1. Mangaging Menopause Through Naturopathic medicine.

2. Menopause a brief review Definition: 1.the complete cessation of menstruation for an interval of 6 – 12 months 2.when women make a transition from a reproductive to non-reproductive stage It is a period of declining ovarian function that usually spans 2 – 5 years

3. Usually occurs between the ages of 48 to 55 – The average age of menopause in industrialized countries is 51 – According to Chinese medicine, documented over 2,000 years ago – in the Nan Jing, average age 49 – Menopausal age has not changed for centuries

4. It is not a question of WHEN ….but of HOW menopause be experienced The severity of the problems a woman experiences during the menopause depends on: – Lifestyle and dietary habits through her life

5. The main symptoms most women experience : Headaches Tiredness, Lethargy, Irritability, Anxiety, Nervousness Depression, Insomnia Inability to concentrate, Hot flashes 85 % Vaginal dryness Night Sweats 45 % of women may experience these symptoms for 5 – 10 years after menopause

6. Hormone Replacement therapy What we learned from WHI (The Women’s Health Initiative Study) Was an NIH study of Prempro 1 (conjugated estrogen and progesterone) was to be an 8 yr study but was d/ced spring 2002, at yr 5. 1 Prepro is manufactured by Wyeth Ayerst who also makes Premarin, Provera, AND……… Fen Fen

7. The listed side effects of Prepro Serious Reactions : thromboembolism stroke MI enlargement gallbladder dz breast CA endometrial CA endometrial hyperplasia uterine fibroid cholestatic jaundice pancreatitis porphyria aggravation asthma exacerbation depression dementia HTN ovarian CA hypercalcemia, severe (met. breast CA) anaphylaxis

8. verses Common Side effects vaginal bleeding/spotting breast changes/pain abdominal bloating/cramps nausea/vomiting cervical secretion changes headache/migraine fluid retention elevated BP mood changes vaginal candidiasis glucose intolerance weight changes libido changes contact lenses intolerance vision changes rash melasma/cholasma hair loss hirsuitism

9. “… most important information I should know about conjugated estrogen and medroxyprogesterone combinations?” increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots

10. The study found there was a net increase of risk to women : 41% increase in strokes a doubling of venous thromboembolism 29% rise in heart attacks 22% increase in all cardio-vascular diseases 26% increase breast cancer

11. Yet ……. there was some good news!! 1.37% reduction in colorectal cancer 2.33% reduction in hip fractures and 3.24% decrease in overall fractures

12. In a companion paper in JAMA: (Journal of the American Medical Association) ERT (estrogen replacement therapy) – has increased risk of ovarian cancer and breast cancer

13. …… And the number # 1reason doctors prescribe HRT controlling hot flashes, sleep disturbances mood swings …… alternative to divorce…. sort of

14. Want to buy a Horse? Pregnant Mares need a home! Wyeth Ayerst have closed down many of their stables due to the plummeting sales of Prempro – since WHI terminated its study

18. Questions that remain………… Was it the hormones themselves …… Or that they were conguagated (synthetic) and not bio-identical??????? AND EVEN BIGGER QUESTION……… is hormone ‘replacement’ therapy in post menopausal women necessary at all???

19. The Alternatives to HRT: supplementation with herbs : Black cohosh Native American use for uterine disorders; spasmolytic and anti- inflammatory. Since 1956 Remifemin (a standardize extract) prescribed in Europe for menopausal symptoms Angelica sinensis (asian) Dang Qui Hypotensive and a uterine tonic Angelica (European) Blue cohosh Valerian

20. Other herbs Licorice – Common in many chinese herbal formulas – Taking too much alone may cause hypertension Alfalfa Vitex agnus castus

21. Phytoestrogens Three types : Isoflavonoids: Soy (genistein and daidzein), legumes, Genistein: prevents bone loss Lignans: Plant-wall constituents e.g. flaxseed, wholegrains, beans Coumestan: Soy sprouts, red clover, sunflower seeds