Menopause: Signs, Symptoms, Solutions

Woman on a beach
March 12, 2014 (Updated: May 13, 2015)
Leigh Erin Connealy, M.D.

What comes to mind when you hear the word “menopause”? If you immediately think of hot flashes, sleepless nights, emotional upheavals, and other miseries, it’s time to set the record straight. Once again, conventional medicine and Big Pharma have taken a perfectly normal experience and created a profit center, so they can sell prescription medication.

Unfortunately, the menopause relief products that are offered by conventional medicine are risky choices at best. But before looking at what does work safely and effectively, I’d like to point out the fallacy behind this type of medication madness. Selling drugs to treat an inevitable, natural occurrence is a clever marketing scheme, pure and simple. And to my mind, prescribing a synthetic product – like CEE (conjugated equine estrogen), also known as Premarin®, derived from the urine of a pregnant horse – is not the solution. In fact, these types of synthetic hormones became an even bigger problem than menopausal symptoms themselves, as I’ll explain in a moment.

What Is Menopause?

I’m not going to go into great detail about what happens during menopause, since most people, especially women, already know what occurs. Basically, the ovaries stop producing eggs, as well as the hormones estrogen, progesterone, and testosterone. Menstruation may not stop completely at first. Many women experience an irregular, on-again, off-again monthly period. Cramps may continue, but eventually these occurrences end, too. This gradual process – known as perimenopause – typically begins anytime from the mid-30s to the 50s, and can take months or even years to complete.

Few women complain about the lack of a monthly period and/or cramping. But the shortage of estrogen, progesterone, and testosterone causes other, less desirable side effects, including heart disease, hardening of the arteries, hot flashes, vaginal dryness, insomnia, weight gain, and brittle bones (osteoporosis). These symptoms are all caused by an imbalance in hormone production.

The Hormone Fiasco

If you’re a woman and live long enough, you’ll experience menopause. Is it uncomfortable? It can be at times. But does that mean you should take drugs that could increase your risk of some very serious health issues? Because the truth is, while synthetic hormones are fairly effective at treating hot flashes, the results of a series of landmark studies known as the Women’s Health Initiative (WHI), found an increase in heart disease, breast cancer, stroke, and blood clots among women using a combination of synthetic estrogen and progestin.

The WHI was a federally funded, multi-year effort that was launched in the late 90s with more than 160,000 postmenopausal women. One component of the study was designed specifically to determine the effectiveness and safety of synthetic hormone replacement therapy (HRT) pairing estrogen and progestin, a combination that was believed to be an improvement over estrogen-only replacement.

Although the estrogen/progestin portion of the study was supposed to last for nine years, the researchers shut it down in 2002, after only five years, when it became apparent that this type of HRT was linked to very serious health issues, including breast cancer, stroke, blood clots, and heart disease. In addition, less than two years later, a second branch of the study, designed to examine the effects of estrogen replacement only, was also shut down prematurely. The reason? Women who were taking only synthetic estrogen did not experience protection against heart disease or strokes, contradicting previous research.

The study findings had a tremendous impact on American women. Although nearly 40 percent of them were taking synthetic hormones, these results were enough to convince roughly half of them to stop. I have treated thousands of menopausal patients and individuals with hormone problems. None of them take synthetic hormones and they are quite comfortable. And with no worries about becoming pregnant, they’re enjoying their newfound freedom, finding that they now have time to do things they’d only dreamed about earlier in life. Their lives are not all roses and lollipops. But my point is this –

Your expectations about events dictate a great deal about the outcomes.

This is why I encourage female patients who are having difficulties with menopausal discomfort to take a long look at their attitudes regarding aging and change of life. In my experience, I’ve noticed that women who are looking forward to a new life stage don’t find the difficulties posed by menopause to be much more than a bump in the road, rather than a massive blockade.

In other words, if you’re convinced that menopause is going to be a horrendous experience, it will be. On the other hand, if you consider “change of life” to be an opportunity to overhaul your life and try new things, then that’s more likely to be what happens. As I explain to my patients, your expectations can become self-fulfilling prophecies, so expect the best!

The fact that expectations are crucial to outcomes has been clearly established by a number of studies. For example, researchers discussed expectations with a group of 140 patients with neck pain who were receiving physical therapy. Those who believed that therapy would help had better outcomes than those who were unsure about obtaining pain relief from therapy.

In a second clinical trial, researchers examined 102 patients who had either knee or hip replacement surgery. Those who expected the surgery to successfully relieve their pain and improve their functional abilities had better outcomes and greater success than those who had low expectations.

A Closer Look at What Does Work

Now it might seem as though simply replacing the missing hormones would eliminate bothersome menopause symptoms. But as I mentioned earlier, the Women’s Health Initiative found that using synthetic hormones was not a good solution.

This is because hormones are highly complex. There are dozens of different hormones in the body, and they are intimately involved in thousands of processes. So simply prescribing a one-size-fits-all replacement pill or cream – without first determining a patient’s hormonal status with a blood test – is not the way to go about it. Furthermore, synthetic hormones do not match those produced in the body. As a result, complications – like those mentioned earlier, including heart disease, stroke, blood clots, and breast cancer – are common, as are side effects, such as headaches, fluid retention, nausea and vomiting, high blood pressure, vaginal bleeding, and problems with blood sugar.

By now, you may be thinking that there’s no safe, effective way to survive menopause. Not true! These days, integrative medicine has given us bio-identical hormones. Products like these, which are made from things like soybeans or wild yams, are exact copies of naturally occurring hormones, so side effects are minimal. You can get bio-identical hormones at a compounding pharmacy, with a prescription from your doctor. Ideally, you’ll have a blood test first to determine exactly which hormones you need. But the end result is well worth it. Properly balanced, bio-identical hormones protect your heart and bones, ease emotional upsets, and restore a great deal of pre-menopausal quality of life. In addition, here are seven supplements that many of my patients have found helpful.

Black cohosh (Cimicifuga racemosa): There are dozens of studies examining the effects of black cohosh on menopause symptoms. In my experience, extracts from this plant work best for younger women (in their 30s or 40s) who are still producing some estrogen. Research has shown that black cohosh can ease hot flashes, anxiety, and, when combined with St. John’s wort, even depression. I recommend taking 20 mg twice daily.

Chaste tree or chasteberry (Vitex agnus-castus):  Although there are no large, conclusive clinical trials testing the effectiveness of chaste tree on menopausal symptoms, many women say they have benefitted from these supplements, especially when combined with St. John’s wort. Chaste tree appears to help the body maintain a healthy balance of estrogen and progesterone. In addition, research has shown that it can help with hot flashes, mood swings, and even the heavy menstruation that sometimes occurs in perimenopause. An occasional upset stomach or mild rash seem to be the only side effects. I suggest taking 20 mg daily.

DHEA (dehydroepiandrosterone):  DHEA is a hormone that’s produced by the adrenal glands. Your body can convert DHEA to other hormones, including estrogen and testosterone, on an as-needed basis. But DHEA also provides a boost for “feel good” brain neurotransmitters known as endorphins. As a result, I often recommend DHEA to patients who are troubled by emotional difficulties or mood swings. DHEA is available in pill form as well as a cream that can be applied topically. Take 5 to 20 mg daily.

GABA (Gamma-aminobutyric acid): Sleep issues are one of the most common complaints among menopausal patients. Often, the problem seems to be racing thoughts produced by an overly active brain. GABA is the most prevalent neurotransmitter in the brain, and one of its duties is to calm the irritability and restlessness that results fro too much stimulation. In other words, GABA helps with relaxation and sleep. It also reduces hot flashes. Take 200 to 750 mg daily.

5-HTP (5-hydroxytryptophan): 5-HTP is a key ingredient used in the body to manufacture serotonin, a brain neurotransmitter that plays a role in emotions, sensations of pain, sleep, and inflammation. I often recommend 5-HTP as an insomnia remedy, along with melatonin, and several herbs, including valerian. I suggest 100 to 400 mg daily. Although 5-HTP is helpful for sleep, it can be taken during the day, as well as at night.

Maca (Lepidium meyenii): This member of the mustard family is native to the Andes mountain region of Peru, where it has been used for centuries to restore sexual vigor in both men and women. Maca has a well-deserved reputation for balancing female hormones and reducing hot flashes. Take 2 to 3 grams daily, and be patient; it can take six to 12 weeks to reach therapeutic levels in the body.

Omega-3 essential fatty acids (EFAs): Last but not least, I recommend omega-3s to nearly all middle-aged and older patients. While typical menopause symptoms are annoying, as a physician I’m more concerned about my patients’ unseen, internal changes, like becoming more vulnerable to heart disease, stroke, memory difficulties, and certain types of cancer as you age. So while it’s certainly beneficial to eliminate hot flashes and insomnia, it’s equally important to prevent damage to your cardiovascular system, maintain strong brain functions, and keep cells healthy. Fortunately, omega-3s excel at all those things. Optimal results are obtained from omega-3 supplements containing a higher ratio of DHA to EPA (fish oil’s two essential elements). I recommend taking 1,000 mg of a purified, molecularly distilled omega-3 product three times a day with meals. For your convenience, my own omega-3 product (which comes from a sustainable source) includes vitamin D, another essential nutrient that most people are lacking.

If you’re dreading menopause, please don’t get swept up in all the myths and misunderstandings. Like most things, there are good and bad aspects to this major life event. But just because a friend or co-worker had bad experiences is no guarantee that you will. Try these integrative remedies and I think you’ll discover the change of life experience can be a change for the better.

Did You Enjoy This Article?

Sign up to get FREE access to more health tips, latest research, and exclusive offers to help you reach your health and wellness goals!

Hide

Get Your FREE Subscription to
Dr. Leigh Erin Connealy's Health News E-letter