Q: What is the best herbal product for a lady with low bone density who has been diagnosed with an early menopause at 42 years?  She wants to try and get her periods back. 

A: If there is no medical reason for the early menopause, it is well worth following a nutritional approach to try and get the periods back. A while back a lady of 40 came into the clinic because her periods had stopped suddenly and she was getting hot flushes.  She had been to see her doctor and blood tests showed she was menopausal. I asked her what had been happening around the time that her periods ceased and she said that she had been made redundant and had also lost her father.

I explained that the aim would be to ensure that she was as healthy as possible, addressing any problems with her diet, checking out any vitamin and mineral deficiencies, working on her stress levels and using some herbs to help balance her hormones. Within a couple of months, her periods returned and a further test at her doctors showed that she was no longer ‘menopausal’.

During times of stress, the body starts to shut down the reproductive system in order to give that woman the resources she needs to cope with what is going on.

Agnus castus is very much the herb of choice when trying to bring back periods as it has a balancing effect on hormones.  (The one I would suggest is Agnus Castus Plus which also contains other helpful herbs – see Resources the Page).

The term peri-menopause is a recent one and it simply refers to the eight or so years before the menopause when your periods finally stop for good.  So, as the average age for menopause in the UK is 51, for most women the peri-menopause begins in the early 40s, but it can begin as early as 35, especially if you have had a later pregnancy.

Peri means ‘around’ and the peri-menopause is a time of fairly subtle hormonal changes that start to become more obvious as you approach the menopause. If you have any health conditions such as PMS, irregular periods or migraines, you may find that declining levels of oestrogen aggravates these conditions. You may have your first hot flush or night sweat during this time and hear yourself saying ‘Is it hot in here or just me?’ You may also feel tired and find it hard to concentrate or feel irritable or anxious for no reason.  In addition, the peri-menopause is a time when many women experience weight gain (especially around the middle) and find attempts to loss weight near futile. You may, for example, be eating the same foods and exercising the same but find that instead of maintaining or losing weight as before your weight is slowly creeping up.

 

Are you in the peri-menopause?

If you tick five or more of the following symptoms the chances are you are in the peri-menopause:

 

• Have your periods changed? Have they become irregular or has your cycle got shorter?
• Are you irritable, bloating and craving sweet foods just before your period?
• Are you getting headaches?
• Are you finding it hard to sleep?
• Have you had any hot flushes or night sweats?
• Are you having mood swings?
• Do you have frequent memory lapses?
• Have you noticed a reduction in vaginal secretions?
• Have you noticed that your hair is thinner?
• Is your skin drier, more sensitive or spot prone?
• Are you finding it harder than ever to lose weight?

 

There are a number of good reasons why weight loss is harder during the  peri-menopause. First of all as you get older your growth hormone levels decline and muscle is gradually replaced by fat. This affects your metabolic rate – the rate at which your body burns calories and the less muscle you have the lower your metabolism. But that’s not all. Your body starts to hang onto fat because it is a source of the sex hormone oestrogen, which your body is gradually making less of from the ovaries as you approach the menopause. And if you find that most of your weight gain is around your middle this is because your body can manufacture oestrogen from the fat cells stored around your waist. It really wants to keep this fat so you may find that the hardest place of all to lose weight is your belly.

 

And if you’ve gone on a strict diet to lose weight this could make things even worse because fad diets encourage you to cut out certain food groups or restrict calories and don’t give your body the nutrients it needs to kick start your metabolism and help you lose weight in the long term. You may get an initial weight loss but this is mainly muscle and water and as soon as you start eating normally again you’ll gain all the weight back again as fat – along with saggy skin. Not to mention the fact that if you eat unhealthily you risk heart disease, osteoporosis and even cancer.

 

For most of us the peri-menopause is a tougher ride than the menopause and life beyond and you are not imagining it – it is harder to lose weight than ever before. Fortunately it is not impossible to lose weight. What you need are some new diet rules – because the old ones don’t work anymore – that can not only help your body adjust to lower levels of oestrogen so that any symptoms of the peri-menopause subside but also give your body the foods it needs to shed pounds, boost your energy and fight the effects of gravity.

 

Your peri-menopause diet rules

 

1)       Boost your metabolism

Physical activity is necessary to effectively maintain a constant body weight with increasing age and doing more exercise is the best way to boost your metabolism and encourage weight loss during the peri-menopause. Exercise also builds muscle and muscle burns more calories than fat even when you aren’t exercising. Weight bearing exercise like brisk walking and jogging are two excellent exercise choices that cost little more than a good pair of shoes and comfortable clothing.

 

During the peri-menopause I recommend at least 30 minutes aerobic exercise a day, five times weekly and two to three weight training (resistance) sessions a week. And during the day, try to fidget more. Research has shown that people who can’t sit still burn an extra 350 calories a day so tap your feet and wriggle more in your chair.

 

You’ll also need to drink plenty of water to keep your metabolism boosted, especially if you are doing a lot of exercise. Drinking at least 6 to 8 glasses of water a day can help boost your metabolism by at least 30 per cent according to scientists. 

 

2)       Don’t go on a diet

 

Although this feature is called the peri-menopause diet it isn’t really a diet but a healthy eating plan to transform the way you eat so that you can enjoy healthy, delicious food that will keep you looking and feeling younger and slimmer. You may have spent years focusing on losing weight but if you can change the focus to healthy eating your whole relationship with food will change and weight loss will be a natural result.

 

Healthy eating does mean cutting out sugary and fatty foods but thinking about sugary and fatty foods as major causes of weight gain, wrinkles, diabetes, weight gain and heart disease is a fantastic motivator. This doesn’t mean you can’t eat any of these foods it just means following my 80/20 rule. If you eat healthily 80 per cent of the time you can let go for the other 20 per cent.

 

3)       Eat more often

 

You should be eating five to six times a day – breakfast, lunch and dinner plus a mid morning and mid afternoon snack in between. If your mum told you not to snack between meals, she was wrong.

 

Snacking can help you lose weight because it reminds your body that you are not starving and there is a regular supply of food. If you go for long periods without a meal (over three hours) your body will slow down your metabolism because it thinks starvation is around the corner. Snacking can also keep your blood sugar levels steady – unstable blood sugar levels cause many symptoms of the peri-menopause such as mood swings and irregular periods. If your blood sugar levels are stable this will keep your hormone levels balanced, your periods regular, your mood stable and your weight down.

 

When I say snack I don’t mean chocolate or cake or a cup of coffee as sugar and fatty food and caffeine are peri-menopause diet no nos. Try healthy snacking instead with, for example, some antioxidant rich fruit with a few mood balancing nuts and seeds or a hormone regulating humus on a craving busting oat cake.

 

4)       Forget low fat

 

Eating a low fat diet can speed up the age4ing process. Fats and oils provide essential anti-inflammatory protection, which is crucial for wrinkle free skin. They also help keep your blood sugar and your hormones balanced which is essential for regular periods and weight loss.

 

Fat is crucial for your health and for smooth skin over the age of 40 but it must be the right kind of fat. Saturated and trans fats increase your risk of heart disease – which already goes up at the menopause – and some cancers. But healthy essential fats like omega 3 and 6 found in nuts, seeds and oily fish will give you healthy hair, skin, joint, heart and hormone balance.

 

I would strongly advise you to ditch low fat diet foods as they are often packed with sugar, salt or artificial sweeteners to replace the flavour and texture of the fat. And lots of sugar means blood sugar lows that spark cravings, give you wrinkles (sugar disrupts skin’s collagen production and makes you age faster) and up your risk of health problems like obesity (sugar that isn’t burned off is stored as fat) and diabetes.

 

5)       Slow down the sugar release

 

Eating foods that release their energy content slowly gives you a sustained release of energy and helps balance your blood sugar levels to stop you feeling hungry and to protect you against food cravings. Steady blood sugar levels can also encourage hormone balance, which is crucial for easing symptoms of the peri-menopause and encouraging weight loss.

 

Foods high in sugar or white flour enter your blood stream far too quickly and can cause wild blood sugar swings and food cravings so you need to go for foods that give you a sustained energy release. You can use complicated GI tables to help you work out the impact of certain foods on your blood sugar levels but a good rule of thumb is to go for whole grains, fruits and vegetables, legumes, nuts and seeds and other foods that are natural and unprocessed. In general the more refined a food is the more likely it is to cause blood sugar swings.

 

Eating protein with every meal or snack will also help slow down the release of sugar so that you don’t get food cravings. So have a few nuts with a piece of fruit, beans with rice (go for brown rice where possible) or potatos, an egg or cottage cheese with wholemeal toast. Another great way to slow down the sugar release is to choose higher fibre options whenever you can so always go for wholemeal bread and pasta and brown rice instead of white.

 

6)       Get your phytoestrogens

 

Eat lots of phytoestrogen rich beans e.g. soya, chickpeas, lentils, kidney beans etc. which can help balance your hormones which in turn will help ease your symptoms and encourage weight loss. Phytoestrogens can have a dramatic effect on the symptoms of the peri-menopause and every woman over 40 should ensure she is getting enough.

 

Phytoestrogens are substances found in foods that have a similar chemical structure to the oestrogen your body produces, and this may explain their hormone balancing effect. Studies show that they can not only take the place of natural oestrogens and increase oestrogen levels when they are too low but they can also reduce them when they are too high. Although research has tended to focus on soya, which is a fine source of phytoestrogen there are plenty of other forms such as linseeds, wholegrains such as brown rice, oats and legumes such as chickpeas and lentils. Fennel, garlic, celery, parsley and hops are also phytoestrogens. Vegetables, in particular green leafy or cruciferous vegetables such as broccoli, cabbage and brussel sprouts have been shown to have hormone balancing and anti-cancer properties, are another great source of phytoestrogens. Other sources of phytoestrogen include herbs such as cinnamon, sage, hops, fennel and parsley and seeds including linseeds, sesame, pumpkin, poppy, caraway and sunflower.

 

If you are avoiding processed and refined foods, eating a whole food diet with plenty of vegetables and fruit and making sure you are getting enough healthy fat and protein, the chances are you’ll be getting a good amount of antioxidants, phytoestrogens and all the other good things you need to help balance your hormones at the peri-menopause, beat your symptoms and lose weight.

There are women who are lucky enough to sail through the menopause with few or no symptoms but for others the hormonal changes that typically occur in our late forties and early fifties are a source of misery.

Hot flushes during the day can be embarrassing and exhausting to cope with. You may also wake up in the middle of the night drenched in sweat. Vaginal dryness can lead to loss of interest in sex and headaches and concentration problems can disrupt your daily routine. Fortunately, all these unwanted symptoms can be easily dealt with by making simple and natural diet and lifestyle changes.

 

Follow my advice below for easing the transition through the menopause and for beating specific symptoms of menopause and the chances are you’ll be one of those lucky women gliding through the menopause and having the time of her life.

 

Easing the transition with diet and exercise

 

First of all eat a healthy balanced diet rich in fresh fruits, vegetables, oily fish, nuts, seeds, legumes and whole grains. Drink eight glasses of water a day and avoid sugar, caffeine, alcohol and all refined or processed food. You should also eat plenty of phytoestrogens, substances which have a mild oestrogenic action and occur naturally in plants. Phytoestrogens have hormone balancing properties and can help relieve your symptoms and reduce your increased risk of heart disease, breast cancer and osteoporosis. Great sources of phytoestrogens include soya, flaxseeds (linseeds), lentils, chickpeas, sunflower, pumpkin and sesame seeds.  Aim for around 100 mg of phytoestrogen rich food a day. In addition to a healthy diet as an insurance policy, a good quality multivitamin and mineral designed for the menopause is advised to guard against nutritional deficiencies that can contribute to hormonal imbalance. (see MenoPlus on the Resources Page).

 

Regular exercise is a must at the menopause to help balance your hormones, prevent osteoporosis and boost your mood and your immunity. Aim for 30 minutes each day five times a week. Best choices include brisk walking, swimming, dancing, jogging and aerobics. It also helps to spend at least 20 minutes a day relaxing because high levels of stress are known to trigger symptoms, such as hot flushes.

 

Beating specific symptoms

 

Hot flushes and night sweats: These are caused by a lack of oestrogen that may affect your hypothalamus – the region of your brain that controls body temperature. To help yourself, try the following:

• Take long, slow and deep breaths to calm yourself down when you feel a hot flush coming on.
• Wear several layers of clothes made of natural fibres so you can remove them if you get too hot.
• Eat little and often and avoid spicy food. Large meals and spicy foods can sometimes bring on a flush.
• Herbal remedies that can offer relief include black cohosh, sage and dong quai (see Black Cohosh Plus on the Resources Page).

 

Painful sex: Lack of oestrogen at the menopause causes a decrease in the mucous producing cells that keep the walls of the vagina lubricated and the result is that sex becomes painful.

To help yourself, try the following:

• Pelvic floor exercises to strengthen your pelvic muscles and keep your vagina healthy. To find out which muscles you need to use, stop urinating mid stream by contracting your muscles; these are your pelvic floor muscles. Use them to perform the Kegel exercises: contract and hold for a count of five and then relax. Repeat 10 times at least five times a day.
• Have more sex as regular sex and lots of foreplay can help vaginal lubrication.
• Acidophilus inserted vaginally can help prevent yeast infection (see Intrafresh on the Resources Page).
• Use a natural lubricant like Sylk or Yes that does not contain chemicals you would not want inserted into the vagina. 

 

Headaches: These are common during the menopause and may be the result of changing body temperature and hormones, fatigue due to hot flushes or general stress and anxiety.

To help yourself, try the following:

• Complementary therapies such as massage, acupuncture and aromatherapy that can help ease headache pain.
• Missing meals can trigger headaches so eat little and often.
• Make sure you are drinking enough liquid.
• Have a snack before you go to bed to avoid swings in blood sugar during the night that can trigger a headache.
• Make sure your diet is rich in magnesium as deficiency can trigger headaches. Good food sources include leafy green vegetables, nuts and seeds and whole grains.
• The herb fever few may be beneficial for headaches and migraines.

 

Dry skin and wrinkles: This is due to the effect of lowered oestrogen on the skin’s main structural protein which keeps it firm and supple, collagen.

To help yourself, try the following:

• Make sure your skin is well moisturised day and night.
• Drink at least six glasses of water or herb teas a day to keep your skin hydrated.
• Eat plenty of oily fish such as salmon. Oily fish is rich in omega 3 fatty acids which help keep your skin soft and smooth.
• Takevitamin C 1,000mg as it helps in the manufacture of collagen.

  

Aching joints: Declining levels of oestrogen can cause aching joints.

To help yourself, try the following:

• Eat plenty of foods rich in omega 3 fatty acids, such as oily fish, nuts and seeds as these foods help create anti-inflammatory prostaglandins that can ease the pain and inflammation of swollen joints. Also take a good fish oil supplement like Omega 3 Plus (see the Resources Page).
• Try a heating pad or soaking in a warm bath for 30 minutes to increase the blood flow to the muscles. Try adding valerian essential oil to the bath water.
• Use a supplement containing both MSM and glucosamine to help keep the joints flexible and reduce pain.  (See MSM Plus on the Resources Page).
• Ginger baths, soaks and compresses may bring soothing relief to sore, aching joints.

 

Irritability: Feeling tearful or irritable is a common menopausal symptom that is probably caused by hormonal changes.

To help yourself, try the following:

• Relaxation techniques such as meditation or calming complementary therapies like yoga.
• Talk to friends and loved ones about how you feel.
• Don’t leave more than three hours between meals and snacks as long gaps between meals can trigger mood swings and irritability.
• Get at least 15 minutes a day of fresh air and natural daylight as sunlight is vital for physical and emotional health.
• Herbal remedies that can help with menopausal emotional distress include St John’s Wort and Agnus Castus. 

 

Insomnia: Common causes include stress and night sweats. It is important to have good quality sleep because once you sleep better your mood and your concentration will improve and you will have more energy the next day.

To help yourself, try the following:

• Get up at roughly the same time each day. If you need to catch up on your sleep go to bed earlier. Getting up late can unsettle your body clock and give you symptoms of jet lag without the holiday.
• Avoid watching, reading or listening to anything too stimulating before you go to bed. Soothing music is ideal.
• Lavender is a well known sleep remedy. Try using a lavender sleep pillow or put a few drops on essential oil on a cotton ball of handkerchief and tuck it into your pillow.
• Valerian root has been used for centuries to induce sleep. Other herbs include catnip and chamomile.