The Natural Menopause Advice Service (NMAS) has been set up to provide insights, information and services which may help women passing through this stage of life. This new leaflet and an accompanying series of Fact Sheets, outline choices. NMAS details some useful additional steps, which can be taken to help one through a menopause naturally as well as providing information on other choices such as Hormone Replacement Therapy (HRT).

What is the menopause?

The word Menopause comes from the Greek 'meno', meaning month with 'pausis' meaning 'ending'. Strictly speaking the 'menopause' refers to one date, the last day of the final period. The term is commonly used though to refer to the time before, during and after this event. It is a time when women may experience many changes hence the menopause is often called "the change".

It is not a disease

This is simply a natural stage in every woman's physical and emotional development. A time when her body ceases to be fertile because ovulation stops. A time when oestrogen and progesterone levels decrease as monthly periods end.

For many women this happens between the age of 45 and 55. As with menstruation the menopause is a very personal experience. Many women sail through this time. But others, as is increasingly the clinical observation of many doctors, particularly those who had a very stressful decade in their 30's may experience considerable discomfort and disruption. Problems can continue for many years.

Rather a metamorphosis

Perhaps this is how women should best regard this time, as a change for the better as they leave behind constant anxieties about another pregnancy and the trials of the monthly period. No longer bound by biology but rather what happens to our bodies. So just what does one have to do to emerge as the free from menstruation wise woman? Can this be accomplished naturally?

A brief look at the problems the menopause may bring

Oestrogen and progesterone are the two primary sex hormones which work as partners in different ways during the various stages of a woman's cycle. During her fertile years ovulation normally occurs each month. After the period oestrogen levels start to rise and, once ovulation has taken place, progesterone levels also increase in order to prepare the body for pregnancy.

In the years leading up to the menopause, however, ovulation gradually becomes less frequent and less efficient with the output of these hormones diminishing. This can cause irregular periods. When menopause is reached ovulation ceases and both oestrogen and progesterone levels fall. Because these are completely normal stages for the body to go through, and changes take place over a number of years, most women's bodies are able to adapt. Nutritional balance is important at this time and if stress levels are high this can compound problems.

Some of the most common problems associated with the menopause include:

• hot flushes
• night sweats
• depression
• insomnia
• fatigue
• irritability
• headaches
• pain in the joints
• heart palpitations
• vaginal dryness
• weight gain
• poor concentration/memory

Hot flushes, night sweats and palpitations are thought to be experienced by 70% of women for a year. Around 30% suffer for five years and 5% to 10% of women find the problem persists for 10 years. A long haul for some.

Other lifestyle changes also often occur in a woman's life at this time, children leave home and elderly parents need care making it quite possible for the menopause to mistakenly be blamed for other emotional symptoms that such stress can cause. Many women in their 40's and 50's today also lead higher profile lives at work, whilst still running a home and being more active in the community than their parents' generation. This adds further pressures at a potentially vulnerable time.

Finding ways to cope

The role of nutrition

Most women recognise that a healthy diet should always form the basis for good nutrition. However increasingly busy lives, where home and family has to be balanced with work, can create anxieties. This stress load can quickly deplete the body of essential nutrients, such as vitamin C and magnesium at a time when busy women have less time to focus on their diets.

Food is the body's fuel

High quality fuel helps the body perform at its best. The best way to access the vitamins and minerals needed is to eat a balanced, healthy diet. Avoid smoking, reduce intake of alcohol, caffeine, refined sugar, soft drinks and keep salt to a minimum. Try to reduce levels of animal protein, especially red meat, but include oily fish, white meat and vegetarian sources of protein such as pulses, nuts, seeds and beans. Try to eat more nutrient-rich fresh fruit and vegetables every day together with complex carbohydrates such as wholegrain cereals, pasta, rice, beans and legumes.

Plant-oestrogens can help too

Recent research has shown that plant-oestrogens can help relieve symptoms of the menopause. These natural substances, similar to oestrogen, are found in more than 200 plants. Some good plant sources are linseeds, soya protein and clover extracts for example.

Cope with confidence

Some women may wish to individually tailor their intake of additional natural vitamin supplements whilst others may find it convenient to take a balanced all in one formulation. One such supplement is Confiance, a vitamin and mineral supplement formulated specifically for women going through the menopause and beyond. This is one way to rapidly ensure a good supply of essential nutrients on a daily basis. The minerals magnesium and boron in combination with B vitamins, vitamin E and other nutrients are known to be helpful in maintaining hormone balance.

HRT - Pros and Cons

Traditionally, Balanced HRT involves the medical replacement of oestrogen, usually in combination with synthetic progestogens unless there has been a hysterectomy. It is shown to prevent existing osteoporosis from deteriorating and is claimed by some to reduce the risk of heart disease. Balancing oestrogen and progesterone is important too. Often it is progesterone levels which plummet to zero whilst the average oestrogen drop stabilises at one half or a third of former levels. Applying a natural progesterone cream, like Oestra, can be very helpful in redressing this balance.

Side effects of HRT

Side effects can include a slightly increased risk of uterine and breast cancers, thrombosis, digestive problems, headaches, hair loss, joint pains, memory loss, weight gain and depression. While HRT works for many women, others simply cannot tolerate it and, for some women with certain medical conditions, the risks and benefits of HRT need to be carefully evaluated.

Other choices

For those who elect not to enter into long-term hormone treatment there are other choices. Non-medicinal action, such as improving nutrition and lifestyle can be very beneficial. Also a variety of other alternative therapies is on offer such as acupuncture, reflexology, homeopathy, herbalism, acupressure, aromatherapy, osteopathy and chiropractic. There is a wealth of choice but it is important to find a reputable practitioner by contacting the association representing the natural therapy you want to try.

Harley Place Screening

Simple, easy to access tests can help to assess nutritional status, hormone balance and bone density. Sometimes it is difficult to decide exactly which course of action to take without knowing exactly what the problem areas may be. It is now possible though to have a hair sample analysed to check on mineral status, making it easier to select the correct nutritional supplements to address specific needs. Analysis of a urine sample can help give an indication of bone metabolism whilst a saliva test can be used to assess hormone levels and balance. Harley Place Screening offers a number of these tests, several of which, can be arranged from home. An interpretation of each individual test is provided when the results are returned.

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