Page Title

Text Box: Let’s start by talking
about what the National Institutes of Health has chosen not to give your doctor since 1942. Doctors look to the National Institutes of Health (NIH) to create clinical trials to give them the tools and knowledge to treat different illnesses. The NIH runs many different kinds of clinical trials to find out which regimen will work best. In every area of endocrine medicine, except for the treatment of ovarian failure, the NIH has used many different formulations to find the best regimens. Unfortunately, for the treatment of ovarian failure, almost every trial the NIH conducted for the past 65 years has used the same product with no modernization of treatment. The product used most for clinical testing is Premarin™. Premarin™ has consistently failed women yet it is tested over and over again with the same results. In practice, most women abandon it within 6 months to a year of starting it. Perhaps an important reason is that Premarin™ has never been associated with restoring sexual response, one of the primary reasons women agree to take it.
By not having a trial
on ovarian replacement, your doctor does not have a protocol, or set of previously tested instructions, that show the greatest health benefits. For the NIH to continue to primarily use Premarin™ for 65 years is unlike any other area of medical research. By not changing the regimen for 65 years the NIH is making a choice to not modernize. Every other area of

Text Box: endocrine medicine has modernized and improved treatment options except treatment for hypogonadism in women. The NIH has chosen not to use physiologic replacement, thereby stalling any modernization of treatment. Hypogonadism is not going away. It is only going untreated because those doctors who want to see a clinical trial on physiologic replacement first don’t have that.
Hypogonadism deserves treatment in spite of the failure of the NIH and its decision to not modernize its clinical trials. Without a standard protocol or even one clinical trial to review it is understandable why doctors would not want to treat hypogonadism. Some doctors however, have the foresight and courage to treat it without a protocol or any clinical trials. These doctors should be applauded. There is no medical reason for the NIH to tie a doctor’s hands when treating organ failure and those that treat hypogonadism know it.
Doctors expect the NIH
to be their partner in providing quality care to you. Yet, when given the opportunity to treat hypogonadism in women the NIH primarily tested Premarin™ over and over again and has never tested physiologic replacement. The NIH has rejected the opportunity to modernize the treatment and has abandoned doctors by doing so. In no other area of endocrine medicine has a doctor been similarly abandoned. Effective protocols exist for the treatment of low thyroid function, low

Text Box: insulin function (diabetes), low testicular function (hypogonadism in men) and low pituitary function (growth hormone). All areas of endocrine medicine have had better and more effective clinical trials performed over time, except for ovarian failure.
The current treatment
in all other areas of endocrine medicine is modern, state of the art, based on well designed clinical studies and appropriate physiologic replacement, and shows time and again bio-identical replacement to be the superior option. The current treatment for women is outdated, poorly defined, lacks even one clinical trial on physiologic replacement to create a protocol, and questions the importance and effectiveness of bio-identical hormone replacement.
Your doctor faces many obstacles when trying to treat hypogonadism in women. With this in mind, if your doctor chooses not to treat it or only treat it for a short time, try to understand their position and the role the NIH played in their decision. The reality is that your doctor has no protocol for physiologic replacement, no products specifically designed for replacement, and no training in medical school for physiologic replacement of ovarian hormones. With all of these obstacles if your doctor still wants to medically treat your hypogonadism with ovarian replacement therapy, Bravo!