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.