Menopause

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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

Navigating the change

I have worked with a great many women going through the 'change' and so have had many opportunities to see what both what works as well as what doesn't really help. Each woman has distinct differences but there is also a lot of common ground and it is the strategies that I have seen to consistently help the most that I primarily want to share here.

The first and perhaps most important thing to grasp is that menopause is not a disease, it is a change. How we navigate the physical and emotional components of that change determine its ease and speed.

Hormone Replacement Therapy

Before I talk about those physical and mental/emotional components I want to recount that, when I began practice in 1989, at least 90% of the perimenopausal women who came in to see me were already taking HRT (hormone replacement therapy). There can be no doubt that these are powerful drugs that profoundly affect how a person feels and functions but I found that most women were still having considerable problems with their symptoms and most felt rather stuck! I felt then, and still feel now, that taking HRT to arrest the menopause is highly problematic because, aside from any side-effects, when do you finally stop and let nature take its course? These days only a small fraction of women take HRT but I see that it is has been getting a resurgence and there are many vocal advocates for it being safe to use for short periods in low doses... maybe, maybe not. There is a place for everything but I could not advise HRT to my own patients in good conscience; if you have not already seen some of the controversial literature on HRT safety you can read a study I have linked on it here.

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The adrenal take-over

Women need oestrogen and progesterone throughout their lives and, rather remarkably, once the ovaries shut down their production of these hormones it is the adrenal glands that continue to produce them for the remainder of their lives. Our adrenal health is greatly affected by how much stress we have had and still have in our lives and, given the inevitability of that stress, it is hugely helpful that there are certain herbs that are exceptionally helpful in supporting this area.
There are other useful allies as well but the two main herbs I recommend for adrenal support are Withania somnifera and Panax ginseng.

Withania

I have had a lot of positive experience using Withania in this area I believe it to be one of the most important herbs for navigating the change of the menopause for how it a) nourishes the adrenal glands, b) supports thyroid health and c) just helps people to feel generally better! In the ancient system of Ayurvedic medicine Withania is called Ashwaganda, and you can read a detailed write up, including suggestions on how to use it, here

Panax ginseng

Whilst just about anyone can take Withania, Panax ginseng does not suit everyone. I introduce this subject of different constitutions in a little more depth at the end here but suffice to say here that if you are already a person who felt the heat easily in the past and are now really struggling with overheating from hormonal changes then this may not be the right remedy for you. If, however, you have always been a cooler constitution then it may be one of the best herbs to help your adrenal health up to the point that it can take over from your ovaries properly and you can get through the change. There's a detailed write up on Panax here.


Panax ginseng

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Thyroid health

It is abundantly clear that, along with the adrenals, the state of health of the thyroid gland has the potential to have a very strong influence on the relative ease or difficulty of the menopause. Thyroid health is an important subject in its own right and, given how frequently an underactive thyroid is missed in routine blood tests that only show a red flag when things are really bad, I suggest you might be wise to do a simple temperature test at home that may be better at picking up if this is in fact a problem that needs attention. This process is described in practical detail, along with what to do it if actually is a problem, in an article on thyroid health here.

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Herbs for Menopause

Once we have some support in place for the adrenal glands, and possibly the thyroid, we can turn our attention to using one or more of those herbs that have been seen to help a great many women get through the change.

Sage for Sweats

If a woman is being plagued by hot flushes and excess sweating then the first and sometimes best remedy to try is Sage. What follows is copied from the article on Sage that you can find here.

Sage can be a stand-out remedy for excessive sweating; from any cause, but be prepared to take it strong for it to really work! For a strong medicinal tea of Sage take up to 2 heaped tablespoons (dried or fresh are equally good) and place in a saucepan with about a litre of water. Bring to the boil then lower the heat right down and just simmer for a good 10 minutes. Then take off the heat and leave for another 15 minutes. Strain the tea and either drink when sufficiently cooled or refrigerate.

For some people with excess sweating this tea will be fine to drink at room temperature but for others it will be even better if it is chilled right down by being placed in the fridge. For some people a small and regular dose through the day will clearly work much better and for others it will make no difference to their results to have one or two large doses that then appear to have a lasting benefit. Be guided by your own body and what makes you respond the best. It is okay to add some honey or maple syrup to taste.

Note that the above recipe is a way to make Sage about as strong as it gets. If this is more Sage than you need to get a good result then either simply decrease the amount you drink or decrease the amount of the starting materials. In practice I also give Sage in tincture form where we can easily adjust the dose up or down as needed. I have found that some people respond to quite small doses e.g. just 2 or 3 mls in a day, whereas another person might need 3 or 4 times that much to see an obvious reduction in their excess sweating. I hope that you have clearly got the idea that there is not one fixed dose or regime that works best for this herb - this is true of most of our great herbal remedies and it is why much of the art of the successful herbal medicine lies in the 'dose'.


Salvia officinalis (Sage)

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Skullcap for soothing

If the main trouble or one of the main problems with the change is an overheating nervous system that shows in such symptoms as irritability, insomnia or anxiety then one of the best remedies for this time of life is the rather gentle, lovely but deceptively potent Skullcap. Again, like so many of our great medicinal herbs, it must be taken in sufficient doses to get the true action of the remedy but when taken correctly the effect on an agitated nervous system can be profound, and rapid! Read more about how to use it here.


Scutellaria lateriflora (Skullcap)

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Black Cohosh - maybe!

Black Cohosh is probably the most famous 'menopause herb' in the commercial world now, especially popularised in the drug Remifemin. For many women it does greatly help ease the symptoms of the change but for others it makes little difference or they actually get worse on it! Black Cohosh is really a very potent remedy that will cause a change to the hormonal levels and, like most herbs, it will suit some people but not others. If you are not able to visit with a herbalist who is experienced in its use then the only way you may be able to tell for sure is just to try and see but I would firstly encourage you to learn a lot more about it by reading about it here.


Cimicifuga racemosa (Black Cohosh)

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Wild Yam - for unwinding

I love to use Wild Yam for some women who are struggling with the menopause but I think that, at least compared to Black Cohosh mentioned just now and the Chaste tree next, its hormonal action is only very mild. Wild Yam is excellent when the woman has a great deal of physical tension in her belly and I think it somehow it seems to ease the change by simply helping her to relax through it! Like all the above remedies it is not going to suit everyone and in this case I believe the body will tell you within a matter of days whether it is agreeable or it will make no appreciable difference, more info about it here.


Dioscorea villosa (Wild Yam)

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Chaste tree - possibly!

One of my top favourite herbs for helping with heinous menopause symptoms is the enigmatic Chaste tree (Vitex agnus-castus). This has been popularised as a herb for premenstrual syndrome but it is very much more than that for some women. If you will try to use this remedy then you must be aware that it will likely have some considerable effects on your hormonal balance so, if there was ever a herb to learn about before using... I have a detailed write up about all these matters in its monograph here.


Vitex agnus-castus (Chaste tree)

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Freedom from the 'Wheel'

Menopause is celebrated in all the old cultures as a kind of graduation from the school of life. The woman who has survived to this age is now liberated from the ever-turning wheel of her cycle and is now free to become a 'wise-woman' a village elder, a sought after and respected guide for her people, in other words a matriarch. Compare this attitude to our Western worship of youth and aversion to age and you will immediately see a large part of the reason why women in traditional cultures do not associate the menopause with suffering as we do in our modern world.

In her monthly cycle a typical woman goes through peaks and troughs, ups and downs, with her physical, emotional and mental health. The only thing that is constant is change and many women do instinctively understand this and learn to go with rather than against their imperative biology, their moon-led tidal fluctuations. Menopause, at least in theory, is a freedom from this constant changing to a more complete and lasting integration of their being as a whole. However, if there are areas in a woman's inner life that have not been able to be nourished, for example because of her commitments to work or family, the change may bring these things out into the stark open where they can no longer be put aside in a busy life.

I need to make it clear that I am not saying that the upheaval of menopause a woman can suffer is all due to her psychology. I am no more suggesting that than I would that all troubles can be laid at the feet of pure biology! In menopause, as with any chronic trouble we face in the long journey of life, it is always a combination of factors, the mind and the body, and as much as we might like to be simplistic and blame it all on a hormone, or some 'thing' it is always a complexity, which is why a holistic approach that allows for tending to more than one area at a time is usually so much more successful.

If you who are reading this are struggling with your mental and emotional health then I advise you to not just turn to a substance alone as your sole remedy but, as well as getting some key support from nature, also take steps to help you adapt to the internal change that your body is urging you towards. The voice of change from within might take a great many forms if you give it a real chance to be heard. For example, you may find that there are some parts of you that have been lying dormant for a long time that are aching to see the light of day. We all of us can get stuck, but we never have to stop growing!

It must be said that, come the change, you do have to pay particular attention to any areas in your mental health that have been let slide in the past. If you were experiencing some low moods in the past then they are likely to come in more strongly and, even if you don't identify with this rather loaded word, if there are some elements of depression in this phase of your journey then do carefully read the detailed article on this subject and take the recommended steps described within, because they work! You can find it here.

Likewise, if you had been carrying too much tension in your life and had not found ways to truly unwind, then the change may see you getting considerably higher levels of tension and even anxiety. Once again, if this is the case, there are very practical and certainly effective steps you can take that will certainly help a great deal, this all written up here.

In any case I do most warmly recommend that you allow yourself the freedom, which means the time and the space, to reconsider your place in the world and what it is that you now really want from life. We often talk as if we like change and find it refreshing but when people are not well they would rather that change just left them alone! However, there may not be a choice about this when it comes to the menopause, it is not just a physical change that is happening but a profoundly internal one as well, and there may be no getting around the fact that if you resist it then it will simply persist!

I hope you already have or can find a trusted person to talk with through this process as, whatever else may be happening, you can be sure that getting it out in the open will be better than keeping it in. In terms of not overly resisting but rather relaxing into the process of change, it may also be that some of the material on my page on music and relaxation may help too; that's here.

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Constitutional Health Note

Lastly it may be of great benefit to learn about your constitution to help better understand how to best navigate this great period of change in your life. Constitutional health is an old and fascinating way of understanding our differences and, to demonstrate a little of how it works it can be seen that the dryer constitutions can struggle badly with hot flushes if they are not able to easily sweat and the hotter constitutions can feel especially oppressed by getting extra surges of heat when they were already hot enough! Damp constitutions in the menopause can do especially well with Sage tea. The hot & dry woman can respond best to Skullcap whilst the cool & dry woman might find Black Cohosh the most helpful. Everyone can potentially benefit from the tonic herbs. Of course these are just generalisations but they come from observing a lot of patterns, in any case there is a brief introduction to this subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd