A natural approach to the menopause

The menopause is a natural point in every woman’s life, a sign that the childbearing years are drawing to a close. But, however normal, this ‘change of life’ can cause some difficult physical and emotional symptoms.

Here we examine how and why the menopause can affect a woman’s life and how a natural approach to treatment could be effective.

During the menopause a woman’s ovaries stop producing eggs and levels of the hormones oestrogen and progesterone fall rapidly. Chemicals in the brain called dopamine and serotonin can also become disrupted. These changes can cause symptoms that last for an average of two years, although for some women they can continue for as long as six.

Symptoms

• Headaches
• Hot flushes and night sweats
• Mood swings
• Fatigue
• Dizziness
• Anxiety
• Depression
• Bladder problems
• Poor libido
• Vaginal dryness
• Itchy skin
• Breast tenderness
• Wrinkling of the skin
• Heart palpitations
• Shortness of breath
• Insomnia.

Natural treatments

There is evidence that some natural treatments may work very well in relieving menopausal symptoms - some herbs in particular have been used for many years and are backed by evidence from clinical trials.

Black Cohosh

This herb is native to North America and was used by the North American Indians who boiled up the root and drank the tea when it was required to ease menstrual cramps and childbirth pains. 

The most important trials to date show that it may help alleviate hot flushes, though studies have shown varying results. It is thought that certain compounds that the herb contains allow it to help balance the brain chemicals dopamine and serotonin which are often disrupted in menopausal women. Imbalances of these chemicals are thought to cause mood swings, irritability, depression, weepiness and a lack of concentration. Therefore Black Cohosh may be effective for the emotional symptoms which accompany the menopause.

Recent research suggests that black cohosh does not act like oestrogen, as once thought. This reduces concerns about its effect on hormone-sensitive tissue (e.g. uterus and breast). Black cohosh has had a good safety record over a number of years.

Agnus Castus

Also known as Vitex or Chaste Tree this herb comes from the Mediterranean and has a peppery odour. The herb has been traditionally used for the early stages of the menopause.

Agnus Castus has been well studied - research has shown that it has a hormone regulating effect and is particularly useful in the peri-menopausal phase to help settle the hormone fluctuations. The perimenopausal period is the transition from reproductive years to menopause and can occur up to 10 years prior to a woman's last menstrual period. Agnus Castus is only useful if hormones are not already being taken. It has been used in Germany widely where herbal medicines are often used alongside traditional medicines. It is used for impaired ovarian function, period problems and PMS.

Little is known about its effect on specific menopausal symptoms however many clinical trials show that it can help with the symptoms of PMS such as hot flushes and irritability. Due to the fact that these symptoms are identical to menopausal symptoms scientists take this as proof that Agnus Castus is effective for both conditions. Like black cohosh, it is thought that Agnus Castus helps to balance out levels of the chemical dopamine in the brain, although the compounds in the herb involved are different.

Dong Quai

This Chinese herb has been used for centuries in the East and has become popular in the West too. It appears to work far more effectively when combined with other herbs. A clinical trial in China revealed that when combined with several other herbs in a formula it was helpful for relieving hot flushes and other menopausal symptoms. In another study patients with menstrual migraines were provided with 100mg of dong quai, 60mg of soy isoflavones and 50mg of black cohosh over 24 weeks. The results clearly showed that the average frequency of migraines fell. It is not yet clear how dong quai works, but herbalists have two main theories. The first is that the herb contains plant oestrogens that can help restore a woman’s hormone balance. The second theory is that the herb works thanks to the compounds called coumarins that it contains that can dilate blood vessels and may also be anti inflammatory. It is thought this may allow the herb to help reduce the severity of menstrual cramps.

St John's Wort

St John's Wort is commonly referred to as "Nature's Prozac" and works by inhibiting neurotransmitters in the brain to have an anxiety reducing and anti-depressant effect. Shown in some studies to be as effective as certain traditional anti-depressants but better tolerated without the side effects. It may be useful for women suffering mild to moderate anxiety and depressive symptoms at the menopause.

Evening Primrose Oil or Starflower Oil

Although there is no scientific evidence to suggest as such, Evening Primrose Oil is well known for its breast pain relieving properties. In fact Evening primrose oil was once available on prescription for breast pain - it has now been withdrawn as a prescription drug. It can be bought as either Evening Primrose Oil or Borage (Starflower) Oil, the most important thing to look for is the amount of GLA (gamma linoleic acid) in each capsule. As a guideline aim for 240mg per day for a couple of months and then try reduce the dose after that. While it has been found to be useful for breast pain and mood swings but is unlikely to be helpful for hot flushes.