Despite soothing reassurances from the medical fraternity, I have had a recent rush of enquiries from women who are more that a little disconcerted to learn that taking hormone replacement therapy (HRT) can double the risk of breast cancer. Shocking though it may be, this recent research is just part of a pile of evidence that suggests HRT is not the magic elixir pharmaceutical companies would have us believe it to be. For instance, while it was originally claimed that HRT could stave off heart disease and improve quality of life, new evidence suggests this is simply not the case. Also, statistics show that the majority of women who start HRT are off it again with a couple of years, with many citing intolerable side-effects or concerns about cancer as their reason for stopping. While it is famed for its ability to control hot flushes, it seems HRT also has the capacity to bring some women out in a cold sweat.

Fortunately, for those who have concerns over the potential hazards of HRT, alternatives do exist. Some medicinal herbs, for instance, are loaded with substances that mimic the effect of the hormone oestrogen – a falling off of which is believed to be the principal cause of menopausal symptoms such as hot flushes, night sweats and vaginal dryness. Plant oestrogens (known as phytoestrogens) have an action that is far weaker than the chemically synthesised or horse-urine hormones generally found in conventional HRT. Nonetheless, despite their supposedly muted effects, phytoestrogens appear to have the power to take the heat out of menopausal symptoms.

One phytoestrogen-rich herb that generally offers considerable benefits in practice is Black cohosh (Cimicifuga racemosa). Several studies show that this natural remedy has the power to control not just the physical symptoms of the menopause, but some of its common psychological sequelae such as depression and anxiety as well. The standard dose is 2 – 4 mls of a tincture (alcoholic extract) of Black cohosh, taken three times a day for up to six months. Another natural substance that many women find has medicinal value in the menopause is vitamin E, and a few studies that bear this out. Nuts and seeds, particularly sunflower seeds, are rich sources of vitamin E. However, it is nigh impossible to get from the diet the hefty doses required to work in practice. I recommend supplementing with 800 – 1000 IU (530 - 670 mg) of vitamin E per day.

Women attempting to junk their HRT are best advised to do this gradually. It is quite a jolt for the body to find itself bereft of extraneous hormones it may have been getting for some years. An abrupt withdrawal from HRT almost always sees menopausal symptoms return with a vengeance, with the result that many women will again seek solace in the very medication they are attempting to escape. Gradual weaning down of HRT over, say, three to six months generally increases the chances of success. Another useful tactic is to put into place one or more natural alternatives for a month or two before reducing conventional HRT. In my experience, this approach is usually very effective in helping women keep their cool through the change.

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