What a word! What a concept! How do a couple of gynecologists who have been practicing medicine for more than a combined 80 years explain the changes that they see in their patients before, during and after the menopause transition?
Irwin J. Kerber, MD, FACOG, FACS, NCMP, Associate Professor of Obstetrics and Gynecology at the University of Texas Southwestern Medical School in Dallas, Texas, and Ralph J. Turner, MD, FACOG, NCMP, Associate Professor of Surgery, at the University of Texas Health Northeast in Tyler, Texas, have consider three basic questions related to hormones, especially estrogen, and hormone replacement therapy for decades. Their quest began with three questions. On this website, their thoughts will arise from the contemplation of these questions.
1) Is the very low concentration of estrogen in the blood (hypo-estrogenemia in physiological/medical terms) in menopause physiological (natural) or pathological (diseased or not-natural)?
2) Estrogen receptors are everywhere in the body. We know that they are found in over 3600 different metabolic pathways (series of biochemical reactions in the cells) in the body. Is it normal for estrogen receptors that modulate so many cellular functions in the body (both men and women) not to function properly once reproductive years are over?
3) If menopause is physiological (natural), then why do we treat low or deficient estrogen (hypo-estrogenemic) conditions such as hot flashes/night sweats, osteoporosis or uro-genital/vulvo-vaginal atrophy?
The purpose of this website is provide information on:
1) the current recommendations for hormone replacement therapy.
2) the historical use of hormone replacement therapy as was practiced by gynecologists and other physicians in the 1970′s-1990′s.
3) the major studies employing hormone replacement therapy as a drug to treat various medical conditions in menopausal women, even up to 30 years beyond menopause.
4) our theory of “eu-estrogenemia”, first published by Drs. Kerber and Turner in the Journal of Applied Physiology in 2005.
5) pertinent studies in the basic science literature that give us an understanding of what eu-estrogenemia looks like in the laboratory and in the animal and molecular/biochemical studies that are the foundation for many breakthroughs in science and medicine.
This website is for dissemination of the current literature for physicians, scientists and patients to consider what is known about estrogen. A special blog on this website will be “Kerber’s Corner”, where Dr Irwin J. Kerber will provide his thoughts on estrogen, hormone therapy and the care for patients. Dr Kerber and I (Ralph J. Turner, MD) are amazed with the breakthroughs in the basic science concerning estrogen as a hormone of homeostasis, a critical regulator of metabolism and not just a sex hormone made in the ovary, from people who do not treat patients.
Finally, any medical decision-making should be done with the patient and her doctor in light of the specific clinical needs of the patient. Final public health policy is usually determined decades after the initial understanding of a disease process is presented in the peer-reviewed literature.
We still practice medicine and care for patients as our “day job”. Dr Turner still accepts new patients at the University of Texas Health Northeast in Tyler, TX. Posting new content may be sporadic. We hope you enjoy our website.