Dealing with Menopause Naturally
Dealing with Menopause Naturally
Menopause known as the "change of life" is the point in a woman's life when menstruation stops permanently, signifying the end of her ability to have children. Menopause is the last stage of a gradual biological process in which the ovaries reduce their production of female sex hormones--a process that begins about 3 to 5 years before the final menstrual period. This transitional phase is called the climacteric, or perimenopause. Menopause is considered complete when a woman has been without periods for 1 year. In American women, on average, this occurs at about age 50. But like the beginning of menstruation in adolescence, timing varies from person to person.
How Does It Happen?
The reproductive system is regulated by hormones. The ovaries contain structures called follicles that produce eggs for fertilization. A woman is born with about 2 million undeveloped eggs and by puberty there are about 300,000 left. Only about 400 to 500 ever mature fully to be released during the menstrual cycle. The rest will degenerate over the years. During childhood the ovaries and uterus are inactive. As a woman reaches her reproductive years the brain goes to work, signaling the pituitary gland to secrete hormones, causing the reproductive organs to mature. Each month, the follicle secretes estrogen and an egg matures and is released. This is called ovulation. Estrogen causes ovulation. Progesterone, produced after ovulation, prepares the uterine lining for a fertilized egg. If fertilization does not occur, hormone levels drop, the lining of the uterus breaks down, and menstruation occurs.
For unknown reasons, during the mid-thirties, the ovaries begin to reduce hormone production. In the late forties, the process accelerates and hormones fluctuate more, causing irregular menstrual cycles and unpredictable episodes of heavy bleeding. By the early to mid-fifties, periods finally end altogether. However, estrogen production does not completely stop. The ovaries decrease their output significantly, but still may produce a small amount. And, another form of estrogen is produced in fat tissue with help from the adrenal glands (near the kidney). Although this form of estrogen is weaker than that produced by the ovaries, it increases with age and with the amount of fat tissue.
At menopause, hormone levels don't always decline uniformly. They alternately rise and fall again. Changing ovarian hormone levels affect the other glands in the body, which together make up the endocrine system. The endocrine system controls growth, metabolism and reproduction. This system must constantly readjust itself to work effectively. Ovarian hormones also affect all other tissues, including the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, and skin.
Menopause officially occurs after women stop menstruating. By the age of 55, 99% of women reach menopause.
The years prior to menopause are known as perimenopause. This is a time when a woman is still menstruating but may experience some symptoms of menopause. During this time estrogen and progesterone levels begin to decline, so women experience missed cycles and symptoms of menopause/perimenopause.
Both Perimenopause and menopause are typically characterized by hormonal and physical changes often accompanied by emotional and psychological fluctuations. It is important to remember that perimenapuase and menopause are individualized processes that differ for each woman. Symptoms can vary among different women. Some women can have symptoms that last as long as 5 years while some women will only have them for 1 year. Common symptoms include:
Hot flashes, Night Sweats, and Insomnia
These occur in 85% of women. Hot flashes usually last between three and six minutes and may occur several times a day. They can be disabling and physically draining. They can be associated with profuse sweating and can be quite embarrassing. They can also cause insomnia. Hot flashes generally begin suddenly on the chest, neck and face.
Irregular or heavy menstrual periods
Changes in the menstrual flow are common during the climacteric. The most common is a decrease in flow, missed periods and finally no bleeding. However, it is not unusual to see an increasing flow and longer or more frequent periods. Most often episodes of excessive bleeding can be treated with hormones. . Vaginal dryness, itching or infections Vaginal tissues become dryer and thinner. This can result in painful intercourse, urinary tract problems and sagging pelvic organs.
Emotional stress including: Weeping, Mood swings, Irritability, Forgetfulness
While these symptoms are temporary, other changes taking place have more long-term effects.
Long Term Health Risks
Before menopause, estrogen protects a woman against osteoporosis. At menopause, women loose the protective effects of estrogen and the natural process of bone loss speeds up so that bone is lost faster than it is replaced. In osteoporosis, bones become brittle and are easily fractured. It is the cause of the distinctive hump noticed in some elderly women and of dangerous hip fractures - the twelfth leading cause of death in the United States. Osteoporosis affects 50 percent of American women over age 60.
Dr. Freedolph Anderson writes in his book Build Bone Health that yoga and weight training help prevent osteoporosis in the spine. He states " Exercise is perhaps the most important powerful medicine available to us today. It can enhance self- image, alleviate depression and anxiety, and help prevent chronic, degenerative diseases like osteoporosis.
Cardiovascular disease is the leading killer of postmenopausal American women. Before menopause, some studies suggest that estrogen may have a protective effect, helping women maintain a healthy balance between LDL (bad) and HDL (good) cholesterol, making them six times less likely to experience a heart attack than men age 50 and younger. Once a woman passes menopause, the protective effects, if any, of estrogen are lost and a woman's risk begins to approach that of a man's; though the studies are conflicting.
Researchers at Harvard University have reported new evidence that links early menopause and smoking to heart disease. The report is based on the ongoing Nurses Health Study. For the past 18 years scientists have been keeping track of over 35,000 women as they went through menopause. Dr. Frank B. Hu has published their findings in the latest edition of the Archives of Internal Medicine. What Dr. Hu and his associates have discovered is that if a woman smokes and passes through an early menopause
[before age 40] her risk of heart disease increases by over 53%.
In a recent article in the New England Journal of Medicine the authors concluded that a healthy lifestyle with a low-fat diet, moderate exercise for 30 minutes a day, and no smoking puts women at a low risk for heart disease. These are lifestyle changes that all of us can make.
Increased risk for Breast cancer
Not all women were found to be at increased risk, only the postmenopausal women over 55 years old. Dutch researchers lead by Dr. Huibert Burger, at the University Medical Center, Utrecht, Netherlands reviewed over 900 records including over 300 women with breast cancer. Their findings were published in the August 15th issue of the International Journal of Cancer.
The fact is the post-menopausal years if managed properly can be a time of revitalization. Scientific studies show the benefits of hormone replacement therapy but, many women struggle with the decision to take hormones, because although there are many benefits, there are also disturbing drawbacks.
Eat the right diet
Eat organic whenever possible - Dr. Aaron R. Folsom, of the University of Minnesota in Minneapolis studied 36,000 peri and postmenopausal women for 6 years. The study published in the April issue of the American Journal of Clinical Nutrition found that women who had the highest intake of whole grains and fiber had a 21% decreased risk of developing diabetes.
Reduce consumption of fatty foods- Current dietary guidelines from both the American Heart Association and the National Cholesterol Education Program recommend restricting consumption of fat to an upper limit of 30% of daily caloric intake. These diets are effective in lowering blood cholesterol levels and consequently are advocated as the primary dietary strategy for reducing cardiovascular risk. ,
Reduce intake of alcohol- Alcohol has shown to exacerbate menopausal symptoms, especially hot flashes and insomnia.
Eliminate or reduce intake of caffeine- These substances can make symptoms worse and are not good for overall health. Many women say that caffeine in particular makes hot flashes flare. Caffeine also contributes to calcium loss.
Avoid junk food - These foods can make menopause worse. They can weaken the immune system and cause heart disease.
Some of your everyday habits can be harming your health and making menopausal symptoms worse. Here are some lifestyle modification plans
Quit Smoking - In the US, more than 140,000 women die each year from smoking related diseases. In addition to heart disease and cancer, smoking worsens menopausal symptoms and contributed to osteoporosis. Women who smoke typically experience menopause earlier in life than nonsmokers.
Get Physical - This is your key to lifelong optimal health and vitality. It will reduce menopausal symptoms, depression, stress, anxiety, and reduce the risk of osteoporosis. Patients who exercise tend to have fewer problems getting through menopause. The National Institutes of Health recommends light to moderate exercise at least 30 minutes a day.
Herbs can provide powerful support during the pausal transition, because they contain phytoestrogens (Plant Estrogens), which have estrogen-like effects. Phytoestrogens have a normalizing effect. Herbs like black cohosh, Dong quai, Red Clover are traditional remedies for menopause. Many experts say these natural remedies can be safe and effective, in low doses, to lower cholesterol and reduce bone loss, and may protect against cancer. They can also help with cases of estrogen dominance, characterized by fibroids, breast disease and PMS. There is conflicting evidence about whether it is healthy to take high doses of phytoestrogens.
While phytoestrogens mimic estrogens, they are 1/400th as potent as synthetic estrogen. For menopausal symptoms, it was found that phytoestrogen- containing herbs may offer significant advantages over prescribed estrogen. Phytoestrogens, taken in the recommended dose, are not associated with side effects, while estrogen replacement may pose significant health risks, including gallbladder disease, increased risk of cancer and stroke. However, in women with estrogen dependent breast cancer, soy isoflavones are not recommended.
In Germany, 70% of physicians prescribe herbal remedies. The German Health Department's Commission on Herbal Remedies, known as Commission E, has reviewed 315 medical herbs. Two thirds of those reviewed were deemed safe and effective, when used in the amount and manner prescribed.
A Word About Standardization
Most herbs provide the most benefits when they are standardized. These products are made by extracting beneficial constitutes to create a solid extract that can be put into a capsule or tablet. "Standardization ensures that each capsule has the same amount of therapeutic activity" according to Karolyn Gazella.
Since herbs contain many compounds and vary by nature, standardization with markers is important. Through this process, consumers can be assured they are buying a high-quality product that will produce consistent results.
Standardization provides the most potent, consistent health benefits with herbs that have identifiable active compounds. "Accurate measurement of active constituents allows the herbal extract to be duplicated again and again, assuring consistent potency in each batch," says herbalist Dr. James Duke.
Eating soy and soy isoflavones is the most popular way to increase estrogen. Current evidence suggests that Soy has estrogenic properties and can act like hormones to help maintain normal cholesterol levels and reduce the risk of thinning bones in post-menopausal women. Soy is a powerful food, rich in estrogen- like, isoflavones. Isoflavones have been well studied for their beneficial health effects, including the relief of menopausal symptoms. Soy also contains iron, zinc, B vitamins, Vitamin E and EFA.
The scientific community is recognizing the incredible health benefits of soy. Soy has been identified as the chief constitute that may be responsible for providing multiple health benefits including: ameliorating menopausal symptoms such as hot flashes and night sweats; lowering cholesterol; increasing bone density to prevent osteoporosis; They help replace estrogen in menopausal and postmenopausal women; may support a healthy cardiovascular system and prevent breast cancer , that is associated with menopause. Some studies suggest soy may prevent cancers, but the relationship has not been proven and the evidence is conflicting
What is the best form of Soy Isoflavones?
It is important to be aware and knowledgeable about the different soy isoflavones present in products. There are 2 forms of soy isoflavones: Aglycones, (otherwise known as free isoflavones) a term given to a soy isoflavones which don't have a glucose molecule attatched to them; and Glucosides, (otherwise known as bound isoflavones) a term given to soy isoflavones which do have a glucose molecule attached to them. The alycones are more efficiently absorbed and are the form of isoflavones that have been shown to provide the health benefits discussed above.
A soy study enrolled 177 women in 16 centers. All of the women were complaining of at least five hot flashes a day. After 12 weeks on a soy extract containing 50 mg of genistin and 50 mg of daidzin a day, the women reported less severe hot flashes and a dramatic 60% decline in night sweats. Other double blind research has reported significant reduction in the number of hot flashes.
University researchers from Italy and Wales have just published another soy study in the August issue of Obstetrics and Gynecology. They revisited the 104 postmenopausal women in their original study. The women had supplemented their diet with 60 g of soy powder a day and reported a 45% decrease in frequency of hot flashes. This finding along with previous studies showing soy's ability to reduce hot flashes has prompted millions of women to add soy to their diet.
It is interesting to note that Asian women have a much lower rate of heart disease and cancers of the breast and colon. They also have fewer menopausal complaints. Studies have shown that this is mainly because they typically consume much more of the soy-based food than North American women.
A study at Bowman Gray Medical School showed twenty grams of soy a day decreased hot flashes. Compared to a placebo (sugar pill) group, it also lowered both blood pressure and cholesterol. A study at the University of Illinois showed a significant increase in bone density after six months of a high soy diet.
According to registered dietitian Patti Tveit Milligan, MS, RD " In Japan the average person consumes 20 to 100 mg of isoflavones a day from soy foods. It has been suggested that 50 mg daily or more of isoflavones would be prudent to consume through soy foods." She says "The soybean may be small in size but science is confirming that it packs a huge punch when it comes to protecting and enhancing your health". The safe dose for soy has not been established.
Black Cohosh has been studied for the past 50 years, and shown the most promise in controlling the symptoms of menopause. In 1960, Dr. Bruckner, a German physician published a 4-year study involving 517 women who used black cohosh extract to relieve menopausal symptoms. Dr. Bruckner recorded a number of benefits and no side effects. Since then several other studies have confirmed his results demonstrating that Black Cohosh is beneficial for alleviating menopausal mood swings, depression, anxiety fatigues, hot flashes and vaginal dryness and, that it is very safe.
Black Cohosh is fairly well studied in Germany, by the German Commission E (the german council that analyzes herbal medicines) where it is used to treat hot flashes. All studies have shown the clinical value of black cohosh. Experiments have shown that the herb has substances that bind to estrogen receptors in animal models and lower LH (a hormone which is elevated in menopause) in both animals and humans.
Double blind studies support the usefulness of black cohosh for women with hot flashes associated with menopause. A review of eight trials concluded black cohosh to be both safe and effective.
According to Mark Stengler ND author and naturopathic physician "clinical studies involving more than 1,700 patients over a 3-6 month period showed excellent tolerance of black cohosh." "
Chasteberry, a whole fruit, provided as an extract, contains several different components, thought to be medicinally active. Clinical studies over the past 40 years have shown that chastetree berries help balance estrogen and progesterone levels. They do this by influencing the pituitary glands and the hypothalamus, which in turn helps normalize FSH (follicle stimulating hormones) and LH (luteinizing hormones) production causing estrogen to be produced. In addition, chaste tree berries helps control symptoms associated with menopause including hot flashes, dizziness, vaginal dryness and depression. For this reason chastetree berries are one of the most commonly prescribed herbs in Europe for the treatment of perimenopausal and menopausal symptoms.
Czech researchers recently conducted a double blind, placebo controlled clinical trial on vitex. They found that women who took vitex experienced diminished breast pain and that vitex was well tolerated.
Herbalist David Hoffmann reports that the most important use of Chaste Tree in England is for treating menopause symptoms, and that this is the only female health situation in which he uses Chaste Tree by itself. For relieving symptoms such as hot flashes, he claims good results after 2 or 3 months of taking 2 ml of Chaste Tree a day. Side effects associated with chaste tree berries are rare. It is a safe and non-toxic herb when taken at recommended dosages.
Valerian is used extensively in Europe as a mild sleep aid and for nervous tension during menopause. Several clinical studies on humans have shown it to safely relieve occasional insomnia, and improve sleep quality. It can be used to control night sweats that come with menopause.
In one double blind, placebo-controlled, crossover study with 128 volunteers, the effects of a valerian root extract on sleep latency and sleep quality were investigated. For nine nights, 400 mg of valerian extract or placebo were taken in crossover design. Compared to placebo, the extract produced significant improvements in sleep latency and in sleep quality, particularly in relatively poor sleepers.
In another double blind, placebo-controlled randomized study, 27 adult females suffering from insomnia compared a valerian extract preparation with placebo on successive nights. The subjects ingested either 400 mg of valerian or of the placebo each night for two nights. The results were based on a subjective evaluation method using a self-reporting scale. By comparison with placebo, the valerian preparation demonstrated a good and statistically significant effect on poor sleep. In the valerian group, 89% reported improved sleep, 78% rated the valerian preparation better than placebo, and 44% reported perfect sleep. No adverse side effects were reported for either group. And, there appears to be no hangover effect.
St. John's Wort
The efficacy of St. John's Wort in mild to moderate depression is of interest to many perimenopausal women. In Germany it was approved for the treatment of mild depression. Dr. Barak Gaster lead a group of researchers from the Department of Medicine at the University of Washington in Seattle, in reviewing all of the scientific studies on St. John's Wort and depression, conducted over the past 18 years. They were of high quality, randomized, controlled and double blind. Overall, the response rate of those treated was from 23% to 55% higher than those on a placebo. The results agree with a meta-analysis published by Dr. Linde in Great Britain in 1996. Dr. Linde found depressed patients were 2.67 times more likely to respond to St. John's Wort than to placebo.
Dong Quai (Angelica sinensis), often referred to as the "female ginseng" helps promote normal hormone balance and is particularly useful for women experiencing premenstrual cramping and pain. It contains phytoestrogens , or plant estrogens which are shown to be helpful in the treatment of female problems such as hot flashes, menopause, PMS, and vaginal dryness. , It may also help regulate hormonal shifts and regularize the menstrual cycle
Vitamin E is an antioxidant. Can it prevent hot flashes? There were studies done in the late 1940's showing it can help relieve hot flashes and postmenopausal vaginal dryness. Another new double blind, placebo controlled study done in New York on vitamin E therapy for hot flashes in breast cancer survivors proved this too. The study used 800 IU a day for 4 weeks. The results showed that vitamin E reduced hot flashes by 25% while the placebo reduced hot flashes by 22%. Vitamin E was more effective than placebo.
There are other benefits as well. We know from the Nurses Health Study that women who took vitamin E over a two-year period reduced their risk of fatal heart attacks by 40%. Vitamin E is also being studied for its effect on Alzheimer's disease and cancer. Combining vitamin E with other antioxidants such as selenium, chromium, beta-carotene, and vitamin C may offer a synergistic effect. That means they work better together than separate.
Boron is a trace mineral, now considered to be essential to human health. But many Americans may not be getting enough in their diets. Boron is necessary for the prevention of postmenopausal osteoporosis. It probably does this by activating vitamin D and estrogen. One study showed that postmenopausal women who took 3 mg of boron a day decreased the amount of calcium lost in their urine and increased their estrogen levels. It is recommended to take 3-9 mg a day.
Calcium supplementation is generally recommended to help prevent osteoporosis in postmenopausal women. Several studies have shown that calcium supplementation can help slow down bone loss but does not prevent it. In osteoporosis, calcium does not replace the bone loss, which has already occurred. Women who are taking estrogen for osteoporosis should also be taking calcium.
Another study showed daily supplementation of the diet with calcium may reduce the risk of bone fractures. According to researchers from Tuffs University in Boston 389 women over the age of 65 took 500 mg. of calcium at bedtime for three years. These women were compared to a similar group who did not take the supplements. After three years the group that took the vitamin and mineral supplement had a fracture rate of 5.9% compared to a 12.9% fracture rate for the group that did not take the supplements. Calcium is a widely available, safe and inexpensive way to help protect your bones.
Vitamin D deficiency is more common than previously thought. Each year in the US, hip fracture results in approximately 300,000 hospital admissions. Close to 40% of all women will suffer some type of fracture after age 50. Most of these fractures result from osteoporosis among women who experience accelerated bone loss after menopause.
The Journal of the American Medical Association reports on a striking new study. The study was conducted at Brigham and Women's Hospital in Boston on 98 postmenopausal women who were to undergo hip replacement. Of the 98 admitted 30 had just fractured their hip. The other 68 did not have a fracture, they needed a hip replacement for other reasons. What they found was the women with the fractures had significantly lower vitamin D levels than the women without the fractures. They concluded that "Correction of vitamin D deficiency...may lead to a reduction in the exponential rise of fractures that occur with age."
For more information on our menopausal products click below:
Womax - A safe and natural alternative to hormone replacement therapy
Maxi Soy Supreme - Super soy isoflavones (40% isoflavone glucosides)
Maxi Vitex - Chaste tree berry formula
Black Cohosh and Dond Quai - Alcohol free, liquid extract, herbal combination