Facing menopausal change

[attach]852[/attach]Grade school girls might squirm in their seats during sexual education classes but they are, at least, being informed about the changes happening to their bodies.

The same can’t be said for middle-aged women who are approaching menopause.

Dr. Pamela Frank, a naturopathic doctor who takes the herbal approach to soothing menopausal symptoms, says women come to her frustrated, irritated and just plain embarrassed.

She says most women who talk to her are looking for alternatives to hormone therapies, which some say put women at greater risk of heart disease, stroke and breast cancer. Many women, Frank says, are unaware of what options are out there.

“I think that women need to be better educated about the ways and means of dealing with it that aren’t hormone replacement therapies,” says Frank, who owns the Forces of Nature naturopathic clinic in Toronto.

According to Dr. Christine Derzko, a specialist in mature women’s health, women are not as well-educated as they could be about hormone therapies. She says women tend to hear only the negative connotations and become worried.

She cites recent studies that suggest there are many benefits — aside from relief from typical symptoms like hot flashes — to women who begin therapies to increase levels of estrogen and progestin.

Women who begin treatment between the ages of 50 and 60 are said to have cognitive benefits and a healthier cardiovascular system, Derzko says.

When therapies are started within 10 years of a woman’s last menstrual cycle, Derzko says, the health risks are greatly decreased.

“It’s important to remember that a lot of our medicines came from herbs,” she says.

Although the doctor says she’s not against the idea of naturopathic approaches, she adds there’s a lack of research and scrutiny over those methods. The products naturopaths prescribe are not classified as drugs and therefore aren’t tested as drugs, Derzko says.

“What I need to know is that if I’m telling you to use it, that it is safe,” says Derzko, a clinician with St. Michael’s Hospital and the treasurer and a founder of the Canadian Menopause Society.

Unlike medical treatment options, there have been few studies on the risks of naturopathic options — including mixes of herbs and vitamins like magnesium, zinc, wild yam and black cohash — which she says act as very mild hormone therapies.

In one of the few studies that have been done, Frank says the use of black cohash in higher doses was associated with a greater risk of developing breast cancer.

Frank’s concern about medical treatments, she says, is they simply replace lost hormones rather than stimulate the body to produce more.

Just because the body begins to lose estrogen as a woman begins menopause, Frank says, it doesn’t necessarily mean more needs to start being put back in.

“If a girl is going through puberty, you wouldn’t just medicate her back into girlhood,” she says. “Medicating her wouldn’t be right. Yet somehow it’s right to medicate a woman back into their child-bearing years.”

Frank says herbs can help the adrenal glands to again produce hormones rather than putting them directly into the body through treatments, which once stopped would mean hormone levels deplete again.
“We’re helping your body make your own estrogens,” she says.
Frank’s goal for her patients is to eventually have them taking little more than a multivitamin and fish oil.
Both doctors agree, however, that herbal and medical treatments are just a small part of menopause management.
Derzko suggests women maintain a healthy lifestyle, including a balanced diet, getting enough exercise, reducing stress and going for regular mammograms.
“Hormones are only a small part of the picture,” Derzko says. “Hormones aren’t going to solve the problem.”