| Submitted by: Nancy W.
Q: I am confused about
what the difference is between menopause and perimenopause,
and what kind of natural treatment would you recommend?
A: The current generation
of women who will be or are going through perimenopause and
menopause may be the first generation that lives nearly half
their lives without menstruation. They are navigating through
uncharted waters and that may be why there is some confusion
and misconception about what to expect, if anything, and what
needs to be done, if anything, when symptoms arise.
The Western view would have us believe that menopause is
an estrogen-deficiency disease that needs to be treated with
estrogen to compensate for the normal decline of estrogen
levels with aging. Contrary to popular belief, perimenopause
is not a hormonal transition associated with the lowest levels
of estrogen. The fact is that hormonal levels are fluctuating
wildly and estrogen levels may peak to a point equal to that
of when the woman was twenty years old and then as quickly
as it went up, estrogen levels may then rapidly plummet.
Perimenopause, therefore, is difficult to define because
follicle stimulating hormone (FSH) and estradiol (the two
most common markers used to determine menopause status) can
appear in the postmenopause range one day and in the premenopause
range a few days later.
The most common complaint of early perimenopause is the temperature
variant called a hot flash (or flush). Other common
complaints are menstrual irregularities, breast tenderness,
increased fibrocystic changes, growth of uterine fibroids,
flare-ups of endometriosis, emotional stress, and weight gain.
Another important and common finding that warrants consideration
for perimenopause is low levels of progesterone.
This is especially important because, among other reactions
in the body, low progesterone is related to a short luteal
phase (the part of the menstrual cycle where ovulation occurs)
and a short luteal phase is associated with increased bone
loss. This is a very important situation to consider because
bone mineral density studies are usually not ordered until
after menopause but the average age of perimenopause is 47
and bone mineral loss begins at around the age of 40 - 10
or 15 years before it is usually even tested for. And as with
many situations in the body, the earlier an imbalance is detected
the better the prognosis. As I indicated in a previous article
on osteoporosis, it is the number one bone condition in the
United States. Eight million women have osteoporosis, over
a million with fractures, many of which were potentially preventable.
There are over 70,000 deaths related to preventable hip fractures
and over 50,000 requiring long term care.
Another important aspect to recognize is that hyperinsulinemia
(high levels of insulin in the blood) influences estrogen
synthesis and overall hormone balance or imbalance. A number
of nutritional, diet, and lifestyle interventions can improve
insulin sensitivity and reduce symptoms associated with these
hormone imbalances in women. The dietary program needs to
include low glycemic index foods, such as most fruits, berries,
nuts, a variety of vegetables, whole grains (not refined grains),
fish, eggs, soy products, and lamb. Also consider the following
specific nutrients: D-chiro-inositol, chromium, antioxidants,
omega-3
fatty acids, and magnesium.
Thyroid function is another important area that appears to
change in the perimenopausal period. Many of the common symptoms
of perimenopause may be attributed to thyroid dysfunction
such as weight gain, depression, anxiety, fatigue, cold intolerance,
loss of libido, and abnormal menses. As part of the perimenopausal
evaluation, I would, therefore, recommend a comprehensive
thyroid panel. If hypothroidism is evident, I may suggest
the following: elimination of dietary sources of gluten-containing
grains such as wheat, and casein-containing products from
dairy, such as milk, cheese, etc. These potential food antigens
could induce antibodies that cross-react with the thyroid
gland. I will also recommend organic iodine from fucus (seaweed),
selenium,
zinc,
omega-3 fatty acids, and antioxidants (including vitamins
A, C, and E).
One major underlying issue to consider is that a stress hormone
called cortisol plays a major factor in disrupting the orchestrated
symphony of the body that is the endocrine hormonal system.
Among other lifestyle factors exercise has been proven time
and again to have direct positive benefits on stress and on
the hormone imbalances related to menopause. Some of these
benefits include decreased blood cholesterol levels, decreased
bone loss, decreased fat storage, improved ability to deal
with stress, improved circulation, improved heart function,
increased endurance and energy, increased self-esteem and
mood, reduced blood pressure, and relief from hot flashes.
In summary, treatment for symptoms associated with
perimenopause needs to be centered around balancing estrogen,
raising progesterone levels, controlling insulin and blood
sugar, and correcting thyroid imbalances.
In addition to previously mentioned nutrients, I would consider
standardized botanical medicines. Black cohosh (Cimicifuga
racemosa) helps to reduce hot flashes. Chasteberry
(Vitex agnus-castus) used for symptoms of perimenopause. Dong
Quai (Angelica sinensis) and licorice (Glycyrrhiza glabra)
have also been shown to decrease symptoms associated with
perimenopause and menopause. Also consider gamma oryzanol
for hot flashes and soy protein isoflavones. Certain
individuals may benefit from progesterone augmentation.
We live in bodies where all the systems are very interrelated
in a web-like balance of interactions. We cannot just listen
to one instrument when addressing the human body but rather
have to respect and consider the entire symphony. As usual,
I would recommend a consultation for an individualized, comprehensive
assessment.
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|
Dr. Chad Larson
Excellent combination formulas to help decrease menopause symptoms:
