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MENOPAUSE: WHAT'S A WOMAN TO DO? PART 2

Updated 7/24/2013   


         Dr. Bernard Presser D.C.

5696 Magnolia Woods Drive

Memphis, TN 38134



 

If you have any questions, please contact us at 901-417-7905

 More articles coming soon.

 


Menopause should be experienced as just another natural stage of life.  Yet, due to personal health issues-illness, nutritional deficiencies, glandular fatigue, toxic overload, or others-many women experience discomforts and disruptions. The most common complaint is hot flashes. What are hot flashes (or hot flushes) anyway?

No one knows for sure. Generally, it is believed that they are caused by low estrogen levels.  One line of thought is that estrogen creates a certain degree of tone in the capillaries which prevents excessive vasodilation (blood vessel expansion).  With menopause, the amount of estrogen is reduced, this capillary tone is not maintained, the capillaries balloon, and you feel the heat.  In a study back in the 1960s, women given supplements containing various flavonoids (parts of the vitamin C complex which help restore the normal structure, tone, and integrity of blood vessel walls) experienced a reduction in vasodilation, hot flashes, and night sweats.  The flavonoid hesperidin is particularly believed to reduce the dilation.  One study found that hot flashes were eliminated in 53% of women taking hesperidin and reduced in 34% of them.  Whole vitamin C complex, with all its synergistic components, is the best course.  Oranges and lemons, for example, are good sources of hesperidin.  Vitamin E complex and magnesium are also important to blood vessel integrity and flexibility.  Other scientific thought contends that hot flashes are caused when the hypothalamus gland, which regulates body temperature, is not able to adjust to changes in hormone levels.  Low estrogen may cause the hypothalamus to malfunction or to imbalance natural brain opiate-like substances.  Hesperidin is among supportive nutrients.

Some researchers believe hot flashes are caused by too much dopamine, which affects the cardiovascular and nervous systems, metabolic rate, temperature, and smooth muscle.  The herb sage is being tested to see if it helps to fend off the release of excess dopamine.  As a tea, sage is licensed in Germany to treat night sweats and is used extensively in England for treating hot flashes and night sweats.  A survey in Scotland showed that women taking sage had 85% fewer hot flashes after 3 months.  Red clover isoflavones-parts of the herb-have been tested too.  One study showed they reduced hot flashes by 56%.  Yet women who took the placebo had a 40% reduction in symptoms.  Yes, the power of suggestion lowers the incidence of hot flashes.  Whole herbs can be more physically helpful than parts as they contain all the natural co-factors.  All too often, a separated part is used in studies-with less than optimal results-and the ineffectiveness is attributed to the whole herb.  This is the medical/drug-industry type of study.

Various drugs may reduce the number of hot flashes including antidepressants (SSRIs [selective serotonin reuptake inhibitors like Prozac and Zoloft] and SNRIs [serotonin norepinephrine reuptake inhibitors like Paxil and Effexor]), blood pressure-lowering drugs (like clonidine), and antiseizure drugs (like gabapentin).  The drugs perform a bit better than placebos, and not as well as estrogen.  And they have many side effects (unwanted effects).

Hot flashes are different for each woman who experiences them.  For some, they last a couple of minutes; for others, it‘s an hour.  Some women have a few hot flashes per year; some have a few a day; others have dozens a day.  Some women have other symptoms with the hot flashes such as weakness, sweating, dizziness, anxiety, irritability, panic, numbness or tingling in hands and arms, heart palpitations, or headaches.  If hot flashes are mild to moderate and don‘t interfere much with life, nothing may need to be done about them.  But if they are debilitating, interfere with the ability to enjoy life or to function normally, then some action is needed!  Almost two-thirds of postmenopausal women have hot flashes, and 10% to 20% find them nearly intolerable.  Almost a third say symptoms last up to 5 years after natural menopause, and 20% say they persist for up to 15 years.  Menopause induced by surgery means about a 90% probability of hot flashes during the first year; symptoms are far more abrupt and severe and can last longer than those associated with natural menopause.  Although hot flashes are more common in women with low estradiol or estrone (two forms of estrogen) than in those with high concentrations, the prevalence in women with similar circulating hormone concentrations varies.  So the "low estrogen" theory is not a sure thing.  Besides, estrogen remains low throughout menopause and most hot flash symptoms subside with time.  Even though a fall in estrogen could be a trigger, it "might not directly cause the symptoms".  Hot flashes are actually associated with several biochemical changes-including changes in neurotransmitters and in hormones from the pituitary gland, hypothalamus, thyroid, and adrenals.

Women who are underweight, those who do little or no exercise, and those who smoke have an increased risk for hot flashes.  Women who exercise daily have far fewer and less severe hot flashes.  Current smokers are about twice as likely to have moderate or severe hot flashes and daily hot flashes as women who never smoked.  The risk is even higher for women who smoke more than a pack a day or who smoked for many years.

Smoking lowers estrogen levels, but it also depletes vitamin C (and thus flavonoid) levels.  Women who are overweight are likely to suffer with more hot flashes and night sweats than those who are not overweight.  The frequency of hot flashes and their association with other symptoms differ among populations and cultures.  Asian women don‘t complain of hot flashes as much as white women;  African American women are more likely than Caucasians to report symptoms.  American women suffer 8 times as many hot flushes as Japanese women.

Hot flashes increase with anxiety or depression.  A woman should pay heed to feelings and thoughts that arise before and after a hot flash. Meditation, breathing and relaxation exercises decrease hot flashes-frequency, intensity, or both-by as much as 90%!  Spicy foods, caffeine, and alcohol have not been scientifically proven to cause hot flashes, but many women swear that they do.  Some researchers believe hot flashes have more to do with insomnia than with menopausal hormone changes.  But they‘re not sure whether the flashes cause the insomnia or whether lack of sleep causes the flashes.  Chronic insomnia is experienced by 80% of women who suffer with hot flashes.  Researcher Ellen Grant, MD, finds that women suffering from hot flashes may have "a vascular allergic reaction to common foods or chemicals".  Foods that commonly cause vascular reactions, including flashes, headaches, and pulse or blood pressure rises include wheat, oranges, eggs, tea, coffee, corn, yeast, and cane sugar.  The commonest chemical allergens are cigarette smoke and domestic gas.  Flashing can also be caused by various cancers, migraines, Parkinson‘s disease, spinal-cord injuries, some diseases of the digestive tract, various drugs like opiates, and some food additives like MSG, sodium nitrite, and sulphites. i

PHYTOESTROGENS

Plant hormones.  Many women are turning to foods and herbs that contain isoflavones, lignans, coumestans, and other components that are thought to mimic hormones enough so that they reduce hot flashes and other symptoms of menopause.  The foods and herbs often have value, but it‘s still questionable whether plant hormones are the reason.  The hormone-like chemicals in plants are not true estrogens or human hormones.  They are not steroidal in form so don‘t have the same chemical makeup.  Yet they‘re believed to act like female hormones by attaching themselves to the same receptors on human cells, kind of like a key fitting into a lock.  Then they‘re thought to provide a woman‘s body with enough estrogen-like activity to keep menopausal symptoms such as hot flashes at bay.  Even if they do bind to receptors on cells, they seem to function as hormone surrogates only in some tissues, not in others.  "In general, phytoestrogens are much, much weaker than estrogens," says Marjorie Bowman, MD, University of Pennsylvania School of Medicine.  She says a phytoestrogen molecule has between .01 and .001 the potency of an estrogen molecule.  A phytoestrogen "just doesn‘t do the same things as estrogen."  Many women are disappointed in the results.

Further, how phytoestrogens affect the female physiology is "extremely complex and poorly understood."  Focusing on one purported function of one compound in an herb or food breaks up the whole compound and skews the view!  Since phytoestrogens are believed to increase estrogen and progesterone production if levels are low and lower hormone levels that are too high, they are not behaving as human hormones.  Rather, they are food components that the body may use to help balance hormones.  This is why they seem to "work" for both high and low hormone levels.  Besides, phytoestrogens like isoflavones and lignans must undergo complex enzymatic metabolic conversions in the gastrointestinal tract in order to become compounds with the so-called "estrogenic" activity.  The extent of these metabolic reactions vary among individuals-anywhere from 5% to 70% of the raw materials become metabolized into active compounds.  A person‘s diet, gut microflora, and intake of medications (especially antibiotics) are among the reasons for the variability.  And some of the foods (notably soy), if not prepared correctly, cannot be optimally handled by the body, and may disrupt reactions.

Soy, other beans, clover, and alfalfa contain isoflavone precursors that are converted to genistein, daidzein, and equol by intestinal bacteria.  In addition to isoflavones, lignans, flavones, chalcones, diterpenoids, triterpenoids, coumarins, and acyclics are among the phytoestrogen compounds found in over 300 plants.  Flax seeds, other seeds, legumes (beans, peas), whole grains (such as rice, oats, wheat, barley, rye), nuts, some fruits (berries, grapes, all citrus fruit, watermelon, apples, cherries, plums), vegetables (carrots, fennel, garlic, celery, parsley, broccoli, sweet peppers, spinach, green beans, potatoes, rhubarb), sprouts (red clover, alfalfa, mung bean), and herbs (sage, fennel, parsley) contain raw materials that can be converted into ‘estrogen-like‘ compounds by intestinal bacteria.  Manufacturers now make supplements of highly concentrated substances taken from foods (especially soy) in potent doses to supposedly substitute for hormone replacement therapy.  Whole foods are often ignored for commercial advantages of the wistful magic bullet.  Isolated phytoestrogens are usually used in studies, disrupting the synergistic function of the plant so its real benefits may not be fully realized.  For example, isoflavones separated from soy or clover may be less effective than the whole or they act more like drugs.

Study results are all over the map-slight increases in estrogen, slight decreases in estrogen, and/or some kind of steroid-like activity.  Very often phytoestrogens just don‘t work for the symptoms tested.  They appear to play only a negligible role in reducing the risk of breast cancer or other cancers, in promoting strong bones, or in preserving cognitive function.  One problem may be the use of separated phytoestrogens-‘broken' parts, expecting one component of foods or herbs to have a drug/hormone function.  It‘s better to look at the woman, her overall health and history, regular dietary habits, deficiencies, imbalances, and toxic load, the numerous factors that may affect her general health and functions of glands and hormones.  Nevertheless, consuming phytoestrogens in "normal dietary amounts" is not harmful.  One conclusion of an exhaustive analysis of natural menopause therapies was that beans and other foods are benign interventions, but "no such presumption of safety can be made for the isolated, often high-dose, isoflavones that are currently sold over the counter." ii

SOY

Soybeans have taken on an almost supernatural aura as a cure-all.  Women cling to the idea of soy as a natural hormone replacement.  Soy products are touted as having similar effects as estrogen, as helpers for hot flashes, night sweats, psychological complaints, low energy, and bone strength, as preventers of high cholesterol, heart attacks and breast cancer.  Soybeans have a high concentration of isofavones, but "there is enormous variation depending on where the soybean is grown and how it is prepared".  The isoflavones are more bioavailable (able to be used by the body) from fermented soy products (such as tempeh and miso) than other soy products.  Unless soybeans are fermented or soaked (for a total of 24 hours, with water changes every 8 hours), their nutrients are not really available, they can interfere with nutrients in the body and can cause other disruptions.  Soy, in far-eastern countries, is used as a condiment, as we use salt and pepper, and not as a food.  The soy-as-food hoax in this country has reached epidemic proportions!

Some studies indicate that soy products reduce hot flashes.  Others don‘t.  Conventional estrogen drugs reduce hot flashes by about 70%.  Placebos decrease hot flashes by 15% to 50%.  Soy comes along at the placebo level. "The data regarding the benefit of soy for hot flashes are mixed."  Only 3 of 8 studies showed any benefit and that was modest and short-lived.  In one study, women getting soy and women getting whole wheat both experienced reductions of hot flashes.  Another study showed 30% of women getting a soy beverage had reduced hot flashes, but 40% of women getting a rice drink had reductions!  Soy compounds don‘t appear to help bone density or cognitive function in postmenopausal women.

For every study that shows a benefit to bone, there‘s another one that shows no benefit.  And the positive studies aren‘t necessarily consistent.  So far, the only study that convincingly suggests that soy might prevent osteoporosis pertained to natto, a fermented Japanese soybean product rarely sold in the US.  And the bone building probably didn‘t come from the soybean itself.  Natto is high in vitamin K, a fat-soluble vitamin manufactured by bacteria involved in the fermentation process.  Vitamin K is essential for bone health, yet is absent from soy milk and other soybean products (unless fermented).  A couple of trials indicated some improvement in mental flexibility and planning ability, but nothing spectacular.  Soy has no effect on vaginal dryness.  Short-term use doesn‘t seem to affect the endometrium (lining of the uterus), but long-term use at high doses may be a concern because of excess tissue growth.  Neither isoflavone nor soy protein isolate supplements improve cholesterol levels as previously thought.  They don‘t have any effect on oxidative damage or other supposed "markers" of cardiovascular disease.  Maybe they increase HDL (so-called "good") cholesterol slightly.

Equol, which the body can make from isoflavones, binds to estrogen receptors more strongly than isoflavones.  But only 30% of women produce it.  If isoflavones come from improperly prepared soy, they may not be converted to equol.  At this time, no firm conclusions can be made about the effects of soy and isoflavones on menopausal symptoms or on any disorder or disease.  Although some benefit may come from fermented soy products, the effects are modest at best.  Isolated soy protein, as in soy milk and numerous food products, should be avoided.  It cannot be digested properly, causes allergies and intolerances, and can block uptake of nutrients in the body.  Besides, isolated soy protein doesn‘t seem to affect any biological indicators of estrogen activity in women.  In August 2005, a government panel found unclear or insufficient evidence that soy can prevent heart disease, relieve menopausal symptoms, or prevent osteoporosis.  "Studies on soy and menopause are inconsistent, contradictory, or poor design and too short duration to warrant any meaningful conclusions from them."  A review completed by the Agency for Healthcare Research found insufficient data among 200 human studies to suggest that soy had an effect on bone health, cancer, kidney disease, endocrine function, reproductive health, cognitive function, or glucose metabolism.  A wide variety of soy products were studied.  What‘s more, the average dose used in the studies (36 grams of soy protein per day) was equivalent to eating more than a pound of tofu each day.  Soy has been grossly overrated, but it sells well!

Although Asian women have fewer menopausal symptoms and lower rates of breast cancer-thought to be due to their higher consumption of soy- "there‘s no clear answer we can give" because the research doesn‘t draw a straight line between soy and menopause or breast cancer.  "What‘s more, something else about soy eaters might have cut the risk of breast cancer or osteoporosis."  Asians consume more vegetables and more seafood than do American women; their diets are lower in animal products (such as meats from animals given synthetic hormones); they also eat fewer processed and refined foods, though they‘re catching up.  Women in the Middle East and South America don‘t experience as many menopausal symptoms as women in the West.  And they don‘t eat much, if any, soy.  Harvard researchers found that eating beans-any kind-two or more times a week is linked to a reduced risk of breast cancer.  Considering the data available so far, "it‘s not possible to draw definite conclusions."  A Dutch study found that women who consume the most soy and other foods rich in plant estrogens (particularly isoflavones) are just as likely to develop breast cancer as those eating few of these foods.  Overall the research into soy has been "complicated, inconsistent, and inconclusive."

In America, only a tiny percentage of soy is sold as fermented or traditionally prepared products that normally make this bean healthy and digestible.  The majority is processed in oil and in dairy or protein "analogues" like soy milk, soy cheese, yogurt, vegeburgers, sausages, soy protein isolate, soy flour, and desserts.  Scientists have found so many inexpensive ways to process soy that it‘s now an ingredient in most supermarket and (un)health food store foods.  Actually, phytoestrogens abound in most beans.  Bean sprouts have up to a hundredfold increased content of phytoestrogens.  Pinto beans have almost as much genistein and daidzein as soybeans.  Some beans have more genistein (the more active phytoestrogen) than soy-yellow split peas, black turtle beans, lima beans, anasazi beans, red kidney beans, and red lentils.  Other beans are also quite high.  Kudzu, an indigenous Asian herb that has become a pest in this country, contains the highest levels of the phytoestrogenic isoflavones genistein and daidzein of any safe plant tested.  In one analysis, kudzu root contained 317 ppm genistein and 950 ppm daidzein compared to 24 ppm genistein and 35 ppm daidzein from soy.  "Soy is not the best or only source of phytoestrogens based on research on constituent levels in other sources of these constituents." iii

BLACK COHOSH

Numerous high quality clinical trials have demonstrated the value of black cohosh in relieving a range of menopausal symptoms from hot flashes and night sweats to depression, without any significant adverse effects.  In some studies, women experienced the same degree of benefit as was seen in hormone replacement therapy (HRT) trials, especially in relieving hot flashes.  This herb has traditionally been used for hundreds of years for menopausal symptoms.  Evidently, it helps to maintain healthy levels of luteinizing hormone (a pituitary hormone that sends messages to the ovaries) and binds to estrogen receptors.  It‘s believed that black cohosh acts as a SERM (selective estrogen receptor modulator), meaning it has an estrogen-like effect on some tissues but not on others.  For some tissues, it appears not to be estrogen-like (breast, vagina, uterus), but for other tissues (those involved in generating menopausal symptoms, probably in the brain, and on bone tissue), it appears to be.  But perhaps the point of view should change.  Black cohosh is not a hormone drug.  It's a complex herb containing plant compounds.  Maybe it simply provides substances the body can use to balance hormones.

There is no evidence of increased risk of breast or uterine cancer from taking black cohosh, not even for women with a history of estrogen-responsive breast cancer.  To weigh on the cautious, though, it‘s advised that women with such a history should limit use to 2 or 3 months at a time under professional supervision.  Remifemin®, a standardized extract (uniform dosage of a single component) of black cohosh is the most OB/GYN-recommended, non-prescription menopause herb.  Using the whole herb will ensure getting the entire synergistic and balanced complex of ingredients.  The German Commission E (their equivalent of our FDA) approves use of 40 milligrams per day for 6 months for relief of menopausal symptoms.  A combination of black cohosh and St. John's wort may be even more effective in reducing menopausal symptoms like hot flashes and depression than each herb alone.  One trial reported a 50% reduction in physical symptoms and a 41.8% drop in psychological symptoms.  This is comparable to women taking HRT for three months!  Black cohosh appears to have a favorable effect on bone metabolism.  A long-term (52-week) study found indications of slowed bone resorption (bone preservation).  This didn‘t show up in short-term studies of up to 3 months.  If the results are verified, long-term use of this herb may help slow deterioration of bone.

Recently, concern has risen that black cohosh may cause rare cases of an allergic reaction which results in liver damage.  There isn‘t much evidence to prove this, and the relationship appears to be merely coincidental, particularly considering that black cohosh is widely used.  From 2002 when reports of liver damage began, to early 2006, there were about 50 adverse reaction reports.  The European Medicines Agency Committee on Herbal Medicinal Products evaluated all the cases.  Only two were considered "probable."  One was proven to have no connection to black cohosh, and the other one could have been caused by prescribed drugs (all known to cause the type of liver damage experienced but were not initially mentioned).  There was "no evidence to establish either general or specific causation," nothing to back up claims that the herb contained toxic chemicals. Thus, even the two "probable" cases were found to be improbable.  The long-term, 52-week study mentioned above was notable, also, for the lack of any evidence of liver toxicity.

The quality of black cohosh products is an issue.  Three of 11 black cohosh supplements tested in the US didn‘t even contain black cohosh, but less expensive extracts of other herbs.  In other cases, the wrong species of black cohosh were found.  Even when supplements contain the right kind of black cohosh, the amounts can vary widely as can components within the herb (depending on how and where it was grown, how it was handled and processed).  A reputable, dependable source is imperative.  And, like any herb, results may differ from person to person.  A recent National Institutes of Health-funded study found that black cohosh didn‘t relieve hot flashes.  The supplement used may have been poor quality or another problem may have skewed the results.  Most all studies have found benefits for symptoms.  Yet, dependence on one thing, one magic bullet, is also a mistake.  There are usually multiple causes for menopausal symptoms, so multiple therapies may be needed. iv

OTHER HERBS

Phytoestrogens are just one group of phytonutrients.  Because phytonutrients (like all nutrients) work synergistically, classical herbalists contend that, for best results, whole herbs (or whole parts such as the root or leaves or flowers) should be used in most cases.  Nature balances the so-called "active" ingredients with other substances that modify, symmetrize, potentize, and generally bolster them as well as offset any tendency to overwhelm the body.  Conversely, a drug is made from a single, often manufactured, active ingredient with no other natural substances present to regulate it.  Powerful side effects can result.  Sadly, there is a push to turn herbs into drugs by isolating an "active ingredient" and using it-sometimes with a bit of whole herb-to suppress symptoms.  No wonder studies on herbs come up with confusing results!  Further, many people look to herbs as drug substitutes.  While some herbs do have drug-like abilities, they are different in their natural whole state than from manufactured chemical, standardized, drugs.  It's easier to seek out an herb, thinking of it as a ‘natural drug', than to work on one‘s total health and lifestyle.  No herb-and certainly no standardized, isolated ‘active ingredient'-is going to fix difficulties that may come with menopause.  Biochemistry is much more involved than that.  Herbs may certainly serve as part of a comprehensive health program.

Red clover contains isoflavones like soy, but even more concentrated.  Study results have been mixed and confusing.  Some studies show it eases hot flashes and night sweats, aids bone density and cardiovascular health.  Others show little or no effect.  Extracts (parts) or standardized herbs (a separated ‘active ingredient' added to the herb) are often used.  Thus, part of the problem may be the products used.  There is some evidence for a biological effect of the herb, but many prepared supplements flunk the test.  The whole herb may be best.  Alfalfa is another plant in the legume family that contains phytoestrogens.  It too has been used to relieve hot flashes, balance hormone levels, slow osteoporosis development, and generally supply needed minerals.

Dong quai is a tonic or "female ginseng".  It doesn‘t contain typical phytoestrogens, yet may help relieve hot flashes, vaginal dryness, and other symptoms.  Chinese practitioners use dong quai with other herbs.  Used alone, it may not have as much effect, although a recent study using a high quality dong quai showed a significant decline in hot flashes and their intensity.  Dong quai is used as either as a uterine tonifier or to help a woman use her existing estrogen more efficiently.  It has also traditionally been used for bone injuries and shows some action in slowing bone loss.  Vitex (or chaste tree) is rich in flavonoids and has been used over 2 thousand years to regulate hormone imbalances and as a remedy for menopausal symptoms.  Most practitioners consider it as "one of the best herbs for use in the early stages of the menopausal transition."  Some women find it helps hot flashes, night sweats, heart palpitations, vaginal dryness and thinning, libido, mood swings, insomnia, breast tenderness, lack of concentration, and headaches.  Tests indicate it works primarily on the pituitary and hypothalamus glands, balancing luteinizing hormone and follicle-stimulating hormone.

Valerian root can be useful when anxiety and tension inhibit relaxation and sleep.  Kava kava may relieve hot flashes and anxiety.  St. John's wort helps with mood swings and may help relieve some physical symptoms of menopause.  Licorice helps replenish adrenal function and may increase estrogen activity when blood levels are low.  Some women report fewer hot flashes and improvements in mood swings and vaginal dryness.  Caution should be used if blood pressure is high since prolonged use of high doses may raise blood pressure.  Maca, a cruciferous vegetable from the Andes, acts on the pituitary gland, which then regulates ovarian and adrenal function.  It appears to amplify the effect of all sex hormones.  It may aid decreased sex drive, hot flashes, vaginal dryness, depression, and osteoporosis.  American ginseng works for some women to increase stamina, energy, libido and lubrication.  Korean ginseng benefits depression, insomnia, and extreme fatigue as well as other postmenopausal symptoms.  It seems to have an anti-stress effect.  Ashwaganda, an Indian ginseng, can also help in these arenas.  Shatavari, an Ayurvedic herb, has been traditionally used for treating menopausal symptoms.  Sage has been used since ancient times to avert hot flashes and sweating associated with menopause.  Well researched, tribulus is a popular herb in Europe for treating menopausal symptoms.  Like false unicorn and wild yam, the leaf of this plant is rich in steroidal saponins.  In studies, menopausal women experienced improvements in symptoms like hot flashes, sweating, insomnia, and depression.  The herb doesn‘t raise estrogen or other hormone levels, but it relieves symptoms-in up to 98% of women.  Unfortunately, many tribulus products are from the wrong plant part (fruit or root instead of leaf) and don‘t work the same.  

Flaxseed is rich in plant ‘estrogens', particularly lignans.  When menopausal women were given either hormone replacement therapy (HRT) or flaxseed, it was found 6 months later that the flaxseed relieved hot flashes as well as HRT.  Another study found flaxseed was as effective as HRT in improving hormone levels, decreasing menopausal symptoms, and decreasing glucose and insulin levels.  Other trials found that serum hormones did not change.  Flaxseed helps reduce bone loss by reducing calcium excretion.  Flaxseed may modulate estrogen metabolism in postmenopausal women in favor of less biologically active estrogens.  This is thought to mean it has potential to prevent breast cancer.  Since flaxseed helps to lower total cholesterol and low-density lipoprotein cholesterol, it is considered a heart disease preventive.  Some women say it improves anxiety and depression.  Flaxseed contains several building blocks necessary for hormone production.  A quarter cup of ground flaxseed daily has been recommended.  Wild yam as a whole herb taken orally is very different from topical wild yam creams.  Wild yam doesn't contain progesterone and doesn't have effects like progesterone.  It may have effects more like estrogen, but only when it‘s taken by mouth.  In the digestive tract, it forms a substance called diosgenin which has properties like other phytoestrogens. v

What about the claims for wild yam "progesterone" creams and other "bioidentical" hormones?  This and more will be covered in Menopause Part 3.

This website has excellent nutritional protocols for menstrual and menopausal problems which are available in conjunction with the Symptom Survey.  Take the Symptom Survey to discover specifically what nutrition you need for your individual health problems.

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Originally published as an issue of Nutrition News and Views, reproduced with permission by the author, Judith A. DeCava, CNC, LNC.