PRESCRIPTIONS
Diet, herbs may help relieve menopause symptoms

By Amy Tousman

•	Hawaii Dietetic Association's Nutrition, Health and Wellness Fair 10 a.m. to 2 p.m. March 2 at Ward Warehouse Free Learn more about nutrition, exercise, and natural remedies; get your medications and herbal products reviewed; take in food samples, body fat analysis, cholesterol and glucose screening, keiki games. 522-2485

The word menopause comes from the Greek and Latin words for "moon" and "stop." It refers to the ending of a woman's menstrual cycle, viewed throughout history to be influenced by the moon.

As estrogen levels decrease, some women experience hot flashes, mood swings, insomnia, memory lapses, vaginal dryness, bladder infections and palpitations. Decreased estrogen also increases risk of heart attacks and brittle bones.

To counteract these effects, women have two choices: hormone replacement therapy, commonly known as HRT, or natural remedies. Your family history and health status are important in deciding which option is best.

• Hormone therapy is often a combination of estrogen and progesterone. This strengthens bones, eliminates hot flashes and relieves vaginal dryness.

Some studies indicate that hormone therapy may help prevent heart disease. However, other studies contradict this. In has been suggested that the therapy also may reduce the risk of Alzheimer's disease and osteoarthritis, but these areas need further study.

Drawbacks to hormone therapy include a slightly increased risk of breast cancer and monthly bleeding.

• Herbal remedies and a change in diet also may help prevent or lessen symptoms.

John Westerdahl, a registered dietitian and herbalist at Castle Medical Center, says hot flashes are rare in Asian countries compared to Western countries. In fact, he said, hot flashes are "so rare among women living in Japan, that there is no word in their language to describe them."

"The typical American diet is rich in meat and fat compared to Asian diets. High-fat, low-fiber diets increase the body's estrogen levels. At menopause, those on high-fat diets experience a dramatic drop in estrogen levels. Since Asian women eat less fat, they experience a less dramatic drop in their estrogen levels at menopause. This may explain why their resulting symptoms are milder or even nonexistent."

Westerdahl says that "in addition to a low-fat diet, plant estrogens may be useful in regulating hormone fluctuations that occur during menopause." They mimic the body's natural estrogen, yet are less potent than the real thing. Some sources of plant estrogens include tofu, miso, oats, broccoli, cauliflower and flaxseed.

It has been suggested that soy may suppress hot flashes. Margo Woods, a researcher at Tufts University, disputes this. Her research shows that soy does not stop hot flashes, as hormone therapy does. There is, however, a small decrease in severity and frequency of symptoms. It may be that the combination of a low-fat diet and soy products may explain the shortage of menopausal symptoms among women in Asian countries.

Known benefits of soy products include decreasing heart disease risk, protecting bones and relieving vaginal dryness. Eating soy before menopause may protect against breast cancer, but large amounts after menopause may actually promote it.

Women who have a history of breast cancer or those taking tamoxifen should limit soy to three or four servings per week. Other women can eat two servings daily.

Herbal remedies are usually weaker than hormone replacement therapy, but some are helpful. The following remedies are considered safe and effective (although you should talk to your doctor before taking them):

• Black cohash relieves hot flashes, palpitations, vaginal dryness and mood swings.

• Chasteberry helps regulate irregular periods.

• St. John's wort helps control mood swings.

• Ginkgo improves memory and concentration.

• Cranberry prevents bladder infections (10 ounces of a 27 percent cranberry-juice beverage is recommended daily.)

The following herbal products are advertised to help with menopausal symptoms, but have not been found to work in scientific studies: don quai, ginseng, red clover, licorice root (this may work, but can increase blood pressure) and wild yam.

Gynecologists feel the benefits of hormone replacement therapy outweigh those of natural therapies. Since the therapy does have drawbacks for some folks, natural remedies may be worth a try.

Whichever therapy you choose, make sure you get adequate calcium, eat a heart-healthy diet and exercise regularly.

Amy Tousman is a registered dietitian at Straub Clinic & Hospital Inc. and a member of the Hawai'i Dietetic Association. Write: Prescriptions, 'Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; consult your doctor.