Nightsweats. Dryness. Pain and mood swings. They’re all symptoms of menopause that can make life miserable, affecting roughly 40% of women who’ve been through this milestone. Are there solutions? You can try hormone replacement therapy (HRT). Or you can try their natural alternatives.
HRT is a system of medical treatments designed to mimic the effects of estrogen and progesterone – two hormones that level off during menopause. They both play a key role in health and sexual functioning during a woman’s reproductive years, which in part explains how HRT can alleviate some menopause symptoms and make the process more comfortable.
So what’s the catch? Well, a 2002 study found that HRT may increase risk of breast cancer and heart disease, among other ailments. Worse, a follow-up British study found that HRT heightened risk of endometrial (womb) and ovarian cancer. The findings were enough to make two prominent American health organizations warn against HRT for menopause symptoms. Sales have yet to recover.
Of course, you’re not without hope during this transitional stage of the female anatomy. Ever heard of black cohosh or red clover? We’ll discuss them shortly, and several other natural alternatives to HRT, that may soften the blow of those dreaded symptoms.
About HRT
Estrogen and progesterone both line the uterus and prepare it for possible implant of a fertilized egg. Estrogen also influences how the body uses calcium, which is important for bone health and healthy cholesterol levels in the blood.
As menopause approaches, the ovaries produce less of these female sex hormones, which can trigger hot flashes, decreased interest in sex, dryness and other symptoms of menopause, including risk of osteoporosis.
Hormone replacement therapy is designed to reduce menopause symptoms with either:
Estrogen Therapy – In which the patient supplements with estrogen alone, with a daily pill, patch or cream.
Progesterone/Progestin-Estrogen Hormone Therapy – Sometimes called ‘combination therapy’, this option combines estrogen and a synthetic form of progesterone, called progestin. Combination therapy can cause monthly bleeding, in which case, estrogen and a lower dose of progesterone, taken continuously, may be appropriate.
Women who pursue HRT and still have their uterus should use the combination therapy treatment because estrogen without progesterone can increase risk of endometrial cancer.
Don’t Do HRT If…
You have active breast cancer or history of it. The same goes for women linked to endometrial cancer, abnormal vaginal bleeding, blood clots, history of stroke, liver disease or pregnancy.
Smokers should try to quit the habit before doing HRT as well.
Sales of HRT prescriptions plummeted in 2002 when researchers published their findings from the Women’s Health Initiative study, in which they found that women who did the estrogen/progestin treatment were more likely to experience heart attack, stroke, blood clots and breast cancer.
Two subsequent studies, including the Million Women Study, conducted by British researchers in 2006, confirmed these links and added two more cancer risks to this already concerning series of risks from HRT.
Some medical experts take issue with how researchers conducted the studies. They note, for example, that most of the study participants were caucasian, former smokers and slightly overweight. And in March 2013, South African researchers published a review of the three studies in the Journal of Family Planning and Reproductive Health Care, in which they claimed the link to breast cancer is tenuous.
Women who pursue HRT and still have their uterus should use the combination therapy treatment because estrogen without progesterone can increase risk of endometrial cancer.
Still, it’s a discerning link. We know that HRT can increase risk of endometrial cancer, blood clots and stroke in some women. Knowing that, it’s not a huge leap from there to conclude the link between HRT and breast cancer is more than noteworthy.
Having reviewed this information, speak with your doctor if you’re still interested in HRT. He knows your medical history and can best recommend your strategy from there. Even then, he’ll likely recommend a low dose and for the shortest time possible.
You’ve got another option too: treat menopause symptoms naturally, without HRT. A wise choice if you’re in this camp, and it starts with the foods that end up on your plate.
The Menopause Diet
Menopause is a biological milestone in a woman’s body. You might alleviate symptoms during and after this momentous occasion with dietary patterns including:
Up your calcium intake – Calcium tends to trail off during menopause, which in part explains why women are at higher risk of osteoporosis. Aim to eat and/or drink four sources of calcium each day, whether that’s dairy, fish with bones, broccoli or legumes, among others. Women above 51 should aim for 1,200 grams of calcium each day.
Eat more iron – Like calcium, iron levels fall during menopause, making it important to get at least three iron servings each day. Sources of iron include lean red meat, poultry, fish, eggs, nuts and green leafy vegetables. Your daily target: 8 mg.
Fibre – It’s hard to go wrong with fibre-rich foods like whole grain breads, cereal, pasta, (brown) rice, fresh fruits and vegetables. Try for 21 grams each day and you’re much less likely to experience digestion problems too.
Read the labels – Check the labels of packaged foods to help you buy more nutritious foods for a healthy lifestyle.
Drink water – Aim for eight glasses of water each day. This meets the needs of most adult women while factoring in variables like daily calories consumed, activity levels and climate.
Keep a Body Mass Index (BMI) between 20 and 24 – This gets more difficult with age, but do try, because it will affect menopause symptoms. Reduce portion size if necessary, or cut back on high fat foods rather than skipping meals. Speak with your doctor or a dietician for more information.
Limit high fat foods – As a general rule of thumb, fats should comprise 25%-35% of your diet, with saturated fats limited to 7% because they raise unhealthy cholesterol levels and increase risk of heart disease. Try to keep cholesterol to 300 mg daily while you’re at it, and severely limit (or abstain from) trans fats.
Watch the sugar and salt – Excessive sodium can raise blood pressure. Smoked, salt-cured and charbroiled foods aren’t much better because they contain high levels of nitrates, which are linked to cancer.
Limit alcohol – Keep alcohol consumption to one drink per day.
Black Cohosh: A Natural Alternative to HRT
The menopause diet is a good place to start and should at least reduce menopause symptoms. Now, do you want natural alternatives to HRT? Try black cohosh root.
You might’ve heard of this tall, flowering plant before. Native to eastern North America, native Americans have used black cohosh for at least 200 years to ease menstrual cramps and symptoms of menopause. Natural health enthusiasts have caught on too; it’s now approved by the German government as a natural menopause treatment, and sales are brisk in the United States.
Research shows a beneficial effect between black cohosh and menopause. Early German studies reveal that it improved both physical and psychological symptoms, including dryness, hot flashes, night sweats and anxiety. In one study, of 120 women, black cohosh was more effective at reducing night sweats and hot flashes than the antidepressant Prozac.
Studies are back and forth with black cohosh. Some have found little benefit, and the American College of Obstetricians and Gynecologists (ACOG) claims that many of the early studies were poorly designed and don’t explore use of black cohosh root beyond six months.
Nonetheless, the proof is there. Clinical studies show that black cohosh root can reduce menopause symptoms at least on a short-term basis. Even ACOG, the same organization that criticizes some of the earlier black cohosh studies, recognizes its value as a natural menopause treatment.
You can buy black cohosh root as capsules or tablets, liquid tinctures, extracts or dried root to make a tea. The recommended daily dose for black cohosh root is between 40-80 mg per day. Look for tablets standardized with 1 mg of 27-deoxyactein. Or alternatively, buy it in a natural libido pill for women like Provestra.
To make a black cohosh tea, put 20 g of the dried root in 34 oz of water. Boil the water, then let simmer for 20-30 minutes until the liquid is reduced by a third. Then strain, cover and store it in the refrigerator or a cool place. Drink black cohosh tea three times daily.
Red Clover, Probiotics and a Few Others
As well, red clover might be a good natural remedy for menopause symptoms, according to research published in the Journal of the British Menopause Society, in which researchers found this isoflavone reduced bone loss, improved cardiovascular health and may offer protection from breast and endometrial cancer.
Red clover might also reduce hot flashes in perimenopausal and menopausal women. In one eight week study, women who took a 40 mg red clover supplement each day reported a 58% lower incidence of hot flashes, with reduced severity of night sweats as well.
The red clover supplement, Promensil, is available over the counter and without a prescription.
In one eight week study, women who took a 40 mg red clover supplement each day reported a 58% lower incidence of hot flashes, with reduced severity of night sweats as well.
You can also try probiotics. The Lactobacillus acidophilus and Bifido strains are the ‘good’ bacteria that live in the intestines. They establish balance in the gut and kill dangerous microflora, but they also assist with metabolism and help the body use estrogen. Some experts believe they also reduce yeast infections. Get probiotics from food and supplements.
Finally, consider a book written by pharmacist Steven G. Ottariano, Medicinal Herbal Therapy: A Pharmacist’s Viewpoint, in which he discusses the many vitamins and minerals he believes can help women treat menopause symptoms. Among his favorites? Vitamin E, Dong Quai, Evening Primrose Oil and Ginseng.
Resources For Menopause
Of course, you’re not alone in this journey. Menopause symptoms – those severe enough to make women consider HRT – affect most women at some point during this time of immense change. This being the global village that it is, you might find the following internet resources can help you reduce symptoms, preferably without HRT, for smooth sailing to the next phase of your life:
WebMD – WebMD has a little something for everyone. Their menopause section is particularly extensive.
Women’s Health Initiative – The group that championed the first large-scale study of HRT and its health risks, the Women’s Health Initiative remains at the forefront of HRT research and safety. You can learn more about the study and the most recent developments on their website.
Prevention – We can’t finish an article on natural alternatives to HRT for women without mention of the kings of natural health. Prevention magazine has a great section on menopause. Check out their article, 14 Natural Remedies for Hot Flashes.
