenopause or begining 
menopause do experience what is called formication and occasionally itching of 
the skin. Apparently, it gets better after a while.  Sometimes, itching can 
just be due to an allergic reaction. 


Dr. Jean-Murat:   Dearest, I am hoping that it will be a smooth transition for me.


lynn:   What is formication?


Dr. Jean-Murat:   Formication, means ants, or a sensation of something 
crawling under the skin. 


MenoMom:   I had a very hard time in peri-meno and my blood levels were always 
normal.  I felt big changes but couldn't always articulate clearly about 
everything.  I would have liked to know my relevant hormone levels.  What about 
the soy/thyroid controversy?  Thank you Dr. Carrolle and Dearest and Cinda for 
being here tonight.  :)


Dr. Jean-Murat:   That is why I never do blood levels on women. They 
can be normal while a woman is miserable. Sometimes, they are low and the woman 
has no symptoms.  I do not know of any soy/thyroid controversy. 


MenoMom:   I did not receive good results from the treatment plan offered to me - 
but I'm past that now.  Other post-meno problems now.  Thank you.


Dearest:   I keep telling women to forget about all the hormone tests.


Dr. Jean-Murat:   Ditto!!!!


Dearest:   Dr. Carolle, thank you for joining us in Power Surge tonight for a 
stimulating conversation. I recommend everyone read "Menopause Made Easy" It's 
simply and clearly written for the layperson and is a wealth of information for 
women at midlife and in menopause.


Dr. Jean-Murat:   You are welcome!


Dearest:   Don't forget to visit Dr. Carolle's Web site at  www.DrCarolle.com.



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