Rockledge, Florida

Marja Sprock, M.D., FACOG, FPMRS Board Certified
Fellowship Trained Urogynecologist

Now Accepting New Patients

info@CFUroGyn.com      Phone:  321-806-3929

Recently Published

new  New Treatments for Vaginal Atrophy

new  The Healthy Weight Lifestyle Formula

new  Small Battery Can Fix Bowel Control Issues

new  Laser and the Vagina

new  Fecal Incontinence  - More Common Than You Think!

new  Overactive Bladder

new  Painful Bladder Syndrome / Interstitial Cystitis

new  Stress Urinary Incontinence

new  The Thrill is Gone

new  Chronic Constipation

Laser Treatment for Vaginal Atrophy

Have You Had Your Pap Smear?

Resources for Pelvic Floor Disorders

The Uterine Fibroid Dilemma

Are You Leaking ?

New Non-Surgical Laser Solution for Stress Urinary Incontinence

New Treatment Option for Stress Urinary Incontinence

Non-hormonal Vaginal Atrophy Treatment -- Non-painful Sex Without Estrogen

In-Office Painless Laser Vaginal Tightening

Central Florida UroGynecology Announces LASER 4D Aesthetics

Accidental Bowel Loss - A Socially Hidden Problem

Nerve Stimulation to Treat Urinary and Fecal Problems

Is UTI a Major Health Problem?

It Appeared to be an Overactive Bladder

Pessary Treatment of Prolapse

Overactive Bladder Evaluation Chart

Accidental Bowel Loss or Fecal Incontinence

Overactive Bladder Guidelines

Vaginoplasty and the “Designer Vagina”

Surgical Treatment of Stress Urinary Incontinence

Recurrent UTI - Urinary Tract Infection

Pads are "Out of Style"

Stool or Bowel Incontinence

Pain with Sex

Nightime Urination

A Tighter Vagina - the Answer to Happiness

Do not Let Urine Loss Color the Golden Years

Office Injection Procedure for Urinary Incontinence

Read a Magazine and Regain Urinary Continence

Position Statement on Mesh Midurethral Slings

Botox Covered by Insurance

Walk to Guard Against Disease!

Estrogen Treatment Possible Side-Effects Often Overstated -- Consider the Benefits!

What the doctor does not tell you…

Tips from Dr. Sprock
September 2013

Health and Feeling Good About Yourself

I have to Go All the Time

Treatments for Fecal Incontinence

Third Generation i-Lipo Xcell now available!  FIRST IN U.S.A.

Central Florida UroGynecology Opens Its New Facility on Eyster in Rockledge

Tips from Dr. Sprock
    
 March 19     March 10

But I don't have to go ...

Pelvic floor muscle training and the In Tone® device

Jessica Alba had i-Lipo, Would you?

Take Action in the New Year !!

InTone Home Device to Treat Urinary Incontinence

Regenlite Skin Tightening and Collagen Stimulation

New Options for Incontinence

Sexy Meshes ???

Control Incontinence.  Enjoy Being a Senior!

A Happy Patient Testimonial - Swimming Again After Bladder Procedure  <external>

Getting Rid of Adult Diapers

Nocturia, Nighttime Voiding

Dr. Sprock Connects with her Patients

Inches Off Where You Want Them Off - I-Lipo® Introduction

Another Incontinence Success Story

Space Coast Daily:  Dr. Sprock Does I-Lipo  <external>


Previously Published by Category

URINARY ISSUES

FECAL STOOL ISSUES

SEXUAL HELP

COSMETIC GYNECOLOGY

I-LIPO

PROLAPSE

OVERVIEW


Technical & Educational Info


All Published Articles

 

Estrogen Treatment Possible Side-Effects Often Overstated -- Consider the Benefits!
By Marja Sprock, M.D.
FACOG, FPMRS board certified

Just when I thought to have a peaceful, quiet relaxing weekend, I picked up the mail. Among the stack was a mailing from a medical insurance company. I was glancing through it and my eye got caught by:"common high-risk medications". In general every medication has potential risks, and the benefits need to be determined on an individual basis. I was, however, struck by total surprise and amazement when there were 20 medications mentioned of which 10 were estrogen or estrogen and progesterone products. I was not sure what to do with this information and what message this was supposed to send to women struggling with hot flashes or women suffering with a painful vagina with thin tissue who would like to be in an intimate relationship. Not even mentioning the women encountering premature surgical menopause, for which research has shown that removal of ovaries at an age less than 60 increases morbidity and mortality.

I would rather encounter a driver on the Eau Gallie Causeway who accidentally took two of her estradiol pills, than one who took two Percocet®. The latter, however, did not make the list as a common high-risk medication as per Medicare guidelines.

Since I do not have to pay for the medications, nor get a kick back when I prescribe them, I would like to inform the postmenopausal women with more realistic and honest info. The group of otherwise healthy women going through surgical menopause at a young age is at a higher risk of significant bone loss and at higher risk of heart disease. The average age of menopause in the US is slightly above age 51 and the level of naturally produced estradiol in the body by the ovaries is several times higher than what would be ingested by replacement. Putting this in perspective with higher morbidity and mortality when ovaries are removed by age 60, you can draw your own conclusions. 

Women at age 51 often like to be sexually active. As a lot of postmenopausal women trying to stay away from these "common high risk medications" have noticed; you can insert an entire tube of KY jelly, Astroglide®, or whichever lubricant of your choice in your vagina, it will still not be comfortable or often even impossible to have intercourse. Also orgasm tends to be less intense without at least some estrogen in the vagina. In defense of the 50% of the high risk medication list containing estrogen products, the Estring®, was not mentioned. This is a vaginal insert, with negligible secretion of estrogen in the bloodstream or to the uterus. It makes the vagina look and feel like a 30 year old; however, it is not a covered medication by the medical insurance company sending out this misplaced warning. Other options like Osphena®, a selective estrogen receptor modulator, which is indicated for painful intercourse is also not a covered benefit. Osphena® works as an anti-estrogen on the breast, and pro estrogen on the bones and vagina. The effect on the uterus seems to be small, but more long-term studies have to be performed. In regards to estrogen and progesterone, a lot of women have resorted to bio identical hormones, assuming they have less risk. Often bio identical is confused with compounded. Compounded means made by the pharmacist according to certain specifications. Compounded drugs are often cheaper, however, remember estradiol is our natural hormone and can be ordered compounded as well as a drug company packaged product.

Now what should you do if you are 54 year old Alice who cannot sleep at night because of hot flashes, whose husband just came home with a new prescription for Viagra®. Not only does she feel cranky because of her lack of sleep and hot flashes, her vagina is not as pliable as it used to be and the last thing on her mind is sex. She has bought all the supplements in the health food store to curb mood and hot flashes and her doctor has put her on Clonidine® and Effexor®, but nothing seems to work. She is at the end of her wits, however, she read the insurance company warning of common high risk medications and she does not want to start estrogen. Are we really being fair to Alice? Does research support us to make Alice feel guilty and at least for a couple of years go on estrogen and get her life back? Not even mentioning that a drug like Clonidine® is potentially very dangerous to come off of and Effexor® makes it difficult to climax and diminishes the sex drive. To make it more complicated even the 2002 study which made a lot of women quit estrogen was not performed on women just entering menopause. There are several studies showing that this group may actually have some other health benefits from estrogen. Also in this same study the women on estrogen experienced a slightly higher risk of stroke and the highly publicized increased risk of breast cancer was low and only in the estrogen and progesterone group.

What is Alice supposed to do? Well we leave it up to Alice, but continuing the way she is, will not ensure a "and they lived happily ever after."

Women should have options and choices and not get misinformed. Every medication has risks and benefits. There are contraindications and indications. To single out non habit forming, non-addictive drugs like hormones as high risk medications is not beneficial to the health and well-being of women.

Marja Sprock is a board certified urogynecologist as well as a board certified obstetrician and gynecologist and practices in Rockledge at Central Florida UroGynecology. Call us at 321-806-3929 or www.CFUroGyn.com

"Central Florida UroGynecology where high tech and common sense meet"


Central Florida Urogynecology

101 Eyster Boulevard, Rockledge, FL 32955

Phone 321-806-3929

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updated:  January 11, 2016