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A Natural Approach for A Natural Transition
By Dr. Trevor Holly Cates


It has been estimated that by the year 2015 nearly 50% of women in the U.S. will be menopausal. While this may seem surprising, it shows the need for more awareness and honor for women entering menopause. Cultural expectations and personal discomfort can create negative feelings and associations. Although menopause is often treated as a disease, it is a natural and necessary change in every woman’s life. The transition of menopause is the beginning of a new phase of life with fewer family obligations, greater freedom and new opportunities.

About Menopause
The term menopause specifically refers to one year since a woman’s last menstrual period, with or without symptoms. The average age is 51 years old, but changes can begin to occur as early as 40 years old. During perimenopause, the time leading up to menopause, erratic hormone levels may cause irregular cycles and hot flashes. The pattern and intensity of symptoms can vary greatly. Other symptoms women may experience during menopause include: skin changes, vaginal dryness, fatigue, decreased libido, mood swings, and sleep disturbance. Most menopausal symptoms occur within the first 4 years and improve over time. Bone is sensitive to estrogen, and the changes during menopause lead to a decline in mineral density and an increased risk of fracture. Other osteoporosis risk factors include: short and slender stature, fair-skinned, blonde, blue-eyed, family history of osteoporosis, history of amenorrhea (lack of menstrual period), inadequate calcium and vitamin D intake or poor diet, sedentary lifestyle, and smoking. In addition to looking at a woman’s history, there are certain lab tests which can help reveal an increased risk or a current problem. Though the concerns of cardiovascular disease are often focused on men, it is the leading cause of death in women. High blood pressure, high cholesterol, family history of heart disease, smoking, obesity, and sedentary lifestyle are associated with an increased risk of cardiovascular disease. There are many options for women to help support optimal cardiovascular functioning and lower their risk for developing heart disease. There are some things that women can do naturally which can help manage symptoms and prevent conditions associated with menopause. Homeopathy, nutritional support, exercise, acupuncture, meditation practices, herbal medicine, natural hormones and other therapies can help stabilize, support and nourish the body during a time of change. The goal in a naturopathic treatment approach is to manage symptoms and prevent diseases such as heart disease and osteoporosis. An individualized approach works best to determine each woman’s symptoms and predisposition to diseases. This kind of approach requires a more comprehensive health history, laboratory analysis, and physical exam. A healthcare provider who understands the full spectrum of options from the most natural to the most conventional, is the ideal person to help with a treatment plan. With all of the books and internet information on natural therapies, some women choose to self-prescribe supplements. A woman who self-treats may be managing symptoms such as hot flashes and mood swings, but may not address the long-term health concerns and will miss having her health monitored over time. Additionally, certain symptoms that are associated with menopause may actually be signs of another illness such as thyroid disease or clinical depression.

Eating a whole foods diet high in fiber, antioxidants and essential fatty acids (EFA’s) helps lower the risk of heart disease and cancer. Flaxseeds (whole ground uncooked) help reduce cholesterol and can improve menopause symptoms. EFA’s found in fish, nuts and seeds can help lower the risk of cardiovascular disease and increase calcium absorption. Mineral-rich foods that are high in calcium and magnesium support healthy bones: soy, dark leafy greens, nuts and seeds, fish, dairy, and calcium-fortified foods. Limit or avoid caffeine and alcohol since they can exacerbate symptoms, lead to nutritional deficiencies and increase risk for heart and bone disease. Excess animal protein, carbonated beverages and sodium in the diet can also put one at risk for osteoporosis. Soy may help reduce symptoms such as hot flashes and vaginal dryness as well as reduce cholesterol and LDL. In addition, a high-soy diet appears to improve short-term and long-term memory (avoid soy supplementation if taking Tamoxifen). Soy foods appear to be more effective than supplements for managing menopausal symptoms according to a study of 29 randomized controlled trials of CAM. In addition to a healthy diet, certain nutritional supplements can help manage symptoms and reduce chances of heart disease and osteoporosis. Vitamin E appears to not only reduce the hot flashes but can also decrease the risk of cardiovascular disease. A good-quality calcium and magnesium supplement protects bone and cardiovascular health. Vitamin D can enhance absorption of calcium and help to reduce the incidence of fractures. Other nutrients such as Boron, Copper, Zinc, Folic Acid, Vitamin B6, Vitamin C and Vitamin K are important for bone health.

Some herbs have been proven to be effective in menopause support. For example, Black Cohosh can help reduce hot flashes. Valerian may improve sleep and reduce anxiety. Hawthorne solid extract, Ginger and Garlic appear useful at lowering cholesterol. The results using individual herbs can be variable, and it is best to seek the guidance of a healthcare provider well-trained in herbal medicine. Often a custom herbal formula yields the greatest results.

Exercise & Stress Management
The importance of exercise and stress management techniques shouldn’t be overlooked. Walking as little as 4 hours per week reduces hip fracture risk and more exercise further reduces the risk. Aerobic exercise and weight training helps lower triglycerides and cholesterol. Improving body composition (increasing muscle-to-fat ratio) is an important component of enhancing the body’s ability to balance hormone production.
In addition to the physical benefits, exercise can also help soothe the mind. Other stress management and relaxation techniques should be integrated into a natural approach. One study found that listening to soothing music (especially Classical) reduced the amount of time it took for postmenopausal women to fall asleep and it reduced the number of night time awakenings.

Natural vs. Synthetic Hormones
The Women’s Health Initiative study evaluated hormone replacement therapy in 16,608 women. The trial was stopped because there was an increased risk of breast cancer, heart attack, heart disease and stroke. Even though there was a reduction seen in fracture and colorectal cancer, risks outweighed the benefits. Synthetic hormones, or hormones made from the urine of pregnant mares, aren’t the same hormone molecules as our own. Since these foreign hormones are excreted more slowly than our own hormones, they can potentially negatively affect our bodies.
Natural hormones are plant derived and considered bio-chemically and molecularly identical to human hormones. Natural sources are less likely than synthetic hormones to cause unwanted side effects such as weight gain, depression, and breast tenderness. Estrogen, progesterone testosterone, and DHEA and can be manufactured from plant-derived substances, usually soybeans or Mexican wild yam. Oral, sublingual, patches, creams, and gels are some of the available forms. Even though these hormones are called natural, they do affect the hormone levels of the body and can be misused. It is important to seek the care of a healthcare provider educated in the proper use of natural hormones.

Healthy Guidelines
• An individualized approach to symptom management and disease prevention yields the greatest results. Every woman has unique circumstances that may require individualized attention.
• Eat a whole foods diet high in fruits, vegetables, high quality protein, whole grains and legumes. Avoid or limit your intake of caffeine, sugar, alcohol, and processed foods.
• Avoid nicotine which can bring on menopause symptoms earlier and increase the risk of cardiovascular disease and osteoporosis.
• Exercise: strength training regular weight bearing, and aerobic exercise.
• A well-selected homeopathic remedy can help alleviate many symptoms of menopause and can strengthen vitality.
• A custom herbal formula and nutritional supplements aid in promoting health, reducing symptoms and preventing osteoporosis and heart disease.
• If natural therapies don’t provide sufficient results, properly-prescribed natural hormones can be used. Sometimes natural hormones still are not enough to manage symptoms, so short-term use of HRT can help relieve symptoms. Risks versus benefits should always be considered.
• Participate in a yearly doctor-supervised cleansing program to enhance liver functioning and proper hormone metabolism.
• Practice stress management techniques and treatments such as meditation, breath work, guided imagery, hypnosis, counseling, massage and CranioSacral Therapy.

Dr. Cates is a licensed naturopathic physician and received her medical degree from the National College of Natural Medicine in Portland, OR in 2000. She is a primary care physician specializing in women’s and children’s health with an integrative, holistic approach. Nutrition, herbal medicine, homeopathy, environmental medicine and craniosacral therapy are her modalities of choice. She is a frequent lecturer and writes articles on natural medicine for various local and national publications. Visit: www.SummitIntegrative.com and www.sbcnm.com