The menopause is a natural part of the life cycle of every woman, which occurs anywhere between the ages of 38 and 55. Put simply, it is the cessation of periods and the ability to get pregnant. The menopause happens when the store of eggs in your ovaries is exhausted.
In a natural menopause the hormone levels decline gradually, allowing your body to adjust over a period of time. Your ovaries will continue to produce oestrogen for up to 12 years after your menopause. Oestrogen is also produced by the adrenal glands and in body fat. Your ovaries will continue to produce testosterone the hormone that helps with sex drive and arousal. (Yes, women produce testosterone too!)
Oestrogen helps to form the lining of the women and protects your bones. However, too much oestrogen in your body can lead to endometriosis, fibroids, lumpy and tender breasts and increased risk of breast or womb cancer.
A surgical menopause happens when the ovaries have been removed and the supply of hormones is terminated abruptly. This can be very traumatic for your body resulting in loss of libido and the symptoms often associated with the menopause. It is likely that you will be prescribe HRT to alleviate the symptoms of a “surgical menopause”.
Before having a hysterectomy it is useful to discuss retaining your ovaries with your surgeon. It has been common practise for the ovaries to be removed at the same time that a hysterectomy is performed as a precautionary measure against ovarian cancer. However, unless you have a strong family history of ovarian cancer removal of your ovaries may be unnecessary.
Sadly, many women dread the menopause years, expecting to experience at least some of the following symptoms:
- Hot flushes and night sweats
- Dry skin Hair loss
- Weight gain
- Reduced energy and fitness
- Joint pains
- Vaginal dryness
- Loss of libido
- Depression or mood swings
However, not all of these symptoms are directly related to the menopause. Some are a part of the ageing process and experienced by men as well as women. However, even symptoms related to ageing can be lessened by taking care of your diet and lifestyle.
If you have suffered from pre-menstrual tension (PMT) during your fertile years, it is likely that you will experience similar symptoms during your menopause due to changing hormone levels. However, balancing your hormones with good diet and herbs will help to alleviate the symptoms.
The Myths about HRT
HRT was first introduced in the 1930s when scientists decided that if oestrogen levels fell during the menopause they should be replaced. However, it did not become popular until the 1960s when a gynaecologist called Robert Wilson wrote a book singing the praises of HRT as the answer to the “living decay” of the menopause.
The oestrogens in HRT are chemical equivalents of the hormones produced by the ovaries. Conjugated oestrogens are made from the urine of a pregnant mare and contain oestrogens which are appropriate for a horse but not for a human being. Most HRT preparations contain oestradiol, which is the most carcinogenic form of oestrogen.
HRT is often prescribed to alleviate hot flushes and maintain bone density. However, it’s effectiveness only lasts while you continue to take HRT. As soon as you stop taking HRT your body will display all of the symptoms which prompted you to take it in the first place, due to the abrupt withdrawal of hormones. For this reason, if you are taking HRT now, you should withdraw from it gradually.
The known possible side effects of HRT are:
- Breast tenderness
- Weight gain
- Increased blood pressure
- Skin rashes
- Hair loss
- Vaginal thrush
- CystitisIn addition to these side effects, there is mounting evidence that HRT carries with it many other health risks:
There have been numerous studies over the past 30 years which indicate that the risk of breast cancer is increased by as much as 35% in women taking HRT. In 2002 a major study of 27,000 women was abandoned when it was found after 5 years that women taking HRT had a 26% higher risk of breast cancer, 41% higher risk of a stroke and 29% higher risk of heart problems.
Further studies have shown that the risk of breast cancer increases as soon as you start taking HRT, but fortunately decrease as soon as you stop.
Cancer of the Womb:
Because oestrogen stimulates cell growth in the womb, it makes sense that this could lead to cancer. As long ago as 1975 a study showed that women taking oestrogen only HRT increased the risk of womb cancer by 7 times. Since then, women who have not had a hysterectomy are usually prescribed a combined pill using progesterone to cause a monthly bleed. However, even on the combined pill the risk of womb cancer is doubled.
Blood clots and strokes:
HRT increases the risk of blood clots and strokes by as much as 41%. You should be aware of this when in high risk situations such as long haul flights and being sedentary. When you stop taking HRT the risk is diminished. Use elasticated stockings to support your legs, take plenty of water, avoid alcohol and above all MOVE. Walking stimulates the muscles of the legs which are responsible for pumping blood back to the heart. Herbs such as Gingko Biloba will help to increase blood flow and improve the tone and elasticity of blood vessels.
The myth that HRT will protect your heart appears to have begun in 1985 following a very suspect study of American nurses. The results seemed to indicate that those nurses who took HRT had less incidence of heart problems. However, it appears that a nurse with a history of heart problems would not have been given HRT because even then it was known that existing conditions such as high blood pressure or history of blood clots rule out being prescribed HRT.
Later properly controlled studies have shown that HRT increases the risk of heart problems.
HRT can increase bone density, however the benefit of taking HRT for your bones only lasts while you continue to take it. Once you stop taking HRT you can experience a rapid decline in bone density. Studies have shown that by the time you are 75 your bone density may be no better than that of a woman who has never taken HRT.
The Risk Factors for Osteoporosis:
The following list of risk factors are all associated with a higher risk of developing osteoporosis. You cannot change your genetic make-up or family history but there are changes which you can make to your diet and lifestyle which will help to strengthen your bones.
- If either parent had osteoporosis then you are at a higher risk.
- If you are of Asian or European descent your risk factor is higher.
- If you currently or in the past have suffered from anorexia or bulimia the reduction in your body fat can affect your bones.
- If your periods have been absent or irregular the absence of oestrogen circulation can have an effect on your bones.
- Smoking can reduce bone density and increase the risk of hip fractures by up to 25%. Smoking alters female hormones and is linked to an earlier menopause.
- Use of steroids, laxatives and diuretics, thyroid drugs and blood thinning drugs can all affect bone density.
- Lack of weight bearing exercise.
- Intense prolonged physical exercise which results in loss of body fat.
- Being underweight.
- Early menopause.
Digestion problems resulting in prolonged use of antacids. People with coeliac disease.
You can help to boost the strength of your bones by eating a healthy diet. Make sure that you avoid fizzy drinks, animal protein, dairy foods, caffeine, sugar, salt, alcohol and bran which are all known to adversely affect bone health.
Do make sure that you eat plenty of fruit and vegetables and phytoestrogens.
Make sure that you exercise regularly, including weight bearing exercise in your routine.
If you are stressed – do something about it. The adrenal glands produce oestrogen at the menopause, but if they are exhausted by stress then they will not be able to perform that function.
Maintain a sensible body weight and do not “crash” diet.
Nutritional Supplements that could help. (Refer to the individual supplement for cautions in use.)
|Supplement/Herb||What it does||Dosage|
|Black Cohosh||Can relieve common menopausal symptoms such as hot flushes, vaginal dryness, depression, low self esteem etc. In fact, comparison studies have shown black cohosh to be far superior to HRT in reducing menopausal complaints.||200 – 400mg per day|
|Vitamin E||Vitamin E has been shown to help reduce menopausal symptoms such as hot flushes (due to correcting the associated vascular dysfunction), pains in muscles and joints, palpitations, nervousness and depression.||100 – 400IUs per day|
|Dong Quai||Commonly used for relieving hot flushes, night sweats, palpitations and irritability. It appears to have an oestrogen regulating effect and may be especially valuable in perimenopause — the period between normal menstruation and full menopause — when periods become irregular and menopausal symptoms begin to occur.||150 – 450mg per day|
|Soy Isoflavones||Isoflavones are phytoestrogenic and are frequently employed to modify oestrogenic activity in the body. Helps in slowing down the rate at which bone is broken down.||30 – 80mg per day|
|Essential Fatty Acids||EFAs are important to balance oestrogen, progesterone and testosterone and maintain hormone health through the menopause.||1000 – 2000mg fish oil per day|
|Calcium||Bone loss accelerates as oestrogen levels reduce. Oestrogen reduction happens from approximately the mid 30s, but is particularly prominent at menopause, hence the association with increased osteoporosis risk. See ‘Osteoporosis’ section||as directed|
|Red Clover||An excellent vitality booster in the menopause, helps to control mood swings, hot flushes, depression and irritability.||as directed|
|Sage||Useful to help reduce night sweats and menopausal flushing.||as directed|
|St John’s Wort||Helps combat depression.||as directed|
Diet and Lifestyle Factors
A balanced diet will contain complex carbohydrates, proteins, fruit, vegetables, and water in appropriate amounts.
Complex carbohydrates are the main energy source for the body. They are found in whole grains, and are broken down slowly to provide a steady, even release of energy.
- Best complex carbohydrates are wholegrain granary bread, oats, barley, brown rice, millet, rye bread, quinoa, corn bread. They are rich in B complex vitamins, minerals, fibre and help to keep the digestive system healthy and cholesterol levels low.Proteins build and replace tissues, carry nutrients through the blood stream to cells and help maintain the hormonal chemistry that keeps the body going. Our protein requirement varies from person to person, depending upon your metabolic type, but as a rough guide you might aim to take around 40% of your food intake as proteins.
Best Protein foods are salmon, tuna, mackerel, herrings, tofu, eggs, seaweeds, brazil nuts, walnuts, linseeds, pumpkin seeds, sesame seeds, sunflower seeds. Sprouted grains and seeds, haricot beans, lima beans, chickpeas, soya beans and lentils.
Fresh fruits and vegetables are an essential part of your diet, providing you with vitamins, minerals, fibre and carbohydrates. Most of the vitamin and mineral content of fruits and vegetables lie just below the surface, so scrub rather than peeling them. Vegetables should be lightly steamed so that they are still firm. When you boil vegetables until they are soft, most of the nutritional value is lost.
The recommended daily consumption of fruit and vegetables is 5 portions per adult. Eating lots of raw or steamed vegetables and fruits will help to boost your immune system and help combat damage caused by free radicals.
It is important to eat a wide range of vegetables, as they each contain vitamins and minerals which your body needs. Eat locally grown vegetables and fruits in their season. If you shop at a supermarket look at where the produce has come from. Strawberries in December will have come from abroad and may already be a week or more old before you buy them! By this time, the nutitional value will have deteriorated to such an extent that there will be little food value left in them.
Best fruits and vegetables are broccoli, cauliflower, brussel sprouts, mushrooms, turnips, carrots, asparagus, artichokes, spinach, avocados, apples, pears, pineapples, strawberries, raspberries, blackberries, cherries.
For menopausal women, including phytoestrogens in the diet is very important. Phytoestrogens have been shown to decrease hot flushes and night sweats and studies are now taking place to see if they can help prevent breast cancer and heart disease.
Isoflavones are abundant in soya products such as tofu, miso, and soya milk. Look for soya products which are not genetically modified and are made from the whole bean. Avoid soya protein isolates which undergo chemical treatments which add nitrates to the end product.
Good sources of phytoestrogens are:
- Sprouted beans such as mung and alfalfa
- Seeds such as linseeds, pumpkin, sunflower, sesame, poppy and caraway.
- Whole grains such as oats, barley, wheat, rye and brown rice.
- Fruit and vegetables such as apples, plums, cherries, broccoli, carrots and potatoes.
- Legumes such as soya, lentils, chickpea, kidney beans, aduki beans.
For Vaginal dryness try local application of Evening Primrose or Borage Oil or Higher Nature “V Gel”. Sylk (obtainable on prescription in the UK if you’re over 60) is available from direct from Sylk & Amazon also stock it! (Personally I couldn’t face going and telling my GP I have a problem with vaginal dryness!) Another product I’ve found great is Solgars PM Phytogen, which is a supplement. I’ve found that it’s sorted out the problem completely.
Homoeopathic Remedies which may help. (Refer to the individual remedy for guidance on the one that is most appropriate for you.)
- Calcarea carbonica
- Natrum mur
Suggested further reading: