Monday, January 2, 2023

Emtone for Cellulite


Almost all of us have cellulite, especially women. Ugh! 80-90% of women develop cellulite after puberty whereas only 10% of men have it. And let me be perfectly clear.....being overweight is not THE cause so stop beating yourself up. Cellulite can appear anywhere but is most common on the butt, thighs and tummy. 


The cause of cellulite is multifactorial and represents a chronic inflammatory process.  Cellulite forms when fibrous bands connecting your skin to the underlying muscle tighten irregularly. This tightening pulls down on your skin, and the layer of fat beneath the skin pushes upward. This results in a puckered appearance to the skin.


In women the subcutaneous tissue connects to the muscles differently than in men. In men, the fibers that make up the connective bands crisscross together. In women, the fibers that make up the connective bands run the same direction and are an equal distance apart. (see above) These "parallel"  bands may show puckering more than crisscross bands. Hormonal factors play a role too. Higher amounts of estrogen cause cellulite. Cellulite often develops more rapidly when women produce more estrogen, like during adolescence or pregnancy.  A high-calorie diet that features a lot of carbs, fats, salt and preservatives can also contribute to the development of more cellulite. And since cellulite is a chronic inflammatory process, it can be made worse by smoking which diminishes blood flow to the area and weakens the formation of collagen. 



Again, cellulite is a chronic inflammatory process, therefore it can be hard to get rid of and keep away. Treatments include liposuction, Qwo, and Cellfina for example, all of which can work but have their associated costs, swelling, bruising and down time. There are multiple at home devices and other noninvasive medical devices as well, none of which we have been very satisfied with in the past. Until now.......

EMTONE IS OUTSTANDING!!



Emtone is the first and only device that delivers both thermal and mechanical energy to treat all the contributing factors to cellulite. In clinical studies Emtone showed a 93% visible reduction in cellulite. 

It is appropriate for all skin and body types. It is completely noninvasive, painless, requires no downtime and requires no anesthesia. We sell Emtone in a package of 4 that usually last 20-30 minutes for each treatment and are done 1 or 2 times per week. Many many people see results after the first treatment. Results typically continue to improve over the next few months as well. 




With this monopolar radiofrequency combined with a targeted pressure energy and  mechanical effect, after an Emtone treatment the size of the fat chambers are diminished. Collagen begins to remodel. Blood flow to the area is enhanced and skin elasticity is restored. Plus, there is an increase in metabolic waste removal. 





It's very popular to combine an Emtone package with an EmsculptNeo package (see previous blog on Emsculptneo.)  Both are noninvasive and painless; they can remove fat, build & tone muscle plus treat cellulite. Ask us about our January 2023 special! 501-228-6237



We look forward to helping you achieve some of your New Year's goals!

Anne R Trussell MD ABAARM FAARM
owner/physician
Sei Bella Med Spa

10310 West Markham
Suite 202
Little Rock, AR 72205

501-228-6237
www.seibellamedspa.net

#Emtone #cellulite #EmsculptNeo #Emsculpt #Emsella #bodycontouring #coretofloor #RF #radiofrequency #monopolarRF #HIFEM #BTL #BTLEsthetics #urinaryincontinence #bodysculpting #bodyshaping #core #musclebuilding #fatloss #fitness #abdomen #booty #legs #physician #doctor #medspa #medicalspa #seibellamedspa #drannetrussell #LittleRock #fatreduction #bodypositivity #newyearsresolutions #nonsurgical #noninvasive 

Tuesday, December 14, 2021

Emsella

 

 
 Emsella is one of our most exciting devices! As a med spa, and as a retired internal medicine physician, I like to focus on health and wellness, not just beauty. Emsella offers just that. It is FDA approved to treat urinary incontinence in women AND men. It is completely noninvasive and you get to stay fully clothed!



Emsella strengthens all the pelvic floor muscles with HIFEM technology (High Intensity Focused Electromagnetic Energy). It's like doing 11,000 Kegels in one 28 minute session. 

BTL has performed multiple studies with multiple providers. An article published in Lasers and Surgery in Medicine, 2019 reported that on average 64.42% of patients showed improvement in their ICIQ-UI score (a score of incontinence severity) and 53.68% decrease in absorbent pad use. 34.3% considered themselves completely cured. 64.29% of patients reported less leakage with sleeping. 44.19% reported they did not need to use absorbent pads at all! This study was done in patients who received 6 treatments. 

Another study published in Female Pelvic Medicine and Reconstructive Surgery Journal, December 19, 2019 showed significant improvement of pelvic floor integrity proven by 3D ultrasound. Treated patients achieved a 3X higher level of improvement in their PDFI-20 questionnaire (another marker of improvement in symptoms.) All assessment methods showed the HIFEM technology (Emsella) is more effective than electrostimulation for treatment of weakened pelvic floor muscles. 


Now let's talk about sexual wellness. Emsella is not FDA approved to improve sexual wellness, orgasms, etc., HOWEVER, studies are showing it works very well in this area! A study presented at the Annual Meeting of the American Society for Laser Medicine and Surgery 2021, reported on 33 females (around 50 years of age) who showed decreased interest in sexual activity accompanied by urinary incontinence.  Both desire and incontinence improved. Makes sense doesn't it? I mean who wants to dribble during sex?! Their ICIQ-UI (see above) score decreased by 61%. FSFI score (sexual function score) increased by 33%. PISQ-12 (another continence, sexual wellness questionnaire) increased significantly by 24%. Patients also benefited from increased sexual desire, improved lubrication, and orgasmic response.



If you're ready to stop dribbling when you cough, laugh or sneeze, ready to stop using pads, sitting with your legs crossed all the time, or having to carry around a change of clothes......give us a call! Emsella is completely noninvasive and painless and may be a great option for you!

501-228-6237

Anne R Trussell MD ABAARM FAARM
owner/physician
Sei Bella Med Spa
10310 West Markham, Suite 202
Little Rock, AR 72205

#drannetrussell #seibellamedspa #BTL BTLEsthetics #urinaryincontinence #coretofloor #sexualwellness #EmsculptNeo #noninvasive #RF #HIFEM #LittleRock #medicalspa #medspa #doctor #physician #incontinence #pelvicfloormuscles #Kegel #pelvicfloor #Kegelexercises

Monday, November 22, 2021

EMSCULPT NEO

 


We are so excited about EMSULPT NEO! We were able to offer noninvasive permanent fat loss with SculpSure, but now we can offer better permanent fat loss painlessly AND build and tone muscle in multiple areas of the body at the same time! BMI up to 35 can benefit unlike other devices!

EMSCULPT NEO is the only non-invasive technology that simultaneously uses Radiofrequency (RF) and HIFEM+ (high intensity focused electromagnetic field) to permanently eliminate fat and build muscle. This results in more fat reduction and more muscle growth than with any other single device. Due to the RF heating, EMSCULPT NEO is the only aesthetic procedure that works out heated muscles, similar to what a warm up activity does before any workout. Fat destruction temperature is reached in less than 4 minutes. Bypassing brain limitations, HIFEM+ energy contracts muscle fibers at intensities not achievable during a voluntary workout. On average muscle volume increases by 25% and fat decreases by 30%.




The synchronized RF is the only patented radiofrequency heating in the world that works simultaneously within a magnetic field. HIFEM+ is the #1 muscle sculpting technology and the Emsculpt Neo has newly designed protocols that operate simultaneously with the RF heating. It offers the fastest thermal effect on the market, with settings that are fully adjustable. And with the Edge applicators that were introduced in December 2022, we can treat flanks and love handles now. In total, we can treat 11 different body areas.



Check out this patient testimonial:




Reproducible results are supported by 7 clinical studies in more than 500 patients and 30 peer-reviewed HIFEM publications since 2018 with more than 30 investigators. This makes HIFEM the most intensively researched technology used in non-invasive body shaping. These results were proven by ultrasound, MRI and electron microscopy.


Multiple applicators allow for effective treatment of multiple body parts including abdomen, buttocks, inner thighs, outer thighs, front of thighs, back of thighs, biceps, triceps, and calves, flanks and love handles. The temperature and intensity of muscle contractions is customizable to each patient and the computer saves all information from previous treatments.


Treatments are usually done in a series of 4-6 sessions approximately a week apart. Call for your appointment today! 501-228-6237. Individual treatments are available, but only recommended for maintenance of results. Treatment packages are needed to achieve optimal results. Price varies depending on area treated and number of treatments. We will go over that with you when you call! 501-228-6237



501-228-6237

#EmsculptNeo #bodysculpting #bodyshaping #bodycontouring #Emsella #BTL #BTLEsthetics #coretofloor #core #musclebuilding #HIFEM #RF #radiofrequency #fitness #fatloss #booty #abdomen #abs #thighs #arms #biceps #triceps #exercise #beauty #weightloss #bodygoals #drannetrussell #LittleRock #seibellamedspa #femaleownedbusiness #physician #doctor #medspa #medicalspa #noninvasive #fatreduction #nonsurgical #nononvasive #sculpting #health #bodypositivity

Sei Bella Med Spa
Anne R Trussell MD ABAARM FAARM
10310 West Markham
Suite 202
Little Rock, AR 72205

www.seibellamedspa.net

Monday, July 19, 2021

SCULPSURE......Permanent Non-Invasive Fat Loss

SculpSure or, "warmsculpting, " as it has come to be called, offers permanent noninvasive fat loss in multiple areas such as arms, bra fat, abdomen, flanks, banana roll (right under the buttocks), love handles, saddle bags and inner & outer thighs. Surgical options include various forms of liposuction which are effective, but can be more costly and definitely result in downtime which SculpSure does NOT have. There is also Coolsculpting which offers permanent non-invasive fat loss as well, but the treatment sessions are longer, and patients usually have bruising and swelling in the treated area that requires massage. With SculpSure there is zero downtime. No bruising. No swelling. 

y


SculpSure uses a 1060 nm laser that targets only fat and has a cooling plate that rests on your skin. This wavelength is clinically proven to selectively target and reduce fat cells without disrupting the skin. "Feathering of heat" ensures that the area being treated is continuous and consistent. It is effective on all skin types and ethnicities. During the laser lipolysis, fat cells are destroyed and naturally eliminated from the body via the lymphatic system. Most results are seen at the 6 and 12 week mark, but permanent fat loss can continue up to 6 months. Tissue samples in clinical studies showed fat cell damage begins as early as the first week and continues up to 6 months.  


So how well does SculpSure work and how satisfied were patients and clinicians with the results in clinical studies?

  • 95% of patients' results could be see in post-treatment photos of the abdomen
  • There was a 1.5 mm reduction at 6 weeks and 2.65 mm reduction in measurements at 12 weeks after just one treatment.
  • 91% of patients were satisfied with their results. 
  • 90% of patients' results could be seen in post treatment photos of the flanks. 
  • Age and BMI have no effect on the results of the treatment.
  • 96% of patients were satisfied with the results on their flanks. 
  • 100% of patients who received SculpSure for post liposuction deformities were graded as improved by blinded evaluators.
  • Physicians rated 100% of the patients as improved who were treated for post liposuction deformities. ,
  • In patients treated for fat removal in the inner thighs and upper arms, 91% were satisfied with their results.
  • There was a 9mm reduction of fat on the arms recorded 6 months after one treatment of SculpSure. 
  • 90% of patients showed a significant change in their fat layer as proven by ultrasound. 






Ask about our SculpSure Club for year long savings. You can treat multiple areas, more than once as needed, for a huge cost savings! Call today to schedule your appointment! 501-228-6237



Anne R Trussell MD ABAARM

owner/physician

Sei Bella Med Spa

 www.seibellamedspa.net

References:

Bass L. Safety and Efficacy of a Noninvasive 1060 nm Diode Laser for Fat Reduction of the Abdomen, Journal of drugs in dermatology: JDD. 2018;17 (1): 106-112

Katz B, Doherty S. Safety and Efficacy of a 1060 nm Diode Laser for Fat Reduction of the Flanks. Dermatologic Surgery. 2018;44(3):388-396

Schilling L, Saedi N, Weiss R. 1060 nm Diode Hyperthermic Laser Lipolysis: The Latest in Non-invasive Body Contouring. Journal of drugs in dermatology: JDD 2017;16(1):48-52

Balaratnam S. Evolution of laser lipolysis in non-invasive fat reduction and body sculpting. Journal of Aesthetic Nursing. 2017;6(9):466-471

Petti C. Stoneburner J. Clinical Study to Assess the 1060 nm Diode Laser for the Treatment of Post-Liposuction Deformities. Lasers in Surgery and Medicine. 2019;51(9):785-789

Petti C. Lasers in Surgery and Medicine. 2018;50(4):369-392

Hoffman, K., Hoffman K. Lasers in Surgery and Medicine. 2017;49(S28)

Bass, L. et al. Lasers in Surgery and Medicine. 2016;48(S27)

McDaniel D., et al. [51} Lasers in Surgery and Medicine. 2016;48(S27)

R. Sierra, J. Decorato, B. Chen. [91] Lasers in Surgery and Medicine. 2014;46(S25)

#SculpSure #fatloss #Coolsculpt #Warmsculpt #bodycontouring #laser #drannetrussell #seibellamedspa #medspa #medicalspa #physician #LittleRock #BMI #SculpSureClub #liposuctionalternative #laserlipolysis #lipolysis #apoptosis

Saturday, June 26, 2021

 

NEOCUTIS SKINCARE


Over 15 years ago, NEOCUTIS was founded on the basis of extensive wound healing research performed in Lausanne, Switzerland. When their first wound healing technology was found to scarlessly heal burned skin, while making it appear healthier and more youthful, NEOCUTIS scientists began to explore how to apply the same principles to improve the appearance of aging skin. Unlike young skin, which heals quickly and easily, older skin acts more like wounded skin. NEOCUTIS began developing products that support natural healing by stimulating the processes that regenerate and restore the key building blocks of skin structure—namely, collagen, elastin, and hyaluronic acid. Dr. Trussell and her staff tested these products themselves and loved them, so we are introducing our three favorites first!

Neocutis2.jpg

LUMIERE FIRM

Illuminating & Tightening Eye Cream

Target the delicate eye area with this advanced anti-aging formulation. Human Growth Factors + Proprietary Peptides reduce the appearance of fine lines and wrinkles, crow’s feet, puffiness and under-eye darkness in as soon as 14 days.

Non-comedogenic • Dermatologist tested • Paraben, dye and fragrance free • Not tested on animals

15 ml (0.5 fl oz)$108.00

  1. Reduces the appearance of fine lines and wrinkles with Growth Factors

  2. Supports Collagen and Elastin production with Proprietary Peptides

  3. Improves firmness, elasticity, tone, and texture

  4. Moisturizes under-eye skin with Sodium Hyaluronate

  5. Glycyrrhetinic Acid helps lighten the appearance of under-eye darkness

  6. Helps minimize the look of skin puffiness with Caffeine

  7. Refreshes the delicate eye area to help alleviate the signs of fatigue with Bisabolol, a skin-conditioning agent found in Chamomile Extract.


You can receive a FREE Lumiere Firm at our big annual birthday event on Thursday July 8th, 2021 from 9 am-5 pm when you purchase an Ultherapy upper face! Stop by or give us a call! 501-228-6237

NEO THERAPY

Neck & Décolleté Tightening Cream

Neocutis3.jpg
An intensive anti-aging treatment to support the results of Ultherapy neck and décolleté treatments with an added skin brightening benefit. This moisturizing complex helps firm and tighten skin, support the restoration of lost collagen and elastin, and diminish the appearance of age spots and uneven skin tone.

Ultherapy is the only FDA-cleared, non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest.

Paraben-free • Non-comedogenic • Dermatologist tested • Free of color additives and fragrances • Not tested on animals

50 g (1.69 fl oz)$135.00

  1. Helps to create an optimal environment for Elastin formation, leading to a more youthful, sculpted profile

  2. Reduces the look of fine lines and wrinkles by cultivating Collagens III and VII

  3. Firms thin, loose skin on the neck, collarbone and bust by supporting Collagen I and Hyaluronic Acid

  4. Conditions skin while defending against premature aging with Beet Root Extract

  5. Rejuvenates crepey-looking skin with Glycolic Acid and diminishes the appearance of age spots and uneven skin tone

  6. Shields against skin-aging oxidative stress and detrimental environmental factors with stabilized Vitamin C

  7. Infuses moisture and fortifies skin with a blend of Glycerin, Argan and Jojoba oils alongside Wild Yam Root Extract


You can receive a FREE Neo Therapy plus 10 FREE units of Xeomin ($140 value) at our big annual birthday event on Thursday July 8th, 2021 from 9 am-5 pm when you purchase an Ultherapy lower face and neck treatment! Stop by or give us a call! 501-228-6237

Neocutis.jpg

JOURNEE

Revitalizing Day Cream SPF 30

A powerful day cream that provides four benefits in one: skin revitalization, anti-oxidant care, broad-spectrum UVA and UVB protection and lasting hydration.

Non-comedogenic • Dermatologist tested • Free of color additives and fragrances • Not tested on animals.

15 ml (0.5 fl oz)$83.00

50 ml (1.69 fl oz)$189.00

  1. Formulated with growth factors to help reduce the appearance of fine lines and wrinkles

  2. Provides lasting hydration and moisture retention with Sodium Hyaluronate (SH) and Glycerin

  3. Fights against daily environmental stressors with an intensive anti-oxidant blend of polyphenol-rich Green Tea Extract, stabilized Vitamins C and E, and Melanin

  4. Provides broad-spectrum UVA/UVB sun protection SPF 30 with a non-whitening blend of Octinoxate and micro-fine Zinc Oxide

  5. Fast-absorbing, non-greasy formula blends flawlessly into skin for lightweight sun protection

You can receive a FREE 15 ml Journee plus 10 FREE units of Xeomin ($140 value) at our big annual birthday event on Thursday July 8th, 2021 from 9 am-5 pm when you purchase an Ultherapy full face treatment! Stop by or give us a call! 501-228-6237


Anne R Trussell MD ABAARM
owner/physician
Sei Bella Med Spa
www.seibellamedspa.net

Saturday, April 18, 2020

Lumenis Resurfx Laser for Scars and Stretch Marks and Photorejuvenation!

Lu for Scars and Stretch Marks and 




The Resurfx non-ablative fractional laser emits precise columns of heat energy into the skin to stimulate new collagen growth and retexture the skin. The controlled heat laser delivery has been used for decades in dermatology to trigger the body to "repair" the skin, leading to collagen production. Stimulating new collagen production is the key to more radiant, youthful looking skin.
Non-ablative means the skin is not broken, so the resurfaced skin will not bleed or get infected during treatment or after, as it can with other technologies. Thus there is minimal downtime and risk. No required time to rest or heal means no social downtime. There may be some redness and swelling right after the procedure and the following few days.  You must wear sunscreen and stay out of the sun for a few days. You can reapply makeup the next day. A series of 3-5 sessions gives optimal results, done in 4-6 week intervals. Gradual improvement in tone may be seen as soon as a couple of weeks after the procedure, and benefits of collagen production start appearing after three months. 


With the Lumenis M-22 platform, we can offer our "Photofabulous" treatments as well! This combines the benefits of IPL and Resurfx laser. The combination of these two modalities will address both tone and texture. By decreasing pigmentation and redness while simultaneously triggering collagen production, your skin will become more even in color and texture.
For your utmost comfort, we are going to have you arrive 30 minutes before your scheduled appointment so that we can wash your face and apply a topical numbing cream. You may experience a warm or prickling sensation as the laser is applied to the skin, but the treatment should not be painful.
IPL and Resurfx laser are not for everyone. We can not treat over an active infection, inflammatory skin conditions, or skin cancer. Tanning beds must be avoided two weeks prior to treatment as well as extended sun exposure. We will not be able to treat you if you have fake tanner on unless you can completely exfoliate it off prior to your session. Some antibiotics must be avoided too. Patients with lupus and some other autoimmune diseases are not usually good candidates either.




Call to schedule your appointment today! 501-228-6237

Anne R Trussell MD ABAARM
Diplomate American Academy of Anti-Aging Medicine
owner/physician
Sei Bella Med Spa

501-228-6237

10310 West Markham
Suite 202
Little Rock, AR 72205

www.seibellamedspa.net

#laser #hairremoval #Lumenis  #seibellamedspa #drannetrussell #Resurfx #scars #acne #stretchmarks #photofacial #IPL #photofabulous #medspa #doctor #confidence #medicalspa #sundamage #hyperpigmentation #telangectasias #photorejuvenation #rejuvenation #antiaging #A4M #ABAARM #lasers #nonablative #photofractional 

Tuesday, March 31, 2020

Bioidentical Hormones for Menopause and Andropause


Everyday 3500 women enter menopause. Maybe more. Natural menopause usually occurs between the ages of 43 and 55, which means we could live half our life in menopause! Our hormone levels can start dropping 15 years before that, so we should not wait until we actually stop having menstrual cycles to seek treatment. And 20% of men are in andropause by the age of 50. The symptoms are not fun!! During this pandemic, the inability to go about our daily routine adds increase stress to our lives and can actually make our symptoms worse.

Menopause impacts 25 million women worldwide each year. We all know the symptoms.....hot flashes, night sweats, mood swings or depression, sleep problems, fatigue, brain fog and no sex drive. Those are just the ones I hear most commonly. Menopause is also associated with an increased risk of cardiovascular disease, dementia, and osteoporosis. Men with low testosterone have the same risks and experience fatigue, depression, moodiness, loss of muscle mass, erectile dysfunction and low libido.

We need estrogen! It has 400 functions in the female body. Estrogen deficiency is a state of accelerated aging.  In a 2013 study, researchers estimated that over the past decade 18,600-91,600 postmenopausal women, ages 50-59 who have had hysterectomies may have died prematurely because they were not given estrogen!

WHY NOT?!


Well, in 1991 a large trial called the Women's Health Initiative was begun by the U.S. National Institute of Health. The study was stopped early due to a 41% increase in stroke, 29% increase in heart attacks, 26% increase in breast cancer and a 100% increase in the rate of blood clots. So all doctors were cautioned about hormone replacement in menopause, and to use the lowest dose possible to control symptoms and to only continue treatment for 5 years at the most. There were HUGE flaws in this study. The estrogen being given to women was synthetic, made from pregnant horse urine. These compounds have about 40 different estrogens, none of which bind to the estrogen receptors in our body correctly. Furthermore, some of these women were treated with artificial progesterone as well (progestins or medroxyprogesterone). Women on these synthetic progesterones had the highest rates of breast cancer. If you're taking synthetic hormones, then you are exposing yourself to these risks. Just because they are FDA approved, doesn't mean they are safe!


Fortunately we have very safe, effective and convenient alternatives to synthetic hormones. Bio-identical hormones are not only "natural"; bio-identical means they are EXACTLY like the hormones we used to produce. They bind to our bodies' hormone receptors EXACTLY like the hormones we used to produce. They DO NOT increase our risk of cancer, stroke, blood clots nor heart attacks. As a matter of fact, bio-identical hormones are protective against these things! Specifically testosterone replacement does not cause prostate cancer in men! The French Cohort Study published in 2002 followed 3,175 postmenopausal women taking bio-identical hormones for 9 years, proving there was no increased risk of breast cancer. There are many more studies out there proving the same facts. Most of us have heard about bio-identical creams, which are very safe. Bio-identical hormone pellets are another safe, effective, convenient alternative I provide at Sei Bella Med Spa! I personally have been getting pellets for almost 7 years. I love them! 


The process is simple. You come in for an office visit with me and I take a complete medical history. You have a panel of lab drawn. When that lab is available in about a week, it is entered into the HTCA computer formula, along with your medical history and symptoms. A dose of hormones is then generated which I can adjust as I need to. The prescription is then sent to Well's Pharmacy who then ships your pellets to you that have been calculated specifically for you. The pellets, which are the size of a grain of rice and smaller, are then inserted by me into the fat of your bottom in a quick, painless in-office procedure. It truly takes all of 2-3 minutes to insert them. Your pellets will last 4-6 months and gradually dissolve. When symptoms return, you know it's time to tell me you are ready to be repelleted. Bio-identical hormone pellets are safe, convenient and effective, not to mention healthy! And although this blog has mostly focused on menopause, pellets are very popular in men as well!

You can read more on my website at www.seibellamedspa.net.
Give us a call today and get your appointment set up to start feeling better. 501-228-6237

Anne R Trussell MD ABAARM
owner/physician
Sei Bella Med Spa

#menopause #andropause #bioidenticalhormones #bioidenticalpellets #bhrt #htca #lowT #hormonepellets #hormonereplacementtherapy

Literature sources:
de Lignieres, B., et al "Combines hormone replacement therapy and the risk of breast cancer in a French cohort study of 3175 women." Climacteric, 2002 Dec; 5(4):332-40

Friedman, 2013

Bain J, Maturitas 2010; (66):16-22 Kaufmann JM, J Clin Endocrinol Metab 2001;26:833-78

North American Menopause Society

Birge,S, "The use if estrogen in older women," Clini Geriatr Med 2008: 19(3):617-27

Studd, J.W.W., Cardozo, L.Stanzyck, & Thom

Sarrel, et al, "The mortality toll of estrogen avoidance: An analysis of excess deaths among hysterectomized women aged 50-59 years." American Journal Public Health 2013: July 18