Ask The Naturopath
As if getting older wasn't difficult enough: For women, perimenopause and meno?pause are physical proof of the body slowing down. During this transition, the decreased production of estrogen and progesterone from the ovaries leads to hormonal imbalances that can bring about physical, mental and emotional symptoms—all of which can be tough to treat. Luckily, there have been advancements in natural therapies that have been proven to ease symptoms and help bring the body back to a hormonal equilibrium. The latest research on treatment options can help point your customers in the right direction.
Beyond hot flashes
Most of the symptoms of menopause are expressions of a hormonal imbalance, and they vary widely. Some of the primary symptoms are what most people associate with menopause: hot flashes, night sweats and emotional instability, including depression, anxiety and irritability. But women may also suffer from disturbed sleep, vaginal dryness, heart palpitations and cognitive changes, including forgetfulness, decreased concentration and indecisiveness.
With each symptom, it's important to try to figure out what, specifically, might be causing it. For example, symptoms of emotional instability, depression and anxiety can look similar. If the adrenal glands were already stressed, they may be unable to take on the added responsibility required of them as the ovaries decrease the production of estrogen. If adrenal fatigue or adrenal stress is present, treating the adrenals may be necessary in order to have an easier menopausal transition.
Calming raging hormones
The goal is to choose a treatment that will bring overall balance to the hormonal cycles, and choices vary widely depending on symptoms. While hormone replacement therapy has been proven to treat all symptoms, it's not without its drawbacks. Even natural or bioidentical hormone replacement can interrupt the hormonal transition that is naturally occurring in the body. As part of the aging process, the body naturally decreases the production of estrogen and progesterone and will, over time, equilibrate to the lower levels of hormones. Natural therapies, other than natural or bioidentical HRT, can assist in bringing the body back to balance throughout this transition of decreased hormonal output, as well as help ease a woman's symptoms. Changes most women can make immediately include:
Eating a healthy diet. Fresh vegetables and fruit, whole grains, good-quality fats and adequate protein, including cold-water fish, have all been shown to ease symptoms. In Ayurvedic think?ing, these foods support menopausal women through moistening and cooling properties. New research published in the January Endocrinology News also shows that a healthy diet can help decrease cholesterol levels, which can rise as women age. Decreasing or eliminating sugar, caffeine, salt, alcohol and processed foods, including refined flour products, is also a good idea.
Getting more exercise. Moderate exercise on a regular basis—30 to 45 minutes three times a week of cardiovascular exercise, plus 10 to 15 minutes two to three times a week of weight training—has been shown to ease symptoms. New research published in the April issue of the Annals of Behavioral Medicine finds moderate exercise, like walking and yoga, boosts women's emotional well being, helping to make menopause a little easier. Experts at Oregon Health & Science University showed that menopause may also increase appetite. By studying hormones in monkeys, the researchers concluded that, with decreased hormones, many monkeys increased their food intake by 67 percent. Exercise can help offset this increased appetite.
Upping essential fatty acids. These are not always acquired adequately in the diet alone, and supplementation of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) and omega-6 fatty acids (gamma-linolenic acid) can assist in balanc?ing the 28-day hormonal cycle. Omega-3 fatty acids, found primarily in flaxseeds and fish, can be taken from day one of menstruation through day 14 (new moon to full moon if menstruation has ceased). Omega-6 fatty acids, found in borage oil, black currant oil and evening primrose oil, can be taken day 15 through 28 (full moon to new moon if menstruation has ceased). The cycling of these oils gives specific support to the follicular and luteal phases of the cycle.
Regulation of the hormonal cycle is directed by the hypothalamus-pituitary-ovarian axis, a brain-to-ovary communication system. A few herbs, including chaste tree berry, black cohosh, dang gui and white peony, specifically affect HPO axis activity. Each works in its own way to bring about balance in this vital communication system. Additionally, herbs that contain both triterpenoid saponins and steroidal saponins help regulate the HPO axis. These include licorice, ginseng, wild yam, beth root, fenugreek and false and true unicorn root. Because of their ability to balance overall hormonal levels, these herbs can ease many of the symptoms of menopause.
Surviving the symptoms
A guide to treating the most common discomforts of menopause:
More than 60 percent of women experience hot flashes and night sweats during menopause. These symptoms occur when the brain center is attempting to reset the internal thermostat, and it hasn't reached equilibrium yet. Some natural therapies to consider are:
- Vitamin E (d-alpha tocopheryl), 400 IU per day.
- Tea of sage and peppermint or spearmint, 2 tablespoons of each to 4 cups of water, let steep 20 minutes. Strain and drink, 2 to 4 cups per day, room temperature.
- Black cohosh tincture, half a teaspoon in water three times a day. Black cohosh capsules, 40 to 80 milligrams twice a day, standardized to 2.5 percent triterpene glycosides (deoxyactein).
- Essential oils of clary sage (5 drops), rose (10 drops) and vetiver (2 drops), in a spritzer; spray face and body regularly and as needed.
- Tincture of burdock and dandelion, half a teaspoon three times a day, to move the liver chi.
- Tincture of vervain and motherwort, half a teaspoon two times a day, to strengthen the nervous system.
- Gamma-oryzanol, 100 milligrams three times a day.
- Hesperidin methyl chalcone, 100 to 250 milligrams, two to three times a day.
Not getting seven to eight hours of shut-eye a night can make everything else in life feel out of balance. The inability to sleep and stay asleep could be caused by night sweats, but other factors, such as anxiety and emotional instability, can also play a role. Consider the following remedies:
- Exercise earlier in the day to help release any stress in the body that is interfering with nighttime sleep.
- Take half a teaspoon tincture of California poppy (3 parts) and hops (1 part), one hour before bed and repeated at bedtime.
- Take tea of chamomile and linden flowers, 1 tablespoon per cup, 1 cup one hour before bedtime.
- Take tea or tincture of passionflower, specifically for thoughts that either keep you awake or wake you.
- Valerian will work for some, taken as a capsule by most to avoid its "dirty sock" smell and bitter taste.
- Essential oils of rose (rosa damascena), neroli (orange blossoms) and lavender angustifolia (specific species, but not too much), infused or applied with carrier oil topically can help.
- Take melatonin, 3 milligrams, one hour before bedtime.
This can be treated locally, or intern?ally through supplements. Local treatments could include:
- Topical application of natural estro?gen or progesterone creams.
- Vitamin E capsule inserted vaginally nightly.
- Herbal suppositories inserted vaginally. These include moistening and nutritive herbs, including slippery elm, marshmallow, licorice, comfrey, calendula and yarrow. Many commercial brands will also include vitamin A and E.
- Vitamin E, 400 IU per day.
- Black cohosh tincture, half a teaspoon in water three times a day.
- Black cohosh capsules, 40 to 80 milligrams twice a day, standardized to 2.5 percent triterpene glycosides (deoxyactein).
- Essential fatty acids, both omega-3 and omega-6.
- Tea or tincture of Gotu kola, which strengthens the connective tissue.
- Tea of red clover and/or alfalfa, 4 table?spoons of herb to 4 cups water, steep 10 hours, strain and drink 2 to 4 cups a day.
- Red clover caps, 500 milligrams, 1 to 2 caps per day.
Internal treatment could include:
Decreased cognitive function
Herbal medicine can be effective in reconnecting brain synapses. Consider:
- Ginkgo, tincture or capsule. Many people prefer the capsule standardized to 24 percent ginkgo heterosides, 40 milligrams two to three times a day. Tincture would be 1 teaspoon two times a day.
- Bacopa is an Ayurvedic herb that also works to improve cognitive function. Also called Brahmi, it is mostly used in Southern India, and is taken at 2 grams of powder per day.
- Gotu kola is another Ayurvedic herb that works to improve cognitive function. It, too, is called Brahmi, mostly used in Northern India. This herb is nicely made into a tea, 1 tablespoon per cup water, 2 to 4 cups per day, or can be used as a tincture, ? - 1 teaspoon, three to four times a day.
- Many circulatory herbs, including cayenne, ginger and prickly ash, will improve overall circulation, as well as circulation to the brain, hence, improving cognitive function.
- Holy Basil or Tulsi, as a tea, tincture or topical use of the essential oil, will act as an antioxidant, improve circulation and enhance memory.
- Exercise enhances circulation of blood to the brain, which improves cognitive function.
Herbs that work directly with the cardiovascular system, the nervous system or both have been proven to ease this scary symptom:
- For an irregular heartbeat that is not related to severe cardiovascular disease, try hawthorn and motherwort.
- Hawthorn is good as a tonic tea, 1 tablespoon per cup of water of the flower or leaf, steeped 15 minutes, two to three cups per day. The berries can be used as well, but the flower has the highest flavonoid content.
- Motherwort is very bitter and difficult to take as a tea daily. These two combined can be taken in capsule form or in a tincture. The tincture would be a 3:1 ratio of hawthorn to motherwort, ? to ? teaspoon, four times a day.
- Essential oils of geranium and lavender are also useful, infused or topical, in regaining a steady cardiac rhythm.
As the baby boomer generation now moves into perimenopause and menopause, there are a greater number of women experiencing the symptoms brought on through this transition. With more research showing that HRT is not a safe option for all women, natural remedies have become more popular—and prevalent—than ever.
Robin DiPasquale, N.D., R.H. (AHG), is a naturopathic physician and chairwoman of botanical medicine at Bastyr University.
Natural Foods Merchandiser volume XXVIII/number 5/p.36,38