Menopause refers to the time during which a woman’s ovaries begin producing less estrogen and progesterone and cease the ripening and releasing of ova. The transition can last up to five years and typically occurs at mid-life. The hallmark of menopause is a woman’s loss of menstrual cycle—rendering her unable to conceive for the remainder of her life. But a woman’s body undergoes many additional changes that are both physical and psychological in nature, including hot flashes, night sweats, irregular heartbeat, headaches, and sleep difficulties. Menopause is also often accompanied by mood swings, irritability, depression, and anxiety, as well as cognitive symptoms like forgetfulness. Other symptoms of menopause may include urine leakage, vaginal dryness, infection, painful sexual intercourse, and joint aches or pains. The first few years of menopause are also associated with a temporary period of increased bone loss because the body is making less of the hormones estrogen and progesterone, which puts women at risk for osteoporosis.

The age at which a woman starts having menstrual periods is also not related to the age of menopause onset. Most women reach menopause between the ages of 45 and 55, but menopause may occur as earlier as ages 30s or 40s, or may not occur until a woman reaches her 60s. The average length of perimenopause is four years, but for some women this stage may last only a few months. Perimenopause ends when a woman has gone 12 months without having her period.

The menopause transition is an interesting example of a bio-psychosocial process in that the majority of women experience some physiological changes, which may be influenced by a range of psychological, social and cultural factors. In the 19th century, western psychiatry dominated thinking on menopause, and it was considered a time of emotional vulnerability with women losing emotional control and exhibiting ‘hysterical’ behaviour. In the 20th century, the medical approach took hold and centred on gynaecology; menopause became an ‘oestrogen deficiency disease’, akin to diabetes, and with a whole host of physical and emotional challenges, which could be treated with hormone therapy. Late 20th-century and early 21st-century thinking moved towards possible long-term health risks associated with menopause, such as increased risks of depression, heart disease, osteoporosis, cognitive impairment and even dementia.

Until recently, hormone replacement therapy (HRT) was the main treatment for menopausal symptoms in most western countries. HRT is central to the biological/medical model and boasts a 75 per cent reduction in hot flushes and night sweats. However, many studies and trials suggest an increased risk of breast cancer and stroke on taking HRT, and prevention of cardiovascular risks have not been supported.

The relationship between depressed mood, menopause and hot flushes is complex; in general, some studies have found a slight increase in depressed mood which subsides after the menopause, while other studies find no change. Anxiety before the menopause is associated with the presence and severity of hot flushes; “women with moderate or high anxiety levels were three and five times more likely to report hot flushes than women in the normal anxiety range” (Freeman et al., 2005).

A bit about physiology – At puberty, a female’s ovaries begin releasing the hormone estrogen in synchronization with each monthly menstrual cycle. The estrogen level rises suddenly in mid-cycle, which triggers the release of an egg. Estrogen hormones play an essential role in the growth and development of female secondary sexual characteristics such as breasts, pubic and armpit hair, endometrium, and the regulation of the menstrual cycle and reproductive system. Progesterone is a female hormone produced by the ovaries during release of a mature egg from an ovary. Progesterone helps prepare the lining of the uterus to receive the egg if it becomes fertilized by a sperm. If the egg is not fertilized, progesterone levels drop and menstrual bleeding begins.

Estrogen deficiency can cause the following symptoms:

• Fatigue
• Depression
• Poor libido
• Poor memory
• Hot flushes (fluctuating estrogen levels)
• Droopy breasts
• Irregular periods
• Light or absent periods
• Uncomfortable intercourse due to poor lubrication
• Decreased vitality of vulva & vaginal area
• Recurrent bladder infections
• Stress incontinence
• Joint stiffness & discomfort
• Dry eyes & mouth
• Small sharp wrinkles above upper lip & corner of eyes

 

Therapy –

Black cohosh is a plant containing potent phytoestrogens. Since 1956, over 1.5 million women in Germany have used an extract of black cohosh to treat menopausal complaints with great success and without side effects. It has been compared to estrogen replacement therapy in several controlled trials and has been found to be equal to or better than estrogen in relieving menopausal complaints. Clinical studies have shown its effectiveness in alleviating not only hot flashes, but also depression and vaginal atrophy.

Vitamin E, which was studied primarily in the 1940’s, was found to relieve not only hot flashes, but also menopausal vaginal complaints. Vitamin C and hesperidin (a bioflavonoid found in citrus fruits) were shown in one study to relieve menopausal symptoms in 53% of the subjects and reduce them in an additional 34% when used in combination. [Note: Hesperidin might lower blood pressure. In theory, taking hesperidin might make blood pressure become too low in people who already have low blood pressure].

Maca – Women use maca for female hormone imbalance, menstrual problems, and symptoms of menopause. Maca is also used for weak bones (osteoporosis) and depression.

Passionflower may help reduce anxiety by increasing the levels of gamma-aminobutyric acid, also known simply as GABA, a chemical in the brain. This chemical induces relaxation and reduces anxiety by decreasing the activity of some brain cells. Alkaloids in passionflower may inhibit monoamine oxidase, which would give the herb a similar effect to monoamine oxidase inhibitors.

Red clover has come to be known as an effective, all-natural treatment for lowering menopause symptoms, improving bone mineral density, and lowering risk for heart-related problems like high cholesterol and high blood pressure symptoms.

Sweet violet is used for nervous strain, physical & mental exhaustion, symptoms of menopause (hot flashes), depression & irritability.

Sage or Salvia officinalis, is rich in essential oils that form an important part in the plant’s medicinal function. Today, sage extracts are well known and widely used for their ability to help relieve the symptoms of menopausal sweats and hot flushes.

Ashwagandha many benefits can ease several menopause symptoms. Because of its hormone balancing effect it may even help with some of the symptoms of Perimenopause.

Extracts of Wild Yam (Dioscorea villosa), which are applied topically in the form of a cream, are known to contain steroidal saponins, including diosgenin, which has been claimed to influence endogenous steroidogenesis.

Menopausal women need to ensure they are consuming enough foods rich in vitamin D or taking supplementation to prevent bone loss. Vitamin D is needed to absorb calcium.

Dong Quai can restore hormone balance and ease the many symptoms of menopause.

The items listed above are just a few natural remedies that can help women to cope with perimenopause and menopause. This does not mean that you must take a cocktail of them. With a little bit of time and trial and error, you’ll discover the combination of natural steps that works for you and relieves your symptoms.

Menopause and weight gain tend to go hand in hand, thanks to a combination of factors including decreased estrogen, slower metabolism, and lifestyle factors like poor diet and lack of exercise. Keep an eye on nutrition. Reducing sodium, caffeine and protein from animal products can also help the body maintain calcium stores. Opt for more alkaline foods – vegetables, fruits, seeds, nuts and yogurt – to help prevent calcium reserves being leaked from the bones. Eat foods high in magnesium and boron. AVOID – Refined sugar and other sweeteners such as sucrose and any foods containing refined sugar – this contributes to weight problems and over stimulates the nervous system, triggering hot flushes. Wheat is best avoided if possible, as it can cause bloating, wind and constipation. The same goes for pasta – and also avoid white rice, which has no nutritional value. Avoid milk as it depletes the calcium from your bones. The milk myth has spread around the world based on the flawed belief that this protein and calcium-rich drink is  essential to support good overall health and bone health in particular at any age. Too much salt is not good for you as it triggers flushes and can contribute to high blood pressure, which often appears in  menopause.

Menopause doesn’t have to be a miserable experience or a  time of loss, but a chance to embark on an exciting, less restricted and newly empowered life.

 

© – Article by: A B M Procaccini – Psychologist and Naturopathist