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Naturopathic Causes and Treatment of Menopause

See also Carahealth Menopause

Menopause describes the permanent cessation of ovarian function, which results in the cessation of ova release, uterine lining creation, and subsequent uterine lining shedding. Menopause typically occurs in women during their late 40s or early 50s, and signals the end of the fertile phase of a woman's life. Menopause is a change that every woman will experience if she lives long enough.

The transition from reproductive to non-reproductive is the result of a major reduction in oestrodiol and progesterone production by the ovaries. This transition normally occurs over a period of years, and is a natural consequence of aging. For some women, however, the accompanying signs and effects that occur during the menopause transition can significantly disrupt their daily activities and their sense of well-being.

Age

In the Western world, the most typical age range for menopause is between the ages of 40 and 60 and the average age for last period is 51 years. In some countries such as Indonesia and the Philippines, the median age of natural menopause is considerably earlier, at 44 years.

On average, women who smoke cigarettes experience menopause significantly earlier than non-smokers. Women who have undergone hysterectomy with ovary conservation go through menopause on average 3.7 years earlier than the expected age. Functional disorders such as endometriosis, polycystic ovary syndrome and cancer of the reproductive organs can also speed up the menopausal process and create more significant physical and emotional health problems.

Premature menopause

Rarely, a woman's ovaries stop working at a very early age, ranging anywhere from the age of puberty to age 40. This is known as premature ovarian failure (POF). POF is not considered to be due to the normal effects of aging. Some known causes of premature ovarian failure include autoimmune disorders, thyroid disease, diabetes mellitus, chemotherapy, and radiotherapy, cigarette smoking, higher body mass index, racial/ethnic factors, emotional stress and chronic illnesses. However, in the majority of spontaneous cases of premature ovarian failure, the cause is unknown.

From a complementary medicine perspective, the causes of POF are the same as for the causes of menopause, with a particular focus on deficiency of the endocrine system from a naturopathic perspective, and Jing deficiency from a Traditional Chinese Medicine. These and are outlined further below.

Diagnosis

On average, the first evidence of the onset of the menopause transition time is variations in the length of the menstrual cycle. These variations become more pronounced over time, and eventually lead to skipped ovulations, skipped periods, and spans of time with no periods, after which menstruation may resume. The transition is considered to be over once a woman has experienced 12 months without any menstrual bleeding, even though perimenopausal symptoms may extend well beyond this.

Symptoms include irregular menses, vasomotor instability (hot flushes and night sweats), atrophy of genitourinary tissue, increased stress, breast tenderness, vaginal dryness, forgetfulness, mood changes, and in certain cases osteoporosis and/ or heart disease. These effects are related to the hormonal changes a woman’s body is going through, and they affect each woman to a different extent. The symptoms are largely due to deficiency of oestrogen.

Menopause cannot satisfactorily be defined as the permanent "stopping of the monthly periods", because what is happening to the uterus is secondary to what is happening to the ovaries .For example, when for medical reasons, the uterus has to be surgically removed (hysterectomy) in a younger woman, her periods will of course cease permanently, and the woman will be incapable of pregnancy, but as long as at least one of her ovaries is still functioning, the woman will not have reached menopause. In contrast to this, in circumstances where a woman's ovaries are removed (oophorectomy), even if the uterus were to be left intact, the woman will immediately be in "surgical menopause". Surgical menopause is a menopause which is induced both suddenly and totally, by removal of both ovaries prior to the age of natural menopause.

Hormones

Menopause is based on the natural or surgical cessation of oestradiol and progesterone production by the ovaries. In younger women, during a normal menstrual cycle the ovaries produce oestradiol, testosterone and progesterone in a cyclical pattern under the control of FSH and luteinising hormone (LH), which are both produced by the pituitary gland. Blood oestradiol levels remain relatively unchanged, or may increase approaching the menopause, but are usually well preserved until the late perimenopause due to elevated FSH levels. However, menopause is characterised by marked, and often dramatic, variations in FSH and oestradiol levels, and because of this, measurements of these hormones are not considered to be reliable guides to a woman's exact menopausal status.

Biosynthesis of oestrogen

Oestrogens are produced primarily by developing follicles in the ovaries, the corpus luteum, and the placenta. Luteinizing hormone (LH) stimulates the production of oestrogen in the ovaries. Some estrogens are also produced in smaller amounts by other tissues such as the liver, adrenal glands, and the breasts These secondary sources of estrogens are especially important in postmenopausal women. Fat cells also produce oestrogen, potentially being the reason why underweight woman experience more sever menopausal symptoms and underweight or overweight women are at an increased risk of infertility.

Aromatase

(Aromatase is an enzyme that is responsible for a key step in the biosynthesis of oestrogens) Because certain oestrogens also promote certain cancers and other diseases, aromatase inhibitors are frequently used to treat those diseases. Aromatase is suspected and has therapeutic implications in humans with obsessive-compulsive disorder.

Natural decline of other hormones due to aging

In contrast to the sudden fall in oestradiol during menopause, the levels of total and free testosterone, as well as dehydroepiandrosterone sulphate(DHEAS) and androstenedione appear to naturally decline more or less steadily with age. An effect of natural menopause on circulating androgen levels has not been observed. Therfore the effects of natural menopause cannot be attributed to loss of androgenic hormone production.

Terminology

Menopause

Clinically speaking, menopause is defined as the day after the final episode of menstrual flow finishes. This date is fixed retrospectively, once 12 months have gone by with no menstrual flow at all. At this point a woman is considered to be a year into postmenopause, is considered to be infertile, and no longer needs to take into consideration the possibility of pregnancy.

In common speak, however, the word "menopause" usually refers to the whole of the menopause transition years. This span of time is also commonly called the change of life, the change, or the climacteric and more recently is known as "perimenopause", (literally meaning "around menopause").

Perimenopause

Perimenopause is the term used to describe the menopause transition years. In women who have a uterus, perimenopause describes the years both before and after the final period. Perimenopause from a medical perspective is when menses start to become irregular and FSH levels have increased, through until 12 months after the last menstrual bleed.

During the perimenopause years, many women undergo noticeable and clinically observable physical changes resulting from hormonal fluctuations. The most well-known of these is the "hot flush", a sudden temporary increase in body temperature. The "hot flush" occurs as the body temperature increases, reaching a peak very rapidly. The "hot" sensation does not result from the initial temperature rise but occurs as a reaction to the slowness of the body's return to a more normal temperature range. Other common effects encountered during the perimenopausal period include mood changes, insomnia, fatigue, and memory problems.

Menopause may, in some women, bring about a sense of loss related to the end of fertility. In addition this change often occurs at a time of life when other stressors associated with aging are present.

Premenopause

Premenopause is a word used to describe the years leading up to the last period, when the levels of reproductive hormones are already becoming lower and more erratic, and the effects of hormone withdrawal may be present.

Postmenopause

The term postmenopause is applied to women who have not experienced a menstrual bleed for a minimum of 12 months. In women without a uterus, menopause or postmenopause is identified by a very high FSH level. In women who have no uterus, and therefore have no periods, post-menopause can be determined by a blood test which can reveal the very high levels of Follicle Stimulating Hormone(FSH) that are typical of post-menopausal women.

Any period-like flow that might occur during postmenopause, even just spotting, must be reported to a doctor. The cause may in fact be minor, but the possibility of endometrial cancer must be checked for and eliminated.

Review : Function of oestrogen

Structural

Promote formation of female secondary sex characteristics

Accelerate metabolism

Reduce muscle mass I

ncrease fat stores

Stimulate endometrial growth

Increase uterine growth Increase vaginal lubrication

Thicken the vaginal wall

Maintenance of vessel and skin

Reduce bone resorption, increase bone formation

Protein synthesis

Increase hepatic production of binding proteins

Coagulation

Increase circulating level of factors 2, 7, 9, 10, plasminogen

Decrease antithrombinIII

Increase platelet adhesiveness

Lipid Increase HDL, triglyceride Decrease LDL, fat deposition

Fluid balance

Salt (sodium) and water retention

Increase cortisol, SHBG

Gastrointestinal tract

Reduce bowel motility

Increase cholesterol in bile

Melanin Increase

pheomelanin, reduce eumelanin

Cancer

Support hormone-sensitive breast cancers

Lung function

Promotes lung function by supporting alveoli (in rodents but probably in humans). Sexual desire is dependent on androgen levels rather than oestrogen levels.

Mental health

Oestrogen plays a significant role in women’s mental health. Sudden oestrogen withdrawal, fluctuating oestrogen, and periods of sustained oestrogen low levels correlates with significant mood lowering. Clinical recovery from postpartum, perimenopause, and postmenopause depression has been shown to be effective after levels of oestrogen were stabilised and/or restored.

Oestrogen and serotonin

Oestrogen enhances the amino acid tryptophan by reducing its rates of breakdown. Tryptophan is a precursor to serotonin. Low oestrogen therefore means low tryptophan. Profuse night sweats can be relieved with tryptophan 500mg in juice a few hours before bed.

Oestrogen also promotes serotonin in two other ways

1. Enhances serotonin transporters SERTs

2. Increases serotonin receptors

Signs and symptoms

A number of effects may appear during menopause, as the body responds to the rapidly fluctuating and dropping levels of oestrogens and progesterone. Not every woman experiences negative symptoms however. The range of effects and the degree to which they appear is variable. Effects that are due to low oestrogen levels (for example vaginal atrophy and skin drying) will continue after the menopause transition years are over; however, many effects that are caused by the extreme fluctuations in hormone levels (for example hot flushes and mood changes) usually disappear or improve significantly once the perimenopause transition is completely over. Some of the effects, such as formication (crawling, itching, or tingling skin sensations), may be associated directly with hormone withdrawal.

Most women identify lack of energy as the most frequent and distressing effect. Other effects can include vasomotor symptoms such as hot flushes and palpitations, psychological effects such as depression, anxiety, irritability, mood swings, memory problems and lack of concentration, and atrophic effects such as vaginal dryness and urgency of urination.

The average woman also has increasingly erratic menstrual periods, due to skipped ovulations. Typically, the timing of the flow becomes unpredictable. In addition the duration of the flow may be considerably shorter or longer than normal, and the flow itself may be significantly heavier or lighter than was previously the case, including sometimes, long episodes of spotting. Early in the process it is not uncommon to have some 2-week cycles. Further into the process it is common to skip periods for months at a time, and these skipped periods may be followed by a heavier period. The number of skipped periods in a row often increases as the time of last period approaches.

Vascular instability

· Hot flushes, including night sweats and, in a few people, cold flushes

· Possible but contentious increased risk of atherosclerosis.

· Migraine

· Rapid heartbeat

Urogenital atrophy, also known as vaginal atrophy

· Thinning of the membranes of the vulva, the vagina the cervix, and also the outer urinary tract, along with considerable shrinking and loss in elasticity of all of the outer and inner genital areas.

· Itching

· Dryness

· Bleeding

· Watery discharge

· Urinary frequency

· Urinary incontinence

· Urinary urgency

· Increased susceptibility to inflammation and infection, for example vaginal candidiasis, and urinary tract infections

Skeletal

· Back pain

· Joint pain, Muscle pain

· Osteopenia and the risk of osteoporosis gradually developing over time

Skin, soft tissue

· Breast atrophy · breast tenderness +/- swelling

· Decreased elasticity of the skin

· Formication (itching, tingling, burning, pins and needles, or sensation of ants crawling on or under the skin)

· Skin thinning and becoming drier

Psychological

· Depression and/or anxiety

· Fatigue

· Irritability

· Memory loss and problems with concentration

· Mood disturbance

· Sleep disturbances, poor quality sleep, light sleep, insomnia

Sexual

· Dyspareunia (painful intercourse)

· Decreased libido

· Problems reaching orgasm

· Vaginal dryness and vaginal atrophy

Medical Management

Perimenopause is a natural stage of life. It is not a disease or a disorder, and therefore it does not automatically require any kind of medical treatment. However, in cases where the physical, mental, and emotional effects of perimenopause are such that they disrupt the everyday life of the woman experiencing them, palliative medical therapy may sometimes be appropriate.

Hormone replacement therapy (HRT)

HRT refers to the use of oestrogen plus progestin for a woman who has an intact uterus, or oestrogen alone for a woman who has had a hysterectomy. Traditionally such therapy was provided as tablets but now is available in a range of formulations including skin patches, gels, skin sprays, subcutaneous implants and so forth.

A popular alternative to conventional HRT is a synthetic hormone (derived from the Mexican yam) called tibolone. Of the non hormonal therapies for hot flushes, some of the SSRIs appear to provide some pharmaceutical relief. Adverse effects of HRT appear to vary according to formulation and dose. In addition to relief from hot flushes, hormone therapy can alleviate vaginal dryness, improve sleep quality and joint pain. It is also extremely effective for preventing bone loss and osteoporotic fracture.

A woman and her doctor should carefully review her situation, her complaints and her relative risk before determining whether the benefits of HT/HRT or other therapies outweigh the risks. Until more becomes understood about the possible risks, women who elect to use hormone replacement therapy are generally well advised to take the lowest effective dose of hormones for the shortest period possible, and to question their doctors as to whether certain forms might pose fewer dangers of clots or cancer than others.

Conjugated equine oestrogens

Conjugated equine oestrogens contain oestrogen molecules conjugated to hydrophilic side groups (e.g. sulphate) and are produced from the urine of pregnant Equidae (horses) mares. Premarin is the prime example of this, either alone or in Prempro, where it is combined with a synthetic progestin, medroxyprogesterone acetate. Women had been advised for many years by numerous doctors and drug company marketing efforts (at least in the USA) that hormone therapy with conjugated equine estrogens after menopause might reduce their risk of heart disease and prevent various aspects of aging. However, a large, randomised, controlled trial (the Women's Health Initiative) found that women undergoing HT or HRT with conjugated equine estrogens (Premarin), in combination with a synthetic progestin (medroxy pogesterone acetate (Premarin plus Provera known as Prempro)), had an increased risk of breast cancer and heart disease.

The 2002 and 2003 announcements of the Women's Health Initiative of the American National Institute of Health and The Million Women Study of the UK Cancer Research and National Health Service collaboration respectively, that HRT treatment coincides with a increased incidence of breast cancer, heart attacks and strokes, lead to a sharp decline in HRT prescription throughout the world, which was followed by a decrease in breast cancer incidence.

Antidepressants

Antidepressants such as paroxetine (Paxil), Fluoxetine hydrochloride (Prozac), and Venlafaxine hydrochloride (Effexor) have been used with some success in the treatment of hot flushes, improving sleep, mood, and quality of life.

Gabapentin

Gabapentin (sometimes called by its brand name, Neurontin) and other GABA analogs are anti-seizure medications.

Other therapies

Lack of lubrication is a common problem during and after perimenopause. Vaginal moisturisers can help women with overall dryness, and lubricants can help with lubrication difficulties that may be present during intercourse.

Low-dose prescription vaginal oestrogen products such as oestrogen creams are generally a safe way to use oestrogen in order to help vaginal thinning and dryness problems (see vaginal atrophy) while only minimally increasing the levels of oestrogen in the bloodstream.

In terms of managing hot flushes, lifestyle measures, such as drinking cold liquids, staying in cool rooms, using fans, removing excess clothing layers when a hot flash strikes, and avoiding hot flash triggers such as hot drinks, spicy foods, etc., may partially supplement (or even obviate) the use of medications for some women.

Individual counselling or support groups can sometimes be helpful to handle sad, depressed, anxious or confused feelings women may be having as they pass through what can be for some a very challenging transition time.

Naturopathic causes of menopause

Essentially a natural art of aging, menopause is not a medical condition and should not be accompanied by uncomfortable symptoms. If however menopause comes to early or is accompanied by debilitating symptoms there are causes according to a naturopathic perspective.

  • Oestrogen and progesterone deficiency
  • Adrenal exhaustion (failure of the adrenal gland to produce adrenalin and oestrogen production)
  • Nervous system exhaustion

Menopausal symptoms are aggravated by

  • Obesity, sedentary lifestyle
  • Diet high in sugar, refined CHO and animal foods
  • OH, caffeine, and caffeine rich foods
  • smoking and high fat intake
  • Vasoactive amines

Treatment Principles

  • Increase the intake of phytoestrogen rich foods
  • Tonify the adrenal glands to support adrenal production of oestrogen
  • Tonify the nervous system
  • Avoid caffeine, OH, nicotine and spicy foods

Complementary medicine

In the area of complementary and alternative therapies, acupuncture treatments are promising. Numerous studies indicate positive effects, especially on hot flushes. There are regular claims that soy isoflavones are beneficial concerning menopause. Remedies, which work in studies, include red clover isoflavone extracts and black cohosh. Black cohosh (Cimicifuga racemosa, also known as Actaea racemosa) is a North American native plant. It has common usage internationally for the treatment of hot flushes and sweats experienced by postmenopausal women. Black cohosh has been associated with reports of acute liver toxicity and a concern has been raised regarding the stimulation of pre-existing breast cancer based on an animal study and should be prescribed by a qualified herbalist trained in pharmacology.

Traditional Chinese Medicine (TCM) and Menopause

While Western medicine views menopause as a disease, Chinese medicine recognises this change in a woman's body chemistry as a natural transitional process. Ideally menopause is relatively uneventful, and in the East it often is, largely due to due to high soy intake. Unfortunately, due to the stresses of a modern life, underlying patterns of disharmony often give rise to the typical menopausal symptom complex of hot flushes, night sweats, headaches, mood swings, etc.

In Chinese medicine, oestrogen is said to be similar to Jing, the essence that we received from our parents at the moment of conception. As we age, Jing declines and can lead to various signs and symptoms including loss of libido, backache, fatigue, and greying hair. Although Jing cannot be replenished according to Chinese medicine, it can be nourished and supported, slowing down the side effects and making the transition more graceful.

Another cause of menopausal symptoms is an underlying deficiency of Kidney Yin. The concept of Yin is one of cooling moistening and nourishing. If Kidney Yin is deficient, heat signs will arise, including hot flushes, night sweats, heart palpitations, and insomnia.

Liver Qi stagnation is also often involved in excessive menopausal symptoms. One of the primary functions of the Liver is to control the smooth flow of Qi (energy), Blood, and emotions throughout the body. If Liver Qi becomes constrained, often due to drugs including HRT, diet and stress, symptoms such as mood swings, depression, headaches and insomnia may arise.

Practitioners of TCM first determine what pattern of disharmony exists and what organ systems are involved. Chinese medicine has strategies to treat these imbalances. Acupuncture is useful to help balance the Qi and to strengthen the internal organ systems. Chinese herbal medicine and dietary therapy is very effective in addressing the underlying Jing, Yin, or Qi deficiencies.

Treatment with acupuncture and Chinese herbal medicine can begin while one is on HRT whilst slowly weaning under medical supervision if that is your wish. For symptoms of yin and Jing deficiency, I specifically prescribe Carahealth Kidney/Antiaging Tonic. I alternate this with Carahealth Menopause.

Dietary therapy for menopause

Eat more

  • Cold water fish such as salmon, tuna, herring, mackerel and halibut for their beneficial omega 3 fatty acids
  • Flaxseeds
  • Soy foods, tofu, tempeh and miso
  • Legumes
  • Whole grains and seeds
  • Sea vegetables
  • Wild yams
  • Sage tea is anti-hydrotic

Reduce or avoid

Sea vegetables and menopause

Sea vegetables offer the broadest range of minerals of any food, containing virtually all the minerals found in the ocean-the same minerals that are found in human blood. Sea vegetables are an excellent source of iodine and vitamin K, a very good source of the B-vitamin folate, and magnesium, and a good source of iron and calcium, and the B-vitamins riboflavin and pantothenic acid. In addition, sea vegetables contain good amounts of lignans, plant compounds with cancer-protective properties.

Prevention of hormone dependant and normal cancers

Lignans, phytonutrients found in sea vegetables, have been shown to inhibit angiogenesis, or blood cell growth, the process through which fast-growing tumours not only gain extra nourishment, but send cancer cells out in the bloodstream to establish secondary tumours or metastases in other areas of the body. In addition, lignans have been credited with inhibiting oestrogen synthesis in fat cells as effectively as some of the drugs used in cancer chemotherapy. In postmenopausal women, fat tissue is a primary site where oestrogen is synthesised, and high levels of certain oestrogen metabolites (the 4OH and 16OH metabolites) are considered a significant risk factor for breast cancer. In addition to lignans, sea vegetables are a very good source folic acid. Studies have shown that diets high in folate-rich foods are associated with a significantly reduced risk for colon cancer.

Thyroid health

Sea vegetables are nature's richest sources of iodine, which as a component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). The thyroid gland adds iodine to the amino acid tyrosine to create these hormones. Without sufficient iodine, your body cannot synthesise them. Because these thyroid hormones regulate metabolism in every cell of the body and play a role in virtually all physiological functions, an iodine deficiency can have a devastating impact on your health and well-being.

Prevention of cardiovascular disease

Folic acid is also needed to break down a dangerous chemical produced during the methylation cycle called homocysteine. (Methylation is one of the most important cellular cycles through which a wide variety of important chemicals are produced.) Homocysteine directly damages blood vessel walls, and high levels of this chemical are associated with a significantly increased risk of cardiovascular disease and stroke. Sea vegetables are a very good source of magnesium, which has also been shown to reduce high blood pressure and prevent heart attack. Magnesium acts as a natural relaxant, has been shown to help prevent migraine headaches and to reduce the severity of asthma symptoms.

Anti-Inflammatory Action

Sea vegetables contain carbohydrate-like substances called fucans, which are natural anti-inflammatories.

Relief for menopausal symptoms

Magnesium rich sea vegetables also help restore normal sleep patterns in women who are experiencing symptoms of menopause. Lignans in sea vegetables act as weak versions of oestrogen and can relieve effects of oestrogen deficiency seen in menopause. For women suffering from symptoms such as hot flushes, sea vegetable's lignans may be just strong enough to ease their discomfort.

List of sea vegetables

  • Wakame is a sea vegetable that requires soaking and is a great addition to your soup.
  • Arame does not require cooking, but does need to be soaked for about 15 minutes before you eat it. It is a good addition to a garden fresh salad.
  • Dulse can be purchased in the form of flakes which are easy to add to your daily salad or your salad dressing. They add a salty flavour and are especially liked by children.
  • Hijiki is referred as the "beauty vegetable" by the Japanese and is the vegetable that is given credit for the lustrous, long hair and beautiful complexion Japanese women. Once soaked, hijiki makes a nice accompaniment to vegetable dishes and goes well with fish.
  • Kombu is a great addition to any soup. It will add a nice salty flavour and softens as it cooks.
  • Kelp is typically sold in the form of kombu.
  • Irish (Carrageen) Moss can be used as a thickening agent for any liquid. Simply heat it in the liquid and allow to cool.
  • Nori is another convenient sea vegetable because it can be purchased as flat sheets or in the form of soup seaweed in Asian grocers.
  • Agar Agar A very healthy addition to any dish that needs to be thickened.

Soy and menopause

Soy has also been shown to be helpful in alleviating the symptoms associated with menopause. Soy foods, like tofu, contain phytoestrogens, specifically the isoflavones, genistein and diadzein. These compounds look similar to the oestrogen molecule and can dock on the oestrogen receptors and act like very, weak estrogens. Soy is said tyo be amphoteric that is, blocks excess oestrogen when levels are high, and exerting a postive effect when oestrogen levels are low.

Health benefits of phytoestrogens

  • They bind at oestrogen receptors and prevent the body from over-producing oestradiol;
  • They dilute xenoestrogen-type toxins by binding at receptor sites and function as anti-estrogens;
  • They boost progesterone expression and help to normalize the body's important oestrogen to progesterone ratio;
  • They reduce cholesterol and support the liver in its critical role of detoxifying the blood and converting excess oestradiol into the more benign form of oestriol;
  • They are powerful antioxidants
  • They prevent the formation of new blood vessels that feed abnormal cells
  • They inhibit abnormal cell growth, and
  • They boost several beneficial enzymes within the body that prevent DNA adducts and reduce cellular damage and aging.

Soy isoflavones also promote the resorption of bone and therefore inhibit postmenopausal osteoporosis. Additionally, most types of tofu are enriched with calcium, which can help prevent the accelerated bone loss for which women are at risk during menopause. Tofu is a naturally good source of calcium.

Emphasise natural forms of soybean products such as tofu, tempeh and soy milk. whislt there is some bad press regarding soy, this is mainly in relation to artificial soy products such as soy protein isolates. Stay away from soy protein isolates. Mimicking the Asain consumtption of soy is good advice as epidemiological evidence shows that this is beneficial. Regarding supplements, I do not recommend soy supplements, as I prefer to increase soy naturally and regularly in the diet instead. My tincture Carahealth Menopause is naturally high in phytoestrogens.

Cardiovascular benefits of soy

Soy products help to lower total cholesterol levels by as much as 30%, lower LDL (bad cholesterol) levels by as much as 35-40%, lower triglyceride levels, reduce the tendency of platelets to form blood clots, and possibly even raise levels of HDL (good cholesterol).

High LDL cholesterol levels leads to a build up of cholesterol deposits in the blood vessels. These deposits can cause a heart attack or stroke. Triglycerides are fats transported in the blood, so high triglyceride levels, often seen after menopause and in particular diabetes, also contributes to the development of cholesterol deposits and heart disease. Blood clots also cause heart disease, since they can precipitate a heart attack or stroke.

Tofu contains omega-3 Fats

Tofu provides omega-3 fatty acids. Omega-3s helps prevent erratic heart rhythms, make blood less likely to clot inside arteries (which is the ultimate cause of most heart attacks), and improve the ratio of good HDL to bad LDL cholesterol.

Tofu is rich in iron

Tofu is a very good source of iron. Iron is primarily used as part of hemoglobin, a molecule essential to energy production since it is responsible for transporting and releasing oxygen throughout the body. Hemoglobin synthesis also relies on copper. Without copper, iron cannot be properly utilised in red blood cells. Both iron and copper are supplied in tofu.

Tofu displays antioxidant, anti-cancer & anti-Inflammatory qualities

Copper, along with manganese, also in tofu, an essential cofactor of a key oxidative enzyme called superoxide dismutase. Superoxide dismutase disarms free radicals produced within the mitochondria. Copper is also necessary for the activity of lysyl oxidase, an enzyme involved in cross-linking collagen and elastin, both of which provide the ground substance and flexibility in blood vessels, bones and joints.

Tofu is a good source of selenium. Selenium is a necessary cofactor of one of the body's most important internally produced antioxidants, glutathione peroxidase, and also works with vitamin E in numerous vital antioxidant systems throughout the body. Selenium is involved in DNA repair, yet another way in which adequate intake of this mineral is associated with a reduced risk for cancer.

Wholegrains

Eating a serving of whole grains, such as quinoa, barley, lentils, chickpeas etc at least 6 times each week is an especially good idea for postmenopausal women with high cholesterol, high blood pressure or other signs of cardiovascular disease (CVD). A 3-year prospective study of over 200 postmenopausal women with CVD, published in the July 2005 issue of the American Heart Journal, shows that those eating at least 6 servings of whole grains each week experienced both:

  • Slowed progression of atherosclerosis, the build-up of plaque that narrows the vessels through which blood flows
  • Less progression in stenosis, the narrowing of the diameter of arterial passageways.

The women's intake of fibre from fruits, vegetables and refined grains was not associated with a lessening in CVD progression.

Food sources of Oestrogenically active compounds

Eat liberal and regular amounts of the following foods rich in phytoestrogens, compounds that display oestrogenic like activity.

Isoflavones

Coumestans


Resorcyclic acid lactones

Lignans

Steroidal saponins

Others
Soy beans
Chickpeas
Cherry
Alfalfa
Parsley
Liquorice
wholegrains   Mung bean
Alfalfa
Soyasprouts 
Cow pea
Greenbean        
Kidney bean
Split peas
Mung beans
olives
Oats
Barley
Rye
Sesame
Wheat
Peas
Corn
Rice
Linseed
Rye
Buckwheat
Millet
Sesame and sunflower seed
Legumes and beans
Whole grains
Liquorice
potato
Fennel
Carrot
Aniseed
Hops
Cabbage, Cauliflower
Broccoli
Pakchoi
Sage
Rhubarb
Beetroot
Yeast
Plum
Garlic

Nutritional supplements for menopause

Calcium

Calcium becomes notably important during the menopausal transition. Oestrogen stimulates the osteoblasts (the bone building cells). Lack of oestrogen results in a sharp decrease in bone density and increased risk of osteopoenia and osteoporosis. Hydrochloric acid naturally declines with age, which means that calcium absorption also declines with age as and we need a high stomach acid to absorb calcium. Ensuring you obtain adequate calcium through your diet may be a challenge. As such, it may be helpful to take a calcium supplement. Calcium is also thought to promote restful sleep during menopause, particularly in combination with magnesium.

There are a number of different forms of calcium but research suggests that calcium citrate is the well-absorbed form. Calcium requires certain cofactors to be property utilised by the body, which is why many calcium supplements will also contain vitamin D, magnesium and also vitamin C. Obtaining enough sunshine in off-peak hours for ten to fifteen minutes each day can help to obtain sufficient vitamin D but living in Ireland may be a disadvantage. Therefore, a vitamin D supplement may become essential for calcium absorption.

Magnesium

Magnesium is an important mineral for bone health.. Magnesium is also known as 'nature's tranquilliser', so it alleviates symptoms such as anxiety, irritability and other mood changes.

Vitamin C

Vitamin C is a cofactor in 100s of enzymatic reactions on the body. It is partculary known to benefit the immune system, strengthens blood vessels and also displays antioxidant activity and can be beneficial at the menopause. Vitamin C and bioflavonoids have been shown to help reduce hot flushes. Vitamin C helps to build up collagen which gives skin its elasticity and it is therefore helpful in the prevention and treatment of vaginal dryness (which can cause discomfort when the vagina loses some of its 'stretch'). It can also help retain the elasticity in the urinary tract and so prevent leakage or stress incontinence, which is common at the menopause. Collagen is also important for your bones. Vitamin C is a cofactor in the production of adrenalin and helps maintain adrenal gland function.

B Vitamins

The 'antistress' vitamins support and tonify the nervous system to help you cope in times of stress. Symptoms of B-vitamin deficiency include anxiety, tension, irritability and poor concentration. During the menopause it is important that to provide assistance to your adrenal glands (which takeover oestrogen production). B5 in particular, is involved with the formation of adrenalin.

Essential Fatty Acids (EFAs)

Signs of an essential acid deficiency are dry skin, lifeless hair, cracked nails, fatigue, depression, dry eyes, lack of motivation, aching joint, difficulty in losing weight, forgetfulness, breast pain. These symptoms could all result form hormone imbalance seen during the menopause. In general EFAs also help to 'lubricate' the body and can help with vaginal dryness.

Vitamin E

Clinical studies have shown its effect on reducing hot flushes. Vitamin E is also helpful for vaginal dryness and one study showed that just 400iu taken daily for between 1 and 4 months helped 50 percent of the women given supplemental vitamin E. It can also be used internally inside the vagina every night for about six weeks to help relieve dryness. Heart disease is the biggest killer and after menopause a woman’s risk of heart disease equals that of a mans due to the protective effect of oestrogen on the cardiovascular system. In 1996 a study published in the Lancet showed that 2000 patients with arteriosclerosis (fatty deposits in the arteries) had a 75 percent reduction in their risk of heart attack when given vitamin E. At the time, researchers claimed that vitamin E was even more effective than aspirin in reducing heart attacks.

Melatonin

Recent research shows that melatonin supplementation in perimenopausal women can produce a significant improvement in thyroid function and gonadotropin levels, as well as restoring fertility and menstruation and preventing the depression associated with the menopause.

Kudzu root

Kudzu (Pueraria lobata) is a legume rich in isoflavonoid phytoestrogens including genistein and daidzein, compounds now recognized for safely supporting critical hormone levels within the body in both men and women. Kudzu has a starchy edible root that has been traditionally used in China for over two thousands years to treat alcoholism and is also widely used to treat high blood pressure and angina. Kudzu is used traditionally in China to treat headaches, diarrhoea, dysentery, acute intestinal obstruction, gastroenteritis, deafness, to promote measle eruptions and to induce sweating. Studies have shown that the root lowers blood sugar and blood pressure.

The phytoestrogen puerarin reportedly has 100 times the antioxidant activity of vitamin E. Research is showing that phytoestrogens are beneficial for preventing and treating many of the major degenerative diseases plaguing our society today.

Kudzu Root Against Addiction

Kudzu vine root can be used to make a tasty alternative to wheat flour. Kudzu has been used as a medicinal herb in China for over 2,200 years and has been noted for treating drunkenness since 600 A.D. The starchy root and its extracts have been proven to help Oriental people overcome alcohol addiction, sober up faster, block alcohol's intoxicating effects and prevents hangovers. Scientific studies in the U.S. support these findings.

Herbal Medicine

Carahealth Menopause is a natural alternative to HRT. It contains Red Clover Trifolium pratense, Hops Humulus lupulus, Motherwort Leonurus cardiaca, Black cohosh Cimicifuga racemosa, Wind flower Anemone pulsatilla, Ladies mantle Alchemilla vulgaris and Liquorice Glycyrrhiza glabra

This mix contains a blend of herbs that are naturally high in phytoestrogens. These act to increase safely oestrogen levels in menopausal women and prevent symptoms of oestrogen deficiency experienced by menopausal women such loss of libido, hot flushes, excessive sweating, headaches, itching or burning sensation in the skin, insomnia, fatigue, arthritis, irritability and anxiety, sudden increase in facial hair, dry skin and or sudden onset of wrinkles, vaginal dryness and dizziness. Please note that, unlike artificial oestrogen, which contributes to an increased risk of breast, endometrial and ovarian cancer, phytoestrogens decrease the risk of these hormone dependant cancers a,s they occupy the oestrogen receptor sites and allow the dangerous cancer promoting oestrogen to be eliminated via the liver and bowel.

Red Clover Trifolium pratense – Red clover is an alterative, antiscrophulatic, antispasmodic, aperient, anti-cancer, detergent, diuretic, expectorant, sedative and tonic. Red clover is safe and effective herb with a long history of medicinal usage. It is commonly used to treat skin conditions. It is a folk remedy for cancer of the breast, a concentrated decoction being applied to the site of the tumour in order to encourage it to grow outwards and clear the body. It has also shown anti-cancer activity, poultices of the herb have been used as local applications to cancerous growths, Flavonoids in the flowers and leaves are oestrogenic and benefit menopausal complaints.

Hops Humulus lupulus – Hops are anodyne, antibacterial, antiseptic, antispasmodic, antioxytocic, bitter, diuretic, febrifuge, galactogogue, hypnotic, male anaphrodisiac, nervine, oestrogenic, sedative, sopoforic, stomachic and tonic. Hops have a long and proven history of herbal use, where they are used for their soothing, sedative, tonic and calming effect on the body and the mind. Humulus is a central nervous system relaxant used to treat insomnia. Their strongly bitter flavour accounts for their ability to strengthen and stimulate the digestion, increasing gastric and other secretions. Humulus helps relieve tension and anxiety and may be used where tension results in restlessness, headache and indigestion. Alcoholic extracts of Humulus show a strong antispasmodic action on smooth muscle and is of benefit wherever there is visceral tension, for example, in nervous dyspepsia, nervous colitis, palpitations, nervous or irritable coughs, and asthma. It reduces the effects of the nervous system on the digestive system; whilst at the same time gently stimulates digestion. Its’ relaxing and astringent actions can be applied to mucous colitis as well as tense bowel states such as irritable bowel syndrome, diverticulitis or Crohn's disease. Humulone and lupulone have an anti-inflammatory action. The hairs on the fruits contain lupulin, a sedative and hypnotic drug. When given to nursing mothers, lupulin increases the flow of milk. Hops are said to remedy swellings and hardness of the uterus. Recent research suggests an anti-oxytocic property, supporting the claims for its use in dysmenorrhoea and amenorrhoea (particularly when associated with anorexia nervosa).

Motherwort /Lions tail Leonurus cardiaca - Motherwort is astringent, antispasmodic, birthing aid, emmenagogue, sedative, nervine, mildly hypotensive, cardiac tonic, gentle uterine stimulant, mild stimulant to the womb, relaxant, carminative, diaphoretic. Motherwort is especially valuable in the treatment of female weaknesses and disorders, allaying nervous irritability, inducing quiet and passivity of the whole nervous system. It is indicated for cardiac debility, tachycardia and amenorrhoea. Motherwort is an excellent heart tonic. Research has shown that it calms palpitations, tachycardia and irregular heartbeats. It is a specific remedy for tachycardia caused by anxiety, and may be used in all heart conditions associated with anxiety and tension. The alkaloid leonurine produces central nervous depressant and hypotensive effect. The glycosides have a short-term ability to lower blood pressure. Leonurus is valuable in the stimulation of suppressed or delayed menstruation, and to ease dysmenorrhoea, especially where there is anxiety or tension involved. It may be used to ease false labour pains, and the infusion, taken after childbirth, will help restore the uterus and reduce the risk of post-partum bleeding. The alkaloids encourage and ease uterine contractions. It is also helpful during the menopause.

Black cohosh Cimicifuga racemosa - Black cohosh is an alterative, anti-inflammatory, antirheumatic, antispasmodic, astringent, birthing aid, cardiotonic, diaphoretic, diuretic, emmenagogue, expectorant, hypnotic, hypoglycaemic, sedative, tonic, and vasodilator. Black cohosh is a traditional remedy of the North American Indians where it was used mainly to treat women's problems, especially painful periods and problems associated with the menopause. Black cohosh is the trophorestorative of the female reproductive system. Research has shown that the root has oestrogenic activity and is thought to reduce levels of pituitary luteinizing hormone, thereby decreasing the ovaries production of progesterone. It maybe used beneficially in cases of painful or delayed menstruation. Ovarian cramps or cramping pain in the womb will be relieved by Black cohosh. It is very active in the treatment of rheumatic pains, but also in rheumatoid arthritis, osteoarthritis, in muscular and neurological pain. It finds use in sciatica and neuralgia, associated with the third trimester of pregnancy.

Wind flower Pulsatilla vulgaris - Pulsatilla is an analgesic, alterative, antispasmodic, bactericidal, central nervous system depressant, diaphoretic, diuretic, emmenagogue, expectorant, nervine, ophthalmic and sedative. It is taken internally in the treatment of pre-menstrual syndrome, inflammations of the reproductive organs, tension headaches, neuralgia, insomnia, hyperactivity, bacterial skin infections, septicaemia, spasmodic coughs in asthma, whooping cough and bronchitis. It is indicated for dysmenorrhoea with scanty menses, orchitis, ovaralgia, epididymitis, tension headache, hyperactive states, insomnia, boils, skin eruptions associated with bacterial infection. This herb is particularly applicable to women, and is of value in neuralgia, headache and nervous exhaustion, particularly premenstrually or during the menopause. It is a specific remedy for pain and inflammation of the reproductive system, especially when this is associated with poor flow. It alleviates menstrual cramps, especially when accompanied by anxiety or irritability. It will help insomnia and general over-activity. It is applicable to inflammation and infection of both male and female reproductive organs and tissues. Ladies mantle Alchemilla vulgaris – Ladies mantle is astringent, diuretic, anti-inflammatory, emmenagogue, vulnerary. This and other species of Alchemilla have been widely used in folk medicine throughout Europe. Lady's Mantle will help reduce pains associated with periods as well as ameliorating excessive bleeding. It also has a role to play in easing the changes of the menopause. As an emmenagogue it stimulates the proper menstrual flow if there is any resistance. However, in the often apparently paradoxical way of herbal remedies, Lady's Mantle is a useful uterine astringent, used in both menorrhagia and metrorrhagia

Liquorice Glycyrrhiza glabra – Liquorice is alterative, anti-inflammatory, antispasmodic, demulcent, diuretic, emollient, expectorant, laxative, pectoral, and tonic. It is a very sweet, moist, soothing herb that detoxifies and protects the liver and is also powerfully anti-inflammatory, being used in conditions as varied as arthritis and mouth ulcers. The constituents, glycyrrhizin and glycyrrhetinic acid, inhibit 11-beta-hydroxysteroid dehydrogenase. This inhibition blocks metabolism of prostaglandins E and F2 alpha and may be responsible for peptic ulcer healing. Liquorice has also been shown to have a hormonal effect similar to the ovarian hormone. Liquorice root is much used in cough medicines and also in the treatment of catarrhal infections of the urinary tract. It is taken internally in the treatment of Addison's disease, asthma, bronchitis, coughs, peptic ulcers, gastric and duodenal ulcers, arthritis, allergic complaints and following steroidal therapy. In TCM liquorice is said to be sweet, neutral and warm. It enters all 12 meridians but mainly the heart, lung, spleen and stomach meridians. Liquorice tonifies the spleen & stomach Qi and is used to treat digestive disorders, moisten the lungs and stops dry cough, tonifies the heart Qi to regulates pulse, clears heat & toxic fire, alleviates pain, stops spasms, harmonize & moderates the characteristics of other herbs and is an antidote for toxicity. It should be used in moderation and should not be prescribed for pregnant women or people with high blood pressure, kidney disease or taking digoxin-based medication. Prolonged usage raises the blood pressure and causes water retention. After the ovaries atrophy and die the adrenal glands are supposed to take over the production of oestrogen. As an adrenal tonic, liquorice has the ability to tonify the adrenal glands to replace adrenal stores of adrenalin, cortisol, aldosterone and DHEA which is a sex hormone precursor to oestrogen.

Carina is available to lecture for your group or institution on this subject

Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu. is a practitioner of 11 years, complementary medicine lecturer of 4 years and mother of six in Galway, Ireland who practices what she teaches.

For an appointment call Carina directly on 083 34 66 333.

All products are available through www.carahealth.ie. Remember, we are here for a good time not a long time, enjoy your food life!

Carahealth Galway Ireland. Acupuncture, Naturopathy, Homeopathy, Herbal Medicine, Nutrition, Nutritional therapy, Flower essences, Iridology, Short Courses

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