Hormone Replacement Therapy became a hot topic in 2002. Prior to
that time, when women approached menopause they were placed on hormone
replacement therapy (HRT) to help prevent symptoms of menopause like: hot
flashes, mood swings, osteoporosis, etc. According to the WHI study, over one
year, 10,000 women taking estrogen plus progestin might experience:
- Seven more cases of heart disease than women taking a placebo
- Eight more cases of breast cancer than women taking a placebo
- Eight more cases of stroke than women taking a placebo
- Eighteen more cases of blood clots than women taking a placebo
- An increase in abnormal mammograms, particularly false positives
The study found no increased risk of breast cancer or heart
disease among women taking estrogen without progestin. Now the media can be a
wonderful thing – but for this study and many others out there it was not. The
media claimed that breast cancer was on the rise with the use of hormone
therapy. While, there was a slight increase – it was not to the extent that the
Who Is A Candidate for Hormone Therapy?
It is important to remember that every medication has a risk
versus benefit. With that being said, estrogen has it’s risk. Starting hormone
replacement therapy is based on symptoms and how life-altering those symptoms
are. Symptoms of menopause are:
Mood swings Insomnia Heavy
bleeding or Skipped Cycles
Hot flashes Mood swings
Fluid retention Fuzzy
Despite the health risks, estrogen is still the gold standard
for treating menopausal symptoms. The absolute risk to an individual woman
taking hormone therapy is quite low — possibly low enough to be acceptable to
you, depending on your symptoms.
The benefits of short-term hormone therapy may outweigh the
risks if you:
Experience moderate to severe hot flashes or other menopausal
Have lost bone mass and either aren’t able to tolerate other
treatments or aren’t benefitting from other treatments
Stopped having periods before age 40 (premature menopause) or
lost normal function of your ovaries before age 40 (premature ovarian failure)
Women who experience premature menopause or premature ovarian
failure have a different set of health risks compared with women who reach
menopause near the average age of about 50, including:
- A lower risk of breast cancer
- A higher risk of osteoporosis
- A higher risk of coronary heart disease (CHD)
In addition, hormone therapy appears to reduce the risk of
osteoporosis and CHD when started soon after menopause in young women. For women
who reach menopause prematurely, the protective benefits of hormone therapy may
outweigh the risks.
Who Should Not Take Hormone Therapy?
Hormone Therapy is NOT recommended for women:
- Who have or had breast cancer
Who have a first degree relative with breast cancer (sister or
- Who have a history of blood clots or a clotting disorder
- Who have had or have a risk of stroke
- who have liver disease
- who have unexplained vaginal bleeding
Hormone therapy might not be advisable for some women who have:
- Fibrocystic breast disease
- Uterine fibroids
- Gallbladder disease
- Increased risk of blood clots
- Migraine headaches
- Recent heart attack or known heart disease
Some Alternative and Natural Therapies For Menopause
Black Cohosh (Remifemin) – Black Cohosh is an
herb that exerts its effects on the endocrine regulatory (hormonal) mechanism
in your body. It’s a phytoestrogen, but by definition that means it’s weaker
than the estrogens your body creates. Structurally, black cohosh more closely resembles
estradiol, which researchers believe offers protection against cancer of the
endometrium, ovaries and breast.
The most commonly used preparation is black cohosh extract
called Remifemin. It is standardized (that’s good because you know just how much
of the herb you’re getting each time you take a capsule) to contain 250 mg of
black cohosh extract.
Some studies show that taking 60 mg of soy every day for three
months can reduce hot flashes and menopause night sweats by up to 45%. Sounds great,
doesn’t it? But other studies show that simple sugar pills also reduced hot
flashes by a similar amount. It appears that more studies need to be done to
find out if soy can really help reduce menopause symptoms.
Soybeans and soy products contain high levels of phytic acid,
which inhibits assimilation of calcium, magnesium, copper, iron, and zinc.
Therefore, soy is only recommended in small amounts.
Chillow Cooling Pad
A Chillow is like having a small waterbed for your head and
shoulders, helping you get to sleep with little or no hot flashes. These can be
very helpful if you suffer from hot flashes and to keep you cool at night.
An antidepressant has which has been found to decrease the hot
flashes associated with menopause and breast cancer treatment.
Wicking Clothing and Bedding
Specialty clothes, sleepwear, bedding and other items such as
pillow cases, t-shirts, and sleepwear are available. They wick moisture away
from the body helping to keep you dry. You can find products on-line including
NiteSweatz, Haralee Cool
for Hot Women, Nidraa, and Wildbleu.
The Truth About Bio Identical Hormones
Bioidentical hormones have become popular in recent years,
partly because of
celebrity endorsements and partly in reaction to reports of increased health
risks with standard hormone therapy. The term “bioidentical” means
in the product are chemically identical to those your body produces. In fact,
they are — but so are the hormones used in many FDA-approved hormone
Marketers of bioidentical hormones say their products have these
over standard hormone therapy:
They’re derived from plant chemicals, not synthesized in a
FDA-approved products (Estrace, Climara patch and Vivelle-Dot patch, and
Prometrium natural progesterone) are also derived from plants.
They’re produced in doses and forms that differ from those in
products. Some bio identical hormone products are available without a
prescription, but most require a prescription. Also, for many nonstandard
combinations, you need to go through a compounding pharmacy. Compounding
pharmacies specialize in making medications customized for individual needs,
such as inability to swallow solids or allergy to a binding agent in a tablet.
However, products from compounding pharmacies have not been subject to the same
rigorous quality assurance standards that standard commercially available
hormonal preparations have to meet.
They’re custom made for you, based on a test of your saliva to
unique hormonal needs. Unfortunately, however, the hormone levels in your
don’t reflect the levels in your blood or correspond to menopause
Some women may benefit from nonstandard doses and forms of
bio identical hormone preparations, but there is almost no scientific support
an advantage of these compounds over common commercially produced preparations.
So, if your symptoms are driving you crazy then talk to your
health care provider about what is best for you. What may work for you, may not
work for everyone else. But, there is something that can help you through this
time in your life. Just remember, this too shall pass!