More women are using food and herbs to ease menopausal symptoms. But does the natural way work? Sylvia Thompson reports
Over the past 10 years, there has been a huge growth of interest in the use of nutritional therapy and herbal medicine for the alleviation of menopausal symptoms. During that time, the medical profession has become more cautious about prescribing hormone replacement therapy (HRT) due to findings that it increases the risk of both heart disease and breast cancer in some women.
Dr Marilyn Glenville, UK-based nutritional therapist and author of several books on natural approaches to the menopause, is adamant that the menopause is a natural stage in a woman's life and should be treated as such. She will give public lectures on female hormonal problems at the Your Health Show in the RDS, Ballsbridge, Dublin later this month.
"Since I wrote my book, Natural Approaches to the Menopause - since updated and re-published as The New Natural Alternatives to HRT, my conviction that our first choice should always be the natural approach - and that it will suit the majority of women - has been strengthened. HRT should remain the last resort," she says.
Glenville runs nutritional clinics in London and Kent, England. Much of the nutritional advice she gives menopausal women has become more mainstream healthy eating advice in the past decade. So, for instance, many people are now aware of the importance of complex carbohydrates (a major plank of the GI diet, they are the predominant nutrient in wholegrain foods), fewer saturated fats (particularly less red meat and full fat dairy products) and a moderate intake of tea, coffee and alcohol.
Some people have also become more aware of the importance of phytoestrogens (plant hormones which help regulate human hormones when eaten in sufficient quantities) and essential fatty acids (valued for their role in lubricating the joints, skin and the sex organs) since Glenville first began recommending soya, pulses, oily fish, nuts and seeds over 10 years ago.
However, she says that while such nutrients are beneficial to everyone's health, research has found that many women suffering from menopausal symptoms will find specific help from a diet rich in phytoestrogens and essential fatty acids.
"We know that women who eat a diet rich in phytoestrogens [ soya, lentils, chick peas, garlic] have significantly fewer hot flushes and also are protected against breast cancer," she says.
She suggests menopausal women include one portion of phytoestrogens every day by eating hummus or lentil soup, including kidney beans in a stirfry or using organic soya milk on their cereal.
Glenville says: "Many of the women I see complain of aching and stiff joints at the menopause and I usually recommend that they increase their intake of essential fatty acids by eating more nuts, seeds and oily fish." To these important nutrients, she adds the herb black cohosh which, she says, "research has found to be very effective in restoring female hormonal balance and relieving hot flushes".
On another point, she says, women in their 40s and 50s should be careful not to ascribe too many symptoms to the menopause. "Dry skin, lifeless hair, cracked nails, fatigue, depression, dry eyes, lack of motivation, aching joints and forgetfulness are all symptoms which could be blamed on the menopause but which are, in fact, warning that there is a deficiency in essential fatty acids," she says.
Similarly, she says that mood swings, irritability, anxiety, tiredness and a lack of energy can be due to blood sugar swings. "Too much tea or coffee and using chocolate to keep going can cause these symptoms. A good GI diet [in which complex carbohydrates are used to keep blood sugar levels balanced] would get rid of most of these symptoms so that women could see what really are menopausal symptoms," she explains.
Like many nutritional therapists, she advocates the use of food supplements alongside a healthy diet.
"A national food survey conducted in 1995 found that the average person in Britain was grossly deficient in six out of the eight vitamins and minerals surveyed. You need to eat a good variety of food to give yourself the best chance of getting all the nutrients you need. It's important to remember that supplements are the extras. You can't eat junk food topped up with nutritional supplements and hope to stay healthy," she cautions.
In her book, The New Natural Alternatives to HRT, she recommends women take a multivitamin and mineral supplement designed for the menopause. She also suggests capsules are preferable to tablets as they are more easily absorbed through the digestive system and contain fewer extra ingredients.
Dr Mary Short, a GP in Blackrock, Co Dublin with a special interest in female hormone problems, says: "A lot of women do look to alternative therapies for answers during the menopause. Whether they are well informed enough about what they try, I'm not sure. I think many of them are buying over-the-counter products in health stores.
"I believe there are misconceptions about HRT in that people now believe it causes breast cancer. It doesn't cause breast cancer, it increases a woman's risk of getting breast cancer - and heart disease. Ultimately, there is most evidence for phytoestrogens.
"I'd say to women who don't want to take HRT, try soya [a good source of phytoestrogens], review the situation and keep an open mind."