A Natural Alternative to HRT?
Last Updated on Monday, 07 December 2009 02:02
Herbal Medicine has become a popular alternative for women with debilitating menopausal symptoms, particularly in the light of the Womenâ€™s Health Initiative (WHI) study of 2002, which suggested that health risks may exceed benefits during prolonged hormone replacement therapy (HRT). The effect of the initial publications of the WHI resulted in a decline in HRT use of around 50% in the UK. Medical Herbalist Deborah Grant BSc(Hons) MNIMH reportsâ€¦
Recent research funded by the National Institutes of Health (NIH) in the USA, one of the world's foremost medical research centres, states that â€œthe study of alternative therapies for menopause symptoms is a rewarding and important area deserving of further inquiryâ€. The NHS is also listing several herbs in their leaflet on alternative therapies for the treatment of menopausal symptoms.
As a qualified Medical Herbalist with diagnostic and clinical training at a degree level and degree level training in medicinal plant chemistry (phytochemistry), I have successfully treated many women, who come to me for help in alleviating uncomfortable and debilitating menopausal symptoms. I have found that in most cases it is easy to get significant results in a relatively short period of time. Most patients are feeling considerably better by the time of their first follow-up consultation, which is usually two weeks after the initial consultation.
Paula (not the patientâ€™s real name to protect her privacy), a 45 year old fit and healthy woman, came to see me in July 2008 to discuss her concerns about what she thought might be menopausal symptoms. For the past 6 weeks she had been experiencing around 6 hot flushes during the day, which were uncomfortable and embarrassing. Every night she was aware of waking up hot about 4 times, making the sheets wet with sweat, and had trouble getting back to sleep. She had not had a period for 9 weeks. She was surprised at how â€œdown and quite depressedâ€ she felt compared to her usual upbeat mood. She also felt constantly tired and anxious, which was unusual for her.
A very detailed case history of this patient was taken, discussing her past medical history, her family medical history, her diet, lifestyle and allergies. We also discussed what medication she had been on. I asked about her various body systems and discovered that she had a long standing problem with her digestive system.
My prescription for Pamela included plant extracts to decrease both the number and severity of the hot flushes and night sweats; to treat her depression and lift her mood. I also included herbs, scientifically proven to contain phytoestrogen, which act to a certain extent like oestrogen in the body and attach to the oestrogen receptors of the cells, thereby helping to alleviate menopausal symptoms. I also addressed Paulaâ€™s long-standing digestive problem by adding a herb to the prescription, which would boost her liver function and aid the digestive process. I asked Paula to have a blood test to see what her hormone levels were doing. She was asked to take the herbal medicine 3 times a day and to return for a follow-up consultation in 2 weeks.
At the next meeting, the patient reported that the hot flushes had reduced to 2-3 per day and were not so intense. She was getting just one night sweat. Her mood had lifted. Her digestive problem had eased. The result of her blood test showed that she was indeed perimenopausal. She was asked to come back in 2 weeks to see how the treatment was going.
At the next meeting, Paula reported that she had no hot flushes during the day and no sweats at night. Her mood had lifted and she felt â€œback to normalâ€. Her energy levels had also increased and she was no longer tired during the day. Her digestive problem had resolved itself. As the patient was doing so well on this prescription, it was agreed that I would see her every 4 weeks to see how she is and if the prescription needs to be tweaked to take into account the changing hormone levels. The beauty of a herbal prescription is that it can be adapted to meet the patientâ€™s unique needs, unlike a one-size-fits-all medication.
What is the menopause?
Menopause is the time when periods stops permanently either due to gradual natural processes or abruptly when induced by artificial means (surgery or radiation). Prior to the final menstrual period there is a transitional time, perimenopause, lasting up to eight years. During this time most women begin missing periods and their menstrual cycles lengthen. A woman is usually considered postmenopausal 12 months after her last period.
The entire menopausal process can take up to thirteen years. Menopausal signs and symptoms are due to the body's inability to respond to a decrease in oestrogen, progesterone and possibly androgens such as testosterone and dehydroepiandrosterone (DHEA). Other hormonal changes include an increase in follicle stimulating hormone (FSH) and luteinizing hormone (LH).
What are the signs and symptoms?
They can include any of the following:
- irregular and/or heavy periods
- breast tenderness and swelling
- dry vagina
- low libido
- hot flushes and night sweats
- anxiety and agitation
- mood swings
- behaviour or feelings, which are out of character
- impaired memory, concentration and vagueness
- heart palpitations
- itchy skin
- thinning and ageing of the skin and/or hair
- weight gain
In addition to the fluctuations in hormone levels, other possible causes of menopausal discomfort may include adrenal exhaustion and impaired liver function. If you think you may be experiencing the menopause, a blood test will tell you what your hormone levels are.
What is the aim of herbal treatment during the menopause?
Support of the adrenal glands: As the ovaries slow down, the adrenals are capable of producing oestrogen
Support of the nervous system to alleviate anxiety, depression and insomnia
Reduce the number and severity of hot flushes and night sweats Increase vitality, where the patient is feeling tired or exhausted
Boost liver function: Adequate metabolism of hormones by the liver helps to ease many menopausal symptoms.
Herbal support for women planning to stop taking HRT
The majority of women begin taking HRT, when uncomfortable or debilitating menopausal symptoms disrupt their life. After the 2002 findings regarding the undesirable side effects of HRT, it is now recommended that for most women HRT only be used in the short term. This recommendation is questionable as it only briefly delays menopausal symptoms. The effect of the initial publications of the WHI, and also the Million Women Study (MWS), resulted in a decline in HRT use of around 50% in the UK.
For those who have chosen to stop HRT, the dose should be gradually reduced in order to minimise the effects of hormone withdrawal. Ideally, herbal treatment will begin prior to any change in the dosage of HRT. This can be done with the co-operation of your doctor. In fact, many GPs are now referring perimenopausal patients to Medical Herbalists.
How to get herbal treatment for your menopausal symptoms
There are over-the-counter remedies such as Black Cohosh. However, this herb is only a small part of a Medical Herbalistâ€™s prescription for the relief of menopausal discomfort and is never used in isolation. Every woman experiences menopause in a slightly different way to others so a one-size-fits-all over the counter remedy does not always get the best results. A Medical Herbalistâ€™s prescription is tailored to meet each patientâ€™s unique needs. Patients find that this approach gets the best results.
This natural approach to the menopause is becoming increasingly popular. So why put on a brave face and suffer in silence, when there is now a safe, gentle way forward?
Written by: Deborah Grant
Deborah Grant BSc(Hons)Herb.Med.MNIMH
For more information visit: London Herbal Medicine