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Estrogen replacement therapy
(ERT), once thought to be
the “magic” treatment for menopausal symptoms, has become controversial because there are serious side
effects that no woman should ignore: breast cancer, endometrial or uterine cancer, blood clots. and nausea. Rightfully
so women are confused about whether to take ERT or not.
As a physician, I was confused as well. However, after repeatedly examining the data, I arrived at the same conclusion:
the only option that made sense was a natural one. Studies have
shown that certain plant estrogens are being used successfully
and without adverse side effects.
Thousands of women in this country begin menopause each
year. As more baby boomers move into their early 50s.
how to address menopausal symptoms has become an issue of great concern. Approximately 20% of women in the U.S. go through
menopause without significant problems. Others experience
one or more of the following: hot flashes, flushing, night
sweats, vaginal dryness, lack of sex drive, mood swings, depression.
and susceptibility to osteoporosis and heart disease.
In fact, Sarah, a 50-year-old woman, visited my office
a few months ago; she had entered menopause and was experiencing
all the characteristic symptoms. She had read literature
regarding the benefits and risks of estrogen replacement therapy, but
she was still undecided. She wanted to be free of the unpleasant menopausal symptoms, but she did not want to risk the
possible side effects of blood clotting or cancer.
Serious Side Effects of Estrogen Replacement Therapy
It appears that in the pursuit of profits, studies have
been ignored by the medical/pharmaceutical industries regarding
the serious effects of estrogen use and cardiovascular disease.
Many studies indicate that estrogen has been a significant
factor in
heart disease, and that deaths from strokes were 50%
higher among women who took estrogen (Lee 1996a). Studies reveal that high doses of estrogen can result in blood clotting.
Reports show that certain high-dose estrogens can cause hypercoagulability, where the blood has a tendency to clot, increasing the
risk
of heart attack and stroke. For women who smoke or who
already have clogged arteries even moderate doses of estrogen
may increase the risk of blood clotting. (Beckman 1995) Dietary and
stress factors also play crucial roles in coronary disease, and these
should not be over-looked (Sellman 1996). Furthermore. there is growing evidence
connecting high estrogen levels with breast, uterine,
and ovarian cancers.
Dr. Graham
Colditz, Harvard University, stated that unopposed
estrogen (estrogen levels that are not balanced with progesterone) is responsible
for 30-35s of breast cancer cases. Some experts think this percentage
is even higher. It is generally believed that the only known cause of endometrial cancer
is unopposed estrogen (Lee 1996a). Synthetic hormones are also linked to cervical
cancer. In addition. because hormones control skin pigmentation, women taking
estrogen have a higher risk of developing melanomas (Neil 1994). Dr. Lee warns:
“We will soon regard making estrogen the key ingredient in HRT (hormone
growth replacement) as a major medical mistake” (Lee 1996b). Sarah. my patient.
had heard about Remifemin. I told her that although Remifemin has become
popular as an alternative use for menopausal symptoms. there are other
plant extracts available that offer even more benefits. A primary consideration
is that Remifemin contains only one ingredient, Black cohosh, whereas other all-natural
formulas contain additional ingredients that are more comprehensive in
addressing menopause.
Plant Extracts for Natural Estrogen Support
Angelica
sinensis. In recent years. significant advances
have been made in chemical and pharmacological studies of this plant ingredient
(Mei 1991). Angelica sinensis has been shown to increase sexual activity
in females. enhance red blood cell count and circulation. help reduce the risk of high
cholesterol and high blood pressure, protect the liver. and stimulate the immune
system. It also has been used
as an analgesic. a sedative, and a menstruation regulator (Hikino 1985).
Another source lists the use of Angelica for menopausal
symptoms. premenstrual syndrome. allergies. and smooth muscle spasm. Predominantly
regarded as a female” remedy. Angelica has been used to alleviate dysmenorrhea
(painful menstruation). amenorrhea (absence of menstruation). metrorrhagia (abnormal
menstruation), menopausal symptoms (especially hot flashes). and to
assist in a healthy pregnancy. It also has been used to address abdominal
discomfort, anemia. injuries. arthritis. migraine headache, and many other conditions
(Duke 1985: Zhu 1987).
Plant estrogenic substances
(phytoestrogens) are components
of herbs historically used for restoring a woman’s hormonal balance. Angelica
is used to address conditions with either high or low estrogen levels. “When estrogen
levels are low, phytoestrogens exert some estropnic activity; when estrogen levels are
high. phytoestrogens reduce overall estrogenic activity. This alternative
action of angelica phytoestrogens is probably the basis of much of the plant’s use in amenorrhea
and menopause” (Murray 1995). Chinese angelica (Angelica sinensis or Polyorpha) and Japanese
angelica (Angelica acutilobu) seem to be most useful
in alleviating the discomforts of menstruation. menopause (particularly hot flashes). and
uterine cramps (Murray 1995). Cimicifuga racemosa (Black cohosh). Studies conducted
on older women using this plant extract showed that it helped alleviate depression
and hot flashes commonly associated with menopause. Clini-cal findings indicate
that this extract pro-motes and/or restores healthy menstrual activity: soothes irritation
and congestion of the uterus, cervix, and vagina; relieves discomfort
associated with pregnancy; and contributes to easy deliveries (Castleman 1991).
One study indicates that black cohosh is homeopathically rec-ommended for
stimulating the female system, including menopausal difficulties. such as muscle-joint
inflammation (Duke 1985). In Germany, where the use of herbs is more
mainstream than in the U.S., black cohosh is a primary ingredient in three drugs prescribed
for menopausal discomfort. “According to the German text Herbal Medicine, ‘the drugs
appear to be effective. We can, in many cases, man-age without hormones,
though . . . success is not instant. The drug has to be given over some time
. . . . These drugs are not available in the U.S. but the herb itself is” Castleman
1991). In yet another study. the authors state. “Remifemin is
an ethanolic extract of the rhizome of Cimicifuga racemosa and is known to affect
climacteric symptoms. particularly depression and hot flushes” (Duker 1991).
The study tested the effects of this preparation on LH and FSH secre-tion of menopausal
women for eight weeks. The authors concluded that this extract was “able
to suppress LH secretion in menopausal women . . . since LH secretion and the
occurrence of hot flushes are closely related, the measurement of LH levels is
a suitable parameter to study the potency of plant extracts in regard to the reduction
of hot flushes” (Duker 1991).
According to the FDA. black cohosh has no known toxicity
(Mowrey 1993). How-ever. overdoses can cause side effects. and the use of this
extract should be under the supervision of your physician. Dioscorea spinosa. Most
species of yams contain large amounts of plant steroids. primarily
diosgenin. Japanese and Central American varieties of wild yam (Dioscorea)
contain diosgenin, a saponin precursor in the synthesis of progesterone (Weiss
1988).
Some pharmaceutical firms use dios-genin to manufacture
progesterone and cortisone (Mirkin 1991). According to Dr. Mirkin, “Yams
can be used for estrogen replacement. but only if they are eaten in large quantities
and are not cooked.” However, diosgenin is most known for providing progesterone
and is used to balance the use of estrogenic plant extracts. Glycyrrhiza glabra. This plant’s phy-tosterols
(plant steroid chemicals) are responsible for estrogenic
activity, as suggested by a number of studies reported in the Journal
of the American Pharmaceutical Association and the Journal of Pharmacy
and Pharmacology. Also known as licorice. when used orally, this plant
extract helps the conditions of viral infections, inflammation, and men-strual/ menopausal
disorders. The primary
component of licorice root is gly-cyrrhizin. “Licorice
is believed to exert an alternative action on estrogen metabo-lism- when estrogen
levels are too high, it will inhibit. action when used in greater amounts.
(Murray 1995).
For women who are in menopause or approaching it. it is
reassuring to know that you have more choices than you thought. Thanks to
the resurgence of phy-toestrogens as a positive alternative, you no longer have to suffer
the discomforts of menopause, endure the side effects of estrogen replacement
therapy. or increase your risk of cancer and cardiovascular problems. In addition,
you are not limited to just one plant extract (black cohosh as in the drug
Remifemin. There are superi-or plant products available that are more comprehensive
in easing women through menopause. Consult your physician re-garding the use
of phytoestrogens as a viable alternative, and look forward to those golden
years.
References
Beckham, N. (1995). Menopause - A Positive Approach Using Natural Therapies.
Australia: Penguin Books, pp. 42-3.
Castleman, M. (1991). The Healing Herbs: The Ulti-mate
Guide to the Curative Power of Nature's Medicines. Emmaus, PA: Rodale
Press, pp 75-8.
Duke, JA (1985). CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC
Press, Inc., pp. 43-4, 120-21.
Duker M.E. et al. (1991). “Effects of extracts from Cimicufa racemosa
on gonadotropin release in menopausal women and ovariectomized rats” Planta
Med; 57: 420-4.
Hikino, H. (1985). “Recent research on Oriental medicinal plants..”
Econ Med PIant Res, 1: 53-85.
Lee, J.R (1996a). What Your Doctor May Not Tell You About Menopause.
New York, NY: Warner Books, pp 207,220,287.
Lee, J.R (1996b). The Sunday Telegraph. May 12.
Mei, Q.B. et al. (1991). “Advances in the pharma-cological studies
of radix angelica sinensis
(oliv) diets (Chinese danggui).” Chinese Medi-cal Journal; 104 (9):
776-81.
Mirkin C. (1991). “Estrogen in yams.” JAMA; 265 (7): 912.
Mowrey, D.B. (1993). Herbal Tonic Therapies. New Canaan, CT Keats Publishing
Inc., pp. 330-X
i Murray, M.T. (1995). The Healing Power of Herbs: The Enlightened
Person's Guide to the Wonders
of Medicinal Plants Rocklin, CA: Prima Publi-shing pp. 43-9.
Neil, K. (1994). Balancing Hormones Naturally. London, Ion Press, p.
41.
Sellman. S. (1996). ‘Hormone heresy Estrogen’s deadly truth, part 2.”
Nexus Magazine 3(5).
Stormer, EC. et al. (1993). ‘Glycyrrhizic acid in liquorice: Evaluation
of health hazard" Fd Chem Toxicol; 31 303-12. Weiss, RE (1988). Herbal Medicine.
Beaconsfieid,
England: Beaconsfield Publishers, pp. 330-l.
Zhu. D.P.Q. (1987). “Don quai.” Am J Chin Med; 15: 117-25.
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