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Dr Miriam: WHAT's BEST AFTER HRT?

Posted on: Monday, 20 December 2004, 09:00 CST

I'VE been on HRT for three and a half years and don't want to come off it. I feel fabulous, hardly look my age and my sex life is great.

I dread the time I may have to stop. When I do, are there any good alternatives to HRT?

THE word "good" makes it difficult for me to say yes. There are many things that are being pushed at women but few are any good.

As Professor Edzard Ernst says - and I greatly respect his opinion - herbal medicines are now heavily promoted as risk-free solutions to the HRT dilemma but research into herbal treatments is very thin on the ground.

Many British women feel tempted to try herbal remedies but neither the government nor medical charities invest more than 1 per cent of their medical research budgets in studying this field. Nevertheless, the little research that has been done could be encouraging.

Several trials have suggested black cohosh extracts reliably alleviate menopausal symptoms and prevent some of the long-term consequences of the menopause.

It's believed the effects of this remedy are like those of oestrogen. Unfortunately, this could mean its risks are also not dissimilar but the lack of reliable evidence means we cannot be sure.

The best-researched herbal remedy for menopausal symptoms is red clover. This evidence shows indisputably that red clover is effective in reducing symptoms, in particular hot flushes.

There is also evidence to suggest it might prevent osteoporosis, and one study reports it may protect some women from heart disease. Unfortunately, we don't yet know whether red clover carries any of the risks of HRT. And its benefits, although proven, are smaller than those provided by HRT.

In the UK, herbal remedies are not yet regulated as stringently as conventional drugs. This means the quality of products can differ greatly. Some remedies, particularly at the cheaper end of the spectrum, may be under-dosed, for instance.

Anything else? Relaxation techniques can make hot flushes more bearable; soy contains plant-based oestrogen and can combat oestrogen deficiency, so including soy in your diet may not be a bad idea. Regular exercise beats depression and helps in preventing osteoporosis.

Anyone who searches on the internet will find dozens, if not hundreds, of "alternatives" to HRT. However, the evidence is either absent or not strong enough for any positive recommendations.

Source: Daily Mirror

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