Natural ways to manage your menopause
Earlier this month the BBC aired Kirsty Wark’s great documentary about the menopause: The Menopause and Me. The documentary explores how the menopause affects every woman in a different way. Some women sail through and others experience physical and psychological changes that affect their lives for decades. This blog explains what the menopause is and why you experience some of the symptoms you do. It also explores some natural medicines (including natural hormones) you may want to try before reaching for pharmaceutical HRT.
WHAT IS THE MENOPAUSE
Biology of the menopause
A woman is considered to be at the menopause when she has not menstruated (had a period) for 12 months. This normally occurs between the ages of 40 and 55 years with an average age in Western societies of 50 years. She is considered to have had a natural menopause at this time if there is no other cause for the cessation of her menstrual cycle, other than her ovaries no longer producing an egg.
Function of the menopause
The evolutionary explanation of why women experience the menopause is that it provided Homo sapiens with a competitive advantage over other species. It is proposed that without the burden of continued birthing and raising of children, “older” women were able to provide better for their existing children as well as play an important role in the raising of their grandchildren (finding food, protecting them from danger, passing down skills and so forth). Thus ensuring the survival of their descendants.
In today’s society things are a little different. Some women are giving birth to their first child in their 40s and many women in their 50s and 60s are still busy working. Nonetheless, for many women the menopause and the subsequent years can be a time of freedom and taking up new challenges as well as sharing their skills and knowledge with the younger generation.
Stages of the menopause
The menopause can be divided into three phases: the oopause in which fertility significantly decreases even though regular menstruation is still occurring (up to 10 years before the menopause itself); the perimenopause in which menopausal symptoms intermittently appear as egg numbers in the ovary reduce, ovulation doesn’t always take place and the menstrual cycle fluctuates between shortened and prolonged cycles; and finally the menopause itself as described above.
Symptoms of the menopause
The majority of women report some symptoms during the perimenopause and menopause, even if very mild. The symptoms are most often related to declining levels of oestrogen in the body during the menopause as well as a reduction in related progesterone production. The following are the most commonly reported symptoms with an explanation of why they may occur.
Hot flushes and night sweats
Experienced by circa 50% – 85% of women
The hot flush is like an intense heat spreading over the entire body, and is often accompanied by extreme sweating to bring the body temperature down. The flush is caused by disturbance in the temperature regulating mechanisms in the hypothalamus, related to oestrogen decline, which lead to an increase in blood flow to the surface of the body, increased heart rate and increased electro-dermal activity (more info).
Sleep problems (with or without night sweats, with or without depression)
Experienced by circa 25% – 50% of women
Oestrogen stimulates the production of serotonin that plays an important role in helping us fall asleep and stay asleep. It also regulates the production of cortisol, especially morning cortisol production. Withdrawal of oestrogen can therefore lead to sleep problems, especially maintaining sleep and these sleep disturbances can often lead to mood changes including depression and anxiety (more info).
Vaginal dryness, vaginal infections, painful sexual intercourse and reduced sex drive
Experienced by 13% – 34% of women
The vagina contains oestrogen receptors that when stimulated cause vaginal cells to produce mucus to lubricate the vagina and maintain the optimal PH balance inside the vagina. As oestrogen production reduces, vaginal mucus production decreases, sometimes making intercourse uncomfortable and sometimes leading to infection.
The neurotransmitter dopamine plays a key role in our sexual arousal and ability to orgasm. Dopamine production is stimulated by oestrogen and by testosterone. Oestrogen levels decrease during the menopause and testosterone levels decrease with age. For this reason some women report a loss in sex drive around the time of the menopause, though this can sometimes be related to other symptoms they are experiencing.
Heavy bleeding and clotting
When ovulation does not occur the ovary does not enter the luteal phase of the cycle where progesterone is produced. This means that oestrogen is unopposed and stimulates the lining of the uterus to proliferate without the stabilising effects of progesterone. If the cycle length is long then this can lead to heavy bleeding. When the uterine lining is shed too quickly, enzymes that break down the lining and turn it into liquid blood don’t have a chance to take effect, this can cause clots to be passed.
Hypothyroidism is also associated with heavy menstrual bleeding and can also develop during the menopause. If you are also experiencing weight gain, constipation and hair fragility you may want to ask your GP to check your thyroid hormones.
A range of other symptoms are reported by women during the menopause including: irritability, an increase in fat deposition around the waist, urinary leakage, severe tiredness, brain fog, joint pain and loss of hair and skin changes.
Complications of the menopause
After the menopause women can become more susceptible to developing certain conditions due to decreased levels of oestrogen. These conditions include osteoporosis and cardiovascular disease, however the good news is that risk of developing these conditions can be modified through diet, lifestyle and exercise.
There are a number of NHS solutions for menopausal symptoms including hormone replacement therapy (replacing lost oestrogen or progesterone) and cognitive behavioural therapy (a form of psychotherapy). More information can be found about these therapies, their benefit and their risks on the British Menopause Society website. However, for most symptoms pharmaceutical medicine need not be the first line of defence (more info).
Self-help / stress reduction strategies
Being able to talk to other people about what you are going through is really important and a great stress relief. Stress can make the symptoms of the menopause more severe for some women and so finding ways to relieve symptoms and stress can be very useful. There are many self-help strategies recommended online – from wearing layers and self-massage to flower essences and saying no – but this is one of my favourite websites.
Because humans and plants have evolved together over millions of years we contain biologically similar compounds. Compounds from plants can therefore be used to replace some of the hormones we lose during the menopausal years as well as help treat some of the symptoms we may experience.
Many herbal medicines can be useful during the menopause and key herbs, supported by research, are outlined below. Whilst you can purchase herbal supplements from a good health food shop, for best results visit a qualified Medical Herbalist. A Medical Herbalist will take a holistic approach to your wellbeing and support you with other lifestyle changes that you may find useful. In addition, some of these herbs can interact with other medications you may be taking. A Medical Herbalist is trained in pharmacology and will know where these contraindications occur.
We are Medical Herbalists based in Watford and Berkhamsted, Hertfordshire. We also offer supportive therapies including Maya abdominal massage (which is great if your symptoms include digestive issues) and Reiki to help with relaxation and stress reduction. For a herbalist near you please visit the National Institute of Medical Herbalists and for other local massage therapies visit the resources page of our website.
- Black Cohosh (Cimicifuga racemosa)
This is one of the most widely researched herbs in relation to the menopause. It contains oestrogen like compounds that bind to oestrogen receptors in the human body. For this reason it has been found to reduce symptoms related to oestrogen withdrawal such as hot flushes, night sweats, insomnia and vaginal dryness. May cause headaches.
- Chaste Tree (Vitex agnus-castus)
This herb is useful for balancing oestrogen and progesterone hormones during the perimenopausal period and can therefore help to reduce hot flushes, heavy bleeding and vaginal dryness.
- Red Clover (Trifolium pratense)
This herb contains phytoestrogen compounds – isoflavones. These are a form of natural oestrogen that bind weakly with oestrogen receptors and therefore help to reduce some of the symptoms of menopause including hot flushes, vaginal dryness and insomnia.
- Hops (Humulus lupulus)
This herb contains one of the most powerful plant-derived oestrogenic compounds and has also been shown to have beneficial sedative effects. This herb should be taken at night time.
- St John’s Wort (Hypericum perforatum)
This herb increases the amount of serotonin available in the brain. Consequently it has been found to be useful for improving mood and decreasing anxiety and sleep disorders during the menopause. Good to take with Black Cohosh.
Sexual desire enhancers
- Korean Ginseng (Panax ginseng)
The effectiveness of this herb for increasing libido is thought to be related to its ability to decrease the production of cortisol, our stress hormone. Cortisol can disrupt the production of oestrogen.
- Shatavari (Asparagus racemosus)
This herb contains hormone like compounds that are thought to impart hormone like activity in the female reproductive system. It helps to promote menstruation and improve sexual desire.
Dietary changes may help to relieve menopausal symptoms, especially reducing stimulants such as coffee and alcohol. Positive dietary changes are often good to use in conjunction with herbal medicine to begin with if your symptoms are more severe. You can then move on to diet alone once things have settled down to help maintain adequate hormone levels.
A diet high in phytoestrogens (natural oestrogen compounds), particularly isoflavones, may help reduce menopausal symptoms for some women. Isoflavones are found in foods such as legumes, lentils, chick peas and especially soybeans (frozen edamame beans are a good source).
Flaxseed is also rich in isoflavones as well as dietary lignans. It is best to buy the seeds, grind them and sprinkle onto porridge and salads. 40g / a tablespoon per day is recommended. Flaxseed may also help to protect against developing cardiovascular disease.
Other nutrients that may be useful are Vitamin B complex, calcium (for bone mineralisation), essential fatty acids (omega 3s), probiotics (especially if you’re susceptible to vaginal infections), Vitamins C, D, E and Zinc. For more ideas on good foods to eat see our Dietary Recommendations and for more information about probiotics and gut health see our blog about the digestive system.
POST MENOPAUSE SUPPORT
Post menopause support focuses on maintaining a healthy weight and supporting your bones, heart and blood vessels through eating the right foods and through exercise, in order to reduce the risk of developing osteoporosis and heart disease.
Continuing to eat foods rich in phytoestrogens as listed above can be useful in providing your body with a natural source of oestrogen. Otherwise, make sure you include plenty of vegetables and fruits of all different colours in your diet (aim for 5 – 10 portions per day), whole grains, olive oil and lean meats and fish.
Resistance (e.g. yoga with weights) and impact (e.g. jogging) exercises are considered to be the most effective for retaining bone mineralisation and reducing the risk of osteoporosis. However other exercise can be useful too (e.g. swimming, tai chi, Pilates) with the added benefit of reducing the risk of developing cardiovascular disease (more info).
Image credit: Pexels.com
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