Page updated: 10-12-2007
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Page updated: 10-12-2007 |
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Perimenopause - Symptoms & InformationLifestages and Perimenopause Dr. Horner explains perimenopause Perimenopause - Natural Medicine by Dr. Marci Scott Menopause Dr. Camilla Parham explains menopause Menopause symptoms and descriptions Alternative Treatments for perimenopause symptoms from peer reviewed research journals Estriol Cream may offer benefits for post-menopausal women without side effects Progesterone What are the benefits and side effects? Plastic endocrine disruptor Soy endocrine disruptor
MEDLINEplus Health Encyclopedia - Menopause A.D.A.M. / National Library of Medicine www.nlm.nih.gov Menopause Symptoms Mayo clinic www.mayoclinic.com Menopause Symptoms Emedicine.com www.emedicinehealth.com What are the symptoms of menopause and their treatments? Univ Maryland www.umm.edu Menopause Self-help Guide National Health Service, NHS Direct online United Kingdom www.nhsdirect.nhs.uk Menopause Symptoms Aetna InteliHealth / Harvard Medical School www.intelihealth.com Get Free Information about Herb, Vitamin and Drug Interactions!Health Notes is the leading provider of science-based information on healthy living. Gathered from scientific studies published in over 550 peer-reviewed medical and scientific journals. Visit Health Notes for drug interactions
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Perimenopause SymptomsBy th National Institutes of Health (NIH) Changes in periods. One of the first signs may be a change in a woman’s periods. Many women become less regular; some have a lighter flow than normal; others have a heavier flow and may bleed a lot for many days. Periods may come less than 3 weeks apart or last more than a week. There may be spotting between periods. Women who have had problems with heavy menstrual periods and cramps will find relief from these symptoms when menopause starts. Hot flashes. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Flashes can be as mild as a light blush or severe enough to wake you from a sound sleep (called night sweats). Most flashes last between 30 seconds and 5 minutes. Problems with the vagina and bladder. The genital area can get drier and thinner as estrogen levels change. This dryness may make sexual intercourse painful. Vaginal infections can become more common. Some women have more urinary tract infections. Other problems can make it hard to hold urine long enough to get to the bathroom. Some women find that urine leaks during exercise, sneezing, coughing, laughing, or running. Sex. Some women find that their feelings about sex change with menopause. Some have changes to the vagina, such as dryness, that makes sexual intercourse painful. Others feel freer and sexier after menopause — relieved that pregnancy is no longer a worry. Until you have had 1 full year without a period, you should still use birth control if you do not want to become pregnant. After menopause a woman can still get sexually transmitted diseases (STDs), such as HIV/AIDS or gonorrhea. If you are worried about STDs, make sure your partner uses a condom each time you have sex. Sleep problems. Some women find they have a hard time getting a good night’s sleep – they may not fall asleep easily or may wake too early. They may need to go to the bathroom in the middle of the night and then find they aren’t able to fall back to sleep. Hot flashes also may cause some women to wake up. Mood changes. There may be a relationship between changes in estrogen levels and a woman’s mood. Shifts in mood may also be caused by stress, family changes such as children leaving home, or feeling tired. Depression is NOT a symptom of menopause. Menopause TermsBy the National Institutes of Health (NIH)
Use your back button to navigate the menopause symptoms menu.
Menopause (natural menopause) The word “menopause” (“ménespausie”) was used for the first time in 1816 by Gardanne.26 Initially, the phenomenon of menopause was explained as a deficiency of ganglionic regulatory functions. In 1910, Marshall27 recognized that the ovary should be classified as an endocrine organ. From the endocrine perspective, the menopause represents a primary ovarian insufficiency and has an inception between the ages of 40 and 56 years, with a mean age of 51 years.28 From a scientific perspective, natural menopause coincides with the FMP, and this cannot be determined until there have been12 months of amenorrhea.9 This definition is based on clinical epidemiological evidence that the probability of resumption of menstruation after 12 months of amenorrhea is vanishingly small.29,30 Much confusion has been caused by differing definitions used in relationship to changing ovarian status. Definitions were provided by the World Health Organization (WHO) Scientific Group on Research on the Menopause in the 1990s.9 More recently, these definitions and others were considered by the Council of Affiliated Menopause Societies (CAMS) of the International Menopause Society (IMS). The only change recommended to the WHO definitions was the inclusion of the term “climacteric,” considered by many clinicians to be descriptive of this phase of life. The list of menopauserelated definitions given below was approved by the IMS in October 1999, in Yokohama, Japan.31
The term “natural menopause” is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Natural menopause is recognized to have occurred after 12 consecutive months of amenorrhoea, for which there is no other obvious pathological or physiological cause. Menopause occurs with the FMP, which is known with certainty only in retrospect a year or more after the event. An adequate biological marker for the event does not exist.
The term “perimenopause” should include the period immediately prior to the menopause (when the endocrinological, biological, and clinical features of approaching menopause commence) and the first year after menopause.
The term “menopausal transition” should be reserved for that period of time before the FMP when variability in the menstrual cycle is usually increased.
This phase in the aging of women marks the transition from the reproductive phase to the nonreproductive state. This phase incorporates the perimenopause by extending for a longer variable period before and after the perimenopause. Climacteric syndrome IMS The climacteric is sometimes, but not necessarily always, associated with symptomatology. When this occurs, it may be termed the “climacteric syndrome.”
The term “premenopause” is often used ambiguously to refer to the 1 or 2 years immediately before the menopause or to refer to the whole of the reproductive period prior to the menopause. The group recommended that the term be used consistently in the latter sense to encompass the entire reproductive period up to the FMP.
The term “postmenopause” is defined as dating from the FMP, regardless of whether the menopause was induced or spontaneous.
Ideally, premature menopause should be defined as menopause that occurs at an age more than two standard deviations below the mean estimated for the reference population. In practice, in the absence of reliable estimates of the distribution of age at natural menopause in populations in developing countries, the age of 40 years is frequently used as an arbitrary cutoff point, below which menopause is said to be premature. Induced menopause WHO The term “induced menopause” is defined as the cessation of menstruation, which follows either surgical removal of both ovaries (with or without hysterectomy) or iatrogenic ablation of ovarian function (e.g., by chemotherapy or radiation). Figure 2–5 shows the relationships between different time periods surrounding the menopause.
The process of the menopausal transition appears to take about a decade. The earliest signs of this transition are (1) shorter menstrual cycles by 2–3 days and (2) infertility. After birth, the number of oocytes continuously decreases. At puberty, 1 million oocytes are left.32 This number decreases to 0.3 million by the age of 20 years.32 Menopause is marked by the exhaustion of the ovarian supply of oocytes.33 Although only approximately 400 follicles or less than 0.01 percent of all oocytes proceed through ovulation between menarche and menopause,33,34 long-standing amenorrhea or the prolonged intake of a contraceptive pill does not seem to postpone menopause.13 Reduced fertility due to the aging process of the oocytes and to abnormal follicular maturation is the first sign of ovarian aging. After the age of 40, about 30–50 percent of all cycles show an abnormal basal temperature.35,36 Two to eight years before menopause, the incidence of luteal insufficiency and anovulatory cycles increases,37 resulting in a higher incidence of persisting follicles and dysfunctional bleeding. Shorter menstrual cycles appear to be detectable at about age 38–40.38,39 The subtle but common shortening of the intermenstrual interval is clinically valuable, as it seems to be predictive of other perimenopausal changes. On the other hand, as long as the active follicular phase permitting the maturation of healthy follicles remains stable and the luteal phase normal, fertility is maintained. Therefore, contraception is still needed during the menopause transition, despite moderately elevated FSH levels. An isolated elevated serum FSH level is not proof of the occurrence of menopause and is not sufficient to consider a perimenopausal woman infertile so that she could cease reliable contraception.43
Environmental influences may alter the ovarian aging process. Smoking advances the age of menopause by about 2 years.28 Recent studies suggest that high levels of galactose consumption may do the same. However, most of the determinants of menopause are innate. Familial and genetic factors appear to be the most predictive at present.44 One recent study described an ER• polymorphism that is associated with a 1.1 year advancement in the age at menopause and a nearly threefold RR of hysterectomy for benign disease.45 Ovarian surgery, adhesions, and pelvic endometriosis appear to be associated with poor ovarian stimulation for in vitro fertilization and perhaps are also risk factors for early age at menopause.46 Menstrual cyclicity is currently the best indicator of menopausal status. The large variability in intermenstrual intervals that occurs at this time of life probably reflects a combination of short cycles38 and skipped cycles. Treloar et al.37 reported a detailed analysis of intermenstrual intervals of women encompassing over 20,000 menstrual cycles. Variability of cycle length was enormous in both the perimenarcheal years and the years of menopausal transition. Cycle length shortening is probably due to elevated FSH levels in the early follicular phase/late luteal phase of the cycle. Subtle reproductive hormonal changes occur in the face of these minor cycle changes. FSH appears to rise throughout reproductive life, but the elevation becomes obvious in the late thirties/early forties in women.40 Although it is elevated for most of the menstrual cycle, early follicular phase FSH concentrations are most easily discriminated from “normal” concentrations on cycle days 2–5. An elevated FSH is a harbinger of menopause, although it may still be many years away, and has clearly been shown to augur poorly for future fertility.41 It is a poor predictor of age at menopause, however, and the clinician cannot make any conclusions on the timing of an individual woman’s menopause based upon the presence or degree of FSH elevation.42
Phytoestrogens are plant compounds that have a close similarity in structure to estrogens. Evidence for the effects of phytoestrogens on reducing menopausal symptoms, hot flushes, and vaginal dryness come from two main sources—observational studies and clinical trials. The first source is from epidemiological data of populations who have high dietary intakes of phytoestrogen compounds and who have a very low rate of hot flushes (for example, 5–10 percent of Japanese women report hot flushes compared with 70–80 percent of Western women).87 Japanese women are reported to consume 20–150 mg/day of isoflavones88 compared to Western women, where less than 5 mg/day is consumed.89 |
Perimenopause - Black CohoshBy Marcus Laux, NMDUse your back button to navigate the Perimenopause - Black Cohosh menu. What exactly happens in menopause? Can women at high risk for HRT use natural products? Until recently, when a woman entered menopause, her physician or healthcare practitioner would often recommend hormone replacement therapy (HRT). Not only because HRT eased the hot flashes, insomnia, and other distressing symptoms of menopause, but because the drugs were also believed to offer major, long-term protective health benefits, especially with cardiovascular disease (heart attacks and strokes) and osteoporosis.1-3 However, in July of 2002, researchers conducting a very large clinical study revealed the dramatic and quite unexpected results that HRT does not prevent heart attacks and strokes. It can cause them.4 And, not only are there concerns about cardiovascular disease, it can increase the risk of invasive breast cancer as well. Many of the 20 million women taking HRT, at the time of these research findings, heard this alarming news and began immediately to search for less harmful ways to manage their menopausal symptoms. They contacted their healthcare practitioners, logged onto the Internet, and called their mothers, sisters, daughters, and friends looking for solutions.5 What they found was that they did not have to choose between suffering hot flashes or risking heart disease; there are safe, effective, and 100 percent natural nutritional supplements that effectively stop the hot flashes, reduce the mood swings, and relieve the insomnia. What better way to treat the symptoms of menopause? After all, menopause is a natural process and a normal part of aging, not a disease in need of cure. What exactly happens in menopause?Menopause signals the end of a woman’s fertility. Her body slowly stops the production of the sex hormones estrogen and progesterone. Her periods become less frequent and more irregular, finally stopping about 3 to 5 years later. She may experience hot flashes, mood swings, joint pain, and vaginal dryness. Because estrogen is no longer there to protect her, she is also more prone to heart disease, osteoporosis, and other health problems.3,6,7 On average, menopause occurs at about age 50. But just like the beginning of menstruation in early adolescence, the timing of menopause varies greatly among women. It’s estimated that every day in North America, over 5,400 women enter menopause (menopause is termed complete after one year without a period). Because the United States’ overall population is getting older, by the year 2015 approximately half of all the women in this country will be menopausal. Women at age 54 can easily expect to live another 30 years. About two-thirds of the total US population will survive to age 85 or longer. This means that the average American woman will spend one third to one-half of her life after menopause.3 What are the common symptoms of menopause?Every woman’s menopausal experience is unique. Some women may have all of the symptoms of menopause; others may have just a few. The intensity of menopausal symptoms can also range from mild to quite severe.1,2 In early menopause, some women may experience mood swings, panic attacks, sleep disturbances, depression, anxiety, changes in tolerance to heat or cold, joint and muscle pain, allergies, and headaches. As production of estrogen decreases, additional menopause-related changes may include night sweats, fatigue, vaginal dryness, fluctuations in sexual desire or response, forgetfulness, hot flashes, and weight fluctuations.1-3 If menopause is a normal part of aging, why do physicians prescribe hormones?While menopause is not a disease, the symptoms associated with it can make a woman’s life miserable. By substituting the dwindling stores of natural estrogen with prescription synthetic or animal estrogen, the visible symptoms of menopause such as hot flashes, mood swings, and vaginal dryness can be lessened.3-5 When estrogen is given alone, however, there is an increased risk for development of cancer of the uterus. To reduce this risk, progestin (a synthetic form of progesterone) is usually added to the estrogen. This prescription drug regimen of estrogen and progestin for menopause is termed hormone replacement therapy or HRT.3-5 What did the large 2002 study show that changed the HRT recommendations?The Women’s Health Initiative (WHI) was a groundbreaking study designed to determine, once and for all, if hormone replacement therapy (HRT) could provide safe and effective treatment of the symptoms of menopause and prevention of chronic disease such as cardiovascular disease and osteoporosis. While an estimated 20 million women in America take HRT, no one really knew for sure what its long-term benefits or risks were. The results from past HRT research were conflicting. Some showed benefit, many others did not. Because the WHI study was going to last a long time (8 years), was so large (40 clinical sites across the country), involved so many women (16,608), and was so well designed, the researchers who led the study felt certain the results would clear up the confusion. They expected to confirm that HRT was a safe and effective treatment for menopause, and for the prevention of certain chronic diseases.1 However, as they collected the data, the researchers were dismayed to discover that the women in the HRT group were developing some serious problems. The women taking HRT had significantly more heart disease, strokes, blood clots in the legs, and invasive breast cancer than the placebo group. In July 2002, the researchers, recognizing that HRT was causing more health hazards than health benefits, abruptly stopped the study. All of the WHI participants were sent letters telling them to stop taking their pills immediately and to contact their clinical center for further guidance.1 The researchers also held a press conference announcing these alarming results to the public so that all women taking HRT pills, not just those in the study, would be alerted to these health hazards.2 What exact health problems did the HRT group have?The WHI results revealed that compared to the women taking the placebo pills, women in the HRT group had: • A 41 percent increase in strokes • A 29 percent increase in heart attacks • A doubling of rates of blood clots • A 22 percent increase in total heart disease • A 26 percent increase in breast cancer It’s easy to see why the researchers involved in the study were quite concerned. While the symptoms of menopause may make women miserable, the hazards of HRT are just too significant to warrant its use.1 Before this study, there were reports of side effects where certain women should not be on HRT. Is this true?Yes. Women with a history of breast cancer, current breast cancer, or at a higher-than-normal cancer risk are usually not candidates for HRT. And for other women, use of HRT must be avoided because of uterine bleeding, liver and gallbladder disease, pancreatitis, endometriosis, uterine fibroids, or fibrocystic breast disease. In addition, some women simply feel “out of sorts” while using HRT.3-5 Fortunately there are several safe and effective nutritional supplements available to treat menopausal symptoms without the HRT-associated risks. What natural supplements might be appropriate for a menopausal woman who does not want HRT?Black cohosh is a highly effective treatment for menopause.8 Modern clinical research has shown that black cohosh is as effective as HRT for relief of hot flashes, night sweats, and vaginal dryness, but without its complications.8-12 How does black cohosh work?Scientific research on the specific chemistry of black cohosh has established that this natural medicine suppresses secretion of a substance called luteinizing hormone (LH).8 One function of estrogen is to suppress the effects of LH. Menopause results in high levels of LH in the blood, which in turn causes lots of uncomfortable symptoms including, hot flashes, night sweats,headaches, heart palpitations, and vaginal dryness.3,6,7 While no one knows for sure how black cohosh exactly works to suppress LH activity, researchers believe that several chemical compounds may be involved in its beneficial activity.8 Clinical studies have shown without any uncertainty, however, the effectiveness of the herb in treating menopausal symptoms. In 1982, a German study collected data on 629 patients treated with black cohosh from 131 health care practitioners and gynecologists. The researchers found that after six to eight weeks of treatment, 80% of patients experienced beneficial effects.9 A 1987 double blind study compared estrogen replacement therapy with black cohosh for three months in 80 women. Thirty women were given estrogen, 30 were given black cohosh, and 20 received placebo. The authors concluded that the black cohosh preparation not only produced safe and effective results, but that compared to estrogen replacement therapy, it is suitable as the treatment of choice for menopausal women.10 Does black cohosh relieve the other symptoms of menopause?While black cohosh is very effective in treating some symptoms of menopause, other herbal supplements are needed to treat fatigue, irritability, anxiety, sleep disturbances, and mood changes. What other dietary supplements work for menopause?There are several herbs that address menopausal symptoms and concerns.8-25 Ginseng and green tea: These herbal supplements are very effective in treating two of the most aggravating menopausal symptoms: a lack of energy and the inability to concentrate.13-15 As women pass into middle age, they are generally freed from the demands of caring for young children and have more time on to spend on themselves. However, they often discover they just feel too tired and too distracted.3 What should be an exciting time in their lives is instead a period of fatigue and frustration. Ginseng is an ancient herb that has been used to combat fatigue and weakness. Ginseng also restores stamina and improves concentration. In a double blind, placebo controlled study with 384 symptomatic postmenopausal women, the use of ginseng extract for 16 weeks showed a significant improvement in mood and well being. Some mild ability to stop hot flashes was also attributed to the ginseng extract in this study.13 Many biologic activities have been attributed to green tea. One component is caffeine. Caffeine has been studied for its ability to increase stamina and decrease fatigue.15 Because moderation of caffeine is sometimes recommended during menopause,3 supplements should contain 50 mg of caffeine or less. Green tea is also a rich source of catechins and flavonols. These tea compounds inhibit the growth of breast and other cancers, important benefits to women of menopausal age.16,26 Valerian, theanine, and hops: Sleep disturbances are common during menopause. Poor sleep at night can lead to difficult, irritable days. Women may find they have even less ability to conimpressive. centrate after a poor night’s sleep.3,5,6 Use of prescribed sleep and sedative medications will eliminate these problems in menopausal women. However, these medications also have significant side effects, including dry mouth, daytime drowsiness, and depression. Tolerance and addiction to these drugs may also occur.27 Valerian is a remarkably effective herbal supplement that decreases the time it takes to fall asleep, improves the quality of sleep, and reduces the number of night awakenings, all without any associated daytime drowsiness. Several clinical trials have shown these impressive properties in valerian.20-24,28,29 While hops is best known as an ingredient in beer, it has also been used medicinally. Many years ago, workers who picked hops were noted to tire easily, apparently as a result of the accidental transfer of some hop resin from their hands to their mouths. Hops and valerian have been found to work synergistically and are often used together in sleep formulas.25 Theanine was discovered as an amino acid in green tea. Japanese people (the longest-lived people on earth) have known about the calming effect of theanine for centuries. Theanine readily crosses the blood-brain barrier and helps the brain relax. The effect is often compared to taking a hot bath or a relaxing massage. Theanine is different than other herbal calmatives, such as kava, because it doesn’t cause drowsiness. And unlike tranquilizing drugs, theanine doesn’t interfere with the ability to think. Studies have shown that theanine enhances the ability to learn and remember, increases concentration, and focuses thoughts.17,18 Can women for whom HRT is especially high risk use natural products?Yes, two clinical trials conducted in gynecological practices studied the use of black cohosh in women who had either refused HRT or were suffering from health conditions such that HRT was contraindicated. The results were conimpressive. The doctors noted clear improvement in their patients’ menopausal ailments within four weeks with black cohosh extract therapy. The women experienced an overall decrease in complaints such as hot flashes, as well as marked improvement in psychological symptoms including decreases in fatigue, depression, irritability, and increases in energy and mood. In other words, they improved not only physically but emotionally as well.31,32 What if a woman has a history of breast cancer or other type of cancer?Because of its assured safety, black cohosh can be used to relieve menopausal symptoms in all women, including those women with a history of breast, uterine, or ovarian cancer. Black cohosh is not, however, a treatment for cancer. What should consumers look for in a quality menopause formula?The black cohosh should be standardized to 2.5% triterpene glycosides. Women should look for a product from a reputable company with a focus on quality and scientific validation. For more troubling symptoms of menopause, look for a formula that combines herbs to alleviate a broader spectrum of symptoms like green tea and ginseng for daytime alertness and energy, and theanine, valerian and hops to ensure quality sleep and muscle relaxation. Menopause - ConclusionWhile menopause may very well be a normal part of aging, it can also be quite challenging. Fears that women might have to make a choice between hot flashes or heart disease, however, fortunately need not be part of this challenge. Black cohosh, ginseng, green tea, valerian, theanine, and hops can safely reduce the symptoms of menopause. Most importantly, these effective supplements provide women with an empowering ally in this natural transition to the second half of their lives. Perimenopause References1. The Woman’s Health Initiative Study Group. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002;288:321-333. 2. Wallis C. The truth about hormones. Time Magazine 2002;12:43-50. 3. Basic facts about menopause. The North American Menopause Society (NAMS). Available at: htttp://www.menopause.org 4. Young LY, Koda-Kimble MA, Eds. Menopause. In: Applied Therapeutics: The Clinical Use of Drugs. 6th ed. Vancouver, Wash: Applied Therapeutics, Inc; 1995:Chapter 46, 23-26. 5. Lehne RA. Hormone replacement therapy after menopause. In: Pharmacology for Nursing Care. 3rd ed. Philadelphia, Pa: W.B. Saunders; 1998: 629-630. 6. Mehring PM. Menopause. In: Porth CM. Pathophysiology: Concepts of Altered Health States. 5th ed. Philadelphia, Pa: Lippincott; 1998: 1183- 1184. 7. Guyton AC, Hall JE. Menopause. In: Textbook of Medical Physiology. Philadelphia, Pa: W.B. Saunders Company; 2001: 939-940. 8. Foster S. Black Cohosh: Cimicifuga racemosa. Austin, TX: American Botanical Council. 2000: 1-6. 9. Stolze H. An alternative to treating menopausal complaints. Gyne. 1982;3:14-16. 10. Stoll W. Phytopharmacon influences atrophic vaginal epithelium. Double-blind study: cimicifuga versus estrogenic substances. Therapeuticum. 1987;1:23-31. 11. Lieberman S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause. J Womens Health. 1998;7:527-528. 12. Duker EM, Kipanski L, Jarry H, et al. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med. 1991;57:420-424. 13. Wiklund IK, Mattsson LA, Lindgren R, Limoni C. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group. Int J Clin Pharmacol Res. 1999;19:89-99. 14. Tode T, Kikuchi Y, Hirata J, Kita T, Nakata H, Nagata I. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet. 1999;67:169-174. 15. Fleming T., ed. In: Green tea. In: PDR® for Herbal Medicines. Montvale, NJ: Medical Economics Company; 2000: 369-372. 16. Nakachi K, Suemasu K, Suga K, Takeo T, Higashi Y. Influence of drinking green tea on breast cancer malignancy among Japanese patients. Jpn J Cancer Res. 1998; 89;254-261. 17. Yokogoshi H, Mochizuki M, Saitoh K. Theanineinduced reduction of brain serotonin concentration in rats. Biosci Biotechnol Biochem. 1998;62:816-817. 18. Yokogoshi H, Kobayashi M, Mochizuki M, Terashima T. Effect of theanine, r-glutamylethylamide, on brain monoamines and striatal dopamine release in conscious rats. Neurochem Res. 1998;23:667-673. 19. Atelle AS, Xie JT, Yuan CS. Treatment of insomnia: an alternative approach. Altern Med Rev. 2000;5:249-259. 20. Leathwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav. 1982;17:65-71. 21. Leathwood PD, Chauffard F. Aqueous extract of valerian reduces latency to fall asleep in man. Planta Med. 1985;51:144-148. 22. Lindahl O, Lindwall L. Double blind study of a valerian preparation. Pharmacol Biochem Behav. 1989;32:1065-1066. 23. Balderer G, Borbely AA. Effect of valerian on human sleep. Psycho- Pharmacol. 1985;87:406-409. 24. Schulz H, Stolz C, Muller J. The effect of valerian extract on sleep polygraphy in poor sleepers: a pilot study. Pharmacopsychiatry. 1994;27:147-151. 25. Foster S, Tyler VE. The Honest Herbal. New York, NY: The Haworth Herbal Press;1999: 26. Valcic S, Timmerman BN, Alberts DS, et al. Inhibitory effect of six green tea catechins and caffeine on the growth of four selected human tumor cell lines. Anti-Cancer Drugs. 1996;7:461-486. 27. Benzodiazepines. In 2001 Lippincott’s Nursing Drug Guide. Philadelphia, Pa: Lippincott Williams & Wilkins;2001:29-31. 28. Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry. 2000;33:47-53. 29. Dominguez RA, Bravo-Valverde RL, Kaplowitz BR, Cott JM. Valerian as a hypnotic for Hispanic patients. Cultur Divers Ethni Minor Psychol. 2000;6:84-92. 30. Lehmann-Willenbrock E, Riedel HH. Clinical and endocrinological examinations concerning therapy of the climacteric symptoms following hysterectomy with remaining ovaries. Zentralbl Gynakol. 1988;110:611- 618. 31. Daiber W. Artzl Praxis. 1983;35:1946-1947. 32. Vorberg G. ZFA. 1984;60:626-629. |
Pycnogenol May Offer An Alternative Method To Reducing Menopause Symptoms Without Unwanted Side EffectsA randomised, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopausal women. By the Department of Obstetrics and Gynecology, Ham-Ming Hospital, Taiwan. Study appears in the Acta Obstetricia et Gynecologica Scandinavica; 2007;86(8):978-85 BACKGROUND: French maritime pine bark extract (Pycnogenol) was found to alleviate menstrual pain and reduce hyperactivity in clinical studies. These results suggest the possibility to observe positive effects in treating climacteric syndrome. OBJECTIVE: Clinical investigation of the effect of Pycnogenol, French maritime pine bark extract, on the climacteric syndrome. METHODS: Some 200 peri-menopausal women were enrolled in a double-blind, placebo-controlled study, and treated with Pycnogenol (200mg) daily. Climacteric symptoms were evaluated by the Women's Health Questionnaire (WHQ), patients were checked for antioxidative status and routine chemistry. A total of 155 women completed the study. RESULTS: All climacteric symptoms improved, antioxidative status increased and LDL/HDL ratio was favourably altered by Pycnogenol. No side effects were reported. CONCLUSION: Pycnogenol may offer an alternative method to reducing climacteric symptoms without unwanted effects. Estrogen-like effect of a Black Cohosh extractSeptember 2007, Department of Human Physiology and Pharmacology, University of Rome La Sapienza Black cohosh (Cimicifuga racemosa) is used in the treatment of painful menstruation and menopausal symptoms. Data about the nature of the active compounds and mechanism(s) of action are still controversial, chiefly with respect to its estrogenic activity. This work aimed to assess the possible estrogenic activity of a commercial dry hydro-alcoholic extract of Black Cohosh. Continue Herbal Supplement Black Cohosh Fails to Relieve Hot FlashesBy The National Institute of Aging - The herbal supplement black cohosh, whether used alone or with other botanical supplements, did not relieve hot flashes in postmenopausal women or those approaching menopause Continue Hormonal imbalances can cause or worsen the following:By The National Institute of Health • Acceleration of the aging process
Perimenopause ResourcesYou can find out more about perimenopause by contacting the National Women's Health Information Center at 800-994-WOMAN (9662) Alternative Therapies for Managing Menopausal Symptoms Use of Botanicals for Management of Menopausal Symptoms Menopause & Hormones Can menopuase change your sex life? Menopause - A pathfinder
Osteoporosis Menopause Risks National Osteoporosis Foundation North American Menopause Society The Hormone Foundation Perimenopause
See also: Menopause What is perimenopause?It is the time leading up to menopause (when you have not had your period for twelve months). During perimenopause, your body starts making less of certain hormones (estrogen and progesterone), and you begin to lose the ability to become pregnant. How long does perimenopause last?It varies. Women normally go through menopause between ages 45 and 55. Many women experience menopause around age 51. However, perimenopause can start as early as age 35. It can last just a few months or a few years. There is no way to tell in advance how long it will last OR how long it will take you to go through it. I've been depressed in the past. Will this affect when I start going through perimenopause?It could. Researchers are studying how depression in a woman's life affects the time she starts perimenopause. Some studies have found that women with a history of depression started perimenopause earlier than women without depression. Women who took antidepressants started perimenopause even earlier. If you start perimenopause early, researchers don't know if you reach menopause faster than other women or if you're just in perimenopause longer. What should I expect as I go through perimenopause?Some women have symptoms during this time that can be difficult. These symptoms include:
I don't understand why I get hot flashes. Could you tell me what's going on with my body?We don't know exactly what causes hot flashes. It could be a drop in estrogen or change in another hormone. This affects the part of your brain that regulates your body temperature. During a hot flash, you feel a sudden rush of heat move from your chest to your head. Your skin may turn red, and you may sweat. Hot flashes are sometimes brought on by things like hot weather, eating hot or spicy foods, or drinking alcohol or caffeine. Try to avoid these things if you find they trigger the hot flashes. I am feeling so emotional lately. Is this from the changes in my hormones?Your mood changes could be caused by a lot of factors. Some researchers believe that the decrease in estrogen triggers changes in your brain causing depression. Others think that if you're depressed, irritable, and anxious, it's influenced by other symptoms you're having, such as sleep problems, hot flashes, night sweats, and fatigue-not hormonal changes. Or, it could be a combination of hormone changes and symptoms. Other things that could cause depression and/or anxiety include:
What can I do to prevent or relieve symptoms of perimenopause?
I'm going through perimenopause right now. My period is very heavy, and I'm bleeding after sex. Is this normal?Irregular periods are common and normal during perimenopause, but not all changes in bleeding are from perimenopause or menopause. Other things can cause abnormal bleeding. Talk to your health care provider if:
Can I get pregnant while in perimenopause?Yes. If you're still having periods, you can get pregnant. Talk to your health care provider about your options for birth control. Keep in mind that methods of birth control, like birth control pills, shots, implants, or diaphragms will not protect you from STDs or HIV. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sexual contact. Be aware that condoms don't provide complete protection against STDs and HIV-the only sure protection is abstinence (not having sex of any kind). But appropriate and consistent use of latex condoms and other barrier methods can help protect you from STDs. For more information...You can find out more about perimenopause by contacting the National Women's Health Information Center at 800-994-WOMAN (9662) or contact the following organizations: Agency for Healthcare Research and Quality National Center for Complementary and Alternative Medicine Food and Drug Administration (FDA) National Cancer Institute National Institute on Aging American College of Obstetricians and Gynecologists Melpomene Institute National Osteoporosis Foundation North American Menopause Society The Hormone Foundation August 2003 Contact NWHIC
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