Natural Choices for Menopause

By Laura Kovalcik, D.O., The Downing Clinic

THE CHANGE

Women want solutions that are safe and that work. Often they suffer from hot flashes, mood changes, vaginal dryness, depression, bone loss, heavy and irregular periods, tender breasts, fluid retention, fatigue, thickening waistlines, poor sex drive, mental dullness, and just not feeling like themselves. They want vigor and youthful feelings again.

Starting around age 40, women may begin to have symptoms from hormone changes. During the 50’s, periods stop and hormone levels fall. Menopause begins when there is no period for a year. It is one of life’s great transitions, a marker for the end of fecundity. Some women breeze through it while others suffer emotional and physical upheaval.

TRADITIONAL HRT

For years, physicians obligingly prescribed strong prescription hormones to help reduce symptoms. Most often Premarin and Provera were prescribed. Premarin (made from pregnant horse urine) is many times stronger than human estrogens. Provera (synthetic progesterone substitute) does not protect the breast the way natural progesterone does. When The Women’s Health Initiative study in 2004 showed increased risks of breast cancer from these hormones, many women simply stopped taking them. Often they felt wretched, but neither they nor their physicians knew there were safer options. Bio-identical hormones have been safely used since the 1980’s, and herbal phytohormones have been around for generations.

BIO-IDENTICAL HRT

Three estrogens, and one progesterone, are made by the body. The estrogens are E1, estrone; E2, estradiol; and E3, estriol. When used for hormone replacement, Mexican wild yam or soy provide ring structures that are then completed in the lab to the same identical molecules the body produces. Hence, the term bio-identical hormones.

Estriol is a weak estrogen that competes for binding sites with the two stronger estrogens; estradiol and estrone. When estriol is on a receptor, it keeps the stronger two estrogens from stimulating that receptor. During reproductive years, estrogen is balanced by progesterone in a cyclic fashion. Whereas estrogen stimulates breast and uterine tissue to proliferate, progesterone opposes these effects.

Balanced human hormones speak to receptors in harmony with nature while artificial substitutes are unbalanced and send different and often harmful messages.

MOTHER NATURE DID IT RIGHT!

Jonathan Wright, M.D. first prescribed these same-as-the-body-makes hormones in the 1980’s for treatment of menopausal symptoms. Dr. Wright used estrogens in a balanced fashion mimicking Mother Nature. He always added progesterone to oppose and balance the estrogens. Dr. Wright used these bio-identical hormones for more than 20 years, treating thousands of women, and didn’t see an increase in breast cancer among his patients.

When a woman asks her physician for bio-identical hormones, she will receive a prescription for estrogen balanced with progesterone. Many different dosage forms exist, including capsules, creams, gels, troches. Often other hormones are used, including testosterone, DHEA, and pregnenolone. There is a wide variation in proper doses and needs for individual women, and risk factors need to be evaluated whenever hormones are used.

A key part to managing hormone therapy is routine hormone testing. This helps identify when one of the many hormones is out of balance – which will present symptoms.

HERBS

Women often seek herbal options such as black cohosh, damiana, false unicorn root, vitex agnes casti, dong quai, blue cohosh, red clover, licorice root, red raspberry leaf, motherwort, maca or sage to help with menopausal symptoms. Many of these herbs are active at the estrogen and progesterone receptors, but they are much weaker than the actual hormones. Some women combine herbs with bio-identical hormones, a good choice for women in their 60’s or 70’s. Other women rely upon established homeopathic formulas such as pulsatilla or sepia to help with symptoms. Today’s women have many good choices!

Looking and feeling great also depends upon a good diet along with physical exercise and time out for stress reduction and personal reflection. Women choosing fresh foods, lots of greens, colorful fruits and vegetables, nuts, seeds, olive oil, fish, poultry, lean meat, and whole grains, will fare the best. Especially helpful are flax seed, soy foods, leafy greens and the broccoli family.

Women today can truly live the poem written by Elizabeth Barrett Browning, “Grow old along with me, the best is yet to be; the last of life for which the first was made.” The natural choices available today combined with a healthy lifestyle will reward you with a truly enjoyable time of life.

Dr. Laura Kovalcik is board-certified in internal medicine. Her work at the The Downing Clinic focuses on internal and integrative medicine and bio-identical hormones and natural menopause treatments. She graduated from Michigan State University School of Osteopathic Medicine and completed her internship and residency at Genesys Regional Medical Center.