Natural alternatives and HRT

Whatever the motivation, whether it is a concern about breast cancer or something else, many women choose to avoid HRT and often seek out natural alternatives. The important questions to ask when choosing a product are: “is this product safe and is it the right one for me?”

Other considerations should include the quality and price of the product. It is sometimes better to pay extra for a product that contains the correct therapeutic dose of the active ingredients of the herb, as it does work better. 


Phytoestrogens are plant-derived chemicals that have an affinity for the estrogen receptor. Although there has been much speculation about the possible risk of phytoestrogens from soya and herbs stimulating breast cancer, the many epidemiological (i.e. population) studies on women who use these products have not supported this hypothesis at all. In fact, the evidence suggests that these products play a protective role and medical researchers are recommending that women increase their intake of phytoestrogens in their diets to help prevent breast cancer.

Adding soya to your diet is a very good idea. Research has shown that phytoestrogens extracted from soya foods and given in a concentrated supplement, seem to stimulate estrogen dependent cancers in laboratory animals. However, soya foods consumed as part of your daily diet protects against these types of cancers. Epidemiological studies of Asian woman that have a diet high in soya, vegetables and legumes show that their diet protects them against breast cancer. Whereas studies that followed Asian women who have converted to a Western diet devoid of soya, have diets that are lower in fibre and higher in both animal fats and sugar and this leads to an increase in breast cancer risk.

How is it possible that phytoestrogens can be protective against breast cancer when they have an affinity for the estrogen receptor? The point is that phytoestrogens generally have an affinity for the estrogen receptor beta, which provides protection against breast cancer. In addition to this, in cases where they do bind to estrogen receptor alpha they displace the stronger and naturally produced types of estrogen a woman produces that stimulate breast cancer.

Beyond phytoestrogens

In addition to products that work by way of phytoestrogens, there are other treatments such as herbs that help with the symptoms of menopause without affecting estrogen at all. These products give women that are worried about stimulating breast cancer more options. Various herbs and nutraceutical products have shown to relieve the symptoms of menopause by affecting pituitary hormones and neurotransmitters instead of estrogen and progesterone. Many women find that the correct, individualised homeopathic remedy also offers adequate relief.

In order to achieve the greatest benefit one has to realise that what works for your friend may not work for you. Treatment for the symptoms of menopause needs to be individualised. If there is a risk of breast cancer, herbal and other types of alternative treatment should be prescribed by a practitioner with up-to-date knowledge and experience instead of buying products in health shops. This will also help ensure that the treatment doesn’t interfere with your current medication.

Unfortunately, medically trained practitioners with a thorough knowledge of how to individualise herbal treatment in women who are at risk, are few and far between.

In my practice I try to employ a conservative approach. If the patient can afford it, I give a very specific extract of rhubarb that is an exclusive estrogen receptor beta agonist. It offers protection against breast cancer, while relieving the symptoms of menopause. If the patient’s complaints are emotional or related to sleep disturbance, then I often prescribe something more specific to those symptoms.

When a woman cannot or will not take HRT there is a higher risk of osteoporosis (a gradual loss of bone density), which puts her at risk for fractures. Chemotherapy and estrogen-blocking drugs also increase the risk of osteoporosis. Research has shown that women with a high intake of soya foods and other phytoestrogens maintain their bone density better than those who do not. In addition to this regular weight bearing exercise and an appropriate intake of calcium and vitamin D can also help. Beyond this your doctor may recommend a drug for the prevention of osteoporosis. In this situation be sure to find out as much as you can about the side effects of the drug before you start taking it.

Written by Dr Cornelia Botha

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