Hormone Replacement Therapy: Alternative Options to HRT
By Jason Cheng, DO
Menopause is classified by many as a disease. This classification allows it to be scientifically studied, analyzed and medicated. Anything that can be medicated can be capitalized upon, or turned into profit. Menopause, like puberty is not a disease. It is a natural process every woman must go through.
As a former pharmaceutical representative, I am not here to bash on the pharmaceutical industry. If it weren’t for the advances made by medical science and technology, few people would be around long enough to even complain of the cancers and chronic conditions. In reality each person owes the longevity of his or her life to some extent to the pharmaceutical industry.
However, I also believe that not every phase of life needs a pill. Menopause is a milestone that deserves the attention of natural and holistic therapies that can either be partnered with ongoing health maintenance to ease the discomfort and annoyances it creates. As a medical doctor, I prefer to stay away from touchy-feely words like “holistic” or “mind-body” therapies. The jargon professionals’ use is INTEGRATIVE Approach.
What is the INTEGRATIVE approach to menopause?
Integrative approach focuses on the fact that hormones are important, but should be used as an extension of your endocrine system and all other functions that effect your endocrine system, not as a replacement for it. A rapidly emerging new field of medicine called PNI (Psycho-neuro-endocrine-immunology) is studying the applications and outcomes of the integrative approach. This is scientific jargon for mind-body medicine. The first aspect of the integrative approach does not require pills, doctors or money. It only requires you get honest with yourself and make some lifestyle choices.
Lifestyle Choices Still Your Best Ally: “You are what you eat", AND "what you do”
Consider what would happen if you fed your dog a daily diet of hamburgers and fries, forced him to smoke cigarettes and refused to take him for a walk? He probably wouldn’t live past 5 years, dying either from a heart attack, stroke or escalated aging. For whatever reasons humans seem to think they are separate from the rest of the animal kingdom in terms of evolution and biological functions.
People are busy and we depend on fast food to fuel our fast lives. Why bother learning yoga when sipping a few glasses of wine or puffing away that pack of cigarettes alleviates stress so much more quickly? And because we’re so exhausted after a long day sitting in traffic, sitting at work and sitting at the Drive-thru, we need to relax at home by laying on the couch watching our 175 TV channels while snacking on chips and draft. Does this sound familiar to anyone?
Current and very disturbing health trends are reminding us that the human body hasn’t adapted to the Internet age. Our bodies is still stuck somewhere in the Stone Age, functioning only to hunt fish and wild boar, eat berries and fruits and store fat for the cold winter. In the Stone Age, few lived past twenty. Today’s health dangers stem from too much of a good tasting or good feeling bad thing. Saber tooth tigers no longer prey on us. Our predators are heart disease, diabetes and cancer. Our predators are our own fault and enter our domain through poor diet and lack of physical activity. Note: walking and sex are considered excellent forms of physical activities---things you do in a healthy relationship!
Since you can’t go back to the Stone Age or rewind the biological clock what can you do? What alternative choices do you have?
Complementary and Alternative Medicine
You are in a unique time when you are renewing your focus on exercise, nutrition, and complementary healing systems such as Chinese medicine, ayurvedic medicine, osteopathy, naturopathy and homeopathy. I tend to augment traditional medicine by placing more emphasis on exercise, nutrition, acupuncture and herbs. My focus in Couples Health will be primarily on recent developments stemming from research in medical centers across the US as well as the National Institute of Health that are focusing on herbs and acupuncture.
I will quickly preview some of the topics for women’s health that will proceed, largely because of the renewed interest in alternative therapies for HRT.
HERBS that ease Menstrual & Menopausal Symptoms
Black Cohosh (Cimicifuga racemosa):
- Uses: Some studies report a decrease in hot flashes and other perimenopausal symptoms such as PMS, painful periods, and other perimenopausal symptoms. Though relatively new in the US, this therapy has been used in Europe for over 40 years.
- Side Effects: Some of the reported problems include abdominal pain, diarrhea, dizziness, headaches, joint pains, and altered heart rate.
- Alert: Because it is thought to act like a “natural estrogen”, it is important that those who have a history of breast cancer, endometriosis, or endometrial cancer counsel their physician about this herb. This means there are possible complications with this herb combined with HRT (hormone-replacement therapy) or contraception. In addition, because long-term studies have not been conducted, it is recommended that it be used for NO MORE than 6 months. It takes 6 to 8 weeks for effect to be noticed.
- Dosage: .3 to 2 grams (capsules) or 2-4ml a day (tincture). 40mg standardized tablet extract once a day.
Chaste-Tree Berry (Vitex agnus-castus) :
- Uses: Hormonally balances menstrual cycle, preventing heavy bleeding during menstruation.
- Side Effects: Few are known, but it may cause an acne-like rash or itch.
- Dosage: .5-1.0 grams (fruit) three times a day
Dong Quai (Angelica sinesis) :
- Uses: Similar to black cohosh, for relief of hot flashes and uterine stimulant.
- Side Effects: Since it contains anticoagulants (blood thinning) agents, it should be avoided when on other anticoagulation therapy for stroke prevention.
- Dosage: 3-10 grams of sliced dried root/day; liquid: .5-2ml three times daily.
These are some examples of the herbs that are recommended by medical practitioners. They should not be thought of as a replacement for whatever medical treatment you might be under. Just like prescription pharmaceuticals, they should be discussed with your health care provider. This is crucial. Some over the counter herbs and natural therapies can react adversely with medication causing paralysis, stokes and even death. Do not begin taking any herbs, nutritional supplements or natural remedies without first consulting your doctor.
Other forms of therapy include addressing diet deficiencies that may contribute to certain symptoms you may have and developing a good exercise regimen including aerobic, lightweight bearing and meditative/stretching forms. I highly recommend ballroom dancing, Tai chi, yoga, Pilates and swimming for their beneficial effects on flexibility and overall stress reduction and management.
In the next month, I will develop a list of foods, especially SOY that many practitioners advocate for reproductive health, as well as discuss with acupuncture experts on how female sexual disorders and menopausal issues are dealt with from a Chinese Medicine perspective.
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