Menopause: HRT, ERT or Alternative Medicine?

Menopause happens to every woman. There is no way to avoid it, but there are ways to cope with the changes. Menopause is a transition in a woman's life when the ovaries stop producing eggs. This may happen over night or could take years before the process is completed. This is the time when the body stops producing the hormones estrogen and progesterone.

Symptoms and the onset menopause occur differently in every woman so it is difficult to say what each woman will experience and when. The normal age at which a woman begins menopause is anywhere from 40 to 55 depending on the woman. A study has been done and it has shown that woman who are malnourished tend to start menopause at an earlier age then women who are well-nourished. Another factor in when menopause will begin is when the woman began having menstruation. Women who start menstruation earlier tend to have menopause occur later in life.

The symptoms of menopause also vary from woman to woman. The most common symptoms include hot flashes, missed period, sleep disruption, mood swings (changing mood), vaginal dryness, hot flashes and a low sex drive. These changes are caused by a change in your estrogen levels.

To combat symptoms of menopause, women have many options. There are two types of hormone therapy the first being hormone therapy replacement (HRT) is a combination of progesterone and estrogen and the second, estrogen replacement therapy (ERT). HRT is an excellent way to help alleviate the symptoms of menopause, but it has its downfalls. Studies have shown that HRT does slightly increase your chances of breast cancer, heart attack and stroke. If you are at high-risk for any of These consult your health care provider using HRT.

With ERT, there are three different types of replacement therapy. The first method is by using the hormone estrogen by itself as a cream, vaginal or oral pill. The second method is similar to the way you use the birth control pill. You take estrogen pills or use the patch daily, but you also use progesterone for a set amount of days out of the month. The final one is continuous therapy, which is estrogen plus the use of progesterone pills taken a few times a day.

ERT has risk factors and side effects including premenstrual symptoms (PMS) such as bloating and tender breasts. There also is an increased risk for breast cancer, coronary artery disease, blood clots, gallstones, uterine fibroids and stroke. There is a possibility of weight gain while on treatment.

If a woman decides against hormone therapy, there are a number of different alternative practices she can use. Some alternative methods include starting an exercise routine, staying away from beverages and foods containing caffeine, avoiding alcohol and staying clear of spicy foods, all of which will help decrease hot flashes. An alternative to hormone therapy for hot flashes would be to use Paxil or Prozac. They have been known to help also. For vaginal dryness there are several over the counter lubricants that can be used.

There are many different ways to help ease the transition of menopause. The best option is to speak with your health care provider and give them a family history of any disease or illness. This will help you make an educated decision on what treatment is best suited for you.

The Functional Medicine Model and Health Information from Dr Mark Hyman MD

Kevin: My guest is Dr. Mark Hyman, M.D., who is a respected medical consultant, New York Times best-selling author and a leader in the emerging field of functional medicine. Functional medicine is ideal medicine made real. It is a new medical model, a more successful way of treating human illness and disease born of recent technological and clinical advances applied in a fresh methodology. As Dr. Hyman says, "the future of medicine available now." Functional medicine moves beyond diagnosis-based medicine to allow treatment of the underlying causes of disease. It works with the body's natural forces to achieve what Dr. Hyman calls ultra wellness, lifelong good health and vitality. Doesn't that sound good?

So what I want to do now is welcome Dr. Hyman to the program. This is exciting. You're one of my own personal heroes in terms of medicine and I've read all your books and I'm really excited to have you here.

Mark: Well, it's a great opportunity to be able to talk about the work I do and it's really grown out of my own experience of being sick and my own patients and learning a whole new field, called functional medicine.

Kevin: Well, why don't you talk a little bit about how you got here and your story from when you first started and now, how it's developed into functional medicine?

Mark: Well, actually my original development started way back when I was in college where I was very interested in Chinese and Asian studies and actually the ancient healing systems of China. I learned Chinese and then I actually became a yoga teacher and way before I went to medical school I was very interested in health and was a vegetarian and actually thought I was going to go into medicine to do this kind of work in the first place.

So I had this sort of in my mind right from the beginning and then I slowly got into medical school and sort of got brainwashed little bit and took on the medical model fairly strongly, because it was pretty convincing model. Over the years, I began to realize that even if I was doing a great job with this model I could only do so much for people. It was kind of like I was putting my finger in the dam. In about my mid 30s, I went to China and actually I was there doing a project there, but I got sick. I
got mercury poisoning. I got back to the states and a number of different things happened and my whole body collapsed and I developed chronic fatigue syndrome. It was through the process of my own illness and recovery and through my work as the medical director at Canyon Ranch that I discovered a new way of treating and diagnosing illness that was based not on symptoms, but based on the causes of illness. It was based on the underlying issues that are really at the root of why we get sick and I realized that with putting your finger in the dam and simply treating symptoms you may quiet them down briefly, but the disease, or the processes that are causing the disease still are going on.

So for example, if you take a high blood pressure pill your blood pressure normalizes, but if you stop the pill your blood pressure goes up. So you really haven't done anything to treat the high blood pressure. All you've done is suppress the symptoms. So I began to have to understand this not in sort of an academic way, but in a very real way to my own process of detoxification and healing, because I had no other way to get better. Conventional medicine didn't offer me any solutions other than here take some Prozac, or take some drugs that deal with this or that, that were really not helpful anyway and so I got very lucky at the time and I was working at Canyon Ranch and I was introduced to the work of Jeffrey Bland, who is a nutritional biochemist, student of Linus Pauling, who's been working over the last 35 years really reframing our medical science in a way that allows us to understand things and how they work together.

This is called systems biology and it's an understanding that there are thousands and thousands of diseases, but there are really only about seven underlying systems in the body that has to function in order for you to be healthy and those things, when they're not functioning create illness and the treatment and the diagnosis has to be focused on those seven things. So the rest of the names in the things we call diseases really become more irrelevant as we understand those seven causes. So you can have migraines, or depression, or Alzheimer's disease, or heart disease, or diabetes or irritable bowel, or whatever. Those are just names for collections of symptoms and that any two people with exactly the same named disease can totally different problems. We have no way of knowing that if you have depression, one person might have mercury poisoning. Another person might be severely folate deficient, or B12 deficient. Another person might be hypothyroid and you can't treat them all with Prozac. They're not suffering from a Prozac deficiency. They are suffering from some fundamental, underlying imbalance that has to be addressed in order for them to get better and the body has to get the things it needs to function and thrive properly.

So this is sort of the evolution of functional medicine which has happened over the last 15 years and we have just recently published a textbook of functional medicine that lays out this paradigm in great detail. For those who are health practitioners, it's a wonderful resource, with over 20,000 scientific references. I contributed a couple of chapters to that. Mine was very large chapter on influence of diet on health, which is a big topic. It's a really exciting model, because it's not just an idea. I'm a practicing physician and every day I see patients in my office and I always say I get to be a witness to miracles.

Kevin: Wow. What's the difference between integrative medicine and alternative medicine, as opposed to functional medicine?

Mark: Great question. That's a great question and I think it's an important question. Let me just go through the history of how we got to where we are. We had conventional medicine, which is basically a reductionistic science. It breaks things down into component points, component parts. We have organ systems. We have various diseases. Then came along holistic health, which said we should pay attention to some other things, like mind-body effect and we should use some other treatments that help the body heal, like meditation, or yoga, or massage, or energy healing and then there was sort of a movement in awareness of other modalities, called alternative medicine, which included things like Ayurveda and Chinese medicine, which unto themselves are entire, whole healing systems with their own philosophy and methodologies that are very different from conventional medicine. Then Andy Wilde came along and he said there's all these great things out there that we're really not paying attention to that have been around for centuries or even some newer techniques that can really help the body heal, whether it's osteopathy, or acupuncture, or herbs and we should integrate those treatments with conventional approaches to kind of have the better outcome. So what that does is that it says well, here are the conventional diagnoses; migraine, irritable bowel, depression, arthritis, whatever. We're going to use these treatments, these alternative therapies and integrate them with conventional therapies.