Perimenopause_Cover-400x516

Hot Flash!

  • No More Periods — Hooray, BUT…
  • How Can You Stay Healthy?
  • There Are 40 Known Symptoms

Look Inside, And Find Out How To Manage Yours….

This issue of Nutrition News is dedicated to the millions of women everywhere who find themselves with reduced sex hormone output;

to the women who suspect that their reduced sex hormones might be the explanation for their otherwise inexplicable behavior;

and to the women who know the dictates of Nature inevitably have them headed in that direction.

 

 

 

Perimenopause_Cover-400x516

 

Topic: Peri-Menopause & Menopause

It’s a fact that by the year 2015, nearly 50 percent of all women in the United States will be menopausal. Since the average age for menopause is 52, this means half the female population will be 52 or older. Interestingly, in the same year, 23 percent of the population of developed countries will be 50 or older.

Hot Flash!

• No More Periods — Hooray, BUT…

• How Can You Stay Healthy?

• There Are 40 Known Symptoms.

Look Inside, And Find Out How To Manage Yours….

This issue of Nutrition News is dedicated to the millions of women everywhere who find themselves with reduced sex hormone output; to the women who suspect that their reduced sex hormones might be the explanation for their otherwise inexplicable behavior; and to the women who know the dictates of Nature inevitably have them headed in that direction.

 

Menopause has only one rule:

Every Woman’s Experience Is Different.

Some lucky women, ten percent of us, have no significant indications that they are menopausal. They just stop having periods…period. At the opposite end of the spectrum, others may experience symptoms for years.

Typical symptoms include hot flashes, loss of libido, vaginal dryness, and sleep problems. However, symptoms can range from mild hot spells at night to constant dripping sweats 24/7. Some women spot for a few months, others bleed heavily seemingly forever. A few still have hot flashes long after they have become postmenopausal.

Although symptoms vary for each woman, the cause is always hormone imbalance. That said, when the normal balance between estrogen, progesterone, and testosterone (yep, we’ve got it) is disrupted, the symptoms appear. Addressing them requires an approach that can restore hormone balance, not necessarily only estrogen loss. Further, many women try treatments that don’t work, resulting in greater hormonal imbalances. Symptoms are also related to diet, lifestyle, and genetic factors.

The one most important fact each menopausal woman must realize is that hormonal imbalance combined with increasing years puts her at elevated risk for contracting heart disease, osteoporosis, and certain cancers.

Bio-Tech

Technically, menopause means the end of menstruation (menses). Menopause is considered to have occurred once an entire year has passed without a period. Climacteric is the word for the transition from the reproductive to the post reproductive stage of life. The part of this transition before menopause is called perimenopause. 

Menopause is a normal midlife event, not a disease. The average age of menopause is 52, and ranges from the 30s to the 60s. Perimenopause is usually considered the 2-5 years beforehand, although some women have symptoms for 10-15 years. One in 100 women experiences premature menopause defined as forty or younger. Medical menopause is usually the result of removal of the ovaries or cancer treatment. An incredible 25 percent of all women come into menopause this way!

During our reproductive years, the pituitary gland sends out a hormone called FSH (follicle stimulating hormone), which causes the ovary to produce estrogen and eggs. (This feedback system also results in the production of progesterone.) In perimenopause, the follicles begin to decay, and the eggs degenerate. Eventually, progesterone ceases to be produced altogether, the eggs are gone, and fertility is over.

The old explanation that symptoms are caused by low estrogen levels is wrong. The ensuing shifts in the levels of both estrogen and progesterone are directly related to our confounding symptoms. Furthermore, like the tonsils, menopausal ovaries are not just taking up space. In a complicated hormonal dance, they continue to support estrogen production. 

In the past, many women coming into menopause no longer worked or had never worked outside the home. Today, it is not unusual for women to turn 50, work 60 hours a week, and take care of a family (children, grandchildren and parents). They have little time for themselves, and their adrenals are burned out. This compounds the stress of the menopause experience.

In her natural state, a healthy woman feels good, has lots of energy, sleeps soundly, has an intact sex drive, and a healthy active metabolism. Both her immune and digestive systems function perfectly. The physicians on womantowoman.com commented that most women are surprised to learn that they should feel this way their entire lives.

Take Back Your Body!

Following is a natural approach to menopause that you can adapt for your own use. You may need 1-2 months to ascertain the entire effects of the steps. On the other hand, some relief may be immediate.

Step 1: The basic program is one you already know. Eat lots of fresh foods, particularly steamed veggies and salads, get enough protein, and drink plenty of water (6-8 glasses daily). Eat good fats (raw nuts, avocados, fish).1 Experiment with soy and flax laden foods. Stay away from sugar and other processed carbohydrates. (They stress the body and encourage weight gain.) Do your best to get sufficient rest, relaxation, and exercise.

1 We have written many times about the importance of good fats. We continue to recommend at least a gram of fish oils in supplement form daily. Ann Louise Gittleman reports that her clients found great relief from mood changes, anxiety, irritability, headaches, breast pain, and fluid retention with GLA (gamma-linolenic acid) from evening primrose, borage, or organic black currant oils. They come in 300 mg caps. Take 1 w/each of 3 meals.

Continue your multivitamin-mineral (especially the B vitamins); up your intake of vitamin E (1200 IU is reported to help with hot flashes); vitamin A (10,000 IU for skin integrity); and increase vitamin C to at least a gram. (I take 2 grams of “The Right C” for adrenal support.) Make sure you are taking a bone building formula that supplies 500 mg or more of magnesium and 1,000 IU of vitamin D. Consider adding vitamin K2.

Step 2: Add a woman’s herbal. In this issue, we discuss soy, black cohosh, red clover, hops, and lignans, and how they work.

  Step 3: Get some progesterone, and maybe DHEA. See “Hormones At The Health Food Store”.

Step 4: If your brain’s not working the way it used to, try some “smart pills.” My thoughts get slippery whenever I’m under stress. I use ginkgo biloba and a brain food formula containing phosphatidyl serine. Perhaps because my brain is used to receiving this food, I often have results within a few hours.

Step 5: Last resort, find a doctor who will prescribe natural hormones for you.

Don’t Forget to Exercise

Exercise is one of the most important things you can do for yourself. Both aerobic and weight work are recommended. Yoga is good too. Exercise helps to maintain bone integrity, helps you to feel good about yourself (because of the endorphins and because you’re doing it), helps to allay hot flashes, keeps you strong so you can do the things you like, gives you energy, keeps your joints supple, helps to get the toxins out of your system, and increases the probability of a good night’s sleep. In addition, exercise deflects stress.

Incidentally, findings published in JAMA in 2007 indicate that fitness – regardless of weight – is the single strongest predictor of mortality risk. Drop your unhealthy habits, focus on exercise, and forget about some fictional ideal weight. 

Weight A-Gain

Speaking of ideal weight (see exercise above), weight gain is the single most complained about symptom of menopause. (Hot flashes are in second place.) What is happening? At least two biological events. 1) When we menstruate, our bodies burn an additional 300 calories a day during ovulation, 10-14 days per month This equals to 3000-4200 calories or about a pound a month. Unless one compensates with a reduction of calories or burning an extra 150 calories daily throughout the month, then a weight gain of at least 12 pounds per year is inevitable.

2) Pamela M. Smith RD (Take Charge of the Change) reports that “losing our figures” is nature’s way of compensating for lowered estrogen levels. As soon as our fat cells detect a slightly lower estrogen level, they start to produce estrogen for us. They do this by increasing their size, number, and ability to store fat. Our tummy cells grow the most because they are better at producing estrogen. In a University of Pittsburgh study, women with the largest fat cells produced 40 percent more estrogen than those with the smallest fat cells. The body wants to gain about a pound and a half of fat yearly through the perimenopausal years – at least twelve pounds. And, it doesn’t want to lose the weight. It’s a bummer – and a relief to know what’s happening.

FYI: A final hormone connection is with depression. Estrogen boosts the production of serotonin, the feel good neurotransmitter, in the brain. Thus, bodies with less estrogen have less serotonin. The result is mood changes, restless sleep, and anxiety. Try St. John’s wort and/or 5HTP. 

Hormones In The Health Food Store

Three useful hormones are available in natural products stores: DHEA, progesterone, and melatonin. DHEA is a hormone secreted by the adrenal gland, the sex glands, and the brain. Decline in production is related to aging. DHEA has been shown to improve mood, neurological functions, immune function, energy, feelings of well-being, and the maintenance of both bone and muscle mass. In women, DHEA often converts to testosterone, making it possible to raise testosterone levels using DHEA supplementation. Uzzi Reiss, MD, emphasizes that most women tolerate only 10 to 15 mg of DHEA daily, while 10 percent don’t tolerate even 5 mg. (www.UzziReissmd.com)

As noted, at menopause, the body no longer makes progesterone. Many women find that taking it completely knocks out their symptoms. Oral progesterone is only available by prescription. However, the skin is a fine hormone receptor and there are several quality progesterone creams available. Look for one that contains more than 400 mg per ounce of cream.

Christine Northrope, MD, suggests 1/4 to 1/2 tsp massaged into the skin 1-2 times daily. She writes, “There is virtually no danger of overdose, and many women use the equivalent of 400 mg per week.” Keep in mind that wild yam does not contain progesterone and your body does not convert wild yam extract into progesterone.

FYI: Many books, articles, and studies use the word “progesterone” when the actual substance used was a progestin. Progestins are dangerous. Several studies have shown that heart attacks induced in monkeys taking progestins (such as Provera) would have been lethal without immediate drug intervention. Bioidentical progesterone is the only substance that should be used for replacement purposes. Not only is it far superior for symptom relief, it has virtually no unwanted side effects.

Melatonin is a sleep-inducing hormone that has been shown to have a healthy effect on the female body. It is worth a try if you are having problems sleeping. (I’ve solved those finally with progesterone.)

Estrogen From The Earth

Since ancient times, women have used herbs to ease their passage. These herbs work because they deliver phytoestrogens, plant estrogens, into the body. Here we talk about those with the most science behind them and the best reputations for delivering results: soy, black cohosh, and red clover.2 We introduce the herb hops (Humulus lupulus L), currently recognized as the most potent phytoestrogen source known. We also write briefly about lignans.

2 Supplements of the soy isoflavone genistein put a stop to my hot flashes while a German black cohosh product helped with skin thinning and vaginal drying.

Phytoestrogens have a weak estrogenic effect, and exert only a fraction of the strength of true estrogen. (Estimates vary from 1/100to to 1/1000th strength.) During menopause, these weak estrogens help alleviate symptoms stemming from too little estrogen by binding with estrogen receptors. It has long been known that plant estrogens can help maintain healthy bones, heart, and blood vessel linings. They may also be protective against cancer.

SOY continues to be controversial. On the one hand, studies exist that led NutritionAction to conclude that “Soy is probably no better than a sugar pill”. On the other, women physicians in the field have gotten impressive results and don’t understand the negativity. About 20 percent of the population doesn’t tolerate soy well, and those with hypothyroid need to remember that soy can have a dampening effect on that gland’s output.

Isoflavones are the active phytoestrogens in the plants we discuss. In one study, 80 percent of women using a soy extract experienced a significant decrease (averaging 48 percent) in the number of daily hot flashes. These women also reported statistically significant improvements in other menopausal symptoms, including sleep disorder, anxiety, depression, vaginal dryness, loss of libido, and bone pain.

To relieve menopause symptoms, 40-80 mg of isoflavones per day are recommended. An 8 ounce glass of full fat soy contains 20 mg as does a serving of tofu. Of course, you can dodge counting isoflavones by taking genistein supplements the way I did. Get Organic! There are a lot of GMO soy beans out there, and for the extra money, you’re far better off not putting GMO beans in your body. (GMO equals Genetically Modified Organisms.) Finally, soy isoflavones are good for both heart and bones.

BLACK COHOSH (Cimicifuga racemosa) has been used and researched in Germany for its applications during menopause since 1945. It is the world’s most thoroughly studied alternative to estrogen replacement therapy. Studies have involved thousands of women. Overall findings show it relieves hot flashes, depression, and vaginal thinning.

Black cohosh also shows well in protecting against heart disease, osteoporosis, and cancer. In a trial comparing black cohosh with estradiol (the most benign of the three estrogens produced by our bodies), both lowered LDL but only the cohosh raised HDL (“good” cholesterol), and it prevented bone loss in lab animals. Most impressive, researchers from the University of Pennsylvania School of Medicine found that women who took black cohosh for menopausal symptoms lowered their risk of breast cancer by more than 60 percent.

RED CLOVER (Trifolium praetense) until recently was the highest known source of isoflavones. While soy beans contain 0.3% isoflavones, red clover contains 3.0%, 10 times as much. In one study, participants experienced a 58 percent reduction in hot flashes after 8 weeks, and a significant reduction in night sweats. According to research published by the Journal of the British Menopause Society, red clover isoflavone supplements have been shown to have a significant positive effect on the rate of bone loss, improved heart health, and protective effect against breast and endometrial cancer. Look for caps containing standardized extracts of 40 mg isoflavones. 

FYI: One caution, red clover contains coumestans, which have blood thinning properties. Women on blood thinning meds should have their clotting time monitored if they choose to use it.

LIGNANS are a different type of phytoestrogen, a fibrous compound. They occur in particularly high amounts in seeds such as flax, chia, alba, and sesame. They have been studied for their protective effects against cancer. They can also normalize blood pressure and protect against osteoporosis.

Recently, highly potent lignans were extracted from the knots of Norway spruce trees (Picea abies). (Who figures out this stuff?) Known as HMR (hydroxymatairesinol), it is effective against hot flashes, cutting the daily number of occurrences in half. This is a substance we are bound to hear more about in future.

Sidebar: Here It Comes!

When you respond to the check list below, you begin to appreciate the complicated roller coaster ride many women are experiencing. As you consider the 40 symptoms, you may also be relieved to learn that you’re not nuts.

— Menstrual irregularity

— Hot flashes and/or flushes; night sweats

— Dry vagina

— Insomnia and/or weird dreams

— Sensory disturbances (vision, smell, alterations to taste)

— Funny sensations in the head

— Lower back pain (crushing of vertebrae)

— Waking in the early hours of the morning

— Onset of new allergies or sensitivities

— Fluctuations in sexual desire and sexual response

— Annoying itching around the vagina

— Sudden bouts of bloat lasting only an hour or two

— Chills or periods of extreme warmth

— Indigestion, flatulence, gas pains

— Rogue chin whiskers

— Overnight appearance of long, fine facial hairs

— Bouts of rapid heartbeat

— Crying for no reason

— Aching ankles, knees, wrists or shoulders

— Waking up with sore heels

— Thinning scalp and underarm hair

— Graying scalp and pubic hair

— Mysterious appearance of bruises

— Frequent urination

— Urinary leakage (when coughing or sneezing, or during orgasm)

— Prickly or tingly hands with swollen veins

— Lightheadedness, dizzy spells, or vertigo

— Weight gain, and in unusual places (on the back, breasts, abdomen)

— Sudden and inappropriate bursts of anger

— Sensitivity to being touched by others 

— Inexplicable panic attacks

— Tendency to cystitis (inflammation of the bladder)

— Vaginal or urethral infections

— Anxiety and loss of self-confidence

— Depression that cannot be shaken off

— Painful intercourse

— Migraine headaches

— Easily wounded feelings

— Crawly skin 

— Disturbing memory lapses

Sidebar: Hop Out of Hot Flashes

Hops – yes, the very same herb used in brewing beer – has been found to contain a constituent that is, without question, the most potent phytoestrogen ever tested. According to an article in Life Extension Magazine, controlled clinical studies show that most women who take hops experience a rapid and significant reduction in hot flashes and other discomforts. It appears to be a unique blend of power and safety. Called 8-PN, studies show it is effective at a mere 100 mcg per day. (More was not more effective.) 

Indications are that it also provides protection against heart problems, bone loss, and cancer. Although potency was first remarked in a 1999 study, 8-PN/hops now seems to be coming into prominence. Although indications are brilliant, the in depth LE article reveals that more human trials are called for.