Research presented at the 29th Annual San Antonio Breast Cancer Symposium (December 2006) showed a significant drop in the incidence of breast cancer in 2003 – a dramatic fall that has never previously been observed in a single year. In women aged 50-69 years of age there was a 12% decline in oestrogen dependent cancers and a 4% decrease in non-oestrogen dependent cancers. It appears that the decreased use of hormone replacement therapy (HRT) may be responsible, at least in the case of oestrogen dependent breast cancers.
Another research team reporting in a recent issue of the Journal of Clinical Oncology cameto similar conclusions, “Hormone therapy use dropped by 68% between 2001 and 2003, and shortly thereafter we saw breast cancer rates drop by 10% to 11% and this drop was sustained in 2004, which tells us that the decline wasn’t just a fluke”.
The use of HRT declined significantly after the results of two long-term studies were published in 1998 and 2002. The most significant of these was the Women’s Health Initiative (WHI) study which involved almost 162,000 women between the ages of 50 and 79 years. The role of the WHI was to focus on defining the risks and benefits of treatments that could potentially reduce the incidence of heart disease, breast and colorectal cancer, and fractures in postmenopausal women.
The aims of the WHI study were to assess the risks and benefits for women using HRT, including combined HRT (oestrogen/progestin) or oestrogen alone. The planned duration of the study was 8.5 years. However, after just 5.2 years, in mid 2002 an independent monitoring board recommended stopping the combined HRT trial because they considered the health risks of taking combined HRT outweighed any health benefits.
There were a number of negative outcomes resulting from this trial and although some of the risks are relatively small, they do exist.
In relation to breast cancer the WHI trial found that relatively short-term combined oestrogen/progestin use increased breast cancers, which were diagnosed at a more advanced stage compared to women not using HRT.
Despite the early termination of the WHI combined HRT (oestrogen plus progestin) trial, the oestrogen-alone trial was continued with ongoing careful scrutiny by the monitoring board. However, in February 2004 the National Institutes of Health (NIH) decided to terminate the oestrogen-alone trial after 6.8 years, rather than allowing it to run the full 8.5 years. They determined that oestrogen therapy did not offer significant benefits compared to the possible risks.
As with combined HRT, oestrogen alone therapy also reduced the risk of fracture although it did not have the same protective effect against bowel cancer that combined HRT appeared to offer.
There are a number of different reasons why women either choose to take HRT or are prescribed HRT by their doctor. Each individual woman has to decide, with the help of a health care professional, how important the use of HRT is for her.
I see many women in my clinical practice who want to stop taking HRT and I work with them to achieve this aim very successfully. On the other hand I see women who choose to take HRT and are happy to continue doing so. I totally respect this choice.
HRT has been traditionally prescribed not only to alleviate the symptoms of menopause but also to protect against conditions such as heart disease, dementia and osteoporosis. We now understand from extensive clinical trials that HRT does not carry the protective effect previously assumed for heart disease and dementia. In fact, the use of HRT (particularly combined HRT) increased the risk of these conditions.
For some women HRT may be important to help prevent or reduce the severity of osteoporosis. This is particularly important for women with increased risk eg a strong family history of osteoporosis and a significant number of risk factors including:
Slight build, therefore less bone mass
Inability to participate in weight bearing exercise eg severe arthritis of the knees or hips
Sedentary life style
Diet high in salt and caffeine, these leach calcium from the body
History of eating disorders such as anorexia or bulimia
Use of drugs such as corticosteroids which decrease bone density
The answer is a very big YES. In most cases menopausal symptoms are extremely easy to treat with natural therapies and women have a significant improvement in a relatively short period of time. The type of treatment used depends on the individual woman, her lifestyle and the symptoms experienced.
Yes, it is definitely possible to stop taking HRT, however it is not a good idea to do so suddenly. I have helped many, many women wean off HRT and the best way is to do so gradually. However, before making the decision to stop HRT, it is important to consider the reason that HRT was initially prescribed and how relevant it is to your long-term health and wellbeing.
It is important to understand that the uncomfortable symptoms of menopause are caused by the reducing levels of female hormones, particularly oestrogen. By taking HRT you are only delaying the inevitable. If HRT is stopped suddenly, particularly without any other support being offered, the body once again has to go through the withdrawal process, causing you to suffer the original symptoms all over again.
The importance of the adrenal glands
It is the adrenal glands that produce oestrogen after menopause. Therefore healthy adrenal function is necessary to avoid menopausal symptoms, both at the onset of menopause and when weaning off HRT. When we consider this function of the adrenals it is hardly surprising that so many women experience symptoms during the perimenopausal and postmenopausal time. The major factor that depletes the adrenals is stress, particularly over a long period of time.
When I work with women wanting to come off HRT the first thing we do, before reducing the dose of the HRT, is improve adrenal function. This can easily be done with herbal medicines and a few different nutrients. By taking this first important step the risk of menopausal symptoms is very much reduced.
Improving adrenal function naturally
There is a very fundamental difference between HRT and herbal medicine for the treatment of menopausal symptoms. It needs to be remembered that menopause is not a disease process but a natural occurrence in the life of all women who reach a certain age. Herbal medicines provide the support for the body to do what it should naturally be doing. That is, produce hormones in the adrenal glands. HRT does just the opposite. By putting hormones into the body you actually shut down the natural process of adrenal hormone production.
There are a number of herbal medicines and nutritional factors that quickly improve adrenal function so that the body can increase the natural production of female sex hormones, DHEA and testosterone. Women need a small amount of testosterone, obviously not as much as men, but it is still a very necessary hormone for women. If you have low levels of testosterone and DHEA you will have very low energy and low libido. As with HRT if you take DHEA and/or testosterone as drugs (in any form) you shut down the adrenal production of these hormones and when they are stopped it can take time for the adrenals to start producing them again.
In the preparation phase of treatment I will often prescribe herbs that help the body deal with stress and generally tonify the nervous system. This further takes the load off the adrenals and helps them to recover faster.
Once adrenal function has improved the dose of HRT can gradually be reduced until it is no longer required. What this means is that we have begun to restore the body to a natural state of health.
At this stage of the process the herbal medicines may change. We might introduce herbs that are specific for any symptoms that may arise during the weaning off period. Where necessary we continue to support the nervous system because stress is a major cause of adrenal depletion and often stress is ongoing.
So, you can see, it is easy to come off HRT if desired. All you need to do is take it slowly and use the appropriate herbs and nutrients for each stage of the process.
If you are using HRT and are not sure if you wish to continue or if you are contemplating starting HRT, why not give me a call to discuss your options - 07 3349 3122.
Article by Berris Burgoyne ©
I am passionate about helping people improve their health and well-being.
I believe that the human spirit has the potent ability to bring about healing when it is given the necessary support to do so.
This support can be achieved in a number of ways including dietary and lifestyle adjustments and natural medicines.
These address any imbalances, and by adopting healthy habits and attitudes that nourish your spiritual, emotional and physical well-being you can achieve optimal health.