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The Rise and Fall of Hormone Replacement Therapy

The story of hormone replacement therapy begins in 1938 with the discovery of diethylstilbestrol (DES). This ‘synthetic estrogen’ was later used to prevent miscarriages, but by 1960 DES was found to cause sex organ abnormalities and increased cancer risk in children born to mothers taking it. Eleven years later, in 1971, DES was finally removed from the market. During those years, Robert Wilson’s book, Feminine Forever, (1966) diverted attention away from the DES disasters and towards his theory, “menopause is an estrogen-deficiency disease”.

Wilson’s book warned that insufficient estrogen* at menopause, “causes a woman to lose her youth, beauty, cheerful attitude, and bone density all at once…” The drug industry almost had hysterics with delight, and without missing a beat, donated $1.3 million to set up the Wilson Foundation for the sole purpose of developing and promoting estrogen drugs. The advertising people cooked up a great slogan; “Estrogen Replacement Therapy. Better living through chemistry”. ERT was born, and the cash registers began to ring.

A little bit of a hiccup occurred in 1975 when unopposed estrogen was shown to cause cervical cancer, but that was rapidly turned to an advantage with the addition of synthetic progesterone to the formula —which then became know as HRT. I won’t bore you with all the politics, flawed and superficial studies, advertising hype, and skewed statistics that brought us to the screeching halt brought to the National Institutes of Health, Women’s Health Initiative HRT study.

HRT has more recently been proposed as the way to prevent ‘menopause induced’ heart disease and osteoporosis risks. But the NIH study, funded by Wyeth-Ayerst, the manufacturer of the product used in the study, backfired on the company and drug industry — because it was stopped 3 years early. The study was proving what many researchers and doctors had been saying for years — HRT increases the risk of breast cancer, heart disease and stroke, and the risks so far outweigh the benefits that it was considered unethical to continue.

Studies as far back as the early 1990’s had shown that cancer, heart disease and many other health problems were associated with HRT use, but they were either ignored or misinterpreted. An important note is that women at high risk for heart disease and cancer were unlikely to be prescribed HRT, meaning that women with lower risk for both diseases were put on the hormones. Dr. Susan Love, MD asked this question, “Do hormones make you healthy, or do healthier women take hormones”?


If your doctor prescribed HRT to prevent menopause symptoms, and you stop HRT ‘cold turkey’ you may begin to experience your menopause symptoms again. Phytoestrogens, plant and herbal substances with estrogen-like qualities, are not necessarily a magic answer for every woman. For women who have had a surgically induced menopause (hysterecomy/oophrectomy), or who have been taking HRT for several years, it can be a bumpy transition from HRT to phytoestrogens.

Unlike their HRT counterparts, herbs and plants are not actual hormones. They bind to estrogen receptor sites and are only about 2% as active. When estrogen is high they can help to reduce its overall activity, when it is low, they can act as precursors to hormones.

Most women who are just entering menopause or are experiencing perimenopausal changes can certainly help to balance the changes using diet, exercise, stress reduction and plant/herb products. If phytoestrogens are part of the lifestyle prior to menopause, there will not be such a radical drop when the body begins to downshift estrogen production.

It is important to work with a naturopath to create a personal program to help you with your hormone balance, and there are also general health and dietary principles that you can follow…


Eat whole, unprocessed, organic, high fiber foods. Plenty of fresh fruit and vegetables, whole grains, nuts and seeds, especially flax.

Avoid excessive soy, (soy can depress thyroid function, leading to symptoms similar to menopause!) but do eat lima, navy and other beans for their pytoestrogen isoflavone, genistein and daidzein content.

  • Avoid trans fats (hydrogenated and microwaved fats). Eat good fats from flax seeds, avocados, salmon, nuts and seeds.

  • Avoid sugar, coffee, soda, alcohol. Alcohol can intensify almost every type of menopausal symptom, and hot flashes are most severe after stress or alcohol consumption.

  • Good liver function and intestinal ecology—good bacteria convert isoflavones to biologically active estrogenic compounds, and also prevent damaging estrogen from ‘recycling’.

  • Get exercise but don't try to be Super Woman.

  • Laugh, enjoy yourself and try to do more things you've always wanted to do.

  • Avoid stressors as much as you can. I know....

* For some women this theory is incorrect. For some women progesterone levels can drop to near zero at menopause. If estrogen levels have been high throughout the childbearing years, problems begin to arise when progesterone is not available to keep balance.

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