Menopause: Alternative treatment

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Some women also report success in using natural remedies to treat the unpleasant symptoms of menopause. Not all women need estrogen and some women can't take it. Many doctors don't want to give hormones to women who are still having their periods, however erratically. Indeed, only a third of menopausal women in the United States try HRT and of those who do, eventually half of them drop the therapy. Some are worried about breast cancer, some can't tolerate the side effects, some don't want to medicate what they consider to be a natural occurrence.

Herbs have been used to relieve menopausal symptoms for centuries. In general, most herbs are considered safe, and there is no substantial evidence that herbal products are a major source of toxic reactions. But because herbal products aren't regulated in the United States, contamination or accidental overdose is possible. Herbs should be bought from a recognized company or through a qualified herbal practitioner.

Women who choose to take herbs for menopausal symptoms should learn as much as possible about herbs and work with a qualified practitioner (an herbalist, a traditional Chinese doctor, or a naturopathic physician). Pregnant women should avoid herbs because of unknown effects on a developing fetus.

The following list of herbs include those that herbalists most often prescribe to treat menstrual complaints:

• black cohosh (Cimicifuga racemosa): hot flashes and other menstrual complaints
• black currant: breast tenderness
• chaste tree/chasteberry (Vitex agnus-castus): hot flashes, excessive menstrual bleeding, fibroids, and moodiness
• evening primrose oil (Oenothera biennis): mood swings, irritability, and breast tenderness
• fennel (Foeniculum vulgare): hot flashes, digestive gas, and bloating
• flaxseed (linseed): excessive menstrual bleeding, breast tenderness, and other symptoms, including dry skin and vaginal dryness
• gingko (Gingko biloba): memory problems
• ginseng (Panax ginseng): hot flashes, fatigue and vaginal thinning.
• hawthorn (Crataegus laevigata): memory problems, fuzzy thinking
• lady's mantle: excessive menstrual bleeding
• mexican wild yam (Dioscorea villosa) root: vaginal dryness, hot flashes and general menopause symptoms
• motherwort (Leonurus cardiaca): night sweats, hot flashes
• oat (Avena sativa) straw : mood swings, anxiety
• red clover (Trifolium pratense): hot flashes
• sage (Salvia officinalis): mood swings, headaches, night sweats
• valerian (Valeriana officinalis): insomnia

Proponents of plant estrogens (including soy products) believe that plant estrogens are better than synthetic estrogen, but science has not yet proven this. The results of smaller preliminary trials suggest that the estrogen compounds in soy products can indeed relieve the severity of hot flashes and lower cholesterol. But no one yet has proven that soy can provide all the benefits of synthetic estrogen without its negative effects.

It is true that people in other countries who eat foods high in plant estrogens (especially soy products) have lower rates of breast cancer and report fewer "symptoms" of menopause. While up to 80% of menopausal women in the United States complain of hot flashes, night sweats, and vaginal dryness, only 15% of Japanese women have similar complaints. When all other things are equal, a soy-based diet may make a difference (and soy is very high in plant estrogens).

The study of phytoestrogens is so new that there aren't very many recommendations on how much a woman can consume. Herbal practitioners recommend a dose based on a woman's history, body size, lifestyle, diet, and reported symptoms. Research has indicated that some women were able to ease their symptoms by eating a large amount of fruits, vegetables, and whole grains, together with four ounces of tofu four times a week.

What concerns some critics of other alternative remedies is that many women think that "natural" or "plant-based" means "harmless." In large doses, phytoestrogens can promote the abnormal growth of cells in the uterine lining. Unopposed estrogen of any type can lead to endometrial cancer, which is why women on conventional estrogen-replacement therapy usually take progesterone (progestin) along with their estrogen. However, a plant-based progesterone product can sometimes be effective alone, without estrogen, in assisting the menopausal woman in rebalancing her hormonal action throughout this transition time.

Many women find that yoga (the ancient meditation/exercise developed in India 5,000 years ago) can ease menopausal symptoms. Yoga focuses on helping women unite the mind, body, and spirit to create balance. Because yoga has been shown to balance the endocrine system, some experts believe it may affect hormone-related problems. Studies have found that yoga can reduce stress, improve mood, boost a sluggish metabolism, and slow the heart rate. Specific yoga positions deal with particular problems, such as hot flashes, mood swings, vaginal and urinary problems, and other pains.

Exercise helps ease hot flashes by lowering the amount of circulating FSH and LH and by raising endorphin levels that drop while having a hot flash. Even exercising 20 minutes three times a week can significantly reduce hot flashes.

Regular, daily bowel movements to eliminate waste products from the body can be crucial in maintaining balance through menopause. The bowels are where circulating hormones are gathered and eliminated, keeping the body from recycling them and causing an imbalance.

This ancient Asian art involves placing very thin needles into different parts of the body to stimulate the system and unblock energy. It is usually painless and has been used for many menopausal symptoms, including insomnia, hot flashes, and irregular periods. Practitioners believe that acupuncture can facilitate the opening of blocked energy channels, allowing the life force energy (chi) to flow freely. This allows the menopausal woman to keep her energy moving. Blocked energy usually increases the symptoms of menopause.

Therapeutic massage involving acupressure can bring relief from a wide range of menopause symptoms by placing finger pressure at the same meridian points on the body that are used in acupuncture. There are more than 80 different types of massage, including foot reflexology, Shiatsu massage, or Swedish massage, but they are all based on the idea that boosting the circulation of blood and lymph benefits health.

Some women have been able to control hot flashes through biofeedback, a painless technique that helps a person train her mind to control her body. A biofeedback machine provides information about body processes (such as heart rate) as the woman relaxes her body. Using this technique, it is possible to control the body's temperature, heart rate, and breathing.

— Laith Farid Gulli, M.D.