THE MENOPAUSE

The time interval from a woman’s full sexual maturity until the ovaries cease to function is called climacteric, variation or menopause. This is not a disease but is a natural phase in a woman’s life. The average age for the last menstrual period is around 51 though it is not uncommon for the menopause to begin at the age of 45.

The reduction in female sex hormones in the blood causes some physical changes in the woman that lead to discomfort. Frequently, this manifests itself through tachycardia, sweats, hot flashes, mood swings, sleep disorders, weight gain from water and fat deposits or dry mucous membranes.

About one third of all women experience severe symptoms, one third have mild discomfort and the remainder do not suffer from hormonal changes. Many women, a few years into the menopause, find this phase rewarding, bringing tranquility, joy and a good quality of life.

Risk factors for increased suffering from menopausal complaints

• Excess weight
• Smoking
• Low socioeconomic status
• Little physical activity.

For most women, the symptoms of the menopause disappear after a few years, however in around 10% the symptoms persist and have a strong influence on the psychological and physical well-being of those affected. Frequently, they are so strong that only taking sex hormones will provide relief. However, these often provoke strong side effects and therefore treatment with phytotherapeutic and homeopathic preparations is advisable before the hormone “mace” is prescribed. Sufferers should refer to their gynaecologist about the possibilities of alternative treatment.

Complaints during the menopause

• In some women, hot flushes, sweating, dizziness and dazed feelings (so-called vasomotor feelings) can arise suddenly and unexpectedly and can produce redness of the face, head and neck, sometimes extending to the upper body. These can be accompanied by heart palpitations followed by chills. The duration of hot flushes and the intervals between them vary from one woman to another. Triggers can be hot drinks, especially coffee, but also alcohol. These flushes are most pronounced at night.

• Sleep disorders. Owing to gradual changes in the sleep pattern, sufferers often have problems with waking up at night; sometimes this is triggered by night sweats. Fatigue and depression create stress. Insomnia, palpitations and sweating here are due to a disorder of the autonomic nervous system, which is associated with hormonal change.
• Weight gain. During the menopause, energy consumption changes with the inevitable redistribution of fat, which leads to weight gain and an alteration of the body shape (the waist tends to disappear as fat is stored in the abdominal area).
• Psyche. Estrogen deficiency often has an effect on women’s psychological condition. Possible symptoms are nervousness, irritability, despondency and mood swings that can lead to depression. Women who have previously suffered from mental disorders are more at risk. Again, the complaints should be treated with a homeopathic or phytotherapeutic drug before stronger preparations with chemical components that provoke side-effects are used.
• Forgetfulness and decreased ability to perform tasks. These are further symptoms of the menopause, which are still not fully understood. They can often be alleviated by taking ginkgo biloba and eleutherococcus senticosus.
• Dry skin and mucous membranes. Owing to the absence of estrogen, the vaginal mucosa gives off less moisture and the vagina glands produce less vagina secretions. As a result, there is a feeling of dryness, which can cause pain during sexual intercourse and which can also lead to infections. Many women also have difficulty controlling their urination. A lack of libido and desire are also features of the menopause. The ocular and oral mucosa also alte as a result of the hormonal changes. The skin and the mucous membranes become thinner and lose their elasticity, bleeding gums can also be a symptom.

• Post-menopause diseases. There may be long-term consequences owing to a drop in the production of estrogen together with the process of aging. The risks of: osteoporosis; osteoarthritis; joint pains; diabetes; cardiovascular disease (stemming from a rise in blood pressure); heart attacks and strokes can increase. Women should take account of their family history and take the necessary precautions.
• Reinforcement of the androgenic effect. Hormones such as testosterone also exist in the female body however, the proportion is much lower than in men. Nevertheless, a hormonal imbalance can cause an overproduction of androgens which leads to hair loss and growth changes (the appearance breast or facial hair) and sometimes also to blemished skin.

Diagnosis

Diagnosis should be determined by the patient’s general practitioner or gynaecologist based on hormonal measurements. Levels of the FSH (follicle stimulating hormone) increase strongly as the ovarian function decreases. Thyroid disorders can be excluded though some of the symptoms can be very similar.
For women in the right age range with typical symptoms, including having had no periods for more than a year, it can be said that the menopause has begun.
Where there is excessive bleeding and other control problems, sufferers should arrange to see their gynaecologist in addition to their annual checkup. Causes other than the impending menopause can then be established or eliminated.

Non-drug-taking measures

• Having a good sleep routine
• Avoiding heat and staying cool for hot flushes
• Taking sufficient physical exercise and avoid becoming overweight
• Abstaining from nicotine and alcohol as far as possible
• Ensuring a low-fat, vegetable, calcium and vitamin D-rich diet with a good supply of essential fatty acids
• Maintaining sexual activity
• Paying attention to the appearance of the skin and treating any dryness with skin care products on a regular basis
• Finding the inner balance between social life, autogenic exercise and yoga

Allopathic drug treatment

Estrogens are taken either orally or transdermally (TTS systems) or locally in the form of gels and ointments for the treatment of the menopause.

However, where there is a longer-term systemic treatment with estrogens, the risk of cardiovascular disease and also breast cancer is markedly increased.

The absence of estrogen also increases the risk of osteoporosis, which can be prevented and treated by the addition of calcium, vitamin D, bisphosphate and the hormone calcitonin.

Low levels of estrogen often also cause depressive moods that will require the use of antidepressants. However, their use is limited due to possible secondary effects.

Cimicifuga (black cohosh) is the most commonly used plant in phytotherapeutic remedies. In some patients, these medications can cause indigestion and in very rare cases liver damage, especially if there is prior liver degradation and the liver function tests have not been properly assessed for several months. In cases of yellowing of the skin and changed liver test values, the patient should cease taking the medication. The liver will then quickly recover.

Other herbal remedies are also appropriate in various combinations for nervousness and insomnia from plants such as: valerian, hops and passion flower.

St. John’s Wort is particularly useful for treating depressive moods. Heart problems and palpitations respond well to hawthorn or motherwort.

Discussions are ongoing as to whether other herbal products coming from: soya (phytoestrogens); red clover (isoflavones); rhapontic rhubarb and wild yam can also help. Flaxseed and linseed oil have a favourable effect on hot flushes and sweating outbreaks as does sage.

Homeopathic remedies that provide relief are:

• Cimicifuga racemosa
• Lachesis officinalis
• Sanguinaria canadensis
• Sepia officinalis
• Acid sulfuricum

Traditional homeopaths will choose a tailored prescription for each patient. In pharmacies and drug stores, however, women are also able to obtain products originating from several individually-active ingredients.

Sanguicimin – drops against complaints arising from the menopause

Sanguicimin is a mixture of 2 herbal mother tinctures and a homeopathic dilution, which together are very effective. The composition is as follows:

1 ml contains

The individual components have the following effect:

Sanguinaria canadensis

The Canadian bloodroot is the only type of genus sanguinaria of the family of poppy plants (papaveraceae).

Sanguinaria derives from Latin: “sanguineus” (“blood”, “blood red”). The rhizome contains a blood-red milk juice which was used by the native Indians to dye their faces, as an insect repellent and also as a medicine against various ailments. The root contains about 1% sanguinarine, an isochinoline alkaloid that has a purgative effect.

Cimicifuga racemosa

Otherwise known as black cohosh, cimicifuga racemose comes from the buttercup family (ranunculacea) and is also called a bug herb or rattlesnake herb. With the cimicifuga racemosa, the roots containing triterpene glycoside are processed and then simulate the effect of estrogen though the ingredients of black cohosh have a completely different chemical construction from estrogens. They do not directly affect the estrogen receptors of the female body but modulate some of them in such a way that they can develop estrogen-like effects. These substances are also called Phyto-SERM, “Selective Estrogen Receptor Modulators”. The results of taking the cimicifuga extract produce only limited effects but without the side-effects of the estrogens, in particular, it has no impact on the breast tissue.

Plant estrogens (phytoestrogens), such as red clover and phyto soya, attack the estrogen receptors of the female body directly and produce the same side effects as synthetic estrogens when taken in high doses.

Black cohosh helps against mild and moderate complaints in the menopause and is scientifically proven to be especially effective against hot flushes. However, the full effect will only begin to be seen after 4 to 6 weeks. It is therefore recommended to take the application for at least 3 months to achieve a satisfactory improvement and relief of the symptoms. If there is no change however, other therapy measures should be considered.

Sepia gruneris

Cuttlefish belong to the group of ten-armed squid and live in the Mediterranean, the North Sea and the Atlantic.

Dosage

The usual dosage is 20 drops diluted in water twice daily.

Application restrictions

Sanguicimin must not be taken in cases of hypersensitivity to one of the ingredients and where there is pre-existing liver damage, Sanguicimin is not recommended.

Side effects

Owing to the presence of the triterpene glycosides, slight stomach aches and nausea can occur in rare cases after eating, as they have properties that can irritate the mucous membrane.
In very rare instance, there may be signs of liver damage. Where this occurs, there can be a yellow colouring of the conjunctiva of the eyes or skin, darkened urine and discoloured skin. The sufferer should then stop taking Sanguicimin and consult their medical doctor.