Elaine Magee
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 Over the past few years, a great debate has ensued in the research community: Will eating more soy during menopause keep hot flashes away? A recent Italian study suggests soy isoflavones perhaps don't actually minimize hot flashes but instead have the ability to improve mood, thereby rendering women less inclined to care about their hot flashes. The theory makes sense, given that estrogen receptors exist in the mood area of our brain, and soy is rich in natural plant estrogens.
Soy good for the heart? |
Herbert Ross, DC with Keri Brenner, L.Ac.
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 Hormone fluctuations influence body temperature and as a result can cause insomnia indirectly because of the increased frequency of hot flashes and night sweats during perimenopause and menopause.8 In a recent study, over 81 percent of women with severe, frequent hot flashes showed signs of insomnia, including unsatisfying sleep patterns and problems falling asleep. Therefore, treating hot flashes could be an important way to ease the symptoms of insomnia for menopausal women. |
Elaine Magee
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| A recent Italian study suggests soy isoflavones perhaps don't actually minimize hot flashes but instead have the ability to improve mood, thereby rendering women less inclined to care about their hot flashes. The theory makes sense, given that estrogen receptors exist in the mood area of our brain, and soy is rich in natural plant estrogens.
Soy good for the heart? The definitive news on how soy affects heart health has not yet been reported because researchers are still looking into whether-and how-it helps. |
Bottom Line Health
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| HOT FLASHES
As many as 80% of women experience hot flashes during menopause. One theory is that the hypothalamus, which controls body temperature, is somehow triggered by hormonal fluctuations.
•Avoid spicy foods. Foods containing cayenne or other peppers have a thermogenic effect, meaning that they raise body temperature.
•Cook using garlic, onion, thyme, oreg-ano and sage. These seasonings contain very small amounts of phytoestrogens (plant-based estrogens, such as lignans and isoflavones, that occur naturally in certain foods) and can help restore hormone balance.
•Cut down on caffeine. |
Andreas Moritz
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 Wild yam root, applied topically, may relieve hot flashes almost immediately. Evening primrose oil also helps the ovaries maximize their output of estrogen during the early stages of menopause. For those who still don't find relief, maca root may be the answer; it jogs the pituitary and hypothalamus and balances hormones in the body. Maca root has helped to reduce hot flashes by 80 percent. Start taking two teaspoons per day, one in the morning and one in the late afternoon. Since maca has an energizing effect, you should avoid it too close to bedtime. |
Joan Liebmann-Smith, Ph. D., and Jacqueline Nardi Egan
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 If you're a woman, you may be having hot flashes, a classic sign of menopause. The redness of hot flashes usually vanishes quickly.
If the flush persists, however, it may be an indication of rosacea. (See Chapter 4.) Rosacea is a type of rash that sometimes resembles a face mask or butterfly but is different from the "mask of lupus" (see Butterfly Mask, below) or the "mask of pregnancy" (see Dark Patches on Cheeks, below). In its early stages, rosacea may merely cause periodic flushing or blushing, but it then progresses to permanent redness on the face. |
| Feeling hot a lot and having hot flashes are telltale signs of menopause, but not all women who complain of heat intolerance are having menopause-related hot flashes. And not all heat-intolerance sufferers are women. Heat intolerance is a classic sign of several hormone-related conditions, especially hyperthyroidism, in which excess thyroid hormone raises your temperature and speeds up your metabolism. (See Appendix I.) Other common signs are nervousness, weight loss, excessive hunger and thirst, and bulging eyes. |
John J. Ratey, MD
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 Exercise is one alternative, although evidence for its effects on hot flashes and night sweats is inconclusive. Several large observational studies, one of which included sixty-six thousand menopausal Italian women, have shown that lower levels of exercise correlate to more vasomotor symptoms, but other studies have shown no association.
Some ob-gyns will tell you that exercise actually triggers hot flashes. At least with exercise you can safely conduct your own experiment without fear of long-term side effects. |
| What gets lost in the question of whether exercise helps menopausal women with hot flashes is the big picture, namely that it guards against heart disease, diabetes, breast cancer, and cognitive decline.
The physical symptoms of menopause exacerbate the mood symptoms, and there's no question exercise helps in this regard. One woman told me that the most frustrating part of aging is that she feels like her body is out of control. She gained weight, suffered hot flashes and high blood pressure, and her vision deteriorated. On top of that, she feels anxious and depressed at times. |
| CONSIDER THE SYMPTONS
The most common reason women seek HRT is to alleviate the physical symptoms of menopause, specifically hot flashes, and nobody disagrees that it works wonders on this front. Exercise is one alternative, although evidence for its effects on hot flashes and night sweats is inconclusive. Several large observational studies, one of which included sixty-six thousand menopausal Italian women, have shown that lower levels of exercise correlate to more vasomotor symptoms, but other studies have shown no association. |
Bill Sardi
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 Some women continued to take HRT because they simply didn't want to face a return to all those hot flashes and mood problems and the increased risk for breast cancer was considered statistically small. Other women continued to take the hormone pills for more frivolous reasons. As a report in New York Times said, "Some women said they could never give up the pills, not because they needed them for severe menopause symptoms but because they were convinced that estrogen prevented wrinkles or because it staved off mental foggi-ness. |
Tori Hudson, N.D.
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 Despite the lack of effect in some studies on soy and lipids, when we look at the role of soy in other aspects important to women's health— reducing the incidence and severity of hot flashes, loss of bone mass, vaginal dryness, and female-related cancers—the most convincing effects of soy are in fact in the area of its action on lipids. The North American Menopause Society seems to agree with this perspective in a 2000 consensus opinion.121
With many good reasons for women to eat soy, blood pressure may be another area of benefit. |
| However, because it depletes estrogen receptors, side effects include hot flashes, nausea and vomiting, breast discomfort, and headaches. It can also have detrimental effects on cervical mucus and the endometrial lining. Severe side effects occur in less than 2 percent of women using it. CC can lead to an increase in multiple gestations at a rate of about 6 to 10 percent. Most of these tend to be twins; less than 1 percent are triplets or higher-order multiples. Past concern about increasing the risk of ovarian cancer has faded with recent research showing no increased risk. |
David Hoffman, FNIMH, AHG
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 Hot Flashes
The most common symptom caused by the menopausal decline in estrogen secretion is hot flashes, or flushing, described as feelings of warmth and sweating. About 85% of women over the age of 50 are affected. The onset is sudden, and when associated with palpitations, dizziness, or faintness, they can be a frightening experience. Emotional stress, exercise, alcohol, and certain foods can bring them on for some individuals. Typically, hot flashes occur several times a day and last a few minutes at a time. Vitex agnus-castus is an effective remedy for this often distressing symptom. |
Tori Hudson, N.D.
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| This same study also demonstrated significant improvement in hot flashes and night sweats. However, another study on transdermal progesterone cream delivering 32 mg daily did not show evidence that it supplied sufficient hormone to enter the body to achieve a biologic or therapeutic effect on lipid levels or bone mineral markers or to improve vasomotor symptoms or moods.158 Bio-identical progesterone cream has yet to be adequately studied to show sufficient protection of the uterus when given with an oral estrogen or estrogen patch. |
Marshall Editions
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 Other medication: Anti-depressant drugs, the selective serotonin reuptake inhibitors (SSRIs) drugs in particular (including Prozac®, Zoloft®, and Lexapro®), can be helpful in reducing episodes of hot flashes. Natural treatments such as vitamin E, taken at a dose of 400-800 IU daily, and black cohosh extract standardized to 5% triterpene glycosides, taken at 40 drops daily, are also recommended. Soy phyto-estrogens as well as the phytoestrogens found in celery, parsley, whole grains (flax in particular), and alfalfa are weak estrogens that may be helpful. |
Tori Hudson, N.D.
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| There are hundreds of studies on soy and dozens on hot flashes, some showing effect and others not, making it difficult to make conclusions. For now, I'd like to pass on the results of two systematic reviews of isoflavones and menopausal symptoms and one consensus opinion from the North American Menopause Society that offer a good summary of the research. The first systematic study was a review of the literature for the randomized controlled clinical trials on soy and perimenopausal symptoms. |
Bottom Line Health
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| It also helps reduce anxiety and hot flashes.)
Apply lA teaspoon once in the morning and once at night. Rub the cream on areas where you see capillaries, such as the wrist, back of the knee and neck—these are where the skin is thinnest and the cream is easily absorbed. Alternate where you apply the cream on a daily basis.
•Magnesium. Levels of magnesium, a natural sleep aid, are depleted when you consume too much coffee, cola, alcohol, sugar or salt. Foods that are high in magnesium include halibut. . .whole-wheat bread.. .leafy green vegetables such as spinach, .nuts... |
Bill Sardi
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| Reduction in testosterone may result in hot flashes, breast enlargement, changes in mood, decline in sex drive, fatigue, anemia and bone loss and fractures. [Current Urological Reports 6: 210-16, 2005] Men with prostate cancer may already have low bone mineral density prior to any hormone therapy. [Cancer 91: 2238-45, 2001] Various medications, calcium and vitamin D may be recommended to strengthen bones. However, these measures alone may be ineffective. [Canadian Journal Urology 12: 9-15, 2005S]
As men with prostate cancer live longer, the prevalence of bone loss increases. |
| Journal Clinical Oncology 18: 3595-3603, 2000; Urology 57: 122-26, 2001]
A report in the Journal of Urology stated the side effect profile of PC-SPES was "comparable to estrogen treatment," with 42% experiencing nipple tenderness, 8% breast enlargement and 7% hot flashes. [Journal Urology 164: 1229-34, 2000]
Dr. Charles Myers of the American Institute for Diseases of the Prostate, in Charlottesville, Virginia, reported the case of a man whose PSA was nearly 3,000, an alarming level, but after taking PC-SPES it fell rapidly to below 1. Dr. |
| The strongest data show that phytoestrogens reduce the number and intensity of hot flashes, although the reduction is a modest 10-20%. [Journal Nutrition 133:1983S-6S, 2003]
—? A review of published dietary intake studies involving prostate cancer did not show any protective action from phytoestrogens. [Preventive Medicine 41:1-6, 2005]
"The relevant research is complicated, inconsistent, and inconclusive. |
| J Steroid Biochemical Molecular Biology 83: 133-47, 2002]
However, a study published in 2001, did not find that women who had completed breast cancer treatment experienced a reduction of hot flashes when taking black cohosh. [J Clinical Oncology 19: 2739-45, 2001]
Approximately 30% of women experience menstrua I ly-re-lated migraine attacks. The provision of soy, black cohosh or dong quai extracts has been shown to relieve symptoms and reduce frequency of these attacks. [Biomed Pharmacotherapy 56: 283-88, 2002]
The current recommended dose of black cohosh is 40-80 mg per day. |
Gerald E. Markle and Frances B. McCrea
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 Throughout the 1980s and 1990s, postmenopausal women took estrogen along with progestin, a combination that purportedly offered the benefits of the old ERT, for maladies ranging from hot flashes to osteoporosis, as well as protection from heart disease and breast cancer. Risks from this so-called hormone replacement therapy (HRT) were denied or minimized. A survey conducted in 1995 showed that about 38% of women aged 50 to 75 were using HRT. At the turn of millennium, some 55 million postmenopausal women were on HRT.30
Yet there were problems. |
Tori Hudson, N.D.
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| The signs and symptoms of perimenopause can include menstrual irregularities, hot flashes, vaginal dryness and thinning, skin changes, fatigue, decreased libido, mood swings, depression, changes in memory and cognition, sleep disturbance, hair loss on the head, hair growth and acne on the face, heart palpitations, nausea, headaches, urinary tract infections, joint pains, and the beginning stages of osteoporosis and heart disease.
Menopausal Symptoms
The transition to menopause usually begins sometime in a woman's 40s. |
Marshall Editions
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| HERBALISM
Black cohosh: This herb is recognized for its ability to reduce or eliminate menopausal symptoms such as hot flashes, insomnia, fatigue, depression, irritability, and mood swings. Black cohosh also acts as an anti-spasmodic, anti-inflammatory, digestive stimulant, mild sedative, and blood pressure lowering agent by relaxing blood vessels in the extremities. Clinical studies show that black cohosh standardized to 1% triterpene glycosides (Remifemin® and Menofem®) does indeed reduce symptoms of menopause in a similar manner to low-doses of estrogen replacement. |
Mehmet C. Oz., M.D. and Michael F. Roizen, M.D.
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 Memory loss No change
Hip/spine fracture 2 percent decrease
hot flashes, vaginal 94 percent gone dryness, insomnia
Overall changes 4.8 percent increase if you count all major adverse effects as equal
Delay of two to Delay of two to Delay of four to three years three years six years
2.2 percent decrease 2.2 percent decrease 2.2 percent decrease
94 percent gone 94 percent gone 94 percent gone
29.8 percent 2 percent increase 18.2 percent decrease decrease for first ten (47. |
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