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Bottom Line Personal March 15, 2006

For decades, women relied on hormone replacement therapy (HRT) to relieve symptoms of menopause—hot flashes, sleep disturbance, anxiety and mood swings. But several large studies have linked long term HRT with increased risk of breast cancer, dementia, heart attack and stroke.

Fortunately, there are safer, natural alternatives to HRT

More Than Just Estrogen

People typically attribute menopausal symptoms to declining production of the female hormones estrogen and progesterone. But poor eating and lifestyle habits also play a role, by overtaxing the adrenal glands. For women who are going through menopause, the adrenal glands are nature’s backup system. When the ovaries decrease their production of estrogen and progesterone, the adrenals have the ability to produce hormones to compensate. Poor diet and lifestyle choices put stress on the adrenals, creating an imbalance in body chemistry and contributing to the uncomfortable symptoms that we associate with menopause.

If you are a woman with menopausal symptoms, adopting healthier habits can help to even out these imbalances.

If you are a man and the woman you love is going through menopause, you can help by understanding that she is experiencing a profound physiological change. Your kindness and patience can ease her transition through a time that is confusing—for her as well as for you.

Common symptoms and natural solutions…

Hot Flashes 

As many as 80% of women experience hot flashes during menopause. One theory is that the hypothalamus, which controls body temperature, is triggered in some way by hormonal fluctuations.

Avoid spicy foods. Foods containing cayenne or other peppers have a thermogenic effect, meaning that they raise body temperature.

Cook with garlic, onion, thyme, oregano and sage. These seasonings contain very small amounts of phytoestrogens (plant-based estrogens such as lignans and isoflavones that occur naturally in certain foods) and can help restore hormone balance.

Cut down on caffeine. Caffeine stimulates the adrenal glands, leading to a spike in blood sugar levels followed by a plunge in blood sugar to even lower levels that before. This stresses the body and aggravates menopause woes.

Better than coffee: Green, white and black teas have less caffeine and are high in disease-fighting antioxidants. Try substituting tea for coffee. Then transition to herbal tea or hot water with lemon.

Add flaxseed. Ground flaxseed contains lignans, which seem to modulate fluctuating estrogen and progesterone levels. Aim for two tablespoons a day. Ground flaxseed has a pleasant nutty flavor—sprinkle it on cereal, yogurt and salads. Bonus: Flaxseed reduces cholesterol, helps prevent certain cancers and relieves constipation (be sure to drink plenty of water).

Eat soy foods in moderation. Some countries with diets high in soy report low rates of menopausal symptoms and breast cancer. But I’m cautious about soy. Preliminary research suggests that while isoflavones in soy appear to protect against some breast cancers, they may stimulate growth of other types of breast cancer.  I’m especially concerned about isolated soy protein, which often is added to protein powder, energy bars and supplements. This put far more soy isoflavones into the diet that other cultures typically consume—and these high amounts may not be healthful.  If you enjoy soy foods, limit your consumption to two servings a week, and eat them in their whole-food form—as tofu, tempeh, miso and edameme.

Be wary of herbal remedies. I’m cautious about black cohosh, red clobber and other plant remedies with estrogen-like properties. Research has not demonstrated clearly that they help, and some can have harmful side effects if not properly monitored. However, some women do report good results for m these remedies. Check with your doctor first. If you don’t notice a clear change in symptoms after two to three weeks of trying a new remedy, ask your doctor about trying something else.

What men can do: Buy a dual-control electric blanket so that you both will be comfortable. Make her a cup of herbal tea. Join her in eating flaxseed—it is good for your colon and prostate.

Insomnia 

During menopause, elevated levels of the stress hormone Cortisol make it difficult to fall asleep and can trigger intermittent awakening throughout the night. Natural sleep aids…

Wild yam cream. This topical cream extracted form yams grown in Mexico is a source of naturla progesterone. It’s is available at most health-food stores and some pharmacies. Applying small amount of wild yam cream daily may help to balance cortisol levels and enhance sleep. (The cream also helps reduce anxiety and hot flashes.)

Magnesium. Levels of magnesium, a natural sleep aid, are depleted when you consume too much coffee, cola, alcohol, sugar or salt. Foods high in magnesium include halibut…whole-wheat bread… leafy green vegetables such as spinach…nuts…and dried beans (soaked and cooked). If your diet is low in magnesium, take 200 milligrams (mg) to 400 mg in supplement form at bedtime.

Zinc. This mineral can help quiet an overactive mind. Foods rich in zinc include poultry, red meat and nuts, but it is hard to get enough zinc from food. Take 25 mg to 45mg in supplement form before bed.

Exercise. One study found that women over age 50 who walked, biked or did stretching exercises every morning fell asleep more easily. Try to get a half-hour of exercise most morning. Avoid working out in the evening—you may have trouble winding down. And don’t go to extremes. Over exercising (more than two hours of strenuous, nonstop activity every day) can lead to hormonal imbalance.

What men can do: Exercise with her in the morning. Make sure there is a bottle of magnesium tablets by the bedside at home and when traveling.

Mood Swings 

Drinking less coffee and eating frequent small meals will go a long way toward balancing your moods by reducing spikes in blood sugar and stress on adrenals. In addition…

Eat a balanced diet. The emotional and mental stress of menopause can lead to a vicious cycle in which stress depletes important mineral stores, further taxing the adrenals.

Among the minerals depleted by stress are copper, calcium, magnesium, potassium, sodium and zinc. To restore these minerals, eat an adrenal-supportive diet rich in bright colored fruits and vegetables, legumes, lean meats and whole grains. Avoid sugar and other refined carbohydrates.

Recommended: Sea vegetables, such asnori, arame, wakame andhijiki. These are especially high in key minerals. Health-food stores sell them in dried form. They can be crumbled into soup and over fish, salad and vegetables.

Get the right kind of fat. Though you should avoid saturated fats (found in pork, beef, and high-fat dairy products) and hydrogenated fats (in margarine, shortening and many packaged baked goods), certain fats are necessary for hormonal regulation and proper functioning of the nervous system. Known as essential fatty acids (EFAs), these healthy fats help to stabilize blood sugar.

Strive to consume two tablespoons a day of health oil (use it in cooking, salad dressings, etc.). Olive, sesame, almond, macadamia and flaxseed oils are especially high in EFAs. (Flaxseed oil does not cook well.)

Take B-complex vitamins. B vitamins are known as the anti-stress vitamins because they nourish the adrenals. Good sources of B vitamins include whole grains and dried beans (soaked and cooked). Most diets are too low in these vitamins, so supplements usually are needed to make up the deficit. Take 50 mg to 100 mg of vitamin-B complex daily.

What men can do: Make it easy for her to avoid sugar and caffeine by cutting back on them yourself—your health will benefit, too. If she seems distant or on edge don’t take it personally. Remind yourself that it is not you—it is her biochemistry that is acting up.

Weight Gain 

One reason why so many women gain weight during menopause is that the ovulation process burns calories—as many as 300 per day during the first 10 days of the menstrual cycle. When ovulation stops, fewer calories are burned and metabolism slows. Foods to counter the slowdown…

Protein. Increasing protein intake can raise the body’s metabolic rate by as much as 25%. Aim for three to four ounces of lean protein form fish, poultry, beef of lamb twice a day. Eggs and beans also are good sources.

Healthy carbohydrates. Whole grains, vegetables and fruits metabolize slowly and give you energy throughout the day. Try to consume daily at least two servings of fruits, three servings of vegetables and three serving of whole grains.

What men can do: Don’t nag her about her weight. Support her by not buying high-calorie foods, such as potato chips and rich desserts.