Menopause, Part of 2 of 2.

Menopause,  Part 2 of 2.

In the last article about Menopause,  I outlined what exactly the Menopause was and how to handle it.  It’s not an easy,  one size fits all solution so I would advise you to call into Grant’s and discuss the options available to you.

I will briefly recap on the main points of the last article first.

• Menopause commonly refers to the extended period of change, when egg supply is exhausted and levels of hormones (oestrogen and progesterone) fall, especially the latter
• Ovulation (release of egg) and menstruation (the bleed of a period) become less frequent and eventually stop. This usually occurs between 45 and 55 years of age.
• Menopause is Not a disease!
• Should be a natural process whereby the body re-adapts to the ovaries producing less hormones and the adrenals taking over (though oestrogen levels fall below reproductive levels)
• The absence of follicles reduces oestrogen and progesterone, causing the pituitary to release FSH in large and continuing quantities.
• FSH and LH cause the ovaries and adrenals to secrete androgens that can be converted to oestrogens in fat cells in the hips and thighs
• Severe symptoms occur due to hormones fluctuating up and down as the body tries to balance hormones through its feedback mechanism
• The more gradually the woman goes through menopause, the more gentle the fluctuations, the easier the transition
• More severe menopausal symptoms are experienced when hormones are fluctuating widely.
• This can occur due to:
  • Pressure on the adrenal glands: due to stress, inflammation, poor blood sugar balancing, stimulants such as caffeine, alcohol and smoking, etc
  • Lack of supporting nutrients:
    • phytoestrogens: fermented soy, whole bean soy, flaxseed, apples, carrots, legumes to provide a hormone balancing effect
    • poor omega 3:6 balance (to reduce inflammation)
    • lack of fiber to assist with the removal of ‘old’ oestrogens and to support ‘good’ gut bacteria that ferment soya in the gut to gain phyto-estrogenic benefits

Symptoms in the transitional period may be felt for a short period or for several years depending on the body’s ability to adapt.

Menopausal symptoms may include:

• change in the frequency or volume of blood flow
• emotional swings, irritability, anxiety
• depression
• hot flushes and night sweats
• headaches
• insomnia
• loss of sex drive
• Vaginal dryness and recurrent vaginal infections
• Weight changes (increase), reduction in breast tissue
• Inflammation
  • Oestrogen modulates inflammation and incidences of inflammatory conditions increase after menopause when oestrogen levels drop (eg heart disease, Alzheimers)
• Bone Health
  • Can cause increased bone resorption (breakdown of bone) after menopause

Last time,  we talked about the supplements, minerals and dietary changes that help reduce symptoms.  Today I will review the herbs.

Herbs

There are a number of herbs that have traditionally been used at the menopause. The main ones are termed ‘adaptogens’, which have a balancing effect on the body.

Black Cohosh (Cimicifuga racemosa)

This is the herb of choice for the menopausal symptoms of hot flushes and night sweats and there have been a number of good clinical trials that show its effectiveness. Also, Black Cohosh can help alleviate mood swings and anxiety associated with menopause.

Black cohosh does not increase oestrogen levels and has no effect on the cells in the vagina or womb. This is important because of the risks linked with HRT where increasing oestrogen levels to a point which may be not clinically wanted in oestrogen receptive cancers.  You can therefore be assured that it offers relief from menopause symptoms without oestrogen-like effects.

So how is black cohosh working on the menopausal symptoms if it is not having an oestrogenic effect? It is actually working as a SERM (selective oestrogen receptor modulator). These are substances that can stimulate oestrogen receptors in some parts of the body and not others. So they can block stimulation in places like the womb and breast where it would be unsafe to have cells over-stimulated but they can stimulate oestrogen receptors  in other places, where you would want stimulation such as the bones and brain. These SERMS are then able to target cells appropriately rather than the HRT approach, which is just to replace hormones.

SERMS are the new drug alternatives to HRT but nature already supplies us with SERMS in the form of black cohosh and foods like phytoestrogens.

A couple of years ago there were concerns about black cohosh and liver disease. This problem is extremely rare and there have only been four complaints compared to the estimated 9 million treatment days (as it is termed) purchased each year.

When the European Medicines Agency (EMEA), reviewed all the evidence worldwide, it concluded that it was not clear whether black cohosh caused the problem. The National Institutes of Health in the US believes there’s no case to answer and they have stated that black cohosh has few side effects and that ‘liver damage has been reported in a few individuals using black cohosh, but millions of people have taken the herb without apparent adverse health effects. There is no scientific evidence to show that the herb causes liver damage.’

Agnus Castus (Vitex agnus castus)

This herb is classed as an adaptogen as it has a balancing effect on your hormones. It works on the pituitary gland which is the gland that sends the message down to the ovaries to release hormones. Agnus castus can help increase certain hormones if they are too low and decrease them if too high. This is particularly helpful in the peri-menopause years because your hormones can be fluctuating widely and this herb helps to create a kind of stability. It is also the best herb to take if you are getting mood swings, anxiety and tension.

Dong Quai (Angelica sinensis)

Dong quai is a herb from Traditional Chinese Medicine and is helpful for both the hot flushes and night sweats. It has a long history of traditional use. Research has shown that it not only starts to help reduce the hot flushes and night sweats in one month but it is also helpful for fatigue and disturbed sleep.

Sage (Salvia officinalis)

This herb,which is also easily used as a tea, is helpful in controlling both the hot flushes and night sweats.

Milk thistle (Silymarin marianum)

Again in any situation where you are aiming to balance the female hormones it is so important to add in herbs which can improve liver function. It is your liver that is doing the hard work of detoxifying your hormones so you want to make the job as easy as possible.

Ginkgo Biloba

As we get older, both men and women can find that their memory and concentration is not as good as it was. This is often a problem to do with age rather than hormones. The herb ginkgo biloba has been found to generally have a rejuvenating effect on the brain. A number of clinical trials have shown that it improves learning ability, memory and concentration. Studies are also being undertaken at present to establish whether gingko may slow down the progression of Alzheimer’s disease.

Caution You should not take any of the above herbs if you are taking, “The Pill”, Fertility drugs, HRT or any other hormonal treatment or other medication unless they are recommended by a Doctor or Pharmacist.

Plan of Action Reminder

Nutrition

Ensure you are getting the right nutrition.

Supplements

The supplement programme below should be taken for at least three months in order to achieve best results

Nutrients & amounts

Hormone Replacement Treatment is not discussed today.  HRT allows many, many women to function who have experienced severe menopausal symptoms not responsive to all the methods mentioned here.

Leonie, Janet or any Pharmacist in Grant’s Pharmacy can tell you more about the products used to treat menopause including HRT, in private and in confidence. Every Grant’s Pharmacy has a private consultation room where you can discuss any personal ailments discreetly and without embarrassment. Pop in and experience a fast, friendly and informed service. We will be happy to advise you on your best course of treatment.  Grant’s Pharmacy is located in Wexford town, in Enniscorthy town (Duffry and Rafter St), in Arklow town – all beside Pettitts SuperValu and in Gorey town opposite the GPO.  Find us on Facebook.

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