Living Well through Menopause

With any medical treatment, the end must justify the means. With this in mind, hormone replacement therapy (HRT) is primarily used to treat symptoms associated with menopause including hot flashes, vaginal atrophy, urinary incontinence, and emotional imbalance. Also, HRT has been shown to decrease the incidence of osteoporosis thus reducing the risk of fracture. Although menopausal symptoms may be very troublesome, they are not life threatening. With time, menopausal discomforts will fade, yet the side effects of HRT may not.

It is important to consider the known side effects of hormone replacement and the risks associated with the therapy. It is crucial to weigh the risks against the benefits. Side effects of estrogen replacement therapy include the following: water retention, bloating, nausea, breast soreness, and headaches. Unfortunately, hormone replacement also increases a woman’s chances of suffering from a multitude of life threatening conditions including stroke (41% increase), blood clots/thromboembolic disease, breast cancer (26% increased risk), uterine cancer, endometrial cancer, ovarian cancer, colon cancer and gallbladder disease, specifically gallstones. For these reasons, it may be wise to investigate alternatives.

Explore options such as:

• Acupuncture
• Applied relaxation
• Diets rich in soy and phytoestrogens
• Moisture Management Clothing
• Biofeedback
• Black Cohosh
• St. John’s Wort
• Calcium, Vitamin D and Magnesium supplementation
• Exercise

You may benefit from a course of acupuncture and/or applied relaxation which have been shown to appreciably reduce hot flashes. Acupuncture has also been proven to significantly decrease nocturnal (night time) hot flashes. Diets rich in soy and phytoestrogens have also been investigated; increased consumption of foods containing these products may alleviate symptoms such as hot flashes and vaginal dryness. For episodes of hyperhydrosis (excessive sweating), there is a line of clothing called HotCool Wear which features moisture management clothing that dries quickly; this type of garment may enable you sleep more comfortably . Biofeedback is a system by which you teach your mind to control the involuntary functions of your body. Women suffering from urinary incontinence may benefit from a course of biofeedback therapy. Studies analyzing the effects of black cohosh* and St. John’s wort* for the treatment of both physical and psychological components of menopause are promising. A specific product featuring black cohosh is Remifemin* which has been shown to reduce hot flashes, sweating, isomnia and anxiety. Remember : You may be unaware of potential contraindications and drug interactions. For your protection, always speak with your healthcare provider before initiating a course of herbal therapy. As for osteoporosis, calcium, magnesium, and vitamin D supplementation coupled with regular weight bearing exercise may be protective in some patients. These prophylactic and therapeutic measures may decrease a woman’s risk of pathological fractures associated with trabecular resorption. Ideally, young women would pay attention to calcium intake throughout the life span and habitually exercise in order to prevent the onset of osteoporosis. Exercise is great for a woman’s mind, body and soul. Walk, jog, bike, hike, swim, and be active!

In light of a variety of plausible alternatives to hormone replacement, women of menopausal years should first consider natural methods of relieving their symptoms. Speak candidly about your concerns with members of your health care team. The doctors at Lehigh Valley Chiropractic aim to offer alternatives in an integrative setting while providing you with individualized health care. Learn about your options and LIVE WELL.

*Always speak with a member of your healthcare team before taking nutritional or herbal supplements.

References:

1. Levine JP. Long-term estrogen and hormone replacement therapy for the prevention and treatment of osteoporosis. Current Womens Health Rep. 2003 Jun; 3(3):181-6.
2. Odmark IS, Bäckström T, Jonsson B, Bixo M. Well-being at onset of hormone replacement therapy: comparison between two continuous combined regimens. Climacteric. 2004 Mar;7(1):92-102
3. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/007111.htm
4. Huang MI, Nir Y, Chen B, Schnyer R, Manber R. A randomized controlled pilot study of acupuncture for postmenopausal hot flashes: effect on nocturnal hot flashes and sleep quality. Fertil Steril. 2006 Sep;86(3):700-10.
5. Zaborowska E, Brynhildsen J, Damberg S, Fredriksson M, Lindh-Astrand L, Nedstrand E, Wyon Y, Hammar M. Effects of acupuncture, applied relaxation, estrogens and placebo on hot flushes in postmenopausal women: an analysis of two prospective, parallel, randomized studies.
Climacteric. 2007 Feb;10(1):38-45
6. Welty FK, Lee KS, Lew NS, Nasca M, Zhou JR. The association between soy nut consumption and decreased menopausal symptoms. J Womens Health (Larchmt). 2007 Apr;16(3):361-9 (Available at: http://www.hotcoolwear.com/aboutus.php)
7. Aksac B, Aki S, Karan A, Yalcin O, Isikoglu M, Eskiyurt N. Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence. Gynecol Obstet Invest. 2003;56(1):23-7. Epub 2003 Jul 14.
8. Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HH. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study. Maturitas. 2007 Aug 20;57(4):405-14. Epub 2007 Jun 21.