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Dr. Northrup:
Okay. Thanks, Pam. We have another question we received, and it was if you have breast cancer, can you take hormone replacement therapy? What a great question. I was just asked this today at the hairdresser's. Now the studies on this are mixed, so there are actually a surprising number of studies that show that you can take a small amount of estrogen even if you've had estrogen positive—estrogen receptor positive breast cancer and the mortality rate and even the recurrence rate is not high. However, other—other studies show the opposite. This will depend a lot on the quality of your life. If you are not sleeping, if you're—the quality of your life isn't worth living, then you and your doctor have to decide, is it worth it to maybe increase the risk of breast cancer growth? The studies, as I said, are mixed. Let me tell you one thing that isn't mixed. And that is that a small amount of vaginal estrogen has minuscule systemic absorption, and generally this is considered safe, even by oncologists. So do talk with your doctor because there are things you can do—other things you can do: omega-3 fats, high amounts of omega-3 fats are important, enough vitamin D, make sure you're not deficient in vitamin D, exercise and then taking foods high in phytonutrients or plant nutrients. Flaxseed, for instance. Soy in some people. Again, that's controversial. But you can do quite a bit. Also, by the way, acupuncture and Chinese herbs. But do talk to your doctor about the idea of hormone replacement. For some people, progesterone is all they need. Just a small amount. One quarter teaspoon of 2 percent progesterone, about 30 milligrams rubbed into the skin, can reduce hot flashes in some women. And it may be worth it. But discuss it with your doctor first. All right. Jean. Jean's on the phone from Orange, Massachusetts.

Jean:
Hi.

Dr. Northrup:
Hi.

Jean:
I'm 62 years old and I went through menopause—it's been about 10 years now.

Dr. Northrup:
Yeah.

Jean:
With no symptoms. I didn't have hot flashes or anything. It was basically I—I missed a couple periods and that was it and I had no trouble. My question is, I'm wondering if the hormone therapy would benefit me at all.

Dr. Northrup:
Someone like you, Jean, you're doing so great, why would you mess with that? Are you feeling good?

Jean:
Yeah, basically, yeah. I'm going to be 63 in July and I'm—I'm—I mean, I do have some problems, but I'm pretty healthy. I mean, I've got a—I shovel my driveway, I exercise, I—I feel good.

Dr. Northrup:
Right. I would stick with that. My mother is 82. She's currently driving her RV out to Arizona for the winter. This is the first winter that she hasn't skied every day.

Jean:
Oh.

Dr. Northrup:
And she's never been on a hormone in her life.

Jean:
Wow.

Dr. Northrup:
You know, and as sharp as a tack. And like I said, driving a big old RV herself out to Arizona. So I'm kind of the school if it ain't broke, don't fix it. And you sound like you're not only not broke, you're thriving.

Jean:
Well, I just—I heard you speaking about the vaginal dryness and elasticity.

Dr. Northrup:
Yeah.

Jean:
Would taking anything help me in that area?

Dr. Northrup:
Oh, yeah, just a little vaginal estrogen will help dramatically.

Jean:
Okay.

Dr. Northrup:
So you can get a prescription for that. That's a no-brainer, and that is easy and there are just no risks with that at all. Very little.

Jean:
And does it need to be a special, you know, blend like the compounding?

Dr. Northrup:
Nope. You can get it right from your regular pharmacy with a prescription. There's many different varieties, but go for one that's just called estradiol cream. That's the generic name. So there are different brands of that.

Jean:
Okay, great.

Dr. Northrup:
All right?

Jean:
All right.

Dr. Northrup:
Thanks, Jean.

Jean:
Thank you very much.

Dr. Northrup:
Okay. Now Ann is on Skype from St. Louis. Ann, what's your question?

Ann:
Hi, doctor. I will be turning 35 this year, and I was wondering what can I do now to make this transition a little bit easier for me later on.

Dr. Northrup:
I do love that, Ann. I'm a big preventive medicine person. So here's what I would say to you. What are your periods like? What happens to you premenstrually?

Ann:
They're pretty regular. I don't have too many problems. You know, I'm pretty healthy in general.

Dr. Northrup:
Okay, that's good. So you don't have bad PMS or anything?

Ann:
I don't think so. Maybe my boyfriend might think so.

Dr. Northrup:
The menstrual cycle is a wonderful cycle for us to tell what's really going on in our lives. Because a time when women have PMS is really premenstrual truth-telling, and all the stuff you can shove under the carpet during the first half of the cycle comes up in the second half of the cycle to be processed. It doesn't sound like you've got any of that. So usually someone like you, especially someone like you who would even ask the question, is never going to have any problems. Now what you could do, if you wanted to, and you had the money, and you were interested, is somewhere between 35 and 40 you could get a baseline level of—a hormone profile of your hormones and then we'd know what your prime hormone level looked like. This is really research, and it's future-oriented because we don't really know what to do with that stuff yet. But it would be like banking your eggs like maybe later on it would be worthwhile. But right now I'd keep doing what you're doing. But pay attention to what happens to you the week before your period. And if everything's good and you stay well nutriented and all of that, you should be absolutely fine. Oh, one question. What was your mother's menopause like?

Ann:
She said it was pretty normal. It started around the age of 50 and not too many, you know, huge problems at all.

Dr. Northrup:
Yeah, see, there you go. Like mother, like daughter. You're going to be fine. No problem.

Ann:
Thank you.

Dr. Northrup:
Okay, good. Thanks, Ann. Once again, I'm Dr. Christiane Northrup. I wrote the book The Wisdom of Menopause, and tonight we're continuing the conversation about hormone replacement therapy that you saw on The Oprah Show today. Christie's on the phone from Dunkirk, Maryland.

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