Hormone Replacement Therapy

In this feature we will look at Hormone Replacement Therapy or HRT. For years this has been touted as the solution for women experiencing menopause, but is it safe ? This is a compliment to our section on Menopause.

The "miracle" hormone estrogen hit the marketplace in the 1960's, becoming one of the top selling drugs in North America for the treatment of menopause symptoms in women. In 1968, with financial backing from Ayerst Laboratories, Dr. Robert A. Wilson wrote Feminine Forever. The basic attitude underpinning the promotion of estrogen is summed up in the following words : " The unpalatable truth must be faced that all post menopausal women are castrates... From a point of view, a man remains a man until the very end." A multi-billion dollar business was built on the concept that menopause castrates women.

Wilson's book and it's effect on Premarin sales were the beginning of a multi-million dollar, dangerous love affair between estrogen and menopause. By the 1970's, women taking estrogen were found to have a 14 fold increase in endometrial cancer (cancer in the endometrial lining of the uterus) and a 30% increase in breast cancer. With this news, estrogen lost it's appeal for a short time. Then drug companies purported to have "solved" the cancer problems by introducing synthetic progestin. Now women who still had their uterus would be "safe" from endometrial cancer, and women who had their uterus removed during hysterectomy could keep taking unopposed estrogen, but no one discussed breast cancer rsik in those women taking estrogen alone, and it is still hotly debated today. Women were told that they could safely take estrogen with synthetic progestin (commonly called HRT) because progestin stopped the overstimulation of the uterine lining caused by estrogen. Despite the use of synthetic progestin, the looming risk of cancer continued to haunbt HRT.

HRT : The Panacea Drug :

Hormone replacement therapy is about to hit it's demographic sweet spot. With the largest number of baby boomers just turning 43 this year, it's expected that future sales will be in the multi-billions. HRT was originally developed to halt the symptoms of menopause, but doctors have also prescribed HRT to prevent cardiovascular disease and bone loss, halt teenage girls from growing too tall, relieve depression; reduce urinary incontinence, stop colon cancer and Alzheimer's, and keep us young forever. It has become the panaceaq drug for all sorts of women's conditions and is touted as the "fountain of youth", even though the safety of HRT is still being heavily debated. No randomized, controlled clinical trials have ever been conducted to suggest HRT should be used for all of these conditions, and it's safety in healthy women has never been proven. That is until now.

Last July (2002), the Women's Health Initiative study, a clinical trial designed to determine if HRT was beneficial to healthy women, was halted five years and two months into the study due to serious safety concerns. This study, which was supposed to last eight years, involved 16,608 healthy, post menopausal women who were at low risk for heart disease. The women received 0.625mg of equine (horse) estrogen (Premarin) along with 2.5mg of synthetic progestin for 5.2 years. Premarin (made by Wyeth-Ayerst) contains estradiol plus at least two or more horse estrogens, such as equilin and equilenin. The study concluded that the combination of estrogen and progestins posed a significant health risk to women and that any benefits from HRT were not worth the side-effects. The study found a 41% increase in the risk of stroke, a 29% increase in the risk of heart attack, a doubled risk of blood clots, a 22% increase in cardiovascular disease, and a 26% increase in the risk of invasive breast cancer. Nix the Premarin.

Medicalization of menopause :

How could this hormone craze go on for so long ? The simple answer : We have medicalized menopause. Physicians have been trained to treat menopause as a disease ( see Different Way ) of the endoctrine system that requires drugs to return a woman's hormone levels to "normal", and to believe that all women need estrogen for optimal health during the menopausal years.

Menopause is not a disease but a normal process in a woman's life; it is not an estrogen deficiency disease. Some women sail through menopause with no symptoms whatsoever; others are debilitated by hot flashes, night sweats, memory problems, mood swings, insomnia, weight gain and more. When our ovaries take a rest, our adrenal glands should kick in and produce some estrogen. If we have not taken care of ourselves in the decades before menopause, our adrenal glands may become exhausted and be unable to help support estrogen production. We may also have a clogged-up liver from years of exposure to prescription drugs, stress, bad food and environmental poisons. Our liver is essential to the processing and packaging of our hormones, so if it is clogged, it can't help during menopause either. Let's treat the cause of nasty menopause symptoms by returning our liver and adrenals to a healthy state with foods and nutrients. The following five steps can help balance your hormones and ease menopausal symptoms.

Step One :

Eat a diet rich in cruciferous vegetables such as broccoli, brussels sprouts, cauliflower, cabbage and kale. You should have at least two 1/2 cup (125gram) servings per day. Cruciferous vegetables contain indole-3-carbinol and sulforaphane, important nutrient for maintaining balanced hormones in our liver whle reducing our risk of breast cancer. Add flax seeds, fennel, chick peas, lentils and soy to your diet for their hormone balancing action.

Step Two :

Walk briskly swinging your arms. Walking briskly every day for thirty minutes cuts hot flashes by 50%, while improving your heart and bone health at the same time. If you are having trouble sleeping, take 100mg of 5-HTP (5-hydroxytryptophan, a precursor to serotonin, the "sleep" hormone") three times a day, at breakfast, dinner and before bed to improve your mood and aid restful sleep.

Step Three :

Take black cohosh, dong quai, viyex, red clover, gamma oryzanol and wild yam to reduce night sweats, hot flashes, vaginal dryness, heavy erratic periods, mood swings, weight gain and sleep disturbances. Your health food store carries a variety of menopause formulas containing different combinations of these herbs. Take a multivitamin with minerals every day along with essential fatty acids and bone-building nutrients to ensure your heart and bones are protected.

Step Four :

Eat breakfast every day. More than 40% of women do not eat breakfast. Research has shown that women who skip breakfast are at higher risk of heart disease. Eatinig a protein rich breakfast ensures you have adequate amino acids to make the mood-enhancing and sleep-enducing serotonin. (see Alternative Proteins)

Step Five :

Reduce the stress in your life. Have a massage at least once a month. Start looking after yourself. Do one thing you love to do at least once a day. Tell your loved ones you "need" extra love, attention and help. It is OK to ask.

If you are a young woman reading this, start taking care of yourself today so that your body is ready for the change. If you are in menopause and suffering, adopt all five steps to regain healthy hormones, vitality and optimal health (see Optimum Health) If you are taking HRT, start weaning yourself off the drug while adopting the recommendations above (ED: it is best to do this with the guidance of a naturopathic practitioner). Do not fall into the trap that menopause is a disease that has to be treated with harmful prescription drugs. Embrace menopause; no more periods, freedom from pregnancy, and this is a time to focus on you.



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