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HRT & You: What Next?
Hormone Replacement Therapy includes the use of both estrogen and progesterone
and sometimes androgen, a male hormone. Estrogen used alone is known as ERT or Estrogen Replacement Therapy. Estrogen first became available in the early 1940's. It became popularized in the 1960's after gynecologist, Robert A. Wilson published his book titled: "Feminine Forever". His book was soon distributed to doctor's offices throughout the country by Wyeth Ayerst sales reps. By the mid 70's it became evident that women using estrogen began to show a significant increase of endometrial cancer. Doctors stopped prescribing estrogen for women, except for those who had hysterectomies and therefore not at risk for endrometrial cancer. The pharmaceutical companies then came up with a progestin (synthetic progesterone) called Provera to protect a woman's uterus. These synthetic hormones are not the same as those found in a woman's body. The most recent studies have shown a significant increase in breast cancer risk and also, after years of saying the opposite, the American Heart Association (AHA) is recommending that (HRT) should not be initiated for secondary prevention of cardiovascular disease (CVD) in postmenopausal women, (JAMA, Vol. 286 No. 8, August 22/29/2001 - "New Advice For Women Patients About Hormone Therapy & The Heart.") |
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Premarin (from Wyeth-Ayerst) has been around as a menopause treatment for
decades. Although worldwide sales of the drug are estimated at over $2 billion last year (and may grow to nearly $4 billion by 2002), many American women know little or nothing about this (or other treatments) to relieve menopausal symptoms. In the U.S., for example, only about a third of the 40 million women aged 50 and over seek treatment for menopause-related conditions.
Premarin used to be prescribed only for the treatment of menopausal symptoms such
as hot flashes, night sweats and mood swings, but it is being used more now for prevention of heart disease and osteoporosis.
Extracted from the urine of pregnant horses, Premarin is a complex mix of at least 10
natural estrogens and other active components - most of which have never been fully characterized. As such, no generic versions of Premarin are available, but several related treatments can be found. For example, compounds isolated from soybeans and yams have been shown to be effective in treating many of the symptoms that come with menopause (hot flashes, night sweats, mood swings). Like prescription medications, these plant-derived extracts may also have heart, bone and cancer- prevention benefits in addition to their effects in relieving menopausal symptoms - yet with few of the side effects commonly reported for hormone replacement therapies. |
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What are my options?
Not doing anything is an option. The first thing for women to know is that you have
different options. If you aren't bothered by hot flashes, night sweats, insomnia or vaginal dryness, you can choose to do nothing. More than likely, your doctor will tell you to get on HRT regardless of whether you are experiencing any symptoms of menopause. Many women who were symptom-free before HRT begin to have side effects after they go on HRT such as: weight gain, bloating, leg cramps, headaches, migraines, breast tenderness, changes in sex drive, etc. However, you can be assured if you ask your doctor "could Premarin (or any other prescribed synthetic HRT) cause these side effects, he will tell you emphatically "no".
Life Style Changes - The American Heart Association recommends the tried and
true approach: women should attempt to reduce their risk factors through such lifestyle modifications as smoking cessation, increased exercise and weight loss and if needed, medications to improve cholesterol levels and lower elevated blood pressure. Regular exercise has been shown to reduce the frequency and severity of hot flashes, improve circulation, reduce blood cholesterol levels and relieve stress.
Adopting a Low Fat, High Fiber Diet - with at least 5 to 9 servings of fruits and
vegetables and reducing animal protein is one of your best defenses against heart disease, stroke, cancer, diabetes, arthritis and cataracts. While it is important to reduce saturated fat, it is also important to include the "healthy fats" found in Omega 3's in flaxseed, flaxseed oil and cold water fish, which are all beneficial. Consuming tuna, sardines, herring, salmon or mackeral several times a week can lower cholesterol and the risk of heart disease and stroke, relieve the pain associated with inflamed arthritis joints and combat depression. Limit animal protein and red meat in particular as it is high in phosphorous as are carbonated drinks such as colas and other sodas. Phosphorous can cause the excretion of calcium from your bones.
Women in Asian and Mediterranean regions seem to have an easier time both
physically and emotionally. These cultures value the experiences and wisdom that comes with age, whereas in the West, it is stigmatized as something to dread and fear. Research has found the lack of physical symptoms in these other cultures is due to their high intake of phytoestrogens such as legumes, soy and chickpeas. Incorporating soy into your diet can relieve many menopausal symptoms. Soybeans are rich in isoflavones and phytoesterols. Synthetic hormone replacement has been linked to increasing rates of cancer. Studies show that Japanese women who eat an average of 30-50 grams of soy a day (150-200mg of isoflavones) have a relatively low rate of hormone-related cancers. Several years ago the FDA listed soy as a cholesterol lowering product. Soy has been shown to reduce the risk of breast cancer. Studies have also shown soy to help increase bone density and bone mineral content. You can include soy in your diet by consuming soy milk, tempeh, tofu and soy cheese - all are rich in isoflavones. If you do not particularly care for the flavor of soy, you can get a soy formula from a health food store. |