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Menopause didn't really come into vogue as a topic of concern for the medical profession until the 1960s. In 1966 a New York gynecologist, Dr. Robert Wilson, wrote a best seller called Feminine Forever, extolling the virtues of estrogen replacement to save women from the "tragedy of menopause which often destroys her character as well as her health." His book sold over 100,000 copies in the first year. Wilson energetically promoted menopause as a condition of "living decay".
According to him, estrogen replacement was a kind of long sought-after youth pill that would save poor, fading women from the horrors of age. He popularized the erroneous belief that menopause is a deficiency disease. Women's magazines eagerly seized upon his ideas and extensively promoted his concepts. This pleased Wilson no end, since he had earlier set up The Wilson Foundation for the sole purpose of promoting the use of estrogen drugs.
The pharmaceutical industry generously contributed over US$1.3 million to his Foundation. Each year he received funds from such companies as Searle, Wyeth-Ayerst Laboratories and Upjohn which made hormone products that Wilson claimed were effective in treating and preventing menopause. Pharmaceutical companies jumped on the bandwagon with aggressive promotions and advertising campaigns. His message hit a receptive chord: mid-life women need hormone drugs to be rescued from the inevitable horrors and decrepitude of this terrible deficiency disease called menopause. Wilson pioneered the use of unopposed estrogen. [Nexus Magazine, Volume 3, #4 (June - July 1996)]
A clear distinction must be kept in mind, namely that non-human or artificial estrogens and progestins are more dangerous and less beneficial than using the natural forms. The use of natural estrogens and progesterone is important in some women at menopause, when troubling symptoms continue. The continued use of the appropriate natural hormone(s) for years can be without side-effects and provide ongoing significant health benefits.
Causes & Development
Surgical menopause involves the removal of the uterus and/or ovaries. A hysterectomy usually indicates that part or all of the uterus was removed. An oophorectomy means that one or both of the ovaries have been removed. If the uterus is removed but one or more ovaries remain, then technically a person is in menopause since menopause means the end of having periods. The symptoms usually associated with menopause are due to declining hormone production from the ovaries and may occur many years after surgical menopause, usually around age 50.
Treatment & Prevention
One study has suggested that dong quai, sometimes recommended in menopause, is no better than a placebo at relieving the symptoms of menopause.
References & Further Information
You can develop a clearer understanding of the nature of menopause and the interplay of female hormones by reading an informative book such as Natural Hormone Balance by Uzzi Reiss, MD, or What Your Doctor May Not Tell You About Menopause by John Lee, MD.
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Conditions that suggest Menopausal Issues: | | | | | Hormones |  Estrogens Low |
Metabolic |
 Syndrome X | A recent Australian study tracked the metabolic health of 265 women aged 46-57 for five years as many of them progressed through menopause. The study found that a surprisingly high percentage of these women - nearly 1 out of 6 - developed impaired fasting glucose levels during this time.
During the menopause transition, more fat often starts to accumulate around the stomach and insulin levels begin to inch upwards. This subtle change can trigger a drop in levels of sex-hormone-binding-globulin (SHBG), the substance that attaches to sex hormones in the bloodstream and makes them inert. With reduced SHBG levels, greater amounts of bioactive "male" sex hormones - androgens such as testosterone and DHEA - begin to circulate inside a woman's body.
Over time, this oversupply of active androgens can make women more male-like in appearance, fuel more obesity in the stomach region, and disrupt glycemic control. Left unchecked, these imbalances often become self-perpetuating, thus stimulating further weight gain and metabolic dysfunction that eventually increases the risk of syndrome X, diabetes, cardiovascular disease, and certain cancers. [Obes Relat Metab Disord. 2001;25(5): pp.646-51] |
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Uro-Genital |
 Postmenopausal Issues
Counter-indicators:
 Postmenopausal Issues |
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Menopausal Issues suggests the following may be present: | | | | | Metabolic | Syndrome X| | A recent Australian study tracked the metabolic health of 265 women aged 46-57 for five years as many of them progressed through menopause. The study found that a surprisingly high percentage of these women - nearly 1 out of 6 - developed impaired fasting glucose levels during this time.
During the menopause transition, more fat often starts to accumulate around the stomach and insulin levels begin to inch upwards. This subtle change can trigger a drop in levels of sex-hormone-binding-globulin (SHBG), the substance that attaches to sex hormones in the bloodstream and makes them inert. With reduced SHBG levels, greater amounts of bioactive "male" sex hormones - androgens such as testosterone and DHEA - begin to circulate inside a woman's body.
Over time, this oversupply of active androgens can make women more male-like in appearance, fuel more obesity in the stomach region, and disrupt glycemic control. Left unchecked, these imbalances often become self-perpetuating, thus stimulating further weight gain and metabolic dysfunction that eventually increases the risk of syndrome X, diabetes, cardiovascular disease, and certain cancers. [Obes Relat Metab Disord. 2001;25(5): pp.646-51] |
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Recommendations and treatments for Menopausal Issues: | | | | | Botanical |  Black Cohosh| | Black Cohosh has been used successfully to control menopausal symptoms in a high percentage of women. It may need to be taken for several weeks before benefits are noticed. It is often found in an extract form called Remefemin, available from health food stores. |
 Vitex / Chasteberry| | Low levels of progesterone are believed to contribute significantly to menopausal symptoms. The ability of vitex to increase the secretion of luteinizing hormone which raises progesterone levels is the likely mode of action. Physicians in Europe commonly recommend vitex for the treatment of hot flashes. |
Maca| | Dr. Malaspina, a respected cardiologist in Lima, has been using the maca root in his practice for a decade and reports finding maca to be effective for women with menopausal symptoms, including one who had had her ovaries removed. Maca is usually taken several months before symptoms subside. |
 Red Clover| | Red clover extract (80mg per day of isoflavones for a 12-month period) reduced the number of hot flashes in a double-blind, placebo-controlled trial of 30 women who had not had a period for over 12 months and were experiencing more than five hot flashes per day. [North American Menopause Society 12th Annual Meeting, Oct 4-6, 2001, New Orleans, LA.] |
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Diet |
Soy Isoflavones (genistein, daidzein)| | Although study results are sometimes confusing on the issue of soy extracts and menopause, some studies have shown clear benefit. One such study concluded that a particular soy product "...may be a safe and efficacious therapy for relief of hot flushes in women who refuse or have contraindications for hormone replacement therapy." [Menopause 2000;7: pp.105-111]
The North American Menopause Society suggests that soy isoflavones can also be a natural alternative to estrogen replacement therapy for relief of mild menopausal symptoms. It may help offset the drop in estrogen and regulate its fluctuations that occur at menopause. Many women have reported a reduction in their hot flashes and night sweats when they regularly consume soy foods, such as tempeh or tofu.
Another study found that consuming one capsule tid of a soy extract totaling 100mg of soy isoflavones per day effectively alleviated vasomotor symptoms, such as hot flashes associated with menopause, over a 4-month period compared with a placebo. Total cholesterol and low-density lipoproteins were reduced also in the soy isoflavone group compared to placebo. No difference in FSH and LH levels were observed between the placebo and the soy isoflavone group. An increase in estrogen levels was observed only in the soy isoflavone group but this did not result in an increased endometrial thickness. [Obstet Gynecol 2002;99: pp.389-94]
Four months of treatment with a soy isoflavone product reduced the number of hot flashes and other menopausal symptoms in a study of 190 postmenopausal women in Spain. [Phytomedicine 2002;9(2): pp.85-92] |
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Hormone |
Natural Progesterone |
Lab Tests/Rule-Outs |
Test for Hormones| | Checking primarily for estrogens and progesterone at this time of life, with subsequent hormone balancing, can provide both immediate and long-term benefit. |
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Vitamins |
Vitamin E| | Vitamin E, at a dose of 800 IU per day, is modestly effective in reducing hot flashes, on average cutting the number by one per day. [The Lancet Oncology 2001;2: pp.199-204]
Vitamin E is worth trying because it is safe, inexpensive, and has demonstrated efficacy. Up to 3,000 IU per day is considered more effective by some doctors, but will have somewhat of a blood thinning effect. |
Vitamin Paba |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | Very strongly or absolutely counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Cardiovascular
Pertaining to the heart and blood vessels.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
DHEA (DHEA-S)
Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Estrogen (Oestrogen)
One of the female sex hormones produced by the ovaries.
Glucose
A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Hysterectomy (Hysterectomies)
Surgical removal of the uterus, by way of either an abdominal or vaginal incision. Removal might include removal of the cervix (total hysterectomy) or not (subtotal / partial hysterectomy). A radical hysterectomy involves surgical removal of the uterus, upper vagina, tissues adjacent to the uterus and possibly the ovaries; usually undertaken for carcinoma of the uterus. A hysterectomy with oophorectomy involves the removal of the uterus and one ovary (unilateral oophorectomy) or both ovaries (bilateral oophorectomy).
Insulin
A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.
IU (mIU, uIU)
International Unit: An arbitrarily defined but agreed upon unit that depends on what is being measured.
mIU: 0.001 or one thousandth of an IU.
uIU: 0.000001 or one millionth of an IU.
Lipoproteins (Lipoprotein)
Molecules composed of lipids and proteins that carry fats and cholesterol through the bloodstream.
Luteinizing Hormone
Anterior pituitary hormone stimulating estrogen production by the ovary; promoting formation of progesterone by the corpus luteum in women and stimulating testosterone release in men.
Male Pattern Baldness
The most common type of hair loss in men. It usually follows a typical "horseshoe" pattern of receding hairline and hair thinning on the top of the head, and is caused by hormones and genetic predisposition.
Menopause (Menopausal)
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Oncology
The study of cancer.
Ovary (Ovaries)
Ovaries are about the size of an almond and lie on either side of the lower abdomen beside the uterus. They usually produce one egg each month and whether the egg is fertilized or not, the reproductive process follows a monthly cycle, with constant changes in various hormone levels, preparing another opportunity for conception. The ovary is responsible for most of the estrogen production in women. At menopause (sometime after middle-age), egg production ceases and hormone levels drop significantly.
Placebo (Placebos)
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Postmenopause (Postmenopausal)
The postmenopausal phase of a woman's life begins when 12 full months have passed since the last menstrual period and any menopausal symptoms have become milder and/or less frequent.
Progesterone
This is the hormone secreted after ovulation by the corpus luteum. It is a steroid (similar to a cholesterol), enters receptive cells to stimulate their growth, and acts as an anabolic agent. Estrogen should be viewed as the primary coat underneath all the cycles during a woman's reproductive years, with progesterone, its antagonist, surging for ten or twelve days in ovulatory months. Most of the actions of progesterone cannot occur without estrogen having previously induced the growth of progesterone-receptive binding sites.
SHBG (Sex Hormone Binding Globulin, Sex Hormone-Binding Globulin)
A glycoprotein, synthesized in the liver, which binds testosterone and 5 alpha-dihydrotestosterone strongly, and estradiol somewhat less strongly. Circulating testosterone is mainly bound to protein - primarily SHBG, but also to albumin and cortisol-binding globulin. Since variations in the carrier protein levels may affect the concentration of testosterone in circulation, SHBG levels are commonly measured as a supplement to total testosterone determinations. The "free androgen index" (FAI), calculated as the ratio of total testosterone to SHBG, has proved to be a useful indicator of abnormal androgen status in conditions such as hirsutism.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
TID
Three times a day.
Uterus (Uterine)
The part of the female reproductive system specialized to allow the implantation, growth and nourishment of a fetus during pregnancy.
Vitamin E
An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.
Vitex
Vitex agnus castus. Common name: chaste tree berry.
Last updated: Jul 12, 2008
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