Q: For the past two years I suffered from agonisingly heavy periods. My doctor has suggested a hysterectomy, should I go ahead with it?

A: A hysterectomy is a surgical procedure in which a woman’s womb and sometimes her ovaries are removed. Every year thousands of women undergo hysterectomies and the most common cause for this is heavy periods, but in my opinion the too-frequent removal of a fundamental part of a woman’s body is nothing short of scandalous. Of course, there are times when this surgery is necessary, e.g. cancer, but with other problems it is better to see whether there are other ways of managing the problem.

 

Doctors are trained to offer their patients solutions and a hysterectomy is an immediate solution to the problem of heavy periods, whereas less invasive treatments may take longer to be effective. It may well turn out that you do need a hysterectomy for legitimate medical reasons, but before you make this big decision I strongly urge you to investigate other options. The only time I feel a hysterectomy should be an option is if you have cancer and your life is at stake. In all other instances (including heavy periods, and fibroids – another common reason for a hysterectomy) ask yourself the following questions before you consider a hysterectomy:

• Do I really need this procedure?
• Are the symptoms affecting the quality of my life to the extent that I can’t do the things I want to do?
• Have I tried all the alternative medical treatments?
• Have I tried the natural approach?
• Am I planning to start a family or to have more children?
• Am I ready to deal with the symptoms of sudden early menopause?

A hysterectomy is not an easy option. It’s major surgery that requires a lengthy stay in hospital, incisions, general anaesthesia and painful days and weeks after. It can also trigger sudden and unexpected physical, sexual and psychological changes; and if the ovaries are also removed a woman will have to deal overnight with the symptoms of early menopause. Not to mention the irreversible fact that she will no longer be able to have children. And, even if you do not have your ovaries removed, a hysterectomy may still cause a woman to have an early menopause. Many women just want to have the surgery but they don’t take into account the hot flushes, vaginal dryness, mood swings, forgetfulness, headaches, muscle and joint pain and other symptoms of menopause that may result. Women who undergo hysterectomy can also experience urinary incontinence, as well as deepening of the voice and weight gain. All these physical changes are the result of declining oestrogen levels.

 

About 20 per cent of hysterectomies are for heavy bleeding, but in my opinion a hysterectomy should never be considered as a treatment for this condition as natural therapies can be highly effective – as can a less invasive procedure called endometrial ablation, in which the lining of the womb is removed but the womb is left intact.

 

In next month’s issue there’s a feature on natural ways to treat heavy periods so be sure to read that. In the meantime avoid coffee and alcohol, which can increase menstrual flow, and make sure you eat plenty of hormone-balancing phytoestrogens (found in soya, legumes and wholegrains) and essential fatty acids (found in oily fish, nuts and flaxseeds), which increase the amount of beneficial prostaglandins that can reduce blood flow. You also need to cut down on red meat and dairy produce because a diet rich in saturated fat can encourage the production of excess oestrogen, which increases menstrual flow.

 

Remember, a hysterectomy is often an overkill solution to problems that have other viable treatment options; so if your doctor has recommended it to you and you don’t feel right about it, ask what your alternatives are and if need be get a second, third or even a fourth opinion. Take all the time you need to make the decision. In the great majority of cases, especially when heavy periods are the case, there is no rush.

As we age we all become more vulnerable to certain health conditions, but there are plenty of natural ways to prevent them so you can live your life to the full. Whatever your age, the following natural well being plan will help you control some of the most common age-related problems.

Your 40s

 

Sleep problems

Sleeplessness is more likely to occur in your 40s when the hormonal changes of the menopause approach and this can increase your risk of stress, anxiety and fatigue. Along with a healthy diet and regular exercise studies have shown that a quality night’s sleep is essential for weight management, hormone balance and good health in general.

 

To encourage a good night’s sleep boost your calcium and magnesium intake by eating more green leafy vegetables, whole grains, nuts and seeds during the day. Calcium and magnesium work together and are often described as ‘nature’s tranquilisers.’ You may also want to try a little herbal help with valerian, which, along with passion flower and hops, is known for its sleep-inducing and calming qualities.

 

Try to get at least 30 minutes exercise in the fresh air as natural daylight and activity can result in 50 percent improvement in sleep patterns. It can also help to make sure your bedtime routine is relaxing. Have a warm bath with aromatherapy oils to wind down and avoid drinking caffeine during the afternoon and evening. Don’t take your worries to bed. Make a list of things you need to think about tomorrow. If you still can’t get to sleep don’t lie there tossing and turning and clock watching – get up and do something relaxing, such as listening to calming music, until you feel sleepy.

 

Lack of energy

Many women over the age of 45 say they suffer from tiredness and as you enter your 40s you may start to find your energy levels dropping. As we age, metabolic and physiological changes can impact on your body’s energy levels, causing fatigue. But this doesn’t mean you can’t do anything about it. With the right diet and exercise plan and a positive mind set, many women in their 40s – and beyond – feel more energetic than ever. Take the actress Meryl Streep, for example, anyone who saw her singing, dancing, and leaping around in the movie ‘Mama Mia’ would have found it hard to believe she is a year shy of 60.

 

In the next few issues I’ll be giving you more advice about natural ways to boost your energy levels, but for now the most important things you can do are to exercise more and cut down on caffeine and sugar. Regular exercise is essential for keeping your energy levels up. Caffeine and sugar may give you an instant hit but they’ll leave you feeling tired and depleted in the long run. A healthy, balanced diet is crucial as nutritional deficiencies can trigger fatigue (see also the article on ‘Eating for energy’) and you could also benefit from supplementing with a daily multivitamin and mineral, especially one that contains vitamin B12, which is known to boost energy. Choose a multivitamin and mineral that is designed for leading up to and through the menopause, the one I use in the clinic is called Menoplus. Herb wise, ginseng is the ultimate energy booster. Several trials have shown it to be effective in alleviating the symptoms of low energy but for women it is better to use Siberian ginseng rather than any other kind of ginseng, otherwise the effects can be too strong and some women found they were having palpitations. (See the Resources Page for information on the supplements and herbs).

 

Peri-menopause and menopause

During your 40s you are most likely to experience the symptoms of peri menopause. This occurs when your ovaries have reduced egg supply and they gradually cease to produce the female hormone oestrogen. Perimenopause can occur as early as five to ten years before the actual menopause, which is most likely to occur in your early 50s. The symptoms of perimenopause are lighter but mirror those of the menopause and include irregular periods, hot flushes, mood swings, weight gain and insomnia.

 

If you’re experiencing hot flushes, avoid clothes made from synthetic fabrics and wear layers instead to keep warm. Use bedclothes made from cotton and layers rather than a big duvet. Watch what you eat and drink – a hot drink before bedtime can often trigger night sweats or make them worse. Other triggers include caffeine, alcohol and spicy foods. And although it may make you feel hotter and sweatier in the short term, women who exercise regularly seem to have fewer flushes.

 

There are a number of natural therapies to choose from if you are in the early stages of peri-menopause. Phytoestrogens are hormone like substances that act like a weaker version of oestrogen and can help balance fluctuating hormones. They are present in foods like soya, legumes and linseeds (flaxseeds). The herb sage is known to be helpful at the menopause and black cohosh has shown to be effective for the hot flushes and night sweats. The ancient Chinese herb dong quai can also help balance hormones. (I think a combination of herbs is often more effective than single herbs so I use one called Black Cohosh Plus in the clinic. This contains black cohosh, dong quai, sage and milk thistle – see the Resources Page).

 

Bowel cancer

Over the age of forty your risk of bowel cancer increases. To find out how simple diet and lifestyle changes can reduce your risk of getting it, refer to the article ‘Bowel cancer: How to protect yourself’ in this issue.

 

Your 50s

 

Concentration and memory

In your 50s you may find that words and putting names to faces sometimes eludes you. Age does tend to affect our ability to store and retrieve information, but try not to panic. It’s very unlikely that this is an early sign of dementia. Doctors have recently confirmed that forgetfulness is a perfectly normal stage of ageing, just like greying hair. It may even be of benefit to avoid cluttering your mind with too much information. For example, you may forget where your spectacles are but you won’t forget what they are or what they are for! 

 

So instead of worrying about remembering – which just makes it harder to remember – take simple steps to help you remember things that you often forget. For example, put your keys in the same place every time and use visual association to help you remember names. For instance, if a woman you are introduced to is called Elizabeth, picture her standing beside Queen Elizabeth or Helen Mirren. It also helps to keep your mind active.

 

Just as your body needs regular exercise, your brain needs regular exercise too. Keep it fit by playing cards and chess games, reading books, doing crosswords, learning an instrument or new language or by pursuing a new hobby. The supplement ginkgo biloba is recommended for its memory boosting properties – studies show that taking this herb on a regular basis can improve concentration powers (see the Resources Page).

 

High blood pressure

High blood pressure or hypertension is becoming increasingly common with age and after the menopause women no longer have the protective effect of oestrogen. It is estimated that as many as one in four women over the age of 50 may have high blood pressure and if it is not controlled it can put incredible strain on your heart and arteries and increase your risk of stroke and diabetes. Symptoms include frequent headaches, dizziness or blurred vision, but worryingly it can often manifest without symptoms.

 

To reduce your risk of age related high blood pressure, cut down on your salt intake. Eating too much salt can send blood pressure soaring. The recommended maximum intake of salt per day is 6 grams so try replacing salt in cooking with herbs and spices for seasoning. And take note of hidden salt in foods – the British Heart Association estimates that three quarters of the salt we eat may come from processed foods and even basic foods such as white bread and cereals contain salt, so be sure to read food labels carefully.

 

Taking regular exercise will lower your blood pressure and will also help you to lose weight but you should also be sure to eat a healthy, balanced diet. Five portions of fruit and vegetables a day are a must. You should steer clear of saturated fats, added sugar and refined foods as these can increase the amount of cholesterol in your blood; the higher your cholesterol the greater your risk of high blood pressure, heart disease and stroke.

 

Potassium intake can also help lower blood pressure – foods rich in this mineral include dried apricots, pulses and nuts. And the minerals magnesium (found in brazil nuts, sunflower seeds and soya beans) and calcium (found in dairy products and green leafy vegetables) have also been shown to lower blood pressure. The herb ginger has traditionally been used to help lower blood pressure. Garlic is also recommended for general heart health. You can take both ginger and garlic in supplement form if you think you can’t get enough with your food. I would recommend a specific form of garlic called Aged Garlic which is organically gown and odourless, but more importantly it is cold aged for 20 months which results in a more potent garlic. Co-enzyme Q10 is a vitamin-like substance contained in nearly every cell of your body. It is important for energy production and normal carbohydrate metabolism. Deficiency in co-enzyme Q10 can occur with ageing. In one randomised double-blind trial patients with high blood pressure who were taking blood pressure medication were given co-enzyme Q10. On the Q10 they had lower blood pressure and their HDL (‘good’ cholesterol) increased.  (See the Resources Page for information on supplements and herbs).

 

Osteoporosis

As many as one in two women will develop osteoporosis over the age of 50, because loss of bone density speeds up after the menopause as oestrogen levels decline. Many women aren’t aware that their bones are thinning dangerously until they get a broken bone after a minor bump or fall. But the good news is that osteoporosis can often be prevented and treated with natural therapies if detected early enough.

 

The first step is to give up smoking and to avoid passive smoking as both these can have a weakening effect on the bones. It is also vital to make sure that you don’t drink more than 10 units of alcohol a week, as alcohol depletes your body of bone-building nutrients. Calcium is bone food and it is found in dairy products, green leafy vegetables, sesame seeds, beans and dried fruit. You can also take it in supplement form, usually in combination with magnesium and vitamin D, which helps aid its absorption. Regular weight bearing exercise such as brisk walking, aerobics and jogging helps to strengthen bones and you should aim for at least five sessions a week for a minimum of 30 minutes. (For more detail on the prevention and treatment of Osteoporosis see my book ‘Osteoporosis – the silent epidemic’.)

 

Your 60s

 

Diabetes

As you age your body’s ability to deal with glucose (energy from food) declines and this decline increases your risk of diabetes. As many as eight out of ten people with diabetes are overweight, so eat a healthy diet and exercise regularly to keep your weight down. Studies have shown that women who exercise for 30 minutes a day and eat a diet low in trans fatty acids (found in hydrogenated vegetable oils and processed foods, such as biscuits and margarine) and high in fibre (found in wholegrains, fruits and vegetables), reduce their risk of diabetes by up to 90 percent. So eat a diet rich in fruit and vegetables, wholegrains, brown rice and pasta and choose monosaturated oils, such as olive oil, rather than trans fatty acids found in processed foods.

 

Diverticular disease and IBS

After the age of 60, diverticular disease, which is an inflammation of the intestines, is increasingly common, although many people don’t realise that they have it. Symptoms include constipation, diarrhoea, abdominal pain, fever and vomiting. IBS (irritable bowel syndrome) has similar symptoms. The exact cause isn’t known, but it is thought that stress and anxiety can be triggers.

 

Avoiding large meals, spicy foods, caffeine and alcohol, increasing fibre intake, and drinking plenty of water can all help. Relaxation is especially important. Certain supplements may also help keep your digestive system healthy and these include peppermint oil, which has an anti-spasmodic effect; artichoke extract which can reduce symptoms of bloating and probiotics (e.g. BioKult), which can replace healthy bacteria in the colon and ease digestive problems.

 

If you are experiencing any changes in your bowel motions, then it is important to see your doctor for a check up. 

 

Arthritis

Your risk of developing arthritis increases as you get older because arthritis is a wear and tear disease. Millions of people suffer from arthritis in the UK and the majority of them are over the age of 60, but it is certainly not inevitable.  

 

It is important to keep as flexible and mobile as possible – so gentle exercise, such as swimming, is a good idea. You should also keep pressure off your joints. As always, a healthy diet rich in fruit and vegetables and omega 3, found in oily fish, nuts and seeds, is essential for healthy joints.

 

Many arthritis sufferers find that the supplement bromelain eases inflammation. Bromelain is a natural enzyme found in pineapples. Omega 3 fish oils have an anti-inflammatory effect and can sometimes work as well as prescription drugs to ease pain. Make sure you get a fish oil with high levels of EPA and DHA, the one I use in the clinic (Omega 3 Plus) contains 700mg EPA and 500mg DHA from just two capsules a day. Ginger has also been found to have anti-inflammatory properties and glucosamine is an amino acid found naturally in your body’s cartilage that may help with joint repair. I find that the combination of MSM and glucosamine seems to work even better than either glucosamine on its own or combined with chondrotin (see MSM Plus on the Resources Page). 

 

As far as herbs go, boswellia and turmeric can also be extremely helpful for joint pains. Apple cider vinegar is also often recommended for arthritis as, contrary to what one might think, it actually helps the body to be more alkaline, so reducing inflammation. 

You might have thought you’d left breakouts behind with teenage angst. Then suddenly your skin starts to erupt again. Falling oestrogen levels, which mean that testosterone can be more dominant, are to blame. Stress can also be a trigger. You may notice that your spots cluster around the lower part of your face. They may appear as angry red lumps, rather than ‘pop-able’ pimples and since adult pimples are darker than teen pimples the ensuing discolouration can last a few weeks. Prescription drugs should be your last resort as they won’t help address the real cause of the problem. Try to identify the trigger factors. If it’s stress aim for eight hours sleep a night and take time out each day for meditation, yoga or other forms of relaxation.

The following natural remedies may help keep the blemishes under control:

• It’s especially important that you include plenty of phytoestrogens in your diet, found in soya, nuts and legumes. Phytoestrogens can help your body control the amount of testosterone circulating in your blood. Vitamin B6, zinc and essential fatty acids have also been shown to be beneficial.
• If you notice any dietary triggers for acne, avoid those foods. You should also watch your intake of alcohol, sugar, processed food, salt, butter, caffeine, chocolate, fried foods, meat, margarine, wheat, soft drinks and food containing hydrogenated vegetables oils.
• To ease inflammation or prevent infection, eat lots of garlic. Garlic is a powerful antibiotic. Grate it on your food or take it as a supplement every day. (See Aged Garlic on the Resources Page)
• Sulphur-rich foods, such as eggs, onions and live yogurt with bifidus and acidophilus bacteria, help to rebalance the bacteria in your gut and can help protect against skin inflammation. You could also take a probiotic (e.g. BioKult), I would not recommend the probiotic drinks as they are often loaded with sugar. 
• Regular exercise is helpful because it encourages hormonal balance and healthy blood flow to your face to help flush out toxins.
• Heavy cosmetics and rich moisturisers can clog your pores so use a lighter lotion on your trouble zones. Avoid abrasive scrubs. They do not remove dead skin, but they can cause infection and make acne worse. Never pick or squeeze spots – this can cause scarring.
• Tea-tree oil has good antiseptic, anti-bacterial and anti-fungal properties. Use it to dab onto your spots. A study conducted by the Department of Dermatology of the Royal Prince Alfred Hospital in New South Wales, Australia, found a 5 per cent solution of tea tree oil was as effective as a 5 per cent solution of benzoyl peroxide for most cases of acne, and had no side effects.
• Pure aloe vera gel is antibacterial and soothing. Some women find that dabbing it on their acne every day really helps. For angry inflamed spots or acne, witch hazel is cooling and soothing. Dab directly on the acne. Echinacea is one of nature’s most powerful antibiotics. Dab a tincture or cream on the affected skin daily.
• If your doctor tells you that you have higher than normal androgen (male hormone) levels, the herb saw palmetto can work as an anti-androgen and this can also be helpful for pre-menstrual acne. Perhaps the most helpful herb though is Agnus Castus. Other beneficial herbs include burdock root, red clover and milk thistle which are powerful blood cleansers.
• Light therapy, which involves shining different types of light on the acne, from UV to simply coloured light can help. Red lights have been shown to open capillaries and boost circulation while blue light closes them. Ask a dermatologist for advice.