Hormone Replacement Therapy: What Are The Natural Alternatives?

Tuesday, January 16, 2007 - 4:58pm

By Michèle Turcotte, MS, RD/LDN

Menopause occurs when estrogen levels drop and menstruation ceases. The average age for women in menopause is 51. Common symptoms include hot flashes, night sweats, difficulty sleeping, vaginal dryness, memory impairment, mood swings and difficulty concentrating. For many years, hormone replacement therapy (HRT) has been the standard therapy in the United States for treating menopausal symptoms. In July 2002, the Women's Health Initiative (a large clinical trial) reported that HRT posed more health risks than benefits for women in this trial. As the number of health hazards increased, doctors stopped prescribing HRT.

Diet and lifestyle considerations to alleviate menopause symptoms

For some women, the benefits of short-term therapy outweigh potential risks. However, diet and lifestyle modifications can alleviate the symptoms of menopause for many women. They include:

  • Eating a low-fat diet high in fruits, vegetables, whole grains and soy protein
  • Exercising regularly
  • Not smoking
  • Limiting caffeine and alcohol
  • Reducing stress through yoga, meditation, etc.

A shift in hormones during menopause makes it difficult for the body to regulate its temperature, which results in hot flashes. Avoid situations that raise body temperature (sitting in a warm room or eating spicy foods). Some studies have shown that acupuncture may reduce the severity of night sweats while improving sleep quality in women experiencing these symptoms.

Soy and flaxseed may help with the menopause

Only 10% of postmenopausal women in Japan experience hot flashes, compared to 80% of their Americans counterparts. While some of this may be related to cultural differences in attitudes toward aging, many experts believe that the difference has to do with the abundance of soy in the Japanese diet. Soy contains natural estrogens called phytoestrogens. Research has shown that women who consume soy products regularly experience fewer hot flashes and less vaginal dryness than those who do not. Regular consumption of soy products may even increase bone density.

The amount of soy needed to obtain beneficial effects is approximately 40-80 milligrams of soy isoflavones per day. There is some controversy about whether natural plant estrogens (such as soy) can stimulate the growth of breast cancer cells in women with a history of breast cancer. There are substances in soy that may inhibit cancer cells in general. A few studies have demonstrated protection against breast cancer with the regular use of soy products.

Flaxseeds also contain phytoestrogens and substances called lignans, which may protect against cancer and relieve symptoms of menopause. Flaxseed can be purchased at a health food store. To use it, refrigerate and grind before eating (it keeps for 24 hours). Try sprinkling 2 tablespoons of ground flaxseed on cereal or mixing it with yogurt. Flaxseed is rich in vitamin E, which also helps prevent hot flashes.

Are there supplements to alleviate the menopause?

Black cohosh (Actaea racemosa) is the only herb approved by the Germany's Commission E (similar to the U.S. FDA) for the treatment of menopausal symptoms. Studies have demonstrated that the roots and rhizomes of this herb, when standardized properly to the terpene glycoside fraction (the active compound within the root), appear to be an effective treatment for menopausal symptoms. Adverse effects are extremely uncommon, and there are no known significant drug interactions.

Future research is needed to fully support claims that soy and black cohosh (estrogenic substances) alleviate menopausal symptoms safely regardless of breast cancer history. Most studies of black cohosh have used the extract known as Remifemin, which is standardized to contain 1 milligram of terpene glycosides per 20 milligram tablet. The most commonly used dosage of Remifemin is two 20 milligram tablets twice daily. Maximum effect usually occurs in four to eight weeks. Talk to your doctor before incorporating any of these items or supplements into your current regimen.

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3. Tyler VE. "Five herbs that ease menopause." Prevention, March 1999.