Some women sail through menopause like they’re traversing the calm waters of Walden Pond. You know who you are. First, your periods seem to be changing a little–shorter, longer, irregular, but overall not worth much thought. Then one day you realize you haven’t had one in months.
“Well,” you think to yourself. “That was a piece of cake. What’s the big deal?” And surely you don’t miss the cramps, the worry about bleeding onto a conference room chair at work, or those mood swings. Given the number of women who are living well into their 80s and 90s, it’s a safe bet you’ve got decades of smooth sailing in front of you.
For a second group of menopausers, the waters are a bit choppier. Once or twice a day you feel a totally unexpected wave of heat (“Was that a hot flash?”). Maybe a couple nights a week you awaken from dreaming that you’re trapped in a Dutch oven, your nightgown drenched, pillow sponging sweat from the back of your head. Maybe your brain is a wee bit foggy, too, your sex drive more of a memory. (Well, perhaps a fictionalized memory. Most of us are historical revisionists when it comes to sex.)
If you’re in this mid-range menopause group you may need just a bit of help, but certainly no intervention from Mayo Clinic. Moderate menopause symptoms are fairly easy to treat naturally, without hormone therapy. I’ll get into the specifics of that a bit later.
Members of the third group are facing Industrial Strength Menopause, clinging to their tiny sailboats as they’re battered about in a stormy sea of miserable symptoms, which, if gender transfer could be arranged, would bring most men to their knees. By their 50s, virtually all women are familiar with their devilish hormone shifts, uncharted territory for men. After a couple of drenching night sweats and a day at the office babbling with brain fog, sweat dripping onto his keyboard, you’d need to take a guy experiencing this kind of menopause to an emergency room where he could explain his symptoms to a resident.
(“Oh, don’t worry, sir. It’s just menopause. We’re seeing more and more of it these days in men. We think it’s the GMOs. We can’t put you on Premarin now, can we? Just live with it.”)
Menopause treatment
The lucky ducks in the first group need no treatment at all. Best not to discuss menopause with them. Your envy could trigger a hot flash.
If you’re in either the “I can live with it” Group Two or the “Get me out of here!” Group Three, you have a lot of options. Just about every woman troubled by the symptoms of menopause can either reduce them to an acceptable tolerability or zero them out altogether.
In her book The Wisdom of Menopause Christiane Northrup, MD, offers two very sensible pieces of advice. First, your choice of treatment is your own, not your doctor’s. And second, don’t attempt to eliminate every last hot flash. Regard the leftovers as daytime power surges.
Herbs are the least expensive, simplest treatment for mild-to-moderate menopause symptoms. The mainstay is black cohosh, which our apothecary carries in the form of the best-selling Menopause AM/PM by Integrative Therapeutics. After years of research, no one has yet figured out exactly how black cohosh works. Since menopause symptoms are caused by declining estrogen levels, you’d assume black cohosh was an herbal estrogen. But it doesn’t show any estrogenic activity. Sometimes we just have to accept the unknown.
Tried and true menopause relief replaces flagging hormones themselves. Conventional doctors prescribe Premarin or Prempro, the latter Premarin + progesterone, in the hope that the concentrated urine of a likely now-dead but once pregnant horse (PREgnant MARe urINe–get it?) is just what your body craves. More convenient and certainly tasteful are the new estrogen skin patches (Vivelle-Dot, Climara) and these do work, but they should be used along with oral progesterone because so-called unopposed estrogen (estrogen therapy without progesterone) increases your uterine cancer risk.
At WholeHealth Chicago, if you’re going the hormone route we recommend you use bioidentical hormones. Available in capsules or skin creams, bioidenticals are manufactured from soy. They’re called bioidentical because they’re biologically identical to the hormones your own ovaries have been making throughout your life. By using bioidenticals, we’re trying to re-create the hormonal milieu of you at about age 30. A typical capsule contains two estrogens (estradiol and estriol), progesterone, and if you’ve got a libido issue, some testosterone for seasoning.
Bioidenticals are the mainstay of compounding pharmacies, and (pardon my cynicism here) because they help women, are safe and effective, and aren’t products of Big Pharma, many–though not all–health insurance companies fabricate a variety of excuses to avoid paying for them.
And now for some fresh good news. Well, not at all news to us at WholeHealth Chicago, but news to most conventional medical professionals.
Acupuncture works for hot flashes. Believe me, if back in the WholeHealth Chicago practitioner’s lounge I held up a journal and blurted, “Hey, everybody–look at this! A medical journal reports that acupuncture works for hot flashes!” I’d get dagger stares from Mari Stecker, Cindy Kudelka, and Helen Strietelmeier.
Mari would be the first, “David, are you doctors out of your minds? What do you think I’ve been doing with these needles for the last 20 years? Needlepoint? Embroidery?!”
But now it’s official. Published this week in Menopause: The Journal of the North American Menopause Society, researchers reviewed a total of 104 previous studies in which acupuncture was used to treat menopause symptoms. Twelve of the studies, with a total of 869 participants, met the inclusion criteria for this effort. Articles like these are called meta-analyses, meaning researchers review older studies, mine the data, and take a second look. Why re-invent the wheel? Twelve well-conducted studies with nearly 900 participants are sure to tell you something.
And they did.
Acupuncture works for hot flashes, night sweats, and menopause-related symptoms like low libido, brain fog, mood issues, and vaginal dryness. Interestingly, the effects were also fairly long lasting. Once symptoms were brought under control, the benefits lasted about three months. Returning symptoms were milder and could be brought back under control with additional treatments.
Although bioidentical hormones are considered very safe, many women worry about taking any hormones. With health insurance no longer covering bioidenticals, and reimbursement for acupuncture treatments appearing more often as an added benefit, acupuncture for your menopause symptoms may actually turn out to be a more economical choice than hormones. And absolutely safe.
Be well,
David Edelberg, MD
[…] here to visit original postIf you are suffering from menopause symptoms: urinary problems, then prolonged exposure to estrogen … who took estrogen for more than 5 years were much more likely to suffer from incontinence than […]
Menopause Symptoms: Urinary Problems Linked to Estrogen Use | Mojo Menopause | Symptoms, Remedies, and More
1, According to the latest published papers, hormone replacement therapy actually reduces the risk of nonsmoking women developing adenocarcinoma of the lung. Therefore, I would think bioHRT is safe
2. I’d recommend “Preventing and Reversing Osteoporosis” by Alan Gaby MD for the best natural approach to osteoporosis. The prescription meds all get mixed reviews but Reclast, which is intravenous, does avoid the very uncomfortable gastrointestinal side effects of the other meds in this group
3. The progesterone component of bioidentical frequently comes from an inedible plant–the Mexican wild yam
4. Even though they started at the same time, I don’t think the hot flashes and dry mouth are related. At 87, I would recommend black cohosh for the hot flashes. Dry mouth is a common side effect of prescription meds, so before you do anything, review your meds to see if any of these could be the culprit. If not,you can get artificial saliva from your pharmacist
5. Black cohosh is considered safe for breast cancer patients experiencing hot flashes
DrE
DR. E-
I went on Estradiol supplement almost a year ago due to hot flashes and low libido, etc… and it has been working. I took bio-identical hormone supplements when living in Chicagoland, but now am in Ohio and did not know of a doc who works with bio-identicals. I am thinking of going off the estradiol as I am concerned about increased risk for cancer. Can you recommend a Holistic physician in Columbus, Ohio??
Gail Mendenhall
dr.E
Sounds like black cohash may be a safe treatment for menapause symptoms in women
with history of estrogen based breast cancer. can you clarify or confirm your opinion? thanx.
fm smith
What is your prescription for hot flashes and dry mouth. I am 87 yrs. old had a very mild menopause experience many years go. Hot flashes and dry mouth are very recent occurrences.
Phyllis
Doc, in addition to black cohosh, I have also used pueraria mirifica with very good results. For some reason I was under the impression that bio-i’s were made from yams. Also, a lot of the soy consumed in Japan is of the fermented (healthier) kind. And Mari is absolutely correct…………I’ve been using acupuncture with great success for treatment of menopause symptoms for nearly thirty years.
Respectfully,
David B.
Dr. David W Bailey, DC
I had the same experience as Susan: black cohosh worked perfectly for 6 months, then stopped cold. And oral hormones in any form screw up my digestion. But for vaginal dryness, vaginal Estrace cream is great. You just need to be careful not to OD on it. As for hot flashes, I’ve learned to live with them–and darned well better, because I still have them 11 years into menopause!
Barbara
Dr. E- Do you have any thoughts on whether women with a history of adenocarcinoma should avoid estrogens, even bioidentical ones you get from consumng soy? Adenocarcinomas are known to contain estrogen receptors. I don’t want to put you on the spot here, I know there is no widely agreed upon medical answer to this! Just would like your thoughts, with whatever disclaimer you think is appropriate 🙂 I am a 51 year old perimenopausal (with some hellacious mood swing symptoms)woman who had a stage 1a adenomacarcinoma removed from my lung. I’m doing great, but trying to do everything to prevent recurrence. Stop eating my tofu and never do hormone replacement?
Meg W
I’d like info on available treatments for osteoporosis. I’ve heard of a few options: pills, injections, calcium deposits into the blood stream, etc. As a candidate for hip replacement, osteoporosis is an added risk factor, acc to the orthopod. Any thoughts on how to improve bone density before a hip replacement?
Thanks.
Ann P. White
I tried the bio-idebticsls and they caused horrible indigestion issues. Black cohosh worked great for about 6 months but when I cut back from 2 per day to one night sweats cane back – just started back on 2 so fingered crossed – into year 3 of hit flashes – horrible. May try the needles
Susan
…and is the soy they use GMO free?
Lisa
Soy isn’t “bad” for you. In fact, the high soy intake is the reason Japanese women have fewer menopause symptoms than American women. Soy is only “bad” if your allergic to it–fortunately not too common.
Some women even manage to hold menopause symptoms at arms length with a Starbuck’s soy latte each morning. Just be forewarned the sugar content of this beverage is pretty high
Dr
Great article! I haven’t gone the menopause path yet but want to be prepared when it arrives. I thought soy was very bad for you but then it’s in bioindentical hormones?
Mary