BHRT SERIES – PART III
April 21st-23rd, 2017 — Clearwater, FL
October 27th-29th, 2017 — Park City, UT
PART IIl - Course Description:
The educational process for Part III is both didactic and interactive with maximum audience participation. All of the most complex, interesting, and confusing cases experienced by Dr.Rouzier over the last ten years are presented. The participants decide on the corrective management with literature reviews to guide therapy. Be forewarned, as in the past, many concepts taught in other academies are contrary to the medical literature presented in this course. The attendee will decide therapy based on evidence based guidelines rather than public opinion. Although there are no medical boards for this type of practice, Part III is similar to a medical board that digs deeper into the complexities of age management medicine. Clinical cases will be analyzed to formulate appropriate treatments and management to improve the understanding and level of care provided to patients. In
Parts I & II the cases and studies are simple and straightforward.
Objectives: Upon completion of this workshop the health care professional will be able to:
• Become proficient in newer age management protocols not presented in Parts I or II: more recent pertinent literature update and reviews, lab updates, and complex and interesting cases.
• Discuss the most current literature for bio-identical hormone replacement therapy (BHRT), thyroid, testosterone, DHEA, estrogen and progesterone.
• Determine the risks and benefits of transdermal estrogen vs. oral estrogen, why one vs. the other one, and review the statistics that claim HRT increases blood clots, or does it?
• Discuss new research demonstrating estrogen’s protective effects in men, the lack of any harm, and the harm of suppressing estrogen in men.
• Examine current policy statements for hormone replacement therapy by the North American Menopause Society (NAMS) and American College of Obstetricians and Gynecologists (ACOG), with a critique and review of their recommendations.
• Describe rational approaches for the use of progesterone in treating PMS and PPD.
• Discuss new therapies for prostate cancer as well as better diagnostic sensitivity and specificity of MRI-S scan.
• Determine current management strategies for preventing loss of pregnancy in Polycystic Ovary Syndrome (PCOS) as well as improving pregnancy rates with aromatase inhibitors.
• Describe the clinical evaluation including laboratory analysis and treatment of Vitamin D deficiency and how much is too much.
• Examine literature reviews as to what level of Vitamin D protects against cancer, CAD, osteoporosis, dementia, type II DM and AMD.
• Discuss the pathophysiology of vaginal atrophy and the use of rings, tabs, troches, creams, and DHEA. •
• Discuss the importance of sex hormone binding globulin (SHBG) in men and women and why it is most predictive of CAD, MS and cancer.
•Describe the data demonstrating that androgen suppression therapy, as well as estrogen deprivation, is associated with poor survival in men in comparison with placebo.
• Outline advanced treatment protocols for over 100 clinical cases based on clinical presentation, laboratory analysis, treatment, and complications in the Q & A sections.
• Discuss the inverse relationship of estrogen and prostate cancer. • Develop an understanding and treatment rationale for prostate cancer survivors through case presentations and literature review.
• Appreciate the lack of efficacy of estriol in spite of purported benefits.
• Describe the difference in clotting between Premarin®, Provera®, esterified estradiol, and micronized progesterone as per JAMA.
• Examine data proving that oral progesterone decreases clotting risk and inflammation as opposed to MPA that increases these risks as per the ESTHER trial.
• Appreciate the data demonstrating that only certain types of estrogen increase the production of fatty acid esters that result in protection against atherosclerosis and plaque deposition at the blood vessel wall.
• Demonstrate an understanding of the importance of maintaining low levels of aldosterone in patients with PCOS.
•Demonstrate an understanding of the importance of body weight in determining which type of HRT to prescribe.
• Critique the data demonstrating that testosterone can both increase and decrease CVD in women and learn to decipher the correct approach.
• Identify the two mechanisms by which estrogen treats and protects against prostate cancer.
• Review treatment of endometrial proliferation with serial ultrasound results and laboratory monitoring.
• Illustrate a historical perspective on progesterone presenting no risk of breast cancer or VTE.
• Present over 200 complex case studies to compare, contrast and analyze treatment protocols.
• Demonstrate skills in case studies with interactive discussion to ensure interpretation and treatment protocols are as demonstrated in our evidenced based scientific literature.
• Examine the medical literature to understand how hormones affect cardiovascular disease for both men and women.