How to treat hormonal ups and downs.
Help with symptoms of the menopauseHow can they be treated?
Unfortunately, not much can be done about the hormonal ups and downs that come with the menopause. However, help is available for the symptoms. There are many different approaches to minimising and effectively alleviating menopause symptoms.
Unsurprisingly, nutrition plays an important role. A balanced diet rich in vitamins and minerals can help to minimise symptoms of the menopause. Similarly, you should incorporate regular exercise and relaxation techniques into your daily routine. It’s also important to avoid any stress factors so that your symptoms do not worsen. Below, you’ll find a summary of potential treatment methods, as well as what hormone replacement therapy is all about – we also discuss hormone-free treatments to relieve menopause symptoms. Read on to find more detailed information.
Graduate biochemist
DR. KADE
Medical Affairs
What will be discussed
Wave menopause symptoms goodbye! Available treatment options
Various treatment options are available to combat symptoms of the menopause. Any and all treatments should be tailored to your individual needs:
Symptoms of the menopause can be treated with herbal medicine. Phytotherapy offers a number of traditional herbal remedies that are effective at relieving menopause symptoms. Herbal remedies are a hormone-free alternative and are therefore also suitable for breast cancer patients. Nevertheless, some preparations contain phytohormones that have an oestrogen-like effect and are therefore unsuitable for certain groups. Products containing the black cohosh root extract (Cimicifuga racemosa) have proven to be very effective. Additional information regarding phytotherapy is summarised for you below.
Current hormone replacement therapy (HRT) for oestrogen deficiency-related symptoms during the menopause, such as mood swings and hot flushes, uses hormones identical to those naturally found in the body.
HRT usually involves taking oestrogen and progestogen preparations. If you still have a uterus, you’ll likely be given a combination preparation of oestrogen and progestogen, which protects the lining of the uterus. If you’ve had your uterus removed, you’ll usually be treated with an oestrogen-only preparation. Keep reading to learn more about HRT.
Homeopathic remedies are also well-established in the treatment of menopausal symptoms. This includes the intake of globules, a hormone-free treatment approach.
Taking hormones during the menopause: yay or nay?
Few medical topics have been as hotly debated as whether or not to taking hormones during the menopause. Perhaps you’re also unsure whether you need to take hormones to actively combat your menopause symptoms such as hot flushes, excessive sweating (especially at night) and sleep disturbances. Our aim is to help you make the right decision and to explain the various options available to you. The most important thing is that, whichever treatment option you choose, it’s tailored to your individual needs.
Hormone therapy for symptoms of the menopause:
What preparations are available?
Gels, plasters, syringes and tablets or capsules? Hormone replacement therapy is available in various oestrogen and progestogen preparations in different dosage forms. You and your doctor will agree on the hormone replacement therapy that best suits your needs.
If you decide to take hormone tablets during the menopause, various factors will be used to decide which hormone combination and dosage are right for you. Tablets and capsules are usually taken daily. Oestrogen tablets will be administered as monotherapy if you’ve had your uterus removed. Progestogen tablets will be used if you still have a uterus and are also taking another form of oestrogen, for example via the skin. Combined tablets are available in various dosages and contain various progestogens.
- Hormone gels are applied to the skin once a day.
- Plasters must be changed 1–2 times a week. They adhere so well that it’s possible to shower, bathe and do exercise when used correctly.
- Hormone injections are used to deposit hormones into the body and need to be administered into the glutes or upper arm every 4 weeks .
- Creams and suppositories are suitable if you experience vaginal dryness or pain during sexual intercourse. They are applied vaginally.
Remember: After weighing up the benefits and risks with your doctor, the most important thing is to choose the hormone therapy that best suits your needs.
Hormone-free menopause treatment:
herbal remedies
Many people are unsure whether they should take hormones or not. If you relate, a herbal remedy could be a great alternative to traditional hormone replacement therapy for you. Certain plants contain substances that act in the same way as hormones in the human body. These are called as phyto-oestrogens or phytohormones.
One example of this is soya-based preparations. The soya bean contains large quantities of the yellowish plant pigment isoflavones, which can balance out a lack of oestrogen. It is assumed that the soya-rich diet in Asian countries is the reason why Asian women generally suffer from fewer menopause symptoms. Isoflavones relieve hot flushes, among other things, and may also reduce the risk of developing osteoporosis.
If you’d rather avoid hormone-like substances altogether, try black cohosh extract (Cimicifuga racemosa). The advantage of this herbal medicine is that its effectiveness is unlikely to be based on a hormonal effect. Instead, it appears to act directly in the central nervous system.
Remember: black cohosh preparations have been tried and tested in the treatment of classic symptoms of the menopause. It is particularly effective at treating symptoms such as hot flushes and excessive sweating.
What are phytohormones?
The term phytohormones is often used in connection with relieving menopause symptoms such as hot flushes and sweating. The term phytohormones is used to describe plant compounds with hormone-like effects.
In general, hormones are messenger substances that transmit important signals. In humans, for example, they transmit messages from the body to the brain. Phytohormones also act as messenger substances in plants. They provide the plant with important information about its environment. They also play an important role in growth and development.
What phytohormones are available and how do they work?
As their name suggests, phytohormones act in a similar way to hormones in the human body. Just like hormones, their effects on the human body can vary greatly. A difference is made mainly between oestrogen-like and progesterone-like phytohormones. However, plant hormones with a testosterone-like effect also exist.
Does a herbal oestrogen for the menopause exist? Yes! The chemical structure of phytoestrogens is similar to that of the female oestrogen estradiol. They also dock onto the same special binding sites (receptors) in the female body. Due to this structural similarity to the oestrogens produced in the body, phytoestrogens can therefore also influence sexual functions and the psyche. In medical terminology, phytoestrogens are referred to as selective oestrogen receptor modulators.
The best known phytoestrogens are isoflavones, which are found in certain legumes, such as the soya plant (Glycine) and red clover (Trifolium pratense). The isoflavone genistein found in soya is particularly active. However, it doesn’t work for around 30% of women. This is because genistein itself has no hormonal effect. It must first be converted into the active molecule equol by certain bacteria found in the gut. If these bacteria are not present in the intestinal flora, the isoflavone genistein is ineffective.
The so-called hydroxystilbenes also have an oestrogen-like effect. They are obtained from rhapontic rhubarb (Rheum rhapontikum). This plant belongs to the knotweed family (Polygonaceae) and is better known as ‘Siberian’ or ‘Bulgarian rhubarb’.
Phytoestrogens also include lignans. They are found in linseed, pumpkin seeds and various cereals. Hops (Humulus lupulus) also have a strong oestrogen-like effect.
Remember: soya isoflavones don’t work for everyone.
Herbal progesterone functions in a similar way to the female sex hormone progestin. It promotes sleep and relieves anxiety, amongst other things. It is found in yam root (Dioscorea) and monk’s pepper (Agnus castus).
The mechanism of action of phytoandrogens is not fully understood. However, known effects are similar to those of the male sex hormone testosterone. Phytoandrogens are extracted from ginseng (Panax ginseng) and Scots pine (Pinus sylvestris), for example.
Important for you: A hormone-like effect is also discussed for black cohosh (Cimifuga racemosa).(1,2) However, a hormone-independent mechanism of action is predominantly assumed. No undesirable effects on the endometrium or breast tissue are known.(3)
Which symptoms are phytohormones used for?
Many women like to use preparations containing herbal ingredients to treat menopause symptoms. These are perceived to be milder and better tolerated than chemically synthesised products. However, their effectiveness is not always well demonstrated.
Going through the menopause and experiencing hot flushes? Herbal remedies can help. Isoflavones from soya beans or red clover are highly recommended to relieve uncomfortable hot flushes. However, there are no clear data on their effectiveness. Neither a harmful nor a positive effect has been proven to date, particularly when taken in the form of food supplements. In contrast, the effectiveness of hydroxystilbenes from rhapontic rhubarb has been considered proven for hot flushes, sleep disturbances, depressive moods and anxiety.
Firm skin and thick hair: isn’t that what everyone over a certain age dreams of? In some animal studies, the thickness, elasticity and blood circulation of the skin appeared to improve after administration of plant oestrogens from red clover. Some women also reported a subjective improvement and a positive effect of phytohormones on skin, hair and dry mucous membranes. However, there is no solid evidence to support this.
Phytohormones are generally well tolerated. However, just because something is herbal, doesn’t mean it’s risk-free! This is especially true of hormone-like herbal substances. Phytohormones are only considered safe as long as they are consumed as part of a normal diet in the form of food or drink.
However, undesirable effects can occur when taken in high doses or with long-term use. Common and usually mild side effects are:
- Gastrointestinal complaints
- Nausea
- Skin redness
- Swelling
It is unclear to what extent these side effects are directly attributable to phytohormones. It is possible that other ingredients in phytohormone preparations can also trigger symptoms. If you experience any unpleasant symptoms after taking a phytohormone, stop taking the preparation immediately. Symptoms usually subside quickly. It’s also a good idea to speak to your gynaecologist.
The potential undesirable hormonal effects are much more serious than nausea and skin redness, as phytohormones, like all hormones, affect the body’s hormone balance. What does this mean? Breast tissue and tissue in the uterus is influenced by sex hormones.
Isoflavones, for example, have the same effect. They can therefore cause changes in these tissues. Negative effects on the thyroid gland are also suspected. For this reason, long-term use is not recommended for women going through the menopause. There is also an increased risk of breast cancer. However, short-term use is considered safe. However, in general, phytohormones should not be taken in cases of suspected or existing hormone-dependent cancer.
Remember: Phytohormones are available in Germany in the form of dry extract. They are administered alone or in combination with other plant extracts or vitamins. The proportion of the active phytohormone can vary greatly.
Tips: Phytohormones in everyday life
Phytohormones are also to do with diet. These ‘plant hormones’ have been part of the traditional diet in Asia for a long time; the soya beans and soya products frequently consumed there contain many hormone-like substances. It was also discovered some time ago that Asian women are less likely to suffer from menopause symptoms. However, it is unclear whether this is related to a diet much richer in soya, which contains particularly high levels of phytohormones. In addition, the effect of phytohormones appears to depend on the way they are consumed. While in Asia, intake takes place in natural form through food, in Germany isolated and enriched dosage forms (for example as food supplements) are used.
In any case, a balanced and healthy diet is invariably good for your health and improves your general well-being. For many, simply eating a balanced diet is enough to get their menopause symptoms under control. Drinking teas or eating foods containing phytoestrogens can also help:
- Pulses
- Wholegrain products
- Linseed
- Soya beans
Large selection of phytohormones – how the preparations differ
A glance into any pharmacy shows that phytohormones are available in many different forms.
These include dietary supplements in capsule or tablet form. In some cases, vitamins, minerals or other plant extracts are added. The decisive factor when it comes to the effectiveness of any preparation is the specified amount of phytohormones. For isoflavones, at least 50 mg per unit is recommended.
Important for you: determining whether phytohormones will be effective can be challenging, as they do not work equally well for everyone. Try it out and see what works for you personally. Try to take the preparations with food, as this reduces the risk of potential digestive side effects. If you are unsure, talk to your gynaecologist about whether herbal hormones are suitable for you.
Sources:
- European Medicines Agency (EMA). HMPC “Assessment report on Cimicifuga racemosa (L.) Nutt., rhizoma Draft-Revision” (EMA/HMPC/48744/2017; 18 July 2017 Committee on Herbal Medicinal Products [HMPC]). 2017. 1-64.
- Kraft, K (2012). Phytotherapie versus Hormone bei klimakterischen Beschwerden. EHK 61(04): 208-213.
- Fachverlag Gesundheit und Medizin GmbH & Co. KG. Pflanzliche Mittel bei Wechseljahren. Online unter http://www.stark-gegen-schwitzen.de (accessed on 26/02/2018)