NEWS YOU CAN USE - May 2024

Spring Is Ongoing, Enjoy it While You Can

Can you believe we haven’t had a day 100+ yet??? This seems amazing to me. Pepe and I have been enjoying sleeping in and putting off our walks until after 0700, but that won’t last. What are your plans for staying active when the heat hits? There are a number of local indoor, all-level, fairly reasonable pricing options to keep you fit throughout the summer, here are some of my faves:

Consider calling a fitness friend to help you be accountable for showing up.

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As you may have heard Ellen Ludwig is moving to SLC. Please see my resources page for acupuncture referrals.

I will also continue conducting ALL VISITS VIA TELEMED, usually via phone except for new patients which will be by virtual appointment platform, the link is available on website.

I also need to reiterate these guideline, so PLEASE READ:

  • For texts, unless urgent or canceling appointment, please limit texting to between 9am-5pm, do not expect immediate replies, & please sign your name.

  • Make an appointment via online scheduler first; if cannot find time there, let me know. I am scheduling about 3 weeks out.

  • To receive refills, I need to have appointment with you at least once per year, usually via phone. Otherwise, call pharmacy.

  • For emails, like you, I am inundated. Limit emails to quick questions, updates, etc. If new issue or have to write paragraph+, schedule a phone appointment. For established patients, I likely have more availability than what scheduler shows.

  • For labs, sign up for account with Sonora Quest of Labcorp; if want to discuss results/follow up after, schedule appointment

Thank you in advance for your understanding & assistance.

 

Menopause this Month!

Well, really last 2 months, but I had COVID so things a bit delayed, and there have been CRAZY amounts of articles and good info published this week for those 40+!

  • Ms Magazine published an article in response to the Lancet article that created a buzz amongst women struggling with menopause and menopause specialists alike

  • How HRT can improve the efficacy of semaglutide for weight loss.

  • A contemporary view of menopausal hormone therapy, by past president of Menopause Society

  • Risks v benefits of using hormones past age 65 (hint: there’s no reason to stop if still benefitting)

  • And a re-evaluation of the Women’s Health Initiative findings.

Link to all these articles and more can be found on my Menopause page here & please feel free to share with friends and family that would benefit from seeing unbiased menopause information.

Please know that you can always reach out to me with any questions re: hormones and women health and share anything you see on social media that may be misinformation.

 

MHT Delivery Options

I get questions about this every day and if you have already met with me about menopausal hormone therapy, you likely know the option, but there are a couple new options:

First, testosterone: the price of the testosterone gel for men has come way down with a Good RX, currently through CVS this is $92 for what is a month’s worth for men, but lasts women 6 months! This ends up being way more cost effective than the compounded forms and the 1/8 tsp of gel absorbs very fast. Until we get an approved form for women this is the best we have, the pellets and injections WILL cause supra-physiologic level, very expensive, and just aren’t safe

Second, systemic estradiol: you likely use a twice weekly patch and that probably works great and it is what insurance likes to cover. BUT if for some reason it doesn’t work, there is the daily Evamist, daily Divigel, daily estradiol pill (though transdermal delivery is considered safer for cardiovascular reasons), and one per 3 month vaginal FemRing. The mist, ring and gel van be covered by insurance but typically need a prior authorization demonstrating one has ‘tried & failed’ the patch. The ring can also help with genitourinary issues like the vaginal options below, All of these form are FDA approved and considered ‘bio identical’. As with testosterone estradiol pellets are NOT recommended and for the same safety and cost concerns.

Third, vaginal applications: here we have twice a week estradiol cream, twice a week estradiol tablets, daily prasterone (DHEA) Intra Rosa suppositories and the Estring once per 3 months estradiol vaginal ring. Most people and insurances like the cream and the tablets, but some may have better success with the DHEA suppositories, and the ring is simply easier for some. These all are ‘bioidentical’ and only locally acting.

Finally, progesterone: For 99%, the nightly ‘bio identical’ progesterone pill works great and helps with sleep to boot…every now and then there is someone who just likes to bleed and we may have to use a daily synthetic progestin pill or a 3 or 7y progesterone IUD, unfortunately these do not help with sleep..

A word about semaglutide: this is not a hormone exactly, actually it mimics the hormone GLP-1 which is released in the stomach in response to eating, causing the body to produce insulin, thereby decreasing blood sugar. As you likely know, I have not wanted to prescribe the injections because honestly most of my patients do not meet the criteria & it is just so darn expensive BUT there is now a compounded sublingual formulation that is about $300/3 months through Camelback Compounding, certainly far less than the $1000 per injections. This formulation also allows lower doses for those who want to reduce the ‘food noise’ in their head without the side effects so many complain about with the injections.

Please contact me if you have any questions about these hormones.

 

All Things Menopause on Flipside of Midlife Podcast

OK it was just a matter of time, as a podcast enthusiast myself, I was so honored to be invited to be on an episode of local Phoenix Karli Newman’s podcast, the Flipside of Midlife re: menopause. You can learn more about Karli here and listen to the episode here.

 

AND LASTLY, A RECIPE

So we still have tons of lemons and the blueberries at Sprouts are amazing so along the lines of my last post, this too is in the theme of cake for breakfast. What can I say, I lose weight with each round of Covid, and this time I lost taste, so I imagine, and hear from my family, this tastes amazing.

If you follow me on IG you know I am a big fan of cake for breakfast. Combined with a full fat yogurt with nuts & berries, and an orange, you have a meal full of calcium, fiber, vitamin C, and healthy fats & protein.

This time I made Alexandra Cooks’ One Bowl Lemon Blueberry Quick Bread! Since I have sourdough discard I subbed that in for the sour cream, but if not for that I would’ve used full fat yogurt..

Eat & drink well!

 

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Arcadia Women’s Wellness