European Stars and Stripes (Newspaper) - January 17, 1990, Darmstadt, Hesse                                The stars and stripes Page 11 letters a pms its still a big mystery to physicians Arm Landers dear readers the dream of every person Over 30 is a magic Pill taken before each meal that would remove All the calories. In the absence of that magic Pill we continue to try dozens of diets spend a Fortune on exercise equipment and health club memberships. And even hire trainers who will come to our Homes and work out with us. Quot thin Quot is supposed to be Beautiful. Even though some of the top models look emaciated and consumptive. Butter is out Margarine is in. Eggs arc no longer considered the All american breakfast because of what we have Learned about cholesterol. Cereals Are supposed to be wonderful for you and millions of health nuts have become addicted to oat bran. We read so much about what is Good and what is bad that the picture has become muddied. Advertising is so Slick we Don t know what to believe. So Here Are some hard facts from the september Issue of Fortune Magazine that could help put things in the proper perspective. The author. Brian of Reilly makes it Clear that avoiding the common killers is largely up to you. Did you know that cardiovascular disease causes nearly half of the deaths in the United states. This year 1.3 million americans will sultor a heart attack and 500,000 will die. 300.000 of them before reaching a Hospital. About 43 percent of the Coron Aries will hit people under 63. Strokes will kill 150,000. Most strokes Are preventable your chances of getting cancer arc half the risk of heart disease and stroke but cancer is still the second big Gisl killer. More people die or lung cancer than any other kind. Cigarette smoking accounts for nearly 85 percent of All lung cancer. Women who smoke gel wrinkles sooner. Vegetables such As Broccoli Brussels sprouts and carrots seem to improve the Odds against digestive tract cancers. Men in i hair 30v who exercise regularly have More Energy and a better sex life and can work longer hours than those who Don t the role of Del is unclear hut it seems to be a Factor in about one third or All cancers. The villain seems to be d Ciary Fai according to the surgeon general s report on nutrition the person least Likely to gel cancer does t smoke or drink or drinks in moderation and eats lots of vegetables. If you dont smoke cholesterol is the greatest threat 10 your health because ii clogs the arteries and causes heart attacks. Stress has Long been fingered As a killer but the fads Are that most stress including constant worry is not fatal in itself. The real villain is chronic anger. The person who finds himself constantly screaming at the morons and chisel cars who try to get ahead Olim in tines is the one who is at ask for heart Truble. Or. Bedford Williams a Duke University internist specializing in stress said a the Rushing around Workaholic is not Al risk As Long As stress is not a stimulus for anger 1 he noted that More than 15 percent of the 25-Ycar-old doctors and lawyers who scored High in hostility tests were dead by 50. The message to All you volatile hot temp Rcd types is simply this of you want to live to a Ripe old age. Cool it. C ids Angl Tim  Trad crat9f� sir Haals this letter is written after Reading capt. Dennis e. Coker s recent response regarding progesterone Thapy for pms premenstrual syndrome. The woman writing the initial letter ended by mentioning that a it Wasny to Long ago that men were telling us that menstrual cramps w Ere All in our  2 million women Are not just statistics. By emphasizing the Success of placebos and making a Blanket denial of a particular kind of treatment is it possible that you Are contributing to the perpetuation of the notion that women Are Overly emotional and consequently irrational. Progesterone might not be effective in All eases of pms. But should the 5 percent who suffer a serious chemical imbalance be ignored because some of the quoted 40 percent who experience some of the symptoms some of the time Are aided by placebos. I for one am very thankful that a caring non judging Mililay doctor prec Ribco progesterone for me. To say that is has improved the Quality of my life would be an understatement. A Martha s. Ostertag Heidelberg West Germany 1 would like to know whether the studies of progesterone therapy he cites used synthetic or natural progesterone. Synthetic hormones do indeed wreak havoc on a woman s health and Many researchers believe that it is the use of birth control pills and other synthetic hormones which induces pms in Many women. Natural progesterone causes no such symptoms. Unfortunately Many physicians refuse to distinguish Between synthetic and natural hormones and the different effects they have on women s health. These individuals Are not Reading their literature and keeping up with current research. They invariably dismiss my problems As being the Normal lot of women. For treatment they prescribe Tranquili Zers or anti depressants and suggest that i take up knitting or make new friends. The Only thing that has helped my pms was natural non Placebo progesterone therapy. While it is True that not All types of pms respond to progesterone significant numbers of women Nave been helped by it. A Heather Milter Giessen West German not Only did it insult the Many sufferers by implying that their problem was psychological in origin and a a Placebo Quot was All that was needed to fool them into Relief it also neglected to describe Many of the already Prosn and effective dietetic approaches. A Uip fostering the male a oriented illusion that pms is a psychological problem. Yes there Are symptoms which do produce psychological dilemma for the sufferers but to characterise the sufferers As having some psychological detect is onerous. Instead look at the volumes of research that dict biochemical imbalances As the culprit in Many cases. Lets help women and men by supplying them with Basic and reliable information thai has already been proven to afford Relief. Women Are the direct sufferers of pms but husbands family members relatives and friends also suffer greatly As the pms sufferers atypical Behaviours surface to disrupt the usual order of life. A Bill Archer osterholz West Germany. Unfortunately the doctor is i lit. The Long term dependency on hormones and chemicals is More damaging and not a it Orth the immediate Relief that they provide. Immediate Relief was what i wanted of course. Symptom treatment for controlling pms is simple common sense taking care of yourself. The problem was i did t Lake care of myself my secret to living harmoniously with pms 9 diet i laughed hard at the instruction of giving up coffe cutting Back sugar and Salt intake. A exercise. Don t go out for the olympics but do it for yourself. A getting to know and love that special person a me. That is another big step and is sort of a combination of the other two Points. Taking time out for myself and learning to let go of guilt. No. It is not easy and it is not immediate Relief but it has made a big difference in my life and it is Worth the Effort to see the results. You will not be feeling 100 percent wonderful but you w jul notice the difference. A name and location withheld editor s note a capt. Dennis Ecoker assistant chief. Clinical support division Heidelberg medical department activity replies thank you for another Opportunity to respond to the letter concerning premenstrual syndrome and its effects. In the original response 1 failed to identify the two sources used in the response. The bulk of information was extracted by the i30lh station Hospital s chief obstetrics can co logy service from the american College of obstetrics and gynaecology cog committee opinion on premenstrual syndrome pull shed in january 1989. The second source was the chief. Pharmacy service w to provided historical information regarding the results of the january 1988 meeting of the therapeutic agents Board Tabtab is composed of eight physicians Deputy commander for c clinical services and department chief the chief. Pharmacy service and the chief 1-Ogistics division. They meet to review he Hospital formulary or drug Slick age list and make necessary changes based on requests to add or delete drags from the list. I he Board s recommendations go to the commander for approval and subsequent implementation. In the Case which generated the original pms letter Tab disapproved the implementation of the proposed therapy based on the results of carefully controlled studies which showed hat control groups of women undergoing progesterone therapy had worse results than women taking placebos. Based on he letters 1 received would like to provide More information on pms from the cog committee opinion. A estimates regarding the prevalence of pms generally agree that 20 percent to 40 percent of All women experience some difficulty but Only s percent report significant Impact on work or lifestyle. No menstrual Cycle related changes occur in glucose insulin or glucose tolerance and Cycle related abnormalities i ingot be selected lit women complaining of pms. Nevertheless dietary changes Are recommended including Low intake of refined sugar sail and no caffeine or chocolate. A although neither synthetic progestin nor natural progesterone have been demonstrated to be effective in appropriately dwindled studies pro gestational treat Siut i of pms symptoms is common. The lung term safety and consequences or such treatment have not Heen Well documented. A physicians and patients face a similar dilemma in dealing with pms. There is no path physiologic explanation and no Clear Cut effective treatment. Both the physician and the patient should be aware of the Placebo effect which is not so much a response to a Pill As a process that begins with patient Confidence in the physician and extends to the full functioning of the patient s own Healing system it is very Likely that successful therapy of pms regardless of the agent or method used depends on a significant degree on the Placebo  i do not intend to suggest that pms does not exist. Is strictly a psychological problem or wish to minimize its effects. Nord t endorse the Quot Ivall in their head Quot theory or make a Blanket denial of a particular kind of treatment. The Ruth remains that physicians do not know what causes pms. The Many different treatment regimens each obtaining varying degrees of Success focus primarily on the symptoms. If you have questions or you want additional information. 1 strongly encourage you to consult a physician. European edition co Luehe 6.t0whkho. Usan comm and a edit let �1 Cluife it Cox 8uzannc l Phillips. Usan Deputy commander Ede or w Coral Loanie rom Nicra meat Proctor Deame a. Mess Mott production manager minting editor Cit Cubon manager Tyrl new Tjw a Luth unfed Yno wipe put Celion of member of the military a Tviet Oversea con Unis of Tow Star and strip Are not Neceia Anav the official tie or. Or Anck Maec by. The o s government. In department of Dilenge of in u s european command the appearance or adverting m the put Caton. 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