Menopause: HRT and Natural approaches

   

Some of you have been asking for advice and inspiration for menopausal women. We’ll always do our best to answer any questions that you have and cover topics that interest you.

In one recent email, I was asked about “foods to help with hot flushes, the consequences of HRT and foods to help”. This article aims to explore the basics of the menopause, and how natural approaches might help.

About the menopause

The onset of menopausal symptoms usually happens in a woman’s mid to late forties (according to the NHS website 1% of women will experience it before the age of 40 and just 0.1% before the age of 30).

As a normal part of the ageing process menopause happens to every woman but the way it affects us can vary from person to person. At the root of menopausal symptoms are hormonal changes particularly a drop in oestrogen which stop ovulation and menstruation.

These can lead to various troublesome symptoms, from fatigue, low libido, stress incontinence and hair loss, to hot flushes – a classic symptom which 70% of perimenopausal women experience.  Weight gain is also a common effect. This may be because our fat cells, especially those in the hips, thighs and lower abdomen, can also produce oestrogen. In response to falling oestrogen levels, the body may act by trying to lay down more fat. Our weight can also be affected by changes in appetite as a result of stress and lack of sleep.

In addition to these dramatic hormonal and physical changes, many women experience emotional changes, including severe mood swings.

Coping with hot flushes

As well as being one of the most common symptoms, hot flushes can also be the most stressful. Cutting down on alcohol and stimulants such as caffeine and hot spices can help, but hot flushes can become a vicious cycle, with episodes brought on by stress too. Gentle exercise such as yoga, or deep breathing meditation, may help you overcome this as well as helping with your sleep patterns.

Should I change my diet?

A diet that is rich in vitamins, minerals and essential fats, and low in refined carbohydrate, will help your body to cope with the hormonal changes related to the menopause. The menus that you find on your meal planner take all of this into consideration by including plenty of fruit, vegetables, oily fish, nuts and seeds.

Should I take HRT?

Hormone replacement therapy (HRT) replaces some of the hormones (oestrogen and progesterone), and is known to help with symptoms such as hot flushes and vaginal dryness. 

A good balanced diet is as important as ever

It was originally promoted as something of a wonder drug; but while it has been shown to help prevent bone fractures, studies suggest that it may increase the risk of cardiovascular disease and dementia if used long-term. According to NHS Choices the benefits far outweigh the risks as long as it is used for no more than five years. There are lots of different kinds of HRT so if you find that one type doesn’t suit you it is worth discussing alternatives with your doctor. HRT can be taken in oral tablet form (most commonly) but is also available as a cream or gel implant patch or injection. Read more about the types of HRT and how each works here. 

Which natural or alternative therapies are effective?

German researchers recently carried out a review study of alternative treatments for menopausal symptoms. They found that acupuncture could be effective in severe cases of hot flushes.

There is strong evidence that isoflavone supplements particularly one called genistein which usually comes from soy beans can also reduce the frequency and intensity of hot flushes. This is thought to be because isoflavones are known as phytoestrogens and have a similar - but much gentler - action in the body to the synthetic oestrogens found in HRT. Isoflavones are also found in red clover supplements.

One supplement containing a mixture of isoflavones black cohosh valerian and vitamin E helped to improve menopausal symptoms overall but the researchers concluded that there wasn’t enough evidence to recommend black cohosh on its own.

There is a theory that agnus castus can help with hot flushes but scientific evidence for this is also lacking.

When looking at the research on alternative therapies it’s important to recognise that when scientists conclude that treatments aren’t effective it is often because there isn’t enough evidence. That doesn’t necessarily mean that they don’t work just that not many well-designed studies have been carried out. Many people find relief from herbal supplements and those noted above are all generally considered safe. Like HRT it is worthwhile experimenting with different supplements to find out if they work for you under the guidance of your doctor or another health professional.

For more information about alternative natural treatments take a look at the website Menopause Matters.

Your experiencesPlease tell us about your own experiences with menopausal symptoms by posting in the Community or emailing us at support@amandahamilton.co.uk. We’d love to hear what approaches you have taken to coping with the effects of the menopause and also what else you’d like more information on. — Burbos N. & Morris E.P. (2011) Menopausal symptoms. Clinical Evidence. — Aidelsburger P. et al. (2012) Alternative methods for the treatment of post-menopausal troubles. GMS Health Technology Assessments. 8:Doc03— Taku K. et al. (2012) Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: a systematic review and meta-analysis of randomized controlled trials. Menopause.19(7): 776-90.— Marjoribanks J. et al. (2012) Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database of Systematic Reviews. 7:CD004143."