Menopausal Problems

Menopause simply means the end of menstruation, but the term is also used to refer to the months and years in a woman's life before and after her final period-a time that may or may not bring with it some physical or emotional changes. Most women menstruate for the last time at about 50 years of age; a few do so as early as 40, and a very small percentage as late as 60. Most women notice some menstrual changes-such as irregular periods and light menstrual flow-up to a few years before menstruation ceases.

Some symptoms-including hot flashes and mood swings-are temporary and will pass as your body adjusts. But more-permanent problems can also result. Decreased levels of estrogen, for example, affect the way bones absorb calcium and can raise cholesterol levels in the blood; post menopausal women thus face in-creased risk for developing both osteoporosis and cardiovascular diseases such as atherosclerosis.

Causes

Typically during a woman's forties, her ovaries slow and then cease their normal functions, including the production of eggs. Even more significant, they decrease their production of estrogen and progesterone. As levels of these hormones-especially estrogen-decline, they cause changes throughout the body and particularly in the reproductive system, the most notable change being the end of menstruation. Decreased estrogen levels may also be responsible for the various symptoms associated with menopause.

Treatment

In both conventional and alternative medicine, the most common approach to treating menopausal problems is to resupply the body with the estrogen it no longer produces in sufficient quantities. Known in conventional medicine as hormone re-placement therapy, this technique is somewhat controversial because of certain side effects, so you should carefully consider the risks and the benefits in consultation with your doctor.

Conventional Medicine

Hormone replacement therapy (HRT) consists of estrogen and progestin supplements-usually given orally or through a skin patch. Most HRT patients take a combination of estrogen and progestin because estrogen alone has potentially serious side effects, such as endometrial cancer and uterine cancer. Progestin can cause side effects such as irregular bleeding, headaches, bloatedness, and breast swelling and pain. You may even develop an artificial monthly period, depending on the dosage regimen you're on. If you have had a hysterectomy and have no uterus, you do not need progestin.

Your doctor may recommend HRT to help prevent cardiovascular disease and osteoporosis, particularly if these diseases run in your family.

Your doctor may prescribe a vaginal estrogen cream to help stop the thinning of vaginal tissues and improve lubrication.

If you have had breast cancer, endometrial cancer, liver disease, or blood clots, you should not take estrogen, because it increases your chance of a recurrence. But progestin alone may relieve hot flashes.

Alternative Choices

Chinese Herbs

Some Chinese herbs - including dong quai (Angelica sinensis) and Asian ginseng (Panax ginseng)-contain a form of estrogen known as phytocstrogen, or plant estrogen. Exact proportions are important, and some dosages are toxic; consult an herbalist.

Herbal Therapies

Phytocstrogen is found in a variety of herbs and foods. Extracts and teas made from black cohosh (Cirnicifuga racemosa) may supply beneficial amounts of phytoestrogen. Estrogenic herbal creams may help relieve vaginal dryness and dry skin.

Combinations of motherwort (Leonurus cordiaca), chaste tree (Vitex agnus-castus), wild yam (Dioscorea villosa), and other herbs may help with the rapid heartbeat that comes with hot flashes.

Nutrition and Diet

Eating foods high in plant estrogens, such as soy beans and lima beans, may alleviate symptoms; other sources include nuts and seeds, fennel, celery, parsley, and flaxseed oil.

At-Home Remedies

• Raise your calcium intake and engage in weight-bearing exercises to avoid osteoporosis and maintain general good health.
• Take 400 to 800 IU) of vitamin E daily to treat hot flashes and reduce the risk of cardiovascular disease.

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