Menopause Questions and Responses

Menopause Questions and Responses

Lorraine Rothman, author of Menopause Myths and Facts answered your questions:

My doctor recommends hormones to prevent osteoporosis, what do you think?
I'm confused about whether or not I need HRT to prevent heart disease?
I have hot flashes - is HRT the only option?
I have very sore nipples - could this be from too much progesterone?
My doctor prescribed progesterone for 10 days, because my period was so heavy that I became anemic. Now that I've gone off HRT, do I need something to protect against bone loss?

scroll down to see responses

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QUESTION
I had a complete hysterectomy in the late 1980s. At that time I was told to take Premarin which I did. I am now 56, and after educating myself about the negatives of HRT (hormone replacement therapy), I went off of Premarin. I have only been off of Premarin for a week without any noticeable side effects. This past year I had a bone density test which was quite good and in the normal range. Do you feel that I should talk with my physician about resuming estrogen therapy through alternative methods? There are so many choices available. I am aware of what one should do to protect herself from bone loss, and do incorporate at least 1500 mg of calcium in my diet each day.

RESPONSE
Studies today show that healthy older women who live physically active lives, eat healthy diets, don't smoke, drink little alcohol, don't take drugs that are known to deplete our bones of calcium, and are not taking hormone drugs, do not appear to have serious bone loss. It's staying physically active, eating and drinking healthily, controlling stress in our lives, and otherwise enjoying life, that keeps us mentally and physically - including our bones - healthy. We have other organs in our bodies that make all the same hormones our ovaries do. When our ovaries are removed and we work at staying healthy, the adrenal glands and our body fat are wonderful producers and take over the task. It's a good idea to continue to monitor your bone density because it can remind you if you are beginning to slack off in physical activities. Remember that bones respond to muscles working hard against them and use calcium (as well as other minerals) in our foods to offer our muscles the support they need to do their work.

QUESTION:
I am a 45 year old female. I have had 5 children with all pregancies being normal. Over the last year I have experienced some bleeding problems. Earlier this year I had a spot on my cervix that needed to be frozen to prevent bleeding mid cycle. I have noticed also that my periods have become heavier especially the first full day of bleeding. I have just made a point of staying close to a bathroom on those days. However this past month I began my period and it was so bad that within 2 days I became anemic. My gyn prescribed Medroxyprogesterone for 10 days. Now 22 days later I have what appears to be a very heavy period again. My Dr. again prescribed another 10 days of progesterone and said that we should try this for a few months to see if it will help. Quite frankly I'm not sure that this therapy makes sense to me. I've read that progesterone is for post menopausal women or if your period is irregular and you do not get it. I have had 2 negative biopsies so there is no sign of trouble to cause this heavy bleeding and I'm wondering if I just try to live with this heavy bleeding and continue to take my iron to avoid anemia. Perhaps this is a normal course for peri-menopause. I could use a little insight as I have read very little about peri-menopause. Any comments would be greatly appreciated.

RESPONSE:
It sounds like you need to find a progressive women's health care specialist and an endocrinologist to run some tests that can help unravel underlying health problems. Your present doc is trying to stop the heavy bleeding and get your ovaries back into their normal hormonal production. Docs like to try this first, because it is the easiest and occasionally it works. As to the cause, something is upsetting your endocrine system, of which the ovaries are a part. It could be as simple as long term poor diet, poor nutritional absorption, etc. that cause people to be nutritionally deficient. For example, the cells that make our estrogens must have vitamin A in them as well. Or the liver can be complaining with too many toxins to handle, indirectly upsetting the hormones. Or it could be any number of other health problems that are just now surfacing - minor and easily corrected or more troublesome. Depending on drugs to stop what are early warning signs of underlying health problems, can forstall early diganosis and treatment, leaving the problems to surface later with a vengence. Find experienced wholistic women's health care specialists who can help do the detective work to get you back to health.

QUESTION:
I'm 49 and my doctor says that I'm entering menopause and should start taking hormones to prevent osteoporosis. I've always been active all my life, still do my own housework, like to walk to the grocery store and try to eat healthy. Why do I need to take hormones?

RESPONSE:
You don't. Menopause does not cause osteoporosis. We all lose some bone mass as we age. Bone is a living changing tissue that responds to stimulation. Weight-bearing exercise is the very best way to keep our bones healthy and strong. Eating healthy, getting lots of exercise daily, and controlling our stress levels contribute to healthy bodies overall and strong muscles and bones specifically. See "Hotter Than a Red-Assed Bee" Part II for more info on nutrition, osteoporosis prevention, and herbs to assist..

QUESTION:
My doctor says hormone replacement therapy (HRT) will help prevent heart disease and she wants me to start on them right away. Some of my relatives did die from heart disease and my sister had by-pass surgery this year. I went through my menopause a year ago and I'm not sure what I should do. Can you give me some insight on this most confusing problem I'm faced with?

RESPONSE:
Heart disease is a degenerative condition of aging aggravated by Western lifestyles. Menopause does not increase our chances of developing this serious condition. Although our family's genetic tendencies play a role, keeping our bodies healthy through good nutrition, lots of exercise, stress control, avoiding -- as much as we possibly can -- the toxins in our environment, all help us to enjoy full lives, no matter what ages we are. There is no clear evidence in medical research that the hormone drugs given to older women can help prevent heart disease. In fact some studies show the opposite.

QUESTION:
I have read that hormone replacement therapy (HRT) is the best and only way to get through my menopause "discomforts" -- hot flashes and irritability. Yet, I'm not comfortable with the idea of taking hormones that can cause cancer. Do you have any suggestions on what else I can do?

RESPONSE:
If your health care provider has told you that your hot flashes and irritability are not the result of more serious health problems, you do have a variety of safer choices. Because alternative and natural healing practices are rapidly becoming part of Western medicine today, they are much easier to find. If you want to work with an experienced practitioner, ask for referrals from your own provider, talk with women's health care specialists who are excellent resources for alternative treatments, check with your local health food store's listing of licensed wholistic health care providers, ask friends and co-workers for referrals. If you want to try alternatives on your own, you'll need to be doing some reading on what's available and what's new. Ask your health care provider for reading material, check out your health food stores' reading section, check out your local library, surf the Internet -- there is lots of information available. We need to remember, however, that when we are on our own, we may be getting incorrect information and don't have the benefit of more experienced people's guidance.
Several herbal and natural remedies are covered in midwife and herbalist Carol Leondard's articles, "Hotter Than a Red-Assed Bee" Part I and Part II.

QUESTION
I have been using NHRT (natural hormone replacement therapy) for about 9 months with success. I have now developed very sore nipples. Would this be a result of too much natural progesterone? If not, what else could it be?

RESPONSE
Since "natural" progesterone has been around for such a short while, and very little if any research is being done to track its benefits and/or problems; we are all pretty much on our own to monitor ourselves.

You may want to read the Physicians' Desk Reference, available at most libraries, on Provera just for background on progestin drugs. Provera is not in the "natural" category of course. However, you may be responding in ways that are listed under Provera's Warnings, Precautions, and Adverse Reactions. The PDR does talk about water retention, breast swelling and other effects to the breasts. Can the "natural" progesterone you are taking be performing like the totally synthetic progestin Provera and produce very sore nipples?

"Natural" progesterones are actually reconstituted in the laboratory from wild Mexican yams. We cannot get progesterones directly from eating the yam. The lab people work over the yam's molecular structure to produce something that very much resembles human progesterone. And we are a part of this big experiment because it is so new with no data to back up its performance or safety.

Then again, is it possible that some outside factor has created an irritation-type response on your nipples? You would want to rule out this possibility too.

I think it very important to check with a health professional who is familiar with "natural" progesterones and who also uses a lot of common sense to help you figure out what's going on. Sore nipples are no fun and need to be de-activated.

Disclaimer: FWHC makes health information accessible in the belief that knowledge leads to empowerment, that people make better health decisions when they have as much information as possible.

written in 2001-2002

Changing Woman Ritual

Feminist Women's Health Center