Hormone Replacement Therapy

When I think of addiction, I go right to alcohol or drugs. But one of the most common (and most dangerous) addictions is sugar addiction.

Like most narcotics, eating a diet high in sugar gives you a “high,” and can help to mask negative feelings like loneliness, depression, resentment, or fear. In fact, sugar has opioid or narcotic properties, meaning it acts like an endorphin in your body. But, like any drug, this lift is short-lived, and soon you need more and more sugar to achieve the same effect.

There is also physical withdrawal from sugar. During the SkyLab bootcamps that I run, we break sugar addictions from the onset. And within four to five days, many of the participants experience sugar withdrawal. This can take the form of shaking, anxiety, low energy, and extreme cravings as they come off sugar. And research has shown this detox to be very real.

In a study published in the June 2002 issue of Obesity Research, scientists deprived rats of food for 12 hours, then fed them a glucose solution for the next 12 hours. Withdrawal was then induced using either 24 hours of food deprivation or the withdrawal drug naloxone. In both cases, the rats showed signs of withdrawal, including teeth chattering, shaking, and tremors. Researchers concluded that withdrawal from repeated, excessive sugar intake created symptoms that were similar to those of withdrawal from morphine and nicotine.

Sugar Wreaks Havoc on Female Hormones

Sugar depletes your body of important nutrients, including calcium, magnesium, and potassium. This leaching actually leads to cravings and binges as your body desperately seeks to replenish the nutrients that have been taken away.

It also increases estrogen levels, which can exacerbate estrogen dominance and worsen menopause symptoms, including hot flashes, night sweats, and other menopause problems.

Sugar Sabotages Weight Loss

If you have a few extra pounds you have been fighting to lose, then sugar may be the culprit. Sugar is a born enemy of natural weight loss. Sugar contributes to false fat, increases inflammation, and can worsen digestive problems. It also provides empty calories, meaning you tend to overeat sugary, starchy foods without ever really feeling full and satisfied.

So, if you are looking to lose weight, reduce the appearance of cellulite, and regain appetite control, cut the sugar…today!

Sugar Damages Your Skin

Sugary foods overstimulate your sebaceous glands and can trigger excess oil production. They can also contribute to blood sugar imbalances, which can worsen symptoms of anxiety and stress, both of which can lead to breakouts. Who needs acne at our age!

Sugar also has a vasoconstrictive effect, which translates to decreased circulation to the skin. This can lead to wrinkles and sallow-looking skin. So wrinkle-free skin is your goal, then losing the sugar is the best natural skin care program you can find.

Overcoming Sugar Addiction

Beating any addiction can be difficult, and sugar is no different. I have found that the best way to break your sugar addiction is to go cold-turkey. This means no candy, bakery items, sugary coffee drinks, etc. Nada. Nothing.

This will take about five days to completely break. In that time, lean on fruits when you need a sweet treat, and drink lots and lots of water and herbal tea to help flush the sugar out of your system.

You can also try using to of the nutrients Dr. Lark recommends for controlling your appetite and reducing cravings. These include 5-HTP and chromium.

5-HTP is the precursor to serotonin, a critical neurotransmitter in your brain that influences mood and diminishes hunger. Take 50 mg of 5-HTP twice per day. Take it with half of an apple and 50–100 mg of vitamin B6 to facilitate uptake into the brain.  

Chromium is an essential trace mineral that is necessary for controlling blood sugar and helping to reduce food cravings. Aim for 100–200 mcg of chromium picolinate once or twice per day.

Essential fatty acids (EFAs) are health-promoting nutrients that your body needs to perform a whole range of functions. Premenopause women or those in early menopause will find that proper amounts of EFAs will help to reduce the inflammation and pain seen in conditions such as endometriosis and menstrual cramps. 


Women who are in menopause need EFAs to prevent a wide range of health concerns, including heart disease and breast cancer. These incredible healthy fats also provide moisture to tissues of the skin, vagina, and bladder, as well as the hair.

 In fact, a study published in the British Medical Journal found that women who consumed foods rich in EFAs enjoyed greater vaginal lubrication and tissue thickness. Over a six-week period, researchers took smears from the vaginal wall every two weeks to see if the addition of these types of foods would cause a beneficial hormonal effect on the vagina. Typically, the vaginal mucosa thins out and becomes more prone to trauma and infections as the estrogen level drops with menopause. Interestingly, the vaginal mucosa responded significantly to the additional ingestion of flaxseed oil and soy flour, but returned to previous levels eight weeks after these foods were discontinued and the women went back to their usual diet.

If you are in early menopause or premenopause or suffer from menopause symptoms such as hot flashes and night sweats, you should definitely up your intake of EFAs.

There are several different types of EFAs, but the two main categories include omega-3 fatty acids—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—and omega-6 fatty acids (linoleic acid).

Omega-3 EFAs consist primarily of EPA and DHA. EPAs are your heart-healthy fats. They also promote beautiful, healthy skin, hormonal balance, and immune function. EPA also makes serotonin, the “happy” neurotransmitter. DHA, on the other hand, is a natural brain booster. Your brain needs DHA to create healthy nerve cell membranes. Your brain uses nerve cells for mood, attention, and memory. 

Two of the best sources of omega-3 EFAs are flaxseed and fish. (Other good sources include soybean, hemp powder, walnuts, canola oil, eggs, organ meats, and some forms of algae.) In the case of flaxseed, both the oil and the ground meal are rich in EFAs.

When it comes to fish, I recommend cold-water choices such as salmon, tuna, and mackerel. The colder the water a fish lives in, the more omega-3 its body requires and possesses, simply to keep it warm enough.

With omega-6 fatty acids, there are three main types: linoleic acid (LA), arachidonic acid (AA), and gamma linolenic acid (GLA). You only need to supplement with GLA, because you likely get enough of the other omega-6 fatty acids through your regular diet. However, the stress of daily life (as well as poor nutrition, alcohol, chemical carcinogens, cholesterol, saturated fats and low levels of some vitamins), may prevent your body from turning linoleic acid into GLA.

The reason GLA is particularly important for women is that it is converted into inflammation-fighting prostaglandins that help ease menopause symptoms such as depression and breast tenderness. They also help balance blood sugar and may also play a role in preventing certain cancers.

The best food sources of omega-6 fatty acids are whole grains, seeds, and vegetable oils. Other oils such as evening primrose, borage, and black currant are especially rich stores of GLA. If you would prefer to take a supplement, try 3,000–4,000 mg of evening primrose oil per day.

Ideally, you want to aim for a balance of omega-3 and omega-6 fatty acids, somewhere in the 4:1 and a 1:1 ratio of omega-6 to omega-3 fatty acids. To achieve this, up your intake of fish, nuts, and seeds (especially flaxseed), and decrease your consumption of red meat and dairy products, which are high in linoleic and arachidonic acids.

With all the discussion surrounding conventional hormone replacement therapy and bioidentical hormones, it’s no wonder that women are at a loss for ANY solution, natural or otherwise, to their menopause symptoms. If you are looking for a quick, easy, effective, and delicious option to ease the discomfort of night sweats, hot flashes, and other signs of menopause, then soy is for you.

Soy contains phytoestrogens, weak, estrogen-like plant compounds. The specific phytoestrogens found in soy are genistein and diadzein. They are also often referred to as isoflavones. These soy isoflavones have been shown ease menopausal symptoms in thousands of women.

Plus, eating soy-based foods has other long-term health benefits. For example, soy does not appear to have a carcinogenic effect on uterine cells or breast tissue. Plus, the EFAs in soy are good for heart health and supple skin.

To ensure you are getting adequate amounts of soy in your diet, Dr. Lark suggests aiming for 50–100 mg of soy isoflavones per day. This translates to two cups of soy milk (35–40 mg in one glass), ½ cup of edamame (150 mg in ½ cup), or one cup of tofu (35 mg in ½ cup). Just be sure to always, always choose organic soy products, as soy is one of the two most common genetically modified crops in the United States.

Here are a few easy and delectable ways to ensure you are getting enough soy in your diet:

• Make a smoothie for breakfast. Mix one cup soy milk with one banana, a handful of strawberries, one tablespoon of ground flaxseed, and a few cubes of ice. Blend well and enjoy your 70 to 80 mg of soy isoflavones.
• Enjoy a hormone-healthy salad for lunch. Mix 1 cup chopped romaine lettuce with one tomato (diced), ½ a cucumber (diced), ½ cup edamame (whole soybeans), and 2 tablespoons of pumpkin seeds. Toss with a bit of extra-virgin olive oil and balsamic vinegar and enjoy.
• Whip up an easy dessert. Place four ounces soft tofu, one cup mango, one cup papaya, and 1 teaspoon honey in a blender. Mix well and share with a friend. You’ll each get about 15 to 20 mg of soy isoflavones.
   

Ever since the Journal of the American Medical Association (JAMA) reported on the dangers of conventional hormone replacement therapy (HRT) in the July 17, 2002 issue of the journal, women have been scrambling to find a safer, yet still effective treatment for menopause symptoms.

In case you are not familiar with the study, JAMA reported on the findings from one part of the Women’s Health Initiative, an 8.5 year project funded by the National Institutes of Health. According to the findings, menopausal women taking estrogen/progestin for five years or more had an increased risk for blood clots, coronary heart disease, strokes, and breast cancer. In fact, researchers felt so strongly about the negative implications of long-term combined HRT, especially the unacceptably high risk for breast cancer, that they ended the study three years early! Participants were contacted and instructed to stop taking the drug—immediately.

As you can imagine, the pharmaceutical companies have been in a panic ever since, as hundreds of thousands of women have stopped taking their medication and look to natural medicine for answers…answers that many have found in bioidentical hormones.

Dr. Lark has written about and prescribed bioidentical hormones for more than 20 years. In fact, in our book Hormone Revolution, we have devoted several pages to the topic. And when it comes to using bioidentical hormones to treat menopause symptoms such as night sweats, hot flashes, and other signs of menopause, the most commonly prescribed hormone is estriol.

Given the sudden drought in conventional HRT usage (and therefore loss of money to pharmaceutical companies), as well as the increased interest and media attention surrounding the usage and efficacy of bioidentical hormones—namely estriol—it shouldn’t come as a surprise that the FDA is now cracking down on these natural options.

According to the FDA’s Web site, the “use of ‘bio-identical’ as a marketing term implying a benefit for the drug, for which there is no medical or scientific basis.” They even go so far as to state that estriol “is not a component of an FDA-approved drug and has not been proven safe and effective for any use.”

This is simply ridiculous and just plain outrageous. Estriol is the weakest, and therefore safest, of your three main types of estrogen. It has been studied in various animal and human studies and has been shown to be less likely to promote excessive tissue growth, and even helps prevent breast and endometrial cancers.

To me, that seems to contradict the “not been proven safe” part of the FDA’s statement. And, as for the “not been proven effective for any use,” I cannot help but wonder if the FDA is familiar with the JAMA study that found that estriol was particularly effective in treating vaginal atrophy, mood swings, and hot flashes. Or, how about study from Alternative Medicine Review, which found that estriol provided the protection of conventional hormone replacement therapy without the risks. Plus, estriol was found to ease menopause symptoms, including hot flashes, insomnia, vaginal dryness, and urinary tract infections.

Don’t be fooled by the FDA’s “concerns.” Sadly, in this arena, their main concern seems to be with the pharmaceutical company’s checkbooks, not your health. Keep yourself informed by reading blogs, newsletters, and informative emails from trusted sources and doing research for yourself. And fight for your right to natural alternatives to all your health concerns.

According to a study published in the latest edition of the journal Cancer Epidemiology, Biomarkers and Prevention, long-term use of hormone replacement therapy may cut the risk of colorectal cancer. The greatest reduction in risk was seen in women who used a combination of estrogen plus progestin for two to five years. Current users had the greatest risk reduction, but past users who had stopped at least five years ago also benefited.

So, based on this study, would I recommend using conventional hormone replacement therapy now that it has been found to reduce your risk of colorectal cancer? My answer is unequivocally no! It has been well established that conventional hormone replacement therapy has been associated with a significant increase in the risk of invasive breast cancer, cardiovascular disease, strokes, heart attacks, blood clots, and Alzheimer’s disease. So, while HRT is helpful in reducing menopause symptoms like hot flashes and night sweats—and now colorectal cancer—it is at the expense of your breast, heart, and brain health!

There are much safer and more effective ways to reduce your risk of colorectal cancer—even if you are at high risk due to family history:

1. Eat a Mediterranean diet rich in fruits, vegetables, wild-caught fish, nuts, whole grains, free-range poultry, and unsaturated fats such as olive oil and almond butter; avoid red meat, dairy products, fried and processed foods, and refined sugar and flour. 

2. Add 4 to 6 Tbsp. ground flaxseed to your diet. It’s a great source of fiber, as well as mucilage and lubricants, which provide bulk and soften your stool, helping to promote its elimination through the intestines. 

3. Don’t smoke. Smokers are 30 to 40 percent more likely than nonsmokers to die of colorectal cancer.

4. Exercise. Inactive people have a higher risk of developing not only colorectal cancer, but many other types of cancer, including breast cancer.

5. Drink alcohol in moderation, if at all.

6. Take these supplements:

Selenium is an antioxidant that has been found to inhibit cancer in animal studies. Additional research indicates that selenium shows promise in colorectal cancer prevention in humans. I recommend 50–200 mcg a day.

Calcium helps reduce the risk of colorectal cancer and precancerous polyps. I recommend at least 700 mg a day, along with 800 IU of vitamin D.

Resveratrol, a naturally-occurring compound found in grapes, may help protect against the growth and proliferation of colon cancer cells. In fact, a study published in Cancer Letters found that resveratrol reduced the growth rate of colon cancer cells by 70 percent! I recommend 200 mg, standardized to at least 8 percent total resveratrol, mixed with flavonoids for better bioavailability.

In a previous post, I discussed a common perimenopause symptom: fibroids. I also told you how to use diet to control this problem that’s so common in early menopause. Today, I am going to give you some supplements that can reduce fibroids and their symptoms.

Nutritional supplements can help balance hormones and reduce estrogen levels. When used properly, they can dramatically reduce bleeding, pain, and cramps that may accompany fibroids. In particular, I suggest using:

• B-Complex Vitamins—help regulate estrogen levels and reduce menstrual cramps. I recommend taking 50–100 mg of B-complex vitamins daily, with an additional dose of 50–100 mg of vitamin B6 (not more than 100 mg total of B6), which has been shown to be particularly helpful in reducing menstrual cramps, fluid retention, weight gain, and fatigue.

• Vitex (Chaste Tree Berry)—normalizes the secretion of hormones and helps bring estrogen and progesterone into balance. I recommend taking 40 mg once or twice a day.

• Vitamin C and bioflavonoids—work to build collagen and strengthen blood vessels, while promoting normal estrogen production and blocking its fibroid-stimulating effects. I suggest taking 1,000 to 5,000 mg of a mineral-buffered vitamin C and 750-2,000 mg bioflavonoids daily, in divided doses (choose a product with additional rutin, a potent bioflavonoid derived from alkaline buckwheat, rather than naringin, an acidic, grapefruit-derived bioflavonoid). With both nutrients, start at the low end of the dosage range and work your way up.

• Vitamin A—a study of 71 women found that those with excessive bleeding had significantly lower blood levels of vitamin A than the normal population. I suggest taking 5,500 IU of vitamin A, as beta-carotene, per day.
 

Another common perimenopause symptom is uterine fibroids. Approximately 40 percent of women have fibroids by mid-life, and usually, they don’t cause problems. However, fibroid removal accounts for nearly one-third of all hysterectomies performed annually in the United States, many of which are completely unnecessary. The fact is, many fibroids will likely shrink and may even disappear with menopause.

As with estrogen dominance, another premenopause symptom, fibroids can be largely controlled through diet. You need a wide range of nutrients to help balance your hormones and reduce your estrogen levels, decrease cramping and inflammation, and generally improve your physical and mental well-being. Increasing your intake of the foods listed below will provide the necessary nutrients to produce these effects.

1. Whole grains are excellent sources of B vitamins, as well as vitamin E, magnesium, calcium, and potassium. Fiber in whole grains absorbs estrogen, helps remove it from the body, and normalizes bowel function.
 

2. Legumes contain fiber and are high in calcium, magnesium, and potassium. I am especially fond of soybeans, which help regulate estrogen levels.

3. Fruits and vegetables contain a wide range of nutrients that can relieve menstrual cramps, including vitamin C and bioflavonoids.

4. Seeds and nuts, especially flaxseed and pumpkin seeds, are wonderful sources of essential fatty acids (EFAs), the raw materials necessary for the production of prostaglandins.

5. Fish contains linolenic acid and is an excellent source of minerals, especially iodine and potassium. Salmon, tuna, mackerel, and trout are especially good for women with menstrual cramps.

6. Oils containing vitamin E help to balance mood, and ease fatigue and cramps that occur at the onset of menstruation for women with fibroids. Good oil sources include sesame seeds and wheat germ.

7. Avoid saturated fats; dairy products such as yogurt, milk, cheese, and cottage cheese; salt; refined sugar; caffeine; and alcohol.

Wyeth Pharmaceuticals is the largest maker of hormone replacement therapy (HRT) drugs, including Prempro—which was found to be associated with an increased risk of breast cancer in the Women’s Health Initiative studies. However, that didn’t stop Wyeth from developing a new HRT formulation named Aprela for the relief of menopause symptoms such as menopause hot flashes and sleep disturbances, reportedly without increasing a woman’s risk of estrogen-related cancers.

 According to Wyeth, Aprela combines estrogen (Premarin) with a SERM (selective estrogen receptor modulator) called bazedoxifene. SERMs block the action of estrogen in certain tissues, including the breast, by occupying estrogen receptors so that estrogen cannot attach to the receptor sites. At the same time, SERMs reportedly stimulate estrogen receptors in other tissues, such as the liver, bone, and uterus (which increases your risk of uterine cancer!). But Wyeth’s studies suggest that bazedoxifene doesn’t have that uterine-stimulating effect, thereby making it a better SERM for a safer HRT drug. In clinical trials, women have been taking Aprela daily for two years while being monitored for breast cancer. However, the study is less than three years old, and it can take 10 years for breast cancer to develop!

If you need to take hormone replacement therapy to relieve menopause symptoms, I much prefer that you consider taking bioidentical hormones, which can provide menopause relief without increasing your risk of life-threatening cancer. Talk to your doctor about bioidentical hormones, a much safer and more effective option.
 

As I wrote in my blog back in early November, there are several spices that are particularly beneficial for women in early menopause or premenopause. These spices—namely ginger and cinnamon—can help to ease perimenopause symptoms. Not to mention, they taste fabulous!

The best way I know to stay in delicious hormonal balance is to incorporate these spices into your life. And what could be a tastier way to enjoy these spices than gingerbread!

Nothing says "Happy Holidays" to me quite like the smell of gingerbread baking. So, my gift to you this season, is a healthy version of my mother’s amazing gingerbread.

You can find this recipe and others like it (including several for women suffering from menopause symptoms such as hot flashes and night sweats) in Hormone Revolution.

Gingerbread
Serves 9

½ cup canola oil
½ cup erythritol
1 egg
½ cup light molasses
1 ½ cups Pamela’s wheat-free baking mix
¾ teaspoon salt
½ teaspoon baking soda
½ teaspoon ginger
½ teaspoon cinnamon
½ cup boiling water

1. Preheat oven to 350°F
2. Cream oil and erythritol for 30-45 seconds.
3. Add egg and molasses and beat thoroughly.
4. In a separate bowl, sift together baking mix, salt, baking soda, ginger, and cinnamon.
5. Add dry ingredients to egg mixture, alternating with boil water, until well blended.
6. Pour mixture into a lightly greased 8x8 pan and bake for 40 minutes, or until toothpick, comes out clean.
7. Serve warm or at room temperature.

One of my patients had a hysterectomy in her late 30s for endometriosis, and her doctor at the time put her on low-dose hormone replacement therapy. She was on hormone replacement therapy for seven years, but found that when she hit her early 50s, her body began to change. Her nails began to crack and split and her skin became incredibly dry. Lotions and other solutions didn’t work.

She came to me to see what we could do about this problem. I looked at her diet and made some changes that would support estrogen production in her body. First and foremost, she cut out caffeine and alcohol. I started her on wheat germ oil and flaxseed (a great omega-3–based food) to moisturize her skin from within. She also started eating wild salmon, butterfish, and other fish high in omega-3s. In addition, I recommended that she up her B-vitamin and silica intake.

Within months, her nails went from being really soft to strong and firm. Her skin also became much more moist and supple. We also noticed a slight increase in her estrogen levels, which helped to ease her other menopause symptoms, such as hot flashes and night sweats.

If you are already taking hormone replacement therapy but want to transition to some of the natural therapies I’ve discussed throughout my blog, discuss your decision and alternative therapies with your doctor before you make any changes. A good physician will work with you to come up with a plan specific to your needs.

One of the first things you should talk to your physician about is weaning yourself off your current hormone replacement therapy dose. You should do this slowly, because stopping abruptly can increase the severity of the symptoms for which you began taking hormone replacement therapy, such as night sweats and menopause hot flashes.

Begin by cutting the dose of estrogen by one-half each month for one or two months. Then cut back to every other day for a month, then to twice each week, and then once a week each month. Continue to take the progesterone regularly until you have stopped all estrogen, so that you stay in balance.

Tired?

You’re not alone! I can’t even begin to tell you how common insomnia can be during menopause. And menopause symptoms such as hot flashes and night sweats are some of the major reasons for insomnia, as well as stress, anxiety, and thyroid disorder, just to name a few.

If you are menopausal, I urge you to use a natural form of hormone replacement therapy to treat your symptoms. Acupressure is also a great remedy. The two acupressure points traditionally used to relieve insomnia are the Spirit Gate and the Inner Gate. The Inner Gate is located in the middle of the inner side of the forearm, two and one-half finger widths from your wrist. The Spirit Gate is located on the inside of the wrist crease, in line with the little finger. To promote sleep, apply pressure to one point and then the other. You’ll soon learn whether you get the most benefit from pressing both points or one in particular.

In my 30-plus years of practice, I've found that most women eventually see an end to menopause hot flashes and night sweats—even if it takes a few years. But unfortunately, some women never become completely immune to these symptoms, regardless of their age.

About half of menopausal women suffering from hot flashes see them disappear within a year, even without hormone replacement therapy, while another 30 percent experience these symptoms for up to three years. The last 20 percent of women endure menopause hot flashes for five to ten years or longer. I've worked with women in their 60s, 70s, and even early 80s who continue to have menopause hot flashes if they're not on some form of hormone replacement therapy. Luckily, safe, natural therapies for menopause such as vitamin E, black cohosh, and soy isoflavones (which I’ve talked about in other posts) are useful in eliminating menopause hot flashes, no matter what your age.

This combination not only eliminates menopause hot flashes, but also provides additional support to the cardiovascular system and bones. As a rule, I recommend taking the following daily dosages for menopause relief: 400–1,000 IU vitamin E; 80–160 mg black cohosh; and 50 mg–150 mg soy isoflavones.