Hormone replacement therapy

Some women benefit from hormone replacement therapy, but most women would be better off using natural alternatives

Woman thinking

Forty-seven-year-old Joyce, an art director, had been experiencing hot flashes. After a trip to her gynaecologist, she was told that she was experiencing symptoms of menopause. "My gynaecologist started telling me what would happen to me next," Joyce said. "The menstrual decline that would occur; the bone loss, heart disease, and sexual dysfunction. She wanted to start me on hormone replacement therapy right away."

Joyce first came to me looking for an alternative. She had heard of treatments for a variety of ailments, from cancer to diabetes and asthma. She was glad to learn that there are a number of alternative choices for women seeking to avoid prescription medication for post-menopausal syndrome [PMS]. In fact, natural oestrogen alternatives are beneficial for a host of conditions, including PMS and irregular menstrual cycles.

When I put Joyce on natural oestrogen programme, she was sceptical. But, a change in her diet, along with a supplement programme, did the trick. After six weeks she was relieved of her hot flashes and most of her other symptoms. "Why doesn't anyone know about this treatment?" she asked.

Good v/s bad

You've heard of "good" and "bad" cholesterol. Just as there is good and bad cholesterol, there are "good" and "bad" oestrogens. Bad oestrogens are responsible for the promotion of tumours, and are found in high proportions in synthetic oestrogen used in birth control pills, or prescribed for the "treatment" of menopause. Bad oestrogens contain low amounts of a substance called oestriol, and a higher amount of oestradiol. The ratio of oestriol to oestradiol determines whether oestrogen is harmful or not.

Good oestrogens, containing a high amount of oestriol, are found in a wide variety of foods, including raspberries, strawberries, soybeans, sweet potatoes, yams, and eggplants.

Isoflavones, for example, are one of the good natural oestrogens, found in soy, a staple of Japanese diet.

Incidentally, Japanese women have one-fifth the risk of breast cancer as do their Western counterparts.

Isoflavones appear to block angiogenesis - the process by which new blood vessels are formed. The blockage of angiogenesis hinders the growth and spread of tumour cells.

Japanese women also experience very few menopausal syndromes. At one time, this was believed to be due to the stoical nature of the Japanese. That view has now changed, and the absence of symptoms is attributed to the Japanese diet, where the main ingredient is soy. A cup of soy contains approximately the same amount of plant oestrogen as the body produces in one day. Different types of soy products, such as soy milk and tofu, have different amounts of natural oestrogens, tofu being the highest.

Other weapons in the fight are IC3s. IC3s, or, Indole-3 carbinols, present in broccoli and cabbage are subject of intense research. IC3s in low doses appear to prohibit oestrogen from breaking down into harmful metabolites. Natural oestrogens are "weak" oestrogens, meaning they bind to receptors but produce minimal side-effects. Unlike what is commonly believed, weak oestrogens are not beneficial to women alone; it appears to serve both sexes.

Studies in Japan, where plant oestrogens are consumed extensively, indicate that prostate cancer is nearly non-existent among Japanese men, and that the incidence of breast cancer in Japan is among the lowest in the world. The same goes for heart disease, since natural oestrogens present in many plant foods appear to act as powerful anti-oxidants, preventing free radical damage to lipids. They, therefore, help in preserving the lining of the arteries. Natural oestrogens are present not only in plant food, but in supplements as well, offered by many pharma companies.

Nature, the best healer

Oestrogen replacement therapy is now prescribed only for women who have had hysterectomies, since oestrogen alone has been shown to increase the risk of cancer of the uterine lining. Progestin, a synthetic that acts as progesterone, is added to prevent endometrial cancer. However this may be, synthetic progesterone can cause adverse side-effects, including breast tenderness, and skin sensitivity. Progesterones are present in many foods containing natural oestrogens, so alternatives need to be considered.

Natural progesterone has shown to raise HDL cholesterol - the good cholesterol - more than synthetic progesterone. Natural progesterones are available in some pharmacies.

Experts suggest the possibility that plant oestrogens, and possibly progesterones, might be reasonable alternatives to synthetic derivatives, currently in vogue.

Most women can avoid oestrogen replacement therapy by following a regimen that includes high calcium intake, regular exercise, and diet rich in foods containing natural plant oestrogen and progesterone.

[Note: Oestrogens, whether synthetic or natural, may promote the growth of hormone sensitive tumours. Women are strongly advised to seek medical advice prior to beginning any treatment].

Hormone replacement therapy [HRT] became popular in the early 1990s after numerous studies showed that it could prevent osteoporosis and reduce the risk of heart disease in women. Oestrogen replacement therapy has been sold to the public as an elixir of youth, making synthetic oestrogen the #1 drug sold in the US [Oestrogen replacement therapy uses oestrogen alone; hormone replacement therapy is oestrogen combined with progestin - a synthetic that acts like progesterone]. However, synthetic hormones come in a package along with potential risks.

A landmark study of over 70,000 nurses published in The New England Journal of Medicine, found that women taking oestrogen replacement therapy for longer than five years had a 40 per cent increased risk of breast cancer, a percentage that increased steadily the longer oestrogen was taken.

There is much debate in the medical, or healthcare, community on whether every post-menopausal woman should take oestrogen replacement, or hormone replacement. While there are some women who may benefit from synthetic oestrogens, most women would be much better off using natural plant alternatives.

Menopause typically begins by the age of 50. However, it can start as early as 30s. When the body's production of oestrogen and progesterone decreases, menstruation stops. After one year without a period, a woman is said to be going through menopause. This can be confirmed through laboratory tests. It should, however, not be confused with other syndromes where a normal cycle ceases. Symptoms of menopause often include hot flashes, sexual dysfunction, as well as impaired daily functioning due to pronounced vasomotor reactions.

One of the most subtle messages that women receive is that menopause is a medical condition. This classification has allowed "treatment" protocols to be developed. These treatments, as already cited, may be harmful. Most women should avoid oestrogen replacement therapy altogether if they take certain appropriate measures, in consultation with their therapist.

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Richard Firshein
Richard Firshein, DO, is Medical Director of the Firshein Center for Comprehensive Medicine in New York City. A leading authority in the field of preventive medicine and medical nutrition, and Board Certified in Family Medicine and authorised medical acupuncturist, Firshein’s groundbreaking books include: Reversing Asthma, The Nutraceutical Revolution, and Dr Richard Firshein’s ‘Breath of Life’ Program: 7 Steps Towards an Asthma Free Child.

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