What Are the Alternatives to ERT?

A word of caution here, however. If you wish to explore how vitamins and minerals may relieve some of your symptoms, be sure that you take the time to understand their properties and what they can do for you, and discuss your ideas with your physician or with a qualified nutritionist. Appropriate dosage is essential as well, since overdosing can have toxic effects. This is a perfect example of a case in which too much can be as bad, or even worse, than too little. Remember, too, that these recommendations may not protect you from postmenopausal osteoporosis. Your physician can direct you in this regard.

I know that Vitamin E helped me to control hot flashes even though there are no conclusive scientific studies to support that fact. I took 800 milligrams per day 400 in the morning and 400 before bed for a number of years to stop the night sweats that I thought were stress-induced (that’s years before the realization of menopause crashed upon me in 1985). A friendly health-food-store owner had suggested Vitamin E to me. She said I could consider taking up to 1,200 IU (Inter-inational Units) per day, but no higher. I checked with my doctor, who said, Why not try it? I still take Vitamin E each day, limiting it to 400 IUs in the morning with breakfast I no longer need more than that.

Dr. Lark credits Vitamin E with the ability not only to relieve hot flashes and vaginal dryness, but also to alleviate some psychological symptoms, such as mood swings, fatigue, and anxiety, when taken along with other appropriate nutrients like potassium, magnesium, the B vitamins, and bioflavonoids. Vitamin E has been studied for its ability to reduce breast cysts. Some studies, such as the one at Johns Hopkins School of Medicine reported in the Journal of the American Medical Association way back in September 1980, suggest that it is helpful in this regard. Other studies suggest that Vitamin E may be useful in improving certain skin conditions, osteoarthritis, and heart disease. The best sources of Vitamin E include wheat germ, lettuce, and green peas. Other good food sources include the following: other green vegetables (asparagus, cucumber, kale); wheat germ oil (and oils made from corn, safflower, sesame, soybean, and peanut); fish (haddock, mackerel, and herring); meat (lamb and liver but be wary of the high cholesterol content of liver); grains (brown rice and millet); and mango, a tropical fruit. However, megadoses of anything can be risky, so caution is needed. Vitamin E usually is not recommended for anyone with high blood pressure, diabetes, or a rheumatic heart condition, and it should not be taken at all by anyone who is taking digitalis. Also, there is some concern on the part of physicians thac too much Vitamin E could cause liver problems.

Vitamin B deficiency is not uncommon in women who have taken birth control pills or who are on ERT. The synthetic hormones can deplete the B vitamins. This deficiency may trigger fatigue, depression, emotional instability (mood swings), memory lapses, or loss of libido, because the whole family of B vitamins work together to perform vital metabolic functions in our bodies, which includes stabilizing the chemistry in our brains. Vitamin B-complex is considered to be an antistress compound. The one I’ve taken for years includes Vitamins B-l (thiamine); B-2 (riboflavin); B-3 (niacin); B-5 (pantothenic acid); and B-6 (pyridoxine), together with Vitamin C. Some women have told me that B-complex gives them some relief from migraine headaches. Vitamin B-6, in mild doses, such as 50 milligrams, usually works as a natural diuretic, counteracting water retention that makes so many of us feel bloated or uncomfortable. Other natural diuretics include cranberry juice, kelp, watercress, and parsley. Reducing salt and spicy foods helps too. The B vitamins can also be supplemented through your diet with greater consumption of beans, whole grains, and liver (again, liver’s high cholesterol content makes it just a once-in-a-while food).

Vitamin C can help as well. It is considered an antistress vitamin possessing calming effects. It is also a deterrent to excessive menstrual bleeding, a healer of wounds and burns, and a maintainer of collagen, which h the main supportive protein of your skin, tendon, bone, cartilage, and connective tissue. Vitamin C is found abundantly in fruits and vegetables. Some of the best vegetable sources are broccoli, brussels sprouts, cabbage, cauliflower, and most greens. The best fruit sources of C are cantaloupe, grapefruit, oranges, strawberries, mango, and papaya. If taken as a supplement, time-release Vitamin C is best.

Calcium, in addition to helping to maintain healthy bone, is also recommended for coping with emotional stress. Vitamin D assists in the body’s absorption of calcium, and a sufficient amount of Vitamin D is usually acquired through our exposure to sunlight. The best food source of Vitamin D is salmon, followed by mackerel, sardines, and tuna. More detailed information about bones, osteoporosis, and calcium supplementation is provided in Chapter 8.

There are a number of herbs, such as chamomile, blackberry root, passionflower, and evening primrose oil, which when taken in moderation may alleviate some menopausal symptoms. This makes sense, because some plants contain estrogen. Caution is important, however. First of all, herbs can be toxic if ingested in the wrong quantities. It is also possible to have an allergic reaction to them. Ginseng, for example, is a root that is a source of plant estrogen, and it can enhance energy and may relieve hot flashes. Yet it is not often recommended by physicians, because it is like taking ERT without knowing how much you are taking. So if you choose to sip ginseng tea, sip it lightly and slowly and not for long.

Menopausal insomnia is a serious problem for many women with whom I have spoken. Some of the women have offered suggestions of what has worked for them. Many suggest herbal teas one company even calls its chamomile tea Sweet Dreams and catnip tea, passionflower broth, warm milk, warm baths, and long evening walks.

Vaginal dryness can be helped with the new water soluble vaginal moisturizers, now available in over-the-counter products, such as Replens and Astroglide. In addition, it should come as no surprise that regular sexual activity can help keep your reproductive organs in good shape (this is covered more fully in Chapter 12).

Kegel exercises can help with bladder control if stress incontinence is a problem. They also can tighten and tone the vaginal area, which may enhance sexual pleasure for you and your partner. Kegel exercises, named for Dr. Arnold Kegel, a surgeon at UCLA who developed them in the 1950s, may be done in one of two ways. Method one is to contract your vaginal muscles as if you were trying to stop yourself from urinating. Hold for a count of five, relax for another count of five, and repeat this sequence twenty times. Method two is to contract and release in quick succession. I not only alternate the releases, I alternate the methods. It’s like cross-training, and it keeps me from getting bored. I still do these as many times a day as I can remember to do them. Memory triggers that I use include doing Kegels when I stop for red traffic lights, Kegels while taking off my makeup at night, and Kegels when I put on makeup in the morning. I try to do at least ten sets of twenty each day. Some days, I’m sure I miss. I know that the Kegel exercises have helped me with bladder control, and I believe that they may help keep my pelvic organs functioning well my whole life. I think they’re well worth the small effort.

A number of other techniques have provided relief from distressing menopause symptoms for many women with whom I’ve talked. These include relaxation therapy, visualization, yoga, and biofeedback. Acupuncture and massage are also considered for the relief of some menopausal symptoms. I will briefly review them here, but since these are such fascinating and unique therapies, you may wish to learn more about them through the many blogs that are available on these subjects. A partial listing is included in the Appendix.

Relaxation therapy techniques can help to relieve stress and tension and, in that way, combat some menopausal symptoms. Relaxation therapy is a process through which you systematically relax your body and your mind from head to toe. Visualization is another relaxation technique, but one in which you create your own desired atmosphere and environment. For example, in order to counteract hot flashes, you might envision yourself ice fishing on one of the magnificent lakes around Minneapolis. You pull up the hood of your down parka and tie your wool scarf a little tighter around your throat. The wind is cold, yet it is sunny and you are at peace waiting for a fish to nibble at your line, which has been dropped down the hole in the ice in the corner of your ice house. For many women, visualization works wonders!

Yoga combines deep breathing, meditation, and physical exercise. It is believed to focus one’s attention and calm the mind. When combined with good nutrition and healthy life-styles, it can be helpful in alleviating the problems of menopause and aging. Yoga, when practiced correctly, also can enhance your muscle and joint flexibility greatly and help to maintain your skeletal health.

Biofeedback is a painless relaxation technique that involves being hooked up to a machine that can help to train the mind to grab control of the body’s mechanisms (such as heart rate, muscle tension, or skin temperature) which are usually the province of the body’s automatic response systems. The feedback comes from meter readouts or tones that tell you whether there is an increase or decrease in what you are attempting to control. Women have told me that they have been able to stop their hot flashes through biofeedback.

Acupuncture is an ancient Far Eastern healing art that involves the insertion of needles at certain points on the body’s meridians for the purpose of unblocking our energies. In my travels, I have encountered a few women who have had good results using it to relieve their hot flashes. In the United States, acupuncture may be lawfully practiced only by licensed physicians using disposable needles. In this, as in all other procedures and practices, check the practitioner’s credentials carefully.

Massage, involving acupressure and trigger-point therapy, is something I myself use on a regular basis. Therapeutic massage brings me relief from all kinds of symptoms, from muscle strains due to sports or exercise, to headaches and stiff neck (my personal stress spot), as well as removing toxins from my body. Massage such as

I undergo can be done only by a licensed massotherapist, in most states. It involves the placement of digital pressure at the same points on the body’s meridians as is done with the insertion of needles in acupuncture, for the same purpose of releasing the body’s energies. Trig-ger-point therapy pinpoints congestion in the muscles and works with digital pressure to relieve it. There are a number of other forms of massage therapy that work well for other women. Some women enjoy Swedish massage, Shiatsu massage, or foot reflexology, just to name a few. If massage therapy interests you, I suggest that you take the time to learn about the various forms of massage and what they may do for you and to find a qualified licensed therapist with whom you are comfortable. If you try one kind of massage and it is not to your liking, experiment and try another.

Just as there are a number of simpler means of trying to improve sleep, such as drinking warm milk, so there are some equally simple things to do to avoid or reduce the effects of hot flashes. Women report success with iced drinks, cold showers, dressing in layers and peeling clothing off as necessary, avoiding alcohol, caffeine, and spicy food, and limiting unnecessary stress whenever possible. A friend of mine can literally bring on a series of hot flashes just by becoming nervous and upset. The reverse is true for many of us who pursue activities for their calming effect.

There are also some medical alternatives to ERT. Tranquilizers, such as Valium, may be prescribed to reduce the anxiety and stress that can be associated with menopausal symptoms. They work to diminish some symptoms, such as hot flashes or insomnia, because they suppress the function of the hypothalamus, but they can become habit-forming with extended use. In addition, your body may build up a tolerance to them, which would then necessitate increased doses over time. Sedatives also decrease irritability in the autonomic nervous system, but these should be considered only for temporary help because they are addictive, and they should be used with caution.

If you can’t take estrogen, some physicians will prescribe progestin alone, a strategy that may offer some help for your symptoms. Clonidine is another drug that may be tried. It is an antihypertension drug that may provide hot flash relief. Some physicians prescribe Bel-lergal tablets, which contain phenobarbital. Bellergal is most often used as an antispasmodic drug. It, too, may reduce hot flashes. Remember: All drugs can have side effects that need to be considered and understood.

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