The purpose of this health care provider section is to re-frame knowledge about women's reproduction to an approach that is life cycle based, ovulation-focused and woman-centered. Those providing medical services related to women’s reproduction have been trained largely by gynecologists and given a pelvis-based and surgically focused knowledge that may or may not be practical for and acceptable to women. In addition this section provides practical tools and handout materials for women’s reproductive care.
Because reproductive medical education, journals and textbooks continue to be dominated by a gynecological approach, some of the CeMCOR's research may not yet be published. Hence the information may vary from current standard recommendations and recommendations provided may or may not be supported by published Level 1 or 2 evidence. However, in each instance the physiology, epidemiology and, sometimes, randomized double blind controlled trial evidence for the approach will be provided with peer-reviewed references.
In addition, the CeMCOR website offers health care providers of all levels of training the opportunity to ask key questions and obtain detailed and practical answers from Dr. Prior.
This article was prepared in conjunction with a conference presentation in May 2015. It outlines new information and updates to what is known about ovarian hormone therapy.
In less than a year, two influential articles reporting on consensus recommendations for therapy of “menopause-associated” and “menopausal” symptoms concluded that estrogen (with or without progestin) is the optimal therapy.
The purposes of this article are to propose that progesterone therapy is an equally or more effective hot flush/night sweat therapy than estrogen and to show that progesterone is safer than estrogen or estrogen with progestin (a synthetic cousin of progesterone) therapy.
Dr. Jerilynn C. Prior, Scientific Director of the Centre for Menstrual Cycle and Ovulation Research, has never advocated the use of hormones as an ongoing "replacement" for menopause. She does not feel that menopause is a medical condition that needs to be "fixed". Rather it is a normal stage of life. She strongly advocates use of new term for the few women who do need therapy in menopause. The new term is: Ovarian Hormone Therapy.
For the woman who isn't trying to get pregnant, does it matter if an ovulatory pattern is normal? Recent studies indicate that it does. One study showed that women with only one nonovulatory cycle a year lost an average of 4% of their spinal bone. Strong evidence suggests that lack of cyclic normal progesterone is detrimental to good health.
The purpose of this article is to highlight the ways in which oral micronized progesterone therapy (taken by mouth as a pill) can be helpful for menopausal women with hot flushes, sleep disturbances or osteoporosis (menopause being one year after all flow has ceased).
This series of articles, originally published in the CeMCOR newsletter, illustrate the importance of ovulation throughout women's reproductive life. The articles explain what ovulation is and address some of the issues and implications of ovulatory disturbances.
The largest and best-controlled trial testing whether hormone “replacement” therapy prevented heart disease was stopped three years early in July 2002. The Women’s Heath Initiative (WHI) study included over 16,600 healthy menopausal women without symptoms. These women were randomized to daily conjugated equine estrogen (Premarin, 0.625 mg) plus medroxyprogesterone (Provera, 2.5 mg) or an identical placebo. Hormone therapy increased breast cancer significantly (by 26% over placebo) and caused higher rates of heart attacks (29%), strokes (41%) and blood clots (211%). These risks outweighed this therapy’s significant benefits in preventing osteoporotic fractures of the hip (decreased by 34%) and colon cancer (decreased by 36%).
Since July 2002,hundreds of talk shows and editorials across North America have discussed these results. Many doctors and medical groups have offered criticisms. However, no one has yet identified what I believe is most important.
We hear a lot of things about hormone therapy (often wrongly called Hormone Replacement Therapy or HRT) (1). Most of the time when “HRT” is used it is referring to the treatment of women who had natural (not surgical) menopause at a normal age. Before about 1998 we believed that estrogen made everything better, but now most of what we hear is bad. And that bad news doesn’t apply to you! Early or surgical menopause needs hormone therapy, but natural, normally timed menopause does not. Some women with early menopause have told me that their doctors stopped their hormone treatment when the Women’s Health Initiative results came out. That’s how confused even doctors are! The purpose of this is to help you feel confident about knowing how and when to take ovarian hormone therapy for a long and healthy life.
Answering questions about “polycystic ovary syndrome” (also called PCOS but which CeMCOR calls Anovulatory Androgen Excess or AAE) and exploring new and helpful information about this mysterious condition.
Painful periods are known as cramps. This section looks at what causes cramps and how to ease the discomfort. Doctors call painful periods or cramps “dysmenorrhea.” They are caused by high levels of prostaglandins, a kind of hormone that increases the normal squeezing or contraction of the muscle in the wall of the uterus.