While menopause is a natural process that very woman goes through, the physical and emotional symptoms can affect some women worse than others. Severe symptoms can be challenging to manage, as it is a chronic condition, rather than an acute illness, and needs long term therapy. The onset of menopause leads to discomfort, not only the discomfort brought on by the symptoms, but also the emotional discomfort associated with these changes.
Some women prefer holistic, more natural, options for the treatment of menopausal symptoms and ways to make menopause more manageable, rather than taking drugs for hormone replacement therapy, due to the risks associated with it.
The natural approach to the treatment of the symptoms of menopause works in a completely different way than prescription drugs. While these holistic treatments are more gentler options than drugs, women often are doubtful whether natural treatments would be powerful enough to relieve the severe discomfort of menopausal symptoms.
What is menopause?
Menopause is a natural stage of life that everyone with ovaries will go through during midlife. Menopause is defined as being without a monthly period for 12 consecutive months. The most common symptoms that women in the 40’s starts to notice are changes in menstrual cycles and the onset of hot flashes.
When moving into the menopausal stage of a woman’s life, the ovaries no longer produce high levels of the two hormones estrogen and progesterone. At around the age 50 the ovaries stop producing estrogen, although the adrenal glands and fat tissue continue to produce small amounts of estrogen. According to the Cleveland Clinic, these two hormones are important for the normal functioning of the female body:
- Estrogen plays a role in body functions such as thickening of the lining of the uterus, the way the body uses calcium, assisting in maintaining healthy cholesterol levels, helping to prevent osteoporosis, and keeping the vagina healthy.
- Progesterone plays a role in body functions such as helping to prepare the uterus for the implantation of a fertilized egg, maintaining the early pregnancy, regulating blood pressure, and improving mood and sleep.
Symptoms of menopause:
Women experience menopause symptoms differently, with many experiencing various physical symptoms. These symptoms may start before menstruation ends and can last for several years.
- Hot flashes are a common symptom and feel like a sudden sensation of heat in the upper body: Vasomotor nerves control the dilation and constriction of blood vessels in response to temperature changes in the environment. Low levels of estrogen cause vasomotor instability, which results in hot flashes and night sweats. A hot flush refers to the redness in the face and neck that occurs during a hot flash.
- Vaginal dryness, itchiness, discomfort, and painful intercourse may start before menopause and continue into menopause. Lower hormone levels may also contribute to a reduced or loss of sex drive.
- Sleep disturbances can occur during menopause and may be caused by high levels of anxiety, night sweats, an increased urge to urinate more frequently, or urinary incontinence (leakage) due to weakening of the pelvic floor muscles. Insomnia can occur.
- Many physical changes may develop, such as weight gain and the buildup of fat around the abdomen, changes to hair color, hair loss and thinning, breast reduction and tenderness of the breasts, thinning and decreased elasticity of the skin, and increased facial hair growth.
- Emotional changes are common during menopause, such as anxiety, depression, headaches, mood swings, irritability, tiredness, sadness, and spells of crying.
- As women approach menopause they may experience trouble with concentration and memory.
Holistic treatment for symptoms of menopause.
While some women go through menopause feeling physically and emotionally fine, others are bothered by one or more of the typical symptoms, which can range in severity. Natural treatments can make symptoms of menopause much more manageable, mainly through lifestyle changes.
Dietary steps: Food choices are the most effective medicine that exists. A menopause friendly diet can help to relieve vasomotor symptoms such as hot flashes and night sweats.
Recommended foods for menopause include a balance of the three macronutrients, namely lean protein at every meal, a balance of good fats such as olive oil and avocados, and complex carbohydrates such as vegetables, fruit, and whole grains.
- A balanced Mediterranean diet is recommended for women experiencing hot flashes.
- Soy contains low levels of plant estrogens and although studies in this regard have shown mixed results, the food forms of soy, such as tofu and soy milk, are recommended.
- Ground flaxseed or flaxseed oil contain ingredients which acts as plant estrogens and may help hot flashes in some woman, although studies showed mixed results. The whole flaxseed is difficult to digest and should be avoided.
- Spicey food, alcohol, and caffeine are common triggers for hot flashes. Caffeine and alcohol are diuretics that encourage dehydration, which can aggravate hot flashes.
- Cut back on processed sugar and fat.
- Eat foods rich in calcium (for example Greek yogurt, cottage cheese, tofu) and vitamin D (for example eggs, salmon, sardines and mackerel), as estrogen loss leads to a drop in bone density. Estrogen is important for bone development and bone density. Healthy plant sources of calcium are greens (esp kale) and beans as well as seeds such as chia, sunflower; dried figs and almonds.
- Sunlight touching the skin turns on the natural production of vitamin D, which helps the digestive tract to absorb calcium from food.
- A low sodium diet (no more than 2 grams per day) has been shown to improve bone health in postmenopausal women. As salt is deemed to increase calcium loss via the kidneys, cutting salt intake could reduce the daily calcium requirement.
- Research has shown that ginseng may help with some menopausal symptoms such as mood and sleep disturbances.
Exercise: Regular physical activity is an essential component in the natural management of menopause, as it can help to reduce stress and anxiety. Regular exercise can also improve sleep quality and help to support bone health. For example, yoga combines exercise and mediation in one activity and helps menopause by improving muscle strength and increasing range of movement at joints, while reducing irritability and even hot flashes in some women. Regular aerobic exercise, such as a daily vigorous walk or any other equivalent physical activity, is said to ease hot flashes. Avoid a sedentary lifestyle, as bones that have nothing to do, lose their strength, while physical activity that includes weight-bearing and strength-training exercise, adds to optimal bone health.
Sexual discomfort: Sexual function changes during menopause due to the decreases in ovarian hormone production, with many women experiencing symptoms such as vaginal dryness and a decline in sexual desire and function. Many women prefer to avoid hormone creams and rather counter these changes with hormone-free treatment, such as using water-based vaginal lubricants to ease intercourse and reduce friction when the vagina is dry, while vaginal moisturizers are available without a prescription to maintain vaginal moisture and help keep the vaginal pH low for a healthy vaginal environment. Vaginal health can also be maintained through regular painless sexual stimulation, which promotes blood flow to the genital area.
Emotional changes: For some women menopause is associated with significant levels of stress due to the changes they experience. Depression and irritability are also common for menopausal women. Psychotherapy can be useful in this regard. A few stress reducing practices, for example yoga, meditation, and deep breathing exercises can promote relaxation and may help to manage emotional symptoms such as mood swings and anxiety, or even panic attacks. It helps to know that the psychological effects of menopause, including occasional memory lapses and poor concentration, are temporary.
Lifestyle changes: A few other changes in your lifestyle may help to ease menopausal symptoms, such as to quit smoking, keeping body weight at a healthy level, and to drink no more than one alcoholic drink per day.
Hormone replacement therapy:
Hormone replacement therapy utilize drugs to treat symptoms of menopause and may not be for everyone, depending on factors such as age, personal medical history, and severity of menopausal symptoms. Hormone therapy is used to boost hormone levels and relieve some of the symptoms of menopause, but is associated with certain benefits and risks.
There are two main types of hormone therapy, namely where estrogen is taken alone, usually after a hysterectomy, or a combination of doses of estrogen/progesterone is usually prescribed for women who still have a uterus.
Benefits of hormone therapy include the relief of menopausal symptoms, such as hot flashes, vaginal dryness, and night sweats, while also having a reduced risk of developing osteoporosis and reduced risk of breaking a bone. It can also improve mood and a sense of wellbeing in some women.
Risks of hormone therapy, according to the Cleveland Clinic, include the following:
- An increased risk of endometrial cancer (cancer that forms in the tissue lining the uterus) in women who still have their uterus.
- Increased risk of breast cancer with long-term use.
- Increased risk of blood clots, stroke, and gallbladder/gallstone problems.
- Increased risk of dementia if hormone therapy is started after midlife, but with a reduced risk if hormone therapy is started during midlife.
The last item is of particular concern, as the results of a major nationwide study in Denmark, recently published in BMJ (British Medical Journal 2023), found that “menopausal hormone therapy was positively associated with development of all cause dementia and Alzheimer’s disease, even for short term usage around the age of menopause onset.”
The medical records of Danish women aged 50 t0 60 without a prior history of dementia were used in this study to determine the effect of hormone replacement therapy on their mental health. The study found that estrogen-progestin therapy posed a 24% higher risk after the first year of developing dementia and Alzheimer’s disease, and the longer the duration of therapy, the higher the risk of dementia, with an increased risk of close to 75% for those who have used hormone therapy for more than 12 years.
In this study exposure to menopausal hormone therapy with estrogen and progestogen were linked to an increased rate of all cause dementia, late onset dementia, and Alzheimer’s disease. However, treatments with progestogen only and vaginal estrogen were not associated with the development of dementia.
Conclusion:
When dealing with the discomfort of the symptoms of menopause, the easy option seems to be to take prescribed medication in the form of hormone replacement therapy. But be aware there are risks associated with hormone therapy that may affect some women.
The less easy option is to find the self-discipline to opt for holistic treatment through lifestyle changes to avoid or reduce the severity of the symptoms of menopause in a natural way. Managing menopause symptoms holistically is a gentle, natural, and effective way that also promotes overall health and well-being.
References:
Menopausal hormone therapy and dementia nationwide, nested case-control study. Published 28 June 2023. The BMJ. (International research journal.) (www.bmj.com)
Natural remedies for hot flashes. Published online. The North American Menopause Society. (www.menopause.org)
Five solutions for menopause symptoms. Published online. The North American Menopause Society. (www.menopause.org)
How do I know when I am in menopause. Published online. The North American Menopause Society. (www.menopause.org)
Holistic approaches for symptom relief for menopause. Published via email 25 March 2023. Naples Vitality. Florida. USA. (www.naplesvitality.com)
Holistic care of menopause: Understanding the framework. Published July 2012 in the journal Midlife Health. V.3(2); July-December 2012. PubMed Central. National Centre for Biotechnology Information. US National Library for Medicine. National Institutes of Health. USA. (www.ncbi.nlm.nih.gov)
A natural approach to menopause. Published online. Physicians Committee for Responsible Medicine. USA. (www.pcrm.org)
5 Steps for natural menopause symptom relief. Published online and updated 12 January 2022. Women’s Health Network. USA. (www.womenshealthnetwork.com)
6 Ways to find relief from your menopause symptoms. Published 19 October 2022. Cleveland Clinic. (www.clevelandclinic.org)
Hormone therapy for menopause symptoms. Reviewed 28 June 2021. Cleveland Clinic. (www.clevelandclinic.org)
What are hot flashes? Reviewed 3 July 2022. WebMD. (www.webmd.com)
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