HORMONE REPLACEMENT THERAPY
The Complementary Approach
Women take hormone replacement therapy or 'HRT' for a variety of reasons. The most common is for doctors to start women on HRT for the prevention, or relief of symptoms of the menopause ('change of life'). This is the major decrease in female hormone levels that most women experience around the age of 50. HRT is also widely used to prevent osteoporosis, or thinning of the bones associated with ageing. Less commonly, it has been used as a treatment for depression, preventing skin ageing and for the protection against heart disease. However, the importance of HRT in helping with the latter is not yet proven and in fact, the latest research from the United States has shown there is a slight increase in heart disease and breast cancer in women taking a particular type of HRT which is not available in the UK. Also, those women who have experienced those problems had been taking that particular type continuously for a period of more than five years.
Many women, who have been taking conventional HRT for five years or more, are now looking to complementary therapies because of the latest recommendations from the medical establishment. These state that a woman should not continue for over five years, starting from an age of fifty, or from the date which a woman starts her menopause naturally. Nevertheless, a number of women prefer to continue with HRT because of the claims made by some manufacturers that continuous use helps to prevent osteoporosis. However, there are other ways that women can help in preventing thinning of the bones including a diet rich in calcium and vitamin D, which is found in cod liver oil, regular weight bearing exercises, as in walking and jogging and not smoking. The latter, of course is very important for a person's general well being.
So, what can a woman take or do to help those distressing symptoms of the menopause such as weight gain, night sweats, hot flushes, vaginal dryness and reduced, or absent, sex drive? These are the symptoms most likely to be helped by conventional HRT. More difficult to pin point, however, are the symptoms relating to difficulty in concentration, problems of memory, and a general feeling of tiredness and depression which can respond to the complementary approach.
Therefore, how can a complementary approach help? Research has shown that herbal products (both medicinal and traditional Chinese) can be effective in relieving symptoms of the menopause. These include medicinal herbs such as salvia, cimicifuga, agnus castus and motherwort. These can be taken either as ready-made tablets or as an individualised mixture from experienced herbalists. However, it is important to remember that herbal remedies do not undergo the same testing as conventional medicines and so not all their possible side-effects are known. How they affect established medications when being taken at the same time is still a matter of debate and further research, particularly within the European Union.
Hypericum, or St John's Wort, is increasingly used for menopausal women and has been shown to help with feelings of depression, low sex drive and the physical effects such as hot flushes. It can, however, react badly with blood thinning drugs, so care is needed when it is taken. Chinese herbs, such as Dong Quai ('Chinese angelica'), are also widely used and have been shown to contain potent plant oestrogens.
Homeopathic remedies, unlike herbal remedies, have no known interactions with conventional medicines, and can therefore be taken safely alongside or as an alternative to conventional HRT. Commonly used remedies include belladonna, which is useful where there is noticeable reddening of the face or the body during a flush. Glonoine can be taken during a flush or sweat to help cut short the attack. Deeper acting remedies, such as Sepia, Lilium.tig and Sulphur can all help but need to be individualised to the patient for best effect.
Vaginal dryness is an upsetting, but infrequently talked about symptom of the menopause and one for which most women use conventional oestrogen-containing vaginal creams, pessaries or gels. It can be difficult at times to treat but research has shown that a diet high in phyto-oestrogens, such as those contained in soya-derived foods, can help. Also vitamin and mineral supplements containing vitamins E and C, magnesium, zinc and bioflavanoids, together with supplements containing gamma-linoleic acid (GLA) often recommended by nutritionists treating women in the menopause. Evening primrose oil or flaxseed oil are recommended as well.
Acupuncture is another therapy that can be used as an alternative to HRT and is backed by current research. This is not a painful therapy, contrary to popular belief, but may well need a succession of treatments before its full effect is reached.
Finally, it is important not to forget the usefulness of relaxation therapies such as yoga, meditation, massage or aromatherapy during the menopause. If a woman feels better in herself, then the menopausal symptoms will be moderated. A feeling of general well being is the underlying aim of all of the therapies mentioned above and what is euphemistically known as the change of life could well be a change for the better.
© Dr Jeni Worden 8.3.06