The scary part of this revelation is that medical doctors commenting on the study's results downplayed the seriousness of these findings. Some tried to camouflage the risks by saying that in a group of 10,000 women, there would be "only" 8 more cases of invasive breast cancer, "only" 8 more strokes, etc. I guess this would be fine unless you are one of the women who gets breast cancer or who has a stroke. Others suggested that the answer would be to continuing to take the drugs, just at a lower dose, but one of the principal investigators of the study, Dr. Susan Hendrix, suggested that women will need to "get back to the basics" of controlling menopause with diet and exercise.

There are a great many more safe and effective remedies for menopause symptoms than just diet and exercise, as important as those are. There is a tendency to diminish the effectiveness and value of herbal and nutritional approaches to menopause, but I want to make it clear that, in my experience, herbs, vitamins, lifestyle changes, acupuncture, and homeopathic remedies work. The key is to get an analysis of your situation to determine which one(s) you need, not just take everything and anything in a shotgun approach which at best may waste your money and at worst may make your symptoms worse.

But before we get to the alternatives to hormone replacement therapy (HRT), let's look at what menopause is. If you believe the drug companies, menopause is a terrible disease, a scourge on womankind, and probably another fallout from the Garden of Eden thing. Actually, menopause is a natural gradual transition period during which a woman's body returns to the method of making sex hormones (estrogen, progesterone, and testosterone) which worked during childhood before the maturation of the ovaries. During childhood, our adrenal glands made the raw material which would become the sex hormones, and in menopause, the adrenal glands take that function up again. One biochemist likes to say that we should call it "adrenopause," because often women who have the worst symptoms at menopause are those with the most exhausted adrenals. How do the adrenals get exhausted? Stress, lack of sleep, white sugar, stress, working two jobs, homophobia as a daily experience, caffeine, steroids and other drugs, lack of exercise, stress.

The most important factor, then, in a smooth transition to menopause is to feed and strengthen the adrenal system and to decrease the body's demands on the adrenals. If the adrenals are busy making high levels of cortisol, the main stress hormone, they cannot make as much estrogen and progesterone precursors. So, taking time for oneself, getting enough rest and enough exercise, good diet, lowering stress in one's life are important lifestyle changes for all women, both those going through menopause and those before and in perimenopause to prepare for a smooth transition. Herbs such as cordyceops, ginseng and rhodolia in appropriate doses are useful to build the adrenals.

While we are talking about a good preparation for menopause, let's talk about bone density and menopause. Most women know that the gradual decrease of estrogen which precedes and accompanies menopause often produces a decrease in bone density. What most women don't know is that this problem begins in adolescence with poor calcium intake and poor deposition of calcium into bone due to lack of exercise. When a woman with marginal bone density during her 20s and 30s reaches the years of gradually decreasing estrogen, her bone density falls into the problematic range and pathological fractures can result. But if a woman pays attention all her life to good calcium intake and appropriate exercise, her bones grow strong and when they begin to decrease slightly in density, due to the normal decrease in estrogen, she stays within the safe range. I recommend all women take a supplement of calcium, preferably as microcrystalline hyrdroxyapatite, accompanied by magnesium, preferably as magnesium glycinate, daily. The amount of calcium taken depends on family history since those with a family or personal history of kidney stones should take much smaller amounts of calcium at a time than the general population.

Why is this an issue for Lesbians? Medical research shows that Lesbians are more at risk for breast cancer than the general female population. This may be because many of us do not bear children and do not breast feed. These activities are thought to have a protective effect against breast cancer. It may also be due to the increased stress of living in a homophobic culture. Whatever the reasons, the data show that we are at greater risk. So it is even more important that Lesbians find ways other than hormone replacement therapy to smooth the transition through menopause, since hormone replacement therapy also significantly raises the risk of breast cancer.

Tune in next month for a discussion of some of the more common symptoms of menopause, how they happen and what natural and safe remedies can be of help with each symptom. But please remember, menopause is not a disease. It's a transition, kind of like coming out.

Part II >>