As an anti-aging medical doctor, one of the biggest issues associated with women health is menopause. If asked to give a simple definition for this medical condition I would easily say: it means going at least one year without a menstrual period. But menopause can also refer to the changes a woman experiences as she reaches the end of her reproductive years. This time and the period leading up to menopause can also bring symptoms that may be unpredictable and hard to deal with.
Over 75% of women report some symptoms due to menopause, and 20 to 25% of those women ultimately seek medical treatment to help them cope. Often the first question a woman asks her doctor is about hormone replacement therapy, or HRT.
This once standard treatment has seen its share of controversy in recent years. I will discuss some of the issues surrounding HRT and other solutions so that you, together with your doctor, can decide what treatments are best for you.
HRT and Alternatives
During menopause and in the years leading up to it, a woman’s body stops producing certain hormones in the same way it once did. Hormone replacement therapy is used
to counteract the effects of this change in estrogen and progesterone levels. Replenishing these hormones often relieves symptoms like hot flashes, night sweats, insomnia and vaginal dryness that make menopause so disruptive for many women.
When findings from the Women’s Health Initiative, a large-scale study covering menopause, were released in 2002, the thinking on HRT shifted dramatically. The highly reputable study found that long-term use of HRT increases risk of breast cancer, heart disease, stroke and blood clots. Follow-up studies, however, have suggested that HRT may be acceptable for short-term use for certain women.
One such study published in the Journal of Women’s Health (January/February 2006) found that the risk of heart disease may not be as severe as the Women’s Health Initiative suggested.
Today, the decision to use hormones in some form (a low-dose or estrogen-only version, for example) is made on an individual basis by a woman and her physician. There are alternatives to HRT, and more natural therapies are being studied everyday. Black cohosh, for example, may reduce sweating and hot flashes. Other herbs being used include red clover, dong quai, kava, and evening prime rose.
There are various remedies for vaginal dryness besides hormone therapy. Lubricants can help the problem while increasing sensation. Vaginal creams containing estrogen may not carry the same risks as HRT because they are applied only to the specific area. Other options include an estrogen ring that is inserted into the vagina. Researchers are working hard on developing alternatives to hormone therapy.
Another area of study revolves around bioidenticals, or hormones manufactured by scientists from natural compounds. The proper doses of bioidenticals have not been well-established, however, and many of these products have not yet been FDA-approved. To explore this option, be sure to see a highly qualified physician who has extensive experience in treating patients with bioidenticals.
Eat to Beat Symptoms
You know that the food you eat can make a big difference in your health and the way you feel on a daily basis. Before and during menopause, this is especially true. Eat whole foods as opposed to processed snacks. You will reduce your sodium intake, which contributes to belly bloat; increase vitamins and minerals, which fight disease; and improve your energy level thanks to protein, fiber and healthy fats. Some foods can even make symptoms worse. Spicy foods, alcohol and caffeine are all known to contribute to hot flashes.
Soy foods are often discussed in relation to menopause. Some studies indicate that soy protein from tofu, soybeans, soy milk or tempeh, can reduce hot flashes. Other studies contradict these findings, and some even suggest that soy may be dangerous for women with a high risk of estrogen-related breast, ovarian or uterine cancer. Your doctor can help you weigh the pros and cons of these options and evaluate your risk.
If you are experiencing menopause, I hope this information has provided some new options to consider with your doctor. If you have not yet begun this change, try to approach menopause with a healthy perspective. Behaviors in place now, like regular exercise, stress reduction and maintaining a healthy weight will help you cope when menopause starts.