Menopause

Menopause is a natural process that all women must go through. It is a major life change, mentally and physically, during which most women (85-90% in most studies) experience side effects.

To many women these side effects are unbearable and they seek help from the medical profession in dealing with them. Unfortunately this has led to menopause being seen as a disease or ordeal to be got through, with all the emotional connotation that this carries.

Hormones are now extremely big business, and hormone replacement therapy (HRT) is promoted as the saviour of all women. Gail Sheehy, in her influential book, The Silent Passage, which promises a healthy menopause and post menopausal life, is a very strong advocate of HRT. However she, like most other devotees of HRT, gives very little information as to the source of natural HRT (catheterised pregnant mares tethered in concrete stables for the whole of their reproductive life), and the side effects. In fact recent clinical studies of HRT have now been scrapped because the increased risk of breast cancer, heart disease, thrombosis and stroke was found to be unacceptable.

Much has been made of the apparently beneficial effect on Alzheimers disease, and the transiently beneficial effect on osteoporosis – but once you stop taking HRT bone density drops alarmingly – so to combat osteoporosis you would have to take HRT for the rest of your life.

Many more women are now asking for alternatives to HRT as they realise that the benefits of drug treatment do not outweigh the risks. There are plenty of things you can do and this leaflet is a brief outline – the most important thing you can have is information – I suggest you read up as much as possible – two good books are ‘Natural alternatives to HRT’ by Marilyn Glanville (new edition 2003) and ‘Menopausal years’ by Susun Weed.

If you are already on HRT and want to stop you should do it slowly over about three months or you will get withdrawal symptoms. During those three months you should be adjusting your diet and using herbs as described below. You can do this on your own, or with the help of a practitioner such as myself – if you are going to use herbs I would strongly suggest you consult a herbalist in order to get the best prescription for yourself, we are all individuals, and what suits one menopausal woman will not necessarily suit another. You should only need one or two consultations and they will save money in the long term as you should get the herbs right first time.

Physiological changes of menopause

During our fertile years our ovaries, stimulated by gonadotrophins produced by the pituitary gland, produce oestrogen and eggs ready for fertilisation. There are a finite number of eggs available, and when these begin to run out from the age of about 40 we have menstrual cycles which do not produce as much oestrogen. This reduction in oestrogen causes many of the symptoms seen in menopause.

Pre menopause, the main type of oestrogen present is oestradiol made by the ovaries, post menopause the main type is oestrone, produced indirectly by the adrenal glands. Oestrone can replace up to 75% of pre menopausal levels of oestrogen if a woman is healthy and not too thin (as body fat stores are used in its production). Hormones adjust gradually in a natural menopause, and it is this time of transition that is often uncomfortable. This explains why those who have had an abrupt menopause – due to surgery or cytotoxic drug treatment – may have devastating symptoms. Hormonal changes of menopause are not only of oestrogen, we also undergo changes in levels of progesterone,luteinising and follicle stimulating hormones.

Self help with herbs, diet and natural healing

Most menopausal symptoms can be overcome by a combination of diet, sufficient exercise and relaxation/meditation; other problems ca be helped with herbs. Some plants contain phytosterols (plant hormones), which can be converted to useful hormones in our bodies – these can be used very successfully to help the transition.

A good diet would be one rich in plant based oestrogens :

  • bean sprouts – alfalfa, fenugreek, lentils, mung beans
  • pulses - soya beans, lentils, chick peas, kidney beans etc
  • wholegrains – wheat, rye, oats, millet, buckwheat
  • culinary herbs – chervil, chives, parsley, garlic, ginger, sage, nutmeg
  • fruit – banana, papaya, avocado, mango
  • dried fruit – dates, prunes, figs, raisins
  • nuts and seeds – linseeds, pumpkin, sesame, sunflower, almonds etc

Your diet should also include lots of fresh fruit and vegetables – organically grown if possible, and eaten raw as often as possible.

Essential fatty acids are also important - food sources include linseeds, oils, nuts and avocados.

Probably one of the most important dietary aspects of menopause and after is related to calcium. After the age of 35 women lose bone mass more rapidly – this is due to poor nutrient absorption, lack of weight bearing exercise, and to hormonal imbalance which causes calcium loss. However a combination of weightbearing exercise – such as walking, running or cycling, and a diet with plenty of calcium rich plants will completely reverse any changes due to bone mass loss. Magnesium is also essential for proper calcium uptake and is generally found in many calcium rich plant foods.

Calcium rich plants include :

  • seaweeds – such as kelp, wakame, nori
  • wheat and barley grass
  • almonds, hazelnuts and brazil nuts
  • sesame and sunflower seeds
  • dark green leafy vegetables
  • spirulina
  • parsley, sage, dandelion leaf, nettles, raspberry leaves
  • quinoa

A good dietary supplement that is easy to make at home is a calcium rich vinegar. Fill a jar with some or all of the following herbs (always include the first two) :

  • nettles
  • raspberry leaves
  • dandelion leaves
  • dock leaves
  • red clover leaves
  • borage leaves
  • plantain leaves

The herbs should be torn or shredded – you can use a blender or food processor if you want – and the jar filled to cover the herbs with organic cider vinegar. Leave this for six weeks, shaking every day, then strain through muslin or a fine sieve, and bottle. Take one tablespoonful before each meal, with water if you like. This not only supplies calcium, but also helps with its absorption due to the acidity of the vinegar.

Many foods inhibit calcium absorption – they include tea, coffee, alcohol, refined sugar, processed foods, too much protein (especially meat protein) and too much salt. Food containing oxalic acid – such as spinach and rhubarb – also inhibit calcium absorption, as does food containing phytic acid, such as grains and legumes.

Calcium is traditionally seen as being derived from dairy products; manufacturers and producers stress this in their adverts, and most of us have grown up ‘knowing’ that we need milk for calcium. However in countries with a high dairy intake – the average diet in the USA contains 25% dairy – there is a high incidence of calcium deficiency problems such as osteoporosis, and in countries with a low dairy intake such as China and SE Asia the incidence of these problems is very low. Evidence points to poor calcium absorption from dairy products because of a lack of cofactors necessary for its absorption – these cofactors are present in calcium rich food plants.

Herbal medicine

Therapy with herbs will vary from woman to woman depending on her symptoms and her needs. Generally I prefer to treat and prescribe to everyone individually, especially as a herb used to treat one symptom might have an unwanted effect elsewhere. There are many herbs that have been shown to be very helpful in relieving hot flushes, depression, headaches, insomnia, vaginal dryness, itchy skin, palpitations, anxiety and painful joints.

  • hot flushes – try elderflowers, sage, motherwort, black cohosh. Limit sage to one cup a day, and have a break for a few days every couple of weeks
  • vaginal dryness – try oatstraw and seed, wild yam, vitex agnus castus – use olive oil, calendula ointment or macadamia oil as a lubricant
  • herbs for the nervous system include skullcap, motherwort, black cohosh and St Johns wort
  • oestrogenic herbs include dong quai, black cohosh, fennel, hops, liquorice, parsley, sage and wild yam

If you self prescribe please only use the whole herb, as a tea, powder or tincture - the herbal extracts that are available over the counter are not the same as the original herb and may be the cause of recent problems encountered by some people. I never use extracts and cannot recommend them.

Herbs take a little longer to be effective as they work by encouraging our bodies to function properly. Good results should be seen within a few weeks; continue taking the herbs for a few months when all symptoms should have disappeared and then just use the herbs occasionally as required. For herbs to work properly a healthy lifestyle and diet is paramount.

We might manage our difficult transition better if we stop denying or postponing the change, and see it as a change back to the way we were before our hormones began to cause problems as adolescents. The solution is within ourselves, to love and understand our bodies, and to help each other with words, herbs and natural healing, just as we did in the past with our ancient womens mysteries. Remember, menopause is your liberation from the shackles of hormones – a new and exciting part of your life is just beginning.