Menopause
From Wiki4CAM
Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether. [1] It normally occurs between the ages of 45 and 55. Once menopause is complete (called postmenopause), one can no longer become pregnant. The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman.
In some women, menstrual flow comes to a sudden halt. More commonly, it tapers off. During this time, your menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely. A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe.
Because hormone levels fall, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue decreases. This is called atrophy of the labia.
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Symptoms
Decreased sex drive Hot flashes and skin flushing Insomnia Irregular menstrual periods Mood swings including irritability, depression, and anxiety Night sweats Spotting of blood in between periods Urinary tract infections Vaginal dryness and painful sexual intercourse Vaginal infections
The long-term effects of menopause include:
Bone loss and eventual osteoporosis Changes in cholesterol levels and greater risk of heart disease
Exams and Tests
Blood and urine tests can be used to measure hormone levels that may indicate when a woman is close to menopause or has already gone through menopause. Examples of these tests include: Estradiol FSH LH
A pelvic exam may indicate changes in the vaginal lining caused by declining estrogen levels. The doctor may perform a bone density test to screen for low bone density levels that occur with osteoporosis.
What is Hormone Replacement Therapy (HRT) and why should it be avoided?
Hormone replacement therapy is the main treatment offered by conventional therapy. Many physicians believed in the past that HRT was not only good for reducing menopausal symptoms, but also reduced the risk of heart disease and bone fractures from osteoporosis. But the results of the major study, called women’s health initiative (established by the Government United States of America), had led physicians to revise their recommendations. In fact this important study was stopped early because the health risks outweighed the health benefits. Women taking the hormones greatly increased their risk for breast cancer, heart attacks, strokes and blood clots. [2] The number prescriptions written for the drugs used in the study dropped within a year almost to half of their previous level. It was followed by large and successively larger drops in new breast cancer diagnosis, at six months, one year, and 18 months. There is a cumulative 15% drop by the end of 2003. Some opinions prevail that using the oestrogen/progesterone course of therapy which do not contain the form of progesterone used in the study can be helpful. However all hormone replacement therapies probably do carry some health risks, including high blood pressure, blood clots, and increased risks of breast and uterine cancers.
CAM Therapies for Menopause
Ayurveda
Homeopathy
Homoeopathy has a role in managing the menopausal symptoms. Many studies have proved the efficacy of homeopahty in menopausal symptoms. Homeopathy is providing remedy, as per Hahnemann’s principles, in most harmless way to the menopausal women. There are several remedies given under rubric ‘menopause’ in repertories. The indication of menopause and menopausal symptoms are given under many remedies in the homeopathic materia medica(s), and homeopaths have been successfully managing the cases.
Studies and reports that prove the efficacy of homeopathy for managing the menopausal symptoms
There are several studies, which have been validating the time tested homoeopathic efficacy (in menopausal symptoms) with scientific tool. It is worthy to mention that most of such studies have been published in journals which are not related to homoeopathy. Such studies also provide homoeopaths to have knowledge about what are the first line remedies and most frequently used remedies. Few of such studies are as follows.
(a) Multi-centric, placebo-controlled, double blind trial with homeopathic medicine: A multi-centric, placebo-controlled, double blind GCP- (Good Clinical Practice)-study was carried out with a homoeopathic complex remedy (with the constituents Cimicifuga D2, Ignatia D3, Sanguinaria D2 and Sepia D2) in 7 gynaecological test centers in Kiev (Capital of Ukrain). Criteria for selection of patients were acute climacteric complaints not more than 3 years and patients with at least 20 score from a maximum of 100. Total number of patients was 233 (homoeopathy group – 118 and placebo group – 115) and the age group was between 40 and 54 years. The test medication was taken by the patients at a dosage of 3 x 2 tablets per day. Check up examinations were performed after 28, 56 and 84 days. The change on the Menopause Rating Scale (MRS) and ten other climacteric related disorders (Fluor vaginalis, seborrhea/acne, alopecia, weight increase, rheumatic complaints, headaches/migraine, nose bleeds, changes in mood, sadness/ worry, indifference to family and work) were the target parameters of the study. Patients were assessed as free from symptoms, much better, better, unchanged or worse after a treatment period of maximum 12 weeks. At the end of the study 6.8% and 69.5% patients from the homoeopathic group were completely free from the complaints and very much improved respectively, where as nil patients from the placebo group reported either. Complaints unchanged in, 7.6% patients from homoeopathy group and 64.3% patients from placebo group. Only 4.72% patients from homoeopathy group prematurely withdrew the treatment, where as 72.45% patients from placebo group prematurely withdrew. [3]
(b) Review of observational studies and uncontrolled trials: A paper published in the Journal of the British Menopause Society, with a brief introduction about the homoeopathic system of medicine and its principles. It concluded from case histories, observational studies and uncontrolled trials that the homoeopathic approach can offer a clinically relevant choice for women with menopausal symptoms and those with breast cancer whether they are taking tamoxifen (an anticancer drug used in hormone therapy to block the effects of estrogen) or not. [4]
(c) Database review: A review aimed to evaluate evidence for the benefits and risks of homoeopathy and other complementary and alternative medicine. It was published in The American Journal of Medicine. Search strategies included electronic searches of online databases (PubMed, PsycINFO, Medline), direct searches of target journals, and citation-index searches. A total of 12 intervention studies were identified for review. This review finds homoeopathy significantly improves subjective measures of hot flash frequency and severity, mood, fatigue, and anxiety in uncontrolled, open-label studies. [5]
(d) Analysis of the homoeopathic remedies and herbs successfully used in menopause: Another paper has discussed about the menopausal symptoms, and the harmful effects of the HRT. It mentioned that more than 70 homoeopathic remedies and herbs have been used with clinical success with menopausal women. [6]
(e) Observational study: An observational study published in a homoeopathic journal, reports on an investigation of the homoeopathic approach to the management of symptoms of oestrogen withdrawal in women with breast cancer. Forty-five patients entered the study. The most common presenting symptoms were hot flushes, mood disturbance, joint pain, and fatigue. Other symptoms included sleeplessness, reduced libido, weight gain, cystitis, vaginal dryness and skin eruptions. The active intervention was an individualised homoeopathic medicine. Significant improvements in mean symptom scores were seen over the study period and for the primary end-point ‘the effect on daily living’ scores. Symptoms other than hot flushes such as fatigue and mood disturbance appear to be helped. Significant improvements in anxiety, depression and quality of life were demonstrated over the study period. The homoeopathic approach appears to be clinically useful in the management of oestrogen withdrawal symptoms in women with breast cancer whether on or off Tamoxifen and improves mood disturbance. [7]
(f) Homoeopathic remedies as placebo alternatives – an investigation: This is an interesting study. With the example of treatment of menopause-related vegetative and emotional disturbances, the author verifies the effectiveness of the use of Ignatia amara containing complex homoeopathic remedies (IACCHR) as an alternative to placebo. Surprisingly the author observed that IACCHR diminished or disappeared climacteric complaints completely in the majority of women (95.7% by patient evaluation and 96.2% by physician evaluation). Compared to standard pharmaceuticals, IACCHR treatment was tolerated better and lower risk of side effects was also observed. The results obtained in this work indicate the significant therapeutic potential of this group of treatments, which is in line with the therapeutic effect of the placebo. Nevertheless, the showing of specific effects in pharmacological tests disqualifies the investigated treatments from use in a clinical trial in place of a placebo. [8]
(g) Open, multinational prospective, pragmatic and non-comparative observational study: A very recent observational study, is not only shows the efficacy of homoeopathic treatment, but also provides an idea about the most frequently used remedies. The study objective was to evaluate homoeopathic treatment for hot flushes in menopausal women in terms of prescribed medical treatment, effectiveness and impact on quality of life. This open, multinational prospective, pragmatic and non-comparative observational study included 438 patients. Ninety percent of women reported disappearance or lessening of their symptoms. These changes mostly taking place within 15 days of starting homoeopathic treatment. The most prescribed remedies were Lachesis, Belladonna, Sepia, Sulphur, Sanguinaria and Gloninum, which comprised 58.90% of the total number of prescription. [9]
References
- ↑ Menopause
- ↑ 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. JAMA 2002;288(3):321-33
- ↑ Prof. Ingrid Gerhard and Prof. Boris Ventskovsky, Klimakterische Beschwerden: Wirksamkeit eines Kombinationshomöopathikums, Der Kassenarzt 2006, 15, Offprint pp 1-4
- ↑ Thompson E.A.,Homeopathy and the menopause, Journal of the British Menopause Society, Volume 8, Number 4, December 2002, pp. 151-154(4)
- ↑ Carpenter, J. Neal, Other complementary and alternative medicine modalities: acupuncture, magnets, reflexology, and homeopathy, The American Journal of Medicine, Volume 118, Issue 12, Pages 109 – 117
- ↑ C. Gardner, Ease through menopause with homeopathic and herbal medicine, journal of PeriAnesthesia Nursing , Volume 14 , Issue 3 , Pages 139 – 143
- ↑ 7. E. A. Thompson and D. Reilly, The homoeopathic approach to the treatment of symptoms of oestrogen withdrawal in breast cancer patients – A prospective observational study, Homeopathy, Volume 92, Issue 3, July 2003, Pages 131-134
- ↑ 8. Bohdan W. Wasilewski, Homoeopathic remedies as placebo alternatives — verification on the example of treatment of menopause-related vegetative and emotional disturbances, Science and Engineering Ethics, Volume 10, Number 1 / March, 2004
- ↑ 9. Bordet MF, et al., Treating hot flushes in menopausal women with homoeopathic treatment--results of an observational study, Homeopathy, Volume 97, issue 1, January 2008, Pages 10-5
