THE MEDICINE CABINET
Hormone Replacement Therapy
By Jean Sutherland

     The word came down from on high last July that Hormone Replacement Therapy (HRT) is not such a good thing after all. I was 38 when I started going through menopause. It took the doctor two years to figure out what was wrong with me. Every six months he would pat me on the knee and say...”Stress.” I was none too pleased that a couple of days after my 40th birthday he finally said “Ahhh menopause.”
     Suddenly here I was in this thing called menopause and had no idea what it was really all about. He shuffled me off to the OBGYN who put me on hormone replacement therapy and I actually sat there and asked “Can I still get pregnant?” Needless to say he looked at me rather strangely and of course told me NO!! It’s amazing how much information I had when I started getting periods and how little I knew when they ended. I asked him just how long I was going to have to stay on HRT and again I got that dumbfounded look and he replied “Forever.” That was a shock. I assumed menopause was something that happened one day and you were soon over it. Forever. What a huge surprise.
     Back to the powers on high. After considering what they were saying and researching it as much as possible on the net, I decided that as a smoker and someone who is a tad overweight, maybe I should reconsider this therapy.
     Everyone started to say herbal was the way to go. So off I went on the herbal hunt. Except for a herbal remedy developed by American Indians, most of the exotic berries, teas, herbs and oils frequently taken by women to ease menopause symptoms have been ineffective in clinical trials.
     Researchers at Columbia University and George Washington University examined the results of 29 independent studies on alternative treatments for hot flashes and found that only the herb black cohosh appeared to work. Three of four trials found the herb had a benefit, according to the Annals of Internal Medicine.
     Black cohosh, a member of the buttercup family, is among the most popular of alternative treatments for menopause. Most clinical studies involved a concentrated brand called Remifemin, manufactured by GlaxoSmithKline.
     Other popular herbal treatments, including ginseng, red clover, dong quai and oil of evening primrose, were found to have no discernible effect on symptoms as hot flashes, vaginal dryness, sleeplessness and other ills blamed on menopause. Researchers said studies have also found few documented benefits from acupuncture, vitamin E, relaxation techniques and progesterone creams.
     The study said a few alternative treatments showed promise. Women who ate soybean dietary supplements reported hot flashes that were less intense, though in many cases the benefits disappeared after a few weeks. Authors of the study have said that most of the trials examining the benefits of alternative treatments were small and inconclusive. Few looked at the benefits or harm of using herbal remedies for many months or years. “Product advertising far exceeds scientific knowledge,” they wrote. “We’re seeing pharmaceutical companies get interested in these products. We are seeing the government get interested. It would be wonderful if we could see some bigger clinical trials before people start spending millions of dollars on nontraditional therapies.”
     That is the bottom line. Basically they don’t have anything for us to take with a degree of certainty that it will be beneficial and certainty that it will not be harmful.
     HRT does have benefits that for some may make it a worthwhile treatment and may make it worth the risk. But women need to have as much information as possible in order to make this decision and that is where talking to your OBGYN comes in. Get the facts, talk with your doctor and then make an informed decision.