More than eight years have passed since the landmark Women’s Health Initiative study linked synthetic estrogen (Premarin) and progestin (Provera) to increased risk of heart disease and breast cancer. And, according to recent data, hormonal cancer rates have dropped precipitously as copious studies have confirmed the WHI finding. In turn, with 6,000 women embarking on “the change of life” each day, according to the North American Menopause Society, those seeking symptom relief are still steering clear of prescription hormones in favor of bioidentical and topical hormones, dietary supplements and other natural alternatives. A journal Menopause study found that 80 percent of women now use complementary and alternative medicine to lessen symptoms.
It is imperative that you are vigilant in addressing menopause because new research has shown that during this time, a sudden drop in estrogen make women more prone to heart disease and stroke. Following is a primer to help navigate what is new with menopause.
Insomnia, Mood Swings, Tender Breasts and Irregular Periods
Chaste tree berry (Vitex)
Insomnia, mood swings, tender breasts and irregular periods are often the first signs of perimenopause (the three- to 10-year period leading up to the halt of menses), and the culprit is often a dip in the calming sex hormone progesterone. The herb chaste tree berry is among the most widely used phytoprogesterones—plant compounds that mimic progesterone in the body and may indirectly help boost progesterone production.
Low-dose bioidentical progesterone creams are also available. (Although prescription varieties contain an average of 10 percent progesterone, over-the-counter versions, by law, must contain less than 30 percent.) Unlike the synthetic Provera, bioidentical progesterone (often derived from plant sterols in wild yams or soy) has a molecular structure identical to that of the progesterone our own bodies make. Work with an expert such as myself when taking any kind of hormone.
By far the most researched herb for menopause relief. A 2010 meta-analysis showed that in six out of nine recent trials, the botanical worked better than placebo. A 2006 study of 301 women found that those who took black cohosh for 16 weeks halved their hot-flash incidences; the placebo group improved by 20 percent. Another recent trial found that black cohosh extract was as effective as low-dose prescription estrogen for the treatment of menopause-induced hot flashes, anxiety and depression.
Scientists long assumed that black cohosh was a general phytoestrogen, acting on estrogen receptors throughout the body to quell symptoms. But recent research has called that theory into question, suggesting it may instead work on the central nervous system and have no estrogenic effect on the breast or endometrium. This makes it a safer option for women with a history of breast cancer who cannot take estrogen.
In topical form, soy phytoestrogens are effective at the right dose. Soy phyoestrogen supplements are not recommended, as the data has been mixed. Consuming fermented organic soy products are recommended in moderation for a positive hormone balancing boost.
I still support ground flaxseed for their hormone balancing lignans as well as a good soluble fiber source.
My top recommendation for boosting libido in men and women is the Peruvian maca root. It is a powerful sex enhancer, and it has absolutely zero toxicity. As an adaptogen (or stress modulator), maca root has long been used in Peru to help the body maintain healthy hormone levels in the face of stress or illness in men (sustaining testosterone and balancing cortisol) and women (maintaining beneficial estrogens well as balancing cortisol). In a few select cases, maca can adversely affect thyroid levels.
Other Sexual Dysfunction
A common cause of sexual dysfunction in menopausal women is vaginal dryness, a result of dipping estrogen levels. One possible remedy is pueraria mirifica. Also known as Thai kudzu, it contains a compound called miroestrol, which has exhibited estrogen-like effects on vaginal tissue, similar to prescription estrogen but without the side effects.
Women Over 65
Synthetic hormone replacement therapy is not recommended because it has been linked to an increase incidence od dementia when started in women 65 years and older.
I have not changed my position since my last post on bioidenticals. If you did not get a chance to read this when it was published, here it is.
As a certified menopause educator, feel free to schedule a change of life appointment so that I may individualize your peri, post, or menopausal needs through dietary and lifestyle modification.
P.S. If you have tried everything and are still having menopausal symptoms, we will be starting a dietary supplement trial shortly. Please email Steve at firstname.lastname@example.org if you would like to be involved.
My opinion on Human growth hormone (HGH), touted for its ability to keep men virile into old age, has not changed. I am vehemently opposed to it. If taken by healthy adults it could cause a host of unhealthy side effects, including joint pain, soft tissue swelling, carpal tunnel syndrome, increased breast size in men, and a heightened risk of diabetes and pre-diabetes. Growth hormone should not be used for anti-aging purposes or virility. It can cost hundreds to thousands of dollars a month, there is no scientific evidence supporting it, and very real, potentially serious side effects may occur.
There are still too many unknowns. In the few studies that have been done, the reported side effects are numerous.
My one and only favorite for libido and testosterone enhancement at the moment is maca root. The other available supplemental options are too risky with regards to side effects.
Low testosterone is a clear and present issue as evidenced by an October Journal of Alzheimer's Disease study showing that serum levels of bioavailable testosterone (BT) can predict risk for Alzheimer's disease (AD) in older men. The need to find safer therapies to boost levels are an important public health issue.
In my opinion, the most effective way for men to improve their testosterone is to lower their estrogen levels. A saliva or blood test can confirm this. Eliminating dietary, environmental, and lifestyle factors that are contributing to an overabundance of estrogen is imperative. The earth is rife with xenoestrogenic chemicals in our water, food, medication, household, and place of work. Once pinpointed, they must be minimized or eliminated. One quick and easy way to assure that bad estrogens are being metabolized and excreted is to frequently consume brassica vegetables, such as broccoli, cauliflower, brussels sprouts, and bok choy. If you feel you need assistance in pinpointing the area where you may be creating an overabundant estrogenic effect, feel free to schedule an appointment.