Hormone Information and Consent Form
Patient terms and conditions:
This is a legally binding agreement between Slendermed and affiliated Doctors Pr 0182680.
Please read carefully and do not submit unless you fully agree and understand these terms and conditions.
General:
I hereby confirm that:
- I have freely chosen this practice to consult with and I am signing these terms and conditions voluntarily without being forced, influenced, pressed or harassed to do so.
- I am aware of the fact that the availability of my doctor is generally limited to office hours and consulting times. I understand that I can contact my doctor in times of emergency out of office hours and that my doctor has the right to charge a fee for these consultations. I accept that my time of appointment might change at short notice if my doctor is busy with an emergency.
- I understand that I have the right to ask my doctor to explain and disclose medical information to me before I consent to a medical procedure or treatment. I know I have the right to seek a second opinion at any time.
- I hereby authorize the use and disclose of my medical infomation to my medical aid, relevant specialist that may be referred to, the laboratory, the hospital for admission purposes or as required by law.
- I understand that I am under the obligation to inform the practice of any relevant changes to my personal, medical and / or financial information and not doing so constitutes to fraud.
- I understand that my doctor reserves the right to withdraw or terminate any medical advice or treatment at any time but that I will be informed by letter of the discontinuation of the doctor-patient relationship.
I have read the terms and conditions contained in this agreement, by submitting this document you legally bind yourself to the terms and conditions contained herein.
Warning: the reason for the informed consent:
There are widespread concerns about the risk (however rare) of all adrenal and gonadal hormone therapies (corticosteroids, prednisone, sex hormones including for birth control, and their substitutes, and sex pills e.g. Viagra* etc), from whichever plants or chemicals they come. These risks include, for example, phytohormones may cause liver damage, thrombosis or cancer from black cohosh or kava; hormone birth or sex hormone therapy causing fluid retention, raised blood pressure or mood disturbances, cortisone causing fractures or infection.
A slight but significant increase in low-grade breast cancer has been seen in woman on Premarin* for more tha 12 to 15 years, but this seems to occur only with oral estogen combined with oral synthetic progestin, and not with modern birth control hormones.
No clear association of significant risk has ever been associated with long-term (40 year) use of appropriate supervised non-oral physiological human hormone replacement, e.g. injected testosterone in men, testosterone implants or creams of testosterone / estrogen / progesterone in woman, but no mandatory long-term controlled trials (i.e. beyond 2 years) have ever been carried out on such hormones. Such mandatory trials have never been required on any drugs, and because unlike designer drugs foreign to humans, the human race has evolved over a million years for optimal health, function and safety. Such hormones have never been shown to cause cancer in appropriate use – and although een appropriate conservative doses may trigger growth of cancers that are already present but not yet detectible, regular screening detects them early, they are more easily cured than “spontaneous” cancers, and thus the death rates from all causes are lower in such people on supervised replacement.
Two 10 year trials have been carried out on appropriate hormone therapy – the Woman’s Health Initiative and in the Oulu trial in Finland. In these trials hormonal therapy was given by mouth and they were not using physiological doses of human hormones. Also these woman were started soon after menopause, using modertae doses of either Premarin* or estradiol, with or without a synthetic progestin. In both these trials, there was major lessening in all risks, chronic diseases and thus premature deaths. The protective benefits of long-term appropriate hormone replacement are mostly lost when they are stopped – so there must be strong reason to stop them, and this is usually only temporary e.g. while cancer is treated.