By Dave Warner
If you’re a middle-aged woman, chances are you know all about hot flashes. Waking up in the middle of the night in a sweat, your skin flushed, unable to get back to sleep.
It can be an annoying and uncomfortable time for women, typically between the ages of 45 and 55, as they suffer the effects of changes in estrogen and progesterone levels.
But new research shows that it may not be all bad news for menopausal women suffering the hot flash blues.
A study at the Fred Hutchinson Cancer Research Center in Seattle says there appears to be a correlation between women who suffer hot flashes, and a lower rate of breast cancer.
Indeed, the study showed a 40 to 60 percent reduction in the two most common forms of breast cancer among women who experience night sweats and hot flashes.
That is particularly true for women who experienced such intense hot flashes that they woke them up at night.
“While menopausal symptoms can certainly have a negative impact on the quality of life, our study suggests that there may be a silver lining if the reduction in breast cancer risk is confirmed in future studies,” said the senior author of the report, Dr. Christopher I. Li.
“If these findings are confirmed, they have the potential to improve our understanding of the causes of breast cancer and improve approaches to preventing this disease,” he said.
The women in the study were between 55 and 74 years old.
It has long been know that estrogen and progesterone play a role in breast cancer.
The Seattle study suggests that the cancer rate drops as the levels of those two hormones actually declines.
In other words, the reduction in the levels might protect women.
The Seattle report comes against the background of a major study on Hormone Replacement Therapy that determined that the risk of taking estrogen plus the synthetic hormone progestin outweighs the benefits. That study consisted of data from the Women’s Health Initiative, which was sponsored by the National Institutes of Health.
The National Cancer Institute said that among those issues are increased risk of breast cancer, heart disease, stroke and blood clots.
According to Dr. Susan Shurin, the acting director of the National Heart, Lung and Blood Institute of NIH, “It is clearer than ever that women who are considering postmenopausal hormone therapy for menopausal symptoms should discuss their risk of heart disease and other risks – such as breast cancer, stroke and dangerous blood clots – with their doctors before starting therapy.”
The HRT therapy was designed to supplement the level of estrogen and progesterone, using the man-made type of progesterone, called progestin. That treatment, more common before the Women’s Health Study in 2002, helped ease the symptoms of menopause, like hot flashes.
Doctors still can prescribe HRT, but tend to recommend very low doses, and only for short periods of time.
A new study, published in a recent edition of the Journal of the American Medical Association, sheds more light on the continuing discussing of treatment for menopause.
Written by Andrea Z. LaCroix, a professor of epidemiology at the Fred Hutchinson Cancer Research Center in Seattle, the paper studies results from the Women’s Health Initiative. The study included only women who were postmenopausal, and who had also had a hysterectomy.
They participated in a study in which they took estrogen only, but not the progesterone that is often prescribed with it. They took the estrogen for an average of six years.
The good news is that the rate of breast cancer for all women decreased after they took the estrogen. And for women in their 50s, there was a decrease in heart attacks and death.
For women in their 70s, however, the rates for heart attacks and death, plus those for colorectal cancer, actually increased.
In other words, said LaCroix, who holds a doctorate in epidemiology, “Several end points…differ by age.”
Would you be better off with what are called bioidentical drugs or the more traditional HRT? Many celebrities have touted the benefits of bioidenticals and created quite a buzz in the media. The U.S. Food and Drug states that there is “no evidence that bioidenticals are safer or more effective” than traditional medicines. Some doctors state that bioidenticals most likely have the same safety profile as synthetic ones. One key difference is that, depending on how the bioidenticals are made, they may not come with patient education and safety warning materials so it is important to have a very thorough conversation with your doctor.
Some bioidenticals are made by pharmaceutical companies and are approved by the FDA and will have the patient safety information included. Others are created individually by compounding pharmacies. Compounded medications are not regulated by the FDA because they are designed to be created on a patient-by-patient basis, therefore, there is no standardized, large-scale data set to review.13 If a woman is interested in compounded bioidenticals, the best advice is to have a conversation with your doctor about the benefits and risk of HRT and to find a compounding pharmacy that is accredited by the Pharmaceutical Compounding Accreditation Board (PCAB).
The National Heart, Lung and Blood Institute lays out some alternatives for women who are suffering menopausal symptoms, but who do not want to undergo HRT.
Among them:
- For hot flashes, make sure you dress in a way that you will tend to be cooler. Also, avoid spicy foods and caffeine, and try relaxation techniques like deep breathing.
- Soy-based foods contain phytoestogens, which are estrogen-like substances. The institute warns, however, there is no proof that they work, but also suggests trying other plant sources like black cohosh, wild yam, and valerian root.
- Prescription anti-depressants.
- For vaginal dryness, try over-the-counter lubricants and moisturizers.
- For mood swings, the institute suggests being physically active, getting enough sleep, anti-anxiety drugs and relaxation exercises.
- For insomnia, the institute suggests over-the-counter sleeping aids, dairy products, and a warm shower or bath before bed.
Drug-free ways to ease menopause symptoms
The good news is that you can take steps yourself to feel better during menopause, without getting into the hormone therapy issue.
They all involve lifestyle changes, and you may find some easier to carry out than others.
But try some of these, and they may ease your symptoms:
- Caffeine, alcohol and spices are good things to avoid.
- Foods made from soy are good for you at this time.
- Make sure your calcium and vitamin D intake is adequate.
- Exercise.
- Try things like yoga, tai chi or meditation to help you relax.
- Remain sexually active.
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