Dr Erika Schwartz, MD.

Dr. Erika’s Tips on How to Get Your Hormones Back in Balance

Facebook Live Chat With Dr. Josh Trutt

Tune in next week on August 9th, Tuesday, at 7pm ET. for another Facebook Live Chat! Dr. Josh Trutt will be joining me again to talk more about Men and Testosterone. Ladies let's take care of our men in our lives and invite them to join us next week!

What is Male Menopause?
Night sweats in men: Is there such thing?
Does Testosterone lower heart risk in older men?
Does Testosterone cause heart attacks?
Depression in Men: Is Testosterone to be blamed?
What are bad testosterone?
Testosterone in your 30s, 40s, 50s and 60+, are the levels the same?
I don't have the energy to workout, what is wrong with me?

These are some questions that were sent to me this week. We will try to cover them all!

See you soon and don't forget to send in your questions!! Thank you!

https://www.facebook.com/drerika.schwartz/

How Are You Feeling?

I was honored to be the keynote speaker for the white coat ceremony at SUNY Downstate Medical School class of 2019 yesterday.  I am passionate about the message I shared with this enthusiastic group of future physicians. I hope you find meaning and value in it as much as they did.

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Hello everybody, good afternoon. How are you feeling? Thank you dean Pattoo, thank you president Williams, dean Putman thank you class of 2019 family and friends.

First let me tell you what an honor it is for me to be standing in front of you today. I must admit that I spent a lot of time trying to figure out how I can share with you in this unique day and maybe help inspire you in some small way with a true and passionate message that can last and a message that can stay with you for the next 4 years.

I found this to be very difficult because today is a day you and your families and friends will never forget regardless of what I say.  It’s such a momentous occasion. It certainly stands on its own. It marks the start of the most life defining four years of your life.

You’ve worked so hard for so many years to get to today. The process of getting here has been grueling, highly competitive and even isolating.

Most of you probably knew you wanted to be doctors from the time you were little kids, many of you figured it out along the way.  It gives me pause just to think how difficult it is to get into medical school.  And yet, here you are.

You are unequivocally the few chosen ones.

And it’s such a joy to see your faces so full of excitement, hope and promise.

You are our future and YOU will define how that future looks in health care.

You are starting medical school in a time of major change. This is a very difficult time to become a doctor in our country. To be part of the class of 2019 you must not only excel academically, you must be dedicated and committed to overcoming so many obstacles to becoming a truly impactful physician. You are coming in at a time when healthcare is in such tremendous turmoil.

The position and role of the doctor which was so clear 40 years ago is now confused and confusing. The priorities of the industry have changed dramatically. Insurance companies, drug companies, academic institutions, all parties involved with healthcare have their own agendas and will be pulling you in their direction.

At the end of the next four years, as you finish medical school you will come out a very different person, but hopefully only from the standpoint of more knowledge, better understanding of your profession and clearer perspective on the health care system.

What I hope doesn’t change is what the look on your faces expresses today- excitement, promise and hope.

Fortunately you are part of a new breed of doctors that carry the mandate to change and the commitment to improve the way healthcare is delivered in this country. You are literally pioneers on the frontier of the new medicine that is starting to take shape now.

Medicine has changed dramatically over the past 50 years. We’ve waxed extreme from a uniquely relationship driven type of practice to a technologically advanced and financially driven system. The time has come for us to bring these extremes together. Only when these two models of medical practice are integrated will we truly deliver great healthcare. And you are the instruments of this crucial change.

This change can only be implemented by you and will be determined by your relationship with your patients.

You may think it’s premature for me to say that because you haven’t seen a patient yet, but this is the perfect time for you to hear the message. I promise.

Just stay with me and I will show you the very few but crucial ingredients you need to internalize, absorb and live by to become the best doctors anyone could ever hope to be…

In the next few minutes I’m going to share some of my experiences with patients that have deeply impacted me and the direction my practice of medicine has taken leading me to become the kind of doctor I am which I hope will serve to inspire you as well. What I’m about to tell you can not be found in the medical school curriculum and will take a while to figure out…. It’s a very individual process and it is all about who you are first as a human being and then a doctor.

You’ll figure out your specialty a lot faster and sooner but who YOU are, the kind of doctor you are, the impact you make on your patients will take a long time to understand, to really figure out.

That process is part of your journey. Medicine is not just a career, a trade or even a profession. It is a life calling, a passion. It will define of you as a human being, not just a doctor. 

Let’s use today to just stop for a moment. I want you to take stock of who you are right now, today. Just stop and think… Why have you worked so hard and sacrificed so much to get here? What motivated you to be so passionate and determined?  How come you out of tens of thousands who applied YOU are now the class of 2019?

Spend a moment and hold on tight to that most important part of you - the human being sitting here in front of me rearing to go.

So how are you feeling? I can’t hear you….How are you feeling?

I want you to know that these four words are the most important four words of your career.

Let me explain…

I’m gonna start with when I was a little kid in Romania where I was born. Our family doctor made house calls.

I remember to this day 60 years later that the man was a wonderful old man, he had grey hair and big warm hands and kind eyes and I actually looked forward to his visits. Even at five I understood at some subliminal level that he was there to take care of me. He would examine me and then, more often than not, he’d give me a shot. It was usually penicillin because fortunately for me I was born after penicillin was discovered.

Surprisingly… I was never scared or afraid of our old house call making doctor. After he was done with me he would sit at the kitchen table with my mother and have a cup of coffee. I have no idea what they chatted about but it was clear to me they were both comfortable and had a lot in common. He was part of the community. A member of the family, a friend. In fact he went to weddings and funerals, he was kind of omnipresent in our lives…..

Those days are long gone. Medicine has changed a lot.

As it changed, we went from having few or no tools for diagnosing and treating disease to becoming experts and specialists. And technologically so advanced, we have genetic testing, CT scans and MRIs, blood tests to drown the entire earth in, advanced surgical procedures, lasers, robots, radiation and chemotherapy, certainly amazing stuff has been developed.

On one hand this is great and it helps us provide highly advanced care, but on the other hand in the process…. we traded the human touch.

This kind of trade is just too extreme.

The outcome is a huge canyon, a chasm that led to a terribly dangerous disconnect between the doctor and the patient.

Suddenly we are faced with a system where the most important person in the system is also the most overlooked- the patient.

The patient and the doctor are no longer sitting at the proverbial kitchen table talking and very few doctors show up at their patients’ weddings and funerals.

In fact too often the relationship has become adversarial.

That just doesn’t work. In fact from where I stand I honestly and strongly believe this disconnect is one of the primary reasons our health care system is in such shambles.

The wrong priorities define the kind of care we provide. But don’t worry you can change the system you can make it better. Remember, you are the agents of change.

Let me go back in time again.. 

When I first went into private practice I remember a guy coming into the office to see me. My usual greeting you already know…. It was and always is: How are you feeling? How can I help you?

And the patient, this man, just looks at me. And I am really young at this point in my early 30s and he says to me how should I know? You’re the doctor…

A light bulb goes off in my head and I say to myself how should I know you are the patient.

I don’t live inside your body.  I have no way to know what’s going on inside your body so how could I possibly be able to tell you what’s wrong with you. If you tell me how YOU feel I probably will be able to start working with you and together we can try to figure out what’s really going on inside of you.

I don’t think the guy got it.

But I did.  Doctors don’t live inside the patient. So unless we communicate really well with each other, we don’t stand a chance of helping the patient.  So I understood I need to be able to communicate with the patient. And the patient needs to understand that even though I have an MD after my name, I am not a mind reader.

Shortly after that incident I started questioning things like if we are spending  5- 10 minutes with a patient in the frenzy to make more money working for an insurance company, a drug company, anyone but the patient, how can we honestly expect to help the patient.

How can I just write a prescription for a patient and tell him what to do when I don’t even know him… 

How is his family? His job? What does he eat? Does he sleep? Does he work out? What’s stressing him? How many kids is she putting through school?

Honestly, you can get the answers to these questions in three minutes and they certainly will put the million dollar blood and MRI work-up into context.

And if I don’t know the patient why would she or he listen to me? Just because I’m a doctor? Seriously?… those days are also long gone…. Nobody believes the doctor knows best anymore…. What’s wrong with that expectation?

So let’s move on a little bit.

Again, years ago when I was in my 30s I went into private practice.  Doctors I had been working with in the hospital took pity on me because I didn’t have any patients.

Someone sent me a woman in her 50s with end stage breast cancer and she had undergone chemo, radiation, surgery and there was nothing left for the conventional medical system to do for her. So my buddies sent her to me. They always told me I was someone the patient could talk to. At the time I had just ended 5 years of running the emergency department at a major academic trauma center and had just gone into internal medicine practice and I really was not very knowledgeable or clear on what to do with people when you can no longer DO things to them anymore.

So the woman came in crying- it was October and she was saying she wasn’t going to see Thanksgiving… I felt very guilty that I was young, healthy, had all my life ahead of me and that she was at the end of hers, it seemed to me so unfair that she was on her last days and I had nothing to offer.

But because I was trained to believe I am a healer, a physician who has to find something, anything, to do I couldn’t just tell her I had nothing to give her so I thought really hard.

I have no idea how this came out then, but now I know it came from my heart. So I said to her: if you think you’re going to die before thanksgiving why don’t you have thanksgiving at your house next weekend and bring your family together.  

The woman stopped crying and looked at me.  After what seemed like a very long time but was a few seconds, she said- I never thought of doing anything like that. No one mentioned that option….

I hesitated but told the truth. I said I have nothing else to give you so just try doing that.

And she tried it.

She had thanksgiving in October.

And she stayed my patient and she didn’t die.

In fact she lived another 20 years. She lived to dance at her daughter’s wedding. The cancer never came back. I never did anything about the cancer.

But I,  made a little connection. I made the connection that you don’t always have to do something medical. You don’t always have to give meds, radiate, operate, do a test, you just don’t.

You need to learn to stop and listen to the patient, to see the patient like your mother, your sister, your grandmother, another human being just like you…. Then you’re probably going to come up with a common sense solution for the moment because all we have is this one moment.

And if you don’t have any idea what to do…. Just empathize. Feel for real. Feel for the patient. They are you.

And you know what? Today, you know how to empathize better than you will four years from now. I promise that is a fact. You are experts at feeling. Hold on, to that expertise.

So let’s go on... I’ve been very fortunate in my career because I’ve seen a lot of patients and have learned so much from them.

Eventually I got out of acute medicine and internal medicine because they are all about waiting for patients to get sick…. In our culture and medical training, disease unfortunately has the highest status.  And I decided that maybe disease shouldn’t have the highest status and maybe keeping people healthy was the higher status.. at least for me and my patients.

From my perspective..  life is a continuum of health with minor interruptions when we are sick.

So I began focusing on how to help patients lead the highest quality life possible, less worry about missing a disease, more time healthy and enjoying life.

But before I got there…. While I was on call one night in my late 30s I remember another interesting turning point story. 

This woman came in with a little girl around 10 years old. The little girl had blue skin from her neck down to her waist. The rest of her body was just fine. She didn’t have any shortness of breath, she didn’t have any blood pressure problems, was speaking perfectly well. When I asked the girl how she was feeling, she said fine with a smile. The mom was concerned. So I examined the kid from head to toe and couldn’t come up with anything wrong…

How are you feeling? I asked again clueless as to the cause of The blue trunk.

Finally I took a 4x4 sponge soaked it in warm water and soap and just rubbed the girl’s forearm and the blue came right off. So I asked the mom if the girl wore a blue sweater or sweatshirt. The mom said:  oh yeah.

So I said: did she get wet while wearing it?

And the mother said: yeah we just got caught in the rain this afternoon right before I noticed her turn blue….

So I said just take your daughter home and give her a shower and don’t worry about it. Just soap her up. It’ll all come off.  It’s just the dye that ran off the sweatshirt.

On their way out, the mom highly relieved and the daughter happy I didn’t poke her too much, the little girl looked at my nametag. It said E. Schwartz. The little girl said what does the E stand for and I said Erika. She said: omg my dog’s name is Erika! We both laughed.

And for a second I realized something that for the following 30 years of my life has affected the way I practice medicine every day. I realized the little girl and I had connected at a level where the girl and I were equals. The ten year old and me the doctor were pals. We had something in common. My name was Erika and she had a dog named Erica.

Suddenly the distance between me the doctor and her the 10 year old patient disappeared and was replaced by only the similarity between us. We were both just two humans sharing a personal anecdote. She felt safe.

So these little stories I shared with you should give you a little insight into what really makes the difference in the practice of  medicine.

Over the next four years you’re going to study a lot of advanced, esoteric and very important scientific facts. You will become experts: experts in various areas of medicine, you will understand biochemistry, physiology, anatomy, pathology, genetics, you will understand very difficult concepts, how the human body works, how drugs work, you will become experts at diagnosing disease.

You will become experts at treating disease.  And while we’re on the topic of disease, let me tell you one more thing.

Don’t treat disease.

The disease doesn’t need your help. 

Treat patients, the patient needs your help…

And finally, at the end of your training you will become part of the hierarchy that is our medical profession.

Some of you will become interested in research, some will become clinicians, and some of you will work for drug companies or insurance companies while some of you will be very clear they have become doctors for only one reason.

Just like I did 40 years ago, you too can decide to only work for the patient.

To listen to the patient, to respect the patient, to connect with the patient, to never scare the patient and to serve the patient.

And you know what, I never regretted making that decision and I never got burned out.  That decision has served me really well. I love what I do. I wake up every morning excited to go to work. That’s because I love my patients. And they love me. And medicine at the end of the day no matter how scientific or lucrative it is, is an art, it’s the art of listening and the art of caring. And it’s the art of being compassionate.

So I wish you a great career, I wish you a great 4 years at the end of which I hope you come out as human and as caring and as passionate about saving the world as you are today.

Congratulations and don’t forget those four life-defining words: How are you feeling????

Thank you.

 

 

Scent Of A Woman – And A Man

My latest article for WAG Magazine

Recently, while doing a TV interview about sex and my upcoming book, the interviewer, a lovely man, seemed stumped when I said both men and women had the same sex hormones. He made me repeat the sentence. “What do you mean?” he said. “I never heard of that. Don’t men have testosterone and women estrogen?” Of course, the answer is yes. But it’s yes to both men and women. We all have estrogen and testosterone and even the hormone made specifically after ovulation, progesterone. The difference between men and women is that we don’t make these great sex hormones in the same quantities, pulses or cycles. Men have a lot more testosterone and women a lot more estrogen and progesterone. But the beauty of it is that we need all three of these so-called sex hormones to be, shall we say, a real man and a real woman.

Yes, the dance of these sex hormones along with oxytocin and other less well-known hormones – their rise and fall and interaction – leads us to the highest of highs in our sexuality, romance, desire to mate and get close with another human, while their loss or imbalance throws us into the deepest troughs of depression and loss of libido. It’s as simple as that. Well, maybe not that simple but pretty close. When our estrogen, progesterone and testosterone levels are in perfect balance, and when we make pheromones – another type of hormones that attracts us to each other sexually – we’re able to continue our quest for an all-encompassing romantic relationship or just something as simple as the desire to have sex. 

But there are other complicating factors I’d like to remind you of. Our culture is probably the most significant of complicating factors when it comes to our sexuality and how we interpret and express it in our everyday life. We live in a youth-obsessed culture and as a result, we gauge our sexuality and hormone balance by what our youth do or say on the pages of magazines or in the social and visual media. So we believe sex and youth are one and the same and a marriage made in heaven based on lots of sex when we are 20 is the only way a marriage will last into our 60s when the hormones are long gone, the kids have left home and we are looking at the stranger across the table and wishing we could desire him or her the way we did decades ago. Well, the truth is that things don’t work out that way, at least not most of the time. 

When we get a bit older, when the kids come into play and stop us from paying attention to each other and take the focus away from the couple and move it onto their never- ending needs for at least the next two decades, with or without the help of hormones, we start a slow but definite decline in our sexual drive. Getting caught in the act by 5-year- olds, staying up all night with a vomiting 7-year-old and waiting for the teen to come home at curfew are not exactly ways to improve and increase our sex drive nor will they bring romance onto the front burner of our married lives. So what do we do, we fake it, lie to our friends and family about it and make believe everything is fine. It’s one way to hope things will work out and our marriages and sexuality will survive. That’s the course most of us take. We saw our parents do it and we continue on their path.

Others, the lucky ones, put the kids and busy lives on the back burner at least once a week on date night and keep on having sex and chasing each other around the house and  the block. Those are the ones who have kept the spouse’s scent not just in their nostrils but also in every cell of their bodies and doggedly won’t let go. Good for them. 

The others, well, they slow down. We hope they develop a relationship that keeps them together beyond the kids and sex, because if they don’t I can assure you that one of the parties will make sure they uncouple by the time the youngest goes to college. But that is not all about hormones. It’s about life and culture and what I like to call our own personal truth. If you listen to yourself and have been working honestly at making the relationship work and stay romantic and woo each other and caress and hug and yes, have sex, you will probably keep the passion going, the intimacy will last and you will live to celebrate the 60^th anniversary and go home and get back between the sheets even if it only is for a cuddle and sleep.

So keep in mind, it starts with the hormones when we are teens and stays with hormones for about four decades and then it’s also about commitment, love, intimacy and yes, holding each other close and tight while the vicissitudes of life attack you. But you keep each other’s scent and presence in your life and enjoy it indeed forever.

The Super Power Of Hormones

My latest article in WAG...

When my editor gave me this topic for this month’s column, I thought it funny. Doesn’t everyone know how hormones affect everything we do? Doesn’t everyone know we are our hormone balance?

The answer to these questions is an unfortunately (sigh) still no.

To someone like me who has been working with hormones and specifically bioidenticals (human identical hormones) in women and hormones in general in men for almost two decades, who lives and breathes hormones, who totally understands their tantamount roles in our health and disease, it seems odd that our advanced society, our highly developed culture, has no understanding or insight into the role of hormones in our lives.

A primer: When we are young, it is the abundance and perfectly tuned balance of hormones that makes us vital, wrinkle-free, sexually turned on and quick to recover from colds and flu.

Hormones keep us fertile, and our joints limber and well- lubricated. It is our hormones that help us think well, remember where we put our keys and relate to others in intimate, connected ways.

As we age, hormones begin to fade, though exposure to toxins, eating badly processed foods, leading sedentary lives and not getting enough sleep also play their parts.

We can reverse or at a minimum stall the ravages of aging with hormone support. There are many types of hormones that work together to create the puzzle that becomes our lives and the more pieces (hormones) of the puzzle we put together in proper balance and in the right formulations, the more likely we are to age in a healthy, vibrant and beautiful way.

The best hormones to use are the bioidentical ones. They are prescription medications estradiol, progesterone, testosterone, thyroid and adrenal support, and they are pharmaceutically made to look identical to the hormones our own bodies make when we are young and healthy. These types of hormones can be found at drugstores in FDA-approved forms, and they can be made to order by compounding pharmacies that specialize in tailoring them to the individual.

Without hormones we get old and frail and become a burden to society and to an already overloaded health-care system.

With the proper hormones, prescribed by doctors who are trained and experienced in how to use them and when to use them safely and effectively, we spend less money on health care, on going from doctor to doctor and test to test with no hope of improvement in sight.

With hormones in balance we don’t need yo-yo dieting. Our bodies stay at their optimal weight, and exercise is pleasant with results we can be proud of. With hormones we find ourselves getting sleep again and feeling refreshed in the morning. 

Hormones are not snake oil. They are safe and they protect us from diseases of aging. They protect our bones from osteoporosis and our hearts and brains from deterioration.

Doctors who deny this fact are uninformed and don’t care about you or how you feel.

Yes, it may sound like hormones are the fountain of youth, but all you have to do is ask and look at those who take them and compare them to their peers who don’t.

Last night I had dinner with a physician. He is a highly successful radiologist who has run and owned multiple successful and technologically advanced radiologic centers around New York City. 

He told me that just like most physicians he always considered himself a skeptic when it came to hormone use in prevention and wellness. Unfortunately he is not alone. Despite clinical research and scientific articles abounding on the topic, the majority of the conventional medical profession still has no knowledge of the role of hormones in prevention and wellness. That’s because disease is more lucrative to the industry than prevention. Indeed, conventionally trained physicians come out of medical school without insight into hormones, diet, exercise, lifestyle, sleep and supplements, all crucial connections to keeping us healthy well into old age.

So back to the physician I had dinner with last night. He was telling me how over two decades as he hit his 40s he started to gain three pounds a year and slowly found himself, old, obese, sluggish and pre-diabetic. His training would have ordinarily just sent him to the cardiologist to have his heart checked and the gastroenterologist to have his colon looked at; to take a few prescriptions to help his aching joints, rising blood pressure and sugar and sent him home telling him it’s all part of normal aging. It’s not.

Instead, while on a plane he saw an advertisement for an anti-aging group catering to men and treating them with testosterone (a hormone, folks) and diet, exercise and lifestyle changes. Feeling downtrodden and unclear how to proceed but unwilling to just let Mother Nature take its course, he called the number on the ad and became a patient in the practice touting turning back to clock as the outcome of the treatment.

Skeptic (as he only mentioned three times during the conversation) that he was, he thought it would be a waste of money. But something pushed him to give it a try.

After a thorough evaluation of blood tests, biomarkers  helping the doctors figure out how his heart, lungs, skin and general metabolism worked regardless of his age and an hour long consultation with the doctor who asked him more questions about himself than he had ever been asked, he was prescribed testosterone injections and given some supplements and recommendations on diet and exercise.

Within a week he felt better but had gained a couple of pounds and called the doctor. He was told that as his body was rebalancing and detoxifying (coming clean of toxins), he may be retaining water for a while but not to worry, just stick with the program. And that he did.

Within six months he lost the weight he had put on over two decades, became interested in sex again (he had lost that interest a decade before) and started building muscles when he exercised. His mood became upbeat again, his outlook positive and more than anything else, in his own words, “my brain came back.” He felt young and healthy again. 

That was one and a half years ago. Since then, he has sold his radiological practices and has been taking courses to become proficient in the use of hormones in preventive medicine.

He is no longer a skeptic. He now believes, as do I, that everyone requires the proper combination of hormones to prevent disease, keep us young, functional and healthy and reduce our skyrocketing healthcare costs.

When I see patients for the first time I ask: If you didn’t know how old you are, how old would you think you are?

The answer from people on hormones is always 20 years younger. From those who don’t take hormones, it’s always at least 20 years older. 

Which would you like to be?

Not All Hormones Are The Same

The video from my talk presented at the 14th Clinical Applications for Age Management Medicine. 

 

Hormones are the juice of life. When you are 20 regardless of whether you are a man or a woman, you are full of hormones, you are fertile, diseases are rare and recovery is swift, we are fertile, do not have wrinkles, can get our body weight under control with diet and exercise and we want to have sex.

With the aging process, we loose our hormones and along with their loss we start experiencing symptoms that make us feel crummy. We have hot flashes, night sweats, insomnia, irritability, stubborn weight gain, loss of libido, infertility and chronic illnesses like high cholesterol and high blood pressure become the norm.

In short we become roadkill.

You can try to exercise, change your diet, get some rest and take supplements but unless you address the hormone balance and recreate the environment of your 30s and early 40s, aging will prevail and turn you into an old, chronically ill and unhappy person.

There are options for the safe and intelligent use of hormones to decrease the risks brought on by aging but they are not taught in medical school. Understanding there is no class effect in hormones is key to helping patients and making the difference between a borderline life and a vibrant, healthy life.

Bioidentical hormones or human identical hormones are a class of hormones that have been in conventional medical use for more than six decades. Hormone formulations and preparations are crucial and they DO affect outcome in both men and women. The science of hormones is solid and the clinical application and use of hormones in wellness and disease prevention is of utmost importance in the practice of prevention.

Understanding the difference between hormones and their application are the key to ideal hormone balancing.

The Importance Of Your Voice In Health Care

If we all had voices, medical care would be a lot better for us and the outcomes would be more positive and far less fear-driven.

It’s a pretty big statement, but I have been practicing medicine for too many decades, and am a woman to boot, so I know all too well how true the statement is.

When I first ran the trauma center at Westchester Medical Center in Valhalla, the patients we saw in most dire straits were the ones without voices. They were very sick and most often unable to speak. So much of the treatment we gave them was guessing based on what happened or what a relative or friend told us. In these cases, we had no choice and neither did the patients. This is the only situation in medicine in which it’s OK not to have a voice.

In the day-to-day doctor-patient interaction that occurs in clinics and offices all over the country, the circumstances are not dire, the opportunity to speak is there and the need to speak is imperative. But the problem is most people just don’t speak and the results are disastrous.

How often do you go to the doctor and out of fear or sheer embarrassment don’t tell the doctor the truth about what is bothering you, the medication you are taking, the supplements, the hormones?  You just wait for the doctor to guess.

One of my first patients in private practice told me in no uncertain terms when I asked what was wrong with him: “You are the doctor.  You should know.” How could I know? I don’t live in anyone’s body but my own.

I can assure you most women do not speak their minds when they are sitting on the examining table or across the desk from the doctor. They do not have the courage. They tell me they’re afraid the doctor will disagree with their course of action or yell at them. Really, who is this doctor? And why are you still going to see him or her? The only thing you will get out of that type of relationship is bad care.

So they can’t find their voices and represent their own best interest in the relationship with the doctor. If they don’t, do you think the doctor will? Not so sure about that.

This is a sad state of affairs in 2013 in the U.S., where we profess to be equal and have voices that are heard.

Since all I do is listen to patients all day long, I can tell you without a doubt that we don’t have voices and if we do, we don’t use them where we can best benefit from them. I don’t want to say all doctors are uncaring and all patients have no voices, but unfortunately there are more who don’t than do. 

Think back to your last visit to the doctor. I bet one of two things happened –either you didn’t tell the doctor what you felt, because the doctor bullied you or didn’t even notice you, or you thought there was no use in telling him or her what you really thought, because the outcome would not be affected by what you said. How sad is that:  To think so little of yourself to allow the doctor, who doesn’t live inside your body and certainly has no clue how you feel, to decide what is right for you.

We aren’t little girls. These are our lives and health we are putting on the line when we become shrinking violets with little-girlish voices.

The other option is that you decided to confront the situation and make yourself heard. That usually happens as women age and wisdom brings them to a more outspoken and less fear-driven place. The problem there is that instead of you coming across as your own advocate, the doctor, who has no training whatsoever in how to communicate with patients, becomes either scared of you or swats you away by telling you that you are being unreasonable, confrontational and bothersome, just to get you out of the office.

And then you leave with a prescription you probably don’t need anyway. 

How often have you gone to the doctor and found yourself leaving intimidated and frustrated, not feeling heard? 

When I first started to realize that doctors were treating women so badly, I became a patient advocate, because I recognized this happens when women are too quick to accept status quo.

How about my friend who tells me she’s going to the gynecologist with the problem of  low libido and the doctor pats her on the shoulder paternalistically, saying “What do you expect, honey, you are menopausal. It’s normal. You are getting older.”

So she leaves, feeling old and useless. To me that is unacceptable. There are many things she can do to feel sexier and one of them is find a better doctor to help her with medical and hormone support, and the other is to get a partner who turns her on.

When I started working with bioidentical hormones, many women told me they loved how they felt on the hormones but were afraid to tell their gynecologists, because the doctors didn’t agree with them. So they told the doctors they were feeling great but omitted to tell them why. The doctors in their ignorance didn’t care and didn’t learn. By lacking courage and keeping their doctors in the dark, the women deprived many other women from getting access to the hormones that made them feel better.

That story comes from almost two decades ago. Unfortunately, it’s still true today.

How sad is that.

It may sound harsh and tough to absorb, but the truth is, unless you find your voice and use it now, time flies and the next generation of women will get only worse medical care and you will have missed the opportunity to make yourself heard. 

It’s really all your choice.

New 'Low T' Research

Surprising new federal research suggests low testosterone isn't the only thing men need to worry about as they age. The female hormone estrogen also plays a role in the same issues tied to "low T" — such as increased body fat and diminished libido, strength, and energy. 

But wellness expert Erika Schwartz, M.D., tells Newsmax Health the findings shouldn't prompt the millions of men who take testosterone to suddenly drop it and start loading up on estrogen.

 

The take-home message, she says: Male and female hormones are both critical to men's health in midlife and beyond. Making sure all men have adequate levels tailored to their individual needs — by supplementing them with natural bioidentical hormones — can stave off obesity-related conditions and boost their overall health.

Please click here to read the full article on the NewsMax Health web site. 

Mastectomy, Angelina Jolie And YOU

There was a lot of buzz and questions that resulted from Angelina Jolie announcing her choice to have a double mastectomy based on a blood test that showed she had a higher percentage chance of breast and ovarian cancer.  I wanted to create a video that talked through the many issues this has raised so you will make the best decisions for YOU that are based on facts and not fear. 

Why I never give my patients the newest and fanciest of drugs

In the 1980s when I started my private practice in internal medicine, drug reps came to my door every day promoting their newest products.

Every time they brought a new drug for me to try out on my patients, they brought along scientific studies to support their case and encourage me to use the new drugs as better and more likely to help my patients than the competition or older drugs with the same action.

While initially I did listen and read the data, it didn't take long until I figured out that new drugs, even though all FDA approved, have no long term data on their safety or efficacy. It takes a long time and a lot of users to determine the truth about any drug.

At that point in my growth as a physician and human being I vowed that I would not jump on the new drug bandwagon so fast. I would give a new drug only under circumstances that required its use and an old comparable drug that was proven safe could not be found. If I was treating under emergency circumstances, the patient was terminal or the drug was useful in extremely specialized areas of care by all means, but under usual circumstances, old seemed always a safer bet than new.

Since most of my patients are mostly healthy and trying to stay well by using true prevention to achieve their goals, I find they don't need to be treated with new drugs as a first line of therapy in my practice.

Let the drugs be tested and proven over the course of years on millions of people to solidify or discredit their effectiveness and side effects.

My patients need not be guinea pigs.

Maybe I am a bit extreme, but then, I deal with the importance of treating individual human beings who have entrusted me to tell them the truth about what I am treating them with. If I don't know the truth, I will say so and that will often mean, I stay away from many a drug promoted to be the newest and best.

Case in point Vytorin, an FDA-approved cholesterol-lowering drug prescribed to three million people a month before a study found that it appeared  to increase the risk of cancer. The drug was new and its track record too fresh to determine its true safety.

Vytorin and its companion pill Zetia generated $5 billion in sales Before their rapid disappearance from the market.

Too many doctors react to drug reps and marketing hype without waiting for more information. I am sure they believed new drugs to be safe. I doubt any doctor would ever prescribe a drug thinking it wasn't safe. However, the fact is, we just don't know and relying on the "FDA approved" statement all too often only gives us a false sense of security.

While new drugs get promoted as panacea today, only to flop after hurting people in short order, old drugs like bioidentical/ human identical hormones that so many doctors are unwilling to prescribe because of misinformation and confusion and the false belief that big pharmaceutical companies are not marketing them and they can only be obtained from compounding pharmacies, have been around and proven safe and effective for decades.

There are many FDA approved bioidenticals and they contain the same as the compounded estradiol, progesterone and testosterone. Their track record is safe on both sides of the FDA story.

And still doctors are confusing scared patients who don't need to suffer.

Go figure!

At the end of the day, you need to be your own doctor, take responsibility for listening and making your own decisions. It's your health after all!