Menopause, the hormonal change in a woman's body in which her menstrual cycle stops, can happen as early as before age 40, but most often occurs in women between age 45 and 55.
   Menopause actually occurs at the end of a woman's last menstrual period. However, that fact is established only later, when a woman has had no periods for at least 12 months. The average age at which menopause occurs is about 50 years, but menopause may occur normally in women as young as 40. Regular menstrual cycles may continue up to menopause, but usually the last periods tend to vary in duration and amount of flow.
 

Natural supplements for menopause treatment
In 2002, when the initial findings of a National Institutes of Health study, also known as the Women’s Health Initiative project, reported that women on conventional hormone therapy were at increased risk for heart disease, cancer, stroke and blood clotting, the market for alternative treatments soared. Approximately two-thirds of women develop perimenopause and menopause symptoms. Vasomotor symptoms are reported as the most common, followed by anxiety, mood changes such as sadness or depression, sleep disruption, body aches, and fatigue. Herbal alternatives to hormone replacement therapy are of increasing interest. Perimenopausal and postmenopausal women are among the highest biggest users of herbal and dietary supplements. Useful herbs include black cohosh (Cimicifuga racemosa), chasteberry, vitex (Vitex agnus-castus), dong quai (Angelica sinensis), ginseng (Panax ginseng), kava (Piper methysticum), kudzu (Pueraria mirifica), maca (Lepidium meyenii), red clover (Trifolium praetense), rhubarb (Rheum rhaponticum,) St. John’s wort (Hypericum perforatum,) burdock root (Arctium lappa), licorice root (Glycyrrhiza glabra), motherwort (Leonurus cardiaca), wild yam root (Dioscorea villosa), and pycnogenol.

Some Herbs and nutrients that may be helpful, but keep in mind that research on the role of herbs and menopause continues to be inconsistent and sometimes contradictory:

Red clover has been studied for menopause treatment
Black Cohosh root extract -  Black Cohosh is available at Physician Formulas
Chaste Berry extract -  Chaste Berry is available at Physician Formulas
Ginseng extract info by Ray Sahelian, M.D.

Menopause benefit from soy supplements, a possible alternative menopause treatment
Soy supplements that contain isoflavones do not seem to help lower cholesterol, boost bone density and keep the mind sharp after menopause, new research suggests. Isoflavones, compounds found in soybeans, chickpeas and other legumes, are similar to the female hormone estrogen. Because of this, researchers have been studying whether soy protein or supplements containing isoflavones might act as a sort of "natural" hormone replacement therapy, to counter the changes that often accompany the loss of estrogen in menopause.  However, the July 2004 Journal of the American Medical Association report suggests that this is not the case.

No benefit from red clover or black cohosh for hot flashes
Stacie Geller of the Chicago school enrolled 89 women with moderate to severe hot flashes in a randomized, double-blind clinical trial. The women, who experienced at least 35 hot flashes and night sweats per week, were followed for 12 months. Some of them were given black cohosh and red clover and were compared with others receiving the standard of care -- hormone therapy -- or a placebo. The study, published in Menopause, found the average number of hot flashes per week decreased 34 percent among those who took black cohosh, 57 percent for red clover, 63 percent for placebo and 94 percent for hormone therapy.I n the second study, 66 women were tested for memory. Stacie Geller found that none of the botanicals had either a beneficial or a detrimental effect on memory, but the hormone therapy Prempro had a slight negative impact on memory.

Exercise benefit for menopause
Moderate exercise like walking and yoga makes the transition through menopause a little easier.

Surgical menopause symptoms and consequences
Premenopausal women who undergo surgical removal of the ovaries (oophorectomy) have an increased risk of developing neurological disorders, including cognitive decline, dementia, and parkinsonism.

Menopause Symptoms
With age, the ovaries become progressively less responsive to stimulation by luteinizing hormone and follicle-stimulating hormone, which are secreted by the pituitary gland. Consequently, the ovaries secrete smaller and smaller amounts of estrogen and progesterone, and egg release (ovulation) eventually stops. During the time before menopause (technically called the climacteric, but more recently called perimenopause), symptoms may be nonexistent, mild, moderate, or severe. Hot flashes affect 75 percent of women. During a hot flash, the skin, especially on the head and neck, becomes red and warm (flushed), and perspiration may be profuse. Most women have hot flashes for more than a year, and 25 to 50 percent have them for more than 5 years. A hot flash lasts from 30 seconds to 5 minutes and may be followed by chills.

Psychological and emotional symptoms of menopause
Psychological and emotional symptoms -- fatigue, irritability, insomnia, and nervousness -- may be caused by the decrease in estrogen levels. Night sweats may disturb sleep, making fatigue and irritability worse. A woman occasionally may feel dizzy, have tingling sensations (pins and needles), and be unusually aware of her heartbeat, which may seem to be pounding. Loss of bladder control, inflammation of the bladder or vagina, and pain during intercourse because of vaginal dryness may also occur. Sometimes muscles and joints ache.

Hormone replacement therapy and menopause
Studies indicate that long term replacement with Premarin (horse derived estrogens) and synthetic progesterone increases the risk for heart disease, cancer, blood clots and gallbladder disease. 

Menopause hormone replacement therapy danger
Women who take hormone-replacement therapy pills for menopause symptoms more than double their risk of developing potentially fatal blood clots. The risk is significantly higher during the first year of treatment. Blood clots in the arteries are a common cause of heart attacks and strokes. Vein blood clots can kill if they move through the body to the lungs.

What is the opinion of the medical establishment?
The field of hormone or herbal therapy during or after menopause is very complicated and there is no consensus within the medical community regarding the best option for long term therapy. The medical community seems to be shifting its viewpoint on hormone replacement. It appears that most traditional doctors now prefer using low doses of hormones for a brief period of time to treat menopausal symptoms, but prefer not to continue hormone replacement therapy indefinitely as in the past.

Side effects of menopause hormone treatment
Hormone replacement therapy used to treat postmenopausal symptoms seems to accelerate the build-up of deposits in the coronary arteries of women who have abnormal glucose tolerance -- a sign of impending or full-blown diabetes.

Menopause emails
Q. "I'm not a beast when I take them," says my wife Jody. She is a 48 year old caucasian and has been going through menopause since Feb. of 2003. She refused to take hormones and struggled to get out of bed to face the day. Her energy level and the psychological were dismal; although, she has a great sense of humor and is an upbeat person. I began to search for a supplement to help her and assist in allowing a beautiful personality to emerge. She has been taking two Black Cohosh with one of the MP in the A.M. with great results. Side effects include: mental balance, coping ability, sexual drive and responsiveness, overall feeling of well being. When she ran out of pills for three days she digressed to unfounded inner rage and anxiety. She described the feeling as "ready to jump out of her skin."

Q. I very much appreciate the honest approach of your website and have purchase a DHEA supplement 5 mg doses. I need your help locating some general information on the best herbs available for menopause and low functioning adrenal glands. I have had severe allergies all my life, so my adrenals are poorly functioning, which leads to poor wound healing, bruising, and chronic hives. I am taking 10 mg of DHEA today (for about the last two weeks) that has helped tremendously, but I recognize the potential side effects. Any other solutions for these common menopause problems?
   A. Research with herbs and menopause is not consistent and difficult to interpret.

Q. Does 5htp help with menopause symptoms?
   A. 5HTP may help balance mood in some women with symptoms menopause.

Q. I am 46 and in peri menopause. To put it bluntly my vaginal area is pretty dry. I read that Schizandra is revered for promoting normal fluids for healthy sexual functioning. I currently use Progesterone Cream and nothing else.
   A. We are not familar with research regarding schisandra for vaginal dryness. Passion Rx works well for sexual functioning and many women like using half a capsule every other day. Please have your doctor's approval.

Q. I am going through menopause at the present time. I went off of a black cohosh supplement and starting taking SAM e for depression. I find that taking 400 mg a day is not enough and are still depressed and have hot flashes often. Can I take the black cohosh with SAM e for the hot flashes or should I increase the SAM e to 600 mg first? I realize the SAM e will not help the hot flashes, but I need to get the depression under control first. I can deal with the hot flashes.
   A. Please ask your doctor to read the page on depression and help you through this time of menopause symptoms and low mood with natural supplements.