Healthy Living Today

Plastic surgery for the uterus- that's the way some coyly describe endometrial ablation, but for the potential halfmillion women who are mostly aged 40 to 55 for whom this 10minute procedure could lessen the need for a hysterectomy, this is no laughing matter.

Minimally invasive procedures which have a recovery time measured in hours to days are increasingly taking the place of traditional largely invasive surgeries that leave women laid up for weeks to months. If that is "not your father's Oldsmobile," then should the hormone regiments your doctor is prescribing necessarily be the same that were given to your mother or grandmother?

In medicine, what you don't know can hurt you. Too many physicians stop learning after they graduate from residency and practice the same way for decades. They do so under a shroud of "bedside manner" or insurance captivity. The latter is a process by which the insured finds the doctor based on proximity only and then sticks by that decision. The former is based on the fact that the doctor is "nice" and "seems to know what they are doing."

Why do we sometimes have more criteria to pick a hairdresser or dry cleaner? The truth is that a great surgeon can have both great bedside manner and great surgical ability and is going to give you options and alternatives. Often the best alternatives are procedures that are more difficult on the doctor, but provide for a quicker recovery for the patient.

The old adage is "we work hard so you don't have to." Unfortunately, the dirty little secret is that those procedures pay doctors less for their time than the traditional surgeries and thus the doctor never learned it or does not offer it as an option.

Another gynecologic alternative is "natural" bio-identical hormone replenishment therapy. A woman might choose BHRT as an alternative to traditional and synthetic hormones. Although the massmarketed and massproduced drugs meet the needs of most patients and are also relatively safe, there are still a number of patients who require pharmacists to customize (compound) medication to meet their unique needs.

Bioidentical hormone replenishment therapy can be made in a wide variety of dosage forms and strengths and even help with sexuality. Bioidentical hormones, which are regulated by the FDA, should not to be confused with over-the-counter "natural" hormones that are not FDA regulated.

Whether it is traditional hormone replenishment therapy or BHRT, you should know that the media has blown the hormone "controversy" out of proportion. An overgeneralization, for brevity's sake, would read that estrogen does not cause breast cancer. Estrogen can feed a preexisting breast cancer which may actually be a good thing because we know that those on HRT when they have their breast cancer diagnosed often have it detected at an earlier and more treatable stage.

While not the fountain of youth, estrogen can improve your mood, skin elasticity, hot flash frequency and intensity, bladder infection frequency, sexuality and reduce your risk for colon cancer and osteoporosis. It is time to open your eyes and your mind and find a traditional gynecologist who can offer alternatives to menopause management before you let menopause manage you.