Until fairly recently, Hormone Replacement Therapy (HRT) was the major breakthrough and considered by many doctors as a treatment for life. It provided the perfect answer to shortterm discomforts, such as hot flashes, night sweats, mood swings and a dry vagina. It was also seen as a protector against longer-term risks, such as heart disease and osteoporosis. It seemed there wasn’t a symptom that it couldn’t help. Today, following the results of a number of international studies, a different story is beginning to emerge. It now seems, rather than being a cureall,
HRT can increase the risk of breast cancer and may not protect the heart. As a result, the medical fraternity has had to think again. It has now been recommended that HRT should be prescribed only in the lowest possible dose needed to bring short-term symptoms under control and for the shortest possible time, if at all. Doctors are advised to review women taking HRT at least annually. If their symptoms persist, they should only re-prescribe the treatment for a maximum of five years, rather than a lifetime. Once symptoms have been quelled, women should be weaned off HRT and encouraged to use an alternative approach.
If you feel you still want to give HRT a try, go through the checklist on the following page to make sure you are a suitable candidate:
You Should Avoid HRT If You Have:
• A family history of breast or ovarian cancer
• Undiagnosed vaginal bleeding
• Endometriosis (where the womb lining grows, and subsequently bleeds, outside the womb)
• Severe cardiac, liver or kidney disease
• An impending operation within the next six weeks (an operation can increase the risk of thrombosis)
• Uterine fibroids (HRT can cause heavier bleeding)
• Diabetes (HRT can change blood sugar levels)
• Breast cysts or pain
• A personal or strong family history of thrombosis (blood clots), especially if you are
HRT may also aggravate:
• Multiple sclerosis
• High blood pressure (occasionally)
Common initial side-effects include:
• Breast tenderness and enlargement
• Premenstrual symptoms, such as mood swings
• Nausea and vomiting
• Possible weight gain
• Breakthrough vaginal bleeding mid-cycle
• Leg cramps
• Enlargement of pre-existing uterine fibroids
• Intolerance of contact lenses
• Patchy increase in skin pigmentation
• Loss of scalp hair
• Increase in body or facial hair
Wean Yourself Off HRT
If you are already taking HRT and want to come off it, take heart. Our latest study of 100 women who had followed our menopausal program revealed that we managed to wean over 91% of women off HRT within five months. Before coming off HRT, it is vitally important to get yourself established on a scientifically based alternative regime. Details of our successful program for naturally beating menopause appear
on the following pages and include an isoflavonerich diet and a selection of recommended supplements, plus doing some moderate exercise and relaxation. After four to six weeks, the benefits of the program start to kick in and you can begin
to reduce your HRT dose accordingly. Research shows that you should wean yourself off HRT gradually, rather than just stopping it, as you can experience fairly severe withdrawal symptoms if you suddenly come off it after taking it for some time.
If you are on a high-dose HRT pill or high-dose patch, ask your GP to prescribe a lower dose for a month or two before stopping HRT completely. Then halve your dose for approximately one month as follows:
• If you are taking pills, break them in half, or take one every second day.
• If you use patches, cut them in half, or use one every second day.
• If you use a nasal spray, use it less, or use it on alternate days.
When you feel the time is right, choose a day to stop taking HRT altogether. If you experience mild flashes during the next couple of months, simply increase the amount of isoflavones in your program and increase your intake of Promensil in
Q Bio-identical hormones have been in and
out of the menopause headlines recently,
but what exactly are they?
A They are made from plant-derived sources of estrogen such as yams and soy products with a molecular structure that is designed to be an exact match with the hormones found in the human body. As such, they are thought to havefewer potential side-effects than synthetic nonbio- identical hormones found in HRT. They also
offer women the chance of taking a medication tailor-made to their own specific symptoms. They may well turn out to be a viable alternative to HRT, but as yet there is no scientific evidence to back up their potential benefits and the longterm
effects are unknown.
Denise Pemberton, from Michaelston-y-Fedw in
Wales, was suffering with severe migraines.
Following a very stressful period in my life, when we lost three relatives in quick succession, my migraine headaches reached the point of becoming constant. As I was approaching menopause, my GP tried me on HRT, but it made no impression on the symptoms, so after four months I contacted the NHAS for help after reading an article in the newspaper about their work. I made gradual improvement during the
first few weeks of the NHAS Program. Withina few months, I felt so much better that I came off HRT. I now only get the occasional mild headache, I have so much more energy and I’msleeping better. Two symptoms I had suffered for years – swollen ankles and burning eyes – have cleared up completely. I have maintained a
good standard of health ever since I started the program. It’s very satisfying to know I’m now in control, thanks to the NHAS.
Did You Know?
Women taking HRT should avoid drinking significant amounts of alcohol because it can increase their risk of developing estrogen-positive breast cancer, according to research carried out by Swedish scientists at the Karolinska Institute. It can also be
the trigger for hot flashes and night sweats.
Doubts about the benefits of HRT began in 2003 when part of a large US trial, The
Women’s Health Initiative, was halted when it was found that combined HRT (the most commonly prescribed form – a mixture of estrogen and progesterone) increased the risk of breast cancer,blood clots, stroke and heart disease.
Next came the UK Million Women Study. The findings, published in the medical journal The Lancet, showed that women taking combined HRT had double the risk of breast cancer. In 2005, more findings from this study showed that when the rates of breast cancer and endometrial cancer are calculated together, the overall risk is highest for women taking combined HRT. This means that around 3 in 100 women taking combined HRT will develop breast or endometrial cancer within a five-year period. This compares with a rate of around 2.5 women per 100 who take estrogenonly HRT or a newer form of HRT called tibolone, and just 1.5 women per 100 who have never taken any form of HRT.
In 2003, the Well-Hart study at the University of California reported that HRT did not in fact slow down the build-up of fatty deposits in arteries (atherosclerosis) for women who already had the condition, as it was once thought to do. The jury is still out on whether HRT may help slow atherosclerosis for women without pre-existing heart disease.
Helen Benton, a university administrator, lives with her
husband Eric and their two daughters, Sally and Marie.
I started getting menopausal symptoms when I was 45. For years, I felt I was only living half a life. I suffered tiredness to the point of collapse, excessive bloating, wind,
breast tenderness, pain on ovulation and a gradual loss of interest in sex. I felt totally miserable. The way I felt affected everything about my life, including my relationships with my family and friends. I used to have such a lot of energy, but found it more and more difficult to cope. That made me feel depressed and reduced me to tears.
Eric was sympathetic, but at the same time he was bewildered by the way I had changed. Because I had lost so much self-confidence, I couldn’t open up to him, which made him feel shut out. The girls would say, “Oh, mum’s having one of her
funny turns again” or “She’s in a bad mood again”. It was very upsetting. I’d been to the doctor when the symptoms started and he did tests, but said I hadn’t reached menopause. So I put up with the symptoms for five years until the doctor finally
thought HRT would help me. I felt very uneasy about it, partly because my
mother had breast cancer, although thankfully she had recovered from it. But the doctor said the benefits from HRT far outweighed the risk of breast cancer in my case. He put me on Prempac C, which is estrogen and progestogen. For the first
three months, I felt wonderful, but then some of the symptoms returned. My stomach seemed ten times bigger, my clothes wouldn’t fit and I felt frumpy and ugly. I had headaches and migraines and my skin became dry.I thought my natural periods might have stoppedand I wanted to find out. In fact, my periods didn’t resume. Instead I had hot flashes about 12 times a day because of the estrogen withdrawal. The heat would start in my stomach and envelop my whole body for several minutes. Afterwards I’d get this cold, clammy feeling, as if someone was walking over my grave. After two months, I thought, “I’ve had enough. I’m going to take control of my body.” I’d always been interested in self-help remedies. I’d heard of the NHAS and went for a consultation. I began the Natural Menopause Program, which
included a change in diet, plus exercise and relaxation. They took me off wheat and caffeine. I was told to eat nuts and pulses and soy-based foods, plus fresh fruit and vegetables three times a day. I was prescribed multi-vitamins and supplements to overcome the hot flashes and guard against osteoporosis. Within a week, I felt a
difference. The hot flashes disappeared and I had bags more energy. I felt more positive, much more relaxed and far happier. Eric is delighted to see the return of the wife he always knew, especially as my libido is returning. I know it’s a cliché, but I really do feel like a new woman. I’ve got my life back and for the first time in years I feel positive about the future.