Introduction to Professional Resources

Welcome to the professional resources section of www.GeorgiaHormones.com.

This website is a work in progress. It is my desire to make available to physicians, other health professionals and interested lay people detailed and clear information that they will hopefully find useful in their clinical practices and their own personal lives.

If you want to begin right away initiating Bioidentical Hormone menopause therapy, skip now to the section: Menopause Evaluation and Therapy.

Dr. Goldman’s Background:

I have been practicing Obstetrics and Gynecology for over thirty years. I was first taught female hormone physiology by Fred Benjamin, MD and Norma Gastillo, MD, both working at Queens General Hospital in the early 1970s. There was a newly available assay for FSH and the Hypothalamic-Pituitary- Ovarian relationships were being worked out. Drs. Benjamin and Gastillo were conducting clinical research. Their clear vision and desire to do the best for their patients has been a gift to me for my entire career.

In 2001 I found the American Board of Holistic Medicine and the American Holistic Medical Association on a web search. I ordered a set of review tapes and thus began my introduction to modern Holistic medicine. In 2002, I became interested in the resources of the North American Menopause Society. In October 2003, I took the exam and became certified by that organization as a Menopausal Practitioner. I thought I was up to date with available menopausal therapies.

Two months later, I took over the practice of a gynecologist who was leaving our area. When I began seeing his patients, I found that many were taking Biest and Progesterone. I knew what progesterone was but not where one could obtain it. I had no idea what Biest was. I called the patient’s pharmacy and was even more surprised to find that it was an 80%/20% blend of Estriol and Estradiol. The benefits of Estriol were just being written about when I took my Ob/Gyn board exam in 1977, but it never came on the market so far as I knew. How was it possible that I had just studied all the menopausal management materials of the North American Menopause Society and there was never a single mention that bioidentical hormones existed and were a treatment option? In April of 2004, I took a PCCA/ZRT Labs sponsored course in Bioidentical Hormone use. They recommended compounded creams and patient evaluation by salivary hormone levels. I returned from the weekend course. On Monday, Suzanne Somers was on every channel on TV promoting her new book, The Sexy Years, extolling the merits of bioidentical hormones. Dr. John Lee had been studying and lecturing about the importance of bioidentical progesterone for over 25 years. Suzanne Somers did more for public and physician awareness in three months than Dr. John Lee accomplished in an entire, long career.

A new age:

I have always viewed irregular bleeding and other gynecologic problems as primarily endocrine abnormalities, but proper therapies to address these issues have only been unfolding gradually. Current knowledge of the underlying physiology has come a long way, with some of the biggest advances coming in only the last decade. Commercial laboratory tests have become so precise that levels can be ascertained for hormones that circulate in the blood at concentrations of only a few parts per trillion. Although synthesis of the steroid hormones is not new, the return of pharmacists who can prepare medications tailored to individual patients has made all the difference. We have reached a new age. The combination of more advance knowledge of hormonal physiology, advanced and precise laboratory testing and the availability of individually compounded hormone preparations creates an environment that allows treatments tailored to the individual patient.

The body’s hormone systems constitute a network, a web. Everything affects everything else. The entire hormonal system is interactive. Thyroid activity sets the metabolic pace. Cortisol affects hypothalamic production of releasing hormones, brain function and the conversion of T-4 to T-3. Progesterone and Testosterone affect thyroid activity and basal body temperature. Estrogen effects craving for carbohydrate foods, fat storage and metabolism, fluid balance and brain activity. The list of interactions goes on and on. More recently, the relationships between insulin, insulin resistance, and female hormone issues have been elucidated. Hormones like Inhibin B, IGF-1, their receptors and carrier proteins have come to prominence with better understand of their roles in bleeding patterns, weight, fat, and cholesterol problems. There is a lot to know.

A few years ago I received a call during the middle of my office hours. A friend and fellow gynecologist was on the phone. He had a patient in his office who had read Suzanne Somers’ book and was interested in being treated with bioidentical hormones. He asked if I had a minute to tell him how to prescribe the hormones. I offered to spend a weekend with him to give him an introduction. He declined the offer.

My goal is to build the Professional Resources section of this site as a guide and teaching tool so that interested physicians, P.A.s, nurse practitioners, and pharmacists can begin a practice in bioidentical hormone use.

Layout of the Professional Resources section:

The Professional Resources are grouped into general sections. The information is broken down into manageable bites that can be printed out for study at your leisure. Within sections, I have tried to present topics in an order designed to help build a working understanding of the topic.

The entire field is quite large. Rather than wait until I was able to present the whole work, I have decided to build the web site gradually as various sections were completed. I plan to present important clinically relevant topics first. To some extent, I am starting with the important but easier topics. I would like to give readers the opportunity to “wet their feet” in bioidentical hormone management. As you get more experience, you can delve further into the details of this interesting physiology and patient care.

If you have comments or questions, you can contact me at drbob@GeorgiaHormones.com.