| 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.
Perimenopause
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.
Common Symptoms
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.
Headaches
Itchy skin
Incontinence
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
Osteoporosis
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.
Heart disease
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.
Treatments
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.
Lifestyle tips
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.
Herbal Remedies
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.
Soy Isoflavones
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
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/Vitex
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 Root
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
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
Nutritional Supplements
Vitamin E
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
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
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
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
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