Suddenly an intense heat hits all over the head and neck. On top of being unpleasant, it is embarrassing to be the only one sweating in the room. Knee joints ache, but doctors do not find anything wrong. It is hard to get sound sleep at night. It hurts during sexual intercourse, and sometimes bleeding occurs.
Menopause brings various kinds of discomfort to women, mostly caused by estrogen deprivation. The introduction of hormone replacement therapy (HRT) was sensational. It cured them all. It not only reduced menopausal discomfort, but it also seemed to revive women’s youth. But in 2002, the tragic news came out; the risk of breast cancer, stroke and heart disease was reported to increase in HRT users. It was later revealed that the previous report contained major errors and the researchers say the benefits of HRT outweigh the risks. Yet, women are still reluctant to get HRT. Instead, they began to look for something more “natural.”
Phytoestrogens, extracted from plants (phyto means plant in Greek), are structurally similar to estrogens. The most well-known among them is isoflavone found abundantly in soybeans and red clover; women must have heard at least once that soybeans are good for them. Therefore it was suggested that phytoestrogen can replace HRT’s role in reducing hot flushes and cardiovascular protection. Additionally, they believe that as a “natural” product, phytoestrogen should be harmless unlike HRT.
Phytoestrogen sounds attractive to menopausal women. They want to stay young and get rid of all the menopausal symptoms, but they don’t want any of the risk of HRT either. But with phytoestrogen, what is there to lose? The worst thing that can happen is to waste some money.
Actually, phytoestrogen can be harmful. To begin with, its effectiveness against menopausal symptoms as well as the safety is not proven. The results of studies vary, but in most of the well-designed ones phytoestrogen was no better than a placebo in reducing hot flushes and improving cardiovascular function. Also, whether phytoestrogen imposes any health risks is unknown. Moreover, soy is one of the most common sources of allergies, putting some women at serious risk. Furthermore, the preparations of phytoestrogen may contain a mixture of unlabeled ingredients in unclear concentrations. Thus, taking phytoestrogen is not a nothing-to-lose-option.
In recent studies, the researchers found that HRT is likely to induce the growth of existing cancer cells in breasts rather than new tumor cells, resulting in a mild form of cancer. So breast cancer patients after HRT survived longer than patients without an HRT history. In addition, when used at the early stage of menopause, HRT can provide cardiovascular protection.
We all feel drawn to something “natural.” It sounds more physiologically safe. But we should look closely at which is truly physiologically safe — a mixture of unknown ingredients that has no proven effect or harm, or a well-defined component with minimal amount of estrogen and progestin that have proven benefits and known risks? The latter sounds better to me.
The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an e-mail to the writer at firstname.lastname@example.org, or call the hospital’s English-speaking coordinator at (02)2250-5577, or visit the hospital’s website, http://eng.mariababy.com/.