Natural Treatment For Menopause

“Rather than use estrogens to artificially counteract the symptoms of
menopause, the natural approach focuses on improving physiology through diet, exercise, nutritional supplementation, and the use of botanical medicines.”

     ~ Michael T. Murray, ND,
     & Joseph Pizzorno, ND –
     The Encyclopedia of
     Natural Medicine (3rd Ed.2012)

Are you over age 40 and noticing that your body has been changing? Are you confused about how to address those changes? No two women experience menopause in exactly the same way, and very often other health issues are present that can complicate treatment. If you prefer to rely on holistic means of addressing your body’s natural signs of aging, the information below can help you start moving in the right direction.

What is Menopause?
Menopause is a normal physiological process that can be narrowly defined as the cessation of menstruation for 6-12 months. On average, it sets in around age 51, but can also occur as early as age 40. Perimenopause, the time before menopause defined as the shortening of the menstrual cycle, can produce various symptoms for as many as 10-12 years, but more commonly for 4-7 years.

Declining gland function (hypothalamus, pituitary, adrenal, thyroid, and ovary) is viewed as the root cause of peri/menopause. Genetics, age, diet, lifestyle, and environmental factors also contribute to onset. Menopause generally occurs when the ovaries no longer produce viable eggs, and the absence of active follicles (the cellular housing of the eggs) causes reduced production of estrogen and progesterone. Menstruation ceases when the reduction in estrogen production stops thickening the uterus lining. Estrogen levels drop 40-60% (the ovaries, adrenal glands, and body fat continue to make it), but progesterone levels can drop to near zero in some women. Surgical removal of the ovaries, or uterus and cervix (hysterectomy), along with chemotherapy and drugs designed to shut down ovarian estrogen production, can also induce menopause.

Menopause Symptoms
Every woman’s menopause transition is unique, and some have minimal-to-no symptoms. Within the first 4 years, however, roughly 75% of women can experience, with varying degree and frequency, various physical, mental, and emotional symptoms, including: (1) irregular menses (frequency/flow); (2) night sweats and/or daytime hot flashes (the most common symptom; dilation of the peripheral blood vessels that leads to increased skin temperature and skin flushing); (3) headaches; (4) atrophic vaginitis (vaginal thinning/dryness that can cause painful intercourse and vaginal infection, itching or burning); (5) cosmetic changes (skin dryness/wrinkles/acne, head hair loss, facial hair growth, gum disease, dry eyes, weight gain); (6) fatigue; (7) decreased libido/arousal/orgasmic response; (8) emotional changes (depression/irritability/ anxiety/feelings of overwhelm); (9) reduced memory/cognition; (10) insomnia; (11) heart palpitations/increased heart rate; (12) dizziness/nausea; (13) UTIs/incontinence; (14) frozen shoulder syndrome and joint pain; and (15) voice changes. According to John R. Lee, M.D., the pioneering researcher and proponent of natural progesterone cream, “estrogen dominance” (the existence of excess estrogen relative to progesterone) is a key cause of menopausal symptoms. (See Progesterone Cream below)

The Conventional Approach
Any practitioner-devised menopause treatment plan should begin with the review of a woman’s complete medical history and a physical exam. Rather than treating both hormonal changes and attendant, related other health issues separately, mainstream doctors commonly treat all symptoms of menopausal imbalance with a 1-to-4 year prescription of hormone replacement therapy (HRT), various high-dose natural and synthetic estrogens and progestin (synthetic progesterone). The 2002 Women’s Health Initiative study showed that synthetic PremPro (a combination of Premarin, conjugated estrogen made from pregnant mares’ urine, and progestin) increased the risk of breast cancer, blood clots, strokes, and coronary heart, liver, and gallbladder diseases. Moreover, Dr. Lee has maintained that there are, “reams of evidence that synthetic estrogens are highly toxic and carcinogenic,” particularly when unopposed (i.e., taken without any progesterone). Michael Murray, ND, has asserted that the synthetic versions of progesterone used in HRT “are likely to be even more problematic than the conjugated (synthetic) estrogens.”

Tori Hudson, ND, has maintained that, while HRT poses in most women (those without estrogen-receptor positive breast cancer genes, family histories of breast cancer, or current breast cancer issues) only a slight risk for breast cancer, blood clots, and stroke; natural bio-identical hormone treatment decreases these risks. She also cautions that women who start HRT 10 or more years after menopause may have a slightly increased risk of heart disease. Moreover, although HRT often is not necessary to treat menopausal symptoms, some experts argue that it may be indicated for women with osteoporosis or at high risk for this disease, especially if they cannot tolerate osteoporosis medications.

Supportive Lifestyle Changes
While the natural remedies discussed below may alone provide menopausal symptom relief, regular exercise and a health-promoting/cancer-prevention diet can greatly complement their benefits. Studies of menopausal women have established that exercising moderately at least 3 times per week (for a total of at least 3.5 hours) can improve: (1) hot flashes and the resulting reduction in brain blood flow; (2) bone loss and cholesterol; (3) heart function/ blood pressure/circulation; (4) mood, self-esteem, energy/endurance, and the ability to cope with stress; (5) oxygen levels and nutrient utilization in all tissues; (6) breast cancer risk; and (7) BMI and body fat.

Consuming less animal-based foods, but more that are organic and plant-based, especially those high in phytoestrogens, is one dietary change that a menopausal woman can make to reduce her symptoms. Phytoestrogens are plant-derived substances that weakly bind to estrogen receptors, and thus have a weak estrogenic effect in some tissues, and a weak anti-estrogenic effect in others. Phytoestrogenic foods, which some studies establish are cancer-protective, include non-GMO/organic soy (ideally 45-90 grams/day, the range in a traditional Asian diet), sesame seeds, apples, celery, carrots, coffee, oats, barley, legumes (lentils, chickpeas, black-eyed peas, peas, black beans), and yams. Any woman concerned about consuming these foods should discuss this option with a holistic practitioner. (See also Soy Isoflavones below)

Proven Botanicals & Nutritional Supplements
Scientific evidence supports the safe use of the herbs and nutrients discussed below to address menopausal symptoms. When trying them, use the lowest effective dose and duration consistent with health goals.

Black Cohosh: This most frequently studied herbal alternative for menopause has proven highly effective for hot flashes/night sweats and mood swings (it acts like an SSRI to boost serotonin, the mood-elevating hormone and neurotransmitter), insomnia, and body aches. Studies show that it not only positively affects the brain/hypothalamus, bone, and vagina, but also poses no cancer risk to the breast or uterus, including in breast cancer patients, in part because it does not contain phytoestrogens and has no estrogenic action. The usual recommended dose is 40 mg/day, and liver function tests should be conducted at the start of use, and then every 3-6 months thereafter. Studies also show that it more effectively combats hot flashes, depression, anxiety, and insomnia when combined with Saint John’s Wort extract.

Kava Kava: Studies have shown that, even in the first week of use, a woman using this root extract (not the leaf), ideally standardized for 70% kavalactones, may see improvements in hot flashes/night sweats, insomnia, anxiety/heart palpitations/chest pains, dizziness, and depression. The typical dose is 100mg, 3 times per day.

Maca: Although there are 175 different species with unequal physiological impact, limited evidence has made this non-hormonal, cruciferous root from the Peruvian Andes best known for its potential to improve libido and general sexual dysfunction in both sexes. Clinical research of early-postmenopausal women has shown the variety Lepidium peruvianum to have potential for reducing HRT dependence in that it stimulates production of progesterone and estradiol (E2, the strongest form of estrogen that the ovaries produce), relieves hot flashes/night sweats, improves bone density, blood pressure and body weight, and reduces insomnia, anxiety/nervousness, depression, and heart palpitations. Dosing ranges from 2-3.5g/day, depending on the variety used.

Omega-3 Fatty Acids (Fish Oil): Preliminary studies have shown that fish oil can reduce hot flashes and depression in menopausal women. Effective dosing depends on the frequency and severity of symptoms. In one 2009 8-week study of 120 menopausal women, researchers provided subjects with 1,200mg EPA+DHA. Other researchers in a smaller 2011 study discovered these results when administering 2g/day of fish oil, or a total of 1,680 mg EPA + 750 mg DHA.

Progesterone Cream (Natural/Bioidentical – Compounded or OTC): John Lee, MD, pioneered the use of this remedy and used it in his clinical practice for almost 10 years. He maintained that estrogen is a potent and potentially dangerous hormone when not balanced by adequate progesterone. Not to be confused with synthetic progestins or Mexican wild yam/diosgenin/ dioscorea (which the body cannot use to make progesterone), natural progesterone cream is created in a lab to match the identical molecular configuration of the body’s progesterone. Progesterone supplementation is intended to restore normal physiologic levels of bioavailable progesterone, ideally based on a saliva, urine, or blood test, which should be conducted on a regular basis. While a holistic practitioner can prescribe a custom-formulated, pharmacy-compounded cream, certain OTC products containing a total of 900-1,000mg of progesterone in two ounces, or approximately 20 mg in ¼ teaspoon, have also proven safe and effective.

Soy Isoflavones: Information about the safety of phytoestrogenic soy can be confusing. Soy contains isoflavones (e.g., genistein, daidzein), antioxidant polyphenols that are viewed as phytoestrogens because of their molecular similarity to estradiol (E2), one type of estrogen linked to cancer. Estrogen influences cells through estrogen receptors. Beginning in the late 1990s, scientists discovered the cancer-inhibiting effect of certain estrogen receptors (ER-beta), the primary influence of isoflavones on these receptors, and a favorable soy isoflavone –cancer connection. Even the American Cancer Society has recognized that soy isoflavones have anti-estrogenic, antioxidant, and anti-inflammatory properties, and some studies show that isoflavones are breast and endometrial cancer protective.

In women who do not include soy in their diets, 45-90mg/day of non-GMO soy isoflavone supplements, when taken with a probiotic to ensure their conversion to equol (a non-steroidal phytoestrogen compound) can safely, effectively reduce hot flashes. Soy consumption can also improve vaginal atrophy, bone density, cholesterol, and blood pressure.

Vitamin E: Limited, older studies have proven this versatile antioxidant effective in relieving hot flashes and atrophic vaginitis, though its mechanism is not fully understood. While one study showed that 400 IU/day relieved vaginal problems in 50% of the postmenopausal subjects, up to 3,000 IU/day is generally safe and may be necessary to produce results. Vitamin E suppositories, oil, or creams/ointments can also provide vaginal relief.

The statements in this article have not been evaluated by the Food and Drug Administration, are for educational purposes only, and are not intended to take the place of a physician’s advice.

Submitted by J. Erika Dworkin, Board Certified in Holistic Nutrition®, Nutrition Consultant and Owner of the Manchester Parkade Health Shoppe (860.646.8178), 378 Middle Turnpike West, Manchester, CT, www.cthealthshop.com, nutrition specialists trusted since 1956. Erika is available to speak to groups.

All statements in this article are evidence-based and references are available upon request.

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