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experienced at menopause, indirectly stimulates the growth of osteoclasts, thus increasing the risk for developing osteoporosis. HRT containing oestrogen should therefore help prevent osteo- porosis. From this point of view it does. However, osteoclast cells have been shown to have no oestro- gen receptors in themselves, so cannot directly build new bone. On the other hand, osteoblast cells, which are responsible for mak- ing new bone, have been shown to have not oestrogen but proges- terone receptors. What this means is that it is progesterone (the natural form, not the synthetic progestins), not oestrogen, which is responsible for building bone tissue. This view is upheld in the Scientific American Updated Medicine Text 1991, which states, "Oestrogens decrease bone resorption, but associated with the decrease in bone resorption is a decrease in bone formation. Therefore, oestrogen should not be expected to increase bone mass." The authors also discuss oestro- gen side-effects, including the risk of endometrial cancer which “is increased sixfold in women who receive oestrogen therapy for up to five years; the risk is increased to fifteenfold in long-term users." Dr Kitty Little from Oxford found masses of tiny clots in the bones of rabbits treated with hormones. She is convinced that HRT in the form of oestrogen and progestins will increase the risk of osteoporosis. Blood clots originate from sticky clumps of platelet cells in the blood. She believes that blood clots in the bones can cause bone to break down, leading to osteoporosis.’* More and more research findings are emerging that challenge the oestrogen-deficiency/osteoporosis relationship and reinforce the progesterone-deficiency link. The results of a three-year study of 63 post-menopausal women with osteoporosis verify this. Women using transdermal progesterone cream experienced an average 7 to 8 per cent bone-mass density increase in the first year, 4 to 5 per cent in the second year, and 3 to 4 per cent in the third year! Untreated women in this age category typically lose 1.5 per cent bone-mass density per year! These results have not been found with any other form of hormone replacement therapy While it is easy to prescribe HRT for women, there is hardly any medical data concerning the effects of stopping HRT in women who have received long-term treatment.'* In one trial last- ing three-and-a-half years, withdrawal lasted for six months. So, unbeknownst to women, ‘menopause's little helper' could in fact be making oestrogen junkies out of them. It's great news for the pharmaceutical companies, but a calamity of untold proportion for women. Not only do they experience a wide range of physical symptoms but they also suffer from psychiatric disturbances. Dr Ellen Grant has said that “when higher-than-expected rates of attempted suicide and violent deaths were recorded among HRT-takers, the excuse was that more women suffering from depression are put on oestrogens in an attempt to treat them." Oestrogens are rarely considered as an implicating factor in depressive behaviour. Hormone Balance and Illness: Debunking the Myths HRT is now almost universally recommended to menopausal women for a wide variety of reasons. The two most significant reasons women are encouraged to embark upon the HRT band- wagon are HRT's supposed contribution in preventing or lessening the effects of osteoporosis and of cardiovascular disease. The tremendous fear of these two illnesses that is instilled by well- meaning doctors—who, after all, are the targets of effective phar- maceutical advertising and education (usually the only source of information they receive about these products)—often overrides a woman's natural instincts. It's time to unravel the myths that hide the real story. ¢ Osteoporosis To understand osteoporosis it is important to know a bit about bones. Bone-forming cells are of two different kinds. One type are called osteoclasts, and their job is to travel through the bone in search of old bone that is in need of renewal. Osteoclasts dissolve bone and leave behind tiny unfilled spaces. Osteoblasts move into these spaces in order to build new bone. A lack of oestrogens, as MYTHS OF OSTEOPOROSIS | Dr John Lee, author of What Your Doctor May Not Tell You About Menopause, writes’ this about the myths of ostéo- porosis: Myth #1: Osteoporosis is a calcium-deficiency disease. Most women with osteoporosis are getting plenty of calcium in their diet. It is quite easy to get the minimum daily. | requirement of calcium in even a relatively poor diet. The truth is that osteoporosis is a disease of excessive calcium- | loss caused by many factors. In osteoporosis, calcium is being lost fromthe bones faster than it is being added, regard- less of how much calcium a woman consumes. | Myth #2: Osteoporosis is an oestrogen-deficiency disease. | Not even basic medical texts agree with this. It is a fabrication of the pharmaceutical industry with no scientific evi- | dence to support it. Osteoporosis begins long before oestrogen levels fall, and accelerates for a few years at menopause. Taking oestrogen can slow bone-loss for those few years, but-its effect wears off within a few-years after menopause. Most importantly, oestrogen cannot rebuild new bone. Myth #3: Osteoporosis is a disease of menopause. : ‘This is at least a decade short of the truth. Osteoporosis begins anywhere from five to 20 years prior to menopause, | when oestrogen levels are still high: Osteoporosis accelerates at menopause or when a woman's ovaries are surgically Fremoved or become non-functional, such as can happen after hysterectomy. It is staggering to. think how many thou- -sands or millions of women have been doomed to a crippled old age or early death because their ovaries and/or uterus F were unnecessarily removed before menopause and natural progesterone replacement was ignored. NEXUS ¢ 25 AUGUST-SEPTEMBER 1996