Menopause 101

©2006 Publications International, Ltd.
Menopause can begun anywhere between the ages of 40 and 60.

Technically, menopause is a woman's last natural period, but this definition is much too narrow; we all use the term menopause to refer to a broad stretch of life during which a woman's reproductive capabilities wind down. This span of midlife years is sometimes called the change of life. Climacteric is another term you might hear; it is a little less ominous than "the change."

In fact, climacteric, in another context, refers to the condition of fruit just before it is ripe -- an apt analogy. You can also think of the climacteric as a counterpart to puberty; during puberty, a girl experiences menarche (the beginning of menstruation), and during the climacteric, a woman experiences menopause (the end of menstruation).

Around menopause, a woman's principal sex glands, the ovaries, begin to shut down. Ovulation, the process in which eggs are produced, stops, and the monthly cycle becomes unpredictable or absent. Also, during menopause, the ovaries gradually stop producing their hormones, primarily estrogen and progesterone, and then, finally, testosterone.

Menopause may occur gradually -- with hormonal changes and menopausal symptoms lasting many years -- or it may happen very quickly. Some women notice subtle changes starting in their 30s, which may include irregular periods, mild flushing sensations, and premenstrual mood changes.

Many women will have no menopausal symptoms whatsoever, except that their periods disappear in their 50s. The average age of natural menopause is 51, but natural menopause can occur anytime between 40 and 60. The exact timing depends on several factors, including heredity and environment, such as diet and exposure to toxins or hormones.

Surgical menopause occurs when a woman's ovaries have been surgically removed. Although surgical menopause has its own set of concerns, many of its discomforts and health problems are shared with natural menopause.

The physiologic events experienced during menopause go along with a lot of other changes in a woman's life. The end of ovulation represents the end of childbearing years, and to the extent that a woman connects her own self-image with her childbearing ability, this may or may not be of importance to her. Sexually, menopause is the beginning of the time when sex is no longer connected to having babies. For some, this is a liberating experience, and many women enjoy sex enormously after menopause -- even more than before. For other women, sex may seem an increasing burden.

Finally, menopause represents the passage into another generation. As parents age and children mature, the midlife woman must adapt to changes around her. Some women, who have been stay-at-home mothers, may choose to join the workforce once they have "empty nests." Others may be presented with the task of caring for elderly parents. And still others may have adult children returning to the home, often with toddlers in tow, further taxing the energies of the midlife woman.

The exciting news about menopause today, however, is that women are better informed and are more proactive in their approach to their mature years than ever before. With forty years of life ahead of her, a woman of forty-something can't afford to sit quietly and let the world pass her by.

A large component of menopause is the production, or the lack or production, of certain hormones. We will review this process in the next section.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

©2006 Publications International, Ltd.
Hormones like estrogen regulate and control many of the functions in the human body, including the menstrual cycle.

Hormones are chemicals that are made in small organs called glands. Hormones move about the body, usually through the bloodstream, and change or regulate the function of other organs and structures. In effect, the release of hormones is one of the ways that different parts of the body communicate with each other. The hormones we are most concerned about here are estrogen, progesterone, and testosterone. These are made in a woman's ovaries, the small almond-shaped sex glands in the pelvis that also produce a woman's eggs.

The sex glands are active during fetal development, but they become relatively inactive throughout infancy and childhood. Then, at puberty, the sex glands kick in bigtime to produce adult sexual development and urges, as well as the mood swings we all associate with puberty. After that, most women then settle into a more or less regular pattern of ovulation.

The ovaries make estrogen and progesterone, as well as various other hormones, in a cyclic fashion, and the levels of these hormones rise and fall with ovulation. For most women, this will be a monthly cycle, interrupted now and then by pregnancy or disrupted by stressful events.

Thought of as the primary female hormone, estrogen builds up the uterine lining, stimulates breast tissue, and thickens the vaginal wall. It also affects almost every other organ in the body. Estrogen plays a critical role in bone building and is thought to have important protective effects on the cardiovascular system.

Progesterone, which is made only during the second half of the menstrual cycle, prepares the uterine lining for an egg to implant, but progesterone also has other important effects on many of the tissues sensitive to estrogen. Testosterone, also made in the ovaries, plays a role in stimulating sexual desire, generating energy, and developing muscle mass.

The balance of hormones in your body at any given point is affected by many factors. The pituitary gland, at the base of your brain, and your ovaries are constantly communicating via their respective hormones, dictating the changing hormone levels of your monthly cycle and the production of eggs. The pituitary produces follicle-stimulating hormone and other hormones. Stress, body weight, time of day, time of the month, and any medications you take can all cause temporary changes in your hormone levels.

Menopause brings major, permanent changes to the hormone levels and hormone balance of your body. The ovaries stop producing eggs, and they also quit producing their hormones. This does not happen all at once. By their late 30s, many women produce less progesterone, which can lead to heavier, more frequent periods early in the "perimenopause" process. Then the ovaries' estrogen production tapers off. It is the fluctuations in estrogen production and, later, the lack of estrogen that primarily brings on the discomforts and health concerns that are associated with menopause.

Fluctuating and falling estrogen levels disrupt your internal thermostat, causing vasomotor instability, the scientific name for the process that causes hot flashes. Your sleep cycles and some muscle tone, most notably in the pelvic area, are also affected by the drastic reduction in estrogen levels.

One of the possible treatments for menopause is hormone replacement therapy. In the next section, we will explore this controversial process.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

©2006 Publications International, Ltd.
Some doctors will recommend hormone replacement therapy for extreme menopause symptoms.

Hormone replacement therapy (HRT) is one of the most controversial approaches to the management of menopausal symptoms. HRT literally replaces the hormones that a woman's body no longer produces. There are two primary types of HRT: estrogen replacement therapy (ERT) and combination estrogen/progesterone therapy. Other hormones less commonly used in HRT include androgens, specifically testosterone, and dehidroepiandrosterone (DHEA).

Estrogen is primarily produced in a woman's ovaries. The ovaries produce little estrogen during childhood, but at puberty, estrogen production increases, making girls develop breasts and wider hips and building the uterine lining each month in preparation for pregnancy. In the central nervous system, estrogen and its companion hormone, progesterone, help to regulate mood and sleep-wake cycles. During menopause, the ovaries begin to shut down; they no longer produce eggs and stop producing estrogen and progesterone.

Some doctors think that menopause is a "failure of the ovaries" and that estrogen should be given indefinitely to almost every woman going through menopause. But most doctors think that HRT should be used only for a short period of time to alleviate severe symptoms of menopause.

Clinical Studies

Doctors have learned quite a bit since HRT was first introduced. In the l940s, scientists discovered how to make estrogen that could be taken in a pill. The first orally active estrogen was made from pregnant mares' urine, hence the familiar brand name, Premarin. Premarin and other forms of estrogen became very popular in the l950s. In the 1960s, reports appeared that women taking estrogen supplements had an increased risk of endometrial (uterine) cancer. Further research revealed that as long as estrogen was balanced with a second hormone, progesterone or a synthetic "progestin'" the combination -- which is also used in oral contraceptives -- did not cause endometrial cancer.

By the 1980s, combination estrogen/progestin therapy was widely used to manage menopausal symptoms in women who had a uterus, but it was not usually used to treat women who had hysterectomies, as they do not need protection from endometrial cancer. At the time, many thought that the combination therapy might protect women against heart disease and Alzheimer's disease as well, but this has never been proven.

In the 1990s, the federal government funded clinical trials to evaluate the safety of HRT. The Women's Health Initiative conducted two studies: the estrogen-alone study of women who had hysterectomies and the combination estrogen/progestin study of women with a uterus. Conclusions from both studies showed that HRT increases women's risk of stroke and blood clots. The estrogen-alone study indicated no increased risk for heart attack or colorectal cancer and a decreased risk of fractures, but effects on breast cancer were uncertain.

However, the combination estrogen/progestin study indicated an increased risk of heart attack and breast cancer and a decreased risk of colorectal cancer and fractures. As a result of the studies, the Food and Drug Administration (FDA) recommends that women who use HRT take the lowest effective dose for the shortest amount of time possible, that health care providers consider prescribing topical products to address vaginal symptoms, and that non-estrogen medications be considered first to treat women at risk for osteoporosis.

Why would a woman use HRT? There are several benefits. Estrogen helps to preserve bone mass and prevent fractures, alleviates thinning of the vaginal wall and bladder, and effectively treats hot flashes. Many women also feel better on HRT; they sleep more soundly, have more energy, and feel less fatigue and irritability. And many find that their skin seems moister and less prone to wrinkling.

Additional Precautions

Recently, products advertising that they are "natural" or "bioidentical" have been gaining popularity. The term "natural" is primarily a marketing term and is commonly used to describe herbal and over-the-counter nutritional supplements aimed at treating menopausal symptoms. "Bioidentical" hormones are chemically identical to those the human body produces. No large-scale, long-term clinical trials have been conducted to evaluate the safety of these products.

When taking estrogen, taking progesterone protects against endometrial cancer. But estrogen can also be combined with another hormone, testosterone. Although usually thought of as a male hormone, testosterone is, in fact, produced in small amounts in women's ovaries. Some women notice a decrease in libido and general well-being after menopause (particularly surgical menopause) but find that taking testosterone supplements improves their sex drive. However, side effects include facial hair, thinning scalp hair, acne, and deepening of the voice. Furthermore, most of the products on the market are for males and use in women is "off-label." There have been no long-term safety studies of testosterone use in women.

Another hormone, DHEA, which is normally made in the adrenal glands, is available in over-the-counter supplements, and some studies indicate it can improve libido and well-being. Since the FDA has classed it as a dietary supplement and it is available over the counter, DHEA is not as tightly regulated as are prescription pharmaceuticals, and as a result, products may vary in potency. No long-term safety studies have been done.

Side effects of HRT are common; many women experience vaginal spotting and bleeding, fluid retention, and breast tenderness. Many blame midlife weight gain on HRT, although aging and slowing metabolic rate are probably the culprits.

The brand name products mentioned in this publication are trademarks or service marks of their respective companies. The mention of any product in this publication does not constitute an endorsement by the respective proprietors of Publications International, Ltd. or HowStuffWorks.com, nor does it constitute an endorsement by any of these companies that their products should be used in the manner described in this publication.

Lifestyle Considerations

Personal and family history can play a role in helping you to decide whether to take HRT. Here are some factors to consider:

• Family history of osteoporosis: If your ancestors are similar to you in body build and lifestyle and had problems with bone fractures from minor injuries as they aged, you may be at increased risk for bone loss and may want to consider estrogen for it bone benefits. However, ask your doctor about non-estrogen treatments first.
  
  
• Personal and family history of breast or endometrial cancer: Women with a strong family history of female tumors should talk with their doctors before taking HRT. Women with a personal history of breast or endometrial cancer will likely be advised against HRT, particularly estrogen alone, but topical or low-dose therapy may be recommended for specific conditions.
  

• Family or personal history of blood clots: It is known that HRT increases the risk of blood clots. Women with a family or personal history of blood clots should be carefully assessed by a doctor before taking HRT.

• Are you sedentary? Physical activity and exercise help develop strong bones. Sedentary women, on the other hand, have a higher risk of osteoporosis. If you can't or won't change your lifestyle, the benefits of estrogen may be great. Women who are disabled, in particular, may require the bone-protecting benefits of HRT.
  

• Do you smoke? Smokers go through menopause several years earlier than nonsmokers, increasing their risk of osteoporosis. Although HRT may protect against osteoporosis, smokers may not be able to take it due to their increased risk of developing blood clots.
  

• Are you obese? Obese women have a greater risk of breast and endometrial cancer but may have a lower risk of osteoporosis.
  

• Are you a health nut? If you eat a nutritious, varied diet, exercise regularly, and avoid items that you do not consider "natural," you may prefer not to take HRT on philosophic grounds. Fortunately, your diet and exercise regimen will help to protect you against heart disease and osteoporosis, but you may still benefit from HRT's ability to stave off bone loss.
  

• Are you stressed? Many women find that hormonal fluctuations during perimenopause lead to sleep loss, fatigue, mood swings, and irritability -- contributing factors for stress. Some women on HRT experience improved sleep and less irritability. However, HRT does not treat major depression or other significant biochemical mood disorders. Women suffering from these conditions should seek medical attention from a mental health professional.

Other issues can also play a major role in your decision to take HRT. A very busy, high-profile woman may not be able to function with sleep disruption during menopause, and she may benefit from this aspect of HRT. Some women find that their skin and hair are fuller and "younger" looking on HRT; other women find that vitamins and a healthy lifestyle accomplish the same thing. A woman who travels a lot may find bleeding an unacceptably inconvenient side effect of HRT. Other women like the bleeding, because it feels "normal" to them.

Only you can piece all these factors together for your own well-being. Above all, try to keep in mind that HRT is not a replacement for other health habits. You should decide about HRT at the same time you are working on increasing exercise, eating a healthier diet, and quitting smoking--not instead of making these vital changes. You, too, must do your part.

If you or you doctor decides that hormone replacement therapy is right for you, your next biggest decision will be what type of hormone you take. In the next section, we will help you make an informed choice.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

The brand name products mentioned in this publication are trademarks or service marks of their respective companies. The mention of any product in this publication does not constitute an endorsement by the respective proprietors of Publications International, Ltd. or HowStuffWorks.com, nor does it constitute an endorsement by any of these companies that their products should be used in the manner described in this publication.

©2006 Publications International, Ltd.
Estrogen pills are the most common method for taking replacement estrogen.

Most women are confused about which form of estrogen is best--and with good reason. There are many forms of estrogen and progesterone -- pills, patches, injections, suppositories, and implants. Furthermore, there are many different brands and chemical formulas of both hormones, and more brands and forms will become available in the future. There is no way of making this subject, or the choice, simple. First, we will consider the different delivery methods. 

• Estrogen pills: Most American women on HRT take estrogen in pill form. Most pills are taken more or less daily. They are convenient for most women and are usually less expensive than some of the other forms of estrogen. Some women experience side effects (spotting, flashes, headaches) from the "peak" blood level of estrogen, which usually occurs several hours after a pill is taken, and from the "trough," which occurs before the next pill is absorbed. The peaks and troughs and duration of action vary with different pills.
  

• Estrogen patches: Estrogen is also available in patch form. Estrogen patches can make the rise and fall in blood levels of estrogen more gradual; hence, they may be better for women who get headaches or flashes from daily fluctuations in hormone levels. They are normally used every few days (once or twice weekly) and are nice for women who forget to take pills, since the presence of a patch serves as a reminder to change the patch. Skin irritation from the patch can be a problem, and sometimes the patch may fall off when you sweat.
  

• Estrogen gels and creams: Estrogen is available in gel and cream form both over the counter and by prescription. Over-the-counter gels and creams are not regulated by the FDA and have not been tested for safety. These products are usually used once or twice daily.
  

• Estrogen injections: Injections are not widely used or widely available in the United States, but they may become more popular in the future. Injections, usually weekly or monthly, provide more even blood levels of the hormones. They also eliminate the problem of having to remember your pill or keep track of your patch. However, they can require a visit to the doctor's office and may provide higher hormone levels than necessary.
  

• Estrogen vaginal creams: Estrogen vaginal cream can help with sexual lubrication, bladder irritation, and infection brought on by the thinning of the bladder wall. In theory, all of the potential side effects of estrogen can apply to vaginal use. In practice, however, the amount absorbed is a fraction of what would be absorbed through standard HRT.
  

• Estrogen pellets: A health care practitioner inserts these small pellets of long-acting estrogen under the skin. They are not widely used because they require an office visit for insertion, and there are concerns about the safety of potentially high estrogen levels.

Another consideration is whether you want your HRT regimen to be "cyclic" or "continuous." Combination estrogen/progestin therapy, used by women who have a uterus, can be taken in several ways. The most popular method is called "continuous combined hormone therapy," in which estrogen and progestin are put into a single product -- pill, patch, gel, or cream. This method is simple, ensures an appropriate balance of hormones, and minimizes the risk of endometrial cancer; breakthrough bleeding (spotting) is a common side effect.

Many estrogen products, however, do not contain progesterone; hence, women must take two different products cyclically. Many women and their doctors prefer to use less frequent progestin at regular intervals -- also called a pulsed regimen -- for 12 to 14 days. This counteracts any uterine lining buildup stimulated by the estrogen. Depending on the estrogen dose and your risk factors for endometrial cancer, doses of progestin may be cycled as often as once a month or as infrequently as every six months. Talk with your doctor about the different methods -- and benefits and risks associated with each -- of taking HRT.

Reevaluate the Decision

Once you have made a decision about HRT, don't just continue indefinitely on autopilot! New information becomes available all the time about the pros and cons of HRT. New doses and routes of administration will arise that may be favorable for your lifestyle or risk factors. Also, a new health condition may increase the risks of either taking or not taking HRT.

Ask your doctor about your situation at annual visits. Some doctors, if you don't ask, will not raise the issue and will either automatically refill your existing prescription or not mention the possibility of starting HRT if you aren't already taking it. A woman who was not previously sexually active but is now may benefit from the vaginal lubricating effects of estrogen.

At five-year intervals, women should very thoroughly take stock of their hormone therapy. Update your family and personal history with your doctor, and see if there is new information that may be significant for you.

Hormone therapy is not the only treatment for menopause. On the next page, we'll take a look at some nonhormonal treatments for menopause.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

©2006 Publications International, Ltd.
Hot flashes can be effectively treated with nonhormonal medications.

Many women and, unfortunately, their doctors assume that the only treatment for menopausal discomforts is hormone therapy. Actually, a number of different medications are useful for the hot flashes, mood swings, and sleeping problems that can occur around menopause. Look into the following medication before taking HRT.

A high blood pressure medication called clonidine can reduce the severity and the frequency of hot flashes in some women. It is believed to work by suppressing hormone surges in the brain. Common side effects are dry mouth and fatigue, but clonidine can be a particularly convenient treatment for women who need medication for their blood pressure, anyway. Another blood pressure medication, propranolol, is sometimes prescribed for menopausal women. It, too, can affect the frequency and severity of hot flashes. Propranolol, technically called a beta-blocker, controls the dilation of the blood vessels that can cause a flash.

Another commonly prescribed medication is called Bellergal. This drug is really a combination of three ingredients: phenobarbital, ergotamine, and belladonna. Together these ingredients produce a sedating effect on your nervous system, thus helping to stabilize your temperature and improve your sleep. Side effects include dry mouth and constipation. Unlike clonidine and propranolol, Bellergal cannot be used by women who have high blood pressure.

Antidepressants (such as fluoxetine, sertreline, paroxetine, lexapro) that raise serotonin levels can have a significant impact on hot flashes and may counteract the irritability that many women experience with menopause. And a drug called neurontin, used to treat seizure disorders and neuropathic pain, has been reported to reduce hot flashes.

Some other nonhormonal treatments, such as magnesium supplements and vitamins E and B, have been said to help, but there is not much evidence to confirm this yet. Black cohosh supplements and soy supplements have a modest impact on flushing in clinical trials. Many women find simply exercising regularly, eating a healthy diet, and ignoring menopause symptoms works well for them. The most important thing is to explore the alternatives. Not all women can or should take hormones. Most women can, at least, get their flashes down to a livable nuisance by nonhormonal means.

There are many more herbal and alternative treatments available for menopause. We'll investigate some of them in the next section.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

The brand name products mentioned in this publication are trademarks or service marks of their respective companies. The mention of any product in this publication does not constitute an endorsement by the respective proprietors of Publications International, Ltd. or HowStuffWorks.com, nor does it constitute an endorsement by any of these companies that their products should be used in the manner described in this publication.

©2006 Publications International, Ltd.
Acupuncture can relieve some of the tension and stress due to the side effects of menopause.

Because menopause is a natural process that happens to all women, some doctors recommend some simple alternative menopause treatments. Here are a few of the most popular.

Get a Massage

A good massage can relieve tension in your body caused by stress, and relaxation can do wonders for your hot flashes and your sleep. Massage may also help relieve some arthritis pains because of the increased blood circulation. Many people find a massage makes them feel less anger and hostility, which accumulate in the form of tension in your body. During the massage, you can concentrate on good feelings within and about your body. Learn to breathe deeply and focus on relaxation instead of stress-filled situations.

What will you encounter when you go for a massage? Most professionals use a rather firm, but comfortable, specially constructed massage table with a soft face rest for you to use while lying on your stomach. Usually, you will have a choice of music to listen to during your massage to enable your mind to relax and drift. A variety of oils will be used so that the massage therapist's hands glide more easily.

Massage can be a good part of your routine of taking care of yourself and learning to relax more.

Try Acupuncture of Acupressure

Have you thought about trying acupuncture? Some women who do not find relief from their discomforts using traditional medications opt for acupuncture. Instead of ingesting prescription drugs, some women rely on acupuncture to treat their hot flashes and other discomforts. Acupuncture is regarded by most physicians as an "alternative" method of healing, because it is not yet in the mainstream of Western medicine. However, since the early 1970s, it has been gaining popularity in the United States.

Acupuncture is a technique developed thousands of years ago by Asian practitioners to relieve pain and improve well-being in a variety of ways. The philosophy behind acupuncture is that the life force flows through certain pathways in the body, known as meridians. Manipulating certain points on these meridians with acupuncture releases and facilitates the flow of energy to interrupt patterns of illness or the discomforts of mild or severe pain. The technique involves inserting specially designed, very thin needles under the skin to activate the flow of vital life force or energy. Acupuncture has been used in place of anesthesia during and after surgery and as a painkiller after diagnostic and surgical procedures.

A related technique is acupressure, another ancient technique based on applying finger pressure to the same specific points on the body where acupuncture is used. Acupressure is helpful for some women with neck and back tension or pain, headache, and a variety of other discomforts. Acupressure releases tension and helps to increase circulation, enabling more oxygen and other nutrients to flow freely throughout the body.

To find a specialist in acupuncture or acupressure, contact a school for Eastern medicine in a major city. Acupuncturists are licensed to practice in some states in the United States; in other states, only licensed physicians may perform acupuncture. Many hospitals and medical practices have incorporated acupuncturists into their practices.

Turn to an Herbal Remedy

If you don't like taking prescription drugs, try an herbal remedy. Herbs are natural substances that have been used medicinally to treat menopausal symptoms for many thousands of years. Modern medicine began with the ancient knowledge of herbal remedies. In fact, many herbs have nonnutritive compounds that promote a desired biological process or change an unwanted process. Even today, nearly 75 percent of the world's population relies on herbal or traditional medications. Herbs are used all over the world for maintaining health and curing ills.

Oriental herbal therapies are based on maintaining and restoring a balance of our vital energy. Prescriptions are individually prepared for each patient. For example, for hot flashes, one Oriental herbalist might recommend a combination of ginseng and licorice. Another might recommend a cup of raspberry leaf tea. In general, do not treat yourself with herbal remedies without checking with your doctor or a trained herbalist. Since some herbs can interact with other medications, always inform your doctor of any extra at-home treatments you are presently taking.

Why use herbal therapies instead of traditional prescription drugs? Many women like herbal therapies because the herbs are "natural," they've been used for thousand of years, they are found in food products, and they are usually available over the counter. However, herbal remedies, unlike prescription medications, are not strictly regulated.

The quality of herbal products varies widely, and some products may contain toxic levels of some herbs or contaminants. Other concerns include taking an ineffective herbal product when a safer, more effective prescription drug is available or delaying medical care for a serious condition while trying an herbal product.

Although herbs often may be less expensive than prescription drugs, they may cost more at times. Some herbal practitioners insist that you use only his or her product, which may be more expensive. Herbal remedies are not covered by insurance. And sometimes one relatively inexpensive medication may work as well as or better than multiple costly herbal remedies.

The good news is that many women find that herbal remedies fit their philosophic approach to treating minor ailments and menopausal symptoms, and many of the products are helpful as well.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Nontraditional ideas about staying healthy at midlife and beyond include turning to nutritional therapy. There is a wide range of approaches to nutritional therapy. Some women swear by a vegetarian diet. Some purchase only organically grown products that have no chemical contamination. Others avoid specific foods such as red meat or caffeinated beverages. Certain roots, herbs, and mushrooms are believed, in Chinese medicine, to strengthen the immune system or to help counter the side effects of chemotherapy.

Garlic and onions, remedies well-known for healing in many folktales, actually have been shown to reduce levels of serum cholesterol. Oatmeal and ground flaxseed can also reduce cholesterol levels. Extra folic acid may reduce the risk of heart disease. Diets with a good balance of soy products (roughly two servings a day in the form of bean products and soy milk products) can both reduce cholesterol and diminish hot flashes. Some women find that vitamin E seems to reduce hot flashes.

A diet that helps you cope with menopause is great, but remember to eat a variety of foods. A balance of healthy protein sources, a variety of fruits and vegetables, and whole grain products is critical to good health. If you experience digestive problems, consult with a physician or dietitian as to whether you may be intolerant to lactose, gluten, or other products, as food sensitivities are common.

Try Meditating

©2006 Publications International, Ltd.
Meditation has been used for centuries to help relax and clear the mind.

To help you relax and clear your mind, try meditating. Meditation is a technique for focusing mental energy in a way that can have physical and psychological benefits. For example, through meditation, some people have been able to reduce their blood pressure and heart rate. It may also improve immune system function and decrease chronic pain. More commonly, people use meditation to help reduce physical tension and overcome effects of a stressful life, both of which can wreak havoc on a woman with hot flashes who hasn't had enough sleep.

Meditation is not a new idea. Modern meditating techniques have evolved from centuries-old traditions in Eastern cultures. Currently, meditation is considered one of many "complementary therapies," because it involves no pharmaceutical products and is self-directed. Many holistic health practitioners now include different meditation techniques in their repertoire of therapies.

Meditation usually takes one or more 15- to 20-minute periods each day. A relatively quiet atmosphere is necessary for complete concentration. Some people focus on an object, such as a candle flame, whereas others meditate with closed eyes. Some use a special word, or "mantra," that they say repeatedly to block out distracting thoughts.

Meditation is often used in conjunction with other relaxation techniques, such as biofeedback and yoga.

You can learn more about meditation as a nontraditional method of handling your menopausal symptoms by contacting a local holistic health center, a center for Eastern medicine, or a traditional hospital or health-care center that has a complementary or integrative medicine program.

Though menopause happens to every woman, some women might approach it with fear or apprehension. Most of all, you must learn to be comfortable with your changing body and changing roles. In fact, for many women, the years surrounding menopause can be the best years of their lives, as they enjoy their adult children and grandchildren or new interests and hobbies. The more positively you look at menopause, the more positive the experience -- and life -- will be.

^©Publications International, Ltd.

About the Consultant:

Dr. Linda Hughey Holt practices obstetrics and gynecology with a special focus on menopause. She is the co-author of several books on women's health, including The American Medical Association Book of Woman Care. She attended Yale University and obtained her medical degree at the University of Chicago Pritzker School of Medicine. She is a founding partner of the Midwest Center for Women's Healthcare, an associate clinical professor at the Feinberg School of Medicine at Northwestern University, and a fellow of the American College of Obstetricians and Gynecologists. Additional information on Dr. Holt is available at www.midwestcenterforwomenshealth.com.

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