The Dilemma of Hormone Therapy in Menopause

Estrogen, the main hormone during a woman’s reproductive years, is no longer produced after menopause which is the cessation of periods. This deficiency of estrogen has an amazing wide range of effects on various tissues and organs of the body. The menopausal woman may have symptoms of which the most common is hot flushes. This is an intense sensation of heat on the upper part of the body, lasting up to few minutes, and coming on several times a day in severe cases. Around 45% of women report palpitations or ‘ghabrahat’ as the first symptom. Such women will require a cardiology checkup before attributing these to menopause. Complaints like frequency, urgency of

There has been considerable interest in certain bioactive , non- nutrient plant derived Estrogenic compounds and whether they can serve as alternatives to  Hormone Replacement Therapy (HRT) in menopause . These phytochemicals exhibit estrogenic actions in humans either by acting as modulators of estrogen receptors ( SERMs ) or as enzyme modulators (SEEMs) . These compounds are called Phytoestrogens. The blanket term Phytoestrogens refers to various plant constituents , their extracts which are available as pills, as well as to synthetic compounds like Ipriflavone, which is similar in structure to estrogen and Isoflavones.


Abnormal uterine bleeding accounts for a significant number of gynecological referrals. The diagnostic approach depends essentially on the age – group of the patient. In most premenopausal women the cause of the abnormal bleeding is dysfunctional wherein pregnancy related complications, local abnormalities of the uterus, like fibroids and polyps, and systemic causes have been ruled out. Dysfunctional uterine bleeding is thus a diagnosis of exclusion, most commonly caused by anovulation and the diagnostic approach is geared towards finding out the cause of anovulation.