Restoring Healthy Menopausal Rhythms – The Holistic ApproachMichael Vertolli, RH May 1, 2010
This has been quite an unusual spring so far. It has been much sunnier and warmer than is typical for this time of year, as were February and March. In fact, this past winter was the warmest and driest on record for Ontario. On the positive side, it’s been great for outdoor activities. On the down side, if we don’t get some significant rain soon, we will likely be experiencing a drought this summer. Except in the moister low lying areas, the soil in mid April (when I am writing this), in both open areas and woodlands, is already as dry as it would normally be around late June. This isn’t just because it has been warmer and drier, but also due to the lack of snow this past winter and that it became warm so fast in early March that what little snow we had melted very rapidly while the ground was still frozen. As a result, the water ran off into the creeks and rivers and very little of that moisture penetrated into the ground.
As an herbalist, I have to be very aware of these natural cycles. Since I primarily use tinctures made from fresh herbs, I have to keep a close watch on the development of the herbs that I use. Once they reach the point in their life cycle when their potency is at its peak, I have to harvest enough to make enough tincture to last me a full year. If I miss it for any given herb, I won’t have the opportunity of using it for the next year.
This year, most of the herbs and trees are leafing out and flowering about two weeks earlier than normal, and three weeks earlier than last year because we had a very cool and wet spring and summer in 2009. For much of the twentieth century our weather patterns were pretty consistent in this part of the world. But things started to change in 1970. I remember that winter well because we didn’t get any snow until mid January. Since that time, in each succeeding decade our weather has become increasingly more unpredictable and extreme. In the 25 years since I began harvesting herbs, I have seen how this has had a significant influence on when I have to harvest the herbs that I use.
These changes in our weather patterns are an example of how the natural cycles of nature have become altered in significant ways largely as a result of the changes we humans have made to the ecosystems in which we live, both locally and globally. Just as the way we live has begun to radically alter the rhythms of nature, it is also altering the natural cycles and rhythms of our body.
One of the natural rhythms that is most easily disturbed when our life is out of balance is the reproductive cycle in women. Because the levels of different sex hormones are constantly changing relative to each other throughout this cycle, anything that produces minor changes to any of them has the potential to throw the entire cycle out of balance. In addition, all of our hormones interact with each other directly or indirectly, so disturbances of hormones that are not directly involved in the reproductive cycle can still have an influence on this cycle.
These days, as a result of our diet, lifestyle and the environment we live in, the reproductive and other cycles in most of us tend to be out of balance to some degree. Unless we learn to live and eat in a more natural way, the degree to which these cycles are out of balance tends to increase throughout our lifetime.
One of the symptoms of imbalance that is prevalent in today’s society is the increasing number of women who are experiencing many uncomfortable symptoms just prior to and during menopause. Mainstream medical practitioners believe that the symptoms of menopause are a normal consequence of hormonal changes that occur when women reach the end of their reproductive years. Although statistically speaking it is true that the symptoms we associate with menopause are fairly normal in our society, there can be a significant difference between what is normal and what is natural.
What passes for normality in a society where we are out of balance with the natural rhythms of nature is not necessarily what would be normal if we were living in a more natural way. This is the case with menopause as it commonly manifests in our society, which is largely the result of our diet and lifestyle. This can be illustrated by the fact that in other societies, menopause as it tends to be experienced in North America does not occur. In fact, in some cultures they don’t even have a word for it. However, when women move from cultures where menopause is less severe or non-existent to North America, the greater the degree to which they adopt a typical North American lifestyle, the greater the likelihood that they will experience the symptoms of menopause common among North American women.
The symptoms of menopause are not something that suddenly manifests when a woman’s hormones start changing in their 40s or 50s. They are the result of the cumulative effect of their reproductive cycle being out of balance to some degree throughout their reproductive years. Symptoms include mood swings, menstrual cramps, breast tenderness, scanty or heavy bleeding, irregular or absent periods, low fertility, hormonal acne, and others. It is also the reason that conditions like fibrocystic breasts, uterine fibroids, endometriosis and ovarian cysts are increasing. In addition, many women are going through menopause earlier than in the past and many girls are beginning to menstruate at a younger age. Cancer of the reproductive organs is also on the increase.
There are a number of general patterns of diet and lifestyle prevalent in our society that affect everyone to varying degrees. Many of these have a significant potential to disturb the reproductive cycle in women. Those that are the most significant will vary from person to person.
Psychological stress has a profound effect on the functioning of the reproductive system. Excessive levels of stress will inevitably lead to imbalances of the female reproductive hormones. In addition, when under stress many people experience increased tension in their abdominal region. This reduces blood flow to the abdominal organs including the ovaries and uterus, putting further stress on these organs.
Identifying and reducing exposure to stressful situations whenever possible is important, but it is also essential that we learn how to deal with potentially stressful situations more effectively, as stress is primarily the result of how we respond to situations rather than inherent in the situations themselves. This is why different people will experience different degrees of stress in the same situations.
Exercise helps to reduce stress and improve blood flow to the uterus, ovaries and other endocrine glands. It also helps the body to eliminate toxicity. Disciplines such as meditation, yoga, tai chi and various stress management techniques can also be helpful because they both reduce stress directly, and they are tools that can help us learn to respond differently in stressful situations.
FOODS, DRUGS, AND PACKAGING TO AVOID
Consumption of stimulants has basically the same effect on our body as stress. It is therefore important to reduce consumption of coffee, tea, cola, chocolate, and the so called “energy drinks” that have become popular in the last few years.
Other foods that, when eaten in excess, have a negative effect on the female reproductive cycle include sweets, red meats, dairy products, processed foods, and bad fats such as those in processed or deep fried foods and any other sources of rancid and hydrogenated fats and oils. The issue of rancid fats in particular has largely been ignored. No doubt this is because food production companies don’t want the public to know that the oils that they are using to replace hydrogenated oils, and thereby reduce those dreaded trans fats, are rancid due to heating and other food processing methods. These rancid oils are probably as bad for our health as trans fats.
The use of birth control pills and synthetic hormone replacement therapies has a significant negative influence on a woman’s reproductive cycle. Unfortunately, these kinds of therapies are commonly used to treat reproductive symptoms during a woman’s menstruating years, and they are recommended to virtually all women when they reach menopause for the treatment of symptoms such as reduced bone density.
Synthetic hormonal treatments only address the symptoms of reproductive conditions but not the underlying condition, which these therapies often aggravate. They are also associated with a variety of side-effects including an increased risk of cancer in hormone sensitive tissues.
Blood hormone levels are significantly higher than normal in women who are taking hormone drugs. This leads to a significant increase in the amount of hormone that is excreted in their urine. There are so many women taking synthetic hormones for various reasons that the rivers and lakes of the world now contain significant levels of these hormones. Not only does this have severe ecological impacts on fish, amphibians, and other animals that live in the water, it is also a source of exogenous hormone toxicity that is one of the major contributing factors to the development of reproductive conditions in both women and men.
Toxicity in general has a significant impact on most of what ails us, including reproductive issues. Of particular concern is that many environmental toxins are hormone disruptors. This includes most pesticides, herbicides and fungicides. It is also a major issue for any foods or liquids that are stored in plastic. This includes canned products and juice box type containers as they all have a plastic coating on the inside to prevent the contents from coming in contact with the aluminum or other metals that are part of the packaging. In the last couple of years the issue of plastics has finally been given some of the attention it deserves. The recent availability of stainless steel water bottles is a step in the right direction, however most of them still have plastic lids. Glass is still the best option, with ceramic a close second as long as it doesn’t contain lead.
NUTRITIONAL MEDICINE FOR MENOPAUSE
Maintaining a healthy body weight is also important. For every woman there is an ideal weight range that is unique for her body. If her weight strays out of that range in either direction (underweight or overweight), it has a significant impact on her reproductive functioning as well as her health in general.
To support the health of our reproductive system it is necessary to increase consumption of whole foods, especially fresh fruits and vegetables. It is best to eat certified organic foods as much as possible. This is even more important with animal products than with produce, but it’s best to eat everything organic if it is available. Essential fatty acids are also very important, especially omega 3 fats (my favourite source is cold pressed flax seed oil).
Beans are another important food group that have benefits for the reproductive system. Not only are they very nutritious, but they contain a group of chemical constituents called isoflavones that have a regulating action on estrogen. Sometimes isoflavones and certain other plant constituents are called ‘phytoestrogens’ which means plant estrogens. This term is a misnomer because as a general rule plants to not contain hormones that are found in animals.
Isoflavones are not chemically related to estrogen, but they do have the ability to stimulate estrogen receptors in the human body. When isoflavones bind to estrogen receptors, they stimulate them but not as strongly as estrogen does. This means that they will increase estrogen activity in women who have low estrogen levels. However for women who have high estrogen levels, isoflavones decrease estrogen activity because they compete with estrogen for receptor sites and don’t activate the receptors as strongly as estrogen when they bind to them. As a result, isoflavones have a regulating effect on estrogen activity in the body. They also compete with environmental hormone disruptors and reduce their effect on our health as well. This means that isoflavones probably reduce the likelihood of someone developing estrogenic tumours rather than enhancing that possibility. It also means that they can help to control menopausal symptoms by increasing estrogen activity in post-menopausal women whose estrogen levels have fallen too low.
In terms of supplements, antioxidants are always helpful, as is vitamin D. For vitamin D, I recommend 2 – 4,000 IU daily from early September to late April, plus some sun exposure to at least your face and arms on a regular basis during the warmer months. But avoid over-exposure and be careful about how much sun you get between 11 am and 2 pm when the sun is strongest. Dark skinned people generally need more vitamin D than light skinned people. (Ed note: Those who work indoors all day should supplement with a minimum of 1,000 IU/day in spring/summer as well.)
Calcium supplements can help with bone density issues, but should be used in moderate doses. Many practitioners recommend that women take supplements for their entire recommended daily amount of calcium. Yet calcium is found in every food, so it isn’t necessary for most people to take more than 250-350 mg per day.
What is more important is the form of calcium. Firstly, it should always be taken together with magnesium. For women who are vegetarians, a 2:1 ratio of calcium to magnesium is best. For women who are not vegetarian, a 3:2 or 1:1 ratio is preferred. Calcium supplements should also include vitamin D. A bit of zinc is also a good idea. It is important that all of the minerals in your supplement are in a form that is easily assimilated. The best forms that are readily available are citrates and amino acid chelates.
It is possible to find good complete supplements for bone building. They will usually contain other important nutrients for bones such as manganese, silicon, boron and vitamin K.
HERBS FOR MENOPAUSAL SYMPTOMS
Herbs have a lot to offer for the treatment of menopausal symptoms. The focus of an herbal treatment is to reduce the underlying causes of reproductive and endocrine imbalances and normalize reproductive hormone levels. This treatment requires two distinct stages. It is also possible that a woman’s reproductive function is indirectly being impacted by disturbances of the functioning of other non-reproductive organs. If that is the case, they will also need to be supported. At all stages of treatment we must also address the effects of stress. This necessitates the inclusion of herbs that are nerve tonics in any formulations that we use.
In the first stage of treatment, the focus is on improving digestion and liver function, as well as detoxification. Of particular importance is ensuring proper liver function. The liver is our major organ of detoxification and fat metabolism. It is also the organ responsible for breaking down excessive levels of hormones in the body. Factors that impede liver function include overeating, overconsumption of fatty and heavily processed foods, and all sources of toxicity. Liver function can be aided by increasing consumption of fresh fruits (especially lemons), and vegetables (especially bitter green vegetables such as rapini, escarole, mustard, endive, dandelion and chicory).
I discussed how to create a good liver/detox formulation in the April issue of Vitality.
Your detox formulation should be taken for 3-6 months. It might be necessary to take it longer for anyone who suffers from significant levels of toxicity, particularly if they suffer from any chronic inflammatory conditions. When using any formulation over a period of months it is preferable to change one or two of the herbs in your formulation periodically rather than taking the same formulation over a long period of time.
In addition to using detoxifying herbs, it is also important to reduce exposure to additional sources of toxicity. Be sure to eat foods that are certified organic and reduce your use of toxic household cleaning products, commercial cosmetics, and other toxic chemicals in the home and workplace as much as possible.
HERBS THAT SUPPORT THE REPRODUCTIVE SYSTEM
In the second stage of herbal treatment for menopause we continue to use some version of the first detox formulation, but we alternate it with an additional formulation that supports the reproductive system. The second formulation should include a couple of herbs that are also in the detox formula. Some of the herbs that work well in a detox formula and are also compatible with female reproductive formulas are sweet clover herb (Melilotus spp.), red clover herb (Trifolium pratense), blue vervain herb (Verbena hastata), turmeric rhizome (Curcuma longa) and ginger rhizome (Zingiber officinale). The first two herbs mentioned above contain isoflavones; it is best not to use them in the same formulation.
A good menopause formulation should include two herbs that are effective hormone regulators. Some of the best choices are:
– Queen Anne’s lace seed (Daucus carota),
– motherwort herb (Leonurus cardiaca),
– partridgeberry herb (Mitchella repens),
– raspberry leaf (Rubus idaeus),
– blue vervain and high-bush cranberry bark or fruit (Viburnum opulus).
Angelica root (Angelica spp.) is also a good choice, but it can cause light sensitivity, especially when used during the warmer months by fair skinned people. With most of these herbs it is best to include them in a 20-25% proportion, but angelica is best at 15-20%. Motherwort and blue vervain are also fairly bitter, so it is best not to include them in the same formulation.
A reproductive formulation also requires a warming circulatory herb. These herbs have to be used in very specific proportions or the formulation will be too hot. For the warming part of the formulation I recommend using chaste tree fruit (Vitex agnus-castus) at 10%, combined with either turmeric rhizome at 10% or ginger rhizome at 5%. It’s OK if you use ginger or turmeric in both formulations, but chaste tree should only be used in the reproductive formula.
There are also a couple of herbs that can enhance the effectiveness of a menopause formulation. They are sweet clover herb or red clover herb at a proportion of 20-25%, or black cohosh rhizome (Actaea racemosa) at 10-15%. Only one of these three herbs should be included in any single formula.
The menopause formulation is taken in a similar way to the detox formulation: three times per day on an empty stomach before meals or bed. However, it is taken according to a very specific schedule. For women who are still menstruating, begin taking the menopause formulation one week before you expect to get your period, and continue taking it until one or two days after your period is over. Then switch back to the detox formulation and take it until one week before your next period. Do not take the two formulations at the same time.
For women who have stopped menstruating, simply alternate between them at two week intervals.
The best way to use these herbs is as tinctures made from the fresh herbs. However, dry herb tinctures or teas will also work if that is what’s available. It may be possible to find similar formulations to what I have described above in retail stores. If you purchase a ready made formulation, only use tinctures or teas as it is necessary to taste the herbs when you take them in order for them to be fully effective. Also, if a formulation contains more than six or seven herbs, it’s usually a sign that the product is poorly formulated.
The dosage of tinctures depends on their strength. If you make your own formulation, follow the directions of whatever products you are using. If you are combining single tinctures, the dosage of your whole formulation will be similar to the recommended dosage of your individual herb tinctures (i.e. if the recommended dosage for the individual tinctures is 25 drops, this will be the dosage of your entire formulation, not 25 drops of each tincture). If you are making a tea, use 2-3 teaspoons of your combination of herbs (not each individual herb) for each cup of tea and steep it in a covered container for 10-15 minutes.
As always, if you have any unusual reactions to these herbs, stop taking them immediately and consult with a herbalist or other professional experienced with the use of Western herbs. Similarly, if you are taking any medications you should not follow this or any other herbal protocol without the supervision of a qualified professional.
There are no absolute guarantees with any treatment, but in my experience most women will experience significant improvement in their symptoms following this kind of protocol. One thing to keep in mind is that many women these days are transitioning into menopause prematurely. In those cases it is possible that when you use these herbs your menstrual period may resume for some time. This is normal and nothing to be concerned about.
One of the best ways to help harmonize our natural body rhythms is to spend more time connecting with nature, and May a beautiful time of the year. It’s a much better time than January 1st to make a resolution to spend more time outdoors. Enjoy the spring!
Michael Vertolli is a Registered Herbalist practising in Vaughan (just north of Toronto). He is the Director of Living Earth School of Herbalism, which offers in-class and online general interest courses, certificate, and diploma programs. More information: 905-303-8723, ext. 1. Visit: http://www.livingearthschool.ca/index.html Blog: http://michaelvertolli.blogspot.com/