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Valerie Monroe's avatar

I wish you would investigate the use of drugs prescribed for osteoporosis. The anecdotal evidence of bad side effects (at least in my world) is far greater than what I've read about in the media (meaning I haven't scoured academic journals). A friend who'd undergone a long jaw surgery as a result of one of the drugs said that her doctor's waiting room was full of women who'd experienced similar side effects. Do you believe side effects are under-reported? I know many women (including a few physicians) who have decided not to take the drugs because of side effects as well as the effects on bone health after you must stop taking the drugs. I highly respect your thoughts on all health issues and would appreciate more on your thoughts about these drugs. Thank you!

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Leonie's avatar

In my personal experience, urine exacerbates LS, so at my clinic (Jean Hailes), the patients are encouraged to use Dermeeze ointment a few times a day to "coat" the mucosa on the vulva. My vulval dermatologist, Dr. Tanja Bohl, told me about a group of nurses who implemented this protocol at one particular aged care facility and reduced vulval dermatitis in patients by a significant amount. It's like urine is "corrosive". I don't have the right words, but to me, LS is about an impaired barrier and inflammation. If anyone is interested in learning about LS, etc, do a search on YouTube for "Dr Tanja Bohl." She is a fantastic educator. Love your work, as always. Enjoy the conference.

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Dr. Jen Gunter's avatar

Oh a barrier ointment is essential for women with LS and for women with itching or incontinence it really almost any vulvar symptom. Getting urine off the skin by treating incontinence helps immensely as does a bidet over wiping. I’ve just never heard of it offered as a cause of LS as in part of the biological trigger.

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Val Schonberg's avatar

Thank you so much for sharing this summary! The International Osteoporosis Federation also has a calcium calculator that appears to be a little more comprehensive than this one. My understanding of the increased recommendation for calcium had to do with accounting for issues with decreased calcium absorption in older people. Different, but somewhat similar to differing recommendations for prediabetes criteria between ADA and WHO and NICE guidelines. Another example is iron recommendations for vegetarians are 1.8 times higher than meat eaters. I look forward to seeing what else you find out.

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Jackie Rene's avatar

Looking forward to your deep dive on calcium. I’ve looked at that calculator before and for someone on a plant based diet it predicts very low calcium intake as the options to select there are heavily dairy and fish based. Dr Gregors website has many videos on calcium which *seem* evidenced based. Would be interested in your thoughts… here is one but that are many others… https://nutritionfacts.org/video/are-calcium-supplements-effective/

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bussle's avatar

Very interesting and, as a plant based eater, reassuring video. I'd be interested to see what Dr Gunter or other experts think.

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Beehave's avatar

Do you have a post on osteoporosis, DEXAs and frax scores as you mentioned here, or a good updated link to info. I need to read up to understand and know what I should be ordering for my pts?

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JJ's avatar
2dEdited

Is there any talk of rebranding “menopause”? It feels like menopause is such an emotionally laden term with so many negative connotations rather than being thought of a natural phase of life.

It’s ripe for an entire rebranding and seems like ObGyns would lead this. Any thoughts? (This could be a future article 😁 ((I know you’ve touched on this before, but I don’t recall rebranding specifically))

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Trish Brown's avatar

Curious about that Osteoporosis graph -- what do the numbers on the vertical axis correlate with?

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S. Levin's avatar

Dr. Jen, this is amazing. Thanks so much. This reminds me of the 'sensory overload' NP conference I used to go to (didn't even need an airplane to get there), which is now 'dearly departed.'

I'd love more updates on bone health and Ca++ (my bones are 'fading'). For a time, I was borderline hyperparathyroid, & my endocrinologist advised against Ca++ suppl. (The only Ca++ outside of food now is 200mg from Centrum Silver).

Red light tx... that's a good one; sounds like a red flag for snake oil...

Since the clitoris is above the urethra, how is urine collecting there?

Looking fwd to more news from this conf.!

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Dr. Jen Gunter's avatar

Dripping, wiping…it’s very close

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Mechele's avatar

I hope you will be breaking Incretin-based MHT more for us laypeople. Thank you for all you do.

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Dominika's avatar

Very informative

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Christine wildman's avatar

This is so wonderful - thank you for sharing this information with us. I would imagine if a woman is still having a regular menstrual cycle and has other peri symptoms including depressive mood, the antidepressant would be recommended over estrogen?

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S. Levin's avatar

I created an acct for Fraxplus, but couldn't navigate it.

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Dr. Jen Gunter's avatar

It worked fine for me, I did it yesterday

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Beehave's avatar

What combined patches are available now in the US? Do any have isomolecular progesterone or only the synthetics?

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S. Levin's avatar

Climara Pro & Combipatch are the only ones I'm aware of; they have synth. progestogens, not progesterone.

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margaret sledziewski's avatar

For any Canadian's combined patch here is Estalis. Climara Pro manufactured by Bayer is not longer available here.

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Hope Perlman's avatar

What is protestogen? Is it progesterone?

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Dr. Jen Gunter's avatar

Typo, progestogen which is either a progesterone or a progestin

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