Menopause

Menopause is a normal biological event marking the end of a woman’s reproductive years. It is defined by complete absence of menstruation for one year. While the age at which a woman enters menopause is variable, the average age in the US is 51. Because the ovaries reduce their production of female sex hormones, including estrogen, during menopause, many of the following symptoms occur most commonly:

  • Irregular menstrual cycles — menstrual bleeding slows, becomes erratic, and then stops permanently (the process can take four years)
  • Hot flashes — flushing of face and chest (may be accompanied by heart palpitations, dizziness, headaches)
  • Night sweats
  • Cold hands and feet
  • Headaches or migraines
  • Vaginal changes — dryness, itching, bleeding after intercourse
  • Urinary changes — frequent urination, burning during urination, urinating at night, incontinence
  • Insomnia
  • Mood changes — depression, irritability, anxiety, tension (usually occurring with sleep disturbances)
  • Loss of skin tone leading to wrinkles
  • Weight gain and change in weight distribution, with increased fat in the central abdominal area

Over time, depleted estrogen levels can contribute to the development of more serious medical conditions, including the following:

  • Osteoporosis
  • Cardiovascular disease
  • Alzheimer’s disease
  • Macular degeneration
  • Glaucoma
  • Colon cancer

Chinese medicine and menopause

Recent research published in the Journal of the American Medical Association showed that HRT (hormone replacement therapy) may lead to an increased risk of heart disease, breast cancer, stroke, blood clots, gallstones and gallbladder disease. Because of the risks and side effects associated with HRT, more and more women are turning to Chinese medicine for the treatment of menopausal symptoms. Acupuncture and Chinese herbs are natural therapies, offering significant relief from the debilitating symptoms women often experience as they go through menopause, without the risks associated with conventional treatment.

Acupuncture enhances endorphin release, and may improve mood, reducing feelings of anxiety, depression and fear, in menopausal women (87%), according to a 1993 study. Acupuncture also balances the hormones via signaling along the hypothalamus-pituitary-ovarian axis, and can relieve hot flashes.

Chinese herbs have demonstrated their effect on the endocrine system via numerous in vivo and in vitro studies. They may help to alleviate hot flashes, improve vasomotor instability, prevent loss of bone mass, and reduce many other symptoms associated with menopause, without the risks of hormone replacement therapy.

In addition to dietary therapy, the following preventive measures may help diminish symptoms and reduce the risk of diseases prevalent in post-menopausal women:

Quit smoking — Smokers tend to begin menopause a year or two earlier than nonsmokers; smokers are also at increased risk of heart disease and osteoporosis.

Taking calcium supplements helps protect against bone loss.

Exercising slows the rate of bone loss, reduces hot flashes, and improves mood.

Consuming lowfat diets helps prevent cardiovascular disease by decreasing LDL “bad” cholesterol and by lowering the chances of weight gain.

Taking certain medications (such as estrogen or non-hormonal medications) prevents longterm negative effects associated with menopause, such as osteoporosis.

Avoiding caffeine — Some studies suggest that caffeine consumption may increase the risk of osteoporosis in postmenopausal women.

Western treatments for menopause

There are many medications available in the form of natural and synthetic hormones (estrogen and progesterone) to treat the symptoms of menopause. The use of these is commonly referred to as hormone replacement therapy (HRT).

Hormone replacement therapy (HRT) — The purpose of hormone replacement therapy is to supply the body with an external source of hormones, including estrogen and/or progesterone. While there are numerous forms, Premarin (conjugated estrogen) and Provera (medroxyprogesterone) remain the most popular brands.

Estrogen — Studies indicate that estrogen may help to reduce hot flashes, vaginal dryness, improve cholesterol levels, and slow bone loss. Women who take estrogen may be at lower risk for Alzheimer’s disease, colon cancer, and macular degeneration. There are, however, side effects like bloating, nausea, and breast tenderness associated to increasing estrogen in the body. Studies also indicate that estrogen increases the risk of developing breast cancer, gallbladder disease, asthma, liver disease, blood clots, stroke, and uterine cancer.

Progesterone reduces the risk of developing uterine cancer by causing monthly shedding of the endometrium. Typically progesterone is prescribed in combination with estrogen in women that still have a uterus. Progesterone is available in synthetic form (progestins) and in natural form. Both can have side effects such as increased cholesterol levels, edema, weight gain, and bleeding.

Biphosphonates for osteoporosis include alendronate (Fosamax), etidronate (Didronel), pamidronate (Aredia), tiludronate (Skelid), and risedronate (Actonel). These substances treat osteoporosis primarily by blocking the loss of bone mass. Biphosphonates such as alendronate (Fosamax) may increase bone density by 5% to 10%, if taken daily for three years continuously. Side effects of these drugs include nausea, diarrhea, esophageal irritation, and esophagitis. Laboratory studies show that the use of these drugs is associated with the development of cancer (thyroid adenoma and adrenal pheochromocytoma).

SERM (selective estrogen receptor modulator) — Raloxifene (Evista) works by facilitating the utilization of calcium for proper bone maintenance and prevention of osteoporosis. It is contraindicated in patients with liver problems.

Clonidine (Catapres) relieves hot flashes by stabilizing the blood vessels via binding to alpha-adrenergic receptors. Clonidine is rarely prescribed, because it has significant side effects, such as postural dizziness, blurred vision, first-dose syncope and withdrawal hypertension.