Menopause is defined as the changes a woman goes through just before and after she stops her periods and is no longer able to get pregnant naturally. Some women go through this time with few, if any, symptoms. But one in four will suffer severely with hot flushes, night sweats, and pain during sexual intercourse, hair loss, forgetfulness, depression and sleeping disturbances among other complaints.
The menopause happens when the ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.
Medical experts recommend women who have menopausal symptoms which they would like to help manage should see her healthcare professional who can discuss a number of suitable treatments, so she can make a decision about the best choice for her.
These can include medical and non-medical based treatments, depending on the symptom and medical history of the woman.
One of the treatments, Hormone Replacement Therapy (HRT), which is often dished out to alleviate symptoms in menopausal women has been associated with breast cancer. According to the research published in The Lancet, HRT might raise the risk of breast cancer by a third. Interestingly, breast cancer patients undergoing anti-hormonal treatment also experience menopausal symptoms.
Various substances and methods of managing these conditions have been suggested to alleviate the side effects, originating from conventional medicine as well as from complementary and alternative medicine. The approaches of conventional medicine include gabapentin, fluoxetine, venlafaxine and clonidine. However, the adverse effects often limit the general use of these drugs, whereas weight loss, behavioural therapy and exercise appear to be a promising alternative way of reducing hot flushes.
Complementary and alternative medical practices suggest administration of vitamin E, soy, black cohosh and red clover. The use of phyto-oestrogens, however, is not generally accepted, due to possible stimulation of breast cancer cells.
Another approach is acupuncture, which has been shown to improve symptoms in several trials, possibly via a calcitonin gene-related peptide. However, the fact that acupuncture leads to an elevation of oestradiol levels and a decrease in the levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) raises concerns regarding its safety in breast cancer patients.
A recent meta-analysis concluded that soy food intake might be associated with prolonged survival, particularly in postmenopausal patients. These finding and additional research, which demonstrated that oestrogen may induce apoptosis in oestrogen deprivation-resistant breast cancer, clearly suggest that the present concepts of anti-hormonal treatment must be reconsidered.
However, researchers have identified safe and cheap natural alternatives to HRT that ameliorate the unpleasant side effects of menopause. Researchers have demonstrated how royal jelly – secreted by honeybees to feed their queen – could also be used to combat symptoms of the menopause.
Scientists found taking ‘bee milk’ daily was four times more effective at combating hot flushes as placebos in women going through “the change.” It comes after a bombshell study last week linked Hormone Replacement Therapy (HRT) – often dished out to alleviate symptoms in menopausal women – to breast cancer.
However, experts have today issued caution over the findings, warning it is only a small study and more trials are needed. Half of the 200 women in the study were given 1000mg of royal jelly capsules to take daily. The others received a placebo.
Each participant was asked to keep up the same routine for eight weeks, comparing the effects of royal jelly against sugar pills. All were aged between 45 and 60 – the average age that the menopause begins is 51, according to the British National Health Service (NHS).
Hormozgan University of Medical Sciences experts quizzed them on the severity of their symptoms, giving them a score of between zero and 44. This was based on 11 common side effects, including hot flushes, irritability, bladder problems and vaginal dryness.
On average, the women scored 32 before beginning the two-month trial, published in Complementary Therapies in Clinical Practice.
Volunteers taking the royal jelly pills saw their symptoms almost halve in severity, with their score dropping to 19 at the end of the study. The team wrote: “The findings showed daily consumption of oral royal jelly (1000 mg) for eight weeks was effective in alleviating the menopausal symptoms.
“It can be concluded that royal jelly might be considered as a complementary treatment for menopausal symptoms.” No side effects were noted. But the team led by Seyedeh Nazanin Sharif said further research is needed to “confirm the effects of royal jelly” on menopausal symptoms.
The study was not listed as being funded by the industry. It used royal jelly pills made by the Canada-based Natural Life Company. Women were not allowed to take part in the study if they were already taking HRT – the most common way of alleviating the effects of the menopause.
The researchers admitted it is “not exactly clear how royal jelly improves menopausal symptoms.” However, they speculate that it may stimulate the production of testosterone, which could help the body create oestrogen.
They also say the substance contains compounds similar to the hormone itself, such as its main component – 10-hydroxy-2-decenoic acid. Haitham Hamoda, consultant gynaecologist and chair of the British Menopause Society, issued caution over the findings.
He said: “This is a small study of only 200 woman and more research will be needed to replicate these findings before royal jelly can be considered a clinically proven treatment for menopausal symptoms.” Another study published in the journal Molecular and Clinical Oncology demonstrated that bee pollen and honey could be used for the alleviation of hot flushes and other menopausal symptoms in breast cancer patients.
The study investigated whether bee pollen can alleviate menopausal symptoms in patients receiving tamoxifen and aromatase inhibitors/inactivators. The researchers compared a pollen-honey mixture with pure honey (placebo) in a prospective, randomized crossover trial in breast cancer patients receiving anti-hormonal treatment.
The menopausal complaints were assessed using the Menopause Rating Scale (MRS). A total of 46 patients were recruited; 68.3 per cent (28/41) of the patients reported an improvement in their symptoms while taking honey, compared with 70.9 per cent (22/31) who reported an improvement with pollen (the difference was non-significant).
The results were confirmed by significant improvements in the postmenopausal complaints in the two groups in a pre-post analysis in the MRS and its three subscales. The study provided evidence that honey and bee pollen may improve the menopausal symptoms of breast cancer patients on anti-hormonal treatment. “Of note, honey, which was intended to be used as a placebo, produced similar effects as pollen and they both exceeded the extent of a placebo effect in this setting,” the researchers wrote.
They concluded: “In conclusion, this study provided evidence that honey and bee pollen improve menopausal symptoms in breast cancer patients receiving anti-hormonal treatment. As we observed an increase in the serum levels of oestradiol with honey treatment in patients receiving aromatase inhibitors/inactivators, and due to evidence regarding the effect of honey and bee pollen on ovarian function and the direct effects of these products, honey and bee pollen should be used with caution in cancer patients. Whether this caution is justified remains to be established. As previously mentioned, the scepticism regarding soy products also does not appear to be justified, according to Chi et al.
“Honey and bee pollen may be offered to women who have failed to respond to other reasonable alternatives to cope with postmenopausal symptoms (example, acupuncture) and who would otherwise discontinue treatment. However, the fact that flavonoids, which are found in both honey and pollen, have been found to prevent breast cancer, supports the use of both products in women with menopausal problems without a history of breast cancer. The use of honey and pollen for menopausal complaints in healthy women and patients with breast cancer should be addressed in future trials.”
Recommended lifestyle tips that may help reduce hot flashes include identifying trigger points and avoiding them.
The factors that increase the frequency and severity of hot flashes vary from woman to woman. Common triggers include: warm weather, stress, spicy or hot foods and beverages, and alcohol. Most women do not need to avoid trigger points entirely, but knowing which specific factors worsen hot flashes allows women to deal with them when they occur.
Stopping smoking: Smoking may speed up the onset of menopause and increase the severity of symptoms, especially hot flashes. Losing weight: Obesity and an unhealthy body weight are thought to increase in the intensity and frequency of hot flashes.
Carrying cool water at all times: Drinking cold water or splashing it over the face and wrists can help quickly cool the body during hot flashes. Having a cold shower or running the face and wrists under cold water helps lower body temperature even quicker.
Staying hydrated might also help steady body temperatures. Keeping a fan close by: The breeze generated by fans can help keep bedroom temperatures cool and steady throughout the night. Handheld fans can also provide instant cooling relief.
Relaxation techniques and exercises
Stress causes the release of a substance called epinephrine, which increases body temperature and sweating. Relaxing activities may help reduce the severity and frequency of hot flashes. Relaxation techniques such as yoga, Tai chi, and meditation may help reduce the frequency of hot flashes.
Recommended relaxation exercises include: yoga, guided thought, mediation, Tai chi and qi gong, acupuncture, talk therapy or counselor services, massage, and breathing exercises. Keeping calm: The intensity of hot flashes can cause a sense of panic, intensifying symptoms. Rushing to find relief, such as a damp towel or rapidly fanning oneself may increase body temperature.
Eating a healthful diet
Nutrients, in particular proteins and fats, help guide healthy hormone and nerve signaling.
A well-balanced diet can also reduce blood sugar changes that cause similar symptoms to hot flashes. Women should eat foods high in omega-3 fatty acids, such as cold-water fish or ground flax seed, or consider a fish oil supplement.
Many plants contain compounds called phytoestrogens or “dietary estrogens,” which are capable of binding to human estrogen receptors. Plant-based estrogens are thought to help women experiencing reduced estrogen levels by increasing the effect of the hormone on the body.
There are different types of phytoestrogens found in legumes, seeds, and whole grains. Legume and bean products, such as soy, contain phytoestrogens called isoflavones, the most studied plant estrogen. In North America, lignans, found in seeds, such as flax and sesame, are the most commonly consumed form of phytoestrogen.
Source: Medical World Nigeria