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Have you ever wondered why when you go to the doctor and talk to him/her about your cruddy symptoms and suspect it might be your hormones, they minimize or bash hormone replacement therapy options?  Doesn't it make sense to expect your primary care provider, your ob-gyn, or even your endocrinologist to be educated, trained, or have experience with hormone replacement therapy?

Doctors are not being straight with their patients about their knowledge, or lack of knowledge, about hormone replacement therapy, and the therapeutic effects of optimizing hormones.  New information has been out for a while now and doctors are not educating themselves with this information.  Most providers are under the mindset that if they didn't learn it in medical school, it must not be of value.  As if medical school was the "end-all" for new concepts in medicine.  Doctors are relying solely on what they learned in medical school.  How long ago was that anyway?  Like technology, medicine has made some monumental advances when it comes to optimizing hormones.

There has been significant concern by health care organizations and experts that physi­cians are failing to learn of new information presented in medical journals and the lack of ability to translate that information into treatments for their patients. The concern is essentially that doctors erroneously rely on what they have previously been taught and don't change treatment philosophies as new information becomes available. This is espe­cially true for endocrinological conditions, where physicians are very resistant to chang­ing old concepts of diagnosis and treatment despite overwhelming evidence to the con­trary because it is not what they were taught in medical school and residency.

I spent many years educating both men and women about declining hormones and replacement therapy options.  Patients are very candid about what their providers are telling them.  Some of the things I've heard are:

"My doctor says estrogen causes cancer"
"My OB GYN said I should take the lowest dose possible to treat the symptoms"
"My doctor said I should get a hysterectomy if I don't like my horrible periods"
"My doctor said low dose HRT is better"
"My doctor said take the lowest possible dose for the shortest possible time"

When I hear these things from my patients, it drives me up the wall.  The statements these doctors are giving are inaccurate.  So why aren't doctors more knowledgeable about hormones?  Most doctors don't read the medical journals that are available to them. They are bombarded with new material daily. For a doctor to get the information needed, he/she would need to read through all the medical journals every month. Time is really an issue especially if the physician has a busy practice.  Drug reps come into the office to educate but the education is one sided and biased.  

What about medical conferences?  Most physicians will satisfy their required amount of continuing medical education (CME) by going to a conference a year, usually at a highly desirable location that has skiing, golf, boating, etc. A physician is rarely monitored as to if they actually showed up for the lectures. One must also understand that the majority of conferences by medical societies that are sponsored by phar­maceutical companies. While these pay­ments are called unrestricted grants, in that the society has free reign to do what they want with the money and can thus claim there is no influence of lecture content by the pharmaceutical company. The problem is that if the society wants to continue get­ting these unrestricted grants from the par­ticular company, they better provide content that is of benefit to the pharmaceutical com­pany that paid for the grant. Consequently, ground-breaking research that goes against the status quo and does not support the drug industry receives little attention. The doctor must actively search for these stud­ies, which only a few percent are willing to do on a consistent basis.

So just because your doctor is clueless about hormones, doesn't mean you have to accept the treatment they recommend for your hormone deficiency symptoms.  Find someone who has the education and clinical experience to balance your hormones.  Why take the advice of someone who has very little knowledge or experience in hormones to treat your hormone deficiencies?  Start requiring more from your provider.   Would you go to your general practitioner to treat your heart issues?  Look for my download entitled 10 HRT Questions to Ask Your Doctor.

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