The Estrogen Replacement Dilemma
mention the word and immediately women
cringe. For some, it's anticipated worry.
For others, it's a living nightmare. And
still others sail right through menopause,
hardly affected. No matter one's experience,
the question still lingers, "Should
I take estrogen?" This question has
become even more urgent in light of recent
studies warning about the potential health
risks of taking estrogen.
decision to take hormone replacement therapy (ie. estrogen
and progesterone) during and after menopause is difficult;
there is your future health to consider. Common sense prevails:
get informed and then make a choice. Let's take a look at
some of the important "estrogen issues."
Long Does Menopause Last?
Menopause can last three, five, or even
up to ten years. This transition period
is termed, "perimenopause."
That is the time when your estrogen levels
decline, possibly producing annoying physical
symptoms like hot flashes, night sweats
and mood swings.
this time your delicate brain chemical balance is disrupted
(there's lots going on!), affecting communication between
brain and body. Hence, there is a very erratic and uncomfortable
body will recuperate from its loss of hormones with time.
However, permanent estrogen-sensitive tissue changes do
occur in the vagina, urinary tract, skin and hair, resulting
in dryness. Adding back lost estrogen is the only way to
halt these changes.
good news: there are some lifestyle choices you can make
to help control menopausal symptoms
and make living
through it much more comfortable.
Products are Saviors
Soy products may help to prevent and alleviate
menopausal symptoms like hot flashes,
night sweats and mood swings. Soy products
like tofu, soymilk, soy flours and tempeh
produce plant hormones called phytoestrogens,
which are weak versions of human estrogen.
foods provide an "estrogen lift" to estrogen-sensitive
cells, without raising the risk of breast cancer. Interestingly
enough, most Japanese women who consume soy foods on a daily
basis throughout the lifecycle, experience very little perimenopausal
and have lower breast cancer rates.
Various herbal products are touted to
help provide symptomatic relief for annoyances
like sleep disturbances, mood swings,
skin and hair changes. However, they will
not prevent the permanent tissue degeneration
that occurs with falling estrogen levels.
In other words, herbs will not halt bone
loss or prevent plaque formation in blood
vessel walls, which occur in the years
A woman's hips and spine are sensitive
to bone loss in the five to ten years
following menopause. Estrogen replacement
will slow down bone destruction, helping
exercise including strength training of the upper body,
combined with 1200 to 1500 mg of calcium, is an excellent
protocol for prevention of bone loss. Strong muscles are
essential to supporting bones well into the later years.
The earlier in life you start, the better the long-term
outlook. This combination of diet and exercise may greatly
reduce one's dose of supplemental hormones required, if
replacement therapy is chosen.
The number one cause of death in North
American women is heart disease. Estrogen
plays a role in protecting pre-menopausal
women from heart disease. In the presence
of estrogen, the liver produces more good
cholesterol and less bad cholesterol,
along with preventing plaque formation
in the blood vessel walls.
menopause, the profile is reversed, placing women at greater
risk for high cholesterol and heart disease. While hormone
replacement therapy will slow the cardiovascular changes
following menopause, a long-term commitment to sensible
nutrition, physical activity and stress reduction will also
reduce the risk.
Breast tissue is exposed to hundreds of
estrogen cycles throughout a woman's lifetime.
The estrogen receptors in breast tissue
may make breasts particularly vulnerable
to tumour development following menopause.
After menopause, risk factors for breast
cancer start adding up, while body defences
against cancer naturally slow down. With
age, the enzymes responsible for repairing
cell damage get a little tired.
question is, will replacing estrogen increase one's risk
of breast cancer? Estrogen replacement may promote breast
tumour development. However, the risk is more significant
when hormone replacement therapy is taken for longer than
management throughout the lifecycle may play a significant
role in maintaining breast health in the later years, given
the direct link between estrogen levels and body fat. A
plant-based diet, rich in antioxidants (fruits, vegetables,
nuts, seeds) can be very effective in protecting the breasts.
Exercise helps by lowering fat tissue, building muscle tissue
and boosting the immune system, helping to stave off early
Romaniw, B.A.Sc., R.D.N., is the Community Nutritionist
at the Upper Fraser Valley Health Unit, Abbotsford, British
Columbia, Canada (604) 864-3400