It is a daily occurrence in my clinic for women to ask me about menopause-related health issues. I was chatting to a patient the other day and it inspired this weeks BLOG. She was considering whether she should take hormone replacement therapy, and what the long-term effects might be. She asked how women in Asian countries deal with menopause, and if there are natural, safe alternatives to artificial hormone replacement.
For Chinese women, hot flashes and night sweats are uncommon experiences, and very few of them are ever put on hormone replacement therapy by their doctors. It is an interesting fact that only 10% of Asian women experience noticeable menopausal symptoms, compared with 75% of the women in the Australia. Why has this natural transitional period in a woman’s life become a dreaded event for Western women? What explains the difference between the typical Chinese woman’s experience of menopause and the typical Australian woman’s experience? These are important questions for women to ask, and for us health care professionals to answer.
Based on my study and observations, I would say that it is a combination of diet, acupuncture, and Chinese herbal medicine that is the determining factor in maintaining the health of Asian women through menopause.
The use of food as medicine is a basic idea in Chinese culture, and a fundamental principle in traditional Chinese medicine. Most people who have seriously studied the effect of diet on health are prepared to say that more than 75% of health problems are related to diet. Just consider that the three leading causes of death in this country - heart attack, cancer, and stroke - are all closely correlated with poor diet. For a Chinese medicine practitioner, evaluating the patient’s diet is a fundamental part of the diagnostic and treatment process. The deficiencies and imbalances that a patient has are taken into account, and recommendations are made regarding what foods to eat and what foods to avoid.
Some of the most interesting research for those concerned with women’s health issues has been done in the field of plant chemistry, and specifically in studies of chemicals called phytoestrogens. Phytoestrogens are chemicals produced by certain plants which resemble the estrogens that are produced by the human body, and which bind readily to estrogen receptors in the human body, but which are "weaker" forms of estrogen than human estrogen. Scientific studies suggest that higher levels of "strong" estrogen correlate with higher incidence of breast cancer in women. That is why women with a history of breast cancer, or a high risk of developing it are not recommended to be on hormone replacement therapy. Unfortunately, women in Western countries are exposed to higher levels of environmental estrogen than women in undeveloped countries. It is estimated that our environment adds 40% more "strong" (and harmful) estrogens to the body than are produced naturally. This could explain why the incidence of breast cancer is higher in developed countries, and is probably a complicating factor in many hormone-related conditions. The benefit of eating foods which are high in phytoestrogens, like soy beans, is that the "weak" estrogen of the plant binds to the body’s estrogen receptors, displacing the "strong" estrogens, which are then discharged harmlessly from the body.
Studies indicate that a diet rich in phytoestrogens can reduce the adverse symptoms associated with menopause. The phytoestrogens that are bound to the body’s estrogen receptors release slowly and naturally into the blood stream, providing a continuing source of estrogen as the body’s naturally-produced estrogen supply diminishes. As long as phytoestrogens are replenished by eating phytoestrogen-rich foods, there will be a safe, natural supply of estrogen to cushion a woman through the process of menopause and into her post-menopausal years. One study suggests that a diet high in soy could increase the number of cells in the vaginal epithelium, which would prevent the thinning of the vaginal wall. Although soy has never been a hugely popular food in the West, it is the richest source of phytoestrogens known, and it forms a major part of the typical Asian diet. Soy beans and soy food products like soymilk and tofu are eaten at every meal. The average Asian woman eats 50-60 grams of soy per day, compared with less than five grams eaten by an Australian woman. It is never too late to change over to a healthier way of eating, but it is true that soy foods have to be eaten in large quantities over a long period of time in order to receive the full benefit. A woman who wants a trouble-free menopause should begin to eat soy in her twenties or thirties. Included below is a recipe for a typical Chinese meal which utilises tofu and other healthy vegetables.
Chop finely: 2cm cube fresh ginger 2 cloves fresh garlic
Blend with: 2 tbsp. soy sauce Pour this over: 250grams firm tofu, cut in 2cm cubes (increase tofu to taste) Let this marinate while preparing vegetables below: 1 red capsicum, cut in triangles 3 - 4 fresh shiitake mushrooms, sliced (3 -5 dried) 1/2 cup snow peas Heat a wok with 1 Tbsp. oil Add capsicum, stir-fry one minute. Add mushrooms and snow peas, stir-fry one minute.
Add the tofu and marinade, stir-fry one minute, then cover and steam until hot.
Serve over brown rice.
For those women who are already experiencing the distress of hot flashes, night sweats, headaches, and insomnia, acupuncture and Chinese herbal formulas can provide a safe and effective way to achieve a trouble-free menopause.
To achieve the most effective level of treatment, acupuncture is combined with Chinese herbal medicine. There are very few women who don’t respond well to acupuncture treatments. Many feel an improvement after just a few sessions. A good example is Sue, a 53 year old school teacher who came to my clinic this summer. She began menopause early, at age 43, and was put on hormone replacement therapy by her doctor. Then she developed breast cancer and went through a mastectomy, chemotherapy, and radiation therapy. After that, her doctor wouldn’t resume hormone replacement therapy, and Sue’s menopausal symptoms became severe. She had daily headaches, night sweats, and hot flashes every twenty minutes. She was unable to sleep through the night, and had to get up to change her sweat-soaked nightgown at least once a night. Her emotions were volatile, and she became irritated or began crying under the slightest stress. When she came to see me, she was in great distress because she felt that it would be impossible for her to resume teaching in February. After her first acupuncture treatment, her hot flashes and sweating decreased noticeably, and she slept through the night for the first time in a year. After a month of twice-weekly treatments, the hot flashes, headaches, and night sweats were gone, and Sue began her teaching year. Now Sue comes in for treatments once or twice a month, to manage stress-related symptoms.
I am seeing more women who are referred by their gynecologists for acupuncture. The scientific evidence that corroborates the ancient practices of Traditional Chinese medicine is mounting up, giving women who want an alternative to hormone therapy real hope.
Most women in China are evaluated by a traditional Chinese medicine practitioner well before they reach menopause. In Chinese medicine theory, women with certain deficiencies or imbalances of the body are at risk to develop severe menopausal symptoms in the future. If a practitioner saw a younger woman who showed signs of Kidney Yin Deficiency, for example, he would project that she would be likely to have a difficult time at menopause unless the deficiency was corrected. Many of the most valuable Chinese herbal formulas are designed to be tonics for Qi, Blood, Yang, or Yin, and can be used on a regular basis with no adverse side effects. A woman who displayed symptoms of Yin Deficiency, such as insomnia or heart palpitations, would be recommended to take a Yin tonic formula. The practitioner can tell by the signs which internal organ is most affected by the deficiency, and will recommend a tonic which is formulated specifically for that organ. A time-tested formula for Kidney Yin Deficiency, often given to menopausal and pre-menopausal women is Kidney Yin Tonic (Rheumania Six Formula).
So let this give you hope that there are natural ways to decrease the likelihood of having a terrible transition into menopause and if you are already in the throes of it, a way to master Menopause.