The Sexy Years: Discover the Hormone Connection: The Secret to Fabulous Sex, Great Health, and Vitality, for Women and Men [Paperback]

One point Suzanne makes in this book that I find a little worrisome is manipulating the hormone formulation to make sure that you're having periods, or rather periodic monthly bleeding in order to mimic the natural hormonal cycle of your premenopausal years. I guess that's accurate to want to do that rather than taking continuous HRT but I find it a little disturbing the thought of having a period into my 70s or 80s.

I'm also concerned about the recent research that has cast a dark shadow over HRT. Prempro carried risks of heart attack, stroke, blood clots, breast cancer, and dementia. Premarin carried the same risks for stroke and dementia. Putting these facts aside, I believe it is not the best idea to be touting yet another type of hormone therapy for prevention when the research to support its safety and efficacy is not comparable whatsoever. Bioidentical seems better, but there have been no randomzied controlled trials to prove it works for all of these diseases...

Also I think it's not good for women to believe that having premenopausal levels of hormones our entire lives will insure our longevity. I think the evidence is actually to the contrary: high estrogen levels seem good only as far as keeping our bones strong. Lifetime estrogen levels (ie age of menopause) seem unrelated to one's risk of heart disease. But women with naturally high levels of estrogen, even after menopause (yes the ovaries don't completely "quit" - they continue to produce small amounts of hormones), run higher lifetime risks of breast and uterine cancer. Also (and I read this is the Journals of Neurology and Neuroscience), some research is actually indicating that high levels of estrogen throughout life are associated with more cognitive deficits and Alzheimer's. One study showed that women with the highest natural levels of estrogen, whether postmenopausally or those who had the most menstruating years, had higher risks of dementia. Even more disturbing, hysterectomized rats given estradiol lost their abilities completely to learn new tasks. This information is line with the recent evidence showing that estrogen or estrogen/progestin ups the risk for dementia. So to say it's good for the brain is probably wrong. I realize Suzanne touts testosterone for healthy brain function, but it's far from proven; the same goes for estrogen. Again, I think we need to wait for the proof.....

I also am not buying into the idea that menopause takes away our beauty, vitality, and sexuality. I personally found sex better after the change - my kids were grown, I didn't have to worry about unplanned pregnancy. Also, and I think this is important - there IS good reason to believe that menopause is necessary for the survival of the species. If you think about it, there's good reason why 70-something-year-old women can't reporduce any longer. At that age, your health is more likly to be compromised due to aging(though not necessarily!) so the thought of having another baby would be bad for the baby, especially if the mother isn't well enough to care for it!! And since our children naturally spend the first 20+ years of life in or around the nest, it makes sense to me that menstruation ceases at an early enough age so that the mother would have enough healthy years remaining to raise the very last child she was capable of having (although most of us don't want any new babies at 50!! :)). But all in all, this seems the most plausible explanation as far as the life cycle goes and the posibble benefit of having menopause prgrammed in.

But back to the book, bioidentical HRT is a viable option for combating the symptoms of menopause and is more likely to agree with a woman's system as compared to the synthetics. But I don't believe there is any conclusive evidence whatsoever to show that they're better for us over the long haul. They might be, but it's imperative we wait for the proof, lest we repeat the mistakes of the last 30 years by giving women hormones preventively for life only to learn that they're dangerous.

PS: Larry King need not reply.