Book Review – An MD’s Life Saving Health Solutions by James A. Schaller

Book Review – An M.D.’s Life-Saving Health Solutions by James A. Schaller

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Although not apparent from the title of this book, An M.D.’s Life-Saving Health Solutions: A Gynecologist’s Advice, Dr. James Schaller shares some very interesting thoughts about hormones from his long clinical practice in obstetrics and gynecology. He writes in an engaging fashion, almost like you were sitting in his office and having a conversation with him.

He is very clear that progestins (which he calls castrating drugs) are not progesterone. He calls the large Women’s Health Initiative (WHI) study ill-conceived and and says it fails to answer the question that that they sought. The question asked by the study was “Can hormones delay the onset of chronic disease in women?” Because the study used only Premarin and Premarin with medroxyprogesterone (progestin), we only learned that the synthetic or non-human identical hormones do not delay the onset of chronic disease in women.

Dr. Schaller discusses the relationship between hormone balance and body fat at great length. He states ideally, a woman should have about 22% body fat. Less than 13% body fat and low estrogen at menopause is a real concern because there is not enough fat to allow for adequate estrogen storage. Consequently, very thin women have more sensitivity to swings in estrogen which occur throughout the cycle or in perimenopause. “Fat cells store, produce and release estrogen. The number of fat cells affects all hormonally-related effects,” Dr. Schaller claims.

Very thin women can experience stopped monthly periods because there is not enough estrogen available to build up the endometrium. Recall that cycling begins in a young woman who has at least 13% body fat. These women are also at higher risk for osteoporosis.

On the other hand, women who are overweight with more than 30% body fat, store plenty of estrogen in their fat cells. They have a life-long imbalance in progesterone needed to balance the estrogen they accumulate and store. Periods may also stop for obese women but they will likely experience abnormal bleeding.

It is important women understand normal ovarian function. Young girls usually experience pain during the first one to two days of their periods indicating that an ovulation has occurred. After a vaginal delivery this pain may stop. Pain can also occur at mid cycle or two weeks before bleeding begins. This pain can be stabbing or a dull ache and represents the pain of the follicle bursting through the ovary wall. He recommends avoiding strenuous activity when this happens. The ovaries can actually sway with rigorous exercise and prevent healing of the rupture in the ovarian wall.

Dr. Schaller’s book contains many more practical hints. He warns against using psychoactive drugs, medications that have an effect on mood, behavior, or thinking processes, for PMS when progesterone addresses the underlying issue and is less expensive too. He says statins are very dangerous. He notes that cholesterol-lowering drugs do not save lives but actually increase mortality and produce depression and memory problems.

Dr. Schaller is accepting of some doses of NSAIDS (non-steroidal anti-inflammatory drugs) for ovulation pain; however, he says using NSAIDs in excess can cause serious problems because of their potential for gastric ulceration. Drugs which are used for excess stomach acid actually prevent absorption of critical nutrients and bisphosphonate drugs used for osteoporosis interfere with normal bone metabolism.

It was a privilege to read this book and reap the benefits of the observations of a physician in practice for over 40 years. I am sad to see our medicine system turning into one which allows patients only a few minutes with a practitioner and uses treatment plans based on algorithms instead of treating people like individuals and tapping into the vast stores of knowledge and experience from physicians such as Dr. Schaller.

Book Review – An MD’s Life Saving Health Solutions by James A. Schaller2018-01-22T10:56:17-05:00

A New Treatment Program to Improve Memory Loss

A New Treatment Program to Improve Memory Loss

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

In spite of hundreds of clinical trials over the past ten years, Alzheimer’s disease (AD) has no effective treatment. AD affects 5.4 million Americans, predominately females. It is estimated that women have a greater chance of developing AD than breast cancer.

Research supports the theory that an imbalance in brain nerve cell signals causes this disorder. Specific signals make nerve connections to cement memories while others allow irrelevant memories to be lost. This signaling system becomes imbalanced so that new memory connections are inhibited while more information is forgotten. Reversible metabolic processes may be involved in the early stages of AD.

Dr. Bredeson and his colleagues at UCLA believe that a comprehensive, personalized approach is the best way to treat memory loss. They have developed a program that optimizes diet (no simple carbohydrates, gluten, or processed foods), utilizes meditation and yoga, and emphasizes the importance of sleep, hormones, good oral health, and exercise. Patients may use supplements as well as medium chain triglycerides like coconut oil or Axona.

The researchers believe that free T3 and T4, estradiol, testosterone, progesterone, pregnenolone, and cortisol need to be optimized. Nine out of ten patients in this pilot program had cognitive improvement.

Additional Resources:

For more resources from Women’s International Pharmacy, see our Mental Health Resources page.

A New Treatment Program to Improve Memory Loss2018-04-04T15:44:16-05:00

Book Review – Adrenaline Dominance by Michael E. Platt, MD

Book Review – Adrenaline Dominance: A Revolutionary Approach to Wellness by Michael E. Platt, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

We know what a surge of adrenaline feels like. It is the hormone that gives us the strength for “fight or flight.” Our hearts beat harder, stronger, faster. Blood is diverted from less important things like digestion to our muscular tissue. Thought processes seem to happen at lightning speed. There are many stories of superhuman feats performed under extraordinary circumstances with surges of adrenaline.

Dr. Michael E. Platt has written his book Adrenaline Dominance because he feels that practitioners and their clients lack understanding of this very important hormone. He finds that knowing how adrenaline functions enables him to successfully guide his patients towards wellness.

Adrenaline is produced by an inner part of the adrenal glands. Dr. Platt explains that there are two reasons for adrenaline to be released: One reason is in response to stress as described above, and the second reason is to ensure that the brain has received enough sugar (glucose). The body uses adrenaline to help create more glucose from protein as well as stimulate the release of glucose stored in the liver. Consequently, as glucose releases, insulin releases. These two hormones are intimately involved with adrenaline.

Dr. Platt organized his book according to “The Good, the Bad and the Ugly,” the classic Clint Eastwood western, to illustrate that adrenaline has both desirable and undesirable effects. He believes that right-brained creative thinkers acquire those qualities from plenty of adrenaline ensuring lots of glucose to the brain. Superb athletes also get their edge from adrenaline. These are “good” mental and physical effects of generous amounts of adrenaline.

It starts to get “bad” when adrenaline output is too generous or our bodies don’t have the ability to moderate the high adrenaline. High adrenaline can be tied into depression, anxiety, irritable bowel syndrome, hypertension, diabetes, obesity, headaches, restless leg syndrome, addictions, and bedwetting. It gets “ugly” when syndromes such as fibromyalgia, interstitial cystitis, road rage, autism, or post-traumatic stress disorder appear.

Progesterone, which is also produced by our adrenal glands, is the natural modifier of excess adrenaline. Dr. Platt recommends progesterone in men and women, as well as children. Along with progesterone, Dr. Platt guides his patients with their food choices. Dr. Platt recognizes the relationship between glucose and insulin and claims the timing and types of foods ingested can make significant changes in the presentation of excess adrenaline.

It is not difficult to imagine the ramifications of adrenaline being out of balance since Dr. John Lee introduced us to the concept of “estrogen dominance.” Many practitioners surprisingly don’t recognize the significance of progesterone in moderating both the effects of estrogens and adrenaline. Thanks to Dr. Platt, we can raise our awareness on an ever enlarging picture about hormone balance. He reveals his evidence and thinking in great detail in his book, which is sure to expand every reader’s thinking about our bodies.

  • Platt ME. Adrenaline Dominance: A Revolutionary Approach to Wellness. Michael E. Platt, MD; 2014.
Book Review – Adrenaline Dominance by Michael E. Platt, MD2018-04-03T16:34:47-05:00

Bioidentical Progesterone vs. Synthetic Progestins

Bioidentical Progesterone vs. Synthetic Progestins

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

There is nothing that bothers bioidentical hormone proponents more than to have the scientific community categorize bioidentical progesterone with synthetic progestins. In 2002, the Women’s Health Initiative (WHI) study found a slight increase in breast cancer risk for women using conjugated equine estrogens (CEE) with medroxyprogesterone acetate (MPA). In spite of the fact that the study authors cautioned that their results did not necessarily apply to bioidentical progesterone, the popular press has put progesterone in the same category with MPA ever since.

More recent studies support the fact that, contrary to popular belief, MPA and progesterone do not have the same breast cancer risk. Two of these studies occurred in France, where bioidentical hormones are widely used. A study published in 2008 found that, of the 2,354 cases of invasive breast cancer found among 80,377 postmenopausal women, estrogen plus progesterone hormone therapy did not increase the risk of invasive breast cancer while estrogen plus synthetic progestins did. A later study published in 2013 supported these findings.

Progesterone may indeed be beneficial in protecting women against breast cancer. A breast cancer cell-line study supports the theory that progesterone actually causes the destruction of specific breast cancer cells. Another study found that progesterone reduced estradiol-induced growth of female breast tissue when applied 10-13 days before breast surgery. Still another study found that women with progesterone blood levels = or > 4ng/ml before breast cancer surgery had the best survival rate.

It is time that we stop espousing quasi-science by equating bioidentical progesterone with synthetic progestins. They are not the same and never will be.

  • Rossouw JE, et al. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA. 2002 Jul 17;288(3):321-33.
  • Fournier A, et al. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study.Breast Cancer Res Treat. 2008 Jan; 107(1): 103-111. Epub 2007 Feb 27.
  • Cordina-Duverger E, et al. Risk of Breast Cancer by Type of Menopausal Hormone Therapy: a Case-Control Study among Post-Menopausal Women in France. PLoS One. 2013 Nov; 8(11):e78016. doi: 10.1371/journal.pone.0078016. eCollection 2013.
  • Formby B, Wiley TS. Progesterone Inhibits Growth and Induces Apoptosis in Breast Cancer Cells: Inverse Effects on Bcl-2 and p53. Ann Clin Lab Sci. 1998; 28(6):360-369.
  • Chang KJ, et al. Influences of percutaneous administration of estradiol and progesterone on human breast epithelial cell cycle in vivo. Fertil Steril. 1995 Apr; 63(4):785-793.
  • Mohr PE, et al. Serum progesterone and prognosis in operable breast cancer. Brit J Cancer. 1996 Jan 16; 73:1552-5.
Bioidentical Progesterone vs. Synthetic Progestins2018-04-03T11:05:28-05:00

Ingrid Edstrom’s Proactive Breast Wellness Program

Ingrid Edstrom’s Proactive Breast Wellness Program

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

Our current medical system has been designed to take our hands and give us direction when disease has become evident, but it has left us sadly wanting when it comes to prevention. Finding and accessing the information necessary to prevent disease is difficult and time consuming. And, even if we do find it, interpreting it and understanding it may take some help.

Thankfully, a comprehensive compilation of what we currently know about keeping our breasts free from disease, including breast cancer, is available as an engaging multimedia presentation offered by Ingrid Edstrom, FNP, MEd, CTT. The Proactive Breast Wellness Program is her magnus opus and a labor of love.

A nationally certified family nurse practitioner, Edstrom combined her nursing degree with a minor in clinical nutrition. She also earned a master’s degree in Health Education, and has completed clinical training programs at the Mind Body Medical Institute. Ingrid Edstrom has skillfully combined all of her educational and clinical skills, and gift wrapped them in a delightful presentation so that we would have the resources we need to keep our breasts healthy.

Edstrom includes information about the various effects that hormones have on the breasts, the type of diet and foods that can be used to improve breast health, and the environmental issues affecting the breast. She even includes a meditation so that listeners can help reduce high cortisol, making us aware of the emotional and spiritual aspects of dealing with our breasts and our bodies.

The Power of Progesterone

Edstrom’s presentation covers a complete program for breast health, but let’s just focus in on one section she calls “The Power of Progesterone” as a sample. She states that after age 35, many women cease having ovulatory cycles, even though they continue to bleed regularly. This lack of ovulation increases the estrogenic dominance by 100 times. Add on the burden of many environmental exposures to estrogen-like compounds (which she also covers extensively) and the normal counter balance of progesterone for estrogen is greatly diminished.

Quoting Dr. John Lee, Edstrom maintains that progesterone should be used for breast cancer protection, during breast cancer treatment, and after breast cancer treatment. She also cites Dr. Susan Love, a breast surgeon, who recommends that any breast surgery should be done on days 13 through 28 of the menstrual cycle (progesterone levels are higher then) or, if that is not possible, progesterone cream should be applied to the breasts for two weeks before the planned surgery. Published studies have documented better outcomes when progesterone plays a role.

Edstrom discusses the problems with artificial progestins and brings up the issue of California’s mandatory cancer warning labeling on the over-the-counter progesterone products. She points out that California rule makers depended upon compilations of studies that primarily involved progestins, and then concluded erroneously that the required warning should pertain to progesterone as well. Progesterone, itself, has not been proven to be a carcinogen but instead offers protection. She cites the studies that demonstrate this.

Edstrom also discusses various dosage forms at length and details her preferences. She gives practical hints on how to use different dosage forms and offers some clinical suggestions. For example, she recommends that progesterone creams not be applied to the abdomen because this application may have the most significant effect in slowing gut motility. She learned from compounding pharmacists that progesterone cream applied directly to dense or thickened areas of the breasts may have the best results. She likes to use progesterone drops prepared with organic jojoba oil, and warns that progesterone is in suspension in this dosage form and should therefore be shaken very thoroughly before using to ensure proper dispersion.

Screening Methods

A cornerstone of Edstrom’s presentation, as well as her clinical practice, is the use of breast thermography as a tool for early warnings of issues presenting in the breast. Thermography is not an invasive test but captures the subtle differences in the temperature of the skin in a color scale. As might be imagined, the hot spots indeed appear as yellow to red colors, while normal temperatures appear in the blue and green ranges. The temperatures and color differences show areas of increased metabolic activity in the breast tissue long before a mass that could be palpated would form or would appear on a mammogram. This imaging allows for early interventions and also allows for a measure of the success of the interventions.

While mammograms are firmly entrenched in our medical system, there are some negative aspects with this type of testing. Mammograms introduce radiation (a known carcinogen) into our bodies. Mammograms do not prevent breast cancer and are not the best tool for an early warning. Both false negatives and false positives are common. Mammograms can actually damage or spread cancerous cells because of the high pressure applied to breasts in order to obtain the imaging. Breasts that are lumpy or have thick tissue present problems for accurate diagnoses with mammograms.

Thermography, on the other hand, measures physiologic changes rather than physical. As a cancer tumor develops, new blood vessels are formed feeding the tumor. This enhanced metabolic activity is easily detected with thermograms. Additionally, the increased metabolic activity can show up three to eight years before a tumor has actually developed. A suspicious thermogram can be followed up with an MRI, and neither of these diagnostic techniques subjects the body to radiation.

Edstrom thinks that thermography may replace mammography as the primary early screening tool in the not too distant future. She says that other screening methods are also being developed, such as a way to test fluid expressed from the nipples for cancer cells, and a saliva assay to test for a protein linked to breast cancer.

A Proactive Approach

As the incidence of breast cancer has steadily risen, we probably all know someone who has been affected. Ingrid Edstrom’s Proactive Breast Wellness Program is information that every one of us can use and benefit from, whether we are worried about breast cancer, are undergoing breast cancer treatment, or need to know how to prevent a reoccurrence.

If Ingrid Edstrom can be successful in her proactive approach to breast health, then the pink ribbon campaigns will become history. Just imagine the progress that would be made if women gathered in their neighborhoods, or their book clubs and coffee shops, and listened to presentations like this together, with the chance to discuss and disseminate the valuable information she offers. Let’s change the campaign from “breast cancer awareness” to “breast health awareness.” We encourage you to take advantage of Ingrid’s gift to us!

We were pleasantly surprised to see that Edstrom references several of our Connections newsletters when she covered the topic of hormones and balance. She also links to a collection of abstracts on hormone therapies that we compiled and published. Please feel free to explore these resources for additional information that may contribute to your breast health awareness.

Ingrid Edstrom’s Proactive Breast Wellness Program2018-04-02T16:49:13-05:00

A Tribute to Dr. Katharina Dalton

A Tribute to Dr. Katharina Dalton

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

Even though they’re not really funny, PMS jokes abound in today’s society. It’s very likely that most of us toss around the acronym of PMS (for premenstrual syndrome) without giving a thought as to where or how it originated.

In 1994, there was a movie titled Tom and Viv about the relationship of the American poet T.S. Eliot and his wife, Vivienne Haight-Wood Eliot, whom he married in 1915. Upon their marriage, he became the custodian not only of her money, but also of her physical being. Vivienne suffered terribly each month from what we now would recognize as PMS. After unsuccessfully trying to help her, T.S. Eliot had his wife committed to an asylum where she spent the remainder of her days. He never saw her again after she was committed. This movie reflected the thinking at that time. Women who suffered from hormone disturbances were thought to have mental rather than physical problems.

Dr. Katharina Dalton made a huge contribution to our understanding of hormone disturbances, and she is also the one who named the syndrome PMS. She identified and successfully treated many problems that were uniquely female. As we explore the mysteries and benefits of hormone therapies today, we are standing on the shoulders of her achievements, which include a tremendous amount of observation and study.

On her death at the age of 87 on September 17, 2004, Dr. Dalton’s life and work were reviewed by many major newspapers in Great Britain, where she practiced, and in the United States, where she also made a huge impact by identifying physical reasons for issues that had previously been dismissed as hysterical or only a figment of the mind. The concept of a women’s health movement may very well have started with her work.

At age 32, Dr. Dalton was still a medical student and pregnant when she wondered why she was suddenly free of the severe headaches she had experienced monthly. She took her observations to Dr. Raymond Greene, an endocrinologist, and speculated that progesterone, which is abundant during pregnancy and also should be abundant during the luteal phase (the second half of the menstrual cycle), might be the key. She and Dr. Greene first published their clinical experiences and theory in British medical journals in 1958, and proposed the term premenstrual syndrome. By then, Dr. Dalton had successfully treated premenstrual asthma, epilepsy, and migraine headaches with progesterone.

Progesterone, which has an effect throughout the body, is produced in the adrenal glands in addition to the progesterone produced by the ovaries. Dr. Dalton used progesterone that was equivalent in structure to the hormone found naturally in the human body. She was adamant that other synthetic derivatives of progesterone could not be used, contrary to what her medical colleagues believed.

Throughout her career, Dr. Dalton carefully examined her patients, collected data, posed theories, and tested her ideas. She developed a system of charting to help monitor the large number of symptoms that could present with PMS. An adaptation of the Symptoms Chart is available for download from our website.

One of Dr. Dalton’s observations was that some of the symptoms of PMS (including edema, hypertension, and albumin in the urine) seemed to also occur as early signs of toxemia in pregnancy. She began trials of intervention with progesterone, in collaboration with a maternity hospital. The hospital records showed an average incidence of toxemia to be 9%. After the first patients who were treated delivered babies in 1955, the incidence dropped to a low of 1.0%. Each patient was given a test dose of progesterone when early symptoms occurred, and then treated continually if symptoms resolved, while moderating the doses according to symptom relief.

Men, women, and children all have progesterone receptors in operation throughout their lifetime. Dr. Dalton focused her attention on progesterone receptors and, because only natural progesterone fits the receptors, she felt this was the only appropriate hormone to use. She also understood that, if there was too much adrenaline being produced, progesterone would not be able to be picked up by the receptors. Similarly, if women were experiencing swings of low blood sugar, progesterone would also not activate the receptor.

Dr. Dalton used very generous doses of progesterone to treat women; often a 400 mg suppository would be the minimum dose. Tests to measure levels of progesterone in the body using various means were immaterial, in her opinion, because the only meaningful test would be at the receptor sites. Successful treatment would be verified by a positive response to supplementation.

Dr. Dalton observed that progesterone has a very positive effect on hair growth in women. After delivery of a baby, many women experience significant hair loss because of the sudden drop in progesterone. When progesterone is supplemented for those women, the hair regrows luxuriantly.

Progesterone has also proven to be effective for brain trauma because of its protective effect on the myelin sheath, which covers nerve tissue. Additionally, progesterone can reduce swelling in the brain and has even been used by neurosurgeons prior to surgery.

Dr. Dalton also claimed that there was no unsafe dose of progesterone. In high enough doses, started before ovulation, progesterone could be used as a safe contraceptive. It was also safe to use with breast cancer, even concurrent with breast cancer treatments.

Prior to menopause, Dr. Dalton noticed that progesterone would typically start to become deficient for at least two years. During this time, women would develop symptoms that were similar to those she identified as PMS, which we now identify as symptoms of perimenopause.

She also identified the onslaught of symptoms some women experience after childbirth as having a pattern similar to PMS. She advocated for using large doses of progesterone immediately after childbirth, especially in those women with a history of PMS, to cushion them from the effects of the huge drop in progesterone that occurs at delivery.

Unlike current conventional thinking, Dr. Dalton claimed that women who have had a hysterectomy need more than the amount of progesterone needed by a woman who has undergone a natural menopause. The reasons behind most hysterectomies are consistent with a long-term progesterone deficiency; thus, so much more progesterone is needed to relieve symptoms afterwards. Ignoring the considerable research on progesterone receptors throughout the body, many practitioners today still believe that women with a hysterectomy do not need any progesterone because they maintain that it is only the uterus that benefits from progesterone and, because the uterus has been removed, progesterone no longer has any function.

As an active advocate in the justice system, Dr. Dalton also published a book titled Premenstrual Syndrome Goes to Court. She studied women serving time in prison and found that a large majority of the violent crimes committed (such as manslaughter, baby battering, and assault) occurred during the luteal phase in women who had a history of PMS symptoms. As part of her study, Dr. Dalton devised a menstrual chart indicating symptoms and their cyclical occurrence, helping the women establish the cyclical and hormone dependent nature of the symptoms. She appeared in court in about 50 trials in defense of women suffering from PMS and claiming a state of diminished responsibility if their criminal actions occurred during the luteal phase of their cycle.

She tried to find an independent marker for PMS and studied sex hormone binding globulin (SHBG). In the groups studied, she found that SHBG, which would bind estrogens and testosterone tightly, was low in the women suffering with PMS. She theorized that low SHBG translated into more free estrogens, which then created inadequate progesterone activity. This premise, unfortunately, was not verified by other scientists.

Dr. Dalton practiced the true scientific method. She made her observations based on the evidence she found, devised a theory that tested the observations she made, and tested her theory. She even applied her theory to situations beyond PMS, recognizing the implications of a host of different symptoms, to further an understanding of the importance of progesterone, as illustrated by her observations of patients with post-partum depression and toxemia during pregnancy.

Today, faced with the numerous symptoms that present with PMS, scientists only look at one issue at a time. Instead of turning to progesterone, which is indeed the golden key for progesterone receptors (as Dr. Dalton has shown), we treat PMS piecemeal with diuretics for edema, with narcotics and anti-inflammatories for pain, with anti-epileptics for seizures, and with antidepressants, anxiolytics, and antipsychotics for mood disorders.

Some say it takes 50 years for a new idea to take hold in our collective minds and, since we are now more than 50 years from her first publication, the time is now ripe for acceptance of Dr. Katharina Dalton’s work with progesterone. Pointing to the current widespread use of bioidentical hormone therapies in women’s health today as proof, perhaps her ideas have at last garnered a place in our consciousness.

  • Gilbert B. Tom & Viv. Oxford, Oxfordshire, England, UK; Miramax Films; 1994.
  • Oliver M. Katharina Dalton, 87; First Doctor to Define, Treat PMS [obituary]. Los Angeles Times. September 28, 2004.
  • Dalton K, Holton W. Depression after Childbirth: How to Recognise, Treat, and Prevent Postnatal Depression (4th Edition). Oxford, United Kingdom: Oxford University Press; 2001.
  • Allen LV Jr, et al. Interview: Katharina Dalton, MD: Progesterone and Related Topics. Int J Pharm Compd. 1999 Sep/Oct:332-9.
  • Dalton K, Holton W. Once a Month: Understanding and Treating PMS (6th Edition). Alameda, CA: Hunter House Publishers; 1999.
  • Dalton K. Premenstrual Syndrome Goes to Court. Droitwich, UK: Peter Andrew Publishing Co Ltd; 1990.
  • Dalton K. Should Premenstrual Syndrome be a Legal Defense? In: Ginsburg BE, Carter BF, eds. Premenstrual Syndrome: Ethical and Legal Implications in a Biomedical Perspective. Boston, MA: Springer-Verlag US; 1987:287-300.
  • Dalton ME. Sex hormone-binding globulin concentrations in women with severe premenstrual syndrome. Postgrad Med J. 1981 Sep;57(671):560-1.
  • Dalton K. Toxaemia of Pregnancy Treated with Progesterone during the Symptomatic Stage. Br Med J. 1957 Aug 17;2(5041):378-81.
A Tribute to Dr. Katharina Dalton2019-05-22T10:15:52-05:00

Progesterone May Help Control Perimenstrual Seizures

Progesterone May Help Control Perimenstrual Seizures

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

 

Progesterone, a neuroactive steroid hormone, produces profound effects on brain function. It not only protects nerve tissue after traumatic injury, but can act as an anti-epileptic as well. It is particularly beneficial when used in women suffering from perimenstrual seizures.

The anti-seizure effects of progesterone were first reported in 1942, and have since been substantiated by both animal and clinical human studies. The rapid drop in female progesterone levels prior to menses may precipitate seizures in susceptible women.

Andrew Herzog studied a small group of women who suffered seizures between day 25 and day 2 of the menstrual cycle. They all had low progesterone levels during the mid-luteal phase. When progesterone was administered daily prior to seizure activity, 18 of the 25 women saw a decline in their daily seizure frequency. Herzog later treated a group of 294 subjects with the same dose. Post-study results found a therapeutic benefit for those women who experienced higher levels of perimenstrual seizure activity.

  • Herzog AG. Progesterone Therapy in Women with Complex Partial and Secondary Generalized Seizures. Neurology. 1995 Sep;45(9):1660-2.
  • Herzog AG, et al. Progesterone vs Placebo Therapy for Women with Epilepsy: A randomized clinical trial. Neurology. 2012 Jun 12;78(24):1959-66. doi: 10.1212/WNL.0b013e318259e1f9. Epub 2012 May 30.
Progesterone May Help Control Perimenstrual Seizures2018-04-05T11:49:44-05:00

Dr. Katharina Dalton’s Impact on Women’s International Pharmacy

Dr. Katharina Dalton’s Impact on Women’s International Pharmacy

– Written by the Women’s International Pharmacy Staff

Dr. Katharina Dalton’s studies, and other studies like hers, provided the basis of knowledge for many pharmacists including our founder, Wallace (Wally) Simons. Wally used his scientific understanding of progesterone to benefit the women coming to his pharmacy from the “PMS Clinic” next door. Wally knew the importance of creating a progesterone formulation that would be absorbed via the lymphatic system into the blood stream rather than immediately being broken down by the liver when taken orally. Today, 28 years later, WIP pharmacists are still utilizing and expanding upon the core compounding practices Wally developed. One of our pharmacists, Carol Petersen, was recently recognized in Pharmacy Today‘s June profile edition in an article titled Compound interest: Petersen shares expertise on women’s health, leads APhA-APPM Compounding SIG. The legacy of Women’s International Pharmacy’s mission to find solutions to meet patient-specific needs endures.

Dr. Katharina Dalton’s Impact on Women’s International Pharmacy2019-05-22T10:16:32-05:00

Can Estrogen Help Migraines?

Can Estrogen Help Migraines?

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

Forty percent of women and 20% of men experience migraine headaches in their lifetime. Up to 60% of female migraine sufferers have headaches associated with menstruation. According to the International Headache Society, menstrual migraines without aura (a pre-headache visual, sensory, motor or verbal disturbance) can begin two days before to three days after bleeding starts.

Possible triggers include a decrease in estradiol, release of inflammatory substances from the uterine lining, low magnesium, decreases in certain brain chemicals like serotonin and GABA, dehydration, suspected foods and insufficient sleep. Some migraine specialists believe that a decrease in estradiol levels is the most likely trigger.

According to Dr. E. Anne MacGregor, raising premenstrual estradiol levels can help to avert or minimize the effect of these migraines. Maintaining estrogen in a range of 45-75 pg/ml may reduce the intensity and frequency of migraine headaches. Estradiol 1.5mg gel, applied six days prior to bleeding and continued through day 2 of menses, has been shown to effectively decrease the number of migraine days in some women. Extending this time period beyond day 2 and tapering the dose may help prevent “withdrawal” headaches caused by stopping estradiol abruptly. Progesterone may also help decrease these headaches because progesterone helps regulate pain and pain perception through GABA receptors in the brain.

Additional Resources:
Can Estrogen Help Migraines?2018-04-02T17:23:55-05:00

Hormones and the Aging Voice

Hormones and the Aging Voice

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

We have all heard it. Your aging mother’s voice has changed. It cracks, it quivers, it wobbles, and the tone is lower. The voice you hear over the phone is breathy and lacks the robustness it once had. You suddenly realize, this is the voice of an old person.

Unlike the dramatic changes a young man’s voice goes through at puberty, the changes that happen to a woman’s voice are gradual, often taking years to present.

A woman may use facelifts, tummy tucks and Botox to “stay young” but her voice will still betray her. She will still have an old person’s voice, and it seems there is nothing she can do about it. Or is there?

As it turns out, the voice is extremely sensitive to hormone changes. We know this from an extensive study done with women who depend on their voices for their livelihood: singers. Women at the top of their vocal careers in their 40s and 50s may find that menopause brings it to a dead stop. With menopause, the voice range often deteriorates and those lovely high notes are no longer attainable; or worse, during a performance, the voice cracks and no note comes out at all. Many professional singers have no option but to end their career at this point.

So, what is going on with hormones to affect the voice? The larynx and the vocal cords contained within are extremely sensitive to thyroid and the sex hormones. In fact, cyclical changes occur in women’s voices starting at menarche. In the first part of the cycle (follicular phase), estrogen dominates and progesterone is at lower levels. During this time, there is more fluid build up in the vocal chords and a relaxation of the nasal passages, changing the perception of the voice. During the second half of the cycle (luteal phase), progesterone dominates, causing the larynx epithelium to slough off, and opposing estrogen-induced proliferation. Singers often find that their ability to reach the high notes is compromised during this phase.

In other words, if progesterone is not abundant enough, the singer suffers from estrogen dominance in the luteal phase (or during PMS), and voice clarity or efficiency suffers. Vibratos wobble and it is difficult to sing softly. This condition is known as dysphonia premensturalis.

Researchers Jean Abitbol and his wife Beatrice performed a study that compared slides of swabs obtained from the vocal cords with slides containing cervical smears, both taken at various intervals of the menstrual cycle. The slides were indistinguishable from each other! Their astounding discovery is that vocal chords and vaginal tissue are the same kind of tissue. The vaginal dryness experienced at menopause is similar to the dryness experienced in the vocal chords.

Research has also demonstrated that progesterone, operating as a neurosteroid, protects the myelin sheath. Ian Duncan at the University of Wisconsin illustrated the effect of progesterone on the brain in 1995. With the significant drop in progesterone production that occurs at menopause, nervous tissue is less protected, which leads to a voice that is less controlled.

Testosterone deficits also have an effect on the voice in that the muscles and cartilage that make up the larynx become flaccid and weakened. Not only that, but low testosterone contributes to less muscular strength throughout the body. Singing is hard work and requires good structure and posture, strong abdomen muscles, great breath control, and plenty of endurance. Perversely enough, women who receive too much testosterone replenishment may find that their voices change to a lower timbre, which is thought to be permanent.

Both hypothyroidism and hyperthyroidism also cause voice disturbances. Low thyroid produces hoarseness and a lack of range. This may be from elevated polysaccharides (think mucin) in the vocal chord folds, leading to fluid retention and thickening of the vocal chords. Treating hypothyroidism generally relieves these symptoms. Too much thyroid hormone also causes hoarseness, which is usually relieved with treatment.

Other chronic diseases that accompany aging can also impair the voice. For example, diabetes sufferers often experience dry mouth, which can be a vocal hindrance. Hearing loss, another hallmark of aging that can also occur with diabetes, can cause difficulties in the quality of the vocal sounds produced.

Does hormone replenishment really make a difference? It seems to. This area certainly warrants further exploration. Keeping oneself in good physical condition with exercise, a healthy diet, and good hydration also goes a long way toward maintaining a youthful voice.

Not surprisingly, there are specific exercise programs that singers use to keep their voices working effectively. Just as they say with regard to sex, “if you don’t use it, you lose it;” yet another parallel between vaginal tissue and the vocal chords.

  • Kadakia S, et al. The Effect of Hormones on the Voice. J Sing. 2013 May/June;69(5):571-4.
  • Benninger MS, Abitbol J. Dysphonia and the Aging Voice. Voice. American Academy of Otolaryngology-Head and Neck Foundation; 2006:67-85.
Hormones and the Aging Voice2017-12-11T16:24:52-05:00