Power Surge News

Issue 27


A Free E-Mail Newsletter
of the Power Surge Women's
Midlife and Menopause Community
The Power Surge Web Site
Dearest (Alice Stamm)
Founder and Facilitator

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nother year has come and gone. Not an unwelcome departure, I might add, from what I hear in the Power Surge chats and read on the message boards, "This year can't end too soon for me!, "Good riddance to bad mood swings, " or "I've had enough hot flashes, palpitations, and dizziness to last a lifetime!"

Athough winter is upon us, many of you are still in the "summer solstice" of perimenopause -- hot flashes once a day -- ALL day! They often seem to begin the moment you wake up in the morning, and at times, the only respite seems to come with sleep. Right? Wrong! At night you're awakened in a pool of your own perspiration. We're even deprived of sleep.

As evolved and enlightened as we may be, hot flashes can often be embarrassing. Remember the last lap of pregnancy, when people would approach you with those infamous words, "So, no baby yet? When is this child coming?" as though you possessed some magical control over childbirth. It's much the same with menopause.

Your husband or partner, children or boss may query, "How long does menopause last, anyway?" If you're thin-skinned (and many of us are during this transition) you're likely to feel hurt, uncared for, and daily becoming more keenly aware of the insensitivity of some people. Some may even go the whole nine yards, and actually feel guilty for being in menopause and even show anger at being questioned about a transition you never asked for and over which you have only so much control.

On the other hand, if you've realized that retaining a sense of humor through this rite of passage is your only saving grace, your retort might be, "Oh, I've heard it lasts about eight to twelve years" -- with a Cheshire cat grin on your face. It may not be the answer they're hoping for, but you're both likely to find yourselves in a fit of laughter. I realize, more than you know, the difficulties associated with menopause, but the day I lose my sense of humor about it, I may as well crawl into a closet and not come out until it's over (which, believe it or not, I've considered!).

You may be out to dinner with your husband, partner, or a charming new man you've met. He orders your favorite Chardonnay. You take a sip, and not five minutes pass before . . .the hot flash!

Can't we enjoy a simple glass of wine without setting the whole menopausal process in motion?

You're at an office staff meeting ready to give your presentation. You've prepared for months, and as you approach the lecturn . . . the hot flash!

Wear a button to the next meeting or convention that says, "I'm in menopause and I carry a gun!"

You're at your high school or college reunion. You've dieted for months to get back into a reasonable size. You feel and look wonderful. You run into your old sweetheart,. While reminiscing about old times, suddenly you feel it coming on . . . the hot flash!

Save the reunions until the worst part of menopause has passed.

Perhaps you're one of the lucky few who's unfamiliar with those feelings -- never had any symptoms, no HRT and nary a vitamin, to say nothing of trying to down a Dong Quai or Black Cohosh capsule. However, for most of us in pre/peri/menopause, there are symptoms enough to fill a wheelbarrow to roll to our next gynecological visit -- with a doctor who often doesn't understand anything we're talking about, vehemently insists we're too young to be in menopause, that our hot flashes and palps are merely the result of "nerves" and whips out the trusty prescription pad to patronize us with tranquilizers or anti-depressants.

Next time you refer to the almighty in the feminine diminutive, remember, *SHE* would never have given us menopause.

This past year we've shared new information for managing our menopausal complaints -- on the Power Surge message boards, in our chats with celebrated guest physicians, naturopaths, and authors, accomplished in the areas of women's issues, health and menopause. We now know more about NHRT - natural hormone replacement therapy - and that lower doses of natural estrogen can produce excellent results, especially in combination with natural progesterone.

What's also beautiful about naturally compounded hormones is that the compounding pharmacist working with your doctor can "tweak" the doses to suit your individual needs unlike the commercially sold synthetic HRT which usually comes in one dose. Additionally, we're discovering new and exciting alternative remedies every day, such as the soy isoflavones and protein in Revival Soy, which have been very effective in reducing so many of my perimenopausal symptoms.

Researchers and doctors are finally jumping on the menopausal bandwagon. Fascinating, isn't it, that the inquisitive baby boomers effected these stunning results. Why does something have to become "trendy" before anyone does anything about it? The revelations about Melatonin have made sleepless nights a thing of the past for many of us.

The rediscovery of DHEA has restored some semblance of spiritedness and a general sense of well-being to many of us who experience awful mood swings and depression. Herbs that have been around thousands of years are finally helping those of us who are doing meno au naturel.

It has been a good year for Power Surge. We've had the opportunity to question prominent guests and experts in the area of menopause and women's issues. The guest list has been impressive. Prayers and kudos to all of you in menopause. Power Surge will continue to strive to provide the most timely information next year as well.

Happy Holidays and a healthy and happy New Year.

"Sharing Is What Power Surge Is All About"

Whatever your propensity in treating menopause, a peaceful journey. Dearest


The Massachusetts Women's Health Study showed that 40 percent of those on hormones (synthetic) continued to experience symptoms, and soon quit taking their medication, or took it intermittently. Five percent experienced no relief at all, and twenty percent never filled their prescriptions. Previous studies found that half of all women on estrogen quit taking the hormone within one year after starting it.

Women are beginning to say, "Wait a second..." Possible direct side effects from conventional HRT are greater risk of cancer, headaches, stroke, blood clots, bleeding, bloating, nausea, weight gain or mood changes, and all that at a cost of a minimum of $30-$50 per month."

Estriol is not a carcinogen; in fact a 1978 study printed in JAMA found that estriol reversed breast cancer in 37% of those tested. It is the only safe estrogen, but no woman should take any estrogen until she gets her progesterone level back to normal, and those in menpause or who have had hysterectomies produce almost zero progesterone--the bone-builder. Estrogen will keep one from losing bone for only 3 to 5 years and not at all after age 65 - New Eng.Journal of Medicine.

A woman can start on progesterone cream rub and stay on estrace if she cuts the estrace back 50% because the progesterone will strengthen the estrace.



"The Hormone Lament"
Sung To The Tune Of, "Chestnuts Roasting On An Open Fire"

Hormones roasting and I'm all afire
Night sweats struggling to win
Mothers all bake them at Holiday time
But, *I* rub yams into my skin :(

Everybody knows I'm going through my changes now
And all I want is some respite
Why is it so, when I EXIT a room,
I always seem to turn ON the light? (sigh)
They say that freedom's on the way
With patience I shall live to see a better day
And then instead of these mood swings
My fingers once again will fit into my rings

And, so I'm offering this fervent prayer
For Surgettes' lingering in sorrow
Read, understand and empower yourselves
For there WILL be a brighter tomorrow



Other than the fact that breast cancer is the number two cancer killer of women and prostate cancer the number two cancer killer of men, the two diseases would appear to have little in common. But both strike in response to the workings of sex hormones. Moreover, some scientists now suspect that women and men can take exactly the same step to reduce the risk of succumbing to these diseases. The answer, they believe, is in the diet. As it turns out, plant foods, like humans, have hormones.

These plant hormones, called phytoestrogens, are weaker versions of human estrogen. And research suggests that if they are consumed in large enough amounts, they may have profound effects not only on the incidence of breast and prostate cancer but also on menopausal symptoms such as hot flashes and mood swings. It may even be that phytoestrogens will prove an alternative to estrogen replacement therapy, a treatment regimen now used by more than 10 million American women but which has the downside of potentially raising the risk for breast cancer as well as cancer of the uterus.

Animal nutritionists have known for decades that the hormonal balances of mammals could be affected by plant foods. Sheep, for example, can become infertile or lambs go into heat by grazing on red clover sprouts. But the array of plant foods involved and the extent to which the animal findings apply to humans has only recently come under scientific scrutiny.

The "phyto" in phytoestrogens is from the Greek for plant, an apt prefix since phytoestrogens are found in all manner of plant foods. There are several classes of phytoestrogen compounds:

  • Coumestans are contained in bean sprouts, red clover, and sunflower seeds.

    Lignans are formed when bacteria in the human gut "nibble on" compounds found in such grains as rye and wheat and in seeds like sesame and linseed.

  • Isoflavones exist in many different types of plants, including "everyday" fruits and vegetables, but they are especially prominent in soy--apparently the most potent food in terms of its estrogen-like effects on the body.

So far, some 300 plants with estrogen-like activity have been identified, including common foods such as carrots, corn, apples, barley, and oats. Yet products made from soybeans--tofu, for instance--have received the lion's share of attention because they appear to pack a much more potent estrogenic punch. Indeed, researchers have observed that in countries where people eat diets high in soy foods, such as Japan, China, and Korea, breast cancer rates are much lower than in the West, death from prostate cancer is minimal, and the unpleasant symptoms of menopause appear scant.

Understanding the hypothesis behind the protective effects of the phytoestrogens in soy and other foods can be a bit tricky, especially when it comes to women, because it relies on seemingly contradictory concepts that have to do with whether a woman is pre- or post-menopausal. Namely, scientists speculate that during childbearing years, prior to menopause, phytoestrogens stave off breast cancer by blocking the action of some of the body's naturally occurring estrogen and thereby acting as antiestrogens.

Consider that in females, estrogen is necessary for reproduction as well as for the development of the breasts and other secondary sex characteristics. But it can also cause a problem, because inside breast tissue it can encourage cancerous tumors to develop.

After menopause, however, when a woman's natural estrogen declines by 70 percent, phytoestrogens provide an estrogen "lift" to make up for the "lack" of the hormone--without raising cancer risk. In men, phytoestrogens appear to act as a blocker of testosterone--the male hormone that, while necessary for a man's maleness, can spur the growth of prostate tumors. And they accomplish the task without making men "feminine."



Q. What is the incidence of depression among women at the onset of menopause? For how long are antidepressants usually prescribed for menopausal depression?

A. "There is a mental health side to menopause that is as much a part of the physical process as our minds are part of our bodies," says Rosemary Tofalo Bowes, Ph.D., a Washington D.C.-based psychologist. "Yet, just as menopause is a natural passage, not itself a physical illness, the mental side of this passage should not be confused with mental illness."

Menopause, the cessation of menstrual periods, occurs on average at age 51.There is NO evidence to suggest that women are more susceptible to clinical depression after menopause. Because of declining estrogen levels after menopause, many women experience short-term physical symptoms such as hot flashes, irregular uterine bleeding and vaginal dryness. Irritability, depression (feeling "depressed" as opposed to a clinical diagnosis) and mood swings are the most common emotional symptoms.

They are not believed to be the result of declining estrogen levels, but rather the result of the physical symptoms of menopause. For example, when hot flashes occur at night (night sweats), the quality and quantity of sleep can be significantly affected, leaving one more susceptible to mood swings. Women who develop constructive responses to menopause tend to live healthier and more balanced lives. Dr. Bowes offers the following tips:


  • smoke or abuse alcohol try not to be too thin or allow yourself to be too heavy drink caffeine or soft drinks, except in moderation fret or focus on negative thoughts
  • close down and think you are alone


  • exercise and stretch use relaxation techniques, especially deep breathing watch your diet, and be wary of fats and cholesterol think positive thoughts try to be flexible try to laugh as often as possible
  • see your friends



Drinking Raises Estrogen Levels In Women Taking HRT
By Damaris Christensen

For postmenopausal women who take estrogen replacement therapy, drinking the equivalent of one to two glasses of wine can lead to a threefold increase in the levels of estrogen circulating in their blood, according to a new study. "If alcohol alters the intended biological effects of estrogen replacement therapy, it could weigh negatively when assessing the risks against the benefits of hormone replacement," said researcher Dr. Elizabeth S. Ginsburg, of the division of obstetrics and gynecology at Brigham and Women's Hospital in Boston. For example, increased blood levels of estrogen may heighten a woman's risk of breast cancer, Ginsburg speculated.

Previous studies have linked estrogen replacement therapy with the development of breast cancer, she noted. But this link is highly controversial, pointed out Trudy L. Bush, a professor of epidemiology and preventive medicine at the University of Maryland School of Medicine in Baltimore. "I don't see any clinical implications from this study," she said, adding that the observed rise in estrogen levels may have no effect. "In premenopausal women, estrogen levels may vary more than threefold over the course of a month." An estimated 25 percent of U.S. women over age 50 take estrogen replacement therapy to combat the symptoms of menopause, prevent bone loss and stave off heart disease. (Note: This was written prior to the abrupt halting of the WHI Study (Women's Health Initiative) due to concern over unexpected results.

Read more about it The HRT Controversy: Conventional Hormone Replacement Therapy: The Risks Outweigh The Benefits.) Ginsburg's team looked at the effects of drinking alcohol in 24 postmenopausal women, 12 of w hom used estrogen replacement. In the study, published Wednesday in the Journal of the American Medical Association, the women were admitted into a hospital in the afternoon and fed specified meals and snacks. The following morning, each woman was given either an alcoholic drink or a non-alcoholic drink. Her blood was sampled every 10 minutes for six hours.

Each woman remained in the hospital and the next morning was given either an alcoholic or non-alcoholic drink _ whichever she had not received the day before. Again, her blood was tested every 10 minutes for six hours. Estrogen levels of the women on estrogen replacement began to rise within 10 minutes of taking a drink of alcohol, but not after the nonalcoholic drink, the researchers found.

As a woman's blood-alcohol levels rose, so did her blood-estrogen levels; as alcohol levels dropped, so did estrogen levels. The estrogen levels remained elevated for up to five hours, the team reported. Women who were not using estrogen replacement did not show any significant changes in their blood-estrogen levels, which were much lower to start with, the study showed. "It's a very interesting study," said Dr. William C. Andrews, a professor of obstetrics and gynecology at Eastern Virginia Medical School in Norfolk, Va.
"But it's too early to say whether this has any implications for a woman who may have one or two drinks once in a while. I don't think that, at this point, this should affect a woman's choice to use estrogen replacement therapy," he said. The study did not replicate "real life," Ginsburg noted, since each of the women ate a controlled diet, drank a specified amount of alcohol and was carefully monitored.

More research is needed to look at whether these high estrogen levels occur in a less controlled setting, and if they might raise a woman's chance of developing breast cancer, Ginsburg added. © Medical Tribune News Service



Heavy bleeding, while usually not medically serious, can cause major disruption in a woman's life. It can cause embarrassment and result in a decrease in exercise and other beneficial activities. If severe enough, it can also result in anemia.

Dysfunctional Uterine Bleeding (DUB) refers to excessive bleeding that is not related to fibroids, polyps, endometriosis, adenomyosis, pregnancy, cancer or other identifiable causes. It is usually related to hormone imbalance or changes and is more likely to occur during perimenopause when women often do not ovulate regularly. About half of the cases are women between 40 and 50 and 20% are adolescents. Some of the common imbalances are excessive estrogen, lack of progesterone or an imbalance of these hormones. Hypothalamic dysfunction, pituitary or adrenal hyperplasia (which is usually associated with excessive hair growth or other signs of virilization) or thyroid problems can also cause heavy bleeding.

Drugs such as steroids and psychopharmacologic agents can inhibit ovulatory function and result in bleeding problems. But because bleeding can be an indication of cancer, fibroids, endometriosis, polyps or pregnancy, it is important to have it evaluated by your health care provider. An abnormality of the arteries supplying the uterus can also cause bleeding, but this is rare. Dr. Winifred Cutler found that for some women, excessive bleeding may be a consequence of having intercourse during menses. Obesity, polycystic ovary syndrome, stress, crash diets, and excessive exercise can all disrupt ovarian function.

Those on hormone replacement therapy may experience bleeding problems but it is rarely a cause of heavy bleeding. DIAGNOSIS The most important step is to determine what is causing the bleeding. Dilatation and Curettage (D&C) involves scraping the interior of the uterus and may still be used for diagnosis,. However, a procedure which reduces the risk of uterine puncture and is less expensive, is aspiration curettage which removes a thin layer of the endometrium with suction.

While an endometrial biopsy (a sample of the uterine lining is taken to determine if suspicious cells are present) has been standard procedure to check for precancerous conditions, the use of ultrasound which shows the thickness of the uterine lining is becoming more common. Studies reported in both the American Journal of Obstetrics and Gynecology and the Journal of Reproductive Medicine found that ultrasound was an effective screening tool for the presence of uterine abnormalities. It identifies those who need further diagnostic evaluation such as a biopsy if the test is abnormal or inconclusive.

This procedure allows a view of the whole uterus. A biopsy may not be representative of the condition of the entire endometrium. If abnormalities are found further procedures such as Magnetic Resonance Imaging (MRI) which uses a magnet to create images of live tissue, Computerized Axial Tomography (CT or CAT) which takes X-ray pictures of slices of a region, and hysteroscopy which allows the physician to look at the inner walls of the uterus and cervix may be used.

One of the key questions in dealing with DUB is recognizing whether you are dealing with life-threatening bleeding (causing severe anemia, or caused by cancer) or lifestyle-threatening bleeding which is the most common cause of hysterectomies in this country. (See issue 3.3 on hysterectomy.) While heavy bleeding can be very disruptive to your daily activities, the safest approach is appropriate diagnosis and therapy beginning with the least invasive procedures. While DUB is the reason given for 20% of hysterectomies in this country, there are less drastic measures available that may solve the problem. Nonsteroidal anti-inflammatory drugs such as Advil may work for some women.

These are to be started one week before menses and continued through the flow. For perimenopausal women, oral contraceptives may be effective. Cyclic progesterone treatment or hormone replacement therapy are additional options. For more severe cases Danazol or injections of Depo-Provera or Depo-Lupron may be used. (D&C) may stop the bleeding, but it may return and is seldom used. Endometrial ablation (burning away or vaporizing the uterine lining) with laser or electrocautery is also often an effective alternative to hysterectomy.

A report this year in the New England Journal of Medicine reported that after five years 79% to 87% of women were happy with this surgery and it controlled bleeding in at least 85% of the women. During five years of follow up, only 9% underwent hysterectomy and 10% had another ablation. One possible down side to this treatment is future endometrial cancers may be harder to diagnose due to scar tissue in the uterus. A procedure which uses a catheter with a balloon attached is being studied. The catheter is inserted into the uterus. The balloon is inflated with sterile solution so it fills the uterus and takes its shape. Then a heating element raises the temperature to 189 degrees. This destroys the endometrial lining. This is still an experimental procedure but new techniques will be evolving.

If you have consulted with your health care provider, you are dealing with heavy bleeding and no cause has been identified, here are some things you can do for yourself.

  • Diet: If you are losing a lot of blood, you want to protect yourself from anemia by getting extra iron. Liver is a good animal source. A non-animal source is legumes, but you should take vitamin C (75mg.) with it because it aids absorption. Seeds, nuts, blackstrap molasses, some fruits such as raisins, dates, and prunes and some vegetables such as beets, corn, spinach, sweet potato, and dandelion greens, are also good. Fresh, dark green, leafy vegetables are a good source of Vitamins K and C and iron. Deficiencies in these may contribute to heavy bleeding. Herbs: Lady's mantel, Vitex (chasteberry), wild yam root, uva ursi, raspberry leaves, garden sage, black haw bark, golden seal, yellow dock, turmeric, silymarin and pau d'arco. Bioflavonoids: Citrus fruit inner peel, buckwheat, elder, hawthorn, horsetail, shepherd's purse. Essential Fatty Acids: Oils -- flax seed, borage seed, black currant, and evening primrose. Homeopathy: Lachesis, sepia, belladonna, ipecacuanha, secale, sabina, china, crocus sativa, natrum mur, sulfur. Supplements: Zinc, Copper, Iodine, Vitamin B6 Warning: Large doses of vitamin C may thin the blood and increase bleeding.
  • Acupressure, yoga: Some women find specific yoga positions or acupressure points helpful.

The belief is that these approaches balance the body and stabilize energy flow, allowing the body to heal. See Heavy Menstrual Flow & Anemia by Dr. Susan Lark for further information.

For some women hysterectomy is the only solution. However, this surgery is too often used for problems that are not life-threatening. Because it is so common, we may not recognize its seriousness and too many women are not told of the possible side effects such as reduced sex drive, urinary problems, constipation, or back pain. If you consider surgery, be sure you are fully informed.



Excellent article prepared by herbalist, Kathy Shull Abascal. Contained herein is information about various herbs which have been found to be helpful in combatting menopausal symptoms, without resorting to synthetic prescription drugs or hormones, for those who choose the more natural path.

Herbal formulations cannot take the place of medical care by a doctor or medications prescribed by a doctor. Herbalists have traditionally recommended the herbs discussed in this article for peri-menopause and menopause. They are a safe adjunct to medical care but are NOT a substitute for medical treatment and have not been shown to treat or cure any disease condition. Herbs marked with an asterix (*) hold some degree of risk in pregnancy, real or potential.

The common names of the herbs are in bold, their latin name follows in parenthesis. Long ago, wise women began collecting herbs to maintain the health of their people. Herbalism grows out of women's knowledge and ways. As you might expect, there are herbal remedies for a wide variety of women's needs: Herbs can balance menstrual cycles, increase fertility, help maintain pregnancy and ease birthing. Herbs can also help women through the transition into menopause. This article will touch on a few herbs than can be of great help in peri-menopause and menopause.


As we approach menopause, our menstrual cycles shift. In some women they get longer, in others they get shorter. Cycles double up, overlap, and become more irregular. We may begin to experience migraines, bloating, breast tenderness, hot flashes and moodiness as our hormones change. Herbs can be used to restore balance to our menstrual cycles in menopause.

A cyclic herbal elixir chosen for the individual woman will provide the most relief. Nonetheless, even single herbs may provide substantial relief -- provided our cyclical nature is respected. Our menstrual cycles can be divided into two phases. Phase One begins on the first day of menses and ends at ovulation, fourteen days before the next menses. Phase Two begins at ovulation and runs to the first day of menses. Different herbs are needed in the two phases.

  • Herbs For Phase One

    In Phase One of the menstrual cycle, estrogen dominates. The estrogen causes uterine and breast tissue to proliferate. It also helps mature an egg. In Phase One, less than perfect menstrual cycles can be balanced by herbs that help the body cycle up estrogen. Both cycles that are too long and cycles that are too short are helped by the same herbs. In a long cycle, herbs increase the effect of circulating estrogen, allowing an earlier ovulation. In a short cycle, herbs increase the ability of estrogen to form adequate progesterone binding sites, which will stabalize the cycle. In both cases, the herbs should be taken only during Phase One of the cycle --Day one to Day fourteen.

    Dong Quai (Angelica sinensis) helps promote the body's use of, and response to, available estrogen. Dong Quai is available as a tincture that can be added to a little warm or cold water. Most of us need about 30 drops of tincture three times a day. Dong Quai is also available as thin slices of cured root. One/16th of a slice of root once a day is about right for most women. The root can be chewed or brewed into tea. (Dong Quai is also available in powder form. The quality and potency of the powder varies greatly, and may not be adequate.)

    Gotu Kola (Centella) helps the body utilize circulating thyroid hormones. Thyroid is important to ovulation. Gotu Kola is particularly helpful in women with long cycles because they may be having trouble maturing an egg. Thyroid levels increase at night, so Gotu Kola will be most effective if taken midday, at dinner, and right before bed in Phase One.

    Herbs for Phase Two

    In Phase Two (from ovulation to menses) progesterone is the dominant hormone. Progesterone is secreted by corpus luteum that is formed when the egg matures. This hormone organizes the tissue in our breasts and uterus for pregnancy. As we approach menopause, many of our eggs fail to secrete enough progesterone. We always have some estrogen circulating in the background. When progesterone dies back, estrogen takes over. Estrogen dominance in Phase Two will make the lining of the uterus thicker and our breast tissue "disorganized." This causes water retention, breast tenderness, and longer menses. Herbs that help maintain our progesterone phase are most helpful when taken from ovulation to menses.

    Chasteberry (Vitex agnus) probably stimulates the hypothalamus to increase Luteinizing Hormone which matures the egg and the corpus luteum. Chasteberry is a basic herb for women with longer menstrual cycles.

    Yellow Pond Lily (Nufar ) can help restore balance to the overly short menstrual cycle. It is a tonic sedative to "heat" in the ovaries.

    Herbal Teas that provide minerals in dissolved form can be a tremendous aid in Phase Two. During this phase, tissue is manufactured and broken down at a rapid pace. These activities generate a lot of waste that the liver must process. Providing an abundance of bioavailable minerals will help your body handle the increased waste load without stress. Mineral rich herbal teas also provide a good source of calcium which becomes increasingly important as you approach menopause. Good mineral rich tea can be brewed from any combination of: Lemon Balm, Raspberry, Green Oat Straw, Nettles, Dandelion, and Mormon Tea. A strong cup of tea once a day in Phase Two will minimize bloating, breast tenderness, and headaches.

    Garlic as food, in capsule or in tincture can be very helpful in the PMS period -- especially if the blood pressure rises premenstrually -- which happens frequently to women in their 30s and 40s. This blood pressure rise is often accompanied by an increase in blood fats. Fat filled blood does not move well through our capillaries and often causes premenstrual headaches, acne, and hemorrhoid flare-ups. Garlic "thins" the blood by increasing its electrical charge, allowing it to flow better.


    As we move into menopause, our cycles will become increasingly unpredictable. Cyclical heral elixirs do not fit any longer because the phases blur together. Eventually, our menstrual cycles stop. As our estrogen levels drop, our hypothalamus will begin secreting large amounts of Follicular Stimulating Hormone (FSH) in a vain attempt to make our ovaries secrete estrogen. High levels of FSH often change the levels of thyroid in our bodies. These hormonal changes account for many of the metabolic shifts we experience in menopause: Hot flashes, night sweats, headaches, bloating, mood changes, etc. Herbs can be wonderful allies in this change.

    Dong Quai (Angelica sinensis) can be taken on a daily basis in menopause. It increases the effectiveness of the estrogen that now is eleased primarily from our fat tissue (rather than from our ovaries). Dong Quai can substantially soothe menopausal discomfort.

    Black Cohosh (Cimecifuga) or *Baneberry (Actea) are often helpful in menopause. (These two herbs work identically, so either one can be used. I prefer Baneberry because it is usually harvested more environmentally.) These herbs quiet the hypothalamic screams for estrogen. The hypothalamus perceives them as estrogen breakdown products. Estrogen breakdown products signal the hypothalamus that there is enough estrogen in the system, and less FSH is manufactured. Five to ten drops of either herb, taken as needed, can quiet a hot flash or ease other menopausal discomfort as the body adapts to menopause. More is not better though. Taking more than 15 drops at one time can increase the discomfort.

    Chasteberry (Vitex agnus) can also be taken on a daily basis in menopause, and it works wonderfully for many women, again by soothing the hypothalamus. Chasteberry is more individual though, and can cause discomfort in some women.

    As our estrogen levels decline, other hormones that were always in the background (like small amounts of testosterone) play a greater role in our metabolism. This can make our kidneys retain more sodium and water which raises our blood and cerebrospinal fluid pressure. We may experience bad headaches when the pressure rises.

  • Pulsatilla (Anemone) can be wonderful here. Five drops of Pulsatilla when we feel a tightness over the eyes can turn an impending migraine around. It is also good for emotional surges that are hard to deal with. Pulsatilla is a "low dose" herb, however. Do not take more than 10 drops at a time.

    There are many other herbs that will help us through the emotional changes that often come with menopause. *Blue Vervain (Verbena) can be used as a tonic in a menopausal woman who experiences sudden angry outbursts. It relaxes the arteries, and creates a sense of relief and well being. Oat tincture (Avena) can help cycle up endorphins and help us relax at night (which can decrease those night sweats). It is a great soother when life gets a little exhausting. Kava Kava (Piper methysticum) can prevent headaches caused by tight muscles in the neck and shoulders, and can keep the mind feeling light.

    Finally, as our estrogen levels decrease, we have to pay greater attention to our calcium metabolism if we are going to keep our bones strong. A daily cup of calcium rich herbal tea becomes important. The calcium in herbal tea is absorbed directly into our blood from the stomach. It is more bioavailable than other sources of calcium that are absorbed through our intestine. A cup of Oat Straw, Nettle, Dandelion Leaf, and Mormon Tea with Raspberry Leaf and Peppermint for flavor will boost our calcium levels. Dandelion Root vinegar is easy to make, and a tablespoon of that vinegar in a salad dressing will provide a significant amount of easily absorbed calcium.

    Ultimately, herbs do not work the way prescription drugs do. Usually herbs do not suppress symptoms. Instead, selected for a particular individual, herbs will change blood and hormone flow so that the body achieves a balance. A good balance cures the symptoms.

    A woman experiencing an unpleasant transition to menopause can benefit greatly from an individual herbal consultation. (Herbal consultations are available by mail as well as by personal visit.) The herbalist can select a combination of herbs that will support the liver, the kidneys, and the entire body as the woman goes through the metabolic change of menopause.

    The herbalist will also know of herbs that can ease other problems like flooding, fibroids, and vaginal dryness. A good herbalist will also recommend appropriate dietary and life style changes that will support a healthful balance in the individual woman. Exploring herbal alternatives before starting on hormone replacement therapy will also ensure that the woman knows that she has considered all of the choices and has chosen a path through menopause that really is best for her and her body. Read more about herbs in Power Surge Recommendations.

    Kathy Shull Abascal, C.H., J.D., P.D.T.
    Power Surge Herbal Consultant



FemPatch(TM) is an innovative, low-dose transdermal estrogen replacement system for the treatment of menopausal symptoms. Using a low, 0.025 mg dose of 17 beta-estradiol (a natural form of estrogen) in a thin, flexible once-weekly patch, FemPatch provides highly effective relief of vasomotor symptoms such as hot flashes and night sweats.

In clinical trials, the vasomotor symptom relief of FemPatch was comparable to that achieved with a 0.05 mg transdermal dose of 17 beta-estradiol. FemPatch treats moderate to severe vasomotor menopausal symptoms using a patented matrix system that delivers estradiol through the skin in a consistent, low dose, reaching maximum blood levels within 24 hours and then maintaining constant blood levels for seven days.

Clinical studies with FemPatch showed a low incidence of discontinuation due to skin effects (3%) or adhesion failure (less than 2%). Overall, discontinuation due to adverse events for FemPatch (2.8%) was comparable to placebo (2.8%). Transdermal estrogen replacement systems currently on the market all contain the active ingredient 17 beta-estradiol in doses ranging from 0.0375 mg to 0.1 mg. "FemPatch delivers a 0.025 mg daily dose of estradiol, giving women and their health care providers a new low-dose option for the treatment of moderate to severe vasomotor menopausal symptoms," said Jean Rowan, M.B. Ch.B., senior director, Clinical Research Department, Parke-Davis Pharmaceutical Research Division. "Physicians who have menopausal patients requiring low-dose estrogen will find FemPatch to be a desirable choice." There are approximately 15 million women in the U.S. between the ages of 45 and 55; the typical age range for menopause.

Menopause, characterized by the cessation of menstruation, can result in vasomotor symptoms ranging from multiple hot flashes during the day to numerous nighttime flashes, or "night sweats." In clinical trials, FemPatch was shown to effectively reduce vasomotor symptoms by consistently delivering a nominal 0.025 mg dose of estradiol.

Two independent, 12-week, double-blind, placebo-controlled studies conducted with 324 surgically or naturally menopausal women, with moderate to severe vasomotor symptoms (a mean of 80 hot flashes per week and a range of 56-140 hot flashes per week), showed that FemPatch significantly reduced the number of hot flashes. By week 12, hot flash frequency decreased from 80 hot flashes to 13 per week -- a reduction of 84%. Reduction of hot flashes was significant as early as week two in some treatment groups, and by week three in all treatment groups.

FemPatch is a translucent, skin-like, rectangular-shaped laminated matrix system composed of three distinct layers. The recommended starting dose of FemPatch, when initiating estrogen replacement therapy in the management of vasomotor symptoms of menopause, is one patch every seven days. The buttocks is the preferred site of FemPatch application. As with other estrogen replacement therapies, FemPatch may not be suitable for all patients and should not be used by women with any known or suspected pregnancy, breast cancer or estrogen-dependent neoplasia; undiagnosed abnormal genital bleeding; active thrombophlebitis; or thromboembolic disorders.

Side effects with FemPatch are similar to those seen with other estrogen replacement therapies. As with all estrogen products, there are possible common side effects such as: headache, nausea, abdominal cramps, fluid retention, irregular bleeding, breast tenderness or increase or decrease in weight. Estrogens also have been reported to increase the risk of endometrial carcinoma in postmenopausal women.



Many of you have posted on the Power Surge boards that you have, or are about to stop taking HRT, due to poor reactions to it, or a desire to switch to a natural hormone. Since our Power Surge group is a microcosm of the big world out there, I'd imagine many other women are doing/have done the same thing. It's not advisable to simply stop taking HRT.

In her book, "Hormone Replacement Therapy: Yes or No?" Dr. Betty Kamen discusses Natural Progesterone, at length, as well as how to gradually taper off estrogen if you are currently taking it. She's also made and distributes two audio tapes. In past Power Surge newsletters, I've written or provided numerous articles on natural progesterone, and on Dr. John Lee who has been researching and writing about natural progesterone, menopause and hormones since the 1940's. His "Menopause: What Your Doctor May Not Tell You" is a comprehensive study into and look at hormones. Why, do you suppose, don't our doctors tell us about natural progesterone? Notice how quickly they provide free samples of prescription drugs manufactured by the mega-pharmaceutical houses? Natural Progesterone is a "natural" substance. This means it CAN'T be patented, thus the drug companies can't make any money on it. Excerpted from, "Hormone Replacement Therapy: Yes Or No? :How to make an informed decision about Estrogen, Progesterone, & other strategies for dealing with PMS, Menopause and Osteoporosis" by Dr. Betty Kamen.

If you can't locate it in your local library, or at your favorite bookstore, it's published by Nutrition Encounter, Box 5847, Novato, CA 94948; Tel. (415) 883-5154. Dr. Betty Kamen writes, "The word Progesterone was first proposed by William Allen and George Corner in 1934, when they isolated this newly discovered sex hormone. Since then, more than 5,000 plants have been identified as containing substances with progesterone-like chemistry. In 1943, Russel Marker successfully manufactured progesterone from the roots of Mexican yams. "With minor conversion in the laboratory, the Mexican yam extract, diosgenin, has been made to match natural progesterone exactly.

But the manufacture of cortisone and progestogens from the saw raw materials attracted far more attention. The neglect of progesterone led Dr. Dalton to refer to it as 'the forgotten hormone.' The success of many practitioners has helped us to catch up with this hormone. The spotlight has been turned back in progesterone's direction." You can read more about natural progesterone in Issue 13 of the Power Surge Newsletter, which is exclusively devoted to Dr.Kamen's book and the subject of Natural Progesterone. The following list was prepared by Aeron LifeCycles.


    More than 400 mg progesterone per oz:

  • Pro-Gest Natural Progesterone Cream (Emerita: Portland, OR) Bio Balance (Garon Pharmaceuticals: Scottsdale, AZ) Progonol (Bezwecken: Beaverton, OR) OstaDerm (Bezwecken: Beaverton, OR) Pro-Alo (Healthwatchers Sys.:Scottsdale, AZ) PhytoGest (Karuna Corp.:Novato, CA) NatraGest (Broadmoore Labs, Inc.:Ventura, CA) Angel Care (Angel Care, USA: Atlanta, GA) Equilibrium (Equilibrium Lab, Boca Raton, FL) Pro-G (TriMedica: Scottsdale, AZ) ProBalance (Springboard, Monterey, CA) Femme Naturale (Sarati Inernational, Pheonix, AZ)

    Creams containing 2-15 mg progesterone per oz:

    Pro-Dermex (Gero Vita Int'l.:Reno, NV) Endocreme (Wuliton Labs: Palmyra, MO) Life Changes (MW Labs: Altanta) Protesterone-Plus (Prof. Health Products:Sewickley, PA)

    Creams containing less than 2 mg or NO progesterone/oz:

    Yamcon (Phillips Nutr.: Laguna Hills, CA) Born Again (Phytopharmica: Green Bay, WN) Fermarone (Wise Essen, Inc.:Minneapolis, MN) Wild Yam Cream (Alvin Last, Inc.: Yonkers, NY) Progestone-HP (Dixie Health, Inc.: Atlanta, GA) Progestone 10 (Dixie Health, Inc.: Atlanta, GA)

  • Woman Wise (Jason Natural Cosmetics: Culver City, CA)



The Illinois Center for Clinical Trials is helping women who are experiencing hot flashes. Women ages 40-65 who are experiencing menopause or are hysterectomized may be eligible for a research study which provides free medication, physical exams and diagnostic tests. Those who qualify and complete the study will receive $125. If you are in the Chicago area (or know someone) and would like more info, please e-mail us or call (312) 565-5180.


The Women's Health Initiative is the first long term research study to examine the major causes of death in women, i.e. breast cancer, heart disease and osteoporosis. It is specifically looking at how hormone replacement therapy, diet, and calcium and vitamin D can reduce the major causes of death. It is being sponsored by the National Institutes of Health and is currently being conducted at 40 clinical sites across the United States. (Detroit, Chicago, Buffalo, Tuscon, Columbus, Milwaukee, etc.) All visits, pills, exams, labs, etc. are at no cost to you. We are seeking women between the ages of 50 - 79 who are post-menopausal. The findings of this study by The National Institutes of Health are constantly being updated. Hopefully, the findings will help our daughters, granddaughters and future generations of women.

(Note: This was written prior to the abrupt halting of the WHI Study (Women's Health Initiative) due to concern over unexpected results. Read more about it The HRT Controversy: Conventional Hormone Replacement Therapy: The Risks Outweigh The Benefits.)



Help us explore the herbal traditions that healers from other countries have brought to New York City. If you are a woman over the age of 18 and are symptomatic for:

  • Endometriosis Fibroid Tumors Menopausal Hot Flashes
  • Menorrhagia (Heavy Menstrual Flow)

We invite you to participate in a study investigating the herbal preparations used by other cultures to treat these conditions. If you are interested, please call: (212) 544-1095 Dr. Kronenberg
Columbia-Presbyterian Medical Center

The Institutional Review Board of Columbia-Presbyterian Medical Center has approved the solicitation of subjects to participate in this study. (IRB#7395).



Soy products, including tofu, tempeh, soy milk and soy cheese, can help reduce the risk of cancer and reduce symptoms of menopause. Soybeans contain powerful phytochemicals (plant compounds that can act therapeutically when eaten) that have been, and still are the subject of much research. Isoflavones are just one set of compounds discovered in soy. Isoflavones are phytoestrogens (plant estrogens) that have an inhibiting effect on hormone-related cancers such as prostate and breast cancers. These compounds may also have a positive effect on menopause by mimicking estrogen, which may reduce some of those difficult symptoms such as hot flashes.

  • Is there soy in your future?

Soy, which contains relatively high levels of the phytoestrogens that some scientists now think may help stave off breast and prostate cancer as well as unpleasant menopausal symptoms, has an image problem in the United States. When Americans think of soy-based foods like tofu, for instance, they conjure up bland blocks of floating bean curd unacceptable to many Western palates.

Yet there is more to soy than bean curd. Food manufacturers now make soy products with Western taste buds in mind--everything from chocolate soy milk to soy cheese to soy ice cream to soy-based meat analogues meant to resemble turkey, chicken, hamburger, and bologna. But many of these items can be high in fat and low in essential nutrients such as calcium, a problem when people use them in place of dairy foods.

Another issue is that just as it's too early to know if soy is the miracle food some researchers suspect, it's impossible to tout specific soy products for their phytoestrogen content. Scientists at Tufts did find in one small experiment that four brands of tofu had about 10 times as much of the phytoestrogen genistein as a commercially available soy drink. But because research on the matter is just under way, and because of the variability due to differences in soy bean varieties and processing methods, exactly how much phytoestrogen a particular food contains remains largely an unknown.

One thing researchers are willing to speculate about is that, based on Asian eating habits, it looks as though only about two ounces of traditional soy foods a day are needed to reap the possible cancer-fighting, menopause-mitigating benefits in their phytoestrogens. Among those traditional soy foods: not just tofu but also tempeh and miso (described in the adjacent column). Although they are as fatty as many cuts of meat, they are low in saturated fat, the kind that is most apt to result in clogged arteries. And, prepared properly, they can satisfy even many inflexible meat-and-potato palates.

You can usually find tofu in the produce section of a regular supermarket, while tempeh and miso are generally available in health food stores and Asian markets. Following are some ideas for cooking these items along with nutritional information. There are no guarantees, of course, that the phytoestrogens in these foods will help temper the symptoms of menopause or fight cancer; it's just too early in the research game for that. At the very least, however, these dishes will help broaden your repertoire for healthful eating.

- By itself, tofu tastes rubbery and flavorless to many people. But in recipes, it acts like a sponge that soaks up the flavors of the other ingredients. Crumble it into a pot of spicy chili sauce, add it to casseroles and soups, or use it in vegetable stir-fries. The nutrient content of tofu varies by brand and consistency (it comes soft, firm, and extra firm), but a three-ounce serving contains in the neighborhood of 50 calories, about 20 of which come from fat--just about all of it unsaturated. It also has no cholesterol and very little sodium--about 1 percent of the 2,400-milligram daily limit recommended by the government. Tofu contributes some protein, too, and many brands provide up to 150 milligrams of calcium, the amount you would find in a half cup of milk. They may provide a little iron as well. Check the "Nutrition Facts" panel before purchasing.

Tempeh - A chunky, tender, and chewy cake of soybeans usually mixed with a grain such as rice or millet, tempeh (pronounced TEMpay) has a rich flavor sometimes described as smoky or nutty or akin to that of mushrooms. It can be steamed and marinated in a lemon-based or barbecue sauce and then grilled until browned. Chunks of tempeh can also be added to spaghetti sauce, sloppy joe, or chili mix or pan fried with mushrooms, onions, and bread crumbs for a delicious stuffing. Three ounces of tempeh supply about 150 calories (30 to 40 from fat), up to 80 milligrams of calcium (10 percent of the RDA for an adult), and as much as 20 percent of a woman's RDA for iron (3 milligrams' worth).

Miso - A salty condiment in which soybeans and sometimes a grain such as rice are combined with salt, miso can be used to flavor soups, sauces, dressings, and marinades. A quarter cup in a quart of water makes a decent soup stock. A tablespoon of miso has 60 to 80 calories and very little to no fat. It is quite high in sodium, however, which is why it should be used sparingly. A single tablespoon contains about 600 milligrams, or a fourth of the daily recommended maximum.



The reported benefits of eating tofu and other plant-based foods prompted one National Institutes of Health researcher to announce to an audience of international scientists that his mission was clear: "I guess I'm going to have to learn to eat soybean meal and drink green tea . . . and become an Oriental woman," said Cyrus R. Creveling, Ph.D., of the National Institute of Diabetes and Digestive and Kidney Diseases. Though the comment prompted a laugh, it was based on serious data.

Epidemiologic evidence indicates that Asian women have a lower incidence of breast and colon cancer, better response to cancer treatment, and fewer problems with menopause than Western women. And among the apparent reasons for this is that Asians, in general, consume more soy products -- tofu included -- and green tea.

Work Like Estrogens
Researchers looking into the disease-prevention qualities of plant foods like soybeans and green tea credit compounds that may work like estrogens as one reason for the benefits. To date, research has shown that the most potent of these compounds have about 0.5% of the activity of natural estrogens. Of these phytoestrogens, the two categories creating the most research furor are isoflavonoids and flavonoids -- most especially an isoflavonoid know as genistein.

At the September symposium where Creveling and other researchers presented their work, at least two-thirds of the 26 oral presentations mentioned genistein. "The mechanism of genistein is a very interesting chapter in research, and we have to see what's going on," said Herman Adlercreutz, M.D., Ph.D., Department of Clinical Chemistry, University of Helsinki. At the symposium, a University of Alabama researcher revealed what he said was the first in vivo evidence that genistein retards cancer development. In his study, newborn female rats were exposed to a carcinogen known to induce mammary tumors later in their life and then given genistein or an inactive compound.

All of the rats receiving the inactive compound developed tumors; only 60% of the rats receiving genistein got cancer. Dr. Coral A. Lamartiniere says, "This study is the first to show in vivo that genistein can protect against chemically induced cancer," said Coral A. Lamartiniere, Ph.D., of the university's Department of Pharmacology and Toxicology. Other researchers are beginning to unlock the secrets of how genistein works at the molecular level.

These researchers are finding the compound may exert itself at a number of points along the "carcinogenesis pathway," modifying cell proliferation through inhibition of key proteins, targeting the metabolic pathways that control mutagenesis, and inhibiting cell proliferation and angiogenesis, the process by which tumors grow new blood vessels necessary for their supply of oxygen and nutrients. And while most of these studies are being done in laboratory animals receiving the compounds by injection, genistein can be taken orally, making its preventive potential more practical.

Hinders or Promotes
Whether tea hinders or promotes cancer development is still an open question, according to Chung S. Yang, Ph.D., of Rutgers, the State University of New Jersey, New Brunswick. Although studies have shown that tea -- green tea in particular -- can inhibit incidence, growth, and progression of many forms of cancer in laboratory animals, its effect in real life is difficult to determine. Some studies have in fact shown a relationship between tea consumption and higher rates of cancer, Yang said, although this may be due to the cultural habit, in some areas of Asia, of gulping scalding tea rather than an effect of the tea itself. "If you ask me if tea prevents cancer, I would say yes in animal models; no conclusions in humans," Yang said.

The impact of phytoestrogens on estrogen-sensitive diseases has not yet been studied in detail. Stephen Barnes, Ph.D., of the University of Alabama, said of genistein: "There's no evidence that it cures cancer, and there's no evidence that it makes it worse." Tackling this question, David T. Zava, Ph.D., and colleagues at Aeron Biotechnology, Inc., and CPHF/Cancer Research Foundation in San Leandro, Calif., studied the capacity of genistein and the isoflavonoid equol, along with bioflavonoids kaempferol and quercetin, to bind to estrogen-sensitive breast cancer cell lines. The researchers found that all the substances bound to the cells, but had a much lower affinity than human estrogen or tamoxifen for the cell's hormone receptors. All but quercetin stimulated growth in estrogen-sensitive cancer cell lines in culture.

No Tofu?
Is this an indication that women with breast cancer should not consume soy products? Zava said no, because there are many other factors involved in cancer development. And, as researchers at the symposium pointed out, phytoestrogens are only weakly estrogenic and it is unclear how they react in humans. However, several researchers noted that the effects of phytoestrogens, if any, on the ongoing treatment of breast cancer have yet to be determined and should be of high research priority. Studies measuring the effects of phytoestrogens on endogenous estrogens have produced mixed results; at least one researcher at the symposium was unable to detect any biological activity in human subjects fed soy products. Many speakers placed this research issue among the top two or three needing further, concerted effort. "Estrogenic isoflavones that differ only slightly in structure can differ substantially in metabolism and disposition in humans," said Lee-Jane W. Lu, Ph.D., of the University of Texas Medical Branch at Galveston. People will also differ in their reaction to phytoestrogens depending on their own endogenous estrogen background, said John A. McLachlan, Ph.D., of the National Institute of Environmental Health Sciences in Research Triangle Park, N.C. Excretion and absorption are not the only areas of phytoestrogen research in which there are gaps in our knowledge, researchers agreed. "There's a huge amount of work to do in quality control," said epidemiologist Walter Willett, M.D., of Harvard University. "If we're going to move forward in this area, what we need is a national quality control system for measurement of endogenous hormones with accuracy and precision."

Dr. David P. Rose Further, several basic assumptions seemed to underlie many presentations on phytoestrogens. For instance, "Everybody assumes genistein lowers breast cancer risk -- does it?" said David P. Rose, M.D., Ph.D., of the American Health Foundation. And although Mark J. Messina, Ph.D., of the North Central Soybean Projects, Port Townshend, Wash., said that "We know soy is safe. We could replace tamoxifen with soy." Daniel Sheehan, Ph.D., National Center for Toxicology Research, Jefferson, Ark., was not so sure.
  • Proven Safe?

"I disagree that soy has been proven safe," said Sheehan, who said full characterization of the compound's activities may take decades. Though research into phytochemicals has been expanding, the pace has not been as fast as some would like. David G. Longfellow, Ph.D., of the National Cancer Institute's Chemical and Physical Carcinogenesis Branch, commented that competition for new initiatives with federal money is tough. Nevertheless, NCI, NIEHS, the Department of Agriculture, and other federal agencies continue to fund projects on a grant-by-grant basis, and organizations are finding other ways to fill in. The University of Illinois' Functional Foods for Health program, for example, receives foundation and manufacturing association support.

At the end of the symposium, the researchers offered suggestions for the most important types of research needed for the field to evolve, including research on:

  • ... the actions of phytoestrogens that are weakly anti-estrogenic, ... the actions of anti-estrogens that are weakly estrogenic, ... factors that influence dietary absorption of phytoestrogens, and
  • ... how endogenous and exogenous hormones work

Jan Ziegler



Clues to a possible connection between plant hormones and a reduced incidence of breast cancer began to surface in the early 1980s, when the by-products of phytoestrogens were first discovered in human urine. Researchers then went on to show that soy is the best source of a class of phytoestrogens known as isoflavones and that feeding soy to rats reduced the incidence of mammary tumors. More important, they found that when they removed the phytoestrogens from soy and again fed it to rats, the soy no longer suppressed tumor growth, further implicating phytoestrogens as anticancer agents.

Phytoestrogen researcher Kenneth Setchell, PhD, of Children's Hospital Medical Center in Cincinnati, speculates that the phytoestrogens in the soy may have helped by providing an antiestrogenic effect, in essence blocking the cancer-promoting action that estrogen is capable of having. The potential mechanism for how phytoestrogens are thought to block the undesirable effects of estrogen goes as follows. Breast tissue cells contain what are known as estrogen receptors, which enable them to "recognize" estrogen.

Think of the receptors as locks or key holes and the body's chemical compounds as keys, with estrogen-shaped compounds the only keys that will fit. Perhaps, speculates Dr. Setchell, because the weak plant estrogens have structures very similar to the estrogen of mammals, they are able to insert themselves into the locks and "jam" them. That, in turn, could keep out some of the naturally produced estrogen and thereby reduce its ability to cause the production of cancer cells. The argument makes sense to some researchers because the synthetic anticancer drug tamoxifen, which is also a weak estrogen, is thought to work in the same way. Real life appears to support the theory.

Japanese women following the traditional Japanese diet are much less likely to develop breast cancer than women in the U.S. They also eat more in the way of soy foods, enough to make the level of the isoflavone class of phytoestrogens circulating in a Japanese woman's blood 15 to 20 times as much as an American woman's. Another theory about how soy reduces the risk for breast cancer is that it results in less frequent exposure to estrogen by lengthening the menstrual cycle. At the beginning of each cycle (after the period), a woman experiences an estrogen surge.

Thus, the longer the time between periods, the less often the hormonal surge occurs. In Asian women, the menstrual cycle is about two to three days longer than in Americans. Even more telling, in research conducted in England, women fed about two ounces of soy protein a day had delayed ovulation and, subsequently, more time between periods. Tufts breast cancer researchers Barry Goldin, PhD, and Sherwood Gorbach, MD, are now feeding premenopausal women three glasses of soy milk each day to check for themselves whether soy increases cycle length as well as whether it acts as an estrogen blocker.

Of course, at this point all the theories remain speculative, and much more research needs to be conducted. It may be, after all, that Japanese and other Asian women are less prone to breast cancer because of some variation in diet or life-style that has nothing to do with soy. For instance, it could be because they have fewer years of exposure to estrogen as a result of beginning menstruation later in life than Americans--a difference attributable to the fact that American girls take in more calories and thus lay down fat stores, a necessary prerequisite for ovulation, at an earlier age.

Some scientists have even wondered if there is something genetically different about Asian women that might explain their lower breast cancer rates. However, the fact that American descendants of Asian migrants to the U.S. have higher breast cancer rates than their ancestors largely disproves that notion. In addition, a study at the National University of Singapore found that premenopausal Chinese women who did not have breast cancer tended to eat more soy products than very similar Chinese women who did have breast cancer, suggesting that even if genetics is part of the "equation," something about life-style has an impact as well.



Researchers are fond of repeating the claim that there is no word for "hot flash" in Japanese. Indeed, one study found that only 9 percent of Asian women complained of menopausal symptoms, in contrast to 55 percent of American women. Of course, Asian cultures may simply rear women to complain less; thus, it would not be surprising that women there report less menopausal discomfort. Still, at least part of the answer could be as simple as diet.

Perhaps, researchers suspect, phytoestrogens lessen menopausal symptoms like night sweats and mood swings and possibly reduce the vaginal tissue thinning that accompanies menopause and can make sex painful. There are even hints that phytoestrogens may stave off osteoporosis by providing an estrogen-like assist that can save bone. It certainly has an intuitive appeal--the idea that just a few ounces of soy foods each day would provide menopausal women with enough of an estrogen "bonus" to keep unpleasant symptoms at bay.

Australian researchers conducted the first human study on menopause and plant hormones in 1990 in which they fed postmenopausal women soy and linseed, another food high in phytoestrogens. They found increased cell growth in the vaginal walls, an indication that the foods were estrogenic in nature as well as a sign that they might reduce some of the thinning of vaginal tissues associated with the cessation of menstruation. Tufts's Dr. Goldin is looking at soy's effects on vaginal cells, too. And another Tufts investigator, Margo Woods, MD, is beginning a trial of her own that will investigate whether eating soy will reduce postmenopausal hot flashes and night sweats. Half of Dr. Woods's subjects are breast cancer patients or women at high risk for breast cancer, say, because of a family history of the disease.

They don't want to undergo traditional estrogen replacement therapy because research has suggested it would place them at an increased risk of ending up with a breast tumor. Dr. Woods is hoping soy may prove to be a workable alternative. What it comes down to is that just as soy may act to reduce the risk of breast cancer in women of childbearing age, as noted earlier, it may provide the pluses of estrogen replacement therapy in older women without any attendant risks.

It may even be found someday that the phytoestrogens in soy do some of the "heavy duty" work of estrogen replacement therapy: keep postmenopausal women at a lower risk of having a heart attack (estrogen raises the level of "good" HDL-cholesterol, which keeps arteries clear) and reduce their chances of suffering osteoporosis (estrogen also helps preserve bone density). Future studies hold the key.



Dearest asks Power Surge medical consultant, Dr. Diane Eisman, "Why would the good cholesterol have been safeguarded by using micronized progesterone? Could you give me the exact differentiation between micronized and not?

Dr. Eisman's reply: "Forgive me if I sound pedantic. I'm probably giving you a lot of information you already have. But, in my personal opinion, this PEPI study was a real landmark - for woman...a decent study just about women....finally. PEPI was a multicenter investigation sponsored by the National Heart, Lung, and Blood Institute and other National Institutes of health institutes. It followed almost 900 women, aged 45 to 64. Among the things the study looked at were HDL Cholesterol levels in these women. It was a three year study, and, unfortunately, it did use Premarin.

They stated they used it because Premarin was the most widely used estrogen preparation in the U.S. market. Estrogen had a beneficial effect on HDL cholesterol . When Provera was given, it had a negative effect on the HDL (but this was not too much, I believe). However the "micronized progesterone had significantly less negative effect on the estrogen-associated rise in HDL."....to quote Dr. Elizabeth Barrett-Connor, who was one of the PEPI investigators.

I don't recall whether this was stated in the study: But it is my belief that it was the progesterone that had less negative effects....the fact that it was the same progesterone the body puts out....and not Provera (which, as you know, is a Progestin). I think micronized is important in that it is hard for the body to absorb oral progesterone but when it is all chopped up and micronized it is better absorbed.

Just want to leave you with a quote from an interivew I found with Dr. Bernadine P. Healy who was talking about the PEPI trial: "I think the biggest surprise certainly was the HDL effect of micronized progesterone....Also, we have to find out more about micronized progesterone. Why is it so different from Provera? Physiologically, you wouldn't expect that it should be." Interesting.



Dearest asked Power Surge medical consultant, Dr. Allan Aven, "What can you tell me about FSH tests?" "The absolute number depends on your lab but an FSH (follicle stimulating hormone which is produced by the pituitary gland in the brain and is necessary to begin the cycle of ovulation whereby an egg is brought to maturity) above 35 in our lab generally means menopause. In lay terms, the pituitary is "screaming" at the ovaries to produce eggs, but since there are no eggs to respond to FSH, the pituitary keeps on making more and more FSH. A measurement of the actual estrogen as estradiol is also interesting to get and in our lab if the level is below 59, that means menopause. Estrogen is a product of the ovarian tissue and also depends on the presence of eggs.

The LH (not LSH) is a measurement of another pituitary hormone (luteinizing hormone) which in the menstruating woman is called in to make the egg mature after FSH has started the process - so a high LH (over the lab's usual norms for menstruating women) suggests menopause also.



Or, You Can't Have Too Much Information About Hormone Therapy

  • What is hormone replacement therapy?

    Hormone replacement therapy refers to providing a woman who has gone through menopause with hormones that her body has stopped producing. Menopause, also referred to as the "change of life," occurs when a woman's ovaries stop producing the hormones estrogen and progesterone. When menopause occurs, menstruation stops and a woman is no longer able to conceive. The average age of menopause is about 50 years old. Menopause can also occur when a woman has an operation in which her ovaries are removed (oophorectomy). This type of menopause is known as surgical menopause because it has occurred due to a surgical procedure.

    Why is menopause important?

    U.S. women now live one-third of their lives after menopause. Women are living longer. The average life expectancy for a U.S. woman is about 76 years. This is important because scientists are discovering many physical changes that occur after menopause that influence a woman's risk of disease, including bone loss, coronary heart disease and cancer.

    What are the benefits of hormone replacement therapy?

    One immediate benefit of hormone replacement therapy is the relief of uncomfortable symptoms that may occur with menopause, such as "hot flashes" (a wave of heat and sweating), night sweats and painful intercourse. Hormones also help alleviate other menopausal symptoms, such as changes in urination, irritability and depression.

    Osteoporosis - Another benefit of therapy is prevention of bone loss. Bone loss speeds up after a woman's body stops producing estrogen on its own. This bone loss, which results in fragile, brittle bones that break easily, is called osteoporosis.

    Are there other benefits to hormone replacement therapy?

    Coronary heart disease - In addition to the relief of menopausal discomforts and the prevention of osteoporosis, hormones appear to reduce a woman's risk of serious coronary heart disease, including heart attack. After menopause a woman's risk of having a heart attack rises quickly, approaching the same risk as for a man. In addition, the first heart attack is more likely to be fatal among women than among men. A woman who takes estrogen has about a 50% less chance of death from coronary heart disease than a woman not taking estrogen.

    For women taking both estrogen and progestin, the exact amount of the benefit is not clear. It appears that the combination of both hormones can still lower a woman's risk of oronary heart disease, but it is not certain if the benefit will be as great as 50%.

    What are the risks?

    The risks depend on the type of treatment prescribed, whether the woman has a uterus, and how long hormones are taken. With short-term therapy of less than 5 years, there are very few risks of treatment.

    Endometrial cancer - If estrogen alone is taken by a woman who has a uterus, there is an increased risk of endometrial cancer (cancer of the lining of the uterus). This increased risk can be eliminated by the addition of a second hormone, a progestin, to the regimen. This is the reason it is important for a woman who has a uterus to be taking both hormones. Another important fact about endometrial cancer is that it is usually caught early and is rarely fatal. Because the primary symptom of this cancer is vaginal bleeding, your clinician will monitor you closely for any signs of unusual bleeding.

    Breast cancer - There have been many studies done to look at whether hormones cause breast cancer in postmenopausal women. The studies do not agree. Some find no increased risk. Some find a small increased risk after many years (10 to 15 years or more) of regular use. With short-term therapy (less than 5 years), studies show that women are not at increased risk of breast cancer.

    Are there different kinds of hormone replacement therapy?

    Yes. Sometimes estrogen alone is prescribed, other times both estrogen and a progestin are prescribed. Most often, a woman will be given estrogen alone if she does not have her uterus (has had a hysterectomy). If the woman has a uterus, then she usually will take both estrogen and progestin. Hormones can be given in oral tablets, vaginal creams, or patches placed on the skin.

    What are the side effects?

    Side effects of estrogen include breast tenderness, edema, nausea, headache, and breakthrough bleeding. Progestins may cause fluid retention, acne, premenstrual-like symptoms, anxiety, depression, and irritability. These side effects are not medically serious, although they can be bothersome, and can often be helped by changing the dose or medication.

    How do I know if hormone replacement therapy is right for me?

  • There is no question that short-term therapy will help relieve menopausal symptoms. Whether or not you will benefit from taking hormones for many years to prevent disease and prolong life must be based on your risk factor profile. It's important to discuss the risks and benefits of therapy with your physician so that you understand how they apply to you. For example, a woman at high risk of coronary heart disease or osteoporosis may benefit from long-term treatment even more than a woman not at risk of these diseases.

Robert James Gallo, M.D., F.A.C.O.G.

(Note: This was written prior to the abrupt halting of the WHI Study (Women's Health Initiative) due to concern over unexpected results. Read more about it The HRT Controversy: Conventional Hormone Replacement Therapy: The Risks Outweigh The Benefits.)



Eat tofu for hot flashes? The idea is not as weird as it sounds. At the American Heart Association's annual scientific meeting Sunday, researchers discused the growing evidence that soybean protein - found in tofu - may indeed relieve th miseries of the change of life. Dr. Gregory L. Burke or Bowman Gray School of Medicine in Winston-Salem, N.C., outlined the results of an experiment into soy's effects on menopause. The study involved 43 women between ages 45 and 55 who suffered at least one bout of hot flashes or night sweating daily.

For six weeks, they worked 20 grams of powdered soy protein into their diets, mixing it with their orange juice or sprinkling it on their cereal. For another six weeks, they did the same with powdered carbohydrate. No one knew until the end of the experiment which they were eating. The women reported significantly less intense symptoms while using the soy protein, although they occurred just as frequently. Burke plans another study, involving 240 women, in which larger doses of soy will be tried. Another study, conducted recently at the University of Manchester in England, suggests this can reduce the frequency of hot flashes, as well.

Experts believe the key ingredient of soy protein is phytoestrogen - the plant form of the female hormone estrogen. Human estrogen is widely used to relieve the effets of menopause, although some women are reluctant to take it because of side effects. Laboratory studies suggest that soy estrogen acts on the same chemical targets in the body that human estrogen affects, although it is 1,000 times less potent.

Doctors have other reasons to think that soy might be a treatment for menopausal symptoms. One is the rarity of these problems in Asian countries, where the soybean is common. Indeed, Burke said there is no phrase in Japanese for "hot flash."


Visit Power Surge's Bookstore

Power Surge has welcomed many wonderful authors. Here is a list of their most recent books.

  • Barbach, Lonnie, Ph.D. -- The Pause De Angelis, Barbara, Ph.D. - TV Informercial, "Making Love Work" and
    "Ask Barbara:The 100 Most-Asked Questions About Love, Sex & Relationships." DeAngelis, Lissa, CCP and Molly Siple -- Recipes For Change DeMarco, Carolyn, MD. --Take Charge Of Your Body Friday, Nancy -- The Power Of Beauty; My Mother, Myself Hufnagel, Victoria, M.D. -- No More Hysterectomies; No More Menopause Kamen, Betty, Ph.D. -- Hormone Replacement Therapy - Yes Or No? Libov, Charlotte -- The Complete Guide To Keepintg Your Heart Healthy; What To Do If Things Go Wrong; 50 Essential Things To Do When The Doctor Says It's Heart Disease Northrup, Christiane, M.D. - Women's Bodies, Women's Wisdom Ojeda, Linda, Ph.D. -- Menopause Without Medicine Pogrebin, Letty Cottin -- Getting Over Getting Older Rako, Susan, M.D., - The Hormone Of Desire:The Truth About Testosterone, Sexuality and Menopause Sheehy, Gail -- Silent Passage; New Passages
  • Weed, Susun -- Menopausal Years:The Wise Woman Way



Visit Power Surge's Bookstore

  • Andrews, Lynn V. Woman at the Edge of Two Worlds: And The Spiritual Journey of Menopause. 1993.
    The author of Medicine Woman describes her spiritual experience with menopause.

    Budoff, Penny Wise, M.D.
    No More Hot Flashes and Other Good News. 1983.

    Advocates hormone replacement therapy (HRT).

    Cherry, Sheldon H, M.D. The Menopause book: a Guide to
    Health and Well-Being for Women After Forty.
    Offers pros, cons, and alternatives to HRT as well as
    an overview of menopause and aging.

    Doress, Paula Brown. Ourselves Growing Older; Women
    Aging with Knowledge and Power
    . 1987
    Our Bodies, Ourselves format. Facts interspersed
    with women's personal stories.

    Dranov, Paula. Estrogen: Is it Right for You? A Thorough, Factual Guide to Help You Decide. 1993
    A journalist evaluates the benefits and the risks
    of estrogen replacement.

    Greenwood, Sadja, M.D. Menopause Naturally: Preparing
    for the Second Half of Life. 1989.

    A general practice physician shares her experience as a
    doctor and as a women who has gone through menopause.

    Greer, Germaine. The Change: Women, Aging, and the Menopause. 1992.
    "A brilliant philosophical complement to Gail Sheehy's The Silent Passage;
    Greer looks at menopause through history
    and literature, skewering the medical establishment."

    Henkel, Gretchen. Making the Estrogen Decision. 1992.
    Pros and cons of HRT from both doctors (mostly male) and women.

    Ito, Dee. Without estrogen: Natural Remedies for Menopause and Beyond. 1994
    Written by a journalist specializing in health issues,
    this book offers a self-help approach to alternative therapies
    for women who can't or choose not to rely on HRT.

    Jacobowitz, Ruth S. 150 Most-Asked Questions about
    Menopause: What Women Really Want to Know
    . 1993.

    An overview of menopausal issues with a pro HRT emphasis. The Menopause, Hormone Therapy, and Women's Health. Congress of the
    Published in response to questions raised by representatives Pat Schroeder
    and Olympia Snowe on the current state of knowledge regarding
    the menopause and its management in the United States.

    Nachtigall, Lila, M.D. Estrogen: the Facts Can Change Your Life
    the Latest Word on What the New, Safe Estrogen Therapy Can Do for Great Sex,
    Strong Bones, Good Looks, Longer Life, Preventing Hot Flashes. 1986.
    A specialist in female hormones claims that estrogen
    replacement therapy prevents, rather than causes, cancer.

    Ojeda, Linda. Menopause Without Medicine: Feel Healthy, Look Younger, Live Longer 1989.
    General health outlines with an emphasis on lifestyle and holistic practices.

    Ryneveld, Edna Copeland. Secrets of a Natural Menopause: a Positive Drug-Free Approach. 1994
    Presents drug-free methods of alleviating the symptoms of menopause.

    Stoppard, Miriam. Menopause 1994
    An illustrated presentation of various aspects of menopause and aging, from osteoporosis to beauty treatments.

    Taylor, Dena and Amber Sumrall, eds. Women of the 14th Moon: Writings on Menopause. 1991
    Menopause celebrated in prose and poetry.

    Utian, Wulf H. and Ruth S. Jacobowitz. Managing Your Menopause. 1990
    The Utian Menopause Management Program,O is pro hormone therapy.

    Weed, Susun S. Menopausal Years: the Wise Woman Way. 1992
    A personal and supportive text on menopause and growing older, with an emphasis on herbs and natural remedies.

  • Wolfe, Honora Lee. Menopause: a Second Spring: Making a Smooth Transition with Traditional Chinese Medicine. 1993



    Contributed By Mary Raver

    Mary Raver, a Southern California resident and owner of Adelante Publishing, created the Women's Health Diary to help women track their symptoms and take control of their health the "write" way. The Women’s Health Diary provides women with a compact, easy-to-use form for tracking symptoms and the effects of treatments over a four to six month period. The diary's convenient checklist format and daily note section takes the "pain" out of recording common health symptoms. In addition, the diary has a glossary of symptom terms, a reading resources list, and other helpful sections. The Women’s Health Diary empowers women with essential information for taking control of their health during an important time of change. Price: $4.95, wholesale and quantity discounts available.

    Order from:
    Adelante Publishing
    P.O. Box 501584
    San Diego, CA 92150-1584
    Tel: (619) 748-6192
    Fax: (619) 748-3033



The Power Surge Newsletter disclaims any representation for the accuracy or completeness of information contained herein. The sharing of information herein is not indicative of Power Surge's personal endorsement of same. It is purely for informational purposes. Health matters should be taken up with one's personal physician. Nothing in the Power Surge Newsletters, chats, message base, bulletin boards is intended as a substitute for professional medical advice. Opinions expressed are Dearest's and the authors who contribute to Power Surge and don't reflect the opinions of America Online.

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Power Surge Bookstore

Books! Books! Books!

'Power Surge recommends Revival Soy Protein to replenish estrogen

Doctor-formulated Revival Soy Protein is the #1 doctor-recommended soy protein in the country. Soy isoflavones eliminate menopausal symptoms.

Read one of Medical Director,
Dr. Aaron Tabor's transcripts

Ask the Soy Doctor 

'For natural, bioidentical hormones, Pete Hueseman and Bellevue Pharmacy Solutions

Why put your body through the rigors of adjusting to the "one-size-fits-all" HRT when naturally compounded, bio-identical hormones can be tailor-made to your body's needs?

Read Pete Hueseman's,
most recent transcript about natural, bio identical hormones.

Ask The Pharmacist

Also, read Paul Hueseman, PharmD's transcript
on bio-identical hormones


Visit our recommendations page for tips and advice on multi-vitamins and supplements to help ease menopausal symptoms, and improve your overall health.


If you haven't already done so, why not check out our extensive Educate Your Body area. There you will be able to read articles on midlife issues, as well as answers to commonly asked questions such as:

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