Positive Health Online

Introduction

Many women are searching for an effective natural approach to relieving their menopausal symptoms because of the recent negative findings of hormone replacement therapy (HRT). On May 31, 2002, the National Institutes of Health in the US stopped a major long-term clinical trial of the risks and benefits of combined oestrogen and progestin before the trial was completed. Due to the increased risk of breast cancer, coronary heart disease, stroke, and blood clots, it was determined that HRT's risks outweigh its benefits.[1]

The first thing to remember is that menopause is not a disease. It is a natural part of a woman's reproductive life cycle which can be managed with exercise and diet.[2] Hot flashes, night sweats, mood swings and bone loss are the chief complaints among women going through menopause. Learning to deal with these unpleasant symptoms will help you cope with life's changes.

Menopause not only causes a decline in hormone levels, but can also leave you feeling moody, irritated, tired and unfocused. This is partly due to the lack of a good night's sleep caused by night sweats. Regular exercise (at least three to four times a week) is probably the most important thing you can do to improve your night-time rest and overall health. (Taking a cool shower before bedtime can also help promote a good night's sleep.)

Benefits of Exercise

Exercising strengthens your muscles and bones, helps circulate your blood (which nourishes the skin and internal organs), improves your mental outlook (about yourself and life in general) and promotes a tranquil night's sleep.[3] It also increases your levels of serotonin, endorphins and dopamine.[4],[5] Serotonin, a chemical your brain manufactures, produces a calming effect and creates a sense of satisfaction and well-being. Endorphins decrease pain, reduce stress, cause mood stability and a sense of happiness and joy. Dopamine increases your vitality, concentration and alertness.

Weight-bearing exercises and strength training is also one of the most effective methods of fighting bone loss and osteoporosis.[6] Resistance placed upon the skeleton during physical activity makes bones stronger and denser while improving posture, balance and muscle tone. The positive effects of exercising keeps you fit, trim, feeling younger and energetic. Taking a daily dose of calcium (1,200 mg to 1,500 mg), magnesium (500 mg to 750 mg) and vitamin D (400 IU) also helps preserve bone density and strength.

Phyto-Oestrogen-Rich Foods

The next step to help you through the symptoms of menopause is to increase your intake of phyto-oestrogen-rich foods. Many women experience positive results by eating soy. Soy foods contain isoflavones (natural plant oestrogen) that have similar properties to human oestrogen, but are much weaker. Isoflavones can bind to the body's oestrogen receptors and help offset the drop in oestrogen that occurs at menopause.[7]

Scientists have shown isoflavones function similarly to HRT without producing the risks associated with this controversial treatment.[8] Soy foods offer women a more natural way to treat their menopausal symptoms.[9] Research on soy's protein and isoflavones indicate that soy can help to relieve hot flashes, night sweats, fatigue and vaginal dryness.

Besides helping regulate oestrogen when it is declining, soy can also help with other conditions such as osteoporosis,[10] heart attack,[11] stroke[12] and breast cancer.[13],[14] Women have an increased risk for these disorders during and after menopause. Many studies show that soy can prevent these diseases by helping the body absorb and retain calcium, inhibit bone loss, lower LDL (the bad) cholesterol and decrease blood clotting.

The best forms of soy are those with the highest amount of isoflavones and protein, such as whole soybeans (edamame), tempeh, textured soy protein (TVP), soynuts and some soy protein powders. Next would be tofu, soyamilk and miso. However, the actual isoflavone content has to be high enough to produce positive effects. Some foods made from soy protein concentrate, like soy hotdogs, have very little isoflavones due to their processing method. Other products, such as soybean oil and soy sauce, contain no isoflavones in them at all.

Researchers recommend consuming at least 25 g of soy protein and 30-50 mg of isoflavones daily (equal to 1-2 servings). This is only a starting point. You can safely consume 2-3 times this amount. The North American Menopause Society suggests 60 to 90 mg of isoflavones a day.

Many health experts encourage people to incorporate soy foods into a balanced diet and discourage solely taking soy supplements. Soy foods have various nutrients and compounds that contribute to its health benefits, while soy supplements usually only contain isoflavones. They advise taking soy supplements along with soy foods. This way the benefits of both forms can complement and enhance each other.[15]

Some women have found that taking natural herbal supplements like Red Clover, Black Cohosh, Dong Quai and Evening Primrose Oil can also provide relief from hot flashes, night sweats and other menopausal symptoms. Red Clover and Black Cohosh are significant phyto-oestrogen herbs that women have safely used for centuries to help manage their hormones. Dong Quai and Evening Primrose have also shown to be helpful, but display weaker oestrogenic effects. Of these four herbs, Red Clover and Black Cohosh have been shown to be the most beneficial in relieving menopausal symptoms.[16],[17] Vitamin E (400 IU to 800 IU daily) is another safe alternative. Vitamin E has been shown to be an effective approach to reducing hot flashes in women who want to avoid substances that contain any form of oestrogen, such as women who have or survived breast cancer.[18]

Since each woman is unique and reacts differently to natural treatments, try them out for yourself. Women who exercise regularly and consume soy daily generally have fewer menopausal symptoms than those who do not. Test these approaches for at least six to eight weeks to see if you get positive results.

To get you started, try this easy and delicious soy recipe from my book Virtues of Soy: A Practical Health Guide and Cookbook (www.virtuesofsoy.com).

Golden Tofu Strips

5.3 oz of firm tofu (1/3 of a 16 oz block)
1/4 teaspoon salt
1/4 teaspoon turmeric
1/2 tablespoon canola oil
Cut tofu into strips 1/4 in wide and 2 in long. Heat 1/2 tablespoon canola oil. Add tofu strips, 1/4 teaspoon salt and 1/4 teaspoon turmeric. Stir to coat all sides of tofu thoroughly. Cook tofu strips about 5 minutes or until golden brown. Serve on top of a salad, stir-fry or stuffed in a pita with shredded lettuce. (Makes 1-2 servings)

References

1. Rossouw JE et al. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women - Principal Results From the Women's Health Initiative Randomized Controlled Trial. JAMA. 288(3): 321-333. July 17, 2002. http://jama.ama-assn.org/issues/v288n3/abs/joc21036.html
2. Morelli V et al. Alternative therapies for traditional disease states: menopause. Am Fam Physician. 66(1): 129-34. July 1, 2002.
3. Kramer AF et al. Ageing, fitness, and neurocognitive function. Nature. 400(6743): 418- 419. July 1999.
4. Hansen, CJ et al. Exercise duration and mood state: how much is enough to feel better? Health Psychology. 20(4): 267-275. July 2001.
5. Blumenthal JA et al. Effects of exercise training on older patients with major depression. Arch Intern Med. 159(19): 2349-56. Oct 25, 1999.
6. Vincent KR et al. Resistance exercise and bone turnover in elderly men and women. Medicine & Science in Sports & Exercise. 34(1): 17-23. 2002.
7. Setchell KD. Soy isoflavones - benefits and risks from nature's selective estrogen receptor modulators (SERMs). Journal of the American College of Nutrition. 20(5 Suppl): 354S-362S; discussion 381S-383S. 2001.
8. Arena S et al. A natural alternative to menopausal hormone replacement therapy. Phytoestrogens. Minerva Ginecol. 54(1): 53-7. 2002.
9. Hall LL. Taking charge of menopause. FDA Consumer. 33(6): 00-1310. 1999. www.fda.gov/fdac/features/1999/699_meno.html
10. Scheiber MD et al. Dietary Soy Isoflavones Favorably Influence Lipids and Bone Turnover in Healthy Postmenopausal Women. Third International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. Session 2, Osteoporosis: In Vitro, Animal and Human Studies. October 31 - November 3, 1999.
11. Ashton EL et al. Effects of Soy, as Tofu Vs. Meat on Coronary Heart Disease Risk Factors. Third International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. Session 7, Plenary Session. Hypertension, Renal Disease, and LDL Oxidation. October 31 - November 3, 1999.
12. Teede HJ et al. Soy Protein Dietary Supplementation Improves Lipid Profiles and Blood Pressure: A Double-Blind, Randomized, Placebo-Controlled Study in Men and Postmenopausal Women. Third International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. Session 7, Plenary Session. Hypertension, Renal Disease, and LDL Oxidation. October 31 - November 3, 1999.
13. Messina MJ. Legumes and soybeans: overview of their nutritional profiles and health effects. Am J Clin Nutr. 70(3 Suppl): 439S-450S. www.oncolink.org. 1999.
14. Cline JM et al. Effects of Dietary Soy on the Uterus and Breast of Macaques.Third International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. Session 3, Cancer: In Vitro, Animal, and Human Studies. October 31 - November 3, 1999.
15. Setchell KDR. Isoflavone Absorption/Metabolism and Effects of Processing, Absorption and Metabolism of Soy Isoflavones-from Food to Dietary Supplements and Adults to Infants. Third International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. Session 1. October 31 - November 3, 1999.
16. Liu J et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem. 49(5): 2472-9. 2001.
17. Hardy ML. Herbs of special interest to women. J Am Pharm Assoc (Wash). 40(2): 234-42; quiz 327-9. 2000.
18. Barton DL. Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. J Clin Oncol. 16(2): 495-500. 1998