Yes folks, Oprah’s in menopause.
“You feel flat and you feel tired, you haven’t had a good night’s sleep in two years [and you’re] just going through the motions, trying to get through the day,” Oprah says. “You feel like your life force is being sucked out of you.”
To her credit, Oprah seems to be trying to frame the HRT issue as a debate – “Should you replace your hormones?” she asks. A reasonable question, I’d say.
Her magazine features a well-written article that frames the issues nicely and is medically up to date and fairly well-balanced. Everything you need to know is in there, albeit with a little too much paragraph space given to the theories that support HRT use and not enough to the facts that recommend against it. Still, it’s a good start.
But Oprah’s blowing it with her show.
She gets points for working with Christiane Northrup, the author of the book The Wisdom of Menopause, and the leading medical guru to the public on HRT. While Northrup’s book is a bit too long and a bit woo-woo for most of my patients, it is medically correct, and I really liked her Public TV Special last year.
Dr Oz dropped the ball
This is not informed choice – it’s pure salesmanship, and both the patient and Oz fall for it hook, line and sinker. Oz even puts Hall’s crazy regimen up on the screen as if it were gospel – 2 mg of estradiol and 150 mg of progesterone twice a day – 8 times the starting doses I use in my practice, and much more than most women need even at the start of treatment.
DR OZ – Who should take hormone replacement?
DR HALL – Anyone who has a low hormone should have that hormone replaced.
Huh????? I though we got away from this craziness with the WHI.
Oprah, I’m disappointed.
You had such good intentions, but you’re giving way to the hype, and taking your viewers along with you. Like poor Michelle, who you promise to take to Dr Hall for her “Oprah Hormone Makover”-
OPRAH:…It’s ultimately up to you to make the choice for what’s right for your body. We just want women to start to feel better and to be in charge of your own health. Because you don’t have to feel this bad. Look at Michelle. Michelle, there is hope for you.
MICHELLE: I’m going to get myself some of these hormones.
OPRAH: Yeah. Yeah.
MICHELLE: Sign me up!
This is not letting Michelle make her own decisions, Oprah. This is pulling her into your club. HRT is not a makover that you offer your viewers for free. It’s a medical treatment, with risks and benefits about which every woman deserves to be properly informed. Your show, unfortunately, is not informing. It’s hyping.
Things are no doubt going to get even worse when Oprah gives the stage over to Suzanne Sommers later this week for part 2 of her HRT series. (Northrup will be airing a Webcast Thursday evening that will be worth listening to, but I don’t think is going to be on the show again.).
I take HRT, and I prescribe it to my patients who want to use it for treatment of menopausal symptoms. Every one of my patients who takes HRT is informed of the potential risks, and their decision to use it or not is made in light of their own risk factors, symptoms and concerns.
In the end, most of my menopausal patients don’t need HRT or don’t want the risks, and we either find them non-hormonal alternatives or they find other ways to handle their symptoms. It’s called informed choice.
I prescribe FDA-approved regimens, mostly bioidentical but not always, and sometimes custom-made formulations for women who can’t find the right regimen among the approved products. I recommend the lowest dose for the shortest time, and prefer transdermal estrogen over oral forms if possible.
I also offer alternatives to HRT, including SSRI’s and neurontin for hot flashes, low dose vaginal estrogen for dryness (along with over the counter non-hormonal remedies for the same), and encourage all my patients to eat well, exercise, avoid dietary and stress triggers for hot flashes and take care of themselves.
If you want to learn about HRT
Check out the readings listed at the bottom of this post. Or my series on HRT. Or talk to your doctor.
_______________________________________________Menopause Reading list–The Menopause Guidebook by North American Menopause Society – The Cliff Notes of menopause management. Everything you need to know without the hype.
–Is It Hot in Here, or Is It Me? by Barbara Kantrowitz and Pat Wigert Kelly – The What to Expect while you’re in Menopause book. Q&A format, easy to read in short segments.
–The Wisdom of Menopause by Christiane Northrup. The Torah of Menopause – Everything’s there, along with the book of Job. Read it and believe.
–Our Bodies, Ourselves for the New Century. If you liked the original, you’ll love this version.
–Medicine Net answers FAQ’s about bio-identical HRT and Oprah.