Monthly Archives: March 2011

Should I take hormone therapy?

Expert:  Wendy Klein, M.D., co-author of The Menopause Makeover

Dear Dr. Klein,

HELP, I am so confused about hormone therapy after the latest headlines about breast cancer and hormones.  I had a hysterectomy 5 years ago, and my doctor prescribed the Vivelle patch 1.0 mg and I love it.  Should I stop using it?  I am afraid of getting breast cancer even though it does not run in my family. What should I do?

The headlines about breast cancer associated with hormone therapy use, although recent, do not really represent new data. We have known for many years that HT use  greater than 5 years increases breast cancer risk. That said, adverse effects are generally dose related, and all the research showing increased risk was done using doses of estrogen that are 3-4 times higher than what is used today.

The newest headlines reflect a long-term follow up of 2002 WHI results, in which it was found that prolonged use of estrogen and progesterone slightly increased the risk of breast cancer death. Of note is that this was not seen in women like yourself who, after hysterectomy, took estrogen only.

The best approach is to consult with a clinician who can help assess your risk for breast cancer by looking at personal medical history, family history, age, race and ethnicity, reproductive history, and history of breast biopsies. If you have no increased risk, then staying on estrogen for now may be appropriate. The answer in part depends upon personal considerations, such as the age at which you had your hysterectomy, your risk for bone loss, and how long you have been treated with estrogen.

Also, it is reasonable to consider very slowly lowering your dose of Vivelle, so that you are on the lowest effective dose. Above all, consult with your healthcare provider so that you can jointly make a thoughtful and carefully considered decision that meets your individual needs. There is no need to make sudden changes.

Living a healthy lifestyle, such as maintaining an ideal weight, not smoking, regular exercise, consuming low to medium glycemic carbohydrates, and limiting alcohol consumption can also help reduce your risk of breast cancer.

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Posted in hormones, ask the expert

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Posted in Contests

Aging: What Are We So Afraid Of?

illustrationfaceliftI live in the land of angels, but in Los Angeles these guardians are nipped and tucked with crooked smiles and lopsided eyes frozen on a static expression.

At 52 I am really pissed off that aging — a thing that happens as soon as we take our first breath — is such a big deal! Why does a large part of our population struggle with aging?

Considering that the average lifespan in the early 1900s was 49, and now it’s 77, perhaps old age is a more recent phenomenon. Thanks to modern technology and medical advances, we have an easier life compared to our ancestors. A hundred years ago when the average person was dying by age 50, wrinkles were a badge of honor displaying wisdom and earning respect for a life long-lived.

My first signs of aging appeared as a growing colony of spider veins and brown spots that surfaced after years of sun damage. Witnessing these skin tone imperfections sent me running to the nearest celebrity dermatologist for a quick fix. Six months and $1,200.00 later, those spider veins and brown spots reappeared. Don’t they know I paid good money to banish them forever?

I revisited that famous dermatologist insisting the procedures did not work. She said, “Staness don’t you know? You have begun your journey chasing youth.” What? I have no intention of chasing youth, just fix it so I can move on with my life as I was — young with perfectly clear, tight skin.

A few martinis later, I decided to cover up those spider veins and brown spots with a spray on tan. Living in Los Angeles this is a perfectly acceptable treatment. Ahhhh, with just one spray tan session for $36.00 I felt much better with those brown spots and spider veins artificially covered. But, this trick only lasted a few months. Self-tanning is a time consuming job with sketchy results. This last ditch effort to conceal brown spots and spider veins, left orange evidence around my elbows, fingers, and ankles. Now what?

When the elasticity of my skin started to relax, the anti-aging battle seemed hopeless. I was now wearing a permanent suit styled with a draping midsection, accessorized with paisley spider veins, and finished off with a set of droopy boobs and a deflated tush to match. It wasn’t pretty! An aging alien was trying to squeeze into my body and take over.

Keeping up with aging was a full time job without any benefits. My self-esteem was being tested daily. No one prepares us for this transition of fading youth.

Thou shalt not lose your youth and beauty in Los Angeles. Breaking this unwritten commandment can contribute to job-related age discrimination, result in a divorce or secure a spot in the never-married line.

Men and women in Los Angeles have an unusual attraction to altering their looks, and demanding flawless skin. They are willing to give up their human right to have natural expressions by electively going “under the knife.” We have many versions of Angelina Jolie living in Los Angeles with perfectly plump lips, high check bones, full breasts and tight butts. People in their 20s, 30s and 40s casually chat about who did their implants, and where to get the best price for Botox injections.

Don’t get me wrong, having surgical and non-surgical cosmetic options available can change someone’s life for the better. A nose job can promise better self esteem, removing a scar can boost confidence, and reconstructive procedures can give hope after devastation.

Botox, fillers, and plastic surgery can relax, plump or pull a wrinkle out of existence – temporarily. These technologies can be helpful, but don’t depend on them to deliver everlasting youth.

Personally, I refuse to rely on cosmetic procedures to cling onto my youth. It was time to investigate how the beneficiary of youth — beauty — was defined in my life.

Growing up an Air Force brat, we moved almost every year. I learned at an early age that if I was the helpful girl, not the pretty girl, I had friends. My worth was not defined by my looks. That changed when I moved to Los Angeles where beauty was a cloak of power. When that cloak wears out after years of use, people will do anything to keep it looking youthful.

Do I miss my youth? Yes, a little now, probably even more later. I miss having joints that don’t ache when I exercise. I miss the ease of not working hard to be healthy. I miss the days my purse was not full of reading glasses. I miss the cheaper health insurance. But, those inconveniences are nothing compared to knowing who I am.

I feel some sadness as my youth leaves center stage and a more wrinkled version of myself claims the spotlight. In another decade I become an official cast member of Cocoon. Fortunately with good nutrition, exercise, and a few beauty products my aging process will hopefully be a graceful one.

The good news — I am not alone. According to the 2005 U.S. Census report, by 2030 there will be 72 million Americans aged 65 or older. That is more than double the 35 million in 2000. Our population is getting older.

If the youth of America sees a generation of baby boomers ashamed to age, what message does that send? Twenty year olds are having Botox parties, plumping their lips and changing their body shape. Is this obsession with body altering the result of our fear of aging?

We see our local newscasters come back from vacation “refreshed” with tighter skin, and that wide-eyed surprised look. Networks pressure newscasters to stop aging after 40, studios hire the 20 and 30 year-old actors for the lead parts, and magazines completely retouch their covers and editorial spreads.

Why are we not obsessing about being older and wiser? I applaud Kaiser Permanente for having the right attitude in their commercial campaign When I grow up I want to be an old woman.

Mother Teresa spent her life dedicated to helping the poor and helpless. Do people look at her and say, “Check out those wrinkles, that girl needs some Botox?”

As I try to make peace with my own signs of aging, it was challenged when I visited a dermatologist for an irritating skin condition and at the end of the appointment the doc said, ” I can make you look 10 to 15 years younger with some Botox and fillers.” Ouch, I thought I looked OK. After the blood from my face started flowing back to the rest of my body, I proudly said, “I love my wrinkles, dammit!”

After our 40s and 50s aging isn’t necessarily pretty. Can there be beauty in age? Most definitely. Those permanent crinkles between my eyebrows are the result of fun times in the sun riding horses and sailing boats. The lines that cradle my eyes are a reminder that I have had a life full of smiles. I invite those surprise lines in my forehead to stay forever. They remind me of the unexpected moments I learned great lessons.

When I was 10, anyone over the age of 30 was ancient. When I was 30, anyone over the age of 50 was a dinosaur. Now that I am in my 50s, being 60 isn’t looking so bad.

These days I am committing my life to things more important than wrinkles. Maybe the only one who cares about my wrinkles is moi. Maybe the only one who cares about your wrinkles is you. Maybe it is time to get on with things that really matter.

Do I love my wrinkles? I am trying to, dammit!

References

Speroff, L. and M.A. Fritz. Clinical Gynecologic Endocrinology and Infertility. Philadelphia: Lippincott Williams & Wilkins; 2005.

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Posted in beauty