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Maca as an HRT Option

Rather than face the now-proven risks of hormone replacement therapy (HRT), an estimated six million women may now be searching for other options to help relieve menopausal symptoms. One option that is likely to become more familiar to women and their practitioners is the Peruvian herb maca. Maca is a cruciferous root vegetable that when freshly harvested resembles a small turnip. Maca has been used as both a food and medicine for thousands of years by native people from the Andes Mountains.

The search for safer alternatives to HRT intensified after reports were issued by the National Institutes of Health (NIH), indicating that the use of combination estrogen/progestin drugs in healthy menopausal women increases the risk of invasive breast cancer, heart disease, stroke, and blood clots, outweighing the drugs’ possible health benefits. NIH stopped a large-scale clinical trial and recommended the 16,000 participants stop taking the estrogen/progestin drugs immediately.

New York-based anthropologist Viana Muller, Ph.D., has been making collecting/study trips to Peru since 1989, exploring both the rainforest and Andes Mountains in search of effective herbal remedies unknown to North Americans. According to Dr. Muller, women who are stopping HRT may want to explore using maca root extract with one of the growing number of holistic medical doctors and other healthcare practitioners who are familiar with herbal medicine.

Says Dr. Muller, “Maca has been used successfully by native people of Peru for hormonal imbalances, menstrual irregularities, fertility, and menopausal symptoms, including hot flashes, vaginal dryness, loss of energy, libido and depression.”

Since introducing maca to medical doctors practicing CAM (Complementary/Alternative Medicine) at the Anti-Aging Medical Conference 1997, Dr. Muller has seen a dramatic increase in the use of this medicinal herb by holistic practitioners in the U.S.

Research has shown that maca contains no plant hormones, unlike soy/genistein and black cohosh. Instead, its action relies on plant sterols, which act as chemical triggers to help the body itself produce a higher level of hormones appropriate to the age and gender of the person taking it. Clinical case studies have shown that maca can be effective for premenstrual syndrome (PMS), as well as menopausal symptoms, and may help symptoms of hypothyroidism as well.

Alan Warshowsky, M.D., is an ob-gyn who serves as Director of Women’s Health at the Continuum Center for Health and Healing at Beth Israel Hospital in New York. Says Dr. Warshowsky: "At least 50 percent of my menopausal patients are using maca and doing well.

Karen Paris, a Physician’s Assistant of the Atkins Center in New York, the clinic founded by famed weight loss expert Robert Atkins, M.D., has said that the clinic began using organic maca root extract last year, finding it effective for their menopausal patients.

Says Paris, "We have had great success using maca in conjunction with some nutritional supplements, to wean women off of hormone replacement therapy. Some of them have been on HRT for many years. For the few women who still have some symptoms, we have developed a combination protocol that works very well, involving maca extract and a tiny amount of natural estrogen together with natural progesterone--which unlike progestin, is not carcinogenic."

Cynthia Watson, M.D., a Santa Monica physician specializing in women’s health, integrated the use of maca into her approach to menopausal symptoms six years ago. Says Dr. Watson, " I give my patients a choice--either natural hormones which are made to be bioidentical to human estrogen and progesterone or maca extract." In her opinion both approaches are equally successful. "The ones who have chosen to go with maca extract are doing phenomenally well," she added.

Dr. Muller recommends that any woman considering use of maca for menopausal symptoms do their own research. Says Dr. Muller, "If they have never used any hormone replacement, they can start using organic maca extract on their own without encountering any special problems. But if they have osteoporosis or if they have been on HRT for more than a few months, they are definitely going to need the guidance of health care practitioners who have integrated herbal therapies into their medical practice and are informed about available alternatives to prescription drugs for effective relief of menopausal symptoms."

She also feels that in order to evaluate the effectiveness of any natural therapy for the maintenance of bone strength or to help reverse osteoporosis, women need to work with practitioners who can order tests to establish base line hormone levels before starting the maca therapy, and follow up two months later with a second series of hormone tests to find out if the dose the patient is taking is sufficient.

"Even more accurate a measure of bone protection," says Dr. Muller, “is to do a base line and follow up bone resorption test to establish the rate at which calcium is being excreted into the urine. That avoids the problem of ‘false positives’ that women may get when taking phytoestrogenic herbs."

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