By guest contributor Michelle Boyd MHSc WHM, GradCert HEd, BHScNat, FNHAA Naturopath and Herbalist, University Lecturer, Clinical Educator & Author.
Michelle Boyd, Naturopath, Herbalist, Lecturer, Clinical Educator and Author.
Menopause is a natural stage of life; it is not a disease. Managing menopausal symptoms is only one part of the big picture in supporting a woman’s adjustment through mid-life changes. Ideally, planning for menopause should begin long before it starts.
The menopausal transition usually occurs from 45 to 55 years of age and may take a woman 5 to 10 years to transit menopause, with this stage of fluctuating hormones (and hence irregular menstrual cycles) referred to as perimenopause1. Perimenopause is recognised by many as a time of ‘hormonal chaos’ during which up to 80% of women suffer from both physical and emotional symptoms (60% mild to moderate; 20% severe), including hot flushes and sweats(mostly), anxiety/depressed mood and insomnia.2
Menopausal hot flushes are thought to be hormonally driven, however they are also influenced by stress and diet (blood sugar fluctuations). No matter what the cause, it’s all about the ‘bothersome’ factor – whether women have 2 or 20 hot flushes a day, if it’s ‘bothersome' enough for them to seek help then they need relief!
The most reliable herbal relief for hot flushes is found with Actaea racemosa (Black cohosh). Most recent Actaearacemosa studies3,4,5 involving 1200+ menopausal womendemonstrated statistically relevant reduction of major menopausal symptoms especially the incidence and severity of hot flushes with results seen within 2-4 weeks, with continued improvement shown over 3 and 9 months.
Stress/diet related factors that may exacerbate hot flushes also need to be identified. Erratic eating behaviour plays havoc with blood sugar levels promoting the incidence/severity of hot flushes. Menopausal women need to eat (less) more regularly and think ‘paddock to plate’:Combine good quality protein with colourful plate of antioxidant rich fruits and vegetables
Relax before meals and eat dinner (early) at the table
Alcohol promotes hot flushes – reduce/stop intake
Anxiety and stress
Midlife women have many sources of anxiety and stress -juggling work with life, bringing up teenagers, caring for grandchildren and/or aging parents and their own ageing.
Anxiety and stress can be part of the menopause picture and/or result from a very busy, caffeinated and stressful mid-life! Either way, these women need nervous system support, e.g., herbal Hypericum perforatum (St. John’s wort) is shownto relieve stress and anxiety, improving midlife mood – as does reducing caffeine intake!
Women can suffer hot flushes and/or sweats 24/7 which can cause insomnia. Alternatively, insomnia may be due to worrying about ‘midlife stuff’ becoming tired, cranky and frustrated – more midlife moodiness! Reducing the incidence/severity of hot flushes/sweats and promoting a good night’s sleep will help resolve her suffering and Valeriana officinalis (Valerian) and Humulus lupulus (Hops)combination, mimic the body’s natural sleep hormone (melatonin) promoting a restful good night’s sleep.6
Post-menopausal women may continue to experience menopausal symptoms; however, it is the ‘silent changes’ due to the decline in the ‘protective effects’ of oestrogen that require far more important attention. Cardiovascular disease (CVD) is the leading cause of death in post-menopausal women and cardiovascular markers like increased body weight (especially abdominal fat), high blood pressure and high cholesterol, all increase in post-menopause.7 Lifestylechanges are essential to increase longevity and decrease the risk of osteoporosis and CVD. Healthy eating and regular exercise are most important to manage weight and prevent disease.
A diet rich in antioxidant/anti-ageing culinary herbs and spices have been shown to be beneficial for cardiovascular health.8 Most notable is turmeric, the ‘spice of life!’ with antioxidant/anti-inflammatory properties providingtherapeutic benefits for various conditions ailing menopausal women. Others include ginger, cumin, marjoram, cardamom, garlic, cinnamon, oregano and rosemary.
Periodic testing of blood pressure and blood lipid (fat) levels (importantly triglycerides) is recommended for menopausalwomen as is bone mass density (BMD).
Menopause is an important time to check BMD to identify any health issues early. On average, it is estimated women will lose up to 10% of their BMD in the first 5 years post menopause. Promoting healthy bones requires both regular exercise and adequate vitamin D levels and calcium intake.9
Menopausal women require 1300 mg/day of calcium, preferably from low calorie dietary sources (which will also contain other healthy nutrients),10 with a calcium supplement (maximum 500-600 mg per day) to top up the difference if need be.
Low levels of vitamin D are commonly seen in menopausal women. Vitamin D is naturally produced in our skin when exposed to ultraviolet sun light. Osteoporosis Australia’s website www.osteoporosis.org.au provides a vitamin D sunshine map to help you identify the best time/duration depending on location/time of year for optimal exposure and regular intake of vitamin D3 supplement is beneficial for those with inadequate levels.
Regular exercise is important for menopausal heart and bone health and there are several reasons why.11
Upright weight-bearing activity promotes strong healthy bones.
Inner core strength exercise helps maintain balance to help prevent falls.
Improving reflexes promotes quicker response to help break falls.
Menopausal women need to consult their doctor and a qualified exercise specialist to establish their individual needs.
Exercise builds muscle cells providing benefits for metabolism and improved energy to enjoy midlife and beyond!
In closing …
Many menopausal women (including myself) soon realise their menopausal symptoms just don’t go away overnight and some of us must endure them for many years. In knowing this, our focus becomes that of finding efficacious, clinically proven, natural treatments with good safety track records.Look for them – they’re out there
1. Menopause Symptoms, Signs, Treatment, Definition (medicinenet.com)
2. Symptoms of menopause | Jean Hailes
3. Lopatka L et al. Black Cohosh in the Treatment of Menopausal Complaints – Results of an Observational Study with Cimifemin Uno. Journal of Menopause(English version) 2007; 2:16-21.
4. Schellenberg R et al. Dose-Dependent Effects of the Cimicifuga racemosa Extract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study. Evidence-Based Complementary and Alternative Medicine. 2012. doi: 10.1155/2012/260301.
5. Drewe et al. The effect of a Cimicifuga racemosaextracts Ze 450 in the treatment of climacteric complaints – an observational study. Phytomedicine.2013; 20:659-666.
6. Koetter U et al. A Randomized, Double Blind, Placebo-Controlled, Prospective Clinical Study to Demonstrate Clinical Efficacy of a Fixed Valerian Hops Extract Combination (Ze 91019) in Patients Suffering from Non-Organic Sleep Disorder. Phytotherapy Research. 2007; 21:847-851.
7. Menopause | Health and wellbeing | Queensland Government (www.qld.gov.au)
8. Iyer A et al. Potential Health Benefits of Indian Spices in the Symptoms of the Metabolic Syndrome: A Review. Indian Journal of Biochemistry & Biophysics. 2009; 46:467-481.
9. Menopause and osteoporosis - Better Health Channel
10. Calcium - Better Health Channel
11. Grindler NM & Santoro NF. Menopause and exercise. Menopause. 2015; 22(12):1351-1358.