In the popular 1966 book “Feminine Forever,” Dr. Robert A. Wilson, a gynecologist, used disparaging descriptions of aging women (“flabby,” “shrunken,” “dull-minded,” “desexed”) to upend the prevailing idea of menopause as a normal stage of life. Women and their physicians, Dr. Wilson wrote, should regard menopause as a degenerative disease that could be prevented or cured with the use of hormone drugs.
“No woman can be sure of escaping the horror of this living decay,” Dr. Wilson wrote. “There is no need for either valor or pretense. The need is for hormones.”
I don’t think this is a very good time in history for women to grow old. We’re surrounded by media messages saying you can have great sex after menopause, into your 60s, your 70s, your 80s! (The mag articles almost always features an older woman with ‘my much-younger lover’.)
So they’re holding out this enticement about having great sex, but the older I get, the less able I am to find romantic partners. The men I meet are either married, or want to be with someone younger.
Assuming I do find a partner, sex is actually difficult b/c i’m going thru menopause. I’m bleeding all the time. And when mnps is done, sex without RX creams will be problematic, and just not as fun anymore.
And yet we’re surrounded by those damn media messages about how great it can be!
It’s like being lactose-intolerant and living in a Baskin Robbins.
I wish our culture would just say it’s ok to go with the natural flow of things and not want sex anymore, and quit trying so hard.
And don’t even get me started on the artificially extended sex lives of men, with Viagra.
In general, after 50 years of hormone contraception since we were students, with more than a hundred million women now on low-dose hormone contraception, such synthetics – a progestin with or without ethinylestradiol EE2 – are considered pretty safe in current low dose compared to unplanned pregnancy or physical contraceptive methods, provided contra-indications are respected; with almost 50% reduction in future endometrial and ovarian cancer; and no change in mortality from breast cancer.
Does that make such massively profitable contraceptive hormones that were designed in fierce competition for fertility (and ovarian) suppression in healthy young women both safe and effective for the ageing no-longer-healthy fattening (post)menopausal women? Parenteral physiological balanced HRT does not cause the fattening and muscle loss that OHT does.
Now young Janey asks an important question: “I am 56 yrs old and very happy with Yaz (ethinyl estradiol EE2 plus drospirenone). I do menstruate while on the placebo. I would like to find a doctor who will let me stay on Yaz, which I like a lot, or if absolutely necessary try the Testosterone, Bi-estrogen, Progesterone combo. I worry about weight gain that occurs in almost all cases of oral HRT. I need the bone protection and hair, skin and vagina health benefits that have been wonderful on Yaz. “
CANCER RISK OF ORAL XENOHORMONE THERAPY:
In July this column last visited ovarian cancer as a relatively rare disease but with high mortality, hence far more to be feared than other womens’ cancers eg breast, endometrial or ovary.
So it is worth revisiting the major Danish observational study spanning 10 years published last July ; which documented almost a million women for 8 years. The crude primary ovarian cancer OvCa incidence rate in never-users (5 million women-years) was only 0.04%, vs 0.052% in current HT users (1.4million women-years) ie overall, hormone therapy HT increased the risk by 1.3, or 30%. That study concluded: “Combined therapy with norethisterone was associated with an increased risk of epithelial ovarian cancer (RR, 1.55; 95% CI, 1.36-1.76), which was not significantly different from the RRs associated with medroxyprogesterone, levo- norgestrel, or cyproterone acetate”.
The only regime in that series which was not statistically significantly associated with increase in OvCa was in the 23 women who developed OvCa on solo transdermal E2TD ie hormone replacement HRT (out of a total of 64000 women-years on E2TD), where OvCa relative risk increased by 13% but the 95% confidence interval spanned unity (0.74 – 1.71) ie p was > 0.05. By contrast, oral estrogen HT for some 287 000women years increased OvCa risk significantly by 34%; and any progestin added to estrogen ie in some 847 000 women years increased OvCa risk above no HT by 47% to 68%.
This neutral effect on OvCa only of unopposed EzTD is most reassuring for women. All the synthetic progestins they compared were associated with significantly more OvCa (let alone BRCA).
The nub of the matter is that gynecological cancers generally do not apparently proliferate without the influence of female cyclical hormone levels- FSH, LH, estrogen – and especially oral estrogens and progestins. In the main study of cancer with Turner syndrome, in 3425 women in UK followed for some 17years ie 58000 patient-years, breast cancer was 70% less common than average women, while the only gynecolological cancers that appeared to increase were endometrial cancer 8fold at age 15-44years, and gonadoblastoma of the ovary by 8% by age 25years- and gonadoblastoma is over 90% associated with the ‘male’ chromosome Y . These statistics are reassuring considering that most such women were treated with oral estrogen therapy, and that uterine cancer is avoidable if estrogen therapy is appropriately opposed with some progestin, with periodic withdrawal bleeding allowed.
Unbalanced anabolics eg vitamins or sex hormones merely promote dormant malignant cells already present, they do not cause cancer de novo; and adult cancers take an average of 20 years to present clinically.
There is no report on Pubmed of testicular cancer developing on testosterone TT replacement let alone abuse; nor of increased ovarian or breast or uterine or colonic cancer in long term female testosterone users – if anything long term testosterone replacement in women appears to diminish breast proliferation in rodents, monkeys and humans, as this column has regularly reviewed..
It is common cause from clinical menopause practice and trials that pharmacological ie unphysiological oral estrogen – progestin therapy – while improving bone density- increases body fat and if anything decreases lean ie muscle mass and collagen -hence the increasing postmenopausal fatness frailty and urinary incontinence of elderly women on oral HT.
DROSPIRENONE
The new combinations with drospirenone for contraception ( Yaz/Yasmin- drospirenone DSP -ethinylestradiol EE2 in fertile women), and post menopause (Angeliq – DSP -estradiol E2) certainly seems to reduce fluid retention and thus weight and hypertension problems, and to have anti-androgenic benefits when required. There is apparently no published longterm data on DSP to judge it’s influence on cancer and mortality.
This column has regularly detailed reasons for postmenopausal women PMW to avoid oral transhepatic sexhormone therapy with the high doses of oral estrogen needed to control menopause symptoms, and the multiple adverse effects of transhepatic xenohormones like EE2, premarin and progestins. But 50 years of experience including the under 60’s cohort of the WHI, and the Oulu trial (Heikkinen ea ) certainly showed overwhelming benefit of oral estradiol/conjugated estrogen-progestin combination when started appropriately in well young PMW for up to 10 years. It has been well known for three decades that continuing such OHT well beyond 10 years gradually increases the incidence of BRCA above non-users.
However, as we have repeatedly discussed, why should Kitty subject herself to the longterm risks of eg breast cancer from such oral use of any designer hormones like orohepatic estrogens and progestins? when evidence is that physiological human HRT with non-oral, or oral micronized (see Dr Lee Vliet’s books) sexhormones, has no risks, only benefits – especially when human E2+- estriol E3 are balanced by progesterone P4 and testosterone TT as by creams, or implants, or tiny subcutaneous self-injection, all easily available by prescription in US.
And when oral EE2 ethinylestradiol for contraception is associated with low but real thrombosis and biliary risks; and when it is enormously potent compared to human estradiol; and when it’s successor competitor diethylstilbestrol DES is still causing horrendous problems in women and their children and grandchildren after it was recklessly prescribed from the 1940s to the 1970 without there ever being evidence of benefit let alone safety.
Lowdose EE2 has certainly proved it’s relative safety when used as birth control in young healthy non-overweight women. But just as oral prempro has proved that it causes problems and little benefit when started after the age of 60years in overweight women ie those already with atheromatous disease, why take potent synthetic oral EE2 post menopause? Using a potent synthetic is neither prudent, physiological nor replacement.
Recently a Brazilian trial confirms equal benefit of “nonoral HRT (nasal spray- estradiol -micronized vaginal progesterone) ; or oral HT (low-dose estradiol-drospirenone ) for 2 years on metabolic, vascular and body fat risks in early postmenopause;” but once again that “Triglycerides and von Willebrand factor levels decreased significantly only with nonoral treatment”- ie the nonoral- parenteral- route is better protection against atheroma and thrombogenesis.
DSP combined with oral E2 is certainly theoretically advantageous HT for those PMW with hypertension and fluid retention. But since no longterm trials or studies of DSP use are available yet, it is too early to judge if DSP+E2 is as safe as physiological HRT with appropriate combination of E2/ estriol E3/ P4/ TT.
But as we have repeatedly pointed out, the evidence from both evolution, and 60 years of experience, and trials, is that physiological parenteral human hormones ie not by the orohepatic route have distinct safety and physiological benefits, as comprehensively detailed by l’Hermite, Genazzani ea on behalf of the International Menopause Society recently , as well as all the data this column has previously reviewed on the importance of balance non-oral testosterone as part of the HRT regime.
So the answer for KJaney is: be a volunteer guinea-pig if you like, try Taz -or, better, the natural estradiol -containing Angeliq – in low dose; but preferably enroll yourself in a longterm randomized comparative trial of the new oral Angeliq) versus the ancient (balanced human sex hormones) . Why risk the new but long-term unproven when the evidence for the old (as long as human evolution with balanced non-oral human estrogen +P4+TT) is so strong.
And while you may find out the best by your trial and error without longterm adverse effect, none of us may learn better by your self-experimentation?
You could be losing one percent of bone from your spine every year during this decade. That’s why you need to be especially diligent.
Diet/Fitness In addition to keeping up the calcium (still 1,000 mg), you should add weight training to your workouts, to help strengthen muscles around your bones.
Doctor visit If you experience early menopause, get a bone-density test; you’re greater risk for osteoporosis than if you go through menopause at the average age (51).
Your 50s and beyond
Bone loss accelerates at menopause; you can lose up to 20 percent of bone density in the first 5 to 7 years.
Diet/Fitness Your calcium requirements go up to 1,200 mg; add another serving of calcium-rich foods or an additional supplement. If you didn’t start weight training earlier, now’s the time. Lifting even light weights will make you stronger and protected you against falls, a serious threat as you get older and sustain fractures more easily.
Doctor visit Find out where you stand. Ask about a bone-density test; if your mineral stores are low, your doctor may suggest hormone-replacement therapy (estrogen) or raloxifene (brand name: Evista). These can cut the risk of a fracture by 39 to 50 percent. Other drugs that can help: alendronate sodium (Fosamax) and risedronate sodium (Actonel), which help build new bone. – Sally Katigbak
HORSETAIL Equisetum arvense
Horsetail is said to be one of the oldest recorded plants on earth, discovered approximately 600 million years ago. It is rich in the trace element silica which aids in the absorption of calcium, and is a basic element in the growth and repair of bone and tissue (strengthening bones, hair, nails and teeth). Herbalists claim it is useful in the repair and regeneration of the damaged connective tissue disorders. Another long standing use of horsetail has been as mild treatment in the prevention and treatment of kidney stone formation, bacterial and inflammatory disorders of the lower urinary tract, and as a diuretic. Horsetail has been a traditional treatment for allergies, pulmonary tuberculosis, cystitis, kidney stones, water retention, fevers, eye diseases, gout and rheumatism.
IRISH MOSS Chondrus crispus
Harvested from the water off the European coast, Irish moss is actually a seaweed. Rich in proteins, iodine and other substances, many herbalists also considers it is excellent “nutritive tonic”, and traditionally it has been prescribed for ulcers, dysentery (infectious diarrhea) and the other gastrointestinal disorders. Contemporary herbalists consider it a valuable soothing agent (demulcent) for dry coughs, bronchitis, tuberculosis and other upper respiratory tract ailments. It is also thought to help in the treatment and alleviation of peptic and duodenal ulcers. Considered to have anti-inflammatory, immunosuppressive, blood-pressure lowering, and other potentially beneficial properties, Irish moss is also thought to have healing properties beneficial in treating ulcers and other problems relating to the digestive system.
LAVENDER Lavandula angustifolia
In an age of extremes lavender is essentially able to produce a balancing and harmonizing effect, by having a pronounced regulating effect on the nervous system. Stress has long been known to deplete the immune system, and can be the cause, or the precipitating agent, for all types of illness and disease. With this in mind, lavender is thought to have a restorative effect in cases of a weakened nervous system and have a calming effect on those prone to be stressed or agitated. For years herbalists have used the calming effects of lavender to treat nervousness, anxiety, worry and depression. Lavender is used as a symptomatic treatment of stress-related conditions. It has been used for insomnia, headaches, and immune as well as digestive problems.
LICORICE Glycyrrhiza glabra
Long ago, in China, licorice acquired the name of “The Great Detoxifier”. They believed that continuous consumption of licorice root would help to rid the body of poisons and could contribute to the body’s blood building efforts. It has since been used in many Chinese prescriptions treating dry coughs and lung disorders, asthma, sore throats, laryngitis, ulcers, as well as inflammation of the urinary and intestinal tracts. It is sad that licorice root increases vital energy, and that it is able to strengthen digestive and metabolic function. It is believed that licorice root “harmonizes” the ingredients in an herbal formulation and eliminates any harshness, thus promoting smooth activity of the herbs. Licorice is useful in the treatment of peptic ulcers, abdominal colic, stomach inflammation, colitis, and has been used as an expectorant in cases of bronchitis.
KOREAN GINSENG Panax ginseng
People have long used ginseng in their health practices, claiming it has the power to balance one’s energy. It appears to have the quality to help regulate and strengthen body functions, improving metabolism, increasing both immune system resistance and respiratory performance. Extracts from this herb have been used to provide a mental stimulant, thought to improve memory and cognitive power, and many claim that with regular use it can often reverse mental deterioration. It can also lessen the effects of menopause. Among its many uses, Panax ginseng is beneficial in treating fatigue, providing increased physical energy, increasing metabolism, fastening recovery from illness and surgery, and empowering its users with an increased alertness and power of concentration, as well as instilling a general sense of well-being and vitality.
PASSIONFLOWER Passiflora incarnate Passionflower has found worldwide acclaim in the reduction of nervous tension, alleviating irritability and anxiety, and lowering blood pressure. It is also used to promote restful sleep. As an antispasmodic it has also been successfully used in the treatment of bronchial asthma. Passionflower has an overall soothing and calming effect over the entire body, offering relief from stress and stress-related headaches and pain. It has been employed in the treatment of muscle cramps, premenstrual tension, and disturbances often associated with menopause.
RED CLOVER Trifolium pratense
Red clover is rich in isoflavones, including genistein and biochanin A (an antioxidant which protects against cells aging). Used as an antibiotic, it has been used in fighting bacterial infections and dealing with kidney and liver diseases. Over the years it has been tried with some success as a tumor and cancer remedy (for breast and prostate cancer in particular). Red clover has also been used as a treatment for skin disorders, such as eczema and psoriasis, as it claims to cleanse the blood. Herbalists also recommend red clover for reducing uncomfortable menopausal symptoms, and improving overall health, including its use as an expectorant to clear chest congestion caused by coughs, colds, asthma and bronchitis.
Throughout our lives, it’s inherent in our nature to question our purpose in life. It’s natural for us to wonder whether or not we’re taking the right steps towards achieving that in which we view as success. As years fold into decades, it seems harder and harder to wash away our worries and concerns. It seems that our fears and apprehensions have precipitated into our daily lives, making it more difficult to complete day-to-day tasks. We reach a certain age where death becomes an imminent reality - our hopes become eclipsed by the shadows of mortality. We don’t feel like ourselves anymore. We feel as if there’s something missing in our lives, we feel incomplete. As we age, our bodies begin to change, and as our bodies change, so do our values, our goals and our idea of success. We’re constantly changing who we are, improving who we are and shaping the person who we want to be.
A Mid-Career Crisis:
Career menopause is a term used to describe the frustration and restlessness experienced by men and women in their careers. Although our careers are an integral part of what we do, we can’t use our careers to define who we are. The only thing we fear more than change is permanence. We’re afraid that our careers will eventually plateau – we fear that all the joy and pleasure that we used to get out of our career has been sucked dry.
What You Can Do:
So what’s to blame for career menopause? Be it a mid-life crisis or a mid-career plateau, the anxiety, heart palpitations, night sweats and mood swings are all a direct result of hormonal imbalance. Hormonal imbalances affect millions of men and women each year, many unknowingly. The good news is hormonal balance is not a disease and it can be corrected with proper attention and specialized treatments. One of the most natural and effective ways to treat underlying hormonal imbalances is bioidentical hormone replacement therapy (BHRT). BHRT uses bioidentical hormones to replace the hormones that your body no longer produces, using hormones that are molecularly identical to the hormones your body would produce naturally. Unfortunately, chances are it’s not the job, it’s you. The good news is you can do something about it! You don’t have drudge on throughout the workday anymore, now you can regain your passion and rekindle the joy and pleasure that you used to get out of your career. Rediscover you!
Many women going through menopause have to make a difficult choice, deal with hot flashes and night sweats, or risk cancer with HRT. However, today there is another choice; natural supplements and herbs. Since 2002, when a federal study found that HRT increased the risk of cancer in women, millions of women have tried natural alternatives with varying levels of success.
Dong Quai Root
Very few of these natural treatment options have been proven to work, but, despite that fact,women are flocking to these alternatives. Another reason that natural alternatives are gaining popularity is the fact that the treatment plans are customizable to the individual needs of the woman. Not everyone goes through menopause the same so it is only logical to treat for the symptoms that you have.
There is a dark side to natural alternative because of the fact that most of them have not been tested and fully researched. The long term side effects of many of these supplements are unknown, which can be scarier thought than hot flashes. Many of the natural products claim that they have compounds that are “bioidentical” to the estrogen that women make normally. The term “bioidentical” is, in fact, a marketing term that has no medical meaning or substance. Prescription drugs have been utilizing hormones that chemically match estrogen for some time.
However, there is a shining light when it comes to natural alternatives. Feminestra, a natural menopause relief supplement, has been clinically proven to work. They, in fact, advertise all the ingredients in their supplement on their website and advertise that they do not use any artificial hormones or chemicals. Feminestra was found effective in alleviating the symptoms of menopause in 90% of women. This clinical study showed that Feminestra has proved effective in significantly reducing the symptoms of menopause, as compared to 8% of those taking the placebo.
When choosing a natural alternative to HRT for menopausal symptoms, make sure to research each of the products you are thinking about taking and consult with a pharmacist or doctor. What might work for some may not work for you and it is important to know how different things will affect you. To learn more about different types of natural supplements Natural Menopause Relief.
