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LISE CLOUTIER-STEELE

Juillet 7, 2003

BIO-IDENTICAL HORMONES AS A TREATMENT OPTION FOR MENOPAUSAL SYMPTOMS

By Lise Cloutier-Steele

Since the U.S. National Health Institutes pulled the plug on their largest study of conventional hormone replacement therapy (HRT) last year, the media have issued countless reports on the dangers of supplementing with hormones.

Among the important research discoveries: Conventional HRT does not protect your bones or your heart, two of the primary benefits once used by doctors as selling points to get women to fill their prescriptions. Another claim was that the conventional HRT could alleviate the discomfort of severe flushing and night sweats. As a woman who experienced full-blown surgical menopause at age 38, I tried several forms of therapies, in a variety of doses, and none could deliver on that promise either.

I wondered if those facts hadn’t been known before the 2002 major hoopla about HRT. A couple of weeks ago, I met Jean Cottam, Ph.D., at a book fair in Ottawa, and she told me that she had criticized HRT back in 1989. "I sent an article on this subject to the Canadian Medical Association’s Journal," she said. "I argued that HRT didn’t decrease the incidence of heart attacks, but in fact increased the risk of breast cancer. My article was then rejected, but I have been proven correct!" My guess is that many more experts submitted similar findings over the years.

So what’s a woman without ovaries to do?

Short-term use of conventional HRT, a tactic some doctors are suggesting, may not do the trick. Unlike women undergoing natural menopause, during which time the ovaries gradually stop producing as many of the essential hormones, trying to find the right mix of HRT to restore quality of life can be a trying experience. In my case, looking for help in all the wrong places only added to my hormone dilemma.

As did many oophorectomized women who wanted a safer alternative for relief from their symptoms, in June of 1999, I made the switch to natural compounded hormones, also known as natural hormonal replacement therapy (NHRT). It wasn’t easy to connect with a Canadian gynecologist willing to prescribe this therapy, but as with anything else, if you pound on enough doors, one is bound to open.

I remember what Dr. Alvin Pettle of Toronto first told me: "How can you expect to feel normal when you’re supplementing with estrogen only? Your ovaries used to produce several types of estrogens, progesterone and androgens (testosterone being one of them). What we need to do, is try to mimic (naturally) what your ovaries did on their own, before they were removed." This made sense to me. It made even more sense when I noticed a significant improvement in my moods, and a dramatic decrease in the amount of flushing I did in a hour. Best of all, NHRT did not sabotage my weight loss efforts.

What are natural compounded hormones?

According to Montreal-based compounding pharmacist, Mel Alter, NHRT may be one solution for women who did not respond well to the traditional estrogens derived from animal sources, such as Premarin or Prempro, which are derived from the urine of pregnant mares. NHRT, or bio-identical hormones (another term used for them lately), are made from plants and combine all three estrogens that the ovaries generate naturally (estriol, estradiol and estrone — the tri-est formula for short). To this mix, a compounding pharmacist will add natural micronized progesterone, because it has a calming effect on the brain. Progesterone also promotes new bone growth and protects breast tissue from excessive stimulation by estrogen. This would explain why my breast pain became more tolerable.

The delivery

A customized medication can be prepared in the form of a topical cream, sustained release capsules, sublingual drops or troches. Many women opt for the topical cream, and according to Dr. John Lee, author of What your Doctor may not Tell you about Menopause — The Breakthrough Book on Natural Progesterone, the best way to get the hormones into the body is through the skin. Alternating the sites with each application is also advised.

Recently, my friend and colleague, Mary Anne Wyatt of MA, explained that the mode of delivery and application are equally crucial to a woman’s success with NHRT. "This is cookbook chemistry, at best," she says. "But at least with bio-identical hormones, women have somewhat greater control over what their bodies need, if topically applied." Help from an empathetic endocrinologist would also prove beneficial to any woman trying to achieve hormonal balance through NHRT.

But is NHRT any safer?

In his December 2002 newsletter on nutrition and healing, Dr. Jonathan V. Wright of Washington says that in the 20 years that he has prescribed NHRT for his patients, he has always been very careful about explaining that even natural treatments are not entirely safe. But he adds that he believes the bio-identical estrogens, progesterone and testosterone are safer than estrogens made up of horse urine. He cautions that large quantities of bio-identical estrogens can raise a woman’s risk of blood clots or stroke; however, he explains that these risks are preventable if a woman adds omega-3 fatty acids (one tablespoonful of cod liver oil) and vitamin E (400 IU) to her daily regime. Finally, Dr. Wright says that it’s better to be safe than sorry, and recommends close monitoring by your doctor to make sure that your natural hormone therapies remain safe and effective.

Recommended Reading:

For more information on NHRT and lots of other health topics to help us live well, visit the web site of Larry Frieders, R.Ph. and subscribe to his newsletter.

Jeannah of Florida, a contributor to Misinformed Consent, has done extensive research into NHRT and offers valuable information and support to all who visit her Hysterectomy Awareness web site.

You’ve Hit MENOPAUSE, Now What?
3 Simple Steps to Restoring Hormone Balance
A new book by George Gillson, M.D., Ph.D. and Tracy Marsden, BscPharm
Copies are not yet available at Amazon, but anyone interested can get one here.

What Your Doctor May Not Tell You about Menopause:
The Breakthrough Book on Natural Progesterone
John R. Lee, M.D., with Virginia Hopkins (Warner Books, 1996)
ISBN 04466771444

Lise Cloutier-Steele is a communications specialist and a professional writer and editor, who has survived a traumatic experience with hysterectomy. She is also the author of Living and Learning with a Child Who Stutters. And she is the recipient of a Canada 125 Award in recognition of a significant contribution to the community and to Canada for her volunteer efforts to help the parents of children who stutter. She has appeared on Canada AM, the Women's Television Network (now W), The Phil Donahue Show, The Body and Health Show, and several other media to talk about the important topic of unnecessary hysterectomy in North America.

She is also the author of MISINFORMED CONSENT- WOMEN’S STORIES ABOUT UNNECESSARY HYSTERECTOMY