Mind & Body

Help with managing menopause.Working with NatureIs Hormone Replacement Therapy in Your Future?

By Triston V. Sanders 

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Hot flashes. Night sweats. Insomnia. Mood swings. Anxiety. Irritability. Low energy. Memory problems. Vaginal dryness. Low libido.

With all of the conflicting information in the media, many women don’t know where to turn. Some fear that taking hormone replacement therapy may increase their risks of breast cancer, heart attack, stroke or Alzheimer’s disease.

Many or all of these symptoms greet women when they hit menopause – the time in a woman’s life when her hormone production decreases. Women typically enter this phase in their lives between the ages of 45 and 52, and there is a dizzying array of things a woman can do to fight these frustrating symptoms.

One of the most popular solutions – with a mind-boggling set of options – is to replace those depleted hormones.

“The advantages of natural hormone replacement are the complete relief of menopausal symptoms and emotionally a return to normalcy,” said Tallahassee doctor Alex Davenport, a board-certified obstetrician/gynecologist with about 30 years of experience in hormone therapy. “Anxiety and depression are decreased and a feeling of well-being is experienced.”

An estimated six million American women agree with Davenport and take hormone replacement therapy (HRT).

One of Davenport’s patients has found that HRT allows her to keep her life and her career in high gear through menopause. Tallahassee real-estate agent Cassandra Harbin said the benefits outweigh the risks for her.

With all the conflicting information in the media, many women don’t know where to turn. Some fear that taking hormone replacement therapy may increase their risks of breast cancer, heart attack, stroke or Alzheimer’s disease.

“There are a lot of benefits from hormone replacement therapy, and it’s those benefits that I’m looking at,” Harbin said. “It was nice to have a doctor that would work with me on that. I’m still able to feel good and enjoy the same things I would have 30 years ago. I work more than 60 hours every week. And I just don’t think I would have that if I didn’t have the hormones.”

But with all of the conflicting information in the media, many women don’t know where to turn. Some fear that taking hormone replacement therapy may increase their risks of breast cancer, heart attack, stroke or Alzheimer’s disease.

Several studies have been done on hormone replacement therapies and their effects on a woman’s health. Perhaps the most widely recognized was the Women’s Health Initiative, which was conducted by the National Institute of Health and designed by cardiologists.

The Women’s Health Initiative study indicates that estrogen plus progestin significantly increases the risk of invasive breast cancer and blood clots in the legs and lungs. It suggests that women taking this drug have a higher risk of heart attack and stroke. The hormone formulation used in this trial was CEE/MPA, more commonly known as Prempro.

The Women’s Health Initiative also conducted a study using estrogen only, CEE, or Premarin. In that study, researchers claim there is an increased risk of stroke and no reduction in the risk of heart diseases in postmenopausal women who have had a hysterectomy.

These studies changed the way millions of women and their doctors approached HRT. Many women were left looking for alternatives for fear that their therapy would have life-threatening consequences.

While Premarin, which is made from a pregnant mare’s urine, still is an option for women, a newer, more popular option has emerged, dubbed by marketers as “bioidentical hormones.” These are made from the same hormones a woman’s body produces, and are made from soy or yams.

Because bioidentical hormones were not the ones used in the Women’s Health Initiative study, many doctors say most of that research has little to do with the HRTs being used today. These doctors argue that the cardiologists in the studies never used bioidentical hormones, so the data is not applicable because they’re not the same chemicals.

Davenport prescribes these bioidentical hormones to his patients.

“Natural hormone replacement is thought to be protective of the heart and cardiovascular system before heart disease starts, to prevent and reverse osteoporosis, and to decrease the incidence of Alzheimer’s and colon cancer,” he said. “With many women, is it appealing to replace progesterone regardless of the absence of a uterus. Natural progesterone has many other benefits, including the ability to rebuild bone – even after it has been lost – and to improve sleep, mood, concentration and memory. Estrogen replacement is often a quality-of-life issue for women.”

Davenport added that “animal experiments and observational studies support the concept that estrogen replacement reduces arteriosclerosis and protects the cardiovascular system. These animal studies, the HERS study and the WHI study suggest no benefit after the development of arteriosclerosis. Estrogen replacement may be best viewed from a preventative perspective. Optimal hormone replacement involves both monitoring the blood levels and adjustment of the dose according to individual blood levels and symptomatic response.”

Although some in the medical community have decided to disregard the Women’s Health Initiative studies, many health organizations still base their recommendations for women on them. The American Heart Association advises women to “weigh the potential risks of therapy against the potential benefits for menopausal symptom control.” And it states that “hormone therapy should be used for the shortest time period.” The organization’s Web site even directs visitors to the Women’s Health Initiative study.

Although treatment of menopause is controversial there appears to be a consensus that exercise and diet may minimize the effects of menopause.

The Food and Drug Administration (FDA) also refers to the Women’s Health Initiative research and explains that women in one of the studies stopped receiving HRT when it appeared that “risks exceeded benefits.” The FDA points out that not all of the Women’s Health Initiative studies are completed.

For those wary of taking hormones, there are alternatives. Angela Myers, a nurse practitioner who owns and operates the Medical Healing Center LLC in Tallahassee, said that “herbal and alternative options help when women refuse HRT. But I feel a combination of HRT and alternatives work best. It can allow you to use a lower dose of HRT.”

Myers and her colleagues at the center say that each patient responds differently, and that depending on her physiology, lifestyle and a host of other criterion, each woman’s care should be individualized.

Although treatment of menopause is controversial, there appears to be a consensus that exercise and diet may minimize the effects of menopause.

The process starts with a complete physical exam, including testing a woman’s current hormone levels and taking a medical history. There are many possibilities for dealing with menopause, and the choice is made taking into consideration several factors, including such things as hormone levels, family history, and severity and types of symptoms.

Remember, your quality of life, health and happiness depend on your taking action. Individual physicians may have a unique approach for treating menopause that may not be appropriate for you. Talk to several health care professionals to develop your proper treatment plan.

Triston Sanders anchors WCTV’s “Good Morning Show” Monday through Friday at 6 a.m. and Eyewitness News at Noon. She also covers the latest in medical advancements in her daily segment “Health Matters,” which airs weekday mornings.