Menopauses Mysteries

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Menopauses Mysteries

• L. Z. Killinger, DC

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Recommended Reading

• The Wisdom of menopause Creating Physical and
  Emotional Health During Change- Christine
  Northrup
• The Seven Sacred Rites of Menopause- Kristi
  Meisenbach Boylan (9.50 Amazon.com)

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Why is this important?

• Over 1 in 3 US women are over 50 years old!
• That means this is a hot topic for your patients!

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What Patients May Experience

• Missed periods (pre-menopause)
• Chills/Hot flashes or sweats
• Flushes
• Dizziness
• Wooziness
• Palpitations
• Sleep disturbances
• Sexual symptoms
• Mood swings, anxiety, panic attacks,
  overreacting!
• Maybe Depression, memory loss, skin wrinkling,
  fatigue, thinning of hair, stiffness in joints
  and muscles

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When Does It Occur?

• Average Age 50-51 Years old
• Usual medical treatment Hormones ERT/HRT
  (WARNING!)
• Assessment
• Blood test Follicle Stim. Hormone (FSH)
• Menopause Defined No menstruation for 12 months
  The definitive diagnosis

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Can we predict menopause?

• Missed periods Most reliable predictor
• Missed a period 65 will have menopause within 2
  years 100 within 4 years
• Other predictors like hot flashes, not nearly as
  reliable. Source Taylor, et al.
  Menopause. J N Amer. Menopause Soc. 11 40-45.

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Perimenopause

• Age 44-51 ( The 8 yrs before menopause
• Estrogen declines more rapidly (Adjust w/care!)
• Decline in childbearing potential (Careful!)
• First, menses comes more often (YIKES!)
• Then, menses becomes irregular
• Bleeding may become heavier
• Hot flashes-usually 1-4 years before menopause
  (worse at night)
• Insomnia, irritability, forgetfulness, sexual
  symptoms

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Post-Menopausal Health Risks

• Increased risk of
• Heart disease
• Osteoporosis
• Uterine cancer
• Breast cancer
• Ovarian cancer
• Depression
• Colon cancer, etc, etc.

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What can we do?

• Bone Density Loss Counsel pts. about physical
  activity, diet, and supplementation, and
  lifestyle choices
• Heart Disease Risk Increases Counsel pts on
  physical activity, Mediterranean diet,
  supplements, etc.
• Depression/Anxiety Counsel pt about physical
  activity, socialization, volunteering, etc.

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What can we do ?

• Uterine cancer-Low fat diet, control weight and
  diabetes, regular pelvic exams.
• Colon cancer-Fiber 30 g/day, regular screenings,
  calcium supplements
• Breast cancer-physical activity, weight loss, low
  fat diet, lower alcohol intake, no smoking!
  Regular exams/self-exam!

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TrendsBreast Cancer Survival Rates

• 1974-79 10 survived 5 yrs
• 1980-84 14
• 1985-89 22
• 1990-94 29
• 1995-2000 44

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Why are survival rates up?

• EARLY DETECTION!!
• Mammography
• Treatment (chemo.) in earlier stages Sour
  ce Giordano SH. Cancer. Jan 04 10044-52

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Why not take HRT?

• The Womens Health Initiative study (large study
  on HRT for postmenopausal women) cancelled the
  arm of the study in which women were taking HRT
  (Estrogen/Progesterone combined)
• After 5 years women taking HRT had increases in
  several diseases.
• The risks of HRT were shown to outweigh the
  potential benefits (Slightly decreased incidences
  of colon cancer and hip fractures)

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Increased Risks of HRT (When taken for 5 years)

• Heart Attack 3.7/1000 women instead of 3
• Stroke2.9/1000 women instead of 2.1
• Blood Clots in Legs or Lungs 3.4/1000 instead of
  2.6
• Breast Cancer 3.8/1000 instead of 3
• But, decreased risk of osteoporosis and perhaps
  colorectal cancer
• JAMA 2002288872-881.

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Herbs and Menopause

• For thousands of years eastern healers have
  observed that some herbs have a positive impact
  on female troubles, including menopause
• Although used for centuries with success, such
  products are now being scrutinized using the
  scientific method (Experimental studies, placebo
  studies, controlled clinical trials)

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Herbs for Menopause

• Soy products (isoflavones)
• Black cohosh
• Wild yam
• Clover
• Ginseng
• Licorice
• Dong quai
• ANDVit B6, B9, etc.

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Which Herbs/For What?

• Herbs For Bone Loss
• Wild Yam natural progesterone source
• Chaste Berry-LH/Progesterone stimulant
• Red Clover All 4 isoflavones
• Daidzen, Genistein, Formononetin, Biochanin
• Source Nestel et al. J Clin Endocrinol Metab.
  1999 84(3)895-8.

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More Herbs

• Black Cohosh Used for relief of
  general menopausal symptoms, nervousness,
  anxiety, hot flashes, vaginal dryness
• Resources Whiting, Clouston, Kerlin. M J
  Australia 2002177(8)440-443.
• Leiberman J Womens Health 19987(5)525-529.

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More Herbs

• Passion flower Sedative and anti-spasmodic, for
  female anxiety, restlessness, insomnia, and night
  sweats of menopause
• Alfalfa Hot flashes, insomnia, night sweats,
  dizziness, etc.
• Soy isoflavinoids (eat more soy!)

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Tending and Befriending How Women Handle
Stress

• Recent study showed that men and women respond to
  stress differently (Duh!)
• Men either behave aggressively, or seek solitude
• Women tend and befriend Clean, organize, call
  friends, call on female friends
• Women that have close female friends live
  healthier, longer after traumatic injury/event,
  etc.

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So, what does this mean to us?

• Encourage women, who are stressed over menopausal
  changes to do what comes natural tend and
  befriend
• Avoid caffeine Increases insomnia, night sweats,
  breast cysts, bone loss, etc.
• Avoid alcohol-Increases breast cancer risk,
  depression, bone loss, etc
• Volunteer, socialize, stay active, eat right, try
  natural remedies, talk to others

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Encourage a Diet Consciousness

• Increase water consumption
• Decrease fats in diet
• Increase fruits/veggies in diet (for female
  cancer prevention in general)
• Increase fiber in diet-protects colon health
  (helps w/ mood?)
• Increase Calcium, Vitamin D, Soy

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Encourage Physical Activity!(So, you thought we
might get through a day without hearing this
again, eh?)

• Decreases stress
• Increases muscle mass and bone density
• Decreases pain
• Improves mood/decreases depression
• Decreases blood pressure and heart disease risk
• Improves overall health status, balance, self
  -image, sex drive, etc!!!
• (Stay tuned for more benefits!)

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Advantages of Menopause

• Freedom from birth control (finally!)
• Sex with no fear of pregnancy
• Protection from anemia (chronic problem with many
  menstruating women)
• Feeling of independence for women
• Hormonal stability after a lifetime of
  fluctuation

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Resources

• Www.healthywomen.org (National Womens Health
  Resource Center) (202-537-4015)
• www.4women.org (National Womens Health
  Information Center) 1-800994-WOMAN (9662)
• 1-800 MENO-ASK National Menopause Foundation

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Thank You!