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Alternatives to hrt

MagazineJune 2002 (Vol. 13 Issue 3)Alternatives to hrt

Most of the problems associated with menopause can be alleviated simply by improving your overall health

Most of the problems associated with menopause can be alleviated simply by improving your overall health. Building on a foundation of a varied wholefood diet, you could try to:


* Seek out support. The social context in which a woman ages has a great deal to do with her experience of menopause (J Women Aging, 1999; 11: 57-73; Maturitas, 2000; 35: 11-23). Expectations of disease, degeneration and menopause as a medical condition can sometimes become self-fulfilling.


* Remember your adrenal gland. If your adrenal gland is healthy, it will continue to supply your postmenopausal body with a form of oestrogen. Continual high levels of stress will cause the adrenals to atrophy (shrink). Also, when under stress, the adrenal gland is too busy producing the stress hormone cortisone to produce other useful substances.


* Supplement - with more than calcium and vitamin D. Make sure you are getting enough potassium (2-3 g daily) and pantothenic acid (vitamin B5, 25-100 mg daily), either in your diet or through supplements. Low levels of vitamin B5 can result in fatigue, headache, sleep disturbances, nausea and abdominal discomfort. Your body needs adequate amounts of vitamins C and B6 as well as zinc and magnesium for the adrenal gland to manufacture its hormones.


* Take boron. This is helpful in preventing postmenopausal osteoporosis as it stimulates the body to produce more of its own oestrogen (J Trace Elem Exp Med, 1992; 5: 237-46). Low levels of boron have been associated with an increased risk of atherosclerosis and a decline in cognitive function (Biol Trace Elem Res, 1997; 56: 273-86; Environ Health Perspect, 1994; 102 [Suppl 7]: 65-72).


* Consume more fish oil. Evidence suggests that including more fish oils in the diet can alleviate some of the more common perimenopausal problems, such as painful menstruation, bloating, headaches, nervousness and irritability (Nutr Res, 2000; 20: 621-32). If you are taking HRT, supplementing with fish oils may counteract the rise in triglycerides, but you need to take around 4 g daily (Am J Clin Nutr, 2000; 72: 389-94). Such high levels may cause stomach upset, fishy odour, increased bleeding time and weight gain. To avoid these effects, you may prefer to get your oil from dietary fish sources such as salmon, mackerel and herring.


* Check your thyroid. An underactive thyroid is common in women over 60 (Arch Intern Med, 2000; 160: 526-34). Complications of low thyroid function - osteoporosis, high cholesterol, fatigue, weight gain, constipation, dry skin, brittle hair and menstrual irregularities - can be confused with menopausal 'symptoms'.


* Find the cause of your 'symptoms'. Hot flushes, for example, can be triggered by dietary factors such as hot cups of tea and whiskey (J Urol, 1989; 64: 507-10). Removing these from the diet can decrease the incidence of hot flushes by as much as 50 per cent. Quitting smoking, avoiding spicy foods, and reducing or eliminating such foods as yeast, dairy and wheat can have a dramatic effect on a whole range of vascular symptoms - from hot flushes to migraine headaches.


* Stay active. Just about every menopausal symptom, including osteoporosis, diabetes, and risk of stroke or heart failure, can be reduced through daily physical activity. Recent evidence suggests that women who exercise at least 30 minutes a day cut their risk of breast cancer by 10 per cent; one hour a day cuts the risk by 20 per cent (Arch Intern Med, 1999; 159: 2290-6). Weight-bearing exercise can increase bone mineral density (BMD) in premenopausal women by 14-37 per cent (Lancet, 1996; 348: 1343-7). Postmenopausal women who engage in weight-bearing exercise can increase lower spine BMD by 6 per cent (Ann Intern Med, 1988; 108: 824-8). Although exercise has only a modest effect on bone mass, women who engage in some form of regular exercise generally have better balance and overall health, and a 50-70 per cent reduced risk of hip fracture (Epidemiology, 1991; 2: 1625; BMJ, 1989; 299: 889-92).


* Consider herbs - carefully. Remifemin, a standardised extract of black cohosh, can relieve hot flushes, depression and vaginal atrophy. Although it is popularly thought of as a phytoestrogen and does have oestrogenic effects, studies show that its action is more complex than that (Planta Med, 1991; 57: 420-4). While it inhibits the secretion of luteinising hormone (LH) by the pituitary gland, it does not appear to affect the pituitary release of prolactin or FSH (follicle-stimulating hormone). Researchers conclude that if remifemin were simply an oestrogen mimic, these hormones would also be affected.


* Try acupuncture and homoeopathy. Acupuncture has been shown to be effective in relieving vascular-related symptoms, such as hot flushes, with effects lasting for up to three months after stopping treatment (Lakartidningen, 1994; 91: 231-22; J Altern Complement Med, 2001; 7: 651-8). Likewise, homoeopathy has long been used to treat flushing, poor sleep, irritability, depression, decreased libido and heart palpitations (Complement Ther Nurse Midwifery, 1997; 3: 46-50; Huisarts en Wetenschap, 1993; 36: 414-5).


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