Posted on: Sunday, July 21, 2002

COMMENTARY
Hormone news puts women in quandary

By Rekha Basu

It's not yet 9:30 p.m. on a Saturday and the usually animated partygoer is fading out.

Maddy Maxwell quit taking hormones last week. Since then she can't seem to stay awake. And that's not all. Her emotions are spiking like crazy. It's been 12 years since she experienced life without benefit of added estrogen; the last three included progestin.

"You get highs and lows. You become manic," she says of the transition. "It's scary. ..."

The federal government's abrupt decision last week to end a study of the health effects of combining estrogen and progestin landed like a boulder in the path of thousands, if not millions, of menopausal women, who responded by going off them. That process is messing with their emotions, sleep patterns and libidos, even provoking the odd heart palpitation.

Nearly 17,000 women in the study were told to stop taking the hormone combination pills immediately because of the new fears of heart attacks, cancer and strokes to long-term users. But 6 million women routinely use estrogen with progestin. You can just imagine all the panicked calls to doctors.

"Hormones affect all parts of our body. They make a big difference with moods, so when you suddenly withdraw them, it's going to be tragic for a lot of women," says Lisa Kamphuis, a Des Moines nurse practitioner in women's health, who says it's best to go off hormones gradually.

Maxwell went cold turkey.

This sudden reversal of course by the National Institutes of Health has sparked panic across the nation, but the attention is too little too late. After all, it's just menopausal women. And women are already expected to get through childbirth, postpartum depression, 40-odd years of pregnancy prevention and PMS.

Try to imagine the pandemonium if painkillers or antidepressants were suddenly pulled from drugstores. Or imagine how fast there'd be a solution if a panel of corporate male board members issued a collective yawn and put their heads down during a dinner meeting.

I'm not suggesting a conspiracy, but if men were subjected to hot flashes, mood swings and sleeplessness or the uncontrollable urge to sleep, I'm betting the medical profession and government would have figured out a better, safer alternative before it became a crisis.

Maybe I am suggesting a conspiracy. The news confirms what Kamphuis and others have long believed, that the risks from taking the hormones may outweigh the risks of just letting menopause take its course.

"A lot of doctors have said you need it to prevent heart disease, osteoporosis or Alzheimer's," says Kamphuis.

Maxwell says while friends went the natural route, she really needed hormone therapy because of the severity of her symptoms.

But Mary Helen Grace, an art teacher who has been easing off her estrogen-progestin combination since last week, has decided she prefers the menopausal mood swings to the sense of complacency she got on hormones, because those moods brought creativity.

"Before I was on estrogen, I had felt this kind of yearning," she said. "I could regain my emotional equilibrium when I would paint and draw. The six months I've been taking hormones, I've felt hardly any urge to paint at all. "

Now regaining that urge, she marvels, "I don't think heaven needs to be any better."

Needs vary. Women are different. Each need requires a safe, unburdensome solution. In case anyone needs reminding why this matters, half the population will eventually go through this so-called "change of life." The other half, at least, has mothers.

Columnist Rekha Basu writes for The Des Moines Register.