There are so many natural remedies, you don’t have to suffer through it. You don’t have to tough it out.
Like the gentle rhythm of the tides, a woman’s hormones pull and tug at her throughout her lifetime, influencing every aspect of her physical, mental, and emotional existence. As a child becomes a young woman, as a woman embraces motherhood, as a mature adult approaches midlife, hormones dance through her body. In the years leading up to menopause, it’s especially important to get in sync with this hormonal rhythm because this is the time when a woman can best prepare for smooth gliding in the years ahead.
Perimenopause, simply put, is the period of time when a woman’s body gets ready for menopause. Some of its symptoms are similar to menopause, a phase of life that some women dread. They associate it with drama, trauma, and the end of their biological reason for living. But for others, and increasingly more of them, the thought brings comfort. As life expectancies have gradually increased over generations, the postmenopause period of a woman’s life has come to be a greater portion of the whole, and many are recognizing the progression toward it as a sign of the rich and rewarding time to come.
Traditional herbal medicine offers many ways to combat discomforts associated with perimenopause and help ensure a smooth transition to menopause. A woman who understands the hormonal changes that are occurring and investigates natural and herbal ways to help support her body during this time can think confidently about living out her life in health and comfort. She can develop good habits now that will become crucial to her health after menopause. She can anticipate problems and solutions and make sensible decisions concerning hormone replacement therapy (HRT).
“The majority of symptoms in the premenopause and menopause eras of our life are influenced, mediated, and minimized by taking better care of ourselves in the premenopause stage,” says Jesse Hanley, a Malibu, California, medical doctor who focuses on women’s health issues and has used herbal remedies in her practice for more than fifteen years. She is co-author with John R. Lee, M.D., of What Your Doctor May Not Tell You About Premenopause (Warner, 1999).
This is a time, Hanley says, when women should listen to their inner needs, look for the early signs of hormonal imbalance, and bring their bodies and lives back into balance.
What is perimenopause?
Women know they’ve entered perimenopause when they begin to notice changes in their monthly cycles, but many health practitioners now recognize that hormone fluctuations—and the symptoms related to them—can begin long before that, as early as age thirty to thirty-five.
Periods may become heavier or lighter, last for more or fewer days, or come and go irregularly. Premenstrual syndrome (PMS) may appear at this time in women never before bothered by it. Hot flashes and night sweats often occur. Other signs include dry skin, loss of muscle tone, weight gain, tender or lumpy breasts, a decrease in sexual desire, vaginal drying, and uterine fibroids.
Some women also experience fatigue, depression, headaches, and mood swings, which can add to their fear and negative feelings about menopause.
“The psychological problems related to perimenopause are hormonal,” says Hyla Cass, M.D., a psychiatrist with a holistic approach who counsels many women over forty who have difficulty with this life change. Cass is an assistant clinical professor of psychiatry at the University of California–Los Angeles School of Medicine and has integrated nutritional and herbal medicine into her longtime clinical psychiatry practice. “When hormones are balanced, the psychological issues seem to disappear. It’s not such a big deal once we handle the physical side,” she says.
Evidence suggests that severe menopause symptoms are directly related to certain diet and lifestyle choices typical of the West. This may hold true for perimenopause symptoms as well because of the link to hormonal fluctuations. Women in many other parts of the world don’t experience the menopausal symptoms so prevalent in the West, and consequently seldom seek medical attention or HRT for their symptoms. In recent years, much attention has focused on Japanese women, who experience hot flashes and other menopausal symptoms at a much lower and less severe rate than North American women. Various reports show that only 18 to 25 percent of Japanese women have hot flashes, compared to 75 to 80 percent of Canadian and American women. Similar findings have been made in studies of women in other parts of Asia, as well as in the Middle East and South America.
The hormone dance
A woman’s body begins the business of making a variety of hormones, including estrogen and progesterone, from the time she is a young girl. Estrogen is not a specific hormone but rather a large group of compounds. Produced chiefly in the ovaries, estrogen helps a child develop and maintain her sexual organs, and it plays many other roles in keeping the body healthy and functioning normally, affecting cell growth, muscle tone, cholesterol levels, and the suppleness of the skin.
A spiral of health issues surrounds estrogen as we age. An excess can result in PMS, uterine fibroids, endometriosis, and other tissue-growth problems, and estrogen in large quantities can be carcinogenic. And in addition to the body’s estrogen, we are constantly exposed to environmental estrogens, Hanley says, in the form of plastics, pesticides, adhesives, solvents, automobile exhaust, and other facets of modern living that are believed to disrupt the human hormone system.
Although during the menopausal years it is the decline in estrogen that causes the symptoms, in the years leading up to menopause, progesterone plays an even more important role. Progesterone is a precursor of estrogen that works to counterbalance its effects. The two work together, so a decline in progesterone can create and aggravate an excess of estrogen. Progesterone is manufactured primarily in the ovaries after ovulation, and as ovulation begins to decrease, so does the body’s supply of available progesterone. HRT products such as Provera and Premarin include synthetic progestins for their protective effect. Instead, for many women in this age group, Dr. Hanley recommends a progesterone cream, an easy-to-use remedy synthesized from plants, which is available over the counter in health-food stores.
As women come closer to menopause, their body’s estrogen production winds down and a cascade of menopausal symptoms can occur. If a woman heads into her menopause years with her hormones in balance, she may be able to avoid severe problems and never have to decide whether to use HRT. Many woman don’t want to go the HRT route, whether because of the increased risk of breast cancer, the side effects (one-third of women stop filling their prescriptions within a year because of unpleasant side effects), or perhaps they just don’t like the idea of estrogen synthesized from the urine of pregnant horses.
HRT “doesn’t make sense from a holistic medicine point of view—to choose a hormone that’s high risk and can actually cause cancer and other illnesses,” Dr. Cass says. “That’s a spurious choice, not the only choice. There are so many natural remedies, you don’t have to suffer through menopause. You don’t have to tough it out.”
Gittleman, Ann Louise, and Jonathan V. Wright. Before the Change: Taking Charge of Your Perimenopause. San Francisco: Harper, 1999.
Hobbs, Christopher, and Kathi Keville. Women’s Herbs, Women’s Health. Loveland, Colorado: Interweave Press, 1998.
Lee, John R., Jesse Hanley, and Virginia Hopkins. What Your Doctor May Not Tell You About Premenopause. New York: Warner Books, 1999.
Sheehy, Gail. The Silent Passage: Menopause. New York: Pocket Books, 1998.