Menopause

Menopause, the time in a woman’s life when menstruation ends, is a normal
and natural stage of life usually occurring around age 50. Over the
next two decades, 40 million American women will experience this important
change of life, and by the year 2020, 60 million will be at or through
menopause. While this transition can be a pleasant experience
for some women, many unfortunately experience significant discomfort.
Symptoms can include hot flashes, night sweats, sleep disturbance, depression,
mood swings, decreased libido, and vaginal dryness. The most common
of these complaints, hot flashes, affects 75% of women passing through
menopause and lasts for an average of about 2 years.

The first few years of menopause are also associated with a temporary
period of increased bone loss because the body is making less of the hormones
estrogen and progesterone, which puts women at risk for osteoporosis.
Fortunately, there are a number of natural remedies that can significantly
reduce or eliminate the symptoms of menopause, some of which also reduce
the risk of developing osteoporosis and other age-related diseases such
as heart disease.

The standard medical therapy of menopause usually consists of hormone
replacement therapy (HRT), which is a combination of estrogens and a progestin
(a synthetic substance with progesterone like effects). HRT unquestionably
relieves many menopausal complaints such as hot flashes and vaginal dryness.
It also decreases the risk for osteoporosis related hip fractures. These
benefits, however, do not come without a price. Hormone replacement
therapy is associated with a number of severe side effects including depression,
breast tenderness, weight gain, and an increased risk for breast cancer,
stroke, heart attack, and gall bladder disease. It also promotes
the formation of blood clots in smokers.

While commonly prescribed progestins such as Provera act similarly to
progesterone in the body, they are chemically different. Natural
progesterone, in contrast to synthetic progestins, is identical to the
body’s own progesterone and is relatively free of side effects. It
is usually derived from the wild yam or the soy bean, although it is not
naturally found in either of these plants.

In a study performed by Dr. John Lee, natural progesterone was found
to reverse bone loss. Dr. Lee, who has pioneered the use of natural
progesterone, found that his patients experienced a 5-10% increase in bone
mineral density after one year of supplementation. At the end of
the three year study, the average increase in bone density was 15.4%, and
none of the subjects experienced a loss of bone density. This is
in sharp contrast to the 4-5% loss of bone density that would have been
expected over three years without hormonal treatment.

In addition to osteoporosis prevention and reversal, natural progesterone
can also help relieve some of the symptoms of menopause such as hot flashes.

Many plants also contain compounds, known as phytoestrogens, that have
estrogen like effects in the body. These phytoestrogens, however,
tend to balance the female hormones rather than directly stimulate estrogen
or progesterone. They also have a tonifying and nourishing effect
on the female reproductive and glandular systems, and are useful in the
treatment of a wide variety of female conditions. While most phytoestrogens
don’t appear to modify the risk of developing osteoporosis, they do offer
relief from hot flashes and other menopausal complaints without the significant
side effects associated with estrogen usage. Examples of some plants
that contain phytoestrogens include soy, alfalfa, fennel, licorice root,
dong quai, black cohosh, and chaste berries. Some of these merit
specific mention.

Soy, which has a long history of use in Asian cuisine, has recently been
the focus of a significant amount of research. It is particularly
rich in phytoestrogens, and is thought to be the reason that Japanese women
living in Japan rarely experience the unpleasant symptoms of menopause.
In fact, hot flashes are so rare in Japan that there is not even a word
in the Japanese language to describe them. Besides alleviating many
of the complaints of menopause, the consumption of soy has been associated
with a reduced risk of developing a variety of cancers including breast
cancer. It may also reduce the risk of developing heart disease and
osteoporosis.

Black cohosh is a plant containing potent phytoestrogens originally used
by the American Indians, and now used extensively in Germany. Since
1956, over 1.5 million women in Germany have used an extract of black cohosh
to treat menopausal complaints with great success and without side effects.
It has been compared to estrogen replacement therapy in several controlled
trials and has been found to be equal to or better than estrogen in relieving
menopausal complaints. Clinical studies have shown its effectiveness
in alleviating not only hot flashes, but also depression and vaginal atrophy.

There are several nutritional supplements which are effective in relieving
hot flashes, including vitamin E, hesperidin, and vitamin C. Vitamin
E, which was studied primarily in the 1940’s, was found to relieve not
only hot flashes, but also menopausal vaginal complaints. Vitamin
C and hesperidin (a bioflavonoid found in citrus fruits) were shown in
one study to relieve menopausal symptoms in 53% of the subjects and reduce
them in an additional 34% when used in combination.

Exercise is another important part of a holistic approach to the management
of menopause. Beyond relieving hot flashes, with as little as 3-5
hours per week exercise can reduce the risk of developing heart disease,
diabetes, cancer, and many other diseases.

The decision as to which of the above natural remedies is appropriate
for an individual should factor in the symptoms a woman is experiencing
as well as her individual risk for developing osteoporosis, heart disease,
and breast cancer, among others. For this reason, it is a choice
best made with the assistance of a qualified medical professional such
as a naturopathic
physician.