by Jan Roberts B.Pharm (Hons) Diploma Clinical Nutrition
In Western society during the last 40 years, menopause, once unmentioned and borne in silence, has come to be regarded as one of the key life events that might compromise a woman’s physical, mental and emotional wellbeing. With the increase in life expectancy and the further expectation of retaining vitality and vigour for far longer than their mothers, doctors, for the most part, have looked at how to address the main physiological change in a woman’s body – the reduction in hormone production. Unfortunately rather than looking at the multi-faceted and interrelated aspects of a woman’s physiology, doctors initially offered a solution in the form of Hormone Replacement Therapy. However, HRT is a fairly crude attempt to offset a range of physiological changes which include a decline in natural hormone levels by introducing a variety of synthetic or animal estrogenic compounds and/or progestins, at various levels, with dosage largely adjusted by a process of trial and error. Fortunately since the Women’s Health Initiative in 2001, many pharmaceutical companies and compounding pharmacists have moved to the use of just one or two (instead of up to 200) different estrogenic compounds and bio-identical progesterone, which chemically mirror those substances occurring naturally in a woman’s body.
While HRT was initially embraced enthusiastically, by a woman wishing to avoid hot flashes, night sweats and what she was led to believe was an inevitable decline in “her youth”, skin and hair texture, sex drive, memory and mood - HRT has now been shown to come with potential risk factors. While there was still no conclusive opinion on the reasons for HRT’s potential side effects such as increased risk of breast cancer and stroke, many doctors have either prescribed much lower doses for shorter periods of time and/or reverted to bio identical hormones. However, whether the use of bio identical hormones will reduce the adverse effects seen with HRT is still open to debate and will only truly be known in the longer term.
Furthermore, and even with lower dosages, unless a doctor is monitoring hormone levels on a regular basis, both HRT and bio-identical hormone therapy rely on a trial and error approach which may take considerable time to fine tune. The other issues are: What process of delivering hormones is safest? How long can a woman take hormones? What effect does an exogenous source of hormones have on parts of the body such as the liver and kidney? What happens when a woman has a history of breast cancer in the family? What about other hormone levels which might be below optimal? What about other aspects of a woman’s health such as metabolic rate and gastrointestinal absorption? And importantly what happens to a woman’s own hormone production when it has been supplemented by external sources for an extended period?
Not surprisingly, women (and many practitioners) have increasingly turned to natural alternatives, with plant-based solutions including Black Cohosh, Red Clover, Wild Yam and soy-containing compounds. While certainly lacking the potential side-effects, these phyto compounds generally impact only one aspect of the overall physiological changes that occur during peri and post-menopause. Efficacy is also an important consideration when dealing with natural alternatives - while many natural products appear the same, the lack of regulation means that it is often up to the consumer to compare dosages, evaluate quality and know-how to differentiate between fact and fiction. In fact, very few companies have actually completed double-blind placebo-controlled clinical studies on their specific menopause product, and even fewer studies have been published in reputable, peer-reviewed medical journals.
But most importantly, while many natural alternatives may reduce some symptoms with average success rates of between 45%-60% at best, as a group, they have been clinically shown by the National Institute of Health to have little real effect on actual hormone levels. It is this decline in hormone levels at menopause that directly relates to a woman’s susceptibility to cardiovascular disease (heart attack and stroke), osteoporosis and cognitive decline and is why many MDs and Naturopathic Doctors, in an attempt to avert these life-threatening conditions, continue to prescribe hormone therapies.
Cardiovascular disease is, in fact, the number one cause of death in women in the US. If you add the second, third and fourth causes together they don’t add up to the number of deaths from cardiovascular disease. And yet a woman has only low risk throughout her life until menopause, when it jumps significantly to the same risk as that of a man and rises even further later in life. The loss of hormones such as estrogen and progesterone are the key reasons for this increased risk. Estrogen increases HDL “good cholesterol,” lowers LDL “bad cholesterol” and maintains the elasticity of arteries and blood vessels.
Progesterone protects arteries from spasms. Women’s arteries are much smaller than a man’s and spasms of heart arteries can adversely affect blood flow to the heart, with women being many times more likely to die from a heart attack post menopause due to the loss of progesterone.
This is only too evident with women often experiencing first hand that even with the same diet and exercise program before and after menopause, it isn’t until after menopause that they have health issues relating to cholesterol, blood pressure or body weight. This clearly emphasizes how much the decline in hormone levels impacts their health.
As well as estrogen and progesterone, low levels of growth hormone, thyroid and adrenal hormones or “adrenal fatigue“ and the biological effects of stress, mediated by hormones produced in the adrenal glands, play a major role in obesity and its deadly consequences, which include inflammation, insulin resistance, hypertension, atherosclerosis, and other conditions that together constitute “metabolic syndrome.” Excess body weight puts extra stress and pressure on a woman’s heart and high blood pressure or hypertension can result in increased risk of stroke, blood clots and heart disease.
However, there is good news! Leading the way in a more holistic approach, are adaptogenic herbs which stimulate a woman’s Hypothalamus Pituitary Adrenal Axis to create an environment for optimal health throughout her body and support her own hormone production. One product, which I and other leading doctors in the UK, Japan, Australia and the United States have prescribed and whose benefits I have enjoyed first-hand, is Femmenessence. With extensive clinical research and therapeutic efficacy, Femmenessence is the first herbal based product to demonstrate statistically significant support in peri and post-menopausal women of key hormones such as estrogen, progesterone, adrenal and thyroid hormones and reduce FSH (Follicle stimulating hormone). The positive effects of Femmenessence across endocrine and other regulating systems result in increased bone density, increased cardio vascular health by increasing HDL (good cholesterol) and reducing LDL (bad cholesterol), triglycerides and body weight, as well as increases in energy, mood, libido and reductions in hot flashes, night sweats and vaginal dryness in 84% of women within 2-3 weeks.
However, the holistic effects of Femmenessence, which support hormone levels, are further enhanced from the understanding that the distressing symptoms that affect 75% of Western women at menopause can be largely considered as diet, lifestyle and environment-related. So as the baby boomers reach this stage of life, as wellness-focused care becomes the catch-cry of this generation, women who adopt health-promotion measures can make menopausal symptoms a thing of the past.
So what are these self-help efforts? First of all, you should know that all the hormones, the neurotransmitters, the endorphins and other chemical factors that can help to reduce menopausal symptoms, depend on an adequate supply of vitamins, minerals, amino and essential, fatty acids. Unfortunately, most modern diets are unlikely to supply an adequate complement of all those building blocks.
Simple steps towards supplying your body with everything it needs means eating organically grown and pasture-raised produce, which essentially is “healthy food grown on healthy soil.” Eating the appropriate balance of protein, carbohydrate and fat lead to a host of good things … normal appetite, emotional stability, mental clarity, more energy and even fat loss, just from eating the right proportion of these different food groups - in other words, the right balance can help to reduce menopause symptoms. To achieve the balance select a protein portion (about the size of the palm of your hand), then an abundance of green leafy (low-glycemic) vegetables, reduced amounts of high-glycemic foods (such as grains, which are top-heavy in Western diets) and a serving of healthy oil (such as olive) at each meal. Also, try to avoid gluten and dairy where possible.
Eight glasses of purified water every day is another key step in this equation. Make sure you select a water filter that does not remove all the trace elements along with the impurities but puts important trace minerals back into the water! This can be achieved by also adding “Sole” using Original Himalayan Crystal Salt which has 84 trace minerals www.himalayancrystalsalt.com. Either way, stopping the use of normal table salt in all cooking is essential and replacing it with Original Himalayan Crystal Salt. Additionally, robust, comprehensive vitamin and mineral supplementation will not only provide an insurance policy, but help your body deal with the other lifestyle and environmental stressors that lead to nutritional deficits such as alcohol, cigarettes, caffeine or other drugs as well as the chemical or heavy metal pollution that can come from the workplace or even from the kitchen, laundry or bathroom cupboards! Electromagnetic radiation from mobile phones, computer screens, video games, electric blankets, water beds, high voltage power lines and cosmic radiation (flying) can also contribute to compromised health, so you should try to reduce your exposure to as many of these factors as possible.
But even with the most rigorous efforts to steer clear of all these things, you also need to get rid of pre-existing toxicity. Because, just like landfill sites that become overloaded and wreak havoc in the environment, your body can become a toxic waste dump and wreak havoc with your health. For example, accumulated toxicity will trigger biochemical processes that tell your body to store fat. And unfortunately being overweight, with the poor body image that may accompany it, can contribute to the depressed state that some women experience during menopause. Good detoxification processes require an abundance of essential nutrients (particularly anti-oxidants such as Vitamins C, E and zinc) and at least eight glasses of purified water every day. A practitioner-guided detoxification program will enhance and support all of these self-help measures.
Another contributing factor to healthy ageing and reduced experience of menopausal symptoms is the amount of lean muscle in your body. In fact, muscle mass is actually the number one biomarker for vitality and longevity. Muscle does much more than just move your body around – it’s a very important organ – as important as the heart, the liver and the kidneys. It is like the engine that powers the car. But without a conscious effort to maintain muscle mass, it is lost at the rate of 3kg/decade and the loss accelerates after age 45. As muscle is lost, fat levels increase. Reduced muscle mass means poor blood glucose control, with the potential for mood swings and emotional instability, again, common symptoms of menopause also compromised mobility and reduced levels of activity, which further translate into some of the issues of menopause. But it’s possible to build muscle in any decade – you just need to do some weight training exercise at the gym, alternatively yoga or pilates and with that muscle building in place, you can overcome a number of menopausal issues.
A forgotten factor that adds to the overall burden that might contribute to a difficult menopause is lack of touch. Touch is vitally important throughout your life, yet generally given very little attention in Western society. The sense of touch is the first sense to develop and also the most fundamental. Of course, this offers you and your partner a wonderful opportunity to connect at a very intimate level by giving and receiving a massage, by holding, caressing and cuddling, with a very real place not only in enhancing total wellbeing but in keeping intimacy (often a victim of menopause), well and truly alive. Nurturing touch promotes the production of oxytocin, a very important hormone that has the opposite effects of the well-known fight or flight hormones. Oxytocin promotes calm, connection, love, and intimacy and can help reduce stress. It also stimulates the production of growth hormone further supporting your body’s core or foundation health. So a regular massage should not be a luxury but a necessary part of your overall health-promotion program.
High levels of stress will compromise all aspects of health, and potentially exacerbate menopausal symptoms. Effective stress management involves reducing the levels of stress to which you are exposed, while at the same time, improving the means by which your body copes with stress. Coping better requires good nutrition, a program of regular exercise, meditation or another type of relaxation practise, time for family and leisure pursuits, and ‘time-out’ to nurture yourself. Then, of course, regular, restful sleep (at least 8 hours) is important and satisfying sex is one of the most effective de-stressors of all. Unfortunately, with diminished libido, a common symptom of menopause, this most fundamental and effective form of stress reduction is frequently forgotten.
Your state of mind also has a profound effect on your ability to enjoy long term, good health and vitality. And the best way to nurture that emotional state or what some individuals refer to as your ‘energetic anatomy’ is to “love your life”, letting go of all the hurts and unhappiness from your past. Accept life as it comes and responds to change as a positive force, and of course, that includes accepting ageing. When you accept it with grace, revelling in your acquired wisdom, enjoying and being pro-active in this new stage of life, you are less likely to resist or resent the loss of reproductive capacity and the passing of youth and will find this attitude further fosters ongoing health and vitality.
In summary, while the responsibility for a positive attitude must rest squarely with you, it is equally important to make lifestyle choices and create an environment conducive to optimal health. Diets consisting of whole organic raw foods and mineral-rich water combined with weight-bearing exercise, nurturing touch, restful sleep, satisfying sex, and clinically proven products to promote hormone production all work holistically to enhance your foundation health, easing the transition through menopause.
About the Author: Jan Roberts has spent almost 45 years in the health care industry. For more than 30 years she has provided information for prospective Mums and Dads – “the physical and mental health of your children is in your hands and has its foundation in your own health before conception.” Jan is the author of six best-selling books, has made hundreds of presentation to professionals and prospective parents and most recently she has developed a casual game to teach and entertain. She believes that this important information must be widely available and engaging, when baby-making is still in the future. Both prospective parents, working together, can ensure that their future children will reach their full genetic potential! But it doesn’t stop with conception – Jan is also a staunch advocate of the healthiest possible choices during pregnancy and breastfeeding, as well as the nurturing parenting practices that foster a child’s emotional health, build self-esteem and promote the wellbeing of the whole family