By: Jean Johnson for Uterus1
Hot flashes and night sweats. Vaginal dryness which can lead to painful intercourse. Insomnia. Depression or moodiness. Problems thinking or remembering things. Urinary incontinence or loss of the ability to control urination. Painful joints or muscles. Low libido or a lack of interest in sex. If that isn’t a downer list we don’t know what is, but it’s the roster of menopausal symptoms according to experts in the field.
|Traditional and Alternative Treatments|
According to a University of Pittsburg affiliated Web site, the following are traditional and alternative options women choose to treat menopause.
Testosterone (often used to increase sex drive)
Other Drugs (Prescription drugs used for hot flashes and osteoporosis)
Naturopathic Medicine: Naturopathic medicine uses herbs, homeopathy, acupuncture and other alternative treatments.
Herbs: Herbs can help some of the symptoms of menopause.
Vitamins: Vitamins in higher than usual doses can help some of the symptoms of menopause.
Soy and Phytoestrogens: Naturally occurring estrogen-like compounds found in food.
Diet: Improving your diet can not only decrease hot flashes but may reduce your risk of cancer and heart disease.
Reiki: A Japanese non-invasive healing modality
Click here to read more from the University of Pittsburg.
The science on menopausal symptoms is murky at best. The first three symptoms, according to the National Institutes of Health (NIH), are linked most strongly to menopause. The others, states the NIH, are more uncertain as to genesis since research thus far has not determined whether they are related to menopause itself or simply problems that can “come with aging – a dynamic that can bring stress, economic concerns, or changes in personal relationships.”
Women’s Health Initiative Study Raised Hormone Replacement Therapy Alarms in 2002
Traditionally, symptoms associated with menopause have been managed by mainstream physicians who use combinations of synthetic estrogen and progestin, or prescriptions of estrogen alone, in what is known as hormone replacement therapy (HRT).
PREMPRO, a combination treatment, was one of the more widely used. But things changed on July 9, 2002, when the U.S. National Heart, Lung, and Blood Institute (part of the NIH) announced it was stopping the study of PREMPRO that had been ongoing for more than five years.
Part of the Women’s Health Initiative (WHI), a 15-year study by the NIH, was initially launched to assess whether long-term use of PREMPRO would reduce the risk of coronary heart disease in postmenopausal women. What researchers found, however, was the reverse – plus additional unanticipated side effects.
According to the NIH, heightened risks for coronary heart disease and stroke began emerging during the first year of use. Risk for stroke started to increase after two years of use, and increased risk for breast cancer appeared three to four years into traditional HRT regimes. These risks associated with long-term HRT were seen with normal dosages. Consequently, now “experts theorize that long-term adverse effects associated with low-dose estrogen are lower,” states the NIH even as it acknowledges that “the precise risks and benefits are not known.”
Even as the NIH applies an even-handed measure to traditional, mainstream methods of managing menopausal symptoms, it also has worked to assess complementary and alternative medical approaches that have become more popular since the uproar caused by the unexpected results of the WHI study on PREMPRO. Toward that end, the NIH gathered dozens of physicians from across the nation together for a State-of-the-Science (SoS) Conference on the Management of Menopause-Related Symptoms in 2005. Independent panels, reviews of medical literature, presentations by investigators working in relevant areas, a two-day public question and answer session, followed by a day of closed deliberations all contributed to an NIH SoS statement.
In this series exploring alternative approaches to treating menopausal symptoms, Uterus1 will use comment from the NIH report to balance our interviews with naturopathic clinicians.
Indeed, as the NIH report states: “Decision making for women regarding treatment of menopausal symptoms requires balancing of potential benefits against potential risks. Women at high risk for serious medical outcomes with the use of estrogen include those with a history of breast cancer, those with an elevated risk for breast, ovarian, or both types of cancer on the basis of genetic factors, family history, or both; and those who have, or are at high risk for, cardiovascular disease.
“Women with these risk factors,” concluded the NHS SoS statement, “may be particularly motivated to seek non-hormonal therapies to treat menopausal symptoms.”
Immediate Aftermath of WHI Study Report
To appreciate the importance of this discussion, it’s helpful to recall the initial response to the 2002 news that the HRT physicians had used for decades was no longer a wise option.
Experts say menopause needs to be ‘demedicalized’ and understood as a normal change of life.
Results from the Women’s Health Initiative in 2002 unexpectedly indicated that long-term regular dosage use of PREMPRO (a combination synthetic estrogen and progesterone hormone replacement drug for menopausal women) predisposed women to coronary heart disease and stroke, as well as breast and ovarian cancer. The study was summarily curtailed and since that time women have increasingly sought alternative ways to deal with symptoms of menopause.
Complementary and Alternative Medicine (CAM) is increasingly being recognized as a fruitful approach to health and wellness. For updated information about CAM treatments, the National Institutes of Health has established the National Center for Complementary and Alternative Medicine at nccam.nih.gov.
To take part in clinical studies, or learn the latest findings and suggested treatments from the Women’s Health Initiative study, visit the WHI’s official Web site.
Donna Hoke, for example, who is now 52 told Knight Ridder Tribune Business News in 2003 that since the study focused on normal doses and long-term use of hormone replacement therapy, she planned to use low doses of estrogen over the shorter term to help navigate the aftermath of the total hysterectomy she underwent.
“I would rather take estrogen than play games,” said Hoke, who manages staff education and training at St. Joseph’s and Candler, two of the oldest continuously operating hospitals in the United States located in Savannah, Ga. “I am not interested in herbal replacements. I would rather take a certain dose of hormones each day.”
On the other hand, Lorna Vanderhaeghe, B.Sc. – the Vancouver, Canada-based award winning medical journalist who co-authored “No More HRT” with Karen Jensen, N.D. a naturopathic physician – countered Hoke’s comments in the Knight Ridder article.
“There isn’t a single menopausal symptom that can’t be taken care of nutritionally,” Vanderhaeghe said. “Most women are so nutrient deficient that simply adding a multivitamin with minerals and some essential fatty acids helps prevent hormone imbalances.”
Demonstrating the zeal with which women rallied around their position in the debate, Vanderhaeghe added, “We have terrible infertility today, miscarriages, early menstruation. We know this is related to too much estrogen in the body, too much environmental estrogen disturbing hormones. It is important that we reduce fat. The more fat we have, the more toxic estrogen we are carrying.”
With such fierce stand-offs over approaches to managing menopausal symptoms in the popular press, we looked for emerging commonalities that might provide a more settled point of departure. The NIH and two naturopathic physicians at Nature Cures Clinic in Portland, Ore., didn’t let us down. Although the two perspectives quickly find much to debate, they do agree that we will be well served to think of menopause as a normal part of a woman’s life.
“Menopause is ‘medicalized’ in contemporary U.S. society,” stated the NIH. “There is great need to develop and disseminate information that emphasizes menopause as a normal, healthy phase of women’s lives and promotes its demedicalization. Medical care and future clinical trials are best focused on women with the most severe and prolonged problems.”
Similarly, Rose Paisely, N.D., a naturopath doctor at Nature Cures noted that, “Women in some cultures, like many countries in Asia, don’t report any changes or problems at all.”
In the subsequent parts of this series, we’ll explore the ways naturopathic physicians manage menopausal symptoms. As we do, we will keep an eye on comment from the NIH and other mainstream sources so that we can provide a balanced report on the current thinking. Stick with us. It’s all about widening the lens to include both the tried and true and the new kids on the block. In the process, we should run across more than one nugget of truth that will help our readers make sound decisions when it comes to their own healthcare.
Continued in Part Two
If you enjoyed this article, you might also be interested in the following:
Examining Conflicting Views on Hormone Replacement Therapy
Do You Feel the Heat? Hot Flashes – How They Happen and Why
Menopause and Depression – Jury Still Out on the Connection
Alternatives to Hormone Replacement Therapy for Menopause