When it comes to physical fitness, forget the hormones
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Hey. We’re all going to get there one day – slowing down, lower coordination, challenged balance, right? Hmm, maybe not. At least I’d like to think that it’s possible to delay or stave off the natural physical decline of aging. So what’s the deal anyhow?
Estrogen strikes again!
Declining levels of estrogen as a women ages are linked to changes within the body that directly affect physical function. And like many other age-related changes that occur, hormone therapy has been overpromised as a panacea for physical functioning. In fact, for years, women have been advised the hormone therapy might benefit and even improve overall functioning. Yet, reports supporting this particular benefit of hormone therapy have been inconsistent, with some showing improvements and other, actually showing detriment.
The latest evidence to emerge against hormone therapy comes from a comprehensive analysis of 2,400 older postmenopausal women who had taken HRT or placebo tablet. The women had all been part of the the Women’s Health Initiative Study, which, as you may recall, was halted when HRT was found to increase the risk for heart attack, stroke, blood clots and breast cancer.
In the analysis, women were assessed for physical function (i.e., grip strength, chair stand – the number of times a woman could stand up from a chair without using her arms and timed walk – the time it took to walk a 6-meter course) at the study’s start, and at 1, 3 and 6 years.
What they found.
Over the study’s course:
- Grip strength declined by 12%
- Chair stands declined by 3.5%
- Walk pace slowed by 11.4%
- No differences in physical function were seen in women taking HRT compared to those who had taken placebo
The overall conclusion? Hormones will not slow or benefit physical declines that occur as we age.
So, are we all doomed?
Studies suggest that to stave off physical declines as we age, we need to keep moving! Walking for 30 minutes a day can help to maintain bone strength. Yoga and bo su can help build and maintain balance. Tai Chi or Chi Gung can assist with focus and keep those muscles suppple. Whatever you do, it’s a use it or lose it proposition.
What’s your strategy?
Want to read more? Reuter’s Health has an excellent write-up on this study. (Special thanks to Executive Editor Ivan Oransky for pointing me to these data.)
Read MoreWednesday Bubble: what’s black and red and so not over?
How about black cohosh and red clover?
Naysayers keep bashing both of these herbs for relief of menopausal symptoms. And yet, anecdotal evidence show otherwise; I know quite a number of women who have successfully shut down their flashes and night sweats with standardized black cohosh in particular. For red clover, the results have not been quite as favourable. Still, I say this bubble ain’t over yet.
In the latest study, published in Menopause journal, researchers examined the safety and effectiveness of standardized black cohosh or red clover compared to hormone replacement or placebo in 89 menopausal women with severe hot flashes or night sweats (52 to 71 per week). Participants took one of these compounds for a year.
The results showed that while all women reported improvements, reductions in the frequency of symptoms varied by compound:
Black cohosh 34%
Red clover 57%
Placebo 63%
HRT 94%
However, contrary to previous reports, both black cohosh and red clover were found to be safe.
So, what should you do when it comes to black cohosh or red clover? As always, speak to a health practitioner about your symptoms so that you and she can make an educated decision about therapeutic strategies. Be sure that any herb you try is standardized and manufactured in a reputable facility. Finally, be aware that herbs take much longer than pharmaceuticals to start working so don’t get discouraged. The good news is that both of these products can be safe when used responsibly and under supervision. Nevertheless, like any medication, they can interact with other drugs and other conditions so you need to do your homework wisely.
Read MoreHRT – the cat’s outta da bag
Does Wyeth’s hormone replacement therapy agent Prempro cause breast cancer? Yes, according to a jury, who recently awarded Connie Barton $75 million in punitive damages.
According to a statement quoted in a New York Times expose, a spokesperson for the pharma giant Pfizer (which recently merged with Wyeth) emphatically claims that Preempro is “a safe, federally approved drug that did not cause [the woman’s] breast cancer.”And yet, Preempro is the very same drug caused the abrupt halt of the Women’s Health Initiative trial when it was found to double the risk for breast cancer as well as increase the risk for heart attack, stroke and blood clots. Moreover, later analysis of the Women’s Health Initiative data showed that hormones also increased the risk for dementia in a subset of women. Still, the company plans to fight every Preempro award, maintaining that it has acted responsibly and has posted every warning in line with FDA guidelines.
So what do you do when a drug has known dangers, a warped risk-benefit ratio and is still widely marketed? As I’ve written time and again on this blog, many in the medical profession continue to believe in HRT and prescribe it regularly, not for “good health” or to slow the aging process but to control the more troublesome symptoms of menopause (e.g. hot flashes, night sweats and vaginal dryness). And thousands of women continue to toe the party line, believing that that hormone replacement is essential to easing the aging journey (as the article’s author so aptly points out, the term “replacement” implies that it is something that is needed).
Interestingly the article maps out strategies that have been used to influence physicians, professional societies and women so as to deflect attention away from cancer concerns towards the positive, risk-preventive properties of hormone therapy. And while this piece makes me want to jump on my soapbox, I won’t attempt to dissect it further because it’s one of the most thorough and well-researched articles I’ve read in some time. The only thing I will leave you with is that Wyeth’s actions are a true reflection of everything that’s wrong with the modern view of menopause, from menopause as a disease to waning estrogen as a symbol of all that is unattractive about an aging woman.
Rather than “rebalancing” our bodies through modern medicine, shouldn’t we be focusing on what we can do to balance the transition as we move through our lives by focusing on our relationships, our activity levels, our psyches, our connections and our diets? You can’t fix something when it’s not broken. And the only thing that appears to be broken here is the hype.
Yes, the HRT cat’s outta da bag. What do you think?
Read MoreHRT and heart disease. And the beat goes on….
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Hormone replacement therapy can help prevent heart disease, right?
Think again. Research has shown that use of HRT increases the risk for stroke, blood clots and heart disease. Although increased risk starts to decline within three years of stopping hormone therapy, women are still cautioned to continue rigorous prevention efforts and to see their physicians for any recommended testing.
So, are you asking yourselves why I’m writing about this if doctors know already about the link between HRT and heart disease? Well it appears that in the early 200s, and despite a marked decline in the use of HRT among women following confirmation of the risk, as many as 8% of women with existing heart disease and 14% with two or more identifiable risk factors were still prescribed hormones by their doctors. Writing in the American Journal of Public Health, investigators of a newly-published analysis said that although the reasons are unclear, women continued to receive HRT for heart risks, even though it “was never proven for this indication and ultimately found to be ineffective.”
To add insult to injury, the International Menopause Society, in concert with the European Society of Cardiology, has just issued a statement staying that hormone therapy, in limited doses, does not increase the risk of heart disease and may even decrease risk in younger women.What’s more, they are now saying that in some cases, HRT may even lower blood pressure. Conversely, they recommended that HRT should not be used in women with a history of heart attack, stroke or pulmonary embolism (blockage of one or more lung arteries).
Are you confused yet?
Some experts have questioned the results of the Women’s Health Initiative studies, which were the first to raise the flag about the dangers of HRT. Some argue that the studies looked at women who were older, i.e. 50 to 79 and not menopausal or perimenopausal. However, others have determined that both the timing (i.e. when HRT is started) and length of time on HRT can affect disease risks, as can type of hormone used.
In some respects, these confusing recommendations echo the recent controversy over mammography, in which medical experts have taken sides, some agreeing the screening is overrated and even dangerous, and others, saying that even the small numbers of lives saved make mammography worthwhile in younger women. That, however, is a post for another time.
Meanwhile, what should you do when it comes to HRT and heart disease risk?
As always, I urge women to err on the side of caution and do their due diligence: make an appointment with an informed health provider and discuss the risks and the benefits. There’s no way to make an informed decision without all the facts and information about how they apply specifically to you, your family and personal medical history and your unique set of needs and symptoms. At the same time, the evidence is pretty darn strong that HRT does not protect your heart and may in fact, exacerbate other risk factors for developing a heart attack or stroke.
Is it worth it? Only you and your practitioner can decide.
Read MoreWednesday Bubble: herbs for breast cancer prevention
In keeping in line with my commitment to inspiring, breast cancer-related bubbles during the month of October, I am happy to share some rather promising news.
This week, it comes from Germany and was reported this past August in Cancer Epidemiology, Biomarkers and Prevention: while hormone replacement therapy appears to increase the risk of breast cancer, use of herbal preparations containing phytoestrogens (plant-based compounds that act similar to estrogen) may actually prevent the most invasive type.
Wow! Sounds promising, right?
There has been a lot of noise surrounding the effectiveness of plant-based estrogens (e.g. soy isoflavones) for menopausal symptoms such as hot flashes, night sweats and mood swings. Some studies suggest they work and others, that they don’t. In fact, I do believe that the verdict is still out, although when used properly and in coordination with a licensed practitioner, they might very well be worth trying — much more so than health risk laden hormones. Moreover, if their use does actually reduce the risk of developing breast cancer, which is the exact opposite of hormone therapy, well, then I am all for them!
In this particular investigation, researchers examined how and when over 10,000 postmenopausal women were using herbs and any possible relationship to development of breast cancer. The findings? Women who used herbs had a 26% lower risk of ever developing invasive breast cancer than those who did not. That’s quite a bit, right?
The researchers are unclear why this may be. However, I’m certainly encouraged by the news, news that an herb a day may keep breast cancer away. Definitely inspired by the fact that a natural compound might both improve menopausal symptoms and offer protection. Happy Wednesday!
[Note! Many oncologists recommend that women with estrogen-positive tumours or those who are prone to them avoid plant based estrogens. As always it is essential to speak to a practitioner before using any over the counter herbal preparation!]
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