BETWEEN A ROCK AND A HOT FLASH:
A Look at Hormone Replacement Therapy
By Marleen M. Quint
Women’s Health Advocate
You Wake-Up in the Morning
You wake-up in the morning in sweat-soaked sheets; you’ve been told your bones are becoming as brittle as glass; your blood pressure, cholesterol and weight are up but your energy is down; if you cough, sneeze or laugh too hard you run the risk of springing a urinary leak--welcome to female middle-age.
It’s okay for me to point out that we’re getting older but lord help me if I slip and use the word "old." No one gets old anymore. We get preserved like pickles or jam. The smile we wear may be the unwanted side-effect of a Botox treatment rather that the reflection of happiness while we suffer silently in the often lonely and nightmarish world called menopause.
What's Out There to Help?
And what’s out there to help us through this process?--nothing encouraging. If menopause isn’t being treated like a demonic form of sorcery from the Middle Ages it’s being treated as an insignificant physiological female event. It’s only when Corporate America can make a profit from female suffering that the subject gets any attention.
It wasn’t until Feminine Forever was published in 1966 characterizing menopause as a female disease that the medical industry took an interest in menopause as a significant medical event. The book was funded by the drug company Wyeth-Ayerst (now known as Wyeth) who just coincidentally had the patent on Premarin, an estrogen hormone replacement for menopausal women. While the medical industry was touting the miraculous rejuvenating powers of estrogen therapy, they were also suppressing data that the use of estrogen therapy caused an increase in uterine cancers.
The Debate Over Hormone Replacement Therapy
Hormone Replacement Therapy (HRT) has never offered women any real choices. Whether you chose HRT or not , it has always been a game a Russian Roulette. No matter what your choice, you know you’re playing with a loaded gun that could go off at any time. While women suffer, drug companies and many other industries continue to make record profits.
The debate over the safety of synthesized HRT has been ongoing for many years now. There has been a systematized push to sanction HRT as the fountain of youth for the aging woman and the only cure for what ails her. This has proven to be, what I believe is, a hoax perpetuated by industry and government which has discouraged more in-depth research in the area of female endocrinology.
There have been studies dating back to the 1950’s indicating serious risk factors with the use of both estrogen replacement therapy (ERT) and the more commonly prescribed combination of estrogen and progestin which I will refer to as combination HRT. It wasn’t until the study results of the Women’s Health Initiative (WHI) in 2002 that the final word was declared on ERT and combination HRT. Follow-up with the women participating in these studies should continue until 2007. Both ERT and combination HRT have significant risks that outweigh their benefits. The study revealed increased disease risks including Alzheimer’s, endometrial cancer, breast cancer, blood clots in lungs, heart attack, stroke and dementia. These therapies also showed less benefits in reducing the risk of osteoporosis.
Okay, so that means doctors will prescribe safer, naturally-occurring hormones that are now on the market, right? Wrong. Because of resistance to researching naturally-occurring hormones, safety claims of natural hormones are not currently backed by science. To make things worse, because allopathic medicine is designed to primarily treat symptoms, most doctors are not knowledgeable in the areas of nutrition and alternative medicine. Therefore, doctors aren’t really qualified to effectively advise a lifestyle regime that would significantly help a menopausal woman other than prescribing drugs.
Hope Lies Within The Community As depressing as this all sounds, there is hope. The hope lies within the community of women themselves not in industry or government. I think most of us have figured out that much.
The power of positive thinking is a critical element before beginning this journey. Think of menopause as a disease and you are doomed to follow the narrow road of allopathic medicine. Think of it as a normal passage in a woman’s life and you become empowered and open to a world of possibilities.
At this point, I can hear many of you saying, "Well, this all sounds peachy-keen in theory but where do I find the right answers and how do I know I’ve found them if and when I do?" Part of the answer is deciding to take charge of your own health. You need to decide that even though you may not have the answers now, you do have the ability to find the answers and know you’ve found them when they work for you. Listen less to the blather of drug company marketing and the allopathic practitioners that serve them and more to your own internal wisdom. Remember, no matter how educated a doctor is, he will never know your body as well as you do. You have the advantage of first hand experience; he never will. Learn to hear your own voice over the chaos.
I am a middle-aged woman myself who has battled for the integrity of her body and mind and continues to do so. I have suffered with cancer, endocrine disease and cardiovascular disease, yet, I have avoided both synthetic and natural HRT and plan to continue to do so unless given no other choice. My intention is to share with the reader information I have acquired along the way offering non-traditional options that have worked for me and many other women. This will include information on various approaches to minimize the stress, symptoms and health risks during and after menopause.
Possible Therapy Options
I’d like to offer possible therapy options broken down into four categories: 1) Synthetic Hormone Therapy 2) Natural Hormone Therapy 3) Dietary Supplementation. 4) Weight-bearing exercise. These categories are purely an arbitrary design of my own to facilitate recommendations. I believe there is a helpful regime possible for most women if they can figure out how to balance theses four options.
Synthetic Hormone Therapy
When I speak of synthetic hormones I’m primarily referring to unopposed estrogen or combination estrogen and progestin (progesterone) that is derived or processed synthetically.
There was a sudden drop in HRT sales shortly after the WHI study results were made public. By 2004 HRT sales, which had previously leveled off, began an upswing. Women were demanding hormonal alternatives but doctors were only equipped to prescribe the age-old hormones that were now confirmed to cause more risk than health benefits. What to do? Drug makers introduced a low-dose version of HRT products and began a new marketing campaign. This is the "new" HRT currently being promoted.
Natural Hormone Therapy
Estriol - Often promoted as a "good" and safer estrogen that doesn’t promote edometrial or breast cancer. There is currently no scientific evidence for these claims. It is often prescribed by alternative practitioners. These same practitioners also promote a mixture of natural human estrogens called tri-est, a composition of estrone, estradiol and estriol.
Natural Progesterone - Usually available in cream form that’s applied to the skin. There are claims it can prevent hot flashes, osteoporosis and even breast cancer. Dr. John M. Lee has almost single-handedly promoted natural progesterone as a means to balance a woman’s otherwise estrogen dominant hormonal system and claims that natural progesterone has none of the side effects of synthetic progestins.
Although there does seem to be some benefit from natural progesterone over synthetic progestins, the jury is still out on whether it is safer and more efficient than its synthetic counterpart.
Phytoestrogens - This is a nutritional estrogen from plants. Phytoestrogens are a much milder form of our own bodies estrogen. There are a number of phytoestrogen sources. I will discuss a few beginning with what I believe to be the best source of phytoestrogen and the easiest to incorporate into a nutritional menu.
* Tofu - In my opinion, tofu is the best and easiest source of nutritional estrogen supplementation. Today tofu is available at almost any grocery store.
I know, I know. It’s tasteless and you don’t know how to prepare it to make it palatable. Well, I do and it’s so simple. Here goes:
Buy a block of very firm tofu from your local market or health food store. It can be in a plastic tub of water or wrapped in plastic with very little water. I prefer the tofu wrapped in plastic with less water because it’s firmer and gets to the consistency of meat faster when frying. I live in California and have many choices -- you may not.
Cut tofu in bite-size, half-in cubes while a frying pan with a little olive oil is heating. Throw the tofu in the pan with soy sauce. As it’s frying, add the flavors you like in your favorite meats such as garlic, herbs, chicken or beef broth, more soy sauce, etc. Season generously. Tofu seems to soak-up salt and other seasoning flavors. Stir tofu every couple of minutes while adding more seasoning as necessary. The longer you fry tofu the drier and more "meat-like" it becomes. Keep frying until desired taste and consistency is achieved. Use tofu as you would any other meat, over pasta, in omelets, salads, soups, etc. You’ll be amazed how versatile and tasty it can be.
One block of tofu makes enough for two meals, sometimes more. I would suggest frying up an entire block at one time and refrigerating what you don’t use. You can then add it to salads an entrees as needed.
You can also get a very creamy version of tofu called silken tofu. It has the consistency of custard pudding and is great in smoothies in place of yogurt.
* Soy Beans - In some grocery stores you can buy whole soy beans in the pod or shelled. They can be added to salads, soups, stir-fry or eaten them raw like nuts.
* Soy Milk - You can use soy milk in place of regular milk for just about everything and anything you want. Even just replacing regular milk for soy milk in your coffee or tea can add significant phytoestrogens in your diet.
* Tempeh - This is a fermented cooked soybean with a nutty mushroom flavor. You can easily substitute meat or mushroom recipes with tempeh. At one time it was only possible to find tempeh in natural foods and Asian stores but tempeh is now becoming more available in supermarkets.
Vitamin and Mineral Supplementation
* Vitamin B Complex - I’m amazed at how seldom vitamin B supplements are recommended by doctors these days to ease the stress and symptoms of menopause. As a menopausal woman myself, I can’t imagine surviving without a vitamin B Complex supplement.
I remember when my mother was going through menopause back in the 60’s, her doctor gave her vitamin B shots occasionally when she was crying and jumping out of her own skin. It helped her a great deal.
For perimenopausal and postmenopausal women I would recommend a super vitamin B Complex which includes B2, B6 and B12.
* Vitamin E - Helps to alleviate hotflashes.
* Calcium, Magnesium & Zinc - Relieves nervousness and irritability. Protects against bone loss (osteoporosis).
There are too many for me to discuss them in depth but I can list some herbs known to minimize the effects of menopause. There are a number of herbal supplements that combine herbs specifically designed for menopausal women. Each woman is different so trial and error would be the only way to see if any of these individual herbs or combined formulas would work for you. Keep in mind that even though herbs are usually milder than drugs, they still have a pharmacological effect which can include adverse side effects.
Here are a list of some herbs known to help alleviate menopausal symptoms: black cohosh , camomile, dong quai , fennel, flaxseed, ginseng, gotu-kola, ginko, green tea, licorice, passion flower and sarsaparilla.
Foods To Avoid
* Coffee, alcohol, salt and sugar - It usually isn’t necessary to completely eliminate these foods, however, it is a good idea to minimize them as much as possible. Coffee and alcohol encourage hotflashes, sugar encourages yeast infections and salt causes water retention.
Weight-bearing exercise and taking a calcium-zinc-magnesium daily supplement is probably the best and safest way to prevent calcium bone loss during menopause. It is usually not necessary to take synthetic hormones to prevent bone loss if you do incorporate a weight-lifting or weight-resistance regime in your daily or weekly routine. Factor in good nutrition along with the proper vitamin-mineral supplements, and you have a safer and more effective alternative to HRT.
* If you’re currently on synthetic HRT, try to slowly transition to natural HRT. Natural hormone replacement hasn’t been proven to be safe but we are certain that synthetic hormones do carry significant risks. Some natural HRTs are available over-the-counter so women have more control over how much they take and when they take it.
If you are among the very few and fortunate who has a physician who is familiar and supportive of natural HRT, then, by all means, work with your physician. But, if you do not have a good rapport with your physician and you would like to consider natural HRT, I would seek out a physician in alternative medicine or begin researching and experimenting on your own. Remember, currently, physicians don’t really have a clue.
* Diet modification and nutritional supplementation can make or break the menopausal process. Whether you are on an HRT regime or not, adding nutritional phytoestrogens with vitamin and mineral supplementation can possibly replace the need for HRT. At the very least, it can smooth out the rough edges during the menopausal process while you are at the helm calling the shots.
You’ve heard the saying, "Old-age ain’t for sissys." I think they specifically had menopausal women in mind when making that statement. The transition from being a reproductive female to a productive female who no longer reproduces is at least a difficult if not a harrowing process.
Science has no real interest in learning and understanding the female endocrine system for the sake of women. If it benefits mankind, great; if it benefits womankind, what’s the point?
Government has even less interest in helping women understand and control their own bodies. It’s the governments job to keep the status quo, also known as ‘The Good-Ole Boy’ system. It’s called that for a reason--girls ain’t allowed in this club.
What I’m trying to say is, "Ladies, we’re on our own." The only people looking out for us is us. But, Hey, that’s saying a lot. Women are the largest underrepresented group in the world. We need to begin by connecting with each other and building a communication network. We then take the power of that network to educate the masses. If enough of us forfeit the current disease approach to menopause which medicates and manipulates, then we have a good chance of finding the approach that nature originally intended. Laws and policy change usually follow.
Change doesn’t happen overnight but the hormonal revolution is already happening. Women have long been caught between a rock and a hotflash. The squeeze has recently become so tight, we can no longer breathe. If the powers that be won’t open the right doors for us, then, I guess, we’ll just have to kick-in a few doors ourselves.
If you have any comments or experiences that you would like to relate to us regarding this subject, please contact Marleen at MQhealthpge@aol.com
PLEASE NOTE: The above article must not be published in either electronic form, or print, or be edited or otherwise altered or used without the express permission of the author Marleen M. Quint. All rights reserved. www.wildcelt.com. 2005
References and Resources:
Taking Hormones and Women’s Health. National Women’s Health Network, 2000
Menopause and Hormone Replacement Therapy: Difficult Decisions in Uncertain Times. The Network News, Nov/Dec 1999
Hormones and Heart Disease: Medical Bias Disregards Best Evidence. The Network News, Sept/Oct 2000
Women’s Health Initiative http://www.nhlbi.nih.gov/whi
Hormone Havoc, Michelle Depoali http://www.newsreview.com/issues/reno/2003-11-06/cover4.asp
Menopause Info & Alternative Treatments AltHealth, June 10, 2005 http://www.althealth.co.uk/services/info/ailments/menopause1.php
Marleen M. Quint
Originally from Hawaii, Marleen was also raised in Japan and Guam. Her background is extremely eclectic and ranges from working in the field of cartography to performing as a singer, dancer and actress.
In 1990, Marleen was diagnosed with thyroid disease followed by breast cancer less than two years later. She lost both breasts and her thyroid with no family history that would predispose her to either disease. After much research, Marleen is convinced that environmental pollution played a significant role in the development of her life-threatening diseases.
Since 1995, Marleen has dedicated herself as a women's health advocate. She has served as a consultant for several health organizations including the National Cancer Institute in Washington, DC and UCSF Mt. Zion Cancer Center in San Francisco.
Marleen has combined her skills to develop a women's health presentation which delves into the connections between the politics of gender bias and the level of morbidity suffered by women. Marleen is an active speaker in the San Francisco Bay Area.