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MENOPAUSE:
Easing The Transition
by Eva Urbaniak, N.D.
Menopause is a natural phenomenon among women. Just as menarche signals the beginning of ovulation and menses in young women, menopause represents the cessation of these hormonally regulated activities. The period of time from when the hormone levels start decreasing through menopause and after is called the climacteric period. Menopause is the actual event of the ovaries ceasing their monthly function, with consequent cessation of menstruation. What menopause is NOT is a disease condition requiring "correction" by pharmaceuticals!!!

The menopausal period affects each woman differently, but most experience the change at around fifty years of age. Some women have no symptoms, some have mild symptoms, and others are affected more deeply. Going through menopause can take up to five years and although estrogen levels do drop during the post-menopausal period, the hormone does not ever disappear altogether. The adrenal glands, fat cells, and other cells in the body take over production of estrogen as the ovaries slow down and finally stop production.

As researchers continue to study the human body, its physiology and biochemistry, one thing continues to challenge science, and that is the complexity of the human being. Menopause can create many complex changes in a woman's body, impacting many systems in the body such as the digestive, definitely the endocrine, including thyroid, adrenals, pituitary and hypothalamus, and the cardiovascular and neurological/emotional, but again, it is a natural process, one which women went through for thousands of years without any "help" from the pharmaceutical companies. Native American women especially bore knowledge of herbs, which nourished them and eased childbirth and their transition through menopause.
Allopathic medicine, with its primary focus on treating symptoms, offers estrogen replacement therapy, or hormone replacement therapy, recently given the more friendly (?) designation of HRT. And, in fact, the concept of replacing something that is waning or lacking altogether does make sense, BUT it is not that simple.

Premarin, the primary drug prescribed by doctors is HORSE ESTROGEN. The word "Premarin" is an acronym derived from pregnant mare's urine. Besides the subtle and not so subtle variations among species and their byproducts, estrogen therapy has significant risks, which are often downplayed by doctors. There is increased risk of several types of cancer; breast, endometrial, and cervical, and a significant risk of thrombosis, or blood clots. Some doctors are putting postmenopausal women on the birth control pill, which causes many additional problems, such as resumption of monthly bleeding, bleeding and spotting throughout the artificially induced cycle, vitamin deficiencies, and all the other side-effects of the birth control pill. These are synthetically produced hormones and their action in the body is unpredictable. The reasoning behind putting women on the pill who have already gone through menopause is that recent studies have shown that progesterone seems to play a more important role in preventing osteoporosis, but the pill contains the synthetic progestin. Synthetic progesterone has many side effects ranging from depression, weight gain, water retention, high blood pressure, thyroid dysfunction, headaches, asthma and thrombosis! Women beware!! Beware of three page drug ads promising the "cure" for osteoporosis. Many of these new drugs have not been tested in long-range studies and they can suppress vital functions of the skeletal system. Many women are frustrated by the treatment they get at their doctor's offices because their options are so limited. The choices seem to be pharmaceutical hormonal therapy, and when the complications of such therapy, such as abnormal bleeding and hemorrhaging, tumor development, or cancer develop, of course, hysterectomy with continued hormone replacement seem to be the only avenue left. This is just one of many illustrations of what has gone wrong in medicine today.

Estradiol, or E2, and in the case of Premarin, horse estradiol, is the strongest form of estrogen. In fact, the ovaries actually secrete this extra strong form of estrogen every month at ovulation time to create the most fertile environment for a potential fertilized egg. Mucus changes, the endometrium (the inner lining of the uterus) thickens, and the liver is employed to conjugate or clear this stronger form into a form 80% milder called Estriol or E3. There is a special subset of women; women who have had only their ovaries removed, and women who have gone through chemotherapy for breast cancer or other cancers and gone through "chemical" menopause, who may be candidates for some short term hormone replacement therapy to help their bodies get through the shock of having ovarian function suddenly cease. But even in their cases, the milder form, Estriol, would be preferred. Also, if the cancer for which they were treated happens to be estrogen sensitive, no HRT should be undertaken whatsoever.

In fact, the drug Tamoxifen, which has been around long enough to have had studies performed and statistics well-documented, can be helpful in cases where estrogen production is still excessive, and continues to feed a cancerous condition.
Most recently, the myth that estrogen HRT can prevent cardiovascular disease, as was previously suggested, was debunked by doctors themselves performing a study on menopausal women. In fact, the study was halted, when several of the women participating died from cardiovascular accidents. Recently, also, a special alert was sent to all practicing pharmacists and most doctors from the Wyeth pharmaceutical company, makers of Premarin, Prempro, and other hormonal medications, WARNING that treatment with these hormones should be limited to short duration, that women taking them should be closely monitored, and that prolonged use is NOT RECOMMENDED!

ALTERNATIVES
The good news is that there are natural substances and a variety of products made from these substances on the market and available through your naturopathic physician or informed holistic medical doctor that are safe, non-toxic, and every bit as or more effective than HRT. There are even foods which can enhance estrogen-like activity.

First of all, soy beans and soy products like tofu, soy milk, and soy cheeses all possess analogs of estrogen in their chemical makeup. Some other foods which can support the changing needs of women going through menopause are blackstrap molasses for minerals, kelp for proper thyroid function, broccoli for fiber and vitamins and minerals, dandelion greens in salads for liver support and as a mild diuretic, and canned salmon and sardines for calcium. If hot flashes are a particular problem, limit dairy and meat (unless it is certified organically grown), because synthetic hormones are often fed to cattle and can affect the delicate hormonal balance in humans. Refined sugar has also been implicated in contributing to hot flashes.

Specific nutrients that may be included in the diet are:

Bitters, enzymes, or hydrochloric acid aid digestion.
Lecithin aids absorption of Vitamin E and has the ability to "move fat" because of its phospholipid properties.
Essential Fatty Acids in the form of Evening Primrose Oil, Borage Oil, or Black Currant Oil have a sedative and diuretic effect, are good for hot flashes, help in the production of hormones, and promote healthy skin.
B-Complex vitamins with the assurance of at least 50 mg. of B-6 (for water retention) and at least 100 mg. of B-5 (a powerful anti-stress vitamin, supports the adrenal glands)
Vitamin E, from 400 to 1600 IUs for hot flashes and healthy skin, heart, and reproductive tissues. If necessary to increase, do so slowly.
Calcium/Magnesium/Zinc multi-mineral supplement. Best to find equal parts calcium to magnesium 1000 mgs minimum daily, to prevent osteoporosis. Some supplements also contain Boron, which has been shown to play a role in the prevention of osteoporosis.
Selenium from 200-600 mcg per day also ensures support to the reproductive system.
Vitamin C - 1 to 3 grams daily
For special needs, glandulars prescribed by your naturopathic physician can also be of great help in supporting specific tissues and organs. Note: Strict vegans would have to find alternatives to glandulars since they are of animal origin.

  • Some of my favorite herbs to blend for a variety of menopausal complaints are as follows:
    1) ALFALFA. This herb is probably one of the most potent "phytoestrogens" in the plant world. Phytoestrogen means a plant having similar action to estrogen. In the case of alfalfa, it is the perfect herb. If a woman has too much estrogen, a condition that predisposes to fibroids, heavier bleeding, sore breasts, etc., the alfalfa binds to the estrogen receptors of the cells and prevents the actual estrogen from binding. In the case of menopause, where less estrogen is the case, it binds to the cell's receptors and mimics estrogen. It is also very nutritive, rich in trace minerals, therefore aiding in prevention of osteoporosis. It is a hormone balancer and blood purifier and there is no toxicity associated with its use.
    2) BLACK COHOSH. Also a phytoestrogen, a nerve, muscle and pain sedative, and ovarian normalizer.
    3) CHASTE TREE. Also called Monk's pepper or Vitex Agnus Castus. A menstrual regulator, pituitary normalizer, aphro or anaphrodisiac properties, whichever is appropriate. (Some herbs have a curious normalizing property; in the case of menopause-induced lack of interest in sex this herb can restore sex drive.)
    4) FALSE UNICORN ROOT. A uterine tonic and adaptogenic to the ovaries.
    5) LADY'S MANTLE. Uterine tonic, astringent, anti-hemorrhagic and anti-inflammatory.
    6) LICORICE. Anti-inflammatory, demulcent, adrenal agent, sex hormone precursor. Caution should be taken if high blood pressure is present, as licorice can raise blood pressure even higher.
    7) WILD YAM ROOT. Contains phytosterols, steroidal saponins, and is a progesterone balancer.
    8) SQUAW VINE. Uterine tonic, reproductive tonic, stops heavy bleeding.
    9) RED RASPBERRY LEAF. Astringent, uterine tonic, strengthens muscular layer of the uterus, good for menstrual difficulties.
    10) DONG QUAI. Added to many Chinese medicines as a carrier for other herbs. It is a female hormone balancer, can relieve hot flashes, combined with Ginseng and Gotu Kola, can relieve depression.
    11) DAMIANA. Nerve tonic, antidepressant, aphrodisiac, some testosterone-like activity.
    12) OAT STRAW. Rich in calcium, steroidal saponins, and vitamin B. It is a nerve tonic, antidepressant, and nourishes the nervous system. (There are some products on the market today claiming to stimulate sex drive in women who are over-worked and the main ingredient in such products is oat straw.) This herb can also be eaten as food in the form of porridge or gruel, but the tea made from the straw is very effective. Some other actions of oat straw are anti-inflammatory for aching joints and muscles.

There are also transdermal skin creams available for women who wish to have a little more control over their dosage of estrogenic and progesteronic substances. This is in contrast to the patch, which continuously sends estrogen into the body. Some of the creams can be applied directly to the area needing the estrogen as in the case of vaginal dryness. These creams are made from plant substances as mentioned above, and some have natural progesterone added for an enhanced effect. Your naturopathic physician can tailor-make any number of herbal preparations specially formulated for specific symptoms. For example, if heart palpitations are a problem, an herb like Motherwort can be added to a formula to address this. Also, homeopathic medicine can help alleviate problems.

Another word about hot flashes and night sweats.... Sometimes they are just inevitable and can be very annoying. Some suggestions for dealing with them are:

  • Investing in an oscillating fan to be kept next to the bed, and/or keeping a handy portable mini-fan in your purse. I have even seen mini-fans on a string, which can be worn around your neck and turned on as needed.
  • Drinking at least eight 8-oz. glasses of water per day, and adding a little ice to your water can be helpful in bringing the heat down faster
  • Eating plenty of fruits and vegetables, and avoiding sugary snacks, alcohol, and coffee, all of which can bring on a hot flash.
    Menopause can be a great blessing in a woman's life. It can be a liberating experience, an initiation into a new phase; sexual feedom without worry of pregnancy; sometimes the children are grown and on their own, a chance to embrace change and have satisfaction in life. Unfortunately, there has been considerable negative programming of women regarding menopause and this magical time in a woman's life is still looked upon with dread by many women. If women are to enter this phase of their lives as whole and beautiful beings, some light on the subject of how to deal with the changes of menopause in a natural, non-toxic, non-invasive and supportive way seems to be a good first step.

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