Health perspectives
Menopause
The Physician’s Approach
By Tracy Morton MD
“Doc, you’ve got to do something about these hot flashes!”
Unfortunately, hot flashes are a common symptom experienced by many women going through the period of transition known as the menopause.
Technically, menopause is defined as the absence of menstrual periods for twelve months. However, the cardinal symptoms of menopause—hot flashes, mood swings, cognitive changes and vaginal dryness—often begin years before periods end. For some women, the end of periods is a joy. But for most, this transition can be difficult and even depressing.
Fortunately, there are many treatments that can help. For some, exercise, a healthy diet, cutting down on caffeine and quitting smoking may be all that’s required. Many others use supplements or medications.
Supplements: Since the beginning of time, many vitamins and herbal products have been used to help with symptoms of menopause. These include vitamin E, soy products, red clover, black cohosh, evening primrose oil, and B vitamins. While these all have a long history of safe use, there have been few long-term studies showing a benefit when compared to taking a placebo.
Hormones: Hands down, nothing beats hormones for control of menopausal symptoms. When hormones are prescribed for menopause, we call it hormone replacement therapy (HRT). The hormones estrogen and progesterone are used at the lowest effective dose to control symptoms. Estrogen is the important one, while progesterone’s main role is to protect the uterus from the effects of estrogen (thus, it is not needed if there has been prior hysterectomy).
Before 2002, doctors prescribed HRT with great comfort, with the one caveat that we knew that estrogen increased the risk of breast cancer, particularly if used for more than 5 years. However, the medical world was rocked in 2002 by the publication of a Women’s Health Initiative study. Involving 18,000 women, it looked at the outcomes of long-term use of HRT. The study revealed that during an average of 5 years on HRT, women had higher rates of heart attack, stroke and blood clots. They also had lower rates of osteoporosis and colon cancer.
The increased risk of heart disease is small, but present. To put this risk into perspective, 250 women would have to take HRT for 5 years for one of them to have a heart attack because of HRT. (The numbers for stroke are 250, blood clots 100, and breast cancer 200). In 2 months, HRT use dropped by over 50%.
Doctors still use HRT, but at the lowest dose for the shortest period—generally less than 2 or 3 years. There are other non-hormonal medications that can help with symptoms, including a type of antidepressant, and gabapentin, an epilepsy medicine which in low doses can help control hot flashes.
For more information, have a look at www.menopause.org (discusses HRT in detail), or try Dr Christiane Northrup’s book Wisdom of Menopause. Your family doctor will also have lots of information so that you can make an informed decision that’s right for you.
The Alternative Approach
By Julie Chaplin CHHP
Rightly named the “change of life,” menopause is an inevitable stage of womanhood, just like the changing of the seasons—leaves falling from the trees in autumn and buds blossoming in the spring.
Menopause can be seen as the “second springtime” of a woman’s life. Spring is a time for renewal, growth and exploration. Pursue your interests, explore your creativity, discover a deeper understanding of your inner beliefs, desires and goals.
Menopause is neither an illness nor a hormone deficiency disease: it is Mother Nature knowing that those levels of hormones are no longer necessary for this stage in a woman’s life. Menopause is a time to tap into the power, strength and wisdom of your inner self. Having a positive attitude and open mind will offer you an enjoyable, inspirational menopause experience.
Consider healthy alternatives for a natural menopause. A holistic approach reaps the healing benefits of each alternative.
Nutritional Therapy consists of eating the right foods and avoiding the wrong ones. Beneficial foods include fresh produce, complex carbohydrates, fiber, soy products, and essential fatty acids. Choose a variety of colours and flavours for optimum nutrition. Supplement with B-complex, vitamin E, magnesium, evening primrose oil and acidophilus. Reduce sodium (salt), meat and dairy consumption, and avoid caffeine, alcohol, preservatives and processed, artificial foods.
Herbal Medicine addresses the cause while alleviating the symptoms as the body becomes balanced. Doses of an herb can decrease until you no longer need it. Effective menopausal herbs include chasteberry (vitex), black and blue cohosh, wild yam, dong quai, yarrow, dandelion, false unicorn root, and motherwort.
Homeopathy encourages your body’s own healing abilities and is very safe. See a qualified homeopath for a personalized remedy assessment.
Acupuncture restores the balance of Qi, or life energy, by stimulating acu-points with needles along the body’s energy pathways. Acupuncture evenly distributes Qi in the body, promoting balance and healing. Doctors of Oriental Medicine, registered acupuncturists and some medical doctors perform individualized treatments for a variety of menopausal complaints.
Aromatherapy is the use of essential plant oils that have a therapeutic effect on your organs, glands and tissues. Use in the bath or shower, in massage oil, or for inhalation. For menopausal symptoms try chamomile, geranium, rose, jasmine, neroli, ylang ylang, bergamot, sandalwood, and clary sage.
“Every woman, though barraged with conflicting advice, must listen carefully to her individual inner guidance to hear her personal truth about how best to negotiate this life stage with maximum access to her inner wisdom and power to create health.” (Women’s Bodies, Women’s Wisdom, p. 516).
Listen to your inner guidance and trust your body. It knows exactly what to do!
For more detailed information, I highly recommend The Wisdom of Menopause by Dr. Christiane Northrup, and Natural Alternatives to HRT by Marilyn Glenville.
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