Menopause

What is the menopause?

Although recently being endowed with all sorts of myths and fantasies, the menopause is for women a normal natural time of their life, just as infancy, puberty and the fertile years. Menopause literally means the last menstrual period but is now taken to mean the transition time or climacteric, when women gradually become infertile. Of practically all animal species, humans alone outlive their ability to reproduce. In fact a woman may spend ONE THIRD of her life after the menopause. It is not appropriate for women to write themselves off - getting older does not equal being useless or that life is over. This time is important and can be viewed as an opportunity for change for the better.

In fact the climacteric years are often a time of looking forward to some personal fulfilment. As children grow older, become independent and maybe leave home, a woman can feel fewer ties binding her to previous responsibilities. She may see more potential professionally - and her finances are sometimes less restricted. Opportunities lie ahead.

These years do however represent a time of CHANGE, and as human beings we are naturally resistant to any change. If changes such as the birth of a baby, or a holiday can be stressful, how much more is an internal change, and one which happens over a period of time? As always, Nature provides, because that time gives us the opportunity to adapt, just as the nine month period of pregnancy allows our body and mind to prepare as well as giving time for physical development of the baby.

I would emphasise that the menopause is NOT an illness. It has been described (often by male doctors) as a deficiency disease where the woman is short of oestrogen (as a Diabetic is short of insulin) but at best this description is an over simplification and at worst it is an insult. The menopause is a process and has many positive advantages. Some (and only some) women experience some adverse symptoms during their Menopause, and some of these may be connected with a reduction in oestrogen. Often doctors see only the women who are having problems and therefore the bias of their attitude towards the Menopause becomes one of seeing the medical problems as all inclusive, and connecting some normal symptoms of ageing and psychological adjustments to this process.

Hormone Replacement Therapy

Doctors never see the 15% to 20% of women who have no symptoms ever at all, except that their menstrual periods stop. The conventional response and one which is promoted avidly by the pharmaceutical companies is Hormone Replacement Therapy (HRT). HRT has a place but I believe it is presently over prescribed and is often accepted readily as an easy option because women are unaware of some of the risks it poses.

Here are some considerations :-

• HRT is marketed as a 'natural' oestrogen but in fact comes from the urine of mares and is therefore more natural for horses than women
• HRT is also marketed as a 'youth drug' but oestrogen cannot reverse or slow the ageing process. Ageing creates the menopause, not the other way round
• Studies have shown that taking oestrogen can lead to an increased risk of endometrial cancer, breast cancer, gallbladder disease and hypertension
• Side effects of HRT include breast tenderness, weight gain, pelvic pain, vaginal bleeding, leg pain, digestive disorders (nausea/vomiting), recurrence of allergies, headaches, fluid retention and depression

There may be a place for HRT. I suggest it may be appropriate for a woman experiencing severe problems, who is informed about the risk and who, with her doctor, can make a calculated decision that the benefits outweigh the risks. She may however, wish to try some complementary or alternative approaches first.

Hot Flushes

Hot Flushes seem to be the most consistently recorded unpleasant symptom of the menopause. The flushes vary immensely between women - from the occasional flash of heat to drenching sweats as often as every half hour. Often stress can make these flushes worse. There are various self-help measures, some of which may seem to be common sense approaches. It is important to value yourself enough to try out these options and see which suit you best.

It helps to :-

• wear natural fibres, especially cotton and to wear several layers so that it is easy to adjust clothing to suit body temperature
• check ventilation. Open windows and/or use an electric fan
• relax as much as possible particularly as you feel a flush approaching. Practise breathing exercises to help you relax
• let the flush pass over you as a wave. By fighting it the symptoms seem worse (as happens when you try to resist a wave when standing in the sea)
• cut out all stimulants - e.g. tea, coffee, alcohol, spicy foods and SUGAR. This will also improve the rate of absorption of vitamins and minerals from your gut and so improve your general health too
• stop smoking
• check your stress levels and learn to say 'No'. When you are under pressure the hot flushes are aggravated
• try a Vitamin E supplement. Vitamin E is best absorbed with Vitamin C and Selenium. Combined formulae are available over the counter but avoid yeast based Selenium. An increased intake of vegetable oils, nuts, seeds, soya and lettuce will also help. NB Do not take a Vitamin E supplement if you are already taking anticoagulant drugs (e.g. for a thrombosis or a pulmonary embolism). If you are diabetic, take Vitamin E with caution as it may reduce the need for insulin and could therefore precipitate a hyperglycaemic attack
• try Ginseng, which provides some oestrogen in plant form and has some effect in stimulating natural production of oestrogen in your body
• take a plant oestrogen - Phytoestrol - to be found in rhubarb, hops, soya and celery. Japanese women on a low fat diet and eating plenty of soya products were found to have up to 1000 times more oestrogen in their urine than American women. The Japanese also suffered less from hot flushes. Phytoestrol is also available in tablet form from some supplement companies
• take Bach Flower Rescue Remedy in water. Especially for night attacks have a glass of water by the bed with four drops of Rescue Remedy in. Carry a bottle with you in your handbag

The flushes WILL subside and will eventually stop coming altogether. In fact it is not directly true that a lack of oestrogen has caused the flushes. It may be more of a withdrawal effect. Where a woman is born with no ovaries, or in a girl whose ovaries are removed before puberty, they experience no hot flushes at all - except if they are given oestrogen supplements for more than one year. In that case, on stopping the supplement the woman will experience hot flushes. It is therefore a reasonable working hypothesis that the flushes are actually withdrawal symptoms following a reduction in the woman’s own oestrogen levels. It could only perpetuate the problem to give oestrogen.

Osteoporosis

Another concern of menopausal women is Osteoporosis. Again myths abound.

In fact :-

• HRT only gives significant higher bone mineral density if taken for over seven years, and possibly for a minimum of ten years
• on stopping HRT the bone mineral density declines quickly, so that by the age of 75, even having taken HRT for at least ten years, the density is only 3.2% higher than in those women who had never taken oestrogen
• women are most at risk of hip fractures in their 80's. Yet women take HRT in their 50's, so they are being 'protected' when they are least at risk! To stay on HRT for life increases the other risks (especially of cancers)

There are many self-help measures to help guard against risks of osteoporosis :-

• Exercise is the most important single helpful measure. It must be a form of weight bearing exercise (i.e. not swimming which can help with general fitness, but is not ideal support for your bones). It is suggested that the need for sensible exercise actually increases with age. Regular exercise can help overall health and fitness, reduce the risk of infections and increase bone density. A study of women aged 32-78 years, who performed only 30 SECONDS of daily exercise (hand grips) showed a significant increase in bone density after only six weeks
• Diet matters. Cut out junk food, reduce fat and protein intake. Since calcium is needed to metabolise protein, the more protein you eat, the more calcium may be leeched from your bones. Vegetarians are less at risk of osteoporosis than meat eaters, so choose to eat less meat (or none) and eat more vegetables. (3½oz of cooked spinach contains 600mg calcium, 3½oz Tofu contains 507mg calcium)
• STOP SMOKING, which helps in all areas of our health
• supplements must be in an absorbable form - e.g. calcium lactate/gluconate/sulphate and orotate. You may also need a digestive supplement of Hydrochloric Acid (e.g. Acidol pepsin or Muripsin available on the NHS) and magnesium to help the absorption of calcium. The best ratio is 2 of Magnesium to 1 of Calcium, together with sunlight to ensure adequate Vitamin D. Too much calcium can lead to kidney stones. Therefore do not take calcium supplements if there is a family history of stones or of hyperparathyroidism

Depression

You do not have to be menopausal to be depressed or forgetful. It can happen at any age and may happen more often or more readily to some people. It is true however that adjusting to a different time or stage in our life, growing to see our potential or aims in different ways, can put emotional pressure on women - on top of the social pressures which are already ever present. This is where counselling can help, whether with a professional or on a more informal basis, even as a regular opportunity to get together with a good friend to have a moan (not a wallow). A homeopathic consultation also gives you the opportunity to review your life and how you manage your stress levels.

Bach Flowers

Bach Flower remedies are particularly helpful as they work purely on the emotional level, helping to balance and give a more positive slant to self destructive emotions. It is safe to choose remedies for yourself, and the remedies are readily available but you may prefer to spend an hour with a professional practitioner examining your feelings, discussing and choosing a blend of remedies.

Bach remedies which may be particularly helpful are :-

• Walnut - for times of change and to help readjust at milestones in our life
• Larch - to help boost our self belief where we lack confidence
• Olive - for feelings of complete exhaustion, where we have no reserves of energy left so cannot enjoy our life
• Rescue Remedy – is a great support when we need ‘rescuing’ emotionally. It is a good idea to carry a bottle with you

Homeopathy

As well as the self-help measures and nutritional suggestions already mentioned, Homoeopathy has much to offer and at a personal consultation, a professional homeopath will consider you as a person with individual symptoms and will take a holistic view rather than just focus on isolated symptoms.

An experienced homeopath will choose a remedy which best matches the symptom picture you present. There are many remedies to choose from. The homeopath's responsibility is to choose the exact simillimum for each patient.

Whatever approach a woman finally chooses to take towards her Menopause, and there are many positive avenues to explore, let her stride forward with confidence in herself and her future. This Change can truly be a Change for the Better.

References

Biology of Women - Ethel Sloane
Your menopause - Myra Hunter
The Change - Germaine Greer
A Woman's Guide to Homoeopathic Medicine - Dr Trevor Smith
Materia Medica - Boericke
What Doctor's Don't Tell You - Volume 4 No's. 9 and 10