Menopause

Description

Menopause marks the permanent cessation of menstruation. It is usually preceded by a gradual decline of the menstrual process; physiologic menopause is the normal decline in ovarian function due to aging.

Changes usually begin between the ages of 40 and 50 and is normally complete near age 55, at which time it is referred to as climacteric, the point which denotes the end of the woman's reproductive ability. Pathologic menopause, or premature menopause, is the gradual or abrupt cessation of menstruation before age 40. Severe infection and reproduction tract tumors are common causes of this condition. Both types of menopause may be accompanied by hot flashes, weakness and, in some cases, mental disease.

Treatment of menopause does not cure the condition; it is directed only towards the symptoms.

Causes

The primary cause of menopause is the decrease in estrogen levels due to declining ovarian function. Pathological factors, which may increase the chances for early onset, are:

Psychological Factors
Stress

Physical Factors
Vasomotor instability
Genital atrophy
Infection
Tumors of the reproductive tract
Malnutrition
Debilitation
Excessive radiation
Surgical procedures which impair the ovarian blood supply

Signs & Symptoms

Psychological Factors
Anxiety
Irritability
Depression
Apprehension
Decreased concentration abilities
Lack of confidence
Insomnia

Physical Factors (specifically occur during onset)
Decrease in amount and duration of menstrual flow
Spotting
Episodes of amenorrhea and polymenorrhea

Other Physical Symptoms
Increased frequency of urination
Burning sensation during urination
Stress incontinence in the urinary tract
Dryness in the vagina
Hot flashes
Excessive perspiring, especially night sweat
Pounding heartbeat
Joint pains
Headache
Itching skin
Loss of skin elasticity and turgor
Increased facial hair
Decreased armpit and pubic hair
Decreased breast size
Onset of osteoporosis, since estrogen is involved in
calcium resorption in bones
Atherosclerosis (relation unknown)

Nutritional Supplements

Structure & Function: Women's Health

---------------------------------
General Supplements
---------------------------------

	Adult
Bioflavonoid	100 - 500 mg
Brewer's yeast	2 - 5 tsps
Calcium	400 - 600 mg
DHEA*
EPO	1 - 3 g
Magnesium	200 - 300 mg
Vitamin B-6	10 - 100 mg
Vitamin C*
Vitamin E	200 - 800 IU
Indole 3 Carbinol*

* Please refer to the respective topic for specific nutrient amounts.

Discussion:-

The most novel item on this list would probably be the multi-hormone: DHEA. For menopausal patients this could probably be obtained through prescription. It may also still be available over-the-counter at some health food stores, while the health food store would also, most likely, have the natural version from the Mexican wild yam (diascorea) which comes as a cream.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

No special dietary measures are prescribed for menopause. Menopausal women have nutritional requirements similar to those of younger women with one exception - when menstrual blood loss has ceased there is a decreased need for dietary iron.

A Dietary Goals Diet provides ample nutrients for building a sound and disease-resistant body. A woman who is in peak physical and nutritional health can cope with the endocrinal changes of menopause, as well as the physiological changes associated with aging.

Homeopathic Remedy

1. Lachesis mutus tinct. - 30C or 30X long term
2. Manganum aceticum - 30C or 30X long term
3. Sanguinaria canadensis - 30C
4. Amylenum nitrosum - 30C

Advanced, by symptom:

1. Low libido - Sepia.

2. Weight gain and panic attacks - Calcarea carbonica

3. Suspiciousness, tendency to talk too much - Lachesis mutus tinct..

Hot Flash (Menopause)

1.* Sulphur - 30C
2.* Sepia - 30C
3.* Sanguinaria canadensis

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

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Herbs
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Menopause - Female

Black Cohosh Root (Cimicifuga racemosa)
Buchu
Dong Quai (Angelica)
Sage (Salvia officinalis)
Vitex
Wild Yam Plant (Dioscorea villosa)

Vaginal lubrication

Slippery Elm Bark

Andropause - Male

Ginseng
Sarsaparilla

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Panax Ginseng and Sarsaparilla, together, may help to rebalance male hormones.

Black Cohosh Root (Cimicifuga racemosa) extracts show as much as 80% response rate in the varying symptom complexes of (female) menopause.

Herbalist, David Winston, offers some specific symptoms:

Black cohosh	Hot flashes due to low estrogen with muscle
	aches, headaches, osteoarthritis and nervousness.
Dong Quai	Hot flashes with constipation, vaginal dryness and
	fatigue.
Sage	Hot flashes with sweating & night sweats.
Vitex	Hot flashes with a sense of "skin crawling", dizziness and
	depression.

He also mentions both Black and Blue cohosh as being useful for uterine fibroids.
        
Dr. Tori Hudson has paired a number of botanical therapies with frequently reported ailments associated with menopause:

Anxiety	Kava kava
Cardiovascular disease	Hawthorn
Depression	St. John's wort (Hypericum)
Insomnia	Valerian
Irregular bleeding	Vitex (as well as Black cohosh)
Memory loss	Ginkgo biloba
Nausea	Ginger
UTI	Buchu

        
Chinese herbs are increasing in popularity in the West. They may be taken singly, or in combinations. They are also being added to Western compound formulas.

Dong Quai
Vitex

Newall has compiled a list of hormonally Active Herbs:

Herb	Effect
Agnus Castus	Hormonal imbalance disorders
Alfalfa	Estrogenic, in vivo
Aniseed	Estrogenic
Bayberry	Mineralocorticoid
Cohosh, Black	Estrogenic
Fucus	Hyper-/hypothyroidism reported.
Ginseng	Estrogenic, human
Horseradish	May depress thyroid activity
Licorice	Mineralocorticoid activity, human.
	estrogenic in vivo, in vitro
Motherwort	oxytocic
Pleurisy Root	Estrogenic
Red Clover	Estrogenic in vivo
Saw Palmetto	Estrogenic and anti-androgenic in vivo,
	human use in prostate cancer.
Vervain	Inhibition of gonadotrophic activity
Wild Carrot	Estrogenic

Zava has divided foods, herbs and spices between estrogen and progestin bioactivity:

Estrogen	Progestin
Soy	Oregano
Licorice	Verbena
Red clover	Turmeric
Thyme	Thyme
Turmeric	Red clover
Hops	Damiana
Verbena

Slippery Elm Bark was used as a vaginal lubricant by the Oklahoma Seminole tribe.

References:

Duker, E.M. et al., Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med. 57 (5) (1991): 420-424.

Howard, JH & Lena, W: Oklahoma Seminoles: Medicines, Magic and Religion. U OK Press, 1984.

Hudson, T: Gynecology and Naturopathic Medicine: A Treatment manual., 2nd Ed.T K. Publications, Beverton Oregon. 1992.

Hudson, T et al., A pilot study using botanical medicines in the treatment of menopausal symptoms. National College of Naturopathic Medicine and Bastyr University of Natural Health Sciences, 1994.

Hudson, T: Naturopathic specific condition review: menopause. The Protocol J. of Botanical Medicine, Spring, 1996.

Winston, D: Eclectic specific condition review: menopause. The Protocol J. of Botanical Medicine, Spring, 1996.

Zava, DT: Estrogen and progetsin bioactivity of foods, herbs and spices. Proc. Soc. Exp. Biol. Med. 1998, 217:369-378.

Aromatherapy - Essential Oils

Angelica Essence	Basil Essence,
Chamomile Essence,	Cardamom Essence,
Clary Sage Essence,	Cypress Essence,
Jasmine Essence,	Lavender Essence,
Melissa Essence,	Rosemary Essence,
Sage Essence,	Sandalwood Essence,
Thyme Essence.

Related Health Conditions

Aging
Atherosclerosis
Bleeding
Depression
Hot flash
Menstruation
Itching

Abstracts

References

Adera T et al., Premature menopause and low back pain. A population-based study. Ann Epidemiol, 1994 Sep, 4:5, 416-22.

Albala C et al., Obesity as a protective factor for postmenopausal osteoporosis. Int J Obes Relat Metab Disord, 1996 Nov, 20:11, 1027-32.

Anderson JJ: Calcium, phosphorus and human bone development. J Nutr, 1996 Apr, 126:4 Suppl, 1153S-8S.

Beeson, P.B. & Mc Dermott, W. eds. 1975. Textbook Of Medicine. 14th ed. Saunders Pub. Co., Philadelphia. 1892 pp.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Blatt, MHG et al., Vitamin E and climacteric syndrome: failure of effective control as measured by menopausal index. Arch. Intern. Med. 1953, 91:792.

Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide. William Morrow and Company Inc., Pub. 594 pp.

Dawson-Hughes B: Calcium and vitamin D nutritional needs of elderly women. J Nutr, 1996 Apr, 126:4 Suppl, 1165S-7S.

Duker, EM: Effects of extracts from Cimicifuga ravemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med. 1991,57:420-424.

Farrell, P.M. & J.G. Bieri. Megavitamin E Supplementation in Humans. American Journal Of Clinical Nutrition, 28. 1975.

Felson, D. T. et al: The Effect of Postmenopausal Estrogen Therapy on Bone Density in Elderly Women. New England Journal of Medicine, October 14, 1993;329(16):1141-1146.

Gozan, HA: The use of vitamin E in treatment of the menopause. NY State J. Med. 1952, 52:1,289.

Hamilton, H.K. ed. 1982. Professional Guide To Diseases Intermed Communications Inc. Pub, Springfield, Massachusetts. 1323 pp.

Harris SS et al., Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr, 1994 Oct, 60:4, 573-8.

Heinerman, John. 1982. Herbal Dynamics. Root of Life, Inc.: Publ.

Hextall A & Cardozo L: Managing postmenopausal cystitis. Hosp Pract (Off Ed), 1997 Jun 15, 32:6, 191-8.

Howard, JH & Lena, W: Oklahoma Seminoles: Medicines, Magic and Religion. U OK Press, 1984.

Jiu LJ: The effect of tochu bark on bone metabolism in the rat model with ovariectomized osteoporosis. J Nutr Sci Vitaminol (Tokyo), 1994 Jun, 40:3, 261-73.

Knight, DC & Eden, JA: A review of the clinical effects of phytoestrogens. Ob. Gyn. 1996, 87:897-904 (review).

Kryzhanovskii, G.N. et al: A-Tocopherol-Induced Activation of The Endogenous Opioid System. Bulletin of Experimental Biology and Medicine, November 1989;108(11):566-567.

Lane, J.D. et al: Menstrual Cycle Effects on Caffeine Elimination in the Human Female. European Journal of Clinical Pharmacology, 1992;43:543-546.

Li Z et al., Effects of gender and menopausal status on plasma lipoprotein subspecies and particle sizes. J Lipid Res, 1996 Sep, 37:9, 1886-96.

Lutz, J. & H.M. Linkswiter. Calcium Metabolism in Post-menopausal Women. American Journal Of Clinical Nutrition, 34. 1981.

Mannisto S et al., Body-size indicators and risk of breast cancer according to menopause and estrogen-receptor status. Int J Cancer, 1996 Sep 27, 68:1, 8-13.

Palmer, J. R. et al: Reproductive Factors and the Risk of Myocardial Infarction. American Journal of Epidemiology, 1992;136(4):408-416.

Panotopoulos G et al., Menopause, fat and lean distribution in obese women. Maturitas, 1996 Aug, 25:1, 11-9.

Penland, J. & Hunt, J.: Diet Related to Menstrual Symptoms,/Nutritional Status and Menstrual-Related Symptomatology. FASEB Journal, 1993;7:A379.

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