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March 26, 2001
Date: Mar 26 2001 23:34:58 EST
From: "Dr. Komer, MD & Joan Komer" <news@drkomer.com>
Subject: News from Dr. Komer, MD Questions and answers on Women's Health & Encouragement
Spring is fighting its way into Ontario. We're glad that it is ending our winter here!
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.
We were pleased to be guests on "The Doctor Is In" with Dr. Elliot Brown, MD on his
drive-time radio program on WALE 990AM in Providence, Rhode Island. We were pleased to be heard in southern Massachusetts, Rhode Island, and eastern Connecticut as well as via the internet
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. I am inquiring about estrogen for my wife. How does she obtain medicine & what forms does it come in? I have heard of creams but she was wondering if it came in tablet or liquid forms as well. I would appreciate your response, thanks.
A. Estrogen comes in several different kinds of tablets, a gel, skin patches and injections The injections are not a good choice. There are no liquid forms. There are some benefits to the tablets as opposed to the gels and patches and vice versa. Most physicians have their own favourites because of their experience with them.
Good luck,
Dr Larry Komer
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Q. Dear Dr Komer: I am 42 years old and never had a real weight problem until now. About a year ago, I took Paxil for depression and gained 20 lbs in 2 months! Needless to say, I stopped taking the drug after that (with extreme withdrawal
symptoms) and have now been taking Celexa for the past 3
months (it doesn't seem to effect my weight). I initially lost 10 lbs after about 3 months (am down to 133
lbs) but cannot seem to lose the last 10. I have never been this heavy in my life, nor had I have to watch what I eat. I remember about 1 1/2 years ago, buying a package of 4
éclairs and eating 2 (this wasn't normal for me, but the point is, I could do this type of thing every once in a while and still remain at 122 lbs. ) I never have had a "food" thing and have always had a pretty small appetite. My "normal" day for eating would consist of a Zone nutritional bar for breakfast, a tuna sandwich for lunch and maybe some pasta, fish or chicken and a baked potato! !. I have a "sweet tooth" and am well aware of it now but it never seemed to affect me a couple of years ago. I have had my thyroid tested and it is normal. I also take ballet classes once a
week (have been in dancing class since I was little) and usually exercise about 1 hour, 2 times a week after that.
What is going on? Am I premenopausal? Can I be taking something to boost my metabolism?
A. Unfortunately, you have run up against one of the problems that we sometimes see on some of the antidepressants, namely an increased appetite and weight gain. Often with depression one is less active than usual and burns off fewer calories but in addition some of the medications stimulate the appetite. You were wise to get off Paxil and find one that worked better.
This is not at all predictable. Losing 10 lbs after that took a great effort and you are to be congratulated. One of the problems that all of us run into with each advancing year is a metabolism that is slowing. We need to eat less and exercise more just to keep our weight steady, let alone lose weight.
You are on the right track exercising since this does increase the
metabolism. Studies have shown that women have to exercise more than men to increase their metabolism because of the hormones, at least 45 minutes 4 or 5 times per week. Often a sweet tooth can be curbed by taking in more chromium in the diet and there are many products that do contain chromium
for weight loss. I would try one of these in addition to increasing exercise.
At 42 you may be perimenopausal and this could go on for many years, since the average age of menopause is 51.3 years. If your cycles are becoming irregular or you suffer from occasional hot flashes or night sweats, you are probably perimenopausal. If your periods are regular and you have no
symptoms, then hormones are not to blame.
One common problem is hypothyroidism (underactive thyroid) and to determine this I would have your TSH (thyroid stimulating hormone) checked by a blood test.
Good luck,
Dr Larry Komer, MD
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Q. Dear Dr Komer,
I was wondering if you would give me your opinion of the new( or at least new to me) medication available for
HRT. It is called femHRT and contains Norethindrone Acetate and Ethinyl Estradiol
Tablets, PD Std-1mg/5mcg. This is supposed to be a combined estrogen/progesterone tablet but is it the
equivalent or as good as Premarin 0.625 mg and Prometrium 100mcg,in your estimation?
I would greatly appreciate knowing your opinion on this matter. My thanks in advance!
A. Premarin is the gold standard with 60 years of research. The
combination of Premarin 0.625 mgm and Prometrium 100 mgm is my favourite combination and works well for most people but not everyone. It is nice to have some other choices and femHRT will be a good addition. The patients who have used it find it is well tolerated. My first choice would still be Premarin and Prometrium however.
Good luck,
Dr. L Komer, MD
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Q. How do I know if I have PCOS and does Metformin only help women who have this condition. Thanks for your help in clearing up an issue that is still confusing to me even though I am currently taking Metformin to aid in conceiving.
A. PCOS stands for polycystic ovarian syndrome. This is a condition where there are numerous small fluid sacs on the ovary. Often periods are irregular and it can lead to increased hair growth and acne. Infertility is common with this condition, as are irregular periods. Diagnosis is made from the history of the patient, plus lab tests. The level of the hormone LH is increased and the level of the hormone FSH is decreased.
Insulin is somehow involved with this problem. Women with PCOS often, but not always, are on the heavier side and often have problems losing weight.
Metformin is a medication that allows the person's insulin to work more effectively. Often on this medication, the patient with PCOS will lose weight, start having periods and may conceive, if she is trying. The side effects of Metformin can be nausea and bowel upset but these tend to improve over time. If periods do not regulate on Metformin, Clomid may be
added to help with regular ovulation and conception.
I hope this helps.
Dr. L Komer, MD
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Q. I have just recently heard of "WILD Yam." I am 46 & have begun night sweats & missed periods. I do not want to go on hormone therapy. Do you think this is a good alternative? Thank you
A. The wild yam is often used for the starting material that companies change in their labs through a large number of manufacturing steps, into the hormones of birth control pills and some hormone therapies. The extract of the wild yam itself has no chemical action in its natural form and so is unlikely to be helpful. You will see non-physicians advocating it usually to sell their product. If you do not want to go on hormones, a good quality soy extract may be helpful as there is good research to show actual benefits. To learn much more about
Soy, go to www.drkomer.com and push the button labeled Health Topics and then on the next screen on the left, click on the section
labeled Soy. If you prefer to listen to benefits, much is explained about soy, as well as a full discussion on menopause, including hormones and other natural therapies, on our audio tape Be Menopositive, also available on the website.
Soy tends to smooth out hormone levels and improves hot flashes and night seats by about 80%, in about 80% of women.
I hope that this helps.
Dr. L Komer, MD
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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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