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gynecology

CONQUERING MENOPAUSAL SYMPTOMS
CONQUERING MENOPAUSAL SYMPTOMS


With alternative approaches, your symptoms can not only be well controlled without side effects, but they may actually be able to be resolved long term.

Are you menopausal or perimenopausal? Do you have night sweats, hot flashes, mood swings, vaginal dryness, and/or decreased libido? Has your doctor suggested taking either HRT (Hormone Replacement Therapy) or other medications (such as antidepressants) to control the symptoms, but you’d rather not try them due to the potential side effects?

You’re in luck because with alternative approaches, your symptoms can not only be well controlled without side effects, but they may actually be able to be resolved long term. Here’s how:

Change Your Diet
First, just altering your diet may help. A balanced diet can help all the symptoms of menopause, especially eating foods that contain plant estrogens (phytoestrogens), particularly soy and lima beans. In fact, very few Asian women have menopausal symptoms because they consume diets high in phytoestrogens. Other beneficial foods include nuts and seeds, fennel, celery, and parsley. These foods can increase the levels of estrogen in your body, although they may not be enough to prevent all menopausal symptoms (they contain “weak” estrogens).

A diet low in saturated fat can help prevent post-menopausal heart disease. If you are a post-menopausal woman, you can be especially sensitive to salt, and limiting salt intake to one teaspoon daily can significantly reduce your blood pressure if it is high.

If you are overweight, simply losing weight can decrease menopausal symptoms. It has been documented that the more body fat you have, the more likely you are to have hot flashes and night sweats during menopause.

Undergo Acupuncture for Long-Term Relief
Of course, diet alone may not control all your symptoms, but there are other alternative approaches that can. The first to start with is acupuncture, which can reduce most menopausal symptoms long term without the need for taking drugs or even herbs. Often, night sweats may resolve in as early as three to four sessions and hot flashes in five to six. You might need additional sessions for maximum benefits, or for other symptoms such as libido, vaginal dryness, and mood swings. Not all styles of acupuncture are effective for menopause, so check with your acupuncturist about their experience and success with treating menopausal symptoms. Acupuncture may also be beneficial for other conditions related to menopause, including fatigue and incontinence.

Chinese Herbs to Reduce Vasomotor Symptoms
Several Chinese herbs are very effective at reducing menopausal symptoms, as much or more than pharmaceuticals. Dong Quai is the most commonly used single Chinese herb. However, it does not seem to be beneficial when taken alone, but is when used with other herbs. A commonly prescribed and effective herbal combination in China is called Er Xian Tang (which does contain Dong Quai). If hot flashes persist and there is evidence of Yin deficiency (as determined by a Chinese herbalist), Zhi Bai Di Huang Wan is another formula that is effective. You should notice initial improvement within three weeks but may need to take them longer for complete or ongoing relief.

Supplements to Reduce Vasomotor Symptoms
There are several western herbs and supplements that can also be beneficial for menopausal symptoms. Many of these are derived from plants that contain estrogens, referred to as phyto-estrogen (plant-estrogen). Black cohosh is the most supported by research and helps reduce many menopausal symptoms. There are also many products that combine black cohosh with other phytoestrogens. Red clover contains phytoestrogens as well, but they are weaker than those in black cohosh. Flaxseed is also very effective and you can take it along with black cohosh. I don’t recommend flax oil or flax oil capsules because the oil deteriorates within one month and so loses its potency quickly: Freshly ground is the best or sprinkle some seeds on your cereal or salad.

Gamma-oryzanol, derived from rice bran oil, is very popular in Japan for hot flashes, and also can lower cholesterol. If you don’t want to use soy in your diet, taking a soy extract can often reduce symptoms. In Germany, an extract of rhubarb was found to significantly reduce menopausal symptoms.

There are many other herbs that have estrogenic activity and have been used for menopausal symptoms, but there is no research evidence that they are effective. These include chasteberry, kudzu, alfalfa, hops and licorice. At this time, they are not recommended.

“Natural” Hormones: Are They the REAL Thing?
Commonly, alternative medicine providers recommend so-called natural (‘bio-identical’) hormones, which are synthesized from plant compounds. Natural progesterone is considered the most effective. Natural estrogens are also used, but usually only if you still have symptoms that are not relieved by natural progesterone. Natural testosterone is also available, primarily to treat low sex drive. Although natural hormones are reported to be beneficial in controlling menopausal symptoms, their use is still somewhat controversial.

Natural hormones can be purchased in health food stores or the Internet or they can be compounded (mixed together) by a compounding pharmacist trained in these techniques, which is preferred. The different hormones can be compounded alone or in combination with other hormones, including DHEA (see below). You can take natural hormones in several forms, including creams, capsules, troches, and suppositories. Natural testosterone is the only natural hormone that requires a doctor’s prescription.

Supplements to Reduce Non-Vasomotor Symptoms
The above herbs and supplements can reduce the vasomotor symptoms of menopause, but may not be effective for the non-vasomotor symptoms (see sidebar). However, there are other supplements that may be able to reduce these.

DHEA may help to increase your energy and well being, and also may help with cognitive functions such as memory. DHEA breaks down into estrogen and androgens (like testosterone) and may also help reduce the central fat that occurs during menopause (you need 50 mg daily for that effect). Beware that doses greater than 50 mg can cause masculinizing effects.

There is some evidence that taking Panax ginseng might help menopausal symptoms such as fatigue, insomnia, and depression.

Applying vitamin E oil helps to hydrate vaginal membranes and counteract vaginal dryness. Calendula, comfrey, and St. Johns wort can be made into creams or ointments that reduce vaginal burning, itching, and other symptoms caused by thinning of the vaginal skin.

Intravaginal natural estrogen cream can be used for vaginal dryness as well. The cream should contain primarily estriol, which works the best and has the least risks of all the estrogen forms. If that does not work, micronized progesterone (which is also natural but must be prescribed by a doctor) is helpful in place of the cream form of natural progesterone.

You Don’t Need To Suffer
In sum, you don’t need to suffer: There is a variety of alternative medical approaches that can greatly reduce menopausal symptoms and sometimes even resolve them completely. Many of these methods are superior to HRT and other conventional drugs. It is always advisable however, to obtain advice and follow-up from a medical provider experienced in these alternative approaches.

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"CONQUERING MENOPAUSAL SYMPTOMS"
   authored by:
ALTERNATIVE MEDICINE
Dr. Altshuler graduated magna cum laude from Duke University in 1972, and received his medical degree from the University of Oklahoma School of Medicine in 1976. A board certified Internist since 1979, he founded the Balanced Healing Medical Center,...



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