So what caused that drop of 50 per cent in taking HRT? It seems this is what John Lee described as women ‘voting with their bodies’ rather than the medical profession prescribing less.

A study undertaken in 2009 at Stanford University in California found that women who take HRT for more than five years double their risk of suffering breast cancer for every 12 months they spend taking it. Breast cancer is the most common form of the disease diagnosed in women in Britain and one in nine women will develop the disease at some form in their life. More than 45,000 cases are diagnosed every year and about 15,000 women die from the cancer, although survival rates have increased significantly in recent years.

However, the good news is that within a year of stopping HRT the risk of developing breast cancer was almost back to normal. This was not a small scale study either, unlike the original research on HRT, as more than 57,0000 women were studied which enabled the research team to say conclusively that there was very strong evidence that HRT causes breast cancer.

Cancer, wherever it occurs, brings a whole maelstrom of emotions and feelings along with the physical effects and depression is certainly one of them. If a woman with breast cancer takes Paroxetine, the generic name of an SSRI drug now commonly prescribed for depression, there is a serious risk to consider.

Paroxetine may be given under the trade names of Seroxat or Paxil and if taken at the same time as Tamoxifen has an increased risk of death according to a study published on the British Medical Journal website. Why the increased risk? Because paroxetine itself does not cause or influences the course of breast cancer but it impairs the effectiveness of Tamoxifen.

Whatever the advisability or not of taking Tamoxifen, the reality is that in order to work, it must be converted into an active metabolite (endoxifen) by the liver and antidepressants can interfere with this process. Because it is common for women with breast cancer to be on antidepressants for long periods of time, and although many antidepressants have little or no impact on tamoxifen’s metabolism, paroxetine is a potent inhibitor of the metabolic step that converts tamoxifen to endoxifen.

This latest research was carried out by Dr Catherine Kelly and colleagues at the Institute for Clinical Evaluative Sciences (ICES) in Toronto and they concluded that Paroxetine, but not other SSRIs, in combination with Tamoxifen, was associated with an increased long-term risk of breast cancer death. The researchers estimate that treatment with paroxetine for 41 percent of the total time on Tamoxifen will result in one additional breast cancer death at five years for every 20 women so treated. One of the study’s authors, David Juurlink a scientist at ICES, went further and stated that “these results highlight a drug interaction that is extremely common, widely underappreciated and potentially life-threatening, yet uniformly avoidable.”

This means that the choice of antidepressant can significantly influence survival in women taking Tamoxifen for breast cancer, so needs to be thoroughly discussed with your doctor or cancer team. Any women currently taking this potentially lethal duo also needs to discuss withdrawal of the antidepressant as it should not be abruptly withdrawn to minimise side effects.

Dr John Lee said that normally they would disappear altogether at menopause and that to reduce them a progesterone regime should do the trick. My experience is that many women do suffer from fibroids around their thirties and forties and that they can be a real nuisance.

Fibroids are round, firm benign lumps of the muscular wall of the uterus, composed of smooth muscle and connective tissue, and seldom do you just get one. In size they start small and grow to something the size of an orange, but can get much bigger. The most usual consequences are painful or irregular periods and heavy bleeding, often accompanied by pain.

The usual option offered is a hysterectomy and many women, depending on their age, opt for this. If you have a highly skilled surgeon they can just remove the uterus intact, but this is not usually the case.

Prevention is the best option, so tackling oestrogen dominance is the first step because fibroids are produced by excess oestrogen and their growth is stimulated by it. Ensuring that you have adequate supplies of progesterone is a priority, so establish this with a blood or saliva test, and by using natural progesterone regularly you should be able to shrink the fibroids in size without resorting to surgery.

Once menopause is under way the fibroids will begin to shrink naturally, but if you are around ten years or so off your menopause you need to be aware that you are probably having anovulatory (non-ovulating) cycles and so you are producing much less progesterone than before but still the same amount of oestrogen. To check for this, have a blood or saliva test to check progesterone levels the week following your usual ovulation date. A low reading indicates lack of ovulation and the need to supplement with natural progesterone. 
 
If you experience any of the common signs of oestrogen dominance you will want to keep an eye out for fibroids and take action earlier rather than later to avoid surgery.

It’s estimated that around 30% of menopausal women will get some form of hot flashes. How affected you are will depend on several factors, including where you live and what you eat. Some lucky women never get them at all and they are certainly very much more common in the western world. There is no word in Japanese for instance to cover this phenomenon because there do not seem to suffer from them – unless they have switched to a predominantly western diet. So if you are unlucky enough to suffer from hot flashes it might help to learn why they occur and let you gauge whether or not you are likely to be a sufferer.

The Reasons Why
Although some lucky women escape completely, there are some very good reasons why we experience the heat that we associate with menopause:

1 – Blood Vessels
Hot flashes occur when the blood vessels below the skin dilate. This causes more blood to rush to the skin’s surface, and that is what makes you look red and flushed, and feel that tell-tale rise in temperature. The body’s normal response to this is to try and cool you down, and it does this by making you sweat. When your body temperature increases your body immediately goes into action and how it normally brings your temperature down is through making you sweat. What is unique about hot flashes is that this mechanism kicks in when the outside temperature can be very low and you do not have any signs of fever.

2– Fluctuating hormones
Well you know all about this during menopause, and in fact the changing levels of your hormones are the prime cause of hot flashes. When your hormone levels fluctuate they cause the temperature control mechanism in the body to be disturbed. The centre which controls this is in a part of the brain called the hypothalamus and it seems that it is changing levels of oestrogen and FSH (follicular stimulating hormone) that can upset this delicate balance and cause hot flashes.

Women having hot flashes usually have decreased oestrogen levels and increased FSH levels, but it is important to remember that it is the changes and fluctuations in the hormone levels – rather than the actual amount of hormone being produced – that produces hot flashes.

3 – Surgical menopause
It is to be expected that menopause symptoms come naturally when a woman’s childbearing years are coming to a close and the menopause or perimenopause is under way. However, women who have a hysterectomy or their ovaries removed at an age when they would not normally be going through menopause are more likely to experience more severe and frequent hot flashes after the surgery than in a natural menopause transition.

Even if the ovaries are retained it is no guarantee that an early menopause will not occur, as their effectiveness at producing progesterone will be affected and will diminish over time.

These are the reasons, and I hope it helps explain why you may be feeling hot and bothered. After all knowledge is power, and some women do like to refer to their hot flashes as power surges!

With osteoporosis your bones become fragile and brittle and so are easily broken. As more severe bone loss occurs, then even minor accidents can result in fractures, most frequently in the spine, wrist, hip and pelvis. If the condition becomes advanced, and is untreated, then the vertebrae of the spine are prone to compression fractures, which affect surrounding nerves and organs. This also results in a loss of height for which the old nickname was ‘the dowager’s hump’ as it was frequently seen in the bent over posture of old ladies. It is also accompanied by chronic pain.

Risk Factors
Women are four times more likely than men to develop osteoporosis, and women over 55 are the most susceptible, although younger women can also be at risk depending on certain factors. It has also more recently been seen that more men are being diagnosed with osteoporosis. It is hard to know whether this is because they are now more susceptible because of the increased hormone levels in the water and food chain, or because they have not been diagnosed. As the greatest number of cases are seen in women, many doctors have not thought to link broken bones in men to osteoporosis. A simple scan by ultrasound can diagnose this and if a man is subject to bones breaking more easily then this would be a good check to make.

Knowing your medical history is important as osteoporosis often runs in families, but if this is not the case for you then it is the declining hormone levels as we age that are an important factor in whether or not you develop osteoporosis,. Both oestrogen and progesterone are essential for bone building and production of both these slow down as we get older. Normal bone tissue is broken down by cells called osteoclasts (a process which needs oestrogen) and rebuilt by osteoblasts. (which needs progesterone). As we age, the rate at which the bone is broken down exceeds that at which it is built up and this leads to bone loss.

It can also affect younger women who have had a surgical menopause through having a hysterectomy and also anyone who has undertaken severe dieting or has a history of anorexia or bulimia. There is a severe mineral loss involved in these conditions and during the teens and twenties and this can do permanent damage to the bones.

There are a number of ways to deal with osteoporosis and three of the important ones in the prevention and management of this condition are stress management, diet and exercise. Low levels of exercise can make the condition worse, and there are many good books on nutrition on this subject, but it will certainly be worsened by a diet high in animal protein, too much salt, heavy metal toxicity, cigarettes, numerous pregnancies and prolonged breast feeding.

Being aware of your own risk factors will enable you to take charge of your health and minimise the effect osteoporosis may have on you.

Sadly, women with POF are also run a much higher risk of osteoporosis, heart disease, memory loss, and a higher risk of premature death. The usual treatment that is offered is replacement hormone treatment from either the contraceptive pill or HRT. Both of these medications carry a higher risk of risk of stroke, heart disease and breast cancer as well the unpleasant side effects many women suffer when taking them. .

Now a small study done in Scotland has found that young women with ovarian failure would benefit from taking natural bio-identical hormones rather than synthetic ones and certainly safer for them than taking the contraceptive pill to try and improve their condition.

The women in the study were given an oestradiol patch (a natural oestrogen) and either vaginal or oral progesterone, not a synthetic progestogen. The doses of progesterone (200mg) and oestradiol (0.10 mg) that were given daily are quite high, but it was found that on the natural hormone regime the women’s’ blood pressure went down and their kidney function improved significantly.

The Scottish study believe that the success of the treatment was down to the transdermal delivery of the hormones and the fact they did not have any of the side effects you would expect from using synthetic hormones.

One other benefit for women using natural progesterone for POF instead of being given either the contraceptive pill or HRT is that they get the bone-building benefit of natural progesterone and are so more protected from osteoporosis which does not occur when the synthetic hormones are given.

There are any number of reasons why you may be vulnerable for either condition and some may well relate to health problems you might have had in the past like anorexia, but there could also be other factors affecting your bones right now.

The good news is that both osteoporosis and osteopenia can be treated and your bone strength can be improved by both slowing the breakdown of old bone and, at the same time, building up new strong bone.

There are three important things that you have to consider if you want to improve your bones. These are:-

1 – Taking supplements to make sure that your bones have the correct nutrients in the right balance to build strong new bone.
2 – Regularly taking weight bearing exercise
3 – Checking that your oestrogen/progesterone hormone balance is favourable for the building up of new bone

Supplements:

It used to be thought that we only needed calcium and vitamins D, C and K to build our bones, but this is not true as many nutrients are needed. Yes, we do need calcium but it must be combined with an equal amount of magnesium so that the calcium can be properly used by the bones. If there is too much calcium to magnesium in your diet then it can be deposited in your joints and arteries which you certainly want to avoid . Boron, zinc and silica in small amounts will help to build strong bone as well as the benefits from the Omega 3 Fatty acids.

Rather than taking all these separately there are a number of supplements that have these already combined for you on the market that will contain most of the items here but you will need to take the vitamin C and the Omega 3 separately. It is a good idea to consult a nutritionist so you can have an individual programme designed for you.

Weight-bearing exercise:
There are many options for this, but any exercise that puts impact through your bones is effective. Whatever you choose to do, make sure it is something you enjoy so that you will regularly keep it up. You can go to the gym, play tennis, dance, skip, walk briskly gym or try something different like tai chi or yoga. Another benefit of exercise if you are vulnerable to osteoporosis is that it keeps you supple and so you are less likely to fall and risk breaking a bone.

Hormone balance:
It is a fallacy to believe that it is only oestrogen that is needed for healthy bones. In reality all oestrogen can do is slow bone breakdown, and it certainly cannot help build up new strong bone. HRT is often suggested to help with osteoporosis, but the problem here is that the oestrogen will slow down bone breakdown, but he bone only stays there while you take the oestrogen in the HRT. When you stop, then you lose all the retained bone and a further problem is that even if you keep taking oestrogen over time, this retained bone becomes old and brittle.

The only hormone that helps to build up new strong bone is progesterone, and that is not to be confused with the chemical progestogen found in the contraceptive pill and HRT.

Drugs for osteoporosis:
There are certain drugs such as Fosamex that slow bone breakdown, and these can be useful if you have severe osteoporosis, but the problem is the same as with oestrogen. They only have an effect while you take them and this is reversed when you stop. Also the retained bone becomes old and brittle.

There are other osteoporosis drugs that contain strontium, but there is considerable debate about its benefits, either as a medication or a supplement. It makes the bones appear denser on x-rays but this does not necessarily mean they are stronger. It does this because it is a chemical that has a higher atomic weight than calcium and shows up more densely on x-rays.

Last word:
The most important thing to remember if you are diagnosed with either osteopenia or osteoporosis is that there is no need to panic. New strong bone can be built up and your bones can be improved. It is not just a case of preventing the condition from worsening, but taking positive action to ensure the best possible conditions for building new, strong and healthy bone.

A Danish study showed that the average age of breast development in young girls has gone down by a full year since 1990. This was a 15 year study and found that whereas in the early 90s, the average age was 10.88, at present it is occurring around 9.86 years of age. 


Doctors often put this down to childhood obesity, and certainly diet plays a significant role because of what they are eating. A diet containing plenty of non-organic meat and dairy products can certainly give a young girl a dose of hormones and growth promoters that are present in those foods that she doesn’t need.

Young girls hormones are impacted by food and additional hormones coming in from what seems like a healthy option like soy milk. Unfortunately though soy milk can be a useful addition to a mature woman’s diet, the levels of phytoestrogen that are present in it are not helpful to young girls.

Development of the breast that occurs at puberty is dependent on oestrogen, but that needs to come from the girls own body. Putting in additional dietary sources can seriously affect her hormone balance.

Early puberty brings with it additional problems, the most serious of which is the high incidence of breast cancer associated with the early onset of physical maturity. We know that oestrogen is implicated in breast cancer, so it makes sense to not to provide a diet that would artificially increase the amounts of this hormone in the body.