Alternatives to Hormone Therapy

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Why do some women choose not to use hormone therapy in menopause?

Many women choose not to use hormone therapy during their menopause. Hormone Therapy (HT) is also known as hormone replacement therapy or HRT. It is a hormone treatment prescribed to offset the lower levels of estrogen and progesterone that happen naturally at the beginning of menopause.

Some of the reasons women choose not to use HT are:

  • They see menopause as a natural life transition and not as a disease that needs to be treated.
  • They experience no symptoms of menopause or have manageable symptoms.
  • They don't want to take medication for a long period of time.
  • They have other medical conditions that make it unsafe to use HT.

What self-care strategies can I use to manage my menopausal symptoms?

There are many things you can do to help reduce the discomforts and symptoms of menopause.

You can make changes to your diet, such as:

  • Using beans, dried peas and lentils for inexpensive, low-fat meals, high in protein, fibre, iron and calcium.
  • Introducing soy and flaxseed in your diet. These, as well as some beans, peas and lentils, contain "phytoestrogens" (plant compounds similar to estrogen). Researchers think phytoestrogens may reduce menopausal symptoms such as hot flashes, and may also help prevent heart disease and osteoporosis. But this has not yet been proven.
  • Eating more soluble fibres found in oat bran, oatmeal, legumes, apples, grapes and citrus fruits.
  • Getting your daily requirements of calcium and vitamin D.

You can get regular exercise. This may help you have fewer and milder hot flashes. It will also help to prevent osteoporosis and heart disease. For ideas on how to be active, visit Canada's Physical Activity Guide Web Site, or call 1-800-OCANADA to order a free copy.

If you have hot flashes, you can manage them by:

  • dressing in layers;
  • carrying a fan; and
  • keeping your environment cooler - turn down the heat and open the windows.

Some women find that certain foods trigger their hot flashes and that it helps to avoid them. Common triggers are:

  • spicy foods;
  • hot beverages;
  • alcohol;
  • chocolate; and
  • caffeine.

To prevent and treat vaginal/genital dryness and itching you can:

  • Use water-soluble lubricants during sex as well as daily for ongoing comfort.
  • Have regular sexual activity or masturbate regularly to encourage lubrication and promote healthier vaginal/genital tissues.
  • Avoid hot tubs and saunas that can dry the vaginal tissues.
  • Drink plenty of water that will also help to keep tissues hydrated.
  • Use a vaginal moisturizer, available over the counter in drugstores.

Dryer, less flexible vaginal tissues can easily scratch or tear, increasing your risk for sexually transmitted infections. Practice safer sex to protect your health.

To help prevent urinary incontinence , do regular Kegel exercises. Kegels are repeated contraction and relaxation of the muscles that cause urine flow. Kegels can also improve vaginal sexual function and enjoyment. To learn more about the benefits and how to do these exercises, talk to your doctor or visit Exercising Your Pelvic Muscles.

Talk with and learn from other women going through menopause. Look for self-help groups, book clubs, or other ways to get together with women in mid-life. Menopause can be a time of great change and renewal in women's lives, and support from other women can be very important as we make our way through this time.

Can I use herbs to manage my symptoms?

There are several herbs that some women find useful for symptoms such as hot flashes, poor memory, concentration, vaginal dryness, and irregular bleeding. Some of these herbs have undergone clinical trials-others are prescribed by health practitioners based on anecdotal evidence and historical use.

For the safest use of herbs:

  • Buy herbs that have been standardized. This means that every tablet you take has the same amount of the active ingredient. Look for a D.I.N. (Drug Information Number) or G.P. (General Public) number, which shows that Health Canada has reviewed and approved the product's information, labelling and instructions for use.
  • Tell all your health care providers about any herbs that you are taking, especially if you are also taking any prescription medication.
  • Start with one herb at a time and observe its effects on your body.

A qualified alternative practitioner such as a naturopathic doctor or a Traditional Chinese Medicine practitioner can tell you about which herbs may deal with for your symptoms, and can help you to monitor the results. There are also several excellent books that can help you make herbal treatment choices.

  • Managing Menopause Naturally with Chinese Medicine . Honora Wolfe, ed., Blue Poppy Press, 1998.
  • Menopause: A Naturopathic Approach to the Transitional Years . Karen Jensen, Prentice Hall Canada, 1999.
  • Menopause and Homeopathy: A Guide for Women in Midlife . Ifeoma Ikenze, Publishers Group West, Inc., 1998.
  • New Menopausal Years, The Wise Woman Way: Alternative Approaches for Women 30-90 . Susan Weed, Ash Tree Pub., 2001.
  • Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine . Tori Hudson, Keats Publishing, 1999.

How can complementary or alternative therapy help my perimenopausal symptoms?

Complementary or alternative therapy refers to natural, non-invasive therapies that focus on disease prevention. Some women use these therapies instead of conventional medicine; others use them in addition to their conventional health care.

Naturopathic physicians specialize in natural medicine. They may prescribe changes to lifestyle, diet, and use of vitamins, herbs or homeopathics for symptom relief and disease prevention. Some are also trained in acupuncture and Chinese Medicine. For more information and to find a naturopathic physician in your area, contact the Canadian Association of Naturopathic Doctors.

Other alternative practices may also provide symptom relief, improved quality of life, or a general sense of well being during your menopausal years. Consult the following Canadian associations for more information about practitioners' education, credentials, treatments available or referrals to a practitioner in your area.

The Canadian Chiropractic Association (1-416-781-5656)

Canadian Federation of Aromatherapists (1-905-886-2567)

The Chinese Medicine and Acupuncture Association of Canada ( 1-519-642-1970)

Homeopathic Medical Council of Canada (1-877-722-4622 )

The National United Professional Association of Trained Homeopaths (1-888-282-3878 )

Reflexology Association of Canada (1-877-722-3338)

Canadian Association of Naturopathic Doctors (1-800-551-4381)

Where can I go for more information?