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Oprah:
Okay. So we're keeping the conversation going from today's show about hormone replacement therapy. I'm taking the night off, so you've got Dr. Christiane Northrup all to yourself. I say that she wrote the Bible on menopause, The Wisdom of Menopause. We hit a big old nerve with our shows. More than 22,000 of you responded online wanting to know more. So here you go. Take it away, Dr. Christiane Northrup.

Dr. Northrup:
Hello, everybody. I'm taking your phone calls live tonight, so call 866-677-2496. That's 866-OPRAH-XM. Call with all of your questions. So let's get started. First up, Sylvia is joining us from Agoura Hills, California. Hi, Sylvia. What's your question?

Sylvia:
Hi, Dr. Northrup.

Dr. Northrup:
Hi.

Sylvia:
Hi. I'm years old 53. I went to menopause in 2001. All my friends have menopause symptoms except me. I've always maintained a good diet, and I never gained a lot of weight, so I was wondering, is this normal?

Dr. Northrup:
This is ideal, Sylvia. Thank you so much for calling. You set the tone for the whole evening. You are one of those people who sailed through menopause and perimenopause because your diet is good, your exercise is good, your adrenals are good and you've taken good care of yourself. So congratulations. You are super normal.

Sylvia:
Oh, thank you.

Dr. Northrup:
Okay, good. You don't need to worry. No truck is going to run you over that's named menopause.

Sylvia:
Okay, good.

Dr. Northrup:
All right? Okay. Thank you. All right. Elizabeth from St. Louis is on the phone. What's your question, Elizabeth?

Elizabeth:
Hi, Dr. Northrup.

Dr. Northrup:
Hi.

Elizabeth:
My question has to do with discontinuing the use of birth control pills.

Dr. Northrup:
Yep.

Elizabeth:
What is the best way to get off The Pill, say if it's a person that's been taking it for over 20 years and if you are of perimenopausal age? Should you gradually reduce the dosage or just quit cold turkey?

Dr. Northrup:
It actually depends whether or not you need birth control. You actually need birth control for a full year after you've had the final menstrual period. So it depends a lot on that. If you're using The Pill for perimenopausal symptoms, that's another conversation, and you can, believe I or not, switch from The Pill to a type of hormone replacement. But when you're done with needing birth control, a year after your final menstrual period, then you can simply stop them. And if your diet is good and you're exercising and so on, you might do absolutely fine. The body always goes through a readjustment period when a person stops The Pill, whether they're 30 or 45. So you'd have to just stop and see what happens.

Elizabeth:
But you can have perimenopausal symptoms while you are still on The Pill. Is that correct?

Dr. Northrup:
Most people don't. You can, because the brain changes. But most people don't. The Pill kind of quiets everything down because it puts the ovaries to sleep.

Elizabeth:
Yes.

Dr. Northrup:
All right.

Elizabeth:
Well, thank you very much.

Dr. Northrup:
All right. Thanks, Elizabeth. Another Skyper standing by, Phillipa, a 27-year-old from Elkins Park, Pennsylvania. Hi, Phillipa. You're pretty young for this show.

Phillipa:
Hi, Dr. Northrup. This is my question: I went to the doctor less than a month ago, and my testosterone level was high and my question is, is it going to affect me in getting pregnant any time soon or, you know, the question—the answer that I got from the doctor wasn't, how do I say it, it didn't settle my questions, I guess or it didn't answer my questions.

Dr. Northrup:
Okay. Are you having normal periods?

Phillipa:
No, I'm not. It's very irregular, and that was the reason I went to the doctor.

Dr. Northrup:
Okay. What you can do is I would continue to work with your doctor, perhaps a gynecologic endocrinologist. But I want you to know that through proper diet and exercise, you can get your levels back to normal, because a lot of what you have is related to lifestyle. And I would assume that you're going to have no problem getting pregnant. I want you to begin thinking of yourself as a healthy, 27-year-old, very fertile young woman. That alone will reduce stress in your body and you'll feel better. I would check out my book, Women's Bodies, Women's Wisdom. There's a whole chapter on this.

Phillipa:
Okay. And another question. So the soy and the edamame that I'm eating is not going to help at all? Because I read online that it can decrease your testosterone level.

Dr. Northrup:
What you want to do is follow a high-fiber, healthy fat diet. The main thing to cut down on is white foods: sugar, white flour, white potatoes and prepared foods. Things like that. Okay?

Phillipa:
All right, got it. Thanks, doctor.

Dr. Northrup:
Thank you, Phillipa. Corinne is Skyping us all the way from Australia. Corinne, what time is it there?

Corinne:
Oh, it's now 1 o'clock. 1 p.m.

Dr. Northrup:
Oh, good.

Corinne:
It's Friday for us.

Dr. Northrup:
That's good. It's not the middle of the night. So what is your question?

Corinne:
Thank you for answering my question. I am concerned about the quality of the bioidentical hormones. There seems to be—(inaudible)—but the manufacturing doesn't seem to be standardized and it seems to rely on the doctor being able to find a good compounding pharmacy, so how can I be assured that I will get a good quality of hormone?

Dr. Northrup:
The way you do that is to know that very good quality bioidentical hormones that are very nicely tested are available in all pharmacies. You read the label, and you make sure that what you're taking is progesterone. Not medroxyprogesterone acetate, but progesterone, and then you look for estradiol. Sometimes 17 beta estradiol. And those are bioidenticals and you'll be fine with those. You just have to sort through what's available in the pharmacies, and all you have to do is read the package insert and it's right there. Or the PDR. The Physician's Desk Reference will tell you, and they list everything. All right?

Corinne:
Great, thanks. Thank you very much, Dr. Northrup. Thank you.

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