Drawbacks of Hormone Replacement Therapy

Some of the potential side effects are listed here for your information. One aspect of a particular form of treatment that we feel should be mentioned is regarding certain HRT drugs that are derived from the urine of pregnant mares (horses.)

From the website ‘People for the ethical treatment of animals’ www.peta.org : “According to an industry report, 19 ranches in remote areas of Canada house approximately 1,300 pregnant mares who produce urine for Premarin and Prempro. For most of their 11-month pregnancies, these horses are confined to stalls so small that they cannot turn around or take more than a single step in any direction. The animals must wear rubber urine-collection bags at all times, which causes chafing and lesions, and their drinking water is limited so that their urine will yield more concentrated estrogen. Once the foals are born, the horses are impregnated again, and this cycle continues for about 12 years. PMU ranchers are expected to follow the “Recommended Code of Practice for the Care and Handling of Horses in PMU Operations,” but following these guidelines is optional.

• Some of the potential side effects of HRT are:
• Abnormal Vaginal Bleeding
• Breast  Tenderness
• Candidiasis
• Depression
• Gall Bladder Disease (Increased Risk)
• Headaches Or Migraines
• Jaundice
• Loss Of Hair
• Loss Of Sexual Drive (Libido)
• Thrombosis (Blood Clots)
• Uterine And Breast Cancer (Increased Risk)
• Vomiting Or Nausea
• Weight Gain

Not all sources of HRT drugs are from mares by any means, but clearly, this particular source is tainted by an element of animal cruelty.

Many women have found a better way, for them at least, by using a natural nutritional and herbal approach for the changes that accompany menopause.

Why Nutrition May Work Better

As to whether or not the human female evolved to suffer adverse symptoms at the menopause, can be addressed in a number of ways. In the first place, it seems rather unlikely to be so, since most natural systems evolve to work properly, at least when conditions are favourable. We cannot possibly know whether cave women suffered from the menopause, though it is clear that they often failed to live long enough to experience it. However, it is a lot easier to ask whether adverse menopause symptoms are the norm today, on a global basis rather than just looking at our own society. It has been reported that the incidence of hot flushes, the most common of the symptoms of the menopause, varies from 70-80% of menopausal women in Europe, 57% in Malaysia, but only 18% in China and 14% in Singapore. (3) (4)

Whilst it could be genetically based, such a wide global divergence strongly suggests differences in lifestyle. Substantial dietary differences exist between these populations, especially with regard to the consumption of soya products. Soya beans contain substances called phytoestrogens, which, although for the most part are not steroids like the normal human oestrogens, exert weak but definite oestrogenic effects in the human body. Obviously, such substances have the potential to give significant physiological support to menopausal women whose symptoms arise from relative oestrogen deficiency.

Foods that are high in phytoestrogens include certain fruits (apples, cherries, olives, plums, coconuts), legumes (soy beans, peanuts), tubers (carrots, yams), members of the nightshade family (eggplant, tomatoes, potatoes, peppers), grains (cereal grains and especially wheat germ, but not rye, buckwheat or white rice). Similar components are found in yeast. Fennel, anise, and liquorice all contain estrogenic compounds. However, concentrations and activities vary greatly and none appear to rival the soybean in effectiveness.

The menopause is after all only a necessary physiological phase in human life. It is therefore possible to hypothesize that it was usually quite manageable without significant symptoms in Western countries so long as the diet of the population remained unaffected by industrialization and modern farming practices. This would have generally ensured that people ate large amounts of unprocessed plant foods. Depending upon the choice of foods, this would tend to ensure a certain daily intake of phytoestrogens. The industrialization of farming and food processing would certainly have greatly reduced this intake, for example, by stripping off the outer coat from grains – the phytoestrogen content of rice is an oil-soluble fraction within the bran, for instance. This is known as gamma oryzanol and can be obtained in isolated form. Clearly, the drop in circulating oestrogens and progesterone that occurs at the menopause, which is a drop to about one third of the premenopausal level, is potentially critical. The proposal made here is that this criticality was held at bay by the make up of human diets of unprocessed foods over the last two million years, but became exposed as soon as industrialized diets came about and removed a proportion of the phytoestrogen support.

There are, however, two other nutritional theories to add to the above. The first of these is that the status in other nutrients can have an effect upon the level of the body’s own oestrogen production. This appears to be true of the mineral chromium. One report by Evans et al (5) indicates that by ensuring adequate status of chromium in the body after the menopause, a woman can increase her internal production of the oestrogen dehydroepiandrosterone by some 20%.  The Meeting Abstract, in which the references to the hormone insulin are of particular interest, reads:

“Osteoporosis results from the resorption of bone due in part to the absence or inaction of insulin and estrogens. Insulin resistance impairs bone calcium deposition and leads to hyperinsulinaemia that impairs the synthesis of DHEA. In post-menopausal women, DHEA is the only source of estrogens, inhibitors of osteoclast activity. Because chromium supplements reverse insulin resistance, we tested the effect of chromium picolinate (CrPic) supplements on factors which lead to osteoporosis. For a period of 60 days, 27 postmenopausal women, age 52-63, took two capsules per day that contained either a placebo or 200mcg Cr as CrPic. After a 3-month washout, the women were given the opposite supplement. During the period on CrPic, plasma insulin (2hr post-75g oral dextrose) decreased 37.6%, plasma glucose decreased 26% and DHEA increased 24%. During that period, the urinary hydroxyproline/creatinine ratio decreased by 23.5% and the urinary calcium/creatinine ratio decreased by 19%. The placebo had no effect on any of the parameters measured. When an 800mg/day calcium supplement was combined with CrPic supplements for 60 days, the urine hydroxyproline/creatinine ratio decreased by 47%. These results suggest that chromium, through its effect on insulin, may be effective in preventing osteoporosis.”

The reader is invited to read this quotation again later, after reading the section on osteoporosis, when the details of it will be more easily understood. However, referring specifically to the biochemical parameters measured in the above paper, the drop in plasma insulin may be taken to show that insulin is being used more effectively as a result of the chromium supplement. The decrease in plasma glucose also indicates the  better use of insulin. The rise in DHEA level is important because DHEA affects the way we feel and it is a precursor of oestrogen. The urinary hydroxyproline/creatinine ratio will be discussed below, but a reduction in this value indicates that less bone tissue is being broken down. The urinary calcium/creatinine ratio also diminishes when less bone is being broken down or when more bone mineral is being deposited. The results of the above study appear to indicate that bone metabolism is being very strongly supported by chromium supplementation and that a large proportion of the benefit is mediated through increase in the level of circulating oestrogen.

This has been given here as an example of the way in which micronutrient status may affect menopausal symptoms. In this case the micronutrient involved has no obvious connection with the production of oestrogens, but was nonetheless found to be quite closely connected.

The fact that oestrogen production in the body was found to be inhibited by “insulin resistance” is potentially very important and is apparently related to Western lifestyle factors. This  phenomenon  of  “insulin resistance” is widespread, being associated with obesity, with Type II diabetes and  with  pre-diabetic conditions that arise from micronutrient  imbalance  and deficiency. Hence, the simultaneous prevalence in society of “insulin resistance”, obesity and of menopausal symptoms are quite likely to be jointly associated with factors in the Western lifestyle.

This may be a good example of the kind of way in which other nutrients may influence either the circulating oestrogen levels after the menopause or, perhaps, directly affect menopausal symptoms. New research on the trace minerals boron and strontium has shown that they have a major impact on bone integrity. They are mentioned here to further highlight the complexity of bone metabolism, and to draw sharp attention to the fact that substances other than oestrogen can have major effects on bone density.

Rosetta Reitz, in a book called “Menopause – A Positive  Approach”,  certainly  believes  from her work in the field that the quality of  food and  nutrients generally affect the severity of menopause symptoms. She wrote, “Among the women I interviewed I found that those who were concerned with the food they ate were experiencing their menopause  with  more  ease.” Elsewhere she writes, “Altogether, have noticed that the women who take vitamins regularly have less problems.” The reader is invited to bear these observations in mind while studying the detailed sections that follow. Overall, there are both general and specific reasons for thinking that by avoiding nutritional imbalances one becomes freer from symptoms.