Medical Decisions, Estrogen and Aging

If you are a woman between the ages of 45 and 75 and are trying to decide whether to try, or stick with, hormone therapy (HT), or if you are a physician with patients fitting this description, this book is for you unless you are looking for a simple answer. If you are looking for a simple answer, you can go to the web site of one of the companies that manufactures hormones or makes money by administering hormone therapy (e. g. , AntiAgingGroup. com), or you can go to the we bsite of an organization that advocates 'natural' aging (e. g. , the Inter National Organization to Reclaim Menopause; Inorm. org). Any impartial advisor, however, is going to admit that the answer isn't at all clear-cut. Jay Schulkin, I believe the reader will find, is such an impartial advisor, and he is going to take you several steps beyond simply acknowledging the ambiguity; he's going to educate you about the biology, history, sociology, business, and ethics of hormone replacement therapy. As a prominent scientist doing research on hormones, a medical researcher, an expert on decision making, he is the ideal guide to the intricacies of the topic. You might think that all of this sounds superfluous for making an informed decision: Just the facts, please.

Written for both specialists and generalists in the field Bridges diverse features that surround the decision-making concerning hormone therapy

Klappentext

The decision-making process that underlies ovarian hormone therapy (HT) is a fallible one. The question is whether or not physicians should prescribe HT to menopausal women, who are at a time in their lives when they are factoring various concerns into their decision to take (or not take) HT. Not only is it difficult to determine whether or not to prescribe HT, but what kind; should physicians recommend estrogen or progestin, or another combination of related hormones? The decision of whether or not to use HT has affected, and will continue to affect, many women in the United States and throughout the world and is an important model elucidating the forces that influence medical decision-making.

Two recent large-scale studies, one conducted here in the United States (the Women's Health Initiative) and the other in Great Britain (the Million Women Study), were highly publicized and cast a negative light on the use of HT. Since HT's inception, views have oscillated, due in part to expectations of benefits extending over the course of long-term use beyond the peri-menopausal period, and perhaps due to the overselling of research investigating the efficacy of HT. Thus, the decision for women to go on HT remains a controversial issue, and the decision-making process is undermined further by overzealous advertising and an exaggerated understanding of the research results (both positive and negative).

This book is unique in that it integrates core findings from within the Decision Sciences and Evidence Based Medicine in light of the research that has been done on HT. Medical Decisions, Estrogen and Aging integrates the various components that go into medical decision making in the context of understanding the dilemmas that surround HT. Therefore this book is intended for both specialists and generalists in the field, and it is ideally suited for use by graduate and medical students, medical health care professionals, behavioralscientists, medical ethicists, gerontologists, historians of science, and endocrinologists.

Inhalt
Hormone Therapy: Biological, Social, and Medical Context.- Demythologized Human Decision-Making.- Autonomic Regulation, Heart, and Strokes.- Bad NewsGood News: Cancers and Bone.- Brain, Mood, and Cognition.- Physicians' and Women's Responses to HT Findings: Implications for Continuous Learning and Self-Corrective Inquiry for Physicians.