(This is Dr. Love's Third Visit to Power Surge)

Dearest: My special guest tonight needs no introduction. She is
truly one of my favorite people, as most of you know. This is
her third visit in Power Surge Live!

DR. SUSAN LOVE is one of the most renowned physicians addressing 
women's issues today. She is a member of the Medical Advisory 
Committee of the Women's Health Initiative. She is currently working 
on the largest study ever on postmenopausal women in the United States.

"Dr. Susan Love's Breast Book" has been called "the bible" by The 
New York Times. It changed the way women think about breast 
cancer. Dr. Love is currently at work on the 3rd edition of her 
"...Breast Book" and welcomes your suggestions as to what you'd 
like to see included.

"Dr. Susan Love's Hormone Book" is one we refer to often in Power 
Surge, Dr. Love talks to women about dealing with hot flashes and 
the many other issues endemic to menopause. Dr. Love can help you 
sort through the confusing media reports, complex and 
contradictory scientific evidence, and medical bias regarding 
hormone therapy.

Respected by millions of women for her down-to-earth manner and 
willingness to tell the truth, Dr. Love has tackled the subject 
of menopause and hormone therapy with thoroughness and honesty. 
She challenges the notion that every woman needs to take hormone 
drugs her entire life to prevent disease later in life. Find out 
what your options are.

Dearest:   Dr. Love, it's a pleasure to welcome you back to Power 
Surge :)  Please share with us more about your third edition of 
"The Dr. Susan Love's Breast Book."  Thanks :)


Dr. Susan Love:   Well, I am just getting started, but I would 
welcome any suggestions. 


Dearest:   How about if we go to some of the audience questions 
and then set up a question about what they'd like to see in your 
revised book, okay? 


Dr. Susan Love:   Sounds good. GAS 

(Ed. note: In chat protocol, GA is used to indicate that the typing is 
finished and the guest may "Go Ahead" with a reply. The guest mistakenly 
typed an "s" at the end - leading to the light-hearted sequence which 
follows)


Dearest:   Haha! GAS? Susan, have you been eating too much soy? :)


Dr. Susan Love:   I guess so, but it sure did stop my hot flashes! 


Dearest:   Hahaha!  Me, too!. That's the bottom line. Let's go to JOJOWL's 
question. 


JOJOWL:   I am 50 and had LAVH last week for EH--complex w/atypia. 
I was on HRT for 7 yrs before. Is there any reason to take 
testosterone?


Dr. Susan Love:   What is LAVH? 


JOJOWL:   Laproscopically assisted vaginal hysterectomy with 
ovaries removed.



Dr. Susan Love:   Ohhhh... I don't know why you would take testosterone. 
Some have suggested it for libido but it is unproven as to safety 
at this point. 


JOJOWL:   I read a review of a book on the web indicating that it 
could help muscles, strength, etc. I am quite athletic. 


Dr. Susan Love:   It may be able to help muscles in men, I haven't seen 
data in women.  Exercise will do just as well. 


JOJOWL:   So in other words, I should just stay with ERT and 
forget the testosterone for now. That sounds reasonable.


Dr. Susan Love:   That's what I would suggest and get your exercise, 
especially weight training to maintain your muscles. 


JOJOWL:   Thank you. That's an easy thing to do. I was afraid 
that my muscles would turn to mush.


Dearest:   Susan, I've asked you this before, but it boggles the 
mind, why are women being handed this bill of goods about hormone 
replacement therapy? They have us all dying of heart disease and 
stooped over with osteoporosis if we don't take it :(  


Dr. Susan Love:   The story on HRT isn't in yet.  With all the hype 
about it preventing heart disease, the first randomized 
controlled trial in women with heart disease showed no benefit at 
all!  So it may not actually prevent heart disease!!  As to 
osteoporosis, not everyone will get it (about 1 in 4 women) and 
they get it late. There are other life style things we can do to 
prevent it. The idea that we all need to be on drugs our whole 
lives is crazy. 


Dearest:   Didn't the JAMA report actually show that there were 
more heart deaths from women on HRT than those in the placebo 
group?  


Dr. Susan Love:   In the first few years there were more deaths in the 
women on HRT. The drug companies couldn't believe it. They had 
been so sure that it would work. 


Dearest:   Amazing. It's so good to have you here telling us the 
truth. Thank you for that.  RCHCTH, go ahead, please.


RCHCTH:   Why do Dr.'s seem to ignore progesterone/creams?


Dr. Susan Love:   The problem with progesterone creams is that they are 
unstudied and unregulated.  Some have no progesterone in them and 
some even have provera added to them. It is hard to get a handle 
on them. Some women have reported good results in symptoms, but 
even Dr Lee has yet to publish any studies supporting their use. 


Dearest:   Susan, it's difficult to stay on top of all the 
theories to disprove theories. Every week we read that estrogen 
supplementation will lower our LDL (bad cholesterol) and raise 
our HDL (good cholesterol), but I just read a report that said 
that conjugated estrogens RAISE our triglycerides? (Conjugated 
estrogens = Prmarin, Pempro, Pemphase) and we all know that
elevated triglycerides are a contributing actor to heart disease.


Dr. Susan Love:   Very true. If someone has high triglycerides they 
should not take HRT. In addition Provera blocks some of the lipid 
effects. Better to lower your cholesterol with diet and exercise. 
Soy works well too.


Dearest:   So, while HRT is touted as a heart protector, it may 
in fact be causing heart problems? 


Dr. Susan Love:   In some women. I just read a provocative study which 
indicated that some women respond to HRT and others do not 
depending on the kind of abnormal cholesterol they have. It is 
probably genetic. One size does not fit all. 


Dearest:   Don't most women in menopause experience high 
cholesterol? 


Dr. Susan Love:   Everyone has a rise in cholesterol as they get older. 
In fact heart disease does not increase faster after menopause. 
It just steadily increases with age in both men and women, and 
women never catch up to men. 


Dearest:   Thanks, Susan.  Spud0812, go ahead, please. 


Spud0812:   Are compounded natural estrogen/progesterone creams 
effective? safe? and what about side effects?  



Dr. Susan Love:   Compounded natural estrogen/progesterone creams are 
probably effective. They are no more safe than any other form of 
added hormones. That is, they still give you higher levels of 
hormones than you would naturally have. It is also harder to 
monitor the dose with creams since the absorption is variable. 


Dearest:   What ideal protocol do you recommend for a woman in 
perimenopause?  Soy?  Vitamins? Herbs? 


Dr. Susan Love:   I think the first step is getting your lifestyle in 
order, that is low fat diet, exercise, quit smoking. If you are 
symptomatic, I would add soy - 40gm of protein a day.  If you 
need more, than I would add black cohosh (remifemin). In addition 
take calcium and vitamin D and a multivitamin to get your b 
vitamins . 


Dearest:   Thanks, Susan :)  Kaaitjie, go ahead, please.


Kaaitjie:   What is your opinion on natural compounded capsules - 
for example, micronized estradiol and progesterone in oil capsule? 


Dr. Susan Love:   Again just because it is naturally compounded doesn't 
make it safe. Progesterone is better than provera, but we don't 
have either one postmenopausally. Estriol is weaker than estrone 
or estradiol, but neither one is natural postmenopausally. So the 
problems of blood clots, breast cancer, etc, are the same. The 
good thing is that some women tolerate them better than the one 
size fits all Premarin and Provera that are usually used. But HRT 
is HRT whether it is natural or not. 


Kaaitjie:   What would you advise instead?  To go off it?  


Dr. Susan Love:   It depends on why you are on it.  If it is for symptom 
relief you usually only need to take it for two to three years 
and then taper off over six to nine months and you will be all 
right. If it is for prevention then you may be better taking 
something more specific, such as cholesterol lowering drugs for 
high cholesterol or osteoporosis drugs for low bone density. 


Kaaitjie:   Thank you!  Thank you!  


Dearest:   Susan, is it my imagination, or has the risk of breast 
cancer caused by HRT been minimized on a regular basis by 
doctors, pharmacists, etc?   Why does it seem the cautions re 
breast cancer risk with HRT keep getting less and less? 


Dr. Susan Love:   I am not sure since the data is getting stronger that 
there is a increase in breast cancer in women who take HRT for 
more than five years. If you take it for twenty years there is 
double the risk of breast cancer. I think everyone thinks the new 
drugs - like Evista - will take care of everything. The trouble 
is that it is way too early to tell. And it isn't a very good 
osteoporosis drug either. 


Dearest:   Thank you, BEVBCC, go ahead, please. 


BEVBBC:   I've been on HRT for approximately 1 year. Is it true 
that your risk of breast cancer only increases after 5-10 years? 
Also, does it truly decrease your risk for Alzheimer's and colon 
cancer? 


Dr. Susan Love:   It increases with every year that you are on it but it 
only really becomes significant after five years. The increased 
risk mirrors the increased risk that you see with late menopause. 
The data on Alzheimer's is sparse and it is much too soon to 
tell.  So far I have not been impressed. 


BEVBBC:   Thanks!


Dearest:   Thank you, Susan. MARFGR, go ahead, please.


MARFGR:   My doc wants me to take HRT, even though Breast Cancer 
runs in my family. What are your thoughts on this? I don't want 
to take it.


Dr. Susan Love:   I would not take HRT unless there was a compelling 
reason (I am not sure I can think of one). I certainly wouldn't 
take it with Breast cancer in the family.  The best way to 
prevent breast cancer is to have your ovaries out at thirty and 
not take anything (of course you would have other problems!) 
Still it is hormones that fuel breast cancer. 


Dearest:   To what do you attribute the tremendous rise in breast 
cancer? It seems another woman in Power Surge reports it weekly 
and she's always on HRT. 


Dr. Susan Love:   There are probably lots of reasons. We are awash in 
estrogen in the drugs we take and in the pesticides and 
environmental hazards. There is also preliminary data that women 
who take the pill and then take HRT may be at higher risk then 
women who just take HRT. The baby boomers are the first 
generation to do both and we are just hitting fifty.


Dearest:   Thanks, Susan. Sue, go ahead, please.


Sue:   You just touched on this. There was a report released 
earlier this week about a link between increased incidences of 
breast cancer and pesticides finding their way into the food 
chain.  Any comments?  How can we avoid this?  


Dr. Susan Love:   It is almost impossible. Although pesticides have been 
outlawed in this country they still come in on the fruits and 
vegetables that we import from South America. You can try to eat 
only organic but it is in the water and the ground forever. Plus it 
may be what we were exposed to as kids that is even more important 
(I grew up in New Jersey and chased the DDT truck that came during 
the polio epidemics. Who knows what we were breathing.) 


Dearest:   (sigh) ...Thanks, Susan. Catalina, go ahead, please.



Catalina5:   Does muscle tissue produce more estrone than fat 
tissue, lb. for lb.?


Dr. Susan Love:   It produces at least as much, as far as I can tell. 
The same enzyme aromatase is in both muscle and fat and that is 
what converts androsteindione and testosterone to estrogen 
postmenopausally.


Dearest:   Meladonna, your question, please:)


MELADONNA:   Can black cohosh be taken while using xanax, and 
would 180mg of soy be too much per day?


Dr. Susan Love:   The studies look at 40-60 grams of soy protein.  It 
can be confusing because sometimes they are talking about soy 
protein and other times about mg's of isoflavones (which would be 
higher). I would limit soy to 60 grams. I think you can take 
black cohosh with Xanax,  but would have to look it up. There is a 
new book, the German Commission E Monograph that actually tells 
you that kind of stuff. 


MELADONNA:   Thank you.


Dearest:   Interesting. JOJOWL, go ahead, please.


JOJOWL:   What if small breasts, thin (high osteo. risk), & heart 
disease in family but bad endo hyperplasia - would you still 
recommend against ERT? 


Dr. Susan Love:   Uterine endometrial hyperplasia or breast? 



JOJOWL:   Uterine, but just had the hysterectomy and ovaries out. 


Dr. Susan Love:   Oh yeah the LAVH :) I would take ERT for a bit to tide 
you over the symptoms and then decide on the prevention issues. 
Remember that we don't have evidence that it prevents heart 
disease, so it is better that you deal with that directly with 
antihypertensives or cholesterol lowering drugs. As for 
osteoporosis, exercise. Or you could get a bone density and find 
out if you are at risk. Being thin is not a problem alone.


JOJOWL:   Thanks. 


Dearest:   Thank you, Susan. Kaaitjie, go ahead, please.


Kaaitjie:   When you last visited with us I asked you what your 
personal choice would be regarding HRT. Do you still feel the 
same way? Can you elaborate?



Dr. Susan Love:   I am 50 and flashing. I have missed a few periods, but 
am not over the hump. For me soy and black cohosh do the trick 
for now. I try to exercise and eat a good diet. I don't smoke and 
I think that chocolate is a vegetable. I think menopause is 
natural and I see no reason to mess with what is programmed into 
my body at this time. The data that is coming in (no heart 
advantage and breast risk) seem to support my current choice. But 
I am always open to data and will change if something compelling 
comes out. 


Kaaitjie:   Yeah to chocolate!


Dearest:   Wonderful response, Susan. Thank you :)  TZ, go ahead, 
please.


TZdoe:   Are there cancer or other risks in taking natural 
progesterone during perimenopause and menopause?  


Dr. Susan Love:   There are no studies on natural progesterone's safety. 
In the limited data that exists it appears that adding provera to 
estrogen only increases the breast cancer problem.  I don't think 
we can assume that progesterone is safe in the breast.


TZdoe: Oh my.  Thanks 


Dearest:   Do you think NP creams help? I've used various 
brands/doses and it never did a thing but make my skin smoother. 


Dr. Susan Love:   It depends.  Some of them have provera added to them. 
Even the wild yam creams may have things added to them. 


Dearest:   Thanks.  Suburban, go ahead, please.


Suburban M:   All of my uncomfortable symptoms went away after 5 
weeks on Revival soy protein and natural progesterone cream. I went 
off the cream for a week and I got nipple soreness. Any idea why?


Dearest:   Revival is put out by mainstream medical doctors. Each 
dose has 180 mg. of isoflavones. (soy protein shake)


Dr. Susan Love:   That's a new one to me.  Were you rubbing the cream on 
your nipples? :) 


Suburban M:   No, but on my breasts at times.  I am convinced the 
cream works. It has gone away now that I am back on.


Dr. Susan Love:   It may well work. I am not saying it doesn't. I am 
just saying that there have been no studies. This is in part 
because it can't be patented and the drug companies don't want to 
study it. And the natural hormone companies that sell it don't 
feel like they need to since they are unregulated. There is one 
study that I am aware of in Pennsylvania and I await the results 
with interest. I would be careful about putting the cream on your 
breasts though.  There is always a higher dose on the part that 
you put it on and it may increase cell division in the breast. 



Dearest:  I have heard doctors and naturopaths comment that Dr. 
John Lee's studies regarding natural progesterone creams are 
mostly anecdotal. May I have your thoughts on this?  


Dr. Susan Love:   Indeed they are, and only published in his book! 


Dearest:   Interesting.   RCHCTH, go ahead.


RCHCTH:   Would you use natural progesterone pill/cream to 
control heavy bleeding & constant spotting?


Dr. Susan Love:   No, the absorption is too spotty (pun intended!). I 
think you would do better with either Provera or oral 
progesterone (which was just approved by the FDA) called 
Prometrium. 


Dearest:   Thanks, Susan. BlockLen, go ahead, please.


BlockLen:   Does wild yam have an estrogenic effect or 
progesterone effect when in cream form? 


Dr. Susan Love:   It is thought to have a progesterone effect. All 
hormones except for Premarin come from the wild yam. The problem 
is that the body does not necessarily take wild yam cream and 
convert it to hormones the same way the laboratory does. I think 
that wild yam creams are safe as long as someone hasn't added 
something to them. Check with the list published by the group in 
SF.  I am blocking on their name. 


Dearest:   Aaeron Life Cycles?


Dr. Susan Love:   Yup thanks 


Dearest:   Ok, we have that list published in Power Surge.  
VBrando, go ahead, please.



VBrando101:   Are calcium deposits in the breast a sure sign of 
cancer? What are the odds?


Dr. Susan Love:   No, calcium deposits are usually benign (70%) of the 
time. Sometimes they can be a sign not so much of cancer as of 
precancer. If they are suspicious (small and very hard to see) 
they should be biopsied to make sure.  This can be done in the 
xray department and doesn't require surgery. If they are benign 
looking you don't need to do anything. 


VBrando101:   Thank you!!


Dearest:   Susan, share with us what you want to know for your 
3rd edition of what the NY Times calls "The Bible" -- "Dr. Susan 
Love's Breast Book."  


Dr. Susan Love:   I am soliciting any comments or experiences that women 
have had that they think would be helpful.  This is your chance 
to be in the bible!!!  


Dearest:   Ahh, shall you rename it "Dr. Susan Love's Evangelical Breast Book?" :)


Dr. Susan Love:   Wait until I find the way to prevent breast cancer.  
Then it will be a few pages and I can rest. 


Dearest:   I have faith in you :)  I'll post messages on various 
Power Surge boards and send you the responses via Email, ok?


Dr. Susan Love:   Yes please.  


Dearest:   Great.....  Susan, thanks so much for joining us in 
Power Surge and fielding our questions about women's health, 
menopause and breast health. Everyone can locate copies of 
Dr. Susan Love's excellent and informative books at fine
bookstores anywhere. They're also available directly from
the Power Surge Reading List -- "Dr. Susan Love's Hormone Book" and 
"Dr. Susan Love's Breast Book" (Random House).


Dearest:   Please know that we have the greatest admiration for 
not only your knowledge, but your honesty and integrity.


Dr. Susan Love:  It was a pleasure :)  Anytime.


Dearest:     Goodnight, Susan 


Dr. Susan Love:     Good night, Dearest 




Read Susan Love's first transcript
Read Susan Love's second transcript
Read/Listen to Susan Love's fourth transcript
 with Dr. Love, Dr. Marcie Richardson and Dearest


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Dearest
aka Alice Stamm
Power Surge
Founder, Facilitator, Host


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