Here is my opinion, and though i am not a doctor, it is shared by many enlightened doctors and those who believe that we shouldn't regard the menopause as an illness.
HRT is one of the darkest chapters in medical history.
HRT had a long prescription history before the discovery that it doubled the risk of breast and cervical cancer, and other serious diseases. Premarin was introduced in 1942, long before synthetic alternatives existed. It became the most prescribed drug in the USA, and perhaps the most prescribed drug ever. It is a highly profitable drug, and is now being peddled in Asian and African countries where for centuries women treated menopausal symptoms with natural remedies and diet.
Yet whilst HRT became the drug of choice for the menopause, what sort of 'disease' is this? Is puberty regarded as a disease? If not, then why is its reverse, menopause, treated as one?
Germaine Greer once stated that women had passed through the menopause for thousands of years without any significant help from doctors - but that this all changed when the drug companies wanted to sell its HRT drugs!
The risks and side effects of HRT were known many years before 'scientific' research highlighted its dangers.
Martin Walker's book 'HRT. Licenced to Kill and Maim' (2006) questions a health care system that first creates illnesses (menopause), and then creates profitable drugs to 'cure' them.
Are we really that wise to argue with Nature's wisdom and defy it?
Yes it's true that some women are at an increased risk of osteoporosis when their estrogen level drops, but bone density can be increased naturally, without relying on HRT. Moreover bone mineral density varies widely in a population and decreases with age, how can we decide where to draw the line and call it abnormal? When does it become a disease requiring treatment?
My mother was diagnosed as suffering from 'severe osteoporosis' after being tested at 43, when she entered menopause. And yet the so-called 'abnormal' result of the test may have a simple explanation: she has always been very thin, and her bones are small and light.
She was prescribed Fosamax, a drug manufactured by Merck, which incidentally, set up a nonprofit organization called the Bone Measurement Institute, to spread the use of cheaper scanning machines that brought down the price of bone exams. So, here we have Big Pharma 'generously' promoting the development of small, less expensive scanners that could be used on a heel or wrist in a doctor’s office. Unsurprisingly the majority of post-menopausal women tested were found to suffer from "dangerously low bone density", and prescribed Fosamax!
The problem with the smaller peripheral machines is that taking a measurement of someone’s heel or forearm isn’t going to tell you what you need to know about the bones in the parts of the body that, if fractured, increase a woman’s risk of death — the hip and spine.
My mother stopped taking Fosamax due to serious side-effects, and guess what? She has never had a fracture!
Aging is natural, and so is a decrease in our bone density. If we want to lead a healthy and active life well past the menopause, we can do so without relying on drugs. Yoga, weight-bearing exercise, prevention of falls, quitting cigarettes, curtailing alcohol and caffeine, and ensuring adequate intake of calcium and vitamin D are all beneficial.
For symptoms such as hot flashes and night sweats, Black Cohosh, a phytoestrogen, helps many women manage menopause symptoms. Other herbs recommended as beneficial include Dong Quai, Evening Primrose Oil and Vitex Agnus Castus.
For a treatment plan, one can consult a naturopath, or a Chinese medicine doctor (Chinese medicine has been very effective in treating my friends' symptoms)
It's not natural to eat processed food, nor to forego the important foods that can help balance our hormones. It's not natural to go without physical exercise, live in a polluted environment....and then take HRT and antidepressants to feel 'normal'.
Almost all this "unnaturalness" is imposed from without - from the polluted environment, the stress of maintaining two-income households, eating processed food for convenience, or getting less exercise due to labour-saving devices. But these factors have a negative impact on a woman's hormonal balance and overall health, and may ultimately be linked to her seemingly 'sudden' menopausal symptoms and 'sudden' ill health.
We need to take our lives back.
I think of HRT as that seawall. It gives you a false sense of security as it cannot protect you from life unforeseeable and extreme events.
Overall, a holistic approach to managing menopausal symptoms is preferable. It is important to remember that a seawall is a static feature, it conflicts with the dynamic forces of nature and impedes the exchange between land and sea (that is, between you and the transforming force of menopause).
This is a time of Change and Renewal. It may feel like a storm at times, but we can all become riders on the storm, to paraphrase The Doors!