Menopause – Hormone Dysregulation
Due to the early termination of the National Institutes of Health (NIH) research on Hormone Replacement Therapy (HRT), many women who are either on HRT, or are considering it, have a difficult decision to make. Whether or not to go on HRT is a critical decision because estrogen imbalance is responsible for many of the adverse effects associated with menopause. Estrogen may be, on occasion, a woman’s best friend, but its fluctuation throughout life causes a host of problems for some women. It has been documented that in the United States, synthetic estrogen pharmaceuticals are among the most commonly prescribed and dispensed drugs in community practice. However, there are significant risks associated with this form of therapy. The NIH study (Press Release: Tuesday July 9, 2002) and additional studies, including several published in theJournal of the American Medical Association (JAMA) and in the New England Journal of Medicine, have indicated that the risks associated with HRT far outweigh the benefits. Some of the adverse side effects associated to long term use of HRT are invasive breast cancer, ovarian cancer, endometrial cancer, endometriosis, heart attack, stroke, blood clots, insulin resistance, type II diabetes, adult onset asthma and a wide range of other frequent adverse effects, such as abdominal bloating, migraine, or other kinds of headache, weight gain, anxiety, depression and breast tenderness. With these obvious, documented risks, alternative therapies to HRT should be considered before any decisionis made. Some of the Natural Alternatives to Hormone Replacement Therapy Women who decline to use HRT may choose from a variety of natural remedies that are available. These include: plant hormones called phytoestrogens, which are found in soy based products, and herbs such as black cohosh, ginseng, dong quai, and licorice root which have been used safely for centuries to eliminate menopausal symptoms. Past research has indicated that phytoestrogens may prevent heart disease, and slow bone loss without the risks associated with HRT. Creams containing wild yam extract offer enzymatically converted hormones with molecular structures that are identical to what the body produces. Menopausal symptoms such as hot flashes and vaginal dryness can be addressed using these bio-identical natural hormones. Natural versus Synthetic Estrogens: To test the effect of natural estrogens, called phytoestrogens (found in soy foods and herbs such as Black Cohosh), researchers at Tufts University School of Medicine in Boston exposed estrogen-dependent breast-cancer cells to a variety of synthetic estrogens (the same hormones found in traditional hormone replacement therapy). They found that the synthetic estrogens promoted cell proliferation in the breast cancer cells, while the natural estrogens inhibited breast cancer cell growth. Nutrition and Cancer, 1998;30;232-9. The Benefits of Soy Isoflavones in Menopause: Considerable evidence appears to indicate that soy isoflavones in the diet exert “weak” estrogenic effects that may confer anti-aging benefits, help prevent bone and joint disease, and cancer. They also promote cardiovascular wellness, help to maintain a healthy urinary tract, and modify the symptoms of menopause. Earl Mindell, PhD, in his popular consumer book titled Earl Mindell’s Soy Miracle, points to the value of soy in suppressing menopausal symptoms. Dr. Mindell clearly reports the results of studies by Canadian researchers of Japanese women where menopausal complaints such as hot flashes are much less prevalent in Japanese than Western women. Dietary supplementation with soy phytoestrogens offers a possible alternative to the commencement of synthetic hormone replacement therapy with all its known drawbacks. The prospect of using a natural means with soy isoflavone supplementation to reverse these adverse associations of menopause is very exciting.Phytoestrogens for a Healthier Menopause by Steven Holt, MD published in Alternative and Complementary Therapies-June 1997. The Benefits of Natural Estrogen and Progesterone Creams in Menopause Transdermal cream of naturally derived progesterone and estrogen can be useful in coping with the symptoms associated with the decrease in hormone production during perimenopause, menopause, and following a hysterectomy. The formula should be designed to match the natural pattern of circulating estrogens found in the female body; 80% estriol, 10% each of estrone, and estradiol. Progesterone should be no less than 480 mg per ounce of cream. The advantage of transdermal application is better absorption. It goes directly into the bloodstream, thereby bypassing the problems associated with poor digestion and liver breakdown that can occur with oral supplementation. Wright, JV., Morgenthaler, J. Natural Hormone Replacement. Smart Publications, Petaluma, CA, 94955, 1997. Lee, JR., Hopkins, V. What Your Doctor May Not Tell You About Menopause, Warner Books, Inc., 1271 Avenue of Americas, New York, NY 10020, 1996.
Naturopathic Approach to Menopause
A naturopathic approach to treating someone in menopause, would start with a complete hormone panel to evaluate the current status of the hormones, to know what treatment would be most beneficial to bring the hormones back into balance. Although it is common for most post- menopausal women to have no detectable amounts of most sex hormones, we know that that is not normal. Normal is that females should have detectable amounts of all of the sex hormones well into old age. Why it is common to not have detectable amounts of sex hormones, is that, when the ovaries “time out” it is up to the adrenal glands to kick in the extra hormones. If the adrenal glands (which are responsible for producing all of our stress response hormones) are worn out – it’s like trying to get water out of a rock. They have nothing to give and the sex hormones register non-detectable. Therefore the long term treatment is to nourish and replenish the adrenal glands, while the short term treatment is to get some hormones back into the body! This can be done through the use of bio-identical hormones or natural botanical hormones. The hormone panel is then re-tested 6 months later to see if the appropriate balance has been established. As the adrenals are replenished and start producing the sex hormones on their own, the use of bio-identical or botanical hormones will be discontinued.