Dearest:  Erika Schwartz, M.D. is a healthcare pioneer, a woman's physician, a 
researcher and expert on all things hormonal. Dr. Schwartz is the author of two 
books, "Natural Energy," and "The Hormone Solution." She has appeared on TV
shows like The View and has been quoted in Newsweek, Vogue, The Wall Street 
Journal, USA Today and Self Magazine, fielding questions about hormones and
stress, hormones and aging, hormones and the life cycle.

Montefiore Medical Center sponsored and aired a four-year television program 
produced and hosted by Dr. Schwartz, Health Horizons, the first program in the 
greater metropolitan NY area directed at bridging the information gap between 
physicians and patients.

Dr. Schwartz has a true passion and commitment to empower and educate women
to be the healthiest they can be. She's been practicing medicine for 20 years
and specializes in women's health.

Dr. Erika, welcome back to Power Surge :) 


Erika Schwartz, M.D.:  Thank you so much, Dearest. 


Dearest:  Share with us, if you would, some information about the study you're 
conducting on natural hormones. Thanks


Erika Schwartz, M.D.:  We are running a three month study on 100 women between
the ages of 45-56 with insomnia, hot flashes, night sweats and anything else that 
goes along.  We are treating them blindly with either placebo, black cohosh and oil 
of evening primrose over the counter Progest cream or prescription strength 
estradiol and micronized progesterone in cream form.


Dearest:  I have put that up on the Web site, Dr. Erika. I'm so pleased you're 
conducting such a study on naturally compounded hormones. 


Erika Schwartz, M.D.:  I am, too, and our patients are also very interested and 
willing to help figure out what works best for short term symptom relief and
long term prevention. 


Dearest:  One more question - are there specific requirements other than age?
Say a woman is on medication of some kind, anti-depressant, anti-hypertensive. 


Erika Schwartz, M.D.:  Yes, if someone is taking medication we will screen them
and if they qualify we will work with their medications or just stop them if the 
participant agrees. 


Dearest:  The women don't have to be there in person to participate, correct?


Erika Schwartz, M.D.:  Absolutely not. We will send them questionnaires and if
they qualify, the three months supply of medications free of charge.  We will 
follow them every month.  The results will be published in Health magazine in
the Fall 2003. 


Dearest:  Excellent. I'm sure women will want to participate in this important 
study about alternatives to traditional HRT.  


Erika Schwartz, M.D.:  Thank you for bringing it up.


Dearest:  You're welcome, Dr. Erika. I think many women need to know about
such important studies.


BentWench:  I'm 50, mostly having periods, sometimes not. I'm using natural 
progesterone and testosterone. There are 2 successive generations of uterine
cancer in my family, so I'm afraid to use any estrogen when my hormones dip
even further. Right now I'm balanced and feeling great. Any thoughts or 
recommendations concerning this complication? 


Erika Schwartz, M.D.:  You are right. Even if you have a family history of cancer, 
using natural estrogens is not contraindicated as long as you use it in combination 
with progesterone. You should also know that testosterone turns to estrogen in your 
body so while you think you are avoiding taking estrogen you are in fact 
supplementing your body with estrogen through the testosterone supplementation.
If you are feeling OK, stay the way you are, but do not eliminate taking estrogen 
when you need it. 


BentWench:  Yes, I do know that about the testosterone and I thank you for the
help regarding the estrogen.


Sheri:  After using HRT for about 15 years, I am in the process of weaning myself 
off. I have been in full menopause for about 7 years and just wonder if I'm going 
to feel any affect at this time? 


Erika Schwartz, M.D.:  You never know when and if you will feel any effect after 
discontinuing hormone therapy.  The best approach is to wait and see and if you get 
symptoms treat them with natural hormones not synthetic HRT the next time. Good 
luck. 


Dearest:  Truth or fiction, Dr. Erika - taking natural hormones will cause fibroids 
to grow! 


Erika Schwartz, M.D.:  Fiction.  Natural hormones make fibroids shrink, if 
anything. 


Dearest:  Why have women been told for years to avoid estrogen or estrogenic 
products it they had fibroids?


Erika Schwartz, M.D.:  Because no one understood the importance of the balance 
between estrogen and progesterone rather than the individual role of the individual 
hormones. 


BarbaraBC:  I am 50 and still having regular periods although noticing differences 
in my body functions like stomach bloating, temper flare ups. Is there anything I 
can do to stop the stomach bloating. Also I am urinating frequently and having some 
insomnia. Any advise? I am not taking anything. Any advise? 


Erika Schwartz, M.D.:  You need estradiol, the estrogen of youth, and progesterone.  
The combination properly prescribed in natural hormones will make the bloating 
disappear and help with the stomach function.  It will also diminish the frequency 
of urination. 


BarbaraBC:  Sounds like a miracle solution. 


Erika Schwartz, M.D.:  It is.


Marney:  I've heard of facial creams with estradiol, testosterone and progesterone 
to help with sagging etc.  Have you prescribed them and if so, what do you think
of them?


Erika Schwartz, M.D.:  To date, unfortunately there are no creams with hormones 
that work, not because the hormones wouldn't help the sagging but because no 
vehicle has been created to keep the hormones in the skin long enough for them
to make a difference.  However, there are lots of people working on finding the 
right cream base. 


Dearest:  Dr. Erika, why do you choose "cream" as the delivery system of natural 
estradiol and micronized progesterone, rather than gels, pills, etc.? 


Erika Schwartz, M.D.:  I like creams because they are easily absorbed, user-
friendly, easy to adjust dose by the individual and they protect the liver which
no pill will do.  Gels also have alcohol and give many allergic reactions.


MaryO:  Dr. Schwartz, this is related to Sheri's question. So many women on the 
message boards are asking about weaning off hormones lately. How do you recommend 
that people wean off HRT so that they have the fewest symptoms?


Erika Schwartz, M.D.:   Depends. Weaning of synthetic HRT is important if you plan 
to take no other hormones.  If you transition to naturals you can wean and start 
the new hormones together and feel good throughout the process. 

Dearest also has an excellent article on the web site on weaning off
synthetic hormones.

Dearest:  How are bio-identical hormones different from the synthetic hormone 
combination of estrogen/progestin (Prempro) used in the Women's Health Initiative 
study? 


Erika Schwartz, M.D.:  Bio-identicals or natural hormones are molecularly identical 
to the hormones our bodies make when we are young and healthy.  Synthetics are 
foreign molecules with chemical structures foreign to our bodies. 


Dearest:  And you've been prescribing natural hormones for years, yes?  Not just 
since the halted WHI study.


Erika Schwartz, M.D.:  I have been working with natural hormones for almost 10 
years. I started working with them when I started having symptoms of premenopause 
and I found that my patients and I had terrible reactions with synthetic hormones 
and birth control pills. 


Marlo:  Do Natural Hormones make you gain weight? Are they dangerous if you have 
varicose veins? Also I get hot flashes everyday at the same time. What does this 
mean? 


Erika Schwartz, M.D.:  If well balanced, natural hormones should make you lose 
excess weight. They have not been connected to blood clots or thrombophlebitis
so they should not affect your varicose veins.  The fact that you get hot flashes 
every day at the same time is not unusual. Unfortunately, I can't tell you what 
causes that to happen except that maybe the same situation triggers hormone 
fluctuations in you every day.


Dearest:  Something I'd like to note here .... 

Dr. Chris Northrup, author of "The Wisdom of Menopause," writes, "Although the 
number of bioidentical hormone combinations is extensive, there are two 
formulations that I've found especially useful for relief of menopausal symptoms. 
These were developed by two pioneers in the bioidentical hormone field, Dr. Joel 
Hargrove and Dr. Erika Schwartz." Congrats! That's a lovely testimonial from 
another women's physician/health care advocate.


Erika Schwartz, M.D.:  Dearest, You make me blush!  Thank you 


Dearest:  I'm very proud of the important work you've done and that you're 
associated with Power Surge! :)  


Erika Schwartz, M.D.:  I think what you are doing is impressive!  Helping so many 
women!!! 


Dearest:  Thank you :) 


Debrikkia:  I had a total hysterectomy 13 years ago. I have been on natural 
hormones for 3 years now--Biest/progesterone/testosterone combination. Is the 
progesterone necessary in my case in your opinion? 


Erika Schwartz, M.D.:  Absolutely.  Progesterone is very important even for women 
without a uterus.  That is because you have progesterone receptors all over
your body, on every cell, so even though you don't have the uterus, you need the 
progesterone to protect your breasts, heart, bones, etc. 


TCML:  I am 5 years post menopause and have osteopenia. Will hormones help and
if so which ones?


Erika Schwartz, M.D.:  Hormones will only help to a certain point.  You have 
genetics to take into consideration and you must eat right, exercise- strength 
building and take calcium, magnesium and zinc supplementation. 


Dearest:  I read a question a woman wrote to you about diet in which she said
her doctor recommended that she remain on the "induction phase" of the Atkins
Diet, limiting herself to 20 gm. of carbohydrates per day - eliminating fruits, 
vegetables. How can a doctor recommend such an extreme diet and what do you 
recommend as the best diet for losing and maintaining proper weight? 


Erika Schwartz, M.D.:  A doctor who doesn't care about how the patient feels
and how it will affect her in the long run will recommend this type of diet.
A well balanced high protein, low carbs, medium to low fat and high fiber diet
in five small meals a day is the only viable answer. 


Marney:  I was on the BC pill for many, many years and oddly, I actually tolerated 
it quite well. Now at 51, I am off the pill and still having periods, though they 
are irregular. I'm on HRT -- estradiol and sometimes prometrium or micronized 
progesterone. My problem is that I cannot tolerate progesterone, even my own!
After I ovulate, my mood gets very, very depressed. I only feel good right before
I ovulate. I feel good taking estrogen alone. What can I do?


Erika Schwartz, M.D.:  Increase the estradiol and add a little micronized 
progesterone.  It is about the balance, not only the individual hormones.
I am sure progesterone alone will depress you, but the right amount of estradiol 
will help.  Also consider testosterone and have your thyroid function checked. 


GGc0ok:  Doctor Schwartz, is estradiol cream used the same way as the progesterone 
cream? Will it help the vaginitis dryness? Knowing where to go on its own?


Erika Schwartz, M.D.:  Best way to use the creams is in combination and to apply 
them to the same area all the time.  I prefer the mid breast bone and inner wrists.  
Stay away from below the waist.  It brings fat cells to the midriff area. 


Dearest:  Dr. E., why do you suppose so many women are "afraid" of hormone 
supplementation, even natural hormones? 


Erika Schwartz, M.D.:  Because synthetics have ruined the field, we identify the 
word hormone  with the perils of synthetic hormone replacement therapy.  We don't 
realize that hormones make us young and heathy and fertile and without wrinkles.  
It is only the synthetics that make us sick.  Our own hormones or natural hormones 
in balance protect us from aging and its attendant ills. 


Dearest:  And yet, isn't it interesting that probably a good majority of these
same women took strong, synthetic birth control pills at one time?


Erika Schwartz, M.D.:  Of course. Actually we are doing a mini study on birth 
control pills for a women's magazine and the data is looking awfully negative
for the side-effects of birth control pills. 


SondraBags2:  I was on Prempro for 10 years been off the last 10 months. I've
tried herbs and soy, and the cream.  Nothing has help with the symptoms. I'm at
my wits with all the information out there about natural hormones and the doctors 
don't know. 


Erika Schwartz, M.D.:  I totally sympathize with you.  I hear your story daily all 
too many times.  Call me and we will try to help you either find a doctor or I will 
do it myself. 


Dearest:  Sondra, one of the things I've tried to do in Power Surge in the last
9 years has been to bring guests and provide information to make things clearer
to women because there's so much confusing information out there.


SturdyWoman:  Dr E, I have been tested 3 different times and found all hormones
are very low, still having regular periods, have almost no progesterone and when
I try to take different forms it really makes me depressed.  I took myself off 
Estrace because I couldn't tolerate the progesterone, any suggestions for me? 
(please?)


Erika Schwartz, M.D.:  Estrace does not contain progesterone. You probably didn't 
get the right balance or formulation. 


SturdyWoman:  I know, but I did not want to take it alone. 


Erika Schwartz, M.D.:  It takes some time and real commitment to get it worked
out, to make each woman balanced.  You should take a combination. 


SturdyWoman:  I've been trying for a year and a half. 


Erika Schwartz, M.D.:  Call me at the number mentioned and I will help. 


Bamericab:  Can natural estrogen creme (Triest) cause anxiety? I am also using 
natural progesterone creme and 2 mg testosterone (natural) capsules daily.
I was recently prescribed the Triest and have felt anxious since this addition.
By the way - progesterone creme alone made me depressed.


Erika Schwartz, M.D.:  Again it is about the combination and the balance between 
the hormones used. I don't advocate Biest or Triest. I am simple.  I work with 
estradiol, which is the estrogen of youth, and micronized progesterone. 


Dearest:  Remember, we are talking about "natural" estrogen and progesterone. 


Lentje:  I was on the pill for about 20 years and in the last 2 years I was on a 
low dose and had no periods for about 12 months will using natural hormones mean 
having periods? 


Erika Schwartz, M.D.:  Not necessarily.  The beauty of natural hormones is that 
they only bolster your own system, they don't override it like birth control pills 
or other synthetic hormone impostors. 
 

Dearest:  Lentje, if it's any consolation, I was postmenopausal when I tried 
natural hormones and never started having my period again. 


Erika Schwartz, M.D.:  You are not unusual, Dearest. Most women who stopped
menstruating, do not start again on naturals.


Marney:  I've been reading a lot about pregnenolone lately.  What do you think 
about adding that to the mix?


Erika Schwartz, M.D.:  Pregnenolone is a hormone precursor meaning progesterone
and other hormones are made from it.  If your body can transform the pregnenolone 
you are taking in pill form into active hormones in your body then it is worth 
trying.  If your body can't transform it, you are wasting your money.   Try it and 
see after a couple of weeks how you feel. 


SondraBags2:  What mg. do you usually start your patients on (Estradiol and 
Micronized Progesterone)?


Erika Schwartz, M.D.:  Estradiol .6mg and micronized progesterone 200 mg a day is 
the average dose that works for most people.  If it doesn't, it doesn't mean the 
dose is wrong, most likely the culprit is the preparation. 


SondraBags2:  Can I have my doctor write me a script for that and have it filled 
at my drug store? 


Erika Schwartz, M.D.:  If your drug store is a good compounding pharmacy that
knows how to do it then the answer is yes. 






Dearest:  Erika, thank you for another very informative chat about natural hormones 
for treating menopause. I also recommend Dr. Erika Schwartz's book, The Hormone Solution.


Read Dr. Erika Schwartz's first transcript
Read Dr. Erika Schwartz's second transcript
Read Dr. Erika Schwartz's fourth transcript
Read Dr. Erika Schwartz's fifth transcript 



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Power Surge
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