Women's Health Hot Line


Do we need hormone therapy for menopause?

Menopause is mega-business. Already, some 100 books on the subject are filling the bookstores. There's even talk of a "hot flash" deodorant hitting the market!

With an estimated 3,500 American baby boomers becoming hot flashers daily, it is no wonder that menopause is, well, a hot topic. We represent an enormous opportunity for the makers of hormones, vitamins and other specialty products. But do we really need them?

Do we need our hormones replaced?

Consider one of the most potent forces now marketed to rapidly aging baby-boomers: Replacement hormone therapy. Estrogen is touted to alleviate symptoms from hot flashes, prevent osteoporosis (the so-called "brittle bone" disease of aging) and reduce the risk of cardiovascular disease.

But estrogen is not without risk. Because "pure" estrogen increases the risk of uterine cancer, some women take a combination pill which combines estrogen and progestin. Although this lowers the risk of uterine cancer, some experts worry that any replacement hormone might increase the long-term risk of breast cancer. The long-awaited results of the Postmenopausal Estrogen/ Progestin Intervention Trials released last November revealed that hormones reduced the risk of heart disease but the study was too short-term to address the possible long-term breast cancer risk.

Estrogen or exercise?

Before you reach for a hormone pill or a patch, consider a "wonder" therapy that you may have overlooked. It's called exercise.

Perhaps you think that unless you break out into a sweat, exercise is useless. Increasingly, studies are showing that even low-to-moderate forms of exercise can pay off; in fact, one 1994 study showed that even strolling can have a beneficial effect on blood cholesterol levels.

Walking has been shown to lower high blood pressure and exercise can help control, and possibly even prevent, diabetes. Both high blood pressure and diabetes are strong heart disease risk factors in women.

As for osteoporosis, weight-bearing exercises, such as walking and lifting weights, help build strong bones. Even swimming, not traditionally thought of as a bone-builder, may be beneficial.

Regarding menopausal symptoms, a 1994 study at the University of Illinois found that women who spent the most time engaged in leisurely physical activities, such as ballroom dancing, reported the fewest symptoms.

Remember, though, if you have heart disease, or other medical problems, talk to your doctor before undertaking vigorous exercise.

If you've undergone a hysterectomy, have severe menopausal symptoms or very strong risk factors for heart disease or osteoporosis, hormones may benefit you. But whether or not you opt for replacement hormones, you may want to join me in trying exercise, the other "miracle" therapy.