Women seeking safer hormone replacement therapy.


Article Last Updated: 11/20/2005 11:53 PM

Three years ago the world of women's health turned upside down. That was when a large study, the Women's Health Initiative, showed that hormone replacement therapy could have serious health consequences.

HRT was expected to protect women from heart attacks and strokes. Instead, it actually increased the risk of cardiovascular complications. The study also confirmed that hormones like estrogen and progestin elevated a woman's chance of developing breast cancer.

Ever since these alarming results hit the headlines, prescriptions for Premarin and Prempro have plummeted. During the heyday of HRT, almost 80 million prescriptions were filled every year for estrogen or estrogen-and-progestin products. So far this year, fewer than half that many prescriptions have been filled.

Now women are looking for alternatives. It is estimated that 5,000 American females enter menopause every day. They are experiencing symptoms such as hot flashes, night sweats and vaginal dryness.

Many women have questions about what to do: "I am 55 and going through menopause. My physician had me on Premarin for several years. We discussed the advantages and disadvantages of this treatment several times, and he assured me that Premarin helped with bone density and heart attacks as well as other problems associated with the change of life.

"When I heard of the study showing problems with Prempro, he finally agreed that I should stop. I would still like some relief from my uncomfortable symptoms, and I asked him about natural hormones. His answer was, `I don't know anything about that, so I can't give any advice on it.'

"I have gone to this doctor for years, and I felt abandoned. I am really suffering with hot flashes, mood swings and trouble sleeping. My physician has no suggestions for me at all."

Many women like her are looking for alternatives to relieve symptoms without increasing their risk of heart attacks, strokes or breast cancer.

Over the past few years there has been a huge increase in the sales of so-called bio-identical hormones. Compounding pharmacists use soy and yams to formulate estrogen and progesterone that are supposed to mimic the hormones a woman's own body used to produce. Proponents claim these products are safer.

Despite their popularity, bio-identical hormones are coming under scrutiny. The Food and Drug Administration says that doctors and patients should assume that all hormones have a similar profile of benefits and risks, regardless of how they are made.

Dr. Susan Love, a leading advocate for women's health, points out that high levels of progesterone are not natural after menopause. The American College of Obstetricians and Gynecologists also warns that there is no evidence that long-term use of bio-identical hormones is safe.

For women suffering severe menopausal symptoms, short-term use of female hormones can be helpful. This is still the most effective treatment for hot flashes and night sweats.

Q. I have been eating two cloves of raw garlic every day at my evening meal. It may be a coincidence, but I have not had a cold in more than 10 years, and I don't get sick for any other reason either. I'm 84 years old and am shooting for 120.

A. Garlic has a long history of medicinal use. As far back as Hippocrates, healers used it for toothaches and chest pain. Grandmothers have been administering garlic for centuries to overcome colds and other respiratory infections.

Although there is no scientific evidence to validate garlic's power against viral infections, eating two cloves daily may keep others so far away that they can't give you their colds.

Q. Some time ago you wrote about a person who had taped a bean to the inside of his wrist at bedtime as an aid against insomnia. By pushing on an acupressure point, it gave him a decent night's sleep. What I would like to know is whether you use the same bean over and over or a new bean every night.

A. That reader told us that he taped a dried kidney bean between the two tendons on the inside of his right wrist. He located a spot the width of three fingers from the wrist crease.

According to our research, this is an acupressure point called the "Inner Gate." Pushing on it is supposed to relieve anxiety and promote sleep. You should be able to use a dried kidney bean many times without replacing it.

You may also want to investigate 1st Choice Sleep Band, which has a plastic button embedded in a Velcro strap. It stimulates a different acupressure point. For more information, visit www.acuband.com.

Q. I am very sensitive to arthritis medicines. Ibuprofen gives me heartburn, and aspirin makes my ears ring. I really liked Vioxx because it did neither, but now it is gone. My doctor says Celebrex is a problem because I have high blood pressure plus a history of heart disease in the family.

My chiropractor recommended a combination of fish oil, glucosamine and magnet therapy. What can you tell me about these weirdo approaches?

A. While fish oil, glucosamine and magnets are not considered mainstream, there are scientific studies to support their use in treating arthritis. Fish oil has measurable anti-inflammatory activity, and glucosamine has been shown to relieve arthritis symptoms (Annals of Pharmacotherapy, June 2005).

Magnet therapy remains far more controversial. A study in the British Medical Journal (Dec. 18-25, 2004) suggested that this approach was better than placebo for hip and knee pain.

Q. My mother was told by a beekeeper that people with seasonal allergies should ingest one tablespoon of honey a day. However, the honey must come from local beehives. What do you know about this?

A. There are reports that eating honeycomb from the local area can relieve allergy symptoms. Theoretically, honey desensitizes the allergic reaction to pollen, but there is no science to support this claim.

Joe Graedon is a pharmacologist. Teresa Graedon has a doctorate in medical anthropology. E-mail them at peoplespharmacy@gmail.com or visit their Web site: www.peoplespharmacy.org. Check with your physician before following any advice in this column.

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