OnlineHost: Eeisman has entered the room. Dearest: It's my pleasure to introduce you all to one of Power Surge's medical consultants ... but, more importantly, one of our *friends* -- Dr. Diane Eisman :) Eeisman: Thank you, Dearest. MameB: How long on average do menopausal symptoms last? Goosetess1: Mame, if I only knew the answer to that question! Dearest: Mame, some women go through menopause in a matter of two years and others as long as 10 years or more. BLewis6882: What uses for prednisone during perimenopause have I missed? I thought it was for nasal congestion. Eeisman: Prednisone has many uses. Are you talking about inhaled Prednisone type drugs? BLewis6882: Yes Eeisman: Inhaled cortisone drugs can be used indefinitely. Very little is absorbed systemically. NitaFar: I use Azmacort and prednisone when my asthma is out of control. Dearest: Okay, who has a question for our esteemed guest, Diane Eisman, M.D.? Batchika2: What's the story with candida? Is it systemic? Eeisman: There is a real organism called Candida Albicans. It causes infections on skin surfaces, like vaginal yeast infections, if you take antibiotics and let the yeast overgrow. It can invade the blood stream when people are dying, as withh AIDS. SGETT: Dr. Allanba has had some recent postings on fibrocystic breasts and food allergies. Are you of the same mind on the matter? What do you think about hormone replacement therapy (HRT) and fibrocystic spots? Eeisman: I do believe that caffeine and chocolate increase cysts in some people. Some people on HRT do get an increase in fibrocystic, lumpy bumpy breasts. I hate to call it a disease. Mammograms may be harder to interpret on HRT. FBriggs113: Can quitting smoking after a zillion years precipitate perimenopause or hypothyroid? Eeisman: I don't believe so. I have not heard of this yet. Hyperthyroidism and the onset of menopause have been related to stress by some people. That's really stretching! Stopping smoking is definitely related to stress in smokers. EleanordeW: Is it okay to drink decaffeinated coffee or do the chemicals in that cause problems too? Eeisman: If coffee is decaffeinated using chlorohydrocarbons, there is a question about safety, but if a water based method is used, that is okay. Nickhelenc: Do you prescribe natural estrogen and progesterone through a compounding pharmacy? Eeisman: Yes, I do. Dearest: Nickhelen, email me and I'll send you directions to the newsletters. They are loaded with information about natural progesterone and estrogen. MameB: How long should one stay on HRT? Is this a forever thing? I feel I'm part of a medical experiment. Eeisman: Mame, you asked one of the hard questions. It is a very individual decision. Some people stay on it forever. Others start about ten years after menopause. Still others start immediately at menopause. Right now I have no definite answer for you. I wish I knew. Nickhelenc: Could you give me suggestions on finding a prescribing physician in the Chicago area? Dearest: Dr. Allan Aven is in the Chicago area, Nickhelen. He's one of Power Surge's consultants. You can email him on AOL at the name "Allanba." Eeisman: You could also try the University of Chicago where I went to school. Batchika2: Can systemic candida affect health in normal people? Eeisman: Normal people do not get systemic candida. I know you read it all the time. Systemic candida is a pre-morbid condition. Some people think it causes Chronic Fatigue Syndrome, but I don't find that and I see a lot of CFS people. Sallyp24: Do you know anything about Visken? Eeisman: Visken is a beta blocker. Do not stop any beta blockers suddenly without tapering off under your doctor's care. EleanordeW: Should I be going to my general practitioner with questions about menopause? Is he or she likely to know these details? Eeisman: Eleanor, your general practitioner is a good place to start. If she or he does not listen to you and talk to you, then ask around for others. You must have a doctor who will listen. Menopause is trial and error to find the right balance for each patient. Dearest: Anyone who wants to be added to the Power Surge mailing list, please e-mail me at Dearest. I'll send you out the Power Surge Fact Sheet. BLewis6882: Any special concerns for exercise such as weight training and aerobics during perimenopause and beyond? Eeisman: Exercise is the wonder drug and it does not have to be a fancy class. Just brisk walking and swinging your arms is wonderful. A little weight lifting to keep those muscles stressing your bones to be strong is also wonderful. Postrain: I have been lucky in that I haven't gained weight. Is this normal in peri-menopause? Will it happen later? Eeisman: Not necessarily, Post. Just keep your body moving. Drink plenty of water and exercise. You don't necessarily need to gain weight. RCHCTH: At what age should one get a baseline bone scan? Eeisman: You mean densitometry? Bone scans are another test. I am not sure about age, but I would guess around 35. EleanordeW: I hate exercising. I've managed to avoid it for 43 years. Eeisman: Poor Eleanor, but it is time to start walking. Get some good shoes. Put earphones in and march away to the Canadian Brass, my personal favorite for exercise. Postrain: How long does one have to challenge estrogen with progesterone? Eeisman: I don't think of it as challenging, Post. Progesterone helps keep estrogen in balance, protects the uterus, has a calming effect, and increases bone density among many things. FBriggs113: My mother had two primary breast cancers and she died of metastatic cancer. She had her uterus and ovaries out after the first primary episode. What about HRT? Eeisman: That would depend upon several factors, FB. At what age did your mother die? Was it pre or post menopausal onset? Is there anyone else in the family with breast cancer? Is there cardiovascular disease in your family or osteoporosis? You need to sit down with your doctor and weigh the risks and benefits. I do have patients who have had breast cancer and are now doing well on HRT. This is a very individual decision. Remcee: Do you know if one type of estrogen is better than another for memory problems? Eeisman: Some people think Estradiol may be a little better for memory problems. But, horror of horrors, the Premarin people came out saying one of their estrogens, equilin, is good for protecting brain nerve cells. We don't make equilin, only horses do. Dearest: By the way, the April or May newsletter has an excellent article on the horrors of animal abuse and Premarin (wondering why Premarin contains caranuba wax -- sigh) Nickhelenc: Vliet suggests tests for thyroid, TSH, prolactin, FSH, LH, etc. Do those cost a lot of money? Eeisman: The most sensitive test for hypothyroid is TSH. Hypothyroid often occurs as we age and we do that supplement. Other tests vary from hour to hour, but do give a ballpark idea about where we are at. MameB: I take progesterone for 12 days per month and I get a bit nutsy. Some of my other friends have the same problem. Do others have the same problem? Eeisman: If you are taking Provera, you may need to look into a natural progesterone. LdyJane886: Premarin makes my heart beat real fast. What is the problem? Dearest: Maybe you should get off the HRT, LdyJane, and take magnesium like I do. 500 mg. of magesium taken in one fell swoop is very effective in diminshing palpitations. Eeisman: I can't explain why, but I have found some of my patients get high blood pressure and racing hearts on Premarin. Many of them feel much better on natural hormones or something like Estrace. Talk to your doctor. It may not be the Premarin, but it should be checked out. Dearest: Diane, thanks so much for joining us tonight :) End of log of Dr. Diane Eisman's visit to Power Surge - 7/7/96 Dearest aka Alice Stamm Power Surge Founder, Host, Facilitator Power Surge E-mail Dearest Copyright©1994-1998 by Power Surge. All Rights Reserved.