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Holistic Health’s Female Focus

What are the top women’s health risks? According to the Centers for Disease Control and Prevention, (CDC) the leading causes of death in females in the United States are heart disease, cancer and stroke.

Another way of answering this question depends on their age group. Tori Hudson, ND, who serves on the scientific advisory board for Gaia Herbs (North Carolina), said teenagers are often concerned with skin and weight, and perhaps contraception and STDs. PMS, menstrual cramps, headaches and mood are also on the list. Twenty- to 30- something women are often facing issues of contraception, fertility, pelvic pain and STDs. In their 40s, many women become more urgent about their fertility, but irregular menses, pelvic pain, weight gain, insomnia, mood and anxiety disorders also rank as areas of concern. For women in their 50s, menopause symptoms dominate the attention of many, including hot flashes, insomnia, mood changes, low libido and more.

“Primary care issues begin to demand more attention and from here on, the top women’s health concerns appear to be— along with heart disease and breast cancer— osteoporosis, depression and autoimmune disease,” Dr. Hudson added. “For almost all age groups though, [weight issues] and obesity has taken the lead as a top women’s health concern, increasing the risk of heart disease, type 2 diabetes, several cancers and premature death.”

Causes

Though serious, women can take control of their health in many instances. “If we take the top five in general, lifestyle has links to all of them, but especially heart disease,” Dr. Hudson said. “Each of these top five has their own risk factors though. For heart disease, key risk factors include smoking, being overweight, type 2 diabetes, high blood pressure, high cholesterol, increasing age, physical inactivity, heredity and increasing age. For breast cancer, the American Cancer Society lists the following as risk factors: increasing age, genetic mutations in certain genes, a first degree relative with breast cancer, Caucasian race, a previous breast biopsy, previous chest radiation, never having had children, the onset of menstruation prior to age 12 or menopause after age 55, consuming more than seven alcohol drinks/week, obesity and the use of DES” (diethylstilbestrol).”

The two most significant risk factors for osteoporosis in women include increasing age and weighing less than 127 pounds, Dr. Hudson continued. Moderate risk factors include a personal history of a postmenopausal fracture and a mother with a history of a hip fracture; weaker but important risk factors include Caucasian race, early menopause, insufficient calcium intake, currently Smoking, excess alcohol and lack of exercise.

Many in Menopause

Lara Armstrong, ND, is principle medical blogger on behalf of From The Earth Naturally Ltd. In Alberta, Canada for the Menomission (www.menomission.com) website, which is dedicated to a community of women aged 40 years and up. She pointed out that 37.5 million women are currently reaching or are in menopause in the U.S., while eight million women in the U.S. are living with heart disease.

“By definition, menopause is the natural process in which cessation of menses occurs for one year in women, ranging in age from 45 to 55 years,” said Dr. Armstrong. “This change in a woman’s ovarian function and the symptoms that she can experience with this change can last anywhere from six to 13 years.

“As naturopathic treatment can include a number of modalities, every naturopath would approach a woman in menopause differently,” she continued. “We use diet and lifestyle, botanical medicine, homeopathy, Chinese medicine and acupuncture, and nutritional supplementation as the main approaches to treatment. These approaches will not stop the process of menopause, but rather ease the transition through this rite of passage for women.”

Diet and lifestyle can make a huge difference in the way a woman’s body adjusts to menopause, noted Dr. Armstrong. “There are many foods that women can add to their diet or eliminate in order to help improve symptoms associated with menopause.Many women can attest to certain foods that can trigger hot flashes.” Alcohol and caffeine are the top two consumables that will bring on a hot flash for a number of women, and a diet that is high in meat has also been shown to worsen symptoms of menopause. “It is well known that in countries such as Japan, where the diet is higher in plant-based foods, women tend to experience less symptoms associated with menopause. These women also have a diet that is rich in soy foods (phytoestrogens) and have half the rate of breast cancer compared to the U.S.”

Foods that are high in indole-3-carbinol can be very beneficial for women in perimenopause in order to improve the balance between estrogen and progesterone. These foods include broccoli, brussels sprouts, cabbage, kale and cauliflower.

Exercise can have a profound effect on mood, aids in improving body composition and can decrease symptoms of menopause (hot flashes, depression, anxiety and mood swings) significantly, noted Dr. Armstrong.“Getting into a good exercise program where the body is challenged will provide benefits beyond alleviating symptoms of menopause.

Having good sleep hygiene is also essential to decreasing severity of menopause-associated symptoms.”

Natural Transition

Addressing menopause, Holly Lucille, ND, a lecturer, educator and author who holds a position on the American Association of Naturopathic Physicians board of directors and is on the faculty of the Global Medicine Education Foundation, said her message is that it is not a disease but a phase of a woman’s life that has been medicalized and pathologized for decades, “almost to the point where women unconsciously blame menopause for many of the symptoms they are experiencing.My point with both is that these are normal hormonal transitions and shouldn’t be as symptomatic as they are for some.”

Restoring function is a priority in Dr. Lucille’s view. “Looking at lifestyle, diet,history,horemone imbalances,hydration,sleep,strees,adrenal function,thyroid,etc., can help a practitioner understand a root cause, and then slowly sometimes, but surely,increase the quality of life and health and decrease symptoms. Most of these cases are mulitifications in natre when it comes treatment approach not a one tricky pony or silver bullet.”

While the fluction and decline of reprocuctive hormones is a normal and expected event in mid-life women, the associated symptoms are nonetheless disruptive, noted Dr. Lucille. “Until very recently, millions of women alleviated their hot flashes and right sweats with conjugated equine estogens and medroxyprogesterone acetate (synthetic hormone replacement therapy, or HRT). However, mounting evidence from several clinical trials has shown that women using synthetic HRT are significant increased risk of developing breast cancer, coronary heart disease, pulmonary embilism and stroke.

“With little room for HRT in current practice and little else in the traditional medicine chest to consider, physicians are increasingly turning to natural non-hormonal therapies for women who need relief from menopausal symptoms,” Dr. Lucille explained. “As a naturopathic physician, I have used botanical medicines and other natural alternatives for many years with great success to help women create and maintain hormonal health. I’ve found the most effective approach combines stress management, diet, exercise and nutritional supplements to support and work with a woman’s body, not against it.”

Botanical Medicine

There are many herbs that can be used to alleviate the symptoms associated with menopause. Dr. Armstrong offered a few recommendations:

• Hypericum perforatum (St.John’s wort): This is a botanical that has a long history of use in menopause. In particular, it is used to improve mood issues that occur during menopause (anxiety, depression, mood swings) and has been shown to improve hot flashes, especially when used in combination with Cimicifuga racemosa.

• Rhodiola rosea (rhodiola): This herb is considered an adaptogen, which refers to the herb’s ability to increase the body’s resistance to stressors such as exhaustion, fatigue, aging, illness and acute stress. It is used traditionally in this manner to prevent fatigue and enhance physical and mental performance.It also has an action on adrenal function and can reduce cortisol levels and prevent depletion from the adrenal glands.

“Maintaining proper adrenal function during menopause is imperative, as these glands will be the sole producers of hormones once the ovaries no longer produce estrogen and progesterone,” said Dr. Armstrong. “If a woman has good adrenal function, she will tend to have less symptoms and a smoother transition through menopause compared to a woman who has poor adrenal function.”

• Cimicifuga racemosa (black cohosh): Well known for its use in treating menopausal symptoms, cimicifuga has been shown to decrease the frequency and intensi Intensity of hot flashes and has shown to improve psychological complaints. It can also provide some benefit for vaginal dryness.

• Trifolium partense (red clover): Trifolium is a source of isoflavones, which have been shown to aid in decreasing hot flashes. Soy is also an excellent source of isoflavones.

“We strongly suggest that when choosing a product, several reputable sources should be checked for the biological actions within the body,” said Anita Dyrbye, co-founder and CEO of From the Earth Naturally Ltd.“There are four sources we suggest: Pubmed, Natural Standards monographs, the American Journal of Medicine and the monographs listed with the Natural Health Products Directorate of Canada (NHPD).All four of these have listings of individual botanicals as well as combinations and clinical data to support the biological effects on the body.We can confidently say that each of these four sources have reference to the four botanical ingredients in our product VIVACA for menopause.”

In addition, California-based Metagenics offers Estrovera, which contains Err 731, a phytoestrogen extract from Rheum rhaponticum L. (Siberian rhubarb).Multiple clinical studies have demonstrated that Err 731 offers significantly effective relief for the 11 most common menopausal symptoms, including hot flashes. Users have reported symptom reduction that continues over three to 24 months without unwanted side effects.

Err 731 does not contain estrogen; its phytoestrogens are selective estrogen receptor‚Err 731 does not contain estrogen; its phytoestrogens are selective estrogen receptor ‚ (ER‚) agonists and have no effects on ER‚.ER‚, which mediates the anxiolytic and antidepressant effects of estrogen, has been suggested to alleviate menopausal symptoms.ER‚ also negatively regulates ER` and may therefore protect against unwanted ER`- mediated effects in the breast and endometrium.

Studying Women’s Health

Good news for women is there are hundreds, if not thousands, of recent health studies examining women’s health issues, said Dr. Hudson, who cited three noteworthy examples:

• Lipovac M, Chedraui P, Gruenhut C, et al. Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts. Maturitas 2010;65:258-261.

One hundred and nine postmenopausal women were randomly assigned to take either two capsules daily of a red clover extract totaling 80 mg of isoflavones, or a placebo, for three months.

After taking the red clover extract, women had a significant reduction (improvement) in the scores in both of the rating scales, with a 75 percent reduction for anxiety and 78. 3 percent reduction for depression using the HADS tool, and an 80.6 percent reduction in the total SDS score. After taking the placebo pills, the HADS and SDS scores only reduced by an average of 21.7 percent.

• LascoA, Catalano A, Benvenga S. Improvement of Primary Dysmenorrhea Caused by a Single Oral Dose of Vitamin D: Results of a Randomized, Double-blind, Placebo-Controlled Study. Arch Intern Med. 2012;172(4):366-367.

Something as simple as vitamin D can help some with menstrual cramps. A recent study included 40 women ages 18 to 40 years who had menstrual cramps for at least four consecutive months within the previous six months and who had a blood level of vitamin D < 45 ng/mL.

Women were randomized to receive a single high dose of vitamin D of 300,000 IU or placebo five days before the anticipated onset of their next menstrual period. The primary measured outcome was the intensity of the menstrual pain and the secondary outcome was the use of NSAIDS. After two months/two menstrual periods, the pain scores decreased 41 percent in the vitamin D group and there was no difference in the placebo group. The greatest reduction in pain was seen in the women in the vitamin D group who had the most severe pain at baseline.

• Caan B, Natarajan L, Parker B, et al. Soy food consumption and breast cancer prognosis. Cancer Epidemiol Biomarkers Prev 2011;20(5):854-858.

Data from Women’s Healthy Eating and Living (WHEL) was used to examine the effect of soy intake on breast cancer prognosis in 3,088 breast cancer survivors. These women were early stage breast cancer patients who were followed for an average of 7. 3 years. Soy isoflavone intakes were measured after the diagnosis with a food frequency questionnaire. The association between soy intake and breast cancer recurrence and/or death was then tracked.

As soy isoflavone intake increased, the risk of death decreased.Women at the highest levels of soy isoflavone intake (> 16.3 mg isoflavones/day) had a 54 percent reduction in risk of death.

References:

Jody Godfrey Meisler, MS, RD, “Soy: The Bean Most Likely to Succeed in Fending Off Cancer, Heart Disease,” Environmental Nutrition, May 1994.

Burghardt M. Exercise at menopause: a critical difference. Medscape Womens Health.1999 Jan-Feb; 4(1):1.

Elavsky S, Gonzales JU, Proctor DN, Williams N, Henderson VW. Effects of physical activity on vasomotor symptoms: examination using objective and subjective measures.Menopause. June 2012.

Hormone Disruption & Detox

Marianne Marchese, ND, a clinician, author and educator based in Arizona, said she considers breast cancer, endometriosis, thyroid disorder, polycystic ovarian syndrome, uterine fibroids and infertility the top women’s health concerns.

“The main theme with all these conditions is hormones.Whether it is thyroid hormone, estrogen, progesterone, testosterone or cortisol, hormone imbalance plays a role in the etiology and pathogenesis of these conditions. But it is not just a woman’s own production of hormones, but exogenous hormones play a role as well,” said Dr.Marchese, noting that examples of exogenous hormones are hormonal forms of contraception, menopausal hormone replacement therapy and environmental hormones. Environmental sources of hormones and chemicals in the environment that mimic hormones are often overlooked by physicians and a cause of women’s health conditions.

The exposure to chemicals comes from numerous sources including pesticides on found on fruits and vegetables, non-organic meat and dairy products tainted with dioxins, fish that have high levels of mercury and pesticides, as well as bisphenol-A and phthalates in plastic items, unfiltered well water and city water, household cleaning products, cosmetics, perfumes, dry cleaning, carpet, vinyl floors and more.

“I have found that the first step needs to be removing exogenous sources of hormones including educating the patient on how to avoid chemicals in their food, air water, cosmetics and other products.Dietary changes include eating only organic foods to avoid hormones, pesticides and other chemicals. Next, the body’s ability to metabolize hormones in the liver and excrete the metabolites through the kidney and bowel must be supported. This process is called detoxification.

“The basic principle behind detoxification is to remove the toxins stored in the body.Once they are released, they will re-enter the blood stream and will be metabolized through the liver,” said Dr.Marchese. “This is where it is critical to support liver phaseone and phase-two detoxification pathways. Next, the organs of elimination need to be supported to get the toxic byproducts produced from the liver out of the body.” 

Nutrients to support liver phase one and phase two enzymatic pathways include vitamins A, C, D and E, all of the B vitamins, calcium and magnesium, zinc and copper, molybdenum, kelp and iodine, selenium, choline and inositol. Other nutrients to consider include whey protein, green tea, curcumin, arcticum root, taraxacum root, silymarin, beetroot, artichoke, calcium-Dglucarate, N-acetylcysteine, alpha lipoic acid and folic acid.

According to the CDC, the leading causes of death in females in the U.S. are heart disease, cancer and stroke.

In countries where the diet is higher in plant-based foods, women tend to experience less symptoms associated with menopause.

Environmental sources of hormones and chemicals that mimic hormones are often overlooked by physicians and a cause of women’s health conditions.

FOR MORE INFORMATION:

CDC, www.cdc.gov  

From the Earth Naturally, (780) 418-0948, www.fromtheearthnaturally.com  

Gaia Herbs, (800) 831-7780, www.gaiaherbs.com  

Metagenics, (800) 692-9400, www.metagenics.com