Tag: heart disease

Women’s health-choosing and using hormones

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.

post updated January 11, 2023

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

taken at the Tulsa Performing Arts Center

Hormone Pills for birth control 

Most oral contraceptives, OCPs, or birth control pills consist of two hormones, an estrogen, usually ethinyl estradiol and a progestin-norethindrone,levonorgestrel, desogestrel, norgestimate, or drospirenone.

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 . 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.

Homones through the skin

Hormonal birth control can be delivered by patches applied to the skin, that is transdermal. These also contain an estrogen-ethinyl estradiol and a progestin-levonorgestrel, or norelgestromin, 1 patch every 3 weeks with 1 week off.

Vaginal hormone 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 hormone 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. The newest version (2023) named Liletta is effective for 8 years. Earlier brands could be left in place from 3 to 8 years.

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

Reproductive Health

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 hope you enjoyed the photos. I took them all on various travels.

Dr. Aletha

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

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Exploring the Multifaceted Nature of Health

Exploring health involves understanding it as a complex, multifaceted concept beyond merely the absence of disease. Authors Dr. David Agus emphasizes the importance of embracing technological advancements and personal agency in managing health. The interplay between diet, environment, and metabolism is vital, reflecting the continual adaptation required for well-being.

What does “health” mean to you?

Maybe you think of something like the World Health Organization definition of health.

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

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

But do you know

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 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 the 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 and everything around us, including people, our jobs, and 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, and 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 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 fullness” 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

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Dr. Aletha