Menopause denotes the cessation of menstruation for at least 6 – 12 months. It usually occurs when a woman reaches the age of 50. Cigarette smoking significantly increases the risk of an early menopause, approximately doubling the risk of occurrence to take place between the ages of 44 and 55.
Did you know…
In western society menopause is viewed as a deficiency disease. It is focused on as a physiological disorder, but it is much more than simply a biological event. Studies of menopausal women in many traditional cultures demonstrate that most will pass through menopause without hot flashes, vaginities, and other symptoms common to menopausal women in developed countries. The cultural view of menopause is directly related to the symptoms of menopause. Those who see it as a positive event that would provide them with acceptance as a respected elder as well as relief from child-bearing have no symptoms.
Causes of Menopause
Many years before a woman stops menses, her ovaries slow their production of the hormones estrogen, progesterone, and testosterone. Cells in the vagina, bladder, breasts, skin, bones, arteries, heart, liver and brain all contain estrogen receptors, and require this hormone to stimulate these receptors for normal cell function.
Menopause is thought to occur when there are no longer any eggs left in the ovaries. The absence of active follicles results in reduced production of estrogen and progesterone levels. In response to this drop in estrogen, the pituitary increases secretion of the hormones FSH and LH which cause the ovaries as well as the adrenal glands to secrete increased amounts of androgens which can be converted to estrogens by the fat cells of the hips and thighs. But the total estrogen levels are still far below the levels in women with reproductive function. A blood test to determine the level of a hormone called follicle-stimulating hormone (FSH) is helpful in determining whether you are experiencing perimenopause. FSH levels increase as estrogen diminishes.
Symptoms
In many cultures of the world most women do not experience the symptoms associated with menopause. This observation raises some interesting questions about menopause being a socio-cultural event.
The most common complaints of menopause are:
· Hot flashes: A rise in skin temperature lasting up to 2 minutes with cold chills thereafter. The most common symptom occurring in 65 – 80% of perimenopausal women.
· Headaches
· Atrophic vaginitis: Thinning and drying of the vaginal lining due to the lack of estrogen. Women should avoid antihistamines, alcohol, caffeine and diuretics.
· Frequent urinary tract infections: Occurs in 15% of perimenopausal women, due to a breakdown in the natural defense mechanisms which protect against bacterial growth in the urinary tract.
· Cold hands and feet: There are three major causes – hypothyroidism, low iron levels in the body and poor circulation.
· Forgetfulness and the inability to concentrate: Is a result of decreased oxygen and nutrient supply to the brain. The goal is to improve the supply of blood, oxygen and nutrients to the brain. This might be what you notice first. Your period may no longer be regular.
Possible Changes In Menstrual Flow:
How much you bleed could change. It could be lighter than normal. Or, you could have a heavier flow. Periods may be shorter or last longer. These are all normal results of changes in your reproductive system as you grow older. But, just to make sure there isn’t a problem, see your doctor if:
Your periods are coming very close together.
You have heavy bleeding.
You have spotting.
Your periods are lasting more than a week.
Hormone Replacement Therapy
Is it necessary?
There are three main hormones involved in menopause: estrogen, progesterone and testosterone. Estrogen is needed to keep the skin smooth and moist, and the body’s internal thermostat operating properly. It is also necessary for proper bone formation. Progesterone has a calming effect on the brain and appears to affect other aspects of nervous system function as well. Testosterone is the hormone that is most important for sex drive.
One of the Current treatments of menopause primarily involves hormone replacement therapy (HRT), in which a combination of estrogen and progesterone are supplemented. The benefits of HRT are relief of hot flashes and other menopausal symptoms, and a significant reduction in osteoporosis. It may offer some protection against heart disease and strokes. The use of short-term (less than 6 months) HRT for menopausal symptoms only provides temporary relief. It’s not a permanent cure.
Estrogen replacement therapy is associated with 4 to 13 times increased risk of developing endometrial cancer. To combat this link physicians began recommending that estrogen be combined with progesterone. If a woman is at risk for or has a disease aggravated by estrogen, such as breast cancer, active liver disease and certain cardiovascular diseases, then progesterone alone should be used. Until the risk of breast cancer is cleared up, it can be concluded that well-intentioned physicians and their female patients are probably better off avoiding HRT.
Recommendations
Rather than use estrogens to artificially counteract the symptoms of menopause, the natural approach focuses on improving physiology. This improvement can be accomplished through diet, exercise, nutritional supplementation and the use of botanical medicines.
The goal is to improve the supply of blood, oxygen and nutrients to the brain. This might be what you notice first. Your period may no longer be regular. Diet, exercise and lifestyle factors have been shown to offer identical benefits without the risks of HRT
Diet
It is recommended to increase the amount of plant foods while reducing the amount of animal foods in the diet.
Increase the intake of phytoestrogen-containing foods such as: fennel, fermented soy, nuts, whole grains, apples, alfalfa, celery and parsley. A high intake of phytoetrogesn is thought to explain why hot flashes and other menopausal symptoms rarely occur in cultures consuming a predominantly plant-based diet.
Increase the intake of fermented soy. Fermented soy aids in the relief of atrophic vaginitis and prevention of breast cancer. It also protects LDL cholesterol from oxidation, an effect of great significance for the prevention of cardiovascular disease.
Decrease the intake of dietary saturated fat. There is a positive correlation between breast cancer risk and saturated fat intake in postmenopausal women.
Exercise
Facilitate a regular exercise program. Do weight-bearing exercise, such as walking, jogging, or dancing, at least 30 minutes at least 3 days each week for healthy bones. Try to be physically active in other ways for your general health.
There are numerous benefits of exercise:
Relief from hot flashes.
Decreased bone loss.
Improved heart function.
Improved circulation.
Reduced blood pressure.
Decreased blood cholesterol levels.
Improved ability to deal with stress.
Improved oxygen and nutrient utilization n all tissues.
Increased self-esteem, mood, and frame of mind
Increased endurance and energy levels.
Supplements
Supplements that treat hot flashes:
Vitamin E: Also effective in relieving menopausal vaginal complaints. Take 800 IU/day until symptoms have improved, then 400 IU/day.
Hesperidin: 900 mg/day
Vitamin C: 1,200 mg/day
Gamma-oryzanol (ferulic acid): A growth-promoting substance found in grains. Take 300 mg/day.
Botanical Supplemants:
· Dong Quai: Used for menopausal symptoms, especially hot flashes.
· Licorice root: Lowers estrogen while simultaneously raising progesterone
levels.
· Black cohosh: Relieves hot flashes, depression and vaginal atrophy.
· Ginkgo biloba: Effective in improving cold hands and feet, and the forgetfulness which often accompany menopause.
How to Handle Hot Flashes
Try to keep track of when hot flashes happen—a diary can help. You might be able to use this information to find out what triggers your flashes and then avoid it.
When a hot flash starts, go somewhere cool.
If night sweats wake you, try sleeping in a cool room or with a fan on.
Dress in layers that you can take off if you get too warm.
Use sheets and clothing that let your skin “breathe.”
Have a cold drink (water or juice) when a flash is starting.
Baseline evaluations
With so many changes going on in your body before, during and after menopause it is recommended to get a baseline evaluation from your doctor. The baseline evaluation of should include:
Detailed personal and family medical history.
Breast examination and instructions on self-examination of the breasts.
Pelvic examination.
Laboratory tests: complete bloodcount, blood chemistry panel and cholesterol evaluation.
Thyroid function panel
Baseline Thermogram
Baseline bone-densitometry
After this initial evaluation, these tests should be repeated every year. The bone density studies can be used a sa gauge to whether HRT is necessary.
References
1. Prescription for Nutritional Healing, Phyllis Balch, CNC, 2006, pgs.565-570
2. Pizzorno & Murray, Textbook of Natural Medicine, pgs. 1387 – 1396
3. www.nlm.nih.gov/medlineplus/menopause.html
“The nutritional suggestions in this material are not offered to treat, mitigate or cure disease, and should not be used as a substitute for sound medical advice. This information is designed to be used in conjunction with the services of a trained, licensed healthcare practitioner.”
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