Alternatives to HRT

The beginning of the end or the end of the beginning?

Women taking the combined oestrogen/progestagen form of HRT are at much greater risk of developing and dying from breast cancer, according to the Million Women Study published in last week's medical journal, The Lancet (8 August 2003). It's only a year since American scientists were ordered to stop a large study on HRT because some of the participants were developing serious illnesses like breast cancer, heart disease and strokes. This sent thousands of women rushing to their doctors wanting to know if they should stop taking their HRT. Now, there's even more reason to question what place this treatment has in dealing with the problems of the menopause.

I am increasingly concerned by the way in which the pharmaceutical industry is medicalising ordinary life events in order to create new drugs to treat these 'conditions'. How has it been possible for millions of women to be prescribed HRT with its already known risks of increased breast cancer, increased uterine cancer for oestrogen-only treatment, and increased risk of heart disease. The most important principle of all forms of health care practice is 'first do no harm', and this precautionary principle is increasingly being ignored through the heavy promotion of new drug therapies. There has never been real proof of the safety of HRT and for the vast majority of women the risks far outweigh the benefits. The Million Women Study is now irrefutable proof that safe alternatives should be the first line of treatment.

The menopause is not a disease or an illness but a natural progression that prevents pregnancy at a time when a woman's body can no longer sustain the demands of childbearing. Sadly the folk lore of the menopause means that many women approach it with fear and trepidation. They see it as the beginning of the end of their useful productive years, but nothing could be further from the truth. Freed from the tyrannies of the monthly cycle, the miseries of PMS, and worrying about conception and contraception, this is a time of freedom.

This is not the beginning of the end but the end of the beginning and the open door to a whole new life. Having a positive attitude to the menopause is the first step in overcoming the difficulties and it's certainly true that there are specific problems. Now is the time to look at all the natural alternatives to HRT and explore the many lifestyle changes which will help you sail through the potentially difficult times and avoid the long term consequences.

Once women lose the protection of their own natural hormones the risks of osteoporosis and heart disease increase dramatically and at the same time the distressing symptoms of hot flushes, irritability, memory loss, poor concentration, skin ageing and sexual difficulties start to be a problem. But the remedies are simple. Lifestyle, diet and natural supplements can transform your life.

The Power of Plants

The majority of cancer specialists have been wary of HRT for some time and most women are, for good reason, very nervous of it. HRT does have a place for women whose symptoms are life-destroying and for some the benefit may be worth the risk. But for all the others the natural approach is the only sane starting point, and that means simple changes to your diet and lifestyle, specific vitamin and mineral supplements, and plant extracts which have a direct effect on the hormone-linked symptoms.

There's growing evidence that eating regular amounts of soya-based foods - soya beans, tofu, soya milk and yoghurt - is a good way to protect yourself from many of the unpleasant effects of the menopause. In the Far East, where soy is a staple part of the diet, there's no word for hot flushes and osteoporosis is a rare condition. Soy extracts, like Estroven, contain plant oestrogens and are widely available. According to Dr. Shirley Bond, a specialist in women's health, Estroven is a valuable source of isoflavones, naturally oestrogen-like compounds, and supply at least as much as the diets in Asian countries. They're believed to be instrumental in helping the bones to stay strong.

One of the most exciting areas of research are studies of extracts of red clover. This extraordinary plant is a rich source of isoflavones, the most powerful of the oestrogen-like compounds in red clover. Unfortunately it's been hard to obtain consistent extracts as the amount of the isoflavones varies with the process, seasonal changes, and different growing conditions.

Now the availability of a standardised extract, in which every capsule of every batch contains an exact amount of the plant hormones, has resulted in a highly positive, double-blind, placebo study conducted by Johannes Huber, Professor of Gynaecology at the University of Vienna. He used Menoflavon on a group of 110 post-menopausal women who were not taking HRT. Over a three month period 81 percent of the patients reported significant reduction of their menopausal symptoms.

According to Professor Huber, "The natural active substance of red clover exhibits the effects usually achieved by the conventional hormone replacement therapy. The advantage of this new dietary supplement is that the intake of red clover had no undesirable side effects." Because Menoflavon does not alter the body's own levels of circulating hormones, there is no increased risk of breast cancer so it's suitable for women who've had the disease or who are at risk of it.

Marilyn Hazelwood, 51 from Birmingham, was prescribed HRT by her doctor nine years ago, but in 1997 she developed breast cancer which was successfully treated but she had to stop HRT. "In 1999 I had to have a hysterectomy and overnight became fully menopausal. It was difficult to cope on a day to day basis as working for the police meant dealing with the public in a predominantly male environment - not easy. Dr. David Sturdee, my consultant, told me that red clover could help with the menopause so I started taking Novogen Red Clover tablets and I've never looked back."

An EU study has found that women in the UK are getting less than 1 mg a day of natural isoflavones from their diet, compared to up to 100 mg a day for Asian women and far less than the amount needed for any hormonal benefits. Japanese women eat around 30 times more soya-based foods each day than women in the UK and as well as suffering hardly any of the obvious symptoms of the menopause, their death rate from breast cancer is 20 times lower than ours. Aria is another soya isoflavone supplement containing 50 mg of isoflavones in each one-a-day tablet.

Black Cohosh is an herbal remedy that has been clinically proven to relieve some of the most distressing symptoms of the menopause including hot flushes and night sweats. Recent research suggests that this Native American plant acts on the hypothalamus where it may help to regulate body temperature as well as sleep disturbances, nervousness and irritability.

Agnus castus (chaste berry) has been used since ancient Roman times as a treatment for hormonal imbalance. It's especially helpful to relieve the symptoms of the menopause and has also been shown to help with other hormonal problems like PMS. German research showed it was so successful at relieving the symptoms that researchers advise that it should be used in the treatment of this debilitating condition.

Many women endure bouts of depression during the menopause and the herbal remedy St. John's Wort is a safe, non-addictive and effective treatment. This herb does interact with some prescribed drugs like warfarin and cyclosporines so check with your doctor or pharmacist if necessary.

Vitamins and minerals are really valuable and a major study by Dr. Michael Brush included 157 menopausal women taking Confiance, a one-a-day supplement of vitamins B1, B2, B3, B6, pantothenic acid, and the minerals magnesium, boron, manganese, selenium and chromium. Over three months 87 percent of women with hot flushes and 93 percent of those with cold sweats improved significantly.

Osteoporosis is a major concern during the menopause but it's never too late to strengthen and protect your bones. More calcium, magnesium, zinc and vitamin D, sunlight and weight bearing exercise will all help. Get them from food by eating spring greens, green, red and yellow peppers, nectarines, or any of the dark green or yellow fruit or vegetable, chickpeas, pumpkin seeds, sardines and other oily fish, yoghurt and low-fat cheese. Here too natural hormone extracts like Menoflavon, Estroven, Novogen or Aria are important. Also take a daily calcium plus vitamin D supplement.

Loss of libido and vaginal dryness affect many menopausal women. Falling oestrogen levels reduce vaginal secretions but an active, regular sex life will delay these changes. It doesn't matter whether the sexual stimulation is the result of intercourse or masturbation, it's having regular orgasms which counts. Vitamins A and E are vital, so use plenty of olive oil, nuts and seeds, wholegrain cereals, liver, and all orange and green fruits and vegetables. Ginseng is one of the most valuable herbs for these problems and most of the other menopausal symptoms. It enhances the action of oestrogens, so making the most of what your body is producing. It also has an oestrogen-like activity of it's own so take some on a regular daily basis.

The menopause comes to every woman, though not always in later life. Hysterectomy, the removal of ovaries, anorexia, extreme physical exercise and some illnesses can all trigger an early menopause. No matter what your age start using these natural remedies and make simple changes to your diet as soon as possible, and for maximum protection make sure you include as much soya based food as you can on a regular daily basis.

As a Naturopath I've never been a great supporter of HRT especially when there are many safe natural remedies that encourage nature to achieve its own healing balance.