Naturopathic Alternatives to Hormone Replacement Therapy in Menopause

chillibreeze writer — Hazel D Souza

Introduction

For many women, menopause is a turning point in their emotional, physical, and mental lives. It indicates a decline in the level of the female hormone Estrogen (E), and a cessation of fertility. This cessation of fertility and diminished hormone production is called Menopause. Even though it is a natural phenomenon, for some women menopause can be an extremely uncomfortable period of time with variable symptoms ranging from hot flashes, dizziness or fatigue to headaches sleeplessness and anxiety.

Post Menopausal Hormone Replacement Therapy was advocated as a specific treatment for menopause symptoms. But in recent times, many women are expressing an aversion to ‘artificial ingredients’ and are turning towards more natural products, which do not overload the body with chemicals. Recent studies have indicated that long term use of HRT can carry a larger risk of breast cancer ,deep vein thrombosis, strokes etc .As a result more women now prefer a more natural mode of therapy without such dangerous risks.

Botanical hormones or Phytoestrogens are now slowly gaining an edge over Hormone replacement therapy (HRT).Phytoestrogens are plant derived hormones, which mimic the action of estrogen inside the body. Naturopathic herbs like Black Cohosh contain a large amount of Phytoestrogens and are more likely to be adopted for long term use over HRT.

What is menopause?

Women are born with all the eggs they will require in their lifetime, approximately 500,000. At the time of puberty, the pituitary gland in the brain releases two important hormones called Follicle stimulating hormone (FSH) and Luteinizing hormone (LH) which stimulate the ovary to produce a new egg from a new follicle every month. The ovaries simultaneously produce two new hormones every month called Estrogen (E) and Progesterone (P) .E maintains the health of the newly released egg while P prepares an enriched lining inside the uterus to receive the fertilized egg, which develops into a baby.

However, if fertilization does not occur, then the unfertilized egg and the thickened uterine lining are shed through the vaginal canal in the form of a bloody discharge called menstruation. This process repeats itself every month, till the early 40s when the ovaries undergo aging and are now exhausted of ovarian follicles. As a result egg production drops, hormone levels of E and P start to fluctuate and irregular menstrual cycles start .By the late 50s egg production stops completely.
The pituitary gland increases the secretion of FSH and LH to stimulate the ovaries to produce more estrogen, but the ovaries can produce only a minimal amount, which is insufficient for the body. Menopausal symptoms are felt due to this sudden fluctuation and drop in the levels of estrogen.

E and P play an important role in maintaining the various body systems and different tissues. E increases the uptake of calcium into bone, regulates body temperature, maintains healthy blood cholesterol levels, regulates salt and water levels, keeps skin and mucus membranes soft and supple and also influences mood and behavior. As the levels of E and P fluctuate and drop in menopause, all body systems are affected resulting in a range of symptoms like

• Hot flashes
• Rapid heart beats
• Irritability, mood swings, headaches
• Sudden bouts of crying, depression
• Sleeplessness
• Sweating at night
• Irregular periods
• Dry skin and mucus membranes (oral and vaginal)
• Tiredness
• Anxiety, apprehension
• Disorientation and memory lapses
• Itching skin
• Aching joints and muscles
• Gum problems with increased bleeding
• Burning sensations in the mouth and tongue
• Cramping and weight gain
• Breast tenderness
• Gastrointestinal disturbances, bloating
• Osteoporosis
• Weak nails
• Increased allergies

Treatment

The changing estrogen levels in the female body produces a range of symptoms, which vary from woman to woman. Hormonal Replacement Therapy was advocated to replace a woman’s declining hormone levels with a prescription hormonal medication. Beginning in the early 1950s, synthetic estrogen and other combinations of hormones were prescribed to postmenopausal women to prevent these symptoms. HRT seemed to have a beneficial effect by reducing hot flashes, increasing bone density, reducing fractures and the incidence of cardiovascular disease. Thus, a long term use of HRT was started for menopausal women.

But in the mid 1970s, several studies on the long term use of HRT produced disturbing results. It was noted that a continued use of HRT in post menopausal women beyond two years produced adverse effects like

• An increased risk of dangerous blood clotting
• An increased risk of heart attacks and strokes.
• An increased risk of breast cancer.
• Deep vein thrombosis
• An increased risk of dementia in post menopausal women over 65 years of age.
• An increased risk of pulmonary emboli in post menopausal women over 50 years of age.

Due to the increased incidence of these dangerous adverse effects, long term use of HRT was discontinued. Doctors now prescribe HRT only to relieve the symptoms of menopause, using the lowest dose of hormones, and for the shortest time possible, depending on the woman’s medical history, health risks and severity of symptoms.

Naturopathic alternatives to HRT

As a result, women who realized the pros and cons of HRT started searching for healthier and safer alternatives. This is where Botanical hormones or Phytoestrogens became helpful. Naturopathy relies on improving the entire body’s health rather than focusing on a specific condition, but this article deals with only the use of Phytoestrogens as an alternative to hormone replacement therapy.

Botanical hormones or Phytoestrogens are plant derived hormones which exert a weak estrogen like effect inside the body without any side effects. Certain cells inside our body have special areas called estrogen receptor sites. Estrogen binds to these sites to produce an effect inside the cell and in the body; Phytoestrogens also bind to the same sites producing a weaker estrogenic effect. However this weaker effect is sufficient to make up the deficit which occurs during menopause.

The four major chemical compounds which act as Phytoestrogens are: isoflavones, lignans, coumestans, and resorcyclic acid lactones. These Phytoestrogens are commonly available in the form of chemical compounds in herbs.

• Isoflavones :are water soluble chemicals containing a special group of Phytoestrogens like Genistein, Daidzein,Glycetein.these are commonly found in foods like soy .The herb red clover contains the isoflavones Biochanin A and Formononetin, which are also strong phytoestrogens.These isoflavones have a beneficial effect by increasing the uptake of calcium into bones, decreasing hot flashes, and decreasing cholesterol levels.
• Lignans: are naturally occurring chemicals widely found in the plant world. They contain several resins-like compounds like Enterolactones, Enterodiol, Secoisolariciresinol, which are phytoestrogeni. Lignans are extremely effective in controlling hot flashes and decreasing the risk of breast cancer after menopause. Lignans are found in large quantities in flax seeds, sesame seeds, linseed meal, cranberries, pumpkin seeds and green tea.
• Coumestans: contain these important phytoestrogenic compounds like coumestrol, 5-methoxy-4'-Omethylcoumestrol, 4'-O-methylcoumestol, sativol, medicagol, 3'-methoxycoumestrol, trifoliol, lucernol
• Resorcyclic acid lactones: This group of Phytoestrogens has a much weaker effect than the other compounds.

Availability

Phytoestrogens are available in three different forms

1. Daily food products rich in Phytoestrogens like soya, whole grains, etc., which can be consumed on a daily basis.
2. Mild food herbs, which can be taken for a limited period as general tonics
3. Phytoestrogenic herbs, which are extremely powerful

1. Phytoestrogenic foods

These PE compounds are found in small quantities in everyday foods. These foods can be eaten everyday while the herbs contain strong amounts of PE which can only be eaten in specific doses for a limited period of time. PE foods are:

• Whole grains (rye, oats, barley, millet, rice, wheat, corn)
• Edible seeds (buckwheat, sesame, sunflower, pumpkin, amaranth, quinoa)
• Beans (yellow split peas, black turtle beans, baby limas, black beans, red kidney beans, red lentils, soy beans)
• Leafy greens and seaweed (parsley, nettle, kelp, cabbage, broccoli, kale, collards, Lamb’s quarter)
• Fruits (olives, cherries, grapes, apples, pears, peaches, plums, strawberries, blackberries, raspberries, salmon berries, apricots, crab apples, quinces, rosehips, blueberries)
• Olive oil and seed oils
• Garlic, onions and their relatives - leeks, chives, scallions, ramps, shallots.
• Soy: soy is a staple food in many Asian countries and is available in many forms like miso, tempeh, tofu, textured and hydrolyzed vegetable protein, meat substitutes, soy flour; soy milk etc.It is one of the richest sources of isoflavones (Genistein and Daidzein). It also contains a rich source of proteins and valuable nutrients. Soy beans are regarded as the primary reason why Japanese women seem to have a lesser incidence of breast cancer. Researchers found that higher concentrations of urinary isoflavonoids decreased the incidence of breast cancer and stomach cancer. These isoflavones also regulate hormone levels and ease menopausal symptoms

2. Mild food phytoestrogenic herbs

There are also a group of mild food herbs which can be used as general tonics. These can be used for a period of three months only to have the best possible effect.

• Citrus peel,
• dandelion leaves and/or roots,
• fenugreek seeds,
• flax seeds, green tea,
• hops,
• red clover,
• red wine

3. Phytoestrogenic herbs

Phytoestrogenic herbs on the other hand are extremely powerful and cannot be used for a long period of time. It is advisable to consult an experienced naturopathic physician before starting on these herbs. A naturopathic physician can provide specific guidance about herbal blends and prescribe the specific dosage required for the individual depending on existing symptoms and previous medical history. The following herbs are commonly used to treat the symptoms of menopause,

• Black Cohosh: this herb contains a large amount of isoflavones (Genistein and Formononetin), Triterepene glycosides (acetin and cimcifugide) and tannins. The isoflavones Formononetin binds to estrogen receptor sites produces a strong estrogen like effect. It decreases the risk of breast cancer and has a strong suppressive effect on hot flashes. It contains the anti-inflammatory salicylic acid which decreases pain sensations.
• Red clover: The herb contains four types of strong estrogens, Biochanin A, Daidzein, Formononetin and Genistein. These are very effective in reducing hot flashes. It also acts as a strong antispasmodic and a mild stimulant. It also contains coumarins which act as vasodilators by increasing the blood supply to the organs and stimulating the nervous system.
• Chaste berry: this herb has been used since ancient times to regulate the female reproductive system. It can regularize monthly periods, ease menstrual pain, treat dysmenorrhea, and reduce hot flashes and mood changes. Chaste berry stimulates and normalizes the female reproductive system by restoring a favorable Estrogen to Progesterone ratio.
• Dong quai: This is one of the most popular herbs used in the Orient to treat the female reproductive system. It has a large range of phytosterols which act on the uterine tissue to relax it and ease cramping. It has a soothing effect on the vaginal mucosa by hydrating it and decreasing the dryness occurring during menopause. It reduces headaches, palpitations, postmenopausal insomnia and uterine pains. It also contains an abundant store of minerals which act as mood stabilizers and tone the liver. It also contains abundant coumarins which act as vasodilators increasing the blood supply to different organs
• Linseed meal: contains a large amount of lignans which decrease hot flashes and the risk of breast cancer.
• Rhubarb: contains the Phytoestrogens lindleyin
• Agaves root
• Black currant
• Black Haw
• Cramp bark
• Devils club root
• Wild yam: this herb was once used to synthesize the hormones used in contraception; it contains a large amount of steroidal saponins and the estrogens Diosgenen, Dioscin which are strong antispasmodics.
• False unicorn root
• Life root herb
• Groundsel herb
• Licorice
• Motherwort herb: It is used to treat headaches, insomnia, palpitations and uterine spasms.
• Peony root
• Raspberry leaves
• Sage leaves: It contains phytosterols which are used to treat hot flashes, sweating and heavy uterine bleeding
• Sarsaparilla root
• Saw palmetto berries: It is used to treat an excess of androgen hormones due to its dihydrotestosterone content
• Yarrow blossoms
• Alfalfa: it is an extremely nutritious herb containing large amounts of vitamins and minerals which have a soothing effect on the body. It also contains a mild amount of phytosterols which help during menopause.
• Ladies mantle
• Family blazing star
• Shepard’s purse
• American ginseng

Conclusion

Even though Western medicine is rapidly evolving and changing, there is a simultaneous increase in healthcare costs. As a result more than 80% of the worlds population cannot afford or do not have access to this type of medicine. Alternative therapy on the other hand is readily available, and more importantly cheap. Most of the herbs being prescribed since ages are proven courses of treatment while many others are being researched. The main basis of any herbal therapy depends on improving one’s diet, lifestyle changes, behavioral changes and exercises rather than the use of expensive medicines, laboratory procedures and surgeries which are painful and fraught with side effects. If recovery is possible using a cheaper and healthier alternative without adverse effects, then that is enough to make herbal therapy an extremely popular option.

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—About our writer: Hazel writes for chillibreeze.

 

 

 

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