menopause
3 interactions related to menopause
hrt + soy isoflavones
The idea that soy isoflavones add an extra estrogen dose on top of HRT is not supported by the best human evidence; pooled randomized-trial data show isoflavones do not meaningfully raise estradiol, suppress FSH, or thicken the endometrium in postmenopausal women.
estrogen + dong quai
Dong quai (Angelica sinensis) shows estrogen-agonist activity in laboratory studies and can stimulate the growth of estrogen receptor-positive breast cancer cells in cell and animal models. Taken alongside prescribed estrogen, it adds an extra, unmeasured estrogenic signal in hormone-sensitive tissues. Dong quai also contains coumarin compounds that can add to bleeding risk, with one case report describing potentiation of warfarin.
smoking + hrt
Smoking speeds up how the liver breaks down estradiol, lowering circulating estrogen and reducing the effectiveness of oral hormone replacement therapy. It also adds to the blood-clot risk that oral HRT already carries.