By Natasha Ratajczak, PT, DPT

You may remember there were some clinical trials back in 2002 that began this idea of combining estrogen and progesterone (ie Prempro) for managing perimenopause, menopause and postmenopause. The trials led to a finding of slightly higher risk of breast cancer, heart disease, stroke and blood clots (Harvard). Because of this, many women and their clinicians decided against the use of hormone replacement therapy. And with that decision came the return of hot flashes, sleepless nights, vaginal dryness, and other symptoms associated with menopause.

However, did you know that hormone replacement therapy is still the BEST way to effectively manage symptoms of menopause?

Let's bring in an approach of "natural:" a product that is made from plant or animal based material. The new kinds of hormonal therapy are trying to bring this idea of natural to the table. There's a difference between natural and bioidentical, and that difference is that bioidentical hormones try to be carbon copies to our original hormonal mapping. There are several examples of "natural" hormones versus bioidentical hormones. Two natural hormone replacement medications that come to mind are Premarin and Cenestin. Premarin is made from a pregnant mare's urine, which contains estrogen, although that estrogen is not a carbon copy of human estrogen. The same goes for Cenestin, which is made from plant estrogen (Harvard).

Types of bioidentical hormone replacement, which again strive to be identical to our own hormonal system, include 17 beta-estradiol, estrone, and estriol for estrogen. Bioidentical progesterone is simply progesterone that is finely ground to be better absorbed by the body (Harvard). These are FDA approved and can be prescribed by your physician.

You may have also heard the term "compounded bioidentical hormones" before. This treatment idea stems that one size does not fit all in women's health. These medications are individualized to a patient's specific needs if there is no availability of appropriate dosages with existing drugs (Harvard). Keep in mind, these compounded drugs are made on the spot, so they are not FDA approved and health insurance does not always pay to cover the cost. However, this can be a very helpful way of keeping menopausal symptoms under control.

The bottom line is that it is important to talk to your physician and make an informed and educated decision together about what it the best option for you. For more information about the stages of menopause, and potential treatments, please visit www.project-aware.org.

Harvard Women's Health Watch. What are bioidentical hormones?

Harvard Health Publications. 1996. Found at: http://www.health.harvard.edu/newsweek/What-are-bioidentical-hormones.htm. Accessed June 20, 2014.

Maureen Mason, MSPT, WCS

Following a cancer diagnosis and treatment, most individuals are left with a lower quality of life and lower fitness level. Advances in treatment have produced lower morbidity and mortality rates, however survivor status may be fraught with challenges. Complications of treatment may include pain, sleep disorders, fatigue, muscle atrophy, and difficulties with instrumental activities of daily living. If you are a cancer survivor reading this, it is likely that you have experienced some of these symptoms. Medical instructions to "re-start exercise" may be insufficient to promote a gradual progressive increased activity and functional level.

Women: The American Physical Therapy Association has developed an optimal treatment model for breast cancer patients involving an initial consultation and periodic re-checks over a 3 to 12 month time, assessing and treating for lymphedema, pain, strength, range of motion, and functional status. This "surveillance model "has provided a cost saving and higher functional outcome level than those that do not receive intervention, and develop taxing complications. The surveillance model is in line with institute of medicine guidelines.

Males: A specific tailored assessment and recommendation for care following prostate treatment can help your quality of life and survivorship, and receiving an exact exercise prescription for your needs is a key to optimal functioning.

Specialty Pelvic Physical Therapy at Comprehensive Therapy Services can help with gastro-intestinal, colo-rectal, bladder, and sexual functioning. Biofeedback can assist muscle re-education in the case of weakness, spasm, and pain. Scar, soft tissue and visceral mobilization, bladder and bowel habit training, and critical functional and aerobic fitness can improve your quality of life. Recent research indicates that high BMI levels, and low activity levels are correlated with poorer outcomes in cancer survivorship. Conversely, energy balance with walking programs and strength training can improve functional fitness and quality of life. Yoga practice can help enhance mind-body wellness and fitness. At CTS we are pleased to help you with a team approach in the care and rehabilitation from cancer diagnosis to optimally functioning survivorship. Truly the best compliment that we can receive is that we "help you get your life back."

Ganz, Patricia, Update on Progress in Cancer Survivorship Care and Research Journal of Clinical Oncolog: 2012

Roland, Julia, Cancer Survivorship: A new challenge in delivering Quality Cancer Care, Journal of Clinical Oncology, 2006

Chan DS, Vieira AR, Aune D, et al. Body Mass Index and Survival in Women With Breast Cancer - Systematic Literature Review and Meta-analysis of 82 Follow-up Studies Ann Oncol. 2014 Apr 27

http://www.medscape.com/viewarticle/810291 Yoga tied to better sleep after cancer, J Clinical Oncology 2013

http://www.medscape.com/viewarticle/821467_6 Survivorship Health Information Counseling for Patients with Prostate Cancer, Urol Nursing 2013

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In This Issue

What's The Deal With Bioidenticals?

Physical Therapy for Oncology Rehabilitation

Pilates

Maintain that summer body with Pilates classes!

Group Apparatus

Class Schedule

Reach your fitness goals, then challenge yourself to new ones! Check out our expanded class schedule and find a Pilates class for you.

Bladder Basics

Educate Yourself

Join us for our next round of educational seminars to learn all you need to know about bladder health!

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CoreAlign

Balance & Strengthen

Contact our office for information about this new way to activate your core and balance your body. Free 15 minute trials available.

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