The Wisdom of Menopause

by Christiane Northrup

  A woman taking Revival wrote: “I have been taking Revival for many months with great success (it reduced the size of my fibroid and slowed the bleeding). I started HT and within a month my fibroid was growing again and I was bleeding again. I stopped. I am now back on Revival and here to stay.”

  Another of my patients told me that when she started to take a soy drink from her health food store, her hot flashes and hypoglycemia symptoms went away completely. Later, she said, “I began to doubt that something as simple as a soy drink could eliminate hot flashes. So I stopped. Sure enough, my hot flashes returned within a week. So I started taking my soy again. I wish I hadn’t stopped it, because it took another two weeks for it to kick in again.”

  Soy Can Be Used by the Whole Family

  Making soy part of family meals can benefit everyone in your family. In men, soy protein has been found to help maintain healthy prostate tissue. In fact, many have found that they no longer need to get up at night to urinate once they start taking supplemental soy. A substantial body of research has documented the benefits of soy on prostate health, showing that eating soy can both help prevent prostate cancer as well as inhibit the progression of already established prostate cancer.42

  Use Non-GMO Soy Products

  It is estimated that about 20 percent of the American soy crop has undergone genetic modification to enhance drought resistance and other desirable traits. Such genetic engineering raises some disturbing ethical and health questions, and in Europe, unease about this development has led to the banning of genetically modified organisms (GMOs). The same movement is now becoming active in the United States. Until we know more about the possible health or environmental risks, stick with soy that is labeled non-GMO whenever possible.

  Flaxseed: Super Source of Lignans, Fiber,

  and Omega-3 Fats

  Flaxseed is the best available source of anticancer and phytoestrogenic compounds known as lignans—with a concentration more than a hundred times greater than other lignan-containing foods, such as grains, fruits, and vegetables. Lignans are plant substances that get broken down by intestinal bacteria into two chemicals, enterodiol and enterolactone. These substances then circulate through the liver and are later excreted in the urine.43 Flaxseed is also an excellent source of fiber and of omega-3 fats.

  There are a number of reasons why we all should be interested in incorporating more lignans into our diet. The following are some of the most compelling.

  Lignans

  LIGNANS HAVE POTENT ANTICANCER EFFECTS. An impressive number of studies have shown that flaxseed lignans help in both prevention and treatment of breast and colon cancer because of their ability to modulate the production, availability, and action of the hormones produced in our bodies.44

  LIGNANS ARE POTENT PHYTOESTROGENS. In women who consume flaxseed, studies have shown significant hormonal changes, including alterations in estradiol levels, similar to those seen with soy isoflavones. This makes flaxseed oil or ground flaxseed a great choice for women who can’t use soy or who simply want another source of phytohormones.45

  LIGNANS ARE GOOD ANTIOXIDANTS. Like soy and many herbs, lignans have antiviral, antibacterial, and antioxidant properties, which means they help prevent free-radical damage to tissues—the cellular-level injury associated with aging and disease.

  LIGNANS HELP PROTECT THE CARDIOVASCULAR SYSTEM. Studies have also found that lignans in the form of flaxseed significantly lower LDL cholesterol (the “bad” cholesterol), raise HDL cholesterol (the “good” cholesterol), and reduce the incidence of atherosclerosis.46

  Fiber

  Flaxseed is an excellent source of fiber. In addition to its phytoestrogenic properties, flaxseed is rich in both soluble and insoluble fiber. Adding a daily serving of ground flaxseed to your diet may eliminate any problems you have with constipation. (Just be sure you take it with enough liquid.) While the fiber in wheat bran is quite hard and can irritate the bowel, the fiber in flaxseed is much softer. When combined with fluid, flax fiber forms a mucilage in the body that can significantly help reduce the risk for diabetes and cardiovascular disease. Fiber has been shown to reduce both total cholesterol and triglyceride levels in the bloodstream.

  The total dietary fiber content in 45 g of flaxseed (about ¼ cup) is 11.7 g. This is nearly four times greater than the fiber contained in a ½ cup serving of oatmeal.

  Note: Ground hemp seeds are also an excellent source of high-quality protein and fiber—1/3 cup contains 14 grams of fiber and 11 grams of protein. (For more information, see www.nutiva.com.)

  Omega-3 Fats

  Flaxseed is an excellent source of omega-3 fats. These fats are essential for the health of every cell in our bodies, including the cells in our brains and hearts. A deficiency of omega-3 fatty acids, which is quite common, can result in fatigue, dry skin, cracked nails, thin and breakable hair, constipation, immune system malfunction, aching joints, depression, arthritis, and hormone imbalances. Omega-3s are also linked to healthier weight and body composition. Research from Australia has linked higher blood levels of the omega-3 fatty acids EPA and DHA to lower rates of obesity. People with higher omega-3 blood levels had lower body mass indexes, narrower waists, and smaller hip circumferences. In addition, the cell membranes of the overweight and obese people in the study were nearly 14 percent lower in omega-3s than in those with healthy weights.47 And a Spanish study published in 2008 showed that for overweight and obese people participating in a weight loss program, omega-3s boosted the feeling of fullness after a meal.48

  Omega-3 fats are found not just in flaxseed, but in fatty fish (especially salmon, bluefish, mackerel, sardines, and anchovies), fish oil, organ meats, egg yolk, and algae. Flaxseed meal is an excellent source of omega-3 fats if it’s freshly ground. (Flaxseed oil also provides omega-3s, but it does not provide fiber. In addition, the oil must be kept refrigerated, or it will turn rancid.)

  Fish, especially the cold-water fatty kinds, is a better source of DHA, the brain tissue building block that your body can’t manufacture. That may be why studies show that individuals who consume fish exhibit a lower incidence of depression. Additional benefits of fish oil include lessening the frequency and severity of hot flashes (by 25 percent over twenty-four weeks, according to one Italian study)49 and even increasing survival time in women undergoing chemotherapy for breast cancer.50 If you can’t or don’t want to consume fish regularly, I think DHA (200–2,500 mg per day) is one of the best supplements you can take. (See Resources.)

  How to Take Flaxseed

  Not all flaxseed is created equal. I recommend buying golden flax grown in the northern Great Plains regions of North America (Manitoba and the Dakotas), where the rich soil and climate produce flax that is high in omega-3 fats and flavor. (See Resources.) Although the brown flax found in most health food stores has all the nutritional benefits of golden flax, I personally prefer the taste of golden flax. For best results, use ¼ cup flaxseed three to seven days a week. Grind your daily serving in a coffee grinder and then stir the meal into soups and beverages, or sprinkle it on cereal or salad. I add half my daily dose to my morning soy drink and eat the other half with vanilla yogurt at the same meal. This combination makes a wonderfully fiber-full, phytoestrogen-rich perimenopausal power breakfast. And it takes less than three minutes to prepare!

  Bioflavonoids

  Another rich food source for phytoestrogens are the bioflavonoids contained in many herbs and fruits. Bioflavonoids compete with excess estrogen for receptor sites and are therefore also helpful for balancing menopausal hormones and tonifying the pelvic organs. The white spongy inner peel of citrus fruits is a very rich source, so eat some of it along with your orange or grapefruit. (I usually just take the orange peel and eat the inner white part directly—the same as I would an artichoke leaf.) Other rich sources of bioflavonoids include cherries, cranberries, blueberries, bilberries, many whole grains, grape skins, and red clover. In supplement form, 1,000 mg of bioflavonoids with vitamin C daily has been s
hown to relieve hot flashes.51

  TRADITIONAL CHINESE MEDICINE AND

  ACUPUNCTURE FOR MENOPAUSE

  Over the years I’ve referred hundreds of women for acupuncture and Traditional Chinese Medicine (TCM), a system of medicine that is over two thousand years old, for the relief of a wide variety of gynecological problems, including those related to menopause. I have personally used elements of Traditional Chinese Medicine, including various herbal formulas and acupuncture, to relieve menstrual cramps and hot flashes.

  Traditional Chinese Medicine is by its very nature holistic, tailoring treatment to the individual’s body, mind, spirit, and emotions. This system of medicine views our health as a balance between the two contrasting states of yin and yang. The following is a very simple explanation, courtesy of my own personal mother-daughter acupuncture team, of the most common pattern that occurs during menopause.52 According to Chinese medicine, the part of us that is referred to as yin—our vital fluids—begins to diminish as we grow older. This leads to an excess of yang—vital energy and heat—and/or stagnation of chi (life energy). Ideally, when our yin, yang, and chi are in balance, our body acts something like a kettle containing liquid (yin) heated by fire (yang). The resulting steam (the enhanced chi flow) circulates throughout the body, warming and nourishing it.

  How much and to what degree yin becomes depleted depends upon our lifestyle, diet, and genes. Depletion of yin causes the vital liquid in the kettle to burn off, so the fire burns without producing the steam necessary to moisten and nourish.

  Excess heat leads to hot flashes, the most obvious symptom, as well as to dryness of the skin, eyes, and vagina. Excess heat can dislodge the shen (spirit) from the heart, causing restlessness and insomnia. If excess heat enters the blood, it can cause heavy menstrual periods. Chi stagnation can cause pain anywhere in the body, as well as moodiness and emotional instability. A combination of excess heat and chi stagnation can lead to restlessness and anxiety.

  Diet

  According to Chinese medicine, diet is the most effective way to relieve many symptoms, and my experience bears this out. All heat-producing foods and substances should be eliminated. Caffeine, alcohol, refined sugar, food coloring, preservatives, and additives (including antibiotics and hormones fed to animals during the production of most meat, chicken, and eggs) will cause excess heat and yin depletion. Red meat should be consumed in small quantities, but being a complete vegetarian (vegan) is not recommended. You should eat at least 2–4 ounces of meat or fish every week or two, depending upon your size and lifestyle. It is also helpful to limit spicy, pungent foods, such as curries or chilies, and greasy, fried, or oily foods.

  Foods should be lightly cooked, not raw or cold. (These days I microwave my salad greens for about thirty seconds with a little lemon juice on them.) The body has to work much harder to digest raw food, which creates heat and chi stagnation. Cold food, contrary to popular belief, doesn’t cool the body in a balanced way. Instead, cold and ice create blockages in the chi channel, which creates chi stagnation. The following foods are especially cooling and helpful: melons, bean sprouts, tofu, white ocean fish, celery, apples, asparagus, and grapes.

  Smoking obviously makes everything worse. When you smoke you are quite literally breathing in fire and toxins that enter the brain and bloodstream directly. It is also well documented that smoking poisons the ovaries, decreasing our estrogen levels about two years sooner than would normally occur.

  Practitioners of Traditional Chinese Medicine also discourage the regular use of ginger and Asian ginseng (Panax ginseng) and Siberian ginseng during perimenopause because both are considered heat producing.

  Chinese Herbs for Menopause

  An incredible variety of Chinese herbs and herbal combinations are available to treat every condition known to humanity—and the symptoms of perimenopause are no exception. While many individual Chinese herbs have Western counterparts, the most effective Chinese herbal combinations are unique to this system of medicine. Many of these so-called patent formulations have been tested and refined for thousands of years.

  A full discussion of Traditional Chinese Medicine and Chinese herbs is beyond the scope of this book. The preparations mentioned below don’t even begin to scratch the surface of what is available and safe for almost all people to take. Since most herbal prescriptions are based on an individual’s unique constitution, it is best to work directly with a practitioner trained in this system.

  If you are buying herbal formulations from a health food store, make sure that the ingredients are listed on the label.

  The following are particularly useful for perimenopausal symptoms.

  JOYFUL CHANGE is a safe, general perimenopausal herbal tonic. It consists of over a dozen different herbs, including dong quai and peony. It was especially created for the complex menopausal symptoms of women in our culture by knowledgeable practitioners of Chinese medicine. It is effective for symptoms such as hot flashes, insomnia, and dryness. It also addresses the cause of the symptoms by draining heat and nourishing yin. Joyful Change is helpful for balancing the menstrual cycle in those women whose periods have become irregular and scant because of skipping ovulations.

  YUNNAN BAI YAO (also known as Yunna Pai Yao) is very helpful in controlling the heavy bleeding that is so common in perimenopausal women. It should not be used on a long-term basis (more than a month) because it is not a cure. In other words, you should also take measures to address and treat the underlying cause of your bleeding, such as estrogen dominance or a fibroid.

  CHAI HU LONG GU MULI WANG moves the liver chi and sedates the spirit. It is helpful for moodiness, anxiety, emotional instability, outbursts of anger, and feelings of frustration. It is also used to treat insomnia. This herbal combination can be taken indefinitely; it is widely used by the general population in China, not just menopausal women.

  Acupuncture

  Acupuncture is an essential part of Traditional Chinese Medicine. Because it works to normalize the flow of life energy or chi in the body, it is particularly appropriate for perimenopause, a time when our energy is completely renewing itself. It is extremely effective for relieving hot flashes, insomnia, night sweats, anxiety, restlessness, emotional instability, moodiness, menstrual cramps, and excess bleeding.

  Though most people resort to acupuncture only after conventional Western drugs and surgery have failed, and though it is often effective even in these difficult situations, acupuncture is best used as preventive health care or at the onset of symptoms. It can unblock stuck chi long before the problem manifests in actual illness.

  When I was in my thirties, I was able to eliminate my menstrual cramps with acupuncture treatment. They have never returned. I have also referred patients for acupuncture who have had illnesses ranging from migraine headaches to chronic urinary tract infections. Acupuncture can help regulate menstrual periods, control heavy menstrual bleeding, stop seizures, and even in some cases help shrink fibroids. Research has shown that acupuncture improves cortisol balance in the body, enhances immune function, and helps quell addictions to cigarettes and alcohol.

  Acupuncture works by redirecting the flow of chi along energy pathways in the body known as meridians. Because the meridians have no known anatomical counterparts, allopathic medicine dismissed acupuncture’s effectiveness for years, until the presence of meridians was definitively demonstrated in a French study. Researchers injected a radioactive tracer into both traditional acupuncture points and into random sham points. The tracer that was injected into the genuine acupuncture points could easily be tracked as it ran up the meridians.53 The clinical evidence of acupuncture’s effectiveness has also become too compelling to ignore.

  START SOMEWHERE

  Don’t let all these choices overwhelm you or become another heavy list of “shoulds.” The wisdom in nature is user-friendly, and you have a lot of it within you already. To tap into it, just pick the herb, the formula, or the foods that seem to jump out at you and say, “Try me.”
Because all of the herbs and foods I’ve mentioned contain phytohormones of some kind and have virtually no side effects, feel free to experiment.

  7

  The Menopause Food Plan: A

  Program to Balance Your Hormones

  and Prevent Middle-Age Spread

  Over the years, countless women in their late thirties or forties have come to me with one or more of the following complaints: “Where did this spare tire around my middle come from?” “Why can’t I lose that last five to ten pounds I used to be able to shed within a few weeks?” “Why is it that although I weigh the same as I did in college, my body seems different?”

  Some women find themselves gaining weight at midlife even if they are eating no more than before. Others simply change shape: their waistlines thicken, and fat accumulates on their abdomen, flanks, and shoulders. Most of us have to make changes in our diets and exercise regimens if we expect to negotiate menopause without ten to twenty pounds or so of extra baggage, weight that, in addition to wreaking havoc with our appearance, is also a well-documented health risk.1

  Midlife weight gain results from a series of metabolic changes that actually begin decades before but then reach critical mass (no pun intended) during perimenopause. Rapid changes in hormonal levels along with increased stress hormones also exacerbate midlife weight gain.