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what are they?
The term menopause refers to the cessation of menstruation and strictly speaking can only be applied after the event.
It usually occurs between the ages of 45 and 55, although a small number of women experience an earlier 'premature' menopause. The average age of onset is around 51.
Although the menopause can have a positive effect on physical and emotional health, some health problems can occur in the years leading up to and surrounding it — that is the perimenopause — and in the longer term.
Symptoms vary tremendously from one woman to another but may include:
- Hot flushes and/or night sweats. A feeling of intense heat or sweating that can last anything from minutes to over an hour. These may disturb sleep and lead to tiredness.
- Dry vagina. The skin lining the vagina becomes thinner, less moist and more delicate. This in turn can lead to uncomfortable or painful sex.
- Urinary problems. Thinning tissues can also lead to frequency (needing to pass urine frequently), urgency (needing to pass urine urgently) and an increased tendency to develop cystitis .
- Memory and mood changes. Women frequently complain of forgetfulness and other changes such as mood swings, anxiety and depression.
- Weight redistribution. Body fat tends to accumulate around the waist, giving you an 'apple' shape rather than the 'pear' shaped distribution on hips and thighs more often seen in younger women.
- Osteoporosis. In the longer term an increased loss of calcium from the bones caused by lack of oestrogen can lead to a greater risk of osteoporosis, a disorder in which the bones become more porous and brittle.
- Heart disease. Oestrogen appears to protect women's blood vessels during the reproductive years. However after the menopause the risk of heart disease catches up with that of men (see high blood pressure and high cholesterol).
what causes them?
As you approach the menopause the ovaries gradually stop producing oestrogen, the hormone which is responsible for preparing your body for a potential pregnancy each month.
Other hormonal changes happen too: there are increased levels of follicle stimulating hormone (FSH), which triggers the development of the follicles (egg sacs) each month, and higher levels of androgens, which are responsible for male characteristics such as hair growth and weight gain.
However it is the changes in oestrogen levels that are chiefly responsible for menopausal symptoms.
how complementary therapies may help
Each therapy has been coded from 1 to 5 depending on the amount of scientific evidence there is for its effectiveness. The higher the number the stronger the evidence, so 5 = definitely, 4 = probably, 3 = possibly, 2 = opinion, and 1 = rumour. (There is more detail about these in the 'does it work?' section of 'before you start'.)
Having said this, the codes aren't meant to be cast in stone or to put you off trying a particular therapy or therapies if you feel they might be helpful to you.
Go to therapies for a full description of each individual treatment, plus information on how to find practitioners.
acupuncture
(code 4)
Research carried out in 1994 found that acupuncture helped reduce hot flushes in the short term and may also help ease other menopausal symptoms.
herbal medicine
(code 3)
Trials have shown that the herb vitex agnus castus, traditionally reputed to help balance the hormones, can help ease menopausal symptoms. In fact in one study it was more effective than hormone replacement therapy (HRT).
St John's Wort may be effective for mild or moderate depression caused by the menopause and some herbalists also prescribe it to help alleviate hot flushes. Another herb, red clover, which is rich in plant oestrogens (phytoestrogens), is frequently prescribed, and some trials have shown it to be effective, especially in reducing hot flushes.
Other herbs that may be prescribed include agnus castus vitex, which is said to help rebalance hormones, to alleviate flushes and sweats; valerian, to help ease insomnia; liquorice and sage, both of which are said to help balance oestrogen levels.
nutritional therapy
(code 3)
A nutritional therapist will want to know about your diet and may suggest cutting down on or cutting out caffeine, which may increase the tendency to flushing.
S/he may also advise a diet rich in phytoestrogens (plant oestrogens), such as soya products (eg, tofu, miso, tempeh and soya milk), linseeds, chickpeas, lentils and other pulses. Women in cultures where these kinds of foods are consumed regularly are said to experience fewer menopausal symptoms and less breast cancer, the risk of which increases after the menopause.
Some studies have shown that soy-based foods may decrease hot flushes and help prevent other symptoms of oestrogen withdrawal such as bone loss and heart disease. In the US, manufacturers of soy products are allowed to claim that they can help lower cholesterol as part of a balanced diet.
Supplements such as red clover (see above), vitamin E (which is said to help reduce hot flushes and may have protective effects on the blood vessels), vitamin C and a bioflavonoid hersperidin (which has been found in some trials to help alleviate hot flushes) may be recommended. Calcium, magnesium, vitamin D and boron may be advised to help protect against osteoporosis.
homeopathy
(code 2)
A homeopath is likely to prescribe constitutional treatment. Before starting this, specific remedies may be prescribed to treat individual symptoms. These may include belladonna, for sudden intense flushes with a throbbing feeling in the head; graphites, for irritability, concentration problems, tearfulness and over-excitability; ignatia, for emotional ups and downs;
pulsatilla, for mood swings and depression.
other therapies
As a form of gentle exercise yoga can help tone the muscles, and by using the body's own weight may help strengthen the bones, relax you and help improve your body image. Osteopathy may be useful in helping to lift depression and ease hot flushes. Creative therapies may be useful if you are finding the menopause difficult to come to terms with. Other stress relieving therapies such as relaxation and breathing , massage and aromatherapy may be helpful.
» help and info
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(July 2002)
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