Some Pointers on Weaning Yourself Off of Synthetic Hormone
Replacement Therapy
..and Onto Bioidentical Hormones
by Melissa Block
Following the publication of the Women's Health Study in 2002 - the one that finally knocked down the notion that synthetic HRT drugs like PremPro were good preventatives against age-related diseases - women began to stop taking these drugs in droves. By the millions, they tossed their HRT pills into the trash. Many felt they had been lied to by the medical community, having been told that these drugs would help them to avoid heart disease, stroke, and osteoporosis. None of these benefits panned out in the end - aside from small decreases in risk of osteoporosis, colon cancer,and ovarian cancer, none of which were of a magnitude that merited the significant risks of these drugs.
Since that time, several more studies have relegated traditional HRT to the lost land of misguided medical therapeutics. One study showed that risk of Alzheimer's doubled in women who used HRT. Another showed that women who did not have menopausal symptoms had no improvement in quality of life when they took these drugs. Yet another showed limited benefit for estrogen-only therapy in women who have had hysterectomies (a relief, since good results from that arm of the WHI study would probably have put millions of women with healthy uteruses under the knife so that they could use unopposed estrogens).
You can successfully wean yourself off of synthetic hormones. And you don't have to completely quit using hormones; you can gradually switch to natural, bioidentical progesterone and estrogens from the synthetic estrogens and progestins that have kept menopausal symptoms at bay.
Today, estrogen/progestin HRT is recommended only under limited circumstances: for women who have very severe hot flashes or night sweats during the menopausal transition, and for women who are at risk for osteoporosis and can't tolerate any of the other medications used to preserve bone mass.
It is estimated, however, that ¼ of the women who gave traditional synthetic HRT drugs the boot ended up going back to them again. Their symptoms re-emerged with a vengeance. "I was going through menopause again at sixty," reported one woman who quit her HRT cold turkey. Women who had the worst symptoms before going on HRT had the worst relapses after quitting. The longer they had used HRT, and the higher the dosage, the worse time they had after they stopped.
Many found that the only answer their doctors could provide was: "If you can't deal with the symptoms, you'll have to go back on the HRT." Some embattled women seeking refuge from night sweats, insomnia, depression, irritability, vaginal dryness, tingling or burning sensations, episodes of very rapid heartbeat, and hot flashes decided that they would rather take the risk of using HRT than deal with these kinds of symptoms.
If any of this rings a bell for you, keep reading. You can successfully wean yourself off of synthetic hormones. And you don't have to completely quit using hormones; you can gradually switch to natural, bioidentical progesterone and estrogens from the synthetic estrogens and progestins that have kept menopausal symptoms at bay.
Here are some guidelines, culled from experts like John R. Lee, MD.
Take better care of yourself. Women who do all they can to support their own health are less vulnerable to menopausal discomforts. If you haven't done so already, clean up your diet - stick with whole foods, lots of vegetables, and lean, high-quality protein. Eat fish two or three times a week to benefit from its heart-protective essential fatty acids. Use a multivitamin every day. Exercise daily and take steps to better deal with stress in your life. Burning the candle at both ends is no longer an option!
Don't quit cold turkey. While some women seem to be able to cease taking synthetic HRT abruptly without problems, most women do better with a gradual weaning process. First, get yourself a USP natural progesterone cream and immediately begin to use it in place of the synthetic progestins. Begin to reduce your estrogen dose gradually. If you take pills, you can try cutting them into pieces.
In the first month: start the natural progesterone cream. Take your synthetic estrogen pill (Premarin, Estrace, etc.) every other day or cut your estrogen patch in half. If you are taking a separate synthetic progestin such as Provera, stop taking it immediately.
In the second month: Continue to use the natural hormone cream. Take synthetic estrogen every third day or cut your patch in quarters; you may need to hold the patch in place with paper tape.
In the third month: Still using the natural cream, take the estrogen pill every fourth day or go completely off of the estrogen patch. By the fourth month, you should be off of all synthetic hormones and on your natural hormone replacement program.
Or, at the beginning, you can simply add the progesterone cream while maintaining your regular prescription HRT regimen. Begin to taper off the prescription hormones after about two weeks. If you find you are still having menopausal symptoms after tapering this way, try adding in some bio-identical estrogens.
The more severe your menopausal symptoms before HRT, the slower you should wean yourself off of the estrogen you have been using. Some women can do it in a month, but you can take six to 12 weeks if you need to.
Progesterone replacement activates estrogen receptors. Many women who thought they needed to use estrogens find that progesterone alone brings them into hormonal balance, relieving their menopausal symptoms. Women who have problems with vaginal dryness - a symptom of estrogen deficiency - can use vaginal estriol cream. According to Christiane Northrup, M.D., vaginal estriol is also helpful for women with urinary incontinence.
Night sweats and hot flashes may recur in some women, who can try natural estrogens such as Bi-Est (estradiol plus estriol); talk to your doctor about these, because they are only available by prescription. Premarin will work too, if that's all you can get. Some women do well with phytoestrogen creams or supplements, such as EstroRenew.
Experiment to see what combination works best for you, but stay on the progesterone cream if you use any estrogens at all.
The good news on natural HRT gets even better: the bio-identical hormones are every bit as good at helping with menopausal complaints, and they don't increase risk of breast cancer or other diseases when they're used properly. They have been found to increase bone mineral density and to protect the uterus against the carcinogenic effects of estrogens just as well as the synthetic progestins.
In short, you can take advantage of the benefits of hormone replacement therapy without the undue risks of conventional estrogen/progestins. You no longer have to cling to your outmoded HRT regimen because of withdrawal symptoms. Live a life free of menopausal symptoms and protect yourself against osteoporosis and heart disease by gradually shifting to bio-identical hormones.
©Alternative Medicine Network 2009
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