Hormone help?

[Diane Fosson]

I have recently stopped taking the pill (which I was only taking to control bleeding, mood swings and hot flashes). My doctor told me to stop taking it and see if I even still have a period on my own. After two months, I don't so far.  My hot flashes come on an average of about 3 an hour and I'm not thrilled about continuing to live this way. What are the risks of me just staying on the pill...ortho tri cycline Lo is the one that I take, as opposed to getting on a patch or different hormone pill?  My mother had ovarian cancer when she was 39, which was caught immediately and then she developed breast cancer in both breasts when she was 74. So, I'm trying to decide the safest approach to take.
I have cut the fat way back in my diet. I'm eating more soy as well. Any advice?

[Machelle Seibel, MD]

Whether or not to take estrogen either as HT or as the pill is one of the most challenging decisions facing women as the approach menopause and the best answer varies from woman to woman. You did not list your age so it isn't clear how close to menopause you are. However, some of the new pills take advantage of women's familiarity with birth control pills and the fact that low dosages are very helpful for bleeding issues and help control hot flashes.

Alternative approaches to estrogen include soy as  you are taking. Try to read the labels and see how many isoflavones are in the soy you eat. In general, about 50 to 100 mg of soy isoflavones or 25 to 40 grams of soy protein daily are the ranges to aim for. These are the ranges of the typical Asian diet and are believed to be safe. Flax seed (ground) 1-2 tablespoons in your cereal each morning can help and some women find black cohosh (20 - 40 mg daily) helpful.

One thing to consider with your family history. Because your mom had both breast and ovarian cancer, she could have been a carrier for one of the breast cancer  (BrCa) genes. Testing for these genes is something to discuss with your doctor. It is a blood test and if present, would mean you are at a particular risk for these cancers even above family history. It would also mean that taking the pill might be a positive thing to prevent cancer. If the gene is positive, some women consider having their ovaries removed and have testing with both MRI and mammograms for their breasts alternating one every 6 months with the other.
Machelle M. Seibel, MD

[CD2]

for hot flashes try black cohosh & HRT night time hey do work