By Dr. Kay and Dr. Max

Results of the Women’s Health Initiative study in 2002 suggested that estrogen replacement after menopause may increase a woman’s risk of breast cancer, heart disease, stroke and Alzheimer’s disease. This has led to a 50 percent drop in estrogen use in the United States.

Recent data has further shown that the incidence of breast cancer in the U.S. did, in fact, decrease by about 7 percent in 2003, the year after many women stopped using estrogen. This translated into about 14,000 fewer women being diagnosed with breast cancer in 2003.

Armed with this information, many women now seek alternative therapies for such menopausal symptoms as hot flashes and night sweats. It is estimated that about 12 percent of American women use herbal remedies to alleviate menopausal symptoms. Popular alternatives include black cohosh, other herbs and soy products.

A recent year-long study published in the Annals of Internal Medicine studied 351 women (45-55 years old) using five different treatment regimens for menopausal symptoms:

? Black cohosh.

? A multi-herb product containing black cohosh plus nine other herbs commonly used for menopause, including dong quai, chaste tree, ginseng and licorice.

? A multi-herb product plus dietary soy counseling.

? Estrogen with or without a progestin.

? A placebo.

The study concluded that there was no significant benefit achieved from either the black cohosh or the multi-herb mixture. The group eating more soy also did not achieve any benefit, but the group did not eat the target number of servings of soy foods per day. The estrogen group was stopped early when it was found that estrogen could increase the risk of breast cancer and vascular disease. As in many other studies, the women in the placebo group had a 30 percent reduction in their symptoms.

This study has been challenged by a number of well-known researchers in the field of alternative medicine for several reasons, including the fact that multiple studies involving more than 3,000 women have shown positive results with black cohosh, especially the products Remifemin and Klimadynon, which were not used in this study.

We also think it’s important to note that 30 percent of the women getting a placebo had an improvement in their symptoms. Once again this shows us that our minds can be an important ally in dealing with troubling physical symptoms — a positive attitude and a belief that you will improve may often help your symptoms. Other interventions that may help reduce menopausal symptoms include relaxation techniques such as meditation and yoga, as well as regular aerobic exercise.

So what do we suggest for menopausal hot flashes? Exercise regularly, learn to relax, wear cool layers, and keep the thermostat down. You may try herbal supplements if you are so inclined. If you feel miserable — and you have no personal or family history of breast cancer — then talk to your doctor about whether a short trial of estrogen is right for you.

About the writer:
Drs. Kay Judge and Maxine Barish-Wreden are medical directors of Sutter’s Downtown Integrative Medicine program. Have an alternative medicine-related question? E-mail adrenaline@sacbee.com.

Source: Sacbee.com