Menopausal Health

By Joel Fuhrman, M.D.

Hormone Replacement Therapy And Increased Cancer Risks!

Menopause, the occurrence of the last spontaneous menstrual period, results from a loss of ovarian function. It usually occurs at about age 50. The typical symptoms of night sweats and hot flashes can begin at that time or even earlier during perimenopause, as ovarian function starts to decline. The symptoms of estrogen loss can include insomnia, irritability, mood disturbances, vaginal atrophy, stress incontinence, and even a little thinning of the skin.

It is well established that estrogen replacement after menopause can aid in relieving some short-term menopausal symptoms such as hot flashes and the irritation and dryness associated with vaginal and urinary atrophy. The prevalence of these symptoms is highest in the two years immediately after menopause and lessens with time.

Hormonal replacement for a number of years after menopause clearly has benefits for most women, but it also has known risks. The benefits, risks, and possible severity of symptoms should be explained thoroughly to each woman so that she can make an informed decision to use or not use hormone replacement.

The main risk of hormonal replacement is increased risk of breast cancer. The main benefits include feeling better and a reduction in risk of colon cancer.1 However, colon cancer is more effectively prevented through excellent nutrition—specifically, adherence to a plant-based, nutrient-rich diet with a high phytochemical index. So estrogen use should be thought of as the major factor within a woman’s control. A family history of breast cancer should be a significant factor affecting this decision.

Best Protection

Eating a healthful diet for years prior to menopause is the best protection. Health in our midlife and later years is powerfully related to our nutritional practices early in life. Nutritional excellence and physical fitness earlier in life is protective, not just against cancer and heart disease, but against dementia, osteoporosis, and even menopausal symptoms after menopause.

Eating a diet high in animal products and processed foods leads to excess body fat and heightened estrogenic stimulation throughout childhood and young adulthood. This unnaturally high level of circulating hormones influences the number of estrogen receptors on target tissues. The body develops fewer estrogen receptors and reduced estrogen sensitivity in an environment of excess hormones. As a result, after menopause and the relative lack of estrogen that accompanies it, the reduced number of estrogen sensors leads to more dramatic postmenopausal symptoms.

Women who exercise, take better care of their bodies, and eat a diet rich in greens and cruciferous vegetables have fewer menopausal discomforts and usually handle menopause more easily. Green cruciferous vegetables also contain biological compounds that enable the body’s conversion of estrogens and other hormones into harmless compounds that are excreted in the urine.

According to the American Institute for Cancer Research, various components in cruciferous vegetables have been linked to lower cancer risks. Some have shown the ability to stop the growth of cancer cells for tumors in the breast, uterine lining (endometrium), lung, colon, liver, and cervix. Other studies that track the diets of people over time have found that diets high in cruciferous vegetables are linked to lower rates of prostate cancer.

Studies show that the phytochemicals found in cruciferous vegetables can stimulate enzymes in the body that detoxify carcinogens before they damage cells and can fuel cellular mechanisms that repair damaged cellular DNA.The generous consumption of these green vegetables throughout life not only offers dramatic protection against cancer, but also reduces the uncomfortable experiences that can accompany menopause.2


1. Mandelson MT, Miglioretti D, Newcomb PA, et al. Hormone replacement therapy in relation to survival in women diagnosed with colon cancer. Cancer Causes Control 2003;14(10):979-84.

2. Higdon JV, Delage B, Williams DE, Dashwood RH. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 2007;55(3):224-36.

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