Menopause

Menopause is the physiological cessation of menses as a result of decreasing ovarian function,
indicating the end of fertility. It is also referred to as the “change of life”.

When a woman stops ovulating, her ovaries stop producing the hormones estrogen and progesterone.
Circulating levels of these hormones are markedly reduced but testosterone decreases only slightly.
Estrogen acts on different organs in the body, cells in the vagina, bladder, breast, skin, bones, arteries, heart, liver
and brain all contain estrogen receptors, and require this hormone to stimulate these receptors for normal cell function.
Estrogen is needed to keep the skin smooth and moist and the arteries unclogged.
It is also necessary for proper bone formation.


Etiology:

Natural menopause: occurs at an average age of 50 to 51yr, the menopausal period is
different for each individual woman, and the transition usually last up to 5 years.

Premature menopause: refers to ovarian failure of unknown cause that occurs before age 40.
Smoking is associated with early menopause.
Radiation exposure, chemotherapeutic drugs, and surgery that impairs ovarian blood supply can also hasten menopause.

Artificial menopause: follows ovariectomy or radiation of the pelvis, including the ovaries.


Symptoms: 

Some woman go through menopause with few or no noticeable symptoms.
·    Hot flushes and sweating affect 75 % of woman, most have hot flushes for >1 yr and 25 to 50 % for > 5 yr.
·    Psychologic and emotional symptoms of fatigue, lack of sleep, irritability, mood swings, anxiety, depression,
      insomnia and nervousness may be related to both estrogen deprivation and the stress of  aging and changing roles.
·    Intermittent dizziness, paresthesias, palpitations and tachicardia may occur; the incidence of heart disease increases.
·    Dyspareunia (disconfort during sexual intercourse),  pooor libido, increasing pelvic relaxation, urinary incontinence,
     cystitis,  vaginal dryness and vaginitis tent to occur.
·    Nausea, headaches, dizziness, flatulence, constipation, diarrhea, arthralgia, and myalgia are common complaints.
·    Osteoporosis is the major health hazard. Those at high risk are slender, white woman who smoke, take corticosteroids,
     or have a little physical activity. Bone mass losses average 1 to 2 % yr after menopause and result in numerous fractures.        Primary sites are the vertebrae, leading to stooping and backache, hip and wrist. These fractures may occur with
little trauma, and in the elderly, with no trauma.

It is important to remember that menopause is not a disease. It is a natural process in a woman’s life.
How a woman views this time of her life can have a lot to do with how frequent and severe her symptoms are.
If menopause is viewed as the end of youth and sexuality, this time will be much  more difficult than if it is viewed as
the next natural phase of life.


Diagnosis:

Menopause is usually obvious.
In younger woman, the diagnosis is substantiated by elevated levels of follicle-stimulating hormone.
Endocrine disorders such as thyroid disease, diabetes mellitus, and hyperparathyroidism should be rule out.


Conventional treatment:

Estrogen replacement  therapy to sustain systems dependent on ovarian hormone secretion and to relieve hot flushes
and vaginal atrophy as well as to prevent osteoporosis.
When estrogens are contraindicated ( eg. history of estrogen-dependent neoplasia of the endometrium or breast,
thrombophlebitis, or liver disease) treatments for reducing disconfort due to hot flushes include sedative-hypnotics
( barbiturates or benzodiazepines), progestin or clonidine.

The goal of hormone replacement therapy (HRT) is to restore a woman’s hormonal balance, primarily her estrogen level.
In addition to relieving menopausal symptoms HRT appears to prevent osteoporosis and heart disease.
However, HRT also has a serious dark side, which includes a possible connection to several forms of cancer ( breast, ovarian)
and autoinmune disorders such as lupus.
A 1995 report by The New england Journal of Medicine reaffirmed the suspected link between ERT and breast cancer,
while another report  suggested the risk of ovarian cancer.

It is inadvisable to take estrogen if there is a personal or family history of breast cancer, uterine cancer or fibroid tumors
as well as liver or gall bladder disease.


Natural treatment:

Help alleviate the most common symptoms of menopause.
Rather than use estrogens to artificially counteract the symptoms of menopause, the natural approach focuses on improving physiology, through diet, nutritional supplementation, the use of botanical medicines, and exercise.

Diet: Certain foods or nutrient deficiencies are known to trigger or exacerbate symptoms of menopause.
Food also may boost the body's tolerance for fluctuating hormone levels.
The most important dietary recommendation may be to increase the amount of plan foods,
especially those high in phytoestrogens, while reducing the amount of animal foods in the diet.

Foods Containing Natural Estrogens:

A number of different foods and herbs are sources of natural plant estrogens, and can be very helpful during menopause,
The following is a list of some of the best food sources of estrogen. These foods are also high in vitamins, minerals, fiber,
and essential fatty acids, and they are low in saturated fat. In other words, they are nutritious and should be part of your diet
on a regular basis. 

Alfalfa	Cucumbers	Olive oil	Red beans
Anise seed	Dates	Olives	Red clover
Apples	Eggs	Papaya	Rhubarb
Barley	Eggplant	Parsley	Rice
Beets	Fennel	Peas	Sage
Carrots	Flaxseeds	Peppers	Sesame seeds
Cherries	Garlic	Plums	Soybean sprouts
Chickpeas	Hops	Pomegranates	Split peas
Clover	Licorice	Potatoes	Sunflower seeds
Cowpeas	Oats	Pumpkin/Yams	Tomatoes

Estrogen Inhibiting Foods:

Berries	Melons
Broccoli	Millet
Buckwheat	Onions
Cabbage	Pears
Citrus Foods	Pineapples
Corn	Squashes
Figs	Tapioca
Fruits (except apples, cherries,            dates, pomegranates)	White rice
Grapes	White flour
Green beans

 
Foods that contain phytoestrogens help prevent hot flashes and other symptoms of estrogen depletion:
Yams
Carrots
Apples
Potatoes  
Tofu and other soy products:
Soy
Eating soy and its isoflavones are the most popular natural way to increase estrogen. Soybean products such as
tofu contain natural plant estrogens (called phytoestrogens) that may reduce menopausal symptoms.
Soybean is the main active ingredient in Provera, the top-selling HRT progestin in the USA.
Soy, like hormone replacement, appears to lower cholesterol and reduce bone loss in postmenopausal women.
Phytoestrogens are also found in lima beans, berries, and several other foods.

It's been scientifically proven that women can minimize, and perhaps eliminate, menopausal hot flashes and mood swings
by incorporating soy foods into their diets. Italian researchers found that isolated soy protein can be used in place of hormone replacement therapy. Investigators at the University of Bologna found that women receiving a soy supplement realized a
reduction of 45 percent in hot flashes. Other women in the study, who were given a placebo, reported a 30 percent reduction.
It was suggested that the reduction in the incidence of hot flashes by soy group was due to the phytoestrogens found naturally
in soy. All women in the study were aged 45 to 62. Those receiving the soy supplement took 60 grams each day over a
12-week period.

Research shows that Japanese women, who regularly consume soy products rather than animal protein, report
markedly fewer menopausal symptoms than American women.
Japanese women also have only one-fourth as much breast cancer as American women.

Substituting soy protein for animal protein can help slash breast cancer risk at any age because of its genistein content.
Genistein is a chemical that blocks an enzyme that turns on cancer genes and inhibits the growth of new blood vessels
needed to feed growing cancers. The average Asian woman eats about 50 to 75 milligrams of genistein a day 
the amount in about one serving of four ounces of firm or soft tofu.

Studies also show that eating a soy-rich diet can help build bone mass. This is because eating animal protein washes away
much more calcium out of the body through the urine than consuming soy protein.

One study showed that women eating meat lost 50 milligrams more calcium per day than when they ate the same amount of
protein in soy milk. This is very significant. Difference of 50 mg calcium loss a day can translate to substantial loss of bone
when we spread it over a 20 year period.

Common menopause symptoms such as mood swings and hot flashes, insomnia, depression, diminished sexual vitality and decreased bone mass may be effectively managed by drinking a cup of soy milk and eating four ounces of firm or soft
low-fat tofu each day. (Tofu is soybean curd and an excellent substitute for animal protein. Use it in salads,
vegetable stir fries, soups, or braise it with vegetables and serve over rice.)

It's wise to use soy foods, like soy milk and tofu, in moderate amounts in your diet.

Certain foods may trigger hot flashes, mood swings, vaginal discomforts, and other menopausal symptoms.
These culprits include sugar, caffeine, alcohol, refined foods, and spicy foods.
Keeping a diary that notes symptoms and food intake can be helpful in pinpointing which foods may be provoking
which symptoms.

Foods to Eat:
A low-fat, high-fiber diet will help the body to adjust more easily to changing hormonal levels. 
Whole grains
Fresh vegetables
Beans
Seaweed
Miso
Tofu and tempeh
Seeds and nuts (especially sunflower seeds)
 
Foods rich in calcium help prevent osteoporosis: 
Sesame seeds
Almonds
Low-fat yogurt
Dark, leafy greens, such as kale, collards, and broccoli
Sardines

Foods to Avoid: 
Animal foods
Fat found in fried foods, dairy products, nut butters, etc.
Sugar and refined carbohydrates contribute to mood swings.
Caffeine can cause hot flashes.
Alcohol can cause hot flashes.
Tobacco

Water: a good preventive measure is drinking at least eight glasses of purified water per day for hot flashes and
vaginal dryness.

Acupuncture:
Can alleviate many menopausal symptoms by rebalancing the hormonal system,
especially headaches and migraines, hot flushing, heavy flooding periods, back pain and sagging skin tone.
Heavy and erratic menstrual bleeding in perimenopausal women can be relieved by this technique. Also relieves the pain
and headache associated with menstruation.
Acupuncture also has positive effects on insomnia and stress. Treatment can also improve the mobilization of chi to
the nervous system to aid poor memory and concentration.

A Swedish study of 21 women with menopausal hot flashes found that acupuncture significantly reduced symptoms,
with its effects lasting at least three months after treatment had ended.
Acupuncture may used alone or in combination with herbs and other remedies.
Some alternative practitioners suggest that acupuncture affects aspects of the nervous system that give rise to hot flashes.

Homeopathy:
Homeopathic practitioners treat the menopausal symptoms by constitutional treatment.
This is the process by which a homeopathic practitioner selects and administers a woman's own constitutional remedy
based on the totality of her symptoms and her physical, mental and emotional state. This strengthen the body's vital defenses
and restore a healthy balance and sense of well-being.
Most of the major homeopathic remedies may be used for the symptoms of menopause.


Acceptance as a natural part of life:

Menopause is a transition not a disease! Let us recognize menopause in this light.
Centuries before us, older women were the respected and wise elders looked to for their knowledge, advise and aged kindness.
Many traditions for healing were handed down from mother to daughter and passed from village to village to help
one another stay well.

Women can reclaim this tradition by becoming knowledgeable of the menopause process.
We can also join other women to honor this wonderful time in our lives.

The transitions in a woman's life are marked by several events:

The first event is the menarche which occurs in puberty and is the start of the menses or menstrual periods.
It is truly a time of joy for a girl to start to have her monthly bleeding because it marks her time of fertility and
she is now able to reproduce and maintain the survival of the human race.
Living in this century we have witnessed a great change in attitudes towards fertility and reproduction.
Suffice it to say, even though we need to be conscientious of our population growth and responsibility for parenting,
we do need to appreciate a woman's body for her reproductive ability.

On the other end of the continuum is the cessation of the menses or the menopause.
The menopause occurs during the climacteric period of a woman's life which can span a 10 to 15 year period.
There are many myths and inaccurate beliefs around this time in a woman's life, compounded by cultural pressure
to stay forever young.
The medical profession communicates to women they no longer need their uteruses, should take hormones to stay young
and healthy, and basically deny the aging process.
The dread of passing into our older years that so many women feel, needs to be reexamined and a refreshing outlook to our "golden or crone" years must be acknowledged to maintain a healthy, positive future.

Please be advised: This information is provided for personal interest. 
As every individual case is different, it is essential that a certified health professional be consulted before initiating any treatment regime.
Should you wish to discuss the specifics of your case you can contact Dr. Comas (416) 515-8493
or e-mail: Dr-Comas@NaturalMedicineSolutions.com