Every month or so there seems to be a new pronouncement on HRT and recently we were all informed that HRT is safe for women to take at menopause after all. A panel of experts informed the public that they feel the health risks have been greatly exaggerated and that HRT is safe to take for women aged between 50 and 59 to give them relief from such symptoms as hot flushes and to maintain healthy bones.

‘It does not significantly raise heart disease risk and its impact on breast cancer is minimal’ said a review from the first Global Summit on Menopause Related Issues. The experts argue that although the risk of heart disease and breast cancer is slight it is dwarfed by other risk factors, such as obesity, drinking alcohol and eating fatty foods.

 

The above findings are designed to set the record straight after six years of health scares which have led many women to stop taking HRT and the recommendation is to urge more doctors to prescribe HRT for women going through the menopause.

 

My initial reaction to this pronouncement was concern that many women may unnecessarily decide to take a drug with unpleasant side effects and serious health risks. Apart from the fact that the experts in the study do acknowledge there may be a slight risk, it’s impossible to ignore the 2002 Women’s Health Initiative Study which found that women on HRT for several years had a massive 26 per cent increased risk of breast cancer and a 29 percent increased risk of heart attack. In addition, the team of experts did not mention any of the side effects caused by HRT which can include any of the following:

 

·         endometrial (womb) cancer

·         undesirable weight gain/loss

·         breast tenderness/enlargement

·         bloating

·         depression

·         thromblophlebitis (inflammation of a vein)

·         elevated blood pressure

·         reduced carbohydrate tolerance

·         skin rashes

·         hair loss

·         abdominal cramps

·         vaginal candidiasis (thrush)

·         jaundice

·         vomiting

·         cystitis-like syndrome

 

Also there was a particularly significant piece of research published in the National Cancer Institute Bulletin in 2007.  Researchers looked at breast cancer rates in the year following publication of the 2002 Women’s Health Initiative results that had scared women off taking HRT.  They found that the rate of breast cancer dropped by 12 per cent in 2003 among 50-69 year old women: the largest single drop in breast cancer incidence within a single year.  Establishing even further the very definite link between HRT and breast cancer.

 

And last, but by no means least, the team of experts also failed to mention that a great many women have found that simple diet and lifestyle changes are all that are needed to ease their symptoms and reduce their health risks. In short, you don’t have to take HRT at the menopause there are highly effective natural alternatives.

If you’re trying to make up your mind about whether or not to take hormone replacement therapy (HRT) or try natural alternatives a major new study by the Women’s Health Initiative gives food for thought. The US study suggests HRT patients face a higher cancer risk long after they have stopped treatment, when compared to those who never had the treatment.

Previous studies have shown a link between HRT and breast cancer – but it was thought that the increased risk disappeared fairly quickly.  This new study, however, shows that the risk of breast cancer can linger for up to three years after stopping HRT.

The results published in the Journal of the American Medical Association suggest that the risk of breast cancer remained 27% higher while risks of any type of cancer were 24% higher.  The other health risks associated with HRT e.g. strokes and clots do not persist and return to normal after stopping HRT.

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’.