Once women reach the menopause years, typically around the age of 50, a variety of physiological changes and menopause symptoms occur that can have a profound impact on their lives. Menopause is a term that refers to the end of menstruation, the result of the natural decline in the hormones (estrogen, progesterone and others) produced in the ovaries. After years of preparing and releasing eggs, the ovaries eventually reach a point where they end their monthly routine. As hormone levels decrease, a number of symptoms may emerge, although their presentation and severity varies greatly from woman to woman. The most common menopause symptoms are hot flashes, depression, insomnia, vaginal dryness, irritability, mood swings and headaches.
Most women report that they experience hot flashes during pre- and perimenopause. Hot flashes typically begin to occur when women start to have irregular periods, and usually end one or two years after menstruation has ceased. Sometimes women will experience flushing or warmth in their faces and upper bodies, others might actually have sweating and chills. Hot flashes can occur at any time of day or night. While it is not entirely clear what causes hot flashes, some researchers suggest it might have to do with mixed signals from the hypothalamus, a region in the brain that regulates body temperature and sex hormones. The hypothalamus may be reacting to decreasing levels of estrogen, and this may explain why hot flashes cease when estrogen replacement is given.
There are two tests that your doctor can perform that will determine if a woman is "officially" in menopause. One is to test the follicle-stimulating hormone (FSH) level. This hormone increases significantly after the ovaries shut down. Another procedure is to take a Pap-like smear from the vaginal walls and check for any thinning and drying out of the vagina.
Suggested Lifestyle Changes for Menopause Treatment
Mental attitude has a lot to do with how well a woman adjusts to menopause. If it is seen as a tragic end to youth, fertility and sexuality, it can cause significant disruptions in one's day-to-day life, and create the temptation to "solve" the problem with unproven therapies that promise eternal youth. If menopause is seen as simply the natural transition to the next phase of life, it can be readily accepted and more easily handled. The risks and benefits of estrogen replacement therapy should be carefully considered, and many women do quite well without any medical intervention for menopause treatment. Following an anti-inflammatory diet, getting adequate aerobic exercise, and relaxation practices can help address the many practical problems that menopause can bring. Menopause is not a disease, and there is no reason for it to decrease interest in or enjoyment of sex. Vaginal dryness can make intercourse more difficult, however, and an over-the-counter product such as Replens Vaginal Lotion, as well as lubricants such as Astroglide can help. Your doctor can also prescribe a topical estrogen cream which will restore normal vaginal tissue.
Nutrition and Supplements - Herbs for Menopause
Try the following natural remedies and herbs for menopause:
- Soy foods. The isoflavones in soy foods help balance hormone levels and have some estrogenic activity. There is ongoing research about the safety and efficacy of isolated soy isoflavone supplements. While the initial results look promising, we currently recommend using natural soy foods rather than supplements. Choose from tofu, soy milk, roasted soy nuts or tempeh.
- Flaxseed. Substances called lignins in flaxseed are important modulators of hormone metabolism. Grind flaxseed daily in a coffee grinder at home and use 1 to 2 tablespoons a day.
- Dong quai. Dong quai (Angelica sinensis) is known both in China and the West for its ability to support and maintain the natural balance of female hormones. It does not have estrogenic activity. This is one of the herbs for menopause that should not be taken if a woman is experiencing heavy bleeding.
- Black cohosh (Cumicifuga racemosa). One of the best-studied traditional herbs for menopause, black cohosh is used to help alleviate some symptoms of menopause, including hot flashes. Black cohosh seems to work by supporting and maintaining hormonal levels, which may lessen the severity of hot flashes. Many women report that the herb works well but it isn't effective for everyone. While any therapy that influences hormonal actions should be a concern, black cohosh does not appear to have estrogenic activity and thus may be safe for women with a personal or family history of breast cancer.
- Vitamin E. A daily dose of 400 IUs of natural vitamin E (as mixed tocopherols and tocotrienols) can help alleviate symptoms of hot flashes in some menopausal women.
- B vitamins. This group of water-soluble vitamins may help women deal with the stress of menopausal symptoms.
- Evening primrose oil or black currant oil. These are sources of gamma-linolenic acid (GLA), an essential fatty acid that can help influence prostaglandin synthesis and help moderate menopausal symptoms.
Read more of Dr. Weil's articles and advice for more information on menopause symptoms.