Reduce Hot Flashes

By Bonnie Jenkins, Advanced Natural Medicine

You’ve got to give credit to an industry that can take bad news and turn it into an opportunity. When HRT – which has already been linked to breast cancer, stroke and heart disease – was recently shown to increase the risk of developing dementia, many people said it was the final straw that would break the back of pharmaceutically-treated menopause. But if they thought the pharmaceutical industry was just going to quietly walk away from the lucrative menopause market, they should have known better. Within days of the new HRT-dementia link, Glaxo Smith Kline came out with its own study promoting the antidepressant Paxil as a way to cut the frequency hot flashes in half.

Paxil is a Selective Serotonin Re-Uptake Inhibitor, or SSRI. If you read “Prozac Nation,” you might remember that I told you how taking SSRIs can result in sexual side effects, heart irregularities, headaches and even hallucinations. So if you think that taking Paxil for your menopause symptoms is somehow safer than HRT, think again. You might simply be trading in one set of side effects for another.

It amazes me how the pharmaceutical industry continues to insist that menopause is a disease rather than a normal part of a woman’s life. The problem is that a lot of doctors – and women for that matter – buy into this mindset. But menopause isn’t something you can “cure,” despite what the doctors and drug companies tell you. And I hope that women won’t fall for this latest attempt to medically manage this natural life transition.

Chill Out Naturally

However, just because menopause is natural, that doesn’t mean it’s always pleasant. I don’t care how many optimists call a hot flash a “power surge” – when your entire body radiates heat from the inside out, when you begin to sweat and get dizzy and nauseous, when your heart pounds for no apparent reason, when a wave of panic washes over you, and when all of this happens several times a day, you’ll consider just about anything. If you’ve ever had a hot flash, you know exactly what I mean. Unfortunately so do the folks at GlaxoSmithKline and they’re counting on our vulnerability to sell more Paxil.

But there are a lot of other options – natural ones with far better safety profiles. The best known is soy, primarily because of the isoflavones genistein and daidzein. Isoflavones are plant sterols that act like weak estrogens similar to the estrogens your own body makes. Because of this, there have been hundreds of studies investigating soy’s ability to reduce menopausal symptoms. In one of these studies, women given a soy protein supplement with 76 mg. of isoflavones had a 45 percent reduction in their hot flashes. Other studies have found that soy can, on average, lower the incidence of hot flashes by 40 percent. Black cohosh (Cimicifuga racemosa), a Native American herb that was the primary ingredient in a popular 19th century remedy called Lydia Pinkham’s Vegetable Compound, also boasts isoflavones. In a review of 29 randomized, controlled clinical trials exploring alternative treatments for hot flashes, researchers from Columbia University found that black cohosh and phytoestrogen rich foods like soy, are particularly helpful for reducing hot flashes. In another review of the clinical data by the University of Illinois-Chicago, the researchers concluded that, while black cohosh is an effective treatment or hot flashes, it may also reduce the night sweats, insomnia and anxiety that often accompany menopause. While soy and black cohosh can help reduce the frequency and severity of hot flashes, red clover (Trifolium pratense) might be even more effective. Ten to twenty times more potent than soy, red clover not only provides genistein and daidzein, it also contributes two additional isoflavones not found in soy, biochaninA and formononetin. A two-month patient-controlled study of 23 symptomatic menopausal women conducted by Tufts University School of Medicine found that red clover decreased hot flashes by 56 percent. So, is red clover the top dog among phytoestrogens? Not necessarily. While soy, black cohosh and red clover have all been effective in clinical trials, most women have to experiment to find the one that works for her. You may even want to try a combination. For example, taking black cohosh or red clover may work better if you increase your intake of soy foods.

Beyond Estrogen

Estrogen isn’t the only hormone involved in triggering hot flashes. According to the groundbreaking work of John Lee, MD, low progesterone levels can also bring on the heat. A randomized, placebo-controlled study of 102 women at St. Luke’s Hospital in Bethlehem, PA, found that boosting progesterone significantly improved the frequency of hot flashes. In the study, the women were instructed to apply a quarter teaspoon of either a natural progesterone cream or a placebo to their skin daily. After a year, the women using the progesterone cream reported an incredible 83 percent improvement compared to only 19 percent in the placebo group. Unlike the synthetic progesterone in many HRT formulas, natural progesterone is identical to the hormone made by the body. But progesterone isn’t just good for hot flashes. Dr. Lee points out that natural progesterone also gives you more energy, promotes more restful sleep, boosts concentration and digestion, and builds bone. But here’s the kicker – progesterone actually protects against breast and endometrial cancer. Let’s see HRT – or antidepressants – match that!

One Last Thing ...

A lot of women I know complain about the emotional roller coaster that often accompanies menopause. If you suffer from depression and anxiety during menopause – and a lot of us do – you certainly don’t need an SSRI like Paxil. Instead, pick up a bottle of S-adenosyl-L-methionine, or SAMe. SAMe is a naturally-occurring compound involved in many biochemical processes within the body. In a recent study, researchers found that SAMe significantly improved depression in the 80 postmenopausal women who participated in the study. Other research suggests that SAMe is more effective than placebo in treating mild to moderate depression and is just as effective as anti-depressant medications without the side affects. Plus, antidepressants like Paxil tend to take six to eight weeks to begin working, while SAMe seems to begin much more quickly than that.

This Just In ...

Last week I told you about a study that claimed eating mercury-laced fish wasn’t unhealthy for pregnant women after all. Now, I don’t know who funded the research (I can only guess), but it seemed like an irresponsible study to me. Apparently, I wasn’t the only one with doubts. According to a new report by researchers at Johns Hopkins University, mercury is indeed toxic, and moms-to-be aren’t the only people at risk. Any adult who eats fish contaminated with high levels of mercury could find that it impairs their concentration, dexterity and verbal memory. The biggest culprits are large fish like shark and swordfish. So, once again, if you want the omega-3 benefits of fish without the toxins, stick to low mercury varieties like wild salmon or tilapia. ***

References: “Antidepressant helps relieve hot flashes: US study.” Reuters. 3 Jun 2003.

Kronenberg F, et al. “Complementary and alternative medicine for menopausal symptoms: a review of randomized controlled trials.” Annals of Internal Medicine. 2002; 137:805-813.

Leonetti HB, et al. “Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss.” Obstetrics and Gynocology. 1999; 94:225-228.

Mahady GB, et al. “Black cohosh: an alternative therapy for menopause?” Nutrition in Clinical Care. 2002; 5:283-289.

Van de Weijer P, et al. “Isoflavones from red clover (Promensil®) significantly reduce menopausal hot flush symptoms compared with placebo.” Maturitas. 2002; 42:187.