Last month we took an in-depth look at hormone replacement therapy and the complications. This month we are going to examine the natural alternatives for treating menopausal symptoms.

Two thirds of women experience menopausal symptoms during menopause-mainly hot flashes-and are recommended hormone replacement therapy (HRT). However, after the Women’s Health Initiative (WHI), many women are reluctant to use HRT and are turning to more natural options (http://www.nhlbi.nih.gov/whi/). Let’s find out why.

Phytoestrogens. What exactly is a phytoestrogen? Phytoestrogens are naturally occurring nonsteroidal plant compounds. Due to their structure being similar to estradiol (17-beta-estradiol), they have the ability to cause both estrogenic or antiestrogenic effects. Phytoestrogens exert their effects primarily through binding to estrogen receptors throughout the body.

When compared to synthetic hormones, phytoestrogens only contain 2% of the strength (Duar, 2005). Therefore, in terms of treatment, they provide a more safe and modulating approach. If estrogen is low within the body, phytoestrogens increase the effect of estrogen. In addition, if estrogen is high, the binding of phytoestrogens to estrogen receptors will actually decrease the effect of estrogen.

Food sources of phytoestrogens consist of: soybeans, flaxseeds, apples, carrots, fennel, celery, parsley, and other legumes. Herbal phytoestrogens include: Trifolium Pratense (Red Clover), Cimicifuga Racemosa (Black Cohosh), Panax Ginseng (Chinese or Korean Ginseng), Dong Quai (Angelica Sinensis), Dioscorea Villosa (Wild Yam Root) and Glycyrrhiza Glabra (Licorice).

The phytoestrogens found in soy are the isoflavones: genistein, daidzein and glycitein. These isoflavones bind to estrogen receptors on the uterus, breast, brain, bone and arteries. They weakly mimic estrogens in some tissues and block the effect of estrogen in others. Soy has been found to decrease the risk of fractures in post-menopausal women by increasing bone mineral density, decrease the frequency of hot flashes and help with mood and sleep disturbances (Pizzorno, 2008). In a study by Powles et al., it was shown that diets high in phytoestrogen isoflavones (such as soy) were protective against osteoporosis and hot flashes (Powles et al., 2004).

In terms of herbal treatments, Red Clover is an herb commonly used in a naturopathic medical practice to reduce symptoms of menopause. In the 1940s, farmers noticed for the first time that red clover fields were found to have a positive effect on grazing sheep and their fertility. In a study by Hidalgo et al., 53 women took red clover for 90 days to determine that their menopausal symptoms were reduced compared to placebo and their cholesterol and triglyceride levels were also reduced (Hidalgo et al., 2005). Black Cohosh is another common herb used to treat hormonal dysregulation, particularly menopause. Geller et al., proved that Black Cohosh is safe and effective for reducing menopausal symptoms, primarily hot flashes and possibly even mood disorders (Geller et al., 2005).

Contrary to the western medical belief system phytoestrogens ARE protective against breast cancer. The issue that comes up is that if HRT can increase your risk of breast cancer, then what about phytoestrogens? In a study conducted by Atkinson et al., 205 women (age 49-65) were monitored for one

year taking red clover daily to determine the effect on breast tissue. It was found that unlike conventional HRT, which increases breast density, red clover did not increase breast density (Atkinson et al., 2004). Therefore phytoestrogens are unlikely to cause an increased risk of breast cancer.

The trend is catching on! In July 2010, 423 menopausal women were contacted with questions about their menopausal symptoms and status. 91% of the women reported trying alternative therapies for their symptoms. The most common treatments were vitamins (61.5%), relaxation techniques (57%), yoga/meditation (37.6%), soy products (37.4%) and prayer (35.7%). The most beneficial therapies reported were prayer/spiritual healing, relaxation techniques, counseling/therapy, and therapeutic touch/Reiki (Lunny et al., 2010).

Make empowered and educated decisions when it comes to your health. Do your research! Know that there are EFFECTIVE AND SAFE alternatives to HRT.

Yours in health,

Dr. Sarah Hawthorn, BAS, ND