Awhile back, when it became obvious by symptoms that I was getting memopausal, I started researching and reading everything I could about it.

It is a complicated subjecct, and in an effort to understand better, I put a post on TV. I got some fascinating, insightful and very practical advice and ideas. Far better than any of the (three) OGBYN docs I have seen, who all - without exception - wanted to simply perform a full hysterectomy. This despite a PAP smear with the lowest grade (LSIL) and without aytpical cells.

I just did not understand it. I assummed low sil was a good result. But still they want to rip it all out.

So then started on the task of trying to get natural progesterone, since that prescriped by the whizz-kid laprascopic surgeon at Bumrungrad gave me stabbing pains in the calves and head (my imagination quickly decided this was clots forming, apparently one of the worst side effects of this "Primulut N"

Sheryle on this forum was a treasure, and a gold mine of information. But now it seeems there is another problem, and I am not sure if it is hormone related or 'just' menopause symptoms.

It is true there are some fairly traumatic events going on in my life right now (as if menopause isn't enough), but number one son is leaving in January for University at the tender age of 16. So I am worried that he will take care of himself -- ie cook once a day, or eat at least, be able to handle the studies etc.

I would normally handle pressures and worries like this fairly easily, being a down toearth practical type of person. But For the last four or five days, I am literally weeping almost all day.

Anything can start me off - a note on a recent birthday card - my beloved partner saying he will love me forever - even now, tears spring to my eyes.

What on earth is wrong with me?

Hormonally, although I have estrogel in the red tube, I am not using it as it builds up the lining to tthe womb which is dangerous unless shed monthly. So from 12th Nov been taking 2 caps Uterogestan at night (100 each) and one cap in the morning. Period started two days ago so stopped taking progesterone.

Itching at night is not quite so bad, and flushes are reduced too with progesterone. But I have still drawn a blank with finding natural progesterone in a gel format. We went to KL last week, hunted down about 20 pharmacies, only one had something called Crinone 8% gel. These are pre formed vag injections of natural progestergel. Used two at two day intervals last week, which seemed to help bring on the period. I am not really sure whether I should have done that or not.

No other pharmacy had natural progestogel. So now not sure what to do. And after period stops, pressume it is ok to start with a little pea sized dab of estrogel once a day? This really does work at eliminating the worst of the meno symptoms, but in my case, also causes overgrowth of the endometrium, which can cause the big C.

I did read somewhere that depression can be a meno symptom, and guess I have that too, but the constant weepyness?????

Desperate to find out what it is and what to do about it -- any ideas please anyone?

of course its hormonal due to menopause... just like pms only the opposite... my mom actaully just used antidepressants of the mild kind; one of my friends swears by yoga, thinking possitively and eating and sleeping properly as this is also recommended for any kind of basic depression ... and any family stuff gets exacerbated when mixed with hormones. i learned along time ago not to make major decisions the week before my period as i was always going extreme in reactions from anxiety to whatever...

so change in lifestyle plus hormones = weeping .... and weeping is a sign of depression. depression doesnt mean u are depressed in the daily used sense of the word but depressed in the clinical sense... weeping, sleepy or cant sleep, loss of appetite or too much etc etc... but since u are aware of what is going on, it helps tod eal with it all.... also u seem to change meds for hormones an awful lot which can also run havoc with u'r hormones and affect your mental state too...

dont worry, kids deal... and i'm sure he'll find ways of feeding himself, boys always eat... its the girls going off to boarding schools etc that are the problem... worse case scenario i would say is the not showering if mom doesnt tell him too --and there is internet and telephones to remind him to do homework etc ; as my mom always reminds me -- this too will pass...

hang in there, do your hair, do some sports everyday sleep early and DO NOT watch tear jerk movies, read the newspapers, or read sad books or listen even to sad tear jerky type music. those are all liable to set u off too...

bina

israel

of course its hormonal due to menopause... just like pms only the opposite... my mom actaully just used antidepressants of the mild kind; one of my friends swears by yoga, thinking possitively and eating and sleeping properly as this is also recommended for any kind of basic depression ... and any family stuff gets exacerbated when mixed with hormones. i learned along time ago not to make major decisions the week before my period as i was always going extreme in reactions from anxiety to whatever...

so change in lifestyle plus hormones = weeping .... and weeping is a sign of depression. depression doesnt mean u are depressed in the daily used sense of the word but depressed in the clinical sense... weeping, sleepy or cant sleep, loss of appetite or too much etc etc... but since u are aware of what is going on, it helps tod eal with it all.... also u seem to change meds for hormones an awful lot which can also run havoc with u'r hormones and affect your mental state too...

dont worry, kids deal... and i'm sure he'll find ways of feeding himself, boys always eat... its the girls going off to boarding schools etc that are the problem... worse case scenario i would say is the not showering if mom doesnt tell him too --and there is internet and telephones to remind him to do homework etc ; as my mom always reminds me -- this too will pass...

hang in there, do your hair, do some sports everyday sleep early and DO NOT watch tear jerk movies, read the newspapers, or read sad books or listen even to sad tear jerky type music. those are all liable to set u off too...

bina

israel

Thanks Bina - good ideas and info. Much appreciated. Went to a Thai farmacy and got "Flava Soy" capsules it says "for relief of menopausal symptoms". It is mostly in Thai but I think it is a soy bean extract which I think is similar to estrogen, or the plant form of it anyhow. Not sure now whether to take it, may wait until my period has gone before trying it. The pharamacist was very helpful and said Thai ladies take one a day but big farang lady may need two a day! She made me smile. Must google it and find out more info. My thanks again.

I went through my mom's menopause as a teen. She had had a hysterectomy when younger and when she was diagnosed with breast cancer she went from full hormonal levels to zero in a day. What a nightmare for her and for her family. Fortunately for her I was also about 16 and aware of the problem so didn't take her mood swings personally

Since she had breast cancer she could not take any hormones at all and researched natural methods of dealing with the awful side effects of menopause. If you'd like, I can contact her and ask her what she did. I know alot of it was diet based, meditation and just plain coping.

Good luck to you

Yes, hormones and menopause for sure. Personally I don't suffer the weepiness but do get depression and rage especially pre-menstrually - meaning a full 2 weeks before menstruation, basically all the time except for during my period and maybe 10 days thereafter. Started suffering when I turned 40. Tried all manner of things that didn't help (Evening Primroose oil, Vit E, soy etc) then finally got partial relief from natural progesterone and almost complete relief when I went on an SSRI (anti-depressent) after literature came out showing it was effective for PMS. I'm still on it, would like to go off but have resigned myself to needing to wait until I'm through menopause and hormones have stabilized. (Whixh seems to be taking FOREVER...the books talk about perimenopause as lasting a few years, but it's been almost 15 for me...and I'm still menstruating at 54 although the night sweats are getting worse so I suppose it can't be too much longer).

While I don't get weepy, plenty of women do, so it is not unusual.

Agree with ina that you need to get your hormone regimen stabilized. I don't know what you have found out re the progestogel but anyhow, no problem to restart the estrogel in the smallest dose necessary to control symptoms. You should add whatever form of natural progesterone you can get. The trick is to decide when to take it. This is confusing as there is no consensus about it. Some docs recommend continuous (estrogen & progesterone together all the time; there will be some breakthrough bleeding but ignore it). Sonme recommend cyclical and the advise for cyclical use varies from:

estrogen all the time, progesterone just the first 12 days of each montgh

estrogen only when aboslutely necessary, progesterone from 8th to 26-30th of each month (whichever is closer to your natural cycle) -- this last is specific fopr women with endometriosis

In other words there is no consensus at all on how to do the cyclical therapy except to be sure to add progesterone at some point.

You are going to eed to find the best approach with some trial and error but I suggest you avoid switching about too frequently -- give an approach a few months try before altering it -- otherwise your hormone levels will be so unstable that uyou'll have trouble figuring out hwats working.

Personally I feel it makes sense to try to mimic the natural cycle as much as possible and also to allow at least a week off all hormones (if symptoms allow) so I would suggest estrogen + progesterone from day 8 to however long your normal ccyle was or until you menstruate, whichever comes first, and nothing for the first 8 days unless you have symoptoms in which case just a little estrogen. This is juist a suggestion as a place to start, try it for at kleast 2-3 cycles and then adjust as you feel necessary.

You may also want to try a low dose of an SSRI, sertraline (Zoloft) is the one that has been studied specifically for mood swings connected to the menstrual cycle but others would also probably work. I don't recommend Prozac though because its long half life makes dosage adjustnment very difficult plus you don't see the results quickly. Zoloft at 25-50 mg daily, you'll know within 2 weeks if it is helping. Can get it over the counter, at that dosage it is pretty safe unless you have any liver or kidney problems in which case consult a doc first.

I held out for a long time against taking an SSRI because I didn't like the idea of anti-depressent medication. I could have saved myself a lot of suffering if I had started sooner. When I first began it I felt ashamed to be taking it, embarassed to ask for it at a drugguist etc. Now I have just accepted that my flunctuating hormones make it necessary and I don't worry about it. Once I'm through menopause and hormones have settled down I'll think about going off it, for now it's necessary.

With it the mood swings/depression are well under control.

Yes, hormones and menopause for sure. Personally I don't suffer the weepiness but do get depression and rage especially pre-menstrually - meaning a full 2 weeks before menstruation, basically all the time except for during my period and maybe 10 days thereafter. Started suffering when I turned 40. Tried all manner of things that didn't help (Evening Primroose oil, Vit E, soy etc) then finally got partial relief from natural progesterone and almost complete relief when I went on an SSRI (anti-depressent) after literature came out showing it was effective for PMS. I'm still on it, would like to go off but have resigned myself to needing to wait until I'm through menopause and hormones have stabilized. (Whixh seems to be taking FOREVER...the books talk about perimenopause as lasting a few years, but it's been almost 15 for me...and I'm still menstruating at 54 although the night sweats are getting worse so I suppose it can't be too much longer).

While I don't get weepy, plenty of women do, so it is not unusual.

Agree with ina that you need to get your hormone regimen stabilized. I don't know what you have found out re the progestogel but anyhow, no problem to restart the estrogel in the smallest dose necessary to control symptoms. You should add whatever form of natural progesterone you can get. The trick is to decide when to take it. This is confusing as there is no consensus about it. Some docs recommend continuous (estrogen & progesterone together all the time; there will be some breakthrough bleeding but ignore it). Sonme recommend cyclical and the advise for cyclical use varies from:

estrogen all the time, progesterone just the first 12 days of each montgh

estrogen only when aboslutely necessary, progesterone from 8th to 26-30th of each month (whichever is closer to your natural cycle) -- this last is specific fopr women with endometriosis

In other words there is no consensus at all on how to do the cyclical therapy except to be sure to add progesterone at some point.

You are going to eed to find the best approach with some trial and error but I suggest you avoid switching about too frequently -- give an approach a few months try before altering it -- otherwise your hormone levels will be so unstable that uyou'll have trouble figuring out hwats working.

Personally I feel it makes sense to try to mimic the natural cycle as much as possible and also to allow at least a week off all hormones (if symptoms allow) so I would suggest estrogen + progesterone from day 8 to however long your normal ccyle was or until you menstruate, whichever comes first, and nothing for the first 8 days unless you have symoptoms in which case just a little estrogen. This is juist a suggestion as a place to start, try it for at kleast 2-3 cycles and then adjust as you feel necessary.

You may also want to try a low dose of an SSRI, sertraline (Zoloft) is the one that has been studied specifically for mood swings connected to the menstrual cycle but others would also probably work. I don't recommend Prozac though because its long half life makes dosage adjustnment very difficult plus you don't see the results quickly. Zoloft at 25-50 mg daily, you'll know within 2 weeks if it is helping. Can get it over the counter, at that dosage it is pretty safe unless you have any liver or kidney problems in which case consult a doc first.

I held out for a long time against taking an SSRI because I didn't like the idea of anti-depressent medication. I could have saved myself a lot of suffering if I had started sooner. When I first began it I felt ashamed to be taking it, embarassed to ask for it at a drugguist etc. Now I have just accepted that my flunctuating hormones make it necessary and I don't worry about it. Once I'm through menopause and hormones have settled down I'll think about going off it, for now it's necessary.

With it the mood swings/depression are well under control.

Hi Sheryl

So glad to hear the voice of reason (and experience) again. How on earth have you coped with the big M for 15 years! Staggering to think it can go on so long. I just cant believe how my mood swings from elation and joy (with tears of course) to despair and complete abject depression (again, plus the tears) all within the space of a few hours. My husband seems to think that the "hormones" hook is just a convenient handle on which to hang various subjects. I am going to insist he reads this thread to at least get a basic grasp of how debilitating and forceful the big M can be for some women.

I love him dearly, and dont want to lose him, but right now, his understanding and appreciation of this tremendous struggle I am facing seeems zero. He is a kind and caring man, so I am hoping understanding the cause of the problems will help. How do you other ladies cope with 'educating' your partners? I can well imagine how menopause could cause serious and even terminal problems with relationships.

So sorry to hear about the other nasty side efffects Sheryl, of which I knew nothing. Rage as well as depression coupled with mood swings? How horrible. Fully agree that following the natural cycle as much as possible, and coming off hormones etc asap is the long term goal. Until the last two years or so, I was lucky enough to rarely have to take even an aspirin.

These symptoms are so debilitating, it makes me wonder how women of previous generations got through it at all? Maybe it is natures way of finishing off the old women? I suppose they had no choice but to 'grin and bear it'. I take my hat off to all these brave, courageous women. I do feel like a weeping ninny compared to them. And usually am so practical, calm, sensible and even keeled. So the effects are even more devastating.

I too would resist taking even a mild anti-depressant, even though it is plainly obvious that the problems are being caused by menopause. But why not save ourselves some of the anguish if we can? We are fortunate to have the option and should take advantage of it.

On the natural progesterone gel front, no, still not able to get it. Spend ages in KL looking, they had Uterogestan, and the pessary type (Crinone I think) but not the natural gel. I have been meaning to chase up the importers in Bkk but so much else going on right now, slipped my mind.

I have been researching natural progesterone gel on the internet as it seems a better way of keeping the dose to the bearest minimum. Apparently it is also the best way for the hormone to be absorbed directly too, as it does not have to pass the liver. Anyhow, Brits who are realising just how good this stuff is, compared to synthetic progesterone, are going to Spain to stock up,where it is available at two euros(about 90bt I think) per tube. If I can find no other way, guess I will be Spain bound. Also saw it advertised online for US$40 per tube - plus $40 for shipping!

Maybe anyone who is already booked to go to Spain could bring some back for us girls? Just an idea.

Been having more thoughts about having the hysterectomy too. Hubby thinks that if I had that, it would all disappear like magic, but I gather that is not the case at all. So why do it? Especially since it may not cure endometriosis, never mind the gruelling symptoms of menopause.

SBK - my heart goes out to your mum, what a brave lady. She was lvery ucky to have you around to help her cope.

Thank you ladies for your time, knowlege and understanding. You are all well worth your weight in gold.

i have just found out that i am menopausal at just 41 yrs old. i suspect that i probably have been for some time as my menstruation has been all over the place for a few years.

the initial devastation wore off after a few days (i forgot to have kids) but i am ok now. i got my lovely mum to send me over some wonder pills from australia. made by a company called carson, i think they are called 'potent menopause formula'.

since taking these, i have not had one hot flush. this was my main symptom and it would wake me at night in a hot sweat, having to take showers at 3am! needless to say, i was a tad emotional, but i think that this was more than likely due to lack of sleep!

i guess i am a bit emotional at times, but this could also be due to external influences going on in my life at the moment, so i am really unsure if i can 'blame' menopause for this. time will tell.

but if your hot flushes are getting to you, google the above name as it is WONDERFUL. i highly recommend these. they also have a good dose of calcium, which is needed as our bones decalcify faster than when we are pre-menopausal.

i dont use any gels or hormones. what i am on appears to be enough at this stage.

Edited November 29, 200619 yr by donna

Sorry to hear that donna, that is quite young to be menopausal.

Make sure to keep on the calcium, as you said, calcium loss due to menopause can be quite high, and if your family has a history of osteoporosis, it is even more so.

Also, one thing I learned from watching my mom, be sure to do the little things to make your life better. Spoil yourself from time to time, you are worth it

thanks sbk. i am keeping up with the tablets as they are wonderful. all natural.

i have also been told to do weight bearing exercise to as this will help strengthen my bones.

yes, 41 IS young in my opinion. the doctor here in phuket, however, though it quite funny and actually had a little chuckle when he told me. the bedside manner of a gnat i think.

i was shocked as i have been quite clucky of late but the chances of me falling pregnant now are next to nothing as i think that my ovaries have shrivelled up to the size of raisins!

i guess everything happens for a reason. there is no point at all of me stressing this as it will probably make the symptoms worse. theres no point in crying over spilt milk and theres no point in crying over what i initially thought were lost years.

the truth of the matter is that i never met 'the one' who i wanted to have kids with until now.

i have a lot of love to give, so maybe i just need to give it to other kids who dont have it from their own parents. thailand has many kids like this so it looks like thats where my path is taking me in this life time.

EFL - you can easily get your hormone levels checked at a hospital. thats what i did. Dr Gnat gave me the results and they were pretty conclusive. its just a simple blood test. for peace of mind get it checked, as well as your thyroid. symptoms could be similar from what a friend of mine with thyroid trouble tells me.

Edited November 29, 200619 yr by donna

thanks sbk. i am keeping up with the tablets as they are wonderful. all natural.

i have also been told to do weight bearing exercise to as this will help strengthen my bones.

yes, 41 IS young in my opinion. the doctor here in phuket, however, though it quite funny and actually had a little chuckle when he told me. the bedside manner of a gnat i think.

i was shocked as i have been quite clucky of late but the chances of me falling pregnant now are next to nothing as i think that my ovaries have shrivelled up to the size of raisins!

i guess everything happens for a reason. there is no point at all of me stressing this as it will probably make the symptoms worse. theres no point in crying over spilt milk and theres no point in crying over what i initially thought were lost years.

the truth of the matter is that i never met 'the one' who i wanted to have kids with until now.

i have a lot of love to give, so maybe i just need to give it to other kids who dont have it from their own parents. thailand has many kids like this so it looks like thats where my path is taking me in this life time.

EFL - you can easily get your hormone levels checked at a hospital. thats what i did. Dr Gnat gave me the results and they were pretty conclusive. its just a simple blood test. for peace of mind get it checked, as well as your thyroid. symptoms could be similar from what a friend of mine with thyroid trouble tells me.

Hi Donna - You are quite young to get menopause, it's true. What a shock it must have been to you, especially receiving it from Dr. Gnat. I did ask at my local hospital for hormone blood test in the early days, when I was not sure, but was told "they dont get involved with hormones". I was quite stunned, as it is supposed to be considered a "good" hospital for Pattaya.

But now with all the other symptoms, I know it is menopause causing all the hassles.

Your natural meds from good old mum sound great. I wonder what is in them? I read somewhere that Black Cohosh (not a tribe of native American Indians but apparently a plant) is good, as is soy, and soy related products. I have some Flava Soy capsules bought in Bkk when trying to hunt down natural progesterone, which seems as easy to find as hens teeth. It is supposed to be for the relief of all menopausal symptoms. The pharmacist who dispensed it to me said many women, both Tha and Farang swear by it.

I have not tried it yet as I am trying to figure out the least estrogen like substances I can use to control or relieve symptoms, without growing more endometrium.

How wise of you to understand that your love can be spread around. Many children and thousands and thousands of unwanted animals would be delighted to share their love with you.

You're also very wise to stick to the minimum meds needed to control the worst symptoms. At least we are lucky enough to have these things to fall back on if we need them.

I wonder if the time we get our menopause is inherited? Did your mum get hers early too?

Best of luck with everything and thanks for your interesting post.

my older sister is pre-menopausal at 43 but my oldest sister still hasn't had it start yet.

I suspect I will follow a more normal pattern as most of my hormonal related issues have been within norms whereas my pre-menopausal sister has had hormone/female problems since puberty.

thanks EFL. i went in to the examination with the 'hope' that it would 'only' be my thyroid, but the menopause news hit me like a ton of bricks. the doctor just said to me 'so, if youre taking any birth control pills, you might as well stop as there is NO WAY youre gonna fall pregnant'. all this with a big smile on his face too.

anyway, life goes on and having a child just wasnt in the plan for me in this life time (unless a miracle happens). stressing about it will only worsen the symptoms i guess.

the tablets i am taking are as follows and they do mail order - just google the name and you will see it all:

MICROGENICS

Complete Menopause

Each tablet contains:

Clycine Max (soy) seed

Angelica Polymorpha (dong quai) root

Dioscorea villosa (wild yam) root

Trifolium pratense (red clover) herb

Cimicifuga racemosa (black cohash) root

Salvia officinalis (sage) leaf

Passiflora incanata (passion flower) herb top flower

Smilax officinalis (sarsparilla) root

Zingiber oficinalis (ginger) rhizome

calcium

these are fantastic. i didnt take them over the weekend - forgot - but today started feeling hot again. i popped two of these babies and am feeling fine again.

my mum had a full hysterectomy early on so she didnt really experience what i am going through. but my two older sisters are both going through it at the moment too. one of them put me on to these tablets. thank goodness mum will keep me in supply so thats a good thing.

i went in to the examination with the 'hope' that it would 'only' be my thyroid, but the menopause news hit me like a ton of bricks. the doctor just said to me 'so, if youre taking any birth control pills, you might as well stop as there is NO WAY youre gonna fall pregnant'. all this with a big smile on his face too.

Dr Gnat indeed, what an idiot

I have no faith in Drs that want to gut a person immediately. I was 20 something, had one fibroid, and my ogbyn wanted to give me a hysterctomy (sp?), but then he was an a-hole.

I was going to suggest soy (I think I have read about it somewhere, just can't remember where) but then that has already been suggested to you. So If I may.... try soya bean nuts. Just straight 'ole crunchy (not sure how they have been prepared) nuts. Then you can snack on them during the day, and then you are not taking in whatever additives and un-warranted sugar that you will have with the milk drink.

You can also get soya bean cooking oil for your food preparations.

I am 43 and for the past year have had erratic or no periods. Whereas before they were on the dot. Also have had the sweats, mood swings, and also anxiety attacks for no reason.

I am not stupid and have thought for a while that this is the symptoms of menopause. I am on holiday with both my mother and my sister next month so shall have a little "daughter/sister talk" with them on the beach and ask when they went through it. I know that my sister had a hysterectomy about 6 years ago when she was 47 and then she went through a sort of menopause. But my mother is so enclosed and private about anything to do with female "things" it may take a bit of time to get it out of her. I'm still waiting for her to tell me about the birds and the bees and periods!

haha! welcome to MY world Patsycat!

seriously, it sounds like you and i are in the same boat. try to get your hands on my wonder drugs (all natural by the way) and you will notice the difference in no time at all. you can mail order them too, which is great. in australia you can just buy them in the health food shop.

but how dumb is this: i moved house and couldnt stay there because, despite the fact that it had no air conditioning, i found in unbearably hot. especially at night when i had to get up at 3am and shower! i was going crazy from this. didnt put two and two together (well, it WAS un-airconditioned after all). i searched for a new house, and found out soon after that i was menopausal.

although i like my new house much more than the old one and would probably have moved anyway, i often think to myself that i am the only person who has moved house due to menopause!

Have you considered having an hysterectomy with conservation of ovaries. Unless they are diseased there is no reason to lose them. You could then go ahead with whatever form of HRT you fancy.

Just an idea.

Newest study on alternatives to HRT for menopausal symptoms shows Black Cohosh to be ineffective:

A new research study shows that natural remedies based on a number of popular herbal and food ingredients (including black cohosh) are no more effective than a placebo at relieving unpleasant symptoms of menopause such as hot flashes and night sweats. It confirms that hormone replacement therapy (HRT) remains a significantly effective treatment.

The study is published in the Annals of Internal Medicine .

The scientists studied 351 women experiencing at least 2 episodes of "vasomotor symptoms" (hot flashes or night sweats) per 24 hour period. Half the women were perimenopausal (started menopause but still having menstrual periods) while the others were menopausal but had stopped their periods.

The women were randomnly split into five groups. Each group took a different "remedy": (1) A placebo (containing no active ingredient), (2) Black cohosh, (3) A "multibotanical" of 10 ingredients, including black cohosh, alfalfa, ginseng, boron, licorice, oats, and pomegranate, (4) A multibotanical plus advice to encourage consumption of soya-based food, and (5) Hormone therapy.

The women recorded how often their night sweats and hot flashes occurred and how bad they were, at the start of and then three times over 12 months. The results were then compared across the five groups.

The scientists found that the women who took HRT had the fewest symptoms, while all other four groups had very similar symptoms, making the placebo group's results virtually indistinguishable from those of the three natural remedy groups.

Black cohosh is a herb that is sold as a dietary supplement, often in health food shops. It has become popular as a safe alternative to hormone therapy for relief of menopausal symptoms, but according to the National Institutes of Health (NIH), current evidence is unconvincing.

But, when coupled with the research that shows a direct link between HRT and hormonal based breast cancers, I would stick with trying out different natural alternatives. I think that many remedies can have different effects on different people--for some none, for others, very. Its worth trying out just to see what works for you.

Agree that trying natural alternatives first is a good idea. But I would also add re the dangers of HRT:

1) The dangers are associated with long term use...prior to the results of the Nurses Health STudy, many docs were putting women on HRT longterm to decrease risk of osteoporosis. It was also thought (wrongly, as it turned out) that it would decrease risk of heart disease. Evidence suggests that short-term use to control menopausal symptoms, as opposed to using HRT indefinitely, does not pose a significant risk. I think this is worth stressing because now many women are afraid to use HRT at all, even when they are really suffering.

2) The studies focused on HRT as usually prescribed, i.e. premarin + provera or something similiar. This is horse estrogen plus a synthetic progestin. Synthetic progestins are not at all chemically similar to natural progesterone; their only point of similiarity is that both control endometrial proliferation but beyond that they are entirely different, and synthetic progestins have a LOT of uinpleasant side effects that natural progesterone does not. The only reason they were ever developed is profit: natural substances can't be patented, so to make more money the drug componanies came up with an artifical substitute. There have been no scientifically rigorous studies of HRT using NATURAL hormones (human estrogen, natural progesterone). We cannot say whether or not any risks would be associated with it or not, as it is unstudied. But it seems probable that there would be less risk with natural hormones.

Every woman has to make her own informed decision; personally I have decided to use natural HRT in the smallest amount needed to control bothersome symptoms until I am through menopause and then go off it. From the information available, this would seem a relatively safe option. If I were not experiencing symptoms bad enough to affect my quality of life, I wouldn't use any form of HRT, but as I am, this is what I do.

Of course, women with a family history of breast, ovarian or uterine cancer or past history of same are in a special category and should discuss with a doctor before taking even the natural hormones.