We hope you find this information helpful. It is important to Dr. Goodman that you expand your knowledge during this new phase of your life. But please note that Dr. Goodman is no longer accepting new menopausal medicine patients. He is, however, accepting new patients for difficult/chronic GYN issues (ask staff for details*) and genital plastic and cosmetic procedures.
Answering your questions when it comes to cellulite, progesterone, and aspirin
Genes, Diet, Hormones, and (the Dreaded) Cellulite
Quick cellulite facts:
- Cellulite is due in part to your genetic makeup, but metabolism plays a larger part in the amount and balance of fat, especially “brown fat” vs. “white fat,” and hormones (especially estrogens) also play a part. Estrone (vs, estradiol) is more dangerous for the development of cellulite. **Orally administered estrogens are metabolized more into estrone than transdermals (patches; gels); a reason I like transdermals more than orals…) Genetics operate here in the area of polymorphism (which helps so far as biodiversity is concerned, but not necessarily for an individual’s cellulite!).
- Of greater danger for the development of cellulite in elevated cortisol. The condition that is most likely to increase cortisol is stress. Therefore, increased stress = increased cellulite.
- Different kinds of fat have different distribution. “Age fat” (yellow, thick) is very different from “young fat” (white, equally distributed). Abdominal fat (thick, yellow fat) is the most difficult to metabolize.
- Aged fat = more fibers. What does this mean? “Young fat” cellulite is easy to remove; older, darker fat is more difficult.
- Muscles fight fat!
“All Progestogens (includes “natural” progesterone and synthetic “progestins…”) Are NOT Created Equal!”
The Women’s Health Initiative (or WHI)—the study that scared so many women into stopping hormone therapy—taught us many things, again reminding us to be careful about practicing medicine according to popular press prognostications.
It’s sad that so many undereducated physicians and practitioners persist in eschewing estrogen therapy based on the faulty data presented in the WHI. It turned out that it was NOT the estrogen (Premarin) that led to the small increase in breast cancer seen in the WHI study—rather, it was the synthetic progestin “Provera” (generically, medroxyprogesterone acetate, or “MPA”) that was part of the tablet given to women in the study.
A very recent study may show us why MPA is so risky when given day-by-day:
MPA exerts an anti-androgenic effect on breast epithelial cells that is associated with increased proliferation and destabilization of androgen receptor protein, which may contribute mechanically to the increased risk of breast cancer in women taking MPA. (Ochnik et al, Menopause, Vol. 20, 2013)
A recent French study (Cordina-Duverger et al) evaluates the breast cancer risk of different progestins (“artificial” progesterones) compared with oral micronized progesterone. With [“natural”] micronized progesterone, breast cancer risk was not increased. In contrast, the odds of breast cancer for users of some progesterone-like derivatives, including MPA, was 3.35 times higher!
Also interesting is the fact that MPA is the progestogen of choice for insurance companies because it costs much less. The insurance companies have done their actuarial work well. They are willing to pay for the increased amount of breast cancer in women taking MPA in order to save the greatest amount of money by supplying the very cheap MPA rather than the far safer, but more expensive, bioidentical progesterone!
When Is the Use of Aspirin for CVD Prevention in Women Appropriate?
Question: Should all women (and men) take a daily baby aspirin (or the less expensive alternative: half a regular aspirin every other day)?
Answer: In the large-scale Women’s Health Study (WHS), women aged 65 or older without known coronary vascular disease and women of any age with an increased risk of coronary vascular disease or “CVD” (e.g strong family history of CVD, diabetes, obesity, hypertensive and/or hypercholesterolemic) are likely to experience a benefit from low-dose aspirin therapy and should be considered for such therapy unless aspirin is contraindicated.
So: in addition to the proverbial “apple a day,” an aspirin a day (or every other day) may also help “…keep the doctor away..!
Keep tuned to this site for Part 2 of Menopause Quick Facts