To HRT or not

Who’s afraid of menopause? Many women, and men, too, who are bothered by the discomforts felt by the women around them, like their wives, mothers, sisters, colleagues and employees. Because women going through menopause can hardly function, experiencing as they do such symptoms as hot flashes, fluid retention, night sweats, depression, mood swings, irritability, weight gain, headache, fatigue, stress – to name a few.

What causes menopause, and when does it occur? Menopause is the time in a woman’s life when she stops having menstrual periods. At this period her hormone production drops below the level required to continue men-struating. This changes the rate and patterns of hormone release. It can happen generally at age 51, but a woman may have it earlier. If she does not menstruate for 12 consecutive months, then she is undergoing menopause.

Is there a way to treat the symptoms of menopause? Well, for the past 50 years, the accepted standard care for menopausal symptoms has been Hormone Replacement Therapy (HRT). HRT consists of forms of medication containing one or more female hormones, commonly estrogen plus progestin (synthetic progesterone).

However, there are people who claim that HRT was introduced in the pharmacopoeia before rigorous evidence of its efficacy and safety was required by the US Food and Drug Administration and other regulatory agencies.

According to Ronald C. Hamdy, M.D., F.R.C.P., F.A.C.P., doubts about the efficacy of HRT started after the results of the HERS Study (Julley et al, JAMA 1998; 280; 605-613) were published. The study had to be prematurely terminated because, according to Hamdy, more patients in the estrogen/progesterone group sustained cardiovascular incidents during the first year of the study. In fact the claim that HRT helps in the treatment of osteoporosis is now being questioned.

The doubts about HRT, says Hamdy, have been intensified by a study by the Women’s Health Initiative (WHI) in 2002 which showed that HRT is associated with less benefits and more risks.

This development has prompted health authorities to require that HRT products carry precautionary advice: that HRT should be used only for a short period of time, and only for the relief of menopausal symptoms – not for osteoporosis, and that herb-based therapies for relieving menopausal symptoms may be explored.

The good news is that an all-natural herbal supplement, Hemofer Liquid Herbal Tonic Supplement, is now available in the Philippine market to help give relief to menopausal symptoms. It is said to contain eight herbs that have been used for hundreds of years, specifically by women on Chinese traditional medicine.

Hemofer Liquid Herbal Tonic Supplement is manufactured by Pangashou Pharma-ceutical Co., Ltd. in Guangzhou , China, and is exclusively distributed in the Philippines by Spring Vine Herbal Trading Corporation. It is now available in all Mercury Drugstores, Watsons, Mansons, and other leading drugstores.

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Last Christmas, I featured the Christmas feast of Gilda Cordero-Fernando. This time, I am writing about the Noche Buena prepared by my ophthalmologist Phoebe Lim-Catipon. Phoebe relates that when she was still growing up in Dumaguete city, upon the prodding of her Chinese mother, she was already learning to cook. When she married Boy Catipon, a businessman, she honed her cooking skills further. She prepares the food for special occasions – birthdays, anniversaries, and the traditional Noche Buena – herself, from marketing to baking and cooking. Her five children – four of whom are medical doctors who are married to doctors too – are very picky eaters, and know that it’s their mom, not maids, who did the cooking.

These past days, Phoebe has been shuttling between her clinics (one at Chino Roces Ave. in Makati , and the other in Parañaque ) and markets to get ready for her Noche Buena cooking. She says, "Noche Buena is the most important occasion for our family. It’s the only time in the entire holiday season when all the children and grandchildren are together, go to church, enjoy the Christmas fare, and open presents afterwards."

Here’s the Catipon Christmas Eve menu: Stuffed Roast Turkey, Baked Ham, Leg of Lamb. Galantina, Paella, Embutido, Fruit Salad, Queso de Bola, Potato Salad and traditional native food like Humba (Visayan), Kilawin (San Pablo, Laguna), Dinuguan, Suman, lots of fruits and nuts and freshly-baked Honey Bread.

Phoebe stuffs the turkey with Paella, a family tradition. The fowl is soaked in salt and water (a process called brining) overnight. "I order the biggest turkey available as I have a big family – children and their spouses and their children – over for the feast," says the eye specialist. The preparation begins the day before, on December 23, with brining (the fowl is placed in salt and water overnight) then marinating it in soy sauce, calamansi and pepper. The bird is then stuffed with Paella and thrusted. The skin is rubbed with Kitchen Bouquet, mustard and margarine. The stuffed bird is wrapped with aluminum foil and roasted at 300 degrees F for five to six hours (for birds over 5 kilos), then the foil is removed, and the bird is browned with bastings from drippings, and the oven turned up to 450 degrees for another one to two hours. This is served with gravy made fro drippings and chopped meat from the neck, liver, and gizzard. Cranberry sauce is served at the side. "I time the baking so that the turkey is ready to serve when we come home from the Misa de Gallo."

For the Galantina, Phoebe debones the chicken and marinates the skin in soy sauce, pepper and calamansi, cheese, salt and pepper. The skin is placed flat on the chopping board or table and over it is spread the ground pork, chopped ham, chorizo bilbao , and sausage (that have all been ground together), strips of carrots, pickles, red pimiento, and boiled egg perched at the center. The whole thing is rolled tightly in cheese cloth and cooked in the broth (turkey bones, celery, onions, pepper and salt) for an hour. It is served cold, with aspic and décor.

Humba, says Phoebe, is a Visayan fare – "a must in all Negros Oriental feasts just as Kilawin is ever present in San Pablo households. Humba is made from pork hocks while Kilawin is from liver, spleen, pork tenderloin, heart and raddish. My dinuguan is my own specialty. I don’t use pork intestines, instead I use pork liempo (pork belly), face and lots of tongue with the blood soaked in lemon grass, and seasoned with patis."

Dessert is lots of fruits, says Phoebe. "I used to make my own fruit cake, but my children tells me they’d rather have my honey bread – straight from the oven. So be it."

The best thing about preparing her Noche Buena fare is that Phoebe utterly enjoys doing it.

My mouth waters as I write this.

Have a merry, full-filling Noche Buena, folks.

My e-mail: [email protected]