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June 17, 2004 |
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Menopause JAMA Study on HRT If you own a television or radio, read any newspaper or magazine, or even had a conversation with a friend, family member, or co-worker, then you’ve undoubtedly heard what my newsletter and e-letter subscribers have known for yearsconventional hormone replacement therapy (HRT) is dangerous and should be avoided. While I am thrilled that women across America have finally heard loud and clear what I have been saying for years, it seems that as many questions have been raised as answers given. I’d like to spend our time together today helping you to sort out the findings of the eye-opening study presented in the July 17, 2002 issue of the Journal of the American Medical Association (JAMA), highlight a few studies that have actually prophesized these findings, show you how to wean yourself off of conventional HRT, and offer natural solutions for relief from menopausal symptoms. Be sure to share this information with all the women in your life. Explanation of the Study The study presented in last week’s issue of JAMA reported on the findings from one part of the Women’s Health Initiative (WHI), an 8.5 year project funded by the National Institutes of Health. The WHI involves 161,809 postmenopausal women between the ages of 50 and 79 and focuses on outlining the benefits and risks of a variety of treatments designed to lower the incidences of several diseases, including heart disease, breast and colon cancer, and fractures in postmenopausal women. Of this group, 16,608 women who were healthy and had an intact uterus participated in one part of the WHI, which tested the effectiveness of estrogen/progestin therapy. According to the findings, women taking estrogen/progestin for five years or more had an increased risk for blood clots, coronary heart disease (CHD), strokes, and breast cancer. They did find that the treatment decreased the risk for colorectal cancer and hip fracture. The researchers concluded that, “The results indicate that this regimen should not be initiated or continued for primary prevention of CHD.” In fact, researchers felt so strongly about the negative implications of long-term combined HRT, especially the unacceptably high risk for breast cancer, that they ended the study three years early. The Research Path Leading Up to the Study While the national media reports that the medical community is shocked and stunned by the results of the recent JAMA study, I can’t help but wonder why. Reports on the risks associated with conventional HRT have filled medical journals for more than twenty years. Two different studies presented in 1975 in the New England Journal of Medicine found that estrogen significantly increased the risk of cancer of the uterine lining. In a 1997 study published in the Lancet, researchers looked at 51 earlier studies involving a total of more than 161,000 women. They concluded that conventional HRT increased the risk of breast cancer with each year of use. Women using HRT for five or more years were at 35 percent greater risk. In that same year, the Medical Tribune reported that after ten years of use, ERT (replacement therapy using estrogen alone) increased a woman’s risk of dying from breast cancer by 43 percent. In 1998, the Heart and Estrogen/progestin Replacement Study (HERS), focused on the connection between conventional HRT and heart disease, and involved nearly 2,800 postmenopausal women with an average age of 67 who were given either a combination of estrogen/progestin or placebo for about four years. All participants had a history of heart disease. The findings of this study, which were presented in the August 19, 1998 issue of JAMA, found that the estrogen/progestin combination did not prevent heart attacks or death from coronary heart disease, but in fact, did increase the risk for clots in the veins and lungs. Finally, in January 2000, concerns about combined estrogen-progestin hormone replacement treatment identified by a large National Cancer Institute study were reported in JAMA. The study concluded that women who took the combined treatment for five years had a 40 percent greater chance of developing breast cancer than women taking estrogen alone or no hormones. Similarly, other recent studies have confirmed an even higher 60 to 70 percent increase in breast cancer risk with the long-term use of HRT. My Recommendations One of the questions that has been posed in every newspaper and on every television program since the release of the JAMA findings is “Now What?” Many women fear that giving up HRT means a return of dreaded menopausal symptoms such as hot flashes, night sweats, and anxiety. For those of you who receive my newsletter, my answer to this question is quite simpleuse a combination of safe, natural therapies like phytoestrogens, vitamins, and natural progesterone. Not only are these complementary treatments gentle and highly effective, they are readily available in most health food stores. For relief of the symptoms associated with menopause, as well as support for your cardiovascular system and bones, I recommend taking the following daily dosages: 400 to 2,000 IU of vitamin E per day; 80 to 160 mg of a standardized extract of black cohosh per day (this dose should contain a total of 2 to 4 mg of the active component triterpenes, calculated as 27-deoxyacteine); and/or 50 to 150 mg of soy isoflavones per day. You will also need to elevate your progesterone levels with a natural form. Although it’s available by prescription as a pill, most women prefer to use natural progesterone as a topical cream or spray, which is absorbed through the skin. A typical dosage of natural progesterone cream is 1/4 to 1/2 teaspoon applied to any clean area of the skin once or twice a day (be sure it contains 400 to 600 mg of progesterone per ounce). A typical dosage of the spray is 5-10 sprays per day.
Read More on Menopause: Getting Started Keep it SIMPLE Tip Taking Herbs Nutritional Therapies HRT
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