Twenty-five percent of all American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease, according to the American Heart Association. When to begin drug therapy typically depends on your risk factors for high cholesterol.
Testosterone: This hormone, an androgen, appears to play an important role in women's bodies. Often thought of incorrectly as exclusively a male sex hormone, testosterone is secreted by the ovaries and is therefore natural to the female body. Surgical menopause (removal of the ovaries) may have a negative effect on sex drive. Testosterone therapy is sometimes prescribed to help. Taking the correct dose is very important. Too much testosterone may not provide the desired improvement in sex drive, and can make the woman feel agitated, overly aggressive, and/or depressed. Higher doses can cause masculinizing side effects (that may not go away after stopping therapy) such as facial and body hair growth, acne, an enlarged clitoris, a lowered voice and muscle weight gain. Testosterone may also be associated with adverse heart-related conditions, such as increased risk for atherosclerosis.
Since the safety of taking testosterone for extended periods of time has not been established, women should be very cautious when considering this type of hormone treatment.
Alternatives to Hormone Therapy for Osteoporosis Prevention
Among the lifestyle changes that have been shown to improve bone density in young women and prevent fractures in older women are dietary calcium, avoiding smoking and excessive alcohol consumption. Prescription drugs used to treat and/or prevent osteoporosis include:
- Alendronate (Fosamax): approved by the FDA to treat and prevent osteoporosis, Fosamax (from the bisphosphonate class of drugs) has been shown to increase bone mass and reduce the risk of spine, hip, wrist, and other fractures in women with osteoporosis.
- Risedronate (Actonel): approved by the FDA to prevent and treat osteoporosis, Actonel (another type of bisphosphonate drug) has been shown to increase bone mass and decrease the risk of spine, hip and other fractures.
- Calcitonin (Miacalcin): approved by the FDA to treat women who are five years postmenopausal and cannot tolerate estrogen therapy, calcitonin helps maintain bone mass.
- Selective Estrogen-Receptor Modulators (SERMS). This class of drugs, including raloxifene (Evista) appears to prevent bone loss at the spine, hip and total body. One of the drugs in this class, raloxifene (Evista) has been shown to reduce the chance of spinal fracture by half in women with osteoporosis.
- Teriparatide (Forteo). This new drug, approved by the FDA in November 2002, is the first medication to actually stimulate bone formation instead of just slowing the breakdown of bone. You take it as a once-a-day shot.
Not all women should take these drugs and each medication has side effects. Ask your health care professional for more information.
Some women report that vitamin and herbal supplements are helpful in managing menopausal symptoms. For instance, phytoestrogens — naturally occurring compounds in certain plants, herbs and seeds — are similar in chemical structure to estrogen and/produce estrogen-like effects.
Soy products like tofu, tempeh, soy milk, soy burgers and roasted soy nuts contain phytoestrogen. These are healthy foods that are excellent sources of protein and calcium that can be added to your diet. Good scientific research is limited on the effects of soy on menopausal symptoms and ideal doses for specific symptoms have not been established. Research on effectiveness of soy products on hot flashes is mixed. Some research suggests that a serving of soy foods eaten daily may help relieve hot flashes.
Black cohosh supplements may also help relieve hot flashes, according to some research, but may take several weeks before effects from the supplement are felt. Extracts from the root of this herb — a relative of the buttercup family — were considered an important medicinal herb in Native American cultures for a variety of conditions. A federally funded study investigating the use of black cohosh for menopausal symptoms is currently underway at the Center for Complementary and Alternative Medicine Research in Aging and Women's Health at Columbia University College of Physicians and Surgeons.
Some women report vitamin E helpful in reducing hot flashes. However, there is limited scientific evidence to support its use. There is also no scientific evidence to support the effectiveness of evening primrose oil, flaxseed oil and dong quai root although some women report improvements n reducing menopausal symptoms.
Discuss any herbal or vitamin supplements you are considering taking with your health care professional. Bear in mind that studies related to their effectiveness are sparse and that the FDA doesn't oversee the production of supplements, nor does it require manufacturers to prove their products are safe. Also be aware that high doses of certain vitamins and herbal supplements can be dangerous. For example ephedra used in some weight loss products has potential serious side effects.
Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)