The Important Truth About Menopause & Hormones

• Drug-Free Solutions
• Other Options
• Hormone Replenishment
• Hormone Therapy That's Actually Good for You!

With all the press about the dangers of hormone replacement therapy (HRT), women today know that they need to explore alternative choices, but may be unsure of the benefits and downsides of their choices. To make matters worse, most medical doctors also lack the information they need to understand the full array of choices, and are unsure themselves about what to recommend and why. But safer, healthier, natural choices do exist, and I’m going to discuss some of them here.

Since menopause is, by definition, a time of transition, the whole idea of it is to treat any discomfort related to it for a temporary period of time. There is a way to make menopausal transition smooth and harmonious that may or may not require hormones, and that uses diet, nutrients, exercise, herbal relief, and natural hormones as needed.

Since each woman is unique—one may feel revitalized after adjusting her diet, while another may need hormonal assistance for a short time. Talk with your doctor. Testing your hormonal health will give you a baseline that is a valid starting point for therapeutic intervention. And in the end, as you regain internal balance and strength, trust God and your body to guide you to the level of therapy that is right for you.

The good news is that there are a number of safe, natural, effective, and drug-free steps you can take to manage your symptoms and ease your way through this time of transition.

Drug-Free Solutions

Eat a balanced diet

• Eating for hormonal balance is crucial to a smooth transition through menopause whether your symptoms are mild or severe. Eating nutrient-rich whole foods can prevent or soothe menopausal discomfort. Instead of a slab of meat with a few vegetables, strive for the multi-flavored, multi-colored, “mini-taste treat” dinners common to Asian and Mediterranean cultures.
• Eat your protein. Contrary to conventional medical opinion, emerging science suggests that most of us do not get enough protein in our diets. Protein, in the form of animal sources (beef, pork, game, lamb, chicken, and seafood) as well as plant sources (nuts, seeds, and legumes), is necessary for the building blocks of our existence—blood, flesh, and bones.
• Focus on phytosterols by eating largely organic, plant-based meals—vegetables, roots, tubers, grains, legumes, fruits, seeds, nuts, and sea vegetables. Phytosterols in plants can help ease menopausal discomfort by producing a weak estrogen-like effect, and can even regulate hormonal fluctuations, increasing or decreasing estrogen effects in your body as needed. One of the best sources of phytosterols is broccoli—which is also rich in diindolylmethane or DIM, which helps balance hormones by eliminating excess estrogens. Other sources include: artichokes, bamboo shoots, Brussels sprouts, red cabbage, eggplant, okra, turnips, apricots, figs, muskmelon, pomegranate, rye, barley, chickpeas, or pine nuts.
• Soy packs a powerful punch when it comes to balancing and supporting hormones. A study at Bowman Gray Medical School in North Carolina showed that 20 grams of soy protein a day decreased hot flashes. I recommend you use cultured (fermented) soy products, such as natto, tempeh, miso, and tamari, since they do not rely on friendly flora in your gut to convert genistein, soy’s primary isoflavone, to an active phyto-estrogen.

Food Foes

• In excess, these foods are known to aggravate hormonal imbalance symptoms. If limiting them doesn’t work, try eliminating one of the foods below for fourteen days. Pay attention to how you feel during that time. Slowly reintroduce a modest amount of the food, and track how you feel. A journal can help you put the pieces together. Avoid a different food from this list every two weeks. Limit, or eliminate, the following foods: caffeine, refined sugar, table salt, alcohol, diet sodas and soft drinks, fried foods and other saturated fats, partially hydrogenated oils, and chocolate or cocoa. If your hot flashes are persistent, you also may want to avoid spicy cuisines.

Essential Exercise

• Exercise helps to balance the hormonal see-saw that defines menopause. For some women, adding consistent exercise to their daily routine will make all the difference in how menopause affects their lives. There are three forms of exercise that every woman should practice on a weekly basis: strength training, cardiovascular workout, and stretching. I recommend 3-1/2 to 4 hours of exercise per week. That’s less than two percent of your week for a therapy that could make the difference between premature aging and aching and being an energetic, vital woman. Nothing gives you greater return for your mind, body, and spirit than the time spent on exercise.

Herbal Helpers

• Take 20 mg of black cohosh, of a standardized extract containing 2.5 percent triterpene glycosides, twice a day. Compounds in black cohosh effectively manage the major symptoms of menopause. Be patient; you could feel improvement in certain symptoms in a matter of days or weeks, but it may take up to two months to experience the full benefit.
• Supplement with two 60-mg tablets of gamma oryzanol, a rice bran oil extract, three times per day with meals. Research suggests that it can be as effective as black cohosh for menopausal symptoms. A Japanese study done in 1984 reported that women who took 300 mg per day of gamma oryzanol showed an 85-percent improvement in their menopausal symptoms within two months. It is especially useful for night sweats, heart palpitations, and stress, and has a high safety profile.
• Use 400 mg Chaste Tree Berry (Vitex agnus-castus) three times per day. Vitex increases the brain’s production of the progesterone regulating, luteinizing hormone (LH). LH tells the ovaries to increase the production of progesterone, thus improving the estrogen/progesterone balance during the second half of a woman’s cycle. It is specifically helpful for early symptoms of transition and possibly low progesterone levels—break-through bleeding, weak libido, missed periods, hot flashes, and night sweats. Vitex works slowly, so be patient. I prefer to use the whole plant if available; if not, use a standardized extract.
• Take a tablespoon of borage oil or black currant oil once or twice a day. Excellent alternatives to the usually more expensive evening primrose oil, they contain high levels of gamma linolenic acid (GLA), an essential fatty acid that helps regulate anti-inflammatory prostaglandins (cellular hormones). Organic oils are highly preferred, and better brands are refrigerated, nitrogen-flushed, and come in opaque or black bottles to prevent rancidity (lipid peroxidation).
• Try 100 mg of a standardized extract of ginseng one to two times per day with meals, or—if you’re taking the whole root—1–2 grams per day. A double-blind placebo-controlled study of menopausal women showed overall symptom relief and improvement in mood and well-being after ginseng supplementation. Due to its stimulating nature, I recommend you take it for three to four weeks with one week off. For maximum benefit, I prefer the whole root of this plant. If you can’t find it, take a standardized extract.
• Supplement with 1,000 mg ashwagandha two to three times per day, and 1-4 g of licorice root three times per day. Also known as “Indian ginseng,” ashwaganda supports the adrenal glands, the “back-up system” for hormones. Licorice root has been found to possess activity similar to at least two hormones of the adrenal glands, and helps support normal adrenal function. At midlife, the adrenal glands assist the hormonal balance by producing low levels of sex hormones and DHEA. Note: Long-term use of excessive levels of licorice root could raise blood pressure.

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Other Options

• Take a high-quality multivitamin that contains at least 100 IU of natural vitamin E (d-alpha tocopherol). Taking 50–100 IU of Vitamin E daily has been shown to improve hot flashes and night sweats by 75 percent in just four weeks. Other studies have linked vitamin E to relief of sweats, backaches, muscle pain, heavy bleeding, fatigue, and nervousness. Take vitamin E as d-alpha tocopherol or mixed tocopherols plus tocotrienols.

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Hormone Replenishment

The good news is that science and nature have perfected a hormone replacement option that is natural, effective, gentler, and much safer than HRT—bioidentical plant-derived hormones, or what I call “natural hormones.” Available by prescription and FDA-approved, pharmaceutical, bioidentical hormones are the natural and real hormone replacement therapy. By definition, they are biologically and biochemically identical to your own hormones. When used correctly, they help give all the expected benefits and minimize any possible risks and side effects.

Contrary to media and pharmaceutical portrayal, estrogen is not a single hormone but an entire class of hormones. The three most important estrogens include estrone (E1), estradiol (E2), and estriol (E3). These estrogens, and progesterone, are the hormones that may need replenishing during menopause. Below you’ll find information on several different types of bioidentical products.

• Progesterone is a “precursor” hormone that the body can use to create other steroid hormones, such as estrogens and testosterone, and bring about hormonal balance. Many women at perimenopause and menopause benefit from natural progesterone by itself. It is important to use natural progesterone, as the conventionally prescribed, synthetic imposters can actually cause menopause-like side effects. Beware of products that don’t show progesterone on the label, or those that say “yam” cream. I do not recommend them and, to date, am unaware of any science that validates their use.
• Tri-estrogen (tri-est) plus progesterone is one part estradiol to one part estrone to eight parts estriol, with some balancing progesterone. It is particularly effective for women with moderate to severe symptoms. Estriol is a protective and beneficial estrogen, while estradiol and estrone are added to help alleviate symptoms such as hot flashes and night sweats. Because of the cancer-preventing effects of estriol, I highly recommend you start your natural replenishment program with tri-est in the above formula.
• Estradiol plus progesterone is a good short term choice under certain conditions, such as immediately following a hysterectomy when tri-est may not be strong enough to manage menopausal symptoms. Estradiol plus progesterone has been shown to be superior to conventional HRT—having all of the benefits with none of the side effects. After an initial course of estradiol plus progesterone, most women should be able to switch to the safer, long-term combination of tri-estrogen plus progesterone. Your doctor can prescribe a custom dose from a compounding pharmacy.
• Estriol plus progesterone is ideal for women with milder menopausal symptoms that do not respond to herbal therapies. Estriol plus progesterone can relieve discomforts such as vaginal dryness, atrophy, and urinary tract infections.
• The androgens DHEA and testosterone are often referred to as male hormones, but play important roles in women’s health as well. Androgens are helpful in building bones, improving energy, lifting libido, and improving memory and immunity. Women who have experienced surgical menopause need to replenish these hormones as well. Depending on symptoms and test results, some androgens can make all the difference in feeling like yourself once again.

Conventional HRT has never been the right prescription for anybody. Its decades of use, and continued existence, is simply another indication that women’s health care has been in the dark ages too long. With all the recent studies showing conventional HRT’s empty promises and its ominous dangers, a new era of menopausal management is here today. I’ve been practicing it and writing about it for decades, and I will continue to do so. Remember, there is a safe, natural way to restore your health and vitality.