Menopause

• Acupuncture Reduces Hot Flashes
• Alternatives to HRT
• Easing Menopause Symptoms
• Lignans support Breast Health and reduce Hot Flashes

Acupuncture Reduces Hot Flashes  
By Andrew Gaeddert

Not only is acupuncture as effective as drug therapy at reducing hot flashes in breast cancer patients, it has the added benefit of potentially increasing a woman’s sex drive and improving her sense of well-being, according to a Henry Ford Hospital study. Study results show that acupuncture, when compared to drug therapy, has a longer-lasting effect on the reduction of hot flashes and night sweats for women receiving hormone therapy for breast cancer treatment. Women also report that acupuncture improves their energy and clarity of thought.

The study, published online this week in the Journal of Oncology, is the first randomly controlled trial to compare acupuncture and drug therapy in this way. Acupuncture offers patients a safe, effective, and durable treatment option for hot flashes, something that affects the majority of breast cancer survivors. Compared to drug therapy, acupuncture actually has benefits, as opposed to more side effects¹, says study lead author Eleanor Walker, M.D., division director of breast services in the Department of Radiation Oncology at Henry Ford Hospital.

According to the National Cancer Institute, one in eight women will develop breast cancer in her lifetime. For these women, conventional medical treatment often involves chemotherapy and five years of hormone therapy. With such a long course of treatment, side effects of hormone therapy such as vasomotor symptoms — hot flashes and night sweats — can become a major cause of decreased quality of life, and even discontinuation of treatment.²

In 1976, the FDA approved the use of HRT for treating menopausal symptoms such as hot fl ashes, yet many women have been reluctant to take hormones. Concerns over HRT were heightened by recent Women’s Health Initiative studies showing that the treatment may increase the risk of heart attack, stroke, and breast cancer. Some of the more popular alternatives include soy products, black cohosh, and Chinese herbs.

NuLignan is derived from spruce trees, it reduces hot flashes and night sweats and supports breast, bone and cardiovascular health. NuLignan converts friendly intestinal bacteria into enterolactone. Enterolactone helps buffer hormonal fluctuations and helps to manage menopausal symptoms, and reduces the risk of developing hormonal related cancers. There is strong epidemiological links between cardiovascular mortality rates and plasma enterolactone levels. Subjects with osteoporosis have been shown with lower than normal urinary enterolactone level and that higher bone mineral density is correlated positively with higher urinary enterolactone levels. NuLignan is a powerful antioxidant and free radical scavenger. The therapeutic dosage is just two capsules per day. Health Concerns has also produced the Chinese herbal formulas, Three Immortals for broad-spectrum menopausal support, and Great Yin, which targets hot flashes and night sweats.

1. Eleanor M. Walker, AlbaI. Rodriguez, Beth Kohn, Ronald M. Ball, Jan Pegg, Jeffrey R. Pocock, Ramon Nunez, Ed Peterson, Susan Jakary, and Robert A. Levine. Acupuncture versus Venlafaxine for the Management of Vasomotor Symptoms in Hormone Receptor Positive Breast Cancer Patients: A Randomized Controlled Trial. Journal of Clinical Oncology. Aug. 31, 2009. http://jco.ascopubs.org/cgi/content/abstract/JCO.2009.23.5150v1.
2. 2. Acupuncture reduces hot flashes, improves sex drive for breast cancer patients. Health & Medicine. December 29, 2009. http://esciencenews.com/articles/2009/12/29/acupuncture.reduces.hot.flashes.improves.sex.drive.breast.cancer.patients – Accessed on 1/29/10.

Alternatives to HRT
By Andrew Gaeddert

In the popular 1966 book Feminine Forever, Dr. Robert A. Wilson, a gynecologist, used disparaging descriptions of aging women (flabby, shrunken, dull-minded, desexed) to upend the prevailing idea of menopause as a normal stage of life. Women and their physicians, Dr. Wilson wrote, should regard menopause as a degenerative disease that could be prevented or cured with the use of hormone drugs.

“No woman can be sure of escaping the horror of this living decay,” Dr. Wilson wrote. “There is no need for either valor or pretense. The need is for hormones.” It is believed that Dr. Wilson came up with the concept of hormone “replacement” therapy (HRT). While drugs may effectively treat hot flashes, there is no evidence that women need hormonal drugs during menopause.

As the popularity of estrogen grew, an increasing number of women developed cancer of the uterine lining, the endometrium. Two studies published in the mid-1970s in the New England Journal of Medicine reported that taking estrogen therapy had increased the risk of endometrial cancer by at least five times. In 1980, researchers at Boston University Medical Center estimated that the use of hormone therapy had caused more than 15,000 cases of endometrial cancer (often-termed uterine cancer) in the United States between 1971 and 1975 alone.1

By the 1990s, millions of American women were told, by gynecologists, medical associations, and drug companies that they could help their bodies ward off major illness by taking menopausal hormone drugs. Hormonal drugs were recommended to not only stop hot flashes and night sweats, but also for heart and bone health. Then the evidence came in. The WHI Estrogen-plus-Progestin Study was stopped in July 2002, when investigators reported that the overall risks of estrogen plus progestin, specifically Prempro™, outweighed the benefits.2 The researchers found that use of this estrogen-plus-progestin pill increased the risk of breast cancer, heart disease, stroke, blood clots, and urinary incontinence. However, the risk of colorectal cancer and hip fractures was lower among women using estrogen plus progestin, than among those taking the placebo.2 In addition, the WHI Memory Study showed that estrogen plus progestin doubled the risk for developing dementia (a decline in mental ability in which the patient can no longer function independently on a day-to-day basis) in postmenopausal women age 65 and older. The risk increased for all types of dementia, including Alzheimer’s disease.3

The WHI Estrogen-Alone Study, which involved Premarin™, was stopped in February 2004, when the researchers concluded that estrogen alone increased the risk of stroke and blood clots. In contrast with the WHI Estrogen-plus-Progestin Study, the risk of breast cancer was decreased in women using estrogen alone compared with those taking the placebo. Use of estrogen alone did not increase or decrease the risk of colorectal cancer.4 Similar to the results seen in the Estrogen-plus-Progestin Study, women using estrogen alone had an increased risk of urinary incontinence and a decreased risk of hip fractures.

Observational studies have shown that estrogen and estrogen plus progestin is associated with increased risk of ovarian cancer. It is believed that menopausal estrogen use by women who have already been diagnosed with breast cancer, may promote further tumor growth, however studies have produced conflicting results. Survivors of other gynecological cancers may be putting themselves at risk by taking hormones, as these cancers are often hormone dependent. For women who don’t wish to take hormones, exercise, stress reduction and eliminating alcohol and smoking can decrease the risk of chronic disease. Hot flashes and night sweats can be effectively be treated with NuLignan, derived from spruce trees, and the traditional Chinese formula Great Yin (modified du bu yin), while women with a constellation of menopausal symptoms including insomnia, migraine, low back pain, vertigo, depression, five-palm heat, and lowered sex drive, can be treated with Three Immortals. Taking calcium and vitamin D can preserve bone mass while BioStrong contains a mineral proven to increase bone density and prevent fractures. OsteoHerbal is an empirical Chinese herbal formula with ingredients shown to support bone health, reduce fracture risk and to support balance.

References

1. Singer, Natasha, Wilson, Duff. Menopause, as Brought to You by Big Pharma. New York Times online. December 12, 2009 http://www.nytimes.com/2009/12/13/business/13drug.html?_r=1&pagewanted=2. Accessed on 3/11/10.
2. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women’s Health Initiative randomized controlled trial. Journal of the American Medical Association 2002; 288(3):321–333. http://www.cancer.gov/cancertopics/factsheet/Risk/menopausal-hormones#r1 Accessed on 3/10/10.
3. Shumaker SA, Legault C, Rapp SR, et al. Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: The Women’s Health Initiative Memory Study: A randomized controlled trial. Journal of the American Medical Association 2003; 289(20):2651–2662.
4. Anderson GL, Limacher M, AssafAR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: The Women’s Health Initiative randomized controlled trial. Journal of the American Medical Association 2004; 291(14):1701–1712.

Easing Menopause Symptoms
By Andrew Gaeddert 

Menopause is manifested as the end of menstruation. It is brought about by the decreased production of estrogen, progesterone, and testosterone. Beginning around age 35, daily production of most major hormones starts to slow. This decline affects metabolism, reproductive function, immune system function physical and mental capacities and more. By the fifth or sixth decade of life, hormone production is only about 25 percent of what it was in the second and third decades.

Ovarian function starts to decline around age 40, and most women encounter a transition period, perimenopause, during which they experience sporadic symptoms of menopause for five to ten years. Most women reach menopause around ages 45 to 55, but it can occur anytime from age 40 to 59. Menopause that occurs before age 40 is considered premature and warrants further medical evaluation.

Women can experience the symptoms in wide variations. These include night sweats, hot flashes, insomnia, mood swings, irritability, concentration difficulty, memory changes, decreased sexual drive, fatigue, depression, vaginal dryness, pain with intercourse, muscle and joint aches and pains and menstrual irregularities. In addition, women face an increased risk for osteoporosis and heart disease.            

The severity of perimenopausal and menopausal symptoms can range from mild to severe. Some women experience a few irregular menstrual cycles or missed periods and have no bothersome symptoms whatsoever. Others, however, start having hot flashes, mood swings and several other symptoms before they ever have an irregular period. After menstruation stops, vasomotor symptoms may continue for another five to ten years. In general, a woman’s experience with menopause is usually similar to that of her mother’s. Fortunately, herbs can be used to manage and prevent symptoms.

NuLignan supports breast, bone, and cardiovascular health making it an ideal supplement for patients in menopause. In a recent study hot flashes were reduced 53 percent, however clinical reports suggest an even greater response. Three Immortals works on the basis of TCM to treat the constellation of menopausal symptoms, whereas Great Yin is traditionally used to treat hot flashes and night sweats by clearing heat and nourishing yin. Woman’s Balance® is indicated for irritability, PMS and irregular periods. The abovementioned formulas can be used singly or combined depending upon patients symptoms. 

Lignans support Breast Health and reduce Hot Flashes
By Andrew Gaeddert 

Increased intake of lignans may reduce a postmenopausal woman’s risk of breast cancer by about 15 percent, says a new meta-analysis of the available data. But according to findings published in the American Journal of Clinical Nutrition, there was no overall beneficial effect when women of all ages were considered, suggesting the benefit may be limited to postmenopausal women. The meta-analysis, which used data from 21 published studies, adds to the overall body of science supporting the link between increased dietary lignan intake, and reduced risk from a wide range of conditions. Breast cancer, prostate cancer, and reduced hair loss were cited as the most notable of these.

Plant lignans, from sources such as flax seed, whole grain cereals, berries, vegetables and fruits, are metabolized in the colon by microflora into enterodiol and enterolactone. Previous research has focused on plant lignans as reducing the risk of prostate cancer, and in improving menopause health.

The main lignan from flaxseed is secoisolariciresinol diglucoside (SDG), which is metabolized to give enterodiol and enterolactone. These two metabolites are then absorbed from the gut and transported to the liver where they undergo further reactions before entering circulation.

The new meta-analysis follows hot on the heels of a review published in Comprehensive Reviews in Food Science and Food Safety that found that flaxseed lignans might offer protection against breast, prostate, colon, and skin cancers, while the soluble fiber they contain could help maintain steady blood sugar levels.1

NuLignan (7-hydroxymatairesinol) from Norwegian spruce is metabolized differently in the body, forming mostly enterolactone (ENL) and some 7-hydroxyenterolactone (HENL), but no enterodiol. It was shown to reduce hot flashes in an eight-week study of 20 menopausal women. Prior to randomization, twelve women were selected for a pharmacokinetic study to determine serum levels of 7-hydroxymatairesinol and enterolactone. Blood was drawn at baseline and then through 72 hours, following a 7-hydroxymatairesinol dosage. Women were randomized into two dosages corresponding one capsule (25mg) and two capsules (50mg) a day. The mean age group of the 25mg group was 53.9 years and 55.9 for the 50mg group. Blood was drawn at week four and week eight. ENL, enterodiol, SHBG, HS-CRP, CBc, and CMP and hot flash diaries were collected.

At baseline, both groups had a similar mean number of hot flashes per day. Between the two groups, there were significant advantages in the 50mg group. In the 50mg group the change in hot flashes from baseline where reduced 37.2 percent after four weeks, and 53.5 after eight weeks. Mean serum enterolactone levels were significantly increased at 24 and 48 hours of a 72 hour monitoring period, and concentrations of 7-hydroxymatairesinol also increased.

1. Katharina Buck, Aida Karina Zaineddin, Alina Vrieling, Jakob Linseisen, and Jenny Chang-Claude. Meta-analyses of lignans and enterolignans in relation to breast cancer risk. American Journal of Clinical Nutrition. Published online ahead of print, doi: 10.3945/ajcn.2009.28573 

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