Alternatives to HRT
is the Menopause?
The menopause is a time during which the levels of a woman's reproductive hormones - oestrogen and progesterone - decline to the point where menstruation ceases. It is important to remember that the menopause is not a disease, but a completely natural phenomenon. Many cultures celebrate this dawn of a new era in a woman's life, revering the wisdom that comes with the years, but we in the west tend to associate it with a period of 'identity crisis' and negative attitudes.
The average age of the onset of menopause in the UK is 50. This coincides with mid-life, when both men and women begin to feel the effects of their lifestyles over the preceding years, and many of the symptoms that are blamed on the menopause are actually the result of poor lifestyle choices and eating habits. Some symptoms may have other causes, so if they persist, you should seek advice from your GP or herbalist.
Hormonal change begins to happen anything up to ten years before the periods cease completely. Many menopausal symptoms occur as a result of declining levels of oestrogen and progesterone, particularly if levels of these hormones fall suddenly or 'out of sync' with each other. As the ovaries decrease production of oestrogen and progesterone, the adrenal glands start to produce a type of oestrogen, as well as a small amount of progesterone and testosterone (the 'male' hormone). The adrenal oestrogen can replace up to 75% of pre-menopausal levels, but thin women, and those suffering from ill-health, produce much less and may therefore have more problems during menopause. Smoking is associated with an early menopause, and total hysterectomy (as well as some chemotherapy and radiotherapy treatments) results in an artificial menopause, usually accompanied by more severe symptoms than a natural menopause.
The conventional treatment for those hormonal changes is HRT - artificially synthesised hormones which 'fool' the body into believing that it is not menopausal. According to surveys, only 10% of menopausal women in the UK have symptoms that are considered to be severe enough to warrant treatment, but a far higher proportion of women are currently taking HRT. However, such treatment simply postpones the inevitable. When HRT is stopped, the body immediately resumes its menopausal changes, and symptoms are generally much more severe because of the very dramatic and sudden fall in hormone levels on ceasing replacement therapy. A woman is much better able to cope with such symptoms, both physically and emotionally, while she is in her fifties than she is if the menopause is delayed until she reaches her sixties or seventies.
Finally, never forget that the pharmaceutical industry's campaign to eliminate the menopause is a billion dollar business. Persuading you that the menopause is a disease is to their great financial advantage.
PROS AND CONS OF HRT
Prevention of osteoporosis? -: HRT can reduce likelihood of fractures by 50% if taken for at least 5 years, but is ineffective if started over the age of 60.
Relief from hot flushes and night sweats? - these cease with HRT, but also stop on their own eventually. On ceasing HRT they will return in a more severe form.
Reduced risk of heart disease and stroke? - Studies are inconclusive.
Reduction of emotional symptoms? - there is no evidence that HRT has any effect whatsoever in alleviating symptoms like depression and anxiety, but this is one of the most common reasons for prescribing it.
Vaginal dryness and discomfort during intercourse? - HRT usually very successful.
Side-effects? - combined HRT produces a monthly bleed. Progesterone therapy can cause headaches, depression, loss of energy, fluid retention, breast tenderness and leg cramps.
Breast Cancer? - After 15 years the breast cancer risk increases by 30% in oestrogen-only HRT, but is doubled in combined HRT.
Endometrial Cancer? - Combined therapy: risk increases by a third; Oestrogen-only therapy - risk is trebled. The current medical view is that progesterone may protect against endometrial cancer.
HRT is also connected with the development of gallbladder disease
Implants? - Addictive behaviour has been reported - ie many women need ever higher doses to maintain the same effect.
Women who have had breast cancer, endometrial cancer or liver disease SHOULD NOT consider HRT. You should also think long and hard if you are a heavy smoker, suffer from fibroids or endometriosis, or have a history of heart disease, thrombosis or hyperlipidaemia.
Coming off HRT? - Symptoms often come back even more severely, and some women seem to age alarmingly. It is advisable to wean off gradually.
can you do to help ensure a trouble-free menopause?
It is never too early to begin to prepare for the menopause. The following section gives a few general guidelines.
Poor diet is known to be related to hormone imbalance, and those women who experienced premenstrual difficulties during their reproductive years have been shown to be more prone to menopausal problems.
Try to eat food that is in as natural a state as possible - lots of fresh fruit and vegetables, wholegrains, pulses, seeds and nuts. Reduce your meat intake and avoid all processed and 'junk' foods. Season your meals with herbs rather than salt. Hot, spicy foods can aggravate flushing
We in the West eat far more protein than is necessary, so it is a good idea to reduce our intake of meat and dairy produce. Much of the meat and dairy produce in this country contains traces of hormones deliberately given to animals to increase milk and meat yields.
Calcium intake need not be affected by a reduction in dairy products if you eat more foods such as seeds, nuts, oats, blackstrap molasses, sardines, salmon, figs and parsley. Almonds contain 250mg of calcium per 100g, cows milk only 120mg per 100mls. The recommended daily amount of calcium is 1000mg prior to the menopause, rising to 1500mg during and after the menopause.
Faddy diets should be avoided at all costs, particularly the currently fashionable high-protein Atkins Diet, which can result in serious long-term health problems. Those ladies who are having difficulty losing weight should consider joining a 'Weightwatchers' or 'Slimming World' group; both these organisations offer a sensible, balanced approach to weight loss and provide moral support.
It is a good idea to increase your intake of 'phyto-oestrogenic' foods to allow a good level of hormone production to be maintained. Japanese women, whose diet is rich in these foods, rarely suffer from the menopausal symptoms that afflict Western women and, in fact, have no equivalent word for 'hot flush'! Phyto-oestrogenic foods include soya, corn, apples, bananas, almonds, cashew nuts, oats, pulses, broccoli, cauliflower and green leafy vegetables.
Eat regularly - hot flushes may be related to fluctuations in blood sugar levels. Try to eat fewer sugary foods which can cause a surge in blood sugar.
Try to drink at least two litres of water per day (you can include nettle or dandelion leaf tea in this total, but NOT coffee, alcohol or fizzy drinks). Try to have no more than two cups of ordinary tea per day.
Ensure that you empty your bowel at least once a day, otherwise toxic build-up will aggravate your symptoms.
Regular exercise keeps you fit, helps to maintain bone density, delaying the onset of osteporosis, helps prevent weight gain, lifts the spirits and boosts your immune system. Be realistic - chose an exercise regime that you are going to be able to stick to. For example:
Take a twenty-minute walk every day. Don't amble, walk briskly.
Join a keep-fit class.
Go swimming twice a week
Buy an exercise video and do 20 minutes every morning.
Gentle, stretching exercises such as yoga, can help you to relax.
Take time to wind down before you go to bed. Have a warm bath with a few drops of lavender oil.
Don't eat too close to bedtime and avoid coffee in the evenings
If you suffer from 'restless legs', try taking magnesium and vitamin E supplements for a few months.
Make sure you allow time each day to spoil yourself. Sit back and listen to your favourite music, go for a walk, or book an aromatherapy massage
Eat regularly, and avoid stimulants such as coffee.
Practice relaxation techniques, for example, deep breathing, meditation or yoga.
menopausal symptoms, their causes, and how to treat them naturally.
The remedies described below are generally safe to take, but please seek professional advice first if you are currently taking any other medication. Several of the herbs used to treat menopausal symptoms should not be taken at the same time as conventional HRT treatment, the contraceptive pill, or if you have a history of breast cancer. Women with thyroid problems and those on anticoagulant therapy should also seek professional advice before taking any herbs or supplements.
In most cases, the remedies described here will reduce the severity and frequency of symptoms within three months, sometimes more quickly. If you find that they are not having the desired effect, then don't despair. There are many additional herbs and supplements available that may help you. We are all unique individuals, and a consultation with a qualified herbal practitioner will ensure that the best combination of herbs and supplements for YOU can be chosen.
flushes and night sweats
Falling levels of oestrogen are one of the causes of hot flushes. However, increased levels of histamine can also be a factor. Histamine production rises when you are under stress, if you are sensitive to particular foods, or if you smoke or drink alcohol. Highly processed foods are also culprits.
Sage (Salvia officinalis) helps to balance the brain's sweat-regulating mechanism. Black Cohosh can also be of benefit as it mimics oestrogen in the body. This herb should not be taken in conjunction with HRT or if you or a relative has a history of breast cancer.
You should also stop smoking and
address your diet. Try to eat foods which are in as natural a state as possible,
drinks lots of water, and avoid coffee and alcohol. Drinking nettle tea several
times a day can reduce histamine levels. Vitamin C is also a natural
Irritability and anxiety
Irritability and anxiety may be due to a deficiency of the B-vitamins and magnesium, essential for a healthy nervous system and adrenal glands. Low progesterone levels can also be a factor, particularly in women with a history of PMS. Lack of sleep will exacerbate symptoms.
B-complex and Magnesium supplements should be of benefit, and Passionflower (Passiflora incarnata) or St. John's Wort (Hypericum perforatum) will help to relieve symptoms. If you are taking any other medication, please check that St.John's Wort is safe for you to take. Bach Flower remedies may also offer effective treatment - choose the remedy most suited to your personality type.
Research has shown that osteoporosis is due to nutritional deficiencies as much as, or even more than hormonal changes. Thin, meat-eating women who eat a high protein, high salt diet are most prone to osteoporosis. Low magnesium levels, lack of exercise, smoking and alcohol are also factors. Although conventional HRT can protect against osteoporosis, as soon as you stop bone density falls rapidly. Improving your diet and lifestyle is a far better long-term solution.
Since the body requires magnesium in order to absorb calcium, you should increase your consumption of magnesium-rich foods such as wholegrains, pulses, nuts, seeds and fresh fruit and vegetables. You should avoid all faddy diets, in particular the high-protein Atkins diet, which has many potentially dangerous side-effects. Nettle (Urtica dioica) helps with calcium absorption, whilst Black cohosh, which attaches to oestrogen receptors in the bones, will help maintain bone density.
Oestrogen is a mild anti-depressant, and a sudden fall in levels can cause mild depression. Symptoms such as flushing can also make you feel quite tired and emotionally low.
Regular exercise encourages the body's production of chemicals known as endorphins; these are known to increase feelings of well-being. Take a brisk walk daily, visit your local swimming pool or join a dance class. Exercise is extremely important for your general health and will also help with any weight-loss regime.
St.John's Wort (Hypericum perforatum) is a marvellous treatment for mild depression. However, it can be harmful if taken alongside several conventional drugs, so you should always check with your herbalist or GP before you take it. If it does prove to be inadvisable, then try Passionflower (Passiflora incarnata) or Lemon Balm (Melissa officinalis) instead. Both have an uplifting effect on the spirits and can help to reduce nervous tension.
Fatigue can be caused by lack of sleep due frequent night sweats or anxiety, low iron levels due to very heavy periods, other nutritional deficiencies, or inefficient removal from the body of toxins due to constipation.
Iron levels can be boosted by a natural iron tonic such as Floradix which, unlike conventional iron supplements, will not make you constipated. Too much wheat can cause feelings of tiredness and bloating, so try to reduce the amount of bread, pasta and other wheat products in your diet. Coffee and other stimulants should be avoided, especially in the evening.
Herbs such as Valerian (Valeriana officinalis), and Passionflower (Passiflora incarnata) can help you to relax. Another useful herbal sleep-inducer is Hops (Humulus lupulus), although this should not be taken if you suffer from depression. Give yourself an energy boost with Siberian ginseng (Eleutherococcus senticosus). Chinese or Korean ginseng (Panax ginseng) is NOT recommended because it is a little too stimulating. Chinese angelica (Angelica sinensis, or Dong Quai) may help induce general feelings of well-being. Oats (Avena sativa) help to calm and nourish the nervous system.
High levels of oestrogen in relation to progesterone can result in frequent, heavy periods. High oestrogen levels may be caused by a poorly functioning liver, particularly if the bowel is a little sluggish. Chaste berry (Vitex agnus-castus) will help to balance oestrogen and progesterone levels, although it can take up to three menstrual cycles to reach its optimum effect. This herb should be avoided if you are on conventional HRT or are taking the contraceptive pill.
Liver function can be given a boost with milk thistle (Carduus marianus) and dandelion root (Taraxacum officinale); the latter is also a gentle laxative.
Flooding is not a normal symptom of menopause and should be reported to your GP
if severe or if it continues for a long time. Similarly, if bleeding recurs
after menstruation has ceased for six months or more, you should tell your GP.
aches and pains
Poor diet, leading to a build-up of uric acid, can cause joint pain, but low oestrogen levels can also be a factor. Nettle or celery seed tea help to dissolve uric acid crystals. Black cohosh (Cimicifuga racemosa) will relieve symptoms caused by falling oestrogen levels. The discomfort and inflammation of osteoarthritis can be relived by Devil's claw (Harpagophytum procumbens).
gain and 'bloating'
The primary causes are poor diet, over-eating and/or lack of exercise. The remedy is obvious! Other factors include the consumption of too much coffee and salt and not enough water. A poorly functioning bowel and too many wheat-based foods in the diet will result in bloating, and a poorly functioning liver is unable to metabolise fats properly.
A gentle laxative such as dandelion root (Taraxacum officinale) wills both improve liver function and increase the efficiency of the bowel. Milk thistle (Carduus marianus) will ensure that your liver is working efficiently. Dandelion leaf tea (not the root) is a potent diuretic that will help to reduce fluid retention. Aromatherapy massage can also help.
Low levels of oestrogen can cause thinning of the lining of the bladder which may lead to mild incontinence, for example when you cough or sneeze. It can also give rise to recurrent bladder infections like cystitis.
Pelvic floor exercises are effective in alleviating stress incontinence. One of the easiest and most convenient ways to do this is to tense your pelvic muscles each time you empty your bladder, stopping the flow of urine for a few seconds before allowing it to flow again.
It is important to drink lots of water to ensure that the bladder is flushed out regularly. Coffee, fizzy drinks and alcohol can all irritate the bladder, so intake of both should be reduced. Sugar, sugary foods and yeast can exacerbate candida and bacterial infections. Taking cranberry juice daily helps prevent bacteria from sticking to the bladder lining, but beware of juices with a high sugar content, as this can actually make your symptoms worse. Cranberry is available in capsule form, with no added sugar.
Bearberry (Arctostaphylos uva-ursi) helps to disinfect the bladder. It works most effectively in an alkaline environment, so you should reduce acid-forming foods like sugar and alcohol to an absolute minimum.
This is caused by low oestrogen levels and, sometimes, lack of Vitamin E. Black cohosh will help balance oestrogen levels. If a vitamin E supplement is required, take 200 to 400 i.u. daily.
skin, thinning hair and brittle nails
These are most likely to be caused by nutritional deficiencies as a result of poor diet over many years, although falling oestrogen levels can result in thinning hair. Poor calcium absorption and a lack of silica and zinc may make the nails brittle and cause the skin to lose its elasticity.
Adopt the same dietary measures as those described for osteoporosis. It may also be necessary to take a multi-vitamin and mineral supplement for a few months. Kelp (Fucus vesiculosis) may be of benefit, but should not be taken by women with thyroid problems. Silica will improve the nails, skin tone and hair thickness if taken over three to four months. Nettle tea is also of benefit.
Herbal Medicine for the Menopause: This is an easy to understand reference guide to tried and tested herbs for the menopause according to symptoms. Clear guidelines are provided on self-help measures and a line is drawn indicating when it becomes advisible to consult a qualified practitioner. Herbal Medicine for the Menopause is a valuable asset to add to your bookshelf.
NB: You should not self-medicate with herbs or dietary supplements without first discussing your needs with a qualified herbalist and/or your GP. Several of the herbs used to treat menopausal symptoms should not be taken at the same time as conventional HRT treatment, the contraceptive pill or if you have a history of breast cancer. Women with thyroid problems and those on anticoagulant therapy should also seek professional advice before taking any herbs or supplements.
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For your safety I am prohibited from giving specific medical advice to individuals over the internet or telephone so please do not waste your time or mine by emailing or calling me with detailed information about your health problems - I can only undertake face-to-face consultations for what should be obvious reasons. Diagnoses cannot be made remotely, and I am unable to offer any advice or treatment until I am completely satisfied that I know what I'm dealing with! The herb profiles and treatment suggestions on this website will help enable you to choose which herbs might be appropriate for minor ailments. For more serious or chronic conditions you should seek professional advice. This is particularly important if you are taking medication from your doctor or pharmacist, as some herbs can interact adversely with other drugs. If you would like to have a consultation with a medical herbalist then you should click here then scroll to 'Professional Organisations' at the bottom of the page to find a qualified practitioner in your area.
Christine Haughton, MA MNIMH MCPP FRSPH
Wold Farm, West Heslerton, Malton, North Yorkshire YO17 8RY, UK
Last updated 3rd September 2013 İPurple Sage Botanicals