13 January 2011

A natural approach to menopause

Women usually go through menopause between the ages of 45 and 55. It marks the end of a woman's reproductive role and an exciting new phase in her life.


A natural approach to menopause

In this series of articles, we take a look at what you can do or take to prevent, alleviate or cure common ailments naturally. As many complementary and alternative medicine therapies haven't undergone rigorous testing, we base the recommendations here on the amount of evidence that is currently available (indicated with asterisks):

Natural Steps for Menopause (check the Evidence rating)
*** Good Evidence of a health benefit.
** Some Evidence of a health benefit.
* Traditionally used with only anecdotal evidence.

The following lifestyle aspects are important for menopause.

  • Stop smoking
  • Manage your stress
  • Follow Japanese diet guidelines
  • Make time to relax
  • Exercise

Avoid the following:

  • Refined and processed foods.
  • Artificial foods that contain additives and chemicals.
  • Full fat dairy and other high fat products.
  • Sugar and high sugar products.
  • Excess alcohol.

These nutrients have been shown to help Menopause:

  • Vitamin C *
  • Vitamin E *
  • Vitamin B complex *
  • Calcium **
  • Boron **
  • Zinc *
  • magnesium *

The following herbs are normally used for Menopause:

  • Black cohosh ***
  • Chasteberry **
  • Wild yam *
  • Dong quai *

Homeopathics remedies to help Menopause:

  • Calendula *
  • Lachesis *
  • Pulsatilla *
  • Sepia *

Alternative/Complementary Therapy
The most commonly used Complementary Approaches to Menopause are:

  • Herbal Medicine *
  • Naturopathic Medicine *
  • Nutritional Medicine *
  • Exercise*

Please Note: This natural medicine guide does not replace the assessment and advice of your doctor.

Consultation with a health professional is important if you are experiencing persistent or severe symptoms of Menopause.

Women usually go through menopause between the ages of 45 and 55. It marks the end of a woman's reproductive role and an exciting new phase in her life. However, this transition may not always be smooth and can trigger off many physical and emotional problems. Fortunately, many of these problems respond very well to natural therapies and remedies. In fact a lot of the dreaded symptoms can be avoided by adopting simple lifestyle changes.

The start and duration of menopause is not only determined by our genes, but also by our medical history and other lifestyle factors such as diet, excessive alcohol intake, smoking, calcium intake and stress.

What is menopause?
During menopause a woman's ovaries stop producing oestrogen and progesterone. Other body parts, including the adrenal glands, liver, brain and fatty tissue continue producing oestrogen. The unpleasant symptoms that some women experience while going through menopause are caused by this drastic drop in hormone levels. Therefore most menopause treatments, natural or otherwise, aim at stimulating or increasing the production of oestrogen and progesterone.

The most common symptoms of menopause include hot flushes, night sweats, irregular periods, anxiety, headaches and migraines, low libido, vaginal dryness, fatigue, mood swings, depression, loss of short term memory, heart palpitations, insomnia and odema.

Emotional problems and stress
Coupled with the physical symptoms of menopause is a whole range of other emotional problems, such low self-esteem or possible major life changes (such as children leaving home). Work or financial stress only exacerbates the symptoms.

Many modern womens' lives are already stressful, what with trying to juggle a career, a marriage and a family. If women do not learn stress management techniques or how to relax, menopause can be a very stressful and difficult time.

Hormone replacement therapy
Many women go onto hormone replacement therapy (HRT) that involves using oestrogen and progesterone supplements to boost hormone levels and help women over the difficult phase of menopause. Unfortunately, although this therapy is very effective in counteracting the symptoms of menopause, there is a lot of controversy over whether it is safe for long-term use.

The decision on whether or not to go onto HRT should ultimately be based on your individual risk factor profile. Discuss all these issues with your doctor before making any decisions and ask him/her whether natural therapies, such as including soya products in your diet, could, in your individual case, be sound alternatives to HRT.

The natural approach to menopause acknowledges the fact that menopause is an inevitable and NATURAL part of a woman's life. The therapies and remedies that follow are geared to make the whole process easier for women, rather than stopping or suppressing it with drugs.

What to do

1. Exercise
Regular exercise can boost your mood and alleviate depression as it raises your endorphin level. Researchers believe that exercise can also reduce hot flushes. When combined with a healthy diet, exercise ups your metabolic rate and helps you control your weight. It also prevents and slows the progress of osteoporosis.

Exercise is of paramount importance to one's health throughout one's life, but even more so after one hits the thirties and the metabolism starts to slow down. Many once slender women often experience a noticeable weight problem by menopause. Exercise increases the metabolic rate.

For menopausal women, exercise has countless benefits, including the prevention of bone density loss, lower blood pressure and cholesterol and the relief of symptoms of depression and insomnia. Exercise is one of the best ways to ease the symptoms of menopause and some studies suggest that aerobic exercise may actually boost oestrogen levels.

If you do not presently exercise, start walking for 15 minutes three times a week and slowly increase this to a 20 to 60 minute workout session during which you do a bit of resistive weight training, stretching and aerobics.

Dr Arien Van der Merwe recommends weight bearing exercises such as walking, swimming, aerobic exercise, cycling and dancing. Water aerobics is also becoming popular.

2. Follow a "Japanese" diet
Did you know that Asians don't even have a word for menopause? This is because Asian women in general do not experience drastic symptoms during menopause; their periods just stop. Researchers believe that this has something to do with their diet. Asians do not consume a diet high in animal products like westerners do.

To follow a Japanese diet, eat lots of foods that contain plant hormones such as celery, fruits, fennel, rhubarb, lucerne, whole grains and linseeds. Also eat three servings of oily fish such as salmon, trout, tuna, mackerel and sardines every week because they contain essential fatty acids. Nuts, seeds, cold-pressed vegetable oils and whole grains also contain essential fatty acids that are vital for hormone production and healthy skin and nerves.

The Japanese diet is also high in soy products (including foods like tofu, tempeh, soy milk, soy burgers, roasted soy nuts, soya protein powder and soya beans). Soy products contain high concentrations of phytoestrogens (plant hormones) that aid in the prevention of osteoporosis. These phytoestrogens appear to mimic the action of human oestrogen and might compensate for the falling hormone levels associated with menopause.

These plant hormones can also block the action of oestrogen when there is an imbalance in the ratio of oestrogen to progesterone.

Studies have shown that a daily diet supplemented with soy flour reduces hot flushes by up to 40%. Soy is also believed to help reduce the night sweats associated with menopause.

3. Reiki
This unusual, non-invasive healing therapy helps to balance the energy system within one's body and thereby helps the body to heal itself. This practice is similar to the ancient "laying-on" of hands and the sessions are very relaxing.

Reiki can be very beneficial to menopausal women because it is known to help balance the different systems in the body, including the hormonal system. During menopause, one's hormones run amok resulting in problems like menstrual cramps, premature menopause, hot flushes, premenstrual migraines and extreme mood swings.

Reiki can help normalise menstrual cycles, reduce cramping and migraines and can lessen the intensity and frequency of hot flushes.

Get reiki treatment form a professional until your symptoms disappear or do a Reiki 1 workshop in which you will learn self-treatment or combine the two. Read more about reiki.

4. Aromatherapy
Natural health expert, Dr Arien van der Merwe recommends inhaling sage, cypress and geranium essential oils to alleviate the physical symptoms of menopause. These oils can also be added to your bath (six to eight drops) or used as a massage oil by blending 15 drops of each oil to a 100ml of carrier oils (Van der Merwe suggests almond, coconut, olive or grape seed carrier oil).

For stress and depression associated with menopause, Van der Merwe recommends geranium, lavender, grapefruit, camomile, bergamot, neroli, clary sage, vertivert oils and benzoin essential oils. Add these oils to your bath or massage them into your abdomen, neck or temples using the dilutions suggested above. Read more about aromatherapy.

5. Manage your stress
Too much stress can cause a drop in your oestrogen level. Natural health expert Dr Arien van der Merwe lists havinf a positive attitude and the "single most important factor in managing menopause". She says that atress management techniques and accepting the fact that you are getting older and are entering a new exciting phase of your life is essential.

Enrol in a stress management course, read books that give you practical ways to reduce and manage stress or enjoy the relaxing benefits of massage and meditation.

6. Have sex
Regular sexual activity along with stress management can reduce your risk of developing vaginal dryness by improving natural lubrication and keeping the vagina moist and toned. It may also help to take a warm bath before sexual intercourse. If all else fails try using short-acting, water-based vaginal lubricants.

If sexual desire lessens during menopause, the cause may be physical - lower oestrogen levels sometimes cause physical changes in the sexual organs, making sex uncomfortable. Physical reasons for decreased sexual response should be identified and treated. Some women have decreased sexual desire because of changes in self-perception and lifestyle stresses. Counselling and support groups can provide useful strategies for coping with this, as well as with physical and emotional symptoms.

7. Stop smoking
Not only is smoking bad for your health in every way, but according to Dr Arien van der Merwe, it can also lead to early symptoms of menopause (smokers go through menopause two to three years earlier than their non-smoking peers). Smoking also increases your risk of osteoporosis as it robs your bones of minerals and cardiovascular disease, as it lowers the oestrogen level. On top of all this, smoking contributes to premature ageing.

8. Drink water
You should be drinking a minimum of six glasses of water a day. If you are experiencing hot flushes, avoid hot drinks like tea and coffee, alcohol and spicy foods. If you have to, drink decaffeinated coffee or tea. Also keep your workplace and home cool and wear loose clothing in layers that can be easily removed. Avoid confined spaces and hot, humid weather if possible.

9. Boost your energy levels
Dr Arien van der Merwe recommends getting the right amount of sleep. She also lists energy-boosting foods such as raw honey, red grapes (with pips), spirulina, Rosa roxburghii, Chlorella, brewer's yeast, molasses, lecithin and kelp (or marine algae)

What to take

1. Supplements
You can find the following list of supplements and the required dosages in Dr Arien Van der Merwe's book Health and Happiness:

Calcium: in supplement form is essential. According to Van der Merwe, "The body's minimum daily requirement is 1200 mg, which is almost impossible to obtain through diet alone." Your supplement should also contain magnesium, vitamin D, vitamin C, boron and potassium to ensure maximum calcium absorption. Van der Merwe says that it is imperative that women start taking calcium supplements from a very young age if they want to prevent osteoporosis and have an easier menopause. But, she says, it is never too late to start.

Chromium: keeps blood sugar levels constant and reduces sweet cravings.

Essential fatty acids: like evening primrose oil, linseed oil or salmon oil can alleviate almost all of the symptoms of menopause. Van der Merwe says that these essential fatty acids also "prevent bad LDL-cholesterol levels from increasing".

Fish oil: if you are not eating enough fish, this supplement will aid in hormone production.

Iodine and kelp: support the thyroid gland that, in turn, improves female hormone function.

Iron: very important until the end of menopause but also for a little while after your period stops.

Vitamin A: a potent antioxidant that supports the mucosa and the skin. Van der Merwe also recommends beta carotene.

Vitamin B complex and magnesium: support the nervous system thereby relieving mild depression, irritability and anxiety. They also support the pituitary gland and the female urogenital system in general.

Vitamin C and flavonoids: reduce hot flushes.

Vitamin E and selenium: treat vaginal dryness and hot flushes. These supplements also protect against cardiovascular disease and delay the ageing process because of their strong antioxidant action.

Zinc: used for depression and general health of the female urogenital system.

2. Herbal remedies
Consult your doctor or a professional herbal practitioner before using any of the herbs mentioned in the following section, especially if you suffer from a chronic disease or are on other medications. Also read the section on herb safety.

Many herbs have the ability to act as mild oestrogens and can help rebalance the disrupted hormone levels. Herbal treatment for menopause should include red sage and dong quai (Angelica sinensis), two herbs that will provide general benefits. Linseed and evening primrose oils can also help and wild yam, which is rich in natural progesterones, can be taken orally or applied topically to ease menopause symptoms.

Dong quai (Angelica sinensis): Regarded as one of the most important herbal medicines for the maintenance of the female urogenital system is a non-toxic, popular Chinese remedy. According to natural health expert, Dr Arien van der Merwe in her book Health and Happiness, dong quai acts as an anabolic (building up) tonic which boosts blood circulation and the body's own production of hormones. Van der Merwe recommends two capsules twice a day or one dropper full of the tincture in a little water twice daily.

Wild yam (Dioscorea villosa): This herb is rich in natural progesterones, and can be taken orally or applied topically in gel form, to ease menopause symptoms. Van der Merwe writes that "unlike synthetic progesterone, natural progesterone does not promote virilisation (manly qualities) and fluid retention".

She also points out that "progesterone is the most important hormone to supplement during and after menopause," because during menopause the ovaries stop producing this hormone and unlike oestrogen, other organs do not produce progesterone.

According to Dr Van der Merwe, using wild yam and fenugreek (both of which have the effect of progesterone) can balance the oestrogen effect of unicorn, soya beans and calendula.

Van der Merwe recommends rubbing the wild yam gel/cream on your face, abdomen, breasts, back and thighs, one to two times a day for 23 days, followed by a five day break. A tea can also be made from the wild yam root or you can take about 500 mg, in capsule form, every day. Double the dose after two or three months if the symptoms have not abated.

Chasteberry (Vitex agnus castus): Dr Van der Merwe recommends this herb for the general alleviation of menopausal symptoms like vaginal dryness and hot flushes. Van der Merwe says that chasteberry increases the production of dopamine, a neurotransmitter in the brain. She adds that it has a hormonal effect on the body without any side effects.

Black cohosh (Cimicifuga racemosa): Dr Van der Merwe explains that black cohosh lowers the level of the lutenising hormone, the primary cause of hot flushes, which is secreted by the pituitary gland. "Unlike conventional oestrogen replacement therapy," writes Van der Merwe, "Black cohosh does not interfere with the secretion of the other hormones from the pituitary gland." The recommended dosage is usually one capsule twice a day. This herb should not be used by pregnant or breastfeeding women.

Match the herbs to your symptoms:

Abnormal hair growth: Saw Palmetto

Anxiety: Motherwort, passion flower and valerian.

Depression: St John's wort, black cohosh, gingkgo biloba and verbena.

Excessive menstrual flow: Yarrow can regulate an excessive period in the months preceding the cessation of menstruation. Do not use this herb if you have hot flushes.

Fatigue: Ginseng boosts energy levels

Forgetfulness: Ginkgo biloba and hawthorn

Hot flushes: Chasteberry, black cohosh or motherwort teas or supplements. Peppermint, taken as a tea or inhaled, has cooling qualities. Agnus castis is an ancient Egyptian remedy for hot flushes. Sage and black cohosh also help.

Insomnia: St John's wort, hops and valerian. Try Dr Van der Merwe's recipe for a good night's sleep: make a tea out of fresh ginger root, sage, camomile, lime blossom and valerian root with a little honey.

Night sweats: Chasteberry, black cohosh or motherwort teas or supplements. Van der Merwe recommends making a sage drink by adding three drops of the essential oil and some honey to a cup of hot water. Or just brew some fresh sage tea.

Tension: Valerian

Vaginal dryness: Motherwort, dong quai or black cohosh. Read more about herbs.

3. Homeopathic remedies

Calendula ointment: treats vaginal dryness

Lachesis: for hot flushes, night sweats, heavy bleeding, uterine cramps and irritability.

Pulsatilla: also for hot flushes and mood swings.

Sepia: for hot flushes, painful sex, loss of libido and anxiety. Read more about homeopathy.

Read more about menopause on Health24's Menopause Centre.

This article contains some extracts (where indicated) from natural health expert, Dr Arien van der Merwe's (MBChB) book Health and Happiness. You can order her books, published by Tafelberg, in English and Afrikaans online at
Health & Happiness
Geluk & Gesondheid
Herbal Remedies
Kruie met Geneeskrag


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