“The Change”

Menopause

Meno – monthly pausis – stop Women can enter menopause

anywhere from 35- 60 years of age Median age is between 50-52

The transition from reproductive to non-reproductive age takes from 2 to 6 years

Physiological activities

Remaining ova begin to degenerate. The ovaries become less responsive to the gonadotrophic hormones, LH & FSH, fewer follicles are stimulated. Oestrogen (estradiol) and progesterone production in the corpus luteum ceases.

Testosterone is continued to be produced by the ovaries

Physiological activities cont..

Concentrations of FSH and LH increase because the negative feed back from estradiol does not occur.

Hypothalamus releasing patterns of Gonadotrophic Releasing Hormone (GnRH) change. Responsiveness of the Anterior Pituitary gland declines.

Physiological activities cont…

Peripheral oestrogen conversion continues in adipose, hepatic and adrenal cells produces a weaker form of oestrogen (oestrone)

The adrenal glands become the major producers of progesterone and oestrone

Physical Manifestations

Symptoms produced by this hormonal shift include:

Hot flashes/flushes Night sweats Vaginal dryness Breast atrophy Menstrual irregularities

Physical Manifestations

Dizziness Weight gain Increased urinary frequency Headaches Disturbed sleep Non-specific aches and pains Changes in elasticity and firmness

Pathological Risk Factors

An increase in the risk of osteoporosis

An increase in the risk of mortality from cardiovascular disease

Psychological Manifestations

Loss of self esteem Irritability Depression Loss of concentration Loss of libido Feelings of missing out on life and

that time is running out. Loss of life purpose

Western Medical Paradigm

“Oestrogen deficiency” Remedied with HRT - Hormone

replacement therapy – either oestrogen alone or oestrogen and progesterone combined

35-40% of American women start treatment, 15% continue with long term treatment

Hormone Replacement Therapy

Advantages: Decreases menopausal symptoms Can be used to soften the blow of

oestrogen decline Decreases risk of osteoporosis by

50% Associated with a decrease in

mortality from cardiovascular diseases by 35%

Hormone Replacement Therapy cont…

Disadvantages: Oestrogen alone HRT is associated with

increased potential for breast cancer “Natural” Oestrogen is harvested from

pregnant mares in “battery horse” style barns.

Only delays the inevitable process of oestrogen depletion

Hormone Replacement Therapy cont…

Is a big business proposition for pharmaceutical companies

Doesn’t effect a decrease in hot flushes in Asian women

Psychological Paradigm

From a Jungian perspective, menopause involves the woman meeting her masculine aspect. The meeting of the animus. New, possibly unwanted energies are revealed. These need to be integrated within the self.

Female shamanistic paradigm

Menopause is “retaining the blood”, or holding the power within.

The base primordial energies of the root chakra rise to connect with the spiritual energies of the crown chakra. This enables unification of S’akti and S’iva- the male and female principle. (aka kundalini)

Female shamanistic paradigm

Hot flushes are considered a manifestation of this new energy. Women are encouraged to “ride the fire” to allow the veil of consciousness to contract and reveal a superior state. (Stepanich 1992)

Contemporary Attitudes

Negative attitudes can surround this transition from mother to crone, considering it “another burden after the curse of menstruation”

The crone/old hag archetype blinds the modern woman to the wisdom and beauty (Kenton 1996)

Often considered in terms of loss, and as a partial death

Contemporary Attitudes cont..

Positive attitudes consider it a celebration that a woman’s creativity is no longer bound to the obligations to propagate the species. A new sexual freedom is found.

A time of great power, energy and freedom, and a transformation into the wise woman archetype

Role of the Naturopath

50% of women seek some sort of treatment for menopausal symptoms

Many women are rejecting HRT and are seeking natural solutions to ease unwanted symptoms

We have many ways to support and encourage this transformation

Role of the Naturopath

Provide space and time Hear their story Encourage and support exploration of this

phase Help to develop a positive attitude Explore new outlets for creative

expression

Role of the Naturopath - Nutrition

Ensure adequate fibre and complex carbohydrates, a high intake of fruits and vegetables, regular moderate intake of protein

Limit salt, fat, sugar, caffiene, and alcohol intake. Avoid hot foods

Omega 3 and 6 essential fatty acids should be consumed regularly

Role of the Naturopath - Nutrition

Focus should be placed on: Health of GIT calcium and phosphate intake and

absorption. Low oestrogen levels hinders calcium and phosphate absorption. Low oestrogen also increases resorption from bones, diminishing bone density.

Role of the Naturopath - Nutrition

Phytoestrogens are nonsteroidal plant compounds with a phenolic ring that bind to the oestrogen receptors in human cells.

The major types are lignans and isoflavonoids.

They are 160 to many thousand times weaker than natural oestrogen.

Role of the Naturopath - Nutrition

In menopausal women there is some evidence that they mimic oestrogen activity.

100gms of tofu and 1 tbsp linseed/day has been shown to reduce hot flushes.

Role of the Naturopath - Nutrition

Another study revealed a 25% reduction in hot flushes from 60g isolated soy protein/day

They are found in legumes, wholegrains, seeds, fruit and vegetables (esp. sprouts) and various medicinal plants

Role of the Naturopath - Herbal

We have a large array of herbs to assist women through this transition including:

Peony Chamaelirium

Vitex Zizyphus (Sun-Ten)

Cimicifuga Angelica

*Trifolium *Medicago sativa

Role of the Naturopath - Lifestyle

Exercise- Weight bearing exercise is recommended

to ensure bone density maintenance- Help to maintain healthy BMI and

waist:hip ratio Encourage relaxation, meditation,

inspiring music & making time and caring for the self

Summary

The passage through menopause differs as much as the women who experience it. We can support the body’s hormonal orchestra whilst it tune up and rehearses a new symphony, called by Margaret Mead, “Post Menopausal Zeal”

References

Glazier, M G “A Review of the Evidence for the Use of Phytoestrogens as a Replacement for Traditional Estrogen Replacement Therapy”, Archive Internal Med/ Vol161, May 14 2001

Greer, Germain The Whole Woman, Doubleday, 1999 Kenton, Leslie Passage to Power Vermillion Press, 1996 Myers, R “Menopause – its management and treatment” Aust

J Med Herbalism Vol 4 (3) 1992 Stepanich, Kisma Sister Moon Lodge, Llewellyn Pub, 1992 Shuttle, P & Redgrove, P The Wisewound, Harper Collins, 1994 Tortora & Grabowski Principles of Anatomy and Physiology,

Harper Collins 1997 Trickey, Ruth Women, Hormones and the Menstrual Cycle,

Allen & Unwin, 1998 Willis & Reid Life in the Middle, Academic Press, 1999