Coping With Menopause Naturally

Some women sail through menopause with ease – they have no symptoms, except that they stop menstruating. Other women can experience a range of uncomfortable symptoms: vaginal dryness, hot flashes, and/or insomnia, to name a few. These symptoms can be annoying and disruptive, but they are your body’s way of sending you a signal – a warning that the amount of estrogen your body is producing is falling dramatically. The more extreme your symptoms are, the more dramatic the decline in estrogen.

Time to take stock

Menopause is a natural event not a disease. But because women now live on average 20-40 years after the end of the reproductive years, estrogen loss at menopause increases the risk of losing bone mass and developing heart disease in the years after menopause. Now it’s time to take charge of your health and make some decisions.

So, at menopause and with your doctor’s help, you assess your family and personal risk factors for osteoporosis and heart disease. You explain your menopause symptoms and discuss whether or not estrogen or hormone replacement therapy is right for you.

Menopause without Hormone Replacement

What do you do if you’ve decided that you can’t – or won’t – take replacement hormones after menopause? If you’ve chosen a totally natural menopause, now you really have to get to work. Even with no apparent risk factors, 1-in-2 American women is at risk of breaking a bone after menopause due to osteoporosis. And 1-in-3 women after the age of 65 develop coronary heart disease.

To help prevent osteoporosis:

  • Take calcium – 1,500 mg total (diet plus supplements) daily, with meals for better absorption – and take between 400 and 800 I.U. of vitamin D a day. Vitamin D is essential for calcium absorption, and as we get older our bodies are less able to absorb Vitamin D from sunlight.
  • Exercise regularly, with weight-bearing exercise (brisk walking, jogging, bicycling) that exerts intermittent pressure on your bones. Swimming is not a weight-bearing exercise.
  • Cut down the amount of protein in your diet – eating too much protein leaches calcium from your bones.
  • Avoid drinking alcohol, caffeine, and carbonated sodas (which contain high levels of phosphates) – all of these increase bone loss.
  • Eat plenty of whole grains, fruits, and vegetables, especially leafy green vegetables, and consider taking a nutritional supplement for trace minerals and nutrients.

To help prevent heart disease:

  • Again, exercise regularly, with steady aerobic exercise: walking, jogging or biking.
  • Eat a very low-fat diet – no more than 2 grams of fat per 100 calories – and avoid saturated fats.
  • Meditate or perform other stress reduction exercises every day. Stress plays a significant role in the development of heart disease.
  • Keep your blood pressure, cholesterols, and triglycerides at healthy levels and monitor them regularly.
  • Take 100-4001.U. of Vitamin E daily; the Harvard Nurses’ Health Study (released May 1991 showed this may reduce heart attack risk by at least 40%.
  • Ask your doctor if you should take aspirin. Low-dose (80 mg) aspirin, taken daily or every other day, can reduce the risk of heart attack and stroke.
  • Finally, to greatly decrease your risk for bone fractures, heart disease, and stroke stop smoking. Smoking may also cause an early menopause in some women.

Reducing Symptoms

Vitamin E and a low-fat diet high in vegetables may have the added benefit of reducing hot flashes. Doctors and researchers don’t know exactly why menopausal women get hot flashes, but they do know that hot drinks, alcohol, hot and spicy foods, stress, and warm surroundings can trigger hot flashes or make them worse. Vitamin E oil or creams can be substituted for estrogen creams in treating vaginal dryness; over the- counter lubricants (such as Astroglide®) or moisturizers (VagiMoist®, for example) are also available.

Medical Alternatives

If you want to take estrogen but can’t, some medical alternatives do exist. While not as effective as estrogen, progestins (medroxyprogesterone acetates, like Provera®, Amen®, and Cycrin®) can reduce menopause symptoms significantly. Tamoxifen® – a nonsteroidal, antiestrogen agent taken by women being treated for breast cancer – can also help reduce a woman’s risk of heart disease by half. Tamoxifen may also reduce spinal bone loss, but the FDA has not approved it for use against osteoporosis.

Calcitonin, an “antiresorptive” agent approved for osteoporosis treatment by the FDA, stops the loss of bone and has minimal side effects. Calcitonin is given by injection now, but it is now being tested as a nasal spray, which is more slowly absorbed and almost eliminates the side effects.

Etidronate, a bisphosphonate that is FDA-approved for treatment of another bone disease (Paget’s disease), has fewer short-term side effects than calcitonin and can be taken for short periods to stop bone loss. If etidronate is taken for too long, however, it can actually inhibit bone formation and increase the risk of fractures. Other bisphosphonates, currently in clinical trials, may increase bone formation – these drugs will be available in a few years.

For More Information

Menopause Naturally, by Sadja Geenwood, M.D., Volcano, Calif: Volcano Press, 1992.
Menopause without Medicine, by Linda Ojeda, Ph.D., Alameda, Calif: Hunter House Press, 1992.

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Elle Michels

Elle Michels

Based in Washington, D.C., Elle Michels is a contributing writer to Womenshealth.com.

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