by E
Application: buccal tablet
Brand (hormone): Testim (testosterone)
Bioidentical: Yes
Application: gel
Brand (hormone): Testosterone (testosterone)
Bioidentical: Yes
Application: various generics and compounded cream, implant, gel, injection, and cream
Brand (hormone): Testred (methyltestosterone)
Bioidentical: No
Application: various generics, compounded pill, sublingual tablet
Combination Estrogen/Progestin76
Brand (hormone): Activella (estradiol, norethindrone acetate)
Bioidentical: No
Application: pill
Brand (hormone): Angeliq (drospirenone, estradiol)
Bioidentical: No
Application: pill
Brand (hormone): Climara-Pro (estradiol, levonorgestrel)
Bioidentical: No
Application: patch
Brand (hormone): CombiPatch (estradiol, norethindrone acetate)
Bioidentical: No
Application: patch
Brand (hormone): FemHRT (ethinyl estradiol, norethindrone acetate)
Bioidentical: No
Application: pill
Brand (hormone): Prefest (estradiol, norgestimate)
Bioidentical: No
Application: pill
Brand (hormone): Premphase (conjugated estrogens, medroxyprogesterone acetate)
Bioidentical: No
Application: pill
Brand (hormone): Prempro (conjugated estrogens, medroxyprogesterone acetate)
Bioidentical: No
Application: pill
Combination Estrogen/Testosterone
Brand (hormone): Covaryx (esterified estrogens, methyltestosterone)
Bioidentical: No
Application: pill
Brand (hormone): Covaryx HS (esterified estrogens, methyltestosterone)
Bioidentical: No
Application: pill
Brand (hormone): Essian (esterified estrogens, methyltestosterone)
Bioidentical: No
Application: pill
Brand (hormone): Essian HS (esterified estrogens, methyltestosterone)
Bioidentical: No
Application: pill
Brand (hormone): Estratest (esterified estrogens, methyltestosterone)
Bioidentical: No
Application: pill
Brand (hormone): Estratest HS (esterified estrogens, methyltestosterone)
Bioidentical: No
Application: pill
resources and notes
Menopause and Shmirshky Health
“The Endangered Uterus” by Peg Rosen
http://www.more.com/4488/2382-the-endangered-uterus
FDA: For Women
http://www.fda.gov/womens
GynEndo News
http://www.gynendonews.com
Healthfinder.gov
http://www.healthfinder.gov/scripts/SearchContext.asp?topic=541
Mayo Clinic
http://www.mayoclinic.com/health/menopause/DS00119
Medline Plus: Women’s Health
http://www.nlm.nih.gov/medlineplus/womenshealth.html
North American Menopause Society (NAMS)
http://www.menopause.org
Project AWARE (Association of Women for the Advancement of Research and Education)
http://www.project-aware.org/Experience/premature.shtml
Shmirshky.com
http://www.shmirshky.com
WHI Publications: Hormone Therapy
http://www.nhlbi.nih.gov/whi/references.htm#ht
Women’s Health Initiative (WHI)
http://www.nhlbi.nih.gov/whi
Women’s Healthcare Forum
http://www.womenshealthcareforum.com/menopause.cfm
Your Total Health: Hormone Replacement Therapy
http://yourtotalhealth.ivillage.com/hormone-replacement-therapy.html? pageNum=1
General Health
Harvard Medical School
http://hms.harvard.edu/hms/home.asp
HealthGrades
http://www.healthgrades.com
Mayo Clinic
http://www.mayoclinic.com
Medline Plus: Medical Encyclopedia
http://www.nlm.nih.gov/medlineplus/encyclopedia.html
University of Colorado Denver Anschutz Medical Campus
http://www.ucdenver.edu/about/denver/Pages/AnschutzMedicalCampus.aspx
Thyroid Information
About.com: Thyroid Disease
http://thyroid.about.com/library/links/blthyroid.htm
American Association of Clinical Endocrinologists
http://www.aace.com
American Thyroid Association
http://www.thyroid.org
Endocrine Society
http://www.endo-society.org
EndocrineWeb
http://www.endocrineweb.com
EndocrineWeb: How Your Thyroid Works
http://www.endocrineweb.com/thyfunction.html
Parathyroid.com
http://www.parathyroid.com
Thyroid-info.com
http://www.thyroid-info.com
Thyroid Power
http://www.thyroidpower.com
Researching Doctors and Pharmacies
American Board of Medical Specialties (the service is free, but registration is required)
https://www.abms.org/WC/login.aspx
American Medical Association
http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure/state-medical-boards.shtml
International Academy of Compounding Pharmacists
http://www.iacprx.org
National Association of Boards of Pharmacy
http://www.nabp.net/
RateMDs
http://www.ratemds.com/social
Acupuncture and Alternative Medicine
American Academy of Medical Acupuncture Referral Search
http://www.medicalacupuncture.org/findadoc/index.html
National Institutes of Health: National Center for Complementary and Alternative Medicine
http://nccam.nih.gov/health/acupuncture/introduction.htm
State-by-state acupuncture certification requirements
http://www.acupuncture.com/statelaws/statelaw.htm
Information on Clinical Drug Trials
CenterWatch
http://www.centerwatch.com
National Institutes of Health: ClinicalTrials.gov
http://www.clinicaltrials.gov
Women’s Health Initiative: Participant Web site
http://www.whi.org
Other Helpful Links
Association of Sewing and Design Professionals
http://www.paccprofessionals.org
Find a Dressmaker
http://www.findadressmaker.com/list.html
Shmirshky.com
http://www.shmirshky.com
Spanx
http://www.spanx.com
additional notes
All Web sites mentioned in the book were last retrieved on October 9, 2010, unless otherwise specified. All sources cited in the book are found in the Shmirshky Not-So-Fun Terms, which correspond to specific points in the text and footnotes, except for the following citations:
meet the shmirshky
For the number of shmirshkies in M from page 2, see Mary Shomon, “Thyroid Problems and Menopause,” Thyroid-info.com:
http://www.thyroid-info.com/articles/menopause.htm
CHAPTER 8, sleepless in PM&M
For the complete University of Arizona College of Nursing study on PM&M symptoms by Berg, Larson, and Pasvogel, see the Journal of Clinical Nursing:
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2702.2007.02112.x/full
CHAPTER 9, the thyroidian slip
There is a footnote about Hashimoto’s disease on page 34. For the statistics on hypothyroidism, see Mary Shomon, “The Thyroid/Menopause Connecti
on: Information from Richard and Karilee Shames,” Thyroid-info.com:
http://www.thyroid-info.com/articles/shamesmenopause.htm
There is a footnote about the treatability of thyroid cancer on page 37. For more information, see MedlinePlus: Medical Encyclopedia,“Thyroid Cancer”:
http://www.nlm.nih.gov/medlineplus/ency/article/001213.htm
CHAPTER 14, shmirshky numbers
The suggested ranges for Total cholesterol, HDL, LDL, and Triglycerides on page 60 are explained further in the American Heart Association’s “What Your Cholesterol Levels Mean”:
http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean UCM 305562 Article.jsp
The cholesterol/HDL range on page 60 is explained further in Lab Tests Online, “HDL Cholesterol: The Test”:
http://www.labtestsonline.org/understanding/analytes/hdl/test.html
The suggested range for TSH on page 63 is explained further in American Association of Clinical Endocrinologists, “Thyroid Awareness Month Tip Sheet”:
http://www.aace.com/public/awareness/tam/2006/pdfs/TAMTipSheet.pdf
For more on the discrepancy between various recommended TSH levels on page 63, see Mayo Clinic, “Subclinical Hypothyroidism: An Update for Primary Care Physicians”:
http://www.mayoclinicproceedings.com/content/84/1/65.full
The suggested range for Vitamin D on page 64 is explained further in:
http://orthoinfo.aaos.org/topic.cfm?topic=A00567
For additional information about PM&M and Vitamin D3, see “Vitamin D—Overhyped or Underused” by Ginny Graves:
http://www.more.com/2030/24164-vitamin-d-overhyped-or-underused
CHAPTER 15, to hrt or not to hrt?
The definition of estrogen dominance came from Dr. Margery Gass, Executive Director, The North American Menopause Society. The NAMS’s own “Menopause Glossary” can be found at
http://www.menopause.org/glossary.aspx
CHAPTER 20, shmirshky redecorated
For more on hysterectomies from pages 89 and 90, see Peg Rosen, “The Endangered Uterus,” More Magazine (December 2008/January 2009):
http://www.more.com/4488/2382-the-endangered-uterus
shmirshky daily symptoms chart
(continued)
my shmirshky journal
Letter
Dearest You,
Let me be the first to welcome you to the shmirshky movement! Shmirshky is all about reaching out, so come chat and party with me at shmirshky.com.
You can find support on the message board, get the lastest shmirshky blogs and PM&M news, and find great tips on how to host a Shmirshky Party!
The shmirshky community wants to hear from you, so keep us posted about your life and how you’re feeling.
Remember, reaching out is IN. Suffering in silence is OUT!
Hugs,
E
About the Author
“E” is the pen name of Ellen Sarver Dolgen. She is a shmirshky in PM&M (perimenopause and menopause). E represents everyone, as Shmirshky: the pursuit of hormone happiness is a little piece of every woman’s story. She is founder and president of Shmirshky Universal and is very active in promoting women’s health and well-being around the world through board representation, event organization, and fundraising. She currently serves on the Community Advisory Board of Scripps Memorial Hospital La Jolla. She resides in Coronado, California, with her husband, David. She has two children, Sarah and Jack.
E wrote Shmirshky in collaboration with her son, Jack Dolgen, who is a writer, musician, and creative entrepreneur.
www.shmirshky.com
Copyright
Copyright © 2011 Shmirshky Universal, LLC
Parts of this book were previously published in 2009, under the title Shmirshky: think inside the box.
The author does not give medical advice or engage in the practice of medicine, and no doctor-patient relationship is offered or created.
All statements and information herein are for informational or entertainment purposes only and are not meant to replace the services of a physician. All readers should consult their own physicians about any symptoms that may require diagnosis or medical attention or before pursuing any course of treatment.
The author does not recommend, endorse, or make any representation about any tests, practices, procedures, treatments, services, opinions, health care providers, physicians, or medical institutions that may be mentioned or referenced.
The names and identifying characteristics of some people and places in the book have been changed for the protection and privacy of those individuals.
Shmirshky™, the pursuit of hormone happiness™, think inside the box™, Erlick™, PM&M™, FF™, SUMO FREE™, and all other trademarks and logos associated with Shmirshky are valuable trademarks owned by Shmirshky Universal, LLC.
Spanx® is a registered trademark of Spanx, Inc.
All rights reserved. Except as permitted under the U.S. Copyright Act of 1976, no part of this publication may be reproduced, distributed, or transmitted in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. For information address Hyperion, 114 Fifth Avenue, New York, New York 10011.
The Library of Congress has catalogued the original print edition of this book as follows:
E (Ellen Sarver Dolgen).
Shmirshky : the pursuit of hormone happiness / by E. — 1st ed.
p. cm.
Includes bibliographical references.
ISBN 978-1-4013-4168-8
1. Menopause—Popular works. 2. Perimenopause—Popular works. I. Title.
RG186.E2 2010
618.1’75—dc22
2010040075
eBook Edition ISBN: 978-1-4013-9650-3
Hyperion books are available for special promotions and premiums. For details contact the HarperCollins Special Markets Department in the New York office at 212-207-7528, fax 212-207-7222, or email [email protected].
Cover design by Marika van Adelsberg
First eBook Edition
Original hardcover edition printed in the United States of America.
www.HyperionBooks.com
1 Birthday Friend Forever
2 I’d love to see the census people knocking on doors asking shmirshkies if they are in PM&M. Most common response: door slam.
3 Shmirshky Parties are the best! Have the gals over for cocktails, laughter, and love. You can visit shmirshky.com to find fun tips for your next Shmirshky Party!
4 PMS (premenstrual syndrome) refers to the symptoms that shmirshkies often get before their period arrives. In addition to what’s mentioned above, you may get a headache and feel unusually emotional, irritable, tired, anxious, or depressed, just to name a few. Sounds like fun, right?
5 By permission. From Merriam-Webster’s Medical Dictionary © 2005 by Merriam-Webster, Incorporated (www.Merriam-Webster.com).
6 Definition by permission of Dr. Margery Gass, Executive Director, North American Menopause Society.
7 I wish I could tell you exactly at what age this storm will start to brew, but it’s different for every shmirshky. Most shmirshkies begin to experience symptoms in their forties or fifties. Early storms can also occur for some shmirshkies, which in some cases is referred to as premature menopause. You can find more on this in chapter 6, “How to Schedule PM&M.”
8 Alzheimer’s disease is a form of dementia. It’s a progressive, degenerative brain disease that affects one’s capacity for memory and thought.
9 You may come across another term called early menopause. Early menopause describes both natural and induced menopause before the age of forty-five, which includes all cases of premature menopause. I hate to be early to a party, personally, but everyone’s got their own style! However, there are some resources that don’t consider surgically induced menopause before the age of forty to be premature menopause. I know this may be confusing, and you’re proba
bly thinking, “Who gives a rat’s ass about these definitions? All I want is to feel good.” Since these terms are out there in the PM&M world, I do want you to understand what they mean. Knowing where you fit into the PM&M calendar can help you feel calmer and better equipped to work with your doctor.
10 Why aren’t there any traditions to make this easier? When you turn seven, you take your first Communion; when you turn thirteen, you’re bat mitzvahed; when you start throwing cans of soup at your partner, you’re in PM&M.
11 Thyroid conditions affect the thyroid gland, which is a small, two-lobed gland in your neck that uses iodine to make thyroid hormones that help regulate your metabolism.
12 Hyperthyroidism, or an overactive thyroid gland, is usually caused by the autoimmune illness called Grave’s disease. In this condition, the body’s immune system produces an antibody that stimulates the gland to make an excess amount of T3 and T4, the two forms of thyroid hormone. (By the way, the 3 and the 4 refer to the number of iodines in that form of the hormone.) If you’re a “hyper,” you may experience some of these symptoms: enlarged thyroid gland (goiter), bulging eyes, sudden weight loss, rapid heartbeat, increased appetite, nervousness and anxiety, irritability, tremor in the hands and fingers, sweating, changes in menstrual patterns, increased sensitivity to heat, more frequent bowel movements, and difficulty sleeping.
13 In hypothyroidism, the thyroid gland doesn’t produce enough thyroid hormone, which slows down the body’s metabolism. If you’re a “hypo,” you may experience weight gain, increased sensitivity to cold, dry skin and hair, slow pulse, low blood pressure, constipation, depressed mood, muscle aches/weakness, hair loss, low energy, and all kinds of sluggishness. It is usually caused by Hashimoto’s disease (see below). Studies show that by the time shmirshkies hit age fifty, one out of every ten to twelve has some degree of hypothyroidism. By age sixty, it’s one shmirshky out of every five or six.