By: Jean Johnson for Fibroids1Hormone replacement therapy (HRT) used to be the main choice for menopausal women until the 2002 study that showed risks of breast cancer and heart disease outweighed benefits. What researchers didn’t realize at the time was that when the 9,351 women taking HRT abandoned the treatment, over half the women who presented with symptoms including hot flashes, night sweats, vaginal dryness, and pain or stiffness at the time they enrolled in the study, experienced a return of the symptoms when they stopped taking the replacement therapy.
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Managing hot flash triggers naturally:
Try to ease the pressure in your life by taking extra time to get places and to relax before engaging in activities like presentations that you know are stressful.
Avoid alcohol, caffeine and diet pills.
Also stay away from spicy food, hot food and hot tubs.
Dress in layers, avoid turtlenecks and keep the ice water handy.
Stick with cotton clothes and sheets and considering picking up a pretty fan you can carry along and take out when necessary.
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The new study of the latest findings from the Women’s Health Initiative (WHI), a major clinical trial of risks and benefits of menopausal hormone therapy supported by the National Institutes of Health, indicated that data suggests physicians need to rethink approaches to weaning women from artificial hormones. The paper, “Symptom Experience After Discontinuing Use of Estrogen Plus Progestin,” was published in the July 13 issue of the Journal of the American Medical Association (JAMA) by Judith K. Ockene Ph.D. of the University of Massachusetts Medical School in collaboration with other WHI investigators. “This study is a significant first step in the effort to understand the lasting effects of combination menopausal hormone therapy (MHT) and offers some important initial answers to questions about what happens when women stop MHT,” Ockene said. “These findings of a recurrence of symptoms should be considered when women are deciding with their clinicians whether to use hormone therapy for menopausal symptoms. More research is needed about alternatives for women to treat their menopausal symptoms, such as exercise, increased fluid intake, and herbal and natural hormones.”
“I thought they’d never ask,” said Marny Phillips of California’s Napa Valley. “It’s sounding a lot like all the holistic health approaches the counterculture has been advocating since the late sixties. And here all we’ve gotten is criticism for our drugs, sex, and rock ‘n’ roll.” Phillips chuckles and then grows serious. “But I’m no different than the next critter. When I started getting hot flashes in my late-forties, off I went to the physician. But nary a word did I hear about water and exercise and what not. Instead it was ‘here’s the sheets on hormones – read them because you are the one who has to decide.’”
Phillips says she went against her better judgment and took HRT for two or three years. When she stopped she doesn’t remember the hot flashes returning as pronounced as initially, although she points out that she still occasionally gets them, especially when she’s eaten too heavily and feels an extra pound or so creeping on. Her bottom line though, is that “it ticks me off now that I think about it. I trusted my physician, and I didn’t get a full picture. That’s why I love the Internet and frequent places like Body1 to get clued in before I go into the see the gals with the M.D. behind their names.”
But back to the news – Sherry Sherman Ph.D. of the Geriatrics and Clinical Gerontology Program at the National Institute on Aging observed that “before this study we knew little about the effects a woman experiences when she suddenly stops menopausal hormone therapy use. Now women are learning that their symptoms might return, even after using these hormones for more than five years.”
And Diana B. Petitti M.D. of Kaiser Permanente Southern California, Pasadena, weighs in as well, underscoring points made by Ockene, Phillips and Sherman. “Middle age is time of change physically, psychologically, socially and economically, and these changes affect the body and the mind. Aches, pains, fatigue, and some other symptoms that are reported frequently by middle-aged women may be a consequence of simple (or not so simple) aging. Delineation of which symptoms are truly due to ovarian aging and which are due to general aging would permit more specific symptom management strategies. Hormone therapy could be used for the symptoms resulting from a decline in natural hormone levels. Treatments that carry minimal risk, including self-management strategies and positive changes in lifestyle, could be recommended for women with other symptoms.”
In her editorial in JAMA that accompanied the Ockene article, Petitti continued. “Most clinicians would agree with the American College of Obstetricians and Gynecologists that when symptoms of menopause necessitate hormone therapy, treatment should be prescribed at the lowest effective dose for the shortest possible time. The high frequency of symptoms reported by the WHI participants may be a result of the abrupt withdrawal from hormone (or placebo) therapy. Thus, when it is time to consider discontinuing hormone therapy, gradual tapering of the dose would be a logical clinical strategy arising from these new observations from the WHI.”
