Soon after starting medical school, my periods had stopped. Further evaluation led to a diagnosis of hypothalamic amenorrhea, a form of infertility in which insufficient hormones for ovulation are produced. I had always thought of having children, but years down the road, in my 30s, with an established career. At that time I was 27, going to school more than 300 miles away from my husband. Starting a family was not at the top of my mind.
Tag: hormones
BPA substitute could spell trouble for hormones
A few years ago, manufacturers of water bottles, food containers, and baby products had a big problem.
A key ingredient of the plastics they used to make their merchandise, an organic compound called bisphenol A, had been linked by scientists to diabetes, asthma and cancer and altered prostate and neurological development. The FDA and state legislatures were considering action to restrict BPA’s use, and the public was pressuring retailers to remove BPA-containing items from their shelves.
The industry responded by creating “BPA-free” products, which were made from plastic containing a compound called bisphenol S. In addition to having similar names, BPA and BPS share a similar structure and versatility: BPS is now known to be used in everything from currency to thermal receipt paper, and widespread human exposure to BPS was confirmed in a 2012 analysis of urine samples taken in the U.S., Japan, China and five other Asian countries. Read full article.
ASRM Statement on New Study on Hormone Therapy for Menopausal Women
In the WHI study, women were in their 60´s when they began taking hormones, in this study, the average age of the women was only 50 when they first began using HT. This study much more closely resembles the use of HT in clinical practice. Data from WHI in women aged 50-59 also showed that women receiving estrogen alone had a significantly reduced rate of CVD and a reduced mortality in the 11 year follow-up.
Jury to Decide if Hormone Therapy Caused Utah Woman’s Breast Cancer
More than eight years after alleging hormone therapy drugs caused and promoted her breast cancer, Toshiko Okuda is finally getting her day in court.
Okuda was among dozens of Utah women — and thousands nationwide — who filed federal civil lawsuits against Wyeth and other drug manufacturers after researchers halted a National Institutes of Health sponsored study in 2002 upon finding an increased risk of invasive breast cancer among those using hormone replacement drugs. Her lawsuit, along with 68 others filed in Utah, was initially transferred to the Eastern District of Arkansas; three were remanded back to Utah’s district court in April 2010. Read full article.
Testing What We Think We Know
BY 1990, many doctors were recommending hormone replacement therapy to healthy middle-aged women and P.S.A. screening for prostate cancer to older men. Both interventions had become standard medical practice.
But in 2002, a randomized trial showed that preventive hormone replacement caused more problems (more heart disease and breast cancer) than it solved (fewer hip fractures and colon cancer). Then, in 2009, trials showed that P.S.A. screening led to many unnecessary surgeries and had a dubious effect on prostate cancer deaths.
How would you have felt — after over a decade of following your doctor’s advice — to learn that high-quality randomized trials of these standard practices had only just been completed? And that they showed that both did more harm than good? Justifiably furious, I’d say. Because these practices affected millions of Americans, they are locked in a tight competition for the greatest medical error on record.
The problem goes far beyond these two. The truth is that for a large part of medical practice, we don’t know what works. But we pay for it anyway. Our annual per capita health care expenditure is now over $8,000. Many countries pay half that — and enjoy similar, often better, outcomes. Isn’t it time to learn which practices, in fact, improve our health, and which ones don’t?
To find out, we need more medical research. But not just any kind of medical research. Medical research is dominated by research on the new: new tests, new treatments, new disorders and new fads. But above all, it’s about new markets. Read full article.
Can’t Get Pregnant? Consider These 5 Tests
Fertility has become a very hot topic these days with the surge in both assisted reproductive technology (ART) and adoptions.
ART typically consists of medications, intrauterine insemination (IUI) or in vitro fertilization (IVF) with the sole purpose of becoming pregnant.
In general, experts tell women under 35 years old to try regularly to get pregnant at ovulation for 12 months before considering additional work-up. Women between 35 and 40 years old should try for six months.
Whether you are in your first month or your first year without success, here are five tests to talk about with your doctor….
What Are Fertility Drugs?
There are a variety of drugs used for fertility treatment. Some are used to produce more ovarian egg follicles. Some are also used to suppress the pituitary gland and prevent ovulation. Others are used to support the uterine lining and early pregnancy.
Medications That Affect Follicles:
Eggs are housed in a protective sac called a follicle. To promote the growth of ovarian egg follicles, the pituitary gland naturally secretes the hormone Follicle Stimulating Hormone (FSH) into the blood stream. Typically only enough FSH is secreted each month to promote the growth of one egg follicle despite there being many follicles available in each ovary. A tablet form of fertility medication called clomiphene citrate (Clomid) can be taken to increase the amount of FSH being secreted by the ovary. In this manner clomiphene citrate induces the growth of multiple egg follicles, typically 2-4 in number.
Alternatively, injections of FSH (called gonadotropins, Follistim, Gonal-F, Menopur, and Bravelle) can be used to induce the growth of even more follicles. These injections are given subcutaneously (under the skin) for 8-12 days. Once the follicles are ready, an injection of the hormone hCG (Ovidrel, Pregnyl) is used to ovulate the follicles. At this point eggs are either combined with artificial insemination or harvested and fertilized in the lab (in-vitro-fertilization) to create embryos which can then be transferred directly to the uterus.
Medications That Affect Ovulation:
During in-vitro fertilization treatment, drugs are used to turn off the natural pituitary hormones in order to synchronize egg follicles and prevent premature ovulation. The most common drug used for this purpose are oral contraceptive pills. During in-vitro treatment, injections of gonadotropin help eggs to develop better. However, during this stage eggs become vulnerable to premature ovulation. A second medication called leuprolide acetate (Lupron) can be used, in conjunction with oral contraceptive pills or alone, in order to prevent premature ovulation. Interestingly, leuprolide acetate actually belongs to a class of drugs called GnRH agonists- which, when injected, initially cause the pituitary gland to produce more FSH. However, with continued use, the drug eventually overwhelms the pituitary gland resulting in the opposite effect – pituitary suppression. For women who make a low number of eggs, leuprolide acetate in sometimes administered in micro-dose amounts to promote higher pituitary FSH production in order to yield more eggs. Instead of administering leuprolide acetate for a prolonged period of time to achieve pituitary suppression, a similar medication called a “GnRH antagonist” (Ganirelix, Cetrorelix), can be injected when egg follicles begin to grow. The use of this additional drug prevents the pituitary gland from causing premature ovulation. The “antagonist” provides instant pituitary suppression unlike that of leuprolide acetate which requires prolonged use to achieve suppression.
Medications That Support The Uterine Lining:
During a normal menstrual cycle, one egg follicle is recruited under the influence of pituitary FSH and subsequently ovulates as a result of the pituitary LH surge. The egg follicle makes a potent hormone called estradiol during the first two weeks of the egg’s development (pre-ovulation). After the egg is ovulated the remaining part of the egg follicle then begins to produce progesterone in addition to estradiol. These hormones together cause the uterine lining (the endometrium) to thicken and begin to secrete molecules which help the embryo develop into a pregnancy. In some forms of fertility treatment such as frozen embryo transfer, egg donation and surrogacy, tablets or patches of estradiol and suppositories or injections of progesterone are given to artificially prepare the endometrium to be able to support the early pregnancy.
How to stabilize your hormones – a guide for pcos patients
Mary Ramie Hinckley, M.D. of Reproductive Science Center for San Francisco, discusses the many ways hormones and insulin resistance can be controlled for women with polycystic ovarian syndrome. This “How-To” video was made possible by an …
Hormone therapy for men results in weight loss
HOUSTON, June 24 (UPI) — Men using testosterone replacement therapy experienced significant weight loss, researchers in Germany found.
Lead author of Bayer Pharma in Berlin said previous research showed testosterone-deficient men consistently show changes in body composition, but the net effect on weight seemed unchanged. However, in the current study had a longer follow-up by at least two years and used long-acting injections of testosterone.
The investigators restored testosterone to normal levels in 255 testosterone-deficient men, whose average age was nearly 61. Treatment lasted for up to five years, with injections given at day one, after six weeks and then every 12 weeks after that. Patients did not follow a controlled diet or standard exercise program but received advice to improve their lifestyle habits.
Single hormone shot can replace daily doses in IVF: study
(Reuters) – Women preparing for fertility treatment get a series of daily, sometimes uncomfortable, hormone shots to kick their ovaries into overdrive, but a European review of previous studies suggests that one long-acting shot may work just as well.
In an analysis of four past studies including over 2,300 women with infertility, researchers found the women were just as likely to get pregnant – and didn’t have any more complications – when they got a single, long-acting dose of follicle-stimulating hormone (FSH).
For in vitro fertilization, extra FSH is used to trigger the ovaries to grow and release multiple eggs, which are then fertilized outside the body and transferred to the uterus.
“Long-acting FSH (weekly injection) is a good and safe alternative to daily injections in the first week of ovarian stimulation for IVF,” said Jan Kremer from Radboud University Nijmegen Medical Center in the Netherlands, who worked on the study.