Archive for the ‘Hormone Clinic’ Category

Alzheimer disease risk reduced by hormone therapy for breast cancer treatment | Image Credit: Graphicroyalty - Graphicroyalty - stock.adobe.com.

There is an association between hormone therapy use for breast cancer and protection against Alzheimer disease and related dementias (ADRD) when aged 65 years and older, according to a recent study published in JAMA Network Open.1

Thirty-one percent of all new cancer cases in the United States are breast cancer, and 83% of invasive breast cancers are observed in women aged at least 50 years. Data has indicated a median age of 62 years during diagnosis, and a median age of 69 years at breast cancer death.2

Over time, breast cancer survival has improved, leading to over 2.5 million breast cancer survivors aged over 65 years.1 This has increased concerns about treatment-related complications among older adults.

Alzheimer disease is reported in 10.8% of patients aged 65 years and older and is the seventh leading cause of death in the United States. The number of people with ADRD is expected to increase over time, leading to concerns about development in breast cancer survivors.

Investigators conducted a study to determine the association between hormone-modulating therapy (HMT) among breast cancer patients and ADRD risk. Demographic, sociocultural, and clinical information about breast cancer patients was obtained from the Surveillance, Epidemiology, and End Results Medicare linked database.1

Participants included women aged at least 65 years recently diagnosed with breast cancer between 2007 and 2009. HMT types included selective estrogen receptor modulators (SERMs), aromatase inhibitors (AIs), and selective estrogen receptor degraders (SERDs).

ADRD was defined as the primary outcome of the analysis, reported based on International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes. ADRD subtype codes were also included to account for all ADRD patients. Covariates included demographic, sociocultural, medical, and treatment variables.

There were 18,808 breast cancer patients included in the final analysis, 65.7% of whom had HMT exposure within 3 years after diagnosis and 34.3% did not have HMT exposure. Patients were most commonly aged 75 to 79 years, with a mean age at diagnosis of 75 years in the HMT group and 76 years in the non-HMT group.1

A mean time to start HMT of 5.6 moths from diagnosis was reported, with 76.1% of HMT users initiating with AIs, 23.6% with SERMs, and only 0.3% with SERDs. HMT lasted for a mean 24 months within 3 years after breast cancer diagnosis.

ADRD was reported in 23.7% of HMT users and 27.9% of non-HMT users by the end of the follow-up period. Death was reported in 26.4% and 27.5%, respectively. This indicated a significant association between HMT use and reduced risk of ADRD, with a hazard ratio (HR) of 0.93.1

HRs were also significant for AI and SERM separately, at 0.93 and 0.89, respectively. However, SERD was not significantly associated with reduced risk of ADRD, with an HR of 0.37.

An age-modified association between HMT and ADRD risk was identified during subgroup analyses. Patients aged 65 to 69 years had the most reduced risk with an HR of 0.48. In comparison, by the age of 80 years, HMT was positively associated with ADRD, with an HR of 1.40.

These results indicated an association between HMT use and improved protection against ADRD among breast cancer patients, with age considered an important modifier in this link. Investigators recommended further research to validate these associations in diverse populations.1

Reference

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Alzheimer disease risk reduced by hormone therapy for breast cancer treatment - Contemporary Obgyn

Researchers believe that human bioidentical hormones confer a lower risk of breast cancer compared to conjugated estrogens.

Dear Dr. Roach: I am 62 years old and postmenopausal. I am reading more about bioidentical hormones giving added protection to the heart and brain, in addition to helping with hair loss and weight gain. However, it seems that the only way one can obtain these hormones is through nontraditional doctors. I havent asked my insurance yet if I can get these, but Im pretty certain that they will not prescribe these to me. (I will ask on my next visit.)

Can you offer any advice on the efficacy of these hormone replacement therapy (HRT) treatments? It seems past opinions about how HRT could lead to increased cases of breast cancer have changed.

P.M.

You are right that our understanding of the relationship between HRT and breast cancer, as well as heart disease, continues to evolve. HRT is approved to treat symptoms of menopause, such as hot flashes.

With increasing frequency, physicians prescribe bioidentical hormones rather than conjugated equine estrogens and medroxyprogesterone, which were tested in large trials. They showed an increased risk of coronary artery disease when given to women over 60 or women who are 10 years past menopause. They also showed an increased risk of breast cancer when they were used in combination.

Researchers believe that human bioidentical hormones confer a lower risk of breast cancer compared to conjugated estrogens. As long as they are given right after menopause, biodientical hormones have a low risk of heart disease. I do not start estrogen for women who are more than 10 years past menopause, due to the increased risk of heart attack. I also do not prescribe any oral estrogen in a woman with a history of breast cancer, and I consult with a womans oncologist before using any estrogen, even topical.

There are some doctors who use custom-compounded hormones, and the dosing may be based on blood levels. I dont advise custom compounding, as the safety and efficacy is not well-established; the potency is variable; and they are not subject to regulatory oversight. For this reason, when I prescribe HRT, I prescribe the FDA-approved bioidentical hormones that are extensively tested.

Although I frequently prescribe HRT for women with symptoms of menopause, I do not prescribe these regimens for the purpose of preventing heart or brain disease, as we know they have risks (including a small risk of blood clots). Also, the benefit in protection is unproven. Observational trials suggest that there may be a benefit in prevention of heart disease and breast cancer with the newer regimens, but I am await strong interventional studies before prescribing treatments to prevent disease.

My colleagues in gynecology tend to have more experience in prescribing HRT. After the release of the large trials, many internists stopped prescribing these medications, which is a shame because they remain highly effective for menopausal symptoms. When used properly, they are very safe for most women. However, I have had many readers tell me that they have been unable to find a physician who will prescribe these medicines for their symptoms, even if they are willing to take the risks.

Email questions to [emailprotected].

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Your Good Health: Some types of hormone replacement therapy are difficult to obtain - Times Colonist

Did you know the gut microbiome has over 100 trillion microbes consisting of bacteria, fungi, yeast, and viruses, all influencing how our body functions and responds to stress, certain foods, and even some medications? "There is so much attention and research on the microbiome and gut health now that experts often refer to it as the 'second brain,'" registered dietitian Kristian Kirkpatrick, RD, told Cleveland Clinic.

RELATED: Doctors Share 9 Signs You Have "Healthy Poop"And What to Do If You Don't.

According to Max Nieuwdorp, PhD, an endocrinologist and researcher, maintaining a healthy gut microbiome has many added benefits, such as a healthy hormone balance. In his most recent book, The Power of Hormones, Nieuwdorp explains that gut microbes play a pivotal role in the release and production of different hormones, which in turn affect many of our daily processes, like metabolism and mood. And this is why he recently shared three things you should avoid to keep your gut health in check. ae0fcc31ae342fd3a1346ebb1f342fcb

"The microbiome can really talk to the body by producing specific substances from the diet that are good or bad for you," Nieuwdorp told Business Insider. Those substances can have a positive or negative impact on the function of hormones. Because of this, Nieuwdorp is super particular about what he puts in his body.

One food group Nieuwdorp likes to avoid for optimal gut health is red meat. In his Business Insider interview, he explained that red meat alters the composition of the gut microbiome by producing "dangerous" metabolites during the digestion process.

"I try to not eat meat every day," he said.

While protein is good for you, building a meal plan that's centered around red meat can increase your risk for diabetes, heart disease, stroke, and colorectal cancer, per Scripps Health. Red meat is also high in cholesterol, saturated fats, and sodium.

RELATED: 9 Supplements That Can Damage Your Stomach, Doctors Say.

Nieuwdorp also avoids ultra-processed foodsfor example, sweetened breakfast cereals, processed meat, soda, and some frozen ready-to-eat meals. Instead, he prioritizes fresh foods that don't contain preservatives or additives.

"Ultra-processed foods contain large quantities of saturated fat and trans-fat, added sugar, salt, and food additives that seriously affect the gut and physical health," gastroenterologist Preeya Goyal, MD, explained in an interview with PIH Health. She added that consuming ultra-processed foods can also harmfully disrupt brain functions.

Finally, Nieuwdorp avoids taking antibiotics unless absolutely necessary. "They drive dysbiosis in the gut," he said.

Dysbiosis refers to a lack of diversity in microorganisms, explains Cleveland Clinic. This imbalance can make us "vulnerable to infections from germs living inside and outside of our bodies," their experts explain. "It can also interfere with other important services that our microbiomes normally provide for us."

With an imbalanced gut microbiome, our hormones can also be negatively affected.

We offer the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.

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Hormone Doctor Shares 3 Things He Avoids for Gut Health Best Life - Best Life

DeTar Healthcare System is hosting a hormone replacement therapy information presentation for the Crossroads, targeting women going through menopause or looking to be informed about treatment.

The presentation will be held 6-7 p.m. May 30 in DeTar Hospitals North Education Classroom at 101 Medical Drive and will be presented by gynecologist and obstetrician Dr. Philip Suarez.

HRT is most commonly used as both a menopausal and postmenopausal hormone therapy to treat symptoms associated with female menopause, according to a news release. It can be beneficial to women seeking relief from side effects from menopause, such as vaginal dryness or hot flashes.

Menopause occurs 12 months after a womans last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition or perimenopause, according to the National Institute on Aging.

The menopausal transition most often begins between ages 45 and 55 but can happen earlier, according to the institute. It usually lasts about seven years but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it begins, race and ethnicity.

Age, family medical history, personal medical history and severity of ones symptoms are important factors to consider when deciding whether or not to take HRT, according to the release.

Were very excited to have Dr. Suarez share his knowledge of HRT, positive effects of taking HRT and the different forms in which its available. We encourage anyone interested in learning more about HRT to attend the presentation, so that they can develop a deeper understanding of their hormone functions before, during and after menopause. said Mary Claire Bradshaw, DeTar Women & Childrens Center director. In addition to the information shared, women will have the opportunity to take note of questions they may have for their primary care provider.

For further questions regarding information or to RSVP, please contact 361-788-6125 or 361-788-6111. Attendees are encouraged to bring a guest to the free presentation.

Link:
DeTar Healthcare System to host hormone replacement therapy seminar - Victoria Advocate

A healthcare organization that operates clinics inside Seattle public schools says it can now offer gender-affirming hormone treatment to children, emails from a health center program manager reveal.

Emails obtained by The Daily Wire reveal that Neighborcare Health, a healthcare organization that runs clinics in middle and elementary schools in the Seattle Public Schools district, announced in January 2023 that hormone treatments were now included in the gender-affirming care it could offer.

The Neighborcare Health team wanted to share an exciting new update to our School-based Health Center services, the email from a Program Manager for Neighborcare Health, which was obtained by Parents Defending Education through a public records request, reads. Our program will begin offering comprehensive, evidence-based, gender-affirming care services to our students and families who need them.

The change meant that the group could now give hormone treatments to children, it explained. While our School-based Health Centers have long offered a continuum of gender-affirming care services including supportive student counseling, promotion of social identity, and health education, this step will allow us to begin offering families access to important medical interventions including hormone treatments, it states.

The offerings mark one of the boldest efforts to create what Manhattan Institute Fellow Leor Sapir has dubbed the school-to-clinic pipeline whereby young school children are encouraged to undergo irreversible medical interventions that seek to change their sex.

Neighborcare, which runs 14 different school-based clinics in Seattle Public Schools and Vashon Island School District, states that its mission is tohelp students do better in school by working to address health concerns, prevent serious illness, and promote healthy lifestyles. The clinic does not, however, openly admit to providing so-called gender-affirming care, which is conspicuously absent from its services offered list despite announcing that it would begin offeringhormone therapies at some of its school-based clinics over a year ago.

The company official stated in the email that its foray into hormone treatment for children would initially be to a pilot program and that the administration of the irreversible drugs would only occur with parental approval.

These services will be a small pilot available to students and families within the existing schools we serve, the email went on to state, also noting that hormone therapy will only be administered to those who have the approval of parents or legal guardians.

The company defended its decision to offer cross-sex hormone therapy to children in a comment to The Daily Wire, claiming that it was a form of life-saving care.

Gender-affirming care in its many forms represents life-saving care for many of the youth and their families who choose it, spokeswoman Mary Schilder told The Daily Wire. Neighborcare Health offers care for transgender and non-binary students that align with best practices defined by regional and national pediatric care authorities and is aimed at meeting needs expressed by the students and families we serve.

Rhyen Staley, a researcher for Parents Defending Education, which obtained the documents through a public records request, called the administration of irreversible treatments to children in schools unconscionable.

It is deeply concerning that the institutions Americans have traditionally trusted with keeping children healthy and safe are now giving them access to harmful medical practices, Rhyen Staley, a researcher for Parents Defending Education, told The Daily Wire. It is unconscionable that this is happening within the K-12 school setting.

A separate email from an unidentified individual working in public health for Seattle and King County flagged the Neighborcare Health email to people associated with the Seattle Childrens Hospital and Seattle Schools.

I know many of you are already providing different levels of care and support for your students around gender and I simply wanted to share this, the email states, before pointing out that there is the possibility of media interest in the program.

Though medical institutions that turn a profit by administering irreversible cross-sex hormones to children claim that transgender medical interventions are life-saving, European countries to the left of the United States have recently restricted the use of puberty blockers and hormone therapy.Sweden and England have both taken steps to limit the availability of medical interventions that seek to change the sex of patients. The Scandinavian country stopped hormone therapy for minors with few exceptions while Englands National Health Service stopped prescribing puberty blockers.

Some of the most vocal advocates in favor of administering puberty blockers and cross-sex hormones to children actually receive funding from the very same pharmaceutical companies that manufacture the drugs that are given to children suffering from gender dysphoria, Daily Wire investigations have revealed.

Seattle Public Schools, which did not respond to a request for comment, has pushed medical gender transitions more blatantly than perhaps any other school district, but it is far from the only one to encourage children to undergo irreversible medical interventions intended to modify ones sex.

The Daily Wire previously revealed that the Los Angeles Unified School District reached out to a transgender youth clinic at the Childrens Hospital of Los Angeles after staff found out that a student was considering going on testosterone therapy. The district, which frequently pushes transgenderism on students through its lesson plans, book readings, and spirit day celebrations, had just recently hosted members of the Childrens Hospital of Los Angeles to advertise the transgender clinics offerings to parents.

Conservative journalist and activist Chris Rufo revealed that public schools in Chicago teamed up with the Lurie Childrens Hospital of Chicago to promote pro-transgender curriculum and gender-affirming books aimed at children.

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EXCLUSIVE: Health Centers At Seattle Public Schools Offer 'Gender-Affirming' Hormone Therapy To Children - The Daily Wire

Email communications recently provided to The Daily Wire show that Seattle, Washington schoolchildren can acquire transgender hormone therapy from public school clinics.

[RELATED: Study Shows The Vast Majority of Children Confused About Their Gender Grow Out of The Feelings Without Intervention]

The healthcare organization offering the treatments, Neighborcare Health, operates 14 public school based clinics in middle and elementary schools in Seattle and in the nearby Vashon Island School District.

This clinics are similar in form and function to the school-based clinics at a number of Maine public school districts, including one at Lawrence High School that made headlines last year after her father alleged that they sent his minor daughter home with an unlabeled baggy of Prozac.

[RELATED: Maine Dad Says High School Clinic Sent 17-Year-Old Daughter Home with Secret Baggy of Zoloft, Sicced Child Protective Services on Him For Complaining]

Our program will begin offering comprehensive, evidence-based, gender-affirming care services to our students and families who need them, said a Neighborcare Health program manager in emails originally acquired by Parents Defending Education.

The emails show that hormone therapy has been available in the school clinics since January 2023, but it is unclear how many children have received the drugs.

According to Neighborcare Health, the organization had been providing some gender-affirming care such as counselling, and helping children socially transition, even before they began hormone therapies.

The group celebrated its new ability to provide hormone therapy along with unspecified other important medical interventions.

Although it is unclear what other medical interventions the group can provide, it could possibly refer to puberty blockers, which do irreversible damage to children, and have been restricted in multiple European countries due to their negative effects.

[RELATED: UK Bans Puberty Blockers for Minors as Maine Pushes Sanctuary Status for Gender-Affirming Treatments]

Given that the Neighborcare clinics serve elementary and middle schools, the vast majority of children receiving the hormone treatment and other transgender medical intervention from them would be under 13.

According to the healthcare groups website, the clinics will also offer referrals to gender clinics which will provide further, surgical transgender procedures.

In the emails provided to the Daily Wire, the company claimed that its new hormone treatments are only a pilot program, and will only be prescribed to children with parental consent.

These services will be a small pilot available to students and families within the existing schools we serve, said the company.

It is unclear whether the program is still in its pilot stage, as the emails come from early 2023.

As American liberal organizations and states, including Maine, have pushed forward with radical gender ideology, multiple European countries, including Britain, Norway, and France, have moved to restrict gender transitions for children.

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Students in Seattle Schools can Acquire Hormone Therapy from In-House Clinics: Daily Wire - The Maine Wire

What We Know

Hormonal contraceptives (HC) may help stabilize the fluctuations in estrogen and progesterone that occur during the menstrual cycle and in perimenopause that are particularly impairing for neurodivergent women, however research has found a correlation between some types of oral HC use and higher rates of depression in women with ADHD.

The impact of sex hormones, including estrogen and progesterone, on ADHD symptoms in women has only recently become the subject of scientific inquiry. A recent study found that various ADHD symptoms wax and wane depending on the menstrual phase. Researchers found that estrogen has a protective effect for both cognition and emotional regulation, and that ADHD symptoms tend to worsen when estrogen drops. 1

These findings are reflected in the lived experience of ADDitude readers. In a recent survey, a full 98% of respondents reported experiencing hormone-related changes in cognitive function and/or mood, including changes in focus, attention and memory as well as emotional regulation.

Oral HC, or birth control pills, typically contain synthetic estrogen and progesterone. In addition to preventing pregnancy, they are often used to treat heavy menstrual bleeding, painful cramps, irregular periods, polycystic ovarian syndrome, and acne. In addition, some clinicians prescribe oral HC to stabilize hormone levels in women and treat premenstrual syndrome (PMS) and/or premenstrual dysphoric disorder (PMDD), which impact two-thirds of women with ADHD, according to an ADDitude survey.

Until recently, the implications of oral HC use for women with ADHD were entirely uninvestigated, however a recent study published in Journal of the American Academy of Child and Adolescent Psychiatry (JAACP),2 revealed that:

Systemic hormonal contraception contains progestins that inhibit the ovulatory cycle and thereby smoothens the hormonal profile, but it may also mimic the negative mood symptoms experienced from natural progesterone during the luteal phase of the menstrual cycle, explains Lotta Burg Skoglund, M.D., Ph.D., a lead author on the study. However, most women do not experience these negative mood effects and, somewhat counterintuitively, some progestins may even alleviate symptoms of PMDD.

An ADDitude survey of nearly 5,000 women revealed that 93% of respondents aged 45 and older experienced elevated and aggravated ADHD symptoms in perimenopause and/or menopause. More than half of these women said their ADHD symptoms including feelings of overwhelm, procrastination, and memory issues had a life-altering impact in menopause. We know that for hormone replacement therapy (HRT) can effectively alleviate common symptoms of menopause, such as hot flashes, mood lability, and insomnia, and it may offer other benefits.

Studies show that HRT, if initiated within 10 years of menopause, reduces all-cause mortality and risks of coronary disease, osteoporosis, and dementia,3 explains Jeanette Wasserstein, Ph.D., in the ADDitude article, Menopause, Hormones & ADHD: What We Know, What Research is Needed. Overall, recent research suggests that the risk in using any type of HRT is lower than previously reported in literature.

Research has revealed heightened risk for some cancers associated with some forms of HRT, so Wasserstein highlights that a thorough consultation with a medical provider is critical before beginning HRT.

No studies have probed the implications of HRT use for climacteric women with ADHD and we know very little about the potential benefits or risks of HC for women with ADHD.

ADHD is a common illness, but few studies have looked at the association of hormonal stages and ADHD symptoms, write the authors of a systematic review of sex hormones, reproductive stages, and ADHD published in Archives of Womens Mental Health.4Notably, we did not find any studies investigating ADHD symptoms in other female physiological states such as pregnancy or menopause or looking at the response of patients with ADHD to hormonal treatments such as hormone replacement therapy.

The small puzzle pieces of existing data are surrounded by questions. Why, for example, did women with ADHD on oral HC experience far higher rates of depression while those on hormone implants or IUDs did not? Until more research is conducted, researchers are left to theorize.

It may be that, when taking oral birth control, women with ADHD might be extra susceptible to forget to take their birth control pills or may take them irregularly, causing hormonal fluctuations that may destabilize mood, explained Skoglund in her ADDitude webinar, The Emotional Lives of Girls with ADHD. Also, a womans hormonal levels will fluctuate during assumed pill-free intervals.

Some anecdotal reports suggest the use of oral HC, which minimize hormonal fluctuations, may improve ADHD symptoms in some women.

I was surprised and amazed by the extent to which my focus and my executive functioning improved since I started hormonal birth control, said Silvia, an ADDitude reader in Italy. I totally reshaped my life: I decided to start coaching people again, joined a company and am thinking of going back to university again to obtain a second degree. I dont experience mood swings anymore and I feel less exposure to RSD.

These anecdotal reports offer promise. But without research, clinicians lack a solid foundation of data to make treatment recommendations.

We need to find out why some women feel better with oral contraceptives and others feel depressed, says J.J. Sandra Kooij, M.D., Ph.D. It is about hormone sensitivity, and how hormones interact with neurotransmitters such as dopamine in women with ADHD, but exactly what drives this difference is still unclear.

Given a total lack of research studies, there is virtually no reliable science regarding the risks and benefits of HRT for peri- and post-menopausal women. Among the many questions that remain unanswered are the following:

Hormonal contraceptives are among several first-line treatments for PMS and PMDD, which impact women with ADHD with heightened frequency and intensity.5 Symptoms of these mood disorders are frequently debilitating, and include suicidal ideation. A comprehensive understanding of possible treatment options for these women could significantly improve quality of life and reduce the risk of self-harm.

Reliable, well-tolerated contraception is also critical for girls and women with ADHD because they are six times more likely to give birth as teenagers compared with women without this diagnosis, according to a recent study led by Skoglund. 6

These dramatically heightened rates of unplanned pregnancy were also found in the groundbreaking Berkeley Girls with ADHD Longitudinal Study, led by Stephen P. Hinshaw, Ph.D., professor of psychology at the University of California, Berkeley. By the time they reached their mid to late 20s, about 43% of the BGALS participants in the ADHD group had one or more unplanned pregnancies, Hinshaw told ADDitude.

Research has found that experiencing unwelcome psychological side effects is the most commonly reported reason for the discontinuation of hormonal contraception, a decision which could have far-reaching implications.7

Unwanted pregnancy undermines womens schooling, health and social status and is directly linked to the negative psychosocial impact of ADHD on health, autonomy, academic performance, and quality of life, Skoglund says. Averting underage parenthood through effective contraception methods will likely benefit womens education, empowerment, health and quality of life, their families, offspring, and society from a health economic perspective and have broad and public health benefits, extending far beyond the targeted group.

Hormonal contraceptives earn mixed reviews from readers, some of whom find them helpful in balancing mood and reducing ADHD symptoms; others report that HC use increases in anxiety, irritability and depression, among other intolerable side effects.

Hormonal birth control affected me so negatively that I went off of it. It was highly disruptive to my mood and overall wellbeing, says Jen, a reader in Utah. I dont mess with the hormones even though they love to mess with me.

I had an IUD for 7 years. Within a few days, I could not believe the change in my mood. I felt more emotionally even and steady than I had felt in years, shares ADDitude reader Anne.

My PMDD was exacerbated by any hormone preparation, including the pill. The low-dose Mirena was an absolute nightmare for me, says Nicole, an ADDitude reader. Im so hesitant to try anything to manage impending menopause, which has me ever more on edge, and Im not sure yet how to advise my teen on these matters.

I started birth control due to PMDD. The mini-pill has been fantastic for my ADHD. I have fewer hormonal fluctuations, says Karen, an ADDitude reader in Idaho. I can finally rely on myself to be functional every day (as long as I get enough sleep and take my ADHD meds).

I detested the combined pill. It wrecked my mental health, and gave me dangerous migraines), offers another ADDitude reader. I was still disorganized, unmotivated with the added bonus of all the physical and mental downsides of the combined pill.

ADDitude readers often report improved brain fog, memory issues, and mood swings while on HRT, though some say their doctors resist prescribing hormone replacement.

As I approach menopause, my ADHD symptoms have worsened exponentially severe memory and concentration problems, plus brain fog, mood swings, acne, sleep problems, fatigue. Ive been barely able to work for almost a year now, says Jennifer, an ADDitude reader in California. I begged my doctor for HRT, but they wont prescribe it since Im not technically in menopause yet. They put me back on the pill to see if that would help, but it didnt help at all with any of my current symptoms and gave me terrible cramps and made me feel crappy the whole time.

I am really glad to be on estrogen HRT because it is preventing the double-whammy of menopause and ADHD, at least for now, says Jaime, an ADDitude reader in North Carolina.

I have recently started on hormones for women in (peri)menopause, and the horrendous brain fog Ive been dealing with for the past 18 months has lifted a great deal, says Isabella, an ADDitude reader in the Netherlands.

I am postmenopausal, and take estrogen replacement daily, says Amy, an ADDitude reader in Michigan. I think my ADHD is worse on days that I miss my dose of estrogen.

Given the known relationship between fluctuating hormones and ADHD symptoms, researchers must explore how we can safely employ HC and HRT to ameliorate both mood and cognitive symptoms.

Given the increased risk of depression in women with ADHD, which may be further increased by oral HC use, future clinical trials on contraception need to include women with mental health problems, including ADHD, to guide prescribers on the best available choices for these women, write the authors of the JAACP study.

In medicine, women are still understudied because they are considered less reliable research subjects than men, due to hormonal changes during the lifespan, explains Kooij in Hormonal Sensitivity of Mood Symptoms in Women with ADHD Across the Lifespan.8 Women with ADHD have been even more understudied, while exactly their hormonal mood changes and increased severity of ADHD urgently need our research attention.

Females with ADHD are usually excluded from studies on contraceptive effectiveness and tolerability, Skoglund explains. As contraception is a burden for women to carry due to male methods being less effective, lack of knowledge on how different contraceptives affect women with ADHD may create an undue burden.

Intro: Top 10 Research Priorities

1 Eng, A.G., Nirjar, U., Elkins, A.R., Sizemore, Y.J., Monticello, K.N., Petersen, M.K., Miller, S.A., Barone, J., Eisenlohr-Moul, T.A., & Martel, M.M. (2024). Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Hormones and Behavior, 158(105466). ISSN 0018-506X. https://doi.org/10.1016/j.yhbeh.2023.105466

2 Lundin, C., Wikman, A., Wikman, P., Kallner, H. K., Sundstrm-Poromaa, I., & Skoglund, C. (2023). Hormonal Contraceptive Use and Risk of Depression Among Young Women With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 62(6), 665674. https://doi.org/10.1016/j.jaac.2022.07.847)

3 Langer, R. D., Hodis, H. N., Lobo, R. A., & Allison, M. A. (2021). Hormone replacement therapy where are we now?. Climacteric : The Journal of the International Menopause Society, 24(1), 310. https://doi.org/10.1080/13697137.2020.1851183

4 Camara, Bettina, et al. Relationship between sex hormones, reproductive stages and ADHD: a systematic review. Archives of Womens Mental Health, vol. 25, no. 1, Feb. 2022, pp. 1+. Gale OneFile: Health and Medicine

5 Ali SA, Begum T, Reza F. Hormonal Influences on Cognitive Function. Malays J Med Sci. 2018 Jul;25(4):31-41. doi: 10.21315/mjms2018.25.4.3. Epub 2018 Aug 30. PMID: 30914845; PMCID: PMC6422548.

6 Skoglund C., Kopp Kallner H.,,Skalkidou A. et al. Association of attention-deficit/hyperactivity disorder with teenage birth among women and girls in Sweden. JAMA Netw Open. 2019; 2e1912463 https://doi.org/10.1001/jamanetworkopen.2019.12463

7 Lindh I., Hognert H., Milsom I. The changing pattern of contraceptive use and pregnancies in four generations of young women. Acta Obstet Gynecol Scand. 2016; 95: 1264-1272 https://doi.org/10.1111/aogs.13003

8 Kooij JS. Hormonal sensitivity of mood symptoms in women with ADHD across the lifespan. Eur Psychiatry. 2023 Jul 19;66(Suppl 1):S23. doi: 10.1192/j.eurpsy.2023.92. PMCID: PMC10417850.

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HRT, Birth Control Pill for ADHD Women: Hormone Replacement Therapy Info - ADDitude magazine

Health & Wellness

May 2, 2024

Hormone therapy is a treatment that uses medications containing hormones like estrogen or progesterone to replace those the body stops producing during menopause. It can be a powerful tool for managing menopausal symptoms.

"While hormone therapy can significantly improve quality of life and overall health for many women, its not a one-size-fits-all solution," says Dr. Taryn Smith, a Mayo Clinic internist and womens health specialist.

She emphasizes the importance of a personalized medicine approach to hormone therapy, allowing healthcare providers to consider your health and potential risks.

Having discussions around menopause is important because it's often not a topic that is openly discussed or acknowledged, despite its significance and importance, she says. Menopause is a natural biological process, marking the time that a woman ends her menstrual cycle. It's diagnosed after a woman goes 12 months without a menstrual period.

"Many women dont know how to navigate menopause and the symptoms that come along with it, such as hot flashes and night sweats. Hormone therapy is used to manage many of these symptoms," says Dr. Smith. "But it's not for everybody."

Watch: Dr. Taryn Smith talks about hormone replacement therapy

Journalists: Broadcast-quality sound bites with Dr. Smith are available in the downloads at the bottom of the posts. Name super/CG: Taryn Smith, M.D./Internal Medicine/Mayo Clinic

Menopause symptoms and hormone therapy Hormone therapy is used to manage symptoms of menopause, such as hot flashes, night sweats, trouble sleeping, and irritability.

"For the average healthy woman, these options are very safe. But if there are any concerns about these risk factors, its best to consult your physician or your womens health specialist," she says.

Treatment options Hormone therapy is a prescribed medication that can come in different forms, including patches, gels, sprays and oral medications.

Those options may include "A patch you wear on the skin, almost like a bandage in the lower groin or over the buttocks. We have gels that you can rub into the inner thigh and sprays that can be sprayed on the forearm. We also have some oral options. With all the options available, typically, we can find a good option that meets the average woman's needs," says Dr. Smith.

Expected outcomes After starting hormone therapy, women can expect relief from symptoms. In many cases, hot flashes can be completely resolved, improving the womans quality of life.

"Often, we're able to completely resolve hot flashes. But if we cannot completely resolve them, we hope to get significant relief at least and help a woman restore her quality of life," she says.

Safety concerns While there are safety concerns associated with hormone therapy, such as potential risks of breast cancer, stroke, or heart disease, it is generally safe for the average woman who is close to the menopause transition and younger than 60.

"For the average healthy woman, these options are very safe. But if there are any concerns about these risk factors, it's best to consult your physician or your women's health specialist," says Dr Smith.

For those who are unable to take hormone therapy or choose not to, there are FDA-approved nonhormonal treatments for menopause symptoms. Talk with your healthcare team to find out what is the best option.

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Hormone therapy: Four things a Mayo Clinic women's health specialist wants you to know - Mayo Clinic

Hormone therapys benefits to treat menopausal symptoms outweigh the risks for women under 60. And its safer than previously thought, according to a new study published in JAMA, the journal of the American Medical Association. But the use of menopausal hormone therapy is not recommended to prevent heart disease, stroke, dementia or other chronic illnesses. It doesnt reduce those risks.

The study says roughly 55 million women in the U.S. and 1.1 billion worldwide are postmenopausal. A national coalition of researchers launched the Womens Health Initiative, which is the biggest study of womens health in the country, enrolling 161,808 postmenopausal women ages 50 to 79, to inform clinical practices around aspects of health impacting older women. Recruitment for the study began in 1993 and each participant was followed for up to 20 years.

For years, it was believed that hormone replacement therapy lowered the risk of heart disease, stroke, dementia, chronic disease and even death. But as United Press International reported, one of the Womens Health Initiatives clinical trials slammed the brakes on hormone replacement therapy in 2002, however, reporting that women taking combination (estrogen and progestin) hormone therapy had an increased risk for breast cancer, heart disease, stroke and blood clots.

But they continued to study the issue, as the popularity of hormone replacement therapy dropped and many doctors stopped prescribing it. The article said that a more nuanced picture of hormone therapys risks and benefits has emerged as the research continued.

The article said that research over time has continued to show that hormone therapy doesnt solve age-related risks like heart disease or hip replacements, which other early studies suggested. But its not as risky as believed for younger women bothered by symptoms as they approach menopause. And in menopause, hormone replacement therapy can offer relief from those symptoms. .

Per NPR, Most significantly, there are now different types of hormones delivered at lower doses that are shown to be safer.

Women should know that hormone therapy is safe and beneficial, Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, told NPR.

The same studys findings do not support routinely recommending women take calcium plus vitamin D supplements to prevent fractures, but these supplements are appropriate to fill nutritional gaps for women who dont get enough of those nutrients through their diet, the researchers said.

They also noted that a low-fat dietary pattern with increased intake of fruits, vegetables and grains did not prevent breast or colorectal cancer, but was associated with lower rates of death from breast cancer in long-term follow-up, offering an option for women seeking to reduce this risk, Dr. JoAnn Manson, chief of Preventive Medicine at Brigham and Womens Hospital and first author of the new report in JAMA, said in a news release. Women also have more options for treatment now, including estrogen in lower doses and delivered through the skin as a patch or gel, which may further reduce risks; non-hormonal treatments are also available.

The Mayo Clinic News Network talked with Dr. Taryn Smith, one of Mayos internists and womens health specialists, about the value of a personalized approach to medicine when it comes to hormone replacement therapy. Smith offered four things women should know:

More here:
For women under 60, no reason to fear hormone replacement therapy - Deseret News

Back in 2003, preliminary

But the findings of the study were later debunked, and other researchers discovered that the original study looked at women who were 65 and up who already had a greater risk of heart attack, stroke, blood clots, and more, which ended up skewing the data. The study also didnt factor in how old the women were when they started hormone therapy, which further muddled the results.

Now, a longitudinal follow-up to the Womens Health Intitiative (WHI) study is out in JAMAand the findings suggest that women in menopause are just fine to take hormone therapy.

The WHI findings should never be used as a reason to deny hormone therapy to women in early menopause with bothersome menopausal symptoms, lead study author JoAnn E. Manson, M.D., chief of the division of preventive medicine at Brigham and Womens Hospital and the Michael and Lee Bell Professor of Womens Health at Harvard Medical School, said in a press release. Many women are good candidates for treatment and, in shared decision making with their clinicians, should be able to receive appropriate and personalized healthcare for their needs.

Dr. Mason also noted that women have more options for treatment now, including receiving estrogen in lower doses and delivered through the skin as a patch or gel which may further reduce risks.

But the study findings stop short of saying that hormone therapy will help with health issues associated with menopause, like bone loss, dementia, and heart disease, although other studies have found it may be helpful. Thats caused several doctors who treat women in menopause to be frustrated. Heres what you need to know.

The new study looked at long-term follow-up data of up to 20 years from the Womens Health Initiative. It found that women below the age of 60 had lower rates of adverse events and a more favorable benefit-to-risk ratio of hormone therapy than women in later menopause. Meaning, they got more out of doing hormone therapy than not taking it.

The study results found that women in early menopause had less moderate-to-severe hot flashes, night sweats, and other symptoms of menopause when they were on hormone therapy. However, they concluded that hormone therapy should not be used to prevent heart disease, stroke, dementia, or other chronic diseases.

The study also looked at calcium and vitamin D supplements, concluding that these should not be recommended to prevent fractures in all postmenopausal women. However, researchers also found that calcium and vitamin D supplements may be helpful to fill in nutritional gaps for women who dont get enough in their diet.

The researchers also concluded that a low-fat diet with more fruits, vegetables, and grains didnt reduce the risk of being diagnosed with breast or colorectal cancer, but it was linked with a lower risk of dying from breast cancer.

Hormone therapy and hormone replacement therapy are terms that are usually used interchangeably. Both terms are used to describe a medical treatment that may help relieve the symptoms of menopause and perimenopause (the period before menopause), according to the American College of Obstetricians and Gynecologists (ACOG). This can also be referred to as menopausal hormone therapy.

The Menopause Society uses the term hormone therapy to acknowledge that were not trying to replace pre-menopause levels of hormones, says Lauren Streicher, M.D., a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. But hormone replacement therapy is a term that most women are familiar with. Doctors will often use the term menopausal hormone therapy when discussing this topic, though, Dr. Streicher says.

You could make an argument that hormone therapy applies to treatments like estrogen vaginal cream for vaginal dryness that has no systemic benefits, but theyre usually used interchangeably, says G. Thomas Ruiz, M.D., lead ob/gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.

There are mixed emotions about this study. This is really not astonishingly new information, says Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary. We know from previous studies that hormone therapy is quite safe in women proximate to menopause and that indeed it is the most effective intervention for women suffering from many menopausal symptoms.

But, despite its benefits, many women are scared of the idea of taking hormone therapy given the findings of the original Womens Health Initiative study. This study can help with reassuring women that hormone replacement therapy is, in fact, beneficial, says womens health expert Jessica Shepherd, M.D., an ob/gyn in Texas and author of the upcoming book on menopause, Generation M. However, there needs to be a more demonstrative approach to show the benefits and how to use hormone replacement therapy preventatively.

But some doctors are frustrated with these findings. Saying that this study should never be used as a reason to deny hormone therapy? Guess what? Thats exactly what the effects of the original study were, Dr. Ruiz says.

Dr. Streicher calls the study infuriating, adding, theyre taking data that was poorly designed and flawed in the first place and are commenting on it.

Dr. Streicher also says the conclusion that hormone therapy shouldnt be used to lower the risk of heart disease and breast cancer is tricky, given that other studies have found hormone therapy can be a helpful tool for lowering risk. Dr. Minkin agrees.

The one major anxiety of American women is breast cancer, she says. Even in the initial WHI studies, the group of women who were taking estrogen alone never showed any increased risk of breast cancer on estrogen alone; indeed they showed a reduced risk of breast cancer. And followup long-term studies on estrogen plus progestin showed no increases in mortality from estrogen and progestin. So, we have very good documentation of safety.

For prevention, we do know that estrogen therapy is protective against developing osteoporosis, Dr. Minkin says. We also know that for very young women, particularly those under the age of 45 who were not studied in the WHI studythat looked exclusively at women over 50that estrogen therapy is vital to help protect those very young women against heart disease and dementia, she says. But that data is not addressed in this particular study because the Womens Health Initiative study only looked at women over the age of 50, Dr. Minkin says.

What to do if youre interested in hormone therapy for menopause

There is still a lot of misinformation tied to the original Womens Health Initiative study, and some doctors are not up to speed on current data surrounding the benefits of hormone therapy, Dr. Ruiz says.

Thats why he and other ob/gyns recommend seeing a specialist if youre interested in taking hormone therapy for menopause. See someone who knows what they are talking about and understands the data, Dr. Streicher says. They should be able to help you find the right treatment based on your personal circumstances and goals.

Its up to patients and their healthcare providers to determine if HRT is right for them. Dr. Manson tells Prevention that the follow-up WHI study was designed to provide clarification to healthcare providers on the use of hormone therapy in menopausal women. Ive heard from women across the country saying that theyre having trouble finding someone who will still prescribe hormone therapy, she says. Were saying very clearly from the WHI investigators who know the trials extremely well that these findings should not be used as a reason to deny hormone therapy to women seeking treatment of bothersome menopausal symptoms.

Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Mens Health, Womens Health, Self, Glamour, and more. She has a masters degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.

Read more:
Study: Hormone Replacement Therapy Helps Menopause Symptoms - Prevention Magazine

Nothing will have you Googling HRT therapy faster than your first hot flash.Hormone Replacement Therapy, or HRT, can be a lifesaver for many women navigating the challenges of menopause. It helps ease those sneaky hot flashes, stabilizes wild mood swings, and can even mitigate some of the physical changes that come with the change. Yet with all the options available, deciding on the right path can feel daunting. While HRT offers various treatment methods, each comes with its own set of risks and benefits.

One of the biggest concerns surrounding HRT is the potential for side effects and health risks. These can range from minor irritations to more severe complications, depending on the delivery method and individual health factors. The risks of taking hormone therapy differ for each individual, says Cincinnati, OH OB/GYN Somi Javaid, MD. Factors like the type, dose, duration of use, route of administration, and timing of initiation all play a role in determining safety and effectiveness.

Hormone therapy can be delivered systemically, affecting the entire body, or locally, targeting specific areas. According to Dr. Javaid, systemic therapy is usually aimed at addressing broader menopausal symptoms, while local therapy targets specific issues like vaginal dryness. Systemic therapy can be delivered orally or via transdermal patches, gels, sprays, or pellets, she explains.

Oral tablets are the simplest method, but Dr. Javaid warns about higher risks like blood clots and vascular events associated with this form of delivery. Transdermal patches, on the other hand, provide a consistent hormone release and are generally considered safer due to a reduced risk of clotting issues, she notes.

Hormone gels and sprays are another option you can apply directly to the skin. These allow for more precise dosing says Dr. Javaid, but cautions, They require careful application to avoid unintentional transference to others.

Implants or pellets, which are inserted under the skin, offer a steady hormone release over several months. However, Duxbury, MA plastic surgeon Christine DiEdwardo, MD points out that Dosage adjustments with pellets can be challenging since once a pellet is placed, it cannot be easily removed.

Each HRT delivery method has its pluses and minuses.Willowbrook, IL dermatologistJessie Cheung, MDnotes the convenience and flexibility of some: The advantage of oral and topical therapies is that you can quickly adjust the dosing, as most are taken daily and patches are applied every few days. However, this flexibility can come at a cost. The disadvantage with pellets is that most pellet procedures are done every three to six months. So dosing cant be adjusted easily. There also some soreness for a few days after, Dr. Cheung explains.

Pellets can be convenient due to their long-lasting nature, but they do require a minor surgical procedure for insertion. For many patients, the convenience of pellets outweighs the inconvenience of a 5-minute, in-office procedure, says Dr. Cheung.

However, Lauren Streicher, MD,clinical professorofobstetricsandgynecologyatNorthwestern Universitys Feinberg SchoolofMedicine says the cons of pellets are many. Pellets are not FDA approved and not recommended by most academic menopause experts, she explains. Every single professional society, including ACOG and The Menopause society has a very clear statement saying that pellets are unregulated, result in dangerously high levels of hormones and are associated with bleeding, uterine pre-cancer, cancer increased rates of hysterectomy and other side effects.

Conversely, creams offer quick adjustments in dosage but can be messy and require daily application. Creams can transfer to clothing or be passed to others and theres variable absorption, adds Dr. DiEdwardo.

The pros of transdermalestrogenin the form of patches, creams, gels and sprays: since they are not metabolized by the liver and unlike oral estrogen, do not increase the risk of blood clots or gallbladder disease, notes Dr. Streicher.Dr. Javaid adds that one thing to consider with patches is they might not be ideal for individuals who have adverse reactions to adhesives or those who dont want others to know theyre using HRT.

The best form of HRT is one that the patient is comfortable with and compliant in using, Dr. Cheung says. The choice is influenced by several factors, including health history, lifestyle and specific symptoms. Dr. Javaid advises considering your health history and any medications youre currently taking. The risks of taking hormone therapy differ for each individual, depending on type, dose, duration of use, route of administration and timing of initiation, she adds.

Patients should also consider their daily routines and personal preferences. Dr. Cheung mentions that some patients grow weary of applying creams twice a day, while others find pellet insertion procedures uncomfortable.

Discuss your options with your healthcare provider to determine which method aligns best with your needs and lifestyle, says Dr. Javaid.

There have been shown to be benefits of HRT, however there are also potential risks and contraindications to hormone therapy. Therefore factors that are evaluated prior to HRT include underlying medial history and risk of certain diseases, like cancer, heart disease, stroke, and blood clots, age at the start of hormone therapy, type and route of administration, dosage and how long you are on the medication, notes Dr. DiEdwardo. A thorough medical and family history, discussion of symptoms, physical exam and extensive testing are part of the evaluation prior to initiating HRT.

Read this article:
Pellets, Patches, Sprays and Creams: All the Ways to Get Hormone Replacement Therapy - NewBeauty Magazine

A long-awaited final report on the state of treatment for gender dysphoria in children and teens under the care of Englands National Health Service (NHS) has revealed the current clinical approach utilizing puberty blockers and cross-sex hormones is based on remarkably weak evidence stemming from poor quality of the published studies, and misinformation while exhibiting expectations of care that are far from usual clinical practice.

In the foreword to the report, British pediatrician Dr. Hilary Cass, who led an independent review team from the University of York, wrote that while the medical field is usually cautious in recommending new treatments for children and teens, quite the reverse happened in the field of gender care for children:

This is an area of remarkably weak evidence, and yet results of studies are exaggerated or misrepresented by people on all sides of the debate to support their viewpoint. The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.

[T]he toxicity of the debate is exceptional, Cass said about the issue of medical gender treatments for children. The knowledge and expertise of experienced clinicians who have reached different conclusions about the best approach to care are sometimes dismissed and invalidated.

The reports summary clearly asserts that, while some think the clinical approach should be based on a social justice model, the NHS works in an evidence-based way.

Our current understanding of the long-term health impacts of hormone interventions is limited, the review notes as it also acknowledges the rapid surge in referrals for such medical treatment.

The numbers of children and young people presenting to the UK NHS Gender Identity Service (GIDS) has been increasing year on year since 2009, with an exponential rise in 2014, the report observes, noting the use of puberty blockers began following the emergence of the Dutch Protocol.

The review team stressed the rapid push to utilize puberty blockers, despite any evidence showing effectiveness:

Preliminary results from the early intervention study in 2015-2016 did not demonstrate benefit. The results of the study were not formally published until 2020, at which time it showed there was a lack of any positive measurable outcomes. Despite this, from 2014 puberty blockers moved from a research-only protocol to being available in routine clinical practice and were given to a broader group of patients who would not have met the inclusion criteria of the original protocol.

The systematic review by the University of York found multiple studies that show puberty blockers not only suppress puberty, but also compromise bone density.

Yet, evidence regarding the use of puberty blockers and cross-sex hormones to treat gender dysphoria had already been shown to be weak, with a lot of misinformation easily accessible online and remaining currently, the review stated.

The World Professional Association of Transgender Healthcare (WPATH) has been highly influential in directing international practice, although its guidelines were found by the University of York appraisal process to lack developmental rigour, the report asserts.

In March, leaked internal files from WPATH, often touted by Dr. Rachel (born Richard) Levine, a top Biden HHS official, as the premier organization for evidence-based treatment recommendations, revealed its doctors acknowledging children and teens were not capable of comprehending the possible long-term effects of the treatments and surgeries they were prescribed.

The review team notes that while research suggests gender expression is influenced by biological predisposition, early childhood experiences, sexuality and expectations of puberty, and, therefore, requires a multi-disciplinary team approach to assessing the problem areas for each individual child, the most striking problem is the lack of any consensus on the purpose of the assessment process.

Some service users and advocates view an extensive exploration of other conditions and diagnoses as an attempt to find any other reason for the persons distress other than them being trans, the team observes.

While the report states there are some young people for whom medical treatment for gender dysphoria will be the best outcome, it notes as well young adults looking back at their younger selves would often advise slowing down as they and their parents weigh the ramifications.

Some may transition and then de/retransition and/or experience regret, the review acknowledges, concluding a medical pathway is not the best treatment protocol for the majority of young people:

[T]he focus on the use of puberty blockers for managing gender-related distress has overshadowed the possibility that other evidence-based treatments may be more effective. The intent of psychosocial intervention is not to change the persons perception of who they are, but to work with them to explore their concerns and experiences and help alleviate their distress regardless of whether or not the young person subsequently proceeds on a medical pathway.

[N]o changes in gender dysphoria or body satisfaction were demonstrated as a result of puberty blockers, the report plainly asserts.

The review team also addressed the controversy over social transition what has become known as the initial phase of so-called gender-affirming care.

The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence, the report concludes. However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.

Reviewers similarly found no support for the claim by transgender activists that administering puberty blockers allows time for children and their families to consider further medical intervention:

[G]iven that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/ feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.

There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow-up, the review team explains.

In addition, reviewers found no evidence to support the transition or die claim that hormone treatment prevents a high risk of suicide in minors with gender dysphoria.

>> FINNISH STUDY: GENDER-AFFIRMING CARE DOES NOT REDUCE YOUTH SUICIDE <<

The primary predictor of death in gender-dysphoric young people is psychiatric morbidity, the researchers said. Medical gender reassignment does not have an impact on suicide risk.

The current evidence base suggests that children who present with gender incongruence at a young age are most likely to desist before puberty, although for a small number the incongruence will persist, the Cass report concludes.

This final report stresses the need for a holistic assessment of children and teens referred for gender services:

This should include screening for neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment.

Standard evidence based psychological and psychopharmacological treatment approaches should be used to support the management of the associated distress and cooccurring conditions, the team recommends. This should include support for parents/carers and siblings as appropriate.

The release of the Cass report comes only days after Dignitas Infinita on Human Dignity, the most recent document from the Dicastery for the Doctrine of the Faith (DDF), was issued.

The DDF declaration addresses human dignity and reaffirms traditional teachings of the Church, including those on gender ideology and sex-change surgery.

>> READ CVS ANALYSIS OF DIGNITAS INFINITA HERE <<

More:
Report Cites 'Misinformation,' 'Remarkably Weak' Evidence to Support Use of Puberty Blockers and Cross-Sex ... - CatholicVote org

What the public may not be aware of, is that it is relatively common for treatments to be offered in health and mental health, where the research evidence is still emerging and/or limited"

Dr Paul Skirrow, clinical psychologist and neuropsychologist, and strategic advisor at the New Zealand College of Clinical Psychologists, comments:

"We would urge the public to interpret the findings of these reviews with some caution - many people will assume that this research suggests that puberty blockers and hormone treatments should never be offered, which would be mistaken.

The authors ultimately conclude that: No conclusions can be drawn [about the effect of puberty blockers]. This research highlights that we currently do not know how effective these treatments are, or who they are most effective with, but there are many reports of benefit from the people who use them and clinicians who provide them. What research we do have, albeit of limited quality at present, appears to suggest there may be benefits overall, however, we do not currently know who specifically is likely to benefit.

With regard to hormone treatments, the authors do conclude that There is suggestive evidence from mainly pre-post studies that hormone treatment may improve psychological health. However, again, they clearly state that robust research with long-term follow-up is needed.

What the public may not be aware of, is that it is relatively common for treatments to be offered in health and mental health, where the research evidence is still emerging and/or limited. The choice for clinicians is frequently whether to offer nothing - which is unlikely to be helpful - or offer something that we agree can be helpful for some people.

"In doing so, we recommend that the person undergoing these treatments gets the best possible information on what we know about their risks and benefits. For this reason, we very much welcome research studies, such as those released today, which help us fully understand what they may be."

Conflicts of interest statement: I'm not aware of any potential conflicts of interest. My role with the NZCCP involves speaking on behalf of the organisation, specifically the executive leadership team. We have approximately 1800 members, who hold a wide range of views, and so my comments may or may not reflect those of individual members. I also hold a senior lecturer position at Otago University, specialising in neuropsychology.

Link:
Review of evidence for puberty blockers and hormone treatment in youth - New Zealand Doctor Online

Menopause is a natural part of aging that marks the end of the female reproductive years but many people dont know what to expect until theyre in the midst of it. Did you know, for example, that you could experience symptoms up to a decade before menopause actually begins?

Menopause specialistPelin Batur, MD, walks us through the stages of menopause and what you may be able to expect during each one.

The menopause process is all about hormones. Your body begins to produce less of the hormone calledestrogen, which regulates your menstrual cycle, and your ovaries start running low on eggs. But it doesnt happen all at once.

Heres a quick overview of the three stages of menopause:

Dr. Batur explains each stage in greater detail, including the symptoms you might experience andhow to find relief.

You can think about perimenopause as the runway to the big event. It can start as early as a decade before menopause, though the average amount of time spent in perimenopause is four years.

During this time, your body is, little by little, winding down its naturalovulation process. The most common sign of perimenopause isirregular periods and menstrual cycles.

As your estrogen levels start to decrease, your periods and menstrual cycles may start getting a little wonky sometimes, closer together, sometimes skipping cycles, Dr. Batur explains. You may also have some of the typical menopausal symptoms.

Not everyone experiences noticeable symptoms during perimenopause, but they can include:

There are two stages to perimenopause early menopause transition and late menopause transition though theyre not always cut-and-dry and distinguishable from one another.

This first stage of perimenopause is the very beginning when your body is just starting to experience hormonal changes. During this time, your periods and menstrual cycles are still coming regularly, but you may notice other symptoms:

This is a natural phase of life, so if your symptoms are mild, you may be able to make do with lifestyle changes like getting more sleep and upping your cardio, Dr. Batur says. But if theyre really bothersome, speak to your healthcare provider, even if youre still having regular menstrual cycles.

The late menopause transition is when youre gettinga little closer to menopause. Youre more likely to start experiencing irregular periods and menstrual cycles.

During perimenopause, youre not ovulating as regularly, Dr. Batur says. You have up-and-down levels of estrogen, and you may not make progesterone as consistently, so you may skip a menstrual cycle and then have heavy bleeding during the next period because your uterine lining has thickened up from the impact of the estrogen.

Eventually, as you get closer and closer to menopause, you start skipping periods for months at a time, she continues.

If this happens, bring it up with your healthcare provider especially if youre in your early 40s or younger, which can be a sign ofpremature menopauseor a condition calledprimary ovarian insufficiency.

When youve gone a full 12 months without having your period, youve entered menopause (assuming you havent stopped bleeding because of another medical condition or a medication).

That typically happens around age 52, Dr. Batur shares, and then, you live the rest of your life in menopause, where youre no longer ovulating and you no longer have the ability to bear children.

Menopause symptoms typically last for seven to 10 years (though your timeframe may vary), and they can range from mild to severe. If youre in the latter camp, experiencing bothersome symptoms that you just cant shake, dont feel like you have to soldier on in silence.

Just saying, grin and bear it and eat healthier and lose some weight doesnt cut it for people who are really suffering during this time in their lives, Dr. Batur states. Your healthcare provider will also want to make sure that your symptoms arent related to other medical conditions.

Once you enter menopause, youre in menopause for the rest of your life; this is also called the postmenopause stage.

But now, youre at a higher risk for other health concerns. A decrease in estrogen is a risk factor in conditions like:

The older you get, the more tuned in your healthcare provider should be to menopauses impact on your health. But if theyre not bringing it up, you definitely should even if youre feeling fine, but especially if youre not.

The stages of menopause shouldnt make you feel miserable. If your symptoms are especially bothersome and having an impact on your quality of life, its time to ask for help.

Tell your Ob/Gyn or your primary care doctor, Hey listen, I think my hormones are going haywire, Dr. Batur advises. They can talk you through the options, which may include any of the following (or a combination of them):

Just remember: Theres no quick fix for the symptoms of menopause. If you raise concerns about themduring an annual visit, your healthcare provider may ask you to come back for another appointment so the two of you can go more in-depth about what youre experiencing and thats OK.

This is a very individual thing, and it can be very complicated, especially depending on your medical history, Dr. Batur says. Schedule another appointment, if you need it, and make sure your concerns are being addressed during dedicated time with your provider.

See the original post:
What To Expect in Each Stage of Menopause - Health Essentials

The GenderGP Appraisal Pathway

This is a pathway designed by GenderGP which allows you to be in charge of your gender journey.

We believe that you are the expert in your gender, and by offering our expertise in healthcare, we can make sure that your medical transition is suited to what you need and is delivered in the safest way possible.

By going through this process you will be able to provide us with information about you and your health and your gender feelings. This will allow us to come to a joint agreement on the best treatment for you.

If you are in the UK or the EU, we can use our private prescription service. If you are outside the EU then we will carry out any necessary assessments and then issue you with a Treatment Summary for your provider so they can do blood testing and prescribe under our direct supervision.

We will make all the decisions on medication and blood results to keep you safe.

See the rest here:
How much does it cost to use our services - GenderGP

The Care Quality Commission (CQC) has registered Gender Plus Hormone Clinic to provide hormone treatments to 16 and 17-year-old children.

This paves the way for other private clinics to be registered, which would offer controversial medical treatments with lifelong consequences to vulnerable teenagers. The decision of the CQC to license a private clinic, creates a significant risk of a two tier approach, with less protection for those who seek help from the private sector. This further risks undermining the work of the Cass review for NHSE practice.

I want the court to set aside the registration by the CQC of Gender Plus Hormone Clinic to provide hormone treatment for teenagers. I also hope that this litigation will prevent the registration of other private clinics providing this controversial treatment. I want to ensure that those under 18 years old, do not suffer irreversible, lifelong harms both physical and psychological, from taking a controversial hormonal treatment which is not evidenced as safe or effective.

Why I am asking for this Judicial Review

I was in the NHS for nearly 40 years and I am now a psychotherapist in private practice. I have worked with people who present with issues around their gender identity for over 20 years. In my clinical experience of working with children and young people, I have not, to date, encountered a 16 to 17-year-old who I would have assessed to be sufficiently fully informed and psychologically ready to make such a life changing, potentially harmful decision. They are in the process of development from child to adult which involves significant mental and physical adjustments. Many of the young people with gender dysphoria/incongruence have no clear understanding of their underlying motivations to take cross, sex, hormones. However they are usually very aware of the discomfort they experience, and often hold a strong belief that the medication will help them feel better. They hope a change to their physical body will bring about a comfort in their mind. Some also receive strong messages from certain groups that medication is the answer to their difficulties which creates an urgent pressure on them and those around them for a solution. As a result, they are rarely able to give a full, in-depth psychological consideration to the implications and consequences of commencing a physical treatment, which is known to have serious, harmful side-effects, and, as yet has a very low level evidence base for it's efficacy and safety.

Under its current registration by the CQC, Gender Plus Hormone Clinic (GHPC) is not prevented from providing GnRH analogues (blockers) for the purpose of suspending puberty. There are some 16-year-olds who have not reached pubertal maturation. Further, the GPHC has said that it would prescribe puberty blockers alongside oestrogen therapy to achieve feminising effects. The NICE report (National Institute of Clinical Excellence) and the Cass review both state that this treatment model is not proven.

There is also considerable risk of complications due to this powerful medication. There are many known side-effects, including blood clots, gallstones, vaginal atrophy and male pattern baldness for females and potential loss of fertility, amongst many others.

The evidence base

The Cass review was commissioned by the NHS to provide a comprehensive review of the appropriate treatment for children and young people with gender dysphoria. The Cass Review sought advice from the National Institute for Health and Care Excellence (NICE) which conducted two separate evidence reviews.

Neither of them has found sufficient evidence to support the use of either puberty blockers or cross sex hormones as safe and effective.

In her interim report published in February 2022, Dr Cass has emphasised the gaps in the "evidence base regarding hormone treatment" (Para 1.41). Although some of her observations related specifically to puberty blockers, she also addressed cross-sex, hormones, and hormone treatment more generally. She said, among other things:

"The Review is not able to provide definitive advice on the use of puberty blockers and feminising/masculinising hormones at this stage, due to gaps in the evidence base; however, recommendations will be developed as our research programme progresses.

The lack of available high-level evidence was reflected in the recent NICE review into the use of puberty blockers and feminising/masculinising hormones commissioned by NHS England, with the evidence being too inconclusive to form the basis of a policy position(para 5.21)

At present we have the least information for the largest group of patients birth- registered females first presenting in early teens(para 5.11).

Your help:

I need your help to ensure that the registration of GPHC is cancelled and the other private clinics are unable to prescribe this controversial treatment to children under 18. We should not be careless or look away from the potential harms this medical treatment might cause to childrens previously healthy bodies.

Please support me with the legal fees required to mount a judicial review and challenge the CQC decision. I was the original claimant who started the Kiera Bell JR with Mrs A and our application on that occasion was successful in providing further scrutiny and attention in this area of paediatric healthcare. That judicial review potentially helped prevent irreversible harms to much younger children too as it led to a much wider scrutiny of the model of treatment in the GIDS.

I have assembled an expert legal team and will be lodging my claim with the High Court in the next few days. Please join me in seeking to protect vulnerable young people and share this crowdfunder link. I know these cases keep coming but we need to protect the next generation.

My X (twitter) handle is @sueevansprotect

Thank you very much.

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PROTECT TEENAGERS FROM HARMFUL AND IRREVERSIBLE MEDICAL TREATMENT - CrowdJustice

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Stephanie Donovan is the absolute best at what she does. She takes her time to review your labs and to talk about any aesthetic procedures in detail so that you feel completely comfortable with what your goal is. Shes knowledgeable about the latest technology and knows how to customize the right solution just for you. I trust my face, lips, and everything with her!

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Everyone should get their levels checked at one or more points in life to optimize our health and general feeling of wellness and this is a great place to do it! The initial consult was very attentive and detailed. Stephanie spent a lot of time explaining my results so that I felt confident in the drivers of my symptoms and next steps I needed to take. Definitely recommend. 🙂

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I went today to have a pellet as Im visiting from out of town and it was time. I was nervous because it was my first time here and I wanted to make sure it would be pain-free. Stephanie was fantastic. Put my mind at ease. It was not painful at all and she was wonderful to deal with!

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Home - CHS Hormone

My teenage son was indoctrinated by the trans cult from the classroom to the clinic: Mother left 'grieving' fo  Daily Mail

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My teenage son was indoctrinated by the trans cult from the classroom to the clinic: Mother left 'grieving' fo - Daily Mail

The adrenal glands are part of what is called the HPA (hypothalamic-pituitary-adrenal) axis, which controls how your body reacts to stress. When faced with a stressful situation, your adrenal glands release a cascade of hormones, including adrenaline, DHEA, and cortisol as part of your fight-or-flight response. Once the threat has passed, your body processes normalizeyour heartbeat and breathing slow to their usual rate, your muscles relax, and your adrenals turn off production of those hormones until they are needed again.

In cases where stress becomes chronic, there can be a seemingly constant flow of stress hormones, that in turn, overwhelm your body and contribute to brain health/mental health issues. Chronically high cortisol levels also cause your blood sugar and insulin levels to spike. This can lead to harmful changes in the brain, including a drop in the calming neurotransmitter serotonin. High levels of cortisol are linked to mental health conditions, such as anxiety, depression, and PTSD.

In the brain, chronic stress produces more white matter and fewer neurons (gray matter) than normal, skewing their balance and disrupting communication within the brain.

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Hormone Evaluation and Replacement Therapy | Amen Clinics

Depression can hit hard during the winter months, here's how to prevent it  NewsCenterMaine.com WCSH-WLBZ

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Depression can hit hard during the winter months, here's how to prevent it - NewsCenterMaine.com WCSH-WLBZ

As a study finds a stable weight is key to living longer, a leading nutritionist's guide on how to... Escape t  Daily Mail

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As a study finds a stable weight is key to living longer, a leading nutritionist's guide on how to... Escape t - Daily Mail

I worked at the Tavistock gender clinic. Closing it was the right move  The Dallas Morning News

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I worked at the Tavistock gender clinic. Closing it was the right move - The Dallas Morning News

What causes hormonal imbalance and how to avoid it?  GMA News Online

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What causes hormonal imbalance and how to avoid it? - GMA News Online

Your body controls your thyroid hormone (T3 and T4) levels through a complex feedback loop. Your hypothalamus releases thyrotropin-releasing hormone (TRH), which triggers your pituitary gland to release thyroid-stimulating hormone (TSH), which stimulates your thyroid to release T3 and T4.What is thyroid hormone?

Thyroid hormone is the hormone thats mainly responsible for controlling the speed of your bodys metabolism. In infants, thyroid hormone is critical for brain development. Your thyroid, a small, butterfly-shaped gland located at the front of your neck under your skin, makes and releases thyroid hormone. Its a part of your endocrine system.

Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, muscles and other tissues. These signals tell your body what to do and when to do it.

Metabolism is the complex process of how your body transforms the food you consume into energy. All of the cells in your body need energy to function.

Thyroid hormone actually represents the combination of the two main hormones that your thyroid gland releases: thyroxine (T4) and triiodothyronine (T3). Theyre often collectively referred to as thyroid hormone because T4 is largely inactive, meaning it doesnt impact your cells, whereas T3 is active. Once your thyroid releases T4, certain organs in your body transform it into T3 so that it can impact your cells and your metabolism.

Your thyroid also releases a hormone called calcitonin to help regulate calcium levels in your blood by decreasing it. Calcitonin isnt grouped into the thyroid hormone name, and it doesnt impact your bodys metabolism like T3 and T4 do.

The production and release of thyroid hormone thyroxine (t4) and triiodothyronine (T3) is controlled by a feedback loop system that involves the following:

Your hypothalamus is the part of your brain that controls functions like blood pressure, heart rate, body temperature and digestion.

Your pituitary gland is a small, pea-sized gland located at the base of your brain below your hypothalamus. It makes and releases eight hormones.

Your pituitary gland is connected to your hypothalamus through a stalk of blood vessels and nerves. This is called the pituitary stalk. Through the stalk, your hypothalamus communicates with your pituitary gland and tells it to release certain hormones.

To start the feedback loop, your hypothalamus releases thyroid-releasing hormone (TRH) which, in turn, stimulates your pituitary gland to produce and release thyroid-stimulating hormone (TSH). TSH then triggers your thyroid to produce T4 and T3. Of the total amount of hormones that TSH triggers your thyroid to release, about 80% is T4 and 20% is T3. Your thyroid also needs adequate amounts of iodine, a substance you get from the food you eat, to create T4 and T3.

This hormone chain reaction is regulated by a feedback loop so that when the levels of T3 and T4 increase, they prevent the release of TRH (and thus TSH). When T3 and T4 levels drop, the feedback loop starts again. This system allows your body to maintain a constant level of thyroid hormones in your body.

If there are any issues with your hypothalamus, pituitary gland or thyroid, it can result in an imbalance in the hormones involved in this system, including T3 and T4.

Once your thyroid releases thyroxine (T4) into your bloodstream, certain cells in your body transform it into triiodothyronine (T3) through a process called de-iodination. This is because cells that have receptors that receive the effect of thyroid hormone are better able to use T3 than T4. Therefore, T4 is generally considered to be the inactive form of thyroid hormone, and T3 is considered the active form of it.

Cells in the following tissues, glands, organs and body systems can convert T4 to T3:

Thyroid hormone (T3 and T4) affects every cell and all the organs in your body by:

Several blood tests can measure your thyroid levels and assess how well your thyroid is working. These tests are often called thyroid function tests and include:

Your provider may order additional tests to assess your thyroid function, including:

Several conditions can result from or cause abnormal thyroid hormone levels. Thyroid disease is very common, with an estimated 20 million people in the United States having some type of thyroid condition. A person assigned female at birth is about five to eight times more likely to have a thyroid condition than a person assigned male at birth.

Thyroid conditions include:

Issues with your pituitary gland or hypothalamus can also cause abnormal thyroid hormone levels since they help control thyroid hormone levels.

Abnormal thyroid hormone levels usually cause noticeable symptoms. Since thyroid hormone is responsible for controlling the speed of your metabolism, too much thyroid hormone can make it faster than normal and too little thyroid hormone can slow it down. These imbalances cause certain symptoms, including:

If you experience these symptoms, contact your healthcare provider. They can run some simple blood tests to see if your thyroid hormone levels are irregular.

A note from Cleveland Clinic

Thyroid hormone is an essential hormone that affects many aspects of your body. Sometimes, you can have too little or too much thyroid hormone. The good news is that thyroid conditions are highly treatable. If youre experiencing any thyroid hormone-related symptoms or want to know if you have any risk factors for developing thyroid disease, dont be afraid to talk to your healthcare provider. Theyre there to help you.

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Thyroid Hormone: What It Is & Function - Cleveland Clinic

Overview

Menopause is the time that marks the end of your menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States.

Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

Signs and symptoms, including changes in menstruation can vary among women. Most likely, you'll experience some irregularity in your periods before they end.

Skipping periods during perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you've skipped a period but aren't sure you've started the menopausal transition, consider a pregnancy test.

Keep up with regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.

Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your doctor might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams.

Always seek medical advice if you have bleeding from your vagina after menopause.

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Menopause can result from:

Naturally declining reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone the hormones that regulate menstruation and your fertility declines.

In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually on average, by age 51 your ovaries stop releasing eggs, and you have no more periods.

Surgery that removes the ovaries (oophorectomy). Your ovaries produce hormones, including estrogen and progesterone, that regulate the menstrual cycle. Surgery to remove your ovaries causes immediate menopause. Your periods stop, and you're likely to have hot flashes and experience other menopausal signs and symptoms. Signs and symptoms can be severe, as hormonal changes occur abruptly rather than gradually over several years.

Surgery that removes your uterus but not your ovaries (hysterectomy) usually doesn't cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.

After menopause, your risk of certain medical conditions increases. Examples include:

Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often.

Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal estrogen may help relieve symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes that can result in urinary incontinence.

Sexual function. Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Also, decreased sensation may reduce your desire for sexual activity (libido).

Water-based vaginal moisturizers and lubricants may help. If a vaginal lubricant isn't enough, many women benefit from the use of local vaginal estrogen treatment, available as a vaginal cream, tablet or ring.

Dec. 17, 2022

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Menopause - Symptoms and causes - Mayo Clinic