At noon on Wednesday, March 9, in a live Web chat on women's health, including menopause, bioidentical hormone replacement therapy, and other anti-aging treatments. Dr. Rebecca Ryder, a board-certified gynecologist in Chesapeake and co-founder of Synergy, An Integrative Medicine Center for Women, answered readers' questions. Ryder has a background in both traditional medicine and alternative, holistic healing.


 Ask the Experts about menopause, symptoms and treatments(03/09/2011) 
11:55
Don Mann, Producer: 
Welcome to the live chat on menopause! Our experts will be available to answer your questions starting at noon.
Wednesday March 9, 2011 11:55 Don Mann, Producer
11:56
Prue: 
Hi, In just a couple of minutes we'll be welcoming our panelist, Dr. Rebecca Ryder, a gynecologist.
Wednesday March 9, 2011 11:56 Prue
11:57
Prue: 
Dr. Ryder is a board-certified gynecologist. She is also the co-founder of Synergy, Integrative Medicine for Women, an office where she and Dr. Linda Long treat women's health in a holistic fashion. You can type in your questions now.
Wednesday March 9, 2011 11:57 Prue
12:02
Prue: 
Dr. Ryder,
Can you let readers know when you're online and ready to answer questions.
Wednesday March 9, 2011 12:02 Prue
12:02
Dr. Rebecca Ryder: 
It is common to have an increase in symptoms when stopping something like Prempro. You can try taking it every other day for two weeks and then stopping it....
Wednesday March 9, 2011 12:02 Dr. Rebecca Ryder
12:02
[Comment From SSSS: ] 
I am 69 years old and have been on low-dose HRT for 20+ years with no ill effects. Negative breast cancer histroy. When I discontinued use of Prempro, I have hot flashes. Should I just deal with the symptoms?
Wednesday March 9, 2011 12:02 SS
12:03
Dr. Rebecca Ryder: 
...but if the symptoms are just as bad, talk to your gynecologist or a specialist like us here at Synergy to talk about other options
Wednesday March 9, 2011 12:03 Dr. Rebecca Ryder
12:03
Prue: 
Do you prescribe Prempro in your practice?
Wednesday March 9, 2011 12:03 Prue
12:04
Dr. Rebecca Ryder: 
We don't routinely use Prempro, primarily because of the synthetic progestin in it, which may have more health risks than the bioidentical progesterone
Wednesday March 9, 2011 12:04 Dr. Rebecca Ryder
12:04
Prue: 
Welcome Dr. Ryder. Please tell our readers about your Synergy practice and how it's different from other practices -- and please explain the term "bioidentical" and how that is different from the synthetic.
Wednesday March 9, 2011 12:04 Prue
12:04
Dr. Rebecca Ryder: 
Unfortunately, many women even in their 70s will continue to have hot flashes or other symptoms if they stop their hormones
Wednesday March 9, 2011 12:04 Dr. Rebecca Ryder
12:05
[Comment From LittleLittle: ] 
What is your opinion of bioidential hormones and their effects?
Wednesday March 9, 2011 12:05 Little
12:06
Dr. Rebecca Ryder: 
There are good studies reporting beneficial effects of bioidentical hormones, including a 29-40% decreased risk of mortality from all causes, IF they are the right kind of hormones. The most benefit is seen in using bioidentical hormones within 5 years of menopause
Wednesday March 9, 2011 12:06 Dr. Rebecca Ryder
12:07
Prue: 
Readers: We're chatting with Dr. Rebecca Ryder, who is trained in traditional AND alternative medicine. She specializes in the treatment of hormonal imbalance in women of ALL ages. Ask your questions now.
Wednesday March 9, 2011 12:07 Prue
12:07
Dr. Rebecca Ryder: 
These benefits include decreased risk of heart disease, Alzheimers disease, colorectal cancer, hip fracture, and macular degeneration in the eyes, just to name a few
Wednesday March 9, 2011 12:07 Dr. Rebecca Ryder
12:08
Prue: 
What about the connection with increased risk for breast cancer? The reason that many women discontinued hormone replacement therapy. Does this hold up?
Wednesday March 9, 2011 12:08 Prue
12:09
Dr. Rebecca Ryder: 
Breast cancer risk was shown to be increased with the use of Prempro solely, so far. And in the same women in those studies of Prempro, the ones using Premarin alone, the estrogen-only part, have no increased risk of breast cancer with now 7 years of follow up
Wednesday March 9, 2011 12:09 Dr. Rebecca Ryder
12:09
[Comment From SueSue: ] 
How does a woman judge if she should be taking hormones during menopause?
Wednesday March 9, 2011 12:09 Sue
12:10
Dr. Rebecca Ryder: 
We at Synergy think of hormones as preventive medicine for the vast majority of women. Some women do have other medical conditions which may preclude use of certain hormones, but a look at your health and family history would guide those decisions
Wednesday March 9, 2011 12:10 Dr. Rebecca Ryder
12:11
Prue: 
Can you give an example of someone who might be precluded from taking hormones. And could you explain the term "bioidentical" for those who are not familiar with it.
Wednesday March 9, 2011 12:11 Prue
12:11
Dr. Rebecca Ryder: 
And of course some women are just miserable during menopause, with hot flashes, night sweats, can't sleep, etc - so if you are really struggling, hormones can be great for symptom relief as well as preventive medicine
Wednesday March 9, 2011 12:11 Dr. Rebecca Ryder
12:12
Dr. Rebecca Ryder: 
Someone with current breast cancer should probably not take estrogen or progesterone, for the most part, but there are some exceptions. Women on blood thinners should not take oral estrogen
Wednesday March 9, 2011 12:12 Dr. Rebecca Ryder
12:13
[Comment From AmyAmy: ] 
Do these hormone replacements hold the same risks for women who smoke as the other HRTs. My doctor made me stop those because of my smoking.
Wednesday March 9, 2011 12:13 Amy
12:13
Dr. Rebecca Ryder: 
Bioidentical hormones are those that are structurally identical to the hormones produced by your own body. They come from natural sources like yams or soybeans but have to be extracted in the lab
Wednesday March 9, 2011 12:13 Dr. Rebecca Ryder
12:14
[Comment From LittleLittle: ] 
Do you believe they are safer?
Wednesday March 9, 2011 12:14 Little
12:14
Dr. Rebecca Ryder: 
The risk of getting a blood clot in your legs or lungs increases with cigarette smoking and oral estrogen. That does not hold true for estrogen through the skin though. And other hormones can be used that could possibly help decrease your risk, Amy, but stopping smoking would also decrease your risk of heart disease, of course
Wednesday March 9, 2011 12:14 Dr. Rebecca Ryder
12:15
Prue: 
Do you offer any smoking -cessation help at Synergy?
Wednesday March 9, 2011 12:15 Prue
12:15
Dr. Rebecca Ryder: 
Ms. Little, I do believe bioidentical progesterone and estrogen through the skin are safer in general than the synthetic progestin and oral estrogen
Wednesday March 9, 2011 12:15 Dr. Rebecca Ryder
12:15
[Comment From SueSue: ] 
I read recently that women who experience hot falshes early in menopause have a lower incidence of stroke and other ills later in life. And the onset of hot flashes later in menopause mean an increased risk. True?
Wednesday March 9, 2011 12:15 Sue
12:15
Dr. Rebecca Ryder: 
At Synergy, we do have a stop smoking program which includes acupuncture, behavioral modification and stop smoking medications if needed
Wednesday March 9, 2011 12:15 Dr. Rebecca Ryder
12:16
Prue: 
Readers: We are talking to Dr. Rebecca Ryder, board-certified gynecologist who also has "an integrative medical practice" for women, Synergy, which combines traditional and alternative approaches to health. Ask your questions now. We're here until 1 p.m.
Wednesday March 9, 2011 12:16 Prue
12:16
Dr. Rebecca Ryder: 
Sue, the onset of hot flashes later in life can be a predictor of an underlying medical problem, so yes, that can be a sign of something else going on.
Wednesday March 9, 2011 12:16 Dr. Rebecca Ryder
12:17
Dr. Rebecca Ryder: 
Having hot flashes earlier in menopause may happen more to thinner women, who have less estrogen, who also have less risk of heart disease and stroke. So there may be confounding variables there
Wednesday March 9, 2011 12:17 Dr. Rebecca Ryder
12:17
Prue: 
Could you give us a definition of a hot flash? What is actually happening in the body? Is there a "normal" hot flash. How long do they last?
Wednesday March 9, 2011 12:17 Prue
12:18
Dr. Rebecca Ryder: 
And that study was observational. It doesn't mean making your hot flashes go away with medication would increase your risk. Conversely, several studies show a significant decreased risk for heart disease by using hormones within 5 years of menopause
Wednesday March 9, 2011 12:18 Dr. Rebecca Ryder
12:19
[Comment From GuestGuest: ] 
If a woman is healthy, hot flashes not bad, is there a good reason to begin taking hormones?
Wednesday March 9, 2011 12:19 Guest
12:19
Dr. Rebecca Ryder: 
Hot flashes usually are a flushing of the skin and increased body temperature, often on the chest which rises up to the face or head. The medical term for it is "vasomotor instability" - the nerves controlling blood vessel diameter temporarily allow increased blood flow, causing redness and heat. The typical hot flash lasts from seconds to 2 minutes or so.
Wednesday March 9, 2011 12:19 Dr. Rebecca Ryder
12:20
Dr. Rebecca Ryder: 
Yes, we at Synergy believe the 29-40% decreased risk of mortality from all causes with hormone use within 5 years of menopause means most women should take hormones
Wednesday March 9, 2011 12:20 Dr. Rebecca Ryder
12:21
[Comment From GuestGuest: ] 
What are some options for handling menopause symptoms, aside from taking hormones? Can certain foods help, like yams or soybeans? O chocolate, perhaps...?
Wednesday March 9, 2011 12:21 Guest
12:21
Dr. Rebecca Ryder: 
Laughing about the chocolate :) Although dark chocolate is high in antioxidants, and an ounce a day is probably good for you!
Wednesday March 9, 2011 12:21 Dr. Rebecca Ryder
12:22
Prue: 
Readers: we're talking to women's health expert, Dr. Rebecca Ryder. Ask your questions until 1 p.m.
If you can't stay for the whole chat, find the full transcript later at www.dailypress.com/health and click on the tab, Archived Live Web Chats.
Wednesday March 9, 2011 12:22 Prue
12:22
Dr. Rebecca Ryder: 
You cannot make the hormones out of yams, no. Soybeans do have some weak estrogen-like properties, so they may help a little with menopausal symptoms
Wednesday March 9, 2011 12:22 Dr. Rebecca Ryder
12:22
[Comment From KathyKathy: ] 
I've taken generic estrogen for 20 years and feel great, what would you offer that differs from that and make me look and feel better?
Wednesday March 9, 2011 12:22 Kathy
12:24
Dr. Rebecca Ryder: 
Kathy, if you are taking generic estradiol, that IS bioidentical estrogen. At Synergy we do look at other hormones, including DHEA, testosterone and thyroid. If those levels are low and you're having any other symptoms like fatigue, depression, or weight problems, sometimes replacing those hormones can help
Wednesday March 9, 2011 12:24 Dr. Rebecca Ryder
12:24
[Comment From JulieJulie: ] 
I had a complete hystorectomy 2 years ago and was on the lowest dosage of hormone through a patch. Just before Christmas, I began slowly stepping off the patch and am "patch free". I am having severe night sweats. Any ideas on how long they will last and what I can do to minimize them?
Wednesday March 9, 2011 12:24 Julie
12:24
Dr. Rebecca Ryder: 
How old are you Julie?
Wednesday March 9, 2011 12:24 Dr. Rebecca Ryder
12:26
Prue: 
Dr. Ryder, I'm not sure Julie is still with us. Can you give an answer for if she's a) 52 and b) 62
Wednesday March 9, 2011 12:26 Prue
12:26
Dr. Rebecca Ryder: 
Well let me say that the maximum benefits of hormones in decreasing the risk of heart disease and Alzheimers disease seem right now to be with about 5 years of use. So I would usually recommend she stay on the patch for 5 years
Wednesday March 9, 2011 12:26 Dr. Rebecca Ryder
12:27
Dr. Rebecca Ryder: 
But the other answer is - the night sweats may go away within 6 months, or they may last a long time. As I mentioned before, some women still have hot flashes in their 70s
Wednesday March 9, 2011 12:27 Dr. Rebecca Ryder
12:27
Prue: 
What are the different ways of taking hrt - and do you recommend one way over another?
Wednesday March 9, 2011 12:27 Prue
12:28
Dr. Rebecca Ryder: 
For most women we recommend estrogen through the skin via a gel or patch, and bioidentical progesterone in pill form to be taken at bedtime. For some women, however, there are advantages with oral estrogen, especially on the cholesterol profile
Wednesday March 9, 2011 12:28 Dr. Rebecca Ryder
12:28
Prue: 
Sue has several questions that I'll post all together.
Wednesday March 9, 2011 12:28 Prue
12:28
[Comment From SueSue: ] 
I've noticed that actually being exposed to a heat source -- even drinking a hot drink -- can set off a hot flash. Or is that just coincidence?
Wednesday March 9, 2011 12:28 Sue
12:28
[Comment From SueSue: ] 
Then I should be healthy as a horse -- dark chocolate is part of my daily regimen!
Wednesday March 9, 2011 12:28 Sue
12:28
[Comment From SueSue: ] 
If I began to take hormones, what physical or other changes might I expect to see? I'm otherwise very healthy.
Wednesday March 9, 2011 12:28 Sue
12:29
Dr. Rebecca Ryder: 
Yes, hot flashes can be environmentally sensitive, and are often worse in the summer. Stress and alcohol can also cause hot flashes
Wednesday March 9, 2011 12:29 Dr. Rebecca Ryder
12:30
Dr. Rebecca Ryder: 
Hormones help with vaginal dryness, sometimes urinary tract symptoms, and increase the collagen content in our skin, which may help decrease wrinkling. Hormones like testosterone, progesterone and DHEA can help with anxiety, mood, fatigue, muscle mass and libido, to name a few
Wednesday March 9, 2011 12:30 Dr. Rebecca Ryder
12:30
Prue: 
Readers: We're chatting with Dr. Rebecca Ryder of Synergy in Chesapeake. We're here until 1 p.m. for you to ask your questions about women's health.
Wednesday March 9, 2011 12:30 Prue
12:31
[Comment From Donna TaylorDonna Taylor: ] 
Have been in menopause for a few years now, but recently began spotting and cramping. What does that mean?
Wednesday March 9, 2011 12:31 Donna Taylor
12:31
Dr. Rebecca Ryder: 
Donna, you need to see your gynecologist. Any bleeding more than one year after your last period needs to be checked out. Have you gotten a steroid shot for anything lately?
Wednesday March 9, 2011 12:31 Dr. Rebecca Ryder
12:32
[Comment From CarrollCarroll: ] 
How long is too long for a woman to use the Vivelle Dot for Estrogen replacement? Are there any long term effects? I've been using it over 10 years with no problems. Is it safe to contiune under those conditions?
Wednesday March 9, 2011 12:32 Carroll
12:34
[Comment From Donna TaylorDonna Taylor: ] 
no,I have not. Is this serious? I don't have a regular gynecologist.
Wednesday March 9, 2011 12:34 Donna Taylor
12:35
Dr. Rebecca Ryder: 
Carroll, unfortunately we don't know the answer to that question. We know you have gotten some great health benefits by using that bioidentical estrogen patch for more than 5 years. Our only possible concern with longer term use is - does it increase the risk of breast cancer? We have data so far from France that says up to 11 years, it doesn't
Wednesday March 9, 2011 12:35 Dr. Rebecca Ryder
12:35
Dr. Rebecca Ryder: 
That French study is going on for 15 years and then will be published, so we'll know more then.
Wednesday March 9, 2011 12:35 Dr. Rebecca Ryder
12:35
Prue: 
Dr. Ryder, Perhaps you could give readers the contact information for your practice and the Web site so they can see the different services you offer.
Wednesday March 9, 2011 12:35 Prue
12:36
Dr. Rebecca Ryder: 
Donna, bleeding more than one year after your last period can be a sign of a serious problem, yes. You should find a GYN or go see your primary care physician. They can order a pelvic ultrasound which will rule out the serious causes
Wednesday March 9, 2011 12:36 Dr. Rebecca Ryder
12:36
Prue: 
Readers: If you can't stay for the whole chat, be sure to check out the transcript later at www.dailypress.com/health and click on the tab, Archived Live Web Chats.
Wednesday March 9, 2011 12:36 Prue
12:36
[Comment From GuestGuest: ] 
How expensive is bioidentical hormones? How does its cost compare to other hormones?
Wednesday March 9, 2011 12:36 Guest
12:36
Dr. Rebecca Ryder: 
Sure Prue. I have a website for each practice - synergymedicalcenter.com, and gynspecialistschesapeake.com
Wednesday March 9, 2011 12:36 Dr. Rebecca Ryder
12:37
[Comment From LittleLittle: ] 
I am 51 and on Estridol 2 pumps a day and birth control pills and still having horrible hot flashes, mood swings, you name it. I am thinking of trying the bioidentical hormones - it sounds like you think they can work??
Wednesday March 9, 2011 12:37 Little
12:37
Dr. Rebecca Ryder: 
Bioidentical estrogen and progesterone are available from your regular pharmacy, and range from a Tier 1 to a Tier 3 copay. Some hormones like DHEA are over the counter, and compounded testosterone cream can run about $30/month
Wednesday March 9, 2011 12:37 Dr. Rebecca Ryder
12:38
[Comment From Donna TaylorDonna Taylor: ] 
thank you, I will find a doctor right away.
Wednesday March 9, 2011 12:38 Donna Taylor
12:38
Dr. Rebecca Ryder: 
Ms. Little, we at Synergy would normally check some blood tests for hormone levels and go from there
Wednesday March 9, 2011 12:38 Dr. Rebecca Ryder
12:38
Dr. Rebecca Ryder: 
Good Ms. Taylor. Please do
Wednesday March 9, 2011 12:38 Dr. Rebecca Ryder
12:39
[Comment From SusieSusie: ] 
I am a Breast Cancer survivor, and now am approaching that 'Change', what can I do to help with 'power surges'? I was told to stay away from HRT.
Wednesday March 9, 2011 12:39 Susie
12:39
[Comment From SusieSusie: ] 
I am a Breast Cancer survivor, and was told NEVER to use HRT, now 11 yrs into being a survivor, I'm starting to have 'power surges' what can I do?
Wednesday March 9, 2011 12:39 Susie
12:40
Dr. Rebecca Ryder: 
Yes Susie, unfortunately right now that is our best recommendation too. You can try black cohosh, an over-the-counter herb, 20-80 mg once to twice daily. Or there are prescription non-hormonal treatments that can help
Wednesday March 9, 2011 12:40 Dr. Rebecca Ryder
12:40
[Comment From SueSue: ] 
I've been diagnosed with osteoporosis. Would hormones have any effect on bone density, one way or the other?
Wednesday March 9, 2011 12:40 Sue
12:40
[Comment From GuestGuest: ] 
Do hormones help prevent bone loss?
Wednesday March 9, 2011 12:40 Guest
12:40
Dr. Rebecca Ryder: 
Some day though Susie, we will have studies on women like you who are more than 5 year cancer survivors, and a lot of you will be able to use hormones, I'm convinced
Wednesday March 9, 2011 12:40 Dr. Rebecca Ryder
12:41
Dr. Rebecca Ryder: 
Oh yes, hormones have a great deal to do with osteoporosis. There is a good prescription called Evista for osteoporosis though, which not only builds bone density but is PROTECTIVE against breast cancer
Wednesday March 9, 2011 12:41 Dr. Rebecca Ryder
12:42
Prue: 
Could you give more details on Evista and what it is/how it works?
Wednesday March 9, 2011 12:42 Prue
12:42
[Comment From SueSue: ] 
Can Evista be taken safely along with bioidentical hormones?
Wednesday March 9, 2011 12:42 Sue
12:42
Dr. Rebecca Ryder: 
For those of you without breast cancer, estrogen is probably the best bone builder. If you can't take estrogen though, both progesterone and testosterone also build bone density
Wednesday March 9, 2011 12:42 Dr. Rebecca Ryder
12:43
Prue: 
Is there any down side to taking testosterone?
Wednesday March 9, 2011 12:43 Prue
12:43
Dr. Rebecca Ryder: 
Evista is a selective estrogen receptor modulator (SERM). It attaches to estrogen receptors in some tissues, like bone, but not in other places, like the breast. So it has all the beneficial effects of estrogen on the bone, with no effects on the breast
Wednesday March 9, 2011 12:43 Dr. Rebecca Ryder
12:43
Dr. Rebecca Ryder: 
Evista can be taken safely with bioidentical hormones, but you have to put the big picture together to see if both are needed
Wednesday March 9, 2011 12:43 Dr. Rebecca Ryder
12:44
Prue: 
At what age should women have a bone density test?
Wednesday March 9, 2011 12:44 Prue
12:44
Prue: 
And how often thereafter?
Wednesday March 9, 2011 12:44 Prue
12:45
Dr. Rebecca Ryder: 
Bone density testing should be done by age 60 at least, but age 50-55 if you have any risk factors like smoking, body weight less than 127 pounds, fracture as an adult, use of steroids, family history of osteoporosis, or vitamin D deficiency, to name a few
Wednesday March 9, 2011 12:45 Dr. Rebecca Ryder
12:45
Prue: 
Readers: We have just a few minutes for Dr. Rebecca Ryder of Synergy to take your questions.
Wednesday March 9, 2011 12:45 Prue
12:45
[Comment From GuestGuest: ] 
Do you recommend any herbal supplements to combat symptoms of menopause?
Wednesday March 9, 2011 12:45 Guest
12:45
Dr. Rebecca Ryder: 
If the test is normal, repeat testing is indicated every 2 to 5 years depending on your risk factors
Wednesday March 9, 2011 12:45 Dr. Rebecca Ryder
12:46
Dr. Rebecca Ryder: 
We recommend two herbal supplements - either black cohosh, or one called Estrovera, which is a rhubarb extract used in Germany for over 10 years for menopausal symptoms
Wednesday March 9, 2011 12:46 Dr. Rebecca Ryder
12:47
[Comment From SusieSusie: ] 
Can you use Estrovera if you've has breast cancer?
Wednesday March 9, 2011 12:47 Susie
12:48
Dr. Rebecca Ryder: 
Yes. It is non hormonal and I would not have any concerns about it's use in a breast cancer survivor
Wednesday March 9, 2011 12:48 Dr. Rebecca Ryder
12:48
[Comment From LittleLittle: ] 
I see you talking about bioidential patches. I know some practices use bioidentical hormones under the skin. Do you think these are safe or are the patches better?
Wednesday March 9, 2011 12:48 Little
12:49
Dr. Rebecca Ryder: 
The nice thing about the patches is if you have any unwanted side effects, you can take them off and they're gone quickly. The implantable hormones take quite a while to get out of your system
Wednesday March 9, 2011 12:49 Dr. Rebecca Ryder
12:49
[Comment From CynthiaCynthia: ] 
I suffer from severe Lyme disease i'm 51 and going through perimenopause. I follow an organic veg diet and exercise. I have some months without periods. Quality of life is terrible
Wednesday March 9, 2011 12:49 Cynthia
12:51
Dr. Rebecca Ryder: 
Oh I don't like that statement "quality of life is terrible." That's why we're here, to help women feel better and do good things for your health. You are doing your part already with a healthy diet and exercise. But you do need an average of 1 gram of protein for every 2 pounds of body weight per day, so make sure you're getting that
Wednesday March 9, 2011 12:51 Dr. Rebecca Ryder
12:51
Dr. Rebecca Ryder: 
And you need a good holistic practitioner to look at the whole picture, including your hormones, possibly toxicity, cellular aging, etc
Wednesday March 9, 2011 12:51 Dr. Rebecca Ryder
12:52
Dr. Rebecca Ryder: 
Months without periods is probably what is not helping now though - menopause can be miserable
Wednesday March 9, 2011 12:52 Dr. Rebecca Ryder
12:53
Prue: 
Dr. Ryder -- could you expand on the need for vitamin D. How can you tell if you're getting enough. What are good sources for it?
Wednesday March 9, 2011 12:53 Prue
12:54
Dr. Rebecca Ryder: 
Oh my goodness that's a good one Prue. We see probably 80-90% of our patients having vitamin D deficiency. Your vitamin D level can be checked with a simple blood test that all women should have. Lower vitamin D levels are associated with an increased risk of breast and colorectal cancer, depression, arthritis, immune deficiency - all kinds of things
Wednesday March 9, 2011 12:54 Dr. Rebecca Ryder
12:54
Prue: 
Readers: We have a weekly Health web chat every Wednesday at noon. It's a fantastic opportunity to talk to experts in their field. Join us each week at noon on Wednesdays. If you can't make the chat, go to www.dailypress.com/health and look for the transcript under Archived Live Web Chats.
Wednesday March 9, 2011 12:54 Prue
12:55
Prue: 
And what are good sources for vitamin D?
Wednesday March 9, 2011 12:55 Prue
12:55
Dr. Rebecca Ryder: 
Vitamin D fortified milk and cold water fish like salmon are good sources of vitamin D
Wednesday March 9, 2011 12:55 Dr. Rebecca Ryder
12:56
[Comment From SueSue: ] 
For Vitamin D, what about a dose of sunshine every day?
Wednesday March 9, 2011 12:56 Sue
12:57
Dr. Rebecca Ryder: 
Unfortunately, anywhere north of Atlanta, we can only convert vitamin D from the sun between the hours of 10am and 2 pm, primarily during the summer
Wednesday March 9, 2011 12:57 Dr. Rebecca Ryder
12:57
Dr. Rebecca Ryder: 
Oh, and eggs are a good source of vitamin D
Wednesday March 9, 2011 12:57 Dr. Rebecca Ryder
12:57
Prue: 
In closing, can you tell our readers what the most common problems are that you encounter with your patients -- and what lifestyle/diet choices contribute to that. Can we make ourselves healthy?
Wednesday March 9, 2011 12:57 Prue
12:59
Dr. Rebecca Ryder: 
Our number one and two supplement recommendations are vitamin D if deficient and fish oil. Beyond that, eat a healthy, Mediterranean style diet and exercise 5 or more days/week. Even a little bit of exercise like 10 minutes twice a day helps decrease the risk for heart disease and breast cancer
Wednesday March 9, 2011 12:59 Dr. Rebecca Ryder
12:59
Prue: 
I want to thank Dr. Rebecca Ryder for her time and expertise today in answering your questions on women's health. Read Sunday's Daily Press to learn more about bioidentical hormone replacement and her practice at Synergy.
Dr. Ryder - please give your contact information and then I'll close the chat.
Wednesday March 9, 2011 12:59 Prue
1:00
Dr. Rebecca Ryder: 
Thank you all for your questions and comments. We are at Synergy Integrative Medicine in Chesapeake, phone 410-5462 if you have further questions. OUr website, synergymedicalcenter.com, also has a monthly "tip" column that talks about lots of these issues
Wednesday March 9, 2011 1:00 Dr. Rebecca Ryder
1:01
Prue: 
Thanks everyone. For a transcript of the chat, go to www.dailypress.com/health and click on Archived Live Web Chats. Thanks very much for your participation. See you next Wednesday for our chat on allergies.
Wednesday March 9, 2011 1:01 Prue
1:01
[Comment From GuestGuest: ] 
im 46 years old and i feel like im going thru change i get very bad moments thats what i call them of hot flashes and at nite i sweat really bad what should do or take for theses moments?
Wednesday March 9, 2011 1:01 Guest
1:02
Dr. Rebecca Ryder: 
Thanks and have a good day everyone!
Wednesday March 9, 2011 1:02 Dr. Rebecca Ryder
1:02
Prue: 
I don't know if we have time for this final question?
Wednesday March 9, 2011 1:02 Prue
1:02
Prue: 
Guest: I think if you scroll back through the chat you'll find the answer to your question. Thanks. Have a good day.
Wednesday March 9, 2011 1:02 Prue
1:03