The Natural Way out of Menopause

“Is it hot in here, or is it just me?” This is a phrase uttered daily by millions of women coping with menopause, even in sub-zero temperatures. Although hot flushes may make harsh winters seem less cold, the majority of these women report a diminished quality of life as one of the side effects of menopause.

Menopause has really only been on the radar for the past 200 years. Not because menopause itself did not exist, but rather because the last two centuries have been the first time women lived long enough to actually reach menopause. According to Yaso San, who is a consultant medical herbalist, menopause has actually been ‘designed’ to be a flawless transition and modern side effects are attributed to stress, low blood sugar and poor diet. “Interestingly, women in other cultures who follow natural diets and a holistic lifestyle appear to escape menopausal symptoms”, San writes in an article for Primary Health Care.

The most conventional way of addressing the symptoms is to start hormone replacement therapy (HRT). The benefits are tempting: relief of hot flushes, mood swings, insomnia and a decreased chance of osteoporosis as well as lowered cholesterol. Nevertheless, the drawbacks are substantial and include an increased risk of developing blood clots, endometrial cancer and breast cancer. On top of that women are not recommended continuing hormone replacement therapy for extended periods of time. Many women just don’t think the benefits outweigh the downsides of hormone replacement therapy and they start looking for more natural ways out of their menopause troubles.

The main cause of symptoms is a change in hormone production, particularly a decline in the production of estrogen. There already are certain "popular" alternatives to hormone replacement therapy, but recent research is suggesting additional treatment options.

These are options that could be less risky and less costly than hormone replacement therapy, but work just as well:

Flaxseed oil

Flax seed is already relatively popular as a dietary supplement. It is a great source of plant lignans, which are also known as phyto-estrogens. These compounds are similar to human estrogen and they have weak hormonal action in the body. The only problem with phyto-estrogens is the fact that consumption is not controlled, i.e. they are pretty much "over the counter" products that anyone can buy in virtually unlimited quantities. Because they are similar in structure and function to human estrogen, taking too much of it can pose legitimate concerns. For example, a woman who does not want to use hormone replacement therapy, but instead consumes very large amounts of flax seed oil to compensate can get an equivalent, or larger, amount of "hormones" into her body which poses the same risks as those related to HRT.

One big problem with decreasing estrogen levels is a higher risk of cardiovascular diseases. Estrogen normally regulates cholesterol levels, so high cholesterol is often a side effect of menopause. This is one of the easier symptoms to fix though. Flax seed has been shown to be very effective in lowering cholesterol levels, and as a result decrease the risk of cardiovascular diseases and hypercholesterolemic atherosclerosis (i.e. arterial plaque which can lead to cardiovascular diseases or heart attacks).

Unfortunately, the studies that reported this positive effect on cholesterol level, did not find flax seed to have a positive effect on bone metabolism. While flax seed does effectively address some symptoms related to menopause, it does not decrease the risk of osteoporosis.

A relatively inexpensive and safe way of consuming flax seed is in the form of pure flax seed oil. The oil can be mixed in with yogurt or peanut butter to mask the taste, but keep in mind that heating it will destroy its effects. This means that you cannot incorporate it in cooked dishes.

Soy

Soy has similar properties as flax seed oil, but the active compounds are called isoflanoves. These are used as a natural "hormone replacement" as well, but unlike phyto-estrogens they do prevent osteoporosis. To compensate though, soy does not seem to cool down the hot flushes. If osteoporosis is a concern or if it “runs in the family”, then it would be a good idea to consume soy products in moderate amounts. While hot flushes are better prevented with flax seed oil.

To avoid consuming too much phytoestrogens, or similarly isoflavones, it is not a good idea to purchase concentrated supplements, or capsules, containing either soy or flax seed extracts. There have been growing concerns that the concentrations available on the market could be too high and could induce negative side effects similar to hormone replacement therapy. Instead, it is far less expensive, and safer, to purchase pure flax seed oil and/or soy products and incorporate them in your diet.

Sibiric Rhubarb

The North American Menopause Society recently published an article with new research giving a safe and natural treatment alternative for menopause symptoms. The focus of this study, performed at the national medical university of Kiev and Health Research Services in Germany, is Sibiric Rhubarb (Rheum rhaponticum). To study the effects of Rhubarb on menopausal symptoms a special extract is derived from the plant, which is called ERr 731, but has the trade name "Phytoestrol N".

Interestingly, it has already been used for decades in Germany to treat certain hormone related disorders. This means it is already an approved supplement and its safety has been studied. In fact, it is said to be very well tolerated in patients and show very clear results.

The chemical characteristics of the Rhubarb extract are such that it does not cause any of the unwanted side effects associated with many products influencing hormonal receptors in the body. Basically, unlike flax seed oil and soy extracts, Rhubarb does not contain estrogen-like compounds. When Rhubarb was given to women experiencing strong symptoms they reported an obvious decrease in the number and severity of hot flushes, compared to a group that was not given the extract. The scientists performing the study looked at a variety of things to check for side effects. These parameters included breast tenderness, a pap smear, and safety tests. None of the tests showed abnormal results, making Phytoestrol N the most effective and safest alternative for menopause treatment on the market.

In short, research has shown that hormone replacement therapy is not the safest method of treating distressing symptoms. Especially the increased risks of breast cancer and the development of blood cloths are a major concern to women entering menopause. In response, a variety of more ‘natural’ alternatives have been used and investigated, with mixed results. The best options available are flax seed oil and Phytoestrol N (Rhubarb extract). In particular Rhubarb extract has shown very positive results in recent studies, without producing any serious side effects.

Although menopause may be nearly inevitable in modern society, it is becoming progressively easier and safer to avoid uncomfortable symptoms.

References

Marianne Heger, MD, Boris M. Ventskovskiy, MD, PhD, Irina Borzenko, MD, Kyra C. Kneis, Reinhard Rettenberger, PhD, Marietta Kaszkin-Bettag, PhD, and  Peter W. Heger. (2006) Efficacy and safety of a special extract of Rheum rhaponticum (ERr 731) in perimenopausal women with climacteric  complaints: a 12-week randomized, double-blind, placebo-controlled trial. Menopause: The Journal of The North American Menopause Society. Vol. 13, No. 5, pp. 744-759

Jennifer D Brooks, Wendy E Ward, Jacqueline E Lewis, John Hilditch, Leslie Nickell, Evelyn Wong, and Lilian U Thompson. (2004) Supplementation with flaxseed alters estrogen metabolism in postmenopausal women to a greater extent than does supplementation with an equal amount of soy. American Journal for Clinical Nutrition. 79:318 –25.

S. Dodin, A. Lemay, H. Jacques, F. Le´gare´, J.-C. Forest, and B. Masse.  (2005)The Effects of Flaxseed Dietary Supplement on Lipid Profile, Bone Mineral Density, and Symptoms in Menopausal Women: A Randomized, Double-Blind, Wheat Germ Placebo-Controlled Clinical Trial. The Journal of Clinical Endocrinology & Metabolism 90(3):1390–1397.

Yaso San. (2005) Phyto-estrogens and the great soya debate. Primary health care. Vol 15. no. 3.

Andre Lemay, MD, PhD, Sylvie Dodin, MD, MSc, Nadine Kadri, MD, He´le`ne Jacques, PhD, and Jean-Claude Forest, MD, PhD. (2002) Flaxseed Dietary Supplement Versus Hormone Replacement Therapy in Hypercholesterolemic Menopausal Women. The American College of Obstetricians and Gynecologists. Vol. 100, No. 3.