Gynaecologist Useless!!!
Posted , 9 users are following.
Hi there, I have now seen the gynaecologist but it was a waste of time I think!
Docs have told me for 18 months that I've got Vaginal Atrophy and my symptoms match what is mentioned in websites and leaflets re this condition. Soreness, wanting to wee all the time etc.
Anyway I put all my cards on the table with this gynaecologist. But she never mentioned Vaginal Atrophy. Never picked up on it. Anyway fair do's, she gave me a good internal examination. But afterwards she said it was probably Kitchen Sclerosis I had got so she prescribed me some steroid cream. Then she told me to keep using the HRT for the dryness. But I kept saying over and over that none of the three types of HRT that I had tried, worked for me! She never addressed the wanting to wee all the time or the bladder discomfort that comes with Vaginal Atrophy.
So now I feel quite fed up. I will try the creams she gave me, just in case they do help but I honestly think she wasn't hearing me and she is way off beam!!!
1 like, 126 replies
lee12629 shirley84100
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chris00938 lee12629
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lee12629
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shirley84100 lee12629
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lee12629 shirley84100
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shirley84100 lee12629
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lee12629 shirley84100
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shirley84100 lee12629
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jools72842 shirley84100
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xx
shirley84100 jools72842
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nancyo shirley84100
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shirley84100 nancyo
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j78001 shirley84100
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susan21727 j78001
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shirley84100 j78001
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lee12629 j78001
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shirley84100 lee12629
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sheryl37154 j78001
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I have since chased up a compound chemist who makes the implant pellets and have gone back on them now, but so far, I don't think they are as good as the original, although the chemist insists it is the same. I am keeping notes, and keeping my patches ready on hand for signs of menopause symptoms. My body seems to need a lot of oestrogen and lets me know when it is too low. So I am also trialling pregnenolone.
I also use vagifem supps and oestriol cream on outer bits. As a result, I have not had VA. I don't think drs let women know what is down the track for them if they don't use HRT. There are a number of health issues. Prolapse is another problem through lack of oestrogen.
While a lot of drs have their own personal biases which they lay on their patients, we have to educate ourselves and read more than the dramatic headlines about hrt use.
chris00938 sheryl37154
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shirley84100 sheryl37154
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Gynae gave me a prescription for GYNEST cream (Esrtriol) yesterday and also Dermovate cream for the LS but I don't think I've got LS.
shirley84100 chris00938
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chris00938 shirley84100
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shirley84100 chris00938
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chris00938 shirley84100
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chris00938 shirley84100
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chris00938 shirley84100
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sheryl37154 chris00938
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I have/had very bad endometriosis which surgeon tried to remove as much as possible when I had my hysterectomy and oopherectomy (ovaries were blown out by endo). I was put on some Ralovera (Provera) to help prevent activity of any remaining endo by the oestrogen. I have not heard or read of anyone getting endometrial cancer from vagifem, and have been on it for nearly 26 years which I said before. There is no time limit on it (here anyway).
There is a time limit on commencing oestrogen though. It should not be used years after the onset of menopause. That is problematic.
It has me wondering if oestrogen is manufactured differently for UK than it is for Australia, with all the problems I hear from these blogs.
A lot of women in these blogs have not been advised of how HRT will help them and if mentioned, have been warned off instead. When, here in Australia, we are all for it, and don't regret it.
I have some friends who did not use oestrogen at all, because they did not have much or any menopause symptoms at all. Now they are suffering VA, and prolapse, not to mention weight gain and other problems.
All the women I know of who have breast cancer, or other female organ cancers have not used hrt at all. Weird, isn't it?
shirley84100 chris00938
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chris00938 sheryl37154
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tracy12090 chris00938
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The key thing sheryl said is she had a hysterectomy including ovaries this is my case also. Therefore our case is slightly different with no oestrogen at all meaning we would naturally require more of a top up.
chris00938 tracy12090
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lee12629 chris00938
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lee12629
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chris00938 lee12629
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tracy12090 chris00938
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chris00938 tracy12090
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lee12629 chris00938
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chris00938 lee12629
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sheryl37154 chris00938
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Perhaps your endometriol cancer was already in the pipeline before you started, and nobody knew. BTW, how do they treat it? Radium therapy, chemo?
There is no medication which does not have a long, long list of 'possible' side effects and if we were worried about those, we would not be able to take anything.
No, we cannot depend on drs. A study on hrt was carried out on women who were already past menopause symptoms. They were given hrt to see what happens ending with some disastrous results and this study is always the one that is brought into play without telling the details. One must read the whole study to see what women were in the study and the relevance to you. There may be none.
They have probably done a study on women with the breast cancer gene and resulting in breast cancer. Headlines - hrt causes breast cancer!
Even my current gp referred to the outcome of this study and I had to remind her that that study was flawed and even the research team has finally admitted it, and that was a few years ago now.
Yes, it appears that it is less problematic to start using oestrogen early and not years later, when you can't stand it anymore.
I hope you find a solution to your problem soon. I have read about A-ma-ta with Pueraria Mirifica, but even 'natural' products have risks.
lee12629 chris00938
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sheryl37154 chris00938
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There is no mention of risk of endometriol cancer on their instruction sheet, and the 'very rare' risk of cancer of breast, ovaries and the lining of the womb are reported to be related to 'some' types of systemic hrt, and they refer to additional side effects that have been reported to be associated with 'other' types of oestrogen treatment.
As I said, maybe Austn hrt is different, but I doubt it.
chris00938 lee12629
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lee12629 chris00938
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chris00938 sheryl37154
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I actually took the decision to stop Vagifem in the summer of 2014 because I was feeling unwell and didn't know what could be causing it. Several times in years before that I'd told the GP I wanted to stop using it and she'd told me I was being silly - there was no risk and that I'd get problems if I didn't keep using it. I discovered then that it was the Vagifem causing a discharge which improved when I stopped it. My solution - coconut oil. My atrophy was never actually a real problem at all as far as symptoms went and the most I've ever experienced was slight irritation around the vulva and coconut oil works like a dream.
I was fast tracked to a hysterectomy operation where it was grade one, stage one and they thought it was a pretty recent developement so no further treatment was required apart from check ups. Vagifem do not plaster warnings over their site for nothing. And although I was on a higher dose than the twice weekly recommendation, their warnings are for the recommended dose and you can't say they shouldn't be taken seriously. There IS a risk with hormone treatment, so my personal view is that if there is an alternative that is safer, you're better off with that and it's worth trialing other products first. Especially the hyalaronic acid products that studies have shown no risk so they can be used even daily if wanted (and my consuiltant gynie said this too) and they have been shown to act like hormones and improve atrophy and not just mask symptoms. But these don't get mentioned by GP's, so a balanced view, with options simply isn't given. In my experience it was hormones or nothing. And from reading other posts over time on this group many women have had the same option as I did.
chris00938 sheryl37154
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I hope this might help you understand the reality of Vagifem. You really do need to read Prescribers Information to get the full picture!
chris00938 lee12629
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tracy12090 chris00938
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chris00938 tracy12090
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tracy12090 chris00938
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There is still a risk of Endo cancer even with TAHBSO as some Endo cells can get left behind ive recently found out. Very difficult to not put yourself at risk but less of a chance maybe.
chris00938 tracy12090
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It's a bit like treatment for osteoporosis. My GP (different one) put me on alendronic acid because he decided I'd got a spine problem that was linked to low bone density, before my bone density had even been checked and results back. I believed what he told me, started taking the tablets which can cause horrendous side effects because I was told there was a risk of paralysis if I didn't, but they made me so giddy I was falling over, so had to stop taking them and then the results came back and my bone density didn't put me in the high enough risk factor to warrant them! I now take supplements that can give good results for a lower bone density to improve it as do many who have been prescribed alendronic acid but don't want to take it because of risks, but have much lower bone density than mine. But we are so influenced by our GP's because we're given a scenario of 'take this or if you don't you're at risk of this.....' but never the possible side effects of what they're giving us (at least the side effects have never been discussed with me). I had the same with statins years back and my health got SO bad - I didn't know what was going on, until a thyroid consultant saw I was taking statins and took me straight off them. I recovered for the most part. Never quite got the muscle tone back though. SO - while we can research, I think we do tend to go along with what GP's tell us, and that can be biased, but when they tell us the dangers of not taking their advice (maybe rightly or wrongly!) it's tricky! As you said, even studies can be biased, and anyone can write anything on the internet too, so all in all, you pay your money and you take your chance, so to speak.
tracy12090 chris00938
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With regards the ailment sometimes being better than the sideffects from treatment. I remember a male Dr saying that I was lucky going into full blown menopause after my ovaries were removed as some women have it dragged out for years. I don't feel very lucky with full blown VA that might of taken years to develop! If I could have my ovaries back I definitely would even with the risk as im still at risk now with the treatment! Catch 22 really
chris00938 tracy12090
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lee12629 chris00938
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lee12629 chris00938
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tracy12090 chris00938
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I don't think I was quite ready for the other symptoms associated with the condition. It probably would of gotten this bad by the time I was older anyway.
nancyo lee12629
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chris00938 tracy12090
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nancyo chris00938
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chris00938 lee12629
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chris00938 nancyo
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lee12629 chris00938
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chris00938 lee12629
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chris00938
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lee12629 chris00938
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chris00938 lee12629
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sheryl37154 chris00938
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It is not demeaning for women who may have got breast cancer because of hrt, because that is what researchers do. I would say their tests are criminal because women had entered into these not knowing all the facts.
I would not have said it is fine to ignore the list of of possible side effects but to find another word, one must be pragmatic about them, or we would not be taking any medication. Nor would I say that there is no risk with hormones. I always say you must do your homework and seek out the best one, and that is not oral oestrogen-progestogen combinations, which are often prescribed to women in these forums. They are reportably the most problematic.
No, I don't think you are incredibly stupid but you did not explain that you questioned the dr about continuing on 6 per week. If my dr insisted on such a dose even after I questioned her on it, I would seek out another opinion. After all, the instructions were clear. That I use it 3 times a week is a personal need, and that is between me and my dr and we are both in accordance. And that is allowed by Novo Nordisk too.
You say you are warning women about Vagifem, and I am telling the other side of the story, same as other women in this forum who have relatives who used vagifem or other forms of oestrogen for many years.
I have not received the link you say you sent to me to the websites you have read but I have found the one for Novo Nordisk Aust and NZ. The warnings you refer to were for unopposed systemic oestrogen-only and oral combination o/p, not vagifem. It stated that the systemic uptake for vagifem was low and not accumulative.
They reported an interesting stat that the risk for endometrial cancer was 5 in 1000 for those women who did not use hrt at all. And 'for women aged between 50 and 65 who still have a womb and who take oestrogen-only hrt, between 10 and 60 in 1000 will be diagnosed with endometrial cancer (i.e. between 5 and 55 extra cases) .... They were not talking about vagifem. Similar for breast cancer. Systemic oestrogen only, means unopposed oestrogen, i.e. without taking progestogen as well (but not combined as stated above). That means you can have transdermal oestrogen therapy with progestogen in a separate form.
Some of the risks regarding using oestrogen were stated as uncertain, i.e. not proven. I could not find the use of the word 'tablet' at all, reference was to 'oral' which are not the pessaries. I could not see them using the word tablet as it appears that a warning has to be given against taking Vagifem orally.
There was no limit on the time of use of Vagifem - just a need to have a physical (including gyny) 12 months after start of use.
Just last year, I had the experience of my gp doubling my progestogen dose without my knowledge. My pharmacist picked it up, checked with me, then phoned my gp to double check. My gp insisted that that was what she wanted me to have.
I pondered and agonised over why on earth she would do that. There was no good reason and unnecessary. She also left for 1 month's leave that day. As I am in control of what I put in my mouth/body, I kept to my normal dose.
By luck, a couple of months later, I had an appointment with my endocrinologist (I am being treated for a microadenoma on my pituitary gland the past 7.5 yrs), who also knows and sanctions my hrt levels, and he told me it was good that I had made that decision regarding the progestogen. It turns out my gp had accidently clicked on the wrong strength script, and she has done it again before going on leave this year. I will not be using it at that strength.
Your dr does sound like a right turkey, so it is good that you are seeing another one. Unfortunately, you have found out the hard way, like most of us, that drs are not gods, and can and should be questioned, and if all is not in accordance, go to another one.
I have to be pragmatic about cancer too. I am surrounded by people/relatives who have had cancer, some survived and some died, and none of them related to hrt. I, too, have had two doses of cancer, one level 2, and the other deadly but both saved by the complete removal of the tumours (and neither related to hrt). If we are going to get it, we will get it. We just have to keep ourselves healthy in order to survive it.
And these cancers were around long before the advent of hrt. It seems the Neanderthals are responsible for passing on the cancer gene, among many others!
chris00938 sheryl37154
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HIGHLIGHTS OF PRESCRIBING INFORMATION
These highlights do not include all the information
needed to use Vagifem
®
safely and effectively. See full
prescribing information for Vagifem
®
.
®
(estradiol vaginal tablets)
Initial U.S. Approval: 1999
WARNING: ENDOMETRIAL CANCER,
CARDIOVASCULAR DISORDERS, BREAST CANCER
and Vagifem
PROBABLE DEMENTIA
See full prescribing information for complete boxed
warning.
Estrogen-Alone Therapy
•
There is an increased risk of endometrial cancer
in a woman with a uterus who uses unopposed
estrogens (5.3)
•
Estrogen-alone therapy should not be used for the
prevention of cardiovascular disease or dementia
(5.2, 5.4)
•
The W
omen’s Health Initiative (WHI) estrogen-
alone substudy reported increased risks of stroke
and deep vein thrombosis (DVT) (5.2)
•
The WHI Memor
y Study (WHIMS) estrogen-alone
ancillary study of WHI reported an increased risk of
probable dementia in postmenopausal women 65
years of age and older (5.4)
It also says - 'use of oestrogen alone or in combination with progestin should be with the lowest effective dose and for the shortest duration .... 'whereas many go on to use this for the rest of their lives.
The INFORMATION ON THE VAGIFEM SHEET also says QUOTE 'Vagifem is a small round white coated TABLET'. All this is on the link I sent and I'll send it to you privately so you can't miss it.
Again, I reiterate - I DO appreciate that some women will have tried other things and found that they don't work and their quality of life is badly affected BUT there are GOOD alternatives that do not have the risk of Vagifem, such as products with hyalaronic acid in, where studies have now shown that they can get an almost similar result to oestrogen pessaries. So why on earth wouldn't anyone want to try those first! Vagifem doesn't work for everyone - I can't remember the exact percentage but I was looking at a study yesterday and at a guess it was around half of women, and hyalaronic acid was a tad below that. It is obviously your choice if you want to use it, just as it is any women's but at the very least they should be aware that there are risks and it may well be that it's unnecessary taking these risks if there is a good alternative, which the studies show hyalaronic acid products to be, so at least they have a choice if they know about these. I will send you the link privately, so you can see for yourself about the description being called A TABLET and all the other bits that I've tried to copy and past with some difficulty. This is all taking too long, and to be honest life is too short to keep repeating myself to you. You must do what you think is good for you, just as we all make our own decisions, that should be as informed as possible, so I'm actually coming off this discussion now. If anyone does want the link to the whole vagifem page sent privately, please let me know.
sheryl37154 chris00938
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After reading a while, I kept thinking they are not talking about Vagifem. They are referring to oestrogen in general, and the outcomes of the WHI (Women's Health Initiative) Study. So I searched and read the outcomes of the WHI.
Women without a uterus were assigned Premarin only (too bad if they had endometriosis). Women with a uterus were assigned Premarin and a progestin (to reduce the risk of endometrial cancer). Some were given placebos. Now the problem is with Premarin - it has always been problematic and I don't doubt it caused all the problems that caused the study to be abandoned.
The women involved also had to be post menopausal and have no menopausal symptoms. Some up to 80 years old. Of course there are going to be problems. This study has been done before with bad outcomes. Funnily enough, they found that the younger women benefited more from the hrt than the older women. Why do they put women's health at risk with such stupid studies?
Why on earth do they not do a study of a bio-identical oestrogen (oestradiol) that is personally suited to the women as it should be in real life?
Vagifem is not Premarin, it is oestradiol. The dose is so small it does not need a progestin to be taken with it. The small study (small number of women involved) revealed localised problems for some. If you already have poor health to begin with, then abrasion, fungal etc problems are still going to be an issue.
It does state that if you have problems with obesity, thyroid, or precancerous conditions, you are at more risk of endometriol cancer than others. You already had a prolapse problem with the resin being left on the product that was inserted causing chronic abrasion. You also had a bone thinning problem which makes me think that you have been post menopausal for a long time. Your health does not appear to be good at all. If your problem was caused by Vagifem it would come under the very rare event and is not a common result.
If anyone reads your link, they should also google the WHI Study. I have spent a lot of time trying to interpret it as you see it and failed. Yes, please don't keep repeating yourself to me and others on this forum about your ideas about Vagifem because your arguments are flawed by misreading, misunderstanding, and ommitted information.
chris00938 sheryl37154
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Your comment about Vagifem needing to warn not to take 'the tablet' orally - any medication in that form can be referred to as 'a tablet' - it's like telling you not to swallow a tablet computer! And since they tell you how to insert it, on a long stick, it's hardly likely to be put in the mouth. It would only be someone stupid thinking because it's HRT then it has to be by mouth. Do tell me - why would Vagifem not be talking about Vagifem on their own leaflet. No, on second thoughts, don't bother.
To put it in a nutshell - if I have a choice of playing in a safe field with the same benefits, why would I want to go and play in the traffic.
sheryl37154 chris00938
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'There is some evidence that obesity and possibly hypertension or diabetes mellitus are predisposing factors to endometrial carcinoma. In view of this, special care should be taken in the presence of these conditions and also if a family history of endometrial carcinoma is present. Endometrial hyperplasia (atypical or adenomatous) often precedes endometrial cancer.'
And I intended to correct that as soon as I could get back to my computer, which I now have.
I don't think I have jumped to conclusions about you, as I have refered to only what you have said of yourself.
Tablets - pessaries: of no real consequence in this discussion. On an instruction sheet, it says 'Do not swallow Vagifem Low. This modified release pessary is for vaginal use only'. So obviously, they think there are people stupid enough to do so. Or, it is because they have to cover all bases. Maybe it is not on the one you have read, but I have read multiple copies, and read widely.
To the ladies who are interested, when you read links regarding the WHI, you will find that some leading professors of gyneacology have condemned the study, saying it has set back the health of women for decades. Now drs and women will be afraid to use even good hrt to their own detriment.
I suppose you are victims of this study in that you are now looking for solutions to problems you now have as a result. For some reason, anything about oestrogen are compelled to refer to this study. It should be exposed in the media for the flawed study it was. It was in Australia - I had read it before but had forgotten it but have long known about Premarin. Premarin has been known for many decades to be the worst oestrogen supplement by leading menopause specialists.
And I know from other blogs in this forum that there has been huge difficulty in finding something that works, particularly when you are afraid of all things hrt.
By all means, read the WHI study outcomes, as it is important to know to avoid Premarin, and also not to use hrt when it is too late. Having said that, I know there is a person who participates in these blogs who, so far, is happy with Premarin.
So ladies, I am sorry your blog regarding solutions to VA has been shanghaied by a disagreement about hrt, but it is important to know the real truth about hrt and not those made by misleading statements without doing due diligence.
Good luck to all.
nancyo sheryl37154
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sheryl37154 nancyo
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You might find some answers in The Wisdom of Menopause available in most libraries - if not, they will get it in for you. I am not sure what as I did not focus on that chapter as it was not relevant to me when I read it. But I know the author touches on just about every aspect of menopause.