Since the U.S. National Health Institutes pulled the plug on their largest study of conventional hormone replacement therapy (HRT) last year, the media have issued countless reports on the dangers of supplementing with hormones.

Among the important research discoveries: Conventional HRT does not protect your bones or your heart, two of the primary benefits once used by doctors as selling points to get women to fill their prescriptions. Another claim was that the conventional HRT could alleviate the discomfort of severe flushing and night sweats. As a woman who experienced full-blown surgical menopause at age 38, I tried several forms of therapies, in a variety of doses, and none could deliver on that promise either.

I wondered if those facts hadn't been known before the 2002 major hoopla about HRT. A couple of weeks ago, I met Jean Cottam, Ph.D., at a book fair in Ottawa, and she told me that she had criticized HRT back in 1989. "I sent an article on this subject to the Canadian Medical Association's Journal," she said. "I argued that HRT didn't decrease the incidence of heart attacks, but in fact increased the risk of breast cancer. My article was then rejected, but I have been proven correct!" My guess is that many more experts submitted similar findings over the years.

So what's a woman without ovaries to do?

Short-term use of conventional HRT, a tactic some doctors are suggesting, may not do the trick. Unlike women undergoing natural menopause, during which time the ovaries gradually stop producing as many of the essential hormones, trying to find the right mix of HRT to restore quality of life can be a trying experience. In my case, looking for help in all the wrong places only added to my hormone dilemma.

As did many oophorectomized women who wanted a safer alternative for relief from their symptoms, in June of 1999, I made the switch to natural compounded hormones, also known as natural hormonal replacement therapy (NHRT). It wasn't easy to connect with a Canadian gynecologist willing to prescribe this therapy, but as with anything else, if you pound on enough doors, one is bound to open.

I remember what Dr. Alvin Pettle of Toronto first told me: "How can you expect to feel normal when you're supplementing with estrogen only? Your ovaries used to produce several types of estrogens, progesterone and androgens (testosterone being one of them). What we need to do, is try to mimic (naturally) what your ovaries did on their own, before they were removed." This made sense to me. It made even more sense when I noticed a significant improvement in my moods, and a dramatic decrease in the amount of flushing I did in a hour. Best of all, NHRT did not sabotage my weight loss efforts.

What are natural compounded hormones?

According to Montreal-based compounding pharmacist, Mel Alter, NHRT may be one solution for women who did not respond well to the traditional estrogens derived from animal sources, such as Premarin or Prempro, which are derived from the urine of pregnant mares. NHRT, or bio-identical hormones (another term used for them lately), are made from plants and combine all three estrogens that the ovaries generate naturally (estriol, estradiol and estrone - the tri-est formula for short). To this mix, a compounding pharmacist will add natural micronized progesterone, because it has a calming effect on the brain. Progesterone also promotes new bone growth and protects breast tissue from excessive stimulation by estrogen. This would explain why my breast pain became more tolerable.

The delivery

A customized medication can be prepared in the form of a topical cream, sustained release capsules, sublingual drops or troches. Many women opt for the topical cream, and according to Dr. John Lee, author of What your Doctor may not Tell you about Menopause - The Breakthrough Book on Natural Progesterone, the best way to get the hormones into the body is through the skin. Alternating the sites with each application is also advised. Recently, my friend and colleague, Mary Anne Wyatt of MA, explained that the mode of delivery and application are equally crucial to a woman's success with NHRT. "This is cookbook chemistry, at best," she says. "But at least with bio-identical hormones, women have somewhat greater control over what their bodies need, if topically applied." Help from an empathetic endocrinologist would also prove beneficial to any woman trying to achieve hormonal balance through NHRT.

But is NHRT any safer?

In his December 2002 newsletter on nutrition and healing, Dr. Jonathan V. Wright of Washington says that in the 20 years that he has prescribed NHRT for his patients, he has always been very careful about explaining that even natural treatments are not entirely safe. But he adds that he believes the bio-identical estrogens, progesterone and testosterone are safer than estrogens made up of horse urine. He cautions that large quantities of bio-identical estrogens can raise a woman's risk of blood clots or stroke; however, he explains that these risks are preventable if a woman adds omega-3 fatty acids (one tablespoonful of cod liver oil) and vitamin E (400 IU) to her daily regime. Finally, Dr. Wright says that it's better to be safe than sorry, and recommends close monitoring by your doctor to make sure that your natural hormone therapies remain safe and effective.

More about the Author

By the age of sixty, about one third of all North American women have had a hysterectomy, and they are often encouraged to surrender their ovaries at the same time. Most of these procedures are elective, agreed to by women whose doctors said that the uterus and/or the ovaries have no value beyond reproduction, and that the lost hormones can be replaced artificially. Doctors would not recommend the removal of a male patient's testicles once his family was complete, so why do we continue to subject women to unnecessary castration?

In Misinformed Consent, Lise Cloutier-Steele has joined other survivors to  speak out about the prejudices and the traumas that accompanied their  hysterectomies. In combining their moving personal stories, the women of   Misinformed Consent hope to:

1. enlighten readers with honest accounts on the impact that surgical castration can have on a woman's sexuality;
2. dispel the myth that all women feel wonderful after a hysterectomy and/or
   oophorectomy;
3. provide information on alternative treatments;
4. warn others against the potential dangers of hormone replacement therapy;
5. offer validation to those who suffer greatly from the aftereffects of hysterectomy and oophorectomy; and empower women everywhere to demand better and more honest care.

"In order to ensure that we and our physicians become better informed, this poignant book begins with a strong demand for change and ends with a comprehensive list of resources that will help women better protect themselves."

-- Jane Pincus, Co-author of Our Bodies, Ourselves for the New Century, and   Co-founder of the Boston Women's Health Book Collective

Lise Cloutier-Steele is a communications specialist and a professional  writer and editor, who has survived a traumatic experience with  hysterectomy. She is the author of Living and Learning with a Child Who Stutters. And she is the recipient of a Canada 125 Award in recognition of  a significant contribution to the community and to Canada for her volunteer  efforts to help the parents of children who stutter.  She has appeared on  Canada AM, the Women's Television Network, The Phil Donahue Show, The Body and Health Show, and several other media to talk about the important topic   of unnecessary hysterectomy in North America.

Are you interested in Lise's book?

Misinformed Consent
by Lise Cloutier-Steele

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Coping With Menopause Naturally
Alternatives to HRT
by Monique N. Gilbert, B.Sc.
Ever since the NIH stopped its major study on the risks and benefits of HRT, many women have begun to look for safe and effective natural alternatives to treat their menopausal symptoms. In this article from Certified Personal Trainer/Fitness Counselor Monique Gilbert, she tells us how exercise and the using natural estrogens in the form of soy can lead to better health. Included is a recipe for "Golden Tofu Strips" which is a tasty way to serve tofu.

"Sudden Menopause"
by Debbie DeAngelo
Nurse and women's health educator Debbie DeAngelo experienced menopause herself at 26, after ovarian cancer forced her to have both her ovaries removed. Debbie addresses the issue of what faces women who face menopause unexpectedly fromvarious reasons including hysterectomy, chemotherapy, radiation, medication, anorexia or other unusual causes. She offers guidance on the emotional and cognitive difficulties (short-term memory loss), as well as the potential physical problems (osteoporosis, heart disease) related to early menopause, and their treatment (nutrition, hormone replacement therapy, exercise). In this exclusive article on HotFlash, Debbie has also graciously shared the first chapter of her book which tell us a bit more about what sudden menopause is. She goes on to tell us more about sudden menopause, the reasons for hysterectomy and ovarian malfunction, the connection between the brain and menstrual cycle, and the process of natural menopause. Have a question, don't forget to ask it on our FREE support group.

Your Guide to Hysterectomy, Ovary Removal, & Hormone Replacement:
What All Women Need to Know
by Elizabeth Plourde
hosted by Sue Spataro, RN, BSN
interview & FREE excerpt

The Ultimate Rape is a comprehensive look at what it means to have a hysterectomy.  Ms. Plourde takes us along her personal journey, as bumpy and difficult as it is, to educate us about what a hysterectomy really does to a woman. The interview features discussions on the role of progesterone in women's health, the high rate of hysterectomy in our country as well as the medical consequences of this procedure on bone health, high blood pressure and more. The FREE excerpt also features a discussion on depression. Also learn more about ovarian screening to help detect a problem before it's too late.

• FREE meno symptoms chart
  (nice printable chart you can take to your doctor)
  
• FREE meno daily journal
  (day-by-day way to navigate your journey)

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The Green Kitchen Handbook by Annie Berthold-Bond
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