Q: I’m dreading the Christmas and New Year party season as I’m going through the menopause – hot flushes and crowded rooms don’t really mix. Can you suggest anything that can help me deal with them?

A: Hot flushes are among the most common and uncomfortable symptoms of the menopause, but their frequency and severity can vary from woman to woman. Hot flushes occur because the brain decides the body is overheated so it does all it can to cool things down. Hormonal changes involving declining levels of the hormone oestrogen are thought to be the trigger.

 

There are a number of natural ways to help you avoid hot flushes and maintain hormone balance. The first step is to avoid situations and foods that are known to trigger hot flushes and these include:

 

• Spicy food (cayenne, ginger, pepper)

• Acidic foods (pickles, citrus, tomatoes)

• Hot drinks

• Caffeine (coffee, black tea, cola, chocolate)

• Alcoholic drinks, including wine and beer

• White sugar

• Stress

• Hot weather

• Hot tubs and saunas

• Tobacco or marijuana

 

Parties can often get overcrowded and stuffy so if you are going to one try not to stay in one room for long periods of time and if you can stay away from the radiators and try to grab some fresh air by standing close to a door or window or even taking a step outside. Don’t wear synthetic fabrics and avoid clothes with high necks and long sleeves.

 

Plant oestrogens known as phytoestrogens can help alleviate hot flushes so make sure you include plenty in your diet. Phytoestrogens are found in almost all fruit, vegetables and wholegrains but they are most beneficial when they are found in legumes, such as soya, lentil, peas and chickpeas.

 

Exercise directly decreases hot flushes by helping to balance hormones and by raising feel good endorphin levels.  As little as 20 minutes five times a week may reduce flushes significantly.

 

As far as supplements go you may want to try the following:

 

Vitamin C and boioflavonoids: Research has found that by strengthening capillaries these supplements in combination can ease hot flushes. Take 500mg of vitamin C twice a day.

 

Black cohosh is the herb of choice for menopausal symptoms with the most research behind it.

 

Dong quai has been found very helpful for menopausal problems such as regulation of hot flushes, and it is reported to help relieve mental and emotional upset.

 

Agnus castus (Vitex) has been found to affect pituitary function and has many uses, particularly in regulating hot flashes and dizziness.

 

Sage may also reduce the sweating associated with menopausal hot flushes but remember that hot flushes can also be triggered by stress and anxiety and stress and anxiety can be countered by herbs, like valerian, hops or chamomile, that support the nervous system.

 

(You can take a combination of all these herbs together in Black Cohosh Plus – see the Resources Page.)

 

Essential oils basil or thyme may ease hot flushes when inhaled or used in a bath or foot rub or mixed with massage oil. For a portable hot flush remedy, which may come in very handy when you are at a party, place a few drops of an essential oil on a tissue or cotton ball and place in plastic wrap. It may provide instant relief when you open and inhale any time a flush strikes.

Q: I have been diagnosed with an early menopause (early 40s) and have been told I have low bone density.  Is it possible to increase bone density in your opinion or just maintain the bone density you have and stop it getting worse?

A: This is one of those situations where it is ‘never too late’. You can always make improvements in bone density no matter what age you are, although for some women that increase may be smaller than others. It requires though a combination of approaches including dietary changes, vitamin and mineral supplementation and exercise. Obviously the sooner you can make changes the more chance of putting on a greater amount of bone density. 

First of all take a look at your diet and make sure that you are not consuming a lot of foods and drink that can deplete your bones because of their acid effect on the body. I have covered this aspect of bone helath in great detail in my book ‘Osteoporosis – the silent epidemic’.

One of calcium’s roles in the body is to act as a neutraliser. When you eat too much acid food your body calls up calcium reserves from your bones to counteract the acidity. We know that women who consume the most acid-producing diets have four times as many hip fractures as those whose diets are the least acid producing.  One of the most highly acid-forming substances, which cause most calcium to be leached from your bones, is protein, particularly in red meat. 

 

The best way to make your diet more alkaline is simply to aim to have more alkaline-forming foods (fruit and vegetables) each day than acid (animal protein) and choose good quality animal protein like fish or eggs. You also need to watch what you drink as caffeine causes you to lose calcium and soft fizzy drinks will also cause a leeching effect of calcium from the bones.

 

You need to add in certain vitamins and minerals to make sure that you are ‘feeding’ your bones.  The first nutrient that comes to mind is calcium. But many other nutrients are equally crucial for healthy bones, and these include magnesium, vitamin C, vitamin D, zinc and boron. 

 

• Calcium – is essential for bone health and not only improves bone density but also reduces the risk of fractures.  Choose supplements that contain calcium citrate rather than calcium carbonate.  Calcium carbonate is literally chalk and a difficult form of calcium to absorb.  Calcium citrate is almost 30% more absorbable than calcium carbonate.
• Magnesium – helps to metabolise calcium and converts vitamin D to the active form necessary to ensure that calcium is efficiently absorbed. 
• Vitamin D – one of the important ‘bone’ vitamins and it is now thought that having good levels of vitamin D is more important than calcium.
• Vitamin C – important in the manufacture of collagen, which is a sort of ‘cement’ that holds the bone matrix together.   Choose vitamin C as ascorbate rather than the acidic form – ascorbic acid.
• Boron – an important mineral in relation to osteoporosis as it plays a crucial part in the conversion of vitamin D into its active form, which, in turn, is necessary for calcium absorption.

 

(I use a good ‘bone’ supplement in the clinic called OsteoPlus which contains all of the above nutrients plus digestive enzymes for maximum absorption – see the Resources Page)

 

And last by no means least you musst include exercise. When it comes to bones and exercise, it is definitely a case of  ‘use it or lose it’. Use a combination of weight-bearing exercises like walking and dancing and weight resistance like bicep curls and lunges to creat mechanical stress which helps put calcium in the bones.

 

 

Lots of us have spent years thinking low fat but low fat is a big ‘no no’ when you are approaching the menopause when fat has never been more crucial for your health, your skin and your waist line. You just need to make sure you are eating the right kinds of fats.

Saturated fats, found in dairy products and meat can increase your risk of heart disease (which already goes up at menopause) and some cancers. You also need to avoid hydrogenated fats and oils in the form of fried, oxidised or transfats found in processed foods, margarines and fast food snacks as well as cakes, sweets and biscuits as they can increase your risk of heart disease and diabetes. But unsaturated fats found in olive oil and essential oils (EFAs) like omega 3 and 6 found in oily fish, nuts and seeds have a protective effect on your heart and will give you healthy hair, skin (less wrinkles) joints and improved brain function. EFAs also help keep your weight stable during the menopause, when there is a tendency to pile the pounds on especially around the waist, because they delay the passage of carbohydrates into your blood stream and keep blood sugar levels stable and insulin levels down. In fact EFAs are one of the best blood sugar stabilisers around and stable blood sugar levels means less likelihood of menopause related fatigue, mood swings, heart disease, depression and weight gain.

 

Take action

 

• To limit your intake of saturated fats reduce dairy products and eliminate or drastically reduce meat and eat fish and organic eggs instead.
• Trans fats should be avoided completely so you need to read the labels on products and don’t buy any which contain hydrogenated vegetable oils.  If you have been upping your intake of whole foods and fibre and cutting down on sugar and refined carbohydrates you may already have cut down on the transfats in your diet. Instead of margarine it would be better to go for a small amount of organic butter.
• Increase your intake of Omega 6 and especially Omega 3. You’re less likely to be deficient in Omega 6 because it is more common in Western diets and found in foods such as leafy green vegetables and soya, sunflower and sesame oils. Omega 3s are less common and found in the oils of cold water fish, such as mackerel, salmon, herring and sardine, as well as in hemp seeds, flaxseeds, nuts and seeds. 
• Aim to eat oily fish at least twice a week.  If you don’t eat fish you can eat sea vegetables (seaweeds) and up your intake of hemp and flax seeds. Flax and hemp seeds are a good source of omega 3. You might like to try a daily dose of 3 teaspoons of cold pressed flaxseed oil or three tablespoons or ground flax seed. You can also use hemp and flax seeds in salad dressings and smoothies. 
• Nuts such as walnuts, almonds, pecans, brazil and cashew and seeds such as pumpkin, sunflower, hemp and sesame are good sources of EFAs so try to eat a handful every day, perhaps as a snack between meals or sprinkled on your salad, soup or cereal. You can also use them in baking.
• If you are not keen on oily fish, then my recommendation is to add in a fish oil supplement with the oil taken from the body of the fish.  I would recommend that you do not use cod liver or halibut liver oil.  The liver is the waste disposal unit of the body and fish can accumulate toxins and mercury, which then have to pass through their livers.  Extracting the oil from the liver of the fish is likely to provide higher quantities of these toxins than the oil taken from the body of the fish.  (The fish oil I use in the clinic is taken from the body of the fish and is called Omega 3 Plus see the Resources Page.)