menopause
3 interactions related to menopause
hrt + soy isoflavones
Soy isoflavones (genistein, daidzein) act as selective estrogen receptor modulators with preferential binding to ER-beta. Combining high-dose isoflavone supplements with prescribed hormone replacement therapy adds an additional estrogenic signal of uncertain magnitude, which is most concerning for women with a history of estrogen-sensitive cancer.
estrogen + dong quai
Dong quai (Angelica sinensis) shows estrogen-agonist activity in vitro and promotes growth of estrogen receptor-positive breast cancer cells. Combining it with prescribed estrogen therapy may add unwanted estrogenic stimulation, and dong quai's coumarin content increases bleeding risk in patients also on hormone therapy with VTE risk.
smoking + hrt
Smoking accelerates hepatic CYP-mediated metabolism of estradiol, lowering circulating estrogen levels and reducing the efficacy of oral hormone replacement therapy for menopausal symptoms and bone protection. It also compounds the venous thromboembolism risk of oral HRT.