Many of us have been jaded by the constant onslaught of "the latest" medical news, much of which seems to contradict what we just heard or read about the week before.
But on July 9, millions of us - patients and health care providers alike - paid rapt attention when the federal government's National Institutes of Health released findings from a major clinical trial, warning of the risks associated with a widely used type of hormone replacement therapy (HRT) that combines two female hormones, estrogen and progestin.
It's estimated that 6 million postmenopausal American women currently take Prempro or similar combined estrogen-progestin drugs to ease menopause symptoms and to improve their health and well-being.
Risks Outweigh Benefit,
The study, called the Women's Health Initiative (WHI), found that the combined drugs caused increases in breast cancer, heart attacks, strokes and blood clots. Although the risk to an individual woman may be small, the number of cases occurring in the population at large can be great, researchers said. And those risks outweigh the drugs' actual benefits - a small decrease in hip fractures and a decrease in cases of colorectal cancer. The study was released four years earlier than expected because of researchers' concerns.
The WHI study is the first-ever long-term randomized controlled clinical trial - considered the gold standard by medical researchers - of hormone replacement therapy. The WHI was established in 1991 by the government to address the most common causes of death, disability and impaired quality of life in postmenopausal women. The Medical College of Wisconsin is one of 40 WHI clinical sites nationwide where study participants are seen and monitored.
The Women's Health Initiative is a 15-year multimillion-dollar endeavor, and one of the largest US prevention studies of its kind. The study was designed to look at the effects not only of HRT, but also diet modification and vitamin and mineral supplements. Some 67,000 women from across the country, ranging in age from 50 to 79, are participating in the WHI clinical trials. In addition to those women, the study is also following the medical history and health habits of an additional 100,000 women to examine the relationship between lifestyle, health and risk factors with specific disease outcomes. Final results are due out in 2006.
More than 16,600 U.S. women are participating in the combined estrogen-progestin portion of the trial, among them 438 women who are in the Medical College of Wisconsin group. They were sent letters telling them to discontinue taking those drugs. The WHI is continuing to study the effects of ERT, or estrogen-alone drugs, used by women who have had a hysterectomy. WHI has not stopped that portion of the study.
Is there a safe alternative?
For years women have found safe alternatives to synthetic hormone replacement therapy. Because these approaches are not patented you don't always hear about them. When a pharmaceutical company can obtain sole rights to a drug they can charge what they want and can usually make millions if not billions of dollars before the patent runs out. Companies that sell natural products are not able to do this and thus are under considerably more competition and have less resources to advertise. That's why most people not only know about drug therapy approaches but assume there are no other choices.
The good news is there are many safe and effective alternatives to hormone replacement therapy. When considering a healthy hormone state one should consider normal lifestyle habits. Diet, exercise, plenty of clean water, sunshine, and sleep are just a few of the important lifestyle habits to maintain a healthy chemistry. Along with these lifestyle habits different nutritional products have been shown to be very effective. Herbs like black cohosh have a very high success rate in controlling many of the symptoms of menopause like hot flashes. Stronger bones, healthier heart, balanced emotions, healthier skin and a normal sexual response can be maintained by properly balancing hormones during this time of life.
Different foods have been shown to be beneficial in this strategy. Foods made from soybean or flax can help a woman maintain a better hormone balance. At Keefe Clinic we have different options in utilizing these particular foods.
Lab work, symptoms survey questionnaires and vega testing can be helpful in developing a nutritional approach to hormone balance. We carry a line of creams and pellets that have natural estrogen and progesterone to help maintain a proper level. The hormones in these products are derived from plants, yet the estrogen is the actual form of one of the estrogens naturally produced in the body. These hormones have been used for over 20 years with no known side effects.
If you would like to be evaluated for hormone balance, be it for symptoms of menopause or premenstrual syndrome, don't hesitate to ask.