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Natural solutions for estrogen

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AUG 23
Bye to hormones and back to herbs for hot flushes


THIS must be a trying time for menopausal women. The hormones prescribed to help them tide over that difficult period are now believed to do more harm than good.

A landmark American study just out shows that these pills, containing female hormones oestrogen and progesterone, make women more likely to have breast cancer, heart attacks, blood clots, strokes and dementia.

Introduced 60 years ago, its use took off in the 1980s when it came to be seen as the fountain of youth. Perhaps this was why actresses like Elizabeth Taylor continued to look like stunners well into their 50s and 60s.

Menopause occurs when a woman has her last period - when her ovaries stop releasing eggs. On average, this happens around the age of 50 when she passes from the reproductive to the non-reproductive years of her life.

Usually, this is a gradual process but as menopause approaches, the production of hormones by the ovaries slows down and may become erratic.

As a result, menstrual periods become irregular, sometimes bunching much closer together, sometimes getting much further apart.

These fluctuations in a woman's hormones lead to bodily changes, just as they did during her adolescence, only these changes may be more intense now.

Most bothersome of all, there are hot flushes. The woman experiences sudden waves of heat in the upper body that begin with a tingling sensation in the fingers or rapid heart beats.

Next, the skin temperature rises rapidly, sometimes even causing redness in the face. She sweats profusely in the process.

These flushes can last from half to five minutes and if they happen during sleep, drenching sweat can soak the bedding.

However, they tend to be very uncommon five years after menopause.

Such women may also have achy joints, urinate too frequently and have a dry vagina. They could become moody, concentrate or recall less well than before, and may complain of headaches a lot.

These are very real problems that in 10 to 15 per cent of cases need medical attention. But still, they are a temporary phase.

The mood changes and hot flushes may last two or three years, while vaginal dryness and changes in sexual desire may persist after menopause.

As they age, all women do face higher risks of heart disease and osteoporosis (or thinning and weakening of bones with age until they fracture too easily) after menopause.

In fact, it was largely in a bid to stem these problems that doctors first prescribed hormones to replace those that the ovaries no longer produce enough of.

Over the years, even when studies showed a heightened risk of breast cancer, doctors continued to reassure their patients that hormone replacement therapy (HRT), as it was called, promised significant benefits.

These included, they said, protection from heart attacks, osteoporosis, stroke and dementia.

Until last week - when a long-running study called the Women's Health Initiative published its final findings in the prestigious New England Journal of Medicine.

It read like a litany of horrors.

In women receiving HRT drugs, the incidence of heart attacks rose by 29 per cent, breast cancer by 26 per cent, stroke by 41 per cent, blood clots by 111 per cent, and dementia by 105 per cent.

To be sure, there was a 37 per cent decrease in colon cancer and 33 per cent drop in hip fractures. They were only marginally better when it came to hot flushes, sleep and physical functioning.

These findings were no fluke. They were replicated in a British effort, The Million Women Study, published in an equally prestigious journal, The Lancet, at the same time.

Many women stopped HRT therapy when the United States released preliminary results last year. But many also resumed it later as they became miserable without the drug.

Others have turned to 'natural phytoestrogens', or oestrogen-like substances from plants such as legumes and cereals, including soy. Anecdotally, Asian women who consume a lot of soy products seem to have less traumatic menopauses.

No one knows for sure whether the traditional Chinese herb, STYL not found mti dong kuai, or its Western counterpart, black cohosh, work.

Still, the American College of Obstetricians and Gynaecologists has expressed a consensus opinion that black cohosh might help women with hot flushes.

This is a stout, blackish rhizome (or an underground stem like ginger) derived from a species of buttercup that has been used for menopausal problems in the West for centuries.

A black cohosh extract, marketed by GlaxoSmithKline as Remifemin, is now undergoing trials in the US.

Some gynaecologists suggest that women should still consider HRT at the lowest dose and for the shortest time, if they really need it. But no one knows what risks this may pose.

HRT is a therapy that can be stopped any time and restarted any time.

But if a woman has a family history of heart attacks, stroke or cancer, the latest study results should give pause for thought.

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