(Dr. Elizabeth Lee Vliet's first visit to Power Surge) 

Dearest:   It is with great pleasure that I welcome to Power Surge an exemplary doctor, 
lecturer, women's health care advocate, and author of the exceedingly informative, 
best-selling and much needed, eye-opening book,  "Screaming To Be Heard...."
"Screaming To Be Heard: Hormonal Connections Women Suspect . . . And Doctors 
Ignore,"  D R.    E L I Z A B E T H    L E E     V L I E T. 

Dr. Vliet devotes more than 100 days each year doing education programs for women, physicians 
and top health professionals. She is the Founder and Director of HER Place; The Women's Center 
for Health Enhancement and Renewal, Inc. She is on staff at Arizona College of Medicine and 
the University of North Texas Health Science Center.

Dr. Vliet's credits would take the full two hours of Power Surge, so I invite you to  read her 
bio on the "Guests and Advisors" page of the Web site.
          
How many of us must have heard at one time or another, "It's all in your head," or  
"It's your nerves!" or "Take a vacation."  How many of us have left our doctor's offices feeling 
frustrated and lost.  Dr. Vliet will take us from out of that darkness and into the light, where 
women have longed to be for ages.  With her forthright attitude and extraordinary knowledge, 
Dr. Vliet will answer ALL our greatest concerns about hormones!

Welcome to Power Surge, Dr. Vliet. In your opening remarks, could you address the realities of 
HRT in the prevention of heart disease. There are other doctors and/or authors who claim that 
hormone therapy doesn't really protect us from heart disease.  Why the conflicting  opinions 
about this very important issue?  Thanks. 


Dr. Elizabeth Lee Vliet: Thanks Dearest, I saw the question. It's a long one, so will do my best.


Dearest:     Take your time, Dr. Vliet :)


Dr. Elizabeth Lee Vliet:     Recent books say estrogen doesn't protect against heart disease, but 
there are many ways our own estradiol does this, everything from direct effects on the heart and blood 
vessles, to lowering the levels of stress hormones, to relaxing blood vessles, it is pretty amazing 
what mother nature gave us! 


Dearest:     Thanks so much, Dr. Vliet :)


Bskcreed:   I feel so much better on premphase - but why does the progester one part make us so 
weepy?


Dr. Elizabeth Lee Vliet:   The progestin in Premphase commonly causes weepiness.  


BayouClog1:     Just started Premphase, also  noticed blue pills give me blues, why?   Will this 
be every time?


Dr. Elizabeth Lee Vliet:  These are the pills that contain the synthetic progestin, and they often 
cause depressed  mood and weepiness, food cravings, bloating, etc.   This is a serous problem and I 
don't use Premphase for my patients.   I prefer natural progesterone in pills, creams or suppositories 
so that there are fewer of these awful side effects.  You may want to try a more natural form of HRT   


Dearest:         Thank you, Dr. Vliet... Sherbaker, ask your question, please.


Sherbaker:      I felt such relief reading your book I''ve been begging doctors to listen to me 
concerning the obvious (to me) connection between heart palpitations and ovulation and my period.   
Now I'm on climara and natural progesterone but I'm still having awful palps around ovulation 
   


Dr. Elizabeth Lee Vliet:     Sherbaker, thanks, I am glad you feel some support, that was one 
reason I wrote the book, I knew women weren't making it up.


Sherbaker:      I just want to say, I'm discouraged -- still having the palps with HRT. any 
encouraging words?


Dr. Elizabeth Lee Vliet:     Heart palpitations happen at ovulation when estradiol levels drop 
quickly.  Palps with the Climara may happen as the patch is wearing off.  It doesn't always last 
7 days.   I tell my patients to change it sooner  if they feel these things happening. 


Sherbaker:      Thank you. 


Chloecake:      I have NO LIBIDO/  My blood work says I am not in meno. Talked Dr. into estrace and 
estratest hs every 2-3 days.  What do you think?


Dr. Elizabeth Lee Vliet:     Estrace and Estratest together give more estrogen than you probably 
need, and the testosterone in Estratest is different from what the body makes.  You may not be 
getting the right balance yet.  Has anyone checked your hormone levels?  


Chloecake:      Yes, all within normal range


Dr. Elizabeth Lee Vliet:     What's "normal" for the lab range doesn't mean what's "Optimal" for your 
body!!!  


Dearest:         Thank you, Dr. Vliet. Lori, go ahead, please :)


Lori4hlth:      What do you think of Tri-estrogen? Do you think it contains enough estradiol?


Dr. Elizabeth Lee Vliet:     No, I do not.  This "product" in my opinion is more marketing savvy than 
what women really need.  It contains too much estrone, which is the post-menopausal estrogen and is the 
one linked with both higher risk of breast and endometrial (uterine) cancers.  I don't  think it is 
wise to give additional estrone.  


Lori4hlth:      Thank you


Dearest:     Anyone interested in reading Dr. Vliet's fabulous, groundbreaking book, can click here to order 
"Screaming To BeHeard: Hormonal Connections Women Suspect ... And Doctors Ignore", at amazon.com. 
I highly recommend this book. 



Postrain:       What causes what I would call a "quaking feeling" inside?  No periods, no HRT, 
taking.  What causes what I would call a "quaking feeling" inside?  No periods, no HRT, 
taking herbs now.


Dr. Elizabeth Lee Vliet: "Quaking feelings" can have many causes: low estradiol, thyroid problems 
allergic reactions to herbs, excess stimulants like tea and coffee, some of the ephedra type herbs, 
and many others!  


Dearest:         I'd like to insert one thing, Dr. Vliet....


Dr. Elizabeth Lee Vliet:     OK  


Dearest:         Many women in Power Surge have complained about that internal shaking and not 
using caffeine, no thyroid problems. Can you attribute it to menopause itself? 


Dr. Elizabeth Lee Vliet:     Yes, definitely.  It happens when the estradiol levels drop and the 
body reacts with an "alarm" signal from the brain that sends out the "power surge" of adrenalin, 
the fight or flight hormone.  It is REAL!!  


Dearest:         Besides being a wonderful doctor and author, I see you're also a diplomat :)
Thanks. Krhinchi, go ahead.


Krhinckl:       Do the ovaries ever just rest? FSH, Prolactin, T4 OK, 42 and never missed a beat 
before, 7 month though. This seems so long.    


Dr. Elizabeth Lee Vliet:     Yes, sometimes just life stress  (like my exams in medical school!)  
can make the  ovaries "skip a beat"  and we will miss a period.  


SASCREAT:  Breasts sore so going to take my Prempro q.o.d. is that OK? Otherwise feel good.
 

Dr. Elizabeth Lee Vliet:     I think you would have less breast soreness by NOT taking PremPro 
that contains progestin every day,  and change to an estradiol with natural progesterone.  You 
may be reacting to the build up of the progestin (its like Provera), but if you take it every 
other day, you may have hot flashes and restless sleep from the drop in estradiol between doses.  


Stpr:   Other than estrogen, what can I take for flashes and vericose veins in my legs?


Dr. Elizabeth Lee Vliet:     If you want to try Dong Quai, that may help the flashes,  and so will 
Vitamin E - which may also help the veins.  Gingko biloba may also help, and you could also try 
Black Cohosh.


Stpr:     Where can I find dong quai?


Dearest:    In a reputable health food store, Stpr.


Halexd: 45 yrs: hot flashes at night only-sometimes, anxiety attacks last 2 yrs, off schedule, 
skip a period, then 3 weeks, is this the start? Vitamin E? 


Dr. Elizabeth Lee Vliet:     Yes, it sure is!  You may want to ask your doctor to check your hormone 
levels. I suggest doing them on Day 1 of bleeding and Day 20 - the middle of the "PMS" week.  That 
will give you some clues about whether you may also be losing bone now!  
 

Ddkt2:  What is the best form of testosterone to use. My gyn says she hasn't had luck treating with 
tetosterone, but my Family doctor says he will treat me. 


Dr. Elizabeth Lee Vliet:   I recommend natural micronized testo and I prescribe it in tablets, 
cream forms.  


Z J Gragg:      Is it common for anxiety to accompany hot flashes?  Is better on Climara, but
not gone.


Dr. Elizabeth Lee Vliet:     Yes, very common.  The "anxiety" attacks are the "adrenalin power surge" 
going off in the brain when the estradiol levels drop.  You'll see it happening when the Climara patch 
is wearing off or if the dose you are using is too low for what your body needs.  


WRasmus306:     what are the risks of synthetic hormones in the handicapped? Say, muscular 
dystrophy, 44 y/o woman ( wife) and on synthetics. Then lost use of her arms due to pains.


Dr. Elizabeth Lee Vliet:     I would not use a non-human form of HRT in a situation like this, 
because there are too many unknowns about how foreign chemicals affect the body.  I use native 
human forms.  


WRasmus306:  Dr. refused natural hormones on request. Could that be reason for arm problems?


Dr. Elizabeth Lee Vliet:     If your doctor refused "natural hormones" I would suggest looking for 
another doctor  - the forms of estradiol have been approved in US since 1976 (Estrace)  and Estraderm 
came out in 1986.  


Dearest:         Dr. Vliet, could you please name some "non-human" forms of HRT. 


Dr. Elizabeth Lee Vliet:  Non-human forms of HRT:  Premarin, Ogen, Prempro, Premphase, Estratest, 
Menest, and others.


Dearest:      Thank you. Susancee, go ahead with your question. 


Susancee:  Are you against HRT (Prempro) for someone with a history of breast cancer and if "yes", 
what natural forms of HRT do do you recommend?


Dr. Elizabeth Lee Vliet:     Susancee:  Yes, I am not in favor of using Prempro in women with FH 
(family history) of breast cancer.  


Slythy: What HRT do you recommend for your patients who have had breast cancer?  


Dr. Elizabeth Lee Vliet:     I think it is better to just use estradiol. If someone has had breast 
cancer the choices have to be highly individualized.  I check bone density and lots of other things 
before making a recommendation. 


BLSHNANGEL:     My blood pressure rises dangerously high 4 days before menstruation. Not so if I'm 
missing my  period.  What would help?


Dr. Elizabeth Lee Vliet:    BP rises before menses usually has to do with the premenstrual rise in 
progesterone, especially if estradiol dropping prior to meno. Suggest checking actual hormone levels 
at that time to see connections with blood pressure rise.  



Dearest:         Dr. Vliet, how reliable are FSH and other hormone tests?  


Dr. Elizabeth Lee Vliet:     FSH is not as reliable as combining it with actual measures of estradiol, 
progesterone, and testosterone. I find the levels are VERY reliable IF done at the right cycle phase in 
women who are still having periods.  


Dearest:     Thanks. Bayou, your turn. 


BayouClog1:     Why do some doctors frown on natural hormones and give synthetic instead?


Dr. Elizabeth Lee Vliet:     HABIT, and it's easier  


SandraS811:     Under what circumstances would you consider continuous Estrace/progesterone 
therapy?


Dr. Elizabeth Lee Vliet:    If a woman wants it, feels well on it, and doesn't have any medical 
problems to suggest NOT doing it.  


EHamm79739:     46yr, estradiol53, LH37, FSH75, couldn't tolerate hrt before, on nothing now. 2
months no period. Any suggestions? Also could I take pill intermittently?


Dr. Elizabeth Lee Vliet:    Hamm, your E2 is lower than needed to preserve bone and heart health.  
There may be other options to help you tolerate it.  I wouldn't suggest taking pill intermittently.  


Postrain:       Is there a natural method of getting estradiol, like soy?  (non-prescription or 
herbal? How much?) 


Dr. Elizabeth Lee Vliet:     Soy contains genestein, but not estradiol.  G acts at E receptor, but 
doesn't have same overall effects. Estrace, Climara, Vivelle, and Estraderm all contain estradiol that 
is dervied from the SOY precursors and then purified in lab to be what our bodies make naturally.   


SASCREAT:       What do you mean by natural progesterone, ProGest cream? 


Dr. Elizabeth Lee Vliet:     Natural progesterone in PRESCRIPTION strength from a compounding  
pharmacy.  PRO-GEST doesn't contain enough to protect the uterine lining.   I have a number of 
patients who developed hyperplasia thinking PRO-Gest was enough.  
 

Halexd: Can you comment on Dr.John Lee thoughts that it is a progesterone issue, not an estrogen 
issues?


Dr. Elizabeth Lee Vliet:  I wrote an article on HRT options for after having done actual hormone levels 
on several thousand women, I find it is the decline in ESTRADIOL first, and later the loss of progesterone.  


Ddkt2:  Dr wants to treat me with low dose for bleeding problems and early meno....what do you 
suggest?


Dr. Elizabeth Lee Vliet:   What does he want to treat you with?  


Ddkt2:  Now on estraderm and depo.


Dr. Elizabeth Lee Vliet:     Estraderm is good.  Depo-Provera tends to cause a lot of depression 
and weight gain, so I don't use it.  


Dearest:         You're opposed to Premarin, PremPro and Premphase, yes?  


Dr. Elizabeth Lee Vliet:     Yes, because these give women a load of equine (horse) estrogens that 
are foreign to our bodies.  More on that in my book. 


Dearest:         Wonderful.. thanks so much.. ZJ, go ahead. 


Z J Gragg:      How often do you recommend changing Climara? (On every 6 days--but 6th day is rough!)


Dr. Elizabeth Lee Vliet:     I teach my patients to change when YOUR body wisdom says you need to!!  


Lori4hlth:      Is there any contraindication in taking estradiol and eating lots of tofu?


Dr. Elizabeth Lee Vliet:     None that I know of.  Tofu is a good source of low fat protein.  


Bskcreed:       You mentioned two natural estradiol products - any other brand names or types to ask 
for?


Dr. Elizabeth Lee Vliet:     Climara, Estrace, Estraderm, Vivelle, and a new one, FEMPatch,  plus 
the compounded ones from reputable pharmacies.  


SandraS811:     On the continuous Estrace/progesterone therapy, what medical problems might 
arise?


Dr. Elizabeth Lee Vliet:     I noticed your combination earlier, and it raises some concerns for higher 
blood pressure, weight gain, and increase in sweet cravings, but usually not serious unless you are 
diabetic.  


Dearest:         Isn't it confusing, Dr. Vliet?  Some cause our pressure to be lower -- others cause 
our pressure to rise?  How do we know what to do? 


Dr. Elizabeth Lee Vliet:     Estradiol functions in the body to lower blood pressure.  Progesterone  
may raise it depending on ratio with estradiol.  The synthetic ones (non-human) tend to raise BP.  


Dearest:         Thank you. Sue Lacy, go ahead with your question :)


Sue Lacy:       Why does my FSH level show post meno if I still have periods every month? 


Dr. Elizabeth Lee Vliet:     Probably because your E has dropped enough for FSH to rise, but you may 
still make enough to trigger thickening and bleeding.  


Dearest:         Dr. Vliet, how are you holding up for your first online chat?  


Dr. Elizabeth Lee Vliet:   The PACE is fast -- speaking of raising blood pressure.  You guys are loads 
of fun tho and asking good questions!!!  


Dearest:        We'll slow down then :)  


Dr. Elizabeth Lee Vliet:     I'll just have to keep up with the POWER in this group!! 


Dearest:         Hahaha! Bayou, go ahead.. :)


BayouClog1:     What causes the little sharp pain you get sometimes in breast.  Is this part of 
menopause?  What can I do to help?


Dr. Elizabeth Lee Vliet:     Track when it comes with your cycle, and then you have a better idea 
of the hormone shift that causes it.  


Bck2Health:     Why do Doc's prescribe hormones when there are other alternative w/o side-effects? 
ie, cancer


Dr. Elizabeth Lee Vliet:   I don't think hormones cause cancer, and I do think it is a major help to 
many women to have the natural body hormone balance back.  


Bck2Health:     We do know that hormones accelerate cancer


Susancee:       I have hypothyroid.  Will the natural HRT also protect us against Heart Disease and
osteoporosis plus increase our risk of breast cancer?  


Dr. Elizabeth Lee Vliet:     The nat. HRT options I listed DO protect against heart disease and osteo
if you are reaching optimal levels.  See chapter 14 in my  book for a detailed talk about cancer 
issues and what women have NOT been told about this.  


Dearest:         Dr. Vliet, why do so many of us in menopause suffer from such severe insomnia. 
What's the cause and other then occasional Melatonin, what can we take? 


Dr. Elizabeth Lee Vliet:     The cause is the drop in estradiol that affects the sleep centers in 
the brain - can see EEG changes that go wtih this.  Tryptohpan rich foods help and serotonin boosters 
help.  Melatonin can be a problem for women unlike its effects in men.  


Dearest:         Tryptophan is no longer on the market, is that correct?   


Dr. Elizabeth Lee Vliet:     Some health foods stores now have it again.  Madison Pharmacy also 
carries a reliable brand, I believe.  


Dearest:         Great. Thanks so much. I get Tryptophan from Pete Hueseman at College Pharmacy.


CescaSF:        Any advice for those with anxiety disorders in dealing with increased anxiety 
associated with perimenopause? 


Dr. Elizabeth Lee Vliet:     I check hormone levels, work with meal plans to stablize blood sugar, 
use vitamins, exercise, and feedback.  Sometimes using an estradiol patch for a few of the worse days 
can really help too.  


Ddkt2:  Are there other causes of ovarian failure that would mimic meno symptoms?


Dr. Elizabeth Lee Vliet:     Yes, many.  I have had patients have ovarian failure triggered by 
tick bites (LYME), spider bites, and a host of other strange things!  


Postrain:       Can you only get estradiol through a prescription?


Dr. Elizabeth Lee Vliet:     As far as I know, and that is the only way you can also be sure of what 
you are getting. 


Bskcreed:       Do you ever recommend DHEA in combination with HRT?  Also, is there any 
correlation between HRT and asthma? 


Dr. Elizabeth Lee Vliet:     Yes, I often do use DHEA, after checking blood or saliva levels.  
If women take DHEA and don't have enough estradiol they will typically  get marked male-hormone 
side effects. Yes there are connections with some HRT and asthma, particularly the ones with lots 
of dyes and coatings on the tablets.  The dyes can trigger asthma, as well as the drop in estradiol.  


LizzieB:      Read in Prevention Magazine that the diosgenin in wild yam has no effect on meno 
symptoms, but I have had pretty good results with it to stop hot flashes.  Your opinion?


Dr. Elizabeth Lee Vliet:   It can stop hot flashes, but it doesn't maintain bone and heart benefits. 
Remember,   this is about LONG TERM health, not just getting rid of symptoms now. 


Dearest:         While we're on the subject of diosgenin and natural progesterone creams -- how 
do we know which of all of them on the market are effective?


Dearest: The compounding pharmacist consultant for Power Sure, Surge, Pete Hueseman, R.Ph, R.D., 
says OTC natural progesterone creams are "expensive moisturizing creams." A woman can get a 
prescription from her doctor for low dose, natural micronized progesterone that would be 
of more benefit. Pete fills those Rx's all the time. 


Dr. Elizabeth Lee Vliet:     The consumer has no way of knowing; that's why I don't agree with the 
present OTC (over the counter) marketing. Some have lots of progesterone added, and others are just 
marketing hype, and a waste of money. Check chart in my book on the content of these creams. It was 
done by Aeron Labs in CA, a very reputable group of hormone researchers.  


Dearest:         Agree.  Women are also spending a fortune on many things of no value. Anyone interested 
in reading Dr. Vliet's book, can click here to order "Screaming To BeHeard: Hormonal 
Connections Women Suspect . . . And Doctors Ignore." It's wonderfully informative, well written 
and an encyclopedia of knowledge. 


EHamm79739:     What would you suggest?  HRT caused DEPRESSION, anxiety, breast tenderness, 
no period x2mo.


Dr. Elizabeth Lee Vliet:     I think you were not on the right HRT.  Did anyone check  levels and such?  


Chloecake:      Can I make an appt with you in Texas or any place closer to NYC?                                                                


Dr. Elizabeth Lee Vliet:     Yes, the Texas office is easy to reach - just 15 MIN from DFW airport.  
Would love to see you.  


Bck2Health:   Why do they put women on estrogen and say you'll be on this for the rest of your life.  
And then they get cancer and say you'll never be on it again?


Dr. Elizabeth Lee Vliet:     I don't say that.  It can be a woman's decision at every choice point.  I 
have patients who have had breast cancer and  they choose to go back on estradiol.  WE DO THIS VERY 
CAREFULLY,  and it is always the woman's decison.  


Bck2Health:     Agreed.  It needs to be an informed choice. 


Dr. Elizabeth Lee Vliet:    A comment from one of my patients, "It did me no good to survive breast 
cancer if I have to feel this way off my estrogen"  That Really made me sit up and take notice of 
our rigidity that doesn't take the PERSON into account.  


Dearest:    Dr. Vliet, I must tell you, you're doing swell, especially for your first online chat :)


Dr. Elizabeth Lee Vliet:     Thanks, I am really enjoying this group.  


Dearest:         We're enjoying YOU, believe me!  


Norlee: In what way can Melatonin be a problem for women?


Dr. Elizabeth Lee Vliet:     Remember it is the hormone of hibernation - it makes you fat and 
sleepy!


Dr. Elizabeth Lee Vliet:     Sorry, I mean to be funny too. Actually, in women, melatonin taken 
every day can RAISE cortisol, a very undesirable effect.   And it really does cause weight gain, 
plus a tendency to have headaches, and down mood. 


Dearest:         Is that a fat?  errrr...fact?  :)   


Dr. Elizabeth Lee Vliet:     YUP.!  It is the  hormone we try to TURN OFF in seasonal affective 
disorder with bright light therapy - and SAD affects WOMEN 8 times more so than men.  Again - 
gender is crucial. 


Dearest:    What "doesn't" affect us more than men.


Dr. Elizabeth Lee Vliet:     Prostate cancer!!! 


Otis2424:     What are the symptoms of an anxiety attack. I think this could be happening to me.


Dr. Elizabeth Lee Vliet:     Anxiety attack: symptoms are racing heart, high blood pressure, 
shortness of  breath, irritable bowel, sweaty, not sleeping, indigestion, irritablity and a hundred 
other reactions.  


Otis2424:       Yep, that would be me. Thanks  Any suggestions?


Dr. Elizabeth Lee Vliet:     Check with your doctor, and have hormones, thyroid, and other common 
medical causes checked. Also cut down on caffeine, and try some relaxation therapies.  


Slythy: What do you think about using pregnenolone?  What does it do for your patients? 


Dr. Elizabeth Lee Vliet:     I haven't found much benefit to it. We need to remember that in women 
when the ovaries decline, we lose a lot of the key enzymes that take the "precursor" to the active 
hormone.  


BLSHNANGEL:     Hot flashes are intermittent, usually 2 or 3 in afternoons only. Will these increase 
in  frequency and duration -- they only last a minute or 2 now.


Dr. Elizabeth Lee Vliet:     Yes, they probably will increase in both.


CescaSF:        What causes our increased desire for sweets/chocolate?  Is it seratonin related? 


Dr. Elizabeth Lee Vliet:     Probably serotonin loss as we grow older, and also the change in balance 
with drop in estradiol relative to progesterone too, especially the week before bleeding begins.  


Dearest:        Dr. Vliet, on behalf of Power Surge and our audience, I would like to thank you for 
spendng this time with us tonight and for sharing your incredible expertise on women's health, 
hormones, and those connections WE suspect, and doctors ignore. It was a  fascinating  and enlightening 
evening :)


Dearest: Be sure to look for Dr. Vliet's wonderful book for women in menopause,  "Screaming To 
Be Heard: Hormonal Connections Women Suspect...And Doctors Ignore".


Dr. Elizabeth Lee Vliet:     You are very WELCOME!  




Read the transcript of Dr. Vliet's second visit
Read the transcript of Dr. Vliet's third visit



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