Women’s health update-choosing and using hormones

And other studies and reviews have found no long term increased risk of death from hormone use, although the risk of cardiovascular disease is increased while taking the drugs.

Our bodies make the sex hormones-estrogen, progesterone, and testosterone- naturally, but sometimes doctors prescribe synthetically-made ones therapeutically. Like any drug, we should only use them when the benefit clearly outweighs the risks, after considering issues of safety, effectiveness, side effects, ease of use, and cost.

This information is current as of the publication date; it is general medical information that helps a doctor and patient make decisions about what is right for her. Medical recommendations and practice changes as we learn new things. If you deal with any of these issues , please discuss with your doctor before taking any action.

WOMEN- a restroom sign with a female figure and a wheelchair drawing
A new pill for birth control 

Most oral contraceptives, OCPs, or birth control pills consist of two hormones, an estrogen, usually ethinyl estradiol and a progestin, norethindrone. For women who cannot or prefer not to take estrogen, norethindrone can be used alone. The FDA has approved another progestin-only pill.

The new pill contains drospirenone, which has already been used in combination with ethinyl etradiol . It prevents pregnancy effectively although was not specifically tested opposite norethindrone. Another benefit of the drug is controlling acne. As with other new drugs, Slynd, brand name, is more expensive than generic norethindrone.

A new vaginal birth control

Women have had the option of using an estrogen/progestin vaginal ring, kept in place for 3 weeks, then removed and replaced with a new ring 7 days later. (Nuvaring, ethinyl estradiol/etonogestrel) .

Now there is a new option- a ring that contains a different progestin. Annovera is a silicone elastomer device containing ethinyl estradiol and segesterone. The cost, $2000, (per GoodRx) sounds excessive, but this ring can be reused for 13 4-week cycles,unlike Nuvaring which is replaced every 4 weeks. Both rings effectively prevent pregnancy.

photo by Dr. Aletha, taken at the Santa Fe New Mexico airport
Three LARCs –Long-acting reversible contraception 

Three forms of long-acting reversible hormone contraception (birth control) are available to women in the United States.

The birth control injection (shot) is a progestin, depot medroxyprogesterone acetate (Depo Provera). Women who use this method receive an injection every 90 days which effectively prevents pregancy.

Etonogestrel, a contraceptive implant, slowly releases the hormone progestin and does not have estrogen. It can be used in women who cannot take estrogen. The small device is implanted under the skin of the upper arm and replaced every 3 years. Brand names are Nexplanon and Implanon.

Hormonal intrauterine devices, IUDs, contain the progestin levonorgestrel. It is effective for 3 to 5 years, depending on the type, at which time it should be replaced if contraception is still needed.

Here is a link to facts about other forms of contraception from the Department of Health and Human Services

Birth Control Methods

at the New York Metropolitan Museum of Art

Hormone therapy and heart disease

A 2015 Cochrane review of 40,410 postmenopausal women examined the use of oral hormone therapy (estrogen with or without progesterone) taken for at least six months, compared with placebo (no real drug), to determine the effect on death from any cause, and deaths caused by heart disease, stroke, and blood clot in a leg or lung.

The review found no benefits for preventing heart attack (fatal or nonfatal), or death due to any cause. And other studies and reviews have found no long term increased risk of death from hormone use, although the risk of cardiovascular disease is increased while taking the drugs.

Here is a link to a review of hormone therapy benefits and risks.

Menopausal Hormone Therapy
at the New York Metropolitan Museum of Art

Vaginal estrogen and heart health

While oral estrogen replacement after menopause can decrease night sweats, hot flashes, and vaginal dryness, it potentially increases the risk of developing cardiovascular disease-heart attacks and stroke, and some cancers-breast and uterine. But does estrogen given vaginally carry the same risk?

No, according to the results of the Nurses Health Study. Statistics over 18 years showed no increase in these complications in women who used vaginal estrogen, suggesting this is a safe option for women who choose to use estrogen to improve quality of life after menopause. (from the journal Menopause)

Controlling fibroids that bleed

Fibroids are a non-cancerous tumor of the uterus. They often cause no symptoms but can cause heavy and/or painful periods. Now a hormone combination can stop that.

Marketed as Oriahnn, two capsules daily taken morning and evening can decrease menstrual blood loss by 50% or more. One capsule contains 3 hormones-elagolix, estradiol, and norethindrone. The other contains only elagolix. Treatment should not exceed 2 years due to a risk of bone loss, similar to that seen after menopause occurs.

exploring the HEART of women’s health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I hope you enjoyed the photos. I took them all on various travels-even the bathroom sign.

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

                              Dr. Aletha 

a statue of a woman holding a child, "CROSSING THE PRAIRIE"
“CROSSING THE PRAIRIE” by Glenna Goodacre, Broken Arrow, Oklahoma

Here are some affiliate links you may find helpful. Thanks for considering and using, which helps me fund this blog’s mission-to share the HEART of health.

Shop To Fight Breast Cancer! Every Purchase Helps Give Free Hospital Mammograms To Women In Need!

AAPTIV- what I’m using to stay fit now.

JunoActive Plus Size Women's Activewear

 

7 questions about health you need to ask now

Are you “living life to the fullness” and if not, why not? What could you change to make that happen?

What does “health” mean to you?

Let’s continue exploring the heart of health by looking at a couple of interesting books. In another post we considered this definition:

“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”

World Health Organization
2 bandaids crossed on a world globe
photo from the Lightstock collection (affiliate link)

Or you could also say

“There’s a Lot More to Health than Not Being Sick”

There's a Lot More to Health than Not Being Sick by Bruce Larson

So, what is “a lot more”? 

I’m introducing you to two medical writers who believe  health is multifaceted and not centered around the presence or absence of disease.

Health- flux and adaptation

(Note: this post uses affiliate links to sites where you might make a purchase which will help fund this blog; your help is appreciated. )

book cover- The LUCKY YEARS by David B. Agus, M.D.

Enjoying life to the fullest

Despite the author’s  impressive credentials, I was skeptical about a health book called “The Lucky Years”, as if health is just a matter of the luck of the draw or throw of the dice.  

The author is David B. Agus, M.D. , Professor of Medicine and Engineering at the University of Southern California , , author of two bestselling books and a CBS News contributor.

In The Lucky Years- How to Thrive in the Brave New World of Health Dr. Agus covers some hefty topics including

  • how the human body ages
  • Innovative cancer treatments with immunotherapy , DNA sequencing, and molecular targeting
  • The use of clinical trials to study new treatments for cancer and other diseases
  • How cancers metastasize (spread)
  • Potential uses for stem cells
  • New insights into the development of antibiotic resistance
  • Proteomics- study of the body’s proteins
  • The relationship of antibodies to common viruses to onset of chronic diseases

Rather than highly technical detail he offers a broad overview of these new technologies and how they may help treat and potentially prevent the main causes of death, that is cancer and chronic diseases like heart disease and diabetes.

He recommends patients understand and use technology to maintain and improve their health and not rely solely on their doctor to do so and to actively participate in the healthcare system.

He believes that health data will be used to prevent, detect and treat disease and to prolong life.

Large quantities of such data, organized in a secure database, will help us predict risk and recommend preventive measures, such as already done with

  • Colonoscopy to prevent deaths from colon cancer
  • Aspirin and statin use to prevent cardiac deaths
  • Management of low grade cancers conservatively, avoiding the use of surgery or chemotherapy

The body is an incredible self-regulating machine. You don’t need to do much to support its health and optimal wellness.”

Health is in perpetual flux. 

I agree with Dr. Agus’ views on what health is, or rather what it is not.

“I don’t know what true health is, particularly on an individual basis.

For person A, health can be living totally free of illness and disability.

For person B, however, perhaps health means managing a condition well and enjoying life to the fullest despite some disability.

While we can certainly try to measure health in a variety of ways- weight, cholesterol, blood sugar, blood cell count, hormone levels, markers of inflammation, how you look, and how well you sleep, for example- none of those figures or generalizations will tell the whole picture.

And they won’t reveal how many years and days you might have left on this planet.”

He offers this advice –

“I encourage you to view your total health as a complex network of processes that cannot be explained by looking at any one pathway or focal point. Health is in perpetual flux.

book cover- FAST METABOLISM FOOD RX BY HAYLIE POMROY

A constant state of healthy adaptation

Nutritionist Hailey Pomroy, author of Fast Metabolism Food Rx, recommends using food as “metabolic medicine.”  

“Food integrates with your body to create health in a powerful way.”

She explains health using a formula E + M = H which means

Eating, Exercise, Environment  plus

Metabolism, Metabolic pathways, Me  equals

Health, Homeostasis, Harmony

In this formula, E stands for everything we put into our bodies as well as everything around us, including people, your job, the weather.

M is what is inside of you, including your genetic makeup, and what happens when your body processes (or metabolizes) food, nutrients, toxins, medications.

“Health doesn’t always mean you are disease free, It means your body has created a homeostasis or internal balance, …is a constant state of healthy adaptation or flux.”

So, what does HEALTH mean to you?

Considering their advice, think about what health means to you.

Use these questions to get started.

  1. Do you use any type of technology to manage your health and medical care? If so, is it helpful, or just more busy work?
  2. What is your relationship with your personal physician? Do you rely on your doctor to tell you what you should do, or recommend what you should do to stay healthy and treat ailments?
  3. Do you know what  medical conditions you are at risk for, and what you can  do to prevent them?
  4. What health measures are important to you, like blood pressure, cholesterol, weight, BMI, mammogram, and why?
  5. Are you “living life to the fullne” and if not, why not? What could you change to make that happen?
  6. How do you use food?
  7. What factors make up your E and your M? Do they add up to the Health that you want to create?

exploring the HEART of health

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

                              Dr. Aletha 

Here are some affiliate links you may find helpful. Thanks for considering and using, which helps me fund this blog’s mission-to share the HEART of health.

Spring/Summer Banners eBooks Digital Bookstore