(Dr. Stephen Holt's 4th visit to Power Surge) Dearest: My guest tonight is Stephen Holt, M.D. Dr. Holt has practiced medicine since 1972. A Professor of Medicine, Scientist, Board certified gastroenterologist and internist in three countries, the U.S., U.K. and Canada, with higher training in nutrition, clinical pharmacology and medicine of addictions. Most of Dr. Holt's referred patients have been seen by several physicians previously and they often have complex disorders. Dr. Holt is the author of 12 books including the Random House bestseller, The Soy Revolution and Combat Syndrome X, Y & Z. His newest book, The MenoPlan: Natural Ways to Healthy Menstruation and Menopause will be out soon. It's a pleasure to welcome you back to Power Surge, Dr. Holt. Stephen Holt, M.D.: It's great to be back. Dearest: Let's start with why women be cautious of the conventional prescription hormone replacement therapy, HRT, typically prescribed for menopause symptoms by their doctors? Stephen Holt, M.D.: The news is not completely out on the dangers of conventional hormone replacement therapy. There is not doubt that the news is bad and, in some cases, shocking. I need to tell you about studies in the major scientific medical journals in the last couple of years. Please let the information register. In England medical studies report 25,000 new cases of fatal breast cancer as a consequence of taking conventional HRT in the form of estrogen and synthetic progesterone. This combination is often used in the form of PremPro. Studies in the US show that this kind of conventional HRT causes breast cancer. Doctors used to think that conventional HRT prevented heart disease. This is no longer known to be the case and some studies show up to an 81% increase in risk of heart attack in users of conventional HRT. Studies in the last year show certain types of conventional HRT may predispose to dementia in women following menopause, a condition rather like Alzheimer's disease. Conventional HRT is associated with other types of cancer such as cancer of the womb and ovary. Conventional HRT has not even improved the quality of life in women following the menopause. Many doctors and their patients are considering other options in a very serious way. People must realize that conventional HRT will help melt symptoms of menopause but the cost of help is too high. It is a fact that the cost in side effects and poor health from conventional HRT in a combined form may far outweigh the benefits. These matters are discussed in great detail in my upcoming book The MenoPlan and these studies are referenced. Because of these serious risks to health, many women are seeking safe, simple and gentle options to deal with the transitions of menopause. These are serious issues which I invite you to ask about and discuss with your physicians and this evening I will speak with you about what I believe are natural viable options to help promote health and relieve symptoms. Dearest: Dr. Holt, why, knowing this - and that conventional HRT can cause stroke, gall bladder disease, cancer, heart issues, and even dementia - are women STILL using them? Stephen Holt, M.D.: There is no doubt that the estrogen components of conventional HRT has benefits in symptom reduction and some benefits psychologically. Some women like the idea that they still menstruate. Some doctors are saying that they do not completely understand whether or not estrogen alone is acceptable, but it is my experience that estrogen alone does cause problems. There are many other symptoms such as weight gain, blood clots, bloating and even serious blood clots that can block the lung. Again, my forthcoming book stresses all these issues and why many doctors are looking for alternatives for their patients. Many doctors are trying to take many women off conventional HRT. As the evidence becomes clear about the risk to health, it has been stated that HRT given in a conventional setting is a massive experiment on mature women in an uncontrolled manner. Some scientists are questioning why this could have gone on for 25-30 years. Lawyers are sharpening their pencils as I speak. This is a very serious public health issue, which for reasons unknown to me, has not been adequately covered in the media. There are more than 40 million women who are candidates for conventional HRT and they have not been told about the risks in an honest way, in my opinion. These are strong words, but I will stand by my opinion. Dearest: One last question - a thought that just occurred to me - is it possible that there's such a great increase in heart disease and cancer among the baby boomer generation that took birth control pills back in the 60's and thereafter? Stephen Holt, M.D.: When the birth control pills were first introduced, the dosages of the pills was high and there was a gross underreporting of the side effects. Recent information is about low dose birth control pills. These older pills could have caused some of the problems in today's baby boomers but there are other problems including other factors such as Syndrome X. I believe that conventional HRT may be particularly problematic in people with obesity and Syndrome X who already have symptoms of heart disease. Women must look at their lifestyle, nutrition, behavior and other factors that all contribute to poor health in their mature years. In brief, I do believe that old-fashioned birth control pills were quite dangerous in some cases. SelectedDee: What about a transition from Premarin to natural hormones? Is cold turkey okay? I am perimenopausal. Stephen Holt, M.D.: Before I answer this question, let's get some general principles understood. Stopping conventional HRT cold turkey can be like having a second menopause. Nobody should stop HRT suddenly unless there is a clear medical reason to do so. Most medications should be stopped slowly when they have been used with continuity. Before I answer this question, let's look at what natural solutions exist. The options include: herbs or botanicals, dietary supplements. Some people favor natural hormones that are identical body hormones. Other popular natural options include soy isoflavones and black cohosh. These are some of the components of the product MenoPlan which I shall describe in detail later. I do not believe that there is solid evidence that bio- identical hormones are any safer than conventional HRT. This opinion is not necessarily shared by everyone. Dearest: SelectedDee, there's a comprehensive article in Power Surge's, Educate Your Body Library on weaning off synthetic HRT. You'll find it at www.power- surge.com/educate/weanoffhrt.htm. Dr. Holt, would you please tell us about the other ingredients in the MenoPlan, and how it differs from other menopause formulas on the market? Stephen Holt, M.D.: I believe that MenoPlan has a formula that is better than any other product for menopause. The ingredients are all evidence- based and more complete than any other product, to my knowledge. It contains black cohosh in a standardized dose, similar to that found in Remifemin. Black cohosh is now regarded as having scientific support for controlling the symptoms of menopause. It also contains a 40% concentrate of isoflavones in a balanced amount with the black cohosh. The concept of the formula is additive. I believe that high doses of isoflavones aren't safe when used alone. Disclaimer: Every guest in Power Surge is a highly respected professional whose opinions are his/her own. An appearance in Power Surge does not constitute an endorsement of a guest's views. None of these transcripts may be reprinted or reproduced without the express permission of Power Surge" and the respective guest. Read other transcripts by returning to the Library. Dearest aka Alice Stamm Power Surge Founder, Facilitator, Host Copyright© 1994- by Power Surge. All Rights Reserved.