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!

• Genistein is a phytoestrogen that provides significant help for menopause hot flashes, night sweats, and other menopause symptoms. If your hot flashes occur four or more times per day, taking geinstein in divided doses should help. 
• Hops is best known as a flavoring agent in beer, but it also contains a potent phytoestrogen known as 8-prenylnaringenin (8-PN). Studies show that 8-PN brings significant relief from hot flashes and other menopause symptoms within just six weeks of taking 100 mcg per day.
• Kudzu is a prolific vine that contains the phytoestrogen puerarin. It has been used extensively in Traditional Chinese Medicine to relieve menopause symptoms.

Today, I read an article in the Los Angeles Times about a new study published in the Journal of Women's Health that stated that gabapentin (a drug originally used to treat seizures and psychiatric disorders) is useful in helping women who have menopause hot flashes get better sleep. You can see the abstract here: http://www.liebertonline.com/doi/abs/10.1089/jwh.2008.1257.

Poor quality sleep is one of the most common effects of menopause, thanks to sleep-disturbing night sweats. However, I can't support the use of a medication such as gabapentin to help women with insomnia, especially when there are safer, more natural ways to promote better sleep. Side effects of gabapentin include drowsiness, headache, uncontrollable shaking, vision problems, anxiety, memory problems, nausea/vomiting, and strange or unusual thoughts--just to name a few!!

If you are experiencing menopause problems such as night sweats or hot flashes that are disturbing your sleep, I encourage you to try any one of these safe, effective, natural therapies:

Interestingly, with age, the human immune system undergoes something called immunosenescence—a decline in the number and function of immune cells in the bone marrow, blood, and tissues; and a decline in the ability of immune cells to communicate with each other and find the infection, and fight effectively once they get there.

Before menopause, when your female hormones are abundant, your immune system is stronger than a man’s at any age because estrogen is a natural immunostimulant. But as hormonal imbalances and premenopause/menopause occur, another change occurs in your body--your defenses take a hit that’s harder than an older man’s body ever has to deal with. So, along with menopause symptoms like night sweats and menopause hot flashes, another effect of menopause is your immune system's weakening.

These are just a few tips to help oost your immunity and protect yourself against illness this year:

Take zinc. Zinc levels, which are a critical competent for immune response, commonly decline with age, which accelerates immunosenescence. Take10–25 mg of zinc daily, plus 2 mg of copper (because zinc depletes copper). 

Take Propolis, a sticky compound bees produce to seal and protect honey-filled compartments, is rich in immune-modulating polyphenolic compounds. I recommend green Brazilian propolis from Uniflora Health Foods (http://store.uniflora.us).

 Vitamin D3, (the “sunshine” vitamin) is also critically important for immunity. It is critical for healthy mucosal barriers lining your respiratory tract, reproductive tract, eyes, and digestive system. Those barriers are your immune system’s first line of defense, keeping pathogens from getting past their guard. Take at least 2,000 IU of vitamin D3 daily.  

Wishing you the best of health this fall and winter!

I was upset to see news of a recent study conducted at the University of Illinois at Chicago and Northwestern University that concluded that placebo is better than black cohosh and red clover at reducing menopause symptoms like hot flashes. While I acknowledge that red clover has not been studied enough to conclude that it helps relieve certain effects of menopause, I completely disagree with their black cohosh findings. In fact, I have been recommending black cohosh for many years and my patients have experienced great relief from hot flashes, night sweats, and other effecs of menopause.

Black cohosh, native to North America, is derived from the dried rootstock and roots of Cimicifuga racemosa. Traditionally it was used to treat rheumatism, general malaise, kidney ailments, and malaria as well as to provide pain relief during menstruation and childbirth. Native Americans have used the herb throughout history to treat a wide variety of gynecological conditions.

Clinical studies have shown that black cohosh extract not only relieves menopause hot flashes, but also depression and vaginal atrophy. This research has prompted well-publicized studies on the standardized extract of black cohosh and its ability to treat menopause symptoms. 

In one of the largest studies on black cohosh, women with menopause symptoms received forty drops of liquid black cohosh extract twice a day for six to eight weeks. Within four weeks of treatment, a distinct improvement was seen in nearly 80 percent of the women. After six to eight weeks, all symptoms had completely disappeared in half of the women.

Another study found similar results. Scientists gave women with menopause symptoms either high- or low-dose black cohosh for a twelve week period. At the conclusion of the study, approximately 80 percent of both patients and physicians rated the treatment as "good to very good." The investigators reported no differences in either effectiveness or adverse reactions between the two groups.

The only good news that came from this newest study from the University of Illinois at Chicago and Northwestern University is that black cohosh won't hurt you and is considered safe. Well, this is GREAT news indeed, considering the only FDA-approved treatment for menopause symptoms--hormone replacement therapy--is dreadfully dangerous and increases your risk of heart disease, cancer (particularly breast cancer), stroke, and other serious problems. So if you have menopause hot flashes, night sweats, or other menopause symptoms, why not try a natural treatment that has been proven safe? I suggest taking 40 to 80 mg of a standardized extract of black cohosh twice a day. This dose should contain 2 to 4 mg of the active components (triterpenes, calculated as 27-deoxyacteine). 

• L-carnitine is an amino acid found primarily in meat (especially beef and lamb) and dairy products, with smaller amounts also present in grains, fruits, and vegetables. Several studies have been conducted on L-carnitine and weight loss. One study in particular found that individuals who took supplemental L-carnitine every day, in addition to eating a well-balanced diet and engaging in moderate exercise, lost an average of ten pounds in three months -- a 25 percent greater weight reduction than patients who did not take L-carnitine. Additionally, participants taking the supplement reduced their body mass index by 1.5 points, and reduced their low density lipoprotein (LDL) and total cholesterol levels as well as their blood sugar and blood pressure levels. I recommend taking 1,000 mg of L-carnitine per day, in divided doses.
   
• Green tea contains polyphenols, remarkable compounds with a host of therapeutic actions. Polyphenols appear to block the enzyme that breaks down norepinephrine, a brain chemical that regulates your metabolism. The higher your levels of norepinephrine, the faster your metabolism, which in turn allows you to burn calories even more efficiently. I recommend 300 to 400 mg of green tea extract a day.
   
• Hydroxycitric acid (HCA) is an extract of Garcinia cambogia, a small, pumpkin-shaped fruit from India that’s traditionally used as a culinary spice in curry dishes and in traditional folk remedies for a number of ailments. It appears to direct calories away from storing fat and, instead, toward building muscle. In addition, HCA inhibits an enzyme called citrate lyase, which plays a role in turning carbohydrates into fat. By blocking this enzymatic process, HCA is believed to boost the body’s tendency to burn, rather than store, excess carbs. HCA can be found in a variety of diet supplements that are available at most health food stores and vitamin retailers. Some good brands include Life Extension HCA Citrimax (available at www.iherb.com) and Natural Max Super CitriMax (available atwww.nutraceutical.com).

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.