Time and again, Dr. Lark has recommended that women of all hormone types limit, if not avoid, wheat and wheat-based products. I personally subscribed to this advice several years ago and I can tell you first-hand that I believe it has played a large role in balancing my hormones.

Wheat is one of the two most common food allergens, and the gluten found in wheat can trigger a very serious condition known as celiac disease. Those afflicted with the disorder are plagued by diarrhea, gas, vomiting, and anemia, and are at higher risk for more serious conditions, including osteoporosis and gastrointestinal cancer.

Clearly celiac is the very extreme of wheat-related issues, but if you are concerned about your hormonal health, you would be wise to steer clear of wheat. Women suffering from menopause symptoms are often at risk for wheat-related mood shifts, due in part to their growing inability to produce enough enzymes that are needed to digest wheat properly and easily.

And for those of you who are in estrogen dominance or are experiencing early menopause or premenopause, wheat should also been taken off your list. Wheat can worsen PMS symptoms and aggravate all perimenopause symptoms, including heavy menstrual bleeding and irregular menstrual cycles. Plus, studies have shown that an astounding 80 to 93 percent of women suffering from migraines also suffer from food allergies that trigger their headaches, and wheat is one of the most common allergens that affects migraineurs.

What to Eat

Believe me, I know the idea of giving up wheat can be daunting, but remember, it is an ingredient, not an entire food group. That means you can still have bread, pasta, pizza, pancakes, crackers, cookies, etc.—you just need to know what kind to buy. Thankfully, you have this blog to guide you!

For bread, I highly recommend Glutino’s Flaxseed bread. In fact, it’s the only pre-sliced bread I recommend. It is amazing toasted or dipped in an egg and cinnamon mixture and grilled. Top with sautéed apples and you are in for a treat!

For an easy, amazing flour and pancake mix, Pamela’s Products is the way to go. They also have bread, brownie, and cake mixes that you can’t beat. I’ve even swayed my family onto these mixes and they don’t even try to eat wheat-free…the mixes are just that good!

For pizza, you can buy Amy’s rice crust frozen pizza or pick up a bag of Namaste Foods’ pizza crust mix. It is easy and delicious!

For pasta, you can’t go wrong with Bionaturae pastas. My husband ate these pastas for nearly six months before he knew they were wheat-free.

For cookies, there are a large number of wheat-free brands. My personal favorites are Pamela’s Oatmeal Raisin, Paul Newman’s wheat-free, dairy-free Fig Newmans (yes, I spelled that right!), and Jennie’s Chocolate Macaroons.

Most of the brands I’ve mentioned are available at Whole Foods Markets. To locate a store near you, log on to www.wholefoods.com. If there isn’t one in your area, you can still purchase products from the store by visiting www.gaiam.com, clicking on “shop,” then on “health,” and finally on “Whole Foods Market.” You can also visit my Web site at www.decadenthealth.com for a list of wheat-free substitutions and recipes.

And to give you a little taste of how easy and delicious wheat-free can be, here’s a great granola recipe from my grandmother that I’ve tweaked over the years. Enjoy!

Grandma Ginny's Granola

4 cups oatmeal

2 cups soy flour

1 cup almonds, sliced

1 cup sunflower seeds, raw

1 cup coconut, unsweetened

1 cup flaxseed, ground

1/2 cup dried mango

2/3 cup olive oil

2/3 cup honey

1 teaspoon vanilla

1. Preheat oven to 350°F.
2. Grease 13x9-inch baking dish.
3. Combine oats, flour, almonds, sunflower seed, coconut, flaxseed, and mango in a large bowl. Set aside.
4. Combine oil, honey, and vanilla in a small bowl. Pour over oat mixture and blend well.
5. Pour mixture into baking dish and bake for 40–45 minutes or until browned. Stir mixture every 10–15 minutes.           
6. Cool on baking rack. Can be stored in the refrigerator in an airtight container.

As Dr. Lark and I wrote in Hormone Revolution, women with varying hormonal types need to eat very different categories of foods. For example, a woman with menopause symptoms or someone looking for menopause relief (an estrogen deficient-fast processor) would want to steer toward foods with a higher pH and avoid foods that are spicy or acidic.

Conversely, a woman who is in early menopause or premenopause and may be experiencing perimenopause symptoms (estrogen dominant or an estrogen deficient-slow processor) would aim for the exact opposite. She would want to choose foods that are more acidic, spicier, and those high in fiber.

An easy way to work beneficial foods into your specific hormonal program is to start with profile-appropriate spices. Here are three spices that are perfect for each hormonal type and a variety of ways to incorporate those spices into your diet.

Spices to Relieve Menopause Symptoms

Basil: Use basil in your scrambled eggs in the morning, mixed into a salad at lunch or dinner, or layered with eggplant and goat cheese as a delicious side dish.

Peppermint: Mint adds a surprising flavor to quinoa. Mix with dried apples and serve warm. Also makes a perfect after dinner tea.

Herbes de Provence:  This delightful blend of rosemary, basil, marjoram, bay leaf, thyme, and lavender is the perfect mixture for topping chicken or fish. I also like to add it to pureed cauliflower for a quick and easy side dish. If you are really adventurous, try it over a roasted pear for a savory dessert. Yum!

Spices for Estrogen Dominance and Premenopause/Early Menopause

Ginger: Mix ginger into your wheat-free pancake batter for a little kick in the morning. Top with sautéed apples and you are set for the day. Another easy trick is to add sauté shallots and sliced ginger in a little olive oil and serve over chicken.

Turmeric (curry): One of my husband’s favorite sauces is made with two teaspoons of curry paste, a 14-ounce can of coconut milk, ½ a cup of chopped onions and one tablespoon of tamari sauce. Bring to a boil and serve over any mild white fish.

Cinnamon: You can go wild with cinnamon at any meal. Add to oatmeal or a smoothie in the morning. Mix with balsamic vinegar and olive oil for an easy salad dressing. Mix into quinoa or rice and dried fruit for an easy side dish. Or sprinkle on an apple, pear, or even berries for an easy, yet delicious dessert.

During the Today Show’s 9:00 hour, they have a segment on the five health habits to skip. They included: eating breakfast every day, doing a monthly breast exam, taking a daily multivitamin, staying inside when it’s cold out, and not eating after 7:00 pm. While some have value (the staying inside and not eating after 7:00 pm), two are completely irresponsible—telling women that they don’t have to do a monthly breast exam and that they can skip their multinutrient.

I was so floored my toothbrush literally fell out of my mouth. No monthly breast exam? The expert explained that research has indicated that by the time a woman feels a lump in her breast, it is already pretty advanced. Instead, she should opt for yearly mammograms. Also, they indicated that self-exams often have a high rate of false positives, and that women who did them had double the rate of biopsies as women who did not. And the vast majority of those lumps ended up being benign.

Okay, now I get it. Once again, big medicine is telling us to “pay” for prevention rather than showing us free or inexpensive ways to prevent disease on our own. Most interesting is the fact that everything they have said about self-exams is true for mammography!

As Dr. Lark wrote back in August 2002, there are several inherent risks with mammograms. According to a 2000 study from the Journal of the National Cancer Institute, “the cumulative risk of having false positive mammograms is quite significant in many women.” On the flip side, a research article that appeared in the June 27, 2002 issue of The New York Times reported that mammograms don’t detect breast cancer in 30 to 40 percent of women who have the disease. But most telling is a 2000 study from the Journal of the National Cancer Institute, which found that in women between the ages of 50 and 59, mammograms were no more effective in reducing death from breast cancer than self-exams!

So, sorry Today Show, you are very wrong on this one. All women, especially those in early menopause or premenopause, and those women experiencing perimenopause symptoms should absolutely continue to perform monthly breast self-exams. All three of these scenarios are closely tied to excess estrogen, which is a risk factor for breast cancer.

Also, to advise people who “eat a healthy diet” to not take their multivitamins is downright absurd. First of all, how many people can agree on what is a healthy diet? This has been an ongoing debate for decades! Just look at the diet industry!

But even if we can all agree that a healthy diet includes at least five servings of vegetables, four servings of fruit, and four to six servings of whole grains, how many people are really, truly eating this way? According the Johns Hopkins Bloomberg School for Public Health, only 11 percent of Americans are eating five servings of fruits and vegetables a day. That’s one out of every 10 people eating a healthy diet.

And even if you are in that 11 percent, what’s the likelihood you are eating mostly vegetables and mostly organic? I’d wager that the number would start to shrink down to the lower single digits. Plus, the people claiming that you can get all the nutrients you need from the food you eat are delusional. Sure, about 20,000 years ago, the diet of our Neanderthal ancestors supplied all of their major minerals, and the vast majority of their trace minerals. Even in my great-grandparents and grandparents time, farmers used practices that returned minerals and other nutrients back into the soil, such as crop rotation, mulching, and relying on manure as fertilizer. But today’s conventional and large-scale farming practices are not what they used to be.

Now we are finding phosphates and nitrates in the soil, thanks to the widely used conventional NPK fertilizers, which has been shown to deplete the soil of its mineral content. The result has been far fewer micronutrients, especially the minerals selenium, iron, and zinc. So, even if you are eating your fruits and veggies, they are likely not providing you with the nutritional foundation you need for optimal health.

My advice? Watch the Today Show for their take on the news and the latest celebrity gossip, but leave the health and nutrition advice to those less swayed by advertising dollars. And take your multivitamin every day. Your body will thank you.

Ah, the humble flaxseed. Who knew that such a small seed could have such a profound impact on your hormonal health?

As Dr. Lark and I wrote in Hormone Revolution, flaxseed helps women at every stage of hormonal development. For women in the throes of estrogen dominance, premenopause, early menopause, and even perimenopause, flaxseed helps to increase progesterone production while simultaneously flushing excess estrogen from your system. This keeps perimenopause symptoms such as heavy menstrual bleeding at bay.

For women suffering from signs of menopause like dry skin or a flaky scalp, flaxseed helps to keep skin and tissues soft and supple. Plus, it helps to lubricate those creaky joints that seem to show up out of nowhere.

Given all the amazing things that flaxseed can do for women of all ages, the question remains: How do I manage to get the four to six tablespoons a day I need for optimum hormonal health? The answer is deliciously easy.

I find that breakfast is a great time to get flaxseed. I’ve included my three favorite breakfast ideas for you, as well as an easy lunch and dessert option.

1. Add four tablespoons to a smoothie. My favorite is to take half a banana, 1 cup of berries, 1 cup almond milk, 1 cup fresh spinach, a handful of ice, and your flaxseed. Blend until smooth and drink immediately. The fruit “hides” the spinach, yet you are still getting 2+ servings of fruits and veggies!
2. Add four tablespoons to oatmeal. I like to “steam microwave” half an apple (diced) and add to a cup of cooked oatmeal. Sprinkle on some cinnamon and your flax and you have a hot meal that just sings of autumn.
3. Add four tablespoons to scrambled eggs. Yes, to eggs. You’ll have to trust me on this way. It is delicious! Scramble two eggs and add a little goat cheese and dill. Add the flax and mix well. It adds a nutty taste that goes beautifully with the goat cheese and dill.
4. Add two to three tablespoons to your salad. Start with mixed greens of your choice. Add chopped veggies (I like cucumbers, celery, carrots, and mushrooms). Top with four ounces of chicken or salmon and sprinkle on the flax. Dress with two tablespoons of olive oil and one tablespoon of tamari sauce (a wheat-free soy sauce). Presto! A delicious, Asian-inspired salad you’re sure to love.
5. Sprinkle two tablespoons into plain soy yogurt. Add a dropperful of chocolate raspberry liquid stevia to the yogurt, a handful of raspberries, and top with the flax. It’s reminiscent of a sundae…without the unwanted sugar and excess calories.

It's not uncommon for physicians to prescribe birth control pills to control perimenopause symptoms—especially heavy menstrual flow and irregular periods. This is a trend that I find quite disturbing, particularly when there are so many safer ways to control symptoms of premenopause.

Common side effects of birth control pills closely resemble PMS symptoms: anxiety, nausea, bloating, breast tenderness, and depression. And long-term use has been associated with increased risk of blood clots, liver disease, and breast cancer.

If your doctor prescribes birth control pills to control your perimenopause symptoms, consider trying some of the more natural approaches I’ve discussed throughout my blog. Early menopause is a natural part of life—and there are safe, effective ways to control its symptoms!

I thought I had seen it all until I opened one of my monthly health magazines and there it was…an ad touting the “safety” of high fructose corn syrup (HFCS). In a health magazine! Then, about three weeks later, I started seeing ads on TV also claiming that HFCS as “as safe as sugar.”

Are you kidding me? I’ve seen lobbies do and say some pretty remarkable things, but this takes the proverbial, HFCS-laden cake. And, to top it off, the Corn Refiners Association has launched a Web site called www.hfcsfacts.com. (Facts is their word, not mine.) Considering the fact that HFCS constitutes about 55 percent of the sweetener market, the Corn Refiners have a financial interest in keeping their product on the market. Even if doing so is dangerous to your health.

On their site, they claim that HFCS is nutritionally the same as honey. To say this is false is a gross understatement. Honey has many immune-boosting properties. HFCS, on the other hand, depresses immune response. The same site also claims that HFCS is equal in sweetness to table sugar. Also not true. HFCS is ranges from 120–160 on the relative sweetness scale. Table sugar (sucrose) measures in at 100. Even the name itself—HIGH fructose corn syrup tips you off that it will be sweeter than even fructose (which measures in at 140), let alone table sugar.

But this is just the beginning. Studies have shown that HFCS isn’t even metabolized like regular, naturally occurring sugars. HFCS is metabolized in the liver. From there, it is converted into triglycerides, those nasty fats that circulate through the blood. And elevated triglycerides are connected to a whole host of diseases, including heart disease and decreasing “good” HDL cholesterol.

Plus, chronic consumption of HFCS (and other sugars, including table sugar and fructose) kicks off a chain of hormonal imbalances, leading to weight gain and increased risk for diabetes. There is also research to indicate that HFCS may be a root cause of metabolic syndrome, leading a group of Canadian researchers to issue an “urgent need” for more stringent efforts to curb the addition of HCFS to foods and beverages.

On the hormone side, HFCS (and all refined sugars) plays absolute havoc with your system. With chronic use, it can overtax your adrenals, thereby either shutting down hormone production or causing your hormones to go haywire. Plus, a whole host of menopause symptoms, including hot flashes and night sweats, are worsened by excess sugar.

Even premenopause, early menopause, and perimenopause symptoms are severely affected by HFCS and other refined sugar. It worsens these estrogen-dominance conditions and their resultant issues like fibroids, endometriosis, and ovarian cysts. It also worsens PCOS and has been shown to be linked to fertility issues.

The long and short of it is this: Ignore the lobbyists' spin. Avoid HFCS like the plague. This means reading labels on all pre-packaged foods. One safe bet is choosing organic package foods (including ketchup!), as I have never seen HFCS in an organic product.

If you are craving something sweet to drink, try one of Sweet Leaf’s flavored liquid stevias. They have delicious flavors like root beer, orange, apricot, and vanilla cream. I just add a dropperful to a glass of natural mineral water and presto, natural soda! Best of all, I know that I am keeping my taste buds happy while keeping my body healthy.

In addition to the diet recommendations I gave in my last post for undoing estrogen dominance (the most common perimenopause symptom) http://blog.drlark.com/blog/dr-lark/0/0/undoing-estrogen-dominance-with-diet, I urge you to take the following supplements to help to reduce estrogen levels.

• Soy isoflavones—50 to 100 mg as food and in pill form. Soy isoflavones have estrogen-like effects similar to your own estrogen, but in a much weaker and less toxic form.
• Bioflavonoids—750 to 2,000 mg. Bioflavonoids are found in the peel and pulp of citrus fruits and buckwheat and are weakly estrogenic.
• 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. Essential fatty acids, such as flax, are critical for reproductive health.
• Vitamin B-complex—25 to 100 mg daily are necessary for the liver to detoxify 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).

In addition to reducing estrogen levels in your body, you also have to promote progesterone production. This will move you from estrogen dominance back to hormonal balance.

• Take vitamin B-3 (25-100 mg), B-6 (50 mg twice a day), zinc (15-30 mg), vitamin C (1,000-5,000 mg), and magnesium (400-600 mg)
• Vitex, or Chaste tree berry, (40 mg daily) increases the production of the luteinizing hormone that triggers ovulation at midcycle, promoting progesterone production. It also inhibits release of the follicle-stimulating hormone that stimulates estrogen production in the first half of the menstrual cycle. So it normalizes the secretion of hormones and helps to bring estrogen and progesterone into balance during perimenopause (premenopause).

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.

These hormone substitutes provide a safe, estrogen-like effect, and using a combination of them every day can improve your hormone status:

•  Royal jelly has been used for centuries to promote reproductive health and ease menopause symptoms. Doctors from France have reported that women who ate royal jelly during menopause had a complete remission of symptoms! Take 1/4 teaspoon of the liquid form of organic royal jelly twice a day.
•  Dong quai has been used for thousands of years as a female health tonic to prevent or treat menopause symptoms and provide menopause relief—especially from menopause hot flashes, night sweats, and irregular menstruation. I recommend that you take dong quai in powdered form in a 500 mg capsule. Take two capsules two to three times per day. (However, you should avoid it if you are on a blood thinner.)
•  Saffron is a spice that has also been used traditionally to reduce menopause symptoms, enhance calmness, and reduce irritability. To preserve its medicinal properties, stir saffron into hot, cooked food. Use 1/10 of a teaspoon or less per day, as higher amounts may be toxic.

Estrogen deficient–fast processors have more acidic body compositions and can’t handle the acidic foods that estrogen deficient–slow processors thrive on. A 53-year-old patient of mine, Lorraine, is a perfect example of this hormone type.

Lorraine, who had recently entered menopause, came to me complaining of pain, stiffness, and immobility. She also told me that she was feeling more nervous and agitated than ever. On top of that, her skin and hair had become very dry, and she was experiencing unbearable menopause hot flashes, night sweats, insomnia, and vaginal dryness. With all of these severe symptoms, it was clear to me that Lorraine was a typical estrogen deficient–fast processor.

I suggested that she completely eliminate all acidic foods, such as red meat, citrus fruits, and hot spices, and instead follow a vegetarian diet that had greater emphasis on cooked grains, beans, salads, and vegetables. I also recommended that she trade in the hot spices she loved so much for cooler spices like lemon balm, cilantro, basil, marjoram, and chamomile. Almost immediately, Lorraine noticed an improvement in her pain and immobility. A few months later, her menopause symptoms had calmed significantly, and she started to feel much more comfortable in general.

If you are an estrogen deficient–fast processor, you, like Lorraine, need to avoid all acidic and spicy foods and eat a mostly vegetarian, nutrient- and mineral-rich alkaline diet that will help restore you to a naturally healthy state of alkalinity. This includes:

• Most vegetables
• Gluten-free whole grains
• Legumes (beans and peas)
• Small amounts of raw seeds and nuts
• Organic eggs
• Wild fish such as salmon, mackerel, trout, and tuna
• Sea vegetables such as kelp
• Fruits like bananas, melons, and papayas
• Free-range poultry in moderation

Eating a diet rich in these types of foods will help will increase your energy, stamina, and resistance to disease. Plus, you’ll notice a dramatic decrease in troubling menopause symptoms like menopause hot flashes, night sweats, and vaginal dryness.

Women who are estrogen deficient–slow processors tend to have greater reserves of alkaline minerals such as calcium, magnesium, potassium, and zinc within their cells, tissues, and bones. They have the body and hormonal makeup to be able to handle an acidic diet that is rich in red meat and dairy, but these foods lack the essential nutrients that all women need to maintain optimal health. For this reason, estrogen deficient–slow processors are best served by following a diet that is both highly acidic and nutrient-rich. This includes the following foods:

• High-fiber foods such as buckwheat and flaxseed
• Citrus fruits (oranges, limes, lemons, and grapefruit), berries, and pineapple
• All vegetables, especially sauerkraut, spinach, cucumbers, tomatoes, asparagus, and broccoli
• Free-range poultry
• Wild fish such as salmon, mackerel, trout, and tuna
• Free-range beef and lamb, as well as game meats like venison and buffalo
• Soy and soy-based foods
• Vinegar
• Raw nuts (almonds, walnuts)
• Heating spices such as turmeric (curry), ginger, cayenne pepper, chili powder and pepper, cumin, cloves, and cinnamon

By following this diet, estrogen deficient–slow processors are able to regain their energy and zest for life, reduce joint pain, and stabilize their hormone levels. Not to mention, eating a healthy diet provides menopause relief from symptoms like menopause hot flashes and night sweats.

I follow an exercise program for estrogen deficient–fast processors (click here to see my previous blog entry that describes what this is http://blog.drlark.com/blog/dr-lark/0/0/exercise-for-estrogen-deficient-slow-processors). Even though my hormones are healthy and well-balanced, I fall more into this category than any other because I am a petite and slender woman, and I have a fast-paced day-to-day life. To help maintain my hormonal balance, I slow down by following an exercise program that calms me.

Estrogen deficient–fast processors don’t want to heat up their bodies and sweat. It is more important to engage in slower, more expansive and relaxing aerobic activities that are moderately strenuous and can be done in a relaxed and leisurely way. For this reason, the best activities for women in this category include golf, gardening, swimming, and moderately-paced walking and bicycling. You can also try ballroom dancing—in particular, slower dances like the waltz.

In terms of stretching, the best types for this hormonal category include tai chi and hatha yoga, which are slower and more meditative. With these slower-paced exercises, you will tend to breathe more deeply and slowly. Moderate aerobic exercise relaxes, dilates, and expands the network of blood vessels in your body, and enables your heart to work more efficiently. Better circulation and oxygenation, in turn, improve the health of all of your organs, including your ovaries and uterus.

Personally, I am an avid walker. I walk almost every day at a moderate pace, breathing slowly and deeply to maximize the alkalinizing benefits. Walking keeps me limber and has helped me to maintain almost the same weight as when I was in medical school! And another benefit to this and all exercise is the reduction of menopause symptoms like menopause hot flashes and night sweats!

If you are an estrogen deficient–slow processor (see my previous blog entry to determine if you are http://blog.drlark.com/blog/dr-lark/0/0/strong-nails-and-smooth-skin), I recommend keeping your hormones balanced with high-intensity activities such as power walking, cycling, running, triathlons, racquetball, tennis, and fast-paced styles of ballroom dance like the tango, foxtrot, and swing. Women with these hormone profiles tend to be instinctively drawn to strenuous types of exercise that are more contracting and acidifying to counter their natural tendency toward alkalinity. I’ve seen women with these hormonal profiles maintain this level of intense physical activity well into their later years. In fact, it is not unusual to see slow processors participating in triathlons and bodybuilding well into their 70s and beyond!

Stretching and flexibility exercises are also important parts of your workout routine. Stretching keeps you limber and helps your muscles and tendons function well into your older years. The best stretching exercise is Pilates, as it tends to include more intense and faster-paced movements. In addition, yoga is beneficial for these women—particularly the high-energy Bikram (hot), ashtanga, and power yoga.

Another benefit of these exercises? They help reduce menopause symptoms like menopause hot flashes and night sweats!

One of my patients had a hysterectomy in her late 30s for endometriosis, and her doctor at the time put her on low-dose hormone replacement therapy. She was on hormone replacement therapy for seven years, but found that when she hit her early 50s, her body began to change. Her nails began to crack and split and her skin became incredibly dry. Lotions and other solutions didn’t work.

She came to me to see what we could do about this problem. I looked at her diet and made some changes that would support estrogen production in her body. First and foremost, she cut out caffeine and alcohol. I started her on wheat germ oil and flaxseed (a great omega-3–based food) to moisturize her skin from within. She also started eating wild salmon, butterfish, and other fish high in omega-3s. In addition, I recommended that she up her B-vitamin and silica intake.

Within months, her nails went from being really soft to strong and firm. Her skin also became much more moist and supple. We also noticed a slight increase in her estrogen levels, which helped to ease her other menopause symptoms, such as hot flashes and night sweats.

I had a patient named Mary Ellen, who was 57 years old when she came to me to get help with her insomnia (the menopause symptom that was causing her the most distress). She was always somewhat of a light sleeper—she’d have her good nights of deep restful sleep, but when she was under stress, she had more disturbed sleep. And as she got older, she began noticing a shift in her sleep cycle.

During the day, Mary Ellen was groggy and sleepy, which made it hard for her to function at work, and her quality of work was affected. But as the night came, she became more agitated and couldn’t settle down. Over-the-counter products didn’t work, and she didn’t want to get hooked on prescription medications.

I worked with Mary Ellen on some key sleep-inducing exercises. Specifically, a couple of hours before bed, she did some quieting exercises, meditation, peaceful visualization, and prayer, which was compatible with her belief system. In addition, I also recommended that she take low-dose melatonin (300 mcg–1 mg) and 5-HTP (50–100 mg) each evening before bed. She was happy to report a few weeks later that she really achieved great success from this program.

If you’re having similar sleep issues because of night sweats or other menopause symptoms, I urge you to try these two supplements!

If you have found that natural hormone replacement therapy isn’t strong enough to relieve your menopause symptoms, an herb called maca is a perfect option. By some estimates I’ve read about in research studies, approximately 80 percent of menopausal women find menopause relief with maca. 

Maca is most commonly used in traditional medicine to increase libido, promote fertility, and balance hormone levels. An added bonus is that it increases vaginal lubrication, which obviously can improve sexual activity and satisfaction. Because it increases energy, it helps create more vigor for sexual activity, which is why Peruvians have used it for centuries to increase sexual desire.

Dosages are unique to each woman, so you will need to determine the dosage that works for you. You can take it indefinitely—there have been no acute toxic effects, even at very high doses. If you are sensitive to herbs, start with the low end of the recommended dosage, as too much can cause increased menopause hot flashes, breast tenderness, or headaches. Also avoid maca if you have a hormone-related cancer, liver disease, or are pregnant or nursing.

I like the Whole World Botanicals’ Royal Maca brand, which is available at www.wholeworldbotanicals.com.

For my patients whose menopause symptoms do not respond to the various herbs and nutrients I recommend, I have frequently prescribed natural hormone replacement therapy using estriol and natural progesterone. 

Estriol (2–4 mg daily) is prescribed in capsule or cream form to reduce menopause hot flashes, vaginal dryness, and mood swings. Estriol is the weakest and safest type of estrogen and is less likely to promote tissue growth. Unlike conventional estrogen replacement therapy (replacement therapy using estrogen alone) that may cause fluid retention, headaches, nausea, and the buildup of uterine tissue, estriol has few, if any, side effects. You’ll need a prescription and then you or your doctor can contact the Women’s International Pharmacy (www.womensinternational.com) to fill the prescription. If used directly on vaginal tissues, not only will estriol cream rebuild vaginal cells, it can also help restore clitoral sensitivity and orgasmic intensity, and reduce bladder infections.

Many women call them “their own personal summer”—and for good reason. Menopause hot flashes—sudden, intense episodes of warmth and heat—are one of the most uncomfortable symptoms that menopausal women complain about. While the frequency, intensity, and duration of hot flashes vary greatly, they usually involve sweating—mild in some women and profuse in others. These episodes are the result of increased blood flow to the brain and other organs.

Menopause hot flashes are physically draining since the body loses fluids and minerals in the process of perspiring. When they take the form of night sweats, hot flashes may disrupt sleep, soak sheets, and leave a woman exhausted and cranky. If they occur at work or during a social function, they can be embarrassing.

There are several natural remedies for menopause hot flashes, including: 

• 80–160 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);
• 400–1,000 IU vitamin E; and
• 50–100 mg of soy isoflavones daily.

These nutrients are available in most health food stores, nutrition centers, and some pharmacies.

With so much attention given to estrogen, many women don’t know what role progesteron plays in the body. In short, progesterone balances 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 and prevent the uterine lining from becoming too thick, which may lead to uterine cancer. This is the reason progesterone is often a part of hormone replacement therapy.

I suggest looking into progesterone supplementation if you have menopause symptoms or signs of menopause.  There are natural forms of progesterone, which has no known side effects at the usual dose of 20–40 mg daily. Be sure to consult a physician who is knowledgeable about natural progesterone before beginning treatment with it.

Although it's available in pill form, many women prefer natural progesterone in a skin cream base, which you can get without a prescription. Topically applied creams are absorbed into body tissues immediately. Oral progesterone is first metabolized by your liver and converted into three different compounds. You can also use a transdermal spray such as Progest-Ease, that can be applied to the skin and absorbed into the blood stream without going through the liver.

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.

Perimenopausal women can apply the cream from day 12 to day 26 of their menstrual cycle. Menopausal women not taking estrogen may use progesterone for two to three weeks each month. And don't buy products that list wild yam on the label. Unprocessed, wild yam can't be converted to progesterone in your body. This conversion from the plants can only be done in a laboratory. And don't buy progesterone products that are made with mineral oil, which blocks the progesterone from entering your body. You can find a good natural progesterone cream at the Women's International Pharmacy (www.womensinternational.com).

Who would have thought that you can ease menopause symptoms with what you eat! Normally, I tell my patients to avoid spicy or hot foods that an increase the incidence of menopause hot flashes. But there is one spice that can actually decrease symptoms: saffron. This bright yellow Indian spice has been used traditionally to reduce menopause symptoms, enhance calmness, and reduce irritability.

To preserve its medicinal properties, stir saffron into hot, cooked food. Use 1/10 of a teaspoon or less per day. (Higher amounts can be toxic, so be sure not to use more than this amount.)