Usually, when a woman is in her forties she enters what is known as the peri-menopausal phase, during which she has more menstrual cycles when ovulation doesn’t occur even though menstruation appears normal. These cycles are followed by more irregular menstrual periods and some symptoms associated with the menopause. Finally, when she is in her fifties, her periods will stop completely. The menopause should occur gradually, allowing the body to adapt to the changes with ease – this is controlled by the female hormones.
Risks at menopause
With the menopause is the increased risk of osteoporosis, breast cancer or heart disease but, for many women, it is not the fear of those illnesses that most concerns them but how to cope with the debilitating symptoms that affect their daily lives: the hot flushes, vaginal dryness, joint pains, fatigue, headaches, irritability, insomnia, depression and decreased sex drive. The degree to which a woman experiences any or all of these symptoms is highly dependent on how good her nutrition is. Indeed, you don’t have to suffer at all.
What makes menopause so potentially dramatic in effect?
It happens when a woman’s production of oestrogen and progesterone begin to decline because they are no longer needed to prepare the womb lining for pregnancy. As oestrogen levels fall, the menstrual flow becomes lighter and often irregular, until eventually it stops altogether. Even before the menopause, often when a woman is in her forties, many cycles occur in which an egg is not released. These are known as anovulatory cycles.
Whenever this happens, levels of progesterone, produced from the sac that’s left once the egg has been released, decline rapidly. Progesterone is oestrogen’s alter ego and the two need to be kept in the right balance. Too much oestrogen relative to progesterone – so-called ‘oestrogen dominance’ – results in too many growth signals to cells of the breast and womb, raising the risk of cancer. Consequently, many women in their forties, although low in oestrogen, are in a state of oestrogen dominance because their progesterone levels are even lower.
Many of these symptoms can show up during the menopause along with the more common hot flushes, vaginal dryness, and other symptoms described above. So, if your hormones are in real disarray, you experience a distressing burden of symptoms. There is much you can do about this, however, but women are rarely told by their doctors how they can help themselves to cope with the menopause naturally. The usual remedy that doctors used to prescribe with some success was HRT; however, since the risk of HRT increasing breast cancer is now well known, many doctors – and women – are unwilling to go down this route.
Hot flushes – how to turn the heat down
Three-quarters of all British menopausal women, particularly those who are thin, experience some hot flushes. These are not directly a sign of oestrogen deficiency, but a result of increased activity of the hypothalamus gland in the brain, which makes two hormones – follicle stimulating hormone (FSH) and luteinising hormone (LH).
Extra-high levels of these two hormones occur as the menopause approaches, in an attempt by the brain to stimulate any remaining eggs to develop. Meanwhile, oestrogen levels fall, ovulation becomes infrequent and progesterone levels decline rapidly. Using ‘natural’ or bio-identical progesterone cream has been shown to help. Although wild yam extract, which can be processed in a lab to produce progesterone but doesn’t actually contain any progesterone, doesn’t appear to work.
Supplementation with phytoestrogens, which are structurally and functionally similar to the body’s own oestrogen, have been shown to reduce the frequency and severity of hot flushes. Four studies show that the oestrogen-like, plant-derived substances known as isoflavones, found in high concentrations in soy and red clover, approximately halve the incidence and severity of hot flushes. While some studies have not found this effect (at least at a level of statistical significance), they have shown that the higher the isoflavone levels in the urine of the women studied, the lower the incidence of hot flushes. This suggests that a high intake of isoflavones from diet or supplements is likely to help reduce hot flushes in some women, but not all.
This is certainly consistent with the low incidence of hot flushes in Chinese women with a daily intake of soy. I recommend fermented sources of soy where possible, including miso, tempeh, natto and tamari. Tofu, soya milk and soya yoghurt contain less phytoestrogens than fermented sources and also have other disadvantages. Highly processed forms of soy like burgers often have very little. Opt for organic, not genetically modified, sources of soya.
The blood sugar factor
If you have disglycemia – which means your blood sugar level goes up and down like a yo-yo –you are much more likely to experience fatigue, irritability, depression and hot flushes. Specifically, research has found that when you have a blood sugar low this can trigger a hot flush. By keeping your blood sugar level even through ‘grazing’ rather than gorging, and by choosing low-GL foods, you can considerably reduce the number of hot flushes you have. The advice here is no different from that for preventing diabetes: eat a low-GL diet and consider supplementing chromium.
More natural help for hot flushes in part 2 of Patrick Holford’s article will appear on November 9th and this extract is from his book ‘Balance Your Hormones’ and you can buy it here: https://www.patrickholford.com/books/balance-your-hormones