Jonathan92280

Hi Kat!
Thnks for the input.

I have a question for you - do you believe there is something specific going on in the U.S. as to how and why women's hormonal rhythms seem so unbearable compared to say women in Japan who go through menopause with relative ease?? When I read that 85% of US women have hotflashes and night sweats I definitely believe it. In Japan the statistic is about 19%.

Do you believe personally that the diet and amount of exercise might be affecting this? For example there is a much higher fat intake here, people are not as physically active, they continue to smoke (an implicated factor), and the diet is insufficient in fruits and vegetables which provide phytosterols (which is believed to ease the menopausal transition). Our foods are so replete here with hormones or hormone like substances (xenoestrogens) it's no wonder women's bodies are on a hellacious rollercoaster! What I did not point out, and I apologize for this, is that HRT is a proven medicine for symptom relief. It's simply that DURATION of use is debatable depending on severity of symptoms since risks started showing up in the first year.

Now, we have a family friend who has just entered menopause at age 52. She wanted to do it without aid but hotflashes and sleep disturbances incapacitated her and she opted to go on HRT. Well, for 4-5 months she said she found relief from the hotflashes, but now a new problem had struck: she became bloated with migraines and she started throwing up occassionally in the mornings. She claimed that this HRT-regimen had literally made her feel like she was pregnant. Again, an individual case. She went off HRT and yes the hotflashes returned but she did not have these other symptoms. Ann (her name ) now takes Effexor and consumes flaxseeds and soy protein and she feels fine. Her bone density is a bit low (-1.01) in her spine so she says but now she's lifting weights and what not, as is my mom.

Natural hormones vs. synthetic: Yes indeed Premarin itself is a disgrace! To put horse estrogens (aka equine estrogens or equilin) into a woman's body would be a perfect invitation to a little carcinogenic activity. However, I do want to point out that many other clinical trials have tested different forms of estrogen such as estrogen valerate (sp?) or ethinyl estradiol and 17-B estradiol. The WEST trial (women's estrogen for stroke trial) tested an oral 17-B and transdermal estrogen compound. Sadly rather than prevent strokes in women who'd already had them, the women were experiecing an increase in REPEAT strokes and or dying from a severe single stroke moreso than the placebo group. When I think of "natural" I think only about what your body makes and WHEN it makes it. Re-introduing hormones of any kind after menopause is unnatural in my mind. They might indeed be "bioidentical" and of course that sounds better, but I hesitate to assume that it's SAFE. Women's bodies do not produce any progesterone or estriol postmenopausally; the ovaries, fat cells, and adrenal glands continue to produce smalls amounts of estrogen (estrone), testosterone, and androstenedione. So even if hormones taken are identical to what the body made, I don't necessarily think it's better, regardless of route of administration (oral vs topical) or type. Plus, menopause is not fully understood and it cannot be said that the body will recognize reproductive levels of hormones POSTMENOPAUSALLY the way it did before menopause. Why does estrogen not aid in postmenopausal coronary heart disease? Scientists now believe the body shuts down certain receptors for hormones because if it didn't, than those organ systems that were so reliant upon estrogen beforehand would be deprived. The heart in particular is believed to do this...In one sense, heart disease isn't even related to the menopausal transition, especially since the majority of cases are in women over 65, averaging out to about age 74 (31% of women will die of heart disease in this country at some point in their lives). Yes the risk does start climbing in the 50's, but it still isn't something to be petrified of at age 50. Hormone "replacement" I believe means that you supplement with something that you've lost and have to get back. We treat thyroid deficiency and deiabetes with thyroid replacement and insulin and the conditions are mitigated and optimal functioning can resume, estrogen in its basic role as a REPRODUCTIVE hormone does not make a woman premenopausal again. It may mimic the bodily state of being premenopausal but it isn't the same. Now for women who've had ovariectomy or anything else that completely detroyed the ovarian function, HRT makes more sense b/c the ovaries continue producing hormones postmenopausally and so the woman would be "defficient" compared to her other postmenopausal counterparts who have the advantage of still making SOME hormones. How to specifically provide this woman with the trace amount of hormones she would otherwise have is a whole other question.

Now, as far as what you've said about the caricature of the menopausal woman being true in many cases (ie dry skin and dowager hump), I suppose it is true. I guess I was speaking on my terms (meaning my own biases) because I haven't met any older women who were characteristic of this. Yeah most women didn't look at their menopause with fondness, but I guess I've seen a lot of vibrant older women who made me think that the postmenopausal bodily miseries were a rarity.

As for the time-being, I think the jury is still out as to whetehr or not estrogen therapy will provide relief from the dermatological complaints and loss of that feeling of wellbeing. If it is found to do so, in all honesty, I think the choices women make will be even more difficult since the tradeoffs will have to be weighed in. I guess all I can say as someone who hasn't and WON'T ( ) go through this, is to live well, relax, do what you can to feel better. Thanks for your personal input.

Sincerely,
Jonathan