The Revolutionary Book About Bioidentical Hormone Replacement Therapy Now Fully Revised and Updated Over a decade ago, Dr. John Lee first published his startling conclusions about conventional hormone replacement therapy (HRT): synthetic hormones don't work as predicted and, worse, they pose a health threat to women. His findings touched off a storm of controversy. But years later, research has proved him right. Now millions of women concerned about aging must decide whether or not to undergo synthetic hormone replacement therapy-and suffer its side effects and increased health risks. Hundreds of thousands of women have listened to Dr. Lee's potentially life-saving advice and followed his groundbreaking, natural hormone program-experiencing amazing results. Newly revised and updated, this revolutionary book has the latest research, and Dr. Lee's effective plan for restoring balance using bioidentical hormones, including natural progesterone. Discover the benefits of his breakthrough program: * Reduce or eliminate premenopausal and menopausal symptoms * Help eliminate hormone-related problems such as osteoporosis, hot flashes, night sweats, vaginal dryness, weight gain, and fibrocystic breasts * Reduce "middle age" weight gain * Help restore sex drive * Protect against breast cancer * Maintain mental acuity * Help stop and reverse osteoporosis * Restore energy and vibrancy...slow the signs of aging.
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What Your Doctor May Not Tell You About Menopause (Revised & UpdatedThe Breakthrough Book on Natural Hormone Balance
By John R. Lee Virginia Hopkins
Warner BooksCopyright © 2004 John R. Lee and Virginia Hopkins
All right reserved.
Chapter OneTHE CRUX OF THE MATTER: MENOPAUSAL POLITICS AND WOMEN'S HORMONE CYCLES
Not so long ago, menopause was a word you did not say out loud in public, and you had to go to a medical library to find a book on the subject. Go into a typical bookstore these days and you'll find literally dozens of titles on menopause.
They range from praising the wonders of estrogen and hormone replacement therapy to personal stories of the ups and downs some women experience during the "change of life," and there are now many other books written on the subject of natural hormones. What was once a taboo subject has become a mainstay of talk shows and women's magazine articles.
With 30 million menopausal women in North America and some 20 million baby boomer women in menopause or on the brink of it, it's no wonder this is a major topic of discussion. What is a wonder is how we have managed to make menopause, a perfectly natural part of a woman's life cycle, into a disease. It has only just dawned on us that menstruation, pregnancy, and childbirth are not diseases; now we need to realize that menopauseis not a disease despite millions in advertising dollars spent by drug companies to convince us otherwise. The pharmaceutical companies have not failed to notice the huge population of premenopausal women in the pipeline, a financial gold mine in the making. Premarin, a form of hormone replacement therapy made from pregnant mare's urine by the Wyeth-Ayerst Company, was one of the top-selling prescription medicines in the United States until the 2002 Women's Health Initiative (WHI) study showed that PremPro (a combination of Premarin and a progestin) increased the risk of breast cancer, strokes, and gallbladder disease. Although Premarin/ PremPro generated more than $2 billion in sales in 2001 and represented 22 percent of Wyeth's pharmaceutical sales, more recently, sales of Premarin/PremPro have declined about 25 percent.
In 1995, when I first wrote this book, I stated, "A large percentage of advertising and research dollars are spent trying to convince women that estrogen will cure everything from heart disease to Alzheimer's, but there is scant evidence for any of these claims and reams of evidence that synthetic estrogens are highly toxic and carcinogenic." Now the WHI has proven me correct on this, and many millions of women are searching for a safe alternative to PremPro. In my opinion, it's not so much the estrogens per se that are toxic and carcinogenic, it's estrogens used in excess, and with progestins instead of natural progesterone. But you will learn a lot more about this as you read further.
The good news is that women have become guarded and skeptical about having new drugs pushed on them. After being told that DES, a hormone that was supposed to guard against miscarriages, was safe, hundreds of thousands of women discovered the hard way that it caused cancer in their children. Women were told that Valium was a safe and effective remedy for depression and anxiety, only to find out that it was addictive. Then their physicians tried to convince them that once they had reached menopause they should automatically go on hormone replacement therapy featuring synthetic estrogens and progestins, only to find it could increase their risk of deadly diseases rather than save them from the aging process. It is telling that only 10 to 15 percent of menopausal women chose to use conventional HRT despite intense pressure from doctors and the media. The real tragedy is that many thousands of women may have died or been permanently harmed because they used HRT, when the natural forms of these hormones, used wisely and in moderation, could have been, and still could be of very real benefit. In the chapters that follow, we will look more closely at how estrogen and progesterone work in a woman's body and the politics of pushing drugs to women.
What Is Menopause?
Strictly speaking, menopause is the cessation of menses, the end of menstrual cycles. The unpleasant "symptoms" of menopause that some women suffer, such as hot flashes, vaginal dryness, and mood swings, are peculiar to industrialized cultures and, as far as I can tell, they are virtually unknown in agrarian cultures. In native cultures menopause tends to be a cause for quiet celebration, a time when a woman has completed her childbearing years and is moving into a deeper level of self-discovery and spiritual awareness. She is becoming a wise old woman. In these cultures menopausal women are looked up to and revered. They are sought out for advice and their opinions are heavily weighed in the decision-making process of the community.
How strange that sounds to us! We know menopause as a death knell, the end of a woman's sexuality, a descent into a dried-up and painful old age of arthritis and osteoporosis. How did this experience of menopause come to be? I believe it's a combination of poor diet, unhealthy lifestyle, environmental pollutants, cultural attitudes, the incorrect use of synthetic hormones, and advertising. But first, let's look at what happens in a woman's body as menopause approaches.
The Rise and Fall of Hormones During the Menstrual Cycle
In a normal menstrual cycle, every 26 to 28 days, the ovaries, which hold a woman's eggs, receive a hormonal signal from the brain that it's time to get some eggs ready to be fertilized. Anywhere from a few to a few hundred eggs begin to mature inside sacs called follicles. After 10 to 12 days one egg has moved to the outer surface of the ovary and the follicle bursts, releasing the egg into the fallopian tube for its journey to the uterus.
As the egg is ripening in the ovary, the uterus is ripening in preparation for the possibility of growing a fetus. The uterine lining thickens and becomes engorged with blood that will nourish the growing embryo. If no fertilized egg implants itself in the uterus, it sheds its lining. This shedding is the blood of menstruation. Then the cycle begins again, with the signal from the brain telling the ovary to ripen an egg.
Estrogen (from estrus, meaning "heat" or "fertility") is the dominant hormone for the first week or so after menstruation, stimulating the buildup of tissue and blood in the uterus as the ovarian follicles simultaneously begin their development of the egg. Around the time of ovulation, estrogen causes changes in the vaginal mucus, making it more tolerant of male penetration during sexual activity and more hospitable to sperm. At this phase in the menstrual cycle, the vaginal mucus tends to somewhat resemble uncooked egg whites. Watching for this change in mucus combined with a rise in body temperature is one of the best nonlaboratory methods for identifying the time of ovulation.
About twelve days after the beginning of the previous menstruation, the rising estrogen level peaks and then tapers off just as the follicle matures and just before ovulation. After ovulation the now-empty follicle becomes the corpus luteum (so named because of its appearance as a small yellow body on the surface of the ovary). The corpus luteum is the site of progesterone production, which dominates the second half of the menstrual month, reaching a peak of about 20 milligrams (mg) per day.
Progesterone production during this phase of the cycle, along with estrogen, leads to a refinement and "ripening" of tissue and blood in the uterus. Progesterone also contributes to the changes in the vaginal mucus seen at the time of ovulation. The rise of progesterone at the time of ovulation causes a rise of body temperature of about one degree Fahrenheit, a finding often used to indicate ovulation.
If pregnancy does not occur within 10 to 12 days after ovulation, estrogen and progesterone levels fall abruptly, triggering menstruation, and the cycle begins anew. If pregnancy occurs, progesterone production increases and the shedding of the lining of the uterus is prevented, thus preserving the developing embryo. As pregnancy progresses, progesterone production is taken over by the placenta and its secretion increases gradually to levels of 300 to 400 milligrams per day during the third trimester.
A woman's hormone balance can begin to shift at anywhere from her mid-30s to her late 40s, depending on a variety of factors such as heredity, environment, how early or late she began menstruating, whether she had children and if so at what age and how many, and her lifestyle. Was she exhausted trying to juggle career and family? Was she eating junk food, caffeine, sugar, and alcohol or whole grains, fresh vegetables, and fruits? Has she taken vitamins? Has she lived in the city or country? Was she exposed to toxins in the workplace? Hormone balance is intimately connected to stress levels, nutrition, and the environmental toxins encountered daily. We will discuss all of these factors more thoroughly in the chapters to come.
The ability of the follicles to mature an egg and release it may begin "sputtering," so to speak, a decade before actual menopause, creating menstrual cycles in which a woman does not ovulate, called anovulatory cycles. If she isn't ovulating, she isn't producing progesterone from the ovaries and she may begin experiencing menopausal symptoms such as weight gain, water retention, and mood swings.
Menstrual cycles can continue even without the progester-one, however, so most women aren't aware that the lack of progesterone is causing their symptoms. I call this phase premenopause. I will be discussing premenopause symptoms in more detail, and have also written an entire book on the subject called What Your Doctor May Not Tell You About Premenopause. The phase right around the time of menopause, when hormones and brain signals to the ovaries are fluctuating, is called perimenopause.
It used to be true that the majority of women began menopause in their mid-40s to early 50s. In the last generation, however, things appear to have changed. Women now may have anovulatory periods starting in their early 30s and yet do not experience cessation of periods (menopause) until their 50s. During this time, the ovaries continue to produce estrogen sufficient for regular or irregular shedding, creating what I term "estrogen dominance," which will be discussed in detail throughout the book.
Some women may go for years with irregular cycles and slowly wind down, or may just suddenly stop menstruating one month and never menstruate again. They may be over-whelmed with unpleasant symptoms or hardly notice what has happened other than not having to worry about birth control or tampons every month. How menopause is experienced is as individual and unique as each human being.
During the many months of anovulatory periods, estrogen production may become erratic, with surges of inappropriately high levels alternating with irregular low levels. Periods of vaginal bleeding may become erratic, some much heavier than others. When estrogen surges, women undergoing these changes may notice breast swelling and tenderness, mood swings, sleep disturbance, water retention, and a tendency to put on weight. These may be the symptoms of estrogen dominance caused mainly by lack of ovulation and thereby lack of progesterone while their estrogen levels are still in the "normal" range. Their doctors may check their estradiol levels and their follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, but rarely does it dawn on them that their patients' progesterone levels are too low. In taking the usual blood tests, the doctor may find the estrogen normal that day or even a bit on the low side and FSH levels a bit too high. On another day the estrogen might be elevated and FSH levels normal. If the former is found, the doctor may even prescribe some estrogen on the theory that the patient is nearing true menopause. The woman usually finds that this does not help her and often makes things worse.
More often, the doctor ascribes her complaints to emotional causes or simply some defect of Mother Nature that women must endure. In later chapters, I will discuss this phenomenon in more detail. For the present, we will merely say that a rising percentage of women are experiencing premenopausal woes that are related to their hormones. The details concerning environmental toxins, nutritional factors, stress, adrenal hormones, exercise, and weight will be found in the chapters ahead.
Excerpted from What Your Doctor May Not Tell You About Menopause (Revised & Updated by John R. Lee Virginia Hopkins Copyright © 2004 by John R. Lee and Virginia Hopkins. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
|Part I||The Inner Workings of Hormone Balance||1|
|Chapter 1||The Crux of the Matter: Menopausal Politics and Women's Hormone Cycles||3|
|What Is Menopause?||5|
|The Rise and Fall of Hormones During the Menstrual Cycle||5|
|Chapter 2||The Dance of the Steroids||10|
|The Cast of Major Players||11|
|Choreographing the Dance||13|
|The Journey Along the Steroid Hormone Pathway||14|
|The Dance of the Steroids||15|
|Four Movements: The Flow of Steroids in Our Bodies||16|
|Chapter 3||The History of Hormone Replacement Therapy and the Estrogen Myth||19|
|Menopause Becomes a Disease||20|
|The Truth Behind the Hoopla||22|
|Perpetuating the Estrogen Myth||26|
|The HRT Chickens Come Home to Roost||30|
|Chapter 4||What Is Estrogen?||35|
|How and Where Estrogens Are Made and Used in the Body||38|
|Estrogen and Cell Division||39|
|How Estrogen Affects a Woman's Body||40|
|The Myth of Estrogen in Hormone Replacement Therapy||43|
|What Are "Normal" Estrogen Levels?||46|
|Chapter 5||Hormone Balance, Xenobiotics, and Future Generations||50|
|Turning on the Hormone Switch||51|
|The Canary in the Coal Mine?||53|
|The Impact on Future Generations||54|
|Safe Living in a Sea of Estrogens||56|
|Pesticides and Plastics||58|
|Xenoestrogens and Future Generations||63|
|If You Want to Know More||65|
|Chapter 6||What Is Natural Progesterone?||67|
|The Discovery and Use of Progesterone||68|
|Exactly What Is Progesterone?||72|
|The Cycle of Progesterone Production||75|
|Progesterone and Procreation||75|
|How Progesterone Affects the Body||77|
|Progesterone and Steroid Synthesis||77|
|Progesterone and the Brain||79|
|Progesterone and Sex Drive||81|
|Progesterone in Men||83|
|Chapter 7||The Dramatic Difference Between Progesterone and Progestins||85|
|The Difference between Synthetic Drugs and Natural Compounds||87|
|What Is a Progestin?||90|
|Progestins Gave Birth to the Sexual Revolution||95|
|Chapter 8||Sex Hormones and the Brain||98|
|The Basics of Brain Communication||98|
|How the Inner and Outer Brains Regulate the Body||100|
|Estrogen and the Brain||101|
|Progesterone and the Brain||103|
|Progesterone and Fetal Brain Development||103|
|Progesterone and Brain Injuries||104|
|Progesterone and the Elderly||105|
|Progesterone and Libido||105|
|Progesterone and Sleep Patterns||107|
|Chapter 9||What Are Androgens?||108|
|Chapter 10||Hormone Balance and the Menstrual Cycle||115|
|The Rise and Fall of Hormone Levels||116|
|Part II||Hormone Balance and Illness||123|
|Chapter 11||Progesterone and Menopause Symptoms||125|
|The Mystery of Menopause||127|
|A Brief Look at Premenopause||128|
|Falling Estrogen and Progesterone, Rising GnRH, and Hot Flashes||128|
|Menopause and Estrogen||131|
|Androgens and Menopause||132|
|What Can Be Done for Menopausal Symptoms?||134|
|Chapter 12||Hormone Balance and the Adrenal and Thyroid Glands||135|
|Premenopause and Stress||135|
|The Adrenal Glands||141|
|The Adrenal Cortex||142|
|Progesterone and Thyroid Hormone||151|
|Chapter 13||Hormone Balance, Nutrition, and Osteoporosis||154|
|Debunking the Osteoporosis Myths||155|
|What Is Osteoporosis?||156|
|A Bit About How Bones Are Built||156|
|Osteoporosis and Estrogen||158|
|Osteoporosis and Progesterone||162|
|Other Osteoporosis Treatments||171|
|Keeping Your Bones Strong||174|
|How Bones Are Depleted||183|
|What Your Doctor May Not Know About Bone Density Measurement (BMD)||192|
|Chapter 14||Women and Cardiovascular Disease||198|
|Estrogen and Heart Disease||199|
|Progesterone and Heart Disease||200|
|Only Half of Heart Attack Deaths in Women Are Caused by Blocked Arteries||200|
|Insulin and Heart Disease||202|
|What About Cholesterol?||207|
|High Blood Pressure||208|
|C-Reactive Protein (CRP)||214|
|Nutrition and Lifestyle||214|
|What About Aspirin?||216|
|Strokes and Hormone Balance||218|
|The Bottom Line||223|
|Chapter 15||Hormone Balance and Cancer||224|
|Reestablishing Cellular Communication||225|
|How Cancer Develops||226|
|Estrogen Stimulates Cell Growth||228|
|The Cancer-Protective Benefits of Progesterone||234|
|Hormone Receptors in Breast Cancer||239|
|What About Mammograms?||240|
|Tamoxifen and Aromatase Inhibitors||244|
|Transcultural Factors in Breast and Uterine Cancer||248|
|Chapter 16||Getting Off Conventional HRT and on to Natural Hormones||251|
|Questions and Answers About Natural Hormone Replacement Therapy||252|
|Chapter 17||Natural Hormone Balance and Pelvic Disorders||255|
|Pelvic Inflammatory Disease (PID)||257|
|Ovarian Cysts and Mittelschmerz||258|
|Staying Naturally Healthy||265|
|Chapter 18||Hormone Balance and Other Common Health Problems||266|
|Premenstrual Syndrome (PMS)||267|
|Hypothyroidism (Low Thyroid)||271|
|Skin Problems (Acne, Seborrhea, Rosacea, Psoriasis, and Keratoses)||279|
|Urinary Tract Problems||284|
|Gallbladder Disease and Bile Flow||288|
|Part III||Creating and Maintaining Hormone Balance||293|
|Chapter 19||How to Use Progesterone Supplementation||295|
|Types of Progesterone Supplementation||295|
|Testing Hormone Levels||299|
|Not All "Wild Yam Extract" Is Progesterone||301|
|How and When to Use Natural Progesterone||303|
|Possible Side Effects of Progesterone||304|
|How to Get the Most Out of Progesterone Cream||308|
|When During the Month to Use Progesterone Cream||309|
|Where to Find Natural Progesterone||320|
|A Final Reminder||321|
|Chapter 20||How to Use Estrogen, DHEA, Pregnenolone, the Corticosteroids, Testosterone, and Androstenedione||323|
|Chapter 21||Nutrition for Healthy Hormones||332|
|Excess Calories, Not Just Excess Fat||334|
|Good Fats and Bad Fats||335|
|Whole Foods Are Best||338|
|Eat Organic Foods Whenever Possible||341|
|Is Vegetarianism Protective?||341|
|Opt for Free-Range Meats, Eggs, and Poultry||342|
|Are Dairy Foods Right for You?||343|
|Eat Your Phytochemicals||344|
|Eat More Fiber||345|
|Drink Plenty of Clean Water||346|
|Take Your Multivitamins||347|
|Your Ideal Diet||353|
|Get Some Exercise||354|
|How Are Your Adrenal Glands Working?||355|
|Herbs for Hormone Balance||360|
|Chapter 22||Commonly Asked Questions About Using Natural Progesterone||364|
|Appendix||The Structure of Steroid Hormones||425|
Most Helpful Customer Reviews
This easy to read book explains in easy to understand language about the delicate balance of a woman's hormones. The book is not just about menopause, it's packed with information on many aspects of women's health. When I finished the book, I shouted out loud, 'Why didn't someone tell me about this before now?' Every woman should read and re-read this book. It has vital information for women's health. Information that I believe most doctors are unaware of. The use of Natural Progesterone cream has changed my life. Normal mentrual cycles, no more migraines, etc.... Amazing health benefits that my Doctors could not figure out. I have purchased over 30 copies of this book to share with family and friends. I even gave a copy to my doctor who is now recommending natural progesterone cream to some of his other patients. BUY THIS BOOK TODAY, YOU WON'T BE DISAPPOINTED!!
Finally, someone wrote a book about menopause thats not pushing drugs for a cure! I found this old used, well read book at a book trader, and decided to give it a try. So many doctors now days want to push medication, when there is no need for such dangerious pills. Yes go through menopause NATURALLY, like our mothers did. This book was well written and informative on the life-changing women will go through. Thank you Dr John R Lee for an HONEST approach to a natural women occurance that we all must go through.
I was on a Medical Leave of Absence from work because the mysterious symptoms had gotten unbearable. Although I am a medical lab scientist at a major medical center, my physicians are still quite clueless about the subject and never even diagnosed my premenopause. With time off to research my symptoms of extreme fatigue, aches, inability to concentrate, I came upon Dr. Lee's Book. A sympathetic friend gave me some natural progesterone cream. It was stunning that 6-8 hours! later I felt better than in the past few months. The next morning I awoke without the alarm clock. The book reviews everything I learned in college as a major in biology and chemistry and really tied it all together. Truly, the conventional highly educated medical establishment have forgotten the basic lessons. I am now a major advocate for natural progesterone to every woman with ears. I love my life. That is my wish for you.
Without question, Dr. Lee's books continue to be the definitive word in the field of natural progesterone. The women in his medical practice led him to investigate and, then, become a proponent of natural progesterone. He approaches it from a medical point of view, yet includes numerous actual patient cases to illustrate his belief in natural progesterone. Dr. Lee explores the theory of estrogen dominance and his experiences with how natural progesterone helped his patients. Although he beats the drum loudly in favor of natural progesterone, he also mentions any down-sides to this treatment. For authors such as myself who write about menopause (peri and post), Dr. Lee's books are a bountiful reference source. It's understandable, of course, that much of the information in this book is the same as in his book aimed at perimenopausal women. Whether you do or don't subscribe to his stance on natural progesterone, Dr. Lee's books are a worthwhile read. Be informed, ladies, about what's going on in your body!
This book is truly eye-opening! I have struggled with estrogen in every form -- pills, patches, creams, rings -- for ten years -- thinking I was doing something good for myself and making my Dr.'s happy. No more!! Please, ladies -- get this book!!!
I feel the best I've felt in years since following the advice about BHT in this book.
This book clears up any questions you'll have about what to do once your periods cease, and is also a must read for those women who've already made the transition and want optons other than HRT. I'm no longer worried about making this decision, thanks to Dr. Lee & Ms. Hopkins! In fact, I've recently started my thrid cycle of progesterone cream, and I feel fantastic. I was having some of the typical pre-menopausal symptoms that I now know were a signal from my body that I was estrogen dominant and progesterone deficient. This book is a ture bless to those of us making this transition.
I struggled with depression my entire life - in addition to many other hormone/PMS related physical and emotional problems. Natural progesterone, as recommended by Dr. Lee, lifted my depression within one week. I now feel like I always imagined a 'normal' person would feel. I suspected that progesterone would help me because I felt wonderful during my second and third trimesters of pregnancies and during nursing (high natural progesterone times). I went to a reproductive endocrinologist who dashed my hopes and told me that progesterone would not help me (I think he was referring to synthetic progesterone studies). Thank God I found Dr. Lee's books.
This book has life changing and saving information for every woman. Dr Lee presents information that can no longer be overlooked by 'mainstream' medicine. For two years now, this information has changed the lives of many of my female patients and has changed the way I prescribe hormones. I continue to be pleased with the results of Natural Progesterone.
Do you suffer from PMS, osteorporosis, menopausal symptoms, hot flashes, etc? Are you concerned about breast cancer? Then read this book. Dr. Lee gives invaluable information on how to treat these symptoms, disorders and diseases. Buy one for yourself and then buy several for your friends and family!
Dr. Lee is so forthright in his information. I appreciate being given the opportunity to make an informed choice concerning my own hormonal health. Using the information in this book, a woman will be equipped to handle all the changes in her body that come with age. I was amazed by Dr. Lee's explanation of our bones, osteoporosis, and the potential for rebuilding bones with the use of progesterone. Ladies, don't miss this one. It will revolutionize the way you deal with so-called 'female' health problems. Blessings and good success to you.
I am so thankful to Lee and Hopkins for writing this book. It has been a life saver and a relationship saver! I think doctors should have to read his books and then they should hand them out to their patients that suffer from peri-menopause and menopause! So many questions answered and easy to read! Thanks Dr. Lee and Ms. Hopkins!!!!
I'm 25 y/o not menopause, but I've been suffering with HYPOTHYROID for over a year already. If you can't stop the hair loss ( you can stop it, just read the book), or you think smth wrong with your hormones, consider estrogen dominance first, then hypothyroidism. I'm so happy I read this book and feel so great, till the end of my days will i be thankful to the author. And now I can help my mam too. especially read p137 and p151.
I am almost finished with this book, and know that natural progesterone therapy is for me. Dr. John Lee explains in detail how to start feeling better. Having breast cancer almost 2 years ago, I want to try and protect myself as much as I can. Women, read as much as you can to educate yourself about your health. Then let your doctor know what you want, and what you think is best for you! Dr.Lee Thank you!!
The advertisement you have is very misleading. I ordered this ebook accidently, I wanted a paperback. But, you have a picture of a book, not a computer file. This is extremely misleading. It should clearly state on the ad 'This is an ebook, only downloadable through Acrobat'. Your add says available for download; it doesn't state that it is only downloadable. Also, since I do not like ebooks, I didn't know about the no return policy for ebooks since I did not read that section of the website. This policy should also be state on the add. 'This is an ebook and there is a no retun policy or This is an ebook and all ebook sales are final'