The Estrogen Alternative [Hardcover]

Steven R. Goldstein (Author)

Book Description

Publication Date: December 28, 1998

Most women know the benefits of estrogen replacement after menopause: It reduces the risk of osteoporosis, heart disease, even Alzheimer's disease. Many are still reluctant to take it, because it increases the incidence of breast and uterine cancer. But there is a revolution occurring in hormone replacement therapy. Synthetic hormones, Selective Estrogen Receptor Modulators (SERMs) can give women the benefits of estrogen without the risks. And The Estrogen Alternative is the first book to discuss how the latest advances in this field will dramatically improve women's health. Written by Steven R. Goldstein, M.D., a world-renowned obstetrician and gynecologist, and Laurie Ashner, a prominent journalist and therapist, The Estrogen Alternative will answer the questions women have about traditional estrogen therapy, herbal estrogen therapy, SERMs, and arm readers with information they need to have when they consult their doctors. A member of the advisory panel for the team that developed Raloxifene, one of the first SERMs to garner FDA approval, Dr. Goldstein is uniquely qualified to advise women on the cutting-edge of hormone replacement therapy. He discusses the subject in the way every woman wishes her own doctor would, and shows the remarkable strides medicine is making. The Estrogen Alternative is a resource every woman can use to help maintain good health in the second half of her life.

Editorial Reviews

From Library Journal

This book will be sought out by women wishing to know more about Evista, Eli Lilly's trade name for raloxifene, which received FDA approval in January 1998 for the prevention of osteoporosis. Goldstein, a member of the advisory board for the team that developed raloxifene, and Ashner, a journalist and therapist, provide help in assessing the benefits and side effects of this new therapy, which benefits bones and lipid profile while significantly reducing the risk of breast cancer linked to traditional hormone replacement therapy (HRT). The authors emphasize that raloxifene and other SERMs (estrogen substitutes) are approved for use by postmenopausal women. HRT remains the treatment of choice for hot flashes and other symptoms experienced during menopause; postmenopausal women can benefit from raloxifene, which acts like estrogen in the bones and cardiovascular tissues but not in the reproductive system. For those who choose not to take estrogens during menopause, the authors offer suggestions for coping with symptoms. Recommended.?Jodith Janes, Cleveland Clinic Foundation
Copyright 1998 Reed Business Information, Inc.

About the Author

Steven R. Goldstein, M.D., is a professor at New York University School of Medicine and director of the Gynecological Ultrasound Department at NYU Medical Center. The author of two textbooks and numerous research articles, he lives in New York City.

Laurie Ashner, a writer, teacher, and psychotherapist, has co-authored When Parents Love Too Much, The New Chemistry of Love, and When Is Enough, Enough? She lives in Chicago. --This text refers to an out of print or unavailable edition of this title.

Product Details

• Hardcover: 189 pages
• Publisher: Putnam Adult; 1 edition (December 28, 1998)
• Language: English
• ISBN-10: 0399144536
• ISBN-13: 978-0399144530
• Product Dimensions: 8.4 x 5.2 x 0.9 inches
• Shipping Weight: 12.8 ounces
• Average Customer Review: 3.7 out of 5 stars  See all reviews (6 customer reviews)
• Amazon Best Sellers Rank: #4,228,181 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

21 of 22 people found the following review helpful:

5.0 out of 5 stars An excellent and cutting edge health resource for ALL women., August 28, 1999

By 

"superevie" - See all my reviews

This review is from: The Estrogen Alternative (Hardcover)

The Estrogen Alternative by Dr. Steve Goldstein and Ms. Laurie Ashner is a cutting edge resource important for ALL women. As the founder and creator of HotFlash! the online perimenopause/menopause support group and web site, I look for good usable health information. Goldstein and Ashner present a complete and very balanced presentation of the new menopause therapies. These non-hormonal remedies are cutting edge and a book like this is a must read for any woman who either does not want to take estrogen or cannot take estrogen. In addtion to common sense discussions about estrogen alternatives, both Ashner and Goldstein provide a complete health handbook-extending from weight loss to having a good night's sleep. I highly recommend this book to my online support group members and to ALL women. As a nurse and a woman it is refreshing to see a book like this; it is timely and made to help empower women in making good health choices.

28 of 32 people found the following review helpful:

1.0 out of 5 stars This is stolen title and a pack of lies!, April 29, 1999

By A Customer

This review is from: The Estrogen Alternative (Hardcover)

Evista induces ovarian cancer in both mice and rats New Drug Poses Risk of Ovarian Cancer by Samuel S. Epstein M.D. & Pat Cody Chicago, Illinois / Oakland, California Eli Lilly's current full page color ads for Evista, a synthetic hormone with both estrogenic and anti-estrogenic effects, in major national and regional newspapers claim that it offers "a new way to prevent osteoporosis" while admitting that "its effect on fractures is not yet known." The ads also claim that "women taking Evista had no increased risks of breast and uterine cancers" in contrast to hormone replacement therapy, and that it reduces LDL or bad cholesterol blood levels. This should be welcome news to women worldwide, particularly as osteoporosis has now reached epidemic proportions, affecting fifteen to twenty million American women each year; osteoporosis causes over a million fractures including 250,000 hip fractures, and killing some 50,000 elderly women from complications of their fractures. While warning of some possible side effects, such as blood clots or hot flashes, Lilly fails to warn of the more serious risks of ovarian cancer. A company-sponsored publication in the December 4, 1997 issue of The New England Journal of Medicine also ignores this risk. However, Lilly's pre-market clearance study clearly shows that Evista induces ovarian cancer in both mice and rats. Furthermore, carcinogenic effects were noted at dosages extending well below the recommended therapeutic level. However, the study concluded: "The clinical relevance of these tumor findings is not known." Lilly reached this conclusion despite the strong scientific consensus that the induction of cancer in well-designed tests in two rodent species creates the strong presumption of human risk. Nevertheless, Lilly fails to disclose this critical information in its ads and in its "Warning" to patients. Responding to such criticisms by Dr. Samuel Epstein on the January 12, 1998 "Jim Lehrer News Hour" program, a Lilly spokesman claimed that the carcinogenic effects of Evista in the ovaries of sexually mature rodents are irrelevant to such risks in post-menopausal women as their ovaries are inactive, and that no warning is therefore necessary. However, apart from the fact that the rodent studies were specifically designed to evaluate Evista's safety, ovarian cancer is a scientifically documented complication of long-term estrogen replacement therapy in the post-menopausal. Also disturbing is the claim that Evista poses no risks of breast and uterine cancers as this is based on clinical trials over only some 40 months, a period totally inadequate to possibly manifest any such risks. Ovarian cancer strikes about 24,000 U.S. women every year, accounting for 4% of all their cancers. About 15,000 women die from ovarian cancer annually, making it the most lethal of all female reproductive cancers. Lilly's suppression of its own evidence of ovarian cancer risks from Evista is reckless and threatening to women's health and life. Equally reckless is FDA's December, 1997, marketing clearance, especially in the absence of any requirement for warning. Such conduct clearly merits urgent Congressional investigation. This drug should be withdrawn from the world market immediately. As importantly, a "Cancer Alert" should be sent to the over 12,000 women who have participated in U.S. and international clinical trials in the absence of fully informed consent. The doctrine of informed consent is ethically and legally protective only when all facts relevant to benefits and risks are affirmatively disclosed. This is clearly not the case with women who have been involved in the Evista trials. These women should be offered semi-annual lifelong surveillance for the early detection of ovarian cancer, at Eli Lilly's expense.

Samuel S. Epstein M.D., University of Illinois School of Public Health, Chairman, Cancer Prevention Coalition, Chicago, and co-author of The Breast Cancer Prevention Program, Macmillan, 1997. Pat Cody, President, DES Action, Oakland, California.

Reprinted from the Chicago Tribune, April 19, 1998

Note from the editor (Nora Cody) : With so much conflicting information available, it can be difficult and frustrating to try and make the best decision about taking hormones. For personal decisions about your own health care, I encourage you to speak with your health care provider. Please do not send inquiries. For thoughtful and reasoned discussion about hormones, menopause, and alternative approaches to menopausal symptoms, I also recommend the newsletter A Friend Indeed. Related article:  "The Breast Cancer Prevention Program", Samuel S. Epstein, M.D., Book Review by Pat Cody  Doctor claims new drug (Evista) poses risk for ovarian cancer by Nora Cody

9 of 9 people found the following review helpful:

5.0 out of 5 stars A must read for women who can't take estrogen., May 4, 1999

By A Customer

This review is from: The Estrogen Alternative (Hardcover)

I bought this book because my 60 year old mother can't take estrogen and is at serious risk for osteoporosis. This was really an honest evaluation of Evista, a drug my mother is considering. Dr. Goldstein doesn't sell it, but explains it, and who will benefit, who won't and who should wait and see. But this book is really about how to take care of yourself after menopause. It explained herbal therapies, what to do about weight gain, and even what to do about aging skin. The best part about it was that it was short, to the point and very readable. My mother, who doesn't have the patience to read anything, read this book in an evening! If you have a parent who is struggling with the estrogen dilemma, this is really reassuring.