Natural Foods Merchandiser

Hot Flash: Manage Menopause Without HRT

For decades the medical establishment recommended that menopausal women who wanted to alleviate symptoms and protect themselves from osteoporosis, heart disease and Alzheimer's take synthetic hormones. Just last year U.S. pharmacists filled some 67 million prescriptions for hormone replacement therapy. But in July 2002 the Journal of the American Medical Association reported that a large-scale study of HRT was halted when it was found that the increased risk of breast and uterine cancers, heart attack and blood clots associated with HRT far outweighed any benefits the therapy might provide. In May, the Women's Health Innitiative Memory Study reported that women older than 65 who used estrogen plus progestin doubled the risk of developing dementia.

An estimated 46 percent of menopausal women are currently using some form of [natural] products to ease their symptoms.
So where does that leave the millions of women who want relief from such symptoms as hot flashes, night sweats, insomnia, mood swings and vaginal dryness? "It's up to every woman to decide whether or not she wants to take HRT, but if she chooses not to, there are many powerful natural options available to use in its place," says naturopathic doctor Deborah Moskowitz, of the Transitions For Health Women's Institute in Portland, Ore. Like their synthetic counterparts, plant-derived natural hormones work to balance the ebb and flow of a menopausal woman's hormones, thereby relieving the majority of symptoms.

Although most American women don't reach menopause until around the age of 50, menopause-like symptoms caused by shifts in hormones can begin a decade earlier. Specifically, it is the considerable decline in estrogen that is responsible for the hot flashes, mood swings and other annoying problems that have given menopause its bad name. Furthermore, studies have shown that the onset of menopause can contribute to a higher risk of heart disease and a decline in bone density.

The science behind natural menopausal remedies' ability to prevent such symptoms is rapidly building, and already an estimated 46 percent of menopausal women are currently using some form of these products to ease their symptoms, says Moskowitz. In addition to getting regular exercise and cutting back on hot-flash triggers such as spicy food, caffeine, sugar and alcohol, the following natural treatments may help ease the transition.

Soothing Soy
The isoflavones and protein in soy may be the most talked-about natural treatments for reducing menopausal hot flashes. "Consuming the recommended daily dose of soy products can bring about practically pharmaceutical-like results," says Regina Lellman, a naturopathic physician and licensed acupuncturist in Portland, Ore. Although what constitutes the optimal dose is debatable, a 12-week study published in the January 2001 issue of Obstetrics & Gynecology found that 60 grams of soy protein a day reduced hot flashes by 45 percent. Soy has also been found to reduce cholesterol, lower the incidence of breast cancer and prevent osteoporosis.

In addition to the soy protein powders and isoflavone supplements specifically marketed to menopausal women, tofu, tempeh and soymilk are among the plethora of soy products that deliver hefty servings of phytoestrogens.

Black Cohosh
A recent review of eight studies, published in the Journal of Women's Health, Volume 7, 1999, found that black cohosh (Cimicifuga racemosa) is another safe and effective treatment for reducing hot flashes. "It is also great at boosting a woman's libido," Moskowitz says.

Considering its powerful abilities, it is surprising that this herb actually has no estrogenic effects, says Steve Bratman, a Fort Collins, Colo.-based physician. "But there is no question that it works," he says.

Black cohosh's power lies in the triterpenes and flavonoids it contains, which act on a woman's pituitary gland and suppress the secretion of the luteinizing hormone, Bratman says. Since LH is responsible for causing several of the most bothersome menopausal symptoms, like hot flashes and mood swings, black cohosh actually prevents symptoms from occurring rather than simply easing them. However, one must be patient and consistent when using this herb, as it usually takes three to four weeks for its effects to fully kick in. Make sure never to confuse this herb with its potentially dangerous cousin blue cohosh (Caullophyllum thalictroide).

Essential Fatty Acids
By simply incorporating a teaspoon to a tablespoon of flaxseed into their daily diets, your menopausal customers can lessen many of their unwanted symptoms. The omega-3 and -6 essential fatty acids in flaxseed, which are also present in varying degrees in hemp, evening primrose, borage and some nuts and fish, are crucial for the creation and maintenance of nearly all cells and membranes. "The fact that they are called 'essential' means that you have to eat them," says Lellman. "Your body can't synthesize those things.

"Essential fatty acids decrease inflammation and the tendency of blood vessels to clot, so they thin your blood," she adds. That can help alleviate the cramps, bloating and mood swings that can come with premenstrual syndrome and menopause. Essential fatty acids such as flax and borage are sold in liquid or capsule form, and there are also a number of EFA blends on the market aimed specifically at easing menopausal symptoms.

Dong Quai
For centuries, many menopausal women have combated the discomfort of hot flashes by taking the ancient Chinese herb dong quai (Angelica sinesis). While some clinical studies have suggested that this herb is no more effective than a placebo at relieving menopausal symptoms, many physicians question such findings.

Traditionally, dong quai is useful in thinning the blood and calming the blood vessels, thereby preventing the spasms that cause hot flashes. "It is also important to remember that in traditional Chinese medicine, dong quai is never used in isolation as it was in the recent scientific studies; so its well-known powerful effects might be due to herbal synergism," Bratman says.

Finding the perfect synergistic combination of menopausal supplements can be a delicate process, even if they are all plant based. "Using any kind of hormone therapy is not natural, so it should be done with caution, and only when an individual is suffering from symptoms that are troubling," advises Lellman.

Linda Knittel is a Portland, Ore.-based freelance writer.

Natural Foods Merchandiser volume XXIV/number 8/p. 36, 38

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