You can avoid the risks of HRT and ease all the bugbears of menopause with this ancient remedy, says Harald Gaier
I am a very fit 49-year-old, but I think I've started my menopause, which is a real game-changer! Although I still get my periods (somewhat erratically), I now get sudden hot sweats and my skin flushes and turns quite puce. That can happen at any time, but it seems to be more frequent at night. I've also become weepy-I burst into tears at the silliest things, which I never used to do. I've also developed odd joint pains that come and go.
On top of it all, I have become forgetful and sometimes downright confused. When I'm driving I suddenly don't know why I'm going to wherever I'm heading or, worse yet, I've simply forgotten where I'm supposed to go! My eyes, my mouth and my vagina also seem to have become dry recently, which affects my blinking, my speech-because my tongue sticks-and makes intercourse unacceptably painful. I don't want to go on HRT because I'm aware of the increased risk of breast and ovarian cancer. Is this going to get worse when my periods finally stop? What's the best natural way out of my dilemma?
Hazel, Romsey, Hants
It definitely sounds like you're starting the menopause, Hazel. For most women, going through the 'change' is no fun at all, but there is a simple solution in natural medicine that can ease you through the transition.
Every now and again plants in common domestic use prove to have some genuine medicinal qualities as well. This is true of rhubarb (Rheum rhaponticum). Research has shown that the roots (and only the roots) of this common plant contain biochemical substances (in particular, rhaponticin) that, while not being plant hormones, nonetheless resemble human female hormones enough to engage with oestrogenic receptors and so re-trigger your own oestrogen production, which went into 'retirement' with the onset of menopause. For centuries, parts of this and other common plants (hops, for instance, found in beer) have been used traditionally and effectively to treat various kinds of female complaints.1
Apart from Humulus lupulus (the common hop), over the 40 years of my practice I've compared the effects of a number of popular natural menopausal herbal remedies with rhubarb root. Those remedies have included blue cohosh (Caulophyllum thalictroides), dong quai (Angelica sinensis), red clover (Trifolium pratense), evening primrose (Oenothera biennis), black snakeroot (Cimicifuga racemosa) and wild spikenard (Asarum europaeum), all of which have published studies testifying to their effectiveness. But every single time, I have found rhubarb root to be more reliable and more effective when it came to menopausal distress like yours.
Rheum rhaponticumis the locally grown rhubarb with fleshy stems that can be stewed like fruit; it originated in Asia and came to Europe via the Ottoman Empire (now Turkey). Historically, a powder was made from its root-like stem,2 and given to women starting menopause to take over a long period of time.
As it happens, surprisingly high amounts of calcium are found in rhubarb.3 When combined with regular vitamin D2 (calciferol) intakes, it can help to protect against osteoporosis, which so often affects postmenopausal women.
As a bonus, it's also a great tonic for the stomach and restores a healthy appetite to those who no longer feel like eating.4 Its slow, gentle action in increasing peristalsis makes it useful for those who suffer from haemorrhoids5 and, in China, it has even sometimes been used to treat high fever.6
Other vegetables and herbs that contain smaller amounts of substances similar to human oestrogen include anise, celery, fennel, ginseng, alfalfa, red clover, lucerne and liquorice.7
It has been noted, though, that although women take hormones to ease menopausal symptoms, "both synthetic and natural oestrogens may pose significant health risks, including the risk of cancer, gallbladder disease and thromboembolic diseases (stroke, heart attacks and so on)".8 Happily, rhubarb has not been associated with these side-effects.9
As well as being a substantial source of calcium, rhubarb root also contains zinc and magnesium in reasonable amounts, along with vitamins B6 and B3 (niacin),10 all known to be involved in women's hormonal health. Niacin is essential for the synthesis of female oestrogen, while magnesium deficiency contributes to premenstrual tension syndromes and vitamin B affects your neurotransmitters.
What's more, interactions between vitamin B6 and oestrogen receptors have long been confirmed by experimental studies. Zinc is known to help restore regularity to erratic menses.11
It's also been established that when administered at medium-sized doses, rhaponticin promotes the release of luteinizing hormone releasing factor (LH-RF) in your brain's hypothalamus, leading to an increased production of luteinizing hormone (LH), which stimulates ovulation, in the pituitary gland. Yet in the gland itself, such an outpouring of LH is slowed by such 'medium' doses of rhaponticin and, as a direct consequence of this, the LH reservoirs in the pituitary become filled to the brim.
In contrast, very low doses of rhaponticin don't impede the gland's outpouring of LH. This means that these small doses can instead maintain a healthy balance between central nervous stimulation (via your hypothalamus in the brain) and the release of LH from the pituitary (or hypophysis).
German gynaecologist Manfred Mettenleiter studied the adverse effects of stopping oral contraception after years of taking it and discovered that women who'd had period problems or premenstrual tension before taking the Pill and those who'd been symptom-free all experienced problems. Mettenleiter sorted out these complaints by introducing a 'medium' dose of 4 mg of rhubarb root daily for a week before a woman's period started, and these problems were generally allayed.12
In one review, German doctor Gerhard Gerster found that rhubarb root is an all-purpose female hormonal treatment:13
o it corrects the loss of periods in cases of established oestrogen deficiency
o it significantly eases the painful periods associated with a uterus with an underdeveloped inner lining (endometrium)
o it inhibits the production of breast milk following stillbirth
o it is an ideal first-line treatment for endometrial inflammation caused by oestrogen deficiency
o it mitigates again oestrogen withdrawal symptoms after a full hysterectomy
o it alleviates all symptoms of the menopause.
In my view, rhubarb root offers all the benefits of conventional HRT without the well-known side-effects.14 Those joint pains of yours, another sign of oestrogen deficiency, should also respond well.
The rhubarb root preparation I like to use-a popular remedy called Phytoestrol N, made by the M"uller G"oppingen pharmaceutical company in Baden-W"urttemberg, Germany-has been used since the 1950s. This standardized combination of 4 mg of rhubarb root and 90 mg of hops has had more than half a century to reveal its effects in those who have taken it-all with no evident ill effects.
Ask your naturopath or medical herbalist to prescribe Phytoestrol N for you. But remember that you'll need monitoring, as you are still having your periods and there may be various other features in your condition that require careful tweaking of the dosage.
1. Culpeper N. Culpeper's Complete Herbal. London: W Foulsham & Co (undated reprint): 192
2. Willdenow KL. Grundriss der Kr"auterkunde zu Vorlesungen entworfen. Vienna: Ghelenschen Schriften, 1799: 119
3. Willard TL. Textbook of Modern Herbology. Calgary, Alberta, Canada: C.W. Progressive Publishing, 1988: 94
4. Wren RC. Potter's New Cyclopaedia of Botanical Drugs and Preparations. London: C.W. Daniel Co., 1985
5. Kadans J. Encyclopaedia of Medicinal Herbs. New York, NY: Arco Publishing Co., 1973: 172-3
6. Mabey R, ed. The Complete New Herbal. London: Elm Tree Books, 1988: 98
7. J Ethnopharm, 1980; 2: 337-44; Indian J Med Res, 1970; 58: 99-102; Br Med J, 1980; 281: 1100
8. Pizzorno JE, Murray MT. Textbook of Natural Medicine, vol 2 (section VI: Osteop_5). Seattle, WA: John Bastyr University Publications, 1987
9. J Pharm Pharmaceut Sci, 2005; 8: 374-86
10. Kirschmann JD, ed. Nutrition Almanac. New York, NY: McGraw-Hill Book Company, 1979: 216-7
11. Mindell E. Earl Mindell's Vitamin Bible. New York, NY: Warner Books Inc, 1981: 84
12. Fortschr Med, 1980; 98: 498-500
13. Zschr angw Phytother (J Appl Phytother), 1981; 111: 1-8
14. Menopause Int, 2011; 17: 63-5
Harald Gaier, one of the UK's leading experts on alternative medicine and a registered naturopath, osteopath, homeopath and herbalist, practises at
The Allergy and Nutrition Clinic, 22 Harley Street, London. Visit his website at www.drgaier.com.
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