Vital Tools for the Menopausal WomanDr. Verna Hunt, BSc, DC, ND April 1, 2009
With the onset of the menopausal years, many women are seeking ways to minimize hot flashes, restore their sex drive, and regain their youthful appearance. These are the women who brought forth the feminist movement, demanded better forms of birth control, climbed the corporate ladder, demanded equal pay and reached high into the political arena. It is no surprise that they do not go quietly into menopause and beyond.
Do we really know what “normal” aging is for a woman of 50 to 60? Not any more. Many of the common health problems seen in modern women of this age group can actually be attributed to adrenal fatigue, which in turn brings on premature aging and uncomfortable menopausal symptoms. Most women would agree that today’s fast paced world does not work in harmony with the female rhythm. During menstrual years women perform in the work force while pregnant, menstruating, and caring for young children. True, there is often paid maternity leave, but childcare still requires double duty for years after the infant stage, when it’s not unusual to see Mom going to work with little sleep. And even women without kids can simply become worn out from the stress of overachieving. All of these factors combined work to stress the body and in particular the adrenal glands, which then become fatigued and cannot respond to demands effectively.
Abnormal adrenal function shows up during menopause in the form of hot flashes, brain fog, moodiness, aching body, and loss of sexual responsiveness. How do you know if your adrenal glands are fatigued or exhausted? Here is a list of some of the symptoms:
- Getting dizzy when you stand up quickly
- Still tired after a night’s sleep
- Fatigue during and after exercise
- Easily exhausted; craves salty foods
- Sensitive to changes including weather
- Catch colds easily; slow wound healing
- Inflammation, soreness and tenderness
- Hot flashes and other menopausal symptoms
- Problems with blood sugar metabolism including high glucose and insulin resistance
STRENGTHENING ADRENAL FUNCTION TO BOOST HORMONAL BALANCE
When the ovaries stop releasing an egg each month and menstrual periods cease, the estrogen and progesterone that the ovaries were producing also disappears. As well, throughout a woman’s life (even before puberty) the adrenal glands are producing a small amount of estrogen and progesterone to help maintain normal body functions. If the adrenal glands become exhausted by the time menopause occurs, these glands do not produce adequate estrogen and progesterone anymore. So the loss of hormones from both ovaries and adrenals can combine to create a state of severe hormonal deficiency in the menopausal woman.
Many women find that supporting the adrenal glands and balancing their hormone system with natural health products, acupuncture, bodywork and other therapies during menopause is key to improving the experience:
- Acupuncture can improve deficiencies in ‘kidney yin chi’, which will then strengthen adrenal function (for an in depth article on Chinese Medicine for Menopause see the article by Dawn Aarons at http://www.vitalitymagazine.com). Foods that build kidney yin include: mung beans, string beans, black beans, lentils, wild rice, millet, barley, parsley, asparagus, seaweed, raspberries, blackberries, blueberries
- Primrose oil, Borage seed oil, and Flax oil in correct ratios can help alleviate numerous menopausal symptoms.
- Botanical medicines can also help rebalance hormones:
Dong Quai – assists with balancing “blood deficiency”
Black Cohosh – decreases hot flashes and promotes relaxation
Wild Yam – provides nutrients to promote progesterone formation
Sequoia (Gemmotherapy of Sequoia tree buds) – decreases hot flashes
Vitex – has a balancing effect on progesterone; helps with mood and decreased libido
- Homeopathy can assist in decreasing symptoms; remedies are best prescribed by a trained homeopath or naturopathic doctor
The most effective combination of supplements and therapies for restoring adrenal function will be different for each woman, and the best plan is to create a customized regimen based upon consultation with a wholistic practitioner who knows how to interpret the results from hormone blood tests, plus saliva and urine tests.
In addition to restoring a menopausal woman’s wellbeing by rejuvenating her adrenals, it may also be necessary to add supplementary hormones to the mix. The tests mentioned above may reveal the need for hormones such as thyroid and cortisol, in addition to estrogen and progesterone, all of which must be present in a correct ratio to each other.
So what is hormone therapy and where does it fit into healthy aging for women? In 1942, the U.S. FDA approved the use of hormone replacement therapy (HRT), which was made by extracting estrogen from the urine of pregnant mares (female horses) to create a synthetic product called Premarin or Prempro. This drug was found to increase the risk of uterine cancer, largely due to the predominance of estrogen relative to progesterone. To balance the estrogen, a progesterone-rich drug call Provera was then developed and added to the HRT mix, but the Provera was found to be difficult for the body to break down and utilize properly.
In 1991, a massive U.S. government research program called The Women’s Health Initiative (WHI) study was launched, which consisted of a set of clinical trials and an observational study, which together involved 161,808 generally healthy postmenopausal women. These clinical trials were designed to test the effects of postmenopausal HRT, diet modification, and calcium and vitamin D supplements on heart disease, fractures, and breast and colorectal cancer.
The first results of the WHI study were published in 2002, and indicated an overall increase in risk of breast cancer, heart attack, stroke, blood clots, and dementia for women on Prempro. Many of the top problems in women’s health are on that list – particularly for women over 60 taking synthetic HRT. The risk of disease was found to be lower for women in their 40s and 50s taking HRT, however it still remained worrisome.
This was a key turning point for women and they began to doubt the safety of hormone replacement therapy. Many stopped using the synthetic form of HRT and began turning to natural therapies including bio-identical hormones.
BIOIDENTICAL HORMONE THERAPY
In the late 1980s, some forward-thinking practitioners started developing extracts from safer sources like soy (for estrogen) and yam (for progesterone) and putting them into a cream to be applied transdermally. The active ingredients in these transdermals are absorbed through the skin, bypassing the digestive process, which assures a more complete uptake into the bloodstream. Such bio-identical extracts are in a natural form that can be recognized by the hormone receptor sites and taken into the cells. These creams usually contain a combination of estrogen and progesterone at prescribed strengths and ratios. Some creams contain just progesterone, while others have testosterone added in as well – depending on the doctor’s prescription.
Studies have shown that bio-identical progesterone creams may help prevent breast cancer. Many women use the creams to alleviate a variety of symptoms including vaginal dryness, hot flashes, low libido or sex drive, and brain fog related to menopause.
In her books, Ageless and The Sexy Years, and in media appearances to promote them, Suzanne Somers describes how bioidentical hormones relieved her menopause symptoms. She also makes it clear that she intends to stay on them for the rest of her life. Oprah Winfrey has also jumped on the bioidentical hormone therapy (BHRT) bandwagon, bringing experts on her show to discuss their pros and cons. As a result, many medical doctors and naturopathic doctors in the U.S. are being overwhelmed with inquiries from patients wanting to switch over from synthetic HRT to this more natural alternative.
When deciding to use transdermal creams here are some things to consider:
- Have a qualified health care professional, such as a holistic medical doctor or naturopathic doctor, who is trained in hormone balancing, assess your needs to determine the best approach for you.
- Consult a professional to determine the cause of your menopausal symptoms and have this issue addressed as well, i.e. adrenal fatigue, functional hypothyroid, or chronic stress with high cortisol levels blocking hormone receptor sites.
- Have a uterine ultrasound before using BHRT to assure the lining and thickness of the uterus is normal.
- Beware of buying off the internet. All natural health products in Canada should meet the criteria and have the approval of the Natural Health Products Directorate.
- Understand there is a difference between bio-identical hormone transdermal creams created from plant extracts and available by prescription, versus creams which contain the whole plant and are available in health food stores. The former is an extract of the active ingredients, and is more absorbable at target receptor sites on the cells. The latter has more variable rates of absorption, since the body may or may not be able to uptake the nutrients from the whole plant and convert it into hormones.
THE POLITICS OF HORMONE THERAPY
Bioidentical creams are made one prescription at a time by experts known as compounding pharmacists, in the exact strength and ratio as prescribed by a medical doctor. Currently in Ontario, MD’s are the only ones legally entitled to prescribe bioidentical hormone therapy. This makes access to bioidentical hormones somewhat problematic here, since the majority of physicians have little knowledge of how to properly test for and prescribe these products.
However, the scope of practice for naturopathic doctors in Ontario has been going through a long review and soon they will likely have prescribing rights to various substances including bio-identical hormones.
(When naturopaths finally do get prescribing rights, Vitality will update readers right away.)
You may not need bioidentical hormone therapy at all, but in fact can find relief from adrenal exhaustion and hormonal deficiency with natural products and therapies. According to Dr. Marcelle Pick, an American physician who specializes in treatment of menopausal women: “The great majority of women can rebalance their hormones without the use of drugs. We have found that about 85% can find relief through an approach that combines medical-grade nutritional supplements, gentle endocrine support, and dietary and lifestyle changes. We recommend that every woman start with this combination approach as a foundation of health.”
Making sure you have adequate and balanced hormones is influenced by many factors, the most important being the amount of stress you have, how you react to it physically and psychologically, and then how you process it metabolically and emotionally. The next important factor is adequate sleep and recovery time in your life.
Do not confuse aging with being worn out. Take time for yourself and teach your daughters to take time for themselves too.
- John Lee, MD, and Virginia Hopkins, What Your Doctor May Not Tell You About Menopause: The Breakthrough book on Natural Progesterone. www.johnleemd.com
- Sat Dharam Kaur, ND, The Complete Natural Medicine Guide to Women’s Health, phone: (519) 372-9212 email: firstname.lastname@example.org, www.healthybreastprogram.on.ca
- Susun Weed, Wise Woman Herbal for the Menopausal Years, www.susunweed.com/WiseWomanHerbals