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Monday, July 22, 2002
      ( 11:55 AM ) Jackie  

Thanks a Lot! Medical Community

My last three doctors recommended I take Hormone Replacement Therapy (HRT). The first thought I was making a mistake by declining but was able to provide me a list of alternatives that made sense given my own research.

The second, who came highly recommended by a number of lesbians, was stronger in her views. I told her that I was managing the symptoms and doing well using vitamins and supplements. She sneered that it was not about symptoms, it was about prevention. HRT would prevent Heart Disease. We argued about whether there was any real evidence for her claim.

I told her I was more concerned about cancer based on my family history and my research indicated that HRT could cause cancer. She told me that HRT was not associated with increased cancer risk. I was also aware that women on HRT had less reliable mammograms (and that's a whole other discussion!) because they had firmer breast tissue. Now there's a good news/ bad news situation. We parted ways shortly thereafter.

By the time I saw the third doctor, I had completed menopause and she was less interested in pushing HRT. Of course, she had a maximum of 15 minutes for my annual exam so there wasn't a lot of discussion.

My experience is not unusual by any means. Every woman I've discussed this with has had similar or worse experience. Well, the only unusual thing was that a doctor actually gave me information about non-drug approaches to managing the effects of menopause.

Now, of course, the news is out. Or, rather, the news can no longer be hidden. The Women's Health Initiative (WHI), of the National Institutes of Health (NIH), stopped a study of HRT because "Researchers concluded that the risks of HRT clearly outweighed the benefits" (Time Magazine)

Depending on what you read, the study "reported a 22% increase in heart diseases and a 26% greater risk of breast cancer in women taking HRT"( Time). Or "women who are using HRT drugs for five years or more now have a 60-80% increased chance of developing breast cancer." (Health Action)

Of course, this isn't really news. Health Action cites a number of earlier articles going back years giving this information. They list the health danger clearly. But the doctors just weren't listening. Or maybe they were just listening to the pharmaceutical industry.

Oh, but the news is worse. What NONE of these doctors told me, and what my friends and family are mostly unaware of is that menopause brings an increased risk of hypertension. In fact, "one third of women have hypertension in the menopausal decade (45-55 years). This rises to more than 50% by the age of 64 and continues thereafter. Women should, therefore, monitor blood pressure carefully beginning at 45.

But, since doctors don't say this, and don't provide recommendations for monitoring, women may learn that they have hypertension by having a stroke or heart attack.

I can only guess that there is currently more money to be made in the pharmaceutical industry than in providing blood pressure monitoring. My own health care system (Kaiser Permanente) has no place where one can go to have blood pressure monitored. You would have to visit your physician (a formidable task) to have this simple task done.

What was that about an ounce of prevention? No wonder my plan costs so much.

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Words and photos from Jackie in Oakland, CA. More I cannot tell you ... I won't know what it is until I do it.

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