Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.

– World Health Organization, 1948

This month’s case study is ‘Sally’ – who came to the Clinic because of Menopausal symptoms.

Sally’s story:

My periods stopped quite abruptly at the age of 48 and I was suddenly faced with hot flushes and night sweats. I visited my doctor because the night sweats were stopping me from sleeping which was really affecting my energy and mood. She ran some routine blood tests and told me I was going through the menopause. I was quite shocked as I thought the menopause was a gradual transition and that my periods would gradually wind down. She explained that there is no common pattern and with some women their periods just stop and with others the cycle becomes more irregular and then stops.

My doctor talked to me about HRT but I knew that this was something I never wanted to take – no matter how bad my symptoms were. I was prone to lumpy breasts (fortunately just benign) but had heard that HRT could make this worse. However, I knew I had to do something to help myself because the symptoms were impacting on my daily life.

I searched ‘Natural Menopause’ on the internet and it led me to Dr Marilyn Glenville’s website where I downloaded some very useful information and bought her book ‘The New Natural Alternatives to HRT’. It all made so much sense and actually made me feel really positive in the sense that I was actually embarking on a new chapter in my life rather than seeing it as the end of being a woman. This really inspired me.

Having read the book and taken on board the dietary recommendations and nutritional supplements I decided that I needed a bit more expert help and support so I phoned the Dr Marilyn Glenville Clinic from the number in the book. I spoke to a lovely receptionist who put me at ease and booked an appointment for me with one of Dr Glenville’s practitioners in the London clinic.

Before my first consultation I was sent a Nutrition Questionnaire that I was asked to complete and return one week in advance of my consultation to give the practitioner time to look through it before seeing me. This already felt very comforting to know as I always feel so rushed when I see my doctor and get the feeling that my case is never fully looked into.

The first consultation was one hour and the practitioner spent the first twenty minutes taking a full medical history and expanding on the information that I had given in the Nutrition Questionnaire. She explained more about the menopause and how it affects women differently in terms of age, the actual process of the periods stopping and the duration of the menopause.

My diet was given a lot of attention and the first observation was my intake of caffeine and alcohol – two drinks that are known to worsen hot flushes and night sweats as they widen the blood vessels. This brings more blood to the surface of the skin and thus a reddening occurs together with a hot flush and night sweat. I really loved my cups of coffee and glass of red wine, but I knew I had to make some compromises in order to feel well.

The second area to look at was my blood sugar and it was noted that I was eating very little protein in my diet and I was often skipping meals. She explained that something as basic as blood sugar imbalance can cause a flushing sensation as when blood drops to rock bottom, the adrenal glands release two stress hormones – cortisol and adrenaline and in combination they increase blood sugar and make us feel more alert and anxious.

This is particularly true of the early morning night sweats which she felt were more linked to my adrenals pushing out the stress hormones as opposed ‘to true’ menopausal sweats. She explained that by eating protein with each meal and having a small bedtime snack it would help to keep my sugar levels stable.

My practitioner also explained that because women are all so different, there is no one ‘blueprint’ in regards to dietary and supplement protocols. This meant that what was recommended in my first appointment may change along the way and would be modified if necessary. This made perfect sense and I knew that I had invested in my health for the long term and not just for a ‘quick fix’ or to give up if symptoms hadn’t improved in the first 6 weeks!

I was asked to complete a diet/symptom diary until my next appointment which really helped me keep focused. I gradually reduced my coffee and wine intake as recommended rather than simply going ‘cold turkey’ as my practitioner explained how addictive caffeine and alcohol is. I thought it would be really tough cutting the caffeine and alcohol down but once I started the programme it became much easier, plus within the first 3 weeks there was a marked improvement in my hot flushes and night sweats.

The small bedtime snack I was asked to incorporate seemed to really help my sleep pattern and I was no longer waking in the early hours feeling hot and sweaty. Because of this my energy was so much better and my mood was more stable.

I was eating a lot more vegetarian protein including chick peas and lentils and miso and flaxseeds (linseeds) which are rich in compounds called phytoestrogens. Apparently these are very weakly oestrogenic which means they help to ‘top up’ oestrogen levels which are naturally declining during the menopause. They are often referred to as ‘Mother Nature’s gift to women.’

Although they are approximately 1000 times weaker than our own hormone, over time they can make a huge difference. Before the consultation I had never eaten these foods, let alone heard of some of them and now this was second nature to me.

Alongside the dietary changes I was taking vitamins and minerals and an herbal formula containing Black Cohosh, Agnus Castus, Dong Quai, Red Sage and Milk Thistle (called Black Cohosh Plus). This was specifically for the hot flushes and sweats and in combination with the improved diet it was remarkable.

At my follow up consultation my diet was reviewed and a few more useful tips were given and my supplement programme was reviewed. We agreed to have another consultation in 12 weeks to give me more time to get into the programme. This felt reassuring that I would be monitored and not just left to my own devices.

I’m so pleased that I didn’t get tempted into taking HRT and the rewards to my health from visiting the Dr Marilyn Glenville Clinic have been tremendous. I now go through the day without having to carry a fan and at night my husband also gets to sleep because I’m not throwing the duvet off or opening a window every hour! Thank you.

Marilyn’s Comments:

It is often so easy to take the ‘quick fix solution’ and take HRT because for some women they are looking for instant relief and of course HRT is associated with preserving our youth. However, if our body is healthy, through a good diet and taking scientifically tested nutrients and herbs, the menopause can happen smoothly and comfortably.

Sally’s story demonstrates just how effective nutritional therapy can be for women going through the menopause. We see women at the clinic who have tried HRT and are unhappy on it, or like Sally, simply don’t want to take HRT or those who are still on it and desperately trying to ‘wean’ themselves off.

The ‘change of life’ is a gradual process allowing our body to get used to changes and to adapt accordingly. It is a new beginning and not the end.

If Sally’s story has resonated with you, do get in touch and see how we can help.

Black cohosh (Cimicifuga racemosa), a member of the buttercup family, is a perennial plant that is native to North America. Other common names include black snakeroot, bugbane, bugwort, rattle root, rattle top, rattle weed, and macrotys. Insects avoid it, which accounts for some of these common names.

Black cohosh was used in North American Indian medicine for malaise, gynaecological disorders, kidney disorders, malaria, rheumatism, and sore throat. It was also used for colds, cough, constipation, hives, and backache and to induce lactation for breast feeding. In 19th-century America, black cohosh was a home remedy used for rheumatism and fever, as a diuretic, and to bring on menstruation. It was extremely popular among a group of alternative practitioners who called black cohosh “macrotys” and prescribed it for rheumatism, lung conditions, neurological conditions, and conditions that affected women’s reproductive organs (including menstrual problems, inflammation of the womb or ovaries, infertility, threatened miscarriage, and relief of labour pains)

Today black cohosh is known primarily as an herbal treatment for hot flushes and other menopausal symptoms, but does it work and is it safe?

The possibility that black cohosh exhibits hormone balancing estrogenic activity has been studied but the evidence is contradictory. Let’s examine the research on how well it works for menopausal symptoms. In a study of 704 women, 49% of the women who took the preparation experienced complete relief of menopausal symptoms (hot flushes, sweating, headache, vertigo, heart palpitation, and ringing in the ears.) An additional 37.8% reported significant improvement. According to the physicians who participated in the study, 72% of the women who took the black cohosh treatment experienced advantages over those given hormonal treatment.

In another controlled study, of 629 women with menopausal complaints who took a black cohosh twice a day, 76 to 93% had an overall improvement in hot flushes, headache, irritability, heart palpitations, mild depression and sleep disturbances. The reduction in headache, sleep disturbances and heart palpitations is understandable because black cohosh also contains a small amount of salicylic acid (used to make aspirin) that has anti-inflammatory and pain-relieving qualities.

You may have read some recent negative information on black cohosh.  In 2006, The Medicines and Healthcare products Regulatory Agency’s (MHRA) cited 14 cases of women with liver problems that were “possibly” or “probably” linked to black cohosh.  When the European Medicines Agency (EMEA), reviewed all the evidence worldwide, it concluded that, in fact, there were only two “possible” and two “probable” cases and that it is not clear whether black cohosh caused the problem.  These four cases are such a small number when weighed up against an estimated 9 million treatment days of black cohosh used each year. 

The National Institutes of Health in the US believes there’s no case to answer and their website states that black cohosh has few side effects and that ‘liver damage has been reported in a few individuals using black cohosh, but millions of people have taken the herb without apparent adverse health effects.  There is no scientific evidence to show that the herb causes liver damage.’ 

Also worryingly, researchers have found that some black cohosh products on the market contain an Asian species of black cohosh which is cheaper than the North American black cohosh.  Compared with the species cultivated in North America, the Asian variety has different chemical properties and may have different effects on the body.  So I would still recommend that you use black cohosh as the herb of choice for the menopause symptoms but make sure that you buy from reputable companies so that you know you are getting the best quality herb and preferably buy organic. (for a good organic black cohosh formula – see Resources Page).

If you have hot flushes, night sweats, vaginal dryness or itching, depression, or bone loss due to natural or surgically-induced menopause, black cohosh is an herb that you may want to consider. We know that black cohosh is effective for the symptoms of the menopause and a recent study (April 2007) in the International Journal of Cancer has shown that black cohosh may halve the risk of breast cancer.  So this herb can be doubly beneficial for women around the menopause.