Well before i speak specifically about estrogen let me just talk about hormones in general because our bodies make hormone and they sustain the function the lives of the cells of our body that’s the study they circulate in the bloodstream they go to cells all over the body it could be your thyroid hormone it could be your insulin production your growth hormone
Your estrogen estradiol and in understanding hormones take away the concept that there’s a level at which an individual woman’s body functions very well if the hormones are imbalanced for heart there’s a level with is too little and her function will suffer as a result and is level that’s too much and that can function that can be detrimental that’s the starting
Point for understanding this whole story one of the most common issues that we’ve had to deal with the now is sex counseling service at yale has been young women yale students graduate students under graduates on low-dose birth control pills we don’t have enough estrogen in as a result they’re not having periods and typically they will present with vaginal dryness
Because there isn’t enough estrogen to support secretion from cells of the vagina and loss of sexual desire which is pretty upsetting if you’re like 18 or 19 or 20 years old or 22 or 25 or whatever this should be a peak been in your life when in fact it can all be dulled the citizens are not formal there’s an extra little twist to the story with very low dose birth
Detroit because there’s another hormone that the ovaries make that’s important for sexual desire and function and that’s called testosterone normally made by a woman’s ovaries not just by a man’s testicles for men but a woman’s ovaries for women’s health disaster is important but low-dose birth control pills can stimulate the production of a protein that binds
The testosterone and blowers and when it does that this lawsuit is only very simple test a single blood test measures the free testosterone and whenever we have seen that to be low then it’s an automatic it’s a no-brainer for a doctrine such as myself to say no you need to change to different combination pill you can still be protected in a contraception but you
Need a different balance good for you as an individual this isn’t enough to meet a lot of factors so how quickly her liver metabolizes how quickly the kidneys clear how much see there are birth control pills that have an angio genic action it’s very simple to just switch her – from what she’s taking to another birth control pill which is just as safe and just as
Effective only the progestin in it instead of wiping out her testosterone replaces it with an androgen which this is the design and most not just don’t ask about sex and they don’t you know just prescribe when it says i want earth control that’s and then there’s this thing well we’ll give you the lowest dose and this quotes disabled but by no way is that to say
That’s foreign english and the key is the periods aren’t happening they’ve become very scanty like a mincer i got 30 each month i spot for four hours now obviously that’s nothing okay it’s easy to change this is simple simple medicine there are no body could be fun it’s a matter of what she’s experienced if she says well i’m getting up at night chest pressure or
Occasionally having headaches since i’m on this bill or i find i have no interest in sex i don’t dreams in life yesterday they i have sex but it’s not the same that’s london irrelevant you know that’s important that’s her life and so if someone says that to me i said well let’s tweet it let’s just change it you get corrected but i always do measure the free stuff
Because it’s easy its reliable it’s relatively cheap to do it’s covered by the health plan for students would you have to ask the pressures you have to get now the doctors not four minutes so here’s where the power comes into the picture the women need to know this and they need to know they need to open this because all right let’s talk about let’s just like this
Is an aside but a quickie about talking to a doctor about sex this week we’ve done a major national study of over 1200 and what happened to them in doctors offices so you might call it talking about sex the issue are we replay okay so the issue that we’re talking about now is that women can come to see doctor for say a regular checkup and have something that’s
Bothering her but we do know the way medicine is practiced nowadays about 70 percent of all patients leave the doctor’s office feeling they never got to talk about why they came there in the first place 70 percent that’s a big number not just women men also so the woman has to be focused on what’s most important to her and she has to be able to say as soon as the
Appointments thoughts i need to mention that one of my concerns is a change in my sexual feelings since i started on this book and is there anything you can do about that she’s got to get it in quickly because what we’ve also learned is once you start the interview the average physician will say what was your reason for making this point of the water here today
But she has 18 seconds to say why she’s there and then she’s going to get interrupted and lose control of the interview we don’t want her to lose control of it so she needs to be able to state being ready to go and say this is what’s most important to me only pay attention to this and then and we’ve we’ve said to the doctors why don’t you ask routinely do you have
Any questions or concerns about sex since we found that only 5% of doctors ask that at every visit 95% of them well 75% of the doctors in the country over thousand doctors said to us well i don’t ask the women about sexless i don’t want to embarrass them on the field interest we said to the women well why didn’t you mention that you are concerned about something
Sexual when you went for this appointment well i know the doctor has so many more important things to think about i don’t want to bother her with something trivial city the work it’s a collusion it’s what we call a disconnect and and this is one of the places where women have to take it but i really have to take the lead mister doctors are ready they’re really
They’re gonna be receptive we know that they know well yes the doctor is what percent of your patients do you think have some question of concern about sex they say i’m probably 75% of them do you ever ask know why not i’m waiting for her to say sir we have to stop i think i get right out of the box that the women to yourself say this is important to me right
Course not there’s a lot when you would say something i look like hell don’t know the main thing is taking control of the interview so that your oasis for you that’s this this business or 70 which is great but a question related back to so i mean a lot of women are using and i need to use the city a lot more than 3 points or less many another option diet seems
To be one ok immediate conversations often does that also how integration c230 couplers others by affects a woman’s four lives would you say that puts better engine isn’t boys or is it just well her cycle continues so it’s not artificially manipulated way it would be she has her cycle if anything she can have a problem with heavy bleeding or little cramping
And the the newer iuds the ones that are being used today compared to what we use the sixties do have hormones within them so they’re smaller they’re more comfortable they last longer and more effective there have been some very good improvements in iut but the menstrual cycle then continues with a fix life of its own when a woman is taking a birth control pill
What’s happening is the ovaries are not getting stimulated to pop in a mature the cells that need a core moment pop and estrogen plus progesterone none of that is happening the only one moment is what’s in it not with the iud that’s somewhat different and the so whether one is better than the other i think the birth control pills you can find the right combination
For the individual the ruv has many advantages to it i mean thought i deal with that at all on the other hand there many of them you can’t accommodate leading this country and that’s a fact of life so you can’t go advocating that as it’s got issues of its own but it’s also very effective and for millions of women it’s a great solution jessica’s the devil is a
Great solution on the subject of not talking to doctors about what’s important i want to extend it to not talking about hot flashes okay because we still recorded yes obviously the reason why i want to get back and sort of maybe bring us full circle and get back to the women at menopause where the symptom of a hot flash is a very common symptom in the province
Of fatigue are very common an annual visits in today’s society most women will have hot flashes do not mention them in a recent study that we did and was confirmed in still another study almost 90 percent of women at their annual visit women who’ve had hot flashes the doctor didn’t ask and the women didn’t say it’s almost like the taboo on talking about sex when
We asked the women why didn’t you ask they said well because she’s going to push hormones on me and i’m afraid of one or the doctor says well i know if i start a discussion about that it’s going to take too long we don’t have enough time but what happens after that annual visit well it turns out that what happened we studied and just published that in fact march
First was the publication and what we show is that women who had hot flashes never mentioned it at their annual visits in the next 12 months come back for extra healthcare visits over and over and over again with no one getting to the heart of the issue which is suffering from an issue of not enough estrogen in their bodies our study was of a quarter of a million
Women by flashes versus quarter of a million women without flashes no we showed if you didn’t pay attention to the hot flashes in one year the quarter of a million women had a million and a half extra visits and that costs their health insurance companies 337 million dollars in health care costs that could have been that’s
Transcribed from video
Other issues for young women with low estrogen By EmpowHERliveBroadcastDetails{isLiveNowfalsestartTimestamp2015-03-12T183542+0000endTimestamp2015-03-12T185116+0000}