The Wisdom of Menopause

by Christiane Northrup

  ~ CONSIDER TAKING VITAMIN K. Vitamin K2 (menaquinone) is getting a lot of attention these days in regard to the role it plays in bone health. Doctors in Japan have been using this vitamin (in the form of MK-4, also known as menatetrenone) to treat osteoporosis since 1995, with very good results. Although its value remains controversial in the United States because research here has been inconclusive, many human and animal studies from Japan have shown that this vitamin can both increase bone mass and reduce bone loss.82 Some particularly intriguing studies show that vitamin K boosts the positive effect of vitamin D on sustaining bone density in the lumbar spine and preventing fracture.83

  Vitamin K is found in meat, fermented products, cheese and other dairy products, broccoli, Brussels sprouts, cauliflower, chickpeas, kale, and seeds. But studies at both Tufts University and the University of Wisconsin indicate that for strengthening bones, you may need as much as 1,000 mcg per day, which is more of the vitamin than you can get through diet alone—and certainly more than the government’s current daily recommendation for women of 90 mcg per day.84 Note: if you are taking the blood-thinning medication warfarin (sold as Coumadin), you may want to consult with your doctor before supplementing with vitamin K because it may lessen the effects of the drug.

  ~ IF YOU SUFFER FROM JOINT PAIN, SUPPLEMENT FURTHER. NSAIDs such as ibuprofen (Advil, Motrin) have been implicated in the destruction of cartilage over time. Though these popular OTC drugs definitely decrease joint pain, they do more harm than good over the long haul. Alternatively, many women get significant relief from joint pain and arthritis with the following supplements, taken in addition to a good multivitamin:

  ~ Pueraria mirifica (PM): Miroestrol, a potent phytoestrogen found in certain formulations of this herb, is great for bones. Two published studies from researchers at Chulalongkorn University in Bangkok have shown that PM increased bone density in rats that had their ovaries removed. A randomized, double-blind, placebocontrolled study done by researchers at Bangkok’s Mahidol University and published in 2008 in the journal Menopause concluded that PM may have the same effect on humans.85 PM is also very effective at relieving a host of menopausal symptoms, including vaginal dryness, hot flashes, insomnia, and irritability. Take a brand that contains standardized miroestrol (approximately 20 mg of miroestrol per 100 g). Good choices include H.R.T. (Herbal Remedy from Thailand) Plus from Longevity Plus (see www.longevityplus.com) and PM PhytoGen Complex from Solgar. The usual dose is two tablets per day.

  ~ Glucosamine sulfate: 1,000 mg twice per day.

  ~ Turmeric: 250 mg twice per day.

  ~ Omega-3 fats (particularly DHA): These healthy fats, found not only in fish oil, but also in walnuts and flaxseed oil, are indispensable for bone health and enhance bone density.86 (Omega-6 fatty acids, on the other hand, weaken bones.) Make sure you get 1,000–5,000 mg of omega-30 per day.

  ~ Proanthocyanidins (OPCs), made from grape seed or pine bark: start with a loading dose of 1 mg per pound of body weight, daily in divided doses. Take this for 10–14 days. After that, you can decrease to a maintenance dose of 60–200 mg per day. (See Resources.)

  ~ EAT PHYTOESTROGENS. Soy, ground flaxseed, and Pueraria mirifica are particularly potent in this regard. Several studies have suggested that regular intake of soy protein has a bone-protective effect that is equivalent to that provided by estrogen. A six-month double-blind study at the University of Illinois found that postmenopausal women on a diet that was high in soy isoflavones were protected from spinal bone loss.87 In the fall of 2005, findings of a study of more than 24,000 Chinese women were reported in the Archives of Internal Medicine. Researchers noted that women consuming 13 g or more of soy protein every day were half as likely to incur a bone fracture as those eating 5 g or less per day.88 This is pretty exciting, especially when you consider that you can get this amount of soy protein simply by drinking two glasses of soy milk.

  In a Danish study, half the participants were given two glasses of soy milk with isoflavones; the other half drank the same quantity without the isoflavones. Bone loss was measured after two years, and then four years. The first group of postmenopausal women had virtually no bone loss at either interval! The second group saw a decrease in bone mass by a little more than 4 percent, which is still lower than what many postmenopausal women experience. Researchers concluded that although the soy milk they drank didn’t have isoflavones, the daily intake of soy protein still provided some protective benefits for these women’s bones.89

  Yet another study followed fifty postmenopausal women who consumed three servings a day of soy milk (about 7.5 oz each) or three handfuls of roasted soy nuts, for a total daily dose of 60–70 mg of isoflavones. In twelve weeks the study noted a 13 percent increase in osteocalcin, a marker of bone formation, and a 14.5 percent decrease in markers for osteoclasts, cells that cause bone loss. The benefits of soy were not compared side by side with hormone therapy, but soy protein revealed a bone-forming benefit that estrogen does not provide.90

  A 2007 study and a 2008 study, both done at Chulalongkorn University in Bangkok and published in the journal Maturitas, show that the phytoestrogen-rich herb Pueraria mirifica (PM) increases bone density in rats who’ve had their ovaries removed—a sign that this herb might be very promising in treating bone loss in humans.91 However, not all PM on the market is the same. I recommend brands that contain miroestrol (see full discussion in chapter 6).

  ~ DRINK GREEN TEA. Green tea is especially rich in phytohormones and antioxidants. Research has shown that women who drink either green or black tea regularly have stronger bones than those in a control group.92 I keep a pitcher of naturally decaffeinated green tea in my refrigerator and drink it regularly throughout the day.

  ~ DO REGULAR WEIGHT-BEARING EXERCISE. You need three exercise sessions per week, minimum. If you are lifting weights, two sessions per week are sufficient—but activities such as walking, yoga, and Pilates are also good. Basically anything that places force on ligaments, bones, and fascia will help promote healthy bones.

  ~ IF YOU ARE DEPRESSED, GET PROPER TREATMENT. Regular exercise and exposure to natural light are sometimes all that is necessary. If you work under fluorescent fixtures, replace them with full-spectrum lightbulbs. Though most full-spectrum lights don’t provide the UVB light necessary to stimulate vitamin D and calcium uptake, they definitely can help relieve depression and seasonal affective disorder. Interestingly, the nutritional supplement St. John’s wort, which has proven antidepressant effects, also lowers a cytokine known as IL-6, which is one of the chemicals that cause cellular inflammation and is involved with immune system activation. When its levels are normalized, bone density may be positively affected. It is unclear whether standard antidepressant medications also have this effect.

  ~ GET YOUR HORMONE LEVELS CHECKED. Many postmenopausal women have testosterone levels that are normal even for premenopausal women, making them much more resistant to osteoporosis without additional hormones. Some women also have estrogen levels that remain in the low-normal premenopausal range long after menopause. If this is the case, you won’t need to worry about taking a drug to support your bone mass.

  13

  Creating Breast Health

  Iremember the many evenings I sat in the labor-and-delivery area of the hospital with one of my midwife colleagues. Though her own children were nearly grown, this woman would sometimes clutch her chest when she heard a baby cry or saw a particularly adorable newborn. “My breasts are tingling so much, I feel as though I could nurse this child myself,” she would say at such moments.

  Breasts are both literally and symbolically a source of nurturance and pleasurable bonding. Their dual role is in part the result of two brain hormones known as prolactin and oxytocin. These hormones, which are activated during birth, keep the breasts full of milk and also enhance the process of bonding, so that when a mother breast-feeds, both prolactin and oxytocin facilitate the flow of both milk and love to the child. The mother in turn is rewarded not only with
pleasurable physical sensations, but with the emotional fulfillment that comes from providing for a being she deeply loves. Prolactin and oxytocin have such powerful effects that many women experience the letdown reflex, which fills the breasts with milk, even when they’re not actually nursing. Merely thinking about their child or hearing the child’s cries can set the reflex in motion.

  But prolactin and oxytocin secretion doesn’t occur only during breast-feeding. These two hormones have been found to increase in both men and women when they are involved in pleasurable, mutually beneficial relationships. Not surprisingly, the emotions of love and compassion, which nourish our very souls, are often accompanied by the same tingling sensation in the breasts that nursing mothers feel—and which my midwife colleague described so eloquently.

  I like to think of that tingling as proof that the “milk of human kindness” is more than a mere metaphor. Love is hardwired into our biology. That’s why nurturing and supporting others feels so good to most women, and why we so often find ourselves “mothering” others. When the emotion of love can flow freely, our bodies are filled with the same hormone that sustains all human bonds, and our breasts are bathed in the energy of health.

  OUR CULTURAL INHERITANCE:

  NURTURING VS. SELF-SACRIFICE

  Love has a healing, life-enhancing effect if our relationships are truly reciprocal, allowing us to receive as much as we give. But this ideal is not so common. Most women have been brought up to nurture others in ways that often require us to put our own well-being at risk. Throughout history, we women have been revered for our ability to sacrifice ourselves for the good of those around us. It is no wonder that Tammy Wynette’s song “Stand by Your Man” is one of the bestselling country songs of all time. But as it turns out, the man Tammy was standing by for much of her married life was beating her, which brings home very powerfully the degree to which our nurturing tendencies can tip the balance toward dangerous self-sacrifice.

  Our breasts are the part of our anatomy most identified with nurturing. And they are also perhaps the most highly charged area of our bodies, flagrantly exploited by the culture we live in as our most potent weapon in the battle to win the love and approval of a man. Powerful symbols, these breasts. In the movie Erin Brockovich the sassy legal-assistant heroine is asked by her astounded boss how she has managed, without any experience or training, to accumulate so much sensitive, damning information concerning a large utility company’s environmental pollution practices. Looking resplendently voluptuous in her overflowing bustier, actress Julia Roberts replies, “They’re called boobs, Ed.”

  No wonder one of my friends, when she heard I was getting a divorce, asked if I was going to get breast implants. Our culture leads us to believe that without a stunning new set of breasts, it would be impossible for a woman at midlife to attract a new man. What more vivid proof could we find of our need for love—and the lengths to which we are willing to go to get it?

  The Midlife Breast Challenge

  Midlife is when we hear the wake-up call that demands that we start honoring our own needs if we are to stay healthy and joyful. Our children are leaving home or long gone, the time for the kind of self-sacrifice demanded by raising a family is coming to an end, and we now have the opportunity to reexamine our lives. If we are involved in relationships that are getting in the way of self-realization, we need to think about how we can change them. Perimenopause challenges us to get real, to create relationships that are true partnerships with people who will love us for who we really are.

  Learning to form such mutually nurturing relationships, as part of a commitment to love and nurture ourselves on every level, will improve the health of every organ in the body. But the breasts are particularly likely to be affected, because the breasts are located in the fourth emotional center, which is associated with the ability to express joy, love, grief, and forgiveness, as well as anger and hostility. If those emotions are blocked, then the health of all the organs in the fourth emotional center, which include the lungs and heart as well as the breasts, may suffer.

  Forming loving relationships that nurture us, and nurturing ourselves directly through the choices we make about how we live our lives, can help us to create breast health. Such nurturing is not selfish; in fact, it allows us to have within us something that is worth giving to others. Here again we can look to breast-feeding for the wisdom inherent in our bodies. Both the quality and quantity of a mother’s milk are improved when the mother herself is well rested, well nourished, and happy. We need to remember this lesson at midlife, when the opportunity for transformation is boundless and the costs of turning our backs on it may be very high.

  Midlife Breast Pain

  Because of the hormonal changes associated with perimenopause, many women experience breast pain, especially during the second half of the menstrual cycle, from ovulation through the onset of menses. Often because of skipped ovulations and overstimulation by estrogen, breast pain comes and goes seemingly at random. This problem often subsides on its own and is not a sign of cancer. Dietary improvement, taking a good multivitamin, and adding iodine supplementation often quell the inflammation that causes the pain. (See chapter 6, “Foods and Supplements to Support the Change.”) Also, eating foods such as soy and flax can help. Breast expert Dixie Mills, M.D., finds that a sonogram is often very reassuring for women who are really worried.

  Many times breast pain is a sign that a woman needs to do some emotional updating. The following story is a wonderful example of the power of mind-body breast healing at midlife.

  CATHERINE: Fibrocystic Breasts

  Catherine had fibrocystic breasts that had hurt premenstrually for as long as she could remember. Around the time she turned forty, the pain and lumpiness increased to the point where she had only one pain-free week a month. She quit drinking caffeine, took every supplement she had heard might help, used castor oil packs, and regularly went for acupuncture treatments. She also saw an herbalist who created an herbal remedy just for Catherine. “My breasts were taking over my life!” she told me. Her doctor was sympathetic but said he wasn’t sure what else she could do that she wasn’t already doing and, trying to be reassuring, told her that as fibrocystic breasts go, hers weren’t all that bad.

  Then she went to visit her family for two weeks over Christmas. She was in such a rush taking care of last-minute shopping and errands before she left that she forgot to pack her supplements. “Without having to focus on pill-popping, rushing around to practitioners, or figuring out how to tactfully ask my friends about their breasts, I found that mine started hurting less,” she discovered. “But I knew that the fact that I wasn’t taking any supplements and was spending less time worrying about my breast pain was not causing the pain to go away. What I realized was that I needed to pay more attention to this problem on a different level.” She decided to take an inventory. In so doing, she realized that the pain had first come on strong during another family visit about four years ago. The trigger was a comment her uncle made in jest about her grandmother complaining about her breasts hurting all the time. “I was very close to my grandmother,” Catherine told me, “and my uncle and mother regularly made comments I perceived as negative about her, many of them in the context of how she and I had a special relationship—the subtext being that those negative comments they made about her were also meant to apply to me.”

  Catherine realized that while she had recognized her emotions on an intellectual level, she hadn’t really allowed herself to feel them completely. Remembering that one of her yoga instructors used to say, “In order to heal, you have to feel,” Catherine decided to dedicate her yoga and meditation practices to those emotional elements that might be contributing to her breast pain. “I literally dedicated my practices to my breasts!” she told me, and also to the practice of forgiveness, which is a wonderful tonic for all fourth-emotional-center manifestations (including breasts, lungs, heart, and shoulders). For the next several months, she let go of a lot of unsp
oken anger toward her family, much of it anger she had held in her whole life. And it worked. “While my family needs a lot more support from me lately due to my uncle going through the last stages of lung cancer and an incredible amount of drama surrounding this,” she reports, “my breasts are fine—no matter what I put into my body, caffeine included. Since I started letting go of the emotional baggage through forgiveness, my breasts have, in effect, forgiven me. It is truly a miracle.”

  BREAST CANCER RISK FACTORS

  Midlife is also the time when, statistically speaking, your chances of getting breast cancer are on the rise. In fact, for women living in industrialized societies, age is first on the list of established risk factors for breast cancer.1 But that’s only because age is generally associated with the cumulative risk of unhealthy lifestyle patterns. Remember—the vast majority of women don’t get breast cancer.

  ~ Age (over fifty years old; risk increases with age until eighty)

  ~ Early onset of menstruation (before age twelve)

  ~ Family history of breast cancer, in either a first-degree relative (mother, sister, daughter) or a second-degree relative (maternal or paternal aunt, grandmother)