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Menopause’s Mysteries. L. Z. Killinger, DC. Recommended Reading. The Wisdom of menopause: Creating Physical and Emotional Health During Change- Christine Northrup The Seven Sacred Rites of Menopause- Kristi Meisenbach Boylan ($9.50 Amazon.com). Why is this important?.

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menopause s mysteries

Menopause’s Mysteries

L. Z. Killinger, DC

recommended reading
Recommended Reading
  • The Wisdom of menopause: Creating Physical and Emotional Health During Change- Christine Northrup
  • The Seven Sacred Rites of Menopause- Kristi Meisenbach Boylan ($9.50 Amazon.com)
why is this important

Why is this important?

Over 1 in 3 US women are over 50 years old!

That means this is a hot topic for your patients!

what patients may experience
What Patients May Experience
  • Missed periods (pre-menopause)
  • Chills/Hot flashes or sweats
  • Flushes
  • Dizziness
  • Wooziness
  • Palpitations
  • Sleep disturbances
  • Sexual symptoms
  • Mood swings, anxiety, panic attacks, overreacting!
  • Maybe: Depression, memory loss, skin wrinkling, fatigue, thinning of hair, stiffness in joints and muscles
when does it occur
When Does It Occur?
  • Average Age: 50-51 Years old
  • Usual medical treatment: Hormones ERT/HRT (WARNING!)
  • Assessment:
    • Blood test: Follicle Stim. Hormone (FSH)
    • Menopause Defined: No menstruation for 12 months = The definitive diagnosis
can we predict menopause
Can we predict menopause?
  • Missed periods: Most reliable predictor
  • Missed a period: 65% will have menopause within 2 years; 100% within 4 years
  • Other predictors like hot flashes, not nearly as reliable. Source: Taylor, et al. Menopause. J N Amer. Menopause Soc. 11: 40-45.
perimenopause
Perimenopause
  • Age 44-51: ( The 8 yrs before menopause
  • Estrogen declines more rapidly (Adjust w/care!)
  • Decline in childbearing potential (Careful!)
  • First, menses comes more often (YIKES!)
  • Then, menses becomes irregular
  • Bleeding may become heavier
  • Hot flashes-usually 1-4 years before menopause (worse at night)
  • Insomnia, irritability, forgetfulness, sexual symptoms
post menopausal health risks
Post-Menopausal Health Risks
  • Increased risk of:
    • Heart disease
    • Osteoporosis
    • Uterine cancer
    • Breast cancer
    • Ovarian cancer
    • Depression
    • Colon cancer, etc, etc.
what can we do
What can we do?
  • Bone Density Loss: Counsel pts. about physical activity, diet, and supplementation, and lifestyle choices
  • Heart Disease Risk Increases: Counsel pts on physical activity, Mediterranean diet, supplements, etc.
  • Depression/Anxiety: Counsel pt about physical activity, socialization, volunteering, etc.
what can we do10
What can we do ?
  • Uterine cancer-Low fat diet, control weight and diabetes, regular pelvic exams.
  • Colon cancer-Fiber 30 g/day, regular screenings, calcium supplements
  • Breast cancer-physical activity, weight loss, low fat diet, lower alcohol intake, no smoking! Regular exams/self-exam!
trends breast cancer survival rates
Trends:Breast Cancer Survival Rates
  • 1974-79: 10 % survived 5 yrs
  • 1980-84: 14%
  • 1985-89: 22%
  • 1990-94: 29%
  • 1995-2000: 44%
why are survival rates up
Why are survival rates up?
  • EARLY DETECTION!!
  • Mammography
  • Treatment (chemo.) in earlier stages Source: Giordano SH. Cancer. Jan 04; 100:44-52
why not take hrt
Why not take HRT?
  • The Women’s Health Initiative study (large study on HRT for postmenopausal women) cancelled the arm of the study in which women were taking HRT (Estrogen/Progesterone combined)
  • After 5 years women taking HRT had increases in several diseases.
  • The risks of HRT were shown to outweigh the potential benefits (Slightly decreased incidences of colon cancer and hip fractures)
increased risks of hrt when taken for 5 years
Increased Risks of HRT (When taken for > 5 years)
  • Heart Attack: 3.7/1000 women instead of 3
  • Stroke:2.9/1000 women instead of 2.1
  • Blood Clots in Legs or Lungs: 3.4/1000 instead of 2.6
  • Breast Cancer: 3.8/1000 instead of 3
  • But, decreased risk of osteoporosis and perhaps colorectal cancer
  • JAMA 2002;288:872-881.
herbs and menopause
Herbs and Menopause
  • For thousands of years eastern healers have observed that some herbs have a positive impact on female troubles, including menopause
  • Although used for centuries with success, such products are now being scrutinized using the scientific method (Experimental studies, placebo studies, controlled clinical trials)
herbs for menopause
Herbs for Menopause
  • Soy products (isoflavones)
  • Black cohosh
  • Wild yam
  • Clover
  • Ginseng
  • Licorice
  • Dong quai
  • AND…Vit B6, B9, etc.
which herbs for what
Which Herbs/For What?
  • Herbs For Bone Loss:
  • Wild Yam: natural progesterone source
  • Chaste Berry-LH/Progesterone stimulant
  • Red Clover: All 4 isoflavones
    • Daidzen, Genistein, Formononetin, Biochanin
    • Source: Nestel et al. J Clin Endocrinol Metab. 1999; 84(3):895-8.
more herbs
More Herbs
  • Black Cohosh: <Remifemin> Used for relief of general menopausal symptoms, nervousness, anxiety, hot flashes, vaginal dryness
  • Resources: Whiting, Clouston, Kerlin. M J Australia 2002;177(8):440-443.
  • Leiberman: J Women’s Health 1998;7(5):525-529.
more herbs19
More Herbs
  • Passion flower: Sedative and anti-spasmodic, for female anxiety, restlessness, insomnia, and night sweats of menopause
  • Alfalfa: Hot flashes, insomnia, night sweats, dizziness, etc.
  • Soy isoflavinoids (eat more soy!)
tending and befriending how women handle stress
“Tending and Befriending”: How Women Handle Stress
  • Recent study showed that men and women respond to stress differently (Duh!)
  • Men either behave aggressively, or seek solitude
  • Women ‘tend and befriend’: Clean, organize, call friends, call on female friends
  • Women that have close female friends live healthier, longer after traumatic injury/event, etc.
so what does this mean to us
So, what does this mean to us?
  • Encourage women, who are stressed over menopausal changes to do what comes natural: ‘tend and befriend’
  • Avoid caffeine: Increases insomnia, night sweats, breast cysts, bone loss, etc.
  • Avoid alcohol-Increases breast cancer risk, depression, bone loss, etc
  • Volunteer, socialize, stay active, eat right, try natural remedies, talk to others
encourage a diet consciousness
Encourage a Diet “Consciousness”
  • Increase water consumption
  • Decrease fats in diet
  • Increase fruits/veggies in diet (for female cancer prevention in general)
  • Increase fiber in diet-protects colon health (helps w/ mood?)
  • Increase Calcium, Vitamin D, Soy
encourage physical activity so you thought we might get through a day without hearing this again eh
Encourage Physical Activity!(So, you thought we might get through a day without hearing this again, eh?)
  • Decreases stress
  • Increases muscle mass and bone density
  • Decreases pain
  • Improves mood/decreases depression
  • Decreases blood pressure and heart disease risk
  • Improves overall health status, balance, self -image, sex drive, etc!!!
  • (Stay tuned for more benefits!)
advantages of menopause
Advantages of Menopause
  • Freedom from birth control (finally!)
  • Sex with no fear of pregnancy
  • Protection from anemia (chronic problem with many menstruating women)
  • Feeling of independence for women
  • Hormonal “stability” after a lifetime of fluctuation
resources
Resources
  • Www.healthywomen.org (National Women’s Health Resource Center) (202-537-4015)
  • www.4women.org (National Women’s Health Information Center) 1-800994-WOMAN (9662)
  • 1-800 MENO-ASK National Menopause Foundation