Q: I am 56 years old and have been on HRT for nearly six years now and I would like to come off it, what is the best way to do this?  Also can eating phytoestrogens be used to help me come off HRT?

A: The question I am most asked is ‘should I just stop HRT or should I come off it gradually’? You should talk to your doctor about your decision to come off HRT and have any check ups that might be needed. My recommendation is always that a gradual weaning process is actually going to be easier on your body. Stopping HRT suddenly is similar to going ‘cold turkey’ and there have been reports of ‘rebound’ effects from the quick withdrawal of the hormones. The rebound effects can actually give tremendous hot flushes and seemingly worsened menopausal symptoms. 

 

It is better to take three months to gradually wean yourself off HRT. Ask your doctor for a lower dose and if you cannot reduce the dose of the HRT, you could switch to a patch. Because the patch delivers oestrogen through the skin and does not have to be broken down by the liver first, you can get by with a lower dose than if it is taken by mouth. Alternatively, you could use an oestrogen gel, rubbing in smaller amounts of oestrogen each time. Remember, though, that the dose of the progestogen must not be altered if you are on a type of HRT that stimulates a withdrawal bleed. It is important that this happens each month until you come off HRT entirely. 

 

During that three month weaning process, you would then start to introduce phytoestrogens (like soya, chickpeas, linseeds etc) into your diet so that when you stop the HRT you are cushioned by plant oestrogens already circulating in your system and any effects from stopping the HRT should be minimal. If you need extra help then you can use herbs like black cohosh (see Black Cohosh Plus on Resources page). For more information on the menopause see my book ‘The New Natural Alternatives to HRT’.

Cauliflower is actually a type of cabbage, but one in which the flowers never get beyond the bud phase. Like the other brassica family members, such as broccoli and Brussels sprouts, it seems to be especially protective against cancer and heart disease

It is packed with vitamins, minerals and powerful anti-carcinogenic compounds including the phytochemical sulforaphane, which not only stimulates the body’s own defences against disease, but also directly blocks tumours. In a recent study, it disrupted the growth of breast cancer cells in later stages. It is thought that brassicas reduce the risk of cancer by protecting DNA from being damaged, and research into the effects of eating cruciferous vegetables found a significant reduction in DNA cell damage in 20 healthy volunteers who had eaten 113g of cruciferous sprouts a day for two weeks.

 

Cauliflower’s main vitamin is C, with 100g – which is about a sixth of a medium-sized cauliflower head. Vitamin C’s primary role is in the production of collagen, which helps to form teeth, bones, skin and cartilage, but it is also a powerful antioxidant. Not only does it play an important role in wound healing, immunity, and the nervous system, it also helps to protect against cancer, as well as shielding ‘bad’ LDL cholesterol from the free radical damage that can lead to cardiovascular disease

 

B vitamins are well represented, with 100g of cauliflower providing excellent quantities of folate (essential for preventing spina bifida in the developing foetus but can also help reduce the risk of heart disease, vitamin B6 (gives you energy by helping the body to produce proteins and to metabolise) and vitamin B5 (essential for the proper function of the adrenal glands).

 

Eating good amounts of cauliflower could be a good way of protecting against inflammatory conditions such as arthritis. It’s an excellent source of omega-3 essential fatty acids, which are used by the body to produce anti-inflammatory prostaglandins – these can reduce the risk of strokes and heart attacks and also protect against arthritis and rheumatism. And remember those huge vitamin C levels? Epidemiological research suggests that diets rich in vitamin C can protect against a type of rheumatoid arthritis, with those who ate the smallest amounts three times more likely to develop it than those who ate the most.

Serves 4:

• 2 tsp olive or sesame oil
• 2 onions, diced
• 2 tbsp soya sauce or tamari
• 2 medium cauliflowers, cut into florets
• 2 cups of millet
• 6 cups of water

To a heated pan, add the oil and onions and stir until tender.  Add the soya sauce and stir again.  Add the cauliflower, water and millet.  Bring to a boil and cook on a low flame for 30 minutes.  When cooked mash the mixture and serve with leafy green vegetables.