T.S. Wiley before the Special Committee on Aging in front of the United States Senate April 19, 2007
I prescribe to my patients a new method of hormone replacement therapy(HRT) called the Wiley Protocol for women to use as a more accurate form of replacement for lost endocrine function. The remedies available to women suffering from hormone deficiency are woefully inadequate. The commercial pharmaceutical offerings are either bio-identical and too low in dosage to have efficacy, or synthetic drugs, far too dangerous to take. Here in the United States, there are over 40 million women between the ages of 40 and 60.
Worldwide, about 25 million women enter menopause annually. It is estimated that by the year 2030, that number will increase to 47 million women per year. Since 1900, in the developed countries, the life expectancy of women has increase from age 47 to well over age 80, however, the average onset of menopause has remained at 50 as recorded for the last 150 years. That means, overall, women are living at least thirty years longer than they did at the turn of the century.
Our society has never felt the impact of the majority of women living 30 or more years in a hormone deficient state. It won’t be pretty. Right now, modern medicine keeps us propped up with antibiotics and surgery, thanks to blood transfusion and anesthesia. But just being alive does not assure “quality of life.” Without it, extended lifespan is far less than a gift. It’s estimated that eighty percent of women experience a variety of transiently debilitating symptoms in menopause and 30% of those are classified as severe.
About ten years before women ever have a hot flash or a migraine, we have odd, too-short menstrual periods, we’re up half of every night and we start to look old. And almost as soon as we start to look old, we start to feel old. Exhaustion coupled with plummeting sex hormones creates a life in tatters and a mind like Swiss cheese. Sex would be a memory, if we could remember anything. Our joints twinge and, worst of all, we can’t fall asleep or stay asleep. It is anecdotal common knowledge that older people wander around all night limping and bumping into things when they should be out like a light.
Given the evidence that these symptoms of menopause, which can begin for women as early as their late thirties, are the same as the daily challenges the elderly face -- that we become, in fact, “old” when our hormones start to plummet -- we can probably assume we’re going to be sick, too, if we aren’t already. Because it is, again, anecdotal common knowledge that old really equals sick in the preponderance of cases -- and sick and old in our culture means usually means cancer, diabetes, heart disease, glaucoma, depression, even Alzheimer’s, and since we’ve established that menopausal symptoms are the same symptoms “old” people experience, then, menopause must really equal sick, and since all those outcomes above of “sick” can be life-threatening, menopause, itself, must really be life-threatening.
If menopause might really equal cancer, diabetes, heart disease, glaucoma, depression, and Alzheimer’s, why is it, then, that in those ads for “menopause products”, and in the health advice from the North American Menopause Society (NAMS), the Women’s Health Intiative (WHI), the Food and Drug Administration (FDA), the American College of Obstetricians and Gynecologists (ACOG), no one ever mentions any of the life-threatening disabilities associated with hormonal decline and urges women to accurately replace those hormones that have gone missing?
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
Showing posts with label breast cancer screening internal medicine recommendations. Show all posts
Showing posts with label breast cancer screening internal medicine recommendations. Show all posts
Saturday, February 27, 2010
Sunday, January 10, 2010
Reader Survey: Will the USPSTF Breast Cancer Screening Recommendations change what you do?
Clinical Guidelines
Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement
From the U.S. Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, Maryland.
Description: Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population.
Methods: The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammography, clinical breast examination, breast self-examination, digital mammography, and magnetic resonance imaging in order to update the 2002 recommendation. To accomplish this update, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review of 6 selected questions relating to benefits and harms of screening, and 2) a decision analysis that used population modeling techniques to compare the expected health outcomes and resource requirements of starting and ending mammography screening at different ages and using annual versus biennial screening intervals.
Recommendations: The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms. (Grade C recommendation)
The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation)
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. (I statement)
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. (I statement)
The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation)
The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer. (I statement)
The U.S. Preventive Services Task Force (USPSTF) makes recommendations about preventive care services for patients without recognized signs or symptoms of the target condition.
It bases its recommendations on a systematic review of the evidence of the benefits and harms and an assessment of the net benefit of the service.
The USPSTF recognizes that clinical or policy decisions involve more considerations than this body of evidence alone. Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation.
Previous SectionNext SectionSummary of Recommendations and Evidence
The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. This is a C recommendation.
The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. This is a B recommendation.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. This is an I statement.
The USPSTF recommends against teaching breast self-examination (BSE). This is a D recommendation.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. This is an I statement.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.
For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to www.preventiveservices.ahrq.gov
Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement
From the U.S. Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, Maryland.
Description: Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population.
Methods: The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammography, clinical breast examination, breast self-examination, digital mammography, and magnetic resonance imaging in order to update the 2002 recommendation. To accomplish this update, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review of 6 selected questions relating to benefits and harms of screening, and 2) a decision analysis that used population modeling techniques to compare the expected health outcomes and resource requirements of starting and ending mammography screening at different ages and using annual versus biennial screening intervals.
Recommendations: The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms. (Grade C recommendation)
The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation)
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. (I statement)
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. (I statement)
The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation)
The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer. (I statement)
The U.S. Preventive Services Task Force (USPSTF) makes recommendations about preventive care services for patients without recognized signs or symptoms of the target condition.
It bases its recommendations on a systematic review of the evidence of the benefits and harms and an assessment of the net benefit of the service.
The USPSTF recognizes that clinical or policy decisions involve more considerations than this body of evidence alone. Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation.
Previous SectionNext SectionSummary of Recommendations and Evidence
The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. This is a C recommendation.
The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. This is a B recommendation.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. This is an I statement.
The USPSTF recommends against teaching breast self-examination (BSE). This is a D recommendation.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. This is an I statement.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.
For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to www.preventiveservices.ahrq.gov
