Side Effects of HRT

Side Effects of HRT

Hormone Replacement Therapy has some side effects. These side effects are negligible in comparison to the benefits it gives. Hence women should be encouraged to use ERT.

Does HRT have side effects similar to those of birth control pills



The use of HRT has been complicated for menopausal women as well as for prescribing doctors by the contraindications contained in the pharmaceutical data sheets. The similarity between the data sheets for oral contraception's and HRT preparations suggest that the contraindications for the former have been uncritically accepted for the latter.  This has led to the wide spread misconception that oral contraceptive and HRT preparations are similar with regard to contraindications as well as risk for side effects. Since estrogens play such an essential role in the health and well being of women, women should be en

couraged to use ERT so that they continue to enjoy the same quality of life they experienced before menopause.


Are there any drawbacks to HRT

Some patients complain that oral drugs sometimes aggravate menopausal problems.  This could be due to metabolism in the liver and the intestine, resulting in wide fluctuations in plasma hormone levels, changes in hepatic protein synthesis and perturbations of the haemostatic system.

Administering HRT with Transdermal Drug Delivery Systems

HRT is an effective method of easing the menopausal symptoms. Administration of HRT can be oral, parenteral, rectal, vaginal, topical and transdermal. Transdermal Drug Delivery is done through application of patches containing drug to skin. Know more about this method of application.

How is HRT administered

There are various ways of administering HRT. Some of them include: oral, parenteral, rectal, vaginal, topical and transdermal (through the skin).  These treatments can also be classified as oral, percutaneous and transdermal.


What are transdermal drug delivery systems

Transdermal (through the skin) drug delivery system is one way of administering HRT.  Other methods of administering HRT include oral, parenteral, rectal, vaginal and topical.

Transdermal applicators are the patches containing the drug.  They are flat, smooth, discrete and can be used for long term medication. Transdermal delivery systems are not just an alternative route of administration but they improve the therapeutic value of a drug and provide many other advantages including increasing compliance.

Transdermal therapy could be of two types: (a) Reservoir type: Those that control the rate of drug delivery to skin; and (b) Matrix type: Those that allow the skin to control rate of drug absorption.


Why is skin the site for transdermal drug delivery

Skin is one of the most readily accessible organs of the human body. It has a thickness of only a few mm.  Skin is a multi-layered organ composed of many histological layers.  Its three main layers are: the epidermis, the dermis and the hypodermis.

The epidermis is further divided into 5 anatomical layers. The outermost layer is the stratum corneum which is exposed to external environment. The transdermal permeation of neutral molecules at steady state can be considered as a process of passive diffusion through the stratum corneum in the interfollicular region.


General considerations for the use of Transdermal Drug Delivery systems 

The site selected for application should be clean dry and hairless e.g. estradiol patches are applied to buttocks or abdomen, nitroglycerine patches are applied to chest. Scopolamine behind ear. Because of possible occurrence of skin irritation, sites of application for patches are rotated weekly. 
Transdermal patch should not be applied to skin that is already irritated or act so as to ensure maximum absorption. 
Patches should be removed from its protective package being careful not to tear or damage patch. Protective backing should be removed to expose the adhesive layer and it should be applied firmly with the palm of the hand until it is secured in place. 
Patches may be left on when bathing or swimming. If the patch gets dislodged one must re-apply it or it may be replaced.


Benefits and Drawbacks of Transdermal Drug Delivery Systems

Transdermal Drug Delivery systems are the easiest way of ERT. There are some discomforts associated with this but its advantages outweigh the discomforts. Know about this in detail.

Possible discomforts of Transdermal Drug Delivery systems

Transdermal drug delivery systems could be unsuitable for drugs that irritate or sensitize skin. 
The natural limits of drug entry imposed by the skin's permeability indicates that relatively potent drugs are suitable only for transdermal delivery. 
Under various environmental conditions, adhesions of the system to different skin types sometimes result in technical difficulties. 

Advantages of Transdermal Drug Delivery systems

Avoids gastrointestinal tract difficulties during absorption caused by enzymes, drug interactions with food, etc. 
Suitable in instances like vomiting/diarrhoea where oral route is not desirable. 
Avoids first pass i.e. the initial passage of a drug substance through the systemic and portal circulation.
Provides the capacity for multi day therapy with a single application thereby improving patient compliance. Extends the activity of drugs having short half - life through the reservoir of drug present in the delivery system and its controlled release characteristics. 
Therapy can be quickly terminated by removal of the patch from the skin. 
Provides ease of rapid identification of medication in emergencies - non-responsive patients, unconscious or comatose patients. 
Less chances of over or under dosing as the result of prolonged preprogrammed delivery of drug at the required therapeutic rate. 

What is ETS

ETS is a new transdermal hormone replacement therapy that is supposed to be convenient, safe, low dosage estrogen therapy.  It is a once-a-week dosage with a matrix patch, and offers various benefits over the existing treatments:

Physiological low dose hormone
Avoids hepatic first pass
Convenient once a week treatment
Prevents and manages post-menopausal symptoms - early symptoms like depression, anxiety, vaginal dryness, osteoporosis and cardiovascular diseases.

Asthma in Children: Symptoms and Risk Factors

Asthma is the leading cause of chronic illness in children. It affects more than one out of every 10 children in the U.S., and, for unknown reasons, it is steadily increasing. It can begin at any age, but most children have their first symptoms by age 5.

What Makes a Child More Likely to Develop Asthma?

There are many risk factors for developing childhood asthma. These include:

• Presence of allergies
• Family history of asthma or allergies
• Frequent respiratory infections
• Low birth weight
• Exposure to tobacco smoke before or after birth
• Being male
• Being black
• Being raised in a low-income environment

Why Are More Children Getting Asthma?

No one really knows why more and more children are developing asthma. Some experts suggest that children are being exposed to more and more allergens such as dust, air pollution, and second-hand smoke. These are factors that can all trigger asthma. Others suspect that children are not exposed to enough childhood illnesses to build up their immune system. It appears that a disorder of the immune system in which the body fails to make enough protective antibodies may play a role in causing asthma.

Still others suggest that decreasing rates of breastfeeding have prevented important substances of the immune system from being passed on to babies.

How Can I Tell If My Child Has Asthma?

Signs and symptoms to look for include:

• Frequent coughing spells, which may occur during play, at night, or while laughing. It is important to know that cough may be the only symptom present.
• Less energy during play.
• Rapid breathing.
• Complaint of chest tightness or chest "hurting."
• Whistling sound (wheezing) when breathing in or out.
• See-saw motions (retractions) in the chest from labored breathing.
• Shortness of breath, loss of breath.
• Tightened neck and chest muscles.
• Feelings of weakness or tiredness.
• Dark circles under the eyes.
• Frequent headaches.
• Loss of appetite.

Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary from asthma episode to the next episode in the same child. Also note that not all wheezing or coughing is caused by asthma.

In kids under 5 years of age, the most common cause of asthma-like symptoms is upper respiratory viral infections such as the common cold.

If your child has problem breathing, take him or her to the doctor immediately for an evaluation.

How Is Asthma Diagnosed In Children?

Asthma is often difficult to diagnose in infants. However, in older children the disease can often be diagnosed based on your child's medical history, symptoms, and physical exam.

• Medical history and symptom description. Your child's doctor will be interested in any history of breathing problems you or your child may have had, as well as a family history of asthma, allergies, a skin condition called eczema, or other lung disease. It is important that you describe your child's symptoms -- cough, wheezing, shortness of breath, chest pain or tightness -- in detail, including when and how often these symptoms have been occurring.
• Physical exam. During the physical examination, the doctor will listen to your child's heart and lungs.
• Tests. Many children will also have a chest X-ray and pulmonary function tests. Also called lung function tests, these tests measure the amount of air in the lungs and how fast it can be exhaled. The results help the doctor determine how severe the asthma is. Generally, children younger than 5 are unable to perform pulmonary function tests. Thus doctors rely heavily on history, symptoms, and examination in making the diagnosis.

Other tests may also be ordered to help identify particular asthma triggers. These tests may include allergy skin testing, blood tests and X-rays to determine if sinus infections, or gastroesophageal reflux disease (a gastrointestinal condition that causes reflux of acid stomach contents into the esophagus or even into the lungs) is complicating asthma.

Signs and symptoms of breast cancer

Widespread use of screening mammograms has increased the number of breast cancers found before they cause any symptoms. Still some breast cancers are not found by mammograms, either because the test was not done or because even under ideal conditions mammograms do not find every breast cancer.

The most common symptom of breast cancer is a new lump or mass. A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded. They can even be painful. For this reason, it is important to have any new mass, lump, or breast change checked by a health care professional with experience in diagnosing breast diseases.

Other possible signs of breast cancer include:

• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• A nipple discharge other than breast milk

Sometimes a breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast tissue is large enough to be felt. Swollen lymph nodes should also be reported to your doctor.

Still Rocking Away at 92

Jerry Thill, who at the time was 91 years old and rocking away. I thought I would reprise it and add some more info about Jerry, since the article I wrote was short on background information about her. 

Jerry is truly a longevity role model.

Jerry Thill

Jerry Thill, now 92, lives in L.A. and has been in the music scene since her teens. Over the last 60 years she has been leading all-female bands, from big-band and swing bands to jazz ensembles. She’s been on the Tonight show and on TV shows such as The Golden Girls andMarried With Children.

But it was the above video, Hey Jerry, shot and produced by her musician/filmmaker friend Allee Willis last year, that gave Jerry Thill massive exposure. After all, how many nonagenarians are out doing drumming gigs on a regular basis, as Jerry still does?

Jerry currently gigs in Hollywood, CA at the El Cid restaurant. See the video below of her performing the song“Oh Yeah” at the El Cid in 2008. The song begins at the 1 minute mark of the video.

A publicity photo from 1988, when Jerry was a mere pup, at age 71. She's the one on the right.

Since the Hey Jerry video first appeared on YouTube, Jerry has appeared on the cover ofModern Drummer magazine, and has been featured in other articles. Along with that she has received thousands of letters and emails, with people telling Jerry what an inspiration and role model she is.

Jerry says that, “I’ve gotten a lot of emails from people who say, ‘I’m 45, and I’m at a point in my life where I don’t know what to do, and your video inspired me, and I’m going to get off my ass and do something.’ ”

The oxygen tank Jerry has with her (you see it in the above video) is something only recent, in the last year. I assume the oxygen tank is from the occupational hazard of years of gigging in clubs and all the cigarettes that people used to smoke while listening to the music.

Jerry Thill is still going strong at 92 and is a remarkable model of longevity. We should all be rocking away when we hit her age.

Here’s Jerry’s website: http://jerriethill.com/

And don’t forget, next time you’re in Hollywood stop by the El Cid to see her.

Below is the video of her performing in 2008 at the El Cid. The music starts at the 1 minute mark of the video.