The Menopause

All women experience the menopause, a natural change in the female reproductive system which normally takes place between the ages of 45 or 55.  The word menopause specifically means the end of periods, but it is the falling level of the sex hormones oestrogen and progesterone in the body as the ovaries stop working that results in the physical and emotional problems we associate with this phase of women’s lives.

Some women experience few or no problems. Others suffer a great deal for several years. The menopause often coincides with the emotional upheaval of children growing up and leaving home, causing women to feel a loss of identity and focus.

Hot flushes and night sweats are two well-known physical symptoms of this temporary hormonal imbalance – working women in particular often say they find hot flushes very embarrassing, though they are not usually obvious to anyone else. Periods may become irregular, heavier or lighter before they stop entirely. Other side-effects are general tiredness and depression, irritability, broken sleep, and memory lapses, and a lack of interest in sex.  Vaginal dryness can make sex very uncomfortable and you may be more susceptible to vaginal and urinary infections.  Some of these symptoms may occur before periods stop, so it is advisable to have a hormone test once a year from the age of 45 so that any appropriate action can be taken.

All these symptoms are temporary and treatable, but the long-term effects of declining hormone levels include greater risk of osteoporosis and heart disease for some women.

THE ORTHODOX APPROACH

Hormone replacement therapy (HRT) is a comprehensive treatment for the symptoms associated with the menopause, regarded as deficiency disorder by conventional medicine.  H.R.T. replaces some of the hormones that your body is no longer producing with a combination of oestrogen and progestogen or oestrogen alone.  It can be taken in the form of pills, as a cream applied to the skin, as a patch, or it can be implanted.  There are dozens of different preparations now available; some promote a monthly bleed, others do not.

H.R.T. can be taken as soon as symptoms of the menopause, such as hot flushes and vaginal dryness, appear and can, in theory, be take indefinitely.  But H.R.T. is still considered to be controversial and it is not recommended that women take it for any length of time.  Some undoubtedly find it a convenient “one stop” solution to the problem of hot flushes, night sweat, and vaginal dryness.  Staunch advocates regard it as an “elixir of youth”, claiming that it improves the appearance of skin and hair and gives a sense of well-being.  But many women complain of side-effects such as weight gain, hair loss, headaches, tender breasts and water retention.  Recent research also indicates an increased risk of breast cancer.  On the other hand H.R.T., helps protect against osteoporosis and the post-menopausal risks of heart attacks and strokes.

Anyone who has had breast or womb cancer or fibroids is not advised to take H.R.T.

Quite apart from H.R.T. there are conventional treatments available for specific problems.  Your doctor may prescribe a drug containing clonidine hydrochloride for hot flushes and there are a number of gels and pessaries containing oestrogen to combat vaginal dryness.  A vaginal lubricant may also help.

THE HALE APPROACH

Menopause is a natural progression, not a disease, and therefore does not require treatment.  If the symptoms are unpleasant, complementary therapies should be tried first, with orthodox measures such as H.R.T. used only as a last resort.

Menopause is one of the most important “passages” a woman has to face in her life. Particularly in the West, it can be a time of great unease, discomfort, and uncertainty, or a time to value and respect the past and go forward positively with a body which has adjusted to this new state and with a mental/emotional outlook which is looking forward to experiencing this new cycle in a woman’s life.

Many people view the menopause as starting with hot flushes and changes in the pattern or heaviness of periods.  They are not always aware of the pre-menopausal state which starts about five years before the onset of the “real thing”.

As most menopause starts around the age of 50, the average time for pre-menopause is 45.  At this time you could start having mood swings and other symptoms without realizing that you are in pre-menopausal state.  The Hale Clinic would advise women from about 45 onwards to have yearly hormonal tests to ascertain whether hormonal changes have already started. If this is the case, the treatments used for the “menopause proper” will also be great assistance during the pre-menopausal years.

In addition, good nutrition, exercise and massage to promote good circulation and reduce stress levels can help prepare the body and mind so that the “the passage” becomes much easier.

The closest complementary treatment to H.R.T. would be a combination of herbal remedies which contain phyto-estrols, which mimic the role of oestrogen, thereby preventing the menopausal symptoms (although periods will stop eventually).

Trichology and Oxypeel treatments can help any external effects on the hair and skin caused by the menopause.

Osteoporosis screening is also recommended to assess bone density; advice on future courses of action would be given on the basis of the results.

Finally, because the menopause can be such an important time of change in a woman’s life, the Hale Clinic would highly recommend counselling or psychotherapy to assist a woman in integrating this new cycle into her life, and from there approaching the future with an awareness of the many opportunities it can bring.

NATUROPATHY

Herbalists have for centuries used certain plants to treat menopausal symptoms.  Now we know that several of them contain phyto-estrols, which stimulate hormone levels, acting as a mild, safe form of H.R.T.  A naturopath explains: “Phytoestrols are compounds that have a molecular structure similar to that of oestrogen and have effects comparable to, but weaker than oestrogen. This offers the benefits of conventional H.R.T. without the well-known attendant risks”.

Celery, fennel, ginseng, and alfalfa are among the many plants and herbs that contain these compounds. Extract of rhubarb root and hops are also particularly rich sources.  These active oestrogen like alternatives can easily and safely be taken by most women and are effective in treating the effects of hormonal imbalance. 

Herbal mixtures of black cohosh, blue cohosh, dandelion, dong quai, and agnus castus may be prescribed for hot flushes and night sweats.  These work primarily on the liver, which controls the release of hormones in the body.   More about naturopathy...

ACUPUNCTURE

The changes of the menopause affect the functions of the liver and kidneys which regulate the hormonal balance in the body.  “In Chinese medicine the kidney is ‘water’ and the liver is ‘fire’ or ‘wood’”, explains one acupuncturist.  “When these get out of balance the water function becomes sluggish and the heat, the liver function, is too dominant, resulting in the irritability, anxiety, hot flushes, water retention, and other symptoms of hormonal imbalance women experience at menopause”.

Acupuncture aims to rebalance the body by stimulating the kidney function, increasing the energy flowing through this pathway. It may be used in conjunction with Chinese herbs, which will be prescribed for use at home.  Treatment with acupuncture takes about half an hour and 7 to 10 fortnightly sessions are recommended to get the full benefits. More about acupuncture...

PSYCHOTHERAPY

The hormonal changes of the menopause are frequently associated with a number of psychological problems such as depression, loss of confidence and self-esteem or feelings of acute self-doubt and eating problems.  Psychotherapists believe that hormonal changes are part of the cause of these problems, but many are due at least in part to the stage of life.  Women may be particularly vulnerable when their children leave home, an event which often coincides with the menopause.  “Often you find that they are faced with feelings, problems and insecurities they had many years ago that were effectively submerged while they were bringing up a family but now come to the surface again”, explains one psychotherapist.

Talking to a psychotherapist should help you understand your reactions and feelings through examining your past; you can then start challenging your behaviour.  Developing new attitudes and becoming more conscious of the way you react to stressful situations can help overcome many of the emotional difficulties associated with the menopause.  More about psychotherapy...

HOMEOPATHY

Homeopathic treatment for the menopause aims to help your body adapt to change.  Change is inevitable, but it needn’t be disruptive.  Advice should be sought as soon as periods become irregular so that the effect of the inevitable hormonal changes – hot flushes, irritability and sleep disturbance – are managed and contained.  Treatment starts with an assessment of the individual’s overall health and personality and may include a blood test to check hormonal levels.

Septia, Belladonna and Agnus castus are among the natural remedies prescribed to combat menopausal symptoms.  Calc carb, Gelsemium and Graphites may be prescribed for hot flushes.  There are also treatments to counteract the side-effects of H.R.T. and to help women who want to stop taking it without suffering the return of menopausal symptoms. More about homeopathy...

NUTRITION

Menopausal problems can be exacerbated by poor eating habits developed over a long period.  Re-establishing a healthy diet with a wide range of fresh foods is of prime importance.  Leafy greens, soya products, and broccoli should play a major part in your diet; intake of red meat and caffeine should be reduced.  In general, guard against having too much protein in your diet, since this is believed to rob the body of calcium and other essential nutrients.

“There may be vitamin and mineral deficiencies in the diet and a good multi-vitamin program designed for the individual will include supplements of selenium, Vitamin E, and Vitamin C”, is the view of the nutritionist, who also believes that many of the psychological problems experienced at menopause may be due to poor nutrition.

Examining not just what you eat but the way you eat is crucial.  Taking smaller meals throughout the day rather than leaving long gaps between meals maintains blood sugar levels and helps fend off nervousness and low energy.

An initial consultation with a nutritionist will take about an hour and your therapist will work out a diet and supplement plan for you to follow at home.  More about nutrition...

SELF-CARE/TIPS

•           Spicy foods, hot drinks and alcohol can all trigger hot flushes.

•           A Vitamin E capsule inserted into the vagina each day is an effective treatment for dryness.

•           Avoid powerfully scented soaps or vaginal sprays: these may irritate the vaginal area, which his often more sensitive at menopause.

•           Weight-bearing exercise such as brisk walking will build up bone density and improve circulation, which is of benefit during pre-menopause and menopause.

SUPPORTIVE THERAPIES

Maya Abdominal Massage: A non-invasive massage technique that specialises in treating gynaecological and digestive conditions.  It improves organ function by relieving congestion, enhancing blood supply; increasing lymphatic drainage and aiding nerve supply to the pelvic and reproductive organs. Further Details

Osteoporosis Screening:  This is a simple test for measuring bone density. It can identify early signs of bone loss, establish a “base” for future reference and suggest strategies for building up bone density.

Remedial Yoga: Learning to relax and keep the body supple are important in restoring and maintaining an equable and confident approach to life.

Healing: Feelings of fatigue and lethargy can be helped by healing, which works to put energy back into the body.

Hypnosis: Hypnosis can reassure and empower the unconscious mind to intervene, balance and harmonize the body’s natural rhythms.

Chi Kung: Exercises can help counteract specific symptoms of hormone imbalance and make you feel more in control.

Trichology: There a number of scalp therapies and treatments for hair loss due to hormonal changes.  These aim to improve circulation and stimulate follicular cell activity.