Hot Flashes

Hot flashes are among the most common complaints associated with menopause. Sudden fluctuations in body temperature are caused by quick drops in estrogen levels as the body prepares to end ovulation and menstruation. Because estrogen levels are lowest at night and in the evening, many women also experience hot flashes in the form of night sweats.

Fukinolic acid, one of the primary pharmacological components of black cohosh, is a natural, plant-based compound similar to estrogen. Though it does not actually add true estrogen directly to the body, it can relieve hot flashes and night sweats by “tricking” the body into believing that estrogen levels are higher than they actually are. Black cohosh is most commonly used because of its ability to combat menopause-related temperature fluctuations.

Amenorrhea

In both younger women and women experiencing menopause, black cohosh is frequently used to induce menstruation. Perimenopausal women often experience menstrual irregularities as the ovaries and uterus prepare to shut down. While black cohosh can not force menstruation to return on a permanent or regular basis, it can delay the onset of amenorrhea and induce delayed menstrual periods.

Black cohosh has anticoagulant, uterotonic, and estrogenic effects, so it works in a number of ways to bring about menstruation. Large doses of standardized black cohosh cause the uterus to contract, leading to dilation of the cervix and the shedding of the endometrium. Additionally, because it inhibits blood clotting, it can prolong or intensify an abnormally light menstrual period.

Sexual Health

Many women suffer from sexual dysfunction during menopause, and black cohosh may help to prevent or delay some of the underlying physical causes. Because it increases blood-flow to the pelvic region, black cohosh may enable heightened sensitivity of the genitals. This may help to alleviate common sexual problems like frigidity and difficulty achieving orgasm.

Additionally, black cohosh’s estrogenic effects can prevent vaginal dryness, a common complaint among women experiencing menopause. The estrogen-like compounds found in black cohosh can also help to prevent vaginal atrophy (the thinning of genital tissues), which is one of the key underlying causes of sexual dysfunction in perimenopausal women.

Other Conditions

Black cohosh may help to decrease the risk of many diseases and conditions that tend to strike during or after menopause. Arthritis, osteoporosis, and some forms of cancer are alarmingly common in post-menopausal women, but these some of disorders may be alleviated or prevented through the use of black cohosh.

Depression, mood swings, and fatigue are also extremely common for perimenopausal women. However, by helping to enable steadier hormone levels and higher levels of seratonin, black cohosh can alleviate some of these disorders. By treating the underlying causes of irritability, like night sweats and vaginal dryness, black cohosh can enable a stronger sense of self-confidence and general comfort.

Risks and Limitations

It is important for women experiencing menopause to remember that menopause is not a disease. Like puberty, menopause is a natural, normal development of the female body. No medicine, herbal supplement, or therapy can completely prevent the onset of menopause, and while black cohosh may help to relieve some related symptoms, it can not stop or indefinitely postpone this natural change in the female body.

Though generally considered safe, black cohosh is not without risks. Prolonged use of black cohosh has been linked to liver damage, so it should be avoided by women with hepatitis, cirrhosis, or other diseases of the liver. Because of its anticoagulant effects, black cohosh is not recommended for use within one month of surgery.

Black Cohosh

Black cohosh is an herb that contains phytochemicals which are believed to relieve the symptoms of menopause. It also has phytoestrogens, in particular isoflavones, that attach to the estrogen receptors in the body. This ability makes it a great choice for relieving menopause symptoms such as night sweats or hot flashes, anxiety and worry and depression. It reduces the lutenzing hormone in the body, which is responsible for wild temperature changes. This in turn, reduces hot flashes. It may also help with the reduction of heart palpitations that often occur during menopause.

Black cohosh may be taken for up to six months using two pills a day. It should not be taken for longer than six months as it may cause liver damage.

Maca Root

The Maca root is a plant that looks like a radish. It has been used in South America for many years. When combined with food, Maca root was thought to impart aphrodisiac qualities and improve sexual functioning. It can also be used to reduce the incidence and severity of menopausal problems.

While the Maca root does not contain any plant estrogen, it does contain something called adaptogen, which helps to balance the body’s hormonal system. It also has high levels of the B vitamins along with magnesium, zinc and iron. Maca root can be taken in supplement form with a recommended daily dose of about 900 mg. It should be taken three times a day with meals. It can also be boiled and steeped to make a tea.

Red Clover

Red clover contains high amounts of phytoestrogens, or plant hormones that copy the hormones in a woman’s body. These phytoestrogens work to raise the levels of estrogen in your body and help to reduce menopausal symptoms. Red clover also has high levels of vitamins like Vitamin C and minerals like potassium and magnesium. It also contains high levels of calcium which is beneficial in slowing down the progression of bone loss due to menopause. Take red clover in supplement form to relieve menopause symptoms, the recommended dosage is about 400 mg to 500 mg.

Nutritional Benefits

Soy is a legume that contains 38 percent protein, so it is considered a low-fat, high-protein food. According to healthcastle.com, soy is a rich source of phosphorus, zinc, iron, calcium, magnesium, fiber and B-vitamins. Soy foods contain substances known as phytoestrogens, which mimic your body’s estrogen activity. Phytoestrogens are a class of phytonutrients that help our bodies cope more effectively with decreasing levels of estrogen, which is a symptom of menopause, acording to menopause-black-cohosh.org. Isoflavones are a type of phytoestrogen that are known for their healing power for menopausal women. Soy is also high in Omega-3 fatty acids and antioxidants.

Menopausal Benefits

1. Heart Health

Drink soy milk to protect your heart. According to Creighton University School of Medicine, in 1999 the FDA approved the claims linking soy and good heart health. Soy products can lower harmful cholesterol levels. Consuming 25g of soy daily will result in heart-healty benefits. Having a positive mindset, consuming a heart-healthy diet and getting the proper exercise will help menopausal women live a healthy lifestyle, according to the American Heart Association.

2. Bone Health

Drinking soy milk can help improve your bone density, resulting in a stronger skeletal system. The isoflavones found in soy are beneficial to your bone health and have been shown to decrease the risk of osteoporosis. You will experience less bone loss. Menopausal women can lose up to 20 percent of their bone density, so getting more soy in your diet can make a difference.

3. Weight loss

Drinking soy milk for menopause can help you lose weight. Soy is a low-carbohydrate, low-glycemic food. It helps regulate your insulin and blood sugar levels while giving you a sense of fullness with fewer hunger cravings. Eating, or drinking, soy makes it easier to keep a healthy weight level.

4. Nail and hair health

Drinking soy milk for menopause can also help improve your nail and hair health. You may experience reduced vaginal dryness, lower your chances of developing certain forms of cancer and improve your blood pressure. Your hot flashes can be reduced by up to 45 percent, according to Creighton University.

1.      Eliminate meat, dairy products and sugar from your diet as these foods cause hot flashes. Also, avoid all caffeinated foods and beverages.

2.      Eat brown rice for the first 10 days, after that jasmine rice can be added to your diet. No other white food; bread, potatoes, sugar, and forget about chips!

3.      Add vegetables, fruits, soy, and tofu, whole grains, seaweed, and grass; barley and wheat to your diet. If you stick with this diet you will consume vegetable protein, low fat, moderate soy compounds, which have plentiful photo estrogen’ s which mimic female hormones.

4. Drink hot Green tea with all of your meals, because hot breaks down fat content. Always drink eight glasses of water each day. Do not drink alcoholic beverages or soda. Make your own juices, they have natural sugar and are rich in antioxidants.

Traditional Treatments for Menopause

Traditional treatments include hormone replacement therapy-HRT. Menopause is a result of natural depletion of estrogen and progesterone. HRT attempts to level out hormone levels and alleviate some of the symptoms that accompany menopause. Treatment can be estrogen alone, progesterone alone, or a combination of estrogen and progesterone. The preferred treatment is a combination of the two.

Other traditional pharmaceutical treatments include anti-inflammatories to deal with musculoskeletal pain, headaches, and other pain not necessarily related to Menopause. Anti-depressants are used to even out your moods, relieve tension, and reduce stress. Over the counter pain medications may also be used and natural antidepressants may also be used although not all at once.

Holistic treatments are those that consider the mental, physical, spiritual, and emotional parts of a person. They treat the whole person and can include exercise, meditation, and spirituality. Yoga is also very beneficial to relieving menopause symptoms. Holistic treatments can also include natural treatments such as herbal treatments for Menopause.

Herbal Treatments for Menopause

Herbal treatments can include herbs by themselves or a combination of herbs, vitamins, and minerals in tablet or capsule form to provide relief from menopausal symptoms and benefit your over-all health.

Some of the most common herbs used for menopause include Black Cohosh that is believed to contain photo-(plant) estrogens that work similarly to human estrogen. Maca root first increases the levels of estrogen and progesterone. It then balances out the levels of each hormone to a healthy level. Red clover is similar to black cohosh in that it helps to ease hot flashes and mood swings. Dong Quai can be taken in capsule form alone or in a supplement. Dong Quai can also be brewed as tea and taken that way and its effectiveness is enhanced with adding black cohosh.

Herbal supplements or supplements in general are not standardized by the FDA- Food and Drug Administration. In some cases supplements do not have the ingredients they say they do or have things like fillers or preservatives that are not mentioned. You can prevent this if you have good information on herbal supplements for menopause. There is an abundance of information available on the Internet.

In order to be as sure as possible that you are getting the highest quality supplement the ingredients’ metabolism at the molecular level is evaluated as are the interactions of the ingredients’. Only standardized herbal extracts are used with nothing artificial and no preservatives. This helps to ensure that you will get consistent dosing and consistent quality from capsule to capsule. When they are manufactured, they should be made to meet pharmaceutical grade standards. This helps to ensure their safety, effectiveness, and quality. Some herbs can interfere with other medications you may be taking for other conditions; therefore it is advisable to make sure your doctor knows what you are taking.

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This normally occurs when a woman is around 50. What are symptoms of menopause? Below are five categories of menopause symptoms.

1. Changes in blood vessel dilation and constriction.

This blood vessel activity causes hot “flashes” and sleep irregularities. Hot flashes are not related to the internal temperature of the body but rather to the temperature of the skin. There are various theories about why, during menopause, women’s skin temperatures may rise periodically as much as 7 degrees. One of the most intriguing theories is that women who experience hot flashes have a very narrow comfort zone – that zone where they are neither sweating nor chilled. Estrogen seems to widen that zone; conversely lower estrogen narrows the zone. (Studies conducted by Dr. Robert R. Freedman and colleagues, Wayne State Univ., Detroit). Hot flashes contribute to sleep irregularities.

2. Urinary or genital tract changes

Women may experience thinning, drying, itching and bleeding in the vaginal area sometimes associated with pain on intercourse. Another issue may be urinary frequency, urgency or incontinence.

3. Bone changes

Changes in the bones may result in osteopenia (pre-osteoporosis), osteoporosis, joint and muscle pain or back pain.

4. Skin and soft tissue changes

Skin may thin as part of menopause or lose elasticity and breasts may become smaller. These changes are associated with the loss in estrogen that accompanies menopause.

5. Psychological or mood changes

Changes in mood may include irritability and depression or be accompanied by fatigue and memory loss.

I hope these articles help you know about menopause.

The average age of menopause is 51, but a woman is only said to have experienced “premature menopause” if it occurs before the age of 40. Premature menopause is usually caused by illness or injury to the ovaries, but premature menopause occurs naturally in about 1% of all women. On the other end of the scale, some women do not enter menopause until they are well into their fifties. There is no way to predict at what age menopause will occur in a specific woman.

The different phases of menopause are experienced by all women, but may not cause any symptoms. During pre-menopause a woman’s periods are regular. Symptoms such as worsening PMS, periods that are heavier or lighter than normal may be associated with “peri-menopause” or the time “around” menopause. Women in their late thirties may experience these symptoms, but may not enter menopause for another ten years. Symptoms such as this can also be caused by other more serious health conditions and sudden changes should be evaluated by a physician.

Menopause is simply a term that means the end of menstruation. When a woman has not had a period for 12 consecutive months, then she can no longer become pregnant. She is post-menopausal. Women may experience the signs and symptoms of menopause for several years before menopause and for several years following menopause. The most common symptoms for which women seek treatment are hot flashes, night sweats and vaginal dryness.

About 50% of all women have hot flashes and/or night sweats during the phases of menopause. About 10% have them in their pre-menopausal years and the percentage gradual increases as menopause approaches. Researchers refer to these symptoms as “vasomotor symptoms”, because circulation and blood vessel dilation are involved. The exact cause of hot flashes and night sweats are unknown. It is known that women who are surgically menopausal, due to removal of the ovaries, typically have more severe vasomotor symptoms. Men who must take drugs to suppress hormone production also experience hot flashes. All of this seems to indicate that decreased hormone production causes hot flashes. But all women experience a gradual decrease in hormone production, but all do not have hot flashes.

Treating hot flashes and night sweats is nearly as confusing as investigating the cause. Other signs and symptoms of menopause, such as vaginal dryness, are more straightforward. There are clear answers as to their causes and remedies. Vasomotor symptoms, on the other hand, may respond to practically anything or next to nothing. Trial after trial has shown that placebo (an inactive substance) relieves hot flash symptoms by about 20%. Thus, finding an effective remedy means finding something that is more effective than placebo.

Researchers, doctors and experts debate about the effectiveness of different treatment plans. Clinical research yields confusing and sometimes contradictory results. The only long-term studies have focused entirely on hormone replacement therapy. The currently accepted philosophy is that while HRT is effective for relieving the unwanted signs and symptoms of menopause, the health risks should be taken into consideration. These include blood clots, breast cancer, uterine cancer, heart disease and stroke. The health risks increase with long-term use. Minimum dosage for the shortest duration possible is considered acceptable in most cases

Such symptoms are irregular menstrual periods, hot flashes, insomnia, nervousness, decreased sexual desire, or night sweats may signal the approach of perimenopause or menopause, but they can also manifest a number of other disorders and conditions. For accurate results, menopause test employs a hormonal analysis.

The menopause test measures the presence of a hormone known as follicle stimulating hormone (FSH). This hormone is produced by woman’s pituitary gland. Follicle stimulating hormone levels increase temporarily each month to stimulate ovaries to produce eggs. When a woman enters menopause and ovaries stop working, her follicle stimulating hormone levels increase.

Applying urine to the wick of a menopause test kit activates menopause tests. If a woman’s hormonal level is higher than normal, it may signal that she is approaching menopause. However, this test will not show not if a woman definitely is in menopause or even in perimenopause.

Menopause tests may be influenced by oral or patch contraceptives, hormone replacement therapy, or estrogen supplements that a woman has been taking before the test.

There are a number of traditional menopause tests that should be done in doctor’s office. Typically these tests require a sample of blood that is sent to an outside lab for examination. Results are normally available three to five days later.

If the menopause test results show that the hormonal levels are increased above the norm, it is standard medical protocol to perform a second menopause test.

Today, menopause symptoms can be relieved using traditional or herbal therapy methods. If you are concerned about the symptoms of menopause talk to your doctor about a menopause test.

Menopause and Climacteric

Definition. Menopause refers to final cessation of menstruation while climacteric means the period at which the woman gradually changes from the reproductive life into one of senescence. Meno¬pause is also referred by the laity as ‘the change of life’. However both the terms are often synonymously used, menopause being the popular term used. These are physiological processes due to cessa¬tion of ovarian follicular function.
Aetiology. Menopause occurs as result of exhaustion of eggs from ovarian follicles and Consequent oestrogen deprivation.

Physiological Changes in Climacteric or Menopause and Post menopausal age.

Genital. Progressive atrophy of genital organs occurs with more and more deposition of fibrous tissue in them.

Ovary. They go small (5 gm. each), fibrotic with furrowed surface, Follicles get exhausted. Ovarian Vessels become sclerosed. Cortical stromal hyperplasia is a frequent finding due to high LH level in women aged 40¬46 years. Ovarian stroma becomes a source of small amount of androgens.
Fallopian tubes shrink with diminished mortility.

Uterus becomes small and fibrotic due to atrophy of muscle. Endometrium becomes thin and atrophic (senile). In some women, endometrial. hyperplasia may occur after menopause as a result of constant oestrone stimulation. Cervix atrophies and flushes with the vaginal vault. Cervical secretion becomes scant, thick and later 4isappears. The vaginal epithelium atrophies with loss of rugosity. Vaginal smear shows atrophic changes. Vagina contracts with shallowness of the fornices. Vulva gradually atrophies with narrowing of the introitus : pelvic cellular tissue becomes gradually lax.

Secondary sex characteristics. Breasts show gradual atrophy of the glandular tissue resulting in flabbynes. These become pendulous due to deposition of fat around. Pubic and axillary hair becomes sparse.

Physical. Body weight decreases after 65 years. There is decrease in cell mass of organs. Skin wrinkles, becomes less elastic with hair appearing on face. Subcutaneous fat deposition. occurs on the hip and thighs. Height diminishes postraenopausally after 65 years. Kyphosis may develop due to spinal osteoporosis.

Metabolic. Osteoporosis occurs as a result of oestrogen deprivation. Reduction in trabecular bone (collagen matrix) (Osteoblasts) and Calcium leads to oestrogen deprived Osteoporosis. Premenopausally woman is protected against ischaernic heart disease due to high HDL and low LDL cholesterol. The latter rises postmenopause, thus incidence of ischaernic heart disease also rises. Premature menopause natural or by oophorectomy suffers from increased risk of cardiovascular diseases (cardiac and cerebral stroke) and osteoporosis.

Digestive. Hypochlorhydria develops. Motor activity of entire alimentary tract diminishes resulting in dyspepsia and constipation in postmenopausal women. Bladder and urethral epithelia atrophy.
Psychosexual. Emotional upsets are common. At menopause sex urge may increase. After 60 years, sex urge wanes as an aging process.

Endocrinal. There is gonadal failure at menopause. Plasma Oestradiol level falls, oestrone remains normal, ovarian stroma however, produces andostenedione. Extraglandular conversion of androstenedione to oestrone occurs in fatty tissue. Postmenopausally, adrenal cortex becomes the source of oestrone derived from androstenedione. Oestrone becomes the predominating oestrogen after menopause. Postmenopausal daily oestrone formation has been estimated as 15 100 gg/day (Mac Donald et al, 1973) and serum level at 30 70 pg/ml. Progesterone secretion ceases from the ovary due to failure of ovulation. Total urinary oestrogen level falls to about 6 Pg1 24 hours at the postmenopausal period. Androstenedione level mostly from adrenal cortex, little . from ovary comes to one half that seen prior to menopause. Testosterone level does not appreciably fall because postmenopause ovary secretes more testosterone.

Pituitary gonadotrophins. FHS and LH are secreted in increasing amount due to the absence of negative feed back control by the ovarian steroids. LH ovulatory surge disappears, the mean basal serum menopausal gonadotrophin levels are in the range of 50 150 rn LU/ml FSH and 50 100 m IU/ml LH. FSH level is 15 times higher than premenopausal level by 3 5 years after menopause while LH level is increased 3 fold. Prolactin level falls.

Timing. The process of climacteric may gradually start 2 3 years before menopause but may continue 2 5 years after it. The age at which menopause occurs varies widely from 40 to 55 years with mean age of about 47 years. Genetic makeup, race and climate influence age of menopause. Women of tropics get earlier menopause than those in colder climate. Some believe that the early the menarche starts, the later would be the menopause while late coming of the menarche is associated with early menopause. Early or delayed menopause is considered when menopause happens before 35 years or after 55 years respectively. Early menopause may be due to ovarian failure, oophorectomy or ovarian irradiation.

Delayed menopause is usually due to some pelvic pathology like uterine fibroid or in association with disease e.g., diabetes mellitus.

Clinical Features of Menopause and climacteric

Menstrual Symptoms. This occurs in forms of (a) progressive scanty menstrual loss followed by cessation of menses, (b) menses at prolonged intervals finally ceasing, (c) sudden cessation of menses. Prior to menopause menstrual cycles become anovulatory. Any excessive menstrual loss or irregular haemorrhage is not menopausal as in commonly believed by lay public but is due to some pelvic pathology.

Other symptoms. Most women remain asymptomatic. They adapt nicely the physiological changes of menopause. Some may have mild symptoms of putting on weight, joint pains, increase of sex desire followed by its gradual decrease.

Signs. The following signs appear gradually in a normal woman in the menopausal period and thereafter.

1. General signs. Increase in weight, deposition of fat on the hip, buttocks, around breasts. Breasts are examined.

2. Genital signs.
Vulva. Progressive atrophy with scanty hair with narrowing of the vaginal introitus.
Vagina. This becomes narrow with ‘tenting’ of vaginal vault,, thinning of mucous membrane and 18ss of rugae.

Cervix. Portio vaginalis atrophies and gets flushed with vaginal vault.
Uterus. Body is felt small and hard.

Adnexae. Ovaries become impalpable.

Diagnosis. This can be made from clinical features aided by atrophic vaginal smear and elevated serum FSH level of 50 mIU/ml and above. Elevated plasma LH level is less helpful. Urinary or serum oestrogen level shows value similar to follicular phase and thus less reliable for diagnosis.
Differential Diagnosis. Stoppage of menses due to menopause may be simulated by that due to pseudocyesis or pregnancy.

Treatment. Psychotherapy. Explanations for the condition and reassurances are to be given to the woman passing through climacteric when seeking advice for cessation of menses. Improvement of health by dietetic adjustment, adequate rest and exercise and regular evacuation of bowel are to be ensured. For sleep disturbance, diazepam (Valium) 5 mg. or Lorazepam 1 or 2 mg. is taken orally at bed time.

Menopausal or Climacteric Syndrome

Menopausal Syndrome refers to group of symptoms that are experienced by some women during climacteric. Hot flushes (vasomotor instability symptom) that last for one year in 80% are characteristic of menopausal syndrome. It diminishes of its own by 3 4 years. The cause of hot flush is unclear but follows oestrogen withdrawal in women with poor vascular control. Rise of hypothalamic endorphin is implicated. It is experienced by, 25% women with psychological background, particularly following oophorectomy or ovarian irradiation at younger age.
Flush depends on rate of oestrogen loss and extragonadal oestrone formation. The body gradually adjusts itself to natural decline of oestrogen and flushes gradually pass off.
Symptoms. These appear as follows: vasomotor and other symptoms usually follow but even precede cessation of menses.

1. Menstrual. Menses stop as already described under menopause. A proportion of premenopausal women come with emotional symptoms, loss of libido and dry vagina during intercourse, Hot flushes and sweats are complained with scanty and delayed menses by some women.

2. Vasomotor. ‘Hot flushes’ (feeling of warmth) due to cutaneous vasodilatation are commonly experienced by these, women on the face and neck spreading all over the body; this feeling of heat may be followed by sweating. They may come once a day but sometimes every hour; they come particularly at night. These are characteristic manifestations of menopausal syndrome.

3. Emotional. This is manifested by headache, irritability, sleeplessness, giddiness, fatigue, depression, palpitation. There may be sensations of ‘pins and needles’ in the sole and palm. Disturbed sleep can be due to hot flushes and sweats.

4. Sexual. These are decreased libido and dyspareunia due to atrophic vaginitis and lack of vaginal lubrication during intercourse.

5. Musculoskeletal. These appear as backache, pain in joints due to laxity of ligaments and muscles.

Signs. These are same as described under menopause.
Diagnosis. This has been already described under menopause.
Differential Diagnosis. Pseudocyesis of spurious pregnancy may be mistaken by the patient for menopausal syndrome. In the former, amenorrhoea, enlargement of breasts and abdomen due to deposition of fat like that in pregnancy occur; there is also the false feeling of foetal movements due to flatulent dyspepsia. The patient should be assured that her symptoms are menopausal. In all these cases, pregnancy may also occur and should be carefully excluded by thorough examination, immunological urinary pregnancy test and pelvic ultrasound.
Premature Menopause

Definition. Menopause coming on a patient below 35 years is called premature menopause. Cause. Poor stock of ovarian follicles gets exhausted. Clinical Features, Symptoms, Secondary amenorrhoea for more than 6 months. In some hot flushes, mood instability, disturbed sleep, loss of libido, (menopausal syndrome). draying of hair. Signs. Atrophic vaginal epithelism, normal or small sized uterus. Investigations. Raised serum FSH above 50 mIU/ml.; ovarian biopsy showing no ovarian follicles is not done. Treatment Assurance, diazepam for poor sleep. Oestrogen therapy for menopausal syndrome are given. Menstruation can not be brought on hormone therapy.
Male Climacteric. About 10 per cent men experience climacteric symptoms at a later age than women due to androgen deprivation. The rest 90 per cent gradually adapt themselves without symptoms.