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Dr. Larry & Joan Komer Radio
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January 2001
Happy 2001! We hope it is a positive year for you!
Thank you for your many letters and questions. We have answered most of them and several interesting letters and our replies will appear in each newsletter.
I had the opportunity to meet with our Minister of Health in a very positive discussion of issues affecting women's health and well-being.
Both of us will be guests on "The Doctor Is In" with Dr. Elliot Brown, MD on Wednesday, February 28, 2001. It is a call-in
drive-time radio program (WALE 990 AM) in Providence, Rhode Island and will be heard in southern Massachusetts, Rhode Island, and eastern Connecticut It is also broadcast via NABC, North American Broadcasting Company nationally on the internet at website:
www.renaissanceradio.com. Join us if you live in the broadcast area or log on the NABC internet website.
Please keep those letters and comments coming. Go to the website often to get the latest news and read the ever expanding topics.
Best Wishes,
Dr. Larry & Joan Komer
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If you are new to our mailing list family - welcome! If this helps you - please pass it on to your friends and family...
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In this newsletter...
*Questions & Answers
*Seminars On Cassette
*Supernatural Soy Available
*Peak Performance Stores
*Useful Links
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Questions & Answers
(Please note that the topics here were prompted by questions sent in by some of our web family but this information is not intended as personal medical advice - always see your physician for what is best for you. This information is general.)
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Q. Is there an increased risk of cancer involved in estrogen treatment such as taking regularly prescribed estrogen supplement for a 50 year old woman?
A. It appears that there is a slight increase in risk of breast cancer taking estrogen. However the increased risk is not large. See the section in our website
www.drkomer.com . First click on the box Health Topics
and then when that screen comes up scroll down to the title Breast Cancer on the left side. This explains the risk. It appears that hormone therapy reduces the risk of bowel cancer by about 50%. If a woman has not had a hysterectomy then she needs to take progesterone as well as estrogen and with this combination there is no increased risk of cancer of the uterus. We are not aware of any other positive or negative effects on cancer.
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Q. Does estrogen cause hair loss or does it help? My estrogen prescription states a side effect is hair loss and I have been losing hair rapidly. A nurse friend said she thought that menopause hormones should make your hair thicker and stronger. Is estrogen a
menopause hormone? If estrogen is a menopause hormone, then why did my prescription say it may cause hair loss? Is there any
menopause hormone or something else that will make the hair that I have lost grow back? I have now stopped taking estrogen because I would
prefer to have potential bone loss and heart problems than lose my hair.
A. Estrogen does not cause hair loss. In menopause some people do find their hair is thinning and the cause is not known. It may be related to not enough estrogen or extra testosterone (the male hormone of which women make small amounts). Estrogen is indeed a hormone that is used in menopause to replace the estrogen that the ovaries have stopped making.
When you read the information that comes with medication, they tend to list all possible side effects including some that are not caused by the medication and others that are so rare that I have not seen them in 25 years in practice.
I agree that you are wise to continue on estrogen not only for the reduction in heart disease and osteoporosis but also for the reduction in Alzheimer's Disease and the reduction in bowel cancer.
I am not convinced that your hair loss is due to the estrogen. I would suggest getting a referral to a dermatologist to have him or her look into other possible causes of hair loss.
Keep looking at our website www.drkomer.com for accurate relevant information on women's health care.
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Q. Dr. Komer, I am asking this question for my sister, she lives in a small community, where hospital staff stay for approximately 1 year. She saw a program that said women who have had a stroke should not take estrogen? We would like your opinion please. Thank you.
A. There is no information to show that estrogen increases the risk of having a stroke. Someone taking estrogen has a slightly increased risk of a thrombus or blood clot and this could be the cause of some strokes. However there is evidence that suggest that women who are on estrogen and who have a stroke have much less damage and a fuller recovery. Estrogen tends to cause vasodilatation or opening of the blood vessels which is also important in preventing strokes. Your sister might be better to switch to an estrogen patch since estrogen given in this way is less likely to change clotting factors and would give similar benefits. The dose of a patch that is equivalent to Premarin 0.3 mgm is the 25 microgram patch such as Oesclim.
Thanks for looking into our website www.drkomer.com.
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Q. Dr. Komer: I'd like to know how much research has been carried out to date on isoflavone supplements. Has the Food and Drug Administration looked at the matter yet? Thank you so much.
A. There is a moderate amount of research done on soy and this is increasing quickly. The FDA has allowed manufactures of soy protein to state that it reduces cholesterol. Presumably this in turn reduces heart disease.
Soy isoflavones both in combination with soy protein and separate from it has been the subject of research and the results do suggest a decrease in heart disease, osteoporosis and breast and prostate cancer.
The depth of research on estrogen is much greater, it has been around for 60 years and is still subject of some debate. Luckily, more time, effort and money is being poured into menopausal research and the picture gets a little clearer each day.
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Q. I am a 39 year old female who had a hysterectomy in June 1999. I was put on Cenestin shortly after my surgery and took it until a couple of weeks
ago (just kept forgetting to stop at the drug store and pick it up). This past week I noticed that I am sleeping better, have more energy, and feel overall better than I have in a long time. Over the summer I reached a state of depression I didn't think I would come out of - I currently take 60mg of Prozac.
Could the fatigue, depression, insomnia, etc. all be related to taking this medication? I did look at several sites on the www that stated Cenestin had been approved for short term use (studies had only been done on patients taking the medication for 3 - 6 months) and I took it for well over a year.
If it is related to the medication - what would you suggest I try for HRT or should I try anything?
A. Cenestin is a relatively new medication that shares many of the properties of Premarin, a drug that has been available for almost 60 years. Because Cenestin is new, it is suggested for short term use until research data is available. However that does not make it unsafe and it is very unlikely that you have done yourself any harm in taking it for a year.
You mentioned that you had a hysterectomy. This means simply that your uterus has been removed. What is critical is whether your ovaries were removed at the same time. If they were, then you are in menopause and would probably benefit from hormone therapy. There are some completely different medications such as estrogen patches or gels that may suit you better. If Cenestin has not agreed with you, there are many other choices. If you ovaries were not removed, then they probably are still functioning and making hormones and you would not need hormone therapy until you reach menopause naturally.
Keep checking our website www.drkomer.com for the latest information.
I hope that this helps.
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Q. Is it safe when you are taking other prescription drugs? Not HRT drugs but for other things? and... Is it safe if you are not 100% positive that what you are experiencing is menopausal symptoms? I do have what I would
consider "hot flashes" and sweating. Thank you
A. All of the research so far shows soy being safe to take with or without other drugs. In addition it appears to be safe to take with HRT. If you are getting some menopausal symptoms it shouldn't hurt to try a good soy product to see if there is improvement. If there is a benefit it may take two months to notice.
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Q. I started HRT with PremPro four months ago and changed to PreFest after two months, believing that I would not experience the degree of bleeding I was having with the PremPro. I had been ammenoric for over a year and was not happy with resuming bleeding.
After researching HRT more deeply, I have decided to discontinue it. I had a bone density test which came back normal. I have no family history of
osteoporosis or heart disease. However, I do have a fraternal twin who had a mastectomy at age 26 because of breast cancer. She and I have talked about HRT and she was told by her physician that since she has been cancer free for 24 years (we are 50) she is at no greater risk than the general population.
That was what encouraged me to begin HRT.
I have two questions. First, am I wise in discontinuing HRT? I have read of many alternatives (B vitamins, soy, etc.) for guarding against
osteoporosis and would like to begin that. Second, I understand that I need to wean myself from the HRT. Can I do it in the same way as steroids, alternating days and then stretching it out further until I stop? And how long do I need to do this before I stop entirely?
Thank you so much for your help!
A. Although neither of the medications you take is available in Canada, I have done research on a combination like PreFest and we often combine two different tablets to give effects like Prempro.
Early in menopause (i.e. the first 5 years) when one starts on this therapy there is a bleeding rate of 50%.
For women who persist until 6 months on therapy, the percent who have bleeding is under 10%. You should have been warned of this possibility.
The use of HRT is still somewhat confusing. It would not be reasonable for a person in your situation to use soy, vitamins and other natural products to reduce the risk of disease in the future. In addition keep an open mind about new drugs that may come available. One that is being used in Europe is tibilone (Livial)
and it doesn't have the bleeding but has the benefits. It should come to North America soon.
Most of my patients just stop the HRT without weaning themselves and have no ill effects.
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Seminars On Cassette
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US$34.95 (Also available in Canadian dollars as well)
Some of you are some of the 35,000+ people attended our Be Menopositive! seminars on menopause, self-esteem and women's health. Others of you may not have. This has been an important part of our work and the comments we have received over the years have confirmed again and again that these seminars made a difference for women and their families.
Knowing that many could not attend the actual seminars and that many others wanted to be able to review the material, we have taped the
seminar. The 2 1/2 hour seminar was recorded live and is now available on three audio cassettes in an attractive case.
They are great for a review if you were there, they will help your understanding of menopause and women's health
(informative and entertaining for other family members too!) and are a great resource for friends.
You may purchase them online with Visa or MasterCard in either U.S. or Canadian dollars.
For more information about the Seminar Tapes visit www.drkomer.com/audio.htm
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Send Your Questions!
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Due to the high volume of questions, we use the Questions & Answers
section of the newsletters to give you general feedback. Your questions also prompt us to add new sections of the website. If you, your family or friends have questions on women's health, self-esteem,
menopause, andropause (male menopause), breast cancer, hormone replacement therapy, infertility, pregnancy etc. that have not been sent to us, please visit
www.drkomer.com/askjoankomer.htm for
Joan Komer or
www.drkomer.com/askdrkomer.htm for
Dr. Larry Komer. All your email is read by the
Komers.
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Supernatural Soy
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Supernatural Soy is now available for sale on-line.
Heart disease is the number one killer in Western society. Heart disease kills 100 people each hour in the United States and 10 in Canada. It has often been thought of as a disease of men but in fact more women than men die of heart disease. It is occurring in women some ten years later because of the protective effect of estrogen. In menopause, when estrogen levels fall, the incidence of heart disease shoots upwards. As a matter of fact, heart disease kills nine times more women than breast cancer.
Heart disease may be avoidable though. We all know the benefits of exercise and not smoking in the reduction of heart disease but soy can
also play an important protective role. Soy foods are low in saturated or harmful fat and are free of cholesterol. The protein in soy has been shown to lower cholesterol and thus lowers the risk of a heart attack.
Visit www.drkomer.com/soyinformation.htm for more information.
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Seminars In Your Area
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For those of you interested in having Joan Komer present a self-esteem seminar or to have the
Be Menopositive! seminar for a group in your area, email us for more information at
seminars@drkomer.com.
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Peak Performance Stores
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As many of you know, our work in our seminars and other projects is through Peak Performance
Institute. We've called our US and Canadian
online stores Peak Performance. So if you see that name used - that is us!
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Useful Links
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Here are some other websites worth a look...
www.drlamb.com - Understanding & treating pain such as fibromyalgia.
www.drkovacsmd.com - Family medicine and medical/legal issues.
www.drugsanddocs.com - Prescription renewals online in Ontario, Canada.
www.tunnel-bar-b-q.com
- For fun! Those of you who like to BBQ and enjoy some great cooking sauces & spices, drop in at the TBQ site.
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Share this newsletter!
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If you know someone who is interested in women's health - pass this newsletter along! We'll be in touch soon!
Until next time... good health to you and your family.
Dr. Larry & Joan Komer
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The opinions expressed in this newsletter are for general information and should not be taken as specific medical advice. Always consult your physician or other health care provider to determine what is best for you.
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