For the past few years, hormone replacement therapy has become a well-publicized and highly debated topic, and many women are looking for natural alternatives to “standard” hormone therapy. In the reproductive years, varying cycles of estrogen and progesterone and their effects on neurotransmitters lead many women to experience mood swings, painful cramps, bloating, and more than 100 other less-than-pleasant symptoms of PMS (premenstrual syndrome). For perimenopausal women, fluctuations in these same hormones can contribute to hot flashes, night sweats, mood changes, and weight gain. These hormonal fluctuations may go on for years before finally dipping down to post-menopausal levels.
With conventional treatment, women with PMS may end up taking a multitude of medicines, one for each symptom, often with incomplete relief. Women going through menopause might also take the symptom management approach or decide to restore their estrogen and progesterone levels through hormone replacement therapy (HRT).
While HRT can be highly effective in treating symptoms such as hot flashes and night sweats, recent research, including a major 2002 study by the Women’s Health Initiative, has led many to conclude that the risks of HRT exceed the benefits for certain groups of women. Read more about the WHI study here. Much of this research was done using a standard FDA-approved hormone therapy called PremPro, a combination of Premarin (conjugated equine estrogen) and Provera (medroxyprogesterone acetate). Since that time, a lot of debate has arisen regarding the use of so-called “natural” or “bio-identical” hormones over these conventional hormone therapies:
A Word about Bio-identical Hormones
Bio-identical hormones are those which are identical in molecular structure to the hormones that women make in their bodies. Other than in a woman’s body, these hormones are not found in nature and therefore must be synthesized in a laboratory, typically from extracts of soy or yams. FDA-approved bio-identical hormones are available; however, these preparations may also be compounded individually.
In contrast, although standard or conventional hormones such as Premarin come from a natural source (the urine of a pregnant mare), they are not bio-identical and are metabolized into various forms of estrogen other than estradiol, the predominant form of estrogen that declines in menopause. So far, scientific studies have not found that using bio-identical HRT offers any health advantages over standard HRT. Nonetheless, I still prefer using bio-identical hormones in my practice.
An Alternative to Hormone Replacement In my own practice, I will prescribe HRT using bio-identical hormones when needed for women whose lives are deeply disrupted by menopausal symptoms; however, I have found that taking an ayurvedic approach aimed at restoring balance in the whole body eliminates, or at least greatly reduces, the need to use hormones and other medications for both menopause and PMS.
Many of my patients have found that the following lifestyle changes and simple techniques have allowed them to balance their hormones and re-claim their lives.
Eat your broccoli. Cruciferous vegetables such as broccoli, cauliflower, bok choy, Brussels sprouts, cabbage, and kohlrabi contain a substance called indole-3-carbinol (I3C), which is metabolized in the body to produce diindolylmethane (DIM). Both of these substances help modulate estrogens and have been shown to have some anti-cancer effects, particularly for breast cancer.
Maintain a healthy weight. Excessive adipose (fat) tissue can act as an endocrine organ, producing more estrogen in the body. By maintaining a healthy weight, your body is not stimulated to overproduce certain hormones.
Include phytoestrogens in your diet. Found in soy foods, flax seeds, sunflower seeds, bean sprouts, and legumes such as garbanzo beans and peas, phytoestrogens are plant-based substances that can help balance your hormones naturally.
Although there has been some controversy in the media over the consumption of soy, I do not know of any scientific studies showing that eating soy-containing foods is harmful. My view is that consuming small amounts of soy in the diet can be beneficial. However, I would advise against taking phytoestrogens such as soy as supplements as we do not know enough about the effects of taking these compounds in high doses. If you have known thyroid disease, I would also caution against eating foods that contain phytoestrogens raw as goitrogens in these foods may interfere with thyroid function. Cooking does neutralize this effect.
Consider the use of herbal remedies. In my practice, the ayurvedic herb shatavari has been useful for both menopausal hot flashes and PMS associated with irritability and mood swings. For hot flashes, the herb black cohosh (found in our Menopause Wellbeing formula ) has also been found to be effective in a number of clinical trials. As each individual is different, always speak with a trained practitioner before using herbal remedies.
Breathe deeply. Doing 15 minutes of deep belly breathing twice daily has been shown in several clinical trials to decrease hot flashes and night sweats as well as improve a woman’s sense of well-being. In addition, I encourage women (and men) to learn a mind-quieting technique such as Primordial Sound Meditation, which helps decrease stress hormones and allows the body to function more efficiently.