I've never used herbs as a substitute for HRT. For one, I hear they are much less effective than prescription medicines. Although less effective, there have been reports such as this in some peoples reactions to the herbs. I guess we are going to hear about this more often now since the study on prescription HRT showed a danger.
Another interesting article suggests that HRT isn't as bad as once was thought. It can be found here.....
Original page:
http://my.webmd.com/content/Article/95/103114.htm (
http://my.webmd.com/content/Article/95/103114.htm)
A Fresh Look at Hormone Therapy
Women Who Need It Should Take It, Experts Agree, but at Low Doses
By Salynn Boyles (
http://my.webmd.com/content/Biography/7/1756_53655.htm)
WebMD Medical News Reviewed By Charlotte Grayson, MD (
http://my.webmd.com/content/Biography/7/1756_50193.htm)
on Tuesday, October 05, 2004
Oct. 5, 2004 -- The nation's leading menopause group is speaking out against a popular alternative to traditional hormone therapy, saying there is no clinical evidence to back up claims that so-called "bioidentical hormones" are more effective or safer than the conventional treatments.
The North American Menopause Society's (NAMS) third annual report on the status of hormone therapy strongly endorsed the use of traditional estrogen or estrogen plus progesterone therapy as the best available treatment for menopausal symptoms such as hot flashes, sleep disturbance, and night sweats.
The safety of these treatments has been in question for the past three years since a large study known as the Women's Health Initiative (WHI) linked their long-term use in older women with an increased risk of heart disease, stroke, and breast cancer. The latest NAMS recommendations are based on findings from that trial as well as clinical trials reported since then.
The Suzanne Somers Effect
The NAMS panel concluded that the popularity of the alternative treatment known as bioidentical hormones is of concern because there is virtually no clinical evidence to show that it is safe and effective. The alternative to traditional hormone therapy has become wildly popular since the publication of a book earlier this year by actress and author Suzanne Somers touting its benefits.
The custom compounded formulations are supposedly tailored to an individual woman's hormone needs, which are determined through hormone testing. Because they are considered natural formulations, bioidentical hormones are not regulated by the FDA the way traditional hormone therapy is.
NAMS Executive Director Wulf Utian, MD, PhD, says there is no evidence that testing hormone levels during menopause or tailoring hormone therapy is beneficial.
"Women have been sold a bill of goods by people who have conveyed these products as better and safer," he says. "The fact is these are the same hormones in different combinations and permutations, and they are therefore subject to the same risks and benefits."
It's OK to Stay on Hormone Therapy
In addition to urging caution in the use of bioidentical hormones, the NAMS panel concluded that:
Women with menopause symptoms can take estrogen or estrogen plus progesterone for as long as they need to. The panel placed no limit on treatment duration but noted that women on hormone therapy should be monitored by their doctors.
Hormone therapy can still be considered as a preventive treatment for osteoporosis, along with the other drugs approved to prevent the condition.
Hormone therapy should not be used for the prevention of heart disease. The WHI report found that long-term use increased heart risk in older women, but there is some evidence that the opposite is true for women who begin treatment before menopause.
New evidence from the WHI trial also suggests that the increase in breast cancer risk associated with hormone therapy is limited to estrogen plus progesterone combination treatment. Estrogen alone is recommended for women who have had hysterectomies, while estrogen plus progesterone is recommended for those who still have their uterus.
Utian says this finding needs to be confirmed but it is increasingly clear that the increase in breast cancer risk with any form of hormone therapy is very small.
"It is pretty clear that with five years of use or less there is no statistical increase in risk," he tells WebMD. "Beyond five years of use there may be a slight increase, but it is not major."
While the updated report continued to recommend hormone therapy at the lowest effective dose for the shortest duration possible, Utian says the emerging data on its use is reassuring.
"Many women who discontinue therapy have their symptoms recur, and we want to reassure them that it is OK to go back on this treatment and stay on it as long as they need to as long as they continue to be monitored by their doctors."
Other Voices
The NAMS report comes less than a week after the nation's largest group of women's health doctors issued its own recommendations on hormone therapy. The American College of Obstetricians and Gynecologists (ACOG) task force also took aim at alternatives to traditional hormone therapy, concluding that natural treatments such as yam extract, black cohosh, and red clover are not effective for relieving menopausal symptoms.
The ACOG report noted that roughly 10% of menopausal women continue to have symptoms for more than four years. The group agreed with the NAMS finding that long-term treatment is appropriate for these women.
In a news release, ACOG task force chairman Isaac Schiff, MD, noted that roughly 65% of women on hormone therapy stopped after the WHI findings were published three years ago but a quarter of these women later changed their minds and went back on the treatment.
"[ACOG] is moving back to an appropriate balance -- accepting that hormone therapy has risks, but recognizing that it can be appropriate for conditions like hot flashes so long as women are informed about their risks and weigh their decision with their doctor," Schiff says.
SOURCES: North American Menopause Society position statement on hormone therapy, Oct. 5, 2004. Wulf H. Utian, MD, PhD, executive director, NAMS. The American College of Obstetricians and Gynecologists guide to hormone therapy, Sept. 30, 2004. Isaac Schiff, MD, chairman, ACOG Task Force on Hormone Therapy.
© 2004 WebMD Inc. All rights reserved.
I agree! Forget that herbal crap and go with pharms. They always work.