The impulse to shield women from drugs that are potentially harmful is a good one, but unfortunately, estrogen itself has become demonized rather than the specific products that have been shown to pose risks for a woman's health.

The negative result is that women who would benefit greatly from the right kind of hormone replenishment or from a treatment plan that would help them deal with uncomfortable symptoms during menopause don't reach out and get the help they deserve.

Turning a Blind Eye to Menopause
Some women choose to deny the existence of menopause altogether, as if acknowledging it would be admitting that there is a difference between men and women. And some women have even gone so far as to insist that the studying of masculine and feminine differences is subversive to the feminist cause.

From a medical point of view, denying the difference between the sexes can actually have very serious negative consequences and can compound an existing problem. If, as we've said, medical treatment in the United States today is fundamentally based on a male body, then from a diagnostic point of view women are already treated like men--but very unequal men. The problems that are unique to women--in this case, hormonal fluctuations and imbalances--have historically been ignored or have been treated as emotional problems. In fact, the word "hysterical" comes from the Greek word for uterus. In the nineteenth century, the typical English doctor would simply remove the uterus when a woman displayed what to his mind was excessive emotionality. The medical literature is dismayingly rife with such examples. To deny the physical uniqueness of a woman is to collude with the prejudice that women have irritatingly aberrant male bodies.

The debate about hormones is being carried on in the wrong arena. The question is not if you should take hormone replacement therapy drugs, but what constitutes a healthy and vital body at menopause and what specific actions and products you should use to manage symptoms and restore balance to support your hormonal system.

What Is "Unnatural"?
Some women decide that they will just let menopause run its course, because taking supplements for it isn't natural. But the fact is that contemporary life for women has become very unnatural. Over hundreds of thousands of years of evolution, humans have developed sustaining behaviors for their strength and longevity, such as eating a plant-rich diet and moving their muscles regularly. But in the short span of perhaps fifty years, processed foods and preservatives and a more and more sedentary lifestyle have virtually eliminated many of these body-sustaining behaviors from our lives.

It's not natural to eat processed food.

It's not natural to eat anything synthetic that doesn't exist in nature.

It's not natural to forego the important foods that can help balance your hormones.

It's not natural to go without physical exercise.

It's not natural to live in a polluted environment.

Almost all this "unnaturalness" is imposed from without--from the polluted environment, the stress of maintaining two-income households, eating processed food for convenience, or getting less exercise due to labor-saving devices. But these factors have a negative impact on a woman's hormonal balance and overall health, and may ultimately be linked to her seemingly "sudden" menopausal symptoms and "sudden" ill health.

The underlying impulse to stay "natural" is a good one, but women who are saying this may not be thinking the issue through. How far would you be willing to take the "It's not natural" idea? Does this mean saying no to lotion for dry skin? No to lubrication for sexual comfort? No to vitamins? Staying "natural" need not mean rejecting the use of beneficial and safe products to counteract the toxicity of our environment and food supply and help balance hormonal function.

Many of the women who resist the idea of taking anything at menopause don't realize that at the same time they may be unquestioningly taking a variety of prescription drugs, such as the acid blockers Zantac and Tagamet, which are potentially harmful and hardly natural.

If saying "I'm not going to do anything for menopause, it's not natural" is just providing yourself with an excuse to stop taking care of yourself, well, unfortunately, there's nothing we can do to stop you. But acceptance of a normal and important passage of your life is not the same thing as giving in to aging--that is, allowing yourself to slowly balloon out, forget about sexuality, and then eventually sit down for good.

There are women who believe that God meant us to have low hormonal levels after a certain age, so that's how it should be. But think about this: Many Japanese women on their traditional diet have phytoestrogen levels in their urine that are 1,000 times higher than those of U.S. women. This high excretion level means that their diet is so rich in beneficial plant food that all during their lives they have been "supplementing" their hormones naturally. When these women reach menopausal age, they don't have the symptoms so common to Western women. And if this were not reason enough to follow such a diet, these women rarely get breast cancer.(6)

The plants are much smarter than the man-made synthetics. They help you to up-regulate and down-regulate your hormone levels naturally. Unlike Premarin, which contains estrogens that are foreign to your body, and which may slow down the process of excretion, the plant substances are excreted very quickly. This is important because the longer an estrogen foriegn to humans stays in the body, the more opportunity it has to cause you problems in the form of side effects.

Our need for hormones continues through our lifetimes. So yes, menstruation will cease, yes, your ovaries will no longer be producing estrogen and progesterone the way they used to--but hormones will still play a very important part in maintaining your bodily functions. And keeping their levels appropriate and balanced with diet and supplementation will support you healthfully and vitally through old age.

But Grandma Never Took Hormones . . .
Women concerned about whether hormone replacement is "natural" often argue that previous generations seemed to have gotten along fine without it. This is a very good point, and again speaks to the confusion created by the drug industry and the medical establishment. Pharmaceutical companies have worked hard to induce a fear state in which women begin to think their bones will turn to dust and their hearts will stop working if they don't take their prescription drugs for the rest of their lives. These claims are indeed worthy of a good deal of skepticism, especially if the drugs come with significant expense, side effects, and cancer risks.

However, there is still good reason for you to pay attention to your "hormonal health" by balancing and replenishing with plant-derived hormones. Why? Because you and your grandmother may be different in very important ways.

First, we don't really know the exact state of your grandmother's health. Just how healthy is she? Just how active is she? How does she look for her age? And given the reticence of previous generations on matters pertaining to their bodies, it would be hard to know what she may or may not have suffered during menopause. "The Change" has only recently become a topic of public or even private conversation. Also, we don't know what her diet consisted of. If she ate a healthy, preservative-free diet concentrated on fresh vegetables and fruits, then she got a plant-hormone-rich infusion all her life and didn't need to supplement. If she was active and worked her body regularly, then she got enough exercise to keep her bones strong and healthy.

But now we're talking about you, her granddaughter. If you've lived on processed foods and your dietary habits run to Häagen-Daz, coffee, and hamburgers on the run, if you don't move that body of yours but instead spend most of your day behind a desk, if you're supermom juggling a career and family, if you diet incessantly, yo-yoing up and down, if you've taken lots of antibiotics and prescription drugs, then you can't compare yourself with your grandmother. Genetics is only one factor, and may not be the biggest influence. Sure, if you and your grandmother are both lucky genetically, then she may have sailed through menopause and so might you, but there is no guarantee that this will happen to you. A whole different set of contemporary factors comes into play. For starters, your grandmother didn't have to fight off the onslaught of the pollutants of our present environment. She did not grow up on a diet of commercially grown food lacking in nutrients--especially essential minerals--and, unfortunately, very rich in pesticide residue, drugs, and chemical contaminants. And no previous generation has faced today's unique stress levels.

But this does not mean that your body is not biologically and genetically prepared to live to a ripe old age.

Living Longer . . . and Better
An insidious idea has taken hold in the menopause literature: We are told that because women are living longer than ever before (supposedly without precedent in human history), a woman's body after fifty is, so to speak, hormonally unprepared to live very much longer and cannot protect itself against the ravages of old age. This idea has been embraced by the medical profession to justify putting women on permanent HRT beginning at age fifty.

In previous centuries, the mean age of death for women may have been very low as women died as infants, as young children, in childbirth, as victims of epidemics, in famines, in war, etc., but this does not mean that these women were not biologically prepared to live very long lives. Medical anthropologist Margaret Lock, writing in Lancet in l990, said: "Since there is evidence that people have lived to a very old age for at least l00,000 years, this means that from an evolutionary point of view the female body is biologically prepared to do so. The maximum life span potential for a woman is estimated to be about 92 years."(7) (The authors add: "We feel even this is short--and not the actual longevity potential. To prove our point, the oldest known person living today is a 120-year-old woman residing in France.")(8)

In the early fifties, certain doctors began to define menopause as a disease--"estrogen deficiency" disease--which then needed to be treated with a drug. Traditional Asian medicine--which, by the way, is based on a "clinical trial" of at least a 2,000-year heritage and 400 unbroken generations of written patient experience--views menopause in an entirely different way than does standard medical practice in the United States. To the Asians, menopause is a necessary and vital process for the body's health. While obviously a signal that the woman has reached a certain age, passing through menopause actually serves to slow down the aging process by preventing the unnecessary loss of blood and jing, or essence, thus allowing the woman the possibility of good health for at least the next thirty years of life. To ensure a smooth passage in this "second spring" of a woman's life, Chinese doctors will prescribe tonics and other herbal remedies to balance the woman's hormones.(9) For thousands of years, Chinese women could live to a healthy old age--and what's more, they were venerated for it!

Looking Younger Than Ever
What has become evident in the United States is that women act and look younger for their age than in previous generations--forty today is what thirty was twenty years ago. Actresses can now actually be sexy onscreen past forty--Susan Sarandon, Jessica Lange, and Meryl Streep, to name just a few--which was not true a generation ago. Marilyn Monroe was considered over the hill at thirty-six. And now fifty for a woman is what forty was twenty years ago.