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Managing Menopause:
Living with the Change

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Many hormonal changes occur during menopause. Primarily as a result of decreases in estrogen, post-menopausal women are at higher risk of heart disease and osteoporosis. A number of unpleasant symptoms may also accompany menopause. Some, such as vaginal dryness, result from the lack of estrogen. Others, such as hot flashes (or flushes) and decreased libido, are caused by more complex hormonal changes.

While some women may elect hormone replacement therapy (estrogen and progesterone) or estrogen replacement therapy, other alternatives are being researched to help women manage menopause.

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A Natural Alternative
Soy Isoflavones
Vitamins and Exercise
Herbal Options
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Soy: A Natural Alternative
Soybeans are a great source of phytoestrogens—compounds that are related in structure to estrogen. The mild estrogen activity of soy isoflavones may ease menopause symptoms for some women, without creating estrogen-related problems. Researchers have linked societies with high consumption of soy products (see "Supplement Profile") to a low incidence of hot flashes during menopause.

One double-blind trial found that daily intake of 60 grams (just over three ounces) of soy protein led to a 33 percent decrease in the number of hot flashes after four weeks and a 45 percent reduction after twelve weeks. In another study, a group of 58 menopausal women, who experienced an average of fourteen hot flashes per week, supplemented their diets with either wheat flour or soy flour every day for three months; the women taking the soy reduced their hot flashes by 40 percent. As a result of these studies, doctors of natural medicine often recommend that women experiencing menopausal symptoms consume soy foods regularly.

Soy Isoflavones: Beneficial or Bogus?
A recent study suggests that soy lacks "significant" benefit in the reduction of hot flashes associated with menopause.   Published in the March, 2000 issue of the Journal of Clinical Oncology, soy isoflavones did not relieve severe hot flashes—caused either by menopause or by chemotherapy for breast cancer—any better than placebo. Almost one-quarter of the women reported symptom improvement from 150 mg daily doses of the soy isoflavones used in the study. In comparison, one-third of the women in the study noted improvement after taking a placebo.

There are many scientific reasons for the discrepancy between this study and previous studies that have supported the use of soy to quell hot flashes.  For starters, the way a substance affects an individual varies widely from person to person. In addition, soy, as a plant, contains numerous chemicals that may work together in ways that may help quell hot flashes but haven't been proven scientifically. To cool the body down during hormonal changes, many soy advocates suggest adding whole food soy sources to the diet. So while you wait for more news on soy, give it a chance, and tell us of your results! Research
—Editor, Health Journal

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Vitamins and Exercise
Regular exercise is an important health activity for all people, but it's especially important for post-menopausal women, who are at higher risk of heart disease and osteoporosis. The benefits of exercise are probably due to its effects on body weight, blood pressure, blood triglycerides and cholesterol, and glucose tolerance—all of which affect cardiovascular health. Exercise is also known to help protect against bone loss.

Research has shown that exercise also helps ease menopausal symptoms. One study found that sedentary women were more likely to have moderate or severe hot flashes compared with women who exercised. Another trial found that menopausal symptoms were reduced immediately after aerobic exercise.

In addition to exercise, supplementing with certain vitamins has shown to be beneficial. Many nutritionally oriented doctors suggest that women going through menopause take 800 IU per day of vitamin E for a trial period of at least three months to see if symptoms are reduced. Women can continue to take this amount if they find it helpful. Using lower amounts for less time has led to statistically significant changes, but only marginal clinical improvement.

Many years ago, a preliminary trial reported that 1,200 mg each of vitamin C and the flavonoid hesperidin, taken over the course of the day helped relieve hot flashes. Although placebo effects are strong in women with hot flashes, the flavonoid/vitamin C combination was more effective than other treatments used in that trial.

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 For Woman Only provides nutrients to help support and maintain the health of today’s active women.   vitamin-minerals plus essential herbal women factors. Because of the changes in hormone levels throughout a woman’s lifetime, women may experience a variety of symptoms: P.M.S, menstrual irregularities, anxiety, and menopause. Designed specifically to help maintain good hormonal health. 

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EstroSoy Plus
with Soy & Black Cohosh
* Relieves Hot Flashes & Night Sweats.
* Supports Breast Health.
* Promotes healthy bones by Helping the Body Retain Calcium.
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Natural Phytoestrogens (includes:Red Clover Tops Extract, Chasteberry Extract, Black Cohosh Extract, Dong Quai Root Extract), , Saw Palmetto, Damiana Extract, Flavonoids, Sodium Hyaluronate (HA), MSM (Methylsulfonylmethane), Evening Primrose Oil, (Oenothera Biennis), Carbomer, Phenoxyethanol, Tocotrienol (Natural Super Vitamin E), Sodium Bicarbonate, Allantoin, Potassium Sorbate, Grape Seed Extract  Buy Estro Soy Plus
Menopausal Support
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This is a popular women's formula, with herbs traditionally used for menopausal support. Change-O-Life formula is a blend of Black Cohosh and other popular women's supplements for a powerful synergy. Contains: Black Cohosh Root, Blessed Thistle, False Unicorn Root,  Licorice Root, Sarsaparilla Root, Siberian Ginseng Root, Squaw Vine (vine, leaf, fruit)
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Herbal Options
Black cohosh may be useful for women with hot flashes associated with menopause, according to double-blind research. A review of eight trials concluded black cohosh to be both safe and effective. Many doctors of natural medicine recommend 20 mg of a highly concentrated extract taken twice per day.
 
A standardized kava extract was found effective in reducing anxiety as well as other symptoms associated with menopause. Participants in this double-blind study took 100 mg of a kava extract, standardized to 70 percent kava lactones, three times per day.
 
A variety of herbs with weak estrogen-like actions similar to the effects of soy (such as licorice, alfalfa, and red clover) have traditionally been used for women with menopausal symptoms. Red clover appears to improve arterial flexibility—a major cardiovascular risk factor—in post-menopausal women, but no other research has been done that might confirm the potential benefit of these phytoestrogens.
bulletSupplement Profile
Soy for a Smoother "Change of Life"
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Soy, a staple food in many Asian countries, contains valuable protein, isoflavones, saponins, and phytosterols. Soy protein provides essential amino acids and can be used as effectively as animal protein by adults. It's also low in fat and cholesterol-free.

The isoflavones in soy may reduce the risk of hormone-dependent cancers, such as breast and prostate cancer, as well as other cancers.

A meta-analysis study that pooled 38 trials for reanalysis reported that a soy diet led to cholesterol reductions in 89 percent of the studies—intake was associated with a 23 mg per deciliter drop in total blood cholesterol levels.

Soy may be supportive for a variety of other health conditions, including preventing osteoporosis, easing menopause symptoms, and regulating hormone levels in pre-menopausal women.

How much is usually taken?
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Ideal intake is not known, but research suggests that the equivalent of one serving of soy foods per day supports good health, and the benefits increase as soy intake increases.
Are there any side effects?
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A small percentage of people have allergies to soybeans and should avoid soy products. Clinical relevance of interactions between soy and thyroid function remain unclear, but in infants with congenital hypothyroidism, soy formula must not be added to or removed from the diet without consultation with a pediatric endocrinologist. Soy's phytic acid may interfere with mineral absorption, but this mild effect is not likely to be significant in people eating healthful diets.
 
bulletA Natural Approach
Following is a natural approach to menopause that you can adapt for your own use. You may need 1-2 months to ascertain the entire effects of the steps. On the other hand, some relief may be immediate.
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Step 1: The basic program is one you already know. Eat lots of fresh foods, particularly steamed veggies and salads, get enough protein, and drink plenty of water (at least eight glasses daily). Eat good fats. (Raw nuts, avocados, fish.) Experiment with Nina Shandler's soy and flax laden foods. Stay away from sugar and other processed carbohydrates. They stress the body and encourage weight gain. Get sufficient rest, relaxation, and exercise. Continue your multivitamin-mineral (you especially need the B vitamins); up your intake of vitamin E (1200 IU is reported to help with hot flashes); vitamin A (10,000 IU for skin integrity); and increase vitamin C to at least 3 grams (I take two of Ester-C for adrenal support). Make sure you are taking a bone building formula with at least 1500 mg of calcium.
Step 2: Add a woman's herbal. There are many fine herbal formulas on the market, using traditional Chinese herbs, traditional Western herbs, and mixtures of the two. They frequently include Vitex (chaste berry), dong quai, licorice, and black cohosh. Black cohosh extract was a savior for me when I wrote the first edition of "Hot Flash!" I purchased a brand approved in Germany for menopausal symptoms and the most widely tested herb of its kind. Although it only took the edge off my hot flashes, it completely eliminated vaginal and genital skin thinning. Testing has shown that most women have results in 4-12 weeks. It was nearly four months before I got mine. It was worth the wait.
Step 3: Get some progesterone. As noted, at menopause, the body no longer makes progesterone. Perhaps the most important thing about this hormone is that it helps the body to lay down calcium. In addition, many women find that using it completely knocks out their symptoms.
Step 4: If your brain's not working the way it used to... try some "smart pills." My thoughts get slippery whenever I'm under stress. I use ginkgo biloba and a brain food formula containing phosphatidyl serine. Perhaps because my brain is used to receiving this food, I often have results within a few hours.
Step 5: Last resort, find a doctor who will prescribe natural hormones for you.
 
References:
Obstet Gynecol 1996;87:897-904, Obstet Gynecol 1998;91:6-11
Maturitas 1995;213:189-95, Mauritas 1998;29:139-46
Health Psychol 1997;16:203-8 J Clin Oncol 1998; 16:495-500
J Womens Health 1998;7:525-9, Nutr Cancer 1994;21:113-31
Lancet 1993;342:1209-10, New Engl J Med 1995;333:276-82
J Am Diet Assoc 1994;94: 1253-4, Biochem Pharmacol 1997;54:1087-96
J Am Coll Nutr 1997;16:280-2, J Clin Endocrinol Metab. 1999 Mar;84(3):895-8.
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These statements have not been evaluated by the Food and Drug Administration. This web site is not intended to diagnose, treat, cure, or prevent any disease. 

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