john herr psychologist los gatos saratoga california

On Sabbatical

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TITLE: Psychological effects of continuation versus discontinuation of hormone replacement therapy by estrogen implants: a placebo-controlled study.
AUTHOR: Pearce J; Hawton K; Blake F; Barlow D; Rees M; Fagg J; Keenan J
AUTHOR AFFILIATION: University Department of Psychiatry, Warneford Hospital, Oxford, UK.
SOURCE: J Psychosom Res 1997 Feb;42(2):177-86
NLM CIT. ID: 97231250
ABSTRACT: There is conflicting evidence regarding the effects of hormone replacement therapy (HRT) with estrogens on psychological and psychiatric symptoms of menopause. Forty women already attending a menopause clinic for continuing HRT by estrogen implants were studied in a randomized, double-blind, placebo-controlled study of estrogen reimplantation versus implantation of a placebo preparation. Assessment included self rating with visual analog scales, standardized psychological and menopause rating scales (Hospital Anxiety and Depression Scale, Self-Concept Questionnaire, Cognitive Failures Questionnaire, Greene Menopause Index), and interview with the Present State Examination. No difference in outcome with regard to either psychological or psychiatric symptoms was found 2 months after entry to the study between the women who received an active implant and those who received a placebo implant, in spite of the former group having a significant rise in estradiol levels. The only effect of HRT on physical symptoms was a nonsignificant reduction in flushes. Psychiatric morbidity of the study population was high with nearly half being "psychiatric cases" according to the Present State Examination at both initial assessment and follow-up. At entry to the study nearly all the women had levels of estradiol in the premenopausal range and four had supraphysiological levels. It appears likely that women were returning requesting a new implant because of symptoms related to nonhormonal factors. Women receiving continuing HRT for menopausal symptoms should be reassessed both for hormonal status and current psychosocial factors when they present with recurrent symptoms, especially those of a psychological or psychiatric nature.
Estrogen Replacement Therapy/*PSYCHOLOGY
*Patient Acceptance of Health Care
Drug Implants
Middle Age
Support, Non-U.S. Gov't
REGISTRY NUMBERS: 0 (Drug Implants)
50-28-2 (Estradiol)

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On Sabbatical!

When my office lease expired at the end of 2004, I decided to turn it into a "sabbatical" from my private practice. Many years ago, in my grandfather's 89th year of life, he told me, "John, it is important to smell the roses while you can still smell them." His life gave living a very good reputation. It is also true that the pursuit of that philosophy required my grandfather to to re-open his assay office/ore market in Wickenburg, Arizona as a 75-year-old because he had run a little short of retirement money. Thus, if blessed with his luck and health, I'll be back.. --jjh

Copyright 1998-2007  John J. Herr, Ph.D.                                   Please send comments to