The natural transition into menopause
Guardian Lifestyles Editor
Published: Aug 27, 2013
Menopause is a natural life transition for women, associated with a number of uncomfortable symptoms — hot flashes, night sweats, anxiety, insomnia and vaginal dryness — but there is no need for women to suffer though the changes as there are a host of interventions available to help them get through the change comfortably — and naturopathic medicine is one of them.
Naturopathic medicine is essentially an individualized system of medicine where naturopathic doctors aim to get to a patient at all levels and aspects of their life, according to Dr. Vanessa Ingraham, a naturopathic physician, who practices out of the Blake Clinic at Pure Health Bahamas/Blake Integrative Medical Clinic on Blake Road. She focuses on integrative wellness and holistic health, and works with patients to try to determine the root cause of their health problems rather than simply medicating symptoms.
Symptoms she believes are the body’s way of talking, and she believes if people listen to their bodies carefully, instead of always telling it to be quiet with the use of medication, they can achieve vibrant health and wellness. With a clinical interest in hormonal balance, women’s health and preventative medicine, she finds that by helping her patients tune in to what their body needs, they can achieve lasting health on all three levels — mental, emotional and physical.
When it comes to women and menopause, Dr. Ingraham says naturopathic doctors aren’t just seeing a person with hot flashes, but rather a person who has social issues or lifestyle factors and the practitioner seeks to address the patient on three levels — body, mind and spirit.
“We’re addressing them from a more holistic point of view, instead of just seeing their physical symptoms and treating those,” she said. “Menopause is the cessation and alteration in the cycle length, culminating with the cessation of the menstrual period. I see menopause as just another phase in the overall hormonal symphony that women have in their bodies. When we think about menopause, we have to not only think about sex hormones or estrogen/progesterone. We also have to take into account things like adrenal health and adrenal hormones, our thyroid and all these things,” she said.
Preparing the body for menopause
There are things that can be done to help women prepare their bodies for menopause and make the symptoms less intense by ensuring that their body’s hormones are in balance, according to the doctor.
While most women believe that menopause begins with their first hot flash, she says most women should begin to notice some changes in their mid-30s, as their progesterone starts to change —some anxiety, some trouble sleeping, PMS may get a little worse. She said some women may have more bleeding and crave food.
In her 40s, she said the woman’s other hormones start to come out of balance if they’re under a lot of stress, and the thyroid is affected more. By the time a woman is in her 50s, she said estrogen starts to decline and the woman will have the classic symptoms of pre-menopause — a little depression … not that satisfied with life, maybe feeling that their sex drive isn’t where it needs to be and maybe having hot flashes.
But she says there are things women can do when they are in their 30s and 40s that will make actual menopause in their late 50s, benign, or as non-eventful as possible. Diet and lifestyle factors she said are a big part of that, including eating a largely plant-based diet, by not taking in a lot of animal foods which tend to have a lot of residues, pesticides and environmental chemicals which act as estrogens and hormone obstructers in the body.
“An important place to start is having a plant-based diet with enough fiber and enough nutrients to support hormone pathways in the body,” said the doctor who has been practicing in The Bahamas for the last nine months.
“When we think about women’s hormones, we have to take into account that symphony, and that all the hormones are talking to each other, and so basically we have to not only look at what’s happening the few years around menopause, but also, kind of what’s happening early on in the 30s and how that’s going to affect her hormone balances in the 40s and 50s as people actually go through perimenopause,” she said.
Women she said need to ensure that they protect their adrenal glands so that the glands are strong enough to continue their job through menopause to lessen symptoms.
“The adrenal glands are these little endocrine glands that kind of sit right on top of the kidneys. They secrete sex hormones — estrogen/progesterone, testosterone, also cortisol. Basically what happens as we actually go through menopause later in life is the adrenal glands have to take over the production of the sex hormones … the ovaries kind of stop producing them, so if we kind of protect our adrenal function early in life, by the time we get to menopause, the adrenal glands are still strong enough to take over the production of sex hormones so we don’t have all the symptoms of menopause.”
Proper care of the glands, she said, involves anything that reduces stress, sleeping right, finding creative ways to decrease stress, meditation and exercise, she said, helps to support the adrenal glands.
The naturopathic physician also says there are also a class of herbs or botanicals known as adaptagens that women can take that protect the adrenal glands and help hormonal imbalance through the glands, like Siberian ginseng, Maca, Cordyceps, Astragalus and Rhodiola, Ashwaganda, which she described as “powerful” herbs that help to support adrenal function as women get older.
Advice for women already in menopause
For those women already in menopause who did not prepare their bodies for the change, Dr. Ingraham says there are things they can do to help themselves, including consuming an anti-inflammatory diet by reducing red meat and sugar; and increasing the consumption of foods like fatty fish, fish oils and antioxidants to protect the brain and help stop the hot flashes which she said are due to a decrease in estrogen or imbalance of progesterone, also by stimulation of the brain by prostic and inflammatory foods.
She said things like Black Cohosh (Cimicifuga racemosa) are great for the treatment of hot flashes and helps to activate the parasympathetic nervous system (the relaxation side of the nervous system). According to the doctor, studies have shown it reduces heart palpitations, sleep disorders, mood swings, memory loss and low libido.
Vitx, she said, is an herb (from the Chaste Tree) that helps to relieve mood swings, breast swelling, disinterest in sex and irregular periods. She said it’s an herb that works more on the brain to help increase progesterone.
Dr. Ingraham, who describes herself as a patient advocate and a practitioner who does her best to help people understand the pros and cons of any treatment so that they can make an informed decision on the best way to tackle a diagnosis or to remain healthy, says women do have alternatives when it comes to dealing with their menopausal issues, including the use of hormone replacement therapy (HRT), but she notes that a Women’s Healthy Study of 16,000-plus women found that synthetic progestin’s increased rates of cancer and that progesterone is not the same as synthetic progestins.
“We can mimic the body’s natural production of the three types of estrogen by supplementing in a transdermal form. The Women’s Health Study looked at the use of conjugated equine estrogen (from horses), not bio-identical estradiol, estrone or estriol. The oral use of estrogen-like compounds has been linked to increased stroke and blood clots. We only use transdermal estrogen because when applied on the skin, the hormones enter the bloodstream in their pure form. When given orally, the hormones are acted on by the liver, which leads to metabolites that increase the risk of stroke. Estrogen deficiency is rare, but may manifest as vaginal dryness, urinary incontinence, brain fog and bone loss,” she said.
Case by case basis
As every woman is different, Dr. Ingraham says she works on hormonal imbalances per patient. As every organ in the body has receptors for estrogen, progesterone, testosterone and for a lot of the other hormones, she says it’s important to address hormonal balance throughout a person’s life.
According to the naturopathic physician, culture and lifestyle affects hormonal balance and as a result, plays a big part in how women in a society go through menopause. She says in North America, about 40 percent of women experience severe hot flashes and severe symptoms with menopause, whereas in countries such as Japan, Hong Kong and Mexico, she says only 10 percent of the female population suffers through menopausal symptoms.
In preparing the body for menopause, or even if a female is in the middle of menopause, she stressed the importance of sleep for the release of the hormones that are secreted during the rest period to get into the bloodstream. Exercise she also said is important for hormone balance and detoxification. And that there is no need to suffer through the change as there are interventions available to women to help their body through the change and help them feel best at all stages of their life.
Black Cohosh (Cimicifuga racemosa): Decreases hot flashes and activates parasympathetic nervous system (relaxation). Studies also show it reduces heart palpitations, sleep disorders, mood swings, memory loss and low libido.
Hesperidin: A type of bioflavonoid shown to relieve hot flashes, helps prevent varicose veins
Vitamin B complex: Aids liver detoxification (remember liver has to detoxify and rid body of chemicals that impact hormone balance). B6 especially increases serotonin (mood), supports adrenal glands.
Vitamin E mixed tocopherols: Reduces hot flashes, fatigue and heart palpitations. May help with anxiety. Decreases vaginal dryness.
Magnesium citrate/glycinate (do not use magnesium oxide): Helps to relax muscles, helps with sleep and anxiety, relieves headaches.
Cucumin from Turmeric: Decreases inflammation and reduces prostaglandins that may stimulate hypothalamus (part of brain) and cause hot flashes.
Chaste Tree (vitex agnus-castus): Helps to relieve mood swings, breast swelling, disinterest in sex and irregular periods.
Dong quai (Angelica sinensis): 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.
Omega 3 fish oils and evening primrose oil: Decrease inflammation and balance prostaglandins. Helps support hormonal function. Take 500mg EPO per 1000mg fish oil (EPA/DHA) for correct ratio of fats.
Adrenal support: Adaptogenic herbs such as Ashwaganda, Rhodiola, Siberian Ginseng, Cordyceps, Maca.
1. At menopause, ovaries stop producing estrogen and adrenals (and fat cells) have to pick up the slack to produce estrogen and other sex hormones.
2. Excess cortisol from stress affects hormone balance and can rob the body of progesterone, another important female hormone.
3. High cortisol affects thyroid hormone conversion that can lead to weight gain depression and muscle pain.
- Increased fiber helps to clear excess hormones via bowel.
- Ground flax, the herb red clover, organic soy (only organic), sprouts and beans contain phytoestrogens that can ease the symptoms of menopause and may prevent breast cancer.
- Eat less red meat and dairy. Hormones from animals (or lactating animals in dairy) tend to lead to estrogen dominance. Foods higher on the food chain are also more concentrated sources of environmental chemicals that bind hormone receptors, leading to imbalances.
- Aim for five to eight servings (at least) of fruits and vegetables a day. Cruciferous vegetables (broccoli, kale, cauliflower) are especially important as they decrease the formation of a certain estrogen metabolites that increases the risk of cancer.
- Include sources of Iodine-Seaweeds like Nori, Irish Moss etc. to support thyroid function.
Progesterone, because it is the first to decline, many women have what is known as estrogen dominance. Leading up to menopause, estrogen levels begin to fluctuate widely, leading to hot flashes. Essentially by giving progesterone, we can help flatten out the estrogen fluctuations that cause hot flashes. Bio-identical progesterone helps relieve anxiety and insomnia, and reduces breast cell uptake of estradiol (strong type of estrogen) thus helping to protect the breasts from cancer. Progesterone deficiency manifests as anxiety, insomnia, breast cysts, fibroids, hot flashes and low sex drive.
The Women’s Health study found that synthetic Progestins increased rates of cancer. Progesterone is not the same as synthetic progestins.
Estrogen: We can mimic the body's natural production of the three types of estrogen by supplementing in a transdermal form. The Women's Health Study looked at the use of conjugated equine estrogens (from horses), not bio-identical estradiol, estrone or estriol. The oral use of estrogen-like compounds has been linked to increased stroke and blood clots. We only use transdermal estrogen because when applied on the skin the hormones enter the bloodstream in their pure form. When given orally, the hormones are acted on by the liver, which leads to metabolites that increase the risk of stroke. Estrogen deficiency is rare but may manifest as vaginal dryness, urinary incontinence, brain fog and bone loss.