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by Sherrill Sellman, N.D.
Menopause Myths
 he Berlin Wall of Hormone Replacement Therapy came tumbling down on July 17 with the formal announcement in the Journal of the American Medical Association that the $600 million study called the Women’s Health Initiative would be stopped three years earlier than planned. The study presented irrefutable evidence of the harm that estrogen-progestin therapy was doing to women. It was official—Hormone Replacement Therapy (HRT) increased the risk of developing breast cancer, strokes and heart disease. What had, in fact, been known for decades now became public knowledge. The use of synthetic HRT was a major medical mistake.
Doctors are now questioning their most
preferred treatment for menopause. Both
menopausal women and their doctors are in a
true quandary about what to do now. It
appears that there is even more confusion
about HRT and menopausal symptoms than
ever. Therefore, unravelling the many myths,
misinformation and, in some cases, lies about
menopause is vital, ensuring women safe passage
through their menopausal years.
Menopause Myths
- Menopause is a time of decline, physically, emotionally and mentally.
- The ovary fails.
- A menopausal woman ceases to produce estrogen.
- Uncomfortable symptoms are inevitable.
- Hormone replacement therapy is safe.
- Perimenopause is a time of declining estrogen levels.
- Menopausal women are estrogendeficient.
- Estrogen keeps the skin soft and wrinkle-free.
- Synthetic estrogen and progestin do not cause cancer.
- The uterus is a disposable organ after a woman’s childbearing years.
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Historical Myths
The 1960s heralded a new era for the
menopausal woman. No longer was the
prevailing Victorian view of menopause, as a
mysterious debilitating psychological condition,
the vogue. Instead of treating women
with a variety of mood-altering tranquilizers,
shock treatment or, in some instances, institutionalization,
the advent of steroid hormone
drug therapy would elevate menopause into
the realm of legitimate medical concerns.
Menopause, a natural process, would become
pathologized and medicalized as an estrogendeficient
disease.
It didn’t take long for the manufacturers of
the burgeoning steroid hormone market to set
their sights on the menopausal woman. In
1966 a New York gynecologist, Dr. Robert
Wilson, wrote the first book enticing
menopausal women to the medical wonders of
estrogen. Feminine Forever extolled the virtues
of estrogen replacement to save women from
the “tragedy of menopause which often
destroys her character as well as her health.” He
popularized the erroneous beliefs that
menopause was a deficiency disease, the ovaries
shriveled up and that estrogen replacement was
a kind of long sought after youth pill.
Wilson singled out estrogen as the missing
ingredient for the menopausal woman and
pioneered the use of prescribing estrogen for a
wide variety of symptoms. However, there had
been no formal assessment of the safety of estrogen therapy nor were there any studies
demonstrating the safety of its long-term use.
The use of unopposed estrogen went out of
vogue when it was revealed that it prematurely
shortened the lives of its users. In 1975, The
New England Journal of Medicine examined
the rates of endometrial cancer for estrogen
consumers and concluded that five years of use
increased the risk sixfold. Women who had
used estrogen long-term were 15 times more
likely to develop endometrial cancer.
Unopposed estrogen was identified as the only
known cause of endometrial cancer.
Within a few years of the publication of
Wilson’s book, not only was his early research
into estrogen’s supposed benefits publicly condemned
as flawed and invalid, but the FDA
announced that Robert Wilson was an “unacceptable
investigator.”
Unfortunately, for the tens of millions of
women who have been lured into the use of
hormone replacement therapy in the hope of
keeping them young forever, Wilson’s theories
and promises have since been proven completely
wrong.
Hormone Myths
Hormones are very powerful substances. They
are exceptionally potent chemicals that are
made by the body in the tiniest amounts, in
parts per billion or trillion. Begin tampering
with nature’s finely tuned messengers of life’s
processes and you are asking for trouble. This
is especially true for women. A woman’s physiology
and psyche are intimately connected to
her monthly flow of hormones.
Hormones stimulate, regulate and control
all vital bodily functions. They not only direct
and determine physiological processes but also
influence emotional and mental states.
A lot is said about the hormones, estrogen
and progesterone. But what exactly are they?
Estrogen really isn’t a single hormone. To be
accurate it refers to a class of hormones with
estrus activity (i.e. proliferation of endometrial cells in preparation for pregnancy). The key
estrogens are named estradiol, estrone—both of
which are implicated in stimulating abnormal
cell growth when found in higher than normal
amounts in the body—and estriol which is considered
to be cancer inhibiting. Each type of
estrogen has a different function in the body.
These estrogens are produced mainly in the
ovaries although small quantities are secreted
from the adrenal glands, the placenta during
pregnancy and in fat cells.
Increasing progesterone
levels using
a natural transdermal
progesterone cream
(not a progestin)
can alleviate, if not eliminate,
most estrogen dominant symptoms.
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In the case of progesterone, however, we are
talking about only one specific hormone. Thus
progesterone is both the name of the class and
the single member of the class. Progesterone is
also made in smaller amounts by the adrenal
glands in both sexes and by the testes in males.
What is little known is that progesterone is the
precursor hormone from which estrogen, testosterone
and the adrenal cortical hormones are
made. While all the attention has been focused
on estrogen, it is actually progesterone that
deserves a greater starring role in maintaining
hormonal balance in women.
The synthetic hormones, estrogen and progestin,
used in hormone replacement therapy are
actually powerful steroid drugs. More accurately,
hormone replacement therapy should be
known as hormone drug therapy. At a conservative
count, The Physician’s Desk Reference lists a
combined total of approximately 120 potential
risks and reactions associated with HRT.
Synthetic progesterone also known as progestin
such as Provera) is a man-made chemical and
does not even exist in nature. It cannot be converted
by the body into other steroid hormones
unlike natural progesterone, the bio-identical
form. Progestins are also riddled with serious
side effects including cancer and cardiovascular
disease. In fact, the National Institute of Health
and the World Health Organization (WHO)
have listed all synthetic estrogens as well as progestins
as known human carcinogens.
Far from duplicating or supplementing
nature’s hormones, the synthetic hormone components
of HRT introduce powerful drugs into a
healthy woman’s body, predisposing her to serious
physical and emotional imbalances as well as
potentially life-threatening conditions.
The Estrogen Deficiency Myth
At menopause, the amount of estrogen and
progesterone being produced by the ovaries
declines although other hormones continue to be
produced. Estrogen levels drop to only 40–60 percent,
just low enough so that the egg follicles do
not mature, thus making pregnancy
impossible. Contrary to
popular belief, the ovaries do
not shrivel up nor do they cease
functioning. With the reduction
of these hormones, menstruation
becomes scantier and
erratic and eventually ends.
The official definition of
menopause is one complete
year without a menstrual cycle.
However, after menopause
the ovary continues to be a
productive endocrine gland working in conjunction
with other body sites such as the adrenal
glands, skin, muscle, brain, pituitary gland,
hair follicles and body fat to produce estrogen
(estrone), testosterone and androgens well into
old age. A healthy woman never really stops
making estrogen or progesterone.
Doctors who see the ovaries as useless after
menopause point out that in women’s older
years the ovaries grow smaller. However, as
women age, the part of the ovary that shrinks is
known as the theca, the outermost covering
where the eggs grow and develop. The innermost
part of the ovary, known as the inner stroma,
actually becomes active at menopause for
the first time in a woman’s life. With exquisite
timing, one function starts up as the other winds
down.
The female body is able to make healthy and
symptom-free adjustments in hormonal balance
after menopause, provided a woman has taken
good care of herself during the premenopausal
years, with proper lifestyle, diet and mental and
emotional health. The appearance of menopausal
symptoms are more indications of imbalance
than an inevitable decline in health and function.
By incorporating a healthy diet, nutritional support
and positive lifestyle changes, symptoms of
hormonal imbalance disappear. Hormonal symptoms
are really symptoms signalling that the body
is out of balance.
Adrenal exhaustion, thyroid problems,
blood sugar imbalance, toxic livers, inflammation
of the intestinal tract, food allergies, heavy
metal toxicity and Candida are some of the health problems that contribute to hormonal
imbalance.
What is coming to light is the fact many
women actually have an excess of estrogen.
“Estrogen dominance syndrome” is a term that
describes a condition of an imbalance between
estrogen and progesterone. The delicate balance
between these two hormones is now skewed in
estrogen’s favor. Stress, nutritional deficiencies,
environmental estrogenic-like substances found
in pesticides, herbicides and plastics are the
likely contributing factors to the creation of
estrogen dominance (as well as taking synthetic
estrogens combined with an ensuing deficiency
of progesterone).
The following is a list of symptoms that
can be caused or made worse by estrogen
dominance: acceleration of the aging process,
allergies, breast tenderness, decreased sex
drive, depression, fatigue, hair thinning, excessive
facial hair, fibrocystic breasts, foggy thinking,
headaches, hypoglycaemia, increased blood
clotting (increasing risk of strokes), infertility,
irritability, memory loss, miscarriage,
osteoporosis, premenopausal bone loss, PMS,
thyroid dysfunction mimicking hypothyroidism,
uterine cancer, uterine fibroids, water retention,
bloating, fat gain (especially around the abdomen,
hips and thighs), gall bladder disease and autoimmune
disorders such as lupus and MS.
Far from a deficiency in estrogen, modern
menopausal women are much more likely to
have an excess of estrogen.
The Perimenopause Myth
Research is now revealing that the ovary at perimenopause
(the period of time from the first
change a woman notices after age 35– 40 until
one year has passed without a flow) is more
active than it has been since adolescence.
One leading researcher, endocrinologist Dr.
Jerilynn Prior, has found that “the perimenopause
ovary produces erratic and excess
levels of estrogen, with unpredictable moods,
heavy flow, hot flashes and mucous symptoms
that appear suddenly and unexpectedly.” The
many symptoms that women experience during
the perimenopause years, such as weight gain,
irrational hunger, increased migraines, heavy
periods, worsening endometriosis, breast
swelling (with pain or lumps), new or growing
fibroids, new or increasing PMS, pelvic pain and
uterine cramps are caused by high levels of
estrogen.
Dr. Prior has found that the average estrogen
levels in perimenopausal women are higher than
in younger women. The older women not only
had higher levels of estrogen but also had lower
levels of progesterone.
Many of these common health problems
can be offset by increasing the level of natural
progesterone. The problem is not always that
progesterone levels are actually lower than normal
but are low in comparison to elevated
estrogen levels. Increasing progesterone levels
using a natural transdermal progesterone cream
(not a progestin) can alleviate, if not eliminate,
most estrogen dominant symptoms.
These findings have also been supported by
the work of Dr. Peter Ellison from Harvard
University, who has developed a way to measure
women’s ovarian hormones using saliva. He has
reported his findings of ovarian hormone levels
in various populations of distinct genetic, ecological
and cultural backgrounds. He found
that in Western populations premenopausal
estrogen levels represent a high extreme of the
spectrum and should be considered abnormal.
Further, he suggests that these abnormal levels
may relate to the current epidemic of breast and
ovarian cancer. Saliva assay tests are far more
accurate than blood serum tests to assess hormone
levels.
Menopause Facts
- Menopause is a time of increased power, creativity, vitality and wisdom.
- An ovary functions throughout a woman’s life.
- A menopausal woman produces estrogen from her ovaries and her fat cells.
- Nature has intended menopause to be a smooth, symptom-free transition.
- Hormone replacement therapy has 120 possible risks and side effects.
- Perimenopause is a time of high, fluctuating estrogen levels and low progesterone levels.
- Western menopausal women have some of the highest levels of estrogen ever recorded, according to the WHO.
- Estrogen is known to age the skin and cause loss of muscle tone.
- Estrogen and progestins are known human carcinogens.
- The uterus makes hormones that protect the heart and blood vessels.
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Menopause Truths
Women are now faced with the challenge of
redefining menopause. Menopause per se
should be regarded as a normal adjustment
reflecting a benign change in a woman’s biological
life away from childbearing and onward to
a period of new personal power and fulfillment.
The Western perception of menopause as a
threshold of undesirable symptoms and progressive
illness due to estrogen deficiency is an
error unsupported by fact. More accurately,
menopausal problems should be viewed as an
abnormality brought about by industrialized
cultures’ deviation from a healthy lifestyle.
The hormone story is certainly a very complicated
one. Up until now only one version of
the story has been readily available to the majority
of Western women. Serious doubt has been
cast on the efficacy and appropriateness of estrogen
and progestins as a treatment. Women are
certainly suffering more than ever before from a
wide variety of female complaints. What complicates
the hormone story is that HRT, the seeming
cure for these complaints, can actually make
them worse. Without understanding the farreaching
side effects of estrogen and progestins,
doctors are often misdiagnosing the cause of
these aggravated conditions. Other drugs may
be prescribed with disastrous effects, as the spiral
of unnecessary medication increases.
It is indeed time for women to take even
greater responsibility for their health, their
choices and lifestyle. It is also time to ask pertinent
questions of health providers, to demand
answers and to be willing to investigate safe,
effective and natural alternatives. It is up to
every woman to read, question, trust her natural
instincts and learn about the workings of
her own body. It is also essential that women
honor their intuitive wisdom. After all, nature
has fully prepared a woman to journey though
all the stages of her life safely, effortlessly and
naturally.
Sherrill Sellman is the author of the bestselling book Hormone Heresy: What Women Must Know About Their Hormones. She is a contributing writer to many publications, a passionate women’s health advocate and an international lecturer. She can be contacted at: www.ssellman.com, e-mail:
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or P.O. Box 690416, Tulsa, Oklahoma 74169. She also has a free monthly HormoneWise e-Digest. Send an e-mail
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