Finding the right combination was a relief, consultant says

Exhaustion from sleepless nights convinced Vancouver public relations consultant Diana Barkley to try hormone replacement therapy five years ago.

The 50-something professional says she was aware of news reports suggesting a link to breast cancer and heart problems, but decided to look for more information. Insomnia, night sweats and hot flashes - all part of menopause for many women - were becoming unbearable.

"That makes it nearly impossible to work effectively. The night sweats are uncomfortable, obviously. The hot flashes during the day, if you're in the middle of a presentation and you get one, it's very discomforting and it's also very distracting."

For the uninitiated, a hot flash is a short-lived feeling of heat that typically starts in the chest area and spreads. It can lead to blushing and perspiration and affects about three-quarters of woman as their estrogen levels decline. Symptoms typically begin when women stop having regular menstrual periods in their early 50s and continue for years.

Barkley said her research led her to the Westcoast Women's Clinic in Vancouver where she had a number of tests and extensive consultation. She's had the doses adjusted and combinations changed over the years and now takes a progesterone pill, DHEA (dehydroepi-androsterone) in a lozenge and has an estrogen patch.

"I wanted to take really good care of myself because I was aging and to do it the best way possible."

This particular service is not cheap: $2,000 per year. The clinic also offers information sessions.

Most women will have hormone replacement therapy pre-scribed by their family doctors, however, which is covered by medicare.

The Westcoast Women's Clinic specializes in hormone therapy and was created 10 years ago by Dr. Bal Pawa and Dr. Nishi Dhaw. .Pawa said in a telephone interview that the clinic continued to prescribe hormone regimes over the last decade often using low-dose, non-pill forms such as creams or patches on a case-by-case basis.

"We really scrutinized that study (the Women's Health Initiative Trial) and it was quite flawed. The women were much older ... and many of them already had established heart disease.

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Finding the right combination was a relief, consultant says