Menopause symptoms

I often get asked by my patients if I think they may be approaching menopause. Signs of menopause are pretty common for women between 46 and 53. It’s during this time that you’re likely to experience less frequent, lighter periods, (this is called late perimenopause) or stopped periods altogether (this is menopause).

By the time your periods have stopped, your estrogen production will have dropped by 75–90 percent. Meanwhile, your progesterone production has stopped entirely. These hormone drops occur because your ovaries and the follicles containing your eggs are aging.

Although your ovaries and adrenal glands continue to produce estrone (a lower potency estrogen) and some estriol (an estrogen metabolite) is produced by your liver, these amounts don't support bone, breast, brain, heart, and vaginal tissues the way your premenopause hormone production does.

Simply put, menopause is a hormone deficiency condition that causes symptoms such as  menopause hot flashes, night sweats, insomnia, painful intercourse, loss of libido, vaginal infections, loss of muscle and skin tone, achy joints and brittle bones, fatigue, and mental confusion.

Fortunately, through this blog, I will provide you with some of my best solutions for menopause relief.  So keep reading!

So many of my friends and patients who are in menopause mention to me how much they would love to have the boundless energy that they witness in their grandchildren, and even adult kids. Along with night sweats, menopause hot flashes, and weight gain, it’s perfectly normal to experience fatigue and a lack of energy during premenopause and menopause.

To feel like a kid again (at least energy-wise):

Eating the right way gives you the raw material you need to produce lots of energy, and eating the wrong way can cause fatigue. If you are fatigued and just dragging yourself through the days, you can turn this situation around, even if you're 100 years old. It’s best to eat for your body type. For the best diet recommendation, see my previous entries on eating for your body type (Diet for the Estrogen Deficient-Fast Processor and Diet for the Estrogen Deficient-Slow Processor). Most menopausal women fall into one of these two categories. Once you figure out where you fall, follow those diet recommendations.
Avoid caffeine. While it's true that caffeine will give you an immediate boost, ultimately it lets you down, and hard. Used in excess, caffeine increases anxiety, and depletes energy and physical reserves by stressing your nervous system and exhausting the adrenal glands.

According to a study published in the latest edition of the journal Cancer Epidemiology, Biomarkers and Prevention, long-term use of hormone replacement therapy may cut the risk of colorectal cancer. The greatest reduction in risk was seen in women who used a combination of estrogen plus progestin for two to five years. Current users had the greatest risk reduction, but past users who had stopped at least five years ago also benefited.

So, based on this study, would I recommend using conventional hormone replacement therapy now that it has been found to reduce your risk of colorectal cancer? My answer is unequivocally no! It has been well established that conventional hormone replacement therapy has been associated with a significant increase in the risk of invasive breast cancer, cardiovascular disease, strokes, heart attacks, blood clots, and Alzheimer’s disease. So, while HRT is helpful in reducing menopause symptoms like hot flashes and night sweats—and now colorectal cancer—it is at the expense of your breast, heart, and brain health!

There are much safer and more effective ways to reduce your risk of colorectal cancer—even if you are at high risk due to family history:

1. Eat a Mediterranean diet rich in fruits, vegetables, wild-caught fish, nuts, whole grains, free-range poultry, and unsaturated fats such as olive oil and almond butter; avoid red meat, dairy products, fried and processed foods, and refined sugar and flour. 

2. Add 4 to 6 Tbsp. ground flaxseed to your diet. It’s a great source of fiber, as well as mucilage and lubricants, which provide bulk and soften your stool, helping to promote its elimination through the intestines. 

3. Don’t smoke. Smokers are 30 to 40 percent more likely than nonsmokers to die of colorectal cancer.

4. Exercise. Inactive people have a higher risk of developing not only colorectal cancer, but many other types of cancer, including breast cancer.

5. Drink alcohol in moderation, if at all.

6. Take these supplements:

Selenium is an antioxidant that has been found to inhibit cancer in animal studies. Additional research indicates that selenium shows promise in colorectal cancer prevention in humans. I recommend 50–200 mcg a day.

Calcium helps reduce the risk of colorectal cancer and precancerous polyps. I recommend at least 700 mg a day, along with 800 IU of vitamin D.

Resveratrol, a naturally-occurring compound found in grapes, may help protect against the growth and proliferation of colon cancer cells. In fact, a study published in Cancer Letters found that resveratrol reduced the growth rate of colon cancer cells by 70 percent! I recommend 200 mg, standardized to at least 8 percent total resveratrol, mixed with flavonoids for better bioavailability.

In a previous post, I discussed a common perimenopause symptom: fibroids. I also told you how to use diet to control this problem that’s so common in early menopause. Today, I am going to give you some supplements that can reduce fibroids and their symptoms.

Nutritional supplements can help balance hormones and reduce estrogen levels. When used properly, they can dramatically reduce bleeding, pain, and cramps that may accompany fibroids. In particular, I suggest using:

• B-Complex Vitamins—help regulate estrogen levels and reduce menstrual cramps. I recommend taking 50–100 mg of B-complex vitamins daily, with an additional dose of 50–100 mg of vitamin B6 (not more than 100 mg total of B6), which has been shown to be particularly helpful in reducing menstrual cramps, fluid retention, weight gain, and fatigue.

• Vitex (Chaste Tree Berry)—normalizes the secretion of hormones and helps bring estrogen and progesterone into balance. I recommend taking 40 mg once or twice a day.

• Vitamin C and bioflavonoids—work to build collagen and strengthen blood vessels, while promoting normal estrogen production and blocking its fibroid-stimulating effects. I suggest taking 1,000 to 5,000 mg of a mineral-buffered vitamin C and 750-2,000 mg bioflavonoids daily, in divided doses (choose a product with additional rutin, a potent bioflavonoid derived from alkaline buckwheat, rather than naringin, an acidic, grapefruit-derived bioflavonoid). With both nutrients, start at the low end of the dosage range and work your way up.

• Vitamin A—a study of 71 women found that those with excessive bleeding had significantly lower blood levels of vitamin A than the normal population. I suggest taking 5,500 IU of vitamin A, as beta-carotene, per day.
 

Another common perimenopause symptom is uterine fibroids. Approximately 40 percent of women have fibroids by mid-life, and usually, they don’t cause problems. However, fibroid removal accounts for nearly one-third of all hysterectomies performed annually in the United States, many of which are completely unnecessary. The fact is, many fibroids will likely shrink and may even disappear with menopause.

As with estrogen dominance, another premenopause symptom, fibroids can be largely controlled through diet. You need a wide range of nutrients to help balance your hormones and reduce your estrogen levels, decrease cramping and inflammation, and generally improve your physical and mental well-being. Increasing your intake of the foods listed below will provide the necessary nutrients to produce these effects.

1. Whole grains are excellent sources of B vitamins, as well as vitamin E, magnesium, calcium, and potassium. Fiber in whole grains absorbs estrogen, helps remove it from the body, and normalizes bowel function.
 

2. Legumes contain fiber and are high in calcium, magnesium, and potassium. I am especially fond of soybeans, which help regulate estrogen levels.

3. Fruits and vegetables contain a wide range of nutrients that can relieve menstrual cramps, including vitamin C and bioflavonoids.

4. Seeds and nuts, especially flaxseed and pumpkin seeds, are wonderful sources of essential fatty acids (EFAs), the raw materials necessary for the production of prostaglandins.

5. Fish contains linolenic acid and is an excellent source of minerals, especially iodine and potassium. Salmon, tuna, mackerel, and trout are especially good for women with menstrual cramps.

6. Oils containing vitamin E help to balance mood, and ease fatigue and cramps that occur at the onset of menstruation for women with fibroids. Good oil sources include sesame seeds and wheat germ.

7. Avoid saturated fats; dairy products such as yogurt, milk, cheese, and cottage cheese; salt; refined sugar; caffeine; and alcohol.

Wyeth Pharmaceuticals is the largest maker of hormone replacement therapy (HRT) drugs, including Prempro—which was found to be associated with an increased risk of breast cancer in the Women’s Health Initiative studies. However, that didn’t stop Wyeth from developing a new HRT formulation named Aprela for the relief of menopause symptoms such as menopause hot flashes and sleep disturbances, reportedly without increasing a woman’s risk of estrogen-related cancers.

 According to Wyeth, Aprela combines estrogen (Premarin) with a SERM (selective estrogen receptor modulator) called bazedoxifene. SERMs block the action of estrogen in certain tissues, including the breast, by occupying estrogen receptors so that estrogen cannot attach to the receptor sites. At the same time, SERMs reportedly stimulate estrogen receptors in other tissues, such as the liver, bone, and uterus (which increases your risk of uterine cancer!). But Wyeth’s studies suggest that bazedoxifene doesn’t have that uterine-stimulating effect, thereby making it a better SERM for a safer HRT drug. In clinical trials, women have been taking Aprela daily for two years while being monitored for breast cancer. However, the study is less than three years old, and it can take 10 years for breast cancer to develop!

If you need to take hormone replacement therapy to relieve menopause symptoms, I much prefer that you consider taking bioidentical hormones, which can provide menopause relief without increasing your risk of life-threatening cancer. Talk to your doctor about bioidentical hormones, a much safer and more effective option.
 

In response to my recent blog post on "Are You in Perimenopause?," Lisa B. asked if there was a pill available to help relieve perimenopause symptoms. Because this is an issue that touches so many women, I've decided to devote this post to its answer.
 
Estrogen dominance is the most frequent cause of unpleasant symptoms during perimenopause and bringing it back into balance is key to finding relief. While there are many products on the market that claim to provide relief from perimenopause symptoms, I urge you to do your research and pick the product that best fits your unique symptoms.  Some women find relief from their symptoms with just one or two supplements, while others may need to take several in combination. The specific supplements I recommend for estrogen balancing are:

• Soy isoflavones — 50 to 100 mg of soy isoflavones as food and in pill form.
• Bioflavonoids — 750 to 2,000 mg per day.
• Flaxseed oil or ground flax meal — 1 to 2 tbsp of flaxseed oil; or 4 to 6 tbsp ground flax meal mixed into cereals and shakes.
• Vitamin B-complex — 25 to 100 mg daily assists the liver in detoxifying estrogen.
• Herbs such as turmeric (400-500 mg two to three times a day), or dandelion (150-500 mg daily) or milk thistle standardized extract (150-175 mg one to three times a day) and amino acids like L-methionine (200-1,000 mg) or L-cysteine (200 mg twice a day) also promote healthy liver detoxification.
• Oat or rice bran for fiber (1-2 tbsp per day in 8-12 oz water).

On my website, www.DrLark.com, you’ll find many products that meet the specific needs of women, along with valuable information to help you identify a natural solution that will work best for you.

Progesterone's job in your body is to balance the effects of estrogen. Where estrogen is growth stimulating, progesterone is growth limiting. Estrogen is mood elevating; progesterone has a sedative effect on mood. One of progesterone's tasks is to prevent menstrual bleeding from becoming too profuse or long lasting (a symptom common with estrogen dominance). Often, progesterone is often combined with estrogen replacement therapy to control perimenopause symptoms and to provide menopause relief.

If you’re in early menopause (or premenopause), here's a checklist to help you find out if your body produces enough progesterone. If two of these symptoms apply to you, you may benefit from natural progesterone replacement.

o My sleep quality is poor.
o I am often unable to concentrate.
o I'm unable to remain calm under stress.
o I suffer from PMS.
o I'm over 50.
o I'm in perimenopause or early menopause.
o I have a decreased interest in sex.
o I have heavy, irregular bleeding.
o I have premenstrual bloating or swollen breasts.

Most of my patients tend to prefer natural progesterone cream, which is available without a prescription. A typical dosage of natural progesterone cream is 20 mg a day or one-quarter to one-half teaspoon amounts applied to any clean area of the skin twice a day. Look for a product that contains 400 – 600 mg of progesterone per ounce like Pro-Gest or Fem-Gest.

Estrogen dominance is often the cause of the perimenopause symptoms many women experience. Estrogen dominance is when your hormones are imbalanced and your body produces too much estrogen and not enough progesterone. My perimenopause program corrects estrogen dominance by reducing estrogen levels and promoting progesterone production. In this post, I will give you my diet recommendations to reduce your perimenopause symptoms, including estrogen dominance:
 

• Eat soy foods, buckwheat, citrus fruit rind and pulp (not the juice), and ground flax meal in shakes and cereals. They help to reduce estrogen production and prevent the hormone from binding to tissue receptors.
  
   
• Avoid caffeine, alcohol, chocolate, sugar, soft drinks, fruit juices, fried or fatty foods, and salt—all of which hamper the process that metabolizes estrogens and eliminates them from your body.
  
   
• Eat a low-fat, high-fiber diet to help your intestines eliminate estrogens so they are not reabsorbed into your body. Include plenty of fresh fruits, vegetables, whole grains and legumes (beans, peas).
  
   
• Reduce or eliminate red meats. They not only elevate estrogen levels but they also contain the type of fats that cause menstrual cramps and worsen the inflammation of endometriosis. Instead, eat fish such as salmon, mackerel, sardines, trout, and tuna which are high in beneficial omega-3 fatty acids that reduce the pain of menstrual cramps and endometriosis.  Range-fed chicken or poultry are also good dietary options. In addition, instead of hamburgers and hotdogs, buy vegetarian Gardenburgers or Boca Burgers to prepare at home.
  
   
• Avoid dairy products since they have a negative effect on reproductive health similar to that of red meat. Use soy or rice substitutes, including soy and rice milk, cream cheese, sour cream and soy yogurt.

Perimenopause (otherwise known as early menopause or premenopause) is the name given to the seven to 10 years preceding menopause. Here is a checklist to help you determine if you are in this stage of life. If you answer yes to two or more of these questions, you may be in early menopause.

• Do you have heavy, irregular periods?
• Are you retaining fluids?
• Have you gained more than 10 pounds?
• Are you experiencing sleep difficulties?
• Are you having headaches?
• Do you have bouts of brain fog—forgetting your friend's first name, where you put your car keys, or the point of a text you recently studied?
• Have you recently discovered cysts in your breasts?
• Have you been told you have fibroid tumors?
• Have symptoms from endometriosis worsened?
• Are you over age 35?
• Do you suffer from premenstrual anxiety, irritability, and mood swings?
• Do you have a decreased interest in sex?