Menopause

For centuries, the average age for menopause has been around 50. (Smoking cigarettes is the only factor known to cause menopause to start earlier, usually only by a couple of years.) But in recent decades, our life expectancy has lengthened so that today's woman can expect to live much longer after menopause. I'd like to help you make those years as enjoyable as possible.

All the problems associated with menopause are thought to be due to the erratic activity of the pituitary hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone) as they try to overcompensate for the declining levels of estrogen and progesterone. During menopause, FSH levels sometimes increase to as much as 20 times their original levels!

Physicians commonly prescribe estrogen replacement supplements for menopausal women. It is a scientific fact that estrogen increases the bones' ability to absorb calcium, reducing the risk of weak bones and osteoporosis. Estrogen also lowers your risk of heart disease and stroke, which is certainly no small matter, considering that heart disease is the leading killer of women over age 45. But studies show that estrogen supplements can increase the risk of breast and uterine cancer. This is making some doctors more conservative about dispensing prescriptions for estrogen, particularly to women who have a family history of reproductive-system cancer.

Many of these high-risk women are successfully using herbs instead of estrogen to treat their menopausal symptoms. Even women who are not at high risk for reproductive-system cancers find that herbs offer a positive solution to their menopausal woes. And for many women who do take estrogen, the herbs often allow them to take a lower dose.

Licorice, black cohosh, fenugreek, hops, don quai, vitex and ginseng can be used to treat many menopausal complaints, including hot flashes. In fact, black cohosh preparations, such as Cimicifuga-Pentakran, are commonly sold in European pharmacies to reduce the frequency and severity of hot flashes. In studies that were done to determine the herb's effectiveness at relieving hot flashes, researchers found that after two months, the herbs lowered the women's luteinizing hormone levels.

Robert Atkins, M.D., a well-known nutritional specialist, says that out of hundreds of his patients who complained of hot flashes, approximately 80 percent of them responded to ginseng. Most of the rest of the women improved when vitamin E was taken with the herb. It takes most women two to six weeks before they begin to notice the difference, but once they become aware of it, most are amazed that a simple therapy like this one can make such a difference.

Gloria was pleased to be breezing through menopause with only a slight rise in temperature now and again, but then the "big one" hit. She was attending her niece's wedding when she suddenly began to feel uncomfortable. She began fanning her face, but in a minute found herself fleeing for the veranda where no one could see that she was flushed the color of a beet and that her lovely silk dress was soaked with sweat. The very next day, Gloria marched into a bookstore and headed for the health section. In her reading, she discovered that ginseng helps many women in her predicament and has quite a few other beneficial effects as well. She was especially pleased to read that this herb increases energy and mental power—two things she felt she could use a little more of.

So Gloria gave ginseng a try. At first, she noticed little difference except maybe a little more energy. She also had two more devastating hot flashes, but tried not to feel discouraged. Her perseverance paid off. After taking ginseng for a couple of months, she realized that she had not had even a mild hot flash for well over a month.

Gloria was thrilled, and she started a one-woman campaign to convince everyone she thought might benefit from this wonderful herb. Several of her friends tried it—soon, Bev and Jan were also symptom-free. Her friend Mary, however, was still having four to six hot flashes a day. So Gloria got out her books again and read about vitamin E. She told Mary to take this vitamin with the ginseng, and gradually Mary's hot flashes became less severe. They still have not completely gone away, but they have diminished enough to make Mary happy.

If you find that your menopausal symptoms include nervousness or irritability, a good herbal relaxant to choose is hops. Its estrogenlike effects were first discovered when female hops pickers noticed changes occurring in their menstrual cycles. It turned out that hops caused their estrogen levels to rise. For more information on relaxation herbs, see "Stress" in chapter 20.

In the course of her extensive fieldwork, Margaret Mead found that women in many non-Western cultures do not seem to experience menopausal symptoms. She could not determine why, but many theories have been posed, most focusing on diet, lifestyle and, of course, herbal medicines.

It seems that certain plants can increase estrogen during menopause—and not just the plants that we think of as herbs. In one British study, Gisela Wilcox, M.D., and associates gave 25 women who had gone through menopause foods and herbs that were supposed to increase estrogen. When these women ate red clover sprouts, flaxseeds and soy flour every day for two weeks, their estrogen levels rose and remained high. Once they stopped the special diet, the levels fell back down to their original postmenopausal level.

Alfalfa seeds and sprouts may produce a similar effect. These herbs have long been used as a folk cure to relieve hot flashes for women in New Mexico. The large amount of estrogen-like substances in soy and soy products is thought to be one reason that Japanese women experience so few menopausal symptoms. The plant source with the highest level of these substances is pomegranate seeds. This is followed by garden rhubarb stalks and pineapple. Even whole grains, nuts, seeds and avocados contain some estrogen-like compounds.

This is a book about herbs, but sometimes women find that herbs alone are not enough and that they also need to take vitamin E. Herbalists suspect that vitamin E enhances the functioning of some herbs. The use of vitamin E to treat menopausal symptoms is not new. In 1949, the British menopause researcher Hugh McLaren, M.D., who had found this vitamin extremely successful in fighting menopause, predicted that vitamin E would become the preferred menopause therapy, since he thought that estrogen therapy would prove to be carcinogenic. In a 1974 health survey conducted by Prevention magazine, 2,000 postmenopausal women mentioned how useful vitamin E was for them even though the survey questionnaire did not mention menopause. They reported that after taking vitamin E they experienced more energy, fewer leg cramps and hot flashes, and less vaginal dryness. One herb that contains vitamin E is don quai.

It seems that herbs not only can help you avoid menopausal complaints, but also should help prevent osteoporosis and heart disease. We do not know this for sure, however, so you should not rely solely on herbs. So far, mineral supplements and exercise have a more proven track record. A study conducted in New Zealand showed that postmenopausal women who took 1,000 milligrams of calcium a day were able to cut their bone loss in half. Equally as important is magnesium to help with calcium's assimilation. Another way to slow bone loss is with a half-hour session of weight-bearing exercises, or even exercising in a chair, three times a week. All postmenopausal women can take a hint from vegetarian women, who experience less bone loss: Go easy on protein since high amounts block calcium absorption.

Some essential oils also mildly stimulate estrogen-like activity, and when used in massage oils they go right through the skin into the bloodstream. Of course, the massage itself is very relaxing. Fennel, anise, clary sage, cypress and, to some degree, basil can be made into a massage oil. Rose geranium, neroli and lavender are hormonal balancers that are traditionally used in European facial creams to reduce aging and wrinkles. Used in a rejuvenation cream applied inside the vagina, these oils can also counter vaginal dryness. I like to add vitamin E to this herbal cream. Studies conducted in 1949 by Dr. McLaren showed that using vitamin E this way can improve the strength and flexibility of the vaginal lining and help any abrasion that results from a dry vaginal lining to heal more quickly.

Estrogen is not the only hormone you should concern yourself with during menopause. While the emphasis during menopause has previously been on estrogen, progesterone has recently come to be considered equally important. This is probably why vitex helps so many women during menopause. Taking a hint from German herbalists, North American herbalists are now using vitex, usually combined with other menopause herbs, to treat such menopausal symptoms as hot flashes, dizziness, a dry vagina and depression.

While some sources claim that wild yam contains progesterone, this is not true, and much confusion has arisen as a result of the conflicting opinions. Women going through menopause often ask me if taking a tincture of wild yam will provide a natural progesterone increase. I always say no. Although chemists use wild yam for starting compounds to synthesize progesterone, this can be done only in the laboratory. Many of the "natural progesterone" creams with wild yam that are popular for treating symptoms of menopause and PMS do contain a wild yam extract, but their active ingredient is usually the hormone progesterone (even though it does not always appear on the label). Like any hormone, this cream should be used only under the supervision of a professional health care practitioner. Although wild yam (or, more likely, soy bean) is used as a starting point to make progesterone pills and creams, many women do not realize that by the time it is processed in the lab, it is no more herbal than estrogen pills and creams.

Strong adrenal glands and a healthy liver are also important during menopause. Your adrenal glands provide a backup system to supply female hormones that your ovaries are no longer producing and your liver helps to regulate hormones, making menopause easier. For more information on herbal support for the adrenal glands, see chapters 12 through 20.

Menopause Tincture

1 teaspoon black cohosh root

½ teaspoon each tinctures of vitex berry, ginseng root, red clover flower, licorice root, don quai root, motherwort leaf and fenugreek seed

Combine ingredients. This recipe can also be made into a tea using the same proportions of dried herbs and steeping them in 1 quart of boiling water. As a tea, however, this brew is too strong for most people's taste. Take 2 to 5 dropperfuls of tincture or 3 to 6 cups of tea a day.

Vaginal Rejuvenation Cream

2 ounces almond oil or vegetable oil

6 drops each rose geranium and lavender essential oils

1,500 International Units vitamin E oil (in liquid or capsule form)

1 drop neroli essential oil (expensive, so it's optional)

Combine ingredients. For the vitamin E, use either the liquid vitamin or pop open a couple of capsules and empty out the contents. Apply as needed inside the vagina.