Natural Solutions to Treating Menopause
By Suzanne Tang, N.D., L.Ac.
Menopause is the cessation of menstruation in women, which commonly occurs from the late forties to early fifties. Menopause is diagnosed when women are without a menstrual period for six to twelve months. Menopause is a natural transition in which many hormonal changes occur, particularly a drop in estrogen and progesterone and an increase in follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Some women experience hot flashes, night sweats, insomnia, palpitations, depression, anxiety, loss of memory, poor concentration, vaginal dryness, headaches, and decreased sex drive.
However, in many cultures of the world, most women do not experience symptoms of menopause. Important cultural, dietary, and environmental factors likely play a role. Women in menopause are at greater risk for developing osteoporosis and heart disease. Consulting with a naturopathic doctor or medical practitioner is recommended to appropriately screen for osteoporosis and heart disease, and learn preventative measures to address these conditions.
Many physicians used to believe that HRT might be beneficial for reducing the risk of heart disease and bone fractures caused by osteoporosis (thinning of the bones). In addition to treating menopausal symptoms, in the past, most woman experiencing menopause were placed on synthetic hormone replacement therapy (HRT) indefinitely. The results of a new study, called the Women’s Health Initiative (WHI), has led physicians to revise their recommendations regarding HRT.
Started in 1993, the WHI study has enrolled 161,809 women between the ages of 50-79 in 40 different medical centers. The study was intended to examine the health benefits and the risks of hormone replacement therapy, including the risks of breast cancer, heart attacks, strokes, and blood clots. In July 2002, one component of the WHI, which studied the use of estrogen and progestin in women who had a uterus, was stopped early because health risks exceeded the health benefits. The group using estrogen and progestin had a 26% increase in breast cancer.
In March 2004, a second component of the WHI, which studied estrogen-only therapy in women who no longer have a uterus, was stopped early primarily because of an increase in the risk for strokes. Furthermore, this study refutes the thought that HRT helped reduce the risk of heart disease. In fact, the number of heart attacks actually increased 29% among women taking estrogen and progestin. The WHI study also confirmed an increase in the number of blood clots in women taking estrogen/progestin.
The WHI study did show the benefits of HRT for preventing and treating osteoporosis and menopausal symptoms. Women taking HRT had 34% fewer hip fractures and 24% fewer fractures than women not receiving hormones. Most women did experience relief from the hot flashes, sleep difficulties, and vaginal dryness within a few weeks of taking HRT. However the benefits of HRT do not outweigh the potentially-fatal risk of developing coronary heart disease, stroke, blood clots, and breast cancer.
Naturopathic medicine, acupuncture, and Chinese medicine can offer natural solutions to treating menopause with less risk of adverse effects. This may include a comprehensive approach that reviews each woman’s risk for heart disease, osteoporosis, cancer, and Alzheimer’s disease and provides a holistic treatment plan such as healthy diet and lifestyle changes, nutrient therapy, and botanical medicine.
To prevent osteoporosis and heart disease, eating a whole- foods, nutrient-dense diet rich in vegetables, fruit, whole grains, beans, seeds, and nuts, high in fiber and low in animal fat is recommended. Foods rich in calcium such as green leafy vegetables, beans, almonds, tofu, and skim dairy products should be emphasized. Bone loss can also be prevented with proper supplementation of calcium, vitamin D, and other important minerals, such as boron and manganese.
Engaging in aerobic physical activity and exercise is also important, not only for preventing heart disease, but also for treating menopausal symptoms. Sedentary women are more likely to have moderate or severe hot flashes compared with women who exercise.1, 2 In one trial, menopausal symptoms were reduced immediately after aerobic exercise.3 Performing weight-bearing exercises, such as walking, hiking, dancing, tennis, and weight-lifting at least three times per week is also critical for preventing osteoporosis.
Some evidence suggests that Vitamin C and bioflavenoids can help relieve menopausal hot flashes. One study found that vitamin C and hesperidin relieved the symptoms of hot flashes in 53% of the women in four weeks.4
Black cohosh (Cimicifuga racemosa) has been shown to be both safe and effective for treating menopausal symptoms. Double-blind trials support the usefulness of black cohosh for women with hot flashes associated with menopause.5 Clinically Chinese herbal formulas have shown to be very effective in reducing menopausal hot flashes and night sweats. In a double-blind trial, a formula containing tinctures of licorice, burdock, dong quai, wild yam, and motherwort was found to reduce symptoms of menopause.6
Natural hormones, unlike synthetic hormones are plant-based, have less side effects, and contain less chemical additives. A double-blind trial found that topical administration of natural progesterone cream led to a reduction in hot flashes in 83% of women, compared with improvement in only 19% of those given placebo.7 Preliminary research has found that oral, micronized progesterone therapy is associated with improved quality of life among postmenopausal women.
However, oral micronized progesterone is available only by prescription in the United States.8 Please consult with a naturopathic doctor to discuss whether you would be a good candidate for natural hormone replacement therapy. Hot flashes, anxiety, depression, sleep problems, and sexual functioning were among symptoms improved in a majority of women surveyed.
Acupuncture may be helpful in the treatment of menopausal symptoms. Animal research suggests that acupuncture may help normalize some biochemical changes associated with menopausal disturbances of memory, mood, and other functions.9 One preliminary trial in humans demonstrated a significant reduction (more than 50%) in hot flashes in menopausal women receiving either electroacupuncture (acupuncture with electrical stimulation) or superficial acupuncture (shallow needle insertion).10
Transitioning into menopause can be an enjoyable experience in which women can become more aware and in tune with their bodies and emotions, and feel empowered to make wise, healthy lifestyle changes.
1. Ivarsson T, Spetz AC, Hammar M. Physical exercise and vasomotor symptoms in postmenopausal women. Mauritas 1998;29:139-46.
2. Hammar M, Berg G, Lindgren R. Does physical exercise influence the frequency of postmenopausal hot flushes? Acta Obstet Gynecol Scand 1990;69:409-12.
3. Slaven L, Lee C. Mood and symptom reporting among middle-aged women: the relationship between menopausal status, hormone replacement therapy, and exercise participation. Health Psychol 1997;16:203.
4. Smith C. “Non-hormonal control of vaso-motor flushing in menopausal patients.” Chic Med 1964; 67:193-95.
5. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecological disorders. Advances Therapy 1998;15:45-53.
6. 11. Hudson TS, Standish L, Breed C, et al. Clinical and endocrinological effects of a menopausal botanical formula. J Naturopathic Med 1997;7(1):73-7.
7. Leonetti HB, Long S, Anasti JM. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol 1999;94:225-8.
8. Fitzpatrick LA, Pace C, Wiita B. Comparison of regimens containing oral micronized progesterone or medroxyprogesterone acetate on quality of life in postmenopausal women: a cross-sectional survey. J Women’s Health Gender-Based Med 2000;9:381-7
9. Toriizuka K, Okumura M, Iijima K, et al. Acupuncture inhibits the decrease in brain catecholamine contents and the impairment of passive avoidance task in ovariectomized mice. Acupunct Electrother Res 1999;24:45-57.
10. Wyon Y, Lindgren R, Hammar M, Lunde-berg T. Acupuncture against climacteric disorders? Lower number of symptoms after menopause. Lakartidningen 1994;91:2318-22 [in Swedish].
Dr. Suzanne Tang is a board-certified naturopathic doctor and licensed acupuncturist in private practice at Achieve Health Center in Newport Beach, CA. She is dedicated to offering her patients compassionate, comprehensive natural medical care. Her spec-ialties include women’s health, pediatrics, cardiovascular health, and gastroenterology. She may be reached at (949) 706-2300 for questions or appointments. For further information, please visit www.AchieveHealthCenter.com
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