The Female Brain Blog |
BOOK'S ORIGIN: Dr. Fred Luskin’s focus on forgiveness stems from his best friend, Bob, cutting him off. Luskin, an only child and dependent on substitute siblings, pointlessly agonizes about the un-expected un-friending for years. In the late 1990s, he is completing a psychology doctorate and finds forgiveness research sparse, only four studies. He becomes the first researcher to develop strategies that effectively stop negative and unkind actions of others from growing into psychological burdens.
HIGHLY EFFECTIVE STRATEGIES: Positive Emotional Re-focusing Technique (PERT) and HEAL (Hope, Educate, Affirm, Long Term) are the two major strategies (or ways of changing your thinking) that Luskin, director of the Stanford University Forgiveness Project, has tested. His and other research shows these strategies make people feel much better. PERT and HEAL are well explained in the book, all the interested reader has to do is practice.
MAJOR OVERSIGHT*:Women are over-represented as study participants and clients. 75% of participants in one experiment are women. 80% of calls to the Stanford Forgiveness Project are from women. More women than men sign up for forgiveness training, this being confirmed by other researchers and by Luskin’s own teaching experience. In my view, Luskin fails* to ask a pivotal research question – why is this enormous gender disparity occurring? Is there something specifically going on with women causing such a disproportionate percentage of them to present with forgiveness issues as compared to men?
KNOWLEDGE GAPS: My finding is most researchers have severe knowledge gaps regarding the plethora of ways in which human females are very different from men. The stress-responding hypothalamus-pituitary-adrenal (h-p-a) axis, the same for both sexes, appears well understood by Luskin and colleagues. However, few have the same insight into the well documented behavioural effects of the female-specific h-p-ovary (h-p-o) axis.
Forty years of amassing science is reporting that in a significant cohort of women the normal ebb and flow of OVARIAN hormones – estrogen and progesterone – exert un-wanted, un-conscious and un-controllable effects on the central nervous system (brain and spinal cord). A wide spectrum of behaviours can be negatively altered – seizure threshold, mood, sleep, stress response, affect, appetite, thermogenesis (sweats/flushes), gastric motility etc. This is characterized (for lack of better nomenclature) as the linked triad of premenstrual syndrome, post partum depression and difficult perimenopausal transition. Polycystic ovary syndrome (PCOS) is also a significantly prevalent h-p-o dysfunction with negatively life-altering symptoms.
Most researchers and doctors are un-aware that at mid-life estrogen becomes chaotic and 30% higher, not decreasing as the in-accurate conventional wisdom holds. Biomedical science has recently discovered the up-regulation of estrogen to be the start of a phase called perimenopause. This phase can last a decade (plus or minus; great inter-female variation) before the last menstrual cycle. Increased estrogen enhances the excitatory glutamate receptors in brain and amplifies the stress-responding adrenal hormones cortisol and norepinephrine. Hence difficult transition in predisposed neuro-sensitive females. A further complication is two thirds of American women are over-weight or obese. Adipose/fat tissue is an extra-glandular and additional source of estrogen.
EXPECTATION: If the client group is predominately female, I HOPE that researchers will be up to speed on new/emerging knowledge of female physiology and culture (see Twisted Sisterhood review). Phenomena, beyond an individual’s character, might be investigated to expertly tailor therapeutic programs, like this one, specifically for women.
HIGHLY EFFECTIVE STRATEGIES: Positive Emotional Re-focusing Technique (PERT) and HEAL (Hope, Educate, Affirm, Long Term) are the two major strategies (or ways of changing your thinking) that Luskin, director of the Stanford University Forgiveness Project, has tested. His and other research shows these strategies make people feel much better. PERT and HEAL are well explained in the book, all the interested reader has to do is practice.
MAJOR OVERSIGHT*:Women are over-represented as study participants and clients. 75% of participants in one experiment are women. 80% of calls to the Stanford Forgiveness Project are from women. More women than men sign up for forgiveness training, this being confirmed by other researchers and by Luskin’s own teaching experience. In my view, Luskin fails* to ask a pivotal research question – why is this enormous gender disparity occurring? Is there something specifically going on with women causing such a disproportionate percentage of them to present with forgiveness issues as compared to men?
KNOWLEDGE GAPS: My finding is most researchers have severe knowledge gaps regarding the plethora of ways in which human females are very different from men. The stress-responding hypothalamus-pituitary-adrenal (h-p-a) axis, the same for both sexes, appears well understood by Luskin and colleagues. However, few have the same insight into the well documented behavioural effects of the female-specific h-p-ovary (h-p-o) axis.
Forty years of amassing science is reporting that in a significant cohort of women the normal ebb and flow of OVARIAN hormones – estrogen and progesterone – exert un-wanted, un-conscious and un-controllable effects on the central nervous system (brain and spinal cord). A wide spectrum of behaviours can be negatively altered – seizure threshold, mood, sleep, stress response, affect, appetite, thermogenesis (sweats/flushes), gastric motility etc. This is characterized (for lack of better nomenclature) as the linked triad of premenstrual syndrome, post partum depression and difficult perimenopausal transition. Polycystic ovary syndrome (PCOS) is also a significantly prevalent h-p-o dysfunction with negatively life-altering symptoms.
Most researchers and doctors are un-aware that at mid-life estrogen becomes chaotic and 30% higher, not decreasing as the in-accurate conventional wisdom holds. Biomedical science has recently discovered the up-regulation of estrogen to be the start of a phase called perimenopause. This phase can last a decade (plus or minus; great inter-female variation) before the last menstrual cycle. Increased estrogen enhances the excitatory glutamate receptors in brain and amplifies the stress-responding adrenal hormones cortisol and norepinephrine. Hence difficult transition in predisposed neuro-sensitive females. A further complication is two thirds of American women are over-weight or obese. Adipose/fat tissue is an extra-glandular and additional source of estrogen.
EXPECTATION: If the client group is predominately female, I HOPE that researchers will be up to speed on new/emerging knowledge of female physiology and culture (see Twisted Sisterhood review). Phenomena, beyond an individual’s character, might be investigated to expertly tailor therapeutic programs, like this one, specifically for women.
Feb 25 2010 - Book Review
'The Estrogen Errors. Why Progesterone is Better for Women's Health' (2009). Susan Baxter PhD & Jerilynn C. Prior MD
An alternate title to this book could be 'Don't Go to the Doctor's Office without Me'. You get the strong impression that, outside of baby-production, the physiology and health requirements of the human female throughout the rest of her life cycle are simply not taught to physicians.
The co-author, J.C. Prior, is a physician-researcher, professor of endocrinology and top medical authority on mid-life female transition from fertile to sterile. She tells of her up-hill battle to teach University of British Columbia medical students the mounting evidence that progesterone is equally as important as estrogen to bone health. The administration has asked her to drop replicated progesterone research from her week of teaching bone disease. She states they will have to fire her first.
Time after time Prior over-rides the disinterest and obstructing ignorance of her peer medical community. She choses the difficult, but higher, road of practicing evidence-based medicine causing her to question the sketchy research on estrogen.
This book is shot through with more science, intelligence and rational sense, in terms of women's health, than anything else available currently. This is true of all her other publications and website www.cemcor.ubc.ca.
'The Estrogen Errors' is expensive..., however a portion goes to running the non-profit cemcor website. The book gives you the most current science on women's bone, breast and heart health from Prior's researched and elite point of view.
A major focus of the book is that span of life starting in the late 30s or early 40s which has only recently been recognized and labeled perimenopause. A significant cohort of women, but not all women, have from mild to exteme difficulty through what can be a decade (plus or minus) of transition. If this is you, get this book and go right to chapter 3 'Perimenopause: The Forgotten Transition' for the very best science-driven information and management available to the lay public.
The amount of morbidity (suffering and misery) and premature mortality (death) that women might be spared if this book were to be widely read and understood is scary to think about.
'The Estrogen Errors. Why Progesterone is Better for Women's Health' (2009). Susan Baxter PhD & Jerilynn C. Prior MD
An alternate title to this book could be 'Don't Go to the Doctor's Office without Me'. You get the strong impression that, outside of baby-production, the physiology and health requirements of the human female throughout the rest of her life cycle are simply not taught to physicians.
The co-author, J.C. Prior, is a physician-researcher, professor of endocrinology and top medical authority on mid-life female transition from fertile to sterile. She tells of her up-hill battle to teach University of British Columbia medical students the mounting evidence that progesterone is equally as important as estrogen to bone health. The administration has asked her to drop replicated progesterone research from her week of teaching bone disease. She states they will have to fire her first.
Time after time Prior over-rides the disinterest and obstructing ignorance of her peer medical community. She choses the difficult, but higher, road of practicing evidence-based medicine causing her to question the sketchy research on estrogen.
This book is shot through with more science, intelligence and rational sense, in terms of women's health, than anything else available currently. This is true of all her other publications and website www.cemcor.ubc.ca.
'The Estrogen Errors' is expensive..., however a portion goes to running the non-profit cemcor website. The book gives you the most current science on women's bone, breast and heart health from Prior's researched and elite point of view.
A major focus of the book is that span of life starting in the late 30s or early 40s which has only recently been recognized and labeled perimenopause. A significant cohort of women, but not all women, have from mild to exteme difficulty through what can be a decade (plus or minus) of transition. If this is you, get this book and go right to chapter 3 'Perimenopause: The Forgotten Transition' for the very best science-driven information and management available to the lay public.
The amount of morbidity (suffering and misery) and premature mortality (death) that women might be spared if this book were to be widely read and understood is scary to think about.
Dec 30 2010 - N Y Times Tara Parker-Pope should be barred form reporting on estrogen
A few years ago Parker-Pope, before she parted company with the Wall Street Journal, wrote a very pro-hormone replacement therapy book.
On Dec 13/10 she penned a NY Times report titled 'Review Suggests Benefits in Estrogen'**. This person's reporting on anything to do with hormone replacement therapy is NOT trust-worthy because she does not seem to command/grasp all the facts and data. Her knowledge has severe gaps which bias her articles and book.
The government funded Women's Health Initiative (WHI) study was prematurely stopped in 2002 because synthetic estrogen (CEE) and synthetic progestin replacement therapy significantly increased the risk of stroke and cancer in the menopausal female.
One arm of the WHI study followed 10,000+ women aged 50-79 all having had a hysterectomy, therefore surgically postmenopausal. Half the women received synthetic estrogen (conjugated equine estrogens, CEE) and the other half received a placebo. This part of the study was stopped prematurely as well in 2004. However, the data for the 7.1 years that the women were followed showed CEE replacement in women with hysterectomies to be protective against breast cancer.
An oncologist,Joseph Ragaz, has seized on this 2004 finding, and presented it at the recent San Antonio Breast Cancer Symposium - hence Parker-Pope's Dec13/10 news item**.
Dr. Jerilynn C Prior, physician-researcher and UBC professor on endocrinology (study of hormones), points out that any pelvic surgery to include hysterectomy reduces the risk of breast cancer because blood supply to estrogen producing ovaries is cut off. Women in the estrogen-only with hysterectomy WHI already had a reduced risk of breast cancer.
Dr Prior also points out in her book 'Estrogen Errors'(2009) that Premarin, the synthetic hormone drug used in WHI trial stopped in 2002, has 100% of a young woman's concentration of estrogen. The synthetic progestin portion of Premarin was equal to only 25% of what a young woman's progesterone concentration would be. Women in this part of the trial with higher risk of breast cancer were put at even higher risk from Premarin because of high estrogen dosage and in-adequate progestin dosage.
Prior goes on to say synthetic progestin (medroxyprogesterone) is not bio-identical to progesterone, the hormone produced principally by the corpus luteum on the ovary surface after ovulation. If combination therapy is necessary estrogen plus bio-identical progesterone is not associated with an increased breast cancer risk.
<opinion heather ewart>
<Edit> <Delete>
A few years ago Parker-Pope, before she parted company with the Wall Street Journal, wrote a very pro-hormone replacement therapy book.
On Dec 13/10 she penned a NY Times report titled 'Review Suggests Benefits in Estrogen'**. This person's reporting on anything to do with hormone replacement therapy is NOT trust-worthy because she does not seem to command/grasp all the facts and data. Her knowledge has severe gaps which bias her articles and book.
The government funded Women's Health Initiative (WHI) study was prematurely stopped in 2002 because synthetic estrogen (CEE) and synthetic progestin replacement therapy significantly increased the risk of stroke and cancer in the menopausal female.
One arm of the WHI study followed 10,000+ women aged 50-79 all having had a hysterectomy, therefore surgically postmenopausal. Half the women received synthetic estrogen (conjugated equine estrogens, CEE) and the other half received a placebo. This part of the study was stopped prematurely as well in 2004. However, the data for the 7.1 years that the women were followed showed CEE replacement in women with hysterectomies to be protective against breast cancer.
An oncologist,Joseph Ragaz, has seized on this 2004 finding, and presented it at the recent San Antonio Breast Cancer Symposium - hence Parker-Pope's Dec13/10 news item**.
Dr. Jerilynn C Prior, physician-researcher and UBC professor on endocrinology (study of hormones), points out that any pelvic surgery to include hysterectomy reduces the risk of breast cancer because blood supply to estrogen producing ovaries is cut off. Women in the estrogen-only with hysterectomy WHI already had a reduced risk of breast cancer.
Dr Prior also points out in her book 'Estrogen Errors'(2009) that Premarin, the synthetic hormone drug used in WHI trial stopped in 2002, has 100% of a young woman's concentration of estrogen. The synthetic progestin portion of Premarin was equal to only 25% of what a young woman's progesterone concentration would be. Women in this part of the trial with higher risk of breast cancer were put at even higher risk from Premarin because of high estrogen dosage and in-adequate progestin dosage.
Prior goes on to say synthetic progestin (medroxyprogesterone) is not bio-identical to progesterone, the hormone produced principally by the corpus luteum on the ovary surface after ovulation. If combination therapy is necessary estrogen plus bio-identical progesterone is not associated with an increased breast cancer risk.
<opinion heather ewart>
<Edit> <Delete>
Personal Reaction to : Twisted Sisterhood. Unraveling the Dark Lagacy of Female Friendships, 2010
POSITIVE POINTS:
A baffling phenomenon, without a name, has created enormous entropy (rage, sadness, regret, disharmony) in my adult life. The author Kelly Valen in her above captioned book, has captured the source of my un-happiness with the words ‘twisted’ and ‘dark’ to describe the really troubled state of interpersonal relationships among women.
Principally this book is a giant self-help project to come to grips with a dark event that crippled Valen’s life. Her objective seems to be to collect the rationale, evidence, and data that might help to spare her daughters and other females the morbidity she endured. For me she has labelled, defined, described, illustrated a major female-specific psycho-social conundrum that confounded my life. I think her pursuit of new information and knowledge wholly appropriate and urgently needed, whatever the origin of her quest.
MISSING CRUCIAL ELEMENTS IN VALEN'S HYPOTHESIS:
Human female physiology
Reproduction, energy and performance:
One scientific behavioural fact in-adequately addressed by Valen is that a complete reproductive cycle of ovulation, conception, pregnancy, labour and delivery (without complications), lactation and subsequent breastfeeding is far from benign. A full cycle represents the most energy draining experience a mammalian female – mouse, hamster, rat, woman etc., - can be put through (no equivalent exists in male world). My finding with women attempting to combine employment with mother-hood is that they are too tired to do either well and everyone suffers.
Another scientific fact is humans only do one thing at a time well, the ability to multitask is a myth. A high quality job of dominant parent – unfairly but usually assigned to the one who lactates - is 24/7, full time and beyond. The author admits to tiredness and does quit her law firm to stay home with four children. It is not clear that she grasps the science actually motivating her home/family choice. Even though fertility rates have plummeted in the industrialized west, the production of just one or two babies still equals an exhausted woman/mother. Are you on your best behaviour under such fatiguing circumstances?
Effect of ovarian hormones on central nervous system:
Over the past thirty years the effect(s) of the two major reproductive steroid hormones – estrogen and progesterone – on the central nervous system (brain and spinal cord) and therefore behaviour has steadily amassed in science literature. In a significant cohort of women (20% by rough estimate) the normal ebb and flow of estrogen and progesterone exert effects on the central nervous system that negatively and un-consciously alter a variety of behaviours. Such unwanted psycho-neuro sensitivity results in the linked triad of premenstrual syndrome (PMS), postpartum depression, and difficult peri-menopause. To develop workable theories of female paradigms would it not be pivotal to review and incorporate neuro-hormonal physiology that can un-controllably distort behaviour in a large segment of women?
In the late 30s and early 40s estrogen becomes chaotic and 30% higher (not decreasing) representing the start of transition from fertile to sterile or perimenopause. In the neuro-sensitive female this higher estrogen of mid-life can create or exacerbate PMS symptoms of mood swing, sleep disturbances, negative affect, depression, heightened stress response etc. Is it a coincidence that the author, at age 41, finds combining work and family not worth it? Also, at this juncture, is it any wonder that the most distressing event in her life can no longer be suppressed?
The widely held belief that most women in their prime reproductive years have perfectly normal menstrual cycles is in-accurate. Disturbances of ovulation are common. One widely prevalent disturbance is polycystic ovary syndrome (PCOS). An event of some kind in the brain dysregulates the hypothalamus-pituitary-ovarian (h-p-o) feedback loop. Signals become inco-ordinated and hormones imbalanced (high estrogen and androgens and low progesterone) resulting in chronic non-ovulatory cycles. An event well known to disrupt the h-p-o axis is a seizure. Women with PCOS have a higher incidence of epilepsy and seizure disorder. Obesity, diabetes, head hair loss and beard growth can also plague these women. Because they orginate in the brain, it is reasonable to assume PCOS and other hormone distrubances have un-wanted and un-desirable psycho-neuro effects on personality and interactive style.
Bewildering to me,Valen has one paragraph on the oxytocin hormone and its friendly/cuddly effect and nothing at all on estrogen and progesterone.
Economics of being female:
The culture inculcates in young girls that their personal happiness in life centers on marriage and children. Current mounting research on happiness is showing this message to be a colossal lie. Women (and men) can be as happy or unhappy with or without children and with or without marriage.
One direct financial benefit to the child-free woman is she will be richer than women with children. Having a child is now the single best predictor that a woman will end up in financial collapse.
Women are routinely not told of the considerable economic cost for being female. In the US women 25 years and older with a degree and working full time make on average $47,000 per year. Men of similar ages make more than $66,000, a premium of 40%. Attendance at an elite university doesn’t protect against income disparity, Harvard women earn 30% less than male counterparts.
Almost two thirds of American women are overweight or obese. Accumulating research is showing that overweight women suffer a wage penalty that similarly rotund men do not. Direct expenses for obesity such as medical costs and lost wages are almost double for women.
One study by economists has found that menstrual absenteeism accounted for 14% of the difference between female and male earnings. Female employees under 45 tended to miss work consistently on twenty-eight day cycles.
Most married women with children that I know are one husband away from economic difficulty. If these women are earning wages from employment, it is supplementary income to the household. These salaries could not adequately and independently support the family. Should these mothers become divorced (approximately 50% marriages end in divorce) they are at high risk of a free-fall into poverty. They face up to a 73% decline in living standard and are three times more likely than childless people to go bankrupt. The author has given up her income as a lawyer which her husband described as “easy money” to help keep them financially afloat. They are raising their four children on his ambassador to Thailand government salary. I think Valen fits into the category of being one husband away from economic downturn.
In my view, the harsh economic realities of being female are not disclosed to women. To instil in women, from the time they are children, that self-actualization lies in marriage and children and then financially penalize and impoverish them when they carry-out the myth is immoral. I believe many women think they have been tricked and lied to over how to shape their lives. I think rage at being mislead is central to theories to improve female social paradigms.
By April Heather Ewart Andrews RN BN
POSITIVE POINTS:
A baffling phenomenon, without a name, has created enormous entropy (rage, sadness, regret, disharmony) in my adult life. The author Kelly Valen in her above captioned book, has captured the source of my un-happiness with the words ‘twisted’ and ‘dark’ to describe the really troubled state of interpersonal relationships among women.
Principally this book is a giant self-help project to come to grips with a dark event that crippled Valen’s life. Her objective seems to be to collect the rationale, evidence, and data that might help to spare her daughters and other females the morbidity she endured. For me she has labelled, defined, described, illustrated a major female-specific psycho-social conundrum that confounded my life. I think her pursuit of new information and knowledge wholly appropriate and urgently needed, whatever the origin of her quest.
MISSING CRUCIAL ELEMENTS IN VALEN'S HYPOTHESIS:
Human female physiology
Reproduction, energy and performance:
One scientific behavioural fact in-adequately addressed by Valen is that a complete reproductive cycle of ovulation, conception, pregnancy, labour and delivery (without complications), lactation and subsequent breastfeeding is far from benign. A full cycle represents the most energy draining experience a mammalian female – mouse, hamster, rat, woman etc., - can be put through (no equivalent exists in male world). My finding with women attempting to combine employment with mother-hood is that they are too tired to do either well and everyone suffers.
Another scientific fact is humans only do one thing at a time well, the ability to multitask is a myth. A high quality job of dominant parent – unfairly but usually assigned to the one who lactates - is 24/7, full time and beyond. The author admits to tiredness and does quit her law firm to stay home with four children. It is not clear that she grasps the science actually motivating her home/family choice. Even though fertility rates have plummeted in the industrialized west, the production of just one or two babies still equals an exhausted woman/mother. Are you on your best behaviour under such fatiguing circumstances?
Effect of ovarian hormones on central nervous system:
Over the past thirty years the effect(s) of the two major reproductive steroid hormones – estrogen and progesterone – on the central nervous system (brain and spinal cord) and therefore behaviour has steadily amassed in science literature. In a significant cohort of women (20% by rough estimate) the normal ebb and flow of estrogen and progesterone exert effects on the central nervous system that negatively and un-consciously alter a variety of behaviours. Such unwanted psycho-neuro sensitivity results in the linked triad of premenstrual syndrome (PMS), postpartum depression, and difficult peri-menopause. To develop workable theories of female paradigms would it not be pivotal to review and incorporate neuro-hormonal physiology that can un-controllably distort behaviour in a large segment of women?
In the late 30s and early 40s estrogen becomes chaotic and 30% higher (not decreasing) representing the start of transition from fertile to sterile or perimenopause. In the neuro-sensitive female this higher estrogen of mid-life can create or exacerbate PMS symptoms of mood swing, sleep disturbances, negative affect, depression, heightened stress response etc. Is it a coincidence that the author, at age 41, finds combining work and family not worth it? Also, at this juncture, is it any wonder that the most distressing event in her life can no longer be suppressed?
The widely held belief that most women in their prime reproductive years have perfectly normal menstrual cycles is in-accurate. Disturbances of ovulation are common. One widely prevalent disturbance is polycystic ovary syndrome (PCOS). An event of some kind in the brain dysregulates the hypothalamus-pituitary-ovarian (h-p-o) feedback loop. Signals become inco-ordinated and hormones imbalanced (high estrogen and androgens and low progesterone) resulting in chronic non-ovulatory cycles. An event well known to disrupt the h-p-o axis is a seizure. Women with PCOS have a higher incidence of epilepsy and seizure disorder. Obesity, diabetes, head hair loss and beard growth can also plague these women. Because they orginate in the brain, it is reasonable to assume PCOS and other hormone distrubances have un-wanted and un-desirable psycho-neuro effects on personality and interactive style.
Bewildering to me,Valen has one paragraph on the oxytocin hormone and its friendly/cuddly effect and nothing at all on estrogen and progesterone.
Economics of being female:
The culture inculcates in young girls that their personal happiness in life centers on marriage and children. Current mounting research on happiness is showing this message to be a colossal lie. Women (and men) can be as happy or unhappy with or without children and with or without marriage.
One direct financial benefit to the child-free woman is she will be richer than women with children. Having a child is now the single best predictor that a woman will end up in financial collapse.
Women are routinely not told of the considerable economic cost for being female. In the US women 25 years and older with a degree and working full time make on average $47,000 per year. Men of similar ages make more than $66,000, a premium of 40%. Attendance at an elite university doesn’t protect against income disparity, Harvard women earn 30% less than male counterparts.
Almost two thirds of American women are overweight or obese. Accumulating research is showing that overweight women suffer a wage penalty that similarly rotund men do not. Direct expenses for obesity such as medical costs and lost wages are almost double for women.
One study by economists has found that menstrual absenteeism accounted for 14% of the difference between female and male earnings. Female employees under 45 tended to miss work consistently on twenty-eight day cycles.
Most married women with children that I know are one husband away from economic difficulty. If these women are earning wages from employment, it is supplementary income to the household. These salaries could not adequately and independently support the family. Should these mothers become divorced (approximately 50% marriages end in divorce) they are at high risk of a free-fall into poverty. They face up to a 73% decline in living standard and are three times more likely than childless people to go bankrupt. The author has given up her income as a lawyer which her husband described as “easy money” to help keep them financially afloat. They are raising their four children on his ambassador to Thailand government salary. I think Valen fits into the category of being one husband away from economic downturn.
In my view, the harsh economic realities of being female are not disclosed to women. To instil in women, from the time they are children, that self-actualization lies in marriage and children and then financially penalize and impoverish them when they carry-out the myth is immoral. I believe many women think they have been tricked and lied to over how to shape their lives. I think rage at being mislead is central to theories to improve female social paradigms.
By April Heather Ewart Andrews RN BN
 
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by femalebrain @ |
Why I bought this book: When there is something wrong with me, I get the best advice. A four year bio-medical science degree in nursing and then work in advanced management consulting underscores this quest for the finest information. My strategy came into high use when, at 47, I entered what became a perimenopausal transition from hell.
Chief complaint: Eight weeks ago and two years post-menopausal, I encountered severe painful ongoing gastro-intestinal dysfunction and near failure coupled with my usual (but more intense this year) ragweed and leaf mould allergies /rhinitis. I immediately sent for the above captioned book, 4 Weeks to Healthy Digestion (2009) by Harvard’s Dr. Greenberger, a professor of gastroenterology, now in his 51st year of practice. (Harvard’s the best, right?)
Was this book helpful? : Greenberger’s book created mostly questions. FIRST, about his co-author Roanne Weisman, no information is given. In the Library of Congress fine print her 1952 date of birth and another gastrointestinal book title is revealed and that’s it. We don’t know the contribution of each of these authors. Is this book largely ghost-written?
NEXT, except for celiac sprue, there are no footnotes and no reference section of replicated/reliable/ valid bio-science literature. The reader is being asked to accept Dr. Greenberger’s un-footnoted advice as current and correct. After 50+ years in practice, would it not be effortless for Greenberger to cite the biomedical scholarship on which his elimination diets, treatments and other information are based? References permit the so inclined reader to judge how up-to-date and knowledgeable the doctor/author is. Does the physician have encyclopaedic knowledge or are there large and severe gaps?
LAST, Chapter 9 Communicating with Your Doctor, touches on an issue of considerable intellectual conflict for me. Greenberger is not for do-it-yourself-doctoring. He is against patients doing research and presenting in the physician’s office with a substantiated idea/opinion of what their diagnosis is and how it’s to be treated. Here, I would dearly love to agree with Greenberger’s advice, life would be much easier.
DIY doctor: However, I believe Greenberger’s position that patients, especially women, not present as sophisticated and highly knowledgeable is really wrong-headed and potentially lethal*. This belief stems largely from my experience of futilely trying to get good quality medical help for a disabling, symptom-filled transition.
In the late 30s to early 40s estrogen levels in the human female are not decreasing but become chaotic and high, more like a second adolescence (Prior, Endocrine Reviews 1998:19:4:397). This is the start of perimenopausal transition. [One of the pleiotropic effects of higher estrogen is to enhance inflammatory/allergic response by increasing macrophage proliferation (Smith R.S. Med Hypo 1991:36:2:178).] Yet many gynaecologists still believe in and prescribe estrogen replacement therapy (PLoS Med 2010:7:9e1000335). This is despite three large recent studies – Heart and Estrogen/Progestin Replacement Study (HERS,1998), Women’s Estrogen for Stroke Trial (WEST, 2001) and Women’s Health Initiative (WHI, 2002) - amazingly concordant that estrogen replacement puts menopausal women at high risk of stroke or cancer. (*Two of my friends accepted estrogen replacement. One, age 64, has just died of a stroke and the other, age 69, is dying of cancer.)
Treating in the dark: A search of www.pubmed.gov, the world’s largest medical library, turned up a study just released online in Gastroenterology 2011. The lead researcher was H.P. Parkman M.D. The study revealed that of 243 patients with a recognized complex of severe gastric symptoms to include nausea, vomiting, loss of appetite, bloating, abdominal pain, constipation, and heart burn (gastroesophageal reflux) 88% (214) were female with a mean age of 41 years. 19% had an inflammatory illness at an earlier date (I had allergies). This complex or cluster of symptoms - varyingly and in-exactly are referred to as idiopathic gastroparesis (IG) if severe or dyspepsia if milder - is reported in the study to not be well understood and the precise clinical features unknown and not measured before this study!
To discover doctors were essentially fumbling around in the dark, not exactly sure what they were treating in what turns out be a largely female-specific gastro phenomenon is most un-reassuring. IG appears greatly over-represented in women. It’s probably tied directly to perimenopausal transition, given the mean 41 years of age onset, and is likely driven by midlife chaotic/high estrogen.
Gender bias: In 227 pages, Dr. Greenberger has just two paragraphs (p142-143) to offer women in transition – a cohort potentially making up 80+% of his client load given the 2011 study. He indicates while irritable bowel syndrome (80% IBS patients are female) and diarrhea may improve with menopause, this is not the case with GERD and heartburn. Already beaten down by days of unrelenting alimentary agony, an enormous bereft feeling swept over me when I read this seemingly thin, pitiless, un-helpful information. I could be wrong, but I think these meagre paragraphs speak to disinterest, indifference and neglect of the adult female’s health needs.
I have continued on to find quite a lot in the current bio-science literature that is helpful.
By April Heather Ewart Andrews RN BN.
Chief complaint: Eight weeks ago and two years post-menopausal, I encountered severe painful ongoing gastro-intestinal dysfunction and near failure coupled with my usual (but more intense this year) ragweed and leaf mould allergies /rhinitis. I immediately sent for the above captioned book, 4 Weeks to Healthy Digestion (2009) by Harvard’s Dr. Greenberger, a professor of gastroenterology, now in his 51st year of practice. (Harvard’s the best, right?)
Was this book helpful? : Greenberger’s book created mostly questions. FIRST, about his co-author Roanne Weisman, no information is given. In the Library of Congress fine print her 1952 date of birth and another gastrointestinal book title is revealed and that’s it. We don’t know the contribution of each of these authors. Is this book largely ghost-written?
NEXT, except for celiac sprue, there are no footnotes and no reference section of replicated/reliable/ valid bio-science literature. The reader is being asked to accept Dr. Greenberger’s un-footnoted advice as current and correct. After 50+ years in practice, would it not be effortless for Greenberger to cite the biomedical scholarship on which his elimination diets, treatments and other information are based? References permit the so inclined reader to judge how up-to-date and knowledgeable the doctor/author is. Does the physician have encyclopaedic knowledge or are there large and severe gaps?
LAST, Chapter 9 Communicating with Your Doctor, touches on an issue of considerable intellectual conflict for me. Greenberger is not for do-it-yourself-doctoring. He is against patients doing research and presenting in the physician’s office with a substantiated idea/opinion of what their diagnosis is and how it’s to be treated. Here, I would dearly love to agree with Greenberger’s advice, life would be much easier.
DIY doctor: However, I believe Greenberger’s position that patients, especially women, not present as sophisticated and highly knowledgeable is really wrong-headed and potentially lethal*. This belief stems largely from my experience of futilely trying to get good quality medical help for a disabling, symptom-filled transition.
In the late 30s to early 40s estrogen levels in the human female are not decreasing but become chaotic and high, more like a second adolescence (Prior, Endocrine Reviews 1998:19:4:397). This is the start of perimenopausal transition. [One of the pleiotropic effects of higher estrogen is to enhance inflammatory/allergic response by increasing macrophage proliferation (Smith R.S. Med Hypo 1991:36:2:178).] Yet many gynaecologists still believe in and prescribe estrogen replacement therapy (PLoS Med 2010:7:9e1000335). This is despite three large recent studies – Heart and Estrogen/Progestin Replacement Study (HERS,1998), Women’s Estrogen for Stroke Trial (WEST, 2001) and Women’s Health Initiative (WHI, 2002) - amazingly concordant that estrogen replacement puts menopausal women at high risk of stroke or cancer. (*Two of my friends accepted estrogen replacement. One, age 64, has just died of a stroke and the other, age 69, is dying of cancer.)
Treating in the dark: A search of www.pubmed.gov, the world’s largest medical library, turned up a study just released online in Gastroenterology 2011. The lead researcher was H.P. Parkman M.D. The study revealed that of 243 patients with a recognized complex of severe gastric symptoms to include nausea, vomiting, loss of appetite, bloating, abdominal pain, constipation, and heart burn (gastroesophageal reflux) 88% (214) were female with a mean age of 41 years. 19% had an inflammatory illness at an earlier date (I had allergies). This complex or cluster of symptoms - varyingly and in-exactly are referred to as idiopathic gastroparesis (IG) if severe or dyspepsia if milder - is reported in the study to not be well understood and the precise clinical features unknown and not measured before this study!
To discover doctors were essentially fumbling around in the dark, not exactly sure what they were treating in what turns out be a largely female-specific gastro phenomenon is most un-reassuring. IG appears greatly over-represented in women. It’s probably tied directly to perimenopausal transition, given the mean 41 years of age onset, and is likely driven by midlife chaotic/high estrogen.
Gender bias: In 227 pages, Dr. Greenberger has just two paragraphs (p142-143) to offer women in transition – a cohort potentially making up 80+% of his client load given the 2011 study. He indicates while irritable bowel syndrome (80% IBS patients are female) and diarrhea may improve with menopause, this is not the case with GERD and heartburn. Already beaten down by days of unrelenting alimentary agony, an enormous bereft feeling swept over me when I read this seemingly thin, pitiless, un-helpful information. I could be wrong, but I think these meagre paragraphs speak to disinterest, indifference and neglect of the adult female’s health needs.
I have continued on to find quite a lot in the current bio-science literature that is helpful.
By April Heather Ewart Andrews RN BN.
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