Menopause and TCM: Is it okay to stop taking HRT?

Question: I’ve been taking hormone replacement therapy (HRT) for years on the advice of my doctor. In the past few weeks there has been a lot of attention in the media about the risks of HRT. For some time it was believed to cause higher incidences of breast cancer, heart attacks, strokes and blood clots, but now a report finds that it increases the chances of death by 50 percent. I’m afraid to take HRT now. Is it o.k. to just stop it? What will happen to me once I’m off it? What’s the best course of action for me at this point?

Answer: When Western doctors prescribe HRT drugs for women who are nearing menopause or who have already started it, their treatment perspective is only looking at one angle of this health issue. The bottom line is this approach doesn’t consider a woman’s body as a whole—it looks at her body as having a medical condition and treats just the symptoms. Western doctors only look at the angle of the hormones; they only consider that a hormone imbalance can cause menopausal problems like hot flashes, night sweats, and mood swings. From this angle, what they see is true. A hormone imbalance—a lack of estrogen—can cause these symptoms.

However, the Western approach hasn’t seen that adding chemicals to the body in the form of HRT drugs doesn’t actually balance a woman’s hormones. It’s what we call “unnaturally balancing the hormones,” which means the hormones haven’t been balanced, just additional ones have been given from the outside. When the body receives these unnatural hormones, it has to process them. Women are told to take these drugs for years, sometimes for the rest of their life. When the body cannot process all these unnatural hormones, it can cause the internal organs to get even more and more out of balance.

In the Western concept, replacing what is missing (hormones) will restore a woman’s body to function so it won’t have menopausal symptoms. The TCM understanding is that replacing hormones from the outside will not restore the natural function of a woman’s body. Actually, it suppresses it. The body’s wisdom senses the addition of hormones and gets the message that its own hormone production is not necessary any more. And then how do we really know the body is “designed” to handle a higher level of hormones than it naturally produces all the way through old age? TCM believes that if the root cause of menopausal symptoms are not addressed a woman’s body will never function in a healthy way. That’s the basic concept.

One fundamental TCM belief is that we are all born with a healing capacity. Women have a unique ability for self-healing because of their menstrual cycle and their special organs—the ovaries and uterus. It is this inborn capacity that allows women to rebalance and relieve menopausal symptoms without outside hormone therapy. The TCM understanding is that if she has a healthy, balanced body, a woman can produce enough estrogen on her own for her entire life. Naturally, as she ages it won’t be at the same level when she was able to have children, but it can still be at a level sufficient for her body to maintain its healthy function.

From the TCM viewpoint, menopausal symptoms are not caused by the onset of menopause but by the unbalanced state of a woman’s body when she begins this natural transition. This is a key point because many of the symptoms Western women experience with their menstrual cycle, often for years, are seen by TCM doctors as signs that a woman’s body is out of balance. When these symptoms—PMS, irregular periods, excessive bleeding, breast tenderness, headaches, digestive disturbances, and mood swings, to name just a few—are not addressed, as a woman ages and reaches menopause they can lead to more serious issues like heart problems or issues involving cysts, tumors, masses and even breast or uterine cancer. TCM’s focus on true prevention helps women understand that the discomfort they have with their periods is not natural and that effective treatment with natural methods can help them go through menopause and the rest of their life in a healthy, balanced way.

If you have been taking hormones for five or ten years, stopping might be difficult, first, in terms of your emotions. You might worry that if you don’t stop you could get breast cancer, but then worry if you do stop you won’t feel good. This situation can cause too much worry and maybe even anger at the situation you’re in. Strong emotions like these are powerful, and from the TCM perspective they can further unbalance your health.

The truth is most women cannot just stop HRT drugs all at once. You have to look at it this way: for many years this kind of problem in a woman’s body was never really addressed. It was being hidden—put in the basement. The root cause of her health issues at several stages in her life—before menopause and after it started—were never addressed. That’s the whole issue. For women who have been taking HRT, their body hasn’t been able to get better, to really heal; taking the hormones has made the body function even worse. The drugs further weaken the body’s energy system. If you stop you might suffer from other symptoms. More symptoms in your life might be more difficult to handle. Then you have more stress that leads to other conditions. So you cannot just immediately stop this kind of treatment. You have to slowly get off it.

While gradually stopping HRT, try to find someone using TCM or an alternative medicine approach to help you get your body back into balance. Remember, a healthy body can produce enough hormones for the rest of your life. A healthy body shouldn’t have menopause symptoms; menopause symptoms are a sign that your body is out of balance.

When a woman slowly goes off HRT she still has to do something to help her body gain more energy. Generally Chinese medicine looks at this health issue as an energy (Qi) deficiency. As we age our energy naturally declines. This is why health problems can start to show when a woman reaches middles age. So where does the extra energy come from? How can a woman add to her body’s energy supply? It can only come from two sources. One is from the food you eat. One is from good exercise—energy exercise like Qigong. These can increase the amount of energy available to balance the body. Without this balance a woman’s body cannot go on without hormones.

The bottom line is how can a woman achieve balance? There are a couple of issues women have to be concerned with, and these have to be made a priority. Number one is lifestyle. Different lifestyles “cost” different amounts of energy. A stressed-out, over-busy lifestyle uses up an enormous amount of energy, so this kind of energy-draining lifestyle has to change. Then the emotions—women have to consider how to balance their emotions. Different emotions also cost different amounts of energy. Anger, worry, stress—these all drain the body’s energy supply. Third, the diet has to be changed. Different kind of diets also cost a different kind of energy. These are the outside factors women have to look at. The lifestyle has to change; the emotions have to change; and then eating habits have to change.

Think about it: hormones come from where? A healthy body will produce a healthy amount of hormones. So hormones come from health. It’s not from the hormones in a balanced body that women are getting sick. Women are getting sick because their body is out of balance. And it’s not the body out of balance, it’s the emotions out of balance; it’s not the emotions out of balance, it’s the lifestyle out of balance. We really have to go to the root cause of the problem.

Americans have to wake up. We cannot just treat symptoms anymore. We have to understand where the real problem started. The real problem starts with a lifestyle out of balance. A lifestyle out of balance will cause the emotions to fall out of balance. When the emotions are out of balance, they can cause the body to be off balance. When the body is out of balance, the symptoms we see depend on which part of the body is affected and what kind of imbalance. Hormones out of balance, blood out of balance with conditions like high cholesterol and high blood pressure, are all signs that the body is out of balance. Tracing all these back, we can say they are caused by a lifestyle out of balance. Chinese medicine understands the body-mind-spirit dimension of health and how these aspects of being interrelate and affect a person’s overall health.

For thousands of years TCM has had practical clinical experience successfully treating women’s health issues. It recognizes that women have a unique capability to rebalance their body. As long as their body remains balanced, menopausal symptoms won’t exist and a woman’s health will be good throughout her entire life. In modern times, this means not having to take hormones that are unsafe. TCM practitioners treat health problems related to menopause with acupuncture and natural herbal therapy, an approach that does not have any negative side effects. Without a healthy body internally, even if a woman has a good diet her body still cannot absorb the nutritive essence of the food, so the digestive system really has to be rebalanced. Only then will she be able to get off hormone replacement therapy and start to get real relief from her symptoms with natural treatments.

Maybe now is a good time for Western women to seriously think about what is important for their own life, for their own health. If this is the issue, then women have to consider doing something—taking care of their precious health—before menopause comes, before disease and illness enter. Why not learn how to keep your body healthy and balanced, so when the time comes you will be able to go through this transition without any struggle? Then you will be able to enjoy the rest of your life in good health. TCM’s main concept is prevention. True prevention is the real cure. We have to go back to this approach.

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