The menopause is a natural transition from one phase of a woman’s life to another. However, recent attitudes have leaned more towards medicating the menopause and treating it as a ‘deficiency disease’. Because of this, hormone replacement therapy (HRT) has been the main thrust of treatment. But we are now learning that HRT is not always suitable for long-term use, with increased risks of breast cancer and stroke. Indeed even in the early stages of use, 4 out of 5 women find that HRT doesn’t agree with them. A more natural approach to managing menopausal symptoms is very appealing in these circumstances. Indeed long term post-menopausal health problems, including cardiovascular health, osteoporosis and certain cancers, are all intimately linked to diet and lifestyle habits. Symptoms of the peri-menopause (the time leading up to the actual menopause) include mood swings, ‘wooly brain’, vaginal dryness, weight gain and headaches. The main problem is often hot flushes.

Cooling Hot Flushes
Hot flushes can severely interrupt daily activity and interfere with sleep. Yet women in some countries don’t have nearly as many such problems and diet seems to be the reason. It helps to sleep in a cool room with thin layers of cotton sheets so these can be peeled off as needed. While short bursts of exercise can trigger a hot flush, regular exercise will help to reduce the overall number of attacks. Stress also is known to be a potent trigger. Other triggers of hot flushes include hot drinks, caffeine and alcohol.


Hot flushes are much rarer in vegetarian societies and this is put down to higher intakes of phytoestrogens – plant oestrogens – from the diet. These phytoestrogens are structurally similar to the oestrogens we produce in our bodies, but are much weaker. They have an interesting dual effect of supplying more oestrogens when we need them, but also blocking oestrogen ‘receptor sites’ in sensitive body tissues so that more potent and disruptive oestrogens from chemicals in our environment can’t exert a negative effect. In effect this means they act as a gentle form of oestrogen replacement, whilst simultaneously blocking the damaging effects of more potent forms of oestrogen (which are probably involved in breast cancer) – so these phytoestrogens have a balancing effect.

The two most potent dietary sources of phytoestrogens are Soya foods, which provide phytoestrogenic compounds called isoflavones, and linseeds (also called flaxseeds) which provide phytoestrogenic compounds called lignans. There are many other sources of less potent phytoestrogenic compounds in a wide variety of plant foods such as wholegrains, root vegetables, green leafy vegetables, beans and other pulses, nuts and seeds.


The optimum intake to reduce hot flushes and other menopausal symptoms, is around a 100gram serving of tofu, Soya yoghurt or a large glass of Soya milk, five times a week. A tablespoon of ground linseeds sprinkled onto cereal or into yoghurt daily can be effective after about six weeks. However, like anything else, while some is therapeutic, too much may not be advised so don’t consume much more than these amounts. Make sure you also eat wholegrains such as rye bread or crackers, porridge oats and wholemeal bread, a few weekly servings of pulses such as beans, chick peas or lentils and at least five portions of fruit and vegetables daily. Oily fish such as mackerel, sardines, tuna and salmon are also beneficial.

Supplemental Help
There are long histories of botanical remedy-use in European, Asian and Native American herbal traditions to ease menopausal symptoms. Now that science is able to analyse the active compounds in herbs it is obvious why they are effective as they are potent sources of phytoestrogens and other active compounds. The most widely used supplements for reducing menopausal symptoms are:

Black Cohosh – This herb has a phytoestrogen effect and is most useful for easing the peri-menopausal transition. Originally used by Native Americans, today it is the most commonly used herb for the menopause. It is a powerful and effective herb which is precisely why it must be used with care and not taken to excess.
Red Clover – Rich in phytoestrogen compounds this herb is gaining a reputation for effective relief of menopausal problems, such as hot flushes.
Soya – If eating more Soya in the diet doesn’t seem feasible, then Soy supplements or Soy protein mixes are available, though it is important to not take too much.
Sage – This is the prime remedy for easing night sweats and hot flushes. It seems to act directly on the action of the sweat glands.
Agnus Castus – Also called Chasteberry, this is a Mediterranean herb mainly used for PMS but also for the menopause. The active compounds provide progesterone-like compounds which cease to be produced naturally at the menopause and thus may ease the transition phase.
Vitamin E – Taken at moderately high doses of 800-1000ius over three months, Vitamin E is successful at reducing hot flushes in 50% of women.
St John’s Wort – This herb is effective in mild to moderate depression and may help to alleviate some of the temporary low moods associated with the menopause.

Summary
For a woman the menopause is often a time for new freedoms: the children have grown up and her career is firmly established. This leaves more time to enjoy life. Taking control of her menopausal health ensures she has the energy and ability to pursue this new phase of her life and her interests.