Natural Medicine Q&A
Ask Dr. P
by Kasra Pournadeali, ND
Natural Medicine Specialist

Hot flashes, sweats, weight gain, irregular menses, headaches, insomnia, anxiety, depression, nervousness, dry thinning skin, urinary incontinence, fatigue, food cravings, and maybe, the feeling that your body is out of control are common symptoms of the climacteric phase, more commonly known as menopause. Menopause is not a disease, but a normal process when a woman stops ovulating, and her production of ovarian hormones decline. I know, I know, "It doesn't feel very normal," as menopausal symptoms, for many women, can be incapacitating. For those of you suffering have hope, as there are many effective natural treatments for symptoms of menopause. And, although it was previously believed that hormone replacement therapy (HRT) was appropriate for all menopausal women, this is no longer the case. HRT is only for select women, and even then, natural hormones (explained below) are best. Of course, always see your naturopathic doctor or primary care provider to determine the cause of your symptoms prior to using any over-the-counter drugs or herbal medicines.

Q: Dr. P, What causes the hot flashes and sweats of menopause?

Falling hormone levels in the body cause stimulation of the vasoregulatory centers in the hypothalamus of the brain. This results in vasodilation (or relaxation) of the vessels in the body which leads to pooling of blood in those vessels and the "hot flash." Sweats typically accompany vasodilation in the body to help regulate (reduce) the body temperature.

Q: Dr. P, Should I use estrogen?

This depends on many things, and must be discussed in considerable detail one-on-one. Examples of factors affecting this decision include: if you are at risk for or have osteoporosis-- (see last month's column for a summary of risk factors for osteoporosis, and how to test your osteoporosis risk); if you have a family or personal history of endometrial cancer, breast cancer, blood clots, or gall bladder disease; and, if you are at risk for osteoporosis, have you tried to improve your bone density through therapeutic nutrition, weight bearing exercise, lifestyle changes or natural medicines? If in fact, hormone replacement therapy is appropriate for you, I prescribe specially compounded plant-derived natural estrogen and progesterone instead of synthetics prescribed by most doctors. I use progesterone also because it has been shown in studies to build bone vs. estrogen, which only blocks bone loss.

Q: Dr. P, What is the difference between natural hormones, and the hormones most doctors prescribe?

The typically prescribed hormones are from animal origin, and have an altered chemical structure unlike what is normally found in the body. This was not to provide a better therapeutic effect, but to assure that the drug could be patented. A patent on a drug provides a better financial return to a drug company because other manufacturers cannot legally duplicate it. Let's compare natural vs. synthetic estrogen for example: In the body there are actually three types of estrogen: estriol, estradiol, and estrone. Estriol is the predominant estrogen in the body (about 80%), and it has anti-proliferative effects, where estradiol (about 10%) has proliferative effects or makes cells multiply. Estriol is thought to have cancer-preventive effects, while estradiol is cancer promoting. The estrogen prescribed by most physicians and dispensed by most pharmacies is predominately estradiol & estrone, but low in estriol (opposite of what is naturally found in the body.) The synthetic estrogen also contains a completely foreign horse estrogen called equillin. It makes better sense to prescribe natural hormones (without foreign estrogens, in ratios duplicating what's found in the body, and higher in estriol which may be cancer preventive vs. estradiol, which is cancer causing). Restoring the natural ratio of the three estrogens, and eliminating foreign estrogens are reasons why women who don't tolerate synthetic hormones do well on natural hormones. Natural progesterone has a similar story compared to synthetic "progestins". Understand that natural hormones are produced by special compounding pharmacists, are available only by prescription, and that most conventional doctors are unfamiliar with them.

Q: Dr. P, If I don't need natural hormone therapy, but want relief from my hot flashes, and don't want to take antidepressants what do I do?

Many doctors prescribe antidepressants or sleep aids to treat menopausal symptoms, as they are unaware of the natural therapies, which are effective. For example, Vitamin E, Soy protein, Hesperidin, and vitamin C, have all been shown in studies to alleviate symptoms of menopause. Likewise plant medicines like Angelica, Glycyrrhiza, Vitex, Cimicifuga, and Trifolium reduce symptoms through hormone-like activity in the body. Always see your naturopathic doctor for recommendations and dosage specific to your needs.

For more information or to schedule an appointment, please contact the Northwest Center for Optimal Health at (360) 651-9355.