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So you’re a woman and you go to your doctor, saying you don’t feel like yourself, maybe you’re tired or feeling sluggish, you’ve started gaining weight, or maybe don’t take pleasure in things like you used to. You don’t have the sex drive that you used to, your cycles are off, or you’ve suddenly developed allergies you never had before. Has your MD patted you on the head and said to reduce stress, get more sleep, eat better, get more exercise, or maybe prescribed something for a “common” disease, such as thyroid medication, high cholesterol, or maybe even an antidepressant?

Then this book is for you.

How Your Doctor is Slowly Killing You: A Woman’s Health Survival Guide by Dr. Angela DeRosa discusses the often ignored and more often misdiagnosed issue of hormone imbalances in women, from puberty to old age. Not only do hormone imbalances wreck your mood, they can affect your relationships, destroy your energy, and in the long term ruin your overall health.

“Women and doctors have been tricked into thinking that treatment for symptoms of menopause or hormone imbalances put women and their health at risk, when nothing could be further from the truth. Basic hormone deficiencies have the potential to destroy our health, our relationships, and our quality of life. Can hormone replacement therapy really help protect women (and men) against chronic disease? Yes.”

While the title might sound sensational, even controversial, and Dr. DeRosa is an outspoken narrator, she’s also passionate about women’s health – specifically their hormonal health. She’s an advocate of patients taking charge of their own health care, taking back their bodies, and the use of bio-identical hormones. Some of her statements, such as why Big Pharma and the FDA won’t approve low-dose testosterone for women that are widely used in European countries, might come across to some readers as paranoid or conspiracy theory, her reasoning appears sound. She argues that doctors should depend less on labs and more on the patient history, spending more time talking to patients and keeping themselves updated from what they learned in medical school rather than just proscribing antidepressants.

As previously said, this may be a controversial point of view.

While these statements might not be applicable to all women, at the very least Dr. DeRosa explains the intricacies of the female body in an approachable, easy to understand manner, with the interplay of testosterone, estrogen, and progesterone laid out in one of the best similes ever. It at least does no harm to read this book to better understand your hormones in relation to the inner workings of your body, and build awareness as the issues in women’s health. Dr. DeRosa strikes a wonderful tone in this book and the guides for questions to ask a medical practitioner as well as symptom checklist to help identify the hormone issues women might be dealing with is especially valuable.

While this reviewer cannot say one way or another as to the accuracy of the science and research in this volume, it sounds reasonable, especially for women looking to stay off multiple medications and work with their bodies to operate more optimally with bio-identical hormones.


Interview With Dr. Angela DeRosa


Q. Why is there such a disparity between women’s health and men’s health? Why are we still afraid of vaginas in this country?

A. Gender bias in medicine is rampant and as a result women and their health suffer. In drug trials, gender differences matter due to hormonal and physical variations between men and women. When companies do research studies and drug trials, they don’t like to do them on women as our hormonal complexities complicate matters for their data, so too often women have been excluded or underrepresented in drug studies. My time with P&G Pharmaceutical gave me a firsthand look at the disparities between hormone therapies for men versus those being developed (and then refused approval) for women. Like it or not, women are sexual creatures, just like men, and their needs matter just as much as men’s.

Some context on women and drug trials:

“Since 1993, however, the National Institutes of Health has mandated, and the Food and Drug Administration has emphasized, inclusion of women in clinical trials, only to be thwarted by other regulations excluding many women. Gender-specific analyses are required to detect gender differences in effects of pharmaceutical and non-pharmaceutical interventions, but they are seldom performed. The exclusion of women from clinical trials means that women’s healthcare is compromised by lack of sex-specific information about dosing of drugs and unique uses of drugs.”

Additional reading: U.S. Food and Drug Adminstration: Women in Clinical Trials and Journal of the Royal Society of Medicine: Gender bias in research: how does it affect evidence based medicine?

Q. Do you see the attitude toward women’s health/ healthcare in general changing in the next ten+ years?

A. I am hopeful that as women become more educated and less and less tolerant of the status quo that the medical community will begin respecting women for the value they bring to the table, so hopefully, attitudes and standards for care will improve. However, fear propagates ignorance and vice versa.  The longer women remain fearful and uninformed and their doctors remain misinformed, the easier it is for the 24/7 media machine and big pharma to capitalize on these fears. Information is power.

Q. What are ways that women, as well as the men who love them, can advocate for equal healthcare?

A. Unfortunately, money is power, and too often it is used to drive inequality. Women are 51 percent of the world population and yet we continue to be marginalized and underrepresented. People need to openly and vocally support businesses and practices that support women. They must continue to advocate for progressive changes in politics and laws rather than sit back and allow the regressive changes we’re seeing today, along with exerting more pressure on medical researchers and studies to include women.

The continuing disparity between available treatment for sexual dysfunction for men and women is a perfect illustration of the problem – men have scores of drugs and therapies available to them for treatment – women – ZERO. In October of this year, the FDA conducted open hearings on women’s sexual dysfunction – a FIRST – and allowed women to testify that it is indeed a real problem and that it does affect their quality of life. Whether or not this will result in changes remains to be seen. But it’s a step in the right direction.

Q. When it comes to health and healthcare, it seems like every other study contradicts the last one. With so much misinformation and, even worse, way too much information out there, how can patients stay educated and still keep their sanity?

A. When looking at studies, always follow the money. Patients (and doctors for that matter) need to have a basic understanding of what makes a study valid and stop accepting everything that TV lawyers and entertainment based media present as fact. If a study does not reach statistical significance, then the results are no better than chance and it shouldn’t be a part of the discussion. A good example is the recent media frenzy over “testosterone being linked to increased heart attacks and stroke in men”. This small study was seriously flawed to the point of being meaningless, and there were scores of top medical doctors openly calling for retractions and issuing rebuttals. Even after the problems with this particular study were highlighted, the misinformation prompted by this debunked study remains a top story. IT IS AN INVALID study, but since it makes for good headlines and potential class action lawsuits, it’s still dominating the airwaves.

Also, we need to stop believing that the only good research comes from the US. Most research studies in the US are paid for by pharmaceutical companies who have a vested interest in the outcome – in other words, there is a HUGE conflict of interest from inception. There is a wealth of valid independent research studies and ongoing research outside of the US, in particular in relation to hormonal health. Studies done outside of the US are much less biased, as most are independent, university-based and not paid for by pharmaceutical companies. As a result, there is less conflict of interest and an increased chance of validity. While medical providers are evolving in the US, most still practice based on outmoded guidelines, and due to our medical malpractice laws, many are practicing from a place of fear – consequently, people’s health suffer – especially women’s.

Q. When it comes to hormone deficiencies, will women see all of these symptoms or just some of them? Should they be extreme or is just feeling “a bit off,” “not quite themselves,” reason enough to look into hormones?

A. Every woman is different, and they may not experience all of these symptoms, but it’s probable that they will experience a majority of them. Women know their bodies and what is normal for them, yet their feelings and instinct are often ignored or discounted when talking with their medical provider. It happens every day.  Hormones and the endocrine system play a huge role in virtually every major metabolic function of the body, so once something falls out of balance, it’s like a domino chain. Hormonal imbalances are often the underlying issue; increasing the risk factors for developing even more serious diseases; however, testing is also an opportunity to ensure we don’t miss other things that may be driving these symptoms such as anemia, cancers, liver/kidney disease, etc.

Q. With the book being primarily aimed at menopause, what can young women or women of childbearing age take away from this?

A. This book is aimed at women of all ages to empower them with information about how their bodies really work, and how commonly prescribed medications can affect their health from the reproductive years through menopause and beyond. As the book illustrates, even a women in her 20s can have hormone imbalances if they are taking birth control pills, anti-depressants or other medications.

I want women to truly understand how hormones function in their bodies and prepared to ask the right questions. We need to understand the indirect consequences of medications doctors prescribe, and how they can affect our hormone balance and in turn, negatively impact our overall health. This book is for all women and the people who love them.

Q. What are ways for patients to take a more active role in their healthcare?

A. Information is power. For women, asking the right questions (see the book’s checklists) and not accepting a brush off is critical. This book and the information within gives women permission to seek answers and say enough is enough. We want and need to be heard and not passively ignored simply because the majority of physicians do not understand the critical role of hormones in our bodies.

Q. Some might say you come across as anti-big pharma and question your nonmainstream arguments. How would you respond to that kind of criticism?

A. I am not against big pharma, however I am against big pharma when it is not the answer.

Americans are by far the most drugged population in the world and so much of it is unnecessary. We must shift to a preventive focus. Rather than working to prevent disease through lifestyle changes and maintaining good hormonal balance so our bodies can continue to work efficiently and remain healthier longer, we mask symptoms with drugs, and then treat the side effects of the drugs with more drugs. It’s madness.

Pharmaceutical companies do much-needed research and provide lifesaving medications that provide wonderful tools to treat illness and chronic diseases. However, medications should not be the default scenario for illness. Getting to the root cause of symptoms that are often caused by simple hormonal imbalances creates a scenario in which many highly profitable medications would be prescribed far less often. Since medicine in the US is a for profit system, it’s driven by money and the pharmaceutical industry, which is why the type of foundational medicine I practice and write about remains so controversial.

Doctors need to get back to basics – reviewing histories, listening and trusting their clinical observations to diagnose and treat patients, rather than rushing through things and defaulting to their prescriptions pads. Generally speaking, if a patient has high blood pressure, dietary changes, weight loss and physical exercise can usually alleviate the need for medication. If the patient’s high blood pressure is dangerously high or stems from a chronic disease, of course medications are appropriate.

Q. The book’s title is quite sensational, as are some of the statements about doctors, healthcare, and pharma companies. Do you worry that any of this will turn off potential readers?

A. The book’s title was meant to grab attention for sure, in order to get people to the table to discuss a topic that desperately needs attention. If you don’t get people to the table to talk, nothing will change.

I wrote this book for patients, not doctors, although most doctors should read it.  As I state in the book, the vast majority of doctors are not doing anything with ill intention, and in fact most doctors truly want to help their patients and are making their best efforts to do so every day. The problem is that most physicians don’t get the proper education when it comes to women’s health and we need to change that. Unfortunately, the medical community moves very slowly when it comes to changing its educational and practice behaviors, so it falls to patients and like-minded physicians to drive change.

Q. What’s the single most important idea you’d like readers to come away with from your work?

A. If you feel something is “off” or “wrong” continue to seek answers. Do not give up.  Patients are their own best advocates, and they need to take their health into their own hands. Do NOT let doctors or any medical professional make you feel stupid or inferior. Hormones play an enormous role in our bodies and when they are out of balance they can wreak havoc on our lives and our health. What is normal for one person is not normal for another. Each individual is unique and requires a unique assessment.

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