Menopause

Many medical textbooks describe the passage: “deterioration,” “estrogen starvation,” or “living decay.”

“It is the end of youth and beauty, and the beginning of uselessness and waste of women.”

“It is a mistake Mother Nature made in designing women.”

“Without medical intervention during or after menopause, a woman’s remaining years will be a pathetic remnant of a life.”

“It is an aging process that women should fight against mightily.”

Listed quotes are probably the reasons why pharmaceutical companies advocate the treatments to menopause.

“It is a difficult transition from reproductive animal to reflective animal.”

“It is a transition to be passed through to naturally emerge with a greater sense of well-being than any other stage of their lives.”

“Menopause, when understood and supported, provides the next level of initiation into personal power for women.”

“The most creative force in the world is the menopausal woman with zest.”

Quotes from above are probably the reasons why in some traditional native cultures, the older women contained great power and scrutinized all tribal decisions.

You choose what you believe. Our clinic believes that “menopause is no more a disease than menarche and it needs medical intervention only if its symptoms are uncomfortable and distressing.”

General Symptoms:

• Hot flashes (85%)
• Night sweats, often leading to sleep disturbance
• Psychological symptoms such as nervousness, depression, insomnia, and mood swings
• Dizziness
• Osteoporosis with risk of fractures (20% by age 85)
• Arteriosclerosis and coronary artery disease
• Weight gain
• An irregular or rapid heartbeat
• Difficulty holding urine
• Vaginal dryness, itching, or other discomfort that can make sexual intercourse painful
• Skin changes such as dryness and increased moles
• Constipation
• Irregular bleeding
• Some other less common symptoms

Physical changes also occur at menopause. They are not listed here because they are less likely to affect daily life or lead to medical complications.

After menopause, the body is prone to a few conditions. The most concerning are osteoporosis and cardiovascular disease, which include thickening of the arteries (atherosclerosis) that serve the heart and limbs, high blood pressure, angina, and stroke. It is very important to adjust your lifestyle to reduce these risks. Prevention is the best treatment.

Increase calcium-rich foods, plant-based foods, high-fiber whole grain foods, omega-3 oil intake, exercise, vitamin D from sun exposure or supplements, and time spent outdoors.

Reduce or stop sugar, refined carbohydrates, salt, trans fat, saturated fat, red meat, animal fat and protein, alcohol, tobacco, soft drinks, and coffee.

The biological basis of menopause is determined by how ovarian follicles are depleted over a woman’s lifetime, a process that begins even before birth. A woman’s lifestyle and dietary habits from childhood onward determine what kind of menopause she is likely to experience.

• Control blood-sugar levels in an effort to reduce hot flashes.
• Take supplements of the 4 ACES (vitamin A/beta carotene, vitamins C and E, and the mineral selenium). These antioxidant nutrients help the body resist the effects of aging while strengthening the immune system.
• Some people use wild yam cream, though clinical evidence does not support its ability to raise progesterone levels in the body.
• Take supplements of the bioflavonoids naturally found in citrus fruit. Take 600 mg, two to three times per day.
• Exercise: Exercise is one of the best things women can do ahead of time to fare better during their menopausal years. Adopt a program of regular exercise, at least 30 minutes, five times a week. Exercise places stress on bone, increasing its density and strength. Women’s bones lose density after menopause at the rate of about 4 to 6 percent in the first four to five years. The stronger they are to start with, the better. Experts suggest that weight-bearing activities such as walking and running are best. Exercise also helps keep your cholesterol levels down, offering protection against heart disease.
• Pay Attention to Your Diet: Eat a nutritious diet low in saturated fat. This will help reduce cholesterol and the risk of heart disease. Experts recommend keeping your fat intake to 25 percent or less of total calories. Emphasize olive oil and avoid hydrogenated oils and most vegetable oils.
• Add Soy Foods To Your Diet: Increase your intake of soy-containing foods, including tofu and soy flour, as well as flax (linseed) oil. Eat a plant-based diet emphasizing plenty of fresh, preferably organic vegetables, whole grains, legumes, nuts, and fruit.
• Increase Your Calcium Intake: While the decrease in bone mass accelerates at menopause, it begins around age 35. After 35, women lose about 1 percent of their bone mass per year. Be sure to consume enough calcium. We recommend 1,000 milligrams of calcium a day for premenopausal women and 1,500 milligrams for postmenopausal women.
• Skip the alcohol and coffee. These beverages can make the blood vessels dilate and worsen hot flashes. Hot and spicy food can have the same effect.
• Try vitamin E. If your hot flashes are not severe, this nutrient could help you have fewer, less intense episodes. The recommended dosage is 400 international units (IU) per day. Consult your physician before taking vitamin E supplements, as high doses may carry health risks.
• Quit smoking. Smokers are more likely than nonsmokers to have menopausal symptoms. Smokers also tend toward lower bone mass, putting them at greater risk for osteoporosis. Smoking can also cause menopause to begin earlier.
• Drink Plenty of Water: Drink about eight glasses of water a day. Staying properly hydrated is important, especially after exercising, and helps keep body temperature in check.
• Learn to Relax: In one six-week study of menopausal women, stress was associated with an increase in the frequency, intensity, and duration of hot flashes in half of the participants. Try meditation or a soothing tub soak. Yoga, meditation, and breath control are also beneficial. In one study, women experiencing frequent hot flashes were trained to slowly breathe in and out six to eight times over two minutes during each episode. They had fewer hot flashes than women trained to use either muscle relaxation or biofeedback.
• Prevent Dryness: The decrease in estrogen that women experience with menopause can cause vaginal dryness. The elasticity and size of the vagina change, and the walls become thinner and lose their ability to become moist. This can make sex painful or undesirable. Use water-based vaginal lubricants such as K-Y Jelly, Replens, and Astroglide. These are available over the counter. Do not use oil-based lubricants such as petroleum jelly, as they do not dissolve as easily in the vagina and can trigger vaginal infections.
• Stay sexually active. Studies indicate that women who stay sexually active experience fewer vaginal changes than those who do not. Sexual activity promotes circulation in the vaginal area, which helps it stay moist. For women without partners, manual stimulation will help promote circulation and moistness.

Food and Estrogen

Some foods are good sources of natural estrogens, while others inhibit estrogen. Understanding how your food affects estrogen metabolism is an important part of managing menopause and PMS. More information about food and diet can be found in our nutrition section.

Foods Containing Natural Estrogens:

A number of different foods and herbs are sources of natural plant estrogens and can be helpful during menopause. The following is a list of some of the best food sources of estrogen. These foods are also high in vitamins, minerals, fiber, and essential fatty acids, and low in saturated fat. They are nutritious and should be part of your diet on a regular basis.

Alfalfa, Animal flesh, Anise seed, Apples, Baker’s yeast, Barley, Beets, Carrots, Cherries, Chickpeas, Clover, Cowpeas (black-eyed peas), Cucumbers, Dairy Foods, Dates, Eggs, Eggplant, Fennel, Flaxseeds, Garlic, Hops, Licorice, Oats, Olive oil, Olives, Papaya, Parsley, Peas, Peppers, Plums, Pomegranates, Potatoes, Pumpkin, Red beans, Red clover, Rhubarb, Rice, Sage, Sesame seeds, Soybean sprouts, Soybeans, Split peas, Sunflower seeds, Tomatoes, Wheat, Yams

For Hot Flashes

Keep a diary of your hot flashes. Hot flashes follow certain patterns. Certain things can trigger them, including hot weather, caffeine, or stress. When you track your hot flashes for a week or two, you may discover what triggers them. Avoid or eliminate those triggers.

• Layer your clothing, putting one lightweight item over another. If you become hot, remove your jacket or sweater.

• Drink a glass of cold water or juice at the onset of a flash.

• Keep a thermos of ice water or an ice pack by your bed at night.

• Wear clothing made of absorbent material, such as cotton. Avoid silk blouses or other clothes that show perspiration stains.

• Place a small fan on your night table or desk. When a flash hits, direct the cool air toward you.

• Take vitamin E supplements. Start with 400 IU of vitamin E a day. Consult your physician before increasing the dose, as high levels may carry health risks. Good sources of vitamin E include vegetable oils, nuts, whole grains, and wheat germ.

• Take GLA (gamma linolenic acid), naturally found in borage, black currants, and evening primrose oil. Dong Quai is known as the “female ginseng.” This herb can help smooth out mood and promote relaxation. Other herbs such as hawthorn berry, yam root, black cohosh, and blue cohosh may also be useful. Please consult a health professional.

• Chinese herbal formulas have demonstrated great effectiveness in reducing hot flashes. They are formulated by a Traditional Chinese Medicine doctor according to each individual’s condition.

• Studies show acupuncture is helpful in treating hot flashes.

• Keep cool. Wherever you spend the most time, do what you can to stay comfortable. Set your thermostat to a comfortable temperature. Keep an electric or hand-held fan nearby. Sit next to the air conditioner or away from heat ducts at meetings or social gatherings. To reduce night sweats, keep your bedroom cool, open windows, and use an air conditioner in the summer.

• Avoid stressful situations. Stress can trigger hot flashes. For help in managing stress, visit our stress management section.

• Cool off with water. Run cold water over your wrists or splash water on your face to cool off. If possible, take a cool shower.

• Perform deep-breathing exercises. If stress triggers your hot flashes, deep-breathing exercises may help alleviate them.

• Watch your diet. Reduce the number of empty calories you consume each day. Fatty foods and alcohol are common sources. These and other foods may trigger hot flashes. While keeping your hot flash diary, be sure to note all the foods you eat each day and watch for those that seem to trigger hot flashes.

• Ask your doctor about HRT.

• Ask your doctor about other prescription medications. There are non-hormonal prescription medications available if you cannot take HRT.

Vaginal/Urinary Tract Infection

Within 4 or 5 years after the final menstrual period, there is an increased chance of vaginal and urinary tract infections. If symptoms such as painful or overly frequent urination occur, consult your doctor. Infections are easily treated with antibiotics but often tend to recur. To help prevent these infections, urinate before and after intercourse, avoid letting your bladder remain full for long periods, drink plenty of fluids, and keep your genital area clean. Douching is not considered effective in preventing infection.

Vaginal Dryness or Irritation:

• Use a simple, nonirritating, nondrying soap. Temporarily set aside any soaps, lotions, or bath preparations that are even slightly irritating or drying.

• When you are at home in the evenings, wear a nightgown, long T-shirt, or other clothing that allows air to circulate.

• Use vitamin E creams made from marigold flower, aloe vera, or Mexican yam for vaginal dryness.

• Avoid alcohol, caffeine, and the antihistamines found in many cold remedies. All three can dry the mucous membranes.

• Stay sexually active. As with any other muscle in your body, lack of use of the vaginal muscle results in diminished tone and decreased flexibility. Without use, eventually the vaginal muscle can shrink. If you have a regular sex partner, your doctor may recommend regular intercourse to support continued lubrication, muscle tone, and sexual health. Women who engage in sexual activity at least once a week tend to maintain better vaginal health than those who do not.

• Sexual arousal produces some natural lubrication by increasing blood flow to the vagina. Any sexual activity, including masturbation, helps improve blood flow to the vagina and keeps tissues supple.

• Use a lubricant. Some women find that using a water-based lubricant during intercourse helps alleviate problems associated with vaginal dryness. Oil-based products should not be used because they tend to coat the vaginal lining and inhibit your natural secretions.

• Avoid using antihistamines unless truly necessary. They dry mucous membranes throughout the body.

Mood Swings

Some women will experience a roller coaster of moods during menopause. This should level out after about a year. You can try the following remedies to manage the emotional ups and downs.

• Passionflower Tea.

Passionflower, along with other herbs such as chamomile, hops, and catnip, has been found to promote relaxation through its effects on the GABA system, which can support sleep and calmness.

• Exercise:

Exercise helps discharge excess adrenaline that many women experience around menopause due to a shift in hormones. Regular exercise may improve your mood by raising endorphins (feel-good hormones that are known to drop during menopause).

• Rest.

Take an afternoon or midmorning meditation break. Sit quietly with closed eyes. Let your muscles go limp and breathe slowly.

• Chinese herbal formulas have demonstrated great effectiveness in calming the mind. They are formulated by a Traditional Chinese Medicine doctor according to each individual’s condition.

• Studies show acupuncture is effective in treating mood swings.

• Support:

Talk to other women who have gone through or are going through menopause. You can help each other cope.

• Stress Management:

Avoid stressful situations as much as possible. Use relaxation techniques such as yoga, meditation, listening to soft music, and massage. See our stress management section for more ideas.

• Diet:

Eat nutritious foods. Check with your doctor about taking vitamin and mineral supplements.

Insomnia:

• Avoid caffeinated drinks and foods late in the day. If you are having trouble sleeping, avoid coffee, tea, caffeinated soft drinks, chocolate, and other caffeinated foods in the late afternoon or evening. Instead, have a glass of warm milk or take a warm bath. If you are having problems with frequent urination at night, decrease the amount of fluids you drink in the evening.

• Keep to a sleep schedule. Go to bed and wake up at the same times each day.

• Try not to nap during the day, or you may not be tired enough to fall asleep at bedtime.

• Meditation or relaxation techniques before bedtime will help prepare you for sleep by releasing tension and clearing the mind.

• Exercise regularly. Daily workouts tire out the body and prepare it for a good night’s sleep. Do not exercise too close to bedtime, as late-night workouts can overstimulate your body and contribute to insomnia.

• Try not to argue or discuss distressing situations right before bed. Give your mind time to wind down from a busy day. If you find yourself watching the clock at night, put it where you cannot see it or remove it from the room.

• Experiment with different pillows and room temperatures to create the most comfortable environment possible. If noise bothers you, try wearing ear plugs. A slightly noisy fan that makes a steady hum can help mask sounds from a television in another room, cars driving by, or dogs barking. You can also purchase sound machines that produce white noise. Get blackout shades, hang heavier curtains, or wear eye shades to block out light.

• Avoid sleeping pills. Although they may work at first, you will eventually build up a tolerance to their effects.

• Some women report that nightly intimacy or simple caressing helps them sleep.

• Watch your diet. The types, amounts, and timing of foods and drinks may prevent you from falling asleep or may awaken you during the night. A diet high in fat, caffeine, and alcohol can alter sleep patterns. Eating a large, heavy, fatty meal too close to bedtime can keep you awake for hours. You should also avoid drinking too much alcohol. While you may fall asleep quickly after consuming alcohol, it can cause you to awaken several times during the night.

• As you age, you become more susceptible to the effects of heartburn. An unsettled stomach can awaken you and make it difficult to fall back to sleep. Keep track of the foods that seem to give you heartburn and avoid them, especially close to bedtime. An antacid tablet or acid blocker before bedtime may help prevent the problem. Some antacids have the added benefit of calcium, a mineral that all women need.

• Relax before bedtime. A hot bath or relaxation exercises may bring about better sleep. Allow some time to read, watch television, or write before heading to bed. If you cannot sleep once you are in bed, do not try too hard. Instead, get up and try some relaxing activities, such as light reading or simple chores.

• Chinese herbal formulas have demonstrated great effectiveness in treating insomnia. They are formulated by a Traditional Chinese Medicine doctor according to each individual’s condition.

• Studies show acupuncture is effective in treating insomnia.

Osteoporosis:

• Engage in regular weight-bearing exercise. The more you require your bones to support your weight, the more likely they are to remain strong. Walking, jogging, aerobics, and dancing are good exercises for the lower body. Light weight lifting will help keep the bones of the upper body strong.

• Eat plenty of calcium-containing foods (such as dairy products) and take calcium supplements if necessary. Menopausal women should get at least 1,500 mg of calcium per day (roughly the amount in a quart of milk).

• Eat foods high in boron, a mineral that helps the body retain calcium. Boron is found in apples, pears, grapes, and other fruit, as well as in legumes, nuts, and honey.

• Make sure you are getting enough of the trace mineral manganese. You will find manganese in pineapples, nuts, spinach, beans, and whole wheat.

• Vitamin D is necessary for the absorption of calcium, so include plenty of vitamin D foods in your diet (such as vitamin D-enhanced milk). Your skin can also make vitamin D when exposed to the sun. Supplements are helpful, but too much vitamin D is dangerous.

• Chinese herbal formulas have demonstrated great effectiveness in supporting bone health. They are formulated by a Traditional Chinese Medicine doctor according to each individual’s condition.

As mentioned, menopause needs medical intervention only if symptoms are uncomfortable and distressing. When symptoms are severe, Estrogen Replacement Therapy (ERT) with or without progestogen (HRT) is most likely to be prescribed by your family physician. This treatment is usually administered continuously over a long period. Due to the potential risks of long-term use, including breast cancer, ovarian cancer, and uterine cancer, some patients may not be suitable candidates for this treatment.

The World Health Organization (WHO) has listed menopause syndrome as one of the conditions treatable by acupuncture. There is also considerable research on the use of acupuncture and Traditional Chinese herbal medicine for menopause syndrome, and these treatments have demonstrated effectiveness without significant side effects.

Numerous studies suggest that acupuncture stimulation desensitizes or reduces activation in cortical areas believed to be involved with pain signal processing, that it regulates hormone, endocrine, and blood vessel activity to reduce pathological inflammation, and that it regulates neurotransmitter activity in the brain.

Most acupuncture points do not hurt because the needles are hair-fine. Patients typically feel a brief mosquito-bite sensation that is subtle for most people. Some points tend to be more sensitive than others, and we take extra care with those to avoid discomfort.

$95/session, $45 consultation. 30-45 minute initial consultation.

Alberta Health Care does not cover acupuncture. Most company benefits cover acupuncture when treatment is provided through a Registered Acupuncturist. Contact your HR department or insurance company for coverage details.

Many people have benefited from acupuncture and Traditional Chinese herbal medicine for menopause syndrome in North America, Europe, and China. It is a reasonable natural modality with the potential to help, especially for those who do not respond well to pharmaceutical drugs. Like pharmaceutical drugs, “it works for many” does not mean it works for you. As for you, there is only one way to find out.