Managing the menopause

IN MANY cultures, the menopause is considered to be a natural and positive part of a woman's life. Modern medicine, however, deals with the menopause as if it is a disease. In societies with the former approach, most women do not experience many of the symptoms usually associated with menopause. Older Jamaican women often refer to the menopause as the 'change of life', seeing it as a period of transition and adjustment. Even though major hormonal factors are involved, the menopause is more than a biological event, and social and cultural factors contribute significantly to how women react to it.

Interestingly, research of rural Mayan Indians in South America revealed that they do not experience any symptoms of the menopause. Mayan women viewed the menopause as an event that not only makes them accepted as respectable elders, but also relieves them of the responsibility of having children. The researchers concluded that the main reason why these women did not experience any menopausal symptoms probably has to do with their attitude to the event.

What is the menopause?

The menopause is defined as a cessation of menstruation or 'periods' and usually occurs within a few years of the 50th birthday of most women. Twelve months without a period is the commonly accepted medical rule for diagnosing the menopause.

Symptoms of the menopause

• The common symptoms include:
• Hot flashes - excessive heat and sweating;
• Vaginal dryness;
• Forgetfulness and poor concentration;
• Frequent urinary tract infections;
• Headaches and palpitations;
• Cold hands and feet;
• Irritability and mood swings and poor sleep;

Symptoms of osteoporosis.

Causes of the menopause

The menopause is believed to occur when the eggs (ova) in the woman have been depleted. At birth, a woman had about one million eggs in her ovaries. By puberty, the number is decreased to about 400,000. Only about 400 of these eggs will mature during a woman's reproductive years. At the onset of the menopause, the ova cease to function and this results in a reduction in the production of the main female hormones - estrogen and progesterone, and menstruation ceases. Interestingly, though, other tissues, including the fat cells in the body, continue to produce some estrogen.

Medical interventions like surgery, drugs, radiation, as well as a number of diseases, may also prematurely bring on the menopause.

Managing the menopause naturally

Have a medical check-up:

I recommend that at the start of the menopause it is useful to do a routine evaluation, including breast and pelvic examination, blood tests of your hormone levels and if indicated a test for osteoporosis.

Diet

Increase the amounts of plant foods, especially those containing phytoestrogens (estrogen-like substances in plants). These include soy, nuts, whole grains, parsley and fennel. Eat lots of vegetables and fresh fruit and drink green tea. Menopausal symptoms are less in cultures where a predominantly plant-based diet is consumed. Decrease your intake of animal foods, dairy and hydrogenated vegetable oils.

Detoxify

Thousands of chemicals in our food, air, water, household and environment have hormonal-like properties and may significantly contribute to disturbance in the delicate hormonal balance of today's woman. A programme of detoxification (cleansing) can help to reduce hormonal toxicity.

Nutritional supplements

Nutritional supplements especially vitamins E and C, omega-3 fats and magnesium are helpful in reducing menopausal symptoms.

Herbs

Many herbs help to balance the female glandular system These include dong quai, black cohosh, chaste berry, evening primrose and ginkgo biloba. There is now scientific evidence on how some of these herbs act. For example, black cohosh has been shown to balance blood flow, as well as a hormone called leutenising hormone, while reducing inflammation. Dong quai, on the other hand, improves the balance between estrogen and progesterone.

Lifestyle modification

There is an area in the brain called the hypothalamus, which controls many body functions, including body temperature, metabolism, mood, stress reactions and hormones. Many of the symptoms of the menopause seem to be related to alterations in the function of the hypothalamus.

Several natural-lifestyle measures stimulate the body's production of substances called endorphins that balance the functions of the hypothalamus and can have a positive impact on the symptoms of the menopause. These include:

Exercise: Studies clearly show that regular exercise decreases the incidence of hot flashes and vaginal dryness.

Avoid cigarette smoke: Smoking significantly increases the risk of an early menopause while worsening its symptoms.

Manage stress effectively: This is extremely important and will make this period of adjustment much easier. Practices like yoga, tai chi and meditation are particularly useful.

Hormone replacement therapy

This is a controversial issue. In my opinion, hormone replacement therapy is very useful and safe if the following principles are followed:

Have your hormones measured first to determine what needs balancing. A blood or saliva test of your estrogen, progesterone, DHEA, testosterone and thyroid hormones should be done.

Use bio-identical hormones. This means giving back to the body the exact substance that it normally produces, not a drug that is not the same. These drugs invariable carry a high risk of bad side effects and have unfortunately given HRT a bad reputation. These bioidentical hormones are probably best administered as a cream or gel that is absorbed through the skin.

Estrogens, progesterone and testosterone can all be given in this way and are available. Natural progesterone cream is a particularly useful and safe alternative to the synthetic estrogen or progestin drugs often prescribed. Follow the directions of a trained health practitioner.

Monitor your hormone levels and adjust dosages to bring your levels to normal.

So, don't despair, you can manage your menopause safely and naturally.

You may email Dr Tony Vendryes at tonyvendryes@gmail.com or listen to 'An Ounce of Prevention' on POWER 106FM on Fridays at 8 p.m. His new book 'An Ounce of Prevention, Especially for Women' is available locally and on the Internet.