Surgettes, In order to get the full effect of the newsletter and preserve margins, please maximize this window by clicking on the "up" [^] arrow in the upper righthand corner of this window. Those PC users who've written that you're unable to view past copies of the Power Surge newsletter which I've attached to your e-mail, simply use Windows File Manager to "Rename" the file with a ".TXT" extension [File Manager menu, click on File, click on Rename]. Once renamed, simply double click on the filename in File Manager, and you should have no problems opening the newsletter. Mac users should be sure the file is not saved in the Download Manager. If it is, it should be moved to a folder on the hard drive and then opened with whatever software you use. Dearest Meno_Relationship Realities She: "Oh, LORD, I'm SO HOT!" He : "Honey, I had no IDEA I still had this effect on you [smug grin] She: "Errrr.... But...but.... I'm having a HOT flash!" [gulp] He : "Oh! Welllll, g'nite then ... " [sigh] Meno-AOL "IM"-Revelations AOLMale: "What's 'Power Surge'?" Dearest: "Power Surge is blah...blah...yakkety...yak..." AOLMale: "Ohhhh, but I thought it was all in womens' minds!" Dearest: "Arrrggghhhh!" [expletive under her breath] Shaking your heads, are you? Well, this really happened, and if, in fact, some men do think this way, they don't dare utter it. Article Feedback The last Power Surge mass mailing contained the TIME article, "Every Woman's Dilemma." This, then, is a follow-up of some interesting responses / letters to the editor regarding that article. Interesting reading. "Every Woman's Dilemma" "I'll be happy to take estrogen as soon as they come up with a pill that makes flabby, wrinkled, balding men over 50 look younger too." Meredith Small Ithaca, New York "Congratulations for presenting the crucial and complex topic of estrogen therapy [Cover Story, June 26]. It is an issue that directly affects more than half the world's population. How does a woman decide what path to take in a sea of changing and conflicting information? Evidence strongly supports a longer disease-free life-span with sustained independence in women on estrogen- replacement therapy compared with those who do not take estrogen. It seems there is an egg-size risk (breast cancer, uterine cancer) compared with a watermelon-size benefit (less heart disease, less disabling osteoporosis). One should never take a medication that has theoretical benefit in the future if it decreases the quality of life in the present. But seeing a hunched-over woman shuffling behind a walker has to stir the thought, What would her life be like had she been on estrogen the past 20-plus years?" Ricki Pollycove, M.D. San Francisco "A major disservice has been done to the women of this country. The article on estrogen fed the cancer fear in women. Your report was sensationalistic." Halina Wiczyk, M.D. Springfield, Massachusetts "Why do the medical establishment and our culture think every woman wants to look younger than she is and have a menstrual period forever? I'll be happy to take estrogen as soon as they come up with a pill that makes flabby, wrinkled, balding men over 50 look younger too." Meredith Small Ithaca, New York "Aren't we really talking about quality of life vs. quantity of life? My aunt is in her 80s; I am in my 50s. She dances; I run--on estrogen." Jill Sweitzer Orinda, California "I think I'll live with the wrinkles." Beverly Walters New York City "I see approximately 25 women every day who are 50 or older. The difference between women on long-term hormone-replacement therapy and those who are not on it is generally quite striking. If selected properly for family history and certain other cancer risks, patients on HRT can expect a much fuller, happier and healthier life. Those who say menopause is "natural" are entirely misinformed. It is much more natural to take hormones. As for the contention that there are financial incentives for doctors prescribing hormones, this is utter bunk." Brian Peck, M.D. Waterbury, Connecticut "There are myriad ways to get around the estrogen question. A woman can use herbs, vitamins and a positive mental attitude, taking pride in being who and what you are. A woman of my age (40) cannot remain ignorant of the "horrors" that lie ahead. But I wear my vivid shock of silver hair front and center. I survey my body with honest appraisal and admit that I don't look like I used to. And though faced with incontrovertible evidence that I am "a woman of a certain age," I wouldn't be younger for anything or anyone. I am proud of what the years have made me, and that includes looking younger than my age without the help of surgery or drugs." Joellyn Auklandus Marietta, Georgia Meno Querries About *Hot* Flashes! What Can I Do About Hot Flashes And Night Sweats? Hot flashes can be a nuisance and even debilitating (when extreme) but they may have positive side to them. Vicki Noble, author of "Shakti Woman," a book about feminine power, suggests that hot flashes can be viewed as a natural cleansing of our body [I think most of us would rather remain 'dirty']. The increased temperature may be nature's way of killing off cancer cells and viruses that might otherwise lead to illness later on. Hot flashes are rushes of heat primarily to the head and neck region occurring when blood vessels near the surface of the skin dilate. Some women have a premonition of an impending hot flash which may be felt as pressure in the head, anxiety, a tingling sensation, or nausea. The sensation of heat may also be widespread. The heart rate increases. Surges of blood to the hands can result in a tingling sensation. Following a flash, body temperature drops and many women experience a chill. There is no change in blood pressure at this time. About eighty percent of American women experience hot flashes at some time during menopause. They last mostly anywhere from a few seconds to a few minutes but, in rare cases, can extend to a half hour or about an hour. They are associated with but not necessarily caused by fluctuating levels of estrogen since women who experience hot flashes and those who don't have been known to have the same levels of estrogen, according to Susan Weed in "Menopausal Years". Weed's book is an extraordinarily useful source for herbal information about hot flashes and other menopausal changes. Most women have hot flashes for a period between two months and two years. A smaller percentage continue to have them a decade after their last menstrual flow. The worst hot flashes are often experienced by women who have an abrupt loss of ovarian estrogen due to surgery, radiation or chemotherapy. Thinner women may experience more hot flashes since fat cells convert hormones secreted by the adrenals into estrogen [in other words, it's wise to retain a little extra weight during meno]. Hot flashes are much less common in non-western cultures. Studies in Japan, Hong Kong, Pakistan and Mexico suggest that 10 percent or less of menopausal women experience hot flashes. The low incidence in Japan has been linked to high soy bean consumption which stimulates estrogen production. In American society, of those who have hot flashes, only a small minority (10 to 15 percent) experience enough discomfort to seek medical help [hmmm......]. Night sweats, however, can be tough to handle since interrupted sleep can lead to extreme fatigue and anxiety. Hot flashes can be categorized as mild, moderate or severe, according to Ann Voda, Ph.D. in "A Friend Indeed", November, 1994. Mild flashes last less than a minute and produce a feeling of warmth with little or no perspiration. Moderate flashes are warmer, produce obvious perspiration, and last 2 to 3 minutes. Severe flashes causes profuse perspiration, generate intense heat, last longer and interfere with ongoing activity. Clothes made of natural fibers (cotton, wool, silk) can disperse heat away from the body. It is more practical to dress in layers so that clothing can be removed and added as needed. Hot flashes deplete our bodies of the B vitamins, vitamin C, magnesium and potassium so it is helpful to increase our consumption of these nutrients [don't forget Calcium]. Triggers for hot flashes include spicy food, hot drinks, alcoholic drinks, white sugar, stress, hot weather, hot tubs and saunas, tobacco and marijuana and anger, especially when unexpressed, Susan Weed reports. The medical profession has generally ignored natural, less risky approaches to hot flashes in favor of HRT - Hormone Replacement Therapy [who'd a thunk it!]. Alternative approaches tend to strengthen and support the endocrine system. Natural remedies work in conjunction with a healthy diet and adequate exercise and tend to work more slowly. It is important when using herbs and vitamins to pay attention to our bodies' responses and to remember that natural doesn't mean we can take large amounts of a substance without thinking of side effects. Herbs are generally available individually or in combination in capsule or extract form. It is very difficult to prescribe exact doses for herbal remedies since every body responds differently. Sometimes it is useful to work with someone who is familiar with herbs and vitamins to get advice on dosages and adjustments. For ordinary hot flashes, try vitamin E with dosages between 400 and 800 IUs daily [many women take 1000 - 1200 IU's with excellent results]. Read labels carefully. D-alpha tocopherol means that it comes from a natural source, but DL alpha means a synthetic. One common regimen is vitamin E, 600 to 800 IUs daily with vitamin C. When flashes subside, take 400 IUs daily. Perhaps 50 percent to 66 percent of women will find Vitamin E effective. However, it may take 2 to 6 weeks before the effects are really felt. Women who are diabetic or taking high blood pressure medication or with rheumatic heart conditions should take vitamin E under a doctor's supervision [It's advisable that women with a history of hypertension not take dosages higher than 200 IU of Vitamin E at a time]. Do not take vitamin E with digitalis. Bioflavonoid in supplements of 250 mg five to six times daily can help relieve hot flashes. Herbs commonly used to alleviate hot flashes include ginseng, black cohosh, vitex agnus castii, blue cohosh, dong quai, *wild yam root* [natural progesterone, licorice root, false unicorn and sarsaparilla. Experiment with using one herb or several in combination. Evening primrose oil alleviates hot flashes and promotes restful sleep. These benefits may be due to the gamma linolenic acid in the oil which is said to influence prostaglandin production. (Evening primrose oil is used to relieve premenstrual syndrome (PMS) and tenderness of fibrocystic breasts). Depending on the amount of primrose oil in each capsule, effective dosages vary from 2 to 8 capsules a day. (A Friend Indeed, November, 1985). Chickweed tincture (25 to 40 drops) once or twice a day reduces the severity and frequency of hot flashes. A few homeopathic remedies suggested by Susan Weed in "Menopausal Years" and Diane Stein in "The Natural Remedy Book for Woman" are Lachesis for mental irritation and hot flashes, Pulsatilla for hot flashes followed by intense chills and emotional upset, Valeriana for intense sweating and insomnia and Sepia for flashes that make you feel exhausted and depressed. [Another excellent reference book is Dee Ito's "Without Estrogen."] Drink several cups of sage tea daily. Use one tablespoon of sage per cup of water and infuse it for twenty minutes. Many women experience relief from hot flashes with the topical use of a progesterone cream made from extract of wild Mexican yam. ProGest cream is absorbed through the skin and carried directly to where it is needed. It is non-toxic and without the same sorts of side effects as synthetic progesterone. It is available through Professional and Technical Services, 333 Northeast Sandy Boulevard, Portland, Oregon 97232, 1-800-648-8211. Acupuncture, meditation and biofeedback have helped women find relief from hot flashes. Exercise helps to decrease hot flashes by lowering the amount of circulating FSH and LH and by raising endorphine levels (which drop during a hot flash). Even 20 minutes three times a week can significantly reduce hot flashes Slow abdominal breathing, six to eight breaths per minute, can bring about a 40 percent decrease in frequency of hot flashes, according to two research psychologists from Wayne State University. Women used this technique for 15 minutes twice a day and when they felt a hot flash coming on. ("A Friend Indeed", April, 1993). In extremely hot flashes, try: Black cohosh root extract, 30 to 60 drops [or capsules] when taken up to four times a day. Ginseng has earned respect as a way to alleviate hot flashes. The most useful is panex sold as Korean ginseng or American ginseng. ("A Friend Indeed", Nov.,1985). Dosages vary according to body weight. The easiest way to be sure what dosage you are getting is to buy it in capsule form. Use 500 mg twice a day for those weighing less than 130lbs., three times a day for those up to 160 lbs., and four times daily for those over 160 lbs. Ginseng works best on an empty stomach and can be taken before breakfast and before dinner. It is recommended that you not eat fruit for two hours after taking ginseng and that you take it separately from any vitamin supplement. It is not advised for women with high blood pressure or diabetes. Women with asthma or emphysema would do well to avoid ginseng because of its histamine liberating properties. Ginseng is also available in tinctures, teas and tonics. Motherwort extract, 25 to 40 drops every four hours. Royal jelly can be bought in Chinatown or in a health food store. Use 3 to 7 glass ampules a week. Bee pollen, 500 mg, 3 tablets per day reduces hot flashes for some women. Sucking on a piece of hard candy has been known to head off a hot flash or moderate an intense one. For night sweats, try homeopathic Nux vomica when you are awakened and feel chilled and irritable. Use all cotton sheets and natural fibers. Use 10 to 25 drops of Motherwort extract three times a day or upon awakening with a night sweat. You will notice a difference in two to four weeks. For prompt relief, use an infusion of garden sage. Natural Progesterone: Frequently Asked Questions "If natural progesterone is so wonderful, why isn't it used by my doctor?" This is the question most frequently asked of Dr. Lee during his more than 30 years of active clinical practice. To quote from Dr. Lee: "The medical industrial complex refers to the close knit association of organized medicine with the pharmaceutical manufacturers and governmental medical regulatory agencies....The system taken together is neither necessarily corrupt nor evil, but, like any human agency, is subject to the frailties and faults of humankind. Medical research is dependent on the $billions of grants from the National Institutes of Health (NIH) and the private pharmaceutical industry. The two are closely interlocked......Any given pharmaceutical company, like any private enterprise, must make a profit to stay alive. Profit comes from the sales of patent medicines. The system is not interested in natural (non-patentable) medicines, regardless of their potential health benefits. Thus the flow of research funding does not extend to products which cannot be patented. Few people know that the definition of malpractice hinges on whether or not the practice is common among one's medical peers and has little (usually nothing) to do with whether the practice is beneficial or not. A doctor willing to s tudy, to learn the ins and outs of an alternative medical therapy, and to put what he has learned into practice in helping patients is potentially exposing himself to serious charges of malpractice.....But what does all of this have to do with Natural Progesterone? The answer is quite simple, really. Ample medical research regarding progesterone was carried on in the 1940's through the 1960's, and amply reported in mainline, rec ognized medical literature. Since the early 1970's, however, medical res earch has become much more expensive and the grants subsidizing progester one research, (or any unpatentable medicine or treatment technique), have dried up and been blown away by the contemporary trade winds of synthetic drugs, particularly the progestins. The potential market for patentable progestins is vast -- contraceptive pills, irregular menses, osteoporos is, ....-- literally every woman through the age of puberty on is a target for a sale. Do you think the prevailing powers wish to see this lucrative market left to an over-the-counter natural product not in the hands of physician prescribers and not controlled by the pharmaceutical industry? Thus, when he (the physician) hears of the use of Natural Progesterone, he wonders why none of his associates know about it. If it is not commonly known, 'it must in some way be false and/or unapproved.' Having given lectures on the role and medical uses of Natural Progesterone, I have observed numerous instances wherein perfectly fine physicians will inquire about obtaining the product for use by their wives or mother-in-law but not for their patients. What can account for such behavior by profess ionals? I suspect that it is fear of alienation from the flock that is paramount in their minds....If progestins were the equivalent of Natural Progesterone in effect and safety, the argument would be moot. But progestins are not the equivalent of Natural Progesterone and never w ill be.......Patients are aware that they can not leave their health care solely in the hands of the doctor. They must assume responsibility for their own health..." The Medical Reporter By Joel R. Cooper [1995] According to the American College of Obstetricians and Gynecologists (ACOG), over one-third of all women in the United States are over the age of 50, and another 20 million women of the Baby Boomer generation will make the transition to menopause within the next decade. Menopause, or cessation of ovarian function, often produces troubling problems such as hot flashes, night sweats, mood swings, headaches, dry skin, excessive vaginal dryness and shrinkage of genital tissues, and urinary incontinence. It also increases a woman's risk of both heart disease and osteoporosis (brittle bone disease). Today, women in the United States can expect to live 30 years beyond the onset of menopause (which occurs, on average, around age 51 or 52, but which can happen earlier due to heredity, health conditions, exposure to radiation or chemotherapeutic agents, surgical removal of the ovaries, or any surgery which compromises blood flow to the ovaries). It is therefore is extremely important that women be completely informed about menopause so that proper health decisions can be made to ensure optimum quality of life in later years. Prevention of health problems associated with menopause can make a highly positive difference. Some of the best sources of consumer-friendly information I've seen on the subject to date include: The Power Surge Newsletter: This is a monthly newsletter about menopause and those issues endemic to midlife changes. Researched, formatted and written by Dearest --aka Alice Stamm --on America Online. The Power Surge Newsletter is free of charge. Under construction is a mirror site of the AOL Power Surge Reading Room located at the PS Web site for those who don't have access to AOL. You can visit the site at URL: /news.htm Menopause News: This is a newsletter about menopause, midlife, and other womens health issues published six times a year by Judith S. Askew. Annual subscriptions cost $24.00 (U.S.) for individuals and $30 for institutions. To subscribe, contact Judy at Menopause News 2074 Union Street San Francisco, California 94123 (415) 567-2368 1-800-241-MEN . The American College of Obstetricians and Gynecologists ACOG publishes excellent education pamphlets on menopause, midlife, and many, many other aspects of women's health. To request copies, contact: ACOG Office of Public Information 409 12th Street, S.W. Washington, D.C. 20024-2188 Telephone: (202) 484-3321 FAX: (202) 479-6826 This is a glossy color magazine published every two months by Wyeth-Ayerst Laboratories, makers of Premarin estrogen tablets, a hormone replacement therapy for women. Katherine Lawrence is the executive editor, and women who take Premarin may obtain a free subscription by writing to: Seasons magazine 100 Avenue of the Americas 8th Floor New York, NY 10013 1-800-444-0494 Krames Communications: Krames markets a line of professionally produced booklets, brochures, and videos on a wide variety of medical conditions health concerns, and employee wellness and safety issues. Pertaining to menopause, they currently offer booklets on hormone replacement therapy menopause, and osteoporosis priced at $1.25, $1.25, and $1.35 (U.S.) each , respectively. To order or for more information, contact: Krames Communications 100 Grundy Lane San Bruno, California 94066-3030 1-800-333-3032 FAX: 1-415-244-4512 American Academy of Family Physicians (AAFP) publishes a series of highly readable patient education brochures on over 60 individual topics called "Health Notes from Your Family Doctor" which are available free of charge in single quantities. For instance, AAFP publishes one brochure entitled "Menopause: What to expect when your body is changing," and another entitled "Osteoporosis in Women: Keeping your bones healthy and strong." For more information, contact: AAFP 8880 Ward Parkway Kansas City Missouri 64114-2797 1-800-944-0000 FAX: 1-816-822-0580 For additional information on osteoporosis, contact: National Osteoporosis Foundation 1150 17th St. NW Suite 500 Washington, DC 20036-4603 (202) 223-2226 FAX: (202) 223-2237 For information via the Internet on optimum intake of calcium (which may help to prevent or reduce the effects of osteoporosis), contact: "gopher://gopher.nih.gov:70/00/clin/cdcs/individual/97.calcm"> National Institutes Of Health For additional information on preventing heart disease, contact: "gopher://gopher.amhrt.org" The American Heart Association National Center 7272 Greenville Avenue Dallas, Texas 75231-4596 (214) 373-6300, 1-800-AHA-USA1 Or "http://sln.fi.edu/TOC.biosci.html" The Franklin Institute Virtual Heart Exhibit American Medical Women's Association (AMWA). AMWA is a national association of women physicians which spearheads various health education efforts of benefit to women. For more information, contact: AMWA 801 N. Fairfax Street Suite 400 Alexandria, VA 22314 (703) 838-0500 OWL (Older Women's League) OWL is a national membership organization dedicated to achieving economic, political and social equity for midlife and older women. Information: 666 11th Street NW Suite 700 Washington, DC 20001 (202) 783-6686 FAX: (202) 638-2356 Joel R. Cooper The Medical Reporter/Joel R. Cooper Calcium and Osteoporosis: How Much is Enough? "Medical Sciences Bulletin" Reprinted from Medical Sciences Bulletin published by Pharmaceutical Information Associates, Ltd. Drugs mentioned: Etidronate (Didronel/P&G Pharmaceuticals; MGI Pharma) alendronate sodium (Fosamax/Merck) Osteoporosis is one of the most common diseases of aging, occurring when bone resorption by osteoclasts exceeds bone deposition by osteoblasts. The disease afflicts 1 woman in 4 and 1 man in 40, causing more than 1.5 million fractures a year at a cost exceeding $10 billion. Treatments include calcium, vitamin D, fluoride, estrogen, calcitonin, and biphosphonates such as etidronate Didronel/P&G Pharmaceuticals; MGI Pharma and alendronate sodium Fosamax/Merck. Calcium supplementation to prevent bone loss in postmenopausal women has been the subject of intense scrutiny. Since 1988, 43 studies have been published on the relationship between calcium intake, bone mass, and bone loss. Results have been confusing, in part because actual calcium intake cannot be determined. In 19 of the 43 studies, however, the investigators were able to control calcium intake, and in 16 of the 19, calcium slowed or stopped bone loss. Another reason for conflicting data is failure to segregate data for women within 5 years of menopause. According to endocrinologist Robert Heaney, during this period bone loss is due predominantly to estrogen withdrawal, not to whatever calcium insufficiency may also be present. In 12 of the 19 studies in which calcium intake was controlled, women were excluded who were within 5 years of menopause; all 12 studies showed that calcium conferred a significant benefit. A final problem with clinical studies is that follow-up is usually too short to provide meaningful data. Recently, Reid et al. reported the results of their long-term (more than 2 years) placebo-controlled study of calcium intake and bone mineral density in 122 normal woman (average age, 58 years) at least 3 years after they had reached menopause. Mean dietary calcium intake was 750 mg a day, and the supplemented group received an additional 1000 mg elemental calcium (5.24 g calcium lactate-gluconate and 800 mg calcium carbonate, formulated as an effervescent tablet). The control group received an identical-appearing placebo. Subjects were evaluated 3 and 6 months after beginning therapy and then every 6 months for 2 years. Bone densitometry (total body, lumbar spine, and proximal femur) showed that calcium supplementation had a beneficial effect on bone loss that was consistent and statistically significant throughout the skeleton. The placebo group lost bone at a rate of about 1% a year at most sites. On average, the rate of loss of total body bone mineral density was reduced by almost half (43%) in the calcium group, and loss was eliminated entirely in the trunk. The only adverse event was the development of a kidney stone in one patient at 6 months. (Reid IRetal. New England Journal of Med. 1993; 328: 460-464.) How much calcium is enough to prevent postmenopausal bone loss? The 1984 Consensus Conference on Osteoporosis recommended a total intake of 1500 mg per day for women with estrogen deficiency. This is about the average amount of calcium required to keep a postmenopausal woman in calcium balance. This intake is probably two or three times that of most adult women in the United States. The data from Reid et al. indicate that a higher daily calcium intake -- 1750 mg total -- may be more effective for reducing bone loss. And, as Heaney noted, studies suggest that it is never too late to start treatment; reductions in fracture rates can occur in as little as 18 months. 25-Hydroxyvitamin D (400-800 IU daily) is also indicated for elderly patients. Vitamin D levels are commonly low in this age group, and supplementation promotes calcium absorption. Preventing osteoporosis is a worthy goal. A reduction of just 20% in the US hip fracture rate would reduce the number of hip fractures by 40,000 to 50,000 annually, for an average saving of $1.5 to $2 billion. (Heaney RP NEngl J Med. 1993; 328: 503-505. Heaney RP. Annual Rev Nutr. 1993; 13: 287-316.) Source: Medical Sciences Bulletin Contents Pharmaceutical Information Associates Homepage PharmInfoNet Homepage POWER SURGE DISCLAIMER The Power Surge Newsletter disclaims any representation for the accuracy or completeness of information contained herein. The sharing of information herein is not indicative of Power Surge's personal endorsement of same. It is purely for informational purposes. Health matters should be taken up with one's personal physician. Nothing in the Power Surge Newsletter is intended as a substitute for professional medical advice. Sharing is what Power Surge is all about Dearest Love And Good Health! OWN YOUR BODY!